bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring human factors in the operating room: a protocol for a scoping review of training offerings for healthcare professionals
Authors: Lee Alex , Tipney Ben , Finstad Alexandra , Rahman Alvi , Devenny Kirsten , Abou Khalil Jad , Kuziemsky Craig , Balaa Fady
Published: June 2021

Introduction

Applying human factors principles in surgical care has potential benefits for patient safety and care delivery. Although different theoretical frameworks of human factors exist, how providers are being trained in human factors and how human factors are being understood in vivo in the operating room (OR) remain unknown. The aim of this scoping review is to evaluate the application of human factors for the OR environment as described by education and training offerings for healthcare professionals.

Methods and analysis

This scoping review will follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. MEDLINE, Embase, PsycINFO, CINAHL, Health and Psychosocial Instruments and ERIC databases were searched on August 2020 from inception to identify relevant studies that describe the content, application and impact of human factors training for healthcare professionals or trainees who work in or interface with the OR environment. Titles, abstracts and full texts will be independently screened by two authors for eligible studies. Any disagreements will be resolved by discussion or by a third author when disagreement persists. Study information and training characteristics, such as the training tool used and type of learners and teachers, will be charted and summarised, and key themes in human factors training will be identified. Each training offering will be classified under the appropriate knowledge area(s) of human factors described by the Chartered Institute of Ergonomics & Human Factors (CIEHF). Themes that are not captured by the CIEHF framework will be independently recorded by two authors and included based on group discussion and consensus.

Ethics and dissemination

Research ethics board approval is not required for this scoping review. The findings of this study will be disseminated at local and national conferences and will be published in a peer-reviewed journal.
RELATE—a randomised controlled feasibility trial of a Relating Therapy module for distressing auditory verbal hallucinations: a study protocol
Authors: Lincoln Tania M , Pillny Matthias , Schlier Björn , Hayward Mark
Published: June 2021

Introduction

Auditory verbal hallucinations (AVHs) are associated with distress and reduced functioning. Research suggests that distress is associated with the voice hearer’s responding to AVH in a passive and subordinate manner. A novel approach focuses on relating to AVH and teaches assertive responses to AVH using experiential role-plays. A small pilot study found a large effect of this approach on AVH distress but an independent multicentre study is required to ascertain effectiveness across different settings. We aim to estimate the expected effect for a subsequent trial to demonstrate that adding a module of Relating Therapy (RT) to treatment as usual (TAU) is superior to TAU alone in reducing AVH distress. We also test the feasibility of patient recruitment, therapist training, and therapy monitoring in different psychological and psychiatric outpatient facilities in Germany.

Methods and analysis

We will recruit 75 patients diagnosed with a schizophrenia spectrum disorder and persistent distressing AVH across four sites. Patients will be randomised to receive either 16 sessions of RT plus TAU or TAU alone within a 5-month period. Randomisation will be stratified by sites. Single-blind assessments will take place at baseline, at 5 months (T1) and at 9 months (T2). The primary outcome is the distress factor score of the AVH subscale of the Psychotic Symptoms Rating Scale at T2 adjusted for the baseline value. Secondary outcomes are change in depressive symptoms, quality of life, time spent in structured activities as well as negative relating to voices and to other people.

Ethics and dissemination

The trial has received ethical approval from the German Psychological Society Ethics Committee. The trial results will be disseminated through conference presentations, peer-reviewed publications and social media.

Trial registration number

ClinicalTrials.gov Registry (NCT04578314).
Provision of critical care for the elderly in Europe: a retrospective comparison of national healthcare frameworks in intensive care units
Authors: Wernly Bernhard , Beil Michael , Bruno Raphael Romano , Binnebössel Stephan , Kelm Malte , Sigal Sviri , van Heerden Peter Vernon , Boumendil Ariane , Artigas Antonio , Cecconi Maurizio , Marsh Brian , Moreno Rui , Oeyen Sandra , Bollen Pinto Bernardo , Szczeklik Wojciech , Leaver Susannah , Walther Sten Mikael , Schefold Joerg C , Joannidis Michael , Fjølner Jesper , Zafeiridis Tilemachos , de Lange Dylan , Guidet Bertrand , Flaatten Hans , Jung Christian
Published: June 2021

Objectives

In Europe, there is a distinction between two different healthcare organisation systems, the tax-based healthcare system (THS) and the social health insurance system (SHI). Our aim was to investigate whether the characteristics, treatment and mortality of older, critically ill patients in the intensive care unit (ICU) differed between THS and SHI.

Setting

ICUs in 16 European countries.

Participants

In total, 7817 critically ill older (≥80 years) patients were included in this study, 4941 in THS and 2876 in the SHI systems.

Primary and secondary outcomes measures

We chose generalised estimation equations with robust standard errors to produce population average adjusted OR (aOR). We adjusted for patient-specific variables, health economic data, including gross domestic product (GDP) and human development index (HDI), and treatment strategies.

Results

In SHI systems, there were higher rates of frail patients (Clinical Frailty Scale>4; 46% vs 41%; p<0.001), longer length of ICU stays (90±162 vs 72±134 hours; p<0.001) and increased levels of organ support. The ICU mortality (aOR 1.50, 95% CI 1.09 to 2.06; p=0.01) was consistently higher in the SHI; however, the 30-day mortality (aOR 0.89, 95% CI 0.66 to 1.21; p=0.47) was similar between THS and SHI. In a sensitivity analysis stratifying for the health economic data, the 30-day mortality was higher in SHI, in low GDP per capita (aOR 2.17, 95% CI 1.42 to 3.58) and low HDI (aOR 1.22, 95% CI 1.64 to 2.20) settings.

Conclusions

The 30-day mortality was similar in both systems. Patients in SHI were older, sicker and frailer at baseline, which could be interpreted as a sign for a more liberal admission policy in SHI. We believe that the observed trend towards ICU excess mortality in SHI results mainly from a more liberal admission policy and an increase in treatment limitations.

Trial registration numbers

NCT03134807 and NCT03370692.
Muscle stimulation in advanced idiopathic pulmonary fibrosis: a randomised placebo-controlled feasibility study
Authors: Nolan Claire M , Patel Suhani , Barker Ruth E , Walsh Jessica A , Polgar Oliver , Maddocks Matthew , George Peter M , Renzoni Elisabetta A , Wells Athol U , Molyneaux Philip L , Kouranos Vasilis , Chua Felix , Maher Toby M , Man William D-C
Published: June 2021

Objectives

To assess the acceptability of neuromuscular electrical stimulation (NMES) of the quadriceps muscles in people with idiopathic pulmonary fibrosis (IPF) and to identify whether a future definitive trial is feasible.

Design

A randomised, parallel, two-group, participant and assessor-blinded, placebo-controlled feasibility trial with embedded qualitative interviews.

Setting

Outpatient department, Royal Brompton and Harefield Hospitals.

Participants

Twenty-two people with IPF: median (25th, 75th centiles) age 76 (74, 82) years, forced vital capacity 62 (50, 75) % predicted, 6 min walk test distance 289 (149, 360) m.

Interventions

Usual care (home-based exercise, weekly telephone support, breathlessness management leaflet) with either placebo or active NMES for 6 weeks, with follow-up at 6 and 12 weeks.

Primary outcome measures

Feasibility of recruitment and retention, treatment uptake and adherence, outcome assessments, participant and outcome assessor blinding and adverse events related to interventions.

Secondary outcome measures

Outcome measures with potential to be primary or secondary outcomes in a definitive clinical trial. In addition, purposively sampled participants were interviewed to capture their experiences and acceptability of the trial.

Results

Out of 364 people screened, 23 were recruited: 11 were allocated to each group and one was withdrawn prior to randomisation. Compared with the control group, a greater proportion of the intervention group completed the intervention, remained in the trial blinded to group allocation and experienced intervention-related adverse events. Assessor blinding was maintained. The secondary outcome measures were feasible with most missing data associated with the accelerometer. Small participant numbers precluded identification of an outcome measure suitable for a definitive trial. Qualitative findings demonstrated that trial process and active NMES were acceptable but there were concerns about the credibility of placebo NMES.

Conclusions

Primarily owing to recruitment difficulties, a definitive trial using the current protocol to evaluate NMES in people with IPF is not feasible.

Trial registration number

NCT03499275.
Patient and stakeholder involvement in resilient healthcare: an interactive research study protocol
Authors: Guise Veslemøy , Aase Karina , Chambers Mary , Canfield Carolyn , Wiig Siri
Published: June 2021

Introduction

Resilience in healthcare (RiH) is understood as the capacity of the healthcare system to adapt to challenges and changes at different system levels, to maintain high-quality care. Adaptive capacity is founded in the knowledge, skills and experiences of the people in the system, including patients, family or next of kin, healthcare providers, managers and regulators. In order to learn from and support useful adaptations, research is needed to better understand adaptive capacity and the nature and context of adaptations. This includes research on the actors involved in creating resilient healthcare, and how and in what circumstances different groups of patients and other key healthcare stakeholders enact adaptations that contribute to resilience across all levels of the healthcare system.

Methods and analysis

This 5-year study applies an interactive design in a two-phased approach to explore and conceptualise patient and stakeholder involvement in resilient healthcare. Study phase 1 is exploratory and will use such data collection methods as literature review, document analysis, interviews and focus groups. Study phase 2 will use a participatory design approach to develop, test and evaluate a conceptual model for patient and stakeholder involvement in RiH. The study will involve patients and other key stakeholders as active participants throughout the research process.

Ethics and dissemination

The RiH research programme of which this study is a part is approved by the Norwegian Centre for Research Data (No. 864334). Findings will be disseminated through scientific articles, presentations at national and international conferences, through social media and popular press, and by direct engagement with the public, including patient and stakeholder representatives.
ABC of prescribing exercise as medicine: a narrative review of the experiences of general practitioners and patients
Authors: O'Regan Andrew , Pollock Michael , D'Sa Saskia , Niranjan Vikram
Published: June 2021

Background

Exercise prescribing can help patients to overcome physical inactivity, but its use in general practice is limited. The purpose of this narrative review was to investigate contemporaneous experiences of general practitioners and patients with exercise prescribing.

Method

PubMed, Scopus, Science Direct and Cochrane reviews were reviewed using the terms ‘exercise prescription’, ‘exercise prescribing’, ‘family practice’, ‘general practice’, ‘adults’ and ‘physical activity prescribing’.

Results

After screening by title, abstract and full paper, 23 studies were selected for inclusion. Qualitative, quantitative and mixed-methods studies revealed key experiences of general practitioners and patients. Barriers identified included: physician characteristics, patients’ physical and psychosocial factors, systems and cultural failures, as well as ambiguity around exercise prescribing. We present a synthesis of the key strategies to overcome these using an ABC approach: A: assessment of physical activity: involves asking about physical activity, barriers and risks to undertaking an exercise prescription; B: brief intervention: advice, written prescription detailing frequency, intensity, timing and type of exercise; and C: continued support: providing ongoing monitoring, accountability and progression of the prescription. Multiple supports were identified: user-friendly resources, workshops for doctors, guidelines for specific illnesses and multimorbidity, electronic devices, health system support and collaboration with other healthcare and exercise professionals.

Discussion

This review has identified levers for facilitating exercise prescribing and adherence to it. The findings have been presented in an ABC format as a guide and support for general practitioners to prescribe exercise.
Prevalence and mechanisms of injuries in water polo: a systematic review
Authors: Croteau Felix , Brown Harry , Pearsall David , Robbins Shawn M
Published: June 2021

Objective

To summarise the information available in the literature on the prevalence of injuries in water polo and injury risk factors.

Methods

Protocol was registered on Open Science Framework. MEDLINE, CINAHL, Embase and SPORTDiscus databases were searched for keywords relating to water polo and injuries on 3 February 2021. References were searched for additional studies. Only original research papers in English or French were included, and studies without an injured group were excluded. A data extraction file was made based on the Cochrane Collaboration recommendations. Study quality was evaluated with the Newcastle-Ottawa scales for cohorts and a modified version for cross-sectional studies.

Results

The initial search yielded 581 articles, with 5 more added from reference lists, but only 41 remained after removing duplicates and applying inclusion/exclusion criteria. Thirty-one articles identified the head, fingers and shoulders as the most common sites of injury. Ten articles on mechanism of injury focused mainly on the shoulder, with degenerative changes, posture, scapular alignment, strength, flexibility and overhead shooting kinematics as the main injury risk factors. Publication types included cohort studies, cross-sectional studies, and one case series.

Conclusions

Most traumatic injuries affect the hands and the head from unexpected contact with the ball or opponents. Conversely, training injuries seem to affect mainly the shoulder area. Low level evidence suggests a correlation between shoulder injuries and lack of strength or flexibility as well as large volumes of overhead throwing. Further prospective research is needed to investigate risk factors for other body areas.
Smoking cessation, weight gain and risk of cardiovascular disease
Authors: Wang Xiaowen , Dong Jia-Yi , Cui Renzhe , Muraki Isao , Shirai Kokoro , Yamagishi Kazumasa , Kokubo Yoshihiro , Saito Isao , Yatsuya Hiroshi , Sawada Norie , Iso Hiroyasu , Tsugane Shoichiro
Published: June 2021

Objective

To examine whether the relationship between smoking cessation and risk of cardiovascular disease (CVD) was modified by weight gain.

Methods

A total of 69 910 participants (29 650 men and 46 260 women) aged 45–74 years were grouped into six groups by smoking status in the first and 5-year surveys: sustained smokers, recent quitters according to postcessation weight gain (no weight gain, 0.1–5.0 kg, >5.0 kg), long-term quitters and never smokers. Quitting smoking within and longer than 5 years were defined as recent and long-term quitters, respectively. We used Cox proportional hazard models to estimate the HR for incident CVD, coronary heart disease (CHD) and stroke.

Results

We identified 4023 CVDs (889 CHDs and 3217 strokes) during a median of 14.8 years of follow-up. Compared with sustained smokers, the multivariable HR (95% CI) for CVD was 0.66 (0.52 to 0.83) for recent quitters without weight gain, 0.71 (0.55 to 0.90) for recent quitters with weight gain of 0.1–5.0 kg, 0.70 (0.44 to 1.10) for recent quitters with weight gain of >5.0 kg, 0.56 (0.49 to 0.64) for long-term quitters, and 0.60 (0.55 to 0.66) for never smokers. The analysis restricted to men showed a similar association. Prespecified analysis by age suggested that recent quitters overall had a lower HR for CVD among those aged <60 years vs ≥60 years. Similar patterns of association were observed in CHD and stroke.

Conclusions

Postcessation weight gain did not attenuate the protective association between smoking cessation and risk of CVD.
Evaluation of tumor immune contexture among intrinsic molecular subtypes helps to predict outcome in early breast cancer
Authors: Klopfenstein Quentin , Derangère Valentin , Arnould Laurent , Thibaudin Marion , Limagne Emeric , Ghiringhelli Francois , Truntzer Caroline , Ladoire Sylvain
Published: June 2021

Background

The prognosis of early breast cancer is linked to clinic-pathological stage and the molecular characteristics of intrinsic tumor cells. In some patients, the amount and quality of tumor-infiltrating immune cells appear to affect long term outcome. We aimed to propose a new tool to estimate immune infiltrate, and link these factors to patient prognosis according to breast cancer molecular subtypes.

Methods

We performed in silico analyses in more than 2800 early breast cancer transcriptomes with corresponding clinical annotations. We first developed a new gene expression deconvolution algorithm that accurately estimates the quantity of immune cell populations (tumor immune contexture, TIC) in tumors. Then, we studied associations between these immune profiles and relapse-free and overall survival among the different intrinsic molecular subtypes of breast cancer defined by PAM50 classification.

Results

TIC estimates the abundance of 15 immune cell subsets. Both myeloid and lymphoid subpopulations show different spread among intrinsic molecular breast cancer subtypes. A high abundance of myeloid cells was associated with poor outcome, while lymphoid cells were associated with favorable prognosis. Unsupervised clustering describing the 15 immune cell subsets revealed four subgroups of breast tumors associated with distinct patient survival, but independent from PAM50. Adding this information to clinical stage and PAM50 strongly improves the prediction of relapse or death.

Conclusions

Our findings make it possible to refine the survival stratification of early patients with breast cancer by incorporating TIC in addition to PAM50 and clinical tumor burden in a prognostic model validated in training and validation cohorts.
Direct and indirect immune effects of CMP-001, a virus-like particle containing a TLR9 agonist
Authors: Sabree Shakoora A , Voigt Andrew P , Blackwell Sue E , Vishwakarma Ajaykumar , Chimenti Michael S , Salem Aliasger K , Weiner George J
Published: June 2021

Background

CMP-001, also known as vidutolimod, is a virus-like particle containing a TLR9 agonist that is showing promise in early clinical trials. Our group previously demonstrated that the immunostimulatory effects of CMP-001 are dependent on an anti-Qβ antibody response which results in opsonization of CMP-001 and uptake by plasmacytoid dendritic cells (pDCs) that then produce interferon (IFN)-α. IFN-α then leads to an antitumor T-cell response that is responsible for the in vivo efficacy of CMP-001. Here, we explore mechanisms by which the initial effects of CMP-001 on pDCs activate other cells that can contribute to development of an antitumor T-cell response.

Methods

Uptake of CMP-001 by various peripheral blood mononuclear cell (PBMC) populations and response to anti-Qβ-coated CMP-001 were evaluated by flow cytometry and single-cell RNA sequencing. Purified monocytes were treated with anti-Qβ-coated CMP-001 or recombinant IFN-α to evaluate direct and secondary effects of anti-Qβ-coated CMP-001 on monocytes.

Results

Monocytes had the highest per cell uptake of anti-Qβ-coated CMP-001 with lower levels of uptake by pDCs and other cell types. Treatment of PBMCs with anti-Qβ-coated CMP-001 induced upregulation of IFN-responsive genes including CXCL10, PDL1, and indoleamine-2,3-dioxygenase (IDO) expression by monocytes. Most of the impact of anti-Qβ-coated CMP-001 on monocytes was indirect and mediated by IFN-α, but uptake of anti-Qβ-coated CMP-001 altered the monocytic response to IFN-α and resulted in enhanced expression of PDL1, IDO, and CD80 and suppressed expression of CXCL10. These changes included an enhanced ability to induce autologous CD4 T-cell proliferation.

Conclusions

Anti-Qβ-coated CMP-001 induces IFN-α production by pDCs which has secondary effects on a variety of cells including monocytes. Uptake of anti-Qβ-coated CMP-001 by monocytes alters their response to IFN-α, resulting in enhanced expression of PDL1, IDO and CD80 and suppressed expression of CXCL10. Despite aspects of an immunosuppressive phenotype, these monocytes demonstrated increased ability to augment autologous CD4 T-cell proliferation. These findings shed light on the complexity of the mechanism of action of anti-Qβ-coated CMP-001 and provide insight into pathways that may be targeted to further enhance the efficacy of this novel approach to immunotherapy.
Design, synthesis and immunological evaluation of self-assembled antigenic peptides from dual-antigen targets: a broad-spectrum candidate for an effective antibreast cancer therapy
Authors: Shi Wei , Qiu Qianqian , Feng Ziying , Tong Zhenzhen , Guo Weiwei , Zou Feng , Yue Na , Huang Wenlong , Qian Hai
Published: June 2021

Background

Considering the narrow immune response spectrum of a single epitope, and the nanoparticles (NPs) as a novel adjuvant can achieve efficient delivery of antigenic peptides safely, a nano-system (denoted as DSPE-PEG-Man@EM-NPs) based on cathepsin B-responsive antigenic peptides was designed and synthesized.

Methods

Highly affinitive antigenic peptides were delivered by self-assembled NPs, and targeted erythrocyte membranes acted as a peptide carrier to improve antigenic peptides presentation and to strengthen cytotoxic T-cells reaction. Cathepsin B coupling could release antigenic peptides rapidly in dendritic cells.

Results

Evaluations showed that DSPE-PEG-Man@EM-NPs had obvious inhibitory effects towards both MCF-7 and MDA-MB-231 human breast cancer cell lines.

Conclusion

Overall, this strategy provides a novel strategy for boosting cytotoxic T lymphocytes response, thereby expanding the adaptation range of tumor antigenic peptides and improving the therapeutic effect of tumor immunotherapy with nanomedicine.
Embolization strategies for intracranial dural arteriovenous fistulas with an isolated sinus: a single-center experience in 20 patients
Authors: Hendriks Eef J , Lynch Jeremy , Swaminathan Saravana Kumar , Nicholson Patrick , Agid Ronit , Radovanovic Ivan , Pereira Vitor M , terBrugge Karel , Krings Timo
Published: June 2021

Background

Intracranial dural arteriovenous fistulas (DAVFs) draining into an isolated sinus segment constitute a specific entity within the spectrum of cranial dural AV shunts, with under-reporting of their optimal treatment.

Objective

To describe the multimodal treatment approach to isolated sinus DAVFs in a large single-center cohort.

Methods

Retrospective analysis of adult patients with an isolated sinus DAVF treated at our institution between 2004 and 2020 was performed. Cases were analyzed for demographics, clinical presentation, angiographic findings, treatment techniques, angiographic and clinical outcomes, and complications.

Results

Of 317 patients with DAVFs, 20 (6.3%) with an isolated sinus DAVF underwent treatment. Transarterial embolization was performed through the middle meningeal artery in 9 of 12 procedures, with a success rate of 66.7%. Transarterial glue embolization proved successful in two of five procedures (40%) and Onyx in six of seven procedures (85.7%). Transvenous embolization (TVE) with navigation via the occlusion into the isolated sinus was successful in seven out of nine procedures (77.8%). All three open TVE and one pure open surgical procedure gained complete closure of the fistula. There were two major complications. Complete occlusion of the fistula was eventually obtained in all cases (100%).

Conclusions

Isolated sinus DAVFs are always aggressive and require a multimodal approach to guarantee closure of the shunt. Transarterial treatment with Onyx achieves good results. Transvenous treatment appears equally successful, navigating into the occluded segment across the occlusion or via burr hole as backup.
Type 2 myocardial infarction and myocardial injury: eligibility for novel medical therapy to derisk clinical trials
Authors: Sykes Robert , Briscoe Michael , Krysztofiak Thomas , Peck Oliver , Mangion Kenneth , Berry Colin
Published: June 2021

Background

Patients with type 2 myocardial infarction (T2MI) and other mechanisms of nonthrombotic myocardial injury have an unmet therapeutic need. Eligibility for novel medical therapy is generally uncertain.

Methods

We predefined colchicine, eplerenone and ticagrelor as candidates for repurposing towards novel therapy for T2MI or myocardial injury. Considering eligibility for randomisation in a clinical trial, each drug was classified according to indications and contraindications for therapy and survival for at least 24 hours following admission. Eligibility criteria for prescription were evaluated against the Summary of Medical Product Characteristics. Consecutive hospital admissions were screened to identify patients with ≥1 high-sensitivity troponin-I value >99th percentile. Endotypes of myocardial injury were adjudicated according to the Fourth Universal Definition of MI. Patients’ characteristics and medication were prospectively evaluated.

Results

During 1 March to 15 April 2020, 390 patients had a troponin I>URL. Reasons for exclusion: type 1 MI n=115, indeterminate diagnosis n=42, lack of capacity n=14, death <24 hours n=7, duplicates n=2. Therefore, 210 patients with T2MI/myocardial injury and 174 (82.8%) who survived to discharge were adjudicated for treatment eligibility. Patients who fulfilled eligibility criteria initially on admission and then at discharge were colchicine 25/210 (11.9%) and 23/174 (13.2%); eplerenone 57/210 (27.1%) and 45/174 (25.9%); ticagrelor 122/210 (58.1%) and 98/174 (56.3%). Forty-six (21.9%) and 38 (21.8%) patients were potentially eligible for all three drugs on admission and discharge, respectively.

Conclusion

A reasonably high proportion of patients may be considered eligible for repurposing novel medical therapy in secondary prevention trials of type 2 MI/myocardial injury.
Sex-based inequalities in contemporary UK hospital management of stable chest pain
Authors: Morgan-Hughes Gareth , Williams Michelle Claire , Loudon Margaret , Roobottom Carl A , Iacovides Stelios , Wotton Franchesca , Veitch Alice , Schmitt Matthias , Bull Russel
Published: June 2021

Objective

We surveyed UK practice of National Institute for Health and Care Excellence (NICE) “Recent onset chest pain” guidance (CG95, 2016), stratified by sex. We looked for sex-related differences in referral to computed tomographic coronary angiography (CTCA) and subsequent functional imaging (FI), invasive coronary angiography (ICA) and revascularisation.

Methods

This was a prospective analysis of CTCA practice in 8 UK centres between 2018 and 2020. Coronary artery disease (CAD) was recorded with the CAD-reporting and data system. Local electronic records/archiving/communication systems were used to collect data regarding subsequent FI, ICA and revascularisation.

Results

2301 women, 2326 men underwent CTCA; women were older (58±11 vs 55±12 years, p<0.001) but more likely to have normal coronary arteries (46% (1047) vs 29% (685); p<0.001) and less likely to have severe stenosis (7% (169) vs 13% (307); p<0.001). FI was used less for 4% (93) women, 5% (108) men; ICA was also used less for women (8% (182) vs 14% (321)), as was revascularisation (4% (83) vs 8% (177), p<0.001 for all), including those with ≥moderate CTCA stenosis undergoing ICA (53% (79) vs 61% (166); p<0.001).

Conclusions

Women referred for a NICE CG95 (2016) CTCA are more likely to have normal coronary arteries and men more likely to have CAD. More men than women will then undergo ICA and revascularisation even after adjustments for CTCA disease severity. Raised awareness of these inequalities may improve contemporary chest pain care.
A novel regulatory network of linc00174/miR-150-5p/VEGFA modulates pathological angiogenesis in diabetic retinopathy
Authors: Wang Juan-Juan , Wu Kun-Fang , Wang Ding-Ding
Published: June 2021

Diabetic retinopathy (DR) has been regarded as a sight-threatening vascular complication of diabetes mellitus. Accumulating evidence has identified the involvement of long non-coding RNAs (lncRNAs) in DR pathogenesis. We aim to investigate the role and underlying mechanism of linc00174 in the DR process. Samples of human vitreous humour from proliferative DR and non-diabetic individuals were collected to examine the levels of linc00174. Human retinal microvascular endothelial cells (HRMECs) exposed with high glucose (HG) were employed to simulate the pathological statues of DR. Short hairpin RNA specifically targeting linc00174 was applied. CCK-8, transwell, and matrigel tube formation were performed to evaluate cell proliferation, migration, and angiogenesis. Bioinformatics analysis and luciferase reporter assay were conducted to verify the linc00174/miR-150-5p/vascular endothelial growth factor A (VEGFA) regulatory network. Western blotting was employed to determine the expression of VEGFA. Linc00174 was significantly elevated in patients with DR, as well as HG-stimulated HRMECs, of which knockdown repressed HG-induced proliferation, migration, and angiogenesis. miR-150-5p was identified as a downstream effector to be involved in linc00174-mediated protective effects. miR-150-5p directly bound to the 3′ untranslated region of VEGFA. The linc00174/miR-150-5p/VEGFA axis was confirmed in retinal vascular dysfunction. The linc00174 deteriorates diabetic retinal microangiopathy via regulating miR-150-5p/VEGFA pathway, indicating a novel therapeutic target for DR treatment.
Global patterns of ranavirus detections
Authors: Brunner Jesse L. , Olson Deanna H. , Gray Matthew J. , Miller Debra L. , Duffus Amanda L.J.
Published: June 2021

Ranaviruses are emerging pathogens of poikilothermic vertebrates. In 2015 the Global Ranavirus Reporting System (GRRS) was established as a centralized, open access, online database for reports of the presence (and absence) of ranavirus around the globe. The GRRS has multiple data layers (e.g., location, date, host(s) species, and methods of detection) of use to those studying the epidemiology, ecology, and evolution of this group of viruses. Here we summarize the temporal, spatial, diagnostic, and host-taxonomic patterns of ranavirus reports in the GRRS. The number, distribution, and host diversity of ranavirus reports have increased dramatically since the mid 1990s, presumably in response to increased interest in ranaviruses and the conservation of their hosts, and also the availability of molecular diagnostics. Yet there are clear geographic and taxonomic biases among the reports. We encourage ranavirus researchers to add their studies to the portal because such collation can provide collaborative opportunities and unique insights to our developing knowledge of this pathogen and the emerging infectious disease that it causes.
Invariant quantities of scalar–tensor theories for stellar structure
Authors: Kozak Aleksander , Wojnar Aneta
Published: June 2021

We present the relativistic hydrostatic equilibrium equations for a wide class of gravitational theories possessing a scalar–tensor representation. It turns out that the stellar structure equations can be written with respect to the scalar–tensor invariants, allowing to interpret their physical role.
Lepton flavour violating $${\Lambda }_{{b}}$$ decays in non-universal $${Z}^{\prime }$$ model
Authors: Biswas S. , Nayek P. , Maji P. , Sahoo S.
Published: June 2021

Motivated by the recent LHCb results of lepton flavour violation on $$b\rightarrow s$$

b
→
s

and $$b\rightarrow c$$

b
→
c

transitions we study the lepton flavour violating (LFV) baryonic decays $${\Lambda }_{b}\rightarrow {\Lambda }l_{i}^{+}l_{j}^{-}$$

Λ
b

→
Λ

l

i

+

l

j

-

in non-universal $$Z^{\prime }$$

Z
′

model. We discuss the two-fold decay distribution of $${\Lambda }_{b}\rightarrow {\Lambda }l_{i}^{+}l_{j}^{-}$$

Λ
b

→
Λ

l

i

+

l

j

-

decays in terms of transversity amplitudes. From this distribution we study the differential branching ratio and lepton side forward-backward asymmetry in new physics (NP). The predicted values of the observables are very interesting and that might emboss the footprints of NP more aesthetically.
Benchmarking machine learning algorithms for adaptive quantum phase estimation with noisy intermediate-scale quantum sensors
Authors: Costa Nelson Filipe , Omar Yasser , Sultanov Aidar , Paraoanu Gheorghe Sorin
Published: June 2021

Quantum phase estimation is a paradigmatic problem in quantum sensing and metrology. Here we show that adaptive methods based on classical machine learning algorithms can be used to enhance the precision of quantum phase estimation when noisy non-entangled qubits are used as sensors. We employ the Differential Evolution (DE) and Particle Swarm Optimization (PSO) algorithms to this task and we identify the optimal feedback policies which minimize the Holevo variance. We benchmark these schemes with respect to scenarios that include Gaussian and Random Telegraph fluctuations as well as reduced Ramsey-fringe visibility due to decoherence. We discuss their robustness against noise in connection with real experimental setups such as Mach–Zehnder interferometry with optical photons and Ramsey interferometry in trapped ions, superconducting qubits and nitrogen-vacancy (NV) centers in diamond.
Multi-disease Predictive Analytics: A Clinical Knowledge-aware Approach
Authors: Qiu Lin , Gorantla Sruthi , Rajan Vaibhav , Tan Bernard C. Y.
Published: June 2021

Multi-Disease Predictive Analytics (MDPA) models simultaneously predict the risks of multiple diseases in patients and are valuable in early diagnoses. Patients tend to have multiple diseases simultaneously or develop multiple complications over time, and MDPA models can learn and effectively utilize such correlations between diseases. Data from large-scale Electronic Health Records (EHR) can be used through Multi-Label Learning (MLL) methods to develop MDPA models. However, data-driven approaches for MDPA face the challenge of data imbalance, because rare diseases tend to have much less data than common diseases. Insufficient data for rare diseases makes it difficult to leverage correlations with other diseases. These correlations are studied and recorded in biomedical literature but are rarely utilized in predictive analytics. This article presents a novel method called Knowledge-Aware Approach (KAA) that learns clinical correlations from the rapidly growing body of clinical knowledge. KAA can be combined with any data-driven MLL model for MDPA to refine the predictions of the model. Our extensive experiments, on real EHR data, show that the use of KAA improves the predictive performance of commonly used MDPA models, particularly for rare diseases. KAA is also found to be superior to existing general approaches of combining clinical knowledge with data-driven models. Further, a counterfactual analysis shows the efficacy of KAA in improving physicians’ ability to prescribe preventive treatments.
Early Exploration of MOOCs in the U.S. Higher Education: An Absorptive Capacity Perspective
Authors: Huang Peng , Lucas Henry C.
Published: June 2021

Advanced information technologies have enabledMassive Open Online Courses (MOOCs), which have the potential to transform higher education around the world. Why are some institutions eager to embrace this technology-enabled model of teaching, while others remain reluctant to jump aboard? Applying the theory of absorptive capacity, we study the role of a university's educational IT capabilities in becoming an early MOOC producer. Examining the history of MOOC offerings by U.S. colleges and universities, we find that prior IT capabilities, such as (1) the use of Web 2.0, social media and other interactive tools for teaching and (2) experience with distance education and hybrid teaching, are positively associated with the early exploration of MOOCs. Interestingly, we also find that the effect of educational IT capabilities is moderated by social integration mechanisms and activation triggers. For example, when instructional IT supporting services are highly decentralized, educational IT capabilities have a greater impact on the probability of a university offering a MOOC. In addition, for colleges facing an adverse environment, such as those experience a decline in college applications, the effect of IT capabilities on the exploration of MOOCs is much stronger.
Pulsed Current Plating Does Not Improve Microscale Current Distribution Uniformity Compared to Direct Current Plating at Equivalent Time-Averaged Plating Rates
Authors: Maraschky Adam , Akolkar Rohan
Published: June 2021

Suppression of surface roughness and dendrite growth under pulsed current (p.c.) plating is a widely reported effect for a variety of electrodeposited metals. Often, this effect is attributed to the modulation of mass transport during pulsing. In the present contribution, we use numerical simulations and scaling analysis to shed light on the transient mass transport effects near a 2D microscale pattern subjected to p.c. plating. Specifically, we compare the microscale current distribution during p.c. to that during direct current (d.c.) plating at an equivalent time-averaged plating rate. Modeling shows that the more uniform current distribution for a given time-averaged plating rate is that obtained during d.c. plating. The current distribution during p.c. plating is found to be less uniform in comparison to d.c., and the mechanistic rationale underlying this effect is explained using scaling analysis. Results reported herein have implications to the understanding of pulsed currents in applications ranging from thin-film electroplating to battery charging.
Lumbar muscle atrophy and increased relative intramuscular lipid concentration are not mitigated by daily artificial gravity after 60-day head-down tilt bed rest
Authors: De Martino Enrico , Hides Julie , Elliott James M. , Hoggarth Mark , Zange Jochen , Lindsay Kirsty , Debuse Dorothée , Winnard Andrew , Beard David , Cook Jonathan A. , Salomoni Sauro E. , Weber Tobias , Scott Jonathan , Hodges Paul W. , Caplan Nick
Published: June 2021

This study presents novel insights into the morphological adaptations occurring in the lumbar spine after 60-day head-down bed rest and the potential role of artificial gravity (AG) to mitigate them. Results demonstrated no protective effect of AG protocols used in this study. In atrophied paraspinal muscles, the ratio of lipids versus intramuscular water increased in the postural lumbar muscles, which could impair muscle function during upright standing. These findings have relevance for future space explorations.
Longer Time Span Air Pollution Prediction: The Attention and Autoencoder Hybrid Learning Model
Authors: Tu Xin-Yu , Zhang Bo , Jin Yu-Peng , Zou Guo-Jian , Pan Jian-Guo , Li Mao-Zhen
Published: June 2021

Air pollution has become a critical issue in human’s life. Predicting the changing trends of air pollutants would be of great help for public health and natural environments. Current methods focus on the prediction accuracy and retain the forecasting time span within 12 hours. Shorter time span decreases the practicability of these perditions, even with higher accuracy. This study proposes an attention and autoencoder (A&A) hybrid learning approach to obtain a longer period of air pollution changing trends while holding the same high accuracy. Since pollutant concentration forecast highly relates to time changing, quite different from normal prediction problems like autotranslation, we integrate “time decay factor” into the traditional attention mechanism. The time decay factor can alleviate the impact of the value observed from a longer time before while increasing the impact of the value from a closer time point. We also utilize the hidden states in the decoder to build connection between history values and current ones. Thus, the proposed model can extract the changing trend of a longer history time span while coping with abrupt changes within a shorter time span. A set of experiments demonstrate that the A&A learning approach can obtain the changing trend of air pollutants, like PM2.5, during a longer time span of 12, 24, or even 48 hours. The approach is also tested under different pollutant concentrations and different periods and the results validate its robustness and generality.
The Influence of Serum Uric Acid Level on Alzheimer’s Disease: A Narrative Review
Authors: Qiao Mengyuan , Chen Chongli , Liang Yuqing , Luo Yuxi , Wu Wenbin
Published: June 2021

As a powerful antioxidant in the human body, uric acid (UA) has been the subject of increasing research that focused on its influence on Alzheimer’s disease (AD) in recent years. The latest literature was gathered to describe the influence of serum uric acid (SUA) level on the onset and progression of AD and to analyze the possibility that SUA is a biomarker of Alzheimer’s disease. A large number of existing studies suggested that the SUA level was lower or tended to decrease in patients with AD, and increased SUA level may have a protective effect in AD, which could reduce the risk of onset and slowing the course of the disease. However, some Mendelian randomization analyses suggested that genetically determined uric acid was not associated with AD risk. Existing research results are contradictory due to the high inconsistency of the studies, the selection of subjects, and other factors. UA also showed a strong association with cognitive function, and there appeared to be a gender‐selective neuroprotective action. Due to its potent antioxidant properties, the low uric acid level may contribute to oxidative stress to accelerate disease progression. But some preclinical data showed a possibility that in some special cases, UA had a prooxidant properties. The possibility was raised in the discussion of the underlying mechanism that both the low uric acid level and the rapidly progressive course of the disease were the consequence of malnutrition. This paper reviews recent advances in the study of SUA and AD which offers the possibility of new biomarker, new prevention, and treatment strategies for Alzheimer’s disease.
Survival Benefit of Intervention Treatment in Advanced Anaplastic Thyroid Cancer
Authors: Kasemsiri Pornthep , Chaisakgreenon Pimpika , Vatanasapt Patravoot , Laohasiriwong Supawan , Teeramatwanich Watchareeporn , Thongrong Cattleya , Ratanaanekchai Teeraporn , Suetrong Surapol
Published: June 2021

Background. The management of anaplastic thyroid cancer (ATC) is controversial; thus, proper treatment and prognostic factors should be investigated. Objectives. To compare the survival outcomes of the intervention and palliative treatment in ATC patients. Methods. A hospital-based retrospective study was conducted at a single tertiary university hospital. The medical record charts were retrieved from November 20, 1987, to December 31, 2016. The final follow-up ended by December 31, 2017. The patients’ demographic data, laboratory data, clinical presentation, and treatment modality results were analyzed. Results. One hundred twenty-one records were analyzed with a one-year overall survival rate of 3.5% (median survival time: 77 days); however, 16 cases had insufficient data to classify staging and treatment modalities. Therefore, 105 ATC patients (37 with stage IVa, 39 with stage IVb, and 29 with stage IVc disease) were included with a one-year overall survival rate of 4.0% (median survival time of 82 days). Intervention treatment allowed longer median survival times (

p
<
0.05

) and a better survival rate (

p
<
0.05

). Among the interventional treatment groups, postoperative chemoradiation yielded the longest median survival time (187 days) and the highest survival rate (20%) (

p
<
0.05

). The intervention modality allowed a better median survival time at all stages, particularly in stage IVa (

p
<
0.05

). Unfavorable prognostic factors were adjusted for in a multiple Cox regression model showing that significant factors included age ≥65 years (hazard ratio HR: 2.57), palliative treatment (HR: 1.85), and leukocytosis ≥10,000 cells/mm3 (HR: 2.76). Conclusions. Intervention treatment provided a better survival outcome in all stages, particularly in stage IVa, with a significantly better median survival time. Among interventional treatments, postoperative chemoradiation led to the longest survival rate, suggesting that this treatment should be considered in ATC patients with resectable tumors and no poor prognostic factors, such as older age and leukocytosis.
Characteristic Poses in Ballet in the Case of a Retired Classical Ballerina after Bilateral THA: A Case Report and Review of Literature
Authors: Morio Futoshi , Fukunishi Shigeo , Fukui Tomokazu , Kanto Makoto , Amai Kenta , Yoshiya Shinichi , Tachibana Toshiya
Published: June 2021

Background. Ballet dance involves extreme range of motion (ROM) in the hip joint. This ROM can cause injuries including labral strain, tears, and subluxation episodes. Case Presentation. A 69-year-old female classical ballet dance instructor presented bilateral hip pain. The plain radiograph showed end-stage osteoarthritic change in the bilateral hip. She could neither dance nor perform daily activities. Bilateral hybrid total hip arthroplasty (THA) was performed. After surgery, she was able to demonstrate the split position on the floor as an active classical ballerina. The plain radiograph was taken in the split position, and the radiograph did not show any characteristics of impingement or subluxation of the femoral head. Conclusion. She was able to continue working as a classical ballet instructor after bilateral THA. Additionally, any characteristics of impingement or subluxation of the femoral head were not revealed in the postoperative radiograph in the split position.