bluuebunny/crossref_metadata_2025 huggingface dataset:
Tofacitinib and faecal microbiota transplantation in treating checkpoint inhibitor-induced enterocolitis: case report
Authors: Holmstroem Rikke Boedker , Dahl Emilie Kristine , Helms Morten , Nielsen Henrik Vedel , Andersen Janne Bayer , Bjerrum Jacob Tveiten , Svane Inge Marie , Ellebaek Eva , Seidelin Jakob Benedict
Published: December 2022

Background

Immune checkpoint inhibitors (ICIs) can induce a wide range of immune-related adverse events (irAEs), potentially affecting any organ. ICI-induced colitis is a frequently reported irAE, whereas enteritis is rare and not well documented.

Case presentation

We are presenting a patient with metastatic melanoma who developed severe ICI-induced enterocolitis multirefractory for glucocorticoids, infliximab and vedolizumab, partially responding to faecal microbiota transplantation and final complete response to tofacitinib.

Conclusion

This case supports that tofacitinib may be an(other) effective agent in managing multirefractory ICI-induced diarrhoea caused by colitis and/or enteritis.
Time without PSA recurrence after radical prostatectomy as a predictor of future biochemical recurrence, metastatic disease and prostate cancer death: a prospective Scandinavian cohort study
Authors: Ahlberg Mats Steinholtz , Garmo Hans , Adami Hans-Olov , Andrén Ove , Johansson Jan-Erik , Steineck Gunnar , Holmberg Lars , Bill-Axelson Anna
Published: December 2022

Objective

Although surveillance after radical prostatectomy routinely includes repeated prostate specific antigen (PSA)-testing for many years, biochemical recurrence often occurs without further clinical progression. We therefore hypothesised that follow-up can be shortened for many patients without increasing the risk of prostate cancer death. We investigated the long-term probabilities of PSA recurrence, metastases and prostate cancer death in patients without biochemical recurrence five and 10 years after radical prostatectomy.

Design

Prospective cohort study. Stratification by Gleason score (≤3+4=7 or ≥4+3=7), pathological tumour stage (pT2 or ≥pT3) and negative or positive surgical margins.

Setting

Between 1989 and 1998, 14 urological centres in Scandinavia randomised patients to the Scandinavian Prostate Cancer Group study number 4 (SPCG-4) trial.

Participation

All 306 patients from the SPCG-4 trial who underwent radical prostatectomy within 1 year from inclusion were eligible. Four patients were excluded due to surgery-related death (n=1) or salvage radiotherapy or hormonal treatment within 6 weeks from surgery (n=3).

Primary outcome measures

Cumulative incidences and absolute differences in metastatic disease and prostate cancer death.

Results

We analysed 302 patients with complete follow-up during a median of 24 years. Median preoperative PSA was 9.8 ng/mL and median age was 65 years. For patients without biochemical recurrence 5 years after radical prostatectomy the 20-year probability of biochemical recurrence was 25% among men with Gleason score ≤3+4=7 and 57% among men with Gleason score ≥4+3=7; the probabilities for metastases were 0.8% and 17%; and for prostate cancer death 0.8% and 12%, respectively. The long-term probabilities were higher for pT ≥3 versus pT2 and for positive versus negative surgical margins. Limitations include small size of the cohort.

Conclusion

Many patients with favourable histopathology without biochemical recurrence 5 years after radical prostatectomy could stop follow-up earlier than 10 years after radical prostatectomy.
Protocol for a scoping review of measures and definitions of gender-based discrimination linked to health outcomes in low and middle-income countries
Authors: Petitfour Laurène , Srivastava Swati , Shah-Rohlfs Rupal , Orduhan Clara , Quentin Wilm , De Allegri Manuela
Published: December 2022

Introduction

Gender-based discrimination (GBD) is generally defined as unequal or disadvantageous treatment based on one’s gender. Emerging evidence suggests that exposure to GBD in its various forms can yield negative consequences for women’s health, including delaying access to healthcare services and lowering the quality of nutrition. Although consensus exists around the theoretical definitions of GBD, current studies are limited on how to measure GBD empirically in order to assess its true impact on women’s health. Our mixed-methods scoping review aims at synthesising existing evidence by answering the questionHow is gender-based discrimination defined and measured in the health literature, with specific reference to Low and Middle-Income Countries (LMICs)?. Our ambition is to identify commonalities across definitions and measures to generate a dialogue towards reaching consensus around the development of a single standardised tool to be applied in health studies.

Methods and analysis

Our mixed-method scoping review includes quantitative, qualitative and mixed-methods studies and unfolds according to the six stages proposed by Levacet al. Eligibility criteria for studies were defined in order to reflect the three core elements of the search, namely (1) the discrimination based on the gender, (2) the link to health outcomes and (3) the developing countries context. Four databases (PubMed, Web of Science, Cinahl and Econlit) were searched. We will extract and synthesise information from quantitative and qualitative studies following the framework proposed by Hong and use the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review tool as a guide.

Ethics and dissemination

Since our scoping review relies exclusively on information extracted from published articles, its conduct is not subjected to ethical clearance. Results will be described and discussed in a peer-reviewed article and presented at relevant workshops and conferences.
Clinical risk analysis of postoperative delirium in elderly patients undergoing thoracic and abdominal surgery: study protocol of a single-centre observational cohort study
Authors: Liu Jing , Liu Meinv , Li Jianli , Rong Junfang
Published: December 2022

Introduction

Postoperative delirium (POD) acts as a common complication in older patients after surgery, accompanied by longer recovery time, prolonged hospital stay, increased hospitalisation costs, etc. Therefore, it is urgent to reduce POD by implementing some intervention strategies. Early identification of associated risk factors was regarded as an effective method to lower the incidence of POD. Currently, the incidence and risk factors of POD have been widely investigated in orthopaedic and cardiac surgery, while remain scarce in thoracic and abdominal surgery. We will perform an observational cohort study to explore the incidence and potential risk variables of POD in thoracic and abdominal surgery, mainly focusing on some prognostic indicators including age-adjusted Charlson Comorbidity Index (ACCI), Prognostic Nutrition Index (PNI) and Fibrinogen to Albumin Ratio (FAR). In addition, we will further develop a predictive model based on related data to provide a novel method for preventing POD.

Methods and analysis

A single-centre observational study is conducted among patients aged ≥60 years old undergoing thoracic and abdominal surgery from 28 February 2022 to 31 December 2022. The patients will be divided into POD group and non-POD group following the Diagnostic and Statistical Manual of Mental Disorders, fifth edition. Related variables mainly including ACCI, PNI and FAR will be analysed by univariate and multivariate logistic regression analyses. Besides, a predictive model will be established according to associated risk factors, and the receiver operating characteristic curve will be used to further evaluate the accuracy of the predictive model.

Ethics and dissemination

The study has been approved by the Medical Ethics Committee of Hebei General Hospital (approval number 2022021) and will intend to be published in peer-reviewed journals.

Trial registration number

Chinese Clinical Trial Registry (ChiCTR2200057126).
Development and validation of a novel 10-year cardiovascular risk prediction nomogram for the United Arab Emirates national population
Authors: Al-Shamsi Saif
Published: December 2022

Objectives

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality among United Arab Emirates (UAE) nationals. Recent studies have shown that current tools are poor in predicting the risk of incident ASCVD in Emiratis. To improve ASCVD risk prediction in this high-risk population, this study sought to develop and validate a novel and practical 10-year ASCVD risk nomogram using risk factors known to be significant in UAE nationals.

Design

A 10-year retrospective cohort study.

Setting

Outpatient clinics at a large public tertiary care hospital in Al-Ain, UAE.

Participants

Emiratis aged ≥18 years without prior cardiovascular disease (CVD) who had presented to Tawam Hospital’s clinics between 1 April 2008 and 31 December 2008, were included. Patients’ data were collected retrospectively until 31 January 2020.

Exposure

Cox proportional hazards models were developed to estimate the 10-year ASCVD risk.

Primary outcome measure

Model discrimination and calibration were assessed using the Harrell C-statistic and the Greenwood-Nam-D’Agostino (GND) χ2test, respectively. Receiver operating characteristic curve analysis was used to determine the optimal cut-off point of the nomogram for elevated ASCVD risk.

Results

The study included 1245 patients, of whom 117 developed ASCVD within 10 years. The ASCVD risk nomogram comprised age, sex, family history of CVD, hypertension treatment, systolic blood pressure, total cholesterol, glycosylated haemoglobin A1c and estimated glomerular filtration rate. The Harrell C-statistic was 0.826 and the GND χ2was 2.83 (p=0.830), which indicated good discrimination and calibration of the nomogram model, respectively. The optimal cut-off point was determined to be 10% (sensitivity=79%; specificity=77%). The nomogram can be freely accessed as an online calculator at (https://ascvdriskuae.shinyapps.io/ASCVDrisk/).

Conclusions

The developed nomogram provides an accurate prognostic tool for 10-year ASCVD risk prediction in UAE nationals. These findings may help guide future research on CVD prevention in this high-risk population.
Prevalence of prediabetes and associated factors of prediabetic stages: a cross-sectional study among adults in Nepal
Authors: Shakya Pushpanjali , Shrestha Archana , Karmacharya Biraj Man , Shrestha Abha , Kulseng Bård Eirik , Skovlund Eva , Sen Abhijit
Published: December 2022

Objectives

To estimate the prevalence of prediabetes and to assess the association of prediabetic stages with sociodemographic, lifestyle and clinical factors

Design

Cross-sectional study at the screening and inclusion stage of a Diabetes Prevention Education Program (DiPEP) trial

Setting

The study was conducted in two urban communities in Nepal (October 2019–March 2020).

Participants

A total of 6222 residents of two study sites, aged 18–64 years and without a history of diabetes, were eligible for prediabetes screening. Exclusion criteria were pregnancy, history of diabetes and critical illness. A total of 291 participants with prediabetes were included in this study.

Primary and secondary outcome measures

Prevalence of prediabetes based on glycated haemoglobin (HbA1c) criteria (5.7%–6.4%) was the primary outcome of the study. Odds Ratio and 95% CI were estimated to assess the associations between the outcome prediabetic stages (5.7%–5.9% vs 6.0%–6.4%) and sociodemographic, lifestyle and clinical factors in both unadjusted and adjusted models.

Results

Out of 6222 screened participants, 308 (5%, 95% CI: 4.4% to 5.5%) individuals were detected with prediabetes based on HbA1c. The mean age of 291 responded participants was 50.3±7.6 years and 67% were females. Among them, 78% aged 45–64 years, 97% had central obesity, 90% had high waist–hip ratio, 63% were hypertensive and 66% had no family history of diabetes. Approximately, 54% and 46% of individuals with prediabetes had HbA1c of 5.7%–5.9% and 6.0%–6.4%, respectively. Female gender was associated with prediabetes with HbA1c 6.0%–6.4% (OR, 1.98, 95% CI: 1.07 to 3.67) in the adjusted model.

Conclusion

The estimated prevalence of prediabetes was 5% among screened participants, and female gender was associated with the prediabetic stage. As a large proportion of the population with prediabetes were not aware of their status, this study demonstrates a need for regular community screening programmes to detect individuals with prediabetes and provide them a comprehensive lifestyle intervention for diabetes prevention.

Trial registration number

NCT04074148, 2019/783.
Trends and patterns of inequalities in using facility delivery among reproductive-age women in Bangladesh: a decomposition analysis of 2007–2017 Demographic and Health Survey data
Authors: Rahman Md Ashfikur , Sultana Sumaya , Kundu Satyajit , Islam Md Akhtarul , Roshid Harun Or , Khan Zahidul Islam , Tohan Mortuza , Jahan Nusrat , Khan Bayezid , Howlader Md Hasan
Published: December 2022

Objectives

The prime objectives of the study were to measure the prevalence of facility delivery, assess socioeconomic inequalities and determine potential associated factors in the use of facility delivery in Bangladesh.

Design

Cross-sectional.

Setting

The study involved investigation of nationally representative secondary data from the Bangladesh Demographic and Health Survey between 2007 and 2017–2018.

Participants

The participants of this study were 30 940 (weighted) Bangladeshi women between the ages of 15 and 49.

Methods

Decomposition analysis and multivariable logistic regression were both used to analyse data to achieve the study objectives.

Results

The prevalence of using facility delivery in Bangladesh has increased from 14.48% in 2007 to 49.26% in 2017–2018. The concentration index for facility delivery utilisation was 0.308 with respect to household wealth status (p<0.001), indicating that use of facility delivery was more concentrated among the rich group of people. Decomposition analysis also indicated that wealth quintiles (18.31%), mothers’ education (8.78%), place of residence (7.75%), birth order (5.56%), partners’ education (4.30%) and antenatal care (ANC) seeking (8.51%) were the major contributors to the prorich socioeconomic inequalities in the use of facility delivery. This study found that women from urban areas, were overweight, had any level of education, from wealthier families, had ANC, and whose partners had any level of education and involved in business were more likely to have facility births compared with their respective counterparts.

Conclusions

This study found a prorich inequality in the use of facility delivery in Bangladesh. The socioeconomic disparities in facility delivery must be addressed if facility delivery usage is to increase in Bangladesh.
Effectiveness of additional antireflux surgery after resection of oesophagogastric junction cancer: protocol for a systematic review and meta-analysis
Authors: Wang Na , Zheng Peng , Yu Yang , Gao Lei , Li Yu , Ding Fanghui , Wang Bofang , Chen Hao
Published: December 2022

Introduction

Gastro-oesophageal reflux is common in patients with oesophagogastric junction (OGJ) cancer following radical surgery. We aim to conduct a systematic review to investigate the effectiveness and clinical value of additional antireflux surgery (pyloroplasty and fundoplication) for OGJ cancer.

Methods and analysis

We intend to search Medline, Cochrane Library and Embase databases for studies published in English, from database inception to October 2022. Randomised controlled trials and (non-random) controlled clinical trials will be eligible for inclusion. We will search for all eligible studies that have compared proximal gastrectomy plus additional antireflux surgery and proximal gastrectomy alone in patients with resectable OGJ cancer. All potential outcomes related to gastro-oesophageal reflux, including occurrence of reflux symptoms, reflux oesophagitis, reflux occurrence based on barium meal examination, pH of fluid from the lower oesophagus, and 24-hour oesophageal pH test will be assessed as the primary outcomes. Other outcomes, such as patients’ survival and postoperative complications (eg, stenosis, infection and leak) will also be analysed. Two reviewers will independently screen the literature, extract data and assess the risk of bias in the included studies; subsequently, a meta-analysis will be performed using RevMan V.5.3 software to pool the results. The χ2and I2tests will be used for heterogeneity assessment and sources of heterogeneity will be explored using subgroup analysis. The Grading of Recommendations, Assessment, Development and Evaluation method will be applied to assess the level of evidence.

Ethics and dissemination

This proposed study is a secondary analysis of previously published data. Therefore, ethics approval is not required. The results will be presented for publication in a peer-reviewed journal and data will be stored in public databases.
Treatment decision-making and care among older adults with kidney failure: protocol for a multicentre, prospective observational cohort study with nested substudies and linked qualitative research (the Elderly Advanced CKD Programme)
Authors: Siriwardana Amanda , Gray Nicholas A , Makris Angela , Li Chenlei Kelly , Yong Kenneth , Mehta Yachna , Ramos Jannel , Di Tanna Gian Luca , Gianacas Chris , Addo Isaac Yeboah , Roxburgh Sarah , Naganathan Vasi , Foote Celine , Gallagher Martin
Published: December 2022

Introduction

Shared treatment decision-making and planning of care are fundamental in advanced chronic kidney disease (CKD) management. There are limited data on several key outcomes for the elderly population including survival, quality of life, symptom burden, changes in physical functioning and experienced burden of healthcare. Patients, caregivers and clinicians consequently face significant uncertainty when making life-impacting treatment decisions. The Elderly Advanced CKD Programme includes quantitative and qualitative studies to better address challenges in treatment decision-making and planning of care among this increasingly prevalent elderly cohort.

Methods and analysis

The primary component is OUTcomes of Older patients with Kidney failure (OUTLOOK), a multicentre prospective observational cohort study that will enrol 800 patients ≥75 years with kidney failure (estimated glomerular filtration rate ≤15 mL/min/1.73 m2) across a minimum of six sites in Australia. Patients entered are in the decision-making phase or have recently made a decision on preferred treatment (dialysis, conservative kidney management or undecided). Patients will be prospectively followed until death or a maximum of 4 years, with the primary outcome being survival. Secondary outcomes are receipt of short-term acute dialysis, receipt of long-term maintenance dialysis, changes in biochemistry and end-of-life care characteristics. Data will be used to formulate a risk prediction tool applicable for use in the decision-making phase. The nested substudies Treatment modalities for the InfirM ElderLY with end stage kidney disease (TIMELY) and Caregivers of The InfirM ElderLY with end stage kidney disease (Co-TIMELY) will longitudinally assess quality of life, symptom burden and caregiver burden among 150 patients and 100 caregivers, respectively. CONsumer views of Treatment options for Elderly patieNts with kiDney failure (CONTEND) is an additional qualitative study that will enrol a minimum of 20 patients and 20 caregivers to explore experiences of treatment decision-making and care.

Ethics and dissemination

Ethics approval was obtained through Sydney Local Health District Human Research Ethics Committee (2019/ETH07718, 2020/ETH02226, 2021/ETH01020, 2019/ETH07783). OUTLOOK is approved to have waiver of individual patient consent. TIMELY, Co-TIMELY and CONTEND participants will provide written informed consent. Final results will be disseminated through peer-reviewed journals and presented at scientific meetings.
Association between serum uric acid/HDL-cholesterol ratio and chronic kidney disease: a cross-sectional study based on a health check-up population
Authors: Cheng Yang , Zhang Hao , Zheng Hui , Yin Hongli , Wang Ying , Wang Hui , Gu Liubao , Yin Donghua
Published: December 2022

Objective

Evidence suggests that both serum uric acid (SUA) and high-density lipoprotein cholesterol (HDL-C) are risk factors for chronic kidney disease (CKD). The SUA-to-HDL-C ratio (UHR) has recently attracted attention as a new biomarker to evaluate the role between inflammatory and anti-inflammatory substances. Thus, we explored the association between UHR and CKD in a large Chinese population.

Design

A cross-sectional study.

Setting

Annual health check-up population in Nanjing.

Participants

19 458 individuals who underwent an annual health check-up in 2019 were included in our study.

Main outcome measure

CKD was diagnosed according to an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2.

Results

Correlation analysis showed that UHR was negatively associated with eGFR after adjusting for confounding factors (r=−0.34). In addition, participants in the highest quartile of UHR had a higher risk of CKD than those in the lowest quartiles (OR=9.28, p<0.001).

Conclusion

We found that high UHR values were positively associated with CKD risk in health check-up population. An increased UHR may be a useful measure by which to assess CKD risk in the preclinical stage.
Study protocol for a randomised controlled trial evaluating the benefits from bimodal solution with cochlear implant and hearing aid versus bilateral hearing aids in patients with asymmetric speech identification scores
Authors: Jakobsen Yeliz , Christensen Andersen Lou-Ann , Schmidt Jesper Hvass
Published: December 2022

Introduction

Cochlear implant (CI) and hearing aid (HA) in a bimodal solution (CI+HA) is compared with bilateral HAs (HA+HA) to test if the bimodal solution results in better speech intelligibility and self-reported quality of life.

Methods and analysis

This randomised controlled trial is conducted in Odense University Hospital, Denmark. Sixty adult bilateral HA users referred for CI surgery are enrolled if eligible and undergo: audiometry, speech perception in noise (HINT: Hearing in Noise Test), Speech Identification Scores and video head impulse test. All participants will receive new replacement HAs. After 1 month they will be randomly assigned (1:1) to the intervention group (CI+HA) or to the delayed intervention control group (HA+HA). The intervention group (CI+HA) will receive a CI on the ear with a poorer speech recognition score and continue using the HA on the other ear. The control group (HA+HA) will receive a CI after a total of 4 months of bilateral HA use.

The primary outcome measures are speech intelligibility measured objectively with HINT (sentences in noise) and DANTALE I (words) and subjectively with the Speech, Spatial and Qualities of Hearing scale questionnaire. Secondary outcomes are patient reported Health-Related Quality of Life scores assessed with the Nijmegen Cochlear Implant Questionnaire, the Tinnitus Handicap Inventory and Dizziness Handicap Inventory. Third outcome is listening effort assessed with pupil dilation during HINT.

In conclusion, the purpose is to improve the clinical decision-making for CI candidacy and optimise bimodal solutions.

Ethics and dissemination

This study protocol was approved by the Ethics Committee Southern Denmark project ID S-20200074G. All participants are required to sign an informed consent form.

This study will be published on completion in peer-reviewed publications and scientific conferences.

Trial registration number

NCT04919928.
Haemodynamic and prognostic associations of liver fibrosis scores in Fontan-associated liver disease
Authors: Martin de Miguel Irene , Kamath Patrick S , Egbe Alexander C , Jain C Charles , Cetta Frank , Connolly Heidi M , Miranda William R
Published: December 2022

Objectives

Fontan-associated liver disease (FALD) is universal post-Fontan palliation; however, its impact on survival remains controversial and current diagnostic tools have limitations. We aimed to assess the prognostic role of liver fibrosis scores (aminotransferase to platelet ratio [APRI] and fibrosis-4 [FIB-4]) and their association with haemodynamics and other markers of liver disease.

Methods

159 adults (age ≥18 years) post-Fontan undergoing catheterisation at Mayo Clinic, Minnesota, between 1999 and 2017 were included. Invasive haemodynamics and FALD-related laboratory, imaging and pathology data were documented.

Results

Mean age was 31.5±9.3 years, while median age at Fontan procedure was 7.5 years (4–14). Median APRI score (n=159) was 0.49 (0.33–0.61) and median FIB-4 score (n=94) was 1.12 (0.71–1.65). Correlations between APRI and FIB-4 scores and Fontan pressures (r=0.30, p=0.0002; r=0.34, p=0.0008, respectively) and pulmonary arterial wedge pressure (r=0.25, p=0.002; r=0.30, p=0.005, respectively) were weak. Median average hepatic stiffness by magnetic resonance elastography was 4.9 kPa (4.3–6.0; n=26) and 24 (77.4%) showed stage 3 or 4 liver fibrosis on biopsy; these variables were not associated with APRI/FIB-4 scores. On multivariable analyses, APRI and FIB-4 scores were independently associated with overall mortality (HR 1.31 [1.07–1.55] per unit increase, p=0.003; HR 2.15 [1.31–3.54] per unit increase, p=0.003, respectively).

Conclusions

APRI and FIB-4 scores were associated with long-term all-cause mortality in Fontan patients independent of other prognostic markers. Correlations between haemodynamic status and liver scores were weak; furthermore, most markers of liver fibrosis failed to correlate with non-invasive indices, underscoring the complexity of FALD.
Prognosis of patients with hypertrophic cardiomyopathy and low-normal left ventricular ejection fraction
Authors: Choi You-Jung , Kim Hyung-Kwan , Hwang In-Chang , Park Chan Soon , Rhee Tae-Min , Lee Hyun-Jung , Park Jun-Bean , Yoon Yeonyee Elizabeth , Lee Seung-Pyo , Cho Goo-Yeong , Kim Yong-Jin
Published: December 2022

Objective

To investigate whether low-normal left ventricular ejection fraction (LVEF) is associated with adverse outcomes in hypertrophic cardiomyopathy (HCM) and evaluate the incremental value of predictive power of LVEF in the conventional HCM sudden cardiac death (SCD)-risk model.

Methods

This retrospective study included 1858 patients with HCM from two tertiary hospitals between 2008 and 2019. We classified LVEF into three categories: preserved (≥60%), low normal (50%–60%) and reduced (<50%); there were 1399, 415, and 44 patients with preserved, low-normal, and reduced LVEF, respectively. The primary outcome was a composite of SCD, ventricular tachycardia/fibrillation and appropriate implantable cardioverter-defibrillator shocks. Secondary outcomes were hospitalisation for heart failure (HHF), cardiovascular death and all-cause death.

Results

During the median follow-up of 4.09 years, the primary outcomes occurred in 1.9%. HHF, cardiovascular death, and all-cause death occurred in 3.3%, 1.9%, and 5.3%, respectively. Reduced LVEF was an independent predictor of SCD/equivalent events (adjusted HR (aHR) 5.214, 95% CI 1.574 to 17.274, p=0.007), adding predictive value to the HCM risk-SCD model (net reclassification improvement 0.625). Compared with patients with HCM with preserved LVEF, those with low-normal and reduced LVEF had a higher risk of HHF (LVEF 50%–60%, aHR 2.457, 95% CI 1.423 to 4.241, p=0.001; LVEF <50%, aHR 7.937, 95% CI 3.315 to 19.002, p<0.001) and cardiovascular death (LVEF 50%–60%, aHR 2.641, 95% CI 1.314 to 5.309, p=0.006; LVEF <50%, aHR 5.405, 95% CI 1.530 to 19.092, p=0.009), whereas there was no significant association with all-cause death.

Conclusions

Low-normal LVEF was an independent predictor of HHF and cardiovascular death in patients with HCM.
Self-harm in immigration detention: political, not (just) medical
Authors: Aitchison Guy , Essex Ryan
Published: December 2022

Self-harm within immigration detention centres has been a widely documented phenomenon, occurring at far higher rates than the wider community. Evidence suggests that factors such as the conditions of detention and uncertainty about refugee status are among the most prominent precipitators of self-harm. While important in explaining self-harm, this is not the entire story. In this paper, we argue for a more overtly political interpretation of detainee self-harm as resistance and assess the ethical implications of this view, drawing on interviews with detainees from Australia’s offshore system. Self-harm by detainees is not only a medical ‘condition’ arising in response to oppression but a form of political action to lessen or contest it. We first establish how self-harm could be conceptualised as resistance. We then discuss its political purpose, noting it serves at least three functions: intrinsic, instrumental and disruptive or coercive. Viewing detainee self-harm as political resistance is a supplement to (rather than a substitute for) a medical approach. However, conceptualising self-harm this way has several advantages, namely, moving away from the idea that such behaviour is ‘maladaptive’, recognising detainees as political agents, combatting government claims of ‘manipulation’ and ‘blackmail’ and clarifying the duties of healthcare workers who work in detention.
Consolidating the association of biallelicMAPKAPK5pathogenic variants with a distinct syndromic neurodevelopmental disorder
Authors: Maroofian Reza , Efthymiou Stephanie , Suri Mohnish , Rahman Fatima , Zaki Maha S , Maqbool Shazia , Anwa Najwa , Ruiz-Pérez Victor L , Yanovsky-Dagan Shira , Elpeleg Orly , Sudhakar Sniya , Mankad Kshitij , Harel Tamar , Houlden Henry
Published: December 2022

Background

MAPK-activated protein kinase 5 (MAPKAPK5) is an essential enzyme for diverse cellular processes. Dysregulation of the pathways regulated by MAPKAPK enzymes can lead to the development of variable diseases. Recently, homozygous loss-of-function variants inMAPKAPK5were reported in four patients from three families presenting with a recognisable neurodevelopmental disorder, so-called ‘neurocardiofaciodigital’ syndrome.

Objective and methods

In order to improve characterisation of the clinical features associated with biallelicMAPKAPK5variants, we employed a genotype-first approach combined with reverse deep-phenotyping of three affected individuals.

Results

In the present study, we identified biallelic loss-of-function and missenseMAPKAPK5variants in three unrelated individuals from consanguineous families. All affected individuals exhibited a syndromic neurodevelopmental disorder characterised by severe global developmental delay, intellectual disability, characteristic facial morphology, brachycephaly, digital anomalies, hair and nail defects and neuroradiological findings, including cerebellar hypoplasia and hypomyelination, as well as variable vision and hearing impairment. Additional features include failure to thrive, hypotonia, microcephaly and genitourinary anomalies without any reported congenital heart disease.

Conclusion

In this study, we consolidate the causality of loss of MAPKAPK5 function and further delineate the molecular and phenotypic spectrum associated with this new ultra-rare neurodevelopmental syndrome.
Coronary calcification measures predict mortality in symptomatic women and men
Authors: Siegersma Klaske R , Groepenhoff Floor , Eikendal Anouk L M , op den Brouw Willemijn J , Leiner Tim , Appelman Yolande , Tulevski Igor I , Somsen G Aernout , Onland-Moret N Charlotte , Hofstra Leonard , den Ruijter Hester M
Published: December 2022

Objective

To assess the prognostic value of absolute and sex-specific, age-specific and race/ethnicity-specific (Multi-Ethnic Study of Atherosclerosis, MESA) percentiles of coronary artery calcification in symptomatic women and men.

Methods

The study population consisted of 4985 symptomatic patients (2793 women, 56%) visiting a diagnostic outpatient cardiology clinic between 2009 and 2018 who were referred for cardiac CT to determine Coronary Artery Calcium Score (CACS). Regular care data were used and these data were linked to the databases of Statistics Netherlands for all-cause mortality data. Kaplan-Meier curves, multivariate Cox proportional hazards regression and concordance statistics were used to evaluate the prognostic value of CACS and MESA percentiles. Women were older compared with men (60 vs 59 years).

Results

Median CACS was 0 (IQR: 0–54) in women and 42 (IQR: 0–54) in men. After a median follow-up of 4.4 years (IQR: 3.1–6.3), 116 (2.3%; 53 women and 63 men) patients died. MESA percentiles did not perform better compared with absolute CACS (C-statistic 0.65, 95% CI 0.57 to 0.73, vs 0.66, 95% CI 0.58 to 0.74, in women and 0.59, 95% CI 0.51 to 0.67, vs 0.62, 95% CI 0.55 to 0.69, in men, for the percentiles and absolute CACS, respectively).

Conclusions

In symptomatic individuals absolute CACS predicts mortality with a moderately good performance. MESA percentiles did not perform better compared with absolute CACS, thus there is no need to use them. Including degree of stenosis in the model might slightly improve mortality risk prediction in women, but not in men.
Propagation of light in the presence of gravity generated by static and spherically symmetric curved space-times using Maxwell equations
Authors: Falcón-Gómez Enderson , Amor-Martín Adrián , De La Rubia Valentín , Santamaría-Botello Gabriel , De Falco Vittorio , Muñoz Luis Enrique García
Published: December 2022

In this manuscript, we present an alternative method for calculating null geodesics in General Static Isotropic Metrics in General Relativity and Extended Theories of Gravity. By applying a conformal transformation, we are able to consider an analogue gravity model, where curvature is encoded in the dielectric and magnetic properties of a medium. In other words, we pass from curved to flat space-times, where instead of the Einstein field equations, the Maxwell equations are solved. Within this geometrical background, the photon geodesics are calculated. Then, given different black hole and wormhole metrics, we apply this method obtaining an excellent agreement with respect to the exact solutions in the original gravity framework by committing angular deviations below$$3^{\circ }$$3∘. Finally, we provide the image of a Schwarzschild black hole surrounded by a thin accretion disk, and the apparent image of a Morris and Thorne-like wormhole within an angular discrepancy below$$4^{\circ }$$4∘.
DYNAMICS OF OPTIMUM MONETARY POLICY IN A SMALL OPEN-ECONOMY: A NEW-KEYNESIAN DSGE MODEL FOR TURKISH ECONOMY
Authors: DEMIROK MUSTAFA , HASANCEBI SERHAT , ULUSOY VEYSEL
Published: December 2022

The purpose of this paper is to investigate the sources of business cycle fluctuations in a small open economy (SOE) using dynamic stochastic general equilibrium (DSGE) models and to assess the path of optimal policy decisions taken by the Central Bank of the Republic of Turkey (CBRT). To that purpose, the SOE-DSGE model is estimated using the Bayesian technique with Turkish data spanning the quarters 2003Q2–2020Q1. Based on the estimated model, the study finds that the explanatory power of the SOE-DSGE model for household, firm and central bank behavior decreases when consumer habit formation, price indexation and exchange rate sensitivity are included. Furthermore, technology, preferences, and risk premium shocks all have a significant impact on the Turkish economy. The CBRT, on the other hand, was principally concerned with price stabilization, interest rate smoothing, output and output growth stabilization, and nominal exchange rate stabilization, respectively. More importantly, the optimal monetary policy function implies that output growth should be better stabilized if exchange rate sensitivity target is ignored.
A note on the rate of convergence in the Boolean central limit theorem
Authors: Salazar Mauricio
Published: December 2022

Several results giving upper bounds for the speed of convergence in non-commutative central limit theorems are known. A natural question is whether there also exist lower bounds, or whether there exist classes of probability measures where the speed of convergence is faster. In this paper, we answer this for the Boolean central limit theorem in the bounded support case and using the Lévy distance. We show that for a probability measure [Formula: see text] of bounded support and nonzero third moment the rate of convergence is at least [Formula: see text], and when we have zero third moment, then the rate of convergence is [Formula: see text]. To achieve this, we improve a previous result concerning the position and weights of two atoms that eventually appear in the converging measure. The proofs only require elementary techniques of complex analysis.
Extreme states and boundary representations of operator spaces in ternary rings of operators
Authors: Shabna A. M. , Vijayarajan A. K. , Arunkumar C. S. , Syamkrishnan M. S.
Published: December 2022

This paper explores different notions of extreme states on operator systems and on operator spaces. We prove that boundary points of the generalized state space of an operator system in finite dimensions are precisely the restrictions of boundary representations of the generated [Formula: see text]-algebra. We study weak TRO-extreme states on operator spaces in ternary rings of operators as a non self-adjoint version of [Formula: see text]-extreme states on operator systems in [Formula: see text]-algebras. Rectangular boundary point for a rectangular matrix convex set is introduced and its connection with boundary representations of the associated operator space is established in finite dimensional setting. Also, we show that the set of all rectangular boundary points is the minimal spanning set for a compact rectangular matrix convex set in finite dimensions.
Fabrication and Characterization of p-SnS/n-Si Solar Cell by Thermal Evaporation Technique and the Effect of Ag-doped on Its Efficiency
Authors: Abass Khalid Haneen , Adil Anmar , Alrubaie Ali Jawad , Rabee Bahaa H. , Kadim Ashraq Mohammed , Talib Suhair Hussein , Mohammed Kahtan A. , Jassim Ali Saeed
Published: December 2022

Tin sulfide (SnS) is a promising material for solar cell absorber layer applications due to its low cost, ease of availability and lower toxicity than other semiconductor materials, used for the same purpose. Thermal evaporation was used to deposit thin-film solar cells with SnS on glass and silicon substrates, with minimal silver doping ratios (0.02, 0.04 and 0.06) wt.% and thickness in the 125-nm range. Surface morphology, crystallite size and optical and electrical characteristics have all been thoroughly investigated. XRD analysis revealed that /both the undoped and Ag-doped SnS films were well crystallized, with an orthorhombic structure and polycrystalline nature. The (111) plane was the preferred orientation. Due to the low doping ratios, there are no silver-specific peaks. Additionally, the Scherer formula was used to calculate the crystallite size, which showed an increase from 3.7096 to 10.4716[Formula: see text]nm. AFM images showed that SnS: Ag (6[Formula: see text]wt.%) film has bigger grains than other samples. The Hall Effect test revealed that the film is p-type conductivity. The optical bandgap values were found to be in the (2.6–1.7[Formula: see text]eV) range. All of the SnS films had an absorption coefficient of more than [Formula: see text] above the fundamental absorption edge. These polycrystalline and highly absorbing SnS thin films can be used to make heterojunction solar cells. The wider energy gap of the produced films, which allows more light to reach the solar cell junction, was found to be connected to changes in thin film microstructure characteristics. The efficiency of the prepared solar cells reached 5.4% for the 6[Formula: see text]wt.%Ag-doped SnS/Si solar cell, with a fill factor of 0.46.
The Effect of Atomization Force on the Structural Properties of NiTi Thin Films
Authors: Thabit Worod Sobhi , Al-Rawi Bilal K.
Published: December 2022

A study using a pulsed laser deposition (PLD) technique was accomplished by growing NiTi nanoparticles on glass and stainless steel 316L substrates. The effects of laser energy state of deposition on the granule size of the NiTi nanoparticle and the structural properties of its thin film were discussed. X-ray diffraction analyses revealed that the films prepared at 65[Formula: see text]W, 75[Formula: see text]W, 85[Formula: see text]W, 100[Formula: see text]W exhibited amorphous structures. AFM results confirmed that the thin films consist of evenly distributed spherical particles. The results also showed an exponential increase in those particles’ sizes.
Facile Hydrothermal Synthesis of Prussian Blue Films Using Hydrobromic Acid and their Electrochromic Properties
Authors: Liu Zhiyuan , Li Xiaoying , Yang Mingqing , Zhang Shiyu , Wang Lei , Niu Chunhui , Lv Yong
Published: December 2022

Prussian Blue (PB) films were directly grown on FTO glass by a hydrothermal method only using potassium ferricyanide and hydrobromic acid as raw reagents. Hydrobromic acid plays the role of both providing acidic conditions and as a reducing agent which improves the atomic utilization of the raw materials. The as-prepared PB devices exhibited multicolor electrochromic properties: Blue, green and transparent states, reversibly. The maximum optical modulations of PB device could reach the range of 47.7%. The PB films also have a fast coloration/bleaching time of 1.9/1.3[Formula: see text]s, respectively. This study provided a novel method for preparing PB films by a facile hydrothermal method.
In silico de novo drug design of a therapeutic peptide inhibitor against UBE2C in breast cancer
Authors: Añonuevo Andrea Mae , Gomez Marineil , Tayo Lemmuel L.
Published: December 2022

The World Health Organization (WHO) declared breast cancer (BC) as the most prevalent cancer in the world. With its prevalence and severity, there have been several breakthroughs in developing treatments for the disease. Targeted therapy treatments limit the damage done to healthy tissues. These targeted therapies are especially potent for luminal and HER-2 positive type breast cancer. However, for triple negative breast cancer (TNBC), the lack of defining biomarkers makes it hard to approach with targeted therapy methods. Protein–protein interactions (PPIs) have been studied as possible targets for drug action. However, small molecule drugs are not able to cover the entirety of the PPI binding interface. Peptides were found to be more suited to the large or flat PPI surfaces, in addition to their better pharmacokinetic properties. In this study, computational methods was used in order to verify whether peptide drug inhibitors are good drug candidates against the ubiquitin protein, UBE2C by conducting docking, MD and MMPBSA analyses. Results show that while the lead peptide, T20-M shows good potential as a peptide drug, its binding affinity towards UBE2C is not enough to overcome the natural UBE2C–ANAPC2 interaction. Further studies on modification of T20-M and the analysis of other peptide leads are recommended.
A Constitutive Model for Mechanical Behaviors of Novel Double Network Hydrogels with Mechanophores
Authors: Sun Peng , Hu Tianyu , Dai Lu , Xiao Rui
Published: December 2022

Double network hydrogels (DN hydrogels) with high stretchability and toughness have attracted broad research interest. Recently, a kind of novel tough DN hydrogels was designed by means of the reactive strand extension strategy, which introduced mechanophores into the first network. When the strands of the first network reach their nominal stretching limit, the mechanophores allow the strands to survive through force-coupled reactions instead of fracture. As a consequence, the novel hydrogels can achieve a better mechanical performance compared with the conventional DN hydrogels. In this work, we aim to develop a constitutive model for the novel DN hydrogels. The model is based on the worm-like single-chain model by introducing bond deformation. The network alteration theory is used to account for the damage behaviors. The theoretical framework is capable of clarifying the difference in mechanical behaviors between conventional and novel DN hydrogels, which demonstrates the importance of bond deformation on the mechanical behaviors of DN hydrogels.
A graphical user interface (GUI) for model-based radiation-induced acoustic computed tomography
Authors: Simon Michelle , Pandey Prabodh Kumar , Sun Leshan , Xiang Liangzhong
Published: December 2022

Radiation-induced acoustic computed tomography (RACT) is an evolving biomedical imaging modality that aims to reconstruct the radiation energy deposition in tissues. Traditional back-projection (BP) reconstructions carry noisy and limited-view artifacts. Model-based algorithms have been demonstrated to overcome the drawbacks of BPs. However, model-based algorithms are relatively more complex to develop and computationally demanding. Furthermore, while a plethora of novel algorithms has been developed over the past decade, most of these algorithms are either not accessible, readily available, or hard to implement for researchers who are not well versed in programming. We developed a user-friendly MATLAB-based graphical user interface (GUI; RACT2D) that facilitates back-projection and model-based image reconstructions for two-dimensional RACT problems. We included numerical and experimental X-ray-induced acoustic datasets to demonstrate the capabilities of the GUI. The developed algorithms support parallel computing for evaluating reconstructions using the cores of the computer, thus further accelerating the reconstruction speed. We also share the MATLAB-based codes for evaluating RACT reconstructions, which users with MATLAB programming expertise can further modify to suit their needs. The shared GUI and codes can be of interest to researchers across the globe and assist them in efficient evaluation of improved RACT reconstructions.
Vanishing theorems for complete Riemannian manifolds with weighted p-Poincaré inequality
Authors: Pham Duc Thoan , Nguyen Dang Tuyen , Tran Van Khien
Published: December 2022

In this paper, we give some vanishing theorems for harmonic [Formula: see text]-forms on complete noncompact Riemannian manifolds satisfying a weighted [Formula: see text]-Poincaré inequality under the pointwise curvature pinching conditions which are bounded from above by the weight function. In some of our results, the condition on scalar curvature is no longer required as in previous ones.
Research on abnormal event diagnosis method of complex product production based on digital twin
Authors: Wang Yunrui , Wang Yaodong , Wang Yao , Li Juan
Published: December 2022

Facing the challenges of production management of manufacturing enterprises and the demand for intelligent control of manufacturing system abnormalities, this paper proposes a production abnormal event diagnosis method based on digital twin technology to achieve intelligent tracing of the causes of production abnormal events and improve the problems of poor timeliness and lack of feedback mechanism for the diagnosis of production abnormal events of complex products. First, a complex product production abnormal event diagnosis model is constructed, in which physical production workshop, virtual production workshop, workshop twin data platform and abnormal event diagnosis service system work together. Second, the joint method of Bayesian network (BN) and C5.0 decision tree algorithm (C5.0) is used to achieve the diagnosis of production abnormal events. Finally, the feasibility and effectiveness of the scheme are verified by the arithmetic example of key stations in the bogie production workshop. The diagnostic accuracy of 92.49% of the BN–C5.0 model is higher than that of the conventional C5.0 decision tree model with 79.94% accuracy. The proposed method and mechanism provide a reference model for the application of digital twin to the diagnosis of abnormal production events.