bluuebunny/crossref_metadata_2025 huggingface dataset:
Mean‐preserving rounding integer‐valued ARMA models
Authors: Weiß Christian H. , Zhu Fukang
Published: September 2024

In the past four decades, research on count time series has made significant progress, but research on ‐valued time series is relatively rare. Existing ‐valued models are mainly of autoregressive structure, where the use of the rounding operator is very natural. Because of the discontinuity of the rounding operator, the formulation of the corresponding model identifiability conditions and the computation of parameter estimators need special attention. It is also difficult to derive closed‐form formulae for crucial stochastic properties. We rediscover a stochastic rounding operator, referred to as mean‐preserving rounding, which overcomes the above drawbacks. Then, a novel class of ‐valued ARMA models based on the new operator is proposed, and the existence of stationary solutions of the models is established. Stochastic properties including closed‐form formulae for (conditional) moments, autocorrelation function, and conditional distributions are obtained. The advantages of our novel model class compared to existing ones are demonstrated. In particular, our model construction avoids identifiability issues such that maximum likelihood estimation is possible. A simulation study is provided, and the appealing performance of the new models is shown by several real‐world data sets.
The impact of a multifaceted program on fragile individuals. Evidence from an RCT in Italy
Authors: Del Boca Daniela , Pronzato Chiara
Published: September 2024

The increase in poverty rates among families and individuals in Italy over the past two decades can be attributed largely to repeated periods of economic crisis. Growing concern over the problem has driven interest in the role of policy in supporting household welfare. Responding to the currently limited access to (or provision of) public aid and assistance, private institutions and philanthropic foundations have stepped up their efforts to create new initiatives for alleviating poverty. In this paper, we use a randomized control trial (RCT) to evaluate the impact of a new Italian program aimed at supporting vulnerable individuals in four separate but related areas of household welfare: employment, financial circumstances, family responsibilities and housing conditions. The program, known as Integro, was introduced by the Compagnia di San Paolo, one of Italy's largest philanthropic institutions. Our findings indicate a positive and statistically significant impact of Integro on three of the four target outcomes considered, with only the fourth (housing conditions) not being affected. We also sought to identify any initial conditions potentially influencing the extent to which participants benefit from the program. Is Integro equally effective for everyone? According to our data, the program provides the best outcomes for males reporting lower human capital and greater socio‐emotional stability.
The Impact of YabG Mutations on Clostridioides difficile Spore Germination and Processing of Spore Substrates
Authors: Osborne Morgan S. , Brehm Joshua N. , Olivença Carmen , Cochran Alicia M. , Serrano Mónica , Henriques Adriano O. , Sorg Joseph A.
Published: September 2024

YabG is a sporulation‐specific protease that is conserved among sporulating bacteria. Clostridioides difficile YabG processes the cortex destined proteins preproSleC into proSleC and CspBA to CspB and CspA. YabG also affects synthesis of spore coat/exosporium proteins CotA and CdeM. In prior work that identified CspA as the co‐germinant receptor, mutations in yabG were found which altered the co‐germinants required to initiate spore germination. To understand how these mutations in the yabG locus contribute to C. difficile spore germination, we introduced these mutations into an isogenic background. Spores derived from C. difficile yabGC207A (a catalytically inactive allele), C. difficile yabGA46D, C. difficile yabGG37E, and C. difficile yabGP153L strains germinated in response to taurocholic acid alone. Recombinantly expressed and purified preproSleC incubated with E. coli lysate expressing wild type YabG resulted in the removal of the presequence from preproSleC. Interestingly, only YabGA46D showed any activity toward purified preproSleC. Mutation of the YabG processing site in preproSleC (R119A) led to YabG shifting its processing to R115 or R112. Finally, changes in yabG expression under the mutant promoters were analyzed using a SNAP‐tag and revealed expression differences at early and late stages of sporulation. Overall, our results support and expand upon the hypothesis that YabG is important for germination and spore assembly and, upon mutation of the processing site, can shift where it cleaves substrates.
A cross‐sectional study on phlebotomine sand flies in relation to disease transmission in the Republic of Kosovo
Authors: Xhekaj Betim , Hoxha Ina , Platzgummer Katharina , Stefanovska Jovana , Dvořák Vít , Milchram Markus , Obwaller Adelheid G. , Poeppl Wolfgang , Muja‐Bajraktari Nesade , Walochnik Julia , Trájer Attila J. , Sherifi Kurtesh , Cvetkovikj Aleksandar , Kniha Edwin
Published: September 2024

Sand flies (Diptera: Psychodidae: Phlebotominae) are blood‐feeding insects that transmit the protozoan parasites Leishmania spp. and various arboviruses. The Balkan region, including the Republic of Kosovo, harbours a diverse sand fly fauna. Vector species of Leishmania infantum as well as phleboviruses are endemic; however, recent data are scarce. We performed a cross‐sectional study to update the current sand fly distribution in Kosovo and assess biological as well as environmental factors associated with sand fly presence. CDC light trapping was conducted at 46 locations in 2022 and 2023, specifically targeting understudied regions in Kosovo. Individual morphological species identification was supported by molecular barcoding. The occurrence data of sand flies was used to create distribution maps and perform environmental analyses, taking elevation, wind speed and climate‐related factors into account. In addition, PCR‐based blood meal analysis and pathogen screening were conducted. Overall, 303 specimens of six sand fly species were trapped, predominated by Phlebotomus neglectus (97%). Barcodes from eight of nine known endemic sand fly species were obtained. Combining our data with previous surveys, we mapped the currently known sand fly distribution based on more than 4000 specimens at 177 data points, identifying Ph. neglectus and Ph. perfiliewi as the predominant species. Environmental analyses depicted two geographical groups of sand flies in Kosovo, with notable differences between the species. In total, 223 blood meals of five sand fly species were analysed. Of seven identified host species, the predominant blood meal source was observed to be cattle, but the DNA of dogs and humans, among others, was also detected. This study assessed biological as well as ecological factors of sand fly occurrence, which should help better understand and evaluate potential hot spots of disease transmission in Kosovo.
Navigating household food insecurity and environmental sustainability on a low income: An exploration of Sheffield mothers
Authors: Garratt Elisabeth A. , Jackson‐Taylor Christine
Published: September 2024

In 2023, 25% of adults in England, Wales and Northern Ireland experienced food insecurity. The concentration of food insecurity in both socioeconomically disadvantaged groups and households containing children raises concerns about its uneven nutritional and health impacts across different groups. In parallel with rising food insecurity over the past decade, concerns about the environmental consequences of human diets are intensifying, where urgent changes are needed to people's diets to avoid irreversible environmental damage. It is generally assumed that cost has a significant impact on people's ability to adopt more environmentally sustainable food practices. This UK Research Council‐funded project seeks to gain insights into the ways in which low‐income mothers (are able to) engage with environmentally sustainable food practices. RQ1 will examine the day‐to‐day food practices that mothers undertake for their families to offer insights into everyday food insecurity and the relevance of environmentally sustainable food practices. RQ2 will explore biographical experiences to highlight how mothers' life histories influence their familial food practices, including their current household food security and engagement with environmentally sustainable food practices. Finally, RQ3 will explore mothers' upcoming prospects of food insecurity and environmentally sustainable food practices. These research questions will be explored through a qualitative longitudinal, feminist study of 15 low‐income mothers in Sheffield, UK, combining in‐depth interviews with ethnographic elements. Gaining improved knowledge of mothers' food practices on a low income will be valuable to influence realistic, effective and meaningful philosophies, policies and practical action that prioritises equity, good nutrition and environmentally sustainable food practices.
Phenotypes, Genetics, and Estimated Prevalence of Focal Dermal Hypoplasia (Goltz Syndrome): A Single‐Center Report
Authors: Herlin Laura Krogh , Herlin Morten Krogh , Vinter Hanne , Blechingberg Jenny , Andersen Brian Nauheimer , Kruse Casper , Sommerlund Mette
Published: September 2024

Background

Focal dermal hypoplasia (FDH), also known as Goltz syndrome, is a rare ectodermal dysplasia that primarily affects the skin, skeleton, and eyes. It is an X‐linked dominant disorder, predominantly seen in females, caused by pathogenic variants in PORCN.

Methods

We characterized a case series of four genetically confirmed FDH patients (three females, one male) at Aarhus University Hospital, Denmark. We estimated the FDH prevalence from our local cohort and nationwide registry data.

Results

Three patients had characteristic dermatological findings suspicious for FDH and confirmed by targeted PORCN analysis. One patient had an atypical presentation with several malformations but only subtle skin changes and was diagnosed following trio exome‐sequencing analysis. Skin atrophy with fat herniations and telangiectasias were typical cutaneous findings. Limb malformations included oligodactyly (cleft foot), syndactyly, and polydactyly. Eye abnormalities included coloboma and microphthalmos. Facial dysmorphology was defined by asymmetry, thin upper lip, and malformed ears. One patient developed a giant cell bone tumor, which is a rare feature of FDH. Dental findings included enamel hypoplasia with vertical grooving and irregular crowns. Four PORCN variants were identified, including three not previously reported in the literature.We estimated a regional point prevalence in Western Denmark of 1.6 cases per million population (95% confidence intervals (CI): 0.7–3.7 per million) and a nationwide registry‐based point prevalence of 1.2 cases per million population (95% CI: 0.6–2.4 per million).

Conclusions

FDH is an extremely rare and complex multisystem disorder of variable presentation, which requires close multidisciplinary collaboration for diagnosis and patient care.
Lefschetz theorems in flat cohomology and applications
Authors: Cotner Sean , Zavyalov Bogdan
Published: September 2024

We prove a version of the Lefschetz hyperplane theorem for fppf cohomology with coefficients in any finite commutative group scheme over the ground field. As consequences, we establish new Lefschetz results for the Picard scheme.
The Matching Mechanism and Flow Mechanisms of Supersonic Through-Flow Variable-Pitch Tandem Cascade
Authors: Sheng Xiaoying , Lu Xingen , Li Ziliang , Wu Yunfeng , Yuan Hang , Yang Chengwu
Published: September 2024

The geometric structure of the supersonic through-flow variable-pitch tandem fan poses challenges in ensuring optimal relative blade positions across various operating modes. This study employed numerical simulations to investigate the impact of axial overlap and percent pitch on the aerodynamic performance of fan in typical modes. Furthermore, it delved into the intricate interplay between the front and rear blades, offering detailed insights into the selection principles governing the relative blade positions in the supersonic through-flow variable-pitch tandem fan. The findings underscored the pivotal role of percent pitch based on chord direction in fan's aerodynamic performance. Specifically, supersonic and transonic modes exhibited superior performance when chord direction percent pitch was set at 10% and 100%, respectively. The key factor contributing to these lower losses was the influence of low-speed fluid from the wake of the front blade, which weakened the shock boundary layer interaction on the rear blade's surface. In the high-speed windmilling mode, within the confines of geometric constraints, higher percent pitch based on chord direction values corresponded to reduced losses. This outcome was primarily attributable to the gap-blocking effect, which diminished the shock boundary layer interaction on the rear blade's pressure side and improved the wake of the rear blade. However, in this mode, the loss demonstrated a positive correlation with the pressure ratio. Consequently, the selection of the relative blade position required a delicate balance between the competing demands of these two factors.
Dependence of tropical cyclone seeds and climate sensitivity on tropical cloud response
Authors: Hsieh Tsung-Lin , Vecchi Gabriel A. , Wang Chenggong , Yang Wenchang , Zhang Bosong , Soden Brian J.
Published: September 2024

Projections of future tropical cyclone frequency are uncertain, ranging from a slight increase to a considerable decrease according to climate models. Estimation of how much the Earth’s surface temperature warms in response to greenhouse gas increase, quantified by effective climate sensitivity, is also uncertain. These two uncertainties have historically been studied independently as they concern different scales: One quantifies the extreme weather and the other the mean climate. Here, we show that these two uncertainties are not independent and are both influenced by the response of tropical clouds to warming. Across climate models, we show an anticorrelation between shortwave cloud radiative feedback and changes in the frequency of seed vortices, a prevalent type of tropical cyclone precursors. We further show an anticorrelation between effective climate sensitivity and tropical cyclone frequency changes, suggesting that global tropical cyclone frequency tends to decrease more substantially in models with larger temperature increase.
Easy-to-configure zero-dimensional valley-chiral modes in a graphene point junction
Authors: Davydov Konstantin , Zhang Xi , Ren Wei , Coles Matthew , Kline Logan , Zucker Bryan , Watanabe Kenji , Taniguchi Takashi , Wang Ke
Published: September 2024

The valley degree of freedom in two-dimensional (2D) materials can be manipulated for low-dissipation quantum electronics called valleytronics. At the boundary between two regions of bilayer graphene with different atomic or electrostatic configuration, valley-polarized current has been realized. However, the demanding fabrication and operation requirements limit device reproducibility and scalability toward more advanced valleytronics circuits. We demonstrate a device architecture of a point junction where a valley-chiral 0D PN junction is easily configured, switchable, and capable of carrying valley current with an estimated polarization of ~80%. This work provides a building block in manipulating valley quantum numbers and scalable valleytronics.
A spatially resolved single-cell lung atlas integrated with clinical and blood signatures distinguishes COVID-19 disease trajectories
Authors: Da Silva Filho João , Herder Vanessa , Gibbins Matthew P. , dos Reis Monique Freire , Melo Gisely Cardoso , Haley Michael J. , Judice Carla Cristina , Val Fernando Fonseca Almeida , Borba Mayla , Tavella Tatyana Almeida , de Sousa Sampaio Vanderson , Attipa Charalampos , McMonagle Fiona , Wright Derek , de Lacerda Marcus Vinicius Guimaraes , Costa Fabio Trindade Maranhão , Couper Kevin N. , Marcelo Monteiro Wuelton , de Lima Ferreira Luiz Carlos , Moxon Christopher Alan , Palmarini Massimo , Marti Matthias
Published: September 2024

COVID-19 is characterized by a broad range of symptoms and disease trajectories. Understanding the correlation between clinical biomarkers and lung pathology during acute COVID-19 is necessary to understand its diverse pathogenesis and inform more effective treatments. Here, we present an integrated analysis of longitudinal clinical parameters, peripheral blood markers, and lung pathology in 142 Brazilian patients hospitalized with COVID-19. We identified core clinical and peripheral blood signatures differentiating disease progression between patients who recovered from severe disease compared with those who succumbed to the disease. Signatures were heterogeneous among fatal cases yet clustered into two patient groups: “early death” (<15 days until death) and “late death” (>15 days). Progression to early death was characterized systemically and in lung histopathological samples by rapid endothelial and myeloid activation and the presence of thrombi associated with SARS-CoV-2
+
macrophages. In contrast, progression to late death was associated with fibrosis, apoptosis, and SARS-CoV-2
+
epithelial cells in postmortem lung tissue. In late death cases, cytotoxicity, interferon, and T helper 17 (T
H
17) signatures were only detectable in the peripheral blood after 2 weeks of hospitalization. Progression to recovery was associated with higher lymphocyte counts, T
H
2 responses, and anti-inflammatory–mediated responses. By integrating antemortem longitudinal blood signatures and spatial single-cell lung signatures from postmortem lung samples, we defined clinical parameters that could be used to help predict COVID-19 outcomes.
Transcriptomic characterization of recombinant
Clostridium beijerinckii
NCIMB 8052 expressing methylglyoxal synthase and glyoxal reductase from
Clostridium pasteurianum
ATCC 6013
Authors: Kumar Santosh , Agyeman-Duah Eric , Awaga-Cromwell Marian M. , Ujor Victor C.
Published: September 2024

Bioconversion of abundant lactose-replete whey permeate to value-added chemicals holds promise for valorization of this expanding food processing waste. Efficient conversion of whey permeate-borne lactose requires adroit microbial engineering to direct carbon to the desired chemical. An engineered strain of
Clostridium beijerinckii
NCIMB 8052 (
C. beijerinckii
_mgsA+mgR) that produces 87% more butanol on lactose than the control strain was assessed for global transcriptomic changes. The results revealed broadly contrasting gene expression patterns in
C. beijerinckii
_mgsA+mgR relative to the control strain. These were characterized by widespread decreases in the abundance of mRNAs of Fe-S proteins in
C. beijerinckii
_mgsA+mgR, coupled with increased differential expression of lactose uptake and catabolic genes, iron uptake genes, two-component signal transduction and motility genes, and genes involved in the biosynthesis of vitamins B
5
and B
12
, aromatic amino acids (particularly tryptophan), arginine, and pyrimidines. Conversely, the mRNA patterns suggest that the L-aspartate-dependent
de novo
biosynthesis of NAD as well as biosynthesis of lysine and asparagine and metabolism of glycine and threonine were likely down-regulated. Furthermore, genes involved in cysteine and methionine biosynthesis and metabolism, including cysteine desulfurase—a central player in Fe-S cluster biosynthesis—equally showed reductions in mRNA abundance. Genes involved in biosynthesis of capsular polysaccharides and stress response also showed reduced mRNA abundance in
C. beijerinckii
_mgsA+mgR. The results suggest that remodeling of cellular and metabolic networks in
C. beijerinckii
_mgsA+mgR to counter anticipated effects of methylglyoxal production from heterologous expression of methylglyoxal synthase led to enhanced growth and butanol production in
C. beijerinckii
_mgsA+mgR.

IMPORTANCE

Biological production of commodity chemicals from abundant waste streams such as whey permeate represents an opportunity for decarbonizing chemical production. Whey permeate remains a vastly underutilized feedstock for bioproduction purposes. Thus, enhanced understanding of the cellular and metabolic repertoires of lactose-mediated production of chemicals such as butanol promises to identify new targets that can be fine tuned in recombinant and native microbial strains to engender stronger coupling of whey permeate-borne lactose to value-added chemicals. Our results highlight new genetic targets for future engineering of
C. beijerinckii
for improved butanol production on lactose and ultimately in whey permeate.
Bruck syndrome in pregnancy
Authors: Manohar Shravya , Jakes Adam , Watt-Coote Ingrid , Khalil Asma
Published: September 2024

Bruck syndrome is a rare, autosomal-recessive condition associated with features of both arthrogryposis and osteogenesis imperfecta. It is characterised by congenital large joint contractures with pterygia and bone fragility, leading to fractures and deformities, along with a short stature caused by progressive skeletal deformities. There are fewer than 50 described cases of Bruck syndrome in the literature, with no reported cases in pregnancy. We describe a case of a successful pregnancy in a woman with Bruck syndrome.

In pregnant women with Bruck syndrome, we recommend a multidisciplinary approach including input from obstetric and fetal medicine specialists, midwives, anaesthetists, geneticists, occupational therapists and physiotherapists.
Evaluating the impact of malaria rapid diagnostic tests on patient-important outcomes in sub-Saharan Africa: a systematic review of study methods to guide effective implementation
Authors: Otieno Jenifer Akoth , Were Lisa Malesi , Sagam Caleb Kimutai , Kariuki Simon , Ochodo Eleanor
Published: September 2024

Objective

To perform critical methodological assessments on designs, outcomes, quality and implementation limitations of studies evaluating the impact of malaria rapid diagnostic tests (mRDTs) on patient-important outcomes in sub-Saharan Africa.

Design

A systematic review of study methods.

Data sources

MEDLINE, EMBASE, Cochrane Library, African Index Medicus and clinical trial registries were searched up to May 2022.

Eligibility criteria

Primary quantitative studies that compared mRDTs to alternative diagnostic tests for malaria on patient-important outcomes within sub-Sahara Africa.

Data extraction and synthesis

Studies were sought by an information specialist and two independent reviewers screened for eligible records and extracted data using a predesigned form using Covidence. Methodological quality was assessed using the National Institutes of Health tools. Descriptive statistics and thematic analysis guided by the Supporting the Use of Research Evidence framework were used for analysis. Findings were presented narratively, graphically and by quality ratings.

Results

Our search yielded 4717 studies, of which we included 24 quantitative studies; (15, 62.5%) experimental, (5, 20.8%) quasi-experimental and (4, 16.7%) observational studies. Most studies (17, 70.8%) were conducted within government-owned facilities. Of the 24 included studies, (21, 87.5%) measured the therapeutic impact of mRDTs. Prescription patterns were the most reported outcome (20, 83.3%). Only (13, 54.2%) of all studies reported statistically significant findings, in which (11, 45.8%) demonstrated mRDTs’ potential to reduce over-prescription of antimalarials. Most studies (17, 70.8%) were of good methodological quality; however, reporting sample size justification needs improvement. Implementation limitations reported were mostly about health system constraints, the unacceptability of the test by the patients and low trust among health providers.

Conclusion

Impact evaluations of mRDTs in sub-Saharan Africa are mostly randomised trials measuring mRDTs’ effect on therapeutic outcomes in real-life settings. Though their methodological quality remains good, process evaluations can be incorporated to assess how contextual concerns influence their interpretation and implementation.

PROSPERO registration number

CRD42018083816.
Resection versus biopsy in patients with glioblastoma (RESBIOP study): study protocol for an international multicentre prospective cohort study (ENCRAM 2202)
Authors: Gerritsen Jasper Kees Wim , Young Jacob S , Krieg Sandro M , Jungk Christine , Ille Sebastian , Schucht Philippe , Nahed Brian V , Broekman Marike Lianne Daphne , Berger Mitchel , De Vleeschouwer Steven , Vincent Arnaud J P E
Published: September 2024

Introduction

There are no guidelines or prospective studies defining the optimal surgical treatment for glioblastomas in older patients (≥70 years), for those with a limited functioning performance at presentation (Karnofsky Performance Scale ≤70) or for those with tumours in certain locations (midline, multifocal). Therefore, the decision between resection and biopsy is varied, among neurosurgeons internationally and at times even within an institution. This study aims to compare the effects of maximal tumour resection versus tissue biopsy on survival, functional, neurological and quality of life outcomes in these patient subgroups. Furthermore, it evaluates which modality would maximise the potential to undergo adjuvant treatment.

Methods and analysis

This study is an international, multicentre, prospective, two-arm cohort study of an observational nature. Consecutive patients with glioblastoma will be treated with resection or biopsy and matched with a 1:1 ratio. Primary endpoints are (1) overall survival and (2) proportion of patients that have received adjuvant treatment with chemotherapy and radiotherapy. Secondary endpoints are (1) proportion of patients with National Institute of Health Stroke Scale deterioration at 6 weeks, 3 months and 6 months after surgery; (2) progression-free survival (PFS); (3) quality of life at 6 weeks, 3 months and 6 months after surgery and (4) frequency and severity of serious adverse events. The total duration of the study is 5 years. Patient inclusion is 4 years; follow-up is 1 year.

Ethics and dissemination

The study has been approved by the Medical Ethics Committee (METC Zuid-West Holland/Erasmus Medical Center; MEC-2020-0812). The results will be published in peer-reviewed academic journals and disseminated to patient organisations and media.

Trial registration number

NCT06146725.
Ten years trajectories of estimated glomerular filtration rate (eGFR) in a multiethnic cohort of people with type 1 diabetes and preserved renal function
Authors: Ayis Salma , Mangelis Anastasios , Fountoulakis Nikolaos , Collins Julian , Alobaid Thamer S , Gnudi Luigi , Hopkins David , Vas Prashanth , Thomas Stephen , Goubar Aicha , Karalliedde Janaka
Published: September 2024

Objectives

We aim to evaluate estimated glomerular filtration rate (eGFR) patterns of progression in a multiethnic cohort of people with type I diabetes mellitus and with baseline eGFR ≥45 mL/min/1.73 m2.

Design

Observational cohort.

Setting

People with a clinical diagnosis of type 1 diabetes, attending two university hospital-based outpatient diabetes clinics, in South London between 2004 and 2018.

Participants

We studied 1495 participants (52% females, 81% white, 12% African-Caribbean and 7% others).

Primary and secondary outcome measures

Clinical measures including weight and height, systolic blood pressure, diastolic blood pressure and laboratory results (such as serum creatinine, urine albumin to creatinine ratio (ACR), HbA1c were collected from electronic health records (EHRs) and eGFR was estimated by the Chronic Kidney Disease–Epidemiology Collaboration. Ethnicity was self-reported.

Results

Five predominantly linear patterns/groups of eGFR trajectories were identified. Group I (8.5%) had a fast eGFR decline (>3 mL/min/1.73 m2year). Group II (23%) stable eGFR, group III (29.8%), groups IV (26.3%) and V (12.4%) have preserved eGFR with no significant fall. Group I had the highest proportion (27.6%) of African-Caribbeans. Significant differences between group I and the other groups were observed in age, gender, HbA1C, systolic and diastolic blood pressure, body mass index, cholesterol and urine ACR, p<0.05 for all. At 10 years of follow-up, 33% of group I had eGFR <30 and 16.5%<15 (mL/min/1.73 m2).

Conclusions

Distinct trajectories of eGFR were observed in people with type 1 diabetes. The group with the highest risk of eGFR decline had a greater proportion of African-Caribbeans compared with others and has higher prevalence of traditional modifiable risk factors for kidney disease.
Omission of sentinel lymph node biopsy in patients with clinically axillary lymph node-negative early breast cancer (OMSLNB): protocol for a prospective, non-inferiority, single-arm, phase II clinical trial in China
Authors: Li Xuan , Wang Lexin , Wang Yuanyuan , Ma Lingjun , Zheng Ran , Ding Jingjing , Gong Yichun , Yao Hao , Wang Jue , Zha Xiaoming
Published: September 2024

Introduction

Sentinel lymph node biopsy (SLNB) is a standard procedure for patients with clinically assessed negative axillary lymph nodes (cN0) during early-stage breast cancer (EBC). However, the majority of EBC patients have a negative pathological confirmation of the sentinel lymph node (SLN), and axillary surgery is inevitably associated with postoperative complications. Considering that SLNB has no therapeutic benefit, this trial aims to determine the safety of omitting SLNB in patients with cN0 early invasive breast cancer.

Methods and analysis

The OMSLNB trial is a prospective, single-arm, non-inferiority, phase II, open-label study design involving female breast cancer patients with a tumor of ≤3 cm in diameter, who are considered axillary lymph-node-negative based on two or more radiological examinations, including axillary lymph node ultrasonography. Eligible patients will avoid axillary surgery but will undergo breast surgery, which is not limited to breast-conserving surgery. The trial begins in 2023 and is scheduled to end in 2027. The primary endpoint is 3 year invasive disease-free survival (iDFS). The secondary endpoints include the incidence of breast cancer-related lymphoedema, patient-reported outcomes, locoregional recurrence, local recurrence and regional recurrence. It is expected that the 3 year iDFS in patients undergoing SLNB is about 90%, combined with a non-inferiority cut-off of 5%, 80% power, 95% CIs, 0.05 test level, and 10% loss to follow-up rate, the planned enrollment is 311 patients. All enrolled patients will be included in the intention-to-treat analysis.

Ethics and dissemination

This trial was approved by the Ethics Committee of the First Affiliated Hospital of Nanjing Medical University (No.2023-SR-193). All participants must provide written informed consent to be eligible. The protocol will be described in a peer-reviewed manuscript, and the results will be published in scientific journals and/or at academic conferences.

Trial registration number

NCT05935150.
Automatic retinal image analysis methods using colour fundus images for screening glaucomatous optic neuropathy
Authors: Shi Chuying , Lee Jack , Shi Di , Wang Gechun , Yuan Fei , Zee Benny Chung-Ying
Published: September 2024

Objectives

Train an automatic retinal image analysis (ARIA) method to screen glaucomatous optic neuropathy (GON) on non-mydriatic retinal images labelled with the additional results of optical coherence tomography (OCT) and assess different models for the GON classification.

Methods

All the images were obtained from the hospital for training and 10-fold cross-validation. Two methods were used to improve the classification performance: (1) using images labelled with the additional results of OCT as the reference standard and (2) generating models using retinal features from the entire images, the region of interest (ROI) of the optic disc, and the ROI of the macula, and the combination of all the features.

Results

Overall, we collected 1338 images with paired OCT scans. In 10-fold validation, ARIA achieved sensitivities of 92.2 %, 92.7% and 85.7%, specificities of 88.8%, 86.7% and 80.2% and accuracies of 90.6%, 89.9% and 83.1% using the retinal features from the entire images, the ROI of the optic disc and the ROI of the macula, respectively. We found the model combining all the features has the best classification performance and obtained a sensitivity of 92.5%, a specificity of 92.1% and an accuracy of 92.4%, which is significantly different from other models (p<0.001).

Conclusion

We used two methods to improve the classification performance and found the best model to detect glaucoma on colour fundus retinal images. It can become a cost-effective and relatively more accurate glaucoma screening tool than conventional methods.
Lifetime effects and cost-effectiveness of statin therapy for older people in the United Kingdom: a modelling study
Authors: Mihaylova Borislava , Wu Runguo , Zhou Junwen , Williams Claire , Schlackow Iryna , Emberson Jonathan , Reith Christina , Keech Anthony , Robson John , Parnell Richard , Armitage Jane , Gray Alastair , Simes John , Baigent Colin
Published: September 2024

Background

Cardiovascular disease (CVD) risk increases with age. Statins reduce cardiovascular risk but their effects are less certain at older ages. We assessed the long-term effects and cost-effectiveness of statin therapy for older people in the contemporary UK population using a recent meta-analysis of randomised evidence of statin effects in older people and a new validated CVD model.

Methods

The performance of the CVD microsimulation model, developed using the Cholesterol Treatment Trialists’ Collaboration (CTTC) and UK Biobank cohort, was assessed among participants ≥70 years old at (re)surveys in UK Biobank and the Whitehall II studies. The model projected participants’ cardiovascular risks, survival, quality-adjusted life years (QALYs) and healthcare costs (2021 UK£) with and without lifetime standard (35%–45% low-density lipoprotein cholesterol reduction) or higher intensity (≥45% reduction) statin therapy. CTTC individual participant data and other meta-analyses informed statins’ effects on cardiovascular risks, incident diabetes, myopathy and rhabdomyolysis. Sensitivity of findings to smaller CVD risk reductions and to hypothetical further adverse effects with statins were assessed.

Results

In categories of men and women ≥70 years old without (15,019) and with (5,103) prior CVD, lifetime use of a standard statin increased QALYs by 0.24–0.70 and a higher intensity statin by a further 0.04–0.13 QALYs per person. Statin therapies were cost-effective with an incremental cost per QALY gained below £3502/QALY for standard and below £11778/QALY for higher intensity therapy and with high probability of being cost-effective. In sensitivity analyses, statins remained cost-effective although with larger uncertainty in cost-effectiveness among older people without prior CVD.

Conclusions

Based on current evidence for the effects of statin therapy and modelling analysis, statin therapy improved health outcomes cost-effectively for men and women ≥70 years old.
Multi-objective optimization and simulation of earthwork equipment configuration in the upper reservoir of a pumped storage power station
Authors: Huang Lin , Zuo Shuangying , Yu Bo , Chen Shiwan
Published: September 2024

To find the optimal equipment configuration for the earthwork construction in the upper reservoir of pumped storage power stations, the discrete event simulation was combined with the multi-objective optimization to optimize the construction equipment configurations of the upper reservoir in this paper. According to the daily filling intensity, different types and numbers of equipment were combined and the daily construction time of various combinations was calculated through simulation. Then, the equipment costs and carbon emissions were calculated by a multi-objective model. Setting different weights for each objective to consider the decision preferences of decision-makers, the optimal equipment configuration of earthwork construction was obtained by the multi-objective decision. This optimization framework was applied to a reservoir engineering in karst depressions, the results show that different preferences have an impact on the decision of optimal schemes. At the same time, the obtained schemes show low average queuing trucks and road congestions, and a high utilization rate of the equipment.
Numerical simulation of pulsatile flow of tangent hyperbolic fluid in a diseased curved artery with electro-osmotic effects
Authors: Shabbir M. S. , Hussain M.
Published: September 2024

This paper presents a numerical solution to the problem of time-dependent blood flow via a w-shaped stenotic conduit, driven by pulsatile pressure gradient. The problem is formulated in cylindrical coordinates by employing the theoretical model of tangent hyperbolic fluid. The electro-osmotic effects are also taken into consideration. To simplify the non-dimensional governing equations of the flow problem, a mild stenosis assumption is utilized and the impact of the blood vessel wall is mitigated by employing a radial coordinate transformation. An explicit finite difference method is used to solve the resulting nonlinear system of differential equations, considering the auxiliary conditions specified at the boundary of the blood channel. After obtaining the numerical solution to the problem, an examination is carried out for various flow variables, such as axial velocity, temperature field, mass concentration, skin friction, Nusselt number, and Sherwood number. These results are presented graphically, and a concise explanation is provided using physical facts. An increase in flow rate and blood velocity leads to a rise in response, while an increase in stenosis height, Weissenberg number, and power-law exponent leads to a reverse response. Furthermore, the temperature field is significantly affected by the Brinkman number and the Prandtl number.
Analysis for peristaltic transport of MHD hybrid nanofluid with Darcy–Forchheimer porous medium
Authors: Hayat T. , Amjad S. , Nisar Z. , Alsaedi A.
Published: September 2024

Hybrid nanofluids can be designed to exhibit multiple functionalities, such as improved thermal conductivity, electrical conductivity, and magnetic properties. Magnetic hybrid nanofluids are gaining recognition in various mainstream applications, including heat transfer, solar systems, acoustic applications, and more. Further, hybrid nanofluids improve the thermal efficiency of radiators, efficiency of heating, ventilation, and air conditioning systems and drug delivery systems. Their notable advantage lies in their capacity to enhance the thermophysical properties of the constituent particles. Peristalsis of MHD hybrid nanomaterial [Formula: see text] in symmetric channel is emphasized. Darcy–Forchheimer law explores nonlinear nature of porous media. Effects of Joule heating and viscous dissipation are considered. The viscosity of fluid depends on temperature. The dimensionless system after invoking lubrication approach is analyzed numerically. Characteristics of prominent variables on the quantities under interest are examined. Comparative analysis of heat transfer rate of hybrid nanofluid and nanofluid are also discussed in detail. Heat transfer rate of system increases by increasing the quantity of nanomaterial in the fluid. Therefore, the temperature of the fluid decreases and the efficiency of the system increases.
Magnetic Behavior and Compensation Temperature in Sulflower-Like Nanostructures: A Monte Carlo Study
Authors: Kabouchi Doha , Fdil R. El , Sabbah Hussein , Fadil Z. , Husain Fohad Mabood , Kabouchi Bousselham , Salmani E. , Mhirech A. , Raorane Chaitany Jayprakash , Kim Seong Cheol
Published: September 2024

This study delves into the magnetic behavior of sulflower-like nanostructures, particularly focusing on compensation and blocking temperatures. Through the construction of a phase diagram detailing crystal and external magnetic fields (D/[Formula: see text], H/[Formula: see text], stable phases were identified, shedding light on how spin configurations evolve with variations in H/[Formula: see text] and D/[Formula: see text]. The analysis of blocking temperature ([Formula: see text]/[Formula: see text] and compensation temperature ([Formula: see text]/[Formula: see text] relative to [Formula: see text]/[Formula: see text], [Formula: see text]/[Formula: see text] and H/[Formula: see text] reveals intriguing patterns. Additionally, an examination of hysteresis cycles uncovers dynamic behavior, characterized by multiple loops and magnetization plateaus. These findings open promising avenues for spintronic applications of sulflower-like nanostructures, offering valuable insights into their magnetic behavior and potential utility in future technologies. This involves the fabrication of high-density data storage devices, where its tunable magnetic characteristics may result in the development of effective data manipulation and storage components.
Tail dependence, risk contagion and industry systemic risk: Based on method of Lasso-Expectile
Authors: Zhang Qianqian , Zhang Yue , Yang Wenhua , Wang Shu
Published: September 2024

Using third-level industry data of CSI 300, we introduce the Lasso approach into the high-dimensional CARE to model the tail dependence network among the financial sector and real sectors and measure the industry systemic risk. We find that the realized systemic risks between industries are affected by individual risk exposures and marginal systemic risk contributions. Real estate’s marginal systemic risk contribution is the highest in real sectors, and the financial sector’s integrated finance industry shows vital marginal systemic risk contribution and network centrality. Auto parts, construction materials, metals and mining, construction engineering, electrical equipment, and means of transportation in real sectors strongly correlate with other industries. The capital markets industry has a tail dependence with 20 different industries.
Designing Coins with Evolutionary Computation
Authors: Machado Penousal , Martins Tiago , Correia João , Santo Luís Espírito , Lourenço Nuno , Cunha João , Rebelo Sérgio , Martins Pedro , Bicker João
Published: September 2024

In recent years, the application of Artificial Intelligence (AI) for creative and artistic endeavours has attracted considerable attention, increasing the opportunities to use AI for many art and design tasks. This paper describes our response to a unique challenge presented by the Portuguese National Press-Mint (INCM): to use AI to design a commemorative coin that celebrates the "digital world". We explain the process of this coin's co-creation, from conceptualisation to production, highlighting the design process, key obstacles encountered, and technical innovations made to meet the challenge. These include developing an evolutionary art system guided by Contrastive Language-Image Pre-training (CLIP) and Machine Learning (ML)-based aesthetic models, a system for prompt evolution, and a representation for encoding genotypes in mintable format. This collaboration produced a limited edition 10 euro silver proof coin (Figure 1), with a total of 4,000 units minted by the National Press-Mint. The coin was met with enthusiasm, selling out within two months. This work contributes to Computational Creativity (CC), particularly co-creativity, co-design, and digital art, and represents a significant step in using AI for Numismatics.
Feedbacks Regulating the Salinization of Coastal Landscapes
Authors: Kirwan Matthew L. , Michael Holly A. , Gedan Keryn B. , Tully Katherine L. , Fagherazzi Sergio , McDowell Nate G. , Molino Grace D. , Pratt Dannielle , Reay William G. , Stotts Stephanie
Published: September 2024

The impact of saltwater intrusion on coastal forests and farmland is typically understood as sea-level-driven inundation of a static terrestrial landscape, where ecosystems neither adapt to nor influence saltwater intrusion. Yet recent observations of tree mortality and reduced crop yields have inspired new process-based research into the hydrologic, geomorphic, biotic, and anthropogenic mechanisms involved. We review several negative feedbacks that help stabilize ecosystems in the early stages of salinity stress (e.g., reduced water use and resource competition in surviving trees, soil accretion, and farmland management). However, processes that reduce salinity are often accompanied by increases in hypoxia and other changes that may amplify saltwater intrusion and vegetation shifts after a threshold is exceeded (e.g., subsidence following tree root mortality). This conceptual framework helps explain observed rates of vegetation change that are less than predicted for a static landscape while recognizing the inevitability of large-scale change.
Menstrual cycle phase differences in myofiber damage and macrophage infiltration following electrical stimulation-induced muscle injury
Authors: Pfeifer Brandon , King Briell , Ahmadi Mohadeseh , Kaluhiokalani Jamie P. , Shimizu Krista S. , Hunter W. Noah , Deshler Collin , Nielsen Madeline N. , Hancock Chad R. , Nelson W. Bradley , Hyldahl Robert D.
Published: September 2024

The menstrual cycle has widespread physiological effects across many systems, including skeletal muscle. In this study, we show that women in the late follicular phase of the menstrual cycle may be more susceptible to myofiber necrosis following electrical stimulation. We also show reduced evidence of inflammation in the late follicular phase. This is the first study to demonstrate a difference in the response of human skeletal muscle to a necrotic stimulus across a menstrual cycle.
Kinematic and neuromuscular characterization of cognitive involvement in gait control in healthy young adults
Authors: Lana Valentin , Frère Julien , Cabibel Vincent , Réguème Tristan , Lefèvre Nicolas , Vlamynck Elodie , Decker Leslie M.
Published: September 2024

The kinematic and neuromuscular signatures of cognitive involvement in gait control have rarely been studied jointly. We sought to address this issue using gait perturbation and dual-task paradigms. The protocol consisted of a fixed-speed treadmill walk to which visual and cognitive constraints were applied separately and together. The results revealed that young adults optimally regulated their gait to cope with these constraints by maintaining relatively stable muscle synergies and flexibly allocating attentional resources.
Neural encoding for spatial release from informational masking and its correlation with behavioral metrics
Authors: Li Jia-Ying , Wang Xing , Nie Shuai , Zhu Meng-Yuan , Liu Jia-Xing , Wei Lai , Li Huan , Wang Ning-Yu , Zhang Juan
Published: September 2024

The neural encoding of spatial release from masking (SRM) can be observed in normal-hearing young adults. Spatial separation between target and masker improves speech perception in noise and enhances central auditory processing. The behavioral results showed mild-to-moderate correlations with electrophysiological measures, with acoustic change complex (ACC) amplitude being a better indicator than onset components. Cortical auditory evoked potentials (CAEPs) may contribute to predictions about spatial release from masking, especially when behavioral tests are less reliable.