bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the novelMCM8gene mutation: primary ovarian insufficiency and uterine hypoplasia in siblings
Authors: Mishra Rashmi , Kumar Naresh , Bargali Arun , Maich Grisha
Published: July 2024

This case report elucidates a scenario involving two sibling sisters born out of consanguineous marriage—one initially presenting with lower respiratory infection, concurrently exhibiting short stature and primary amenorrhoea. Investigation into the primary amenorrhoea unveiled hypergonadotropic hypogonadism, confirmed by the absence of ovaries and a hypoplastic uterus on pelvic MRI. Genetic analysis via whole exome sequencing identified a homozygous variant NM_001282717.2: c.808C>T in the MCM8 gene, located on exon 8 of chromosome 20, inherited in an autosomal recessive manner. The scarcity of primary ovarian insufficiency cases linked toMCM8highlights the necessity of thoroughly investigating the genetic and clinical consequences of such variants.
Neurological Wilson’s disease without hepatic involvement in an adolescent female
Authors: Kumar Naresh , Mishra Rashmi , Rohatgi Anurag , Bargali Arun
Published: July 2024

A female adolescent presented with a 9 month history of progressive involuntary movements, initially manifesting as finger tremors and evolving into flinging motions of the extremities, resulting in an inability to walk over the last 4 months. Concurrently, she developed dysarthria. Neurologically, she exhibited normal power, rigidity and brisk deep tendon reflexes, with a downgoing plantar reflex. Contrast-enhanced MRI revealed hyperintensity in bilateral caudate lobes, basal ganglia and pons, indicative of Wilson’s disease. Liver function tests and ultrasound were normal while Kayser–Fleischer rings were confirmed by slit lamp examination. Serum ceruloplasmin was low, 24-hour urine copper was elevated (125.5 mcg) and whole exome sequencing identified a heterozygous ATP7B mutation, confirming the diagnosis. Isolated neurological involvement without hepatic involvement is an extremely rare presentation and needs clinical expertise to delineate Wilson’s disease as a possible aetiology.
Congenital pyloric atresia associated with epidermolysis bullosa junctionalis: a novel lethal variant
Authors: Reddy M Sai Pratap , Anand Rohit , Padhi Phalguni , Katravath Shirisha
Published: July 2024

A term male baby was born vaginally to a primi mother. An antenatal ultrasound revealed polyhydramnios and a distended stomach in the baby. At birth, the baby had well-defined areas of peeling skin on the face and blisters on the forearm region. The abdominal X-ray revealed a single gastric bubble, which is consistent with pyloric atresia and needs surgery. Pyloroplasty was initially performed, but it was unsuccessful. Therefore, a feeding jejunostomy and gastrostomy were performed. However, the baby developed sepsis and septic shock and died at about 2 months of age. Skin biopsy revealed cleavage above the lamina densa, and genetic analysis indicated heterozygosity in ITGB4 exons 10 and 16, which are associated with epidermolysis bullosa junctionalis and pyloric atresia.
Intramuscular mesenchymal chondrosarcoma surrounded by a split fat sign mimicking a benign lesion
Authors: Starostin Dmitriy , Crompton Samuel , Fernando Malee , Kotnis Nikhil
Published: July 2024

Mesenchymal chondrosarcoma (MCS) is an aggressive malignant mesenchymal tumour of uncertain differentiation. This is rare, accounting for 2%–4% of chondrosarcomas. Its peak incidence is in the second and third decades, though it can occur at any age. These tumours show a widespread distribution, mainly in bone, but with approximately 40% affecting somatic soft tissue. We present a case of MCS arising within the soleus muscle. The lesion was surrounded by a split-fat sign/fatty rind which is a typical feature of peripheral nerve sheath tumours or other benign intramuscular tumours. However, percutaneous biopsy showed MCS. We highlight how perilesional fat is not exclusive to benign intramuscular lesions and, although much less common, can be associated with malignant lesions. This is, to the best of our knowledge, the first reported case of MCS presenting with a split-fat sign at MRI.
It’s about time to exercise: development of the Exercise Participation Explained in Relation to Time (EXPERT) model
Authors: Healy Sean , Patterson Freda , Biddle Stuart , Dumuid Dorothea , Glorieux Ignace , Olds Tim , Woods Catherine , Bauman Adrian E , Gába Aleš , Herring Matthew P , Kastelic Kaja , Lachapelle Ugo , Volpe Stella L , Benedičić Tomat Saška , Pedisic Zeljko
Published: July 2024

A perceived ‘lack of time’ is consistently the most commonly reported barrier to exercise. However, the term fails to capture the multifaceted nature of time-related factors. Recognising the need for a more comprehensive analysis of ‘lack of time’ as a barrier to exercise, the aim of this study was to develop the exercise participation explained in relation to time (EXPERT) model. The model was developed through a sequential process including (1) an umbrella literature review of time as a barrier, determinant, and correlate of physical activity; (2) a targeted review of existing temporal models; (3) drafting the model and refining it via discussions between eight authors; (4) a three-round Delphi process with eight panel members; and (5) consultations with seven experts and potential end-users. The final EXPERT model includes 31 factors within four categories: (1) temporal needs and preferences for exercise (ie, when and how long does an individual need/want to exercise), (2) temporal autonomy for exercise (ie, autonomy in scheduling free time for exercise), (3) temporal conditions for exercise (ie, available time for exercise) and (4) temporal dimensions of exercise (ie, use of time for exercise). Definitions, examples and possible survey questions are presented for each factor. The EXPERT model provides a comprehensive framework for understanding the multi-dimensional nature of ‘time’ as it relates to exercise participation. It moves beyond the simplistic notion of 'lack of time' and delves into the complexity of time allocation in the context of exercise. Empirical and cross-cultural validations of the model are warranted.
Communicating exploratory unsupervised machine learning analysis in age clustering for paediatric disease
Authors: Spear Joshua William , Pissaridou Eleni , Bowyer Stuart , Bryant William A , Key Daniel , Booth John , Spiridou Anastasia , Denaxas Spiros , Pope Rebecca , Taylor Andrew M , Hemingway Harry , Sebire Neil J
Published: July 2024

Background

Despite the increasing availability of electronic healthcare record (EHR) data and wide availability of plug-and-play machine learning (ML) Application Programming Interfaces, the adoption of data-driven decision-making within routine hospital workflows thus far, has remained limited. Through the lens of deriving clusters of diagnoses by age, this study investigated the type of ML analysis that can be performed using EHR data and how results could be communicated to lay stakeholders.

Methods

Observational EHR data from a tertiary paediatric hospital, containing 61 522 unique patients and 3315 unique ICD-10 diagnosis codes was used, after preprocessing. K-means clustering was applied to identify age distributions of patient diagnoses. The final model was selected using quantitative metrics and expert assessment of the clinical validity of the clusters. Additionally, uncertainty over preprocessing decisions was analysed.

Findings

Four age clusters of diseases were identified, broadly aligning to ages between: 0 and 1; 1 and 5; 5 and 13; 13 and 18. Diagnoses, within the clusters, aligned to existing knowledge regarding the propensity of presentation at different ages, and sequential clusters presented known disease progressions. The results validated similar methodologies within the literature. The impact of uncertainty induced by preprocessing decisions was large at the individual diagnoses but not at a population level. Strategies for mitigating, or communicating, this uncertainty were successfully demonstrated.

Conclusion

Unsupervised ML applied to EHR data identifies clinically relevant age distributions of diagnoses which can augment existing decision making. However, biases within healthcare datasets dramatically impact results if not appropriately mitigated or communicated.
Prevalence and factors associated with depression and anxiety among patients recovered from COVID-19: a cross-sectional study in a tertiary care hospital in Nepal
Authors: Rai Prasanna , Karmacharya Biraj Man , Gautam Kamal , Dhital Shalik Ram , Shrestha Shrinkhala , Paneru Bandana , Chaudhary Kalpana , Shrestha Akina
Published: July 2024

Introduction

COVID-19 has immensely affected the mental health of all people with prominent effects among the COVID-19 survivors who underwent hospitalisation. The evidence of the long-term mental health implications among the recovered COVID-19 patients remains unknown in Nepal. The study aimed to determine the prevalence of depression and anxiety and the associated factors among COVID-19 recovered patients.

Methods

An analytical cross-sectional study was conducted from May to August 2021 among 269 COVID-19 recovered patients admitted to Dhulikhel Hospital during the first wave (July 2020 to January 2021), and second wave (April 2021 to July 2021) of the COVID-19 pandemic. Anxiety and depression of the participants were assessed using the Hospital Anxiety and Depression Scale. Multivariate logistic regression analysis was performed to determine the factors associated with anxiety and depression.

Results

The prevalence of anxiety and depression were 38.66% (95% CI 32.99 to 44.65), and 30.48% (95% CI 25.24 to 36.28), respectively. Participants who received COVID-19 related information from the radio reported higher levels of anxiety and depression symptoms. Similarly, stigma, and being a health worker were significantly associated with a higher level of anxiety and depression symptoms, respectively. However, social support and long recovery duration were protective factors against anxiety and depression symptoms. Participants receiving a higher level of social support and having a recovery duration of 3–6 months, 7 months and more reported lower odds of anxiety and depression symptoms, respectively.

Conclusions

The greater prevalence of anxiety and depression symptoms among recovered COVID-19 patients highlights the need to design and implement appropriate mental health interventions. This could be done through psychosocial support and counselling services in health facilities, mental health service in emergency situation and post-discharge rehabilitation programmes.
Signs and symptoms of serious illness in infants aged up to 6 months: rapid review of clinical guidelines
Authors: Maramba Inocencio Daniel Cortes , Lim Emma , Menzies Julie Christine , Nijman Ruud , Zhou ShangMing , Latour Jos M
Published: July 2024

Background

There is a need to empower parents and carers of young infants to recognise signs of serious illness and to act on these appropriately. Compiling the signs and symptoms of serious illness in infants found in clinical guidelines will support the evidence-based update of the 30+-year-old content of the Baby Check App to empower parents and carers.

Objective

To systematically review clinical guidelines for signs and symptoms related to serious illness in infants aged 6 months and below.

Methods

A rapid review was carried out by searching PubMed, CINAHL, NICE, Cochrane and Embase for clinical guidelines reporting signs and symptoms of serious illness in young infants. The time period was restricted from 2018 to 2023. Only guidelines published in English were included.

Results

Fourteen clinical guidelines from 2307 retrieved articles were reviewed. Sixty signs and symptoms indicative of serious illness in infants were identified from the clinical guidelines. The guidelines originated from the UK (n=9, 65%), Italy (n=1, 7%), South Africa (n=1, 7%), Switzerland (n=1, 7%), USA (n=1, 7%), UK and USA (n=1, 7%). The 10 most frequent signs and symptoms were decreased consciousness, tachypnoea, looks seriously unwell to a health professional, high fever, central cyanosis, apnoea, seizures, frequent vomiting, non-blanching rash and noisy breathing.

Conclusions

Knowledge of the most frequently occurring signs and symptoms that were found in the reviewed guidelines will contribute to the update of the content of the Baby Check App. This will ensure that guidance for parents and carers is consistent with the current evidence base.
Effect of COVID-19 on paediatric TB service delivery and patients’ comfort receiving TB services in Cameroon and Kenya during COVID: a qualitative assessment
Authors: Mbunka Muhamed Awolu , Katirayi Leila , McCormick Samantha , Ndimbii James , Masaba Rose , Denoeud-Ndam Lise , Petnga Saint-Just , Ouma Millicent , Kuate Albert , Okomo Gordon , Simo Leonie , Yara Donald , Tiam Appolinaire , Tchounga Boris
Published: July 2024

Background

The outbreak of COVID-19 has caused a setback to the gains achieved in tuberculosis (TB) control by impairing TB diagnosis, delaying treatment initiation and aggravating TB deaths. This study explored the effect of COVID-19 on paediatric TB services provided through the Catalysing Paediatric TB Innovations (CaP-TB) project among caregivers of children receiving TB services and healthcare workers (HCWs) providing TB services in Cameroon and Kenya.

Methods

From March to September 2021, in-depth interviews (44) were conducted with caregivers whose children under 5 years had gone through TB services and programme managers (10) overseeing the CaP-TB project. Focus group discussions were conducted with HCWs (07) and community health workers (04) supporting TB care services. Transcripts were coded and analysed by using MAXQDA V.12.

Results

The COVID-19 pandemic has caused fear and anxiety among HCWs and caregivers. This fear was motivated by stigma related to COVID-19 and affected the ability to screen patients for TB due to the similarity of symptoms with COVID-19. The health-seeking behaviour of patients was affected, as many caregivers avoided hospitals and those accessing the facilities concealed their sickness due to fear of testing positive or being vaccinated. In addition, COVID-19 mitigation strategies implemented by both government and health facilities to curb the spread of the virus limited patient access to paediatric healthcare services. These included temporary closure of health facilities due to COVID-19 infections among staff, transfer of services to other spaces, spacing out patient appointments and reduced time spent with patients.

Conclusions

The outbreak of COVID-19 has induced fear and stigma that affected patients’ health-seeking behaviour and provider attitudes towards paediatric TB service delivery. In addition, facility and governmental measures put in place to mitigate COVID-19 impact negatively affected paediatric service delivery. Training for health personnel, timely provision of personal protective equipments and appropriate communication strategies could help mitigate COVID-19 impact on paediatric TB service delivery.
Real-world impact of ivacaftor in people with cystic fibrosis and select ivacaftor-responsive mutations
Authors: McKinnon Craig , Thorat Teja , Craft Alexander , Higgins Mark
Published: July 2024

Background

Ivacaftor approval was extended to people with cystic fibrosis (CF) with ≥1 of 28 additional ivacaftor-responsive mutations in the USA in 2017 based on preclinical in vitro data. This retrospective, observational study assessed real-world clinical response to ivacaftor in people with CF with ≥1 of these mutations, using data from the US Cystic Fibrosis Foundation Patient Registry.

Methods

Participants aged ≥2 years with ≥1 of 28 eligible mutations initiating ivacaftor between May 2017 and December 2018 were included. Clinical outcomes data were evaluated for ≤1 year before and ≤2 years after ivacaftor initiation. Participants initiating ivacaftor between May and December 2017 (2017 cohort) were used for the primary analysis because up to 2 years of post-ivacaftor-initiation data were available. Analyses were descriptive; key outcomes included percent predicted forced expiratory volume in 1 s (ppFEV1), body mass index (BMI) and BMI z-score, pulmonary exacerbations (PEx) and hospitalisations.

Results

The study included 1004 eligible participants. In the 2017 cohort (n=613), mean absolute change in ppFEV1from pre-ivacaftor initiation was 1.9 (95% CI 1.4, 2.4) and 1.8 (95% CI 1.0, 2.7) percentage points in years 1 and 2 post-ivacaftor initiation, respectively; mean absolute change in BMI was 0.6 (95% CI 0.5, 0.7) and 1.0 (95% CI 0.8, 1.2) kg/m2in years 1 and 2, respectively; BMI z-score was unchanged. Annualised event rates of PEx and hospitalisations per patient-year were lower with ivacaftor (0.24 (95% CI 0.21, 0.26) and 0.28 (95% CI 0.25, 0.31), respectively) compared with pre-ivacaftor initiation (0.41 (95% CI 0.37, 0.46) and 0.45 (95% CI 0.41, 0.49), respectively).

Conclusions

These real-world observational study findings support the effectiveness of ivacaftor in people with CF aged ≥2 years with selectedCFTRmutations.
Low household income increases risks for chronic obstructive pulmonary disease in young population: a nationwide retrospective cohort study in South Korea
Authors: Chung Chiwook , Lee Kyu Na , Shin Dong Wook , Lee Sei Won , Han Kyungdo
Published: July 2024

Background

Low socioeconomic status is a risk factor for chronic obstructive pulmonary disease (COPD); however, the association between low household income and COPD in young populations remains unclear.

Methods

We screened individuals aged 20–39 years who underwent the national health examination between 2009 and 2012 using the Korean National Health Information Database, which was searched until December 2019. We identified 5 965 366 eligible individuals, and 13 296 had newly developed COPD based on health insurance claims. We evaluated household income levels based on the health insurance premiums, categorised them into quartiles and ‘Medical aid’ (the lowest 3% income group), and assessed the annual income status from the preceding 4 years. Multivariate Cox proportional hazard models were used to estimate the adjusted HR (aHR) of risk factors for COPD.

Results

In the Medical aid group, the incidence rate for developing COPD was 0.56/1000 person-years, with an aHR of 2.45 (95% CI 1.91 to 3.13) compared with that of the highest income quartile group. This association was prominent in consecutive recipients of Medical aid (aHR 2.37, 95% CI 1.80 to 3.11) compared with those who had never been Medical aid beneficiaries. Those who experienced a decline in household income between the previous (preceding 4 years) and baseline time points had an increased risk of developing COPD, regardless of previous income status.

Conclusion

Low household income was associated with an increased risk of developing COPD in the young population. This risk was augmented by sustained low income and declining income status.
Combination of carvedilol with variceal band ligation in prevention of first variceal bleed in Child-Turcotte-Pugh B and C cirrhosis with high-risk oesophageal varices: the ‘CAVARLY TRIAL’
Authors: Tevethia Harsh Vardhan , Pande Apurva , Vijayaraghavan Rajan , Kumar Guresh , Sarin Shiv Kumar
Published: July 2024

Objectives

Beta-blockers and endoscopic variceal band ligation (VBL) have been preferred therapies for primary prophylaxis of variceal bleeding. However, the choice of therapy in patients with advanced liver disease with high-risk varices is not clear. A comparison of these therapies alone or in combination to prevent the first variceal bleed in advanced cirrhosis patients was carried out.

Design

330 Child-Turcotte-Pugh (CTP) B and C cirrhosis patients, with ‘high-risk’ varices were prospectively enrolled (n=110 per group) to receive carvedilol (group A), VBL (group B) or combination (group C). Primary endpoint was reduction in the incidence of first variceal bleed at 12 months. The secondary endpoints included overall mortality, bleed-related mortality, new-onset decompensation, change in hepatic vein pressure gradient (HVPG) and treatment-related adverse events.

Results

The patients were predominantly males (85.2%), aged 51.4±10.5 years with CTP score of 8.87±1.24, MELD score 15.17±3.35 and HVPG-16.96±3.57 mm Hg. The overall incidence of variceal bleed was 23.8% (n=78) at 1 year. Intention-to-treat analysis showed that the combination arm (group C) significantly reduced the incidence of first variceal bleed by 62.9% as compared with group B (HR 0.37, 95% CI 0.192 to 0.716, p<0.003) and by 69.3% as compared with group A (HR 0.31, 95% CI 0.163 to 0.578, <0.001). The overall mortality was 13.6% (45/330). The 1-year mortality in group C was lowest among the three groups (A, B, C=20%, 14.5%, 6.3%, p=0.012). Reduction in HVPG (20.8% vs 25.1%, p=0.54) and the rate of non-response to carvedilol (53.4% vs 41.25%, p=0.154) were not different between group A and C patients. The incidence of new-onset ascites, spontaneous bacterial peritonitis, shock, and acute kidney injury and postbleed organ failure was also comparable between the groups.

Conclusion

In CTP B and C cirrhosis patients with high-risk varices, combination of carvedilol and VBL is more effective than either therapy alone, for primary prevention of variceal bleeding.

Trial registration number

NCT03069339
.
Combined detection of SHOX2 and PTGER4 methylation with serum marker CYFRA21-1 for improved diagnosis of malignant pleural mesothelioma
Authors: Zhang Nana , Li Yongmeng , Sun Zuyu , Dong Yujie , Zhou Lijuan , Zhang Chen , Liu Zichen , Zhang Qiuyi , Li Kun , Xu Fudong , Zhang Li , She Bin , Ren Xiaosha , Che Nanying
Published: July 2024

Aims

To investigate the performance of a combined biomarker approach using the methylation status of the short stature homeobox 2 (SHOX2) and prostaglandin E2 receptor EP4 (PTGER4) genes, along with the serum levels of CYFRA21-1, for differential diganosis of malignant pleural mesothelioma (MPM) from benign reactive mesothelial hyperplasia (RMH).

Methods

We analysed 48 MPM tissue or pleural effusion cell block specimens and 42 cases with RMH. Real-time quantitative methylation-specific PCR was used to examine the methylation status ofSHOX2,PTGER4, ras association domain family 1 isoform A, septin 9 gene and homeobox gene A9 genes. Additionally, we employed electrochemiluminescence immunoassay to measure nine serum tumour markers commonly used in pan-cancer screening tests.

Results

The receiver operating curve indicated thatSHOX2,PTGER4gene methylation and serum biomarker CYFRA21-1 exhibited good diagnostic performance in identifying MPM, with area under curves (AUCs) of 0.761, 0.904 and 0.847, respectively. The combination ofSHOX2,PTGER4methylation and CYFRA21-1 yielded an AUC value of 0.972. The diagnostic sensitivity and specificity of this panel in differentiating MPM from RMH were 91.3% (42/46) and 97.6% (41/42), respectively. Both tissue and cell block specimens can be used in the diagnostic process. Furthermore, elevated CYFRA21-1 levels were associated with poor prognosis (p<0.05). Hypermethylation level ofPTGER4may indicate an unfavourable prognosis of MPM, but the difference was not statistically significant.

Conclusions

The combined detection ofSHOX2andPTGER4methylation alongside serum CYFRA21-1 level significantly enhances the diagnosis of MPM. Additionally, CYFRA21-1 can serve as a prognostic indicator for MPM.
Primary desmoplastic small round cell tumour of the prostate
Authors: Qian Jingyu , Yang Yanjin , Xie Xin , Kang Yifan , Zhong Jinjing , Chen Xueqin , Chen Ni , Zhou Qiao , Nie Ling
Published: July 2024

Desmoplastic small round cell tumour (DSRCT) is a highly aggressive soft-tissue sarcoma with distinctive morphological features and characteristicEWSR1::WT1gene fusion. DSRCT occurs in a variety of anatomic sites, with abdominal cavity being the most common location. Primary DSRCTs arising in the male genital system are exceedingly rare, with no documented definitive cases of primary DSRCT of the prostate to date, although 28 cases of DSRCT in the testicular or paratesticular regions have been reported. We here present two cases of primary DSRCT of the prostate. Both cases demonstrated the distinct morphology and the typical multiphenotypic immunohistochemical profile, and the characteristicEWSR1::WT1fusion verified by fluorescent in situ hybridisation. Our cases expand the anatomic distribution of primary DSRCT and highlight the importance of considering this rare tumour in the differential diagnoses of small cell malignancies of the prostate.
Response: arguments to abolish the legal age limits of access to information about the gamete donor by donor offspring
Authors: van Nistelrooij Inge , Woestenburg Nicolette
Published: July 2024

TheJournal of Medical Ethicspreviously published on the debate in the UK and the Netherlands concerning the legal age limits imposed on donor-conceived people for access to information about the identity of gamete and embryo donors. In that publication, three arguments were foregrounded against lowering these age limits as a general rule for all donor-conceived people. In this contribution, we engage with these arguments and argue why we think they are insufficient to maintain the age limits. In contrast, we argue for a more suited, contextual and relational ethical framework based on care ethics, which emphasises relational autonomy and its dynamic, contextual development. This framework, we argue, provides a comprehensive approach for the analysis we made of the question of age limits and was applied in research performed in the Netherlands, commissioned by the Dutch Minister of Health. The framework enabled us to weigh the multidisciplinary—legal, psychological, phenomenological and ethical—findings of our research.
Do men who have sex with men recognise syphilis symptoms? A syphilis awareness campaign in Amsterdam, the Netherlands
Authors: Nieuwenburg Silvia Achia , van Bijnen Arjan , Vermey Koenraad , Stam Arjen , Zuilhof Wim , Hoornenborg Elske , Schim van der Loeff Maarten Franciscus , de Vries Henry John Christiaan
Published: July 2024

Introduction

Syphilis incidence is rising among gay, bisexual and other men who have sex with men (GBMSM). To improve early health-seeking behaviour, we developed an online syphilis symptom score tool for GBMSM to self-identify a higher likelihood of infectious syphilis and promoted its use via an online and offline awareness campaign.

Methods

From October 2018 through September 2019, a dedicated website on syphilis including the online symptom score tool was promoted. The reach of the campaign was measured by website metrics and the completion of the self-assessment tool. The impact of the campaign was assessed by comparing the monthly number of syphilis serology tests and the percentages of infectious syphilis diagnoses at the Centre for Sexual Health (CSH) in Amsterdam between three periods: 12 months preceding, 12 months during and 6 months after the campaign.

Results

During the campaign, 20 341 visitors viewed the website. A total of 13 499 (66.4%) visitors started the self-assessment algorithm, and 11 626 (86.1%) completed it. Prior to the campaign, the mean number of syphilis tests per month was 1650 compared with 1806 per month during the campaign (p=0.02). In the 6 months after the campaign, the mean number of tests per month was 1798 (compared with the period of the campaign, p=0.94). Prior to the campaign, the percentage of infectious syphilis diagnoses was 2.5% compared with 3.0% during the campaign (p=0.009). The percentage of infectious syphilis diagnoses in the 6 months after the campaign was 2.2% (p<0.0001 compared with the period of the campaign, and p=0.045, compared with the period prior to the campaign).

Conclusions

Although we did not find definite proof of a (sustained) effect, syphilis symptoms awareness campaigns deserve further evaluation and improvements to help those suspected of syphilis to get tested.
Social, clinical and biological barriers to hepatitis B virus suppression with nucleos/tide analogue therapy: who is at risk and what should we do about it?
Authors: Im Yu Ri , Mohammed Khadija Said , Martyn Emily , Lumley Sheila , Ko Joy , Mokaya Jolynne , Flanagan Stuart , Matthews Philippa Clare
Published: July 2024

Optimising treatment outcomes for people living with hepatitis B virus (HBV) is key to advancing progress towards international targets for the elimination of viral hepatitis as a public health threat. Nucleos/tide analogue agents (most commonly tenofovir or entecavir) are well-tolerated and suppress viraemia effectively in the majority of those who are offered therapy. However, outcomes are not consistent, and we explore the factors that may contribute to incomplete therapeutic responses. We discuss situations in which therapy is not accessible, affordable or acceptable, reflecting the impact of social, cultural and economic barriers, stigma and discrimination, low awareness, poor access to health systems and comorbidity. These challenges are amplified in certain vulnerable populations, increasing the risk of adverse outcomes—which include liver cirrhosis and hepatocellular carcinoma—among people who already experience marginalisation and health inequities. We also tackle the physiological and biological mechanisms for incomplete virological suppression in individuals receiving HBV treatment, considering the possible impact of inadequate tissue drug levels, poor drug–target avidity and genomic resistance. These factors are interdependent, leading to a complex landscape in which socioeconomic challenges increase the challenge of consistent daily therapy and set the scene for selection of drug resistance. By putting a spotlight on this neglected topic, we aim to raise awareness, prompt dialogue, inform research and advocate for enhanced interventions. As criteria for HBV treatment eligibility relax, the population receiving therapy will expand, and there is a pressing need to optimise outcomes and close the equity gap.
Effect of thermal cycles on sand-concrete interface under constant shear stress
Authors: Rafai Mouadh , Tang Anh Minh , Badinier Thibault , De Sauvage Jean , Salciarini Diana
Published: July 2024

Energy geostructures provide a profitable solution for structural support as well as the heating and cooling of buildings. However, their activation can produce in structure and its surrounding soil thermally-induced stresses and strains with a crucial role played by the soil-structure interface which is the thin layer that transmits the thermal and mechanical loads. In the present work, the thermo-mechanical behaviour of the soil–structure interface is investigated using a temperature-controlled direct shear box. Tests were conducted on loose and dense sands in contact with a concrete plate representing the structure's surface. After applying the normal stress (25, 50, or 100 kPa), a shear stress was increased up to 45% of the shear strength. This stress state was then maintained while 20 cycles of temperature varying between 13 °C and 34 °C at the soil-concrete interface were applied. The obtained experimental results reveal that temperature cycles lead to irreversible cumulative displacements in both normal and shear directions. These displacements were found to be more significant in loose sand compared to dense sand. Additionally, under higher stress levels, greater displacements were observed for both soil densities.
Quantifying changes in floods under different bathymetry conditions for a lake setting
Authors: Tilano Sergio Andrés Redondo , Boucher Marie-Amélie , Lacey Jay , Parent Jérémy
Published: July 2024

Floods can cause extensive damage proportional to their magnitude, depending on the watershed hydrology and terrain characteristics. Flood studies generally assume bathymetry as steady, while in reality it is constantly changing due to sediment transport. This study seeks to quantify the impact of different lake bathymetry conditions on flood dynamics. The Hydrotel and Telemac2D models are used to simulate floods for a lake with bathymetries from multiple year surveys. The bathymetries differ in bed elevation due to sediment accumulation and/or remobilisation. Results show that bathymetric differences produce a more noticeable effect for moderate flows than for maximum flows. During moderate flows, shallower bathymetries induce higher water levels and larger water extents. For peak flows, differences in water levels and extent are practically negligible for the different bathymetries tested. Higher water levels during moderate flows could produce longer flooding times and affect the community’s perception of flood impacts.
High-resolution laboratory measurements of M-shell Fe EUV line emission using EBIT-I
Authors: Fairchild Alexander J. , Hell Natalie , Beiersdorfer Peter , Brown Gregory V. , Eckart Megan E. , Hahn Michael , Savin Daniel W.
Published: July 2024

Solar physicists routinely utilize observations of Ar-like Fe IX and Cl-like Fe X emission to study a variety of solar structures. However, unidentified lines exist in the Fe IX and Fe X spectra, greatly impeding the spectroscopic diagnostic potential of these ions. Here, we present measurements using the Lawrence Livermore National Laboratory EBIT-I electron beam ion trap in the wavelength range 238–258 Å. These studies enable us to unambiguously identify the charge state associated with each of the observed lines. This wavelength range is of particular interest because it contains the Fe IX density diagnostic line ratio 241.74 Å/244.91 Å, which is predicted to be one of the best density diagnostics of the solar corona, as well as the Fe X 257.26 Å magnetic-field-induced transition. We compare our measurements to the Fe IX and Fe X lines tabulated in CHIANTI v10.0.1, which is used for modeling the solar spectrum. In addition, we have measured previously unidentified Fe X lines that will need to be added to CHIANTI and other spectroscopic databases.

Graphical Abstract
Asymmetric Effects of Local and Global Variables on Domestic Food Prices in China: An Evidence from Quantile on Quantile Regression Technique
Authors: Chang Bisharat Hussain , K. Saxena Ashish , Privara Andrej , Uddin Mohammed Ahmar , Cruz Sebastian
Published: July 2024

The existing research investigates the impact of global and national variables on local food prices. This study adds to the current research by examining such impact at various quantiles, frequencies, and time periods. Utilizing data from January 2004 to June 2021, our research incorporates six global factors and three domestic factors as explanatory variables. Furthermore, this study employs cutting-edge econometric techniques such as Quantile-on-Quantile Regression (QQR), Wavelet Coherence (WC), and Granger Causality in Quantiles (GCQ). Similarly, this research utilizes the Quantile Regression (QR) method to assess the robustness of the results. Results based on the GCQ technique indicate that the association between the variables exists at most quantiles, except for the lowest, and middle quantiles for all variables. Moreover, the WC findings demonstrate a strong correlation between the determinants of local food prices and their occurrences at various moments and intervals. Likewise, QQR results indicate that the impact of independent variables on local food prices varies across quantiles. The QR technique also supports these results. Finally, our research suggests policy recommendations based on the findings of this study.
Tectono-thermal evolution from the proximal to hyperextended domains of the northern South China Sea margin since initial rifting
Authors: Li Gang , Mei Lianfu , Hu Jie , Tian Hongyu , Ye Qing , Zheng Jinyun
Published: July 2024

The Pearl River Mouth Basin (PRMB) is located on the northern margin of the South China Sea (SCS). Heat flow measurements indicate that the PRMB is a typical ‘hot basin' characterized by a high background heat flow. However, the tectono-thermal evolution of the PRMB and the mechanisms involved are still controversial due to the different input parameters used in tectono-thermal models, small datasets and the limited area of the basin studied. We used tectono-thermal modelling with a multi-stage finite stretching model, constrained by extensive well data, to systematically analyse the tectono-thermal evolution of the PRMB since the onset of rifting. The study area was expanded relative to previous studies to cover both the proximal and hyperextended regions of the northern SCS margin, providing a more comprehensive understanding of its tectono-thermal history. Numerous wells and seismic data covering the entire basin were used, along with appropriate input parameters, to address the gaps in previous studies and to enhance the accuracy of the results. Our findings indicate that the PRMB underwent two phases of heating, primarily due to thinning caused by lithospheric extension during rifting. By the end of rifting, the Northern Depression Zone and the Kaiping Sag had reached peak heat flow, while the Panyu Lower Uplift and Baiyun Sag saw their highest heat flow since the initial rifting. The PRMB experienced thermal decay during the post-rift stage, but a significant reheating event occurred from 23.03 to 13.82 Ma, likely due to northwards lower crustal flow from the Baiyun Sag. The Panyu Lower Uplift and the Baiyun Sag had reached their peak heat flow by 13.82 Ma and the heat flow generally increased by 1–3 mW m
−2
in the other studied areas during this stage. The basin's thermal decay slowed at 5.33 Ma and localized heating events linked to magmatic activities in the southern Dongsha Uplift were observed. In general, the proximal domain of the northern SCS margin reached peak heat flow by the end of rifting, whereas the hyperextended domain reached peak heat flow by 13.82 Ma. The heat flow in the hyperextended domain was generally higher than that in the proximal domain as a result of the thinner crust of the hyperextended domain caused by intense multiple lithospheric detachment–extensional thinning processes. During the rifting stage, the lithospheric extensional thinning process was the most important factor influencing the tectono-thermal evolution of the northern SCS margin, while lower crustal flow and magmatism were the most important factors during the post-rift stage.
Binary Iterative Hard Thresholding Converges with Optimal Number of Measurements for 1-Bit Compressed Sensing
Authors: Matsumoto Namiko , Mazumdar Arya
Published: July 2024

Compressed sensing
has been a very successful high-dimensional signal acquisition and recovery technique that relies on linear operations. However, the actual measurements of signals have to be quantized before storing or processing them. One-bit compressed sensing is a heavily quantized version of compressed sensing, where each linear measurement of a signal is reduced to just one bit: the sign of the measurement. Once enough of such measurements are collected, the recovery problem in one-bit compressed sensing aims to find the original signal with as much accuracy as possible. The recovery problem is related to the traditional “halfspace-learning” problem in learning theory.

   For recovery of sparse vectors, a popular reconstruction method from one-bit measurements is the
binary iterative hard thresholding (BIHT)
algorithm. The algorithm is a simple projected subgradient descent method and is known to converge well empirically, despite the nonconvexity of the problem. The convergence property of BIHT was not theoretically fully justified (e.g., it is known that a number of measurement greater than

\(\max \lbrace k^{10}, 24^{48}, k^{3.5}/\epsilon \rbrace\)

, where
k
is the sparsity and

\(\epsilon\)

denotes the approximation error, is sufficient, Friedlander et al. [2021]. In this article we show that the BIHT estimates converge to the original signal with only

\(\frac{k}{\epsilon }\)

measurements (up to logarithmic factors). Note that, this dependence on
k
and

\(\epsilon\)

is optimal for any recovery method in one-bit compressed sensing. With this result, to the best of our knowledge, BIHT is the only practical and efficient (polynomial time) algorithm that requires the optimal number of measurements in all parameters (both
k
and

\(\epsilon\)

). This is also an example of a gradient descent algorithm converging to the correct solution for a nonconvex problem under suitable structural conditions.
A Unified Framework for Analyzing Textual Context and Intent in Social Media
Authors: Prakash V. Jothi , Vijay S. Arul Antran
Published: July 2024

In the realm of natural language processing, tasks like emotion recognition, irony detection, hate speech detection, offensive language identification, and stance detection are pivotal for understanding user-generated content. While several task-specific and multitask learning models have been proposed, there remains a need for a unified framework that can effectively address these tasks simultaneously. This research introduces a novel unified framework designed to tackle multiple NLP tasks concurrently, aiming to outperform existing task-specific and multitask models in terms of accuracy, F1-score, and AUC-ROC. We compared our proposed framework against several baseline models, including task-specific models like SVM, RF, LSTM, CNN, and BERT, as well as multitask learning frameworks such as Hard Parameter Sharing, Soft Parameter Sharing, Cross-stitch Networks, MMoE, and T5. The performance was evaluated across various tasks, and statistical significance was assessed using the Wilcoxon signed-rank test. Additionally, an ablation study was conducted to determine the contribution of individual components within our proposed method. The proposed framework consistently outperformed other models across all tasks. For instance, in emotion recognition, our model achieved an accuracy of 0.899, F1-score of 0.883, and AUC-ROC of 0.971, surpassing all baseline models. The Wilcoxon signed-rank test further confirmed the statistical superiority of our model over the baselines across all datasets.
Impact of Unreliable Devices on Stability of Quantum Computations
Authors: Dasgupta Samudra , Humble Travis
Published: July 2024

Noisy intermediate-scale quantum (NISQ) devices are valuable platforms for testing the tenets of quantum computing, but these devices are susceptible to errors arising from de-coherence, leakage, cross-talk, and other sources of noise. This raises concerns regarding the stability of results when using NISQ devices since strategies for mitigating errors generally require well-characterized and stationary error models. Here, we quantify the reliability of NISQ devices by assessing the necessary conditions for generating stable results within a given tolerance. We use similarity metrics derived from device characterization data to derive and validate bounds on the stability of a 5-qubit implementation of the Bernstein-Vazirani algorithm. Simulation experiments conducted with noise data from IBM washington, spanning January 2022 to April 2023, revealed that the reliability metric fluctuated between 41% and 92%. This variation significantly surpasses the maximum allowable threshold of 2.2% needed for stable outcomes. Consequently, the device proved unreliable for consistently reproducing the statistical mean in the context of the Bernstein-Vazirani circuit.
FedRL: A Reinforcement Learning Federated Recommender System for Efficient Communication Using Reinforcement Selector and Hypernet Generator
Authors: Di Yicheng , Shi Hongjian , Ma Ruhui , Gao Honghao , Liu Yuan , Wang Weiyu
Published: July 2024

The field of recommender systems aims to predict users' latent interests by analyzing their preferences and behaviors. However, privacy concerns about user data collection lead to challenges such as incomplete initial information and data sparsity. Federated learning has emerged to address these privacy issues in recommender systems. However, federated recommender systems face heterogeneity among edge devices regarding data features and sample sizes. Moreover, differences in computational and storage capabilities introduce communication overhead and processing delays during parameter aggregation at the third-party server. This paper introduces a framework named A Reinforcement Learning Federated Recommender System for Efficient Communication Using Reinforcement Selector and Hypernet Generator (FedRL) to address the proposed issues. The Reinforcement Selector (RLS) dynamically selects participating edge devices and helps maximize their use of local data resources. Meanwhile, the Hypernet Generator (HNG) optimizes communication bandwidth consumption during the federated learning parameter transmission, enabling rapid deployment and updates of new model architectures or hyperparameters. Furthermore, the framework incorporates item attributes as content embeddings in edge devices' recommender models, enriching them with global information. Real-world dataset experiments demonstrate that the proposed solution balances recommender quality and communication efficiency. The code for this work is publicly available on GitHub:
https://github.com/diyicheng/FedRL
.
Electrochemical Kinetic Behaviors and Sensing Performance of Au@ZIF-8 and Ag@ZIF-8 Nanocomposites-Based Platforms Towards Ultrasensitive Detection of Chloramphenicol
Authors: Pham Tuyet Nhung , Tien Van Manh , Ong Van Hoang , Nguyen Le Nhat Trang , Linh Ho Thuy Nguyen , Tan Le Hoang Doan , Hoa Nguyen Quang , Tran Hoang Vinh , Ngo Xuan Dinh , Tran Quang Huy , Dinh Vu Lam , Le Anh-Tuan
Published: July 2024

Silver (Ag) and gold (Au) nanoparticles (NPs) are incorporated into the zeolitic imidazolate framework-8 (ZIF-8) host matrix, which is successfully coated the screen-printed electrodes (SPEs) for the effective detection of chloramphenicol (CAP). The morphological and structural characteristics are examined using scanning electron microscope (SEM) and X-ray diffraction (XRD) analysis. Additionally, the electrochemical characteristics and sensing performance of CAP on the proposed electrodes are investigated in detail using cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), chronoamperometry (CA), and differential pulse voltammetry (DPV) measurements, respectively. The results suggest the SPEs modified with Ag@ZIF-8 and Au@ZIF-8 exhibit impressive enhancements in sensitivity, linear concentration range, limits of detection (LODs), and repeatability. Under the optimum conditions, the proposed electrochemical sensors had a linear range of 0.25–50 μM for Ag@ZIF-8/SPE and 5–50 μM for Au@ZIF-8/SPE, corresponding to LODs of 0.16 and 0.404 μM, respectively. Notably, a series of kinetic parameters related to the redox reactions of both standard Fe(CN)6
3−/4− probe and CAP molecules in phosphate-buffered saline (PBS) buffer are determined. Furthermore, valuable insights into the influence mechanism nature of Ag@ZIF-8 and Au@ZIF-8 nanocomposites on the electrochemical behaviors are proposed, demonstrating the great potential of the developed sensors for CAP detection.