bluuebunny/crossref_metadata_2025 huggingface dataset:
Rice husk ash: Economical and high-quality natural-based reinforcing filler for linear low-density and high-density polyethylene
Authors: Nazarpour-Fard Hamed
Published: September 2022

Rice husk ash (RiHA) was employed as the bio-originated and inexpensive filler prepared from agricultural wastes for reinforcing high-density polyethylene (HDPE) and linear low-density polyethylene (LLDPE). X-ray fluorescence (XRF) spectroscopy showed ∼80.82% for the silica content of RiHA as well as the values of other components present in this bio-based filler. The composites were obtained via melt mixing followed by the compression molding by the hot press forming. Characterization of the composites by FT-IR spectroscopy revealed that the filler has the sheer effects on the vibrational bands of the polymers. The usage of X-ray diffraction (XRD) analysis to investigate the d-spacing values and the crystallinity of the samples, exhibited the increase of d-spacing upon reinforcing the polymers with RiHA. The scanning electron microscopy (SEM) images showed an average size of 32 µm for the irregular RiHA particles which uniformly dispersed in the polymeric matrices. The energy dispersive X-ray (EDX) analysis displayed C, O, and Si as the main constituting elements of the composites and alternatively confirmed the well dispersion of the filler particles into the polymer matrices. The mechanical measurements showed the significant improvements in Young’s modulus, yield stress, and hardness results of the polymers after reinforcing with the rice husk ash. For example, Young’s modulus of HDPE was increased ∼15% after incorporating 7 wt.% of RiHA into this polymer. These mechanical properties of the polymers were increased upon increasing the RiHA content, while the parameter of elongation at break was decreased.
Prevalence of refractive errors among school students in Ethiopia: A systematic review and meta-analysis
Authors: Sume Bickes Wube , Seyoum Girma
Published: September 2022

Objective:

Refractive errors are most common ocular disorders among children and adolescents. They remain as secondary causes of avoidable blindness in impoverished areas in Africa, most notably in Ethiopia. The problem worsens if it is not managed and addressed early. The aim of this systematic review and meta-analysis was to determine the prevalence of refractive errors among school students in Ethiopia.

Methods:

We searched international databases such as PubMed/Medline, Web of Science, CINAHL, Embase, Scopus, Cochrane Library, Google Scholar, and Science Direct for relevant articles. Data were extracted using Microsoft Excel and exported to Stata version 14.0 software for analysis. The Cochrane Q and I2 tests were used to assess heterogeneity. Funnel plot, Egger’s, and Begg’s tests were used to assess reporting bias. Random effect meta-analysis model was employed to estimate pooled prevalence of refractive errors. A regional subgroup analysis was carried out.

Results:

We reviewed 22 qualified studies with 23,355 study participants. The overall prevalence of refractive errors among school students was 7.36% (95% confidence interval = 6.05, 8.67). The prevalence of myopia, hyperopia, and astigmatism was 5.10% (95% confidence interval = 3.79, 6.40), 0.95% (95% confidence interval = 0.59, 1.31), and 0.01% (95% confidence interval = 0.01, 0.04), respectively. From subgroup analysis, the highest prevalence of refractive errors was reported in Amhara Region (9.18%, 95% confidence interval = 6.63, 11.74), followed by Southern Nations, Nationalities, and Peoples’ region (6.78%, 95% confidence interval = 4.65, 8.92) while the lowest prevalence of refractive errors was reported in Addis Ababa (3.93%, 95% confidence interval = 3.30, 4.56).

Conclusion:

In Ethiopia, the prevalence of refractive errors among school students is higher (7.36%) compared to what it was 5 years (7.05%) ago. Amhara Region has the highest prevalence of refractive errors among school students in Ethiopia with myopia being the most common type of refractive error.
Fetal and maternal outcome of higher-order multiple pregnancies in a tertiary hospital: A 5-year single-center observational study from Nigeria
Authors: Ogumu Emmanuel I , Anikwe Chidebe Christian , Okorochukwu Bartholomew C , Umeononihu Osita S , Nwokoye Basil I , Chigozie Okoroafor F , Ofojebe Chukwuemeka J , Lawani Lucky O
Published: September 2022

Objective:

The aim of this study was to determine the pattern and outcomes of higher-order multiple pregnancies in a tertiary hospital in Nigeria

Methods:

This is a retrospective review of all cases of higher-order multiple pregnancies that were managed between 1 January 2012 and 31 December 2016 in Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria. Data obtained were represented with frequency tables, percentages, bar charts, and odds ratio.

Results:

There were 22 higher-order multiple pregnancies over the study period and 12,002 deliveries, giving a higher-order multiple prevalence rate of 0.2%. Five of the mothers (four triplets and one quadruplet) had in vitro fertilization (0.4 per 1000 deliveries), while other mothers conceived naturally. Many of the women (12, 54.6%) were in the 30–34 years age group, and more than half (16, 72.7%) were multiparas. More than half of the neonates were delivered preterm (13, 59.1%). Being booked is associated with better neonatal outcomes although not significant (odds ratio = 3.06. 95% confidence interval: 0.55–16.83, p = 0.197). Anemia was common in the antepartum and postpartum periods. Half of the women (11, 50%) were delivered by elective cesarean section and 7 (31.8%) by emergency cesarean section (C/S), while 4 (18.2%) had a spontaneous vaginal delivery. The neonates had a mean birth weight of 2.14 ± 0.35 kg. Overall, 61 neonates (91.0%) were born alive and 6 (9.0%) suffered perinatal deaths, giving a perinatal mortality rate of 89.8 neonates per 1000 live births.

Conclusion:

Our study shows that higher-order multiple pregnancies are high-risk pregnancies that are associated with fetal and maternal complications. Anemia is the commonest complication seen in our study. The majority had preterm delivery. Proper antenatal care and close feto-maternal monitoring are important in reducing adverse outcomes associated with these pregnancies.
The components of the gaming consumption experience: From virtual realisation to real-world virtualisation
Authors: Trabelsi-Zoghlami Amira , Touzani Mourad , Abbes Molka , Charfi Ahmed Anis
Published: September 2022

Massively multiplayer online role-playing games (MMORPGs) attract consumers looking for fun, experiences, and challenges. This research adopts an integrative perspective to focus on the gaming experience and its major components. This research studies how gaming affects real life and how real life affects virtual experience. We use in-depth interviews, a netnographic study, and a three-year ethnographic immersion. The results provide an overview of gamers’ consumption experience, its major components, and their links. MMORPGs appear to be a complex experience where virtual and real-life continuously interrelate. Gaming as a virtual experience affects gamers’ real lives (virtual realisation), and gamers’ real lives affect how they experience the game (real-world virtualisation). A significant contribution of our study is to show that gaming is not a process with clear, separated chronological steps. Gaming is an experience where boundaries between virtual and real-life are not delimited and where the virtual and real-life are far from disjointed experiences.
A case of Schistosoma japonicum retroperitoneal pseudotumor diagnosed by cone-beam CT-guided coaxial biopsy system
Authors: Matsushita Shu , Hamamoto Shinichi , Morita Ryo , Shirano Michinori , Inoue Takeshi , Okuma Tomohisa , Manabe Takao
Published: September 2022

We report a rare case of retroperitoneal pseudotumor caused by Schistosoma japonicum that was diagnosed by computed tomography (CT) guided percutaneous biopsy in a 15-year-old Filipino male. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a mass lesion, including a mesenteric artery, in the right retroperitoneal space. His mother had a history of S. japonicum infection but his initial stool examination was negative. As schistosomiasis was suspected, cone-beam CT-guided biopsy was performed to enable transcatheter therapeutic arterial embolization to be performed immediately in the event of hemorrhage. Histopathological examination revealed schistosomal eggs. Cone-beam CT-guided technique with a coaxial biopsy system is a safe and accurate diagnostic procedure for S. japonicum retroperitoneal pseudotumor.
Learning Through a Pandemic: Youth Experiences With Remote Learning During the COVID-19 Pandemic
Authors: Nandlall Nadia , Hawke Lisa D. , Hayes Em , Darnay Karleigh , Daley Mardi , Relihan Jacqueline , Henderson Joanna
Published: September 2022

The objective of this paper was to examine the school-related experiences of youth during the COVID-19 pandemic. Participants represented both clinical and community youth aged 14 to 28 who were sampled as part of a larger study. Feedback from youth attending school during the pandemic was qualitatively examined and youth who planned to attend school prior to the pandemic and did ( n = 246) and youth who planned to attend but did not ( n = 28) were compared quantitatively. Youth appreciated the flexibility of online learning and some also reported experiencing a lack of support from their school and the need for instructor training on how to deliver virtual classes effectively. Future studies should examine what factors influence student engagement with virtual learning, what strategies could improve supports for student in their long-term career development, and the longitudinal experiences of youth who may have chosen not to go back to school due to the pandemic. This survey was conducted in Ontario, Canada. A more diverse sample collected outside of Ontario would improve generalizability. Qualitative data were based on survey responses and not interviews. Thus we were unable to discern the reasons youth decided to attend school, or not, during the COVID-19 pandemic.
COVID-19-Combating English with Chinese Characteristics in the CAT’s Translations
Authors: Li Ping , Tian Chuanmao
Published: September 2022

During the COVID-19 outbreak, the China Academy of Translation translated and officially released five groups of Key Words to Understand China: The Fight Against COVID-19 for daily precautions, policy publicity, and information dissemination. Based on the translations and relevant data from Chinese and English media, this study makes a tentative analysis of the linguistic, ideological, and cultural features of English used in the translations. The findings are that China English is outstanding with respect to translating some Chinese-specific words and expressions in the translations, which generally results from the method of literal rendering. It is suggested that literal translation and transliteration can be used more frequently in English texts related to big events in order to strengthen the Chinese characteristics of China English as a major variety of world Englishes.
The Effects of Expatriate’s Personality and Cross-cultural Competence on Social Capital, Cross-cultural Adjustment, and Performance: The Context of Foreign-Owned Multinational Firms
Authors: Qomariyah Alfiyatul , Nguyen Phuoc-Thien , Wu Wann-Yih , Tran-Chi Vinh-Long
Published: September 2022

Expatriation is still a challenging task, although the determinants of expatriate adjustment and performance have been evaluated extensively. This study aimed to empirically investigate the influence of the expatriates’ personality and cross-cultural competence on social capital, cross-cultural adjustment, and performance with expatriates from foreign-owned multination firms in Taiwan. This study integrated three perspectives to explain expatriate success and failure. The first perspective involves expatriate-related factors, including the Big Five personality traits, and the emotional intelligence (otherwise known as emotional quotient or EQ) of expatriates. The second perspective is cross-cultural competence factors, including cultural intelligence, cultural adaptability, and cultural empathy. The third perspective is the social capital of expatriates, which includes leader-member exchange (LMX), perceived organizational support (POS). Furthermore, this study incorporated these perspectives into antecedents and identified their individual and combined effects on expatriates’ cross-cultural adjustment and performance. The findings of this study may be helpful for human resource managers in managing their expatriates. The findings may also help academicians in exploring expatriate management.
A Unique Presentation of Amniotic Band Syndrome: A Newborn With a Tail
Authors: Brown Carla , Baber Megan , White Gwenevere
Published: September 2022

A 1-day-old late preterm, small-for-gestational-age female presented with a caudal appendage—a rare finding—and abnormalities in all 4 limbs most consistent with amniotic band syndrome. The caudal appendage was lateral to midline, measured 3 cm × 0.5 cm, and had no bony abnormalities or spinal cord tethering. Limb abnormalities consisted of brachydactyly, oligodactyly, and syndactyly. Renal and head ultrasounds and an echocardiogram were normal. Chromosomal microarray showed deletion of EPHA3, which is not associated with a known phenotype. The multidisciplinary approach of managing this infant with the rare finding of a caudal appendage and limb abnormalities is presented.
Pursuing equal pay for equal work: Gender diversity in management positions and the gender pay gap throughout the wage distribution
Authors: Santero-Sánchez Rosa , Núñez Belén Castro
Published: September 2022

Despite the massive incorporation of women into the labor market, equal pay for equal work remains a challenge. This article analyzes the influence of gender diversity in management positions on the gender wage gap (GWG) throughout the entire pay scale in Spain. The results show the existence of a GWG, particularly for wages below the average; though it decreases when female participation in management is higher. This is in line with the reduction of information asymmetry problems considered in statistical discrimination theories, which explain the barriers to promotion associated with dynamics at entry-level and low-qualified positions.

JEL CLASSIFICATION: C31, J31, J71, M14
Changes in the spatial differences of immigrants by country of birth’s income between 2008 and 2021 in South Korea
Authors: Kim Chanyong , Kim Donghyun
Published: September 2022

Immigrants play a new role in the spatial dynamics of residential segregation in South Korea. The featured graphic depicts changes in the geographical patterns of immigrant enclaves and the spatial segregation among four immigrant groups divided by the average per capita income of their birth countries from 2008 to 2021. Cartograms show that immigrants from advanced (Q1) economies concentrate in the center of Seoul, and enclaves formed by upper middle (Q2) economy-born groups are spatially isolated in the southwestern part of the Seoul Metropolitan Area. Immigrants from lower middle (Q3) and low-income (Q4) economies are more likely to reside in rural and industrial areas apart from Seoul Metropolitan Area. This study identifies that a deepening heterogeneity exists regarding the residential choice of immigrants, and socioeconomic backgrounds determine how each group will occupy specific places.
Factors influencing vertical urban development at the parcel scale: The case in Brisbane, Australia
Authors: Huang Yuanyuan , Lieske Scott N. , Liu Yan
Published: September 2022

Increasing urban density has become an important focus in mitigating the adverse impacts of urban sprawl. A common way to increase urban density is the development of multi-story residential housing, or vertical urban development (VUD). Compared to low-rise detached housing, VUD has been purported to be more effective in mitigating the adverse impact of urban sprawl. This paper examines factors influencing VUD through a case study of Brisbane, Australia. Three types of housing developments – low-rise detached houses, low-rise apartments, and medium- to high-rise apartments – are explored, with the latter two types classified as VUD. Building on the literature that suggests a range of environmental, socio-demographic, built environment, and planning regulations factors driving or constraining VUD, our study further explores how land parcel size and parcel change over time either through parcel amalgamation or subdivision as factors driving VUD. The findings show that parcel size and parcel amalgamation are key factors leading to VUD, particularly in the form of medium- to high-rise apartment development. On the other hand, land use upzoning alone does not appear to be sufficient to drive VUD. Our study enriches the understanding of the scale effects of land parcels and zoning regulation on vertical urban development, and contributes to parcel-based land use planning policies that are targeted at more intensive urban land use.
A method to derive small area estimates of linked commuting trips by mode from open source LODES and ACS data
Authors: Credit Kevin , Arnao Zander
Published: September 2022

This paper describes a fully customizable open source method to create linked origin-destination data on commuting flows by mode at the Census tract scale by combining LODES and ACS data from the US Census Bureau. With additional work, the method could be scaled to the entire US (with a small number of exceptions) for every year from 2002 to 2019. For demonstration purposes, the paper applies this method to 2015 commuting flows in Cook County, Illinois. At an aggregate scale, the results of this application show that commuting by all modes is dominated by travel to large regional employment centres. However, the pattern is more localised for the walking mode, and focused along corridors of mode-specific infrastructure investment for the cycling and transit modes, as might be expected. The auto and work from home modes demonstrate the most distributed pattern of travel, revealing more instances of commuting to regional sub-centres than the other modes.
Effectiveness of a Cluster Randomized Controlled Trial Involving Community-Based Intervention for Older Adults With Type 2 Diabetes Mellitus in Singapore
Authors: Seah Siang Joo , Harding Susana Concordo , Wang Jing , Aw Su , Lam Jocelin , Lim Raymond Boon Tar
Published: September 2022

Purpose:

The purpose of the study was to investigate the effectiveness of a community-based intervention on improving knowledge about diabetes, self-care behaviors, and glycemic control among older adults with type 2 diabetes mellitus (T2DM) in Singapore, a country in Asia with a high prevalence of diabetes.

Methods:

A 3-arm cluster randomized controlled trial involving community-dwelling older adults ages 55 to 99 with T2DM was conducted. Intervention group 1 and 2 participants received a 12-session intervention program designed to teach knowledge and practical skills in diabetes self-care with psychological techniques for behavioral change like problem solving, goal setting, and motivational interviewing. In addition, intervention group 2 participants received a glucometer and a supply of accessories each. The control group received routine care from their health care providers.

Results:

Compared to the control group, intervention group 2 reported an increase in medication adherence and self-monitoring of blood glucose (SMBG) at 3-month follow-up and increased knowledge about diabetes and self-care behavior in general diet control at 6-month follow-up.

Conclusions:

The community-based intervention should be extended to more older adults with T2DM in the community. Glucometers and accessories could be provided at subsidized rates or be made free contingent on older adults’ income status to overcome the barrier of performing SMBG.
Impacts of the COVID-19 Pandemic on Pediatric Type 1 Diabetes Management: A Qualitative Study
Authors: Ferguson Kacey , Moore Hailey , Kaidbey Jasmine H. , Khattak Shazmenna , Saeed Abbas , Cogen Fran R. , Streisand Randi , Sylvetsky Allison C.
Published: September 2022

Purpose:

The purpose of this study was to understand impacts of the coronavirus (COVID-19) pandemic on pediatric type 1 diabetes management.

Methods:

In-depth qualitative interviews were conducted with 15 parents of children (age 6-12 years) with type 1 diabetes. Parents responded to 8 open-ended questions about their experiences managing their children’s type 1 diabetes during the COVID-19 pandemic. All interviews were transcribed, coded, and analyzed using qualitative thematic methods.

Results:

Parents reported both positive and negative aspects of managing their children’s type 1 diabetes during the COVID-19 pandemic. Facilitators of diabetes management included spending more time together at home and enhanced convenience of telehealth appointments and online supply ordering. Parents also described difficulties managing their children’s type 1 diabetes during the COVID-19 pandemic, including a lack of structure in their child’s daily routine, which led to increases in sedentary behavior. Furthermore, they reported psychosocial challenges of type 1 diabetes management, which were exacerbated by the pandemic.

Conclusion:

While the COVID-19 pandemic was described as having overall positive impacts on pediatric type 1 diabetes management, efforts to support parents in increasing children’s physical activity and reducing screen time are needed, along with readily accessible mental health resources for both parents and their children with type 1 diabetes.
Persistent Mϋllerian duct syndrome presenting as bilateral cryptorchidism: a case report
Authors: Joshi Mahesh , Sahu Ramdayal , Dubey Prama , Barala Abhishek
Published: September 2022

Background

Persistent Mϋllerian duct syndrome is a rare condition marked by the presence of Mϋllerian duct derivatives (uterus and fallopian tubes) in males who are seemingly (phenotypically and karyotypically) normal. Diagnosis can be made with physical examination, radiological investigations and karyotyping. The management aims at preserving fertility and removing Mϋllerian duct structures.

Case presentation

We report a case of PMDS encountered in a patient presenting with bilateral non-palpable testes since birth who was treated with orchidopexy and removal of Mϋllerian duct structures.

Conclusion

A remote possibility of persistent Mϋllerian duct syndrome should be borne in mind while dealing with a case of undescended testes. If such an encounter occurs, orchidopexy with removal of Mullerian duct structures is the preferred management.
Genomic prediction with whole-genome sequence data in intensely selected pig lines
Authors: Ros-Freixedes Roger , Johnsson Martin , Whalen Andrew , Chen Ching-Yi , Valente Bruno D. , Herring William O. , Gorjanc Gregor , Hickey John M.
Published: September 2022

Background

Early simulations indicated that whole-genome sequence data (WGS) could improve the accuracy of genomic predictions within and across breeds. However, empirical results have been ambiguous so far. Large datasets that capture most of the genomic diversity in a population must be assembled so that allele substitution effects are estimated with high accuracy. The objectives of this study were to use a large pig dataset from seven intensely selected lines to assess the benefits of using WGS for genomic prediction compared to using commercial marker arrays and to identify scenarios in which WGS provides the largest advantage.

Methods

We sequenced 6931 individuals from seven commercial pig lines with different numerical sizes. Genotypes of 32.8 million variants were imputed for 396,100 individuals (17,224 to 104,661 per line). We used BayesR to perform genomic prediction for eight complex traits. Genomic predictions were performed using either data from a standard marker array or variants preselected from WGS based on association tests.

Results

The accuracies of genomic predictions based on preselected WGS variants were not robust across traits and lines and the improvements in prediction accuracy that we achieved so far with WGS compared to standard marker arrays were generally small. The most favourable results for WGS were obtained when the largest training sets were available and standard marker arrays were augmented with preselected variants with statistically significant associations to the trait. With this method and training sets of around 80k individuals, the accuracy of within-line genomic predictions was on average improved by 0.025. With multi-line training sets, improvements of 0.04 compared to marker arrays could be expected.

Conclusions

Our results showed that WGS has limited potential to improve the accuracy of genomic predictions compared to marker arrays in intensely selected pig lines. Thus, although we expect that larger improvements in accuracy from the use of WGS are possible with a combination of larger training sets and optimised pipelines for generating and analysing such datasets, the use of WGS in the current implementations of genomic prediction should be carefully evaluated against the cost of large-scale WGS data on a case-by-case basis.
Clinlabomics: leveraging clinical laboratory data by data mining strategies
Authors: Wen Xiaoxia , Leng Ping , Wang Jiasi , Yang Guishu , Zu Ruiling , Jia Xiaojiong , Zhang Kaijiong , Mengesha Birga Anteneh , Huang Jian , Wang Dongsheng , Luo Huaichao
Published: September 2022

The recent global focus on big data in medicine has been associated with the rise of artificial intelligence (AI) in diagnosis and decision-making following recent advances in computer technology. Up to now, AI has been applied to various aspects of medicine, including disease diagnosis, surveillance, treatment, predicting future risk, targeted interventions and understanding of the disease. There have been plenty of successful examples in medicine of using big data, such as radiology and pathology, ophthalmology cardiology and surgery. Combining medicine and AI has become a powerful tool to change health care, and even to change the nature of disease screening in clinical diagnosis. As all we know, clinical laboratories produce large amounts of testing data every day and the clinical laboratory data combined with AI may establish a new diagnosis and treatment has attracted wide attention. At present, a new concept of radiomics has been created for imaging data combined with AI, but a new definition of clinical laboratory data combined with AI has lacked so that many studies in this field cannot be accurately classified. Therefore, we propose a new concept of clinical laboratory omics (Clinlabomics) by combining clinical laboratory medicine and AI. Clinlabomics can use high-throughput methods to extract large amounts of feature data from blood, body fluids, secretions, excreta, and cast clinical laboratory test data. Then using the data statistics, machine learning, and other methods to read more undiscovered information. In this review, we have summarized the application of clinical laboratory data combined with AI in medical fields. Undeniable, the application of Clinlabomics is a method that can assist many fields of medicine but still requires further validation in a multi-center environment and laboratory.
Impact of adaptive filtering on power and false discovery rate in RNA-seq experiments
Authors: Zehetmayer Sonja , Posch Martin , Graf Alexandra
Published: September 2022

Background

In RNA-sequencing studies a large number of hypothesis tests are performed to compare the differential expression of genes between several conditions. Filtering has been proposed to remove candidate genes with a low expression level which may not be relevant and have little or no chance of showing a difference between conditions. This step may reduce the multiple testing burden and increase power.

Results

We show in a simulation study that filtering can lead to some increase in power for RNA-sequencing data, too aggressive filtering, however, can lead to a decline. No uniformly optimal filter in terms of power exists. Depending on the scenario different filters may be optimal. We propose an adaptive filtering strategy which selects one of several filters to maximise the number of rejections. No additional adjustment for multiplicity has to be included, but a rule has to be considered if the number of rejections is too small.

Conclusions

For a large range of simulation scenarios, the adaptive filter maximises the power while the simulated False Discovery Rate is bounded by the pre-defined significance level. Using the adaptive filter, it is not necessary to pre-specify a single individual filtering method optimised for a specific scenario.
The immune subtypes and landscape of sarcomas
Authors: Weng Weiwei , Yu Lin , Li Zhang , Tan Cong , Lv Jiaojie , Lao I. Weng , Hu Wenhuo , Deng Zhenzhong , Liu Zebing , Wang Jian , Xu Midie
Published: September 2022

Background

Considering the molecular heterogeneity of sarcomas and their immunologically quiet character, immunotherapy (e.g., immune checkpoint inhibitors) plays a viable role in only a subset of these tumors. This study aimed to determine the immune subtypes (IMSs) of sarcomas for selecting suitable patients from an extremely heterogeneous population.

Results

By performing consensus clustering analysis of the gene expression profiles of 538 patients with sarcomas in online databases, we stratified sarcomas into three IMSs characterized by different immune cell features, tumor mutational burdens (TMBs), gene mutations, and clinical outcomes. IMS1 showed an immune “hot” and immunosuppressive phenotype, the highest frequencies of CSMD3 mutation but the lowest frequencies of HMCN1 and LAMA2 mutations; these patients had the worst progression-free survival (PFS). IMS2 was defined by a high TMB and more gene mutations, but had the lowest frequency of MND1 mutations. IMS3 displayed the highest MDN1 expression level and an immune “cold” phenotype, these patients had the worst PFS. Each subtype was associated with different expression levels of immunogenic cell death modulators and immune checkpoints. Moreover, we applied graph learning-based dimensionality reduction to the immune landscape and identified significant intra-cluster heterogeneity within each IMS. Finally, we developed and validated an immune gene signature with good prognostic performance.

Conclusions

Our results provide a conceptual framework for understanding the immunological heterogeneity of sarcomas. The identification of immune-related subtypes may facilitate optimal selection of sarcoma patients who will respond to appropriate therapeutic strategies.
Fine mapping of the gene controlling the weeping trait of Prunus persica and its uses for MAS in progenies
Authors: Wang Luwei , Pan Lei , Niu Liang , Cui Guochao , Wei Bin , Zeng Wenfang , Wang Zhiqiang , Lu Zhenhua
Published: September 2022

Background

Fruit tree yield and fruit quality are affected by the tree’s growth type, and branching angle is an important agronomic trait of fruit trees, which largely determines the crown structure. The weeping type of peach tree shows good ventilation and light transmission; therefore, it is commonly cultivated. However, there is no molecular marker closely linked with peach weeping traits for target gene screening and assisted breeding.

Results

First, we confirmed that the peach weeping trait is a recessive trait controlled by a single gene by constructing segregating populations. Based on BSA-seq, we mapped the gene controlling this trait within 159 kb of physical distance on chromosome 3. We found a 35 bp deletion in the candidate area in standard type, which was not lacking in weeping type. For histological assessments, different types of branches were sliced and examined, showing fiber bundles in the secondary xylem of ordinary branches but not in weeping branches.

Conclusions

This study established a molecular marker that is firmly linked to weeping trait. This marker can be used for the selection of parents in the breeding process and the early screening of hybrid offspring to shorten the breeding cycle. Moreover, we preliminary explored histological differences between growth types. These results lay the groundwork for a better understanding of the weeping growth habit of peach trees.
A photograph of the researcher on the invitation letter did not affect the participation rate of a postal survey: a randomized study within a trial (SWAT)
Authors: Prediger Barbara , Könsgen Nadja , Bora Ana-Mihaela , Schlimbach Anna , Pieper Dawid
Published: September 2022

Objective

Participant recruitment is one of the main challenges in research. It is suggested that including researcher photographs might increase participation rates, but empirical evidence is lacking. This study within a trial (SWAT) aims to assess whether invitation letters including researcher photographs increase the participation rate in the context of a survey on medical second opinions.

Methods

Through 25 local register offices in Berlin and Brandenburg (Germany), we identified a random sample of 9990 persons. We randomly assigned our sample to the intervention group (IG) receiving an invitation letter with researcher photographs and control group (CG) receiving an invitation letter without photographs in a 1:1 ratio. Our primary outcome was the participation rate. Furthermore, we compared participants to non-participants’ characteristics.

Results

Of 9990 invitations, 9797 could be delivered (IG: 4890, CG: 4907). Of these, 1349 (13.8%) participated. There were 682/4890 (13.9%) participants in the IG and 662/4907 (13.5%) in the CG with an odds ratio of 1.030 (95% confidence interval: 0.918–1.156). Additional analyses on non-participant characteristics did not show any differences.

Conclusion

We could not find any difference in the participation rates. Our study does not confirm the results of previous studies. The length of our questionnaire may have affected our results.

Trial registration

Queens University Belfast – SWAT Store, SWAT 104.
Evaluating sensitivity to classification uncertainty in latent subgroup effect analyses
Authors: Loh Wen Wei , Kim Jee-Seon
Published: September 2022

Background

Increasing attention is being given to assessing treatment effect heterogeneity among individuals belonging to qualitatively different latent subgroups. Inference routinely proceeds by first partitioning the individuals into subgroups, then estimating the subgroup-specific average treatment effects. However, because the subgroups are only latently associated with the observed variables, the actual individual subgroup memberships are rarely known with certainty in practice and thus have to be imputed. Ignoring the uncertainty in the imputed memberships precludes misclassification errors, potentially leading to biased results and incorrect conclusions.

Methods

We propose a strategy for assessing the sensitivity of inference to classification uncertainty when using such classify-analyze approaches for subgroup effect analyses. We exploit each individual’s typically nonzero predictive or posterior subgroup membership probabilities to gauge the stability of the resultant subgroup-specific average causal effects estimates over different, carefully selected subsets of the individuals. Because the membership probabilities are subject to sampling variability, we propose Monte Carlo confidence intervals that explicitly acknowledge the imprecision in the estimated subgroup memberships via perturbations using a parametric bootstrap. The proposal is widely applicable and avoids stringent causal or structural assumptions that existing bias-adjustment or bias-correction methods rely on.

Results

Using two different publicly available real-world datasets, we illustrate how the proposed strategy supplements existing latent subgroup effect analyses to shed light on the potential impact of classification uncertainty on inference. First, individuals are partitioned into latent subgroups based on their medical and health history. Then within each fixed latent subgroup, the average treatment effect is assessed using an augmented inverse propensity score weighted estimator. Finally, utilizing the proposed sensitivity analysis reveals different subgroup-specific effects that are mostly insensitive to potential misclassification.

Conclusions

Our proposed sensitivity analysis is straightforward to implement, provides both graphical and numerical summaries, and readily permits assessing the sensitivity of any machine learning-based causal effect estimator to classification uncertainty. We recommend making such sensitivity analyses more routine in latent subgroup effect analyses.
Development and pilot implementation of guidelines for culturally tailored research recruitment materials for African Americans and Latinos
Authors: Cunningham-Erves Jennifer , Kusnoor Sheila V. , Villalta-Gil Victoria , Stallings Sarah C. , Ichimura Jabari S. , Israel Tiffany L. , Harris Paul A. , Wilkins Consuelo H.
Published: September 2022

Background

Previous studies support cultural tailoring of recruitment materials as a strategy to promote the enrollment of minoritized groups in clinical trials. However, there is a lack of guidance for research teams to create culturally tailored materials, potentially contributing to low recruitment rates of minoritized groups. We describe the development and pilot testing of recruitment material guidelines used to culturally tailor clinical trial recruitment materials targeting African Americans and Latinos.

Methods

The guideline development team consisted of investigators, research staff, and community leaders and members experienced in the recruitment and community engagement of minoritized groups. The recruitment material guidelines were developed using the literature, focus groups with African Americans and Latinos, the teams’ research experience, and guidance from a community advisory board. To assess the effectiveness of the guidelines, a pilot study was conducted comparing advertisement click-through rates and enrollment outcomes between two institutions differing in use of culturally tailored versus non-tailored Facebook banner ads for the “Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-Term Effectiveness” (ADAPTABLE) study.

Results

Five themes emerged from focus groups: (1) employ diversity and inclusion in recruitment efforts; (2) access multiple recruitment channels to increase reach and possible participation; (3) increase your “footwork”; (4) personalize outreach and recruitment to specific groups’ beliefs and values; (5) align recruitment messaging with language preferences and motivations for study participation; and (6) specify incentives for participation. Guidelines were: 1) be inclusive; 2) use all forms of media; 3) take a personalized approach; 4) align recruitment messaging with motivations for study participation; 5) specify incentives; and 6) get out into the community. Additional guidelines were developed addressing specific considerations for images and language when targeting African American and Latino populations. Pilot study results demonstrated that clicks per impression ratio (0.47 clicks per impression vs. 0.03 clicks per impression) and the percentage of African American enrollment were significantly higher when using tailored compared to non-tailored ads (12.8% vs. 8.3%, respectively).

Conclusion

The recruitment material guidelines offer practical recommendations to reach diverse populations for clinical trial participation more effectively. Our preliminary data supports use of these guidelines as a strategy to enhance recruitment of minoritized groups into clinical research studies.
Strongyloides stercoralis hyperinfection syndrome mimicking pseudomembranous enteritis, complicated by Escherichia coli bacteremia and Pneumocystis jirovecii pneumonia in a patient after immunosuppressive therapy: a case report
Authors: Cai De-Han , Wang Jun , Fang Xiao-Lin
Published: September 2022

Background

Strongyloidiasis, caused by Strongyloides stercoralis (S. stercoralis), is endemic worldwide, especially in countries with warm and humid climates. Strongyloides stercoralis hyperinfection syndrome (SHS) is an extremely serious manifestation of strongyloidiasis, which results from an acute exacerbation of auto-infection and is often fatal.

Case presentation

We present a case of SHS mimicking pseudomembranous enteritis with a final definitive diagnosis of a triple infection including S. stercoralis, Escherchia coli (E. coli) and Pneumocytis jirovecii (P. jirovecii) that occurred in a microscopic polyangiitis (MPA) patient after immunosuppressive therapy. SHS, together with E. coli bacteremia and Pneumocytis jirovecii pneumonia (PJP) in the same patient, is rare in clinical practice, which is first reported worldwide, to our knowledge. After the diagnosis was confirmed, the treatment protocol was quickly adjusted; however, the patient’s life could not be saved.

Conclusion

This case reminds us of the necessity to consider strongyloidiasis as a differential diagnosis in immunocompromised populations who live in or have visited to S. stercoralis endemic areas, especially patients with suspected pseudomembranous enteritis, even if stool examination, serological tests, and eosinophilia are negative. For this group, it is advisable to complete the relevant endoscopy and/or PCR as soon as possible. The fundamental solution to prevent this catastrophic outcome is to implement effective preventive measures at multiple levels, including physicians, patients, and relevant authorities.
Reducing malaria transmission in forest-going mobile and migrant populations in Lao PDR and Cambodia: protocol for stepped-wedge cluster-randomised controlled trial
Authors: Htike Win , Oo Win Han , Lynn Thet , Sovanda Lun , Agius Paul A. , Oo May Chan , Galau Naw Hkawng , Thu Kaung Myat , Zaw Aung Khine , Htwe Ei Phyu , Cutts Julia C. , Kearney Ellen A. , Scott Nick , O’Flaherty Katherine , Wang Bangyuan , Khamlome Boualam , Vilay Phoutnalong , Siv Sovannaroth , Fowkes Freya J. I.
Published: September 2022

Background

Countries of the Greater Mekong Sub-region aim to achieve malaria elimination by 2030. In the region, malaria is concentrated in high-risk areas and populations such as forest-going mobile and migrant populations (MMPs). However, routine protective measures such as long-lasting insecticidal nets do not prevent all infectious bites in these high-risk populations. Evidence for the effectiveness of a personal protection package tailored to forest-going MMPs which is acceptable, feasible, and cost-effective for reducing malaria transmission is required to inform the malaria elimination toolkit in the region.

Methods

A personal protection package consisting of long-lasting insecticidal hammock net, insect repellent and health communication pamphlet was developed in consultation with relevant implementing partners from Cambodia and Lao PDR. An open stepped-wedge cluster-randomised controlled trial will be conducted over a period of 12 months in a minimum of 488 villages (~ 428 in Lao PDR and ~ 60 in Cambodia) to evaluate the effectiveness of the personal protection package. Villages will be randomised into 11 blocks, with blocks transitioned in random order from control to intervention states at monthly intervals, following a 1-month baseline period. The primary outcome of the trial is the prevalence of Plasmodium spp. infection diagnosed by rapid diagnostic test. Difference in prevalence of malaria infection will be estimated across intervention and control periods using generalized linear mixed modelling. Nested within the stepped-wedge cluster-randomised controlled trial is a mixed-methods study to explore the acceptability of the personal protection package, feasibility of implementing a personal protection package as a vector control intervention, and knowledge, attitude and practice of MMPs regarding malaria prevention; and cost-analysis to determine the cost-effectiveness of implementing a personal protection package.

Discussion

This study, using a rigorous design and mixed-methods methodology, will evaluate whether a personal protection package can reduce residual malaria transmission among forest-going MMPs in Cambodia and Lao PDR. It will also measure implementation research outcomes such as effectiveness of the intervention package, cost-effectiveness, acceptability, and feasibility, in order to inform potential national and regional policy.

Trial registration This trial was prospectively registered on ClinicalTrials.gov (NCT05117567) on 11th November 2021
Smoking status and SARS-CoV-2 infection severity among Lebanese adults: a cross-sectional study
Authors: Hoballah Abbas , El Haidari Rana , Badran Rima , Jaber Ali , Mansour Samir , Abou-Abbas Linda
Published: September 2022

Background

A paradoxical hypothesis about the effect of smoking on patients infected with severe acute respiratory syndrom 2 (SARS-CoV-2) infection still exists. Furthermore, gender-discrepancy in the impact of smoking on COVID-19 severity was given little attention. Thus, the aims of the present study were to evaluate the prevalence of smoking and the COVID-19 infection severity in a sample of adult patients diagnosed with COVID-19 and to explore the relationship between smoking status and SARS-CoV-2 infection severity in the overall sample and stratified by gender.

Methods

A retrospective analytical study was conducted on patients diagnosed with COVID-19 cases between December, 2020 and April, 2021 from three leading laboratories in Lebanon. Sociodemographic characteristics, smoking status and clinical symptoms were collected. Multinomial logistic regression analysis was used to explore the relationship between smoking status and SARS-CoV-2 infection severity.

Results

A total of 901 confirmed COVID-19 cases participated in the study, 50.8% were females. The mean age of patients was 38.4 years (SD = 15.3). Of the total sample, 521(57.8%) were current smokers. Regarding infection severity, 14.8% were asymptomatic, 69.9% had mild symptoms, while 15.3% had severe infection. In the overall sample, smoking status, smoking types and dose–response were not significantly associated with infection severity. Upon stratifying the entire sample by gender, no association was found between all the considered variables with infection severity among females. However, a significant association was found among male with mild infection compared to their asymptomatic counterparts (OR = 1.78 95% CI (1.01–3.13)). Waterpipe smoking was found to be associated with infection severity among male with mild infection (OR 2.64 (95% CI 1.32–5.27)) and severe infection 2.79, 95% CI (1.19–6.53) compared to their asymptomatic counterparts.

Conclusion

Our fundings highlight sex differences in the association between tobacco smoking and COVID-19 severity. Current tobacco smoking was not associated with SARS-CoV-2 infection severity among female patients, however, tobacco smoking, particularly waterpipe, was found to be associated with infection severity among male. Thus, the battle against smoking should continue by assisting smokers to successfully and permanently quit.