bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficient Mapping Between Void Shapes and Stress Fields Using Deep Convolutional Neural Networks With Sparse Data
Authors: Bhaduri Anindya , Ramachandra Nesar , Ravi Sandipp Krishnan , Luan Lele , Pandita Piyush , Balaprakash Prasanna , Anitescu Mihai , Sun Changjie , Wang Liping
Published: November 2023

Establishing fast and accurate structure-to-property relationships is an important component in the design and discovery of materials. Physics-based simulation models like the finite element method (FEM) are often used to predict deformation, stress, and strain fields as a function of material microstructure in material and structural systems. Such models may be computationally expensive and time intensive if the underlying physics of the system is complex. This limits their application to solve inverse design problems and identify structures that maximizes performance. In such scenarios, surrogate models are employed to make the forward mapping efficient. Still, the high dimensionality of the input microstructure and the output field of interest may render them inefficient, especially when dealing with sparse data. Deep convolutional neural network (CNN) based surrogate models have been typically found to be very useful in handling such high-dimensional problems. In this paper, the system under study is a single ellipsoidal void structure under a uniaxial tensile load represented by a linear elastic FEM model. We consider two deep CNN architectures, a modified Convolutional Autoencoder (CAE) framework with a fully connected bottleneck and a UNet Convolutional Neural Network (CNN), and compare their accuracy in predicting the Von Mises stress field for any given input void shape in the FEM model. A sensitivity analysis is also performed using the two methods, where the variation in the prediction accuracy on unseen test data is studied with the increasing number of training samples from 20 to 100.
Design and Tracking Control of a Large-Range Reluctance-Actuated Compliant Nano-Manipulator
Authors: Li Xuexuan , Liu Yijie , Zhang Zhen
Published: November 2023

A large-range and high-dynamic nano-manipulator system enables high-precision and high-throughput applications in manufacturing and measurement. Reluctance actuators, with their high force density and non-contact nature, are competitive for applications that require high precision and relatively large range. The successful application of reluctance actuators in single-axis compliant nano-manipulator and bi-axis compliant micro-manipulator motivates us to pursue a reluctance-actuated bi-axis compliant nano-manipulator. To address the nonlinearity caused primarily by varying motor constant and negative stiffness of the reluctance actuator, a lead compensation controller is employed to stabilize the closed-loop system. Additionally, a model-free adaptive iterative learning control (MFAILC) approach is adopted to reduce the tracking error along the iteration axis. The proposed reluctance-actuated bi-axis compliant nano-manipulator and MFAILC based controller are experimentally verified by the triangle and the spiral trajectories. When the reference is set as a 1 Hz triangle wave with amplitude of ±1 mm, the error is reduced to 66.1 nm. The results demonstrate that the manipulator is capable of achieving large-range and nanometric-precision trajectory tracking.
Numerical and Experimental Study on the Correlation Between Wear and Transmission Error of Carbon Fiber-Reinforced Polymer Gears Cured in Autoclave
Authors: Černe Borut , Vukašinović Nikola , Bergant Zoran , Zorko Damijan
Published: November 2023

This study presents a comprehensive investigation of the wear properties of carbon fiber reinforced polymer (CFRP) gears manufactured by an autoclave curing process. The composite gears were mated with a 42CrMo4 steel pinion and subjected to nominal tooth bending stresses between 60–150 MPa. Infrared cameras were used to monitor temperature in real time while wear rates were measured at regular intervals. Finite element analysis was performed to investigate the in-mesh contact and root stress behavior of the gears at various loads and running times. The results showed a significant deviation from the ideal meshing and stress conditions with increasing wear. In addition, the influence of the measured wear level on the path of contact and transmission error of the gear pair was studied in detail. Since the transmission error is a critical factor affecting the NVH performance of the gear pair, it is crucial to understand the potential influence of the deviations from the ideal gear meshing conditions caused by the gear wear on this phenomenon. The study has shown that while even small levels of wear have a significant impact on transmission error, the correlation between these two characteristics is generally not linearly proportional. Similarly, wear was found to influence the actual path of meshing contact very substantially.
Does active participation in a daily quiz (TOPday) improve long-term retention in biomechanics?
Authors: Eggermont Florieke , Munneke Moniek A. M. , Adriaens Vera , Fluit Cornelia R. M. G. , Kooloos Jan G. M. , Tanck Esther
Published: November 2023

A daily quiz on Newtonian biomechanics has previously been shown to improve student self-confidence, enthusiasm, and test results in biomechanics courses. This study investigated whether such a quiz could also improve retention of knowledge over a longer term. Our study found that students who participated very actively in daily quizzes scored significantly better on a retention test compared to those who participated less actively or not at all. From these results, we can conclude that very active participation in a daily quiz resulted in a slight gain in the long-term retention of biomechanics knowledge.
Nonlinear oscillator acceleration and period variation with amplitude
Authors: Hinrichsen Peter F.
Published: November 2023

A classic nonlinear spring mass oscillator, the nonlinearity of which could be varied by changing the initial stretching of the spring, was used to investigate how the amplitude dependence of the period and the harmonic content depended on the nonlinearity. The oscillations were measured with a photogate and a MEMS accelerometer, allowing both the oscillation period and the Fourier components of the motion to be precisely determined. The results were in good agreement with theory.
Comment on the article “A note on Newton's shell-point equivalency theorem” [Am. J. Phys. 90, 394 (2022)]
Authors: Carimalo Christian
Published: November 2023

When central forces follow a power law, Cameron Reed [Am. J. Phys. 90(5), 394–396 (2022)] showed that the resulting force on a test particle located outside an object with spherical symmetry is the same as if the source were located at the center of the sphere, if and only if the potential is either Newtonian, F ∝ r−2, or Hookean, F ∝ r. This Note shares another simple proof of this result and comments on the result in the light of the so-called transmutation law of central forces.
Enteric glia promote visceral hypersensitivity during inflammation through intercellular signaling with gut nociceptors
Authors: Morales-Soto Wilmarie , Gonzales Jacques , Jackson William F. , Gulbransen Brian D.
Published: November 2023

Inflammation in the intestines causes abdominal pain that is challenging to manage. The terminals of sensory neurons innervating the gut are surrounded by glia. Here, using a mouse model of acute colitis, we found that enteric glia contribute to visceral pain by secreting factors that sensitized sensory nerves innervating the gut in response to inflammation. Acute colitis induced a transient increase in the production of proinflammatory cytokines in the intestines of male and female mice. Of these, IL-1β was produced in part by glia and augmented the opening of the intercellular communication hemichannel connexin-43 in glia, which made normally innocuous stimuli painful in female mice. Chemogenetic glial activation paired with calcium imaging in nerve terminals demonstrated that glia sensitized gut-innervating nociceptors only under inflammatory conditions. This inflammatory, glial-driven visceral hypersensitivity involved an increased abundance of the enzyme COX-2 in glia, resulting in greater production and release of prostaglandin E
2
that activated EP
4
receptors on sensory nerve terminals. Blocking EP
4
receptors reduced nociceptor sensitivity in response to glial stimulation in tissue samples from colitis-model mice, and impairing glial connexin-43 reduced visceral hypersensitivity induced by IL-1β in female mice. The findings suggest that therapies targeting enteric glial–neuron signaling might alleviate visceral pain caused by inflammatory disorders.
Massive serous cyst adenoma with ovarian abscess causing fatal septicaemia
Authors: Tambawala Zenab Yusuf , Saquib Shabnam , Shinko Ikram Abdelaziz , Nagshabandi Zuhdi
Published: November 2023

Isolated unilateral ovarian tumour without obvious concomitant tubal pathology is unlikely to cause intrabdominal abscess or septicaemia. Benign serous cystadenoma is a fairly common ovarian tumour but rarely causes fatality. We present a patient in mid-30s with massive ovarian serous cystadenoma presenting with abscess and septicaemia, leading to mortality. To our knowledge, no previous serous cystadenoma causing abscess formation has been reported before.
Delayed identification of compound heterozygous (Phe508del/Arg117His) cystic fibrosis variants in a patient awaiting liver transplantation
Authors: Hu Mostin , McLellan Thomas , Grogono Dorothy , Karia Sumit , Herre Jurgen
Published: November 2023

A man in his 60s undergoing liver transplant assessment was referred to the respiratory team after a thoracic CT scan revealed diffuse tree-in-bud changes. He had a history of infertility, chronic pancreatitis and liver cirrhosis with portal hypertension. Broncho-alveolar lavage was positive forPseudomonas aeruginosa. Genetic screening found two cystic fibrosis transmembrane conductance regulator variants: Phe508del and Arg117His-7T. The patient was referred to the regional cystic fibrosis (CF) centre for follow-up but died from hepatobiliary complications. The atypical presentation with relatively late onset of pulmonary disease and hepatobiliary disease predominance created a diagnostic challenge. This case is a reminder that while CF is a monogenic disorder, its manifestation, natural history and extent can be highly variable. Taking a thorough medical history of any chronic illness is essential, and patients with the appropriate clinical presentation, regardless of age, should be investigated for CF.
Use of Yamane technique for secondary intraocular lens implantation following open globe injury
Authors: Thomas Jonathan , Armstrong Grayson
Published: November 2023

A woman in her 50s presented with suspected open globe injury (OGI) of the right eye after being hit with a high velocity piece of plastic. Visual acuity at the time of presentation was counting fingers in the affected eye. Slit lamp examination revealed a full thickness laceration of the cornea and a traumatic cataract. Primary corneal repair was performed and the patient was left aphakic after cataract removal. Secondary intraocular lens placement was deferred for 2 years, after which time a scleral-fixated intraocular lens was implanted using the Yamane technique. Postoperative visual acuity of 20/50 was achieved, with the vision limited by persistent diabetic macular oedema. Thus, this case of successful implantation of a secondary lens using the Yamane technique in a patient with prior corneal laceration and traumatic cataract highlights that the Yamane technique can result in visual improvement in patients with prior OGI.
Inflammation of actinic keratosis from chemotherapy in a relapsed multiple myeloma patient
Authors: Khan Abdul Moiz , Micho Ulbeh Tarec , Zonder Jeffrey , Balasubramanian Suresh
Published: November 2023

A man in his 60 s with a history of actinic keratosis (AK) and relapsed IgG kappa multiple myeloma (MM) recently received VD-PACE (bortezomib, dexamethasone, cisplatin, doxorubicin, cyclophosphamide, etoposide) chemotherapy and presented with numerous haemorrhagic, scaly lesions on his scalp and face. He also had sepsis from methicillin-sensitiveStaphylococcus aureus(MSSA) bacteraemia. Since the lesions were only present in the areas of pre-existing AK, a diagnosis of inflammation of AK secondary to chemotherapy was made. Sepsis was treated with appropriate antibiotics, and inflammation of AK was managed with topical steroids, leading to complete recovery.
Impact of the COVID-19 pandemic on patients with hepatocellular carcinoma in the West of Scotland: a cohort study
Authors: McLaren Alistair Stewart , Spoor Johannes A , Cartwright Douglas , Naylor Gregory , Barclay Stephen , Priest Matthew , Puttagunta Srikanth , Armstrong Kirsty , Ballantyne Stuart , Stanley Adrian , Jeffry Evans Thomas R
Published: November 2023

Objective

The COVID-19 pandemic had an undoubted impact on the provision of elective and emergency cancer care, including the diagnosis and management of patients with hepatocellular carcinoma (HCC). Our aim was to determine the effects of the COVID-19 pandemic on patients with HCC in the West of Scotland.

Design

This was a retrospective audit of a prospectively collated database of patients presented to the West of Scotland Multidisciplinary Team (MDT) between April and October 2020 (during the pandemic), comparing baseline demographics, characteristics of disease at presentation, diagnostic workup, treatment and outcomes with patients from April to October 2019 (pre pandemic).

Results

There was a 36.5% reduction in new cases referred to the MDT during the pandemic. Patients presented at a significantly later Barcelona Cancer Liver Clinic stage (24% stage D during the pandemic, 9.5% pre pandemic, p<0.001) and with a significantly higher Child-Pugh Score (46% Child-Pugh B/C during the pandemic vs 27% pre pandemic, p<0.001). We observed a reduction in overall survival (OS) among all patients with a median OS during the pandemic of 6 months versus 17 months pre pandemic (p=0.048).

Conclusion

The impact of the COVID-19 pandemic is likely to have contributed to a reduction in the presentation of new cases and survival among patients with HCC in the West of Scotland. The reason for this is likely multifactorial, but disruption of standard care is likely to have played a significant role. Resources should be provided to address the backlog and ensure there are robust investigation and management pathways going forward.
Association between dyslipidaemia and dry eye disease: a systematic review and meta-analysis
Authors: Li Yingsi , Xie Luoying , Song Wenjing , Chen Shudi , Cheng Yu , Gao Yuan , Huang Meiting , Yan Xiaoming , Yang Songlin
Published: November 2023

Purpose

To report a systematic review and meta-analysis of the association between dry eye disease (DED) and dyslipidaemia.

Methods

PubMed, Embase, Web of Science and Cochrane Library were systematically searched from January 2000 to December 2021. We included observational studies to assess the correlation of DED with meibomian gland dysfunction and dyslipidaemia without any language restrictions. The pooled OR with 95% CI was calculated in Stata V.15.

Results

Of 6727 identified studies, 18 studies (21 databases) with a total of 2 663 126 patients were analysed in our meta-analysis. The results showed that DED risk was associated with dyslipidaemia (OR=1.53, 95% CI: 1.41 to 1.66, p=0.001), especially elevated total cholesterol levels (OR=1.57, 95% CI: 1.25 to 1.99, p<0.001), elevated low-density lipoprotein cholesterol levels (OR=1.13, 95% CI: 1.06 to 1.20, p<0.001) and high-density lipoprotein cholesterol levels (OR=1.06, 95% CI: 1.01 to 1.11, p<0.001), but not with serum triglyceride levels. Moreover, having a history of lipid-lowering drug use (OR=1.41, 95% CI: 1.19 to 1.67, p<0.001) was also found to be positively associated with DED risk.

Conclusions

The findings suggested that dyslipidaemia and lipid-lowering drug use might be associated with an increased risk of DED. More evidence is needed to confirm the findings by prospective studies.

PROSPERO registration number

CRD42022296664.
Skills and competencies in health data analytics for health professionals: a scoping review protocol
Authors: Nkwanyana Akhona , Mathews Verona , Zachary Iris , Bhayani Vishwa
Published: November 2023

Introduction

Healthcare data analytics is a methodological approach to the systematic analysis of health data, and it provides opportunities for healthcare professionals to improve health system management, patient engagement, budgeting, planning and performing evidence-based decision-making. Literature suggests that certain skills and/or competencies for health professionals working with big data in health care would be required. A review of the skills and competencies in health data analytics required by health professionals is needed to support the development or re-engineering of curriculum for health professionals to ensure they develop the abilities to make evidence-based decisions that ultimately can lead to the effective and efficient functioning of a healthcare system.

Methods

Using Arksey and O’Malley’s framework, this study will review literature published in English from January 2012 to December 2022. The database search includes Academic Search Complete, CINAHL, and MEDLINE via EBSCOhost, PubMed, Science Direct, Scopus, and Taylor and Francis. The reference lists of key studies will be searched to identify additional appropriate studies to include. The review will be conducted using an inclusion and exclusion criteria. Iterative processes will be involved at the various stages of search strategy piloting, screening and data extraction. Articles will be reviewed through a two-step process (title and abstract, and full-text review) by at least two reviewers. Data will be described quantitatively and/or qualitatively and presented in diagrams and tables.

Ethics and dissemination

Ethical clearance has been received, and strict protocol measures will be followed to ensure the data reported is of quality and relevant to the review purpose. The results will be disseminated through a peer-reviewed scientific journal, presentation at national and/or international conferences, and other platforms such as social media (eg, LinkedIn, Twitter), and relevant stakeholders.
Clinical Observation, Management and Function Of low back pain Relief Therapies (COMFORT): A cluster randomised controlled trial protocol
Authors: Abdel Shaheed Christina , Ivers Rowena , Vizza Lisa , McLachlan Andrew , Kelly Patrick J , Blyth Fiona , Stanaway Fiona , Clare Philip James , Thompson Rachel , Lung Thomas , Degenhardt Louisa , Reid Sharon , Martin Bradley , Wright Michael , Osman Rawa , French Simon , McCaffery Kirsten , Campbell Gabrielle , Jenkins Hazel , Mathieson Stephanie , Boogs Monika , McMaugh Jarrod , Bennett Carol , Maher Christopher
Published: November 2023

Introduction

Low back pain (LBP) is commonly treated with opioid analgesics despite evidence that these medicines provide minimal or no benefit for LBP and have an established profile of harms. International guidelines discourage or urge caution with the use of opioids for back pain; however, doctors and patients lack practical strategies to help them implement the guidelines. This trial will evaluate a multifaceted intervention to support general practitioners (GPs) and their patients with LBP implement the recommendations in the latest opioid prescribing guidelines.

Methods and analysis

This is a cluster randomised controlled trial that will evaluate the effect of educational outreach visits to GPs promoting opioid stewardship alongside non-pharmacological interventions including heat wrap and patient education about the possible harms and benefits of opioids, on GP prescribing of opioids medicines dispensed. At least 40 general practices will be randomised in a 1:1 ratio to either the intervention or control (no outreach visits; GP provides usual care). A total of 410 patient–participants (205 in each arm) who have been prescribed an opioid for LBP will be enrolled via participating general practices. Follow-up of patient–participants will occur over a 1-year period. The primary outcome will be the cumulative dose of opioid dispensed that was prescribed by study GPs over 1 year from the enrolment visit (in morphine milligram equivalent dose). Secondary outcomes include prescription of opioid medicines, benzodiazepines, gabapentinoids, non-steroidal anti-inflammatory drugs by study GPs or any GP, health services utilisation and patient-reported outcomes such as pain, quality of life and adverse events. Analysis will be by intention to treat, with a health economics analysis also planned.

Ethics and dissemination

The trial received ethics approval from The University of Sydney Human Research Ethics Committee (2022/511). The results will be disseminated via publications in journals, media and conference presentations.

Trial registration number

ACTRN12622001505796.
Dietitian-led cluster randomised controlled trial on the effectiveness of mHealth education on health outcomes among pregnant women: a protocol paper
Authors: Er Ying Ting , Chan Yoke Mun , Mohd Shariff Zalilah , Abdul Hamid Habibah , Mat Daud Zulfitri 'Azuan , Yong Heng Yaw
Published: November 2023

Introduction

Nutrition education is the cornerstone to maintain optimal pregnancy outcomes including gestational weight gain (GWG). Nevertheless, default for appointments is common and often lead to suboptimal achievement of GWG, accompanied with unfavourable maternal and child health outcomes. While mobile health (mHealth) usage is increasing and helps minimising barriers to clinic appointments among pregnant mothers, its effectiveness on health outcomes has been inconclusive. Therefore, this study aimed to address the gap between current knowledge and clinical care, by exploring the effectiveness of mHealth on GWG as the primary outcome, hoping to serve as a fundamental work to achieve optimal health outcomes with the improvement of secondary outcomes such as physical activity, psychosocial well-being, dietary intake, quality of life and sleep quality among pregnant mothers.

Methods and analysis

A total of 294 eligible participants will be recruited and allocated into 3 groups comprising of mHealth intervention alone, mHealth intervention integrated with personal medical nutrition therapy and a control group. Pretested structured questionnaires are used to obtain the respondents’ personal information, anthropometry data, prenatal knowledge, physical activity, psychosocial well-being, dietary intake, quality of life, sleep quality and GWG. There will be at least three time points of data collection, with all participants recruited during their first or second trimester will be followed up prospectively (after 3 months or/and after 6 months) until delivery. Generalised linear mixed models will be used to compare the mean changes of outcome measures over the entire study period between the three groups.

Ethics and dissemination

Ethical approvals were obtained from the ethics committee of human subjects research of Universiti Putra Malaysia (JKEUPM-2022-072) and medical research & ethics committee, Ministry of Health Malaysia: NMRR ID-22-00622-EPU(IIR). The results will be disseminated through journals and conferences targeting stakeholders involved in nutrition research.

Trial registration number

Clinicaltrial.gov ID:NCT05377151.
Perceived value and benefits of the Community Paramedicine at Clinic (CP@clinic) programme: a descriptive qualitative study
Authors: Marzanek Francine , Nair Kalpana , Ziesmann Andrea , Paramalingam Aarani , Pirrie Melissa , Angeles Ricardo , Agarwal Gina
Published: November 2023

Objectives

Community Paramedicine (CP) is increasingly being used to provide chronic disease management for vulnerable populations in the community. CP@clinic took place in social housing buildings to support cardiovascular health and diabetes management for older adults. The purpose of this study was to examine participant perceptions of their experience with CP@clinic as well as potential ongoing programme benefits.

Design

This descriptive qualitative study used focus groups to understand resident experiences of the CP@clinic programme. Groups were facilitated by experienced moderators using a semistructured guide. An inductive coding approach was used with at least two researchers taking part in each step of the analysis process.

Setting

Community-based social housing buildings in Ontario, Canada.

Participants

Forty-one participants from four CP@clinic sites took part in a focus group. Convenience sampling was used with anyone having taken part in a CP@clinic session being eligible to attend the focus group.

Results

Analysis yielded six themes across two broad areas: timely access to health information and services, support to achieve personal health goals, better understanding of healthcare system (Personal Benefits); and sense of community, comfortable and familiar place to talk about health, facilitated communication between healthcare professionals (Programme Structure). Participants experienced discernible health changes that motivated their participation. CP@clinic was viewed as a programme that created connections within the building and outside of it. Participants were enthusiastic for the continuation of the programme and appreciated the consistent support to meet their health goals.

Conclusions

CP@clinic was successful in creating a supportive and friendly environment to facilitate health behavioural changes. Ongoing implementation of CP@clinic would allow residents to continue to build their chronic disease management knowledge and skills.

Trial registration number

Trial registration number:NCT02152891, Clinicaltrials.gov.
Nurses’ experience with presenteeism and the potential consequences on patient safety: a qualitative study among nurses at out-of-hours emergency primary care facilities
Authors: Moore Angelena , Knutsen Glette Malin
Published: November 2023

Objectives

This study aimed to gain new insight and knowledge on out-of-hours emergency primary care nurses’ experience of presenteeism in their workplace and their outlook on the impact they recognised the phenomenon to have on patient safety when caring for acute patients.

Design

An explorative qualitative study.

Setting

The study was conducted at three out-of-hours primary care facilities in southwest Norway.

Participants

A total of 10 female nurses were recruited as interviewees. Nurses providing direct patient care were included in the study.

Results

The analysis resulted in four major themes: strong work ethics influence the decision to attend work unwell; work environment factors have a negative impact on nurses’ health; nurses’ awareness of consequences on the quality of care and patient safety and nurses make use of coping strategies when engaging in presenteeism.

Conclusion

Presenteeism is a common experience among nurses at out-of-hours emergency primary care clinics, with work-related stress being a significant contributing factor. Despite recognising a decrease in performance while engaging in presenteeism, nurses displayed adaptive behaviour. They were confident that their suboptimal health issues did not significantly impact patient safety while caring for acute patients. However, the true impact of presenteeism on patient safety in an out-of-hours emergency care setting remains uncertain due to the reliance on subjective reporting systems as quality indicators. More research is needed to understand the phenomenon and its implications on patient safety fully.
Early 6 months usage of single anTiplAtelet OR anTicoAgulant followed by single antiplatelet after transcatheter aortic valve replacement: protocol for a multicentre, open-label, randomised controlled clinical trial
Authors: Hu Xiangming , Xu Haiyan , Wang Can , Wang Yang , Wang Yan , Zhou Daxin , Zhu Qifeng , Xu Kai , Yang Jian , Zhang Haibo , Jiang Nan , Zhang Junjie , Fang Zhenfei , Fu Guosheng , Guo Yingqiang , Li Yi , Wang Moyang , Feng Dejing , Niu Guannan , Zhang Erli , Chen Yang , Ye Yunqing , Wu Yongjian
Published: November 2023

Introduction

The strategy for initiating antithrombotic therapy to prevent bioprosthetic valve thrombosis (BPVT) after transcatheter aortic valve replacement (TAVR) remains uncertain. There is still lacking evidence on the efficacy and safety of early 6 months usage of single-antiplatelet therapy (SAPT) or oral anticoagulant (OAC) after TAVR in patients without anticoagulant indications.

Methods and analysis

This is a multicentre, randomised controlled, open-label trial, and 650 patients undergoing TAVR from 13 top TAVR centres in China will be recruited. Each eligible participant will be randomly assigned to two groups (1:1 ratio) as (1) SAPT (aspirin 75–100 mg for 6 months) group or (2) OAC group (warfarin, therapeutic international normalised ratio at 1.8–2.5 for 6 months), both followed by sequential aspirin 75–100 mg for 6 months. Participants in both groups will be invited for three follow-up visits of 1, 6 and 12 months after discharge. We will use both the net clinical benefit endpoint (composite of all-cause mortality, myocardial infarction, stroke/transient ischaemic attacks, peripheral artery thrombosis, intracardiac thrombosis and major bleeding and disabling or life-threatening bleeding) and the BPVT endpoint evaluated by four-dimensional CT as our primary endpoints. P value of <0.05 of two-sided test will be considered statistically significant.

Ethics and dissemination

The present study was approved by the Institutional Review Boards at Fuwai Hospital, National Center for Cardiovascular Diseases of China (Approval No. 2023-1947). All patients will be informed of the details of the study and will sign an informed consent prior to inclusion in the study. Results of this study will be published in a peer-reviewed journal.

Trial registration number

NCT05375474.
Impact of consensus molecular subtypes on survival with and without adjuvant chemotherapy in muscle-invasive urothelial bladder cancer
Authors: Koll Florestan J , Döring Claudia , Herwig Leon , Hoeh Benedikt , Wenzel Mike , Cano Garcia Cristina , Banek Severine , Kluth Luis , Köllermann Jens , Weigert Andreas , Chun Felix K-H , Wild Peter , Reis Henning
Published: November 2023

Aims

Adjuvant chemotherapy after radical cystectomy can reduce the risk of recurrence and death in advanced muscle-invasive urothelial bladder cancer (MIBC). Molecular subtypes have been shown to be associated with survival. However, their predictive value to guide treatment decisions is controversial and data to use subtypes as guidance for adjuvant chemotherapy is sparse. We aimed to assess survival rates based on MIBC consensus molecular subtypes with and without adjuvant chemotherapy.

Methods

Gene expression profiles of 143 patients with MIBC undergoing radical cystectomy were determined from formalin-fixed, paraffin-embedded specimen to assign consensus molecular subtypes. Expression of programmed cell death ligand-1 (PD-L1) and immune cell infiltration were determined using multiplex immunofluorescence. Matched-pair analysis was performed to evaluate the effect of adjuvant chemotherapy on overall survival (OS) for molecular subtypes applying Kaplan-Meier and Cox regression survival analyses.

Results

Samples were luminal papillary: 9.1% (n=13), luminal non-specified: 6.3% (n=9), luminal unstable: 4.9% (n=7), stroma-rich: 27.9% (n=40), basal/squamous (Ba/Sq): 48.9% (n=70) and neuroendocrine-like (NE-like): 2.8% (n=4). Ba/Sq tumours had the highest concentration of PD-L1+ tumour and immune cells. Patients with luminal subtypes had better OS than those with NE-like (HR 0.2, 95% CI 0.1 to 0.7, p<0.05) and Ba/Sq (HR 0.5, 95% CI 0.2 to 0.9, p<0.05). No survival benefit with adjuvant chemotherapy was observed for luminal tumours, whereas Ba/Sq had significantly improved survival rates with adjuvant chemotherapy. Retrospective design and sample size are the main limitations.

Conclusion

Consensus molecular subtypes can be used to stratify patients with MIBC. Luminal tumours have the best prognosis and less benefit when receiving adjuvant chemotherapy compared with Ba/Sq tumours.
Polycomb repressor complex 2 suppresses interferon-responsive MHC-II expression in melanoma cells and is associated with anti-PD-1 resistance
Authors: James Jamaal L , Taylor Brandie C , Axelrod Margaret L , Sun Xiaopeng , Guerin Lindsey N , Gonzalez-Ericsson Paula I , Wang Yu , Sanchez Violeta , Fahey Catherine C , Sanders Melinda E , Xu Yaomin , Hodges Emily , Johnson Douglas B , Balko Justin M
Published: November 2023

Background

Despite the remarkable success of immunotherapy in treating melanoma, understanding of the underlying mechanisms of resistance remains limited. Emerging evidence suggests that upregulation of tumor-specific major histocompatibility complex-II (tsMHC-II) serves as a predictive marker for the response to anti-programmed death-1 (PD-1)/programmed death ligand 1 (PD-L1) therapy in various cancer types. The genetic and epigenetic pathways modulating tsMHC-II expression remain incompletely characterized. Here, we provide evidence that polycomb repressive complex 2 (PRC2)/EZH2 signaling and resulting H3K27 hypermethylation suppresses tsMHC-II.

Methods

RNA sequencing data from tumor biopsies from patients with cutaneous melanoma treated with or without anti-PD-1, targeted inhibition assays, and assays for transposase-accessible chromatin with sequencing were used to observe the relationship between EZH2 inhibition and interferon (IFN)-γ inducibility within the MHC-II pathway.

Results

We find that increased EZH2 pathway messenger RNA (mRNA) expression correlates with reduced mRNA expression of both presentation and T-cell genes. Notably, targeted inhibition assays revealed that inhibition of EZH2 influences the expression dynamics and inducibility of the MHC-II pathway following IFN-γ stimulation. Additionally, our analysis of patients with metastatic melanoma revealed a significant inverse association between PRC2-related gene expression and response to anti-PD-1 therapy.

Conclusions

Collectively, our findings demonstrate that EZH2 inhibition leads to enhanced MHC-II expression potentially resulting from improved chromatin accessibility atCIITA, the master regulator of MHC-II. These insights shed light on the molecular mechanisms involved in tsMHC-II suppression and highlight the potential of targeting EZH2 as a therapeutic strategy to improve immunotherapy efficacy.
Impact of the COVID-19 pandemic on acute coronary syndrome hospital admission and management in Slovenia
Authors: Furlan Tjaša , Bijec Janez , Bonča Petra Došenović , Ograjenšek Irena , Jug Borut
Published: November 2023

Aims

We evaluated the effects of the COVID-19 pandemic on hospital admission and quality of care for acute coronary syndrome.

Methods and results

Data for all patients admitted to hospital care for acute coronary syndromes in Slovenia (nationwide cohort) between 2014 and 2021 were obtained by merging the national hospital database, national medicines reimbursement database and population mortality registry using unique identifying numbers. Using interrupted time series analysis, we assessed the impact of the COVID-19 pandemic on hospital admission rates and quality of care (in-hospital and 30-day mortality, reperfusion and secondary preventive medication uptake). Data were fitted to segmented regression models with March 2020 as the breakpoint. Data on 21 001 patients were included (7057 ST-elevation myocardial infarction (STEMI), 7649 non-ST elevation myocardial infarction (NSTEMI) and 6295 unstable angina). Hospital admissions for STEMI remained stable (92 patients; +1 patient per month, p=0.783), whereas the pandemic was associated with a significant reduction in NSTEMI (81 patients; −21 patients per month, p=0.015) and unstable angina admissions (47 patients; −28 patients per month, p=0.025). In patients with STEMI, the pandemic did not affect reperfusion rates (0.29%, (95% CI) −1.5% to 2.1%, p=0.755) or in-hospital mortality (0.1%, (95% CI) −0.9% to 1.1%, p=0.815), but was associated with a significant negative trend for secondary preventive medication uptake (−0.12%, (95% CI) −0.23% to −0.01%, p=0.034).

Conclusion

In Slovenia, hospital admissions for STEMI remained stable throughout the COVID-19 pandemic, but NSTEMI and unstable angina admissions dropped significantly. While mortality and reperfusion rates were not affected, the pandemic was associated with a continual negative time trend for the uptake of secondary preventive medication.
EVALUATION OF COMMERCIAL INFECTIOUS BRONCHITIS VIRUS ENZYME-LINKED IMMUNOASSAY KITS
Authors: Tan Yen-Pei , Wang Ching-Ho
Published: November 2023

In Taiwan, infectious bronchitis virus (IBV) is mainly restricted to two groups Taiwan Group I (TW-I) and Taiwan Group II (TW-II) that are distinct from other countries. To evaluate the reliability of commercial enzyme-linked immunosorbent assay (ELISA) kits, imported commercial test kits (namely, A, B and C) were used to test field samples. The results were further compared with hemagglutination inhibition (HI) test to figure out the consistency. Results showed that the three commercial ELISA kits had only partial consistency with HI results. In fact, testing results of breeders and layers bore resemblance to HI, whereas there were ELISAs negatively detecting results of broilers opposed in HI. The specificities of these ELISA kits were 0.45, 0.86 and 0.77 for kits A, B and C, respectively, and their sensitivities were 0.79, 0.68 and 0.70, respectively. The commercial ELISA kits may not sustainably provide us the whole view of birds infected or vaccinated status. Based on the results of in-house ELISA and western blot, different IBV strains showed different antigen–antibody interaction. Thus, different ELISA coatings with different antigens might result in different antibody titers. Furthermore, according to HI results, 91% (256) and 70% (198) of the 282 tested sera were positive to H120 (as a Massachusetts vaccine) and 3263/04 (as a field strain), respectively. These high positive rates indicate that in spite of popular use of Massachusetts vaccines, the chickens are still commonly infected with field IBVs in Taiwan.
Explainable Deep Learning for Mental Health Detection from English and Arabic Social Media Posts
Authors: Kumar Abhinav , Kumari Jyoti , Pradhan Jiesth
Published: November 2023

The research communities have recently begun exploring the detection of depression through social media, making it a relatively new development in this field. Some research has been done to identify depressive signs from English social media postings, while little work has been done for the Arabic posts. This paper proposes a BERT and Bi-LSTM pipeline for the identification of depressive signs from Arabic social media posts. A fine-tuned RoBERTa-based model is also proposed for English social media posts for depressive state identification. Along with the proposed model, seven conventional machine learning and eight deep learning models are also explored for the identification of depressive signs from Arabic and English social media posts. The performance of the proposed model is validated on two Arabic datasets and one English dataset. The proposed BERT and Bi-LSTM pipeline achieved state-of-the-art performance with an
F
1
-score of 1.00 and 0.82 for two different Arabic datasets, whereas the proposed fine-tuned RoBERTa achieved a
F
1
-score of 0.60 which is comparable in identifying depressive sign from English social media posts. The majority of the suggested deep learning models are end-to-end, which necessitates a greater explanation for their success. An explainable AI-based model may enhance decision-making, transparency, and interpretability. Therefore, this research identifies where the suggested system learned well and where it failed in recognition of the depression signs that can help in future developments in the field of depression detection.
Bob or Bot: Exploring ChatGPT's Answers to University Computer Science Assessment
Authors: Richards Mike , Waugh Kevin , Slaymaker Mark , Petre Marian , Woodthorpe John , Gooch Daniel
Published: November 2023

Cheating has been a long-standing issue in university assessments. However, the release of ChatGPT and other free-to-use generative AI tools has provided a new and distinct method for cheating. Students can run many assessment questions through the tool and generate a superficially compelling answer, which may or may not be accurate. We ran a dual-anonymous “quality assurance” marking exercise across four end-of-module assessments across a distance university computer science (CS) curriculum. Each marker received five ChatGPT-generated scripts alongside 10 student scripts. A total of 90 scripts were marked; every ChatGPT-generated script for the undergraduate modules received at least a passing grade (>40%), with all of the introductory module CS1 scripts receiving a distinction (>85%). None of the ChatGPT-taught postgraduate scripts received a passing grade (>50%). We also present the results of interviewing the markers and of running our sample scripts through a GPT-2 detector and the TurnItIn AI detector, which both identified every ChatGPT-generated script but differed in the number of false positives. As such, we contribute a baseline understanding of how the public release of generative AI is likely to significantly impact quality assurance processes. Our analysis demonstrates that in most cases, across a range of question formats, topics, and study levels, ChatGPT is at least capable of producing adequate answers for undergraduate assessment.
Dependency-based BERT for Chinese Event Argument Extraction
Authors: Li Daiyi , Yan Li , Ma Zongmin
Published: November 2023

Existing event extraction methods independently identify and classify each argument role separately, ignoring the interdependence between different parameter roles. Further, these methods rely on simple vectors to represent word embeddings. By embedding explicit syntactic constraints in the attention mechanism, we address these shortcomings by using dependency syntax to guide the text modeling. Specifically, we use dependency syntax to guide the BERT model for Chinese event argument role extraction, which mainly consists of three stages. First, the self-attention method guided by a dependency syntactic parsing tree is embedded in the Transformer computing framework of the BERT model. In addition to obtaining a deep two-way linguistic representation of a word according to its context information, this method also expresses the long-distance syntactic dependency relationships between words based on context information. Secondly, the designed conditional layer normalization method is applied to the event argument extraction model in order to integrate the semantic information of trigger words into the text, thereby improving the accuracy of the argument role extraction. Lastly, conditional random fields (CRFs) are used to determine the optimal sequence of labels at the sentence level based on the dependence relationships between adjacent labels. According to the experimental results, the constructed model outperforms several strong baselines in the Chinese event argument extraction task on the ACE2005 dataset and the iFLYTEKA.I.2020 dataset.
Scene Text Recognition via Dual-path Network with Shape-driven Attention Alignment
Authors: Hu Yijie , Dong Bin , Huang Kaizhu , Ding Lei , Wang Wei , Huang Xiaowei , Wang Qiu-Feng
Published: November 2023

Scene text recognition (STR), one typical sequence-to-sequence problem, has drawn much attention recently in multimedia applications. To guarantee good performance, it is essential for STR to obtain aligned character-wise features from the whole-image feature maps. While most present works adopt fully data-driven attention-based alignment, such practice ignores specific character geometric information. In this article, built upon a group of learnable geometric points, we propose a novel shape-driven attention alignment method that is able to obtain character-wise features. Concretely, we first design a corner detector to generate a shape map to guide the attention alignments explicitly, where a series of points can be learned to represent character-wise features flexibly. We then propose a dual-path network with a mutual learning and cooperating strategy that successfully combines CNN with a ViT-based model, leading to further accuracy improvement. We conduct extensive experiments to evaluate the proposed method on various scene text benchmarks, including six popular regular and irregular datasets, two more challenging datasets (i.e., WordArt and OST), and three Chinese datasets. Experimental results indicate that our method can achieve superior performance with a comparable model size against many state-of-the-art models.
Functional role of glial-derived neurotrophic factor in a mixed allergen murine model of asthma
Authors: Drake Li Y. , Wicher Sarah A. , Roos Benjamin B. , Khalfaoui Latifa , Nesbitt Lisa , Fang Yun Hua , Pabelick Christina M. , Prakash Y. S.
Published: November 2023

Local production of growth factors within the airway with autocrine/paracrine effects can promote features of asthma. Here, we show that glial-derived neurotrophic factor (GDNF) is a procontractile and proremodeling factor that contributes to allergen-induced airway hyperreactivity and tissue remodeling in a mouse model of asthma. Blocking GDNF signaling attenuates allergen-induced airway hyperreactivity and remodeling, suggesting a novel approach to alleviating structural and functional changes in the asthmatic airway.
Examining the Optimal Amount of Moringa Leaf Extract to Improve the Morphological and Inner Quality of Cabbage (Brassica oleracea var. capitata)
Authors: Yaseen Arshad Abdulkhalq , Madar Ágota Kovácsné , Vojnović Đorđe , Takács-Hájos Mária
Published: November 2023

Moringa leaves contain a proper amount of antioxidants, amino acids, vitamins, hormones, macronutrients, and micronutrients. Therefore, it is applied as a natural, inexpensive, and simple-to-make biostimulant to boost nutritional value and growth parameters in a variety of plants. The main purpose of this study is to determine the optimal concentration of Moringa oleifera L. leaf extract (MLE) as an effective biostimulant to improve nutritional and physical quality in cabbage (Brassica oleracea var. capitata). To do this, three concentrations of MLE (6, 8, and 10%) were foliar sprayed to the plant leaves at a rate of 25 mL plant−1 for every two weeks from transplantation till harvest, while control plants (Ø) were sprayed with distilled water only. Our results show that MLE greatly increased cabbage growth, nutrient content, pigment content, and nutrient absorption, while a high concentration of 10% MLE could also significantly reduce nitrate content in cabbage leaves. In comparison to the control plants, sprays of 6%, 8%, and 10% MLE reduced nitrate content by 23%, 14%, and 12%, respectively. However, the lowest nitrate content was found for the plants sprayed with 6% MLE. Except for the dry matter, all the growth parameters, mineral content, and pigment content were significantly higher after spraying with 10% MLE, while better vitamin C and lower nitrate were found in the plants treated with 6% MLE. A Pearson correlation reveals that head weight has a positive correlation with head diameter, head height, chlorophyll a, and carotenoids at

p

levels of 0.01 and a positive correlation with chlorophyll b and vitamin C at

p

levels of 0.05. Vitamin C and dry matter, on the other hand, had a negative connection with nitrate content.