bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating the ethics of machines assessing humans
Authors: Fischer Isabel
Published: May 2023

The case focusses on AQA (formerly known as Assessment and Qualification Alliance), one of England’s largest exam boards, and its evaluation of whether Artificial Intelligence (AI) could be deployed, in principle, for marking high-stakes assessments. At a time when generative AI, such as ChatGPT, has gained popularity, the case offers insights into the challenges and risks of algorithmic decision making and algorithmic fairness, such as accuracy and explainability. The case allows students to explore the role of ethics when developing an AI-based tool in an area that they all know very well: Most students will have had to sit high-stakes assessments in the past and are still likely to be assessed on an ongoing basis as a current student. Students will thus be able to relate to the case and have their own stake(s) and opinion(s) about whether they would want to be assessed by AI. The case is also more broadly applicable in raising general awareness of the challenges and potential risks involved when using AI for decision making and it encourages students to consider the wider consequences for all stakeholders that are triggered by the use of digital technology.
Safety and tolerability of intramuscular and sublingual ketamine for psychiatric treatment in the Roots To Thrive ketamine-assisted therapy program: a retrospective chart review
Authors: Tsang Vivian W.L. , Tao Brendan , Dames Shannon , Walsh Zach , Kryskow Pam
Published: May 2023

Background:

In the last few years, ketamine is becoming increasingly common in the treatment of mental health conditions, but there is a lack of safety data informing intramuscular and sublingual dosing in a community-focused group psychotherapy setting. The Roots To Thrive ketamine-assisted therapy (RTT-KaT) program is a unique 12-week RTT-KaT program with 12 community of practice (a form of group therapy) sessions and three ketamine medicine sessions.

Objectives:

This study reports on adverse effects of intramuscular and sublingual ketamine dosing in a community group psychotherapy setting among 128 participants across four cohorts.

Design:

Retrospective chart review.

Methods:

A chart review of the RTT-KaT Program was performed retrospectively on four cohorts ( n = 128) that participated in 448 sessions running between September 2020 and December 2021. Baseline characteristics and adverse events were captured including medication administration before, during, and after RTT-KaT sessions. Analyses by session and by individual were conducted. Chi-square test with Yates’ continuity correction was used to assess side effects in subgroups from ketamine administration.

Results:

RTT-KaT was well tolerated with none of the 128 participants dropping out of the program. Primarily, of the 448 sessions, 49.16% had elevated blood pressures post-KaT session by session. In terms of other adverse effects, 12.05% of participant-sessions experienced nausea, 2.52% had an episode of vomiting, 3.35% had a headache, and seven participant-sessions experienced dizziness. Analysis by individual revealed congruent findings.

Conclusion:

These findings suggest good safety and tolerability for RTT-KaT among individuals seeking treatment for mental health issues. The majority of participants did not experience adverse reactions and the adverse events that were recorded involved transient symptoms that were resolved with rest and/or medications. The group therapy model described provides a comprehensive approach and presents a promising model for operating a KaT program in a community setting.
Does the co-use of cannabis exacerbate the effect of alcohol on the risk of crashing? A systematic review and meta-analysis
Authors: White Michael A , Burns Nicholas R
Published: May 2023

This is the second of two closely related systematic literature reviews with meta-analyses by the same authors. The first concluded that there is no convincing epidemiological evidence that the prior use of cannabis (as indicated by the presence of THC in a body fluid) directly increases the risk of crashing. The purpose of this second review is to consider the possibility that the co-use of cannabis indirectly increases the risk of crashing by exacerbating the effect of alcohol on the risk of crashing. The starting point for both reviews is a systematic literature search that identifies seventeen epidemiological studies of the relationship between the prior use of cannabis and the risk of crashing. Twelve of those studies also investigated the joint effects of cannabis and alcohol on the risk of crashing. Although the authors of some studies claimed to have found an exacerbation (or equivalent) effect, the results of a meta-analysis of exacerbation odds ratios failed to support the claim. It is concluded that there is no credible evidence from the twelve epidemiological studies that the co-use of cannabis exacerbates the effect of alcohol on the risk of crashing.
Surveillance capitalism and systemic digital risk: The imperative to collect and connect and the risks of interconnectedness
Authors: Curran Dean
Published: May 2023

Zuboff's The Age of Surveillance Capitalism provides a powerful analysis of the emergence of surveillance capitalism as a particular type of informational capitalism. Many of the important impacts of this project of creating larger and more integrated systems of ‘behavioural surplus’ are captured powerfully by Zuboff; yet as different risk and organisational scholars such as Beck, Perrow, and Vaughan have argued, integrated systems often do not function as intended. While the imperfection of these systems may raise the possibility that surveillance capitalism may not be as bad as Zuboff suggests, there is also a way in which these systems not functioning as intended can make surveillance capitalism an even more dystopian possibility. In this vein, this paper asks: what are the consequences when the tools of a surveillance capitalist society break down? This paper argues that it is by thinking through Zuboff's framework that we can identify the systemic fragility of a surveillance capitalist society. This systemic fragility emerges through how surveillance capitalism generates imperatives towards the maximal collection of data for exploitation, which in turn generates a corresponding imperative to connect all aspects of life. Both of these imperatives, of collect and connect, in turn create an immensely fragile digital system, which has vast ramifications throughout social life, such that small imperfections and gaps in the system can magnify risk throughout society.
Intelligent lung cancer MRI prediction analysis based on cluster prominence and posterior probabilities utilizing intelligent Bayesian methods on extracted gray-level co-occurrence (GLCM) features
Authors: Yang Jing , Yee Por Lip , Khan Abdullah Ayub , Karamti Hanen , Eldin Elsayed Tag , Aldweesh Amjad , Jery Atef El , Hussain Lal , Omar Abdulfattah
Published: May 2023

Lung cancer is the second foremost cause of cancer due to which millions of deaths occur worldwide. Developing automated tools is still a challenging task to improve the prediction. This study is specifically conducted for detailed posterior probabilities analysis to unfold the network associations among the gray-level co-occurrence matrix (GLCM) features. We then ranked the features based on t-test. The Cluster Prominence is selected as target node. The association and arc analysis were determined based on mutual information. The occurrence and reliability of selected cluster states were computed. The Cluster Prominence at state ≤330.85 yielded ROC index of 100%, relative Gini index of 99.98%, and relative Gini index of 100%. The proposed method further unfolds the dynamics and to detailed analysis of computed features based on GLCM features for better understanding of the hidden dynamics for proper diagnosis and prognosis of lung cancer.
COVID-19 misinformation on YouTube: An analysis of its impact and subsequent online information searches for verification
Authors: Kessler Sabrina Heike , Humprecht Edda
Published: May 2023

Objectives

COVID-19 vaccination misinformation on YouTube can have negative effects on users. Some, after being exposed to such misinformation, may search online for information that either debunks or confirms it. This study's objective is to examine the impact of YouTube videos spreading misinformation about COVID-19 vaccination and the influencing variables, as well as subsequent information seeking and its effect on attitudes toward vaccination.

Methods

In this observational and survey study, we used a three-group pre-test and post-tests design ( N = 106 participants). We examined the effects of YouTube videos containing misinformation about COVID-19 vaccination on attitudes toward vaccination via surveys, employed screen recordings with integrated eye tracks to examine subsequent online information searches, and again surveyed participants to examine the effects of the individual searches on their attitudes.

Results

Receiving misinformation via video tended to have negative effects, mostly on unvaccinated participants. After watching the video, they believed and trusted less in the effectiveness of the vaccines. Internet searches led to more positive attitudes toward vaccination, regardless of vaccination status or prior beliefs. The valences of search words entered and search duration were independent of the participants’ prior attitudes. Misinforming content was rarely selected and perceived (read). In general, participants were more likely to perceive supportive and mostly neutral information about vaccination.

Conclusion

Misinformation about COVID-19 vaccination on YouTube can have a negative impact on recipients. Unvaccinated citizens in particular are a vulnerable group to online misinformation; therefore, it is important to take action against misinformation on YouTube. One approach could be to motivate users to verify online content by doing their own information search on the internet, which led to positive results in the study.
Motivations for game stream spectatorship: A content analysis of Danmaku on Bilibili
Authors: Pan Xin
Published: May 2023

This article explores the motivations of viewers who watch Danmaku game streams on Bilibili, a Chinese streaming platform, by analysing Danmaku comments (弹幕, danmu). Drawing upon and extending findings from previous research, I establish a framework that synthesizes different types of Danmaku (emotion-expression, information, social, and entertainment) with viewer motivations (knowledge-sharing, entertaining, and communicating). To demonstrate how it works, this study employs content analysis based on virtual observation. After examining 37,331 Danmaku comments across 9 streams in three different categories ( Esports, Speedrun, and Let’s Play), it is found that the primary motive for Danmaku game stream viewing is to communicate, and the distribution of motivations varies depending on the stream category. The article addresses a gap in the research of Chinese game streaming, providing empirical insights into the behaviours and motivations of viewers on these platforms. Danmaku is identified as a prominent feature of Chinese game streaming that offers a distinctive perspective for studying viewer motivations within the context of Chinese online video culture.
Sensemaking About the Organization–Occupation Relationship in Constructing Identification at Work: A Cross-Occupational Approach
Authors: Lee Eun-Suk , Paik Yonjeong
Published: May 2023

Departing from the prior assumption that identification with organization and identification with occupation are constructed separately, we explore how employee identifications with these multiple targets are co-constructed at work, using a grounded-theory approach. An analysis of interview data collected from members of three occupations (engineers, human resource [HR] staff, and marketers) in a large global company reveals that organizational identity’s impact on employee identification is not independent of but significantly influenced by occupational identity; specifically, occupational identity provides a lens through which individuals actively interpret the organizational identity. Using the occupational lens, individuals engage in sensemaking about the alignment between organization and occupation and, based on this sensemaking, construct their identification with both targets. We identify four types of identification configurations constructed under the nexus of these organizational and occupational identity inputs: holistic, prioritized, parallel, and conditional identification, which vary systematically across occupations.
How Terms of Trade Impact Economic Growth: The Case of the United States
Authors: Shahzad Umer , He Xiaoyin , Muhammad Said
Published: May 2023

Trade has a crucial role in a country’s economic development. This study scrutinizes the impact of terms of trade (TOT), labor force, and capital on the United States’ economic growth. This study aims to investigate the short and long-run impacts of Capital, Labor, and Terms of Trade on the economic growth of the United States. To accomplish the study’s goals, this study analyzed a time series of annual data for the United States from 1980 to 2021. The Philipps-Perron test, the model of Augmented Dickey-Fuller (ADF) model, and the Autoregressive Distributed lag (ARDL) of the bound tests were applied to test whether the data is stationary or not. We employed an Autoregressive Distributed lag (ARDL) unit root model to examine the study variables’ short- and long-term associations. The outcomes of the unit root of the (ADF) test explain that both the Trace and Maximum Eigenvalues values showed that the study’s variables were stationary at both level and first difference, but stationarity was not there at the first difference using the PP model. At I(0) and I(1), the log(GDP), labor, capital, and log(TOT) stayed stationary. However, the estimated results of the (ARDL) model revealed that the economic growth of the United States was negatively and significantly affected by the (TOT), but economic growth, capital, and the labor force have favorable long and short-run relationships. The results of ECM(-1) imply that 7% of adjustment from disequilibrium to equilibrium from short-run to long-run. This study’s findings suggest that policymakers and governments ease trade between countries to achieve the highest economic growth.
ACEs and Angst: Adverse Childhood Experiences, General Strain Theory, and Adolescent Male Suicidal and Violent Behaviors
Authors: Van Wyk Judy A.
Published: May 2023

This study tests General Strain Theory (GST) as an explanation for associations between adverse childhood experiences (ACEs) and risk of violent and suicidal behaviors. Data comprise a census of archival information about the lives of 2,195 delinquent boys who resided at a U.S. treatment facility between 1975 and 2019. Logistic regression tests the effects of 12 combined ACEs, anger, low self-control, depression, race/ethnicity, and poverty on violent and suicidal behaviors. Interactive associations predicted by GST are examined by Zmediation and χ2 analyses. Nearly 93% of residents experienced at least one ACE, and 87% had ≥4. ACEs increase risk of violent and suicidal behaviors net of controls. They interact with low self-control and anger to increase risk of violence, and anger and depression mediate risk of suicidal behaviors. Rehabilitative programming for troubled boys should begin with thorough assessment of these experiences, and both outcomes require equal consideration in the ACEs research.
Use of QR Code in Dairy Sector in Slovenia
Authors: Žurbi Tina , Gregor-Svetec Diana
Published: May 2023

The increasing use of smartphones has allowed quick response (QR) codes to build a stronger connection between consumers and products, enabling a bridge between offline and online products and providing quick access to product information, traceability, and food safety. This study focuses on two primary aspects: familiarity with QR codes and their usage by consumers and FMCG (fast-moving consumer goods) producers in Slovenia. Additionally, authors examined consumers’ motivations to scan QR codes for food products, particularly dairy products. Data collected through online research, interviews, and field investigations revealed that consumers rarely scan QR codes. To increase its usage, it should be included in an overall advertising campaign to provide instant benefit; consequently, it would increase consumer engagement with the product. Field research and interviews revealed that only a few packaged products are equipped with QR codes, primarily to support trade marketing activities. In addition, most consumers scan the code at home seeking information regarding its origin, which provides insights into future implementation possibilities. Furthermore, from the design point, QR codes should be positioned on the side panel of the packaging together with an invitation to motivate and explain how scanning would benefit the consumer.
Examination of Sensory Recovery of Breasts Reconstructed With Silicone Breast Implants After Nipple-Sparing Mastectomy
Authors: Sasaki Masahiro , Aihara Yukiko , Sasaki Kaoru , Oshima Junya , Shibuya Yoichiro , Sekido Mitsuru
Published: May 2023

Background: Reconstructed breast with silicone breast implants (SBIs) after nipple-sparing mastectomy (NSM) provides high patient satisfaction from a cosmetic point of view, but low patient satisfaction with respect to hypoesthesia of the reconstructed breast, and reinnervation is required. Currently, few reports are available on reinnervation in breast reconstruction with implants, and detailed data on desensitization of reconstructed breasts are lacking. Therefore, we examined perceptual data after NSM with respect to reinnervation. Methods: In our department, after NSM, tissue expander or SBI was used to perform 1-stage or 2-stage breast reconstruction, and touch, warm and cold, and pain sensations in 31 cases more than 1 year after completion of reconstruction were examined. Results: All tests of sensations tended to be better in the medial region than in the lateral region, but no correlation with postoperative years was found. In the comparison of the incision lines, in the Semmes-Weinstein monofilament test (SW test), a significant difference was observed between the inframammary fold (IMF) incision and the para-areola incision in the breast D region, between the lateral incision and the para-areola incision, and between the IMF incision and the para-areola incision in the areola b region. In addition, linear regression analysis of postoperative years did not establish a predictive formula for the SW test or pain sensation in any of the 9 regions. Conclusions: The difference in the excision range was considered to be the largest factor affecting hypoesthesia. We also speculated that preservation of the internal mammary artery perforators during mastectomy led to preservation of the anterior cutaneous branch of the intercostal nerves, and therefore, the perception of the medial region was better than that of the lateral region. In the case of NSM in which the anterior cutaneous branch was preserved, the recovery of outer perception including that of the nipple-areolar complex (NAC) was poor, so it was considered that nerve reconstruction between the lateral cutaneous branch and the NAC was effective for reinnervation.
Comparing Fixed and Individualized Channel Interaction Coefficients for Speech Perception With Dynamic Focusing Cochlear Implant Strategies
Authors: Caswell-Midwinter Benjamin , Arenberg Julie G.
Published: May 2023

Dynamic focusing cochlear implant strategies aim to emulate normal cochlear excitation patterns by varying the degree of current focusing as a function of input level. Results on the speech perception benefits of these strategies have been mixed. In previous studies, channel interaction coefficients ( K), which mediate the relationship between current level and degree of focusing, were fixed across channels and participants. Fixing K without accounting for channel interaction and the current required to accurately stimulate target neurons may elicit suboptimal loudness growth and speech perception. This study tested whether individualizing K improved speech perception relative to fixed- K and monopolar strategies. Fourteen ears of implanted adults were programmed with 14-channel strategies matched on pulse duration, pulse rate, filtering, and loudness. Sentence recognition and vowel identification was measured at 60 dB SPL equivalent in quiet and four-talker babble. On the group level, speech recognition in quiet and noise was similar between strategies. On the individual level, there were participants who benefitted with dynamic focusing strategies for speech perception in noise. Patterns of benefit were generally unclear, beyond associations between focused thresholds, duration of hearing loss, and individual- K benefit. Participants rated dynamic focusing like monopolar in clarity and ease of listening. Almost all participants expressed their willingness to use the strategies in a take-home trial. These results suggest that while individualizing K does not benefit all, there are individuals who benefit, for which the electrode–neuron interface may play a role. Future studies will evaluate acclimatization of dynamic focusing strategies using take-home trials.
Effects of Socio-educational Interventions on the Quality of Life of People with a Digestive Ostomy
Authors: Duque Paula A. , Valencia Rico Claudia L. , Campiño Valderrama Sandra M. , López González Luz A.
Published: May 2023

Introduction

The creation of digestive stomata is associated with a change in people's lives. Causing a strong impact that influences all dimensions of life. This paper reports on the effects of socio-educational interventions on the quality of life (QOL) of people with a digestive ostomy.

Objective

To describe the effect of a nursing intervention on the QOL of people with a digestive ostomy.

Methods

A quasiexperimental study was conducted whose sample consisted of 12 people who were ostomized in a public hospital in Colombia. Participants were selected through convenience sampling and randomly assigned to the intervention group and the control group. For the control group, an educational process was carried out through a theoretical session with virtual mediation (educational video). The QOL was evaluated before and after the interventions through the Montreux questionnaire.

Results

The average age was 57(+7) years. No statistical differences were found between the groups in the QOL index or for any of the dimensions that make up QOL. Pretest and post-test analysis for each intervention separately showed improvement in two dimensions of QOL for each group; in the intervention group body image dimension ( p  =  .017) and the positive coping dimension ( p  =  .027). In the control group, the physical well-being dimension ( p  =  .037) and social concerns dimension ( p  =  .034).

Conclusions

The personalized educational intervention or carried out through virtual pedagogical mediation, generated a clinically significant increase in the dimensions of QOL, without statistical differences. The study adds knowledge about the impact that digestive stomata have on the QOL, which is why it is necessary to establish specialized interdisciplinary teams to care for the person's new condition at home during the following months.
Practical Applications of ChatGPT in Undergraduate Medical Education
Authors: Tsang Ricky
Published: May 2023

ChatGPT is a chatbot developed by OpenAI that has garnered significant attention for achieving at or near a passing standard on the United States Medical Licensing Exam (USMLE). Currently, researchers and users are exploring ChatGPT's broad range of potential applications in academia, business, programming, and beyond. We attempt outline how ChatGPT may be applied to support undergraduate medical education during the preclinical and clinical years, and highlight possible concerns regarding its use which necessitates the creation of formal policies and training by medical schools.
Development and evaluation of probabilistic forecasting methods for small area populations
Authors: Grossman Irina , Bandara Kasun , Wilson Tom , Kirley Michael
Published: May 2023

Planning and development decisions in both the government and business sectors often require small area population forecasts. Unfortunately, current methods often produce forecasts that are inaccurate, particularly for remote areas and those with smaller populations. Such inaccuracy necessitates the development and evaluation of methods to forecast and communicate forecast uncertainty, however, little research has been conducted in this domain for small area populations. In this paper, we evaluate a set of probabilistic forecasting methods which include Autoregressive integrated moving average, Exponential Smoothing, THETA, LightGBM and XGBOOST, to produce point forecasts and 80% prediction intervals for Australian SA2 small area populations. We also investigate methods to combine the intervals to produce ensemble forecasts. Our results show that individual probabilistic methods generally produce prediction intervals which underestimate forecast uncertainty. Combining forecasts improves the overall accuracy of point forecasts and the coverage of their intervals, however, coverage still tends to be less than the expected 80% for all but the most conservative combination method.
Selecting the Number and Labels of Topics in Topic Modeling: A Tutorial
Authors: Weston Sara J. , Shryock Ian , Light Ryan , Fisher Phillip A.
Published: May 2023

Topic modeling is a type of text analysis that identifies clusters of co-occurring words, or latent topics. A challenging step of topic modeling is determining the number of topics to extract. This tutorial describes tools researchers can use to identify the number and labels of topics in topic modeling. First, we outline the procedure for narrowing down a large range of models to a select number of candidate models. This procedure involves comparing the large set on fit metrics, including exclusivity, residuals, variational lower bound, and semantic coherence. Next, we describe the comparison of a small number of models using project goals as a guide and information about topic representative and solution congruence. Finally, we describe tools for labeling topics, including frequent and exclusive words, key examples, and correlations among topics.
Rituximab and mycophenolate mofetil combination in patients with interstitial lung disease (EVER-ILD): a double-blind, randomised, placebo-controlled trial
Authors: Mankikian Julie , Caille Agnès , Reynaud-Gaubert Martine , Agier Marie-Sara , Bermudez Julien , Bonniaud Philippe , Borie Raphael , Brillet Pierre-Yves , Cadranel Jacques , Court-Fortune Isabelle , Crestani Bruno , Debray Marie-Pierre , Gomez Emmanuel , Gondouin Anne , Hirschi-Santelmo Sandrine , Israel-Biet Dominique , Jouneau Stéphane , Juvin Karine , Leger Julie , Kerjouan Mallorie , Marquette Charles-Hugo , Naccache Jean-Marc , Nunes Hilario , Plantier Laurent , Prevot Grégoire , Quetant Sébastien , Traclet Julie , Valentin Victor , Uzunhan Yurdagul , Wémeau-Stervinou Lidwine , Bejan-Angoulvant Theodora , Cottin Vincent , Marchand-Adam Sylvain
Published: May 2023

Background

Standard of care for interstitial lung disease (ILD) with a nonspecific interstitial pneumonia (NSIP) pattern proposes mycophenolate mofetil (MMF) as one of the first-step therapies while rituximab is used as rescue therapy.

Methods

In a randomised, double-blind, two-parallel group, placebo-controlled trial (NCT02990286), patients with connective tissue disease-associated ILD or idiopathic interstitial pneumonia (with or without autoimmune features) and a NSIP pattern (defined on NSIP pathological pattern or on integration of clinicobiological data and a NSIP-like high-resolution computed tomography pattern) were randomly assigned in a 1:1 ratio to receive rituximab (1000 mg) or placebo on day 1 and day 15 in addition to MMF (2 g daily) for 6 months. The primary end-point was the change in percent predicted forced vital capacity (FVC) from baseline to 6 months analysed by a linear mixed model for repeated measures analysis. Secondary end-points included progression-free survival (PFS) up to 6 months and safety.

Findings

Between January 2017 and January 2019, 122 randomised patients received at least one dose of rituximab (n=63) or placebo (n=59). The least-squares mean change from baseline to 6 months in FVC (% predicted) was +1.60 (se1.13) in the rituximab+MMF group and −2.01 (se1.17) in the placebo+MMF group (between-group difference 3.60, 95% CI 0.41–6.80; p=0.0273). PFS was better in the rituximab+MMF group (crude hazard ratio 0.47, 95% CI 0.23–0.96; p=0.03). Serious adverse events occurred in 26 (41%) patients of the rituximab+MMF group and in 23 (39%) of the placebo+MMF group. Nine infections were reported in the rituximab+MMF group (five bacterial infections, three viral infections, one other) and four bacterial infections in the placebo+MMF group.

Interpretation

Combination of rituximab and MMF was superior to MMF alone in patients with ILD and a NSIP pattern. The use of this combination must take into consideration the risk of viral infection.
Drivers determining tuberculosis disease screening yield in four European screening programmes: a comparative analysis
Authors: Zenner Dominik , Brals Daniella , Nederby-Öhd Joanna , Menezes Dee , Aldridge Robert , Anderson Sarah R. , de Vries Gerard , Erkens Connie , Marchese Valentina , Matteelli Alberto , Muzyamba Morris , van Rest Job , Spruijt Ineke , Were John , Migliori Giovanni Battista , Lönnroth Knut , Cobelens Frank , Abubakar Ibrahim
Published: May 2023

Background

The World Health Organization End TB Strategy emphasises screening for early diagnosis of tuberculosis (TB) in high-risk groups, including migrants. We analysed key drivers of TB yield differences in four large migrant TB screening programmes to inform TB control planning and feasibility of a European approach.

Methods

We pooled individual TB screening episode data from Italy, the Netherlands, Sweden and the UK, and analysed predictors and interactions for TB case yield using multivariable logistic regression models.

Results

Between 2005 and 2018 in 2 302 260 screening episodes among 2 107 016 migrants to four countries, the programmes identified 1658 TB cases (yield 72.0 (95% CI 68.6–75.6) per 100 000). In logistic regression analysis, we found associations between TB screening yield and age (≥55 years: OR 2.91 (95% CI 2.24–3.78)), being an asylum seeker (OR 3.19 (95% CI 1.03–9.83)) or on a settlement visa (OR 1.78 (95% CI 1.57–2.01)), close TB contact (OR 12.25 (95% CI 11.73–12.79)) and higher TB incidence in the country of origin. We demonstrated interactions between migrant typology and age, as well as country of origin. For asylum seekers, the elevated TB risk remained similar above country of origin incidence thresholds of 100 per 100 000.

Conclusions

Key determinants of TB yield included close contact, increasing age, incidence in country of origin and specific migrant groups, including asylum seekers and refugees. For most migrants such as UK students and workers, TB yield significantly increased with levels of incidence in the country of origin. The high, country of origin-independent TB risk in asylum seekers above a 100 per 100 000 threshold could reflect higher transmission and re-activation risk of migration routes, with implications for selecting populations for TB screening.
Serial lung ultrasound in monitoring viral pneumonia: the lesson learned from COVID-19
Authors: Clofent David , Culebras Mario , Felipe-Montiel Almudena , Arjona-Peris Marta , Granados Galo , Sáez María , Pilia Florencia , Ferreiro Antía , Álvarez Antonio , Loor Karina , Bosch-Nicolau Pau , Polverino Eva
Published: May 2023

Background

Lung ultrasound (LUS) has proven to be useful in the evaluation of lung involvement in COVID-19. However, its effectiveness for predicting the risk of severe disease is still up for debate. The aim of the study was to establish the prognostic accuracy of serial LUS examinations in the prediction of clinical deterioration in hospitalised patients with COVID-19.

Methods

Prospective single-centre cohort study of patients hospitalised for COVID-19. The study protocol consisted of a LUS examination within 24 h from admission and a follow-up examination on day 3 of hospitalisation. Lung involvement was evaluated by a 14-area LUS score. The primary end-point was the ability of LUS to predict clinical deterioration defined as need for intensive respiratory support with high-flow oxygen or invasive mechanical ventilation.

Results

200 patients were included and 35 (17.5%) of them reached the primary end-point and were transferred to the intensive care unit (ICU). The LUS score at admission had been significantly higher in the ICU group than in the non-ICU group (22 (interquartile range (IQR) 20–26)versus12 (IQR 8–15)). A LUS score at admission ≥17 was shown to be the best cut-off point to discriminate patients at risk of deterioration (area under the curve (AUC) 0.95). The absence of progression in LUS score on day 3 significantly increased the prediction accuracy by ruling out deterioration with a negative predictive value of 99.29%.

Conclusion

Serial LUS is a reliable tool in predicting the risk of respiratory deterioration in patients hospitalised due to COVID-19 pneumonia. LUS could be further implemented in the future for risk stratification of viral pneumonia.
Asthma innovations from the first International Collaborative Asthma Network forum
Authors: Gaston Benjamin , Gardner Donna D. , Mahan Kenzie , Akuthota Praveen , Mendonca Eneida A. , Durrington Hannah , Marozkina Nadzeya , Martinez-Nunez Rocio T. , Newcomb Dawn , Ainsworth Benjamin , Owora Arthur H. , Chung Kian Fan , Walker Samantha , Fowler Stephen J. , Siddiqui Salman , Winders Tonya , Zein Joe , Jarjour Nizar , Huang Yvonne J. , Cahill Katherine N. , Djukanovic Ratko
Published: May 2023

Background

Many patients have uncontrolled asthma despite available treatments. Most of the new asthma therapies have focused on type 2 (T2) inflammation, leaving an unmet need for innovative research into mechanisms of asthma beyond T2 and immunity. An international group of investigators developed the International Collaborative Asthma Network (ICAN) with the goal of sharing innovative research on disease mechanisms, developing new technologies and therapies, organising pilot studies and engaging early-stage career investigators from across the world. This report describes the purpose, development and outcomes of the first ICAN forum.

Methods

Abstracts were solicited from interdisciplinary early-stage career investigators with innovative ideas beyond T2 inflammation for asthma and were selected for presentation at the forum. Breakout sessions were conducted to discuss innovation, collaboration and research translation.

Results

The abstracts were categorised into: 1) general omics and big data analysis; 2) lung–brain axis and airway neurology; 3) sex differences; 4) paediatric asthma; 5) new therapeutic targets inspired by airway epithelial biology; 6) new therapeutics targeting airway and circulating immune mediators; and 7) lung anatomy, physiology and imaging. Discussions revealed that research groups are looking for opportunities to further their findings using larger scale collaboration and the ability to translate theirin vitrofindings into clinical treatment.

Conclusions

Through ICAN, teams that included interdisciplinary early-stage career investigators discussed innovation, collaboration and translation in asthma and severe asthma research. With a combination of fresh ideas and energetic, collaborative, global participation, ICAN has laid a firm foundation and model for future collaborative global asthma research.
Response to endobronchial valve treatment: it's all about the target lobe
Authors: Hartman Jorine E. , Roodenburg Sharyn A. , van Dijk Marlies , Koster T. David , Klooster Karin , Slebos Dirk-Jan
Published: May 2023

Background

Bronchoscopic lung volume reduction using endobronchial valves (EBV) has been shown to be beneficial for severe emphysema patients. The most important predictor of treatment response is absence of collateral ventilation between the treatment target and ipsilateral lobe. However, there are still a substantial number of nonresponders and it would be useful to improve the pre-treatment identification of responders. Presumably, predictors of response will be multifactorial, and therefore our aim was to explore whether we can identify response groups using a cluster analysis.

Methods

At baseline and 1 year follow-up, pulmonary function, exercise capacity and quality of life were measured. A quantitative chest computed tomography scan analysis was performed at baseline and 2–6 months follow-up. The cluster analysis was performed using a hierarchical agglomerative method.

Results

In total, 428 patients (69% female, mean±sdage 61±8 years, forced expiratory volume in 1 s 27±8% predicted, residual volume 254±50% pred) were included in our analysis. Three clusters were generated: one nonresponder cluster and two responder clusters. Despite solid technical procedures, the nonresponder cluster had significantly less clinical response after treatment compared to the other clusters. The nonresponder cluster was characterised by significantly less emphysematous destruction, less air trapping and a higher perfusion of the target lobe, and a more homogeneous distribution of emphysema and perfusion between the target and ipsilateral lobe.

Conclusions

We found that target lobe characteristics are the discriminators between responders and nonresponders, which underlines the importance of visual and quantitative assessment of the potential treatment target lobe when selecting patients for EBV treatment.
Factor H preserves alternative complement function during ARDS, linked to improved survival
Authors: Bain William , Tabary Mohammadreza , Moore Sara R. , An Xiaojing , Kitsios Georgios D. , McVerry Bryan J. , Ray Prabir , Ray Anuradha , Mallampalli Rama K. , Ferreira Viviana P. , Lee Janet S. , Nouraie S. Mehdi
Published: May 2023

Background

Effective regulation of complement activation may be crucial to preserving complement function during acute respiratory distress syndrome (ARDS). Factor H is the primary negative regulator of the alternative pathway of complement. We hypothesised that preserved factor H levels are associated with decreased complement activation and reduced mortality during ARDS.

Methods

Total alternative pathway function was measured by serum haemolytic assay (AH50) using available samples from the ARDSnet Lisofylline and Respiratory Management of Acute Lung Injury (LARMA) trial (n=218). Factor B and factor H levels were quantified using ELISA using samples from the ARDSnet LARMA and Statins for Acutely Injured Lungs from Sepsis (SAILS) (n=224) trials. Meta-analyses included previously quantified AH50, factor B and factor H values from an observational registry (Acute Lung Injury Registry and Biospecimen Repository (ALIR)). Complement C3, and complement activation products C3a and Ba plasma levels were measured in SAILS.

Results

AH50 greater than the median was associated with reduced mortality in meta-analysis of LARMA and ALIR (hazard ratio (HR) 0.66, 95% CI 0.45–0.96). In contrast, patients in the lowest AH50 quartile demonstrated relative deficiency of both factor B and factor H. Relative deficiency of factor B (HR 1.99, 95% CI 1.44–2.75) or factor H (HR 1.52, 95% CI 1.09–2.11) was associated with increased mortality in meta-analysis of LARMA, SAILS and ALIR. Relative factor H deficiency was associated with increased factor consumption, as evidenced by lower factor B and C3 levels and Ba:B and C3a:C3 ratios. Higher factor H levels associated with lower inflammatory markers.

Conclusions

Relative factor H deficiency, higher Ba:B and C3a:C3 ratios and lower factor B and C3 levels suggest a subset of ARDS with complement factor exhaustion, impaired alternative pathway function, and increased mortality, that may be amenable to therapeutic targeting.
Diagnosis and treatment of primary urethral melanoma with regional lymphatic metastasis in an elderly woman: a case report and review of available therapies
Authors: Alvarez Restrepo Juan Camilo , Alvarez Restrepo Juan Felipe , Maya Giraldo Daniel S , Santafé Galvis Jhonatan S , Riveros Carlos Andres , Puentes Bernal Andres Felipe , Manrique Otto
Published: May 2023

Background

Mucosal melanomas account for 17% of melanomas, and less than 1% affect the urogenital tract. Primary urethral melanoma is extremely rare; less than 200 cases have been reported so far since it was first described. The clinical presentation is usually delayed, and the prognosis is generally poor.

Case presentation.

An 86-year-old female was referred to urology due to the presence of a three-month-old violaceous mass in the urethral meatus protruding through the vagina. On physical examination, a pedunculated, hyperpigmented, friable, and tender lesion was seen in the urethral meatus bulging between the labia minora. After initial diagnostic studies, the patient was taken to surgical resection of the lesion. The pathology report identified the lesion as a malignant melanoma of the urethra, and staging studies revealed regional lymph node metastases. After discussing the treatment options with the patient, palliative therapy with nivolumab was started. In follow-up at 26 months, the patient had evidence of extensive lymph node involvement, but a conserved performance status and no visceral metastases.

Conclusion

Primary melanoma of the female urethra is an uncommon disease with a poor prognosis. Despite the deficiency in literature regarding its management, it is important to consider patient expectations and preferences when treating this rare disease.
Combined central retinal vein occlusion and cilioretinal artery occlusion as the initial presentation of frosted branch angiitis: a case report and literature review
Authors: Albahlal Abdullah , Khayyat Waleed , Alsulaiman Sulaiman M.
Published: May 2023

Purpose

To report a case of combined central retinal vein occlusion (CRVO) with cilioretinal artery occlusion (CLRAO) that heralded the development of frosted branch angiitis (FBA).

Case report

A 25-year-old healthy male presented with sudden painless visual loss in his left eye with a visual acuity (VA) of 20/300. Fundus exam and fluorescein angiography showed signs of combined CRVO and CLRAO. Without treatment, his vision gradually improved until it reached 20/30 within four months. Five months after initial presentation, he returned with severe visual loss (20/400) in the same eye and a clinical picture of severe occlusive periphlebitis resembling a frosted branch angiitis pattern associated with severe macular edema. This was promptly and successfully treated with systemic steroids and immunosuppressive medications.

Conclusion

CRVO in young population can have an unusual course and one should carefully rule out underlying uveitic etiologies in each visit. Clinical suspicion and close follow‑up are required for early detection and timely management of FBA.
Balancing selection on the complement system of a wild rodent
Authors: Nandakumar Mridula , Lundberg Max , Carlsson Fredric , Råberg Lars
Published: May 2023

Background

Selection pressure exerted by pathogens can influence patterns of genetic diversity in the host. In the immune system especially, numerous genes encode proteins involved in antagonistic interactions with pathogens, paving the way for coevolution that results in increased genetic diversity as a consequence of balancing selection. The complement system is a key component of innate immunity. Many complement proteins interact directly with pathogens, either by recognising pathogen molecules for complement activation, or by serving as targets of pathogen immune evasion mechanisms. Complement genes can therefore be expected to be important targets of pathogen-mediated balancing selection, but analyses of such selection on this part of the immune system have been limited.

Results

Using a population sample of whole-genome resequencing data from wild bank voles (n = 31), we estimated the extent of genetic diversity and tested for signatures of balancing selection in multiple complement genes (n = 44). Complement genes showed higher values of standardised β (a statistic expected to be high under balancing selection) than the genome-wide average of protein coding genes. One complement gene, FCNA, a pattern recognition molecule that interacts directly with pathogens, was found to have a signature of balancing selection, as indicated by the Hudson-Kreitman-Aguadé test (HKA) test. Scans for localised signatures of balancing selection in this gene indicated that the target of balancing selection was found in exonic regions involved in ligand binding.

Conclusion

The present study adds to the growing evidence that balancing selection may be an important evolutionary force on components of the innate immune system. The identified target in the complement system typifies the expectation that balancing selection acts on genes encoding proteins involved in direct interactions with pathogens.
ETGPDA: identification of piRNA-disease associations based on embedding transformation graph convolutional network
Authors: Meng Xianghan , Shang Junliang , Ge Daohui , Yang Yi , Zhang Tongdui , Liu Jin-Xing
Published: May 2023

Background

Piwi-interacting RNAs (piRNAs) have been proven to be closely associated with human diseases. The identification of the potential associations between piRNA and disease is of great significance for complex diseases. Traditional “wet experiment” is time-consuming and high-priced, predicting the piRNA-disease associations by computational methods is of great significance.

Methods

In this paper, a method based on the embedding transformation graph convolution network is proposed to predict the piRNA-disease associations, named ETGPDA. Specifically, a heterogeneous network is constructed based on the similarity information of piRNA and disease, as well as the known piRNA-disease associations, which is applied to extract low-dimensional embeddings of piRNA and disease based on graph convolutional network with an attention mechanism. Furthermore, the embedding transformation module is developed for the problem of embedding space inconsistency, which is lightweighter, stronger learning ability and higher accuracy. Finally, the piRNA-disease association score is calculated by the similarity of the piRNA and disease embedding.

Results

Evaluated by fivefold cross-validation, the AUC of ETGPDA achieves 0.9603, which is better than the other five selected computational models. The case studies based on Head and neck squamous cell carcinoma and Alzheimer’s disease further prove the superior performance of ETGPDA.

Conclusions

Hence, the ETGPDA is an effective method for predicting the hidden piRNA-disease associations.