bluuebunny/crossref_metadata_2025 huggingface dataset:
Early Moderate to Vigorous Physical Activity After Concussion Is Associated With Faster Symptom Resolution Time
Authors: Rademacher Jacob G. , Wingerson Mathew J. , Smulligan Katherine L. , Little Casey C. , Wilson Julie C. , Howell David R.
Published: June 2023

Context: Early physical activity (PA) after concussion may promote symptom resolution. Prior studies have investigated exercise frequency/duration, yet precise PA intensity or volume required for optimal recovery requires further investigation. moderate to vigorous physical activity (MVPA) is beneficial for physical health. We investigated whether sedentary time, light activity time, MVPA time, or activity frequency in the weeks following concussion are associated with time to symptom resolution among adolescents. Design: Prospective cohort study. Methods: Adolescents 10–18 years of age were tested ≤14 days of concussion and followed until symptom resolution. At the initial visit, participants rated symptom severity and were provided wrist-worn activity trackers to monitor PA for the following week. PA behavior was categorized each day based on heart rate: sedentary (resting), light PA (50%–69% age-predicted max heart rate), and MVPA (70%–100% age-predicted max heart rate). Symptom resolution was defined as the date when participants reported cessation of concussion-like symptoms. Patients were not given specific PA instructions, though some may have received instructions from their physician. Results: Fifty-four participants were included in the study (54% female; mean age = 15.0 [1.8] y; initially assessed 7.5 [3.2] d after concussion). Female athletes recorded more sedentary time (900 [46] vs 738 [185] min/d; P = .01; Cohen d = 0.72), and less time in light PA (194.7 [64.5] vs 224 [55] min/d; P = .08; Cohen d = 0.48) and MVPA (23 [17] vs 38 [31] min/d; P = .04; Cohen d = 0.58) than male athletes. After adjusting for sedentary time, hours per day with >250 steps, sex, and initial symptom severity, more MVPA time was associated with faster symptom resolution time (hazard ratio = 1.016; 95% confidence interval, 1.001–1.032; P = .04). Conclusion: Our findings offer preliminary insight into how varying PA intensities affect concussion recovery, as MVPA may be a higher intensity than what is typically prescribed in concussion care.
The Drosophila tumor necrosis factor receptor, Wengen, couples energy expenditure with gut immunity
Authors: Loudhaief Rihab , Jneid Rouba , Christensen Christian Fokdal , Mackay Duncan J. , Andersen Ditte S. , Colombani Julien
Published: June 2023

It is well established that tumor necrosis factor (TNF) plays an instrumental role in orchestrating the metabolic disorders associated with late stages of cancers. However, it is not clear whether TNF/TNF receptor (TNFR) signaling controls energy homeostasis in healthy individuals. Here, we show that the highly conserved Drosophila TNFR, Wengen (Wgn), is required in the enterocytes (ECs) of the adult gut to restrict lipid catabolism, suppress immune activity, and maintain tissue homeostasis. Wgn limits autophagy-dependent lipolysis by restricting cytoplasmic levels of the TNFR effector, TNFR-associated factor 3 (dTRAF3), while it suppresses immune processes through inhibition of the dTAK1/TAK1-Relish/NF-κB pathway in a dTRAF2-dependent manner. Knocking down dTRAF3 or overexpressing dTRAF2 is sufficient to suppress infection-induced lipid depletion and immune activation, respectively, showing that Wgn/TNFR functions as an intersection between metabolism and immunity allowing pathogen-induced metabolic reprogramming to fuel the energetically costly task of combatting an infection.
Distorted neurocomputation by a small number of extra-large spines in psychiatric disorders
Authors: Obi-Nagata Kisho , Suzuki Norimitsu , Miyake Ryuhei , MacDonald Matthew L. , Fish Kenneth N. , Ozawa Katsuya , Nagahama Kenichiro , Okimura Tsukasa , Tanaka Shoji , Kano Masanobu , Fukazawa Yugo , Sweet Robert A. , Hayashi-Takagi Akiko
Published: June 2023

Human genetics strongly support the involvement of synaptopathy in psychiatric disorders. However, trans-scale causality linking synapse pathology to behavioral changes is lacking. To address this question, we examined the effects of synaptic inputs on dendrites, cells, and behaviors of mice with knockdown of SETD1A and DISC1, which are validated animal models of schizophrenia. Both models exhibited an overrepresentation of extra-large (XL) synapses, which evoked supralinear dendritic and somatic integration, resulting in increased neuronal firing. The probability of XL spines correlated negatively with working memory, and the optical prevention of XL spine generation restored working memory impairment. Furthermore, XL synapses were more abundant in the postmortem brains of patients with schizophrenia than in those of matched controls. Our findings suggest that working memory performance, a pivotal aspect of psychiatric symptoms, is shaped by distorted dendritic and somatic integration via XL spines.
A CRE/DRE dual recombinase transgenic mouse reveals synaptic zinc–mediated thalamocortical neuromodulation
Authors: Kouvaros Stylianos , Bizup Brandon , Solis Oscar , Kumar Manoj , Ventriglia Emilya , Curry Fallon P. , Michaelides Michael , Tzounopoulos Thanos
Published: June 2023

Synaptic zinc is a neuromodulator that shapes synaptic transmission and sensory processing. The maintenance of synaptic zinc is dependent on the vesicular zinc transporter, ZnT3. Hence, the ZnT3 knockout mouse has been a key tool for studying the mechanisms and functions of synaptic zinc. However, the use of this constitutive knockout mouse has notable limitations, including developmental, compensatory, and brain and cell type specificity issues. To overcome these limitations, we developed and characterized a dual recombinase transgenic mouse, which combines the Cre and Dre recombinase systems. This mouse allows for tamoxifen-inducible Cre-dependent expression of exogenous genes or knockout of floxed genes in ZnT3-expressing neurons and DreO-dependent region and cell type–specific conditional ZnT3 knockout in adult mice. Using this system, we reveal a neuromodulatory mechanism whereby zinc release from thalamic neurons modulates
N
-methyl-
d
-aspartate receptor activity in layer 5 pyramidal tract neurons, unmasking previously unknown features of cortical neuromodulation.
An osmium(II) methane complex: Elucidation of the methane coordination mode
Authors: Sempsrott Peter J. , Trinh Brian B. , Lovitt Charity Flener , Capra Nicolas E. , Girolami Gregory S.
Published: June 2023

The activation of inert C─H bonds by transition metals is of considerable industrial and academic interest, but important gaps remain in our understanding of this reaction. We report the first experimental determination of the structure of the simplest hydrocarbon, methane, when bound as a ligand to a homogenous transition metal species. We find that methane binds to the metal center in this system through a single M···H-C bridge; changes in the
1
J
CH
coupling constants indicate clearly that the structure of the methane ligand is significantly perturbed relative to the free molecule. These results are relevant to the development of better C─H functionalization catalysts.
Rapid recruitment and IFN-I–mediated activation of monocytes dictate focal radiotherapy efficacy
Authors: Tadepalli Sirimuvva , Clements Derek R. , Saravanan Sanjana , Arroyo Hornero Rebeca , Lüdtke Anja , Blackmore Beau , Paulo Joao A. , Gottfried-Blackmore Andres , Seong David , Park Soyoon , Chan Leslie , Kopecky Benjamin J. , Liu Zhaoyuan , Ginhoux Florent , Lavine Kory J. , Murphy John Patrick , Mack Matthias , Graves Edward E. , Idoyaga Juliana
Published: June 2023

The recruitment of monocytes and their differentiation into immunosuppressive cells is associated with the low efficacy of preclinical nonconformal radiotherapy (RT) for tumors. However, nonconformal RT (non-CRT) does not mimic clinical practice, and little is known about the role of monocytes after RT modes used in patients, such as conformal RT (CRT). Here, we investigated the acute immune response induced by after CRT. Contrary to non-CRT approaches, we found that CRT induces a rapid and robust recruitment of monocytes to the tumor that minimally differentiate into tumor-associated macrophages or dendritic cells but instead up-regulate major histocompatibility complex II and costimulatory molecules. We found that these large numbers of infiltrating monocytes are responsible for activating effector polyfunctional CD8
+
tumor-infiltrating lymphocytes that reduce tumor burden. Mechanistically, we show that monocyte-derived type I interferon is pivotal in promoting monocyte accumulation and immunostimulatory function in a positive feedback loop. We also demonstrate that monocyte accumulation in the tumor microenvironment is hindered when RT inadvertently affects healthy tissues, as occurs in non-CRT. Our results unravel the immunostimulatory function of monocytes during clinically relevant modes of RT and demonstrate that limiting the exposure of healthy tissues to radiation has a positive therapeutic effect on the overall antitumor immune response.
Supplemental Material: The process of crustal thickening in the southern Lhasa terrane during India-Eurasia collision: Constraint from Eocene high-Sr/Y rocks in the Quxu pluton
Authors: Wang Zhenzhen , Zhao Zhidan , al. et.
Published: June 2023

Supplemental geochemical data and figures.
Sclerosing epithelioid fibrosarcoma of the kidney
Authors: Pathak Neha , Kakkar Aanchal , Kaushal Seema , Batra Atul
Published: June 2023

A woman in her 20s presented with headache and back pain and was found to have a left renal mass with bony metastases. She underwent nephrectomy, and on histopathology was initially diagnosed with stage 4 clear cell sarcoma of the kidney. She underwent palliative radiation and chemotherapy; however, the disease progressed and she came to our centre. We started her on second-line chemotherapy and submitted her tissue blocks for review. Due to her age and lack of sclerotic stroma in the tissue, we had our doubts about the diagnosis and hence, tissue sample was submitted for next-generation sequencing (NGS). NGS detected anEWSR1::CREBL1fusion, clinching the final diagnosis of sclerosing epithelioid fibrosarcoma of the kidney, a singular diagnosis rarely reported in the literature. Currently, the patient is post her third line of chemotherapy, is on maintenance, and is doing well and has resumed her daily activities.
Epidemiology of hepatitis B virus infection among preconception couples in South China: a cross-sectional study
Authors: Liang Zhijiang , Qiu Jialing , Xiang Qianqian , Yi Jing , Zhu Juan , Zhao Qingguo
Published: June 2023

Objectives

Hepatitis B virus (HBV) infection is a global public health threat, and couples of reproductive age comprise a key population in aiming to reduce both the vertical and horizontal transmission of HBV. We aimed to update knowledge on the seroepidemiology status of HBV in Guangdong, China among a large number of couples planning conception, and to identify high-risk subgroups.

Design

A cross-sectional study was performed in Guangdong, China from 2014 to 2017.

Setting

The data were collected from 641 642 couples (1 283 284 individuals) participating in the National Free Preconception Health Examination Project in Guangdong, China from 1 January 2014 to 31 December 2017. For each participant, sociodemographic data were obtained and a serum sample was tested for HBV infection status.

Results

161 204 individuals (12.56%) were positive for hepatitis B surface antigen (HBsAg+), and 47 318 (3.69%) were positive for both HBsAg and hepatitis B e antigen (HBsAg+ and HBeAg+). There was a higher prevalence of HBsAg+ (12.77% vs 9.42%, p<0.05) and HBsAg+ and HBeAg+ (3.77% vs 2.45%, p<0.05) among the participants with a Guangdong household registration than a non-Guangdong household registration. Similarly, the prevalence of HBsAg (13.26% vs 11.72%, p<0.05) and HBsAg+ and HBeAg+ (4.31% vs 2.94%, p<0.05) was higher among participants not living in the Pearl River Delta than those living in the Pearl River Delta. At the couple level, 12 446 couples (1.94%) were both positive; in 51 849 (8.08%), only the wife was positive; in 84 463 (13.16%), only the husband was positive. Moreover, HBsAg+ prevalence was lowest in couples where both individuals were vaccinated (18.63%) and highest in couples where neither the wife or husband was vaccinated (24.46%).

Conclusion

There was a relatively high HBsAg+ prevalence in married couples in this high-epidemic region and urgent prevention strategies are required, such as ensuring access to health services for those not living in the Pearl River Delta, and expanding vaccine programmes to high-risk adults.
Robotic Arthroplasty Clinical and cost Effectiveness Randomised controlled trial (RACER-knee): a study protocol
Authors: Griffin James , Davis Edward T , Parsons Helen , Gemperle Mannion Elke , Khatri Chetan , Ellard David R , Blyth Mark J , Clement Nicholas David , Deehan David , Flynn Nicholas , Fox Josephine , Grant Nicholas J , Haddad Fares S , Hutchinson Charles E , Mason James , Mohindru Bishal , Scott Chloe E H , Smith Toby O , Skinner John A , Toms Andrew D , Rees Sophie , Underwood Martin , Metcalfe Andrew
Published: June 2023

Introduction

Robotic-assisted knee replacement systems have been introduced to healthcare services worldwide in an effort to improve clinical outcomes for people, although high-quality evidence that they are clinically, or cost-effective remains sparse. Robotic-arm systems may improve surgical accuracy and could contribute to reduced pain, improved function and lower overall cost of total knee replacement (TKR) surgery. However, TKR with conventional instruments may be just as effective and may be quicker and cheaper. There is a need for a robust evaluation of this technology, including cost-effectiveness analyses using both within-trial and modelling approaches. This trial will compare robotic-assisted against conventional TKR to provide high-quality evidence on whether robotic-assisted knee replacement is beneficial to patients and cost-effective for healthcare systems.

Methods and analysis

The Robotic Arthroplasty Clinical and cost Effectiveness Randomised controlled trial-Knee is a multicentre, participant-assessor blinded, randomised controlled trial to evaluate the clinical and cost-effectiveness of robotic-assisted TKR compared with TKR using conventional instruments. A total of 332 participants will be randomised (1:1) to provide 90% power for a 12-point difference in the primary outcome measure; the Forgotten Joint Score at 12 months postrandomisation. Allocation concealment will be achieved using computer-based randomisation performed on the day of surgery and methods for blinding will include sham incisions for marker clusters and blinded operation notes. The primary analysis will adhere to the intention-to-treat principle. Results will be reported in line with the Consolidated Standards of Reporting Trials statement. A parallel study will collect data on the learning effects associated with robotic-arm systems.

Ethics and dissemination

The trial has been approved by an ethics committee for patient participation (East Midlands—Nottingham 2 Research Ethics Committee, 29 July 2020. NRES number: 20/EM/0159). All results from the study will be disseminated using peer-reviewed publications, presentations at international conferences, lay summaries and social media as appropriate.

Trial registration number

ISRCTN27624068.
Early biomarkers of neurodevelopmental disorders in preterm infants: protocol for a longitudinal cohort study
Authors: Zhao Yilu , Liu Yunfeng , Gao Xuping , Wang Dan , Wang Ning , Xie Rao , Tong Xiaomei , He Yong , Yang Li
Published: June 2023

Introduction

Preterm (PT) infants are at high likelihood for poor neurodevelopmental outcomes, including autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD) and other neurodevelopmental disorders (NDDs), which could considerably impair the individuals’ functions throughout their whole life. The current cohort study aims to investigate adverse outcomes, especially NDDs, in PT children, and the related early aberrant brain developmental biomarkers.

Methods and analysis

This is a prospective cohort study in Beijing, China. We plan to recruit 400 PT infants born at <37 weeks of gestational age (GA), and 200 full-term (FT) controls during the neonatal period (40 weeks corrected GA), then follow them up until they reach 6 years of age. This cohort is designed to assess neuropsychological functions, brain development, related environmental risk factors and the incidence of NDDs by using the following measures: (1) social, emotional, cognitive and sensorimotor functions; (2) MRI, electroencephalogram and functional near-infrared spectroscopy; (3) social economic status, maternal mental health and DNA methylation; and (4) symptoms and diagnosis of NDDs. Main data analyses will include comparing the neurodevelopment outcomes and brain developmental trajectories between PT and FT children using linear or logistic regressions and mixed-effects models. Regression analyses and machine learning will be used to identify early biological predictors and environmental risk or protective factors for later NDDs outcomes.

Ethics and dissemination

Ethical approval has been obtained from the research ethics committee of Peking University Third Hospital (M2021087). This study is under review in the Chinese Clinical Trial Register. The study results from the current cohort will be disseminated and popularised through social media to participating parents, as well as parents who are giving care to PT children.
Implementation of a frailty intervention in the transition from hospital to home: a realist process evaluation protocol for the FORTRESS trial
Authors: Manuel Kisani , Block Heather , Crotty Maria , Harvey Gillian , Kurrle Susan E , Cameron Ian , Lockwood Keri , Sherrington Catherine , Pond Dimity , Nguyen Tuan A , Laver Kate
Published: June 2023

Introduction

Frailty in Older people: Rehabilitation, Treatment, Research Examining Separate Settings (the FORTRESS study) is a multisite, hybrid type II, stepped wedge, cluster, randomised trial examining the uptake and outcomes of a frailty intervention. The intervention is based on the 2017 Asia Pacific Clinical Practice Guidelines for the Management of Frailty and begins in the acute hospital setting and transitions to the community. The success of the intervention will require individual and organisational behaviour change within a dynamic health system. This process evaluation will examine the multiple variables at play in the context and mechanism of the frailty intervention to enhance understanding of the outcomes of the FORTRESS study and how the outcomes can be translated from the trial into broader practice.

Methods and analysis

The FORTRESS intervention will recruit participants from six wards in New South Wales and South Australia, Australia. Participants of the process evaluation will include trial investigators, ward-based clinicians, FORTRESS implementation clinicians, general practitioners and FORTRESS participants. The process evaluation has been designed using realist methodology and will occur in parallel to the FORTRESS trial. A mixed-method approach will be used with qualitative and quantitative data collected from interviews, questionnaires, checklists and outcome assessments. Qualitative and quantitative data will be examined for CMOCs (Context, Mechanism, Outcome Configurations) and programme theories will be developed, tested and refined. This will facilitate development of more generalisable theories to inform translation of frailty intervention within complex healthcare systems.

Ethics and dissemination

Ethical approval for the FORTRESS trial, inclusive of the process evaluation, has been obtained from the Northern Sydney Local Health District Human Research Ethics Committees reference number 2020/ETH01057. Recruitment for the FORTRESS trial uses opt-out consent. Dissemination will be via publications, conferences and social media.

Trial registration number

ACTRN12620000760976p (FORTRESS trial).
Individualised versus standard duration of antibiotic therapy in children with acute uncomplicated febrile urinary tract infection: a study protocol and statistical analysis plan for a multicentre randomised clinical trial
Authors: Sethi Naqash , Carlsen Emma Louise Malchau , Schmidt Ida Maria , Cortes Dina , Nygaard Ulrikka , Sehested Line Thousig
Published: June 2023

Introduction

Febrile urinary tract infection is one of the most common bacterial infections in children. Currently, recommended antibiotic duration is 10 days. However, recent evidence suggests that 90%–95% of children with febrile urinary tract infections are afebrile and clinically improved 48–72 hours after treatment initiation. Accordingly, individualised duration of antibiotic therapy, according to the recovery time, might be more beneficial than current recommendations, but no evidence exists.

Methods and analysis

An open-label randomised clinical trial equally randomising children aged 3 months to 12 years from eight Danish paediatric departments with uncomplicated febrile (≥38°C) urinary tract infection to either individualised or standard duration of antibiotic therapy. Children allocated to individualised duration of antibiotic therapy will terminate antibiotic therapy 3 days after clinical improvement with no fever, flank pain or dysuria. Children allocated to standard duration will receive 10 days of antibiotic therapy. Co-primary outcomes are non-inferiority for recurrent urinary tract infection or death within 28 days after the end of treatment (non-inferiority margin 7.5 percentage points) and superiority for the number of days with antibiotic therapy within 28 days after treatment initiation. Seven other outcomes will also be assessed. A total of 408 participants are needed to detect non-inferiority (one-sided alpha 2.5%; beta 80%).

Ethics and dissemination

This trial has been approved by the Ethics Committee (H-21057310) and the Data Protection Agency (P-2022-68) in Denmark. Regardless of the trial’s findings (whether positive, negative or inconclusive), the results will be compiled into one or more manuscripts for publication in international peer-reviewed scientific journals and presented at conferences.

Trial registration number

NCT05301023.
Healthcare professionals’ experiences of job satisfaction when providing person-centred care: a systematic review of qualitative studies
Authors: Gustavsson Kristoffer , van Diepen Cornelia , Fors Andreas , Axelsson Malin , Bertilsson Monica , Hensing Gunnel
Published: June 2023

Objectives

This qualitative systematic review aimed to explore and synthesise healthcare professionals’ (HCPs) experiences of job satisfaction when providing person-centred care (PCC) in healthcare settings in Europe.

Method

This systematic review of qualitative studies was followed by a thematic synthesis applying an inductive approach. Studies concerning HCPs and different levels of healthcare in Europe were eligible for inclusion. The CINAHL, PubMed and Scopus databases were searched. Study titles, abstracts and full texts were screened for relevance. Included studies were assessed for methodological quality using a quality appraisal checklist. Data were extracted and synthesised via thematic synthesis, generating analytical themes.

Results

Seventeen studies were included in the final thematic synthesis, and eight analytical themes were derived. Most studies were conducted in Sweden and the UK and were performed in hospitals, nursing homes, elderly care and primary care. Thirteen of these studies were qualitative and four used a mixed-method design in which the qualitative part was used for analysis. HCPs experienced challenges adapting to a new remoulded professional role and felt torn and inadequate due to ambiguities between organisational structures, task-oriented care and PCC. Improved job satisfaction was experienced when providing PCC in line with ethical expectations, patients and colleagues expressed appreciation and team collaboration improved, while learning new skills generated motivation.

Conclusion

This systematic review found varied experiences among HCPs. Notably, the new professional role was experienced to entail disorientation and uncertainty; importantly, it also entailed experiences of job satisfaction such as meaningfulness, an improved relationship between HCPs and patients, appreciation and collaboration. To facilitate PCC implementation, healthcare organisations should focus on supporting HCPs through collaborational structures, and resources such as time, space and staffing.

PROSPERO registration number

CRD42022304732.
Well-being and flourishing mental health in adults with inflammatory bowel disease, multiple sclerosis and rheumatoid arthritis in Manitoba, Canada: a cross-sectional study
Authors: Almweisheer Shaza , Bernstein Charles N , Graff Lesley A , Patten Scott B , Bolton James , Fisk John D , Hitchon Carol A , Marriott James J , Marrie Ruth Ann
Published: June 2023

Objectives

Among people with immune-mediated inflammatory disease (IMID), including multiple sclerosis (MS), inflammatory bowel disease (IBD) and rheumatoid arthritis (RA) most research has focused on mental illness rather than on mental health. We assessed dimensions of mental health among persons with IMID and compared them across IMID. We also evaluated demographic and clinical characteristics associated with flourishing mental health.

Design

Participants: Adults with an IMID (MS, 239; IBD, 225; RA 134; total 598) who were participating in a cohort study.

Setting

Tertiary care centre in Manitoba, Canada.

Primary outcome measure

Participants completed the Mental Health Continuum Short-Form (MHC-SF), which measures emotional, psychological and social well-being, and identifies flourishing mental health. This outcome was added midway through the study on the advice of the patient advisory group. Depression, anxiety, pain, fatigue and physical function were also assessed.

Results

Total MHC-SF and subscale scores were similar across IMID groups. Nearly 60% of participants were considered to have flourishing mental health, with similar proportions across disease types (MS 56.5%; IBD 58.7%; RA 59%, p=0.95). Older age was associated with a 2% increased odds of flourishing mental health per year of age (OR 1.02; 95% CI: 1.01 to 1.04). Clinically meaningful elevations in anxiety (OR 0.25; 95% CI: 0.12 to 0.51) and depressive symptoms (OR 0.074; 95% CI: 0.009 to 0.61) were associated with lower odds. Higher levels of pain, anxiety and depressive symptoms were associated with lower total Mental Health Continuum scores at the 50th quantile.

Conclusions

Over half of people with MS, IBD and RA reported flourishing mental health, with levels similar across the disease groups. Interventions targeting symptoms of depression and anxiety, and upper limb impairments, as well as resilience training may help a higher proportion of the IMID population achieve flourishing mental health.
Rehabilitation cooperation and person-centred dialogue meeting for patients sick-listed for common mental disorders: 12 months follow-up of sick leave days, symptoms of depression, anxiety, stress and work ability – a pragmatic cluster randomised controlled trial from the CO-WORK-CARE project
Authors: Björkelund Cecilia , Saxvik Ausra , Svenningsson Irene , Petersson Eva-Lisa , Wiegner Lilian , Larsson Maria , Törnbom Karin , Wikberg Carl , Ariai Nashmil , Nejati Shabnam , Hensing Gunnel , Hange Dominique
Published: June 2023

Objectives

To study whether early and enhanced cooperation within the primary care centres (PCC) combined with workplace cooperation via a person-centred employer dialogue meeting can reduce days on sick leave compared with usual care manager contact for patients on sick leave because of common mental disorders (CMD). Secondary aim: to study lapse of CMD symptoms, perceived Work Ability Index (WAI) and quality of life (QoL) during 12 months.

Design

Pragmatic cluster randomised controlled trial, randomisation at PCC level.

Setting

28 PCCs in Region Västra Götaland, Sweden, with care manager organisation.

Participants

30 PCCs were invited, 28 (93%) accepted invitation (14 intervention, 14 control) and recruited 341 patients newly sick-listed because of CMD (n=185 at intervention, n=156 at control PCCs).

Intervention

Complex intervention consisting of (1) early cooperation among general practitioner (GP), care manager and a rehabilitation coordinator, plus (2) a person-centred dialogue meeting between patient and employer within 3 months. Control group: regular contact with care manager.

Main outcome measures

12 months net and gross number of sick leave days at group level. Secondary outcomes: 12 months depression, anxiety, stress symptoms, perceived WAI and QoL (EuroQoL-5 Dimensional, EQ-5D).

Results

No significant differences were found between intervention and control groups concerning days of sick leave (intervention net days of sick leave mean 102.48 (SE 13.76) vs control 96.29 (SE 12.38) p=0.73), return to work (HR 0.881, 95% CI 0.688 to 1.128), or CMD symptoms, WAI or EQ-5D after 12 months.

Conclusions

It is not possible to speed up CMD patients’ return to work or to reduce sick leave time by early and enhanced coordination among GP, care manager and a rehabilitation coordinator, combined with early workplace contact over and above what ‘usual’ care manager contact during 3 months provides.

Trial registration number

NCT03250026.
Scoping review update on somatic symptom disorder that includes additional Chinese data
Authors: Wu Heng , Manglike Ayinuer , Chen Yixiao , Liu Ziming , Fritzsche Kurt , Lu Zheng
Published: June 2023

Somatic symptom disorder (SSD) is a new diagnosis introduced into the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is expected to solve the diagnostic difficulties of patients with medically unexplained symptoms.

Based on the previous work, this review aims to comprehensively synthesise updated evidence related to SSD from recent years in English publications and, more extensively, from data published in Chinese language journals.

The scoping review update was based on an earlier scoping review and included Chinese language publication data from China National Knowledge Internet (CNKI), WANFANG and WEIPU between January 2013 and May 2022 and data from PubMed, PsycINFO, and Cochrane Library between June 2020 and May 2022.

Initially, 2 984 articles were identified, of which 63 full texts were included for analysis. In China, SSD is mainly applied in scientific research, but it also shows good predictive validity and clinical application potential. The mean frequency of SSD was 4.5% in the general population, 25.2% in the primary care population and 33.5% in diverse specialised care settings. Biological factors, such as brain region changes and heart rate variability, are associated with the onset of SSD. Psychological impairment related to somatic symptoms is the best predictor of prognosis. While adolescent SSD was significantly associated with family function, SSD overall is associated with an increased dysfunction of cognition and emotion, decreased quality of life, and high comorbidity with anxiety and depressive disorders. Further research is needed on suicide risk and cultural and gender-related issues.

Updating the data of Chinese language studies, our research enriches the evidence-based findings related to the topics addressed in the text sections of the SSD chapter of DSM-5. However, research gaps remain about SSD reliability, population-based prevalence, suicide risk, and cultural and gender-related issues.
Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of gynecologic cancer
Authors: Disis Mary L , Adams Sarah F , Bajpai Jyoti , Butler Marcus O , Curiel Tyler , Dodt Shelley A , Doherty Laura , Emens Leisha A , Friedman Claire F , Gatti-Mays Margaret , Geller Melissa A , Jazaeri Amir , John Veena S , Kurnit Katherine C , Liao John B , Mahdi Haider , Mills Anne , Zsiros Emese , Odunsi Kunle
Published: June 2023

Advanced gynecologic cancers have historically lacked effective treatment options. Recently, immune checkpoint inhibitors (ICIs) have been approved by the US Food and Drug Administration for the treatment of cervical cancer and endometrial cancer, offering durable responses for some patients. In addition, many immunotherapy strategies are under investigation for the treatment of earlier stages of disease or in other gynecologic cancers, such as ovarian cancer and rare gynecologic tumors. While the integration of ICIs into the standard of care has improved outcomes for patients, their use requires a nuanced understanding of biomarker testing, treatment selection, patient selection, response evaluation and surveillance, and patient quality of life considerations, among other topics. To address this need for guidance, the Society for Immunotherapy of Cancer (SITC) convened a multidisciplinary panel of experts to develop a clinical practice guideline. The Expert Panel drew on the published literature as well as their own clinical experience to develop evidence- and consensus-based recommendations to provide guidance to cancer care professionals treating patients with gynecologic cancer.
Filling gaps in female gout: a cross-sectional study of comorbidities in 192 037 hospitalised patients
Authors: Rodríguez-Sosa Enrique , De Miguel Eugenio , Borrás Fernando , Andrés Mariano
Published: June 2023

Objective

There is room for improvement in the knowledge of female gout, often noted at risk of gender blindness. This study aims to compare the prevalence of comorbidities in women versus men hospitalised with gout in Spain.

Methods

This is an observational, multicentre, cross-sectional study in public and private Spanish hospitals analysing the minimum basic data set from 192 037 hospitalisations in people with gout (International Classification of Diseases, Ninth Revision (ICD-9) coding) from 2005 to 2015. Age and several comorbidities (ICD-9) were compared by sex, with a subsequent stratification of comorbidities by age group. The association between each comorbidity and sex was assessed using multivariable logistic regression. A clinical decision tree algorithm was constructed to predict the sex of patients with gout based on age and comorbidities alone.

Results

Women with gout (17.4% of the sample) were significantly older than men (73.9±13.7 years vs 64.0±14.4 years, p<0.001). Obesity, dyslipidaemia, chronic kidney disease, diabetes mellitus, heart failure, dementia, urinary tract infection and concurrent rheumatic disease were more common in women. Female sex was strongly associated with increasing age, heart failure, obesity, urinary tract infection and diabetes mellitus, while male sex was associated with obstructive respiratory diseases, coronary disease and peripheral vascular disease. The decision tree algorithm built showed an accuracy of 74.4%.

Conclusions

A nationwide analysis of inpatients with gout in 2005–2015 confirms a different comorbidity profile between men and women. A different approach to female gout is needed to reduce gender blindness.
Cancer treatment refusal decisions in advanced cancer: a retrospective case–control study
Authors: Akpoviroro Ogheneyoma , Sauers Nathan Kyle , Akpoviroro Oghenetejiro Princess , Uwandu Queeneth , Castagne Myriam , Rodrigues Elga , May Patrick , Lewis Meredith , Bolden Brian , Mirza Wasique
Published: June 2023

Objective

Cancer remains one of the leading causes of death worldwide. Despite advancements in anticancer therapy, some patients decide against treatment. Our study focused on characterising therapy refusal in advanced-stage malignancies and further determining if certain variables significantly correlated with refusal, compared with acceptance.

Methods

Our inclusion criteria were patients aged 18–75 years, stage IV cancers between 1 January 2010 and 31 December 2015 and treatment refusal (cohort 1 (C1)). A randomly selected group of patients with stage IV cancers who accepted treatment within the same timeframe was used for comparison (cohort 2 (C2)).

Results

There were 508 patients in C1 and 100 patients in C2. Female sex was associated with treatment acceptance (51/100, 51.0%) than refusal (201/508, 39.6%); p=0.03. There were no associations between treatment decisions and race, marital status, BMI, tobacco use, previous cancer history, or family cancer history. Government-funded insurance was associated with treatment refusal (337/508, 66.3%) than acceptance (35/100, 35.0%); p<0.001. Age was associated with refusal (p<0.001). Average age of C1 was 63.1 years (SD:8.1) and C2 was 59.2 years (SD:9.9). Only 19.1% (97/508) in C1 were referred to palliative medicine, with 18% (18/100) in C2; p=0.8. There was a trend for patients who accepted therapy to have more comorbidities per the Charlson Comorbidity Index(p=0.08). The treatment of psychiatric disorders after cancer diagnosis was inversely associated with treatment refusal (p<0.001).

Conclusions

The treatment of psychiatric disorders after cancer diagnosis was associated with cancer treatment acceptance. Male sex, older age and government-funded health insurance were associated with treatment refusal in patients with advanced cancer. Those who refused treatment were not increasingly referred to palliative medicine.
Predicting the long-term effects of electronic cigarette use on population health: a systematic review of modelling studies
Authors: Vu Giang T , Stjepanović Daniel , Sun Tianze , Leung Janni , Chung Jack , Connor Jason , Thai Phong K , Gartner Coral E , Tran Bach Xuan , Hall Wayne D , Chan Gary
Published: June 2023

Objective

To systematically review and synthesise the findings of modelling studies on the population impacts of e-cigarette use and to identify potential gaps requiring future investigation.

Data source and study selection

Four databases were searched for modelling studies of e-cigarette use on population health published between 2010 and 2023. A total of 32 studies were included.

Data extraction

Data on study characteristics, model attributes and estimates of population impacts including health outcomes and smoking prevalence were extracted from each article. The findings were synthesised narratively.

Data synthesis

The introduction of e-cigarettes was predicted to lead to decreased smoking-related mortality, increased quality-adjusted life-years and reduced health system costs in 29 studies. Seventeen studies predicted a lower prevalence of cigarette smoking. Models that predicted negative population impacts assumed very high e-cigarette initiation rates among non-smokers and that e-cigarette use would discourage smoking cessation by a large margin. The majority of the studies were based on US population data and few studies included factors other than smoking status, such as jurisdictional tobacco control policies or social influence.

Conclusions

A population increase in e-cigarette use may result in lower smoking prevalence and reduced burden of disease in the long run, especially if their use can be restricted to assisting smoking cessation. Given the assumption-dependent nature of modelling outcomes, future modelling studies should consider incorporating different policy options in their projection exercises, using shorter time horizons and expanding their modelling to low-income and middle-income countries where smoking rates remain relatively high.
New optical soliton solutions and dynamical wave formations for a fractionally perturbed Chen-Lee-Liu (CLL) equation with a novel local fractional (NLF) derivative
Authors: Ouahid Loubna , Alanazi Meznah M. , Shahrani Jameelah S. Al , Abdou M. A. , Kumar Sachin
Published: June 2023

In this work, we use a novel fractional-order derivative for the fractionally perturbed Chen–Lee–Liu nonlinear equation. The new extended hyperbolic function (EHF) method is applied for obtaining new optical soliton solutions of the mentioned equation. Three-dimensional graphics and projection 3D plots are used for showing the dynamic wave formations of the soliton solutions. Then, we contrast our findings with the earlier existing results for the nonlinearly perturbed CCL. The generated solutions show that the extended hyperbolic function (EHF) method for finding soliton solutions to highly nonlinear equations is productive, suitable, and competent in optical fibers, fractional calculus, and nonlinear sciences.
FL4IoT: IoT Device Fingerprinting and Identification Using Federated Learning
Authors: Wang Han , Eklund David , Oprea Alina , Raza Shahid
Published: June 2023

Unidentified devices in a network can result in devastating consequences. It is, therefore, necessary to fingerprint and identify IoT devices connected to private or critical networks. With the proliferation of massive but heterogeneous IoT devices, it is getting challenging to detect vulnerable devices connected to networks. Current machine learning-based techniques for fingerprinting and identifying devices necessitate a significant amount of data gathered from IoT networks that must be transmitted to a central cloud. Nevertheless, private IoT data cannot be shared with the central cloud in numerous sensitive scenarios. Federated learning (FL) has been regarded as a promising paradigm for decentralized learning and has been applied in many different use cases. It enables machine learning models to be trained in a privacy-preserving way. In this article, we propose a privacy-preserved IoT device fingerprinting and identification mechanisms using FL; we call it FL4IoT. FL4IoT is a two-phased system combining unsupervised-learning-based device fingerprinting and supervised-learning-based device identification. FL4IoT shows its practicality in different performance metrics in a federated and centralized setup. For instance, in the best cases, empirical results show that FL4IoT achieves ∼99%
accuracy
and
F1-Score
in identifying IoT devices using a federated setup without exposing any private data to a centralized cloud entity. In addition, FL4IoT can detect spoofed devices with over 99%
accuracy
.
Worbel: Aggregating Point Labels into Word Clouds
Authors: Bhore Sujoy , Ganian Robert , Li Guangping , Nöllenburg Martin , Wulms Jules
Published: June 2023

Point feature labeling is a classical problem in cartography and GIS that has been extensively studied for geospatial point data. At the same time, word clouds are a popular visualization tool to show the most important words in text data which has also been extended to visualize geospatial data (Buchin et al. PacificVis 2016). In this article, we study a hybrid visualization, which combines aspects of word clouds and point labeling. In the considered setting, the input data consist of a set of points grouped into categories and our aim is to place multiple disjoint and axis-aligned rectangles, each representing a category, such that they cover points of (mostly) the same category under some natural quality constraints. In our visualization, we then place category names inside the computed rectangles to produce a labeling of the covered points which summarizes the predominant categories globally (in a word-cloud-like fashion) while locally avoiding excessive misrepresentation of points (i.e., retaining the precision of point labeling). We show that computing a minimum set of such rectangles is
NP
-hard. Hence, we turn our attention to developing a heuristic with (optional) exact components using
SAT
models to compute our visualizations. We evaluate our algorithms quantitatively, measuring running time and quality of the produced solutions, on several synthetic and real-world data sets. Our experiments show that the fully heuristic approach produces solutions of comparable quality to heuristics combined with exact
SAT
models, while running much faster.
A Primer on
Seq2Seq
Models for Generative Chatbots
Authors: Scotti Vincenzo , Sbattella Licia , Tedesco Roberto
Published: June 2023

The recent spread of Deep Learning-based solutions for Artificial Intelligence and the development of Large Language Models has pushed forwards significantly the Natural Language Processing area. The approach has quickly evolved in the last ten years, deeply affecting NLP, from low-level text pre-processing tasks –such as tokenisation or POS tagging– to high-level, complex NLP applications like machine translation and chatbots. This article examines recent trends in the development of open-domain data-driven generative chatbots, focusing on the
Seq2Seq
architectures. Such architectures are compatible with multiple learning approaches, ranging from supervised to reinforcement and, in the last years, allowed to realise very engaging open-domain chatbots. Not only do these architectures allow to directly output the next turn in a conversation but, to some extent, they also allow to control the style or content of the response. To offer a complete view on the subject, we examine possible architecture implementations as well as training and evaluation approaches. Additionally, we provide information about the openly available corpora to train and evaluate such models and about the current and past chatbot competitions. Finally, we present some insights on possible future directions, given the current research status.
Start-Up Charging Strategy for a Large-Format NMCA/Graphite Pouch Cell from Subzero Temperature Using an Electrochemical, Thermal, and Mechanical Life Model
Authors: Song Minseok , Choi Munnyeong , Choe Song-Yul
Published: June 2023

Start-up strategy of battery pack in vehicular applications is crucial to secure the performance of the battery system, particularly at subzero temperatures. In this paper, a new strategy for cold start-up is proposed using an electrochemical, thermal, and mechanical life model. Especially, the conventional mechanical model that requires complex multi-dimensional lithium-ion concentration is simplified to reduce the computational cost. The developed model is experimentally validated with voltage responses at −10 °C under various current profiles, which predicts capacity fade by chemical and mechanical degradation. Further analysis is performed using the model, which provides the detailed mechanisms of the degradation. Finally, a new charging algorithm targeting the start-up strategy at subzero temperature is developed. The proposed profile consists of discharge pulses applied at the start to stimulate the increase of the battery temperature and then charging current that optimally minimizes the capacity fade and charging speed. The pulse parameters and charging current profile are optimized using Genetic algorithm and nonlinear model predictive control, respectively. The algorithm is implemented in a battery-in-the-loop system and compared with CC/CV charging methods from a subzero temperature. The results of the new method have shown improved charging efficiency and cycle life.
Structure-Electrochemical Property Relationship of F vs 2F Substituents in Low Bandgap Conjugated Polymers
Authors: Cevher Duygu , Toppare Levent , Cirpan Ali
Published: June 2023

Two alternating copolymers bearing fluorinated benzothiadiazole as a strong acceptor unit and dithienopyrrole as a strong donor unit were designed and synthesized to discuss the effect of the number of fluorine atom substitution. The polymers were characterized via cyclic voltammetry, spectroelectrochemistry, electrochemical impedance spectroscopy and galvanostatic charge discharge studies. Besides a red shift in absorption spectra, an anodic shift was also observed in the oxidation potentials when number of fluorine atom increases in the polymer backbone. Galvanostatic charge-discharge (GCD) studies revealed that difluorinated polymer exhibited enhanced area specific capacitance compared to mono fluorinated polymer.