bluuebunny/crossref_metadata_2025 huggingface dataset:
Proteomic analysis of meropenem-induced outer membrane vesicles released by carbapenem-resistant
Klebsiella pneumoniae
Authors: Fan Fangfang , Chen Guangzhang , Deng Siqian , Wei Li
Published: January 2024

Carbapenem-resistant
Klebsiella pneumoniae
(CRKP) is an important multidrug resistance (MDR) pathogen that threatens human health and is the main source of hospital-acquired infection. Outer membrane vesicles (OMVs) are extracellular vesicles derived from Gram-negative bacteria and contain materials involved in bacterial survival and pathogenesis. They also contribute to cellular communication to nearby or distant recipient cells and influence their functions and phenotypes. In this study, we sought to understand the mechanism of bacterial response to meropenem pressure and explore the relationship between pathogenic proteins and the high pathogenicity of bacteria. We performed whole-genome PacBio sequencing on a clinical CRKP strain, and its OMVs were characterized using nanoparticle tracking analysis, transmission electron microscopy, and proteomic analysis. Thousands of vesicle proteins have been identified in mass spectrometry-based high-throughput proteomics analyses of
K. pneumoniae
OMVs. Protein functionality analysis showed that the OMVs were predominantly involved in metabolic, intracellular compartments, nucleic acid binding, survival, defense, and antibiotic resistance, such as Chromosome partition protein MukB, 3-methyl-2-oxobutanoate hydroxymethyltransferase, methionine—tRNA ligase, Heat shock protein 60 family chaperone GroEL, and Gamma-glutamyl phosphate reductase. Additionally, a protein-protein interaction network demonstrated that OMVs from meropenem-treated
K. pneumoniae
showed the highest connectivity in DNA polymerase I, phenylalanine–tRNA ligase beta subunit, DNA-directed RNA polymerase subunit beta, methionine–tRNA ligase, DNA-directed RNA polymerase subunit beta, and DNA-directed RNA polymerase subunit alpha. The OMVs proteome expression profile indicates increased secretion of stress proteins released from meropenem-treated
K. pneumoniae
, which provides clues for revealing the biogenesis and pathophysiological functions of Gram-negative bacteria OMVs. The significant differentially expressed proteins identified in this study are of great significance for exploring effective control strategies for CRKP infection.

IMPORTANCE

Meropenem is one of the main antibiotics used in the clinical treatment of carbapenem-resistant
Klebsiella pneumoniae
(CRKP). This study demonstrated that some important metabolic changes occurred in meropenem-induced CRKP-outer membrane vesicles (OMVs), The OMVs proteome expression profile indicates increased secretion of stress proteins released from meropenem-induced
Klebsiella pneumoniae
. Furthermore, this is the ﬁrst study to discuss the protein-protein interaction network of the OMVs released by CRKP, especially under antibiotic stress.
Does ECG monitoring affect resuscitation for neonates with pulseless electrical activity in the delivery room? A simulated, pilot, crossover randomised trial
Authors: Assaad Michael-Andrew , Gariepy-Assal Laurence , Moussa Ahmed
Published: January 2024

Objective

To evaluate whether ECG monitoring impacts resuscitative steps during simulated neonatal resuscitation in the setting of pulseless electrical activity (PEA) in the delivery room.

Design

This pilot, crossover randomised controlled trial recruited providers in teams of three who participated in two simulation scenarios (PEA with and without ECG monitoring). Teams were randomised to one scenario and then crossed over. All sessions were video-recorded. The primary outcome was time to pulse check once the manikin was programmed to become pulseless. The secondary outcomes were total pulse checks, time to positive pressure ventilation, intubation, chest compressions and administration of epinephrine, and teams’ quotes and behaviours during resuscitation. The primary outcome was analysed using Kaplan-Meier survival curve. The secondary outcomes were compared with Wilcoxon signed-rank test. The quotes were analysed using content analysis with pattern coding.

Results

Eighty-two healthcare providers were approached and 30 consented (10 teams). The mean time to check the pulse once the manikin was pulseless was 38.5 s (SD 30.1) without ECG vs 88.1 s (SD 46.1) with ECG (p<0.01). There was a significantly decreased number of pulse checks with the ECG compared with without (p<0.01). Time to intubation, chest compressions, start of positive pressure ventilation and epinephrine administration was not different between the groups. Quotes/behaviours revealed false reassurance and over-reliance on ECG monitoring, repeated pulse check errors and troubleshooting behaviours.

Conclusions

ECG monitoring in simulated neonatal resuscitation results in delayed recognition of a pulseless state, decreased number of pulse checks and a possible false sense of security. Simulated resuscitation clinical endpoints are unaffected.
All cause and cause specific mortality in obsessive-compulsive disorder: nationwide matched cohort and sibling cohort study
Authors: Fernández de la Cruz Lorena , Isomura Kayoko , Lichtenstein Paul , Larsson Henrik , Kuja-Halkola Ralf , Chang Zheng , D’Onofrio Brian M , Brikell Isabell , Rück Christian , Sidorchuk Anna , Mataix-Cols David
Published: January 2024

Objective

To estimate the risk of all cause and cause specific mortality in people with obsessive-compulsive disorder (OCD) compared with matched unaffected people from the general population and with their unaffected siblings.

Design

Population based matched cohort and sibling cohort study.

Setting

Register linkage in Sweden.

Participants

Population based cohort including 61 378 people with OCD and 613 780 unaffected people matched (1:10) on sex, birth year, and county of residence; sibling cohort consisting of 34 085 people with OCD and 47 874 unaffected full siblings. Cohorts were followed up for a median time of 8.1 years during the period from 1 January 1973 to 31 December 2020.

Main outcome measures

All cause and cause specific mortality.

Results

4787 people with OCD and 30 619 unaffected people died during the study period (crude mortality rate 8.1 and 5.1 per 1000 person years, respectively). In stratified Cox proportional hazards models adjusted for birth year, sex, county, migrant status (born in Sweden versus abroad), and sociodemographic variables (latest recorded education, civil status, and family income), people with OCD had an increased risk of all cause mortality (hazard ratio 1.82, 95% confidence interval 1.76 to 1.89) and mortality due to natural causes (1.31, 1.27 to 1.37) and unnatural causes (3.30, 3.05 to 3.57). Among the natural causes of death, those due to endocrine, nutritional, and metabolic diseases, mental and behavioural disorders, and diseases of the nervous, circulatory, respiratory, digestive, and genitourinary systems were higher in the OCD cohort. Conversely, the risk of death due to neoplasms was lower in the OCD cohort compared with the unaffected cohort. Among the unnatural causes, suicide showed the highest hazard ratio, followed by accidents. The results were robust to adjustment for psychiatric comorbidities and familial confounding.

Conclusions

Non-communicable diseases and external causes of death, including suicides and accidents, were major contributors to the risk of mortality in people with OCD. Better surveillance, prevention, and early intervention strategies should be implemented to reduce the risk of fatal outcomes in people with OCD.
Association of metabolic dysfunction-associated fatty liver disease with gastrointestinal infections: insights from National Inpatient Sample Database
Authors: Patel Jay , Sohal Aalam , Bains Kanwal , Chaudhry Hunza , Kohli Isha , Khanna Tejasvini , Dukovic Dino , Roytman Marina
Published: January 2024

Objectives

The study aimed to compare the risk of gastrointestinal infections among patients with and without metabolic dysfunction-associated fatty liver disease (MAFLD).

Methods

This was a population-based, retrospective, observational study using data from the National Inpatient Sample (NIS), the largest all-payer US inpatient care database.

Setting

Hospitalisation of adults aged ≥18 years old admitted in 2020 was identified using the NIS. Patients were stratified by the presence and absence of MAFLD.

Participants

26.4 million adults aged ≥18 years old were included in the study. Patients younger than 18 and those with missing demographic or mortality data were excluded.

Primary and secondary outcomes

Primary outcome was to assess the overall risk of gastrointestinal infections in patients with and without MAFLD. Secondary outcomes were demographics and comorbidities stratified by the presence or absence of gastrointestinal infection, and the risk of specific gastrointestinal pathogens.

Results

Of 26.4 million patients admitted in 2020, 755 910 (2.85%) had the presence of MAFLD. There was a higher prevalence of bacterial gastrointestinal infections in patients with MAFLD than those without (1.6% vs 0.9%, p<0.001). The incidence ofClostridioides difficile(1.3% vs 0.8%, p<0.001),Escherichia coli(0.3% vs 0.01%, p<0.001), andSalmonella(0.07% vs 0.03%, p<0.001) was higher in patients with MAFLD. The presence of MAFLD was associated with higher odds of developing gastrointestinal infections (adjusted OR (aOR) −1.75, 95% CI −1.68 to 1.83, p<0.001). After adjusting for confounders, results remained statistically significant (aOR −1.36, 95% CI - 1.30-1.42, p<0.001).

Conclusion

Even after adjusting for confounding factors, our study demonstrates an increased risk of gastrointestinal infections in patients with MAFLD, specifically ofC. difficile,E. coli, andSalmonella. The immune and microbiota changes seen within MAFLD potentially contribute to the increased risk of gastrointestinal infections.
Peculiar aetiology for orbital apex syndrome: Wyburn-Mason syndrome as orbital apex lesion
Authors: Barros Lívio Leite , Lima Pedro Lucas Grangeiro de Sá Barreto , de Oliveira Júnior Pedro Helder , Dias Daniel Aguiar , Santos Carolina de Figueiredo , Braga-Neto Pedro , Nóbrega Paulo Ribeiro
Published: January 2024

Background

Wyburn-Mason syndrome is a rare, non-hereditary congenital disease, belonging to the group of neurocutaneous syndromes with fewer than 100 cases reported since its first description in 1937.

Case report

A young adult man was initially evaluated at the age of 2 years for proptosis and progressive visual impairment of the right eye, followed by impairment in ocular abduction, adduction and elevation as well as amaurosis. MRI revealed an expansive formation centred in the right orbit compromising conal spaces with distortion of eye muscles and optic nerve. The lesion extended through the superior orbital fissure into the right cavernous sinus and to the contralateral orbit. Despite embolisation, proptosis and oedema of the periorbital tissue continued to worsen. The combination of facial, ocular and intracranial vascular malformations and the exclusion of alternative aetiologies led to a diagnosis of cerebrofacial arteriovenous metameric syndrome (CAMS) 1 (Wyburn-Mason syndrome).

Discussion

Important differential diagnoses are other CAMS, such as Sturge-Weber syndrome, as well as other conditions such as retinal cavernous haemangioma and vasoproliferative tumours. The optimal treatment regimen for severe cases of this syndrome is still unclear. Wyburn-Mason syndrome should be considered in patients presenting multiple arteriovenous malformations with orbital apex lesions.
Repurposing radiosensitising medicines for radiotherapy: an overview
Authors: Low Jie Man , Rodriguez-Berriguete Gonzalo , Higgins Geoff S
Published: January 2024

Repurposing established non-cancer drugs for the treatment of cancer offers potential benefits such as speed of clinical translation and financial efficiencies. In this study, we assess the landscape of repurposing drugs for combined use with radiotherapy (RT) based on their capacity to increase tumour radiosensitivity. Using a literature-based approach, we identified 42 radiosensitising drugs with varied non-cancer indications and mechanisms of action, that have entered or completed clinical trials in combination with RT or with chemoradiotherapy. Two compounds, nicotinamide and nimorazole, have entered routine but limited clinical use in combination with radiotherapy. We provide an overview on these successfully repurposed drugs, and highlight some examples of unsuccessful repurposing efforts and drug candidates with an uncertain prospect of success. Upon reviewing the trials, we identified some common themes behind the unsuccessful efforts, including poor trial reporting, absence of biomarkers and patient selection, sub-optimal pharmacological properties, inappropriate trial design, lack or inadequate consideration of pre-clinical and clinical data, and limited funding support. We point out future directions to mitigate these issues and increase the likelihood of success in repurposing drug treatments for radiotherapy.
Clinical outcome of rural in-hospital-stroke patients after interhospital transfer for endovascular therapy within a telemedical stroke network in Germany: a registry-based observational study
Authors: Leitner Miriam Antonia , Hubert Gordian Jan , Paternoster Laura , Leitner Moritz Immanuel , Rémi Jan Martin , Trumm Christoph , Haberl Roman Ludwig , Hubert Nikolai Dominik
Published: January 2024

Objectives

Little is known about in-hospital-stroke (IHS) patients with large vessel occlusion and subsequent transfer to referral centres for endovascular therapy (EVT). However, this subgroup is highly relevant given the substantial amount of IHS, the ongoing trend towards greater use of EVT and lack of EVT possibilities in rural hospitals. The study objective is to explore the clinical outcomes of this vulnerable patient group, given that both IHS and interhospital transfer are associated with worse clinical outcomes due to a higher proportion of pre-existing conditions and substantial time delays during transfer.

Design and setting

Prospectively collected data of patients receiving EVT after interhospital transfer from 14 rural hospitals of the Telemedical Stroke Network in Southeast Bavaria (TEMPiS) between February 2018 and July 2020 was analysed.

Participants

49 IHS and 274 out-of-hospital-stroke (OHS) patients were included.

Outcome measures

Baseline characteristics, treatment times and outcomes were compared between IHS and OHS. The primary endpoint was a 3-month modified Rankin Scale (mRS).

Results

In IHS patients, atrial fibrillation (55.3% vs 35.9%, p=0.012), diabetes (36.2% vs 21.1%, p=0.024) and use of oral anticoagulants (44.7% vs 20.8%, p<0.001) were more frequent. Stroke severity was similar in both groups. Treatment times from symptom onset to first brain imaging, therapy decision or EVT were shorter for IHS patients. IHS patients displayed worse clinical outcomes: 59.2% of IHS patients died within 3 months compared with 28.5% of OHS patients (p<0.001). They were less likely to achieve moderate outcomes (mRS 0–3) 3 months after stroke (20.4% vs 39.8%, p=0.010). After controlling for possible confounding variables, IHS was associated with worse clinical outcomes (adjusted OR 3.04 (95% CI 1.57 to 6.04), p<0.001).

Conclusions

The mortality of IHS patients after interhospital transfer and EVT was high and functional outcomes were worse compared with those of OHS patients. Further research is needed to ascertain whether IHS patients benefit from this therapeutic approach. A more careful selection of IHS patients for transfer and means to enable faster treatment should be considered.

Trial registration number

NCT04270513; Post-results.
Protocol for the air purification for eosinophilic COPD study (APECS): a randomised controlled trial of home air filtration by HEPA
Authors: Saeed Muhammad S , Denoncourt Cailey M , Chao Isabella A , Schortmann Sophia , Nassikas Nicholas J , Synn Andrew J , Koutrakis Petros , Coull Brent A , Kang Choong-Min , Wolfson Jack M , Ferguson Stephen T , Rebuli Meghan E , Jaspers Ilona , Liu Jessica P , Greco Kimberly F , Phipatanakul Wanda , Rice Mary B
Published: January 2024

Introduction

Exposure to particulate matter (PM) pollution has been associated with lower lung function in adults with chronic obstructive pulmonary disease (COPD). Patients with eosinophilic COPD have been found to have higher levels of airway inflammation, greater responsiveness to anti-inflammatory steroid inhalers and a greater lung function response to PM pollution exposure compared with those with lower eosinophil levels. This study will evaluate if reducing home PM exposure by high-efficiency particulate air (HEPA) air filtration improves respiratory health in eosinophilic COPD.

Methods and analysis

The Air Purification for Eosinophilic COPD Study (APECS) is a double-blinded randomised placebo-controlled trial that will enrol 160 participants with eosinophilic COPD living in the area of Boston, Massachusetts. Real and sham air purifiers will be placed in the bedroom and living rooms of the participants in the intervention and control group, respectively, for 12 months. The primary trial outcome will be the change in forced expiratory volume in 1 s (FEV1). Lung function will be assessed twice preintervention and three times during the intervention phase (at 7 days, 6 months and 12 months postrandomisation). Secondary trial outcomes include changes in (1) health status by St. George’s Respiratory Questionnaire; (2) respiratory symptoms by Breathlessness, Cough and Sputum Scale (BCSS); and (3) 6-Minute Walk Test (6MWT). Inflammatory mediators were measured in the nasal epithelial lining fluid (NELF). Indoor PM will be measured in the home for the week preceding each study visit. The data will be analysed to contrast changes in outcomes in the intervention and control groups using a repeated measures framework.

Ethics and dissemination

Ethical approval was obtained from the Institutional Review Board of Beth Israel Deaconess Medical Centre (protocol #2019P0001129). The results of the APECS trial will be presented at scientific conferences and published in peer-reviewed journals.

Trial registration

NCT04252235. Version: October 2023.
Patient acceptability of intravitreal complement inhibitors in geographic atrophy (GA): protocol for a UK-based cross-sectional study
Authors: Dinah Christiana , Enoch Jamie , Ghulakhszian Arevik , Sekhon Mandeep , Crabb David P , Taylor Deanna J
Published: January 2024

Introduction

Geographic atrophy (GA) is the advanced form of the non-neovascular (‘dry’) type of age-related macular degeneration (AMD). Previously untreatable, complement inhibitors delivered by regular intravitreal injections have recently been demonstrated to slow down the progression of GA lesions in phase 3 trials. One such treatment, Syfovre (pegcetacoplan), was approved by the US Food and Drug Administration in February 2023. These therapies slow down, but do not stop or reverse, the progression of GA; they may also increase the risk of developing the neovascular (‘wet’) type of AMD. In light of these developments, this study aims to quantify the acceptability of these new intravitreal injection treatments to patients with GA in the UK and explore factors that may influence the acceptability of these treatments.

Methods and analysis

In this cross-sectional, non-interventional study, the primary objective is to determine the proportion of patients with GA that find regular intravitreal therapy acceptable for slowing the progression of GA. We will use a validated acceptability questionnaire in order to quantify the acceptability of new treatments among patients with GA. The correlation between acceptability and functional and structural biomarkers of GA will be established. We will also explore demographic, general health and ocular factors that may influence acceptability. 180 individuals with a diagnosis of GA will be recruited from 7 to 8 participating National Health Service trusts across the UK. Multiple regression analysis will be conducted to determine the simultaneous effects of multiple factors on patient acceptability.

Ethics and dissemination

The study received ethical approval from the Health Research Authority on 14 March 2023 (IRAS Project ID: 324854). Findings will be disseminated through peer-reviewed publications and conference presentations to the medical retina community, as well as through dialogue with patients and macular disease charities.
Effect of modified endotracheal intubation protocol combined with early oral intake on postoperative recovery quality in thyroid and parathyroid surgery at a tertiary hospital in China: a 2x2 factorial randomised controlled trial protocol
Authors: Wu Juelun , Zhang Yuelun , Shen Le
Published: January 2024

Introduction

Early oral intake (EOI) is supposed to be safe and beneficial to patients’ recovery. However, the optimal timing of resuming oral intake has not been validated in thyroid and parathyroid surgery. On the other hand, a modified electromyography (EMG) endotracheal intubation protocol with real-time EMG monitoring during video laryngoscope/fibrescope-guided intubation was presented in 2022, which was regarded as an effective way to shorten the intubation time. We aimed to use Quality of Recovery-15 (QoR-15) questionnaire to compare the efficacy and safety of different EMG endotracheal intubation protocols combined with different postoperative oral intake strategy in thyroid and parathyroid surgery.

Methods and analysis

This prospective, single-centre, 2×2 factorial, randomised controlled trial will be conducted in the Peking Union Medical College Hospital (PUMCH), China. We plan to recruit 200 adult patients who will receive thyroid or parathyroid surgery under intraoperative nerve monitoring. Eligible patients will be randomly divided into two groups, which will receive either the modified intubation protocol (M group) or conventional intubation process (C group). After patients enter postanaesthesia care unit and Steward scores ≥4, they will be randomly divided into two groups again, which will receive early resumption of oral intake (E group) or delayed resumption of oral intake (D group). Patients will be followed up during hospitalisation and the QoR-15 questionnaire will be administered to compare the quality of recovery on the day before surgery (T0), the first day after surgery (T1) and the day of discharge (T2). The primary outcome is the QoR-15 scores at T1.

Ethics and dissemination

The study protocol has been approved by the Research Ethics Committee of Peking Union Medical College Hospital (IRB K-2501). All participants will give written informed consent before participation. The results from this study will be shared at conferences and disseminated in international journals.

Trial registration number

NCT05624463.
Pre-post feasibility trial of a telephone-delivered exercise intervention for patients during chemotherapy for recurrent ovarian cancer: the ECHO-R trial protocol
Authors: Hayes Sandra C , Spence Rosalind R , Janda Monika , Eakin Elizabeth , Shannon Catherine , Goh Jeffrey , Beesley Vanessa L , Vagenas Dimitrios , Webb Penny , Coward Jermaine , Gordon Louisa G , O’Neill Helene , Williams Merran , Rye Sheree , Newton Melissa J , Baniahmadi Sara , Nascimento Marcelo , Nicklin James , Garret Andrea , Obermair Andreas
Published: January 2024

Introduction

The benefits of exercise in reducing treatment-related morbidity and improving quality of life following a primary diagnosis of cancer have been well documented and have led to exercise being recommended by oncology societies for all people with a cancer diagnosis. However, these recommendations are derived from research typically involving cohorts with more common cancers and relatively good prognosis, such as breast and prostate. Evidence from these cancers may not apply to women with recurrent ovarian cancer. Therefore, the primary objective of this trial is to evaluate the feasibility and safety of a home-based, telephone-delivered exercise intervention for women undergoing chemotherapy for recurrent ovarian cancer.

Methods and analysis

The Exercise During Chemotherapy for Recurrent Ovarian Cancer (ECHO-R) trial is a single-arm, phase II, pre/postintervention trial of a 6-month, telephone-delivered exercise intervention (consistent with recommended exercise oncology prescription). The target sample size is 80 women who are currently undergoing (or are scheduled to receive) chemotherapy for recurrent ovarian cancer. Recruitment is through participating hospital sites in Queensland, Australia, or via self-referral. The exercise intervention comprises 12 telephone sessions over a 6-month period delivered by trial-trained exercise professionals and supplemented (where feasible) by five sessions face to face. Exercise prescription is individualised and works towards an overall goal of achieving a weekly target of 150 min of moderate-intensity, mixed-mode exercise. Assessments via self-administered survey and physical fitness and function tests occur at baseline and then at 6 and 9 months postbaseline. Data to inform feasibility and safety are recorded as case notes by the exercise professional during each session.

Ethics and dissemination

Ethics approval for the ECHO-R trial was granted by the Metro North Human Research Ethics Committee (HREC/2020/QRBW/67223) on 6 November 2020. Findings from the trial are planned to be disseminated via peer-reviewed publications and both national and international exercise and oncology conferences.

Trial registration number

ACTRN12621000042842.
Effectiveness of patients’ involvement in a medical and nursing pain education programme: a protocol for an open-label randomised controlled trial including qualitative data
Authors: Serafini Alice , Rossi Maria Grazia , Alberti Sara , Borellini Erika , Contini Annamaria , Cernesi Simone , D'Amico Roberto , Díaz Crescitelli Matías Eduardo , Ferri Paola , Fornaciari Davide , Ghirotto Luca , Giugni Linda , Lui Fausta , Rossi Francesca , Cuoghi Costantini Riccardo , Santori Valentino , Padula Maria Stella
Published: January 2024

Introduction

Pain is a multidimensional experience that varies among individuals and has a significant impact on their health. A biopsychosocial approach is recommended for effective pain management; however, health professionals’ education is weak on this issue. Patient involvement is a promising didactic methodology in developing a more holistic perspective, however there is a lack of reliable evidence on this topic. The aim of the present study is to evaluate the effectiveness of patient involvement in pain education in undergraduate medicine and nursing students.

Methods and analysis

An open-label randomised controlled trial including qualitative data will be conducted. After an introductory lesson, each student will be randomly assigned to the intervention group, which includes an educational session conducted by a patient–partner along with an educator, or to the control group in which the session is exclusively conducted by an educator. Both sessions will be carried out according to the Case-Based Learning approach. Primary outcomes will be students’ knowledge, attitudes, opinions and beliefs about pain management, whereas the secondary outcome will be students’ satisfaction. The Pain Knowledge and Attitudes (PAK) and Chronic Pain Myth Scale (CPMS) will be administered preintervention and postintervention to measure primary outcomes. Students’ satisfaction will be measured by a questionnaire at the end of the session. Two focus groups will be conducted to evaluate non-quantifiable aspects of learning.

Ethics and dissemination

The protocol of this study was approved by the independent Area Vasta Emilia Nord ethics committee.

Adherence to The Declaration of Helsinki and Good Clinical Practice will ensure that the rights, safety and well-being of the participants in the study are safeguarded, as well as data reliability. The results will be disseminated through scientific publications and used to improve the educational offer. A version of the anonymised data set will be released for public access.

Trial registration

Trial was not registered on ClinicalTrials.gov as the interventions being compared only concern educational programmes and the outcomes considered do not refer to any clinical dimension.
Prevalence of attention-deficit hyperactivity disorder in children, adolescents and adults in the Middle East and North Africa region: a systematic review and meta-analysis
Authors: Al-Wardat Mohammad , Etoom Mohammad , Almhdawi Khader A , Hawamdeh Ziad , Khader Yousef
Published: January 2024

Objectives

To systematically estimate the overall prevalence of attention-deficit hyperactivity disorder (ADHD) in children, adolescents and adults across the Middle East and North Africa (MENA) region.

Design

Systematic review and meta-analysis conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement.

Data sources

Medline and Scopus databases were comprehensively and systematically searched between 1990 and February 2023.

Eligibility criteria for selecting studies

We included all cross-sectional or cohort studies that diagnosed ADHD using validated diagnostic tools (eg, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria, ADHD rating scales and ADHD diagnostic interview) or non-validated tools (eg, brain imaging techniques, computerised cognitive tests and quantitative electroencephalography).

Data extraction and synthesis

Two reviewers performed the data extraction independently using standardised data collection sheet. Newcastle-Ottawa Scale was used to assess the quality of the included studies. Individualised and pooled event rate and upper and lower limit at 95% CI were calculated according to the ADHD cases and the total sample size using a random-effect model. The subgroup prevalence analyses according to ADHD subtypes, gender, MENA country and age were also performed.

Results

A total of 63 articles met the inclusion criteria involving 849 902 participants. The overall prevalence of ADHD was 10.3% (95% CI 0.081 to 0.129). The prevalence rate ranged from 1.3% (Yemen) to 22.2% (Iran). Subgroup analyses showed that the prevalence in adults was 13.5 and 10.1 in children and adolescents. Males exhibited significantly higher prevalence compared with females as these were 11.1% and 7%, respectively. Attention-deficit subtype was significantly the most prevalent (46.7%) compared with hyperactivity/impulsivity (33.7%) and combined types (20.6%).

Conclusion

The overall prevalence of ADHD was high in the MENA region. It is crucial to allocate more attention and resources towards the prevention and treatment of ADHD in children, adolescents and adults within the region.
Treatment-emergent antidrug antibodies related to PD-1, PD-L1, or CTLA-4 inhibitors across tumor types: a systematic review
Authors: Galle Peter , Finn Richard S , Mitchell Catherine Ruth , Ndirangu Kerigo , Ramji Zahra , Redhead Gabrielle Sophie , Pinato David J
Published: January 2024

Background

Increased understanding of how the immune system regulates tumor growth has innovated the use of immunotherapeutics to treat various cancers. The impact of such therapies, including programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitors, on the production of antidrug antibodies (ADAs) and their impact on outcomes, is poorly understood. This study aims to evaluate the clinical trial evidence on ADA incidence associated with PD-1, PD-L1, and CTLA-4 inhibitors in the treatment of cancer and to assess associations between treatment administered, ADA incidence, and treatment outcomes.

Methods

Embase®, Medline®, and EBM Reviews were searched via the OVID®platform on February 15, 2022. Conference proceedings, clinical trial registries, and global regulatory and reimbursement body websites were also searched. Eligible publications included clinical trials enrolling patients receiving cancer treatment with either PD-1, PD-L1, or CTLA-4 reporting outcomes including incidence or prevalence of ADAs and the impact of immunogenicity on treatment safety and efficacy. Reference lists of eligible publications were also searched. The review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and evidence quality assessment was conducted using the appropriate Joanna Briggs Institute Critical Appraisal tool.

Results

After screening 4160 records and reviewing 97 full publications, a total of 34 publications reporting on 68 trials were included. A further 41 relevant clinical trials were identified on ClinicalTrials.gov and a further 32 from searches of packaging inserts. In total, 141 relevant trials covering 15 different checkpoint inhibitors and 16 different tumor types were included. Across the included trials, atezolizumab was associated with the highest incidence of ADAs (29.6% of 639 patients), followed by nivolumab (11.2% of 2,085 patients). Combination checkpoint inhibitor treatment appeared to increase the rate of ADAs versus monotherapy. Only 17 trials reported on the impact of ADAs on treatment outcomes with mixed results for the impact of ADAs on treatment efficacy, safety, and pharmacokinetics.

Conclusions

Checkpoint inhibitors for the treatment of cancer are immunogenic, with the incidence of treatment-emergent ADAs varying between individual therapies. It remains unclear what impact ADAs have on treatment outcomes.
Diagnosis of intracranial aneurysms by computed tomography angiography using deep learning-based detection and segmentation
Authors: You Wei , Feng Junqiang , Lu Jing , Chen Ting , Liu Xinke , Wu Zhenzhou , Gong Guoyang , Sui Yutong , Wang Yanwen , Zhang Yifan , Ye Wanxing , Chen Xiheng , Lv Jian , Wei Dachao , Tang Yudi , Deng Dingwei , Gui Siming , Lin Jun , Chen Peike , Wang Ziyao , Gong Wentao , Wang Yang , Zhu Chengcheng , Zhang Yue , Saloner David A , Mitsouras Dimitrios , Guan Sheng , Li Youxiang , Jiang Yuhua , Wang Yan
Published: January 2024

Background

Detecting and segmenting intracranial aneurysms (IAs) from angiographic images is a laborious task.

Objective

To evaluates a novel deep-learning algorithm, named vessel attention (VA)-Unet, for the efficient detection and segmentation of IAs.

Methods

This retrospective study was conducted using head CT angiography (CTA) examinations depicting IAs from two hospitals in China between 2010 and 2021. Training included cases with subarachnoid hemorrhage (SAH) and arterial stenosis, common accompanying vascular abnormalities. Testing was performed in cohorts with reference-standard digital subtraction angiography (cohort 1), with SAH (cohort 2), acquired outside the time interval of training data (cohort 3), and an external dataset (cohort 4). The algorithm’s performance was evaluated using sensitivity, recall, false positives per case (FPs/case), and Dice coefficient, with manual segmentation as the reference standard.

Results

The study included 3190 CTA scans with 4124 IAs. Sensitivity, recall, and FPs/case for detection of IAs were, respectively, 98.58%, 96.17%, and 2.08 in cohort 1; 95.00%, 88.8%, and 3.62 in cohort 2; 96.00%, 93.77%, and 2.60 in cohort 3; and, 96.17%, 94.05%, and 3.60 in external cohort 4. The segmentation accuracy, as measured by the Dice coefficient, was 0.78, 0.71, 0.71, and 0.66 for cohorts 1–4, respectively. VA-Unet detection recall and FPs/case and segmentation accuracy were affected by several clinical factors, including aneurysm size, bifurcation aneurysms, and the presence of arterial stenosis and SAH.

Conclusions

VA-Unet accurately detected and segmented IAs in head CTA comparably to expert interpretation. The proposed algorithm has significant potential to assist radiologists in efficiently detecting and segmenting IAs from CTA images.
Repeat thrombectomy after large vessel re-occlusion: a propensity score matched analysis of technical and clinical outcomes
Authors: Zohdy Youssef M , Saad Hassan , Howard Brian M , Cawley C Michael , Pabaney Aqueel , Akbik Feras , Dimisko Laurie , Maier Ilko , Spiotta Alejandro M , Jabbour Pascal , Wolfe Stacey Q , Rai Ansaar , Kim Joon-tae , Mascitelli Justin , Starke Robert M , Shaban Amir , Yoshimura Shinichi , De Leacy Reade , Kan Peter , Fragata Isabel , Polifka Adam J , Arthur Adam S , Park Min S , Matouk Charles , Levitt Michael R , Tjoumakaris Stavropoula I , Liman Jan , Waiters Vanesha , Pradilla Gustavo , Fargen Kyle M , Alawieh Ali , Grossberg Jonathan A
Published: January 2024

Background

Endovascular thrombectomy (EVT) remains the standard of care for acute large vessel occlusion (LVO) stroke. However, the safety and efficacy of repeat thrombectomy (rEVT) in recurrent LVO remains unclear. This study uses a large real-world patient cohort to study technical and clinical outcomes after rEVT.

Methods

This is a retrospective cohort study including patients who underwent thrombectomy between January 2013 and December 2022. Data were included from 21 comprehensive stroke centers globally through the Stroke Thrombectomy and Aneurysm Registry (STAR). Patients undergoing single EVT or rEVT within 30 days of LVO stroke were included in the study. Propensity score matching was used to compare patients undergoing single EVT versus rEVT.

Results

Out of a total of 7387 patients who underwent thrombectomy for LVO stroke, 90 (1.2%) patients underwent rEVT for the same vascular territory within 30 days. The median (IQR) time to re-occlusion was 2 (1–7) days. Compared with a matched cohort of patients undergoing a single EVT procedure, patients undergoing rEVT had a comparable rate of good functional outcome and mortality rate, but a higher rate of symptomatic intracranial hemorrhage (sICH). There was a significant reduction in the National Institutes of Health Stroke Scale (NIHSS) score of patients who underwent rEVT at discharge compared with baseline (−4.8±11.4; P=0.006). The rate of successful recanalization was similar in the single thrombectomy and rEVT groups (78% vs 80%, P=0.171) and between index and rEVT performed on the same patient (79% vs 80%; P=0.593).

Conclusion

Short-interval rEVT is associated with an improvement in the NIHSS score following large vessel re-occlusion. Compared with single thrombectomy, there was a higher rate of sICH with rEVT, but without a significant impact on rates of functional independence or mortality.
Potential impacts of reduced seafood consumption on myocardial infarction among coastal First Nations in British Columbia, Canada
Authors: Marushka Lesya , Hu Xue Feng , Kenny Tiff-Annie , Batal Malek , Fediuk Karen , Sadik Tonio , Golden Christopher D. , Cheung William W. L. , Salomon Anne K. , Chan Hing Man
Published: January 2024

The objective of this study is to examine the potential cardiovascular risk of climate-related declines in seafood consumption among First Nations in British Columbia by assessing the combined effects of reduced omega-3 fatty acids and mercury intake from seafood on the risk of myocardial infarction (MI) in 2050 relative to 2009. The data were derived from the First Nations Food, Nutrition, and Environment Study. Seafood consumption among 369 randomly selected participants was estimated, and hair mercury concentrations were measured. Declines in seafood consumption were modelled based on previously projected climate change scenarios, and the associated changes in nutrients and contaminants were used to estimate the cardiovascular risk. Reduced seafood consumption was projected to increase the risk of MI by 4.5%–6.5% among older individuals (≥50 years), by 1.9%–2.6% in men, and by 1.3%–1.8% in women under lower and upper climate change scenarios, respectively. Reduced seafood consumption may have profound cardiovascular implications. Effective strategies are needed to promote sustainable seafood harvests and access to seafood for coastal First Nations.
Automatic Dependent Surveillance-Broadcast Deceptive Jamming Detection Method Based on Track Data
Authors: Li Jiahe , Zhou Yazhou
Published: January 2024

The characteristics of automatic dependent surveillance-broadcast (ADS-B) technology, such as unencrypted channels and open data protocols, make it extremely vulnerable to various intentional or unintentional spoofing and jamming, which seriously threatens air traffic safety. Traditional approaches do not update their high-bit data for a long time, which causes the situations of the same encoding results to have different aircraft positions and it is difficult to determine the real position of the aircraft and effectively detect ADS-B jamming. Therefore, it is urgent to propose more effective detection methods for ADS-B spoofing and jamming. First, the methods and principles of frequency shift calculation and automatic monitoring algorithm are introduced. Then, signal consistency detection and error robustness are analyzed, and a track-data-based detection model for abnormal ADS-B data are proposed. The track-data-based detection methods can use multi-point sampling judgment algorithm to realize the reception and processing of data bits. This method makes full use of the information of multiple sampling values of each data bit and the reference power value obtained in the preamble detection, and determines the data value and confidence value through the relationship between the two. The detection methods for ADS-B spoofing and jamming distinguishes the true and false signals and the authenticity of target positions by comparing the arrival time difference of each signal at the ground station. Finally, the research results show that, with the increase of signal to noise ratio, no matter the estimation based on virtual array translation or the estimation based on circular stationary signal, their estimation accuracies are improved with gradually increasing trends.
Designing and Application of Modified SCSO-Based LADRC Controller for Dicing Saw Chuck Table Systems
Authors: Shi Jun , Zhu Wei , Li Xiaoning , Cao Weifeng
Published: January 2024

In this paper, the linear active disturbance rejection control (LADRC) is applied to the position control of a dicing saw chuck table, which is used to improve the steady-state accuracy and anti-interference ability of the control system. Aiming at the problem that LADRC parameters are difficult to adjust, a parameter adjustment method based on an improved sand cat swarm algorithm is proposed. The nonlinear convergence factor strategy and multiple chaotic map optimization strategy are used to improve the algorithm. In order to verify the performance of the proposed method, the improved sand cat swarm optimization algorithm is compared with the standard sand cat swarm optimization algorithm, grey wolf optimization algorithm and salp swarm optimization algorithm. The final experimental results show that using the improved sand cat swarm optimization algorithm to optimize the LADRC controller has higher steady-state accuracy, stronger anti-interference ability, and better optimization results.
A Convolutional Neural Network Image Compression Algorithm for UAVs
Authors: Dai Yongdong , Tan Jing , Wang Maofei , Jiang Chengling , Li Mingjiang
Published: January 2024

In the task of power line inspection, Unmanned Aerial Vehicles (UAVs) are frequently used for capturing images. With the rapid advancement of sensor technology, the spatial, radiometric, and spectral resolutions of UAV images are constantly improving, leading to an increased storage requirement for individual images. Given that UAVs usually operate with limited computational resources, transmission capability and storage space, there are significant challenges in image compression, storage and transmission. This underscores the importance of a high-performance image compression technique. To solve the above problem, we unveil a compression strategy for images that have been acquired through learning utilizing discrete Gaussian mixture-based probability distributions to increase the efficiency of image compression and the fidelity of reconstruction. In addition, to speed up decoding, we employ a parallel context model, which facilitates decoding in a highly parallel manner. Experimental evidence indicates that our approach attains performance that is at the forefront of the field while significantly expediting the decoding process (speeding up the decoding process by more than 49.78%) in our experiments, outpacing traditional coding standards and existing learned compression approaches by 5.75 dB and 1.23 dB in PSNR.
Estimation of Random Mobility Models with Application to Unmanned Aerial Vehicles
Authors: Li Tao , Wan Yan , Liu Mushuang , Li Songwei , Pinheiro Murilo Augusto , He Chenyuan , Lewis Frank L.
Published: January 2024

Random mobility models (RMMs) capture the statistical movement characteristics of mobile agents and play an important role in the evaluation and design of mobile wireless networks. Particularly, RMMs are used to model the movement of unmanned aerial vehicles (UAVs) as the platforms for airborne communication networks. In many RMMs, the movement characteristics are captured as stochastic processes constructed using two types of independent random variables. The first type describes the movement characteristics for each maneuver and the second type describes how often the maneuvers are switched. We develop a generic method to estimate RMMs that are composed of these two types of random variables. Specifically, we formulate the dynamics of movement characteristics generated by the two types of random variables as a special Jump Markov System and develop an estimation method based on the Expectation–Maximization principle. Both off-line and on-line variants of the method are developed. We apply the estimation method to the Smooth–Turn RMM developed for fixed-wing UAVs. The simulation study validates the performance of the proposed estimation method. We further conduct a UAV experimental study and apply the estimation methods to real UAV trajectories.
Polytopes and machine learning
Authors: Bao Jiakang , He Yang-Hui , Hirst Edward , Hofscheier Johannes , Kasprzyk Alexander , Majumder Suvajit
Published: January 2024

We introduce machine learning methodology to the study of lattice polytopes. With supervised learning techniques, we predict standard properties such as volume, dual volume, and reflexivity with accuracies up to 100%. We focus on 2d polygons and 3d polytopes with Plücker coordinates as input, which outperform the usual vertex representation.
Algorithm-System-Hardware Co-Design for Efficient 3D Deep Learning
Authors: Liu Zhijian , Tang Haotian , Lin Yujun , Han Song
Published: January 2024

3D point cloud deep learning has received significant attention due to its wide applications, such as augmented/mixed reality, autonomous vehicles/drones, and robots. Despite its remarkable accuracy, the computational cost and sparse nature of 3D point cloud deep learning models greatly hinder their use in real-world, latency-sensitive applications. In this paper, we develop efficient algorithms, systems, and hardware for 3D deep learning to overcome the computational challenges (especially sparsity) of 3D point cloud data, making it more applicable in a broader range of real-world scenarios. From the algorithm perspective, we introduce novel 3D building blocks (PVCNN and SPVNAS∗, https://pvnas.mit.edu ) that are tailor-made for point cloud data to reduce sparse and irregular overheads. On the system level, we develop a high-performance library (TorchSparse∗, https://torchsparse.mit.edu ) that can handle sparse and irregular workloads on general-purpose hardware, which is typically optimized for dense and regular workloads. Furthermore, we develop a specialized hardware accelerator (PointAcc∗, https://pointacc.mit.edu ) that can support various types of point cloud deep learning primitives and mitigate memory bottlenecks for sparse point cloud computing.
Inherent Limitations of AI Fairness
Authors: Buyl Maarten , De Bie Tijl
Published: January 2024

AI fairness should not be considered a panacea: It may have the potential to make society more fair than ever, but it needs critical thought and outside help to make it happen.
Algorithmic Advance: The Group Isomorphism Problem
Authors: Klarreich Erica
Published: January 2024

Exploring a potential way to immensely speed up algorithms for the group isomorphism problem.