bluuebunny/crossref_metadata_2025 huggingface dataset:
What accounts for turnover intention in the Australian public mental health workforce?
Authors: Haywood Darren , Crocker Kaitlyn M. , Gnatt Inge , Jenkins Zoe , Bhat Ravi , Lalitha Anoop Raveendran Nair , Butterfield Ingrid , Castle David J.
Published: October 2023

High staff turnover is common within the Australian public mental health workforce, contributing to workforce shortages and ultimately impacting the ability to provide stable efficient, effective, and ongoing optimal care to the community. In this study, we aimed to (a) establish the most pertinent factors associated with increased turnover intention in the public mental health workforce in Australia, and (b) establish whether such factors differ between metropolitan and rural services. We used a cross‐sectional, correlational design using an online survey method. In total, 235 mental health service staff of various disciplines and levels, from four public hospitals in Victoria, Australia participated in the study. We used three feed‐forward multiple regression analyses to assess the study aims. We found that job satisfaction, occupational burnout, and understaffing may be the most pertinent factors to consider regarding turnover intention. Job satisfaction and occupational burnout were factors endorsed across the entire sample, as well as specifically within both the metropolitan and rural services, while understaffing was a pertinent factor regarding turnover intention across the entire sample and for rural services, but not metropolitan services. Our findings regarding the pertinence of job satisfaction, occupational burnout, and understaffing in turnover intention provide key information that may be used to inform interventional targets aimed at reducing attrition from the public mental health workforce in Australia.
RETRACTED: Effect of hyperbaric oxygen treatment on diabetic foot ulcers: A meta‐analysis
Authors: Imam Mohamed S. , Almutairi Ahmed Khalid , Alhajri Abdullah Mutrik , Alharby Mishary Mosleh , Alanazi Mohammed H. , Alotaibi Ahmad G. , Abdelrahim Mohamed E. A.
Published: October 2023

The meta‐analysis aimed to assess the effect of hyperbaric oxygen treatment on diabetic foot ulcers. Using dichotomous or contentious random or fixed effect models, the outcomes of this meta‐analysis were examined and the odds ratio (OR) and the mean difference (MD) with 95% confidence intervals (CIs) were computed. 17 examinations from 1992 to 2022 were enrolled for the present meta‐analysis, including 7219 people with diabetic foot ulcers. Hyperbaric oxygen treatment had a significantly higher healed ulcer (OR, 14.39; 95% CI, 4.02–51.52, p < 0.001), higher adverse event (OR, 2.14; 95% CI, 1.11–4.11, p = 0.02), lower mortality (OR, 0.22; 95% CI, 0.07–0.71, p = 0.01) and higher ulcer area reduction (MD, 23.39; 95% CI, 11.79–34.99, p < 0.001) compared to standard treatment in patients with diabetic foot ulcers. However, hyperbaric oxygen treatment and standard treatment had no significant difference in amputation (OR, 0.62; 95% CI, 0.22–1.75, p = 0.37), major amputation (OR, 0.59; 95% CI, 0.18–1.92, p = 0.38), minor amputation (OR, 0.64; 95% CI, 0.15–2.66, p = 0.54) and healing time (MD, −0.001; 95% CI, −0.76 to 0.75, p = 0.99) in patients with diabetic foot ulcers. The examined data revealed that hyperbaric oxygen treatment had a significantly higher healed ulcer, adverse event, and ulcer area reduction and lower mortality, however, there was no significant difference in amputation and healing time compared to standard treatment in patients with diabetic foot ulcers. Yet, attention should be paid to its values since most of the selected examinations had a low sample size and some of the comparisons had a low number of selected studies.
Transition to adulthood of adolescents with profound intellectual and multiple disabilities: Content validation of the SGU‐PIMD to support families
Authors: Luitwieler Nicole , Luijkx Jorien , van der Stege Heleen A. , Grootoonk Anneke , van der Schans Cees P. , van der Putten Annette A. J. , Waninge Aly
Published: October 2023

Background

For families with adolescent children, the transition to adulthood is usually challenging. This period may be extra demanding for families with a child with profound intellectual and multiple disabilities due to the child's strong and persistent support needs. To support these families during this phase and to facilitate the transition process of these adolescents, we adapted the Canadian skills for growing up (SGU) into the skills for growing up‐profound intellectual and multiple disabilities (SGU‐PIMD). The aim of this study is to determine its content validity.

Method

A Delphi study with family members and healthcare professionals was conducted.

Results

Results showed good content validity. However, the Delphi panel suggested minor adjustments to improve relevance, comprehensibility and comprehensiveness.

Conclusions

The current SGU‐PIMD can be used in practice for supporting adolescents with profound intellectual and multiple disabilities. However, there are also recommendations for research into the feasibility and acceptability of the instrument.
Do exchange traded funds affect corporate cash holdings?
Authors: Lin Beiqi , Mei Shunji , Tan Kelvin Jui Keng , Zhang Lei
Published: October 2023

We examine the effects of equity ownership by exchange traded funds (ETFs) on corporate cash holdings. We find that firms increase their cash holdings in response to higher anticipated risks generated by ETFs. To establish a causal interpretation, we use the Russell 1000/2000 index reconstitution as an instrument for ETF ownership. We further show that shareholders place a higher value on the additional cash held by firms with higher ETF ownership. These findings are more pronounced among financially constrained firms. Overall, our results suggest that firms hold more precautionary cash to mitigate future funding needs due to higher ETF‐induced risks.
European Neuroendocrine Tumour Society (ENETS) 2023 guidance paper for nonfunctioning pancreatic neuroendocrine tumours
Authors: Kos‐Kudła Beata , Castaño Justo P. , Denecke Timm , Grande Enrique , Kjaer Andreas , Koumarianou Anna , de Mestier Louis , Partelli Stefano , Perren Aurel , Stättner Stefan , Valle Juan W. , Fazio Nicola
Published: October 2023

This ENETS guidance paper for well‐differentiated nonfunctioning pancreatic neuroendocrine tumours (NF‐Pan‐NET) has been developed by a multidisciplinary working group, and provides up‐to‐date and practical advice on the management of these tumours. Using the extensive experience of centres treating patients with NF‐Pan‐NEN, the authors of this guidance paper discuss 10 troublesome questions in everyday clinical practice. Our many years of experience in this field are still being verified in the light of the results of new clinical, which set new ways of proceeding in NEN. The treatment of NF‐Pan‐NEN still requires a decision of a multidisciplinary team of specialists in the field of neuroendocrine neoplasms.
Language Proficiency and the Relation to Word–Problem Performance in Emergent Bilingual Students with Mathematics Difficulties
Authors: King Sarah G. , Powell Sarah R.
Published: October 2023

As students enter the upper elementary grades, word problems become a main component of mathematics instruction, increasing in complexity as students advance through the curriculum. For students identified as emergent bilinguals with mathematics difficulty (MD), the linguistic complexity inherent in word problems may serve as a barrier to word–problem proficiency. The current study investigated the potential relation between academic English proficiency and word–problem outcomes for emergent bilinguals with MD. After analyzing data from 241 third–grade students, results indicated students who participated in an evidence–based word–problem intervention outperformed students who did not receive the intervention. Moreover, students’ academic English–language proficiency scores in the domains of reading and writing positively correlated with higher scores on a measure of word–problem solving.
Lateral gene transfer generates accessory genes that accumulate at different rates within a grass lineage
Authors: Raimondeau Pauline , Bianconi Matheus E. , Pereira Lara , Parisod Christian , Christin Pascal‐Antoine , Dunning Luke T.
Published: October 2023

Lateral gene transfer (LGT) is the movement of DNA between organisms without sexual reproduction. The acquired genes represent genetic novelties that have independently evolved in the donor's genome. Phylogenetic methods have shown that LGT is widespread across the entire grass family, although we know little about the underlying dynamics.

We identify laterally acquired genes in five de novo reference genomes from the same grass genus (four Alloteropsis semialata and one Alloteropsis angusta). Using additional resequencing data for a further 40 Alloteropsis individuals, we place the acquisition of each gene onto a phylogeny using stochastic character mapping, and then infer rates of gains and losses.

We detect 168 laterally acquired genes in the five reference genomes (32–100 per genome). Exponential decay models indicate that the rate of LGT acquisitions (6–28 per Ma) and subsequent losses (11–24% per Ma) varied significantly among lineages. Laterally acquired genes were lost at a higher rate than vertically inherited loci (0.02–0.8% per Ma).

This high turnover creates intraspecific gene content variation, with a preponderance of them occurring as accessory genes in the Alloteropsis pangenome. This rapid turnover generates standing variation that can ultimately fuel local adaptation.
The GRAS protein OsDLA involves in brassinosteroid signalling and positively regulates blast resistance by forming a module with GSK2 and OsWRKY53 in rice
Authors: Meng Fanwei , Zheng Xunmei , Wang Jia , Qiu Tiancheng , Yang Qingya , Fang Kexing , Bhadauria Vijai , Peng You‐Liang , Zhao Wensheng
Published: October 2023

Brassinosteroids (BRs) play a crucial role in shaping the architecture of rice (Oryza sativa) plants. However, the regulatory mechanism of BR signalling in rice immunity remains largely unexplored. Here we identify a rice mutant dla, which exhibits decreased leaf angles and is insensitive to 24‐epiBL (a highly active synthetic BR), resembling the BR‐deficient phenotype. The dla mutation caused by a T‐DNA insertion in the OsDLA gene leads to downregulation of the causative gene. The OsDLA knockout plants display reduced leaf angles and less sensitivity to 24‐epiBL. In addition, both dla mutant and OsDLA knockout plants are more susceptible to rice blast compared to the wild type. OsDLA is a GRAS transcription factor and interacts with the BR signalling core negative regulator, GSK2. GSK2 phosphorylates OsDLA for degradation via the 26S proteasome. The GSK2 RNAi line exhibits enhanced rice blast resistance, while the overexpression lines thereof show susceptibility to rice blast. Furthermore, we show that OsDLA interacts with and stabilizes the WRKY transcription factor OsWRKY53, which has been demonstrated to positively regulate BR signalling and blast resistance. OsWRKY53 directly binds the promoter of PBZ1 and activates its expression, and this activation can be enhanced by OsDLA. Together, our findings unravel a novel mechanism whereby the GSK2‐OsDLA‐OsWRKY53 module coordinates blast resistance and plant architecture via BR signalling in rice.
Clinical application of 675 nm laser therapy for dorsal hand skin hyperpigmentation
Authors: Alter Ido , Fusco Irene , Madeddu Francesca , Zingoni Tiziano
Published: October 2023

Background

Noninvasive skin rejuvenation treatment is growing in recognition to aesthetic medicine.

Aim

The objective of the study was to assess the efficacy and the safety of the 675‐nm laser source treatment of photodamaged hands.

Materials and methods

The study included 21 patients (6 males and 15 females) with a mean age of 63 (± 9) years. Patients were treated with —two to three sessions of the 675‐nm laser with a 1‐month interval between sessions. Photos of each patient were collected at baseline, and 3 months after the last laser session. The 5‐point Global Aesthetic Improvement Scale (GAIS) was recorded with their final assessment session (3 months).

Results

The total GAIS scores showed satisfactory results: 15 patients (71%) experienced 4 score (excellent improvement) changes and 6 patients (29%) experienced 3 score (good improvement) changes. Clinical images showed good efficacy and visible aesthetic results for the management of photodamaged skin. No serious adverse effects were recorded.

Conclusion

This study demonstrates the safety and efficacy of for the aesthetic improvement of skin pigmentation and texture for photodamaged hands.
Root numbers and parity phenomena
Authors: Kellock Lilybelle Cowland , Dokchitser Vladimir
Published: October 2023

The parity conjecture has a long and distinguished history. It gives a way of predicting the existence of points of infinite order on elliptic curves without having to construct them, and is responsible for a wide range of unexplained arithmetic phenomena. It is one of the main consequences of the Birch and Swinnerton‐Dyer conjecture and lets one calculate the parity of the rank of an elliptic curve using root numbers. In this handbook, we explain how to use local root numbers of elliptic curves to realise some of these phenomena, with an emphasis on explicit calculations. The text is aimed at a ‘user’ and, as such, we will not be concerned with the proofs of known cases of the parity conjecture, but instead, we will demonstrate the use of the theory by means of examples.
Deciphering the “Art” in Modeling and Simulation of the Knee Joint: Assessing Model Calibration Workflows and Outcomes
Authors: Andreassen Thor E. , Laz Peter J. , Erdemir Ahmet , Besier Thor F. , Halloran Jason P. , Imhauser Carl W. , Chokhandre Snehal , Schwartz Ariel , Nohouji Neda Abdollahi , Rooks Nynke B. , Schneider Marco T. Y. , Elmasry Shady , Zaylor William , Hume Donald R. , Shelburne Kevin B.
Published: October 2023

Model reproducibility is a point of emphasis for the National Institutes of Health (NIH) and in science, broadly. As the use of computational modeling in biomechanics and orthopedics grows, so does the need to assess the reproducibility of modeling workflows and simulation predictions. The long-term goal of the KneeHub project is to understand the influence of potentially subjective decisions, thus the modeler's “art”, on the reproducibility and predictive uncertainty of computational knee joint models. In this paper, we report on the model calibration phase of this project, during which five teams calibrated computational knee joint models of the same specimens from the same specimen-specific joint mechanics dataset. We investigated model calibration approaches and decisions, and compared calibration workflows and model outcomes among the teams. The selection of the calibration targets used in the calibration workflow differed greatly between the teams and was influenced by modeling decisions related to the representation of structures, and considerations for computational cost and implementation of optimization. While calibration improved model performance, differences in the postcalibration ligament properties and predicted kinematics were quantified and discussed in the context of modeling decisions. Even for teams with demonstrated expertise, model calibration is difficult to foresee and plan in detail, and the results of this study underscore the importance of identification and standardization of best practices for data sharing and calibration.
Membrane-enclosed
Pseudomonas
quinolone signal attenuates bacterial virulence by interfering with quorum sensing
Authors: Li Xia , Wang Gerun , Guo Quan , Cui Binbin , Wang Mingfang , Song Shihao , Yang Liang , Deng Yinyue
Published: October 2023

Outer membrane vesicle (OMV)-delivered
Pseudomonas
quinolone signal (PQS) plays a critical role in cell–cell communication in
Pseudomonas aeruginosa
. However, the functions and mechanisms of membrane-enclosed PQS in interspecies communication in microbial communities are not clear. Here, we demonstrate that PQS delivered by both OMVs from
P. aeruginosa
and liposome reduces the competitiveness of
Burkholderia cenocepacia
, which usually shares the same niche in the lungs of cystic fibrosis patients, by interfering with quorum sensing (QS) in
B. cenocepacia
through the LysR-type regulator ShvR. Intriguingly, we found that ShvR regulates the production of the QS signals cis-2-dodecenoic acid (BDSF) and N-acyl homoserine lactone (AHL) by directly binding to the promoters of signal synthase-encoding genes. Perception of PQS influences the regulatory activity of ShvR and thus ultimately reduces QS signal production and virulence in
B. cenocepacia
. Our findings provide insights into the interspecies communication mediated by the membrane-enclosed QS signal among bacterial species residing in the same microbial community.

IMPORTANCE

Quorum sensing (QS) is a ubiquitous cell-to-cell communication mechanism. Previous studies showed that
Burkholderia cenocepacia
mainly employs cis-2-dodecenoic acid (BDSF) and N-acyl homoserine lactone (AHL) QS systems to regulate biological functions and virulence. Here, we demonstrate that
Pseudomonas
quinolone signal (PQS) delivered by outer membrane vesicles from
Pseudomonas aeruginosa
or liposome attenuates
B. cenocepacia
virulence by targeting the LysR-type regulator ShvR, which regulates the production of the QS signals BDSF and AHL in
B. cenocepaci
a. Our results not only suggest the important roles of membrane-enclosed PQS in interspecies and interkingdom communications but also provide a new perspective on the use of functional nanocarriers loaded with QS inhibitors for treating pathogen infections.
Exploration of the novel fluoroquinolones with high inhibitory effect against quinolone-resistant DNA gyrase of
Salmonella
Typhimurium
Authors: Toyting Jirachaya , Miura Nami , Utrarachkij Fuangfa , Tanomsridachchai Wimonrat , Belotindos Lawrence P. , Suwanthada Pondpan , Kapalamula Thoko Flav , Kongsoi Siriporn , Koide Kentaro , Kim Hyun , Thapa Jeewan , Nakajima Chie , Suzuki Yasuhiko
Published: October 2023

Quinolone-resistant nontyphoidal
Salmonella
, one of the prominent pathogens causing acute gastroenteritis, has become a public health concern globally. The World Health Organization has ranked fluoroquinolone-resistant
Salmonella
as a high-priority pathogen for researching and developing new antibiotics. WQ-3034 and WQ-3154 are relatively new synthetic fluoroquinolones with distinctive structures. WQ-3034 has 6-amino-3,5-difluoropyridine-2-yl at R
1
, 3-hydroxyazetidinyl at R
7
, and the addition of chlorine atom at R
8
. WQ-3154 has a similar basic pharmacophore to WQ-3034 except for the modification at R
8
with a methyl group. In this study, the inhibitory effect and DNA cleavage effect against wild-type (WT) and mutant
Salmonella
Typhimurium DNA gyrases of WQ-3034 and WQ-3154 were examined along with WQ-3810 and ciprofloxacin by measuring the drug concentration that inhibits half of the enzyme activity (IC
50
) and the drug concentration that induces 25% of maximum DNA cleavage (CC
25
). The minimum inhibitory concentration (MIC) of the compounds was assessed against
Salmonella
Typhimurium and
Salmonella
Enteritidis. Among four compounds, WQ-3034 demonstrated the highest inhibitory effect against both WT and mutant
Salmonella
Typhimurium DNA gyrases with amino acid substitution at codon 83 and/or 87, while ciprofloxacin showed the lowest inhibitory effect. Remarkably, WQ-3034 and WQ-3154 exhibited a significantly higher inhibitory effect than ciprofloxacin against
Salmonella
Typhimurium DNA gyrase with double amino acid substitution, Ser83Phe-Asp87Asn. Similarly, CC
25
of WQ-3034 against mutant
Salmonella
Typhimurium DNA gyrase was lower than ciprofloxacin. Notably, MICs of WQ-3034 and WQ-3154 were higher than ciprofloxacin. In conclusion, this study revealed that WQ-3034 and WQ-3154 could potentially be effective therapeutic agents against quinolone-resistant nontyphoidal
Salmonella
.

IMPORTANCE

Quinolone-resistant nontyphoidal
Salmonella
is a pressing public health concern, demanding the exploration of novel treatments. In this study, we focused on two innovative synthetic fluoroquinolones, WQ-3034 and WQ-3154. Our findings revealed that these new compounds demonstrate potent inhibitory effects, even against mutant strains that cause resistance to existing quinolones. Hence, WQ-3034 and WQ-3154 could potentially be effective therapeutic agents against quinolone-resistant
Salmonella
Typhimurium. Furthermore, the data obtained in this study will be baseline information for antimicrobial drug development.
Airway microbiota correlated with pulmonary exacerbation in primary ciliary dyskinesia patients
Authors: Zhou Weitao , Guo Zhuoyao , Chen Jinglong , Chen Yao , He Chen , Lu Aizhen , Qian Liling
Published: October 2023

Primary ciliary dyskinesia (PCD) is characterized by symptoms such as productive cough, rhinitis, and recurrent infections in both the upper and lower airways, which can lead to chronic infection, bronchiectasis, and decreased pulmonary function. Our study aimed to analyze the diversity and composition of the microbiota in the respiratory tract and investigate the correlation of the microbiota with pulmonary exacerbation in PCD patients. This study employed 16S rRNA amplicon sequencing to explore the microbiota present in both bronchoalveolar lavage fluid (BALF) and sputum samples collected from PCD patients. Eighty-five airway samples (17 BALF and 68 sputum samples) were collected from 72 patients aged 2 months to 60 years. Significantly lower sputum microbiota diversity and richness were found in the pulmonary exacerbation group than in the pulmonary stabilization group; additionally, the relative abundance of
Pseudomonas
increased when pulmonary exacerbation occurred. There was a positive correlation between pulmonary exacerbation and the relative abundance of
Pseudomonas
, while
Streptococcus
,
Moraxella
, and
Haemophilus
showed a negative correlation. Although there was no significant difference in the sputum microbiota diversity and composition in children aged 6–18 years with pulmonary exacerbation,
Pseudomonas
increased during pulmonary exacerbation. BALF samples of pediatric patients with pulmonary exacerbation had a lower microbiota diversity and richness; furthermore,
Pseudomonas
had a higher abundance and a moderate distinguishing effect. We found that microbiota beta diversity and dominance were decreased during pulmonary exacerbation. Additionally,
Pseudomonas
had a higher abundance and moderate distinguishing effect in pediatric patients with pulmonary exacerbation.

IMPORTANCE

PCD is a rare disease characterized by productive cough, rhinitis, and recurrent infections of the upper and lower airways. Because the diagnosis of PCD is often delayed, patients receive more antibiotics, experience a heavier financial burden, and have a worse prognosis; thus, it is very important to identify the pathogeny and use the correct antibiotic. In this large single-center study of PCD microbiota, we identified an outline of the bacterial microbes from the respiratory tract; furthermore, we found that the microbiota diversity in pediatric sputum was richer than that in pediatric BALF through sequencing, indicating a heterogeneous community structure. The microbiota diversity and richness were lower during pulmonary exacerbation than during pulmonary stabilization. A significantly higher abundance of
Pseudomonas
had a moderate distinguishing effect for lung exacerbation, which attracted more attention for the study of
Pseudomonas
therapy in pediatric patients with PCD.
The volatile record of volcanic apatite and its implications for the formation of porphyry copper deposits
Authors: Stonadge George , Miles Andrew , Smith Daniel , Large Simon , Knott Thomas
Published: October 2023

Volatile saturation influences the physicochemical behavior of magmas and is essential for the sequestration of metals in porphyry copper deposits. Tracking the evolution of volatile components (F, Cl, H2O, S) in arc systems is complicated by their mobility and tendency to rapidly re-equilibrate with late-stage melts. We demonstrate that accurate measurements of volatile concentrations in apatite offer a reliable method for identifying the occurrence of volatile saturation. Fluorine, Cl, S, and calculated OH concentrations in apatite obtained by scanning electron microscope–energy-dispersive X-ray spectroscopy and electron microprobe analysis were used to compare two end-member volcanic systems in the West Luzon Arc (Philippines): Pinatubo (a fluid-saturated analogue for porphyry copper deposits) and Taal (a barren and fluid-undersaturated comparator). Apatites from Pinatubo are S-rich (0.04–0.64 wt%) and show a progressive decrease in XCl/XOH (0.6–0.25) and an increase in XF/XCl (1.5–8) and XF/XOH (0.75–1.2) during crystallization. Modeling indicates that these changes result from efficient partitioning of Cl into a continuously saturated H2O-rich fluid, while high regions of S in apatite reflect episodic flushing by a separate S-rich flux. Little S is evident in apatites from Taal (<300 ppm), which show increasing XCl/XOH and XF/XOH together with constant XF/XCl during crystallization. This cannot be explained using an H2O-saturated model, and instead reflects fluid-undersaturated crystallization and cooling in a reduced and/or S-depleted system. Measured volatiles in apatite therefore effectively discriminate volatile-saturated and undersaturated magmatic systems, providing an important ‘fertility’ filter for porphyry exploration.
Automated expert-level scleral spur detection and quantitative biometric analysis on the ANTERION anterior segment OCT system
Authors: Bolo Kyle , Apolo Aroca Galo , Pardeshi Anmol A , Chiang Michael , Burkemper Bruce , Xie Xiaobin , Huang Alex S , Simonovsky Martin , Xu Benjamin Y
Published: October 2023

Aim

To perform an independent validation of deep learning (DL) algorithms for automated scleral spur detection and measurement of scleral spur-based biometric parameters in anterior segment optical coherence tomography (AS-OCT) images.

Methods

Patients receiving routine eye care underwent AS-OCT imaging using the ANTERION OCT system (Heidelberg Engineering, Heidelberg, Germany). Scleral spur locations were marked by three human graders (reference, expert and novice) and predicted using DL algorithms developed by Heidelberg Engineering that prioritise a false positive rate <4% (FPR4) or true positive rate >95% (TPR95). Performance of human graders and DL algorithms were evaluated based on agreement of scleral spur locations and biometric measurements with the reference grader.

Results

1308 AS-OCT images were obtained from 117 participants. Median differences in scleral spur locations from reference locations were significantly smaller (p<0.001) for the FPR4 (52.6±48.6 µm) and TPR95 (55.5±50.6 µm) algorithms compared with the expert (61.1±65.7 µm) and novice (79.4±74.9 µm) graders. Intergrader reproducibility of biometric measurements was excellent overall for all four (intraclass correlation coefficient range 0.918–0.997). Intergrader reproducibility of the expert grader (0.567–0.965) and DL algorithms (0.746–0.979) exceeded that of the novice grader (0.146–0.929) for images with narrow angles defined by OCT measurement of angle opening distance 500 µm anterior to the scleral spur (AOD500)<150 µm.

Conclusions

DL algorithms on the ANTERION approximate expert-level measurement of scleral spur-based biometric parameters in an independent patient population. These algorithms could enhance clinical utility of AS-OCT imaging, especially for evaluating patients with angle closure and performing intraocular lens calculations.
Regional differences in firearm ownership, storage and use: results from a representative survey of five US states
Authors: Anestis Michael , Bond Allison E , Baker Nazsa , Semenza Daniel C
Published: October 2023

Background

Firearm access and storage practices influence risk for injury and death; however, prior research has considered only national and regional differences on these variables, overlooking state-level differences.

Objectives

To analyse and describe statewide differences in firearm ownership, storage and use in a representative sample of five US states.

Design

Variables were assessed via an online self-report survey administered between 29 April 2022 and 15 May 2022.

Setting

Surveys were completed online.

Participants

Participants (n=3510) were members of knowledge panel, a probability-based sample recruited to be representative of US adults. All participants were aged 18+ and resided in one of five states: Colorado, Minnesota, Mississippi, New Jersey or Texas.

Measurements

We used χ2tests to examine state differences in firearm ownership, childhood firearm experiences and purchasing. A series of analyses of covariance were then used to assess differences in firearm storage, firearms owned and carrying behaviours while adjusting for pertinent demographic characteristics.

Results

We found significant differences in firearm ownership across states. There were significantly more first-time firearm purchasers during the firearm purchasing surge in New Jersey. Both Mississippi and Texas have elevated rates of unsecure storage practices and firearm carrying outside of the home.

Limitations

Results are cross-sectional and self-report. Findings may not generalise beyond the five states assessed in this survey.

Conclusions

Public health messaging around firearm safety should account for differences in key firearm behaviours related to ownership, storage and use to ensure effective communication and reduce the risk of gun injury and death across states.
Changing the standardised obstetric care by expanded carrier screening and counselling: a multicentre prospective cohort study
Authors: Chen Han-Ying , Lin Shin-Yu , Shih Jin-Chung , Kang Jessica , Tai Yi-Yun , Shaw Steven W. , Chen Kuang-Cheng , Mai Kevin , Lee Chien-Nan
Published: October 2023

Background

Expanded genetic screening before conception or during prenatal care can provide a more comprehensive evaluation of heritable fetal diseases. This study aimed to provide a large cohort to evaluate the significance of expanded carrier screening and to consolidate the role of expanded genetic screening in prenatal care.

Methods

This multicentre, retrospective cohort study was conducted between 31 December 2019 and 21 July 2022. A screening panel containing 302 genes and next-generation sequencing were used for the evaluation. The patients were referred from obstetric clinics, infertility centres and medical centres. Genetic counsellors conducted consultation for at least 15 min before and after screening.

Results

A total of 1587 patients were screened, and 653 pairs were identified. Among the couples who underwent the screening, 62 (9.49%) had pathogenic variants detected on the same genes. In total, 212 pathogenic genes were identified in this study. A total of 1173 participants carried at least one mutated gene, with a positive screening rate of 73.91%. Among the pathogenic variants that were screened, the gene encoding gap junction beta-2 (GJB2) exhibited the highest prevalence, amounting to 19.85%.

Conclusion

Next-generation sequencing carrier screening provided additional information that may alter prenatal obstetric care by 9.49%. Pan-ethnic genetic screening and counselling should be suggested for couples of fertile age.
Do lower limb motor-evoked potentials predict walking outcomes post-stroke?
Authors: Smith Marie-Claire , Scrivener Benjamin J , Stinear Cathy M
Published: October 2023

Background

This observational study examined whether lower limb (LL) motor-evoked potentials (MEPs) 1 week post-stroke predict recovery of independent walking, use of ankle-foot orthosis (AFO) or walking aid, at 3 and 6 months post-stroke.

Methods

Non-ambulatory participants were recruited 5 days post-stroke. Transcranial magnetic stimulation was used to determine tibialis anterior MEP status and clinical assessments (age, National Institutes of Health Stroke Scale (NIHSS), ankle dorsiflexion strength, LL motricity index, Berg Balance Test) were completed 1 week post-stroke. Functional Ambulation Category (FAC), use of AFO and walking aid were assessed 3 months and 6 months post-stroke. MEP status, alone and combined with clinical measures, and walking outcomes at 3 and 6 months were analysed with Pearson χ2and multivariate binary logistic regression.

Results

Ninety participants were included (median age 72 years (38–97 years)). Most participants (81%) walked independently (FAC ≥ 4), 17% used an AFO, and 49% used a walking aid 3 months post-stroke with similar findings at 6 months. Independent walking was better predicted by age, LL strength and Berg Balance Test (accuracy 92%, 95% CI 85% to 97%) than MEP status (accuracy 73%, 95% CI 63% to 83%). AFO use was better predicted by NIHSS and MEP status (accuracy 88%, 95% CI 79% to 94%) than MEP status alone (accuracy 76%, 95% CI 65% to 84%). No variables predicted use of walking aids.

Conclusions

The presence of LL MEPs 1-week post-stroke predicts independent walking at 3 and 6 months post-stroke. However, the absence of MEPs does not preclude independent walking. Clinical factors, particularly age, balance and stroke severity, more strongly predict independent walking than MEP status. LL MEP status adds little value as a biomarker for walking outcomes.
Selection of indicators reporting response rate in pharmaceutical trials for systemic lupus erythematosus: preference and relative sensitivity
Authors: Tian Jingru , Kang Shuntong , Zhang Dingyao , Huang Yaqing , Yao Xu , Zhao Ming , Lu Qianjin
Published: October 2023

Objective

SLE is a common multisystem autoimmune disease with chronic inflammation. Many efficacy evaluation indicators of randomised clinical trials (RCTs) for SLE have been proposed but the comparability remains unknown. We aim to explore the preference and comparability of indicators reporting response rate and provide basis for primary outcome selection when evaluating the efficacy of SLE pharmaceutical treatment.

Methods

We systematically searched three databases and three registries to identify pharmacological intervention-controlled SLE RCTs. Relative discriminations between indicators were assessed by the Bayesian hierarchical linear mixed model.

Results

33 RCTs met our inclusion criteria and we compared eight of the most commonly used indicators reporting response rate. SLE Disease Activity Index 4 (SLEDAI-4) and SLE Responder Index 4 were considered the best recommended indicators reporting response rate to discriminate the pharmacological efficacy. Indicator preference was altered by disease severity, classification of drugs and outcome of trials, but SLEDAI-4 had robust efficacy in discriminating ability for most interventions. Of note, BILAG Index-based Combined Lupus Assessment showed efficacy in trials covering all-severity patients, as well as non-biologics RCTs. The British Isles Lupus Assessment Group response and Physician’s Global Assessment response were more cautious in evaluating disease changes. Serious adverse event was often applied to evaluate the safety and tolerability of treatments rather than efficacy.

Conclusions

The impressionable efficacy discrimination ability of indicators highlights the importance of flexibility and comprehensiveness when choosing primary outcome(s). As for trials that are only evaluated by SLEDAI-4, attention should be paid to outcome interpretation to avoid the exaggeration of treatment efficacy. Further subgroup analyses are limited by the number of included RCTs.

PROSPERO registration number

CRD42022334517.
Anti-SMN autoantibodies in mixed connective tissue disease are associated with a severe systemic sclerosis phenotype
Authors: El Kamouni Hajar , S. Jalaledin Darya , Albert Alexandra , Hoa Sabrina , Vo Caroline , Bourré-Tessier Josiane , Rich Éric , Goulet Jean-Richard , Koenig Martial , Pérez Gemma , Choi May Y. , Troyanov Yves , Satoh Minoru , Fritzler Marvin J. , Senécal Jean-Luc , Landon-Cardinal Océane
Published: October 2023

Objectives

The survival of motor neuron (SMN) complex has an essential role in the assembly of small nuclear ribonucleoproteins (RNP). Recent reports have described autoantibodies (aAbs) to the SMN complex as novel biomarkers in anti-U1RNP+ myositis patients. The aim of this study was to compare phenotypic features of anti-U1RNP+ mixed connective tissue disease (MCTD) patients with and without anti-SMN aAbs.

Methods

A retrospective MCTD cohort was studied. Addressable laser bead immunoassay was used to detect specific anti-SMN aAbs with <300 mean fluorescence intensity (MFI) as normal reference range, 300–999 MFI as low-titre and ≥1000 MFI as high-titre positivity. Comparison of clinical features between anti-SMN+ and anti-SMN− subgroups used two-tailed Fisher’s exact test, and logistic regression analyses.

Results

Sixty-six patients were included. Median age at MCTD diagnosis was 40.6 years, and duration of follow-up was 12 years. Based on the highest available titre, 39 (59%) were anti-SMN+: 10 (26%) had low titre and 29 (74%) had high titre. Anti-SMN+ patients had a higher frequency of fingertip pitting scars (anti-SMN+ 23% vs anti-SMN− 4%, p=0.04), lower gastrointestinal (GI) involvement (26% vs 4%, p=0.04), and myocarditis (16% vs 0%, p=0.04). The combined outcome of pitting scars and/or lower GI involvement and/or myositis and/or myocarditis was highest among high-titre anti-SMN+ patients: adjusted OR 7.79 (2.33 to 30.45, p=0.002).

Conclusions

Anti-SMN aAbs were present in 59% of our MCTD cohort. Their presence, especially at high-titres, was associated with a severe systemic sclerosis (scleroderma) phenotype including myositis, myocarditis and lower GI involvement.
Phenotyping by persistent inflammation in systemic sclerosis associated interstitial lung disease: a EUSTAR database analysis
Authors: Guler Sabina , Sarbu Adela-Cristina , Stalder Odile , Allanore Yannick , Bernardino Vera , Distler Joerg , Gabrielli Armando , Hoffmann-Vold Anna-Maria , Matucci-Cerinic Marco , Müller-Ladner Ulf , Ortiz-Santamaria Vera , Rednic Simona , Riccieri Valeria , Smith Vanessa , Ullman Susanne , Walker Ulrich A , Geiser Thomas K , Distler Oliver , Maurer Britta , Kollert Florian
Published: October 2023

Background

Systemic sclerosis (SSc) is a heterogeneous disease with frequently associated interstitial lung disease (SSc-ILD). We aimed to determine the prognostic potential of phenotyping patients with SSc and SSc-ILD by inflammation and to describe disease trajectories stratified by inflammation and immunosuppressive treatment.

Methods

Patients from the European Scleroderma Trials and Research (EUSTAR) group cohort were allocated to persistent inflammatory, intermediate and non-inflammatory phenotypes if C-reactive protein (CRP) levels were ≥5 mg/L at ≥80%, at 20–80% and at <20% of visits, respectively. Cox regression models were used to analyse mortality risk and mixed effect models to describe trajectories of FVC and diffusing capacity for carbon monoxide (DLCO) %-predicted stratified by inflammation and immunosuppressive treatment.

Results

2971 patients with SSc and 1171 patients with SSc-ILD had at least three CRP measurements available. Patients with SSc-ILD with a persistent inflammatory phenotype had a 6.7 times higher risk of mortality within 5 years compared with those with a persistent non-inflammatory phenotype (95% CI 3 to 15). In the inflammatory phenotype, FVC %-predicted was declining without (−1.11 (95% CI −2.14 to −0.08)/year), but stable with immunosuppressive treatment (−0.00 (95% CI −0.92 to 0.92)/year). In the non-inflammatory phenotype, patients with and without immunosuppressive treatment had a significant decline in FVC %-predicted, which was more pronounced in those with immunosuppressive treatment (−1.26 (95% CI −1.87 to −0.64) and −0.84 (95% CI −1.35 to −0.33)/year, respectively).

Conclusions

Phenotyping by persistent inflammation provides valuable prognostic information, independent of demographics, disease duration, cutaneous subtype, treatment and SSc-ILD severity. The findings from this study support early immunosuppressive treatment in patients with SSc-ILD with persistent inflammation.
Curvature tensor in discrete gravity
Authors: Chamseddine Ali H. , Malaeb Ola , Najem Sara
Published: October 2023

We study numerically the curvature tensor in a three-dimensional discrete space. Starting from the continuous metric of a three-sphere, we transformed it into a discrete space using three integers $$n_1, n_2$$

n
1

,

n
2

, and $$n_3$$

n
3

. The numerical results are compared with the expected values in the continuous limit. We show that as the number of cells in the lattice increases, the continuous limit is recovered.
Responsible AI Pattern Catalogue: A Collection of Best Practices for AI Governance and Engineering
Authors: Lu Qinghua , Zhu Liming , Xu Xiwei , Whittle Jon , Zowghi Didar , Jacquet Aurelie
Published: October 2023

Responsible Artificial Intelligence (RAI) is widely considered as one of the greatest scientific challenges of our time and is key to increase the adoption of Artificial Intelligence (AI). Recently, a number of AI ethics principles frameworks have been published. However, without further guidance on best practices, practitioners are left with nothing much beyond truisms. In addition, significant efforts have been placed at algorithm level rather than system level, mainly focusing on a subset of mathematics-amenable ethical principles, such as fairness. Nevertheless, ethical issues can arise at any step of the development lifecycle, cutting across many AI and non-AI components of systems beyond AI algorithms and models. To operationalize RAI from a system perspective, in this article, we present an RAI Pattern Catalogue based on the results of a multivocal literature review. Rather than staying at the principle or algorithm level, we focus on patterns that AI system stakeholders can undertake in practice to ensure that the developed AI systems are responsible throughout the entire governance and engineering lifecycle. The RAI Pattern Catalogue classifies the patterns into three groups: multi-level governance patterns, trustworthy process patterns, and RAI-by-design product patterns. These patterns provide systematic and actionable guidance for stakeholders to implement RAI.
Context-Aware Auto-Encoded Graph Neural Model for Dynamic Question Generation using NLP
Authors: Dara Suresh , Srinivasulu CH. , Babu CH Madhu , Ravuri Ananda , Paruchuri Tirumala , Kilak Abhishek Singh , Vidyarthi Ankit
Published: October 2023

Question generation is an important task in natural language processing that involves generating questions from a given text. This paper proposes a novel approach for dynamic question generation using a context-aware auto-encoded graph neural model. Our approach involves constructing a graph representation of the input text, where each node in the graph corresponds to a word or phrase in the text, and the edges represent the relationships between them. We then use an auto-encoder model to learn a compressed representation of the graph that captures the most important information in the input text. Finally, we use the compressed graph representation to generate questions by dynamically selecting nodes and edges based on their relevance to the context of the input text. We evaluate our approach on four benchmark datasets (SQuAD, Natural Questions, TriviaQA, and QuAC) and demonstrate that it outperforms existing state-of-the-art methods for dynamic question generation. In the experimentation, to evaluate the result four performance metrics are used i.e. BLEU, ROUGE, F1-Score, and Accuracy. The result of the proposed approach yields an accuracy of 92% on the SQuAD dataset, 89% with QuAC, and 84% with TriviaQA. while on the natural questions dataset, the model gives 79% accuracy. Our results suggest that the use of graph neural networks and auto-encoder models can significantly improve the accuracy and effectiveness of question generation in NLP. Further research in this area can lead to even more sophisticated models that can generate questions that are even more contextually relevant and natural-sounding.
Sequential Routing-based Time-division Multiplexing Optimization for Multi-FPGA Systems
Authors: Lin Wenxiong , Wu Haojie , Gao Peng , Luo Wenjun , Cai Shuting , Xiong Xiaoming
Published: October 2023

Multi-field programming gate array (FPGA) systems are widely used in various circuit design-related areas, such as hardware emulation, virtual prototypes, and chiplet design methodologies. However, a physical resource clash between inter-FPGA signals and I/O pins can create a bottleneck in a multi-FPGA system. Specifically, inter-FPGA signals often outnumber I/O pins in a multi-FPGA system. To solve this problem, time-division multiplexing (TDM) is introduced. However, undue time delay caused by TDM may impair the performance of a multi-FPGA system. Therefore, a more efficient TDM solution is needed. In this work, we propose a new routing sequence strategy to improve the efficiency of TDM. Our strategy consists of two parts: a weighted routing algorithm and TDM assignment optimization. The algorithm takes into account the weight of the net to generate a high-quality routing topology. Then, a net-based TDM assignment is performed to obtain a lower TDM ratio for the multi-FPGA system. Experiments on the public dataset of CAD Contest 2019 at ICCAD showed that our routing sequence strategy achieved good results. Especially in those testcases of unbalanced designs, the performance of multi-FPGA systems was improved up to 2.63. Moreover, we outperformed the top two contest finalists as to TDM results in most of the testcases.
Synthesis of Carbon – TiC/TiB2 Composites at the Electrolytic Reduction of Fused Salts
Authors: Gorlanov Evgeniy S. , Mushihin Evgeniy A. , Schneider Svetlana R. , Kovalskaya Ksennya V.
Published: October 2023

This article presents the results of laboratory testing of the technology for the synthesis of composite carbon—titanium carbide/titanium diboride (C—TiC/TiB
2) material directly in course of electrolytic reduction of cryolite-alumina melts. After the preliminary standard treatment purposing the mixing of initial components—petroleum coke of different fractions, rutile titanium oxide TiO
2, boron oxide B
2
O
3 and binding agent—the cathode specimens were pressed to the specified sizes and thermally treated at the temperature of 1050 °С. Experiments with holding time of 5, 15 and 24 h during the electrolytic reduction process have demonstrated the acceptable wettability of cathode specimen surface. X-ray phase analysis and SEM-EDS-analysis have detected the presence of TiC/TiB
2 and titanium oxycarbide TiC

x

O
1-x
within the volume of cathodes and on their surface. After 15 and 24 h experiments the aluminium layer with good adhesion to the surface was noticed on the cathode surface; which is indicative of wettability of the electrode with metal. This tested technology can be extended to the creation of wide range of composite products in the С—МеС/МеВ
2 system.