bluuebunny/crossref_metadata_2025 huggingface dataset:
Smart navigation via strategic communications in a mixed autonomous paradigm
Authors: Chen Yonghui , Xu Ailing , He Qiao‐Chu , Chen Ying‐Ju
Published: March 2023

Motivated by the emerging mixed autonomous paradigm in cobotic order picking operations, we investigate the optimal information design to navigate human workers (HWs) who cooperate with autonomous mobile robots (AMRs) within an intralogistics system. We incorporate asymmetric information between AMRs and HWs in a routing game where connected AMRs are informed of the congestion state while HWs rely on information provided by the system. The system designs a communication policy aiming to navigate HWs away from congestion. Without strategic communications, we show that the deployment of AMRs cannot mitigate congestion unless the automation level reaches a threshold. Interestingly, we illustrate a substitution effect between automation and strategic communications when information distortion is mild. In contrast, severe information distortion complements automation due to exacerbated congestion. Furthermore, an in‐house AMR fleet is economically more efficient than a third‐party logistics service. Consequently, in‐house automation can be achieved with mild information distortion, while severe information distortion is required to complement the lack of efficiency in the third‐party AMR fleet. With simulated numerical examples to complement the analytical results, we provide managerial insights concerning the optimal information policies under different levels of automation, guiding warehouse managers in their communications with workers to achieve the best performance of the cobotic system.
Why entrepreneur sourcing matters: the effects of entrepreneur sourcing on alternative types of business incubation performance
Authors: Eldering Cornelis , van den Ende Jan , Hulsink Willem
Published: March 2023

This paper investigates the effects of entrepreneur sourcing on business incubation performance. We distinguish between internal and external sourcing concerning the organisation that sponsors business incubation activities. Entrepreneurs can be internally sourced, originating from the parent organisation to become startup founders or externally sourced and recruited from outside the parent organisation to lead and build the startup. Both in the literature and incubation practice, the entrepreneur's trajectory is usually taken for granted. We contribute to research by investigating the effects of entrepreneur sourcing on business incubator performance and by offering an alternate categorisation of these performance outcomes. We characterise three basic types of performance outcomes: learning, earning, and returning. During this study, we identified a fourth outcome, namely branding. We examined eight cases at two corporate business incubators. Our findings suggest that internally and externally sourced entrepreneurs affect performance outcomes differently. Contrary to our expectations, we found that internal entrepreneurs contribute to exploratory learning, whereas external entrepreneurs contribute to exploitative learning. Furthermore, our results suggest that internal entrepreneurs generate earnings for the sponsorship organisation and external entrepreneurs contribute to a returning outcome by benefitting society at large. We conclude this study with a tentative conceptual model for future research into incubator design and for managers to align the setup of their incubator programmes to their specific purposes.
Reproductive performance of European‐breed ewes in different seasons of the year under mid‐latitude
Authors: Heinzen Bruna Cristina , Weber Saulo Henrique , Milczewski Viviane , Maia Dhéri , Kozicki Luiz Ernandes , Sotomaior Cristina Santos
Published: March 2023

The study evaluated the reproductive performance of Ile de France, Texel, Suffolk and crossbred ewes in different seasons, considering season of mating, age, body condition score and breed. The herd was located at geographic coordinates −25.66114429 S, −49.27262198 W, in Fazenda Rio Grande, Paraná State, southern Brazil, in a semi‐intensive system. 643 mating were evaluated, under natural oestrous conditions in 10 consecutive breeding seasons (2015–2019), under a body condition score between 2.5 and 3.5 in 93.9%. Data were analysed using Chi‐square tests, binary logistic regression, ANOVA and t‐test. Considering the breeds and crossbred animals, a pregnancy rate (PR) of 83% (winter), 91% (autumn) and 89% (summer) with no differences between them was obtained, except for 77% PR in spring (p < .05). Ile de France and crossbred ewes showed similar PR in all four seasons. Suffolk ewes showed similar fertility rates in summer, autumn and winter, but reduced in spring (p < .05); Texel ewes showed lower PR in summer and spring compared to autumn and winter (p < .05). The twin PR (TPR) in autumn, winter and spring showed no differences, except for summer (p < .05). Age did not influence the PR of ewes <2 years, 2–8 years and >8 years in the seasons, except in summer. It was concluded that the reproduction of European ewes breeds under medium latitude, combined with the use of constant management and feeding conditions, resulted in a fertility rate above 77% in all seasons, resulting in constant production of lambs.
Stories of a long life with HIV: A qualitative study of a narrative intervention
Authors: Jess Mia , Nielsen Steen Peter , Rasmussen Annette , Skov‐Pedersen Jytte , Timm Helle
Published: March 2023

Background

The dominant story of HIV in Denmark portrays HIV as compatible with a nearly normal life. International research on the experiences of elderly people diagnosed with human immunodeficiency virus (HIV) in the 1980s to mid‐1990s challenges this narrative.

Aims

To gain knowledge on the experiences of elderly long‐term survivors of HIV in Denmark and to evaluate if a narrative intervention ‘giving voice’ to this specific group was experienced as improving their quality of life.

Methods

In collaboration with relevant stakeholders, we developed a narrative intervention at REHPA, the Danish Knowledge Centre for Rehabilitation and Palliative Care focusing on the experiences and stories of people having lived a long life with HIV. Nineteen women and men living with HIV were included in the study. The intervention's evaluation design was based on ethnographic fieldwork that included participant observation and focus group interviews. The qualitative data were analysed using thematic content analysis.

Results

The findings show that the dominant story on HIV does not adequately cover the experiences of elderly Danes who have lived a long life with HIV. The participants continue to suffer from late complications and physical, existential, emotional and social challenges. The narrative intervention helped improve how participants experienced their quality of life.

Conclusion

Long‐term elderly Danish survivors diagnosed with HIV in the 1980s to mid‐1990s suffer from complex symptoms and problems related to living their lives with HIV and treatment. They found that telling and sharing their life stories with other people with HIV gave them a sense of coherence, meaning and direction in life.

Relevance

The study documents the experiences of a group of long‐term survivors of HIV in Denmark, making it relevant for organisations supporting people with HIV and for health care professionals working with this group. Furthermore, the study adds to the knowledge base on the use of narrative methods in rehabilitation.
Differences in the effects of a startle stimulus on rate of force development between resistance‐trained rock climbers and untrained individuals: Evidence for reticulospinal adaptations?
Authors: Colomer‐Poveda David , López‐Rivera Eva , Hortobágyi Tibor , Márquez Gonzalo , Fernández‐Del‐Olmo Miguel
Published: March 2023

The aim of the present cross‐sectional study was to determine if chronic rock climbing and climbing‐specific resistance training (RT) would modify the reticulospinal tract (RST) efficacy. Sixteen healthy, elite level climbers (CL; n = 16, 5 F; 29.8 ± 6.7 years) with 12 ± 7 years of climbing and climbing‐specific RT experience and 15 healthy recreationally active participants (CON; n = 15, 4 F; 24.6 ± 5.9 years), volunteered for the study. We quantified RST efficacy by comparing the effects of a startle stimulus over reaction time (Rtime) and measured rate of force development (RFD) and surface electromyography (sEMG) in representative muscles during powerful hand grip contractions. Both groups performed two Rtime tasks while performing rapid, powerful gripping with the right hand (Task 1) or during 3‐s‐long maximal voluntary right hand grip contractions in response to an imperative visual signal alone (V), or combined with a auditory‐non startle stimulus (A) or/and startling auditory stimulus (S). We also tested the reproducibility of these responses on two separate days in CON. Intersession reliability ranged from 0.34 to 0.96 for all variables. The CL versus CON was 37% stronger (p = 0.003). The S stimulus decreased Rtime and increased RFD and sEMG in both groups during both tasks (all p < 0.001). Rtime was similar between groups in all conditions. However, CL had a greater RFD from 50 to 100 ms compared with CON only after the S stimulus in both tasks (p < 0.05, d = 0.85–0.96). The data tentatively suggest that chronic rock climbing and climbing‐specific RT might improve RST efficacy, by increasing RST input to the α‐motoneurons.
Unparallel improvement patterns of dynamic wrinkles and skin quality after botulinum toxin type A treatment on the upper face
Authors: Sun Yixin , Li Yunzhu , Zhang Yixuan , Dong Ruijia , Lan Xinze , Zhang Mengyuan , Yu Nanze , Long Xiao
Published: March 2023

Background

Botulinum toxin type A (BoNT‐A) can not only reduce the dynamic wrinkles but also improve the skin quality. This study aims to quantitaively and comprehensively assess the improvement of dynamic wrinkles and skin quality following BoNT‐A treatment on the upper face.

Methods

Patients were recruited to receive BoNT‐A treatment of the glabellar, frontal, and lateral periorbital wrinkles. Antera 3D camera was used to evaluate the skin quality and dynamic wrinkle severity. Follow‐up visits were at 1 week, 1 month, 3 months, and 6 months after treatment. Different filters were utilized to quantitatively detect the severity of fine wrinkles (FWS), the volume of pores (PV), the roughness of skin texture (STR), and the severity of dynamic wrinkles (DWS).

Results

Twenty‐four participants (average 30.5 ± 7.2 years) were recruited. The significant improvement of PV, FWS, and STR in different areas usually maintained from 1 to 6 months after injections but of DWS only existed within 3 months. For each area, the improvement rates of FWS, PV, and STR peaked at 3 months or 6 months after treatment while the maximal improvement of DWS was observed at 1 month posttreatment.

Conclusion

After BoNT‐A treatment for dynamic wrinkles on the upper face, the skin quality of target regions can also be ameliorated. The improvement of skin quality and dynamic wrinkles presented unparallel patterns. The former is with a slower onset but longer duration while the latter exhibits a more rapid onset but shorter duration.
Tracing 100 million years of grass genome evolutionary plasticity
Authors: Bellec Arnaud , Sow Mamadou Dia , Pont Caroline , Civan Peter , Mardoc Emile , Duchemin Wandrille , Armisen David , Huneau Cécile , Thévenin Johanne , Vernoud Vanessa , Depège‐Fargeix Nathalie , Maunas Laurent , Escale Brigitte , Dubreucq Bertrand , Rogowsky Peter , Bergès Hélène , Salse Jerome
Published: March 2023

Grasses derive from a family of monocotyledonous plants that includes crops of major economic importance such as wheat, rice, sorghum and barley, sharing a common ancestor some 100 million years ago. The genomic attributes of plant adaptation remain obscure and the consequences of recurrent whole genome duplications (WGD) or polyploidization events, a major force in plant evolution, remain largely speculative. We conducted a comparative analysis of omics data from ten grass species to unveil structural (inversions, fusions, fissions, duplications, substitutions) and regulatory (expression and methylation) basis of genome plasticity, as possible attributes of plant long lasting evolution and adaptation. The present study demonstrates that diverged polyploid lineages sharing a common WGD event often present the same patterns of structural changes and evolutionary dynamics, but these patterns are difficult to generalize across independent WGD events as a result of non‐WGD factors such as selection and domestication of crops. Polyploidy is unequivocally linked to the evolutionary success of grasses during the past 100 million years, although it remains difficult to attribute this success to particular genomic consequences of polyploidization, suggesting that polyploids harness the potential of genome duplication, at least partially, in lineage‐specific ways. Overall, the present study clearly demonstrates that post‐polyploidization reprogramming is more complex than traditionally reported in investigating single species and calls for a critical and comprehensive comparison across independently polyploidized lineages.
News about the Sunda Strait Tsunami Disaster: From the Selection of News Sources to the Production Process
Authors: Sukmono Filosa Gita , Junaed Fajar , Fadilla Qholiva Yuni , Loilatu Mohammad Jafar , Fadillah Dani
Published: March 2023

Journalists had to deal with varying information from government entities with power in the disaster sector when covering the 2018 Sunda Strait tsunami. Indonesian catastrophe journalism now faces new difficulties as a result of unequal and shifting information. This is especially true when it comes to respecting the rule that information should be presented quickly and accurately in order to mitigate disasters. This study aims to learn more about the journalism practices at KompasTV, CNN Indonesia, MetroTV, and Trans7 in the news production process as well as how journalists select news sources in emergency situations, particularly when a tsunami strikes the Sunda Strait. According to this study's findings, Indonesia's four top mass media outlets place a high value on issues including validating catastrophe information, upholding a journalistic code of ethics, and the skill of journalists covering disasters. Journalists rely on and trust information obtained from government organizations with power over disasters and other mass media. Because it is impossible to ensure the accuracy of the material posted on social media, journalists avoid and do not utilize it.
Speech beyond the binary: Some acoustic-phonetic and auditory-perceptual characteristics of non-binary speakers
Authors: Merritt Brandon
Published: March 2023

Speech acoustics research typically assumes speakers are men or women with speech characteristics associated with these two gender categories. Less work has assessed acoustic-phonetic characteristics of non-binary speakers. This study examined acoustic-phonetic features across adult cisgender (15 men and 15 women) and subgroups of transgender (15 non-binary, 7 transgender men, and 7 transgender women) speakers and relations among these features and perceptual ratings of gender identity and masculinity/femininity. Differing acoustic-phonetic features were predictive of confidence in speaker gender and masculinity/femininity across cisgender and transgender speakers. Non-binary speakers were perceptually rated within an intermediate range of cisgender women and all other groups.
Large is different: Nonmonotonic behavior of elastic range scaling in polymeric turbulence at large Reynolds and Deborah numbers
Authors: Rosti Marco E. , Perlekar Prasad , Mitra Dhrubaditya
Published: March 2023

We use direct numerical simulations to study homogeneous and isotropic turbulent flows of dilute polymer solutions at high Reynolds and Deborah numbers. We find that for small wave numbers
k
, the kinetic energy spectrum shows Kolmogorov-like behavior that crosses over at a larger
k
to a novel, elastic scaling regime,
E
(
k
) ∼
k
−ξ
, with ξ ≈ 2.3. We study the contribution of the polymers to the flux of kinetic energy through scales and find that it can be decomposed into two parts: one increase in effective viscous dissipation and a purely elastic contribution that dominates over the nonlinear flux in the range of
k
over which the elastic scaling is observed. The multiscale balance between the two fluxes determines the crossover wave number that depends nonmonotically on the Deborah number. Consistently, structure functions also show two scaling ranges, with intermittency present in both of them in equal measure.
THz induced giant spin and valley currents
Authors: Sharma Sangeeta , Elliott Peter , Shallcross Samuel
Published: March 2023

Spin and valley indices represent the key quantum labels of quasi-particles in a wide class of two-dimensional materials and form the foundational elements of the fields of spintronics and valleytronics. Control over these degrees of freedom, therefore, remains the central challenge in these fields. Here, we show that femtosecond laser light combining optical frequency circularly polarized pulse and a terahertz (THz) frequency linearly polarized pulse, a so-called “hencomb” pulse, can generate precisely tailored and 90% pure spin currents for the dichalcogenide WSe
2
and >75% pure valley currents for bilayer graphene with gaps greater than 120 millielectron volts (dephasing time, 20 femtoseconds). The frequency of the circular light component and the polarization vector of the THz light component are shown to represent the key control parameters of these pulses. Our results thus open a route toward light control over spin/valley current states at ultrafast times.
Brønsted acid–catalyzed asymmetric dearomatization for synthesis of chiral fused polycyclic enone and indoline scaffolds
Authors: Tan Tong-De , Qian Gan-Lu , Su Hao-Ze , Zhu Lu-Jing , Ye Long-Wu , Zhou Bo , Hong Xin , Qian Peng-Cheng
Published: March 2023

In the past two decades, substantial advances have been made on the asymmetric alkyne functionalization by the activation of inert alkynes. However, these asymmetric transformations have so far been mostly limited to transition metal catalysis, and chiral Brønsted acid–catalyzed examples are rarely explored. Here, we report a chiral Brønsted acid–catalyzed dearomatization reaction of phenol- and indole-tethered homopropargyl amines, allowing the practical and atom-economical synthesis of a diverse array of valuable fused polycyclic enones and indolines bearing a chiral quaternary carbon stereocenter and two contiguous stereogenic centers in moderate to good yields with excellent diastereoselectivities and generally excellent enantioselectivities (up to >99% enantiomeric excess). This protocol demonstrates Brønsted acid–catalyzed asymmetric dearomatizations via vinylidene–quinone methides.
A self-rotating, single-actuated UAV with extended sensor field of view for autonomous navigation
Authors: Chen Nan , Kong Fanze , Xu Wei , Cai Yixi , Li Haotian , He Dongjiao , Qin Youming , Zhang Fu
Published: March 2023

Uncrewed aerial vehicles (UAVs) rely heavily on visual sensors to perceive obstacles and explore environments. Current UAVs are limited in both perception capability and task efficiency because of a small sensor field of view (FoV). One solution could be to leverage self-rotation in UAVs to extend the sensor FoV without consuming extra power. This natural mechanism, induced by the counter-torque of the UAV motor, has rarely been exploited by existing autonomous UAVs because of the difficulties in design and control due to highly coupled and nonlinear dynamics and the challenges in navigation brought by the high-rate self-rotation. Here, we present powered-flying ultra-underactuated LiDAR (light detection and ranging) sensing aerial robot (PULSAR), an agile and self-rotating UAV whose three-dimensional position is fully controlled by actuating only one motor to obtain the required thrust and moment. The use of a single actuator effectively reduces the energy loss in powered flights. Consequently, PULSAR consumes 26.7% less power than the benchmarked quadrotor with the same total propeller disk area and avionic payloads while retaining a good level of agility. Augmented by an onboard LiDAR sensor, PULSAR can perform autonomous navigation in unknown environments and detect both static and dynamic obstacles in panoramic views without any external instruments. We report the experiments of PULSAR in environment exploration and multidirectional dynamic obstacle avoidance with the extended FoV via self-rotation, which could lead to increased perception capability, task efficiency, and flight safety.
Host-derived mannose glycans trigger a pathogenic γδ T cell/IL-17a axis in autoimmunity
Authors: Alves Inês , Santos-Pereira Beatriz , de la Cruz Noelia , Campar Ana , Pinto Vanda , Rodrigues Pedro M. , Araújo Marco , Santos Sofia , Ramos-Soriano Javier , Vasconcelos Carlos , Silva Roberto , Afonso Nuno , Mira Filipe , Barrias Cristina C. , Alves Nuno L. , Rojo Javier , Santos Lélita , Marinho António , Pinho Salomé S.
Published: March 2023

Autoimmune diseases are life-threatening disorders that cause increasing disability over time. Systemic lupus erythematosus (SLE) and other autoimmune diseases arise when immune stimuli override mechanisms of self-tolerance. Accumulating evidence has demonstrated that protein glycosylation is substantially altered in autoimmune disease development, but the mechanisms by which glycans trigger these autoreactive immune responses are still largely unclear. In this study, we found that presence of microbial-associated mannose structures at the surface of the kidney triggers the recognition of DC-SIGN–expressing γδ T cells, inducing a pathogenic interleukin-17a (IL-17a)–mediated autoimmune response. Mice lacking
Mgat5
, which have a higher abundance of mannose structures in the kidney, displayed increased γδ T cell infiltration into the kidney that was associated with spontaneous development of lupus in older mice.
N
-acetylglucosamine supplementation, which promoted biosynthesis of tolerogenic branched N-glycans in the kidney, was found to inhibit γδ T cell infiltration and control disease development. Together, this work reveals a mannose–γδ T cell–IL-17a axis in SLE immunopathogenesis and highlights glycometabolic reprogramming as a therapeutic strategy for autoimmune disease treatment.
Next-Generation Diarylquinolines Improve Sterilizing Activity of Regimens with Pretomanid and the Novel Oxazolidinone TBI-223 in a Mouse Tuberculosis Model
Authors: Li Si-Yang , Converse Paul J. , Betoudji Fabrice , Lee Jin , Mdluli Khisimuzi , Upton Anna , Fotouhi Nader , Nuermberger Eric L.
Published: March 2023

A regimen comprised of bedaquiline (BDQ, or B), pretomanid, and linezolid (BPaL) is the first oral 6-month regimen approved by the U.S. Food and Drug Administration and recommended by the World Health Organization for the treatment of extensively drug-resistant tuberculosis.
Liquid-Liquid Phase Separation of the DEAD-Box Cyanobacterial RNA Helicase Redox (CrhR) into Dynamic Membraneless Organelles in
Synechocystis
sp. Strain PCC 6803
Authors: Whitman Brendan T. , Wang Yixiong , Murray Cameron R. A. , Glover Mark J. N. , Owttrim George W.
Published: March 2023

Oxygen-evolving photosynthetic cyanobacteria evolved ~3 billion years ago, performing fundamental roles in the biogeochemical evolution of the early Earth and continue to perform fundamental roles in nutrient cycling and primary productivity today. The phylum consists of diverse species that flourish in heterogeneous environments.
Congenital Syphilis: a Review of Global Epidemiology
Authors: Gilmour Leeyan S. , Walls Tony
Published: March 2023

In 2007, the World Health Organization (WHO) launched a global health initiative for the elimination of mother-to-child transmission (MTCT) of syphilis. This condition is highly preventable through antenatal identification of syphilis infection and treatment with penicillin during pregnancy.
Gac Is a Transcriptional Repressor of the Lyme Disease Spirochete’s OspC Virulence-Associated Surface Protein
Authors: Castro-Padovani Tatiana N. , Saylor Timothy C. , Husted Olivia T. , Krusenstjerna Andrew C. , Jusufovic Nerina , Stevenson Brian
Published: March 2023

Borrelia burgdorferi
sensu lato
requires its surface-exposed OspC protein in order to establish infection in humans and other vertebrate hosts. Bacteria that either do not produce OspC during transmission or fail to repress OspC after infection is established are rapidly cleared by the host.
The Interplay of AphB and CadC to Activate Acid Resistance of
Vibrio campbellii
Authors: Schwarz Julia , Brameyer Sophie , Hoyer Elisabeth , Jung Kirsten
Published: March 2023

Acid resistance is an important property not only for neutralophilic enteric bacteria such as
Escherichia
,
Yersinia
, and
Salmonella
, but also for
Vibrio
. To counteract acidic threats, the marine
Vibrio campbellii
, a pathogen for various invertebrates, activates the acid-resistance Cad system.
Draft Genome Sequences of 110 Shiga Toxin-Producing Escherichia coli Isolates Collected from Bovine Manure Samples in the Southern United States
Authors: Baker Christopher A. , Gutierrez Alan , Bell Rebecca , Schneider Keith R.
Published: March 2023

Shiga toxin-producing
Escherichia coli
(STEC) bacteria continue to impact the food industry. Environmental sampling of potential sources of contamination is important to aid epidemiologic efforts in tracking foodborne illnesses throughout the United States. Here, the draft genome sequences of 110 STEC isolates from bovine manure collected in Florida and Texas are reported.
An APOBEC3 Mutational Signature in the Genomes of Human-Infecting Orthopoxviruses
Authors: Forni Diego , Cagliani Rachele , Pozzoli Uberto , Sironi Manuela
Published: March 2023

Analysis of the viral lineages responsible for the 2022 monkeypox outbreak suggested that APOBEC enzymes are driving hMPXV1 evolution. Using 1,624 public sequences, we analyzed the mutations that accumulated between 2017 and the emergence of the predominant variant and those that characterize the last outbreak.
Comparative effectiveness of BNT162b2 versus mRNA-1273 covid-19 vaccine boosting in England: matched cohort study in OpenSAFELY-TPP
Authors: Hulme William J , Horne Elsie M F , Parker Edward P K , Keogh Ruth H , Williamson Elizabeth J , Walker Venexia , Palmer Tom M , Curtis Helen J , Walker Alex J , Andrews Colm D , Mehrkar Amir , Morley Jessica , MacKenna Brian , Bacon Sebastian C J , Goldacre Ben , Hernán Miguel A , Sterne Jonathan A C
Published: March 2023

Objective

To compare the effectiveness of the BNT162b2 mRNA (Pfizer-BioNTech) and mRNA-1273 (Moderna) covid-19 vaccines during the booster programme in England.

Design

Matched cohort study, emulating a comparative effectiveness trial.

Setting

Linked primary care, hospital, and covid-19 surveillance records available within the OpenSAFELY-TPP research platform, covering a period when the SARS-CoV-2 delta and omicron variants were dominant.

Participants

3 237 918 adults who received a booster dose of either vaccine between 29 October 2021 and 25 February 2022 as part of the national booster programme in England and who received a primary course of BNT162b2 or ChAdOx1.

Intervention

Vaccination with either BNT162b2 or mRNA-1273 as a booster vaccine dose.

Main outcome measures

Recorded SARS-CoV-2 positive test, covid-19 related hospital admission, covid-19 related death, and non-covid-19 related death at 20 weeks after receipt of the booster dose.

Results

1 618 959 people were matched in each vaccine group, contributing a total 64 546 391 person weeks of follow-up. The 20 week risks per 1000 for a positive SARS-CoV-2 test were 164.2 (95% confidence interval 163.3 to 165.1) for BNT162b2 and 159.9 (159.0 to 160.8) for mRNA-1273; the hazard ratio comparing mRNA-1273 with BNT162b2 was 0.95 (95% confidence interval 0.95 to 0.96). The 20 week risks per 1000 for hospital admission with covid-19 were 0.75 (0.71 to 0.79) for BNT162b2 and 0.65 (0.61 to 0.69) for mRNA-1273; the hazard ratio was 0.89 (0.82 to 0.95). Covid-19 related deaths were rare: the 20 week risks per 1000 were 0.028 (0.021 to 0.037) for BNT162b2 and 0.024 (0.018 to 0.033) for mRNA-1273; hazard ratio 0.83 (0.58 to 1.19). Comparative effectiveness was generally similar within subgroups defined by the primary course vaccine brand, age, previous SARS-CoV-2 infection, and clinical vulnerability. Relative benefit was similar when vaccines were compared separately in the delta and omicron variant eras.

Conclusions

This matched observational study of adults estimated a modest benefit of booster vaccination with mRNA-1273 compared with BNT162b2 in preventing positive SARS-CoV-2 tests and hospital admission with covid-19 20 weeks after vaccination, during a period of delta followed by omicron variant dominance.
Smartphone apps for point-of-care information summaries: systematic assessment of the quality and content
Authors: Lee Mauricette , Lin Xiaowen , Chai Joanne Zhi Qi , Lee Eng Sing , Smith Helen , Tudor Car Lorainne
Published: March 2023

Background

Clinicians need easy access to evidence-based information to inform their clinical practice. Point-of-care information summaries are increasingly available in the form of smartphone apps. However, the quality of information from the apps is questionable as there is currently no regulation on the content of the medical apps.

Objectives

This study aimed to systematically assess the quality and content of the medical apps providing point-of-care information summaries that were available in two major app stores. We evaluated apps designed specifically for healthcare professionals and assessed their content development, editorial policy, coverage of medical conditions and trustworthiness.

Methods

We conducted a systematic assessment of medical apps providing point-of-care information summaries available in Google Play and Apple app stores. Apps launched or updated since January 2020 were identified through a systematic search using 42matters. Apps meeting the inclusion criteria were downloaded and assessed. The data extraction and app assessment were done in parallel and independently by at least two reviewers. Apps were evaluated against the adapted criteria: (1) general characteristics, (2) content presentation of the summaries, (3) editorial quality, (4) evidence-based methodology, (5) coverage (volume) of the medical conditions, (6) usability of apps and (7) trustworthiness of the app based on HONcode principles. HONcode principles are guidelines used to inform users about the credibility and reliability of health information online. The results were reported as a narrative review.

Results

Eight medical apps met the inclusion criteria and were systematically appraised. Based on our evaluation criteria, UpToDate supported 16 languages, and all other apps were English. Bullet points and brief paragraphs were used in all apps, and only DynaMed and Micromedex and Pathway-medical knowledge provided a formal grading system for the strength of recommendations for all the medical conditions in their apps. All the other apps either lacked a formal grading system altogether or offered one for some of the medical conditions. About 30% of the editorial quality assessment and 47.5% of the evidence-based methodology assessment were unclear or missing. UpToDate contained the most point-of-care evidence-based documents with >10 500 documents. All apps except 5-Minute Clinical Consult and DynaMed and Micromedex were available for offline access. Only Medscape complied with the HONcode principles.

Conclusions

Future apps should report a more detailed evidence-based methodology, be accessible for offline use and support search in more than one language. There should be clearer information provided in future apps regarding the declaration of authorship and conflict of interest.
Reproductive outcomes in women and men conceived by assisted reproductive technologies in Norway: prospective registry based study
Authors: Carlsen Ellen Øen , Wilcox Allen J , Magnus Maria Christine , Hanevik Hans Ivar , Håberg Siri Eldevik
Published: March 2023

Objectives

To determine whether the perinatal outcomes of women or men who were conceived by assisted reproductive technologies are different compared with their peers who were naturally conceived.

Design

Prospective registry based study.

Setting

Medical Birth Registry of Norway.

Participants

People born in Norway between 1984 and 2002 with a registered pregnancy by the end of 2021.

Exposure

People who were conceived by assisted reproductive technologies and have had a registered pregnancy.

Main outcome measures

Comparing pregnancies and births of people who were conceived by assisted reproductive technologies and people who were naturally conceived, we assessed mean birth weight, gestational age, and placental weight by linear regression, additionally, the odds of congenital malformations, a low 5 min Apgar score (<7), transfer to a neonatal intensive care unit, delivery by caesarean section, use of assisted reproductive technologies, hypertensive disorders of pregnancy and pre-eclampsia, preterm birth, and offspring sex, by logistic regression. The occurrence of any registered pregnancy from people aged 14 years until age at the end of follow-up was assessed using Cox proportional regression for both groups.

Results

Among 1 092 151 people born in Norway from 1984 to 2002, 180 652 were registered at least once as mothers, and 137 530 as fathers. Of these, 399 men and 553 women were conceived by assisted reproductive technologies. People who were conceived by assisted reproductive technologies had little evidence of increased risk of adverse outcomes in their own pregnancies, increased use of assisted reproductive technologies, or any difference in mean birth weight, placental weight, or gestational age. The only exception was for an increased risk of the neonate having a low Apgar score at 5 min (adjusted odds ratio 1.86 (95% confidence interval 1.20 to 2.89)) among women who were conceived by assisted reproductive technologies. Odds were slightly decreased of having a boy among mothers conceived by assisted reproductive technologies (odds ratio 0.79 (95% confidence interval 0.67 to 0.93)). People conceived by assisted reproductive technologies were slightly less likely to have a registered pregnancy within the follow-up period (women, adjusted hazard ratio 0.88 (95% CI 0.81 to 0.96); men, 0.91 (0.83 to 1.01)).

Conclusions

People conceived by assisted reproductive technologies were not at increased risk of obstetric or perinatal complications when becoming parents. The proportion of people conceived by assisted reproductive technologies with a registered pregnancy was lower than among people who were naturally conceived, but a longer follow-up is required to fully assess their fertility and reproductive history.
Smartphone Smoking Cessation Application (SSC App) trial: a multicountry double-blind automated randomised controlled trial of a smoking cessation decision-aid ‘app’
Authors: BinDhim Nasser F , McGeechan Kevin , Trevena Lyndal
Published: March 2023

Objective

To assess the efficacy of an interactive smoking cessation decision-aid application (pp) compared with a smoking cessation static information app on continuous abstinence.

Design

Automated double-blind randomised controlled trial with 6 months follow-up (2014–2015).

Setting

Smartphone-based.

Participants

684 participants (daily smokers of cigarettes, 18 years old or over) recruited passively from app stores in the USA, Australia, UK and Singapore, and randomised to one of two sub-apps.

Intervention(s)

Behavioural, decision-aid, smartphone application.

Main outcome(s)

Continuous abstinence at 10 days, 1 month, 3 months and 6 months.

Results

Smokers who received the decision-aid app were more likely to be continuously abstinent at 1 month compared with the information-only app (28.5% vs 16.9%; relative risk (RR) 1.68; 95% CI 1.25 to 2.28). The effect was sustained at 3 months (23.8% vs 10.2%; RR 2.08; 95% CI 1.38 to 3.18) and 6 months (10.2% vs 4.8%; RR 2.02; 95% CI 1.08 to 3.81). Participants receiving the decision-aid app were also more likely to have made an informed choice (31.9% vs 19.6%) and have lower decisional conflict (19.5% vs 3.9%).

Conclusion

A smartphone decision-aid app with support features significantly increased smoking cessation and informed choice. With an increasing number of smokers attempting to quit, unassisted evidence-based decision-aid apps can provide an effective and user-friendly option to many who are making quit decisions without healthcare professionals.

Trial registration number

ACTRN12613000833763.
Randomised controlled trial to determine the efficacy and safety of prescribed water intake to prevent kidney failure due to autosomal dominant polycystic kidney disease (PREVENT-ADPKD)
Authors: Wong Annette T Y , Mannix Carly , Grantham Jared J , Allman-Farinelli Margaret , Badve Sunil V , Boudville Neil , Byth Karen , Chan Jessie , Coulshed Susan , Edwards Marie E , Erickson Bradley J , Fernando Mangalee , Foster Sheryl , Haloob Imad , Harris David C H , Hawley Carmel M , Hill Julie , Howard Kirsten , Howell Martin , Jiang Simon H , Johnson David W , Kline Timothy L , Kumar Karthik , Lee Vincent W , Lonergan Maureen , Mai Jun , McCloud Philip , Peduto Anthony , Rangan Anna , Roger Simon D , Sud Kamal , Torres Vincent , Vliayuri Eswari , Rangan Gopala K
Published: March 2023

Introduction

Maintaining fluid intake sufficient to reduce arginine vasopressin (AVP) secretion has been hypothesised to slow kidney cyst growth in autosomal dominant polycystic kidney disease (ADPKD). However, evidence to support this as a clinical practice recommendation is of poor quality. The aim of the present study is to determine the long-term efficacy and safety of prescribed water intake to prevent the progression of height-adjusted total kidney volume (ht-TKV) in patients with chronic kidney disease (stages 1–3) due to ADPKD.

Methods and analysis

A multicentre, prospective, parallel-group, open-label, randomised controlled trial will be conducted. Patients with ADPKD (n=180; age ≤65 years, estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m2) will be randomised (1:1) to either the control (standard treatment+usual fluid intake) or intervention (standard treatment+prescribed fluid intake) group. Participants in the intervention arm will be prescribed an individualised daily fluid intake to reduce urine osmolality to ≤270 mOsmol/kg, and supported with structured clinic and telephonic dietetic review, self-monitoring of urine-specific gravity, short message service text reminders and internet-based tools. All participants will have 6-monthly follow-up visits, and ht-TKV will be measured by MRI at 0, 18 and 36 months. The primary end point is the annual rate of change in ht-TKV as determined by serial renal MRI in control vs intervention groups, from baseline to 3 years. The secondary end points are differences between the two groups in systemic AVP activity, renal disease (eGFR, blood pressure, renal pain), patient adherence, acceptability and safety.

Ethics and dissemination

The trial was approved by the Human Research Ethics Committee, Western Sydney Local Health District. The results will inform clinicians, patients and policy-makers regarding the long-term safety, efficacy and feasibility of prescribed fluid intake as an approach to reduce kidney cyst growth in patients with ADPKD.

Trial registration number

ANZCTR12614001216606.
Body size measures and risk of venous thromboembolism: protocol for a systematic review and meta-analysis
Authors: Kaze Arnaud D , Bigna Jean Joel , Nansseu Jobert Richie , Noubiap Jean Jacques
Published: March 2023

Introduction

Obesity is significant risk factor for venous thromboembolism (VTE); however, the related mechanisms remain unclear. Previous studies have suggested that this might be related to physical factors including anthropometric measures. We intend to conduct a systematic review and meta-analysis of prospective studies to summarise the extant literature on the associations between a set of seven measures of body size and the risk of VTE.

Methods and analysis

The current systematic review will include prospective cohort studies assessing the association between seven measures of body size (height, weight, body mass index, waist and hip circumferences, waist-to-hip ratio, waist-to-height ratio) and the risk of VTE. We will conduct comprehensive searches of MEDLINE and Excerpta Medica Database (EMBASE) for articles published from inception through 31 August 2017, without any language restriction. Two investigators will independently screen, select studies and perform data extraction and risk of bias assessment, with discrepancies resolved by a third investigator. For each body size measure, study-specific relative risks will be pooled using random effects meta-analysis models. Statistical heterogeneity will be assessed using Cochran’s Q statistic, H and the I2statistics. Sources of heterogeneity will be investigated using subgroup and meta-regression analyses as deemed appropriate. Publication bias will be assessed with funnel plots supplemented by Egger’s test.

Ethics and dissemination

This systematic review will use data from published literature; therefore, ethical approval is not required. We expect our findings to supplement previous epidemiological studies by providing an updated and comprehensive synthesis of the available evidence on the association between body size measures and risk of VTE in the general population. Findings will be published in peer-reviewed journal and presented at scientific meetings.

PROSPERO registration number

CD CRD42017071996.
Study protocol for a prospective cohort study examining the predictive potential of dynamic symptom networks for the onset and progression of psychosis: the Mapping Individual Routes of Risk and Resilience (Mirorr) study
Authors: Booij Sanne H , Wichers Marieke , de Jonge Peter , Sytema Sjoerd , van Os Jim , Wunderink Lex , Wigman Johanna T W
Published: March 2023

Introduction

Our current ability to predict the course and outcome of early psychotic symptoms is limited, hampering timely treatment. To improve our understanding of the development of psychosis, a different approach to psychopathology may be productive. We propose to reconceptualise psychopathology from a network perspective, according to which symptoms act as a dynamic, interconnected system, impacting on each other over time and across diagnostic boundaries to form symptom networks. Adopting this network approach, the Mapping Individual Routes of Risk and Resilience study aims to determine whether characteristics of symptom networks can predict illness course and outcome of early psychotic symptoms.

Methods and analysis

The sample consists of n=100 participants aged 18–35 years, divided into four subgroups (n=4×25) with increasing levels of severity of psychopathology, representing successive stages of clinical progression. Individuals representing the initial stage have a relatively low expression of psychotic experiences (general population), whereas individuals representing the end stage are help seeking and display a psychometric expression of psychosis, putting them at ultra-high risk for transition to psychotic disorder. At baseline and 1-year follow-up, participants report their symptoms, affective states and experiences for three consecutive months in short, daily questionnaires on their smartphone, which will be used to map individual networks. Network parameters, including the strength and directionality of symptom connections and centrality indices, will be estimated and associated to individual differences in and within-individual progression through stages of clinical severity and functioning over the next 3 years.

Ethics and dissemination

The study has been approved by the local medical ethical committee (ABR no. NL52974.042.15). The results of the study will be published in (inter)national peer-reviewed journals, presented at research, clinical and general public conferences. The results will assist in improving and fine-tuning dynamic models of psychopathology, stimulating both clinical and scientific progress.

Trial registration number

NTR6205; Pre-results.
Incidence rate of community-acquired pneumonia in adults: a population-based prospective active surveillance study in three cities in South America
Authors: Lopardo Gustavo Daniel , Fridman Diego , Raimondo Enrique , Albornoz Henry , Lopardo Ana , Bagnulo Homero , Goleniuk Daniel , Sanabria Manuelita , Stamboulian Daniel
Published: March 2023

Objective

To determine the incidence rate and mortality of community-acquired pneumonia (CAP) in adults in three cities in Latin America during a 3-year period.

Design

Prospective population-based surveillance study.

Setting

Healthcare facilities (outpatient centres and hospitals) in the cities of General Roca (Argentina), Rivera (Uruguay) and Concepción (Paraguay).

Participants

2302 adults aged 18 years and older with CAP were prospectively enrolled between January 2012 and March 2015.

Main outcome measures

Incidence rates of CAP in adults, predisposing conditions for disease, mortality at 14 days and at 1 year were estimated. Incidence rate of CAP, within each age group, was calculated by dividing the number of cases by the person-years of disease-free exposure time based on the last census; incidence rates were expressed per 1000 person-years.

Results

Median age of participants was 66 years, 46.44% were men, 68% were hospitalised. Annual incidence rate was 7.03 (95% CI 6.64 to 7.44) per 1000 person-years in General Roca, 6.33 (95% CI 5.92 to 6.78) per 1000 person-years in Rivera and 1.76 (95% CI 1.55 to 2.00) per 1000 person-years in Concepción. Incidence rates were highest in participants aged over 65 years. 82.4% had at least one predisposing condition and 48% had two or more (multimorbidity). Chronic heart disease (43.6%) and smoking (37.3%) were the most common risk factors. 14-day mortality rate was 12.1% and 1-year mortality was 24.9%. Multimorbidity was associated with an increased risk of death at 14 days (OR 2.91; 95% CI 2.23 to 3.80) and at 1 year (OR 3.00; 95% CI 2.44 to 3.70).

Conclusions

We found a high incidence rate of CAP in adults, ranging from 1.76 to 7.03 per 1000 person-years, in three cities in South America, disclosing the high burden of disease in the region. Efforts to improve prevention strategies are needed.