bluuebunny/crossref_metadata_2025 huggingface dataset:
Bifurcations and global dynamics of a predator–prey mite model of Leslie type
Authors: Yang Yue , Xu Yancong , Rong Libin , Ruan Shigui
Published: February 2024

In this paper, we study a predator–prey mite model of Leslie type with generalized Holling IV functional response. The model is shown to have very rich bifurcation dynamics, including subcritical and supercritical Hopf bifurcations, degenerate Hopf bifurcation, focus‐type and cusp‐type degenerate Bogdanov–Takens bifurcations of codimension 3, originating from a nilpotent focus or cusp of codimension 3 that acts as the organizing center for the bifurcation set. Coexistence of multiple steady states, multiple limit cycles, and homoclinic cycles is also found. Interestingly, the coexistence of two limit cycles is guaranteed by investigating generalized Hopf bifurcation and degenerate homoclinic bifurcation, and we also find that two generalized Hopf bifurcation points are connected by a saddle‐node bifurcation curve of limit cycles, which indicates the existence of global regime for two limit cycles. Our work extends some results in the literature.
Lifting the lid on manipulative website contents: A framework mapping contextual and informational feature combinations against associated social cognitive vulnerabilities
Authors: MacLean Piers , Cahillane Marie , Smy Victoria
Published: February 2024

Website contents can be designed to influence individual and group decision‐making for social, political or financial gain. A novel working theoretical framework was developed to provide insights into where website contents have been designed to exploit common cognitive vulnerabilities (CVs) amongst audiences; a form of social cognitive hacking. A literature synthesis on CVs, website content design and credibility identified features on a context credibility (CC) dimension that were mapped against features on an information validity (IV) dimension. Alignment of CC and IV feature pairings with CVs enables evaluation and interpretation of nuanced website content for identification of attempted influence undetectable by machine algorithms. Subjective responses to prompts about features on each dimension generate pairs of numerical values. The value pairs indicate within a quad‐graph the possible presence and extent of CV exploitation. Each value pair can be traced to the underlying CC‐IV features and CVs being targeted. External prima facie assessment suggests the framework can form the basis for standardised human analysis of website contents. Application of the framework provides insights into what and how feature combinations may be manipulated for CV exploitation. It has potential for application in fields such as intelligence analysis, education, and marketing.
A cross‐sectional pilot household study of Schistosoma mansoni burden and associated morbidities in Lake Albert, Uganda
Authors: Dee Dominic P. , Lam Germain , Edielu Andrew , Anguajibi Victor , Webb Emily L. , Wamboko Aidah , Mawa Patrice A. , Friedman Jennifer F. , Simpson Hope , Bustinduy Amaya L.
Published: February 2024

Objectives

Schistosomiasis is persistent in Lake Albert, Uganda, but local data are limited. This study aims to describe the local burden of moderate‐to‐heavy infection and associated morbidity in all ages and identify factors associated with these outcomes to guide further research.

Methods

This cross‐sectional pilot study was conducted in July–August, 2022 in four village sites (Walukuba, Rwentale, Kyabarangwa and Runga) of the Praziquantel in Preschoolers (PIP) trial. Residents (approximately four per household) of any age of households of PIP participants were eligible, but individuals <10 years were only enrolled if no older individuals were available. Socio‐demographic information, household location, single stool Kato‐Katz and hepatic ultrasound results were obtained for a convenience sampled subset of trial households. The primary outcome, moderate‐to‐heavy infection (≥100 eggs per gram of faeces), was analysed using mixed‐effects logistic regression, with a household random effect. Univariate analyses were used for the secondary outcome, periportal fibrosis (Niamey protocol ultrasound image pattern C–F).

Results

Of 243 participants with a median age of 22 (interquartile range 12–33) years from 66 households, 49.8% (103/207 with a Kato‐Katz result) had moderate‐to‐heavy infection and 11.2% (25/224 with ultrasound data) had periportal fibrosis. Moderate‐to‐heavy infection clustered by household (intraclass correlation coefficient = 0.11) and, in multivariable analysis, varied by village (Walukuba vs. Kyabarangwa adjusted odds ratio [aOR] 0.11, 95% CI 0.02–0.71), was highest in participants aged 10–15 years (vs. 5–9 years aOR 6.14, 95% CI 1.61–23.38) and lower in those reporting praziquantel treatment in the past year (aOR 0.39, 95% CI 0.18–0.88).

Conclusions

In this setting, schistosome infection and morbidity are pervasive in all age groups. More intensive interventions are needed, for example more frequent praziquantel treatment, under investigation in the PIP trial and improved water and sanitation. More research is needed to understand local treatment barriers and optimal control strategies.
Putative pemphigus‐like reaction to oral fluralaner in a dog
Authors: Dalmau Annabel , Ordeix Laura
Published: February 2024

A 9‐month‐old mixed‐breed dog developed generalised pustular dermatitis, accompanied by lethargy and hyperthermia, 7 days after oral fluralaner administration. Dermatopathological and microbiological evaluations were consistent with a pustular acantholytic dermatitis. A 4‐month course of immunosuppressive therapy resulted in complete remission of lesions, which did not recur after therapy was withdrawn.
Trends in category and grade for therapeutic plasma exchange in the latest guideline on therapeutic apheresis by the American Society for Apheresis: Hurdles in pursuing evidence‐based medicine
Authors: Kim Han Joo , Chung Yousun , Kim Hyungsuk , Hwang Sang‐Hyun , Oh Heung‐Bum , Ko Dae‐Hyun
Published: February 2024

Background and Objectives

The Writing Committee of American Society for Apheresis released the ninth edition of guidelines for therapeutic apheresis in 2023. Categories have been a part of the guidelines since the first edition, and the grading system was introduced in the fifth edition, with updates in every new edition. In this study, we investigated the category and grade change trends through the latest five editions, focusing on therapeutic plasma exchange, to suggest future directions as part of evidence‐based medicine.

Materials and Methods

Categories and grades for therapeutic plasma exchange (TPE) were collected and analysed from the fifth through ninth editions. We aligned classification changes to the ninth edition's clinical context and compared its categories and grades with those introduced in the guideline.

Results

Among 166 total indications in the ninth edition, 118 included TPE procedure, either as a sole treatment or as one of the therapeutic apheresis techniques. The total number of indications changed, but Category III remained predominant throughout the editions. Similarly, Grade 2C consistently emerged as the most prevalent grade. Notably, 24 cases had grade changes. Of the 16 cases with evidence quality changes, the quality weakened in six and improved in 10. Evidence levels were not improved throughout the study period for 102 clinical conditions.

Conclusion

To address gaps in evidence quality, international collaboration is imperative to establish comprehensive large‐scale studies or randomized controlled trials. This will refine the use of therapeutic apheresis, including TPE, to foster evidence‐based advancements in clinical practice.
Acoustic Emission in Ceramic Matrix Composites
Authors: Tulshibagwale Nikhil , Brodnik Neal , Muir Caelin , Hilmas Ashley , Kiser James D. , Smith Craig E. , Almansour Amjad S. , Presby Michael J. , Daly Samantha
Published: February 2024

The integration of ceramic matrix composites (CMCs) into safety-critical applications, such as turbine engines and aerospace structures, necessitates a sound understanding of their expected damage evolution under in-service conditions and real-time health-monitoring methods to assess their damage state. The measurement of acoustic emissions (AEs), the transient elastic waves emitted during damage formation, offers an enhanced capability for evaluating damage evolution and structural health in CMCs due to its high sensitivity, accurate temporal resolution, and relative ease of use compared to other nondestructive evaluation (NDE) techniques. Recent advances in numerical simulation methods and data-driven model development, in combination with improved multimodal experimental characterization methods and sensor hardware, are rapidly advancing AE to a mature technique for damage quantification. This review discusses the fundamental principles of acoustic emissions, provides practical guidelines on their experimental characterization and analysis, and offers perspectives on the current state-of-the-art.
Eco-evolutionary emergence of macroecological scaling in plankton communities
Authors: Wickman Jonas , Litchman Elena , Klausmeier Christopher A.
Published: February 2024

Macroecological scaling patterns, such as between prey and predator biomass, are fundamental to our understanding of the rules of biological organization and ecosystem functioning. Although these scaling patterns are ubiquitous, how they arise is poorly understood. To explain these patterns, we used an eco-evolutionary predator–prey model parameterized using data for phytoplankton and zooplankton. We show that allometric scaling relationships at lower levels of biological organization, such as body-size scaling of nutrient uptake and predation, give rise to scaling relationships at the food web and ecosystem levels. Our predicted macroecological scaling exponents agree well with observed values across ecosystems. Our findings explicitly connect scaling relationships at different levels of biological organization to ecological and evolutionary mechanisms, yielding testable hypotheses for how observed macroecological patterns emerge.
Roaming in highly excited states: The central atom elimination of triatomic molecule decomposition
Authors: Li Zhenxing , Fu Yan-lin , Luo Zijie , Yang Shuaikang , Wu Yucheng , Wu Hao , Wu Guorong , Zhang Weiqing , Fu Bina , Yuan Kaijun , Zhang Donghui , Yang Xueming
Published: February 2024

Chemical reactions are generally assumed to proceed from reactants to products along the minimum energy path (MEP). However, straying from the MEP—roaming—has been recognized as an unconventional reaction mechanism and found to occur in both the ground and first excited states. Its existence in highly excited states is however not yet established. We report a dissociation channel to produce electronically excited fragments, S(
1
D)+O
2
(a
1
Δ
g
), from SO
2
photodissociation in highly excited states. The results revealed two dissociation pathways: One proceeds through the MEP to produce vibrationally colder O
2
(a
1
Δ
g
) and the other yields vibrationally hotter O
2
(a
1
Δ
g
) by means of a roaming pathway involving an intramolecular O abstraction during reorientation motion. Such roaming dynamics may well be the rule rather than the exception for molecular photodissociation through highly excited states.
Giant solar farms could provoke rainclouds in the desert
Authors: Voosen Paul
Published: February 2024

Updrafts from dark solar panels could fuel storms
Efficacy of therapeutically administered gepotidacin in a rabbit model of inhalational anthrax
Authors: Hilliard Jamese J. , Jakielaszek Charles , Mannino Frank , Hossain Mohammad , Qian Lian , Fishman Cindy , Demons Samandra , Hershfield Jeremy , Soffler Carl , Russo Riccardo , Henning Lisa , Novak Joseph , O'Dwyer Karen
Published: February 2024

Bacillus anthracis
is a Gram-positive Centers for Disease Control and Prevention category “A” biothreat pathogen. Without early treatment, inhalation of anthrax spores with progression to inhalational anthrax disease is associated with high fatality rates. Gepotidacin is a novel first-in-class triazaacenaphthylene antibiotic that inhibits bacterial DNA replication by a distinct mechanism of action and is being evaluated for use against biothreat and conventional pathogens. Gepotidacin selectively inhibits bacterial DNA replication via a unique binding mode and has
in vitro
activity against a collection of
B. anthracis
isolates including antibacterial-resistant strains, with the MIC
90
ranging from 0.5 to 1 µg/mL.
In vivo
activity of gepotidacin was also evaluated in the New Zealand White rabbit model of inhalational anthrax. The primary endpoint was survival, with survival duration and bacterial clearance as secondary endpoints. The trigger for treatment was the presence of anthrax protective antigen in serum. New Zealand White rabbits were dosed intravenously for 5 days with saline or gepotidacin at 114 mg/kg/d to simulate a dosing regimen of 1,000 mg intravenous (i.v.) three times a day (TID) in humans. Gepotidacin provided a survival benefit compared to saline control, with 91% survival (
P
-value: 0.0001). All control animals succumbed to anthrax and were found to be blood- and organ culture-positive for
B. anthracis
. The novel mode of action,
in vitro
microbiology, preclinical safety, and animal model efficacy data, which were generated in line with Food and Drug Administration Animal Rule, support gepotidacin as a potential treatment for anthrax in an emergency biothreat situation.
TRIM56-mediated production of type I interferon inhibits intracellular replication of
Rickettsia rickettsii
Authors: Cheng Ruxi , Zhou Chunyu , Zhao Mingliang , Zhang Shan , Wan Weiqiang , Yu Yonghui , Wen Bohai , Jiao Jun , Xiong Xiaolu , Xu Qin , OuYang Xuan
Published: February 2024

Rickettsia rickettsii
(
R. rickettsii
), the causative agent of Rocky Mountain spotted fever (RMSF), is the most pathogenic member among
Rickettsia
spp. Previous studies have shown that tripartite motif-containing 56 (TRIM56) E3 ligase-induced ubiquitination of STING is important for cytosolic DNA sensing and type I interferon production to induce anti-DNA viral immunity, but whether it affects intracellular replication of
R. rickettsii
remains uncharacterized. Here, we investigated the effect of TRIM56 on HeLa and THP-1 cells infected with
R. rickettsii
. We found that the expression of TRIM56 was upregulated in the
R. rickettsii
-infected cells, and the overexpression of TRIM56 inhibited the intracellular replication of
R. rickettsii
, while
R. rickettsii
replication was enhanced in the TRIM56-silenced host cells with the reduced phosphorylation of IRF3 and STING and the increased production of interferon-β. In addition, the mutation of the TRIM56 E3 ligase catalytic site impairs the inhibitory function against
R. rickettsii
in HeLa cells. Altogether, our study discovers that TRIM56 is a host restriction factor of
R. rickettsii
by regulating the cGAS-STING-mediated signaling pathway. This study gives new evidence for the role of TRIM56 in the innate immune response against intracellular bacterial infection and provides new therapeutic targets for RMSF.

IMPORTANCE

Given that
Rickettsia rickettsii
(
R. rickettsii
) is the most pathogenic member within the
Rickettsia
genus and serves as the causative agent of Rocky Mountain spotted fever, there is a growing need to explore host targets. In this study, we examined the impact of host TRIM56 on
R. rickettsii
infection in HeLa and THP-1 cells. We observed a significant upregulation of TRIM56 expression in
R. rickettsii
-infected cells. Remarkably, the overexpression of TRIM56 inhibited the intracellular replication of
R. rickettsii
, while silencing TRIM56 enhanced bacterial replication accompanied by reduced phosphorylation of IRF3 and STING, along with increased interferon-β production. Notably, the mutation of the TRIM56’s E3 ligase catalytic site did not impede
R. rickettsii
replication in HeLa cells. Collectively, our findings provide novel insights into the role of TRIM56 as a host restriction factor against
R. rickettsii
through the modulation of the cGAS-STING signaling pathway.
Societal and organisational influences on implementation of mental health peer support work in low-income and high-income settings: a qualitative focus group study
Authors: Ramesh Mary , Charles Ashleigh , Grayzman Alina , Hiltensperger Ramona , Kalha Jasmine , Kulkarni Arti , Mahlke Candelaria , Moran Galia S , Mpango Richard , Mueller-Stierlin Annabel S. , Nixdorf Rebecca , Ryan Grace Kathryn , Shamba Donat , Slade Mike
Published: February 2024

Objectives

Despite the established evidence base for mental health peer support work, widespread implementation remains a challenge. This study aimed to explore societal and organisational influences on the implementation of peer support work in low-income and high-income settings.

Design

Study sites conducted two focus groups in local languages at each site, using a topic guide based on a conceptual framework describing eight peer support worker (PSW) principles and five implementation issues. Transcripts were translated into English and an inductive thematic analysis was conducted to characterise implementation influences.

Setting

The study took place in two tertiary and three secondary mental healthcare sites as part of the Using Peer Support in Developing Empowering Mental Health Services (UPSIDES) study, comprising three high-income sites (Hamburg and Ulm, Germany; Be’er Sheva, Israel) and two low-income sites (Dar es Salaam, Tanzania; Kampala, Uganda) chosen for diversity both in region and in experience of peer support work.

Participants

12 focus groups were conducted (including a total of 86 participants), across sites in Ulm (n=2), Hamburg (n=2), Dar es Salaam (n=2), Be’er Sheva (n=2) and Kampala (n=4). Three individual interviews were also done in Kampala. All participants met the inclusion criteria: aged over 18 years; actual or potential PSW or mental health clinician or hospital/community manager or regional/national policy-maker; and able to give informed consent.

Results

Six themes relating to implementation influences were identified: community and staff attitudes, resource availability, organisational culture, role definition, training and support and peer support network.

Conclusions

This is the first multicountry study to explore societal attitudes and organisational culture influences on the implementation of peer support. Addressing community-level discrimination and developing a recovery orientation in mental health systems can contribute to effective implementation of peer support work. The relationship between societal stigma about mental health and resource allocation decisions warrants future investigation.

Trial registration number

ISRCTN26008944.
Effectiveness and clinical application of multidisciplinary combined exercise and nutrition intervention for sarcopenic older adults with metabolic syndrome: study protocol for a multicentre randomised controlled trial
Authors: Lee Sang Yoon , Beom Jaewon , Choi Jun Hwan , Jang Hak Chul , Kim EunYoung , Kim Keewon , Kim Miji , Shim Ga Yang , Won Chang Won , Lim Jae-Young
Published: February 2024

Introduction

Among chronic diseases affecting older adults, metabolic syndrome (MetS) is known to be closely related to sarcopenia. Insulin resistance may play a key role in the increased frequency of sarcopenia associated with metabolic disorders. To date, an exercise–nutrition combined intervention has been the treatment of choice for sarcopenia. However, trials of combined interventions for individuals with sarcopenia and MetS are still lacking. This study aims to develop and conduct a standardised intervention, named the Multidisciplinary combined Exercise and Nutrition inTervention fOR Sarcopenia (MENTORS), for sarcopenic older patients with MetS.

Methods and analysis

This multicentre, randomised controlled trial includes 168 community-dwelling older adults with sarcopenia and MetS. The 12-week MENTORS comprises an exercise intervention consisting of an introductory phase (3 weeks; twice-weekly visits), an expanded phase (3 weeks; twice-weekly visits) and a maintenance phase (6 weeks; once-weekly visits); and a nutrition intervention tailored to the nutritional status of individual subjects. Outcomes will be measured at 0-week, 12-week and 24-week postintervention. The data will be analysed using the intention-to-treat and per-protocol principle.

Ethics and dissemination

Before screening, all participants will be provided with oral and written information. Ethical approval has already been obtained from all participating hospitals. The study results will be disseminated in peer-reviewed publications and conference presentations.

Trial registration number

NCT04948736
Evaluating niraparib versus active symptom control in patients with previously treated mesothelioma (NERO): a study protocol for a multicentre, randomised, two-arm, open-label phase II trial in UK secondary care centres
Authors: Fennell Dean , Griffiths Daniel , Eminton Zina , Morgan-Fox Abigail , Hill Kayleigh , Ewings Sean , Stuart Charlotte , Johnson Lucy , Mallard Kim , Nye Mavis , Darlison Liz , Dulloo Sean , Cave Judith , Luo Jin-Li , Taylor Paul , Spicer Jake , Poile Charlotte , Bzura Aleksandra , Griffiths Gareth
Published: February 2024

Background

Malignant mesothelioma is a rapidly lethal cancer that has been increasing at an epidemic rate over the last three decades. Targeted therapies for mesothelioma have been lacking. A previous study called MiST1 (NCT03654833), evaluated the efficacy of Poly (ADP-ribose) polymerase (PARP) inhibition in mesothelioma. This study met its primary endpoint with 15% of patients having durable responses exceeding 1 year. Therefore, there is a need to evaluate PARP inhibitors in relapsed mesothelioma patients, where options are limited. Niraparib is the PARP inhibitor used in NERO.

Methods

NERO is a multicentre, two-arm, open-label UK randomised phase II trial designed to evaluate the efficacy of PARP inhibition in relapsed mesothelioma. 84 patients are being recruited. NERO is not restricted by line of therapy; however, eligible participants must have been treated with an approved platinum based systemic therapy. Participants will be randomised 2:1, stratified according to histology and response to prior platinum-based chemotherapy, to receive either active symptom control (ASC) and niraparib or ASC alone, for up to 24 weeks. Participants will be treated until disease progression, withdrawal, death or development of significant treatment limiting toxicity. Participants randomised to niraparib will receive 200 or 300 mg daily in a 3-weekly cycle. The primary endpoint is progression-free survival, where progression is determined by modified Response Evaluation Criteria in Solid Tumors (mRECIST) or RECIST 1.1; investigator reported progression; or death from any cause, whichever comes first. Secondary endpoints include overall survival, best overall response, 12-week and 24 week disease control, duration of response, treatment compliance and safety/tolerability. If NERO shows niraparib to be safe and biologically effective, it may lead to future late phase randomised controlled trials in relapsed mesothelioma.

Ethics and dissemination

The study received ethical approval from London-Hampstead Research Ethics Committee on 06-May-2022 (22/LO/0281). Data from all centres will be analysed together and published as soon as possible.

Trial registration number

ISCRTN16171129;NCT05455424.
Protocol for a mixed-method study to assess chronic cough in patients with renal cell carcinoma: the prevalence, impact on quality of life, trigger and potential clinical application of chronic cough as an early screening tool in patients with kidney cancer
Authors: Smith Wendy , Loizidou Marilena , Mazzone Stuart , Mumtaz Faiz , Gurusamy Kurinchi , Ranieri Veronica , Tran Maxine GB
Published: February 2024

Introduction

Cough as a symptom of renal cell carcinoma (RCC) was first described by Creevy in 1935, and despite one (unpublished) study suggesting it may affect 31% of these patients, as well as cough being discussed in forums for patients with kidney cancer, few clinicians are aware of this association. The cough has been described as unusual in nature, resolving rapidly after treatment with nephrectomy/embolisation but returning if the tumour recurs.

Methods and analysis

A prospective study using a questionnaire will identify the prevalence of cough in patients with suspected or confirmed RCC attending the Specialist Centre for Kidney Cancer (London, UK). A longitudinal study in a representative sample of these patients, using EQ-5D-5L and Leicester Cough Questionnaires, together with the use of semi-structured interviews with patients, will identify the impact of cough in addition to having a diagnosis of suspected or confirmed RCC on quality of life. To investigate cough mechanisms, a pilot study using cough hypersensitivity testing will be performed on patients with RCC, with and without a cough. Clinical samples (urine, blood, phlegm and breath condensate) from patients with RCC, with and without a cough, will be collected and analysed for the presence of substances known to trigger or enhance cough and compared with the results obtained from healthy volunteers.

Ethics and dissemination

Ethical approval has been granted (UK HR REC 22/PR/0791 dated 25/08/2022). Study outputs will be presented and published nationally and internationally at relevant conferences. This study will establish the prevalence of cough in patients with suspected or confirmed kidney cancer and support the education of clinicians to consider this diagnosis in patients with chronic cough (eg, recommending protocols to include both kidneys when investigating respiratory symptoms with chest CT scans). If substances known to trigger or enhance cough are identified and elevated in clinical samples, this research could offer potential targets for treatment for this distressing symptom.

Trial registration number

NIHR CRN portfolio CPMS ID:53 372.
Multicentre pilot randomised control trial of a self-directed exergaming intervention for poststroke upper limb rehabilitation: research protocol
Authors: Broderick Michelle , Burridge Jane , Demain Sara , Johnson Louise , Brereton Joe , O'Shea Robert , Bentley Paul
Published: February 2024

Introduction

Technology-facilitated, self-directed upper limb (UL) rehabilitation, as an adjunct to conventional care, could enhance poststroke UL recovery compared with conventional care alone, without imposing additional resource burden. The proposed pilot randomised controlled trial (RCT) aims to assess whether stroke survivors will engage in self-directed UL training, explore factors associated with intervention adherence and evaluate the study design for an RCT testing the efficacy of a self-directed exer-gaming intervention for UL recovery after stroke.

Methods and analysis

This is a multicentre, internal pilot RCT; parallel design, with nested qualitative methods. The sample will consist of stroke survivors with UL paresis, presenting within the previous 30 days. Participants randomised to the intervention group will be trained to use an exergaming device and will be supported to adopt this as part of their self-directed rehabilitation (ie, without formal support/supervision) for a 3-month period. The primary outcome will be the Fugl Meyer Upper Extremity Assessment (FM-UE) at 6 months poststroke. Secondary outcomes are the Action Research Arm Test (ARAT), the Barthel Index and the Modified Rankin Scale. Assessment time points will be prior to randomisation (0–1 month poststroke), 3 months and 6 months poststroke. A power calculation to inform sample size required for a definitive RCT will be conducted using FM-UE data from the sample across 0–6 months time points. Semistructured qualitative interviews will examine factors associated with intervention adoption. Reflexive thematic analysis will be used to code qualitative interview data and generate key themes associated with intervention adoption.

Ethics and dissemination

The study protocol (V.1.9) was granted ethical approval by the Health Research Authority, Health and Care Research Wales, and the London- Harrow Research Ethics Committee (ref. 21/LO/0054) on 19 May 2021. Trial results will be submitted for publication in peer-reviewed journals, presented at national and international stroke meetings and conferences and disseminated among stakeholder communities.

Trial registration number

NCT04475692
Effect of eye-tracking-based attention training for patients with poststroke cognitive impairment: a study protocol for a prospective, single-blinded, single-centre, randomised controlled trial in China
Authors: Wang Weijia , You Mingke , Ma Wanting , Yang Yonghong
Published: February 2024

Introduction

Poststroke cognitive impairment (PSCI) is a common dysfunction that places a great burden on patients who had stroke and their families. Approximately 46%–92% of stroke survivors experience some degree of attention problems after a stroke. Improving attention is considered the core of successfully improving cognitive function and reintegrating patients into daily life. Eye tracking technology provides real-time feedback and accurate monitoring of cognitive processing, and using this technology to introduce attention training may improve patient treatment outcomes. The main purpose of this study was to investigate whether eye-tracking-based attention training has a positive effect on patients with PSCI.

Methods and analysis

This study is a prospective randomised controlled trial. We will recruit 48 patients with PSCI referred to the Department of Rehabilitation Medicine at West China Hospital, Sichuan University, in Southwest China. The participants will be randomly distributed into two groups. Both groups will undergo conventional rehabilitation for 3 weeks, and the intervention group will receive 3 weeks of eye-tracking-based attention training (20–30 min/day). The primary outcome will be the patients’ cognitive function, measured by the Montreal Cognitive Assessment. The secondary outcomes will be the patients’ attention, independence of daily activities and event-related potential. These outcomes will be assessed at baseline, at the end of treatment (3 weeks) and at follow-up (1 month and 3 months after treatment). We will report the statistics and estimations using 95% CI.

Ethics and dissemination

This trial received ethics approval from the Ethics Committee on Biomedical Research, West China Hospital of Sichuan University (2023 review No. 258). The results from this study will be disseminated via academic publication.

Trial registration number

ChiCTR2300068727.
Comparison of two types of extension tubes for people with Parkinson’s disease in advanced treatment with levodopa–entacapone–carbidopa intestinal gel infusions: a prospective, crossover quality study
Authors: Thomsen Trine Hørmann , Olsen Louise , Javidi Mahsa , Karottki Nikolaj Folke La Cour , Biering-Sørensen Bo
Published: February 2024

Background

Within Parkinson’s disease (PD) management, a pivotal juncture often arises when individuals with PD (PwP) necessitate advanced therapies to stabilise symptom fluctuations and reduce off-periods, which are intrinsic to living with PD. One such intervention is the infusion of duodenal levodopa–entacapone–carbidopa intestinal gel (LECIG), which confers a more dependable levodopa plasma concentration compared with conventional oral therapy. It involves the insertion of a percutaneous endoscopic gastrojejunostomy (PEG-J) tube, facilitating direct access to the stomach and jejunum. Then, a slender tube extends into the small intestine, facilitating the continuous delivery of LECIG via a portable pump. The PEG-J incorporates an extension tube that permits patients with PD to connect the medication pump.

Objective

The objective of this study was to assess and compare two types of extension tubes a standard; a standard tube and the ENFit extension tube.

Method

Employing a prospective, crossover design at a single centre in Denmark. Each participant evaluated both extension tubes for 14 days. The primary outcome measure was patient-reported evaluation measures through a nine-item questionnaire using a 5-point Likert scale and 10th open-ended qualitative question.

Results

Of the 12 recruited PwP, 10 successfully completed both testing periods and submitted self-reported questionnaires. The participants, with an average age of 70.3 years, comprised three men and seven women. Among them, five had a spouse or cohabitant, while five lived independently (with one residing in a nursing home). The average duration of PD diagnosis was 16.4 years, with an average of 2.6 years since the implantation of the medication pump. The ENFit tube outperformed the standard tube across all nine evaluation criteria, particularly excelling in terms of usability (items 4–6), safety (item 2) and overall product preference (item 9).
Injuries and illnesses at the Munich 2022 European Championships: a prospective study of 5419 athletes from 52 countries involved in 9 sports
Authors: Edouard Pascal , Dandrieux Pierre-Eddy , Hollander Karsten , Zyskowski Michael
Published: February 2024

Objective

To describe the incidence and characteristics of the sports injuries and illnesses that occurred during the 2022 European Championships.

Methods

We conducted a prospective study on newly incurred injuries and illnesses collected by the national medical teams and the local organising committee physicians using a standardised online report form on a daily basis, in all athletes registered at the 2022 European Championships from 11 August 2022 to 21 August 2022 in Munich (Germany).

Results

In total, 5419 athletes were registered at the 2022 European Championships in 9 sports. A total of 181 in-competition injuries were reported, representing an overall incidence of 33.4 injuries per 1000 registered athletes, with higher values in triathlon, cycling and athletics. More injuries located at the lower limb and involving the muscles and skin were reported in athletics, at the lower limb and involving the skin in triathlon, at the head and trunk and upper limb and involving head and skin in cycling. A total of 65 illnesses were reported, representing an overall incidence of 12.0 illnesses per 1000 registered athletes, with higher values in athletics and rowing. The most affected common system was the cardiovascular system (24.6%), followed by the gastrointestinal (18.5%) and upper respiratory tracts (16.9%). The most frequent causes were exercise (36.9%), infections (30.8%) and ‘others’ (10.8%).

Conclusion

This was the first injury and illness surveillance during multisports European Championships providing relevant results to help anticipate medical services and athletes’ health protection, and highlighting the need for special attention for triathlon and cycling.
Injuries in the emerging sport of roundnet (Spikeball): a cross-sectional study of 166 players
Authors: Paul Ryan W , Gupta Richa , Muchintala Rahul , Boles Skyler , Bishop Meghan E , Freedman Kevin B
Published: February 2024

Objectives

To describe injury frequency and characteristics in roundnet athletes and compare injury characteristics between elite and non-elite athletes.

Methods

This cross-sectional study was performed by convenience sampling recreational and competitive roundnet athletes via a REDCap survey distributed through social media platforms. The custom survey evaluated athlete demographics, past sport participation, training workload and roundnet-related injuries throughout their whole playing career. Injury characteristics were reported for the full study cohort and compared between elite and non-elite athletes.

Results

166 athletes participated in the study, with 33.7% playing at the elite level. 279 injuries were reported, with 86.1% (n=143) of athletes reporting at least one injury throughout their playing career. Injuries most frequently involved the shoulder (20%), ankle (18%), knee (14%) and elbow (14%). 47% of reported injuries occurred due to overuse, and 67% resulted in missed competition time averaging 2.0 months. There were 10 injuries (3.6%) that required surgery. No differences were found in regards to injury frequency (1.9±1.5 vs 1.6±1.1 injuries per athlete, p=0.159) or any injury characteristics between elite and non-elite athletes.

Conclusion

Roundnet athletes experienced a mean of 1.7±1.2 injuries while playing roundnet. Injuries most frequently involved the shoulder and ankle and often resulted in missed competition time. The level of competition does not significantly impact injury frequency or characteristics. Roundnet athletes may benefit from injury prevention programmes that include shoulder strengthening, maintaining shoulder range of motion and ankle stability.
Entry point of machine learning in axial spondyloarthritis
Authors: Chen Yuening , Liu Hongxiao , Yu Qing , Qu Xinning , Sun Tiantian
Published: February 2024

Axial spondyloarthritis (axSpA) is a globally prevalent and challenging autoimmune disease. Characterised by insidious onset and slow progression, the absence of specific clinical manifestations and biomarkers often leads to misdiagnosis, thereby complicating early detection and diagnosis of axSpA. Furthermore, the high heterogeneity of axSpA, its complex pathogenesis and the lack of specific drugs means that traditional classification standards and treatment guidelines struggle to meet the demands of personalised treatment. Recently, machine learning (ML) has seen rapid advancements in the medical field. By integrating large-scale data with diverse algorithms and using multidimensional data, such as patient medical records, laboratory examinations, radiological data, drug usage and molecular biology information, ML can be modelled based on real-world clinical issues. This enables the diagnosis, stratification, therapeutic efficacy prediction and prognostic evaluation of axSpA, positioning it as an emerging research topic. This study explored the application and progression of ML in the diagnosis and therapy of axSpA from five perspectives: early diagnosis, stratification, disease monitoring, drug efficacy evaluation and comorbidity prediction. This study aimed to provide a novel direction for exploring rational diagnostic and therapeutic strategies for axSpA.
Association of nociplastic and neuropathic pain components with the presence of residual symptoms in patients with axial spondyloarthritis receiving biological disease-modifying antirheumatic drugs
Authors: Al Mohamad Fares , Rios Rodriguez Valeria , Haibel Hildrun , Protopopov Mikhail , Rademacher Judith , Sieper Joachim , Torgutalp Murat , Käding Henriette , Proft Fabian , Poddubnyy Denis
Published: February 2024

Objective

To evaluate the association of nociplastic (NoP) and neuropathic pain (NP) components with residual symptoms in patients with radiographic axial spondyloarthritis (r-axSpA) receiving biological disease-modifying antirheumatic drugs (bDMARDs).

Methods

78 patients with r-axSpA from the GErman SPondyloarthritis Inception Cohort receiving a bDMARD for at least 3 months were included in this analysis. The Widespread Pain Index (WPI) and the PainDETECT (PD) questionnaire were used to quantify the NoP and the NP components, respectively. Axial Spondyloarthritis Disease Activity Score (ASDAS) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were used as measures of residual symptoms. C reactive protein (CRP) was used as a measure of systemic inflammatory activity. Univariable and multivariable regression analyses of disease activity were performed. The regions of the WPI score and items of the PD score were used for cluster analyses.

Results

Linear multivariable regression analysis showed that WPI and PD were independently associated with ASDAS (b=0.1, 95% CI 0.04 to 0.17, and b=0.05, 95% CI 0.02 to 0.08, respectively) and BASDAI (b=0.24, 95% CI 0.08 to 0.39, and b=0.17, 95% CI 0.1 to 0.25, respectively) in r-axSpA patients receiving stable treatment with bDMARDs. Furthermore, WPI and PD were found to be significantly associated with the presence of relevant residual symptoms as defined by BASDAI ≥4 (OR 1.93, 95% CI 1.09 to 4.15, and OR 1.32, 95% CI 1.04 to 1.85, respectively). The effects were present also in patients with normal level of CRP. Cluster analysis revealed three distinct pain distribution profiles and four specific sensory symptom constellations allowing differentiation of different pain subtypes.

Conclusion

Both NoP and NP components seem to be associated with residual symptoms in patients with r-axSpA receiving treatment with bDMARDs.
Indirect impact of childhood 13-valent pneumococcal conjugate vaccine (PCV13) in Canadian older adults: a Canadian Immunization Research Network (CIRN) retrospective observational study
Authors: Nasreen Sharifa , Wang Jun , Marra Fawziah , Kwong Jeffrey C , McGeer Allison , Sadarangani Manish , Wilson Sarah E , Fadel Shaza A
Published: February 2024

Background

13-valent pneumococcal conjugate vaccine (PCV13) has been part of publicly funded childhood immunisation programmes in Ontario and British Columbia (BC) since 2010. We assessed the indirect impact of infant PCV13 programmes on invasive pneumococcal disease (IPD) and all-cause pneumonia hospitalisation in older adults (aged ≥65 years) using a retrospective observational study.

Methods

We extracted monthly IPD and all-cause pneumonia cases from laboratory and health administrative databases between January 2005 and December 2018. Using a quasi-experimental difference-in-differences design, we calculated the ratio of risk ratios (RRRs) using incidence rates of IPD or all-cause pneumonia cases before (pre-PCV13 period) and after (PCV13 period) 2010 with rates of fractures as controls.

Results

The rates of all IPD or PCV serotype-specific IPD for older adults in both Ontario and BC did not change in 8 years after childhood PCV13 programme implementation. All-cause pneumonia increased in Ontario (RRR 1.38, 95% CI 1.11 to 1.71) but remained unchanged in BC.

Conclusions

Indirect community protection of older adults from hospitalisation with pneumococcal disease stalled despite maturation of childhood PCV13 vaccination programmes in two Canadian provinces.
Qualitative behaviour of higher-curvature gravity with boundary terms i.e the f(Q) gravity models by dynamical system analysis
Authors: Vishwakarma Pooja , Shah Parth
Published: February 2024

The higher-curvature gravity with boundary terms i.e the f(Q) theories, grounded on non-metricity as a fundamental geometric quantity, exhibit remarkable efficacy in portraying late-time universe phenomena. The aim is to delineate constraints on two prevalent models within this framework, namely the Log-square-root model and the Hyperbolic tangent-power model, by employing the framework of Big Bang Nucleosynthesis (BBN). The approach involves elucidating deviations induced by higher-curvature gravity with boundary terms in the freeze-out temperature ($$T_{f}$$

T
f

) concerning its departure from the standard $$\Lambda $$
Λ
CDM evolution. Subsequently, constraints on pertinent model parameters are established by imposing limitations on $$\vert \frac{\delta T_{f}}{T_{f}}\vert $$

|

δ

T
f

T
f

|

derived from observational bounds. This investigation employs dynamical system analysis, scrutinizing both background and perturbed equations. The study systematically explores the phase space of the models, identifying equilibrium points, evaluating their stability, and comprehending the system’s trajectory around each critical point. Moreover, the application of “Center Manifold Theory” facilitates the examination of stability properties at non-hyperbolic points. The principal findings of this analysis reveal the presence of a matter-dominated saddle point characterized by the appropriate matter perturbation growth rate. Subsequently, this phase transitions into a stable phase of a dark-energy-dominated, accelerating universe, marked by consistent matter perturbations. Overall, the study substantiates observational confrontations, affirming the potential of higher-curvature gravity with boundary terms as a promising alternative to the $$\Lambda $$
Λ
CDM concordance model. The methodological approach underscores the significance of dynamical systems as an independent means to validate and comprehend the cosmological implications of these theories.
A Survey on Robotic Prosthetics: Neuroprosthetics, Soft Actuators, and Control Strategies
Authors: Jyothish K. J. , Mishra Subhankar
Published: February 2024

The field of robotics is a quickly evolving feat of technology that accepts contributions from various genres of science. Neuroscience, Physiology, Chemistry, Material science, Computer science, and the wide umbrella of mechatronics have all simultaneously contributed to many innovations in the prosthetic applications of robotics. This review begins with a discussion of the scope of the term robotic prosthetics and discusses the evolving domain of Neuroprosthetics. The discussion is then constrained to focus on various actuation and control strategies for robotic prosthetic limbs. This review discusses various soft robotic actuators such as EAP, SMA, FFA, and so on, and the merits of such actuators over conventional hard robotic actuators. Options in control strategies for robotic prosthetics, that are in various states of research and development, are reviewed. This article concludes the discussion with an analysis regarding the prospective direction in which this field of robotic prosthetics is evolving in terms of actuation, control, and other features relevant to artificial limbs. This article intends to review some of the emerging research and development trends in the field of robotic prosthetics and summarize many tangents that are represented under this broad domain in an approachable manner.
Enriching Urdu NER with BERT Embedding, Data Augmentation, and Hybrid Encoder-CNN Architecture
Authors: Ahmed Anil , Huang Degen , Arafat Syed Yasser , Hameed Imran
Published: February 2024

Named Entity Recognition (NER) is an indispensable component of Natural Language Processing (NLP), which aims to identify and classify entities within text data. While Deep Learning (DL) models have excelled in NER for well-resourced languages such as English, Spanish, and Chinese, they face significant hurdles when dealing with low-resource languages such as Urdu. These challenges stem from the intricate linguistic characteristics of Urdu, including morphological diversity, a context-dependent lexicon, and the scarcity of training data. This study addresses these issues by focusing on Urdu Named Entity Recognition (U-NER) and introducing three key contributions. First, various pre-trained embedding methods are employed, encompassing Word2vec (W2V), GloVe, FastText, Bidirectional Encoder Representations from Transformers (BERT), and Embeddings from language models (ELMo). In particular, fine-tuning is performed on BERT
BASE
and ELMo using Urdu Wikipedia and news articles. Second, a novel generative Data Augmentation (DA) technique replaces Named Entities (NEs) with mask tokens, employing pre-trained masked language models to predict masked tokens, effectively expanding the training dataset. Finally, the study introduces a novel hybrid model combining a Transformer Encoder with a Convolutional Neural Network (CNN) to capture the intricate morphology of Urdu. These modules enable the model to handle polysemy, extract short- and long-range dependencies, and enhance learning capacity. Empirical experiments demonstrate that the proposed model, incorporating BERT embeddings and an innovative DA approach, attains the highest F1-score of 93.99%, highlighting its efficacy for the U-NER task.