bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative phylogeography and integrative systematic revision of Iberian endemic earthworms (Crassiclitellata, Lumbricidae)
Authors: Pinadero Sergio Jiménez , Marchán Daniel Fernández , Navarro Alejandro Martínez , Tilikj Natasha , Novo Marta , Domínguez Jorge , Díaz Cosín Darío J. , Trigo Dolores
Published: February 2023

The Iberian Peninsula and south‐western France have been postulated as centres of diversification of a wide variety of endemic earthworm species and genera within the Lumbricidae family. However, the phylogenetic position and identity of some of these endemisms is still uncertain and their phylogeographic patterns totally unknown. In the present study, phylogenetic analyses were carried out with the molecular markers COI, 16S, 28S, ND1 and 12S to clarify the phylogenetic position of the Iberian endemism Iberoscolex in the lumbricid tree. In addition, phylogeographic patterns of three of its species (I. albolineatus, I. carpetanus and I. gerardoi) were studied based on the COI marker and compared with patterns of species showing similar distributions within Castellodrilus (C. ibericus and C. chitae), another Iberian endemism. Phylogenetic trees recovered all species of the genus Iberoscolex (with the exception of I. pseudorroseus) within a clade differentiated from Eiseniona where some authors had placed Iberoscolex species before. Moreover, they were clustered with some species (including the type) of Orodrilus, an Iberian‐French endemism also sequenced for this study. Owing to the priority of Orodrilus, Iberoscolex should be considered a junior synonym, with all of the species formerly included within it assigned to a redefined Orodrilus. Strong population structure was observed for Iberoscolex and Castellodrilus species under study, together with a pattern of isolation by distance; however, these genera showed different patterns of genetic variability: the Castellodrilus species under study exhibit lower genetic diversity, with fewer haplotypes per population than the Iberoscolex species.
Ideal growth in amalgamated powers of nilpotent rings of class two and zeta functions of quiver representations
Authors: Bauer Tomer , Schein Michael M.
Published: February 2023

Let be a nilpotent algebra of class two over a compact discrete valuation ring of characteristic zero or of sufficiently large positive characteristic. Let be the residue cardinality of . The ideal zeta function of is a Dirichlet series enumerating finite‐index ideals of . We prove that there is a rational function in , , , and giving the ideal zeta function of the amalgamation of copies of over the derived subring, for every , up to an explicit factor. More generally, we prove this for the zeta functions of nilpotent quiver representations of class two defined by Lee and Voll, and in particular for Dirichlet series counting graded submodules of a graded ‐module. If the algebra , or the quiver representation, is defined over , then we obtain a uniform rationality result.
Architected material with independently tunable mass, damping, and stiffness via multi-stability and kinematic amplification
Authors: Ramakrishnan Vinod , Frazier Michael J.
Published: February 2023

We report on a class of architected material lattices that exploit multi-stability and kinematic amplification to independently adjust the local effective mass, damping, and stiffness properties, thereby realizing congruent alterations to the acoustic dispersion response post-fabrication. The fundamental structural tuning element permits a broad range in the effective property space; moreover, its particular design carries the benefit of tuning without altering the original size/shape of the emerging structure. The relation between the tuning element geometry and the achieved variability in effective properties is explored. Bloch's theorem facilitates the dynamic analysis of representative one- and two-dimensional (1D/2D) systems, revealing, e.g., bandgap formation, migration, and closure and positive/negative metadamping in accordance with the tuning element configuration. To demonstrate a utility, we improvise a waveguide by appropriately patterning the tuning element configuration within a 2D system. We believe that the proposed strategy offers a new way to expand the range of performance and functionality of architected materials for elastodynamics.
Asprosin promotes feeding through SK channel–dependent activation of AgRP neurons
Authors: Feng Bing , Liu Hesong , Mishra Ila , Duerrschmid Clemens , Gao Peiyu , Xu Pingwen , Wang Chunmei , He Yanlin
Published: February 2023

Asprosin, a recently identified adipokine, activates agouti-related peptide (AgRP) neurons in the arcuate nucleus of the hypothalamus (ARH) via binding to protein tyrosine phosphatase receptor δ (Ptprd) to increase food intake. However, the intracellular mechanisms responsible for asprosin/Ptprd-mediated activation of AgRP
ARH
neurons remain unknown. Here, we demonstrate that the small-conductance calcium-activated potassium (SK) channel is required for the stimulatory effects of asprosin/Ptprd on AgRP
ARH
neurons. Specifically, we found that deficiency or elevation of circulating asprosin increased or decreased the SK current in AgRP
ARH
neurons, respectively. AgRP
ARH
-specific deletion of SK3 (an SK channel subtype highly expressed in AgRP
ARH
neurons) blocked asprosin-induced AgRP
ARH
activation and overeating. Furthermore, pharmacological blockade, genetic knockdown, or knockout of Ptprd abolished asprosin’s effects on the SK current and AgRP
ARH
neuronal activity. Therefore, our results demonstrated an essential asprosin-Ptprd-SK3 mechanism in asprosin-induced AgRP
ARH
activation and hyperphagia, which is a potential therapeutic target for the treatment of obesity.
Precise alternating cellular pattern in the inner ear by coordinated hopping intercalations and delaminations
Authors: Cohen Roie , Taiber Shahar , Loza Olga , Kasirer Shahar , Woland Shiran , Sprinzak David
Published: February 2023

The mammalian hearing organ, the organ of Corti, is one of the most organized tissues in mammals. It contains a precisely positioned array of alternating sensory hair cells (HCs) and nonsensory supporting cells. How such precise alternating patterns emerge during embryonic development is not well understood. Here, we combine live imaging of mouse inner ear explants with hybrid mechano-regulatory models to identify the processes that underlie the formation of a single row of inner hair cells (IHCs). First, we identify a previously unobserved morphological transition, termed “hopping intercalation,” that allows cells differentiating toward IHC fate to “hop” under the apical plane into their final position. Second, we show that out-of-row cells with low levels of the HC marker Atoh1 delaminate. Last, we show that differential adhesion between cell types contributes to straightening of the IHC row. Our results support a mechanism for precise patterning based on coordination between signaling and mechanical forces that is likely relevant for many developmental processes.
The complex structure of
Fomes fomentarius
represents an architectural design for high-performance ultralightweight materials
Authors: Pylkkänen Robert , Werner Daniel , Bishoyi Ajit , Weil Dominik , Scoppola Ernesto , Wagermaier Wolfgang , Safeer Adil , Bahri Salima , Baldus Marc , Paananen Arja , Penttilä Merja , Szilvay Géza R. , Mohammadi Pezhman
Published: February 2023

High strength, hardness, and fracture toughness are mechanical properties that are not commonly associated with the fleshy body of a fungus. Here, we show with detailed structural, chemical, and mechanical characterization that
Fomes fomentarius
is an exception, and its architectural design is a source of inspiration for an emerging class of ultralightweight high-performance materials. Our findings reveal that
F
.
fomentarius
is a functionally graded material with three distinct layers that undergo multiscale hierarchical self-assembly. Mycelium is the primary component in all layers. However, in each layer, mycelium exhibits a very distinct microstructure with unique preferential orientation, aspect ratio, density, and branch length. We also show that an extracellular matrix acts as a reinforcing adhesive that differs in each layer in terms of quantity, polymeric content, and interconnectivity. These findings demonstrate how the synergistic interplay of the aforementioned features results in distinct mechanical properties for each layer.
Human Papillomavirus 16 E2 Interaction with TopBP1 Is Required for E2 and Viral Genome Stability during the Viral Life Cycle
Authors: Prabhakar Apurva T. , James Claire D. , Fontan Christian T. , Otoa Raymonde , Wang Xu , Bristol Molly L. , Hill Ronald D. , Dubey Aanchal , Morgan Iain M.
Published: February 2023

Human papillomaviruses are pathogens that cause a host of diseases ranging from benign warts to cancers. There are no therapeutics available for combating these diseases that directly target viral proteins or processes; therefore, we must enhance our understanding of HPV life cycles to assist with identifying novel treatments.
The Intracellular Amastigote of Trypanosoma cruzi Maintains an Actively Beating Flagellum
Authors: Won Madalyn M. , Krüger Timothy , Engstler Markus , Burleigh Barbara A.
Published: February 2023

Understanding the interplay between intracellular pathogens and their hosts is vital to the development of new treatments and preventive strategies. The intracellular “amastigote” stage of the Chagas disease parasite,
Trypanosoma cruzi
, is a critical but understudied parasitic life stage.
Molecular Hydrogen Confers Resistance to Rice Stripe Virus
Authors: Shao Yudong , Lin Feng , Wang Yueqiao , Cheng Pengfei , Lou Wang , Wang Zhaoyun , Liu Zhiyang , Chen Dongyue , Guo Wei , Lan Ying , Du Linlin , Zhou Yijun , Zhou Tong , Shen Wenbiao
Published: February 2023

Although molecular hydrogen has potential therapeutic effects in animals, whether or how this gas functions in plant disease resistance has not yet been elucidated. RSV was considered the most devastating plant virus in rice, since it could cause severe losses in field production.
Tranexamic acid for gastrointestinal bleeding: can a reduction in the risk of death be discounted? A systematic review and meta-analysis of individual patient data from 64 724 bleeding patients
Authors: Ker Katharine , Mansukhani Raoul , Shakur-Still Haleema , Arribas Monica , Beaumont Danielle , Roberts Ian
Published: February 2023

Objectives

HALT-IT was an international, randomised trial which assessed the effects of tranexamic acid (TXA) in 12 009 patients with gastrointestinal (GI) bleeding. The results found no evidence that TXA reduces death. It is widely accepted that results of trials should be interpreted in the context of other relevant evidence. We conducted a systematic review and individual patient data (IPD) meta-analysis to assess if the results of HALT-IT are compatible with evidence for TXA in other bleeding conditions.

Design

Systematic review and IPD meta-analysis of randomised trials involving ≥5000 patients assessing TXA for bleeding. We searched our Antifibrinolytics Trials Register on 1 November 2022. Two authors extracted data and assessed risk of bias.

Data synthesis

We used a one-stage model to analyse IPD in a regression model stratified by trial. We assessed heterogeneity of the effect of TXA on death within 24 hours and vascular occlusive events (VOEs).

Results

We included IPD for 64 724 patients from four trials involving patients with traumatic, obstetric and GI bleeding. Risk of bias was low. There was no evidence for heterogeneity between trials for the effect of TXA on death or for the effect of TXA on VOEs. TXA reduced the odds of death by 16% (OR=0.84, 95% CI: 0.78 to 0.91, p<0.0001; p-heterogeneity=0.40). In patients treated within 3 hours of bleeding onset, TXA reduced the odds of death by 20% (0.80, 0.73 to 0.88, p<0.0001; p-heterogeneity=0.16). TXA did not increase the odds of VOEs (0.94, 0.81 to 1.08, p for effect=0.36; p-heterogeneity=0.27).

Conclusions

There is no evidence for statistical heterogeneity between trials assessing the effect of TXA on death or VOEs in different bleeding conditions. When the HALT-IT results are considered in the context of other evidence, a reduction in the risk of death cannot be discounted.

Trial registration number

PROSPERO CRD42019128260.Cite Now
Government purchasing initiatives involving private providers in the Eastern Mediterranean Region: a systematic review of impact on health service utilisation
Authors: Zaidi Shehla , Das Jai K , Jamal Wafa , Ali Ammarah , Siddiqui Faareha , Thabet Aya , Salah Hassan , Mataria Awad
Published: February 2023

Objective

This paper provides a systematic review of evidence of government purchase of health services from private providers through stand-alone contracting-out (CO) initiatives and CO insurance schemes (CO-I) on health service utilisation in Eastern Mediterranean Region (EMR) to inform universal health coverage 2030 strategies.

Design

Systematic review.

Data sources

Electronic search of published and grey literature on Cochrane Central Register of Controlled Trials, PubMed, CINHAL, Google Scholar and web, including websites of ministries of health from January 2010 to November 2021.

Eligibility criteria

Randomised controlled trials, quasi-experimental studies, time series, before–after and endline with comparison group reporting quantitative utilisation of data across 16 low-income and middle-income states of EMR. Search was limited to publications in English or English translation.

Data extraction and synthesis

We planned for meta-analysis, but due to limited data and heterogeneous outcomes, descriptive analysis was performed.

Results

Several initiatives were identified but only 128 studies were eligible for full-text screening and 17 met the inclusion criteria. These included CO (n=9), CO-I (n=3) and a combination of both (n=5) across seven countries. Eight studies assessed interventions at national level and nine at subnational level. Seven studies reported on purchasing arrangements with non-governmental organisations, 10 on private hospitals and clinics. Impact on outpatient curative care utilisation was seen in both CO and CO-I, positive evidence of improved maternity care service volumes was seen mainly from CO interventions and less reported from CO-I, whereas data on child health service volume was only available for CO and indicated negative impact on service volumes. The studies also suggest pro-poor effect for CO initiatives, whereas there was scarce data for CO-I.

Conclusion

Purchasing involving stand-alone CO and CO-I interventions in EMR positively impact general curative care utilisation, but lacks conclusive evidence for other services. Policy attention is needed for embedded evaluations within programmes, standardised outcome metrics and disaggregated utilisation data.
Knowledge, attitudes and practices regarding antimicrobial use and resistance among healthcare seekers in two tertiary hospitals in Ghana: a quasi-experimental study
Authors: Otieku Evans , Fenny Ama Pokuaa , Labi Appiah-Koran , Owusu-Ofori Alex Kwame , Kurtzhals Jørgen , Enemark Ulrika
Published: February 2023

Objective

To evaluate knowledge of antimicrobial resistance (AMR), to study how the judgement of health value (HVJ) and economic value (EVJ) affects antibiotic use, and to understand if access to information on AMR implications may influence perceived AMR mitigation strategies.

Design

A quasi-experimental study with interviews performed before and after an intervention where hospital staff collected data and provided one group of participants with information about the health and economic implications of antibiotic use and resistance compared with a control group not receiving the intervention.

Setting

Korle-Bu and Komfo Anokye Teaching Hospitals, Ghana.

Participants

Adult patients aged 18 years and older seeking outpatient care.

Main outcome measures

We measured three outcomes: (1) level of knowledge of the health and economic implications of AMR; (2) HVJ and EVJ behaviours influencing antibiotic use and (3) differences in perceived AMR mitigation strategy between participants exposed and not exposed to the intervention.

Results

Most participants had a general knowledge of the health and economic implications of antibiotic use and AMR. Nonetheless, a sizeable proportion disagreed or disagreed to some extent that AMR may lead to reduced productivity/indirect costs (71% (95% CI 66% to 76%)), increased provider costs (87% (95% CI 84% to 91%)) and costs for carers of AMR patients/societal costs (59% (95% CI 53% to 64%)). Both HVJ-driven and EVJ-driven behaviours influenced antibiotic use, but the latter was a better predictor (reliability coefficient >0.87). Compared with the unexposed group, participants exposed to the intervention were more likely to recommend restrictive access to antibiotics (p<0.01) and pay slightly more for a health treatment strategy to reduce their risk of AMR (p<0.01).

Conclusion

There is a knowledge gap about antibiotic use and the implications of AMR. Access to AMR information at the point of care could be a successful way to mitigate the prevalence and implications of AMR.
Changes of health-related quality of life 6 months after high-risk oncological upper gastrointestinal and hepatobiliary surgery: a single-centre prospective observational study (ChangeQol Study)
Authors: Maillard Julien , Elia Nadia , Ris Frédéric , Courvoisier Delphine S , Zekry Dina , Labidi Galy Intidhar , Toso Christian , Mönig Stefan , Zaccaria Isabelle , Walder Bernhard
Published: February 2023

Introduction

Postoperative health-related quality of life (HRQoL) is an essential outcome in oncological surgery, particularly for elderly patients undergoing high-risk surgery. Previous studies have suggested that, on average, HRQoL returns to premorbid normal levels in the months following major surgery. However, the averaging of effect over a studied cohort may hide the variation of individual HRQoL changes. The proportions of patients who have a varied HRQoL response (stable, improvement, or a deterioration) after major oncological surgery is poorly understood. The study aims to describe the patterns of these HRQoL changes at 6 months after surgery, and to assess the patients and next-of-kin regret regarding the decision to undergo surgery.

Methods and analysis

This prospective observational cohort study is carried out at the University Hospitals of Geneva, Switzerland. We include patients over 18 years old undergoing gastrectomy, esophagectomy, pancreas resection or hepatectomy. The primary outcome is the proportion of patients in each group with changes in HRQoL (improvement, stability or deterioration) 6 months after surgery, using a validated minimal clinically important difference of 10 points in HRQoL. The secondary outcome is to assess whether patients and their next-of-kin may regret their decision to undergo surgery at 6 months. We measure the HRQoL using the EORTC QLQ-C30 questionnaire before and 6 months after surgery. We assess regret with the Decision Regret Scale (DRS) at 6 months after surgery. Key other perioperative data include preoperative and postoperative place of residence, preoperative anxiety and depression (HADS scale), preoperative disability (WHODAS V.2.0), preoperative frailty (Clinical Frailty Scale), preoperative cognitive function (Mini-Mental State Examination) and preoperative comorbidities. A follow-up at 12 months is planned.

Ethics and dissemination

The study was first approved by the Geneva Ethical Committee for Research (ID 2020-00536) on 28 April 2020. The results of this study will be presented at national and international scientific meetings, and publications will be submitted to an open-access peer-reviewed journal.

Trial registration number

NCT04444544.
Identifying barriers and facilitators to deprescribing benzodiazepines and sedative hypnotics in the hospital setting using the Theoretical Domains Framework and the Capability, Opportunity, Motivation and Behaviour (COM-B) Model: a qualitative study
Authors: Keller Michelle S , Carrascoza-Bolanos Johan , Breda Kathleen , Kim Linda Y , Kennelty Korey A , Leang Donna W , Murry Logan T , Nuckols Teryl K , Schnipper Jeffrey L , Pevnick Joshua M
Published: February 2023

Objectives

Geriatric guidelines strongly recommend avoiding benzodiazepines and non-benzodiazepine sedative hypnotics in older adults. Hospitalisation may provide an important opportunity to begin the process of deprescribing these medications, particularly as new contraindications arise. We used implementation science models and qualitative interviews to describe barriers and facilitators to deprescribing benzodiazepines and non-benzodiazepine sedative hypnotics in the hospital and develop potential interventions to address identified barriers.

Design

We used two implementation science models, the Capability, Opportunity and Behaviour Model (COM-B) and the Theoretical Domains Framework, to code interviews with hospital staff, and an implementation process, the Behaviour Change Wheel (BCW), to codevelop potential interventions with stakeholders from each clinician group.

Setting

Interviews took place in a tertiary, 886-bed hospital located in Los Angeles, California.

Participants

Interview participants included physicians, pharmacists, pharmacist technicians, and nurses.

Results

We interviewed 14 clinicians. We found barriers and facilitators across all COM-B model domains. Barriers included lack of knowledge about how to engage in complex conversations about deprescribing (capability), competing tasks in the inpatient setting (opportunity), high levels of resistance/anxiety among patients to deprescribe (motivation), concerns about lack of postdischarge follow-up (motivation). Facilitators included high levels of knowledge about the risks of these medications (capability), regular rounds and huddles to identify inappropriate medications (opportunity) and beliefs that patients may be more receptive to deprescribing if the medication is related to the reason for hospitalisation (motivation). Potential modes of delivery included a seminar aimed at addressing capability and motivation barriers in nurses, a pharmacist-led deprescribing initiative using risk stratification to identify and target patients at highest need for deprescribing, and the use of evidence-based deprescribing education materials provided to patients at discharge.

Conclusions

While we identified numerous barriers and facilitators to initiating deprescribing conversations in the hospital, nurse- and pharmacist-led interventions may be an appropriate opportunity to initiate deprescribing.
Self-harm in adolescence and risk of crash: a 13-year cohort study of novice drivers in New South Wales, Australia
Authors: Cullen Patricia , Mőller Holger , Baffsky Rachel , Martiniuk Alexandra , Senserrick Teresa , Rogers Kris , Woodward Mark , Stevenson Mark R , McLean Rebecca , Sawyer Susan , Patton George , Ivers Rebecca Q
Published: February 2023

Introduction

Self-harm and suicide are leading causes of morbidity and death for young people, worldwide. Previous research has identified self-harm is a risk factor for vehicle crashes, however, there is a lack of long-term crash data post licensing that investigates this relationship. We aimed to determine whether adolescent self-harm persists as crash risk factor in adulthood.

Methods

We followed 20 806 newly licensed adolescent and young adult drivers in the DRIVE prospective cohort for 13 years to examine whether self-harm was a risk factor for vehicle crashes. The association between self-harm and crash was analysed using cumulative incidence curves investigating time to first crash and quantified using negative binominal regression models adjusted for driver demographics and conventional crash risk factors.

Results

Adolescents who reported self-harm at baseline were at increased risk of crashes 13 years later than those reporting no self-harm (relative risk (RR) 1.29: 95% CI 1.14 to 1.47). This risk remained after controlling for driver experience, demographic characteristics and known risk factors for crashes, including alcohol use and risk taking behaviour (RR 1.23: 95% CI 1.08 to 1.39). Sensation seeking had an additive effect on the association between self-harm and single-vehicle crashes (relative excess risk due to interaction 0.87: 95% CI 0.07 to 1.67), but not for other types of crashes.

Discussion

Our findings add to the growing body of evidence that self-harm during adolescence predicts a range of poorer health outcomes, including motor vehicle crash risks that warrant further investigation and consideration in road safety interventions. Complex interventions addressing self-harm in adolescence, as well as road safety and substance use, are critical for preventing health harming behaviours across the life course.
Effectiveness of social prescribing for chronic disease prevention in adults: a systematic review and meta-analysis of randomised controlled trials
Authors: Htun Htet Lin , Teshale Achamyeleh Birhanu , Cumpston Miranda S , Demos Lisa , Ryan Joanne , Owen Alice , Freak-Poli Rosanne
Published: February 2023

Background

Social prescribing (SP) enables healthcare professionals to link patients with non-medical interventions available in the community to address underlying socioeconomic and behavioural determinants. We synthesised the evidence to understand the effectiveness of SP for chronic disease prevention.

Methods

A systematic literature search was conducted using five databases and two registries. Eligible studies included randomised controlled trials of SP among community-dwelling adults recruited from primary care or community setting, investigating any chronic disease risk factors defined by the WHO (behavioural factors: smoking, physical inactivity, unhealthy diet and excessive alcohol consumption; metabolic factors: raised blood pressure, overweight/obesity, hyperlipidaemia and hyperglycaemia). Random effect meta-analyses were performed at two time points: completion of intervention and follow-up after trial.

Results

We identified nine reports from eight trials totalling 4621 participants. All studies evaluated SP exercise interventions which were highly heterogeneous regarding the content, duration, frequency and length of follow-up. Majority of studies had some concerns for risk of bias. Meta-analysis revealed that SP likely increased physical activity (completion: mean difference (MD) 21 min/week, 95% CI 3 to 39, I2=0%; follow-up ≤12 months: MD 19 min/week, 95% CI 8 to 29, I2=0%). However, SP may not improve markers of adiposity, blood pressure, glucose and serum lipid. There were no eligible studies that primarily target unhealthy diet, smoking and excessive alcohol drinking behaviours.

Conclusions

SP exercise interventions probably increased physical activity slightly; however, no benefits were observed for metabolic factors. Determining whether SP is effective in modifying the determinants of chronic diseases and promotes sustainable healthy behaviours is limited by the current evidence of quantification and uncertainty, warranting further rigorous studies.

PROSPERO registration number

CRD42022346687.
Fetal reduction, moral permissibility and the all or nothing problem
Authors: Wang Xueshi
Published: February 2023

There is an ongoing debate about whether multifetal pregnancy reduction from twins to singletons (2-to-1 MFPR) is morally permissible. By applying the all or nothing problem to the cases of reducing twin pregnancies to singletons, Räsänen argues that an implausible conclusion seems to follow from two plausible claims: (1) it ispermissibleto have an abortion and (2) it iswrongto abort only one fetus in a twin pregnancy. The implausible conclusion is that women considering 2-to-1 MFPR for social reasonsought toabort both fetuses rather than just one. To avoid the conclusion, Räsänen suggests that it is best to carry both fetuses to term and give one for adoption. In this article, I argue that Räsänen’s argument fails for two reasons: the inference from (1) and (2) to the conclusion rests on a bridge principle that does not work in certain circumstances, and there is good reason to reject the claim that it is wrong to abort only one fetus.
Germline pathogenicSMARCA4variants in neuroblastoma
Authors: Witkowski Leora , Nichols Kim E. , Jongmans Marjolijn , van Engelen Nienke , de Krijger Ronald R , Herrera-Mullar Jennifer , Tytgat Lieve , Bahrami Armita , Mar Fan Helen , Davidson Aimee L , Robertson Thomas , Anderson Michael , Hasselblatt Martin , Plon Sharon E. , Foulkes William D
Published: February 2023

Heterozygous germline pathogenic variants (GPVs) inSMARCA4, the gene encoding the ATP-dependent chromatin remodelling protein SMARCA4 (previously known as BRG1), predispose to several rare tumour types, including small cell carcinoma of the ovary, hypercalcaemic type, atypical teratoid and malignant rhabdoid tumour, and uterine sarcoma. The increase in germline testing ofSMARCA4in recent years has revealed putative GPVs affectingSMARCA4in patients with other cancer types. Here we describe 11 patients with neuroblastoma (NBL), including 4 previously unreported cases, all of whom were found to harbour heterozygous germline variants inSMARCA4. Median age at diagnosis was 5 years (range 2 months–26 years); nine were male; and eight of nine cases had tumour location information in the adrenal gland. Eight of the germline variants were expected to result in loss of function ofSMARCA4(large deletion, truncating and canonical splice variants), while the remaining four were missense variants. Loss of heterozygosity of the wild-typeSMARCA4allele was found in all eight cases where somatic testing was performed, supporting the notion that SMARCA4 functions as a classic tumour suppressor. Altogether, these findings strongly suggest that NBL should be included in the spectrum ofSMARCA4-associated tumours.
Endovascular stroke therapy outside core working hours in a nationwide stroke system
Authors: Fandler-Höfler Simon , Mikšová Dominika , Deutschmann Hannes , Kneihsl Markus , Mutzenbach Sebastian , Killer-Oberpfalzer Monika , Gizewski Elke R , Knoflach Michael , Kiechl Stefan , Sonnberger Michael , Vosko Milan R , Weber Jörg , Hausegger Klaus A , Serles Wolfgang , Werner Philipp , Staykov Dimitre , Sykora Marek , Lang Wilfried , Ferrari Julia , Enzinger Christian , Gattringer Thomas
Published: February 2023

Background

Endovascular therapy (EVT) has been established as a major component in the acute treatment of large vessel occlusion stroke. However, it is unclear whether outcome and other treatment-related factors differ if patients are treated within or outside core working hours.

Methods

We analyzed data from the prospective nationwide Austrian Stroke Unit Registry capturing all consecutive stroke patients treated with EVT between 2016 and 2020. Patients were trichotomized according to the time of groin puncture into treatment within regular working hours (08:00–13:59), afternoon/evening (14:00–21:59) and night-time (22:00–07:59). Additionally, we analyzed 12 EVT treatment windows with equal patient numbers. Main outcome variables included favorable outcome (modified Rankin Scale scores of 0–2) 3 months post-stroke as well as procedural time metrics, recanalization status and complications.

Results

We analyzed 2916 patients (median age 74 years, 50.7% female) who underwent EVT. Patients treated within core working hours more frequently had a favorable outcome (42.6% vs 36.1% treated in the afternoon/evening vs 35.8% treated at night-time; p=0.007). Similar results were found when analyzing 12 treatment windows. All these differences remained significant in multivariable analysis adjusting for outcome-relevant co-factors. Onset-to-recanalization time was considerably longer outside core working hours, which was mainly explained by longer door-to-groin time (p<0.001). There was no difference in the number of passes, recanalization status, groin-to-recanalization time and EVT-related complications.

Conclusions

The findings of delayed intrahospital EVT workflows and worse functional outcomes outside core working hours in this nationwide registry are relevant for optimization of stroke care, and might be applicable to other countries with similar settings.
COVID-19 impact on an oncologic emergency department visits: observational study
Authors: Ram Aurélie , Pagès Arnaud , Cubilier Edouard , Daoudi Nesrine , Vandergheynst Frederic , Scotte Florian , Antoun Sami , Merad Mansouriah
Published: February 2023

Objective

This study aimed at evaluating the impact of COVID-19 on emergency department (ED) visits in a tertiary cancer centre and providing information on the features of the unplanned events during the first wave of COVID-19 pandemic.

Methods

This retrospective observational study based on data from ED reports was divided into three periods of 2 months each around the first lockdown announcement of 17 March 2020: pre-lockdown, lockdown and post-lockdown.

Results

A total of 903 ED visits were included in the analyses. The mean (±SD) daily number of ED visits did not change during the lockdown period (14.6±5.5) when compared with the periods before (13.6±4.5) and after lockdown (13.7±4.4) (p=0.78). The proportion of ED visits for fever and respiratory disorders increased significantly to 29.5% and 28.5%, respectively (p<0.01) during lockdown. Pain, the third most frequent motive, remained stable with 18.2% (p=0.83) throughout the three periods. Symptom severity also showed no significant differences in the three periods (p=0.31).

Conclusion

Our study shows that ED visits during the first wave of the COVID-19 pandemic remained stable for our patients regardless of the symptom’s severity. The fear of an in-hospital viral contamination appears weaker than the need for pain management or for the treatment of cancer-related complications. This study highlights the positive impact of cancer ED in the first-line treatment and supportive care of patients with cancer.
Unmet palliative care service needs: a patient-centred metric
Authors: Safabakhsh Nusha , Lippe Megan P , Govahi Shahrooz , Gonzales Matthew J , Byock Ira
Published: February 2023

Objectives

Financial pressures and competing demands for limited resources highlight the importance of defining the unmet need for specialty inpatient palliative care (PC), demonstrating the value of the service line and making decisions about staffing. One measure of access to specialty PC is penetration, the percentage of hospitalised adults receiving PC consultations. Although useful, additional means of quantifying programme performance are required for evaluating access by patients who would benefit. The study sought to define a simplified method of calculating unmet need for inpatient PC.

Methods

This retrospective observational study analysed electronic health records from six hospitals in one health system in Los Angeles County.

Unmet need for PC was defined by the number of hospitalised patients with four or more chronic serious comorbidities without a PC consultation divided by a denominator of all patients with one or more chronic serious conditions (CSCs) without a PC during the hospitalisation.

Results

This calculation identified a subset of patients with four or more CSCs that accounts for 10.3% of the population of adults with one or more CSCs who did not receive PC services during a hospitalisation (unmet need). Monthly internal reporting of this metric led to significant PC programme expansion with an increase in average penetration for the six hospitals from 5.9% in 2017 to 11.2% in 2021.

Conclusions

Health system leadership can benefit from quantifying the need for specialty PC among seriously ill inpatients. This anticipated measure of unmet need is a quality indicator that complements existing metrics.
Modeling the performance of restricted crossing U-turn intersections including the effects of connected and autonomous vehicles: a case study in California
Authors: Howard Jonathan , Molan Amirarsalan Mehrara , Xu Shuqi , Sajjadi Soheil , Pande Anurag
Published: February 2023

Despite numerous studies demonstrating the effectiveness of restricted crossing U-turn (RCUT) intersection design, its implementation remains close to zero in some large states (e.g., California). The study included four locations on high-speed rural expressways (highways with partial access control) in California. The operational evaluation relies on microscopic simulation models of existing two-way stop-controlled (TWSC) intersections and alternate RCUT designs used to estimate network-wide performance measures. Two series of simulation scenarios were tested: (1) scenarios with no connected and autonomous vehicles (CAVs) and (2) scenarios with different SAE International Level 4 CAV market penetration rates (MPRs) to help policymakers and practitioners in future planning strategies. The microsimulation models were also used to generate trajectory data to create a surrogate measure-based approach. Based on the results, the RCUT designs reduced or eliminated the more severe crossing conflicts. Similar vehicle travel times were identified in various CAV MPRs except for one of the locations with challenging geometric features, where travel time increased at higher CAV MPRs.
Detection Accuracy Improvement on One-Stage Object Detection Using AP-Loss-Based Ranking Module and ResNet-152 Backbone
Authors: Shanmugasundaram Suresh , Palaniappan Natarajan
Published: February 2023

Localization-loss and classification-loss are optimized at the same time to train the one-stage object detectors. Because of the large number of anchors, the severe foreground–background class disproportion causes significant classification-loss. This paper discusses using a ranking module instead of the classification module to mitigate this difficulty and also Average-Precision loss (AP-loss) is utilized on the ranking module. An optimization algorithm is used to make the AP-loss as effective as possible. Optimization algorithm blends the error-driven updating method of perceptron learning and the deep network backpropagation technique. This optimization algorithm handles the foreground–background class disproportion issues. One-stage detector with AP-loss and backbone with ResNet-152 attains improvement in the detection performance compared to the classification-losses-based detectors.
AI and Neurotechnology
Authors: Berger Sara , Rossi Francesca
Published: February 2023

The merging of machine, body, and psyche is on the horizon due to the technological advancements enabled by neuroscience and AI.
Toward Practices for Human-Centered Machine Learning
Authors: Chancellor Stevie
Published: February 2023

Designing for the social, cultural, and ethical implications of ML are just as important as its technical advances.
The AI Tech-Stack Model
Authors: Tsaih Rua-Huan , Chang Hsin-Lu , Hsu Chih-Chun , Yen David C.
Published: February 2023

Management and technology challenges of AI-enabled application projects.
Split Your Overwhelmed Teams
Authors: Limoncelli Thomas A.
Published: February 2023

Two teams of five is not the same as one team of 10.
Mapping the Privacy Landscape for Central Bank Digital Currencies
Authors: Auer Raphael , Böhme Rainer , Clark Jeremy , Demirag Didem
Published: February 2023

Now is the time to shape what future payment flows will reveal about you.
Virtual Influencers in the Real World
Authors: Kugler Logan
Published: February 2023

We are increasingly engaging with these digital personalities, online and offline.
Adding Smarts to Vending Machines Drives Convenience, Efficiency
Authors: Kirkpatrick Keith
Published: February 2023

Advanced feature sets and functionality are projected to drive the market for connected vending to nearly nine million units by 2024.
Considering the Impact of Technology on Society
Authors: Hoffmann Leah
Published: February 2023

Moshe Vardi on having the difficult conversation about technology and social responsibility.
A Map for Innovation
Authors: Denning Peter J.
Published: February 2023

Innovation is less elusive with the right navigational map.
A Legal Challenge to Algorithmic Recommendations
Authors: Samuelson Pamela
Published: February 2023

Reconsidering liability shield considerations.
Online Metric Algorithms with Untrusted Predictions
Authors: Antoniadis Antonios , Coester Christian , Eliáš Marek , Polak Adam , Simon Bertrand
Published: February 2023

Machine-learned predictors, although achieving very good results for inputs resembling training data, cannot possibly provide perfect predictions in all situations. Still, decision-making systems that are based on such predictors need not only benefit from good predictions, but should also achieve a decent performance when the predictions are inadequate. In this article, we propose a prediction setup for arbitrary
metrical task systems (MTS)
(e.g., 
caching
,

k
-server,

and
convex body chasing
) and
online matching on the line
. We utilize results from the theory of online algorithms to show how to make the setup robust. Specifically, for caching, we present an algorithm whose performance, as a function of the prediction error, is exponentially better than what is achievable for general MTS. Finally, we present an empirical evaluation of our methods on real-world datasets, which suggests practicality.
A horizon for haptic perception
Authors: Miller Luke E. , Jarto Felix , Medendorp W. Pieter
Published: February 2023

There are often spatial limits to where an active sensory system can sample information from the environment. Hand-held tools can extend human haptic perception beyond the body, but the limits of this extension are unknown. We used theoretical modeling and psychophysics to determine these spatial limits. We find that the ability to spatially localize objects through a tool extends at least 6 m beyond the user’s body.
The Efficacy of Surgical Resection versus Radiofrequency Ablation for the Treatment of Single Hepatocellular Carcinoma: A SEER-Based Study
Authors: Wu Fang , Wei Chao , Zhang Shicun , Jia Shanshan , Zhang Jidong
Published: February 2023

Background. There is controversy regarding whether patients with single hepatocellular carcinoma (HCC) should be offered radiofrequency ablation (RFA) as a first-line treatment option. Thus, this study compared overall survival after surgical resection (SR) and RFA for single HCC. Methods. The Surveillance, Epidemiology, and End Results (SEER) database was used for this retrospective study. The study included 30- to 84-year-old patients diagnosed with HCC from 2000 to 2018. Selection bias was reduced via propensity score matching (PSM). The study compared the overall survival (OS) and cancer-specific survival (CSS) of patients with single HCC who were treated with SR and RFA. Results. Before and after PSM, the median OS and median CSS were significantly longer in the SR group than in the RFA group (

p
<
0.05

). In the subgroup analysis, the median OS and median CSS for male and female patients with male and female patients with tumor sizes <3, 3–5, and>5 cm, age at diagnosis between 60 and 84 years, and grades I–IV tumors were longer than in the SR group than in the RFA group (

p
<
0.05

). Similar results were reported for patients who received chemotherapy (

p
<
0.05

). Univariate and multivariate analyses revealed that compared with RFA, SR was an independent favorable factor for OS and CSS (

p
<
0.05

) before and after PSM. Conclusion. Patients with SR who had a single HCC showed higher OS and CSS compared with patients who received RFA. Hence, SR should be used as a first-line treatment in cases of single HCC.
Capped Asymmetric Elastic Net Support Vector Machine for Robust Binary Classification
Authors: Qi Kai , Yang Hu
Published: February 2023

Recently, there are lots of literature on improving the robustness of SVM by constructing nonconvex functions, but they seldom theoretically study the robust property of the constructed functions. In this paper, based on our recent work, we present a novel capped asymmetric elastic net (CaEN) loss and equip it with the SVM as CaENSVM. We derive the influence function of the estimators of the CaENSVM to theoretically explain the robustness of the proposed method. Our results can be easily extended to other similar nonconvex loss functions. We further show that the influence function of the CaENSVM is bounded, so that the robustness of the CaENSVM can be theoretically explained. Other theoretical analysis demonstrates that the CaENSVM satisfies the Bayes rule and the corresponding generalization error bound based on Rademacher complexity guarantees its good generalization capability. Since CaEN loss is concave, we implement an efficient DC procedure based on the stochastic gradient descent algorithm (Pegasos) to solve the optimization problem. A host of experiments are conducted to verify the effectiveness of our proposed CaENSVM model.
Present-Day In Situ Stress Analysis in Shale Reservoir of Haiba Block, Southern Sichuan Basin, South China
Authors: Guo Wei , Ju Wei , Zheng Majia , Shen Weijun , Zhang Jian , Liang Pingping , Wang Shengyu , Hu Haohao
Published: February 2023

Natural gas from shale gas reservoirs has been an important contributor for reserve growth, deliverability construction, and profits growth in natural gas industry in the world. Hydraulic fracturing is commonly required in the shale gas commercial development, and thus understanding the present-day in situ stress field is greatly significant for the hydraulic fracturing and efficient development in shale gas reservoirs. However, there are no systematic investigations on the present-day in situ stress field in the Haiba Block from the Sichuan Basin, South China. In this study, the present-day in situ stress orientations and magnitudes in shale reservoir of Haiba Block are investigated based on the well interpretations from borehole image log and geomechanical modeling. Then, the effects of stresses on hydraulic fracturing, horizontal wells, and natural fracture reactivation were discussed. The results indicate that the horizontal maximum principal stress (SHmax) orientation is mainly in the NE-SW-trending, NW-SE-trending, and WNW-ESE-trending in the Haiba Block. The magnitudes of horizontal maximum and minimum principal stresses are 13.5 MPa~85.5 MPa and 2.8 MPa~31.6 MPa, respectively. In the Haiba Block, the differential stress is generally low in the northern part, which indicates that complex hydraulic fracture networks may be produced. While the natural fractures are generally stable under the present-day in situ stress field. When the increase of pore pressure gradient is about 30 KPa/m, nearly all natural fractures in the Longmaxi Formation may be reactivated. The results can provide the insights into a better understanding of the present-day in situ stress distribution so as to optimize perforation orientation, hydraulic fracturing design, and enhance gas production in shale gas reservoirs.
Firefly Algorithm-Based Artificial Neural Network to Predict the Shear Strength in FRP-Reinforced Concrete Beams
Authors: Nikoo Mohammad , Aminnejad Babak , Lork Alireza
Published: February 2023

The shear strength of fiber-reinforced polymer (FRP) reinforced concrete beams is often given a large safety margin by current construction requirements. Six characteristics are utilized as inputs to compute the shear strength of FRP-reinforced concrete beams. This study uses 198 samples from the literature to predict the shear strength of 139 training samples and 59 testing samples. Additionally, the ANN structure is optimized with the firefly algorithm. The FA-ANN model is also compared to ACI-440, CSA-S806, and BISE-99 codes, and the optimized model by Nehdi et al. Findings show that regarding the shear strength of FRP-reinforced concrete beams, the firefly algorithm-optimized model performs better than the other four models. Concerning accuracy, the coefficient of correlation, R2, was calculated as 0.961, while the average absolute error (AAE) is 0.22 for the shear strength of FRP-reinforced beams.