bluuebunny/crossref_metadata_2025 huggingface dataset:
Central toxic keratopathy leading to epithelial ingrowth following femtosecond LASIK
Authors: Gogri Pratik Yeshwant , Vaddavalli Pravin Krishna , Bhalerao Sushank Ashok
Published: May 2024

We report a case of a woman in her 30s who underwent femtosecond LASIK (laser-assisted in situ keratomileusis) in both eyes to correct her simple myopic astigmatism. After the surgery, both eyes developed diffuse lamellar keratitis, and intensive topical steroids were initiated to control the same. Subsequently, central toxic keratopathy (CTK) developed bilaterally. Three weeks after the surgery, the right eye showed signs of progressive epithelial ingrowth involving the pupillary area. Surgical intervention in the form of flap relift followed by debridement of the epithelial cells and an alcohol interface wash were performed to treat the same. This is the first report of an epithelial ingrowth following CTK after femtosecond LASIK.
Significant elevation of serum CA19-9 and CA242 levels induced by dulaglutide
Authors: Shi Xiaomin
Published: May 2024

The use of dulaglutide, a common medication for managing type 2 diabetes, rarely causes elevated pancreatic tumour markers. Here, we report the case of a woman in her mid-60s with diabetes for over 10 years. The patient presented with markedly elevated serum CA19-9 and CA242 levels revealed during a routine health examination despite being asymptomatic. She had been receiving dulaglutide injections for 16 months. Imaging and interventional assessments did not reveal any hepatobiliary, gastrointestinal or pancreatic neoplasm. After excluding alternate diagnoses, the patient was determined to exhibit an adverse reaction to dulaglutide use. Management involved the discontinuation of dulaglutide, which resulted in normalisation of serum CA19-9 and CA242 levels within 6 weeks. This case underscores the importance of discontinuing dulaglutide and monitoring changes in the biomarker levels in asymptomatic patients receiving dulaglutide, rather than immediately resorting to imaging and endoscopic examinations.
Phthiriasis palpebrarum masquerading as blepharitis
Authors: Mittal Parul , Jain Nikhila , Singh Priti , Sharma Bhavana
Published: May 2024

Pthiriasis palpebrarum, a rare condition caused byPhthirus pubis, can mimic blepharitis and manifest as intense itching, inflammation and eyelid redness. We describe a case of Pthiriasis palpebrarum in a young girl with right upper eyelid discomfort. A slit lamp examination revealed eggs on her eyelashes and adult lice on the eyelids’ surface. Dermatology consultation confirmed the diagnosis and successful treatment followed. Family evaluation uncovered genital Phthiriasis pubis in her parents, who received appropriate treatment. This report emphasises the importance of accurate diagnosis and management of this masquerading condition by careful slit lamp and microscopic evaluation. It also highlights the significance of comprehensive family history and examination.
Cost-effectiveness of emicizumab prophylaxis for haemophilia A with inhibitors: an adaptive health technology assessment for the Indian setting
Authors: Kar Sitanshu Sekhar , Sivanantham Parthibane , Ravel Vanessa , Mehndiratta Abha , Tyagi Kirti , Ollendorf Daniel A
Published: May 2024

Objective

To assess the cost-effectiveness of emicizumab prophylaxis for patients having haemophilia A with inhibitors in the Indian context using an adaptive health technology assessment (aHTA) methodology.

Design

Economic evaluation using multiple approaches aimed at adjusting previously generated cost-effectiveness results based on (1) price differences only (‘simple’) and (2) differences in cost and expected treatment duration (‘moderate’) and differences in cost, inflation and life expectancy (‘complex’).

Setting

Typical haemophilia care in India.

Participants

Patients with haemophilia A and inhibitors.

Intervention

Emicizumab prophylaxis using two vial strengths (30 or 150 mg/mL) in comparison to no prophylaxis.

Main outcome measures

Adjusted incremental cost-effectiveness ratio (ICERa), incremental costs and incremental quality-adjusted life years associated with emicizumab prophylaxis from both the health system and societal perspectives.

Results

Using the simple ICER adjustment method, emicizumab prophylaxis resulted in potential cost savings from the payers’ perspective for both vial strengths in patients aged ≥12 and <12 years. However, from a societal perspective, emicizumab prophylaxis was not cost-effective. Using the moderate adjustment method, emicizumab prophylaxis showed potential cost saving from the health system perspective. The complex adjustment method also revealed cost savings for emicizumab prophylaxis from the health system and societal perspectives across different age groups.

Conclusion

We found that implementing emicizumab prophylaxis for patients with haemophilia A and inhibitors in India has the potential to result in cost savings. This study highlights the feasibility of using the expanded aHTA methodology for rapid evidence generation in the Indian context. However, it is crucial to address certain research gaps, including data limitations, challenges in translating international evidence to Indian context and associated uncertainties. Additionally, conducting a comprehensive budget impact analysis is necessary. These findings hold significant implications for decision-making regarding the potential provision of emicizumab prophylaxis through federal or/and state government-funded programmes and institutions in India.
Learning from Ethiopia’s success in reducing maternal and neonatal mortality through a health systems lens
Authors: Melesse Dessalegn Y. , Tadele Ashenif , Mulu Shegaw , Spicer Neil , Tadelle Tefera , Wado Yohannes D , Gajaa Mulugeta , Arja Asrat , Blumenberg Cauane , Manaye Tewabe , Gonfa Geremew , du Plessis Elsabe , Hamilton Elisabeth , Mihretu Awoke , Usamael Abdurehman , Mengesha Magdelawit , Kassahun Gelaw Solomon , Worku Aschale , Woldie Mirkuzie , Abate Biruk , Getachew Theodros , Wondirad Naod , Zelalem Meseret , Tollera Getachew , Boerma Ties
Published: May 2024

Background

This study aimed to enhance insights into the key characteristics of maternal and neonatal mortality declines in Ethiopia, conducted as part of a seven-country study on Maternal and Newborn Health (MNH) Exemplars.

Methods

We synthesised key indicators for 2000, 2010 and 2020 and contextualised those with typical country values in a global five-phase model for a maternal, stillbirth and neonatal mortality transition. We reviewed health system changes relevant to MNH over the period 2000–2020, focusing on governance, financing, workforce and infrastructure, and assessed trends in mortality, service coverage and systems by region. We analysed data from five national surveys, health facility assessments, global estimates and government databases and reports on health policies, infrastructure and workforce.

Results

Ethiopia progressed from the highest mortality phase to the third phase, accompanied by typical changes in terms of fertility decline and health system strengthening, especially health infrastructure and workforce. For health coverage and financing indicators, Ethiopia progressed but remained lower than typical in the transition model. Maternal and neonatal mortality declines and intervention coverage increases were greater after 2010 than during 2000–2010. Similar patterns were observed in most regions of Ethiopia, though regional gaps persisted for many indicators. Ethiopia’s progress is characterised by a well-coordinated and government-led system prioritising first maternal and later neonatal health, resulting major increases in access to services by improving infrastructure and workforce from 2008, combined with widespread community actions to generate service demand.

Conclusion

Ethiopia has achieved one of the fastest declines in mortality in sub-Saharan Africa, with major intervention coverage increases, especially from 2010. Starting from a weak health infrastructure and low coverage, Ethiopia’s comprehensive approach provides valuable lessons for other low-income countries. Major increases towards universal coverage of interventions, including emergency care, are critical to further reduce mortality and advance the mortality transition.
Participant characteristics and exclusion from phase 3/4 industry funded trials of chronic medical conditions: meta-analysis of individual participant level data
Authors: Lees Jennifer , Crowther Jamie , Hanlon Peter , Butterly Elaine W , Wild Sarah H , Mair Frances , Guthrie Bruce , Gillies Katie , Dias Sofia , Welton Nicky J , Katikireddi Srinivasa Vittal , McAllister David A
Published: May 2024

Objectives

To assess whether age, sex, comorbidity count, and race and ethnic group are associated with the likelihood of trial participants not being enrolled in a trial for any reason (ie, screen failure).

Design

Bayesian meta-analysis of individual participant level data.

Setting

Industry funded phase 3/4 trials of chronic medical conditions.

Participants

Participants were identified using individual participant level data to be in either the enrolled group or screen failure group. Data were available for 52 trials involving 72 178 screened individuals of whom 24 733 (34%) were excluded from the trial at the screening stage.

Main outcome measures

For each trial, logistic regression models were constructed to assess likelihood of screen failure in people who had been invited to screening, and were regressed on age (per 10 year increment), sex (malevfemale), comorbidity count (per one additional comorbidity), and race or ethnic group. Trial level analyses were combined in Bayesian hierarchical models with pooling across condition.

Results

In age and sex adjusted models across all trials, neither age nor sex was associated with increased odds of screen failure, although weak associations were detected after additionally adjusting for comorbidity (odds ratio of age, per 10 year increment was 1.02 (95% credibility interval 1.01 to 1.04) and male sex (0.95 (0.91 to 1.00)). Comorbidity count was weakly associated with screen failure, but in an unexpected direction (0.97 per additional comorbidity (0.94 to 1.00), adjusted for age and sex). People who self-reported as black seemed to be slightly more likely to fail screening than people reporting as white (1.04 (0.99 to 1.09)); a weak effect that seemed to persist after adjustment for age, sex, and comorbidity count (1.05 (0.98 to 1.12)). The between-trial heterogeneity was generally low, evidence of heterogeneity by sex was noted across conditions (variation in odds ratios on log scale of 0.01-0.13).

Conclusions

Although the conclusions are limited by uncertainty about the completeness or accuracy of data collection among participants who were not randomised, we identified mostly weak associations with an increased likelihood of screen failure for age, sex, comorbidity count, and black race or ethnic group. Proportionate increases in screening these underserved populations may improve representation in trials.

Trial registration number

PROSPERO CRD42018048202.
Food availability, perceived food environment and social norm perceptions of healthy and vegetarian food consumption at a public music festival in the Netherlands: a cross-sectional study
Authors: Wopereis Tamika M , de Vet Emely , Rongen Frédérique C , Poelman Maartje P
Published: May 2024

Objective

To gain insight into the food availability, the perceived food environment, and social norm perceptions in favour of healthy and vegetarian food consumption at a festival.

Design

Two cross-sectional substudies were conducted to audit food and beverages at the festival, and to measure visitors’ perceptions of the festival food environment (accessibility, affordability, availability, diversity, quality) and their social norms perceptions via a mobile survey.

Setting

Public music festival, the Netherlands.

Sample

75 food stands and 153 adult festival visitors.

Results

75 food stands offered 627 food and beverage items, of which 92.4% were not supportive of a healthy diet. Of all food items, 46.6% were vegetarian (including 20% fries). Participants especially perceived the festival food environment as unsupportive of healthy choices. They also had weak descriptive and injunctive social norm perceptions in favour of healthy and vegetarian food consumption. However, they had stronger descriptive (t(152)=−5.5; p<0.001) and injunctive norm perceptions (t(152)=−4.5; p<0.001) of vegetarian food consumption (mean descriptive social norm perception=2.42; SD=0.82; mean injunctive social norm perception=3.14; SD=0.78), than healthy food consumption (mean descriptive social norm perception=2.10; SD=0.76; mean injunctive social norm perception=2.93; SD=0.78). Participants had stronger injunctive than descriptive social norm perceptions of healthy (t(152)=−12.4; p<0.001) and vegetarian (t(152)=−11.3; p<0.001) food consumption. Participants’ perceived food environment and their perception of social norms were positively correlated.

Conclusion

The festival’s food environment appears unsupportive of healthy and vegetarian food consumption. The limited availability of healthy and vegetarian food coincided with weak social norm perceptions encouraging their consumption, particularly descriptive norms that arise from observing others. The food environment may stand in the way of developing descriptive norms for the consumption of healthy and vegetarian food, as people can only see others consume food that is available. Implementation of public event policies could support healthier, more sustainable festivals.
Factors influencing optimal diabetes care and clinical outcomes in Thai patients with type 2 diabetes mellitus: a multilevel modelling analysis
Authors: Surawit Apinya , Pongkunakorn Tanyaporn , Manosan Thamonwan , Mongkolsucharitkul Pichanun , Chamnan Parinya , Suvarnabhumi Krishna , Puangpet Thanapat , Suta Sophida , Pumeiam Sureeporn , Pinsawas Bonggochpass , Ophakas Suphawan , Pisitpornsuk Sananon , Utchin Chalita , Mayurasakorn Korapat
Published: May 2024

Background

Increasing levels of poor glycaemic control among Thai patients with type 2 diabetes mellitus (T2DM) motivated us to compare T2DM care between urban and suburban primary care units (PCUs), to identify gaps in care, and to identify significant factors that may influence strategies to enhance the quality of care and clinical outcomes in this population.

Methods

We conducted a cross-sectional study involving 2160 patients with T2DM treated at four Thai PCUs from 2019 to 2021, comprising one urban and three suburban facilities. Using mixed effects logistic regression, we compared care factors between urban and suburban PCUs.

Results

Patients attending suburban PCUs were significantly more likely to undergo eye (adjusted OR (AOR): 1.83, 95% CI 1.35 to 1.72), foot (AOR: 1.61, 95% CI 0.65 to 4.59) and HbA1c(AOR: 1.66, 95% CI 1.09 to 2.30) exams and achieved all ABC (HbA1c, blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C)) goals (AOR: 2.23, 95% CI 1.30 to 3.83). Conversely, those at an urban PCU were more likely to undergo albuminuria exams. Variables significantly associated with good glycaemic control included age (AOR: 1.51, 95% CI 1.31 to 1.79), T2DM duration (AOR: 0.59, 95% CI 0.41 to 0.88), FAACE (foot, HbA1c, albuminuria, LDL-C and eye) goals (AOR: 1.23, 95% CI 1.12 to 1.36) and All8Q (AOR: 1.20, 95% CI 1.05 to 1.41). Chronic kidney disease (CKD) was significantly linked with high triglyceride and HbA1clevels (AOR: 5.23, 95% CI 1.21 to 7.61). Elevated HbA1clevels, longer T2DM duration, insulin use, high systolic BP and high lipid profile levels correlated strongly with diabetic retinopathy (DR) and CKD progression.

Conclusion

This highlights the necessity for targeted interventions to bridge urban–suburban care gaps, optimise drug prescriptions and implement comprehensive care strategies for improved glycaemic control, DR prevention and CKD progression mitigation among in Thai patients with T2DM. The value of the clinical target aggregate (ABC) and the process of care aggregate (FAACE) was also conclusively demonstrated.
Financial protection and equity in the healthcare financing system in Iran: a cross-sectional study among slum dwellers with type 2 diabetes
Authors: Ghammari Fawzieh , Heidari Kousar , Jalilian Habib
Published: May 2024

Objectives

This study was conducted to assess financial protection and equity in the healthcare financing system among slum dwellers with type 2 diabetes (T2D) in Iran in 2022.

Design

Cross-sectional study.

Setting

Primary care centres in Iran were selected from slums.

Participants

Our study included 400 participants with T2D using a systematic random sampling method. Patients were included if they lived in slums for at least five consecutive years, were over 18 years old and did not have intellectual disabilities.

Primary and secondary measures

A self-report questionnaire was used to assess cost-coping strategies vis-à-vis T2D expenditures and factors influencing them, as well as forgone care among slum dwellers.

Results

Of the 400 patients who participated, 53.8% were female. Among the participants, 27.8% were illiterate, but 30.3% could read and write. 75.8% had income below 40 million Rial. There was an association between age, education, income, basic insurance, supplemental insurance and cost-coping strategies (p<0.001). 88.2% of those with first university degree used health insurance and 34% of illiterate people used personal savings. 79.8% of people with income over 4 million Rial reported using insurance to cope with healthcare costs while 55% of those with income under 4 million Rial reported using personal savings and a combination of health insurance and personal savings to cope with healthcare costs. As a result of binary logistic regression, illiterate people (adjusted OR=16, 95% CI 3.65 to 70.17), individuals with low income (OR 5.024, 95% CI 2.42 to 10.41) and people without supplemental insurance (OR 1.885, 95% CI 0.03 to 0.37) are more likely to use other forms of cost-coping strategies than health insurance.

Conclusions

As a result of insufficient use of insurance, cost-coping strategies used by slum dwellers vis-à-vis T2D expenditures do not protect them from financial risks. Expanding universal health coverage and providing supplemental insurance for those with T2D living in slums are recommended. Iran Health Insurance should adequately cover the costs of T2D care for slum dwellers so that they do not need to use alternative strategies.
Improving clinical reasoning and communication during handover: An intervention study of the BRIEF-C tool
Authors: Altabbaa Ghazwan , Beran Tanya Nathalie , Clark Marcia , Oddone Paolucci Elizabeth
Published: May 2024

Background

Existing handover communication tools often lack a clear theoretical foundation, have limited psychometric evidence, and overlook effective communication strategies for enhancing diagnostic reasoning. This oversight becomes critical as communication breakdowns during handovers have been implicated in poor patient care. To address these issues, we developed a structured communication tool: Background, Responsible diagnosis, Included differential diagnosis, Excluded differential diagnosis, Follow-up, and Communication (BRIEF-C). It is informed by cognitive bias theory, shows evidence of reliability and validity of its scores, and includes strategies for actively sending and receiving information in medical handovers.

Design

A pre–test post-test intervention study.

Setting

Inpatient internal medicine and orthopaedic surgery units at one tertiary care hospital.

Intervention

The BRIEF-C tool was presented to internal medicine and orthopaedic surgery faculty and residents who participated in an in-person educational session, followed by a 2-week period where they practised using it with feedback.

Measurements

Clinical handovers were audiorecorded over 1 week for the pre- and again for the post-periods, then transcribed for analysis. Two faculty raters from internal medicine and orthopaedic surgery scored the transcripts of handovers using the BRIEF-C framework. The two raters were blinded to the time periods.

Results

A principal component analysis identified two subscales on the BRIEF-C: diagnostic clinical reasoning and communication, with high interitem consistency (Cronbach’s alpha of 0.82 and 0.99, respectively). One sample t-test indicated significant improvement in diagnostic clinical reasoning (pre-test: M=0.97, SD=0.50; post-test: M=1.31, SD=0.64; t(64)=4.26, p<0.05, medium to large Cohen’s d=0.63) and communication (pre-test: M=0.02, SD=0.16; post-test: M=0.48, SD=0.83); t(64)=4.52, p<0.05, large Cohen’s d=0.83).

Conclusion

This study demonstrates evidence supporting the reliability and validity of scores on the BRIEF-C as good indicators of diagnostic clinical reasoning and communication shared during handovers.
Homosexual identity and network overlap predictors of HIV infection among older men from rural China: a case–control study
Authors: Yang Yi , Li Yuan , Fan Shuangfeng , He Jia , Xi Jing , He ShiJiao
Published: May 2024

Background

The number of newly reported older (≥50 years old) people living with HIV/AIDS in China has been steadily increasing, and heterosexual transmission has been identified as the major route.

Methods

In this study, based on biopsychosocial model, a case–control study (74 cases vs 296 controls) was applied to find out predictors (21 potential ones) of HIV infection among older men from rural China. Binary logistic regression with backward selection was applied.

Results

Out of 21 potential predictors of HIV infection, 4 were confirmed: receiving HIV-related health education (HRHE) (OR 0.449, 95% CI 0.238 to 0.848), self-reported homosexual identity (16.517 (95% CI 1.073 to 254.182)), visiting female sex workers (FSW) (58.427 (95% CI 7.895 to 432.403)), complete non-overlap of intimate social network and sexual network (2.912 (95% CI 1.372 to 6.177)), partial overlap (3.334 (95% CI 1.536 to 7.236)).

Discussion

Findings from this study suggest current comprehensive prevention and control services need to be strengthened to provide effective HRHE including condom use to older men and help them to improve condom use, especially during visiting FSW and among self-reported homosexual older men. Moreover, increasing intimacy in their sexual relationships is necessary.
Characteristics and contraceptive practices among Chinese women seeking abortion: a multicentre, descriptive study from 2019 to 2021
Authors: Tu Pengcheng , Hu Denghui , Wu Shangchun , Li Jianan , Jiang Xiaomei , Pei Kaiyan , Zhang Wei-Hong
Published: May 2024

Introduction

Despite the widespread provision of free contraceptives and post-abortion care (PAC) services, China grapples with a high rate of unintended pregnancies and subsequent abortions. We aimed to study the evolving characteristics of women seeking abortion and their contraceptive practices before and after abortions, to shed light on the optimisation of Chinese PAC services.

Methods

This study utilised data from an abortion cohort between 2019 and 2021. We studied their demographic features, contraception and abortion histories, reasons and choices using chi-square or linear-by-linear tests. We also explored the potential impact of receiving services at PAC facilities on post-abortion contraception use and repeat abortions using logistic regression models.

Results

Among the 9005 participants, 43.4% experienced repeat abortion, without a discernible trend over the 3 years. Noteworthy increases were observed in the percentages of college students (from 1.7% to 6.6%, p<0.01) and middle-aged women (from 23.2% to 26.8%, p<0.01) seeking abortions. Surgical abortion was chosen by nearly 90% of participants with a continuously increasing trend (ptrend<0.01). Nearly half of the participants experienced unintended pregnancies due to non-use of contraception. Of the remainder, the majority preferred less or the least effective methods both before and after abortion. Women residing in moderate-gross domestic product (GDP) regions faced a higher risk of repeat abortions (OR 1.33, 95% CI 1.16 to 1.54). Despite this, high-quality PAC services may encourage the use of reliable contraceptive methods, with 86.8% of women changing from least effective or no methods to (most) effective methods post-abortion, and prevent repeat abortions (OR 0.65, 95% CI 0.56 to 0.75).

Conclusions

Increased proportions of college students and middle-aged multiparous women seeking abortions were observed, together with inappropriate preferences for less effective contraception and increasing choice of surgical abortions. Future research should extend the focus to cover the entire abortion period, advocate the rational selection of contraceptive methods, and emphasise the specified PAC services tailored to different socioeconomic groups.
Combining toll-like receptor agonists with immune checkpoint blockade affects antitumor vaccine efficacy
Authors: Jeon Donghwan , Hill Ethan , Moseman Jena E , McNeel Douglas G
Published: May 2024

Background

T cell checkpoint receptors are expressed when T cells are activated, and modulation of the expression or signaling of these receptors can alter the function of T cells and their antitumor efficacy. We previously found that T cells activated with cognate antigen had increases in the expression of PD-1, and this was attenuated in the presence of multiple toll-like receptor (TLR) agonists, notably TLR3 plus TLR9. In the current report, we sought to investigate whether combining TLR agonists with immune checkpoint blockade can further augment vaccine-mediated T cell antitumor immunity in murine tumor models.

Methods

TLR agonists (TLR3 plus TLR9) and immune checkpoint inhibitors (antibodies targeting PD-1, CTLA-4, LAG-3, TIM-3 or VISTA) were combined and delivered with vaccines or vaccine-activated CD8+T cells to E.G7-OVA or MyC-CaP tumor-bearing mice. Tumors were assessed for growth and then collected and analyzed by flow cytometry.

Results

Immunization of E.G7-OVA tumor-bearing mice with SIINFEKL peptide vaccine, coadministered with TLR agonists and αCTLA-4, demonstrated greater antitumor efficacy than immunization with TLR agonists or αCTLA-4 alone. Conversely, the antitumor efficacy was abrogated when vaccine and TLR agonists were combined with αPD-1. TLR agonists suppressed PD-1 expression on regulatory T cells (Tregs) and activated this population. Depletion of Tregs in tumor-bearing mice led to greater antitumor efficacy of this combination therapy, even in the presence of αPD-1. Combining vaccination with TLR agonists and αCTLA-4 or αLAG-3 showed greater antitumor than with combinations with αTIM-3 or αVISTA.

Conclusion

The combination of TLR agonists and αCTLA-4 or αLAG-3 can further improve the efficacy of a cancer vaccine, an effect not observed using αPD-1 due to activation of Tregs when αPD-1 was combined with TLR3 and TLR9 agonists. These data suggest that optimal combinations of TLR agonists and immune checkpoint blockade may improve the efficacy of human anticancer vaccines.
Expanded targeted preconception screening panel in Israel: findings and insights
Authors: Reches Adi , Ofen Glassner Vered , Goldstein Nurit , Yeshaya Josepha , Delmar Galit , Portugali Ellie , Hallas Tova , Weinstein Amit , Kurolap Alina , Berkenstadt Michal , Mantsour Tal , Abu-Gutstein Liat , Ries-Levavi Liat , Reznik-Wolf Haike , Behar Doron Moshe , Yaron Yuval , Pras Elon , Baris Feldman Hagit
Published: May 2024

Background

We aimed to analyse the efficacy and added value of a targeted Israeli expanded carrier screening panel (IL-ECSP), beyond the first-tier test covered by the Israeli Ministry of Health (IMOH) and the second-tier covered by the Health Maintenance Organisations (HMOs).

Methods

A curated variant-based IL-ECSP, tailored to the uniquely diverse Israeli population, was offered at two tertiary hospitals and a major genetics laboratory. The panel includes 1487 variants in 357 autosomal recessive and X-linked genes.

Results

We analysed 10 115 Israeli samples during an 18-month period. Of these, 6036 (59.7%) were tested as couples and 4079 (40.3%) were singles. Carriers were most frequently identified with mutations in the following genes:GJB2/GJB6(1:22 allele frequency),CFTR(1:28),GBA(1:34),TYR(1:39),PAH(1:50),SMN1(1:52) andHEXA(1:56). Of 3018 couples tested, 753 (25%) had no findings, in 1464 (48.5%) only one partner was a carrier, and in 733 (24.3%) both were carriers of different diseases. We identified 79 (2.6%) at-risk couples, where both partners are carriers of the same autosomal recessive condition, or the female carries an X-linked disease. Importantly, 48.1% of these would not have been detected by ethnically-based screening tests currently provided by the IMOH and HMOs, for example, variants inGBA, TYR, PAH and GJB2/GJB6.

Conclusion

This is the largest cohort of targeted ECSP testing, tailored to the diverse Israeli population. The IL-ECSP expands the identification of couples at risk and empowers their reproductive choices. We recommend endorsing an expanded targeted panel to the National Genetic Carrier Screening programme.
Comparison of Pipeline embolization device versus Tubridge embolization device in unruptured intracranial aneurysms: a multicenter, propensity score matched study
Authors: Huang Chi , Ma Gengwu , Tong Xin , Feng Xin , Wen Zhuohua , Huang Mengshi , Xu Anqi , Yuan Hao , Shi HongYu , Lin Jiancheng , Li Can , Ge Runze , Huang Jiwan , Peng Chao , Zhu Yajun , Wang Tao , Huang Changren , Guo Zongduo , Liang Shuyin , Su Shixing , Zhang Xin , Li Xifeng , Liu Aihua , Duan Chuan-Zhi
Published: May 2024

Background

Flow diverter devices (FDs) are increasingly used for treating unruptured intracranial aneurysms (UIAs), but limited studies compared different FDs.

Objective

To conduct a propensity score matched analysis comparing the Pipeline embolization device (PED) and Tubridge embolization device (TED) for UIAs.

Methods

Patients with UIAs treated with either PED or TED between July 2016 and July 2022 were included. Propensity score matching was performed to adjust for age, sex, comorbidities, smoking, drinking, aneurysm size, morphology, neck, location, parent artery diameter, adjunctive coiling, and angiographic follow-up duration. Perioperative complications and clinical and angiographic outcomes were compared after matching.

Results

735 patients treated by PED and 290 patients treated by TED were enrolled. Compared with the PED group, patients in the TED group had a greater number of women and patients with ischemia, a smaller proportion of vertebrobasilar and non-saccular aneurysms, a smaller size and neck, and fewer adjunctive coils and overlapping stents, but a larger parent artery diameter and lumen disparities. After adjusting for these differences, 275 pairs were matched. No differences were found in perioperative complications (4.4% vs 2.5%, P=0.350), in-stent stenosis (16.0% vs 15.6%, P>0.999), or favorable prognosis (98.9% vs 98.5%, P>0.999). However, PED showed a trend towards better complete occlusion over a median 8-month angiographic follow-up (81.8% vs 75.3%, P=0.077).

Conclusion

Compared with PED, TED provides a comparable rate of perioperative and short-term outcomes. Nevertheless, a better occlusion status in the PED group needs to be further verified over a longer follow-up period.
Prevalence of sexually transmitted infections in women of the Czech Republic Armed Forces: a cross-sectional pilot study
Authors: Karasek Lubos , Smetana J , Svobodova P , Smahelova J , Tachezy R , Kiss I , Nejedla D
Published: May 2024

Introduction

Sexually transmitted infections (STIs) are an everlasting health issue globally. The military environment is recognised as a high-risk setting. Human papillomavirus (HPV),Chlamydia trachomatisandNeisseria gonorrhoeaeare the most frequent STIs worldwide. This prospective cross-sectional pilot study focuses on the prevalence of selected STIs in the female population of the Czech Republic’s Armed Forces.

Methods

C. trachomatis,N. gonorrhoeaeand HPV detection and genotyping were performed between August 2020 and December 2022 in 141 women. Participants were divided into three groups according to their military status—recruits (n=72), active soldiers (n=25) and control civilian group (n=44). Cervical smear tests were performed, and data on STI risk factors were obtained through a questionnaire.

Results

A significant difference in the HPV prevalence between recruits (64.5 %) and both active soldiers (46.4 %) and civilians (47.3 %) was found when adjusted for age (p=0.007 and p=0.01, respectively). Lower age of coitarche (median 16; p=0.005) and smaller agglomeration origin (p=0.013) were reported for military recruits. No difference was proven in other researched risk factors. Associations between HPV detection and the higher number of sexual partners (p=0.013), early coitarche (p=0.016) and single marital status (p=0.002) across the groups were observed. Not a single case ofN. gonorrhoeaewas detected in any of the 141 participants. The prevalence ofC. trachomatisdid not differ significantly between the three evaluated groups—recruits, control civilian group, and active soldiers (5.6%, 2.3%, 0%, respectively; p=0.567).

Conclusions

This pilot study showed a significantly higher HPV prevalence in female military recruits compared with both active military and civilian women. Recruits reported earlier coitarche which is a strong STI risk factor. Further study is needed to expand on the findings of this pilot study and generate data to support adjustment of STI preventive measures within the Czech Republic Armed Forces.
Emotional demands at work and risk of disability pension: a nationwide cohort study in Denmark
Authors: Framke Elisabeth , Sørensen Jeppe Karl , Madsen Ida E H , Rugulies Reiner
Published: May 2024

Introduction

Working in emotionally demanding jobs is associated with an increased risk of temporarily leaving the labour market due to long-term sickness absence. We tested whether employees working in emotionally demanding jobs are also at higher risk of permanently leaving the labour market due to disability pension compared with employees working in jobs that are not emotionally demanding.

Methods

We conducted a 10-year cohort study in the workforce in Denmark (n=1 670 825), aged 30–59 years at baseline, by linking job exposure matrices with nationwide registries on social transfer payments and covariates. Using Cox regression, we analysed the risk of disability pension in relation to emotional demands in the full population and sex stratified. Multivariable adjusted models included sex, age, cohabitation, migration background, household disposable income and other work environmental factors (physical workload, influence, possibilities for development and role conflicts).

Results

We identified 67 923 new cases of disability pension during 15 649 743 person-years of follow-up (mean follow-up: 9.4 years). We found an increasing risk of disability pension with higher levels of emotional demands, with HRs of 1.20, 1.23 and 1.73 for medium-low, medium-high and high emotional demands, respectively, compared with low emotional demands in the most adjusted model. There was an exposure–response association in women and a tendency towards an exposure–response association in men.

Discussion

In this nationwide cohort study, we found an increased risk of permanent exit from the labour market due to disability pension in women and men working in emotionally demanding jobs.
Genomic prediction in Brassica napus: evaluating the benefit of imputed whole-genome sequencing data
Authors: Weber Sven E. , Roscher-Ehrig Lennard , Kox Tobias , Abbadi Amine , Stahl Andreas , Snowdon Rod J.
Published: May 2024

Advances in sequencing technology allow whole plant genomes to be sequenced with high quality. Combining genotypic and phenotypic data in genomic prediction helps breeders to select crossing partners in partially phenotyped populations. In plant breeding programs, the cost of sequencing entire breeding populations still exceeds available genotyping budgets. Hence, the method for genotyping is still mainly single nucleotide polymorphism (SNP) arrays; however, arrays are unable to assess the entire genome- and population-wide diversity. A compromise involves genotyping the entire population using an SNP array and a subset of the population with whole-genome sequencing. Both datasets can then be used to impute markers from whole-genome sequencing onto the entire population. Here, we evaluate whether imputation of whole-genome sequencing data enhances genomic predictions, using data from a nested association mapping population of rapeseed ( Brassica napus). Employing two cross-validation schemes that mimic scenarios for the prediction of close and distant relatives, we show that imputed marker data do not significantly improve prediction accuracy, likely due to redundancy in relationship estimates and imputation errors. In simulation studies, only small improvements were observed, further corroborating the findings. We conclude that SNP arrays are already equipped with the information that is added by imputation through relationship and linkage disequilibrium.
On the gauge invariance of the higher-derivative Yang–Mills–Chern–Simons action
Authors: Ghasemkhani M. , Soleimani G. , Bufalo R.
Published: May 2024

In this work, we study the perturbative generation of the gauge invariant effective action for the non-Abelian gauge field in a $$(2+1)$$

(
2
+
1
)

-dimensional spacetime. We present a detailed analysis of the two, three and four-point functions in order to determine the non-Abelian Chern–Simons terms (parity odd) and Yang–Mills terms (parity even). Moreover, these terms are supplemented by the higher-derivative corrections which resulted in the Alekseev–Arbuzov–Baikov effective action (parity even) plus the higher-derivative (HD) corrections to the Chern–Simons terms (parity odd). In order to highlight some features about the perturbative generation of the effective action, we present a discussion based on the dimensional analysis, which allows us to establish the general structure of the permissible terms to guarantee the gauge invariance of the higher-derivative parts.
Investigation of optical properties of molybdenum trioxide (MoO3) thin films using neural networks
Authors: Mohamed R. A. , El-Nahass M. M. , El-Bakry M. Y. , El-Dahshan El-Sayed A. , Aamer E. H. , Habashy D. M.
Published: May 2024

Nowadays, transition metal oxide, the semiconductor molybdenum trioxide (MoO3), is a favorable choice because it has several industrial applications and alluring qualities. It has a significant role as an industrial catalyst due to its electrochromic properties. The optical behavior of the MoO3 thin film onto various substrates of the powder of MoO3 was investigated. x-ray diffraction analysis revealed an orthorhombic structure. Measurements of the average crystallite size and dislocation density were obtained, which were 132.8 nm and 5.7× 10–4 nm−2, respectively. Spectrophotometric measurements of transmittance (T) and reflectance (R) at normal incidence in the 300–1400 nm wavelength range of the film onto various substrates were examined. The dispersion and indirect optical transitions and nonlinear optical parameters were identified for glass and quartz substrates. An estimation of the optical behavior of the MoO3 thin film using the artificial neural network (ANN) model was carried out. Experimental data were used as inputs. The optical characterization of ANN modeling outputs provides excellent results. Error values support the success of the modeling process, with a mean squared error value of < 10−1. Moreover, the theoretical equation describing the experimental results was obtained depending on the ANN model, representing the relation between the inputs and outputs. According to the findings of this research, the ANN model can be utilized as an efficient tool to simulate and predict the optical parameters of the MoO3 thin film. Additionally, it can establish strong connections between theoretical and experimental fields.
Safe Autonomous Docking of Spacecraft: A RRT-combined Output-constrained Recursive Control Method
Authors: Jiang Wenqi , Guo Zeyu , Li Shihua
Published: May 2024

In addressing the challenges of short-range spacecraft docking in the presence of obstacles and disturbances, it is critical to integrate guidance and motion control to ensure autonomous and reliable operation. Traditional methods that separate these two layers often struggle with accurately tracking predefined paths, increasing the risk of collisions. In light of this, a proposed scheme integrating guidance and control in an organic manner has been put forth. This scheme employs the rapidly-exploring random trees (RRT) algorithm within the guidance layer to generate a collision-avoidance trajectory for the control layer, efficiently navigating the spacecraft towards its target. Then the control layer implements a second-order output-constrained controller by adding a power integrator and a novel barrier Lyapunov function (BLF) together, to guarantee that the tracking error of the predefined trajectory remains bounded and the system asymptotically converges to the target. To account for tracking errors, obstacle radii are expanded during path planning through a dilation constant. Based on theoretical derivation and simulation experiments, the effectiveness and advancement of the proposed method are validated.
Addressing Data Challenges to Drive the Transformation of Smart Cities
Authors: Gilman Ekaterina , Bugiotti Francesca , Khalid Ahmed , Mehmood Hassan , Kostakos Panos , Tuovinen Lauri , Ylipulli Johanna , Su Xiang , Ferreira Denzil
Published: May 2024

Cities serve as vital hubs of economic activity and knowledge generation and dissemination. As such, cities bear a significant responsibility to uphold environmental protection measures while promoting the welfare and living comfort of their residents. There are diverse views on the development of smart cities, from integrating Information and Communication Technologies into urban environments for better operational decisions to supporting sustainability, wealth, and comfort of people. However, for all these cases, data are the key ingredient and enabler for the vision and realization of smart cities. This article explores the challenges associated with smart city data. We start with gaining an understanding of the concept of a smart city, how to measure that the city is a smart one, and what architectures and platforms exist to develop one. Afterwards, we research the challenges associated with the data of the cities, including availability, heterogeneity, management, analysis, privacy, and security. Finally, we discuss ethical issues. This article aims to serve as a “one-stop shop” covering data-related issues of smart cities with references for diving deeper into particular topics of interest.
X-squatter: AI Multilingual Generation of Cross-Language Sound-squatting
Authors: Valentim Rodolfo Vieira , Drago Idilio , Mellia Marco , Cerutti Federico
Published: May 2024

Sound-squatting is a squatting technique that exploits similarities in word pronunciation to trick users into accessing malicious resources. It is an understudied threat that has gained traction with the popularity of smart speakers and audio-only content, such as podcasts. The picture gets even more complex when multiple languages are involved. We here introduce X-squatter, a multi- and cross-language AI-based system that relies on a Transformer Neural Network for generating high-quality sound-squatting candidates. We illustrate the use of X-squatter by searching for domain name squatting abuse across hundreds of millions of issued TLS certificates, alongside other squatting types. Key findings unveil that approximately 15% of generated sound-squatting candidates have associated TLS certificates, well above the prevalence of other squatting types (7%). Furthermore, we employ X-squatter to assess the potential for abuse in PyPI packages, revealing the existence of hundreds of candidates within a 3-year package history. Notably, our results suggest that the current platform checks cannot handle sound-squatting attacks, calling for better countermeasures. We believe X-squatter uncovers the usage of multilingual sound-squatting phenomena on the Internet and it is a crucial asset for proactive protection against the threat.
Enhancing Electrochemical Stability of Silicon-Carbon and NMC based Lithium-Ion Batteries through the Synergistic Impact of Charge Balance and Direct-Contact Pre-Lithiation Strategy
Authors: Gautam Manoj , Mishra Govind Kumar , Bhawana K , Kalwar Chhotelal Sah , Mitra Sagar
Published: May 2024

The commercial feasibility of silicon (Si) anodes (≥ 30%) in full-cell systems is constrained by poor cyclic stability and capacity balancing due to continuous active lithium (Li) consumption in each cycle. We proposed a capacity balancing approach by adding additional Li at the cathode side (i.e., ratio of capacity at negative to positive electrode (N/P) ∼ 0.9) and anode side (i.e., pre-lithiated Si) before full-cell fabrication. This approach provided a capacity-balanced full-cell with 91.7% of initial Coulombic efficiency (ICE) and stability up to 50 cycles. In-situ electrochemical impedance spectroscopy (EIS) and distribution of relaxation times (DRT) analysis have been utilized to examine the interface of bare and balanced full cells. In a large format cell, electrolyte wettability is an issue and it has been investigated even at high temperature (50 °C). The post-cycle investigation also indicates the Si particles retained their integrity after cycling. A 110 mAh pouch cell has been constructed, and the pouch cell demonstrated exceptional cyclic stability up to 200 cycles, with a capacity retention of 83.2% at a current rate of 0.1 C. These findings present a capacity balancing approach for high-loading silicon-based anodes that eventually can scale up to high-quality and long-cycle life lithium-ion batteries.
ATRX and Its Prognostic Significance in Soft Tissue Sarcoma
Authors: Cullen Mark M. , Floyd Warren , Dow Bobby , Schleupner Beatrice , Brigman Brian E. , Visgauss Julia D. , Cardona Diana M. , Somarelli Jason A. , Eward William C.
Published: May 2024

Purpose. Recently, the association between ATRX and a more aggressive sarcoma phenotype has been shown. We performed a retrospective study of sarcomas from an individual institution to evaluate ATRX as a prognosticator in soft tissue sarcoma. Experimental Design. 128 sarcomas were collected from a single institution and stained for ATRX. The prognostic significance of these markers was evaluated in a smaller cohort of primary soft tissue sarcomas (n = 68). Kaplan–Meier curves were created for univariate analysis, and Cox regression was utilized for multivariate analysis. Results. High expression of ATRX was found to be a positive prognostic indicator for overall survival and metastasis-free survival in our group of soft tissue sarcomas both in univariate analysis and multivariate analysis (HR: 0.38 (0.17–0.85), P=0.02 and HR: 0.49 (0.24–0.99), P=0.05, respectively). Conclusions. High expression of ATRX is a positive prognostic indicator of overall survival and metastasis-free survival in patients with STS. This is consistent with studies in osteosarcoma, which indicate possible mechanisms through which loss of ATRX leads to more aggressive phenotypes. Future prospective clinical studies are required to validate the prognostic significance of these findings.