bluuebunny/crossref_metadata_2025_split huggingface dataset:
Centrally acting ACE inhibitor (cACEi) and angiotensin receptor blocker (cARB) use and cognitive dysfunction in patients with SLE
Authors: Dobrowolski Chrisanna , Barraclough Michelle , Su Jiandong , Tanic Milica , Bingham Kathleen , Ruttan Lesley , Beaton Dorcas , Wither Joan , Tartaglia Maria Carmela , Sano Mary , Kakvan Mahta , Bonilla Dennisse , Green Robin , Touma Zahi 
Published: July 2023

ObjectiveCognitive dysfunction (CD) is detectable in approximately 40% of patients with SLE. Despite this high prevalence, there are no approved pharmacological treatment options for this detrimental condition. Preliminary murine studies show potential for targeting microglial activation as a treatment of SLE-CD, which may be ameliorated with centrally acting ACE inhibitor (cACEi) and angiotensin receptor blocker (cARB) use. The aim of this study is to determine if there is an association of cACEi/cARB use with cognitive function in a human SLE cohort.MethodsThe American College of Rheumatology neuropsychological battery was administered to patients with consecutive SLE at a single academic health centre at baseline, 6 and 12 months. Scores were compared with sex-matched and age-matched control subjects. Clinical and demographic data were gathered at each visit. The primary outcome was CD defined as dysfunction in two or more cognitive domains. The primary predictor was a total cumulative dose of cACEi/cARB in milligrams per kilogram, recorded as an equivalent ramipril dose. Odds of CD with respect to cACEi/cARB use were determined through generalised linear mixed modelling.ResultsA total of 300 patients, representing 676 visits, completed this study. One hundred sixteen (39%) met the criteria for CD. Fifty-three participants (18%) were treated with a cACEi or cARB. Mean cumulative dose was 236 mg/kg (calculated as equivalent ramipril dose). Cumulative cACEi/cARB dose was not protective against SLE-CD. Caucasian ethnicity, current employment status and azathioprine cumulative dose were each associated with reduced odds of SLE-CD. Increasing Fatigue Severity Scale score was associated with increased odds of CD.ConclusionsIn a single-centre SLE cohort, cACEi/cARB use was not associated with absence of CD. Many important confounders may have influenced the results of this retrospective study. A randomised trial is required to accurately determine if cACEi/cARB is a potential treatment for SLE-CD.
Evaluation of the NHS England ‘Op COURAGE’ High Intensity Service for military veterans with significant mental health problems
Authors: Finnegan Alan , Salem K , Green N , Ainsworth-Moore L , Ghomi M 
Published: July 2023

IntroductionIn November 2020, The NHS for England launched a pilot High Intensity Service (HIS) programme for treating military veterans complex mental health problems. Seven regional grants were awarded to manage the HIS, including NHS Solent, in South East England. This paper details an evaluation of the HIS, which was conducted from February 2021 to August 2022.MethodsThis mixed-methods study gained quantitative data from a specifically designed questionnaire that included a number of validated psychometric questionnaires. These were completed by either HIS staff or beneficiaries at entry and exit from the HIS, and qualitative data were gained from semi-structured interviews with the HIS staff.ResultsData were sourced from 45 pre-questionnaires, 25 post programme questionnaires and 11 interviews. This evaluation identified reductions in situational stressors, symptoms and reported illnesses for veterans in crisis. There were reductions in depression, anxiety and post-traumatic stress disorder following programme exit. Staff reported that there was no notable changes in stress levels which appeared to remain high at programme exit. Staff interviews highlighted the importance of simultaneously understanding the social and psychological needs of veterans in mental health crisis. The benefits of integrating veteran staff members into military veteran health services were identified, demonstrating improvements in education around military culture in civilian services.ConclusionsThe importance of collaboration between clinical and veteran staff members in veteran health services was noted, demonstrating the positive impact social care provision has on veteran’s overall health and well-being. Veteran engagement with the service was advocated as a result of veterans accessing the service feeling understood. This first independent evaluation of the HIS provides a positive reflection, and adds to the limited empirical evidence exploring veteran engagement in health services.
Incident cardiovascular, renal, metabolic diseases and death in individuals identified for risk-guided atrial fibrillation screening: a nationwide cohort study
Authors: Wu Jianhua , Nadarajah Ramesh , Nakao Yoko M , Nakao Kazuhiro , Hogg David , Raveendra Keerthenan , Arbel Ronen , Haim Moti , Zahger Doron , Cowan Campbel , Gale Chris P 
Published: July 2023

ObjectiveRisk-guided atrial fibrillation (AF) screening may be an opportunity to prevent adverse events in addition to stroke. We compared events rates for new diagnoses of cardio-renal-metabolic diseases and death in individuals identified at higher versus lower-predicted AF risk.MethodsFrom the UK Clinical Practice Research Datalink-GOLD dataset, 2 January 1998–30 November 2018, we identified individuals aged ≥30 years without known AF. The risk of AF was estimated using the FIND-AF (Future Innovations in Novel Detection of Atrial Fibrillation) risk score. We calculated cumulative incidence rates and fit Fine and Gray’s models at 1, 5 and 10 years for nine diseases and death adjusting for competing risks.ResultsOf 416 228 individuals in the cohort, 82 942 were identified as higher risk for AF. Higher-predicted risk, compared with lower-predicted risk, was associated with incident chronic kidney disease (cumulative incidence per 1000 persons at 10 years 245.2; HR 6.85, 95% CI 6.70 to 7.00; median time to event 5.44 years), heart failure (124.7; 12.54, 12.08 to 13.01; 4.06), diabetes mellitus (123.3; 2.05, 2.00 to 2.10; 3.45), stroke/transient ischaemic attack (118.9; 8.07, 7.80 to 8.34; 4.27), myocardial infarction (69.6; 5.02, 4.82 to 5.22; 4.32), peripheral vascular disease (44.6; 6.62, 6.28 to 6.98; 4.28), valvular heart disease (37.8; 6.49, 6.14 to 6.85; 4.54), aortic stenosis (18.7; 9.98, 9.16 to 10.87; 4.41) and death from any cause (273.9; 10.45, 10.23 to 10.68; 4.75). The higher-risk group constituted 74% of deaths from cardiovascular or cerebrovascular causes (8582 of 11 676).ConclusionsIndividuals identified for risk-guided AF screening are at risk of new diseases across the cardio-renal-metabolic spectrum and death, and may benefit from interventions beyond ECG monitoring.
Emulated trial investigating effects of multiple treatments: estimating combined effects of mucoactive nebulisers in cystic fibrosis using registry data
Authors: Granger Emily , Davies Gwyneth , Keogh Ruth H 
Published: July 2023

IntroductionPeople with cystic fibrosis (CF) are often on multiple long-term treatments, including mucoactive nebulisers. In the UK, the most common mucoactive nebuliser is dornase alfa (DNase). A common therapeutic approach for people already on DNase is to add hypertonic saline (HS). The effects of DNase and HS used alone have been studied in randomised trials, but their effects in combination have not. This study investigates whether, for people already prescribed DNase, adding HS has additional benefit for lung function or use of intravenous antibiotics.MethodsUsing UK CF Registry data from 2007 to 2018, we emulated a target trial. We included people aged 6 years and over who were prescribed DNase without HS for 2 years. We investigated the effects of combinations of DNase and HS over 5 years of follow-up. Inverse-probability-of-treatment weighting was used to control confounding. The period predated triple combination CF transmembrane conductance regulator modulators in routine care.Results4498 individuals were included. At baseline, average age and forced expiratory volume in 1 s (FEV1%) predicted were 21.1 years and 69.7 respectively. During first year of follow-up, 3799 individuals were prescribed DNase alone; 426 added HS; 57 switched to HS alone and 216 were prescribed neither. We found no evidence that adding HS improved FEV1% at 1–5 years, or use of intravenous antibiotics at 1–4 years, compared with DNase alone.ConclusionFor individuals with CF prescribed DNase, we found no evidence that adding HS had an effect on FEV1% or prescription of intravenous antibiotics. Our study illustrates the emulated target trial approach using CF Registry data.
Effect of the COVID-19 pandemic on emergency department attendances for pediatric injuries in Mozambique’s central hospitals: an interrupted time series and a comparison within the restriction periods between 2019 and 2020
Authors: Amado Vanda , Moller Jette , Couto Maria Tereza , Wallis Lee , Laflamme Lucie 
Published: July 2023

ObjectivesHospital-based studies indicate that restriction measures imposed during the COVID-19 pandemic have affected the number and characteristics of pediatric injuries. However, few studies have been conducted in resource-poor countries. This study aimed to determine whether injury-related emergency department (ED) attendances in Mozambique were affected during the restriction periods in 2020 and how the pattern of injury changed.MethodsMozambique faced two restriction periods in 2020. An interrupted time series was applied to weekly data of pediatric injuries from the ED records of four central hospitals in Mozambique in 2019 and 2020. Weekly numbers of injuries were modeled using a Poisson regression model to estimate the effect of COVID-19 restrictions on trends over calendar time. Then, for each restriction period, differences in injury mechanisms, severity, need for surgery, and intensive care unit (ICU) attendances were compared between 2019 and 2020.ResultsDuring the 76 weeks preceding the restrictions, there was a stable trend in ED attendances. The weekly number dropped by 48.7% after implementation of the first restrictions. By the end of 2020, the weekly numbers were back to the levels observed before the restrictions. Road traffic injuries (RTIs) and falls dropped during the first restriction period and RTIs and burns during the second. There was an increase of 80% in ICU attendances in all periods of 2020 at three hospitals during the first and second restriction periods.ConclusionThe COVID-19 restrictions yielded a reduction in the weekly number of pediatric injuries seen at Mozambique’s central hospitals, above all RTIs and falls. The drop reflects reductions in visits most importantly for RTIs, falls, and burns, but was accompanied by an increase in the proportion of ICU cases. This effect was not maintained when the restrictions were relaxed. Whether this reflects reduced exposure to injury or hesitancy to seek care remains to be determined.Level of evidenceLevel III, retrospective study with up to two negative criteria.
SensorGAN: A Novel Data Recovery Approach for Wearable Human Activity Recognition
Authors: Hussein Dina , Bhat Ganapati 
Published: July 2023

Human activity recognition (HAR) and, more broadly, activities of daily life recognition using wearable devices have the potential to transform a number of applications, including mobile healthcare, smart homes, and fitness monitoring. Recent approaches for HAR use multiple sensors on various locations on the body to achieve higher accuracy for complex activities. While multiple sensors increase the accuracy, they are also susceptible to reliability issues when one or more sensors are unable to provide data to the application due to sensor malfunction, user error, or energy limitations. Training multiple activity classifiers that use a subset of sensors is not desirable, since it may lead to reduced accuracy for applications. To handle these limitations, we propose a novel generative approach that recovers the missing data of sensors using data available from other sensors. The recovered data are then used to seamlessly classify activities. Experiments using three publicly available activity datasets show that with data missing from one sensor, the proposed approach achieves accuracy that is within 10% of the accuracy with no missing data. Moreover, implementation on a wearable device prototype shows that the proposed approach takes about 1.5 ms for recovering data in the w-HAR dataset, which results in an energy consumption of 606 μJ. The low-energy consumption ensures that SensorGAN is suitable for effectively recovering data in tinyML applications on energy-constrained devices.
Dual Recombinase–Based Mouse Models Help Decipher Cancer Biology and Targets for Therapy
Authors: Sket Tina , Falcomatà Chiara , Saur Dieter 
Published: July 2023

Abstract
The advent of next-generation sequencing (NGS) and single-cell profiling technologies has revealed the complex and heterogenous ecosystem of human tumors under steady-state and therapeutic perturbation. Breakthroughs in the development of genetically engineered mouse models (GEMM) of human cancers that are based on the combination of two site-specific recombinase systems [dual-recombinase system (DRS)] offer fundamental new possibilities to elucidate and understand critical drivers of the diverse tumor phenotypes and validate potential targets for therapy. Here, we discuss opportunities DRS-based cancer GEMMs offer to model, trace, manipulate, and functionally investigate established cancers, their interactions with the host, and their response to therapy.
Multiomic Mapping of Acquired Chromosome 1 Copy-Number and Structural Variants to Identify Therapeutic Vulnerabilities in Multiple Myeloma
Authors: Boyle Eileen M. , Blaney Patrick , Stoeckle James H. , Wang Yubao , Ghamlouch Hussein , Gagler Dylan , Braunstein Marc , Williams Louis , Tenenbaum Avital , Siegel Ariel , Chen Xiaoyi , Varma Gaurav , Avigan Jason , Li Alexander , Jinsi Monica , Kaminetzsky David , Arbini Arnaldo , Montes Lydia , Corre Jill , Rustad Even H. , Landgren Ola , Maura Francesco , Walker Brian A. , Bauer Michael , Bruno Benedetto , Tsirigos Aristotelis , Davies Faith E. , Morgan Gareth J. 
Published: July 2023

Abstract

Purpose:
Chromosome 1 (chr1) copy-number abnormalities (CNA) and structural variants (SV) are frequent in newly diagnosed multiple myeloma (NDMM) and are associated with a heterogeneous impact on outcomes, the drivers of which are largely unknown.

Experimental Design:
A multiomic approach comprising CRISPR, gene mapping of CNAs and SVs, methylation, expression, and mutational analysis was used to document the extent of chr1 molecular variants and their impact on pathway utilization.

Results:
We identified two distinct groups of gain(1q): focal gains associated with limited gene-expression changes and a neutral prognosis, and whole-arm gains, which are associated with substantial gene-expression changes, complex genetics, and an adverse prognosis. CRISPR identified a number of dependencies on chr1 but only limited variants associated with acquired CNAs. We identified seven regions of deletion, nine of gain, three of chromothripsis (CT), and two of templated insertion (TI), which contain a number of potential drivers. An additional mechanism involving hypomethylation of genes at 1q may contribute to the aberrant gene expression of a number of genes. Expression changes associated with whole-arm gains were substantial and gene set enrichment analysis identified metabolic processes, apoptotic resistance, signaling via the MAPK pathway, and upregulation of transcription factors as being key drivers of the adverse prognosis associated with these variants.

Conclusions:
Multiple layers of genetic complexity impact the phenotype associated with CNAs on chr1 to generate its associated clinical phenotype. Whole-arm gains of 1q are the critically important prognostic group that deregulate multiple pathways, which may offer therapeutic vulnerabilities.
Optimal AGC of a power system incorporated BESS-EHVAC/DC link using evolutionary techniques
Authors: Kumar Ashwini , Singh Omveer 
Published: July 2023

This research paper reveals the design of controller with optimization techniques for automatic generation control (AGC) in multi-area power system incorporated with diverse energy sources. The diverse sources are conventional thermal, hydro and gas power station (THG). The frequency deviations should be remains constant in modern power systems. Optimization techniques used for proposed model for proportional integral (PI) controller which is tuned for AGC with diverse energy sources. The battery energy storage system (BESS) and extra high voltage alternating current/ direct current (EHVAC/DC) link investigated with proposed model. The proposed model has been tested with 1% step load perturbation (SLP) and MATLAB/Simulink verified their results. All the simulation results justified the area control error (ACE) with frequency deviation &amp; tie-line power flow for area-1 and area-2. The comparative study done for PI controller with GA &amp; PSO in the proposed model. It has shown its efficacy with proposed model including BESS and EHVAC/DC- link using GA and PSO.
Model predictive control using Euler method for switched-battery boost-multilevel inverter
Authors: Abdullah Ahmad Takiyuddin , Idrus Sevia Mahdaliza , Ayob Shahrin Md 
Published: July 2023

<span lang="EN-US">This paper presents the model predictive control (MPC) design using the backward Euler method for an 11-level switched-battery boost multilevel inverter (SBBMLI). The SBBMLI was proposed as the cost-effective solution for the communication power line in a high-speed rail (HSR) system. Initially, a generalized SBBMLI problem formulation was performed, and an open-loop simulation based on voltage and current mode controls was conducted. The finite control set-model predictive control (FCS-MPC) ability to track the reference sinusoidal output with low total harmonic distortion (THD) was then assessed as a performance criterion. Furthermore, the performance was assessed based on no-load and load disturbances. Finally, the results proved the ability of the proposed FCS-MPC to address non-linear dynamics, constraints, and its eﬃciency of implementation.</span>
Darcy Ribeiro, um etnógrafo do Brasil
Authors: Moreira Gisele Jacon de Araujo 
Published: July 2023

Darcy Ribeiro, antropólogo e político brasileiro, foi um homem com muitos atributos intelectuais e assumiu posições importantes na política nacional. Publicou seis volumes de estudos antropológicos, com mais de mil páginas, sobre a formação do povo brasileiro no âmbito das configurações histórico-culturais das Américas e das nações mundiais. Este artigo passeia pelos registros etnográficos dos primeiros anos de vida profissional de Darcy como etnólogo da Seção de Estudos do Serviço de Proteção aos Índios entre 1947 e 1957. Propõe que a originalidade de sua interpretação sobre a formação do povo brasileiro deriva do conhecimento que adquiriu nos anos de vivência e estudo entre os índios e os efeitos do contato violento daqueles povos com as frentes de expansão da civilização. Conclui destacando a importância do seu romance Maíra na literatura e na antropologia brasileiras da segunda metade do Século XX, como um registro crítico e irônico da ciência etnográfica pura e imparcial com relação ao drama indígena na modernidade.
Association Between Maternal Glucose Levels in Gestational Diabetes Screening and Subsequent Hypertension
Authors: Liang Xinyun (Christie) , Savu Anamaria , Ngwezi Deliwe , Butalia Sonia , Kaul Padma , Yeung Roseanne O. 
Published: July 2023

BACKGROUND:
We assessed the association between maternal glucose levels in pregnancy and subsequent hypertension.

METHODS:
This population-level, retrospective cohort study examined women aged 12 to 54 years with singleton pregnancies completed at ≥29 weeks of gestation from October 1, 2008 to December 1, 2018 followed until March 31, 2019 in Alberta, Canada. Women were stratified by results in the 50-gram glucose challenge test and by 75-gram oral glucose tolerance test subtypes (normal oral glucose tolerance test, elevated fasting plasma glucose only [elevated fasting], elevated postload glucose only, or both elevated fasting and postload glucose [combined]. Time to development of hypertension was modeled using Cox proportional hazards models.

RESULTS:
Of 313 361 women, 231 008 (79.1%) underwent a glucose challenge test only while 60 909 (20.9%) underwent either an oral glucose tolerance test only or both. Nine thousand five hundred eighty (3.1%) developed hypertension, and 2824 (0.9%) developed cardiovascular disease over a median follow-up of 5.7 years. Every 1-mmol/L increase in glucose in the glucose challenge test increased the risk of subsequent hypertension by 15% (adjusted hazard ratio and 95% CI, 1.15 [1.14–1.16]). Among those who underwent the oral glucose tolerance test, the combined group conferred the highest risk of subsequent hypertension, followed by elevated fasting, then elevated postload glucose only (reference: glucose challenge test ≤7.1 mmol/L, adjusted hazard ratio [95% CI]: elevated postload glucose only, 1.83 [1.68–2.00]; elevated fasting 2.02 [1.70–2.40]; combined, 2.65 [2.33–3.01]). No significant associations between maternal glucose levels and cardiovascular disease were observed.

CONCLUSIONS:
Increasing maternal glucose levels in pregnancy were associated with increasing risk of subsequent hypertension. These findings may help identify higher-risk women who should be targeted for earlier postpartum cardiovascular risk reduction.
Splanchnic Nerve Modulation Effects on Surrogate Measures of Venous Capacitance
Authors: Kittipibul Veraprapas , Ganesh Arun , Coburn Aubrie , Coyne Brian J. , Gray James Matthew , Molinger Jeroen , Ray Neil , Podgoreanu Mihai , McCartney Sharon L. , Mamoun Negmeldeen , Fitzhugh Robert Curtis , Lurz Philipp , Green Cynthia L. , Hernandez Adrian F. , Patel Manesh R. , Fudim Marat 
Published: July 2023

Background
Splanchnic nerve modulation (SNM) is an emerging procedure to reduce cardiac filling pressures in heart failure. Although the main contributor to reduction in cardiac preload is thought to be increased venous capacitance in the splanchnic circulation, supporting evidence is limited. We examined changes in venous capacitance surrogates pre‐ and post‐SNM.

Methods and Results

This is a prespecified analysis of a prospective, open‐label, single‐arm interventional study evaluating the effects of percutaneous SNM with ropivacaine in chronic heart failure with elevated filling pressures at rest and with exercise. Patients underwent cardiopulmonary exercise testing with invasive hemodynamic assessment pre‐ and post‐SNM. Blood pressure changes with modified Valsalva maneuver and hemoconcentration, pre‐ and post‐SNM were compared using a repeated measures model. Inferior vena cava diameter and collapsibility (>50% decrease in size with inspiration), and presence of bendopnea pre‐ and post‐SNM were also compared. Fifteen patients undergoing SNM (age 58 years, 47% women, 93% with left ventricular ejection fraction ≤35%) were included. After SNM, changes in systolic blood pressure during Valsalva (peak‐to‐trough) were greater (41 versus 48 mm Hg,
P
=0.025). Exercise‐induced hemoconcentration was unchanged (0.63 versus 0.43 g/dL,
P
=0.115). Inferior vena cava diameter was reduced (1.59 versus 1.30 cm,
P
=0.034) with higher collapsibility (33% versus 73%,
P
=0.014). Bendopnea was less (47% versus 13%,
P
=0.025).

Conclusions
SNM resulted in increased venous capacitance, associated decreased cardiac preload, and decreased bendopnea. Minimally invasive measures of venous capacitance could serve as markers of successful SNM. Long‐term effects of SNM on venous capacitance warrant further investigation for heart failure management.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03453151.