Research Network Research Articles

Evaluating current acute aortic syndrome pathways: Collaborative Acute Aortic Syndrome Project (CAASP)

Abstract Background Diagnosis of acute aortic syndrome is challenging and associated with high perihospital mortality rates. The study aim was to evaluate current pathways and understand the chronology of acute aortic syndrome patient care. Method Consecutive patients with acute aortic syndrome imaging diagnosis between 1 January 2018 and 1 June 2021 were identified using a predetermined search strategy and followed up for 6 months through retrospective case note review. The UK National Interventional Radiology Trainee Research and Vascular and Endovascular Research Network co-ordinated the study. Results From 15 UK sites, 620 patients were enrolled. The median age was 67 (range 25–98) years, 62.0% were male and 92.9% Caucasian. Type-A dissection (41.8%) was most common, followed by type-B (34.5%); 41.2% had complicated acute aortic syndrome. Mode of presentation included emergency ambulance (80.2%), self-presentation (16.2%), and primary care referral (3.6%). Time (median (i.q.r.)) to hospital presentation was 3.1 (1.8–8.6) h and decreased by sudden onset chest pain but increased with migratory pain or hypertension. Time from hospital presentation to imaging diagnosis was 3.2 (1.3–6.5) h and increased by family history of aortic disease and decreased by concurrent ischaemic limb. Time from diagnosis to treatment was 2 (1.0–4.3) h with interhospital transfer causing delay. Management included conservative (60.2%), open surgery (32.2%), endovascular (4.8%), hybrid (1.4%) and palliative (1.4%). Factors associated with a higher mortality rate at 30 days and 6 months were acute aortic syndrome type, complicated disease, no critical care admission and age more than 70 years (P < 0.05). Conclusions This study presents a longitudinal data set linking time-based delays to diagnosis and treatment with clinical outcomes. It can be used to prioritize research strategies to streamline patient care.

Exploring the mortality and cardiovascular outcomes with SGLT-2 inhibitors in patients with T2DM at dialysis commencement: a health global federated network analysis

BackgroundSodium-glucose cotransporter 2 inhibitors (SGLT-2is) have demonstrated associations with lowering cardiovascular outcomes in patients with type 2 diabetes mellitus (T2DM). However, the impact of SGLT-2is on individuals at dialysis commencement remains unclear. The aim of this real-world study is to study the association between SGLT-2is and outcomes in patients with T2DM at dialysis commencement.MethodsThis is a retrospective cohort study of electronic health records (EHRs) of patients with T2DM from TriNetX Research Network database between January 1, 2012, and January 1, 2024. New-users using intention to treatment design was employed and propensity score matching was utilized to select the cohort. Clinical outcomes included major adverse cardiac events (MACE) and all-cause mortality. Safety outcomes using ICD-10 codes, ketoacidosis, urinary tract infection (UTI) or genital infection, dehydration, bone fracture, below-knee amputation, hypoglycemia, and achieving dialysis-free status at 90 days and 90-day readmission.ResultsOf 49,762 patients with T2DM who initiated dialysis for evaluation, a mere 1.57% of patients utilized SGLT-2is within 3 months after dialysis. 771 SGLT-2i users (age 63.3 ± 12.3 years, male 65.1%) were matched with 771 non-users (age 63.1 ± 12.9 years, male 65.8%). After a median follow-up of 2.0 (IQR 0.3–3.9) years, SGLT-2i users were associated with a lower risk of MACE (adjusted Hazard Ratio [aHR] = 0.52, p value < 0.001), all-cause mortality (aHR = 0.49, p < 0.001). SGLT-2i users were more likely to become dialysis-free 90 days after the index date (aHR = 0.49, p < 0.001). No significant differences were observed in the incidence of ketoacidosis, UTI or genital infection, hypoglycemia, dehydration, bone fractures, below-knee amputations, or 90-day readmissions.ConclusionsOur findings indicated a lower incidence of all-cause mortality and MACE after long-term follow-up, along with a higher likelihood of achieving dialysis-free status at 90 days in SGLT-2i users. Importantly, they underscored the potential cardiovascular protection and safety of SGLT-2is use in T2DM patients at the onset of dialysis.

Designing Rigorous and Efficient Clinical Utility Studies for Early Detection Biomarkers.

Before implementing a biomarker in routine clinical care, it must demonstrate clinical utility by leading to clinical actions that positively affect patient-relevant outcomes. Randomly controlled early detection utility trials, especially those targeting mortality endpoint, are challenging due to their high costs and prolonged duration. Special design considerations are required to determine the clinical utility of early detection assays. This commentary reports on discussions among the National Cancer Institute's Early Detection Research Network investigators, outlining the recommended process for carrying out single-organ biomarker-driven clinical utility studies. We present the early detection utility studies in the context of phased biomarker development. We describe aspects of the studies related to the features of biomarker tests, the clinical context of endpoints, the performance criteria for later phase evaluation, and study size. We discuss novel adaptive design approaches for improving the efficiency and practicality of clinical utility trials. We recommend using multiple strategies, including adopting real-world evidence, emulated trials, and mathematical modeling to circumvent the challenges in conducting early detection utility trials.

Primary care physicians and laypersons' perceptions of multicancer detection clinical trial designs.

The National Cancer Institute Cancer Screening Research Network is launching a pilot study (Vanguard) to determine feasibility of successful completion of a clinical trial of multicancer detection tests. This focus group study reports perceptions of primary care physicians and laypersons of different clinical trial designs and willingness to participate in a multicancer detection clinical trial. We undertook 14 focus groups with 88 laypersons and 6 focus groups with 45 primary care physicians. Participants were shown graphics of clinical trial designs and asked for their reactions. Focus group recordings were transcribed verbatim, and thematic analysis of the transcripts were conducted to identify emergent themes. Primary care physician and layperson participants recognized the importance of conducting clinical trials to determine the clinical utility of multicancer detection tests. Primary care physicians expressed reluctance to participate in trials because of workload burden, and laypersons expressed hesitancy about enrolling in the control group. Primary care physicians and laypersons expressed concern about a study design in which multicancer detection test results would not be returned to the control group (intended effect), but they respectively indicated a willingness to refer patients to, or participate in, a multicancer detection test clinical trial given transparent and clear communication on collection and use of biospecimens and data, particularly if a multicancer detection test would eventually be run and results eventually returned. This study yielded important insights to guide trial design in planning prospective evaluation of multicancer detection testing. Maintaining transparency and trust while possibly withholding multicancer detection test results to maximize trial feasibility and efficiency is of particular concern.

The role of secondary imaging in children aged under 24 months with proven skull fracture on initial computed tomography scan.

To assess the clinical significance of repeated head imaging in children with minor blunt force head trauma who underwent computed tomography (CT), limited to those who exclude with very low risk of important traumatic brain injury. We conducted a retrospective cohort study of children aged under 24 months with minor head trauma who underwent repeated head imaging and initial CT scans according to the Pediatric Emergency Care Applied Research Network (PECARN) rules. We enrolled 741 children and 110 with skull fracture (SF). Of the 96 patients with SF on initial CT who received head magnetic resonance imaging (MRI) a few days later, 36 (37.5%) patients' initial CT findings revealed intracranial injury in addition to SF. The number of children who exhibited new intracranial findings on follow-up MRI among those with isolated SF without intracranial damage and those with SF and intracranial injury on initial CT was 25/60 (40.7%) and 14/36 (38.9%), respectively. Subcutaneous hematoma on arrival and intersection with the coronal suture and lines of fracture were significantly associated with new intracranial findings. Four children with SF and intracranial injury on initial CT received neurosurgical intervention. No intervention was needed for those with isolated SF. We demonstrated that a proportion of children with head trauma had new findings on follow-up MRI, particularly in those without very low risk of clinically important traumatic brain injury. Patients who exhibit new intracranial MRI findings that satisfy the PECARN rules may not require neurosurgical intervention if their initial CT finding is isolated SF.

A 2-stage model of heterogenous treatment effects for brain atrophy in multiple sclerosis utilizing the MS PATHS research network

BackgroundTwo-stage models of heterogenous treatment effects (HTE) may advance personalized medicine in multiple sclerosis (MS). Brain atrophy is a relatively objective outcome measure that has strong relationships to MS prognosis and treatment effects and is enabled by standardized MRI. ObjectivesTo predict brain atrophy outcomes for patients initiating disease-modifying therapies (DMT) with different efficacies, considering the patients’ baseline brain atrophy risk measured via brain parenchymal fraction (BPF). MethodsAnalyses included patients enrolled in the Multiple Sclerosis Partners Advancing Technology and Health Solutions (MS PATHS) network who started DMT and had complete baseline data and ≥ 6-month brain MRI follow-up. All brain MRIs were acquired using standardized acquisition sequences on Siemens 3T scanners. BPF change risk was derived by linear mixed effects models using baseline covariates. Model performance was assessed by predicted versus actual BPF change R2. Propensity score (PS) weighting was used to balance covariates between groups defined by DMT efficacy (high: natalizumab, alemtuzumab, ocrelizumab, and rituximab; moderate: dimethyl fumarate, fingolimod, and cladribine; low: teriflunomide, interferons, and glatiramer acetate). HTE models predicting 1 year change in BPF were built using a weighted linear mixed effects model with low-efficacy DMT as the reference. ResultsAnalyses included 581 high-, 183 moderate-, and 106 low-efficacy DMT-treated patients. The mean and median number of brain MRI observations per treatment period were 2.9 and 3.0, respectively. Risk model performance R2=0.55. After PS weighting, covariate standardized mean differences were <10 %, indicating excellent balance across measured variables. Changes in BPF between baseline and follow-up were found to be statistically significant (p < 0.001), suggesting a pathological change. Patients with low brain atrophy risk had a similar outcome regardless of DMT selection. In patients with high brain atrophy risk, high- and moderate-efficacy DMTs performed similarly, while a 2-fold worse BPF change was predicted for patients selecting low-efficacy DMTs (p < 0.001). Similar results were observed in a sensitivity analysis adjusting for pseudoatrophy effects in a sub-population of patients treated with natalizumab. ConclusionsThe relative benefit of selecting higher efficacy treatments may vary depending on patients’ baseline brain atrophy risk. Poor outcomes are predicted in individuals with high baseline risk who are treated with low-efficacy DMTs.

Incisional hernia after major pancreatic resection: long term risk assessment from two distinct sources – A large multi-institutional network and a single high-volume center

BackgroundPost-operative incisional hernia (IH) is a common complication following abdominal surgery. Data regarding IH after major pancreatic surgery are limited. We aim to evaluate the long-term risk of IH following major pancreatic resection. MethodsA dual-approach study: a large multi-institutional research network (RN) was investigated for IH incidence and risk factors in propensity-score matched survivors after pancreaticoduodenectomy (PD) and distal pancreatectomy (DP), was complemented by a patient-reported questionnaire. ResultsRN analysis identified 22,113 patients that underwent pancreatic surgery. 11.0% of PD patients and 8.6% of DP patients developed IH (P < 0.0001). IH rates were higher with open surgery compared with minimally invasive approaches in PD (OR = 1.56, P = 0.03) and DP (OR = 1.94, P = 0.003). BMI>35 was found to correlate with increased IH rates for PD and DP (OR = 1.87, and OR = 1.86, respectively, P < 0.0001 each), as did postoperative intraabdominal infections (P < 0.0001). Patient-based survey of 104 patients, revealed that 16 patients (15%) reported post-operative IH during the follow-up period. BMI≥30, SSI and intra-abdominal abscesses were associated with increased IH risk (P < 0.05). ConclusionImproved survival after pancreatic resection has led to an increased prevalence of long-term surgical sequela. In this study, we demonstrate significant rates of IH among long-term survivors and assess potential risk factors.

Implementation of a “One Health” territorial network for operational research following the emergence of the West Nile and Usutu arboviruses in New Aquitaine in 2022

Implementation of a “One Health” territorial network for operational research following the emergence of the West Nile and Usutu arboviruses in New Aquitaine in 2022

Integrated planning research of active distribution networks considering electric vehicle integration in the context of dual carbon

Abstract Against the backdrop of the dual carbon strategy, electric vehicles are experiencing rapid growth in popularity due to their environmentally friendly characteristics. However, their load volatility, randomness, and impact also present new challenges to the carrying capacity of the distribution network. Addressing the inadequacies of existing research in tackling these challenges from the perspective of distribution network planning, this paper proposes a method that integrates the optimization planning of distributed energy supply systems, flexible DC systems, and charging piles in the active distribution network by analyzing the spatiotemporal characteristics of electric vehicle charging loads and ensuring the basic charging needs of electric vehicles, utilizing flexible regulation resources such as V2G, flexible DC systems, and energy storage, and comprehensively considering system carrying capacity, green and low-carbon level, and economic factors through the analytic hierarchy process. Typical case studies demonstrate that through this method, the planning system can effectively enhance the carrying capacity of the distribution network, improve the self-consistency of green energy, and reduce the overall life-cycle energy costs in the region during operation.

Exploring Research Trends and Network Characteristics in Blended Learning in Higher Education: Bibliometric Methods and VOSViewer Software Analysis

Exploring Research Trends and Network Characteristics in Blended Learning in Higher Education: Bibliometric Methods and VOSViewer Software Analysis

O13 ASSOCIATION OF SECONDHAND SMOKE EXPOSURE IN RELATION TO HYPERTENSION TREATMENT STATUS WITH STROKE OCCURRENCE IN GHANA AND NIGERIA

Background and objective: It is unclear whether secondhand smoke exposure (SHSE) in hypertensive states with a disproportionate gap in hypertension treatment status is fuelling the epidemic of stroke in sub-Saharan Africa. This study, therefore, assessed the association of SHSE in relation to hypertension treatment status with stroke occurrence among West Africans. Methods: The Stroke Investigative Research and Educational Network (SIREN) is a case-control study across 16 study sites in Ghana and Nigeria. Cases were acute stroke (n =3684) with age- and sex-matched stroke-free controls (n =3684). Hypertension definition was based on standard guidelines, and SHSE was based on self-reported exposure to smoke from a burning cigarette or exhaled from a smoker in any indoor area. We evaluated the associations of untreated hypertension, treated but uncontrolled hypertension, and controlled hypertension at BP of &lt;140/90 mmHg with odds of stroke occurrence. Multivariable-adjusted logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) of the risk of stroke by hypertension treatment and SHSE status. Results: Overall, mean age was 59.0±14.9 years, and 54.2% were male. Among stroke cases, the prevalence of SHSE was 352 (20.7%), and the frequencies of no hypertension, untreated hypertension, treated but uncontrolled hypertension, and controlled hypertension were 4.0%, 47.7%, 37.1%, and 9.2%. The aOR and PAR (95% CI) for untreated hypertension were 6.58 (5.15-8.41) and 35.4% (33.4-37.4); treated but uncontrolled hypertension was 9.95 (7.60-13.02) and 35.9% (34.2-37.5); and controlled hypertension was 5.37 (3.90-7.41) and 8.5% (7.6-9.5) respectively. The aOR (95% CI) of stroke, given exposure to secondhand smoke, was 1.15 (0.94-1.41), while among untreated hypertensives and treated but uncontrolled hypertensives was 1.54 (0.99-2.37) and 1.15 (0.48-1.46) respectively. Conclusion: SHSE with hypertension significantly aggravated the odds of stroke occurrence, particularly when hypertension is untreated. Implementing targeted multi-sectoral interventions that advocate for clean air and aggressive hypertension treatment can potentially reduce the escalating burden of stroke in Africa.

Digital Economy's influence on R&D Network configurations: Integrating resource dependence theory and institutional theory

This study addresses the transformative impacts of the digital economy, which forges connections throughout Research & Development (R&D) networks, prompting leaders of forward-thinking organizations to predict market shifts, guided by the frameworks of institutional theory and resource dependence theory. Institutional theory highlights the pressures, both coercive and normative, arising from the digital economy and regulatory environments, whereas resource dependence theory elucidates the strategic approaches organizations adopt to acquire vital resources and minimize network dependencies. This innovative research investigates how an organization's orientation towards the digital economy affects its role within R&D networks, leveraging insights from both theoretical standpoints. By pinpointing technology transformation and legal environment as key moderators, this study assesses their moderating effects. The analysis utilizes a comprehensive dataset containing 141,118 patents spanning from 1995 to 2018, concentrating on R&D efforts within China's strategic emerging sectors. The outcomes show that an organization's digital economy orientation, shaped by institutional norms and resource interdependencies, positively influences its network centrality but negatively impacts its structural hole position. Additionally, technology transformation and the legal environment, as institutional mechanisms, negatively modulate the relationship between digital economy orientation and network centrality, but positively influence the structural hole relationship. The study concludes with a bibliometric analysis to situate our findings within existing literature and discusses the theoretical and practical implications, rooted in institutional and resource dependence theories.

Bibliometric Networks for Researchers in Health Professions Education.

Bibliometric network analysis is an analytical approach that enables researchers to visualize the relationships between a set of research items (e.g., journal articles, books). There are 3 types of bibliometric network analyses, and multiple tools to conduct the analysis and visualize results (e.g., VOSviewer , 1Gephi2 ). For health professions educators, bibliometric network analysis is valuable for discovering the field's emerging trends, popular topics, and multidisciplinary relationships. 3,4.

P221 ANKLE BRACHIAL INDEX AND ASSOCIATION WITH CHRONIC KIDNEY DISEASE IN THE H3 AFRICA KIDNEY DISEASE RESEARCH NETWORK

Background and Objective: Abnormal ankle brachial index (ABI) is common in patients with chronic kidney disease (CKD). We evaluated the association of ABI, a non-invasive tool to evaluate peripheral arterial disease and arterial stiffness, with CKD among West Africans enrolled in the H3Africa Kidney Disease Research Network (H3AKDRN). Methods: We recruited 9206 participants (5356 with CKD), from Ghana and Nigeria in the H3AKDRN, a multinational case-control study. CKD was defined as estimated glomerular filtration rate of &lt;60 ml/min/1.73m2 and/or albuminuria as albumin/creatinine ratio &gt;3.0 mg/mmol (&gt;30 mg/g) for ≥3months. ABI was divided into low (≤0.9), normal (0.91 – 1.3), and high (&gt;1.3). We assessed low ABI, a marker of peripheral artery disease, and high ABI, the marker of arterial stiffness. We determined association of ABI with CKD by multivariate logistic regression. Results: The mean age of participants was 45.8±15.36 years and 56.3% were males. The prevalence of low ABI was higher in CKD group (32%% versus 16% (control), p=0.013). The prevalence of high ABI was also higher in CKD (15% versus 10.9% (control), p = 0.01). Patients with CKD and low ABI have reduced BMI, low haemoglobin, higher systolic BP and increased albuminuria. Male gender, history of hypertension and diabetes were independently associated with CKD. Higher BMI was associated with reduced odds of CKD (p = &lt; 0.03). After adjustment for covariates, low ABI was associated with CKD, with 26% increased odd (aOR 1.26 (CI, 1.01 – 1.56; p = 0.037)), but high ABI was not associated with CKD (aOR 1.45 (0.88 – 2.38, p = 0.147)). Conclusion: The prevalence of abnormal ankle brachial index is high among adult populations of Ghana and Nigeria, with and without CKD. The Marker of peripheral arterial disease, but not marker of arterial stiffness was associated with CKD. A longitudinal study is required to determine the true relationship between ABI and CKD in West Africa.

The UK resuscitative endovascular balloon occlusion of the aorta in trauma patients with life-threatening torso haemorrhage: the (UK-REBOA) multicentre RCT.

The most common cause of preventable death after injury is haemorrhage. Resuscitative endovascular balloon occlusion of the aorta is intended to provide earlier, temporary haemorrhage control, to facilitate transfer to an operating theatre or interventional radiology suite for definitive haemostasis. To compare standard care plus resuscitative endovascular balloon occlusion of the aorta versus standard care in patients with exsanguinating haemorrhage in the emergency department. Pragmatic, multicentre, Bayesian, group-sequential, registry-enabled, open-label, parallel-group randomised controlled trial to determine the clinical and cost-effectiveness of standard care plus resuscitative endovascular balloon occlusion of the aorta, compared to standard care alone. United Kingdom Major Trauma Centres. Trauma patients aged 16 years or older with confirmed or suspected life-threatening torso haemorrhage deemed amenable to adjunctive treatment with resuscitative endovascular balloon occlusion of the aorta. Participants were randomly assigned 1 : 1 to: standard care, as expected in a major trauma centre standard care plus resuscitative endovascular balloon occlusion of the aorta. Primary: Mortality at 90 days. Secondary: Mortality at 6 months, while in hospital, and within 24, 6 and 3 hours; need for haemorrhage control procedures, time to commencement of haemorrhage procedure, complications, length of stay (hospital and intensive care unit-free days), blood product use. Health economic: Expected United Kingdom National Health Service perspective costs, life-years and quality-adjusted life-years, modelled over a lifetime horizon. Case report forms, Trauma Audit and Research Network registry, NHS Digital (Hospital Episode Statistics and Office of National Statistics data). Ninety patients were enrolled: 46 were randomised to standard care plus resuscitative endovascular balloon occlusion of the aorta and 44 to standard care. Mortality at 90 days was higher in the standard care plus resuscitative endovascular balloon occlusion of the aorta group (54%) compared to the standard care group (42%). The odds ratio was 1.58 (95% credible interval 0.72 to 3.52). The posterior probability of an odds ratio > 1 (indicating increased odds of death with resuscitative endovascular balloon occlusion of the aorta) was 86.9%. The overall effect did not change when an enthusiastic prior was used or when the estimate was adjusted for baseline characteristics. For the secondary outcomes (3, 6 and 24 hours mortality), the posterior probability that standard care plus resuscitative endovascular balloon occlusion of the aorta was harmful was higher than for the primary outcome. Additional analyses to account for intercurrent events did not change the direction of the estimate for mortality at any time point. Death due to haemorrhage was more common in the standard care plus resuscitative endovascular balloon occlusion of the aorta group than in the standard care group. There were no serious adverse device effects. Resuscitative endovascular balloon occlusion of the aorta is less costly (probability 99%), due to the competing mortality risk but also substantially less effective in terms of lifetime quality-adjusted life-years (probability 91%). The size of the study reflects the relative infrequency of exsanguinating traumatic haemorrhage in the United Kingdom. There were some baseline imbalances between groups, but adjusted analyses had little effect on the estimates. This is the first randomised trial of the addition of resuscitative endovascular balloon occlusion of the aorta to standard care in the management of exsanguinating haemorrhage. All the analyses suggest that a strategy of standard care plus resuscitative endovascular balloon occlusion of the aorta is potentially harmful. The role (if any) of resuscitative endovascular balloon occlusion of the aorta in the pre-hospital setting remains unclear. Further research to clarify its potential (or not) may be required. This trial is registered as ISRCTN16184981. This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 14/199/09) and is published in full in Health Technology Assessment; Vol. 28, No. 54. See the NIHR Funding and Awards website for further award information.

Lessons from the pandemic: An innovative scheme to support research in the North West Coast

In 2021, a Clinical Research Fellow (CRF) scheme was created to serve the North West Coast (NWC) region in line with the key health priorities set out by the Clinical Research Network. Five doctors in pre-specialist training were placed in NHS trust research departments across the NWC. The scheme aimed to provide early career research experience while also enhancing the provision of research across the region. The CRFs were involved in writing clinical trial grant applications and study protocols, with the scheme providing additional experience in leadership roles and time management. In addition, the CRF scheme has had a positive impact in adopted NHS trusts, which have seen their overall research capacity and capability improve, through increased flexibility and medical oversight. Research departments have benefited from increased financial income and improved national reputations. Overall, this real-world experience provided a vital ‘foot in the door’, which is essential for research-interested medics to advance in a future academic career. In the wider NWC region, the CRF scheme successfully delivered achievable and financially sustainable research. Innovative programmes such as this one should be seen as a viable option for research provision through the NHS, in the UK.

Prevalence and spectrum of germline pathogenic variants in cancer susceptibility genes among mexican patients with exocrine pancreatic cancer

BackgroundAlthough universal germline genetic testing is recommended for patients with exocrine pancreatic cancer (PC), access to genetic testing remains limited in low- and middle-income countries. This study aims to narrow the gap in our understanding of the spectrum of germline pathogenic and likely pathogenic variants (PVs) in cancer susceptibility genes in the Mexican population. MethodsThe landscape of PVs in cancer susceptibility genes was identified by next-generation sequencing multigene panel assays among patients with PC who were enrolled in the Clinical Cancer Genomics Community Research Network prospective registry in Mexico City. ResultsFrom August 2019 to April 2023, 137 patients underwent genetic testing. The median age at diagnosis was 60 years (range 36–85), 58.4 % were women, and 38.7 % were metastatic at diagnosis. The frequency of germline PVs was 16 % (n = 22): ATM 36.4 % (n = 8), CDKN2A/p16INK4A 27.3 % (n = 6), BRCA2 9.1 % (n = 2), PALB2 9.1 % (n = 2), CHEK2 9.1 % (n = 2), TP53 4.5 % (n = 1), and NF1 4.5 % (n = 1). Additionally, 2 carriers of monoallelic germline variants in MUTYH were identified. No significant differences were observed between carriers and non-carriers in terms of family history of pancreatic cancer. ConclusionsWe identified a significant frequency of actionable germline PVs in Mexicans with PC, wherein the majority were in a broad spectrum of genes associated with the homologous recombination DNA repair mechanism. Most pancreatic cancer associated PVs were detected in non-BRCA genes, so our findings support the recommendation of multigene panel testing for genetic cancer risk assessment of Mexican individuals with PC.

A dataset of soil organic carbon density of typical ecosystems in the arid areas of Northwest China from 2005 to 2020

The soil organic carbon pool is the largest and most active part of the terrestrial ecosystem carbon pool, and plays an important role in the global carbon cycle and global climate change. The arid region of northwest China is located in the hinterland of Eurasia, with extremely fragile ecosystems and extremely sensitive responses to climate change. It is a hot area that many scholars have paid attention to in recent years, and the estimation and spatial distribution characteristics of soil organic carbon storage have increasingly become one of the research focuses in this region. However, insufficient data sharing and the relative lack of measured data are important factors causing the uncertainty of the research results. Based on the long-term soil observation data collected from the ecological field stations of China Ecosystem Research Network (CERN) located in five provinces and regions of northwest China, the soil organic carbon density dataset of typical ecosystems in the arid region of Northwest China was calculated by organic carbon estimation model. This dataset contains the soil organic carbon density data of topsoil (0-20 cm) and soil profile of various long-term observation plots at 11 ecological field stations from 2005 to 2020, in order to provide valuable measured data for the estimation of soil carbon storage and the study of carbon cycle process in the arid area of northwest China.

Differences in Somatosensory Function Related to Hand Dominance: Results of a Quantitative Sensory Testing Study in Healthy Volunteers.

Quantitative sensory testing commonly utilizes the unaffected, contralateral side as a control to detect somatosensory dysfunction. There is scant evidence that somatosensory function for the volar dominant and non-dominant hands is equivalent, therefore intra-patient comparisons are unwarranted. This study aimed to identify dominance-related differences in palmar hand somatosensation, thereby determining if the unaffected contralateral hand is a valid comparator in clinical populations. With ethical approval (IREC_13_1_10) and informed consent, 110 healthy adult volunteers' participated in this clinical measurement study. Somatosensory function was assessed with the German Research Network on Neuropathic Pain (DFNS) quantitative sensory testing (QST) protocol. Half of the participants were tested on the dominant hand. Thirteen parameters of thermal and mechanical detection and pain threshold were evaluated at both the dorsal and volar hand (distal middle finger). Tests were performed in the same order and instructions were read from a standardized script. Results for dorsal hand tests were compared to DFNS normative data to confirm participants met study inclusion criteria. Between-group differences for age and sex were investigated with the independent samples t-test and Chi-square test of independence, respectively. Group differences for dominant and non-dominant hands for all 13 continuous QST parameters were investigated with the Mann-Whitney U-test. Data for 106 participants were included in statistical analysis. Fifty percent of participants were tested on the dominant hand [n=53]; there were no differences for age or sex between groups (dominant or non-dominant hand test group). The dominant volar hand was significantly more sensitive to vibration detection threshold than the non-dominant hand (P=0.001). There were no significant differences related to dominance for other DFNS QST measures. For quantitative sensory testing with the DFNS protocol in healthy cohorts, the contralateral, unaffected hand is a valid control, with the exception of vibration detection threshold.

Relationship Between Janus Kinase Inhibitor Use and Development of Retinal Vein Occlusion

Background and Objective: Janus kinase (Jak) inhibitors may have increased risk of thromboembolism compared to tumor necrosis factor (TNF) inhibitors. This study investigates the association between Jak inhibitor use and retinal vein occlusion. Patients and Methods: This retrospective, non-randomized cohort study used a federated health research network. Propensity-score matched risk ratios with 95% CI were calculated for central and branch retinal vein occlusion (CRVO, BRVO) in patients with immune-mediated inflammatory diseases (IMIDs) treated with Jak inhibitors versus TNF inhibitors. Results: Jak and TNF inhibitor cohorts each had 5,249 patients. Risk ratio for CRVO with Jak inhibitors ( n = 11) versus TNF inhibitors ( n = 18) was 0.61 [CI (0.29,1.29)]. Risk ratio for BRVO with Jak inhibitors ( n = 17) compared to TNF inhibitors ( n = 19) was 0.89 [CI (0.47,1.72)]. Conclusion: This study did not find evidence of increased risk of RVO with the use of Jak inhibitors compared to TNF inhibitors among patients with IMIDs, contributing to literature on Jak inhibitor safety. [ Ophthalmic Surg Lasers Imaging Retina 2024;55:xx–xx.]