Number Of References Research Articles

P045 Google Internet Searches Related to Inflammatory Arthritis: an Observational Study Using Google Trends Data

Abstract Background/Aims Inflammatory arthritis (IA) care involves a paradox. Rheumatologists focus on reducing disease activity through treat-to-target (T2T). But surveys/qualitative studies show patients’ main concern is pain. As these studies include a minority of patients, their findings may not be generalisable. The internet has transformed how patients access health information. Examining search engine data provides an alternative method to understand the health areas of most importance to people with IA. We examined publicly available Google search engine data, to determine the relative popularity of searches for different aspects of health made in conjunction with IA. Methods We used Google Trends data from 2011-2022 to determine the relative popularity of searches for “patient symptom” (pain; work; stiffness; fatigue; mood) and “T2T” (DMARDs; inflammation; synovitis; corticosteroids) domains made with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) in the UK/USA. Google Trends normalises a sample of search data by popularity over time and region, presenting it on a 0-100 scale at each time-point (100 represents the time-point with most searches). It allows comparisons of up to five search term combinations. We evaluated >100 search term combinations to ascertain the most popular “patient symptom” and “T2T” domains (comparing mean normalised scores across time-points). Results Patient Symptom Domains: in all IA forms in the UK/USA, pain was the most popular term. Its popularity increased over time. UK searches for pain gave mean scores of 58, 34, and 39 with RA, PsA, and AS. UK searches for other patient symptom domains gave mean scores ranging 2-7 with RA; no scores were generated with PsA/AS. In the USA, pain gave mean scores of 79, 51, and 63 with RA, PsA, and AS, compared to scores ranging 2-6 for other domains. T2T Domains: methotrexate was the most popular search term with RA and PsA in the UK (mean 28 and 21) and USA (mean 63 and 33); it was only slightly more popular than searches for synovitis and inflammation. For AS, in the UK and USA inflammation was most popular (mean 9 and 34). Most Popular Patient Symptom vs Most Popular T2T Domain: for RA, PsA, and AS, pain was substantially more popular in the UK (mean 58, 30, 52) and USA (mean 79, 54, 63) than methotrexate in RA and PsA in the UK (mean 16 and 14) and USA (mean 15 and 11) and inflammation in AS in the UK (mean 6) and USA (mean 8). Conclusion Pain is the most popular search term used with IA in Google searches in the UK/USA, supporting surveys/qualitative studies showing pain is the health aspect of most importance to people with IA. Routine pain assessments should be embedded within T2T strategies to ensure patient perspectives are considered. Disclosure M. Akthar: Grants/research support; ‘M.A. previously received funding by the National Institute for Health and Care Research (NIHR Academic Clinical Fellowship in Rheumatology)., The views expressed are those of the author and not necessarily those of the NIHR, NHS or the Department of Health and Social Care.’. K.J. Mason: Grants/research support; ‘K.J.M. is funded by the National Institute for Health and Care Research (NIHR; Grant Reference Number NIHR203281)., The views expressed are those of the author and not necessarily those of the NIHR, NHS, or the Department of Health and Social Care.’. I.C. Scott: Grants/research support; ‘I.C.S. is funded by the National Institute for Health and Care Research (NIHR Advanced Research Fellowship, NIHR300826)., The views expressed are those of the author and not necessarily those of the NIHR, NHS, or the Department of Health and Social Care.’

Effects of repetitive transcranial magnetic stimulation on fear of cancer recurrence and its underlying neuromechanism

IntroductionMany breast cancer patients suffer from fear of cancer recurrence (FCR). However, effective physical intervention for FCR has been scarce. Previous studies have confirmed that repetitive transcranial magnetic stimulation (rTMS) can help improve patients' anxiety, depression, fear, and stress level. Therefore, this study aims to assess the efficacy of rTMS in the treatment of FCR in breast cancer patients and explore its underlying neural mechanism. Methods and analysisand analysis: Fifty breast cancer patients with high FCR (FCR total score >27), and fifty age- and gender-matched patients with low FCR (FCR total score <7) will be recruited to participate in this study. Patients in the high FCR group will be randomly assigned to receive 4-week low-frequency rTMS targeting the right dorsolateral prefrontal cortex (rDLPFC) + treatment as usual (TAU) (n = 25), or to receive sham stimulation + TAU (n = 25). Patients in the low FCR group will only receive TAU. All participants will take a baseline fMRI scan to examine the local activities and interactions of brain activity between the prefrontal cortex (DLPFC), amygdala and hippocampus. Fear of Cancer Recurrence Questionnaire (FCRQ7), Patient Health Questionnaire (PHQ9), Generalize Anxiety Disorder (GAD7), Numeric Rating Scale (NRS), and Insomnia Severity Index (ISI7) will be used to measure an individual's FCR, depression, anxiety, pain, and insomnia symptoms at week 0 (baseline), week 4 (the end of intervention), week 5 (1 week post-treatment), week 8 (1 month post-treatment), and week 16 (3 months post-treatment). Participants in the high FCR group will receive a post-treatment fMRI scan within 24 h after intervention to explore the neural mechanisms of rTMS treatment. The primary outcome of the study, whether the rTMS intervention is sufficient in relieving FCR in breast cancer patients, is measured by FCRQ7. Additionally, task activation, local activity and functional connectivity of the DLPFC, amygdala and hippocampus will be compared, between high and low FCR group, and before and after treatment. DiscussionStudies have shown that low-frequency rTMS can be used to treat patient's FCR. However, there is a lack of relevant evidence to support the efficacy of rTMS on FCR in cancer patients, and the neural mechanisms underlying the effects of rTMS on FCR need to be further investigated. Ethics and disseminationEthical approval for the study has been obtained from the Ethics Committee of Guangdong Provincial People's Hospital (reference number: KY-N-2022-136-01). The results of the investigation will be published in scientific papers. The data from the investigation will be made available online if necessary. Trial registrationNCT05881889 (ClinicalTrials.gov). Date of registration: May 31, 2023.

Efficacy of a Tailored COMET Protocol Combined with Medication on Vibratory Perception and SkinConductance in Diabetic Neuropathy- A Protocol for Randomized Controlled Trial

This research attempts to evaluate the effectiveness of a customized COMET protocol in conjunction with medicine for the treatment of diabetic neuropathy, with vibratory perception and skin conductance being the main focus. Participants will be allocated to either the intervention group, which will get the customized COMET protocol and medicine, or the control group, which will receive standard medication alone, in a randomized controlled trial. Validated measurement instruments will be used in the trial to evaluate variations in skin conductance and vibratory perception both at baseline and during the course of the investigation. Strict adherence to ethical rules will guarantee the safety and well-being of participants. This study intends to provide important insights into the holistic management of diabetic neuropathy by examining the effects of the customized COMET protocol in conjunction with medication on vibratory perception and skin conductance. This could result in better treatment plans and an improvement in the quality of life for those who are affected. CTRI Reference Number CTRI/2023/07/055366,https://ctri.nic.in/Clinicaltrials/rmaindet.php?trialid=89691&amp;EncHid=88073.73654&amp;modid=1&amp;compid=19,20/07/2023

Prospective with historical control, case-matched cohort study of the tertiary survey beneficial in critically severe trauma patients

Background The tertiary survey is an evaluation process conducted after the primary and secondary surveys. It aims to identify missed injuries. This research aims to study the benefits of tertiary surveys in severely traumatized patients. Methods This prospective with historical control, case-matched cohort was conducted on critically-ill trauma patients who were admitted to the surgical intensive care unit (SICU) of Thammasat University Hospital. The study compared the period before and after the implementation of the tertiary survey. Tertiary survey record form was used in all severely traumatized patients with Injury Severity Score (ISS) &gt; 15 within the first 24 hours and before discharge from SICU between August 2022 and February 2023. The comparison data were retrieved from electronic medical records of patients admitted to SICU with ISS &gt; 15 between April 2020 and July 2022. Results We identified 55 type II missed injuries in 39 of 100 cases prior to implementation and 1 type II missed injury after implementation. Type II missed injury decreased from 31% to 4%, and the missed injury detection rate was 56% after implementing the tertiary survey. However, there is no statistically significant difference in morbidity and mortality rates from missed injuries before and after implementation. Conclusions Using tertiary surveys can reduce missed injury rates and increase missed injury detection rates. This research highlights the importance of implementing tertiary surveys as a routine part of trauma evaluation to improve patient care. However, there is no effect on the outcomes, which may require more sample size. Clinical Trials Registry (reference number TCTR20230625001).

Assessment of body composition in breast cancer patients: concordance between transverse computed tomography analysis at the fourth thoracic and third lumbar vertebrae.

Specific body composition markers derived from L3 axial computed tomography (CT) images predict clinical cancer outcomes, including chemotherapy toxicity and survival. However, this method is only applicable to those undergoing lumbar (L3) CT scanning, which is not universally conducted in early breast cancer cases. This study aimed to evaluate CT analysis at T4 as a feasible alternative marker of body composition in breast cancer. All patients participated in the Investigating Outcomes from Breast Cancer: Correlating Genetic, Immunological, and Nutritional (BeGIN) Predictors observational cohort study (REC reference number: 14/EE/1297). Staging chest-abdomen-pelvic CT scan images from 24 women diagnosed with early breast cancer at University Hospital Southampton were analysed. Adipose tissue, skeletal muscle, and muscle attenuation were measured from the transverse CT slices' cross-sectional area (CSA) at T4 and L3. Adipose tissue and skeletal muscle area measurements were adjusted for height. Spearman's rank correlation coefficient analysis was used to determine concordance between body composition measurements using CT analysis at L3 and T4 regions. Derived estimates for total adipose tissue, subcutaneous adipose tissue, and intramuscular adipose tissue mass following adjustment for height were highly concordant when determined from CSAs of CT slices at T4 and L3 (Rs = 0.821, p < 0.001; Rs = 0.816, p < 0.001; and Rs = 0.830, p < 0.001). In this cohort, visceral adipose tissue (VAT) and skeletal muscle estimates following height adjustment were less concordant when measured by CT at T4 and L3 (Rs = 0.477, p = 0.039 and Rs = 0.578, p = 0.003). The assessment of muscle attenuation was also highly concordant when measured by CT at T4 and L3 (Rs = 0.840, p < 0.001). These results suggest that the CT analysis at T4 and L3 provides highly concordant markers for total adipose, subcutaneous adipose, and intramuscular adipose estimation, but not VAT, in this breast cancer population. High concordance between T4 and L3 was also found when assessing skeletal muscle attenuation. Lower concordance was observed for the estimates of skeletal muscle area, potentially explained by differences in the quantity and proportions of axial and appendicular muscle between the thorax and abdomen. Future studies will determine the value of T4 metrics as predictive tools for clinical outcomes in breast cancer.

Protocol for a Randomized Controlled Trial to Evaluate a Permissive Blood Pressure Target Versus Usual Care in Critically Ill Children with Hypotension (PRESSURE).

Management of hypotension is a fundamental part of pediatric critical care, with cardiovascular support in the form of fluids or vasoactive drugs offered to every hypotensive child. However, optimal blood pressure (BP) targets are unknown. The PRotocolised Evaluation of PermiSSive BP Targets Versus Usual CaRE (PRESSURE) trial aims to evaluate the clinical and cost-effectiveness of a permissive mean arterial pressure (MAP) target of greater than a fifth centile for age compared with usual care. Pragmatic, open, multicenter, parallel-group randomized control trial (RCT) with integrated economic evaluation. Eighteen PICUs across the United Kingdom. Infants and children older than 37 weeks corrected gestational age to 16 years accepted to a participating PICU, on mechanical ventilation and receiving vasoactive drugs for hypotension. Adjustment of hemodynamic support to achieve a permissive MAP target greater than fifth centile for age during invasive mechanical ventilation. Randomization is 1:1 to a permissive MAP target or usual care, stratified by site and age group. Due to the emergency nature of the treatment, approaching patients for written informed consent will be deferred until after randomization. The primary clinical outcome is a composite of death and days of ventilatory support at 30 days. Baseline demographics and clinical status will be recorded as well as daily measures of BP and organ support, and discharge outcomes. This RCT received Health Research Authority approval (reference 289545), and a favorable ethical opinion from the East of England-Cambridge South Research Ethics Committee on May 10, 2021 (reference number 21/EE/0084). The trial is registered and has an International Standard RCT Number (reference 20609635). Trial findings will be disseminated in U.K. national and international conferences and in peer-reviewed journals.

Beta-blockers or Placebo for Primary Prophylaxis (BOPPP) of oesophageal varices: study protocol for a randomised controlled trial

BackgroundLiver disease is within the top five causes of premature death in adults. Deaths caused by complications of cirrhosis continue to rise, whilst deaths related to other non-liver disease areas are declining. Portal hypertension is the primary sequelae of cirrhosis and is associated with the development of variceal haemorrhage, ascites, hepatic encephalopathy and infection, collectively termed hepatic decompensation, which leads to hospitalisation and mortality. It remains uncertain whether administering a non-selective beta-blocker (NSBB), specifically carvedilol, at an earlier stage, i.e. when oesophageal varices are small, can prevent VH and reduce all-cause decompensation (ACD).Methods/designThe BOPPP trial is a pragmatic, multicentre, placebo-controlled, triple-blinded, randomised controlled trial (RCT) in England, Scotland, Wales and Northern Ireland. Patients aged 18 years or older with cirrhosis and small oesophageal varices that have never bled will be recruited, subject to exclusion criteria. The trial aims to enrol 740 patients across 55 hospitals in the UK. Patients are allocated randomly on a 1:1 ratio to receive either carvedilol 6.25 mg (a NSBB) or a matched placebo, once or twice daily, for 36 months, to attain adequate power to determine the effectiveness of carvedilol in preventing or reducing ACD.The primary outcome is the time to first decompensating event. It is a composite primary outcome made up of variceal haemorrhage (VH, new or worsening ascites, new or worsening hepatic encephalopathy (HE), spontaneous bacterial peritonitis (SBP), hepatorenal syndrome, an increase in Child–Pugh grade by 1 grade or MELD score by 5 points, and liver-related mortality. Secondary outcomes include progression to medium or large oesophageal varices, development of gastric, duodenal, or ectopic varices, participant quality of life, healthcare costs and transplant-free survival.DiscussionThe BOPPP trial aims to investigate the clinical and cost-effectiveness of carvedilol in patients with cirrhosis and small oesophageal varices to determine whether this non-selective beta-blocker can prevent or reduce hepatic decompensation. There is clinical equipoise on whether intervening in cirrhosis, at an earlier stage of portal hypertension, with NSBB therapy is beneficial. Should the trial yield a positive result, we anticipate that the administration and use of carvedilol will become widespread with pathways developed to standardise the administration of the medication in primary care.Ethics and disseminationThe trial has been approved by the National Health Service (NHS) Research Ethics Committee (REC) (reference number: 19/YH/0015). The results of the trial will be submitted for publication in a peer-reviewed scientific journal. Participants will be informed of the results via the BOPPP website (www.boppp-trial.org) and partners in the British Liver Trust (BLT) organisation.Trial registrationEUDRACT reference number: 2018–002509-78.ISRCTN reference number: ISRCTN10324656. Registered on April 24 2019.

Objective Evaluation of Gaze Location Patterns Using Eye Tracking During Cystoscopy and Artificial Intelligence-Assisted Lesion Detection.

Background: The diagnostic accuracy of cystoscopy varies according to the knowledge and experience of the performing physician. In this study, we evaluated the difference in cystoscopic gaze location patterns between medical students and urologists and assessed the differences in their eye movements when simultaneously observing conventional cystoscopic images and images with lesions detected by artificial intelligence (AI). Methodology: Eye-tracking measurements were performed, and observation patterns of participants (24 medical students and 10 urologists) viewing images from routine cystoscopic videos were analyzed. The cystoscopic video was captured preoperatively in a case of initial-onset noninvasive bladder cancer with three low-lying papillary tumors in the posterior, anterior, and neck areas (urothelial carcinoma, high grade, and pTa). The viewpoint coordinates and stop times during observation were obtained using a noncontact type of gaze tracking and gaze measurement system for screen-based gaze tracking. In addition, observation patterns of medical students and urologists during parallel observation of conventional cystoscopic videos and AI-assisted lesion detection videos were compared. Results: Compared with medical students, urologists exhibited a significantly higher degree of stationary gaze entropy when viewing cystoscopic images (p < 0.05), suggesting that urologists with expertise in identifying lesions efficiently observed a broader range of bladder mucosal surfaces on the screen, presumably with the conscious intent of identifying pathologic changes. When the participants observed conventional and AI-assisted lesion detection images side by side, contrary to urologists, medical students showed a higher proportion of attention directed toward AI-detected lesion images. Conclusion: Eye-tracking measurements during cystoscopic image assessment revealed that experienced specialists efficiently observed a wide range of video screens during cystoscopy. In addition, this study revealed how lesion images detected by AI are viewed. Observation patterns of observers' gaze may have implications for assessing and improving proficiency and serving educational purposes. To the best of our knowledge, this is the first study to utilize eye tracking in cystoscopy. University of Tsukuba Hospital, clinical research reference number R02-122.

Using Odih-Score (Modified Klotz Score) for quality of defecation after anorectal malformation following posterior sagittal anorectoplasty (PSARP): Study of validation

Abstract* Objective The diagnostic scale or score is a clinical assessment tool used to determine diagnosis and evaluate further therapy results. The Klotz Score is a previous score modified to create a new instrument, the Odih-score. This new instrument is specifically designed to evaluate the quality of defecation success after operative anorectal malformation and is expected to be simpler and easier to apply in research hospitals. Its primary use is to evaluate the quality of defecation in post-PSARP anorectal malformation patients. Method The study conducted between 2016 and 2021, a longitudinal prospective study was conducted at RSUD Arifin Achmad Pekanbaru Riau Indonesia. The study aimed to validate the reliability of the Odih-Score (Modified Klotz Score) research instrument for evaluating defecation quality in post-PSARP anorectal malformation patients. Pearson validation test and Cronbach alpha reliability test were used as parameters for the validation, while the sensitivity and specificity of diagnostic tests were evaluated using research instrument (IBM SPSS Statistics version 25) The research was approved by the Ethical Clearance Board of the Faculty of Medicine, University of Riau, under reference number No.031/UN.19.5.1.1.8/UEPKK/2019. Results The analysis of the validation test results indicates that the Odih-Score is statistically significant (Sig.&lt;0.05) and has a greater r-count value (0.573-0.790) than the r-table value (0.202). The research reliability test also shows a high level of reliability (Cronbach alpha 0.814) for all five items of the Odih-Score instrument. Further, the sensitivity and specificity test as a diagnostic test resulted in an AUC value of 0.798, with an Odih-Score cut-off point of 11. Conclusion Odih-Score (Modified Klotz’s score) is considered valid and reliable and can be used as a diagnostic test instrument to evaluate the quality of post-anorectal Malformation defecation with PSARP.

Appreciation for Agriculture in Public Communication. A Content Analysis of the Influence of the First Lockdown on Reporting About Agriculture in the Mass Media

The call for greater societal appreciation of agriculture has been a recurring theme in recent years, both within and outside the sector. The following article examines the extent to which social value communication can be found in media articles compared to other evaluative statements about agriculture and the effects that occurred at the beginning of the Coronavirus crisis. Using quantitative analysis and based on a theoretical concept of recognition, statements of social esteem and disrespect are collected and contrasted with acceptable and critical statements in issues of the mainstream, regional and farming press in 2019 and 2020 and evaluated in terms of their authorship and references to agricultural issues. In this context, it can be shown that even before the Coronavirus crisis, the level of social esteem accorded to agriculture in public communication was higher than the level of disrespect. It then increased during the first pandemic lockdown, combined with a significantly higher number of references to the issue of security of supply. At the same time, it is clear that the type of statement most often published in the media is not a direct expression of social esteem or disrespect, but rather a perception of disrespect for agriculture. The sources of these statements most often come from the agricultural sector itself.

Predictive value of a novel digital risk calculator to determine early patient outcomes after major surgery: a proof-of-concept pilot study

BackgroundA structured risk assessment of patients with validated and evidence-based tools can help to identify modifiable factors before major surgeries. The Protego Maxima trial investigated the value of a new digitized risk assessment tool that combines tools which can be easily used and implemented in the clinical workflow by doctors and qualified medical staff. The hypothesis was that the structured assessment and risk-grouping is predictive of short-term surgical quality reflected by complications and overall survival.MethodsThe Protego Maxima Trial was a prospective cohort analysis of patients undergoing major surgery (visceral, thoracic, urology, vascular and gynecologic surgeries) as key inclusion criterion and the absence of an acute or acute on chronically decompensated pulmo-cardiovascular decompensation. Patients were risk-scored with the software (The Prehab App) that includes a battery of evidence-based risk assessment tools that allow a structured risk assessment. The data were grouped to predefined high and low risk groups and aggregate and individual scores. The primary outcome was to validate the predictive value of the RAI score and the TUG for overall survival in the high and low risk groups. Secondary outcomes were surgical outcomes at 90-days after surgery (overall survival, Clavien-Dindo (CD) 1–5 (all complications), and CD 3–5 (major complications)). The study was carried out in accordance with the DIN ISO 14,155, and the medical device regulation (MDR) at Frankfurt University Hospital between March 2022 and January 2023.ResultsIn total 267 patients were included in the intention to treat analysis. The mean age was 62.1 ± 12.4 years. Patients with a RAI score > 25 and/or a timed up and go (TUG) > 8 s had a higher risk for mortality at 90 days after surgery. The low-risk group predicted beneficial outcome and the high-risk group predicted adverse outcome in the ROC analysis (Area Under the Curve Receiver Operator Characteristics: AUROC > 0.800; p = 0.01). Risk groups (high vs. low) showed significant differences for 90-day survival (99.4% vs. 95.5%; p = 0.04) and major complications (16.4% vs. 32.4%; p < 0.001).ConclusionThe proof-of-concept trial showed that a risk assessment with ‘The Prehab App’ may be viable to estimate the preoperative risk for mortality and major complications before major surgeries. The overall performance in this initial set of data indicated a certain reliability of the scoring and risk grouping, especially of the RAI score and the TUG. A larger data set will be required to proof the generalizability of the risk scoring to every subgroup and may be fostered by artificial intelligence approaches.Trial registrationEthics number: 2021-483-MDR/MPDG-zuständig monocentric; The Federal Institute for Pharmaceuticals and Medical Devices/BfArM, reference number: 94.1.04-5660-13655; Eudamed: CIV-21-07-0307311; German Clinical Trial Registry: DRKS 00026985.

The Relevance of Marketing in Sports Betting Perceptions and Behaviors Across Different age Groups.

Sports betting and its associated problems are increasing rapidly. Moreover, it has been widely advertised and marketed, successfully reaching young adult males. This work aims to review recent publications regarding the relationship between marketing and sports betting perceptions and behaviors across different ages. For this purpose, a search in the PubMed database was set for 5 years (November 2014 - November 2019). The search terms included: "Sports betting AND children", "Sports betting AND young adult", "Sports betting AND adult". The search generated 131 articles, including some duplications. Once duplicates were eliminated, the titles and abstract analysis led to 21 references. To this, four more recent references were added to complement the introduction and discussion sections. The total number of references is 25. The inclusion criteria were as follows: (a) human study, (b) quantitative, experimental, clinical study, or review, (c) emphasis on the relationship between marketing and sports betting perceptions and behaviors, (d) specified number of subjects, (e) male or female gender, and (f) written in English (title and abstract). The findings indicated that: (1) marketing plays a significant role in normalizing gambling in sports, (2) policymakers should consider comprehensive approaches to reduce the exposure of sports betting advertising to young individuals, and (3) future studies should explore potential differences in results based on gender and developmental stage. For instance, sports betting is more prevalent among males than females, and younger children tend to be more impulsive than older children.

Determining households from patient addresses and unique property reference numbers in general practitioner electronic health records

IntroductionHouseholds are increasingly studied in population health research as an important context for understanding health and social behaviours and outcomes. Identifying household units of analysis in routinely collected data rather than traditional surveys requires innovative and standardised tools, which do not currently exist. ObjectivesTo design a utility that identifies households at a point in time from pseudonymised Unique Property Reference Numbers (UPRNs) known as Residential Anonymised Linkage Fields (RALFs) assigned to general practitioner (GP) patient addresses in electronic health records (EHRs) in north east London (NEL). MethodsRule-based logic was developed to identify households based on GP registration, address date, and RALF validity. The logic was tested on a use case on the household clustering of childhood weight status, and bias in success of identifying households was examined in the use case cohort and in a full population cohort. Results92.1% of the use case cohort was assigned a household. The most frequent dominant reason (55.3%) for a household not assigned was that a person had no valid household RALFs available across their patient registration address records. Other reasons are having none or multiple valid household RALFs, or not being alive at the event date. In the use case, children not assigned to a household were more likely to attend schools in City &amp; Hackney and living in the third most deprived quintile of lower super output areas. 88.9% of the population cohort was assigned a household. Patients not assigned to a household were more likely to be aged 18 to 45 years, living in City &amp; Hackney, and living in the second quintile of most deprived lower super output areas. ConclusionsWe have developed a method for deriving households from primary care EHRs that can be implemented quickly and in real-time, providing timely data to support population health research on households.

Enhanced performance prediction of ATL model transformations

Model transformation languages are domain-specific languages used to define transformations of models. These transformations consist of the translation from one modeling formalism into another or just the updating of a given model. Such transformations are often described declaratively and are often implemented based on very small models that cover the language of the input model. As a result, transformation developers are often unable to assess the time required to transform a larger model.Hence, we propose a prediction approach based on machine learning which uses a set of model characteristics as input and provides a prediction of the execution time of a transformation defined in the Atlas Transformation Language (ATL). In our previous work (Groner et al., 2023), we already showed that support vector regression in combination with a model characterization based on the number of model elements, the number of references, and the number of attributes is the best choice in terms of usability and prediction accuracy for the transformations considered in our experiments.A major weakness of our previous approach is that it fails to predict the performance of transformations that also transform attribute values of arbitrary length, such as string values. Therefore, we investigate in this work whether an extension of our feature sets that describes the average size of string attributes can help to overcome this weakness.Our results show that the random forest approach in combination with model characterizations based on the number of model elements, the number of references, the number of attributes, and the average size of string attributes filtered by the 85th percentile of their variance is the best choice in terms of the simple way to describe a model and the quality of the obtained prediction. With this combination, we obtained a mean absolute percentage error (MAPE) of 5.07% over all modules and a MAPE of 4.82% over all modules excluding the transformation for which our previous approach failed. Whereas, we obtained previously a MAPE of 38.48% over all modules and a MAPE of 4.45% over all modules excluding the transformation for which our previous approach failed.

Comparison of intra-articular platelet-rich plasma injection versus placebo for clinical outcomes in patients with knee osteoarthritis; a double-blind, randomized trial

Introduction: Osteoarthritis (OA) is a progressively debilitating condition that leads to musculoskeletal pain, particularly in the knee joint. Most clinical guidelines recommend platelet-rich plasma (PRP) for knee OA. However, the use of PRP in knee OA is increasing. Objectives: This study aimed to investigate the effects of intra-articular administration of PRP on the symptoms, lower limb function, and daily living activities in patients with knee OA. Patients and Methods: A double-blind, randomized, controlled clinical trial was conducted and 34 patients with grade 2 or 3 knee OA were enrolled. The knees of each participant were randomly allocated to receive either 3cc PRP injection (PRP knees) or needling only (control knees). Patients were evaluated by a general practitioner before, three, and six months after the intervention using the EuroQol-visual analog scales (EQ-VAS), the International Knee Documentation Committee (IKDC), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and the Tegner Activity Score (TAS). Results: The mean (±SD) age of patients with knee OA was 56.6 ± 10.2 years. Seventy-point-six percent of patients were female. 67.6% and 32.4% of patients were in stages 2 and 3 of the disease, respectively. IKDC, WOMAC, TAS, and EQ-VAS scores in knees under PRP injection and control of knees, three and six months after injection showed significant improvement. Three and six months after the intervention, IKDC, WOMAC, TAS, and EQ-VAS scores in the PRP and control knees were not significant (P &gt; 0.05). Inter-group comparison indicated that the IKDC score significantly increased six months in comparison to three months (P = 0.048) in PRP knees, but not significant in the control knees (P = 0.133). TAS score in PRP and control knees significantly increased six months compared to three months after injection. WOMAC and EQ-VAS score in PRP and control knees was not significant at six months in comparison to three months after the intervention. Conclusion: Our findings could suggest safety and feasibility data for the intra-articular administration of PRP in patients with knee OA that may help to appraise a larger clinical trial. Findings show that PRP injection improves IKDC, WOMAC, TAS, and EQ-VAS scores, however, there was no significant difference with needling only (control knees). Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trial (identifier: IRCT2015010112823N2; https://en.irct.ir/trial/12827, Ethics committee reference number: 93/551664) and Research Registry (Research Registry Unique Identifying Number: researchregistry9843).

Diversity and complexity of arthropod references in haiku.

Haiku are short poems, each composed of about 10 words, that typically describe moments in nature. People have written haiku since at least the 17th century, and the medium continues to be popular with poets, amateurs, educators, and students. Collectively, these poems represent an opportunity to understand which aspects of nature-e.g., which taxa and biological traits-resonate with humans and whether there are temporal trends in their representation or the emotions associated with these moments. We tested this potential using a mix of linguistic and biological methods, in analyses of nearly 4,000 haiku that reference arthropods. We documented the taxa and the life history traits represented in these poems and how they changed over time. We also analyzed the poems for emotion and tone. Our results reveal a mix of predictable trends and compelling surprises, each of which stand to potentially inform engagement strategies. At least 99 families of arthropods, in 28 orders, are represented in these haiku. The eight most commonly referenced taxa, from highest to lowest number of references, include: Lepidoptera, Hymenoptera, Diptera, Coleoptera, Araneae, Orthoptera, Hemiptera, and Odonata. Several common, conspicuous orders were never referenced, including Trichoptera, Plecoptera, and Megaloptera. The most commonly referenced traits relate to ecology (especially habitat, phenology, time of day), behavior (especially sound production), phenotype (especially color), and locomotion (especially flight). The least common traits in haiku relate to arthropod reproduction and physiology. Our analyses revealed few obvious temporal trends in the representations of taxa, biological traits, or emotion and tone. The broader implications of these results and possible future directions are discussed.

Collaborative design of a health research training programme for nurses and midwives in Tshwane district, South Africa: a study protocol

IntroductionNurses are essential for implementing evidence-based practices to improve patient outcomes. Unfortunately, nurses lack knowledge about research and do not always understand research terminology. This study aims to develop an...

Natural capital accounting for sustainability: Bibliometric analysis and explainable artificial intelligence modeling for citation counts

Natural capital accounting plays a pivotal role in the sustainable management and conservation of natural resources. This paper aims to contribute to this field by conducting a bibliometric review of 1409 articles and employing explainable artificial intelligence modeling (XAI) to identify and predict the factors that influence the impact of natural capital accounting (NCA) research, especially in terms of citations to this research. The findings revealed that the Journal of Cleaner Production is the leading publication in this field, with the highest h-index of 37. The XAI found that age of publication and number of references significantly impacted the likelihood of a paper receiving many citations. This study offers an innovative and practical framework for forecasting citation counts and provides effective strategies for authors and editors to enhance the citation impact of their work.

Exploring the Relationship Between Growth Hormone Secretagogue Receptor (GHSR) Gene and Body Proportions in Bangkok Chickens: Insights from DNA Sequencing and Hin6I Enzyme-Restricted PCR-RFLP Analysis

The purpose of this study was to determine the diversity of the growth hormone secretagogue receptor (GHSR) gene and also to analyze the association of the GHSR gene with the body proportions of Bangkok chickens. A total of 125 Bangkok chickens were reared, and blood samples were taken. Bangkok chickens were kept in colony cages with ad libitum feeding and drinking. The GHSR gene polymorphism was determined using the PCR-RFLP method. The restriction enzyme used in this study was Hin6I. The data analyzed were indicators of body proportions, which included data on body weight, carcass weight, and commercial cut weight. Single nucleotide polymorphism (SNP) identification using the Molecular Evolutionary Genetics Analysis 7 program with reference number AB095994.1. Allele frequency values, genotype frequencies, and Hardy-Weinberg balance values were also analyzed. The association between the GHSR gene and the traits observed in Bangkok chickens was analyzed using the T-test. The results of the study showed that the GHSR gene in Bangkok chickens had two genotypes, namely TT and CT. The values for Ho and He were 0.224 and 0.198, respectively. The genotype frequencies of TT and CT were 0.776 and 0.224, respectively. The two genotypes were associated with body weight, carcass weight, and commercial weight (p &lt; 0.05). For all measured criteria, the TT genotype showed a higher weight value than the CT genotype. The GHSR gene has the potential to be used as a genetic marker for the selection process on body weight, carcass weight, and commercial weight traits.

Is obesity more likely among children sharing a household with an older child with obesity? Cross-sectional study of linked National Child Measurement Programme data and electronic health records

Background/objectivesWe identified household members from electronic health records linked to National Child Measurement Programme (NCMP) data to estimate the likelihood of obesity among children living with an older child with...