Subjective Ratings Research Articles

Prediction of successful training outcomes for drug detection dogs using subjective ratings and behavioral test measures: A case study in Japan customs

Prediction of successful training outcomes for drug detection dogs using subjective ratings and behavioral test measures: A case study in Japan customs

Beyond the Score: Exploring the Associations Between Adverse Childhood Experiences and Electrophysiological Responses to Errors.

Adverse childhood experiences (ACEs) have diverse effects on physical development and mental health. This study aimed to clarify the relationship between the quantity of ACE exposure, type of ACE exposure, and subjective level of stress felt, correlated with event-related potential activity across the scalp, while controlling for relevant confounding variables. Fifty-three participants aged 18-32years completed questionnaires assessing their current mental health, self-regulation, childhood socioeconomic status, and history of traumatic events. Electroencephalographic activity was recorded while participants completed the Combined Attention Systems Task, a modified flanker task. Using cluster-corrected robust statistical approaches, significant relationships existed between the total number of ACEs, ACE type, the subjective impact of trauma, and amplitudes during the error-related negativity (ERN) and error positivity (Pe) at various scalp locations. In the ERN time window, greater error-correct differences were associated with greater total ACEs, abuse, and other ACEs at C5, P9, and TP10/C1 clusters, respectively. In addition, reduced error-correct differences at cluster-maximal C2 during the timing of the Pe were related to experiencing greater numbers of total ACEs while increased error-correct differences at cluster-maximal FPz during the timing of the Pe were associated with greater numbers of other ACEs. The subjective impact of total number of ACEs was not associated with error-correct differences, however, the subjective impact of household dysfunction, abuse, and 'other' ACE types were linked to error-correct differences at various scalp locations and timings. Notably, increased, rather than decreased, subjective impact of household dysfunction was related to greater error-correct differentiation during the timing of the ERN, maximal at Cz. These results suggest that both ACE type and subjective rating are relevant to future outcomes. The effects extended beyond the ERN-affecting error-related positivity and later event-related potentials-indicating associations with the number, type, and subjective impact of ACEs across a larger time window and scalp topography.

External trigeminal nerve stimulation (eTNS) Exhibits relaxation effects in fatigue states following napping deprivation.

In the face of inevitable declines in alertness and fatigue resulting from sleep deprivation, effective countermeasures are essential for maintaining performance. External trigeminal nerve stimulation (eTNS) presents a potential avenue for regulating alertness by activating the locus coeruleus and reticular activating system. Here, we conducted a within-subject study with 66 habitual nappers, subjecting them to afternoon nap-deprivation and applying either 20-minute of 120Hz eTNS or sham stimulation. We compared participants' performance in PVT and N-back tasks, subjective fatigue level and alertness ratings, and changes in heart rate variability, cortisol, and salivary alpha-amylase before and after stimulation. The results revealed a significant decline in PVT and N-back tasks performance, along with increased subjective fatigue levels in the sham stimulation group. In contrast, the eTNS stimulation group maintained behavioral performance, with lower post-stimulation fatigue levels than sham group. After stimulation, the eTNS group exhibited decreased mean R-R interval and elevated LF/HF ratios, i.e., a shift in autonomic nervous system activity towards sympathetic dominance, and a significant reduction in cortisol levels, indicating a state of relaxation alleviating drowsiness. These findings suggested that 120Hz eTNS stimulation might induce a relaxing effect, and thereby alleviate fatigue while preserving alertness and cognitive performance.

Nature Posters Enhance Subjective but not Objective Cleanness in Public Housing: Evidence from a Field Experiment

Littering has negative effects on the environment and is seen as a sign of social disorder. A previous field experiment in public housing buildings showed that implicit posters using eyes and nature posters were more effective in reducing litter than explicit posters using norms and financial costs. The aim of the present field experiment was to test the effects of the nature poster against a control group. We assessed “objective” (based on ratings of photos) and “subjective” cleanness (based on residents’ reports) and explored the role of connectedness to nature. Results from 182 waste disposal areas and 739 residents show that nature posters did not enhance objective cleanness, but did enhance subjective cleanness after one month. This effect was partly accounted for by feelings of connectedness to nature in residents. Also, objective ratings indicated greater cleanness compared to subjective cleanness ratings. We conclude that nature posters had little impact on objective cleanness but enhanced subjective experiences of cleanness, which can be an important driving force for feelings of social order and comfort.

Development of the office lighting control algorithm based on spatial luminance distribution analysis

ABSTRACT The lighting conditions in office buildings have a significant impact on the productivity and well-being of individuals. It is therefore essential to ensure that the artificial lighting system provides an optimal light environment. Currently, though, most automated office lighting control systems consider only workplace illuminance, without accounting for the luminance distribution in the room which largely determines the level of visual comfort. In this study, a basic algorithm for controlling artificial lighting is presented and evaluated. The algorithm is designed after examining the spatial distribution of luminance in a standard office space with daylight access. The algorithm utilizes the established methods for capturing High Dynamic Range images and linear programming. The suggested algorithm was compared to a proportional closed-loop control algorithm based on light sensors, commonly adopted for controlling lighting in rooms with daylight availability. Data for the comparison was derived from the experiment involving 13 participants, based on the subjective assessment of lighting quality and objective measures of visual performance. The study indicates that the lighting control algorithm proposed received significantly higher subjective ratings from the experiment participants. However, further research is required to evaluate visual performance.

Generating context-specific sports training plans by combining generative adversarial networks.

Personalized sports training plans are essential for addressing individual athlete needs, but traditional methods often need to integrate diverse data types, limiting adaptability and effectiveness. Existing machine learning (ML) and rule-based approaches cannot dynamically generate context-specific training programs, reducing their applicability in real-world scenarios. This study aims to develop a Generative Adversarial Network (GAN)- based framework to create context-specific training plans by integrating numeric attributes (e.g., age, heart rate) and motion features from video data. The research focuses on improving context-specific efficiency and real-time adaptability while addressing the limitations of traditional methods. The proposed GAN framework combines numeric and motion features using a generator-discriminator architecture to produce tailored training plans. The model is evaluated quantitatively through metrics like mean square error (MSE) and generation time and qualitatively through subjective ratings from athletes and coaches using a five-point Likert scale for context-specific, scientificity, applicability, and feasibility. Statistical significance is analyzed using ANOVA testing. The proposed GAN model outperforms traditional ML and rule-based methods, achieving a 22% reduction in MSE and a 45% improvement in generation time. Subjective evaluations reveal significant improvements in context-specific and applicability, with ratings averaging 4.8/5 compared to 3.9/5 for baseline models. The GAN framework effectively integrates multimodal data, demonstrating dynamic adaptability and high efficiency suitable for real-world applications. The proposed GAN-based framework advances the generation of personalized sports training plans by integrating numeric and motion data, achieving superior adaptability and efficiency. These results highlight the model's potential for practical deployment in athletic coaching systems, addressing critical gaps in existing methodologies and offering scalable solutions for individualized training.

Comparison of laparoscopic performance using low-cost laparoscopy simulators versus state-of-the-art simulators: a multi-center prospective, randomized crossover trial.

Simulator training is an efficient method for the development of basic laparoscopic skills. We aimed to investigate if low-cost simulators are comparable to more expensive box trainers regarding surgeons usability, likability, and performance. This multi-center, randomized crossover study included 16 medical students, seven abdominal surgeons, and seven urological surgeons. Participants performed four laparoscopic tasks (peg transfer, circle cutting, balloon resection, suture and knot) on both, a "Low cost trainer" (LCT) or a "high cost trainer" (HCT) in a randomized order. The primary endpoint was the subjective rating of both training simulators in terms of camera view, depth perception, movement of instruments, pricing, and usability for training. Secondary endpoints were force parameters, task completion time, surgical errors, and psychological workload. Participants rated the LCT better concerning view (p < 0.001), depth perception (p = 0.003), pricing (p < 0.001), and usability for digital training (p < 0.001), but worse in terms of instrument movement (p = 0.004). Overall, the LCT was rated better than the HCT (p = 0.015). Regarding force parameters, participants showed a significantly lower force exertion on the HCT during the peg transfer task (p = 0.008). The force exertion in the other tasks were comparable between both trainers. Participants were significantly faster using the HCT during the peg transfer (p = 0.049) and significantly slower in balloon resection (p = 0.049) and suture and knot task (p = 0.026). The assessment of the participants' workload showed no differences. The LCT was generally rated better than the HCT. The differences concerning force exertion and task completion time showed better results during peg transfer at the HCT but were generally inconclusive and without systemic advantage for either trainer. However, the LCT could be a promising and cost-effective augmentation for modern laparoscopic training.

A clinical case study of individual with Obsessive Compulsive Disorders and the treatment with Exposure Response Prevention

Obsessive Compulsive Disorder (OCD) is a chronic psychiatric illness characterized by distressing and intrusive thoughts, impulses or images (obsession) and repetitive covert or overt behaviors (compulsion) that are performed to reduce distress. The case aims to provide insights into the comprehensive assessment and evidence-based interventions of OCD in various clinical contexts of OCD relapsing control by using exposure response prevention. The case highlights the importance of the using of Cognitive Behavioral Therapy (CBT) as the primary treatment approach and also using exposure response prevention for reducing relapsing tendency. Developing impulse control capacity in individuals treated with OCD through ERP. The main tools of subjective assessment were in-depth clinical interview, observation of client in the session and thought diary. In-depth clinical interview was done by the therapist through open-ended and closed questions, empathetic listening, and active listening. This case found at the 4th session the client improved 40%, 7th session 60%, and lastly 13th session she improved 90% she was benefited from the treatment day by day. She also reported that her anxiety and depression level also was decreased. Subjective rating of Mrs. X’s problem was taken intermittently in assessment and treatment sessions. She rated her overall problem at the starting of psychotherapy with 100 in a ‘0 to 100’ scale, in the 13th session she rated her problem with 25%. By sharing these cases, mental health professionals who are interested to this field can gain valuable insights into the assessment and management of OCD in various clinical contexts.

Racial Differences in Discrepancies Between Subjective Ratings and Objective Assessments of Hearing Impairment.

To better understand racial/ethnic disparities in hearing aid use, we examined racial differences in discrepancies between subjective hearing ratings and objective hearing tests as a potential source of this disparity. A cross-sectional assessment was conducted using the data from the Health and Retirement Study (HRS). Our analytic sample included 2,568 participants aged 50 and older: 1,814 non-Hispanic White Americans and 754 non-Hispanic Black Americans. Discordant groups were identified based on self-ratings of hearing abilities (positive versus negative) and objective hearing test results (normal versus hearing loss). Analysis of HRS data revealed that approximately 73% of participants with objectively measured hearing loss reported positive hearing ratings. False positive hearing rates were found to be 80% among Black older adults and 70% among their White counterparts. Odds for false positive hearing ratings were significantly greater for Black older adults, men, those with less than a high school education, more health conditions and depressive symptoms, and current smoking. Racial differences were maintained after adjustment for these covariates. While cost of hearing aids has been a predominant explanation of low hearing aid use in Black Americans, false positive perceptions of hearing abilities may also play a significant role as a psychosocial mechanism. Future studies examining racial/ethnic differences in possible psychosocial mechanisms for discrepancies between objective and subjective hearing could guide the development and evaluation of culturally appropriate educational interventions.

Closed-loop vibration stimulation based on heart rhythm for reducing sleep inertia.

The aim of this study was to determine whether closed-loop vibration stimulation, delivered at +3% of the heart rate frequency at an imperceptible intensity before waking, could reduce sleep inertia. Participants napped on a bed equipped with a woofer that delivered vibration stimulation every 5 min, starting 30 min before their scheduled wake time. The effects of the stimulation were assessed using a Psychomotor Vigilance Task performed immediately upon waking, along with the analysis of salivary cortisol and melatonin levels, as well as subjective arousal ratings based on the Karolinska Sleepiness Scale and the Stanford Sleepiness Scale. The results indicated that vibration stimulation at +3% of the heart rate frequency improved Psychomotor Vigilance Task reaction times and increased self-reported arousal scores, thus reducing sleep inertia compared with the control condition without stimulation. Additionally, salivary melatonin levels were lower immediately after waking. These findings suggest that closed-loop vibration stimulation at +3% of the heart rate frequency before waking could be an effective method to reduce sleep inertia. This non-invasive approach may facilitate cognitive recovery following sleep. Further research is required to investigate the underlying mechanisms, and confirm these findings across different populations and settings.

Untreated exstrophy-epispadias complex: outcomes of Indiana pouch and primary abdominal wall closure

BackgroundWe assessed the outcomes of adult patients with untreated exstrophy-epispadias complex who underwent Indiana continent catheterisable pouch type of urinary diversion along with primary closure of the abdominal wall utilizing the de-epithelised muscular coat of the vesical remnant.MethodsThis retrospective study analysed data between July 2019 and December 2023. All patients underwent a standard evaluation and surgical procedure and were followed up at 6 weeks, 3, 6 and 12 months and then annually. At each visit, renal function test and ultrasonography were performed and a 3 day CIC diary was obtained. The objective success was defined as complete diurnal and nocturnal continence with a pouch capacity of at least 300 ml, whereas the subjective success was defined as the Patient Global Impression of Improvement (PGI-I) score of 1 or 2 at 12 months post-surgery.ResultsA total of ten patients were included, and the mean operative time was 370 min, the mean blood loss was 400 ml and the mean hospital stay was 17 days. The overall complication rate was 40% and there was 1 Clavien IIIb complication. The mean duration of follow-up was 15.6 months and the mean maximum capacity of the pouch was 450 ml and the mean CIC frequency was 4.9 per day. The objective and subjective success rates were 100% and 100%, respectively.ConclusionIndiana pouch continent cutaneous urinary diversion is a feasible option with acceptable complication rates. It is a technically simpler procedure and obviates the need for extensive reconstructions and inter-departmental expertise and provides durable results.

Abstract P013: Low-dose radiation acts as a promising preconditioning regimen for dendritic cell vaccines

Abstract Background: While anti-tumor immunity can be improved with dendritic cell vaccines, it is not fully known what approved preconditioning agents, if any, improve dendritic cell vaccine-induced antitumor T-cell response and tumor elimination. We explored the effect of whole-body and tumor-directed low-dose radiation (LD RT), cyclophosphamide, and paclitaxel as preconditioning regiments for antigen-loaded dendritic cell vaccine-induced antitumor T-cell response. Methods: Syngeneic KP tumors were engineered with ovalbumin and injected subcutaneously into the flank of wild-type B6 mice. Preconditioning regiments of LD RT (2 Gy to the whole body), cyclophosphamide (250mg/kg), LD RT (2 Gy to the whole body) + cyclophosphamide (250mg/kg), paclitaxel (20mg/kg), or nothing (control) were given on day 4. Bone marrow dendritic cells (DCs) were electroporated with ovalbumin protein, and then one million cells were injected i.v. on days 5 and 8. Blood collection was done, and ovalbumin-specific T-cell populations were examined by tetramer staining for SIINFEKL-specific TCR over time. Tumor size was measured over time, and survival data was analyzed accordingly. Results: The usage of cyclophosphamide and paclitaxel resulted in a higher tumor burden than the no preconditioning group, which indicated that lymphodepletion chemotherapy should be avoided during dendritic cell vaccines, unlike in other cellular therapies such as CAR T-cells. Whole-body LD RT performed significantly better than the control group in both tumor burden and survival, which led to further examination of LD RT and the potential difference in whole-body and tumor-specific LD RT as a preconditioning regimen. There was a significant difference in the percentage of SIINFEKL tetramer+ T-cells amongst all CD8+ cells when LD RT was administered compared to other preconditioning regimens. Furthermore, whole-body LD RT produced a significantly higher percentage of SIINFEKL tetramer+ T-cells than tumor-directed LD RT. The overall survival rate and tumor burden of subjects receiving whole-body or tumor LD RT significantly improved compared to all other groups. Interestingly, intergroup comparisons of tumor growth and survival rates between the whole-body and tumor LD-RT groups had no significant difference. Conclusions: Here, we find that LD-RT is the most effective preconditioning regimen before dendritic cell vaccination for inducing an antitumor T-cell response and achieving tumor control over time. LD RT provides a promising method to supplement dendritic cell vaccination to potentially improve patient outcomes. However, further study of the differences in whole-body and tumor-specific LD RT is necessary to determine the most ideal preconditioning regimen for dendritic cell vaccination. Citation Format: Eric Kwon, Shelby Namen, Solomon Kang, Colin Wiloughby, Kevin Zhang, Gaurav Pandey, Carl J. DeSelm.Low-dose radiation acts as a promising preconditioning regimen for dendritic cell vaccines.[abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Translating Targeted Therapies in Combination with Radiotherapy; 2025 Jan 26-29; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(2_Suppl):Abstract nr P013

Gadopiclenol Enables Reduced Gadolinium Dose While Maintaining Quality of Pulmonary Arterial Enhancement for Pulmonary MRA: An Opportunity for Improved Safety and Sustainability.

Pulmonary magnetic resonance angiography (MRA) is an imaging method with proven utility for the exclusion of pulmonary embolism and avoids the need for ionizing radiation and iodinated contrast agents. High-relaxivity gadolinium-based contrast agents (GBCAs), such as gadopiclenol, can be used to reduce the required gadolinium dose for pulmonary MRA. The aim of this study was to compare the contrast enhancement performance of gadopiclenol with an established gadobenate dimeglumine-enhanced pulmonary MRA protocol. In this retrospective single-center study, data from 152 patients who underwent pulmonary MRA at 1.5 T were analyzed. Imaging was performed with either 0.05 mmol/kg gadopiclenol (n = 75) or 0.1 mmol/kg gadobenate dimeglumine (n = 77), using dedicated multiphasic imaging protocols with precontrast, pulmonary arterial phase, immediate delayed phase, and a low flip-angle T1-weighted spoiled gradient echo acquisition. Subjective image quality evaluation was performed blinded by 2 radiologists on a 5-point Likert scale. For the estimation of interrater reliability, Cohen weighted κ was calculated. For semiquantitative assessment, signal intensities were measured in the pulmonary arteries, and relative signal enhancement was calculated. Data from groups were compared with Mann-Whitney U tests using Bonferroni corrections. Signal enhancement relative to precontrast in the first-pass pulmonary arterial phase was higher with 0.05 mmol/kg gadopiclenol compared with 0.1 mmol/kg gadobenate dimeglumine (20.0-fold ± 5.6-fold vs 17.8-fold ± 5.8-fold; P = 0.015). Readers observed no difference in subjective rating in terms of intravascular contrast, peripheral vessel depiction, and diagnostic confidence with substantial interrater reliability (Cohen κ = 0.73 [95% confidence interval: 0.57-0.89], 0.65 [0.55-0.75], and 0.74 [0.65-0.84], all P's < 0.001). No severe adverse events were recorded for any clinical MRA examination. The high-relaxivity contrast agent gadopiclenol can facilitate a reduction in gadolinium dose by 50% without compromising contrast enhancement for pulmonary MRA. This approach may enhance the safety and sustainability of pulmonary MRA in the long term.

Efficiency of immersive virtual reality game technology on pain management in children with limb fractures: A randomized controlled trial.

Children with fractured limbs usually have moderate to high pain, and distraction can help reduce their pain and anxiety. Virtual reality technology is an emerging method of distraction. We investigated whether the use of immersive virtual reality gaming technology to treat perioperative pain in children with school-age limb fractures effectively. Ninty-nine patients who had limb fracture surgery between October 2021 and September 2022 were randomly assigned to receive immersive virtual reality game therapy (Group A), non-immersive virtual reality game therapy (Group B), or conventional treatment group (Group C). Changes in pain, anxiety, fear, and biochemical markers were assessed at various time points in the three groups using subjective and objective rating scales. Both Group A and Group B consistently showed lower pain scores, fear levels, and anxiety levels compared to Group C after surgery, statistical analysis revealed significant differences among the three groups (p<0.001). Additionally,serum levels in group A were significantly lower than those in other groups, showing a notable statistical discrepancy (p<0.001). Both immersive and non-immersive virtual reality gaming significantly reduce perioperative pain, fear, and anxiety in children with limb fractures, and have practical significance for pain management of pediatric orthopedic patients. Immersive virtual reality, however, appears to have a more pronounced effect. The trial was registered prior to patient enrollment at the Chinese Clinical Trial Registry(ChiCTR210004583).

Psychometric properties of the Chinese version of Everyday Cognition Scale (ECog) in Taiwanese older adults.

The Everyday Cognition Scale (ECog) is widely employed for the subjective rating of functional activities of daily living in older adults. This study aimed to examine the psychometric properties of both informant-rated and self-rated ECog in Taiwanese older individuals to assess its applicability in this context. A total of 1166 subjects, including older adults (n = 583) and their primary caregivers or family members (n = 583), were recruited. Both self-rated and informant-rated ECog assessments were administered twice within a one-month period. The study evaluated internal consistency, test-retest reliability, random measurement error, discriminative validity, construct validity, and concurrent validity using the Mini-Mental State Examination (MMSE) as a gold standard. The informant-rated ECog demonstrated high internal consistency, acceptable to good test-retest reliability, small to moderate random measurement error, good discriminative validity, and moderate correlations with the MMSE. Additionally, a seven-factor model of the informant-rated ECog was supported. Conversely, the self-rated ECog exhibited high internal consistency, acceptable test-retest reliability, moderate to large random measurement error, adequate discriminative validity, and small correlations with the MMSE. Notably, only the domains of memory, verbal, planning and organization were supported by a one-factor model. The psychometric properties of the informant-rated ECog surpassed those of the self-rated ECog. However, the self-rated ECog is recommended as a supplementary tool for assessing individuals' awareness of their cognitive function, particularly in the domain of memory.

Identifying the Minimal Clinically Important Difference in Emotion Regulation Among Youth Using the JoyPop App: Survey Study.

The minimal clinically important difference (MCID) is an important threshold to consider when evaluating the meaningfulness of improvement following an intervention. The JoyPop app is an evidence-based smartphone app designed to improve resilience and emotion regulation. Information is needed regarding the JoyPop app's MCID among culturally diverse youth. This study aims to calculate the MCID for youth using the JoyPop app and to explore how the MCID may differ for a subset of Indigenous youth. Youth (N=36; aged 12-18 years) were recruited to use the JoyPop app for up to 4 weeks as part of a larger pilot evaluation. Results were based on measures completed after 2 weeks of app use. The MCID was calculated using emotion regulation change scores (Difficulties in Emotion Regulation-Short Form [DERS-SF]) and subjective ratings on the Global Rating of Change Scale (GRCS). This MCID calculation was completed for youth overall and separately for Indigenous youth only. A significant correlation between GRCS scores and change scores on the DERS-SF supported face validity (r=-0.37; P=.04). The MCID in emotion regulation following the use of the JoyPop app for youth overall was 2.80 on the DERS-SF. The MCID for Indigenous youth was 4.29 on the DERS-SF. In addition, most youth reported improved emotion regulation after using the JoyPop app. These MCID findings provide a meaningful threshold for improvement in emotion regulation for the JoyPop app. They provide potential effect sizes and can aid in sample size estimations for future research with the JoyPop app or e-mental health technologies in general. The difference between overall youth and Indigenous youth MCID values also highlights the importance of patient-oriented ratings of symptom improvement as well as cultural considerations when conducting intervention research and monitoring new interventions in clinical practice.

Warm/cool judgments as a function of hue, value, and chroma

Besides conventional perceptual attributes of hue, brightness, and saturation, colors are universally classified along a warm/cool dimension. Previous estimates of how warm/cool values are distributed across color space have relied on subjective ratings. Here we employed simple ordinal judgments between stimulus pairs using maximum likelihood conjoint measurement (MLCM) to assess the influence of Munsell hue, value, and chroma on warm/cool judgments. We also evaluated an identification task for single stimulus presentations. For the MLCM procedure, observers judged on each trial which of the two stimuli appeared warmer. For the identification task, observers classified individually presented color patches as cool or warm. The judgments were analyzed with probit regression to estimate the underlying perceptual scale values. The results confirm that the contributions of different dimensions to warm/cool variations in color space can be estimated using only ordinal judgments. While for most observers, warm/cool judgments depended on hue, there were individual variations in the extent to which value contributed to warm/cool, and little evidence for an effect of chroma.

Clonal hematopoiesis of indeterminate potential and type 2 diabetes mellitus among patients with STEMI: from a prospective cohort study combing bidirectional Mendelian randomization

AimBoth clonal hematopoiesis of indeterminate potential (CHIP) and type 2 diabetes mellitus (T2DM) are conditions closely associated with advancing age. This study delves into the possible implications and prognostic significance of CHIP and T2DM in patients diagnosed with ST-segment elevation myocardial infarction (STEMI).MethodsDeep-targeted sequencing employing a unique molecular identifier (UMI) for the analysis of 42 CHIP mutations—achieving an impressive mean depth of coverage at 1000 × —was conducted on a cohort of 1430 patients diagnosed with acute myocardial infarction (473 patients with T2DM and 930 non-DM subjects). Variant allele fraction ≥ 2.0% indicated the presence of CHIP mutations. The association between CHIP and T2DM was evaluated by the comparison of (i) the prevalence of CHIP mutations among individuals with diabetes versus those without, (ii) the clinical characteristics delineated by CHIP mutations within the cohort of diabetic patients and (iii) the prognostic significance and correlation of CHIP mutations with mortality rates in T2DM subjects. Furthermore, a two-sample bidirectional Mendelian randomization study was performed using genetic instruments from the genome-wide association study for TET2 mutation CH from the UK Biobank (UKB) (2041 cases,173,918 controls) to investigate the causal relationship with T2DM from the FinnGen consortium (65,085 cases and 335,112 controls), and vice versa.Results(i) Most commonly CHIP mutations exhibiting a variant allele fraction of ≥ 2.0% were identified in 50/473 (10.6%) patients with T2DM, demonstrating a greater prevalence compared to non-DM subjects [69/930 (7.4%); P < 0.05] across various age groups. (ii) After multivariable adjustment, the mortality of any CHIP mutations were 2.03-fold higher in DM [adjusted hazard ratio (HR) 2.03; 95% confidence interval (CI) 1.07–3.84, P < 0.05]. (iii) In gene-specific analyses, TET2 somatic mutation presented the highest association with mortality among T2DM (adjusted HR 5.24; 95% CI 2.02–13.61, P = 0.001). ASXL1 CHIP mutation which displayed a striking correlation with cardiac death (HR: 3.14; 95% CI 1.24–7.93; P < 0.05) with consistent associations observed among T2DM subgroup (HR: 4.51; 95% CI 1.30–15.6; P < 0.05). (iv) The correlation between PCSK9 and the Tet2-CHIP mutation was observed in both the T2DM cohort (correlation = 0.1215, P = 0.011) and the overall enrolled cohort (correlation = 0.0578, P = 0.0382). (v) Bidirectional Mendelian randomization studies indicated that the development of T2DM increases the propensity for CHIP. However, CHIP does not subsequently accelerate the onset of T2DM.ConclusionCHIP mutations, particularly TET2, are more prevalent in patients with T2DM compared to individuals without diabetes. The presence of these mutations is associated with adverse clinical outcomes, notably increased mortality rates. Moreover, bidirectional Mendelian randomization analyses provide supporting evidence for a potential causal relationship between TET2-related CHIP and the development of T2DM.Graphical abstractCentral Illustration: The association between clonal hematopoiesis of indeterminate potential (CHIP) and type 2 diabetes mellitus (T2DM): The prevalence of CHIP is notably higher in individuals with T2DM, as demonstrated in a prospective study within an Asian cohort of acute myocardial infarction (AMI). Furthermore, the predictive value of CHIP as a marker for poor clinical prognosis in T2DM has been assessed in this study. Mendelian randomization studies suggest that the development of T2DM may increase the propensity for CHIP, as indicated by findings from the UK Biobank and FinnGen consortium. T2DM, type 2 diabetes mellitus; CHIP, clonal haematopoiesis of indeterminate potential.

Ride Quality Measurement and User Ratings: Results from Main Field Trials

Improved techniques for assessing ride quality have been developed by the authors that more closely simulate the responses of humans to whole-body vibration and vehicle ride dynamics across a broad range of vehicle classes. The new ride model aims to address some fundamental issues related to road unevenness measurements which frequently do not correlate well with subjective ratings of pavement rideability. Field trials were conducted to test the models on a total of twenty-one pavement sections covering a wide range of roughness levels. Nine vehicles were used in the main trials, two from each of four vehicle classes (motorcycles, cars, SUVs and trucks) and an extra car, and a further two cars were added from an earlier pilot trial. In total, ten test subjects were recruited with a range of driving backgrounds, each driving one of the test vehicles. The modelled ride responses were compared with measured ride vibration and user ride ratings, all were taken on the same pavement test sections. Portable vibration measuring equipment was used to record ride vibration comprising accelerometers and a data logger and incorporating GPS. Subjective ratings of ride vibration on each pavement section were obtained from test subjects during the conduct of tests.

Treatment outcomes of Manchester procedure versus vaginal hysterectomy for mid-compartment prolapse: A systematic review and meta-analysis.

To compare the effectiveness and safety of Manchester procedure versus vaginal hysterectomy in the treatment of mid-compartment prolapse in women. We searched PubMed, Web of Science, Google Scholar, and the Cochrane Library for randomized controlled trials (RCTs), prospective, or retrospective studies comparing the Manchester procedure and vaginal hysterectomy up to July 2024. Primary outcomes included anatomical recurrence, subjective recurrence, overall complication rate, and reoperation. Secondary outcomes included estimated blood loss, operative time, and relevant subgroup analyses. This study has been registered in PROSPERO with the registration number CRD42024575874. A total of 11 783 cases from 1 RCT, 1 prospective study, and 9 retrospective studies were included. For the primary outcomes, the Manchester procedure demonstrated significantly lower subjective recurrence rates (risk ratio [RR] = 0.85; 95% confidence interval [CI]: 0.73-0.98; I2 = 0%; p = 0.03) and reoperation rates (RR = 0.62; 95% CI: 0.43-0.89; I2 = 64%; p = 0.009) compared with vaginal hysterectomy, with no significant difference in anatomical recurrence rates (RR = 0.84; 95% CI: 0.58-1.21; I2 = 54%; p = 0.34) and overall complication rates (RR = 0.89; 95% CI: 0.79-1.00; I2 = 0%; p = 0.06) between the two groups. Secondary outcomes indicated that the Manchester procedure had a significantly shorter operative time and less estimated blood loss (p < 0.05). Subgroup analysis indicated that the Manchester procedure was associated with lower short-term (1-3 years) subjective recurrence rates (RR = 0.87; 95% CI: 0.78-0.98; I2 = 0%; p = 0.02) and reoperation rates (RR = 0.71; 95% CI: 0.55-0.92; I2 = 0%; p = 0.008). No significant differences were found between the two groups in terms of short-term anatomical recurrence rates or in mid- to long-term (>3 years) subjective recurrence rates, anatomical recurrence rates, and reoperation rates (p > 0.05). Overall, the rates of anatomical recurrence and overall complications for Manchester procedure and vaginal hysterectomy are similar. Manchester procedure appears to have a lower subjective recurrence and reoperation rate in the short term, but this advantage was not observed in mid- to long-term follow-up. Further high-quality prospective studies are needed to confirm these findings.