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The Lancet. Rheumatology Jun 2024Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a proinflammatory cytokine overproduced in several inflammatory and autoimmune diseases, including axial...
Granulocyte-macrophage colony-stimulating factor neutralisation in patients with axial spondyloarthritis in the UK (NAMASTE): a randomised, double-blind, placebo-controlled, phase 2 trial.
BACKGROUND
Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a proinflammatory cytokine overproduced in several inflammatory and autoimmune diseases, including axial spondyloarthritis. Namilumab is a human IgG1 monoclonal anti-GM-CSF antibody that potently neutralises human GM-CSF. We aimed to assess the efficacy of namilumab in participants with moderate-to-severe active axial spondyloarthritis.
METHODS
This proof-of-concept, randomised, double-blind, placebo-controlled, phase 2, Bayesian (NAMASTE) trial was done at nine hospitals in the UK. Participants aged 18-75 years with axial spondyloarthritis, meeting the Assessment in SpondyloArthritis international Society (ASAS) criteria and the ASAS-defined MRI criteria, with active disease as defined by a Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), were eligible. Those who had inadequately responded or had intolerance to previous treatment with an anti-TNF agent were included. Participants were randomly assigned (6:1) to receive subcutaneous namilumab 150 mg or placebo at weeks 0, 2, 6, and 10. Participants, site staff (except pharmacy staff), and central study staff were masked to treatment assignment. The primary endpoint was the proportion of participants who had an ASAS ≥20% improvement (ASAS20) clinical response at week 12 in the full analysis set (all randomly assigned participants). This trial is registered with ClinicalTrials.gov (NCT03622658).
FINDINGS
From Sept 6, 2018, to July 25, 2019, 60 patients with moderate-to-severe active axial spondyloarthritis were assessed for eligibility and 42 were randomly assigned to receive namilumab (n=36) or placebo (n=six). The mean age of participants was 39·5 years (SD 13·3), 17 were women, 25 were men, 39 were White, and seven had previously received anti-TNF therapy. The primary endpoint was not met. At week 12, the proportion of patients who had an ASAS20 clinical response was lower in the namilumab group (14 of 36) than in the placebo group (three of six; estimated between-group difference 6·8%). The Bayesian posterior probability η was 0·72 (>0·927 suggests high clinical significance). The rates of any treatment-emergent adverse events in the namilumab group were similar to those in the placebo group (31 vs five).
INTERPRETATION
Namilumab did not show efficacy compared with placebo in patients with active axial spondyloarthritis, but the treatment was generally well tolerated.
FUNDING
Izana Bioscience, NIHR Oxford Biomedical Research Centre (BRC), NIHR Birmingham BRC, and Clinical Research Facility.
PubMed: 38942047
DOI: 10.1016/S2665-9913(24)00099-7 -
Water Research Jun 2024Against the backdrop of severe leakage issue in water distribution systems (WDSs), numerous researchers have focused on the development of deep learning-based acoustic...
Against the backdrop of severe leakage issue in water distribution systems (WDSs), numerous researchers have focused on the development of deep learning-based acoustic leak detection technologies. However, these studies often prioritize model development while neglecting the importance of data. This research explores the impact of data augmentation techniques on enhancing deep learning-based acoustic leak detection methods. Five random transformation-based methods-jittering, scaling, warping, iterated amplitude adjusted Fourier transform (IAAFT), and masking-are proposed. Jittering, scaling, warping, and IAAFT directly process original signals, while masking operating on time-frequency spectrograms. Acoustic signals from a real-world WDS are augmented, and the efficacy is validated using convolutional neural network classifiers to identify the spectrograms of acoustic signals. Results indicate the importance of implementing data augmentation before data splitting to prevent data leakage and overly optimistic outcomes. Among the techniques, IAAFT stands out, significantly increasing data volume and diversity, improving recognition accuracy by over 7%. Masking enhances performance mainly by compelling the classifier to learn global features of the spectrograms. Sequential application of IAAFT and masking further strengthens leak detection performance. Furthermore, when applying a complex model to acoustic leakage detection through transfer learning, data augmentation can also enhance the effectiveness of transfer learning. These findings advance artificial intelligence-driven acoustic leak detection technology from a data-centric perspective towards more mature applications.
PubMed: 38941677
DOI: 10.1016/j.watres.2024.121999 -
Frontiers in Psychiatry 2024Individuals with anxiety disorders (ADs) often display hypervigilance to threat information, although this response may be less pronounced following psychotherapy. This...
BACKGROUND
Individuals with anxiety disorders (ADs) often display hypervigilance to threat information, although this response may be less pronounced following psychotherapy. This study aims to investigate the unconscious recognition performance of facial expressions in patients with panic disorder (PD) post-treatment, shedding light on alterations in their emotional processing biases.
METHODS
Patients with PD (n=34) after (exposure-based) cognitive behavior therapy and healthy controls (n=43) performed a subliminal affective recognition task. Emotional facial expressions (fearful, happy, or mirrored) were displayed for 33 ms and backwardly masked by a neutral face. Participants completed a forced choice task to discriminate the briefly presented facial stimulus and an uncovered condition where only the neutral mask was shown. We conducted a secondary analysis to compare groups based on their four possible response types under the four stimulus conditions and examined the correlation of the false alarm rate for fear responses to non-fearful (happy, mirrored, and uncovered) stimuli with clinical anxiety symptoms.
RESULTS
The patient group showed a unique selection pattern in response to happy expressions, with significantly more correct "happy" responses compared to controls. Additionally, lower severity of anxiety symptoms after psychotherapy was associated with a decreased false fear response rate with non-threat presentations.
CONCLUSION
These data suggest that patients with PD exhibited a "happy-face recognition advantage" after psychotherapy. Less symptoms after treatment were related to a reduced fear bias. Thus, a differential facial emotion detection task could be a suitable tool to monitor response patterns and biases in individuals with ADs in the context of psychotherapy.
PubMed: 38938460
DOI: 10.3389/fpsyt.2024.1375751 -
Scientific Reports Jun 2024In the petroleum and coal industries, digital image technology and acoustic emission technology are employed to study rock properties, but both exhibit flaws during data...
In the petroleum and coal industries, digital image technology and acoustic emission technology are employed to study rock properties, but both exhibit flaws during data processing. Digital image technology is vulnerable to interference from fractures and scaling, leading to potential loss of image data; while acoustic emission technology is not hindered by these issues, noise from rock destruction can interfere with the electrical signals, causing errors. The monitoring errors of these techniques can undermine the effectiveness of rock damage analysis. To address this issue, this paper focuses on the restoration of image data acquired through digital image technology, leveraging deep learning techniques, and using soft and hard rocks made of similar materials as research subjects, an improved Incremental Transformer image algorithm is employed to repair distorted or missing strain nephograms during uniaxial compression experiments. The concrete implementation entails using a comprehensive training set of strain nephograms derived from digital image technology, fabricating masks for absent image segments, and predicting strain nephograms with full strain detail. Additionally, we adopt deep separable convolutional networks to optimize the algorithm's operational efficiency. Based on this, the analysis of rock damage is conducted using the repaired strain nephograms, achieving a closer correlation with the actual physical processes of rock damage compared to conventional digital image technology and acoustic emission techniques. The improved incremental Transformer algorithm presented in this paper will contribute to enhancing the efficiency of digital image technology in the realm of rock damage, saving time and money, and offering an innovative approach to traditional rock damage analysis.
PubMed: 38937588
DOI: 10.1038/s41598-024-65790-y -
International Journal of Infectious... Jun 2024To clarify the infection route in maternal death due to invasive group A streptococcal (GAS) infection and toxic shock syndrome (TSS).
OBJECTIVE
To clarify the infection route in maternal death due to invasive group A streptococcal (GAS) infection and toxic shock syndrome (TSS).
METHODS
A retrospective study was conducted on maternal deaths due to GAS-TSS in Japan between January 2010 and March 2024. The final causal diagnosis of maternal death and the infection routes of GAS were analysed using medical records, laboratory data, and autopsy findings.
RESULTS
Among the 616 maternal deaths during the study period, 48 (8%) involved infectious diseases. The most common infection was invasive GAS (56%, n=27), 21 (78%) and six cases occurred during the antepartum and puerperium periods, respectively. In the GAS-TSS group, 71% (15/21) infections were originated the upper respiratory tract. However, in the puerperium cases, 67% (4/6) were infected from the genital tract. In addition, no maternal deaths due to GAS-TSS were reported during the COVID-19 pandemic period in Japan from 2020-2023.
CONCLUSION
Most antepartum GAS infections were from the upper respiratory tract. They may be reduced by preventive measures, including frequent disinfection, wearing masks, and isolation from persons at high risk of carrying GAS, such as symptomatic children. On the other hand, GAS-TSS during puerperium infection via the genital tract.
PubMed: 38936654
DOI: 10.1016/j.ijid.2024.107154 -
Journal of the American Dental... Jun 2024People with special health care needs in long-term care settings have difficulty accessing a traditional dental office. The goal of the authors was to assess initial...
BACKGROUND
People with special health care needs in long-term care settings have difficulty accessing a traditional dental office. The goal of the authors was to assess initial treatment decision concordance between dentists conducting traditional in-person examinations using mobile equipment and additional dentists conducting examinations using asynchronous teledentistry technology.
METHODS
Six dentists from Access Dental Care, a North Carolina mobile dentistry nonprofit, saw new patients on-site at 12 participating facilities or asynchronously off-site with electronic dental records, radiographs, and intraoral images, all captured by an on-site dental hygienist. Off-site dentists were masked to other dentists' treatment need decisions; 3 through 5 off-site examinations were conducted for each on-site examination. Demographic and binary treatment need category data were collected. For the 3 most prevalent treatment types needed (surgery, restorative, and new removable denture), the authors calculated the percentage agreement and κ statistics with bootstrapped CIs (1,000 replicates).
RESULTS
The 100 enrolled patients included 47 from nursing homes, 45 from Programs of All-Inclusive Care for the Elderly, and 8 from group homes for those with intellectual and developmental disabilities. Mean (SD) age was 73.9 (16.5) years. Among dentate participants, the percentage agreement and bootstrapped κ (95% CI) were 87% and 0.74 (0.70 to 0.78) for surgery and 78% and 0.54 (0.50 to 0.58) for restorative needs, respectively, and among dentate and edentulous participants, they were 94% and 0.78 (0.74 to 0.83), respectively, for new removable dentures.
CONCLUSIONS
The authors assessed the initial dental treatment decision concordance between on-site dentists conducting in-person examinations with a mobile oral health care delivery model and off-site dentists conducting examinations with asynchronous dentistry. Concordance was substantial for surgery and removable denture treatment decisions and moderate for restorative needs. Patient characteristics and facility type were not significant factors in the levels of examiner agreement.
PRACTICAL IMPLICATIONS
This evidence supports teledentistry use for patients with special health care needs and could help improve their access to oral health care.
PubMed: 38934969
DOI: 10.1016/j.adaj.2024.05.004 -
Frontiers in Artificial Intelligence 2024Time series is a typical data type in numerous domains; however, labeling large amounts of time series data can be costly and time-consuming. Learning effective...
Time series is a typical data type in numerous domains; however, labeling large amounts of time series data can be costly and time-consuming. Learning effective representation from unlabeled time series data is a challenging task. Contrastive learning stands out as a promising method to acquire representations of unlabeled time series data. Therefore, we propose a self-supervised time-series representation learning framework via Time-Frequency Fusion Contrasting (TF-FC) to learn time-series representation from unlabeled data. Specifically, TF-FC combines time-domain augmentation with frequency-domain augmentation to generate the diverse samples. For time-domain augmentation, the raw time series data pass through the time-domain augmentation bank (such as jitter, scaling, permutation, and masking) and get time-domain augmentation data. For frequency-domain augmentation, first, the raw time series undergoes conversion into frequency domain data following Fast Fourier Transform (FFT) analysis. Then, the frequency data passes through the frequency-domain augmentation bank (such as low pass filter, remove frequency, add frequency, and phase shift) and gets frequency-domain augmentation data. The fusion method of time-domain augmentation data and frequency-domain augmentation data is kernel PCA, which is useful for extracting nonlinear features in high-dimensional spaces. By capturing both the time and frequency domains of the time series, the proposed approach is able to extract more informative features from the data, enhancing the model's capacity to distinguish between different time series. To verify the effectiveness of the TF-FC method, we conducted experiments on four time series domain datasets (i.e., SleepEEG, HAR, Gesture, and Epilepsy). Experimental results show that TF-FC significantly improves in recognition accuracy compared with other SOTA methods.
PubMed: 38933470
DOI: 10.3389/frai.2024.1414352 -
Plants (Basel, Switzerland) Jun 2024"Omics" typically involves exploration of the structure and function of the entire composition of a biological system at a specific level using high-throughput... (Review)
Review
"Omics" typically involves exploration of the structure and function of the entire composition of a biological system at a specific level using high-throughput analytical methods to probe and analyze large amounts of data, including genomics, transcriptomics, proteomics, and metabolomics, among other types. Genomics characterizes and quantifies all genes of an organism collectively, studying their interrelationships and their impacts on the organism. However, conventional transcriptomic sequencing techniques target population cells, and their results only reflect the average expression levels of genes in population cells, as they are unable to reveal the gene expression heterogeneity and spatial heterogeneity among individual cells, thus masking the expression specificity between different cells. Single-cell transcriptomic sequencing and spatial transcriptomic sequencing techniques analyze the transcriptome of individual cells in plant or animal tissues, enabling the understanding of each cell's metabolites and expressed genes. Consequently, statistical analysis of the corresponding tissues can be performed, with the purpose of achieving cell classification, evolutionary growth, and physiological and pathological analyses. This article provides an overview of the research progress in plant single-cell and spatial transcriptomics, as well as their applications and challenges in plants. Furthermore, prospects for the development of single-cell and spatial transcriptomics are proposed.
PubMed: 38931111
DOI: 10.3390/plants13121679 -
International Journal of Environmental... Jun 2024Air pollution has emerged as a global public health concern. Specifically, in Medellín, Colombia, episodes of elevated air pollution have been documented. Medical...
Air pollution has emerged as a global public health concern. Specifically, in Medellín, Colombia, episodes of elevated air pollution have been documented. Medical students' knowledge of air pollution is paramount for implementing future interventions directed toward patients. The aim of this research was to delineate the knowledge, attitudes, and practices regarding air pollution among medical students at a private university in Medellín. A cross-sectional study involving 352 medical students was conducted. A questionnaire was administered, generating scores ranging from 0 to 100, where a higher score signified better knowledge, attitudes, and practices. Data were analyzed using frequencies, summary measures, non-parametric tests, and linear regression. : In total, 31% rated the education received at the university on the relationship between health and air quality as fair to poor, and 81% perceived the air quality in the city as poor. The knowledge score was 77.8 (IQR 71.1-85.6), with 90% acknowledging that exposure to air pollution increases the risk of various diseases. The attitudes score was 82.1 (IQR 71.8-87.2), and 25.9% believed that air pollution is a multifactorial problem, rendering their actions ineffective. In terms of practices, the score was 50 (IQR 42.9-57.1), indicating that students either did not employ protective measures against pollution or used inappropriate practices such as masks or air purifiers. Regression analysis revealed no association between knowledge and practices. The findings of this study underscore that medical students possess commendable knowledge regarding the health effects of air pollution. However, their adoption of inappropriate practices for self-protection is evident. The lack of correlation between knowledge and practices highlights the necessity of educational initiatives to be complemented by regulatory and cultural interventions.
Topics: Humans; Students, Medical; Health Knowledge, Attitudes, Practice; Female; Male; Air Pollution; Cross-Sectional Studies; Colombia; Surveys and Questionnaires; Young Adult; Adult
PubMed: 38929035
DOI: 10.3390/ijerph21060789 -
International Journal of Environmental... May 2024The aircraft-acquired transmission of SARS-CoV-2 poses a public health risk. Following PRISMA guidelines, we conducted a systematic review and analysis of articles,... (Review)
Review
The aircraft-acquired transmission of SARS-CoV-2 poses a public health risk. Following PRISMA guidelines, we conducted a systematic review and analysis of articles, published prior to vaccines being available, from 24 January 2020 to 20 April 2021 to identify factors important for transmission. Articles were included if they mentioned index cases and identifiable flight duration, and excluded if they discussed non-commercial aircraft, airflow or transmission models, cases without flight data, or that were unable to determine in-flight transmission. From the 15 articles selected for in-depth review, 50 total flights were analyzed by flight duration both as a categorical variable-short (<3 h), medium (3-6 h), or long flights (>6 h)-and as a continuous variable with case counts modeled by negative binomial regression. Compared to short flights without masking, medium and long flights without masking were associated with 4.66-fold increase (95% CI: [1.01, 21.52]; < 0.0001) and 25.93-fold increase in incidence rates (95% CI: [4.1, 164]; < 0.0001), respectively; long flights with enforced masking had no transmission reported. A 1 h increase in flight duration was associated with 1.53-fold (95% CI: [1.19, 1.66]; < 0.001) increase in the incidence rate ratio (IRR) of cases. Masking should be considered for long flights.
Topics: COVID-19; Humans; Aircraft; SARS-CoV-2
PubMed: 38928901
DOI: 10.3390/ijerph21060654