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Reply to: “RIPK3 in acute decompensation cirrhosis: Prognostic promise and analytic pitfalls”
No full textAssociations between plasma levels of coagulation factors VIII and IX and incident cardiovascular disease and mortality: systematic review and meta-analysis
No full textBACKGROUND: Associations of plasma levels of coagulation factors VIII (FVIII) and IX (FIX) with incident cardiovascular disease (CVD) and mortality remain uncertain. OBJECTIVE: To clarify associations of FVIII and FIX with CVD and mortality in a meta-analysis in general population prospective studies. METHODS: We conducted a systematic literature review up to 19 July 2024, of PubMed and Cochrane databases, reporting estimates (and measures of variability) of associations of plasma levels of FVIII or FIX with risks of incident CVD. Pooled risk ratios (RRs), adjusted for age, sex, systolic blood pressure, total cholesterol, smoking and diabetes, were estimated in a random effects meta-analysis for effects of FVIII and FIX levels on incident CVD, and CVD and total mortality. RESULTS: In 7 studies (8888 cases in 32,123 participants) for FVIII and 4 studies (2273 cases in 6951 participants) for FIX the pooled RRs (95% confidence interval) for incident CVD per 1 SD higher were 1.12 (1.09, 1.14) and 1.05 (1.00, 1.12), respectively. Corresponding CVD mortality and total mortality RRs for FVIII were 1.17 (1.07, 1.28) and 1.16 (1.12, 1.19), and for FIX;1.14 (1.06, 1.22) and 1.13 (1.07, 1.18), respectively. Comparing factor levels above versus below the 90th percentile, pooled RRs were 1.34 (1.25, 1.44) for FVIII; and 1.02 (0.85, 1.22) for FIX. CONCLUSIONS: Risks of CVD, CVD mortality and total mortality increase across higher population distributions of FVIII levels. Risks of CVD mortality and total mortality also increase across FIX levels, but no evidence of an independent effect for incident CVD risk
Cognitive Behavior Therapy for Depersonalization-Derealization Disorder (CBT-f-DDD): a feasibility randomized trial
No full textBackground:
Depersonalization-derealization disorder (DDD) is characterized by feelings of “unreality” about the self and/or external world. Cognitive Behavioral Therapy adapted for DDD (CBT-f-DDD) has been effective in published clinical audits. This study aimed to provide feasibility and acceptability data.
Methods:
An individually randomized design of CBT-f-DDD versus Treatment as Usual (TAU) was carried out with adult DDD participants from NHS Trusts in London. The CBT-f-DDD group received individual sessions over a 6-month period from CBT therapists. Qualitative interviews were conducted with CBT-f-DDD participants and their clinicians. Eight feasibility objectives were evaluated (recruitment, retention, resources, representativeness, acceptability of study design and intervention, preliminary responses to intervention, and health economics).
Results:
Thirty participants with DDD were recruited over 13 months. Only 63% completed the final assessment, so retention needs improvement. Resources were acceptable. The sample was comparable to previous studies, although younger, with a shorter duration of DDD and lower mean DDD scores. In a post-study questionnaire, no aspect of the study or treatment was rated unacceptable; however, some areas need improvement. Qualitative interviews with participants and clinicians recorded positive responses to CBT-f-DDD. Those in the CBT arm had a mean decrease of 16.9 points (SD 43.6) on the Cambridge Depersonalization Scale versus a mean decrease of 5.5 points (SD = 25.0) for the TAU arm. Health economics analyses found that CBT-f-DDD saved £153 per person. Participants reported an additional 0.08 Quality-Adjusted Life Years at low cost.
Conclusions:
This study suggests that a subsequent RCT for CBT-f-DDD is feasible and represents the first step in the process of establishing evidence-based treatments for DDD. However, refinements to the current design and delivery were indicated for a future fully powered definitive RCT of CBT-f-DDD
Bayesian Inference of Sex-Specific Mortality Profiles and Product Yields from Unsexed Cattle Zooarchaeological Remains
No full textZooarchaeological age-at-death profiles for domesticated ruminants can be inferred from tooth eruption, replacement, and wear. These profiles contain important information on slaughter management and have been used informally to infer the goals of past husbandry strategies. In principle, sex-specific survival curves could inform on various productivity parameters, including herd growth rates and sustainability, milk and meat yields, macronutrient and calorie yields, and feed consumed. Knowledge of these parameter values would allow identification of differences in husbandry economics in different archaeological contexts. However, archaeological age-at-death profiles are rarely sex-specific and are often derived from small sample sizes. As such, challenges remain in inferring sex-specific survival curves using explicit models that account for sampling uncertainty. We present a Bayesian inference approach for inferring sex-specific survival curves from unsexed cattle zooarchaeological age-at-death profiles that can accommodate data from any combination of age class boundaries. Our approach relies on the assumption that asymmetric sex-specific slaughter leads to a change in sex ratio over time, which we inform from slaughter practices in modern unimproved cattle herds. By combining inferred sex-specific archaeological survival curves with ethnographic productivity data from modern unimproved cattle, we are able to estimate herd growth rate, milk and meat yields, macronutrient and calorie yields, and feed consumed per animal. We apply our approach to zooarchaeological age-at-death profiles previously proposed to prioritise milk or meat production and to a set of profiles from ten Neolithic sites located across Europe. We infer that there was scope for improvement in prehistoric slaughter management
Clinical metagenomics for diagnosis and surveillance of viral pathogens
No full textMetagenomics is becoming more widely used for diagnosis of viral infections and surveillance of viruses. Its pathogen-agnostic approach makes metagenomics useful for unknown and novel infection diagnosis, outbreak investigation, and new and emerging pathogen surveillance. New metagenomics methods, such as the use of rapid sequencing technologies and approaches that can selectively enrich for a wide range of viruses, are expanding the range of clinical and public health scenarios in which metagenomics can be used. Following the COVID-19 pandemic, there is increasing interest in viral surveillance worldwide, using clinical samples, potential zoonotic reservoirs and environmental sources, such as wastewater. Validation and accreditation of metagenomics protocols to ensure quality, together with further innovation in methods, will be necessary to bring metagenomics into routine service in clinical and public health laboratories
Clinical and Cost-Effectiveness of Blended Cognitive Behavioral Therapy or Psychodynamic Therapy versus Face-To-Face Psychotherapy for Depression (BLENDED Study): protocol for a pragmatic, multicenter, assessor-blinded randomized controlled non-inferiority trial
No full textLearner-initiated self-selection as a next speaker in a technology-mediated L2 learning environment: A multimodal conversation analytic perspective
No full textExtensive research on next speaker selection in L2 classrooms has predominantly examined teacher-initiated nominations (e.g., Mortensen, 2008; Lauzon & Berger, 2015) or student self-selection under teacher coordination (Waring, 2011). This study shifts the focus to how L2 Chinese learners accomplish learner-initiated self-selection in a real-world, technology-mediated environment without teacher presence or institutional scaffolding. Building on Sacks et al. (1974), we reconceptualise learner-initiated self-selection as an interactional trajectory – a sequentially and multimodally achieved process, rather than a competitive act of floor-taking.
Using Multimodal Conversation Analysis (CA), we examine interactions in the Chinese Digital Kitchen (CDK), a task-based language learning environment where 72 beginner-to-advanced L2 Chinese learners cooked authentic recipes using the Linguacuisine App (Seedhouse et al., 2019). The app provided video, audio, image, and text instructions, but learners received minimal guidance and no teacher support. Analysis of the cooking sessions identifies four recurrent trajectories of learner-initiated self-selection: knowledge-display, sequential-organisation, technology-mediated opportunity, and embodied. These trajectories are not mutually exclusive but form overlapping pathways through which learners coordinate turns, manage task progression, and negotiate epistemic and procedural alignment.
Theoretically, this study contributes to CA-for-SLA by reframing self-selection as a distributed, multimodal accomplishment shaped by technological and material affordances rather than institutional regulation. It extends CA-for-SLA into non-institutional, real-world environments, showing how learners mobilise verbal, embodied, and digital resources to self-organise participation and task completion. These findings offer portable analytic categories for examining learner-initiated interaction in informal, teacher-absent, technology-mediated L2 task, and inform the design of multimodal, learner-directed learning environment