The Impact of Telegram on Syntactic Complexity of the Saudi Female EFL Undergraduates’ Argumentative, Classification, and Reaction Essays

The aim of this exploratory experimental quantitative is to investigate the impact of the learning environment and text types on the syntactic complexity of female Saudi students majoring in English language. Specifically, the study seeks to explore how and when the syntactic complexity of these students increases/decreases as a whole and across the fourteen measures of syntactic complexity (MLS, MLT.MLC.C/S, VP/T, C/T, DC/C, DC/T, T/S, CT/T, CP/T, CP/C, CN/T, CN/C) in two learning contexts: traditional learning context (TLC) and blended learning context (BLT) across three writing tasks (argumentative, classification ,and reaction). It purports, also, to find out when and which learning context leads to the most/least increase/decrease in the syntactic complexity (as a whole and across specific measures) of Saudi undergraduate in the three writing tasks. To answer such questions, 48 female Saudi EFL undergraduate students were recruited from the pool of level six students. The participants were randomly divided into the control and experimental groups. The control group consisted of 28 students; while the experimental group was comprised of 20 students. The 288 students’ writing productions were analyzed according to the fourteen measures of syntactic complex by using a paired t-test and an independent t test. For the first question, the results of this study show that there was no increase/decrease in syntactic complexity, either as a whole or partially across individual measures, for the control group for the three writing tasks (argumentation, classification, and reaction). This would suggest that traditional learning method does not reach to level to be significant to the participants in the control group. For the second research question, the t-tests showed that the syntactic complexity of the participants in the experimental group increased as a whole in both the classification and reaction essays. An increase in complexity was shown across the following measures for the classification essay: MLS, MLT, MLC, CN/T/VP/T, and CN/C. For the reaction essay, an increase in complexity was shown across MLS, MLT, MLC, and CN/T measures. Although the syntactic complexity of these participants did not increase/decrease as a whole for the argumentation essay, the CN/T measure did show some increase. Finally, the comparison between the results of the two groups revealed that, although the experimental group in this study showed more improvement in syntactic complexity than the control group, the degree of difference between the two groups was too small to draw any definite conclusion about the relative effectiveness of the two methods. This may be due to the comparatively short duration of the study: ten weeks. The findings of this research have significant implications for academic research and for Saudi EFL teachers at the university level.

Decreased Human Platelet Activation and Mouse Pulmonary Thrombosis by Rutaecarpine and Comparison of the Relative Effectiveness with BAY11-7082: Crucial Signals of p38-NF-κB

Platelets play a critical role in arterial thrombosis. Rutaecarpine (RUT) was purified from Tetradium ruticarpum, a well-known Chinese medicine. This study examined the relative activity of RUT with NF-κB inhibitors in human platelets. BAY11-7082 (an inhibitor of IκB kinase [IKK]), Ro106-9920 (an inhibitor of proteasomes), and RUT concentration-dependently (1–6 μM) inhibited platelet aggregation and P-selectin expression. RUT was found to have a similar effect to that of BAY11-7082; however, it exhibits more effectiveness than Ro106-9920. RUT suppresses the NF-κB pathway as it inhibits IKK, IκBα, and p65 phosphorylation and reverses IκBα degradation in activated platelets. This study also investigated the role of p38 and NF-κB in cell signaling events and found that SB203580 (an inhibitor of p38) markedly reduced p38, IKK, and p65 phosphorylation and reversed IκBα degradation as well as p65 activation in a confocal microscope, whereas BAY11-7082 had no effects in p38 phosphorylation. The 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay shows that RUT and BAY11-7082 did not exhibit free radical scavenging activity. In the in vivo study, compared with BAY11-7082, RUT more effectively reduced mortality in adenosine diphosphate (ADP)-induced acute pulmonary thromboembolism without affecting the bleeding time. In conclusion, a distinctive pathway of p38-mediated NF-κB activation may involve RUT-mediated antiplatelet activation, and RUT could act as a strong prophylactic or therapeutic drug for cardiovascular diseases.

Relative Effectiveness of Cell-Cultured versus Egg-Based Seasonal Influenza Vaccines in Preventing Influenza-Related Outcomes in Subjects 18 Years Old or Older: A Systematic Review and Meta-Analysis

Avian mutations in vaccine strains obtained from embryonated eggs could impair vaccine effectiveness. We performed a systematic review and meta-analysis of the adjusted relative vaccine effectiveness (arVE) of seed cell-cultured influenza vaccines (ccIV) compared to egg-based influenza vaccines (eIV) in preventing laboratory-confirmed influenza related outcomes (IRO) or IRO by clinical codes, in subjects 18 and over. We completed the literature search in January 2021; applied exclusion criteria, evaluated risk of bias of the evidence, and performed heterogeneity, publication bias, qualitative, quantitative and sensitivity analyses. All estimates were computed using a random approach. International Prospective Register of Systematic Reviews, CRD42021228290. We identified 12 publications that reported 26 adjusted arVE results. Five publications reported 13 laboratory confirmed arVE and seven reported 13 code-ascertained arVE. Nine publications with 22 results were at low risk of bias. Heterogeneity was explained by season. We found a significant 11% (8 to 14%) adjusted arVE favoring ccIV in preventing any IRO in the 2017–2018 influenza season. The arVE was 3% (−2% to 7%) in the 2018–2019 influenza season. We found moderate evidence of a significant advantage of the ccIV in preventing IRO, compared to eIV, in a well-matched A(H3N2) predominant season.

Real World Evidence of Neutralizing Monoclonal Antibodies for Preventing Hospitalization and Mortality in COVID-19 Outpatients

Background: Neutralizing monoclonal antibodies (mAbs) are authorized for early symptomatic COVID-19 patients. Whether mAbs are effective against the SARS-CoV-2 Delta variant, among vaccinated patients, or for prevention of mortality remains unknown. Objective: To evaluate the effectiveness of mAb treatment in preventing progression to severe disease during the Delta phase of the pandemic and based on key baseline risk factors. Design, Setting, and Patients: Observational cohort study of non-hospitalized adult patients with SARS-CoV-2 infection from November 2020-October 2021, using electronic health records from a statewide health system plus state-level vaccine and mortality data. Using propensity matching, we selected approximately 2.5 patients not receiving mAbs for each patient who received mAbs. Exposure: Neutralizing mAb treatment under emergency use authorization Main Outcomes: The primary outcome was 28-day hospitalization; secondary outcomes included mortality and severity of hospitalization. Results: Of 36,077 patients with SARS-CoV-2 infection, 2,675 receiving mAbs were matched to 6,677 not receiving mAbs. Compared to mAb-untreated patients, mAb-treated patients had lower all-cause hospitalization (4.0% vs 7.7%; adjusted OR 0.48, 95%CI 0.38-0.60) and all-cause mortality (0.1% vs. 0.9%; adjusted OR 0.11, 95%CI 0.03-0.29) to day 28; differences persisted to day 90. Among hospitalized patients, mAb-treated patients had shorter hospital length of stay (5.8 vs. 8.5 days) and lower risk of mechanical ventilation (4.6% vs. 16.6%). Relative effectiveness was similar in preventing hospitalizations during the Delta variant phase (adjusted OR 0.35, 95%CI 0.25-0.50) and across subgroups. Lower number-needed-to-treat (NNT) to prevent hospitalization were observed for subgroups with higher baseline risk of hospitalization (e.g., multiple comorbidities (NNT=17) and not fully vaccinated (NNT=24) vs. no comorbidities (NNT=88) and fully vaccinated (NNT=81). Conclusion: Real-world evidence demonstrated mAb effectiveness in reducing hospitalization among COVID-19 outpatients, including during the Delta variant phase, and conferred an overall 89% reduction in 28-day mortality. Early outpatient treatment with mAbs should be prioritized, especially for individuals with highest risk for hospitalization.

Association Between Age and Outcomes of Catheter Ablation Versus Medical Therapy for Atrial Fibrillation: Results from the CABANA Trial

Background: Observational data suggest catheter ablation may be safe and effective to treat younger and older patients with atrial fibrillation (AF). No large randomized trial has examined this issue. This report describes outcomes according to age at entry in the Catheter Ablation vs Antiarrhythmic Drug Therapy for Atrial Fibrillation trial (CABANA). Methods: Patients with AF age ≥65, or <65 with ≥1 risk factor for stroke, were randomly assigned to catheter ablation versus drug therapy. The primary outcome was a composite of death, disabling stroke, serious bleeding, or cardiac arrest. Secondary outcomes included all-cause mortality, the composite of mortality or cardiovascular hospitalization, and recurrence of AF. Treatment effect estimates were adjusted for baseline covariables using proportional hazards regression models. Results: Of 2204 patients randomized in CABANA, 766 (34.8%) were age <65, 1130 (51.3%) were 65-74, and 308 (14.0%) were ≥75. Catheter ablation was associated with a 43% reduction in the primary outcome for age <65 patients (adjusted hazard ratio [aHR] 0.57, 95% confidence interval [CI] 0.30-1.09), a 21% reduction for age 65-74 (aHR 0.79; 95% CI 0.54-1.16), and an indeterminate effect for age ≥75 (aHR 1.39; 95% CI 0.75-2.58). Four year event rates for ablation versus drug therapy across age groups, respectively, were 3.2% versus 7.8%, 7.8% versus 9.6%, and 14.8% versus 9.0%. For every 10-year increase in age, the primary outcome aHR increased (i.e., less favorable to ablation) an average of 27% (interaction p value= 0.215). A similar pattern was seen with all-cause mortality: for every 10-year increase in age, the aHR increased an average of 46% (interaction p value= 0.111). AF recurrence rates were lower with ablation compared to drug therapy across age subgroups (aHR 0.47, 0.58, and 0.49, respectively). Treatment-related complications were infrequent for both arms (<3%) regardless of age. Conclusions: We found age-based variations in clinical outcomes for catheter ablation compared with drug therapy, with the largest relative and absolute benefits of catheter ablation in younger patients. No prognostic benefits for ablation were seen in the oldest patients. No differences were found by age in treatment-related complications or in the relative effectiveness of catheter ablation in preventing recurrent atrial arrhythmias.

Effective maNagement of Depression among Patients witH cANCEr (ENHANCE): A Protocol for a Hybrid Systematic Review and Network Meta-Analysis of Randomized Controlled Trials of Interventions for Depressive Symptoms.

Background: Depression is common among patients with cancer and is associated with lower treatment participation, lower satisfaction with care, poorer quality of life, greater symptom burden, and higher healthcare costs. Various types of interventions (e.g., pharmacological, psychotherapy) are used for the treatment of depression. However, evidence for these among patients with cancer is limited. Furthermore, the relative effectiveness and acceptability of different approaches is unknown because a direct comparison between all available treatments has not been carried out. We will address this by conducting a network meta-analysis (NMA) of interventions for depression among people with cancer using a hybrid overview of reviews and systematic review methodology. Methods: We will search for and extract data from systematic reviews of randomised controlled trials (RCTs) of depression interventions for patients with cancer from inception, before performing a supplemental search for more recent RCTs. We will include RCTs comparing pharmacological, psychotherapy, exercise, combination therapy, collaborative care, or complementary and alternative medicine interventions with pill placebo, no treatment, waitlist, treatment as usual, or minimal treatment control groups, or directly in head-to-head trials, among adults who have a current or previous diagnosis of cancer and elevated depressive symptoms (scores above a cut-off on validated scales or meeting diagnostic criteria). Our primary outcomes will be change in depressive symptoms (standardised mean difference) and intervention acceptability (% who withdrew). Our secondary outcomes will be 6-month change in depressive symptoms, health-related quality of life, adverse events and mortality. We will independently screen for eligibility, extract data, and assess risk of bias using the RoB2 tool. We will use frequentist random-effects multivariate NMA in Stata, Rankograms and surface under the cumulative ranking curves to synthesize evidence and obtain a ranking of intervention groups. We will explore heterogeneity and inconsistency using local and global measures and evaluate the credibility of results using the Confidence in NEtwork Meta-Analysis (CINeMA) framework.Discussion: Our findings will provide the best available evidence for managing depression among patients with cancer. Such information will help to inform clinical guidelines, evidence-based treatment decisions and future research by identifying gaps in the current literature. Systematic review registration: Submitted to PROSPERO (record number: 290145), awaiting registration