bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 15614: Pericardial and Abdominal Visceral Adiposity Are Associated With Increased Risk of Hospitalization or Death From SARS-CoV-2 Infection: A Collaborative Cohort of Cohorts for COVID-19 Research (C4R) Study
Authors: Sharaf Asma , Terry James G , Balte Pallavi , Carr Jeffrey , Allison Matthew , Anderson Cheryl A , Bhatt Surya , Long Michelle , Shashaty Michael , Al-Naamani Nadine , Christie Jason D , Oelsner Elizabeth , Anderson Michaela R
Published: November 2023

Background
Obesity increases risk of death from SARS-CoV-2 infection. Excess ectopic fat may increase this risk through inflammation, hypercoagulability, and immune dysfunction. We hypothesized that greater pericardial (PAT) and visceral adipose tissue (VAT) would associate with higher risk of hospitalization or death from SARS-CoV-2.

Methods
C4R collected SARS-CoV-2 outcomes from US-based cohort studies. These were linked to chest and abdominal CT scans obtained from Jackson Heart (2007-2010) and CARDIA (2010-2011) studies. We standardized PAT across cohorts and VAT within each cohort to account for differences in VAT measurement protocols. Our outcome was COVID-related hospitalization or death from March 2020 to February 2023 assessed via questionnaires, serosurvey, and record review. Logistic regression models were adjusted for age, sex, race/ethnicity, education, smoking status, and cohort. We adjusted for body mass index (BMI) at COVID assessment in secondary models.

Results
We included 3002 subjects with mean (SD) age of 62 (6) years, of whom 62% were women, 41% White, 59% Black, 59% never smokers, and 13% current smokers. Sixty-one subjects (2%) had SARS-CoV-2 related hospitalization or death. Every 1-standard deviation (SD) increment in PAT volume was associated with 79% higher odds of hospitalization or death (95%CI 1.38-2.33, Fig A); the estimate was similar after adjusting for BMI (OR 1.71, 95%CI 1.27-2.31). Abdominal VAT was associated with higher odds of hospitalization or death (OR 1.47 per 1 SD, 95%CI 1.20-1.81, Fig B), even after adjustment for BMI (OR 1.35, 95%CI 1.05-1.72).

Conclusion
Greater pericardial or visceral adiposity measured 10-15 years prior to SARS-CoV-2 emergence, was associated with higher odds of hospitalization or death from SARS-CoV-2 independent of BMI. Lowering PAT and VAT may have collateral benefit for those who develop SARS-CoV-2 infection. Further study of the role of visceral adipose in viral infection is needed.
Abstract 16082: Racial Differences Among Patients Undergoing Nuclear Myocardial Perfusion Imaging
Authors: Wright Catherine X , Spatz Erica S , Miller Edward J , Feher Attila
Published: November 2023

Introduction:
Noninvasive cardiac stress testing is valuable for early diagnosis and optimizing management of patients with coronary artery disease (CAD). Historically, Black patients have experienced both underdiagnosis and undertreatment of CAD. We evaluated racial disparities in patients undergoing nuclear myocardial perfusion imaging (MPI). Different modalities (MPI (SPECT, PET) vs. stress echocardiography) have variations in accuracy, cost and radiation exposure, which may reflect provider biases.

Methods:
Patient-reported demographics, clinician-reported cardiac risk factors and MPI study characteristics from a large Connecticut health system (2016 - 2022) were compared for Black and White patients in both general and matched cohorts (1:1 matched for demographics and risk factors).

Results:
The study included 123,069 cardiac stress tests from 10.5% Black and 76.2% White patients (largely similar to overall Connecticut population: 12.7% Black, 78.8% White). Black patients were younger (56.7±13.3 vs. 62.1±13.4 years, p< 0.001), more likely female (58.7 vs. 44.7%, p<0.001) and had more risk factors (Table 1). Black patients were more likely to undergo MPI (66.6 vs. 50.5%, p<0.001), inpatient or observation status testing (17.0 vs. 8.4%, p< 0.001), with pharmacological rather than exercise stress (53.9 vs. 37.0%, p<0.001) than White patients. On analysis of the 1:1 matched cohort, Black patients younger than 65 years were more likely to undergo MPI than White patients (62.1 vs. 57.4%, p<0.001), while the reverse is seen for patients over 65 years old (37.5 vs. 42.5%, p<0.001).

Conclusion:
Significant demographic and stress testing pattern differences were found between Black and White patients. These findings may reflect racial disparities in cardiovascular care, including access and clinical referral patterns. Further studies are needed to determine if these differences in stress testing strategies impact downstream clinical outcomes.
Abstract 16084: Impairment of Cardio-Spleno-Bone Marrow Axis Following Myocardial Infarction in Diabetes Mellitus
Authors: Salybekov Amankeldi A , Hassanpour Mehdi , Tashov Kanat , Salybekova Ainur , Sheng Yin , Shinozaki Yoshiko , Kobayashi Shuzo , Asahara Takayuki
Published: November 2023

Introduction:
Precise comprehension of the cardio-spleen-bone-marrow immune cells axis is crucial to understanding the changes occurring during diabetes (DM) pathogenesis. This study aims to investigate the alterations in immune cell kinetics in DM after myocardial infarction (MI).

Methods:
MI was induced in DM and healthy control using C57BL/N6 mice. Animals were sacrificed at D1, D3, D7, & D28 post-MI to obtain their heart, peripheral blood (PB), spleen, and bone marrow (BM) and then each organ cell suspension was isolated, and analyzed by flow cytometry. EPC-colony-forming assay (EPC-CFA) was performed using BM, PB, and spleen-derived MNCs.

Results:
Findings demonstrated that despite the normal production of BM, CD45+ cells are decreased at D1-D3 in spleen and PB of DM’s. Further analysis depicted that total and pro-inflammatory neutrophil (N1) decreased at D1-D3 in PB and spleen at D3-D7 in DM mice, suggesting that DM causes spleen's neutrophil alterations that cannot compensate for PB and ischemia tissue demand. Infiltrated macrophages (total, M1, M2) decreased at D3 in DM-ischemic heart. Total and M1 (D1-D3) and M2 (D3-D7) notably decreased in DM-PB than control group, showing impaired macrophage recruitment/polarization in DM. Moreover, heart myeloid dendritic cells (mDCs) increased from D1-D7, the latter enhanced recruitment of CD8 cells increase from D1 to D28 in DM-infarcted-myocardium. The total CD4 cells decreased at D1-D3 in DM-PB, indicating a delayed adaptive immune response to MI. The B-cells diminished at D1-D3 in PB, at D3 in myocardium, and D7 in spleen, indicating impaired mobilization of those cells from bone marrow to compensate. EPC-CFA demonstrated dramatically decrease of definitive EPC colonies in spleen and BM from D1-D28 in DM mice vs control
in vitro
, indicating that DM significantly impairs EPC colony-forming bioactivity by limiting EPCs' differentiation from primitive to definitive.

Conclusion:
Our study highlights significant alterations of cardio-spleno-bone-marrow immune cells axis following MI in DM animals, revealing delayed innate/adaptive immune responses and impaired differentiation of EPCs.
Abstract 16087: Contemporary Use of Guideline Directed Heart Failure Medications in Patients With Centrifugal Durable Left Ventricular Assist Device
Authors: Nandar Phoo Pwint , Tereshchenko Larisa G , Jacob Miriam , Bhat Pavan , Bhattacharya Sanjeeb S , Starling Randall , Tang Wai Hong W , Martyn Trejeeve M
Published: November 2023

Introduction:
As societal guidelines have recently supported, our large-volume center has recently protocolized the use of guideline directed medical therapy  in patients with left ventricular assist devices  to promote ventricular recovery.

Hypothesis:
We sought to understand the use of, and opportunity to improve upon, GDMT use in the LVAD population.To describe contemporary utilization of comprehensive GDMT in the  LVAD population and to characterize patient factors associated with use of HF medical therapy utilizing a comprehensive GDMT score.

Methods:
We conducted retrospective of analysis of patients who had HM3 implanted at our center  and had at least one ambulatory visit for HF in the prior 12 months. Baseline characteristics, laboratory test, acute care utilization and GDMT score data were extracted from the nearest date of the ambulatory encounter to the data extraction date that occurred on 9/23/22. GDMT score  composition includes beta-blocker, ACEI/ARB [0 for none, 1 for <50% and 2 for ≥50% of max dose], MRA, SGLT2i, ARNI [0 for none and 2 for any dose] and ISDN/Hydra [0 for none and 1 for any dose]. Linear regression analyses of clinical variables associated with GDMT score were performed.

Results:
We observed mean score of 3.23 ± 1.7 with median of 3.0. In this study, mean age was 60, >70% were Caucasian male and mean eGFR was 62. 49% of total cohort [135] were on beta-blocker, 75% [202] on ARB/ACE/ARNI, 47% [127] on MRA, and only 15% [40] on SGLT2i and 20% [53] on ISDN/Hydralazine. Majority [~95%] do not have absolute contraindication to GDMT [based on MAP <65, eGFR <30, K> 5.0]. Adjusted multivariable regression analysis showed GDMT score </= 3 was associated with higher age [adjusted risk score of - 0.25 per every 10 years, 95% CI : -0.43 to - 0.65], higher MAP [adjusted risk score of - 0.19 per every 10 mmHg, 95% CI : -0.34 to - 0.03], and all-cause hospitalizations [adjusted risk score of - 0.23, 95% CI : -0.40 to - 0.06]. There was no significant association with gender, race, heart rate, NT-proBNP, eGFR, potassium and comorbidities.

Conclusions:
We identified significant opportunity to improve use of GDMT in the post LVAD population, with older age and frequent hospitalization being associated with worse GDMT use.
Abstract 16093: Hemodynamic Implications of Transseptal Access for Ventricular Tachycardia Ablation in Patients With Left Ventricular Assist Devices
Authors: Curtis Brett , Deshmukh Amrish , Larson John D , Ghanbari Hamid , Ghannam Michael , Latchamsetty Rakesh , Bogun Frank , Liang Jackson
Published: November 2023

Introduction:
Ventricular tachycardia (VT) is common in patients with left ventricular assist devices (LVAD), and catheter ablation can be an effective treatment strategy. Although transseptal approach for LV mapping and ablation is often preferred, iatrogenic atrial septal defect (ASD) after transseptal access may theoretically result in clinically significant right-to-left shunting. The short- and long-term implications of transseptal puncture, including hemodynamic changes in LVAD patients, remain uncertain.

Methods and Results:
From 2013-2023, 15 LVAD patients (age 68.5±12 years; 2 women) underwent 18 VT ablation procedures with single transseptal access for LV ablation without ASD closure afterwards. Clinical VT was eliminated in 83%. No patients had prior PFO/ASD; Mean RVSP was 45mmHg, 6 (40%) had pulmonary hypertension, and 8 (53.3%) had moderate or severe RV dysfunction. All patients had previously failed at least 1 antiarrhythmic drug (amiodarone 100%; sotalol 33%; mexiletine 94%). Procedural complications occurred in 3 procedures (all related to vascular access, none directly related to transseptal access; 1 patient with interrupted IVC requiring transhepatic access had bleeding due to transection of intercostal artery requiring arterial embolization). Post-procedure echocardiograms (n=14; mean time to echo 90±116 days) showed no intra-cardiac shunting or persistent ASD. Right heart catheterization (pre: n=12; post: n=8, at mean follow-up 187±243 days) showed similar pre- and post-ablation RA pressures (11.6 vs 14.9 mmHg,
p
=0.24) and wedge pressures (14.9 vs 20.4 mmHg,
p
=0.8) with absence of significant shunting based on pre- and post-ablation arterial (95.2% vs 97.7%,
p
=0.06) and PA oxygen saturations (56.5% vs 51.3%,
p
=0.29). No episodes of clinically significant hypoxia occurred after ablation.

Conclusion:
Transseptal access for VT ablation can be safely performed in LVAD patients and is unlikely to result in clinically or hemodynamically significant residual shunting over long-term follow-up. Therefore, empiric ASD closure after transseptal access in all LVAD patients is likely unnecessary.
Transcatheter Palliation With Pulmonary Artery Flow Restrictors in Neonates With Congenital Heart Disease: Feasibility, Outcomes, and Comparison With a Historical Hybrid Stage 1 Cohort
Authors: Sperotto Francesca , Lang Nora , Nathan Meena , Kaza Aditya , Hoganson David M. , Valencia Eleonore , Odegard Kirsten , Allan Catherine K. , da Cruz Eduardo M. , Del Nido Pedro J. , Emani Sitaram M. , Baird Christopher , Maschietto Nicola
Published: November 2023

BACKGROUND:

Neonates with complex congenital heart disease and pulmonary overcirculation have been historically treated surgically. However, subcohorts may benefit from less invasive procedures. Data on transcatheter palliation are limited.

METHODS:

We present our experience with pulmonary flow restrictors (PFRs) for palliation of neonates with congenital heart disease, including procedural feasibility, technical details, and outcomes. We then compared our subcohort of high-risk single ventricle neonates palliated with PFRs with a similar historical cohort who underwent a hybrid Stage 1. Cox regression was used to evaluate the association between palliation strategy and 6-month mortality.

RESULTS:

From 2021 to 2023, 17 patients (median age, 4 days; interquartile range [IQR], 2–8; median weight, 2.5 kilograms [IQR, 2.1–3.3]) underwent a PFR procedure; 15 (88%) had single ventricle physiology; 15 (88%) were high-risk surgical candidates. All procedures were technically successful. At a median follow-up of 6.2 months (IQR, 4.0–10.8), 13 patients (76%) were successfully bridged to surgery (median time since PFR procedure, 2.6 months [IQR, 1.1–4.4]; median weight, 4.9 kilograms [IQR, 3.4–5.8]). Pulmonary arteries grew adequately for age, and devices were easily removed without complications. The all-cause mortality rate before target surgery was 24% (n=4). Compared with the historical hybrid stage 1 cohort (n=23), after adjustment for main confounding (age, weight, intact/severely restrictive atrial septum or left ventricle to coronary fistulae), the PFR procedure was associated with a significantly lower all-cause 6-month mortality risk (adjusted hazard ratio, 0.26 [95% CI, 0.08–0.82]).

CONCLUSIONS:

Transcatheter palliation with PFR is feasible, safe, and represents an effective strategy for bridging high-risk neonates with congenital heart disease to surgical palliation, complete repair, or transplant while allowing for clinical stabilization and somatic growth.
Patterns of Aortic Dilation in Tetralogy of Fallot: An Analysis of 100 Fetal Echocardiograms Compared With Matched Controls
Authors: Dasgupta Minnie N. , Kaplinski Michelle A. , Reddy Charitha D. , Collins R. Thomas
Published: November 2023

Background

Although aortic dilation is common in tetralogy of Fallot (TOF), its progression and risk of dissection are not well understood. The mechanism of dilation is primarily attributed to increased flow in utero; an alternative is unequal septation of the truncus arteriosus resulting in a larger aorta and inherently hypoplastic pulmonary artery (PA). If the latter is true, we hypothesize the aorta to PA ratio in TOF is stable throughout gestation, and sums of great artery dimensions are similar to controls.

Methods and Results

We performed a single‐center retrospective study of fetuses with TOF (2014–2020) and matched controls. We compared sums of diameters, circumferences, and cross‐sectional areas of the aorta and PA and evaluated the aorta to PA ratio across gestation in 2 TOF subtypes: pulmonary stenosis and atresia (TOF‐PA). There were 100 echocardiograms with TOF (36% TOF‐PA) with median gestational age of 31 weeks (interquartile range 26.5–34.4) and median maternal age of 34 years (interquartile range 30–37). There were no differences in sums of great artery dimensions between TOF‐pulmonary stenosis and controls. In TOF‐PA, sums were significantly lower than controls (
P
values <0.01). The aorta to PA ratio was stable throughout gestation (Pearson's
r
=0.08 [95% CI, −0.12 to 0.27], −0.06 [95% CI, −0.25 to 0.14]).

Conclusions

The aorta in fetal TOF is large but grows proportionally throughout gestation, with sums of great artery dimensions similar to controls. TOF‐PA appears distinct from TOF‐pulmonary stenosis (with smaller sums), warranting further investigation. In conclusion, our findings suggest an intrinsic developmental mechanism contributes to aortic dilation in TOF.
A new species of Helietta (Pilocarpinae, Zanthoxyloideae, Rutaceae) from Colombia and notes on the morphology and circumscription of H. glaziovii
Authors: LONDOÑO-ECHEVERRI YEISON , TRUJILLO-LÓPEZ ANA MARÍA , PIRANI JOSÉ RUBENS , PÉREZ-ZABALA JORGE ANDRÉS
Published: November 2023

Helietta magna, a new species from the Magdalena River Valley in Colombia is described and illustrated, with notes on its geographical distribution, phenology, conservation status and taxonomic affinities. The new species shares the character of leaflets with an involute margin apically only with H. apiculata and H. glaziovii and can be distinguished from these two species mainly by its larger leaflets, which are acuminate with involute margin only over the acumen and its ovary puberulous apically. Being the first recorded species from very humid forest, it expands the ecological spectrum of the genus, heretofore known only from mesic to dry habitats. Novel morphological information observed in the type specimens of H. glaziovii is also presented, along with notes on its current circumscription.
Serum neurofilament light chain levels in migraine patients: a monocentric case–control study in China
Authors: Fang Jie , Wu Jielong , Zhang Tengkun , Yuan Xiaodong , Zhao Jiedong , Zheng Liangcheng , Hong Ganji , Yu Lu , Lin Qing , An Xingkai , Jing Chuya , Zhang Qiuhong , Wang Chen , Wang Zhanxiang , Ma Qilin
Published: November 2023

Purpose

Serum neurofilament light chain (sNfL) can reflect nerve damage. Whether migraine can cause neurological damage remain unclear. This study assesses sNfL levels in migraine patients and explores whether there is nerve damage in migraine.

Methods

A case–control study was conducted in Xiamen, China. A total of 138 migraine patients and 70 healthy controls were recruited. sNfL (pg/mL) was measured on the single-molecule array platform. Univariate, Pearson correlation and linear regression analysis were used to assess the relationship between migraine and sNfL levels, with further subgroup analysis by migraine characteristics.

Results

Overall, 85.10% of the 208 subjects were female, with a median age of 36 years. sNfL levels were higher in the migraine group than in the control group (4.85 (3.49, 6.62) vs. 4.11 (3.22, 5.59)), but the difference was not significant (P = 0.133). The two groups showed an almost consistent trend in which sNfL levels increased significantly with age. Subgroup analysis showed a significant increase in sNfL levels in patients with a migraine course ≥ 10 years (β = 0.693 (0.168, 1.220), P = 0.010). Regression analysis results show that age and migraine course are independent risk factors for elevated sNfL levels, and there is an interaction between the two factors. Patients aged < 45 years and with a migraine course ≥ 10 years have significantly increased sNfL levels.

Conclusions

This is the first study to evaluate sNfL levels in migraine patients. The sNfL levels significantly increased in patients with a migraine course ≥ 10 years. More attention to nerve damage in young patients with a long course of migraine is required.
The HEARTS ECG workshop: a novel approach to resident and student ECG education
Authors: El-Baba Mazen , McLaren Jesse , Argintaru Niran
Published: November 2023

Objectives

ECG interpretation is a life-saving skill in emergency medicine (EM), and a core competency in undergraduate medical curricula; however, confidence for residents/students is low. We developed a novel educational intervention—the HEARTS ECG workshop—that provides a systematic approach to ECG interpretation, teaches EM residents through the process of teaching medical students and highlights emergency management.

Methods

We used the Kern Approach to Curriculum Development. A review of ECG education literature and a targeted needs assessment of local students/residents led to goals and objectives including systematic ECG interpretation with clinical relevance. ECGs were selected based on a national consensus of EM program directors and categorized into 5 common emergency presentations. The educational strategy included content based on HEARTS approach (Heart rate/rhythm, Electrical conduction, Axis, R-wave progression, Tall/small voltages, and ST/T changes), and methods including flipped classroom and near-peer teaching. Evaluation and feedback were based on the Kirkpatrick program evaluation. The workshop was piloted with 6 junior EM residents and 58 medical students, and repeated with nine residents and 68 students from four medical schools.

Results

Residents and students agreed or strongly agreed that the workshop improved their perceived ability (100% and 95%, respectively) and confidence (77% and 88%, respectively) in interpreting ECGs. Reports of ECG interpretation causing anxiety declined from pre-workshop (61% and 83% respectively) to post-workshop (38% and 37% respectively). Residents reported behavior change: 3 months after the workshop, 92.3% reported ongoing use of the HEARTS approach clinically and through teaching medical students on shifts. Reported workshop strengths included the pre-workshop material, the clinical application, facilitator-to-learner ratio, interactivity, the ease of remembering and applying the HEARTS mnemonic, and the iterative application of the approach. Suggested changes included longitudinal sessions with graded difficulty, and allocating more time for introductory material for ease of understanding.

Conclusion

The HEARTS ECG workshop is an innovative pedagogical method that can be adapted for all levels of training. Future directions include integration in undergraduate medical and EM residency curricula, and workshops for physicians to update ECG interpretation skills.
Active and productive ageing in India: evidence from the time use pattern of ageing adults
Authors: Irshad C. V. , Lekha P. Padma Sri , Azeez E. P. Abdul , Rajan S. Irudaya
Published: November 2023

Background

With the increasing proportion of older adults in India, it becomes essential to get an insight into the various influencing factors of successful ageing. However, the literature on successful ageing is minuscule in the Indian context. The present study attempted to understand successful ageing in terms of active and productive ageing by exploring their determining factors.

Methods

The data were extracted from the Longitudinal Ageing Study in India (LASI) Wave–1 (2017–2018). We utilized self-reported time use information from the experimental module of the LASI. A total of 7837 ageing adults were included in the study. We employed descriptive statistics, bivariate analysis and a multinominal logistic regression model to examine the prevalence and the determinants of active and productive ageing.

Results

The prevalence of inactive ageing was higher among the Indian ageing population (57.47%), followed by active ageing (29.59%) and productive ageing (12.94%). Poor sleep quality and the prevalence of morbidity and disability limited the ageing population from attaining active and productive ageing. Engagement in physical activity was significantly associated with active and productive ageing (β = 0.83, 99% CI: -0.72–0.94 and β = 0.82, 99% CI: 0.66–0.98), respectively. Rural ageing adults were more likely to attain active ageing and less likely to attain productive ageing.

Conclusion

Engagement in physical activities among the ageing population shall be promoted to attain active and productive ageing. Since the rural ageing population were less likely to attain productive ageing than their urban counterparts, opportunities to participate in more formal economic activities in rural areas could be promoted for the wellbeing of the second demographic dividend.
Post-chemo-radiotherapy response and pseudo-progression evaluation on glioma cell types by multi-parametric magnetic resonance imaging: a prospective study
Authors: Zamanian Maryam , Abedi Iraj , Danazadeh Fatemeh , Amouheidari Alireza , Shahreza Bentolhoda Otroshi
Published: November 2023

Background

We focused on Differentiated pseudoprogression (PPN) of progression (PN) and the response to radiotherapy (RT) or chemoradiotherapy (CRT) using diffusion and metabolic imaging.

Methods

Seventy-five patients with glioma were included in this prospective study (approved by the Iranian Registry of Clinical Trials (IRCT) (IRCT20230904059352N1) in September 2023). Contrast-enhanced lesion volume (CELV), non-enhanced lesion volume (NELV), necrotic tumor volume (NTV), and quantitative values ​​of apparent diffusion coefficient (ADC) and magnetic resonance spectroscopy (Cho/Cr, Cho/NAA and NAA/Cr) were calculated by a neuroradiologist using a semi-automatic method. All patients were followed at one and six months after CRT.

Results

The results of the study showed statistically significant changes before and six months after RT-CRT for M-CELV in all glioma types (𝑝 < 0.05). In glioma cell types, the changes in M-ADC, M-Cho/Cr, and Cho/NAA indices for PN were incremental and greater for PPN patients. M-NAA/Cr ratio decreased after six months which was significant only on PN for GBM, and Epn (𝑝 < 0.05). A significant difference was observed between diffusion indices, metabolic ratios, and CELV changes after six months in all types (𝑝 < 0.05). None of the patients were suspected PPN one month after treatment. The DWI/ADC indices had higher sensitivity and specificity (98.25% and 96.57%, respectively).

Conclusion

The results of the present study showed that ADC values and Cho/Cr and Cho/NAA ratios can be used to differentiate between patients with PPN and PN, although ADC is more sensitive and specific.
Association of body fat percentage with kidney stone Disease: a cross-sectional and longitudinal study among bus drivers
Authors: Zheng Xujuan , Chen Qianqian , Wu Yanxia , Xiong Juan
Published: November 2023

Background

The association between body fat percentage (BFP) and kidney stone disease (KSD) among bus drivers has not been explored in the existing literature. Thus, this study was conducted to explore the influence of BFP on the risk of KSD as well as KSD development for bus drivers to fill the research gap.

Methods

A cross-sectional and longitudinal cohort study was designed. In total, 3433 bus drivers were included in the cross-sectional analyses, and 1864 bus drivers without KSD at baseline and with regular follow-up were included in the longitudinal cohort study.

Results

During a median follow-up of 2.9 years, KSD occurred in 15.0% of bus drivers. Multivariate logistic analysis found that each 5% higher BFP was not only significantly related with higher odds of KSD (odds ratio [OR] = 1.48), but also associated with higher odds of developing KSD (OR = 1.27). The risk of prevalent KSD in obesity group based on BFP was 2.47 times of the normal group; and the corresponding risk of developing KSD was 1.61 times. For obesity bus drives with age < 40, the corresponding risk increased to 4.54 times.

Conclusion

Bus drivers were reported to have a high prevalence of KSD as well as development of KSD. As a significant predictive factor for KSD, BFP can be used to monitor and prevent bus drivers from kidney stone formation. Bus drivers in obesity group based on BFP, especially with age < 40 years should become priority subjects for targeted prevention.
Patient brokering in for-profit substance use disorder treatment: a qualitative study with people with opioid use disorder and professionals in the field
Authors: Clingan Sarah E. , D’Ambrosio Brittany M. , Davidson Peter J.
Published: November 2023

Background

Opioid use and opioid overdose deaths are at an all-time high and evidence-based treatments for people with opioid use disorder (OUD) are underutilized. Therefore, we sought to understand experiences and perceptions of abuses in the for-profit substance use disorder treatment industry that could potentially put people with OUD at an increased risk for an overdose.

Methods

One-on-one semi-structured interviews were conducted from November 2018 to May 2019 in Southern California with 20 people with OUD and 20 professionals who work in the substance use disorder (SUD) treatment field. A grounded theory approach was conducted to discover emerging patterns from the data.

Results

Three major themes emerged:1) financial and material enticements, 2) encouraging substance use in the for-profit treatment sector, and 3) contributors to overdose risk. Participants reported that patient brokers would pay for plane tickets and offer financial incentives (e.g., money) to attract individuals to SUD treatment, capitalizing on insurance profits despite initial expenses. Participants reported being encouraged to use drugs before treatment to meet insurance conditions, thus jeopardizing genuine recovery efforts and adding to the temptation of drug use. Many participants linked patient brokering to increased overdose deaths, emphasizing the dangerous practices of brokers providing drugs, promoting relapse, and creating a revolving door of treatment, which compounds the overdose risk after periods of abstinence.

Conclusions

Patient brokering and unethical abuses in the for-profit treatment industry have caused some people with OUD to seek treatment for money and housing instead of seeking treatment to stop opioid use. The harmful treatment environment was seen as a barrier to care and an unwanted obstacle to overcome on the path to recovery.
Current status and influencing factors of policy identification in health impact assessment: a case study of Zhejiang Province
Authors: Liu Xiang , Liu Yingzi , Xu Yanyun , Song Liyuan , Huang Ziyue , Zhu Xingyu , Zhang Meng
Published: November 2023

Background

Health impact assessment (HIA) is a procedure, method and tool for evaluating the potential health impacts of policies, plans and construction projects, as well as the distribution of these impacts on population. Majority of international studies on health impact assessment have focussed on conceptual papers or case evaluations, neglecting participants’ views on policies.

Methods

A semi-structured interview with 30 health impact assessment experts was employed in this study, and the Nvivo software was utilized to analyse factors that influence policy identification. Subsequently, a multi-stage stratified random sampling method was adopted to survey 655 pilot staff members involved in health impact assessment in Zhejiang Province. Descriptive statistics were used to describe the current status and identify the factors influencing policy identification. In addition, hierarchical linear regression analysis and structural equation modelling were employed to determine the relationship between policy identification and influencing factors.

Results

Statistically significant differences were found among participants in the level of identification of policies across three dimensions. The policy sentiment dimension had the highest score (4.137 ± 0.664), followed by policy cognition (4.075 ± 0.632) and policy evaluation (3.631 ± 0.797) dimensions. Subject trust had a positive impact on policy cognition (β = 0.503, P < 0.001), policy sentiment (β = 0.504, P < 0.001) and policy evaluation (β = 0.465, P < 0.001). Procedural justice had a positive impact on policy sentiment (β = 0.085, P < 0.01) and policy evaluation (β = 0.084, P < 0.05), but not policy cognition (β = 0.056, P > 0.05). Policy identification is influenced by age and average monthly salary among other factors.

Conclusion

These results highlight the importance of subjective trust and procedural justice in policy identification of health impact assessment. They provide valuable insights to developing interventions to overcome barriers to the implementation and enhancement of global identification of policies. Going forward, cross-sectoral synergies, enhanced international communication and training to increase participants’ trust in the policy should be optimized to improve health impact assessment. Additional measures should be taken, such as ensuring seamless communication channels, embedding health impact assessment in administrative mechanisms, and establishing strong oversight and grievance mechanisms to improve fairness and transparency in the implementation and results of health impact assessment.
No obvious effect on mortality from a patient choice reform expanding access to opioid disorder treatment – results from a natural experiment of policy change in Sweden
Authors: Håkansson Anders , Janfada-Baloo Sahar , Berge Jonas
Published: November 2023

Background

Opioid-related overdose deaths remain a common cause of death in many settings, and opioid maintenance treatment is evidence-based for the treatment of opioid use disorders. However, access to such treatment varies and is limited in many settings.

Methods

The present study examines the longitudinal effects of a regional patient choice reform which substantially increased availability to opioid maintenance treatment in one Swedish county, starting from 2014. A previous follow-up, limited in time, indicated a possible effect on mortality from this intervention, demonstrating a lower increase in overdose deaths than in counties without this reform. The present study follows overdose deaths through 2021, and compares the intervention county to the remaining parts in the country, using death certificate statistics from the national causes of death register.

Results

The present study does not demonstrate any significant difference in the development of overdose mortality in the county where this reform substantially expanded treatment access, compared to other counties in the country.

Conclusions

The study underlines the importance to maintain extensive efforts against overdose deaths over and above the treatment of opioid use disorders, such as low-threshold provision of opioid antidotes or other interventions specifically addressing overdose risk behaviors.
Diallyl trisulfide improves spinal cord ischemia–reperfusion injury damage by activating AMPK to stabilize mitochondrial function
Authors: Sun Yang , Xu Dengyue , Yang Weidong , Zhang Hongquan , Su Yi , Gao Bin , Zou Xiaowei , Zhong Yiming , Sun Huanwei , Xiang Liangbi
Published: November 2023

Background

Spinal cord ischemia–reperfusion injury (SCII) is a catastrophic event, which can cause paraplegia in severe cases. In the reperfusion stage, oxidative stress was up-regulated, which aggravated the injury and apoptosis of neurons. As the main active ingredient of garlic, diallyl trisulfide (DATS) displays strong antioxidant capacity. However, it is unknown whether DATS can protect the neurons of SCII.

Materials and methods

In this study, the descending aorta at the distal end of the left subclavian artery was ligated and perfused again after 14 min. Samples including blood and spinal cord (L2–L5) were taken 24 h later for morphological and biochemical examination.

Results

After SCII, the rats showed motor dysfunction, increase apoptosis, malondialdehyde content, mitochondrial biogenesis and dynamic balance disorder. After the application of DATS, the adenosine monophosphate activated protein kinase (AMPK) was activated, the mitochondrial damage was improved, the oxidative stress was weakened, and the neuronal damage was recovered to some extent. However, the addition of compound C significantly weakened the protective effect of DATS.

Conclusion

Oxidative stress caused by mitochondrial damage was one of the important mechanisms of neuronal damage in SCII. DATS could activate AMPK, stabilize mitochondrial biogenesis and dynamic balance, and reduce neuronal damage caused by oxidative stress.
The impact of intraoperative and postoperative fluid balance on complications for transthoracic esophagectomy: a retrospective analysis
Authors: Buchholz Vered , Hazard Riley , Yin Zoe , Tran Nghiep , Yip Sui Wah Sean , Le Peter , Kioussis Benjamin , Hinton Jake , Liu David S , Lee Dong-Kyu , Weinberg Laurence
Published: November 2023

Objective

Transthoracic esophagectomy is associated with significant morbidity and mortality. Therefore, it is imperative to optimize perioperative management and minimize complications. In this retrospective analysis, we evaluated the association between fluid balance and esophagectomy complications at a tertiary hospital in Melbourne, Australia, with a particular focus on respiratory morbidity and anastomotic leaks. Cumulative fluid balance was calculated intraoperatively, postoperatively in recovery postoperative day (POD) 0, and on POD 1 and 2. High and low fluid balance was defined as greater than or less than the median fluid balance, respectively, and postoperative surgical complications were graded using the Clavien-Dindo classification.

Results

In total, 109 patients, with an average age of 64 years, were included in this study. High fluid balance on POD 0, POD1 and POD 2 was associated with a higher incidence of anastomotic leak (OR 8.59; 95%CI: 2.64-39.0). High fluid balance on POD 2 was associated with more severe complications (of any type) (OR 3.33; 95%CI: 1.4–8.26) and severe pulmonary complications (OR 3.04; 95%CI: 1.27–7.67). For every 1 L extra cumulative fluid balance in POD 1, the odds of a major complication increase by 15%, while controlling for body mass index (BMI) and American Society of Anaesthesiologists (ASA) class. The results show that higher cumulative fluid balance is associated with worsening postoperative outcomes in patients undergoing transthoracic esophagectomy. Restricted fluid balance, especially postoperatively, may mitigate the risk of postoperative complications – however prospective trials are required to establish this definitively.
Genotyping and antibiotic susceptibility of Campylobacter species isolated from raw milk samples in Qazvin, Iran
Authors: Ahmadi Zohreh , Pakbin Babak , kazemi Maryam , Rahimi Zahra , Mahmoudi Razzagh
Published: November 2023

Objective

Campylobacter species are major causes of foodborne illnesses, with unpasteurized milk being a significant carrier of these bacteria, posing a public health risk. One of the challenges in managing Campylobacter infections is the emergence and spread of antibiotic resistance. We conducted a study in Qazvin, Iran, testing 84 raw cow’s milk samples to determine the frequency of C. jejuni and C. coli using culture-based and multiplex PCR methods. Additionally, the disk diffusion and RAPD-PCR approaches were utilized to evaluate the phenotypic antibiotic resistance profile and genetic diversity of Campylobacter strains.

Results

The findings indicated that Campylobacter spp. was present in 19.05% of the samples, with C. coli being the predominant isolate. We tested eight antibiotic agents, and the resistance levels of the isolates were as follows: erythromycin 100%, tetracycline 75%, doxycycline 56.25%, ceftriaxone 43.75%, chloramphenicol 37.5%, amoxicillin-clavulanic acid 25%, nalidixic acid 12.5%, and azithromycin 6.25%. Genetic diversity analysis categorized Campylobacter isolates into 39 clusters, indicating a wide diversity among strains. However, no significant correlation was observed between antibiotic resistance and cluster patterns. These findings underscore the role of raw milk as a reservoir for Campylobacter spp. and highlight the substantial antibiotic resistance and genetic diversity within the species population.
Random block-coordinate methods for inconsistent convex optimisation problems
Authors: Staudigl Mathias , Jacquot Paulin
Published: November 2023

We develop a novel randomised block-coordinate primal-dual algorithm for a class of non-smooth ill-posed convex programs. Lying midway between the celebrated Chambolle–Pock primal-dual algorithm and Tseng’s accelerated proximal gradient method, we establish global convergence of the last iterate as well as optimal $O(1/k)$
O
(
1
/
k
)
and $O(1/k^{2})$
O
(
1
/

k
2

)
complexity rates in the convex and strongly convex case, respectively, k being the iteration count. Motivated by the increased complexity in the control of distribution-level electric-power systems, we test the performance of our method on a second-order cone relaxation of an AC-OPF problem. Distributed control is achieved via the distributed locational marginal prices (DLMPs), which are obtained as dual variables in our optimisation framework.
Basic and clinical study of the effect of exogenous hyaluronic acid on the quality of acellular dermal matrix combined with thin intermediate split thickness skin graft
Authors: Chen Fuhuan , Chai Jiake , Zhao Jingyu , Wu Jiang , Chen Baoguo
Published: November 2023

Background

To promote wound recovery in the recipient region, we studied the impact of exogenous hyaluronic acid (HA) on acellular dermal matrix (ADM) paired with thin intermediate-thickness skin transplant.

Methods

This study contains animal and clinical experiments. 50 Japanese big ear rabbits were separated into HA1, HA2, PADM, TS, and NS groups. Clinical part included 50 scar patients dividing into 5 groups (TS + HA + ADM 1, TS + ADM2, TS, TS + ADM and normal skin (NS)).

Results

In the animal trial, after 56 days, the grafts contracted least in the HA2 group; HA2 had the highest microvascular density (MVD), HA concentration, and collagen I and III expression. In clinical work, ADM > HA + ADM2 > HA + ADM1 > TS > NS; Type I and III collagen: HA + ADM1 and HA + ADM2 were higher than ADM; HA content: TS > HA + ADM1 > HA + ADM 2 > ADM.

Conclusions

ADM, exogenous hyaluronic acid mixed with thin skin autograft has better biomechanical qualities and therapeutic impact than acellular dermal matrix alone, and the reconstructive result is near to self-thick skin autograft in all indexes.
Profiling of the fecal microbiota and circulating microRNA-16 in IBS subjects with Blastocystis infection : a case–control study
Authors: Olyaiee Alireza , Yadegar Abbas , Mirsamadi Elnaz Sadat , Sadeghi Amir , Mirjalali Hamed
Published: November 2023

Irritable bowel syndrome (IBS) is a prevalent gastrointestinal (GI) tract disorder. Although the main reason for IBS is not clear, the interaction between intestinal microorganisms and the gut barrier seems to play an important role in pathogenesis of IBS. The current study aimed to investigate the effect of Blastocystis on the gut microbiota profile and the circulation levels of microRNA (mir)-16 of IBS patients compared to healthy subjects. Stool and blood samples were collected from 80 participants including 40 samples from each IBS and healthy group. Upon DNA extraction from stool samples, barcoding region and quantitative real-time PCR were analyzed to investigate Blastocystis and the microbiota profile, respectively. RNA was extracted from serum samples of included subjects and the expression of mir-16 was evaluated using stem-loop protocol and qreal-time PCR. Significant changes between IBS patients and healthy controls was observed in Firmicutes, Actinobacteria, Faecalibacterium, and Alistipes. In IBS patients, the relative abundance of Bifidobacteria was directly correlated with the presence of Blastocystis, while Alistipes was decreased with Blastocystis. Lactobacillus was significantly increased in Blastocystis carriers. In healthy subjects, the relative abundance of Bifidobacteria was decreased, but Alistipes was increased in Blastocystis carriers. The changes in the Firmicutes/Bacteroidetes ratio was not significant in different groups. The relative expression of mir-16 in Blastocystis-negative IBS patients and healthy carriers was significantly overexpressed compared to control group. The presence of Blastocystis, decreased the relative expression of mir-16 in IBS patients compared to Blastocystis-negative IBS patients. The present study revealed that Blastocystis has the ability to change the abundance of some phyla/genera of bacteria in IBS and healthy subjects. Moreover, Blastocystis seems to  modulate the relative expression of microRNAs  to control the gut atmosphere, apply its pathogenicity, and provide a favor niche for its colonization.
Genomic signatures of selection, local adaptation and production type characterisation of East Adriatic sheep breeds
Authors: Lukic Boris , Curik Ino , Drzaic Ivana , Galić Vlatko , Shihabi Mario , Vostry Luboš , Cubric-Curik Vlatka
Published: November 2023

Background

The importance of sheep breeding in the Mediterranean part of the eastern Adriatic has a long tradition since its arrival during the Neolithic migrations. Sheep production system is extensive and generally carried out in traditional systems without intensive systematic breeding programmes for high uniform trait production (carcass, wool and milk yield). Therefore, eight indigenous Croatian sheep breeds from eastern Adriatic treated here as metapopulation (EAS), are generally considered as multipurpose breeds (milk, meat and wool), not specialised for a particular type of production, but known for their robustness and resistance to certain environmental conditions. Our objective was to identify genomic regions and genes that exhibit patterns of positive selection signatures, decipher their biological and productive functionality, and provide a "genomic" characterization of EAS adaptation and determine its production type.

Results

We identified positive selection signatures in EAS using several methods based on reduced local variation, linkage disequilibrium and site frequency spectrum (eROHi, iHS, nSL and CLR). Our analyses identified numerous genomic regions and genes (e.g., desmosomal cadherin and desmoglein gene families) associated with environmental adaptation and economically important traits. Most candidate genes were related to meat/production and health/immune response traits, while some of the candidate genes discovered were important for domestication and evolutionary processes (e.g.,HOXagene family andFSIP2). These results were also confirmed by GO and QTL enrichment analysis.

Conclusions

Our results contribute to a better understanding of the unique adaptive genetic architecture of EAS and define its productive type, ultimately providing a new opportunity for future breeding programmes. At the same time, the numerous genes identified will improve our understanding of ruminant (sheep) robustness and resistance in the harsh and specific Mediterranean environment.
The attitude and behaviors of the different spheres of the community of the United Arab Emirates toward the clinical utility and bioethics of secondary genetic findings: a cross-sectional study
Authors: Rahma Azhar T. , Abdullahi Aminu S. , Graziano Giulia , Elbarazi Iffat
Published: November 2023

Introduction

Genome sequencing has utility, however, it may reveal secondary findings. While Western bioethicists have been occupied with managing secondary findings, specialists’ attention in the Arabic countries has not yet been captured. We aim to explore the attitude of the United Arab Emirates (UAE) population toward secondary findings.

Method

We conducted a cross-sectional study between July and December 2022. The validated questionnaire was administered in English. The questionnaire consists of six sections addressing topics such as demographics, reactions to hypothetical genetic test results, disclosure of mutations to family members, willingness to seek genetic testing, and attitudes toward consanguinity. Chi-squared and Fisher’s exact tests were used to investigate associations between categorical variables.

Results

We had 343 participants of which the majority were female (67%). About four-fifths (82%) were willing to know the secondary findings, whether the condition has treatment or not. The most likely action to take among the participants was to know the secondary findings, so they can make life choices (61%).

Conclusion

These results can construct the framework of the bioethics of disclosing secondary findings in the Arab regions.