bluuebunny/crossref_metadata_2025 huggingface dataset:
Distribution and seasonality of viral respiratory infections in pediatric oncologic patients in a tropical country
Authors: García Gustavo , Freire Dolores
Published: October 2024

Background

Comprehension of the distribution and seasonality viral respiratory infections pediatric oncologic patients in tropical localities remains poor. Due to lack mandatory report of all viruses and limitations in access to molecular biology techniques there is currently few data published on this topic. We report the distribution and seasonality of pediatric viral respiratory infections at a tertiary care oncological hospital in Guayaquil, Ecuador.

Methods

The laboratory database with results of real time PCR panel (Biofire® respiratory panel 2.1) from January to December 2021 was reviewed to collect the relative frequency and seasonality of identifiable viral infections in pediatric (ages < 18 years) patients. The frequency of infection according to sample characteristics including sex and age was compared using chi square test with a significance of 0.05. The frequency of detection was organized per month within the year. Percentage of coinfections was also determined.

Results

Out of 217 included PCR results, 143 (65.8%) tested positive for detectable viral organisms. Mean age was 7.3 years SD 4.8 years. The infection frequency for girl samples was higher than that of boy samples, X2 (1, N=217) = 4.16, p 0.041. The relation between age groups and the frequency of infection was not statistically significant X2 (2, N=217) = 5.24, p 0.073. The most prevalent viruses included Rhinovirus/Enterovirus 53 cases (relative frequency 37.0%), Parainfluenza virus 3 42 cases (relative frequency 29.3%) and Respiratory syncytial virus 19 cases (relative frequency 13.2%). Rhinovirus/Enterovirus, Paramyxovirus and Adenovirus respiratory infections occurred throughout the year while other respiratory viruses including Coronaviruses showed a higher detection rate during the rainy season (December – April). A total of 13 (5.9%) patients were coinfected with two up to four viruses. The most common combination was Parainfluenza virus 3 with Rhinovirus/Enterovirus. No bacterial targets were detected.

Conclusion

Larger and more complex studies are necessary to understand the burden of viral respiratory infections in pediatric oncological patients. In Ecuador, detection was higher in girls and school aged children. Rhinovirus/Enterovirus, Paramyxovirus and Adenovirus were present all year long while seasonality was common for other viruses following dry/rainy season pattern in the region. More understanding of seasonality will aim for preventive measures during more difficult months and to distribute resources accordingly.

Figure 1. Seasonality of respiratory viral infections.
Antifungal Resistance and Breakthrough Candidemia Among Pediatric Cancer Patients: An Emerging Threat
Authors: Madney Youssef , Khedr Reham , Hafiz Hanfy , Adel Naglaa , Elanany Mervat , Alsheshtawi Khaled , Shalaby Lobna , Elhadad Alaa
Published: October 2024

Background

Cancer patients are at risk for candidemia. Resistance and breakthrough Candida represent an emerging threat. The study aims to analyze the clinical features, resistance patterns and breakthrough candidemia among pediatric cancer patients.

Methods

The retrospective study was conducted from 2014 - 2020 in children admitted to Children Cancer Hospital, Egypt. Clinical, microbiological, and outcomes were analyzed. Mortality was estimated within 30 days from Candida spp. Isolation from blood.

Results

Three hundred fifty (350) pediatric cancer patients were diagnosed with candidemia. The median age was four years (4 months- 18 years). Most of the patients had hematological malignancies (54%) while solid tumors represent (46%). Clinical features of the patients included neutropenia (80%), the presence of central venous line (57%), ICU admission (44%), and steroid use (43%). Non-Albicans candida was predominant (71%) compared to Candida Albicans (29%). The isolated species were: C. Albicans (29%), C.Tropicalis (29%), C. parapsilosis (21%), C. krusei (7%), C.glabrata(3%), C. guilliermondii (1.5%)and C. famata (2%). Chronic disseminated candidiasis was reported in 30 (9%) patients, with the liver being the most affected organ. Breakthrough candidemia on top of echinocandin prophylaxis was reported among 62(18%) patients with C. parapsilosis is the most common 31(50%) isolated pathogen. From 96 patients with breakthrough candidemia, all-cause mortality was reported in 32 patient (33%) while candida attributable cause of death in elven (11%) patients. Antifungal resistance was reported in 74(21%) patients: fluconazole (15%), liposomal ampho-B (6%), echinocandin (5%) and voriconazole (3%). Among 74 patients with resistant candidemia, death was reported in 24%. Echinocandin Resistant candida was a direct cause of mortality in 3(17%) patients.

The overall day- 30 mortality rate was 24% (85/350 patients), while candida attributable of mortality was (10%). Patients with septic shock, ICU admission, and resistant candida had a higher mortality risk.

Conclusion

Echinocandin-resistant and breakthrough Candida are significant threat with a high mortality rate among pediatric cancer patients. Antifungal stewardship may be helpful.

Figure 1. Resistance Pattern of Candidemia among Pediatric Cancer Patients
Antiviral Therapy for Congenital Cytomegalovirus Infection: Does It Prevent Late-Onset Sensorineural Hearing Loss?
Authors: de Romero Concepción Alba , Lewald Zachery S , Pifer Traci , Crisan Rachelle , Malhotra Prashant S , Adunka Oliver , Findlen Ursula M , Gerth Holly , Conroy Sara , Medoro Alexandra K , Shimamura Masako , Mejías Asunción , Sánchez Pablo J
Published: October 2024

Background

Congenital cytomegalovirus (CMV) infection is the leading non-genetic cause of sensorineural hearing loss (SNHL) in children. While SNHL is often present at birth, as many as 20% of infants with congenital CMV infection may develop late-onset hearing loss beyond the neonatal period. Antiviral therapy improves hearing outcomes, but its effect on the occurrence of late-onset SNHL is not fully known. The objective is to describe the prevalence of SNHL at birth and late SNHL among infants and children with congenital CMV infection and assess the impact of antiviral treatment on the occurrence of late-onset SNHL.

Methods

From 2013 to 2022, infants with congenital CMV infection referred to the NEO-ID Clinic at Nationwide Children’s Hospital (NCH), Columbus, OH underwent complete evaluation including hearing testing. Pertinent demographic, clinical, audiologic, laboratory, and radiographic data were obtained and stored using an electronic database (REDCap). Infants with SNHL at birth or who developed late-onset SNHL beyond a month of age were identified and compared with respect to receipt of antiviral therapy in the neonatal period.

Results

During the 10-year study period, we enrolled 204 infants with congenital CMV infection: 75% (154/204) had symptomatic disease, while 25% (50/204) had clinically inapparent infection (normal physical examination, growth parameters, and evaluation). Overall, 30% (n=62) had SNHL at birth or on follow-up audiologic evaluation with the majority (95%, 59/62) having symptomatic disease. Of the 62 infants with SNHL, 29% (n=18) had late-onset SNHL in one (n=10) or both (n=8) ears at a median age of 19 months (IQR, 8.5-42 months). Of the 122 infants who received antiviral therapy initiated in the first month of age, 12 (10%) developed late-onset SNHL in one (n=7) or both (n=5) ears. All 12 had symptomatic congenital CMV infection, and 2 received cochlear implants in one ear. Of the 82 infants who did not receive any antiviral therapy, 6 (7%) developed late-onset SNHL (3, unilateral [2, symptomatic]; 3, bilateral [1, symptomatic]) and 2 received cochlear implant. There was no difference in the occurrence of late-onset SNHL in treated (10%) vs. untreated (7%) infants with congenital CMV infection (p=0.6).

Conclusion

In this cohort of mostly symptomatic infants with congenital CMV infection, antiviral treatment did not reduce the occurrence of late-onset SNHL. Further study on the impact of early antiviral therapy on severity of the SNHL is urgently needed to inform optimal treatment management.
Bacteremias in Hemato-Oncological Pediatric Patients: Clinical and Microbiological Characteristics
Authors: Viridiana Enríquez García Estrella , Elena Martínez Bustamante María
Published: October 2024

Background

In haemato-oncologic patients bacteremia is frequent increasing mortality rates, therefore surveillance and close follow up is essential to optimize treatment. The use of invasive devices used frequently in this population increases the incidence of infections by gram-positive microorganisms (currently gram-negative bacilli have been added). Therefore, we propose the characterization the microorganisms to identify the epidemiologic conditions, and the areas of improvement to establish improvement care strategies for this population.

Methods

We conducted a retrospective study at the haemato-oncologic diseases service at the National Medical Center “20 de Noviembre”. Prevalence of bacteremia in pediatric patients with cancer and neutropenia in Mexican population, which ranges from 8% to 36%, assuming that our results could be similar to higher percentage, employing a proportion formula with a study population of 65 patients.

Results

It was demonstrated in our population studied that in all cases of bacteremia, patients were in depth neutropenia at diagnosis. The most prevalence phase of chemotherapy was Induction phase (69.2%), with Total XV ST Jude protocol. The clinical data revealed the following frequencies in 100% of the patients: Fever (92%), Tachycardia (72%), Shivering and piloerection (65%), Elevated acute-phase reactants PCT (51%), CPR (32%), and Tachypnea (28%). Cases of Central Line-associated Bloodstream Infection (CLABSI) was reported in 86.2%, affecting individuals with vascular devices. The predominant microbiological isolate in our patients was Escherichia coli ESBL (31%), followed by Klebsiella pneumoniae (18%), and Pseudomonas aeruginosa (13.8%), Staphylococcus epidermidis (11%). Other bacteria were identified at even lower frequencies, such as Stenotrophomonas maltophilia (5%), Klebsiella oxytoca (5%), Staphylococcus aureus (3%), Serratia marcescens (3%), Enterococcus faecalis (3%), and Enterobacter cloacae (3%). The least observed in our population was the identification of Acinetobacter baumannii (2%). The different outcomes recorded in our sample were highly consistent, with a resolution rate of infection in 97% of cases and 3% of cases resulting in death attributable to bacteremia (Table 1).

Conclusion

The low mortality found in this study may be due to the early initiation of empirical antibiotic treatment in “golden hour”, a protocol carried out in our Center, as well as the identification of severity scales.
Design and Pilot Implementation of an ECHO Module to Facilitate Treatment of Hepatitis C Virus Infection During Pregnancy
Authors: Yee Lynn , Aronsohn Andrew , Shah Seema , Lee Karen , Rodriguez Isa , Otero Sebastian , Gower Patrick , Johnson Daniel , Jhaveri Ravi
Published: October 2024

Background

Pregnant patients are largely excluded from Hepatitis C virus (HCV) research and treatment. Studies show that pregnant patients want to discuss treatment while providers feel they lack the knowledge and training for these discussions. To bridge this gap, we designed an ECHO module about management of HCV in pregnancy and infancy.

Methods

Content experts from pediatric infectious diseases, hepatology, maternal-fetal medicine, bioethics and members of ECHO-Chicago discussed: prior data, potential topics, target audience and scheduling of sessions. We held 8 one-hour sessions with 20-30 minutes of didactics and 30-40 minutes of solicited case discussion. Participants included those who participated in prior ECHO training and prenatal providers in local and regional practices. A 7-point Likert scale pre- and post-training survey was administered to assess metrics of self-efficacy for management of HCV in pregnancy and childhood.

Results

The sessions were conducted from May to June 2023 on the following topics: HCV screening; HCV pathophysiology/clinical presentations; staging fibrosis in HCV; HCV Treatment in non-pregnant patients; harm reduction; clinical considerations of HCV in pregnancy; shared decision-making for HCV treatment in pregnancy; and HCV screening in infants & treatment for children. Fourteen participants completed pre- and post-surveys. In the pre-survey, participants had low ratings of self-efficacy (average 3.0). In the post-survey (Table 1), participants reported dramatic increases in all areas (average 5.2, increase of 2.2) with the largest in the following areas: “Ability to discuss and manage timing of hepatitis C treatment in a pregnant person”, average 5.1, increase of 3; “Ability to identify suitable pregnant candidates for treatment for Hepatitis C”, average 5.2, increase of 2.7. For context, a 1-point increase in self-efficacy is considered meaningful. All respondents reported increased ability to address HCV in a preconception, pregnant, postpartum, or neonatal population.

Conclusion

As pivotal studies of pan-genotypic antivirals indicate efficacy and safety during pregnancy, this ECHO module could be distributed to support providers who are discussing therapy initiation.

Table 1: Average Change in Self-Efficacy between Pre- & Post-Series Surveys
Surveillance on antimicrobial Resistance pattern of Third Generation Cephalosporins at the Benjamin Mkapa Tertiary Hospital in Tanzania
Authors: Yona Yusto J , Zimbwe Kauke B , Caniza Miguela A , Homsi Maysam , Mukkada Sheena
Published: October 2024

Background

Antimicrobial resistance is a burden in Tanzania and the world economy, resulting in financial losses from lower production brought on by illness due to greater treatment expenses and death. Second- and third-line antibiotics like third generations of cephalosporins should be used rather than first-line, which is an expensive option, due to AMR. The direct effects of AMR include severe prolonged illnesses, prolonged hospital stays death, and (Global Action Plan on Antimicrobial Resistance., 2015)

Methodology

The retrospective study design was used to review AST to assess the AMR patterns from 2020-2022 for urine, pus, and blood samples as stated in the National Action Plan-Antimicrobial Resistance 2017.

Results

Three years (2020, 2021, and 2022) of antibiograms based on priority samples, priority pathogens and third generations of cephalosporins for both gram-negative and gram-positive bacteria see Tables 1 and 2. The surveillance identified sensitive (S), intermediate(I), and resistance(R) for tested bacteria. The N is the isolate number. Our antibiograms for third-generation cephalosporins were represented by cefotaxime, ceftazidime and ceftriaxone. The antimicrobial resistance to ceftriaxone for Acinetobacter species was 62.5% while 76% for Citrobacter. E. coli at 60.26%, Enterobacter aerogenes at 67.86%, Klebsiella species at 73.48% at 22.73%, Morganella morganii 65.75% and Staphylococcus aureus at 62.5%, Serratia marcescens 64.56%. Similar resistance trends have been observed in cefotaxime and ceftazidime.

Conclusion

Antimicrobial susceptibility surveillance, antimicrobial rotation and presentation of findings to clinicians for increased awareness and the promotion of a multi-disciplinary approach to successful AMS programmers is essential. Evidence found will optimize the use of antibiotics. Clinicians, pharmacists, and scientists will use obtained evidence in the development of guidelines and protocols for surgical prophylaxis, setting IPC programs, management of bacterial blood infections (septicemia and sepsis) and managing urinary tract infections by focusing on red flags antibiotics and bacteria such E. coli and K. pneumoniae. Avoiding delay of AST results by enough resources, and technology advancement. This enable identification of the causative pathogens facilitated the correct diagnosis, de-escalation, and use of targeted agents, which are necessary to promote the prudent use of antimicrobials.

Antibiograms

Table 1: Antibiogram of gram-negative bacteria

Table 2: Antibiogram of gram-positive bacteria
Plasma Cell-free DNA Metagenomic Next-Generation Sequencing in Immunocompromised Children
Authors: Castejon-Ramirez Sandra , Glasgow Heather , Ferrolino Jose , Hayden Randall , Maron Gabriela , Hijano Diego
Published: October 2024

Background

Plasma cell-free DNA metagenomic next-generation sequencing (mNGS) is a novel diagnostic tool for infectious diseases [1]. Data suggests that plasma mNGS may be useful in immunocompromised adults, changing management in up to 60% of the patients [2]. A prospective study evaluating utility of plasma mNGS for pneumonia in immunocompromised adults concluded that mNGS provided an additive diagnostic value of 12.1% [3]. A similar study in adults with febrile neutropenia reported a sensitivity and specificity of 85 and 100%, respectively [4]. However, there is limited data evaluating the utility of mNGS in immunocompromised children.

Methods

We retrospectively reviewed all pediatric immunocompromised patients who had plasma mNGS testing performed from December 2018 to July 2023 at St. Jude Children’s Research Hospital. Electronic medical records were reviewed to extract relevant clinical data and microbiologic data including results of mNGS, contemporaneous cultures, and related antimicrobial treatment. Descriptive statistics are presented as frequencies and medians (interquartile range, IQR). Comparisons were performed using Fisher’s exact test or Wilcoxon rank-sum test, as appropriate, using R version 3.6.3.

Results

A total of 18 immunocompromised children underwent plasma mNGS testing. Acute lymphoblastic leukemia was the most common malignancy (33.3%), followed by acute myeloid leukemia (22.2%). Two patients (11.1%) had undergone hematopoietic cell transplant, both allogeneic. At the time of testing, 16 patients (88.9%) had fever and 10 (55.6%) had an absolute neutrophil count of <500/mm3. All except one were on antimicrobial therapy at the time of testing, with a median duration of 8 days (IQR=12.25). Only 9 (50%) patients had a positive mNGS result. A positive mNGS resulted in broadening or extending antibiotics course in 4 patients (22.2%); negative mNGS results did not lead to changes in management in any of the cases. There were no significant differences in age, sex, days of fever, neutropenia, gastrointestinal (GI) symptoms, and days of fever before testing between those with positive versus negative results. However, a higher frequency of GI symptoms at the time of testing among those with positive results was observed. Clinical characteristics and impact on management in patients with positive and negative results are summarized in Table 1.

Conclusion

Plasma mNGS had a limited impact on the management of immunocompromised children at our institution. Negative results did not lead to de-escalation of therapy, and positive results led to additional exposure to antibiotics. Further research is needed to determine the role of mNGS in this population, and the interpretation of positive testing in the setting of gastrointestinal disease.
Use of T2Bacteria Panel in Pediatric Hematopoietic Stem Cell Transplant Patients: A Single Center Experience
Authors: Hiskey Lisa , Maron Gabriela , Hijano Diego , Hayden Randall , Glasgow Heather
Published: October 2024

Background

Bloodstream infection is a common complication following hematopoietic cell transplant (HCT), occurring in 10-40% of patients (1,2). Rapid identification of causative bacteria is imperative to provide proper empiric therapy and ensure optimal patient outcomes. The T2Bacteria Panel detects five bacterial pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli) using T2 magnetic resonance (T2MR, T2Biosystems, Lexington MA, USA) directly from blood specimens. Previous studies have reported per-patient sensitivity, specificity, and negative predictive value (NPV) of 84-90%, 85.9-90%, and 99.7%, respectively, as well as 100% positive agreement and 98.4% negative agreement when compared to blood culture (3-5). To date, there have been no studies on the use of this test in pediatric HCT recipients.

Methods

We reviewed all pediatric HCT patients at St. Jude Children’s Research Hospital who had a T2Bacteria Panel performed for fever and suspected infection between January 2019 and September 2022. A total of 706 T2Bacteria Panel results and concurrent blood culture results from 251 unique patients were analyzed to determine assay performance for detection of the 5 targeted pathogens.

Results

T2Bacteria PCR and blood culture showed concordant results in 97% of cases. Overall, our study revealed 65% positive percent agreement with blood culture and 95% negative percent agreement for bacteremia caused by any of the target pathogens. PPV, NPV, sensitivity and specificity for each organism detected by the panel, and the panel overall, are presented in Table 1. Positive predictive value ranged from 28-73%. Negative predictive value was high for all organisms (98-100%). Sensitivity was highest for Pseudomonas aeruginosa (88%), and lowest for Escherichia coli (44%). Specificity was high for all organisms (97-99%).

Conclusion

In pediatric HSCT patients, the T2Bacteria Panel was most useful for rapidly ruling out the presence of target pathogens, with high negative percent agreement, NPV, and specificity. Positive percent agreement was lower than noted in previous studies. Positive predictive value and sensitivity varied per pathogen.
A stableness of resistance model for nonresponse adjustment with callback data
Authors: Miao Wang , Li Xinyu , Zhang Ping , Sun Baoluo
Published: October 2024

Nonresponse arises frequently in surveys, and follow-ups are routinely made to increase the response rate. In order to monitor the follow-up process, callback data have been used in social sciences and survey studies for decades. In modern surveys, the availability of callback data is increasing because the response rate is decreasing, and follow-ups are essential to collect maximum information. Although callback data are helpful to reduce the bias in surveys, such data have not been widely used in statistical analysis until recently. We propose a stableness of resistance assumption for nonresponse adjustment with callback data. We establish the identification and the semiparametric efficiency theory under this assumption, and propose a suite of semiparametric estimation methods including doubly robust estimators, which generalize existing parametric approaches for callback data analysis. We apply the approach to a Consumer Expenditure Survey dataset. The results suggest an association between nonresponse and high housing expenditures.
A simulation study on the sub-threshold joint gravitational wave-electromagnetic wave observation on binary neutron star mergers
Authors: Du Y F , Yorgancioglu Emre Seyit , Rao J H , Kumar Ankit , Yi S X , Zhang S N , Zhang Shu
Published: October 2024

The coalescence of binary neutron stars (BNS) is a prolific source of gravitational waves (GWs) and electromagnetic (EM) radiation, offering a dual observational window into the Universe. Lowering the signal-to-noise ratio (S/N) threshold is a simple and cost-effective way to enhance the detection probability of GWs from BNS mergers. In this study, we introduce a metric of the purity of joint GW and EM detections Pjoint, which is in analogue to Pastro in GW only observations. By simulating BNS merger GWs jointly detected by the HLV network and EM counterparts (kilonovae and short Gamma-ray bursts, sGRBs) with an assumed merger rate density of BNS, we generate catalogs of GW events and EM counterparts. Through this simulation, we analyze joint detection pairs, both correct and misidentified. We find the following: 1. For kilonovae, requiring Pjoint > 95% instead of $P_{\rm astro}>95~{{\%}}$ reduces the S/N from 9.2 to 8.5-8.8, allowing 5-13 additional joint detections per year and increasing the GW detection volume by 9-17%; 2. For sGRBs, requiring Pjoint > 95% instead of Pastro reduces the S/N from 9.2 to 8.1-8.5; 3. Increasing kilonova or sGRB detection capability does not improve Pjoint due to a higher rate of misidentifications. We also show that sub-threshold GW and kilonova detections can reduce the uncertainty in measuring the Hubble constant to 89-92% of its original value, and sub-threshold GW and sGRB observations can enhance the precision of constraining the speed of GWs to 88% of previously established values.
Shadow-boxing: Major gaps to knock out in bird–window interaction research
Authors: Netzley Rebekah , Partridge Hannah C , Gagné Sara A
Published: October 2024

Bird–window collisions are a leading source of bird mortality worldwide, estimated to kill as many as 1 billion birds annually in the U.S. alone. Though researchers have examined the factors contributing to general bird–window collisions, shadow-boxing, a nonfatal but potentially ecologically significant bird–window interaction, has primarily been excluded from the conversation. Shadow-boxing occurs when birds attack their reflection in human-made surfaces believing the reflection to be another individual intruding on their territory. Current bird–window interaction research often does not consider the unique drivers, impacts, and mitigation strategies associated with shadow-boxing. In this paper, we identify 5 major knowledge gaps: (1) building and environmental characteristics that lead to shadow-boxing; (2) the impacts on individual birds, (3) populations, and (4) people; and (5) the effectiveness of existing mitigation strategies for shadow-boxing. For each knowledge gap, we list research questions that will further our understanding of the scale and significance of shadow-boxing.
The landscape of police auditing in the USA: the state of the art
Authors: Jiao Allan Y
Published: October 2024

Various programs have been implemented to improve police performance and accountability. This article is focused on a rarely examined area, police auditing, designed for the same purpose. Many police audits have been conducted over the years to address police efficiency, economy, effectiveness, and compliance. This study answers some basic questions on how police auditing has been used over the years in various police departments, what concerns and issues have led to police auditing, what subject matters have been investigated, and how personnel and entities engaged in police auditing are structured. A nationwide police audit dataset and a quota sample of typical police audit offices/programs were used to develop a landscape or a broad review of police auditing in the USA.
Leadership in Public Sector Interorganizational Networks: A Synthesis of the Literature and Propositions Based on a Multiple Case Study
Authors: Akerboom Moniek , Groeneveld Sandra , Kuipers Ben
Published: October 2024

Previous studies characterize public sector interorganizational networks as sets of horizontal relationships between autonomous organizations. Due to these horizontal relationships, networks seemingly offer a promising context for leadership beyond hierarchical tools of coordination as prevalent in individual, hierarchical organizations. However, despite the promising role of leadership in public sector networks, as yet no conceptualization of the functioning of leadership within this context has been developed. This is mainly due to the current disconnect between various branches of scholarly literature on collaborative governance, network management, and leadership. Based on a synthesis of the literature and an empirical investigation of three public sector networks in The Netherlands, this study aims to fill this gap by providing a conceptual framework of leadership in public sector interorganizational networks constituting the types, distribution, and directions of leadership behaviors and the formulation of four theoretical propositions that relate these behaviors to network context.
The Presidency of Bill Clinton after Thirty Years: A Review Article
Authors: Taylor Mark Zachary
Published: October 2024

Did Bill Clinton destroy the U.S. economy? In a recent book, Nelson Lichtenstein and Judith Stein offer a scathing new critique. In this account, Clinton not only ravaged the United States in his own time but is largely to blame for America's subsequent economic inequality, monopolistic corporations, the Great Financial Crisis, the rise of China, and the advent of Trumpism. And yet, the economic data speak well of the Clinton presidency. He fares poorly on the trade deficit and economic inequality but otherwise delivered a balanced economic boom, far better than most administrations of the past fifty years. How do we square the withering criticisms of Lichtenstein and Stein with Clinton's economic achievements? It is correct that globalization and technological change tend to hurt blue-collar workers. And because Clinton embraced these forces and sought to place the United States at their headwaters, he may, indeed, be a “fabulous failure” from Lichtenstein and Stein's perspective. But the authors, each a labor historian and advocate, willfully dismiss the benefits that the nation as a whole, including workers and their children, enjoyed under Clinton. They also ignore the financial and military crises that Clinton averted. Overall, the Clinton administration created a wealthier and more competitive economy, albeit at the expense of those workers most vulnerable and least able to change. That is, Clinton helped transform the U.S. economy, just not along the lines that Lichtenstein and Stein prefer.
Is Capital Structure Irrelevant with ESG Investors?
Authors: Feldhütter Peter , Pedersen Lasse Heje
Published: October 2024

This paper examines whether capital structure is irrelevant for enterprise value and investment when investors care about environmental, social, and governance issues, which we refer to as “ESG-Modigliani-Miller” (ESG-MM). Theoretically, we show that ESG-MM holds with linear pricing and additive ESG. ESG-MM means that issuing low-yielding green bonds does not lower the overall cost of capital because it makes the issuer’s other securities browner. Hence, a firm’s incentive to make a green investment does not depend on its financing choice. We provide suggestive evidence of failure of ESG-MM, implying that firms and governments can exploit inconsistent ESG attribution or segmented markets.
Impact of immunosuppressive drugs on efficacy of mesenchymal stem cell therapy for suppressing renal fibrosis
Authors: Miyasako Kisho , Nakashima Ayumu , Ishiuchi Naoki , Tanaka Yoshiki , Morimoto Keisuke , Sasaki Kensuke , Nagamatsu Shogo , Matsuda Go , Masaki Takao
Published: October 2024

Preemptive regenerative medicine using mesenchymal stem cells (MSCs) may provide a novel therapeutic approach to prevent the progression from organ damage to organ failure. Although immunosuppressive drugs are often used in patients with organ disorder, their impact on MSC therapy remains unclear. We investigated the effects of immunosuppressive drugs on the therapeutic efficacy of MSCs. We created unilateral ureteral obstruction models, as a well-established model of renal fibrosis, a preliminary stage of organ failure. Three immunosuppressive drugs (methylprednisolone, cyclosporine, and cyclophosphamide) were intraperitoneally administered 3 days after surgery, and MSCs were injected via tail vein the following day. Preadministration of methylprednisolone or cyclophosphamide interfered with MSC activation by reducing expression of interferon-gamma (IFN-γ) and high-mobility group box-1 protein, thus significantly attenuating the therapeutic efficacy of MSCs. Preadministration of cyclophosphamide downregulated the expression of stromal cell-derived factor-1/C-X-C motif ligand 12, which is a potent migration factor for MSCs, resulting in reduced MSC engraftment in the renal cortex. IFN-γ-preconditioned activated MSCs were unaffected by these drugs and maintained their beneficial therapeutic effects. Cyclosporine preadministration had no effect on the therapeutic efficacy of MSCs. Our study demonstrated that the administration of certain immunosuppressive drugs interfered with MSC activation and engraftment at the site of injury, resulting in a significant attenuation of their therapeutic efficacy. These findings provide crucial information for selecting patients suitable for MSC therapy. Use of MSCs preactivated with IFN-γ or other means is preferred for patients on methylprednisolone or cyclophosphamide.
Effect of various levels of standardized ileal digestible branched-chain amino acids on lactating sow and litter performance
Authors: Humphrey Dalton C , Haydon Keith D , Greiner Laura L
Published: October 2024

Three hundred and sixty sows were used to investigate the effect of various dietary branched-chain amino acids (BCAA) levels on sow lactation and piglet growth performance. On day 112 ± 1.4 of gestation, sows were blocked by the parity group (P1, P2, P3+) and randomly assigned to 1 of 6 dietary treatments containing various levels of standardized ileal digestible (SID) Leu, Ile, and Val. The experimental diets were formulated to the desired levels of BCAA by replacing cornstarch in a basal diet with l-leucine, l-isoleucine, and l-valine. Dietary BCAA levels relative to SID Lys were 114% or 180% for Leu, 56% or 64% for Ile, and 64% or 120% for Val. Diets were formulated to be isocaloric (3.23 Mcal ME/kg) and met or exceeded all other NRC (2012) essential amino acid and vitamin and mineral recommendations. Sow body weight (BW) and backfat thickness were measured at the time of entry into the farrowing room and at weaning. Piglet litter weights were recorded after cross-fostering and weaning to calculate the litter growth rate. Data were analyzed using generalized linear mixed models with fixed effects of dietary treatment and parity group and a random effect of lactation group. The models were fit using R (v4.4.1; R Core Team, 2024). The sow and her litter were the experimental unit, and results were considered significant if P < 0.05. On average, sows nursed their litters for 21.3 d (P = 0.998). The mean parity by treatment ranged from 3.8 to 3.9 (P = 0.999). After farrowing, the mean sow BW was 220 kg with a range between treatments of 216 to 222 kg (P = 0.523). On average, sows gained 2.3% of their BW (P = 0.740) with an average daily feed intake of 8.74 kg/d (P = 0.903). As expected, sow Leu, Ile, and Val intakes were different across treatments (P ≤ 0.001) and corresponded to the varying dietary levels of BCAA. Sows entered farrowing with an average backfat thickness of 11.50 mm (P = 0.919) and lost 6.5% backfat through lactation (P = 0.880). Sows started the trial with an average of 14.1 piglets/sow (P = 0.967) and weaned 12.7 piglets/sow (P = 0.995) with a piglet ADG of 0.22 kg/d (P = 0.280) and a daily litter growth rate of 2.90 kg/d (P = 0.547). In conclusion, there was no evidence of an effect of the various leucine, isoleucine, and valine levels evaluated in this study on lactating sow and piglet performance.
Improving rail transit security with enhanced YOLOv5 obstacle detection
Authors: Zhang Zijun , Yu Tianjian , Wu Xun , Liu Chang , Yu Xizhuo
Published: October 2024

As the economy advances and rail transit technology progresses, rail transit plays an important role in alleviating urban traffic pressure and promoting regional economic development. However, railway safety faces potential hazards such as foreign object intrusion in the trackside environment, seriously threatening the safety of trains and passengers. Therefore, to achieve high-performance recognition of obstacle target images in rail transit, a small sample object detection algorithm YOLOv5-RTO, which uses the EVC (Explicit Visual Center) attention mechanism and lightweight up-sampling operator CARAFE (Content-Aware ReAssembly of FEatures) to improve YOLOv5, has been proposed. Based on the self-collected image data of rail transit obstacles, a dense and time-varying dataset was created within the rail transit system, and data augmentation methods were used to reduce the impact of small sample datasets on the detection performance of the subsequent algorithm. Using this dataset, target detection tests were conducted on rail transit obstacle images to analyse the actual performance of the training model. The experiment results indicate that the enhanced YOLOv5-RTO algorithm integrates the advantages of EVC and CARAFE while preserving the lightweight and accurate characteristics of YOLOv5. The improved algorithm scheme has an average inference time of 1.3 ms per frame in the field of rail transit images, achieving an overall mAP of 96.5%, an increase of 1.8% compared to the original algorithm. It has a certain engineering application value and provides reference for further optimizing the safety system of urban rail transit.
VoiceThread in Nursing Education: A Scoping Review
Authors: Hawk Heather , Coriasco Michael
Published: October 2024

AIM

This scoping study aimed to identify the applications for VoiceThread in nursing education.

BACKGROUND

VoiceThread can facilitate collaboration through asynchronous sharing of presentations, images, and videos. To date, no knowledge synthesis exists to inform nurse educators’ use of this technology.

METHOD

Using the Updated Methodological Guidance for the Conduct of Scoping Reviews, relevant published articles and gray literature were identified through a standardized search and selection process, followed by data synthesis.

RESULTS

Thirty-two sources described applications including student presentations, asynchronous discussions, case studies, and instructor lectures. VoiceThread is well accepted by students and faculty with few barriers to its use. There is limited scientific rigor in studies that measured efficacy; most sources did not evaluate the efficacy of VoiceThread.

CONCLUSION

Considering its many applications, more evidence is needed about the effectiveness of VoiceThread in nursing education.
Exploring Research Trends on Digital Health in Nursing Science in Korea
Authors: Kim Hae Won , Choi JiYeon , Kim Ji-Su , Son Youn-Jung
Published: October 2024

Digital health technology is utilized in contemporary nursing practice and education. This review explored the scope of digital health applications and major trends in nursing research involving digital health in Korea using topic modeling. Our analysis of data using the Latent Dirichlet Allocation model identified four distinct research topics: nursing education using digital technologies (35.17%), hospital-based nursing practice using digital technologies (19.88%), digital technologies for health education (25.75%), and development of digital technologies to support self-management of chronic conditions (19.20%). Our findings reveal trends, current issues, and gaps in digital health nursing research.
Prenatal Cannabis Use and Offspring Attention Deficit Hyperactivity Disorder and Disruptive Behavior Disorders: A Retrospective Cohort Study
Authors: Young-Wolff Kelly C. , Kong Kevin , Alexeeff Stacey E. , Croen Lisa A. , Oberman Nina , Kirane Harshal , Ansley Deborah , Davignon Meghan , Adams Sara R. , Avalos Lyndsay A.
Published: October 2024

Objective:

To examine whether maternal cannabis use during early pregnancy is associated with offspring attention deficit hyperactivity disorder (ADHD) and disruptive behavior disorders (DBD).

Methods:

We conducted a population-based retrospective birth cohort study of children (N = 141,570) born between 2011 and 2018 to pregnant individuals (N = 117,130) in Kaiser Permanente Northern California universally screened for any prenatal cannabis use at the entrance to prenatal care (at ∼8–10 wk gestation). Prenatal cannabis use was defined as (1) self-reported use and/or a positive toxicology test, (2) self-reported use, (3) a positive toxicology test, and (4) self-reported use frequency. Cox proportional hazards regression models adjusting for maternal characteristics (sociodemographics, other substance use and substance use disorders, prenatal care initiation, comorbidities) examined associations between prenatal cannabis use and offspring ADHD and DBD diagnosed by age 11 years.

Results:

The sample of pregnant individuals was 27.2% Asian/Pacific Islander, 5.7% Black, 24.5% Hispanic, and 38.8% non-Hispanic White, with a mean (SD) age of 30.9 (5.2) years; 4.6% screened positive for any cannabis use (0.4% daily, 0.5% weekly, 1.1% monthly or less, 2.7% unknown frequency); 3.92% had a positive toxicology test and 1.8% self-reported use; 7.7% of offspring had ADHD and 6.8% had DBD. Maternal prenatal cannabis use was not associated with ADHD (adjusted hazard ratio [aHR]: 0.84, 95% CI, 0.70–1.01), and there was an inverse association with DBD (aHR: 0.83, 95% CI, 0.71–0.97), which remained when cannabis was defined by toxicology testing but not by self-report. Frequency of use was not associated with outcomes.

Conclusion:

Maternal prenatal cannabis use was not associated with an increased risk of offspring ADHD or DBD.
Pharmacogenetics of tuberculosis treatment toxicity and effectiveness in a large Brazilian cohort
Authors: Amorim Gustavo , Jaworski James , Yang Jing , Cordeiro-Santos Marcelo , Kritski Afrânio L. , Figueiredo Marina C. , Turner Megan , Andrade Bruno B. , Velez Edwards Digna R. , Santos Adalberto R. , Rolla Valeria C. , Sterling Timothy R. , Haas David W. ,   the Regional Prospective Observational Research in Tuberculosis (RePORT)-Brazil network
Published: October 2024

Background

Genetic polymorphisms have been associated with risk of antituberculosis treatment toxicity. We characterized associations with adverse events and treatment failure/recurrence among adults treated for tuberculosis in Brazil.

Methods

Participants were followed in Regional Prospective Observational Research in Tuberculosis (RePORT)-Brazil. We included persons with culture-confirmed drug-susceptible pulmonary tuberculosis who started treatment between 2015 and 2019, and who were eligible for pharmacogenetics. Treatment included 2 months of isoniazid, rifampin or rifabutin, pyrazinamide, and ethambutol, then 4 months of isoniazid and rifampin or rifabutin, with 24-month follow-up. Analyses included 43 polymorphisms in 20 genes related to antituberculosis drug hepatotoxicity or pharmacokinetics. Whole exome sequencing was done in a case-control toxicity subset.

Results

Among 903 participants in multivariable genetic association analyses, NAT2 slow acetylator status was associated with increased risk of treatment-related grade 2 or greater adverse events, including hepatotoxicity. Treatment failure/recurrence was more likely among NAT2 rapid acetylators, but not statistically significant at the 5% level. A GSTM1 polymorphism (rs412543) was associated with increased risk of treatment-related adverse events, including hepatotoxicity. SLCO1B1 polymorphisms were associated with increased risk of treatment-related hepatoxicity and treatment failure/recurrence. Polymorphisms in NR1/2 were associated with decreased risk of adverse events and increased risk of failure/recurrence. In whole exome sequencing, hepatotoxicity was associated with a polymorphism in VTI1A, and the genes METTL17 and PRSS57, but none achieved genome-wide significance.

Conclusion

In a clinical cohort representing three regions of Brazil, NAT2 acetylator status was associated with risk for treatment-related adverse events. Additional significant polymorphisms merit investigation in larger study populations, particularly regarding risk of treatment failure/recurrence.
Climbing the Research Ladder: A 25-year Analysis of K-to-R Grant Conversion among Plastic Surgeons
Authors: Arcelona Christian N. , Hallman Taylor G. , Qureshi Umer A. , Gutowski Kristof S. , Donaldson Rachel E. , Figueroa Ariel E. , Gosain Arun K.
Published: October 2024

Background:

We evaluate the performance of plastic surgeons in converting National Institutes of Health K grants in early career to R grants intended for established investigators. We also investigate characteristics that may positively predict successful transition from K to R grants.

Methods:

K08, K23, and R01 (or equivalent) grants awarded to plastic surgeons and physicians within the departments of ophthalmology, dermatology, and neurosurgery were collected. Analyses of successful conversion rates from a K to an R grant between plastic surgeons and physicians within the selected departments were performed. Cross-sectional analysis of characteristics among identified plastic surgeons was completed via logistic regression to elucidate possible predictors of successful conversion.

Results:

Comparison of pathway initiation rates demonstrate that plastic surgeons receive significantly fewer K grants relative to the size of their field when compared with other specialties (all P < 0.01). Of the analyzed plastic surgeons, 52.9% successfully converted to an R-series grant within 5.4 years of beginning their K-series grant. Conversion rates were not significantly different between plastic surgeons and physicians within the selected departments. Logistic regression analyses revealed that the time-adjusted mean relative citation ratio of K series–associated publications is a positive predictor of successful conversion (P = 0.047).

Conclusions:

With regard to increasing National Institutes of Health funding via the K-to-R pathway, we believe the field of plastic surgery could benefit from an increased effort to pursue a pathway of K-to-R conversion with a focus on quality over quantity when publishing articles associated with a K-series grant.
A NOVEL USE OF FINESSE FLEX LOOP FOR PROLIFERATIVE VITREORETINOPATHY (FINESSE LOOP- ASSISTED PHOTOCOAGULATION)
Authors: Erakgun Tansu
Published: October 2024

Purpose:

To describe a novel use of the flexible nitinol loop membrane scraper (Finesse Flex Loop; Alcon, Forth Worth, TX) for applying an effective endolaser photocoagulation in proliferative vitreoretinopathy (PVR) cases.

Methods:

A 27- gauge nitinol flex loop was used to assist applying endolaser photocoagulation to enhance its effectiveness in a case with PVR.

Results:

A 66-year-old female was presented with PVR after an unsuccessful pars plana vitrectomy and silicone oil injection for rhegmatogenous retinal detachment in her right eye. The patient underwent 25- gauge pars plana vitrectomy, preretinal membrane removal, inferior retinectomy, the nitinol flex loop assisted endolaser photocoagulation, and silicone oil reinjection. After the silicone oil extraction, the retina was reattached and her visual acuity had improved from 0.1 (20/200) to 0.3 (20/60).

Conclusion:

The nitinol flex loop can be used to assist endolaser photocoagulation and enhance its effectiveness in PVR cases and reduce the retinal excision area which results unnecessary large retinal defects that may lead to redetachment of the retina.