bluuebunny/crossref_metadata_2025 huggingface dataset:
An In Situ transmission electron microscopy study on the synergistic effects of Au-ion irradiation and high temperature on nuclear graphite microstructure
Authors: Thomas Melonie P , Schoell Ryan , Rasel Md Abu Jafar , Rahman Md Hafijur , Kuo Winson , Watt John , House Stephen , Hattar Khalid , Windes William , Haque Aman
Published: March 2024

The combined effects of high-temperature and heavy-ion irradiation on Mrozowski cracks (MC) and nuclear graphite crystallographic dimensions have been studied using in situ heating and in situ ion-irradiation in the transmission electron microscope (TEM). Electron transparent lamella of nuclear graphite, IG-110, was irradiated using a 2.8 MeV Au beam at an ion flux of 3.991 ×1010 ion cm−2 s−1 for 70 min at 800 °C. Upon high-temperature irradiation, Mrozowski crack closure was studied quantitatively. The analysis showed linear, positive expansion of nuclear graphite which is significantly different from the dimensional changes previously reported for low-dose neutron irradiation of nuclear graphite in which the material undergoes negative to positive expansion via a turnaround radiation dose. The trend of the thermal expansion coefficient (CTE) of pristine IG-110 in this study is consistent with previous reports in the 100 °C–800 °C temperature region in which the dimensional change ranges from negative to positive values.
Explicit integrators for nonlocal equations: The case of the Maxey-Riley-Gatignol equation
Authors: Jaganathan Divya , Govindarajan Rama , Vasan Vishal
Published: March 2024

The Maxey-Riley-Gatignol (MRG) equation, which describes the dynamics of an inertial particle in nonuniform and unsteady flow, is an integro-differential equation with a memory term and its solution lacks a well-defined Taylor series at

t
=
0

t=0

. In particulate flows, one often seeks trajectories of millions of particles simultaneously, and the numerical solution to the MRG equation for each particle becomes prohibitively expensive due to its ever-rising memory costs. In this paper, we present an explicit numerical integrator for the MRG equation that inherits the benefits of standard time-integrators, namely a constant memory storage cost, a linear growth of operational effort with simulation time, and the ability to restart a simulation with the final state as the new initial condition. The integrator is based on a Markovian embedding of the MRG equation. The integrator and the embedding are consequences of a spectral representation of the solution to the linear MRG equation. We exploit these to extend the work of Cox and Matthews [J. Comput. Phys. 176 (2002), 430–455] and derive Runge-Kutta type iterative schemes of differing orders for the MRG equation. Our approach may be generalized to a large class of systems with memory effects.
Implementation of a pharmacy technician career ladder and pharmacy technician training program
Authors: Thames Lisa , Johnston Corry , Cash Julie , Holder Martina , Voils Alissa
Published: March 2024

Purpose

To describe the implementation of a pharmacy technician career ladder and internal technician training program at UF Health Shands Hospital in Gainesville, FL.

As the systems for providing care and receiving reimbursement become more complex, the ability to deliver comprehensive care in the most efficient and effective manner is critical. In order to maximize impact, pharmacists must practice at the top of their license. Recruitment and retention practices that support an optimized pharmacy technician workforce and continued expansion of technician roles are vital to advancement of pharmacy practice. This report describes the efforts to improve technician recruitment, professional development, and retention through the implementation of a technician career ladder and internal training program. The programs contributed to a reduction in technician rolling 12-month turnover rates from 26.72% in July 2015 to 13.1% in March 2023 (a reduction of 51%). Overtime hours as a percentage of total hours worked were reduced from 11.02% in July 2015 to 4.54% in March 2023 (a reduction of 59%). Improvements were noted in pharmacy technician job satisfaction, as evidenced by key employee engagement indicators including responses to the posed statement “Overall, I am a satisfied employee,” with a mean score of 3.32 (on a scale of 1-5) in 2015 as compared to 4.2 in 2019 (a 21% increase).

Conclusion

Implementation of a pharmacy technician career ladder and technician training program creates a sustainable and effective recruitment and retention pathway that may favorably impact technician job satisfaction, turnover, and career development opportunities.
Comprehensive workflow evaluation to improve medication distribution to the emergency department in an academic medical center
Authors: Mills Melanie J , Martschenko Alec , Gomez Keven , Hooker Madison L , Pastoor Charlotte , Vest Tyler A
Published: March 2024

Purpose

The fast-paced environment of the emergency department (ED), with frequent admissions, discharges, and transfers, poses a challenge for pharmacy departments to effectively distribute and store medications. The purpose of this study is to propose a unique workflow of patient-specific medication delivery to the ED from a hospital pharmacy to reduce the number of missing medications resulting in medication messages and redispenses.

Methods

The medication delivery workflow proposed in this study consists of batching the preparation and distribution of patient-specific medications sent from the pharmacy to the ED in the 1 to 2 hours prior to their administration time. Chi-square analysis was completed to compare medication redispenses and “missing medication” messages before and after the intervention, with the significance level set at P < 0.05.

Results

The percentage of redispensed medications was effectively decreased following implementation of the workflow change from 21.6% to 9.2% (P < 0.001), with unit doses having the greatest reduction (25.8% vs 6.1%, P < 0.001). Benefits of this workflow change were also illustrated through a reduction in the percentage of missing-medication messages sent by nursing staff from 97.7% to 93.9% (P < 0.001).

Conclusion

This study showed that implementation of standard, hourly batches of medications dispensed from the pharmacy to the ED resulted in a significant reduction in the total percentage of redispensed medications and missing-medication messages. The overall reduction in redispensed medications as a result of this innovative workflow change not only benefited nursing and pharmacy staff but can reduce medication waste and improve patient care through timely administration of medications.
Evaluation of a pharmacist-led workflow for the FDA Expanded Access Program
Authors: Barta Blake T , McGee Ann , Arvik Beth McLendon , Vest Tyler A
Published: March 2024

Purpose

This project aimed to characterize the resources necessary for pharmacists to support the required steps for obtaining and handling investigational drugs outside of a study protocol in the individual patient and intermediate-size population Expanded Access Program (EAP) processes. The second aim was to characterize the types of EAP requests received.

This retrospective, single-center, observational study was performed by reviewing EAP requests initiated at Duke University Hospital (DUH) between August 1, 2017, and February 11, 2023. The annualized cost of unreimbursed EAP study services was projected to be approximately $196,500 at DUH for 2023. Of the 168 EAP requests submitted after the institutional policy requiring pharmacy and therapeutics (P&T) committee approval was established, 162 (96.4%) were approved by the P&T committee.

Conclusion

Given the lack of published information on a pharmacist-led workflow related to EAP services, this study sought to share DUH’s process for managing EAP requests. As there is no mechanism for reimbursement of EAP services, they can be difficult to manage given the labor resources required. Further work is needed to recoup unreimbursed investigational drug service labor costs to ensure compassionate use programs can be implemented in a manner that is financially sustainable for a health system.
A retrospective review of pregnancies in our psoriasis biologic cohort
Authors: Wolfe Charlotte , Kennard Benjamin , Bewley Anthony , Mehrtens Sarah
Published: March 2024

This review assesses the real-world pregnancy outcomes of 15 pregnancies occurring while on biologic therapy in our psoriasis cohort over a 10-year period. Of the 15 pregnancies, there were 9 successful pregnancies, 4 first trimester miscarriages, 1 stillbirth at 28 weeks and 1 termination of pregnancy. Our study shows that the majority of pregnancies were successful; this reinforces previously published data that biologic therapy for psoriasis in pregnancy does not carry additional significant clinical risk, and contributes to the body of evidence supporting the safety of biologic therapy in pregnancy.
Predictors of Mortality of Streptococcal Bacteremia and the Role of Infectious Diseases Consultation: A Retrospective Cohort Study
Authors: Fourre Nicolas , Zimmermann Virgile , Senn Laurence , Aruanno Marion , Guery Benoit , Papadimitriou-Olivgeris Matthaios
Published: March 2024

Background

Streptococcal bacteremia is associated with high mortality. Thia study aims to identify predictors of mortality among patients with streptococcal bacteremia.

Methods

This retrospective study was conducted at the Lausanne University Hospital, Switzerland, and included episodes of streptococcal bacteremia among adult patients from 2015 to 2023.

Results

During the study period, 861 episodes of streptococcal bacteremia were included. The majority of episodes were categorized in the Mitis group (348 episodes; 40%), followed by the Pyogenic group (215; 25%). Endocarditis was the most common source of bacteremia (164; 19%). The overall 14-day mortality rate was 8% (65 episodes). The results from the Cox multivariable regression model showed that a Charlson comorbidity index >4 (P .001; hazard ratio [HR], 2.87; confidence interval [CI]: 1.58–5.22), Streptococcus pyogenes (P = .011; HR, 2.54;CI: 1.24–5.21), sepsis (P < .001; HR, 7.48; CI: 3.86–14.47), lower respiratory tract infection (P = .002; HR, 2.62; CI: 1.42–4.81), and absence of source control interventions within 48 hours despite being warranted (P = .002; HR, 2.62; CI: 1.43–4.80) were associated with 14-day mortality. Conversely, interventions performed within 48 hours of bacteremia onset, such as infectious diseases consultation (P < .001; HR, 0.29; CI: .17–.48) and appropriate antimicrobial treatment (P < .001; HR, .28; CI: .14–.57), were associated with improved outcome.

Conclusions

Our findings underscore the pivotal role of infectious diseases consultation in guiding antimicrobial treatment and recommending source control interventions for patients with streptococcal bacteremia.
Predictors of textbook outcome following oesophagogastric cancer surgery
Authors: Velayudham Ganesh K , Dermanis Alexander , Kamarajah Sivesh K , Griffiths Ewen A
Published: March 2024

Textbook outcome (TO) is a composite measure representing an ideal perioperative course, which has been utilized to assess the quality of care in oesophagogastric cancer (OGC) surgery. We aim to determine TO rates among OGC patients in a UK tertiary center, investigate predictors of TO attainment, and evaluate the relationship between TO and survival. A retrospective analysis of a prospectively collected departmental database between 2006 and 2021 was conducted. Patients that underwent radical OGC surgery with curative intent were included. TO attainment required margin-negative resection, adequate lymphadenectomy, uncomplicated postoperative course, and no hospital readmission. Predictors of TO were investigated using multivariable logistic regression. The association between TO and survival was evaluated using Kaplan–Meier analysis and Cox regression modeling. In sum, 667 esophageal cancer and 312 gastric cancer patients were included. TO was achieved in 35.1% of esophagectomy patients and 51.3% of gastrectomy patients. Several factors were independently associated with a low likelihood of TO attainment: T3 stage (odds ratio (OR): 0.41, 95% confidence interval (CI) [0.22–0.79], p = 0.008) and T4 stage (OR:0.26, 95% CI [0.08–0.72], p = 0.013) in the esophagectomy cohort and high BMI (OR:0.93, 95% CI [0.88–0.98], p = 0.011) in the gastrectomy cohort. TO attainment was associated with greater overall survival and recurrence-free survival in esophagectomy and gastrectomy cohorts. TO is a relevant quality metric that can be utilized to compare surgical performance between centers and investigate patients at risk of TO failure. Enhancement of preoperative care measures can improve TO rates and, subsequently, long-term survival.
VvWRKY5 positively regulates wounding-induced anthocyanin accumulation in grape by interplaying with VvMYBA1 and promoting jasmonic acid biosynthesis
Authors: Zhang Zhen , Chen Cui , Jiang Changyue , Lin Hong , Zhao Yuhui , Guo Yinshan
Published: March 2024

Wounding stress induces the biosynthesis of various secondary metabolites in plants, including anthocyanin. However, the underlying molecular mechanism remains elusive. Here, we reported that a transcription factor, VvWRKY5, promotes wounding-induced anthocyanin accumulation in grape (Vitis vinifera). Biochemical and molecular analyses demonstrated that wounding stress significantly increased anthocyanin content, and VvMYBA1 plays an essential role in this process. VvWRKY5 could interact with VvMYBA1 and amplify the activation effect of VvMYBA1 on its target gene VvUFGT. The transcript level of VvWRKY5 was notably induced by wounding treatment. Moreover, our data demonstrated that VvWRKY5 could promote the synthesis of jasmonic acid (JA), a phytohormone that acts as a positive modulator in anthocyanin accumulation, by directly binding to the W-box element in the promoter of the JA biosynthesis-related gene VvLOX and enhancing its activities, and this activation was greatly enhanced by the VvWRKY5-VvMYBA1 protein complex. Collectively, our findings show that VvWRKY5 plays crucial roles in wounding-induced anthocyanin synthesis in grape and elucidates the transcriptional regulatory mechanism of wounding-induced anthocyanin accumulation.
Regulation of morphogenesis and pathogenicity by OsMep2, OsCph1, and OsPes1 in dimorphic entomopathogenic fungus Ophiocordyceps sinensis (Hypocreales: Ophiocordycipitaceae)
Authors: Liu Guiqing , Zheng Xuehong , Cao Li , Han Richou
Published: March 2024

Polarized growth plays a key role in all domains of their biology, including morphogenesis and pathogenicity of filamentous fungi. However, little information is available about the determinants of polarized growth. The fungal Mep2, Pes1, and Cph1 proteins were identified to be involved in the dimorphic transition between yeast and hyphal forms in Candida albicans. In this study, evidence that the dimorphic fungal entomopathogen Ophiocordyceps sinensis Mep2, Pes1, and Cph1 proteins are involved in polarized growth is presented. OsMep2 was significantly upregulated at aerial hyphae and conidia germination stages. OsCph1 was significantly upregulated at aerial hyphae, conidia initiation, and conidia germination stages, and OsPes1 was significantly upregulated at the conidia germination stage. Deletions of OsMep2, OsCph1, and OsPes1 provoked defects in the polarized growth. The abilities of hyphal formation and the yields of blastospores and conidia for the ∆ OsMep2, ∆OsCph1, and ∆ OsPes1 mutants were significantly reduced. The conidia yields of the ΔOsMep2, ΔOsCph1, and ΔOsPes1 mutants were decreased by 69.17%, 60.90%, and 75.82%, respectively. Moreover, the pathogenicity of the ∆ OsMep2, ∆OsCph1, and ∆ OsPes1 mutants against Thitarodes xiaojinensis was significantly reduced. The mummification rate caused by wide type and ΔOsMep2, ΔOsCph1, and ΔOsPes1 mutants were 36.98% ± 8.52%, 0.31% ± 0.63%, 1.15% ± 1.57%, and 19.69% ± 5.6%, respectively. These results indicated that OsMep2, OsCph1, and OsPes1 are involved in the regulation of hyphal formation, sporulation, and pathogenicity of O. sinensis. This study provided a basis for the understanding of the fungal dimorphic development and improving the efficiency of artificial cultivation of O. sinensis.
Buena VISTA: a promising outlook on targeting immune checkpoint regulators to combat sepsis
Authors: Mott Madeline D , Trusiano Briana , Allen Irving Coy
Published: March 2024

Regulation of T cell activation by VISTA is implicated in host organism immune response to sepsis and may be a potential therapeutic target.
A direct approach to civic formation that preserves the spirit of pure liberal education
Authors: Love Christopher William
Published: March 2024

According to one historic view of liberal education, such education is incompatible with the express pursuit of civic goods. Call that view ‘pure liberal education’. Students engaged in pure liberal education are set free, temporarily, from utilitarian concerns, for a course of study aimed at intrinsic goods—most notably knowledge but also the formation of a virtuous mind. Proponents claim that a direct pursuit of civic goods would compromise the mode, matter, and/or integrity of pure liberal education—that is, its freedom from utilitarian concern, its wide-ranging and intrinsically valuable subject matter, and its commitment to following the truth wherever it leads. In reply, I offer a pedagogy that requires (almost) no departure from the pure liberal ideal yet which reserves a modest, though important, place for civic formation. That place emerges from the fact that academic and civic life ‘overlap’ in an important respect: both involve a conversation and thus a common set of virtues. The latter consist in those practices and dispositions that enable the conversation to go well, by encouraging mutual understanding and the formation of true beliefs. The existence of this overlap provides a way for pure liberal educators, who already expressly influence their students’ academic formation, to likewise influence their civic formation. It consists in teachers consciously developing those virtues in their students, along with an awareness of the virtues’ relevance for civic life. This pedagogy retains the matter and integrity of pure liberal education, with only brief introductions of the practical mode.
Multi-Stimuli Operando Transmission Electron Microscopy for Two-Terminal Oxide-Based Devices
Authors: Recalde-Benitez Oscar , Pivak Yevheniy , Winkler Robert , Jiang Tianshu , Adabifiroozjaei Esmaeil , Perez-Garza H Hugo , Molina-Luna Leopoldo
Published: March 2024

The integration of microelectromechanical systems (MEMS)-based chips for in situ transmission electron microscopy (TEM) has emerged as a highly promising technique in the study of nanoelectronic devices within their operational parameters. This innovative approach facilitates the comprehensive exploration of electrical properties resulting from the simultaneous exposure of these devices to a diverse range of stimuli. However, the control of each individual stimulus within the confined environment of an electron microscope is challenging. In this study, we present novel findings on the effect of a multi-stimuli application on the electrical performance of TEM lamella devices. To approximate the leakage current measurements of macroscale electronic devices in TEM lamellae, we have developed a postfocused ion beam (FIB) healing technique. This technique combines dedicated MEMS-based chips and in situ TEM gas cells, enabling biasing experiments under environmental conditions. Notably, our observations reveal a reoxidation process that leads to a decrease in leakage current for SrTiO3-based memristors and BaSrTiO3-based tunable capacitor devices following ion and electron bombardment in oxygen-rich environments. These findings represent a significant step toward the realization of multi-stimuli TEM experiments on metal–insulator–metal devices, offering the potential for further exploration and a deeper understanding of their intricate behavior.
Shigella Detection and Molecular Serotyping With a Customized TaqMan Array Card in the Enterics for Global Health (EFGH): Shigella Surveillance Study
Authors: Liu Jie , Garcia Bardales Paul F , Islam Kamrul , Jarju Sheikh , Juma Jane , Mhango Chimwemwe , Naumanga Queen , Qureshi Sonia , Sonye Catherine , Ahmed Naveed , Aziz Fatima , Bhuiyan Md Taufiqur Rahman , Charles Mary , Cunliffe Nigel A , Abdou Mahamadou , Galagan Sean R , Gitteh Ensa , Guindo Ibrehima , Jahangir Hossain M , Jabang Abdoulie M J , Jere Khuzwayo C , Kawonga Flywell , Keita Mariama , Keita Noumou Yakhouba , Kotloff Karen L , Shapiama Lopez Wagner V , Munga Stephen , Paredes Olortegui Maribel , Omore Richard , Pavlinac Patricia B , Qadri Firdausi , Qamar Farah Naz , Azadul Alam Raz S M , Riziki Laura , Schiaffino Francesca , Stroup Suzanne , Traore Sarata Nassoun , Pinedo Vasquez Tackeshy , Yousafzai Mohammad Tahir , Antonio Martin , Cornick Jennifer E , Kabir Furqan , Khanam Farhana , Kosek Margaret N , Ochieng John Benjamin , Platts-Mills James A , Tennant Sharon M , Houpt Eric R
Published: March 2024

Background

Quantitative polymerase chain reaction (qPCR) targeting ipaH has been proven to be highly efficient in detecting Shigella in clinical samples compared to culture-based methods, which underestimate Shigella burden by 2- to 3-fold. qPCR assays have also been developed for Shigella speciation and serotyping, which is critical for both vaccine development and evaluation.

Methods

The Enterics for Global Health (EFGH) Shigella surveillance study will utilize a customized real-time PCR–based TaqMan Array Card (TAC) interrogating 82 targets, for the detection and differentiation of Shigella spp, Shigella sonnei, Shigella flexneri serotypes, other diarrhea-associated enteropathogens, and antimicrobial resistance (AMR) genes. Total nucleic acid will be extracted from rectal swabs or stool samples, and assayed on TAC. Quantitative analysis will be performed to determine the likely attribution of Shigella and other particular etiologies of diarrhea using the quantification cycle cutoffs derived from previous studies. The qPCR results will be compared to conventional culture, serotyping, and phenotypic susceptibility approaches in EFGH.

Conclusions

TAC enables simultaneous detection of diarrheal etiologies, the principal pathogen subtypes, and AMR genes. The high sensitivity of the assay enables more accurate estimation of Shigella-attributed disease burden, which is critical to informing policy and in the design of future clinical trials.
A case of paroxysmal cold hemoglobinuria complicated by latent syphilis
Authors: Hirata Tsuyoshi , Kubota Naoko , Fukushima Kazuaki , Takami Erika , Kato Tsuyoshi , Okamoto Tomomi
Published: March 2024

An 80-year-old man presented in December with the main complaint of jaundice. Blood tests revealed hemolytic anemia and renal dysfunction. Positive syphilis serology results led to a diagnosis of untreated latent syphilis. A positive direct Coombs test led to a diagnosis of autoimmune hemolytic anemia (AIHA). Antibiotics were started for the syphilis, with improvement in the anemia and renal dysfunction observed. However, paroxysmal intravascular hemolysis occurred after his discharge. Based on a positive Donath-Landsteiner (D-L) test, paroxysmal cold hemoglobinuria (PCH) diagnosis was made. The hemolytic anemia improved after further treatment for syphilis, and further avoiding exposure to cold.
Moth eaten alopecia as the only manifestation of syphilis: a case from Nepal
Authors: Shrestha Amrita , Kusha K C , Baral Abal
Published: March 2024

This paper presents a case of Moth-Eaten Alopecia as the only clinical manifestation of secondary syphilis in a 28-year-old man from Nepal. The patient exhibited progressive hair loss in the occipitoparietal region without associated pain or itching. With a positive Rapid Plasma Reagin (RPR) test (1:256), the patient received a three-week course of Benzathine Penicillin G, resulting in complete hair regrowth within four months. This case underscores the significance of recognizing moth eaten alopecia as a potential dermatological sign of secondary syphilis, especially when it appears as the sole clinical symptom.
Secondary syphilis presenting with non-arteritic anterior ischemic optic neuropathy (NAION)
Authors: AlKhayal Fares A , Albusair Moath K
Published: March 2024

Syphilis is a sexually transmitted disease caused by the spirochete bacterium Treponema pallidum. Syphilis is a significant public health issue, notably in (HIV) positive patients. Due to the absence of pathognomonic signs in secondary syphilis and its ability to present and mimic a wide variety of clinical findings, it gained the name “the Great imitator ‘(mimicker).’ Herein, we describe a case of a 51-year-old man who presented with acute painless loss of vision of the right eye preceded by a few erythematous plaques with thick scales over bilateral legs and multiple discrete and confluent scaly papules over the palms and soles. During the hospital stay, a diagnosis of non-arteritic anterior ischemic optic neuropathy (NAION) as a manifestation of neurosyphilis is made. To the best of our knowledge, this is the first reported case of NAION as the presenting symptom of neurosyphilis in secondary syphilis in an immunocompetent patient.
Noninvoluting congenital hemangiomas with hypovolemic shock, anemia and prolonged jaundice in a neonate: a case report
Authors: Aslamzai Mansoor , Hakimi Turyalai , Mushoud Mesbahullah , Mukhlis Abdul Hakim
Published: March 2024

Noninvoluting congenital hemangioma is an extremely rare congenital anomaly in newborn babies and may complicate life-threatening events, including hemorrhage. We present a very rare case of noninvoluting congenital hemangiomas in an Asian and Afghan six-day-old girl that was detected at birth. The noninvoluting congenital hemangiomas were accompanied by hypovolemic shock, anemia, and prolonged jaundice during the first two weeks of life. These diseases were diagnosed by medical history, physical examination, blood analysis, and doppler ultrasonography of the skin lesions. Her hypovolemic shock and hemorrhage were improved after supportive treatment, and she was discharged from the hospital in a good condition. After four weeks of life, the hemangiomas did not regress or progress, suggesting noninvoluting congenital hemangiomas. Hemangioma may complicate severe hemorrhage and shock, as well as there may be an association between congenital hemangioma and prolonged neonatal jaundice.
Service User Representation in Qualitative Research on Cognitive Health and Related Interventions for Psychosis: A Scoping Review
Authors: Gonzales Lauren , Jones Nev
Published: March 2024

Background and Hypothesis

Cognitive health in schizophrenia spectrum psychosis has received substantial empirical attention in recent decades, coinciding with the development and implementation of interventions including cognitive remediation. Subjective experience in psychosis, including qualitative explorations of service user perspectives, has also proliferated; however, there is no available synthesis of service user representation in the psychosis cognitive health literature. This scoping review investigated prevalence and characteristics of qualitative research reporting service user perspectives across the extant research on cognitive health and related interventions in psychosis.

Study Design

We conducted a literature search on qualitative methods in cognitive health and/or related interventions across PubMed, Web of Science, and PsycInfo databases. The review followed the PRISMA-ScR guidelines for scoping reviews and identified 23 papers. Data extraction included study design and sample characteristics, qualitative methodology, and reporting.

Study Results

Of 23 articles, 18 reported on user experiences of interventions, most often in the context of feasibility/acceptability for otherwise quantitative trials. Five studies described service user experiences of cognitive health separately from interventions. Only 3 included any service user involvement or participatory methods. Twenty articles reported any demographic characteristics, and fewer than half (11) reported any racial or ethnic sample characteristics. There was substantial variability in qualitative methodology and reporting across studies.

Conclusions

Qualitative methodology is lacking in its representation and rigor across the cognitive health literature for schizophrenia spectrum psychosis. Additional inclusion of service user lived experience is critical for future research to better characterize cognitive health and inform interventions to promote recovery.
The aryl hydrocarbon receptor differentially modulates the expression profile of antibody isotypes in a human B-cell line
Authors: Bhakta-Yadav Mili S , Burra Kaulini , Alhamdan Nasser , Allex-Buckner Clayton P , Sulentic Courtney E W
Published: March 2024

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is a persistent environmental contaminant and high affinity ligand for the aryl hydrocarbon receptor (AhR). In animal models, AhR activation by TCDD generally inhibits antibody secretion. However, it is less clear if this translates to human antibody production. Using a human Burkitt lymphoma B-cell line (CL-01) that can be stimulated to secrete Ig and undergo class switch recombination to other Ig isotypes, the current study evaluated the effects of AhR activation or antagonism on the human Ig isotypic expression profile with CD40L+IL-4 stimulation. Our results suggest that AhR agonists (TCDD and indirubin) have little to no effect on IgM or IgA secretion, which were also not induced with stimulation. However, AhR activation significantly inhibited stimulation-induced IgG secretion, an effect reversed by the AhR antagonist CH223191. Evaluation of Ig heavy chain (IgH) constant region gene expression (ie Cμ, Cγ1-4, Cα1-2, and Cε that encode for IgM, IgG1-4, IgA1-2, and IgE, respectively) demonstrated differential effects. While Cμ and Cα2 transcripts were unaffected by stimulation or AhR agonists, AhR activation significantly inhibited stimulation-induced Cγ2-4 and Cε mRNA transcripts, which was reversed by AhR antagonism. Notably, AhR antagonism in the absence of exogenous AhR ligands significantly increased IgG and IgA secretion as well as the expression of Cγ2-4 and Cε. These results suggest that modulation of AhR activity differentially alters the IgH isotypic expression profile and antibody secretion that may be partly dependent on cellular stimulation. Since a variety of chemicals from anthropogenic, industrial, pharmaceutical, dietary, and bacterial sources bind the AhR, the ability of environmental exposures to alter AhR activity (i.e. activate or inhibit) may have a direct influence on immune function and antibody-relevant disease conditions.
Unraveling the genetic link: an umbrella review on HLA-B*15:02 and antiepileptic drug-induced Stevens–Johnson syndrome/toxic epidermal necrolysis
Authors: Tham Kar Mun , Yek Jacklyn Jia Lin , Liu Christopher Wei Yang
Published: March 2024

Purpose

This umbrella review was conducted to summarize the association between HLA*1502 allele with antiepileptic induced Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).

Methods

Pubmed, Scopus and EMBASE were searched for eligible reviews in May 2023. Two authors independently screened titles and abstracts and assessed full-text reviews for eligibility. The quality of meta-analyses and case–control studies was appraised with Assessing the Methodological Quality of Systematic Reviews 2 and Newcastle-Ottawa Scale, respectively. Narrative summaries of each antiepileptic drug were analyzed. Preestablished protocol was registered on the International Prospective Register of Systematic Reviews Registry(ID: CRD42023403957).

Results

Included studies are systematic reviews, meta-analyses and case–control studies evaluating the association of HLA-B*1502 allele with the following antiepileptics. Seven meta-analyses for carbamazepine, three meta-analyses for lamotrigine (LTG), three case–control studies for oxcarbazepine, nine case–control studies for phenytoin and four case–control studies for phenobarbitone were included. The findings of this umbrella review suggest that there is a strong association between HLA-B-1502 with SJS/TEN for carbamazepine and oxcarbazepine and a milder association for lamotrigine and phenytoin.

Conclusion

In summary, although HLA-B*1502 is less likely to be associated with phenytoin or lamotrigine-induced SJS/TEN compared to carbamazepine-induced SJS/TEN, it is a significant risk factor that if carefully screened, could potentially reduce the development of SJS/TEN. In view of potential morbidity and mortality, HLA-B*1502 testing may be beneficial in patients who are initiating lamotrigine/phenytoin therapy. However, further studies are required to examine the association of other alleles with the development of SJS/TEN and to explore the possibility of genome-wide association studies before initiation of treatment.
Saccharomyces Cerevisiae as a Model Organism for Retrospective Impedance Biodosimetry
Authors: Hassan Amna , Atkinson Kirk D.
Published: March 2024

Previous studies have shown that measuring changes in electrical impedance that follow radiation-induced suppression of metabolic activity in irradiated yeast cells can be used to determine radiation dose. The current work investigates the radiation response of Saccharomyces cerevisiae cells by using metabolic activity of cells as a damage indicator. Impedance biodosimetry was examined as a method to evaluate the radiation response of yeast cells. Active lab-grade dry yeast cells were used as the biological material as these samples are simple to handle and have a long shelf-life. A novel dosimeter design has been developed with a strict fabrication method and measurement procedure to ensure reproducible measurements are possible. Prepared yeast samples were irradiated to doses from 0.5 to 8 Gy using a 137Cs source, and a dose response curve was developed that showed a linear relationship of dose with changes in impedance measurements. Fading of the impedance signal was also investigated, and it was shown that there was no noticeable fading of the impedance signal over a period of 7 mo. Finally, the lowest detectable limit measured using this methodology was determined to be 300 mGy. This work presents an alternative retrospective dosimetry technique that can be used at a high scale and low cost following large-scale radiological accidents.
Factors Influencing Effects of Low-dose Radiation Exposure
Authors: Mothersill Carmel , Seymour Colin , Cocchetto Alan , Williams David
Published: March 2024

It is now well accepted that the mechanisms induced by low-dose exposures to ionizing radiation (LDR) are different from those occurring after high-dose exposures. However, the downstreameffectsof these mechanisms are unclear as are the quantitative relationships between exposure, effect, harm, and risk. In this paper, we will discuss the mechanisms known to be important with an overall emphasis on how so-called “non-targeted effects” (NTE) communicate and coordinate responses to LDR. Targeted deposition of ionizing radiation energy in cells causing DNA damage is still regarded as the dominant trigger leading to all downstream events whether targeted or non-targeted. We regard this as an over-simplification dating back to formal target theory. It ignores that last 100 y of biological research into stress responses and signaling mechanisms in organisms exposed to toxic substances, including ionizing radiation. We will provide evidence for situations where energy deposition in cellular targets alone cannot be plausible as a mechanism for LDR effects. An example is where the energy deposition takes place in an organism not receiving the radiation dose. We will also discuss how effects after LDR depend more on dose rate and radiation quality rather than actual dose, which appears rather irrelevant. Finally, we will use recent evidence from studies of cataract and melanoma induction to suggest that after LDR, post-translational effects, such as protein misfolding or defects in energy metabolism or mitochondrial function, may dominate the etiology and progression of the disease. A focus on such novel pathways may open the way to successful prophylaxis and development of new biomarkers for better risk assessment after low dose exposures.
Homozygous MTHFR C677T carriers develop idiopathic portal vein thrombosis 20 years earlier than wild type
Authors: Ames Paul RJ. , D’Andrea Giovanna , Arcaro Alessia , Marottoli Vincenzo , Iannaccone Luigi , Margaglione Maurizio , Gentile Fabrizio
Published: March 2024

The aim of this study was to evaluate the impact of methylene tetrahydrofolate reductase (MTHFR) rs1801133 (C→T667 transition) on age at first idiopathic portal vein thrombosis (PVT) and to identify clinical and/or laboratory variables influencing age at first PVT, including plasma homocysteine and the prothrombin rs1799963 PT (G→A transition at position 20210) (PT) mutation.

A retrospective cross-sectional cohort, including 15 MTHFR TT, 32 MTHFR TC and 22 MTHFR CC idiopathic PVT participants contributing demographics, age at PVT, plasma concentrations of homocysteine and of natural anticoagulants.

MTHFR TT carriers presented with a lower age at PVT than heterozygous or wild-type genotypes (31 ± 8 vs. 48 ± 15 vs. 52 ± 13 years, P = 0.001) and were more likely to have a plasma HC concentration above the cut-off (73.3 vs. 32 vs. 50%, P = 0.04). MTHFR TT and protein C predicted age at PVT (P < 0.0001 and P = 0.06); MTHFR TT predicted plasma homocysteine (P = 0.05). In the MTHFR TT group, plasma homocysteine inversely related to protein C (P = 0.03). Plasma homocysteine predicted the extent of PVT (P = 0.03). Compound MTHFR TT + PT GA did not lower age at first PVT compared to MTHFR TT alone (35 ± 9 vs. 30 ± 8 years).

MTHFR TT is associated with a 20-year earlier PVT presentation than heterozygous and wild-type MTHFR genotypes. The inverse relation between plasma homocysteine and protein C contributes to the prematurity of PVT in the MTHFR TT group, whereas plasma homocysteine contributes to the extent of PVT. The recent exclusion of MTHFR genotyping from the thrombophilia screen needs revisiting in this setting.
Association of left ventricular diastolic dysfunction with inflammatory activity, renal dysfunction, and liver-related mortality in patients with cirrhosis and ascites
Authors: Kalambokis Georgios , Christaki Maria , Tsiakas Ilias , Despotis Grigorios , Lakkas Lampros , Tsiouris Spiridon , Xourgia Xanthi , Markopoulos Georgios S. , Dova Lefkothea , Milionis Haralampos
Published: March 2024

Left ventricular diastolic dysfunction (LVDD) is the predominant cardiac abnormality in cirrhosis. We investigated the association of LVDD with systemic inflammation and its impact on renal function, occurrence of hepatorenal syndrome (HRS) and survival in patients with cirrhosis and ascites. We prospectively enrolled 215 patients with cirrhosis and ascites. We evaluated the diagnosis and grading of LVDD by Doppler echocardiography, inflammatory markers, systemic hemodynamics, vasoactive factors, radioisotope-assessed renal function and blood flow, HRS development and liver-related mortality. LVDD was diagnosed in 142 (66%) patients [grade 2/3: n = 61 (43%)]. Serum lipopolysaccharide-binding protein (LBP), plasma renin activity (PRA) and glomerular filtration rate (GFR) were independently associated with the presence of grade 2/3 LVDD and the severity of diastolic dysfunction. Serum tumor necrosis factor-α, cardiac output and plasma noradrenaline were also independently associated with the presence of grade 2/3 LVDD. The diastolic function marker E/e′ was strongly correlated with serum LBP (r = 0.731; P < 0.001), PRA (r = 0.714; P < 0.001) and GFR (r = −0.609; P < 0.001) among patients with LVDD. The 5-year risk of HRS development and death was significantly higher in patients with grade 2/3 LVDD compared to those with grade 1 (35.5 vs. 14.4%; P = 0.01 and 53.3 vs. 28.2%; P = 0.03, respectively). The occurrence and severity of LVDD in patients with cirrhosis and ascites is closely related to inflammatory activity. Advanced LVDD is associated with baseline circulatory and renal dysfunction, favoring HRS development, and increased mortality.
Navigating the Discussion of Mental Illness With Vietnamese Americans
Authors: Do Carter , Le Thinh H. , Nguyen Emily , Pak Thomas K.
Published: March 2024

Approaching mental health issues in the Vietnamese community is challenging due to the distinct cultural practices, the stigma of mental illness, and the language barrier. These complexities are compounded by additional stressors experienced by many Vietnamese Americans stemming from war trauma and the demands of immigration. In this article, the authors discuss the implications that Vietnamese cultural practices have on the perception of mental health in Vietnamese American communities. Specifically, the discussion encompasses mood disorders, particularly depression, and schizophrenia, 2 prevalent mental health conditions that often intersect with cultural nuances. Shedding light on this often-overlooked aspect, the authors provide insight into understanding the specific challenges Vietnamese Americans with depression and schizophrenia face. At the end of this article, a helpful table of commonly used mental health terms, their Vietnamese translations, and explanations in Vietnamese are presented. Beyond linguistics, the article extends its guidance to mental health providers seeking to engage in productive discussion about mental health with their patients. By offering practical tips tailored to cultural context, the article aims to foster a more inclusive approach to mental health in Vietnamese American communities.
Prodromal or Factitious Psychosis: A Cautionary Tale in the Era of Increasing Social Media Use by Vulnerable Individuals
Authors: Bastiaens Leo , Cristofano-Casella Stephanie , Bastiaens Jesse
Published: March 2024

Research on the prodromal phase of schizophrenia has been ongoing for several decades and, more recently, findings from this research are being incorporated into everyday psychiatric practice, such as the use of interviews to evaluate prodromal symptomatology. This evolution is happening in the midst of an explosion of social media use by teenagers and young adults, increasing the exposure of youth to portrayals of psychiatric experiences. For example, reports from around the world of “TIK-TOK tics” emphasize the role of social media in the “creation” of psychiatric symptoms. This case report highlights the importance of a full psychiatric evaluation in acute care settings where quick treatment of psychotic symptoms is the norm. A 15-year-old patient was initially diagnosed with prodromal schizophrenia but, after a more extensive evaluation during a second admission, she was diagnosed with borderline personality disorder. Her antipsychotic treatment regimen was stopped and appropriate education and treatment were started, without the recurrence of “psychotic symptoms” during follow-up. It may be that patients with borderline personality disorder, a frequent condition on inpatient units, are at particular risk of assimilating symptoms as represented on social media.
Shifts in Reduction Mammaplasty Surgical Volumes With the Emergence of a Global Pandemic
Authors: Shah Pearl , Navarro Yelissa , Thawanyarat Kometh , Moody Robert , Ahmed Asim , Collar John , Holmes Kathryne , Yu Jack
Published: March 2024

Introduction

The onset of the COVID-19 pandemic resulted in significant changes to the surgical caseload for various surgery departments across the United States. As medical institutions prioritized resources for the expected increase in patient volumes due to the SARS-CoV-2 viral infection, surgical departments saw a decrease in nonemergent and elective surgical procedures. Reduction mammoplasties, which are largely covered by insurance, are among the elective procedures that provide significant revenue to the hospital. This expected decline in procedures suggests a potential decline in revenue provided by the plastic surgery department of a hospital. The purpose of this study was to analyze the loss of revenue experienced by a single academic medical institution due to changes in breast reduction mammoplasty volumes during the COVID-19 pandemic.

Methods

Upon institutional review board approval, using the Augusta University Medical Center's Financial Billing Data, 373 patients who underwent bilateral reduction mammoplasty were queried. A time horizon of March 2019 to February 2022 was used to determine the pre- and post-COVID case load and charges that were incurred. Statistical analysis to compare the prior 12 months and after 24 months of COVID was conducted using 2 samples of equal variance t test and F test confirming equal variance.

Results

There was a statistically significant increase in the number of reduction mammoplasties performed per month from the year before the onset of COVID-19 (March 2020) to the 2 years after (6.6–11.4 per month, P = 0.0024). There was a statistically significant increase in the per-month charges from the AU Health system for reduction mammoplasties for the same period ($31,780.92–$52,113.34 per month, P = 0.0054). Although there was an increase in per-month revenue from reduction mammoplasties, this increase failed to reach statistical significance ($7,059.95–$10,423.51 per month, P = 0.064).

Conclusions

The plastic surgery department saw a statistically significant increase in reduction mammoplasty cases and subsequent charges in the post-COVID cohort. These findings suggest that the emergence of a nationwide pandemic did not necessarily lead to a decrease in the volume of nonemergent surgical cases despite an expected decrease in caseload due to the need to reallocate hospital resources. On the contrary, there was an increase in caseload suggesting that there may be other factors contributing to patients' pursuance of reduction mammoplasty post-COVID including convenience, resulting from time off due to pandemic, meeting insurance-covered reduction criteria, and projected recovery time.