bluuebunny/crossref_metadata_2025 huggingface dataset:
Common Measures to Evaluate Flavored Tobacco Products: Recommendations From the Tobacco Centers for Regulatory Science (TCORS) Flavored Tobacco Products Measurement Subcommittee
Authors: Bansal-Travers Maansi , Price Simani M , Bold Krysten W , Villanti Andrea C , Barnes Andrew , Chansky Melanie , Krishnan-Sarin Suchitra , Goniewicz Maciej L
Published: July 2022

Introduction

Flavored electronic nicotine delivery systems (ENDS) and tobacco products are associated with the initiation and progression of tobacco use. With recent restrictions around flavored products, it is critical to measure both the product and the flavor being used. The Tobacco Centers of Regulatory Science (TCORS) Flavored Tobacco Products Measurement Subcommittee (FTPMS) was established to develop core measures to assess flavored tobacco and ENDS product usage, facilitate data harmonization, replicability, and comparisons across studies.

Aims and Methods

The FTPMS used a mixed-method approach to inform the development of recommended measures (first use, current use, reasons for use) to assess tobacco and ENDS product flavors. This included reviewing existing surveys, identifying priority areas, developing new measures, cognitive testing, and finalization of recommended measures.

Results

Recommended measures were selected from national surveys (e.g. PATH study) and survey items used in TCORS studies to evaluate first use, current use, and reasons for use of tobacco and ENDS products. Response options were expanded for questions about specific flavors and adapted to allow for assessments relevant to recent federal policies. Supplemental measures were developed for researchers conducting more in-depth research around flavored products.

Conclusions

Using an expert consensus process supplemented with cognitive testing, the FTPMS developed recommendations for core and supplemental measures for flavored tobacco and ENDS products. Harmonizing data on these factors for flavored tobacco and ENDS products are critical for researchers and may provide actionable evidence to federal, state, and local regulators and policymakers, as well as support evaluations of policies restricting flavors in these products.

Implications

The development of core measures to assess first use, current use, and reasons for use of flavored tobacco and ENDS products will facilitate data harmonization, replicability, and comparisons across studies conducted in different samples or across communities with varying levels of regulation for these products. Use of these standardized measures will allow for a greater understanding of the role of flavors and helps to build a more robust evidence base to inform regulatory decisions to reduce tobacco and ENDS use at the population level.
Safety and Efficacy of Dupilumab for the Treatment of Hospitalized Patients With Moderate to Severe Coronavirus Disease 2019: A Phase 2a Trial
Authors: Sasson Jennifer , Donlan Alexandra N , Ma Jennie Z , Haughey Heather M , Coleman Rachael , Nayak Uma , Mathers Amy J , Laverdure Sylvain , Dewar Robin , Jackson Patrick E H , Heysell Scott K , Sturek Jeffrey M , Petri William A
Published: July 2022

Background

Based on studies implicating the type 2 cytokine interleukin 13 (IL-13) as a potential contributor to critical coronavirus disease 2019 (COVID-19), this trial was designed as an early phase 2 study to assess dupilumab, a monoclonal antibody that blocks IL-13 and interleukin 4 signaling, for treatment of inpatients with COVID-19.

Methods

We conducted a phase 2a randomized, double-blind, placebo-controlled trial (NCT04920916) to assess the safety and efficacy of dupilumab plus standard of care vs placebo plus standard of care in mitigating respiratory failure and death in those hospitalized with COVID-19.

Results

Forty eligible subjects were enrolled from June to November of 2021. There was no statistically significant difference in adverse events nor in the primary endpoint of ventilator-free survival at day 28 between study arms. However, for the secondary endpoint of mortality at day 60, there were 2 deaths in the dupilumab group compared with 5 deaths in the placebo group (60-day survival: 89.5% vs 76.2%; adjusted hazard ratio [HR], 0.05 [95% confidence interval {CI}, .004–.72]; P = .03). Among subjects who were not in the intensive care unit (ICU) at randomization, 3 subjects in the dupilumab arm were admitted to the ICU compared to 6 in the placebo arm (17.7% vs 37.5%; adjusted HR, 0.44 [95% CI, .09–2.09]; P = .30). Last, we found evidence of type 2 signaling blockade in the dupilumab group through analysis of immune biomarkers over time.

Conclusions

Although the primary outcome of day 28 ventilator-free survival was not reached, adverse events were not observed and survival was higher in the dupilumab group by day 60.

Clinical Trials Registration

NCT04920916.
Oral Versus Standard Antimicrobial Treatment for Pyogenic Native Vertebral Osteomyelitis: A Single-Center, Retrospective, Propensity Score-Balanced Analysis
Authors: Marconi Lorenzo , Tedeschi Sara , Zamparini Eleonora , Terzi Silvia , Rossi Nicolò , Boriani Luca , Trapani Filippo , Giannella Maddalena , Ruinato Damiano Alfio , Marchionni Elisa , Gasbarrini Alessandro , Viale Pierluigi
Published: July 2022

Background

Interest in shorter antimicrobial regimens and oral treatment for osteoarticular infections is growing. The aim of this study is to assess whether there is an association between the administration of an entirely oral antibiotic therapy (OT) and the clinical outcome of native vertebral osteomyelitis (NVOs).

Methods

We conducted a single-center, retrospective, observational study on consecutive patients with pyogenic NVOs over a 10-year period (2008–2018). We performed multivariate logistic regression analysis to identify risk factors for clinical failure, both in the whole population and in subgroups. The impact of OT versus standard treatment (intravenous induction followed by oral treatment whenever possible) was assessed in patients with a non-multidrug-resistant microorganism (MDRO) etiology, and the impact of a rifampin-containing regimen was assessed in patients affected by NVOs caused by staphylococci or of unknown etiology.

Results

The study population included 249 patients, and 33 (13.3%) experienced clinical failure; the OT group consisted of 54 patients (21.7%). Multivariate regression analysis of the whole population selected Charlson comorbidity index (adjusted odds ratio [aOR], 1.291; 95% confidence interval [CI], 1.114–1.497; P = .001) and MDRO etiology (aOR, 3.301; 95% CI, 1.368–7.964; P = .008) as independent factors for clinical failure. Among patients affected by a non-MDRO NVO, OT was not associated with an increased risk of clinical failure (aOR, 0.487; 95% CI, .133–1.782; P = .271), even after adjustment for the propensity score of receiving OT. In the subgroup of patients with staphylococcal or unknown etiology, NVO rifampin was independently associated with favorable outcome (aOR, 0.315; 95% CI, .105–.949; P = .040).

Conclusions

An entirely oral, highly bioavailable treatment, including rifampin, may be as effective as parenteral treatment in selected patients with NVOs.
Using 3D and 2D analysis for analyzing large-scale asymmetry in galaxy spin directions
Authors: Shamir Lior
Published: July 2022

The nature of galaxy spin is still not fully known. Iye, Yagi, and Fukumoto (2021, AJ, 907, 123) applied a 3D analysis to a dataset of bright SDSS galaxies that was used in the past for photometric analysis. They showed that the distribution of spin directions of spiral galaxies is random, providing a dipole axis with low statistical significance of 0.29σ. However, to show random distribution, two decisions were made, each of which can lead to random distribution regardless of the real distribution of the spin direction of galaxies. The first decision was to limit the dataset arbitrarily to z < 0.1, which is a redshift range in which previous literature already showed that random distribution is expected. More importantly, while the 3D analysis requires the redshift of each galaxy, the analysis was done with the photometric redshift. If the asymmetry existed, its signal is expected to be an order of magnitude weaker than the error of the photometric redshift, and therefore a low statistical signal under these conditions is expected. When using the exact same data without limiting to zphot < 0.1 and without using the photometric redshift, the distribution of the spin directions in that dataset shows a statistical signal of >2σ. Code and data for reproducing the analysis are publicly available. These results are in agreement with other experiments with SDSS, Pan-STARRS, HST, and the DESI Legacy Survey. The paper also examines other previous studies that showed random distribution in galaxy spin directions. While further research will be required, the current evidence suggests that large-scale asymmetry between the number of clockwise and counterclockwise galaxies cannot be ruled out.
Evolutionary instability of selfish learning in repeated games
Authors: McAvoy Alex , Kates-Harbeck Julian , Chatterjee Krishnendu , Hilbe Christian
Published: July 2022

Across many domains of interaction, both natural and artificial, individuals use past experience to shape future behaviors. The results of such learning processes depend on what individuals wish to maximize. A natural objective is one’s own success. However, when two such “selfish” learners interact with each other, the outcome can be detrimental to both, especially when there are conflicts of interest. Here, we explore how a learner can align incentives with a selfish opponent. Moreover, we consider the dynamics that arise when learning rules themselves are subject to evolutionary pressure. By combining extensive simulations and analytical techniques, we demonstrate that selfish learning is unstable in most classical two-player repeated games. If evolution operates on the level of long-run payoffs, selection instead favors learning rules that incorporate social (other-regarding) preferences. To further corroborate these results, we analyze data from a repeated prisoner’s dilemma experiment. We find that selfish learning is insufficient to explain human behavior when there is a trade-off between payoff maximization and fairness.
The engagement of histone lysine methyltransferases with nucleosomes: structural basis, regulatory mechanisms, and therapeutic implications
Authors: Li Yanjing , Ge Kexue , Li Tingting , Run Cai , Chen Yong
Published: July 2022

Histone lysine methyltransferases (HKMTs) deposit methyl groups onto lysine residues on histones and play important roles in regulating chromatin structure and gene expression. The structures and functions of HKMTs have been extensively investigated in recent decades, significantly advancing our understanding of the dynamic regulation of histone methylation. Here, we review the recent progress in structural studies of representative HKMTs in complex with nucleosomes (H3K4, H3K27, H3K36, H3K79, and H4K20 methyltransferases), with emphasis on the molecular mechanisms of nucleosome recognition and trans-histone crosstalk by these HKMTs. These structural studies inform HKMTs’ roles in tumorigenesis and provide the foundations for developing new therapeutic approaches targeting HKMTs in cancers.
Incidental physical pain reduces brain activities associated with affective social feedback and increases aggression
Authors: Wang Yanfang , Li Lu , Cai Junhao , Li Huaifang , Wang Chenbo
Published: July 2022

Physical pain may lead to aggressive behavior in a social context. However, it is unclear whether this is related to changes of social information processing. Thus, this study aimed to investigate the neural mechanisms underlying pain-induced aggression using functional magnetic resonance imaging. In the experiment, 59 healthy participants were recruited: 31 were treated with topical capsaicin cream (pain group) and 28 with hand cream (control group). Participants completed a social network aggression task, during which they underwent two phases: feedback processing and attack exerting. The results revealed that participants in the pain group exhibited more aggression than those in the control group. During the feedback-processing phase, physical pain reduced brain activation in the right insula, left orbitofrontal cortex and anterior cingulate cortex, which typically exhibited stronger activation in response to negative (and positive) vs neutral social feedback in the control group. However, during the attack-exerting phase, pain did not significantly alter the activation of the dorsolateral prefrontal cortex. These findings suggest that pain increased aggression, while before that, it suppressed brain activities of the salience network involved in the process of salient social information and the value system associated with the value representation of social events.
A Deeper Dive Into the Relation Between Psychotic-like Experiences and Suicidal Ideation and Behaviors in Children Across the United States
Authors: Jay Samantha Y , Schiffman Jason , Grattan Rebecca , O’Hare Kirstie , Klaunig Mallory , DeVylder Jordan , Karcher Nicole R
Published: July 2022

Background and Hypothesis

Children who endorse psychotic-like experiences (PLEs) appear to be at a greater risk for suicidal ideation and behavior (SI/SB) compared to their peers who do not endorse PLEs. Despite evidence of differential relations among subtypes of PLEs and SI/SB, the research on which PLE subtypes produce the strongest associations remains mixed. Further, though there is evidence that general psychological distress may help explain the relation between PLEs and SI/SB, no research has investigated the role of distress specific to PLEs in this association.

Study Design

The present study sought to assess the associations among individual Prodromal Questionnaire-Brief Child Version (PQ-BC) items and SI/SB, as well as to explore the role of distress associated with PLEs as a mediator and/or moderator in a demographically diverse sample of children across the United States (N = 11 875).

Study Results

Results revealed that individual items of the PQ-BC may be differentially predictive of lifetime SI (ßs = 0.000–0.098) and SB (ßs=0.002–0.059), even when controlling for sociodemographic variables, internalizing symptoms, and traumatic experiences, with particularly strong associations observed among items indexing thought control, auditory hallucinations, suspiciousness, and nihilistic thinking/dissociative experiences. Item 13, nihilistic thinking/dissociative experiences, displayed the strongest effect sizes. Findings from moderation and mediation models provided evidence consistent with distress as both a partial mediator and moderator of the relation between total PLEs and individual PQ-BC items with SI and SB.

Conclusions

Distress specific to PLEs may be an important modifiable risk factor to target in suicide assessment, prevention, and intervention efforts.
Reserved powers in BVI and Cayman trusts: what we see now
Authors: Mander Henry , Howson Matthew
Published: July 2022

Settlors from a wide range of jurisdictions continue to favour trusts whose terms, in some way, reserve powers and duties over the investment and management of the trust fund away from the trustee. We shall here consider the British Virgin Islands (BVI) and Cayman Islands. Each of these jurisdictions has a statutory form of reserved powers trust which operate in different ways, and each can also accommodate the bespoke reserved powers trust. However the reasons to use these trusts, and the forms favoured, continue to evolve.
Non-Malaria Causes of Fever among under-5 Children with Negative Results for Malaria Rapid Diagnostic Test in South-Western Nigeria
Authors: Orimadegun Adebola E , Dada-Adegbola Hannah O , Michael Obaro S , Adepoju Adedayo A , Funwei Roland E , Olusola Fiyinfoluwa I , Ajayi IkeOluwapo O , Ogunkunle Oluwatoyin O , Ademowo Olusegun G , Jegede Ayodele S , Baba Ebenezer , Hamade Prudence , Webster Jayne , Chandroman Daniel , Falade Catherine O
Published: July 2022

Background

Although the global malaria burden is decreasing, there are still concerns about overdiagnosis of malaria and the danger of misdiagnosis of non-malaria causes of fever. Clinicians continue to face the challenge of differentiating between these causes despite the introduction of malaria rapid diagnostic tests (mRDTs).

Aim

To determine the prevalence and causes of non-malaria-caused fever in children in South-Western Nigeria.

Methods

Secondary analysis of data obtained to evaluate the effect of restricting antimalarial treatment to positive mRDT children in rural and urban areas of southwest Nigeria. Clinical examinations, laboratory tests for malaria parasites (including thick blood film and mRDT) and bacterial identification were performed on children aged 3–59 months (n = 511). The non-malaria group comprised febrile children who had both negative mRDT and microscopy results, while the malaria group included those who were positive for either mRDT or microscopy. We compared the causes of fever among children with non-malaria fever and those with malaria.

Results

The prevalence of non-malaria fever and bacteria–malaria co-infection was 37.2% and 2.0%, respectively. Non-malarial pathogens identified were viral (54.7%) and bacterial (32.1%) infections. The bacterial infections included bacteriaemia (2.7%), urinary tract infections (21.6%), skin infections (11.6%) and otitis media (2.6%). The leading bacterial isolates were Staphylococcus aureus, Pseudomonas aeruginosa and Streptococcus pneumoniae.

Conclusion

The high prevalence and wide range of non-malarial infections reinforces the need for point-of-care tests to identify bacterial and viral infections to optimize the treatment of febrile illnesses in malaria-endemic areas.
Socio-epidemiological factors and comorbidities associated with Chagas disease manifestations in two urban reference health care centres in Rio de Janeiro, Brazil
Authors: Portela Luciana F , Mesquita Maíra B , Giraldes Juliana M , Varela Margareth C , Brasil Pedro Emmanuel A A , Costa Andréa R , Mediano Mauro F F , Sangenis Luiz Henrique C , Pedrosa Roberto C , Hasslocher-Moreno Alejandro Marcel , Saraiva Roberto M
Published: July 2022

Background

Chagas disease (CD) is still an important public health issue in Latin America. This study aims to analyse the association between socio-epidemiological factors and comorbidities with clinical manifestations of CD.

Methods

We performed a cross-sectional study of 985 adult patients (65±11 y; 59.5% women) with CD. Data collection was based on questionnaires and medical records review. CD clinical forms (indeterminate, digestive, cardiac and cardiodigestive) and the stages of the cardiac form were classified according to the II Brazilian Consensus on CD. Statistical analyses were based on univariate and multivariate logistic regression.

Results

Older age and Brazilian birth state (Minas Gerais and Bahia) were associated with a greater likelihood of the cardiac form of CD. A greater likelihood of the digestive form was seen in men and those of older age. Patients with arterial hypertension and diabetes were less likely to have the digestive form. Men had a greater likelihood of having a more severe cardiac presentation. Those from Minas Gerais and Bahia states had a greater likelihood of having stage B1 or B2.

Conclusions

The results reinforce the aging of the CD population living in urban areas in Brazil, the high prevalence of comorbidities and that epidemiology, sex and the presence of comorbidities may be related to the clinical form of CD.
Factors associated with Cyclospora infection in a Venezuelan community: extreme poverty and soil transmission relate to cyclosporiasis
Authors: Chacin-Bonilla Leonor , Sanchez Yulaicy , Cardenas Ricardo
Published: July 2022

Background

Transmission dynamics of Cyclospora cayetanensis in endemic areas and the factors associated with soil contamination remain unclear. The effects of environmental factors on Cyclospora have been insufficiently studied, particularly in South America, thus a Venezuelan community was studied to profile risk factors for infection.

Methods

A cross-sectional stool survey of 732 individuals was conducted. For Cyclospora screening, an acid-fast-stained smear of formalin–ethyl acetate concentrate and ultraviolet (UV) epifluorescence examination of a wet mount were used. Water (n=14), soil (n=50) and produce (n=77) samples were collected, processed and examined by UV epifluorescence. Data were analysed using multivariate logistic regression.

Results

Cyclospora infections were identified in 73 (9.9%) subjects. Variables associated with the infection were age ≤10 y (odds ratio [OR] 14), hut living (OR 5), well water use (OR 18.5), drinking untreated water (OR 7.6), toilet absence (OR 8), having contact with faeces-contaminated soil (OR 4) and poultry exposure (OR 3). Infections (63%) were clustered in 25 huts. Oocysts were identified in 28.6%, 18% and 3.9% of the water, soil and produce samples, respectively.

Conclusions

There was an explicit association of Cyclospora infection with extreme poverty and soil transmission reflecting the household socio-economic correlate of cyclosporiasis in this community.
A single early introduction governed viral diversity in the second wave of SARS-CoV-2 epidemic in Hungary
Authors: Ari Eszter , Vásárhelyi Bálint Márk , Kemenesi Gábor , Tóth Gábor Endre , Zana Brigitta , Somogyi Balázs , Lanszki Zsófia , Röst Gergely , Jakab Ferenc , Papp Balázs , Kintses Bálint
Published: July 2022

Retrospective evaluation of past waves of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic is key for designing optimal interventions against future waves and novel pandemics. Here, we report on analysing genome sequences of SARS-CoV-2 from the first two waves of the epidemic in 2020 in Hungary, mirroring a suppression and a mitigation strategy, respectively. Our analysis reveals that the two waves markedly differed in viral diversity and transmission patterns. Specifically, unlike in several European areas or in the USA, we have found no evidence for early introduction and cryptic transmission of the virus in the first wave of the pandemic in Hungary. Despite the introduction of multiple viral lineages, extensive community spread was prevented by a timely national lockdown in March 2020. In sharp contrast, the majority of the cases in the much larger second wave can be linked to a single transmission lineage of the pan-European B.1.160 variant. This lineage was introduced unexpectedly early, followed by a 2-month-long cryptic transmission before a soar of detected cases in September 2020. Epidemic analysis has revealed that the dominance of this lineage in the second wave was not associated with an intrinsic transmission advantage. This finding is further supported by the rapid replacement of B.1.160 by the alpha variant (B.1.1.7) that launched the third wave of the epidemic in February 2021. Overall, these results illustrate how the founder effect in combination with the cryptic transmission, instead of repeated international introductions or higher transmissibility, can govern viral diversity.
Effect of Nozzle Configuration and Ground Sprayer Speed on Fusarium Head Blight Management in Wheat
Authors: White Nathaniel H. , Stombaugh Timothy S. , Bradley Carl A.
Published: July 2022

Fusarium head blight (FHB), caused primarily by Fusarium graminearum in the United States, is the most important disease of wheat in Kentucky and the surrounding region. In addition to reduced grain yields, grain quality also can be affected due to reduced test weights and contamination of harvested grain by associated mycotoxins, such as deoxynivalenol (DON). Although application of a foliar fungicide during the beginning anthesis growth stage is one of the primary practices used to manage FHB and DON, a major limiting factor in achieving greater efficacy has been fungicide coverage of wheat heads. This research evaluated different nozzle configurations and ground sprayer speeds for their effect on coverage of simulated wheat heads and management of FHB and DON in field trials conducted in 2017 to 2019 at the University of Kentucky Research and Education Center in Princeton, KY. Based on the results from this research, only minor differences in simulated wheat head coverage were observed across nozzle configurations and sprayer speeds. Depending on the nozzle configuration being used, applicators may need to adjust their sprayer speed to achieve maximum control of FHB.
Patient-Important Outcomes Other Than Mortality in Contemporary ICU Trials: A Scoping Review
Authors: Granholm Anders , Anthon Carl T. , Kjær Maj-Brit N. , Maagaard Mathias , Kaas-Hansen Benjamin S. , Sivapalan Praleene , Schjørring Olav L. , Andersen Lars W. , Mathiesen Ole , Strøm Thomas , Jensen Aksel K. G. , Perner Anders , Møller Morten H.
Published: July 2022

OBJECTIVES:

Randomized clinical trials (RCTs) conducted in adult ICU patients increasingly include patient-important outcomes other than mortality. This comes with challenges regarding outcome choices/definitions, handling of deceased patients and missing data in analyses, and choices of effect measures and statistical methods due to complex distributions. This scoping review aimed to characterize how these challenges are handled in relevant contemporary RCTs.

DATA SOURCES:

We systematically searched 10 selected journals for RCTs conducted primarily in adult ICU patients published between 1 January 2018 and 5 May 2022 reporting at least one patient-important outcome other than mortality, including “days alive without”…-type outcomes, functional/cognitive/neurologic outcomes, health-related quality of life (HRQoL) outcomes, and ordinal/other outcomes.

STUDY SELECTION:

Abstracts and full-texts were assessed independently and in duplicate by two reviewers.

DATA EXTRACTION:

Data were extracted independently and in duplicate by two reviewers using predefined and pilot-tested extraction forms and subsequently categorized to facilitate analysis.

DATA SYNTHESIS:

We included 687 outcomes from 167 RCTs, with 32% of RCTs using a patient-important outcome other than mortality as a (co-)primary outcome, most frequently “days alive without”…-type outcomes. Many different functional/cognitive/neurologic (103) and HRQoL (29) outcomes were reported. Handling of deceased patients varied, with analyses frequently restricted to survivors only for functional/cognitive/neurologic (62%) and HRQoL (89%) outcomes. Follow-up was generally longer and missing data proportions higher for functional/cognitive/neurologic and HRQoL outcomes. Most outcomes were analyzed using nonparametric tests (31%), linear regression/t tests (27%), chi-square–like tests (12%), and proportional odds logistic regression (9%), often without presentation of actual treatment effects estimates (38%).

CONCLUSIONS:

In this sample of RCTs, substantial variation in practice and suboptimal methodological choices were observed. This calls for increased focus on standardizing outcome choices and definitions, adequate handling of missing data and deceased patients in analyses, and use of statistical methods quantifying effect sizes.
A Descriptive Study of Maternal Choices for Labor Pain Relief
Authors: Rhode Mary Ann , Murdock Erica L. , Linares Colleen Zarate , Brou Lina
Published: July 2022

Design:

In a setting with a wider than usual variety of available labor pain relief methods, a prospective, descriptive study was conducted of labor pain relief methods desired by low-risk women prenatally, during labor, and at delivery.

Subjects/Methods:

Of all women registering for care between 2017 and 2020, a total of 2562 women were screened for low-risk status and then offered study participation, if eligible. Of 1185 eligible women, 512 remained at low risk until admission in labor and completed the study. Pain relief methods chosen were compared with the type of labor, type of delivery, and between delivery sites.

Results/Conclusions:

Hydrotherapy and a “none/unmedicated” labor were favored by a majority of subjects, regardless of ultimate method used. Multiple labor pain relief methods were used by 54.5% of subjects. Epidural analgesia most often occurred with augmented labor. Hydrotherapy was used more by those with spontaneous labors, water birth deliveries, and birth center births. Effectiveness of all pain relief measures was rated above average. Differences between planned hospital and planned birth center births were clear on most variables. Results can be used by childbirth educators, health professionals, and administrators to respect and improve the individualization of care and satisfaction of laboring women.
Nurses' Perception of Preterm Infants' Pain and the Factors of Their Pain Assessment and Management
Authors: De Clifford Faugère Gwenaëlle , Aita Marilyn , Feeley Nancy , Colson Sébastien
Published: July 2022

In the neonatal intensive care unit, preterm infants undergo many painful procedures. Although these can impair their neurodevelopment if not properly managed, only half of the painful procedures are optimally handled. This cross-sectional study aimed to evaluate nurses' perceptions of preterm infants' pain, to evaluate nurses' pain assessment and management practices, as well as to identify the individual and contextual factors that influence nurses' assessments and interventions for pain management. Secondary analyses, including a mixed-model analysis, were performed with data from a larger study (n = 202 nurses). Nurses were found to have attitudes and perceptions in favor of preterm infants' pain management, although they reported using few standardized instruments to assess pain. Nurses stated that they widely used sucrose, non-nutritive sucking, and positioning as pain management interventions, while skin-to-skin contact was rarely practiced. Nurses' attitudes and perceptions influenced their pain assessment practices, which predicted their implementation of interventions. Several contextual (country, level of care, and work shift) and individual factors (age, level of education, had a preterm infant, perceptions of family-centered care, and skin-to-skin contact) also predicted nurses' pain assessment and management practices.
Progress in the management of patients with diabetes and chronic kidney disease
Authors: Pozo Garcia Leonardo , Thomas Sandhya S. , Rajesh Harsith , Navaneethan Sankar D.
Published: July 2022

Purpose of review

Diabetic kidney disease is the most common cause of chronic kidney disease (CKD) and end-stage kidney disease in the world. Risk factor modification, glucose control, and renin–angiotensin–aldosterone system blockade have remained the standard of care for 2 decades. New therapeutic agents have emerged in recent years, demonstrating kidney and cardiovascular benefits, and herein we review recent clinical trials on this topic.

Recent findings

After the publication of several cardiovascular outcome trials for sodium–glucose cotransporter 2 inhibitors (SGLT-2i), new trials have focused ON primary kidney-specific outcomes demonstrating safety and benefits among patients with proteinuric CKD; patients with or without diabetes, and heart failure with preserved ejection fraction (HFpEF) respectively. Similarly, nonsteroidal mineralocorticoid receptor antagonists (ns-MRAs) and glucagon-like-peptide 1 receptor agonists (GLP-1 RAs) have improved cardiovascular and kidney outcomes. Recently, clinical practice guidelines have also been updated to reflect this new evidence.

In summary, SGLT-2i, GLP-1 RAs, and ns-MRAs have demonstrated cardiovascular and kidney benefits, including all-cause and cardiovascular mortality, progression to end-stage kidney disease, and hospitalizations for heart failure exacerbation among diverse patient population.
“Low infection rate for hand fractures managed with surgical fixation under wide awake local anesthesia with no tourniquet (WALANT) in minor surgery”
Authors: Steve Anna Karlene , Shine Julien John , Yakaback Spencer , Matthews Jennifer Leah , Yeung Justin
Published: July 2022

Purpose:

The purpose of this study was to review the rate and type of infectious complications following surgical fixation of hand fractures managed under wide awake local anesthesia with no tourniquet (WALANT) in minor procedure rooms outside the main operating room.

Method:

A two-surgeon retrospective chart review for patients who received surgical fixation of hand fractures under WALANT in minor surgery from March 2014- March 2019 was performed.

Results:

Fifty-eight patients with fractures of the distal phalanx (16), middle phalanx (7), proximal phalanx (11) and metacarpal (26) were included in the study. Average patient age was 37 with a higher proportion of male patients (51:7). Two patients had two fractures each. Thirty of the 58 cases were already open fractures. Fixation was performed using either plates and screws (25/58), or non-buried Kirschner wires (31/58). Thirty-six percent (21/58) of patients were treated with prophylactic antibiotics. Only one patient developed a post-operative cellulitis. The only case of osteomyelitis occurred in a patient with risk factors known to increase rates of infectious complications (open fracture, smoking history and >24 from injury to treatment). No infectious complications occurred in those who sustained closed fractures.

Conclusions:

While the minor surgery environment varies significantly from the main operating room, infection rates following surgical fixation of hand fractures using WALANT in this setting remain low (3.4%), with no documented infections in fractures that were referred closed and surgically opened for the purpose of operative fixation.
Developing a Video-Based Learning Module to Teach Decision-Making for Cubital Tunnel Surgeries
Authors: Yee Andrew , Padovano William M. , Patterson J. Megan M. , Pet Mitchell A. , Zazulia Allyson R. , Dengler Jana , Novak Christine B. , Coert J. Henk , Mackinnon Susan E.
Published: July 2022

Background:

Although intraoperative educational videos have become increasingly popular, comparatively few videos teach clinical reasoning for surgical procedures. The objectives of this study are to (1) develop an engaging online video-based module to teach decision-making for cubital tunnel surgeries, including supercharge nerve transfer, using a multimedia learning framework, and (2) evaluate its effectiveness and use for continuing professional development.

Methods:

The educational module consisted of a pre-lecture knowledge assessment, choice of two self-guided video lectures (7-minutes and 28-minutes), and a post-lecture knowledge assessment. An additional assessment examined knowledge retention three months after module completion. Surgeon surveys were administered after each knowledge assessment.

Results:

A total of 279 surgeons participated in the educational module (75% practicing surgeons, 25% trainees), 112 surgeons completed the post-lecture assessment, and 71 surgeons completed the knowledge retention assessment. Median score on the pre-lecture assessment was 5 out of 10 (IQR 4 to 7). Scores improved by 3 points (10-point scale, p<0.0001) in the post-lecture assessment. Median score on the knowledge retention assessment was 8 out of 10 (IQR 6 to 9), with participants maintaining a 2-point increase from their pre-lecture score (p=0.0002). Among surgeons completing this assessment, 68% reported that the module had changed their management of cubital tunnel syndrome.

Conclusions:

This study introduces a framework for the development of online multimedia modules for surgical education. It also underscores a demand among surgeons for easily accessible, reusable educational resources. Similar video-based modules may be developed to address this demand to facilitate continuing professional development in surgery.
Evaluation of the Viability and Survival of Diced Cartilage Grafts Shaped with 3D Printed Bioresorbable Polycaprolactone Molds 3D Printed PCL-Diced Cartilage Hybrid Grafts
Authors: Canli Mert , Karasoy Yeşilada Ayşin , Ulağ Songül , Dobral Arzu , Yalçin Özben , Gündüz, Oğuzhan
Published: July 2022

Background:

The main problem with the use of diced cartilage grafts is related to the difficulties encountered in shaping the graft and unpredictible graft resorbtion. Aim of this study is to evaluate the permanence and viability of diced cartilage grafts shaped with the help of biodegradable 3D printed PCL molds.

Methods:

Three groups were studied in the each of the 8 rabbits as block cartilage (group 1), diced cartilage (group 2) and diced cartilage shaped with PCL mold (group 3). A total of 24 cartilage grafts obtained at the end of the 12 week follow-up period and 10 different histopathological parameters were analyzed in each cartilage graft.

Results:

Diced cartilages shaped with 3D printed PCL mold showed increased regeneration potential of chondrocytes, vascularization an collagen production. Use of PCL mold did not cause any additional risk of inflammation, fibrosis or metaplastic bone formation.

Conclusion:

In the study, it has been shown that 3D printed PCL molds can be used safely in shaping diced cartilage grafts. In the light of this study, it will be possible to produce hybrid grafts that can be used safely in many surgeries such as nasal reconstruction, rhinoplasty, auricle reconstruction and repair of orbital floor fractures with the help of molds produced in more complex ways.
The effect of carboxymethyl chitin on capsule formation around silicone implants: an in vivo and in vitro study
Authors: Li Shasha , Ren Liwen , Jia Di , yang Dan , Hao Lijun
Published: July 2022

Background:

Capsular contracture is a serious complication that occurs after augmentation mammoplasty. We previously identified that carboxymethyl chitin (CMC) had an inhibitory effect on capsule formation. This study was performed to elucidate the possible molecular mechanisms through which CMC inhibits the formation of a capsule around silicone implants.

Methods:

In this study, we cultured human dermal fibroblasts and treated them with CMC in vitro. The difference in proliferation between treated and untreated cells was analyzed through the 3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide (MTT) assay. Protein levels of transforming growth factor beta 1 (TGF-β1) and alpha smooth muscle actin (α-SMA) were examined by western blot analysis. Expression levels of type I and type III collagen were checked by enzyme-linked immunosorbent assay (ELISA). In vivo, silicone implants were placed under the pectoralis muscle in 12 female rabbits. The thickness of the capsule was measured by histological analysis, and the effect of CMC on α-SMA, collagen type I and III expression levels was evaluated by real-time polymerase chain reaction (PCR) analysis, ELISA, western blot, and immunofluorescence analysis.

Results:

In the in vitro study, we confirmed that CMC inhibited the proliferation of fibroblasts. The protein expression levels of collagen type I, TGF-β1, and α-SMA were inhibited by CMC treatment. In vivo, CMC treatment reduced capsular thickness and the expression of α-SMA, collagen type I and III in capsules around silicone implants.

Conclusion:

Our results showed that CMC could influence capsule formation around silicone implants by inhibiting the fibroblast activity, interrupting fibroblast to myofibroblast differentiation, and decreasing collagen synthesis.
Three-Dimensional Visualization of Postsurgical Airway Changes Using 3D Printing Technology in a Patient With Mandibular Prognathism: A 5-Year Follow-up Study
Authors: Kim Dong-Hyun , Lee Kyungmin Clara
Published: July 2022

This case-report described the 3-dimensional (3D) evaluation of airway changes using 3D printing technology in a patient with mandibular prognathism, treated via mandibular setback surgery with maxillary posterior impaction. The airway dimensions, following orthognathic surgery, were printed using 3D printing technology and the sequential airway changes were visualized. The patient underwent orthognathic surgery for the correction of mandibular prognathism. Five years later, the airway changes were visualized and evaluated using rapid prototyping. The 3D visualization of the airway changes following surgery alerted clinicians of patients with mandibular prognathism and facilitated effective communication with their patients. This case-report documented the long-term evaluation and visualization of the postoperative airway changes in patients with mandibular prognathism using cone-beam computed tomography and 3D printing technology.
Acoustic signalling and behaviour of Antarctic minke whales (
Balaenoptera bonaerensis
)
Authors: Casey C. B. , Weindorf S. , Levy E. , Linsky J. M. J. , Cade D. E. , Goldbogen J. A. , Nowacek D. P. , Friedlaender A. S.
Published: July 2022

Acoustic signalling is the predominant form of communication among cetaceans. Understanding the behavioural state of calling individuals can provide insights into the specific function of sound production; in turn, this information can aid the evaluation of passive monitoring datasets to estimate species presence, density, and behaviour. Antarctic minke whales are the most numerous baleen whale species in the Southern Ocean. However, our knowledge of their vocal behaviour is limited. Using, to our knowledge, the first animal-borne audio-video documentation of underwater behaviour in this species, we characterize Antarctic minke whale sound production and evaluate the association between acoustic behaviour, foraging behaviour, diel patterns and the presence of close conspecifics. In addition to the previously described
downsweep
call, we find evidence of three novel calls not previously described in their vocal repertoire. Overall, these signals displayed peak frequencies between 90 and 175 Hz and ranged from 0.2 to 0.8 s on average (90% duration). Additionally, each of the four call types was associated with measured behavioural and environmental parameters. Our results represent a significant advancement in understanding of the life history of this species and improve our capacity to acoustically monitor minke whales in a rapidly changing Antarctic region.
A virtual experiment on pedestrian destination choice: the role of schedules, the environment and behavioural categories
Authors: King Christopher , Bode N. W. F.
Published: July 2022

Which locations pedestrians decide to visit and in what order drives circulation patterns in pedestrian infrastructure. Destination choice is understood to arise from individuals trading off different factors, such as the proximity and busyness of destinations. Here, a virtual experiment is used to investigate whether this behaviour depends on the layout of buildings, whether planned or imposed destination schedules influence decisions and whether it is possible to distinguish different choice behaviour strategies in pedestrian populations. Findings suggest that virtual experiments can consistently elicit a range of destination choice behaviours indicating the flexibility of this experimental paradigm. The experimental approach facilitates changing the environment layout while controlling for other factors and illustrates this in itself can be important in determining destination choice. Destination schedules are found to be relevant both when imposed or generated by individuals, but adherence to them varies across individuals and depends on prevailing environmental conditions, such as destination busyness. Different destination choice behaviour strategies can be identified, but their properties are sensitive to the detection methods used, and it is suggested such behaviour classification should be informed by specific use-cases. It is suggested that these contributions present useful starting points for future research into pedestrian destination choice.
Next-generation time of death estimation: combining surrogate model-based parameter optimization and numerical thermodynamics
Authors: Wilk Leah S. , Edelman Gerda J. , Aalders Maurice C. G.
Published: July 2022

The postmortem interval (PMI), i.e. the time since death, plays a key role in forensic investigations, as it aids in the reconstruction of the timeline of events. Currently, the standard method for PMI estimation empirically correlates rectal temperatures and PMIs, frequently necessitating subjective correction factors. To address this shortcoming, numerical thermodynamic algorithms have recently been developed, providing rigorous methods to simulate postmortem body temperatures. Comparing these with measured body temperatures then allows non-subjective PMI determination. This approach, however, hinges on knowledge of two thermodynamic input parameters, which are often irretrievable in forensic practice: the ambient temperature prior to discovery of the body and the body temperature at the time of death (perimortem). Here, we overcome this critical limitation by combining numerical thermodynamic modelling with surrogate model-based parameter optimization. This hybrid computational framework predicts the two unknown parameters directly from the measured postmortem body temperatures. Moreover, by substantially reducing computation times (compared with conventional optimization algorithms), this powerful approach is uniquely suited for use directly at the crime scene. Crucially, we validated this method on deceased human bodies and achieved the lowest PMI estimation errors to date (0.18 h ± 0.77 h). Together, these aspects fundamentally expand the applicability of numerical thermodynamic PMI estimation.
Species delineation and systematics of a hemiclonal hybrid complex in Australian freshwaters (Gobiiformes: Gobioidei: Eleotridae:
Hypseleotris
)
Authors: Thacker Christine E. , Geiger Daniel L. , Unmack Peter J.
Published: July 2022

The rivers of southeastern Australia host a species complex within the carp gudgeon genus
Hypseleotris
that includes parental species and hemiclonal hybrid lineages. These hemiclones can be difficult to distinguish from their parent taxa, making delineation of species unusually difficult. We approach this historical taxonomic problem by using single nucleotide polymorphism (SNP) genotyping to distinguish individuals of each species and hemiclones, enabling us to quantify the variation among evolutionary lineages and assign names to the species.
Hypseleotris klunzingeri
remains valid and does not have any hemiclones. We describe
Hypseleotris bucephala
and
Hypseleotris gymnocephala
from the Murray-Darling Basin and
Hypseleotris acropinna
from the Murray-Darling as well as eastern coastal streams north of the Mary River, part of the range attributed to
H. galii
. We further split
H. galii
to distinguish a species from the Mary River,
Hypseleotris moolooboolaensis
. We designate a neotype and redescribe
H. galii
due to uncertainty about the source and species identity of specimens used in the original description. We reconcile previous taxonomies, provide new common names for parental species, and advocate using the scientific names of both parents when referring to the hemiclone hybrids to avoid confusion with previous common names that did not distinguish parental taxa and hemiclones.