bluuebunny/crossref_metadata_2025 huggingface dataset:
A Systematic review of flower-visiting insect community research on agricultural crops in Indonesia
Authors: Ferdian  , Istiaji B , Buchori D
Published: August 2023

Evolutionary forces have developed many types of insect-plant interactions over millennia, ranging from herbivory, which causes damage, to mutualism between plant pollinators. Pollinators are a very important part of the natural history of plant evolution. Plants have evolved distinguished characteristics of flowers that attract many types of insects. Other than pollinators, flower-visiting insects also consist of various insect groups. The aim of this research was to assess the breadth and depths of research on flower-visiting insects. The research was conducted using secondary data derived from various databases for the past 20 years that were accessed and searched with keywords related to flower-visiting insects. Overall, 135 articles were screened from various databases. Over 42% of research was done by focusing on the diversity of flower-visiting insects, while 19% focused on effectiveness toward productivity, 14% on the landscape, and the rest focused on behavior, pesticide, etc. Fifty-two percent of the research was mostly done on horticultural crops such as tomatoes and cucumbers, while 44% was done on plantation plants-mostly dominated by oil palm research. From the biodiversity aspect, there were 8 orders of flower-visiting insects consisting of 54 families, 186 genera, and 186 species of insects. The flower-visiting insects that were found mostly belong to Hymenoptera and Lepidoptera. Over 50% of flower-visiting insects are pollinators, while the rest are herbivores, predators, and parasitoids. Forty-eight percent of the pollinators studied are hymenopterans. Our results also found that 35 genera of pollinators are identified as generalist pollinators, while 3 genera are specialist pollinators, such as Elaeidobius (oil palm), Forcipomyia (cocoa), and Nodocnemis (snake fruit). Data analysis showed that pollinators are positively correlated with productivity and quality of crops. Increase in productivity due to pollinators range from 27% in coffee to 1900% in zucchini.
Social Behaviour of Endangered Macaque Species at Kalisalak Forest, Central Java-Indonesia
Authors: Al-Hakim R R , Hastuti S B , Nasution E K , Puspitasari I G A A R , Imtiyaaz C D , Rukayah S
Published: August 2023

The long-tailed macaque (Macaca fascicularis) is a primate often found in Indonesia, with the current IUCN Red List status being endangered. One of the habitats of this species is the Kalisalak Forest. The social behaviour of this species has never been studied much; therefore, further research is needed on this site. This study aimed to analyse the frequency and duration of social behaviour of seven age groups of each sex. The study was conducted from April to July 2021. The research used scan sampling and continuous recording rules with 15-minute intervals (8:00 am-5:00 pm). The social behaviour data were analysed by ethogram percentage and compared with each social behaviour and age group using a statistical correlation test. The results show that the highest frequency is playing (42.92%), then grooming (41.29%), while the lowest is agonistic (8.33%), and then mating (7.46%). The duration of grooming (57.61%) is higher than playing (42.39%), while agonistic and mating are not counted because they are event behaviour. No frequency correlation (p-value>0.05) between grooming and age exists. A frequency correlation (p-value<0.05) between playing, agonistic, and mating with age group. There is no correlation (p-value>0.05) between the age group’s duration of grooming and playing.
Humans and seagrass: a complex and intertwining links - an illustration from North Sulawesi, Indonesia
Authors: Digdo A A , Astari E , Arinda B R , Arendege J
Published: August 2023

Interactions between humans and seagrasses in a rural area in North Sulawesi (North Minahasa) were determined by applying the ecosystem goods and services concept and related social-ecological system. The main role in the villages is small-scale fishermen and the general public. By conducting interviews, questionnaires, focus group discussions, community immersion, and field surveys, we discovered complex social-ecological ties that are essential for local society and the ecosystem. Nursery ground and habitat for fish and invertebrates, traditional medicine, indicative for Ramadan season-opening, and sites for bait collection were within the significant seagrass meadow ecosystem services for the local coastal people. We identified 183 traditional fish names that are associated with seagrass. Gleaning (banyare) and trapping fisheries (“soma”, “sero” and “bubu”) in the areas captured seagrass-associated fishes (Siganidae) that contribute a major livelihood source for the fishermen. The seagrass meadow overlaps with species habitats, for instance, dugongs and sea turtles. Out of 90 fishing grounds, 13 overlapped with seagrass beds, which also have dugong feeding trails. Most of the seagrass beds are open and free for all areas, except around LMMAs managed by villages, which likely create positive effects on seagrass meadows.
Impact of Ecological Engineering on Zea mays Plantations to Biodiversity of Insect Pollinators
Authors: Amrulloh R , Buchori D , Priawandiputra W , Sartiami D
Published: August 2023

The presence of pollinating insects has faced extreme challenges due to climate change, pesticides and land use transformation. An important factor that causes a decrease in diversity and abundance of pollinator insects is habitat loss. Ecological engineering can provide a source of food and restore the habitat of pollinator insects. This study aims to analyze the effect of ecological engineering onZea maysplantation to the biodiversity of pollinator insects. The research was carried out in April – September 2022 in Bogor, West Java, Indonesia. Ecological engineering was carried out by planting nine different types of plants, which areMangifera indica, Muntingia calabura, Artocarpus heterophyllus, Cosmossp.,Turnera sp., Helianthussp.,Vignasp.,Arachis pintoi, andAntigononsp. Observations of pollinator insects are carried out every two weeks from 07.00 – 11.00 a.m. Overall, 32 spp of flower-visiting insects were found associated with the flowering plants. The species found were from Hymenoptera (92.3%), Diptera (4.6%), Lepidoptera (1.3%), Coleoptera (0.7%), Thysanoptera (0.7%) and Orthoptera (0.4%).
Analytical Quality Risk Assessment and Design of Experiments to Green HPTLC Method for Simultaneous Estimation of Sildenafil Citrate and Dapoxetine Hydrochloride
Authors: Prajapati Pintu B , Sheta Bhavesh M , Pulusu Veerashakar , Shah Shailesh A
Published: August 2023

A green and robust high-performance thin-layer chromatographic method has been developed for the simultaneous estimation of sildenafil citrate and dapoxetine hydrochloride. A fractional factorial design was applied for analytical quality risk assessment of potential analytical risk factors. The identified critical analytical risk factors were optimized using the design of experiment-based response surface analysis by full factorial design. The analytical design space was navigated for the optimization of the method and the control strategy was framed for low-risk life-cycle management of the chromatographic method. The chromatographic analysis of sildenafil and dapoxetine was carried out on a TLC plate coated with silica gel G60 F254 using n-butanol:ethyl acetate:ethanol (8.0 + 2.0 + 0.5, v/v) as mobile phase. The chromatographic peaks of sildenafil and dapoxetine were found to be at Rf 0.29 and 0.69, respectively. The method was found to be accurate, precise, robust, specific and sensitive. The fixed-dose combinations of sildenafil and dapoxetine were assayed and results were found in compliance with their labeled claim. The present method was developed using safe and eco-friendly organic solvents for the safety of analysts and the protection of the environment. The greenness profiles of developed and reported methods were evaluated using the NEMI scale and AGREE software.
Fetal growth restriction inhibits childhood growth despite catch-up in discordant identical twins: an observational cohort study
Authors: Groene Sophie G , Gremmen Irma J , van Zwet Erik W , Roest Arno A W , Haak Monique C , van Klink Jeanine M M , Lopriore Enrico , Heijmans Bastiaan T , de Bruin Christiaan
Published: August 2023

Objective

Research suggests that postnatal catch-up growth after fetal growth restriction (FGR) occurs frequently. Yet, postnatal growth in singletons may be influenced by multiple factors. Identical twins with discordant prenatal growth, termed selective FGR (sFGR), can be regarded as a natural experiment eliminating these sources of bias.

Design

Observational cohort study.

Methods

Monochorionic twins with sFGR born between 2002 and 2017 (aged 3-17 years) were eligible. Growth measurements (height, weight, head circumference, and body mass index) were performed at follow-up. Detailed growth curves documented by a systematic primary care system in the Netherlands were collected. Measurements were converted to standard deviation scores (SDSs). A mixed-effects model was used to assess within-pair SDS difference and individual height SDS relative to target height SDS.

Results

Forty-seven twin pairs (94 children) were included at a median age of 11 (interquartile range 8-13) years. At the last measurement, smaller twins at birth had a lower height SDS [−0.6 vs −0.3, P < .001, median difference 0.5 (95%CI 0.4-0.7)], lower weight SDS [−0.5 vs −0.1, P < .001, median difference 0.8 (95%CI 0.5-1.0)], and lower head circumference SDS [−0.5 vs 0.2, P < .001, median difference 0.8 (95%CI 0.6-0.9)] compared to larger twins. These differences persisted until the age of 17. Smaller twins showed rapid catch-up growth in the first 2 years and reached their target height range between 8 and 11 years.

Conclusions

Identical twins with discordant prenatal growth maintain a modest but significant difference in height, weight, and head circumference, indicating a persistent, inhibitory effect of an adverse intrauterine environment on childhood growth.
In Defence of Future Generations: A Reply to Stephen Humphreys
Authors: Wewerinke-Singh Margaretha , Garg Ayan , Agarwalla Shubhangi
Published: August 2023

In this reply to Stephen Humphreys, we challenge the dismissal of future generations as a locus of responsibility for present generations. Drawing from diverse sources such as indigenous law, environmental jurisprudence and practice, we demonstrate that global discourse on intergenerationality is broader and more nuanced than Humphreys suggests. Our response highlights the importance of incorporating diverse perspectives to enrich discourse and promote an inclusive approach to the progressive development of international law. Further, we contend that ‘future generations’ discourse has emancipatory power, offering potential for reshaping international law based on a vision of justice and solidarity across time and space. We call for increased dialogue and collaboration among scholars, practitioners and frontline communities to ensure that future generations discourse remains grounded in real-world experiences. By persistently interrogating and developing our understanding of responsibilities owed to future generations, we can imagine and cultivate a more inclusive – and, hence, more promising – approach to addressing climate change and related global crises.
Synergistic effects of succession and microtopography of moraine on the fungal spatial diversity in a glacier forefield
Authors: Masumoto Shota , Mori Akira S , Nishizawa Keita , Naka Minagi , Matsuoka Shunsuke , Wong Shu-Kuan , Uchida Masaki
Published: August 2023

Primary succession and microtopography result in environmental changes and are important processes influencing the community assembly of soil fungi in the Arctic region. In glacier forefields that contain a series of moraine ridges, both processes contribute synchronously to fungal spatial diversity. To reveal the synergistic effects of succession and microtopography, we investigated the fungal community structure and environmental variables in the moraines of the Arklio Glacier, Ellesmere Island. The study sites were established at four locations from the top to the bottom of the ridge slope within each of the three moraine ridges of different post-glacial ages. The location-dependent community composition was equally diverse in both the initial and later stages of succession, suggesting that successional time could alter the effects of microtopography on the fungal community. Moreover, our results suggest that fungal communities at different locations follow different successional trajectories, even if they have passed through the same time lapse. Such a synergistic effect of succession and microtopography of moraines does not allow for parallel changes in fungal communities among moraines or among locations, suggesting that the moraine series contributes substantially to fungal spatial diversity in the glacier forefield.
A National Typology of Health Service Regulation in Assisted Living
Authors: Smith Lindsey , Carder Paula , Hua Cassandra , Zimmerman Sheryl , Sloane Philip D , Zhang Wenhan , Wretman Christopher J , Cornell Portia , Thomas Kali S
Published: August 2023

Background and Objectives

State-regulating agencies use 350 different licenses and certifications to govern assisted living (AL), resulting in significant variation in regulations governing health services, the scope of practice, and capacity. This lack of standardization makes it difficult to compare and contrast AL operations and residents’ outcomes across similarly regulated communities.

Research Design and Methods

We used qualitative and quantitative methods to empirically develop and describe a typology of state AL regulations that captures inter- and intrastate variation. Based on the rules governing health services, we created regulatory specificity scores for 5 thematic dimensions: medication administration, third-party care, skilled nursing, medication review, and licensed nurse staffing. With these scores, we conducted a K-means cluster analysis to identify groups of AL license types. To differentiate the regulatory types, we calculated standardized mean differences across structure, process, outcome, and resident characteristics of the AL communities licensed under each type.

Results

We identified 6 types of AL differentiated by the regulatory provisions governing health services: Housing, Holistic, Hybrid, Hospitality, Healthcare, and Health Support. The types align with previous work and reflect tangible differences in resident characteristics, health service structures, processes, and outcomes.

Discussion and Implications

This typology effectively captures differences across regulated dimensions and can inform and support quality of care. Researchers, policy-makers, and consumers may benefit from using this typology and acknowledging these differences in AL licensure when designing research studies, developing policies, and selecting an AL community.
Gatekeeper’s potential privilege—the need to limit DMA centralization
Authors: Hoffmann Jörg , Herrmann Liza , Kestler Lukas
Published: August 2023

The Digital Markets Act (DMA) aims at promoting contestable and fair markets for core platform services by setting out obligations for designated gatekeepers. As the DMA does not clearly define these objectives, it comes into conflict with national legislation with overlapping objectives. This may include unfair competition laws and sector-specific regulation. Article 1(5) DMA addresses this conflict by stipulating that Member States may not impose further obligations on gatekeepers for the purpose of ensuring contestable and fair markets. The effect this has is that national provisions vis-à-vis gatekeepers may not be applicable anymore, and competences are centralized on the European level more broadly than potentially envisaged by the European legislature. This centralization of competences runs the risk of inadvertently privileging gatekeepers by blocking national laws that are, however, still applicable to small and medium-sized enterprises (SMEs) and other firms competing with gatekeepers. This article suggests solutions to mitigate such a risk.
Effect of Clostridium butyricum on the formation of primary choledocholithiasis based on intestinal microbiome and metabolome analysis
Authors: Li Guofu , Yu Tingting , Du Haiming , Zhang Lichao , Liu Xiaoxuan , Hou Senlin
Published: August 2023

Aims

To investigate the function and probable mechanism of Clostridium butyricum in the development of choledocholithiasis.

Methods and results

The lithogenic diet group and the lithogenic diet + C. butyricum group were used to develop the choledocholithiasis model. During the experiment, C. butyricum suspension was administered to the rats in the lithogenic diet + C. butyricum group. The findings demonstrated that the C. butyricum intervention decreased the Firmicutes/Bacteroidetes ratio in the colon of experimental animals given a lithogenic diet. The relative levels of Desulfovibrio (0.93%) and Streptococcus (0.38%) fell, whereas Lactobacillus (22.36%), Prevotella (14.09%), and bacteria that produce short-chain fatty acids increased. Finally, 68 distinct metabolic products were found based on nontargeted metabonomics, and 42 metabolic pathways associated to the various metabolites were enriched.

Conclusions

We found that C. butyricum decreased the development of choledocholithiasis. It keeps the equilibrium of the rat’s gut microbiome intact and lowers the danger of bacterial infections of the gastrointestinal and biliary systems. It is hypothesized that by controlling lipid metabolism, it may also have an impact on the development of cholelithiasis.
Acute Renal Failure with Severe Loin Pain and Patchy Renal Ischemia after Anaerobic Exercise in Active Duty Marines
Authors: Hughes Kathryn G , Miller Nancy L
Published: August 2023

Acute renal failure with severe loin pain and patchy renal ischemia after anaerobic exercise (ALPE) is a rare cause of exertional acute kidney injury. The proposed mechanism of injury in ALPE is renovascular spasm, in the setting of oxidative stress and muscular damage, which creates a characteristic wedge-shaped infarction pattern on delayed imaging. Patients present with nausea, vomiting, loin or abdominal pain, and fatigue within 1-2 days of anaerobic exercise, associated with an acute rise in serum creatinine, which generally plateaus within 3 days. This process is likely exacerbated by dehydration, analgesic usage, and lower baseline fitness levels. This disease process is distinct from rhabdomyolysis, in that creatine kinase levels are not significantly elevated, myoglobinuria is not seen, and aggressive fluid resuscitation is not beneficial. We present three cases of ALPE following participation in the Marine Combat Fitness Test (CFT), an anaerobic evolution. Medical workup demonstrated no additional etiology for acute renal failure. The average peak creatinine in these patients was 2.9 mg/dL, and all demonstrated return to normal renal function, without hemodialysis. One patient experienced recurrent ALPE, after short-interval CFT participation. Military medical providers should be aware of this diagnosis when evaluating service members with acute renal injury after exercise. The clinical course is benign, and affected service members are at increased risk of recurrence, with subsequent intense exercise. Service members should engage in a graduated exercise program, before intense exercise activities, and should be monitored closely for recurrent renal injury.
Research excellence and scientific advisory boards
Authors: Göser Maya , Wimmer Stefan , Sauer Johannes
Published: August 2023

Scientific advisory boards are frequently established to provide scientific insights and advice to policymakers. Advisory board appointing bodies often state that research excellence and scientific seniority are the main grounds on which advisory board members are selected. Many authors have pointed out that there is more to giving good scientific advice than just being an expert for a specific research field. The aim of this study is to analyse if and how research excellence correlates with the probability of being appointed as a scientific advisory board member. We collected data for scientific advisory boards from both the USA and Germany. We use logit regression models to analyse how research excellence correlates with the probability of appointment to a scientific advisory board. Our results suggest that research excellence is insignificant or even correlates negatively with the probability of being appointed to a scientific advisory board.
Diagnoses and medications associated with delayed ejaculation
Authors: Mulloy Evan , Zhang Amy , Balladelli Federico , Del Giudice Francesco , Glover Frank , Eisenberg Michael L
Published: August 2023

Background

Delayed ejaculation (DE) is a disorder that can cause significant distress for sexually active men. The etiology of DE is largely idiopathic, with even less being known about clinical factors associated with the condition.

Aim

We sought to use data mining techniques to examine a broad group of health conditions and pharmaceutical treatments to identify factors associated with DE.

Methods

Using an insurance claims database, we evaluated all men with a diagnosis of DE and matched them to a cohort (1:1) of men with other male sexual disorders of urologic origin (ie, erectile dysfunction [ED] and Peyronie’s disease [PD]). Given the low prevalence of DE, we incorporated the random forest approach for classification of DE vs controls, with a plethora of predictors and cross-validation with the least absolute shrinkage and selection operator (LASSO). We used both a high-performance generalized linear model and a multivariate logistic model. The area under the curve was reported to demonstrate classifier performance, and odds ratios were used to indicate risks of each predictor. We also evaluated for differences in the prevalence of conditions in DE by race/ethnicity.

Outcomes

Clinical factors (ie, diagnoses and medications) associated with DE were identified.

Results

In total, 11 602 men with DE were matched to a cohort of men with PD and ED. We focused on the 20 factors with the strongest association with DE across all models. The factors demonstrating positive associations with DE compared to other disorders of male sexual dysfunction (ie, ED and PD) included male infertility, testicular dysfunction, anxiety, disorders of lipid metabolism, alpha adrenergic blocker use, anemia, antidepressant use, and psychoses such as schizophrenia or schizoaffective disorder. In addition, the prevalence of several conditions varied by race/ethnicity. For example, male infertility was present in 5% of Asian men compared to <2% of men of other races.

Clinical Implications

Several medical conditions and pharmacologic treatments are associated with DE, findings that may provide insight into the etiology of DE and offer treatment options.

Strengths and Limitations

This study is to our knowledge the first to use using data mining techniques to investigate the association between medical conditions/pharmacologic agents and the development of subsequent DE. The generalizability of our findings is limited given that all men were commercially insured.

Conclusion

DE is associated with multiple medical conditions, a finding that may help identify the etiology for this disorder.
European Society of Sexual Medicine consensus statement on the use of animal models for studying Peyronie’s disease
Authors: Castiglione Fabio , Çakır Onur Ö , Schifano Nicolò , Corona Giovanni , Reisman Yacov , Bettocchi Carlo , Cellek Selim , Ilg Marcus M
Published: August 2023

Introduction

Animal models are frequently used for translational research in Peyronie’s disease (PD). However, due to lack of availability of guidelines, there is some heterogeneity in study design, data reporting, and outcome measures.

Aim

This European Society for Sexual Medicine consensus statement aims to provide guidance in utilization of animal models in PD research in a standardized and uniform fashion.

Methods

PubMed was searched for studies using animal models for PD. The following search terms were used: (“Peyronie’s disease” OR “penile fibrosis” OR “penile curvature” OR “induration penis plastica” OR “erectile dysfunction”) AND (“rodent” OR “mouse” OR “mice” OR “rat” OR “rabbit”).

Outcomes

This European Society for Sexual Medicine statement describes best practice guidelines for utilization of animals in PD research: power calculation, details of available models, surgical procedures, and measurement techniques, while highlighting possible pitfalls and translational limitations of the models.

Results

In total, 2490 studies were retrieved and 2446 articles were excluded. A total of 44 studies were included, of which 40 studies used rats, 1 study used both rats and mice, 1 study used a genetic mouse model, and 2 studies used rabbits. A significant number of the studies (70.5%) used transforming growth factor β 1 for induction of fibrosis. Oxford 2011 Levels of Evidence criteria could not be applied due to the nature of the studies.

Conclusion

Despite certain limitations of PD animal models presented, we aimed to provide guidance for their appropriate use in translational research, with the purpose of improving study quality and reproducibility as well as facilitating interpretation of reported results and conclusions.
Beta spectral power during sleep is associated with impaired recall of extinguished fear
Authors: Denis Dan , Bottary Ryan , Cunningham Tony J , Drummond Sean P A , Straus Laura D
Published: August 2023

The failure to retain memory for extinguished fear plays a major role in the maintenance of posttraumatic stress disorder (PTSD), with successful extinction recall necessary for symptom reduction. Disturbed sleep, a hallmark symptom of PTSD, impairs fear extinction recall. However, our understanding of the electrophysiological mechanisms underpinning sleep’s role in extinction retention remains underdetermined. We examined the relationship between the microarchitecture of sleep and extinction recall in healthy humans (n = 71, both male and females included) and a pilot study in individuals with PTSD (n = 12). Participants underwent a fear conditioning and extinction protocol over 2 days, with sleep recording occurring between conditioning and extinction. Twenty-four hours after extinction learning, participants underwent extinction recall. Power spectral density (PSD) was computed for pre- and post-extinction learning sleep. Increased beta-band PSD (~17–26 Hz) during pre-extinction learning sleep was associated with worse extinction recall in healthy participants (r = 0.41, p = .004). Beta PSD was highly stable across three nights of sleep (intraclass correlation coefficients > 0.92). Results suggest beta-band PSD is specifically implicated in difficulties recalling extinguished fear.
Deletion of IL-1β exacerbates acrylamide-induced neurotoxicity in mice
Authors: Fergany Alzahraa , Zong Cai , Ekuban Frederick Adams , Suzuki Aina , Kimura Yusuke , Ichihara Sahoko , Iwakura Yoichiro , Ichihara Gaku
Published: August 2023

Acrylamide is a neurotoxicant in human and experimental animals. Interleukin-1β (IL-1β) is a proinflammatory cytokine known as a critical component of brain reaction to any insult or neurodegenerative pathologies, though its role in electrophile-induced neurotoxicity remains elusive. The aim of this study was to investigate the role of IL-1β in acrylamide-induced neurotoxicity in mice. Ten-week-old male wild-type and IL-1β knock-out mice were allocated into 3 groups each and exposed to acrylamide at 0, 12.5, 25 mg/kg body weight by oral gavage for 28 days. Compared with wild-type mice, the results showed a significant increase in landing foot spread test and a significant decrease in density of cortical noradrenergic axons in IL-1β KO mice exposed to acrylamide at 25 mg/kg body weight. Exposure to acrylamide at 25 mg/kg significantly increased cortical gene expression of Gclc, Gpx1, and Gpx4 in wild-type mice but decreased them in IL-1β KO mice. The same exposure level significantly increased total glutathione and oxidized glutathione (GSSG) in the cerebellum of wild-type mice but did not change total glutathione and decreased GSSG in the cerebellum of IL-1β KO mice. The basal level of malondialdehyde in the cerebellum was higher in IL-1β KO mice than in wild-type mice. The results suggest that IL-1β protects the mouse brain against acrylamide-induced neurotoxicity, probably through suppression of oxidative stress by glutathione synthesis and peroxidation. This unexpected result provides new insight on the protective role of IL-1β in acrylamide-induced neurotoxicity.
Knowledge and perception of asymptomatic malaria in the Volta region of Ghana
Authors: Orish Verner N , Kyeremateng Caleb , Appiah Baffoe P , Addei Isaac B , Ayaba Moses A , Kwadzokpui Precious K , Marinkovic Aleksandra , Prakash Stephanie , Okorie Chuku , Izurieta Ricardo , Sanyaolu Adekunle
Published: August 2023

Background

The control of asymptomatic malaria is considered a key aspect of malaria control. This study aimed to assess the knowledge and perception of asymptomatic malaria among people in Ho municipality of the Volta region.

Methods

A descriptive cross-sectional study involving questionnaire administration was conducted among randomly sampled residents of the Ho municipality of the Volta region of Ghana. Using SPSS version 25 statistical software, frequency distributions and proportions were computed for sociodemographic variables while knowledge and perception about asymptomatic malaria were computed into percentages and categorized into three levels based on Bloom's cut-off for further analysis. Findings with p-values <0.05 were considered statistically significant.

Results

Among the 200 participants, 197 (98.5%) were aware of malaria. The majority (116 [58.0%]) of the study participants agreed to the possibility of asymptomatic infection, but most (133 [66.5%]) of the community members did not know that asymptomatic individuals can still transmit infections. The majority of the participants (184 [92.0%]) showed interest in getting further education on asymptomatic malaria and a significant majority (180 [90.0%]) expressed a willingness to take treatment after testing positive without showing any symptoms.

Conclusions

Asymptomatic malaria control can be achieved through a mass testing and treatment strategy, therefore improving the knowledge and perception about asymptomatic malaria might improve malaria control.
A comparison of changes in venous lactate and haematocrit during fluid resuscitation of dengue haemorrhagic fever
Authors: Priyankara W D Dilshan , Samarutilake D G N , Viswakula Sameera , Manoj E M , Wijewickrama Ananda , Perera Nilanka , Wanigasuriya J K P
Published: August 2023

Background

Judicious fluid resuscitation and stringent monitoring of clinical parameters improve the outcome of dengue haemorrhagic fever (DHF). The usefulness of serum lactate to monitor adequate fluid therapy has not been adequately explored.

Methods

An observational study was conducted in Sri Lanka, recruiting 162 DHF patients within 12 h of diagnosis of the critical phase. Venous lactate level was measured at each time of performing haematocrit (HCT), using a prevalidated handheld lactate analyser.

Results

The median venous lactate level was 1.3 (range 0.3–6) mmol/L in the study population and 154 (95.2%) patients had median lactate levels of <2 mmol/L. The HCT values in the study participants ranged from 28 to 62, with a median value of 43. There was no statistically significant correlation between the lactate and HCT values obtained at the same time. A significant reduction in venous lactate was not observed following the administration of fluid boluses. The expected reduction in HCT was seen following the administration of dextran and crystalloid/dextran combination. The maximum recorded lactate level positively correlated with the duration of hospital stay.

Conclusions

This study concludes that venous lactate is not an appropriate parameter with which to monitor the response to fluid therapy in uncomplicated DHF.
Underlying Mechanisms of the Hedgehog-Like Panicle and Filamentous Leaf Tissue Symptoms Caused by Sclerospora graminicola in Foxtail Millet
Authors: Zhang Baojun , Zhang Nuo , Li Renjian , Fu Zhenxin , Sun Yurong , Ren Zhixian , Mu Fan , Han Yuanhuai , Han Yanqing
Published: August 2023

Downy mildew caused by Sclerospora graminicola is a systemic infectious disease affecting foxtail millet production in Africa and Asia. S. graminicola-infected leaves could be decomposed to a state where only the veins remain, resulting in a filamentous leaf tissue symptom. The aim of the present study was to investigate how S. graminicola influences the formation of the filamentous leaf tissue symptoms in hosts at the morphological and molecular levels. We discovered that vegetative hyphae expanded rapidly, with high biomass accumulated at the early stages of S. graminicola infection. In addition, S. graminicola could affect spikelet morphological development at the panicle branch differentiation stage to the pistil and stamen differentiation stage by interfering with hormones and nutrient metabolism in the host, resulting in hedgehog-like panicle symptoms. S. graminicola could acquire high amounts of nutrients from host tissues through secretion of β-glucosidase, endoglucanase, and pectic enzyme, and destroyed host mesophyll cells by mechanical pressure caused by rapid expansion of hyphae. At the later stages, S. graminicola could rapidly complete sexual reproduction through tryptophan, fatty acid, starch, and sucrose metabolism and subsequently produce numerous oospores. Oospore proliferation and development further damage host leaves via mechanical pressure, resulting in a large number of degraded and extinct mesophyll cells and, subsequently, malformed leaves with only veins left, that is, “filamentous leaf tissue.” Our study revealed the S. graminicola expansion characteristics from its asexual to sexual development stages, and the potential mechanisms via which the destructive effects of S. graminicola on hosts occur at different growth stages.
A Prediction Model for Severe Maternal Morbidity and Mortality After Delivery Hospitalization
Authors: Frey Heather A. , Ashmead Robert , Farmer Alyssa , Kim Yoshie H. , Shellhaas Cynthia , Oza-Frank Reena , Jackson Rebecca D. , Costantine Maged M. , Lynch Courtney D.
Published: August 2023

OBJECTIVE:

To develop a risk stratification model for severe maternal morbidity (SMM) or mortality after the delivery hospitalization based on information available at the time of hospital discharge.

METHODS:

This population-based cohort study included all pregnancies among Ohio residents with Medicaid insurance from 2012 to 2017. Pregnant individuals were identified using linked live birth and fetal death records and Medicaid claims data. Inclusion was restricted to those with continuous postpartum Medicaid enrollment and delivery at 20 or more weeks of gestation. The primary outcome of the study was SMM or mortality after the delivery hospitalization and was assessed up to 42 days postpartum and up to 1 year postpartum separately. Variables considered for the model included patient-, obstetric health care professional–, and system-level data available in vital records or Medicaid claims data. Parsimonious models were created with logistic regression and were internally validated. Receiver operating characteristic curves were used to evaluate model performance, and model calibration was assessed.

RESULTS:

There were 343,842 pregnant individuals who met inclusion criteria with continuous Medicaid enrollment through 42 days postpartum and 287,513 with continuous enrollment through 1 year. After delivery hospitalization discharge, the incidence of SMM or mortality was 140.5 per 10,000 pregnancies through 42 days of delivery and 330.7 per 10,000 pregnancies through 1 year postpartum. The final model predicting SMM or mortality through 42 days postpartum included maternal prepregnancy body mass index, age, gestational age at delivery, mode of delivery, chorioamnionitis, and maternal diagnosis of cardiac disease, preeclampsia or gestational hypertension, or a mental health condition. Similar variables were included in the model predicting SMM or mortality through 365 days with chronic hypertension, pregestational diabetes, and illicit substance use added and chorioamnionitis removed. Both models demonstrated moderate prediction (area under the curve [AUC] 0.77, 95% CI 0.76–0.78 for 42-day model; AUC 0.72, 95% CI 0.71–0.73 for the 1-year model) and good calibration.

CONCLUSION:

A prediction model for SMM or mortality up to 1 year postpartum was created and internally validated with information available to health care professionals at the time of hospital discharge. The utility of this model for patient counseling and strategies to optimize postpartum care for high-risk individuals will require further evaluation.
Geographic Disparities in Potential Accessibility to Gynecologic Oncologists in the United States From 2001 to 2020
Authors: Desjardins Michael R. , Desravines Nerlyne , Fader Amanda N. , Wethington Stephanie L. , Curriero Frank C.
Published: August 2023

OBJECTIVE:

To use a spatial modeling approach to capture potential disparities of gynecologic oncologist accessibility in the United States at the county level between 2001 and 2020.

METHODS:

Physician registries identified the 2001–2020 gynecologic oncology workforce and were aggregated to each county. The at-risk cohort (women aged 18 years or older) was stratified by race and ethnicity and rurality demographics. We computed the distance from at-risk women to physicians. Relative access scores were computed by a spatial model for each contiguous county. Access scores were compared across urban or rural status and racial and ethnic groups.

RESULTS:

Between 2001 and 2020, the gynecologic oncologist workforce increased. By 2020, there were 1,178 active physicians and 98.3% practiced in urban areas (37.3% of all counties). Geographic disparities were identified, with 1.09 physicians per 100,000 women in urban areas compared with 0.1 physicians per 100,000 women in rural areas. In total, 2,862 counties (57.4 million at-risk women) lacked an active physician. Additionally, there was no increase in rural physicians, with only 1.7% practicing in rural areas in 2016–2020 relative to 2.2% in 2001–2005 (P=.35). Women in racial and ethnic minority populations, such as American Indian or Alaska Native and Hispanic women, exhibited the lowest level of access to physicians across all time periods. For example, 23.7% of American Indian or Alaska Native women did not have access to a physician within 100 miles between 2016 and 2020, which did not improve over time. Non-Hispanic Black women experienced an increase in relative accessibility, with a 26.2% increase by 2016–2020. However, Asian or Pacific Islander women exhibited significantly better access than non-Hispanic White, non-Hispanic Black, Hispanic, and American Indian or Alaska Native women across all time periods.

CONCLUSION:

Although the U.S. gynecologic oncologist workforce increased steadily over 20 years, this has not translated into evidence of improved access for many women from rural and underrepresented areas. However, health care utilization and cancer outcomes may not be influenced only by distance and availability. Policies and pipeline programs are needed to address these inequities in gynecologic cancer care.
Assessment of Human Papillomavirus Non-16/18, Type-Specific Risk for Cervical Intraepithelial Neoplasia Grade 3 or Worse Among Women With Cervical Atypical Glandular Cells
Authors: Yilmaz Emel , Lagheden Camilla , Ghaderi Mehran , Wang Jiangrong , Dillner Joakim , Elfström K. Miriam
Published: August 2023

OBJECTIVE:

To evaluate the risk for cervical intraepithelial neoplasia grade 3 (CIN 3) or worse (including adenocarcinoma in situ [AIS] and invasive cervical cancer) associated with non-16/18 human papillomavirus (HPV) types (other HPV) among women with atypical glandular cells (AGC) in cervical cytology.

METHODS:

This population-based cohort study evaluates the risk of CIN 3 or worse associated with other HPV types. Human papillomavirus genotyping was performed on Pap tests collected in Sweden from 341 women with AGC that were positive for other HPV types from February 17, 2014, to December 31, 2018. The women were followed for histopathologic outcomes using comprehensive registry linkages until December 31, 2019. Cumulative incidence proportions of CIN 3 or worse by specific HPV type were calculated using 1-minus Kaplan-Meier function. Hazard ratios (HRs) for CIN 3 or worse were generated using multivariate Cox regression.

RESULTS:

Of 341 women, 134 (39.3%) had CIN 3–AIS, but there were only five (1.5%) women in the cohort with invasive cervical cancer. Human papillomavirus 45 preceded 80.0% of invasive cervical cancer cases. Among women positive for HPV33, 82.9% (95% CI 58.0–97.3%) had CIN 3 or worse during follow-up. Positivity for HPV31 conferred the highest HR for CIN 3 or worse relative to other types, both in primary cytology and primary HPV screening (HR 2.71, 95% CI 1.47–5.00 and HR 3.41, 95% CI 1.95–5.96, respectively).

CONCLUSION:

Among non-16/18 HPV types in AGC, HPV31 and 33 had the highest risk for CIN 3 or worse, whereas most of the women with invasive cancer were positive for HPV45. Extended HPV genotyping may be helpful for the management of AGC.
Abortion Bans and Resource Utilization for Congenital Heart Disease
Authors: Miller Hayley E. , Fraz Farsam , Zhang Jiaqi , Henkel Andrea , Leonard Stephanie A. , Maskatia Shiraz A. , El-Sayed Yasser Y. , Blumenfeld Yair J.
Published: August 2023

OBJECTIVE:

To investigate the implications of potential national abortion ban scenarios on the incidence of neonatal single-ventricle cardiac defects.

METHODS:

A decision tree model was developed to predict the incidence of neonatal single-ventricle cardiac defects and related outcomes in the United States under four theoretical national abortion bans: 1) abortion restrictions in existence immediately before the June 2022 Dobbs v Jackson Women’s Health Organization Supreme Court decision, 2) 20 weeks of gestation, 3) 13 weeks of gestation, and 4) a complete abortion ban. The model included incidence of live births of neonates with single-ventricle cardiac defects, neonatal heart surgery (including heart transplant and extracorporeal membrane oxygenation [ECMO]), and neonatal death. Cohort size was based on national pregnancy incidence and different algorithm decision point probabilities were aggregated from the existing literature. Monte Carlo simulations were conducted with 10,000 iterations per model.

RESULTS:

In the scenario before the Dobbs decision, an estimated 6,369,000 annual pregnancies in the United States resulted in 1,006 annual cases of single-ventricle cardiac defects. Under a complete abortion ban, the model predicted a 53.7% increase in single-ventricle cardiac defects, or an additional 9 cases per 100,000 live births. This increase would result in an additional 531 neonatal heart surgeries, 16 heart transplants, 77 ECMO utilizations, and 102 neonatal deaths annually. More restrictive gestational age–based bans are predicted to confer increases in cases of neonatal single-ventricle cardiac defects and related adverse outcomes as well.

CONCLUSION:

Universal abortion bans are estimated to increase the incidence of neonatal single-ventricle cardiac defects, associated morbidity, and resource utilization. States considering limiting abortion should consider the implications on the resources required to care for increasing number of children that will be born with significant and complex medical needs, including those with congenital heart disease.
Safety of Vaginal Estrogen Therapy for Genitourinary Syndrome of Menopause in Women With a History of Breast Cancer
Authors: Agrawal Pranjal , Singh Sajya M. , Able Corey , Dumas Kathryn , Kohn Jaden , Kohn Taylor P. , Clifton Marisa
Published: August 2023

OBJECTIVE:

To assess the risk of recurrence of breast cancer associated with vaginal estrogen therapy in women diagnosed with genitourinary syndrome of menopause with a history of breast cancer using a large U.S. claims database.

METHODS:

A U.S. health research network (TriNetX Diamond Network) was queried from January 2009 to June 2022. Our cohort consisted of women diagnosed with breast cancer within 5 years before the initial genitourinary syndrome of menopause diagnosis. Patients with active disease, defined as those undergoing mastectomy, radiation treatment, or chemotherapy within 3 months before diagnosis of genitourinary syndrome of menopause, were excluded. Recurrence was defined as mastectomy, radiation, chemotherapy, or secondary malignancy within 3 months to 5 years after the initiation of vaginal estrogen therapy for genitourinary syndrome of menopause. The study cohort included those with three or more vaginal estrogen prescriptions. The control cohort included women with breast cancer without any vaginal estrogen prescriptions after genitourinary syndrome of menopause diagnosis. Propensity matching was performed. A subanalysis by positive estrogen receptor status, when available, was performed.

RESULTS:

We identified 42,113 women with a diagnosis of genitourinary syndrome of menopause after breast cancer diagnosis with any estrogen receptor status, 5.0% of whom received vaginal estrogen. Of the initial cohort, 10,584 patients had a history of positive estrogen receptor breast cancer, and 3.9% of this group received vaginal estrogen. Risk of breast cancer recurrence was comparable between those who received vaginal estrogen and those who did not in both the any estrogen receptor (risk ratio 1.03, 95% CI 0.91–1.18) and positive estrogen receptor (risk ratio 0.94, 95% CI 0.77–1.15) status analyses.

CONCLUSION:

In a large, claims-based analysis, we did not find an increased risk of breast cancer recurrence within 5 years in women with a personal history of breast cancer who were using vaginal estrogen for genitourinary syndrome of menopause.
Treatment experience with encorafenib plus binimetinib for BRAF V600-mutant metastatic melanoma: management insights for clinical practice
Authors: Augustyn Kourtney , Joseph Jocelyn , Patel Anisha B. , Razmandi Azadeh , Ali Amatul Noor , Tawbi Hussein A.
Published: August 2023

For patients with locally advanced or metastatic melanoma who have BRAF V600 activating mutations, combination therapy with BRAF and MEK inhibitors is now the standard of care. The combination of encorafenib, a highly selective adenosine triphosphate–competitive BRAF inhibitor, plus binimetinib, a potent, selective, allosteric, non–adenosine triphosphate-competitive MEK1/2 inhibitor, was approved by the US Food and Drug Administration for unresectable or metastatic melanoma with BRAF V600E or V600K mutations based on data from the phase III COLUMBUS study (NCT01909453). Clinical data evaluating BRAF and MEK inhibitor combinations in advanced melanoma indicate a specific profile of adverse events that includes serious retinopathy, skin disorders, and cardiovascular toxicities. Here we provide an overview of the rationale for combining BRAF and MEK inhibitors for the treatment of melanoma, long-term safety results from COLUMBUS, and guidance on managing the most common adverse events associated with this combination based on clinical experience. Proactive and appropriate management of adverse events can allow for longer treatment durations and may result in better treatment outcomes.