bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Cognitive Functions in Inflammatory Bowel Disease Patients - An Egyptian Sample
Authors: Albalakosy Amira Mahmoud , Hussein Hend Mubarak , Ragab Askar Safaa , Naguib Rehab Mohamed , Abdelhamid Sherif Ayman Adel
Published: November 2024

Background

Inflammatory bowel disease (IBD) is a lifelong condition characterized by chronic intestinal inflammation, leading to abdominal pain, diarrhea, malnutrition, and premature mortality. In addition to the classic extraintestinal manifestations, such as joint disease and eye disease, there has been some evidence that IBD affects the brain. To date, however, the presence of cognitive impairment has not been systematically established.

Objective

To evaluate the cognitive functions in IBD patients compared to healthy control and study the factors of cognitive impairment in IBD patients.

Patients and Methods

This was a cross-sectional study which was carried out in The IBD outpatient clinic at Tropical Medicine department, Ain Shams University Hospitals. A total of 70 patients were enrolled, 50 of whom were ulcerative colitis patients and 20 patients had Crohn’s disease during the interval between August 2022 and January 2023.

Results

The included patients in our study were predominantly males (60%) while there were 28 female patients, and about 58.9% did not have formal education beyond 9 years. Our study showed that the marital status affected patients’ cognitive functions, where unmarried people showed more cognitive impairment whether divorced (having mean MMSE Score of 21 SD 2.8) or widowed (having mean MMSE score of 24.5, SD 4.95), both of which score ranges reflected mild cognitive impairment. This study showed that the older the patient, the more cognitive impairment was observed.

Conclusion

8.6 % of IBD patients showed cognitive impairment. The mild deficit in global cognitive functions, that has been observed among the IBD patients, who are in remission, is associated with older age, marital status, and the presence of extra-intestinal manifestations.
Efficacy and Tolerability of Tadalafil 5mg Once Daily versus Darifenacin for Ureteric Stent Related Symptoms
Authors: Abdel Rahman Mohammed Elgaml Abdel Rahman Mahdy , Yassin Mohammed Mohammed , Hafez Elawady Hossam
Published: November 2024

Background

After almost five decades of internal ureteral stenting, this endourological standard procedure is still associated with a clear side-effect profile. Thus, ureteral stents should be avoided whenever possible, and removed as soon as possible. However, ureteral stenting remains unavoidable in a considerable number of our patients. In these cases, a proper stent length should be chosen, and patients should be informed thoroughly about potential side-effects and treated with a1-blockers or antimuscarinics.

Aim of the Work

The aim of the present study was to analyze and compare the safety and efficacy of darifenacin versus tadalafil in the relief of ureteric stent related symptoms.

Patients and Methods

This is a randomized comparative blind cross over study conducted on 150 patients admitted in the department of Urology in Ain Shams University Hospitals, All patients underwent DJ stenting after urological interventions were enrolled in the study, according to inclusion and exclusion criteria, 150 patients were included in The study which were randomly divided one by one in to 2 groups 75 patients each The study was divided into two parts each part last for 3 weeks, in the 1st part of the study Group 1 received Tadalafil 5 mg tab once daily orally and Group 2 received darifenacin 7.5 mg once daily orally and then treatment stopped for one week for wash out of the drug. In the 2nd part of the study the two groups switched as follow: Group 1: received darifenacin 7.5 mg tab once daily orally and Group 2: received Tadalafil 5 mg tab once daily orally.

Results

Which was proved in the 2nd part of the study after wash out period (one week) as patients in group 1 which was converted to darifenacin 7.5 mg were found better than patients in group 2 which was converted to tadalafil 5 mg as regard sense of incomplete emptying with mean score (1.88 ± 0.88vs 4.24 ± 0.71), regarding frequency there was improvement in group 1 than in group 2 with mean score (1.44 ± 0.83 vs 4.12 ± 0.75), as regard urgency there was improvement in group 1 than in group 2 with mean score (1.8 ± 0.82vs 3.99 ± 0.76), as regard nocturia there was improvement in group 1 than in group 2 with mean score (0.97 ± 0.7vs 3.52 ± 0.78), and as regard pain there was improvement in group 1 than in group 2 with mean score (2.45 ± 0.58vs 2.71 ± 0.65).

Conclusion

The study showed highly significant improvement of ureteric stent related symptoms in favor of Darifenacin 7.5 mg when compared with tadalafil 5mg. Both of these medications demonstrated a good safety and tolerability profile for medical improvement therapy in patients with ureteric stents.
Interactive multimodal integral field spectroscopy
Authors: García Riber Adrián , García-Benito Rubén , Serradilla Francisco
Published: November 2024

Using sonification on scientific data analysis provides additional dimensions to visualization, potentially increasing researchers’ analytical capabilities and fostering inclusion and accessibility. This research explores the potential of multimodal integral field spectroscopy applied to galaxy analysis through the development and evaluation of a tool that complements the visualization of data cubes with sound. The proposed application, ViewCube, provides interactive visualizations and sonifications of spectral information across a 2D field-of-view, and its architecture is designed to incorporate future sonification approaches. The first sonification implementation described in this article uses a deep learning module to generate binaural unsupervised auditory representations. The work includes a qualitative and quantitative user study based on an online questionnaire, aimed at both specialized and non-specialized participants, focusing on the case study of data cubes of galaxies from the Calar Alto Integral Field Spectroscopy Area survey. Out of 67 participants who completed the questionnaire, 42 had the opportunity to test the application in person prior to filling out the online survey. 81 per cent of these 42 participants expressed the good interactive response of the tool, 79.1 per cent of the complete sample found the application ‘Useful’, and 58.2 per cent rated its aesthetics as ‘Good’. The quantitative results suggest that all participants were able to retrieve information from the sonifications, pointing to previous experience in the analysis of sound events as more helpful than previous knowledge of the data for the proposed tasks, and highlighting the importance of training and attention to detail for the understanding of complex auditory information.
Generative Artificial Intelligence: Applications in Scientific Writing and Data Analysis in Wound Healing Research
Authors: Chen Adrian , Qilleri Aleksandra , Foster Timothy , Rao Amit S. , Gopalakrishnan Sandeep , Niezgoda Jeffrey , Oropallo Alisha
Published: November 2024

Generative artificial intelligence (AI) models are a new technological development with vast research use cases among medical subspecialties. These powerful large language models offer a wide range of possibilities in wound care, from personalized patient support to optimized treatment plans and improved scientific writing. They can also assist in efficiently navigating the literature and selecting and summarizing articles, enabling researchers to focus on impactful studies relevant to wound care management and enhancing response quality through prompt-learning iterations. For nonnative English-speaking medical practitioners and authors, generative AI may aid in grammar and vocabulary selection. Although reports have suggested limitations of the conversational agent on medical translation pertaining to the precise interpretation of medical context, when used with verified resources, this language model can breach language barriers and promote practice-changing advancements in global wound care. Further, AI-powered chatbots can enable continuous monitoring of wound healing progress and real-time insights into treatment responses through frequent, readily available remote patient follow-ups.

However, implementing AI in wound care research requires careful consideration of potential limitations, especially in accurately translating complex medical terms and workflows. Ethical considerations are vital to ensure reliable and credible wound care research when using AI technologies. Although ChatGPT shows promise for transforming wound care management, the authors warn against overreliance on the technology. Considering the potential limitations and risks, proper validation and oversight are essential to unlock its true potential while ensuring patient safety and the effectiveness of wound care treatments.
An Early-Stage Economic Evaluation of Superabsorbent Wound Dressings for the Management of Moderately to Highly Exuding Leg Ulcers in Slovakian Settings
Authors: Veličković Vladica M. , Serafin Anna , Arlouskaya Yana , Milde Thurid-Christiane , Halász Beáta Grešš
Published: November 2024

BACKGROUND

The management of chronic leg ulcers, including venous leg ulcers (VLUs), causes a considerable economic and clinical burden to healthcare systems. Factors such as nursing time, hospital care, and wound dressings account for approximately 85% of the total cost. Superabsorbent dressings (eg, superabsorbent polymers [SAPs]) are recommended as a first-line treatment for moderately to highly exuding VLUs.

OBJECTIVE

To assess the cost-effectiveness of utilizing SAPs compared with the standard of care (SoC) for managing patients with moderately to highly exuding VLUs within the Slovakia healthcare settings.

METHODS

The decision-analytic modeling method used a Markov process as microsimulation, with a time horizon of 6 months, from the perspective of the third-party payer in Slovakia. All model inputs were based on data identified through systematic literature reviews.

RESULTS

According to model predictions, the use of SAPs instead of SoC in patients with moderately to highly exuding leg ulcers in Slovakian settings would lead to an improved healing rate of 2.2%, incremental health-related quality of life of 0.143 quality-adjusted life-weeks, and total direct cost savings of €75 (USD $82) per patient over a 6-month period.

CONCLUSIONS

The evaluation’s results align with clinical recommendations that endorse superabsorbent wound dressings as the preferred first-line treatment for moderately to highly exuding VLUs. The findings support the use of these dressings as a cost-saving solution for the National Insurance in Slovakia, when compared with SoC.
Patients’ Willingness to Perform Self-Wound Care: A Cross-sectional Study in the Primary Healthcare Sector in Singapore
Authors: Goh Ling Jia , Zhu Xiaoli
Published: November 2024

BACKGROUND

Patient adherence to performing self-wound care (SWC) has a direct influence on the success of telewound care, a healthcare delivery mode that emerged in 2016 in National Healthcare Group Polyclinics in Singapore to relieve the healthcare burden. This mode of delivery was useful during the pandemic, when nonurgent face-to-face visits were switched to the use of telecommunications for consultation. Telewound care requires that patients be willing to perform wound care on their own; however, whether patients are willing to do so remains unknown.

OBJECTIVE

To identify factors influencing patients’ willingness to undertake SWC using a locally validated tool, the Self-Wound Care Acceptance Survey (SWCAS).

METHODS

The authors recruited 328 participants with wounds from six polyclinics using convenience sampling. Participants rated the 17 items on the SWCAS using a 5-point Likert-type scale, from 1 (strongly disagree) to 5 (strongly agree). Higher scores indicate greater willingness to perform wound self-care.

RESULTS

Only 34.2% of the participants were willing to perform SWC. Patients who had a wound on their back and had transport provided and medical bills paid by family scored lower on the SWCAS. In contrast, patients who had higher education levels, were in the younger age group, were employed, were students, and had medical bills partially or fully paid by their company or insurance scored higher on the SWCAS. Post hoc tests indicated that patients with a wound on the back scored significantly lower on the SWCAS than did patients with wounds in other locations (Ps < .05).

CONCLUSIONS

Additional patient education is needed to increase patients’ acceptance of the SWC concept. Actively promoting SWC by distributing patient education information sheets and pamphlets to eligible patients, addressing negative thoughts or concerns, and encouraging positive thinking and autonomy may encourage patients to accept this concept.
Prevalence, Risk Factors, Causes, Assessments, and Prevention of Medical Adhesive-Related Skin Injury: A Scoping Review
Authors: Du Meichen , Liu Mei
Published: November 2024

OBJECTIVE

To evaluate research on medical adhesive-related skin injury (MARSI), focusing on its incidence, prevalence, risk factors, causes, assessments, and prevention.

DATA SOURCES

Searches were conducted on Wanfang Data, China National Knowledge Infrastructure, PubMed, Web of Science Core Collection, MEDLINE, EMBASE, and the Cumulative Index of Nursing and Allied Health Literature Plus with Full Text.

STUDY SELECTION

Using search terms “medical adhesive related skin injury”, “MARSI”, “adhesive skin injury”, and “medical tape-induced skin injury”, the authors selected 43 original articles published between January 1, 2001, and May 12, 2022, in English or Chinese.

DATA EXTRACTION

Extracted details included the first author; publication year; study location; study type; and specifics on MARSI, such as causes, affected body areas, assessment methods, incidence, prevalence, and prevention.

DATA SYNTHESIS

Medical adhesive-related skin injury frequently occurred on the face and at venipuncture sites. Acrylate-containing adhesives were more likely to cause MARSI. Risk factors include extended hospital stays, lower Braden Scale scores, mechanical ventilation, edema, poor skin condition, and use of certain medications. Incidence or prevalence exceeded 10% across populations, peaking at 60.3% in the pediatric surgical ICU. Mechanical injury had the highest incidence and prevalence among MARSI types. Studied interventions and quality improvement measures were effective in reducing MARSI.

CONCLUSIONS

Despite increasing interest, evidence for reducing MARSI is limited. Future research should focus on distinguishing MARSI types, clarifying incidence and prevalence, assessing risk factors, and implementing screening and quality improvement initiatives.
Irritant Contact Dermatitis Due to Fecal, Urinary, or Dual Incontinence: It Is Time to Focus on Darkly Pigmented Skin
Authors: Bliss Donna Z. , McNichol Laurie , Borchert Kathleen , Garcia Ashlee F. , Jinbo Anne K. , McElveen-Edmonds Keisha , Brathwaite Shakira , Sibbald R. Gary , Ayello Elizabeth A.
Published: November 2024

ABSTRACT

Irritant contact dermatitis due to fecal, urinary, or dual incontinence (ICD-FIUIDI) is a prevalent problem. Inspection of darkly pigmented skin may miss the signs of inflammation of ICD-FIUIDI, resulting in further skin damage and health disparities. In this article, the authors describe best practices for assessing ICD-FIUIDI in the context of diverse skin types using inspection, interview, health record review, and palpation to develop a plan of care; review ICD-FIUIDI prevention and treatment; and include case examples illustrating the application of these methods. The authors also summarize the epidemiology of ICD-FIUIDI and the basis of skin color and inflammation and discuss issues in practice related to the need to improve assessment of ICD-FIUIDI among patients with darkly pigmented skin. They make recommendations for current practice and future research.

GENERAL PURPOSE

To review best practices related to the assessment of irritant contact dermatitis due to fecal, urinary, or dual incontinence (ICD-FIUIDI) among patients with darkly pigmented skin.

TARGET AUDIENCE

This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES

After participating in this educational activity, the participant will:

1. Identify risk factors for the development of ICD-FIUIDI.

2. Describe clinical features and manifestations of ICD-FIUIDI.

3. Propose recommendations to improve care related to ICD-FIUIDI.
Anterior Column Support With Anterior Lumbar Interbody Fusion Cage Through Posterior Approach Maneuver
Authors: Jo Dae-Jean , Bae Sungsoo , Park Jae-Hyun , Choi Ho Yong
Published: November 2024

Study Design:

Retrospective cohort study.

Objective:

To evaluate the feasibility of anterior column support through a posterior approach using an anterior lumbar interbody fusion (ALIF) cage.

Summary of background data:

Anterior fusion is an effective way to maintain spinal lordosis; however, it may be technically difficult in some cases.

Methods:

Conventional lumbar fusion and spinal deformity correction surgeries were performed using a conventional ALIF cage with a modified extratransforaminal lumbar interbody fusion (ExTLIF). Patients with 1 or 2 fusion levels were classified into group 1, and those with spinal deformity correction were classified into group 2. Radiologic parameters were evaluated during the follow-up periods.

Results:

A total of 51 patients underwent this procedure. Thirty-five patients (19 male and 16 female, 69.4±9.6 y old) with 37 fusion sites were in group 1, and 16 patients (3 male and 13 female, 71.4±5.7 y old) were in group 2. The mean follow-up periods of groups 1 and 2 were 12.3±3.4 and 10.7±4.7 months, respectively. In group 1, the mean lumbar lordosis and segmental lumbar lordosis increased significantly during the last follow-up (39.9±13.0 and 20.6±6.0 degrees, respectively, both P<0.001), and the mean disc space also increased at the last follow-up (P<0.001). The same was observed in group 2 with significant increases in the mean lumbar lordosis and segmental lumbar lordosis at the last of the follow-up period (46.8±9.3 and 16.9±8.9 degrees, respectively, both P<0.001). The disc space also increased significantly (P<0.001). Fusion rates were 94.2% and 87.5% in groups 1 and 2, respectively, and the corresponding subsidence rates were 85.4% and 68.8%. In group 1, there was a significant correlation between subsidence and cage height (P=0.046).

Conclusion:

This procedure (ExTLIF) can be applied in cases where an anterior approach is contraindicated as well as for deformity correction.

Level of evidence:

Level III.
Oral Myeloid Sarcoma as a Marker of Relapse in Acute Myeloid Leukemia
Authors: Meena Akshay , Rout Newshree , Ganesh Rajesh Nachiappa , Ramassamy Sivaranjini
Published: November 2024

A 20-year-old woman with acute myeloid leukemia (AML) with monocytic differentiation in remission presented with a recent onset painful indurated swelling on the tongue with fever. Although her peripheral blood picture was normal, the bone marrow biopsy was suggestive of a relapse of AML. A biopsy from the tongue lesion showed diffuse infiltration of lamina propria and submucosa by blast cells, positive for myeloperoxidase and CD11c and suggestive of oral myeloid sarcoma (MS). This presents an uncommon site of occurrence of MS and was a marker of relapse of AML. This case highlights the variable presentation of MS. It should prompt investigation for relapse of hematological malignancy in the bone marrow even in the absence of evidence from peripheral blood.
New Developments and Therapeutic Drug Monitoring Options in Costimulatory Blockade in Solid Organ Transplantation: A Systematic Critical Review
Authors: de Graav Gretchen N. , Udomkarnjananun Suwasin , Baan Carla C. , Reinders Marlies E. J. , Roodnat Joke I. , de Winter Brenda C. M. , Hesselink Dennis A.
Published: November 2024

Purpose:

In this review, the authors summarized the latest developments in costimulatory blockade to prevent rejection after solid organ transplantation (SOT) and discussed possibilities for future research and the need for therapeutic drug monitoring (TDM) of these agents.

Methods:

Studies about costimulatory blockers in SOT in humans or animal transplant models in the past decade (2014–2024) were systematically reviewed in PubMed, European Union clinical trials (EudraCT), and ClinicalTrials.gov.

Results:

Seventy-five registered clinical trials and 58 published articles were found on costimulation blockade of the CD28-CD80/86, CD40-CD40L, and OX40-OX40L pathways. Belatacept, an antagonist of the CD28-CD80/86 pathway, is the only approved costimulatory agent in SOT, hence accounting for most of the research. Other identified costimulatory blocking agents included abatacept and CD28 antagonists tegoprubart, dazodalibep, and TNX-1500. Although tegoprubart was unsuccessful in pancreas transplantation in nonhuman primates, trials in human kidney transplantation are underway. Dazodalibep trials faced recruitment challenges. TNX-1500 was unsuccessful in animal studies and is currently not pursued in humans. After discontinuation of iscalimab (CD40-CD154 pathway antagonist) in SOT, the alternatives, bleselumab and KPL404, showed promising results in kidney transplantation and cardiac xenotransplantation. Studies on secondary costimulatory pathway antagonists, such as OX40-OX40L, have only used animal models. Despite the low interindividual variability in pharmacokinetics (PK) in all studied agents, TDM could be useful for optimizing dosing in PK/pharmacodynamic (PD) studies.

Conclusions:

The routine use of costimulation blockade in SOT is hindered by problems in efficacy compared with the standard of care. Costimulatory inhibitors could be combined in a calcineurin inhibitor-free regimen. Future PK/pharmacodynamic studies in costimulatory agents and personalized medicine could warrant TDM of these agents.
Surgical Capacity Assessment and Leverage in the Palestinian Land (SCALPEL-I) Study: The First Nationwide Plastic Surgery Capacity Evaluation in Palestine
Authors: Alser Osaid , Ayasa Laith , Alhabil Mohammed , Idais Shahd , Almzayyen Ayah , MohammedAli Majdeddin , Younes Reem , Alghoul Heba , Alser Muath , Stash Bryce , Khundkar Roba , Goodacre Timothy , Gosman Amanda , Pusic Andrea , Bharadia Deepak
Published: November 2024

Background:

Access to surgical care in low-to-middle-income countries (LMICs), especially in war-torn areas such as the occupied Palestinian territory (oPt), is a global health priority. The plastic surgical capacity in the oPt has not been evaluated. This study provides the first systematic evaluation of plastic surgical capacity in the oPt.

Methods:

A cross-sectional study conducted between December 2022 and February 2023 included facilities providing plastic surgery services in the oPt, except private centers run by nonsurgeons. A modified PIPES (personnel, infrastructure, procedures, equipment, and supplies) tool was used. Data were analyzed for geographic and private/public disparities.

Results:

Eleven facilities were included; 6 (54.5%) were in the West Bank and 5 (45.5%) in Gaza. The majority were private hospitals (n = 6, 54.5%). The mean PIPES score was personnel = 4.3 (4.03), infrastructure = 18.4 (2.4), procedures = 9.8 (3.8), equipment = 19.2 (3.6), and supplies = 22.4 (1.9). Hospital beds, operating rooms, and plastic surgeons per 100,000 people were 33.5, 1.0, and 0.5, respectively. There were 8 board-certified plastic surgeons. No facilities had a plastic surgery residency program. Key deficiencies included: 8 facilities (72.2%) not performing microsurgical free tissue transfers (none in Gaza), 5 (45.5%) lacking a system to identify complications, and 7 (63.3%) not offering regular educational courses. Average power supply was 8.0 hours/day in Gaza and 24.0 hours/day in the West Bank.

Conclusions:

Plastic surgical capacity in the oPt shows significant deficiencies, especially in Gaza. These findings should inform stakeholders to address disparities, develop training programs, and improve access to safe plastic surgery.
Competencies for Cultivating the Next Generation of Nurse Leaders
Authors: Okoth Stacey-Ann
Published: November 2024

The healthcare landscape is undergoing rapid transformation, marked by technological advancements, shifting patient demographics, and the increasing complexity of care delivery. In this ever-changing environment, the role of nurse leaders is more critical than ever. As we navigate the challenges of the 21st century, the development of the next generation of nurse leaders must be a top priority. This article explores the most effective approaches to nurturing leadership competencies in emerging nurse leaders, drawing on contemporary research and frameworks to guide our efforts.
Leadership That Leaps Also Runs Deep: Why Purpose Is the Key to Navigating a World of Exponential Change
Authors: Shin Andrew
Published: November 2024

Back-to-back black swan events during the COVID-19 pandemic and the ensuing economic downturn hastened the rate of change in healthcare. Hospitals and healthcare organizations of all sizes and configurations are facing difficult decisions with greater consequences than ever before—for patients, communities, employees, and the delivery of quality care. It can feel like a leap into the unknown.

It takes a different kind of leader to navigate this exponentially changing healthcare environment—and a different kind of training to ensure that those leaders develop the skills and mental models to advance systemic organizational change.

Healthcare needs transformational leaders who have skills that go beyond subject matter expertise and business sense. We need leaders who emphasize people and purpose and who are willing to take risks to improve sustainability, access to care, and health equity and to build organizations that prioritize mission to the community and support those who choose healthcare as their calling.
Women in Healthcare Leadership: A Personal Path to the C-Suite
Authors: Fontenot Teri G.
Published: November 2024

Women represent an overwhelming majority of the healthcare workforce, yet they are significantly underrepresented in leadership positions, particularly at the executive and board levels. However, women are uniquely positioned to leverage traits such as compassion, transparency, and the ability to foster teamwork to lead organizations into the next phase of contemporary healthcare delivery. In the future, the pace with which women gain access to the C-suite will accelerate as organizations embrace diversity and select the best-qualified leaders in terms of both experience and leadership style that supports organizational culture.

While the future for women in healthcare leadership looks bright, many women are currently struggling to reach the executive office, facing glass ceilings, competing priorities, and lack of access to support and guidance. In this article, I discuss the role of women in healthcare leadership and offer practical suggestions on how women can reach the top echelon and achieve their goals and aspirations.
Health information technology to advance care in accountable care organizations: Implications for Medicare patients
Authors: Ghosh Kaushik , Al-Amin Mona , Li Kate Jiayi , Muhlestein David
Published: November 2024

Background

Prior research has explored the link between health information technology (HIT) and performance of accountable care organizations (ACOs). However, the challenges of HIT use in ACOs for the management of chronic diseases among Medicare beneficiaries remain less examined.

Purpose

Given the high costs of implementing HIT and the occurrence of multiple chronic conditions (MCC) among elderly individuals, it is important to understand the extent to which HIT capabilities enable chronic disease management among the Medicare population.

Methodology/Approach

Regression analysis was conducted using data from multiple sources for the year 2017, including Leavitt Partners data, the ACO Public Use File published by the Shared Savings Program of the Centers for Medicare & Medicaid Services (CMS), and the CMS hospital referral region data. The sample consisted of 470 ACOs.

Results

Findings revealed that health information exchange (HIE)- and HIT-enabled patient engagement reduced unplanned admissions for Medicare patients with MCC. When primary care services were utilized, HIE- and HIT-enabled patient engagement and medication reconciliation further decreased unplanned admissions.

Conclusion

This study provides empirical support for HIT’s role in reinforcing the applicability of the chronic care model to improve health outcomes.

Practice Implications

From the managerial perspective, adopting HIT functions that support care management may be important for ACOs to improve patient outcomes.
Waveforms of 4G and 5G Radiofrequency Signals: Are Differences Relevant to Biology or Health?
Authors: Foster Kenneth R. , Maxson David , Zollman Peter M.
Published: November 2024

This Note briefly reviews, at a level that is intended to be accessible to non-specialists, the similarities and differences between waveforms of 4G Long-Term Evolution (4G LTE) and 5G New Radio (5G NR) transmitted by cellular base stations, as a resource for health physicists and others who are engaged in public communication about cellular telephone technologies. Despite the difference in levels of controversy presently existing between 4G LTE (introduced in 2008) and 5G NR (introduced in 2019), the differences in waveform as represented by the baseband waveform are minimal, although 5G NR offers system designers a much wider choice of parameters. Transmitted radiofrequency signals in both technologies appear noise-like, in a frequency range that is narrowly contained in the assigned channel. It is concluded that the modulation differences between 4G LTE and 5G NR are unlikely to have any biological relevance, but the greater range of accessible frequencies in 5G NR suggests the need for further health research, particularly in the 5G FR2 millimeter-wave band.
In Vitro and In Vivo Visualization of Perfluorohexyloctane, an Eye Drop for Dry Eye Disease, Using Infrared Emissivity
Authors: Millar Thomas James , Vittitow Jason , Cavet Megan , Ahmed Simra , Borchman Douglas
Published: November 2024

Purpose:

To visualize the behavior of perfluorohexyloctane (PFHO), an eye drop to treat dry eye disease (DED), on the surface of saline in vitro and on the human ocular surface using infrared emissivity.

Methods:

Emissivity videos were used to measure the spreading and disappearance rates of PFHO on saline (with and without mucin for spreading rate) and layered over a 125 nm film of meibum on the surface of saline using a TearView camera. Ocular surface emissivity was videoed in a volunteer without DED before and after instillation of 1 drop of PFHO. Videos were exported and converted to still photographs, and grayscale levels measured.

Results:

PFHO formed a layer over saline that spread at a mean (SD) rate of 0.89 (0.5) cm2/s and disappeared at 0.0760 (0.0055) μL/min, consistent with reported rates of evaporation for PFHO. Mucin in the subphase did not alter spreading rate (P > 0.2). In vitro, a single drop of PFHO spread over the top of a 125-nm thick film of meibum remaining for 3.3 hours. In the volunteer, an increase in emissivity was detected on the ocular surface for ≥5 hours.

Conclusions:

PFHO quickly spread to form a layer over the surface of saline or meibum in vitro and was detected on the ocular surface in vivo for ≥5 hours after topical administration. This supports findings that PFHO forms a long-lasting barrier to evaporation at the air–liquid interface of the tear film and thus reduces signs and symptoms of DED.
A Quality Improvement Project on Reducing Unplanned Bowel Evacuation During Aquatic Therapy
Authors: Chen Jing , Sachs Christy , Mertins Rachel , Recio Albert
Published: November 2024

Background:

Aquatic therapy can be a safe and effective intervention for individuals with spinal cord injury (SCI). It harnesses the unique physical properties of water—such as temperature, density, viscosity, turbulence, hydrostatic pressure, buoyancy, and resistance—to enhance functional capacities. Despite its benefits, unplanned bowel evacuations during aquatic therapy can disrupt therapy sessions and cause embarrassment and anxiety for patients. Surveillance data from our center between 2018 and 2023 indicated yearly unplanned bowel evacuations rate ranging from 0.13% to 0.65%.

Methods:

A mission statement to reduce unplanned bowel evacuations during aquatic therapy by 50% within 6 months was established. Quality improvement methodologies, including project analysis, solution development, and evaluation were applied.

Results:

After implementing the Plan-Do-Study-Act cycle, the rate of unplanned bowel evacuation dropped to 0% over 6 months from a baseline median of 0.56%. Continuous monitoring is necessary to sustain these results.

Conclusion:

Quality improvement methods can effectively address unplanned bowel evacuations during aquatic therapy for individuals with SCI. While initial results are promising, further data collection is required for conclusive evidence.
When is it a sexually transmitted infection? Intimate contact transmission of pathogens not traditionally defined as STIs
Authors: Raccagni Angelo Roberto , Castagna Antonella , Nozza Silvia
Published: November 2024

Purpose of review

Several microorganisms, which are not traditionally considered sexually transmitted infections (STIs), are capable of sexual transmission and have the potential to cause global outbreaks. The aim of this review is to describe pathogens which are not traditionally defined as STIs, to grant insight on current and potential outbreaks and call for clinical vigilance among members of key populations.

Recent findings

Recent findings emphasize that several pathogens, not traditionally classified as STIs, can be sexually transmissible. These include the mpox virus, enteric infections such as Shigella spp., dermatophytes such as Trichophyton mentagrophytes, ectoparasites and atypical bacterial genito-urinary infections such as Neisseria meningitidis. The internationally reported outbreaks and the reports on potential sexual transmission of these pathogens underlines the emerging risks, the need for a broader STI definition and the importance of vigilant public health control strategies.

These findings suggest that clinical practice should broaden STI testing and awareness to include pathogens not traditionally considered sexually transmissible, particularly among key populations. Clinicians must be vigilant for atypical presentations, ensuring comprehensive sexual healthcare and diagnostic testing. Development of targeted preventive efforts and continuous surveillance to detect and manage emerging sexually transmissible infections is paramount.
Numerical simulation study on the force of overwintering foundation support structure of unsaturated seasonal permafrost under indoor experiments
Authors: Guo Haotian , Zhao Xinzhu , Sun Chao , Li Xiangqun , Yang Kai
Published: November 2024

When analysing the effect of negative temperature on overwintering pit constructions of unsaturated soil, using the mechanical parameter of saturated soil at room temperature leads to an inaccuracy in the research findings. The strength parameters are obtained through indoor experiments. The foundation pit model is created using FLAC3D numerical simulation software based on the indoor experimental data. The influence of different parameters on the stress and deformation of the overwintering deep foundation pit supporting structure is analysed. The numerical simulation results obtained are compared with the actual monitoring data. According to research, the matric suction of the silty clay in its natural state in the Changchun area is 70 kPa. As the temperature decreases, the total cohesion of the unsaturated soil increases, and the internal friction angle tends to decrease. The numerical simulation results are consistent with the actual monitoring data changes. With the excavation, the horizontal displacement of the supporting structure increases first and then decreases, reaching the maximum displacement at two-thirds of the foundation pit. Compared with room temperature, the deformation of the supporting structure is larger under a negative temperature condition. The deformation of the supporting structure simulated by the actual temperature mechanical parameters is larger than that under the condition of normal temperature mechanical parameters. The frost-heaving force increases with the overall excavation, and a surge occurs at the bottom of the pit. The frost-heaving force changes most significantly under the condition of freezing at −20°C for 30 days.
Pangenomic insights into Dehalobacter evolution and acquisition of functional genes for bioremediation
Authors: Bulka Olivia , Mahadevan Radhakrishnan , Edwards Elizabeth A.
Published: November 2024

Dehalobacter is a genus of organohalide-respiring bacteria that is recognized for its fastidious growth using reductive dehalogenases (RDases). In the SC05 culture, however, a Dehalobacter population also mineralizes dichloromethane (DCM) produced by chloroform dechlorination using the mec cassette, just downstream of its active RDase. A closed genome of this DCM-mineralizing lineage has previously evaded assembly. Here, we present the genomes of two novel Dehalobacter strains, each of which was assembled from the metagenome of a distinct subculture from SC05. A pangenomic analysis of the Dehalobacter genus, including RDase synteny and phylogenomics, reveals at least five species of Dehalobacter based on average nucleotide identity, RDase and core gene synteny, as well as differential functional genes. An integration hotspot is also pinpointed in the Dehalobacter genome, in which many recombinase islands have accumulated. This nested recombinase island encodes the active RDase and mec cassette in both SC05 Dehalobacter genomes, indicating the transfer of key functional genes between species of Dehalobacter. Horizontal gene transfer between these two novel Dehalobacter strains has implications for the evolutionary history within the SC05 subcultures and of the Dehalobacter genus as a whole, especially regarding adaptation to anthropogenic chemicals.
Genome and antibiotic resistance characteristics of Shigella clinical isolates in Fujian Province, Southeast China, 2005–2019
Authors: Huang Mengying , Zhang Xiaoxuan , Luo Chaochen , Xu Haibin , Qiu Yufeng , Yang Jinsong
Published: November 2024

Shigellosis is a serious public health issue in many developing countries. The emergence of multidrug-resistant (MDR) Shigella isolates has deepened the treatment difficulty and health burden of shigellosis. China is the largest developing country in the world, but so far, the genome of MDR Shigella isolates has not been well characterized. In this study, 60 clinical isolates of Shigella spp. in Fujian Province, southeast China, from 2005 to 2019 were characterized for drug resistance phenotype, whole-genome sequencing and bioinformatics analysis. The results showed that the MDR rate of Shigella isolates was 100%, among which the resistance rates of cefotaxime, ciprofloxacin and azithromycin were 36.67, 21.67 and 10.00 %, respectively. The positive rate of extended-spectrum beta-lactamase (ESBL)-producing strains was 23.33%. The resistance profiles of Shigella flexneri and Shigella sonnei to some antimicrobials differed. The MDR isolates carried multiple antimicrobial resistance genes, among which blaCTX-M-14
and blaCTX-M-15
mediated ESBL resistance. ‘ISEcp1 -blaCTX−M -IS903’ (type I) and ‘ISEcp1 -blaCTX−M
’ (type II) were the most common genetic environments around the blaCTX-M
genes, and plasmids containing these structures included IncFII, IncI1, IncI2 and IncN. The double gene mutation pattern of gyrA and parC resulted in a significant decrease in the sensitivity of S. flexneri to ciprofloxacin. The overall resistance phenotype and genotype concordance rate was 88.50%, and the sensitivity and specificity of the genotype antimicrobial susceptibility test (AST) were 93.35 and 82.53 %, respectively. However, inconsistency occurred between phenotypic and genotype profiles for a few antibiotics. Phylogenomic investigation with core genome multi-locus sequence typing (cgMLST) and SNPs were used to characterize the endemic transmission of these infections in Fujian and their evolutionary origin within the global context. For S. flexneri, Fujian isolates were all limited to PG3 and could be divided into three phylogenetic clusters. The ciprofloxacin-resistant strains were mainly F2a and FXv and assigned to the three clusters with different quinolone resistance-determining region mutation patterns. For S. sonnei, most Fujian strains belonged to Lineage III with genotype 3.7.6, except three isolates of Lineage I with genotype 1.3. The strains carrying the blaCTX-M
genes were dispersed, indicating different origins of gene acquisition. Most of the circulating isolates in Fujian Province were not related to major international outbreak lineages and were only endemic to the country. In conclusion, multi-drug resistance of Shigella isolates in Fujian Province was serious, and genome-based laboratory surveillance will be crucial to the clinical treatment and public health measures for shigellosis.
Rapid riparian ecosystem recovery in low-latitudinal North China following the end-Permian mass extinction
Authors: Guo Wenwei , Tian Li , Chu Daoliang , Shu Wenchao , Benton Michael , Liu Jun , Tong Jinnan
Published: November 2024

The greatest mass extinction at the end of the Permian, ca. 252 million years ago, led to a tropical dead zone on land and sea. The speed of recovery of life has been debated, whether fast or slow, and terrestrial ecosystems are much less understood than marine. Here, we show fast reestablishment of riparian ecosystems in low-latitude North China as little as ~2 million years after the end-Permian mass extinction. The initial ichnoassemblages in shallow lacustrine and fluvial facies of late Smithian age are monospecific, devoid of infaunalization, with apparent size reduction. In the following Spathian, relatively complex, multi-level, structured riverain ecosystems had been rebuilt including medium-sized carnivores, plant stems, root traces, increased ichnological complexity, and significantly enhanced infaunalization. Specifically, burrowing behavior had re-emerged as a key life strategy not only to minimize stressful climatic conditions, but possibly to escape predation.
Scale-Up of Voluntary Medical Male Circumcisions as Part of Combination HIV Prevention Strategies – Mozambique, 2010-2023
Authors: Canda Marcos , Matsimbe Lúcio , Gaspar Nuno , Langa António , Malimane Inácio , Come Jotamo , Chicavel Daniel
Published: November 2024

Introduction

Voluntary Medical Male Circumcision (VMMC) is a cost-effective HIV prevention strategy, reducing risk of female-to-male transmission by approximately 60%. Mozambique implemented a national VMMC program since 2010, including HIV testing to identify HIV positive men. We used program data to describe the President’s Emergency Plan for AIDS Relief (PEPFAR)-supported VMMC services in seven provinces in Mozambique.

Methods

We analyzed aggregate PEPFAR Monitoring, Evaluation, and Reporting data for 2010–2023 for VMMCs conducted and HIV testing at VMMC sites. VMMC coverage rate was calculated as the number of males who reported medical or traditional circumcisions over the estimated population. Test positivity rate was calculated as positive tests over the total tests conducted. Data were analyzed by fiscal year (October–September), age group (<15 years, 15–29 years, ≥30 years), and province.

Results

During 2010-2023 total 2,534,411 VMMCs were performed, of which, 1,032,789 (41%) among boys <15 years old, 1,368,582 (54%) among men aged 15– 29, and 133,039 (5%), men aged >30. By 2023, national VMMC coverage was 77% (higher among men aged 20–24 years, at 80%). Overall HIV test positivity rate was 1.6% (35,743 positives), with a provincial range of 0.4% to 5.9%. Older men aged 45-49 had higher HIV positivity rate of 24.3%.

Conclusion

VMMC implementation during twelve years reached priority boys and men aged 15-29 for immediate impact on HIV prevention. Essentially, program has circumcised a large amount of boys and men, leading to higher VMMC coverage and anticipated reductions in HIV transmission. Further, services have helped identify men already living with HIV.
Gravitational bremsstrahlung from Yukawa and nucleon collisions
Authors: Steane Andrew M.
Published: November 2024

We obtain the gravitational emission from particles scattering via the Yukawa interaction, presenting both classical and approximate quantum results. We also estimate the contribution from the tensor part of the internucleon interaction. This emission is the main source of a very high frequency component to the stochastic background in the Solar System and in neutron stars. The emission from the Sun (allowing for Debye screening) and from a typical neutron star are obtained. The gravitational wave luminosity of the Sun is 41±10  MW.

Published by the American Physical Society
2024
Frozen autocatalytic fronts in a radial flow
Authors: Negrojević L. , Comolli A. , Brau Fabian , De Wit A.
Published: November 2024

Autocatalytic reaction-diffusion fronts are localized reaction zones propagating at a constant speed with a constant width. We show both theoretically and experimentally that, if the reactant Y of the autocatalytic reaction is injected radially at a constant flow rate in a sea of the autocatalytic species X, a stationary front can be maintained at a fixed position that scales linearly with the flow rate. When this reaction front is about to reach a stationary state, a second outward traveling front emerges to adapt the outer concentration of the autocatalytic species to the stoichiometry ratio between X and Y. Simple analytical solutions to the reaction-diffusion-advection equations governing the dynamics are computed for both fronts. The analytical predictions for the stationary front position and moving front dynamics as a function of injection flow rate, reactant concentration, and gap of the quasi-two-dimensional reactor agree well with experimental results obtained with the autocatalytic chlorite-tetrathionate reaction.

Published by the American Physical Society
2024