bluuebunny/crossref_metadata_2025 huggingface dataset:
Retrospective analysis of wildfire smoke exposure and birth weight outcomes in the San Francisco Bay Area of California
Authors: Fernández Anna Claire G , Basilio Emilia , Benmarhnia Tarik , Roger Jacquelyn , Gaw Stephanie L , Robinson Joshua F , Padula Amy M
Published: May 2023

Despite the occurrence of wildfires quadrupling over the past four decades, the health effects associated with wildfire smoke exposures during pregnancy remains unknown. Particulate matter less than 2.5 μms (PM2.5) is among the major pollutants emitted in wildfire smoke. Previous studies found PM2.5 associated with lower birthweight, however, the relationship between wildfire-specific PM2.5 and birthweight is uncertain. Our study of 7923 singleton births in San Francisco between January 1, 2017 and March 12, 2020 examines associations between wildfire smoke exposure during pregnancy and birthweight. We linked daily estimates of wildfire-specific PM2.5 to maternal residence at the ZIP code level. We used linear and log-binomial regression to examine the relationship between wildfire smoke exposure by trimester and birthweight and adjusted for gestational age, maternal age, race/ethnicity, and educational attainment. We stratified by infant sex to examine potential effect modification. Exposure to wildfire-specific PM2.5 during the second trimester of pregnancy was positively associated with increased risk of large for gestational age (OR = 1.13; 95% CI: 1.03, 1.24), as was the number of days of wildfire-specific PM2.5 above 5 μg m−3 in the second trimester (OR = 1.03; 95% CI: 1.01, 1.06). We found consistent results with wildfire smoke exposure in the second trimester and increased continuous birthweight-for-gestational age z-score. Differences by infant sex were not consistent. Counter to our hypothesis, results suggest that wildfire smoke exposures are associated with increased risk for higher birthweight. We observed strongest associations during the second trimester. These investigations should be expanded to other populations exposed to wildfire smoke and aim to identify vulnerable communities. Additional research is needed to clarify the biological mechanisms in this relationship between wildfire smoke exposure and adverse birth outcomes.
Long-term risks of cardiovascular death in a population-based cohort of 1,141,675 older patients with cancer
Authors: Guan Tianwang , Jiang Yanting , Luo Zehao , Liang Yinglan , Feng Manting , Lu Zhenxing , Yi Min , Teng Yintong , Zhou Ruoyun , Zeng Liangjia , Chi Kaiyi , Ou Caiwen , Chen Minsheng
Published: May 2023

Background

previous studies have focused on the risk of cardiovascular disease (CVD)-related death in individual cancers, adolescents or all cancers.

Objective

to evaluate the risk of CVD-related death in older patients with cancer.

Methods

older patients with cancer (over 65 years) of 16 cancers diagnosed between 1975 and 2018 were screened out from the Surveillance, Epidemiology and End Results program. The proportion of deaths, competing risk regression models, standardized mortality ratios (SMRs) and absolute excess risks (AERs) were used to assess the risk of CVD-related death.

Results

this study included 1,141,675 older patients (median follow-up: 13.5 years). Of the 16 individual cancers, the risk of CVD death exceeded primary neoplasm death in older patients with cancers of the breast, endometrium, vulva, prostate gland, penis and melanoma of the skin over time (high competing risk group). Compared to the general older population, older patients with cancer had higher SMR and AER of CVD-related death (SMR: 1.58–4.23; AER: 21.16–365.89), heart disease-related death (SMR: 1.14–4.16; AER: 16.29–301.68) and cerebrovascular disease-related death (SMR: 1.11–4.66; AER: 3.02–72.43), with the SMR trend varying with CVD-related death competing risk classifications. The risk of CVD-related death in the high-competing risk group was higher than in the low-competing risk group.

Conclusions

for older patients with cancer, six of 16 individual cancers, including breast, endometrium, vulva, prostate gland, penis and melanoma of the skin was at high risk of CVD-related death. Management for long-term cardiovascular risk in older patients with cancer is needed.
A Longitudinal Study of Sleep Habits and Leukemia Incidence Among Postmenopausal Women
Authors: Shang Hui , Hendryx Michael , Liang Xiaoyun , Shadyab Aladdin H , Luo Juhua
Published: May 2023

We sought to assess the relationship between sleep duration, sleep disturbance, and leukemia incidence among postmenopausal women. This study included 130,343 postmenopausal women aged 50–79 years who were enrolled in the Women’s Health Initiative (WHI) during 1993–1998. Information on self-reported typical sleep duration and sleep disturbance was obtained by questionnaire at baseline, and sleep disturbance level was defined according to the Women’s Health Initiative Insomnia Rating Scale (WHIIRS). WHIIRS scores of 0–4, 5–8, and 9–20 comprised 37.0%, 32.6%, and 30.4% of all women, respectively. After an average of 16.4 years (2,135,109 cumulative person-years) of follow-up, 930 of the participants were identified as having incident leukemia. Compared with women with the lowest level of sleep disturbance (WHIIRS score 0–4), women with higher sleep disturbance levels (WHIIRS scores of 5–8 and 9–20) had 22% (95% confidence interval (CI): 1.04, 1.43) and 18% (95% CI: 1.00, 1.40) excess risks of leukemia, respectively, after multivariable adjustment. A significant dose-response trend was found for the association between sleep disturbance and leukemia risk (P for trend = 0.048). In addition, women with the highest level of sleep disturbance had a higher risk of myeloid leukemia (for WHIIRS score 9–20 vs. WHIIRS score 0–4, hazard ratio = 1.39, CI: 1.05, 1.83). Higher sleep disturbance level was associated with increased risk of leukemia, especially for myeloid leukemia among postmenopausal women.
Impulse control disorder in Parkinson’s disease is associated with abnormal frontal value signalling
Authors: Tichelaar Jorryt G , Sayalı Ceyda , Helmich Rick C , Cools Roshan
Published: May 2023

Dopaminergic medication is well established to boost reward- versus punishment-based learning in Parkinson’s disease. However, there is tremendous variability in dopaminergic medication effects across different individuals, with some patients exhibiting much greater cognitive sensitivity to medication than others. We aimed to unravel the mechanisms underlying this individual variability in a large heterogeneous sample of early-stage patients with Parkinson’s disease as a function of comorbid neuropsychiatric symptomatology, in particular impulse control disorders and depression.

One hundred and ninety-nine patients with Parkinson’s disease (138 ON medication and 61 OFF medication) and 59 healthy controls were scanned with functional MRI while they performed an established probabilistic instrumental learning task. Reinforcement learning model-based analyses revealed medication group differences in learning from gains versus losses, but only in patients with impulse control disorders. Furthermore, expected-value related brain signalling in the ventromedial prefrontal cortex was increased in patients with impulse control disorders ON medication compared with those OFF medication, while striatal reward prediction error signalling remained unaltered.

These data substantiate the hypothesis that dopamine’s effects on reinforcement learning in Parkinson’s disease vary with individual differences in comorbid impulse control disorder and suggest they reflect deficient computation of value in medial frontal cortex, rather than deficient reward prediction error signalling in striatum.

See Michael Browning (https://doi.org/10.1093/brain/awad248) for a scientific commentary on this article.
The Örebro Musculoskeletal Pain Screening Questionnaire-Short Form and 2-year follow-up of registered work disability
Authors: Heikkala Eveliina , Oura Petteri , Ruokolainen Olli , Ala-Mursula Leena , Linton Steven J , Karppinen Jaro
Published: May 2023

Background

The Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) was developed to identify psychological and functioning-related risk factors among individuals with musculoskeletal pain at risk of work disability. This study aimed to examine whether the short version of the ÖMPSQ (ÖMPSQ-SF) can be used for this purpose, using registry-based outcomes.

Methods

The ÖMPSQ-SF was completed by the members of the Northern Finland Birth Cohort 1966 at the age of 46 years (baseline). These data were enriched with national registers, including information on sick leaves and disability pensions (indicators of work disability). The associations between the ÖMPSQ-SF categories (low-, medium- and high risk) and work disability over a 2-year follow-up were analysed using negative binomial regression and binary logistic regression models. We made adjustments for sex, baseline education level, weight status and smoking.

Results

Overall, 4063 participants provided full data. Of these, 90% belonged to the low-risk, 7% to the medium-risk and 3% to the high-risk group. Compared to the low-risk group, the high-risk group had a 7.5 [Wald 95% confidence interval (CI) 6.2–9.0] times higher number of sick leave days and 16.1 (95% CI 7.1–36.8) times higher odds of disability pension after adjustments in the 2-year follow-up.

Conclusions

: Our study suggests that the ÖMPSQ-SF could be used for predicting registry-based work disability at midlife. Those allocated to the high-risk group seemed to have a particularly great need of early interventions to support their work ability.
“It’s Just [Complicated] Sleep”: Discourses of Sleep and Aging in the Media
Authors: Breheny Mary , Ross Isabelle , Ladyman Clare , Signal Leigh , Dew Kevin , Gibson Rosemary
Published: May 2023

The media are influential in shaping beliefs and attitudes on aging and health-related behaviors. Sleep is increasingly recognized as a key pillar for healthy aging. However, the role of media representations of sleep is yet to be assessed with regard to discourses of aging. Texts from New Zealand’s main free online news source were collated using key words “sleep” together with “aging,” “older,” “elderly,” or “dementia” between 2018 and 2021. Contents of 38 articles were interpreted using critical discourse analysis. Discursive constructions described an inevitable decline of sleep with aging, including impacts of both physiological decline and life stage transitions; sleep’s role as both a remedy and risk for ill health and disease; and the simplification of solutions for self-managing sleep juxtaposed alongside recognition of its complexity. The audience of these complex messages is left in the invidious position of both pursuing sleep practices to prevent age-related decline, whilst also being told that sleep degradation is inevitable. This research demonstrates the complexity of media messaging and the fraught options it offers: good sleep as both a reasonable achievement to strive for and as impossibly idealistic. Findings mirror two predominant health identities available to older people, as responsible for resisting aging or as falling into inevitable decline. This reveals additional expectations around appropriate time use and behaviors with aging. More nuanced messaging that goes beyond sleep as a resource for health and waking productivity is recommended. Acknowledging the complexity of sleep, aging, and society could be the starting point of such adaptation.
Mind the time: failure response time, variations in the reasons for failures, and learning from failure
Authors: Zakaryan Arusyak , Tzabbar Daniel , Cirillo Bruno
Published: May 2023

How does a firm’s response time to past failures affect its likelihood of experiencing future failures? Does this likelihood depend on the reasons for past failures? Using drug recalls during 2006–2016, we examine the effect of pharmaceutical firms’ response time to their past failures on their learning from failure. Longer response times reduce the likelihood of subsequent failure. Variations in the reasons for past failures increase the potential for subsequent failure. However, a longer response time helps overcome the challenges associated with this variation. By focusing on the temporal dimension of learning from failure, we provide unique theoretical insights into when and how organizations can learn from failure.
Adaptive stabilization for a wave equation subject to boundary control matched harmonic disturbance
Authors: Liu Jun-Jun , Zhao Yan-Xing
Published: May 2023

In this paper, we are concerned with adaptive stabilization for a wave equation subject to boundary control matched harmonic disturbance. We use the adaptive and Lyapunov approach to estimate unknown disturbance and construct an adaptive boundary feedback controller. By the semigroup theory and Lasalle‘s invariance theorem, the well-posedness and asymptotic stability of the closed-loop system is proved, respectively. At the same time, it is shown that the parameter estimates involved in the constructed controller converge to their own real values as time goes to infinity. Some numerical simulations are offered at the end of the paper to illustrate the effectiveness of theoretical results.
Metformin improves fish sperm quality by regulating glucose uptake capacity during in vitro storage
Authors: Liu Qimin , Zhu Chao , Ma Yuxuan , Wang Yang , Zheng Lijuan , Jin Tianqi , He Shuyang , Yang Fangxia , Dong Wuzi
Published: May 2023

A suitable additive for fish sperm storage in vitro is necessary for artificial reproduction. In this study, we evaluated the effects of different concentrations (100, 200, 400, and 800 µmol/L) of metformin (Met) on Schizothorax prenanti and Onychostoma macrolepis sperm under storage in vitro for 72 h. Compared with the control group, 400 µmol/L Met was more effective at improving the quality and fertilization capacity of S. prenanti sperm by increasing the adenosine triphosphate (ATP) content within the sperm. Further study found that Met stabilized the ATP level by enhancing the glucose uptake in S. prenanti sperm, and this effect might be associated with the activation of AMP-activated protein kinase (AMPK) in sperm. In this study, we also found that glucose could be absorbed by the sperm of S. prenanti, which was mainly accumulated in the midpiece of S. prenanti sperm, where mitochondria were located. In addition, Compound C significantly inhibited the beneficial effects of Met on the quality and glucose uptake capacity of S. prenanti sperm by inhibiting AMPK phosphorylation. These results revealed that AMPK played an important role in vitro sperm storage, and Met maintained ATP content and increased the storage time of S. prenanti sperm in vitro for 72 h, possibly due to Met enhanced glucose uptake capacity of sperm by activating AMPK. Similarly, the beneficial effects of Met on S. prenanti sperm were also found in O. macrolepis sperm, suggesting that Met may hold great promise for the practice of storing fish in vitro.
A new subterranean species of Arisubathynella Park & Eun, 2012 (Crustacea: Bathynellacea: Parabathynellidae) from South Korea, with remarks on the phylogenetic relationships among 15 parabathynellid genera
Authors: Ji Su-Jung , Min Gi-Sik
Published: May 2023

Parabathynellidae, Arisubathynella pocheonensis. sp. nov. from a hyporheic zone of a stream in South Korea. The new species is morphologically distinguished from its congeners by having five teeth on the incisor process in the mandible, and four teeth on the dentate lobe of male thoracopod VIII. The species description is supplemented with molecular information in the form of 18S rRNA and partial CO1 gene sequences. Additionally, the phylogenetic relationships among 15 parabathynellid genera from Europe, America, Australia, India, Thailand, Vietnam, and South Korea are inferred on the basis of 18S rRNA sequences. Members of ArisubathynellaPark & Eun, 2012, AllobathynellaMorimoto & Miura, 1957, and EobathynellaBirstein & Ljovuschkin, 1964 from South Korea belong to two separate geographical clades: Arisubathynella to the European-North American clade and the others to the East Asian clade.
PKM2 promotes proinflammatory macrophage activation in ankylosing spondylitis
Authors: Weng Weizhen , Zhang Yanli , Gui Lian , Chen Jingrong , Zhu Weihang , Liang Zhenguo , Wu Zhongming , Liang Yao , Xie Jiewen , Wei Qiujing , Liao Zetao , Gu Jieruo , Pan Yunfeng , Jiang Yutong
Published: May 2023

Macrophages play a critical role in ankylosing spondylitis by promoting autoimmune tissue inflammation through various effector functions. The inflammatory potential of macrophages is highly influenced by their metabolic environment. Here, we demonstrate that glycolysis is linked to the proinflammatory activation of human blood monocyte-derived macrophages in ankylosing spondylitis. Specifically, ankylosing spondylitis macrophages produced excessive inflammation, including TNFα, IL1β, and IL23, and displayed an overactive status by exhibiting stronger costimulatory signals, such as CD80, CD86, and HLA-DR. Moreover, we found that patient-derived monocyte-derived M1-type macrophages (M1 macrophages) exhibited intensified glycolysis, as evidenced by a higher extracellular acidification rate. Upregulation of PKM2 and GLUT1 was observed in ankylosing spondylitis–derived monocytes and monocyte-derived macrophages, especially in M1 macrophages, indicating glucose metabolic alteration in ankylosing spondylitis macrophages. To investigate the impact of glycolysis on macrophage inflammatory ability, we treated ankylosing spondylitis M1 macrophages with 2 inhibitors: 2-deoxy-D-glucose, a glycolysis inhibitor, and shikonin, a PKM2 inhibitor. Both inhibitors reduced proinflammatory function and reversed the overactive status of ankylosing spondylitis macrophages, suggesting their potential utility in treating the disease. These data place PKM2 at the crosstalk between glucose metabolic changes and the activation of inflammatory macrophages in patients with ankylosing spondylitis.
Prevention of Disease and the Absent Body: A Phenomenological Approach to Periodontitis
Authors: Rakhra Dylan , Grīnfelde Māra
Published: May 2023

A large part of the contemporary phenomenology of medicine has been devoted to accounts of health and illness, arguing that they contribute to the improvement of health care. Less focus has been paid to the issue of prevention of disease and the associated difficulty of adhering to health-promoting behaviours, which is arguably of equal importance. This article offers a phenomenological account of this disease prevention, focusing on how we—as embodied beings—engage with health-promoting behaviours. It specifically considers how we engage with oral hygiene regimens to prevent periodontitis and why we are not good at it. The article suggests that poor adherence to health-promoting behaviours can be explained with reference to the concept of the absent body, because prevention of disease is generally concerned with pre-symptomatic illness experience. The final section contains a discussion of some strategies for the improvement of disease prevention based on this viewpoint.
Determining the Projected Crystal Structure from Four-dimensional Scanning Transmission Electron Microscopy via the Scattering Matrix
Authors: Sadri Alireza , Findlay Scott D
Published: May 2023

We present a gradient-descent-based approach to determining the projected electrostatic potential from four-dimensional scanning transmission electron microscopy measurements of a periodic, crystalline material even when dynamical scattering occurs. The method solves for the scattering matrix as an intermediate step, but overcomes the so-called truncation problem that limited previous scattering-matrix-based projected structure determination methods. Gradient descent is made efficient by using analytic expressions for the gradients. Through simulated case studies, we show that iteratively improving the scattering matrix determination can significantly improve the accuracy of the projected structure determination.
Increasing Maternity Leave and Decreasing Attrition Rates of U.S. Active Duty Women in the Prenatal and Immediate Postpartum Period
Authors: Herrick Minette S R , Chai Weiwen
Published: May 2023

Introduction

The USA currently does not have a national parental leave policy. In 2016, the Secretary of Defense increased the allotted maternity leave for active duty U.S. military members from 6 to 12 weeks. The purpose of this study was to understand the potential impact of this change on attrition rates of active duty women in the Army, Air Force, Navy, and Marines from their initial prenatal visit through the first year postpartum.

Methods

All active duty women who had a confirmed pregnancy in the electronic health record from 2011 to 2019 were included for consideration in the study. A total of 67,281 women met the inclusion criteria. These women were followed from their initial documented prenatal visit for 21 months (9 months gestation and 12 months postpartum) for removal from the Defense Eligibility and Enrollment Reporting System signaling attrition from service presumably related to pregnancy or childbirth. Logistic regression models were used to assess the association between maternity leave policy and attrition adjusting for covariates.

Results

Overall, women who were allotted 6 weeks of maternity leave were associated with higher attrition relative to women provided 12 weeks of maternity leave (odds ratio = 1.36; 95% CI, 1.31-1.42; P < .0001), representing a 22% decrease in attrition rates of women given 12 weeks vs. 6 weeks of leave. This impact of attrition rate was the greatest among members who were of lower rank (6 weeks vs. 12 weeks of leave: junior enlisted (E1-E3), 29.2% vs. 22.0%, P < .0001 and non-commissioned officer (E4-E6), 24.3% vs. 19.4%, P < .0001) and who served in the Army (28.0% vs. 21.2%, P < .0001) and Navy (20.0% and 14.9%, P < .0001).

Conclusions

Family-friendly health policy appears to have the intended outcome of retaining talent in the military workforce. The impact of health policy on this population can provide a glimpse into the influence of similar policies should they be implemented nationwide.
Police Unions, Race, and Trust in the Police
Authors: DiSalvo Daniel , Nagler Matthew G
Published: May 2023

It has long been recognized that trust critically influences the effective functioning of political institutions, yet the determinants of trust in the police—a classic order institution—are still not well understood. We examine the effect of police unionization on trust in the police and, in particular, in mediating the adverse impacts of police killings of civilians on trust within the U.S. multiracial context. We analyze trust responses and corresponding demographic data on approximately 5,000 respondents across eleven metropolitan statistical areas from the 2006 Social Capital Community Benchmark Survey, matched to relevant city- and state-level correlates from three additional data sets. Our results confirm prior studies’ findings of a large gap between Black and non-Black trust. Although police killings of civilians normally reduce trust among non-Black people while leaving Black levels of trust unaffected, we find that in jurisdictions where police bargain collectively the drop in non-Black trust is effectively eliminated, suggesting that police unionization essentially abets the polarization of trust in the police between Black people and non-Black people.
Nurses as Disciplinary Agents of the State
Authors: Jenkins Danisha , Wolfe Ian , Dillard-Wright Jess
Published: May 2023

This article reviews legislative initiatives that mandate nurses to report patients, families, and clinicians to law enforcement. Most recently, these laws target transgender and gender diverse (TGD) youth and people seeking abortion. In this article, we examine the ethics of such laws through professional ethical codes. Furthermore, through a biopolitical lens, we critically analyze examples of nurses' participation in complying with laws that harm patients. Finally, we discuss the damage these laws have on the nursing profession and assert the necessity of a resituating of professional ethics that considers the complexity of nursing care amidst increasingly blatant state-sanctioned violence.
Promotion effect of FGF23 on osteopenia in congenital scoliosis through FGFr3/TNAP/OPN pathway
Authors: Zhang Hongqi , Xiang Gang , Li Jiong , He Sihan , Wang Yunjia , Deng Ang , Wang Yuxiang , Guo Chaofeng
Published: May 2023

Background:

Congenital scoliosis (CS) is a complex spinal malformation of unknown etiology with abnormal bone metabolism. Fibroblast growth factor 23 (FGF23), secreted by osteoblasts and osteocytes, can inhibit bone formation and mineralization. This research aims to investigate the relationship between CS and FGF23.

Methods:

We collected peripheral blood from two pairs of identical twins for methylation sequencing of the target region. FGF23 mRNA levels in the peripheral blood of CS patients and age-matched controls were measured. Receiver operator characteristic (ROC) curve analyses were conducted to evaluate the specificity and sensitivity of FGF23. The expression levels of FGF23 and its downstream factors fibroblast growth factor receptor 3 (FGFr3)/tissue non-specific alkaline phosphatase (TNAP)/osteopontin (OPN) in primary osteoblasts from CS patients (CS-Ob) and controls (CT-Ob) were detected. In addition, the osteogenic abilities of FGF23-knockdown or FGF23-overexpressing Ob were examined.

Results:

DNA methylation of the FGF23 gene in CS patients was decreased compared to that of their identical twins, accompanied by increased mRNA levels. CS patients had increased peripheral blood FGF23 mRNA levels and decreased computed tomography (CT) values compared with controls. The FGF23 mRNA levels were negatively correlated with the CT value of the spine, and ROCs of FGF23 mRNA levels showed high sensitivity and specificity for CS. Additionally, significantly increased levels of FGF23, FGFr3, OPN, impaired osteogenic mineralization and lower TNAP levels were observed in CS-Ob. Moreover, FGF23 overexpression in CT-Ob increased FGFr3 and OPN levels and decreased TNAP levels, while FGF23 knockdown induced downregulation of FGFr3 and OPN but upregulation of TNAP in CS-Ob. Mineralization of CS-Ob was rescued after FGF23 knockdown.

Conclusions:

Our results suggested increased peripheral blood FGF23 levels, decreased bone mineral density in CS patients, and a good predictive ability of CS by peripheral blood FGF23 levels. FGF23 may contribute to osteopenia in CS patients through FGFr3/TNAP/OPN pathway.
Impact of low-dose computed tomography screening on lung cancer incidence and outcomes
Authors: Vachani Anil , Caruso Christopher
Published: May 2023

Purpose of review

To review findings from clinical trials of lung cancer screening (LCS), assess contemporary issues with implementation in clinical practice, and review emerging strategies to increase the uptake and efficiency of LCS.

Recent findings

In 2013, the USPSTF recommended annual screening for individuals aged 55–80 years and currently smoke or quit within the past 15 years based on reduced mortality from lung cancer with annual low-dose computed tomography (LDCT) screening in the National Lung Screening Trial. Subsequent trials have demonstrated similar mortality outcomes in individuals with lower pack-year smoking histories. These findings, coupled with evidence for disparities in screening eligibility by race, resulted in updated guidelines by USPSTF to broaden eligibility criteria for screening. Despite this body of evidence, implementation in the United States has been suboptimal with fewer than 20% of eligible individuals receiving a screen. Barriers to efficient implementation are multifactorial and include patient, clinician, and system-level factors.

Multiple randomized trials have established that annual LCS reduces mortality from lung cancer; however, several areas of uncertainty exist on the effectiveness of annual LDCT. Ongoing research is examining approaches to improve the uptake and efficiency of LCS, such as the use of risk-prediction models and biomarkers for identification of high-risk individuals.
Incidence and risk factors for postoperative sore throat after general anesthesia with endotracheal intubation: prospective cohort study
Authors: Bekele Zenebe , Melese Zewde
Published: May 2023

Background:

Postoperative sore throat (POST) is a common, unpleasant, and upsetting complication of tracheal intubation that increases postoperative morbidity and causes patient dissatisfaction after general anaesthesia.

Objective:

To determine the prevalence and risk factors of POST following endotracheal intubation under general anaesthesia.

Materials and methods:

From 20 April to 20 May 2021, a multicenter prospective cohort study design and systematic random sampling were used to select study participants from patients over the age of 18 who underwent anaesthesia-assisted surgery with endotracheal intubation. A structured questionnaire was developed after reading some of the relevant literature. SPSS version 20 was used to enter and analyze the data, and binary logistic regression was used to select a variable for multivariable logistic regression. To identify statistically significant factors, a P value of 0.05 for the association between the independent and dependent variables was used in multivariable analysis.

Results:

Sore throat occurred in 94 (61.8%) of the 152 patients who had undergone surgery under general anaesthesia with endotracheal intubation. The size of the endotracheal intubation was found to have a p value of 0.04, (adjusted odds ratio 0.04, 95% CI 0.002–0.79), and the duration of the anaesthesia was found to have a p value of 0.003, (adjusted odds ratio 4.5, 95% CI 1.66–12.18). The POST was associated with a large endotracheal tube, patient age, and an extended period of anaesthesia in this study, with a prevalence of 94 (61.8%) cases.

Conclusion and recommendation:

In this study, the incidence of POST was high 94 (61.8%), large size endotracheal tube, patient age, and duration of anaesthesia were associated factors for POST. Awareness creation through training based on research findings should be made about the problem for all health professionals who were involved in postoperative patient care.
Understanding Moral Injury in Frontline Health Care Professionals 2 Years After the Onset of COVID-19
Authors: Sharma Maya Elizabeth , Cousins Rosanna
Published: May 2023

Throughout the COVID-19 pandemic, health care professionals have worked in morally challenging situations. The aim of this research was to investigate the predictors of moral injury in United Kingdom frontline health care professionals working in a variety of roles 2 years after the onset of the pandemic. A cross-sectional survey was conducted January 25–February 28, 2022. A total of 235 participants answered sociodemographic, employment, health, COVID-19–related questions, and the 10-item Moral Injury Symptom Scale–Healthcare Professional version. Nearly three quarters had experienced moral injury. Twelve significant predictors of moral injury were entered into a backward elimination binominal logistic regression. The final model included five independent predictors that explained 25.4% variance in moral injury (χ2 [5, N = 235] = 45.7, p < 0.001). Odds of moral injury were significantly raised in young health care professionals (<31 years), smokers, and those reporting low workplace confidence, not feeling appreciated, and feeling burned out. The findings support interventions to relieve moral injury in frontline health care professionals.
Abdominoplasty and Lower Body Lift Surgery Improves the Quality of Life after Massive Weight Loss: A Prospective Multicenter Study
Authors: Berkane Yanis , Saget François , Lupon Elise , Mocquard Camille , Pluvy Isabelle , Watier Eric , Lellouch Alexandre G. , Duisit Jérôme , Chaput Benoit , Bertheuil Nicolas
Published: May 2023

Background:

This study was conducted to assess the impact of abdominoplasty and lower body lift surgery following massive weight loss on both the general quality of life and the sexual life of patients.

Methods:

The authors performed a multicenter prospective study on the quality of life after massive weight loss using three scoring questionnaires: The Short-Form 36 questionnaire, the Female Sexual Function Index questionnaire, and the Moorehead-Ardelt Quality of Life Questionnaire. Seventy-two patients who underwent lower body lift and 57 patients who underwent abdominoplasty in three centers with preoperative and postoperative evaluation were included.

Results:

The mean age of the patients was 43.2 ± 13.2 years. All categories of the Medical Outcomes Study Short-Form 36 Health Status Survey questionnaire were statistically significant at 6 months, and all categories except health change were significantly improved at 12 months postoperatively. Overall, the Moorehead-Ardelt questionnaire showed a higher quality of life in general (1.78 ± 0.92 and 1.64 ± 1.03 at 6 and 12 months, respectively) and in all domains (ie, self-esteem, physical activity, social relationships, work performance, and sexual activity). Interestingly, global sexual activity improved at 6 months but not at 12 months. Some domains of sexual life improved at 6 months (ie, desire, arousal, lubrication, satisfaction), but only desire remained improved at 12 months.

Conclusions:

Abdominoplasty and lower body lift improve the quality of life of patients after massive weight loss and the sexual quality of life. This should be an additional valid reason for promoting reconstructive surgery for massive weight loss patients.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
A Novel Approach to Secondary Repair of the Unilateral Cleft Lip Nasal Deformity
Authors: Toriumi Dean M.
Published: May 2023

Management of the unilateral cleft lip nasal deformity is complex due to the underlying significant asymmetry of the lower lateral cartilages and soft tissues of the nasal base. Suturing and grafting techniques may leave the patient with residual asymmetries of the nasal tip and nostrils. Some of this residual asymmetry may be in part due to the “anchoring effect” of the vestibular skin attachments to the lower lateral cartilages. This paper discusses the use of lateral crural release, repositioning and support with lateral crural strut grafts to manage the nasal tip. The technique involves freeing the vestibular skin from the undersurface of the lateral crura and domes, placement of lateral crural strut grafts with or without amputation of the ipsilateral dome and lateral crura to allow precise re-suturing to the caudal septal extension graft. This technique is coupled with the use of a caudal septal extension graft to stabilize the nasal base and provide a strong foundation for the repair. Treatment of the nasal base may require skeletal augmentation to aid in creating symmetry of the alar insertions. Costal cartilage is needed in most cases to provide adequate structural support. Nuances in technique are discussed to help maximize outcomes.
Management of Acute Surgical Pain in Plastic and Reconstructive Surgery
Authors: Saffari Tiam M. , Saffari Sara , Brower Kristin I. , Janis Jeffrey E.
Published: May 2023

Less than half of all patients undergoing surgery report adequate postoperative pain relief. Poorly managed postoperative pain can lead to complications, increased hospital stays, prolonged rehabilitation and a decreased quality of life. Pain rating scales are commonly used to identify, manage and track the perceived intensity of pain. Changes in perceived pain severity and intensity are a key indicator for course of treatment. Postoperative pain is best treated with multimodal management, which is the use of a variety of analgesic medication and techniques that target different receptors and mechanisms of action in the peripheral and central nervous system. This includes systemic analgesia, regional analgesia, local analgesia (e.g. topical and tumescent analgesia), and non-pharmacological modalities. It is recommended that this approach is individually tailored and discussed through a shared decision-making approach. This review provides an overview of the multimodal management for acute postoperative pain related to plastic surgery procedures. To increase patient satisfaction and provide effective pain control, it is recommended to educate patients on expectations of pain, multimodal options for pain control (including peripheral nerve blocks), complications of unrelieved pain, tracking and monitoring of pain by self-reporting and how to safely reduce the use of opioid-based pain medication.
Health-related Quality of Life and Fatigue in Liver Transplant Recipients Receiving Tacrolimus Versus Sirolimus-based Immunosuppression: Results From a Randomized Trial
Authors: Mulder Midas B. , Busschbach Jan van , van Hoek Bart , van den Berg Aad P. , Polak Wojtek G. , Alwayn Ian P.J. , de Winter Brenda de C.M. , Verhey-Hart Elke , Erler Nicole S. , den Hoed Caroline M. , Metselaar Herold J.
Published: May 2023

Background.

The impact of different immunosuppression regimes on the health-related quality of life (HRQoL) and the severity of fatigue in liver transplant recipients is largely unknown. We investigated the impact of a sirolimus-based regimen compared with a tacrolimus (TAC)-based regimen on the HRQoL and the severity of fatigue.

Methods.

In this multicenter, open-label, randomized, controlled trial, 196 patients were randomized 90 d after transplantation to (1) once daily normal-dose TAC or (2) once daily combination therapy of low-dose sirolimus and TAC. HRQoL was measured with the EQ-5D-5L questionnaire, the EQ–visual analog scale, and the severity of fatigue questionnaire Fatigue Severity Score (FSS). The EQ-5D-5L scores were translated to societal values. We examined the HRQoL and the FSS over the course of the study by fitting generalized mixed-effect models.

Results.

Baseline questionnaires were available for 87.7% (172/196) of the patients. Overall, patients reported the least problems in the states of self-care and anxiety/depression and the most problems in the states of usual activities and pain/discomfort. No significant differences in HrQol and FSS were seen between the 2 groups. During follow-up, the societal values of the EQ-5D-5L health states and the patient’s self-rated EQ–visual analog scale score were a little lower than those of the general Dutch population in both study arms.

Conclusions.

The HRQoL and FSS were comparable in the 36 mo after liver transplantation in both study groups. The HRQoL of all transplanted patients approximated that of the general Dutch population, suggesting little to no residual symptoms in the long term after transplantation.
Wild gibbons plan their travel pattern according to food types of breakfast
Authors: Fei Hanlan , de Guinea Miguel , Yang Li , Garber Paul A. , Zhang Lu , Chapman Colin A. , Fan Pengfei
Published: May 2023

Planning for the future is a complex skill that is often considered uniquely human. This cognitive ability has never been investigated in wild gibbons (Hylobatidae). Here we evaluated the movement patterns from sleeping trees to out-of-sight breakfast trees in two groups of endangered skywalker gibbons (
Hoolock tianxing
). These Asian apes inhabit a cold seasonal montane forest in southwestern China. After controlling for possible confounding variables including group size, sleeping pattern (sleep alone or huddle together), rainfall and temperature, we found that food type (fruits or leaves) of the breakfast tree was the most important factor affecting gibbon movement patterns. Fruit breakfast trees were more distant from sleeping trees compared with leaf trees. Gibbons left sleeping trees and arrived at breakfast trees earlier when they fed on fruits compared with leaves. They travelled fast when breakfast trees were located further away from the sleeping trees. Our study suggests that gibbons had foraging goals in mind and plan their departure times accordingly. This ability may reflect a capacity for route-planning, which would enable them to effectively exploit highly dispersed fruit resources in high-altitude montane forests.
Walking bumblebees see faster
Authors: Rother Lisa , Müller Robin , Kirschenmann Erwin , Foster James J. , Kaya-Zeeb Sinan , Thamm Markus , Pfeiffer Keram
Published: May 2023

The behavioural state of animals has profound effects on neuronal information processing. Locomotion changes the response properties of visual interneurons in the insect brain, but it is still unknown if it also alters the response properties of photoreceptors. Photoreceptor responses become faster at higher temperatures. It has therefore been suggested that thermoregulation in insects could improve temporal resolution in vision, but direct evidence for this idea has so far been missing. Here, we compared electroretinograms from the compound eyes of tethered bumblebees that were either sitting or walking on an air-supported ball. We found that the visual processing speed strongly increased when the bumblebees were walking. By monitoring the eye temperature during recording, we saw that the increase in response speed was in synchrony with a rise in eye temperature. By artificially heating the head, we show that the walking-induced temperature increase of the visual system is sufficient to explain the rise in processing speed. We also show that walking accelerates the visual system to the equivalent of a 14-fold increase in light intensity. We conclude that the walking-induced rise in temperature accelerates the processing of visual information—an ideal strategy to process the increased information flow during locomotion.
Title of the article: Determination of MICs & Gene Mutations Among Fosfomycin Resistant Isolates of Asymptomatic Bacteriuria Cases During Pregnancy
Authors: Khatoon Sajda , Sultan Asfia , Khan Fatima , Khan Tamkin , Singh Anuradha
Published: May 2023

Purpose

Asymptomatic bacteriuria is a common finding during pregnancy. Effective antibiotic treatment could reduce its adverse effects during pregnancy. However, antimicrobial resistance limits the treatment options. Fosfomycin might be a promising drug in this regard, as its resistance is still low. The aim of the study was to determine the antimicrobial susceptibility pattern of Fosfomycin in isolates causing ASB by disc diffusion & agar dilution (in selected isolates), determine MIC by agar dilution in isolates testing resistant by disc diffusion and detect the genetic mutations responsible for fosfomycin resistance.

Material & Methods

This was a 2-year study (Nov. 2019 to Nov. 2021), carried in Department of Microbiology. Total 10252 urine samples from asymptomatic pregnant females (18-45 years) attending the antenatal care OPD were submitted. Identification of pathogen & AST was done as per standard methods. Phenotypic detection of Methicillin resistant S. aureus(MRSA), High level aminoglycoside resistance(HLAR), Vancomycin resistant Enterococci(VRE) & Carbapenem resistant Enterobacterales(CRE) etc. was done. Isolates were randomly tested by agar dilution. Conventional PCR was done for murA, fosA, uhpT & glpT genes on all the isolates resistant to fosfomycin by disc diffusion & agar dilution.

Result

In this study, the prevalence of ASB among pregnant females was around 1173(11.4%), in which E. coli 495(42%) being the predominant organism. CRE & MRSA accounted for 296(40%) & 50(66.6%) respectively. Fosfomycin was sensitive in all MRSA isolates. On agar dilution, 3 isolates showed MIC of 256µg/ml, 2 isolates showed MIC 1024µg/ml & rest with MICs >2048µg/ml. On PCR, murA & glpT genes were detected in 5 & 4 GN isolates respectively, while only 1 GP isolate was positive for fosA gene.

Conclusion

Our study revealed more of chromosomally mediated resistance to fosfomycin than transferrable (plasmid mediated). There was no discrepancy between the results of disk diffusion and agar dilution.
A Bayesian System to Track Outbreaks of Influenza-Like Illnesses Including Novel Diseases
Authors: Aronis John M. , Ye Ye , Espino Jessi , Hochheiser Harry , Michaels Marian G. , Cooper Gregory F.
Published: May 2023

It would be highly desirable to have a tool that detects the outbreak of a new influenza-like illness, such as COVID-19, accurately and early. This paper describes theILI Trackeralgorithm that first models the daily occurrence of a set of known influenza-like illnesses in a hospital emergency department using findings extracted from patient-care reports using natural language processing. We include results based on modeling the diseases influenza, respiratory syncytial virus, human metapneumovirus, and parainfluenza for five emergency departments in Allegheny County Pennsylvania from June 1, 2010 through May 31, 2015. We then show how the algorithm can be extended to detect the presence of an unmodeled disease which may represent a novel disease outbreak. We also include results for detecting an outbreak of an unmodeled disease during the mentioned time period, which in retrospect was very likely an outbreak of Enterovirus D68.
Factors Associated with Maintenance of an Improved Ejection Fraction: An Echocardiogram-based Registry Study
Authors: McElderry Brenna , O’Neill Thomas , Griffin Brian P. , Kalahasti Vidyasagar , Barzilai Benico , Brateanu Andrei
Published: May 2023

Background

Heart failure with improved ejection fraction (HFimpEF) is increasingly recognized as a sizable and distinct entity. While the features associated with improved ejection fraction have been explored and new guidelines have emerged, factors associated with sustaining an improved ejection fraction over time have not been defined.

Objective

We aimed to assess factors associated with maintenance of an improved ejection fraction in a large real-world patient cohort.

Methods

A total of 7,070 participants with heart failure with improved ejection fraction and a subsequent echocardiogram (ECHO) performed after at least nine months of follow-up were included in a retrospective study conducted at the Cleveland Clinic in Cleveland, OH. Multiple logistic regression models, adjusted for demographics, comorbidities, and medications were built to identify characteristics and therapeutic interventions associated with maintaining an improved ejection fraction.

Results

Mean age (SD) was 64.9 (13.8) years, 62.7% were men, and 75.1% were White. White race and the use of angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, or angiotensin receptor-neprilysin inhibitors were correlated with maintaining the ejection fraction at least nine months after ejection fraction improvement. In contrast, male sex, or having atrial fibrillation/flutter, coronary artery disease, history of myocardial infarction, presence of an implanted cardioverter defibrillator, and use of loop diuretics were correlated with a decline in ejection fraction after previously documented improvement.

Conclusion

Continued use of renin-angiotensin aldosterone system inhibitors was associated with maintaining the ejection fraction beyond the initial improvement phase.