bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Nutritional Status on Chemotherapy Related Digestive Toxicity in Women With Breast Cancer
Authors: Olfa Berriche , Salma Mohsen , Othman Rym Ben , Mansour Hajer Ben , Houyem Khiari , Henda Jamoussi , Amel Mezlini
Published: November 2024

Introduction:

Any alteration in nutritional status can compromise the progression of breast cancer, as well as the tolerance and efficacy of chemotherapy. The aims of our study were to assess the nutritional status of breast cancer patients treated with chemotherapy and to identify nutritional factors that may exacerbate chemo-induced digestive toxicity.

Methods:

This descriptive cross-sectional study was conducted within the medical oncology department of the National Institute of Salah Azaiez. A Mediterranean Diet Score (MDS) was used to evaluate the level of adherence to the Mediterranean Diet. Nutritional status was assessed using 2 methods; body composition evaluation utilising the TANITA BC 601 impedance metre and High authority of health (HAS) criteria of malnutrition. Digestive effects were assessed with World Health Organization (WHO) grades ranging from 0 to 4. High grades 3 and 4 signified toxic grades.

Results:

We enrolled 107 adult women diagnosed with breast cancer undergoing the same chemotherapy protocol. The participants had an average age of 52.56 ± 9.75 years and an average BMI of 29.85 ± 5.72 kg/m2 with 78.5% classified as overweight. Malnutrition was observed in 41% of patients, while sarcopenia was present in 12%. Chemotherapy-related adverse effects were predominantly constipation (80%), diarrhea (73%), nausea (70%) and vomiting (63.4%) with one-third experiencing high-grade toxicity. Strong adherence to Mediterranean Diet was observed in 48.6% of cases and higher MDS scores were inversely correlated with the severity of nausea ( P = .01) and constipation ( P = .02). Malnutrition was significantly associated with all digestive toxicities except with constipation. Sarcopenia was associated only with vomiting ( P = .005).

Conclusion:

There is a relationship between nutritional status and digestive toxicity, justifying early nutritional treatment to improve the tolerance and efficacy of chemotherapy.
Thoracic Endovascular Aortic Repair For The Management of Aorto-Esophageal Fistulae: A Systematic Review
Authors: Wang Changtian , Xi Zhilong , von Segesser Ludwig K. , Pozzoli Alberto , Ferrari Enrico
Published: November 2024

Objective:

Aorto-esophageal fistula (AEF) is a rare condition consisting in a fistula between the aorta and the esophagus. The thoracic endovascular aortic repair (TEVAR) has become an accepted treatment for initial AEF management, but large series are not available and outcomes are questionable. This study aims at evaluating the current evidence of TEVAR in AEF.

Methods:

A search on PubMed/MEDLINE and EMBASE was conducted up to June 2023. Data on article type, patients’ demographics, cause and type of AEF, clinical presentation, time from clinical presentation to TEVAR, strategies, mortality, and follow-up were analyzed.

Results:

106 reports published between 1997 and 2023 were deemed eligible for this study (92 case reports; 14 case-series). A total of 163 patients (mean age: 58.9±16.5 years), diagnosed with AEF and treated with TEVAR (with or without staged surgical repair of the esophagus or the aorta) were included. A thoracic aortic aneurysm (34.4%) was the most common cause of AEF, followed by esophageal cancer (25.2%), foreign body in esophagus (13.5%) and post-TEVAR complication (9.8%). Primary AEF were 129 (79.1%), and secondary AEF were 34 (20.9%). TEVAR alone was performed 80 times (49.1%), while TEVAR with staged esophageal or aortic surgery 83 times (50.9%). The overall 30-day mortality was 11.7% (n=19): 18.8% in TEVAR alone and 4.8% in TEVAR with staged surgery, respectively (p=0.006). Mean follow-up time was 12.3±14.7 months. The overall 6-month mortality was 34.4% (n=56): 48.8% in TEVAR alone and 20.5% in TEVAR with staged surgery (p<0.001). Bleeding for recurrence of AEF and sepsis were the main causes of death.

Conclusions:

In case of AEF, TEVAR can be urgently performed for bleeding management and hemodynamic control. TEVAR alone is a valuable yet not definitive procedure. Instead, TEVAR followed by surgical repair may provide better outcomes and should be recommended, when possible.

Clinical Impact

This review summarizes the published papers on endovascular aortic repair for the treatment of aorto-esophageal fistulae. The clinicians can find several important details on how to manage the presence of an esophageal fistulae wich represents a potential life-threatening problem for the patients. The implantation of a thoracic endovascular aortic prosthesis represents a fast and reliable procedure in case of emergency but a second step surgical repair provides better outcomes and should be recommended in suitable patients.
The Super-Turbocharged End-to-Side Abductor Digiti Minimi and Anterior Interosseous Double Nerve Transfer Is Associated With Improved Ulnar Intrinsic Function
Authors: Chi David , Orr Jonah , Johnson Anna Rose , Llaneras Noah , Jacobson Lauren , Peters Blair R. , Patterson Megan M. , Mackinnon Susan E.
Published: November 2024

Background:

Nerve transfers to reinnervate ulnar intrinsic musculature can restore function in severe ulnar neuropathy, and supercharged end-to-side (SETS) nerve transfers have garnered early adoption. Given the relative expendability of the abductor digiti minimi (ADM), redirecting its axons to more critical components of the ulnar motor nerve (UMN) in a turbocharged end-to-side (TETS) nerve transfer with concomitant anterior interosseous SETS nerve transfer (AIN) as a super-turbocharged end-to-side (STETS) or twin-charged double nerve transfer may improve functional recovery.

Methods:

A retrospective study of patients undergoing the STETS AIN/ADM to UMN double nerve transfer or TETS ADM to UMN nerve transfer for severe ulnar neuropathy between 2020 and 2022 was performed. Primary outcomes were improvement in first dorsal interosseous (FDI) strength and Disabilities of the Arm, Shoulder, and Hand (DASH) scores. Dichotomous and continuous variables were compared with χ2 and t tests, respectively.

Results:

Fifty patients with severe ulnar nerve injuries were identified with at least 1-year surgical follow-up. Preoperative symptom duration was an average of 11.3 months. The STETS cohort (n = 42) reported significantly decreased DASH scores from 58 to 28 ( P < .001) and improved FDI Medical Research Council (MRC) score from 0.7 to 3.3 ( P < .001). The TETS cohort (n = 8) reported significantly decreased DASH scores from 54 to 23 ( P = .016) and improved FDI MRC score from 2.0 to 3.6 ( P = .008).

Conclusions:

Distal transfer of the ADM nerve to the ulnar deep motor branch in a turbocharged fashion is reported. The findings suggest that the STETS double nerve transfer may improve patient outcomes and warrants further investigation with prospective cohort studies.
Short-term effectiveness and safety of ustekinumab and vedolizumab in elderly and non-elderly patients with Crohn’s disease: a comparative study
Authors: Dar Lior , Shani Uria , Dotan Arad , Ukashi Offir , Ben-Horin Shomron , Kopylov Uri , Levartovsky Asaf
Published: November 2024

Background:

Inflammatory bowel disease (IBD) presents unique challenges in elderly patients due to comorbidities and treatment-related risks.

Objectives:

This study evaluates ustekinumab (UST) and vedolizumab (VDZ) efficacy and safety in elderly Crohn’s disease (CD) patients.

Design:

A retrospective cohort study at a tertiary medical center.

Methods:

CD patients aged ⩾60 years (elderly) treated with UST, compared to non-elderly (<60 years) patients treated with UST and elderly patients treated with VDZ. Clinical response was evaluated using the Harvey–Bradshaw index (HBI) and clinical biomarkers, alongside monitoring steroid use, hospitalization rates, treatment persistence, and surgical interventions.

Results:

The study included 166 CD patients: 32 elderly and 65 non-elderly patients treated with UST, and 69 elderly patients treated with VDZ. The mean duration of follow-up was 10.8 ± 2.8 months in the non-elderly group, 9.97 ± 3.28 months in the elderly UST group, and 10.0 ± 3.29 months in the VDZ group. Elderly UST patients were more likely to receive corticosteroids at initiation than non-elderly UST patients (44% vs 14%, p = 0.001). At 12 months, clinical response rates did not significantly differ between elderly and non-elderly UST groups, respectively (48% vs 40%, p = 0.5). However, elderly UST patients exhibited higher hospitalization rates over time compared to non-elderly UST patients (6-month: 19% vs 6.2%, p = 0.077; 12-month: 19% vs 4.6%, p = 0.055; log-rank p = 0.004). No significant differences were observed in clinical response and remission rates between elderly UST and elderly VDZ patients at 6 and 12 months. At 6 months, a higher hospitalization rate was observed in the UST group (19% vs 4.3% p = 0.027), but this difference did not persist over time.

Conclusion:

UST and VDZ are effective and safe treatments for elderly CD patients, despite higher hospitalization rates compared to non-elderly patients, likely due to age-related complications.
Global Utilization of Online Information for Anxiety Disorders From 2004 to 2022: An Infodemiological Study of Google and Wikipedia
Authors: Alibudbud Rowalt
Published: November 2024

The utilization of online information can be used as a measure of public concern and interest. It can be explored to institute, inform, and innovate mental health promotion and strategies in addressing the ever-increasing prevalence of anxiety disorders across the globe. As such, this infodemiological study described and analyzed the public utilization of online information for anxiety disorders using relative search volumes (RSV), top and rising related queries and topics from Google Trends, and Wikipedia page views. After describing the data, autoregressive integrated mean averaging (ARIMA) models were employed to predict future RSVs and page views. Results show that RSVs for anxiety disorders have increased over the years and will further increase in succeeding years, while the use of Wikipedia information for anxiety disorders is declining. Top and rising search-related queries and topics primarily revolved around anxiety disorder concepts, management, manifestations, types, etiology, diagnostics, social consequences, and related mental disorders. Based on the search volumes, public utilization of online information about anxiety disorders has increased and will further increase in the coming years. They can be explained by the rising rates of anxiety disorder and the higher internet access across the globe. As such, the Internet is a promising medium for mental health promotion, prevention, and intervention strategies. Moreover, trustworthy and reliable online information about anxiety disorders is ever-crucial in this age of information and disinformation.
Unlocking the Power of Cash Reserves: How Managerial Ability Shapes Firm Performance
Authors: Ali Farman , Ahmad Hassan , Ali Imran
Published: November 2024

Growing literature on cash holding and managerial ability provides the idea of studying these two concepts in the context of the same model. The effect of cash holding on firm performance is established in this study, which also looked at the moderating effect of managerial ability on the direct relationship between cash holding and firm performance—analyzing 2,858 Chinese non-financial firms, we employ OLS, fixed effect, and robust standard error regression to test the formulated hypotheses. We employ several additional tests to confirm the robustness of our findings. This study offers compelling evidence that managerial ability significantly impacts the relationship between cash holding and firm performance. We show that cash holdings boost the operating performance of firms with exceptional managers. Therefore, managerial expertise is essential when considering the cash and performance relationship. Prior studies focus on the direct relationship between cash holdings and firm performance. However, managerial ability, which is a crucial factor and an effect that affects this relationship, is overlooked. This study shows that firms with highly able managers boost their performance by holding more cash.
Trends in Ulnar Collateral Ligament Injuries and Surgery From 2010 to 2019: An Analysis of a National Medical Claims Database
Authors: Solomito Matthew J. , Kostyun Regina O. , Sabitsky Joshua T. , Nissen Carl W.
Published: November 2024

Background:

Ulnar collateral ligament (UCL) injuries have been on the rise for the past 3 decades. Current epidemiological studies on the incidence of UCL injuries have been limited to state or regional data.

Purpose:

To utilize a large national claims database to determine the rates of UCL injuries and UCL surgical procedures over the past decade (2010-2019) and whether there has been a change in UCL surgical procedure patterns in the United States.

Study Design:

Descriptive epidemiology study.

Methods:

The PearlDiver patient claims database was used to identify UCL injuries occurring from 2010 and 2019 that were sustained by male patients between 10 and 34 years of age. The study cohort was divided into 5 age groups (10-14, 15-19, 20-24, 25-29, and 30-34 years). Primary outcomes included the number of patients in each age group who sustained a UCL injury, the number of patients in each age group who underwent surgery, and the mean time from injury to surgery.

Results:

A total of 19,348 UCL injuries occurred between 2010 and 2019, and 13% required a surgical intervention. Most of the injuries (54%) occurred in the 15- to 19-year group. Patients in the 20- to 24-year group were more likely to undergo surgery versus the 15- to 19-year group. Results demonstrated a trend toward delayed surgical interventions in patients in the 20- to 24-year group in the latter part of the decade.

Conclusion:

Data suggested that male patients <20 years account for the majority of UCL injuries, while male patients aged between 20 and 24 years are most likely to undergo surgery. Despite a number of targeted injury-prevention strategies and rule changes in sports, the UCL injury rate remained high. Therefore, there is a clear and present need to continue to develop UCL injury-prevention strategies for the younger population.
Determinants of Multidimensional Poverty: A Study of the Rural District of Madhya Pradesh
Authors: Septa Divya , Acharya Rekha , Dhanora Madan
Published: November 2024

In this study, we estimate the determinants of multidimensional poverty in the rural district of Madhya Pradesh, India. The dependent variable is the multidimensional poverty index, a dummy variable based on the deprivation score of households. The probit model is utilised to analyse the model. The results of this study reveal that income, education, and occupation are significant determinants of multidimensional poverty in rural areas. We further classified the dependent variable into poverty and extreme poverty based on deprivation scores and analysed the results. We find that income, age of the household head, and education are significant determinants of extreme poverty. We also utilised OLS estimation and ordered a probit model for robustness checks in this study. These results are also at par with probit estimation. This study helps to understand the cause and dynamics of rural multidimensional poverty in Madhya Pradesh.
FUT8 upregulates CD36 and its core fucosylation to accelerate pericyte-myofibroblast transition through the mitochondrial-dependent apoptosis pathway during AKI-CKD
Authors: Shang Yaxi , Wang Ziran , Yang Fan , Wang Weidong , Tang Qingzhu , Guo Xianan , Du Xiangning , Zhang Xu , Hao Jiaojiao , Lin Hongli
Published: November 2024

Background

Activation of pericytes leads to renal interstitial fibrosis, but the regulatory mechanism of pericytes in the progression from AKI to CKD remains poorly understood. CD36 activation plays a role in the progression of CKD. However, the significance of CD36 during AKI-CKD, especially in pericyte, remains to be fully defined.

Methods

GEO and DISCO database were used to analyze the expression of CD36 in pericyte during AKI-CKD; IRI to conduct AKI-CKD mouse model; Hypoxia/Reoxygenation (H/R) to induce the cell model; RT-qPCR and Western blotting to detect gene expression; IP and confocal-IF to determine the core fucosylation (CF) level of CD36. Flow cytometry (AV/PI staining) to detect the cell apoptosis and JC-1 staining to react to the change of mitochondrial membrane potential.

Results

During AKI to CKD progression, CD36 expression in pericytes is higher and may be influenced by CF. Moreover, we confirmed the positive association of CD36 expression with pericyte-myofibroblast transition and the progression of AKI-CKD in an IRI mouse model and hypoxia/reoxygenation (H/R) pericytes. Notably, we discovered that FUT8 upregulates both CD36 expression and its CF level, contributing to the activation of the mitochondrial-dependent apoptosis signaling pathway in pericytes, ultimately leading to the progression of AKI-CKD.

Conclusion

These results further identify FUT8 and CD36 as potential targets for the treatment in the progression of AKI-CKD.
Chromosome-level genome assemblies and genetic maps reveal heterochiasmy and macrosynteny in endangered Atlantic Acropora
Authors: Locatelli Nicolas S. , Kitchen Sheila A. , Stankiewicz Kathryn H. , Osborne C. Cornelia , Dellaert Zoe , Elder Holland , Kamel Bishoy , Koch Hanna R. , Fogarty Nicole D. , Baums Iliana B.
Published: November 2024

Background

Over their evolutionary history, corals have adapted to sea level rise and increasing ocean temperatures, however, it is unclear how quickly they may respond to rapid change. Genome structure and genetic diversity contained within may highlight their adaptive potential.

Results

We present chromosome-scale genome assemblies and linkage maps of the critically endangered Atlantic acroporids, Acropora palmata and A. cervicornis. Both assemblies and linkage maps were resolved into 14 chromosomes with their gene content and colinearity. Repeats and chromosome arrangements were largely preserved between the species. The family Acroporidae and the genus Acropora exhibited many phylogenetically significant gene family expansions. Macrosynteny decreased with phylogenetic distance. Nevertheless, scleractinians shared six of the 21 cnidarian ancestral linkage groups as well as numerous fission and fusion events compared to other distantly related cnidarians. Genetic linkage maps were constructed from one A. palmata family and 16 A. cervicornis families using a genotyping array. The consensus maps span 1,013.42 cM and 927.36 cM for A. palmata and A. cervicornis, respectively. Both species exhibited high genome-wide recombination rates (3.04 to 3.53 cM/Mb) and pronounced sex-based differences, known as heterochiasmy, with 2 to 2.5X higher recombination rates estimated in the female maps.

Conclusions

Together, the chromosome-scale assemblies and genetic maps we present here are the first detailed look at the genomic landscapes of the critically endangered Atlantic acroporids. These data sets revealed that adaptive capacity of Atlantic acroporids is not limited by their recombination rates. The sister species maintain macrosynteny with few genes with high sequence divergence that may act as reproductive barriers between them. In the Atlantic Acropora, hybridization between the two sister species yields an F1 hybrid with limited fertility despite the high levels of macrosynteny and gene colinearity of their genomes. Together, these resources now enable genome-wide association studies and discovery of quantitative trait loci, two tools that can aid in the conservation of these species.
Characterization of the sex determining region and development of a molecular sex identification method in a Salangid fish
Authors: Yang Hao , Li Yu-Long , Xing Teng-Fei , Liu Jin-Xian
Published: November 2024

Background

The short-snout icefish, Neosalanx brevirostris, a member of the Salangidae family, is an economically important fishery species in China. Understanding the mechanisms underlying sex determination in this species has crucial implications for conservation, ecology and evolution. Meanwhile, there is a shortage of rapid and cost-effective genetic methods for sex identification, which poses challenges in identifying the sex of immature individuals in sex determination mechanism studies and aquaculture breeding applications.

Results

Based on whole genome resequencing data, sex-specific loci and regions were found to be concentrated in a region on chromosome 2. All sex-specific loci exhibited excess heterozygosity in females and complete homozygosity in males. This sex determining region contains seven genes, including cytochrome P450 aromatase CYP19B, which is involved in steroidogenesis and is associated with 24 sex-specific loci and two W-deletions. A haploid female-specific sequence was identified as paralogous to a diploid sequence with a significant length difference, making it suitable for rapid and cost-effective genetic sex identification by traditional PCR and agarose gel electrophoresis, which were further validated in 24 females and 24 males with known phenotypic sexes.

Conclusions

Our results confirm that N.brevirostris exhibits a female heterogametic sex determination system (ZZ/ZW), with chromosome 2 identified as the putative sex chromosome containing a relatively small sex determining region (~ 48 Kb). The gene CYP19B is proposed as a candidate sex determining gene. Moreover, the development of PCR based method enables genetic sex identification at any developmental stage, thereby facilitating further studies on sex determination mechanisms and advancing aquaculture breeding applications for this species.
Bioinformatics designing of an mRNA vaccine for Mokola virus (MOKV) using immunoinformatics as a secure strategy for successful vaccine development
Authors: Oladipo Elijah Kolawole , Ogunniran James Akinwumi , Akinpelu Oluwaseyi Samuel , Omole Tosin Omoboyede , Adeyemo Stephen Feranmi , Irewolede Boluwatife Ayobami , Iwalokun Bamidele Abiodun , Ajani Olumide Faith , Onyeaka Helen
Published: November 2024

The Mokola Virus belongs to the family Rhabdoviridae and is genotype 3 of the Lyssavirus genera. A small number of cases of animal and human encephalomyelitis, mainly scattered over sub-Saharan Africa, have been linked to the Mokola Virus (MOKV). Currently there is no vaccine to protect against MOKV infection in people or animals. It has been proven that rabies vaccination does not confer immunity against MOKV infection, even though MOKV and the rabies virus are related. Using immunoinformatics approaches, this study designed an mRNA vaccine that can protect against all the five glycoproteins of the Mokola virus. NCBI was used to obtain the viral sequences, which were then screened for antigenicity, allergenicity, toxicity, B-cell epitopes, CD8 + T lymphocytes (CTL), and CD4 + T lymphocytes (HTL). These epitopes were used in the construction of the vaccine. Some extra co-translational residues were added to the mRNA vaccine construct. Its molecular weight is 129.19083 kDa, and its estimated pI is 8.58. It interacts rather steadily and with limited deformability with TLR 3, among other human innate immune receptors. Overall, the results show that the produced candidate vaccine is non-allergen, non-toxic, and can elicit T–cell and B–cell immune responses. These findings can further be subjected to in-vivo and in-vitro techniques for validation.
Urban slum housing quality, and its public health implications in Nigeria: a case of urban slum residents in Enugu metropolis, South East, Nigeria
Authors: Ogbonna Salomey N. , Ochie Casmir N. , Aniwada Elias C.
Published: November 2024

Introduction

Housing remains a strategic social determinant of health. In Sub-Saharan Africa, most urban dwellers live in slums with attendant health implications. This study assessed the housing conditions of the slums of Enugu metropolis and the public health implications.

Methods

This is a community-based cross-sectional study of 459 slum residents of the Enugu metropolis. Ethical clearance was obtained from the UNTH, Health Research Ethics Committee (HREC). Data was collected using a pretested semi-structured interviewer-administered questionnaire and an observational checklist. Data was analysed using IBM SPSS version 23. Data were summarised using mean and standard deviation, frequency and proportion as appropriate and presented in tables and figures. The chi-square test was used for association at p-value ≤ 0.05 significance.

Results

The mean age (SD) of the respondents was 32.93(12.34) years. A higher proportion (N = 180, 39.2%) were 18-27years, females (N = 282, 61.4%), married (N = 297, 64.7%), attained secondary education (N = 273, 59.5%), Igbo (N = 453, 98.7%), and self-employed (N = 327, 71.2%). They demonstrated good knowledge of standard housing specifications (N = 231, 50.3%) and the effects of housing conditions on health (N = 297, 64.7%). Also, most lived in a one-room apartment (N = 201, 43.8%) and cooked in a separate kitchen (N = 150, 32.7%) with a gas cooker as the major source of heat supply for cooking (N = 249, 54.2%). Sixty-three (13.7%) of the respondents didn’t have access to suitable toilet facilities. A higher proportion, (N = 171, 37.3%) used pipe-borne water, and electricity as the major source of light (N = 447, 97.4%). The most prevailing health condition was malaria/fever (N = 258, 97.4%). Despite having pests and rodents-infested dwellings, only (N = 156, 34.0%) had insecticides in the house. Equally, (N = 132, 28.8%) of them lived with broken floors.

Conclusions

Despite good knowledge of the public health implications of poor housing, most dwellings remained substandard and unhealthful with associated prevalent health conditions.

Recommendation

There is a need for a health campaign against the poor living conditions in the slums.
The use of contracts to implement and manage healthy vending: best practice recommendations for effective and sustained interventions
Authors: Dancey Jane , Reeve Belinda , Jones Alexandra , Brimblecombe Julie
Published: November 2024

Background

Contracts can be an effective lever to implement and manage health-enabling food retail environments. However, guidance for the effective use of contracts in food retail settings is limited. The use of contracts to create healthy food vending environments is one area where policy attention has been focussed in high income countries. We applied a public health regulatory framework to publicly available guidance documents on healthy vending to develop best practice recommendations for using contracts to create healthy food vending environments.

Methods

Document analysis involved i) snowball sampling to identify eligible publicly available healthy vending guidance documents from an identified seed paper; ii) application of a public health regulatory framework to extract data across three domains of form, substance and governance of healthy vending initiatives; and iii) synthesis of data to form best practice recommendations. Eligible documents were those aimed at implementing healthier vending; published from 2000 onwards; accessible online; and included recommendations beyond nutrition standards alone, including a reference to at least one regulatory governance process (administration, implementation, monitoring, enforcement or review).

Results

Twelve of 92 documents identified were eligible and all were from the United States (US). All noted that products need to comply with nutrition standards. Other aspects of regulatory substance (i.e., pricing, promotion, placement, labelling and contract length) were less well considered as were elements of regulatory governance (regulatory rules, administration, implementation, monitoring, enforcement and review). Our adapted framework covers three regulatory domains with nine components, and a further 20 recommendations for best practice application in healthy vending.

Conclusions

To be effective, contracts used to manage healthy food vending should include more than the nutrition standards for healthy food and drinks. Clearly stating the contract objectives, operative terms and conditions, and defining responsibilities for monitoring, review and enforcement within the contract, in addition to the nutrition standards, will assist practitioners in creating effective and sustained contract-based initiatives aimed at improving the healthiness of vending, or potentially other food retail environments.
Definition of a measurement technique for hexapod circular smart fixators' perioperative assembly parameters and investigation of alignment and correlation with postoperative measurements: a retrospective cohort study
Authors: Kanar Muharrem , Sülek Yusuf , Seymenoğlu Tolga Hayrettin , Armağan Raffi
Published: November 2024

Background

With the assistance of smart fixator technologies, the correction of complex deformities has been facilitated; however, the accurate integration of specialized radiographs and measurements into the system remains the greatest disadvantage, necessitating specialized imaging and an experienced team. When inexperienced technicians and doctors perform these specialized postoperative radiographs, excessive exposure of the patient and team to radioactive rays exacerbates inadequacies in measurements and delays the correction of residual deformities due to angular and translational adjustments. In this study, we compared postoperative measurements with those taken peroperatively via fluoroscopy, hypothesizing that it reduces the exposure of the patient and team to radioactive rays, allows for more accurate and timely correction of deformities and assembly parameters, and reduces time and costs.

Methods

Between 2013 and 2022, 84 patients with bone deformities were retrospectively reviewed. All patients had bone deformities and were treated with computer-assisted circular external fixator systems (Ca-CEF). Assembly parameter measurements began to be corrected via artificial neural network software via peroperative fluoroscopy in 37 patients and postoperative radiography in 47 patients. The surgical duration for all patients, peroperative measurement values, and number of radiographs taken on postoperative day 1, week, and month until deformity correction were recorded.

Results

The duration until deformity correction was shorter in patients who underwent postoperative measurements (mean 50.24 days) than in those who underwent peroperative measurements (mean 42.31 days), but this difference was not statistically significant (p = 0.102). The surgical duration was significantly shorter in patients with postoperative measurements (mean of 130.37 min) than in those with peroperative measurements (mean of 155.88 min) (p = 0.045).

For patients with postoperative measurements, 56.04 postoperative radiographs were taken. In contrast, patients with peroperative measurements had fewer radiographs totaling 28.7. This difference was statistically significant (p < 0.01). There was no statistically significant difference in the fluoroscopy dose between patients with postoperative measurements (mean 18.54 mGy) and those with peroperative measurements (mean 22.22 mGy) (p = 0.105).

Conclusion

To achieve accurate assembly parameters, minimizing X-ray exposure is crucial but can pose challenges. Our results showed that despite an average increase of 25 min in surgical duration, the time taken for deformity correction was shorter. Additionally, we obtained fewer postoperative radiographs, indicating reduced radiation exposure.
Integrating dermatologists in primary care: impact on delays, patient and professional experiences
Authors: Lovén Maria , Eklund Amanda , Huilaja Laura , Paananen Markus , Torkki Paulus
Published: November 2024

Background

Primary healthcare centres are burdened by the management of patients with skin conditions, while general practitioners might lack the expertise to assess skin changes accurately. The traditional care chain for skin findings is a multistage process that can cause delayed diagnosis and treatment, distressing the patient.

This study aimed to determine whether adding a dermatologist to the primary care team would streamline the care pathway of patients with skin conditions, while examining levels of satisfaction among patients and healthcare professionals.

Methods

A quasi-experimental multicentre study was conducted in three primary health centres in Finland. A dermatologist was integrated into two of the centres (intervention) but not the third (control). Data on timing of diagnosis and treatment and number of contacts were collected from records and analysed per care path. The Patient Enablement Instrument (PEI) and Net Promoter Score (NPS) were used to measure the patient’s experience of the appointment. NPS and professional satisfaction queries were used to measure professional satisfaction.

Results

In total 186 intervention and 176 control patients were included, with 38 primary care professionals. Compared with the control group, the intervention group showed a significantly shorter time to confirmed diagnosis and to treatment start (25 vs. 49 days, p < 0.001), with a higher proportion (49% vs. 27%, p < 0.001) receiving immediate treatment in the primary care setting. Patients in the intervention group required fewer visits. Patient experience by PEI and NPS scores were higher in the intervention group (p ≤ 0.022 for each). Satisfaction levels among professionals in both groups were higher after the intervention than before, although the NPS score did not improve significantly in the control group. Almost all professionals advocated for the continuation of the integrated care pathway.

Conclusions

The integration of dermatologists into the primary care streamlined the management of skin conditions from diagnosis to treatment, while improving the experiences of both patients and healthcare professionals. This integrated care path is beneficial for the management of patients with skin findings in primary care.
Negotiating care in organizational borderlands: a grounded theory of inter-organizational collaboration in coordination of care
Authors: Hedqvist Ann-Therese , Lindberg Catharina , Hagerman Heidi , Svensson Ann , Ekstedt Mirjam
Published: November 2024

Background

Although coordination of care and integrated care models aim to enhance patient satisfaction and perceived care quality, evidence regarding their practical implementation remains scarce. Understanding the nuances of collaboration across care providers to achieve effective coordination of care is imperative for seamless care integration. The aim of this study was to construct a grounded theory of how inter-organizational collaboration is performed to support coordination of care for patients with complex care needs.

Methods

A qualitative design with a constructivist grounded theory approach was applied. In total, 86 participants with diverse backgrounds were recruited across multiple care settings, including hospitals, ambulance services, primary care centers, municipal home healthcare and home care services. The grounded theory was developed iteratively, based on a combination of observations and interviews, and using constant comparative analysis.

Results

Coordination of care, a complex process that occurs across interconnected healthcare organizations, is manifested as “Negotiating care in organizational borderlands.” Care coordination evolves through a spectrum of inter-organizational collaboration, ranging from “Dividing care by disease-specific expertise” to “Establishing paths for collaboration” and ultimately “Co-constructing a comprehensive whole.” These categories highlight the challenges of coordinating care across both professional and organizational boundaries. In the multifaceted healthcare landscape, effective care coordination occurs when healthcare professionals actively bridge the divides, leveraging their collective expertise. Importantly, organizational boundaries may serve a purpose and should not be dissolved to facilitate effective care coordination.

Conclusions

The key to effective care coordination lies in robust inter-organizational collaboration. Even when patients receive integrated care, healthcare professionals may have fragmented roles. This research emphasizes the importance of clearly defined lines of accountability, reinforcing mutual responsibility and facilitating bridging of professional and organizational boundaries. Healthcare professionals and policymakers can use these insights to effectively utilize inter-organizational collaboration in supporting care coordination for patients with complex care needs.
What happens to old insecticide-treated nets after households use in Burkina Faso?
Authors: Hien Aristide S. , Hien Hervé , Bacyè Fidèle Y. , Badolo Herman , Tiono Alfred , Diallo Cheick O. , Somda Serge M.A. , Bazié Herman , Guira Matilibou , Meda Nicolas
Published: November 2024

Background

Insecticide-treated nets (ITNs) are the most commonly deployed tools for controlling malaria transmission in sub-Saharan Africa. However, some reports associate multiple alternative uses of nets with poor disposal practices, prompting this study to assess existing alternative uses and disposal practices of old ITNs in Burkina Faso after four universal distribution campaigns.

Methods

A quantitative survey combined with qualitative data collection was used to describe existing alternative uses and disposal practices for old ITNs in households from selected study sites in the three climatic zones of Burkina Faso. A survey questionnaire was distributed to 3,780 participants, and 12 focus groups were held to elucidate responses regarding existing disposal practices and alternative uses of ITNs.

Results

Of the 3780 households surveyed, 87.4% (3,330) reported having disposed of their ITNs when they were no longer usable due to age or wear. The most commonly cited disposal methods included alternative uses (67.4%), disposal with other garbage (61.4%), and burying (9%). In addition, the most common alternative uses included fencing for crops and seedlings (51.8%); ropes for tying items (40.4%); animal protection fencing (17.8%); house fencing (16.8%); bed covers (13.3%) and curtains for doors or windows (12.6%). Furthermore, trends in ITNs disposal mechanisms and alternative uses differed between study sites in each climate zone. All these ITNs disposal mechanisms and the different types of alternative use of old ITNs were confirmed in the focus group discussions.

Conclusion

The findings underscore the need for comprehensive strategies to manage the disposal and repurposing of old ITNs in Burkina Faso. Addressing gaps in disposal guidelines, promoting safe and beneficial reuse practices, and actively involving communities in the decision-making process can help mitigate health risks associated with the improper disposal and repurposing of old insecticide-treated nets and improve the overall effectiveness of malaria control programmes. Through these efforts, both public health and environmental concerns can be addressed in a sustainable and collaborative manner.
Regulation of disease-associated microglia in the optic nerve by lipoxin B4 and ocular hypertension
Authors: Maurya Shubham , Lin Maggie , Karnam Shruthi , Singh Tanirika , Kumar Matangi , Ward Emily , Sivak Jeremy , Flanagan John G. , Gronert Karsten
Published: November 2024

Background

The resident astrocyte-retinal ganglion cell (RGC) lipoxin circuit is impaired during retinal stress, which includes ocular hypertension-induced neuropathy. Lipoxin B4 produced by homeostatic astrocytes directly acts on RGCs to increase survival and function in ocular hypertension-induced neuropathy. RGC death in the retina and axonal degeneration in the optic nerve are driven by the complex interactions between microglia and macroglia. Whether LXB4 neuroprotective actions include regulation of other cell types in the retina and/or optic nerve is an important knowledge gap.

Methods

Cellular targets and signaling of LXB4 in the retina were defined by single-cell RNA sequencing. Retinal neurodegeneration was induced by injecting silicone oil into the anterior chamber of mouse eyes, which induced sustained and stable ocular hypertension. Morphological characterization of microglia populations in the retina and optic nerve was established by MorphOMICs and pseudotime trajectory analyses. The pathways and mechanisms of action of LXB4 in the optic nerve were investigated using bulk RNA sequencing. Transcriptomics data was validated by qPCR and immunohistochemistry. Differences between experimental groups were assessed by Student’s t-test and one-way ANOVA.

Results

Single-cell transcriptomics identified microglia as a primary target for LXB4 in the healthy retina. LXB4 downregulated genes that drive microglia environmental sensing and reactivity responses. Analysis of microglial function revealed that ocular hypertension induced distinct, temporally defined, and dynamic phenotypes in the retina and, unexpectedly, in the distal myelinated optic nerve. Microglial expression of CD74, a marker of disease-associated microglia in the brain, was only induced in a unique population of optic nerve microglia, but not in the retina. Genetic deletion of lipoxin formation correlated with the presence of a CD74 optic nerve microglia population in normotensive eyes, while LXB4 treatment during ocular hypertension shifted optic nerve microglia toward a homeostatic morphology and non-reactive state and downregulated the expression of CD74. Furthermore, we identified a correlation between CD74 and phospho-phosphoinositide 3-kinases (p-PI3K) expression levels in the optic nerve, which was reduced by LXB4 treatment.

Conclusion

We identified early and dynamic changes in the microglia functional phenotype, reactivity, and induction of a unique CD74 microglia population in the distal optic nerve as key features of ocular hypertension-induced neurodegeneration. Our findings establish microglia regulation as a novel LXB4 target in the retina and optic nerve. LXB4 maintenance of a homeostatic optic nerve microglia phenotype and inhibition of a disease-associated phenotype are potential neuroprotective mechanisms for the resident LXB4 pathway.
Psychological distress among students in Egypt and Jordan during the initial months of the Gaza war
Authors: Hendawy Mohamed , Abouzid Mohamed , Gamal Aliaa , Ghanayem Aseel , Amer Muna , Tanashat Mohammad , Eltewacy Nael Kamel , Mohamed Mohamed Mustafa , Nada Eman Ayman , Ibrahim Ismail A.
Published: November 2024

Background

Psychological distress has significantly impacted students in Egypt and Jordan. These countries have faced many challenges, including the COVID-19 pandemic, the fallout from the conflict in Syria, and the war in Ukraine. These crises have had far-reaching consequences, affecting the economy, food security, and energy supplies, particularly with the increased number of refugees in these countries. Amid these existing complexities, the ongoing war in Gaza further exacerbates the situation, compounding mental health challenges. Therefore, this study aimed to analyze how the war in Gaza impacted the mental health of students in Egypt and Jordan.

Methods

We conducted a cross-sectional study involving students from Egypt and Jordan between December 2023 and January 2024. The questionnaire incorporated the Brief Symptom Inventory 18 (BSI-18) to assess the overall general distress score, as well as the domains of anxiety, somatization, and depression.

Results

A total of 1509 Jordanian and Egyptian students were included in the study, of which 66% were female. Approximately 18% of the students had an elevation (≥ 50) in their BSI-18 total score. Females scored significantly higher in general distress [30 (18–44.25) vs. 24 (11–41), p < 0.001], and all three dimensions. The univariate predictors for elevated general distress (≥ 50) were being Egyptian (OR 1.49, 95% CI 1.08 to 2.08, p = 0.014), watching social media multiple times a day (OR 3.04, 95% CI 1.97 to 4.69, p < 0.001), and having a Palestinian connection (friend, neighbor, colleague, or relative) (OR 1.63, 95% CI 1.23 to 2.16, p < 0.001). These three predictors were retained in the backward stepwise multivariate regression analysis model. The univariate predictors for moderate and marked general distress (≥ 57) were watching social media multiple times a day (OR 3.26, 95% CI 1.78 to 5.99, p < 0.001) and having a Palestinian connection (OR 1.49, 95% CI 1.05 to 2.14, p = 0.026). Only the former was retained in the backward stepwise multivariate regression analysis.

Conclusion

General distress has increased among students in Egypt and Jordan throughout the War in Gaza. Mental, psychological, and social support activities are necessary for these students, particularly those watching social media multiple times daily. The development of coping skills to manage the additional stressors of war and socioeconomic status necessitates further research within this group of students.
CD8
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Tumor-Infiltrating Lymphocytes in Head and Neck Cancer: A Review
Authors: Contrera Kevin J. , Spector Matthew E. , Pantanowitz Liron , Abukhiran Ibrahim M. , Vujanovic Lazar , Whiteside Theresa L. , Mowery Yvonne M. , Zandberg Dan P. , Sriharan Shaum S. , Kim Seungwon , Wilke Christopher , Skinner Heath D. , Zevallos Jose P. , Ferris Robert L.
Published: November 2024

CD8
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tumor-infiltrating lymphocytes (TILs) are increasingly used in oncology as a prognostic and predictive tool to guide patient management. This review summarizes current literature on CD8
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TILs in head and neck squamous cell carcinoma (SCC). Published meta-analyses and clinical trials evaluating CD8
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TILs were analyzed. Consistent positive associations between elevated CD8
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TILs and overall survival have been observed across head and neck sites. CD8
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TILs have been found to predict response to treatment, most commonly immunotherapy, but also chemoradiation. Numerous trials have shown that increased CD8
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TIL frequencies in pretreatment biopsies could identify patients likely to respond to neoadjuvant therapies. CD8
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TIL infiltration has also been elevated in responders both during and after treatment. However, wider adoption of CD8
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TIL quantification as a biomarker has been limited by the need for clinical validation and universal measurement guidelines for head and neck SCC, as there are for other malignancies. Measurement variability includes which tumor compartment is sampled, how TILs are quantified, and which cutoffs are clinically relevant. For several head and neck SCC, measurement of CD8
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TILs in the central or intratumoral compartment, followed by the stromal compartment, has been most consistently associated with survival. Future studies are needed to evaluate subpopulations of CD8
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TILs and biomarker-based treatment selection.