bluuebunny/crossref_metadata_2025 huggingface dataset:
Pregnancy and Childbirth After Spinal Fusion for Adolescent Idiopathic Scoliosis
Authors: Landrum Matthew , Nocka Heidi R. , Ashebo Leta , Hilmara Didja , MacAlpine Elle , Flynn John M. , Ho Michelle , Newton Peter O. , Sponseller Paul D. , Lonner Baron S. ,   Harms Study Group, Cahill Patrick J.
Published: September 2023

Background:

Little data exist on pregnancy and childbirth for adolescent idiopathic scoliosis (AIS) patients treated with a spinal fusion. The current literature relies on data from patients treated with spinal fusion techniques and instrumentation, such as Harrington rods, that are no longer in use. The objective of our study is to understand the effects of spinal fusion in adolescence on pregnancy and childbirth.

Methods:

Prospectively collected data of AIS patients undergoing posterior spinal fusion that were enrolled in a multicenter study who have had a pregnancy and childbirth were reviewed. Results were summarized using descriptive statistics and compared with national averages using χ2 test of independence.

Results:

A total of 78 babies were born to 53 AIS patients. As part of their pre-natal care, 24% of patients surveyed reported meeting with an anesthesiologist before delivery. The most common types of delivery were spontaneous vaginal delivery (46%, n=36/78) and planned cesarean section (20%, n=16/78). Compared with the national average, study patients had a higher rate of cesarean delivery (P=0.021). Of the women who had a spontaneous vaginal birth, 53% had no anesthesia (n=19/36), 19% received intravenous intermittent opioids (n=7/36), and 31% had regional spinal or epidural anesthesia (n=11/36). spontaneous vaginal delivery patients in our study cohort received epidural or spinal anesthesia less frequently than the national average (P<0.001). Of those (n=26 pregnancies) who did not have regional anesthesia (patients who had no anesthesia or utilized IV intermittent opioids), 19% (n=5 pregnancies) were told by their perinatal providers that it was precluded by previous spine surgery.

Conclusion:

The majority of AIS patients reported not meeting with an anesthesiologist before giving birth and those who had a planned C-section did so under obstetrician recommendation. The presence of instrumentation after spinal fusion should be avoided with attempted access to the spinal canal but should not dictate a delivery plan. A multidisciplinary team consisting of obstetrician, anesthesiologist, and orthopaedic surgeon can provide the most comprehensive information to empower a patient to make her decisions regarding birth experience anesthesia based on maternal rather than provider preference.

Level of Evidence:

IV
Cutaneous Atypical Fibroxanthoma With Osteoclast-Like Giant Cell: A Rare but Diagnostic Pitfall
Authors: Shaker Nada , Phelps Robert , Niedt George , Patel Ankush , Wu Douglas , Aung Phyu , Prieto Victor , Church Ann , Pradhan Dinesh
Published: September 2023

Background:

Atypical fibroxanthoma (AFX) is a dermal-based, low-grade neoplasm with no specific lineage of differentiation. The occurrence of AFX with osteoclast-like giant cells is exceptionally rare. Less than 20 cases have been reported in the literature.

Case Presentation:

A 77-year-old man with a medical history of multiple basal and squamous cell carcinomas of the skin, presented with a progressively growing erythematous nodule on the sun-damaged right central parietal scalp. A shave biopsy showed a dermal spindle cell proliferation accompanied by numerous osteoclast-like multinucleated giant cells and predominant atypical mitotic figures. The immunohistochemical staining showed a diffuse positive staining for CD68 and SMA, patchy staining for CD10, and negative staining for SOX-10, pan-cytokeratin, CK5/6, S100, CD34, and desmin. The tumor was completely excised with negative margins. A subsequent follow-up over a period of 13 months showed no recurrence.

Conclusion:

Distinguishing AFX with osteoclast-like giant cells from both malignant and benign skin lesions with osteoclast-like giant cells is crucial. Although AFX tumors display worrisome malignant histologic features, most cases have a favorable prognosis with a local recurrence rate below 5% and exceedingly rare metastasis.
Scaling up essential surgery in rural Africa: outcomes of a novel regional initiative
Authors: Kintu-Luwaga Ronald , DeCiman Ring A. , Semakula Daniel , Makor Ajak , Mwanje Wilbrod
Published: September 2023

Introduction:

South Sudan, like most of rural Africa, has a high surgical disease burden and profound unmet surgical needs. This is against a background of weak surgical service delivery systems, especially in the harder-to-reach areas. Here it is further fueled by armed conflict and poverty. The surgical service delivery models applied so far have not adequately improved surgical care. Through the Intergovernmental Authority on Development Regional Initiative for Capacity Building, a surgical team was deployed to Kuajok Hospital in Warrap state. The team mentored South Sudanese health workers for 2 years while working together with other agencies operating in the locality to improve surgical services. This paper is an account of the capacity building process for surgical service improvement at this site, from 2015 to 2017.

Methods:

A descriptive study of activities and patients seen over a 2-year period at this centre. Quantitatively, statistics were extracted and compiled from all areas of surgical care, including profiles of the various surgical conditions. Qualitatively, information was gathered through unstructured interviews.

Results:

There was a drastic increase in surgical outpatient consultations, admissions, and operations. There was an improvement in the level of surgical care and patient care systems. New facilities like operating theaters, emergency rooms, surgical consultation rooms, and surgical wards were established. Community attitude and health-seeking behavior improved, leading to improved access to care. An indirect financial benefit was experienced due to improved patient care outcomes and reduced expenditure on referrals.

Conclusion:

Improvement of surgical services in Africa’s hard-to-reach areas is readily attainable through partnerships and mentoring of native medical workers by personnel from fellow African countries.
GALAD outperforms aMAP and ALBI for predicting HCC in patients with compensated advanced chronic liver disease: A 12-year prospective study
Authors: Villa Erica , Donghia Rossella , Baldaccini Valentina , Tedesco Calogero C. , Shahini Endrit , Cozzolongo Raffaele , Ascari Sara , Pesole Pasqua Letizia , Coletta Sergio , Critelli Rosina Maria , Lasagni Simone , Schepis Filippo , Semellini Filippo , Giannelli Gianluigi
Published: September 2023

Background and Aims:

Surveillance programs are strongly recommended in patients with liver cirrhosis for early detection of HCC development. Six-monthly ultrasound sonography is the most reliable and commonly used technique, especially when associated with serum determination of α-fetoprotein, but different score systems have been proposed to overcome the unsatisfactory diagnostic accuracy of α-fetoprotein. The aim of this 12-year prospective study is to compare the gender, age, AFP-L3, AFP, des-gamma-carboxy prothrombin (GALAD) versus age, gender, bilirubin, albumin, and platelets and albumin-bilirubin scores in predicting HCC onset.

Approach and Results:

A cohort of 545 consecutive patients with compensated advanced chronic liver disease without suspected focal lesions was followed up every 6 months by liver imaging and α-fetoprotein to detect HCC occurrence. Harrell’s C-index for censored data was employed to evaluate the performance of any parameters or scores helping to predict HCC development. ROC curve analysis showed that the GALAD score was more accurate in evaluating HCC development than albumin-bilirubin and age, gender, bilirubin, albumin, and platelets. The AUC ranged from 0.7268 to 0.6851 at 5 and 10 years, both in the total cohort and in the sub-cohorts (viral hepatitis, NASH, and alcohol). The HCC Risk model was constructed using univariate and multivariate Cox proportional hazard regression analysis, showing a strong association of GALAD with HR > 1, p < 0.05, in the total and sub-cohorts, and a better risk prediction in the alcohol cohort, both alone and standardized with other blood parameters.

Conclusions:

GALAD is the most reliable and accurate score system to detect HCC risk of development in patients with compensated advanced chronic liver disease.
The Importance of Medical Device Reporting by Health Technology Managers Before and After Recalls Are Posted
Authors: Brown Cedric
Published: September 2023

The Food and Drug Administration (FDA) performs postmarket surveillance of medical devices as part of its mission to ensure that devices remain safe and effective while they are on the market. Medical device reporting by manufacturers, user facilities, and the public plays an important role in the agency identifying and resolving medical device safety signals. User facilities are defined as a hospital, ambulatory surgical facility, nursing home, outpatient diagnostic facility, or outpatient treatment facility and do not include physician's offices. The Safe Medical Devices Act requires user facilities to report medical-device–related deaths to the FDA and the device manufacturer, to report device-related serious injuries to the manufacturer, and to submit an annual summary of all device reports to the FDA. If the manufacturer is unknown for a serious injury report, the user facility then submits the report to the FDA. Healthcare technology managers in user facilities use their expertise to recognize, communicate, and evaluate medical device concerns. This article highlights the importance of identifying and reporting medical device issues to the FDA to ensure continued safety and effectiveness of devices on the market.
Effect of Ambient Temperature on Hospital Admissions for Respiratory Disease in Suburban Rural Villages of a Semi-Arid Region in Northwest China
Authors: Zhang Yanan , Luo Xiaofeng , Ma Li , Ding Guowu , Zhang Benzhong
Published: September 2023

Objective

This study evaluated the effects of extreme temperatures on hospital admissions for respiratory diseases (RDs) in a semi-arid region in the Northwest of China.

Methods

Distributed lag nonlinear model was constructed, and stratified analysis by gender and age was performed.

Results

The exposure–response curve between temperature and RD hospital admissions was almost W-shaped. Either extremely cold temperatures or moderately cold temperatures presented a short-term acute harmful effect, and the relative risks were higher among males (1.976, 95% confidence interval [CI]: 1.773–2.203; 1.242, 95% CI: 1.203–1.282) and the elderly (2.363, 95% CI: 1.724–3.240; 1.267, 95% CI: 1.154–1.390). Both extreme and moderately hot temperatures had higher risks among females (2.040, 95% CI: 1.815–2.292; 1.328, 95% CI: 1.276–1.381).

Conclusions

The relationship between air temperature and RD hospital admissions was nonlinear. Vulnerable populations varied according to extreme temperature conditions.
Creative Arts Therapy for Healthcare Professionals Is Associated With Long-Term Improvements in Psychological Distress
Authors: Avallone Mantelli Rafaela , Forster Jeri , Edelblute Anthony , Sinn Hillary , Torres Kristen , Adams Tisha , Morgan Courtney , Henry Michael , Reed Katherine , Moss Marc
Published: September 2023

Objective

Burnout in healthcare professionals (HCPs) is a pressing issue in healthcare. We report the long-term impact of our previous creative arts therapy (CAT) intervention for reducing psychological distress in HCPs.

Methods

Healthcare professionals were randomized to CAT intervention or control group. The CAT group completed surveys evaluating symptoms of psychological distress at 4 months, 8 months, and 1 year postintervention, whereas the control group completed surveys at the 1-year mark.

Results

The CAT group demonstrated sustained improvement in distress scores for anxiety, depression, and affect at 4 and 8 months postintervention. At the 12-month mark, the CAT group exhibited improvements in anxiety, depression, and affect compared with the control group.

Conclusion

Creative arts therapy has lasting benefits for HCPs. Long-term follow-ups are crucial for assessing sustainability, and further investigation should focus on disseminating and implementing CAT programs for HCPs.
Clinical results after external reinforcement of colorectal anastomosis: A systematic review
Authors: Škrabec Clara Gené , Pérez Manel Cremades , Pujol Andrea Fernández , Cortinovis Sara , Rubio Javier Corral , Ibáñez Joan-Francesc Julián , Parés David
Published: September 2023

Objective:

The aim of this review is to describe and assess the existing methods to cover colorectal anastomoses with biomaterials and their clinical impact in reducing anastomotic leakage. (AL).

Summary Background Data:

The most serious complication in colorectal surgery is AL. Despite improvements in its diagnosis and management, AL remains an unresolved issue. To prevent its appearance and clinical consequences, different external reinforcement techniques with synthetic or biomaterials have been described.

Methods:

A systematic review search of the available literature until June 2022 was performed, looking for all literature regarding external reinforcement of colonic or colorectal anastomoses. After the review process, a classification of materials was proposed into solid and liquid materials, and an assessment of their clinical impact was performed. The study protocol has been registered at PROSPERO and has been reported in the line with PRISMA and AMSTAR Guidelines 10,11.

Results:

97 articles fulfilled inclusion criteria, were identified and revised. Overall, 18 of the selected articles focused on human clinical trials and 79 on animal models. Only Fibrin sealants, collagen patches and omentoplasty have shown positive results in humans.

Conclusions:

Fibrin sealants, collagen patches and omentoplasty are, so far, the most studied biomaterials. However, further studies are required to confirm these findings before definite recommendations can be made.
Predictive Value of In-Program Academic Variables for Future Clinical Education Performance in Physical Therapist Education: An Exploratory Study
Authors: Birkmeier Marisa , Maring Joyce , Pinkus Rebecca , Costello Ellen
Published: September 2023

Introduction.

The purposes of this study were to (1) explore the relationship of preclinical assessment outcomes and grade point averages (GPAs) with full-time clinical education experience (CEE) performance and (2) determine the predictive value of associated variables to full-time CEE performance.

Review of Literature.

In-program academic variables such as performance tests, comprehensive examinations, and GPAs reflect a measure of student performance before clinical education. Limited and conflicting physical therapist education research exists examining the relationship between preclinical in-program academic variables and CEE performance.

Subjects.

A retrospective convenience sample of 130 graduated PT student academic records with expected graduation years of 2018, 2019, and 2020.

Methods.

Academic records related to performance test outcomes, cumulative program GPAs, utilization of a practical retake appeal policy, and comprehensive examination performance were correlated with CEE performance. A dichotomous ordinal rating scale quantified CEE performance per full-time experience based on the presence of a learning contract. Overall CEE performance was defined as the percentage from the combined CEE performance scores across all experiences. Data analyses included Pearson's correlation coefficient, Spearman's rho, and a multiple linear regression analysis.

Results.

Ten of 25 course-specific performance tests had significant associations with CEE performance. Cumulative GPA and the practical retake appeal were significantly associated with the CEE III score and overall CEE performance. The practical retake appeal was a significant contributor to clinical performance, explaining 5.3% of the variance (β = 0.24, P = .01, 95% CI 0.01 to 0.09, part correlation = 0.23, tolerance = 0.91).

Discussion and Conclusion.

These findings support the use of performance tests as an effective assessment strategy before CEEs but only represent one aspect of the full picture of readiness to practice. Academic progression policies can offer a mechanism for early identification to support at-risk students before the CEEs.
Evaluation of post-chemotherapy residual seminomatous masses by 18F-fluorodeoxyglucose PET/CT using tumor-to-liver ratio – conundrum or solution?
Authors: Ghosh Suchismita , Agrawal Archi , Rangarajan Venkatesh , Choudhury Sayak , Maitre Priyamvada , Purandare Nilendu , Shah Sneha , Puranik Ameya , Bakshi Ganesh , Joshi Amit , Prakash Gagan , Menon Santosh , Prabhash Kumar , Norohna Vanita , Pal Mahendra , Murthy Vedang
Published: September 2023

Objective

Assessment of diagnostic accuracy of FDG-PET/CT in the detection of viable disease in post-chemotherapy seminomatous residual masses using visual interpretation, SUVmax, and T/L ratio.

Methods

This is a retrospective study assessing the post-chemotherapy seminomatous residual masses of size >3 cm. The PET/CT scan findings were interpreted visually for presence of residual disease which were validated from histopathology reports or imaging follow-up for a maximum of 3 years. SUVmax and T/L ratios were also determined for all the residual lesions. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value NPV were calculated and compared for all three parameters along with ROC analysis to obtain an optimal cutoff value for SUVmax and T/L ratio, respectively.

Results

Sample size was 49. Out of these 49 patients, 8 had validation of PET results with histopathology. Rest was validated with imaging follow-up. FDG-PET was positive in 30 patients and negative in 19 patients by visual interpretation. The sensitivity, specificity, PPV, and NPV by this method were 100%, 62.5%, 73%, and 100%, respectively. The SUVmax and T/L ratios were also calculated for these lesions. The cutoff for these two variables was 4.56 and 1.21, respectively. The sensitivity, specificity, PPV, and NPV at these cutoffs were 76%, 87.5%, 86%, 77.7%, and 92%, 87.5%, 88%, 91%, respectively.

Conclusion

FDG-PET has a favorable diagnostic value in predicting viable disease in post-chemotherapy seminomatous residual masses and using T/L ratio cutoff of 1.21 will increase the specificity of the test.
Potential of preoperative fluorodeoxyglucose-positron emission tomography/computed tomography to diagnose contralateral lymph node metastases in patients with oral cancer
Authors: Wamasing Natnicha , Nakamura Shin , Watanabe Hiroshi , Kuribayashi Ami , Miura Masahiko
Published: September 2023

Objective

To establish a decision tree using preoperative PET/computed tomography (CT) parameters for detecting contralateral lymph node metastasis (CLNM) in oral cancer patients.

Methods

In total, 140 patients with a confirmed histopathological diagnosis of oral carcinoma showed fluorodeoxyglucose accumulation of contralateral lymph nodes in PET images. Of 260 lymph nodes, eight were metastatic. We compared metastatic and non-metastatic nodes using Fisher–Freeman-Halton exact and Fisher’s exact and Mann–Whitney U tests. The diagnostic performance was analyzed using receiver operating characteristic curves. We established a decision tree using exhaustive chi-squared automatic interaction detection algorithm.

Results

Five PET/CT parameters were significantly different between metastatic and non-metastatic nodes: the longest (P = 0.015) and shortest (P = 0.023) diameter, and the maximum standardized uptake values (SUVmax) of the contralateral node (P = 0.030), primary tumor (P < 0.001), and ipsilateral node (P < 0.001). The area under the curves of SUVmax of the primary tumor (0.887), ipsilateral node (0.886), and longest diameter (0.752) were the largest and these three parameters were used as predictive criteria in the decision tree. The accuracy of the decision tree was 97.7% with 100% sensitivity and 97.6% specificity.

Conclusion

Preoperative PET/CT imaging with a decision tree has the potential to diagnose CLNM in patients with oral cancer.
Rabbit systemic glucose metabolism map by total-body dynamic PET/CT technology
Authors: Wang Haochen , Xie Xue , Duan Yanhua , Chai Leiying , Li Kun , Qiu Jianfeng , Cheng Zhaoping
Published: September 2023

Background

This study evaluated total-body glucose metabolism in a preclinical lab animal, the rabbit, by employing a dynamic glucose metabolic image obtained with total-body fluorine-18 fluorodeoxyglucose (18F-FDG) PET/computed tomography (PET/CT).

Methods

The dynamic total-body PET/CT system was used to obtain glucose metabolic imaging from 10 sedated body-matched rabbits. The standard uptake value (SUV) of 18F-FDG was used to evaluate glucose metabolism. In addition, the correlation between glucose metabolism and sexes was assessed, as well as metabolic differences between left- and right sides.

Results

We found significant distribution heterogeneity of glucose in several organs across the entire body. There were no significant metabolic differences between sexes and between bilateral sides in the 10 rabbits. Thereafter, we assayed the major organ SUV changes by dynamic PET/CT of the major organs. The heart, liver, and urinary system showed more 18F-FDG, whereas the skeletal muscle, brain, spinal cord, and lungs incorporated less 18F-FDG. The phenotype of 18F-FDG uptake was highly correlated with the physiological functions. The 18F-FDG accumulation in urinary system were observed which could reflect the renal parenchyma glucose metabolism indirectly. However, the low 18F-FDG uptake in the brain and spinal cord was due to sedation.

Conclusion

The total-body glucose metabolic atlas depicted with 18F-FDG dynamic PET/CT may be used as a reference for assessing pathological 18F-FDG uptake. Furthermore, this study could be a reference for preclinical research involving abnormality of glucose metabolism.
Comparative Analysis of Predetermined Axillary Crutch Length Settings to Individualized Fittings
Authors: Taweel Nicholas , Langman Charles , Sullivan Paul , Schick Faith , Karanjia Homyar , Gulick Dawn T.
Published: September 2023

Axillary crutches are the most common assistive devices given to individuals with musculoskeletal injuries in an acute care setting. Nurses are frequently the care provider fitting injured individuals with crutches. This study compared the crutch length determined by the crutch manufacturer's height setting with the crutch length attained after applying a standard clinical protocol for crutch fitting. A total of 116 adults with lower extremity injuries were enrolled. Self-reported height was documented as well as initial crutch length as indicated by the numbers on the push-button feature of the crutches. Subject height with and without shoes was measured. Proper crutch length was then determined using the method described by Bauer et al. (1991). No change between the initial and adjusted crutch settings was made in 43% of the subjects. Change was made in 57% of the subjects: lengthening in 40% and shortening in 17% of subjects. This study revealed the predetermined crutch settings are unreliable and should simply be used as a starting point during a personalized fitting.
Overview of Antibiotic Prophylaxis in Orthopaedic and Cardiac Procedures
Authors: Karapetyan Kristina , Mei Sally , Choudhury Aeman , Cottreau Jessica
Published: September 2023

Antibiotic prophylaxis (AP) in surgical procedures is commonly used to prevent infections that may occur after operations. There are multiple factors that can contribute to increased risk of postsurgical complications that include prolonged hospitalization, reoperation, and readmissions. One of the strategies of decreasing the risk of bacterial contamination and developing infections is preprocedural antibiotic administration. When selecting an appropriate antibiotic, it is important to take into account surgery type and patient's characteristics which would also impact timing of administration and prophylaxis duration. Although surgical AP is significant for avoiding bacterial complications, it is also associated with some drawbacks such as increased antibiotic resistance and development of adverse reactions. Therefore, it is important to assess risks and benefits and select the most appropriate antibiotic regimen before initiating AP.
Looking Beyond the Growth Curve: A Retrospective Study on Nutrient Deficient Diets in Children with Severe Food Selectivity
Authors: Drayton Amy K. , Knight Rachel M. , Shepard Heather , Andersen Ashley S. , Shriver Daniel
Published: September 2023

Severe food selectivity places children at risk for nutrient deficiencies and long-term medical complications, if unaddressed. However, poor nutrition in highly selective eaters is often overlooked when considering other behavioral or medical concerns. Additionally, studies regarding food selectivity are sparse and limited to children with developmental delays. This study further investigates the nutritional deficiencies and growth characteristics of children with severe food selectivity to assist pediatricians in the earlier identification of patients for nutrition screening. A retrospective chart review was completed for 13 patients admitted to a pediatric feeding program solely for table-textured food selectivity. Nutrition and anthropometric data from the medical record were analyzed. All patients were determined to be following an age-appropriate growth curve but had multiple micronutrient deficiencies. Additionally, 6 children were typically developing outside of the feeding context. Results suggest that children with food selectivity may require more intensive and earlier nutrition screening beyond their growth patterns.
Training program intervention to encourage physical activity for health in people with transtibial amputation: A feasibility study
Authors: Asher Miranda , Strike Siobhan , Diss Ceri
Published: September 2023

Background:

People with transtibial amputation (PTTA) would benefit from increased physical activity levels (PAL) but generic programs developed to support increased PAL do not address the barriers which PTTA experience.

Objective:

To evaluate the effect of a 12-week training program, developed for PTTA, on their PAL.

Methods:

Ten PTTA participated in a 12-week training program, which involved one instructor-led supervised group session per week. The program incorporated balance, flexibility, cardiovascular endurance, strength, and agility, as well as educational elements. Personalized starting level and progression intensity were based on the instructor's assessment in the first training session. The effect of the intervention on PAL (self-report questionnaire and accelerometer), fitness, walking symmetry, and adverse effects was determined by analysis of variance before and after the intervention.

Results:

There was a significant increase in self-reported time in moderate-intensity activity and accelerometer-measured step count and time in movement after the program compared with baseline (p = 0.02). The distance walked in the Six-Minute Walk Test (6MWT) (p < 0.001), time to perform agility test (p = 0.01), and lower-limb strength power (p = 0.01) and endurance (p = 0.01) were significantly greater after the program, and no adverse effects were identified.

Conclusions:

This study demonstrated an intervention designed specifically for PTTA that can increase PAL.
Patient–practitioner interaction within the field of prosthetics and orthotics: A scoping review
Authors: Comstock Brogan C. D.
Published: September 2023

Patient–practitioner interaction has been shown to positively affect patient outcomes and experiences in various medical fields. However, the career of prosthetics and orthotics (P&O) includes components and processes unique to its field. Therefore, the concepts, practices, and information of patient–practitioner interaction need to be identified to understand how P&O practitioners can positively influence patient outcomes. A scoping review of PubMed, PsycINFO, and CINAHL was conducted for empirical research involving patient–practitioner interaction in P&O between the years of 1990 and 2021. Initial searches discovered 646 unique articles. Only 2 quantitative studies and 3 qualitative studies were included in the final analysis. Three interconnected themes were prevalent across the 5 articles: the knowledge available to the patient and the practitioner, the difference in expectations of both patient and practitioner, and communication processes. These 3 concepts create a feedback loop of consequences that can be addressed by ensuring that adequate and useful patient–practitioner communication is applied during the care process. Despite multiple calls for research in this area over the past 50 years, very few articles have addressed patient–practitioner interactions. Future research is needed to understand how interactions in P&O can be optimized to positively affect patient experience and outcomes.
Factors associated with enrollment into differentiated service delivery model among adults with HIV in Kenya
Authors: Lavoie Marie-Claude C. , Koech Emily , Blanco Natalia , Wangusi Rebecca , Jumbe Marline , Kimonye Francis , Ndaga Angela , Ndichu Geofrey , Makokha Violet , Awuor Patrick , Momanyi Emmah , Oyuga Roseline , Nzyoka Sarah , Mutisya Immaculate , Joseph Rachel , Miruka Fredrick , Musingila Paul , Stafford Kristen A. , Lascko Taylor , Ngunu Carol , Owino Elizabeth , Kiplangat Anthony , Kepha Abuya , Ng’eno Caroline
Published: September 2023

Introduction:

Differentiated service delivery (DSD) such as multimonth dispensing (MMD) aims to provide client-centered HIV services, while reducing the workload within health facilities. We assessed individual and facility factors associated with receiving more than three MMD and switching from ≥3MMD back to <3MMD in Kenya.

Methods:

We conducted a retrospective cohort study of clients eligible for DSD between July 2017 and December 2019. A random sample of clients eligible for DSD was selected from 32 randomly selected facilities located in Nairobi, Kisii, and Migori counties. We used a multilevel Poisson regression model to assess the factors associated with receiving ≥3MMD, and with switching from ≥3MMD back to <3MMD.

Results:

A total of 3501 clients eligible for ≥3MMD were included in our analysis: 1808 (51.6%) were receiving care in Nairobi County and the remaining 1693 (48.4%) in Kisii and Migori counties. Overall, 65% of clients were enrolled in ≥3MMD at the time of entry into the cohort. In the multivariable model, younger age (20–24; 25–29; 30–34 vs. 50 or more years) and switching ART regimen was significantly associated with a lower likelihood of ≥3MMD uptake. Factors associated with a higher likelihood of enrollment in ≥3MMD included receiving DTG vs. EFV-based ART regimen (aRR: 1.10; 95% confidence interval: 1.05–1.15).

Conclusion:

Client-level characteristics are associated with being on ≥3MMD and the likelihood of switching from ≥3MMD to <3MMD. Monitoring DSD enrollment across different populations is critical to successfully implementing these models continually.
Social Support Assets and Needs of Underrepresented Students Participating in Health Sciences Pathways Programs in Birmingham, Alabama
Authors: McCollum C. Greer , Carodine Alyssa , Chiedo Ashleigh , Penney Brooke , Long Dustin , Blumenfeld Rebecca , Smith Angela , Hill Samantha , Herbey Ivan Ivanovich , Rana Aadia , Elopre Latesha
Published: September 2023

Background:

Using the Asset Bundle Model, we sought to understand the social support assets and needs of underrepresented minority (URM) high school, undergraduate, and graduate students.

Setting:

Study participants were or had participated in health sciences pathway programs at Birmingham City Schools and/or the University of Alabama at Birmingham.

Methods:

We took a concurrent mixed methods approach to conduct an environmental scan of health science pathway programs in the Birmingham, AL area. Four focus groups were conducted between November 2022 and January 2023, and a 225-item online survey was administered between November 4, 2022, and February 4, 2023. Both tools collected data from high school, undergraduate, and graduate students to examine key components of existing health care pathways programs for URMs and identify barriers and facilitators to successful implementation of such programs.

Results:

Twenty-two students participated in the focus groups, and 168 individuals responded to the survey. Both focus group participants and interview respondents were primarily URMs (eg, 68.2% and 65.7% identified as Black or African American, respectively). Survey responses and focus group discussions showed that, overall, undergraduate and graduate students programs develop more robust identities as future health care professionals through friendships and institutional supports, expand their networks more broadly through mentorship, and feel more supported by family members in their academic endeavors than high school students.

Conclusions:

Health science pathway programs for URMs should facilitate and bolster social supports for students, especially those in high school, to enhance persistence through education and into the workforce.
Building Indigenuity, Generating HIV Science: An HIV/AIDS Research Training Program for Undergraduate and Graduate Indigenous Scholars (BIG HART)
Authors: Balkus Jennifer E. , Conde Marcus , Lewin Anya , Walters Karina L.
Published: September 2023

Introduction:

Although great heterogeneity and resilience exist among American Indians and Alaska Natives, Native Hawaiians and other Pacific Islanders, and Indigenous Latinx Populations across the United States, epidemiological data demonstrate these groups share a troubling commonality with respect to persistent health inequities, including HIV. A strong network of highly trained and productive Indigenous scientists dedicated to research that is culturally grounded is one component of a multifaceted approach that would contribute to ameliorating HIV-related disparities among Indigenous populations.

Methods:

Building on the only long-standing Indigenous-specific HIV/AIDS mentorship program in the United States—the Indigenous HIV/AIDS Research Training Program and with support from the CFAR Diversity, Equity, and Inclusion Pathway Initiative, the University of Washington/Fred Hutch CFAR developed and launched the Building Indigenuity, Generating HIV Science: HIV/AIDS Research Training Program (BIG HART) to introduce undergraduate and graduate Indigenous scholars to the field of HIV research.

Results:

The BIG HART program includes a seminar series to introduce undergraduate and graduate Indigenous scholars to the field of HIV research, opportunities to connect scholars with Indigenous mentors and provide networking opportunities to facilitate training opportunities related to HIV science, and complementary training for mentors to enhance their knowledge and training related to mentoring across difference, with a specific focus on mentoring Indigenous scholars.

Conclusions:

The BIG HART program is an important starting point toward building a sustainable program to attract Indigenous scholars in the field of HIV and grow and empower the next generation of Indigenous HIV scientists.
Two novel variants of the STXBP1 and CHRNB2 genes identified in a Chinese boy with refractory seizures and developmental delay
Authors: Wang Sanmei , Cui Di , Ling Xiuxin , Hou Yu , Sun Jing
Published: September 2023

Autosomal dominant sleep-related hypermotor epilepsy is a rare disease caused by pathogenic variants of CHRNB2, CHRNA4, and CHRNA2 genes, with nocturnal frontal lobe epilepsy as the main symptoms. Syntaxin binding protein 1 (STXBP1) gene mutation can cause developmental and epileptic encephalopathy 4, mainly presenting as a developmental and epileptic encephalopathy. We performed the exome-targeted next-generation sequencing in our patient and identified two heterozygous variants: c.963 + 2T>C of STXBP1 and c.520_527delinsTGCTAC (p.R174Cfs*16) of CHRNB2. Molecular analysis was performed of the variant c.963 + 2T>C. Aberrantly spliced products were observed, proving the pathogenicity of this variant. Refractory seizures and developmental delay could be explained. Although the variant c.520_527delinsTGCTAC could cause the truncation of the proteins, it was ultimately determined to be nonpathogenic. The startle-like responses that occurred occasionally during the night were ultimately determined to be an uncommon phenotype caused by the STXBP1 variant.
Glycosylation and Crowded Membrane Effects on Influenza Neuraminidase Stability and Dynamics
Authors: Seitz Christian , Deveci İlker , McCammon J. Andrew
Published: September 2023

All protein simulations are conducted with varying degrees of simplifications, oftentimes with unknown ramifications on how these simplifications affect the interpretability of the results. In this work we investigated how protein glycosylation and lateral crowding effects modulate an array of properties characterizing the stability and dynamics of influenza neuraminidase. We constructed three systems: 1) Glycosylated neuraminidase in a whole virion (i.e. crowded membrane) environment 2) Glycosylated neuraminidase in its own lipid bilayer 3) Unglycosylated neuraminidase in its own lipid bilayer. We saw that glycans tend to stabilize the protein structure and reduce its conformational flexibility while restricting solvent movement. Conversely, a crowded membrane environment encouraged exploration of the free energy landscape and a large scale conformational change while making the protein structure more compact. Understanding these effects informs what factors one must consider while attempting to recapture the desired level of physical accuracy.

TOC figure

TOC. Schematic of the three systems used here. (A) 2009-H1N1-ungly is the unglycosylated, single protein NA system. (B) 2009-H1N1-gly is the glycosylated, single protein NA system. (C) 2009-H1N1-vir is the NA in the virion context.
Reduced SV2A and GABAAreceptor levels in the brains of type 2 diabetic rats revealed by [18F]SDM-8 and [18F]flumazenil PET
Authors: Kong Yanyan , Xie Fang , Wang Xiuzhe , Zuo Chuantao , Shi Kuangyu , Rominger Axel , Huang Qi , Xiao Jianfei , Jiang Donglang , Guan Yihui , Ni Ruiqing
Published: September 2023

Purpose

Type 2 diabetes mellitus (T2DM) is associated with a greater risk of Alzheimer’s disease. Synaptic impairment and protein aggregates have been reported in the brains of T2DM models. Here, we assessed whether neurodegenerative changes in synaptic vesicle 2A (SV2A), γ;-aminobutyric acid type A (GABAA) receptor, amyloid-β, tau and receptor for advanced glycosylation end product (RAGE) can be detected in vivo in T2DM rats.

Methods

Positron emission tomography (PET) using [18F]SDM-8 (SV2A), [18F]flumazenil (GABAAreceptor), [18F]florbetapir (amyloid-β), [18F]PM-PBB3 (tau), and [18F]FPS-ZM1 (RAGE) was carried out in 12-month-old diabetic Zucker diabetic fatty (ZDF) and Sprague□Dawley (SD) rats. Proteomic profiling and pathway analysis of the hippocampus of ZDF and SD rats were performed.

Results

Reduced cortical [18F]SDM-8 and cortical and hippocampal [18F]flumazenil uptake were observed in 12-month-old ZDF rats compared to SD rats. [18F]florbetapir and [18F]PM-PBB3 uptake were comparable in the brains of 12-month-old ZDF rats and SD rats.

Conclusion

The findings provide in vivo evidence for regional reductions in SV2A and GABAAreceptor levels in the brains of aged T2DM ZDF rats.
Thetidyomicsecosystem: Enhancing omic data analyses
Authors: Hutchison William J. , Keyes Timothy J. ,   The tidyomics Consortium, Crowell Helena L. , Serizay Jacques , Soneson Charlotte , Davis Eric S. , Sato Noriaki , Moses Lambda , Tarlinton Boyd , Nahid Abdullah A. , Kosmac Miha , Clayssen Quentin , Yuan Victor , Mu Wancen , Park Ji-Eun , Mamede Izabela , Ryu Min Hyung , Axisa Pierre-Paul , Paiz Paulina , Poon Chi-Lam , Tang Ming , Gottardo Raphael , Morgan Martin , Lee Stuart , Lawrence Michael , Hicks Stephanie C. , Nolan Garry P. , Davis Kara L. , Papenfuss Anthony T. , Love Michael I. , Mangiola Stefano
Published: September 2023

The growth of omic data presents evolving challenges in data manipulation, analysis, and integration. Addressing these challenges, Bioconductor1provides an extensive community-driven biological data analysis platform. Meanwhile, tidy R programming2offers a revolutionary standard for data organisation and manipulation. Here, we present thetidyomicssoftware ecosystem, bridging Bioconductor to the tidy R paradigm. This ecosystem aims to streamline omic analysis, ease learning, and encourage cross-disciplinary collaborations. We demonstrate the effectiveness oftidyomicsby analysing 7.5 million peripheral blood mononuclear cells from the Human Cell Atlas3, spanning six data frameworks and ten analysis tools.
Effects of Neighboring Phosphorylation Events on the Affinities of pT181-Tau Antibodies
Authors: Min Sehong , Mohallem Rodrigo , Aryal Uma K , Kinzer-Ursem Tamara L. , Rochet Jean-Christophe
Published: September 2023

A tau variant phosphorylated on threonine 181 (pT181-tau) has been widely investigated as a potential Alzheimer’s disease (AD) biomarker in cerebrospinal fluid (CSF) and blood. pT181-tau is present in neurofibrillary tangles (NFTs) of AD brains, and CSF levels of pT181-tau correlate with overall NFT burden. Various immuno-based analytical methods, including Western blotting and ELISA, have been used to quantify pT181-tau in human biofluids. The reliability of these methods depends on the affinity and binding specificity of the antibodies used to measure pT181-tau levels. Although both of these properties could in principle be affected by phosphorylation within or near the antibody’s cognate antigen, such effects have not been extensively studied. Here, we developed a biolayer interferometry assay to determine the degree to which the affinity of pT181-tau antibodies is altered by the phosphorylation of serine or threonine residues near the target epitope. Our results revealed that phosphorylation near T181 negatively affected the binding of pT181-tau antibodies to their cognate antigen to varying degrees. In particular, two of three antibodies tested showed a complete loss of affinity for the pT181 target when S184 or S185 was phosphorylated. These findings highlight the importance of selecting antibodies that have been thoroughly characterized in terms of affinity and binding specificity, addressing the potential disruptive effects of post-translational modifications in the epitope region, to ensure accurate biomarker quantitation.
The Effect of Sunlight Intensity on Flower Opening Time and Exposure Duration in Rice (Oryza sativassp.indica) Landraces
Authors: Deb Debal , Dutta Sreejata , Nauri Mahendra
Published: September 2023

Records of sunlight intensity at anthesis of 388 rice landraces (with 32 replicated populations), flowering in the short-day season of 2022, reveal that under cloudy condition, the rice florets tend to open later, or the sunrise-to-anthesis duration (SAD) is longer when rice florets open than at sunny period. This difference in the length of SAD was statistically highly significant (p< 0.0001), confirmed by two sample permutation test with 10,000 iterations. This finding corroborates our general observation previously reported from a larger set of 1114 landraces (including the 388 landraces in this study). However, the intensity of sunlight at the flower opening time (FOT) may not remain uniformly sunny (high illuminance) or cloudy (low illuminance, < 40000 lux) until the flower closing time (FCT). To understand the effect of uniformly low sunlight intensity, we subsequently recorded solar illuminance at FOT of 33 landrace populations (including 8 repeats). Half of each population was kept under artificial shade, compared to the other half exposed to sunlight. This experiment revealed that low illuminance, mimicking overcast days, significantly (p< 0.01) delays FOT and lengthens SAD, corroborating the pattern detected in our earlier findings. Permutation tests with 10,000 iterations decisively confirms (p< 0.0001) the prolongation of SAD under shade and cloudy condition. Experimental shading has an indeterminate effect on FED of the same landraces. We surmise that the delayed FOT during natural cloudy period is an adaptation in rice plants in anticipation of rain, for protection of the pollen from rainwash.
The optimization ofSalmonellasurveillance programmes for pullet and layer farms using local farm density as a risk factor
Authors: Hobbelen Peter H.F. , Hagenaars Thomas J. , Markovich Michal Peri , Bellaiche Michel , Giovannini Armando , Massis Fabrizio De , de Koeijer Aline
Published: September 2023

Human salmonellosis cases are often caused by Salmonella serovars Enteritidis and Typhimurium and a large percentage of Salmonella outbreaks is associated with the consumption of eggs and egg products. For this reason, many countries implemented general surveillance programmes for the detection and control ofSalmonellaon pullet and layer farms. The infection risk however varies between farms and the identification of risk factors forSalmonellainfection may be used to improve the performance of these surveillance programmes. The aims of this study are therefore to determine 1) whether local farm density is a risk factor for the infection of pullet and layer farms bySalmonellaEnteritidis and Typhimurium and 2) whether the sampling effort of surveillance programmes can be reduced by accounting for this risk factor, while still providing sufficient control of target serovars Enteritidis and Typhimurium. To assess the importance of local farm density as a risk factor, we fitted different transmission kernels to Israeli surveillance data during the period from June 2017 to April 2019. The analysis showed that the distance to infected farms significantly increases the infection risk by serovar Enteritidis within an approximately 4 km radius and by Typhimurium within an approximately 0.3 km radius. We subsequently used these kernels to derive a model for the between-farm R0and used it to optimise a surveillance programme that subdivided layer farms into groups at low and at high risk of between-farm transmission based on the local farm density and allowed the sampling frequency to vary between these groups. In this design, the pullet farms were always sampled one week prior to pullet distribution. Our analysis showed that the risk-based surveillance programme was able to keep the between-farm R0of serovars Enteritidis and Typhimurium below 1 for all pullet and layer farms, using a sampling effort that was reduced by 32% compared to the currently implemented surveillance programme in Israel. The results of our study therefore indicate that local farm density is an important risk factor for infection of pullet and layer farms bySalmonellaEnteritridis and Typhimurium and can be used to improve the performance of surveillance programmes.