bluuebunny/crossref_metadata_2025 huggingface dataset:
Inferring the iron K emissivity profiles of accretion discs irradiated by extended coronae
Authors: Zhang Wenda , Dovčiak Michal , Bursa Michal , Svoboda Jiří , Karas Vladimír
Published: July 2024

One of the most promising methods to measure the spin of an accreting black hole is fitting the broad iron K$\alpha$ line in the X-ray spectrum. The line profile also depends on the geometry of the hard X-ray emitting corona. To put constraints on the black hole spin and corona geometry, it is essential to understand how do they affect the iron K$\alpha$ line emissivity profile. In this work, we present calculations of the illumination and the iron K$\alpha$ emissivity profiles performed with the Monte Carlo GR radiative transfer code monk. We focus on distinction between the illumination and emissivity profiles, which is in most previous studies neglected. We show that especially for the case of black hole X-ray binaries (BHXRBs), the difference is very large. For active galactic nuclei (AGNs), the emissivity profile has a more similar shape as the illumination profile, but it is notably steeper in the innermost region within a few gravitational radii. We find out that the different behaviour between AGN and BHXRB discs is due to the different energy spectra of the illuminating radiation. This suggests that the emissivity profile of the iron K$\alpha$ line cannot be determined by black hole spin and corona geometry alone and the energy spectrum of the illuminating radiation has to be taken into account. We also examined the effect of including the self-irradiation, and find it to be more important than the corona emission in BHXRBs.
Content–state dimensions characterize different types of neuronal markers of consciousness
Authors: Pérez Pauline , Manasova Dragana , Hermann Bertrand , Raimondo Federico , Rohaut Benjamin , Bekinschtein Tristán A , Naccache Lionel , Arzi Anat , Sitt Jacobo D
Published: July 2024

Identifying the neuronal markers of consciousness is key to supporting the different scientific theories of consciousness. Neuronal markers of consciousness can be defined to reflect either the brain signatures underlying specific conscious content or those supporting different states of consciousness, two aspects traditionally studied separately. In this paper, we introduce a framework to characterize markers according to their dynamics in both the “state” and “content” dimensions. The 2D space is defined by the marker’s capacity to distinguish the conscious states from non-conscious states (on the x-axis) and the content (e.g. perceived versus unperceived or different levels of cognitive processing on the y-axis). According to the sign of the x- and y-axis, markers are separated into four quadrants in terms of how they distinguish the state and content dimensions. We implement the framework using three types of electroencephalography markers: markers of connectivity, markers of complexity, and spectral summaries. The neuronal markers of state are represented by the level of consciousness in (i) healthy participants during a nap and (ii) patients with disorders of consciousness. On the other hand, the neuronal markers of content are represented by (i) the conscious content in healthy participants’ perception task using a visual awareness paradigm and (ii) conscious processing of hierarchical regularities using an auditory local–global paradigm. In both cases, we see separate clusters of markers with correlated and anticorrelated dynamics, shedding light on the complex relationship between the state and content of consciousness and emphasizing the importance of considering them simultaneously. This work presents an innovative framework for studying consciousness by examining neuronal markers in a 2D space, providing a valuable resource for future research, with potential applications using diverse experimental paradigms, neural recording techniques, and modeling investigations.
Rehabilitation utilization in malignant primary brain tumors compared to stroke and traumatic brain injury: Analysis using a large claim database
Authors: Giovanazzi Samantha , Ugiliweneza Beatrice , Alvarez Elsa , Boakye Maxwell , Kaelin Darryl , Nelson Megan B
Published: July 2024

Background

There is concern regarding the underutilization of rehabilitation services for the malignant primary brain tumor (MPBT) population following hospitalization. Our aim is to assess physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP) use after an MPBT diagnosis, evaluate the trend from 2001 to 2018, and compare to traumatic brain injury (TBI) and stroke.

Methods

Adult cases of MPBT, TBI, and stroke were extracted from MarketScan database. Inpatient and outpatient data were screened for inpatient rehabilitation use at the time of diagnosis and postdischarge outpatient PT, OT, and SLP over 12 months. Generalized linear regressions were used for analysis.

Results

The cohort was composed of 3381 MPBT, 205 366 stroke, and 24 825 TBI patients. After diagnosis, 1% of MPBTs were discharged to skilled nursing facilities (SNF) and 3% to inpatient rehabilitation facilities (IRF). Rehabilitation use at 12 months was 19% PT, 8% OT, and 6% SLP. These percentages were lower than stroke and TBI; stroke: 8% SNF, 8% IRF, 22% PT, 10% OT, and 8% SLP; TBI: 7% SNF, 7% IRF, 22% PT, 8% OT, and 6% SLP. Outpatient therapies increased from 2001 to 2018, with PT use consistently higher than OT and SLP. MPBT had the greatest increases in OT (7.95 times) and PT (3.89 times) compared to stroke and TBI, while stroke had the greatest increase in SLP (0.98 times).

Conclusions

MPBT patients had the highest increase in OT and PT utilization when compared to stroke and TBI. However, there remains a utilization gap which demonstrates the need for improvement.
The Extent of Illicit Cigarette Sales in Five Rural Districts of Pakistan: A Cross-sectional Study
Authors: Abdullah S M , Ansaari Saeed , Boeckmann Melanie , Khan Amina , Siddiqi Kamran
Published: July 2024

Introduction

The Illicit Tobacco Trade (ITT) subverts tobacco control efforts. Cigarette packs sold without legal health warnings undermine efforts to warn the public about the dangers of tobacco. Furthermore, cigarettes sold below minimum retail prices are indicative of tax evasion leading to revenue loss and budgetary deficits in high tobacco-burden economies. The extent of the ITT in rural areas of such countries might differ from urban. We estimated the extent of illicit cigarette sales in selected rural areas of Pakistan.

Aims and Methods

We analyzed cigarette packs collected from 85 villages in Pakistan as part of a cross-sectional consumer survey of 2550 rural households. We classified cigarette packs as noncompliant if these were missing: A text health warning, pictorial health warning (PHW), underage sale prohibition warning, retail price, or manufacturer details. To measure the extent of tax evasion, we estimated the proportion of packs purchased below the legal minimum retail price.

Results

Only 35% (429/1228) of rural smokers were able to show their cigarette packs. Out of these, 89% (382/429) of packs were noncompliant with the cigarette packaging and labeling laws. In rural areas, 83% (357/429) of packs did not have PHW and 33.8% (145/429) did not have printed retail prices. Among all packs, 41% (177/429) were purchased below the minimum retail price of 63 Pakistani Rupees and hence highly likely to have evaded taxes.

Conclusions

We found a very high previously unreported proportion of noncompliant cigarette packs in selected rural areas of Pakistan indicating weaker implementation of tobacco control laws in rural areas.

Implications

This paper presents previously unreported estimates of the share of illicit cigarette sales in rural areas of Pakistan. Most packs (89%) in our sample were noncompliant with the packaging and labeling regulations and a significant proportion (41%) were purchased below the minimum price. The extent of illicit tobacco was found to be far greater in rural than in urban areas of Pakistan. Taking advantage of poor law enforcement, the tobacco industry may be complicit in flooding the rural markets with illegal and cheap cigarettes. Given this disparity, law enforcement authorities must focus on rural areas.
Clinical reasoning in real-world practice: a primer for medical trainees and practitioners
Authors: Ng Isaac K S , Goh Wilson G W , Teo Desmond B , Chong Kar Mun , Tan Li Feng , Teoh Chia Meng
Published: July 2024

Clinical reasoning is a crucial skill and defining characteristic of the medical profession, which relates to intricate cognitive and decision-making processes that are needed to solve real-world clinical problems. However, much of our current competency-based medical education systems have focused on imparting swathes of content knowledge and skills to our medical trainees, without an adequate emphasis on strengthening the cognitive schema and psychological processes that govern actual decision-making in clinical environments. Nonetheless, flawed clinical reasoning has serious repercussions on patient care, as it is associated with diagnostic errors, inappropriate investigations, and incongruent or suboptimal management plans that can result in significant morbidity and even mortality. In this article, we discuss the psychological constructs of clinical reasoning in the form of cognitive ‘thought processing’ models and real-world contextual or emotional influences on clinical decision-making. In addition, we propose practical strategies, including pedagogical development of a personal cognitive schema, mitigating strategies to combat cognitive bias and flawed reasoning, and emotional regulation and self-care techniques, which can be adopted in medical training to optimize physicians’ clinical reasoning in real-world practice that effectively translates learnt knowledge and skill sets into good decisions and outcomes.
Cognitive Behavioral Psychotherapy as an Add-on in Comprehensive Outpatient Care of Non-affective Psychoses: A Multicenter Randomized-Controlled Effectiveness Trial in a Naturalistic Setting
Authors: Steuwe Carolin , Carvalho Fernando Silvia , Runte Ingo , Bender Stefan , Heiler Wolfgang , Klein Fabian , Kronmüller Klaus , Volmert Kathrin , Norra Christine , Engelbrecht Stefan , Driessen Martin
Published: July 2024

Background and Hypothesis

Non-affective psychoses (NAP) are associated with severe consequences with regard to social functioning, physical health, employment, and suicidality. Treatment guidelines recommend cognitive behavioral therapy for psychosis (CBTp) as an effective additional treatment strategy to psychopharmacology. We hypothesized that outpatient CBTp has an add-on effect in individuals with NAP who already receive comprehensive outpatient care (COC) in Germany.

Study Design

In a randomized-controlled effectiveness trial, 6 months of COC + CBTp were compared to COC. The primary outcomes were change of symptom severity as assessed by the Positive and Negative Symptom Scale (pre-/post-treatment and 6-month follow-up). Mixed linear models and effect sizes were used to compare changes across treatment groups. Additionally, the number of readmissions was compared.

Study Results

N = 130 individuals with chronic NAP were recruited (COC + CBTp: n = 64, COC: n = 66). COC + CBTp participants significantly improved more regarding positive symptom severity (estimated mean difference at follow-up: −2.33, 95% CI: −4.04 to −0.61, P = .0083, d = 0.32) and general psychopathology (estimated mean difference at follow-up: −4.55, 95% CI: −7.30 to −1.81, P = .0013, d = 0.44) than the COC group. In both groups, negative symptom severity did not change significantly over time nor did groups differ regarding readmissions.

Conclusion

The results underline an add-on benefit of CBTp in chronically ill individuals with NAP. Superiority of CBTp was demonstrated in comparison with high-quality comprehensive care and may also be true in different comprehensive care settings.

Clinical Trials Registration

DRKS00015627.
CbCyp51-Mediated Demethylation Inhibitor Resistance Is Modulated by Codon Bias
Authors: Rangel Lorena I. , Wyatt Nathan , Courneya Isaac , Natwick Mari B. , Secor Gary A. , Rivera-Varas Viviana , Bolton Melvin D.
Published: July 2024

Cercospora leaf spot, caused by the fungus Cercospora beticola, is the most destructive foliar disease of sugarbeet worldwide. Resistance to the sterol demethylation inhibitor (DMI) fungicide tetraconazole has been previously correlated with synonymous and nonsynonymous mutations in CbCyp51. Here, we extend these analyses to the DMI fungicides prothioconazole, difenoconazole, and mefentrifluconazole in addition to tetraconazole to confirm whether the synonymous and nonsynonymous mutations at amino acid positions 144 and 170 are associated with resistance to these fungicides. Nearly half of the 593 isolates of C. beticola collected in the Red River Valley of North Dakota and Minnesota in 2021 were resistant to all four DMIs. Another 20% were resistant to tetraconazole and prothioconazole but sensitive to difenoconazole and mefentrifluconazole. A total of 13% of isolates were sensitive to all DMIs tested. We found five CbCyp51 haplotypes and associated them with phenotypes to the four DMIs. The most predominant haplotype (E170_A/L144F_C) correlated with resistance to all four DMIs with up to 97.6% accuracy. The second most common haplotype (E170_A/L144) consisted of isolates associated with resistance phenotypes to tetraconazole and prothioconazole while also exhibiting sensitive phenotypes to difenoconazole and mefentrifluconazole with up to 98.4% accuracy. Quantitative PCR did not identify differences in CbCyp51 expression between haplotypes. This study offers an understanding of the importance of codon usage in fungicide resistance and provides crop management acuity for fungicide application decision-making.
Mid1 aggravates hepatic ischemia–reperfusion injury by inducing immune cell infiltration
Authors: Li Ji , Jin Changlian , Li Yue , Liu Huanqiu
Published: July 2024

Hepatic ischemia–reperfusion injury (HIRI) represents a major risk factor in liver transplantation and resection surgeries. Kupffer cells (KCs) produce proinflammatory cytokines and lead to hepatic neutrophil infiltration in the liver, which is one of the leading causes of HIRI. Mid1 is involved in immune infiltration, but the role of Mid1 remains poorly understood. Herin, our study aimed to investigate the effect of Mid1 on HIRI progression. Male C57BL/6 mice aged 6 weeks were used for the HIRI model established. The function of Mid1 on liver injury and hepatic inflammation was evaluated. In vitro, KCs were used to investigate the function and mechanism of Mid1 in modulating KC inflammation upon lipopolysaccharide (LPS) stimulation. We found that Mid1 expression was up‐regulated upon HIRI. Mid1 inhibition alleviated liver damage, as evidenced by neutrophil infiltration, intrahepatic inflammation, and hepatocyte apoptosis. In vitro experiments further revealed that Mid1 knockdown reduced the secretion of proinflammatory cytokines and chemokines in KCs. Moreover, silenced‐Mid1 suppressed proinflammatory responses by the inhibition of NF‐κB, JNK, and p38 signaling pathways. Taken together, Mid1 contributes to HIRI via regulating the proinflammatory response of KCs and inducing neutrophil infiltration. Targeting Mid1 may be a promising strategy to protect against HIRI.
N-Butyl-2-Cyanoacrylate Adhesive Versus Absorbable Tacks in Laparoscopic Groin Hernia Repair: A Multicenter Randomized Clinical Trial
Authors: Petro Clayton C. , Poulose Benjamin K. , Rosen Michael J. , Carbonell Alfredo M. , El-Ghazzawy Adel G. , Warren Jeremy A. , Lo Menzo Emanuele , Prabhu Ajita S. , Krpata David M. , Szomstein Samuel , Narula Vimal , Totten Crystal F. , Haisley Kelly R. , Bernard Andrew C. , Berdel Henrik O. , Reynolds Jessica K. , Warriner Zachary D. , Roth John S.
Published: July 2024

Objective:

We aimed to determine whether n-butyl-2-cyanoacrylate (NB2C) adhesive is a safe and effective mechanism for nonpenetrating mesh and peritoneal fixation during laparoscopic groin hernia repair.

Background:

Chronic pain after laparoscopic groin hernia repair has been associated with penetrating fixation, but there had been no US Food and Drug Administration–approved devices for nonpenetrating fixation in this context.

Methods:

Patients undergoing laparoscopic transabdominal preperitoneal (TAP) or totally extraperitoneal (TEP) groin hernia repair with mesh at 1 of 5 academic medical centers were randomized to mesh (TAP/TEP) and peritoneal (TAP) fixation with NB2C adhesive or absorbable tacks. The primary outcome was improvement in pain (visual analog scale [VAS]) at 6 months. The noninferiority margin was 0.9 (α = 0.025; β = 80%). Recurrence, successful use of the device, quality of life, and rates of adverse events (AEs) were secondary outcomes.

Results:

From 2019 to 2021, 284 patients were randomized to either NB2C adhesive or absorbable tacks (n = 142/142). Patient and hernia characteristics were comparable, and 65% were repaired using a TAP approach. The difference in VAS improvement at 6 months with NB2C adhesive was not inferior to absorbable tacks in intention-to-treat and per-protocol analyses, respectively (0.25 [95% CI, −0.33 to 0.82]; P = 0.013; 0.22 [95% CI, −0.36 to 0.80], noninferiority P = 0.011). There were no differences in secondary outcomes including recurrence, successful use of each device to fixate the mesh and peritoneum, quality of life, and additional VAS pain scores. Rates of adverse and serious AEs were also comparable.

Conclusions:

NB2C adhesive is safe and effective for mesh fixation and peritoneal closure during laparoscopic groin hernia repair.
Lateral Tibial Plateau Reconstruction Using Tricortical Iliac Crest Autograft as the Weight-Bearing Surface
Authors: Solasz Sara , Ganta Abhishek , Konda Sanjit R.
Published: July 2024

This overview and case presentation demonstrates a novel approach to the reconstruction of a lateral tibial plateau with near-complete bone loss using tricortical iliac crest autograft as the weight-bearing surface.

Video available at:

https://ota.org/education/ota-online-resources/video-library-procedures-techniques/lateral-tibial-plateau
Achieving Limb-Length Equality in Femoral Shaft Fractures
Authors: Eurich Jennifer , Dwyer Emma P. , Gibbs Stephen , Erdman Mary Kate
Published: July 2024

This review demonstrates 4 techniques for establishing limb-length equality following fixation of femoral shaft fractures and describes the pearls and pitfalls of each technique.

Video available at:

https://ota.org/education/ota-online-resources/video-library-procedures-techniques/achievinglimb-length-equality
Antibody-drug conjugates in solid tumors: a new frontier
Authors: Jaime-Casas Salvador , Barragan-Carrillo Regina , Tripathi Abhishek
Published: July 2024

Purpose of review

Antibody-drug conjugates (ADCs) are designed to carry cytotoxic payloads and deliver them to specific molecular targets within tumor cells. Several ADCs are already approved with many more in development across several disease types. In this review, we will provide an overview of the ADCs currently approved and those under investigation in solid tumors.

Recent findings

Currently there are dozens of ADCs under clinical study evaluation of a variety of solid tumors, and preliminary results are promising. Multiple ADCs have received regulatory approval in disease such as breast cancer, non-small cell lung cancer, and bladder cancer. While some are approved in biomarker selected settings with disease specific indication (e.g. breast cancer), others have been approved irrespective of biomarker expression (urothelial carcinoma) and pan-cancer indications in biomarker selected patients (HER2 3+ expression).

Cytotoxic chemotherapy has been the mainstay of systemic treatment for patients with various solid tumors. ADCs offer the advantage of carrying the cytotoxic payload onto a specific molecular receptor, thereby inducing a more selective response. Optimizing selection of target antigen, payload delivery and investigating biomarkers of response will be crucial for further expanding the therapeutic benefit of ADCs across solid tumors.
Survivorship after Hodgkin lymphoma and the right to be forgotten
Authors: Stepanishyna Yana , Meunier Françoise , Bron Dominique
Published: July 2024

Purpose of review

The significantly improved survivorship in Hodgkin lymphoma is fraught with challenges, including persistent symptoms, secondary health complications, and socio-professional obstacles. This review highlights the need for comprehensive survivorship care plans that include detection of relapse, assessment of long-term side effects, screening for secondary cancers, psychological support, and assistance with socio-professional integration.

Recent findings

Cardiovascular diseases, secondary malignancies and other associated risks remains an important problem related to the effective treatment of patients with Hodgkin lymphoma. Furthermore, fertility concerns and endocrine disorders remain prevalent issues posttreatment. An optimal evaluation of the risks before and after treatment is essential to reduce the impact of these side effects on quality of life. Addressing the socio-professional reintegration of survivors, the concept of the ‘Right to be forgotten’ emerges as a critical consideration. This principle seeks to eliminate discrimination against cancer survivors in accessing financial services and aims for legislative changes to ensure that past cancer diagnosis does not unfairly affect survivors’ futures. Implementation of this ‘Right to be forgotten’ in the legislature, is currently underway in European countries.

The focus of survivorship care has shifted towards the holistic management of these long-term outcomes. Quality of life for Hodgkin lymphoma survivors is affected by various treatment-related factors, with evidence suggesting that physical, psychological and socio-professional domains remain impacted years after treatment.
Aggressive Form of Mycosis Fungoides With Bilateral Testicular Involvement and Salivary Gland Mass, Exhibiting Phenotypic Switch
Authors: Rolim Ricardo , Maia Tiago , Ionita Alina , Cravo Mariana , Cabeçadas José
Published: July 2024

We report the case of a 72-year-old man with bilateral testicular involvement by mycosis fungoides (MF). The patient was diagnosed with MF 6 months prior, and testicular involvement was found upon staging. The rare behavior of MF, with early visceral involvement and no hematolymphoid organs affected, had a poor prognosis with patient death 14 months after the original diagnosis despite surgery and chemotherapy. The neoplastic cells showed a phenotypic switch from a CD4+/CD8− profile in the skin to a CD4−/CD8− in the testis and the same clone, confirmed with T-cell receptor gene rearrangement studies, making this the third reported case of MF affecting the testis and the first with clonality studies to confirm it. The clinical evolution may be related to its distinctive biology showcased in the neoplastic cell's switch to a more aggressive CD4−/CD8− profile and the early extension of the disease to an uncommon visceral site.
Psychometric Analysis of the Heart Failure Somatic Perception Scale in Japanese Patients With Heart Failure
Authors: Hayashi Kanako , Okada Akiko , Jurgens Corrine Y. , Ito Shinya , Tsuchihashi-Makaya Miyuki
Published: July 2024

Background

Patients with heart failure (HF) experience a wide variety of symptoms. Appropriate recognition of symptoms is important in HF care. The Heart Failure Somatic Perception Scale (HFSPS) measures the presence of HF symptoms and the degree to which physical symptoms are bothersome.

Objective

The aim of this study was to assess the validity and reliability of the Japanese version of the HFSPS.

Methods

Confirmatory factor analysis was used to assess structural validity. Construct validity was assessed using Spearman's rank correlation coefficient to evaluate the association between HFSPS total and subscale scores and global physical health on the Patient-Reported Outcomes Measurement Information System. Internal consistency was assessed using the model-based internal consistency for the HFSPS as a whole and Cronbach α for the subscales.

Results

Participants were 315 Japanese outpatients (72.1% male), with a mean age of 72.9 ± 12.9 years. The result of confirmatory factor analysis was an adequate model fit by adding error correlations. Construct validity was significant for the correlation with global physical health of the Patient-Reported Outcomes Measurement Information System. The model-based internal consistency was 0.95. Cronbach αs for each subscale were 0.88 for dyspnea, 0.60 for chest discomfort, 0.77 for early and subtle symptoms, and 0.77 for edema.

Conclusions

The findings support the use of the HFSPS in a more diverse population, suggesting that it is a reliable and valid instrument in Japanese patients with HF. The HFSPS may provide an accurate assessment of the symptoms experienced by patients with HF in daily life in future educational intervention studies to improve symptom perception and coping behaviors.
Comparison of Weight-Based Valproic Acid Dosing in Treatment of Mental Illness Among Obese and Nonobese Patients
Authors: Trac Cindy , Zecopoulos Angeleki , Ross Clint , Weeda Erin , McGraw Dan
Published: July 2024

Purpose/Background

A weight-based dosing approach of 20–30 mg/kg per day of valproic acid (VPA) has been shown to achieve rapid attainment of mood symptom control. Due to interindividual pharmacokinetic variability, therapeutic drug monitoring may be a useful tool to avoid VPA toxicity. Limited research exists on the impact of patient body weight on VPA pharmacokinetic profiles. This analysis aims to explore the correlation between steady-state serum levels of VPA and weight-based dosing strategies, including total body weight (TBW), ideal body weight (IBW), and adjusted body weight (AdjBW), between obese and nonobese patients.

Methods/Procedures

This single-center, retrospective, observational cohort analysis evaluated weight-based dosing of VPA in obese and nonobese patients admitted to inpatient psychiatry at a large academic medical center between July 1, 2017, and July 1, 2022.

Findings/Results

This analysis included 93 obese and 93 nonobese patients. No significant difference in median VPA serum concentrations was observed between groups (P = 0.82). However, the obese group received a lower median weight-based dose (15.6 mg/kg) compared with the nonobese group (19.5 mg/kg, P < 0.001). A stronger correlation was found between VPA dose and therapeutic serum levels in the obese group compared with the nonobese group regardless of weight-based dosing strategy. Dosing with AdjBW in obese patients most closely approximated dosing with TBW in nonobese patients.

Implications/Conclusions

In obese patients, our analysis suggests dosing VPA using AdjBW may be considered as the preferred dosing strategy over IBW or TBW to minimize toxicity risk. Further research is needed with larger sample sizes and diverse patient populations to confirm these findings.
Relationship of pancreatitis to pancreatic cancer: from population-based observations to preclinical and mechanistic insights
Authors: Zhang Xiuli , Chen Zhigao , Zhao Xiong , Pan Jiachun , Pandol Stephen , Wen Li
Published: July 2024

Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest malignancies, accounting for 95% of pancreatic cancer cases, with a 5-year survival rate of around 10%. The relationship between pancreatitis and pancreatic cancer has been noted within the medical community. Recent epidemiological data and findings from experimental mouse models have underscored pancreatitis as a critical risk factor for pancreatic cancer. Therefore, exploring the mechanisms underlying the transition from pancreatitis to pancreatic cancer is crucial for improving early detection and treatment strategies for pancreatic cancer. In this review, we conducted a comprehensive search of the PubMed database and discussed relevant original studies, focusing on three key areas: findings from population- and animal-based studies, the role of pancreatic epithelial cell-intrinsic factors, and the impact of immune cells and cytokines. Additionally, we offered our prospectives on possible future research directions.
The Effect of 3D-Printed Custom Insoles on Plantar Pressure for Obese Individual
Authors: Özgün Ali Koray , Sezer Hüseyin Kürşad , Alsancak Serap , Şahin Ismail
Published: July 2024

Introduction

There are many types of insoles made for obese individuals. However, there is a need for studies on insoles produced with 3D printers using flexible materials and comparing and examining the effect of these on plantar pressure.

Materials and Methods

An obese individual with a body mass index (BMI) > 35 recommended by physicians to use insoles was included in this study. The individual’s foot was scanned using a 3D scanner, and insoles were designed using CAD software. The insoles were produced with TPU-75A flexible filament on a 3D printer at different fill rates (5%, 10%, and 15%). The effects of the insoles on underfoot pressures were clinically compared.

Results

Custom insoles with different filling ratios were made for an obese individual using flexible filament in 3D printers. The most appropriate insole print filling ratio for minimum foot pain experienced by the obese patient during their daily activities has been determined. The results reveal that 3D-printed insoles distribute the plantar pressure more effectively with significantly reduced pressure in certain foot locations (i.e., heel, under the first metatarsal) as compared with the existing insoles.

Conclusions

Manufactured by additive manufacturing, these insoles are produced using a fully digitized scanning process that creates virtually no material wastage. The thermoplastic polyurethane was preferred due to its favorable properties. By changing the pressure structure and internal filling system, it allows producing personalized insoles in the desired contact areas of hard and soft.

Clinical Relevance

This study provides evidence that insoles produced in 3D printers with flexible materials are as effective as insoles produced with traditional methods in reducing plantar pressure. Therefore, it is an alternative to traditional methods due to less labor.
Validation of the validity of the new wrist-type fully automatic blood pressure monitor: DBP-2242 according to ISO 81060-2:2018+AMD 1:2020
Authors: Jin Yuehong , Bei Xiaoming , Jin Ying
Published: July 2024

Objective

Evaluation of the accuracy of the wrist-type fully automatic blood pressure (BP) monitor: DBP-2242 in adolescent and adult populations according to ISO 81060-2 : 2018+Amd.1 : 2020.

Methods

BP measurements were taken from the subjects using the same-arm sequential method, and BP data measured by a mercury sphygmomanometer was used as the standard.

Results

This study analyzed 262 sets of data from 89 subjects. According to criterion 1, the mean difference between the SBP of the test and reference devices was −0.57 ± 7.31 mmHg, and the DBP was −2.27 ± 7.17 mmHg, which is in accordance with the requirements. According to criterion 2, the average difference between the SBP was −0.57 ± 6.25 mmHg and the DBP was −2.27 ± 5.99 mmHg, which is in accordance with the requirements.

Conclusion

Wrist-type fully automatic BP monitor: DBP-2242 complies with ISO 81060-2 : 2018+Amd.1 : 2020 and can be used for BP measurement in adolescent and adult populations.
The Use of Clips to Prevent Post-Polypectomy Bleeding: A Clinical Review
Authors: O’Mara Matthew A. , Emanuel Peter G. , Tabibzadeh Aaron , Duve Robert J. , Galati Jonathan S. , Laynor Gregory , Gross Samantha , Gross Seth A.
Published: July 2024

Goals:

The goal of this clinical review is to provide an overview of the current literature regarding the utility of prophylactic clips in reducing postpolypectomy bleeding and to provide an expert statement regarding their appropriateness in clinical practice.

Background:

Colonoscopy enables the identification and removal of premalignant and malignant lesions through polypectomy, yet complications including postpolypectomy bleeding (PPB) can arise. While various studies have explored applying clips prophylactically to prevent PPB, their effectiveness remains uncertain.

Study:

A literature search conducted in PubMed and Embase identified 671 publications discussing clip use postpolypectomy; 67 were found to be relevant after screening, reporting outcomes related to PPB. Data related to clip utilization, polyp characteristics, and adverse events were extracted and discussed.

Results:

The current literature suggests that prophylactic clipping is most beneficial for nonpedunculated polyps ≥20 mm, especially those in the proximal colon. The utility of clipping smaller polyps and those in the distal colon remains less clear. Antithrombotic medication usage, particularly anticoagulants, has been linked to an increased risk of bleeding, prompting consideration for clip placement in this patient subgroup. While cost-effectiveness analyses may indicate potential savings, the decision to clip should be tailored to individual patient factors and polyp characteristics.

Conclusions:

Current research suggests that the application of prophylactic clips can be particularly beneficial in preventing delayed bleeding after removal of large nonpedunculated polyps, especially for those in the proximal colon and in patients on antithrombotic medications. In addition, for large pedunculated polyps prophylactic clipping is most effective at controlling immediate bleeding.
Syphilis Positivity Among Men Who Have Sex With Men With Direct, Indirect, and No Linkage to Female Sex Partners: Exploring the Potential for Sex Network Bridging in Baltimore City, MD
Authors: Schumacher Christina M. , Thornton Nicole , Craig Taylor , Tilchin Carla , Fields Errol , Ghanem Khalil G. , Hamill Matthew M. , Latkin Carl , Rompalo Anne , Ruhs Sebastian , Jennings Jacky M.
Published: July 2024

Background

Syphilis epidemics among women and men who have sex with men (MSM) may be connected, but these connections are poorly understood. Using egocentric network data from a US urban MSM cohort, we examined sociodemographics, behaviors, and syphilis positivity among MSM with (1) direct (MSM who report sex with women, MSMW); (2) indirect (MSM who only report male partners, some of whom are MSMW, MSMO/W); and (3) no (MSM who only report male partners and whose partners only have sex with men, MSMO/O) connection to women.

Methods

Sexually active MSM aged 18 to 45 years were administered behavioral and network interviews (recall period: 3 months) and syphilis/HIV testing. Syphilis positivity was defined as rapid plasma reagin titer ≥1:8. Modified Poisson regression was used to test for differences across groups.

Results

Among 385 MSM, 14.5% were MSMW and 22.3% were MSMO/W. MSMW and MSMO/W were significantly more likely than MSMO/O to report sex behaviors associated with increased syphilis acquisition/transmission risk, including ≥2 sex partners (MSMW: adjusted prevalence ratio [aPR], 1.28 [0.98–1.68]; MSMO/W: aPR, 1.35 [1.09–1.69]) and concurrent sex partners (MSMW: aPR, 1.50 [1.17–1.92]; MSMO/W: aPR, 1.39 [1.11–1.74]), and for MSMW only, transactional sex (aPR, 2.07 [1.11–3.88]). Syphilis positivity was 16.4% and was lower among MSMW (9.4%) and MSMO/W (14.1%) than MSMO/O (18.5%), but differences were not significant.

Conclusions

There may be considerable connectivity between MSM and female sex partners that could facilitate syphilis transmission, and behaviors that increase acquisition/transmission risk among MSMW and MSMO/W may be distinct from MSMO/O. Future work should focus on examining the context and temporal patterns of sex partnerships among MSMW and MSMO/W.
Mycoplasma genitalium Infections Among Participants in an HIV Pre-exposure Prophylaxis Program in Hanoi, Vietnam
Authors: Nguyen Khanh D. , Adamson Paul C. , Bui Hao TM. , Pham Loc Q. , Truong Phuong T. , Le Ngan T. , Le Giang M. , Klausner Jeffrey D.
Published: July 2024

Background

Mycoplasma genitalium causes a sexually transmitted infection and is also emerging as an important antimicrobial resistant pathogen. Data on M. genitalium infections among men who have sex with men (MSM) in low-resource settings are sparse.

Methods

From January to December 2022, participants in an HIV pre-exposure prophylaxis (PrEP) program in Hanoi, Vietnam were enrolled into the study. Demographic, behavioral, and clinical characteristics were collected. Self-collected urine, rectal, and pharyngeal specimens were tested for M. genitalium using the Alinity m STI Assay (Abbott Molecular, USA). Univariate and multivariate logistic regression were performed to assess for factors associated with infections.

Results

Among 477 participants, the median age was 25.3 years (21.7–29.6) and 92.2% (n = 440) identified as MSM; 48.6% had ≥2 sex partners and 38.1% reported condomless anal sex in the prior month. The overall prevalence of M. genitalium infection was 10.9% (52/477); 7.3% (34/464) rectal, 3.2% (15/476) urethral, and 1.9% (9/476) pharyngeal. Infections were asymptomatic in 71.2% (37/52). Among those with M. genitalium, 30.7% (16/52) were co-infected with either Neisseria gonorrhoeae or Chlamydia trachomatis. Among those reporting rectal (n = 51) or urethral (n = 35) symptoms, but without C. trachomatis or N. gonorrhoeae co-infections, five (9.8%) had rectal infections and one (2.9%) had urethral infection. Participants with M. genitalium were more likely to be asymptomatic than participants without M. genitalium (adjusted odds ratio, 1.93; 95% confidence interval, 1.01–3.71).

Conclusions

Mycoplasma genitalium infections were common among primarily MSM engaged in an HIV PrEP program in Vietnam. The prevalence was highest in rectal specimens and nearly three quarters of M. genitalium infections were asymptomatic. Testing for M. genitalium infections among those with symptoms is important to enable pathogen-directed therapy. Additional research on antimicrobial resistance and treatment strategies for M. genitalium in low-resource settings is needed.
The construction of a novel supplementary diagnostic model for patients with indeterminate HIV infection
Authors: Yan Yajun , Yuan Rui , Deng Liping , Hu Hui , Yang Yong , Gui Xien , Yang Rongrong
Published: July 2024

Introduction:

The window period, defined as HIV nucleic acid test (NAT) reactivity but Western blot (WB) test inconclusive, is garnering more attention. Improving the detection efficiency of HIV high-risk populations in the window period is critical to reducing the risk of unanticipated transmission. The purpose of this study was to create an additional strategy for distinguishing indeterminate HIV infection cases.

Methods:

Based on WB follow-up results, the individuals in this study were divided into persons in the HIV window period and persons without HIV. Plasma was analyzed using quantitative liquid chromatography–tandem mass spectrometry (LC–MS/MS) to detect differentially expressed proteins (DEPs). The biological implications of these DEPs were investigated using enrichment analysis. Protein–protein interaction (PPI) analysis and LASSO regression were used to identify key proteins. The calibration curve, decision curve, and nomogram were utilized to create the model.

Results:

Fifty-seven DEPs were screened out, with 33 up-regulated and 24 down-regulated in persons with HIV at window period. The most important Gene Ontology (GO) enrichment items are oxidoreductase activity and heme binding. Oxidoreductases account for half of the 10 main proteins identified from various DEPs. An auxiliary diagnostic model comprised of peroxiredoxin-2 (P32119), band 3 anion transport protein (P02730), and histone H2A type 1 (P0C0S8) was developed. The results of the confusion matrix parameters revealed that this diagnostic approach had strong practicability in distinguishing indeterminate HIV infection cases.

Conclusions:

The three DEPs identified and predicted by proteomics are useful for the supplemental identification of persons in the HIV window period.
Long-time behaviour of a porous medium model with degenerate hysteresis
Authors: Gavioli Chiara , Krejčí Pavel
Published: July 2024

Hysteresis in the pressure-saturation relation in unsaturated porous media, owing to surface tension on the liquid–gas interface, exhibits strong degeneracy in the resulting mass balance equation. As an extension of previous existence and uniqueness results, we prove that under physically admissible initial conditions and without mass exchange with the exterior, the unique global solution of the fluid diffusion problem exists and asymptotically converges as time tends to infinity to a possibly non-homogeneous mass distribution and an
a priori
unknown constant pressure.

This article is part of the theme issue ‘Non-smooth variational problems with applications in mechanics’.
Spatiotemporal changes of pelagic food webs investigated by environmental DNA metabarcoding and connectivity analysis
Authors: Bellardini Daniele , Russo Luca , Di Tuccio Viviana , De Luca Daniele , Del Gaizo Gabriele , Zampicinini Gianpaolo , Kokoszka Florian , Botte Vincenzo , Colloca Francesco , Conversano Fabio , De Luca Pasquale , Iudicone Daniele , Margiotta Francesca , Saviano Simona , Vassallo Paolo , Cianelli Daniela , D’Alelio Domenico
Published: July 2024

Environmental DNA metabarcoding (eDNA metaB) is fundamental for monitoring marine biodiversity and its spread in coastal ecosystems. We applied eDNA metaB to seawater samples to investigate the spatiotemporal variability of plankton and small pelagic fish, comparing sites with different environmental conditions across a coast-to-offshore gradient at river mouths along the Campania coast (Italy) over 2 years (2020–2021). We found a marked seasonality in the planktonic community at the regional scale, likely owing to the hydrodynamic connection among sampling sites, which was derived from numerical simulations. Nonetheless, spatial variability among plankton communities was detected during summer. Overall, slight changes in plankton and fish composition resulted in the potential reorganization of the pelagic food web at the local scale. This work supports the utility of eDNA metaB in combination with hydrodynamic modelling to study marine biodiversity in the water column of coastal systems.

This article is part of the theme issue ‘Connected interactions: enriching food web research by spatial and social interactions’.
A model linking emotional dysregulation in neurodivergent people to the proprioceptive impact of joint hypermobility
Authors: Eccles Jessica A. , Quadt Lisa , Garfinkel Sarah N. , Critchley Hugo D.
Published: July 2024

Emotional feelings are putatively ascribed to central representation of bodily states in the context of expectation and uncertainty in both internal state and external world. Neurodivergent people are more likely to experience co-occurring mental health challenges, although mechanistic insights underpinning this association are scarce. We therefore undertook a study to test whether imprecise processing of proprioceptive error signals may underlie the connection between neurodivergence and emotional dysregulation. In a cohort of people with complex chronic conditions, including chronic pain/fatigue, and complex trauma, and in a comparison group, we assessed presence of neurodivergence, variant connective tissue manifested through joint hypermobility, and emotional dysregulation. We present a data-informed conceptual model showing that variant connective tissue determines whether proprioceptive surprise is linked with emotional dysregulation in neurodivergent individuals. We suggest that future research in this area may have important clinical implications for the interaction of mental and physical wellbeing in neurodivergent people.

This article is part of the theme issue ‘Sensing and feeling: an integrative approach to sensory processing and emotional experience’.
A social cognition perspective on misophonia
Authors: Berger Joel I. , Gander Phillip E. , Kumar Sukhbinder
Published: July 2024

Misophonia is commonly classified by intense emotional reactions to common everyday sounds. The condition has an impact both on the mental health of its sufferers and societally. As yet, formal models on the basis of misophonia are in their infancy. Based on developing behavioural and neuroscientific research we are gaining a growing understanding of the phenomenology and empirical findings in misophonia, such as the importance of context, types of coping strategies used and the activation of particular brain regions. In this article, we argue for a model of misophonia that includes not only the sound but also the context within which sound is perceived and the emotional reaction triggered. We review the current behavioural and neuroimaging literature, which lends support to this idea. Based on the current evidence, we propose that misophonia should be understood within the broader context of social perception and cognition, and not restricted within the narrow domain of being a disorder of auditory processing. We discuss the evidence in support of this hypothesis, as well as the implications for potential treatment approaches.

This article is part of the theme issue ‘Sensing and feeling: an integrative approach to sensory processing and emotional experience’.
Evaluation of antimicrobial pattern of difficult-to-treat resistant Gram negative bacteria from pus samples in a tertiary care setting
Authors: Furqan Warda , Hanif Faisal , Usman Javaid , Irfan Rafia , Naeem Afnan , Satti Luqman
Published: July 2024

Skin and skin structure infections are one of the leading causes of difficult to treat infections. Knowledge about antimicrobial susceptibility and resistance patterns of the isolates yielded from pus specimens will help in efficient and effective management of patients. The aim of our study was to determine the aerobic bacteriological profile from various types of skin and skin structure infections and the susceptibility pattern of difficult-to-treat resistant Gram negative bacteria isolated from pus specimens.
This was a retrospective study conducted in Pak Emirates Military Hospital department of microbiology, Army Medical College (National University of Medical Sciences) Rawalpindi. Data of 1,250 pus specimens from January 2023 to December 2023 was retrieved from hospital management system. Pus was processed according to standard microbiological procedure and antimicrobial susceptibility was determined following Clinical and Laboratory Standards Institute 2023.Data was analyzed using statistical package for social sciences version 26 and p value was calculated. Descriptive factors (frequencies, percentage) were calculated for the socio demographic characteristics and antibiotic susceptibility was determined. P value of less than or equal to 0.05 was taken as significant. A total of 1,250 pus specimens were received during one year. Out of these 416 (33.2%) were Gram negative rods and 356 (28.4%) were Gram positive cocci. The most frequently isolated organism was Escherichia coli 156(30.3%) followed by Klebsiella pneumoniae and Pseudomonas aeruginosa. Acinetobacter baumannii emerged as the most resistant pathogen. It was resistant to all antimicrobials except colistin and tigecycline.
This study has enabled us to determine various types of Gram negative rods present in pus specimens, as well as their sensitivity for different antibiotics. This information will be used to create our institutional antibiogram, which will guide clinicians in making valuable treatment decisions. Additionally, this study highlights the importance of effective infection control and prevention practices in a large hospital setting, which can help prevent antimicrobial resistance and promote optimal patient care.