bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Utility and Patient Compliance With Mobile Applications for Home-Based Rehabilitation Following Transforaminal Lumbar Interbody Fusion
Authors: Cole Adam , Parry Matthew W. , Tang Alex , Vazquez Frank , Chen Tan
Published: September 2024

Study Design

Retrospective chart review.

Objectives

Transforaminal lumbar interbody fusion (TLIF) via open or minimally invasive (MI) techniques is commonly performed. Mobile applications for home-based therapy programs have grown in popularity. The purpose of this study was to (1) compare patient-reported outcome measures (PROMs) between postoperative patients who were the most and least compliant in using the mobile-based rehabilitation programs, (2) compare PROMs between open vs MI-TLIF cohorts, and (3) quantify overall compliance rates of home-based rehabilitation programs.

Methods

A retrospective chart review was performed. Patients were automatically enrolled in the rehabilitation program. Patient-Reported Outcomes Measurement Information System (PROMIS) and Oswestry Disability Index (ODI) scores were collected. Patients were separated into two study groups. Compliance rate was calculated as the difference between the number of active participants at the preoperative phase and final follow-up.

Results

220 patients were included. Average follow-up time was 23.2 months. No difference was found in the change in (∆) PROMIS scores ( P = 0.261) or ∆ODI scores ( P = 0.690) regardless of patient compliance. No difference was found in outcome scores between open vs MI-TLIF techniques stratified by download compliance (downloaded, DL+; did not download, DL-) and phone reminder compliance (set reminder, R+; did not set reminder, R-) postoperatively. Both cohorts demonstrated clinical improvement exceeding minimal clinically important difference at final follow-up. Overall patient compliance was 71% at final postoperative follow up.

Conclusion

Despite high long-term compliance and rising popularity, mobile applications for home-based postoperative rehabilitation programs have low clinical utility in patients undergoing TLIF.
Embedding Diversity: Navigating Newcomer Dissimilarity and Relationship Dynamics for Organizational Cohesion
Authors: Yu Lu , Ren Hong , Singh Romila
Published: September 2024

This study integrates the relational demography perspective with the Job Demands-Resources (JD-R) model to analyze the nuanced interaction between perceived dissimilarity, organizational diversity climate, and their consequences on newcomers’ proactive endeavors in establishing relationships with their supervisors and their eventual organizational embeddedness. It theorizes that perceived dissimilarity acts as a job demand, introducing obstacles for newcomers, whereas a supportive diversity climate functions as a crucial job resource. This climate facilitates newcomers’ proactive engagement in supervisor relationship building, which is instrumental in enhancing their sense of belonging within the organization. Importantly, the study unveils that newcomers are more likely to undertake proactive relationship-building activities in environments that are emphatically inclusive. Such proactive behavior significantly strengthens their organizational embeddedness. Integrating insights from relational demography with the JD-R model, this research sheds light on how perceived dissimilarity, coupled with a conducive diversity climate, influences newcomers’ adjustment processes and their integration into the organizational fabric. It underscores the vital role of proactive supervisor relationship building as a mechanism that markedly promotes organizational embeddedness, offering valuable implications for fostering workplace inclusion and newcomer assimilation. This study contributes to the broader understanding of the interplay between individual differences and organizational climates in shaping workplace dynamics.
Direction of Technical Change and Energy Efficiency: Empirical Evidences at the Global Level
Authors: Rakshit Ipsita , Mandal Sabuj Kumar
Published: September 2024

Energy-saving technical change makes it possible to substitute energy inputs for non-energy inputs, thereby determining the effectiveness of sustainable development policies. Total factor productivity (TFP) is enhanced when technical change coordinates with input mix. The present study analyzes the direction of technical change, its coordination with input mix and its association with energy efficiency at the global level and for different income groups of economies from 1993 to 2013. Malmquist productivity index and data envelopment analysis have been used to compute the direction of technical change and energy efficiency, respectively. The empirical results confirm that the direction of technical change coordinated with the input mix for all sample of economies in the short-run. This is also observed in the long-run, except for low-income economies. With respect to both labour and capital, energy-saving technical change positively associated with energy-efficiency improvements. For certain countries, the mismatch between technical change and input mix resulted in lower energy efficiency and TFP. Hence, it is necessary that the direction of technical change be consistent with input mix of an economy.

JEL Classification: D24, O4, Q4
Children With Hepatitis in a Tertiary Care Center in Nepal: A Prospective Observational Study
Authors: Shrestha Bikash , Singh Umesh , Karmacharya Kavita , Singh Shreejana
Published: September 2024

Objective. Viral hepatitis is a global problem leading to significant morbidity and mortality in adults as well as children. This study explores Hepatitis A among Nepalese children and their water habits. Methods. A prospective observational study was conducted over a period of 10 years among Nepalese children. We included 287 children with hepatitis in our study. Results. Among 287 children studied, 266 had Hepatitis A. There were 33 toddlers (11.5%), 121 pre-school children (42.2%), 102 school children (35.5%), and 31 adolescents (10.8%). Ninety-one (32%) children used filtered water, 55 (19%) used boiled water, 23 (8%) used boiled and filtered water, 53 (18%) used jar water and 65 (23%) used direct tap water. Five children had complications. One child died due to complications. The mortality rate in the study was 0.38%. Conclusion. Hepatitis A affected pre-school and school children most. Boiled and filtered is safest against transmission of Hepatitis A.
Primary Breast Lymphoma: A Case Report of a Common Tumor in an Uncommon Location
Authors: Mremi Alex , Chipongo Hilary , Urassa Ellyagape , Mkwizu Elifuraha , Lodhia Jay
Published: September 2024

Primary breast lymphoma (PBL) is a rare malignant lymphoid neoplasm limited to the breast, accounting for about 0.15% of all malignant breast tumors and 1.7% to 2.2% of extra-nodal lymphomas. PBL must be distinguished from conventional breast carcinomas due to different therapeutic approaches. A 25-year-old female presented with a left breast mass. Histopathology and immunohistochemical tests confirmed the diagnosis of diffuse large B-cell lymphoma (DLBCL). She had no similar lesions elsewhere in the body. She received 1 cycle of R-CHOP chemotherapy but absconded from the treatment and succumbed afterward while at home. Recent developments in DLBCL treatment have greatly improved patient outcomes by incorporating targeted medicines like rituximab, increased chemotherapy regimens, new drugs, and individualized treatment techniques. PBL appears to have a worse prognosis; thus, delay or abscondment from treatment is of serious concern when it comes to improving the prognosis of patients with PBL.
Predictors of outcomes in conservative management of high-grade renal trauma
Authors: Surag K. R. , Gali Kasi Viswanath , Shah Abhijit , Krishnakanth A. V. B. , Singh Anshuman , Goli Abhishek , Chawla Arun , Hegde Padmaraj , Choudhary Anupam
Published: September 2024

Background

Management of high-grade renal trauma is debatable, with the recent evidence embracing a conservative approach in the management of even grade 5 renal injuries. The study aimed to analyze the clinical profile of patients with high-grade renal trauma, assessing their management strategies, outcomes, complications, and need for ancillary procedures.

Methods

A retrospective analysis of prospectively maintained data was performed involving blunt abdominal trauma patients with high-grade renal injuries (Grade 4 and 5) presenting to our hospital from January 2018 to December 2022. Patient data analyzed included demographics, clinical presentation, injury characteristics, complications, ancillary procedures, and mortality rates. All patients underwent renal functional assessment using an isotope renogram scan at the 3-month follow-up. Data collected were entered into a database and subjected to descriptive analysis using Jamovi version 2.3.28.

Results

The study included 45 patients with a mean age of 29 years and a male-to-female ratio of 41:4. Most patients (n = 42) were managed conservatively. Thirty-eight patients had grade 4 injuries, and seven had grade 5 injuries. Twenty-six patients suffered renal parenchymal injuries alone, three patients had renal vascular injuries alone, and 16 patients had both parenchymal and vascular injuries. Grade 5 renal injury (p < 0.001), vascular high-grade injury (p < 0.001), angioembolization (p < 0.001), and blood transfusions (p = 0.021) were significantly associated with the incidence of poorly functioning kidney in high-grade renal trauma patients managed conservatively. Multinomial logistic regression analysis revealed angioembolization (p < 0.001), poorly functioning kidney post-trauma (p < 0.001), and blood transfusions (p < 0.001) were significantly associated with high-grade renal vascular injuries compared to high-grade renal parenchymal injuries.

Conclusion

Conservative management is advisable for high-grade renal trauma in hemodynamically stable patients. High-grade vascular injuries are more severe than parenchymal injuries and correlate with poorer renal functional outcomes. Grade 5 renal injury, predominantly vascular high-grade injury, and the requirement for angioembolization and blood transfusions serve as significant predictors of poorly functioning kidneys post-trauma. Urologists should consider these predictors when counseling patients regarding potential outcomes following conservative management of high-grade renal trauma.
Global, regional, and national burden of intracerebral hemorrhage and its attributable risk factors from 1990 to 2021: results from the 2021 Global Burden of Disease Study
Authors: Xu Libo , Wang Zhenhao , Wu Wenchao , Li Mao , Li Qingsong
Published: September 2024

Background

Intracerebral hemorrhage (ICH) results from the rupture of blood vessels causing bleeding within the brain and is one of the major causes of death and long-term disability globally, particularly in low- and middle-income countries. Despite having a lower incidence than ischemic stroke, ICH imposes a greater social and economic burden. To our knowledge, since the release of the 2021 Global Burden of Disease (GBD) report, there has been no comprehensive update on the epidemiology and trends of ICH. This study aims to analyze the impact of gender, age, and the Sociodemographic Index (SDI) on the burden of ICH at global, regional, and national levels.

Methods

Data on the incidence, deaths, and disability-adjusted life years (DALYs) of ICH and its related risk factors from 1990 to 2021 were extracted from the GBD 2021 project, encompassing 203 countries and regions. Furthermore, temporal trends of the global intracerebral hemorrhage burden were assessed through Joinpoint analysis.

Results

In 2021, there were 3.444 million new cases of ICH worldwide, with an age-standardized prevalence rate of 40.8 per 100,000 people, representing a 31.4% decrease compared to 1990. In 2021, ICH caused 3.308 million deaths, with an age-standardized mortality rate of 39.1 per 100,000 people, a reduction of 36.6% since 1990. Globally, ICH accounted for 79.457 million DALYs, with an age-standardized DALY rate of 92.4 per 100,000 people, representing a 39.1% decrease since 1990. Regionally, Central Asia, Oceania, and Southeast Asia had the highest age-standardized prevalence rates of ICH, whereas Australasia, high-income North America, and Western Europe had the lowest rates. Nationally, the Solomon Islands, Mongolia, and Kiribati had the highest age-standardized prevalence rates, whereas Switzerland, New Zealand, and Australia had the lowest. Hypertension, smoking, and environmental pollution were identified as the primary risk factors for ICH. This study also validated the significant association between SDI and the burden of ICH, with the age-standardized DALY rate of ICH decreasing significantly as SDI increased.

Conclusion

Despite the decreasing burden of intracerebral hemorrhage, it remains a significant public health issue in countries with a lower SDI. Prevention strategies should prioritize hypertension management, air quality improvement, and smoking control to further mitigate the impact of intracerebral hemorrhage.
Predominant approaches to measuring pregnancy-related anxiety in Sub-saharan Africa: a scoping review
Authors: Fraga Sophia Dane , Khan Ibrahim Nawaz , Sharma Tanvi A. , Lawrence Emma R.
Published: September 2024

Background

Pregnancy-related anxiety significantly impacts maternal and fetal health in low- and middle-income countries (LMICs), including those within Sub-Saharan Africa (SSA). Most studies conducted to evaluate pregnancy-related anxiety in LMICs have utilized scales developed in high-income countries, despite significant variations in pregnancy-related anxiety due to socioeconomic and cultural contexts. This review surveyed existing literature in order to identify which scales have been used to measure pregnancy-related anxiety in SSA.

Methods

A systematic search was conducted in PubMed, Health and Psychosocial Instruments, and APA PsycNet for relevant studies published in the English language up to March 22, 2023. Eligible studies focused on anxiety in pregnant populations within SSA, using validated scales or tools. Screening followed PRIMSA guidelines, with blinded review at the abstract/title level and subsequent full-text review. Data was extracted and analyzed to identify trends and characteristics of the screening tools used.

Results

From 271 articles, 37 met inclusion criteria, identifying 24 different tools used to measure anxiety in pregnant women in SSA. The most common tools were the Generalized Anxiety Disorder 7-item scale (seven uses), State-Trait Anxiety Inventory (five uses), and the Self-Reporting Questionnaire 20 (five uses). Seven tools were pregnancy-specific, with only two designed specifically for SSA: the Risk Factor Assessment (RFA), and the 4-Item Screening Tool. Studies were most frequently conducted in South Africa, followed by Tanzania, Ethiopia, Nigeria, and Ghana.

Conclusions

This scoping review illustrates that only two tools (the RFA and 4-item Screening Tool) were created to assess pregnancy-related anxiety specifically in SSA. This highlights the need for more culturally sensitive tools tailored to the specific contexts of pregnant populations in SSA.
The clinical efficacy and safety of platelet-rich plasma on frozen shoulder: a systematic review and meta-analysis of randomized controlled trials
Authors: Zhang Wen-Bin , Ma Yu-Lin , Lu Fei-Long , Guo Hai-Rui , Song Hao , Hu Yi-Mei
Published: September 2024

Objective

To systematically review the clinical efficacy (pain, function, quality of life) and safety of platelet-rich plasma (PRP) in the treatment of frozen shoulder through meta-analysis, and provide evidence-based medical evidence for the effectiveness of PRP in the treatment of frozen shoulder.

Methods

A search was conducted on international databases (Pubmed, Web of science, Embase) and Chinese databases (CNKI, Wanfang, VIP) to search the clinical studies on the efficacy of platelet-rich plasma in treating frozen shoulder (adhesive capsulitis/periarthritis/50 shoulder) and their corresponding references published from inception until January 2024. Thoroughly excluded literature not meeting the predetermined inclusion criteria, extracted relevant data from the literature, and input it into RevMan5.4 for meta-analysis.

Results

This study ultimately included 14 RCTs, with a total of 1024 patients. The results showed that PRP has significant advantages compared with control groups in VAS (mean difference (MD) =-0.38, 95% confidence interval(CI)(-0.73, -0.03), P = 0.03), UCLA (MD = 3.31, 95% CI (1.02,5.60),P = 0.005), DASH (MD = -4.94,95% CI (-9.34, -0.53),P = 0.03), SPADI (SPADI Total: MD =-16.87, 95% CI (-22.84, -10.91), P < 0.00001; SPADI Pain: MD =-5.38, 95% CI (-7.80, -2.97), P < 0.0001; SPADI Disability: MD =-11.00, 95% CI (-13.61,-8.39), P < 0.00001), and the active and passive Range of Motion (active flexion: MD = 12.70, 95% CI (7.44, 17.95), P < 0.00001; passive flexion: MD = 9.47, 95% CI(3.80, 15.14), P = 0.001; active extension: MD = 3.45, 95% CI(2.39, 4.50), P < 0.00001; active abduction: MD = 13.54, 95% CI(8.42, 18.67), P < 0.00001; passive abduction: MD = 14.26, 95% CI (5.97, 22.56), P = 0.0008; active internal rotation: MD = 5.16, 95% CI (1.84, 8.48), P = 0.002; passive internal rotation: MD = 3.65, 95% CI(1.15, 6.15), P = 0.004; active external rotation: MD = 10.50, 95% CI(5.47, 15.53), P < 0.0001; passive external rotation: MD = 6.00, 95% CI (1.82, 10.19), P = 0.005) except passive extension (MD = 2.25, 95% CI (-0.77, 5.28), P = 0.14). In terms of safety, most studies reported no adverse effects, and only one study reported common complications of joint puncture such as swelling and pain after treatment in both PRP and control groups. Previous studies have shown a risk of osteonecrosis caused by corticosteroids. Therefore, the safety of PRP treatment is more reliable.

Conclusion

The results showed that PRP was more durable and safer than corticosteroids and other control groups in the treatment of frozen shoulder.

Study Design

Systematic review.

Trial registration

PROSPERO CRD42022359444, date of registration: 22-09-2022.
Oral health among refugees and asylum seekers utilizing Médecins du Monde clinics in mainland Greece, 2016–2017
Authors: Scales Sarah Elizabeth , Vora Bhumi , Loftus Kyle
Published: September 2024

Background

The oral health of refugees and asylum seekers is understudied. However, oral health has important implications for overall health and wellbeing. This study addresses this gap by characterizing oral health care utilization in Médecins du Monde (MdM) clinics across mainland Greece from 2016 – 2017.

Methods

A retrospective cross-sectional study design was used to estimate proportional morbidities for caries, extraction, developmental, periodontal disease, preventive, and other oral health outcomes. The association between physical health conditions and consultations of interest – upper respiratory tract infections (URTIs) and reproductive health consultations – and oral health were compared using odds ratios (OR) and 95% confidence intervals (CIs). Oral health outcomes between Afghans and Syrians were compared using odds ratios and 95% CIs.

Results

Caries (39.44%) and extractions (28.99%) were highly prevalent in our study population. The utilization of preventive dental consultations (37.10%) was high, particularly among males. Individuals with at least one upper respiratory tract infection (OR = 1.52; 95% CI: 1.30 – 1.77; Or = 1.90; 95% CI: 1.53 – 2.36) and women and girls with reproductive health consultations (OR = 1.30; 95% CI: 1.03 – 1.66; OR = 2.03; 95% CI: 1.49 – 2.76) were more likely to have any dental or caries specific consultations. The observed patterns in oral health needs differed between Afghans and Syrians, with Afghans more likely to have preventive screenings and less likely to have caries, extractions, or other conditions.

Conclusions

Displaced populations utilizing MdM dental clinics had high levels of oral health needs, particularly for caries and extractions. The connection between oral and overall health was seen in the study population, and these findings reinforce the public health importance of oral health for improving health and wellbeing of displaced populations. Evidence-informed policy, practice, and programming inclusive of oral health are needed to address both oral and overall health of refugees and asylum seekers in Greece. Future research should investigate not only oral health care needs but also knowledge and beliefs that inform utilization patterns among displaced populations.
Genetic diversity and virulence properties of caprine Trueperella pyogenes isolates
Authors: Kwiecień Ewelina , Stefańska Ilona , Kizerwetter-Świda Magdalena , Chrobak-Chmiel Dorota , Czopowicz Michał , Moroz-Fik Agata , Mickiewicz Marcin , Biernacka Kinga , Bagnicka Emilia , Kaba Jarosław , Rzewuska Magdalena
Published: September 2024

Background

Trueperella pyogenes is an opportunistic pathogen that causes suppurative infections in various animal species, including goats. So far, only limited knowledge of phenotypic and genotypic properties of T. pyogenes isolates from goats has been gathered. In our study, we characterized the phenotypic and genotypic properties of caprine T. pyogenes isolates and established their relationship by Random Amplified Polymorphic DNA-Polymerase Chain Reaction (RAPD-PCR).

Results

From 2015 to 2023, 104 T. pyogenes isolates were obtained from 1146 clinical materials. In addition, two T. pyogenes isolates were obtained from 306 swabs collected from healthy goats. A total of 51 T. pyogenes isolates were subjected to detailed phenotypic and genotypic characterization. The virulence genotype plo/nanH/nanP/fimA/fimC/luxS was predominant. All of the tested isolates showed the ability to form a biofilm but with different intensities, whereby most of them were classified as strong biofilm formers (72.5%). The high level of genetic diversity among tested caprine T. pyogenes isolates (19 different RAPD profiles) was observed. The same RAPD profiles were found for isolates obtained from one individual, as well as from other animals in the same herd, but also in various herds.

Conclusions

This study provided important data on the occurrence of T. pyogenes infections in goats. The assessment of virulence properties and genetic relationships of caprine T. pyogenes isolates contributed to the knowledge of the epidemiology of infections caused by this pathogen in small ruminants. Nevertheless, further investigations are warranted to clarify the routes of transmission and dissemination of the pathogen.
A description of variant transthyretin amyloidosis (ATTRv) stage 1 patients and asymptomatic carriers in Spain: the EMPATIa study
Authors: Galán Dávila Lucía , Martinez Valle Fernando , Buades Reinés Juan , Gonzalez-Moreno Juan , Losada López Inés , Sevilla Teresa , Muñoz Beamud Francisco , Bárcena Llona José Eulalio , Romero Acebal Manuel , Setaro Francesca , Primiano Diana , Tarilonte Patricia
Published: September 2024

Background

Variant transthyretin amyloidosis (ATTRv) is a rare multisystemic disorder caused by mutations in the transthyretin (TTR) gene. The aim of the present work was to describe the clinical profile of asymptomatic carriers (AC) and Coutinho stage 1 ATTRv patients in Spain.

Methods

National, multicentre, cross-sectional study that included 86 AC and 19 patients diagnosed in the previous 12 months to enrolment. Clinical and demographical data, TTR gene mutations, red flags anamnesis, neurological and cardiological assessments were collected.

Results

The mean age of patients was 56.8 years at onset and 58.6 years at diagnosis; 53% of patients and 51% of AC were from non-endemic areas. Val50Met was the most frequent mutation in both groups. Neuropathy impairment score data (mean 17.7 ± 20.5) and small-fibre function in lower limbs assessed with SUDOSCAN revealed that patients were diagnosed at early stages of neurological impairment. Peripheral polyneuropathy (84.2%), autonomic neuropathy (73.7%), cardiac (63.2%) and gastrointestinal (47.4%) alterations were the most common symptoms in patients. Autonomic neuropathy, gastrointestinal impairment, carpal tunnel syndrome, cardiac and ocular alterations were potentially related to ATTRv in the AC group.

Conclusions

The EMPATIa study provides a detailed description of AC and Coutinho stage 1 ATTRv patients across Spain, confirming the multisystemic clinical profile of the disease. This study reveals a diagnosis delay around 1.8 years, highlighting the importance of a profound disease awareness to reach a diagnose in earlier stages of neurological impairment.
Social cognition, psychosocial development and well-being in galactosemia
Authors: Bry Clémentine , Propice Klervi , Bourgin Jessica , Métral Morgane
Published: September 2024

Background

Classic galactosemia is a rare inherited metabolic disease with long-term complications, particularly in the psychosocial domain. Patients report a lower quality of social life, difficulties in interactions and social relationships, and a lower mental health. We hypothesised that social cognition deficits could partially explain this psychological symptomatology. Eleven adults with galactosemia and 31 control adults participated in the study. We measured social cognition skills in cognitive and affective theory of Mind, and in basic and complex emotion recognition. We explored psychosocial development and mental well-being.

Results

We found significant deficits on all 4 social cognition measures. Compared to controls, participants with galactosemia were impaired in the 2nd-order cognitive theory of mind, in affective theory of mind, and in basic and complex emotion recognition. Participants with galactosemia had a significant delay in their psychosexual development, but we found no delay in social development and no significant decrease in mental health.

Conclusion

Social cognition processes seem impaired among our participants with galactosemia. We discuss the future path research may follow. More research is needed to replicate and strengthen these results and establish the links between psychosocial complications and deficits in social cognition.
Does high-frequency resistance exercise offer additional benefits to older adults? learnings from a randomized controlled trial
Authors: Li Qiaowei , Huang Feng , Cheng Yanling , Dai Yalan , Lin Zhong , Lin Zhonghua , Zhu Pengli
Published: September 2024

Objective

Resistance exercise is an effective strategy to improve muscle strength in older adults. A limited-load resistance would be flexible and suitable for community-based training. It was unclear whether high-frequency resistance exercise offer additional benefits to older adults. Here, we aimed to examine the effect of limited-load resistance exercise among different frequency on muscle parameters in older adults.

Methods

The current study was a single-blind, randomized controlled trial comparing the effectiveness of different-frequency resistance exercise in older adults. Change in skeletal muscle was estimated with a multi-frequency bioelectrical impedance analyzer. Demographics, physical examination, nutritional assessment, prealbumin and lymphocytes were also measured. Fisher’s precision probability test and baseline-adjusted generalized linear models were applied accordingly to analyze the influence of dose-different exercise on prevalence of sarcopenia, muscle parameters and body composition. A two-sided p value of < 0.05 was defined statistical significance.

Results

The participants had a mean age of 71.96 years and close gender ratio. One hundred and twenty-seven participants (control 40; low-dose 46; high-dose 41) completed the 6-month exercise intervention. In contrast to control group, only high-dose exercise groups experienced improvements in muscle mass (0.66 kg, p < 0.001) and max grip strength (+ 2.17 kg, p < 0.001). There were significant dose-response effects of muscle mass (index), fat mass (index), max grip strength, 5-times sit to stand test, 6-minute walking test and visceral fat area (all ptrend <0.01).

Conclusions

As the proved dose-dependent effect, current findings supported high-frequency limited-load resistance exercise applied and extended among older adults in community.

Trial Registration

This study was registered at Chinese Clinical Trial Registry Network (ChiCTR2200062007, Registered on 19 July 2022).
Rare manifestations of cutaneous diphtheria: a case report
Authors: Suwaid Salma Ali , Mustapha Aliyu , Ried Monika , Muhammad Ruqayyah Ali , Liman Aminu Shehu , Yusuf Salma
Published: September 2024

Background

This case report presents an exceptionally rare and atypical presentation of diphtheria in a 17-year-old female of Hausa ethnicity residing in an area with an elevated incidence within Kano State, Nigeria. By the end of 39th epidemiological week of 2023, only two cases of cutaneous diphtheria have been reported among 5,811 cases managed at MMSH diphtheria treatment center (DTC), representing approximately 0.035% of all diphtheria cases during that time period.

Case presentation

A 17-year-old Hausa female presented with a 3-day history of throat discomfort, malaise, and muffled speech. Physical examination revealed a pseudomembrane covering the tonsillar pillars, grade 3 tonsillar enlargement, and an unusual genital manifestation characterized by extensive vulval edema, severe pain, and a large, greyish patch extending into the vaginal introitus. Her medical history was significant for recent exposure to diphtheria and the emotional impact of her sibling's death from the same disease. Diagnostic tests, including throat swab culture and histocytology, confirmed diphtheria in the throat and vulvovaginal regions. The patient was promptly initiated on diphtheria antitoxin, Azithromycin, and innovative sitz baths with hydrogen peroxide. After 4 days of Sitz bath therapy, complete pseudomembrane clearance was observed, and the patient's symptoms resolved.

Conclusion

This case underscores the complexity of diphtheria presentations, particularly with rare pseudomembranes in both throat and vaginal regions. The successful management, combining traditional and innovative therapies, highlights the importance of recognizing and addressing unusual manifestations promptly. The potential role of auto-inoculation and the efficacy of interventions like hydrogen peroxide sitz baths warrant further investigation. Overall, this case contributes to the understanding of diverse diphtheria presentations, guiding future clinical strategies for management of diphtheria cases and emphasizing the imperative of comprehensive vaccination efforts.
Molecular epidemiology, microbiological features and infection control strategies for carbapenem-resistant Acinetobacter baumannii in a German burn and plastic surgery center (2020–2022)
Authors: Vital Marius , Woltemate Sabrina , Schlüter Dirk , Krezdorn Nicco , Dieck Thorben , Dastagir Khaled , Bange Franz-Christoph , Ebadi Ella , Vogt Peter M. , Knegendorf Leonard , Baier Claas
Published: September 2024

Background

Carbapenem-resistant Acinetobacter baumannii (CRAB) frequently causes both healthcare-associated infections and nosocomial outbreaks in burn medicine/plastic surgery and beyond. Owing to the high antibiotic resistance, infections are difficult to treat, and patient outcomes are often compromised. The environmental persistence capability of CRAB favors its transmission in hospitals. A comprehensive analysis and understanding of CRAB epidemiology and microbiology are essential for guiding management.

Methods

A three-year retrospective cohort study (2020–2022) was conducted in a German tertiary burn and plastic surgery center. In addition to epidemiological analyses, microbiological and molecular techniques, including whole-genome sequencing, were applied for the comprehensive examination of isolates from CRAB-positive patients.

Results

During the study period, eight CRAB cases were found, corresponding to an overall incidence of 0.2 CRAB cases per 100 cases and an incidence density of 0.35 CRAB cases per 1000 patient-days. Six cases (75%) were treated in the burn intensive care unit, and four cases (50%) acquired CRAB in the hospital. Molecular analyses comprising 74 isolates supported the epidemiologic assumption that hospital acquisitions occurred within two separate clusters. In one of these clusters, environmental CRAB contamination of anesthesia equipment may have enabled transmission. Furthermore, molecular diversity of CRAB isolates within patients was observed.

Conclusions

CRAB can pose a challenge in terms of infection prevention and control, especially if cases are clustered in time and space on a ward. Our study demonstrates that high-resolution phylogenetic analysis of several bacterial isolates from single patients can greatly aid in understanding transmission chains and helps to take precision control measures.
Navigating the ethical complexities of severe and enduring (longstanding) eating disorders: tools for critically reflective practice and collaborative decision-making
Authors: Jamieson Sacha Kendall , Tan Jacinta , Piekunka Kym , Calvert Shannon , Anderson Stephen
Published: September 2024

Decisions about the treatment of eating disorders do not occur in a socio-political vacuum. They are shaped by power relations that produce categories of risk and determine who is worthy of care. This impacts who gets access to care and recognition of rights in mental health services. Globally, there are calls for more human rights-based approaches in mental health services to reduce coercion, improve collaborative decision making and enhance community care. Treating individuals with longstanding, Severe and Enduring Eating Disorders (SEED) or Severe and Enduring Anorexia Nervosa (SE-AN) can be particularly problematic when it involves highly controversial issues such as treatment withdrawal and end-of-life decisions and, where legally permissible, medically assisted dying. In this article, we argue that the socio-political context in which clinical decision making occurs must be accounted for in these ethical considerations. This encompasses considerations of how power and resources are distributed, who controls these decisions, who benefits and who is harmed by these decisions, who is excluded from services, and who is marginalised in decision making processes. The article also presents tools for critically reflective practice and collaborative decision-making that can support clinicians in considering power factors in their practice and assisting individuals with longstanding eating disorders, SEED and SE-AN to attain their rights in mental health services.
Seasonal habitat use and diel vertical migration in female spurdog in Nordic waters
Authors: Klöcker C. Antonia , Albert Ole Thomas , Ferter Keno , Bjelland Otte , Lennox Robert J. , Albretsen Jon , Pohl Lotte , Dahlmo Lotte Svengård , Queiroz Nuno , Junge Claudia
Published: September 2024

Background

Studying habitat use and vertical movement patterns of individual fish over continuous time and space is innately challenging and has therefore largely remained elusive for a wide range of species. Amongst sharks, this applies particularly to smaller-bodied and less wide-ranging species such as the spurdog (Squalus acanthias Linnaeus, 1758), which, despite its importance for fisheries, has received limited attention in biologging and biotelemetry studies, particularly in the North-East Atlantic.

Methods

To investigate seasonal variations in fine-scale niche use and vertical movement patterns in female spurdog, we used archival data from 19 pregnant individuals that were satellite-tagged for up to 365 days in Norwegian fjords. We estimated the realised niche space with kernel densities and performed continuous wavelet analyses to identify dominant periods in vertical movement. Triaxial acceleration data were used to identify burst events and infer activity patterns.

Results

Pregnant females frequently utilised shallow depths down to 300 m at temperatures between 8 and 14 °C. Oscillatory vertical moments revealed persistent diel vertical migration (DVM) patterns, with descents at dawn and ascents at dusk. This strict normal DVM behaviour dominated in winter and spring and was associated with higher levels of activity bursts, while in summer and autumn sharks predominantly selected warm waters above the thermocline with only sporadic dive and bursts events.

Conclusions

The prevalence of normal DVM behaviour in winter months linked with elevated likely foraging-related activity bursts suggests this movement behaviour to be foraging-driven. With lower number of fast starts exhibited in warm waters during the summer and autumn months, habitat use in this season might be rather driven by behavioural thermoregulation, yet other factors may also play a role. Individual and cohort-related variations indicate a complex interplay of movement behaviour and habitat use with the abiotic and biotic environment. Together with ongoing work investigating fine-scale horizontal movement as well as sex- and age-specific differences, this study provides vital information to direct the spatio-temporal distribution of a newly reopened fishery and contributes to an elevated understanding of the movement ecology of spurdog in the North-East Atlantic and beyond.

Graphical Abstract
A review of human augmentation and individual combat capability: focusing on MEMS-based neurotechnology
Authors: Yoon Youngsam , Cho Il-Joo
Published: September 2024

The purpose of this paper is to identify the relationship between human augmentation and personal combat ability improvement that overcomes physical and mental limitations according to the convergence of advanced science and technology such as biotechnology, brain engineering, and mems-based technology. We will first explain the background of the emergence of human augmentation and derive the characteristics of human enhancement through conceptual analysis of the correlation of human augmentation and cognitive abilities, which hold importance for future warfare. Afterward, through the development of brain engineering, we will present areas where advanced science and technology can contribute to improving military combat capabilities, such as cognitive abilities, decision-making abilities, situation recognition abilities, and brain stimulation. Finally, we will review the MEMS-based neural interface systems for the enhancement of human augmentation and individual combat ability.
Experimental study of processing of PCL (polycaprolactone)-peptides nanoparticles and its biodistribution analysis for drug delivery system
Authors: Khan Mujibur , Yamasta Anthony , Parvin Mahrima , Ferdaus Jannatul , Ahmed Hossain , Arbab Ali S.
Published: September 2024

Two types of cells targeting Peptides, TAMS-1 (CSPGAKVRCY {Lys (Biotin)}) and MDSC-peptide (Biotin {PEG4}-MEWSLEKGYTIK), were synthesized for targeting CD206 M2 macrophage and myeloid-derived suppressor cells (MDSC), respectively. Each peptide was coaxially electro sprayed where PCL (Polycaprolactone) is the core, and the peptide is the sheath to create a PCL nanoparticle with peptides. Electro spraying parameters included applying a voltage of 44 kV, humidity between 35–44%, tip to collector distance at 160 mm, core flow rate of 0.5 ml/hr, and a sheath flow rate of 0.7 ml/hr. UV–VIS (Ultraviolet–Visible) spectrometry, SEM (Scanning Electron Microscopy) imaging, and in vivo biodistribution techniques were used to study the morphology and performance of the PCL-peptide nanoparticles. Peak absorbance values for PCL were found at around 275 nm. Peptides absorbance value was observed between 230 and 250 nm. Scanning Electron Microscope image shows nanoparticles as small as 100 nm and agglomerates as large as 1 µm. In-vivo biodistribution of PCL and CD206 M2 macrophage targeting peptide (TAMS-1) nanoparticles after intravenous injection in the tumor mice model showed uptake to the tumors. On the other hand, MDSC peptide did not show any uptake to the site of tumors. Most activity is shown in the intestine indicating excretion of the agents through the hepato-biliary system.
Scrotal hematoma: a rare complication of transfemoral percutaneous coronary intervention
Authors: Aldoori Jaafar S. , Abdulfaraj Araz , Rasul Shahla M. S.
Published: September 2024

Background

Cardiac catheterization via the transfemoral approach can be associated with access site bleeding complications such as inguinal hematoma, pseudoaneurysm, arteriovenous fistula and retroperitoneal hematoma. Scrotal hematoma is a rare presentation of bleeding complications after transfemoral cardiac catheterization. We report a case of this rare complication.

Case presentation

A 63-year-old male with previous coronary artery bypass surgery underwent percutaneous coronary intervention via transfemoral approach. Few hours after removal of the femoral sheath, he developed a big scrotal hematoma and hemodynamic deterioration. The patient responded successfully to conservative treatment and discharged from hospital after three days in a stable condition.

Conclusions

Bleeding complications after transfemoral cardiac catheterization can rarely present as scrotal hematoma. The management of this complication is usually conservative, and only few cases may require surgical treatment.
First Results of NURE-Combo: A Phase II Study of Neoadjuvant Nivolumab and Nab-Paclitaxel, Followed by Postsurgical Adjuvant Nivolumab, for Muscle-Invasive Bladder Cancer
Authors: Mercinelli Chiara , Moschini Marco , Cigliola Antonio , Mattorre Benedetta , Tateo Valentina , Basile Giuseppe , Cogrossi Laura L. , Maiorano Brigida A. , Patanè Damiano A. , Raggi Daniele , Pastorino Giovanni L. , Re Chiara , Colecchia Maurizio , Lucianò Roberta , Colombo Renzo , Brembilla Giorgio , De Cobelli Francesco , Briganti Alberto , Pavlick Dean C. , Ross Jeffrey S. , Montorsi Francesco , Bellone Matteo , Necchi Andrea
Published: September 2024

PURPOSE

To evaluate the activity and safety of nivolumab with nab-paclitaxel as neoadjuvant therapy, followed by radical cystectomy (RC) and postsurgical adjuvant nivolumab in patients with muscle-invasive bladder cancer (MIBC).

PATIENTS AND METHODS

Eligible patients had an Eastern Cooperative Oncology Group performance status of ≤1 and a T2-4aN0-1M0 stage with >50% urothelial carcinoma histology and were ineligible for or refused cisplatin-based chemotherapy. Patients received four cycles of nivolumab 360 mg once every 3 weeks + nab-paclitaxel 125 mg/m
2
once on days 1 and 8, every 3 weeks, followed by RC, and then adjuvant nivolumab 360 mg once every 3 weeks × 13 cycles. The primary end point was the pathologic complete response (CR) rate (ypT0N0). Secondary end points were major pathologic response (ypT≤1N0), safety, event-free survival (EFS), and overall survival.

RESULTS

Thirty-one patients were enrolled from December 2021 to June 2023; 19 (61.3%) had a cT2 stage, two (6.5%) had N1 stage, and 16 (51.6%) had a variant histology. Five patients (16.1%) received less than four full courses of neoadjuvant treatment because of treatment-related adverse events (TRAEs). Grade 3/4 TRAEs occurred in eight patients (25.8%). Twenty-eight patients underwent RC, and three refused RC after evidence of clinical CR and received a redo transurethral resection of the bladder tumor (reTURBT). The trial met its primary end point: 10 patients (32.3%; 95% CI, 16.7 to 51.4) achieved an ypT0N0 response. By including those who underwent reTURBT, 22 (70.9%; 95% CI, 55 to 87) achieved an ypT≤1N0-x response. After a median follow-up of 12 months (range, 5-22), two patients had a disease relapse after surgery. The 12-month EFS was 89.8% (95% CI, 79.5 to 100).

CONCLUSION

To our knowledge, the first results from NURE-Combo trial suggest that this combination could expand the therapeutic opportunities of immune-chemotherapy in patients with MIBC.
Fission yeast Duc1 links to ER–PM contact sites and influences PM lipid composition and cytokinetic ring anchoring
Authors: Willet Alaina H. , Park Joshua S. , Snider Chloe E. , Huang Jingdian Jamie , Chen Jun-Song , Gould Kathleen L.
Published: September 2024

Cytokinesis is the final stage of the cell cycle that results in the physical separation of daughter cells. To accomplish cytokinesis, many organisms build an actin- and myosin-based cytokinetic ring (CR) that is anchored to the plasma membrane (PM). Defects in CR–PM anchoring can arise when the PM lipid phosphatidylinositol (4,5)-bisphosphate [PI(4,5)P2] is depleted. In Schizosaccharomyces pombe, reduced PM PI(4,5)P2 results in a CR that cannot maintain a medial position and slides toward one cell end, resulting in two differently sized daughter cells. S. pombe PM PI(4,5)P2 is synthesized by the phosphatidylinositol 4-phosphate 5-kinase (PI5-kinase) Its3, but what regulates this enzyme to maintain appropriate PM PI(4,5)P2 levels in S. pombe is not known. To identify Its3 regulators, we used proximity-based biotinylation, and the uncharacterized protein Duc1 was specifically detected. We discovered that Duc1 decorates the PM except at the cell division site and that its unique localization pattern is dictated by binding to the endoplasmic reticulum (ER)–PM contact site proteins Scs2 and Scs22. Our evidence suggests that Duc1 also binds PI(4,5)P2 and helps enrich Its3 at the lateral PM, thereby promoting PM PI(4,5)P2 synthesis and robust CR–PM anchoring.
Odor exposure during imprinting periods increases odorant-specific sensitivity and receptor gene expression in coho salmon (Oncorhynchus kisutch)
Authors: Dittman Andrew H. , May Darran , Johnson Marc A. , Baldwin David H. , Scholz Nathaniel L.
Published: September 2024

Pacific salmon are well known for their homing migrations; juvenile salmon learn odors associated with their natal streams prior to seaward migration, and then use these retained odor memories to guide them back from oceanic feeding grounds to their river of origin to spawn several years later. This memory formation, termed olfactory imprinting, involves (at least in part) sensitization of the peripheral olfactory epithelium to specific odorants. We hypothesized that this change in peripheral sensitivity is due to exposure-dependent increases in the expression of odorant receptor (OR) proteins that are activated by specific odorants experienced during imprinting. To test this hypothesis, we exposed juvenile coho salmon, Oncorhynchus kisutch, to the basic amino acid odorant l-arginine during the parr–smolt transformation (PST), when imprinting occurs, and assessed sensitivity of the olfactory epithelium to this and other odorants. We then identified the coho salmon ortholog of a basic amino acid odorant receptor (BAAR) and determined the mRNA expression levels of this receptor and other transcripts representing different classes of OR families. Exposure to l-arginine during the PST resulted in increased sensitivity to that odorant and a specific increase in BAAR mRNA expression in the olfactory epithelium relative to other ORs. These results suggest that specific increases in ORs activated during imprinting may be an important component of home stream memory formation and this phenomenon may ultimately be useful as a marker of successful imprinting to assess management strategies and hatchery practices that may influence straying in salmon.
A Review of the Economics of Sexual Orientation and Gender Identity
Authors: Badgett M. V. Lee , Carpenter Christopher S. , Lee Maxine J. , Sansone Dario
Published: September 2024

This article reviews the growing literature on the economics of sexual orientation and gender identity, a field that did not exist thirty years ago. We summarize, evaluate, and synthesize the literature on LGBTQ+ peoples’ economic lives and livelihoods across key decision points in the life course: human capital investments, family formation and dissolution, and labor market activities. We identify common themes and patterns in the literature and outline important areas for further inquiry. (JEL D13, I26, I31, J12, J13, J16, J24)
The Resilient Society
Authors: Furman Jason
Published: September 2024

Jason Furman of Harvard University reviews “The Resilient Society” by Markus K. Brunnermeier. The Econlit abstract of this book begins: “Promotes the view that rather than attempting to avoid risks, societies that are resilient to adverse shocks should be proactively developed, addressing how a resilient social contract can be implemented either by governments or via social norms.”