bluuebunny/crossref_metadata_2025 huggingface dataset:
CoPixie, a novel algorithm for single-particle track colocalization, enables efficient quantification of telomerase dynamics at telomeres
Authors: Prince Samuel , Maguemoun Kamélia , Ferdebouh Mouna , Querido Emmanuelle , Derumier Amélie , Tremblay Stéphanie , Chartrand Pascal
Published: August 2024

Single-particle imaging and tracking can be combined with colocalization analysis to study the dynamic interactions between macromolecules in living cells. Indeed, single-particle tracking has been extensively used to study protein–DNA interactions and dynamics. Still, unbiased identification and quantification of binding events at specific genomic loci remains challenging. Herein, we describe CoPixie, a new software that identifies colocalization events between a theoretically unlimited number of imaging channels, including single-particle movies. CoPixie is an object-based colocalization algorithm that relies on both pixel and trajectory overlap to determine colocalization between molecules. We employed CoPixie with live-cell single-molecule imaging of telomerase and telomeres, to test the model that cancer-associated POT1 mutations facilitate telomere accessibility. We show that POT1 mutants Y223C, D224N or K90E increase telomere accessibility for telomerase interaction. However, unlike the POT1-D224N mutant, the POT1-Y223C and POT1-K90E mutations also increase the duration of long-lasting telomerase interactions at telomeres. Our data reveal that telomere elongation in cells expressing cancer-associated POT1 mutants arises from the dual impact of these mutations on telomere accessibility and telomerase retention at telomeres. CoPixie can be used to explore a variety of questions involving macromolecular interactions in living cells, including between proteins and nucleic acids, from multicolor single-particle tracks.
Boosting Smoking Cessation Intervention Utilization in Chinese Health Care Providers: A Randomized Controlled Trial of the “WeChat WeQuit” Medical Education Program
Authors: Wang Yunfei , Peng Pu , Wu Zhenzhen , Liu Yuhang , Wang Chudong , Tang Jinsong , Liao Yanhui
Published: August 2024

Introduction

In China, standard smoking cessation practices are rarely used by health care service providers (HSPs). WeChat, a popular social media app, has been widely used in China.

Aims and Methods

In this single-blind, randomized trial, undertaken in China with 8-week interventions and follow-up to 34 weeks, 1887 HSPs were randomly selected to the intervention (n = 942) or control group (n = 945) from October 2020 to October 2021. The intervention group received regular smoking cessation training program messages from the professional team for 8 weeks and followed for 34 weeks. The control group received thanks messages for 8 weeks, and follow-up to 34 weeks. Both groups received a hard copy of the manual after randomization. The primary outcome measure was the utilization rate of behavioral and pharmacotherapy interventions for smoking patients from 9 to 34 weeks. This trial is registered at ClinicalTrials.gov (number NCT03556774).

Results

HSPs in the intervention group demonstrated a better overall utilization rate of smoking cessation at 20-week follow-up compared to the control group (35.54% vs. 31.41%, p = .036). Additionally, both groups showed a significant increase in the adoption of various components of the 5A’s model—including “Assess,” “Assist: set a quit date,” “Assist: recommend cessation program,” “Assist: provide information,” “Assist: recommend medication,” and “Arrange”—at the 9-week follow-up relative to baseline. Notably, at the 20-week follow-up, the intervention group reported significantly enhanced utilization rates for all these components, except “Assist: set a quit date.”

Conclusions

The “WeChat WeQuit” training program effectively enhanced smoking cessation intervention adoption among Chinese HSPs.

Implications

“WeChat WeQuit” training program was effective in increasing the provision of effective tobacco cessation interventions by Chinese-speaking HSPs to patients with cigarette smoking, which could provide valuable insights into bridging the gap between need and services for smoking cessation in China.
External Validation of Serologic Scores for the Detection of Liver Steatosis Among People With HIV
Authors: Riebensahm Carlotta , Brocker Julia , Berzigotti Annalisa , Günthard Huldrych F , Tarr Philip E , Furrer Hansjakob , Rauch Andri , Wandeler Gilles , Surial Bernard ,   Swiss HIV Cohort Study, Abela I , Aebi-Popp K , Anagnostopoulos A , Battegay M , Bernasconi E , Braun D L , Bucher H C , Calmy A , Cavassini M , Ciuffi A , Dollenmaier G , Egger M , Elzi L , Fehr J , Fellay J , Furrer H , Fux C A , Günthard H F , Hachfeld A , Haerry D , Hasse B , Hirsch H H , Hoffmann M , Hösli I , Huber M , Jackson-Perry D , Kahlert C R , Keiser O , Klimkait T , Kouyos R D , Kovari H , Kusejko K , Labhardt N , Leuzinger K , Martinez de Tejada B , Marzolini C , Metzner K J , Müller N , Nemeth J , Nicca D , Notter J , Paioni P , Pantaleo G , Perreau M , Rauch A , Salazar-Vizcaya L , Schmid P , Speck R , Stöckle M , Tarr P , Trkola A , Wandeler G , Weisser M , Yerly S
Published: August 2024

Background

Fatty liver index (FLI) and hepatic steatosis index (HSI) are serologic scores used to detect liver steatosis. However, their diagnostic performance in people with HIV (PWH) remains unclear. We performed an external validation of FLI and HSI in the Swiss HIV Cohort Study.

Methods

We systematically performed vibration-controlled transient elastography (VCTE) among Swiss HIV Cohort Study participants at Bern University Hospital between November 2019 and August 2021. Individuals with viral hepatitis and pregnant women were excluded. We defined liver steatosis as controlled attenuation parameter ≥248 dB/m using VCTE. Model discrimination was assessed with the C-index and model calibration with calibration plots. A decision curve analysis was performed to compare the clinical usefulness of both scores.

Results

Of 321 participants, 91 (28.4%) were female, the median age was 51.4 years (IQR, 42–59), 230 (71.7%) were Caucasian, and 164 (51.1%) had a body mass index >25 kg/m2. VCTE-confirmed liver steatosis was present in 158 (49.2%). Overall, 125 (38.9%) had an FLI ≥60, and 128 (39.9%) had an HSI ≥36. At these cutoffs, the C-index to diagnose liver steatosis was 0.85 for FLI (95% CI, .80–.89) and 0.78 for HSI (95% CI, .73–.83). Whereas FLI was well calibrated, HSI overestimated the risk for steatosis. Both models showed a positive net benefit, with FLI having a greater net benefit when compared with HSI.

Conclusions

FLI and HSI are valid tools to detect liver steatosis in PWH. FLI should be the preferred score, given its better performance and greater clinical usefulness.
Lower Rates of Staphylococcus aureus Bloodstream Infection in Patients on Hemodialysis Receiving Trimethoprim-Sulfamethoxazole Melioidosis Prophylaxis
Authors: Bryce Aliya , Davison Sara , Currie Bart J , Birrell Johanna M , Baird Robert W , Abeyaratne Asanga , Majoni Sandawana William , Brewster-O’Brien Teana , Tong Steven Y C
Published: August 2024

Hemodialysis is a risk factor for Staphylococcus aureus bloodstream infection (SAB). In this single-center study, SAB rates were 56% lower during the monsoonal wet season when patients on hemodialysis receive supervised melioidosis prophylaxis with trimethoprim-sulfamethoxazole. This intervention may reduce SAB rates in high-risk patients; however, further targeted studies are required.
No small dilemma: small bowel volvulus mimicking acute coronary syndrome
Authors: Armas Cristian D , Bademian Sean , Kcomt Mikaela , Burgess Jessica , Qiao Xian
Published: August 2024

Acute abdominal pathologies can cause electrocardiogram (ECG) changes mimicking an acute coronary syndrome (ACS), resulting in diagnostic uncertainty and delay. We report a 65-year-old male with multiple risk factors for ACS who presented with four hours of progressive epigastric and chest pain that resolved in the emergency department. ECG findings were concerning for new deeply inverted T-waves with normal troponins, raising concerns for Wellens Syndrome. Emergent heart catheterization was negative but abdominal computed tomography angiography showed occlusion of the superior mesenteric vessels. Subsequent exploratory laparotomy revealed a small bowel volvulus with extensive necrosis, resulting in a 430 cm resection.
Artificial intelligence-based personalized clinical decision-making for patients with localized prostate cancer: surgery versus radiotherapy
Authors: Liu Yuwei , Zhao Litao , Liu Jiangang , Wang Liang
Published: August 2024

Background

Surgery and radiotherapy are primary nonconservative treatments for prostate cancer (PCa). However, personalizing treatment options between these treatment modalities is challenging due to unclear criteria. We developed an artificial intelligence (AI)-based model that can identify patients with localized PCa who would benefit more from either radiotherapy or surgery, thereby providing personalized clinical decision-making.

Material and Methods

Data from consecutive patients with localized PCa who received radiotherapy or surgery with complete records of clinicopathological variables and follow-up results in 12 registries of the Surveillance, Epidemiology, and End Results database were analyzed. Patients from 7 registries were randomly assigned to training (TD) and internal validation datasets (IVD) at a 9:1 ratio. The remaining 5 registries constituted the external validation dataset (EVD). TD was divided into training-radiotherapy (TRD) and training-surgery (TSD) datasets, and IVD was divided into internal-radiotherapy (IRD) and internal-surgery (ISD) datasets. Six models for radiotherapy and surgery were trained using TRD and TSD to predict radiotherapy survival probability (RSP) and surgery survival probability (SSP), respectively. The models with the highest concordance index (C-index) on IRD and ISD were chosen to form the final treatment recommendation model (FTR). FTR recommendations were based on the higher value between RSP and SSP. Kaplan-Meier curves were generated for patients receiving recommended (consistent group) and nonrecommended treatments (inconsistent group), which were compared using the log-rank test.

Results

The study included 118 236 patients, categorized into TD (TRD: 44 621; TSD: 41 500), IVD (IRD: 4949; ISD: 4621), and EVD (22 545). Both radiotherapy and surgery models accurately predicted RSP and SSP (C-index: 0.735-0.787 and 0.769-0.797, respectively). The consistent group exhibited higher survival rates than the inconsistent group, particularly among patients not suitable for active surveillance (P < .001).

Conclusion

FTR accurately identifies patients with localized PCa who would benefit more from either radiotherapy or surgery, offering clinicians an effective AI tool to make informed choices between these 2 treatments.
Wuhan
Authors: Yang Dali L.
Published: August 2024

Dali L. Yang’s Wuhan offers a penetrating study of China’s management of the COVID-19 outbreak in Wuhan, a momentous event that has reverberated globally as the most severe pandemic in a century. Yang’s work sheds light on the advantage Chinese health decision makers had, including access to the novel coronavirus’s genomic sequences from several laboratories, as early as the end of December 2019. At this time an emergency action program was initiated to combat the burgeoning outbreak in Wuhan. Regrettably, the severity of the outbreak was grossly underestimated, leading to the adoption of measures that failed to effectively contain the virus. It was only in response to urgent warnings from sources outside Wuhan that national health authorities were spurred to take more decisive action, culminating in the Wuhan lockdown. Wuhan delves into the political, bureaucratic, and cognitive impediments that stymied the flow of crucial information, cultivated an atmosphere of organized silence, and facilitated the uncontrolled escalation of the outbreak in the weeks preceding the lockdown. The book highlights the detrimental effects of fragmented authoritarianism within the Chinese party-state and the strategic leadership weaknesses evident during the outbreak’s early stages. Moreover, it offers fresh insights into the formidable political, organizational, and health-related challenges involved in implementing the mega-lockdown. By examining the crisis’s progression, Wuhan allows readers to evaluate whether and how much of the COVID-19 pandemic could have been prevented. It emphasizes the necessity of transparency, adaptability to emerging information, and candid risk communication during public health crises.
Fragmented Authoritarianism, Inclusion–Exclusion Criteria, and Suppression of Case Submissions
Authors: Yang Dali L.
Published: August 2024

Early in the Wuhan outbreak, a major deficiency was the government’s failure to recognize and test suspected new coronavirus cases in Wuhan in the first half of January 2020, despite reports and warnings from front-line clinicians and hospital administrators. This chapter delves into the reasons behind this inaction, which primarily stem from the strict inclusion–exclusion criteria and political pressures associated with the “two sessions” meetings in Wuhan, Hubei Province. The inclusion–exclusion criteria dictated that exposure to the Huanan Seafood Market was a requisite condition for identifying a case, leading to a substantial underestimation of the outbreak’s severity. Compounding this issue was the prioritization of political interests over scientific evidence, resulting in health leadership suppressing case submissions to present an illusion of control. Despite the growing evidence of sustained human-to-human transmission, the stringent control over information and the adherence to flawed criteria led to a catastrophic public health failure.
The Wall of Silence Surrounding Health Worker Infections
Authors: Yang Dali L.
Published: August 2024

The previous chapter and this chapter underline the political and institutional dynamics of epidemic information manipulation and concealment leading up to the Wuhan lockdown and the fissures of fragmented authoritarianism. This chapter focuses on the second National Health Commission expert group’s visit to Wuhan from January 8 to 16, 2020, tasked with assessing the outbreak’s severity. Amid mounting pressures in Wuhan’s major hospitals and increasing rumors of healthcare worker infections, the expert team faced resistance when they pushed for disclosure of suspected cases. Key local authorities received crucial alerts about the severity of the outbreak around January 11–12, 2020, including information about health worker infections. However, within the context of fragmented authoritarianism, a wall of silence was erected around health worker infections
PhenoAge and PhenoAgeAccel in the context of dyslipidemia: association with stroke and potential as a new predictor in the US general population
Authors: Zhao Weijie , Wang Ziyue , Mi Chuanhao , Wang Yu , Shao Xinxin , Qi Xianghua , Kong Xinru
Published: August 2024

Background

The challenges posed by an aging society are increasingly recognized, particularly regarding the potential impacts of high-fat diets and the trend toward younger ages of disease onset. The purpose of this study was to clarify the relationships between the prevalence of stroke in the general US population and PhenoAge (PA) and PhenoAgeAccel (PAA).

Methods

Key methods included a correlation heatmap to explore linear relationships between some of the variables and weighted multivariable logistic regression to assess associations between PA, PAA, and stroke. Restricted cubic spline (RCS) analysis was used to investigate nonlinear relationships and dose–response effects. The ability of the PAA to predict stroke risk was assessed by a nomogram model and a receiver operating characteristic curve.

Results

After adjusting for confounding variables, both continuous and categorical PA and PAA were significantly associated with stroke prevalence. RCS analysis revealed a significant nonlinear relationship between PA and stroke prevalence. Further subgroup RCS analysis indicated that maintaining PA below 31.6 could provide greater benefits across all races and genders, specifically for individuals aged 40–80 years and those who are overweight or obese.

Conclusion

This study highlights the importance of stroke prevention in overweight and obese populations. Monitoring intermediary factors such as high-density lipoprotein cholesterol and waist circumference may reduce stroke risk. Additionally, PA and PAA may serve as novel markers for stroke, offering new directions for health management in an aging society.
Typicality First
Authors: Wilhelm Isaac
Published: August 2024

Instances of the law of large numbers are used to model many different physical systems. In this paper, I argue for a particular interpretation, of those instances of that law, which appeals to typicality. As I argue, the content of that law, when used to model physical systems, is that the probability of an event typically—rather than probably—approximates the frequency with which that event occurs.
Conceptual engineering is old news
Authors: Sękowski Krzysztof , Landes Ethan
Published: August 2024

According to a prevailing view, conceptual engineering introduces a revolutionary philosophical methodology, challenging traditional conceptual analysis. However, in our paper, we argue that closer scrutiny reveals not only the falsity but also the inherent ambiguity of this narrative. We explore four interpretations of the ‘Anti-Novelty Claim’, the claim that conceptual engineering is not a new way of doing philosophy. Discussing the Anti-Novelty Claim from the perspective of a text's producer, the text's consumers, and the exegetical potential of the text, we examine each perspective's metaphilosophical implications and demonstrate that taking each perspective requires different methods. Adopting these different methods, we argue that the different interpretations of the Anti-Novelty Claim range from nearly trivially true to unlikely but untested. Importantly, we emphasize that each interpretation offers unique philosophical insights, yet addressing them requires diverse types of evidence, preventing a singular, straightforward answer to whether conceptual engineering is new.
The centre of a finitely generated strongly verbally closed group is almost always pure
Authors: Denissov Filipp D , Klyachko Anton A
Published: August 2024

The assertion in the title implies that many interesting groups (for example, all non-abelian braid groups or $\textbf{SL}_{100}(\mathbb{Z})$) are not strongly verbally closed, i. e., they embed into some finitely generated groups as verbally closed subgroups, which are not retracts.
Evaluation of patients’ radiation doses and establishment of institutional diagnostic reference levels in nuclear medicine in Oman
Authors: Ebrahim Fadheela , Aljabri Aziza , Alhaji Amal , Aldebasi Bader , Gismelseed Abbasher , Bouchareb Yassine
Published: August 2024

This study aimed to develop diagnostic reference levels (DRLs) in Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) and Positron Emission Tomography/Computed Tomography (PET/CT) imaging for the most frequent SPECT/CT and PET/CT examinations performed at our institution. A total of 1134 adult patients, who have undergone SPECT/CT and PET/CT scanning over a period of 4 years (2018–2021), were included. The scans consisted of 401 PET/CT and 733 SPECT/CT scans. The CT dosimetry data [CT-dose-index (CTDIvol), dose-length-product (DLP)] and administered activities were collected. The DRLs were calculated for CTDIvol, DLP and administrated activity. The estimated DRLs are given as [median CTDIvol (mGy):median DLP (mGy.cm):median administrated activity (MBq)]: whole body PET/CT: 1.88:175:259; brain PET/CT: 12.9:300:239; cardiac PET/CT: 1.34:32:368; bone SPECT/CT: 2.68:116:763; MPI SPECT/CT (stress-rest): 1.49:52:751-721; parathyroid SPECT/CT: 3.1:126:779; thyroid uptake SPECT: 3.52:147:195; thyroid post-ablation SPECT/CT: 3.85:160:NA. The derived DRLs have allowed careful monitoring of doses delivered to patients and could act as a trigger to investigate doses that systematically exceeds the derived DRLs.
Current frameworks for environmental and health assessment of hydrocarbon streams and products are flexible and ready for alternative non crude oil-based feeds
Authors: Lampi Mark A , Therkorn Jennifer H , Kung Ming H , Isola Allison L , Barter Robert A
Published: August 2024

Hazard and risk assessment of complex petroleum-derived substances has been in a state of continuous improvement since the 1970s, with the development of approaches that continue to be applied and refined. Alternative feeds are defined here as those coming into a refinery or chemical plant that are not hydrocarbons from oil and gas extraction such as biologically derived oils, pyrolysis oil from biomass or other, and recycled materials. These feeds are increasingly being used for production of liquid hydrocarbon streams, and hence, there is a need to assess these alternatives, subsequent manufacturing and refining processes and end products for potential risk to humans and the environment. Here we propose a tiered, problem formulation-driven framework for assessing the safety of hydrocarbon streams and products derived from alternative feedstocks in use. The scope of this work is only focused on petrochemical safety assessment, though the principles may be applicable to other chemistries. The framework integrates combinations of analytical chemistry, in silico and in vitro tools, and targeted testing together with conservative assumptions/approaches to leverage existing health, environmental, and exposure data, where applicable. The framework enables the identification of scenarios where de novo hazard and/or exposure assessments may be needed and incorporates tiered approaches to do so. It can be applied to enable decisions efficiently and transparently and can encompass a wide range of compositional space in both feedstocks and finished products, with the objective of ensuring safety in manufacturing and use.
Assessing the impact of severe acute respiratory syndrome coronavirus 2 infection on hematological parameters
Authors: Alotaibi Badi A , Aldali Jehad A , Aldali Hamzah J , Alaseem Ali , Almuqrin Abdulaziz M , Alshalani Abdulrahman , AlSudais Hamood , Alshehri Nasser A , Alamar Nasser B , Alhejji Mogtba A
Published: August 2024

Background

The current study is a retrospective study designed to evaluate changes in complete blood count and coagulation parameters in adult coronavirus disease 2019 (COVID-19) patients at a prominent Saudi tertiary center to predict disease severity and mortality.

Methods

The cohort consisted of 74 800 adult patients divided into four groups based on a COVID-19 test and the patient’s sex: 35 985 in the female negative COVID-19 group, 23 278 in the male negative COVID-19 group, 8846 in the female positive COVID-19 group and 6691 in the male positive COVID-19 group.

Results

Patients with COVID-19 demonstrated decreased white blood cell counts and increased red blood cell counts. Also, COVID-19–positive participants exhibited more prolonged partial thromboplastin time and lower D-dimer levels than those of COVID-19–negative subjects (p<0.05). The study also revealed gender-dependent impacts on platelet counts, implying a possible relationship with the greater infection mortality rate in men than in women (p<0.001). In addition, the study found a link between changes in coagulation test results and death in COVID-19 patients (p<0.001). The evidence regarding the effects of COVID-19 on blood cell counts and coagulation, on the other hand, is conflicting, most likely due to variances in study populations and the timing of testing postinfection.

Conclusions

According to the findings, COVID-19–related alterations in blood cell count and clotting ability may be risk factors for death.
14Posthumanism
Authors: Nayar Pramod K
Published: August 2024

The year’s work in posthumanism includes both surveys of the field and publications that contribute significantly to posthumanist thought by examining processes and practices that call the singularity of the human into question. If we were to think of the principal strands of posthumanist thought that dominated publications in 2023, then human embodiment, environmentalism, and care-beyond-the-human, appearing in multiple collections and essays, would be clear choices. This review is divided into four key sections that consider how such strands play out in a range of disciplinary contexts in work published across 2023: 1. Surveys and Elaborations, which considers comprehensive accounts of the posthumanist school of thought and works that contribute to specific posthumanist themes; 2. Posthumanism in Literature and Culture, which considers the continuing interest in the literary and cultural enunciations of the posthuman, particularly fiction and art; 3. Posthumanism and the Anthropocene, which considers posthumanism’s intersections with environmental thought; and 4. Posthumanism and Care, which examines work on theorizations of care in which non-human and other-than-human care figure prominently.
Current concepts and targets for preventing the transition of acute to chronic postsurgical pain
Authors: Oweidat Adeeb , Kalagara Hari , Sondekoppam Rakesh V.
Published: August 2024

Purpose of review

It is estimated that approximately a third of patients undergoing certain surgeries may report some degree of persistent pain postoperatively. Chronic postsurgical pain (CPSP) reduces quality of life, is challenging to treat, and has significant socio-economic impact.

Recent findings

From an epidemiological perspective, factors that predispose patients to the development of CPSP may be considered in relation to the patient, the procedure or, the care environment. Prevention or management of transition from acute to chronic pain often need a multidisciplinary approach beginning early in the preoperative period and continuing beyond surgical admission. The current concepts regarding the role of central and peripheral nervous systems in chronification of pain may provide targets for future therapies but, the current evidence seems to suggest that a multimodal analgesic approach of preventive analgesia along with a continued follow-up and treatment after hospital discharge may hold the key to identify and manage the transitioning of acute to chronic pain.

A comprehensive multidisciplinary approach with prior identification of risk factors, minimizing the surgical insult and a culture of utilizing multimodal analgesia and continued surveillance beyond the period of hospitalization is an important step towards reducing the development of chronic pain. A transitional pain service model may accomplish many of these goals.
The Impact of Endplate Coverage on Heterotopic Ossification Following Cervical Disc Replacement
Authors: Kazarian Gregory S. , Cecere Robert , Sheha Evan , Dowdell James , Iyer Sravisht , Qureshi Sheeraz
Published: August 2024

Study Design.

Systematic review and meta-analysis.

Objective.

Describe the impact of endplate coverage on HO in cervical disc replacement (CDR).

Summary of Background Data.

CDR is a motion-sparing alternative to anterior cervical discectomy and fusion. However, the high prevalence of heterotopic ossification threatens to diminish range of motion and limit this benefit associated with CDR.

Materials and Methods.

A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. EMBASE and PubMed databases were queried. Results were deduplicated and screened. Relevant studies were included. All metrics that were reported in ≥3 studies were aggregated for analysis. SPSS was used to perform the meta-analysis.

Results.

A total of 10 studies were included in the systematic review. Endplate coverage was assessed using a wide variety of measurements, including anteroposterior implant depth (ID), endplate depth (ED), exposed endplate depth (EED), implant depth to endplate depth ratio (ID:ED), EED to ED ratio (EED:ED), implant width (IW) to endplate width (EW) ratio (IW:EW), and the implant area (IA) to endplate area (EA) ratio (IA:EA). No evidence has linked ID (three studies) to HO. Mixed evidence has linked ID:ED (3/5) and IW:ED (1/2) to HO. All available evidence has linked ED (2), EED (4), EED:ED (2), and IA:EA (1) to HO. In our meta-analysis, ID was not found to be a significant risk factor for HO. However, EED and ID:ED were found to be significant risk factors for HO formation.

Conclusions.

Exposed endplate, especially as assessed by EED and ID:ED, is a significant risk factor for HO. Surgeons should focus on preoperative planning and intraoperative implant selection to maximize endplate coverage. While optimizing technique and implant selection is crucial, improved implant design may also be necessary to ensure that appropriate implant-endplate footprint matching is possible across the anatomic spectrum.
Incidence and Risk Factors for Mechanical Failure After Anterior Column Realignment in Adult Spinal Deformity Surgery
Authors: Park Se-Jun , Park Jin-Sung , Kang Minwook , Jung Kyunghun , Lee Chong-Suh , Kang Dong-Ho
Published: August 2024

Study Design.

Retrospective study.

Objectives.

To investigate the incidence and risk factors of mechanical failure (MF) following anterior column realignment (ACR) in patients with severe degenerative sagittal imbalance (DSI).

Summary of Background Data.

Considering the biomechanical properties of the procedure, ACR may increase the risk of MF, including proximal junctional kyphosis (PJK) and rod fracture (RF). However, this issue has been poorly documented in the literature.

Methods.

We included patients aged ≥60 years with severe DSI radiographically defined by pelvic incidence (PI)-lumbar lordosis (LL) ≥20° undergoing ≥5-level fusion, including the sacrum. PJK was defined radiographically as a proximal junctional angle (PJA) >28° plus Δ PJA of >22°. RF was evaluated at ACR levels performed. Clinical and radiographic variables were compared with identify the risk factors for PJK and RF, then multivariate analysis was performed by combining PJK and RF into a single composite outcome of MF.

Results.

We included a total of 147 patients in the final study cohort. The mean age was 70.3 years, and there were 126 women (90.6%). The median fusion length was 8 levels. After surgery, PI-LL was corrected from 48.1° to 4.3°. MF developed in 49 patients (33.3%); PJK in 41 (27.9%), RF in 11 (7.5%), and both PJK and RF in 3 (2.0%) patients. Multivariate analyses revealed that osteoporosis (odds ratio [OR]=2.361, 95% confidence interval [CI]=1.270–5.590, P=0.048) and an increased number of ACR levels (OR=1.762, 95% CI=1.039–3.587, P=0.036) were significant risk factors for MF.

Conclusions.

A considerable number of patients (33.3%) developed MF after deformity correction using ACR procedures. Therefore, appropriate surgical strategies are necessary to prevent MF in patients undergoing deformity correction using ACR, with special attention to the risk factors we identified here.
The prevalence and etiology of infertility in a tertiary specialist hospital in the Gambia
Authors: Anyanwu Matthew , Touray Alhaji , Kujabi Tuti , Suwareh Karamaba , Sumbunu Adama , Drammeh Ramatoulie , Odeku Thompson , Nwanganga Ifeoma
Published: August 2024

Background:

Infertility is a public health problem that has received little or no attention in most sub-Saharan Africa, especially in the Gambia. The prevalence of infertility in the Gambia is increasing from 9.0% in 1998 to 14.3% in 2017. Tubal factor was the predominant leading cause for decades, but recent reviews suggest that male factor is driving the epidermic of infertility worldwide. Therefore, the aim of this study was to determine the prevalence and etiological factors of infertility in our practice.

Methodology:

The design was a retrospective quantitative study. Data collection tool was developed and variables were retrieved from case notes between August 2022 to March 2023 at a specialist hospital in the Gambia. The data were entered into a computer database and analyzed using descriptive statistics.

Results:

Total number of women in the reproductive age of 15–49 years that attended gynecology clinic was 1475. Two hundred eighty-five couples (285) had infertility. The prevalence of infertility is 19.3% ~1:5 couples. The causes showed male factor 69 (45.4%), ovulation disorder 34 (22.4%), tubal factor 20 (13.2%), uterine factor 8 (5.3%), and unexplained 21(13.8%). Ovarian factors showed age-related poor ovarian reserve. Overall, male factor infertility was 53%, and female factor infertility was 47%.

Conclusions:

The prevalence of infertility is increasing and male factor is 3-folds and 2-folds higher than tubal and ovarian factors, respectively. The study observed increasing desire of fertility among female in advanced age. Universal access to assisted reproductive technology is essential.
Anatomic Features of the Lamina Cribrosa and Optic Disc in Ocular Hypertension, Glaucoma and Healthy Eyes
Authors: Esen Baris Mine , Guven Suzan
Published: August 2024

Précis:

Central lamina cribrosa thickness (LCT) was found to be higher in eyes with ocular hypertension (OHT) compared with primary open angle glaucoma (POAG) and healthy controls (HCs).

Objective:

To evaluate the anatomic features of lamina cribrosa (LC) and the optic disc (OD) using swept-source optical coherence tomography (OCT) in eyes with OHT.

Materials and Methods:

Treatment naive eyes with OHT and POAG and healthy eyes were included. All eyes underwent a complete ophthalmological examination in addition to swept-source OCT of the OD. Anatomic features of LC, including central LCT, LC depth, prelaminar depth (PLD), and prelaminar tissue thickness, were measured manually using the internal caliper function of the OCT device and compared within groups. OD ovality, disc-foveal angle, and OD torsion were measured on colored photographs, using imageJ software.

Results:

Seventy-one eyes of 37 patients in the OHT group, 41 eyes of 26 patients in the POAG group, and 30 eyes of 30 patients in the HC group were enrolled in the study. Groups were similar in age and sex distribution. Central LCT was significantly higher in the OHT group, compared with HCs (333.8 ± 50.5 vs 304.5 ± 46.3 µm, P = 0.02) and POAG group (286.7 ± 140.4, P = 0.001). PLD and LC depth were both highest in POAG (282.3 ± 145.5 µm and 471.3 ± 195.2 µm), followed by OHT (244.8 ± 30.2 µm and 440.7 ± 18.7 µm) and HCs (170.1 ± 152.6 µm and 412.8 ± 80 µm), only the difference between POAG and HCs in PLD was statistically significant (P = 0.03). Prelaminar tissue thickness, OD torsion, disc-foveal angle, and disc ovality showed no significant difference.

Conclusion:

LC was significantly thicker in eyes with OHT, compared with POAG and HCs. This finding may be relevant to optic nerve protection from high intraocular pressure in patients with OHT.
Trends and projections in rehabilitation demand across 3 decades in China (1990−2019)
Authors: Tu Wenfeng , Wei Wentao
Published: August 2024

Background:

China has a large number of people with disabilities and chronic diseases who have rehabilitation needs.

Objectives:

To estimate the need for rehabilitation in China, we presented the prevalence and years lived with disability (YLDs) of 25 conditions that would benefit from rehabilitation over the course of their life.

Methods:

This study used the data from the Global Burden of Diseases Study 2019 (GBD 2019) to calculate the prevalence and YLDs. The World Health Organization Rehabilitation Need Estimator was used to calculate the results.

Results:

In China, 460 million [95% uncertainty interval (UI), 440−480] individuals [male: 220 (220−230); female: 240 (230−250)] had conditions that would benefit from rehabilitation in 2019, contributing to 63 million (47–80) YLDs [male: 29 (22−37); female: 34 (26−43)]. There has been a 70.4% and 75.0% increase in prevalent cases (male vs. female: 69.2% vs. 84.6%) and YLDs (male vs. female: 70.6% vs. 78.9%), respectively, between 1990 and 2019. In 2019, the age-standardized rates of prevalent cases and YLDs per 1000 were 254 (95% UI, 244−264) [male: 251 (243−261); female: 255 (245−267)] and 35.2 (95% UI, 26.6−44.6) [male: 33.2 (24.9−42.1); female: 36.9 (28.0−46.8)], respectively. There has been a 2.3% and 3.0% reduction in the age-standardized rates of prevalent cases (male vs. female: −1.6% vs. −3.8%) and YLDs (male vs. female: −2.1% vs. −3.9%), respectively, between 1990 and 2019.

Conclusions:

This study shows that the need for rehabilitation services in China has increased significantly in the past 3 decades. Therefore, we propose that rehabilitation must be integral to “Healthy China 2030” and the whole health system—especially in primary health care—to serve more people in need.
Meniscus Injuries in Soccer
Authors: Kuhn Andrew W. , Brophy Robert H.
Published: August 2024

Soccer is considered the most popular sport in the world. The game involves frequent agile maneuvers, such as rapid accelerations/decelerations and pivoting, and carries an inherent risk of high-speed collisions, which can lead to lower extremity injury. Knee and meniscus injuries can cause significant pain and disability, precluding participation in the sport. Understanding the diagnosis and management of meniscal injuries in soccer players is essential to the care of these athletes. This paper reviews meniscal anatomy, biomechanics, and mechanisms of injury; discusses the work-up, diagnosis, and management of meniscus injuries; and reports on rehabilitation, return to sport, and outcomes after meniscal injuries in soccer players.
Psychological distress, forced awakening, and morning blood pressure surge
Authors: Kim Yeonsu , Esquivel Jill Howie , Mattos Meghan Kathleen , Davis Eric M. , Logan Jeongok
Published: August 2024

Background

Morning blood pressure surge (MBPS) has been recognized as an independent predictor of cardiovascular disease events. Psychological distress, including anxiety, depression, and perceived stress, and behavioral risk factors, such as poor sleep quality, have been associated with increased MBPS. Elevations in sympathetic activity induced by forced awakening may also contribute to further increases in MBPS. Yet, no examination of the interrelationships among psychological distress, sleep quality, awakening mode (natural vs. forced awakenings), and MBPS has been undertaken.

Objective

This pilot study aimed: (1) to examine if MBPS differs by awakening mode and (2) to investigate whether psychological distress is associated with MBPS difference between natural and forced awakenings, independent of sleep quality.

Methods

Thirty-two healthy adults were included in this cross-sectional study. Blood pressure was measured using a beat-to-beat blood pressure monitor over two nights, consisting of one night of natural awakening and one night of forced awakening. Psychological distress and sleep quality were assessed using questionnaires. We conducted paired t-tests (aim 1) and multiple linear regressions (aim 2).

Results

MBPS was significantly greater during forced awakening compared with natural awakening. In addition, the MBPS difference between natural and forced awakenings was significantly greater in participants with higher anxiety levels, independent of sleep quality.

Conclusion

We found that augmentation of MBPS by forced awakening was significantly greater in individuals who reported higher anxiety levels. Additional research is needed to examine the potential impacts of forced awakening and anxiety on MBPS in a larger sample of individuals at risk for cardiovascular disease.
Building a culture of belonging
Authors: Nease Beth , Hash Pam L.
Published: August 2024

A book review with lessons for nurse leaders
A Statewide Physician Champion Initiative to Prevent Diabetes: Lessons Learned from North Carolina
Authors: Khan Tamkeen , Ramkissoon Nar , Vasaitis Siga , Walker Franklin , Patil Shivajirao , Sachdev Neha
Published: August 2024

The North Carolina Medical Society (NCMS) and American Medical Association (AMA) collaborated to support diabetes prevention efforts in North Carolina (NC) with a physician champion initiative focused on tracking and increasing referrals to the National Diabetes Prevention Program (DPP). Three focus areas to effectively engage and utilize physician champions included: (1) self-adoption within their practice, (2) engagement and outreach with other healthcare leaders, and (3) influence to peers and colleagues. Six NC physician champions were selected to support the work from January 2020 to January 2023. This resulted in increased outreach to physicians about Diabetes Free NC, increased materials/education for physicians on prediabetes identification and management, and 1943 referrals to the National DPP. This work can be further translated and applied to other states to aid prevention efforts. Physician champions’ expertise coupled with adequate resources can allow them to play a key role in chronic disease prevention and management.
Tenofovir alafenamide compared to tenofovir disoproxil fumarate, induces dysglycemia, and dyslipidemia in Wistar rats
Authors: Hurchund Rajendraparsad , Sibiya Sinegugu E. , Owaga Bernard O. , Owira Peter M.O.
Published: August 2024

Objectives:

To determine the metabolic effects of tenofovir alafenamide (TAF) compared to tenofovir disoproxil fumarate (TDF) in vivo.

Design and methods:

Male Wistar rats (Rattus novergicus, 250–300 g body weight) were divided into three groups (n = 8) and orally treated daily with 1.0 ml distilled water (group 1), TAF (0.42 mg/kg) (group 2), or TDF (5.0 mg/kg) (group 3), respectively, for 56 days. Glucose tolerance tests were done before the animals were sacrificed by halothane overdose, and blood was collected by cardiac puncture for the analysis of plasma lipids, electrolytes, and insulin. The kidney and pancreatic tissues were excised and homogenized to measure oxidative stress. Compartmentation of TAF and TDF was determined in NRK-52 and peripheral blood mononuclear cells (PBMCs).

Results:

There were no significant differences in weight gain among controls, TAF- or TDF-treated rats. TAF-treated rats had significantly increased fasting blood glucose (FBG), fasting plasma insulin (FPI), insulin resistance, impaired glucose tolerance, and dyslipidemia compared to control or TDF-treated rats, respectively. There was increased lipid peroxidation in the pancreas of TAF-treated compared to TDF-treated or control animals, respectively. TDF- treated rats presented with symptoms of Fanconi syndrome compared to TAF-treated or control animals, respectively. Kidney homogenates from TDF-treated animals had significantly reduced antioxidant enzyme activity compared to TAF-treated animals or controls, respectively. Intracellular concentrations of TAF were significantly higher than TDF in both NRK-52E cells and PBMC, respectively.

Conclusions:

TAF treatment is weight-neutral and causes dysglycemia, and dyslipidemia but not Fanconi syndrome compared to TDF.
A point-of-care tenofovir urine test improves accuracy of self-reported preexposure prophylaxis adherence and increases condomless sex reporting among young women
Authors: Zewdie Kidist , Muwonge Timothy , Ssebuliba Timothy , Bambia Felix , Nampewo Olivia , Stein Gabrielle , Mugwanya Kenneth K. , Thomas Katherine K. , Wyatt Christina , Yin Michael T. , Wang Guohong , Gandhi Monica , Mujugira Andrew , Heffron Renee
Published: August 2024

Objectives:

We evaluated a recently developed and validated point-of-care urine tenofovir (POC TFV) test to determine whether its use improves the accuracy of self-reported adherence to preexposure prophylaxis (PrEP) and sexual behavior.

Design:

We enrolled sexually active HIV-negative women ages 16 to 25 years in Kampala, Uganda.

Methods:

Women were followed quarterly for 24 months with HIV prevention counseling, PrEP dispensation, and adherence counseling. Midway through the study, the POC TFV test was introduced as part of routine study procedures. We examined changes in self-reported PrEP adherence, sexual behavior, and accuracy of self-reported PrEP adherence before and after the introduction of the POC TFV test.

Results:

A total of 146 women receiving PrEP refills had at least one visit with a POC TFV test administered before the study exit. At baseline, the median age was 19 years [interquartile range (IQR): 18–21] and the majority (76%) reported having condomless sex within the last 3 months. Participants more frequently self-reported low PrEP adherence [odds ratio (OR): 2.96, 95% confidence interval (CI): 1.89–4.67, P = 0.001] and condomless sex (OR: 1.47, 95% CI: 1.04–2.06, P = 0.03) during visits using the test compared with visits without the test. The accuracy of self-reported PrEP adherence (determined by concordance with TFV-diphosphate levels) was greater when the test was used (61 versus 24%, OR: 4.86, 95% CI: 2.85–8.30, P < 0.001).

Conclusion:

When the POC TFV test was used, we observed greater reporting of condomless sex, low PrEP adherence, and more accurate reports of PrEP adherence. The test could facilitate honest conversations between clients and providers and warrant further investigation.
Aspergillus fumigatus
Authors: Kullik Yannik , Wessendorf Thomas E. , Theegarten Dirk , Winantea Jane , Hautzel Hubertus , Opitz Marcel
Published: August 2024

A 61-year-old woman, referred for recurrent pneumonia over a period of 3 months with insufficient response to antibiotic treatment, presented with coughing and intense right-sided chest pain. Previously, she underwent right upper lobectomy for locally advanced non–small cell lung cancer (squamous cell carcinoma) followed by adjuvant chemotherapy and subsequent partial chest wall resection with polytetrafluoroethylene net insert due to a pleurocutaneous fistula. 18FDG plus a 68Ga-labeled fibroblast activation protein inhibitor (68Ga-FAPI) PET/CT scans were performed to rule out non–small cell lung cancer recurrence. Pathological workup with bronchoscopy and endobronchial ultrasound–guided transbronchial fine-needle aspiration of the lymph nodes showed no evidence of malignancy, but microbiology confirmed Aspergillus fumigatus infection of the middle lobe. Thus, the patient transitioned from antibiotic to antifungal therapy; no second-line oncologic treatment was initiated.