bluuebunny/crossref_metadata_2025 huggingface dataset:
Nipah Virus-Associated Neuropathology in African Green Monkeys During Acute Disease and Convalescence
Authors: Goldin Kerry , Liu Yanling , Rosenke Rebecca , Prado-Smith Jessica , Flagg Meaghan , de Wit Emmie
Published: June 2024

Background

Nipah virus is an emerging zoonotic virus that causes severe respiratory disease and meningoencephalitis. The pathophysiology of Nipah virus meningoencephalitis is poorly understood.

Methods

We have collected the brains of African green monkeys during multiple Nipah virus, Bangladesh studies, resulting in 14 brains with Nipah virus-associated lesions.

Results

The lesions seen in the brain of African green monkeys infected with Nipah virus, Bangladesh were very similar to those observed in humans with Nipah virus, Malaysia infection. We observed viral RNA and antigen within neurons and endothelial cells, within encephalitis foci and in uninflamed portions of the central nervous system (CNS). CD8+ T cells had a consistently high prevalence in CNS lesions. We developed a UNet model for quantifying and visualizing inflammation in the brain in a high-throughput and unbiased manner. While CD8+ T cells had a consistently high prevalence in CNS lesions, the model revealed that CD68+ cells were numerically the immune cell with the highest prevalence in the CNS of Nipah virus-infected animals.

Conclusions

Our study provides an in-depth analysis on Nipah virus infection in the brains of primates, and similarities between lesions in patients and the animals in our study validate this model.
Hair, Roots, and Crystal Balls: Archival Viscerality, Black Conjuring Traditions, and the Study of American Religions
Authors: Greene-Hayes Ahmad
Published: June 2024

Black studies scholars have long argued that archives are violent and dismembering, especially as the universities which house them preserve the physical and immaterial remnants of slavery. Religious studies scholars, especially historians of religion, have begun attending to this quandary while sifting through archives of slavery and religion. This article enters this discourse by focusing on the afterlives of slavery and their relationship to the religious innovations of Black religious actors in the late nineteenth and early twentieth centuries. This article, then, centers the author’s visceral experience in an archival reading room of a university while consulting the material objects of religious practitioners Reverend John L. Reed and Sister Mamie Wade Avant. In the process, the article reconstructs a historical narrative about their lives and argues that religious studies must reckon with the archive of antiblackness and its capture of Black religions.
Understanding Epidemiological Trends in Geriatric Burn Injuries: A National Multicenter Analysis from NEISS 2004-2022
Authors: Boroumand Sam , Katsnelson Beatrice , Dony Alna , Stögner Viola A , Huelsboemer Lioba , Parikh Neil , Oh SeungJu Jackie , Kauke-Navarro Martin , Savetamal Alisa , Pomahac Bohdan
Published: June 2024

Burn injuries pose a significant source of patient morbidity/mortality and reconstructive challenges for burn surgeons, especially in vulnerable populations such as geriatric patients. Our study aims to provide new insights into burn epidemiology by analyzing the largest national, multicenter sample of geriatric patients to date. Using the National Electronic Injury and Surveillance System (NEISS) database (2004-2022), individuals with a “burn” diagnosis were extracted and divided into 2 comparison age groups of 18-64 and 65+. Variables including sex, race, affected body part, incident location, burn etiology, and clinical outcomes were assessed between the 2 groups using 2 proportion z-tests. About 60,581 adult patients who sustained burns were identified from the NEISS database with 6630 of those patients categorized as geriatric (65+). Geriatric patients had a significantly greater frequency of scald burns (36.9% vs 35.4%; P < .01), and third-degree/full-thickness burns (10.4% vs 5.5%, P < .01) relative to nongeriatric adult patients with most of these burns occurring at home (75.9% vs 67.4%; P < .01). The top 5 burn sites for geriatric patients were the hand, face, foot, lower arm, and lower leg and the top 5 burn injury sources were hot water, cookware, oven/ranges, home fires, and gasoline. Geriatric patients had over 2 times greater risk of hospital admission (odds ratio [OR]: 2.32, 95% CI: 2.17-2.49, P < .01) and over 5 times greater risk of emergency department mortality (OR: 6.22, 95% CI: 4.00-9.66, P < .01) after incurring burn injuries. These results highlight the need for stronger awareness of preventative measures for geriatric burn injuries.
Ultrasonic velocity anisotropy of Jurassic shales with different lithofacies
Authors: Liu Weihua , Wang Yang , Shen Hui , Li Min , Fan Wenhao
Published: June 2024

Given the growing importance of organic-rich shale as unconventional reservoirs, a thorough understanding of the elastic and anisotropic behavior of shales is of great concern. However, for lacustrine shales, the complex lithofacies assemblage with geological deposition makes it challenging. Four lithofacies (argillaceous, mixed, siliceous, and calcareous) are recognized for 40 lacustrine shale samples from Jurassic formation in Sichuan Basin on the basis of their mineral compositions. We perform ultrasonic velocity measurements on 40 pairs of shale plugs at varied confining pressures, attempting to uncover the controls on the anisotropic properties of different lithofacies. The experimental results reveal that the total porosity, clay, and organic matter would positively contribute to velocity anisotropy of Jurassic shales. Combined with microstructure and pressure-dependent velocity analysis, the preferred orientations of platy clay particles and lenticular kerogen, the development of clay pores along clay fabric, and the sub-parallel micro-cracks induced by hydrocarbon expulsion are treated to be the controlling mechanisms. We add the total porosity, clay content, and kerogen volume together, intending to distinguish the elastic and anisotropic properties of four lithofacies. Generally, argillaceous shales, the dominant lithofacies in Jurassic formation, could be characterized by the highest clay and total organic content (TOC), the lowest bedding-normal velocities, and the strongest velocity anisotropy. Finally, with the laboratory data, two rock-physics-driven exponential relationships are proposed to predict the P- and S-wave velocity anisotropy with the bedding-normal velocities.
Cellular metabolism and hypoxia interfacing with allergic diseases
Authors: Kellett Shauna K , Masterson Joanne C
Published: June 2024

Allergic diseases display significant heterogeneity in their pathogenesis. Understanding the influencing factors, pathogenesis, and advancing new treatments for allergic diseases is becoming more and more vital as currently, prevalence continues to rise, and mechanisms of allergic diseases are not fully understood. The upregulation of the hypoxia response is linked to an elevated infiltration of activated inflammatory cells, accompanied by elevated metabolic requirements. An enhanced hypoxia response may potentially contribute to inflammation, remodeling, and the onset of allergic diseases. It has become increasingly clear that the process underlying immune and stromal cell activation during allergic sensitization requires well-tuned and dynamic changes in cellular metabolism. The purpose of this review is to examine current perspectives regarding metabolic dysfunction in allergic diseases. In the past decade, new technological platforms such as “omic” techniques have been applied, allowing for the identification of different biomarkers in multiple models ranging from altered lipid species content, increased nutrient transporters, and altered serum amino acids in various allergic diseases. Better understanding, recognition, and integration of these alterations would increase our knowledge of pathogenesis and potentially actuate a novel repertoire of targeted treatment approaches that regulate immune metabolic pathways.
Repellency ofN,N-diethyl-3-methylbenzamide (DEET) during host-seeking behavior of bed bugs (Hemiptera: Cimicidae) in binary choice olfactometer assays
Authors: Hayes Christopher C , Schal Coby
Published: June 2024

The bed bug (Cimex lectularius L.) is one of the most prolific and burdensome indoor pests, and suppression of bed bug populations is a global priority. Understanding bed bug behavior is important to the development of new tactics for their control. Major gaps exist in our understanding of how host cues, insecticide resistance, and exposure modality impact the repellency of formulated products to bed bugs. Here, we validate the use of a binary choice olfactometer for assessing bed bug repellency behaviors using N,N-diethyl-3-methylbenzamide (DEET) in a dose-dependent manner, while considering the role of host-associated stimuli (with vs. without CO2), exposure modality (olfactory vs. olfactory and contact), and resistance status (susceptible vs. resistant) on repellency. We observed that host-seeking insecticide-susceptible bed bugs were repelled only when olfactorily exposed to high concentrations of DEET. However, exposure to DEET by contact repelled insecticide-susceptible bed bugs at 100-fold lower dose of DEET. Further, we demonstrate for the first time that insecticide-resistant bed bugs were significantly more responsive to DEET than susceptible bed bugs. We conclude that the 2-choice olfactometer is an effective tool for assessing the behavioral responses of bed bugs to spatial and contact repellents.
Preliminary result of combined treatment with scanning carbon-ion radiotherapy and image-guided brachytherapy for locally advanced cervical adenocarcinoma
Authors: Tsuchida Keisuke , Yoshida Daisaku , Shima Satoshi , Kusunoki Terufumi , Takayama Yoshiki , Koge Hiroaki , Kano Kio , Takakusagi Yosuke , Mizoguchi Nobutaka , Kamada Tadashi , Kusano Yohsuke , Kato Hisamori , Katoh Hiroyuki
Published: June 2024

Although there is growing evidence of the efficacy of carbon-ion radiotherapy (CIRT) for locally advanced cervical adenocarcinoma, reports on combined treatment with CIRT and image-guided brachytherapy (IGBT) are scarce. We retrospectively analyzed patients with International Federation of Gynecology and Obstetrics (2008) stage II–IVA locally advanced cervical adenocarcinoma who received combined scanning CIRT (sCIRT) and IGBT between April 2019 and March 2022. sCIRT consisted of whole-pelvic irradiation with 36 Gy (relative biological effectiveness [RBE]) in 12 fractions and subsequent local boost irradiation with 19.2 Gy (RBE) in 4 fractions. Three sessions of IGBT were administered after completion of sCIRT. Concurrent chemotherapy using weekly cisplatin (40 mg/m2/week) was also administered. Efficacy, toxicity and dose–volume parameters were analyzed. Fifteen patients were included in the analysis. The median follow-up period was 25 months. The 2-year overall survival, progression-free survival and local control rates were 92.3% (95% confidence interval [CI] = 77.8–100%), 52.5% (95% CI = 26.9–78.1%) and 84.8% (95% CI = 65.2–100%), respectively. Neither severe acute toxicity necessitating treatment cessation nor grade 3 or higher late toxicity were observed. The sigmoid D2cm3 of the patient who developed grade 2 late sigmoid hemorrhage was 65.6 Gy, which exceeded the standard deviation and target dose. The combination of sCIRT and IGBT for locally advanced cervical adenocarcinoma showed acceptable efficacy and safety. Further large-scale and long-term studies are warranted to confirm the efficacy and safety of this treatment.
Licensing Agreements and Other Agreements Involving Intellectual Property Rights
Authors: Alison Jones , Brenda Sufrin , Niamh Dunne
Published: June 2024

This chapter examines some of the different types of intellectual property rights (IPRs) before outlining the relationship between intellectual property and both EU competition law and the EU free movement rules. It focuses, however, on IP licensing agreements and their treatment under Article 101. The chapter traces the development of EU competition policy to IP licensing agreements and examine the current Technology Transfer Block Exemption and the Guidelines in detail. It also examines patent settlement agreements (including pay for delay agreements), patent pools, trademark licences, trademark delimitation agreements, and copyright (other than software) licences not covered by the TTBER and Guidelines.
MeerKAT discovery of a double radio relic and odd radio circle: connecting cluster and galaxy merger shocks
Authors: Koribalski Bärbel S , Veronica Angie , Dolag Klaus , Reiprich Thomas H , Brüggen Marcus , Heywood Ian , Andernach Heinz , Dettmar Ralf-Jürgen , Hoeft Matthias , Zhang Xiaoyuan , Bulbul Esra , Garrel Christian , Józsa Gyula I G , English Jayanne
Published: June 2024

We present the serendipitous discovery of (1) a large double radio relic associated with the galaxy cluster PSZ2 G277.93 + 12.34 and (2) a new odd radio circle, ORC J1027–4422, both found in the same deep MeerKAT 1.3 GHz wide-band radio continuum image. The angular separation of the two arc-shaped cluster relics is ∼16 arcmin or ∼2.6 Mpc for a cluster redshift of z ≈ 0.158. The thin southern relic, which shows several ridges/shocks including one possibly moving inwards, has a linear extent of ∼1.64 Mpc. In contrast, the northern relic is about twice as wide, twice as bright, but only has a largest linear size of ∼0.66 Mpc. Complementary SRG/eROSITA X-ray images reveal extended emission from hot intracluster gas between the two relics and around the narrow-angle tail (NAT) radio galaxy PMN J1033–4335 (z ≈ 0.153) located just east of the northern relic. The radio morphologies of the NAT galaxy and the northern relic, which are also detected with the Australian Square Kilometer Array Pathfinder (ASKAP) at 888 MHz, suggest both are moving in the same outward direction. The discovery of ORC J1027–4422 in a different part of the same MeerKAT image makes it the fourth known single ORC. It has a diameter of ∼90 arcsec corresponding to 400 kpc at a tentative redshift of z ≈ 0.3 and remains undetected in X-ray emission. Supported by simulations, we discuss similarities between outward moving galaxy and cluster merger shocks as the formation mechanisms for ORCs and radio relics, respectively.
How to break the mass sheet degeneracy with the light curves of microlensed Type Ia supernovae
Authors: Weisenbach Luke , Collett Thomas , de Murieta Ana Sainz , Krawczyk Coleman , Vernardos Georgios , Enzi Wolfgang , Lundgren Andrew
Published: June 2024

The standardizable nature of gravitationally lensed Type Ia supernovae (glSNe Ia) makes them an attractive target for time-delay cosmography, since a source with known luminosity breaks the mass sheet degeneracy. It is known that microlensing by stars in the lensing galaxy can add significant stochastic uncertainty to the unlensed luminosity, which is often much larger than the intrinsic scatter of the Type Ia population. In this work, we show how the temporal microlensing variations as the supernova (SN) disc expands can be used to improve the standardization of glSNe Ia. We find that SNe are standardizable if they do not cross caustics as they expand. We estimate that this will be the case for ≈6 doubly imaged systems and ≈0.3 quadruply imaged systems per year from the Vera Rubin Observatory (LSST). At the end of the 10 yr LSST survey, these systems should enable us to test for systematics in H0 due to the mass sheet degeneracy at the $1.00^{+0.07}_{-0.06}$ per cent level, or 1.8 ± 0.2 per cent if we can only extract time delays from the third of systems with counter-images brighter than i = 24 mag.
Historic dog Furs Unravel the Origin and Artificial Selection of Modern Nordic Lapphund and Elkhound dog Breeds
Authors: Wang Shi-Zhi , Yan Yu , Widlund Malin , Qian Chen-Chang , Zhang Liang-Liang , Zhang Shao-Jie , Li Zi-Mai , Cao Peng , Dai Qing-Yan , Feng Xiao-Tian , Liu Feng , Wang Lu , Gao Chao , Fu Qiao-Mei , Hytönen Marjo K , Lohi Hannes , Savolainen Peter , Wang Guo-Dong
Published: June 2024

The origins and extreme morphological evolution of the modern dog breeds are poorly studied because the founder populations are extinct. Here, we analyse eight 100 to 200 years old dog fur samples obtained from traditional North Swedish clothing, to explore the origin and artificial selection of the modern Nordic Lapphund and Elkhound dog breeds. Population genomic analysis confirmed the Lapphund and Elkhound breeds to originate from the local dog population, and showed a distinct decrease in genetic diversity in agreement with intense breeding. We identified eleven genes under positive selection during the breed development. In particular, the MSRB3 gene, associated with breed-related ear morphology, was selected in all Lapphund and Elkhound breeds, and functional assays showed that a SNP mutation in the 3′UTR region suppresses its expression through miRNA regulation. Our findings demonstrate analysis of near-modern dog artifacts as an effective tool for interpreting the origin and artificial selection of the modern dog breeds.
Prediction of WHO grade and methylation class of aggressive meningiomas: Extraction of diagnostic information from infrared spectroscopic data
Authors: Galli Roberta , Lehner Franz , Richter Sven , Kirsche Katrin , Meinhardt Matthias , Juratli Tareq A , Temme Achim , Kirsch Matthias , Warta Rolf , Herold-Mende Christel , Ricklefs Franz L , Lamszus Katrin , Sievers Philipp , Sahm Felix , Eyüpoglu Ilker Y , Uckermann Ortrud
Published: June 2024

Background

Infrared (IR) spectroscopy allows intraoperative, optical brain tumor diagnosis. Here, we explored it as a translational technology for the identification of aggressive meningioma types according to both, the WHO CNS grading system and the methylation classes (MC).

Methods

Frozen sections of 47 meningioma were examined by IR spectroscopic imaging and different classification approaches were compared to discern samples according to WHO grade or MC.

Results

IR spectroscopic differences were more pronounced between WHO grade 2 and 3 than between MC intermediate and MC malignant, although similar spectral ranges were affected. Aggressive types of meningioma exhibited reduced bands of carbohydrates (at 1024 cm−1) and nucleic acids (at 1080 cm−1), along with increased bands of phospholipids (at 1240 and 1450 cm−1). While linear discriminant analysis was able to discern spectra of WHO grade 2 and 3 meningiomas (AUC 0.89), it failed for MC (AUC 0.66). However, neural network classifiers were effective for classification according to both WHO grade (AUC 0.91) and MC (AUC 0.83), resulting in the correct classification of 20/23 meningiomas of the test set.

Conclusions

IR spectroscopy proved capable of extracting information about the malignancy of meningiomas, not only according to the WHO grade, but also for a diagnostic system based on molecular tumor characteristics. In future clinical use, physicians could assess the goodness of the classification by considering classification probabilities and cross-measurement validation. This might enhance the overall accuracy and clinical utility, reinforcing the potential of IR spectroscopy in advancing precision medicine for meningioma characterization.
Differential isocitrate dehydrogenase 1 and isocitrate dehydrogenase 2 mutation-related landscape in intrahepatic cholangiocarcinoma
Authors: Xu Shuaishuai , Cao Linping , Chen Ruyin , Ye Chanqi , Li Qiong , Jiang Qi , Yan Feifei , Wan Mingyu , Zhang Xiaochen , Ruan Jian
Published: June 2024

Background

Patients with intrahepatic cholangiocarcinoma (ICC) are prone to recurrence and poor survival. Targeted therapy related to isocitrate dehydrogenase (IDH) is an extremely important treatment. IDH1 and IDH2 mutations are generally thought to have similar effects on the tumor landscape. However, it is doubtful whether these 2 mutations have exactly the same effects on tumor cells and the tumor microenvironment.

Methods

All collected tumor samples were subjected to simultaneous whole-exon sequencing and proteome sequencing.

Results

IDH1 mutations accounted for 12.2%, and IDH2 mutations accounted for 5.5%, all missense mutations. Tumors with IDH mutations had lower proportions of KRAS and TP53 mutations. Mutated genes were obviously enriched in the kinase pathway in the tumors with IDH2 mutations. The signaling pathways were mainly enriched in the activation of cellular metabolic activities and an increase of inhibitory immune cells in the tumors with IDH mutations. Moreover, tumors had unique enrichment in DNA repair in IDH1 mutants and secretion of biological molecules in IDH2 mutants. Inhibitory immune cells might be more prominent in IDH2 mutants, and the expression of immune checkpoints PVR and HLA-DQB1 was more prominent in IDH1 mutants. IDH mutants were more related to metabolism-related and inflammation-immune response clusters, and some belonged to the DNA replication and repair cluster.

Conclusions

These results revealed the differential IDH1 and IDH2 mutation-related landscapes, and we have provided an important reference database to guide ICC treatment.
Future sea-level rise in northwest Mexico is projected to decrease the distribution and habitat quality of the endangered Calidris canutus roselaari (Red Knot)
Authors: Garcia-Walther Julian , Johnson James A , Senner Nathan R
Published: June 2024

Sea-level rise (SLR) is one of the most unequivocal consequences of climate change, yet the implications for shorebirds and their coastal habitats are not well understood, especially outside of the north temperate zone. Here, we show that by the year 2050, SLR has the potential to cause significant habitat loss and reduce the quality of the remaining coastal wetlands in Northwest Mexico—one of the most important regions for Nearctic breeding migratory shorebirds. Specifically, we used species distribution modeling and a moderate SLR static inundation scenario to assess the effects of future SLR on coastal wetlands in Northwest Mexico and the potential distribution of Calidris canutus roselaari (Red Knot), a threatened long-distance migratory shorebird. Our results suggest that under a moderate SLR scenario, 55% of the current coastal wetland extent in northwest Mexico will be at risk of permanent submergence by 2050, and the high-quality habitat areas that remain will be 20% less suitable for C. c. roselaari. What is more, 8 out of the 10 wetlands currently supporting the largest numbers of C. c. roselaari are predicted to lose, on average, 17.8% of their Highly Suitable Habitat (HSH) areas, with 2 sites completely losing all of their HSH. In combination with increasing levels of coastal development and anthropogenic disturbance in Northwest Mexico, these predicted changes suggest that the potential future distribution of C. c. roselaari (and other shorebirds) will likely contract, exacerbating their ongoing population declines. Our results also make clear that SLR will likely have profound effects on ecosystems outside the north temperate zones, providing a clarion call to natural resource managers. Urgent action is required to begin securing sufficient space to accommodate the natural capacity of wetlands to migrate inland and implement local-scale solutions that strengthen the resilience of wetlands and human populations to SLR.
Association between early-life mosquito repellents exposure and ADHD-like behaviours
Authors: Zhou Cheng , Fu Weiwen , Wei Xinyu , Zhang Zixing , Wang Bin , Fang Xinyu
Published: June 2024

Background

Limited research has explored the impact of mosquito repellents exposure during early life on ADHD symptoms. This study aimed to explore the associations of exposure to mosquito repellents from pregnancy to 3 years old and the prevalence of ADHD-like behaviours among children aged 3–9 years, and further identify the sensitive exposure period.

Methods

A cross-sectional study was conducted, including 12 275 children in Hefei City, China. Exposure was self-reported via primary caregivers. ADHD-like behaviours were measured by the Swanson, Nolan and Pelham, version IV scale (SNAP-IV), and Conners’ Parent Rating Scale (CPRS). Cross-over analysis, binary logistic regression and linear regression were employed.

Results

After adjusting for confounding variables, early-life exposure to mosquito repellents was associated with a higher risk of ADHD-like behaviours (OR = 1.81, 95% CI = 1.49–2.19). By comparing the strength of the association for each subgroup, we found exposure during 1–3 years old was a sensitive period (OR = 1.89, 95% CI = 1.25–2.87) by the cross-over analysis. Furthermore, we found a dose–response relationship in which the likelihood of ADHD-like behaviours increased with children’s early-life mosquito repellents exposure dose.

Conclusions

Early-life exposure to mosquito repellents is linked with an elevated risk of ADHD-like behaviours in children, with a sensitive period identified during 1–3 years old.
Cervical Cancer Screening Among Female Medicaid Beneficiaries With and Without Schizophrenia
Authors: Hwong Alison R , Murphy Karly A , Vittinghoff Eric , Alonso-Fraire Paola , Crystal Stephen , Walkup Jamie , Hermida Richard , Olfson Mark , Cournos Francine , Sawaya George F , Mangurian Christina
Published: June 2024

Background and Hypothesis

In the United States, women with schizophrenia face challenges in receiving gynecologic care, but little is known about how cervical cancer screening rates vary across time or states in a publicly insured population. We hypothesized that women Medicaid beneficiaries with schizophrenia would be less likely to receive cervical cancer screening across the United States compared with a control population, and that women with schizophrenia and other markers of vulnerability would be least likely to receive screening.

Study Design

This retrospective cohort study used US Medicaid administrative data from across 44 states between 2002 and 2012 and examined differences in cervical cancer screening test rates among 283 950 female Medicaid beneficiaries with schizophrenia and a frequency-matched control group without serious mental illness, matched on age and race/ethnicity. Among women with schizophrenia, multivariable logistic regression estimated the odds of receiving cervical cancer screening using individual sociodemographics, comorbid conditions, and health care service utilization.

Study Results

Compared to the control group, women with schizophrenia were less likely to receive cervical cancer screening (OR = 0.76; 95% CI 0.75–0.77). Among women with schizophrenia, nonwhite populations, younger women, urban dwellers, those with substance use disorders, anxiety, and depression and those connected to primary care were more likely to complete screening.

Conclusions

Cervical cancer screening rates among US women Medicaid beneficiaries with schizophrenia were suboptimal. To address cervical cancer care disparities for this population, interventions are needed to prioritize women with schizophrenia who are less engaged with the health care system or who reside in rural areas.
Basic vs electromyographic biofeedback–assisted pelvic floor muscle training for the improvement of sexual function after total hysterectomy: a prospective study
Authors: Wang Yiqun , Wang Jing , Li Wei
Published: June 2024

Background

Pelvic floor muscle training (PFMT) has emerged as a potential intervention to improve post–total hysterectomy (TH) sexual function. Electromyographic (EMG) biofeedback is an adjunct that may improve outcomes.

Aim

In this study we aimed to compare the EMG biofeedback–assisted PFMT and PFMT alone for improving sexual function in women after TH.

Methods

For this prospective study we enrolled women undergoing TH in our hospital between January 2022 and April 2023. Participants were divided according to the treatment they selected: EMG biofeedback–assisted PFMT or PFMT alone.

Outcomes

The primary study outcome was change in patient sexual function evaluated by use of the Female Sexual Function Index. Secondary outcomes were changes in anxiety and depression evaluated with the Hospital Anxiety and Depression Scale score and pelvic floor muscle strength was evaluated with the Glazer assessment performed from before to after treatment.

Results

A total of 73 patients were included, with 38 patients treated with Electromyographic biofeedback–assisted pelvic floor muscle training. After treatment, sexual function was significantly improved compared to baseline in all patients (all P < .001). Compared to patients with pelvic floor muscle training, the changes in total Female Sexual Function Index scores from before to after treatment in patients with Electromyographic biofeedback–assisted pelvic floor muscle training were significantly higher (all P < .05). There were no significant differences between the 2 groups in the changes in the Glazer score and Hospital Anxiety and Depression Scale scores from before to after treatment (both P > .05).

Clinical Translation

The results demonstrate that Electromyographic biofeedback–assisted pelvic floor muscle training may be used to improve the sexual function of patients following TH.

Strengths and Limitations

This study is limited by its single-center design, small sample size, lack of randomization, and absence of estrogen monitoring in enrolled participants.

Conclusions

Electromyographic biofeedback–assisted pelvic floor muscle training appears to be more effective than pelvic floor muscle training alone in improving sexual function among patients after total hysterectomy.
Place of high-flow nasal oxygen in nonoperating room anesthesia
Authors: Nay Mai-Anh , Auvet Adrien
Published: June 2024

Purpose of review

This article aims to assess the utility of high-flow nasal oxygen (HFNO) therapy in nonoperating room anesthesia (NORA) settings.

Recent findings

The number of procedural interventions under deep sedation in NORA is still increasing. Administration of oxygen is recommended to prevent hypoxemia and is usually delivered with standard oxygen through nasal cannula or a face mask. HFNO is a simple alternative with a high warmed humidified flow (ranging from 30 to 70 l/min) with a precise fraction inspired of oxygen (ranging from 21 to 100%). Compared to standard oxygen, HFNO has demonstrated efficacy in reducing the incidence of hypoxemia and the need for airway maneuvers. Research on HFNO has primarily focused on its application in gastrointestinal endoscopy procedures. Yet, it has also shown promising results in various other procedural interventions including bronchoscopy, cardiology, and endovascular procedures. However, the adoption of HFNO prompted considerations regarding cost-effectiveness and environmental impact.

HFNO emerges as a compelling alternative to conventional oxygen delivery methods for preventing hypoxemia during procedural interventions in NORA. However, its utilization should be reserved for patients at moderate-to-high risk to mitigate the impact of cost and environmental factors.
Receipt of Medications for Alcohol Use Disorder in the Veterans Health Administration: Comparison of Rates at the Intersections of Racialized and Ethnic Identity With Both Sex and Transgender Status
Authors: Bachrach Rachel L. , Frost Madeline C. , Fletcher Olivia V. , Chen Jessica A. , Chinman Matthew , Ellis Robert , Williams Emily C.
Published: June 2024

Objectives

Medications for alcohol use disorder (MAUDs) are recommended for patients with alcohol use disorder yet are underprescribed. Consistent with Minority Stress and Intersectionality theories, persons with multiple sociodemographically marginalized identities (eg, Black women) often experience greater barriers to care and have poorer health outcomes. We use data from the Veterans Health Administration to assess disparities in Federal Drug Administration (FDA)–approved MAUDs and all effective MAUDs between the following groups: racialized and ethnic identity, sex, transgender status, and their intersections.

Methods

Among all Veterans Health Administration outpatients between August 1, 2015, and July 31, 2017, with documented alcohol screenings and an International Classification of Diseases diagnosis for alcohol use disorder in the 0–365 days prior (N = 308,238), we estimated the prevalence and 95% confidence intervals of receiving FDA-approved MAUDs and any MAUDs in the following year and compared them using χ
2 or Fisher’s exact test. Analyses are unadjusted to present true prevalence and group differences.

Results

The overall prevalence for MAUDs was low (FDA-MAUDs = 8.7%, any MAUDs = 20.0%). Within sex, Black males had the lowest rate of FDA-MAUDs (7.3%, [7.1–7.5]), whereas American Indian/Alaskan Native females had the highest (18.4%, [13.8–23.0]). Among those identified as transgender, Asian and Black transgender persons had the lowest rates of FDA-MAUDs (0%; 4.3%, [1.8–8.5], respectively), whereas American Indian/Alaskan Native transgender patients had the highest (33.3%, [2.5–64.1]). Similar patterns were observed for any MAUDs, with higher rates overall.

Conclusions

Substantial variation exists in MAUD prescribing, with marginalized veterans disproportionately receiving MAUDs at lower and higher rates than average. Implementation and quality improvement efforts are needed to improve MAUD prescribing practices and reduce disparities.
Coronavirus Disease 2019 (COVID-19) Vaccination and Stillbirth in the Vaccine Safety Datalink
Authors: Denoble Anna E. , Vazquez-Benitez Gabriela , Sheth Sangini S. , Ackerman-Banks Christina M. , DeSilva Malini B. , Zhu Jingyi , Daley Matthew F. , Getahun Darios , Klein Nicola P. , Vesco Kimberly K. , Irving Stephanie A. , Nelson Jennifer , Williams Joshua T. B. , Hambidge Simon J. , Donahue James G. , Weintraub Eric S. , Kharbanda Elyse O. , Lipkind Heather S.
Published: June 2024

OBJECTIVE:

Coronavirus disease 2019 (COVID-19) vaccination is recommended in pregnancy to reduce the risk of severe morbidity from COVID-19. However, vaccine hesitancy persists among pregnant people, with risk of stillbirth being a primary concern. Our objective was to examine the association between COVID-19 vaccination and stillbirth.

METHODS:

We performed a matched case–control study in the Vaccine Safety Datalink (VSD). Stillbirths and live births were selected from singleton pregnancies among persons aged 16–49 years with at least one prenatal, delivery, or postpartum visit at eight participating VSD sites. Stillbirths identified through diagnostic codes were adjudicated to confirm the outcome, date, and gestational age at fetal death. Confirmed antepartum stillbirths that occurred between February 14, 2021, and February 27, 2022, then were matched 1:3 to live births by pregnancy start date, VSD site, and maternal age at delivery. Associations among antepartum stillbirth and COVID-19 vaccination in pregnancy, vaccine manufacturer, number of vaccine doses received, and vaccination within 6 weeks before stillbirth (or index date in live births) were evaluated using conditional logistic regression.

RESULTS:

In the matched analysis of 276 confirmed antepartum stillbirths and 822 live births, we found no association between COVID-19 vaccination during pregnancy and stillbirth (38.4% stillbirths vs 39.3% live births in vaccinated individuals, adjusted odds ratio [aOR] 1.02, 95% CI, 0.76–1.37). Furthermore, no association between COVID-19 vaccination and stillbirth was detected by vaccine manufacturer (Moderna: aOR 1.00, 95% CI, 0.62–1.62; Pfizer-BioNTech: aOR 1.00, 95% CI, 0.69–1.43), number of vaccine doses received during pregnancy (1 vs 0: aOR 1.17, 95% CI, 0.75–1.83; 2 vs 0: aOR 0.98, 95% CI, 0.81–1.17), or COVID-19 vaccination within the 6 weeks before stillbirth or index date compared with no vaccination (aOR 1.16, 95% CI, 0.74–1.83).

CONCLUSION:

No association was found between COVID-19 vaccination and stillbirth. These findings further support recommendations for COVID-19 vaccination in pregnancy.
Individual-Level and Community-Level Predictors of Healthy Pregnancy Outcomes in Multigravid Black Women
Authors: Garr Barry Valene , Martin Samantha L. , Schneider-Worthington Camille , Zhao Peinan , Woolfolk Candice L. , Foraker Randi , Davis Kia L. , Kelly Jeannie C. , Raghuraman Nandini , England Sarah K. , Carter Ebony B.
Published: June 2024

OBJECTIVE:

To identify individual- and community-level factors that predict the odds of multigravid Black women having consecutive pregnancies without adverse pregnancy outcomes.

METHODS:

We conducted a secondary analysis of 515 multigravid Black women from a longitudinal observational study (2017–2019). We assessed the presence of adverse pregnancy outcomes (hypertensive disorders, gestational diabetes, preterm birth, fetal growth restriction, placental abruption, and pregnancy loss) for the index and prior pregnancies. We examined U.S. Census data, medical records, and surveys across multiple socioecologic domains: personal, behavioral, socioeconomic, and policy. We estimated adjusted odds ratios (aORs) and 95% CIs for the association between individual- and community-level factors and consecutive healthy pregnancies using hierarchical logistic regression models adjusted for maternal age, body mass index (BMI), gravidity, interpregnancy interval, and median household income.

RESULTS:

Among 515 multigravid Black women (age 27±5 years, BMI 31.4±8.9, gravidity 4±2), 38.4% had consecutive healthy pregnancies without adverse pregnancy outcomes. Individual-level factors associated with consecutive healthy pregnancies included normal glucose tolerance (aOR 3.9, 95% CI, 1.2–12.1); employment (aOR 1.9, 95% CI, 1.2–2.9); living in communities with favorable health indicators for diabetes, hypertension, and physical activity; and household income of $50,000 per year or more (aOR 3.5, 95% CI, 1.4–8.7). When individual and community factors were modeled together, only income and employment at the individual and community levels remained significant.

CONCLUSION:

Individual and community income and employment are associated with consecutive healthy pregnancies in a cohort of Black patients, emphasizing the need for comprehensive, multilevel systems interventions to reduce adverse pregnancy outcomes for Black women.
Reducing Tracheostomy-Related Acquired Pressure Injury by Flipping the Ventilator Circuit Position Study
Authors: Niroula Abesh , Yang Philip , Campbell Martin Luther , Cruse Alyssa Rose , Gizaw Rahel M. , Vannostrand Keriann M. , Jaber Wissam S. , Schimmel Matthew , Daymude Kelly , Revenig Janine , Berkowitz David
Published: June 2024

BACKGROUND:

Tracheostomy-related acquired pressure injuries (TRPIs) are one of the hospital-acquired conditions. We hypothesize that an uneven ventilator circuit load, leading to non-neutral tracheostomy tube positioning in the immediate post-tracheostomy period, leads to an increased incidence of TRPIs. Does switching the ventilator circuit load daily, in addition to standard post-tracheostomy care, lead to a decreased incidence of TRPIs?

METHODS:

This is a prospective quality improvement study. Study was conducted at two academic hospital sites within tertiary care hospitals at Emory University in different ICUs. Consecutive patients undergoing bedside percutaneous tracheostomy by the interventional pulmonary service were included. The flip the ventilator circuit (FLIC) protocol was designed and implemented in selected ICUs, with other ICUs as controls.

RESULTS:

Incidence of TRPI in intervention and control group were recorded at post-tracheostomy day 5. A total of 99 patients were included from October 22, 2019, to May 22, 2020. Overall, the total incidence of any TRPI was 23% at post-tracheostomy day 5. Incidence of stage I, stage II, and stages III–IV TRPIs at postoperative day 5 was 11%, 12%, and 0%, respectively. There was a decrease in the rate of skin breakdown in patients following the FLIC protocol when compared with standard of care (13% vs. 36%; p = 0.01). In a multivariable analysis, interventional group had decreased odds of developing TRPI (odds ratio, 0.32; 95% CI, 0.11–0.92; p = 0.03) after adjusting for age, albumin, body mass index, diabetes mellitus, and days in hospital before tracheostomy.

CONCLUSIONS:

The incidence of TRPIs within the first week following percutaneous tracheostomy is high. Switching the side of the ventilator circuit to evenly distribute load, in addition to standard bundled tracheostomy care, may decrease the overall incidence of TRPIs.
An Unexpected Post–Egg-Free Influenza Vaccine Granulomatous Reaction
Authors: Engel Casey E. , Fagan Kiley K. , Dorsey Susan B. , Grider Douglas J.
Published: June 2024

A 53-year-old woman presented with a pruritic plaque on the left upper arm that appeared following an egg-free flu vaccine due to a history of reaction to the standard vaccine. The affected area enlarged over a several month period immediately following vaccine administration. Physical examination revealed an 8 × 4 cm coalescent pink plaque on the left upper arm. A shave biopsy of the lesion showed dermal “naked” granulomas, or granulomas with sparse lymphocytic infiltrate at the margins, as typically seen in sarcoidosis. No foreign material was seen in the granulomatous reaction, including with polarization. Special stains, including acid fast bacilli, Grocott methenamine silver, periodic acid–Schiff, and Gram, were negative for organisms. The diagnosis of granulomatous dermatitis was made. Subsequent imaging demonstrated no findings suggestive of sarcoidosis. While vaccine-associated hypersensitivity reactions occur frequently, these reactions are typically due to individual vaccine components, such as egg protein, and do not normally result in the formulation of granulomas. Vaccination-induced granulomas are more often associated with the use of aluminum as an adjuvant; however, this is not present in the egg-free influenza vaccine. Thus, a granulomatous reaction to the egg-free influenza vaccine is very unusual and, to our knowledge, not previously reported.
Catching the Culprit: Benzylpenicillin Neurotoxicity Confirmed by Therapeutic Drug Monitoring in a Critically Ill Patient With Continuous Venovenous Hemofiltration
Authors: van Gelder Thomas G. , Schweitzer Valentijn A. , Uijtendaal Esther V. , Sikma Maaike A.
Published: June 2024

We present the case of a 65-year-old patient who was treated with high-dose benzylpenicillin for severe invasive pneumococcal pneumonia, complicated by acute renal failure managed with continuous venovenous hemofiltration. After cessation of continuous venovenous hemofiltration, the patient experienced multiple tonic–clonic seizures. Therapeutic drug monitoring revealed high total serum concentrations of benzylpenicillin, identifying it as the likely cause of the neurotoxicity. This case study presents the first documented total serum benzylpenicillin concentration associated with neurotoxicity.
Emerging Value of Osseointegration for Intuitive Prosthetic Control after Transhumeral Amputations: A Systematic Review
Authors: Tereshenko Vlad , Giorgino Riccardo , Eberlin Kyle R. , Valerio Ian L. , Souza Jason M. , Alessandri-Bonetti Mario , Peretti Giuseppe M. , Aszmann Oskar C.
Published: June 2024

Background:

Upper extremity limb loss profoundly impacts a patient’s quality of life and well-being and carries a significant societal cost. Although osseointegration allows the attachment of the prosthesis directly to the bone, it is a relatively recent development as an alternative to conventional socket prostheses. The objective of this review was to identify reports on osseointegrated prosthetic embodiment for transhumeral amputations and assess the implant systems used, postoperative outcomes, and complications.

Methods:

A systematic review following PRISMA and AMSTAR guidelines assessed functional outcomes, implant longevity and retention, activities of daily living, and complications associated with osseointegrated prostheses in transhumeral amputees.

Results:

The literature search yielded 794 articles, with eight of these articles (retrospective analyses and case series) meeting the inclusion criteria. Myoelectric systems equipped with Osseointegrated Prostheses for the Rehabilitation of Amputees implants have been commonly used as transhumeral osseointegration systems. The transhumeral osseointegrated prostheses offered considerable improvements in functional outcomes, with participants demonstrating enhanced range of motion and improved performance of activities compared with traditional socket-based prostheses. One study demonstrated the advantage of an osseointegrated implant as a bidirectional gateway for signal transmission, enabling intuitive control of a bionic hand.

Conclusions:

Osseointegrated prostheses hold the potential to significantly improve the quality of life for individuals with transhumeral amputations. Continued research and clinical expansion are expected to lead to the realization of enhanced efficacy and safety in this technique, accompanied by cost reductions over time as a result of improved efficiencies and advancements in device design.
Sleep blood pressure measured using a home blood pressure monitor was independently associated with cardiovascular disease incidence: the Nagahama study
Authors: Tabara Yasuharu , Matsumoto Takeshi , Murase Kimihiko , Setoh Kazuya , Kawaguchi Takahisa , Wakamura Tomoko , Hirai Toyohiro , Chin Kazuo , Matsuda Fumihiko
Published: June 2024

Background:

Nocturnal blood pressure (BP) is associated with cardiovascular disease independently of awake BP. However, nocturnal BP measured using an ambulatory monitoring device has limited reproducibility because it is a single-day measurement. We investigated the association between sleep BP measured on multiple days using a timer-equipped home BP monitor and cardiovascular diseases in a general population.

Methods:

The study population comprised 5814 community residents. Participants were required to sleep with wrapping cuffs on their upper arm and BP was measured automatically at 0 : 00, 2 : 00, and 4 : 00. Actigraph was used to determine BP measured during sleep. Participants were also measured home morning and evening BP manually using the same device.

Results:

During the 7.3-year mean follow-up period, we observed 117 cases of cardiovascular diseases. The association between sleep BP (per 10 mmHg hazard ratio = 1.31, P < 0.001) and cardiovascular events remained significant (hazard ratio = 1.22, P = 0.036) even after adjusting for office BP and confounding factors, such as sleep-disordered breathing. Individuals with sleep-only hypertension (n = 1047; hazard ratio = 2.23, P = 0.005) had a significant cardiovascular risk. Daytime-only hypertension (n = 264; hazard ratio = 3.57, P = 0.001) and combined sleep and daytime hypertension (n = 1216; hazard ratio = 3.69, P < 0.001) was associated with cardiovascular events to the same extent. Sleep BP dipping was not identified as a significant determinant of cardiovascular events.

Conclusion:

Sleep BP measured using a home BP monitor was independently associated with the incidence of cardiovascular disease in a general population.