bluuebunny/crossref_metadata_2025 huggingface dataset:
Stigma and Barriers to Care, Online Mental Health Tools, and Suicidality in California’s Veterans
Authors: Hill Lydia , Inagaki Tristen K , Schmied Emily A , Vaughn Allison A
Published: August 2024

Introduction

Veterans have a higher national suicide rate than non-veterans (31.6 versus 18.0 per 100,000). Psychotherapy and other treatments are effective at reducing suicidality, yet stigma and barriers to care reduce willingness to seek help. For veterans who do seek help, they are often undertreated leaving them still in need of help. Online mental health tools (OMHTs) provide another option for obtaining help; however, there is limited research regarding the relationship between stigma and barriers to care, OMHT use, and suicidality. We hypothesized that stigma and barriers are related to higher likelihood of OMHT use and OMHT use is related to lower likelihood of suicidality.

Materials and Methods

The California Health Interview Survey is a population-based state health survey that collects data over a 2-year cycle via web and phone interviews. The sample was 4,435 veterans (91% male, 75% White, and average age 67 years old). The study was institutional review board exempt because data storage and analyses were done at the Data Access Center at University of California—Los Angeles.

Results

Logistic regressions showed endorsing stigma and barriers indicated a higher likelihood of using OMHTs. Additionally, use of OMHTs was unexpectedly associated with greater suicidality.

Conclusions

Findings reinforce the need for research aimed at identifying ways to reduce stigma and barriers toward seeking help. Online mental health tools are a viable option for individuals experiencing stigma and barriers and for individuals who previously experienced suicidality.
A review of lobomycosis and lobomycosis-like skin disease in cetaceans worldwide, with new data from the Gulf of Guayaquil, Ecuador
Authors: Van Bressem Marie-Françoise , Félix Fernando , Van Waerebeek Koen
Published: August 2024

Lobomycosis, also called paracoccidioidomycosis ceti, is a chronic mycotic cutaneous disease affecting odontocetes. Lobomycosis-like disease (LLD) has a clinical presentation consistent with lobomycosis but lacks a histological and molecular diagnosis. We review the literature on lobomycosis aetiology, clinical signs and pathogenesis, species affected and geographic distribution and examine the factors influencing the presence, transmission and prevalence of the disease, to better understand its ecology. In addition, we provide unpublished information on LLD in two common bottlenose dolphin (Tursiops truncatus) communities inhabiting the Gulf of Guayaquil, Ecuador. Lobomycosis and LLD occur in Delphinidae from the Atlantic, Pacific, and Indian Oceans between 33°N and 35°S. Primary risk factors include habitat, sex, age, sociality, and pollution. In dolphins from the Americas and Japan, lobomycosis is caused by Paracoccidioides ceti, family Ajellomycetaceae. The disease is characterized by cutaneous granulomatous lesions that may occur anywhere on the body, grow to large size, and may ulcerate. Histologically, the lesions consist of acanthosis and histiocytic granulomas between the skin and subcutaneous tissues, with inflammatory changes that extend deep into the dermis. Multiple yeast cells with a double refringent layer stained positive using Gomori-Grocott methenamine silver in the dermis of a T. truncatus from Ecuador diagnosed with LLD since 2011, a first record for the Southeast Pacific. Injuries may enable the entry of P. ceti into the dermis while skin contact likely favours transmission, putting males at higher risk than females. Lobomycosis and LLD may have a negative impact on small communities already threatened by anthropogenic factors.
Within-subject comparison of near-death and psychedelic experiences: acute and enduring effects
Authors: Martial Charlotte , Carhart-Harris Robin , Timmermann Christopher
Published: August 2024

Mystical-like states of consciousness may arise through means such as psychedelic substances, but may also occur unexpectedly during near-death experiences (NDEs). So far, research studies comparing experiences induced by serotonergic psychedelics and NDEs, along with their enduring effects, have employed between-subject designs, limiting direct comparisons. We present results from an online survey exploring the phenomenology, attribution of reality, psychological insights, and enduring effects of NDEs and psychedelic experiences (PEs) in individuals who have experienced both at some point during their lifetime. We used frequentist and Bayesian analyses to determine significant differences and overlaps (evidence for null hypotheses) between the two. Thirty-one adults reported having experienced both an NDE (i.e. NDE-C scale total score ≥27/80) and a PE (intake of lysergic acid diethylamide, psilocybin/mushrooms, ayahuasca, N,N-dimethyltryptamine, or mescaline). Results revealed areas of overlap between both experiences for phenomenology, attribution of reality, psychological insights, and enduring effects. A finer-grained analysis of the phenomenology revealed a significant overlap in mystical-like effects, while low-level phenomena (sensory effects) were significantly different, with NDEs displaying higher scores of disembodiment and PEs higher scores of visual imagery. This suggests psychedelics as a useful model for studying mystical-like effects induced by NDEs, while highlighting distinctions in sensory experiences.
Long working hours and cardiovascular diseases, time for preventive action
Authors: Descatha Alexis , Landsbergis Paul , Li Jian , Sembajwe Grace , Fadel Marc
Published: August 2024

The effects of long working hours, night and shift work on cardiovascular diseases, have been found in different populations around the world. The aim is to emphasize the importance of appropriate action in relation to the association of long working hours with cardiovascular disease. It is time to improve working conditions and health promotion and wellness programmes. Occupational researchers/practitioners have a major role to play in promoting these next steps and potential interventions.
Perceived mental health skills and competence among occupational health physicians
Authors: Majuri M , Malin M , Antila A , Luukkonen R , Palosaari M , Reijula K
Published: August 2024

Background

Mental-health-based consultations in occupational health (OH) are increasing due to ongoing changes in working life.

Aims

We studied the self-assessed mental health competence of trainees and trainers in OH specialist physician training.

Methods

We conducted an online survey from June to August 2022. We analysed how trainees and trainers in OH assessed their own competence in mental health practice with N (%) and means (standard deviation [SD]). We analysed the underlying assumptions about competences specific to OH using an explanatory factor analysis. We applied the Kruskal–Wallis test to determine differences between trainees and trainers using the variables in the factor analysis.

Results

Respondents’ perceptions of mental health competence were more positive among trainers (mean 3.97, SD 0.72) than trainees (mean 3.66, SD 1.08, P = 0.2123). Based on trainee physicians’ own assessments, more experience increases competence, until after 7 years, when the perceived competence seems to decrease. The trainer physicians’ self-assessed mental health competence decreased over time. With factor analyses, we identified five competence factors: general mental health, workplace risks and resources, rehabilitation, promotion and prevention, and special skills. In our results, individual-level mental health competences such as work ability evaluation and to manage return-to-work processes were evaluated better than community-based proactive processes.

Conclusions

Physicians in OH specialist physician training self-assessed their mental health competence better at the employee level than at the workplace level. Based on our results, we need to develop the curriculum of OH specialist physician training to meet the needs of working life in support of mental health.
Hepatocyte MMP14 mediates liver and inter-organ inflammatory responses to diet-induced liver injury
Authors: Kelly Shannon C , Higgins Cassandra B , Sun Jiameng , Adams Joshua A , Zhang Yiming , Ballentine Samuel , Miao Yong , Cui XiaoXia , Milewska Małgorzata , Wandzik Ilona , Yoshino Jun , Swarts Benjamin M , Wada Shun-ichi , DeBosch Brian J
Published: August 2024

The matrix metalloproteinase MMP14 is a ubiquitously expressed, membrane-bound, secreted endopeptidase that proteolyzes substrates to regulate development, signaling, and metabolism. However, the spatial and contextual events inciting MMP14 activation and its metabolic sequelae are not fully understood. Here, we introduce an inducible, hepatocyte-specific MMP14-deficient model (MMP14LKO mice) to elucidate cell-intrinsic and systemic MMP14 function. We show that hepatocyte MMP14 mediates diet-induced body weight gain, peripheral adiposity, and impaired glucose homeostasis and drives diet-induced liver triglyceride accumulation and induction of hepatic inflammatory and fibrotic gene expression. Single-nucleus RNA sequencing revealed that hepatocyte MMP14 mediates Kupffer cell and T-cell accumulation and promotes diet-induced hepatocellular subpopulation shifts toward protection against lipid absorption. MMP14 co-immunoprecipitation and proteomic analyses revealed MMP14 substrate binding across both inflammatory and cytokine signaling, as well as metabolic pathways. Strikingly, hepatocyte MMP14 loss-of-function suppressed skeletal muscle and adipose inflammation in vivo, and in a reductionist adipose–hepatocyte co-culture model. Finally, we reveal that trehalose-type glucose transporter inhibitors decrease hepatocyte MMP14 gene expression and nominate these inhibitors as translatable therapeutic metabolic agents. We conclude that hepatocyte MMP14 drives liver and inter-organ inflammatory and metabolic sequelae of obesogenic dietary insult. Modulating MMP14 activation and blockade thus represents a targetable node in the pathogenesis of hepatic inflammation.
Neurodiversity in the healthcare profession
Authors: Johnson Jo-Anne , Ahluwalia Sanjiv
Published: August 2024

The term neurodiversity was coined in the 1990s to describe a diversity in thinking, learning, and processing the world around us, and is associated with strengths as well as challenges. Rates of diagnosis of neurodivergent conditions are rising rapidly amongst patients and healthcare professionals, largely due to a recent surge in awareness and understanding of neurodiverse conditions and more inclusive diagnostic criteria. Societal adaptation, however, has lagged, and likely explains some of the psychosocial comorbidities of neurodiversity, as individuals are forced to adapt their personality and how they display their emotions to fit societal norms. There remains a lack of awareness and understanding of neurodiversity amongst the healthcare professions. There is also very limited published literature on the challenges and strengths of this group in the clinical environment. Here, we use a case study, focusing on attention deficit hyperactivity disorder to explore the relationship between neurodiversity and work from the perspective of a neurodiverse health care professional. We challenge the notion that neurodiversity itself is a disability, but more likely a result of lack of societal awareness and adaption. We suggest accommodations and training in the clinical environment to raise awareness and support neurodiverse healthcare professionals in order that they flourish rather than struggle in the workplace.
Changes in Prenatal Cannabis Use Among Pregnant Individuals From 2012 to 2022
Authors: Young-Wolff Kelly C. , Chi Felicia W. , Lapham Gwen T. , Alexeeff Stacey E. , Does Monique B. , Ansley Deborah , Campbell Cynthia I.
Published: August 2024

This population-based cross-sectional study analyzed electronic health record data of pregnant individuals in an integrated health care delivery system in California to examine changes in prenatal cannabis use through self-report and urine toxicology testing during standard prenatal care between 2012 (n=33,546) and 2022 (n=43,415), and to test whether trends differed by race and ethnicity or age. The prevalence of prenatal cannabis use increased from 5.5% (95% CI, 5.3–5.8%) in 2012 to 9.0% (95% CI, 8.7–9.2%) in 2022 (adjusted prevalence ratio [aPR] 1.82, 95% CI, 1.72–1.92), with similar increases by toxicology test (aPR 1.70, 95% CI, 1.60–1.81) and self-report (aPR 2.12, 95% CI, 1.95–2.30). The increase in prevalence varied significantly across racial and ethnic and age groups, with the highest prevalence among Black individuals and those aged 13–24 across years. Although rates increased more slowly among groups with the highest prevalence of use, disparities persisted over time.
Human Papillomavirus Vaccination in the Postpartum Period
Authors: Brenner Sara E. , Modesitt Susan , Bednarczyk Robert A. , Dilley Sarah E.
Published: August 2024

OBJECTIVE:

To assess whether routine postpartum human papillomavirus (HPV) vaccination is acceptable and feasible and to identify key themes and strategies that can be used to increase postpartum HPV vaccination rates.

DATA SOURCES:

PubMed and ClinicalTrials.gov were queried from inception to July 2024 for postpartum and HPV vaccination. Studies were limited to human subjects and the English language.

METHODS OF STUDY SELECTION:

Screening was performed for studies of any method that evaluated HPV vaccination in the postpartum period (N=60). Only original research that reported either uptake or acceptability of the HPV vaccine was included. Thirty-nine studies were eliminated after abstract review because they did not meet the inclusion criteria.

TABULATION, INTEGRATION, AND RESULTS:

Nine studies were categorized according to the primary aim of the study (defining the problem, assessing patient perspectives, or testing interventions to increase vaccination) and demonstrated that postpartum HPV vaccination programs can significantly increase HPV vaccination rates and are feasible and acceptable to patients.

CONCLUSION:

Incorporating HPV vaccination into standard postpartum care provides an opportunity to reach vulnerable patient populations, reduces cost for patients, and has the ability to prevent HPV-related cancers.
Effects of Minimally Invasive Versus Open Pancreatoduodenectomy on Short-Term Surgical Outcomes and Postoperative Nutritional and Immunological Statuses: A Single-Institution Propensity Score-Matched Study
Authors: Yumoto Shinsei , Hayashi Hiromitsu , Mima Kosuke , Ogawa Daisuke , Itoyama Rumi , Kitano Yuki , Nakagawa Shigeki , Okabe Hirohisa , Baba Hideo
Published: August 2024

Objective:

To evaluate the feasibility and clinical impact of minimally invasive pancreatoduodenectomy (MIPD) versus open pancreatoduodenectomy (OPD) on postoperative nutritional and immunological indices.

Background:

The surgical advantages of MIPD over OPD are controversial, and the postoperative nutritional and immunological statuses are unknown.

Methods:

In total, 306 patients who underwent MIPD (n = 120) or OPD (n = 186) for periampullary tumors from April 2016 to February 2024 were analyzed. Surgical outcomes and postoperative nutritional and immunological indices (albumin, prognostic nutritional index [PNI], neutrophil-to-lymphocyte ratio [NLR], and platelet-to-lymphocyte ratio [PLR]) were examined by 1:1 propensity score matching (PSM) with well-matched background characteristics.

Results:

PSM resulted in 2 balanced groups of 99 patients each. Compared with OPD, MIPD was significantly associated with less estimated blood loss (P < 0.0001), fewer intraoperative blood transfusions (P = 0.001), longer operative time, shorter postoperative hospital stay (P < 0.0001), fewer postoperative complications (P = 0.001) (especially clinically relevant postoperative pancreatic fistula [P = 0.018]), and a higher rate of textbook outcome achievement (70.7% vs 48.5%, P = 0.001). The number of dissected lymph nodes and the R0 resection rate did not differ between the 2 groups. In elective cases with textbook outcome achievement, the change rates of albumin, PNI, NLR, and PLR from before to after surgery were equivalent in both groups.

Conclusions:

MIPD has several surgical advantages (excluding a prolonged operative time), and it enhances the achievement of textbook outcomes over OPD. However, the postoperative nutritional and immunological statuses are equivalent for both procedures.
Large-scale HEV genotype 3 outbreak on New Caledonia Island
Authors: Abravanel Florence , Vignon Clémence , Mercier Ambroise , Gaumery Jean-Baptiste , Biron Antoine , Filisetti Clément , Goujart Marie-Amélie , Colot Julien , Chamillard Xavier , Demortier Justine , Raz Maxime , Boutet Catherine , Dupont Laura , Duval Sylvie , Castric Catherine , Desoutter Denise , Desoutter Anais , Verge Marjorie , De Smet Clémentine , Demmou Sofia , Lhomme Sébastien , Gourinat Ann-Claire , Nicot Florence , Izopet Jacques
Published: August 2024

Background and Aims:

Several symptomatic cases of HEV infections were reported to the New Caledonia Island Public Health Service between August and December 2023. This prompted epidemiological and virological investigations to identify the source of infection.

Approach and Results:

HEV RNA was assessed in symptomatic patients, various food items, and pig farms on the Island. HEV strains were characterized by sequencing. A seroprevalence study was also conducted on asymptomatic blood donors before and after the outbreak. One hundred twenty-seven symptomatic cases were reported. Hospitalization was required for 29/127 patients (22.8%). Hospitalized patients presented more frequently with comorbidities, including liver and cardiovascular diseases (80.7% vs. 27%, p < 0.01), and 3 persons died (2.3%). Among the 100 HEV RNA-positive samples received at the French National Reference Centre for HEV, viral sequencing was possible for 76 samples. All strains were identified as HEV genotype 3, and 74/76 strains were grouped together (nucleotide identity: 98%–100%). Full-length sequencing indicated a new HEV-3 subtype within HEV-3 subclade abk. Only genotype 3f strains were detected on the Island’s pig farms. No food items tested positive for HEV RNA. The seroprevalence of HEV IgG and IgM in blood donors was 9.2% (9/98) and 0%, respectively, in 2020, rising to 17.3% (17/98) and 2% (2/98) in 2024.

Conclusions:

Although all previous large-scale epidemics in Asia and Africa were associated with HEV-1 or 2, the New Caledonia outbreak was linked to HEV-3. A high number of symptomatic cases were admitted to the hospital, with a case-fatality rate of 2.3%.
A multicenter study of the risk of major bleeding in patients with and without cirrhosis undergoing percutaneous liver procedures
Authors: Blasi Annabel , Garcia-Criado Angeles , Moreno-Rojas Julian , Perez-Serrano Carlos , Ubre Marta , Dieguez Iago , Panzeri Miriam , Caballero Marta , Rivera Lorena , Radosevic Aleksandar , Puig Guillermo , Martinez Laura , Ruiz Sandra , Blaso Alejandro , Bell Pau , Castillo Albert , Ponce Ricardo Jose , Escobosa Paula , Rivas Eva , Cardenas Andres
Published: August 2024

Percutaneous liver procedures are frequently performed in patients with abnormal coagulation tests. Current guidelines suggest prophylactic transfusion is not mandatory in all patients with liver disease or cirrhosis, depending on the risk of bleeding. This study aims to describe the incidence and risk of major bleeding after percutaneous liver procedure in patients with and without cirrhosis. This retrospective study includes patients who underwent percutaneous liver biopsy and radiofrequency and microwave ablation of liver lesions at 3 centers in Spain. A transfusion protocol was considered for platelet counts <50,000 and/or international normalized ratio >1.5. The primary outcome was major bleeding. A total of 1797 patients were included in the study, with 316 having cirrhosis (18%) and 1481 without cirrhosis (82%). Among the patients with cirrhosis, 80 were classified as Child A, and percutaneous liver biopsy was the most frequent procedure (86%). Fourteen patients (0.8%) experienced major bleeding, with 0.4% occurring in radiofrequency and microwave ablation and 0.8% in percutaneous liver biopsy. Bleeding occurred in 0.6% of patients with cirrhosis compared to 0.8% in those without (p = ns). No clinical or procedural variables were associated with bleeding. Twenty-five patients (1.4%) had an international normalized ratio >1.5, and 22 patients (1.2%) had a platelet count <50,000. Only 24% (6/25) of patients with an international normalized ratio >1.5 were transfused with fresh frozen plasma, and 72% (16/22) of those with platelet counts <50,000 received platelet transfusion. Patients with cirrhosis were more frequently transfused (5.9% vs. 1.5%). None of the patients who met the criteria for transfusion experienced major bleeding, regardless of whether they received a transfusion, and none of the patients who had a major bleeding episode met the transfusion criteria. In this cohort, major bleeding after percutaneous liver procedure occurred in <1% of patients, making it a low-risk procedure for patients with and without cirrhosis. Although not uniformly adopted, the current transfusion protocol still led to unnecessary blood product administration.
A case report of a bleeding case after removal of chest drain after lung surgery
Authors: Liang Qichen , He Baoyu , Zhang Bin , Zhang Ziteng
Published: August 2024

Rationale:

Postoperative bleeding after lobectomy is relatively rare. By analyzing and discussing the case history and management of hemorrhagic shock caused by chest tube removal after lobectomy, we can achieve the purpose of preventing postoperative bleeding after thoracic surgery and reducing postoperative complications, which can help avoid the risk of second surgery, shorten the patient’s hospital stay, reduce the cost of medical care, and improve the patient’s quality of life.

Patient concerns:

A case of bleeding from tube removal after lobectomy. The bleeding from chest drain removal on the 3rd day after thoracoscopic lobectomy resulted in hemorrhagic shock, which was stopped by thoracoscopic exploration again under active antishock, and there was no recurrence of bleeding after the operation, and the patient was discharged from the hospital after chest drain removal.

Diagnoses:

Enhanced computed tomography of the chest revealed a space-occupying lesion in the middle lobe of the right lung.

Interventions:

Thoracoscopy was performed again on the condition of active anti-shock.

Outcomes:

On the third day after thoracoscopic lobectomy, the patient underwent removal of the chest drain and subsequently experienced hemorrhagic shock. Given the necessity of maintaining anti-shock measures, the patient was subjected to a second thoracoscopic exploration with the objective of halting the hemorrhage. Following this procedure, the patient did not present with any further episodes of bleeding. Subsequently, a new chest drain was placed, and once the drainage flow had diminished to an acceptable level, the chest drain was removed. The patient subsequently made a full recovery and was discharged from the hospital.

Lessons:

Even if the safely inserted drain tube is removed, the thoracic surgeon must be aware of possible vascular bleeding.
Comparison of the efficacy and safety of different puncture routes for ultrasound-guided fascia iliaca compartment block for early analgesia after hip arthroplasty: A meta-analysis
Authors: Yang Zhi , Xu Wang , Xu Shan
Published: August 2024

Background:

This study aimed to compare the effect of ultrasound-guided fascia iliaca compartment block with different puncture sites on postoperative analgesia in patients undergoing hip arthroplasty.

Methods:

We searched the PubMed, Web of Science, EBSCO, Wiley Library, Embase, China National Knowledge Infrastructure, and Wanfang databases for literature on ultrasound-guided fascia iliaca compartment block through different puncture sites in hip replacement patients. The software package R (4.2.1) was used in the meta-analysis.

Results:

The meta results showed the suprainguinal approach (SA) puncture pathway had a significantly longer operative time than the infrainguinal approach (IA) pathway (mean deviation [MD] = 0.97, 95% confidence interval [CI] [0.09, 1.84], P < .01) when performing orthopedic surgery. In terms of nerve block efficacy, only the block rates of the obturator nerve, lateral femoral cutaneous nerve, and femoral nerve groups did not show significant differences between the SA and IA pathways. In contrast, the results of the Meta combined effect size of visual analogue scale scores during postoperative activity showed that the SA puncture pathway significantly reduced patients’ pain scores compared with the IA pathway at the T1 (3–6 h) and T2 (8 h) time points (MD = −0.39, 95% CI [−0.77, −0.01], P = .04 in the T1 group; MD = −0.58, 95% CI [−0.95, −0.21], P < .01). The differences in pain scores at the T3 (12 h) and T4 (24 h) time points were not significant, and in terms of adverse reaction rates, the differences in the incidence of pruritus, sedation, urinary retention, and nausea and vomiting were not significant.

Conclusions:

This study demonstrates that the SA puncture pathway has a significant advantage over the IA pathway in reducing active pain in early postoperative pain management without increasing the risk of adverse events. This finding supports the prioritization of SA pathway in clinical practice where postoperative pain control is considered. Future research should continue to explore the use of SA pathway in different patient populations and types of surgery, as well as their impact on long-term postoperative recovery, with the aim of optimizing individualized postoperative pain management strategies.
Efficacy and safety of therapeutic vaccines for the treatment of chronic hepatitis B: A systematic review and meta-analysis of randomized controlled trials update
Authors: Geta Mekuanint , Mengistu Getachew , Yizengaw Endalew , Manyzewal Tsegahun , Hailu Asrat , Woldeamanuel Yimtubeznash
Published: August 2024

Background:

Most people diagnosed with chronic hepatitis B (CHB) need treatment to help reduce the risk of liver disease and limit disease transmission. Therapeutic vaccine (TV) candidates have been under study for their clinical effects on inducing HBV-specific host immune responses. This review aimed to systematically synthesize updated evidence on the efficacy and safety of TVs in patients with CHB.

Methods:

This systematic review was performed by searching different databases from January to February 2021. Completed randomized controlled trials that reported TVs' efficacy and/or safety for treating CHB compared with the standard of care (SOC) or placebo were included. Efficacy and safety estimates were reported as the logarithm of the odds ratio and risk differences, respectively. I
2 > 50% was considered significant heterogeneity. Significant publication bias was considered when Egger’s test P value < .10. The risk of bias was assessed using the Cochrane Risk of Bias tool. The GRADE methodology was used to assess the certainty of the evidence for each outcome.

Results:

Twenty-four articles with 2889 pooled samples were included. TVs made a significant difference in hepatitis B envelope antigen (HBeAg) SC (log OR = 0.76, P = .01) and (log OR = 0.40, P = .03) compared to placebo and combination therapy, respectively. HBeAg SC was significantly affected by TVs at the end of follow up (log OR = 0.49, P = .01), with significant HBsAg mean difference (MD = −0.62, P = .00). At the end of treatment, the TVs had no significant effect on HBV DNA negativity over the SOC (log OR = 0.62, P = .09) or placebo (log OR = −0.07, P = .91). TVs do not significantly affect the risk of serious adverse events (RD 0.02, 95% CI 0.00–0.04).

Conclusion:

In patients with CHB, TVs had significant effects on HBeAg SC compared to the SOC or placebo. There was no significant difference between serious adverse events. TVs are promising treatment strategy to overcome CHB.
Acute kidney injury associated with thrombotic microangiopathy: Characterization, prevalence, and prognosis
Authors: Dong Guiying , Gao Peiliang , Shi Fang-E , Yu Jianbo , Zhu Jihong
Published: August 2024

Acute kidney injury (AKI) is an important feature of thrombotic microangiopathy (TMA). This present study aimed to describe and analyze the characterization, prevalence, and prognosis in TMA patients with AKI. This study was an observational, retrospective patient cohort study in which patients were classified as AKI and non-AKI groups. An analysis of the relationship between the risk factors and AKI and in-hospital mortality was conducted using logistic regression. Kaplan–Meier curves were adopted to obtain the link between AKI and in-hospital mortality. There were 27 and 51 patients in the AKI and non-AKI groups, respectively, and the morbidity and mortality of AKI were 34.62% and 40.74%, respectively. AKI was associated with an older age (P = .033) and higher infection rates (P < .001). In comparison with the non-AKI group, the AKI group had tremendously intrarenal manifestations: hematuria (P < .001), proteinuria (P < .001). The AKI group received all continuous renal replacement therapy treatment (P < .001), but fewer glucocorticoids were used (P = .045). In-hospital mortality (P = .045) were higher in the AKI group. The risk factors for AKI (P = .037) were age. In addition, higher total bilirubin (P = .011) and age (P = .022) were significantly correlated with increasing risk of in-hospital mortality. Survival analysis by Kaplan–Meier revealed a significantly poor prognosis predicted by the AKI group (P = .045). Acute kidney injury could be commonly seen in TMA pneumonia and was related to a higher mortality rate.
Exploring the action mechanism of Oxalis corniculata L. decoction in treating osteoarthritis utilizing liquid chromatography–mass spectrometry technology combined with network pharmacology
Authors: Zhang Jian , Shen Wanyan , He Hehe
Published: August 2024

This study aimed to identify the chemical constituents of Oxalis corniculata L. decoction. Furthermore, the mechanism of action of O corniculata L. decoction in treating osteoarthritis (OA) was investigated utilizing network pharmacology. The chemical composition of the O corniculata L. decoction was analyzed by employing UHPLC-Q-Exactive-MS/MS. Subsequently, a “compound-target-pathway” network was established through network pharmacology, offering a novel approach to identify the molecular mechanism underlying the treatment of OA with O corniculata L. decoction. Ultimately, the molecular docking technique was employed to validate the binding ability of the active ingredients with therapeutic targets. A total of 539 compounds were identified in O corniculata L. decoction. Topological analysis of the protein–protein interaction network indicated that compounds, including guanosine, naringenin-7-O-beta-D-glucuronide, noroxyhydrastinine, and chrysophanol 8-O-glucoside, have therapeutic potential for OA. In addition, GAPDH, TNF, TP53, epidermal growth factor receptor, and ESR1 may be key targets for the treatment of OA, primarily involving lipid and atherosclerosis, cellular senescence, IL-17 signaling pathway, and epidermal growth factor receptor tyrosine kinase inhibitor resistance signaling pathways. This method preliminarily identified the chemical composition of O corniculata L. decoction and predicted the active ingredients, potential targets, and signaling pathways of O corniculata L. decoction in treating OA. The findings of this research revealed the potential function of O corniculata L. decoction in anti-inflammation, alongside its ability to promote osteoblast proliferation and differentiation, providing new ideas for the processing of O corniculata L. herbs and related drug development.
Comparative analysis of basal metabolic rate measurement methods in overweight and obese individuals: A retrospective study
Authors: Karagun Baris , Baklaci Nuh
Published: August 2024

The global prevalence of overweight and obesity is on the rise, presenting significant health challenges worldwide. Obesity is associated with various chronic diseases and imposes substantial economic burdens on society. Accurate assessment of basal metabolic rate (BMR) is crucial for effective weight management strategies. This retrospective study, conducted at Baskent University Hospital between October 2019 and October 2023, analyzed data from 133 overweight and obese individuals. Various methods including indirect calorimetry (IC), predictive equations (Harris–Benedict and Mifflin–St Jeor), and bioelectrical impedance analysis (BIA) were used to estimate BMR. Additionally, demographic, clinical, and body composition data were recorded. The mean BMR measured using IC was 1581 ± 322 kcal/day, which was significantly lower than the BMR estimated by other methods such as BIA (1765.8 ± 344.09 kcal/day), Harris–Benedict (1787.64 ± 341.4 kcal/day), and Mifflin–St Jeor equations (1690.08 ± 296.36 kcal/day) (P < .001). Among the predictive equations, the Mifflin–St Jeor method provided BMR estimates closest to the gold standard IC. When BMR measurement methods were compared to IC, 36.8% of measurements with the Harris–Benedict equation method, 50.4% with the Mifflin–St Jeor equation method, and 36.1% with the BIA method were within ± 10% agreement with IC measurements. Significant correlations were found between BMR and body composition parameters such as fat-free mass, muscle mass, and fat mass (R = 0.681, P < .001; R = 0.699, P < .001; R = 0.595, P < .001, respectively). Regression analysis identified that variables such as weight, height, body mass index, and muscle mass significantly predicted BMR measured by IC, accounting for 69.1% of the variance. This study underscores the challenges in assessing BMR in overweight and obese individuals. While IC remains the gold standard, predictive equations and BIA offer alternative methods. The Mifflin–St Jeor equation emerged as a practical option, closely aligning with IC results. However, discrepancies between methods and the influence of body composition highlight the importance of individualized approaches to BMR assessment in weight management strategies.
The Association Between Smartphone Usage and Health-Related Behaviors Among College Students
Authors: Phugat Shivani , Shukla Prachi
Published: August 2024

The smartphone has become a popular device, especially among young adults, with its significance highlighted during the COVID-19 lockdown when online classes became necessary for college students. This research aimed to evaluate the prevalence of smartphone use and its impact on health-related behaviors reported by college-going students in North India. Due to the pandemic, data collection was conducted through a Google form, and a questionnaire was used to gather information on various parameters. The Food Frequency Questionnaire assessed the frequency of food group consumption, while the validated Smartphone Addiction Scale—Shorter Version measured smartphone addiction. A total of 142 participants aged 18 to 24 years, including 59% female and 41% male participants from Delhi-NCR, were recruited using convenience sampling. The findings revealed a smartphone addiction prevalence of 41%. Statistically significant associations were found between smartphone use and sleep quality (p < .001), body mass index status (p = .016), and sedentary behavior (p < .001). Notably, smartphone screen time (p < .001) and stress levels (p = .028) correlated significantly with smartphone addiction based on the Smartphone Addiction Scale—Short Version score. This study highlights the significant prevalence of smartphone addiction (41%) among college students, which is associated with adverse effects on sleep quality, physical activity, and stress levels.
“Muscle foreshortening after free gracilis transfer for smile: Where, when, why?”
Authors: Yver Christina M. , McGonagle Elizabeth R. , Hadlock Tessa A.
Published: August 2024

Background:

Gracilis free muscle transfer (GFMT) remains the standard for smile restoration in patients with long-standing facial palsy. Resting oral commissure lateralization (ROCL) following GFMT is aesthetically unappealing and can cause functional problems including dysarthria and oral incompetence. The risk factors for ROCL following GFMT are poorly understood.

Methods:

Of all patients who underwent GFMT for smile restoration from 2003 – 2021, patients with subsequent ROCL were identified from a facial nerve database using pre-determined search criteria. Medical records were reviewed to identify potential risk factors for muscle foreshortening.

Results:

Of 412 patients who underwent successful GFMT since 2003, we identified 41 (10%) patients who subsequently developed ROCL. ROCL rates varied significantly based on gracilis innervation source, with ipsilateral CN VII innervation and dual-innervation (cross-facial nerve graft (CFNG) plus ipsilateral nerve-to-masseter (NTM)) demonstrating the highest foreshortening rates (27.3% and 15.4%, respectively), compared to the lowest rates of foreshortening when gracilis was innervated by CNFG alone (3.2%), p=0.005. Patients with a history of radiation to the surgical field were significantly more likely to develop ROCL (22%) compared to those without a history of radiation (8.6%), p<0.001. Furthermore, the rate of ROCL was significantly higher among patients who underwent concurrent stabilization of the nasolabial fold using a wide band of fascia lata (20.8%) compared to those who did not (6.6%), p<0.001.

Conclusions:

Herein we report potential risk factors for ROCL following GFMT for smile restoration, including innervation source, radiation history, and concurrent fascia lata static suspension.
Shorter Drainage Tube to the Pancreatic Stump Reduces Pancreatic Fistula After Distal Pancreatectomy
Authors: Nagaoka Tomoyuki , Sakamoto Katsunori , Ogawa Kohei , Hikida Takahiro , Ito Chihiro , Iwata Miku , Sakamoto Akimasa , Shine Mikiya , Nishi Yusuke , Uraoka Mio , Honjo Masahiko , Tamura Kei , Takada Yasutsugu
Published: August 2024

Background:

We investigated the relationship between the length of a prophylactic closed-suction drainage tube and clinically relevant postoperative pancreatic fistula (CR-POPF) in distal pancreatectomy (DP).

Materials and Methods:

The clinical data of 76 patients who underwent DP using a reinforced stapler for the division of the pancreas at Ehime University Hospital between December 2017 and May 2023 were retrospectively analyzed. Laparoscopic DP was performed in 41 patients (53.9%). Closed-suction drainage was performed using a 19 Fr ExuFlow Round Drain with a vacuum bulb. The drainage tube length was defined as the distance between the peripancreatic stump site and the abdominal wall insertion site using abdominal radiography.

Results:

CR-POPF was observed in 12 patients (15.8%). Univariate analyses demonstrated that male sex (P=0.020), American Society of Anesthesiologists Physical Status (P=0.017), current smoking (P=0.005), and drainage tube length (P<0.001) were significantly associated with CR-POPF. The optimal cut-off value of drainage tube length for CR-POPF was 220 mm (area under the receiver operating characteristic curve=0.80). In multivariate analyses, drainage tube length (≥220 mm) was the sole independent predictor for CR-POPF (odds ratio, 6.59; P=0.023). According to computed tomography performed ∼1 week after surgery, the median volume of peripancreatic fluid collection was significantly higher in the long drainage tube group than in the short drainage tube group (P<0.001).

Conclusion:

A drainage tube inserted at a shorter distance to the pancreatic stump may reduce the incidence of CR-POPF after DP.
SpinalTRAQ: A novel volumetric cervical spinal cord atlas identifies the corticospinal tract synaptic projectome in healthy and post-stroke mice
Authors: Poinsatte Katherine , Kenwood Matthew , Betz Dene , Nawaby Ariana , Ajay Apoorva D , Xu Wei , Plautz Erik J , Kong Xiangmei , Ramirez Denise M O , Goldberg Mark P
Published: August 2024

Abstract/Summary

Descending corticospinal tract (CST) connections to the neurons of the cervical spinal cord are vital for performance of forelimb-specific fine motor skills. In rodents, CST axons are almost entirely crossed at the level of the medullary decussation. While specific contralateral axon projections have been well-characterized using anatomic and molecular approaches, the field currently lacks a cohesive imaging modality allowing rapid quantitative assessment of the entire, bilateral cervical cord projectome at the level of individual laminae and cervical levels. This is potentially important as the CST is known to undergo marked structural remodeling in development, injury, and disease. We developed SpinalTRAQ (Spinal cordTomographicRegistration andAutomatedQuantification), a novel volumetric cervical spinal cord atlas and machine learning-driven microscopy acquisition and analysis pipeline that uses serial two-photon tomography-images to generate unbiased, region-specific quantification of the fluorescent pixels of anterograde AAV-labeled CST pre-synaptic terminals. In adult mice, the CST synaptic projectome densely innervates the contralateral hemicord, particularly in laminae 5 and 7, with sparse, monosynaptic input to motoneurons in lamina 9. Motor pools supplying axial musculature in the upper cervical cord are bilaterally innervated. The remainder of the ipsilateral cord has sparse labeling in a distinct distribution compared to the contralateral side. Following a focal stroke of the motor cortex, there is a complete loss of descending corticospinal axons from the injured side. Consistent with prior reports of axon collateralization, the CST spinal projectome increases at four weeks post-stroke and continues to elevate by six weeks post stroke. At six weeks post-stroke, we observed striking synapse formation in the denervated hemicord from the uninjured CST in a homotopic distribution. Additionally, CST synaptic reinnervation increases in the denervated lamina 9 in nearly all motoneuron pools, exhibiting novel patterns of connectivity. Detailed level- and lamina-specific quantification of the bilateral cervical spinal cord synaptic projectome reveals previously undescribed patterns of CST connectivity in health and injury-related plasticity.
In vivo transition in chromatin accessibility during differentiation of deep-layer excitatory neurons in the neocortex
Authors: Sakai Seishin , Maeda Yurie , Kawaji Keita , Suzuki Yutaka , Gotoh Yukiko , Kishi Yusuke
Published: August 2024

During the differentiation process of neurons, their gene transcription pattern changes according to both intrinsic and extrinsic stimuli-induced programs. Chromatin regulation at regulatory elements is involved in this precise control of gene expression. However, developmental changes in chromatin accessibility of the cortical neurons in vivo are less understood, partly because there is no convenient method to genetically label neurons of a specific lineage. Here, we establish a method for labeling the differentiating neurons of specific birthdates. Using this method, we traced the four-day differentiation process of in vivo deep-layer excitatory neurons in mouse embryonic cortex and examined the changes in the genome-wide transcription pattern and chromatin accessibility with RNA-seq and DNase-seq, respectively. The genomic regions of genes associated with mature neuron functions, such as deep layer–specific genes and genes responsive to external stimuli, became open even in the embryonic stage. Moreover, genes with bivalent marks in neural precursor/stem cells (NPCs) became open. Together, our data demonstrate the importance of chromatin regulation in vivo differentiating neurons during the embryonic stage to follow activation of neuronal genes in their maturation process.
SLC35A2modulates paramyxovirus fusion events during infection
Authors: Yang Yanling , Wang Yuchen , Campbell Danielle E. , Lee Heng-Wei , Wang Leran , Baldridge Megan , López Carolina B.
Published: August 2024

Paramyxoviruses are significant human and animal pathogens that include mumps virus (MuV), Newcastle disease virus (NDV) and the murine parainfluenza virus Sendai (SeV). Despite their importance, few host factors implicated in paramyxovirus infection are known. Using a recombinant SeV expressing destabilized GFP (rSeVCdseGFP) in a loss-of-function CRISPR screen, we identified the CMP-sialic acid transporter (CST) geneSLC35A1and the UDP-galactose transporter (UGT) geneSLC35A2as essential for paramyxovirus infection.SLC35A1knockout (KO) cells showed significantly reduced binding and infection of SeV, NDV and MuV due to the lack of cell surface sialic acids, which act as their receptors. However,SLC35A2KO cells revealed unknown critical roles for this factor in virus-cell and cell-to-cell fusion events during infection with different paramyxoviruses. While the UGT was essential for virus-cell fusion during SeV entry to the cell, it was not required for NDV or MuV entry. Importantly, the UGT promoted the formation of larger syncytia during MuV infection, suggesting a role in cell-to-cell virus spread. Our findings demonstrate that paramyxoviruses can bind to or enter A549 cells in the absence of canonical galactose-bound sialic-acid decorations and show that the UGT facilitates paramyxovirus fusion processes involved in entry and spread.
Antihypertensive medications and dementia in older adults with hypertension
Authors: Orchard Suzanne G. , Zhou Zhen , Fravel Michelle , Ryan Joanne , Woods Robyn L. , Wolfe Rory , Shah Raj C. , Murray Anne , Sood Ajay , Reid Christopher M. , Nelson Mark R. , Bellin Lawrie , Polkinghorne Kevan R , Stocks Nigel , Ernst Michael E.
Published: August 2024

Background

Studies on middle-aged or individuals with cognitive or cardiovascular impairments, have established that intensive blood pressure (BP) control reduces cognitive decline risk. However, uncertainty exists on differential effects between antihypertensive medications (AHM) classes on this risk, independent of BP-lowering efficacy, particularly in community-dwelling hypertensive older adults.

Methods

A post-hoc analysis of the ASPREE study, a randomized trial of low-dose aspirin in adults aged 70+ years (65+ if US minorities) without baseline dementia, and followed for two years post-trial. Cox proportional-hazards regression models were used to estimate associations between baseline and time-varying AHM exposure and incident dementia (an adjudicated primary trial endpoint), in participants with baseline hypertension. Subgroup analyses included prespecified factors, APO ε4 carrier status and monotherapy AHM use.

Results

Most hypertensive participants (9,843/13,916; 70.7%) used AHMs. Overall, ‘any’ AHM use was not associated with lower incident dementia risk, compared with untreated participants (HR 0.84, 95%CI 0.70-1.02, p=0.08), but risk was decreased when angiotensin receptor blockers (ARBs) were included (HR 0.73, 95%CI 0.59-0.92, p=0.007). ARBs and β-blockers decreased dementia risk, whereas angiotensin-converting enzyme inhibitors (ACEIs) and diuretics increased risk. There was no association with RAS modulating or blood-brain-barrier crossing AHMs on dementia risk.

Conclusions

Overall, AHM exposure in hypertensive older adults was not associated with decreased dementia risk, however, specific AHM classes were with risk direction determined by class; ARBs and β-blockers were superior to ACEIs and other classes in decreasing risk. Our findings emphasize the importance of considering effects beyond BP-lowering efficacy when choosing AHM in older adults.