bluuebunny/crossref_metadata_2025 huggingface dataset:
Hadronotus pennsylvanicus (Hymenoptera: Scelionidae): a biological control agent for pestiferous leaffooted bugs (Hemiptera: Coreidae)
Authors: Boyle Sean M , Cornelius Mary , Talamas Elijah J , Straser Robert K , Wilson Houston , Daane Kent M , Weber Donald C , Kuhar Thomas P
Published: April 2024

In recent decades, the egg parasitoid Hadronotus pennsylvanicus (Ashmead) has gained substantial attention as an important natural enemy of pestiferous leaffooted bug species in the genera Anasa Amyot and Serville and Leptoglossus Guérin-Méneville. Throughout its native range of North America, H. pennsylvanicus parasitizes Anasa and Leptoglossus eggs in various vegetable and orchard systems. The overreliance on broad-spectrum insecticides in these systems and the demand for effective and sustainable coreid pest management strategies have motivated researchers to consider H. pennsylvanicus as an augmentative biological control agent. The potential use of H. pennsylvanicus as a classical biological control agent has also been studied in Europe in response to the rapid spread of Leptoglossus occidentalis Heidemann, an invasive pest causing significant economic losses to the European pine nut industry. Improved understanding of H. pennsylvanicus taxonomy, life history, host range, parasitoid–host ecology, laboratory rearing, and field deployment techniques have created a robust scaffold on which to build future biological control programs. This natural enemy profile reviews the current advances in the aforementioned areas of H. pennsylvanicus research and outlines the parasitoid’s prospects as a biological control agent.
“Give Me Five”: The Case for 5 Days of Antibiotics as the Default Duration for Acute Respiratory Tract Infections
Authors: El Feghaly Rana E , Jaggi Preeti , Katz Sophie E , Poole Nicole M
Published: April 2024

Acute respiratory tract infections (ARTIs) account for most antibiotic prescriptions in pediatrics. Although US guidelines continue to recommend ≥10 days antibiotics for common ARTIs, evidence suggests that 5-day courses can be safe and effective. Academic imprinting seems to play a major role in the continued use of prolonged antibiotic durations. In this report, we discuss the evidence supporting short antibiotic courses for group A streptococcal pharyngitis, acute otitis media, and acute bacterial rhinosinusitis. We discuss the basis for prolonged antibiotic course recommendations and recent literature investigating shorter courses. Prescribers in the United States should overcome academic imprinting and follow international trends to reduce antibiotic durations for common ARTIs, where 5 days is a safe and efficacious course when antibiotics are prescribed.
How free-ranging Indian Flying Fox (Pteropus medius) forage in urban areas? A study from Kolkata, India
Authors: Roy Kanad , Saha Goutam Kumar , Mazumdar Subhendu
Published: April 2024

Foraging behaviour plays a significant role in the fitness of animals and is influenced by habitat quality. Habitat change due to rapid urbanization often results in altered behaviour and resource use patterns in animals thriving in such changed habitats. Bats play a crucial role as tree pollinators, seed dispersers and forest regenerators. Particularly in urban areas they are among the few pollinators that help regenerating the urban green spaces. Therefore, it is crucial to understand their foraging patterns in these human-dominated landscapes. Loss and degradation of roost and foraging resources threatens the survival of many bat species, including Indian Flying Foxes (IFF). Still, very few studies have been carried out on their feeding behaviour and ecology. Hence, we carried out this study to (i) identify the foraging sites of IFF, (ii) find out the urban land cover features influencing their foraging site selection and (iii) to identify the foraging trees used by them in urban areas. IFFs were observed to forage on 16 species of trees belonging to 10 families in four different sites in urban areas, of which Ficus species are most important. Amongst various urban land covers, the area of tree cover in the foraging sites were found to significantly influence the number of foraging IFFs. Our findings strongly advocate for the protection of the trees preferred by IFFs along with overall urban tree canopy covers, as these are essential resources for the survival of bats, as well as many other species in urban areas.
Transient fading X-ray emission detected during the optical rise of a tidal disruption event
Authors: Malyali A , Rau A , Bonnerot C , Goodwin A J , Liu Z , Anderson G E , Brink J , Buckley D A H , Merloni A , Miller-Jones J C A , Grotova I , Kawka A
Published: April 2024

We report on the SRG/eROSITA detection of ultra-soft ($kT=47^{+5}_{-5}$ eV) X-ray emission (LX =$2.5^{+0.6}_{-0.5} \times 10^{43}$ erg s−1) from the tidal disruption event (TDE) candidate AT 2022dsb ∼14 d before peak optical brightness. As the optical luminosity increases after the eROSITA detection, then the 0.2–2 keV observed flux decays, decreasing by a factor of ∼39 over the 19 d after the initial X-ray detection. Multi-epoch optical spectroscopic follow-up observations reveal transient broad Balmer emission lines and a broad He ii 4686 Å emission complex with respect to the pre-outburst spectrum. Despite the early drop in the observed X-ray flux, the He ii 4686  Å complex is still detected for ∼40 d after the optical peak, suggesting the persistence of an obscured hard ionizing source in the system. Three outflow signatures are also detected at early times: (i) blueshifted H α emission lines in a pre-peak optical spectrum, (ii) transient radio emission, and (iii) blueshifted Ly α absorption lines. The joint evolution of this early-time X-ray emission, the He ii 4686 Å complex, and these outflow signatures suggests that the X-ray emitting disc (formed promptly in this TDE) is still present after optical peak, but may have been enshrouded by optically thick debris, leading to the X-ray faintness in the months after the disruption. If the observed early-time properties in this TDE are not unique to this system, then other TDEs may also be X-ray bright at early times and become X-ray faint upon being veiled by debris launched shortly after the onset of circularization.
Synchro-curvature description of γ-ray light curves and spectra of pulsars: global properties
Authors: Íñiguez-Pascual Daniel , Torres Diego F , Viganò Daniele
Published: April 2024

This work presents a methodological approach to generate realistic γ-ray light curves of pulsars, resembling reasonably well the observational ones observed by the Fermi-Large Area Telescope (Fermi-LAT) instrument, fitting at the same time their high-energy spectra. The theoretical light curves are obtained from a spectral and geometrical model of the synchro-curvature emission. Despite our model relying on a few effective physical parameters, the synthetic light curves present the same main features observed in the observational γ-ray light-curve zoo, such as the different shapes, variety in the number of peaks, and a diversity of peak widths. The morphological features of the light curves allow us to statistically compare the observed properties. In particular, we find that the proportion of the number of peaks found in our synthetic light curves is in agreement with the observational one provided by the third Fermi-LAT pulsar catalogue. We also found that the detection probability due to beaming is much higher for orthogonal rotators (approaching 100  per cent) than for small inclination angles (less than 20 per cent). The small variation in the synthetic skymaps generated for different pulsars indicates that the geometry dominates over timing and spectral properties in shaping the γ-ray light curves. This means that geometrical parameters such as the inclination angle can be in principle constrained by γ-ray data alone independently of the specific properties of a pulsar. At the same time, we find that γ-ray spectra seen by different observers can slightly differ, opening the door to constraining the viewing angle of a particular pulsar.
The Thousand-Pulsar-Array programme on MeerKAT – XIII. Timing, flux density, rotation measure, and dispersion measure time series of 597 pulsars
Authors: Keith M J , Johnston S , Karastergiou A , Weltevrede P , Lower M E , Basu A , Posselt B , Oswald L S , Parthasarathy A , Cameron A D , Serylak M , Buchner S
Published: April 2024

We report here on the timing of 597 pulsars over the last four years with the MeerKAT telescope. We provide times of arrival, pulsar ephemeris files, and per-epoch measurements of the flux density, dispersion measure (DM), and rotation measure (RM) for each pulsar. In addition, we use a Gaussian process to model the timing residuals to measure the spin frequency derivative at each epoch. We also report the detection of 11 glitches in nine individual pulsars. We find significant DM and RM variations in 87 and 76 pulsars, respectively. We find that the DM variations scale approximately linearly with DM, which is broadly in agreement with models of the ionized interstellar medium. The observed RM variations seem largely independent of DM, which may suggest that the RM variations are dominated by variations in the interstellar magnetic field on the line of sight, rather than varying electron density. We also find that normal pulsars have around 5 times greater amplitude of DM variability compared to millisecond pulsars, and surmise that this is due to the known difference in their velocity distributions.
[11C]-methionine positron emission tomography in the evaluation of pediatric low-grade gliomas
Authors: Kim Emily Y , Vavere Amy L , Snyder Scott E , Chiang Jason , Li Yimei , Patni Tushar , Qaddoumi Ibrahim , Merchant Thomas E , Robinson Giles W , Holtrop Joseph L , Shulkin Barry L , Bag Asim K
Published: April 2024

Background

[11C]-Methionine positron emission tomography (PET; [11C]-MET-PET) is principally used for the evaluation of brain tumors in adults. Although amino acid PET tracers are more commonly used in the evaluation of pediatric brain tumors, data on [11C]-MET-PET imaging of pediatric low-grade gliomas (pLGG) is scarce. This study aimed to investigate the roles of [11C]-MET-PET in the evaluation of pLGGs.

Methods

Eighteen patients with newly diagnosed pLGG and 26 previously treated pLGG patients underwent [11C]-MET-PET met the inclusion and exclusion criteria. Tumor-to-brain uptake ratio (TBR) and metabolic tumor volumes were assessed for diagnostic performances (newly diagnosed, 15; previously treated 26), change with therapy (newly diagnosed, 9; previously treated 7), and variability among different histology (n = 12) and molecular markers (n = 7) of pLGGs.

Results

The sensitivity of [11C]-MET-PET for diagnosing pLGG, newly diagnosed, and previously treated combined was 93% for both TBRmax and TBRpeak, 76% for TBRmean, and 95% for qualitative evaluation. TBRmax showed a statistically significant reduction after treatment, while other PET parameters showed a tendency to decrease. Median TBRmax, TBRpeak, and TBRmean values were slightly higher in the BRAFV600E mutated tumors compared to the BRAF fused tumors. Median TBRmax, and TBRpeak in diffuse astrocytomas were higher compared to pilocytic astrocytomas, but median TBRmean, was slightly higher in pilocytic astrocytomas. However, formal statistical analysis was not done due to the small sample size.

Conclusions

Our study shows that [11C]-MET-PET reliably characterizes new and previously treated pLGGs. Our study also shows that quantitative parameters tend to decrease with treatment, and differences may exist between various pLGG types.
Combining anodic alcohol oxidative coupling for C–C bond formation with cathodic ammonia production
Authors: Xu Leitao , Chen Wei , Wang Cairong , Wu Wenjie , Yao Yelin , Huang Zhifeng , Wu Jingcheng , Yang Ming , Wu Yandong , Xie Dianke , Zou Yuqin , Wang Shuangyin
Published: April 2024

Electrocatalytic oxidation of alcohols using heterogeneous catalysts is a promising aqueous, energy-efficient and environmentally friendly approach, especially for coupling different alcohols to prolong the carbon chain via co-oxidation. Precisely regulating critical steps to tailor electrode materials and electrolyte composition is key to selectively coupling alcohols for targeted synthesis. However, selectively coupling different alcohols remains challenging due to the lack of effective catalyst and electrolyte design promoting specific pathways. Herein, we demonstrate a paired electrolysis strategy for combining anodic oxidative coupling of ethanol (EtOH) and benzyl alcohol (PhCH2OH) to synthesize cinnamaldehyde (CAL) and cathodic ammonia production. The strategies involve: (i) utilizing the salt-out effect to balance selective oxidation and coupling rates; (ii) developing platinum-loaded nickel hydroxide electrocatalysts to accelerate intermediate coupling kinetics; (iii) introducing thermodynamically favorable nitrate reduction at the cathode to improve coupling selectivity by avoiding hydrogenation of products while generating valuable ammonia instead of hydrogen. We achieved 85% coupling selectivity and 278 μmol/h NH3 productive rate at 100 mA/cm2 with a low energy input (∼1.63 V). The membrane-free, low energy, scalable approach with a wide substrate scope highlights promising applications of this methodology. This work advances heterogeneous electrocatalytic synthesis through rational design principles that integrate anodic oxidative coupling with cathodic nitrate reduction reactions, having synergistic effects on efficiency and selectivity.
Minimizing the ratio of ionizable lipid in lipid nanoparticles for in vivo base editing
Authors: Chen Qiubing , Wang Xuebin , Zhang Yizhou , Tian Ming , Duan Junyi , Zhang Ying , Yin Hao
Published: April 2024

Lipid nanoparticles (LNPs) have gained clinical approval as carriers for both siRNA and mRNA. Among the crucial components of LNPs, ionizable lipids play a pivotal role in determining the efficiency of RNA delivery. In this study, we synthesized a series of ionizable lipids, denoted as HTO, with a higher count of hydroxyl groups compared to SM-102. Remarkably, LNPs based on HTO12 lipid demonstrated comparable mRNA delivery efficiency and biosafety to those based on SM-102. However, the former reduced the ratio of ionizable lipid/total lipids to mRNA in LNPs by 2.5 times compared to SM-102. The HTO12 LNP efficiently encapsulated adenine base editor mRNA and sgRNA targeting Pcsk9, leading to substantial gene editing within the liver of mice and effective reduction of the target protein. Our study underscores that ionizable lipids with multiple hydroxyl groups may facilitate an improved lipid-to-mRNA ratio to minimize the dosage of ionizable lipids for in vivo delivery.
Arc Foundations and Subduction Initiation: Insights into the Magmatic Evolution of the Lower Crust/Upper Mantle of the Izu–Bonin Forearc during Subduction Initiation
Authors: Loocke Matthew P , Snow Jonathan E
Published: April 2024

Our understanding of the processes at work in the lower crust/upper mantle transition zone during subduction initiation and early arc development has suffered from a general lack of in situ samples. Here, we present the results of petrographic and geochemical analysis of 34 samples (9 harzburgites, 13 dunites, 2 orthopyroxenites, 3 olivine-gabbros, and 7 wehrlites) collected from the inner trench wall of the Bonin Ridge, Izu–Bonin forearc. The sample suite records three main melt–rock reaction events involving melts with forearc basalt (FAB)-like, boninitic, and transitional compositions. The wehrlitic and gabbroic rocks trend towards more transitional to FAB compositions and the rest towards more boninitic compositions. The crosscutting occurrence of all three events in a single sample (wehrlite D31–106) establishes a relative timing of the events like that reported for the volcanic edifice of the Bonin Ridge, which transitioned from forearc basalt volcanism at subduction initiation (c.a., 51–52 Ma) to boninitic volcanism (c.a., 50–51 Ma) as the subduction system matured. We therefore suggest that the lower crust/upper mantle transition of the Bonin Ridge preserves a record of the transition from FAB melts created by decompression melting at subduction initiation to arc-type flux melting and boninitic volcanism thereafter. Orthopyroxenites and two anomalously fresh harzburgites from the sample suite are suggested to represent the later boninitic melts and possibly the result of hybridization between such melts and residual peridotites, respectively. Diffuse melt–rock reaction between the later boninites and/or subduction-related fluids and the earlier-formed FAB-related crust is recorded by enrichments in fluid mobile elements and depletions in first row transition metals in clinopyroxenes from a metasomatic vein in wehrlite sample D31–106. The chemistry of the wehrlitic and gabbroic clinopyroxenes suggests that they crystallized from hydrous, highly depleted melts which lack a slab fluid signature. We thus suggest that highly depleted melt fractions might be created early on during subduction initiation by the introduction of seawater into the proto-mantle wedge. The overall FAB-like nature of the crustal wehrlites and gabbros would suggest that most of the lower arc crust was created by forearc extension during/following subduction initiation and that later, mature arc volcanism may have contributed little or no material to the lower crust/upper mantle record in the outer forearc.
Advances in the study of microparticles in diabetic retinopathy
Authors: Hou Yifeng , Tang Yun , Cai Shanjun
Published: April 2024

Diabetic retinopathy (DR) is one of the common diabetic microangiopathies, which severely impairs vision in diabetic population. The underlying mechanisms regarding the development of DR are not fully understood, and there is a lack of biomarkers to guide clinical, assessment of disease progression. Recently researchers have found that microparticles (MP) and its bioactive molecules are involved in the development of DR. MP is widely distributed in the circulation and can exert autocrine and paracrine benefits in intercellular signalling, provide a catalytic platform for the thrombospondin complex to promote coagulation, and promote the accumulation of reactive oxygen species to cause endothelial damage. MP interacts with advanced glycosylation end products (AGE) and AGE receptor (RAGE) to activate inflammatory pathways. MP carries a variety of miRNAs that regulate the vascular endothelial growth factor generation pathway. MP has also been applied to the exploration of mesenchymal stromal cell replacement therapy to treat DR. In a word, MP provides new ideas for the study of DR. MP has emerged as a marker to assess the progression of DR. As a potential therapeutic target, MP also has considerable research value.
The Excess-Path-Length Distribution of Electrons in Electromagnetic Cascade Showers
Authors: Nakatsuka Takao , Okei Kazuhide
Published: April 2024

The excess-path-length distribution of cascade-shower particles due to the multiple Coulomb scattering of shower electrons is investigated analytically. A diffusion equation for the distribution under the Landau approximation is proposed and solved under the conditions of neglecting and including the ionization loss. Contributions of the Rutherford single scattering on the distribution are also investigated and found to dominate in very large excess regions of path length. The excess-path-length distribution of shower electrons is observed as an arrival-time distribution at a given thickness of traverse. The present results will be valuable for qualitative and quantitative analyses of cascade showers observed by the arrival-time distribution.
Appealing to Americans’ altruism is not enough to nudge them to accept novel vaccines
Authors: Drabo Emmanuel F , Kelley Marcella A , Gong Cynthia L
Published: April 2024

Background

The role of altruism in the acceptance of novel preventive healthcare technologies like vaccines has not been thoroughly elucidated.

Methods

We 1:1 randomized n = 2004 Amazon Mechanical Turk (MTurk) participants residing in the USA into a control or treatment arm with vaccination decisions framed altruistically, to elicit their preferences for COVID-19 vaccination using web-based discrete choice experiments. We used conditional and mixed logit models to estimate the impact of framing decisions in terms of altruism on vaccination acceptance.

Results

Valid responses were provided by 1674 participants (control, n = 848; treatment, n = 826). Framing vaccination decisions altruistically had no significant effect on vaccination acceptance. Further, respondents’ degree of altruism had no association with vaccination acceptance.

Limitations

The MTurk sample may not be representative of the American population. We were unable to ascertain concordance between stated and revealed preferences.

Conclusions and Implications

Framing vaccination decisions in terms of altruism does not appear to significantly influence vaccination acceptance and may not be an effective nudging mechanism to increase the uptake of novel vaccines. Instead, a favorable vaccination profile appears to be the primary driver of uptake.
Same-Day Versus Staged Spinal Fusion: A Meta-analysis of Clinical Outcomes
Authors: Daher Mohammad , Nassar Joseph E. , Balmaceno-Criss Mariah , Diebo Bassel G. , Daniels Alan H.
Published: April 2024

Study Design.

Meta-analysis.

Objective.

This meta-analysis aims to compare same-day versus staged spine surgery, assessing their effects on patient care and health care system efficiency.

Background.

In spinal surgery, the debate between whether same-day and staged surgeries are better for patients continues, as the decision may impact patient-related outcomes, health care resources, and overall costs. While some surgeons advocate for staged surgeries, citing reduced risks of complications, others proclaim same-day surgeries may minimize costs and length of hospital stays.

Methods.

PubMed, Cochrane, and Google Scholar (pages 1–20) were searched up until February 2024. The studied outcomes were operative room (OR) time, estimated blood loss (EBL), length of hospital stay (LOS), overall complications, venous thromboembolism (VTE), death, operations, and nonhome discharge.

Results.

Sixteen retrospective studies were included in this meta-analysis, representing a total of 2346 patients, of which 644 underwent staged spinal fusion surgeries and 1702 same-day surgeries. No statistically significant difference was observed in EBL between staged and same-day surgery groups. However, the staged group exhibited a statistically significant longer OR time (P=0.05) and LOS (P=0.004). A higher rate of overall complications (P=0.002) and VTE (P=0.0008) was significantly associated with the staged group. No significant differences were found in the rates of death, reoperations, and nonhome discharge between the 2 groups.

Conclusions.

Both staged and same-day spinal fusion surgeries showed comparable rates of death, operations, and nonhome discharges for patients undergoing spinal surgeries. However, given the increased OR time, LOS, and complications associated with staged spinal surgeries, this study supports same-day surgeries when possible to minimize the burden on healthcare resources and enhance efficiency.
Corneal Transplantation in a Patient With Nonperforating Ocular Contusion Caused by a High-Pressure Washer: A Case Report
Authors: Miyata Mana , Ono Takashi , Mori Yosai , Sakisaka Toshihiro , Nejima Ryohei , Iwasaki Takuya , Miyai Takashi , Miyata Kazunori
Published: April 2024

Purpose:

This report details a rare case of a high-pressure washer injury that caused ocular contusion, vitreous hemorrhage, and irreversible corneal edema without perforation necessitating corneal transplantation.

Methods:

The medical chart of a patient with a high-pressure washer injury at Miyata Eye Hospital (Miyazaki, Japan) was retrospectively reviewed.

Results:

A 57-year-old man presented to our hospital with a contusion in the left eye caused by a high-pressure washer 1 day prior to the visit. The visual acuity in the left eye was hand motion. Slit-lamp examination of the left eye revealed the presence of corneal epithelial defects, conjunctival lacerations, hyphema, and lacerated iris. Mild clouding of the lens was observed in the anterior chambers, suggestive of cataract. Anterior segment optical coherence tomography revealed the presence of blood in the anterior chamber and a thickened and edematous cornea. Ultrasound examination revealed the presence of vitreous hemorrhage. Therefore, vitreous surgery and traumatic cataract removal were performed under general anesthesia. Postoperatively, the corneal edema and marked opacity persisted, accompanied by glaucoma, and the visual acuity was measured at 0.01. Penetrating keratoplasty was performed 1 year and 2 months after the injury, and scleral fixation of the intraocular lens was performed under local anesthesia 2 years after the injury. The final visual acuity was 0.1 under rigid gas-permeable contact lens usage 3.5 years after sustaining the injury, and the patient required anti-glaucoma drugs.

Conclusions:

Our patient presented with ocular trauma caused by a high-pressure washer. Corneal transplantation was required although no ocular lacerations were detected. Sufficient instructions must be provided on the usage of heavy machinery to develop a safe working environment.
Embryology with precision: effective quality control in the in vitro fertilization laboratory
Authors: Basar Murat , Unsal Evrim , Ergun Yagmur
Published: April 2024

The purpose of this review is to address the critical need for standardization and clarity in the use of key performance indicators (KPIs) within the realm of in vitro fertilization (IVF), particularly emphasizing the integration of preimplantation genetic testing (PGT) processes. This review is timely and relevant given the persistently modest success rates of IVF treatments, which stand at approximately 30%, and the growing complexity of IVF procedures, including PGT practices. The review synthesizes recent findings across studies focusing on technical and clinical KPIs in embryology and genetic laboratories, identifying gaps in current research and practice, particularly the lack of standardized KPIs and terminology.

Recent findings highlighted include the critical evaluation of technical KPIs such as Intracytoplasmic Sperm Injection (ICSI) fertilization rates, embryo development rates, and laboratory performance metrics, alongside clinical KPIs like the proportion of mature oocytes and clinical pregnancy rates. Notably, the review uncovers a significant gap in integrating and standardizing KPIs for PGT applications, which is essential for improving IVF outcomes and genetic diagnostic accuracy.

The implications of these findings are profound for both clinical practice and research. For clinical practice, establishing a standardized set of KPIs, especially for PGT, could significantly enhance the success rates of IVF treatments by providing clearer benchmarks for quality and performance. For research, this review underscores the necessity for further studies to close the identified gaps, promoting a more integrated and standardized approach to KPIs in IVF and PGT processes. This comprehensive approach will not only aid in improving clinical outcomes but also in advancing the field of reproductive medicine.
Missed Opportunities in Screening for Glaucoma
Authors: Tuulonen Anja , Leinonen Sanna , Jóhannesson Gauti
Published: April 2024

Purpose:

To create a holistic and realistic view regarding current knowledge, understanding, and challenges of screening in general and in glaucoma.

Methods/Results:

Based upon available literature, all systems suffer from the same challenges: huge variability of care practices (despite guidelines), simultaneous under care and over care, as well as the unsustainable increase of costs. While the magnitude of these challenges differs immoderately between well-off and developing countries, the Western world has already demonstrated that simply doing more than what we currently do is not the solution. System outcomes also matter in screening, that is, its benefits should outweigh any harms (over-care, false positives/negatives, uncertain findings, etc.) and be cost-effective. However, even when the evidence does not support screening (as is currently the case in glaucoma), it may feel justified as “at least we are doing something.” Strong commercial interests, lobbying and politics star as well and will influence the control arm even in high-quality randomized screening trials (RCT).

Conclusions:

As resources will never be sufficient for all health care activities that providers wish to deliver and what people wish to receive, we need to ask big questions and adopt a public health perspective in glaucoma and eye care. How can we create and maintain a sustainable balance between finding and treating underserved high-risk patients without burdening the broader patient population and societies with over-diagnostics and treatments? Considering numerous biases related to screening, including the variability in care practices, a high-quality RCT for the screening of glaucoma would be very challenging to organize and evaluate its universal usefulness.
The Impact of an Online Educational Intervention on Attitudes of Primary Care Clinicians Toward Managing Patients With Substance Use Disorders
Authors: PhengPhal Miadette , Knight Margaret
Published: April 2024

Background

Negative attitudes of primary care clinicians toward patients with substance use disorders affect the quality and delivery of care in this highly marginalized patient population.

Purpose

This project aimed to improve negative attitudes of primary care clinicians toward managing patients with substance use disorders.

Methods

A pretest-and-posttest design, employing multidimensional online educational interventions, was implemented from June to August 2020. The participants (n= 18) were recruited from a pool of 70 primary care clinicians at two community primary care agencies. The Affect Scale for Substance Users and 15-item Opening Minds Scale for Health Care Providers were administered before, immediately after, and 30 days after the intervention.

Results

There were statistically significant reductions in the immediate postintervention and 30-day postintervention mean scores in the Affect Scale for Substance Users and the disclosure and help-seeking subscale when compared with those of preintervention. The change in attitudes was maintained at 30-day postintervention.

Conclusions

The project findings support conducting and evaluating future educational programs for substance use disorder management among primary care clinicians. Because of the heterogeneity of the participants and the small sample size, the project results have limited generalizability. Overall, this project is among one of the few aimed at substance use disorder management among primary care clinicians.
“We Take Care of Our Young, No Matter What,” Experiences of Engagement in HIV Care Among Black Mothers Parenting Dependent Children in Southwestern Pennsylvania: A Retrospective Descriptive Qualitative Study
Authors: Mangum Laurenia C. , Aidoo-Frimpong Gloria , Alexander Ivana , Waddell Ashley , Whitfield Darren L.
Published: April 2024

This retrospective descriptive study sought to explore the lived experiences of Black mothers with HIV navigating HIV medical care while parenting dependent children. Six themes were generated from the semi-structured interviews conducted with mothers (N = 9) related to motherhood, interactions with health care systems and providers, coping, social support, HIV self-management, and HIV prevention. Findings suggested that supportive interpersonal relationships with HIV health care providers, HIV nondisclosure to family and friends, and social network support, inclusive of health care providers, were protective factors in achieving optimal treatment adherence and viral suppression. Findings may inform interventions for improving social support and reducing stigma in HIV care for Black mothers with HIV who are parenting dependent children.
Meta-analysis of clinical outcomes of robot-assisted partial nephrectomy and classical open partial nephrectomy
Authors: Qu Hongchen , Wang Kai , Hu Bin
Published: April 2024

Background:

Robotic-assisted partial nephrectomy (RAPN) has emerged as a promising alternative to classical partial nephrectomy (CPN).

Aim:

This study aimed to compare the outcomes of RAPN and CPN for treating localized renal tumors through a meta-analysis of available literature.

Methods:

Chinese databases, such as CNKI, Chinese Science and Technology Periodicals Database (VIP), and Wanfang Full-text Database, were searched using Chinese search terms, and all published articles on PubMed and Web of Science were searched using English search terms. Articles on Localized Renal Tumors were included. RevMan5.3 software was used for meta-analysis. The funnel plots were drawn using Stata software to assess publication bias.

Outcomes:

This study aimed to identify the differences between robotic-assisted partial nephrectomy and classic partial nephrectomy in patients with localized renal tumors.

Results:

In total, 67 articles with 17 677 patients were included. The results demonstrate the advantages of RAPN over CPN for localized renal tumors. Compared to CPN and RAPN had significant differences in intraoperative blood loss, hospital stay duration, incidence of perioperative complications, and proportion of patients requiring blood transfusion. Regarding surgical outcomes, RAPN showed more favorable results regarding the incidence of positive resection margins, postoperative decline in glomerular filtration rate (GFR), postoperative local recurrence rate, and proportion of Trifecta achieved. However, there was no significant difference between RAPN and CPN regarding 5-year tumor-specific survival rates.

Clinical implications:

The study suggests that robotic-assisted partial nephrectomy is a viable alternative to classic surgery for renal tumors.

Strengths and limitations:

The strengths of this study are the use of a comprehensive search strategy and the inclusion of studies published in both English and Chinese. The limitations of this study are the small sample size and the need for long-term follow-up data.

Conclusion:

RAPN and CPN have similar overall survival outcomes for treating localized renal tumors. However, RAPN may offer advantages in terms of perioperative outcomes and preservation of renal function. Further studies are needed to confirm these findings and to identify the optimal surgical approach for individual patients.
Prognostic significance of circulating tumor DNA in urothelial carcinoma: a systematic review and meta-analysis
Authors: Liu Haoyang , Chen Junru , Huang Yuchen , Zhang Yaowen , Ni Yuchao , Xu Nanwei , Zhao Fengnian , Tang Yanfeng , Liu Haolin , Sun Guangxi , Shen Pengfei , Liu Zhenhua , Huang Jin , Liao Banghua , Zeng Hao
Published: April 2024

Background:

Circulating tumor DNA (ctDNA) has emerged as a noninvasive technique that provides valuable insights into molecular profiles and tumor disease management. This study aimed to evaluate the prognostic significance of circulating tumor DNA (ctDNA) in urothelial carcinoma (UC) through a systematic review and meta-analysis.

Methods:

A comprehensive search was conducted in MEDLINE, EMBASE, and the Cochrane Library from the inception to December 2023. Studies investigating the prognostic value of ctDNA in UC were included. Hazard ratios (HRs) of disease-free survival (DFS) and overall survival (OS) were extracted. Overall meta-analysis and subgroup exploration stratified by metastatic status, ctDNA sampling time, treatment type, and detection method was performed using the R software (version 4.2.2).

Results:

A total of 16 studies with 1725 patients were included. Fourteen studies assessed the association between baseline ctDNA status and patient outcomes. Patients with elevated ctDNA levels exhibited significantly worse DFS (HR=6.26; 95% CI: 3.71–10.58, P<0.001) and OS (HR=4.23; 95% CI: 2.72–6.57, P<0.001) regardless of metastatic status, ctDNA sampling time, treatment type, and detection methods. Six studies evaluated the prognostic value of ctDNA dynamics in UC. Patients who showed a decrease or clearance in ctDNA levels during treatment or observation demonstrated more favorable DFS (HR=0.26, 95% CI: 0.17–0.41, P<0.001) and OS (HR=0.21, 95% CI: 0.11–0.38, P<0.001) compared to those who did not. The association remained consistent across the subgroup analysis based on metastatic status and detection methods. In the immune checkpoint inhibitor-treated setting, both lower baseline ctDNA level and ctDNA decrease during the treatment were significantly associated with more favorable oncologic outcomes. Furthermore, specific gene mutations such as FGFR3 identified in ctDNA also demonstrated predictive value in UC patients.

Conclusion:

This meta-analysis demonstrates a strong association of ctDNA status and its dynamic change with survival outcomes in UC, suggesting substantial clinical utility of ctDNA testing in prognosis prediction and decision making in this setting.
Management of traumatic brain injury in Africa: challenges and opportunities
Authors: Muili Abdulbasit Opeyemi , Kuol Piel Panther , Jobran Afnan W.M , Lawal Ridwanullah Ajedamola , Agamy Ahmed Amaar , Bankole Nourou Dine Adeniran
Published: April 2024

Traumatic brain injury (TBI) is a major public health concern globally, with significant implications for morbidity, mortality, and long-term disability. While extensive research has been conducted on TBI management in high-income countries, limited attention has been given to the specific challenges and opportunities faced by healthcare systems in sub-Saharan Africa (SSA). This perspective study aims to provide a comprehensive overview of the current status of TBI management in SSA, focusing on the unique challenges and potential opportunities for improvement. The findings highlight several key challenges faced by SSA healthcare systems in managing TBIs, including limited resources, inadequate infrastructure, and a shortage of trained healthcare professionals. Furthermore, social and cultural factors, such as ignorance of driving laws, financial constraints, and limited access to modern technology services. However, the study also identifies potential opportunities for improving TBI management in SSA. These include strengthening healthcare infrastructure, enhancing pre-hospital care and transportation systems, and increasing public awareness and education about TBI. This perspective study emphasizes the urgent need for tailored interventions and strategies to address the unique challenges faced by SSA in managing TBIs. Addressing the challenges and opportunities in brain injury management in SSA requires a comprehensive approach which can be through investing in health infrastructure, addressing socio-economic inequalities, implementing prevention strategies, and fostering evidence-based research collaboration. Through this, the region can significantly improve TBI care and outcomes, thereby improving the well-being of people affected by TBI in SSA.
Silent gallbladder stone in kidney transplantation recipients: should it be treated? A retrospective cohort study
Authors: Lee Myeong Hwan , Jang Yunyoung , Kang Eunjeong , Kim Yong Chul , Min Sang , Lee Sang Hyub , Cho In Rae , Paik Woo Hyun , Lee Hajeong
Published: April 2024

Background:

Treatment and follow-up strategies for silent gallbladder stones in patients before kidney transplantation (KT) remain unknown. Therefore, the authors aimed to elucidate the role of pre-KT cholecystectomy in preventing biliary and surgical complications.

Materials and methods:

This study retrospectively analyzed 2295 KT recipients and 3443 patients waiting for KT at a single tertiary center from January 2005 to July 2022. The primary outcomes were the incidences of biliary and postcholecystectomy complications in KT recipients. Firth’s logistic regression model was used to assess the risk factors for biliary complications.

Results:

Overall, 543 patients awaiting KT and 230 KT recipients were found to have biliary stones. Among the KT recipients, 16 (7%) underwent cholecystectomy before KT, while others chose to observe their biliary stones. Pre-KT cholecystectomy patients did not experience any biliary complications, and 20 (9.3%) patients who chose to observe their stones experienced complications. Those who underwent cholecystectomy before KT developed fewer postcholecystectomy complications (6.3%) compared with those who underwent cholecystectomy after KT (38.8%, P=0.042), including reduced occurrences of fatal postoperative complications based on the Clavien–Dindo classification. Multiple stones [odds ratio (OR), 3.09; 95% CI: 1.07–8.90; P=0.036), thickening of the gallbladder wall (OR, 5.39; 95% CI: 1.65–17.63; P=0.005), and gallstones >1 cm in size (OR 5.12, 95% CI: 1.92–13.69, P=0.001) were independent risk factors for biliary complications. Among patients awaiting KT, 23 (4.2%) underwent cholecystectomy during the follow-up, resulting in one postcholecystectomy complication.

Conclusion:

Gallstone-related biliary complications following KT and subsequent cholecystectomy was associated with more serious complications and worse treatment outcomes. Therefore, when KT candidates had risk factor for biliary complications, pre-emptive cholecystectomy for asymptomatic cholecystolithiasis could be considered to reduce further surgical risk.
The role of national population-based registries in pancreatic cancer surgery research
Authors: Jonas Eduard , Kloppers Christo
Published: April 2024

Research and innovation are critical for advancing the multidisciplinary management of pancreatic cancer. Registry-based studies (RBSs) are a complement to randomized clinical trials (RCTs). Compared with RCTs, RBSs offer cost-effectiveness, larger sample sizes, and representation of real-world clinical practice. National population-based registries (NPBRs) aim to cover the entire national population, and studies based on NPBRs are, compared to non-NPBRs, less prone to selection bias. The last decade has witnessed a dramatic increase in NPBRs in pancreatic cancer surgery, which has undoubtedly added invaluable knowledge to the body of evidence on pancreatic cancer management. However, several methodological shortcomings may compromise the quality of registry-based studies. These include a lack of control over data collection and a lack of reporting on the quality of the source registry or database in terms of validation of coverage and data completeness and accuracy. Furthermore, there is a significant risk of double publication from the most commonly used registries as well as the inclusion of historical data that is not relevant or representative of research questions addressing current practices.
Older living liver donors can enlarge the donor pool: a systematic review and meta-analysis
Authors: ter Burg Hayo W. , Chorley RN Alicia J. , Polak Wojciech G. , Kranenburg Leonieke W. , Boehnert Markus U. , Minnee Robert C.
Published: April 2024

Background:

Living donor liver transplantation (LDLT) is the best option for end-stage liver disease patients. Older potential donors are increasingly requesting donation. This study aims to systematically assess the differences in donor perioperative and postoperative complications, mortality, and quality of life (QoL) between younger and older living liver donors.

Materials and methods:

Embase, Medline, and Cochrane were searched for studies published between 2002 and 2 June 2023. Donor complications, major complications, biliary complications, mortality, and QoL were systematically reviewed, including meta-analyses. Donors aged >50 years were considered older. The methodological quality of the studies was assessed using the Newcastle–Ottawa quality assessment Scale.

Results:

The search yielded 8320 studies, of which 17 were included. The risk ratio (RR) for complications in younger donors was 1.08 [0.90–1.31] (P=0.41). RRs for major complications in younger donors were 0.98 [0.64, 1.48] and 0.89 [0.50, 1.57] using Clavien–Dindo ≥III and ≥IIIb as major complication. RR for biliary complications in younger donors was 1.59 [1.05–2.42] (P=0.03). Mortality rate in younger donors was 47/13 238 (0.4%) and in older donors 13/989 (1.3%). Physical component summary (PCS) in younger donors was 51.87 and in older donors 51.29. Mental component summary (MCS) in younger donors was 52.93 and in older donors 55.40.

Conclusion:

Older donors do not have a higher complication or mortality rate than younger donors after LDLT. They may have a lower rate of biliary complications. Additionally, older donors have a similar QoL after LDLT. With careful selection, older donors can be included in screening programs for living liver donation to expand the donor pool.
Case Records as Medical Stories: Narrating Medicine in Song-Dynasty China: A Song-dynasty Doctor’s Narration of His own Medicine – Xu Shuwei (1080-1154)
Authors: Goldschmidt Asaf
Published: April 2024

The focus in studying or teaching the history of Chinese medicine is often on the doctrines underlying it and on its perception of the body, physiology, pathology, and its treatment. In other words, we often tend to focus on reading and analysing the classical canons and therapy-related texts including formularies and materia medica collections. However, focusing on these sources provides us with a one-sided presentation of Chinese medicine. These studies only show what physicians wrote in order to pass down their knowledge, either theoretical or practical, to their readership. However, these primary sources lack the clinical down-to-earth know-how that encompasses medical treatment, which are represented, for instance, in the clinical rounds of modern medical schools. In other words, our traditional focus on the medical canons and formularies provides almost no clinical knowledge, leaving us with a one-sided narrative that ignores how medicine and healing are actually practiced in the field.

This paper focuses on the latter aspect of medicine from a historical perspective. Using written and visual sources dating to the Song dynasty, the paper depicts the clinical encounter between doctors and patients including their families based on case records recorded by a physician, members of the patient’s family, and bystanders. This array of case records or case stories will enable us to narrate the interaction between physicians and patients both from the clinical perspective and from the social interaction. Namely, we can use these case narratives to illustrate the process of diagnosis and treatment all while interacting with members of the patient’s family. I will also discuss visual depictions of the medical encounter to provide another perspective for narrating medicine during the Song dynasty. Medical case records and paintings depicting medical encounter are exemplary of the potential of Chinese primary sources for narrative medicine.
Bullying Victimization in Children and Adolescents and Its Impact on Academic Outcomes
Authors: Vadukapuram Ramu , Trivedi Chintan , Desai Saral , Mansuri Zeeshan , Jain Shailesh , Reddy Abhishek
Published: April 2024

Bullying victimization has been identified as a significant factor influencing academic outcomes. We sought to evaluate the educational outcomes and psychiatric comorbidities in children and adolescents who are victims of bullying using the National Survey of Children's Health dataset for the study. The participants were children and adolescents (age: 6–17 years) categorized into two groups: group 1, not bullied (n= 21,015), and group 2, bullied more than once (n= 21,775). Individuals whose health status was fair or poor have experienced more bullying (2.4%vs. 1.4%,p< 0.001). Individuals in the group 2 were more likely to repeat the grades than the group 1 (7.1%vs. 5.9%,p= 0.039). Individuals who were missing ≥11 school days and sometimes or never engaged in school were observed to be more in the group 2 compared with the group 1 (5.9%vs. 3.2% and 20.3%vs. 10.6%,p< 0.001). In conclusion, bullying victimization could be a risk factor and associated with decreased academic outcomes.