bluuebunny/crossref_metadata_2025 huggingface dataset:
Physiology of exercise and heart failure treatments: cardiopulmonary exercise testing as a tool for choosing the optimal therapeutic strategy
Authors: Campodonico Jeness , Contini Mauro , Alimento Marina , Mapelli Massimo , Salvioni Elisabetta , Mattavelli Irene , Bonomi Alice , Agostoni Piergiuseppe
Published: October 2023

In the last decades, the pharmacological treatment of heart failure (HF) become more complex due to the availability of new highly effective drugs. Although the cardiovascular effects of HF therapies have been extensively described, less known are their effects on cardiopulmonary function considered as a whole, both at rest and in response to exercise. This is a ‘holistic’ approach to disease treatment that can be accurately evaluated by a cardiopulmonary exercise test. The aim of this paper is to assess the main differences in the effects of different drugs [angiotensin-converting enzyme (ACE)-inhibitors, Angiotensin II receptor blockers, β-blockers, Angiotensin receptor-neprilysin inhibitors, renal sodium-glucose co-transporter 2 inhibitors, iron supplementation] on cardiopulmonary function in patients with HF, both at rest and during exercise, and to understand how these differences can be taken into account when choosing the most appropriate treatment protocol for each individual patient leading to a precision medicine approach.
Exercise oscillatory ventilation: the past, present, and future
Authors: Cunha Gonçalo , Apostolo Anna , De Martino Fabiana , Salvioni Elisabetta , Matavelli Irene , Agostoni Piergiuseppe
Published: October 2023

Exercise oscillatory ventilation (EOV) is a fascinating event that can be appreciated in the cardiopulmonary exercise test and is characterized by a cyclic fluctuation of minute ventilation, tidal volume, oxygen uptake, carbon dioxide production, and end-tidal pressure for oxygen and carbon dioxide. Its mechanisms stem from a dysregulation of the normal control feedback of ventilation involving one or more of its components, namely, chemoreflex delay, chemoreflex gain, plant delay, and plant gain. In this review, we intend to breakdown therapeutic targets according to pathophysiology and revise the prognostic value of exercise oscillatory ventilation in the setting of heart failure and other diagnoses.
Dysregulation of ventilation at day and night time in heart failure
Authors: Contini Mauro , Mapelli Massimo , Carriere Cosimo , Gugliandolo Paola , Aliverti Andrea , Piepoli Massimo , Angelucci Alessandra , Baracchini Nikita , Capovilla Teresa Maria , Agostoni Piergiuseppe
Published: October 2023

Heart failure (HF) is characterized by an increase in ventilatory response to exercise of multifactorial aetiology and by a dysregulation in the ventilatory control during sleep with the occurrence of both central and obstructive apnoeas. In this setting, the study of the ventilatory behaviour during exercise, by cardiopulmonary exercise testing, or during sleep, by complete polysomnography or simplified nocturnal cardiorespiratory monitoring, is of paramount importance because of its prognostic value and of the possible effects of sleep-disordered breathing on the progression of the disease. Moreover, several therapeutic interventions can significantly influence ventilatory control in HF. Also, rest daytime monitoring of cardiac, metabolic, and respiratory activities through specific wearable devices could provide useful information for HF management. The aim of the review is to summarize the main studies conducted at Centro Cardiologico Monzino on these topics.
Neuropathology consultation rates in medico-legal autopsies show substantial within-country variation—a nationwide Finnish study
Authors: Oura Petteri , Eklin Aki , Sajantila Antti
Published: October 2023

Neuropathology consultations are an essential part of medico-legal cause-of-death investigations. However, there are little data on the rates of neuropathological examinations in medico-legal autopsies. The present nationwide, retrospective, register-based study aimed to report and compare neuropathology consultation rates (i.e. the percentages of medico-legal autopsies with a neuropathology consultation) in five Finnish regions from 2016 to 2021. The dataset comprised 50 457 medico-legal autopsies with 1 274 neuropathology consultations. Overall, ~1 in 40 autopsies (2.5%) involved a neuropathology consultation. Consultation rates were lowest in the Southern Finland region (1.4%) and highest in the Southwestern Finland and Åland region (6.5%). Throughout the study period, the consultation rates of Southwestern Finland and Åland were 1.5 to 9.4 times those of other regions (P < 0.001). In conclusion, this nationwide Finnish study identified substantial differences in neuropathology consultation rates between regions, which may indicate regional differences in conventions and policies. However, the “optimal” consultation rate remains unknown. Future studies are required to further understand the differences in autopsy practices within the Finnish context as well as in medico-legal institutions elsewhere.

Key points
Transcription factor CsTT8 promotes fruit coloration by positively regulating the methylerythritol 4-phosphate pathway and carotenoid biosynthesis pathway in citrus (Citrus spp.)
Authors: Sun Quan , He Zhengchen , Wei Ranran , Yin Yingzi , Ye Junli , Chai Lijun , Xie Zongzhou , Guo Wenwu , Xu Juan , Cheng Yunjiang , Xu Qiang , Deng Xiuxin
Published: October 2023

Carotenoids directly influence citrus fruit color and nutritional value, which is critical to consumer acceptance. Elucidating the potential molecular mechanism underlying carotenoid metabolism is of great importance for improving fruit quality. Despite the well-established carotenoid biosynthetic pathways, the molecular regulatory mechanism underlying carotenoid metabolism remains poorly understood. Our previous studies have reported that the Myc-type basic helix–loop–helix (bHLH) transcription factor (TF) regulates citrus proanthocyanidin biosynthesis. Transgenic analyses further showed that overexpression of CsTT8 could significantly promote carotenoid accumulation in transgenic citrus calli, but its regulatory mechanism is still unclear. In the present study, we found that overexpression of CsTT8 enhances carotenoid content in citrus fruit and calli by increasing the expression of CsDXR, CsHDS, CsHDR, CsPDS, CsLCYE, CsZEP, and CsNCED2, which was accompanied by changes in the contents of abscisic acid and gibberellin. The in vitro and in vivo assays indicated that CsTT8 directly bound to the promoters of CsDXR, CsHDS, and CsHDR, the key metabolic enzymes of the methylerythritol 4-phosphate (MEP) pathway, thus providing precursors for carotenoid biosynthesis and transcriptionally activating the expression of these three genes. In addition, CsTT8 activated the promoters of four key carotenoid biosynthesis pathway genes, CsPDS, CsLCYE, CsZEP, and CsNCED2, directly promoting carotenoid biosynthesis. This study reveals a novel network of carotenoid metabolism regulated by CsTT8. Our findings will contribute to manipulating carotenoid metabolic engineering to improve the quality of citrus fruit and other crops.
Inherent irreversibility in unsteady magnetohydrodynamic nanofluid flow past a slippery permeable vertical plate with fractional-order derivative
Authors: Khan Zafar H , Makinde Oluwole D , Usman Muhammad , Ahmad Rashid , Khan Waqar A , Huang Zaitang
Published: October 2023

This study focuses on fractional-order derivatives for the unsteady flow of magnetohydrodynamic (MHD) methanol-iron oxide (CH3OH-Fe3O4) nanofluid over a permeable vertical plate. The utilization of fractional-order derivatives provides a mathematical representation of the flow model. The concluding model, consisting of a system of fractional-order transient partial differential equations, has been solved using the finite difference method, and graphical illustrations demonstrate the effects of key parameters on the flow field. Velocity and temperature profiles provide insights into nanofluid behavior. Additionally, essential quantities such as skin friction coefficient, Nusselt number, Bejan number, and entropy generation rate have been depicted graphically. Comparison with previous studies authenticates the accuracy of the anticipated model, contributing to new intuitions into MHD nanofluid flow over a permeable vertical plate. It is worth noting that the current model, incorporating fractional-order derivatives, contributes to understanding the physical characteristics of MHD CH3OH-Fe3O4 nanofluid flow over a permeable vertical plate, research that has not been extensively explored before.
Laying the Groundwork for a Fulfilling Career in Pediatric Infectious Diseases: The Transition From Fellowship to Faculty
Authors: Kushner Lauren E , Ristagno Elizabeth H , Dong Sara W , Konold Victoria J L , Fatemi Yasaman , Stillwell Terri L , Wohrley Julie D , Sattler Matthew M , Kalu Ibukunoluwa C , Boguniewicz Juri
Published: October 2023

There are limited resources for guidance on the transition from fellowship into a new faculty role in pediatric infectious diseases. This review aims to address this gap and provides a framework for a successful transition that is composed of four essential pillars—(1) stepping into your role, (2) finding your niche, (3) building your network, and (4) self-care—all of which are supported by strong mentorship/sponsorship and continual realignment with one’s personal mission statement. In addition to providing general principles and guidance, this review also outlines specific steps that a junior faculty member can take to expand their influence and build a successful, fulfilling career in pediatric infectious diseases.
Influenza Vaccine Effectiveness Against Influenza-Associated Hospitalization in Hong Kong Children Aged 9 Months to 17 Years, March–June 2023
Authors: Cowling Benjamin J , Kwan Mike Y W , Murphy Caitriona , Chan Eunice L Y , Wong Joshua S C , Sullivan Sheena G , Peiris Malik , Lee So-Lun
Published: October 2023

In March–June 2023, we conducted a test-negative study in 1671 children who were hospitalized with acute respiratory illness in Hong Kong. Two hundred and eighty-six children (17.2%) were tested positive for influenza virus including 188 with A(H1N1). We estimated influenza vaccine effectiveness against influenza-associated hospitalization as 69.6% (95% confidence interval: 49.3%, 81.7%).
Life-threatening urosepsis because of ureteral entrapment within a large inguinal hernia
Authors: Chamzin Alexandros , Galyfos George , Saliaris Konstantinos , Frountzas Maximos , Theodorou Panagiotis , Theodorou Dimitrios
Published: October 2023

Ureteral hernias are an uncommon entity that are usually incidentally discovered during inguinal hernia repair. However, when symptomatic, they could cause severe symptoms from the urinary system and even affect renal function. We aim to report a rare case of a 91-year-old male patient with urosepsis because of ureteral entrapment within an inguinal hernia, and further discuss proper management of such cases.
R Stylo and the authorship determination of Henry V
Authors: Ilsemann Hartmut
Published: October 2023

Over 25 years, Thomas Merriam has argued that Henry V was co-authored by Shakespeare and Christopher Marlowe, and in his most recent publication ‘Is it time to reconsider Henry V’ (2023), he established differences in word length, which gives clear evidence. This article makes use of the R Stylo suite of stylometric tools and employs the Rolling Delta, Rolling Classify, and the General Imposters methods, all of which obtain the same result that Shakespeare used a Marlowe pretext in his composition of Henry V.
The relationship between lymphocyte DNA damage, coronary artery disease, and blood trace elements
Authors: Erdoğu İsmail , Dural Emrah , Altundağ Hüseyin , Oymak Tülay , Süzen Halit Sinan
Published: October 2023

Somatic DNA damage and causative factors (occupational exposures, foods, habits, etc.) are thought to contribute to the pathogenesis of atherosclerosis, although knowledge about their role in coronary artery disease (CAD) is still insufficient. This study aimed to determine the effects of lymphocyte-DNA damage and blood trace element concentrations on CAD. The single-cell alkaline comet was used in the measuring of the lymphocyte DNA damage in blood samples obtained from patients (n = 99) whose CAD grade was determined by the syntax score while the angiographic intervention was carried out. Blood trace element (n = 14) concentrations were monitored by the inductively coupled plasma-optical emission spectroscopy (ICP-OES) after microwave digestion. The relationship between the DNA damage frequencies of the participants and their syntax scores, blood trace element concentrations, and other demographic and clinic parameters were statistically analyzed. Significant correlations were detected between comet data and syntax score (r = 0.858, P < .001), age (r = 0.337, P < .001), blood-urea (r = 0.360, P < .001), creatinine (r = 0.388, P < .001), HbA1c (0.218, P < .05), ECG-QRS time (r = 0.286, P < .01), ECHO-EF (r = −0.377, P < .001), and platelet (r = −0.222, P < .05). The DNA damage frequencies of the groups formed according to their CAD scores were significantly different from the control group (P < .001) and also each other (P ≤ .01). Comet frequencies and CAD grades were found to be correlated with aging (P < .05). DNA damage frequency and syntax score values were significantly (P < .05) higher in males compared to females. Syntax scores were correlated with aging (r = 0.348, P < .01), ECHO-EF (r = 0.374, P < .001), blood-urea (r = 0.398, P < .001), creatinine (r = 0.433, P < .001), glucose (0.218, P < .05), and HbA1c (r = 0.200, P < .05). Significant correlations were observed between trace elements and demographic values, blood parameters, diseases, angio parameters, ECHO, and ECG parameters. It was observed that the concentrations of trace elements detected in the blood were 93.4% correlated with each other. Lymphocyte DNA damage is a strong biomarker for the atherosclerotic indicator of CAD. Aging is an effective factor both in the DNA damage frequency and CAD risk index. Creatinine and urea are factors that have the power to change the CAD risk index and DNA damage frequency. The higher DNA damage and CAD risk were monitored in males compared to females. The relationship between some biomarkers and blood trace element concentrations showed that further studies are needed to more accurately evaluate the relationship between trace elements, DNA damage frequencies, and CAD.
Health benefits from the rapid reduction in ambient exposure to air pollutants after China's clean air actions: progress in efficacy and geographic equality
Authors: Xue Tao , Wang Ruohan , Wang Meng , Wang Yanying , Tong Dan , Meng Xia , Huang Conghong , Ai Siqi , Li Fangzhou , Cao Jingyuan , Tong Mingkun , Ni Xueqiu , Liu Hengyi , Deng Jianyu , Lu Hong , Wan Wei , Gong Jicheng , Zhang Shiqiu , Zhu Tong
Published: October 2023

Clean air actions (CAAs) in China have been linked to considerable benefits in public health. However, whether the beneficial effects of CAAs are equally distributed geographically is unknown. Using high-resolution maps of the distributions of major air pollutants (fine particulate matter [PM2.5] and ozone [O3]) and population, we aimed to track spatiotemporal changes in health impacts from, and geographic inequality embedded in, the reduced exposures to PM2.5 and O3 from 2013 to 2020. We used a method established by the Global Burden of Diseases Study. By analyzing the changes in loss of life expectancy (LLE) attributable to PM2.5 and O3, we calculated the gain of life expectancy (GLE) to quantify the health benefits of the air-quality improvement. Finally, we assessed the geographic inequality embedded in the GLE using the Gini index (GI). Based on risk assessments of PM2.5 and O3, during the first stage of CAAs (2013 to 2017), the mean GLE was 1.87 months. Half of the sum of the GLE was disproportionally distributed in about one quarter of the population exposed (GI 0.44). During the second stage of CAAs (2017 to 2020), the mean GLE increased to 3.94 months and geographic inequality decreased (GI 0.18). According to our assessments, CAAs were enhanced, from the first to second stages, in terms of not only preventing premature mortality but also ameliorating health inequalities. The enhancements were related to increased sensitivity to the health effects of air pollution and synergic control of PM2.5 and O3 levels. Our findings will contribute to optimizing future CAAs.
Unveiling the Human Brain Virome in Brodmann Area 46: Novel Insights Into Dysbiosis and Its Association With Schizophrenia
Authors: Ghorbani Mahin
Published: October 2023

Research suggests a potential role of the oral-neuro and gut-brain axes in schizophrenia, involving non-brain microbiomes such as salivary and gut microbiomes. However, the blood-brain barrier effectively prevents microorganism entry. Additionally, despite approximately 8% of the human genome consisting of retroviruses and the established link between viral infections and schizophrenia, the presence of a resident virome (a viral component of the microbiome) in the brain and its association with mental disorders remain unexplored. Methods: Whole-genome sequencing raw data from postmortem Brodmann Area 46 (BA46) tissue from 49 individuals (20 healthy controls [HCs], 29 with schizophrenia [SCZs]) obtained from the NCBI SRA database from BioProject: PRJNA422380.Virome profiles were retrieved using Metaphlan3, and viral signatures were identified using linear discriminant analysis effect size (LEfSe). Mann-Whitney tests and receiver operating characteristic curve validated the viral signatures. Results: In BA46, 30 distinct species representing 9 phyla, 10 classes, 10 orders, 13 families, and 19 genera were identified. HCs exhibited greater alpha diversity, and there were significant differences in beta diversity between the groups. LEfSe analysis highlighted distinct viral levels, including Escherichia virus Lambda, Escherichia virus phiV10, Human endogenous retrovirus K, Taterapox virus, Alcelaphine gammaherpesvirus 1, and Bovine gammaherpesvirus 4 in HCs, while Glypta fumiferanae ichnovirus and unknown virus showed higher levels in schizophrenia. Conclusion: This is the first study to identify a human brain virome associated with schizophrenia in BA46. Brain virome dysbiosis may be associated with mental illness, and viral signatures may serve as biomarkers for the early detection of schizophrenia.
The Associations Between United States Medical Licensing Examination Performance and Outcomes of Patient Care
Authors: Norcini John , Grabovsky Irina , Barone Michael A. , Anderson M. Brownell , Pandian Ravi S. , Mechaber Alex J.
Published: October 2023

Purpose

The United States Medical Licensing Examination (USMLE) comprises a series of assessments required for the licensure of U.S. MD-trained graduates as well as those who are trained internationally. Demonstration of a relationship between these examinations and outcomes of care is desirable for a process seeking to provide patients with safe and effective health care.

Method

This was a retrospective cohort study of 196,881 hospitalizations in Pennsylvania over a 3-year period (January 1, 2017 to December 31, 2019) for 5 primary diagnoses: heart failure, acute myocardial infarction, stroke, pneumonia, or chronic obstructive pulmonary disease. The 1,765 attending physicians for these hospitalizations self-identified as family physicians or general internists. A converted score based on USMLE Step 1, Step 2 Clinical Knowledge, and Step 3 scores was available, and the outcome measures were in-hospital mortality and log length of stay (LOS). The research team controlled for characteristics of patients, hospitals, and physicians.

Results

For in-hospital mortality, the adjusted odds ratio was 0.94 (95% confidence interval [CI] = 0.90, 0.99; P < .02). Each standard deviation increase in the converted score was associated with a 5.51% reduction in the odds of in-hospital mortality. For log LOS, the adjusted estimate was 0.99 (95% CI = 0.98, 0.99; P < .001). Each standard deviation increase in the converted score was associated with a 1.34% reduction in log LOS.

Conclusions

Better provider USMLE performance was associated with lower in-hospital mortality and shorter log LOS for patients, although the magnitude of the latter is unlikely to be of practical significance. These findings add to the body of evidence that examines the validity of the USMLE licensure program.
Measuring and Comparing Clinical Productivity of Individual Anesthesiologists
Authors: Abouleish Amr E. , Whitten Charles W. , Hudson Mark E.
Published: October 2023

Measuring and comparing clinical productivity of individual anesthesiologists is confounded by anesthesiologist-independent factors, including facility-specific factors (case duration, anesthetizing site utilization, type of surgical procedure, and non–operating room locations), staffing ratio, number of calls, and percentage of clinical time providing anesthesia. Further, because anesthesia care is billed with different units than relative value units, comparing work with other types of clinical care is difficult. Finally, anesthesia staffing needs are not based on productivity measurements but primarily the number and hours of operation of anesthetizing sites. The intent of this review is to help anesthesiologists, anesthesiology leaders, and facility leaders understand the limitations of anesthesia unit productivity as a comparative metric of work, how this metric often devalues actual work, and the impact of organizational differences, staffing models and coverage requirements, and effectiveness of surgical case load management on both individual and group productivity.
A Mixture of Urinary Phthalate Metabolite Concentrations During Pregnancy and Offspring Social Responsiveness Scale Scores
Authors: Yu Emma X. , Braun Joseph M. , Lyall Kristen , Hertz-Picciotto Irva , Fallin M. Daniele , Croen Lisa A. , Chen Aimin , Xu Yingying , Yolton Kimberly , Newschaffer Craig J. , Hamra Ghassan B.
Published: October 2023

Background:

Phthalates are a group of chemicals with ubiquitous exposure worldwide. Exposures to phthalates during pregnancy may play a role in autism spectrum disorder (ASD) etiology by disrupting hormone levels or directly impacting fetal neurodevelopment. However, there is little research quantifying the aggregate effect of phthalates on child ASD-related behaviors.

Methods:

We used data from two prospective pregnancy and birth cohorts—the Health Outcomes and Measures of the Environment (HOME) and the Early Autism Risk Longitudinal Investigation (EARLI). HOME is a general population cohort while participants in EARLI were at higher familial risk for ASD. Using quantile g-computation and linear regression models, we assessed the joint and individual associations of a mixture of six phthalate metabolites during pregnancy with child ASD-related traits measured by Social Responsiveness Scale (SRS) scores at ages 3–8 years.

Results:

Our analyses included 271 participants from HOME and 166 participants from EARLI. There were imprecise associations between the phthalate mixture and SRS total raw scores in HOME (difference in SRS scores per decile increase in every phthalate = 1.3; 95% confidence interval [CI] = –0.2, 2.8) and EARLI (difference in SRS scores per decile increase in every phthalate = –0.9; 95% CI = –3.5, 1.7).

Conclusions:

The cohort-specific effect sizes of the pthalates–SRS associations were small and CIs were imprecise. These results suggest that if there are associations between phthalate metabolites during pregnancy and child SRS scores, they may differ across populations with different familial liabilities. Further studies with larger sample sizes are warranted.
Prior Use of Angiotensin-converting Enzyme Inhibitors or Angiotensin II Receptor Blockers and Clinical Outcomes of Sepsis and Septic Shock: A Systematic Review and Meta-analysis
Authors: Shrestha Dhan Bahadur , Sedhai Yub Raj , Oli Prakash Raj , Proskuriakova Ekaterina , Adelkhanova Alla , Shtembari Jurgen , Khan Tahir Muhammad Abdullah , Singh Karan , Ahmed Muhammad Altaf , Waheed Irfan , Kazimuddin Nisarfathima , Steff Rodney , Acharya Roshan , Patel Nimesh K.
Published: October 2023

Sepsis and septic shock are life-threatening conditions that are associated with high mortality and considerable health care costs. The association between prior angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARBs) use and outcomes after sepsis is elusive. The aim of this study was to evaluate the role of the prior use of ACEi or ARBs and outcomes after sepsis and septic shock. A relevant literature review was performed in 4 databases from inception until July 2022. Independent reviewers first screened the title, abstract, and full text, and then, data extraction and analysis were performed. One post hoc analysis of a trial and 6 retrospective cohort studies were included in this review. There were 22% lower odds of in-hospital/30-day mortality among patients who have used ACEi/ARBs in the past [23.83% vs. 37.20%; odds ratio (OR), 0.78, 95% confidence interval (CI), 0.64–0.96], and reduced 90-day mortality (OR, 0.80, 95% CI, 0.69–0.92). ACEi/ARBs users were found to have 31% lesser odds of developing acute kidney injury as compared with nonusers (OR, 0.69, 95% CI, 0.63–0.76). There was no significant difference in the length of hospital stay (MD 1.26, 95% CI, ‒7.89 to 10.42), need for renal replacement therapy (OR, 0.71, 95% CI, 0.13–3.92), mechanical ventilation (OR, 1.10, 95% CI, 0.88–1.37) or use of vasopressors (OR, 1.21, 95% CI, 0.91–1.61). Based on this analysis, prior use of ACEi/ARBs lowers the risk of mortality and adverse renal events in patients with sepsis and septic shock.
A Systematic Review of Interventions With an Educational Component Aimed at Increasing Enrollment and Participation in Cardiac Rehabilitation
Authors: Vanzella Lais Manata , Konidis Renee , Pakosh Maureen , Aultman Crystal , Ghisi Gabriela Lima de Melo
Published: October 2023

Objective:

The aim of this study was to systematically review the impact and characteristics of interventions with an educational component designed to improve enrollment and participation in cardiac rehabilitation (CR) among patients with cardiovascular disease.

Review Methods:

Five electronic databases were searched from data inception to February 2023. Randomized controlled trials and controlled, cohort, and case-control studies were considered for inclusion. Title, abstract, and full text of records were screened by two independent reviewers. The quality of included studies was rated using the Mixed Methods Assessment Tool. Results were analyzed in accordance with the Synthesis Without Meta-analysis reporting guideline.

Results:

From 7601 initial records, 13 studies were included, six of which were randomized controlled trials (“high” quality = 53%). Two studies evaluated interventions with an educational component for health care providers (multidisciplinary team) and 11 evaluated interventions for patient participants (n = 2678). These interventions were delivered in a hybrid (n = 6; 46%), in-person (n = 4; 30%), or virtual (n = 3; 23%) environment, mainly by nurses (n = 4; 30%) via discussion and orientation. Only three studies described the inclusion of printed or electronic materials (eg, pamphlets) to support the education. Eleven of 12 studies reported that patients who participated in interventions with an educational component or were cared for by health care providers who were educated about CR benefits (inhospital and/or after discharge) were more likely to enroll and participate in CR.

Conclusion:

Interventions with an educational component for patients or health care providers play an important role in increasing CR enrollment and participation and should be pursued. Studies investigating the effects of such interventions in people from ethnic minority groups and living in low-and-middle-income countries, as well as the development of standard educational materials are recommended.
Underestimation of Occupational Radiation Exposure During Endovascular Abdominal Aortic Aneurysm Repair
Authors: Chiang Hsien-Wen , Chuang Tzu-Chao , Chen Tou-Rong
Published: October 2023

During interventional procedures of endovascular abdominal aortic aneurysm repair (EVAR), the dosimeter was conventionally placed on chest facing toward the surgical table, instead of the main source of scatter radiation. Purpose of this study is to evaluate the underestimation of occupational radiation exposure. Phantom experiments were performed in a hybrid operating room equipped with an interventional angiography system. Electric personal dosimeters were placed at the level of eyes, chest, abdomen, and gonad of three positions, representing the principal operator (PO), assistant operator (AO), and sterile nurse (SN). Personal dose equivalent was measured with two different orientations of radiation detection, facing the table and facing the phantom, respectively. In addition to fluoroscopy, the dose produced by digital subtraction angiography was also measured to estimate the radiation exposure of routine EVAR. In this study, staff doses of 26 EVAR cases were also collected in our hospital to correlate the estimated dose. Our results show that the facing-phantom dose normalized by dose area product of patient is significantly higher than the facing-table dose when the latter is regularly seen in clinical practice. This underestimation could be even worse at a more distant position (e.g., AO and SN) as the incident angle of scatter radiation is larger. Besides, the estimated dose is highly correlated with the on-site measured dose (R2 ~ 0.8) at chest and gonad of the PO.
Guidelines and treatment patterns for primary rhegmatogenous retinal detachments: Expert consensus and survey in Taiwan Retina Society
Authors: Huang Yu-Te , Yang Chang-Hao , Chen Shih-Jen , Cheng Cheng-Kuo , Ho Tzyy-Chang , Wu Tsung-Tien , Sheu Shwu-Jiuan , Hsieh Yi-Ting , Chang Chia-Jen , Wu Jian-Sheng , Liu Laura , Chen San-Ni
Published: October 2023

Rhegmatogenous retinal detachment (RRD) is a significant cause of vision loss and requires appropriate surgical intervention. There are several approaches available, including observation, laser demarcation, pneumatic retinopexy, scleral buckling, and pars plana vitrectomy, which are chosen based on patient condition, surgeon experience, and national health insurance policies. Despite the various options, there is still no consensus on the optimal intervention. To address this, the Taiwan Retina Society assembled an expert committee with 11 experienced retina specialists to review the current evidence and develop a guideline with seven recommendations for managing RRD patients. Additionally, a survey was conducted with six questions to assess treatment patterns in Taiwan, which included input from the expert committee and an open poll at the 2023 Congress of the Taiwan Retina Society. This report provides a comprehensive summary of the current knowledge and expert consensus on the treatment of RRD, discussing the characteristics of current approaches and providing an overview of current treatment patterns in Taiwan. These findings aim to provide ophthalmologists with the best possible treatment for RRD.
Outcomes of Extracorporeal Life Support Utilization for Pediatric Patients With COVID-19 Infections
Authors: Jacobson Jillian C. , Ryan Mark L. , Vogel Adam M. , Mehl Steven C. , Acker Shannon N. , Prendergast Connor , Padilla Benjamin E. , Lee Justin , Chao Stephanie D. , Martin Nolan R. , Russell Katie W. , Larsen Kezlyn , Harting Matthew T. , Linden Allison F. , Ignacio Romeo C. , Slater Bethany J. , Juang David , Jensen Aaron R. , Melhado Caroline G. , Pelayo Juan Carlos , Zhong Allen , Spencer Brianna L. , Gadepalli Samir K. , Maamari Mia , Jimenez Valencia Maria , Qureshi Faisal G. , Pandya Samir R.
Published: October 2023

Outcomes of pediatric patients who received extracorporeal life support (ECLS) for COVID-19 remain poorly described. The aim of this multi-institutional retrospective observational study was to evaluate these outcomes and assess for prognostic factors associated with in-hospital mortality. Seventy-nine patients at 14 pediatric centers across the United States who received ECLS support for COVID-19 infections between January 2020 and July 2022 were included for analysis. Data were extracted from the electronic medical record. The median age was 14.5 years (interquartile range [IQR]: 2–17 years). Most patients were female (54.4%) and had at least one pre-existing comorbidity (84.8%), such as obesity (44.3%, median body mass index percentile: 97% [IQR: 67.5–99.0%]). Venovenous (VV) ECLS was initiated in 50.6% of patients. Median duration of ECLS was 12 days (IQR: 6.0–22.5 days) with a mean duration from admission to ECLS initiation of 5.2 ± 6.3 days. Survival to hospital discharge was 54.4%. Neurological deficits were reported in 16.3% of survivors. Nonsurvivors were of older age (13.3 ± 6.2 years vs. 9.3 ± 7.7 years, p = 0.012), more likely to receive renal replacement therapy (63.9% vs. 30.2%, p = 0.003), demonstrated longer durations from admission to ECLS initiation (7.0 ± 8.1 days vs. 3.7 ± 3.8 days, p = 0.030), and had higher rates of ECLS-related complications (91.7% vs. 69.8%, p = 0.016) than survivors. Pediatric patients with COVID-19 who received ECLS demonstrated substantial morbidity and further investigation is warranted to optimize management strategies.
Early Motor Delays During the First 2 Years of Life in Autism Spectrum Disorder: A Scoping Review
Authors: Nies Kara J. , Baldwin Jane , Kaur Maninderjit
Published: October 2023

Purpose:

To summarize and appraise the emerging evidence on early motor skills of infants later diagnosed with autism spectrum disorder (ASD), and the association of early motor delays to later ASD diagnosis/characteristics.

Methods:

A literature search was conducted for studies published from 2000 to 2023 on the motor skills of infants later diagnosed with ASD, followed by screening and data extraction.

Results:

Current evidence suggested presence of early motor deficits including poor anticipatory movements, postural control, and gross/fine motor skills during the first 2 years of ASD. However, there was variability among studies with regard to study sample and methodology.

Conclusion:

Although motor deficits are evident in infants, it is unclear whether these are specific to ASD or a consequence of general developmental disorder. Future research is needed on the investigation of specificity and severity of early motor delays, which can potentially assist in early identification of ASD.
Clinical Impairments and Rotator Cuff Tendon Pathology in Primary and Intrinsic Secondary Adhesive Capsulitis
Authors: Park Gi-Young , Kwon Dong Rak , Cho Hee Kyung , Kwon Do Yun
Published: October 2023

Objective

This study was conducted to compare the differences in clinical impairments between patients with primary and intrinsic secondary adhesive capsulitis and confirm rotator cuff tendon pathology in intrinsic secondary adhesive capsulitis.

Design

This study included 130 patients with unilateral adhesive capsulitis in freezing or frozen stages. Clinical impairment was evaluated using visual analogue scale score (VAS), shoulder passive range of motion, Cyriax stage(CS), and Constant-Murley score(CMS). Plain radiography, ultrasonography, single-contrast arthrography, and intravenous gadolinium-enhanced magnetic resonance imaging were performed in all patients.

Results

Among 130 patients, 77 patients were diagnosed as primary adhesive capsulitis and 53 patients as intrinsic secondary adhesive capsulitis. Among intrinsic secondary adhesive capsulitis patients, 44 rotator cuff tendon tears, 6 calcific tendinitis, and 3 rotator cuff tendon tears with calcific tendinitis were observed. No significant intergroup difference was observed in all clinical parameters, including shoulder passive range of motion, VAS, CS, and CMS. The prevalence of subacromial subdeltoid bursitis was significantly higher in intrinsic secondary adhesive capsulitis compared with primary adhesive capsulitis.

Conclusion

There was no significant difference in all clinical parameters investigated between patients with primary and intrinsic secondary adhesive capsulitis caused by rotator cuff tendon pathology.
Associations Between Lean IT Management and Financial Performance in US Hospitals
Authors: Lee Justin , Hung Dorothy Y. , Reponen Elina , Rundall Thomas G. , Tierney Aaron A. , Fournier Pierre-Luc , Shortell Stephen M.
Published: October 2023

Background and Objectives:

To understand the relationship between Lean implementation in information technology (IT) departments and hospital performance, particularly with respect to operational and financial outcomes.

Methods:

Primary data were sourced from 1222 hospitals that responded to the National Survey of Lean (NSL)/Transformational Performance Improvement, which was fielded to 4500 general medical-surgical hospitals across the United States. Secondary sources included hospital performance data from the Agency for Healthcare Research and Quality (AHRQ) and the Centers for Medicare & Medicaid Services (CMS). We performed 2 sets of multivariable regressions using data gathered from US hospitals, linked to AHRQ and CMS performance outcomes. We examined 10 different outcomes measuring financial performance, quality of care, and patient experience, and their associations with Lean adoption within hospital IT departments. We then focused only on those hospitals that adopted Lean in IT to identify specific practices associated with performance.

Results:

Controlling for other factors, adoption of Lean IT management was associated with lower length of stay (b = –0.098, P = .018) and inpatient expense per discharge (b = –0.112, P = .090). Specifically, use of visual management tools (eg, A3 storyboards, status sheets) was associated with lower adjusted inpatient expense per discharge (b = –0.176, P = .034) and higher earnings before interest, taxes, depreciation, and amortization margin (b = 0.124, P = .042). Such tools were also associated with hospital participation in bundled payment programs (odds ratio = 2.326; P = .046; 95% confidence interval, 0.979-5.527) and percentage of net revenue paid on a shared risk basis (b = 0.188, P = .031).

Conclusions:

Lean IT management was associated with positive financial performance, particularly with hospital participation in value-based payment. More detailed study is needed to understand other influential factors and types of work processes, activities, or mechanisms by which high-functioning IT can contribute to financial outcomes.
Multiscale mobility patterns and the restriction of human movement
Authors: Schindler Dominik J. , Clarke Jonathan , Barahona Mauricio
Published: October 2023

From the perspective of human mobility, the COVID-19 pandemic constituted a natural experiment of enormous reach in space and time. Here, we analyse the inherent multiple scales of human mobility using Facebook Movement maps collected before and during the first UK lockdown. Firstly, we obtain the pre-lockdown UK mobility graph and employ multiscale community detection to extract, in an unsupervised manner, a set of robust partitions into flow communities at different levels of coarseness. The partitions so obtained capture intrinsic mobility scales with better coverage than nomenclature of territorial units for statistics (NUTS) regions, which suffer from mismatches between human mobility and administrative divisions. Furthermore, the flow communities in the fine-scale partition not only match well the UK travel to work areas but also capture mobility patterns beyond commuting to work. We also examine the evolution of mobility under lockdown and show that mobility first reverted towards fine-scale flow communities already found in the pre-lockdown data, and then expanded back towards coarser flow communities as restrictions were lifted. The improved coverage induced by lockdown is well captured by a linear decay shock model, which allows us to quantify regional differences in both the strength of the effect and the recovery time from the lockdown shock.
Controlled molecular arrangement of easily aggregated deoxycholate with layered double hydroxide
Authors: Lee Kyounghyoun , Xie Jing , Park Hyeonjin , Jung Hyun , Oh Jae-Min
Published: October 2023

Deoxycholate (DA) is a natural emulsifying agent involved in the absorption of dietary lipids. Due to the facial distribution of hydrophobic-hydrophilic region, DA easily aggregates under ambient conditions, and this property hinders the practical application of DA in clinical applications. In this study, we found that the molecular arrangement of DA molecules could be controlled by using layered double hydroxide (LDH) under a specific reaction condition. The effect of reaction methods such as co-precipitation, ion exchange and reconstruction on the molecular arrangement of DA was investigated by X-ray diffraction, Fourier-transform infrared spectroscopy, high-resolution transmission electron microscopy and differential scanning calorimetry. It was demonstrated that the self-aggregation of DA molecules could be suppressed by the oriented arrangement of DA between the gallery space of LDH. The DA moiety was well stabilized in the LDH layers due to the electrostatic interaction between DA molecules and LDH layers. The most ordered arrangement of DA molecules was observed when DA was incorporated into LDH via a reconstruction method. The DA molecules arranged in LDH via reconstruction did not show significant exothermic or endothermic behaviour up to 400°C, showing that the DA moiety lost its intermolecular attraction in between LDH layers.
Reducing bias in secondary data analysis via an Explore and Confirm Analysis Workflow (ECAW): a proposal and survey of observational researchers
Authors: Thibault Robert T. , Kovacs Marton , Hardwicke Tom E. , Sarafoglou Alexandra , Ioannidis John P. A. , Munafò Marcus R.
Published: October 2023

Background.
Although preregistration can reduce researcher bias and increase transparency in primary research settings, it is less applicable to secondary data analysis. An alternative method that affords additional protection from researcher bias, which cannot be gained from conventional forms of preregistration alone, is an Explore and Confirm Analysis Workflow (ECAW). In this workflow, a data management organization initially provides access to only a subset of their dataset to researchers who request it. The researchers then prepare an analysis script based on the subset of data, upload the analysis script to a registry, and then receive access to the full dataset. ECAWs aim to achieve similar goals to preregistration, but make access to the full dataset contingent on compliance. The present survey aimed to garner information from the research community where ECAWs could be applied—employing the Avon Longitudinal Study of Parents and Children (ALSPAC) as a case example.
Methods.
We emailed a Web-based survey to researchers who had previously applied for access to ALSPAC's transgenerational observational dataset.
Results.
We received 103 responses, for a 9% response rate. The results suggest that—at least among our sample of respondents—ECAWs hold the potential to serve their intended purpose and appear relatively acceptable. For example, only 10% of respondents disagreed that ALSPAC should run a study on ECAWs (versus 55% who agreed). However, as many as 26% of respondents agreed that they would be less willing to use ALSPAC data if they were required to use an ECAW (versus 45% who disagreed).
Conclusion.
Our data and findings provide information for organizations and individuals interested in implementing ECAWs and related interventions.
Preregistration
. https://osf.io/g2fw5 Deviations from the preregistration are outlined in electronic supplementary material A.
Carboxymethyl starch as a reducing and capping agent in the hydrothermal synthesis of selenium nanostructures for use with three-dimensional-printed hydrogel carriers
Authors: Vishakha Vishakha , Abdel-Mohsen A. M. , Michalicka Jan , White Paul B. , Lepcio Petr , Tinoco Navarro Lizeth Katherine , Jančář Josef
Published: October 2023

The hydrothermal method is a cost-effective and eco-friendly route for preparing various nanomaterials. It can use a capping agent, such as a polysaccharide, to govern and define the nanoparticle morphology. Elemental selenium nanostructures (spheres and rods) were synthesized and stabilized using a tailor-made carboxymethyl starch (CMS, degree of substitution = 0.3) under hydrothermal conditions. CMS is particularly convenient because it acts simultaneously as the capping and reducing agent, as verified by several analytical techniques, while the reaction relies entirely on green solvents. Furthermore, the effect of sodium selenite concentration, reaction time and temperature on the nanoparticle size, morphology, microstructure and chemical composition was investigated to identify the ideal synthesis conditions. A pilot experiment demonstrated the feasibility of implementing the synthesized nanoparticles into vat photopolymerization three-dimensional-printed hydrogel carriers based on 2-hydroxyethyl methacrylate (HEMA). When submersed into the water, the subsequent particle release was confirmed by dynamic light scattering (DLS), promising great potential for use in bio-three-dimensional printing and other biomedical applications.
A high-eigenfrequency differential stiffness probe for high-speed scanning probe microscopy
Authors: Dey S. , Agrawal S. , Kartik V.
Published: October 2023

Microcantilever probes used for high-speed scanning probe microscopy are typically required to satisfy two mutually contradicting objectives: high eigenfrequency (

ω
n

) and low flexural rigidity (

k
b

). The conventional design approach shortens the microcantilever’s length to increase the eigenfrequencies (as

ω
n

∝
1

/

L
2

); however, this also increases the probe’s rigidity (as

k
b

∝
1

/

L
3

). This paper demonstrates—through experiments and physical modelling—the design of a novel high-eigenfrequency probe by redistributing the microcantilever’s mass along its length. A 100% increase in the probe’s eigenfrequency is achieved with this modified design, even while reducing its stiffness by 50%. Through experiments, this reduced stiffness has been found to enhance the probe’s
force sensitivity
. Also, the probe’s design facilitates redistributing the fluid pressure between its underside surface and the sample, thereby improving the
quality factor
by more than 100%. Significant reduction in
‘overshoot’
and
‘parachute’
is observed in contact mode scanning at the video rate. The improvements in the image resolution are proven for a variety of sample surfaces at very high scan rates up to 40 Hz (corresponding to a linear speed of

3.20
 

mm

 

s

−
1

) upon scanning over an area of

40
×
40
 
μ

m

and are successfully demonstrated to map topographies with negligible image artefacts.
Lévy flights as an emergent phenomenon in a spatially extended system
Authors: Jiao Chunxi , Gottwald Georg A.
Published: October 2023

Anomalous diffusion and Lévy flights, which are characterized by the occurrence of random discrete jumps of all scales, have been observed in a plethora of natural and engineered systems, ranging from the motion of molecules to climate signals. Mathematicians have recently unveiled mechanisms to generate anomalous diffusion, both stochastically and deterministically. However, there exists to the best of our knowledge no explicit example of a spatially extended system which exhibits anomalous diffusion without being explicitly driven by Lévy noise. We show here that the Landau–Lifshitz–Gilbert equation, a stochastic partial differential equation (SPDE), despite only being driven by Gaussian white noise, exhibits superdiffusive behaviour. The anomalous diffusion is an entirely emergent behaviour and manifests itself in jumps in the location of its travelling front solution. Using a collective coordinate approach, we reduce the SPDE to a set of stochastic differential equations driven by Gaussian white noise. This allows us to identify the mechanism giving rise to the anomalous diffusion as random widening events of the front interface.