bluuebunny/crossref_metadata_2025 huggingface dataset:
Reducing Initial Loss to Follow-up Among People With Bacteriologically Confirmed Tuberculosis: LINKEDin, a Quasi-experimental Study in South Africa
Authors: Meehan Sue-Ann , Hesseling Anneke C , Boulle Andrew , Chetty Jolene , Connell Lucy , Dlamini-Miti Nomthandazo J , Dunbar Rory , Du Preez Karen , George Gavin , Hoddinott Graeme , Jennings Karen , Marx Florian M , Mudaly Vanessa , Naidoo Pren , Ndlovu Neo , Ngozo Jacqueline , Smith Mariette , Strauss Michael , Tanna Gaurang , Vanqa Nosivuyile , von Delft Arne , Osman Muhammad
Published: December 2023

Every person diagnosed with tuberculosis (TB) needs to initiate treatment. The World Health Organization estimated that 61% of people who developed TB in 2021 were included in a TB treatment registration system. Initial loss to follow-up (ILTFU) is the loss of persons to care between diagnosis and treatment initiation/registration. LINKEDin, a quasi-experimental study, evaluated the effect of 2 interventions (hospital recording and an alert-and-response patient management intervention) in 6 subdistricts across 3 high–TB burden provinces of South Africa. Using integrated electronic reports, we identified all persons diagnosed with TB (Xpert MTB/RIF positive) in the hospital and at primary health care facilities. We prospectively determined linkage to care at 30 days after TB diagnosis. We calculated the risk of ILTFU during the baseline and intervention periods and the relative risk reduction in ILTFU between these periods. We found a relative reduction in ILTFU of 42.4% (95% CI, 28.5%–53.7%) in KwaZulu Natal (KZN) and 22.3% (95% CI, 13.3%–30.4%) in the Western Cape (WC), with no significant change in Gauteng. In KZN and the WC, the relative reduction in ILTFU appeared greater in subdistricts where the alert-and-response patient management intervention was implemented (KZN: 49.3%; 95% CI, 32.4%–62%; vs 32.2%; 95% CI, 5.4%–51.4%; and WC: 34.2%; 95% CI, 20.9%–45.3%; vs 13.4%; 95% CI, 0.7%–24.4%). We reported a notable reduction in ILTFU in 2 provinces using existing routine health service data and applying a simple intervention to trace and recall those not linked to care. TB programs need to consider ILTFU a priority and develop interventions specific to their context to ensure improved linkage to care.
The Global and Regional Prevalence of Hospital-Acquired Carbapenem-Resistant Klebsiella pneumoniae Infection: A Systematic Review and Meta-analysis
Authors: Lin Xing-chen , Li Chang-li , Zhang Shao-yang , Yang Xiao-feng , Jiang Meng
Published: December 2023

Background

Due to scarce therapeutic options, hospital-acquired infections caused by Klebsiella pneumoniae (KP), particularly carbapenem-resistant KP (CRKP), pose enormous threat to patients’ health worldwide. This study aimed to characterize the epidemiology and risk factors of CRKP among nosocomial KP infections.

Method

MEDLINE, Embase, PubMed, and Google Scholar were searched for studies reporting CRKP prevalence from inception to 30 March 2023. Data from eligible publications were extracted and subjected to meta-analysis to obtain global, regional, and country-specific estimates. To determine the cause of heterogeneity among the selected studies, prespecified subgroup analyses and meta-regression were also performed. Odds ratios of CRKP-associated risk factors were pooled by a DerSimonian and Laird random-effects method.

Results

We retained 61 articles across 14 countries and territories. The global prevalence of CRKP among patients with KP infections was 28.69% (95% CI, 26.53%–30.86%). South Asia had the highest CRKP prevalence at 66.04% (95% CI, 54.22%–77.85%), while high-income North America had the lowest prevalence at 14.29% (95% CI, 6.50%–22.0%). In the country/territory level, Greece had the highest prevalence at 70.61% (95% CI, 56.77%–84.45%), followed by India at 67.62% (95% CI, 53.74%–81.79%) and Taiwan at 67.54% (95% CI, 58.65%–76.14%). Hospital-acquired CRKP infections were associated with the following factors: hematologic malignancies, corticosteroid therapies, intensive care unit stays, mechanical ventilations, central venous catheter implantations, previous hospitalization, and antibiotic-related exposures (antifungals, carbapenems, quinolones, and cephalosporins).

Conclusions

Study findings highlight the importance of routine surveillance to control carbapenem resistance and suggest that patients with nosocomial KP infection have a very high prevalence of CRKP.
Christianity and Illiberal Politics
Authors: Hennig Anja
Published: December 2023

This chapter aims to map empirically and frame conceptually the ways in which, particularly in Europe, illiberal politics are linked with “Christianity,” which refers not only to the religion but also to the construction of identity-political narratives. The “Christianity-illiberalism” nexus refers to Christian actors staunchly opposed to progressive morality politics; to a political and secular appropriation of Christianity that opposes the migration of Muslims by constructing them as a civilizational “Other”; to a sense of Christian nationalism; and to the idea of a European (Judeo-)Christian civilization. After systematizing different types of actors, their narratives, and contested issues, the final section offers a typology of how Christianity and illiberal politics are entangled. The chapter concludes by arguing that Christianity can be mobilized in a secularizing Europe because of the ambivalence that is inherent to modernization and globalization, creating a climate for identity-political needs and the appropriation of the illiberal potential of Christian religion.
The Illiberalism of Fox News
Authors: Peck Reece
Published: December 2023

This chapter theorizes the similarities and differences between populism and nationalism through the case of Fox News, conservative America’s main news source. The first sections chart the Fox News careers of Donald Trump and Tucker Carlson to explain the rise of ethno-nationalist discourse in the United States. The nativist logic at the core of their ethno-nationalist politics puts these conservative icons at odds with liberal conceptions of nationhood. The following sections reveal the discursive processes through which Fox pundits like Carlson articulate ethno-nationalist political appeals with populist class critiques. The goal of this programming strategy is, I argue, to create a cross-connotation between ethno-nationalism and populism. Consequently, one type of politics seems to evoke the other. But it is a mistake for analysts to fall for this strategy in their own analysis by conflating populism with ethno-nationalism a priori, a tendency that is all too common in writing on populism.
Populism as Democratic Illiberalism
Authors: Pappas Takis S.
Published: December 2023

When all is said (mostly by the massive bibliography on populism) and done (mostly by the ever-growing number of populist regimes globally), modern populism is a novel political system that combines two core elements—the democratic method with illiberal values. Hence modern populism is appropriately conceived and minimally defined as “democratic illiberalism.” In this understanding, populism is finely distinguished from both liberal democratic and autocratic political systems. Based on these conceptual and theoretical propositions, the chapter has three aims. First, it elucidates the intimate relationship of populism with illiberalism. Second, it contrasts populism with other illiberal systems, both democratic and nondemocratic. Third, it proposes a comprehensive political systems typology inclusive of populism. The conceptual and theoretical clarity thus gained is expected to help make better sense of the renewed surge of illiberal politics that is evident around the world.
Illiberal Constitutionalism in Central and Eastern European States
Authors: Drinóczi Tímea , Bień-Kacała Agnieszka
Published: December 2023

The post-communist countries of Central and Eastern Europe (CEE) share a similar history, which created identities and value preferences that could accommodate illiberal constitutionalism. Nevertheless, illiberal constitutionalism has to date emerged only in Hungary and Poland, which have witnessed the gradual transformation of their political and legal systems (albeit to differing extents) over the past decade. The distinctive factor of illiberal transformation seems to be a charismatic leader who is willing to turn the existing constitutionalism into its illiberal version and attracts support for this project. Although other EU member states in the region have exhibited certain patterns of illiberalism, governing majorities have not transformed their respective constitutional systems into illiberal constitutionalism. In these cases, illiberalism—which may take the form of illiberal ideas in society, exclusion of certain ideas and people, and actions against the EU—remains only an element in political discourse rather than a dominating fact within constitutional and political regimes.
Translation/Adaptation
Authors: Brueck Laura
Published: December 2023

This chapter considers multiple iterations of the Bengali detective Byomkesh Bakshi: in dozens of mid-century Bengali novellas by Sharadindu Bandyopadhyay, in a popular Doordarshan television serial in the 1990s, and in a big-budget Bollywood blockbuster in 2015. Together, these various versions of Byomkesh create an evolving storyworld where Byomkesh grows from a local, vernacular, hometown hero, to a beloved pan-Indian icon, to an international export and an emblem of Indian popular culture on a global stage. This chapter explores how the contours of Byomkesh’s expanding storyworld mobilize the national work/work of the nation that Byomkesh is doing across the decades, with a specific focus on how the nature of that work is shaped by language, setting, and medium.
Introduction
Authors: Anjaria Ulka , Nerlekar Anjali
Published: December 2023

The task of compiling chapters for a book as vast in topic as a Handbook of modern Indian literatures is a challenging one. The Introduction takes a self-reflexive look at the project, highlighting the rationale behind the editorial decisions. Noting the paradigm of monolingualism under which much of literary scholarship on Indian literature suffers, the Handbook offers a multilingual and comparative approach to modern Indian literatures. Highlighting the melding of the trajectories of region, language, and borders, along with a close reading of texts and literary archives, the Introduction provides a fuller picture of the energetic space of scholarship on Indian literature even while interrogating and crossing the borders of the nation as narrowly understood. The Handbook will show the deep connections and collaborations across the limits of genre, language, nation, and region, producing a literature of diverse contact zones that generates newer questions of form, location, technique, culture, and society.
Constitutionalisms in Asia
Authors: Thio Li-ann
Published: December 2023

The rights-oriented and court-centric nature of Western liberal democratic models of constitutionalism has been hegemonic to the discourse, but it does not capture the total expression of constitutionalism, which seeks to structure and direct public power. Studying the varieties of constitutionalisms in Asia helps temper this ethnocentric parochialism, pluralizing our understanding of constitutionalism and clarifying what is an anti-constitutionalist model. This chapter provides a provisional orientation to the diverse terrain of constitutionalism in Asia, with its multiplicity of religions, political ideologies, government systems, colonial history, and levels of economic development. After considering the varying influence of Western liberal models in Asia, it examines three main varieties of non-liberal constitutionalisms: religious, socialist, and communitarian constitutionalism, where there is active state espousal of a vision of the “Good” and where constitutions may influence the shape of human relations not only in terms of rights but right relationships and social harmony.
South Korea
Authors: Rhee Woo-Young
Published: December 2023

This chapter examines South Korean constitutional law from the adoption of South Korea’s current constitution in 1987 to proposals for future reforms. It begins by introducing the constitutional revisions in 1987 that promoted democratization, clarified the relationship between government branches, advanced the protection of fundamental rights, and established the Constitutional Court (KCC). Next, the chapter focuses on the KCC. It charts major developments in key areas of the KCC’s jurisprudence. Finally, there have been vigorous debates about potentially revising the South Korea’s constitution in light of changes in South Korean society. The final section of this chapter explores these proposals.
European Judiciary (ECtHR, ECJ, National Courts)
Authors: Ziemele Ineta
Published: December 2023

The chapter introduces the concept of a European judiciary, and its origins. The concept denotes that all the courts in Europe form a web of judicial interrelations within a common European legal space. It describes European courts and the relations between them and consists of four sections: the concept of a European judiciary; its development; the courts; and future challenges. It shows that the value of the rule of law, as it materializes, inter alia, through the functioning of independent and impartial courts at national and European levels, has become an inalienable feature of European culture. Europeans believe that an independent judiciary has a pacifying function in that it plays a crucial role in restraining power. Especially since the 20th century, European States have brought to international relations the principle of rule of law, of which the notion of independent and impartial courts forms a crucial element. This is part of Europe’s universalist vision.
The Eurasian Economic Union
Authors: Sayapin Sergey
Published: December 2023

The Eurasian Economic Union (EAEU) is a regional trade organization of five post-Soviet nations—Armenia, Belarus, Kazakhstan, Kyrgyzstan, and Russia—designed to promote the free movement of goods, persons, services, and capital in accordance with the EAEU Treaty. The chapter provides an overview of the EAEU structure, law, and practice, and draws normative and functional comparisons with other relevant institutions such as the European Union and the World Trade Organisation. In presenting the material, the chapter generally follows the structure of the EAEU Treaty. The chapter discusses selected parameters of the EAEU Common Economic Space, and concludes with a few policy recommendations.
The Role of Religion in the Formation of International Law in Europe
Authors: Walter Christian
Published: December 2023

The chapter analyses the religious civil wars of the 16th and 17th centuries as the cradle of modern statehood and of secularized relations between independent States. While the internal coordination between State and religion took quite different forms ranging from strict separation to different types of State-churches, international law was limited to addressing the issue of religion from a more distanced level. Freedom of religion and the prohibition of discrimination on religious grounds emerged first as instruments of minority protection and developed later into individual rights. Under the European Convention on Human Rights (ECHR) a clear focus on freedom of religion has emerged, with non-discrimination usually only playing a minor role. More recently, this primary role of freedom of religion has been complemented by the anti-discrimination legislation and jurisprudence of the European Union (EU). The chapter analyses the interplay between these different bodies of law and how they contribute to peacefully living together in pluralistic modern societies.
Switzerland
Authors: Keller Helen , Lüthi Nicole , Sefkow-Werner Violetta
Published: December 2023

As a neutral country, Switzerland takes a special role in the international community. This chapter analyses the role of international law through the lens of Swiss neutrality. Swiss neutrality is a multidimensional concept that interlocks with historical, political, and legal developments and ideas. In order to understand the role of neutrality in Switzerland, this chapter first explains the concept of neutrality. It then provides an account of its evolution throughout history before addressing the changing meaning of neutrality in the current framework of international law and relations. After discussing the challenges and opportunities of neutrality, the chapter summarizes the most important points and provides an outlook on potential future issues in neutrality practice.
Cultural Variation in Childhood Social Learning
Authors: Stengelin Roman , Neldner Karri , Haun Daniel
Published: December 2023

Research on childhood social learning points to interesting patterns of cultural variation and recurrence in how children learn by observation, instruction, or collaboration. In this chapter, the authors provide a contemporary summary of cultural patterns of variation within social learning processes, focusing on evidence from cultural groups regularly underrepresented in psychological research. The authors outline key cultural dimensions impacting social learning, including subsistence styles, learning environments, and socialization goals. The authors argue that while learned content is highly variable across human groups, the repertoire of social learning processes by which children learn from others is cross-culturally recurrent. However, the relative extent to which children in each society rely on each social learning process varies. Therefore, more systematic consideration of cultural moderators is required when theorizing about the developmental roots of social learning in childhood.
Applying Cultural Evolution to Address Climate and Environmental Challenges
Authors: Kaaronen Roope O. , Waring Timothy M. , Borgerhoff Mulder Monique
Published: December 2023

Reducing human impacts on Earth’s biological systems is an urgent global priority. However, while the necessary technical solutions are now very well understood, the social process of developing, refining, and implementing those solutions through social, cultural, behavioural and policy change, remains beyond current scientific understanding and technical capacity. The authors develop the case that the young science of cultural evolution can be of use in achieving sustainable and just human futures. The authors suggest that the process of cumulative adaptive cultural evolution is directly implicated in the emergence of global anthropogenic ecological destruction. Also, the process of cultural evolution is inherent in any effort to foster the emergence and spread of the practices and policies needed to mitigate human impacts. The authors review the current research linking cultural evolution to modern climate and environmental challenges and propose a research agenda to accelerate social change towards an environmentally stable future.
Association between obesity and female sexual dysfunction: a review
Authors: Saadedine Mariam , Faubion Stephanie S , Grach Stephanie L , Nordhues Hannah C , Kapoor Ekta
Published: December 2023

Introduction

Obesity is a global health crisis that has been growing over the past few decades. The economic burden associated with obesity is substantial as it is associated with multiple disabling chronic diseases, such as cardiovascular disease, certain cancers, osteoarthritis, chronic pain, and mental illness. Obesity is known to be a risk factor for sexual dysfunction in men, but this association is less well understood in women.

Aims

To provide a narrative review of the available literature on the relationship between overweight/obesity and female sexual dysfunction, elaborate on the possible mechanisms explaining this association, and discuss the effects of weight loss on sexual function in those with obesity.

Methods

A search of the medical literature was carried out in PubMed and Medline, focusing on original research and systematic reviews of original research on obesity and sexual function in women.

Results

The relationship between obesity and female sexual function is not consistent across studies. While women with obesity are more likely to have worse sexual function and avoid sexual activity, many studies have failed to identify these associations. Lifestyle changes resulting in weight loss lead to better sexual function, and bariatric surgery has been shown to improve sexual function in the first couple of years following the procedure; yet, the long-term effects of weight loss and bariatric surgery are still uncertain.

Conclusions

The evidence on the relationship between obesity and female sexual function is mixed. Nevertheless, weight loss has been shown to improve sexual function in women with obesity. The impact of weight loss medications and the long-term effect of bariatric surgery on female sexual function require further study.
Cell-free expression of RuBisCO for ATP production in the synthetic cells
Authors: Sugii Shugo , Hagino Katsumi , Mizuuchi Ryo , Ichihashi Norikazu
Published: December 2023

Recent advances in bottom-up synthetic biology have made it possible to reconstitute cellular systems from non-living components, yielding artificial cells with potential applications in industry, medicine and basic research. Although a variety of cellular functions and components have been reconstituted in previous studies, sustained biological energy production remains a challenge. ATP synthesis via ribulose-1,5-diphosphate carboxylase/oxygenase (RuBisCO), a central enzyme in biological CO2 fixation, holds potential as an energy production system, but its feasibility in a cell-free expression system has not yet been tested. In this study, we test RuBisCO expression and its activity-mediated ATP synthesis in a reconstituted Escherichia coli-based cell-free translation system. We then construct a system in which ATP is synthesized by RuBisCO activity in giant vesicles and used as energy for translation reactions. These results represent an advance toward independent energy production in artificial cells.

Graphical Abstract
Factors Associated With Various Types of Industry Payments to Academic Spine Surgeons in the Open Payments Database
Authors: McCurdy Michael , Issa Tariq Z. , Lee Yunsoo , Giakas Alec , Mazmudar Aditya , Narayanan Rajkishen , Sellig Mason , Canseco Jose A. , Hilibrand Alan S. , Vaccaro Alexander R. , Schroeder Gregory G. , Kepler Christopher K.
Published: December 2023

Study Design.

Retrospective cohort study.

Objective.

The objective of this study was to investigate associations between spine surgeon characteristics and different types of industry payments.

Summary of Background Data.

Industry funding has played an important role in research and technological innovation within spine surgery, and industry payments supporting research have risen significantly in comparison to funding from other sources. To our knowledge, no studies have investigated academic spine surgeon characteristics associated with different categories of industry payments.

Materials and Methods.

A query was conducted of the North American Spine Society Spine Fellowship Directory from 2021 to 2022 to identify all orthopaedic or neurosurgical spine fellowship selection committee members. A PubMed search was utilized to collect information on surgeon academic productivity up through December 31, 2021. The authors then conducted a query on the Centers for Medicare and Medicaid Services open payments website from 2015 to 2021 to collect payment records of spine fellowship selection committee members.

Results.

On linear regression analysis, total publications (8203, P<0.001), attending years (48,823, P<0.001), and publication rate (57,528, P=0.017) were associated with higher general payments. Southeast spine surgeons (80,043, P=0.038) and fellowship directors (79,874, P=0.007) were associated with more research payments. Total publications (7409, P<0.001), attending years (47,100, P<0.001), and publication rate (47,511, P=0.040) were significantly associated with higher royalties. Having a Twitter/X account (60,800, P=0.018), being a director (51,605, P=0.034), total publications (492, P<0.001), and publication rate (6444, P<0.001) were all predictive of greater consulting payments.

Conclusions.

Spine surgeons who are experienced, academically productive, fellowship directors, and engage with social media receive greater payments on average than their peers across various payment types. As industry influence continues to make its way into health care, experienced leaders in their respective fields will shoulder the responsibility to integrate private innovation in an effective and scientifically rigorous manner.

Level of Evidence.

3.
Relationship between dapagliflozin and urinary albumin-to-creatinine ratio in patients with diabetes mellitus and cardiovascular disease: an observational study
Authors: Wu Zejia , He Xuyu , Xia Shuang , Xiao Xiaoju , Chen Jiyan , Li Liwen
Published: December 2023

Background and purpose:

The potential impact of dapagliflozin on the urinary albumin-to-creatinine ratio (UACR) in patients with type 2 diabetes and cardiovascular disease remained inconclusive. We aimed to investigate the potential impact of dapagliflozin on the UACR in patients with diabetes mellitus complicated with cardiovascular disease.

Methods:

This is a single-center prospective observation study. Diabetic patients with cardiovascular disease were recruited at authors’ center (both outpatients and inpatients) during a period from June 2019 to November 2020. The study subjects were grouped into a dapagliflozin group (receiving dapagliflozin for at least 6 consecutive months) and a non-sodium-glucose cotransporter 2 inhibitors (SGLT2i) group (not receiving dapagliflozin or any other SGLT2i). LgUACR change at 6 months from the baseline were compared between the two groups.

Results:

A total of 57 patients were enrolled during a period from June 2019 to November 2020: 35 in the dapagliflozin group versus 22 in the non-SGLT2i group. LgUACR change from the baseline was −0.07 in the dapagliflozin group, and 0.17 in the non-SGLT2i group (P = 0.021). Dapagliflozin was associated with a decrease in UACR in the univariate regression analysis but not in the analysis of covariance.

Conclusions:

Dapagliflozin may be associated with a decrease in the UACR in patients with diabetes mellitus and cardiovascular disease. In view of the limited sample size, further investigation is needed to verify these findings.
Acute myocardial infarction in a patient with thrombotic thrombocytopenic purpura: a case report and literature review
Authors: Hu Feng , Chen Mengjia , Yuan Xun , Lin Yunling , Chen Lianglong
Published: December 2023

Acute myocardial infarction (AMI) induced by thrombotic thrombocytopenic purpura (TTP) has been previously reported, but comorbidity with autoimmune hemolytic anemia is rare. The index patient, a 55-year-old woman, presented with acute ST-elevation myocardial infarction (STEMI). A diagnosis of TTP was established on the presence of thrombocytopenia, microangiopathic hemolytic anemia, acute kidney injury, fever, and neurologic symptoms (ischemic stroke); autoimmune hemolytic anemia was established based on Comboost test. Percutaneous coronary intervention and dual antiplatelet therapy were not initiated due to elevated risk of bleeding. Instead, the patient was treated with glucocorticosteroid and plasmapheresis. Despite the treatment, the patient suffered a watershed acute cerebral infarction, and finally died of gastrointestinal bleeding. This case highlights the challenges in managing STEMI in TTP patients.
Coronary Artery Bypass Surgery: Evidence-Based Practice
Authors: Thuan Phan Quang , Chuong Pham Tran Viet , Nam Nguyen Hoai , Dinh Nguyen Hoang
Published: December 2023

Coronary artery bypass graft (CABG) surgery remains a pivotal cornerstone, offering established symptomatic alleviation and prognostic advantages for patients grappling with complex multivessel and left main coronary artery diseases. Despite the lucid guidance laid out by contemporary guidelines regarding the choice between CABG and percutaneous coronary intervention (PCI), a notable hesitation persists among certain patients, characterized by psychological reservations, knowledge gaps, or individual beliefs that sway their inclination toward surgical intervention. This comprehensive review critically synthesizes the prevailing guidelines, modern practices, and outcomes pertaining to CABG surgery, delving into an array of techniques and advancements poised to enhance both short-term and enduring surgical outcomes. The exploration encompasses advances in on-pump and off-pump procedures, conduit selection strategies encompassing the bilateral utilization of internal mammary artery and radial artery conduits, meticulous graft evaluation methodologies, and the panorama of minimally invasive approaches, including those assisted by robotic technology. Furthermore, the review navigates the terrain of hybrid coronary revascularization, shedding light on the pivotal roles of shared decision-making and the heart team in shaping treatment pathways. As a comprehensive compendium, this review not only navigates the intricate landscape of CABG surgery but also aligns it with contemporary practices, envisioning its trajectory within the evolving currents of healthcare dynamics.
Sleep and rest-activity rhythms for women at different menopausal statuses: the role of mental health
Authors: Hou Szu-Yu , Chiu Ching-Ju , Shea Jeanne Laraine , Wang Chih-Liang , Tang Hsiao-Han , Kuo Po-Ching , Yang Yi-Chieh , Hsu Hsin-Ping
Published: December 2023

Objective

To examine how mental health interplays with menopausal status in relation to sleep patterns and rest-activity rhythms (RARs) among middle-aged women.

Methods

This cross-sectional study recruited 87 women aged 45 to 60 years from community and a gynecology clinic in Taiwan. Participants wore actigraphy devices for 7 days and were also assessed with self-reported questionnaires. Hierarchical regression was used to examine the effects of menopausal status and mental health on sleep and RARs.

Results

Perimenopausal and postmenopausal women had higher relative amplitude and interdaily stability of RARs than premenopausal women. There were no differences in actigraphy-based sleep parameters across menopausal statuses. There was no difference in depressive symptoms or loneliness across menopausal statuses. Higher levels of depressive symptoms were significantly associated with longer sleep latency (β = 0.26, P = 0.022) and wake after sleep onset (β = 0.28, P = 0.012), and lower sleep efficiency (β = −0.30, P = 0.008) after adjusting for menopausal status and age. In addition, there was marginal significance of the positive association between loneliness and interdaily stability (β = 0.18, P = 0.079). A moderating effect (β
menopausal status*loneliness = −0.40, P = 0.025) showed that lonelier premenopausal women exhibited greater relative amplitude (RA) of rest-activity rhythms, but lonelier menopausal women had lower RA of RAR.

Conclusion

Mental health plays an important role for middle-aged women with different menopausal statuses in relation to sleep patterns and RARs.
First-in-human Use of a Microsurgical Robotic System for Central Lymphatic Reconstruction
Authors: Grünherz Lisanne , Weinzierl Andrea , Puippe Gilbert Dominique , von Reibnitz Donata , Barbon Carlotta , Schneider Marcel André , Giovanoli Pietro , Gutschow Christian Alexander , Lindenblatt Nicole
Published: December 2023

Advances in the development of robotic systems have recently enabled the use of robotic technology in reconstructive lymphatic surgery. Although the advantages of microsurgical robots must be weighed carefully against the costs, their use may allow for smaller surgical approaches and easier access to anatomically deeper structures or even smaller vessels. We report on a case of a patient with central lymphatic dilation causing abdominal pain and severely reduced physical capacity. Sonography-assisted intranodal injection of indocyanine green allowed for localization of the lymphatic cyst and anastomosis with the left ovarian vein, applying robotic-assisted microsurgery for the first time on the central lymphatic system. Following the successful reconstruction of lymphatic drainage and decompression of the cyst, the patient reported a complete regression of her preoperative symptoms. From a surgical point of view, the Symani Surgical System improved precision and allowed significantly smaller surgical access. Considering the high morbidity and rarity of pathologies of the central lymphatic system, central lymphatic surgery is to date rarely performed. With improved precision and significantly smaller surgical access, robotic-assisted microsurgery has great potential to expand the treatment options for central lymphatic lesions.
Choroidal amelanotic mass with vermiform margins, vision loss, and extreme fatigue
Authors: Konstantinou Eleni K. , Card Kevin. R. , Shields Carol L.
Published: December 2023

Purpose:

To describe a case of a previously healthy middle-aged male with an atypical choroidal mass and fatigue.

Methods:

Case report.

Results:

A 56-year-old Caucasian male presented with decreased vision in the right eye (OD) and a choroidal amelanotic mass OD with subretinal fluid. He received bevacizumab (1.25 mg/0.05 mL) injections by multiple providers without improvement in vision and with tumor progression. Visual acuity was 20/400 OD and 20/25 left eye (OS). The anterior segment was unremarkable in both eyes (OU). He was referred with suspected diagnosis of choroidal melanoma, metastasis, or osteoma. On examination, a choroidal amelanotic tumor with vermiform margins measuring 12 mm in base and 1.8 mm in thickness was seen OD. Smaller satellite lesions were noted inferiorly. Fundus OS was normal. Infectious evaluation was unrevealing and angiotensin-converting enzyme, lysozyme, and chest x-ray were normal. Fine-needle aspiration biopsy was declined by the patient. Given the clinical suspicion of choroidal sarcoidosis with characteristic tumor color, vermiform margins, and presence of satellite lesions, oral corticosteroids 60 mg/day for 2 months were started, followed by sub-Tenons triamcinolone acetonide (40mg/1 mL) injection three months later and urgent rheumatologic evaluation. He self-discontinued the oral corticosteroids and the tumor progressed by the next follow-up. Oral corticosteroids were restarted at 80mg/day. 16 months after his presentation to us, he experienced fatigue with electrocardiogram findings of third-degree heart block from sarcoidosis. He received an intracardiac defibrillator and 80 mg/day of corticosteroids with plans to initiate methotrexate for stronger immunosuppression.

Conclusion:

Understanding the numerous manifestations of ocular and systemic sarcoidosis is crucial. Choroidal sarcoidosis characteristically exhibits vermiform margins. Close follow-up and systemic monitoring is necessary in patients presenting with ocular signs of sarcoidosis.

Precis:

The diagnosis of choroidal sarcoidosis can be challenging. Features including vermiform tumor margins, satellite lesions, and choroidal infiltration on OCT are suggestive of choroidal sarcoidosis. All patients with ocular sarcoidosis should be monitored for systemic involvement. In this case, the ocular manifestation guided the diagnosis and eventually the treatment of cardiac sarcoidosis.
Heparin-induced thrombocytopenia thrombosis after pancreaticoduodenectomy without definitive prophylactic or therapeutic use of heparin: a case report
Authors: Wang Mengyi , Huang Nan , Liu Qiaofei , Liao Quan
Published: December 2023

Heparin-induced thrombocytopenia thrombosis (HITT) is a rare and potentially life-threatening complication after abdominal surgery, and it always occurs after the prophylactic or therapeutic use of heparin. HITT after pancreaticoduodenectomy (PD) has not been reported before. Herein, we reported a case of HITT after PD without prophylactic or therapeutic use of heparin. A 74-year-old female patient who suffered resectable pancreatic head cancer was transferred to our center for surgery. An open PD procedure was performed, and the operation was smooth. No heparin was used after surgery. Nine days after surgery, the platelet sharply declined to 48 × 109/L (100–350), and the D-dimer soared up to 33.56 mg/L (0–0.55). Ultrasound examination showed vein thrombosis in both the lower limb and the right upper limb. HIT-antibody was 6.3 U/mL (0–0.6). The diagnosis of HITT was confirmed. Fondaparinux was used. On postoperative day (POD) 23, the platelet recovered to the normal range. On POD 27, she was discharged without thromboembolism or active bleeding, and oral rivaroxaban was prescribed. One month after discharge, the platelet remained normal, and she did not complain of discomfort.
Mediastinal Radiotherapy-induced Early-onset Valvulopathy in a 6-Year-old Boy With Hodgkin Lymphoma
Authors: Doğan Mustafa , Demirsoy Uğur , Başar Eviç Zeynep , Babaoğlu Kadir
Published: December 2023

Mediastinal radiotherapy for childhood cancers, particularly Hodgkin disease, has numerous potential adverse effects, including coronary artery disease, pericarditis, cardiomyopathy, valvular disease, and conduction abnormalities. The prevalence of valvular stenosis is relatively low, and regurgitation is more common. Mediastinal radiotherapy-induced valvular disease develops more than 10 years after radiotherapy. Here, we present a case of a 6-year-old boy with moderate to significant mitral stenosis + moderate mitral regurgitation and mild aortic regurgitation that appeared 1.5 months after radiotherapy and showed a progressive course.
Factors Influencing Physical Medicine & Rehabilitation Trainee Research Engagement
Authors: Strader Shannon , Addoh Ovuokerie , Chi Bradley , Sim Geum , Davidoff Chanel , Chandan Priya , Bean Allison
Published: December 2023

Research engagement during Physical Medicine and Rehabilitation (PM&R) residency and fellowship training is essential for advancing evidence-based medicine and fostering the development of clinician-scientists. Current Accreditation Council for Graduate Medical Education (ACGME) guidelines regarding research requirements during PM&R training are ambiguous, and it is unknown whether PM&R trainees receive adequate support to pursue research at the level they desire. This anonymous survey study aimed to identify perceived barriers and facilitators to research engagement among United States PM&R residents and fellows. Our findings suggest that PM&R trainees value research engagement. However, research productivity during PM&R residency is limited, with many trainees reporting inadequate support and time to participate in research in a meaningful way. Additional support from residency and fellowship programs, including protected time for research, as well as research-specific education and mentorship should be considered to enhance PM&R trainee research engagement.
Small Bowel Neuroendocrine Neoplasms—A Review
Authors: Vulasala Sai Swarupa , Virarkar Mayur , Gopireddy Dheeraj , Waters Rebecca , Alkhasawneh Ahmad , Awad Ziad , Maxwell Jessica , Ramani Nisha , Kumar Sindhu , Onteddu Nirmal , Morani Ajaykumar C.
Published: December 2023

Neuroendocrine neoplasms (NENs) are rapidly evolving small bowel tumors, and the patients are asymptomatic at the initial stages. Metastases are commonly observed at the time of presentation and diagnosis. This review addresses the small bowel NEN (SB-NEN) and its molecular, histological, and imaging features, which aid diagnosis and therapy guidance. Somatic cell number alterations and epigenetic mutations are studied to be responsible for sporadic and familial SB-NEN. The review also describes the grading of SB-NEN in addition to rare histological findings such as mixed neuroendocrine-non-NENs. Anatomic and nuclear imaging with conventional computed tomography, magnetic resonance imaging, computed tomographic enterography, and positron emission tomography are adopted in clinical practice for diagnosing, staging, and follow-up of NEN. Along with the characteristic imaging features of SB-NEN, the therapeutic aspects of imaging, such as peptide receptor radionuclide therapy, are discussed in this review.
Radiomics Analysis to Predict Lymphovascular Invasion of Gastric Cancer Based on Iodine-Based Material Decomposition Images and Virtual Monoenergetic Images
Authors: Shi Cen , Yan Jiulong , Yu Yixing , Hu Chunhong
Published: December 2023

Objective

This study aimed to investigate the utility of virtual monoenergetic images (VMIs) and iodine-based material decomposition images (IMDIs) in the assessment of lymphovascular invasion (LVI) in gastric cancer (GC) patients.

Methods

A total of 103 GC patients who underwent dual-energy spectral computed tomography preoperatively were enrolled. The LVI status was confirmed by pathological analysis. The radiomics features obtained from the 70 keV VMI and IMDI were used to build radiomics models. Independent clinical factors for LVI were identified and used to build the clinical model. Then, combined models were constructed by fusing clinical factors and radiomics signatures. The predictive performance of these models was evaluated.

Results

The computed tomography–reported N stage was an independent predictor of LVI, and the areas under the curve (AUCs) of the clinical model in the training group and testing group were 0.750 and 0.765, respectively. The radiomics models using the VMI signature and IMDI signature and combining these 2 signatures outperformed the clinical model, with AUCs of 0.835, 0.855, and 0.924 in the training set and 0.838, 0.825, and 0.899 in the testing set, respectively. The model combined with the computed tomography–reported N stage and the 2 radiomics signatures achieved the best performance in the training (AUC, 0.925) and testing (AUC, 0.961) sets, with a good degree of calibration and clinical utility for LVI prediction.

Conclusions

The preoperative assessment of LVI in GC is improved by radiomics features based on VMI and IMDI. The combination of clinical, VMI-, and IMDI-based radiomics features effectively predicts LVI and provides support for clinical treatment decisions.
An Analysis of 10,000 Cases of Living Donor Liver Transplantation in Japan
Authors: Eguchi Susumu , Umeshita Koji , Soejima Yuji , Eguchi Hidetoshi , Egawa Hiroto , Fukumoto Takumi , Haga Hironori , Hasegawa Kiyoshi , Kasahara Mureo , Nagano Hiroaki , Takada Yasutsugu , Tokushige Katsutoshi , Ueda Yoshihide , Mochida Satoshi , Matsushima Hajime , Adachi Tomohiko , Ohdan Hideki ,   The Japanese Liver Transplantation Society
Published: December 2023

Objective:

To analyze 10,000 cases of living donor liver transplantation (LDLT) recipient data to elucidate outcomes with special reference to the graft-versus-recipient weight ratio (GRWR), based on the Japanese Liver Transplantation Society (JLTS) registry.

Background:

The JLTS registry has been accurate and complete in characterizing and following trends in patient characteristics and survival of all patients with LDLT.

Methods:

Between November 1989 and August 2021, 10,000 patients underwent LDLT in Japan. The procedures performed during the study period included pediatric liver transplantation (age <18 years, n = 3572) and adult liver transplantation (age ≥18 years, n=6428). Factors related to patient survival (PS) and graft survival (GS) were also analyzed.

Results:

The GRWR was <0.7, 0.7 to <0.8, 0.8 to <3, 3 to <5, and ≥5 in 0.2%, 2.0%, 61.8%, 31.8%, and 2.6% of pediatric patients and <0.6, 0.6 to <0.7, 0.7 to <0.8, and ≥0.8 in 8.0%, 12.7%, 17.7%, and 61.5% of adult patients, respectively. Among pediatric recipients, the PS rate up to 5 years was significantly better in cases with a GRWR ≤5 than in those with a GRWR >5. When the GRWR and donor age were combined, among adult recipients 50 to 60 years old, the early PS and GS up to 5 years were significantly better in cases with a GRWR ≥0.7, than in those with a GRWR <0.7. (P = 0.02). In adults, a multivariate analysis showed that GRWR <0.6, transplant era (<2011), donor age (>60 years), recipient age (>60 years), model for end-stage liver disease score (≥20), and center volume (<10) were significant prognostic factors for long-term PS.

Conclusion:

Although a satisfactory long-term PS and GS, especially in the recent era (2011-2021), was achieved in the JLTS series, a GRWR ≥5 in pediatric cases and relatively old donors with a GRWR <0.7 in adult cases should be managed with caution.
Phytohabitans aurantiacus sp. nov., an actinomycete isolated from soil
Authors: Triningsih Desy Wulan , Harunari Enjuro , Hamada Moriyuki , Enomoto Narumi , Tamura Tomohiko , Komaki Hisayuki , Igarashi Yasuhiro
Published: December 2023

A novel actinomycete, designated RD004123T, was isolated from a soil sample collected in Hokkaido, Japan, and its taxonomic position was investigated by a polyphasic approach. Phylogenetic analysis based on 16S rRNA gene sequence comparisons revealed that strain RD004123T fell within the cluster of the family

Micromonosporaceae

but did not form a reliable cluster with any member of the family. The similarity values between strain RD004123T and the type species of 29 genera in the family

Micromonosporaceae

were 91.7–97.7 %. Meanwhile, phylogenomic analyses indicated that strain RD004123T was closely related to members of the genus

Phytohabitans

. Strain RD004123T contained both meso-diaminopimelic acid and l-lysine as the diagnostic diamino acids of the peptidoglycan. The predominant isoprenoid quinones were MK-10(H8) and MK-10(H6), and the major fatty acids were anteiso-C17 :  0, iso-C16 :  0, iso-C15 :  0 and C17 :  0. The detected polar lipids were phosphatidylinositol mannosides, phosphatidylinositol, phosphatidylethanolamine and diphosphatidylglycerol. These chemotaxonomic features corresponded to those of the genus

Phytohabitans

. Meanwhile, the results of genome comparison analyses and phenotypic characterizations distinguished strain RD004123T from the other members of the genus

Phytohabitans

. Therefore, strain RD004123T should be assigned as representing a novel species of the genus

Phytohabitans

, for which the name Phytohabitans aurantiacus sp. nov. is proposed. The type strain is RD004123T (=NBRC 114997T=DSM 114330T).
ICTV Virus Taxonomy Profile: Jingchuvirales 2023
Authors: Kuhn Jens H. , Dheilly Nolwenn M. , Junglen Sandra , Paraskevopoulou Sofia , Shi Mang , Di Paola Nicholas
Published: December 2023

Jingchuvirales is an order of negative-sense RNA viruses with genomes of 9.1–15.3 kb that have been associated with arachnids, barnacles, crustaceans, insects, fish and reptiles in Africa, Asia, Australia, Europe, North America and South America. The jingchuviral genome has two to four open reading frames (ORFs) that encode a glycoprotein (GP), a nucleoprotein (NP), a large (L) protein containing an RNA-directed RNA polymerase (RdRP) domain, and/or proteins of unknown function. Viruses in the order are only known from their genome sequences. This is a summary of the International Committee on Taxonomy of Viruses (ICTV) Report on the order Jingchuvirales and on the families Aliusviridae, Chuviridae, Crepuscuviridae, Myriaviridae and Natareviridae, which are available at ictv.global/report/jingchuvirales, ictv.global/report/aliusviridae, ictv.global/report/chuviridae, ictv.global/report/crepuscuviridae, ictv.global/report/myriaviridae and ictv.global/report/natareviridae, respectively.