bluuebunny/crossref_metadata_2025 huggingface dataset:
Appropriateness of Mini-Invasive Approaches for Nausea and Vomiting Refractory to Medical Therapy in Palliative Care Setting: A Case Report
Authors: Casadio Chiara , Tassinari Elisa , Carloni Riccardo , Rossi Romina , Tenti Maria Valentina , Fabbri Laura , Maltoni Marco
Published: February 2024

Introduction: Nausea and vomiting are frequent multifactorial symptoms in oncological patients. These manifestations, mainly affecting the advanced disease stages, may lead to existential, psychological, and physical suffering, with a negative impact on the quality of life (QoL) of the individual and his family. The medical approach makes use of a wide range of drugs, with different antiemetic potency and various mechanisms of action, taking into account the etiology and the patient’s response to the different therapeutic strategies. In recent years, in addition to pharmacological treatments, some endoscopic procedures have been integrated into clinical practice as promising palliative approaches. Case Presentation: Herein, we describe and discuss a case of a 64-year-old female affected by advanced stage pancreatic adenocarcinoma, in which different techniques – both medical and endoscopic – have been used to approach a refractory symptomatology with a negative impact on the patient’s QoL. In the context of a multidisciplinary approach in primary palliative care, a tailored intervention encompassing invasive methods for palliative purposes, may be considered adequate and appropriate when the prognostic expectation and the physical functionality indices allow it. Conclusion: Minimally invasive palliative interventions should be offered to patients with advanced cancer when symptoms become refractory to standard medical therapies, as part of the holistic approach in modern treatments. Therefore, the integration of an early palliative approach into the patient’s therapeutic path becomes essential for the management of all the individual’s needs.
Treatment Options for Early Stage Inoperable Breast Cancer: Cryoablation or Radiotherapy?
Authors: Chua Gail Wan Ying , Li Lucia
Published: February 2024

Background: Surgical removal of the tumour is the gold standard treatment for early stage invasive breast cancer. However, with a global ageing population, a larger number of diagnoses are occurring in women with comorbidities that render them unsuitable for surgery. Hence, it is of interest to explore alternative treatment strategies for this group of women. Summary: Our narrative review aims to explore two such techniques, cryoablation and external beam radiotherapy, providing a brief summary of the evidence behind each technique. Following this, we discuss which groups of patients would gain the most benefit from each technique. Factors favouring the use of radiotherapy include patients with larger tumours, more superficial tumours, and those with less well-demarcated tumours where there is uncertainty regarding tumour extent. Meanwhile, patients who may benefit more from cryoablation include those who desire a smaller number of treatment sessions, have concerns regarding cosmesis and skin pigmentation, or who have relative contraindications to radiotherapy such as scleroderma, systemic lupus erythematosus, reduced lung function, or cardiac comorbidities. Key Messages: Continued advancements in both cryoablation and radiotherapy technologies are taking place, in tandem with imaging technologies enabling greater certainty in tumour detection and delineation. These factors will help increase local control rates in this group of non-operable early stage breast cancer patients. Through this review, we hope to aid in the clinical decision-making process regarding the selection and referral of patients for each treatment.
Intravenous Tenecteplase versus Alteplase before Mechanical Thrombectomy in Patients with Large Vessel Occlusion Stroke: A Systematic Review and Meta-Analysis
Authors: Almanna Mohammed A. , Aloraini Ziad S. , Regenhardt Robert W. , Dmytriw Adam A. , Bayounis Mohammed A. , Bin-Mahfooz Mohammed A. , Alghamdi Yousef I. , Bucklain Ysmeen T. , Alhoumaily Abdulrahman Y. , Alotaibi Naif M.
Published: February 2024

Introduction: The use of alteplase (ALT) bridging to endovascular mechanical thrombectomy (MT) has become the standard approach in treating patients with large vessel occlusion (LVO) stroke. Tenecteplase (TNK) has emerged as an equivalent fibrinolytic agent in treating ischemic stroke due to its remarkable pharmacological characteristics. This study aimed to compare the use of intravenous TNK to ALT bridging to MT in patients with LVO. Methods: We included observational and randomized controlled trials of patients with LVO who received bridging TNK versus ALT before undergoing MT. Efficacy outcomes included functional independence which is indicated by a modified Rankin Scale [mRS] score of 0–2 at 90 days. Radiological outcomes included the rate of successful recanalization post-MT (Modified Treatment in Cerebral Ischemia [mTICI] score of 2b/3) and the rate of pre-MT recanalization, indicated by an mTICI of 2b/3 at the first angiographic assessment. The all-cause mortality at 90 days (mRS of 6) was considered the primary safety outcome, while the symptomatic intracranial hemorrhage rate was reported as an adverse event. Results: We identified 5 comparative observational studies and 1 randomized controlled trial, totaling 4,186 patients with LVO. The crude odds ratio (OR) for post-MT recanalization in patients with LVO who received TNK was comparable to those who received ALT (OR = 1.14; 95% CI: 0.57–2.27, I2 = 54%). The rate of pre-MT recanalization was significantly higher in those given TNK as a bridging therapy to MT compared to those who received ALT (OR = 2.66; 95% CI: 1.60–4.41, I2 = 0%; p <0.001). Functional independence at 90 days was not significantly different between patients with stroke who received TNK and those who were given ALT before MT (OR = 1.41; 95% CI: 0.84–2.35; I2 = 45%). The 90-day mortality was similar between patients with LVO who received TNK and those who were given ALT prior to undergoing MT (OR = 0.74; 95% CI: 0.46–1.21; I2 = 0%). Conclusion: Patients with LVO who received TNK as the primary fibrinolytic agent bridging to MT demonstrated higher rates of pre-MT recanalization, similar rates in post-MT recanalization and equivalent functional independence outcomes at 90 days compared to those who received ALT. The administration of TNK before MT showed comparable results in the 90-day all-cause mortality rate compared to those who received ALT. These results warrant further trials for TNK to be used as a superior fibrinolytic agent to ALT in LVO-MT candidates.
DHX37 Variant Is One of the Common Genetic Causes in Japanese Patients with Testicular Regression Syndrome/Partial Gonadal Dysgenesis without Müllerian Derivatives
Authors: Shimura Kazuhiro , Ichihashi Yosuke , Nakano Satsuki , Sato Takeshi , Hamajima Takashi , Numasawa Keita , Narumi Satoshi , Hasegawa Tomonobu , Ishii Tomohiro
Published: February 2024

Introduction: The testicular regression syndrome (TRS) is a form of differences of sex development (DSD) in which the testes differentiate and function during early embryonic development, but subsequently regress. The clinical phenotype of TRS often overlaps with that of partial gonadal dysgenesis (PGD). Previous studies have demonstrated a causal association between TRS/PGD and heterozygous missense variants of DHX37. Methods: We enrolled 11 Japanese 46,XY individuals (from 10 families) with TRS/PGD who exhibited undetected or hypoplastic testes, Müllerian duct regression, and low serum testosterone or anti-Müllerian hormone levels. The subjects underwent targeted sequencing of 36 known causative genes for DSD, PCR-based Sanger sequencing of DHX37, or whole-exome sequencing. Results: Previously described pathogenic variants or novel nonsense variants (SRY, NR5A1, and DMRT1) were observed in four out of 10 families. Additionally, we identified two heterozygous rare variants of DHX37 in four families: a previously reported pathogenic variant (c.923G>A, p.Arg308Gln) in three and a novel likely pathogenic variant (c.1882A>C, p.Thr628Pro) in one. The external genitalia of patients with the DHX37 variants varied from female-type to male-type without micropenis. Eighty percent of Japanese patients with TRS/PGD had monogenic disorders including DHX37 variant being the most commonly identified (40%). The external or internal genital phenotype of TRS/PGD overlaps between DHX37 variant carriers and others. Conclusions: DHX37 variant is one of the common genetic causes in Japanese patients with TRS/PGD without Müllerian derivatives. Genetic test is helpful in detecting DHX37-related TRS/PGD because of the phenotypic diversity of the external genitalia in this disorder.
Valvular Prostaglandins Are Elevated in Severe Human Aortic Valve Stenosis
Authors: Cayer Lucien G.J. , Surendran Arun , Karakach Tobias , Aukema Harold M. , Ravandi Amir
Published: February 2024

BACKGROUND:

Aortic valve stenosis (AVS) is the most common valvular disease in the developed world. AVS involves the progressive fibrocalcific remodeling of the aortic valve (AV), which impairs function and can ultimately lead to heart failure. Due to gaps in our understanding of the underlying mechanisms of AVS, there are no pharmacological treatments or dietary interventions known to slow AVS progression. Recent studies have begun to suggest oxylipins—a class of bioactive lipids—may be dysregulated in the valves of patients with AVS.

METHODS:

We utilized high-performance liquid chromatography–tandem mass spectrometry to conduct a targeted oxylipin analysis on human AV tissue and plasma from a cohort of 110 patients undergoing AV surgery.

RESULTS:

We identified 36 oxylipins in human AV tissue with all showing significant increase in patients with severe AVS. A multivariate model including patient characteristics and valvular oxylipins identified the arachidonic acid-COX (cyclooxygenase) pathway–derived prostanoids to be the most associated with AVS severity. Plasma oxylipin levels were measured in a subset of AV surgery patients and compared with a control group of healthy participants, showing distinct oxylipin profiles between control and disease.

CONCLUSIONS:

Our comprehensive analysis of oxylipins in the human AV identified the inflammatory and osteogenic regulating prostanoids to be positively correlated with AVS severity. This elucidation of prostanoid dysregulation warrants further research into COX inhibition to mitigate AVS.
Hypertension Related Co-Morbidities and Complications in Women of Sub-Saharan Africa: A Brief Review
Authors: Hahka Taija M. , Slotkowski Rebecca A. , Akbar Anum , VanOrmer Matt C. , Sembajwe Lawrence Fred , Ssekandi Abdul M. , Namaganda Agnes , Muwonge Haruna , Kasolo Josephine N. , Nakimuli Annettee , Mwesigwa Naome , Ishimwe Jeanne A. , Kalyesubula Robert , Kirabo Annet , Anderson Berry Ann L. , Patel Kaushik P.
Published: February 2024

Hypertension is the leading cause of cardiovascular disease in women, and sub-Saharan African (SSA) countries have some of the highest rates of hypertension in the world. Expanding knowledge of causes, management, and awareness of hypertension and its co-morbidities worldwide is an effective strategy to mitigate its harms, decrease morbidities and mortality, and improve individual quality of life. Hypertensive disorders of pregnancy (HDPs) are a particularly important subset of hypertension, as pregnancy is a major stress test of the cardiovascular system and can be the first instance in which cardiovascular disease is clinically apparent. In SSA, women experience a higher incidence of HDP compared with other African regions. However, the region has yet to adopt treatment and preventative strategies for HDP. This delay stems from insufficient awareness, lack of clinical screening for hypertension, and lack of prevention programs. In this brief literature review, we will address the long-term consequences of hypertension and HDP in women. We evaluate the effects of uncontrolled hypertension in SSA by including research on heart disease, stroke, kidney disease, peripheral arterial disease, and HDP. Limitations exist in the number of studies from SSA; therefore, we will use data from countries across the globe, comparing and contrasting approaches in similar and dissimilar populations. Our review highlights an urgent need to prioritize public health, clinical, and bench research to discover cost-effective preventative and treatment strategies that will improve the lives of women living with hypertension in SSA.
S-Nitrosylation of Septin2 Exacerbates Aortic Aneurysm and Dissection by Coupling the TIAM1-RAC1 Axis in Macrophages
Authors: Zhang Yan , Zhang Hao , Zhao Shuang , Qi Zhenhua , He Yiwei , Zhang Xuhong , Wu Wencheng , Yan Ke , Hu Lulu , Sun Shixiu , Tang Xinlong , Zhou Qing , Chen Feng , Gu Aihua , Wang Liansheng , Zhang Zhiren , Yu Bo , Wang Dongjin , Han Yi , Xie Liping , Ji Yong
Published: February 2024

BACKGROUND:

S-Nitrosylation (SNO), a prototypic redox-based posttranslational modification, is involved in cardiovascular disease. Aortic aneurysm and dissection are high-risk cardiovascular diseases without an effective cure. The aim of this study was to determine the role of SNO of Septin2 in macrophages in aortic aneurysm and dissection.

METHODS:

Biotin-switch assay combined with liquid chromatography–tandem mass spectrometry was performed to identify the S-nitrosylated proteins in aortic tissue from both patients undergoing surgery for aortic dissection and
Apoe

−/−

mice infused with angiotensin II. Angiotensin II–induced aortic aneurysm model and β-aminopropionitrile–induced aortic aneurysm and dissection model were used to determine the role of SNO of Septin2 (SNO-Septin2) in aortic aneurysm and dissection development. RNA-sequencing analysis was performed to recapitulate possible changes in the transcriptome profile of SNO-Septin2 in macrophages in aortic aneurysm and dissection. Liquid chromatography–tandem mass spectrometry and coimmunoprecipitation were used to uncover the TIAM1-RAC1 (Ras-related C3 botulinum toxin substrate 1) axis as the downstream target of SNO-Septin2. Both R-Ketorolac and NSC23766 treatments were used to inhibit the TIAM1-RAC1 axis.

RESULTS:

Septin2 was identified S-nitrosylated at cysteine 111 (Cys111) in both aortic tissue from patients undergoing surgery for aortic dissection and
Apoe

−/−

mice infused with Angiotensin II. SNO-Septin2 was demonstrated driving the development of aortic aneurysm and dissection. By RNA-sequencing, SNO-Septin2 in macrophages was demonstrated to exacerbate vascular inflammation and extracellular matrix degradation in aortic aneurysm. Next, TIAM1 (T lymphoma invasion and metastasis-inducing protein 1) was identified as a SNO-Septin2 target protein. Mechanistically, compared with unmodified Septin2, SNO-Septin2 reduced its interaction with TIAM1 and activated the TIAM1-RAC1 axis and consequent nuclear factor-κB signaling pathway, resulting in stronger inflammation and extracellular matrix degradation mediated by macrophages. Consistently, both R-Ketorolac and NSC23766 treatments protected against aortic aneurysm and dissection by inhibiting the TIAM1-RAC1 axis.

CONCLUSIONS:

SNO-Septin2 drives aortic aneurysm and dissection through coupling the TIAM1-RAC1 axis in macrophages and activating the nuclear factor-κB signaling pathway–dependent inflammation and extracellular matrix degradation. Pharmacological blockade of RAC1 by R-Ketorolac or NSC23766 may therefore represent a potential treatment against aortic aneurysm and dissection.
Role of Neuron-Specific Enolase, D-Dimer and C-Reactive Protein in the Cranial Nerve Injury After Surgery of Posterior Fossa Tumor
Authors: Mao Xiuqin , Zhou Aifang , Peng Junqin
Published: February 2024

Cranial nerve injury after posterior cranial fossa tumor surgery (PCFTS) is a common symptom in clinic. Intracranial pressure (ICP) monitoring has been widely used in patients with severe posterior cranial fossa injuries. By establishing a rat model of PCFT, we explore the correlation
between neuron-specific enolase (NSE), D-Dimer (D-D) and C-reactive protein (CRP) and provide the better clinical reference to cranial fossa injury treatment. 30 SD female rats aged 20–22 months; randomly divided them into control groups and experimental groups and experimental rats
were further divided into 12 for moderately increased group (21–40 mmHg) and 8 for severely increased group (>40 mmHg) to measure NSE, D-D, and CRP and analyze their relationship. NSE, DD, and CRP in severely increased group and moderately increased group were significantly higher
than those in control group. NSE (103.69±7.84) μg/L, DD (1.52±0.25) mg/L, CRP (47.63)±8.59) mg/L in severely increased group was significantly higher than moderately increased group (NSE (61.77±30.11) μg/L, DD (0.97± 0.37) mg/L, CRP (30.65±
9.56) mg/L) (P < 0.05). ICP is positively correlated with NSE, DD and CRP (r = 0.775, P = 0.000, intracranial pressure=18.589+0.254NSE; r =0.872, P =0.000, IC=10.564+0.254 DD; r =0.825, P =0.000, ICP = 9.73+0.774CRP). There is a positive
correlation between cranial nerve injury and NSE, D-dimer and CRP after PCFTS. It can be evaluated by detecting the above values to assess the degree of cranial nerve injury so as to predict the patient’s condition.
Machine Learning Estimation of Maximum Vertical Velocity from Radar
Authors: Chase Randy J. , McGovern Amy , Homeyer Cameron R. , Marinescu Peter J. , Potvin Corey K.
Published: February 2024

The quantification of storm updrafts remains unavailable for operational forecasting despite their inherent importance to convection and its associated severe weather hazards. Updraft proxies, like overshooting top area from satellite images, have been linked to severe weather hazards but only relate to a limited portion of the total storm updraft. This study investigates if a machine learning model, namely, U-Nets, can skillfully retrieve maximum vertical velocity and its areal extent from three-dimensional gridded radar reflectivity alone. The machine learning model is trained using simulated radar reflectivity and vertical velocity from the National Severe Storm Laboratory’s convection permitting Warn-on-Forecast System (WoFS). A parametric regression technique using the sinh–arcsinh–normal distribution is adapted to run with U-Nets, allowing for both deterministic and probabilistic predictions of maximum vertical velocity. The best models after hyperparameter search provided less than 50% root mean squared error, a coefficient of determination greater than 0.65, and an intersection over union (IoU) of more than 0.45 on the independent test set composed of WoFS data. Beyond the WoFS analysis, a case study was conducted using real radar data and corresponding dual-Doppler analyses of vertical velocity within a supercell. The U-Net consistently underestimates the dual-Doppler updraft speed estimates by 50%. Meanwhile, the area of the 5 and 10 m s−1 updraft cores shows an IoU of 0.25. While the above statistics are not exceptional, the machine learning model enables quick distillation of 3D radar data that is related to the maximum vertical velocity, which could be useful in assessing a storm’s severe potential.

Significance Statement

All convective storm hazards (tornadoes, hail, heavy rain, straight line winds) can be related to a storm’s updraft. Yet, there is no direct measurement of updraft speed or area available for forecasters to make their warning decisions from. This paper addresses the lack of observational data by providing a machine learning solution that skillfully estimates the maximum updraft speed within storms from only the radar reflectivity 3D structure. After further vetting the machine learning solutions on additional real-world examples, the estimated storm updrafts will hopefully provide forecasters with an added tool to help diagnose a storm’s hazard potential more accurately.
Suppression of Mesoscale Eddy Mixing by Topographic PV Gradients
Authors: Sterl Miriam F. , LaCasce Joseph H. , Groeskamp Sjoerd , Nummelin Aleksi , Isachsen Pål E. , Baatsen Michiel L. J.
Published: February 2024

Oceanic mesoscale eddy mixing plays a crucial role in Earth’s climate system by redistributing heat, salt, and carbon. For many ocean and climate models, mesoscale eddies still need to be parameterized. This is often done via an eddy diffusivity , which sets the strength of turbulent downgradient tracer fluxes. A well-known effect is the modulation of in the presence of background potential vorticity (PV) gradients, which suppresses mixing in the direction of the PV gradients. Topographic slopes can induce such suppression through topographic PV gradients. However, this effect has received little attention, and topographic effects are often not included in parameterizations for . In this study, we show that it is possible to describe the effect of topography on analytically in a barotropic framework, using a simple stochastic representation of eddy–eddy interactions. We obtain an analytical expression for the depth-averaged as a function of the bottom slope, which we validate against diagnosed eddy diffusivities from a numerical model. The obtained analytical expression can be generalized to any constant barotropic PV gradient. Moreover, the expression is consistent with empirical parameterizations for eddy diffusivity over topography from previous studies and provides a physical rationalization for these parameterizations. The new expression helps to understand how eddy diffusivities vary across the ocean, and thus how mesoscale eddies impact ocean mixing processes.

Significance Statement

Large oceanic “whirls,” called eddies, can mix and transport ocean properties such as heat, salt, carbon, and nutrients. Mixing plays an important role for oceanic ecosystems and the climate system. In numerical simulations of Earth’s climate, eddy mixing is typically represented using a simplified expression. However, an effect that is often not included is that eddy mixing is weaker over a sloping seafloor. In most areas of the ocean the bottom slope is steep enough for this effect to be significant. In this study we derive an expression for eddy mixing that accounts for oceanic bottom slopes. The present effort provides a physical basis for eddy mixing over oceanic bottom slopes, justifying their use in climate models.
From Friend to Foe: A Case of Naloxone-Induced Pulmonary Edema
Authors: Ghalayni Ruba , Al Kalaji Bilal , Malik Komal
Published: February 2024

Naloxone, an opioid receptor antagonist, effectively reverses opioid overdose and opioid-induced respiratory depression. A few side effects were reported after naloxone administration, including arrhythmia and pulmonary edema. Although rare, naloxone-induced pulmonary edema can be a severe and sometimes life-threatening complication requiring mechanical ventilation. This condition is predominantly linked to an upsurge in catecholamines after opioid reversal as part of acute withdrawal syndrome, especially seen in patients who chronically use opioids. In this report, we present a case of a 66-year-old patient who developed pulmonary edema following the administration of multiple doses of intravenous and intranasal naloxone for opioid overdose. This case highlights the potential adverse effects associated with naloxone use and discusses how to employ this life-saving medication with minimal side effects.
Association Between Social Vulnerability and SARS-CoV-2 Seroprevalence in Specimens Collected From Commercial Laboratories, United States, September 2021–February 2022
Authors: Benoit Tina J. , Kim Yun , Deng Yangyang , Li Zheng , Harding Lee , Wiegand Ryan , Deng Xiaoyi , Jones Jefferson M. , Ronaldo Iachan , Clarke Kristie E.N.
Published: February 2024

Objective:

We conducted a national US study of SARS-CoV-2 seroprevalence by Social Vulnerability Index (SVI) that included pediatric data and compared the Delta and Omicron periods during the COVID-19 pandemic. The objective of the current study was to assess the association between SVI and seroprevalence of infection-induced SARS-CoV-2 antibodies by period (Delta vs Omicron) and age group.

Methods:

We used results of infection-induced SARS-CoV-2 antibody assays of clinical sera specimens (N = 406 469) from 50 US states from September 2021 through February 2022 to estimate seroprevalence overall and by county SVI tercile. Bivariate analyses and multilevel logistic regression models assessed the association of seropositivity with SVI and its themes by age group (0-17, ≥18 y) and period (Delta: September–November 2021; Omicron: December 2021–February 2022).

Results:

Aggregate infection-induced SARS-CoV-2 antibody seroprevalence increased at all 3 SVI levels; it ranged from 25.8% to 33.5% in September 2021 and from 53.1% to 63.5% in February 2022. Of the 4 SVI themes, socioeconomic status had the strongest association with seroprevalence. During the Delta period, we found significantly more infections per reported case among people living in a county with high SVI (odds ratio [OR] = 2.76; 95% CI, 2.31-3.21) than in a county with low SVI (OR = 1.65; 95% CI, 1.33-1.97); we found no significant difference during the Omicron period. Otherwise, findings were consistent across subanalyses by age group and period.

Conclusions:

Among both children and adults, and during both the Delta and Omicron periods, counties with high SVI had significantly higher SARS-CoV-2 antibody seroprevalence than counties with low SVI did. These disparities reinforce SVI’s value in identifying communities that need tailored prevention efforts during public health emergencies and resources to recover from their effects.
Medicaid Expansion and Health Care Use Among Adults With Asthma and Low Incomes: The Adult Asthma Call-Back Survey
Authors: Qin Xiaoting , Mirabelli Maria C. , Flanders W. Dana , Hsu Joy
Published: February 2024

Objectives:

Asthma disproportionately affects Black people and people with low incomes, but Medicaid expansion (hereinafter, expansion) data on these populations are limited. We investigated health care use among adults with asthma, before and after expansion, and examined whether asthma-related health care use after expansion varied by demographic characteristics.

Methods:

We analyzed data from the 2011-2013 and 2015-2019 Behavioral Risk Factor Surveillance System Adult Asthma Call-Back Survey on participants aged 18-64 years with current asthma and low incomes in 23 US states. We assessed 5 asthma-related outcomes, including medical visits (routine and emergency) and medication use, for expansion and nonexpansion groups. We used t tests to compare weighted percentages and 95% CIs, then performed adjusted difference-in-differences analyses. Secondary analyses stratified data by race, ethnicity, and sex.

Results:

Primary analyses (N = 10 796) found no significant associations between expansion and any outcome. Analyses stratified by race and ethnicity found no significant changes (eg, asthma controller medication use among non-Hispanic Black participants in the expansion group was 24.1% [95% CI, 14.4%-37.5%] in 2011-2013 and 35.5% [95% CI, 27.0%-45.1%] in 2015-2019; P = .13). Use of asthma controller medication increased significantly among non-Hispanic Other participants in the nonexpansion group (2011-2013: 16.0% [95% CI, 9.5%-25.5%]; 2015-2019: 40.2% [95% CI, 25.5%-56.8%]; P = .01). Asthma-related hospitalizations decreased significantly among women in the expansion group: 2011-2013 (7.8%; 95% CI, 5.3%-11.3%) and 2015-2019 (3.5%; 95% CI, 2.5%-4.9%) ( P = .009).

Conclusions:

Investigating factors other than health insurance (eg, social determinants of health) that influence the use of asthma-related health care could advance knowledge of potential strategies to advance health equity for adults with asthma and lower incomes.
Reminiscing about Gerald Keown
Authors: Nogalski James D.
Published: February 2024

This biography of Gerald Keown explores events in his professional and personal life, as well as their frequent particularly Baptist context. Those who knew Gerald Keown recognized the many qualities that made him so impressive: his personal charisma, his thirst for knowledge, his scientific training, his joie de vivre, his commitment to bettering his craft, his Baptist identity, his commitment to historic Baptist principles, such as freedom of conscience and the separation of church and state, and his deep abiding commitment to serving the church local and universal, even after some of the leaders of his own denomination sought to do him harm.
Effect of hybrid strategies on the ballistic response of aramid/ultra-high molecular weight polyethylene woven fabrics
Authors: Zhang Rui , Song Xiao-Tong , Zheng Bing-Qian , Huang Ji-Hu , Deng Jian , Ni Chang-Ye , Zhou Yi , Wang Xin
Published: February 2024

The increasing demand for advanced personal protection systems has motivated a considerable interest in hybrid woven fabrics and textile composites. However, the effectiveness of the combination method of fibers on ballistic performance remains uncertain, leaving the selection of an appropriate hybridization strategy unresolved. This study conducted a thorough comparison of the ballistic responses of hybrid aramid/ultra-high molecular weight polyethylene (UHMWPE) woven fabrics, aiming to provide a comprehensive understanding of the hybridization effects. Specimens with inter-layer, intra-layer, and intra-yarn hybrid configurations were manufactured, and ballistic impact tests were performed via a light-gas gun. The residual velocity, energy absorption, dynamic penetration process, and perforation modes of the hybrid specimens were recorded at two selected impact velocities and then compared with those of non-hybrid specimens. The results demonstrated that the enhancement effect of hybridization varied with hybrid configuration and impact velocity. The interlacing of aramid yarns and UHMWPE yarns in intra-layer hybrid specimens did not promote the breakage of UHMWPE fibers, which was responsible for the inferior ballistic performance. In contrast, inter-layer hybridization and intra-yarn hybridization could overcome the insufficient friction of UHMWPE and the low mechanical properties of aramid, resulting in superior ballistic performance.
Religious Experiences, Expectations of Discrimination, and Distress Among Biracial Christians
Authors: Senger Savannah , Vazquez Veola E.
Published: February 2024

Similar to their monoracial counterparts, Black–White biracial individuals experience negative psychological and social responses to discrimination and racial stigma, including experiencing fears of future discrimination (anticipated discrimination). Extending minority stress theory (MST) to the stigma-related experiences of Christians, a unique subgroup of the biracial population, this study assessed responses to future expectations of multiracial discrimination (FEMD; discrimination based upon biracial status) among a community sample of 199 Black–White biracial Christians. We hypothesized that various religious/spiritual experiences might moderate the association between FEMD and distress. Several moderation analyses were conducted evaluating the role of God-centered self-esteem, communion with God, and church support in moderating the association between FEMD and depression, anxiety, and stress. Church support moderated the association between FEMD and depression and stress in an unexpected direction. As participants’ FEMD increased, they reported more depression and stress symptoms, with more depressive and stress symptoms endorsed at medium and high levels of church support but not at low levels of church support. Furthermore, despite the lack of a moderating role in the association between FEMD and distress variables, communion with God demonstrated a negative association (a small effect) with depression, and God-centered self-esteem showed a negative association with depression (a medium effect) and anxiety (a small effect). Clinical implications and directions for future research are presented.
Primary Malignant Melanoma in the Parotid Gland: A Case Report and Literature Review
Authors: Yan Mengmeng , Duan Sujuan , Du Meixia , Xiao Lishan , Yao Guodong , Ning Chunping
Published: February 2024

Primary melanoma of the parotid gland is an extremely rare and challenging tumor with a poor prognosis, and its ultrasonic characteristics have yet to be reported. This article presents a case of a 77-year-old man with a left parotid mass that was confirmed as a melanoma following surgery. The ultrasonic features of melanoma were examined in detail, with a particular focus on their diagnostic value. Furthermore, we summarized the clinical characteristics, treatment options, and outcomes associated with primary melanoma of the parotid gland based on a thorough analysis of the available literature.
Oropharyngeal Stenosis Caused by Significant Scar Hyperplasia Following Tonsillectomy: A Case Report
Authors: Fan Zhi-Tao , Wang Xue-Xia , Dong Wen-Xin , Qiao Tong , Liu Jing-Rui , Wang Yue-Tang , Liu Chao-Bing
Published: February 2024

Oropharyngeal stenosis (OPS) is a relatively rare long-term complication of tonsillectomy in children, resulting from the narrowing of the upper aerodigestive tract between the soft palate, pharyngeal sidewalls, and base of the tongue. This is the first reported case of OPS due to significant scar hyperplasia; however, whether it is as prone to recurrence as skin scar hypertrophy remains unknown. In this article, we present the case of a 5-year-old girl who presented to our otolaryngology clinic with sleep snoring and suffocation. Her medical history included tonsillectomy and adenoidectomy, performed 3 years prior to presentation. The patient underwent a combination of surgery and administration of triamcinolone injections, resulting in significant symptomatic improvement. To date, no signs of recurrence have been reported.
Assessment of Plastic Waste Modification to Asphalt Materials Using the Wet Process
Authors: Bennert Thomas , Ericson Christopher , Haas Edwin , Wass Edward , Tulanowski Drew , Cytowicz Nicholas
Published: February 2024

In 2017, China passed the National Sword Policy that established a policy to no longer import plastic waste from other countries. Before 2017, China imported approximately 45% of the world’s waste plastic. The had a significant impact on how the U.S.A. and other countries around the world handled the tremendous surplus of plastic waste. Research studies as late as the 1970s demonstrated that plastic may be utilized as an asphalt modifier when properly dosed and controlled, although limited recent data exists utilizing the mixture design and testing procedures of today. A research study was conducted to evaluate three different processed waste plastic materials using a wet process. The wet process is defined as the waste plastic being added and blended with the asphalt binder before addition to the asphalt mixture. The different processed waste plastics were blended at three different dosage rates with conventional and research grade asphalt binder characterization conducted. The asphalt binder testing was used to identify the best waste plastic material and dosage rate that was used in an asphalt mixture design subjected to various asphalt mixture performance tests. The results of the study that the indicated plastic type and dosage rate had a significant impact on performance. Overall, the study showed that certain plastic types will be detrimental to asphalt binder and mixture performance, while others may be used to provide performance improvements.
Domesticating Paralinguistic Digital Affordances in Adolescent Romantic Relationships and Parent-adolescent Relationships: A Relational Perspective
Authors: Feng Yulei
Published: February 2024

Paralinguistic digital affordances (PDAs; e.g., the Like button on social media platforms) are becoming increasingly popular for adolescents to manage online relationships. Domestication theory focuses on the taming process of technological use. To reconsider the approach of domestication in the mediascape with diversified types of relationships, this paper analyzes how Chinese adolescents domesticate the PDAs in romantic relationships and parent-adolescent relationships. Based on focus group discussions and in-depth interviews with 23 Chinese adolescents, this study uses thematic analysis and identifies adolescents’ relational domestication of PDAs in accordance with relationship contexts—relational closeness, relational norms, relational dynamics and relational embeddedness. Specifically, the exchange of PDAs with romantic partners and parents has a sense of closeness. However, the different relationship norms determined that PDAs are differently domesticated in a romantic style or authoritative style in romantic relationships and parent-adolescent relationships. Furthermore, adolescents domesticate the dynamic sense of PDAs in an interactive way. Given the existence of real or imagined audiences, adolescents domesticate PDAs within a larger social network. Implications for understanding how the domestication of PDAs intersects with cultural context are discussed.
Noise and silver nanoparticles induce hepatotoxicity via CYP450/NF-Kappa B 2 and p53 signaling pathways in a rat model
Authors: Belji Kangarlou Marzieh , Khavanin Ali , Nadri Farshad , Goodarzi Zahra , Karami Esmaeil , Rashidy-Pour Ali , Kiani Mehrafarin , Hashemi Habybabady Raheleh
Published: February 2024

Co-exposure to noise and nanomaterials, such as silver nanoparticles (Silver-NPs), is a common occurrence in today’s industries. This study aimed to investigate the effects of exposure to noise and the administration of silver-NPs on the liver tissue of rats. Thirty-six adult male albino Wistar rats were randomly divided into six groups: a control group (administered saline intraperitoneally), two groups administered different doses of Silver-NPs (50 mg/kg and 100 mg/kg, 5 days a week for 28 days), two groups exposed to noise in addition to Silver-NPs (at the same doses as mentioned before), and a group exposed only to noise (104 dB, 6 hours a day, 5 days a week for 4 weeks). Blood samples were taken to assess hepatic-functional alterations, such as serum ALP, ALT, and AST levels. Additionally, biochemical parameters (MDA, GPX, and CAT) and the silver concentration in the liver were measured. Histopathological analysis, mRNA expression (P53 and NF-κB), protein expression (CYP450), and liver weight changes in rats were also documented. The study found that the administration of Silver-NPs and exposure to noise resulted in elevated levels of ALP, ALT, AST, and MDA ( p < .01). Conversely, GPX and CAT levels decreased in all groups compared with the control group ( p < .0001). There was a significant increase ( p < .05) in liver weight and silver concentration in the liver tissues of groups administered Silver-NPs (50 mg/kg) plus noise exposure, Silver-NPs (100 mg/kg), and Silver-NPs (100 mg/kg) plus noise exposure, respectively. The expression rate of P53, NF-κB, and cytochromes P450 (CYPs-450) was increased in the experimental groups ( p < .05). These findings were further confirmed by histopathological changes. In conclusion, this study demonstrated that exposure to noise and the administration of Silver-NPs exacerbated liver damage by increasing protein and gene expression, causing hepatic necrosis, altering biochemical parameters, and affecting liver weight.
Increasing the Rate of Venous Thromboembolism Chemoprophylaxis Administration Using the Electronic Medical Record
Authors: Pollock Aaron B. , Harrell Kevin N. , Miles M. Victoria P. , Garrett Emily S. , Carter Breanna L. , Maxwell Robert A.
Published: February 2024

Introduction: Venous thromboembolism (VTE) remains a leading cause of preventable harm among hospitalized patients. Pharmacologic VTE prophylaxis reduces the rate of in-hospital VTE by 60%, but medication administration is often missed for various reasons. Electronic medical record (EMR) prompts may be a useful tool to decrease withholding of critical VTE chemoprophylaxis medications. Methods: In August 2021, an EMR prompt was implemented at a tertiary referral academic medical center mandating nursing staff to contact a provider for approval before withholding VTE chemoprophylaxis. A pre-intervention group from August 2020 to August 2021 was compared to a post-intervention group from August 2021 to August 2022. Rates of VTE chemoprophylaxis withholding were compared between the groups with a P < .01 considered significant. Results: A total of 16,395 patients prescribed VTE chemoprophylaxis were reviewed, with 13,395 (81.7%) receiving low molecular weight heparin. Of the 16,395 patients included, 10,701 (65.3%) were medical and 5694 (34.7%) were surgical. Patients in the pre-intervention cohort (n = 8803) and post-intervention cohort (n = 7592) were similar in hospital length of stay and duration of DVT prophylaxis. In the post-intervention group, the frequency of surgical patients with at least one missed dose had increased by 4.2% ( P = .002), with the trauma and acute care surgery (TACS) show an increase of 6.6% ( P < .001). However, the frequency of medical patients and non-TACS patients with missed doses decreased by 3.1% ( P = .002) and 1.0% (<.001), respectively. Conclusions: EMR prompts appear to be a low-cost intervention that increases the rate of VTE prophylaxis administration among medical and elective surgery patients.
Exploring Barriers and Facilitators for Human Milk Donation and Acceptance Among Donors and Recipients
Authors: Chaudhari Vaishali , Aiyer Sheila
Published: February 2024

Background

There is no ideal alternative to mother’s own milk. In circumstances where an alternative is required, donated human milk is the best available option. To promote the establishment of more human milk banks, it is necessary to know the current attitude and awareness of the general population toward human milk donation as well as its acceptance.

Methods

This is a qualitative study including focused group discussions and in-depth interviews.

Results

Major barriers found to the donation of milk were fear of the insufficient amount of milk remaining for her baby, inconvenience due to stitch pain after lower segment caesarean section, not willing for pre-donation laboratory testing, the donation process being time-consuming, misconceptions like fear of disease transmission, and so on. Factors facilitating milk donation were breast engorgement and altruism. The facilitator for the acceptance of donated human milk was the belief that donated human milk was the best available option at that time. Barriers to acceptance of donated milk were fear of transmission of infections, prevalent misconceptions about donated human milk, and a lack of awareness regarding the process of pasteurization.

Conclusion

Barriers to the donation of milk are related to inadequate knowledge, fear, and low awareness regarding human milk banking. Most mothers were encouraged to donate milk due to excess milk. A lack of knowledge about the process of pasteurization appears to be a significant barrier to the acceptance of donated milk. Pasteurized donated milk, being the only available superior option, made donated milk acceptable among the recipient’s relatives.
Lived Experiences Among Critically Ill and Near-Death Survivors Relating to the COVID-19 Infection: A Phenomenological Study
Authors: Kusoom Wichitra , Krongyuth Sununta
Published: February 2024

Introduction:

The COVID-19 pandemic has resulted in severe illnesses worldwide. Around 655.5 million cases were having been confirmed, including 6.6 million deaths. The extreme cases experienced near death in the intensive care unit (ICU). This study explored the survivors’ experience of being near death while critically ill with the infection.

Methodology:

A descriptive phenomenological study was employed. Data were collected through in-depth interviews with 14 participants from Northeastern Thailand. Content analysis was applied by using Creswell’s strategy.

Results:

Four themes emerged: (a) anxiety and fear of dying alone, (b) environmental chaos, (c) using Thai Buddhist teaching in coping, and (d) returning from the brink of death. Moreover, the patients felt great gratitude and were grateful to the health care team.

Discussion:

Traumas experienced by patients in the ICU included physical and psychological distress, coping strategies, and an understanding of cultural awareness.

Conclusion:

Psychological and culturally congruent care should be implemented for patients in the ICU.
Associations of Career Decision-Making Strategies With Career Decision-Making Self-Efficacy and Difficulties Among French-Speaking Swiss Adolescents and Young Adults
Authors: Levin Nimrod , Masdonati Jonas , Castella Pauline , Grassi Elodie
Published: February 2024

Individuals differ in the strategies, self-efficacy beliefs, and difficulties that characterize their career decision-making process. Although some strategies are deemed adaptive, the differential links of career decision-making strategies to self-efficacy and difficulties, in general and in various cultural contexts, remain unclear. To address this issue, we investigated the associations of 12 career decision-making strategies with self-efficacy and difficulties among 414 adolescents and young adults in the cultural context of the French-speaking part of Switzerland. In doing so, we also sought to develop a French version of the Career Decision-Making Profiles questionnaire (CDMP-F) for assessing career decision-making strategies. Results confirmed the fit of the hypothesized 12-factor model underlying the CDMP-F and the adaptability assumption for six of 12 strategies: information gathering, locus of control, procrastination, speed of making the final decision, dependence on others, and desire to please others. Moreover, differentiated associations were uncovered: high procrastination and external locus of control were linked to lack of motivation; slow speed of making the final decision was linked to general indecisiveness; and high desire to please others was linked to external conflicts. Supporting the structural and construct validity of the CDMP-F and identifying differential associations, implications for research and practice are discussed.
Does anticoagulation in combination with immunosuppressive therapy prevent recurrent thrombosis in Behçet’s disease?
Authors: Erol Serhat , Gürün Kaya Aslıhan , Arslan Fatma , Hasanzade Hasan , Daştan Ahmet Onur , Çiledağ Aydın , Eriş Gülbay Banu , Kaya Akın , Özdemir Kumbasar Özlem , Çelik Gökhan , Acıcan Turan
Published: February 2024

Vascular involvement in Behçet’s disease (BD) occurs in up to 50% of patients. The main mechanism of thrombosis is inflammation. Thus, immunosuppressants (IS) are the mainstay of therapy, and adding anticoagulation (AC) is controversial. In daily practice, we observed that patients who received AC in combination with IS experienced less recurrent thrombosis and decided to investigate our BD patients retrospectively. We hypothesized that adding AC to immunosuppressive therapy may lower the risk of recurrent thrombosis. Treatment at the time of first or recurrent thrombotic events was recorded. Events under the only IS and IS + AC treatments were compared. There were 40 patients (33 males). The most common types of first vascular events were deep vein thrombosis (77.5%) followed by pulmonary embolism (PE) (52.5%). One patient did not receive any treatment. Among the 39 patients, 32 received glucocorticoid and at least one of the azathioprine, or cyclophosphamide, anti-TNF, 5 received monotherapy with azathioprine, 1 received monotherapy with corticosteroid, and the remaining 1 received monotherapy with cyclophosphamide. In total, 22 patients (55%) experienced 27 recurrent venous thromboembolism (VTE) events. Two (7.4%) events while only on AC, 2 (7.4%) events while on AC + IS, and 15 (55.5%) events occurred while on only IS. Eight (19.6%) patients were not receiving any treatment during relapses. The recurrence rate was statistically significantly lower in the IS + AC treatment group compared to IS alone. In conclusion, IS are the mainstay of treatment for BD, and adding AC may help to lower the recurrence risk of thrombotic events.