bluuebunny/crossref_metadata_2025 huggingface dataset:
The antiplasmodial activity of the carboxylic acid metabolite of piperaquine and its pharmacokinetic profiles in healthy volunteers
Authors: Liu Huixiang , Zhou Hongchang , Xing Jie
Published: November 2023

Background

The long-acting antimalarial drug piperaquine can be metabolized into the carboxylic acid metabolite (PQM). However, the clinical relevance of PQM remains unclear.

Objectives

The pharmacodynamics/pharmacokinetics of PQM were studied.

Methods

The antimalarial activity of PQM was studied in vitro (Plasmodium strains Pf3D7 and PfDd2) and in vivo (murine Plasmodium yoelii). The toxicity of PQM was evaluated in mice, in terms of the general measures of animal well-being, serum biochemical examination and ECG monitoring. The pharmacokinetic profiles of piperaquine and its metabolite PQM were investigated in healthy subjects after recommended oral doses of piperaquine.

Results

PQM showed no relevant in vitro antimalarial activity (IC50 > 1.0 μM) with no significant toxicity. After recommended oral administration of piperaquine to healthy subjects, the maximum concentration of PQM was less than 30.0 nM, and it did not accumulate after repeated dosing.

Conclusions

With a low antimalarial potency, PQM should not contribute to the efficacy of piperaquine with clinically acceptable doses.
Species assemblage, abundance, and distribution of Phytoseiid mites (Parasitiformes: Phytoseiidae) in Citrus Under Protective Screen
Authors: Demard Emilie P , Döker Ismail , Qureshi Jawwad A
Published: November 2023

Citrus Under Protective Screen (CUPS) production system excludes the Asian citrus psyllid (ACP), Diaphorina citri Kuwayama, vector of Huanglongbing (HLB), and large predators. However, small pests and beneficial arthropods such as predatory mites may enter the CUPS. Predatory mites from the family Phytoseiidae attack several economically important pests, especially phytophagous mites common in CUPS. The species assemblage, abundance, and distribution of phytoseiid mites in CUPS and open-air (control) were investigated in Ray Ruby grapefruit from 2018 to 2020. Foliar sprays of chemicals for pest suppression were used in both systems and evaluated for effect on predatory mite populations. In the 2 production systems, a significant peak in the phytoseiid mite population was observed in February 2019 and 2020. This increase coincided with the blooming period of grapefruit, which likely provided pollen as an alternative food. A total of 2,234 specimens of 11 species were identified. Amblyseius tamatavensis Blommers and Typhlodromalus peregrinus (Muma) were dominant in both systems. Amblyseius tamatavensis was slightly more abundant in CUPS (50% of total specimens) than T. peregrinus (47%), while T. peregrinus was prevalent (82%) in open-air compared with A. tamatavensis (16%). Shannon index and evenness were significantly higher in CUPS, but species richness was similar. Chlorpyrifos with abamectin and oil, cyantraniliprole with spirodiclofen, copper, and oil as well as pyridaben alone reduced phytoseiid populations between 87% and 96%. Fenbutatin oxide mixed with copper reduced phytoseiids by 48% in open-air only. Our results demonstrate phytoseiid survival, reproduction, and contribution to biological control in CUPS, despite high temperature and humidity.
Investigation of eligibility for adjuvant therapy from real-world data of patients with urothelial carcinoma undergoing radical cystectomy and radical nephroureterectomy
Authors: Matsue Taisuke , Kato Minoru , Kosugi Yuki , Ishizaki Kota , Masuda Hiroo , Yamamoto Shoma , Takeyama Yuji , Yukimatsu Nao , Otoshi Taiyo , Yamasaki Takeshi , Kuratsukuri Katsuyuki , Uchida Junji
Published: November 2023

Objective

Adjuvant nivolumab prolonged disease-free survival compared with placebo in patients at high risk of recurrence following radical cystectomy or radical nephroureterectomy in the CheckMate 274 trial. However, the ideal eligibility criteria for adjuvant therapy in real-world clinical practice remain controversial.

Methods

We retrospectively analyzed clinical data of 409 patients who underwent radical cystectomy (n = 252) or radical nephroureterectomy (n = 157) and validated the risk of recurrence based on the classification used in the CheckMate 274 trial. We also investigated the impact of perioperative chemotherapy, lymph node dissection and pathological factors on prognosis.

Results

The median follow-up time was 37.5 and 32.1 months in bladder cancer and upper tract urothelial carcinoma, respectively. Among the high-risk patients based on CheckMate 274 trial, disease-free survival was considerably shorter for bladder cancer and upper tract urothelial carcinoma patients than for low-risk patients (hazard ratios: 4.132 and 7.101, respectively). The prevalence of adjuvant chemotherapy in high-risk patients was low (24 and 38% for bladder cancer and upper tract urothelial carcinoma, respectively). The extent of lymph node dissection in bladder cancer and presence of lymph node dissection in upper tract urothelial carcinoma did not affect prognosis. Cox proportional multivariate analysis revealed CheckMate 274-high-risk as a poor prognostic factor in bladder cancer and upper tract urothelial carcinoma.

Conclusions

This study validated the risk classification for recurrence following radical cystectomy and radical nephroureterectomy using the CheckMate 274 criteria in real-world practice. Further research would help assess the degree of benefit obtained from adjuvant nivolumab.
Exercise training improves long-term memory in obese mice
Authors: Fuller Oliver K , Egan Casey L , Robinson Tina L , Perera Nimna , Latchman Heidy K , Terry Lauren V , McLennan Emma D , Chavez Carolina , Burrows Emma L , Scott John W , Murphy Robyn M , van Praag Henriette , Whitham Martin , Febbraio Mark A
Published: November 2023

Obesity has been linked to a range of pathologies, including dementia. In contrast, regular physical activity is associated with the prevention or reduced progression of neurodegeneration. Specifically, physical activity can improve memory and spatial cognition, reduce age-related cognitive decline, and preserve brain volume, but the mechanisms are not fully understood. Accordingly, we investigated whether any detrimental effects of high-fat diet (HFD)-induced obesity on cognition, motor behavior, adult hippocampal neurogenesis, and brain-derived neurotrophic factor (BDNF) could be mitigated by voluntary exercise training in male C57Bl/6 mice. HFD-induced impairment of motor function was not reversed by exercise. Importantly, voluntary wheel running improved long-term memory and increased hippocampal neurogenesis, suggesting that regular physical activity may prevent cognitive decline in obesity.
Force Health Surveillance in NATO Does Not Meet the Needs of Its Users: A Structured Evaluation of EpiNATO-2
Authors: Rowh Adam , Lindfield Robert , Gaines Joanna
Published: November 2023

Introduction

Disease and non-battle injuries (DNBIs) cause substantial losses among military personnel. NATO has monitored DNBIs among its personnel since 1996 using multiple versions of a tool now called EpiNATO-2, but the surveillance system has never been systematically evaluated. Following a request from NATO to the CDC, the objective of this study was to assess surveillance system attributes of EpiNATO-2 using CDC’s updated guidelines for evaluating public health surveillance systems.

Materials and Methods

Between June and October 2022, a literature review and key informant interviews were conducted to assess the following attributes: usefulness, simplicity, flexibility, data quality, acceptability, sensitivity, positive predictive value, representativeness, timeliness, stability, informatics system quality, informatics service quality, and informatics interoperability. Key informant interviews were conducted in Kosovo, Germany, and remotely with EpiNATO-2 users spanning three levels: clinical and data entry personnel (tactical level); regional medical and public health officers (operational level); and senior commanders and other governmental entities (strategic level).

Results

Fourteen EpiNATO-2 users participated in interviews, representing 3 of the 5 major NATO missions, 3 partner entities, and 7 nationalities. All users (100%) reported that the system did not meet their needs, with most users noting the following challenges: lack of clearly defined system objectives; poor data quality due to ambiguous case definitions and frequently unsubmitted reports (37% missing during January to June 2022); long delay between the occurrence of health events and the availability of corresponding data (≥2 weeks); and an antiquated and inflexible data management system. Overall, performance was deemed unsatisfactory on 11 of the 13 attributes.

Conclusions

This multinational sample of EpiNATO-2 users at all military levels reported that the system is currently not useful with respect to its stated objectives. Opportunities exist to improve the performance and usefulness of EpiNATO-2: improve case definitions, modernize data infrastructure, and regularly evaluate the surveillance system.
spright: a probabilistic mass–density–radius relation for small planets
Authors: Parviainen Hannu , Luque Rafael , Palle Enric
Published: November 2023

We present spright, a python package that implements a fast and lightweight mass–density–radius relation for small planets. The relation represents the joint planetary radius and bulk density probability distribution as a mean posterior predictive distribution of an analytical three-component mixture model. The analytical model, in turn, represents the probability for the planetary bulk density as three generalized Student’s t-distributions with radius-dependent weights and means based on theoretical composition models. The approach is based on Bayesian inference and aims to overcome the rigidity of simple parametric mass–radius relations and the danger of overfitting of non-parametric mass–radius relations. The package includes a set of pre-trained and ready-to-use relations based on two M-dwarf catalogues, one catalogue containing stars of spectral types F, G, and K (FGK stars), and two theoretical composition models for water-rich planets. The inference of new models is easy and fast, and the package includes a command line tool that allows for coding-free use of the relation, including the creation of publication-quality plots. Additionally, we study whether the current mass and radius observations of small exoplanets support the presence of a population of water-rich planets positioned between rocky planets and sub-Neptunes. The study is based on Bayesian model comparison and shows somewhat strong support against the existence of a water-world population around M dwarfs. However, the results of the study depend on the chosen theoretical water-world density model. A more conclusive result requires a larger sample of precisely characterized planets and community consensus on a realistic water-world interior structure and atmospheric composition model.
Subhalo effective density slope measurements from HST strong lensing data with neural likelihood-ratio estimation
Authors: Zhang Gemma , Şengül Atınç Çağan , Dvorkin Cora
Published: November 2023

Examining the properties of subhaloes with strong gravitational lensing images can shed light on the nature of dark matter. From upcoming large-scale surveys, we expect to discover orders of magnitude more strong lens systems that can be used for subhalo studies. To optimally extract information from a large number of strong lensing images, machine learning provides promising avenues for efficient analysis that is unachievable with traditional analysis methods, but application of machine learning techniques to real observations is still limited. We build upon previous work, which uses a neural likelihood-ratio estimator, to constrain the effective density slopes of subhaloes and demonstrate the feasibility of this method on real strong lensing observations. To do this, we implement significant improvements to the forward simulation pipeline and undertake careful model evaluation using simulated images. Ultimately, we use our trained model to predict the effective subhalo density slope from combining a set of strong lensing images taken by the Hubble Space Telescope. We found the subhalo slope measurement of this set of observations to be steeper than the slope predictions of cold dark matter subhaloes. Our result adds to several previous works that also measured high subhalo slopes in observations. Although a possible explanation for this is that subhaloes with steeper slopes are easier to detect due to selection effects and thus contribute to statistical bias, our result nevertheless points to the need for careful analysis of more strong lensing observations from future surveys.
Orthopaedic surgery residency program ranking and the current state of leadership: what are the characteristics of the leaders in the “Top-tier” programs?
Authors: Huyke-Hernández Fernando A. , Doxey Stephen A. , Qian Lily J. , Cunningham Brian P.
Published: November 2023

Background:

Orthopaedic surgery residency program ranking and leadership can influence applicant and program decision-making. The study objective was to evaluate the relationship between program rankings and characteristics of their leadership.

Methods:

The Accreditation Council for Graduate Medical Education, Doximity, and program-specific websites were queried, identifying 193 programs and 426 leaders for analysis. Leadership positions evaluated included: Chairs, Vice Chairs, Program Directors, and Assistant Program Directors. Residency programs were categorized into tiers based on 2022-2023 Doximity reputation ranking. Program ranking was stratified as follows: Tier 1 (rank 1-50, highest-ranking programs), Tier 2 (rank 51-100), Tier 3 (rank 101-150), and Tier 4 (rank 151-201, lowest-ranking programs). Leaders were described according to demographics, training, research productivity, and experience.

Results:

A total of 426 leaders at 193 programs were included. The average number of leadership positions per program was 2.2±1.0. Higher-tier programs had more leadership positions and were more likely to have chairpeople (P<0.001). They also had a larger proportion of women leaders (P=0.023), although only 11.2% of leaders overall were women. Residency training outside the US did not vary across tiers (P=0.881). Higher-tier leaders were more likely to complete fellowship (P<0.001) and specialize in pediatrics, oncology, and spine (P<0.032), although trauma was the most common specialty among leaders regardless of ranking. Program rank correlated strongly with program size (number of residents) (r2=−0.69) and weakly with leadership h-index (r2=−0.33) and research documents (r2=−0.40). Rank did not correlate with years in practice (r2=0.06), years until attaining a leadership position (r2=0.06), or years in present leadership position (r2=0.07).

Conclusions:

Program ranking correlated with the number of leaders and residents, as well as research productivity, but not with years of experience or training within the US. Top-tier programs have a higher proportion of women leaders, although the overall number is still low.
The Relationship Between Manifestation of Diabetes Insipidus and Estimated Glomerular Filtration Rate in Brain Death
Authors: Varelas Panayiotis N. , Kananeh Mohammed , Brady Paul , Holden Devin , Mehta Chandan , Ata Ashar , Abdelhak Tamer , Greer David , Rehman Mohammed
Published: November 2023

OBJECTIVES:

Systematic reviews have revealed that up to 50% of patients with brain death have residual hypothalamic/pituitary activity based on the absence of central diabetes insipidus (DI). We hypothesized that different degrees of renal dysfunction may impact the presence of DI in patients with brain death.

DESIGN:

Single-center prospective data collection.

SETTING:

ICUs in a tertiary academic hospital.

PATIENTS:

All adult patients declared brain dead over 12 years.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

DI was diagnosed by polyuria, low urine specific gravity, and increasing serum sodium, measured in close proximity. Renal function was assessed by the estimated glomerular filtration rate (eGFR), calculated using the simplified modification of diet in renal disease equation. Analysis was completed in 192 of 234 patients with brain death after excluding those with missing data, those younger than 18 years and those on vasopressin infusions. One hundred twenty-two patients (63.5%) developed DI and 70 patients (36.5%) did not. The proportion of DI decreased significantly with decreasing eGFR: for eGFR greater than 60 mL/min, DI was present in 77.2%; for eGFR 15–60 mL/min, DI was present in 54.5%; for eGFR 14.9–9.8 mL/min, DI was present in 32%; none of the 14 patients with eGFR less than or equal to 9.7 mL/min ever experienced DI (p < 0.001). Using logistic regression, for every 10 mL/min decrease in eGFR, the odds of DI decreased 0.83 times (95% CI, 0.76–0.90, p < 0.001).

CONCLUSIONS:

Renal dysfunction significantly impacts DI’s clinical manifestation in brain death. We report that patients who experience brain death with severe renal dysfunction may not develop clinical signs of DI.
Pulmonary Artery Stenosis in Tetralogy of Fallot
Authors: Gao Botao
Published: November 2023

Tetralogy of Fallot (TOF) is the most common cyanotic congenital cardiac defect. The survival rate after primary complete repair is high (98–100%); however, pulmonary artery stenosis (PAS) is not uncommon after TOF repair, and severe PAS aggravates pulmonary regurgitation, resulting in right ventricle dilation, ventricular arrhythmia, and possibly death. PAS in TOF can be congenital due to hypoplasia or coarctation or can be acquired secondary to a surgical procedure. The latter may be caused by an exogenous conduit implant, compression from the adjacent enlarged ascending aorta, or outflow tract dilation after transannular patch repair. PAS can also be caused by the pulmonary artery plasty strategy itself. Here, the intrinsic mechanisms underlying PAS and pulmonary artery plasty techniques and strategies are reviewed to provide guidance for surgeons.
Review of the Etiology, Diagnosis, Classification, and Therapy of Right Heart Thrombi
Authors: Feldman Jared M. , Frishman William H. , Aronow Wilbert S.
Published: November 2023

Right heart thrombi are a rare phenomenon associated with high mortality rates and embolization to the pulmonary bed. Diagnostic modalities include transthoracic echocardiography, contrast-enhanced echocardiography, and cardiac magnetic resonance imaging. Several treatment options for right ventricular thrombus have been described in case reports and observational studies including anticoagulation, thrombolysis, catheter-based procedures, and surgical embolectomy. Various studies have demonstrated that thrombolysis and surgical embolectomy have better survival outcomes than anticoagulation alone. Present management strategies are supported by observational studies, and further research is needed to guide therapy.
Survey of Surgeon-reported Postoperative Protocols for Deep Inferior Epigastric Perforator Flap in Breast Reconstruction
Authors: Araya Sthefano , Hackley Madison , Amadio Grace M. , Deng Mengying , Moss Civanni , Reinhardt Eliann , Walchak Adam , Tecce Michael G. , Patel Sameer A.
Published: November 2023

Background:

The use of deep inferior epigastric perforator (DIEP) flaps is a well-established breast reconstruction technique.

Methods:

A 29-question survey was e-mailed to 3186 active American Society of Plastic Surgeons members, aiming to describe postoperative monitoring practice patterns among surgeons performing DIEP flaps.

Results:

From 255 responses (8%), 79% performing DIEP surgery were analyzed. Among them, 34.8% practiced for more than 20 years, 34.3% for 10–20 years, and 30.9% for less than 10 years. Initial 24-hour post-DIEP monitoring: intensive care unit (39%) and floor (36%). Flap monitoring: external Doppler (71%), tissue oximetry (41%), and implantable Doppler (32%). Postoperative analgesia: acetaminophen (74%), non-steroidal anti-inflammatory drugs (69%), neuromodulators (52%), and opioids (4.4%) were administered on a scheduled basis. On postoperative day 1, 61% halt intravenous fluids, 67% allow ambulation, 70% remove Foley catheter, and 71% start diet. Most surgeons discharged patients from the hospital on postoperative day 3+. Regardless of experience, patients were commonly discharged on day 3. Half of the surgeons are in academic/nonacademic settings and discharge on/after day 3.

Conclusions:

This study reveals significant heterogeneity among the practice patterns of DIEP surgeons. In light of these findings, it is recommended that a task force be convened to establish standardized monitoring protocols for DIEP flaps. Such protocols have the potential to reduce both the length of hospital stays and overall care costs all while ensuring optimal pain management and vigilant flap monitoring.
Effectiveness of Tranexamic Acid in the Postoperative Period in Body Contour Surgery: Randomized Clinical Trial
Authors: Bayter-Marín Jorge Enrique , Hoyos Alfredo , Cárdenas-Camarena Lázaro , Peña-Pinzón William , Bayter-Torres Andrés Felipe , Díaz-Díaz Carlos Andrés , McCormick-Méndez Mauricio , Plata-Rueda Erika Liliana , Niño-Carreño Claudia Stella
Published: November 2023

Background:

Tranexamic acid (TXA) is used to reduce bleeding in body contouring procedures; however, there are no studies that show the effectiveness of TXA when it is also used in the immediate postoperative period.

Methods:

A controlled, randomized, parallel, and open-label clinical trial was carried out in adult patients undergoing liposculpture and/or abdominoplasty. A control group administering presurgical TXA and a study group with presurgical and postsurgical TXA were formed. The decrease in hemoglobin and the incidence of blood transfusions between both groups were compared as well as the possible adverse effects of TXA.

Results:

Four hundred twenty-seven subjects were included, 208 (48.7%) in the control group and 219 (51.3%) in the study group. The median age was 34 years (interquartile range 28–42). Median postoperative hemoglobin levels at 24 hours were similar in both groups (study 11.3 g/dL versus control 11.1 g/dL, P = 0.07); however, at 72 hours, postoperative hemoglobin was higher in the study group versus control (10.8 versus 10.0 g/dL, P ≤ 0.001). The incidence of transfusions at 72 hours was 1.8% in the study group and 8.6% in the control group, for a risk ratio of 0.21 (95% confidence interval 0.07–0.61). There were no adverse or thromboembolic events.

Conclusion:

TXA proved to be more effective in reducing intra- and postsurgical bleeding and the need for transfusions, when used preoperatively and continued for 48 hours after surgery, than when used only preoperatively, without reporting adverse or thromboembolic effects.
Association of work-related psychosocial factors and day-to-day home blood pressure variation: the Finn-Home study
Authors: Karelius Saana , Pentti Jaana , Juhanoja Eeva , Jula Antti , Koskinen Seppo , Niiranen Teemu J. , Stenholm Sari
Published: November 2023

Objectives:

Stress, and particularly job strain, has been found to associate with ambulatory blood pressure (BP). Moreover, BP is known to vary between days. One potential over-looked factor underlying this day-to-day BP variation could be work-related psychosocial factors. Thus, we aimed to study the association between job strain, job demands, job control and day-to-day BP variation.

Methods:

The home BP of 754 regularly working participants (mean age 50.9 ± 4.8, women 51%) of the Finn-Home Study was measured twice in the morning and twice in the evening over seven days. Average SBP and DBP were calculated for each day. Work-related psychosocial factors were measured with survey. Multivariable-adjusted generalized linear models were used for statistical analysis.

Results:

We found a greater SBP/DBP decrease between weekdays and weekend among participants with high job strain (-1.8 [95% confidence interval, 95% CI, -2.7 to -0.8]/-1.7 [95% CI, -2.3 to -1.1] mmHg) compared to participants with low job strain (-0.7 [95% CI, -1.1 to -0.2]/-0.7 [95% CI, -1.0 to -0.4] mmHg). The participants with high job demands showed a higher BP decrease between weekdays and weekend (-1.4 [95% CI, -2.0 to -0.8]/-1.3 [95% CI, -1.6 to -0.9] mmHg) than the participants with low job demands (-0.5 [95% CI, -1.1 to 0.0]/-0.6 [95% CI, -1.0 to -0.3] mmHg). We did not find BP differences regarding job control.

Conclusion:

High job strain and high job demands were associated with a greater BP reduction from weekdays to the weekend. Work-related psychosocial factors should be considered when assessing day-to-day BP variation.
The Effect of Reiki Intervention on Fatigue and Anxiety in Hemodialysis Patients
Authors: Buyukbayram Genc Zeliha , Citlik Saritas Seyhan
Published: November 2023

This study was conducted to investigate the effects of Reiki on fatigue and anxiety in hemodialysis patients. This study was designed as a randomized controlled study. The population of the study consisted of hemodialysis patients at the hemodialysis clinic of Siirt State Hospital, Turkey, between January and August 2021. The patients were divided into 2 groups: Reiki and control, with 30 patients in each group. The patients in the Reiki group underwent their respective interventions once a day for 4 consecutive weeks (30-35 minutes). The intervention of Reiki reduced fatigue and anxiety in the hemodialysis patients.
Surgical Treatment of Vascular Anomalies in the Extremities: A Single Surgeon Experience
Authors: Rodriguez Colon Ricardo , Cripps Courtney , Blei Francine , Sharma Sheel
Published: November 2023

Objective:

The literature on surgical management of vascular anomalies has primarily focused on the head and neck area, while studies of anomalies on the extremities have typically included larger and more dramatic clinical presentations. In this article, we aim to present our experience with surgical management of smaller symptomatic anomalies of the extremities.

Methods:

We performed a retrospective review of a single surgeon’s experience at a large academic center on patients from January 2013 to March 2022. We collected data on patient demographics, past medical and surgical history, operative dictations, clinic notes, and postoperative follow-up. Included patients were required to have confirmed vascular anomalies based on final pathology reports.

Results:

A total of 47 patients underwent a total of 50 procedures, with 2 patients experiencing recurrence requiring repeat operative management. Our cohort had average age (standard deviation) of 27.16 (18.67). Sixteen patients had prior history of vascular anomalies upon presentation to our institution. The majority of lesions were located in a digit of the hand, the arm, or the foot. On surgical excision, the average size (range) of the excised lesions was 3.54 cm (0.5–15.0 cm) by 2.22 cm (0.3–8.0 cm). Four required coverage with local flaps, 3 with full-thickness skin graft (FTSG) and 2 with microvascular free flap. The 2 most common pathologic diagnoses were arteriovenous malformation and hemangioma, each with 14 patients. Overall complication rate was 2%, with 1 patient experiencing wound dehiscence requiring FTSG. Follow-up ranged from 0.1 months to 46.9 months with an average of 3.86 months.

Conclusions:

In the appropriately selected patient, surgical excision of symptomatic vascular anomalies of the extremities can be successfully performed with a low complication rate. Most lesions can be appropriately treated with direct excision and direct closure, although some may require FTSG, local flap, or microvascular free flap.
Using the lens of trauma informed care to inform pediatric obesity management
Authors: Scott Vanessa P. , Rhee Kyung E.
Published: November 2023

Purpose of review

Summarize the evolution of the trauma-informed care (TIC) approach in pediatrics, highlight the importance of using this lens in pediatric obesity management and treating the whole patient and family, and suggest recommendations for providers to incorporate TIC into their practice.

Recent findings

Implementing TIC in pediatric obesity management is recommended and offers an approach to address trauma-related symptoms associated with obesity. The TIC framework creates a safe, nurturing space to have open conversations with patients and families to promote resilience and reduce stigma related to obesity without re-traumatization. Screening tools may expose symptoms related to trauma, but are limited. Provider training is available and development of TIC related skills may be improved through using the arts and humanities. Success of TIC requires a tailored, integrated healthcare system approach with commitment from all levels.

The TIC approach offers providers skills to uncover trauma-related symptoms and address obesity-related health disparities while reducing stigma. Collaboration across all levels of the healthcare system and community partners is essential. Further research is warranted on the effectives of this approach in pediatric obesity prevention and management.
Scenario Decision-Making About Plasma and Platelet Transfusion for Intracranial Monitor Placement: Cross-Sectional Survey of Pediatric Intensivists and Neurosurgeons
Authors: Nellis Marianne E. , Karam Oliver , Aldave Guillermo , Rocque Brandon G. , Bauer David F. ,   In collaboration with the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network
Published: November 2023

OBJECTIVES:

To report pediatric intensivists’ and pediatric neurosurgeons’ responses to case-based scenarios about plasma and platelet transfusions before intracranial pressure (ICP) monitor placement in children with severe traumatic brain injury (TBI).

DESIGN:

Cross-sectional, electronic survey to evaluate reported plasma and platelet transfusion decisions in eight scenarios of TBI in which ICP monitor placement was indicated.

SETTING:

Survey administered through the Pediatric Acute Lung Injury and Sepsis Investigators and the American Association of Neurologic Surgeons.

SUBJECTS:

Pediatric intensivists and pediatric neurosurgeons.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

A total of 184 participants responded (85 identified as pediatric intensivists and 54 as pediatric neurosurgeons). In all eight scenarios, the majority of respondents reported that they would base their decision-making about plasma transfusion on international normalized ratio (INR) alone (60–69%), or platelet transfusion on platelet count alone (83–86%). Pediatric intensivists, as opposed to pediatric neurosurgeons, more frequently reported that they would have used viscoelastic testing in their consideration of plasma transfusion (32% vs. 7%, p < 0.001), as well as to guide platelet transfusions (29 vs. 8%, p < 0.001), for the case-based scenarios. For all relevant case-based scenarios, pediatric neurosurgeons in comparison with pediatric reported that they would use a lower median (interquartile range [IQR]) INR threshold for plasma transfusion (1.5 [IQR 1.4–1.7] vs. 2.0 [IQR 1.5–2.0], p < 0.001). Overall, in all respondents, the reported median platelet count threshold for platelet transfusion in the case-based scenario was 100 (IQR 50–100) ×109/L, with no difference between specialties.

CONCLUSIONS:

Despite little evidence showing efficacy, when we tested specialists’ decision-making, we found that they reported using INR and platelet count in pediatric case-based scenarios of TBI undergoing ICP monitor placement. We also found that pediatric intensivists and pediatric neurosurgeons had differences in decision-making about the scenarios.
Arizona Department of Health Prevention Services' Work to Advance Health Equity Starts With an Assessment of Its Own Organizational Culture
Authors: Gallaway M. Shayne , Aseret-Manygoats Teresa , Sjolander Sheila
Published: November 2023

Objective:

To identify skills, organizational practices, and infrastructure needed to address health equity.

Design, Setting, and Participants:

We developed an anonymous online staff survey to assess how to address health equity and policy implications and develop a baseline for future initiatives. We distributed invitations to all Arizona Department of Health Services (ADHS) Division of Prevention Services (DPS) state- and non–state-designated employees in February 2021.

Main Outcome Measures:

Employee self-reported perceptions of how agency, division, and programs address health inequities; information about (1) organizational and individual traits needed to support our ability to implement effective health equity–focused work and (2) processes to enable improved organizational and workforce capacities; and implications for strategic planning.

Results:

Seventy-eight percent (N = 123) of eligible staff participated. Overall, we identified 21 of 28 organizational and 17 of 31 workforce capacities needing significant improvement. Organizational capacities were “Institutional commitment to address health inequities” (described using 6 elements), “Hiring to address health inequities” (2 elements), “Structure that supports true community partnerships” (3 elements), “Support staff to address health inequities” (4 elements), “Transparent and inclusive communication” (4 elements), “Community accessible data and planning” (1 element), and “Streamlined administrative process” (1 element). Workforce capacities were “Knowledge of public health framework” (4 elements), “Understand the social, environmental, and structural determinants of health” (1 element), “Community knowledge” (1 element), “Leadership” (4 elements), “Collaboration skills” (3 elements), “Community organizing” (3 elements), and “Problem-solving ability” (1 element). Using survey results, groups of staff identified change needed, specific actions, and training and communication to increase employee understanding. Proposed activities focused on data/evaluation, program planning/contracts, communications, personnel development, and community engagement.

Conclusions:

This survey allowed ADHS to establish a baseline of staff knowledge of the ADHS and DPS organizational commitment to address health inequities; results show us what areas to focus on to strengthen our capacity to achieve better outcomes; and improve health and wellness for all Arizonans.
False-positive HIV screening tests during the COVID-19 pandemic, a passing trend?
Authors: Lasmanovich Rinat , Atias Dor , Mor Orna , Obolski Uri
Published: November 2023

False-positive fourth-generation HIV screening tests are rare and are usually associated with various infections and autoimmune diseases. SARS-CoV-2 infection and vaccination were recently linked with false-positive HIV screening test results. However, little is known about false-positives in people who performed HIV screening tests after outbreaks of different SARS-CoV-2 strains and vaccination campaigns. Here, we examined the false-positive rates in samples collected by the Israeli AIDS Task Force in 2018--2022, with respect to such factors.
Maternal breastfeeding and education impact infant growth and development more than in-utero HIV/antiretroviral therapy exposure in context of universal antiretroviral therapy
Authors: Cherkos Ashenafi S. , LaCourse Sylvia M. , Kinuthia John , Mecha Jerphason , Enquobahrie Daniel A. , Escudero Jaclyn N. , John-Stewart Grace
Published: November 2023

Background:

Exposure to HIV and antiretroviral therapy (ART) in utero may influence infant growth and development. Most available evidence predates adoption of universal ART (Option B+ ART regimens). In a recent cohort, we compared growth and development in HIV-exposed uninfected (HEU) to HIV-unexposed (HUU) infants.

Design:

Prospective cohort study: data from Impact of Maternal HIV on Mycobacterium Tuberculosis Infection among Peripartum Women and their Infants (MiTIPS) in Western Kenya.

Methods:

Women were enrolled during pregnancy. Mother–infant pairs were followed until 24 months postpartum. We used multivariable linear mixed-effects models to compare growth rates [weight-for-age z score (WAZ) and height-for-age z score (HAZ)] and multivariable linear regression to compare overall development between HEU and HUU children.

Results:

About 51.8% (184/355) of the infants were HEU, 3.9% low birthweight (<2.5 kg), and 8.5% preterm (<37 gestational weeks). During pregnancy, all mothers of HEU received ART; 67.9% started ART prepregnancy, and 87.3% received 3TC/FTC, TDF, and EFV. In longitudinal analyses, HEU children did not differ significantly from HUU in growth or development (P > 0.05 for all). In the combined HEU/HUU cohort, higher maternal education was associated with significantly better growth and development: WAZ [β = 0.18 (95% CI 0.01–0.34)], HAZ [β = 0.26 (95% CI 0.04–0.48)], and development [β = 0.24 (95% CI 0.02–0.46)]. Breastfeeding was associated with significantly better HAZ [β=0.42 (95% CI 0.19–0.66)] and development [β =0.31 (95% CI 0.08–0.53)].

Conclusion:

HEU children in the setting of universal maternal ART had a similar growth trajectory and development to HUU children. Breastfeeding and maternal education improved children's weight, height, and overall development irrespective of maternal HIV status.
What are patterns of rise and decline?
Authors: Raulo Aura , Rojas Alexis , Kröger Björn , Laaksonen Antti , Orta Carlos Lamuela , Nurmio Silva , Peltoniemi Mirva , Lahti Leo , Žliobaitė Indrė
Published: November 2023

The notions of
change
, such as birth, death, growth, evolution and longevity, extend across reality, including biological, cultural and societal phenomena. Patterns of change describe how success and composition of every entity, from species to societies, vary across time. Languages develop into new languages, music and fashion continuously evolve, economies rise and decline, ecological and societal crises come and go. A common way to perceive and analyse change processes is through patterns of rise and decline, the ubiquitous, often distinctively unimodal trajectories describing life histories of various entities. These patterns come in different shapes and are measured according to varying definitions. Depending on how they are measured, patterns of rise and decline can reveal, emphasize, mask or obscure important dynamics in natural and cultural phenomena. Importantly, the variations of how dynamics are measured can be vast, making it impossible to directly compare patterns of rise and decline across fields of science. Standardized analysis of these patterns has the potential to uncover important but overlooked commonalities across natural phenomena and potentially help us catch the onset of dramatic shifts in entities' state, from catastrophic crashes in success to gradual emergence of new entities. We provide a framework for standardized recognizing, characterizing and comparing patterns of change by combining understanding of dynamics across fields of science. Our toolkit aims at enhancing understanding of the most general tendencies of change, through two complementary perspectives: dynamics of emergence and dynamics of success. We gather comparable cases and data from different research fields and summarize open research questions that can help us understand the universal principles, perception-biases and field-specific tendencies in patterns of rise and decline of entities in nature.
To glide or to swim? A reinvestigation of the enigmaticWapitisaurus problematicus(Reptilia) from the Early Triassic of British Columbia, Canada
Authors: Bastiaans Dylan , Buffa Valentin , Scheyer Torsten M.
Published: November 2023

Wapitisaurus problematicuswas initially described as a member of the Weigeltisauridae, a clade of Late Permian gliding reptiles from Eurasia and Madagascar. However, the poor preservation of the holotype and only known specimen, from the lower Sulphur Mountain Formation at Ganoid Ridge (British Columbia, Canada), raised doubts about this assignment. Here, we redescribeW. problematicusand reassess its systematic position among diapsid reptiles. Comparison with all known weigeltisaurids, as well as contemporaneous reptiles from the Sulphur Mountain Formation, indicates that the taxon instead represents a thalattosauroid thalattosauriform, with noted similarities toThalattosaurusandParalonectes. This reidentification restricts weigeltisaurids to the Late Permian, with no occurrence in North America.Wapitisaurus problematicuspotentially represents one of the oldest thalattosauriforms and increases our understanding of their diversity and disparity during the late Early and Middle Triassic. The close morphological similarities with later (thalattosauroid) thalattosauriforms and their high abundance in (shallow) marine settings may indicate an earlier invasion of this realm than previously assumed. This parallels observations in early ichthyopterygians with widespread opportunistic trophic niche diversification occurring relatively rapidly after the end-Permian mass extinction event.
Cultural transmission of move choice in chess
Authors: Lappo Egor , Rosenberg Noah A. , Feldman Marcus W.
Published: November 2023

The study of cultural evolution benefits from detailed analysis of cultural transmission in specific human domains. Chess provides a platform for understanding the transmission of knowledge due to its active community of players, precise behaviours and long-term records of high-quality data. In this paper, we perform an analysis of chess in the context of cultural evolution, describing multiple cultural factors that affect move choice. We then build a population-level statistical model of move choice in chess, based on the Dirichlet-multinomial likelihood, to analyse cultural transmission over decades of recorded games played by leading players. For moves made in specific positions, we evaluate the relative effects of frequency-dependent bias, success bias and prestige bias on the dynamics of move frequencies. We observe that negative frequency-dependent bias plays a role in the dynamics of certain moves, and that other moves are compatible with transmission under prestige bias or success bias. These apparent biases may reflect recent changes, namely the introduction of computer chess engines and online tournament broadcasts. Our analysis of chess provides insights into broader questions concerning how social learning biases affect cultural evolution.
Tactile Sensitivity to the Frequency Spectrum of Complex Vibrotactile Signals
Authors: Le Thanh-loan Sarah , Bailly Gilles , Vezzoli Eric , auvray Malika , Gueorguiev David
Published: November 2023

Haptic interactions with objects induce complex vibrotactile signals that are central to tactile perception. Despite the broad literature on vibrotactile perception, there is surprisingly little knowledge of the sensory processing of complex tactile signals made of multiple frequencies. To fill this gap, the study reported here investigated the impact of the constitutive pure tones of a complex vibrotactile signal on its perception. Participants completed a 3-AFC task, in which they were asked to identify an odd signal among two complex references. The odd signal was created by removing one pure tone from the reference, which varied in spectral composition, harmonicity, and inter-frequency intervals. Each reference signal was made of either two, three, or four pure tones. The results revealed that the removed pure tone’s value as well as the inter-frequency interval play a significant role on participants’ performance whereas changes in harmonicity, complexity have little impact. In addition, the results showed that the smaller the ratio between the removed frequency and the lowest one of the reference signals, the better the participants’ capacity to identify the one with a missing tone. Overall, the detection of a missing tone in a complex signal predominantly depends on the tone’s frequency value of the removed signal suggesting a tactile sensitivity to the frequency spectrum of complex vibrotactile signals.

NEW & NOTEWORTHY

This research reports an investigation of the respective roles of frequency range, harmonicity, and complexity on human perception of vibrotactile signals. The results revealed that only pure tones that are close to the lower end of the frequency spectrum are noticed when they are missing. This finding sheds new light on the mechanisms of frequency selectivity in touch.
The prevalence of copy number increase at multiallelic CNVs associated with cave colonization in Mexican tetra (Astyanax mexicanus)
Authors: Pokrovac Ivan , Rohner Nicolas , Pezer Željka
Published: November 2023

Copy number variation is a common contributor to phenotypic diversity, yet its involvement in ecological adaptation is not easily discerned. Instances of parallelly evolving populations of the same species in a similar environment marked by strong selective pressures present opportunities to study the role of copy number variants (CNVs) in adaptation. By identifying CNVs that repeatedly occur in multiple populations of the derived ecotype and are not (or are rarely) present in the populations of the ancestral ecotype, the association of such CNVs with adaptation to the novel environment can be inferred. We used this paradigm to identify CNVs associated with recurrent adaptation of the Mexican tetra (Astyanax mexicanus) to cave environment. Using a read-depth approach, we detected CNVs from previously re-sequenced genomes of 44 individuals belonging to two ancestral surface and three derived cave populations. We identified 102 genes and 292 genomic regions that repeatedly diverge in copy number between the two ecotypes and occupy 0.8% of the reference genome. Functional analysis revealed their association with processes previously recognized to be relevant for adaptation, such as vision, immunity, oxygen consumption, metabolism, and neural function and we propose that these variants have been selected for in the cave or surface waters. The majority of the ecotype-divergent CNVs are multiallelic and display copy-number increases in cave fish compared to surface fish. Our findings suggest that multiallelic CNVs - including gene duplications, and divergence in copy number provide a fast route to produce novel phenotypes associated with adaptation to subterranean life.

Significance Statement

Duplications and deletions of genomic sequences occur frequently within a population. Such inter-individual difference in the amount of genetic material is known as copy number variation and is associated with differences in phenotypic traits. Despite its pervasiveness, the evolutionary impact of copy number variation in complex organisms is difficult to discern, primarily due to the infeasibility of setting up evolutionary experiments in the laboratory. Instances of multiple populations that evolved the same traits in similar environments represent naturally occurring evolutionary experiments and valuable opportunities to study the molecular basis of adaptation. Mexican tetra represents such a system and we use the genomes of surface and cave-dwelling populations to study the role of copy number variation in the recurrent cave adaptation.