bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel Graphene-Based Reversible Physisorption Materials for High Hydrogen Uptake
Authors: Banerjee Arghya Narayan Narayan , Joo Sang W.
Published: August 2024

Carbon-based nanomaterials (graphene, carbon nanotube, microporous carbon, graphitic carbon etc.) are excellent H2 storage materials due to high molecular H2 uptake at the micropores and large H2 adsorption at the graphene network via the formation of dipoles in H2 molecules through London dispersion forces. On the other hand, incorporation of transition metal nanoparticles within the nanocarbon network facilitates dissociation of H2 molecules into constituents H-atoms over the metal nanoparticles, followed by diffusion into the carbon nano-matrix via ‘spill-over’ effect for polarization/hybridization of metal-hydrogen to create high H2 binding energy for high hydrogen adsorption. Therefore, a nanocomposite of graphene-microporous carbon-metal nanoparticle network is expected to deliver excellent H2 uptake capacity and acts as a novel reversible physisorption material for hydrogen storage applications, which is very important for sustainable renewable energy integration.

A simple, cost effective sputtering method is used to fabricate metal incorporated graphitic microporous carbon film and differential resistance measurement showed high H2 uptake. Average number of graphene layer formation is dependent on sputtering parameters, which manifest bi-to-multilayer graphene. With increase in graphene layers, H2 adsorption also increases due to a fourfold effect: higher molecular hydrogen uptake at the graphene layers, more active sites into the micropores, promotion of molecular dissociation into atomic hydrogen by the metal nanoparticles, and the formation of hydrogenated carbon via destruction of the π-bonds.
(Invited) Conjugation of Polyethylene Glycol to Single Wall Carbon Nanotube Sensor Platforms to Decrease Extracellular Protein Interactions
Authors: Iverson Nicole M , Sadak Omer , Acosta Ramirez Ivon , Larsen Jacob
Published: August 2024

Single wall carbon nanotube (SWNT) sensors can be used to quantify extracellular analytes, but proteins released by cells interact with the SWNT and decrease the efficacy of the sensors. We have conjugated a 5 kDa polyethylene glycol (PEG) to SWNT sensor platforms to decrease the impact of extracellular proteins on the SWNT sensors. The development of this PEGylated SWNT sensor platform will allow for quantification of extracellular analytes without signal inhibition from cell associated proteins, providing a more accurate way of analyzing both in vitro and in vivo signaling molecules.
(Invited) New Analytical Method of Near-Field Spectroscopy – hBN Polaritons in Heteronanotubes
Authors: Rotkin Slava V.
Published: August 2024

Near-field spectroscopy is a promising approach for materials nanocharacterization, with a hope to reach beyond trivial materials’ imaging with a high spatial resolution. In a typical method, one uses the spectral modulation of the image spatial scales, determined from such a set of features of near-field scanning maps as a wave pattern or clear wave reflections (if not merely taking the spectral modulation of the image intensity). Applicability of these methods is rather limited and more sophisticated analytical technique would be desirable.

Most severe restriction of abovementioned spectral techniques happens when the material under study possesses spatial non-uniformities much smaller than the excitation wavelength. Then, the patterns are highly influenced by the wave diffraction and not reliable to detect spectral information (in other words, the wave patterns are distorted by interference and excitation localization, which prohibits determining intrinsic wave parameters as a function of excitation).

We have developed a new analytical technique which allows true sub-wavelength resolution, since the image domain required for the wave pattern analysis could be substantially smaller than a wavelength. The method has been used for studying hBN polaritons in heteronanotubes, the new material developed in Prof. Maruyama group at University of Tokyo.

Acknowledgement: This work has been partially supported by NSF DMR-2011839 (MRSEC) and DMR-2039351 (2DCC MIP).
Physiologic hypoxia in the intestinal mucosa: a central role for short-chain fatty acids
Authors: Wang Timothy , Wang Ruth X. , Colgan Sean P.
Published: August 2024

The intestinal mucosa is a dynamic surface that facilitates interactions between the host and an outside world that includes trillions of microbes, collectively termed the microbiota. This fine balance is regulated by an energetically demanding physical and biochemical barrier that is formed by the intestinal epithelial cells. In addition, this homeostasis exists at an interface between the anaerobic colonic lumen and a highly oxygenated, vascularized lamina propria. The resultant oxygen gradient within the intestine establishes “physiologic hypoxia” as a central metabolic feature of the mucosa. Although oxygen is vital for energy production to meet cellular metabolism needs, the availability of oxygen has far-reaching influences beyond just energy provision. Recent studies have shown that the intestinal mucosa has purposefully adapted to use differential oxygen levels largely through the presence of short-chain fatty acids (SCFAs), particularly butyrate (BA). Intestinal epithelial cells use butyrate for a multitude of functions that promote mucosal homeostasis. In this review, we explore how the physiologic hypoxia profile interfaces with SCFAs to benefit host mucosal tissues.
Na-caprate-induced increase in MDCK II epithelial cell leak pathway permeability and opening number is associated with disruption of basal F-actin organization
Authors: Rana Shivani , Nasr Leyla , Chang Daniel , Axis Josephine , Amsler Kurt
Published: August 2024

This study determines the underlying change in the openings in the epithelial tight junction permeability barrier structure that leads to a change in the paracellular permeability to macromolecules (the Leak Pathway) and connects this to disruption of specific F-actin structures within the cells. It provides important and novel insights into how tight junction permeability to macromolecules is modulated by specific changes to cellular and tight junction composition/organization.
Perioperative Nursing Shortages: An Integrative Review of Their Impact, Causal Factors, and Mitigation Strategies
Authors: Xie Ada , Duff Jed , Munday Judy
Published: August 2024

Aim. This study aims to explore contributing factors, impacts, and strategies to address perioperative nursing shortages. Background. Health facilities worldwide are experiencing nursing shortages, especially in specialty fields such as perioperative nursing. Evaluation. This integrative review is reported according to the PRISMA guidelines. The title, abstract, and full article screening, as well as the quality appraisal process, were performed by two independent reviewers, with a third for disagreement. This review focused on empirical and theoretical research published from 2013 to 2023 using databases including CINAHL, Embase, Emcare (via OVID), Medline (via EBSCOhost), Scopus, Web of Science, ProQuest Dissertations and Theses Global, Overton, and GreyNet. Key Issues. This study thoroughly reviewed 84 articles. The perioperative domain confronts significant staffing challenges due to increased demand, lack of experienced nurses, insufficient new entrants, high turnover, and an aging workforce. Notably significant are the deficiencies in recruiting new nurses and the elevated turnover levels, potentially amendable issues. The shortages negatively impact the remaining nurses, patient care quality, and hospital revenue. Strategies to address perioperative nursing workforce challenges include promoting the specialty to undergraduate nursing students, bolstering recruitment efforts, and retaining experienced perioperative nurses. However, none of the studies examined in this review adopted a comprehensive approach. Furthermore, the effectiveness of these strategies relative to one another remains uncertain due to a lack of reliable measurements. Conclusion. Perioperative nursing faces considerable challenges, including an aging workforce, limited new recruits, and high turnover rates. Present strategies primarily prioritise workforce preparation over supporting current staff. Mitigating the perioperative nursing shortages requires comprehensive approaches integrating preparation, recruitment, retention, and retirement plans. In addition, these strategies must be adapted to the diverse regulatory environments of different countries, recognising the absence of a one‐size‐fits‐all solution to perioperative nursing shortages globally. Implication for Nursing Management. Perioperative nursing managers are vital in reducing shortages.
The Role of Bcl‐2 Family Proteins and Sorafenib Resistance in Hepatocellular Carcinoma
Authors: de Melo Silva Alex José , de Melo Gama Juliana Ellen , de Oliveira Sheilla Andrade
Published: August 2024

Liver cancer has been reported to be one of the most malignant diseases in the world. It is late diagnosis consequently leads to a difficult treatment, as the cancer reached an advanced stage. Hepatocellular carcinoma (HCC) is the primary type of cancer diagnosed in the liver, with deadly characteristics and a poor prognosis. The first‐in‐line treatment for advanced HCC is sorafenib. Sorafenib acts by inhibiting cell proliferation and by inducing apoptosis as well as blocks receptors associated with these mechanisms. Due to its constant use, sorafenib resistance has been described, especially to proteins of the Bcl‐2 family, and their overexpression of Bcl‐XL and Mcl‐1. This review focuses on the role of the Bcl‐2 proteins in relation to sorafenib resistance as a consequence of first‐in‐line treatment in HCC.
Novel Biallelic Mutation c.131G>T in MEI1 Causes Meiotic Arrest and Nonobstructive Azoospermia
Authors: Huang Xiang , Zhang Chen , Zhang Congqiao , Zhang Weiyang , An Zhiyuan , Li Qiang , Jia Junting , Ren Laifeng
Published: August 2024

Nonobstructive azoospermia (NOA) is considered to be the most severe form of male infertility. Meiotic arrest is one of the major causes of NOA and can be caused by single gene mutations. Here, a novel homozygous missense mutation (c.131G>T) in the MEI1 gene was identified through whole exome sequencing in a Chinese men with NOA caused by meiotic arrest. Bioinformatics and genetic analysis predicted that this novel mutation may be deleterious. Our findings confirm that spermatogenesis is arrested at the primary spermatocyte stage, with defective programed DNA double‐strand breaks (DSBs) formation. In vitro functional analysis revealed that the defects of DSBs formation may be a result of a lower expression level of MEI1 protein in the mutant. Therefore, the NOA in this patient is likely caused by the single novel mutation in the MEI1 gene leading to meiotic arrest. Our report expands the mutation spectrum of MEI1 and provides new evidence that the MEI1 gene may serve as a diagnostic marker for genetic counseling in NOA patients.
Analyzing and Forecasting E‐Commerce Adoption Drivers Among SMEs: A Machine Learning Approach
Authors: Daoud Yomna , Kammoun Aida
Published: August 2024

This paper investigated the factors in the technology–organization–environment (TOE) framework that affect the decision of whether to adopt electronic commerce (EC) or not within small‐ and medium‐sized enterprises (SMEs). To this end, a questionnaire‐based survey was conducted to collect data from 60 managers or owners of manufacturing SMEs in Tunisia. Unlike the traditional regression approaches, we referred to novel machine learning (ML) techniques and reveal that ML techniques reach a higher level of performance in forecasting driving factors to EC adoption compared to the traditional logistic regression approach. The achieved results also indicate that EC adoption within SMEs is significantly affected by eight factors, namely, IT vendors’ support, the adopted technology complexity degree, chief executive officer (CEO) innovativeness, technology readiness, customers’ pressure, firm size, infrastructure compatibility, and the innovative technology‐perceived relative advantage.
Effect of Total Dissolved Gas Supersaturation on Swimming Performance of Migratory Fish for Traversing Velocity Barriers
Authors: Yuan Quan , Zhang Zhiguang , Li Kefeng , Liang Ruifeng , Zhu Bo , Wang Yuanming
Published: August 2024

This study investigates the impact of total dissolved gas supersaturation (TDGS) on the swimming capabilities of migratory fish (S. prenanti), a common issue during high dam discharges in flood seasons. We assessed fish exposed to 130% TDGS for 2 hr, focusing on their swimming performance in a controlled environment. In our experiments, control group fish, utilizing prolonged swimming, showed reduced maximum distances as flow velocities increased from 3 to 10 BL/s (body length per second), covering distances between 1,285 and 119 BL. In contrast, TDGS‐exposed fish achieved only 15%–95% of these distances. Under burst swimming conditions, control group fish also demonstrated a decrease in maximum distances with increasing flow velocity, achieving 280–124 BL, while TDGS‐exposed fish reached just 48%–64% of these distances. Notably, the critical flow velocity (Ufcrit) for transitioning from prolonged to burst activity level was lower for the TDGS group (7.2 BL/s) compared with the control (9.8 BL/s). In open flume trials, TDGS‐exposed fish displayed a stronger upstream swimming inclination beyond Ufcrit, indicated by quicker times, higher speeds, and shorter trajectories. This study provides novel insights into the adaptive swimming strategies and flow velocity responses of fish under TDGS stress.
An Innovative Production Prediction Model for Fractured Horizontal Wells in Low‐Permeability Gas Reservoirs Accounting for Proppant Embedment
Authors: Gao Xinchen , Guo Kangliang , Yang Haoran , Zhang Shuangshuang
Published: August 2024

This study focuses on addressing the challenge of accurately calculating the production caused by stress sensitivity and proppant embedment during actual production in low‐permeability gas reservoirs. To achieve this, a stress sensitivity model in the matrix zone and a proppant embedding model in the fracture area are established. Additionally, fluid flow models are formulated for the matrix zone and fracture area based on the seepage theory and fluid mechanics. Using these models, a production prediction model is developed for fractured horizontal wells in low‐permeability tight sandstone gas reservoirs considering the impact of proppant embedment. The production prediction model is solved using a coupling solution method, and the calculation results are verified against actual gas production. This study also analyses and discusses the stress sensitivity in low‐permeability gas reservoirs, the factors influencing conductivity, and the factors influencing productivity. The results indicate a strong stress sensitivity in the matrix area of low‐permeability gas reservoirs. In fracturing design, comprehensive consideration of fracture parameters is necessary. After fracturing, the optimal selection of proppants with appropriate particle sizes and careful optimization of the number of layers are crucial for maintaining stable production release. This research is significant for effectively and stably maximizing the productivity of low‐permeability gas reservoirs.
Figure 6 from FLT3/CD99 Bispecific Antibody–Based Nanoparticles for Acute Myeloid Leukemia
Authors: Ali Atham , Phan Alvin , Vaikari Vijaya , Park Mincheol , Pospiech Mateusz , Chu Ryan , Meng Yiting , MacKay J. Andrew , Alachkar Houda
Published: August 2024

Midostaurin-resistant MV4-11 cells show sensitivity to CD99/FLT3 antibody-based nanoparticles. MV4-11 cells were selected with resistance to increasing concentrations of midostaurin during several months of culture and evaluated by flow cytometry. A–C, Apoptosis experiments illustrate how the live-cell (Q4) percentage for midostaurin-resistant MV4-11 cells is decreased when compared to naïve cells, eluding at their maintained and increased sensitivity to the different treatment formulations. D, The antibody-based nanoparticles were evaluated against both naïve and resistant cell lines, which show that the nanoparticles maintain their effect in resistant MV4-11 cells, illustrated by the reduction of cell viability. E and F, Engraftment of 106 MV4-11-R cells in NSG mice following the same treatment regiments as previous MV4-11 in vivo experiments show a significant decrease in the percentage of huCD45 cells between A192 and the Co-Assembled construct. Additionally, naïve MV4-11 cells were engrafted as a control to illustrate the effect of midostaurin.
Figure 4 from FLT3/CD99 Bispecific Antibody–Based Nanoparticles for Acute Myeloid Leukemia
Authors: Ali Atham , Phan Alvin , Vaikari Vijaya , Park Mincheol , Pospiech Mateusz , Chu Ryan , Meng Yiting , MacKay J. Andrew , Alachkar Houda
Published: August 2024

Antibody nanoworms FLT3-A192 and CD99-A192 induce apoptosis and cell death. A–D, Trypan blue staining detects a decrease in cell viability across different cell lines FLT3-ITD+/CD99+ AML cells (MV4-11, MOLM-13), FLT3−/CD99+ cells (U937), and FLT3WT+/CD99− (THP-1). In MV4-11, co-assembling CD99-A192 and FLT3-A192 further reduced viability compared to a combination “mixture” of/or single-targeted nanoworms. E and F, Greater levels of apoptosis (quadrant Q2) were observed by flow cytometry in MV4-11 cells treated with FLT3-A192, CD99-A192, and Co-Assembled formulations. G and H, In THP-1 cells levels of apoptosis did not change between the different treatment groups. I, The CCK-8 assay was used to quantify the dose-dependent cell viability in MV4-11 cells. Nonlinear curve fitting was used to estimate the IC50, which showed that Co-Assembled CD99-A192 and FLT3-A192 (0.2 μmol/L) was more potent than FLT3-A192 (1.7 μmol/L) and CD99-A192 (0.4 μmol/L) by itself. J, Effects of FLT3-A192, CD99-A192, and co-assembled in primary patient samples obtained from USC001 (FLT3-ITD+), USC100 (Refractory/Relapse FLT3-ITD+), USC109 (FLT3-ITD + at diagnosis), and healthy donors (HDs). Mean ± SD (n = 3).
Figure 1 from FLT3/CD99 Bispecific Antibody–Based Nanoparticles for Acute Myeloid Leukemia
Authors: Ali Atham , Phan Alvin , Vaikari Vijaya , Park Mincheol , Pospiech Mateusz , Chu Ryan , Meng Yiting , MacKay J. Andrew , Alachkar Houda
Published: August 2024

Interplay between CD99 and FLT3 in FLT3-ITD AML. Flow cytometry was used to evaluate the surface level expression of FLT3 and CD99. A and B, Compared to naive MV4-11 cells, midostaurin-resistant (MV4-11-R) cells have a significant increase of surface expression of FLT3 (P = 0.0356), and trend of increase of CD99 (P = 0.0568). C, To examine the effect of targeting CD99 on FLT3 surface expression, a panel of cell lines were assessed. U937 do not express FLT3 and were included as negative control. D, THP-1 cells, although they express the FLT3-WT, did not show enhance FLT3 surface level expression upon treatment with CD99-A192. E, In contrast, treatment with CD99-A192 increased FLT3 surface level expression in MOLM-13 cells, which are FLT3-ITD+ (P = 0.05). F, NSG mice were engrafted with 2.5 × 106 MOLM-13 cells, showed a significant increase in survival when treated with both FLT3 and CD99 targeted nanoparticles P < 0.007 and P < 0.003 of combination vs. CD99-A192, FLT3-A192 alone respectively.
Table 3 from Exploring Disparities in Pancreatic Ductal Adenocarcinoma Outcomes among Asian and Pacific Islander Subgroups
Authors: Wu Christopher , McLeod M. Chandler , Song Zhixing , Chen Herbert , Rose John Bart , Bhatia Smita , Gillis Andrea
Published: August 2024

Multivariable survival analysis for patients diagnosed with PDAC
Supplementary Figure 1 from Yttrium-90 Induces an Effector Memory Response with Neoantigen Clonotype Expansion: Implications for Immunotherapy
Authors: Núñez Kelley , Sandow Tyler , Gimenez Juan , Hibino Mina , Cohen Ari , Thevenot Paul
Published: August 2024

Supplemental Figure 1
Figure S2 from FLT3/CD99 Bispecific Antibody–Based Nanoparticles for Acute Myeloid Leukemia
Authors: Ali Atham , Phan Alvin , Vaikari Vijaya , Park Mincheol , Pospiech Mateusz , Chu Ryan , Meng Yiting , MacKay J. Andrew , Alachkar Houda
Published: August 2024

Figure S2 – FLT3 and CD99 surface level expression in primary blasts of sample USC001 and USC100.
Data from Yttrium-90 Induces an Effector Memory Response with Neoantigen Clonotype Expansion: Implications for Immunotherapy
Authors: Núñez Kelley , Sandow Tyler , Gimenez Juan , Hibino Mina , Cohen Ari , Thevenot Paul
Published: August 2024

Abstract
Yttrium-90 (90Y) transarterial radioembolization can safely and effectively treat hepatocellular carcinoma (HCC). Clinical trials combining 90Y with immunotherapy are aimed at improving treatment response rates. The impact of transient 90Y-induced lymphopenia on T-cell homeostasis and functional dynamics is unknown. Paired blood specimens were collected prior to first-cycle 90Y and at imaging follow-up in patients with HCC Barcelona Clinic Liver Cancer stages A–B. Flow cytometry and T-cell receptor (TCR) sequencing were used to monitor changes in T-cell subsets and TCR repertoire following 90Y. Objective response (OR) rates were determined using modified RECIST and defined as either OR or nonobjective response. Time-to-progression (TTP) was defined as progression to Barcelona Clinic Liver Cancer stage C within 6 months following 90Y. 90Y induced shifts in both CD4+ (P = 0.049) and CD8+ (P < 0.001) toward an effector memory T-cell response independent of treatment response rate. Nonresponders to 90Y were characterized by a sustained elevation in both naïve CD4+ cells (P = 0.019) and programmed cell death protein 1 expression in CD8+ cells (P = 0.003). Paired analysis of the TCR repertoire revealed a variable induction of neoantigen clonotypes and expansion of existing clonotypes independent of 90Y response. In patients with an OR, changes in TCR clonality did not influence TTP. However, polyclonal profiles in patients without an OR were associated with shorter TTP (P = 0.005; HR, 10.8) and 75% disease progression rates 6 months following treatment. 90Y induces a population shift from central to effector memory accompanied by neoantigen T-cell responses independent of treatment response rate. Monoclonal shifts in the post-90Y T-cell repertoire had superior overall TTP and improved TTP in patients with a first-cycle nonobjective response.
Significance:
90Y can safely treat HCC; however, it causes transient lymphopenia. In this article, 90Y stimulates a peripheral effector memory response independent of initial treatment response. TCR sequencing revealed that polyclonal profiles in patients without an OR to treatment were associated with rapid progression rates 6 months after 90Y.
METTL3 and IGF2BP1-Mediated m6A Modification of ZHX2 Promotes Tumor Property of Renal Cell Carcinoma
Authors: Xiao Bangming , Li Yalan , Yang Yong , Chen Congbo , Gong Shide , Li Hao , Yao Qisheng , Wang Li
Published: August 2024

Introduction: Renal cell carcinoma (RCC) is a common type of kidney cancer with limited treatment options and a high mortality rate. Therefore, it is essential to understand the role and mechanism of key genes in RCC development and progression. This study aimed to analyze the role of zinc fingers and homeoboxes 2 (ZHX2) in RCC and the underlying mechanism. Methods: RNA expression was analyzed by quantitative real-time polymerase chain reaction, while protein expression was analyzed by Western blotting assay and immunohistochemistry assay. Cell viability was evaluated using CCK-8 assay, and cell proliferation was assessed by EdU assay. The rate of cell apoptosis was quantified by flow cytometry. Transwell assays were conducted to analyze cell migration and invasion. The sphere formation assay was performed to assess the formation of microspheres. Additionally, m6A RNA immunoprecipitation assay and RNA immunoprecipitation assay were utilized to investigate the relationship between ZHX2 and two proteins, methyltransferase like 3 (METTL3) and insulin-like growth factor 2 mRNA-binding protein 1 (IGF2BP1). The stability of ZHX2 mRNA was analyzed through the Actinomycin D assay. Furthermore, a xenograft mouse model assay was conducted to analyze the effect of ZHX2 overexpression and METTL3 silencing on RCC cell tumor properties in vivo. Results: ZHX2 expression was upregulated in both RCC tissues and cells when compared with healthy renal tissues and human renal cortex proximal convoluted tubule epithelial cells. Depletion of ZHX2 inhibited RCC cell proliferation, migration, invasion, and spheroid-forming capacity but promoted cell apoptosis. Moreover, it was found that METTL3-mediated m6A methylation of ZHX2 and IGF2BP1 also stabilized ZHX2 through m6A methylation modification. Furthermore, ZHX2 overexpression showed a potential for attenuating the effects induced by METTL3 silencing and counteracted the inhibitory effect of METTL3 depletion on tumor formation in vivo. Conclusion: METTL3 and IGF2BP1-mediated m6A modification of ZHX2 promoted RCC progression. The finding suggests that ZHX2 may serve as a potential therapeutic target in RCC, providing valuable insights for future clinical interventions.
One Size Does Not Fit All: Micro-, Meso-, and Macrobleeds in Cerebral Amyloid Angiopathy
Authors: Koemans Emma A. , van Harten Thijs W. , Voigt Sabine , Rasing Ingeborg , van Zwet Erik W. , Terwindt Gisela M. , van Osch Matthias J.P. , van Walderveen Marianne A.A. , Wermer Marieke J.H.
Published: August 2024

Introduction: MRI rating criteria for small vessel disease markers include definitions for microbleeds and macrobleeds but do not account for small (<10 mm) hemorrhages with a cystic cavity and/or irregular shape. Such hemorrhages, however, are often present in patients with cerebral amyloid angiopathy (CAA). In this study, we aimed to investigate the frequency, diameter, and volume distribution of these hemorrhages (which we called mesobleeds) in patients with CAA. Methods: We selected participants with Dutch-type hereditary CAA (D-CAA) and sporadic CAA (sCAA) and scored microbleeds, mesobleeds, and macrobleeds on 3T susceptibility-weighted images MRI. Hemorrhage diameter and volume were calculated in a subset of participants using a semi-automatic tool; their distribution was evaluated on a logarithmic scale. Results: We included 25 participants with D-CAA (mean age 56 years) and 25 with sCAA (mean age 73 years). In total, 11,007 microbleeds, 602 mesobleeds, and 195 macrobleeds were observed. Eighty-two percent of participants had ≥1 mesobleed. Hemorrhage diameter and volume were calculated in four participants with 272 microbleeds (median diameter 1.52 mm, volume 0.004 mL), 84 mesobleeds (median diameter 5.61 mm, volume 0.06 mL), and 37 macrobleeds (median diameter 19.58 mm, volume 1.33 mL). Mesobleed diameter and volume were larger than microbleeds (optimal cut-off 0.02 mL) but showed overlap with macrobleeds. Conclusion: Hemorrhages <10 mm with an irregular shape and/or cystic cavity are frequently found in participants with CAA and have a distinct diameter and volume distribution. We propose to name these hemorrhage mesobleeds and to rate them separately from micro- and macrobleeds. Future research is necessary to investigate their pathophysiology and prognostic value.
Evidence-Based Clinical Guidelines for Chronic Constipation 2023
Authors: Ihara Eikichi , Manabe Noriaki , Ohkubo Hidenori , Ogasawara Naotaka , Ogino Haruei , Kakimoto Kazuki , Kanazawa Motoyori , Kawahara Hidejiro , Kusano Chika , Kuribayashi Shiko , Sawada Akinari , Takagi Tomohisa , Takano Shota , Tomita Toshihiko , Noake Toshihiro , Hojo Mariko , Hokari Ryota , Masaoka Tatsuhiro , Machida Tomohiko , Misawa Noboru , Mishima Yoshiyuki , Yajima Hiroshi , Yamamoto Sayuri , Yamawaki Hiroshi , Abe Tatsuya , Araki Yasumi , Kasugai Kunio , Kamiya Takeshi , Torii Akira , Nakajima Atsushi , Nakada Koji , Fukudo Shin , Fujiwara Yasuhiro , Miwa Hiroto , Kataoka Hiromi , Nagahara Akihito , Higuchi Kazuhide
Published: August 2024

The Japan Gastroenterological Association published the first version of its clinical guidelines for chronic constipation 2023. Based on the latest evidence, these guidelines describe the definition, classification, diagnostic criteria, diagnostic testing methods, epidemiology, pathophysiology, and treatment of chronic constipation. They include flowcharts for both diagnosis and treatment of chronic constipation. In the treatment of chronic constipation, the first step involves differentiating between secondary forms, such as organic disease-associated constipation, systemic disease-associated constipation, and drug-induced constipation. The next step is to determine whether the chronic constipation stems from a motility disorder, a form of primary chronic constipation. For functional constipation and constipation-predominant irritable bowel syndrome, treatment should be initiated after evaluating symptoms like reduced bowel movement frequency type or defecation difficulty type. The first line of treatment includes the improvement of lifestyle habits and diet therapy. The first drugs to consider for oral treatment are osmotic laxatives. If these are ineffective, secretagogues and ileal bile acid transporter inhibitors are candidates. However, stimulant laxatives are exclusively designated for as-needed use. Probiotics, bulk-forming laxatives, prokinetics, and Kampo medicines, for which there is insufficient evidence, are considered alternative or complementary therapy. Providing the best clinical strategies for chronic constipation therapy in Japan, these clinical guidelines for chronic constipation 2023 should prove useful for its treatment worldwide.
Development, Evaluation, and User Testing of a Decision-Making Toolkit to Promote Organizations to Implement Universal Tumor Screening for Lynch Syndrome
Authors: Kulchak Rahm Alanna , Wolfinger Tara , Salvati Zachary M. , Schneider Jennifer L. , Cragun Deborah
Published: August 2024

Introduction: The Implementing Universal Lynch Syndrome Screening (IMPULSS) study explained institutional variation in universal tumor screening (UTS) with the goal of identifying ways to aid organizational decision-makers in implementing and optimizing Lynch syndrome UTS programs. Methods: After applying the Consolidated Framework for Implementation Research (CFIR 1.0) to analyze interviews with 66 stakeholders across 9 healthcare systems to develop a toolkit for implementation, we adapted the International Patient Decision Aid Standards (IPDAS) to assess toolkit potential to aid decision-making consistent with organizational values. We then conducted user testing with two experienced and four non-experienced implementers of UTS to improve the content and functionality of the toolkit and assess its acceptability and appropriateness. Results: Toolkit components were organized to address findings related to CFIR 1.0 constructs of evidence strength and quality, relative advantage, cost, engaging, planning, executing, and reflecting and evaluating. A home page was added to direct users to different sections based on whether they are deciding to implement UTS, planning for implementation, improving an existing UTS program, or considering a different approach to identify patients with Lynch syndrome. Upon initial evaluation, 31 of 64 IPDAS criteria were met by the original toolkit. All users rated the toolkit as acceptable and appropriate for assisting organizational decision-making and identified multiple areas for improvement. Numerous iterative changes were made to the toolkit, resulting in meeting 17 of the previously unmet IPDAS criteria. Conclusion: We demonstrate the rigorous development of a toolkit guided by the CFIR and show how user testing helped improve the toolkit to ensure it is acceptable, appropriate, and meets most IPDAS criteria relevant to organizational values-based decision-making.
Prediction of 28-Day All-Cause Mortality in Heart Failure Patients with Clostridioides difficile Infection Using Machine Learning Models: Evidence from the MIMIC-IV Database
Authors: Shi Caiping , Jie Qiong , Zhang Hongsong , Zhang Xinying , Chu Weijuan , Chen Chen , Zhang Qian , Hu Zhen
Published: August 2024

Introduction: Heart failure (HF) may induce bowel hypoperfusion, leading to hypoxia of the villa of the bowel wall and the occurrence of Clostridioides difficile infection (CDI). However, the risk factors for the development of CDI in HF patients have yet to be fully illustrated, especially because of a lack of evidence from real-world data. Methods: Clinical data and survival situations of HF patients with CDI admitted to ICU were extracted from the Medical Information Mart for Intensive Care (MIMIC)-IV database. For developing a model that can predict 28-day all-cause mortality in HF patients with CDI, the Recursive Feature Elimination with Cross-Validation (RFE-CV) method was used for feature selection. And nine machine learning (ML) algorithms, including logistic regression (LR), decision tree, Bayesian, adaptive boosting, random forest (RF), gradient boosting decision tree, XGBoost, light gradient boosting machine, and categorical boosting, were applied for model construction. After training and hyperparameter optimization of the models through grid search 5-fold cross-validation, the performance of models was evaluated by the area under curve (AUC), accuracy, sensitivity, specificity, precision, negative predictive value, and F1 score. Furthermore, the SHapley Additive exPlanations (SHAP) method was used to interpret the optimal model. Results: A total of 526 HF patients with CDI were included in the study, of whom 99 cases (18.8%) experienced death within 28 days. Eighteen of the 57 variables were selected for the model construction algorithm for model construction. Among the ML models considered, the RF model emerged as the optimal model achieving the accuracy, F1-score, and AUC values of 0.821, 0.596, and 0.864, respectively. The net benefit of the model surpassed other models at 16%–22% threshold probabilities based on decision curve analysis. According to the importance of features in the RF model, red blood cell distribution width, blood urea nitrogen, Simplified Acute Physiology Score II, Sequential Organ Failure Assessment, and white blood cell count were highlighted as the five most influential variables. Conclusions: We developed ML models to predict 28-day all-cause mortality in HF patients associated with CDI in the ICU, which are more effective than the conventional LR model. The RF model has the best performance among all the ML models employed. It may be useful to help clinicians identify high-risk HF patients with CDI.
Reproducibility Analysis of Two Speckle Tracking Software for the Antenatal Semiautomated Assessment of the Fetal Cardiac Function
Authors: Di Tonto Andrea , Nogue Laura , Valentini Beatrice , Bennasar Mar , Melito Chiara , Sorrentino Sara , Gómez Olga , Corno Enrico , Baffa Maria Teresa , Ghi Tullio , Crispi Fàtima , Dall'Asta Andrea
Published: August 2024

Introduction: Speckle tracking echocardiography is a non-Doppler modality allowing the semiautomated evaluation of the fetal cardiac function by tracking the speckles of the endocardial borders. Little evidence is available on the evaluation and comparison of different software for the functional assessment of the fetal heart by means of speckle tracking echocardiography. The aim of this study was to evaluate the reproducibility and agreement of two different proprietary speckle tracking software for the prenatal semiautomated assessment of the fetal cardiac function. Methods: The prospective study including non-anomalous fetuses was referred for different indications at two tertiary academic units in Italy (University of Parma) and Spain (University of Barcelona). Two-dimensional clips of the four-chamber view of the fetal heart were acquired by two dedicated operators using high-end ultrasound machines with a frame rate higher than 60 Hz. The stored clips were pseudo-anonymized and shared between the collaborating units. Functional echocardiographic analyses were independently performed using the two proprietary software (TomTec GmbH and FetalHQ®) by the same operators. Inter-software reproducibility of the endocardial global longitudinal strain (EndoGLS) and fractional area change (FAC) of the left (LV) and the right ventricles (RV) and ejection fraction (EF) of the LV were evaluated by the intraclass correlation coefficient (ICC). Results: Forty-eight fetuses were included at a median of 31+2 (21+6–40+3) gestational weeks. Moderate reproducibility was found for the functional parameters of the LV: EndoGLS (Pearson’s correlation 0.456, p < 0.01; ICC 0.446, 95% CI: 0.189–0.647, p < 0.01); EF (Pearson’s correlation 0.435, p < 0.01; ICC 0.419, 95% CI: 0.156–0.627, p < 0.01); FAC (Person’s correlation 0.484, p < 0.01; ICC 0.475, 95% CI: 0.223–0.667, p < 0.01). On the contrary, RV functional parameters showed poor reproducibility between the two software: EndoGLS (Pearson’s correlation 0.383, p = 0.01; ICC 0.377, 95% CI: 0.107–0.596, p < 0.01) and FAC (ICC 0.284, 95% CI: 0.003–0.524, p = 0.02). Conclusion: Our results demonstrate a moderate reproducibility of the speckle tracking analysis of the LV using TomTec GmbH and FetalHQ®, with poor reproducibility for RV analysis.
Hybrid Model for Multistep-Ahead Rainfall Forecast in Northeast India: A Comparative Study
Authors: Shejule Priya Ashok , Pekkat Sreeja
Published: August 2024

Among all hydrometeorological parameters, rainfall strongly correlates with hydrometeorological disasters. The rainfall forecast process remains challenging due to the nonlinear, nonstationary nature and multiscale variability of rainfall. Moreover, the unique microclimate in different regions further complicates the forecasting process. This study proposes a hybrid model employing multivariate singular spectrum analysis (MSSA) and long short-term memory (LSTM) for multistep-ahead hourly rainfall forecasting in urban areas of northeast India. The model is trained and evaluated using high-resolution (12 km) hourly meteorological data from the Indian Monsoon Data Assimilation and Analysis (IMDAA) dataset for Guwahati (plain) and Aizawl (hilly) regions from 2015 to 2019. The hybrid model outperforms the single LSTM model in both plain and hilly regions, with an average percentage gain of 47.99% and 43.88% for symmetric mean absolute percentage error (SMAPE) and root-mean-square error (RMSE) in the case of the Guwahati dataset and 84.59% and 82.27% in the case of the Aizawl dataset, respectively. The performance of the LSTM model significantly improves as the zero values in the observed data are eliminated after reconstruction by MSSA. This enables the model to discern essential patterns and relationships in the data, which leads to more accurate forecasts. However, the hybrid model underestimates the rainfall, which can be tackled by hypertuning the parameters. The study highlights the importance of considering the interplay between rainfall and meteorological parameters for accurate rainfall forecasting in urban areas. The proposed MSSA–LSTM model can be used as a decision support tool for urban planning and disaster management.

Significance Statement

This study addresses a critical need in multistep-ahead hourly rainfall forecasting in urban areas, with a focus on the unique conditions of northeast India. Our research has identified the presence of red noise in the rainfall data, shedding light on the complexities of the underlying rainfall patterns. Furthermore, we delve into the intricate interplay between rainfall and meteorological parameters, providing valuable insights into the factors influencing rainfall dynamics. Notably, our study underscores the region-specific challenges in rainfall forecasting. While the hybrid model demonstrates reasonable accuracy in the plains, its performance in the hilly region falls short of expectations. This highlights the nuanced nature of rainfall prediction in areas with varying topography and emphasizes the need for tailored forecasting approaches.
Employment Among Women with Severe Mental Illness Availing Rural Community-based Rehabilitation Program: A Qualitative Study from South India
Authors: Meera J.  , Sivakumar Thanapal , Chandra Prabha S. , Kumar Devvarta , Shanivaram Reddy K.
Published: August 2024

Background:

Women in India are often disadvantaged in accessing education, employment, health services, and decision-making within families. This inequality is particularly pronounced among women with severe mental illness, especially those from rural areas.

Methods:

The study explored the employment status, facilitators, and barriers to employment among women with severe mental illness availing a rural community-based rehabilitation (CBR) program in Jagaluru, South India. Interviews were conducted with 15 women, their family caregivers, the CBR program social worker, and a community program coordinator of a nongovernmental organization partner. The study used a qualitative research design. Thematic analysis was used to identify emerging themes.

Results:

Ten women were employed. Among five unemployed women, two independently took care of household responsibilities, and one assisted the family. Medication compliance and the desire to earn money for oneself were significant facilitators. Employment opportunities for some women were hindered by poor bus connectivity in interior villages, patriarchal familial attitudes, and challenges in availing loans for livelihood ventures.

Conclusion:

Rural families access treatment for severe mental illness when it is available at the nearest government health facility. With symptom improvement, many women could avail themselves of local employment opportunities without additional inputs from the CBR team.
Evaluation of GFAP, S100B, and UCHL-1 Levels in Children With Refractory Epilepsy
Authors: Aksoy Halil Ural , Yılmaz Celil , Orak Sibgatullah Ali , Ayça Senem , Polat Muzaffer
Published: August 2024

Introduction

A number of biomarkers are used to evaluate the duration of the epileptic seizure and the interictal period following neuronal injury. Invasive diagnostic methods are increasingly being replaced by peripheral or minimally invasive biomarkers that give results faster and are more secure.

Purpose

We aimed to evaluate serum glial fibrillary acidic protein (GFAP), S100B, and ubiquitin C-terminal hydrolase (UCHL-1) levels in children with epilepsy.

Methods

Our study included 3 groups: a nonrefractory epilepsy group, a refractory epilepsy group, and a control group. The GFAP, S100B, and UCHL-1 levels in serum samples collected 2-24 hours after the last seizure were analyzed using enzyme-linked immunosorbent assays.

Results

A total of 69 children participated in the study, with 35 participants in the refractory epilepsy group, 18 in the nonrefractory epilepsy group, and 16 in the control group. The GFAP values in the refractory (25.4 ng/mL) and nonrefractory (26.1 ng/mL) epilepsy groups were found to be statistically significantly higher than those in the control group (17.9 ng/mL; P = .001). The S100B values were found to be significantly higher in the refractory epilepsy group (34.13 pg/mL) than in both the control group and the nonrefractory epilepsy group (28.05 pg/mL; P = .028). No significant differences were observed in the UCHL-1 levels between the 3 groups.

Conclusions

We conclude that the observed differences may be due to the increased expression of S100B and GFAP caused by increased and repetitive neuronal damage in refractory epilepsies compared with nonrefractory epilepsies.
Association Between Domestic Violence and Mental Health Among Nepalese Women: Results from a Nationally Representative Sample
Authors: Gnawali Shreejana , Atteraya Madhu Sudhan , Kim Eungi
Published: August 2024

This study aims to examine the association between exposure to domestic violence and mental health outcomes, such as symptoms of depression and anxiety among married women in Nepal. The 2022 Nepal Demographic and Health Survey was used. Descriptive, bivariate, and multivariate logistic regression analyses were employed. A complex sampling frame was used to ensure the accuracy of the sample. A total of 4,211 women aged 15 to 49 years were analyzed. Among women between the ages of 15 and 49, 22.8% experience anxiety, and 22.5% experience depressive symptoms. Nearly 50% of women who had experienced domestic violence had symptoms of anxiety and depression. At the multivariate level, in Model 1, the study found that wealthy women were less likely to have anxiety (OR = 0.75; 95% CI [0.58, 0.96] and depression (OR = 0.70; 95% CI [0.54, 0.91]) than poor women. Similarly, women of the former untouchable caste were more likely to have anxiety (OR = 1.51; 95% CI [1.14, 2.00]) and depression (OR = 1.20; 95% CI [0.91, 1.58]) than high-caste women. In Model 2, the odds of anxiety and depressive symptoms were 1.70 (95% CI [1.29, 2.24]) and 1.99 (95% CI [1.48, 2.67]), respectively, for those women who had experienced severe physical violence. The odds of experiencing anxiety and depression were 2.88 (95% CI [2.28, 3.64]) and 3.04 (95% CI [2.32, 3.98]) times, respectively, for those women who had experienced emotional abuse. Similarly, women who had been sexually assaulted had 2.34 (95% CI [1.72, 3.20]) and 1.67 times (95% CI [1.23, 2.26]) more likely to experience anxiety and depression than women who had never been sexually assaulted. We found a strong association between mental health problems and women's experience of domestic violence. To address the mental health of Nepalese women, it is critical to strengthen domestic violence prevention programs, especially those targeting the lowest social strata of the population.
Analysis of Ohio Advanced Practice Registered Nurses’ Rate of Prescribing Naltrexone for Patients With Alcohol Use Disorder Since Elimination of the X-Waiver
Authors: Wiggins Morgan , Smith Amy , Helsabeck Nathan
Published: August 2024

Background:

Alcohol use disorder (AUD) is common and deadly. Naltrexone is a treatment for AUD. Previous research examined factors that predict Ohio Advanced Practice Registered Nurses’ (APRNs) utilization of naltrexone to treat AUD. Inclusion criteria included APRNs’ endorsing receipt of the X-waiver, a designation indicating providers’ receipt of substance use disorder education. In 2023, the X-waiver was eliminated. The purpose of this study was to replicate the previous research design in respondents without an X-waiver and compare findings.

Aims:

The aims of this study were three-fold: (1) assess whether race, age, practice setting, years in practice, or work experience with an addiction specialist physician predicted prescription of naltrexone for AUD, (2) assess whether the goal of abstinence or reduced alcohol use as desired treatment affected the likelihood of naltrexone prescription for AUD, and (3) compare differences between the answers in the current respondent group without X-waiver and the previous study’s X-waivered respondents.

Method:

All Ohio APRNs were sent surveys. Eighty-eight responses were included in analysis. Descriptive statistics, logistic regression, and chi-square results were reported.

Results:

Work experience with an addiction specialist physician was negatively associated with prescribing naltrexone for AUD. Respondents from the previous study of X-waivered APRNs were significantly more likely to prescribe naltrexone for reduced alcohol consumption as a treatment outcome than the respondents in this study.

Conclusion:

The recent policy change eliminating the X-waiver provides important context for research, adding to the substance use disorder literature.