bluuebunny/crossref_metadata_2025 huggingface dataset:
Exposure-response relationship of residential dampness and mold damage with severe lower respiratory tract infections among under-five children in Nigeria
Authors: Fakunle Adekunle Gregory , Jafta Nkosana , Okekunle Akinkunmi Paul , Smit Lidwien A. M , Naidoo Rajen N.
Published: March 2023

Background:

Previous epidemiological studies demonstrated an increased risk of respiratory health effects in children and adults exposed to dampness or mold. This study investigated associations of quantitative indicators of indoor dampness and mold exposure with severe lower respiratory tract infections (LRTI) among children aged 1–59 months in Ibadan, Nigeria.

Methods:

In-home visits were conducted among 178 children hospitalized with LRTI matched by age (±3 months), sex, and geographical location with 180 community-based children without LRTI. Trained study staff evaluated the indoor environment using a standardized home walkthrough checklist and measured visible dampness and mold damage. Damp-moldy Index (DMI) was also estimated to quantify the level of exposure. Exposure-response relationships of dampness and mold exposure with severe LRTI were assessed using multivariable restricted cubic spline regression models adjusting for relevant child, housing, and environmental characteristics.

Results:

Severe LRTI cases were more often male than female (61.8%), and the overall mean (SD) age was 7.3 (1.35) months. Children exposed to dampness <0.3 m2 (odds ratio [OR] = 2.11; 95% confidence interval [CI] = 1.05, 4.36), and between 0.3 and 1.0 m2 (OR = 2.34; 95% CI = 1.01, 7.32), had a higher odds of severe LRTI compared with children not exposed to dampness. The restricted cubic spline showed a linear exposure-response association between severe LRTI and residential dampness (P < 0.001) but a nonlinear relationship with DMI (P = 0.01).

Conclusions:

Residential dampness and DMI were exposure-dependently associated with higher odds of severe LRTI among under-five children. If observed relationships were causal, public health intervention strategies targeted at reducing residential dampness are critically important to mitigate the burden of severe LRTI among under-five children.
Quantifying The Burden of Persistent Musculoskeletal Pain in Employees at Rolls-Royce in The United Kingdom
Authors: Abraham Lucy , Russell Rachel , Sanchez-Riera Lidia , Emir Birol , Roomes David , Green Katy , Taylor-Stokes Gavin , Mirams Laura , Wallis Hannah , Burton Kim
Published: March 2023

Objective

We aimed to investigate the burden of persistent musculoskeletal (MSK) pain in Rolls-Royce UK employees.

Methods

Employees with (n = 298) and without (n = 329) persistent MSK pain completed a cross-sectional survey. Weighted regression analyses were conducted to compare sickness absence, work ability, workplace accommodations/adaptations, and emotional well-being between these cohorts, controlling for confounders.

Results

Persistent MSK pain (particularly back pain) had a significant impact on physical work ability and was associated with increased sickness absence due to pain. Many employees (56%) had not disclosed their condition to their managers. Of these, 30% felt uncomfortable doing so, and 19% of employees reported insufficient support at work for their pain.

Conclusions

These findings highlight the importance of creating a workplace culture that encourages the disclosure of work-relevant pain, enabling organizations to consider improved, tailored support for employees.
Comparable Levels of Objectively Measured Physical Activity and Cardiorespiratory Fitness in Firefighters From Two Midwest Fire Departments
Authors: Brin Halle N. , Perumal Mohan D. , Kopp Samantha R. , Hutcheson Evan L. , Dicks Nathan D. , Walch Tanis J. , Carper Michael J. , Barry Allison M.
Published: March 2023

Objective

The aim of the study is to objectively assess if firefighters are meeting the National Fire Protection Association (NFPA) cardiorespiratory fitness (CRF) and American College of Sports Medicine/American Heart Association physical activity (PA) guidelines.

Methods

Two independent fire departments from the Midwest participated in the study. Firefighters wore an accelerometer to track PA and associated intensities. In addition, firefighters completed a stage-graded exercise test TO determine their maximal oxygen uptake (V˙O2max).

Results

A total of 43 career firefighters completed the study (fire department 1 [FD1]: n = 29, FD2: n = 14). Almost half (44.8% FD1 and 42.9% FD2) met the NFPA CRF guidelines. Compared with the American College of Sports Medicine PA Guidelines of 30 min/d of moderate-to-vigorous PA, more than half of FD2 (57.1%) met the recommended amount of PA, whereas FD1 had less than half (48.3%).

Conclusions

These data demonstrate the need to improve firefighters’ PA levels, CRF, and overall health.
Depressive symptomatology in pregnant adolescents: considerations for care
Authors: Wittenberg Madeleine F. , Fitzgerald Shannon , Pluhar Emily
Published: March 2023

Purpose of review

Adolescents who are pregnant experience higher levels of depressive symptoms than nonpregnant peers and pregnant adults. Clinicians caring for youth are often the first point of clinical contact for pregnant adolescents but report low confidence in assessing and treating reproductive health concerns. In the current review, we outline risk factors for depressive symptoms among pregnant adolescents and provide guidance on best practices in assessment and treatment of depressive symptoms in this pediatric sub-population.

Recent findings

Depressive symptoms are persistent across pregnancy. In adolescents, they are linked to greater risk of suicidal ideation, suicidal behavior, and nonsuicidal self-injury. Risk factors for prenatal depressive symptoms among adolescents include lower levels of income, history of depression, exposure to childhood maltreatment and/or recent abuse, and/or lifetime exposure to racial/ethnic discrimination. These risk factors likely interact with each other.

Clinicians should assess carefully for depressive symptoms in all pregnant adolescents using a standardized, validated measure supplemented by thoughtful clinical interviewing. Clinicians can educate adolescents on the distinction between symptoms of pregnancy versus symptoms of depression. We encourage clinicians to increase their comfort in providing psychopharmacological treatment, consulting with colleagues in psychiatry, and referring adolescents for psychopharmacological treatment and therapy as needed.
Neurological manifestations of mycetoma: a cross-sectional community-based study
Authors: Ali Elkhansa A. , Hussien Mohamed Ahmed Khabab Abbasher , Alhusseini Radi Tofaha , Abdallah Abdallah M. , Ibrahim Muaz A. , Siddig Amira , Bahi Eilaf O. , Mahmmoud Fadelallah Eljack Mohammed , Hussien Abbasher
Published: March 2023

Introduction:

Mycetoma is a chronic specific granulomatous progressive and disfiguring subcutaneous inflammatory disease. It is caused by true fungi (Eumycetoma) or by higher bacteria (actinomycetoma). Mycetoma mainly affects the lower limbs, followed by the upper limbs, back, and rarely the head and neck. Mycetoma is mainly transmitted through trauma with infected sharp objects. Herein, we want to determine the neurological manifestations of mycetoma in Sudanese patients.

Methodology:

A descriptive cross-sectional community-based study included 160 patients with mycetoma seen in the White Nile state. A team of doctors collected data using standardized questionnaires that included clinical history, neurological examination, investigations including laboratory, neurophysiological studies, and imaging.

Results:

Almost 160 patients were included in the study; 90% of them were male. Two patients presented with entrapment neuropathy, one presented with proximal neuropathy, one had peripheral neuropathy, one had dorsal spine involvement and presented with spastic paraplegia with sensory level, one had cervical cord compression, and one patient had repeated attacks of convulsion.

Conclusion:

Although it is rare, clinicians should highly suspect neurological involvement in mycetoma patients.
BRCA1/2 mutations in GI cancers: the risk to Pakistani families
Authors: Samad Shahzaib , Khan Aysha
Published: March 2023

An article on the incidence of BReast CAncer gene 1/2 mutations in Pakistan to those of ovarian, breast, and other cancers, as well as their newly found association to gastrointestinal cancers, and the incidence and mortality rates of these malignancies. It involves a perspective on the epidemiological significance of BReast CAncer gene 1/2 mutations to various cancers and their immense risk to Pakistani families, as well as suggestions to tackle the problem, including possible advancement in their detection and treatment options to improve mortality rates.
Synovial sarcoma in the buttocks: an exceptional location – case report according to SCARE guidelines
Authors: Elmir Siham , Arghal Mohammed , Malki Samia , Bennani Amal , Skiker Imane , Abdeljaouad Najib , Yacoubi Hicham , Daoudi Abdelkrim , Bouziane Mohammed , El Oumri Ahmed A.
Published: March 2023

Introduction and Importance:

Pelvic pain is a frequent reason for consultation; the management is complex, given the differences in symptomatic and anatomical orientation. We present an exceptional case of intergluteal synovial sarcoma rarely described in the literature, with an incidence of about 1/1 000 000 and less than 10 cases of intergluteal location are published.

Case Presentation:

Through this publication, we present a very exceptional case of synovial sarcoma. It concerns a 44-year-old male followed for probable intergluteal lipoma for 3 months and admitted for intergluteal mass bleeding. The clinical examination revealed an intergluteal tumor mass, and the surgical resection was in favor of a synovial sarcoma.

The objectives of this work are threefold: to enrich the poor literature with this new case; to underline the importance of multidisciplinary management; to recommend the obligation of anatomopathological evidence to make the diagnosis of lipoma in front of a soft tissue tumor.

Discussion and Conclusion:

Our case enriches the poor literature on intergluteal synovial sarcoma, where less than 10 similar reports are available. We hope through our presentation to highlight this exceptional etiology of gluteal tumor and to recall that there is no relationship between the name of this tumor and the synovium as an anatomical entity.
Bleeding cavernous hemangioma of lower lip: a case report
Authors: Sigdel Brihaspati , Subedi Bipin
Published: March 2023

Introduction:

Hemangioma is a common benign vascular tumor. However, bleeding cavernous hemangioma of the lower lip are a rare condition.

Case presentation:

A 67-year-old female presented with bleeding from the lower lip. The bleeding increased with palpation. A clinical diagnosis of hemangioma of the lower lip was made. It was difficult to localize with ultrasound. It was explored and excised successfully.

Clinical discussion:

Hemangioma can be superficial, deep, or mixed. Generally, hemangioma involute spontaneously. Bleeding hemangioma causing functional disturbances need to be treated, for which various modalities are available, including excision.

Conclusion:

Hemangioma of the lip is a benign tumor of vascular origin. In selected cases, excision can be performed.
The use of acetaminophen in pregnancy: a double whammy
Authors: Shuja Muhammad H. , Shuja Syed H. , Shakil Firzah , Ahmed Ilsa
Published: March 2023

Acetaminophen is the most widely over the counter used analgesic in the world, and the World Health Organization advises using it as first-line treatment for pain issues (WHO).However, various side effects have been documented with its use such as nausea, vomiting, constipation at low doses whereas in large doses, it might even result in hepatoxicity.Recent literature suggests that the use of acetaminophen in pregnancy even in optimal doses could result infant being born with ADHD and autism, so in this short communication we talk about the prevalence of neurodevelopment disorders in infants as a result of its use, as well as shed light to the measures that should be adopted to minimize the adverse effects.
Clinicopathological correlation of aspartate aminotransferase-to-platelet ratio (APRI) and aspartate aminotransferase-to-alanine aminotransferase ratio (AAR) with survival in esophageal carcinoma patients: a retrospective cohort analysis of 951 patients
Authors: Zafar Muhammad Talha , Zia Beenish Fatima , Khalid Saleha Rashid , Bai Jharna , Memon Zahid Ali , Jan Zaka Ullah , Jadoon Sarosh Khan , Khan Noman Ahmed , Kajal Diksha , Ali Farukh , Kirmani Tooba Ahmed , Asghar Muhammad Sohaib
Published: March 2023

Background:

Esophageal cancer is the eighth most prevalent cancer globally. Previously, several biomarkers have been used to predict the prognosis, although with variable reliability. Interestingly, it is noted that changes in liver function tests levels before and after neoadjuvant treatment are predictive in terms of cancer recurrence.

Objectives:

The objectives of the current study were to associate novel markers, including aspartate aminotransferase-to-platelet ratio (APRI) and aspartate aminotransferase-to-alanine aminotransferase ratio (AAR) with survival in esophageal malignancy.

Materials and Methods:

A retrospective study in a tertiary care hospital (single-center) included 951 patients having diagnosed esophageal carcinoma of any age group.

Results:

The median (interquartile range) age of study participants were 50 (38–60) years, including 43% males and 57% female patients, while the median (interquartile range) levels of AAR and APRI were 0.97 (0.81–1.25) and 0.19 (0.13–0.29), respectively. AAR was found to be higher in dysphagia for solids only and dysphagia for both liquids and solids rather than liquids only (P=0.002), while other associations included well-differentiated tumor grade (P=0.011), finding of esophageal stricture on esophagogastroduodenoscopy (P=0.015), and characteristic of mass on computerized tomography scan being both circumferential and mural (P=0.005). APRI was found to be higher in adenocarcinoma (P=0.038), and finding of circumferential±ulcerated mass on esophagogastroduodenoscopy (P<0.001). On survival analysis, adenocarcinoma (P<0.001), luminal narrowing (P=0.002), AAR greater than 1.0 (P=0.006), and APRI greater than 0.2 (P=0.007) were found to be poor survival predictors. On Cox proportional hazards regression, APRI was found to be more associated with poor survival than AAR (Hazard ratio: 1.682, 1.208–2.340, P=0.002).

Conclusion:

This study correlated clinical and pathological features of esophageal malignancy with noninvasive markers of hepatic function.
Is damage control surgery useful in the treatment of colorectal perforation? A single-center case–control study
Authors: Kunitatsu Kosei , Ueda Kentaro , Nasu Toru , Kawashima Shuji , Okishio Yuko , Kato Seiya
Published: March 2023

Background:

Colorectal perforation with systemic peritonitis requires prompt surgical attention, and damage control surgery (DCS) is performed in patients with severe injuries. This study aimed to retrospectively investigate the efficacy of DCS in patients with colonic perforation.

Materials and Methods:

From January 2013 to December 2019, 131 patients with colorectal perforation underwent emergency surgery at our hospital. Among these, 95 patients required postoperative intensive care unit management and were included in this study; of these patients, 29 (31%) underwent DCS, and 66 (69%) underwent primary abdominal closure (PC).

Results:

Patients who underwent DCS had significantly higher Acute Physiology and Chronic Health Evaluation II (23.9 [19.5–29.5] vs. 17.6 [13.7–22]; P<0.0001) and Sequential Organ Failure Assessment (SOFA) (9 [7–11] vs. 6 [3–8]; P<0.0001) scores than did those who underwent PC. The initial operation time was significantly shorter for DCS than for PC (99 [68–112] vs. 146 [118–171]; P<0.0001). The 30-day mortality and colostomy rates were not significantly different between the two groups.

Conclusions:

The results suggest that DCS is useful in the management of acute generalized peritonitis caused by colorectal perforation.
A rare case of Weil’s disease with acute pancreatitis and acute kidney injury: focus on management – a case report
Authors: Hutajulu Reynaldo B. , Bramantono Bramantono , Rusli Musofa , Arifijanto Muhammad V. , Hadi Usman
Published: March 2023

Introduction and importance:

The clinical spectrum of leptospirosis ranges from subclinical infection and anicteric fever to Weil’s disease, a severely fatal infection. Acute inflammation of the pancreas is a rare manifestation of Weil’s disease, and renal involvement is a hallmark in severe forms, leading to acute kidney injury (AKI) and representing a major risk factor for death. The aim of the case report was to present the clinical manifestations of Weil’s disease with acute pancreatitis and AKI and to highlight the management of its complications.

Case presentation:

A 22-year-old male patient presented to the hospital with a chief complaint of a persisting fever, abdominal pain, nausea and vomiting, decreased appetite, malaise, and urine and feces discoloration. The patient’s residence had flooded 2 weeks ago. Laboratory tests were performed and the patient was diagnosed with Weil’s disease with the complication of acute pancreatitis, AKI, hyperkalemia, hyponatremia, hypotonic hypovolemic, metabolic acidosis, and hypoalbuminemia.

Clinical discussion:

The patient was treated with intravenous (i.v.) ceftriaxone at a dose of 2×1 g, i.v. metoclopramide at a dose of 3×10 mg, i.v. calcium gluconate at a dose of 1 g followed by dextrose (D) 40% with insulin 2 IU for six times, avoided nephrotoxic drugs, and fluid balance was maintained at I=O+500 ml. The patient received hemodialysis due to refractory hyperkalemia. Posttreatment follow-up presented improvements in complaints and laboratory parameters.

Conclusion:

Management of severe leptospirosis or Weil’s disease with the complication of acute pancreatitis and AKI requires antibiotics and supportive therapy including adequate fluid resuscitation, proper and adequate nutrition, as well as the initiation of hemodialysis.
Primary tracheal carcinoid tumor misdiagnosed as asthma: a rare case report
Authors: Shrateh Oadi N. , Jobran Afnan W.M. , Jaber Saja , Kahla Ahmad , Shamieh Bashar S. , Bakri Izzeddin A. , Abu Asbeh Yousef
Published: March 2023

Introduction:

About 2% of all lung malignancies are pulmonary carcinoid tumors, a family of neuroendocrine tumors. Rarely does a typical tracheal carcinoid of the trachea manifest as an endoluminal polypoidal tumor.

Case presentation:

The author describe a 61-year-old nonsmoker who complained of growing nonexertional shortness of breath 5 years ago. She also had a wheezy chest and a dry cough. The results of the chest radiography and electrocardiogram revealed no noteworthy abnormalities. The results of the pulmonary function test supported the diagnosis of bronchial asthma. A patient’s treatment has not advanced. After performing a bronchoscopy, a biopsy was taken and sent for pathological analysis. The endobronchial lining was found to have a subepithelial tumor infiltrate made up of nests of homogeneous bland cells with central nuclei and mild granular cytoplasm, according to histopathologic analysis. Considering all of these findings, the patient was diagnosed with a primary tracheal carcinoid tumor, which was misdiagnosed and treated as bronchial asthma.

Discussion and conclusion:

People with stridor or trepopnea symptoms should undergo a computed tomography scan since central airway tumors can mimic the symptoms of bronchial asthma while a chest radiograph may be normal. Tracheal carcinoid that has not progressed to the mediastinum can be successfully removed with flexible bronchoscopy and electrocautery, but the excision site needs to be continuously watched for recurrence.
Predictors of surgical site infection among women following cesarean delivery in eastern Ethiopia: a prospective cohort study
Authors: Adane Amlak , Gedefa Leta , Eyeberu Addis , Tesfa Tewodros , Arkew Mesay , Tsegaye Setegn , Getachew Tamirat , Debella Adera , Yadeta Elias , Abdisa Lemesa , Dheresa Merga
Published: March 2023

Background:

Despite the availability of prophylactic antibiotics prior to skin incisions, surgical site infection (SSI) following cesarean section (CS) remains an unresolved health issue. As a result, this study aimed to assess the incidence and predictors of SSI after a CS.

Methods:

The authors conducted a prospective cohort study in eastern Ethiopia. The women were serially enrolled until the desired sample size was reached. A structured questionnaire was used to collect data. Women were followed at the hospital during their weekly visits. Culture-based microbiological methods were used to identify causal agents. A binary logistic regression model was used to identify the predictors of SSI after CS.

Results:

Among serially enrolled women, 336 were followed for 30 days. The incidence of SSI was 7.74% (95% CI: 7.68–7.80). Rupture of the membrane before operation [adjusted odds ratio (AOR)=3.75, 95% CI: 1.85–16.6], labor duration greater than 24 h (AOR=4.04, 95% CI: 1.52–10.79), and postoperative hemoglobin less than 11 g/dl (AOR=3.42, 95% CI: 1.32–8.87) were all significantly associated with SSI. The most common isolated pathogen was Staphylococcus aureus, followed by Escherichia coli.

Conclusions:

Nearly one-tenth of the women developed SSIs. Factors such as rupture of the membrane before the operation, absence of antenatal care, labor duration greater than 24 h, a midline skin incision, and postoperative hemoglobin less than 11 g/dl were the predictors of SSI. To reduce the incidence of SSI, policymakers should consider the importance of high-quality antenatal care, shorten the duration of labor, and maintain women’s hemodynamics in future SSI prevention bundles.
Infant Electrocution Due to Smartphone Charge Cable—A Hidden Public Health Risk
Authors: Dündar Ahmet Sedat , Sarın Abdullah Benna
Published: March 2023

The report examines the autopsy and scene of accident findings of a 9-month-old male infant who died from electric shock when he bit a telephone charge cable plugged into a 3-socket extension lead.

At the time of the incident, the infant's father was working outside and his mother had gone to the bathroom, leaving the infant alone in the sitting room. The infant crawled across the floor, reached a telephone charge cable that was plugged into a 3-socket extension lead, and bit the end of the cable. He was found lying motionless on the floor, holding the cable in his hand. He was sent to center for the medicolegal autopsy, during which burns and electric shock entry wounds were found on his mouth, tongue, and right hand. Histopathological examination of the samples taken from the wounds garnered findings consistent with electric shock and thermal effect.

This article presents findings of an electric shock entry wound on the tongue, which is rarely seen as the result of a domestic accident. Education is needed to increase awareness among parents about accidents in the home involving children and to encourage preference for electrical products that have shown high success in safety tests.
“Montelukast attenuates retraction of expanded flap by inhibiting capsule formation around silicone expander via TGF-β1 signaling.”
Authors: Dong Chen , Yu Zhou , Du Jing , Zhang Yu , liu Wei , Huang Zhaosong , Xiong Shaoheng , Wang Tong , Song Yajuan , Ma Xianjie
Published: March 2023

Background:

Tissue expansion has tremendous applications in plastic surgery, but flap retraction provides insufficient tissue for use. Inspired by the use of montelukast to suppress capsular contracture, we investigated the effects of montelukast on capsule formation around the expander and retraction of the expanded scalp of the rat.

Methods:

Thirty-six male Sprague Dawley rats were randomly divided into control and montelukast groups. In each group, 12 expanded flaps with or without capsules were harvested for histological and molecular analysis; the six remaining expanded flaps were transferred to repair defects. Myofibroblast and TGF-β1 expression in the capsule was determined using immunofluorescence. Capsule ultrastructure was observed using transmission electron microscopy. Related protein expression in the capsules was detected using Western blot analysis.

Results:

A comparison of control and montelukast groups revealed that areas of the harvested expanded flaps with capsules were greater (2.04 ± 0.11 cm 2 vs. 2.42 ± 0.12 cm 2, respectively; p = 0.04); the retraction rate decreased (41.3 ± 2.16% vs. 28.13 ± 2.17%, respectively; p < 0.01). However, the increased areas and decreased retraction disappeared after capsule removal. The number of myofibroblasts declined. Thin, sparse collagen fibers were observed in the capsules. The expression of COL1, COL3, TGF-β1, EGR1, and phosphorylated ERK1/2 in the capsules decreased. Furthermore, the recipient area repaired by the transferred expanded flap was increased from 4.25 ± 0.39 cm 2 to 6.58 ± 0.31 cm 2（p < 0.01).

Conclusions:

Montelukast attenuates retraction of the expanded flap by inhibiting capsule formation through suppressing TGF-β1 signaling.
Establishing a xenograft model with CD-1 nude mice to study human skin wound repair
Authors: Abbas Darren B. , Griffin Michelle , Fahy Evan J. , Spielman Amanda F. , Guardino Nicholas J. , Pu Adrian , Lintel Hendrik , Lorenz H. Peter , Longaker Michael T. , Wan Derrick C.
Published: March 2023

Background:

A significant gap exists in the translatability of small animal models to human subjects. One important factor is poor laboratory models involving human tissue. Thus, we have created a viable postnatal human skin xenograft model using athymic mice.

Methods:

Discarded human foreskins were collected following circumcision. All subcutaneous tissue was removed from these samples sterilely. Host CD-1 nude mice were then anesthetized, and dorsal skin was sterilized. A 1.2cm diameter, full-thickness section of dorsal skin was excised. The foreskin sample was then placed into the full-thickness defect in the host mice and sutured into place. Xenografts underwent dermal wounding using a 4 mm punch biopsy after engraftment. Xenografts were monitored for 14 days after wounding and then harvested.

Results:

At 14 days postoperatively, all mice survived the procedure. Grossly, the xenograft wounds showed formation of a human scar at POD-14. H&E and Masson Trichome staining confirmed scar formation in the wounded human skin. Using a novel Artificial Intelligence (AI) algorithm using Picrosirius-Red staining, scar formation was confirmed in human wounded skin compared to the unwounded skin. Histologically, CD31 + immunostaining confirmed vascularization of the xenograft. The xenograft exclusively showed human collagen I, CD26 +, and human nuclear antigen in the human scar without any staining of these human markers in the murine skin.

Conclusion:

The proposed model demonstrates wound healing to be a local response from tissue resident human fibroblasts and allows for reproducible evaluation of human skin wound repair in a preclinical model.
Tubular Secretory Solute Clearance and HIV Infection
Authors: Garimella Pranav S. , Scherzer Rebecca , Kestenbaum Bryan R. , Hoofnagle Andrew N. , Jotwani Vasantha , Gustafson Deborah , Karim Roksana , Sharma Anjali , Cohen Mardge , Dumond Julie , Abraham Alison , Estrella Michelle , Shlipak Michael G. , Ix Joachim H.
Published: March 2023

Background:

Tubular secretion is an important kidney function responsible for the clearance of numerous medications, including antibiotics and antivirals. It is unknown whether persons living with HIV have lower secretion compared with HIV-uninfected persons, which might predispose them to the risk of progressive kidney disease or adverse drug events.

Setting and Methods:

We evaluated a panel of 6 endogenous secretory solutes in 199 women living with HIV (WLWH) and 100 women without HIV enrolled in the Women's Interagency HIV Study. Secretory clearance was estimated as the urine-to-plasma ratio of each solute, with adjustment for urine tonicity. Using multivariable linear regression analysis, we compared differences in levels of secretory solute clearance between women with and without HIV and evaluated characteristics associated with secretion.

Results:

WLWH were older (median 40 vs. 38 years) but had similar estimated glomerular filtration rate (eGFR, 96 vs. 100 mL/minute/1.73 m2) compared with those without HIV. African American and Latino race, diabetes, diastolic blood pressure, smoking, hepatitis C, peak HIV viral load, and current and nadir CD4 count were associated with differences in clearance of at least 1 marker after multivariable adjustment. The secretory clearance of 3 solutes (cinnamoylglycine, kynurenic acid, and pyridoxic acid) were on average 10%–15% lower among WLWH compared with those without HIV independent of eGFR, albuminuria and chronic kidney disease risk factors, including HCV, and injection drug use.

Conclusions:

HIV is associated with reduced secretion among women with preserved eGFR. The implications of these findings for drug dosing and adverse events need to be evaluated.
The Work-Life Interface of Registered Dietitian Nutritionists in the United States
Authors: Black Jenna , Williams Karla , Patten Emily Vaterlaus
Published: March 2023

This study explored registered dietitian nutritionists' (RDNs') work-life interface. A thematic analysis was conducted on survey responses from a national sample of RDNs (N = 1118). Three themes describe RDNs' work-life interface: motivators, adaptations and flexibility, and the price and rewards of work-life interface decisions. RDNs primarily identified their nonwork/family life as their priority. They discussed strategies used to adapt their work/career to create a workable lifestyle. RDNs also reflected on the price and rewards of their work-life interface decisions. Understanding motivations and managing the work-life interface may help amplify the contribution RDNs can make and retain practitioners in the workforce.
The Effects of Nutrition Education on the Handgrip Strength and Nutrition Status of Elderly Patients on Hemodialysis
Authors: Duran Sedef , Çakar Halenur , Çağlar Nurbanu , Dağaşan Selen
Published: March 2023

Nutrition education provided to patients on hemodialysis (HD) is important for improving nutritional status. This study investigated the effects of nutrition education on handgrip strength (HGS) of patients on HD. The study was a prospective self-controlled analysis of 29 patients on HD. The patients' measurements, HGS, and the Mini Nutritional Assessment (MNA) scores were examined. The HGS values and MNA scores measured in the first and third months after nutrition education were higher than those measured before nutrition education. The study showed that effective nutrition education may play an important role in improving HGS values of elderly patients on HD.
Effects of Resveratrol Supplementation on Nonalcoholic Fatty Liver Disease Management
Authors: Nemati Arefe , Nikniaz Zeinab , Mota Ali
Published: March 2023

In this study, we aimed to systematically review the studies that investigated the effect of resveratrol in nonalcoholic fatty liver disease (NAFLD). A systematic search of different databases was conducted until June 2021 and a meta-analysis was completed.

Six trials involving 232 participants were included. The meta-analysis results showed that serum triglycerides (P = .04), interleukin-6 (P = .01), tumor necrosis factor-α (P = .02), and systolic blood pressure (P = .04) levels were decreased significantly in the resveratrol group compared with the placebo group, while other parameters were not changed significantly. Although resveratrol might attenuate NAFLD development, more high-quality trials are required in this field.
Development and Evaluation of an Online Simulated Hospital Unit for Nutrition Assessment Training
Authors: Gaba Ann , Costa Sergio A. , Schnoll Roseanne , Dorfman Mary-Ellen , Cordova Steven , Jakuboski Susan , Spiegel Brett , Joshi Ashish
Published: March 2023

Students in a didactic program in dietetics (n = 147) and dietetic interns (n = 50) engaged with a web-based clinical simulation to practice the nutrition care process. An evaluation survey with open and closed-ended questions was used to collect data from participants. Survey results indicated that a majority of participants felt the simulation was easy to engage with, was valuable to their education, and facilitated their understanding of conducting nutrition assessments. Qualitative analysis of open-ended questions produced themes in participants' responses to their experience with the simulation. A web-based clinical simulation can be valuable in dietetics education and effectively support learning.
Assessing Stages of Change Knowledge and Use Among Nutrition Professionals
Authors: Beretich Kaitlan , Funderburk LesLee , Weems Suzy
Published: March 2023

The stages of change construct from the transtheoretical model has been applied to a wide variety of health-related behaviors including nutrition interventions. However, there is limited literature regarding how this construct is being applied in nutrition counseling. The purpose of this study was to survey nutrition professionals on their knowledge and use of the stages of change construct. Most participants are assessing this construct in practice. Use is dependent upon the practice setting and the patient population. Positively, most nutrition professionals would be willing to learn more about and/or use a validated tool to assess this construct in practice.
Temperatures and Voltages From the Electroconvulsive Therapy Stimulus
Authors: Swartz Conrad , Mirkovich David , Dietze Dominik
Published: March 2023

Introduction

Brain voltage and temperature during electroconvulsive therapy (ECT) are not widely understood but are commonly mischaracterized as resembling a blast.

Method

To better understand brain voltage and temperature during ECT, basic mathematical structural models were constructed and calculations were made. In addition, thermographic images were recorded before and after ECT stimuli were applied to a pork shoulder.

Results

A basic structural voltage model indicates that the voltage drop across single brain neurons is about 6 mV, with a gradient of 0.6 V/cm. This is an order of magnitude smaller than the action potential. Basic structural temperature models indicate that 100 joules raises skin temperature underneath ECT electrodes no more than 1°C, and within the brain by much less. The average temperature increase at each electrode was 0.70 to 0.94°C.

Conclusions

Voltage gradients and temperatures in the brain during the ECT stimulus are well within the range of ordinary physiological functioning. These results are consistent with previous reports that only a small fraction of the electrical stimulus enters the brain.
Explosive rigidity percolation in kirigami
Authors: Choi Gary P. T. , Liu Lucy , Mahadevan L.
Published: March 2023

Controlling the connectivity and rigidity of kirigami, i.e. the process of cutting paper to deploy it into an articulated system, is critical in the manifestations of kirigami in art, science and technology, as it provides the resulting metamaterial with a range of mechanical and geometric properties. Here, we combine deterministic and stochastic approaches for the control of rigidity in kirigami using the power of

k

choices, an approach borrowed from the statistical mechanics of explosive percolation transitions. We show that several methods for rigidifying a kirigami system by incrementally changing either the connectivity or the rigidity of individual components allow us to control the nature of the explosive transition by a choice of selection rules. Our results suggest simple lessons for the design of mechanical metamaterials.
Universal dynamics of biological pattern formation in spatio-temporal morphogen variations
Authors: Dalwadi Mohit P. , Pearce Philip
Published: March 2023

In biological systems, chemical signals termed morphogens self-organize into patterns that are vital for many physiological processes. As observed by Turing in 1952, these patterns are in a state of continual development, and are usually transitioning from one pattern into another. How do cells robustly decode these spatio-temporal patterns into signals in the presence of confounding effects caused by unpredictable or heterogeneous environments? Here, we answer this question by developing a general theory of pattern formation in spatio-temporal variations of ‘pre-pattern’ morphogens, which determine gene-regulatory network parameters. Through mathematical analysis, we identify universal dynamical regimes that apply to wide classes of biological systems. We apply our theory to two paradigmatic pattern-forming systems, and predict that they are robust with respect to non-physiological morphogen variations. More broadly, our theoretical framework provides a general approach to classify the emergent dynamics of pattern-forming systems based on how the bifurcations in their governing equations are traversed.
Life-history speed, population disappearances and noise-induced ratchet effects
Authors: Greyson-Gaito Christopher J. , Gellner Gabriel , McCann Kevin S.
Published: March 2023

Nature is replete with variation in the body sizes, reproductive output and generation times of species that produce life-history responses known to vary from small and fast to large and slow. Although researchers recognize that life-history speed likely dictates fundamental processes in consumer-resource interactions like productivity and stability, theoretical work remains incomplete in this critical area. Here, we examine the role of life-history speed on consumer–resource interactions by using a well-used mathematical approach that manipulates the speed of the consumer's growth rate in a consumer–resource interaction. Importantly, this approach holds the isocline geometry intact, allowing us to assess the impacts of altered life-history speed on stability (coefficient of variation, CV) without changing the underlying qualitative dynamics. Although slowing life history can be initially stabilizing, we find that in stochastic settings slowing ultimately drives highly destabilizing population disappearances, especially under reddened noise. Our results suggest that human-driven reddening of noise may decrease species stability because the autocorrelation of red noise enlarges the period and magnitude of perturbations, overwhelming a species' natural compensatory responses via a ratchet-like effect. This ratchet-like effect then pushes species’ population dynamics far away from equilibria, which can lead to precipitous local extinction.
Diet changes thermal acclimation capacity, but not acclimation rate, in a marine ectotherm (Girella nigricans) during warming
Authors: Hardison Emily A. , Schwieterman Gail D. , Eliason Erika J.
Published: March 2023

Global climate change is increasing thermal variability in coastal marine environments and the frequency, intensity and duration of marine heatwaves. At the same time, food availability and quality are being altered by anthropogenic environmental changes. Marine ectotherms often cope with changes in temperature through physiological acclimation, which can take several weeks and is a nutritionally demanding process. Here, we tested the hypothesis that different ecologically relevant diets (omnivorous, herbivorous, carnivorous) impact thermal acclimation rate and capacity, using a temperate omnivorous fish as a model (opaleye,Girella nigricans).We measured acute thermal performance curves for maximum heart rate because cardiac function has been observed to set upper thermal limits in ectotherms. Opaleye acclimated rapidly after raising water temperatures, but their thermal limits and acclimation rate were not affected by their diet. However, the fish's acclimation capacity for maximum heart rate was sensitive to diet, with fish in the herbivorous treatment displaying the smallest change in heart rate throughout acclimation. Mechanistically, ventricle fatty acid composition differed with diet treatment and was related to cardiac performance in ways consistent with homoviscous adaptation. Our results suggest that diet is an important, but often overlooked, determinant of thermal performance in ectotherms on environmentally relevant time scales.
Travel-associated lineages and unique endemic antimicrobial-susceptible lineages of Neisseria gonorrhoeae predominate in Western Australia
Authors: Al Suwayyid Barakat A. , Haese Ethan C. , Mowlaboccus Shakeel , Pearson Julie C. , Whiley David M. , Armstrong Paul K. , Giele Carolien M. , Mak Donna B. , Bastian Lisa , Wise Michael J. , Coombs Geoffrey W. , Kahler Charlene M.
Published: March 2023

In Australia, gonococcal isolates are monitored for antimicrobial susceptibilities. In Western Australia (WA), gonorrhoea notification rates increased by 63 % between 2013 and 2016, with the steepest increase occurring between 2015 and 2016, before stabilizing at this higher baseline between 2017 and 2020. This increased prevalence was associated with antimicrobial-susceptible (AMS) lineages. To understand the provenance of these isolates causing gonorrhoea in WA, whether they were introduced or expanded from endogenous lineages, 741 isolates were collected in 2017 and characterized by both iPLEX typing and whole genome sequencing (WGS). Antibiograms and genocoding of the isolates revealed that AMS isolates were most prevalent in the remote regions, while the urban/rural regions were characterized by antimicrobial-resistant (AMR) isolates. iPLEX typing identified 78 iPLEX genotypes (WA-1 to WA-78) of which 20 accounted for over 88 % of isolates. WA-10 was the most frequently identified genotype in the urban/rural regions whilst WA-29 was the most frequently identified genotype in the remote regions. Genotypes WA-38, WA-52 and WA-13 accounted for 81 % (n=36/44) of the azithromycin-resistant

N. gonorrhoeae

(AziR) isolates. A representative isolate of each iPLEX genotype and AMR biotype was whole genome sequenced and analysed using MLST, NG-MAST and NG-STAR, and the novel core genome clustering Ng_cgc_400 typing scheme. Five predominant Bayesian population groups (termed BPG-1 to 5) were identified in the study collection. BPG-1 and BPG-2 were associated with AMS isolates from the remote regions. BPG-1 and BPG-2 were shown to be unique to the remote regions based on a minimum spanning tree against 4000 international isolates. AMS isolates in urban/rural regions were dominated by international lineages. AziR and Cef DS (decreased susceptibility to ceftriaxone) was concentrated in three urban/rural genomic groups (BPG-3, 4 and 5). Azithromycin minimum inhibitory concentrations (0.5–16 mg l−1) correlated with the accumulation of mtrR mutations or/and the fraction of 23S rRNA C2611T mutated copies. The majority of isolates in BPG-3, 4 and 5 could be correlated with known AMR lineages circulating globally and nationally. In conclusion, the surge in AMS isolates in WA in 2017 was due to importation of international AMS lineages into urban/rural regions, whilst the local AMS lineages persisted largely in the remote regions. Bridging between the urban/rural and remote regions was relatively rare, but continued surveillance is required to prevent ingress of AMR strains/lineages into the remote regions of WA.
Improvement of language function after C7 neurotomy at the intervertebral foramen in patients with chronic post-stroke aphasia: a phase I cohort study
Authors: Feng Juntao , Ma Xingyi , Hu Ruiping , Lv Minzhi , Li Tie , Li Peiyang , Qi Wenjun , Xu Miaomiao , Yang Jingrui , Shen Yundong , Xu Wendong
Published: March 2023

Background

Post-stroke aphasia is a common but intractable sequela which still needs new and more effective treatments. Evidence from follow-ups after contralateral seventh cervical nerve transfer surgery indicated that nerve transection leads to immediate language improvements in patients with right post-stroke aphasia.

Objective

Through a prospective cohort design, this study aims to prove that C7 neurotomy at the intervertebral foramen (NC7) combined with a 3-week intensive speech and language therapy (iSLT) can improve the language function in post-stroke aphasia patients.

Methods

In this study, patients aged over 18 years old and had been diagnosed with post-stroke aphasia for 1 year or longer were included. Primary outcomes were the change in the ability to retrieve personally relevant words in Boston Naming Test (BNT) with follow-up assessment after three-weeks’ iSLT post-operatively. As well as several secondary outcome measures including the Western Aphasia Battery (WAB), daily communication abilities (measured by the Communication Activities of Daily Living Third Edition [CADL-3]) and Fugl-Meyer of upper limb part (UEFM).

Results

The average increase of BNT score was 11.2 points from baseline to 3 weeks post-operatively (P=0.001, 95%CI: 8.1-14.1). The WAB and CADL-3 assessment showed 9.4, 10.4 points increasing in average (P<0.005, 95%CI: 4.6 to 14.1; P<0.001, 95%CI:6.7 to 14.1) from baseline to 4-week follow-up, respectively. The mean difference from baseline to 3 weeks post-operatively in UEFM score decreased 0.8 points (95% CI: -3.2 to 1.6; p<0.405).

Conclusions

NC7 plus iSLT significantly improved the language function in patients with post-stroke aphasia, and did not significantly affect the motor function of the right limb. The mechanism of this surgery needs to be further explored.
Association of Free-Living Diet Composition and Plasma Lipoprotein(a) Levels in Healthy Adults
Authors: Matveyenko Anastasiya , Seid Heather , Kim Kyungyeon , Matienzo Nelsa , Ramakrishnan Rajasekhar , Thomas Tiffany , Reyes-Soffer Gissette
Published: March 2023

Background

Lipoprotein (a) [Lp(a)] is an apoB100-containing lipoprotein with high levels positively associated with atherosclerotic cardiovascular disease (ASCVD). Lp(a) levels are largely genetically determined. Currently, the only approved therapy for patients with extreme elevations of Lp(a) is lipoprotein apheresis, which eliminates apoB100-containing particles including Lp(a). The current study analyzed the association of free-living diet composition with plasma Lp(a) levels.

Methods

Dietary composition data from 28 diverse participants was collected via a standardized protocol by registered dietitians using 24-hour recalls. Data were analyzed with the Nutrition Data System for Research (Version 2018). Diet quality was calculated using the Healthy Eating Index (HEI) score. Fasting plasma Lp(a) levels were measured via an isoform-independent ELISA.

Results

Subjects self-reported race/ethnicity [Black (n=18); Hispanic (n=7); White (n=3)]. The mean age was 48.3±12.5 years with 17 males. Median level of Lp(a) was 79.9 nmol/L (34.4-146.0) and was negatively associated with absolute (g/d) and relative (percent calories) intake of dietary saturated fatty acid (SFA) (SFA absolute: R= -0.43, p= 0.02, SFA calorie %: R= -0.38, p= 0.04), absolute palmitic acid intake (palmitic absolute: R= -0.38, p= 0.04), and absolute steric acid intake (steric absolute: R= -0.40, p= 0.03). Analyses of associations with HEI when stratified based on Lp(a) levels > or ≤ 100nmol/L revealed no significant associations with any of the constituent factors.

Conclusions

We found a negative relationship between dietary saturated fatty acid intake and Lp(a) levels in a diverse cohort of individuals. The mechanisms underlying this relationship require further investigation.