bluuebunny/crossref_metadata_2025 huggingface dataset:
Non-prosthetic peri-implant fracture of both forearm bones
Authors: Prieto Meré Jose Antonio , Barrera-Ochoa Sergi , Liburd-Hernández Dorka , Presas Jésica P
Published: August 2023

Peri-implant fractures occur in association with an implant that was used to treat a previous injury. Peri-implant fractures are considered relatively ‘new’ fractures for which there is no accepted classification system in practice. Treatment is difficult due to altered anatomy, the presence of orthopedic implants and phenomena such as stress shielding, osteopenia when not in use, and fracture remodeling. We present the case of a young man who presented to the emergency room after a sports accident with a successful previous osteosynthesis and a new deformity of the forearm.
Acute endocarditis in a pregnant patient requiring post-partum emergency mitral valve repair: a case report
Authors: Ravishankar Ramanish , Hussain Azar , Loubani Mahmoud , Chaudhry Mubarak
Published: August 2023

A 37-year-old pregnant patient presented with symptoms of shortness of breath, cough and malaise at 36 weeks’ gestation. Antibiotics were started because of suspected bilateral pneumonia. A lower segment caesarean section was undertaken and significant desaturation lead to intubation of the patient. A CTPA confirmed bilateral pneumonia but also elements of heart failure with a 32 mm dilated pulmonary artery. Severe mitral regurgitation was confirmed with trans-thoracic and trans-oesophageal echocardiogram on Day 5 and emergency mitral valve repair was undertaken for possible infective endocarditis (IE) as per the modified Duke criteria, which was confirmed intra-operatively. The patient completed 4 weeks of antibiotics and suffered mild memory impairment post-operatively. She was discharged from complex rehabilitation after 6 weeks of hospital stay at her baseline state. This case presents IE in a pregnant patient with no significant risk factors with successful recovery because of prompt diagnosis and management.
Combined stepladder incision and Sistrunk procedure for en bloc resection of supraclavicular thyroglossal duct cysts
Authors: Matsushima Hirokazu , Katsura Morihiro , Ie Masafumi , Fukuzato Yoshimitsu
Published: August 2023

The accurate diagnosis and therapeutic strategies of thyroglossal duct cysts (TGDCs) are challenging for surgeons if the opening with exudate is far from the hyoid bone. A 7-year-old boy presented with a right supraclavicular mass and persistent pus. Ultrasonography and magnetic resonance imaging revealed the fistula to the hyoid bone. Suspecting a TGDC, we combined the stepladder incision technique and the Sistrunk procedure. The first skin incision cut through the opening in a spindle shape, and the second incision was made in the skin just above the hyoid bone. This combined technique allowed en bloc resection of the TGDC and the hyoid bone to the base of the tongue. Cervical masses are commonly encountered in surgical clinics, and even distant openings off the midline must be considered in the differential diagnosis of TGDCs. This treatment strategy is essential for preventing the recurrence of TGDCs and ensures optimal cosmetic outcomes.
Pseudoaneurysm of radial artery after coronary angiography
Authors: Cunha Roberto , Silva Manuel , Henrique Alberto , Maximiano Pedro , Correia Mafalda , Vieira Isabel , Cássio Isabel , Oliveira Nelson , Dias Emanuel
Published: August 2023

Iatrogenic pseudoaneurysms (IPA) are a rare complication of transradial coronary intervention. This brief report aims to present a case report of a radial artery pseudoaneurysm and to review the current management of this entity. Because of the increased performance of transradial coronary intervention, IPA have become more common. Doppler ultrasonography is a fundamental tool to aid the differential diagnosis with other pathologies. There is no consensus on the treatment, which may range from conservative management to surgical repair. Close surveillance after the procedure and early diagnosis are essential to avoid serious complications, such as ischemia of the hand. The management of IPA depends upon morphological characteristics and associated symptoms.
Not Special People: Lesbian and Gay Men’s Encounters with the East Berlin Government, 1983–90
Authors: Johnson Jason
Published: August 2023

In the 1980s, East Germany granted gay people extraordinary new rights in an attempt to neutralize them as a threat to the communist regime. Within this context of change, though, the East Berlin municipal government refused gay activists permission to form a state-sanctioned club for homosexuals. Speaking to the place of civic life in the country and the history of everyday life of East German lesbians and gay men, this article has two goals. First, it builds on existing historiography by illustrating the precise dynamics of the interactions between gay activists and East German authorities, revealing a familiar modern bureaucratic landscape. Second, this article seeks to explain why municipal officials who demonstrated sympathy toward these activists nevertheless denied this group the right to form a club. This analysis argues that the denial of a club was ironically driven by authorities’ conviction that gay East Germans indeed faced discrimination. Officials believed discrimination in the German Democratic Republic had isolated its gay citizens, rendering them targets of Western enemies of the state and potential fifth columnists as the West could galvanize their resentment into antistate action. To officials, the activists’ attempts to overcome such isolation via a state-sanctioned club actually promised to reinforce isolation and make Western infiltration and subversion more likely.
Associations between gynecologic clinician type and routine female sexual dysfunction screening
Authors: Berry William C E , Capbarat Emily V , Walker Taniya V , Rosenberg Sedona F , Keegan Emma A , Carter-Brooks Charelle M , Cigna Sarah T
Published: August 2023

Background

Female sexual dysfunction (FSD) is a common problem in the United States; however, only 14% to 40% of women are screened by their health care clinicians. There are few data on how differences in clinician type affects screening rates.

Aim

This study aimed to assess differences in FSD screening rates among gynecology clinician types, identify factors associated with screening, and compare screening rates of FSD against conditions with established screening recommendations.

Methods

Data were collected by retrospective chart review of annual visits at an urban tertiary care center. Screening rates for FSD, depression, cervical cancer, and breast cancer were calculated and compared. Multivariable logistic regression modeling was utilized to assess the correlation between various patient characteristics and FSD screening rates.

Outcomes

Study outcome measures included percentages of women who were screened for FSD, depression, cervical cancer, and breast cancer.

Results

FSD screening rate was significantly higher among resident-level clinicians vs nonresident clinicians (59% vs 31%; P < .001). When the nonresident clinicians were subanalyzed, certified nursing midwives were the second most likely to screen for FSD (odds ratio [OR], 0.41), followed by nurse practitioners (OR, 0.29) and attending physicians (OR, 0.22). According to multivariable logistic regression techniques, 5 factors were associated with an increased likelihood of a patient being screened for FSD at an annual examination: patient seen by a resident physician rather than an attending physician, patient history of FSD, patient age ≥40 years, patient report of being sexually active at the time of visit, and patient history of cervical procedures.

Clinical Implications

There is an opportunity to improve FSD screening rates by clinicians. Future research may assess what factors, such as increased sexual function education or greater incentives to document FSD screening, may result in higher screening rates. From this, targeted and effective interventions might be crafted to improve future screening rates.

Strengths and Limitations

This study is one of the first to compare FSD screening rates among clinician types in the same specialty. Study limitations include the inherent limitations of a retrospective design, including selection biases.

Conclusion

Residents were more likely to screen for FSD at annual well-woman visits than attending clinicians, nurse practitioners, and certified nurse midwives. Understanding the reasons for varied FSD screening rates among clinician types may aid in the development of strategies to improve screening for this important aspect of women’s health.
The origin of long soft lags and the nature of the hard-intermediate state in black hole binaries
Authors: Kawamura Tenyo , Done Chris , Takahashi Tadayuki
Published: August 2023

Fast variability of the X-ray corona in black hole binaries can produce a soft lag by reverberation, where the reprocessed thermalized disc photons lag behind the illuminating hard X-rays. This lag is small, and systematically decreases with increasing mass accretion rate towards the hard–soft transition, consistent with a decreasing truncation radius between the thin disc and X-ray hot inner flow. However, the soft lag suddenly increases dramatically just before the spectrum becomes disc dominated (hard-intermediate state). Interpreting this as reverberation requires that the X-ray source distance from the disc increases dramatically, potentially consistent with switching to X-rays produced in the radio jet. However, this change in lag behaviour occurs without any clear change in hard X-ray spectrum, and before the plasmoid ejection event that might produce such a source (soft-intermediate state). Instead, we show how the soft lag can be interpreted in the context of propagation lags from mass accretion rate fluctuations. These normally produce hard lags, as the model has radial stratification, with fluctuations from larger radii modulating the harder spectra produced at smaller radii. However, all that is required to switch the sign is that the hottest Comptonized emission has seed photons that allow it to extend down in energy below the softer emission from the slower variable turbulent region from the inner edge of the disc. Our model connects the timing change to the spectral change, and gives a smooth transition of the X-ray source properties from the bright hard state to the disc-dominated states.
The role of stellar expansion on the formation of gravitational wave sources
Authors: Romagnolo A , Belczynski K , Klencki J , Agrawal P , Shenar T , Szécsi D
Published: August 2023

Massive stars are the progenitors of black holes and neutron stars, the mergers of which can be detected with gravitational waves (GW). The expansion of massive stars is one of the key factors affecting their evolution in close binary systems, but it remains subject to large uncertainties in stellar astrophysics. For population studies and predictions of GW sources, the stellar expansion is often simulated with the analytic formulae from Hurley et al. (2000). These formulae need to be extrapolated and are often considered outdated. In this work, we present five different prescriptions developed from 1D stellar models to constrain the maximum expansion of massive stars. We adopt these prescriptions to investigate how stellar expansion affects mass transfer interactions and in turn the formation of GW sources. We show that limiting radial expansion with updated 1D stellar models, when compared to the use of Hurley et al. (2000) radial expansion formulae, does not significantly affect GW source properties (rates and masses). This is because most mass transfer events leading to GW sources are initialized in our models before the donor star reaches its maximum expansion. The only significant difference was found for the mass distribution of massive binary black hole mergers (Mtot > 50 M⊙) formed from stars that may evolve beyond the Humphreys–Davidson limit, whose radial expansion is the most uncertain. We conclude that understanding the expansion of massive stars and the origin of the Humphrey–Davidson limit is a key factor for the study of GW sources.
Field blue straggler stars: discovery of white dwarf companions to blue metal-poor stars using UVIT/AstroSat
Authors: Panthi Anju , Subramaniam Annapurni , Vaidya Kaushar , Jadhav Vikrant , Rani Sharmila , Thirupathi Sivarani , Pandey Sindhu
Published: August 2023

Blue metal-poor (BMP) stars are the main-sequence stars that appear bluer and more luminous than normal turn-off stars of metal-poor globular clusters. They are believed to be either field blue straggler stars (FBSS) formed via post-mass transfer mechanism or accreted from dwarf satellite galaxies of the Milky Way. A significant fraction of BMP stars are discovered to be potential binaries. We observed 27 BMP stars using UVIT/AstroSat in two FUV filters, F148W and F169M. We report the discovery of white dwarf (WD) companions of 12 BMP stars for the first time. The WD companions have estimated temperatures Teff ∼10 500–18 250 K, and masses 0.17–0.8 M⊙. Based on [Fe/H] and space velocity, we group the 12 BMP/FBSS stars as the thick disc (5) and halo (5), whereas two stars appear to be in-between. All the 5 thick disc BMP/FBSS have extremely low-mass (M < 0.2 M⊙) WDs as companions, whereas the 5 halo BMP/FBSS have low (0.2 M⊙ < M < 0.4 M⊙), normal (0.4 M⊙ < M < 0.6 M⊙), and high mass (M > 0.6 M⊙) WD companions. Our analysis suggests that at least ∼44 ${{\ \rm per\ cent}}$ of BMP stars are FBSS, and these stars hold the key to understand the details of mass transfer, binary properties, and chemical enrichment among the FBSS.
Host adaptation drives genetic diversity in a vector-borne disease system
Authors: Combs Matthew A , Tufts Danielle M , Adams Ben , Lin Yi-Pin , Kolokotronis Sergios-Orestis , Diuk-Wasser Maria A
Published: August 2023

The range of hosts a pathogen can infect is a key trait, influencing human disease risk and reservoir host infection dynamics. Borrelia burgdorferi sensu stricto (Bb), an emerging zoonotic pathogen, causes Lyme disease and is widely considered a host generalist, commonly infecting mammals and birds. Yet the extent of intraspecific variation in Bb host breadth, its role in determining host competence, and potential implications for human infection remain unclear. We conducted a long-term study of Bb diversity, defined by the polymorphic ospC locus, across white-footed mice, passerine birds, and tick vectors, leveraging long-read amplicon sequencing. Our results reveal strong variation in host breadth across Bb genotypes, exposing a spectrum of genotype-specific host-adapted phenotypes. We found support for multiple niche polymorphism, maintaining Bb diversity in nature and little evidence of temporal shifts in genotype dominance, as would be expected under negative frequency-dependent selection. Passerine birds support the circulation of several human-invasive strains (HISs) in the local tick population and harbor greater Bb genotypic diversity compared with white-footed mice. Mouse-adapted Bb genotypes exhibited longer persistence in individual mice compared with nonadapted genotypes. Genotype communities infecting individual mice preferentially became dominated by mouse-adapted genotypes over time. We posit that intraspecific variation in Bb host breadth and adaptation helps maintain overall species fitness in response to transmission by a generalist vector.
An assessment of the effectiveness of an electronic wristband in improving routine immunization timeliness and reducing drop-out
Authors: Sampson Sidney , Adenipekun Adebisi , Atobatele Sunday , Ayodeji Oluwafisayo , Omeje Oluomachukwu , Oni Folake
Published: August 2023

Background

To assess the effectiveness of a wristband for immunization alert (WIA) as a reminder device to caregivers to improve immunization timeliness and reduce drop-outs.

Methods

Eight health facilities, selected from two local government areas in Kano state, Northwestern Nigeria, were clustered in a two-arm study involving an intervention group and a control group. Only the caregivers (757) from the intervention group received WIA as an immunization reminder device. Immunization timeliness data were then collected from the control and intervention groups for the period of intervention and analyzed using Microsoft Excel and IBM SPSS version 21.

Results

A cohort analysis of caregivers who received WIA at their second visit showed an increase in immunization timeliness from 10% at the second visit to 86% at the third visit and maintained at 66% for the fifth visit. A difference-in-difference analysis of the effect of WIA on immunization timeliness from baseline to end-line in the control and intervention groups showed a positive 30% increase in immunization timeliness associated with the introduction of WIA.

Interpretation

Given that immunization timeliness and drop-outs are reported issues of concern in Northwestern Nigeria, the use of the WIA device is a recommended intervention.
Mutation of amino acids in SARS-CoV-2 may be responsible for CoV-2 vaccine long term inefficiency
Authors: Alhaji Saganuwan Saganuwan
Published: August 2023

Objectives

SARS-CoV-2 vaccines confer protection for ~2 months, hence the need for a booster dose. The inefficiency of the vaccines may be attributed to mutated amino acids leading to changes in the structure and function of immunogenetic viral particles. Therefore, literature search was carried out with a view to identifying problems of CoV-2 vaccine long term inefficiency, using missensed amino acids of the immunogens.

Methods

Narrative review of six different COVID-19 vaccines administered at different centres to a total population of 98 979 individuals aged ≥18–95 years was adopted. The number of individuals that came down with infection postvaccination, vaccine dose administered, recorded mortality, postvaccinated infection-free individuals, immunogenicity status, missense mutation, incidence, probability and quality of mutation among amino acids sequences of the vaccinated viral particles were determined.

Key findings

Findings have shown that some live-attenuated vaccines such as BBIBP-CorV, WBIP, ChAdOxnCoV and Ad26.CoV2.5 are efficacious but could induce mortal infection and mutation of amino acids such as aspartic acid, glycine, cysteine, aspartate, tyrosine, phenylalanine, threonine, serine, alanine, methionine, leucine and lysine.

Conclusion

Mutation of some specific amino acids could be responsible for the severe pathogenicity of SARS-CoV-2 and vaccine failure. Modalities that regulate the synthesis of nucleobases and amino acids could be used to avert vaccine failure and improves the immunogenicity of the vaccines.
Compensatory gain based on lysine level in finishing pigs after being fed lysine deficient 97% corn diets for 3 or 6 wk
Authors: Hagen Chloe S , Spencer Joel D , Krahn Greg T , Greiner Laura L
Published: August 2023

The objective of this experiment was to evaluate increasing the concentration of lysine on the compensatory gain of finishing pigs during their recovery period after being fed a 97% corn holding diet for 3 or 6 wk. One thousand six hundred and eighty pigs with a starting body weight of 73.5 ± 2.2 kg were blocked by starting body weight and assigned to a nested arrangement. Twenty replicates of seven treatments were comprised of two restriction lengths [3 weeks (3 wk) vs. 6 weeks (6 wk)], and three lysine concentrations during recovery (Lys:ME same as control:100; control + 10%: 110; control + 20%: 120) plus one control (CONT) that remained nutrient unrestricted. Pen weight and feed intake were recorded on days 0, 21, 41, and at marketing. Whole pens were marketed when the pen average met 130 kg and carcass measurements were collected. Data were analyzed by pen with the fixed effects of restriction length and lysine within restriction length. Nutrient restriction lowered (P < 0.01) average daily gain (ADG) compared to control, with 1.2, 0.4, and 0.5 kg for control, 3 wk, and 6 wk treatments, respectively. Restricted pigs showed decreased feed intake while restricted. After the respective restriction period, pigs were allowed a recovery diet until market. Previously restricted pigs had 16.7% and 27.3% greater (P < 0.01) ADG over control pigs for 3 and 6 wk treatments, respectively, in the first 3-wk of recovery. The lysine concentration in the recovery diet impacted (P < 0.01) the ADG with pigs allowed the highest lysine concentration having a 10% greater ADG than pigs fed the lower Lys:ME concentrations, for both restriction treatments. The increase in ADG was not paralleled by an increase in feed intake over control, thus, there was an improvement (P < 0.01) in gain to feed ratio in the recovery period. Control pigs reached market weight (131.5 kg) on experiment day 49 while pigs fed corn diets for 3 wk or 6 wk were slower to market (57 and 69 days, respectively; P < 0.01). Restricted pigs had greater backfat (CONT: 1.47, 3 wk: 1.55, 6 wk: 1.65 cm; P < 0.01), and decreased loin depth (CONT: 7.32, 3 wk: 7.03, 6 wk: 6.61 cm, P < 0.02) which was also impacted (P < 0.01) by lysine concentration. In conclusion, the use of restrictive diets reduced ADG and increased days to market. The use of recovery diets in which the Lys:ME ratio was greater than control pigs, resulted in increased compensatory growth.
Effect of 4-Ethylbenzaldehyde from the Volatilome of Annona muricata on Meloidogyne incognita
Authors: de Paula Letícia L. , Campos Vicente P. , Terra Willian C. , Pedroso Márcio P. , Barros Aline F. , Pacheco Paulo V. M. , da Silva Maysa S. G.
Published: August 2023

The demand for new soil fumigants has increased as a result of more restrictive legislation regarding the use of pesticides. In the present study, the potent nematicidal activity of volatile organic compounds released by the Annona muricata leaf macerate was demonstrated. In addition, we searched in the A. muricata volatilome for a molecule with potential to be developed as a new fumigant nematicide. In the greenhouse, even the lowest concentration of soursop leaf macerate tested (1.0%) as a biofumigant caused a significant (P < 0.05) reduction in Meloidogyne incognita infectivity and reproduction when compared with the nontreated control (0%). Forty-one compounds were identified through gas chromatography–mass spectrometry analysis, of which three (sabinene, caryophyllene oxide, and 4-ethylbenzaldehyde) were selected for studies against the nematode. Among these compounds, in in vitro trails, only 4-ethylbenzaldehyde showed nematicidal activity at 250 µg ml−1. The effective doses of 4-ethylbenzaldehyde predicted to kill 50 and 95% of the M. incognita second-stage juvenile population after 48 h of exposure were 35 and 88 µg ml−1, respectively. In in vitro tests, 4-ethylbenzaldehyde at 150 µg ml−1 reduced M. incognita egg hatching to values similar (P > 0.05) to those of the commercial nematicide fluensulfone at a concentration of 200 µg ml−1. In plant experiments, as a soil fumigant, 4-ethylbenzaldehyde at a dose of 1 ml/liter of substrate had an effect similar (P > 0.05) to that of the commercial fumigant Dazomet (250 µg ml−1). Therefore, 4-ethylbenzaldehyde shows potential for development as a new nematicide.
Diaphragm Dysfunction Predicts Weaning Outcome after Bilateral Lung Transplant
Authors: Boscolo Annalisa , Sella Nicolò , Pettenuzzo Tommaso , Pistollato Elisa , Calabrese Fiorella , Gregori Dario , Cammarota Gianmaria , Dres Martin , Rea Federico , Navalesi Paolo ,   Padua-Lung Transplant Group
Published: August 2023

Background

Diaphragm dysfunction and its effects on outcomes of ventilator weaning have been evaluated in mixed critical care populations using diaphragm thickening fraction (the ratio of the difference between ultrasound diaphragm thickness at end-inspiration and end-expiration to diaphragm thickness at end-expiration) or neuroventilatory efficiency (the ratio of tidal volume and peak electrical activity of the diaphragm). Such data are not available in bilateral-lung transplant recipients. The authors hypothesized that (1) diaphragm dysfunction, as defined by a diaphragm thickening fraction less than 29%, is more likely to occur in difficult weaning; (2) diaphragm thickening fraction and neuroventilatory efficiency predict weaning outcome; and (3) duration of mechanical ventilation before the first spontaneous breathing trial is associated with diaphragm dysfunction.

Methods

Adult bilateral-lung transplant patients admitted to the intensive care unit were screened at the time of the first spontaneous breathing trial (pressure-support of 5 cm H2O and 0 positive end-expiratory pressure). At the fifth minute, diaphragm thickening fraction and neuroventilatory efficiency were measured during three respiratory cycles. Weaning was classified as simple, difficult, or prolonged (successful extubation at the first spontaneous breathing trial, within three or after three spontaneous breathing trials, respectively).

Results

Forty-four subjects were enrolled. Diaphragm dysfunction occurred in 14 subjects (32%), all of whom had difficult weaning (78% of the subgroup of 18 patients experiencing difficult weaning). Both diaphragm thickening fraction (24 [20 to 29] vs. 39 [35 to 45]%) and neuroventilatory efficiency (34 [26 to 45] vs. 55 [43 to 62] ml/µV) were lower in difficult weaning (both P < 0.001). The areas under the receiver operator curve predicting difficult weaning were 0.88 (95% CI, 0.73 to 0.99) for diaphragm thickening fraction and 0.85 (95% CI, 0.71 to 0.95) for neuroventilatory efficiency. The duration of ventilation demonstrated a linear inverse correlation with both diaphragm thickening fraction and neuroventilatory efficiency.

Conclusions

Diaphragm dysfunction is common after bilateral-lung transplantation and associated with difficult weaning. In such patients, average values for diaphragm thickening fraction and neuroventilatory efficiency were reduced compared to patients with simple weaning. Both parameters showed similar accuracy for predicting success of ventilator weaning, demonstrating an inverse relationship with duration of ventilation.

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Prolonged life-threatening anaphylaxis to Floseal during partial nephrectomy: A case report
Authors: McClintock George , Frishling David , Lam Yen , Mancuso Pascal
Published: August 2023

Floseal Hemostatic Matrix is a topical hemostatic agent used across specialties and commonly applied to the renal bed during partial nephrectomy. Here we present the first adult case of Floseal allergy in the literature and the second case of a topical gelatin hemostatic agent.

A 62-year-old man underwent partial nephrectomy for a Bosniak type IV cyst. After unclamping the kidney, the patient declined precipitously, later determined due to an anaphylactic reaction to the Floseal placed on the renal bed. The patient had a prolonged anaphylactic reaction that required ionotropic support for over 24 h, possibly due to continued exposure. His tryptase level was elevated, and allergy testing revealed an allergy to the gelatin matrix component of the Floseal.

Floseal anaphylaxis should be considered during episodes of cardiovascular collapse after drug administration. However, consideration should be given to removing it to prevent continued exposure and weighed against the risk of prolonged surgery in an anaphylactic patient.
Perception and Challenges of Time Management for Caregivers of People with Heart Failure
Authors: Cuoco Angela , Younas Ahtisham , Boyne Josiane , Juarez-Vela Raul , M. Rice Bridgette , Vellone Ercole , Durante Angela
Published: August 2023

Background

Informal caregivers contribute substantially to the self-care of people with heart failure (HF) by helping with concrete and interpersonal tasks. Time perception and management are essential issues among caregivers. However, investigators have not explored this topic in caregivers of people with HF.

Objectives

The aim of this study was to describe the perceptions and challenges of the time management experience among caregivers who support the self-care efforts of their relatives with HF.

Methods

Adult informal caregivers of patients with HF, taking care of the patient for at least 3 months and without cognitive limitations, were recruited from Spain, Italy, and the Netherlands. Data were collected using semistructured interviews. Maryring's qualitative content analysis strategy with both a deductive and an inductive approach was used for analysis.

Results

We enrolled 50 participants (20 Italians, 19 Spanish, and 11 Dutch). Caregivers had a mean (SD) age of 62.8 (12.8) years and were mostly female (84%). They dedicated 31.2 (SD, 21.7) hours per week to providing caring activities for their patients. After extracting 33 codes from their qualitative interview data, we summarized them into 8 categories and identified 4 main themes: (1) time for yourself, (2) house management, (3) time for the patient (dedicated to directing care), and (4) time for own socialization.

Conclusion

Caregivers navigate the complexity of time management by balancing dedicated time for supporting patients with HF and their own personal time.
Evaluating Firefighter On-Scene Decontamination Practices Using a National Fire Records Management System
Authors: Fernandez Antonio R. , Treichel Alison , Myers J. Brent , Bourn Scott S. , Crowe Remle P. , Gardner Bill
Published: August 2023

Objective

This study describes firefighters’ on-scene decontamination procedure use post–working fire and frequency of adherence to best practice.

Methods

This retrospective analysis of working fires was conducted using records from the ESO Data Collaborative (Austin, TX) national research database from January 1, 2021, to December 31, 2021. Documentation of decontamination procedures was examined among records with smoke or combustion products exposure. Firefighter and incident characteristics were evaluated. Descriptive statistics and univariable odds ratios were calculated.

Results

Among the 31,281 firefighters included in the study, 8.0% documented a fire-related exposure. Of those, 82% performed at least one on-scene decontamination procedure; 5% documented all decontamination procedures defined as best practices. The odds of documenting any decontamination procedure were significantly decreased among firefighters responding to incidents in rural areas compared with urban areas (odds ratio, 0.70).

Conclusions

Fire personnel may not be taking all necessary decontamination steps post–working fires.
Robotic Lobectomy is Cost-Effective and Provides Comparable Health Utility Scores to Video-Assisted Lobectomy
Authors: Patel Yogita S. , Baste Jean-Marc , Shargall Yaron , Waddell Thomas K. , Yasufuku Kazuhiro , Machuca Tiago N. , Xie Feng , Thabane Lehana , Hanna Waël C.
Published: August 2023

Objective:

Determine if robotic-assisted lobectomy (RPL-4) is cost-effective and offers improved patient-reported health utility for patients with early-stage NSCLC when compared to video-assisted lobectomy (VATS-Lobectomy).

Summary Background Data:

Barriers against the adoption of RPL-4 in publicly-funded healthcare include the paucity of high-quality prospective trials and the perceived high cost of robotic surgery.

Methods:

Patients were enrolled in a blinded, multi-centered, RCT in Canada, the USA, and France, and were randomized 1:1 to either RPL-4 or VATS-Lobectomy. EQ-5D-5L was administered at baseline and post-operative day 1; weeks 3, 7, 12; and months 6 and 12. Direct and indirect costs were tracked using standard methods. Seemingly Unrelated Regression was applied to estimate the cost effect, adjusting for baseline health utility. Incremental cost effectiveness ratio was generated by 10,000 bootstrap samples with multivariate imputation by chained equations.

Results:

Of 406 patients screened, 186 were randomized, and 164 analyzed after final eligibility review (RPL-4:n=81; VATS-Lobectomy:n=83). Twelve-month follow-up was completed by 94.51%(155/164) of participants. Median age was 68(60-74). There were no significant differences in body mass index, comorbidity, pulmonary function, smoking status, baseline health utility, or tumor characteristics between arms. The mean 12-week health utility score was 0.85(0.10) for RPL-4 and 0.80(0.19) for VATS-Lobectomy (P=0.02). Significantly more lymph nodes were sampled [10(8-13) vs 8(5-10); P=0.003] in the RPL-4 arm. The incremental cost/QALY of RPL-4 was $14,925.62(95% CI $6,843.69,$23,007.56) at 12-months.

Conclusions:

Early results of the RAVAL trial suggest that RPL-4 is cost-effective and associated with comparable short-term patient-reported health utility scores when compared to VATS-Lobectomy.
PATHOGENECITY AND ENZYME SCREENING OF SOME SELECTED NON-DERMATOPHYTIC MOLDS
Authors: Nwofor CN , Onyenwe NE , Osuaha CB
Published: August 2023

A total of 10 non-dermatophytic molds isolated from both symptomatic and asymptomatic cattle skin which includes Penicillumcitrinum, Aspergillus welwitschiae, Aspergillus aculeatus, Curvulariakusanol, Cladosporium teniussmum, Pestalotiopsismicrospora, Fusarium oxysporum,Fusarium linchenicola, Absidia sp. and Aspergillus fumigatus were subjected to a pathogenecity test using albino mice. These isolates were also screened for five enzymes using standard plate method.Result from pathogenecity test showed that Absidiasp, C.tenuissimum and Aspergillus welwitschiae were able to elicit discolouration, lesion production and alopecia on the albino mice skin respectively which are evidences of clinical symptoms associated of cutaneous mycoses. For enzyme screening  resultrevealed the highest zone of activity for keratinase (65mm), amylase (86mm), protease (60mm), lipase (60mm) and cellulase (86mm) which were observed on P.microspora, A.welwitschiae, C.tenuissimum, A.welwitschiae and  A. welwitschiaerespectively.  Pathogenecity test from this study shows that some of these molds are highly virulent and that can be attributed to their ability to posses some virulent factors which includes secretion of hydrolytic enzyme.
Four Models of Wastewater-Based Surveillance for SARS-CoV-2 in Jail Settings: How Monitoring Wastewater Complements Individual Screening
Authors: Kennedy S , Spaulding AC ,   SWANSS writing group *
Published: August 2023

Objective

To describe four unique models of implementing Wastewater Based Surveillance (WBS) for SARS-CoV-2 in jails of graduated sizes and differing architectural designs.

Methods

This study summarizes how jails of Cook County (Illinois, average daily population [ADP] 6000), Fulton County (Georgia, ADP 3000, Washington DC (ADP 1600) and Middlesex County (Massachusetts, ADP 875) initiated WBS between 2020 and 2023.

Results

Positive signal for SARS-CoV-2 via WBS can herald new onset of infection in a previously uninfected housing unit of a jail. Challenges in implementing WBS included political will and realized value, funding, understanding of the building architecture, and the need for granularity in the findings.

Conclusions

WBS has been effective for detecting outbreaks of SARS-CoV-2 in differing sized jails, both those with dorm-based and cell-based architectural design.

Policy implications

Given its effectiveness in monitoring SARS-CoV-2, WBS provides a model for population-based surveillance in carceral facilities for future infectious disease outbreaks.
The diagnostic role of abductor pollicis brevis -first dorsal interosseous (APB-FDI) index in diagnosing Amyotrophic lateral sclerosis (ALS) and comparison of its diagnostic performance with other tests demonstrating split hand phenomenon among Bangladeshi population
Authors: Islam Md. Shuktarul , Sina Hashmi , Alam Iftikher , Arifuzzaman Md. , Mahmud Reaz
Published: August 2023

Background

The split hand phenomenon is an early and distinctive feature of amyotrophic lateral sclerosis (ALS), resulting from the differential wasting of the intrinsic hand muscles, particularly the thenar muscles. This study aimed to assess the diagnostic role of the APB-FDI Index in the diagnosis of Amyotrophic Lateral Sclerosis (ALS) among the Bangladeshi population. We also compared its diagnostic performances with FDI-ADM and ADM-APB ratios measuring the split hand phenomenon.

Methods

We carried out this cross-sectional study in the Department of Neurology, Sir Salimullah Medical College Mitford Hospital, and Dhaka Medical College Hospital, Dhaka, from March 2019 to September 2021. We determined the APB-FDI index with APB (CMAP) X FDI (CMAP) /ADM (CMAP). We also compared the findings with age and gender-matched healthy control and disease control (Hirayama disease). We studied the value of using APB-FDI, FDI-ADM, and ADM-APB ratios for diagnosis. We analyzed the data with ROC curves and calculated AUC for each ratio. We also used IDI and DCA to compare diagnostic accuracy.

Results

We studied 43 people with ALS, 30 healthy people, and 10 Hirayama patients. Most ALS patients had cervical phenotypes (31, 72%) and a median ALS functional rating score of 27(IQR,25-32). The cutoff values of APB-FDI Index, ADM-APB CMAP amplitude ratio, and FDI-ADM CMAP amplitude ratio are 4.27, 2.20 respectively. The APB-FDI Index has a high AUC of 0.9, with good sensitivity and specificity. However, for Hirayama disease, the APB-FDI Index cutoff value is 11.6. The APB-FDI Index is clinically effective with optimal threshold probabilities identified through the Youden-Index ((APB-FDI Index-0.72, ADM-APB CMAP amplitude ratio-0.51, and FDI-ADM CMAP amplitude ratio-0.17). Its standardized net benefits exceed healthy control and Hirayama when risk thresholds are between 0.1 and 0.8. The IDI results showed that the APB-FDI Index was superior to the ADM-APB CMAP amplitude ratio and FDI-ADM CMAP amplitude ratio in healthy control and Hirayama although p value is insignificant.

Conclusion

APB-FDI Index is the sensitive, specific, and early diagnostic marker for ALS. Its diagnostic performance is better than the other tests.
Imputation of race and ethnicity categories using continental genetic ancestry from real-world genomic testing data
Authors: Rhead Brooke , Haffener Paige E. , Pouliot Yannick , De La Vega Francisco M.
Published: August 2023

The incompleteness of race and ethnicity information in real-world data (RWD) hampers its utility in promoting healthcare equity. This study introduces two methods—one heuristic and the other machine learning-based—to impute race and ethnicity from continental genetic ancestry using tumor profiling data. Analyzing de-identified data from over 100,000 cancer patients sequenced with the Tempus xT panel, we demonstrate that both methods outperform existing geolocation and surname-based methods, with the machine learning approach achieving high recall (range: 0.783-0.997) and precision (range: 0.913-0.981) across four mutually exclusive race and ethnicity categories. This work presents a novel pathway to enhance RWD utility in studying racial disparities in healthcare.
Multi-organ single-cell RNA-sequencing reveals early hyperglycaemia responses that converge on fibroblast dysregulation
Authors: Braithwaite Adam T. , Akbar Naveed , Pezzolla Daniela , Paget Daan , Krausgruber Thomas , Bock Christoph , Carnicer Ricardo , Choudhury Robin P.
Published: August 2023

Diabetes causes a range of complications that can affect multiple organs. Hyperglycaemia is an important driver of diabetes-associated complications, mediated by biological processes such as dysfunction of endothelial cells, fibrosis and alterations in leukocyte number and function. Here, we dissected the transcriptional response of key cell types to hyperglycaemia across multiple tissues using single-cell RNA-seq (scRNA-seq) and identified conserved, as well as organ-specific, changes associated with diabetes complications. By studying an early timepoint of diabetes, we focus on biological processes involved in the initiation of the disease, before the later organ-specific manifestations had supervened. We used a mouse model of type 1 diabetes and performed scRNA-seq on cells isolated from the heart, kidney, liver and spleen of streptozotocin-treated and control mice after 8 weeks and assessed differences in cell abundance, gene expression, pathway activation and cell signalling across organs and within organs. In response to hyperglycaemia, endothelial cells, macrophages and monocytes displayed organ-specific transcriptional responses, whereas fibroblasts showed similar responses across organs, exhibiting a myofibroblast-like phenotype with altered metabolic gene expression and increased differentiation of myeloid-derived fibroblasts. Further, we found evidence of endothelial dysfunction in the kidney, and of endothelial to mesenchymal transition in streptozotocin-treated mouse organs. In summary, our study represents the first single-cell and multi-organ analysis of early dysfunction in type 1 diabetes-associated hyperglycaemia, and our large-scale dataset (comprising 67,611 cells) will serve as a starting point, reference atlas, and resource for further investigating the events leading to early diabetic disease.
New machine learning method identifies subtle fine-scale genetic stratification in diverse populations
Authors: Qin Xinghu , Jia Peilin
Published: August 2023

Fine-scale genetic structure impacts genetic risk predictions and furthers the understanding of the demography of populations. Current approaches (e.g., PCA, DAPC, t-SNE, and UMAP) either produce coarse and ambiguous cluster divisions or fail to preserve the correct genetic distance between populations. We proposed a new machine learning algorithm named ALFDA. ALFDA considers both local and global genetic affinity between individuals and also preserves the multimodal structure within populations. ALFDA outperformed the existing approaches in identifying fine-scale genetic structure and in retaining population geogenetic distance, providing a valuable tool for geographic ancestry inference as well as correction for spatial stratification in population health studies.
The spectrum of inter-organizational relationships and social capital mobilization of MNEs
Authors: Castro-Abancéns Ignacio , Casanueva Cristóbal , Gallego Ángeles
Published: August 2023

Purpose

Multinational enterprises (MNEs) establish a wide range of alliances to access the critical resources that they may need at any one time. Although inter-organizational relationships (IORs) constitute the channels through which social capital flows, MNEs should consider which mechanisms or characteristics of the relations facilitate their actual mobilization.

Design/methodology/approach

A definition of alliance types yielded the parameters for an ordinary least squares regression of a sample from top global-reach MNEs from the airline industry.

Findings

The results showed that certain kind of alliances favored the actual mobilization of social capital.

Practical implications

Managers of MNEs must select the type of IOR taking into account the objective they pursue and the type of activity they will include.

Originality/value

Analyzing the factors that influence the degree of mobilization of social capital and how MNEs actually use the resources of the partners require the establishment of a theoretical framework and the development of empirical evidence.
Co-creation of business and marketing models for SMEs in short food supply chains in Lithuania, Latvia and Poland
Authors: Oleksiuk Adam , Rull Quesada Katarzyna
Published: August 2023

Purpose

The aim of this article is to identify the issues of short food supply chains (SFSCs) in three countries of Central and Eastern Europe, i.e. Lithuania, Latvia and Poland, to compare the barriers to shortening food supply chains and to indicate business models for short supply chains.

Design/methodology/approach

Within the AgroBRIDGES project, the authors organized local co-creation workshops from August to September 2021 in 12 European regions and countries, engaging 150+ agrifood stakeholders of the project’s local communities.

Findings

The development potential of SFSCs in Lithuania, Latvia and Poland is high and seems to be growing every year. Currently, the development potential of SFSCs in Lithuania, Latvia and Poland is stimulated more by social trends than by public support. Traditional business models based on the distribution of food products through local and regional markets have a definitely diminishing potential.

Research limitations/implications

Although this article covers an existing gap in the literature, it also has several limitations that may serve as an inspiration for future research. First, the results draw on a sample of agrifood value chain stakeholders in Lithuania, Latvia and Poland; hence, the findings might be industry specific. Therefore, future studies should explore this topic on wider target groups or different industries. Moreover, the method is qualitative and could be supplemented with additional quantitative analysis of similar tools or the experience of other agrifood companies from European countries.

Practical implications

The article seeks to build bridges between consumers and producers by supporting SFSCs through a systemic, holistic and multi-actor approach.

Originality/value

The study elaborates on the under-researched topic of SFSCs in the context of barriers to shortening food supply chains and business models for short supply chains in Lithuania, Latvia and Poland.
How do resource scarcity reminders influence consumers’ CSR engagement?
Authors: Ye Tian , Mattila Anna S.
Published: August 2023

Purpose

This study aims to understand consumers' reactions to hospitality corporate social responsibility (CSR) campaigns under different resource scarcity reminders, an important but overlooked contextual factor, and examine how such scarcity reminders interact with message framing, a widely used technique in CSR communication.

Design/methodology/approach

Three experimental studies were conducted. Studies 1 and 2 examined the main effect of resource scarcity reminders (environmental vs personal) on consumer engagement via self-other orientation. Study 3 further investigated the interactive effect between resource scarcity reminders (environmental vs personal) and message framing (gain vs loss) with hope as a key mediator.

Findings

Studies 1 and 2 show that environmental (vs personal) scarcity activates a more salient other orientation, subsequently increasing consumers' donation and word-of-mouth intentions. Study 3 reveals that environmental (vs personal) scarcity makes people more hopeful with gain-framed messages. Moreover, the elevated hope enhances perceived efficacy (attitude toward the company), leading to higher donation (word-of-mouth) intention.

Practical implications

Hospitality marketers could remind consumers of the harsh environment to elicit other orientation and encourage CSR participation. Using gain-framed messages or other hope-inducing appeals would be particularly advantageous in engaging consumers in CSR campaigns during heightened environmental scarcity.

Originality/value

Focusing on consumer responses to CSR campaigns, to the best of the authors’ knowledge, this research is the first to reveal reminders of resource scarcity as a novel antecedent factor and further uncover how such reminders interact with message framing to affect CSR engagement.