bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of bulky loco-regional lymphadenopathy in esophageal adenocarcinoma on survival: a retrospective single center analysis
Authors: Tankel James , Nevo Yehonathan , Al Shehhi Ruqaiya , Sakalla Rawan , Dehghani Mehrnoush , Spicer Jonathan , Najmeh Sara , Mueller Carmen , Ferri Lorenzo , Cools-Lartigue Jonathan
Published: June 2024

The relationship between ‘bulky’ locoregional lymphadenopathy and survival has not been investigated in the setting of esophageal adenocarcinoma (EAC). This study aimed to explore whether bulky regional lymphadenopathy at diagnosis affected survival outcomes in patients with EAC treated with neoadjuvant chemotherapy and en bloc resection. A single-center retrospective review of a prospectively maintained upper GI cancer surgical database was performed between January 2012 and December 2019. Patients with locally advanced EAC (cT2-3, N+, M0) treated with neoadjuvant docetaxel-based chemotherapy and transthoracic en bloc esophagogastrectomy were identified. Computed tomography scans from before the initiation of treatment were reviewed, and patients were stratified according to whether bulky loco-regional lymph nodes were present. This was defined as lymphadenopathy >2 cm in any axis. Overall survival was compared, and a Cox multivariate regression model was calculated. Two hundred twenty-five of the eight hundred seventy patients identified met the inclusion criteria. Forty-eight (21%) had bulky lymphadenopathy, leaving 177 allocated to the control group. More patients with bulky lymphadenopathy had ypN3 disease (18/48, 38% vs. 39/177, 20%, P = 0.025). Among patients with bulky lymphadenopathy, overall survival was generally worse (32.6 vs. 59.1 months, P = 0.012). However, among the 9/48 (19%) patients with bulky lymphadenopathy who achieved ypN− status survival outcomes were similar to those with non-bulky lymphadenopathy who also achieved lymph node sterilization. Poor differentiation (HR 1.8, 95% CI 1.0–2.9, P = 0.034), ypN+ (HR 1.9, 95% CI 1.1–3.6, P = 0.032), and bulky lymphadenopathy were independently associated with an increased risk of death (HR 1.7, 1.0–2.9, P = 0.048). Bulky regional lymphadenopathy is associated with a poor prognosis. Efforts to identify the ideal treatment regimen for these patients are urgently required.
Black Cohosh Hepatic Safety: Follow‐up of 107 Patients Consuming a Special Cimicifuga racemosa rhizome Herbal Extract and Review of Literature
Authors: Firenzuoli Fabio , Gori Luigi , di Sarsina Paolo Roberti
Published: June 2024

European Medicines Agency (EMEA) and the Committee on Herbal Medicinal Products (HMPC) on July 2006 have released an alert to get European sanitary authorities aware of 42 cases of suspected hepatotoxic reactions in patients consuming Cimicifuga racemosa rhizome. In the public statement EMEA itself considered reliable as hepatotoxic reactions only four cases, on the base of RUCAM score: two were considered possible and two probable. Lacking in almost all of them a precise description of cases, especially a botanical‐chemical analysis of the suspected substance, we think there is no real proof of supposed C. racemosa rhizome hepatotoxicity. In our department we administer from about 10 years C. racemosa as special herbal dry extract as single substance or mixed with other medicinal plants at the dose of 500–1000 mg daily, for treatment of menopause related disorders without any reported adverse effect. After EMEA′s official signal we have contacted all our patients using a C. racemosa rhizome herbal extract continuously from more than 12 months to verify possible hepatotoxic effects. We followed‐up 107 women, and asked them by telephone (33/107) and/or after anamnesis and clinical examination (74/107) to undergo a blood sample examination. In all the patients there was no sign of hepatic disease, or worsening of already altered but stable parameters. We think on the base of these data and current literature C. racemosa rhizome extract should not be considered a potential hepatotoxic substance.
Acute lymphocytic myocarditis characterized by cardiogenic shock and conduction system abnormalities in patients with Hashimoto’s thyroiditis: a case report and review of literature
Authors: Panattoni Germana , Marino Marco , Ascione Andrea , d’Amati Giulia , Calò Leonardo
Published: June 2024

Background

Acute myocarditis (AM) is an inflammatory heart disease that may occur as a consequence of autoimmune disorders. Although the correlation between myocarditis and hyperthyroidism has been reported in the literature, the association with hypothyroidism is less frequent.

Case summary

We describe a characteristic case of lymphocytic acute myocarditis deteriorated into cardiogenic shock due to Hashimoto’s thyroiditis treated with vasopressor and inotropic drugs in combination with corticosteroid. On admission, electrocardiography revealed a sinus tachycardia with 1st degree atrioventricular (AV) block, right bundle branch block (RBBB), and left anterior fascicular block. Laboratory tests demonstrated a severe hypothyroidism and high-titre serum of antibodies against thyroglobulin. She presented a favourable clinical course, restoring haemodynamic stability. A resolution of hypothyroidism and a progressive reduction of the value of antibodies against thyroglobulin occurred. On Day 35, the patient was discharged showing on electrocardiogram the occurrence of left posterior fascicular block, disappearance of 1st degree AV block and partial improvement of RBBB along with the normalization of the left ventricular contractility abnormalities on echocardiography.

Discussion

Autoimmune features, mostly Hashimoto’s thyroiditis, are associated in lymphocytic acute myocarditis to a worse prognosis and an increased risk of recurrence. More studies are needed to elucidate the underlying mechanism.
Long-read genome assembly of the Japanese parasitic wasp Copidosoma floridanum (Hymenoptera: Encyrtidae)
Authors: Toga Kouhei , Sakamoto Takuma , Kanda Miyuki , Tamura Keita , Okuhara Keisuke , Tabunoki Hiroko , Bono Hidemasa
Published: June 2024

Copidosoma floridanum is a cosmopolitan species and an egg-larval parasitoid of the Plusiine moth. C. floridanum has a unique development mode called polyembryony, in which over two thousand genetically identical embryos are produced from a single egg. Some embryos develop into sterile soldier larvae precociously, and their emergence period and aggressive behavior differ between the US and Japanese C. floridanum strains. Genome sequencing expects to contribute to our understanding of the molecular bases underlying the progression of polyembryony. However, only the genome sequence of the US strain generated by the short-read assembly has been reported. In the present study, we determined the genome sequence of the Japanese strain using Pacific Biosciences high-fidelity reads and generating a highly contiguous assembly (552.7 Mb, N50: 17.9 Mb). Gene prediction and annotation identified 13,886 transcripts derived from 10,786 gene models. We searched the genomic differences between US and Japanese strains. Among gene models predicted in this study, 100 gene loci in the Japanese strain had extremely different gene structures from those in the US strain. This was accomplished through functional annotation (GGSEARCH) and long-read sequencing. Genomic differences between strains were also reflected in amino acid sequences of vasa that play a central role in caste determination in this species. The genome assemblies constructed in this study will facilitate the genomic comparisons between Japanese and US strains, leading to our understanding of detailed genomic regions responsible for the ecological and physiological characteristics of C. floridanum.
otb: an automated HiC/HiFi pipeline assembles the Prosapia bicincta Genome
Authors: Molik David C , Stahlke Amanda R , Sharma Sharu P , Simmonds Tyler J , Corpuz Renee L , Kauwe Angela N , Schrader Jeremy E , Mason Charles J , Sim Sheina B , Geib Scott M
Published: June 2024

The implementation of a new genomic assembly pipeline named only the best (otb) has effectively addressed various challenges associated with data management during the development and storage of genome assemblies. otb, which incorporates a comprehensive pipeline involving a setup layer, quality checks, templating, and the integration of Nextflow and Singularity. The primary objective of otb is to streamline the process of creating a HiFi/HiC genome, aiming to minimize the manual intervention required in the genome assembly process. The 2-lined spittlebug, (Prosapia bicincta, Hemiptera: Cercopidae), a true bug insect herbivore, serves as a practical test case for evaluating otb. The 2-lined spittlebug is both a crucial agricultural pest and a genomically understudied insect belonging to the order Hemiptera. This insect is a significant threat to grasslands and pastures, leading to plant wilting and phytotoxemia when infested. Its presence in tropical and subtropical regions around the world poses a long-term threat to the composition of plant communities in grassland landscapes, impacting rangelands, and posing a substantial risk to cattle production.
An iteration method to study nonlinear wave propagation for a non-Green elastic 1D bar
Authors: Bustamante R , Arrue P , Orellana O , Meneses R
Published: June 2024

The problem of propagation of nonlinear waves in a 1D bar is studied, wherein the linearized strain tensor is considered as a function of the Cauchy stress tensor. Specifically, two constitutive equations for non-Green elastic solids are investigated, introducing a novel numerical iterative method capable of obtaining approximate solutions of one nonlinear constitutive equation for rock, and one constitutive equation that shows a strain-limiting behaviour. The numerical results are compared with exact solutions for the case of a linearized elastic solid.
Attitude toward perioperative safety among operation room clinicians at Ethiopian University Hospital
Authors: Berhe Yophtahe Woldegrima , Ferede Yonas Admasu , Ayen Biresaw , Melkie Tadesse Belayneh , Yiheyis Aklilu , Arefayne Nurhusen Riskey , Bizuneh Yosef Belay
Published: June 2024

Patient safety is a fundamental of good quality and also a high priority for the health-care system. Maintaining patient safety reduces errors and harm that patients can suffer during health care. The operating room clinicians have a vital role in ensuring patient safety. The general objective of this study was to assess attitudes towards perioperative safety and associated factors among the operation room clinicians at the University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia, 2022. A cross-sectional study was conducted on operation room clinicians at UoGCSH. The data were collected by using a self-administered structured questionnaire that included the Safety Attitude Questionnaire (SAQ). Binary logistic regression analysis was employed, and the strength of association was described in adjusted odds ratios with a 95% confidence interval (CI). A total of 260 (76% response rate) operation room clinicians have participated in this study. The mean ± SD of attitude toward perioperative safety was 57.8 ± 0.9. Only 32 (12.3%) operation room clinicians have shown a favorable attitude toward perioperative safety. Most of the clinicians were found to have unfavorable attitudes toward all domains of SAQ except the stress recognition domain. Age >30 years [adjusted odds ratios (AOR): 3.1, CI: 1.1, 8.7, P = .035], working for ≥40 h/week (AOR: 3.9, CI: 1.4, 11.1, P = .01), working in ophthalmologic (AOR: 12.0, CI: 3.8, 38.8, P < .001) and gynecologic (AOR: 3.6, CI: 1.1, 12.7, P = .04) operation rooms, and having training on perioperative safety (AOR: 2.6, CI: 1.1, 6.5, P < .03) were found associated with having favorable attitude toward perioperative safety. Most operation room clinicians had an unfavorable attitude toward perioperative safety and all the domains of SAQ except the stress recognition domain. Older age  ≥ 30 years, working for ≥40 h/week, having safety-related training, and working in ophthalmologic and gynecologic operation rooms were found associated with having a favorable attitude toward perioperative safety.
Development of the Empathy in Design Scale: Measuring Employees’ Empathy Toward Users in Service Design
Authors: Drouet Luce , Bongard-Blanchy Kerstin , Lallemand Carine
Published: June 2024

To design user-centered services, it is essential to build empathy toward users. It is hence strategic to trigger empathy for users among professionals concerned with shaping service user experiences. There is, however, a lack of quantitative tools to measure empathy in design. Through two studies, we report on the development and validation of the Empathy in Design Scale (EMPA-D). The tool aims to measure service employees’ empathy toward users. Grounded in theories from psychology and design, we first generated and tested a pool of items through expert inspection and cognitive interviews. In Study 1, we administered 16 items to 406 full-time service employees from various industries, including employees in customer-facing positions. In Study 2, we iterated on additional items and administered a revised scale to 305 service employees. The selected model consists of 11 items and has a three-factor structure (Emotional interest/Perspective-taking, Personal experience and Self-awareness), which showed an adequate model fit and good internal consistency. Evidence of convergent validity was provided by moderate correlations of the EMPA-D scale with empathy measures in psychology (SITES, Empathy Quotient, Interpersonal Reactivity Index), whereas discriminant validity was demonstrated by low correlations with the narcissism measure Narcissistic Personal Inventory. We outline how this self-reported empathy measure can support organizations in enhancing their services and discuss potential limitations of quantitatively measuring empathy in service teams.

Research Highlights We present the development and validation of the Empathy in Design Scale (EMPA-D), a self-report measure of employees’ empathy toward users of a service. We report on two validation studies and document the psychometric properties of the scale. The selected model consists of 11 items and a three-factor structure (Emotional interest/Perspective-taking, Personal experience and Self-awareness). The resulting EMPA-D scale contributes to filling the gap in metrics to assess empathy in the service design context. In industry, measuring employees’ empathy support the selection of appropriate empathic interventions to foster the service user-centeredness.
Effects of Feedback Type on Touchscreen Navigation for Younger and Older Users
Authors: Chen Yanxiu , Li Bingxin , Yang Tong , Liu Yanfang , Du Feng
Published: June 2024

This study investigates how feedback from different modalities affect window navigation tasks performed on a touchscreen by younger and older users. Thirty-two younger and 32 older users moved a window toward one of four or eight target areas with no feedback or visual, tactile or visual–tactile feedback. Visual feedback produced significantly higher accuracy and shorter task completion times than tactile feedback. Generally, visual–tactile feedback did not produce statistically higher accuracy or shorter task completion time than visual feedback. However, visual–tactile feedback prevented both younger and older users from overshooting the windows. Additionally, when users attempted to move the window to one of the eight target areas, the visual–tactile feedback helped younger users perform better. According to theories about human processing, the reason for the subtle advantage of visual–tactile feedback is that the unintuitive tactile force induces a higher cognitive load than straightforward visual information during window navigation. Nevertheless, visual–tactile feedback elicited the best user experience, as measured by questionnaires on emotion and fatigue, gesture usability and preference. Furthermore, more older users prefer visual–tactile feedback than younger users. Therefore, visual–tactile feedback should be considered, and the tactile feedback should be modified to be more intuitive in window navigation tasks.

Research Highlights Visual feedback improved task performance more than tactile feedback in window navigation task. Visual–tactile feedback did not improve task performance compared to visual feedback. Visual–tactile feedback prevented users from overshooting the window. More older users than younger users prefer visual–tactile feedback.
Evaluating automated machine learning platforms for use in healthcare
Authors: Scott Ian A , De Guzman Keshia R , Falconer Nazanin , Canaris Stephen , Bonilla Oscar , McPhail Steven M , Marxen Sven , Van Garderen Aaron , Abdel-Hafez Ahmad , Barras Michael
Published: June 2024

Objective

To describe development and application of a checklist of criteria for selecting an automated machine learning (Auto ML) platform for use in creating clinical ML models.

Materials and Methods

Evaluation criteria for selecting an Auto ML platform suited to ML needs of a local health district were developed in 3 steps: (1) identification of key requirements, (2) a market scan, and (3) an assessment process with desired outcomes.

Results

The final checklist comprising 21 functional and 6 non-functional criteria was applied to vendor submissions in selecting a platform for creating a ML heparin dosing model as a use case.

Discussion

A team of clinicians, data scientists, and key stakeholders developed a checklist which can be adapted to ML needs of healthcare organizations, the use case providing a relevant example.

Conclusion

An evaluative checklist was developed for selecting Auto ML platforms which requires validation in larger multi-site studies.
Chondroitin sulfate liposome: clustering toward high functional efficiency
Authors: Shioiri Tatsumasa , Tsuchimoto Jun , Fukushige Kaori , Takeuchi Takao , Naito Munekazu , Watanabe Hideto , Sugiura Nobuo
Published: June 2024

Chondroitin sulfate (CS) is a linear polysaccharide chain of alternating residues of glucuronic acid (GlcA) and N-acetylgalactosamine (GalNAc), modified with sulfate groups. Based on the structure, CS chains bind to bioactive molecules specifically and regulate their functions. For example, CS whose GalNAc is sulfated at the C4 position, termed CSA, and CS whose GalNAc is sulfated at both C4 and C6 positions, termed CSE, bind to a malaria protein VAR2CSA and receptor type of protein tyrosine phosphatase sigma (RPTPσ), respectively, in a specific manner. Here, we modified CSA and CSE chains with phosphatidylethanolamine (PE) at a reducing end, attached them to liposomes containing phospholipids and generated CSA and CSE liposomes. The CS-PE was incorporated into the liposome particles efficiently. Inhibition ELISA revealed specific interaction of CSA and CSE with recombinant VAR2CSA and RPTPσ, respectively, more efficiently than CS chains alone. Furthermore, CSE liposome was specifically incorporated into RPTPσ-expressing HEK293T cells. These results indicate CS liposome as a novel and efficient drug delivery system, especially for CS-binding molecules.
Bivalent Omicron BA.4/BA.5 BNT162b2 Vaccine in 6-Month- to <12-Year-Olds
Authors: Sher Lawrence D , Boakye-Appiah Justice K , Hill Sungeen , Wasserman Emily , Xu Xia , Maldonado Yvonne , Walter Emmanuel B , Muñoz Flor M , Paulsen Grant C , Englund Janet A , Talaat Kawsar R , Barnett Elizabeth D , Kamidani Satoshi , Senders Shelly , Simões Eric A F , Belanger Kelly , Parikh Vrunda , Ma Hua , Wang Xingbin , Lu Claire , Cooper David , Koury Kenneth , Anderson Annaliesa S , Türeci Özlem , Şahin Uğur , Swanson Kena A , Gruber William C , Gurtman Alejandra , Kitchin Nicholas , Sabharwal Charu
Published: June 2024

Background

With the future epidemiology and evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) uncertain, the use of safe and effective coronavirus disease 2019 (COVID-19) vaccines in pediatric populations remains important.

Methods

We report data from two open-label substudies of an ongoing phase 1/2/3 master study (NCT05543616) investigating the safety and immunogenicity of a variant-adapted bivalent COVID-19 vaccine encoding ancestral and Omicron BA.4/BA.5 spike proteins (bivalent BNT162b2). The open-label groups presented here evaluate dose 4 with bivalent BNT162b2 in 6-month- to <12-year-olds who previously received three original (monovalent) BNT162b2 doses. In 6-month- to <5-year-olds, primary immunogenicity objectives were to demonstrate superiority (neutralizing titer) and noninferiority (seroresponse rate) to Omicron BA.4/BA.5 and noninferiority (neutralizing titer and seroresponse rate) to SARS-CoV-2 ancestral strains in participants who received bivalent BNT162b2 dose 4 compared with a matched group who received three doses of original BNT162b2 in the pivotal pediatric study (NCT04816643). In 5- to <12-year-olds, primary immunogenicity comparisons were descriptive. Reactogenicity and safety following vaccination were evaluated.

Results

In 6-month- to <5-year-olds, dose 4 with bivalent BNT162b2 met predefined immunogenicity superiority and noninferiority criteria against Omicron BA.4/BA.5 and ancestral strains when compared with dose 3 of original BNT162b2. In 5- to <12-year-olds, bivalent BNT162b2 induced robust Omicron BA.4/BA.5 and ancestral strain neutralizing titers comparable with dose 3 of original BNT162b2. The safety profile for dose 4 of bivalent BNT162b2 given as dose 4 was consistent with that of original BNT162b2 in 6-month- to <12-year-olds. Reactogenicity events were generally mild to moderate. No adverse events led to discontinuation.

Conclusions

These safety and immunogenicity data support a favorable benefit-risk profile for a variant-adapted BNT162b2 in children <12 years old.
Surgical treatment of pancreaticojejunal stenosis after pancreaticoduodenectomy: case report
Authors: Narvaez Salas David , Roldan-Vasquez Estefania , Negrete Ocampo Ricardo , Ballagan Escobar Romina , Roldan Crespo Juan
Published: June 2024

Pancreaticoduodenectomy is established as the procedure of choice for malignant tumor pathologies of the head of the pancreas or ampulla, where the patient’s life prognosis is low. Complications after pancreaticoduodenectomy (e.g. pancreatic fistulas, hemorrhages, or intra-abdominal collection) are well described in the literature and are generally acute. However, there is still a small risk for late complications (e.g. pancreatitis, pancreatic insufficiency), and due to its low incidence, there has not been a consensus on the treatment. We present the case of an 18-year-old female with recurrent bouts of acute pancreatitis as a late complication of a pancreaticoduodenectomy plus pancreatojejunal anastomosis due to a pseudopapillary tumor of the pancreas. The complication was managed though surgical revision consisting of dilation and stent placement in the stenosis. The patient had an adequate postoperative evolution without further complications. Despite the advances in the surgical field, pancreaticoduodenectomy represents a highly complex surgery with high morbidity and mortality rates. The late complications of this surgery are under continuous study due to its low incidence associated with low patient survival.
Medical laboratory scientist motivation to pursue graduate education
Authors: Blagg Lorraine N
Published: June 2024

Background

Medical laboratory staffing shortages have persisted, with challenges in maintaining adequate medical laboratory professionals. The career trajectory for medical laboratory scientists beyond entry level is ambiguous, but advancement opportunities are enhanced with specialist certifications and advanced degrees.

Objective

This study explored the motivation and preferences of medical laboratory scientists in pursuing graduate medical laboratory science education based on the importance of professional development, career advancement, recognition, and employment benefits.

Methods

A quantitative, cross-sectional, and descriptive correlational study surveyed American Society for Clinical Pathology Board of Certification−credentialed medical laboratory scientists using an online questionnaire.

Results

The overall response rate was 2.5%, and 1247 complete surveys were analyzed. Educational preferences varied by respondent age and amount of laboratory experience. Professional development, career advancement, recognition, and employment benefits were all important motivators for seeking graduate degrees, but those who were younger and had less experience indicated they were more important.

Conclusion

This study suggests several areas of improvement for educational programs, health care organizations, and professional organizations to support the motivation of medical laboratory scientists to pursue graduate education.
Massage Therapy Utilization in the Military Health System
Authors: Rupp Tracy L , Amoako Maxwell , Johnson Kevin , Rojas Winifred , Highland Krista B
Published: June 2024

Introduction

Massage therapy is an evidence-based approach for pain management. Information regarding its utilization in the Military Health System (MHS) is lacking. The goal of this study is to evaluate massage therapy utilization patterns across the MHS to include who receives (patient characteristics and diagnoses) and provides (e.g., massage therapists) massage therapy and where (e.g., clinic type).

Materials and Methods

Medical record data of adult TRICARE Prime enrollees receiving outpatient massage therapy (Current Procedural Terminology codes: 97124 and 97140) from June 1, 2021, to May 31, 2023, were extracted from the MHS Data Repository. After identifying the index massage therapy visit, records for 6 months pre- and post-index were included. Descriptive statistics described massage therapy utilization patterns overall. Bivariate analysis compared patients who received massage therapy from massage therapists versus nonmassage therapist clinicians.

Results

Of patients who received massage therapy (n = 179,215), the median number of visits was 2 (interquartile range 1 to 4), the median age was 32 years (interquartile range 25 to 40), they were mostly assigned male (72%), White (53%), Senior Enlisted (51%), with a musculoskeletal diagnosis (90%), and recent non-steroidal anti-inflammatory drug (NSAID) prescription (58%). Massage therapy was primarily delivered by physical therapists (49%) in physical therapy clinics (74%). Massage therapists provided 0.2% of massage therapy. Patients who received massage therapy from massage therapists versus nonmassage therapists significantly varied across several patient and care characteristics.

Conclusions

While massage therapy codes are documented frequently, massage therapists do not commonly provide massage therapy relative to nonmassage therapist providers. Access to massage therapists may be stymied by both lack of massage therapists and need for tertiary pain management referrals to access massage therapist-delivered care. Future research will leverage a health equity framework to (1) evaluate accessibility to massage therapy provided by massage therapists and (2) evaluate real-world evidence of massage therapy effectiveness.
Critical cis-parameters influence STructure assisted RNA translation (START) initiation on non-AUG codons in eukaryotes
Authors: Tidu Antonin , Alghoul Fatima , Despons Laurence , Eriani Gilbert , Martin Franck
Published: June 2024

In eukaryotes, translation initiation is a highly regulated process, which combines cis-regulatory sequences located on the messenger RNA along with trans-acting factors like eukaryotic initiation factors (eIF). One critical step of translation initiation is the start codon recognition by the scanning 43S particle, which leads to ribosome assembly and protein synthesis. In this study, we investigated the involvement of secondary structures downstream the initiation codon in the so-called START (STructure-Assisted RNA translation) mechanism on AUG and non-AUG translation initiation. The results demonstrate that downstream secondary structures can efficiently promote non-AUG translation initiation if they are sufficiently stable to stall a scanning 43S particle and if they are located at an optimal distance from non-AUG codons to stabilize the codon-anticodon base pairing in the P site. The required stability of the downstream structure for efficient translation initiation varies in distinct cell types. We extended this study to genome-wide analysis of functionally characterized alternative translation initiation sites in Homo sapiens. This analysis revealed that about 25% of these sites have an optimally located downstream secondary structure of adequate stability which could elicit START, regardless of the start codon. We validated the impact of these structures on translation initiation for several selected uORFs.
Armed Federalism, Gun Markets, and the Right to Bear Arms in the United States
Authors: Obert Jonathan
Published: June 2024

This article argues that fragmented and varied regulatory, cultural, and electoral responses to guns and gun rights in the contemporary United States are a result of two long-standing features of American political life––its tradition of armed federalism and its unique, domestically oriented market for small firearms. As a result of the intersection of these two phenomena, the past 150 years have seen the growth of a fragmentary regulatory response to firearms on the part of local, state, and federal jurisdictions; the emergence of an organized national gun-rights movement; and, most significantly, the ascendance of a legal strategy by supporters of gun-rights constitutionalism. Only by examining the historical contingencies of American political institutions and markets does the contested transformation of a “right to bear arms” into gun rights make sense.
Job Applications and Labour Market Flows
Authors: Birinci Serdar , See Kurt , Wee Shu Lin
Published: June 2024

Job applications have risen over time, yet job-finding rates remain unchanged. Meanwhile, separations have declined. We argue that increased applications raise the probability of a good match rather than the probability of job-finding. Using a search model with multiple applications and costly information, we show that when applications increase, firms invest in identifying good matches, reducing separations. Concurrently, increased congestion and selectivity over which offer to accept temper increases in job-finding rates. Our framework contains testable implications for changes in offers, acceptances, reservation wages, applicants per vacancy, and tenure, objects that enable it to generate the trends in unemployment flows.
Analysis of heaping-induced decline in olive quality: insights from integrated analysis between phenotypic traits and gene expression profiles
Authors: Wang Chenhe , Cui Qizhen , Liu Qingqing , Fan Yutong , Li Qiaohua , Zhao Min , Zhao Liangmei , Zhang Jianguo , Rao Guodong
Published: June 2024

Heaping is an unavoidable process before olive milling, and its duration significantly affects the olive quality. However, there is limited research on the quality changes of olive fruits on a short-time scale. To gain a better understanding of the molecular mechanisms underlying postharvest deterioration of olives, this study piled olives at room temperature and extracted oil at 0, 8, 24, 48 and 72 h to analyze oil quality parameters. Gas/Liquid Chromatography-Mass Spectrometry (GC/LC–MS) techniques were employed to investigate variations in metabolite contents. Concurrently, the transcriptional profiles of olives during heaping were examined. As piling time progressed, quality indicators declined, and stored fruit were categorized into three groups based on their quality characters: ‘0 h’ belongs to the first category, ‘8 h’ and ‘24 h’ to the second category, and ‘48 h’ and ‘72 h’ to the third category. Metabolite changes were consistent with the expression patterns of genes related to their synthesis pathways. Additionally, ethylene was identified as a crucial factor influencing fruit senescence. These findings establish a foundation for further research on olive deterioration after harvesting and offer insights for optimizing olive oil production.
A Qualitative Study to Explore the Nurses’ Experience of Writing Caring Notes in Diaries for Extracorporeal Oxygenation Membrane (ECMO) Patients: Explore the nurse’s experience
Authors: Norton Tamara , Chechel Laura , Sanchez Courtney , Terterian Garni
Published: June 2024

The use of diaries is known to reduce post-intensive care syndrome in the intensive care unit (ICU) for survivors and families. Studies are needed to explore nurses’ experience with diaries. Although the diaries are written for the patient, the diary entries may be helpful for the nurse as well. Research has shown that ICU diaries fill in significant memory gaps and aid in the resolution of delusional memories. However, there is a shortage of knowledge about the nurses’ experience of writing caring notes in diaries. The purpose of this research was to explore the extracorporeal membrane oxygenation (ECMO) nurses’ experience of writing caring notes in diaries during the patients’ ICU stay. This is a descriptive phenomenological qualitative research study using semi-structured interviews. A one-on-one interview was performed, audiotaped, and transcribed. Three investigators analyzed the data for themes, subcategories, and indicators. A purposive sample of 15 specialty-trained ECMO nurses participated in the study. Three themes emerged from the study relating to the nurse, family, and patient, including positive and negative aspects of writing in the diary and barriers. The vast majority (88%) of 340 comments answered during the interviews were positive. Overall, nurses found the diaries to be beneficial to the nurse, family, and patient. Diary writing may help nurses get back to the core of why we do what they do. Understanding the nurses’ experience may help to improve communication and family satisfaction while optimizing dairy programs.
Cardiogenic Shock
Authors: El Hussein Mohamed Toufic , Mushaluk Camila
Published: June 2024

Cardiogenic shock (CS) is a complex and dreadful condition for which effective treatments remain unclear. The concerningly high mortality rate of CS emphasizes a need for developing effective therapies to reduce its mortality and reverse its detrimental course. This article aims to provide an updated and evidence-based review of the pathophysiology of CS and the related pharmacotherapeutics with a special focus on vasoactive and inotropic agents.
Burnout Among Nurses Working in Critical Care Units During the COVID-19 Pandemic
Authors: Almahmoud Omar , Asmar Imad , Kahala Ahmad , Awadallah Nour , Awad Wala , Sarhan Nida’a , Joulany Sadeen
Published: June 2024

Burnout is a state of emotional and physical depletion. Its occurrence among critical care nurses (CCNs) is a concept that has gained traction yet remains an issue with global consequences. Nurses are especially vulnerable to burnout due to the persistent stressors they are exposed to, which include the general work environment, biological factors, and emerging changes caused by COVID-19. This study aims to assess the severity of burnout among CCNs during the COVID-19 pandemic and its associated factors. A descriptive cross-sectional questionnaire was used in this study to measure the estimated burnout rate among CCNs in Palestine and establish associations with potential factors. Maslach Burnout Inventory questionnaire was used for the task. The results showed out of the 173 participants, more than 35% reported severe overall burnout. Per burnout domains, it was found that around 70% of participants suffered from low personal accomplishment, while 59.5% had severe levels of depersonalization, and finally, more than 65% of critical nurses had severe emotional exhaustion. Out of the various variables tested, gender, age, type of hospital, PPE, and fear of transmission were found to be associated with overall burnout. CCNs in Palestine were found to be severely burned out and should be dealt with before getting out of hand. The research found variables related to burnout contributed to burnout. Recommendations for further studies and prioritization should be made.
Combination Foam and Liquid Sclerotherapy for Lower Extremity Reticular and Telangiectatic Veins: A Single-Center Retrospective Study
Authors: Verma Kritin K. , Friedmann Daniel P.
Published: June 2024

BACKGROUND

Lower extremity reticular and telangiectatic veins are of common cosmetic concern.

OBJECTIVE

To retrospectively evaluate results of lower extremity sclerotherapy using a combination of foam and liquid sclerosing agents.

METHODS

A retrospective chart review of sclerotherapy patients at a dermatology practice (January 2014 to April 2023) was performed.

RESULTS

Eight hundred and nine patients (775 women and 34 men) with a mean age of 49.6 ± 12.2 (18–84) years underwent a mean 1.4 ± 0.7 (1–7) sessions. Multiple different sclerosing agents were used, with 0.2% sodium tetradecyl sulfate foam/liquid predominating, although 72% glycerin liquid and 0.25% to 0.5% polidocanol foam/liquid were also used. Coagula occurred in 61.0% of patients at 2 weeks and 6.4% at 3 months, whereas postsclerotherapy hyperpigmentation was seen in 5.0% and 19.1% of patients at the same time points. Both were more common after first-round treatment, each with a trend toward decreased frequency with increasing session number. Telangiectatic matting was found in 2.3% of 3-month follow-up patients. Edema, superficial venous thrombophlebitis, migraines, and ulceration were rarely seen. Significant clinical improvement was noted in 72.0% of treatments.

CONCLUSION

This retrospective chart review, the largest to date of its kind, confirms the safety and efficacy of cosmetic lower extremity sclerotherapy with a combination of foam and liquid sclerosing agents.
A Retrospective Study Evaluating Neonatal Vancomycin Loading Doses to Achieve a Therapeutic Target
Authors: Fataar Aaqilah , Pillay-Fuentes Lorente Veshni , Decloedt Eric H. , van Eck Andrew , Reddy Kessendri , Dramowski Angela , Bekker Adrie
Published: June 2024

Background:

Vancomycin is a glycopeptide antibiotic that has been used to treat hospital-acquired gram-positive infections for more than 5 decades. However, the literature is divided regarding the therapeutic advantages of vancomycin loading doses in neonates.

Objectives:

This study aimed to investigate the effect of vancomycin loading doses on therapeutic target attainment in neonates with sepsis.

Methods:

A retrospective cohort study was conducted to compare the vancomycin target attainment (area under the curve 0–24 hours/minimum inhibitory concentration ≥400) in neonates before and after the 2019 change in vancomycin prescription guidelines at a neonatal unit in Cape Town, South Africa. As the standard of care, Bayesian modelling software was used to compute the area under the curve from the trough concentrations.

Results:

Two hundred ten neonates were included. Multivariate regression analysis showed a 2-fold increase in the odds of target attainment among neonates receiving a loading dose of vancomycin. Early target attainment (within 8–12 hours of treatment initiation) was significantly higher in the loading dose group compared with the no loading dose group [97/105 (92.4%) versus 64/105 (61.0%); P < 0.001]. However, the overall proportion of neonates achieving target attainment at 24 hours was similar between groups [73/105 (69.5%) in the loading dose group versus 62/105 (59.0%) in the no loading dose group; P = 0.110]. The nephrotoxicity rates were low [2/105 (1.9%) in the loading dose group and 2/105 (1.9%) in the no loading dose group].

Conclusions:

The addition of a vancomycin loading dose to neonates may facilitate early therapeutic target attainment.
JOLT: A Noninvasive Solution for the Correction of the Jowl
Authors: Rosengaus Frank , Sicilia Nathania Cardenas
Published: June 2024

Background:

Sagging and loss of elasticity of the facial skin and tissues leads to jowling and an aged appearance. Jowling is a common reason for aesthetic surgical consultations.

Methods:

Prospective open-label study of the JOLT (jowl lifting) technique using hyaluronic acid (HA) fillers in healthy women 40–65 years of age with Fitzpatrick skin phototypes II–IV (n = 8). To be eligible, patients had jowling grade 2–3 on the jowl appearance scale as assessed by both the physician and patient. Treatment was administered at the baseline visit and consisted of an average of 6 mL of HA filler, 3 mL per side. Efficacy was assessed at baseline, week 4, and week 12. Assessment measures included the jawline rating scale (JRS) and a five-point global aesthetic improvement scale performed by two independent observers. Success was defined as an improvement of 1–2 grades on JRS.

Results:

The mean JRS was improved from 2.75 at baseline to 1.53 at 90 days, which was considered a significant improvement. Mean global aesthetic improvement scale scores at 90 days were 1.44 ± 0.66 (range 1–3), indicating a “very much improved” appearance compared with baseline on both investigator and subject ratings. The procedure was well tolerated by all patients. Injection-related side effects (bruising and localized swelling) resolved spontaneously within 1 week of treatment. No other adverse events were reported.

Conclusions:

The JOLT technique effectively uses HA fillers to lift and tighten the lower face/neck and camouflage the remaining jowl, diminishing marionette lines, defining the mandibular border, and improving jowl sagging.
Bile metabolic fingerprints distinguish biliary tract cancer from benign biliary diseases
Authors: Yang Shouzhi , Fu Jing , Qin Wenhao , Wang Ruimin , Gu Mingye , Huang Yida , Liu Wanshan , Su Haiyang , Xu Xiaoyu , Chen Wei , Yiming Ayizekeranmu , Hu Bing , Huang Lin , Qian Kun , Wang Hongyang
Published: June 2024

Background and Aims:

Biliary tract cancers are aggressive gastrointestinal malignancies characterized by a dismal 5-year overall survival rate <20%. Current diagnostic modalities suffer from limitations regarding sensitivity and specificity. This study aimed to develop a bile metabolite–based platform for precise discrimination between malignant and benign biliary diseases.

Approach and Results:

Samples were collected from 336 patients with biliary tract cancer or benign biliary diseases across 3 independent cohorts. Untargeted metabolic fingerprinting was performed on 300 bile samples using novel nanoparticle-enhanced laser desorption/ionization mass spectrometry. Subsequently, a diagnostic assay was developed based on the exploratory cohort using a selected bile metabolic biomarker panel, with performance evaluated in the validation cohort. Further external validation of disease-specific metabolites from bile samples was conducted in a prospective cohort (n = 36) using quantitative analysis. As a result, we established a novel bile-based assay, BileMet, for the rapid and precise detection of malignancies in the biliary tract system with an AUC of 0.891. We identified 6-metabolite biomarker candidates and discovered the critical role of the chenodeoxycholic acid glycine conjugate as a protective metabolite associated with biliary tract cancer.

Conclusions:

Our findings confirmed the improved diagnostic capabilities of BileMet assay in a clinical setting. If applied, the BileMet assay enables intraoperative testing and fast medical decision-making for cases with suspected malignancy where brush cytology detection fails to support malignancy, ultimately reducing the economic burden by over 90%.
The utility of home blood pressure load in predicting average self-measured blood pressure
Authors: Hinderliter Alan L. , Lin Feng-Chang , Yang Yumei , Viera Laura A. , Olsson Emily , Voora Raven , Viera Anthony J.
Published: June 2024

Objectives:

Average values for self-measured blood pressure (SMBP) more accurately reflect a patient's risk of cardiovascular disease than do office measurements. Oftentimes, however, patients provide lists of individual home blood pressure (BP) measurements, and average values cannot be computed within the time constraints of a clinic visit. In contrast, the home BP load – defined as the proportion of BP values greater than a partition value (e.g., 130 mmHg) – can be easily calculated. We examined the utility of the BP load in predicting the mean SMBP and confirming elevated SMBP.

Methods:

Four hundred twenty untreated adults at least 30 years of age acquired SMBP data twice in the morning and twice in the evening over 10 days. The ‘true’ SMBP was defined as the mean of these 40 determinations.

Results:

Using all 10 days of BP data and a systolic BP threshold of 130 mmHg, the average SMBP associated with a home BP load of 0.50 was 130 mmHg, with a 95% prediction interval of 126–133 mmHg. True systolic SMBP was approximately 6 mmHg lower and higher at home BP loads of 0.25 and 0.75, respectively. There was a 90% probability that the true systolic SMBP was greater than 130 mmHg if the systolic home BP load was at least 0.60. Corresponding values for 3 days and 1 day of SMBP were at least 0.68 and at least 0.84, respectively.

Conclusion:

Our analysis demonstrates that the home BP load can be used to estimate the average BP acquired on home monitoring and confirm elevated SMBP.
Pulmonary vascular resistance predicts the mortality in patients with bronchiectasis-associated pulmonary hypertension
Authors: Xu Jian , Wang Jing-jing , Zhao Qin-hua , Gong Su-gang , Wu Wen-hui , Jiang Rong , Luo Ci-jun , Qiu Hong-ling , Li Hui-ting , Wang Lan , Liu Jin-ming
Published: June 2024

Objective:

Pulmonary hypertension is a severe complication of bronchiectasis, characterized by elevated pulmonary vascular resistance (PVR) and subsequent right heart failure. The association between PVR and mortality in bronchiectasis-associated pulmonary hypertension has not been investigated previously.

Methods:

In the present study, a retrospective analysis was conducted on 139 consecutive patients diagnosed with bronchiectasis-associated pulmonary hypertension based on right heart catheterization, enrolled between January 2010 and June 2023. Baseline clinical characteristics and hemodynamic assessment were analyzed. The survival time for each patient was calculated in months from the date of diagnosis until the date of death or, if the patient was still alive, until their last visit.

Results:

Patients with bronchiectasis-associated pulmonary hypertension exhibited estimated survival rates of 89.5, 70, and 52.9 at 1-year, 3-year, and 5-year intervals respectively, with a median survival time of 67 months. Multivariable Cox regression analysis revealed that increased age [(adjusted hazard ratio per year 1.042, 95% confidence interval (CI) 1.008–1.076, P = 0.015] and elevated PVR (adjusted HR per 1 Wood Units 1.115, 95% CI 1.015–1.224, P = 0.023) were associated with an increased risk of all-cause mortality. In contrast, higher BMI was associated with a decreased risk of all-cause death (adjusted hazard ratio per 1 kg/m2 0.915, 95% CI 0.856–0.979, P = 0.009). Receiver-operating characteristic analyses identified a cutoff value for PVR at 4 Wood Units as predictive for all-cause death within 3 years [area under the curve (AUC) = 0.624; specificity= 87.5%; sensitivity= 35.8%; P < 0.05]. Patients with a PVR greater than 4 Wood Units had a significantly higher risk of all-cause death compared with those with 4 Wood Units or less (adjusted hazard ratio 2.392; 95% CI 1.316–4.349; P = 0.019). Notably, there were no significant differences in age, sex, BMI, WHO functional class, 6-min walk distance, and NT-proBNP levels at baseline between patients categorized as having 4 Wood Units or less or greater than 4 Wood Units for PVR.

Conclusion:

Based on these data, PVR could serve as a discriminative marker for distinguishing between nonsevere pulmonary hypertension (PVR ≤ 4 Wood Units) and severe pulmonary hypertension (PVR > 4 Wood Units). The utilization of a PVR cutoff value of 4.0 Wood Units provides enhanced prognostic capabilities for predicting mortality.