bluuebunny/crossref_metadata_2025 huggingface dataset:
Low concentrations of soybean lecithin nanoparticles had a positive impact on Holstein bulls' cryopreserved semen
Authors: Abdel‐Ghani Mohammed A. , El‐Sharawy Mohamed E. , Zaid Ebtsam K. , Shehabeldin Ahmed M. , Dessouki Sherif M. , Moustapha Moustapha E. , Metwally Abd El‐Salam M. , El‐Shamaa Ibrahim S.
Published: May 2024

Spermatozoa can experience negative changes when subjected to freezing and thawing, including lowered motility, viability and acrosome response. Herein, the effects of different concentrations of soybean lecithin nanoparticles on cryopreserved Holstein bull semen were examined. Semen was collected, cryopreserved and utilized for sperm kinetic parameter analysis following dilution, equilibration and thawing with 0.5% soybean lecithin (E1), the control extender, and 0.75% (E2), 0.5% (E3), 0.25% (E4) and 0.125% (E5) of lecithin nanoparticles. Results revealed that following dilution, the progressive motility (PM) at E3, E4 and E5 of lecithin nanoparticles was higher (p < .05) than it was for E2. After equilibration, compared to the E1, E2, and E3 values, the PM, vitality, normal morphology, membrane integrity and intact acrosome values at the E5 were consistently greater (p < .05). Comparing the percentages of intact acrosome and membrane integrity at E2 and E3 to E4 and E5, a substantial decrease (p < .05) was seen. Following thawing, the percentage of PM improved at E2 and E5, even though their mean PM values were similar (p > .05) compared to E1, E3 and E4. Vigour and progression parameters of sperm (DAP, DCL, DSL, VAP, VCL, VSL and STR) at E5 were higher (p < .05) than those at E1, E2, E3 and E4. In conclusion, the cryopreserved sperm from Holstein bulls revealed outstanding properties both after equilibration and after thawing with 0.125% lecithin nanoparticles, and they were sensitive to high dosages.
SARS‐CoV‐2 delta variant in African lions (Panthera leo) and humans at Utah's Hogle Zoo, USA, 2021–22
Authors: Oltjen Heather , Crook Erika , Lanier William A. , Rettler Hannah , Oakeson Kelly F. , Young Erin L. , Torchetti Mia , Van Wettere Arnaud J.
Published: June 2024

Aims

We conducted a One Health investigation to assess the source and transmission dynamics of SARS‐CoV‐2 infection in African lions (Panthera leo) at Utah's Hogle Zoo in Salt Lake City from October 2021 to February 2022.

Methods and Results

Following observation of respiratory illness in the lions, zoo staff collected pooled faecal samples and individual nasal swabs from four lions. All specimens tested positive for SARS‐CoV‐2 by reverse transcription‐polymerase chain reaction (RT‐PCR). The resulting investigation included: lion observation; RT‐PCR testing of lion faeces every 1–7 days; RT‐PCR testing of lion respiratory specimens every 2–3 weeks; staff interviews and RT‐PCR testing; whole‐genome sequencing of viruses from lions and staff; and comparison with existing SARS‐CoV‐2 human community surveillance sequences. In addition to all five lions, three staff displayed respiratory symptoms. All lions recovered and no hospitalizations or deaths were reported among staff. Three staff reported close contact with the lions in the 10 days before lion illness onset, one of whom developed symptoms and tested positive for SARS‐CoV‐2 on days 3 and 4, respectively, after lion illness onset. The other two did not report symptoms or test positive. Two staff who did not have close contact with the lions were symptomatic and tested positive on days 5 and 8, respectively, after lion illness onset. We detected SARS‐CoV‐2 RNA in lion faeces for 33 days and in lion respiratory specimens for 14 weeks after illness onset. The viruses from lions were genetically highly related to those from staff and two contemporaneous surveillance specimens from Salt Lake County; all were delta variants (AY.44).

Conclusions

We did not determine the sources of these infections, although human‐to‐lion transmission likely occurred. The observed period of respiratory shedding was longer than in previously documented SARS‐CoV‐2 infections in large felids, indicating the need to further assess duration and potential implications of shedding.
COMPARATIVE OF RIVEST-SHAMIR-ADLEMAN CRYPTOSYSTEM AND ITS FOUR VARIANTS USING RUNNING TIME AND MEMORY CONSUMPTION ANALYSIS
Authors: Mandangan Arif , Asbullah Muhammad Asyraf , Syed Adnan Syed Farid , Budiman Mohammad Andri
Published: June 2024

The Rivest-Shamir-Adleman (RSA) algorithm, known for its slow single-precision multiplication (spm) and overall running time, is not commonly employed to encrypt user data directly. As a result, several researchers have developed various RSA-based cryptosystems to enhance the algorithm's performance while maintaining security. This paper presents a comparative analysis of different variants of the RSA cryptosystem, focusing on five specific cryptosystems: RSA, Somsuk-RSA, Modified-RSA (MRSA), Easy Simple Factoring-RSA (ESF-RSA), and Phony-RSA. The methodology involves evaluating the theoretical running time and memory usage through single-precision multiplication (spm) measurements, while the actual running time is estimated using Maple programming. The research has two primary objectives. Firstly, they examined each algorithm of the RSA variants and analysed them according to the proposed methodology. Secondly, to determine which cryptosystem consumes the most time and memory for key generation, encryption, and decryption. The results indicate that ESF-RSA and RSA are the fastest in terms of key generation, ESF-RSA is the quickest for encryption, and Phony-RSA excels in decryption speed. Additionally, ESF-RSA demonstrates the lowest memory usage, whereas MRSA requires the highest memory allocation for all processes.
THE EFFECT OF NUTRITIONAL STATUS AND TNF ALPHA TO LUNG FUNCTION ON MARBLE CRAFTSMAN
Authors: Widajati Noeroel , Tiara Nisrina , Martiana Tri , Mohd Elias Saliza , Priyandani Yuni
Published: June 2024

Marble craftsmen are potentially exposed to marble dust which contains about 60% silica resulting in marble craftsmen facing this hazard and possibly physiological lung disorders. In addition, this hazard will increase Tumor Necrosis Factor-a (TNF- α) levels. This study aims to analyze the effect of working period, nutritional status, and TNF-α on physiological lung disorders. study is a quantitative study with observational research type and cross sectional research design In this study, the data collection techniques used were: (1) measurement of personal river stone dust levels using a personal dust sampler of CCZG2A type; (2) measurement of serum TNF-α levels using the ELISA technique, (3) examination of lung function with MIR spirolab III; (4) collection of data on respiratory complaints using the ATS standard questionnaire as well as to obtain data on age, tenure, length of work and smoking habits; (5) measurement of nutritional status by weighing body weight and measuring height. The data obtained were then presented in the form of tables, narratives, analyzed using statistical programs. The subjects of this study were all marble craftsmen who worked in the marble household industry in Tulungagung Regency as many as 30 people with the number of samples taken as many as 26 craftsmen. The average value of %FVC in obese respondents was lower than that of respondents with normal nutritional status. This indicates a decrease in lung function conditions in obese workers.
IN SILICO PROTEIN INTERACTION ANALYSIS OF DENGUE VIRUS NON-STRUCTURAL 2A AND HUMAN POTASSIUM CHANNEL KV1.3
Authors: Hassan Nur Al Syifaa , Misbah Suzana , Razali Siti Aisyah , Teoh Boon-Teong , AbuBakar Sazaly
Published: June 2024

Dengue virus (DENV) is a mosquito-borne pathogen that causes dengue fever, a potentially severe illness. During infection, DENV interacts with various host factors to facilitate viral production. However, certain host restriction factors, such as the voltage-gated potassium channel Kv1.3, can impede viral replication by limiting DENV entry into host cells. While the interplay of DENV proteins and the specific mechanism facilitating this event remain unclear, our previous yeast two-hybrid interactomes study identified an interaction between DENV non-structural protein 2A (NS2A) and Kv1.3. This study aimed to identify potential binding sites between DENV NS2A and Kv1.3 using in silico approach. Crystal structures of DENV NS2A and Kv1.3 was obtained from RCSB PDB. Protein-protein interaction analysis was conducted using molecular docking with HADDOCK v2.4, and the interaction was assessed based on HADDOCK scores. Our results revealed that the HADDOCK score was -64.7±3.2, indicating an excellent binding affinity between DENV NS2A and Kv1.3. The robust interaction between NS2A and Kv1.3 underscores the need for further investigation into the role of potassium channels in DENV replication.
Uniqueness of Ricci flows from non‐atomic Radon measures on Riemann surfaces
Authors: Topping Peter M. , Yin Hao
Published: June 2024

In previous work (Topping and Yin, https://arxiv.org/abs/2107.14686), we established the existence of a Ricci flow starting with a Riemann surface coupled with a non‐atomic Radon measure as a conformal factor. In this paper, we prove uniqueness, settling Conjecture 1.3 of Topping and Yin (https://arxiv.org/abs/2107.14686). Combining these two works yields a canonical smoothing of such rough surfaces that also regularises their geometry at infinity.
Feature-based maximum entropy for geophysical properties of the seabed
Authors: Knobles D. P. , Hodgkiss William , Chaytor Jason , Neilsen Tracianne , Lin Ying-Tsong
Published: June 2024

The coherent recombination of a direct and seabed reflected path is sensitive to the geophysical properties of the seabed. The concept of feature-based inversion is used in the analysis of acoustic data collected on a vertical line array (VLA) on the New England continental shelf break in about 200 m of water. The analysis approach for the measurements is based on a ray approach in which a direct and bottom reflected path is recombined, resulting in constructive and destructive interference of the acoustic amplitudes with frequency. The acoustic features have the form of prominent nulls of the measured received levels as a function of frequency as a broadband (500–4500 Hz) source passes the closest point of approach to the VLA. The viscous grain shearing (VGS) model is employed to parameterize a two-layer seabed model. The most likely seabed is a sand sediment with a porosity of about 0.42. There is a possibility of a thin (less than 0.5 m) surface layer having a slightly higher porosity between 0.45 and 0.50. Using the estimates for the VGS parameters inferred from the short-range frequency features, a normal mode model is used to predict the received acoustic levels over larger range scales.
The hallmarks of a tradeoff in transcriptomes that balances stress and growth functions
Authors: Dalldorf Christopher , Rychel Kevin , Szubin Richard , Hefner Ying , Patel Arjun , Zielinski Daniel C. , Palsson Bernhard O.
Published: June 2024

Fast growth phenotypes are achieved through optimal transcriptomic allocation, in which cells must balance tradeoffs in resource allocation between diverse functions. One such balance between stress readiness and unbridled growth in
E. coli
has been termed the fear versus greed (f/g) tradeoff. Two specific RNA polymerase (RNAP) mutations observed in adaptation to fast growth have been previously shown to affect the f/g tradeoff, suggesting that genetic adaptations may be primed to control f/g resource allocation. Here, we conduct a greatly expanded study of the genetic control of the f/g tradeoff across diverse conditions. We introduced 12 RNA polymerase (RNAP) mutations commonly acquired during adaptive laboratory evolution (ALE) and obtained expression profiles of each. We found that these single RNAP mutation strains resulted in large shifts in the f/g tradeoff primarily in the RpoS regulon and ribosomal genes, likely through modifying RNAP-DNA interactions. Two of these mutations additionally caused condition-specific transcriptional adaptations. While this tradeoff was previously characterized by the RpoS regulon and ribosomal expression, we find that the GAD regulon plays an important role in stress readiness and ppGpp in translation activity, expanding the scope of the tradeoff. A phylogenetic analysis found the greed-related genes of the tradeoff present in numerous bacterial species. The results suggest that the f/g tradeoff represents a general principle of transcriptome allocation in bacteria where small genetic changes can result in large phenotypic adaptations to growth conditions.

IMPORTANCE

To increase growth,
E. coli
must raise ribosomal content at the expense of non-growth functions. Previous studies have linked RNAP mutations to this transcriptional shift and increased growth but were focused on only two mutations found in the protein’s central region. RNAP mutations, however, commonly occur over a large structural range. To explore RNAP mutations’ impact, we have introduced 12 RNAP mutations found in laboratory evolution experiments and obtained expression profiles of each. The mutations nearly universally increased growth rates by adjusting said tradeoff away from non-growth functions. In addition to this shift, a few caused condition-specific adaptations. We explored the prevalence of this tradeoff across phylogeny and found it to be a widespread and conserved trend among bacteria.
Child Opportunity Index and clinical characteristics at diabetes diagnosis in youth: type 1 diabetes versus type 2 diabetes
Authors: Hoyek Kim , Libman Ingrid , Mkparu Nkeiruka , Hong Yong Hee , Arslanian Silva , Vajravelu Mary Ellen
Published: June 2024

Introduction

Among youth with type 1 diabetes (T1D), longitudinal poor glycemic control is associated with adverse socioeconomic conditions at the neighborhood level. Child Opportunity Index (COI), which encompasses measures of education, health, environment, social, and economic factors, is associated with obesity in youth but has not been evaluated in youth with new-onset T1D or type 2 diabetes (T2D). We hypothesized that lower COI would be associated with adverse clinical outcomes at diabetes diagnosis, and due to differing risk factors and pathophysiology, that youth with new-onset T2D would have lower COI than youth with T1D.

Research design and methods

Retrospective cohort of youth with new-onset diabetes admitted to a large academic pediatric hospital. COI was compared by diabetes type using t-tests and Χ2tests. Multivariable linear and logistic regression analyses were used to evaluate associations between COI and clinical characteristics, stratified by diabetes type and adjusted for age and sex.

Results

The cohort (n=484) differed in race and age by diabetes type (T1D: n=389; 10.0% black, 81.2% white; age 9.6±0.2 years; T2D: n=95; 44.2% black, 48.4% white; age 14.8±0.3 years). Youth with T2D had lower COI (p<0.001). Low COI was associated with diabetic ketoacidosis in T1D and T2D. Black youth with low COI had the highest hemoglobin A1c among youth with T2D and the highest obesity prevalence among youth with T1D.

Conclusions

COI is associated with differing characteristics at diagnosis in youth-onset T1D and T2D but is worse among youth with T2D overall. These findings underscore the need to address socioeconomic adversity when designing interventions to reduce T2D risk and to improve outcomes at diabetes diagnosis in youth.
Exploring factors influencing quality of life variability among individuals with coeliac disease: an online survey
Authors: Elwenspoek Martha , Banks Jonathan , Desale Prajakta Pratap , Watson Jessica , Whiting Penny
Published: June 2024

Objective

Patients with coeliac disease (CD) need to follow a strict gluten-free diet to manage symptoms and prevent complications. Restrictions imposed by the diet can be challenging and affect quality of life (QoL). We explored sources of variation in QoL among patients with CD.

Design

We conducted an online survey of coeliac patients in the UK, including a CD-specific QoL tool (CD-QOL V.1.0), questions on diet adherence and an optional comment box at the end. The survey was disseminated via social media and went live between January and March 2021. We performed multiple linear regression and free text analysis.

Results

We found a median CD-QOL score of 61 (IQR 44–76, range 4–100, n=215) suggesting good QoL (Good >59); however, the individual QoL scores varied significantly. Regression analyses showed that people who found diet adherence difficult and people adhering very strictly had a lower QoL. Free text comments suggested that people who adhered very strictly may do so because they have symptoms with minimal gluten exposure. People who found diet adherence difficult may be people who only recently started the diet and were still adjusting to its impact. Comments also highlighted that individuals with CD often perceive a lack of adequate follow-up care and support after diagnosis.

Conclusion

Better support and follow-up care is needed for people with CD to help them adjust to a gluten-free diet and minimise the impact on their QoL. Better education and increased awareness are needed among food businesses regarding cross-contamination to reduce anxiety and accidental gluten exposure.
Self-compassion letter tool for healthcare worker well-being: a qualitative descriptive analysis
Authors: Powell Melissa , Sexton Bryan , Adair Kathryn C
Published: June 2024

Objective

This qualitative study aimed to identify categories within therapeutic self-compassion letters written by healthcare workers. Resulting categories were assessed for their relevance to the construct of self-compassion.

Design

This was a qualitative descriptive study that used summative content analysis and inductive coding.

Setting

A US-based academic healthcare system.

Participants

Healthcare workers who attended a self-compassion webinar were recruited.

Intervention

The online self-compassion tool asked participants to write a letter to themselves from the perspective of a friend providing support and encouragement.

Results

116 letters were analysed. Five major categories emerged: Looking Forward, Reaffirming Self, Reaffirming Reminders, Hardships and Self-Disparagement. Respondents’ letters were mostly positively framed and forward thinking, including their hopes of improving themselves and their lives in the future. Negative content generally described hardships and often served to provide self-validation or perspective on obstacles that had been overcome.

Conclusion

The writing prompt elicited content from the writers that reflected the core elements of self-compassion (ie, self-kindness, common humanity, mindfulness). Continued research to further understand, refine and improve the impact of therapeutic letter writing to enhance well-being is warranted to reduce burnout and promote quality patient care.
Indigenous herbal medicine use and its associated factors among pregnant women attending antenatal care at public health facilities in Dire Dawa, Ethiopia: a cross-sectional study
Authors: Mohammed Aminu , Amsalu Bezabih , Hailu Mickiale , Sintayehu Yitagesu , Weldeamanuel Tadesse , Belay Yalelet , Hassen Zeyniya , Dinkesa Tesema , Dechasa Natnael , Mengist Betelhem , Mengesha Teshale , Nuri Aliya , Getnet Tewodros , Manaye Yibekal , Aliyi Usso Ahmedin , Legesse Henok , Sertsu Addisu
Published: June 2024

Objective

The aim of this study was to investigate the prevalence of indigenous herbal medicine use and its associated factors among pregnant women attending antenatal care (ANC) at public health facilities in Dire Dawa, Ethiopia.

Design

A facility-based cross-sectional study design.

Setting

The study was conducted in seven public health facilities (one referral hospital, three urban and three rural health centres) in Dire Dawa, Ethiopia, from October to November 2022.

Participants

628 pregnant women of any gestational age who had been on ANC follow-up at selected public health facilities were included.

Main outcome measures

Prevalence of indigenous herbal medicine (users vs non-users) and associated factors.

Results

The study revealed that 47.8% (95% CI 43.8% to 51.6%) of pregnant women used herbal medicines. Lack of formal education (adjusted OR, AOR 5.47, 95% CI 2.40 to 12.46), primary level (AOR 4.74, 95% CI 2.15 to 10.44), housewives (AOR 4.15, 95% CI 1.83 to 9.37), number of ANC visits (AOR 2.58, 95% CI 1.27 to 5.25), insufficient knowledge (AOR 4.58, 95% CI 3.02 to 6.77) and favourable perception (AOR 2.54, 95% CI 1.71 to 3.77) were factors significantly associated with herbal medicine use. The most commonly used herbs were garden cress (Lepidium sativum) (32%), bitter leaf (Vernonia amygdalina) (25.2%), moringa (Moringa oleifera) (24.5%).Commonindications were related to gastrointestinal problems, blood pressure and sugar.

Conclusion

The prevalence of herbal medicine use is high (one in two pregnant women) and significantly associated with education level, occupation, ANC visits, knowledge and perceptions. The study’s findings are helpful in advancing comprehension of herbal medicines using status, types and enforcing factors. It is essential that health facilities provide herbal counselling during ANC visits, and health regulatory bodies ought to raise awareness and implement interventions to lower the risks from over-the-counter herbal medicine use by pregnant women.
Longitudinal Resilience and Risk Factors in Pediatric Postoperative Pain (LORRIS): Protocol for a Prospective Longitudinal Swiss University Children’s Hospitals-Based Study
Authors: Hochreuter Jana , Dreher Thomas , Hasler Carol-Claudius , Canonica Sandro , Locher Cosima , Held Ulrike , Rabbitts Jennifer , Koechlin Helen
Published: June 2024

Introduction

Chronic postsurgical pain (CPSP) is defined as pain that persists after a surgical procedure and has a significant impact on quality of life. Previous studies show the importance of psychological factors in CPSP, yet the majority of studies focused solely on negative emotions. This longitudinal observational study aims to broaden this knowledge base by examining the role of emotional state, emotion variability, emotion regulation and emotion differentiation on the child and the parent level for the development CPSP, and to describe pain and emotion-related trajectories following surgery.

Methods and analysis

We intend to include 280 children and adolescents aged 8–18 years with a planned orthopaedic surgery and their parents. A total of five assessment time points is planned: 3 weeks before surgery (baseline), 2 weeks after surgery (post) and 3 months (follow-up (FU) 1), 6 months and 12 months after surgery. At baseline and post only, children and parents are asked to complete a daily diary thrice a day for a week where they rate their current emotional state and their pain severity (children only). Emotional state ratings will be used to calculate indices of emotion variability, emotion regulation and emotion differentiation. Children and parents will complete questionnaires at each time point, including measures on quality of life, social support, sleep, and symptoms of anxiety and depression.

To predict development of CPSP, generalised linear regression models will be used, resulting in ORs and 95% CIs. Pearson product-moment correlations between predictors and outcomes will be evaluated at each time point. The primary outcome of the prediction model is CPSP at FU1. For the trajectory analysis, the classification method K-means for longitudinal data will be used to determine clusters in the data.

Ethics and dissemination

The Ethics Committee of the Canton of Zurich, Switzerland, has approved the study (ID: 2023-01475). Participants will be compensated, and a dissemination workshop will be held.

Trial registration number

NCT05816174.
Development and validation of a supportive programme for family caregivers of children suffering from cystic fibrosis: protocol for a sequential exploratory mixed-methods study
Authors: Shadi Danial , Jabraeili Mahnaz , Hassankhani Hadi , Alhani Fatemeh , Bostanabad Mohammad Arshadi
Published: June 2024

Introduction

Families with children who have cystic fibrosis (CF) face a multitude of challenges. They require complex and time-consuming daily care, various forms of knowledge and intricate care responsibilities. One of the most critical challenges that Iranian families of children with CF face is the lack of adequate support from health teams in the early stages of diagnosis, frequent hospitalisation and the postdischarge process. Unfortunately, limited studies have been conducted in this field, and the Iranian society lacks a comprehensive support programme for these families after leaving treatment centres or home care teams. Therefore, it is necessary to identify and redefine the needs of these families for better care and support in Iran.

Methods and analysis

A mixed-method research design with an exploratory sequential approach will be used in this study. The study consists of three stages: stage (1) the qualitative phase (conventional content analysis and scoping review); stage (2) the programme design phase (development of a support programme) and stage (3) the quantitative phase (validation of the programme through the Delphi method). In the first stage, data will be collected through interviews. Key concepts, evidence and gaps in research will also be identified, collected and analysed through a scoping review. In the second stage, a support programme will be designed based on the results of the content analysis of interviews and the findings from the scoping review. In the final phase, the study will aim to validate the designed programme through a Delphi study.

Ethics and dissemination

This study formed part of a Ph.D. degree and was approved by the ethics committee of Tabriz University of Medical Sciences (IR.TBZMED.REC.1402.395). Informed consent will be obtained from all study participants. Findings will be published in a peer-reviewed journal.
Estimating the indirect economic burden of cancer in Jordan: a retrospective observational study
Authors: Rashdan Omar
Published: June 2024

Objective

The aim of this study is to estimate the indirect economic burden of 22 cancer types in Jordan using both the human capital approach (HCA) and the value of a statistical life year (VSLY) approach. Additionally, this study aims to forecast the burden of these cancers for the next 5 years while employing time series analysis.

Design

Retrospective observational study with a time series analysis.

Participants

Disability adjusted life years records from the IHME Global Burden Disease estimates 2019 data.

Primary outcome measure

Indirect economic burden of cancer in Jordan.

Results

The mean total economic burden for all cancers is estimated to be $1.82 billion using HCA and $3.13 billion using VSLY approach. The cancers contributing most to the total burden are ‘tracheal, bronchus and lung cancer’ ($359.5 million HCA, $618.3 million VSLY), followed by ‘colon and rectum cancer’ ($300.6 million HCA, $517.1 million VSLY) and ‘breast cancer’ ($292.4 million HCA, $502.9 million VSLY). The indirect economic burden ranged from 1.4% to 2.1% of the gross domestic product (GDP) using the HCA, and from 2.3% to 3.6% of the GDP using the VSLY approach. The indirect economic burden is expected to reach 2.3 and 3.5 billion Intl$ by the year 2025 using the HCA and VSLY approach, respectively.

Conclusion

The indirect economic burden of cancer in Jordan amounted to 1.4%–3.6% of total GDP, with tracheal, bronchus and lung cancer; colon and rectum cancer; and breast cancer contributing to over 50% of the total burden. This will help set national cancer spending priorities following Jordan’s economic modernisation vision with regard to maximising health economic outcomes.
Surgeons’ views of peer comparison and guideline-based feedback on postsurgery opioid prescriptions: a qualitative investigation
Authors: Martinez Meghan , Kirkegaard Allison , Bouskill Kathryn , Yan Xiaowei Sherry , Wagner Zachary , Watkins Katherine E
Published: June 2024

Background

Excess opioid prescribing after surgery can lead to prolonged opioid use and diversion. We interviewed surgeons who were part of a three-group cluster-randomised controlled trial aimed at reducing prescribed opioid quantities after surgery via two versions of a monthly emailed behavioural ‘nudge’ (messages encouraging but not mandating compliance with social norms and clinical guidelines around prescribing) at the end of the implementation year in order to understand surgeons’ reasoning for changing or continuing their prescribing behaviour as a result of the intervention and the context for their rationale.

Methods

The study took place at a large healthcare system in northern California with surgeons from three surgical specialties—orthopaedics, obstetrics/gynaecology and general surgery. Following the intervention period, we conducted semistructured interviews with 36 surgeons who had participated in the trial, ensuring representation across trial arm, specialty and changes in prescribing quantities over the year. Interviews focused on reactions to the nudges, impacts of the nudges on prescribing behaviours and other factors impacting prescribing. Three study team members coded and analysed the transcribed interviews.

Results

Nudges were equally effective in reducing postsurgical opioid prescribing across surgical specialties and between intervention arms. Surgeons were generally receptive to the nudge intervention, noting that it reduced the size of their discharge opioid prescriptions by improving their awareness and intentionality around prescribing. Most were unaware that clinical guidelines around opioid prescribing existed. Some had reservations regarding the accuracy and context of information provided in the nudges, the prescription quantities encouraged by the nudges and feelings of being watched or admonished. A few described discussing the nudges with colleagues. Respondents emphasised that the prescribing behaviours are informed by individual clinical experience and patient-related and procedure-related factors.

Conclusions

Surgeons were open to learning about their prescribing behaviour through comparisons to guidelines or peer behaviour and incorporating this feedback as one of several factors that guide discharge opioid prescribing. Increasing awareness of clinical guidelines around opioid prescribing is important for curbing postsurgical opioid overprescribing.

Trial registration number

NCT05070338
.
Effects of antibiotics, hospitalisation and surgical complications on self-reported immunological vulnerability following paediatric open-heart surgery and thymectomy: a single-centre retrospective cohort study
Authors: Kesäläinen Anssi , Rantanen Rea , Honkila Minna , Helminen Merja , Rahkonen Otto , Kallio Merja , Ruuska Terhi , Kekäläinen Eliisa , Heinonen Santtu
Published: June 2024

Background

Partial or complete thymectomy is routinely performed in paediatric open-heart surgeries when treating congenital heart defects. Whether or not thymectomised children require systematic immunological monitoring later in life is unknown. The objective of this study was to investigate the effects of preoperatively and postoperatively used antibiotics, hospitalisation and surgical complications on self-reported immunological vulnerability in paediatric patients with early thymectomy to better recognise the patients who could benefit from immunological follow-up in the future.

Methods

We conducted a retrospective cohort study, including 98 children and adolescents aged 1–15 years, who had undergone an open-heart surgery and thymectomy in infancy and who had previously answered a survey regarding different immune-mediated symptoms and diagnoses. We performed a comprehensive chart review of preoperative and postoperative factors from 1 year preceding and 1 year following the open-heart surgery and compared the participants who had self-reported symptoms of immunological vulnerability to those who had not.

Results

The median age at primary open-heart surgery and thymectomy was 19.5 days in the overall study population (60% men, n=56) and thymectomies mainly partial (80%, n=78). Broad-spectrum antibiotics were more frequently used preoperatively in participants with self-reported immunological vulnerability (OR=3.05; 95% CI 1.01 to 9.23). This group also had greater overall use of antibiotics postoperatively (OR=3.21; 95% CI 1.33 to 7.76). These findings were more pronounced in the subgroup of neonatally operated children. There was no statistically significant difference in the duration of intensive care unit stay, hospitalisation time, prevalence of severe infections, surgical complications or glucocorticoid use between the main study groups.

Conclusion

Antimicrobial agents were more frequently used both preoperatively and postoperatively in thymectomised children with self-reported immunological vulnerability after thymectomy. Substantial use of antimicrobial agents early in life should be considered a potential risk factor for increased immunological vulnerability when evaluating the significance of immune-mediated symptom occurrence in thymectomised paediatric patients.
Dysregulation of CD4+and CD8+resident memory T, myeloid, and stromal cells in steroid-experienced, checkpoint inhibitor colitis
Authors: He Jun Yan , Kim Yang-Joon , Mennillo Elvira , Rusu Iulia , Bain Jared , Rao Arjun A , Andersen Christopher , Law Karen , Yang Hai , Tsui Jessica , Shen Alan , Davidson Brittany , Kushnoor Divyashree , Shi Yimin , Fan Frances , Cheung Alexander , Zhang Li , Fong Lawrence , Combes Alexis J , Pisco Angela O , Kattah Michael G , Oh David Y
Published: June 2024

Background

Colitis caused by checkpoint inhibitors (CPI) is frequent and is treated with empiric steroids, but CPI colitis mechanisms in steroid-experienced or refractory disease are unclear.

Methods

Using colon biopsies and blood from predominantly steroid-experienced CPI colitis patients, we performed multiplexed single-cell transcriptomics and proteomics to nominate contributing populations.

Results

CPI colitis biopsies showed enrichment of CD4+resident memory (RM) T cells in addition to CD8+RM and cytotoxic CD8+T cells. Matching T cell receptor (TCR) clonotypes suggested that both RMs are progenitors that yield cytotoxic effectors. Activated, CD38+HLA-DR+CD4+RM and cytotoxic CD8+T cells were enriched in steroid-experienced and a validation data set of steroid-naïve CPI colitis, underscoring their pathogenic potential across steroid exposure. Distinct from ulcerative colitis, CPI colitis exhibited perturbed stromal metabolism (NAD+, tryptophan) impacting epithelial survival and inflammation. Endothelial cells in CPI colitis after anti-TNF and anti-cytotoxic T-lymphocyte-associated antigen 4 (anti-CTLA-4) upregulated the integrin α4β7 ligand molecular vascular addressin cell adhesion molecule 1 (MAdCAM-1), which may preferentially respond to vedolizumab (anti-α4β7).

Conclusions

These findings nominate CD4+RM and MAdCAM-1+endothelial cells for targeting in specific subsets of CPI colitis patients.
In the fight against HIV/AIDS: the arduous implementation of government-funded pre-exposure prophylaxis programme in Taiwan
Authors: Huang Hsun Yin , Huang Jyun Rong , Chan Pei Chun , Lee Chia Chi
Published: June 2024

Introduction

The government-funded pre-exposure prophylaxis (PrEP) programme was targeted to those aged under 30 years or serodiscordant couples and implemented in September 2018–October 2020 in Taiwan. The study aimed to examine the effectiveness of the programme and the relationship between sexually transmitted disease (STD) and HIV seroconversion.

Methods

This study was a retrospective cohort analysis with questionnaires designed for participants who joined the aforementioned programme in the PrEP-designated hospitals. The questionnaires included sociodemographic factors, sexual risk behaviours, number and types of sexual partners, and usage of narcotics filled in at the beginning of the programme and every 3 months. The McNemar test was used for the paired questionnaire analysis. The HIV seroconversion status among STD-notified patients nationwide was confirmed by using the data linkage method, followed up until October 2021 with stratification of PrEP programme participation or not.

Results

The programme recruited 2155 people. 11 participants (0.5%) had seroconversion within the programme, while 26 (1.2%) had seroconversion after withdrawing from the programme. Overall, 1892 subjects with repeated questionnaires were included in the analysis for behaviour changes with median follow-up of 289 days. After joining the programme, 94.7% of them claimed that they had sexual behaviours: the rate of those who had condomless sex rose to 5.5% (p<0.001) and the rate of those who used narcotics decreased to 2% (p<0.001), compared with their response in the pre-questionnaire. Notably, the frequency of non-use of narcotics in recent 3 months increased from 16.9% to 38.4% in the pre-questionnaire and post-questionnaire responses, among the 177 who had claimed narcotics usage in recent 12 months (p=0.003). More HIV seroconversion was found among patients with STD who did not join the programme than those who joined the programme (8.7% vs 4.9%, p=0.031).

Conclusions

The government-funded programme showed HIV case reduction and positive changes in health behaviours except for condomless sex which had increased prevalence. The reduction of HIV cases was also observed among people with STD. More resources should be allocated to the PrEP programme.
Fever and infections in surgical intensive care: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document
Authors: Nohra Eden , Appelbaum Rachel D , Farrell Michael Steven , Carver Thomas , Jung Hee Soo , Kirsch Jordan Michael , Kodadek Lisa M , Mandell Samuel , Nassar Aussama Khalaf , Pathak Abhijit , Paul Jasmeet , Robinson Bryce , Cuschieri Joseph , Stein Deborah M
Published: June 2024

The evaluation and workup of fever and the use of antibiotics to treat infections is part of daily practice in the surgical intensive care unit (ICU). Fever can be infectious or non-infectious; it is important to distinguish between the two entities wherever possible. The evidence is growing for shortening the duration of antibiotic treatment of common infections. The purpose of this clinical consensus document, created by the American Association for the Surgery of Trauma Critical Care Committee, is to synthesize the available evidence, and to provide practical recommendations. We discuss the evaluation of fever, the indications to obtain cultures including urine, blood, and respiratory specimens for diagnosis of infections, the use of procalcitonin, and the decision to initiate empiric antibiotics. We then describe the treatment of common infections, specifically ventilator-associated pneumonia, catheter-associated urinary infection, catheter-related bloodstream infection, bacteremia, surgical site infection, intra-abdominal infection, ventriculitis, and necrotizing soft tissue infection.
3D imaging application to the study of the early Neolithic ceramic complex: the decorated pottery of Rio Tana (Abruzzi, Italy)
Authors: Petrinelli Pannocchia Cristiana , Vassanelli Alice , Terranova Agnese , Potenziani Marco , Pingi Paolo , Callieri Marco , Cignoni Paolo
Published: June 2024

This study aims to demonstrate the potential of 3D analysis in the study of prehistoric ceramic complexes. Due to the production systems used, prehistoric pottery decorations can vary significantly. Examining the frequency of various decorative methods used at different sites may help identify areas potentially connected to specific traditional elements. However, this is usually a cumbersome and time-consuming task. 3D digital methodologies can bring several advantages in the interpretation of ceramic decoration, providing new tools that can improve analytical skills, speed up the decision process, and support the researcher’s conclusions. This work focuses on the application of these methodologies to the study of decorated ceramics from the Neolithic site of Rio Tana (Abruzzo, central Italy): firstly, a pottery complex from this site has been 3D digitised; then, an interactive and web-based 3D visualisation system has been developed to enable access and study of these digital data. By comparing archaeological data with experimental data, in parallel with the analysis of 3D models’ surfaces, it has been possible to better define the technique employed and quickly identify the type of tool used to create the ceramic decorations. Furthermore, the web-based system made it possible to share and disseminate the digital dataset with the community, creating the conditions to make it easier to compare the frequency of different decoration methods and tools used at Rio Tana with other sites.
Mapping the elemental distribution in archaeological findings through advanced Neutron Resonance Transmission Imaging
Authors: Marcucci Giulia , Scherillo Antonella , Riccardi Maria Pia , Cucini Costanza , Lemasson Quentin , Di Martino Daniela
Published: June 2024

This work highlights recent application of energy-selective neutron imaging at the ISIS Neutron and Muon Source, specifically focusing on the development of Neutron Resonance Transmission Imaging (NRTI) at the INES instrument. NRTI is a nuclear technique based on resonant neutron absorption reaction, which combines the sensitivity to elemental and isotopic composition with detailed morphological information, using the epithermal portion of the neutron flux available on the INES instrument at the ISIS facility. Unlike standard neutron radiography and tomography methods, NRTI preserves detailed time and energy information for each detector pixel, enabling enhanced visualisation of elemental distribution inside an object’s volume, with the potential for quantitative elemental analysis. These features combined with the non-destructiveness of NRTI make the method promising for applications in the field of Cultural Heritage, especially when it is employed in a multi-technique approach to provide complementary information about the composition and the crystalline structure of archaeological artefacts. A study related to Heritage Science is presented to demonstrate the effectiveness of NRTI in non-destructive investigations of inhomogeneous artefacts, specifically focusing on the excavation finds related to the first evidence of ancient brass production in Milan, Italy, during Roman times.
DNSRF: Deep Network-based Semi-NMF Representation Framework
Authors: Wang Dexian , Li Tianrui , Deng Ping , Luo Zhipeng , Zhang Pengfei , Liu Keyu , Huang Wei
Published: June 2024

Representation learning is an important topic in machine learning, pattern recognition, and data mining research. Among many representation learning approaches, semi-nonnegative matrix factorization (SNMF) is a frequently-used one. However, a typical problem of SNMF is that usually there is no learning rate guidance during the optimization process, which often leads to a poor representation ability. To overcome this limitation, we propose a very general representation learning framework (DNSRF) that is based on a deep neural net. Essentially, the parameters of the deep net used to construct the DNSRF algorithms are obtained by matrix element update. In combination with different activation functions, DNSRF can be implemented in various ways. In our experiments, we tested nine instances of our DNSRF framework on six benchmark datasets. In comparison with other state-of-the-art methods, the results demonstrate the superior performance of our framework, which is thus shown to have a great representation ability.
Intelligent Miniplatform for On-Site Monitoring of Water Samples and Pharmaceutical Production of Ointments Based on Betamethasone and Gentamicin as Active Pharmaceutical Ingredients
Authors: Tuchiu Bianca-Maria , Stefan-van Staden Raluca-Ioana , van Staden Jacobus (Koos) Frederick
Published: June 2024

Betamethasone and gentamicin combination is commonly used in various dermatological conditions. In addition to the topical dosage forms in which this combination can be found, it can also accidentally end up in surface water following removal by washing. For this reason, a disposable miniplatform was constructed by modifying a boron-doped diamond screen printed electrode with calix[4]arene-25,26,27,28-tetrol. Wide linear ranges and low limits of quantification (LOQ) were achieved for both analytes: 1.0 × 10−16–1.0 × 10−2 mol l‒1 and a LOQ of 1.0 × 10−16 mol l‒1 for betamethasone, and 1.0 × 10−17–1.0 × 10−2 mol l‒1 and a LOQ of 1.0 × 10−17 mol l‒1 for gentamicin. The platform was tested on real samples, obtaining recovery values close to 100% and relative standard deviation values below 0.03%. Additionally, a comparison is provided between the proposed approach and existing electrochemical sensors to emphasize the achieved results.
Development of An Eco-Friendly and Cost-Effective Electrochemical Sensor for the Simultaneous Detection of Dopamine and Serotonin
Authors: Moslah Maroua , Dridi Chérif
Published: June 2024

An electrochemical sensor based on eco-friendly green synthesized silver nanoparticles decorated reduced graphene oxide (AgNPs-rGO) modified screen-printed carbon electrode (SPCE) for the simultaneous detection of serotonin (5-HT) and dopamine (DA) is reported for the first time. The experimental parameters affecting the sensor performance were optimized in terms of AgNPs-rGO coating amount, scan rate and electrolyte pH (6–8). Under optimal conditions, the AgNPs-rGO/SPCE was employed to individually determine both analytes using DPV technique. The sensor was also efficient in the simultaneous detection of these species and reported well-resolved oxidation peaks with a linear range of 10–100 μM and detection limits of 7 μM and 7.41 μM, respectively. The developed device showed good selectivity, reproducibility, and repeatability. Furthermore, it was successfully applied to the determination of both biomolecules in artificial urine samples with good recovery. The main advantages of the designed sensor are its simplicity, portability, and low cost.
Tailoring the Active Sites of Nanosheet NiSe/NiSe2 Catalyst by Pulse Electrodeposition on the 3D Microporous Ni-Cu/NF Substrate for both Hydrogen and Oxygen Evolution Reactions
Authors: Modghan Nafiseh Sadat , Mirjalili Mostafa , Moayed Mohammad Hadi , Barati Darband Ghasem
Published: June 2024

Establishing proper intrinsic catalysts with nanostructured high active surfaces endows the paramount electrocatalytic activity. A Ni-Se@Cu-Ni/NF catalyst for hydrogen and oxygen evolution reactions (HER and OER) is prepared via an efficient two-step pulse current (PC) electrodeposition method. The initial 3D film of Cu-Ni is synthesized via the dynamic hydrogen bubble template (DHBT) method to attain further active surface area. Then, Ni-Se film is prepared by direct current (DC) and PC electrodeposition. Morphological, chemical, and electrocatalytic characteristics of the Ni-Se electrodeposited films are evaluated. X-ray photoelectron spectroscopy and high-resolution transmission electron microscopy results show a NiSe/NiSe2 nanofilm on the 3D microporous nanostructured Cu-Ni substrate which reveals an efficient bifunctional electrocatalytic behavior with overpotentials of 74 and 272 mV in the current density of 10 mA cm−2, and Tafel slopes of 78 and 50 mV dec−1 for HER and OER, respectively. The two-electrode examination with NiSe/NiSe2@Cu-Ni/NF catalyst in overall water splitting indicates a required potential of 1.57 V in the current density of 10 mA cm−2.
Supplementary Figure S1 from Targeted and Shallow Whole-Genome Sequencing Identifies Therapeutic Opportunities in p53abn Endometrial Cancers
Authors: Jamieson Amy , Sobral de Barros Juliana , Cochrane Dawn R. , Douglas J. Maxwell , Shankar Sameer , Lynch Branden J. , Leung Samuel , Martin Spencer , Senz Janine , Lum Amy , Drew Yvette , Gilks C. Blake , Huntsman David G. , McAlpine Jessica N.
Published: June 2024

Supplemental figure 1. Flowchart depicting the selection of the cohort.