bluuebunny/crossref_metadata_2025 huggingface dataset:
Swallows on the River
Authors: Whitman Walt
Published: February 2024

Sept. 3. — Cloudy and wet, and wind due east; air without palpable fog, but very heavy with moisture — welcome for a change. Forenoon, crossing the Delaware, I noticed unusual numbers of swallows in flight, circling, darting, graceful beyond description, close to the water. Thick, around the...
Begin a Long Jaunt West
Authors: Whitman Walt
Published: February 2024

The following three or four months (Sept. to Dec. ’79) I made quite a western journey, fetching up at Denver, Colorado, and penetrating the Rocky Mountain region enough to get a good notion of it all. Left West Philadelphia after 9 o’clock...
The Prairies
Authors: Whitman Walt
Published: February 2024

At a large popular meeting at Topeka — the Kansas State Silver Wedding, fifteen or twenty thousand people — I had been erroneously bill’d to deliver a poem. As I seem’d to be made much of, and wanted to be good-natured, I hastily pencill’d out the...
An Hour on Kenosha Summit
Authors: Whitman Walt
Published: February 2024

Jottings from the Rocky Mountains, mostly pencill’d during a day’s trip over the South Park RR., returning from Leadville, and especially the hour we were detain’d, (much to my satisfaction,) at Kenosha summit. As afternoon advances, novelties, far-reaching splendors, accumulate under the...
America’s Characteristic Landscape
Authors: Whitman Walt
Published: February 2024

Speaking generally as to the capacity and sure future destiny of that plain and prairie area (larger than any European kingdom) it is the inexhaustible land of wheat, maize, wool, flax, coal, iron, beef and pork, butter and cheese, apples and grapes — land of ten...
Nights on the Mississippi
Authors: Whitman Walt
Published: February 2024

Oct
29th, 30th, and 31st. — Wonderfully fine, with the full harvest moon, dazzling and silvery. I have haunted the river every night lately, where I could get a look at the bridge by moonlight. It is indeed a structure of perfection and beauty...
Upon our Own Land
Authors: Whitman Walt
Published: February 2024

“Always, after supper, take a walk half a mile long,” says an old proverb, dryly adding, “and if convenient let it be upon your own land.” I wonder does any other nation but ours afford opportunity for such a jaunt as this? Indeed...
Loafing in the Woods
Authors: Whitman Walt
Published: February 2024

March 8. — I write this down in the country again, but in a new spot, seated on a log in the woods, warm, sunny, midday. Have been loafing here deep among the trees, shafts of tall pines, oak, hickory, with a thick undergrowth of laurels...
Jaunting to Canada
Authors: Whitman Walt
Published: February 2024

To go back a little, I left Philadelphia, 9th and Green streets, at 8 o’clock p.m., June 3, on a first-class sleeper, by the Lehigh Valley (North Pennsylvania) route, through Bethlehem, Wilkesbarre, Waverly, and so (by Erie) on through Corning to Hornellsville,...
The Inhabitants — Good Living
Authors: Whitman Walt
Published: February 2024

Grim and rocky and black-water’d as the demesne hereabout is, however, you must not think genial humanity, and comfort, and good-living are not to be met. Before I began this memorandum I made a first-rate breakfast of sea-trout, finishing off with wild raspberries. I...
Carlyle from American Points of View
Authors: Whitman Walt
Published: February 2024

There is surely at present an inexplicable rapport (all the more piquant from its contradictoriness) between that deceas’d author and our United States of America — no matter whether it lasts or not.1 As we Westerners assume definite shape, and result in...
The Boston of To-Day
Authors: Whitman Walt
Published: February 2024

In the letters we get from Dr. Schliemann (interesting but fishy) about his excavations there in the far-off Homeric area, I notice cities, ruins, &c., as he digs them out of their graves, are certain to be in layers — that is to say, upon the...
Birds — and A Caution
Authors: Whitman Walt
Published: February 2024

May 14. — Home again; down temporarily in the Jersey woods. Between 8 and 9 a.m. a full concert of birds, from different quarters, in keeping with the fresh scent, the peace, the naturalness all around me. I am lately noticing the russet-back, size...
“Custer’s Last Rally”
Authors: Whitman Walt
Published: February 2024

Went to-day to see this just-finish’d painting by John Mulvany, who has been out in far Dakota, on the spot, at the forts, and among the frontiersmen, soldiers and Indians, for the last two years, on purpose to sketch it in from reality, or...
Nature and Democracy — Morality
Authors: Whitman Walt
Published: February 2024

Democracy most of all affiliates with the open air, is sunny and hardy and sane only with Nature — just as much as Art is. Something is required to temper both — to check them, restrain them from excess, morbidity. I have wanted, before departure, to bear special...
The Science of Deduction
Authors: Doyle Arthur Conan
Published: February 2024

Sherlock Holmes took his bottle from the corner of the mantelpiece, and his hypodermic syringe from its neat morocco case.* With his long, white, nervous fingers he adjusted the delicate needle, and rolled back his left shirt-cuff. For some little time his...
The Story of the Bald-Headed Man
Authors: Doyle Arthur Conan
Published: February 2024

We followed the Indian down a sordid and common passage, ill-lit and worse furnished, until he came to a door upon the right, which he threw open. A blaze of yellow light streamed out upon us, and in the centre of the glare there...
The Baker Street Irregulars
Authors: Doyle Arthur Conan
Published: February 2024

‘What now?’ I asked. ‘Toby has lost his character for infallibility.’

‘He acted according to his lights,’ said Holmes, lifting him down from the barrel and walking him out of the timber-yard. ‘If you consider how much creosote is carted about London in one...
Uncle Silas
Authors: Le Fanu Sheridan
Published: February 2024

In Victorian Derbyshire, 17 year old orphan and heiress Maud Ruthyn is sent to live at the claustrophobic Bartram-Haugh house with her mysterious Uncle Silas. Silas has a reputation for gambling debts and past accusations of murder, but now lives as a reformed Christian. Sinister schemes and preternatural events unfold as Silas, his son, and a malevolent governess plot against Maud and her fortune.

Uncle Silas has been hailed by contemporaries and modern critics alike as one of the finest works of sensation fiction. With elements of tragic romance, horror, and psychological thriller, Uncle Silas shows Le Fanu at the height of his powers.

With an introduction from Claire Connolly, this edition places the novel in its broadest context and unpicks the layers of Celtic, Christian, and mystic influence behind Le Fanu's best known work.
The smoker
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

Three years later I learned — in a way she probably little expected, and then did not much care about — what really occurred there. I learned even phrases and looks — for the story was related by one who had heard it told — and therefore I venture to narrate what...
Monica Knollys
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

punctually Lady Knollys arrived. She was accompanied by her nephew, Captain Oakley.

They arrived a little before dinner; just in time to get to their rooms and dress. But Mary Quince enlivened my toilet with eloquent descriptions of the youthful Captain whom she had met...
A curious conversation
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

We each had another cup of tea, and were silent for awhile.

‘We must not talk of ghosts now. You are a superstitious little woman, you know, and you shan’t be frightened.’

And now Cousin Monica grew silent again, and looking briskly round the room,...
I talk with Doctor Bryerly
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

Doctor Bryerly had, indeed, arrived at half-past twelve o’clock at night. His summons at the hall-door was little heard at our remote side of the old house of Knowl; and when the sleepy, half-dressed servant opened the door, the lank Doctor, in glossy black...
The story of Uncle Silas
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

And so it was like the yelling of phantom hounds and hunters, and the thunder of their coursers in the air — a furious, grand, and super-natural music, which in my fancy made a suitable accompaniment to the discussion of that enigmatical person — martyr — angel — demon — Uncle Silas — with whom my...
How the ambassador fared
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

Lady Knollys, I could plainly see, when we got into the brighter lights at the dinner table, was herself a good deal excited; she was relieved and glad, and was garrulous during our meal, and told me all her early recollections of dear papa....
An odd proposal
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

As I and Mary Quince returned from our walk that day, and had entered the hall, I was surprised most disagreeably, by Dudley’s emerging from the vestibule at the foot of the great staircase. He was, I suppose, in his travelling costume — a rather soiled white...
I conspire
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

‘That’s a bad ’un, he is — oh, Miss, Miss Maud! It’s nout that’s good as keeps him an’ fayther — (mind, lass, ye promised you would not tell no one) — as keeps them two a talkin’ and a smokin’ secret-like together in the mill. An’ fayther don’t...
A well-known face looks in
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

You who have never experienced it can have no idea how angry and frightened you become under the sinister insult of being locked into a room, as on trying the door I found I was.

The key was in the lock; I could see it...
The hour of death
Authors: Le Fanu Sheridan , Connolly Claire
Published: February 2024

It was a very still night and frosty. My candle had long burnt out. There was still a faint moonlight, which fell in a square of yellow on the floor near the window, leaving the rest of the room in what, to an eye...
Anon: A Play (1903–4)
Authors: Barrie J. M.
Published: February 2024

CHARACTERS

Mr Darling

Peter Pan

John Frederick Darling

Alexander Roger Darling

Tootles

Nibs

Slightly

Curly

First Twin

Second Twin

Captain Hook

Starkey

Mrs Darling

Tiger Lily

Tippy (The Last Fairy)

Wendy Maria Elizabeth Darling

Pirates, Redskins, Beautiful Mothers &c., a crocodile, a lion, a...
SCENARIO for a Proposed Film of PETER PAN or The Boy Who Wouldn’t Grow Up. (1921)
Authors: Barrie J. M.
Published: February 2024

(Note:— The music of the acted play, as specially written for it, should accompany the pictures. Thus there is the music which always heralds Peter’s appearances — the Tinker Bell music — the pirate music — the redskin music — the crocodile music, etc., all of which have a dramatic significance...
Recent Advances in Understanding the Regulatory Mechanism of Plasma Membrane H+-ATPase through the Brassinosteroid Signaling Pathway
Authors: Lin Zhaoheng , Zhu Pan , Gao Liyang , Chen Xuanyi , Li Meijing , Wang Yuhe , He Junxian , Miao Ying , Miao Rui
Published: February 2024

The polyhydroxylated steroid phytohormone brassinosteroid (BR) controls many aspects of plant growth, development and responses to environmental changes. Plasma membrane (PM) H+-ATPase, the well-known PM proton pump, is a central regulator in plant physiology, which mediates not only plant growth and development, but also adaptation to stresses. Recent studies highlight that PM H+-ATPase is at least partly regulated via the BR signaling. Firstly, the BR cell surface receptor BRASSINOSTEROID-INSENSITIVE 1 (BRI1) and multiple key components of BR signaling directly or indirectly influence PM H+-ATPase activity. Secondly, the SMALL AUXIN UP RNA (SAUR) gene family physically interacts with BRI1 to enhance organ development of Arabidopsis by activating PM H+-ATPase. Thirdly, RNA-sequencing (RNA-seq) assays showed that the expression of some SAUR genes is upregulated under the light or sucrose conditions, which is related to the phosphorylation state of the penultimate residue of PM H+-ATPase in a time-course manner. In this review, we describe the structural and functional features of PM H+-ATPase and summarize recent progress towards understanding the regulatory mechanism of PM H+-ATPase by BRs, and briefly introduce how PM H+-ATPase activity is modulated by its own biterminal regions and the post-translational modifications.
Almond Can Be Infected by Plum Pox Virus-D Isolate Penn4 and Is a Transmission-Competent Host
Authors: Rogers Elizabeth E. , Stone Andrew L. , Burchard Erik , Sherman Diana J. , Dardick Chris
Published: February 2024

Although it is currently eradicated from the United States, Plum pox virus (PPV) poses an ongoing threat to U.S. stone fruit production. Although almond (Prunus dulcis) is known to be largely resistant to PPV, there is conflicting evidence about its potential to serve as an asymptomatic reservoir host for the virus and thus serve as a potential route of entry. Here, we demonstrate that both Tuono and Texas Mission cultivars can be infected by the U.S. isolate PPV Dideron (D) Penn4 and that Tuono is a transmission-competent host, capable of serving as a source of inoculum for aphid transmission of the virus. These findings have important implications for efforts to keep PPV out of the United States and highlight the need for additional research to test the susceptibility of almond to other PPV-D isolates.
An Academic-Community Partnership to Address Gun Violence in the Roseland Neighborhood of Chicago
Authors: Schober Daniel J. , Wolf Ashley , Castro Myles C. , Slezak Julie , Hastings Paula , Latiker Diane
Published: February 2024

Background and Objectives:

Gun violence is the leading cause of death for youth. This study examined an academic-community partnership to address gun violence through a strength-based approach called Asset-Based Community Development.

Methods:

We used a case study design. Participants were Black youth who encounter frequent gun violence (average age = 16.7 years; 72% male). Our partnership involved survey development/completion and semistructured discussions. We also interviewed community stakeholders to collect data on local assets. We interpreted data through a communitywide forum to guide social action to address gun violence.

Results:

The majority of youth (76%) witnessed neighborhood violence in the last year. The top youth concerns related to gun violence included poverty, guns, and gangs. Community stakeholders saw local people and local organizations as primary community assets. A community forum to interpret these data led to social action in the form of an environmental strategy—cleaning up an unused commercial building for the development of a youth tech center. The majority of youth participants (89.5%) agreed or strongly agreed that they had a voice in the research process.

Conclusion:

Participatory research that takes an asset-based approach can enable relevant inquiry that engages youth and guides social action to address gun violence.
The Association Between State Characteristics and Latinx People's Treated Hypertension in Established and New Latinx Destination States
Authors: Maldonado Adriana , Laroche Helena H. , Sewell Daniel K. , Afifi Rima , Hoffman Richard M. , Baquero Barbara , Gilbert Paul A.
Published: February 2024

This study sought to quantify the contributions of state-level factors including income inequality, state's legislature political control, and Medicaid expansion in new and established Latinx destination states on Latinx individuals' treated hypertension. Mixed-effects logistic regression analyses were conducted to analyze 2017 Behavioral Risk Factor Surveillance System data from 7524 Latinx adults nested within 39 states. Overall, 70% reported being pharmacologically treated for hypertension, and 66% resided in established destination states. Compared with Latinx people in established destination states, Latinx people in new destinations had lower odds of having treated hypertension (odds ratio [OR] = 0.72, 95% CI = 0.54-0.95). Within established Latinx destinations, the odds of treated hypertension were lower in states where legislatures expanded Medicaid than in states that did not expand Medicaid (OR = 0.84, 95% CI = 0.79-0.89). However, after controlling for the effects of individual-level factors, this association was no longer statistically significant. In new Latinx destination states, Medicaid expansion, legislatures' political control, and income inequality were not associated with treated hypertension. The study results highlight the importance of considering both individual- and state-level factors, as the interplay of such factors could hinder the successful implementation of cardiovascular risk reduction interventions.
Perceptions of African American Youth and Adults Regarding Tobacco Use-Related Factors in Their Community
Authors: Hoetger Cosima , White Augustus , Bono Rose S. , Hall Calvin J. , Hood Kristina B. , Everhart Robin S. , Nana-Sinkam Patrick , Barnes Andrew J. , Cobb Caroline O.
Published: February 2024

Introduction:

The US Food and Drug Administration is poised to restrict the availability of menthol cigarettes and flavored cigars, products disproportionately used by Black/African American (B/AA) individuals. We examined B/AA youth and adult perceptions regarding factors contributing to tobacco use, as well as prevention/cessation resources.

Methods:

In 2 mixed-methods studies in Richmond, Virginia, we conducted cross-sectional surveys among youth (n = 201) and adult (n = 212) individuals who were primarily B/AA and reported past 30-day cigar smoking or nontobacco use, followed by focus groups with a subset (youth: n = 30; adults: n = 24). Focus groups were analyzed using a thematic analysis framework, and descriptive survey data provided context to themes.

Results:

Among focus group participants, 20% of youth and 75% of adults reported current cigar smoking. Six themes emerged across the groups: advertising/brands, sensory experiences, costs, social factors, youth-related factors, and dependence/cessation. Youth and adults perceived cigars as popular; cigar use was attributed to targeted advertising, flavors, affordability, and accessibility. While adults expressed concern regarding youth tobacco use, youth did not perceive tobacco prevention programs as helpful. Adults and youth reported limited access to community tobacco prevention/cessation programs.

Discussion:

Expanded tobacco prevention and cessation resources for B/AA people who smoke could leverage federal regulatory actions to ban tobacco products targeted toward this group and decrease disparities in tobacco-related morbidity and mortality.
Does Neighborhood Social Cohesion Influence Participation in Routine Cancer Screening? Findings From a Representative Sample of Adults in South Florida
Authors: Baeker Bispo Jordan A. , Goo Irene , Ashad-Bishop Kilan , Kobetz Erin , Bailey Zinzi
Published: February 2024

Background and Objectives:

Neighborhood social cohesion (NSC) has been associated with a variety of health outcomes, but limited research has examined its impact on behaviors that support cancer control. The purpose of this study was to examine associations between NSC and guideline-concordant breast, cervical and colorectal cancer screening.

Methods:

Data are from a cross-sectional survey administered to 716 adults in South Florida from 2019 to 2020. The analytic samples included adults eligible for breast (n = 134), cervical (n = 195), and colorectal cancer (n = 265) screening. NSC was measured using a validated 5-item instrument. Associations between NSC and guideline-concordant screening were examined using multivariable logistic regression.

Results:

In fully adjusted analyses, the odds of guideline-concordant breast cancer screening increased by 86% for every unit increase in NSC (aOR = 1.86; 95% CI, 1.03-3.36). NSC was not statistically significantly associated with guideline-concordant cervical cancer screening (aOR = 0.86; 95% CI, 0.54-1.38) or colorectal cancer screening (aOR = 1.29; 95% CI, 0.81-2.04).

Conclusions:

These findings suggest that NSC supports some screening behaviors, namely, mammography use. To better understand heterogeneous relationships between NSC and utilization of preventive care services such as cancer screening, more research is needed that disaggregates effects by sex, age, race/ethnicity, and socioeconomic status.
Prevalence of CYP2D6 structural variation in large retrospective study
Authors: Frear Samantha , Sherman Ashley , Rule Don , Marcath Lauren Ann
Published: February 2024

CYP2D6 is a highly polymorphic gene with clinically important structural variations. Commonly, only exon 9 is assayed on clinical pharmacogenomics panels, as it allows for accurate functional characterization even in the presence of a CYP2D6::CYP2D7 conversion. However, this method does not capture CYP2D7::CYP2D6 (CYP2D6*13) conversions, possibly leading to inaccurate phenotype assignment. The study’s purpose was to determine the frequency of structural variations in CYP2D6 utilizing multiple copy number variation (CNV) assay locations to quantify the potential impact on clinical phenotype classification. A retrospective analysis was conducted of de-identified pharmacogenomics data submitted through the Translational Software, Inc. platform. Samples with CYP2D6 CNV data for exon 9 and at least one additional CNV location (5′UTR, exon 1, intron 2, exon 5 or intron 6) were included. CYP2D7::CYP2D6 and CYP2D6::CYP2D7 conversions were classified according to PharmVar nomenclature. The CYP2D6 copies were capped at four total copies to account for assay limitations in detecting more than four copies. A total of 106,474 samples were included for analysis. CYP2D7::CYP2D6 conversions were present in approximately 2.44% of samples, and 5.84% of samples had CYP2D6::CYP2D7 conversions. Many samples did not have a CYP2D7 conversion detected (91.5%; 97,462/106,474). A full gene deletion was detected in 0.15%, and 5.98% had a duplication or multiplication present. This retrospective study underscores the importance of testing more than one CNV site for CYP2D6. Over 2% of patients were found to have a CYP2D7::CYP2D6 conversion. This translates into potentially misclassified phenotype classification and incongruent clinical recommendations.
Prevalence of The Arterial Hand Dominance Using the Modified Allen Test and Pulse Oximetry among Plastic Surgery Patients
Authors: Alghamdi Hisham G. , Humaid Hameed S. , Alsaber Naif S. , Almubarak Faris R. , Alqifari Faisal A. , Makkawi Mohaned A. , Alzamil Abdullah R.
Published: February 2024

Background:

The ulnar and radial arteries are the major source of blood supply in the hand, as they form the superficial and deep palmar arches. Arterial hand circulation is one of the most complicated arterial trees and connections in the body, with tremendous variations in its structure. This study aimed to evaluate whether the ulnar artery or radial artery is the dominant artery in hand circulation among plastic surgery patients at King Khalid University Hospital and to correlate the arterial hand dominance with handedness and gender.

Methods:

This is an analytical cross-sectional study conducted at King Khalid University Hospital in Riyadh, Saudi Arabia, on plastic surgery patients. The sampling method is purposive sampling. The calculated sample size is 28; however, 100 participants have been enlisted in the study. The data have been collected using the modified Allen test with a pulse oximeter.

Results:

The collective prevalence of dual arterial dominance in our study was 69% compared with 56% and 30% for Little et al (P = 0.013) and Fuhrman et al (P < 0.001), respectively. With regard to gender, women were more likely to have a dual arterial blood supply than men, with the frequency values of 85% and 58.3% for women and men, respectively (P = 0.017).

Conclusions:

Our study found that dual arterial supply is predominant among our participants, with 69% of our participants possessing a dual arterial supply, while 18% and 13% constitute the prevalence of radial and ulnar dominance, respectively. This contrasts with what has been reported previously in the literature.
SARS-CoV-2 Antibody Kinetics in Unvaccinated Hospitalized Children With COVID-19
Authors: Dimopoulou Dimitra , Charakida Marietta , Marmarinos Antonios , Karaviti Dareilena , Avgeris Margaritis , Gourgiotis Dimitrios , Tsolia Maria N.
Published: February 2024

Background:

Antibody levels decline a few months post-acute COVID-19, but humoral memory persists in adults. Age and disease severity may affect antibody responses. This study aims to evaluate the presence and durability of antibody responses in children with COVID-19.

Methods:

A prospective, single-center study, involving unvaccinated children 0–16 years of age who were hospitalized with COVID-19 between October 2020 and December 2021, was conducted. Serological testing for anti-Spike severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG and neutralizing antibodies was performed at diagnosis and at 1-, 3-, 6- and 12-months post-infection.

Results:

A total of 65 immunocompetent children were enrolled [mean age (±SD): 6.7 (±6.4) years; males: 56.9%]. At 3 months, 40/44 (91%) children were seropositive; seropositivity persisted in 22/26 (85%) children at 6 months and in 10/12 (83%) children at 12 months. There was no evidence that age was modifying the prediction of variance of SARS-CoV-2 IgG levels. In contrast, SARS-CoV-2 IgG levels varied with time and disease severity. The association with time was non-linear, so that with increasing time there was a significant reduction in SARS-CoV-2 IgG levels [coef, 0.044 (95% confidence interval {CI}: 0.061–0.028), P < 0.001]. For each increment of time, the higher disease severity group was associated with 0.9 lower SARS-CoV-2 IgG levels. Everyone varied from the average effect of time with an SD of 0.01, suggesting that individuals may have different trajectories across time.

Conclusion:

Disease severity, but not age, influences antibody titers among children hospitalized with COVID-19. SARS-CoV-2 infection induces durable seroconversion in these children with detectable IgG levels at 1 year after infection.
Predictors of Substance Use Risk in Nurse Anesthetists
Authors: Foli Karen J. , Forster Anna K. , Bostic Loretta Ann , Zhang Lingsong , Zhang Zeyu , Stone Linda
Published: February 2024

Background

Certified registered nurse anesthetists (CRNAs) are exposed daily to highly addictive substances and stressful work environments, placing them at risk for substance use disorders (SUDs). Previous research, which is scarce, indicated that drugs of choice were opioids and propofol. Therefore, the purpose of this study was to investigate predictors of SUD risk using the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test.

Method

From June to July 2020, an online survey was sent via the American Association of Nurse Anesthesiology Research Survey Service to 3,000 CRNAs with a response of approximately 225 members.

Results

CRNAs were found to be at a moderate risk for SUDs in the following categories: 10.27% for tobacco, 23.56% for alcohol, and 6.28% for cannabis. Regression analysis by substance category includes robust, differing models in this homogeneous sample. Predictors for all three models include a collection of demographic variables, religiosity, anxiety, difficulties due to anxiety, depression, substance use history, contact with the American Association of Nurse Anesthesiology Peer Assistance Program, and organizational support.

Conclusion

Over 10% of CRNAs are at risk for developing tobacco use disorder, and almost one quarter of those surveyed are at a moderate risk for developing alcohol use disorder. These data are of concern and may indicate a shift of preferred substances used by CRNAs from controlled substances to alcohol.
Analyzing the value of delayed 18F-FDG PET/CT images in diagnosing small colorectal cancer liver metastases in patients with hypothyroidism based on diagnostic accuracy and image standardized uptake value
Authors: Pei Yusong , Wang Zhiguo , Hao Shanhu , Tong Yanan , Wu Ruixian , Qiao Xinxin , Liu Yanqing , Zhang Guoxu
Published: February 2024

Purpose

The objective of this study was to investigate the value of delayed 18F fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) images in patients with small colorectal cancer liver metastases (CRLMs) with hypothyroidism.

Method

We performed a retrospective analysis of 66 small-CRLM patients with hypothyroidism and 66 small-CRLM patients with euthyroidism, all of whom underwent dual-time-point 18F-FDG PET/CT imaging. First, the diagnostic accuracy of PET/CT early imaging and PET/CT delayed imaging on lesions was analyzed. Next, the correlation of metabolic parameters between PET/CT early imaging and PET/CT delayed imaging was analyzed according to the grouping of all lesions. Finally, PET/CT parameters were analyzed for correlation with thyroid hormones.

Results

The diagnostic accuracy of delayed imaging in small-CRLM patients with hypothyroidism is not as good as that in small-CRLM patients with euthyroidism; PET/CT metabolic parameters are also unfavorable for the diagnosis of small-CRLM. For small-CRLM patients with hypothyroidism, the greater the thyroid-stimulating hormone level, the greater the uptake of 18F-FDG in normal liver tissue, and the smaller the ratio of tumor lesion uptake to normal liver tissue uptake.

Conclusion

PET/CT-delayed imaging has better performance than early imaging in small-CRLM patients with euthyroidism. However, the more severe the hypothyroidism, the worse the diagnostic delayed imaging performance. The scan time can be extended appropriately to optimize the imaging efficacy.
The British nuclear medicine research strategy – the framework
Authors: Dizdarevic Sabina , Mccready V. Ralph , Blower Philip J. , Vöö Stefan A. , Wadsley Jonathan , McGowan Daniel R. , Roldão Pereira Luísa , Eccles Amy , Prakash Vineet S. , Abreu Carla , Jessop Maryam , Weston Charlotte J. ,   Research Champions of the British Nuclear Medicine Society (BNMS) on behalf of BNMS Council
Published: February 2024

The British Nuclear Medicine Society (BNMS) has developed a Research Strategy framework led by the Research Champions of the BNMS and overseen by the BNMS Research and Innovation Committee. The objectives of the Research Strategy are to improve translation of cutting-edge nuclear medicine research from bench to bedside, the implementation of state-of-the-art multimodality technologies and to enhance multicentre radionuclide research in the UK. It strives to involve patients and the public in radionuclide research and to contribute to and work with the multi-professional national and international organisations involved in research with an ultimate aim to improve nuclear medicine services, and patients’ outcomes and care.
Sexually Transmitted Infection Prevalence, Partner Notification, and Human Immunodeficiency Virus Risk Perception in a Cohort of Women Completing Sexually Transmitted Infection Screening as Part of a Safer Conception Study
Authors: Beesham Ivana , Isehunwa Oluwaseyi , Kriel Yolandie , Jaggernath Manjeetha , Bennett Kara , Hurwitz Kathleen , Smith Patricia M. , Chitneni Pooja , Bosman Shannon , Bangsberg David R. , Marrazzo Jeanne M. , Smit Jennifer A. , Matthews Lynn T.
Published: February 2024

Background

Integrating sexually transmitted infection (STI) and preexposure prophylaxis (PrEP) care may optimize sexual and reproductive health.

Methods

We nested an STI substudy within a human immunodeficiency virus (HIV) prevention cohort (parent study) of 18- to 35-year-old women from South Africa, planning pregnancy with a partner with HIV or of unknown serostatus. Parent-study women completed annual surveys regarding HIV-risk perceptions and were offered oral PrEP. Preexposure prophylaxis initiators completed quarterly plasma tenofovir (TFV) testing. Substudy women completed STI screening at enrollment, 6 months, onset of pregnancy, and in the third trimester via examination, vaginal swabs tested via PCR for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, and blood tested for Treponema pallidum. Follow-up was 6 months. Women with STIs were treated, offered partner notification (PN) cards, and surveyed regarding PN practices. We describe STI prevalence and incidence, and model factors associated with prevalent infection. Sexually transmitted infection substudy and parent study-only participants were matched on age and number of days on study to assess HIV-risk perception scores between the 2 groups and the proportion with detectable TFV.

Results

Among 50 substudy participants, 15 (30%) had prevalent STI. All 13 completing follow-up reported PN. Most did not prefer assisted PN. Mean HIV risk perception scores and proportion with detected plasma TFV were similar across groups.

Conclusions

High STI prevalence supports the importance of laboratory screening to optimize sexual health for women planning pregnancy. Rates of self-reported PN are reassuring; low interest in assisted PN suggests the need for alternative approaches. Enhanced STI care did not affect HIV-risk perception or PrEP adherence, however both were relatively high in this cohort.
Endoscopic Submucosal Dissection: A Safe and Effective Alternative to Surgical Intervention for Esophageal Hemangioma
Authors: Zhongsheng Lu , Yan Dou , Ezzat Reem , Chen Mu , Jing Yuan , El-Kassas Mohamed , Tawheed Ahmed , Madkour Ahmad
Published: February 2024

Background:

Hemangiomas represent 3% of all benign esophageal tumors. Conventional esophagectomy is the standard treatment with its invasive nature and possible surgical complications. Now, less invasive techniques are used with better results. Endoscopic submucosal dissection (ESD) is one of the novel noninvasive methods used for en bloc removal of tumors. No available data about the use of ESD in removing esophageal hemangioma. Here, we studied the validity and safety of ESD as a minimally invasive procedure to remove esophageal hemangioma.

Methods:

Three patients were diagnosed with esophageal hemangioma and underwent ESD with en bloc resection. Endoscopic ultrasound (EUS) was performed before ESD to better evaluate the layer of origin and vascularity and guard against perforation. Patients were followed up postintervention to document possible complications.

Results:

Among the 3 studied patients, one presented with chronic abdominal pain, the second was complaining of dysphagia, and the third patient was diagnosed accidentally. Pathology reports confirmed the diagnosis of hemangiomas in all cases with no atypia and complete removal of the lesions. No complications were reported during the procedure or over the follow-up period.

Conclusions:

ESD is a proper, minimally invasive method with good en bloc resection that can be used in cases of esophageal hemangiomas.
Modified Internal Pudendal Artery Perforator Flap Interposition for Rectovaginal Fistula
Authors: Yuan Ye , Li Senkai , Li Fengyong , Zhou Yu , Qiang Shuai , Che Kexin , Wang Keke , Yang Kun , Li Qiang
Published: February 2024

Importance

Rectovaginal fistula (RVF) is a challenging condition associated with recurrences and significant functional impairment.

Objectives

The internal pudendal artery perforator (IPAP) flap has become a viable option for reconstructing the vagina and perineal regions. This study aims to introduce a modified technique of IPAP flap interposition and evaluate its postoperative outcomes in the treatment of low RVF.

Study Design

Sixteen patients with RVF who underwent modified IPAP flap interposition between 2016 and 2021 were retrospectively enrolled. Recurrence rate, the satisfaction of vulvar appearance (Visual Analog Scale), and quality of sexual life (Female Sexual Function Index score) were followed up and analyzed.

Results

All patients presented with low fistula with a mean diameter of 8.3 mm. The mean width and length of the IPAP flaps were 3.8 and 6.2 cm, respectively. The mean follow-up period was 14.1 months. All patients achieved successful healing without recurrence. High satisfaction was reported for the cosmetic effect of the vulva with a mean Visual Analog Scale score of 8.4. The proportion of female sexual disorder exhibited a statistically significant reduction, decreasing from 100% preoperatively to 38% after surgery (P < 0.05).

Conclusions

The modified IPAP flap interposition is a reliable and safe option for repairing low RVF, with high success rates and minimal donor site morbidity. Moreover, this procedure provides a suitable volume flap and preserves the vaginal physiological environment, which benefits postoperative sexual function.
Practicality and Safety of Electrical Pulmonary Vein Isolation and Left Atrial Appendage Ligation in Lung Transplant Recipients With Pretransplant Atrial Fibrillation
Authors: Xia Yu , Kim Samuel T. , Cho Peter D. , Dacey Michael J. , Buch Eric , Ho Jonathan K. , Ardehali Abbas
Published: February 2024

Background.

Lung transplant surgery creates surgical pulmonary vein isolation (PVI) as a routine part of the procedure. However, many patients with pretransplant atrial fibrillation continue to have atrial fibrillation at 1 y. We hypothesized that the addition of electrical PVI and left atrial appendage isolation/ligation (LAL) to the lung transplant procedure restores sinus rhythm at 1 y in patients with pretransplant atrial fibrillation.

Methods.

We retrospectively reviewed all adult lung transplant recipients at the University of California Los Angeles from April 2006 to August 2021. All patients with pretransplant atrial fibrillation underwent concomitant PVI/LAL and were compared with lung transplant recipients without preoperative atrial fibrillation. In-hospital outcomes; 1-y survival; and the incidence of stroke, cardiac readmissions, repeat ablations, and sinus rhythm (composite endpoint) were examined at 1 y for the PVI/LAL cohort.

Results.

Sixty-one lung transplant recipients with pretransplant atrial fibrillation underwent concomitant PVI/LAL. No patient in the PVI/LAL cohort required cardiac-related readmission or catheter ablation for atrial fibrillation within 1 y of transplantation. Freedom from the composite endpoint of death, stroke, cardiac readmission, and repeat ablation for atrial fibrillation at 1 y was 85% (95% confidence interval, 73%-92%) for lung transplant recipients treated with PVI/LAL.

Conclusions.

The addition of PVI/LAI to the lung transplant operation in patients with pretransplant atrial fibrillation was safe and effective in maintaining sinus rhythm and baseline risk of stroke at 1 y.
Severe Acute Kidney Injury Postheart Transplantation: Analysis of Risk Factors
Authors: Gale David , Al-Soufi Suhel , MacDonald Peter , Nair Priya
Published: February 2024

Background.

Acute kidney injury (AKI) is a common complication postheart transplantation and is associated with significant morbidity and increased mortality.

Methods.

We conducted a single-center, retrospective, observational cohort study of 109 consecutive patients undergoing heart transplantation between September 2019 and September 2021 to determine major risk factors for, and the incidence of, severe postoperative AKI as defined by Kidney Disease Improving Global Outcomes criteria in the first 48-h posttransplantation and the impact that this has on mortality and dialysis dependence.

Results.

One hundred nine patients were included in our study, 83 of 109 (78%) patients developed AKI, 42 (39%) developed severe AKI, and 37 (35%) required renal replacement therapy in the first-week posttransplantation. We found preoperative estimated glomerular filtration rate (eGFR), postoperative noradrenaline dose, and the need for postoperative mechanical circulatory support to be independent risk factors for the development of severe AKI. Patients who developed severe AKI had a 19% 12-mo mortality compared with 1% for those without. Of those who survived to hospital discharge, 20% of patients in the severe AKI group required dialysis at time of hospital discharge compared with 3% in those without severe AKI.

Conclusion.

Severe AKI is common after heart transplantation. Preoperative kidney function, postoperative vasoplegia with high requirements for vasoactive drugs, and graft dysfunction with the need for mechanical circulatory supports were independently associated with the development of severe AKI in the first-week following heart transplantation. Severe AKI is associated with a significantly increased mortality and dialysis dependence at time of hospital discharge.
Acute Intraoperative Conversion from Endovascular to Open vs Planned Open Operation for Abdominal Aortic Aneurysm: A Propensity-Score Matched Study from the American College of Surgeons NSQIP-Targeted Database
Authors: Li Renxi , Sidawy Anton , Nguyen Bao-Ngoc
Published: February 2024

BACKGROUND:

Evaluating outcomes for acute intraoperative conversion to open surgery during endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) was difficult due to low incidence. This study aimed to compare 30-day outcomes between patients with acute intraoperative conversion during EVAR and planned open surgery, and to identify risk factors associated with acute conversion.

STUDY DESIGN:

Patients who underwent EVAR or planned open AAA repair were identified in American College of Surgeons NSQIP-targeted databases from 2012 to 2021. Patients with acute intraoperative conversion during EVAR were selected. A 1:3 propensity-score matching was used to match demographics, baseline characteristics, surgical indications, aneurysm size and extent, and emergency cases between the conversion open and planned open groups. Thirty-day postoperative outcomes were assessed.

RESULTS:

Of 20,566 EVAR cases, 177 (0.86%) had acute intraoperative conversion to open surgery. The conversion open group was matched to 504 of 5,249 planned open patients. Conversion open and planned open groups had comparable 30-day mortality (23.43% vs 17.46%, p = 0.09) and organ system complications, including major adverse cardiovascular event (14.86% vs 10.71%, p = 0.17), pulmonary complications (17.71% vs 24.01%, p = 0.09), and renal complications (8.57% vs 11.11%, p = 0.39). The conversion open group had lower bleeding requiring transfusion (48.57% vs 75.60%, p < 0.01), shorter operation time (p < 0.01), and shorter length of stay (p < 0.01). Other postoperative outcomes did not differ. Risk factors associated with acute intraoperative conversion included ruptured aneurysm with or without hypotension. Protective factors included hypertension and aortic distal aneurysm extent.

CONCLUSIONS:

Although this study does not endorse a universal “EVAR first” strategy for all patients with AAA, EVAR can be attempted first in eligible patients with AAA. Even when EVAR is unsuccessful, intraoperative conversion to open surgery still appears to be safe compared with planned open repair.
Common genetic risk for Parkinson's disease and dysfunction of the endo-lysosomal system
Authors: Bhore Noopur , Bogacki Erin C. , O'Callaghan Benjamin , Plun-Favreau Helene , Lewis Patrick A. , Herbst Susanne
Published: February 2024

Parkinson's disease is a progressive neurological disorder, characterized by prominent movement dysfunction. The past two decades have seen a rapid expansion of our understanding of the genetic basis of Parkinson's, initially through the identification of monogenic forms and, more recently, through genome-wide association studies identifying common risk variants. Intriguingly, a number of cellular pathways have emerged from these analysis as playing central roles in the aetiopathogenesis of Parkinson's. In this review, the impact of data deriving from genome-wide analyses for Parkinson's upon our functional understanding of the disease will be examined, with a particular focus on examples of endo-lysosomal and mitochondrial dysfunction. The challenges of moving from a genetic to a functional understanding of common risk variants for Parkinson's will be discussed, with a final consideration of the current state of the genetic architecture of the disorder.

This article is part of a discussion meeting issue ‘Understanding the endo-lysosomal network in neurodegeneration’.
Haemophilus influenzae in acute appendicitis
Authors: ADIL Fatima Zahra , BENAISSA Elmostafa , BEN LAHLOU Yassine , LAAMARA Leila , BSSAIBIS Fatna , MALEB Adil , CHADLI Mariama , ELOUENNASS Mostafa
Published: February 2024

Appendicitis, typically caused by appendiceal lumen obstruction, is a prevalent abdominal surgical emergency worldwide. While most cases involve Enterobacterales, Haemophilus influenzae, primarily known for upper respiratory infections, is infrequently associated with gastrointestinal infections. This article presents a case of acute appendicitis caused by Haemophilus influenzae in a 15-year-old child, highlighting the significance of recognizing uncommon pathogens in appendicitis and emphasizing the necessity for thorough microbiological investigations to refine diagnostic approaches.
P-type ATPase zinc transporter Rv3270 of Mycobacterium tuberculosis enhances multi-drug efflux activity
Authors: Chatterjee Debasmita , Panda Aditya Prasad , Daya Manasi A. R. , Ghosh Anindya S.
Published: February 2024

Graphical abstract: The probable model depicting antibiotic export by Rv3270

(a) Antibiotics are reported to enter the cells through porin channels such as Msp family porins .(b) Zn2+ (green dots) imported into the cells through probable Zn2+ importers such as ZIP transporters. (c) Zinc inside the cells may influence the efflux of antibiotics by a co-transportation process through Rv3270 triggered by ATP hydrolysis. (d) Rv3270 possibly captures beta-lactams and extrudes them out of the cells via hypothetical linking proteins (outer membrane efflux adaptor proteins) and porins (Msp family) like AcrAB-TolC and Rv0194. This maintains a lower concentration of the antibiotic inside the cell, reducing its chances of exerting inhibitory effects on cell wall synthesis.