bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance analysis and emission characteristics of VCR diesel engine using palm stearin oil biodiesel as fuel
Authors: Malayathi Sivaramakrishnaiah , Aetty Ramachandraiah Babu , Patan Babu , Anugolu Ravitheja , Balasubramanian Arun , Paramasivam Prabhu
Published: August 2024

The increasing depletion of fossil fuels has prompted international efforts to search for diesel substitutes. One way to considerably reduce fuel shortages would be to use bio-derived fuels as replacements. Transesterification of edible or nonedible vegetable oils yields biodiesel, which is one example of a bio-origin fuel and a workable solution. Biodiesel’s characteristics are often more advantageous than those of diesel. One well-known example of a nonedible vegetable oil is palm stearin. In this work, we investigate the potential use of transesterified palm stearin methyl esters (PSME) as a substitute fuel. A rated compression ratio (CR) of 17.5 and 210 bar of fuel injection pressure were employed in the experimental investigations, which were carried out at a constant speed of 1500 rpm. Our main goals were to reduce emissions and improve engine performance. The evaluation parameters encompassed brake thermal efficiency (BTE), brake-specific fuel consumption (BSFC), and emission indices. It was observed that using PSME led to better performance and fewer emissions when compared to using conventional diesel, especially when the CR was 17.5. Increased BTE, decreased BSFC, lower air–fuel ratios, and decreased volumetric efficiencies were all correlated with higher CR. As a byproduct of palm oil, PSME shows promise as a seasonally and geographically specific feedstock for biodiesel production, providing benefits over conventional diesel fuels in terms of performance and the environment.
Association of Pneumococcal Conjugate Vaccination With Severe Acute Respiratory Syndrome Coronavirus 2 Infection Among Older Adult Recipients of Coronavirus Disease 2019 Vaccines: A Longitudinal Cohort Study
Authors: Lewnard Joseph A , Hong Vennis , Grant Lindsay R , Ackerson Bradley K , Bruxvoort Katia J , Pomichowski Magdalena , Arguedas Adriano , Cané Alejandro , Jodar Luis , Gessner Bradford D , Tartof Sara Y
Published: August 2024

Background

Pneumococcal carriage is associated with increased acquisition and duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among adults. While pneumococcal conjugate vaccines (PCVs) prevent carriage of vaccine-serotype pneumococci, their potential impact on coronavirus disease 2019 (COVID-19)–related outcomes remains poorly understood in populations with prevalent immunity against SARS-CoV-2.

Methods

We undertook a retrospective cohort study of adults aged ≥65 years in the Kaiser Permanente Southern California healthcare system who had received ≥2 COVID-19 vaccine doses, comparing risk of SARS-CoV-2 infection between 1 January 2021 and 31 December 2022 among recipients and nonrecipients of 13-valent PCV (PCV13) employing multiple strategies to mitigate bias from differential test-seeking behavior.

Results

The ajusted hazard ratio of confirmed SARS-CoV-2 infection comparing PCV13 recipients to nonrecipients was 0.92 (95% confidence interval [CI], .90–.95), corresponding to prevention of 3.9 (95% CI, 2.6–5.3) infections per 100 person-years. Following receipt of 2, 3, and ≥4 COVID-19 vaccine doses, aHRs (95% CI) were 0.85 (.81–.89), 0.94 (.90–.97), and 0.99 (.93–1.04), respectively. The aHR (95% CI) for persons who had not received COVID-19 vaccination in the preceding 6 months was 0.90 (.86–.93), versus 0.94 (.91–.98) within 6 months after COVID-19 vaccination. Similarly, aHRs (95% CI) were 0.92 (.89–.94) for persons without history of documented SARS-CoV-2 infection, versus 1.00 (.90–1.12) for persons with documented prior infection.

Conclusions

Among older adults who had received ≥2 COVID-19 vaccine doses, PCV13 was associated with modest protection against SARS-CoV-2 infection. Protective effects of PCV13 were greater among individuals expected to have weaker immune protection against SARS-CoV-2 infection.
Field abundance and spatial patterns of ear-feeding insect pests in relation to levels of defective kernels in processing sweet corn
Authors: Dively Galen P , Yurchak Veronica , Hooks Cerruti R R , Farcuh Macarena
Published: August 2024

In this study, we investigated the within-field distribution of sweet corn insect pests in relation to adjacent habitats and determined the level and specific causes of defective kernels affecting the quality of the final product at the processing cannery. Sap beetles [primarily Carpophilus lugubris (Murray, 1864) (Coleoptera: Nitidulidae)] and stink bugs [primarily Euschistus servus (Say) ((Heteroptera: Pentatomidae)] infested 27.6% and 73.6% of the fields, respectively. Densities of stink bugs were highest along field edges adjacent to wheat, soybean, vegetable crops, and woodlots. Levels of kernel injury were consistently higher in truckloads of ears harvested first from the outer rows. Earworm damage was confined to the ear tip and had no measurable impact on the quality of the final product. Sap beetles and blemished kernels were the major causes of defective kernels in the cannery, even though stink bugs were more abundant in the fields. Defective kernels were more positively related to physiological blemishes than to other causal factors. For all fields, defective kernel levels averaged less than 1%, resulting in excellent quality of the processed product throughout the entire season. Results provided a better understanding of the quality control issues, resulting in practical implications for improvements in field monitoring and decision-making in the cannery to minimize grading problems.
NCI SEER-Linked Virtual Tissue Repository Pilot
Authors: Sanchez Pamela , Van Dyke Alison L , Petkov Valentina I , Yuan Yao , Bonds Sarah , Valenzuela Connor , Tuan Alyssa W , Moravec Radim , Altekruse Sean F , Singhi Aatur D , Serdy Kate M , Wu Yun , Cress Rosemary D , Doherty Jennifer A , Mueller Lloyd , Hernandez Brenda Y , Lynch Charles F , Tucker Thomas C , Wu Xiao-Cheng , Matrisian Lynn , Penberthy Lynne
Published: August 2024

Background

The Surveillance, Epidemiology, and End Results (SEER) Program with the National Cancer Institute tested whether population-based cancer registries can serve as honest brokers to acquire tissue and data in the SEER-Linked Virtual Tissue Repository (VTR) Pilot.

Methods

We collected formalin-fixed, paraffin-embedded tissue and clinical data from patients with pancreatic ductal adenocarcinoma (PDAC) and breast cancer (BC) for two studies comparing cancer cases with highly unusual survival (≥5 years for PDAC and ≤30 months for BC) to pair-matched controls with usual survival (≤2 years for PDAC and ≥5 years for BC). Success was defined as the ability for registries to acquire tissue and data on cancer cases with highly unusual outcomes.

Results

Of 98 PDAC and 103 BC matched cases eligible for tissue collection, sources of attrition for tissue collection were tissue being unavailable, control paired with failed case, second control that was not requested, tumor necrosis ≥20%, and low tumor cellularity. In total, tissue meeting the study criteria was obtained for 70 (71%) PDAC and 74 (72%) BC matched cases. For patients with tissue received, clinical data completeness ranged from 59% for CA-19-9 after treatment to >95% for margin status, whether radiation therapy and chemotherapy were administered, and comorbidities.

Conclusions

The VTR Pilot demonstrated the feasibility of using SEER cancer registries as honest brokers to provide tissue and clinical data for secondary use in research. Studies using this program should oversample by 45% to 50% to obtain sufficient sample size and targeted population representation and involve subspecialty matter expert pathologists for tissue selection.
Occurrence and Case Fatality Rate of Invasive Aspergillosis in Children With Acute Leukemia: A Systematic Review and Meta-analysis
Authors: Duus Rasmus Moeller , Moeller Jesper Bonnet , Rathe Mathias
Published: August 2024

Invasive aspergillosis (IA) is a potentially life-threatening complication of childhood acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). We conducted a systematic review and meta-analyses of studies on acute leukemia in children aged 0–17 years since 2000. Findings were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. We included 24 studies with 3661 ALL patients and 1728 AML patients. IA cumulative incidence varied (0%–10% for ALL and 0%–18% for AML) across the studies. Pooled cumulative IA incidences were estimated at 3.2% (95% CI: 1.8%–5.8%) in ALL and 5.2% (95% CI: 3.1%–8.6%) in AML, with corresponding case fatality rates of 13.3% (95% CI: 6.3%–25.9%), and 7.8% (95% CI: 0.7%–51.2%), respectively. Our analysis highlights the impact of IA in childhood leukemia, underscoring the need to address strategies for prevention, early detection, and treatment of IA in pediatric leukemia.
Risk factors for adverse drug reactions to sulfamethoxazole-trimethoprim prophylaxis in patients with rheumatic and musculoskeletal diseases
Authors: Hiramoto Kazuoto , Akiyama Mitsuhiro , Kaneko Yuko
Published: August 2024

Objectives

Risk factors for adverse drug reactions (ADRs) associated with prophylactic sulfamethoxazole-trimethoprim (SMX/TMP) in patients with rheumatic and musculoskeletal diseases undergoing immunosuppressive therapy remain unclear; we aimed to identify the risk factors associated with ADRs.

Methods

Consecutive patients with rheumatic and musculoskeletal diseases, who were admitted to Keio University Hospital and received prophylactic administration of SMX/TMP, were included. Data regarding ADRs to SMX/TMP were collected to identify the associated risk factors using multivariable analysis.

Results

Of 438 patients included in the analysis, 82 (18.7%) experienced ADRs. Patients in the ADR group were significantly older, had chronic kidney disease, and exhibited lower lymphocyte and platelet counts, lower albumin levels, lower estimated glomerular filtration rates, higher aspartate aminotransferase levels, and higher ferritin levels than those in the non-ADR group. Regarding the underlying rheumatic and musculoskeletal diseases, adult-onset Still’s disease (ASD) was associated with a significantly higher incidence of ADRs (67%) than other diseases. Multivariable analysis identified the presence of ASD and low lymphocyte counts as independent risk factors for allergic ADRs and older age and use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers for nonallergic ADRs.

Conclusions

Risk factors for ADRs associated with prophylactic SMX/TMP treatment in patients with rheumatic and musculoskeletal diseases were identified.
Potential Health Benefits of a Diet Rich in Organic Fruit and Vegetables versus a Diet Based on Conventional Produce: A Systematic Review
Authors: Komati Nathalie , Cravedi Jean-Pierre , Lecerf Jean-Michel , Belzunces Luc P , Tailliez Delphine , Chambrier Claire , Calvarin Johanna , Amiot Marie-Josèphe
Published: August 2024

Context

Over the past decade, the production and consumption of organic food (OF) have received increasing interest. Scientific studies have shown better quality of organic fruit and vegetables (FV) in terms of nutrients and pesticide contents, but it appears difficult to conclude if there are potentially greater health benefits of these products compared with conventional food (CF).

Objective

To determine whether the current scientific literature demonstrates that a diet rich in organic FV is healthier than 1 based on conventional produce.

Methods

A systematic search was conducted using the PubMed and Web of Science databases for articles published between January 2003 and December 2022. Articles were analyzed uniformly by 2 reviewer, using a specific template summary sheet, and scored from 1 to 5. The level of evidence and the quality of studies in humans were assessed using the Jadad score and the French National Authority for Health method.

Results

A total of 12 human studies were included. Studies often reported contradictory or even opposite results, with methodological limitations. Only 6 of the 12 studies found significant associations between OF and the health outcomes evaluated.

Conclusion

The current data do not enable a firm conclusion about a greater health benefit for a diet rich in FV based on products grown organically compared with conventional farming. There is a paucity of available data and considerable heterogeneity in study designs (participants, exposures, durations, health outcomes, and residual confounding factors). Well-designed interventional studies are required.
Multiple Acquisitions of XopJ2 Effectors in Populations of Xanthomonas perforans
Authors: Sharma Anuj , Iruegas-Bocardo Fernanda , Bibi Shaheen , Chen Yun-Chu , Kim Jung-Gun , Abrahamian Peter , Minsavage Gerald V. , Hurlbert Jason C. , Vallad Gary E. , Mudgett Mary B. , Jones Jeffrey B. , Goss Erica M.
Published: August 2024

Type III effectors (T3Es) are major determinants of Xanthomonas virulence and targets for resistance breeding. XopJ2 (synonym AvrBsT) is a highly conserved YopJ-family T3E acquired by X. perforans, the pathogen responsible for bacterial spot disease of tomato. In this study, we characterized a new variant (XopJ2b) of XopJ2, which is predicted to have a similar three-dimensional (3D) structure as the canonical XopJ2 (XopJ2a) despite sharing only 70% sequence identity. XopJ2b carries an acetyltransferase domain and the critical residues required for its activity, and the positions of these residues are predicted to be conserved in the 3D structure of the proteins. We demonstrated that XopJ2b is a functional T3E and triggers a hypersensitive response (HR) when translocated into pepper cells. Like XopJ2a, XopJ2b triggers HR in Arabidopsis that is suppressed by the deacetylase, SOBER1. We found xopJ2b in genome sequences of X. euvesicatoria, X. citri, X. guizotiae, and X. vasicola strains, suggesting widespread horizontal transfer. In X. perforans, xopJ2b was present in strains collected in North America, Africa, Asia, Australia, and Europe, whereas xopJ2a had a narrower geographic distribution. This study expands the Xanthomonas T3E repertoire, demonstrates functional conservation in T3E evolution, and further supports the importance of XopJ2 in X. perforans fitness on tomato.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Localization of Iris Yellow Spot Virus in Naturally Infected Onion Plants: A Sampling Approach for Reliable Diagnosis
Authors: Komondy Lidia , Fuchs Marc , Nault Brian A.
Published: August 2024

Iris yellow spot virus (IYSV) from the genus Orthotospovirus of the family Tospoviridae can cause considerable yield reduction and crop loss in allium crops, especially dry bulb onion. While infected plants may or may not express symptoms of iris yellow spot disease, these onion plants can test negative for the virus because not all tissues contain detectable levels of IYSV due to its uneven distribution. The purpose of this study was to identify tissue locations of symptomatic onion plants that have the highest likelihood of testing positive or IYSV in double antibody sandwich enzyme-linked immunosorbent assay (DAS-ELISA) using specific antibodies. Results revealed that the greatest likelihood of detecting IYSV from a single symptomatic plant occurred with tissue near foliar lesions located on the distal portions of older leaves (range: 42 to 71%). These low to moderate probability detection levels can predictably be overcome by testing pooled tissue samples from the same plant or from multiple plants. Indeed, the likelihood of distal and proximal youngest leaf tissue testing positive for IYSV when changing from a single plant to a four-plant composite sample would increase from 44 to 90% and from 50 to 94%, respectively. Implications of these results for IYSV detection and surveillance in onion production systems are discussed.
CircNAP1L4 regulates pulmonary artery smooth muscle cell proliferation via the NAP1L4‐mediated super‐enhancer‐driven glycolysis gene hexokinase II (HK II) in pulmonary hypertension
Authors: Wang Xiaoying , Guan Xiaoyu , Zhu Xiangrui , Zhang Lixin , Ma Cui , He Siyu , Bai June , Mei Jian , Li Qian , Sun Na , Wu Bingxiang , Zhu Daling
Published: August 2024

Glycolysis is a major determinant of pulmonary artery smooth muscle cell (PASMC) proliferation in pulmonary hypertension (PH). Circular RNAs (circRNAs) are powerful regulators of glycolysis in multiple diseases; however, the role of circRNAs in glycolysis in PH has been poorly characterized. The aim of this study was to uncover the regulatory mechanism of a new circRNA, circNAP1L4, in human pulmonary artery smooth muscle cell (HPASMC) proliferation through the host protein NAP1L4 to regulate the super‐enhancer‐driven glycolysis gene hexokinase II (HK II). CircNAP1L4 was downregulated in hypoxic HPASMCs and plasma of PH patients. Functionally, circNAP1L4 overexpression inhibited glycolysis and proliferation in hypoxic HPASMCs. Mechanistically, circNAP1L4 directly bound to its host protein NAP1L4 and affected the ability of NAP1L4 to move into the nucleus to regulate the epigenomic signals of the super‐enhancer of HK II. Intriguingly, circNAP1L4 overexpression inhibited the proliferation but not the migration of human pulmonary arterial endothelial cells (HPAECs) cocultured with HPASMCs. Furthermore, pre‐mRNA‐processing‐splicing Factor 8 (PRP8) was found to regulate the production ratio of circNAP1L4 and linear NAP1L4. In vivo, targeting circNAP1L4 alleviates SU5416 combined with hypoxia (SuHx)‐induced PH. Overall, these findings reveal a new circRNA that inhibits PASMC proliferation and serves as a therapeutic target for PH.
The Impact of COVID-19 on Substance Use and Related Consequences Among Patients in Office-based Opioid Use Disorder Treatment
Authors: Weinstein Zoe M. , Magane Kara M. , Lodi Sara , Ventura Alicia S. , Bazzi Angela R. , Blodgett Juliana , Fielman Sarah , Davoust Melissa , Shea Margaret G. , Chen Clara A. , Cheng Anna , Theisen Jacqueline , Blakemore Samantha , Saitz Richard
Published: August 2024

Objectives

The COVID-19 pandemic led to increased substance-related morbidity and mortality and transformed care for opioid use disorder (OUD). We assessed the perceived impacts of the pandemic on substance use and related consequences among patients in office-based addiction treatment (OBAT).

Methods

We recruited patients with OUD on buprenorphine from July 2021 to July 2022, with data collection at baseline and 6 months. Exposures of interest were the following 6 domains potentially impacted by COVID-19: personal or family infection, difficulty accessing healthcare/medication, economic stressors, worsening physical or mental health, social isolation, and conflicts/disruptions in the home. Outcomes were past 30-day alcohol and other substance use, increased use, and substance-related consequences at baseline and 6 months. Generalized estimating equations Poisson regression models quantified associations between increasing impact domain scores and relative risks of each outcome.

Results

All participants (N = 150) reported at least one domain negatively impacted by COVID-19 at both time points. Higher “worsening physical or mental health” domain scores were associated with increased relative risk of recent alcohol or drug use (adjusted risk ratio [aRR] 1.04, 95% confidence interval [CI]: 1.01–1.07). Relative risks of experiencing substance-related consequences increased with higher scores in the domains of economic stressors (aRR 1.07, 95% CI: 1.02–1.13), difficulty accessing healthcare/medication (aRR 1.11, 95% CI: 1.04–1.19), and worsening physical or mental health (aRR 1.08, 95% CI: 1.04–1.12).

Conclusions

Among patients with OUD, stressors from COVID-19 were common. Three life domains impacted by COVID-19 appeared to be associated with consequential substance use, highlighting opportunities to address barriers to healthcare access and economic stressors.
Plantar Compartment Block Improves Enhanced Recovery after Hallux Valgus Surgery: A Randomized, Comparative, Double-blind Study
Authors: Swisser Fabien , Brethe Yann , Choquet Olivier , Herteleer Matthias , Bernard Nathalie , Laffont Isabelle , Bringuier Sophie , Capdevila Xavier
Published: August 2024

Background

Walking ability is a key factor in enhanced recovery after foot ambulatory surgery. Plantar compartment block offers an analgesic alternative to popliteal sciatic nerve block (PSNB) for hallux valgus surgery. The objective of this study was to compare these two regional anesthesia strategies on patients’ ability to recover a painless unaided walk.

Methods

This prospective double-blinded (patient; observing anesthesiologist) randomized study compared patients scheduled for hallux valgus surgery receiving PSNB with 1% mepivacaine, then combined plantar and peroneal nerve blocks (plantar compartment block [PCB] group) with ropivacaine 0.5% and dexamethasone, or PSNB with ropivacaine 0.5% and dexamethasone (control group). The primary outcome was the patient’s ability to walk unaided 6 h after PSNB. The test was performed on a GAITRite, spatio-temporal gait analysis mat. For 3 days, the number of patient steps, pain levels, rescue analgesics, patient’s experience, and adverse events were assessed.

Results

Sixty patients were included and 59 were analyzed. The number of patients walking unaided on the GAITRite mat was significantly higher in the PCB group (21 of 30, 70%) than in the control group (4 of 29, 13.8%; P < 0.001). Gait quality using the Functional Ambulation Profile score was 63 ± 13.6 in the PCB group and 49.5 ± 4.7 in the control group (P < 0.001). Median time to free ambulation at home was significantly lower in the PCB group (9 h [8.2 to 11.8]) than in the control group (33.5 h [24 to 47]; P < 0.001). Postoperative pain did not differ between the groups (β = −0.41 [−1.78 to 0.95]; P = 0.548). The number of steps on day 3, the time of first rescue analgesic, the number of patients using rescue analgesia, consumption of morphine, and patient’s experience did not differ between the groups.

Conclusions

PCB decreased the time to return to unaided walking, with improved gait, compared with PSNB, improving effective analgesia and low consumption of rescue analgesics. This innovative regional anesthesia strategy enhanced recovery after surgery.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
Outcomes of the Modified Dunn Procedure Versus Delayed Imhauser Osteotomy for Moderate to Severe Stable Slipped Capital Femoral Epiphysis
Authors: Chau Michael M. , Osborne Lauren , Mayfield Laura M. , Jo Chan-Hee , Morris William Z. , Podeszwa David A. , Sucato Daniel J.
Published: August 2024

Background:

Traditional management of moderate to severe stable slipped capital femoral epiphysis (SCFE) has been in situ fixation followed by reconstructive surgery if symptoms arise. This delayed approach may lead to irreversible intra-articular damage of the hip over time. The purpose of this study was to compare radiographic and clinical outcomes of the modified Dunn procedure (MDP) versus in situ fixation followed by delayed Imhauser osteotomy (DIO).

Methods:

This was a retrospective study from a single institution between 2001 and 2021. Among 250 patients diagnosed with SCFE, a total of 18 (18 hips) treated with MDP and 16 (18 hips) treated with DIO for moderate to severe stable SCFE were included. Most patients who underwent DIO either had concomitant (11/18 hips) or subsequent (2/18 hips) open osteochondroplasty. Mean follow up was 4.7 years (range: 1 to 12.8 y). Radiographs were reviewed to measure Southwick angle, anteroposterior and lateral alpha (α) angles, and femoral head-neck offset ratio preoperatively and at latest follow up. Charts were reviewed for demographics, subsequent surgeries, complications, and Heyman-Herndon clinical outcomes.

Results:

The amount of deformity correction was greater in the MDP than DIO group based on anteroposterior α angles (mean: 22.3 vs. 11.9 degrees, P=0.046) and femoral head-neck offset ratios (mean: 0.26 vs. 0.12, P=0.001). There was no significant difference in Heyman-Herndon scores (both 16/18, 88.9% good to excellent outcomes, P>0.999). Less reoperations were performed in the MDP than DIO group (2/18, 11.1% vs. 9/18, 50%; P=0.004). AVN occurred in 2/18 hips (11.1%) in the MDP group with both surgeries performed early in the series and underwent prior in situ screw fixation compared with 0/18 hips (0%) in the DIO group (P=0.486). One patient in the DIO group was later diagnosed with osteoarthritis.

Conclusions:

MDP resulted in more anatomic coronal and sagittal plane deformity correction, less reoperations, and similar Heyman-Herndon clinical outcomes compared with DIO. AVN occurred in the MDP group whereas osteoarthritis occurred in the DIO group. These complications must be weighed against improved long-term clinical results for patients who would otherwise be at risk for premature degenerative joint disease due to residual proximal femoral deformity.

Level of Evidence:

Level III—retrospective comparative study.
Academic Productivity at Orthopedic Spine Surgery Fellowships Is Positively Correlated With Nonresearch Lifetime Industry Earnings
Authors: Baumann Anthony N. , Gong Davin C. , Bae Seung-Ho , Hitchman Kyle , Anastasio Albert T. , Walley Kempland C. , Rocos Brett
Published: August 2024

Study Design:

Retrospective Analysis.

Objective:

The objective of the study was to assess the impact of academic productivity at both individual and program levels on lifetime industry earnings within US orthopedic spine fellowships.

Summary of Background Data:

Physician-industry transparency was codified by the Physician Payments Sunshine Act (PSSA) in 2010. No study has explored the relationship between academic productivity and industry earnings at the fellowship level.

Methods:

Inclusion criteria encompassed physicians with complete academic and industry data from orthopedic spine fellowship programs listed on the North American Spine Society (NASS) 2022–2023 fellowship directory. Academic productivity was defined via H-index on the Scopus website, and industry productivity by total lifetime earnings on the Open Payments Database (OPD).

Results:

This analysis included 75 orthopedic spine fellowship programs with 320 individual physicians. Median individual physician lifetime earnings were $86,852.71 (mean: $666,580.23 ± $1,887,734.64; minimum–maximum: $10.86–$27,164,431.49) and the median individual physician (n=320 physicians) H-index was 17.0 (mean: 21.82 ± 19.28; minimum–maximum: 0–109). Median combined physician H-index per fellowship (n=75 fellowships) was 65.0 (mean: 93.08 ± 85.67; minimum–maximum: 3–434) and median combined physician lifetime earnings was $927,771.60 (mean: $2,844,075.64 ± $4,942,089.56; minimum–maximum: $1,112.32–$29,983,900.69). A positive correlation was observed between academic productivity and industry productivity at an individual level (P<0.001; Spearman’s rho = 0.467). This correlation was stronger at the fellowship level (P<0.001; Spearman’s rho = 0.734). There was no significant difference in total lifetime earnings (P=0.369) or H-index per fellowship (P=0.232) when stratified by region of the fellowship program in the United States.

Conclusion:

Orthopedic spine surgery fellowship programs in the United States exhibit a positive correlation between academic productivity and nonresearch industry lifetime earnings at both individual and program levels. This correlation is stronger at the program level, and regional differences among fellowship programs do not significantly impact academic or industry productivity.
The Effects of Mandala Coloring and Free Coloring on Mindfulness and the Score of Posttraumatic Stress Disorder in Veterans
Authors: Nasiri Mohammad-Amin , Sajadi Seyedeh Azam , Farsi Zahra , Heidarieh Marzie
Published: August 2024

Due to the nature of the events in war, posttraumatic stress disorder (PTSD) is more difficult to treat in veterans than in other people. Nowadays, using art-making methods such as mandala coloring has attracted the attention of researchers. This randomized controlled trial was conducted with 84 male veterans diagnosed with PTSD. Veterans were recruited by convenience sampling method and randomly assigned to an intervention group (n = 42) and a control group (n = 42). Participants in the intervention group colored a mandala, whereas the control group colored freely for 15 minutes 2 times a week for 3 weeks. All participants completed Brown and Ryan’s Mindful Attention Awareness Scale and Posttraumatic Stress Disorder Checklist for diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). Mean baseline mindfulness scores were not significantly different between the mandala coloring group and the free coloring group (41.73 ± 5.29 vs 40.23 ± 4.59, P = .169). After the intervention, the mean mindfulness score was significantly higher in the mandala coloring group than in the free coloring group (52.23 ± 5.89 vs 46.04 ± 7.28, P < .001). Mean baseline PTSD scores were not significantly different between the mandala coloring group and the free coloring group (65.45 ± 5.89 vs 67.47 ± 4.66, P = .085). After the intervention, the mean PTSD score was significantly lower in the mandala coloring group than in the free coloring group (47.21 ± 5.77 vs 52.38 ± 5.52, P < .001). Both mandala coloring and free coloring increase mindfulness and decrease PTSD symptom severity. However, the mandala coloring method was more effective.
Optimizing Regulatory Reviews for Clinical Protocols That Use Radiopharmaceuticals: Findings of the University of Pennsylvania Radiation Research Safety Committee
Authors: Rhodes Sylvia S. , Jesikiewicz Janelle E. , Yegya-Raman Nikhil , Prasad Kavya , Dreyfuss Alexandra , Mankoff David A. , Taunk Neil K.
Published: August 2024

Institutional radiation safety committees review research studies with radiation exposure. However, ensuring that the potential patient benefit and knowledge gained merit the radiation risks involved often necessitates revisions that inadvertently delay protocol activations. This quality-improvement study analyzed protocols, identified factors associated with approval time by a radiation safety committee, and developed guidelines to expedite reviews without compromising quality. Clinical protocols submitted to the University of Pennsylvania’s Radiation Research Safety Committee (RRSC) for review between 2017 and 2021 were studied. Protocol characteristics, review outcome, stipulations, and approval times were summarized. Statistical analysis (Spearman's rho) was used to investigate stipulations and approval time; rank-sum analysis (Kruskal-Wallis or Wilcoxon) was used to determine whether approval time differed by protocol characteristics. One hundred ten (110) protocols were analyzed. Approximately two-thirds of protocols used approved radiopharmaceuticals to aid investigational therapy trials. Twenty-three percent (23%) of protocols received RRSC approval, and 73% had approval withheld with stipulations, which included requests for edits or additional information. Submissions had a median of three stipulations. Median and mean RRSC approval times were 62 and 80.1 d, and 41% of protocols received RRSC approval after IRB approval. RRSC approval time was positively correlated with stipulations (Spearman’s rho = 0. 632, p < 0.001). RRSC approval time was longer for studies using investigational new drugs (median 80 d) than approved radiopharmaceuticals (median 57 d, p = 0.05). The review process is lengthy and may benefit from changes, including publishing standardized radiation safety language and commonly required documents and encouraging timely response to stipulations.
Uranium in Drinking Water and Bladder Cancer: A Case-control Study in Michigan
Authors: Uduba Perpetua , Soares Lissa , Babalola Tesleem , Slotnick Melissa , Linder Aaron , Meliker Jaymie R.
Published: August 2024

Uranium is naturally occurring in groundwater used for drinking; however, health risks from naturally occurring concentrations are uncertain. Uranium can cause both radiological and chemical toxicity following ingestion. Bladder and kidneys receive a dose when uranium is excreted into the urine. Investigate the association between uranium in drinking water and bladder cancer risk in a case-control study. A population-based bladder cancer case-control study was conducted in 11 counties of southeastern Michigan. A total of 411 cases and 566 controls provided drinking water and toenail samples and answered questions about lifestyle and residential history. Uranium was measured in drinking water and toenails, and its association with bladder cancer was assessed via unconditional logistic regression models. Median uranium concentration in water was 0.12 μg L−1, with a maximum of 4.99 μg L−1, and median uranium concentration in toenails was 0.0031 μg g−1. In adjusted regression models, there was a suggestion of a protective effect among those exposed to the upper quartile of uranium in drinking water (HR = 0.64, 95% CI: 0.43, 0.96) and toenails (HR 0.66; 95% CI 0.45, 0.96) compared to those in the lowest quartile. Our objective is to investigate additional adjustment of drinking water source at home residence at time of recruitment to address potential selection bias and confounding attenuated results toward the null for drinking water uranium (HR = 0.68, 95% CI: 0.44, 1.05) and toenail uranium (HR = 0.80, 95% CI: 0.53, 1.20). This case-control study showed no increased risk of bladder cancer associated with uranium found in drinking water or toenails.
Influence of Neighborhood Disadvantage and Individual Sociodemographic Conditions on Heart Failure Self-care
Authors: Meraz Rebecca , Osteen Kathryn , McGee Jocelyn , Noblitt Paul , Viejo Henry
Published: August 2024

Background

Residence in socioeconomically disadvantaged neighborhoods and individual sociodemographic conditions contribute to worse heart failure (HF) outcomes and may influence HF self-care. However, associations between neighborhood disadvantage, socioeconomic conditions, and HF self-care are unclear.

Objective

The purpose of this secondary analysis was to investigate whether neighborhood disadvantage and individual socioeconomic conditions predicted worse HF self-care.

Methods

This study was a secondary analysis of baseline data from a mixed-method study of 82 adults with HF. Participant zip codes were assigned a degree of neighborhood disadvantage using the Area Deprivation Index. Those in the top 20% most disadvantaged neighborhoods (Area Deprivation Index ≥ 80) were compared with those in the least disadvantaged neighborhoods. The Self-Care of Heart Failure Index was used to measure self-care maintenance and monitoring. Multiple linear regression was conducted.

Results

Of all participants, 59.8% were male, 59.8% were persons of color, and the mean age was 64.87 years. Residing in a disadvantaged neighborhood and living alone predicted worse HF self-care maintenance and monitoring. Having no college education was also a predictor of worse HF self-care maintenance. Although persons of color were more likely to reside in disadvantaged neighborhoods, race was not associated with HF self-care.

Conclusion

Residing in a disadvantaged neighborhood and living alone may be important risk factors for worse HF self-care. Differences in self-care cannot be attributed solely to the individual sociodemographic determinants of race, gender, age, annual household income, or marital status. More research is needed to understand the connection between neighborhood disadvantage and HF self-care.
Significance of incidental thyroid 18F-fluorocholine uptake in patients with hyperparathyroidism imaged for localizing hyperfunctioning parathyroid glands
Authors: Grünig Hannes , Strobel Klaus , Zander Andrea , Pérez Lago Maria del Sol , Lima Thiago , Wicke Corinna , Fischli Stefan , Bhure Ujwal
Published: August 2024

Objective

18F-fluorocholine PET/CT is considered the imaging gold standard for detection of hyperfunctioning parathyroid glands . However, increased uptake might also occur in the thyroid gland. The aim of our study was to assess the incidence and significance of 18F-fluorocholine uptake in the thyroid gland in patients with hyperparathyroidism.

Materials and methods

This retrospective study includes 195 consecutive patients with hyperparathyroidism, who underwent 18F-fluorocholine PET/CT, for detection of hyperfunctioning parathyroid glands. PET/CT images were reviewed by two nuclear medicine physicians for the presence of focal or diffuse thyroid uptake. PET/CT results were compared with laboratory parameters, ultrasonography, EU-TIRADS classification in the presence of thyroid nodules, cytology, and final histology.

Results

25 patients (13%) showed 18F-fluorocholine uptake in the thyroid gland: focal thyroid uptake (FTU) in 7 patients (4%), diffuse thyroid uptake (DTU) in 8 patients (4%), and combined uptake (FTU + DTU) in 10 patients (5%), with a total of 20 active thyroid nodules. There was no correlation between EU-TIRADS classification and PET parameters. One highly 18F-fluorocholine active thyroid nodule and one isoactive thyroid nodule turned out to be papillary thyroid cancers in the final histology; 50% of the patients with DTU had Hashimoto’s thyroiditis.

Conclusion

Incidental 18F-fluorocholine uptake in the thyroid gland was observed in 13% of patients. As reported for 18F-FDG, focal 18F-fluorocholine uptake might represent thyroid cancer and should be evaluated with ultrasound and, if indicated, with fine-needle aspiration cytology. Diffuse 18F-fluorocholine uptake most likely represents multinodular goiter or Hashimoto’s thyroiditis.
National burden of Ebola virus disease in Democratic Republic of the Congo: the urgency to act
Authors: Ahmad Bilal , Sagide Martin , Ntamwinja Sylivia , Byiringiro Elysée , Kihanduka Elie , Rugendabanga Excellent , Hangi Samson , Bhattacharjee Priyadarshini , Ali Babar , Nkundakozera Marie , Kanda Michée Sanza , Guruka Lucie , Onesime Jones , Tague Christian , Langat Amos Kipkorir , Akilimali Aymar
Published: August 2024

Ebola virus disease (EVD) has long been a major public health concern for Democratic Republic of the Congo (DR Congo). First identified in DR Congo in 1976, the country has witnessed more than 25 outbreaks of this deadly disease, which has a case fatality rate of nearly 90% and manifesting with symptoms such as diarrhoea, vomiting, stomachache and haemorrhagic fever. African fruit bats have been speculated to be the reservoir of this virus. DR Congo is currently facing another EVD outbreak simultaneously with other communicable diseases, rendering it vulnerable to a shortage of medical and paramedical staff along with distrust among remote communities towards local authorities due to armed conflict and political instability. Moreover, lack of ring vaccinations and inefficient surveillance of suspected individuals are some other significant hurdles in disease control. Despite the availability of rVSV-ZEBOV/Erbevo vaccine and many antibody-based vaccines, challenges including politicization, low access to remote communities, and illiteracy have limited their effectiveness. Recently, the Congolese govt. has put in efforts such as building local capacities at the health zone level, outbreak control intervention, community engagement and social mobilization to counter the rising EVD cases. Four successive Strategic Response Plans have been implemented to increase resource mobilization by DR Congo and her partners. The Spread of zoonotics such as EVD can be confronted by implementing the One Health approach, which involves medical staff, veterinarians and public health officials.
Immature ovarian teratoma with gliomatosis peritonei, paraneoplastic hyponatremia and growing teratoma syndrome: a case report and literature review
Authors: Mira Ana Rita , Brincat Mark R. , Zalawadia Shruti , Sideris Michail , Dilley James
Published: August 2024

Introduction and relevance:

Paraneoplastic hyponatremia is often secondary to syndrome of inappropriate antidiuretic hormone secretion (SIADH) by tumour cells. Immature ovarian teratomas (IOT) are uncommon and may present with SIADH.

Case report:

A 26-year-old female presented with a 3-month history of abdominal pain and constipation. Imaging identified a mixed solid-cystic right ovarian mass containing fat and peritoneal deposits. Biochemistry showed severe, refractory hyponatremia (117 mmol/l). She underwent diagnostic fertility-preserving right salpingo-oophorectomy and resection of peritoneal nodules with the aim to achieve symptom control and hyponatraemia resolution. Pathology revealed a FIGO Stage 2 Grade 2 IOT with extensive benign peritoneal gliomatosis. Initial management was conservative. After 6 months of active follow-up, a rise in AFP, and recurrent hyponatremia supported the decision to administer three cycles of Bleomycin-Etoposide-Cisplatin chemotherapy. One month later, given radiological disease progression despite satisfactory biomarker response, cytoreductive surgery with complete macroscopic resection was performed. Pathology consisted solely of peritoneal mature glial elements: a growing teratoma syndrome (GTS). The patient remains disease-free after 2 years of surveillance.

Clinical discussion:

Specimen histological assessment from the patient’s initial surgery showed immature neuroectodermal tubules, which are thought to be the source of vasopressin secretion. The authors hypothesise that recurrent hyponatremia and rising AFP levels represented postoperative disease relapse. Biochemical response despite radiological disease progression was pathognomonic of a GTS.

Conclusion:

Paraneoplastic SIADH secondary to an IOT must be considered in female patients presenting with abdominal symptoms and hyponatremia. Management requires a multidisciplinary approach. Serum electrolytes are useful surveillance biomarkers supplementary to tumour markers.
Urothelial cancer: state of art in Ukraine and improvement pathways
Authors: Pikul Maksym , Gordiichuk Prokip , Stakhovsky Eduard
Published: August 2024

Aim:

This study aims to assess the effectiveness of urothelial cancer treatment in Ukraine, utilizing population-based data from the National Cancer Registry. The primary goal is to evaluate trends and approaches to therapy, with a focus on overall survival rates in patients with urothelial tumors.

Materials and methods:

A retrospective cross-sectional analysis was conducted based on the National Cancer Registry, involving 12 698 patients (2008–2020) with urothelial tumors of the upper urinary tract (UTUC) and bladder cancer (BC) who underwent surgical treatment. Demographic indicators, surgical interventions, complications, and survival rates were analyzed.

Results:

The average age for all patients was 70 years. The number of patients undergoing radical treatment was 1820 (15%) among BC and 573 (59%) among UTUC. The 30-day readmission rate was low for both, with a slightly higher preference for UTUC (2.3 vs. 4.6%). Whereas grade III or higher Cl-Dindo complications were seen in only 0.2% of cases. Notable findings include low frequency of neoadjuvant (7%) and adjuvant chemotherapy (28%) among patients with invasive urothelial carcinomas. Median eGFR for invasive UTUC before and after surgery was 63.2 and 51.4 ml/min, respectively (P=0.00054). The directly opposite trend was seen in BC—61.2 and 68.7 ml/min, respectively (P=0.0026).

For BC, the overall survival rates by stages were: I—73%, II—49%, III—18%, and IV—11% (χ2=1807.207; P=0.000001). As for UTUC, the 5-year overall survival rates corresponded to the literature data, but there was a pronounced negative trend towards a decrease in this indicator after a 10-year period for all stages (χ2=146.298; P=0.000003).

Conclusion:

The study emphasizes the importance of effective systemic treatments, adherence to treatment guidelines, and the need for multidisciplinary consultations among Ukrainian patients with urothelial cancer.
Rectal Lymphogranuloma Venereum Among Men Who Have Sex With Men: 7 Versus 21 Days Doxycycline Effectiveness
Authors: Raccagni Angelo Roberto , Siribelli Alessia , Diotallevi Sara , Sampaolo Michela , Bruzzesi Elena , Clementi Nicola , Lolatto Riccardo , Burioni Roberto , Castagna Antonella , Nozza Silvia
Published: August 2024

This is a retrospective study on men who have sex with men (MSM) diagnosed with rectal lymphogranuloma venereum (LGV), treated with 7 or 21 days of doxycycline between 2015 and 2022. Overall, 143 MSM were included: 58 (41%) had LGV. One hundred percent of microbiologic cure was found among MSM with symptomatic or asymptomatic LGV treated with 7 and 21 days of doxycycline.
Willingness of Joining Online Support Groups Among Men Who Have Sex With Men Living With HIV in Shandong Province of China: A Mixed Methods Study
Authors: Jiao Kedi , Ma Jing , Lin Yuxi , Wang Chunmei , Liao Meizhen , Cheng Xiaosong , Song Mingming , Liu Dongying , Kang Dianmin , Ma Wei
Published: August 2024

Background

Online support groups afford new opportunities to help individuals affected by HIV/AIDS to seek social support from peers. The study aimed to understand the willingness and associated factors of joining online support groups among men who have sex with men living with HIV.

Methods

The study followed a mixed methods approach, with qualitative in-depth interviews followed by a quantitative cross-sectional survey in 3 cities of Shandong Province, China, from 2019 to 2020. The in-depth interviews were audio-taped, transcribed verbatim, and analyzed using a thematic approach. In the quantitative analysis, explanatory variables included sociodemographic, behavioral, clinical, psychological, and demand factors. Univariate and multivariable logistic regressions were conducted to examine the associated factors of willing to join online support groups.

Results

A total of 576 and 20 participants were included in the quantitative survey and qualitative interviews, respectively. Only 24.7% (142 of 576) of participants in the quantitative study were willing to join the online support group. Multivariable analysis showed that the associated factors included income level, sexual orientation, and availability of information. The barriers to joining online support groups included privacy disclosure concern and psychological pressure exposed to HIV-related information. Facilitators included information acquisition, mutual medication reminding, and emotional support.

Conclusions

Men who have sex with men living with HIV in China had relatively low willingness to join the online support groups. This study highlighted the importance of safeguarding privacy, involving professional mental health providers, and providing high-quality information when establishing online support groups for people living with HIV.