bluuebunny/crossref_metadata_2025 huggingface dataset:
The triggers of situational syncope do not influence the head-up tilt test response and prognosis
Authors: Russo Vincenzo , Parente Erika , Comune Angelo , Rago Anna , Nigro Gerardo , Brignole Michele
Published: August 2024

Aims

The study evaluated the positivity rate, haemodynamic responses, and prognosis in terms of syncopal recurrence among patients with situational syncope (SS) stratified according to the underlying situational triggers.

Methods and results

We retrospectively evaluated all consecutive patients with SS who underwent nitroglycerine (NTG)-potentiated head-up tilt test (HUTT) at Syncope Unit of the University of Campania ‘Luigi Vanvitelli’—Monaldi Hospital from 1 March 2017 to 1 May 2023. All patients were followed for at least one year. The study population was divided according to the underlying triggers (micturition, swallow, defaecation, cough/sneeze, post-exercise). Two hundred thirty-six SS patients (mean age 50 ± 19.3 years; male 63.1%) were enrolled; among them, the situational trigger was micturition in 109 patients (46.2%); swallow in 32 (13.6%) patients; defaecation in 35 (14.8%) patients; post-exercise in 41 (17.4%) patients; and cough/sneeze in 17 (7.2%) patients. There were no significant differences in baseline clinical characteristics and HUTT responses between different situational triggers. The Kaplan–Meier analysis did not show a statistically different rate of syncope recurrence across patients stratified by baseline situational triggers (log-rank P = 0.21).

Conclusion

Situational syncope appears to be a homogenous syndrome, and different triggers do not impact the HUTT response or syncope recurrence at 1 year.
The association of depression and patient and resuscitation characteristics with survival after out-of-hospital cardiac arrest: a cohort study
Authors: Alotaibi Raied , Halbesma Nynke , Jackson Caroline A , Clegg Gareth , Stieglis Remy , van Schuppen Hans , Tan Hanno L
Published: August 2024

Aims

Out-of-hospital cardiac arrest (OHCA) is a leading cause of death worldwide, with cardiovascular disease (CVD) being a key risk factor. This study aims to investigate disparities in patient/OHCA characteristics and survival after OHCA among patients with vs. without depression.

Methods and results

This is a retrospective cohort study using data from the AmsteRdam REsuscitation Studies (ARREST) registry from 2008 to 2018. History of comorbidities, including depression, was obtained from the patient’s general practitioner. Out-of-hospital cardiac arrest survival was defined as survival at 30 days post-OHCA or hospital discharge. Logistic regression models were used to obtain crude and adjusted odds ratios (ORs) for the association between depression and OHCA survival and possible effect modification by age, sex, and comorbidities. The potential mediating effects of initial heart rhythm and provision of bystander cardiopulmonary resuscitation were explored. Among 5594 OHCA cases, 582 individuals had pre-existing depression. Patients with depression had less favourable patient and OHCA characteristics and lower odds of survival after adjustment for age, sex, and comorbidities [OR 0.65, 95% confidence interval (CI) 0.51–0.82], with similar findings by sex and age groups. The association remained significant among the Utstein comparator group (OR 0.63, 95% CI 0.45–0.89) and patients with return of spontaneous circulation (OR 0.60, 95% CI 0.42–0.85). Initial rhythm and bystander cardiopulmonary resuscitation partially mediated the observed association (by 27 and 7%, respectively).

Conclusion

Out-of-hospital cardiac arrest patients with depression presented more frequently with unfavourable patient and OHCA characteristics and had reduced chances of survival. Further investigation into potential pathways is warranted.
Genomic Underpinnings of Cytoplasmic Incompatibility: CIF Gene-Neighborhood Diversification Through Extensive Lateral Transfers and Recombination in Wolbachia
Authors: Tan Yongjun , Aravind L , Zhang Dapeng
Published: August 2024

Cytoplasmic incompatibility (CI), a non-Mendelian genetic phenomenon, involves the manipulation of host reproduction by Wolbachia, a maternally transmitted alphaproteobacterium. The underlying mechanism is centered around the CI Factor (CIF) system governed by two genes, cifA and cifB, where cifB induces embryonic lethality, and cifA counteracts it. Recent investigations have unveiled intriguing facets of this system, including diverse cifB variants, prophage association in specific strains, copy number variation, and rapid component divergence, hinting at a complex evolutionary history. We utilized comparative genomics to systematically classify CIF systems, analyze their locus structure and domain architectures, and reconstruct their diversification and evolutionary trajectories. Our new classification identifies ten distinct CIF types, featuring not just versions present in Wolbachia, but also other intracellular bacteria, and eukaryotic hosts. Significantly, our analysis of CIF loci reveals remarkable variability in gene composition and organization, encompassing an array of diverse endonucleases, variable toxin domains, deubiquitinating peptidases (DUBs), prophages, and transposons. We present compelling evidence that the components within the loci have been diversifying their sequences and domain architectures through extensive, independent lateral transfers and interlocus recombination involving gene conversion. The association with diverse transposons and prophages, coupled with selective pressures from host immunity, likely underpins the emergence of CIF loci as recombination hotspots. Our investigation also posits the origin of CifB-REase domains from mobile elements akin to CR (Crinkler-RHS-type) effectors and Tribolium Medea1 factor, which is linked to another non-Mendelian genetic phenomenon. This comprehensive genomic analysis offers novel insights into the molecular evolution and genomic foundations of Wolbachia-mediated host reproductive control.
Deep low velocity layer in the sublithospheric mantle beneath India
Authors: Kumar M Ravi , Singh Arun , Saikia Dipankar
Published: August 2024

Globally, there is now a growing evidence for a low velocity layer in the deeper parts of the upper mantle, above the 410 km discontinuity (hereafter called LVL-410). The origin of this layer is primarily attributed to interaction of slabs or plumes with a hydrous mantle transition zone (MTZ) that results in dehydration melting induced by water transport upward out of the MTZ. However, the ubiquitous nature of this layer and its causative remain contentious. In this study, we use high quality receiver functions (RFs) sampling diverse tectonic units of the Indian subcontinent to identify Ps conversions from the LVL-410. Bootstrap and differential slowness stacking of RFs migrated to depth using a 3-D velocity model reveal unequivocal presence of a deep low velocity layer at depths varying from 290 to 400 km. This layer appears more pervasive and deeper beneath the Himalaya, where detached subducted slabs in the MTZ have been previously reported. Interestingly, the layer is shallower in plume affected regions like the Deccan Volcanic Province and Southern Granulite Terrane. Even though a common explanation does not appear currently feasible, our observations reaffirm deep low velocity layers in the bottom part of the upper mantle and add to the list of regions that show strong presence of such layers above the 410 km discontinuity.
#GlobalJustice?: Social Media, Pedagogy, and Activism
Authors: Le Bourdon Madeleine
Published: August 2024

This article addresses the evolvement of pedagogical content on global social injustices across social media during the COVID-19 pandemic. With increasing constraints on how we teach about injustices within formal educational settings, young people are increasingly turning to social media to obtain information on global challenges. Scholars have sought to evaluate particular political knowledge gained through social media and/or debate its effectiveness in mobilizing collective action. This research shifts our focus from such top-down evaluations of political knowledge and activism online to understand how those most active across social media engage with pedagogical content on social injustices. Drawing on focus groups with students aged 13–16 from four schools across the United Kingdom, the article will argue four key points: First, young people are extremely cautious about trusting information on social media; second, they are more likely to trust content from those they feel personally connected to; third, exposure to lived experience through social media creates affective learning and reflexive opportunities; and fourth, social media can provide a catalyst for further learning and activism.
Involving cognitive science in model transformation for description logics
Authors: Hieke Willi , Schwöbel Sarah , Smolka Michael N
Published: August 2024

Knowledge representation and reasoning (KRR) is a fundamental area in artificial intelligence (AI) research, focusing on encoding world knowledge as logical formulae in ontologies. This formalism enables logic-based AI systems to deduce new insights from existing knowledge. Within KRR, description logics (DLs) are a prominent family of languages to represent knowledge formally. They are decidable fragments of first-order logic, and their models can be visualized as edge- and vertex-labeled directed binary graphs. DLs facilitate various reasoning tasks, including checking the satisfiability of statements and deciding entailment. However, a significant challenge arises in the computation of models of DL ontologies in the context of explaining reasoning results. Although existing algorithms efficiently compute models for reasoning tasks, they usually do not consider aspects of human cognition, leading to models that may be less effective for explanatory purposes. This paper tackles this challenge by proposing an approach to enhance the intelligibility of models of DL ontologies for users. By integrating insights from cognitive science and philosophy, we aim to identify key graph properties that make models more accessible and useful for explanation.
Perceptions, prevalence, and patterns of cannabis use among cancer patients treated at 12 NCI-Designated Cancer Centers
Authors: Ellison Gary L , Helzlsouer Kathy J , Rosenfield Sonia M , Kim Yun , Ashare Rebecca L , Blaes Anne H , Cullen Jennifer , Doran Neal , Ebbert Jon O , Egan Kathleen M , Heffner Jaimee L , Lee Richard T , McClure Erin A , McDaniels-Davidson Corinne , Meghani Salimah H , Newcomb Polly A , Nugent Shannon , Hernandez-Ortega Nicholas , Salz Talya , Vidot Denise C , Worster Brooke , Zylla Dylan M
Published: August 2024

Background

The legal climate for cannabis use has dramatically changed with an increasing number of states passing legislation legalizing access for medical and recreational use. Among cancer patients, cannabis is often used to ameliorate adverse effects of cancer treatment. Data are limited on the extent and type of use among cancer patients during treatment and the perceived benefits and harms. This multicenter survey was conducted to assess the use of cannabis among cancer patients residing in states with varied legal access to cannabis.

Methods

A total of 12 NCI-Designated Cancer Centers, across states with varied cannabis-access legal status, conducted surveys with a core questionnaire to assess cannabis use among recently diagnosed cancer patients. Data were collected between September 2021 and August 2023 and pooled across 12 cancer centers. Frequencies and 95% confidence intervals for core survey measures were calculated, and weighted estimates are presented for the 10 sites that drew probability samples.

Results

Overall reported cannabis use since cancer diagnosis among survey respondents was 32.9% (weighted), which varied slightly by state legalization status. The most common perceived benefits of use were for pain, sleep, stress and anxiety, and treatment side effects. Reported perceived risks were less common and included inability to drive, difficulty concentrating, lung damage, addiction, and impact on employment. A majority reported feeling comfortable speaking to health-care providers though, overall, only 21.5% reported having done so. Among those who used cannabis since diagnosis, the most common modes were eating in food, smoking, and pills or tinctures, and the most common reasons were for sleep disturbance, followed by pain and stress and anxiety with 60%-68% reporting improved symptoms with use.

Conclusion

This geographically diverse survey demonstrates that patients use cannabis regardless of its legal status. Addressing knowledge gaps concerning benefits and harms of cannabis use during cancer treatment is critical to enhance patient-provider communication.
Milking Sterne’s Subscription Lists, and Extrapolations Therefrom
Authors: Walker Robert G
Published: August 2024

In the eighteenth century many books were published with lengthy lists of the names, at the front, or occasionally at the back, of those who subscribed to the publication. Scholars have sometimes turned to these lists to make a point about the author or work involved, but it is fair to say that there has never been a consistent attempt to identify and make use of the subscribers of a specific author until just recently, when the publication of an identification list of Laurence Sterne’s subscribers appeared as part of the Florida Edition of Sterne’s works. This article identifies several Sterne subscribers hitherto unidentified or under-identified, discusses techniques for doing so and pitfalls in such techniques, and, finally, makes a case for the usefulness of such identifications both to literary critics and to social historians interested in Sterne’s work.
Is quasar variability regulated by the close environment of accretion?
Authors: Wu Liang , Wang Jun-Xian , Ren Wen-Ke , Kang Wen-Yong
Published: August 2024

Ultraviolet (UV)/optical variability in quasars is a well-observed phenomenon, yet its primeval origins remain unclear. This study investigates whether the accretion disc turbulence, which is responsible for UV/optical variability, is influenced by the close environment of the accretion by analysing the correlation between variability and infrared emission for two luminous quasar samples from the Sloan Digital Sky Survey (SDSS). The first sample includes light curves from SDSS, Panoramic Survey Telescope and Rapid Response System (Pan-STARRS), and Zwicky Transient Facility g-band photometry, while the second sample utilizes SDSS Stripe 82 g-band light curves. We explore the correlation between the g-band excess variance ($\sigma _{\mathrm{ rms}}$) and the wavelength-dependent infrared covering factor ($L_{\rm IR}(\lambda)/L_{\rm bol}$), controlling for the effects of redshift, luminosity, and black hole mass. An anticorrelation between two variables is observed in both samples, which is strongest at wavelengths of 2–3 $\rm{\mu m}$ but gradually weakens towards longer wavelength. This suggests the equatorial dusty torus (which dominates near-infrared emission) plays a significant role in influencing the UV/optical variability, while the cooler polar dust (which contributes significantly to mid-infrared emission) does not. The findings indicate that quasar variability may be connected to the physical conditions within the dusty torus which feeds the accretion, and support the notion that the close environment of the accretion plays an important role in regulating the accretion disc turbulence.
HELLO project: high-z evolution of large and luminous objects
Authors: Waterval Stefan , Macciò Andrea V , Buck Tobias , Obreja Aura , Cho Changhyun , Jin Zehao , Davis Benjamin L , Dixon Keri L , Kang Xi
Published: August 2024

We present the High-z Evolution of Large and Luminous Objects (HELLO) project, a set of $\sim \!30$ high-resolution cosmological simulations aimed to study Milky Way analogues ($M_\star \sim 10^{10-11}$ ${\mathrm{M}}_{\odot }$) at high redshift ($z\sim [2-4]$). Based on the numerical investigation of a hundred astrophysical objects, HELLO features an updated scheme for chemical enrichment and the addition of local photoionization feedback. Independently of redshift and mass, our galaxies exhibit a smooth progression along the star formation main sequence until $M_\star \sim \!10^{10.5}$, around which our sample at $z \sim 4$ remains mostly unperturbed while the most massive galaxies at $z \sim 2$ reach their peak star formation rate (SFR) and its subsequent decline, due to a mix of gas consumption and stellar feedback. While active galactic nucleus feedback remains subdominant with respect to stellar feedback for energy deposition, its localized nature likely adds to the physical processes leading to declining SFRs. The phase in which a galaxy in our mass range can be found at a given redshift is set by its gas reservoir and assembly history. Finally, our galaxies are in excellent agreement with various scaling relations observed with the Hubble Space Telescope and the JWST, and hence can be used to provide the theoretical framework to interpret current and future observations from these facilities and shed light on the transition from star-forming to quiescent galaxies.
Kidney Blood Flow and Renin-Angiotensin-Aldosterone System Measurements Associated With Kidney and Cardiovascular Dysfunction in Pediatric Shock
Authors: Fisler Grace , Murphy Kristina , Mastroianni Fiore , Schneider James B. , Deutschman Clifford S. , Leisman Daniel E. , Taylor Matthew D.
Published: August 2024

IMPORTANCE:

Pediatric acute kidney injury (AKI) is a prevalent and morbid complication of shock. Its pathogenesis and early identification remain elusive.

OBJECTIVES:

We aim to determine whether renal blood flow (RBF) measurements by point-of-care ultrasound (POCUS) and renin-angiotensin-aldosterone system (RAAS) hormones in pediatric shock associate with vasoactive requirements and AKI.

DESIGN, SETTING, AND PARTICIPANTS:

This is a single-center prospective, noninterventional observational cohort study in one tertiary PICU in North American from 2020 to 2022 that enrolled children younger than 18 years with shock without preexisting end-stage renal disease.

MAIN OUTCOMES AND MEASURES:

RBF was measured by POCUS on hospital days 1 and 3 and plasma RAAS hormone levels were measured on day 1. The primary outcome was the presence of AKI by Kidney Disease Improving Global Outcomes criteria at first ultrasound with key secondary outcomes of creatinine, blood urea nitrogen (BUN), Vasoactive-Inotrope Score (VIS), and norepinephrine equivalent dosing (NED) 48 hours after first ultrasound.

RESULTS:

Fifty patients were recruited (20 with AKI, mean age 10.5 yr, 48% female). POCUS RBF showed lower qualitative blood flow (power Doppler ultrasound [PDU] score) and higher regional vascular resistance (renal resistive index [RRI]) in children with AKI (p = 0.017 and p = 0.0007). Renin and aldosterone levels were higher in the AKI cohort (p = 0.003 and p = 0.007). Admission RRI and PDU associated with higher day 3 VIS and NED after adjusting for age, day 1 VIS, and RAAS hormones. Admission renin associated with higher day 3 creatinine and BUN after adjusting for age, day 1 VIS, and the ultrasound parameters.

CONCLUSIONS AND RELEVANCE:

In pediatric shock, kidney blood flow was abnormal and renin and aldosterone were elevated in those with AKI. Kidney blood flow abnormalities are independently associated with future cardiovascular dysfunction; renin elevations are independently associated with future kidney dysfunction. Kidney blood flow by POCUS may identify children who will have persistent as opposed to resolving AKI. RAAS perturbations may drive AKI in pediatric shock.
Simulating the impact of greenspace exposure on metabolic biomarkers in a diverse population living in San Diego, California: A g-computation application
Authors: Teyton Anaïs , Nukavarapu Nivedita , Letellier Noémie , Sears Dorothy D. , Yang Jiue-An , Jankowska Marta M. , Benmarhnia Tarik
Published: August 2024

Introduction:

Growing evidence exists that greenspace exposure can reduce metabolic syndrome risk, a growing public health concern with well-documented inequities across population subgroups. We capitalize on the use of g-computation to simulate the influence of multiple possible interventions on residential greenspace on nine metabolic biomarkers and metabolic syndrome in adults (N = 555) from the 2014–2017 Community of Mine Study living in San Diego County, California.

Methods:

Normalized difference vegetation index (NDVI) exposure from 2017 was averaged across a 400-m buffer around the participants’ residential addresses. Participants’ fasting plasma glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride concentrations, systolic and diastolic blood pressure, hemoglobin A1c (%), waist circumference, and metabolic syndrome were assessed as outcomes of interest. Using parametric g-computation, we calculated risk differences for participants being exposed to each decile of the participant NDVI distribution compared to minimum NDVI. Differential health impacts from NDVI exposure by sex, ethnicity, income, and age were examined.

Results:

We found that a hypothetical increase in NDVI exposure led to a decrease in hemoglobin A1c (%), glucose, and high-density lipoprotein cholesterol concentrations, an increase in fasting total cholesterol, low-density lipoprotein cholesterol, and triglyceride concentrations, and minimal changes to systolic and diastolic blood pressure, waist circumference, and metabolic syndrome. The impact of NDVI changes was greater in women, Hispanic individuals, and those under 65 years old.

Conclusions:

G-computation helps to simulate the potential health benefits of differential NDVI exposure and identifies which subpopulations can benefit most from targeted interventions aimed at minimizing health disparities.
Influenced: Exploring the Effect of Social Media on Medical Students’ Perceptions of Plastic Surgery
Authors: Ford Aubree , Doherty Courtney , Vargo James D.
Published: August 2024

Background:

Medical students rarely receive dedicated education in plastic surgery, exposing them to influence from the internet or television programming that is frequently skewed toward cosmetic procedures. Additionally, social media posts from board-certified plastic surgeons make up a small portion of available content. These biased representations may impact students’ perceptions, narrowing the scope of referrals and limiting career exploration.

Methods:

Medical students at two academic medical centers were surveyed. Blinded data were collected on exposure to plastic surgery, social media usage, observed content, and perceptions of the specialty. Students’ understanding of plastic surgery was evaluated using clinical scenarios.

Results:

The response rate was 24.3%. Social media and television were the primary contributors to understanding of plastic surgery in 51.6% of students, especially for those who had not completed a surgical clerkship (P < 0.026). Students most frequently viewed plastic surgery content posted by influencers (28.1%), followed by board-certified plastic surgeons (24.1%), patients (21.2%), and nonplastic surgeon physicians (19.7%). Posts relating to cosmetic procedures (44.3%) were viewed most frequently. Students who followed board-certified plastic surgeons performed better when answering clinical vignettes (64.8% versus 50.9%).

Conclusions:

Social media and television play a significant role in medical students’ perceptions of plastic surgery. Students are also more likely to see posts from influencers than board-certified plastic surgeons, furthering potential bias. Quality content from board-certified surgeons and professional societies may improve scope of practice creep and student interest.
The Hierarchy of Needs: A Problem-based Framework for Extremity Reconstruction
Authors: Kareh Aurora M. , Souza Jason M.
Published: August 2024

Plastic and reconstructive surgeons continually evolve their surgical strategies with the aim of achieving the optimal patient outcome. Numerous well-known frameworks intended to guide reconstructive planning have been introduced and are entrenched in plastic surgery education, but are limited in their scope due to their procedure-based construct. Here, we introduce the hierarchy of reconstructive needs: a problem-based reconstructive framework that shifts operative planning to the specific needs of the defect and goals for restoration of normality while allowing for further innovation and evolution beyond our existing surgical capabilities.
Association between longitudinal biomarkers and major adverse liver outcomes in patients with non-cirrhotic metabolic dysfunction–associated steatotic liver disease
Authors: Shang Ying , Akbari Camilla , Dodd Maja , Zhang Xiao , Wang Tongtong , Jemielita Thomas , Fernandes Gail , Engel Samuel S. , Nasr Patrik , Vessby Johan , Rorsman Fredrik , Kechagias Stergios , Stål Per , Ekstedt Mattias , Hagström Hannes
Published: August 2024

Background and Aims:

Noninvasive biomarkers provide prognostic information for the development of major adverse liver outcomes (MALOs) in patients with metabolic dysfunction–associated steatotic liver disease (MASLD), but the predictive value of longitudinal biomarker measurements has not been evaluated. We assessed whether changes in biomarkers could predict incident MALO in MASLD.

Approach and Results:

We analyzed a cohort of 1260 patients (71.7% on biopsy) with non-cirrhotic MASLD between 1974 and 2019. Data at baseline and follow-up visits were obtained from medical charts. MALO was determined through medical charts and linkage to national registers until the end of 2020. A joint modeling approach was used to quantify the associations between the trajectory of biomarkers and the risk of MALO. MASLD was diagnosed at a median age of 52 years (IQR: 39–60), and 59% were male. During a median follow-up of 12.2 years, 111 (8.8%) patients developed MALO. The joint modeling showed that an elevated fibrosis-4 score (HR: 2.60, 95% CI: 1.89–3.50), aspartate aminotransferase (HR: 2.69, 95% CI: 2.57–3.05), and lower platelet count (HR: 0.93, 95% CI: 0.90–0.97) at any time point were associated with an increased risk of MALO, whereas the rate of change in these biomarkers had no association with this risk.

Conclusions:

In addition to baseline measurements of noninvasive biomarkers such as fibrosis-4 score, aspartate aminotransferase, and platelets taken at MASLD diagnosis, monitoring their values over time is important, as the latest value of these biomarkers is closely associated with the risk of future MALO. The rate of change may not be as important.
The TBI Model Systems Neighborhood Socioeconomic Disadvantage Index (TBIMS-NSDI): Development and Comparison to Individual Socioeconomic Characteristics
Authors: Kumar Raj G. , Delgado Andrew , Corrigan John D. , Eagye CB , Whiteneck Gale G. , Juengst Shannon B. , Callender Librada , Bogner Jennifer A. , Pinto Shanti M. , Rabinowitz Amanda R. , Perrin Paul B. , Venkatesan Umesh M. , Botticello Amanda L. , Lequerica Anthony H. , Taylor Shameeke , Zafonte Ross D. , Dams-O’Connor Kristen
Published: August 2024

Objective:

To create a census-based composite neighborhood socioeconomic deprivation index (NSDI) from geocoded residential addresses and to quantify how NSDI aligns with individual-level socioeconomic factors among people with traumatic brain injury (TBI).

Setting:

Community

Participants:

People enrolled in the TBI Model Systems National Database (TBIMS NDB).

Design:

Secondary analysis of a longitudinal cohort study.

Main Measures:

The TBIMS-NSDI was calculated at the census tract level for the United States population based on a principal components analysis of eight census tract-level variables from the American Community Survey. Individual socioeconomic characteristics from the TBIMS NDB were personal household income, education (years), and unemployment status. Neighborhood:Individual NSDI residuals represent the difference between predicted neighborhood disadvantage based on individual socioeconomic characteristics versus observed neighborhood disadvantage based on the TBIMS-NSDI.

Results:

A single principal component was found to encompass the eight socioeconomic neighborhood-level variables. It was normally distributed across follow-up years 2, 5, and 10 post-injury in the TBIMS NDB. In all years, the TBIMS-NDSI was significantly associated with individual-level measures of household income and education but not unemployment status. Males, persons of Black and Hispanic background, Medicaid recipients, persons with TBI caused by violence, and those living in urban areas, as well as in the Northeast or Southern regions of the United States, were more likely to have greater neighborhood disadvantage than predicted based on their individual socioeconomic characteristics.

Conclusions:

The TBIMS-NSDI provides a neighborhood-level indicator of socioeconomic disadvantage, an important social determinant of outcomes from TBI. The Neighborhood:Individual NSDI residual adds another dimension to the TBIMS-NSDI by summarizing how a person’s socioeconomic status aligns with their neighborhood socioeconomics. Future studies should evaluate how both measures affect TBI recovery and life quality. Research studying neighborhood socioeconomic disadvantage may improve our understanding of how systemic adversity influences outcomes after TBI.
Nursing Recommendations for Symptom-Specific Self-care of Low Anterior Resection Syndrome
Authors: Solnica Amy , Liebergall-Wischnitzer Michal , Shussman Noam
Published: August 2024

Background

Low anterior resection syndrome (LARS) is a result of removing part or most of the rectum as a treatment for rectal cancer that negatively impacts quality of life. There is a lack of standardized nursing symptom-specific self-care recommendations for patients suffering from LARS.

Objective

The aim of this study was to map the existing research regarding nursing guidelines and symptom-specific recommendations for LARS self-care.

Methods

A systematic scoping review using 4 comprehensive databases (ProQuest, EMBASE, PubMed, and Web of Science) was completed using the PRISMA Extension for Scoping Reviews guidelines. Applying specified search terms, relevant articles were extracted using criteria and entered into an Excel database.

Results

Three publications met the study inclusion criteria: 1 randomized controlled pilot study; 1 nonrandomized, retrospective pilot study; and 1 retrospective, comparative, cross-sectional study. No professional nursing guidelines were found, but 3 nurse-led management programs were reviewed. Publications provided self-care nursing recommendations for all LARS symptoms except for repeated painful stools/tenesmus, soiling, or discrimination disorders/flatulence. Combination of nursing self-care recommendations included dietary/lifestyle modifications, fiber supplements/bulking agents, antidiarrheal and laxative over-the-counter medications, and pelvic floor muscle exercises.

Conclusions

When mapping the literature, there appears to be nurse-led management programs and recommendations for self-care for patients with LARS for almost all symptoms. Yet, there are no standardized recommendations.

Implications for Practice

Professional nursing practice guidelines for all symptoms are lacking. Nursing recommendations for self-care of LARS exist and need to be expanded and standardized to include all symptoms. Further research regarding comprehensive nursing self-care recommendations and management is warranted.
Transcutaneous vagus nerve stimulation effects on chronic pain: systematic review and meta-analysis
Authors: Costa Valton , Gianlorenço Anna Carolyna , Andrade Maria Fernanda , Camargo Lucas , Menacho Maryela , Arias Avila Mariana , Pacheco-Barrios Kevin , Choi Hyuk , Song Jae-Jun , Fregni Felipe
Published: August 2024

Chronic pain is one of the major causes of disability with a tremendous impact on an individual's quality of life and on public health. Transcutaneous vagus nerve stimulation (tVNS) is a safe therapeutic for this condition. We aimed to evaluate its effects in adults with chronic pain. A comprehensive search was performed, including randomized controlled trials published until October 2023, which assessed the effects of noninvasive tVNS. Cohen's d effect size and 95% confidence intervals (CIs) were calculated, and random-effects meta-analyses were performed. Fifteen studies were included. The results revealed a mean effect size of 0.41 (95% CI 0.17-0.66) in favor of tVNS as compared with control, although a significant heterogeneity was observed (χ2 = 21.7, df = 10, P = 0.02, I
2 = 53.9%). However, when compared with nonactive controls, tVNS shows a larger effect size (0.79, 95% CI 0.25-1.33), although the number of studies was small (n = 3). When analyzed separately, auricular tVNS and cervical tVNS against control, it shows a significant small to moderate effect size, similar to that of the main analysis, respectively, 0.42 (95% CI 0.08-0.76, 8 studies) and 0.36 (95% CI 0.01-0.70, 3 studies). No differences were observed in the number of migraine days for the trials on migraine. This meta-analysis indicates that tVNS shows promise as an effective intervention for managing pain intensity in chronic pain conditions. We discuss the design of future trials to confirm these preliminary results, including sample size and parameters of stimulation.
Babesiosis in immunosuppressed hosts: pathogenesis, diagnosis and management
Authors: Heller Howard M.
Published: August 2024

Purpose of review

This review provides the most recent evidence of the challenges that occur in the management of babesiosis in immunocompromised hosts.

Recent findings

The epidemiology of babesiosis is affected by climate change leading to increasing numbers of cases as well as increasing areas of endemicity. Immunosuppressed hosts, especially with asplenia or B-cell defects, are at high risk of having severe disease as well as persistent and relapsed infection. Resistance to the primary therapies azithromycin and atovaquone can develop leading to further challenges in treating persistent or relapsed disease in the immunocompromised host.

Babesiosis is likely to become a more frequent infectious complication in immunosuppressed hosts as the areas of endemicity expand. Reduced efficacy of standard therapies is likely to continue emerging so more effort needs to be placed on methods of assessing resistance in vitro and developing more reliable treatments for resistant infections.
The Impact of Low Workplace Support During Pregnancy on Surgeon Distress and Career Dissatisfaction
Authors: Lwin Thinzar M. , Castillo-Angeles Manuel , Cunningham Carrie E. , Atkinson Rachel B. , Kim Eugene , Easter Sarah Rae , Gosain Ankush , Hu Yue-Yung , Rangel Erika L
Published: August 2024

Objective:

To describe the impact of lack of workplace support (LOWS) for obstetric health on surgeon distress and career satisfaction.

Background:

Although most pregnant surgeons desire clinical duty reductions to mitigate obstetric risk, few modify their schedules due to low workplace support.

Methods:

US surgeons with at least one live birth completed an electronic survey. LOWS during pregnancy was defined as (1) disagreeing that colleagues/leadership were supportive of obstetric-mandated bedrest; (2) feeling unable to reduce clinical duties despite health concerns due to risk of financial penalties, requirement to make up missed call shifts, being perceived as “weak”, burdening colleagues, or accommodations being denied by the workplace. Multivariate logistic regression determined the association between LOWS and burnout, low quality of life, plans to leave clinical practice or to reduce work hours, and likelihood of recommending a surgical career to one’s child.

Results:

Of 557 surgeons, the 360 (64.6%) who reported LOWS during pregnancy were more likely to report burnout (OR:2.57; 95%CI:1.60-4.13), low quality of life (OR:1.57; 95%CI:1.02-2.41), a desire to leave their practice (OR:2.74; 95%CI: 1.36-5.49), plans to reduce clinical hours in the next year (OR:4.25; 95%CI:1.82-9.90), and were less likely to recommend their career to their child (OR:0.44; 95%CI:0.28-0.70).

Conclusions:

LOWS for maternal-fetal health concerns is associated with burnout, low quality of life, and career dissatisfaction. The work environment is a modifiable factor requiring system-level interventions to limit clinical work during pregnancy and provide fair compensation for covering surgeons. Supporting surgeons during pregnancy is a short-term investment with long-term implications for improving longevity and diversity of the workforce.
A rapid on-site loop-mediated isothermal amplification technology as an early warning system for the detection of Shiga toxin-producing Escherichia coli in water
Authors: Alfahl Zina , Biggins Sean , Higgins Owen , Chueiri Alexandra , Smith Terry J. , Morris Dearbháile , O'Dwyer Jean , Hynds Paul D. , Burke Liam P. , O’Connor Louise
Published: August 2024

Shiga toxin-producing Escherichia coli (STEC) is an important waterborne pathogen capable of causing serious gastrointestinal infections with potentially fatal complications, including haemolytic–uremic syndrome. All STEC serogroups harbour genes that encode at least one Shiga toxin (stx1 and/or stx2), which constitute the primary virulence factors of STEC. Loop-mediated isothermal amplification (LAMP) enables rapid real-time pathogen detection with a high degree of specificity and sensitivity. The aim of this study was to develop and validate an on-site portable diagnostics workstation employing LAMP technology to permit rapid real-time STEC detection in environmental water samples. Water samples (n=28) were collected from groundwater wells (n=13), rivers (n=12), a turlough (n=2) and an agricultural drain (n=1) from the Corrib catchment in Galway. Water samples (100 ml) were passed through a 0.22 µm filter, and buffer was added to elute captured cells. Following filtration, eluates were tested directly using LAMP assays targeting stx1, stx2 and E. coli phoA genes. The portable diagnostics workstation was used in field studies to demonstrate the on-site testing capabilities of the instrument. Real-time PCR assays targeting stx1 and stx2 genes were used to confirm the results. The limit of detection for stx1, stx2 and phoA LAMP assays were 2, 2 and 6 copies, respectively. Overall, stx1, stx2 and phoA genes were detected by LAMP in 15/28 (53.6 %), 9/28 (32.2 %) and 24/28 (85.7 %) samples, respectively. For confirmation, the LAMP results for stx1 and stx2 correlated perfectly (100 %) with those obtained using PCR. The portable diagnostics workstation exhibited high sensitivity throughout the on-site operation, and the average time from sample collection to final result was 40 min. We describe a simple, transferable and efficient diagnostic technology for on-site molecular analysis of various water sources. This method allows on-site testing of drinking water, enabling evidence-based decision-making by public health and water management authorities.
Dynamic adaptation to novelty in the brain is related to arousal and intelligence
Authors: Tanner Jacob Colby , Faskowitz Joshua , Kennedy Daniel P , Betzel Richard
Published: August 2024

How does the human brain respond to novelty? Here, we address this question using fMRI data wherein human participants watch the same movie scene four times. On the first viewing, this movie scene is novel, and on later viewings it is not. We find that brain activity is lower-dimensional in response to novelty. At a finer scale, we find that this reduction in the dimensionality of brain activity is the result of increased coupling in specific brain systems, most specifically within and between the control and dorsal attention systems. Additionally, we found that novelty induced an increase in between-subject synchronization of brain activity in the same brain systems. We also find evidence that adaptation to novelty, herein operationalized as the difference between baseline coupling and novelty-response coupling, is related to fluid intelligence. Finally, using separately collected out-of-sample data, we find that the above results may be linked to psychological arousal.
Cortical Complexity Alterations in Motor Subtypes of Parkinson's Disease: A Surface-Based Morphometry Analysis of Fractal Dimension
Authors: Dehghan Yousef , Sarbaz Yashar
Published: August 2024

Background: Based on motor symptoms, Parkinson's disease (PD) can be classified into tremor dominant (TD) and postural instability gait difficulty (PIGD) subtypes. This study aimed to investigate differences in cortical complexity and gray matter volume (GMV) between TD and PIGD. Methods: We enrolled 36 TD patients, 27 PIGD patients, and 66 healthy controls (HC) from the PPMI (Parkinson's Progression Markers Initiative) database. Voxel-based morphometry (VBM) and surface-based morphometry (SBM) were utilized to assess differences in GMV, cortical thickness, and cortical complexity. Additionally, correlations between clinical data and structural changes were examined. Results: In comparison with HCs, PIGD patients exhibited a significant fractal dimension (FD) decrease in many cortical regions, such as the bilateral insula, right superior temporal, and left rostral middle frontal. Moreover, PIGD patients showed significant FD reduction in various regions, including the left supramarginal gyrus, left lateral orbitofrontal gyrus, right superior temporal gyrus, left lateral occipital gyrus, and bilateral insula, compared to the TD group. A significant negative correlation between age and FD was observed in the left insula for the PIGD patients and in the bilateral insula for the TD patients. However, no significant differences were found in GMV, cortical thickness, or other complexity indices. Conclusion: Altered FD, particularly in bilateral insula, indicates that postural instability and gait disturbances in PD may result from a failure to integrate information from various structures, whereas parkinsonian tremor is not associated with this integration.
Reflected entropy and timelike entanglement in
TT¯
-deformed
CFT2s
Authors: Basu Debarshi , Raj Vinayak
Published: August 2024

We develop a covariant formalism to investigate the mixed state entanglement between time-dependent boosted subsystems in TT¯-deformed CFT2s through the reflected entropy. To this end we utilize a conformal perturbation theory to obtain the Rényi reflected entropy through the partition function on the replica manifold. The correction to the reflected entropy to the first order in the deformation parameter μ is then obtained in the replica limit for finite temperature and finite-sized systems. We further perform an analytic continuation of our results to obtain the reflected entropy for timelike subsystems in such TT¯-deformed CFT2s. We verify our field theoretic computations for both spacelike and timelike subsystems by obtaining the dual EWCS in the corresponding bulk cutoff AdS3 geometries and find perfect agreement between the two.

Published by the American Physical Society
2024
Financial innovation and gender dynamics: a comparative study of male and female FinTech adoption in emerging economies
Authors: Kumar Jitender , Rani Vinki
Published: August 2024

Purpose

This paper aims to identify the factors influencing the adoption of financial technology (FinTech) services among Indian residents. Moreover, it compares the awareness levels among both male and female users to offer a comprehensive insight into FinTech adoption.

Design/methodology/approach

The research comprises two cross-sectional surveys utilizing self-administered questionnaires: Study A involves 411 male participants and Study B involves 473 female users in FinTech adoption. This article used a “Statistical Package for Social Science (SPSS) followed by partial least squares-structural equation modeling (PLS-SEM)” for data analysis.

Findings

The exciting finding reveals that attitude and personal innovativeness have a significant impact, while technology anxiety shows a statistically insignificant impact on awareness in both studies. Surprisingly, the socio-demographic factor significantly impacts awareness (in Study A) and has an insignificant impact on awareness in Study B. Moreover, both studies reveal that awareness significantly impacts perceived usefulness and ease of use. Additionally, the outcomes confirm a positive relation between awareness, perceived usefulness, ease of use and FinTech adoption in both studies.

Practical implications

The present research will offer valuable insights to all FinTech service providers and stakeholders, aiding them in planning and designing relevant policies.

Originality/value

As far as the researchers are aware, this study stands as the initial survey into FinTech that specifically examines the impact of gender on technology adoption. The divergence in awareness and adoption rates between males and females and the authors’ insightful findings illuminate the context's uniqueness. Moreover, this article offers a robust model for using FinTech services from the perspective of a developing economy.
Entrepreneurial orientation and product innovation performance: developing the linkages through strategic human resource management and technology capability
Authors: Abdelwahed Nadia A. Abdelmegeed , Al Doghan Mohammed A. , Shah Naimatullah , Soomro Bahadur Ali
Published: August 2024

Purpose

The optimization of product innovation performance (PIP) is paramount to achieving sustained profitability in the face of current organizational challenges. In this study, as researchers, the authors investigate within the context of Saudi Arabian manufacturing firms’ entrepreneurial orientation (EO) direct impact on PIP and its indirect influence mediated by strategic human resource management (SHRM) and technology capability (TC).

Design/methodology/approach

This co-relational study used cross-sectional data. The authors collected the data from the manufacturing firms’ top management team, chief executive officers and other staff members, including human resource (HR) managers and chief information officers. This study’s conclusions are based on 307 cases.

Findings

Using SmartPLS4, this study’s findings demonstrate that EO exerts a positive and significant impact on SHRM, PIP and TC. SHRM has a positive and significant effect on PIP. In addition, TC is a positive and significant predictor of SHRM but not PIP. Turning to the mediating impacts, SHRM plays a positive mediating role between TC and PIP and a negative role between EO and PIP. Finally, TC reinforces the negative connections between EO and PIP.

Practical implications

This study's insights offer valuable guidance to firms and policymakers. They underscore the importance of investing in TC to reinforce SHRM and drive innovation. Moreover, these findings emphasize the need for firms to adopt a dynamic approach that comprises continuous monitoring, adaptation and tailored HR strategies supported by performance metrics. This proactive stance ensures that innovation remains a consistent and impactful element of their long-term strategy.

Originality/value

This study stands out by addressing existing gaps through its innovative integration of EO, SHRM, TC and PIP within a unified framework. It does so within the specific context of Saudi Arabian manufacturing firms and provides a unique and contextually relevant perspective that contributes to the knowledge body of the area.