bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic exposure to polycyclic aromatic hydrocarbons alters skin virome composition and virus–host interactions
Authors: Du Shicong , Tong Xinzhao , Leung Marcus H Y , Betts Richard J , Woo Anthony C , Bastien Philippe , Misra Namita , Aguilar Luc , Clavaud Cécile , Lee Patrick K H
Published: October 2024

Exposure to polycyclic aromatic hydrocarbons (PAHs) in polluted air influences the composition of the skin microbiome, which in turn is associated with altered skin phenotypes. However, the interactions between PAH exposure and viromes are unclear. This study aims to elucidate how PAH exposure affects the composition and function of skin viruses, their role in shaping the metabolism of bacterial hosts, and the subsequent effects on skin phenotype. We analyzed metagenomes from cheek skin swabs collected from 124 Chinese women in our previous study and found that the viruses associated with the two microbiome cutotypes had distinct diversities, compositions, functions, and lifestyles following PAH exposure. Moreover, exposure to high concentrations of PAHs substantially increased interactions between viruses and certain biodegrading bacteria. Under high-PAH exposure, the viruses were enriched in xenobiotic degradation functions, and there was evidence suggesting that the insertion of bacteriophage-encoded auxiliary metabolic genes into hosts aids biodegradation. Under low-PAH exposure conditions, the interactions followed the “Piggyback-the-Winner” model, with Cutibacterium acnes being “winners,” whereas under high-PAH exposure, they followed the “Piggyback-the-Persistent” model, with biodegradation bacteria being “persistent.” These findings highlight the impact of air pollutants on skin bacteria and viruses, their interactions, and their modulation of skin health. Understanding these intricate relationships could provide insights for developing targeted strategies to maintain skin health in polluted environments, emphasizing the importance of mitigating pollutant exposure and harnessing the potential of viruses to help counteract the adverse effects.
Evaluation of antibiotics returned for safe disposal during and after a community pharmacy antibiotic amnesty campaign
Authors: Hamilton Ryan A , Ercolani Marco G , Aggarwal Rakhi , Cooper Donna , Kelly Sam , Root Helen , Pabari Kunjal , Jamieson Conor
Published: October 2024

Background

Community pharmacies in England offer convenient and safe disposal of unwanted medicines, including antimicrobials, and better uptake of this service could limit environmental antimicrobial resistance. However, there is limited information on the extent and nature of antibiotic returns to community pharmacies. The impact of an antibiotic amnesty campaign promoting antibiotic disposal through community pharmacies was evaluated with the intention of collecting detailed information on the antibiotics returned.

Methods

An antibiotic amnesty campaign was delivered by community pharmacies in the Midlands (England) with an audit of returned antibiotics conducted in 19 community pharmacies in Leicestershire. Detailed information on antibiotics returned for disposal was gathered during the month-long amnesty campaign and again 3 months later in the same pharmacies.

Results

Antibiotics accounted for 3.12%–3.35% of all returned medicines. The amnesty campaign led to a significant increase in defined daily doses of returned antibiotics compared to the post-amnesty period (P = 0.0165), but there was no difference in the overall number of returned medicines. Penicillins were the most commonly returned antibiotics in both periods (29.3% and 42.5% of packs, respectively), while solid oral dose formulations predominated. A total of 36.6% of antibiotics returned during the amnesty period were expired, increasing to 53.4% in the post-amnesty period. Amnesty conversations had a significant impact on the number of antibiotic returns but campaign posters did not.

Conclusions

Antibiotic conversations can increase the amount of antibiotics returned to community pharmacies for safe disposal, and passive campaign materials had limited impact. More research is needed to identify the most effective interventions to increase returns.
Energy and nutrient recovery from municipal and industrial waste and wastewater—a perspective
Authors: Rachbauer Lydia , Granda Cesar B , Shrestha Shilva , Fuchs Werner , Gabauer Wolfgang , Singer Steven W , Simmons Blake A , Urgun-Demirtas Meltem
Published: October 2024

This publication highlights the latest advancements in the field of energy and nutrient recovery from organics rich municipal and industrial waste and wastewater. Energy and carbon rich waste streams are multifaceted, including municipal solid waste, industrial waste, agricultural by-products and residues, beached or residual seaweed biomass from post-harvest processing, and food waste, and are valuable resources to overcome current limitations with sustainable feedstock supply chains for biorefining approaches. The emphasis will be on the most recent scientific progress in the area, including the development of new and innovative technologies, such as microbial processes and the role of biofilms for the degradation of organic pollutants in wastewater, as well as the production of biofuels and value-added products from organic waste and wastewater streams. The carboxylate platform, which employs microbiomes to produce mixed carboxylic acids through methane-arrested anaerobic digestion, is the focus as a new conversion technology. Nutrient recycling from conventional waste streams such as wastewater and digestate, and the energetic valorization of such streams will also be discussed. The selected technologies significantly contribute to advanced waste and wastewater treatment and support the recovery and utilization of carboxylic acids as the basis to produce many useful and valuable products, including food and feed preservatives, human and animal health supplements, solvents, plasticizers, lubricants, and even biofuels such as sustainable aviation fuel.

One-Sentence Summary

Multifaceted waste streams as the basis for resource recovery are essential to achieve environmental sustainability in a circular economy, and require the development of next-generation waste treatment technologies leveraging a highly adaptive mixed microbial community approach to produce new biochemicals, biomaterials, and biofuels from carbon-rich organic waste streams.
The View from (T)Here: Perspectives on Security
Authors: Crawford Kerry F , Andersen-Rodgers David
Published: October 2024

The field of security studies largely focuses its gaze on the security provider without consideration of how security practice is perceived as legitimate by those it is meant to protect. This article presents a framework for categorizing how security is understood based on two viewpoints: first, the core responsibility of the state for providing protection and, second, the universality of rights beyond one’s core identity group. These two angles shape a person’s worldview, which then informs how different forms of security practice are seen as legitimate by those who constitute the referent object of that practice. In this article, we offer security studies scholars and practitioners a sorting tool that categorizes these worldviews in four ways: statist, federalist, nativist, and cosmopolitan. We examine each of these four categories and discuss how each perspective shapes practice by so-called security providers and the legitimacy of that practice by referent populations. We introduce four illustrative examples that demonstrate how these perspectives operate in practice. Finally, we discuss the implications of varied security perspectives as they relate to the current global security architecture.
Evolution of H α equivalent widths from z ∼ 0.4 - 2.2: implications for star formation and legacy surveys with Roman and Euclid
Authors: Khostovan A A , Malhotra S , Rhoads J E , Sobral D , Harish S , Tilvi V , Coughlin A , Rezaee S
Published: October 2024

Past studies have investigated the evolution in specific star formation rate (sSFR) and its observational proxy (H $\alpha$ equivalent width; EW) up to $z \sim 6$; however, such measurements may overestimate the typical sSFR/EW at a given redshift due to selection effects. We investigate the ‘intrinsic’ (selection and observational effects corrected) H $\alpha$ EW distributions of $z \sim 0.4 - 2.2$ narrowband-selected H $\alpha$ samples from High-z Emission Line Survey (HiZELS) and Deep and Wide Narrowband survey (DAWN) using a forward modelling approach where we assume an ‘intrinsic’ exponential EW distribution, apply selection and filter effects, and compare with observed H $\alpha$ EW distributions. We find an ‘intrinsic’ EW–stellar mass anticorrelation, EW$_0 \propto M^\gamma$, with steepening slopes $\gamma = -0.18\pm 0.03$ to $-0.24^{+0.06}_{-0.08}$ at $z \sim 0.4$ and $z\sim 2.2$, respectively. At $10^{10}$ M$_\odot$, we find EW$_0 \propto (1+z)^{1.78^{+0.22}_{-0.23}}$ and a steeper evolution with decreasing stellar mass highlighting the high EW nature of low-mass, high-z systems. We model this redshift evolving EW–stellar mass anticorrelation, $W_0(M,z)$, and find it produces H $\alpha$luminosity and SFR functions strongly consistent with observations. Our $W_0(M,z)$ model suggests EW$_{\mathrm{0}}$$> 200$ Å emitters contribute $\sim 40$ per cent to overall cosmic SF at $z \sim 1.5 - 2$, consistent with sSFR $\gt 10^{-8.5}$ yr$^{-1}$ (makes up $\sim 45 - 55$ per cent of cosmic SF at $z \sim 2$) and highlights the importance of high EW systems at high-z. Our $W_0(M,z)$ model also reproduces the cosmic sSFR evolution found in both simulations and observations (including selection limits), such that selection effects in observations may explain the disagreement. Lastly, we forecast Roman and Euclid grism surveys using our $W_0(M,z)$ model including limiting resolution and observational efficiency effects. We predict $\sim 24\,000$ and $\sim 30\,000$$0.5 < z < 1.9$ H $\alpha$ emitters per deg$^{-2}$, respectively, down to $F_{\rm {H\alpha }+\rm {[N{{\small II}}]}} > 5\times 10^{-17}$ erg s$^{-1}$ cm$^{-2}$ including $10^{7.2 - 8}$ M$_\odot$ galaxies at $z > 1$ with EW$_{\mathrm{0}}$$> 1000$ Å. Both Roman and Euclid will observe some of the most bursty/high EW, low-mass star-forming galaxies near cosmic noon in unprecedented detail.
Factors Associated With Death at 30 Days and Evaluation of Clinical Risk Scores Among Patients With Cancer Admitted With Postchemotherapy Infection in Uganda: A Prospective Cohort Study
Authors: Jacinta Ojia Ambaru , Lyon Sophie E , Birungi Jane Francis , Owomugisha Catherine , Muhindo Rose , Sekitene Semei Buwambaza , Moore Christopher C , Nuwagira Edwin
Published: October 2024

Background

Little is known about outcomes from cancer chemotherapy–-associated infections in sub-Saharan Africa. Accordingly, among patients with cancer admitted with postchemotherapy infection in Mbarara, Uganda, we aimed to determine (1) the 30-day case fatality rate, (2) factors associated with mortality rate, and (3) clinical risk score performance.

Methods

We enrolled participants aged ≥18 years if they (1) received cancer chemotherapy within the past 30 days, (2) were admitted to the oncology ward, and (3) were prescribed intravenous antibiotics. We used Cox proportional hazards regression to determine predictors of death at 30 days and calculated the area under the receiver operating characteristic curve (AUC) for each clinical risk score.

Results

Among 150 participants, 67 (45%) were female, and the median (interquartile range) age was 56 (43–66) years. Esophageal cancer (18%) and pneumonia (42%) were the most common cancer and infection, respectively. Death occurred within 30 days in 63 participants (42%). Quick Sequential Organ Failure Assessment (qSOFA) score ≥2 (adjusted hazard ratio, 2.51 [95% confidence interval, 1.42–4.44]; P = .001), and Universal Vital Assessment (UVA) score >4 (2.13 [.08–4.18, P = .03) were independently associated with death at 30 days. An Eastern Cooperative Oncology Group (ECOG) score ≥3 was similarly independently associated with death at 30 days in the qSOFA and UVA models. The AUCs for qSOFA and UVA scores were 0.70 (95% confidence interval, .63–.79) and 0.72 (.64–.80), respectively.

Conclusions

In participants with postchemotherapy infection in Mbarara, Uganda, the case fatality rate was high. ECOG, qSOFA, and UVA scores were associated with death at 30 days.
Feasibility and acceptability of a digital tool to support community-based screening for COVID-19 and other priority medical conditions across rural and peri-urban communities in Guinea
Authors: Diallo Nasser , Bobo Mamadou , Diallo Aboubacar , Baldé Abdoul Karim , Bah Alpha Oumar , Kourouma Mamady , Cisse Mamady , Banks Nick , Kadam Rigveda , Suleiman Khairunisa , Akugizibwe Paula
Published: October 2024

Access to primary healthcare, including diagnostic testing, is limited in Guinea, particularly for low-income residents of rural communities. Here we share findings from an interventional operational research study evaluating the feasibility of deploying a digital tool and rapid diagnostic tests to support community-based testing for priority medical conditions across three rural and peri-urban communities in Guinea. An existing web-based application was modified to include integrated symptom screening for malaria and COVID-19, maximize workflow efficiency and conduct end-to-end data capture on tablet devices. Using the application, community health workers screened participants for symptoms of malaria and COVID-19, with eligible participants tested using rapid diagnostic tests. All participants also underwent blood pressure and blood glucose measurements, while malnutrition screening was offered to pregnant women or children under 5 years. Services were provided to residents through mass consultations and home care visits across the study locations. The intervention reached 5204 people overall, with 3241 people enrolled via the application. 32.4% and 15.8% of participants had elevated blood pressure and blood glucose levels, the majority of whom were previously undiagnosed. Of those tested for malaria, 3.2% (n = 28/876) tested positive. The digital tool was successful in providing end-to-end data capture, with 99% of participants having their rapid diagnostic test results captured in real-time, and all outcomes reported into the Ministry of Health database. Together, the study demonstrates the feasibility of using a web-based digital tool to support community health workers with providing community-based diagnostic services in rural and peri-urban communities in a low-resource setting.
Comparing ministerial evidence cultures: a quantitative analysis
Authors: Christensen Johan , Hesstvedt Stine
Published: October 2024

Evidence-informed policy-making is seen by many as crucial for formulating effective solutions to the complex challenges facing societies today. However, scholarship on evidence and policy-making has repeatedly noted that the use of evidence in government policy-making is highly uneven across policy areas and organizations. Still, we have surprisingly little systematic empirical knowledge about how government organizations actually differ in the use of evidence in policy formulation, and we lack a solid understanding of what accounts for differences across organizations in evidence use. The article seeks to address these knowledge gaps through an analysis of ministerial evidence cultures. Arguing that the government bureaucracy is not a unified entity but rather a collection of organizations with distinct world views and ways of doing things, we expect to find distinct evidence cultures in different government ministries. Moreover, we contend that the informal norms and practices of evidence use leave empirically traceable marks that can be examined quantitatively across ministries. The article maps evidence cultures across all Norwegian government ministries in the period 2000–2020 based on data on ministries’ commissioning of research reports, appointment of experts to advisory commissions, and references to knowledge sources in white papers, revealing striking and systematic differences in evidence cultures across ministries. It also empirically investigates how different evidence cultures are related to institutional differences in task environment, analytical capacity, and personnel. The article contributes both to literature on evidence and policy-making and to public administration scholarship.
Asking about Complex Policies
Authors: Jessee Stephen , Malhotra Neil , Sen Maya
Published: October 2024

As political issues have increased in complexity, public opinion researchers increasingly ask respondents about sophisticated political topics that may require substantive knowledge and analytic skills, raising concerns about survey satisficing. In this note, we examine the correlates of one manifestation of this kind of satisficing—response order effects, or when respondents are more likely to pick the top response options from a list. We do this by analyzing randomized response order experiments embedded in surveys conducted across three years, where 6,291 respondents provided their opinion on 40 complex issues before the Supreme Court. We find an overall response order effect of 2.8 percentage points with substantial heterogeneity related to both question length and respondent knowledge. These factors also interact with one another; among the most sensitive subpopulation—low-knowledge respondents answering long questions—the predicted response order effect was 17.4 percentage points. On the other hand, question complexity and respondent education did not moderate response order effects. Our practical advice for researchers asking about complex issues is that they should focus on being brief, rather than using extra words to make the language simpler.
JMJD1C forms condensate to facilitate a RUNX1-dependent gene expression program shared by multiple types of AML cells
Authors: Chen Qian , Wang Saisai , Zhang Juqing , Xie Min , Lu Bin , He Jie , Zhen Zhuoran , Li Jing , Zhu Jiajun , Li Rong , Li Pilong , Wang Haifeng , Vakoc Christopher R , Roeder Robert G , Chen Mo
Published: October 2024

JMJD1C (Jumonji Domain Containing 1C), a member of the lysine demethylase 3 (KDM3) family, is universally required for the survival of several types of acute myeloid leukemia (AML) cells with different genetic mutations, representing a therapeutic opportunity with broad application. Yet how JMJD1C regulates the leukemic programs of various AML cells is largely unexplored. Here we show that JMJD1C interacts with the master hematopoietic transcription factor RUNX1, which thereby recruits JMJD1C to the genome to facilitate a RUNX1-driven transcriptional program that supports leukemic cell survival. The underlying mechanism hinges on the long N-terminal disordered region of JMJD1C, which harbors two inseparable abilities: condensate formation and direct interaction with RUNX1. This dual capability of JMJD1C may influence enhancer-promoter contacts crucial for the expression of key leukemic genes regulated by RUNX1. Our findings demonstrate a previously unappreciated role for the non-catalytic function of JMJD1C in transcriptional regulation, underlying a mechanism shared by different types of leukemias.
A multimodal approach to data analysis in astronomy: sonouno applications in photometry and spectroscopy
Authors: Casado J , García B
Published: October 2024

In the past decade, multimodal data analysis has gained importance, especially for including individuals with visual impairments in education and science dissemination. However, its application in scientific research is still limited due to a lack of conclusive evidence on its robustness and performance. Various sonification tools have been developed, including xsonify, starsound, strauss, and sonouno, which aim to enhance accessibility for both sighted and visually impaired users. This contribution presents sonouno (a data visualization and sonification tool) using data, and comparing to corresponding visuals displays, from established data bases like SDSS, ASAS-SN, and Project Clea for astronomical data. We show that sonouno is able to replicate the visual data displays and provide consistent auditory representations. Key features include marking absorption and emission lines (in both visual and sonification) and multicolumn sonification, which facilitates spectral comparisons through sound. This approach ensures consistency between visual and auditory data, making multimodal displays more viable for use in research, enabling greater inclusion in astronomical investigation. The study suggests that sonouno could be broadly adopted in scientific research and used to develop multimodal training courses and improve data analysis methods.
The relationships between wanting to nap, actually napping, and depressed and anxious mood
Authors: Ostrow Katherine Domar , Shattuck Lillian , Seehuus Martin
Published: October 2024

Study Objectives

These studies disentangle the relationships between wanting to nap (nap desire), actually napping (nap behavior), and depressed and anxious mood. Study 1 partially replicated and extended findings connecting napping and depressed and anxious mood. Study 2 explored the distinction between nap desire and behavior using a new, larger sample and a different technique.

Methods

Study 1 used a longitudinal, multimethod approach to understand napping and mood among undergraduate students in the United States (N = 104). In Study 2, a cross-sectional survey was conducted on adults over 25 in the continental United States (N = 1406), including items from the DASS-21 and questions about nap desire and behavior.

Results

Study 1 found a significant relationship between same-day napping behavior and depressed mood (Mnap = 1.61, SEnap = 0.08 vs. Mno nap = 1.44, SEno nap = 0.06, p = .018) but not anxious mood (p = .766). Study 2 partially replicated those findings; Analysis of Covariance (ANCOVA) showed that napping desire had a significant effect on anxious (F(1, 1291) = 6.86, p = .009, partial η2 = .005) and depressed mood (F(1, 1291) = 13.46, p < .001, partial η2 = .010), accounting for age, gender, and restedness, but napping behavior did not add to that effect.

Conclusions

Wanting to nap is related to greater depressed and anxious mood, but actual napping did not add to that relationship. These results have implications for clinicians using sleep assessment as a screening tool for mental health and highlight the need for further research on napping motivation.
Australian vertebrate hosts of Japanese encephalitis virus: a review of the evidence
Authors: Moore Kevin T , Mangan Madelyn J , Linnegar Belinda , Athni Tejas S , McCallum Hamish I , Trewin Brendan J , Skinner Eloise
Published: October 2024

Japanese encephalitis virus (JEV) transmission in temperate Australia has underscored a critical need to characterise transmission pathways and identify probable hosts of the virus. This systematic review consolidates existing research on the vertebrate hosts of JEV that are known to exist in Australia. Specifically, we aim to identify probable species involved in JEV transmission, their potential role as hosts and identify critical knowledge gaps. Data were extracted from studies involving experimental infection, seroprevalence and virus isolation and were available for 22 vertebrate species known to reside in Australia. A host competence score was calculated to assess the ability of each species to generate and sustain a viraemia. Based on the host competence score and ecology of each species, we find that ardeid birds, feral pigs and flying foxes have potential as maintenance hosts for JEV in the Australian context. We also note that domestic pigs are frequently infected during outbreaks, but their role as amplification hosts in Australia is unclear. Evidence to confirm these roles is sparse, emphasising the need for further targeted research. This review provides a foundation for future investigations into JEV transmission in Australia, advocating for enhanced surveillance and standardised research methodologies to better understand and mitigate the virus's impact.
The Epidemiology of Pediatric Shoulder Dislocations in the United States
Authors: DiCenso Stefano , Mistovich Ronald Justin , Kaelber David C.
Published: October 2024

Background:

Shoulder dislocations are the most common of all major joint dislocations and are a frequent cause of emergency department (ED) presentations. While the epidemiology of shoulder dislocations has been characterized in adults, it has not yet been done for children in the United States. The primary goal of this study was to calculate the incidence rate of pediatric shoulder dislocations in the United States. Secondary goals were to characterize the demographic information of children with shoulder dislocations as well as trends in management.

Methods:

The US Collaborative Network in TriNetX, a network of clinical data repositories containing patient data from over 100,000,000 unique individuals within the United States, was queried for patients younger than 18 years old diagnosed with shoulder dislocation from 2014 to 2024 using ICD codes. The demographic details were then extracted from the data set, and treatment approaches were determined by CPT coding.

Results:

Over the past 10 years, there were 16,460 pediatric and adolescent patients diagnosed with a first-time shoulder dislocation in either an ED or ambulatory clinic. The overall incidence rate was 60.31 per 100,000 patients, while the incidence rate was 116.61 per 100,000 patients presenting in the ED and 33.95 per 100,000 patients presenting in ambulatory clinics that were under the age of 18 years. Most patients were male (73%), White (59%), and came from the southeastern region of the United States (36%). The most common treatment was a closed reduction (25%), followed by arthroscopic surgery (17%). The number of annual shoulder dislocations has increased over the past decade without an increase in the number of patients undergoing surgical treatment.

Conclusions:

There remains a high incidence rate of shoulder dislocations in the pediatric population of the United States. Despite evidence that early surgical treatment of shoulder dislocations offers improved outcomes, nonoperative treatment continues to be the most common modality without any increase in the percentage of patients undergoing surgical treatment.

Level of Evidence:

Level IV—descriptive epidemiological analysis.
Metabolic acidosis in patients with diabetes 2 undergoing cardiac surgery
Authors: Brekke Hege K. , Holmaas Gunhild , Astor Marianne C. , Steien Egil , Haaverstad Rune , Ghavidel Fatemeh Z. , Farstad Marit
Published: October 2024

BACKGROUND

Sodium-glucose cotransporter 2 inhibitors (SGLT2-i) lower blood sugar and reduce cardiovascular events and kidney failure. However, there have been increasing reports of euglycaemic diabetic ketoacidosis (eDKA) linked to SGLT2-i medicines.

OBJECTIVE

Investigating the association between SGLT2-i use and the incidence of metabolic acidosis in patients with type 2 diabetes undergoing cardiac surgery.

DESIGN

A retrospective observational cohort study comprising 121 patients, with 38 in the SGLT2-i group and 83 in the control group.

SETTING

A 2-year period at Haukeland University Hospital, a tertiary regional hospital in Western Norway.

PATIENTS

Patients with type 2 diabetes undergoing cardiac surgery.

INTERVENTIONS

Collection of clinical and laboratory data, including acid/base balance parameters, surgery details and SGLT2-i use.

MAIN OUTCOME MEASURES

Base excess and anion gap measurements as indicators of ketosis development. A subgroup analysis in patients without renal failure (glomerular filtration rate > 60 ml min−1 m−2).

RESULTS

Lower base excess levels and increased anion gaps were observed in the SGLT2-i group compared with controls at various time points postoperatively, with no significant differences in serum lactate levels.

Twelve hours postoperatively, 41% of SGLT2-i patients without renal failure had a base excess -3 mmol l−1 or less after correction for serum lactate (indicating ketosis) compared with only 8% in the control group (P < 0.001). The anion gap was elevated in the SGLT2-i group compared to the control group at 12 h postoperatively (P = 0.018).

Multivariable regression analysis identified SGLT2-i use as an independent factor associated with a lower base excess after correction for lactate levels (P < 0.001). Cessation of SGLT2-i medication did not correlate with the degree of acidosis.

CONCLUSION

While taking SGLT2 inhibitors, diabetic patients undergoing heart surgery are at an increased risk of ketosis and possibly metabolic acidosis. This emphasises the importance of careful observation and effective treatment strategies within this group.
Role of Autophagy in Myocardial Remodeling After Myocardial Infarction
Authors: Tian Run-Ze , Zhuang Dong-Lin , Vong Chi Teng , He Xuyu , Ouyang Qing , Liang Jing-Hua , Guo Yan-Ping , Wang Yu-Hong , Zhao Shuang , Yuan Haiyun , Ide Nasser Moussa , Li Ge , Ping Zhu
Published: October 2024

Autophagy is the process of reusing the body's senescent and damaged cell components, which can be regarded as the cellular circulatory system. There are 3 distinct forms of autophagy: macroautophagy, microautophagy, and chaperone-mediated autophagy. In the heart, autophagy is regulated mainly through mitophagy because of the metabolic changes of cardiomyocytes caused by ischemia and hypoxia. Myocardial remodeling is characterized by gradual heart enlargement, cardiac dysfunction, and extraordinary molecular changes. Cardiac remodeling after myocardial infarction is almost inevitable, which is the leading cause of heart failure. Autophagy has a protective effect on myocardial remodeling improvement. Autophagy can minimize cardiac remodeling by preventing misfolded protein accumulation and oxidative stress. This review summarizes the nestest molecular mechanisms of autophagy and myocardial remodeling, the protective effects, and the new target of autophagy medicine in cardiac remodeling. The future development and challenges of autophagy in heart disease are also summarized.
INCIDENCE AND PROGRESSION OF AGE-RELATED MACULAR DEGENERATION AMONG PATIENTS WITH AND WITHOUT OBSTRUCTIVE SLEEP APNEA
Authors: Blazes Marian , Ngadisastra Caitlyn , Li Pei-Ru , Lee Cecilia S. , Lee Jiahn-Shing , See Lai-Chu , Lin Ken-Kuo
Published: October 2024

Purpose:

Obstructive sleep apnea (OSA) may increase the risk of age-related macular degeneration (AMD) due to repetitive oxygen deprivation or other mechanisms, though whether OSA increases the risk of AMD progression is unknown. The authors analyzed associations between OSA and AMD risk in the Taiwanese population.

Methods:

The authors identified patients diagnosed with OSA between 2000 and 2018 in the Taiwan National Health Insurance Research Database and used 1:1 propensity score matching on demographics and comorbidities to create a non-OSA cohort. The authors used Cox proportional hazard modeling to investigate the risk of AMD and the risk of progression from nonexudative to exudative AMD in OSA versus non-OSA patients.

Results:

A total of 66,869 OSA patients were matched with 66,869 non-OSA patients. The hazard ratio of AMD in the OSA cohort was 1.36 (95% confidence interval, 1.29–1.43, P < 0.0001). The hazard ratio for progression from nonexudative to exudative AMD for the OSA cohort was 0.94 (95% confidence interval, 0.77–1.14, P = 0.5073).

Conclusion:

Obstructive sleep apnea is associated with a higher risk of developing AMD. However, no increased risk of AMD progression is observed among people with OSA and existing nonexudative AMD.
TRANSRETINAL PUNCTURE WITH A 41G CANNULA FOR POSTERIOR RESIDUAL SUBRETINAL FLUID IN FOVEA-OFF RETINAL DETACHMENTS TREATED BY VITRECTOMY VS FLUID TOLERANCE VS OTHER CONVENTIONAL DRAINAGE TECHNIQUES
Authors: Desira Maxime , Ruiz Thibault , Comet Alban , Matonti Frederic , Conrath John , Gravier-Dumonceau Robinson , Delaporte Charles , Morel Christophe , Devin François , David Thierry , Gascon Pierre
Published: October 2024

Purpose:

To compare functional and anatomical outcomes between posterior drainage of residual fluid using a 41G cannula, fluid tolerance (residual subretinal fluid), and conventional complete drainage methods, including removal through peripheral retinal breaks, perfluorocarbon liquid, and posterior retinotomy.

Methods:

In this retrospective, multicenter study, we evaluated cases for visual acuity at 3 months of follow-up. Secondary outcomes included surgical success, postoperative metamorphopsia, shifts, full-thickness folds, optical coherence tomography parameters, and safety. Subgroup analyses were also conducted.

Results:

Visual acuity did not differ significantly between the three main groups. Subgroup analyses revealed worse visual acuity for posterior retinotomy (20/270 in Snellen conversion, P = 0.002), with significantly more Grade C proliferative vitreoretinopathy (40.0%, P = 0.003). Residual subretinal fluid tended to offer better secondary outcomes, without statistical significance except for postoperative epiretinal membrane (30.8%, P = 0.041). Subgroup analyses found significantly more shifts with PFCL (91.7%, P = 0.036). No cases of postoperative full-thickness folds or macular holes were observed with the 41G.

Conclusion:

Our study introduced the 41G technique, indicating favorable outcomes for fovea-off retinal detachments. Nevertheless, fluid tolerance appeared to be the best option, offering a cost-effective and faster method, with an optimal microstructural profile and visual acuity comparable with that of complete drainage techniques.
Preoperative Posterior Stromal Ripples as Predictive Biomarkers of Visual Recovery After DMEK
Authors: Ventura Mariacarmela , Airaldi Matteo , Ancona Chiara , Neri Enrico , Bonacci Erika , Pedrotti Emilio , Borgia Alfredo , Posarelli Matteo , Levis Hannah J. , Semeraro Francesco , Kaye Stephen B. , Viola Pietro , Romano Vito
Published: October 2024

Purpose:

To investigate the role of preoperative posterior stromal ripples (pre-PSR) on visual acuity recovery after Descemet membrane endothelial keratoplasty (DMEK).

Methods:

This is a comparative case series retrospectively analyzing patients who underwent DMEK. Electronic records and imaging of DMEK patients were reviewed. The last preoperative and first postoperative available anterior segment optical coherence tomography scans for each eye were analyzed for the presence of pre-PSR. The difference in longitudinal trends of visual acuity recovery after DMEK was assessed in eyes with and without pre-PSR. The frequency of rebubbling and measures of proportional relative risk of rebubbling were analyzed according to the presence of preoperative and postoperative PSR.

Results:

A total of 66 patients (71 eyes) were included. Pre-PSR were associated with lower preoperative visual acuity [0.6 (0.5) vs. 0.9 (0.6) LogMAR, P = 0.02] and higher central corneal thickness [613 (73.8) vs. 715.7 (129.6) micron, P < 0.001]. Eyes with pre-PSR had a slower visual recovery up to 3.5 months after surgery compared to eyes without pre-PSR and achieved lower final visual acuity [0.1 (0.2) vs. 0.3 (0.3) LogMAR, P = 0.02]. Cox proportional hazard ratios showed that postoperative PSR were associated with a greater risk of rebubbling [hazard ratio (95% CI), 7.1 (1.3, 39.5), P = 0.02] while pre-PSR were not.

Conclusions:

The presence of pre-PSR is associated with slower visual recovery and lower final visual acuity after DMEK while postoperative PSR confer a higher risk of rebubbling. PSR represent a valuable prognostic biomarker both before and after DMEK.
G-protein–coupled estrogen receptor 30 regulation of signaling downstream of protein kinase Cε mediates sex dimorphism in hyaluronan-induced antihyperalgesia
Authors: Bonet Ivan J.M. , Araldi Dionéia , Khomula Eugen V. , Bogen Oliver , Green Paul G. , Levine Jon D.
Published: October 2024

High molecular weight hyaluronan (HMWH) inhibits hyperalgesia induced by diverse pronociceptive inflammatory mediators and their second messengers, in rats of both sexes. However, the hyperalgesia induced by ligands at 3 pattern recognition receptors, lipopolysaccharide (a toll-like receptor 4 agonist), lipoteichoic acid (a toll-like receptor 2/6 agonist), and nigericin (a NOD-like receptor family, pyrin domain containing 3 activator), and oxaliplatin and paclitaxel chemotherapy–induced peripheral neuropathy are only attenuated in males. After gonadectomy or intrathecal administration of an antisense to G-protein–coupled estrogen receptor 30 (GPER) mRNA, HMWH produces antihyperalgesia in females. In nociceptors cultured from rats that had been treated with oxaliplatin, HMWH reverses nociceptor sensitization from male and GPER antisense–treated female, but not from gonad intact females. G-protein–coupled estrogen receptor–dependent sex dimorphism for HMWH-induced antihyperalgesia was also observed for the prolongation of prostaglandin E2 (PGE2)-induced hyperalgesia in primed nociceptors. While in primed rats, HMWH inhibits early, protein kinase A-dependent hyperalgesia, 30 minutes post PGE2 injection, in both sexes; measured 4 hours post-PGE2, HMWH inhibits the protein kinase Cε (PKCε)-dependent prolongation of PGE2 hyperalgesia only in males and GPER antisense–treated females. In females, hyperalgesia induced by PKCε agonist, ψεRACK, in control but not in primed nociceptors, was inhibited by HMWH. Inhibitors of 2 GPER second messengers, extracellular-regulated kinase 1/2 and nonreceptor tyrosine kinase, also unmasked HMWH antihyperalgesia in females with oxaliplatin chemotherapy–induced peripheral neuropathy, a condition in which nociceptors are primed as well as sensitized. Our results support GPER-dependent sex dimorphism in HMWH-induced antihyperalgesia for pain induced by pattern recognition receptor agonists, and chronic inflammatory and neuropathic pain, mediated by changes in signaling downstream of PKCε in primed nociceptors.
Health Coaching Impacts Stage-Specific Transitions in Multiple Health Behaviors for Patients at High Risk for Coronary Heart Disease and Type 2 Diabetes
Authors: Lee Chiyoung , Yang Qing , Vorderstrasse Allison , Wolever Ruth Q.
Published: October 2024

Background

Multiple behavior change interventions have gained traction in the behavioral health space. Yet, previous studies on health coaching (HC) focused on testing its effect on stages of change for individual health behaviors.

Objective

The purpose of this study was to examine the effects of HC on stages of change across multiple health behavior domains among patients at high risk of coronary heart disease and type 2 diabetes.

Methods

This secondary analysis of a randomized clinical trial included 200 primary care patients (mean age of 47.7 years, 49.0% women, 60.5% Whites) who completed transtheoretical model-based questionnaires related to weight reduction, exercise, healthier eating, and stress management. Multigroup latent transition analysis was used to compare the stage of change distributions and transitions over time between HC and controls at baseline, midpoint of the intervention (3 months), and postintervention (6 months).

Results

Three distinct categories of behavior change were identified (“Contemplation,” “Preparation to Action,” and “Action”), and membership in these categories changed over time as a function of intervention exposure. Both groups exhibited positive transitions through stages of change from baseline to 3 months. Pronounced intervention effects emerged from 3 to 6 months, revealing larger differences in transition probabilities between the groups. In particular, HC increased patients' likelihood of transitioning from “Contemplation” to both “Preparation for Action” and “Action,” as well as from “Preparation for Action” to “Action.” The control group remained stagnant during the same period.

Conclusions

Although HC produces changes across multiple behavioral domains, it was most effective for patients who were reluctant or ambivalent about changing their behaviors.
Emergency Department Workers’ Perceived Support and Emotional Impact After Workplace Violence
Authors: Gillespie Gordon Lee , Cooper Sherry Steele , Bresler Scott A. , Tamsukhin Sara
Published: October 2024

Introduction

Workplace violence (WPV) is a common experience among healthcare workers in the United States. Although WPV may affect workers physically, WPV can also affect workers' mental health. Emergency department (ED) workers' perceptions of available and necessary WPV support have not been previously reported.

Methods

A cross-sectional survey design was used to examine ED workers' perceived level of WPV support and emotional impact that WPV causes them. This study was conducted at six Midwestern U.S. EDs. Respondents confidentially completed an adapted version of the Survey of Violence Experienced by Staff. Data analysis included descriptive statistics, t test, and Kruskal–Wallis test.

Results

Respondents (N = 206) who experienced WPV served as the analytical sample. Respondents predominantly agreed or strongly agreed that support was available after WPV (n = 129, 63.2%). The predominant source of support after WPV was another colleague from the department (n = 127, 62.3%). Less than half of respondents (n = 96, 47.1%) indicated they agreed/strongly agreed that managers were supportive after verbal abuse, but 63.6% (n = 126) indicated that managers were supportive after physical assault. There was no statistical difference between the emotional impact of verbal abuse compared with threats/assaults.

Discussion

Forensic nurses and emergency nurses with forensic nursing training are situated to combine their expertise in trauma-informed care, evidence collection, and expert testimony to support victimized ED workers. Timely support should be offered regardless of the category of WPV experienced. Insight into why support is perceived as available and accessible but may not be used warrants further study.
Physician Assistant Training, Collaboration, and Practice Act Legislation: Perspectives From Practicing Physician Assistants
Authors: Hulse Betty , Schweinle William E. , Kassin Katie , Trimble Nancy D.
Published: October 2024

Introduction

This study examines training, experience, and collaborative practices of physician assistants (PAs) with employment experience and their perspectives on practice act legislation.

Methods

Mixed method study with quantitative and qualitative data.

Results

One hundred eighty participants completed the survey. During clinical employment, 81.05% of respondents reported physicians participated in training. However, supervising physicians trained only 43.46%; 56.54% reported being trained by nurse practitioners (NPs), PAs, and/or other physicians. Onsite collaboration with physicians was reported by 87.2%. Supervising physician involvement was reported by 67.3%, and of these, 59% collaborated with PAs, NPs, and/or other physicians as well. One-third collaborated only with NPs, PAs, and/or other physicians. Daily/weekly collaboration with a supervising physician was reported by 78.89% in their first position and 54.87% in their current/most recent position; 77.22% collaborated with NPs, PAs, and/or other physicians in their first position and 71.68% in their current/most recent position. Most (64.44%) felt PAs should not be legally required to have physician supervision. Most (76.12%) felt care quality would not decrease if supervision were lifted. Most (74.44%) agreed that PAs are hired less frequently than NPs in states where physician supervision is required for PA but not NPs.

Discussion

Findings suggest that team-based practice is already the current structure of PA clinical training and collaboration with PAs receiving significant support from physicians who are not supervising physicians and other nonphysician practitioners. Establishing oversight at the practice level is supported by this practice structure. Determining effects of practice act legislation on employment training, collaboration, and hiring practices warrants further research.
Developing Competencies and Milestones: Putting the Pieces Together for Student Success
Authors: Fernandez Tanya , Dougherty Kelsey , Sivahop Jacqueline
Published: October 2024

Competency-based medical education has become a means in physician assistant (PA) education to ensure learner readiness for practice; align educational expectations; and assess knowledge, skills, and attitudes. Competency-based education may also serve to meet accreditation requirements. Creating program-defined competencies and associated milestones can help a PA program align with their mission and vision, developmentally guide learners through the curriculum, and ensure program assessments measure the tasks required of practice-ready graduates. This review provides an overview of a single program's process for developing program-defined competencies and associated milestones. Beginning with a literature search, the program was able to develop a working list of competencies that was then further refined into competencies with building block milestones that support the development of competency in various domains. Involving faculty in defining a program's competencies is an Accreditation Review Commission on Education for the Physician Assistant requirement that can be done from the ground up or by using previously published competencies that are refined and tailored for the program. The process of creating the competencies provides significant insight into a program's curriculum, goals and expectations for students, and assessment methods.
Clinical outcomes in patients with unintended pregnancy after liver transplantation: A multicenter registry cohort study
Authors: Walia Anjali , Yin Ophelia , Coscia Lisa , Afshar Yalda , Irani Roxanna , Constantinescu Serban , Moritz Michael , Sarkar Monika
Published: October 2024

The consequences of unintended pregnancy in recipients of liver transplants (LTs), a growing part of the high-risk obstetric population, remain unknown. To fill this gap, we conducted a retrospective registry cohort study to describe the risk factors, obstetric and neonatal morbidity, and graft outcomes associated with unintended pregnancy after LT. This study utilized the Transplant Pregnancy Registry International and included 565 pregnancies of recipients of LT between 1967 and 2019 from 289 hospitals, primarily in North America. The primary outcome of acute cellular rejection and secondary outcomes of graft loss, severe maternal morbidity, and neonatal composite morbidity were compared by pregnancy intention. The study population included 60.9% with intended pregnancies and 39.1% with unintended pregnancies. Recipients with unintended pregnancy were more likely to self-report as Black race, to be younger, nulliparous, and to have exposure to teratogenic immunosuppression. Acute cellular rejection was more common with unintended pregnancy (3.7% vs. 1.2%, p=0.047). Unintended pregnancies had lower median birth weight (2806.6 vs. 2948.4 g, p=0.033). Unintended pregnancy was not associated with increased neonatal morbidity or severe maternal morbidity. These findings underscore the importance of family planning counseling, access to safe and effective contraceptive options, as well as multidisciplinary prenatal care in the growing population of recipients of reproductive-aged LT.