bluuebunny/crossref_metadata_2025 huggingface dataset:
Cumulated time to chart closure: a novel electronic health record-derived metric associated with clinician burnout
Authors: Shah Madhura , De Arrigunaga Sofia , Forman Leah S , West Matthew , Rowe Susannah G , Mishuris Rebecca G
Published: February 2024

Objective

We sought to determine whether average cumulated time to chart closure (CTCC), a novel construct to measure clinician workload burden, and electronic health record (EHR) measures were associated with a validated measure of burnout.

Materials and methods

Physicians at a large academic institution participated in a well-being survey that was linked to their EHR use data. CTCC was defined as the average time from the start of patient encounters to chart closure over a set of encounters. Established EHR use measures including daily total time in the EHR (EHR-Time8), time in the EHR outside scheduled hours, work outside of work (WOW8), and time spent on inbox (IB-Time8) were calculated. We examined the relationship between CTCC, EHR use metrics, and burnout using descriptive statistics and adjusted logistic regression models.

Results

We included data from 305 attendings, encompassing 242 432 ambulatory encounters (2021). Among them, 42% (128 physicians) experienced burnout. The median CTCC for all clinicians was 32.5 h. Unadjusted analyses revealed significant associations between CTCC, WOW8, IB-Time8, and burnout. In a final adjusted model, only CTCC remained statistically significant with an odds ratio estimate of 1.42 (95% CI, 1.00-2.01).

Discussion

These results suggest that CTCC is predictive of burnout and that purely measuring duration of interaction with the EHR itself is not sufficient to capture burnout.

Conclusion

Workload burden as manifested by average CTCC has the potential to be a practical, quantifiable measure that will allow for identification of clinicians at risk of burnout and to assess the success of interventions designed to address burnout.
UDGAN: A new urban design inspiration approach driven by using generative adversarial networks
Authors: Gan Wei , Zhao Zichen , Wang Yuankai , Zou Yixuan , Zhou Shiqi , Wu Zhiqiang
Published: February 2024

The morphological design of urban space affects the quality of the environment. The traditional experience-based design approach was greatly improved by introducing computational design tools. However, the existing urban design tools are mostly developed on pre-set rules or given targets, which have few contributions to enhance creativity or generate inspiring schemes. Therefore, this paper proposes a new computational urban design approach named UDGAN, integrating generative adversarial networks (GANs) and multi-objective optimization algorithms. This model utilizes urban design scheme plans over the past 20 years from a particular designer as training datasets. Four preference models were trained to autonomously generate stylized urban design schemes. Eight morphological parameters were used to analyze the model performance by comparing generated results with the ground truth. This GAN-based surrogate approach is combined with a morphological indicator alignment process using multi-objective optimization model to obtain better results. The result shows that the R2 predicted by the improved Pix2Pix model reaches 0.798, and the similarity of the generated results can be stably distributed between 0.7 and 0.8, so the design scheme of this preferred style can be effectively learned. At the same time, the pre-trained model greatly reduces the time consumption of the design scheme generation, taking 5 min approximately to complete a generation process. This approach quickly generated the design scheme with preferred features, supporting the designer with creativity and greatly saving the time of design creation, transforming computational design into an inspiration-driven process.
Evolution of intermediate latency strategies in seasonal parasites
Authors: MacDonald Hannelore , Brisson Dustin
Published: February 2024

Traditional mechanistic trade-offs between transmission and parasite latency period length are foundational for nearly all theories on the evolution of parasite life-history strategies. Prior theoretical studies demonstrate that seasonal host activity can generate a trade-off for obligate-host killer parasites that selects for intermediate latency periods in the absence of a mechanistic trade-off between transmission and latency period lengths. Extensions of these studies predict that host seasonal patterns can lead to evolutionary bistability for obligate-host killer parasites in which two evolutionarily stable strategies, a shorter and longer latency period, are possible. Here we demonstrate that these conclusions from previously published studies hold for non-obligate host killer parasites. That is, seasonal host activity can select for intermediate parasite latency periods for non-obligate killer parasites in the absence of a trade-off between transmission and latency period length and can maintain multiple evolutionarily stable parasite life-history strategies. These results reinforce the hypothesis that host seasonal activity can act as a major selective force on parasite life-history evolution by extending the narrower prior theory to encompass a greater range of disease systems.
Philosophical presuppositions in ‘computational thinking’—old wine in new bottles?
Authors: Dohn Nina Bonderup
Published: February 2024

‘Computational thinking’ (CT) is highlighted in research literature, societal debates, and educational policies alike as being of prime significance in the 21st century. It is currently being introduced into K–12 (primary and secondary education) curricula around the world. However, there is no consensus on what exactly CT consists of, which skills it involves, and how it relates to programming. This article pinpoints four competing claims as to what constitutes the defining traits of CT. For each of the four claims, inherent philosophical presuppositions are identified concerning the nature of thinking, problem-solving, and human–computer relationships. It is argued that most of these philosophical presuppositions are very similar to ones that Hubert Dreyfus and Donald Schön addressed forty to fifty years ago. Therefore, claims about the power of CT raise old discussions in a new disguise. Dreyfus and Schön argued that the presuppositions were wrong. Do their arguments hold and thus defeat contemporary claims about CT? Alternatively, has the technological development since the time of their writings proven them wrong? This article argues that it is necessary to heed the arguments of Dreyfus, Schön, and—later—Bent Flyvbjerg to ensure that CT curricula are built in accord with the value-rational nature of human practice, rather than on misconceived rationalizations of problem-solving, computer use, and computational aspects in the world. However, the pervasive integration of information technology in today's world raises new issues concerning human–machine collaborations that sidetrack the arguments of Dreyfus and Schön. A revised view of CT is required which focusses on articulating how humans can design for, partake in, and critically appraise human–machine collaborations.
Chrysin bonded to β-d-glucose tetraacetate enhances its protective effects against the neurotoxicity induced by aluminum in Swiss mice
Authors: Okoh Victor Ifeanyi , Campos Hericles Mesquita , Yasmin de Oliveira Ferreira Pâmela , Pereira Robbert Mota , Souza Silva Yohanny , Arruda Evilanna Lima , Pagliarani Barbara , de Almeida Ribeiro Oliveira Gerlon , Lião Luciano Morais , Franco dos Santos Gabriel , Vaz Boniek Gontijo , Sabino José Ricardo , Alcantara dos Santos Fernanda Cristina , Costa Elson Alves , Tarozzi Andrea , Menegatti Ricardo , Ghedini Paulo César
Published: February 2024

Objectives

To evaluate whether the glycosylation of chrysin (CHR) enhances its protective effects against aluminum-induced neurotoxicity.

Methods

To compare the antioxidant, anticholinesterase, and behavioral effects of CHR with its glycosylated form (CHR bonded to β-d-glucose tetraacetate, denoted as LQFM280), we employed an integrated approach using both in vitro (SH-SY5Y cells) and in vivo (aluminum-induced neurotoxicity in Swiss mice) models.

Key findings

LQFM280 demonstrated higher antioxidant activity than CHR in both models. Specifically, LQFM280 exhibited the ability to exert antioxidant effects in the cytoplasm of SH-SY5Y cells, indicating its competence in traversing neuronal membranes. Remarkably, LQFM280 proved more effective than CHR in recovering memory loss and counteracting neuronal death in the aluminum chloride mice model, suggesting its increased bioavailability at the brain level.

Conclusions

The glycosylation of CHR with β-d-glucose tetraacetate amplifies its neuroprotective effects, positioning LQFM280 as a promising lead compound for safeguarding against neurodegenerative processes involving oxidative stress.
Assessing the therapeutic potential of dendritic cell vaccine in glioblastoma: a protocol for systematic review and meta-analysis
Authors: Adrien Tangmi Djabo Eric , Jolyvette Mbougo Voufo , Ayantayo Temitayo , Murhega Roméo Bujiriri , Mustapha Mubarak Jolayemi , Zumani Kebby , Ibekwe Jonas Lotanna , Daniel Jeremiah Oluwatomi Itodo , Emhemed Marwa SaedAli , Kyaruzi Victor Meza
Published: February 2024

This study seeks to gather evidence-based information on the therapeutic effect of dendritic cell vaccines in treating glioblastoma. This protocol will follow the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline for 2020. In this review, we determined four primary central databases as sources of information: PubMed, Embase, Scopus and the Cochrane Central Register of Controlled Trials. Ethical approval for this study was unnecessary, as we already used published studies. Study findings will be published in journals and presented at conferences for broader dissemination.

Highlights The most common and dangerous primary malignant brain tumor, glioblastomas (GBM), are still tricky and challenging to treat. Even with multimodal treatment, victims’ median survival is just 15 months. Active immunotherapy called dendritic cell vaccines (DCV) aims to trigger an anticancer immune system reaction. Hundreds of GBM patients have been vaccinated in numerous DCV trials, which have confirmed the vaccine’s viability and safety. This study aims to assess the rationalistic effect of dendritic cell vaccines for treating GBM.
Suspected Mal de Debarquement Syndrome: A Case Report Highlighting the Difficulty in Diagnosis and Management
Authors: Tommas Nathan M , Ferguson Meagan
Published: February 2024

MdDS is syndrome of oscillating vertigo following cessation of passive motion. The pathogenesis of this disorder is not well understood, but functional imaging studies suggest cortical connectivity dysfunction in feedback loops of the vestibulo-ocular system and visuo-spatial system. Patients go through multiple appointments and often specialist referrals before being diagnosed. After diagnosis, optimal management is difficult. Several treatment modalities, including medication, vestibular rehabilitation, and neuromodulation, have had variable success in management. We present the case of a young, female active duty Air Force Captain who developed symptoms while deployed. She underwent multiple treatments with variable success. Her clinical course highlights the difficulties for patients and providers posed by suspected MdDS.
Multi-epoch spectropolarimetry for a sample of Type IIn Supernovae: persistent asymmetry in dusty circumstellar material
Authors: Bilinski Christopher , Smith Nathan , Williams G Grant , Smith Paul S , Leonard Douglas C , Hoffman Jennifer L , Andrews Jennifer E , Milne Peter
Published: February 2024

We present multi-epoch spectropolarimetry and spectra for a sample of 14 Type IIn supernovae (SNe IIn). We find that after correcting for likely interstellar polarization, SNe IIn commonly show intrinsic continuum polarization of 1–3 per cent at the time of peak optical luminosity, although a few show weaker or negligible polarization. While some SNe IIn have even stronger polarization at early times, their polarization tends to drop smoothly over several hundred days after peak. We find a tendency for the intrinsic polarization to be stronger at bluer wavelengths, especially at early times. While polarization from an electron scattering region is expected to be grey, scattering of SN light by dusty circumstellar material (CSM) may induce such a wavelength-dependent polarization. For most SNe IIn, changes in polarization degree and wavelength dependence are not accompanied by changes in the position angle, requiring that asymmetric pre-SN mass loss had a persistent geometry. While 2–3 per cent polarization is typical, about 30 per cent of SNe IIn have very low or undetected polarization. Under the simplifying assumption that all SN IIn progenitors have axisymmetric CSM (i.e. disc/torus/bipolar), then the distribution of polarization values we observe is consistent with similarly asymmetric CSM seen from a distribution of random viewing angles. This asymmetry has very important implications for understanding the origin of pre-SN mass loss in SNe IIn, suggesting that it was shaped by binary interaction.
Spectral and timing evolution of GX 340+0 along its Z-track
Authors: Chattopadhyay Suchismito , Bhulla Yashpal , Misra Ranjeev , Mandal Soma
Published: February 2024

We present the results from spectral and timing study of the Z source GX 340+0 using AstroSat’s SXT and LAXPC data. During the observation the source traced out the complete Z-track, allowing for the spectral evolution study of the horizontal, normal, and flaring branches (HB, NB, and FB) as well as the hard and soft apexes (HA and SA). The spectra are better and more physically described by a blackbody component and a hot Comptonizing corona with a varying covering fraction, rather than one having a disc component. Along the track, the Comptonized flux (as well as the covering fraction) monotonically decreases. It is the blackbody component (both the temperature and radius) which varies non-monotonically and hence gives rise to the Z-track behaviour. Rapid timing study reveals a prominent quasi-periodic oscillation (QPO) at ∼50 Hz at the HB, HA, and upper NB, while a QPO at ∼6 Hz is seen for the other branches. The fractional rms of the QPOs increase with energy and exhibit soft lags in all branches except SA and FB.
Predicting the heaviest black holes below the pair instability gap
Authors: Winch Ethan R J , Vink Jorick S , Higgins Erin R , Sabhahitf Gautham N
Published: February 2024

Traditionally, the pair instability (PI) mass gap is located between 50 and 130 M⊙, with stellar mass black holes (BHs) expected to ‘pile up’ towards the lower PI edge. However, this lower PI boundary is based on the assumption that the star has already lost its hydrogen (H) envelope. With the announcement of an ‘impossibly’ heavy BH of 85 M⊙ as part of GW 190521 located inside the traditional PI gap, we realized that blue supergiant (BSG) progenitors with small cores but large hydrogen envelopes at low metallicity (Z) could directly collapse to heavier BHs than had hitherto been assumed. The question of whether a single star can produce such a heavy BH is important, independent of gravitational wave events. Here, we systematically investigate the masses of stars inside the traditional PI gap by way of a grid of 336 detailed mesa stellar evolution models calculated across a wide parameter space, varying stellar mass, overshooting, rotation, semiconvection, and Z. We evolve low Z stars in the range 10−3 < Z/Z⊙ < ZSMC, making no prior assumption regarding the mass of an envelope, but instead employing a wind mass-loss recipe to calculate it. We compute critical carbon–oxygen and helium core masses to determine our lower limit to PI physics, and we provide two equations for Mcore and Mfinal that can also be of use for binary population synthesis. Assuming the H envelope falls into the BH, we confirm the maximum BH mass below PI is MBH ≃ 93.3 M⊙. Our grid allows us to populate the traditional PI gap, and we conclude that the distribution of BHs above the traditional boundary is not solely due to the shape of the initial mass function, but also to the same stellar interior physics (i.e. mixing) that which sets the BH maximum.
Long-term survivors of glioblastoma: Tumor molecular, clinical, and imaging findings
Authors: Briceno Nicole , Vera Elizabeth , Komlodi-Pasztor Edina , Abdullaev Zied , Choi Anna , Grajkowska Ewa , Kunst Tricia , Levine Jason , Lindsley Matthew , Fernandez Kelly , Reyes Jennifer , Boris Lisa , Burton Eric , Panzer Marissa , Polskin Lily , Penas-Prado Marta , Pillai Tina , Theeler Brett J , Wu Jing , Wall Kathleen , Papanicolau-Sengos Antonios , Quezado Martha , Smirniotopoulos James , Aldape Kenneth , Armstrong Terri S , Gilbert Mark R
Published: February 2024

Background

Glioblastoma (GBM) is the most aggressive primary brain malignancy with <45% living a year beyond diagnosis. Previously published investigations of long-term survivors (LTS) provided clinical data but rarely incorporated a comprehensive clinical and molecular analysis. Herein, we identify clinical, imaging, molecular, and outcome features for 23 GBM-LTS patients and compare them with a matched cohort of short-term survivors (STS).

Methods

Molecularly confirmed Isocitrate Dehydrogenase (IDH) wildtype GBM patients living ≥3 years post-diagnosis (NLTS = 23) or <3 years (NSTS = 75) were identified from our Natural History study. Clinical and demographic characteristics were compared. Tumor tissue was analyzed with targeted next generation sequencing (NGS) (NLTS = 23; NSTS = 74) and methylation analysis (NLTS = 18; NSTS = 28). Pre-surgical MRI scans for a subset of LTS (N = 14) and STS control (N = 28) matched on sex, age, and extent of resection were analyzed.

Results

LTS tended to be younger. Diagnostic MRIs showed more LTS with T1 tumor hypointensity. LTS tumors were enriched for MGMTp methylation and tumor protein 53 (TP53) mutation. Three patients with classic GBM histology were reclassified based on NGS and methylation testing. Additionally, there were LTS with typical poor prognostic molecular markers.

Conclusions

Our findings emphasize that generalized predictions of prognosis are inaccurate for individual patients and underscore the need for complete clinical evaluation including molecular work-up to confirm the diagnosis. Continued accrual of patients to LTS registries that contain

comprehensive clinical, imaging, tumor molecular data, and outcomes measures may pro\vide important insights about individual patient prognosis.
Methylthioadenosine Phosphorylase Genomic Loss in Advanced Gastrointestinal Cancers
Authors: Ngoi Natalie Y L , Tang Tin-Yun , Gaspar Catia F , Pavlick Dean C , Buchold Gregory M , Scholefield Emma L , Parimi Vamsi , Huang Richard S P , Janovitz Tyler , Danziger Natalie , Levy Mia A , Pant Shubham , De Armas Anaemy Danner , Kumpula David , Ross Jeffrey S , Javle Milind , Rodon Ahnert Jordi
Published: February 2024

Background

One of the most common sporadic homozygous deletions in cancers is 9p21 loss, which includes the genes methylthioadenosine phosphorylase (MTAP), CDKN2A, and CDKN2B, and has been correlated with worsened outcomes and immunotherapy resistance. MTAP-loss is a developing drug target through synthetic lethality with MAT2A and PMRT5 inhibitors. The purpose of this study is to investigate the prevalence and genomic landscape of MTAP-loss in advanced gastrointestinal (GI) tumors and investigate its role as a prognostic biomarker.

Materials and Methods

We performed next-generation sequencing and comparative genomic and clinical analysis on an extensive cohort of 64 860 tumors comprising 5 GI cancers. We compared the clinical outcomes of patients with GI cancer harboring MTAP-loss and MTAP-intact tumors in a retrospective study.

Results

The prevalence of MTAP-loss in GI cancers is 8.30%. MTAP-loss was most prevalent in pancreatic ductal adenocarcinoma (PDAC) at 21.7% and least in colorectal carcinoma (CRC) at 1.1%. MTAP-loss tumors were more prevalent in East Asian patients with PDAC (4.4% vs 3.2%, P = .005) or intrahepatic cholangiocarcinoma (IHCC; 6.4% vs 4.3%, P = .036). Significant differences in the prevalence of potentially targetable genomic alterations (ATM, BRAF, BRCA2, ERBB2, IDH1, PIK3CA, and PTEN) were observed in MTAP-loss tumors and varied according to tumor type. MTAP-loss PDAC, IHCC, and CRC had a lower prevalence of microsatellite instability or elevated tumor mutational burden. Positive PD-L1 tumor cell expression was less frequent among MTAP-loss versus MTAP-intact IHCC tumors (23.2% vs 31.2%, P = .017).

Conclusion

In GI cancers, MTAP-loss occurs as part of 9p21 loss and has an overall prevalence of 8%. MTAP-loss occurs in 22% of PDAC, 15% of IHCC, 8.7% of gastroesophageal adenocarcinoma, 2.4% of hepatocellular carcinoma, and 1.1% of CRC and is not mutually exclusive with other targetable mutations.
Conspicuous chloroplast with light harvesting-photosystem I/II megacomplex in marine Prorocentrum cordatum
Authors: Kalvelage Jana , Wöhlbrand Lars , Senkler Jennifer , Schumacher Julian , Ditz Noah , Bischof Kai , Winklhofer Michael , Klingl Andreas , Braun Hans-Peter , Rabus Ralf
Published: February 2024

Marine photosynthetic (micro)organisms drive multiple biogeochemical cycles and display a large diversity. Among them, the bloom-forming, free-living dinoflagellate Prorocentrum cordatum CCMP 1329 (formerly P. minimum) stands out with its distinct cell biological features. Here, we obtained insights into the structural properties of the chloroplast and the photosynthetic machinery of P. cordatum using microscopic and proteogenomic approaches. High-resolution FIB/SEM analysis revealed a single large chloroplast (∼40% of total cell volume) with a continuous barrel-like structure, completely lining the inner face of the cell envelope and enclosing a single reticular mitochondrium, the Golgi apparatus, as well as diverse storage inclusions. Enriched thylakoid membrane fractions of P. cordatum were comparatively analyzed with those of the well-studied model-species Arabidopsis (Arabidopsis thaliana) using 2D BN DIGE. Strikingly, P. cordatum possessed a large photosystem-light harvesting megacomplex (>1.5 MDa), which is dominated by photosystems I and II (PSI, PSII), chloroplast complex I, and chlorophyll a–b binding light harvesting complex proteins. This finding parallels the absence of grana in its chloroplast and distinguishes from the predominant separation of PSI and PSII complexes in A. thaliana, indicating a different mode of flux balancing. Except for the core elements of the ATP synthase and the cytb6f-complex, the composition of the other complexes (PSI, PSII, and pigment-binding proteins, PBPs) of P. cordatum differed markedly from those of A. thaliana. Furthermore, a high number of PBPs was detected, accounting for a large share of the total proteomic data (∼65%) and potentially providing P. cordatum with flexible adaptation to changing light regimes.
Off-pump versus on-pump coronary artery bypass grafting in elderly patients at 30 days: a propensity score matching study
Authors: Wang Chen , Jiang Yefan , Wang Qingpeng , Wang Dashuai , Jiang Xionggang , Dong Nianguo , Chen Si , Chen Xinzhong
Published: February 2024

Background

Elderly patients are at increased risk of perioperative morbidity and mortality after conventional on-pump coronary artery bypass grafting (ONCABG). This study was to determine whether such high-risk population would benefit from off-pump coronary artery bypass grafting (OPCABG).

Methods

A retrospective analysis was performed on patients aged 65 years or older who underwent isolated coronary artery bypass grafting for the first time in Wuhan Union Hospital from January 2015 to January 2021. We used propensity score matching to adjust for differences in baseline characteristics between the ONCABG and OPCABG groups. Morbidity and mortality within 30 days after surgery were compared between the two groups. All operations were performed by experienced cardiac surgeons.

Results

A total of 511 patients (ONCABG 202, OPCABG 309) were included. After 1:1 matching, the baseline characteristics of the two groups were comparable (ONCABG 173, OPCABG 173). The OPCABG group had higher rate of incomplete revascularization (13.9% vs. 6.9%; P = .035) than the ONCABG group. However, OPCABG reduced the risk of postoperative renal insufficiency (15.0% vs. 30.1%; P = .001) and reoperation for bleeding (0.0% vs. 3.5%; P = .030). There were no significant differences in early postoperative mortality, myocardial infarction, stroke, and other outcomes between the two groups.

Conclusions

OPCABG is an alternative revascularization method for elderly patients. It reduces the risk of early postoperative renal insufficiency and reoperation for bleeding.
Evaluation of a novel disposable endoscope for retroflexed endoscopic rubber band ligation of internal hemorrhoids: a randomized pilot study
Authors: Xu Wen , Xia Guili , Li Laihe , Cao Ge , Yan Xianhuan , Dong Ling , Zhu Ying
Published: February 2024

Purpose

Retroflexed endoscopic rubber band ligation (ERBL) for treating Grade II and III internal hemorrhoids using disposable endoscopes has not been previously assessed. We therefore compared the safety and effectiveness of ERBL for internal hemorrhoids using novel disposable endoscopes versus traditional reusable endoscopes.

Methods

This prospective randomized controlled trial involved 42 patients who underwent ERBL for Grade II and III internal hemorrhoids using either a disposable endoscope (n = 21) or a reusable endoscope (n = 21). Safety was assessed by the incidence of equipment failure, device-related adverse events, and in-procedure stability of vital signs. Effectiveness was assessed by the postoperative therapeutic effect, feasibility of retroflexed ERBL, and incidence of complications.

Results

In terms of safety, no life-threatening events, equipment failure, or device-related adverse effects occurred during the procedures in either group. The rate of diastolic blood pressure stability was significantly different between the two groups (P = .049), but the rates of systolic blood pressure and heart rate stability were similar. In terms of effectiveness, the therapeutic effects on postoperative Day 30 were similar in both groups. Image clarity and endoscopic flexibility in the disposable endoscope group were mildly inferior to those in the reusable endoscope group, but without statistical significance. Matching between the endoscope and ligating device was 100% in both groups. The incidence of complications on postoperative Days 1 and 10 was not significantly different between the two groups.

Conclusion

Compared with reusable endoscopes, disposable endoscopes are equally safe, feasible, and reliable in ERBL for internal hemorrhoids.
Investigating socio-ecological factors influencing implementation of tuberculosis infection prevention and control in rural Papua New Guinea
Authors: Marme Gigil , Kuzma Jerzy , Zimmerman Peta-Anne , Harris Neil , Rutherford Shannon
Published: February 2024

Background

Tuberculosis (TB) is a highly transmissible infectious disease killing millions of people yearly, particularly in low-income countries. TB is most likely to be transmitted in healthcare settings with poor infection control practices. Implementing TB infection prevention and control (TB-IPC) is pivotal to preventing TB transmission in healthcare settings. This study investigated diverse stakeholders’ perspectives relating to barriers and strategies for TB-IPC in rural hospitals in Papua New Guinea.

Methods

Multiple qualitative case studies were conducted with 32 key stakeholders with experience in TB services. Data collection drew on three primary sources to triangulate data: semi-structured interviews, document reviews and field notes. The data were analyzed using hybrid deductive-inductive thematic analysis.

Results

Our results reveal that key stakeholders perceive multiple interdependent factors that affect TB-IPC practice. The key emerging themes include strategic planning for and prioritizing TB-IPC guidelines; governance, leadership and accountability at the provincial level; community attitudes towards TB control; institutional capacity to deliver TB care, healthcare workers’ safety, and long-term partnership and integration of TB-IPC programmes into the broad IPC programme.

Conclusions

The evidence suggests that a multi-perspective approach is crucial for TB-IPC guidelines in healthcare institutions. Interventions focusing on addressing health systems strengthening may improve the implementation of TB-IPC guidelines.
Irish farmers’ engagement with dairy calf welfare: An exploratory analysis
Authors: Läpple Doris , Arpinon Thibaut
Published: February 2024

Dairycalf welfare is receiving increasing public attention. To ensure optimal practices, farmers need to engage and be mindful of unethical behavior. However, avoiding information on animal welfare is common and often driven by willful ignorance. We conduct an exploratory analysis on survey data from 546 Irish dairy farmers. We investigate farmers’ choice to view a picture of transported dairy calves and find that over 20 per cent of farmers prefer to remain in a state of ignorance. Higher self-reported calf mortality and education increase the odds of viewing the picture while being a female decreases them. Farmers’ reasons for avoiding include the lack of new information in the picture, anticipated negative feelings, and biased information expectations. Additional explorations suggest that the farmers’ decision is not a survey artifact, but the results are not robust and further research is needed to confirm. Possible suggestions to improve calf welfare are to foster farmers’ trust, package information as new evidence on best calf-rearing practices, and better understand perceptions of animal welfare.
Open Access and Reproducibility in Plant Pathology Research: Guidelines and Best Practices
Authors: Grünwald Niklaus J. , Bock Clive H. , Chang Jeff H. , De Souza Alessandra Alves , Ponte Emerson M. Del , du Toit Lindsey J. , Dorrance Anne E. , Dung Jeremiah , Gent David , Goss Erica M. , Lowe-Power Tiffany M. , Madden Laurence V. , Martin Frank N. , McDowell John , Naegele Rachel P. , Potnis Neha , Quesada-Ocampo Lina M. , Sundin George W. , Thiessen Lindsey , Vinatzer Boris A. , Zeng Quan
Published: February 2024

The landscape of scientific publishing is experiencing a transformative shift toward open access, a paradigm that mandates the availability of research outputs such as data, code, materials, and publications. Open access provides increased reproducibility and allows for reuse of these resources. This article provides guidance for best publishing practices of scientific research, data, and associated resources, including code, in The American Phytopathological Society journals. Key areas such as diagnostic assays, experimental design, data sharing, and code deposition are explored in detail. This guidance aligns with that observed by other leading journals. We hope the information assembled in this paper will raise awareness of best practices and enable greater appraisal of the true effects of biological phenomena in plant pathology.
Comparison of Molecular and Morphological Identification Methods for Anguina Seed Gall Nematodes in Oregon Grasses Grown for Seed
Authors: Rivedal Hannah M. , Temple Todd N. , Starchvick Robert J. , Braithwaite Emily , Lowder Sarah R. , Dorman Seth J. , Núñez Rodríguez Lester A. , Peetz Amy B. , Zasada Inga A.
Published: February 2024

Oregon's grass seed industry specializes in the production of forage grasses, including annual ryegrass ( Lolium multiflorum) and orchardgrass ( Dactylis glomerata). These species are hosts of seed gall nematodes (SGNs): Anguina funesta and Anguina sp. SGNs cause yield-limiting seed galls and can also vector toxic Rathayibacter bacteria. Trade partners have strict phytosanitary regulations leading to rejection of seed lots infested with SGNs. Current best practices for SGN detection focus on postharvest seed evaluation. Methods to evaluate fields before harvest could improve risk management decisions. In this study, we evaluated timing, collection, and detection methods to generate new recommendations for SGN detection throughout the growing season. Fields of annual ryegrass (21) and orchardgrass (7) were sampled in the 2022 and 2023 growing seasons at tillering (March), flowering (May), harvest (July), and germination (November). At each time point, tillers, seed heads, or soil samples were collected. Nematodes were extracted from soil, tiller, and seed head samples using traditional nematology methods. Alternatively, SGN-specific real-time and conventional PCR protocols were evaluated on DNA extracted from tillers or seed heads. Direct enumeration of SGN from tillers with traditional nematology methods resulted in positive detections in 11 to 19% of fields, depending on sample time and year, as opposed to 33 to 44% of fields when using molecular methods. SGNs were detected in 40% of fields using both methods when evaluating seed head samples. This study indicates the utility of incorporating molecular methods for risk evaluations of SGNs and provides recommendations for accurate SGN detection throughout the growing season.

[Formula: see text] The author(s) have dedicated the work to the public domain under the Creative Commons CC0 “No Rights Reserved” license by waiving all of his or her rights to the work worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law, 2024.
Changes in Listening Effort Through Pupil Response After Atresioplasty in Children With Congenital Aural Atresia
Authors: Ahn Jungmin , Cho Yang-Sun
Published: February 2024

Objectives:

This study aimed to determine whether the improvement of hearing by surgical treatment alleviates cognitive demands through pupil response in patients with unilateral congenital aural atresia (CAA).

Design:

A prospective study was performed on patients with unilateral CAA who were scheduled to undergo primary atresioplasty between November 2017 and May 2020. Pure-tone audiometry, auditory digit span test, Korean Speech Perception in Noise test, pupil measurement during speech tests, and questionnaires (Sound-Spatial-Qualities of Hearing Scale; subjective listening effort rating) were performed before and 6 months after surgery.

Results:

Of 30 consecutive patients who initially enrolled, only 18 patients (12 males and 6 females) were included in the analysis. When the improvement of the air-bone gap and interaural difference of air conduction within 30 dB was defined as a successful hearing outcome, successful hearing improvement was achieved in 50% of the 18 patients. In pupil measurement, the success group had a significantly smaller mean pupil dilation response than the nonsuccess group at 0 and −3 dB signal to noise ratio (SNR) (all p < 0.01). In addition, significant differences were identified between the two groups for peak dilation and peak latency at all noise levels (all p < 0.01). When analyzing the change in pupil response before and after surgery, the difference in relative mean pupil dilation in the success group was significantly greater than that in the nonsuccess group at −3 dB SNR (p = 0.02). In addition, the success group showed a significantly greater change in peak latency than the nonsuccess group at the −3 dB SNR (p < 0.01). The difference in peak dilation tended to be greater in the success group than in the nonsuccess group, but the difference was not statistically significant.

Conclusions:

Patients with unilateral CAA who achieved surgically improved hearing had a smaller pupil dilation response than those who did not. These results suggest that successful hearing outcomes after surgery in patients with unilateral CAA may reduce the cognitive effort required to understand speech under difficult listening conditions.
Osteopontin Promotes Angiogenesis in the Spinal Cord and Exerts a Protective Role Against Motor Function Impairment and Neuropathic Pain after Spinal Cord Injury
Authors: Weng Yingqi , Lu Feng , Li Ping , Jian Yanping , Xu Jingmei , Zhong Tao , Guo Qulian , Yang Yong
Published: February 2024

Study Design.

Basic science study using a hemi-section spinal cord injury (SCI) model.

Objective.

We sought to assess the effect of blocking Osteopontin (OPN) up-regulation on motor function recovery and pain behavior after SCI and to further investigate the possible downstream target of OPN in the injured spinal cord.

Summary of Background Data.

OPN is a noncollagenous extracellular matrix protein widely expressed across different tissues. Its expression substantially increases following SCI. A previous study suggested that this protein might contribute to locomotor function recovery after SCI. However, its neuroprotective potential was not fully explored, nor were the underlying mechanisms.

Methods.

We constructed a SCI mouse model and analyzed the expression of OPN at different time points, and the particular cell distribution in the injured spinal cord. Then, we blocked OPN up-regulation with lentivirus delivering siRNA targeting OPN specifically and examined its effect on motor function impairment and neuropathic pain after SCI. The underlying mechanisms were explored in the OPN-knockdown mice model and cultured vascular endothelial cells.

Results.

The proteome study revealed that OPN was the most dramatically increased protein following SCI. OPN in the spinal cord was increased significantly 3 weeks after SCI. Suppressing the OPN up-regulation via siRNA exacerbated motor function impairment and neuropathic pain. Additionally, SCI resulted in an increase in the vascular endothelial growth factor (VEGF), AKT phosphorylation, and angiogenesis within the spinal cord, all of which were curbed by OPN reduction. Similarly, OPN knockdown suppressed VEGF expression, AKT phosphorylation, cell migration, invasion, and angiogenesis in cultured vascular endothelial cells.

Conclusion.

OPN demonstrates a protective influence against motor function impairment and neuropathic pain following SCI. This phenomenon may result from the pro-angiogenetic effect of OPN, possibly due to activation of the VEGF and/or AKT pathways.
Validation of a Novel, Rapid Sepsis Diagnostic for Emergency Department Use
Authors: O’Neal Hollis R. , Sheybani Roya , Janz David R. , Scoggins Robert , Jagneaux Tonya , Walker James E. , Henning Daniel J. , Rosenman Elizabeth , Mahler Simon A. , Regunath Hariharan , Sampson Christopher S. , Files D. Clark , Fremont Richard D. , Noto Michael J. , Schneider Erica E. , Shealey Wesley R. , Berlinger Matthew S. , Carver Thomas C. , Walker Morgan K. , Ledeboer Nathan A. , Shah Ajay M. , Tse Henry T.K. , DiCarlo Dino , Rice Todd W. , Thomas Christopher B.
Published: February 2024

OBJECTIVES:

To assess the in vitro IntelliSep test, a microfluidic assay that quantifies the state of immune activation by evaluating the biophysical properties of leukocytes, as a rapid diagnostic for sepsis.

DESIGN:

Prospective cohort study.

SETTING:

Five emergency departments (EDs) in Louisiana, Missouri, North Carolina, and Washington.

PATIENTS:

Adult patients presenting to the ED with signs (two of four Systemic Inflammatory Response Syndrome criteria, where one must be temperature or WBC count) or suspicion (provider-ordered culture) of infection.

INTERVENTIONS:

All patients underwent testing with the IntelliSep using ethylene diamine tetraacetic acid-anticoagulated whole blood followed by retrospective adjudication for sepsis by sepsis-3 criteria by a blinded panel of physicians.

MEASUREMENTS AND MAIN RESULTS:

Of 599 patients enrolled, 572 patients were included in the final analysis. The result of the IntelliSep test is reported as the IntelliSep Index (ISI), ranging from 0.1 to 10.0, divided into three interpretation bands for the risk of sepsis: band 1 (low) to band 3 (high). The median turnaround time for ISI results was 7.2 minutes. The ISI resulted band 1 in 252 (44.1%), band 2 in 160 (28.0%), and band 3 in 160 (28.0%). Sepsis occurred in 26.6% (152 of 572 patients). Sepsis prevalence was 11.1% (95% CI, 7.5–15.7%) in band 1, 28.1% (95% CI, 21.3–35.8%) in band 2, and 49.4% (95% CI, 41.4–57.4%) in band 3. The Positive Percent Agreement of band 1 was 81.6% and the Negative Percent Agreement of band 3 was 80.7%, with an area under the receiver operating characteristic curve of 0.74. Compared with band 1, band 3 correlated with adverse clinical outcomes, including mortality, and resource utilization.

CONCLUSIONS:

Increasing ISI interpretation band is associated with increasing probability of sepsis in patients presenting to the ED with suspected infection.
Determining Accurate Dye Combinations for Sentinel Lymph Node Detection: A Systematic Review
Authors: Swerdlow Mark , Vangsness Kella L. , Kress Gavin T. , Georgescu Anda , Wong Alex K. , Carré Antoine Lyonel
Published: February 2024

Background:

Lymphatic dyes are commonly used to map the drainage path from tumor to lymphatics, which are biopsied to determine if spread has occurred. A blue dye in combination with technetium-99 is considered the gold standard for mapping, although many other dyes and dye combinations are used. Not all of these substances have the same detection efficacy.

Methods:

A systematic review of PubMed, SCOPUS, Web of Science, and Medline was performed. The predefined search terms were (indocyanine green OR isosulfan blue OR lymphazurin OR patent blue OR methylene blue OR fluorescein OR technetium-99) AND combination AND dye AND (sentinel lymph node biopsy OR lymphedema OR lymphatics OR lymph OR microsurgery OR cancer OR tumor OR melanoma OR carcinoma OR sarcoma).

Results:

The initial search returned 4267 articles. From these studies, 37 were selected as candidates that met inclusion criteria. After a full-text review, 34 studies were selected for inclusion. Eighty-nine methods of sentinel lymph node (SLN) detection were trialed using 22 unique dyes, dye combinations, or other tracers. In total, 12,157 SLNs of 12,801 SLNs were identified. Dye accuracy ranged from 100% to 69.8% detection. Five dye combinations had 100% accuracy. Dye combinations were more accurate than single dyes.

Conclusions:

Combining lymphatic dyes improves SLN detection results. Replacing technetium-99 with ICG may allow for increased access to SLN procedures with comparable results. The ideal SLN tracer is a low-cost molecule with a high affinity for lymphatic vessels due to size and chemical composition, visualization without specialized equipment, and no adverse effects.
A Relative Value Unit–Based Model for Targeted Nipple–Areola Complex Neurotization in Gender-Affirming Mastectomy
Authors: Das Rishub K. , Remy Katya , McCarty Justin C. , Valerio Ian L. , Austen William G. , Carruthers Katherine H.
Published: February 2024

Background:

For transmasculine individuals, double-incision mastectomy with free nipple grafts is the most common procedure for gender-affirming chest masculinization. However, patients report decreased sensation postoperatively. Direct coaptation of intercostal nerves to the nipple–areolar complex (NAC) is an experimental technique that may preserve postoperative sensation, yet whether reimbursements and billing codes incentivize hospital systems and surgeons to offer this procedure lacks clarity.

Methods:

A retrospective cross-sectional analysis of fiscal year 2023 Medicare physician fee schedule values was performed for neurotization procedures employing Current Procedural Terminology codes specified by prior studies for neurotization of the NAC. Additionally, operative times for gender-affirming mastectomy at a single center were examined to compare efficiency between procedures with and without neurotization included.

Results:

A total of 29 encounters were included in the study, with 11 (37.9%) receiving neurotization. The mean operating time was 100.3 minutes (95% CI, 89.2–111.5) without neurotization and 154.2 minutes (95% CI, 139.9–168.4) with neurotization. In 2023, the average work relative value units (wRVUs) for neurotization procedures was 13.38. Efficiency for gender-affirming mastectomy was 0.23 wRVUs per minute without neurotization and 0.24 wRVUs per minute with neurotization, yielding a difference of 0.01 wRVUs per minute.

Conclusions:

Neurotization of the NAC during double-incision mastectomy with free nipple grafts is an experimental technique that may improve patient sensation after surgery. Current reimbursement policy appropriately values the additional operative time associated with neurotization relative to gender-affirming mastectomy alone.
Rate and Predictors of Satisfaction after Noninvasive Facial Cosmetic Procedures: A National Study in Saudi Arabia
Authors: Alenazi Noura Farhan , AlBattal Nouf Z. , Albalawi Ibrahim Abdullah S. , Saleh Najla Alfateh , Alnaim Muna F. , Mahmoud Asmaa Z. Bin , Vasilescu D.C.
Published: February 2024

Background:

In response to the growing popularity of noninvasive facial cosmetic procedures, this study assessed the rate and predictors of satisfaction with such procedures in Saudi Arabia, filling a research gap and emphasizing the role of patient satisfaction in optimizing care and understanding the economic implications for healthcare.

Methods:

This cross-sectional study was conducted from May to June 2023 using an online self-administered questionnaire distributed across all regions of Saudi Arabia. Eligible participants were Saudi adults aged 18 years and older who had undergone noninvasive facial cosmetic procedures. Patients who underwent surgical/invasive cosmetic procedures, nonfacial interventions, or interventions performed by doctors other than plastic surgeons or dermatologists were excluded.

Results:

Most participants reported satisfaction with their procedures. Significant predictors of satisfaction included sex, income, and residential area. Women, higher-income individuals, and residents of certain areas were more likely to report satisfaction. Participants also expressed a high level of satisfaction with the friendly and polite treatment they received from their doctors but showed dissatisfaction with the difficulty they faced in securing immediate postprocedure appointments.

Conclusions:

This study provides valuable insights into the rate and predictors of satisfaction after noninvasive facial cosmetic procedures in Saudi Arabia. These findings underscore the importance of considering sociodemographic factors in patient satisfaction and suggest areas for improvement in patient care, particularly in facilitating immediate postprocedure appointments. Future research should continue to explore these and other potential predictors to further improve patient outcomes in the field of noninvasive facial cosmetic procedures.