bluuebunny/crossref_metadata_2025 huggingface dataset:
A Process Evaluation Approach to Central Line–Associated Bloodstream Infection Reduction in a Neonatal Population
Authors: Riley Soraya , Osterholm Erin , Vadner Emily , Cramer Julianne
Published: November 2024

Objective:

To reduce the rate of central line–associated bloodstream infections (CLABSI) in the M Health Fairview Neonatal Intensive Care Unit (NICU) from 2.15 infections per 1,000 central line days to less than one per 1,000 line days using process evaluation.

Methods:

An interdisciplinary team used process mapping and Failure Modes and Effects Analysis (FMEA) to identify root causes and improvement opportunities in central line maintenance. The focus was on neonates born at <32 weeks of gestational age and weighing less than 750 g. Interventions included standardized clean space, algorithms to reduce line access, and standardized kits for line maintenance.

Results:

Over 4 years, the project achieved an 86.6% reduction in CLABSI events, decreasing from 15 events in 2019 to two in 2023. The CLABSI rate dropped by 85%, from 2.15 to 0.32 per 1,000 line days. Statistical analysis indicated a significant reduction in FMEA risk scores for the identified failure modes, with an average reduction of 33%.

Conclusion:

The process-focused approach and interdisciplinary collaboration significantly reduced CLABSI rates in the NICU. Future efforts should aim to maintain these improvements and achieve a target of zero CLABSI events.
The Application of Sentiment Treatment and Narrative Medicine in Infertility
Authors: TONG Yuheng , CHEN Wei , Vaishnani Deep K , Khaing Wut Yi Hla , CHEN Chen , CHEN Yanman
Published: November 2024

This study delves into the integration of traditional Chinese medicine (TCM) sentiment therapy with modern medical interventions in treating infertility, aiming to enhance the therapeutic outcomes for patients. It posits that infertility encompasses not only physical factors but also significant psychological and emotional dimensions. The synthesis of TCM sentiment therapy and contemporary reproductive medicine signifies a paradigm shift in comprehending the interactions among health, emotions, psychology, and physiology. By analyzing the diagnostic and treatment methods of TCM, this study elucidates how sentiment can enhance modern treatments, thereby promoting a more holistic, patient-centered approach to infertility care. Furthermore, it underscores the necessity of fostering a comprehensive understanding of health and disease within medical education.
Efficacy and complications of endoscopic thoracoscopic versus laparoscopic radical esophagectomy in esophageal cancer treatment: A retrospective study
Authors: Ma Mingquan , Ren Peng , Wang Haitong , Zhang Hongdian , Gong Lei , Qiao Yufeng , Liu Xiangming , Tang Peng
Published: November 2024

To evaluate the efficacy and postoperative complications of endoscopic thoracoscopic and laparoscopic radical esophagectomy compared to open surgery in esophageal cancer treatment. This retrospective study included 103 esophageal cancer patients admitted from August 2018 to March 2022, divided into observation (endoscopic surgery) and control (open surgery) groups. We compared intraoperative parameters, postoperative outcomes, immune function, and one-year overall survival (OS). Intraoperative bleeding volume, the retention time of chest tube, postoperative fasting time, and hospital stay in the observation group were smaller than those in the control group (P < .05). The differences were not statistically significant (P > .05) when comparing operative time, the number of intraoperative blood transfusion cases, and the rate of operating room extubation in these 2 groups. The differences were not statistically significant when comparing the amount of resected lymph nodes and the positive rate of incisal edge in these 2 groups (P > .05). There was no statistically significant difference in the complication rates such as pneumonia, pleural effusion, pneumothorax, pulmonary embolism, anastomotic fistula, the leakage of thoracic duct, the injury of RLN and arrhythmia in these 2 groups (P > .05). At 7 days postoperatively, the CD4+ and CD4+/CD8+ in the observation group and the control group were smaller than the preoperative ones in their same groups, and they were larger in the observation group than those in the control group (P < .05); There was no statistically significant difference on the CD8+ in the observation group and the control group at 7 days postoperatively compared with the preoperative ones in their same groups (P > .05). The 1-year postoperative OS rate was 81.63% (40/49) in the observation group and 72.22% (39/54) in the control group, and the difference was not statistically significant when comparing the OS rates of these 2 groups (P = .238, HR = 0.622, 95% CI = 0.279–1.385). Endoscopic thoracoscopic and laparoscopic esophagectomy offers less invasive treatment with significant short-term benefits and better preservation of immune function in esophageal cancer patients, making it a safe and effective surgical option.
Progressive multiple sclerosis: A bibliometric analysis
Authors: Shawawrah Mays , Alryalat Saif Aldeen
Published: November 2024

Background:

Progressive multiple sclerosis (MS) is a chronic immune-mediated disease with a poorly understood pathophysiology. This bibliometric analysis of the literature aims to gain an overview of the current state of research on progressive MS.

Methods:

The Scopus database was searched using the terms “progressive” and “multiple sclerosis” in the title. The search was done till the 7th of January 2023. We analyzed annual trends, countries, institutions, authors, journals, articles, and keywords based primarily on the citation count.

Results:

One thousand nine hundred ninety-one studies out of 1993 search results were included. The included studies had 65,788 citations with a mean of 33 citations per study. Most studies were published between the years 2016 and 2020 (n = 607) with a mean number of 20 citations. The United States of America had the highest number of publications (n = 547) and citations (n = 24,921). The top 3 authors were Thompson A.J., Miller D.H., and Filippi M., and Multiple Sclerosis Journal had the most publications (n = 227) and citations (n = 6849).

Conclusion:

To our knowledge, this is the first bibliometric study to address the topic of progressive MS in particular and potentially emphasize the direction of progressive MS research.
Use and effectiveness of PCSK-9 inhibitors in heart diseases: A review
Authors: Alorfi Nasser M. , Harbi Maan H. , El Hajj Maguy Saffouh , Alayoubi Samha , Ibrahim Nihal Abdalla , Alayoubi Fakhr Z.
Published: November 2024

Proprotein Convertase Subtilisin/Kexin type-9 (PCSK-9) inhibitors have recently used in the management of different cardiac complications. Several clinical trials demonstrated their effectiveness in patients with hypercholesterolemia. However, the effectiveness of these medications in patients with heart diseases is still controversial. To review and summarize the clinical trials pertaining to the use and effectiveness of PCSK-9 inhibitors in heart diseases and to discuss the pharmacotherapy of these agents. A review was conducted of all clinical trials with PCSK-9 inhibitors for heart diseases registered at ClinicalTrials.gov since inception up to and including January 19th, 2024. These trials were retrieved. Data from these trials were extracted manually, categorized and analyzed. The number of identified clinical trials was 25,371. After screening and excluding irrelevant studies, 12 studies met the search criteria. The majority of these studies were conducted in the US. The total number of patients in these studies was 27,700. Alirocumab and Evolocumab were the most frequently used PCSK-9 inhibitors. This review identified only a few clinical trials on PCSK-9 inhibitors in heart disease patients. Therefore, it is recommended to conduct more randomized controlled clinical trials on PCSK-9 inhibitors in this patient population.
Safety and efficacy of S1P receptor modulators for the induction and maintenance phases in inflammatory bowel disease: A systematic review and meta-analysis of randomized controlled trials
Authors: Akram Abdullah , Ahmed Misha , Farhan Kanza , Omer Areeb , Kaleem Shamama , Khan Ali Tahir , Aslam Uzma , Tahir Muhammad Abdullah , Memon Saria , Karam Ayatul , Furqan Humam , Anjum Muhammad Umair , Bhattarai Pratik
Published: November 2024

Background:

Inflammatory bowel disease (IBD) is a chronic inflammatory condition that significantly affects quality of life. Conventional treatments have had limited success. this study evaluates the safety and efficacy of Sphingosine 1-phosphate receptor modulators (S1PrMs) as a potential treatment for IBD.

Methods:

We conducted a thorough search of published literature on PubMed, EMBASE, and Google Scholar from 2000 to 2023. The inclusion criteria were randomized controlled trials (RCTs) with a target population comprising of IBD patients receiving either S1PrMs or placebo and a comparison of the 2. The statistical analysis was conducted using RevMan (version 5.4). Forest plots presented the results as risk ratios (RR) with a 95% confidence interval.

Results:

A total of 7 RCTs involving 2471 patients were included. The results were reported for both the induction and maintenance phases of treatment. in the induction phase, the intervention group proved to have a significantly higher incidence of histological remission (RR = 2.67; 95% CI [1.97, 3.60]; P < .00001), endoscopic improvement (RR = 2.06; 95% CI [1.66, 2.56]; P < .00001), clinical remission (RR = 2.23; 95% CI [1.43, 3.46]; P < .0004) and clinical response (RR = 1.37; 95% CI [1.01, 1.84]; P = .04) compared to the placebo group. Outcomes assessed in maintenance phase significantly favored the intervention group over placebo as well, histologic remission (RR = 2.39; 95% CI [1.83, 3.11]; P < .00001), endoscopic improvement (RR = 2.20; 95% CI [1.28, 3.77]; P = .004), clinical remission (RR = 3.03; 95% CI [1.84, 4.99]; P < .0001), and clinical response (RR = 1.74; 95% CI [1.25, 2.42]; P = .001).

Conclusion:

S1PrMs show promising potential for establishing histologic remission, endoscopic improvement, clinical remission, and corticosteroid-free clinical remission. With more studies and clinical trials, these modulators may become a reliable therapeutic choice for UC patients everywhere.
Characteristics of initiation timing and anticoagulation of continuous renal replacement therapy in patients following cardiac surgery: A retrospective analysis of 28 patients
Authors: Li Jian , Li Yi , Li Xianglian , Mo Liwen , Zhang Fan , Cheng Yue , Wang Tao
Published: November 2024

Continuous renal replacement therapy (CRRT) used in cardiac surgery-associated acute kidney injury (CSA-AKI) may have different characteristics from other diseases. We reviewed the medical records of patients with CSA-AKI requiring CRRT who underwent cardiac surgery from January 2020 to September 2021. Patients with AKI caused by other reasons who received CRRT during the same period were also evaluated. A total of 28 patients with CSA-AKI and 12 patients with AKI caused by other reasons were enrolled in this study. Compared with AKI patients caused by other reasons, patients with CSA-AKI were found to have lower mean arterial pressure, higher level of bilirubin, higher vasoactive-inotropic score, and larger daily diuretic dosage. The patients with CSA-AKI were prescribed CRRT earlier than the patients with AKI caused by other reasons. There was a significant difference in the CRRT anticoagulation method between patients with CSA-AKI and patients with AKI caused by other reasons. Six patients with CSA-AKI were treated with regional citrate anticoagulation (RCA), and the other 22 patients were treated with low molecular weight heparin or without anticoagulants. The timing of CRRT initiation in patients with CSA-AKI is earlier than that in patients with AKI caused by other reasons. Although RCA is recommended as the preferred anticoagulant for patients without contraindications, patients with CSA-AKI often have circulatory dysfunction and severe liver damage, so the risk of citrate accumulation is greater, whether to use RCA should be determined according to the individual condition of the patient.
Exploring the pathogenesis linking primary aldosteronism and obstructive sleep apnea via bioinformatic analysis
Authors: Zhao Lanlan , Dong Yuehua , Wei Ying , Li Jie , Zhang Songyun
Published: November 2024

Primary aldosteronism (PA) and obstructive sleep apnea (OSA) are both considered independent risk factors for hypertension, which can lead to an increase in cardiovascular disease incidence and mortality. Clinical studies have found a bidirectional relationship between OSA and PA. However, the underlying mechanism between them is not yet clear. This study aims to investigate the shared genetic characteristics and potential molecular mechanisms of PA and OSA. We obtained microarray datasets of aldosterone-producing adenoma (APA) and OSA from the gene expression omnibus (GEO) database. Weighted gene co-expression network analysis (WGCNA) was used to select co-expression modules associated with APA and OSA, and common genes of the two diseases were obtained by intersection. Subsequently, hub genes for APA and OSA were identified through functional enrichment analysis, protein-protein interaction (PPI), datasets, and public database. Finally, we predicted the transcription factors (TFs) and mirRNAs of the hub genes. In total, 52 common genes were obtained by WGCNA. The Gene Ontology (GO) of common genes includes interleukin-1 response, cytokine activity, and chemokine receptor binding. Functional enrichment analysis highlighted the TNF, IL-17 signaling, and cytokine-cytokine receptor interactions related to APA and OSA. Through PPI, datasets, and public databases verification, we identified 5 hub genes between APA and OSA (IL6, ATF3, PTGS2, CCL2, and CXCL2). Our study identified shared 5 hub genes between APA and OSA (IL6, ATF3, PTGS2, CCL2, and CXCL2). Through bioinformatics analysis, we found that the 2 disorders showed relative similarity in terms of inflammation, stress, and impaired immune function. The identification of hub genes may offer potential biomarkers for the diagnosis and prognosis of PA and OSA.
The role of prophylactic transfusion on the maternal and fetal outcomes in pregnant women with sickle cell disease: A systematic review and meta-analysis
Authors: AlMoshary May , Arabdin Maria
Published: November 2024

Background:

In the present review, we aimed to synthesize evidence from studies on the safety and effectiveness of prophylactic blood transfusion in pregnant women with sickle cell disease.

Material and methods:

To gather relevant information, we conducted systematic electronic searches of databases such as SCOPUS, Medline via PubMed, Web of Science, and Cochrane Central Register of Controlled Trials. We included both retrospective and prospective studies that examined the impact of prophylactic blood transfusions during pregnancy. The collected data were analyzed using Review Manager, version 5.3.

Results:

The review included 15 cohort studies. The overall findings indicated a preference for the prophylactic blood transfusion group over the control group across several key parameters. Specifically, the prophylactic group demonstrated lower rates of maternal mortality (odds ratio [OR] = 0.33; 95% confidence interval [CI] = 0.10–1.13; P = .08), reduced incidence of vaso-occlusive painful events (OR = 0.31; 95% CI = 0.14–0.73; P = .007), fewer pulmonary complications (OR = 0.21; 95% CI = 0.08–0.53; P = .001), decreased perinatal mortality (OR = 0.35; 95% CI = 0.17–0.75; P = .03), and lower likelihood of preterm birth (OR = 0.67; 95% CI = 0.47–0.96; P = .02). Notably, statistically significant heterogeneities were observed in the pooled effect estimates.

Conclusion:

The present meta-analysis indicated that prophylactic blood transfusion in pregnant women with sickle cell disease may improve maternal and fetal outcomes. However, substantial variations in the methodology and transfusion protocols among the included studies limited the credibility of the current evidence supporting the routine clinical use of prophylactic transfusion for SCD during pregnancy.
Exploring the causal relationship between plasma lipids and varicose veins of lower extremity: A comprehensive two-sample Mendelian randomization study
Authors: Shen Kailin , Zhu Fangtao , Cheng Cunwei , Yu Haibin
Published: November 2024

Varicose veins of the lower extremities (VVs) is a common chronic vascular disease, with high prevalence rates in some countries; however, their pathogenesis remains unclear. Some studies have identified associations between changes in specific plasma lipid molecules, such as phosphatidylethanolamine (PE), phosphatidylcholine (PC), and sphingomyelin (SM), and the onset of VVs, but due to confounders and reverse causality, the causal relationship remains unclear. Meanwhile, studies on the potential link between other plasma lipids beyond PE, PC, and SM and the risk of VVs in the lower extremities are lacking. This study aimed to explore the potential causal relationship between VVs and plasma lipid levels to provide theoretical insights into the interrelation of plasma lipids and VVs in their occurrence and progression. We conducted a two-sample Mendelian randomization (MR) analysis to assess the potential connection between genetically predicted levels of individual plasma lipids and the risk of developing VVs. We utilized data from a large-scale genome-wide association study involving 7174 Finnish individuals for 179 plasma lipidomes along with VVs genome-wide association study data from 408,455 UK individuals. MR analysis employed methods, such as inverse-variance weighting, weighted median, Bayesian Weighted Mendelian Randomization, and MR-Egger regression. The inverse-variance weighting method was primarily used to assess causality. The validity of the results was demonstrated through sensitivity analysis. In total, 12 lipids were found to have their plasma levels associated with an increased risk of VVs. This includes 3 types of PE, 7 types of PC, and 2 types of phosphatidylinositol. However, no significant causal relationship was found between the plasma levels of 11 types of SM and VVs. These results support the existence of a potential causal relationship between specific types of lipid levels and the risk of VVs, which can provide clues for further studies on biological mechanisms and the exploration of potential therapeutic targets.
Causal relationship between systemic circulatory inflammatory regulators and intervertebral disc degeneration: A bidirectional 2-sample Mendelian randomization study
Authors: Chen Zi-Xuan , Xu Bo , Huang Ze-Ling , Liu Yu-Jiang , Li Yu-Wei , Lu Bin-Jie , Lin Jun , Zhang Xian-Da , Shen Xiao-Feng
Published: November 2024

In the context of the development of intervertebral disc degeneration (IDD), inflammatory mediators play a pivotal role. Nevertheless, due to the influence of the inflammatory microenvironment, the causal relationship between specific inflammatory mediators and the development of IDD remains uncertain. The understanding of the causal relationship between inflammatory mediators and IDD is of great importance in preventing and delaying disc degeneration in the future. We utilized genetic data concerning systemic circulating inflammatory regulators obtained from a Genome-Wide Association Study (GWAS) analyzing 41 serum cytokines in a cohort of 8293 individuals from Finland. The genetic data for IDD were derived from the most recent GWAS summary statistics conducted within the FinnGen consortium, encompassing 37,636 IDD cases and 270,964 controls. Our analysis employed bidirectional 2-sample Mendelian randomization (MR) techniques, which included several MR methods such as MR Egger, weighted median, inverse variance weighted, weighted mode, and simple mode. Additionally, the MR-PRESSO method was employed to identify horizontal pleiotropy, heterogeneity was quantified using the Cochran Q statistic, and MR-Egger intercept analysis was performed to assess pleiotropy. We established causal relationships between 3 specific inflammatory factors and IDD. Elevated levels of MIP-1β (OR = 0.956, 95% CI: −0.08 to −0.006; P = .02) and IFN-G (OR = 0.915, 95% CI: −0.16 to −0.02; P = .01) expression were associated with a reduced risk of IDD. Conversely, genetic susceptibility to IDD was linked to a decrease in IL-13 levels (OR = 0.967, 95% CI: −0.063 to −0.004; P = .03). In this study, we have identified inflammatory factors that exhibit a causal relationship with the onset and progression of IDD, as supported by genetic predictions.
Insights into the mechanism of Danggui Liuhuang Tang in treating night sweats: A network pharmacology and molecular docking approach
Authors: Qiu Jinling , Huang Xingran , Li Hongyang , Jin Shuying , Yang Ruo , Gu Wei
Published: November 2024

Background:

Night sweats can occur independently or in association with a number of medical conditions and can significantly disrupt daily life. This study focuses on the treatment of primary night sweats. Despite the considerable interest in Danggui Liuhuang Tang (DGLHT), an effective traditional Chinese medicine formula, its mechanism of action remains unknown. There is also no existing literature on the subject.

Methods:

Network pharmacology and molecular docking techniques.

Results:

Network pharmacology techniques were employed to identify 109 active ingredients and 808 potential targets of DGLHT, as well as 2385 targets associated with night sweating diseases. The screening process yielded 375 common targets shared between DGLHT and night sweating. These included the active ingredients baicalein, quercetin, huarangiin, and tetrahydroafrican antipyrine, and the core targets interleukin 6, serine/threonine protein kinase 1, tumor necrosis factor, GAPDH enzyme, and Src protein kinase were identified. The Kyoto Encyclopedia of Genes and Genomes enrichment analysis revealed that DGLHT exerts its therapeutic effects primarily by modulating the PI3K–Akt signaling pathway, neuroactive ligand–receptor interactions, lipid metabolism, and atherosclerosis pathways. Molecular docking revealed strong binding activity between the main active ingredients and their potential targets.

Conclusion:

The research identifies promising active ingredients and targets related to the effectiveness of DGLHT in controlling night sweats, thus contributing to the further exploration of potential therapeutics for this condition. In addition, the results of this experiment provide a basis for future research into night sweats.
Associations between life’s essential 8 and femoral neck bone mineral density among adults: A national population-based study
Authors: Liu Linjian , Zhang An , Xiao Xiangjun
Published: November 2024

Osteoporosis represents a significant public health issue, impacting both health outcomes and economic costs. This research investigates how cardiovascular health, as indicated by the LE8 score, correlates with bone mineral density (BMD). Data from the National Health and Nutrition Examination Survey (NHANES) spanning 2011 to 2018 were analyzed in this cross-sectional analysis, including 9018 subjects following the exclusion of individuals lacking BMD or LE8 data. The LE8 score, comprising factors such as diet, physical activity, smoking status, sleep quality, body mass index, lipid profiles, blood glucose, and blood pressure, was used to evaluate cardiovascular health. BMD was determined through dual-energy X-ray absorptiometry (DXA). Relationships between the LE8 scores and BMD at the femoral neck were assessed using linear regression and smooth curve fitting techniques. Enhanced LE8 scores were linked to improved BMD at the femoral neck. Notably, a 10-point increment in the LE8 score was associated with a rise in BMD by 0.04 g/cm² [β = 0.04, 95% CI: 0.03–0.05]. The data indicate a strong positive association between cardiovascular health, as measured by LE8, and BMD. These results support the development of holistic health strategies that promote cardiovascular health to potentially improve bone density.
Protecting maternal health: Strategies against HIV and malaria in pregnancy
Authors: Obeagu Emmanuel Ifeanyi , Obeagu Getrude Uzoma
Published: November 2024

Maternal health remains a global priority, with particular emphasis on combating infectious diseases such as HIV and malaria during pregnancy. Despite significant progress in prevention and treatment efforts, both HIV and malaria continue to pose significant risks to maternal and fetal well-being, particularly in resource-limited settings. The prevention of mother-to-child transmission (PMTCT) programs for HIV and intermittent preventive treatment (IPTp) for malaria represent cornerstone strategies in mitigating the impact of these infections on pregnancy outcomes. PMTCT programs focus on early HIV diagnosis, antiretroviral therapy initiation, and promoting safe infant feeding practices to reduce the risk of mother-to-child transmission. Similarly, IPTp involves the administration of antimalarial medication to pregnant women in malaria-endemic regions to prevent maternal and fetal complications associated with malaria infection. Integration of HIV and malaria prevention and treatment services within existing maternal and child health programs is crucial for maximizing impact and minimizing healthcare system strain. Strengthening health systems, improving access to antenatal care services, and enhancing community engagement are essential components of comprehensive maternal health strategies. Furthermore, promoting awareness, education, and empowerment of pregnant women and communities are vital in fostering health-seeking behaviors and adherence to preventive measures against HIV and malaria. In conclusion, protecting maternal health from the dual threat of HIV and malaria requires a multifaceted approach that encompasses prevention, screening, treatment, and community engagement.
Design of a custom metamaterial insert for improved pressure distribution within transtibial prosthetic sockets
Authors: Owen Meredith K. , Kaluf Brian D. , DesJardins John D.
Published: November 2024

Uneven pressure distribution within a transtibial prosthetic socket can lead to discomfort, skin degradation, and suspended prosthesis use. Current custom interfaces to improve pressure distribution are often costly, time-intensive to fabricate, or cannot be incorporated into standard socket fabrication methods. In this technical note, we describe the design and preliminary clinical evaluation of a novel transtibial prosthetic socket insert with modifiable mechanical properties, which can be incorporated into the current clinical cycle of care. The custom insert (termed “inlay”) relies on a triangular unit cell, which can be modified based on the desired stiffness profile. Inserts are 3D printed in a soft polymer material and inset into shape-matched voids in a socket creating regions of custom offloading. Preliminary clinical efficacy of the inserts was assessed in a pilot long-term cross-over evaluation. After Institutional Review Board approval, 3 pilot participants wore a shape-matched replica of their habitual socket modified for insert use and a shape-matched socket without. Sockets were worn for 4-week each, and inner socket pressures were measured with thin film pressure sensors at the end of the wear period. Peak pressures within the distal tibial region of interest were decreased for 2 of 3 participants during midstance of level-ground walking when wearing the socket with inlays. The technical methods and results presented provide a new method to address high pressure regions within a transtibial prosthetic socket. The 3D-printed inlays can be rapidly produced allowing for easy modification and replacement without require new socket fabrication.
Paraganglioma With Intracranial Invasion Demonstrated on 68Ga-DOTATATE PET/CT
Authors: Kesim Selin , Filizoglu Nuh
Published: November 2024

68Ga-DOTATATE PET/CT demonstrates superior sensitivity compared with other cross-sectional and functional imaging techniques in detecting head and neck paragangliomas. It is the primary recommended imaging modality for the evaluation of head and neck paragangliomas, especially in patients suspected of having locally aggressive, multifocal, or metastatic disease, as well as those being considered for targeted peptide-receptor therapy. Herein, we demonstrate the 68Ga-DOTATATE PET/CT findings of a skull base paraganglioma with extensive local invasion and intracranial extension.
Analysis of the Surgical Efficacy and Risk Factors of a One-stage Unilateral Approach for Clipping Bilateral MCA Mirror Aneurysms
Authors: Wang Chao , Yu Bing , Xu Yifan , Zhang Chonghui , Feng Yugong
Published: November 2024

Background:

Numerous microsurgical approaches are available for treating middle cerebral artery (MCA) mirror aneurysms. However, a definitive conclusion regarding which approach yields the best outcome has yet to be reached.

Methods:

Thirty-three patients with MCA aneurysms were categorized into 2 groups: one-stage unilateral approach and other surgical approaches. Prognostic differences were compared using the Modified Rankin Scale (mRS). In addition, the length of hospital stay and costs were also compared. Among the patients with a proposed preoperative one-stage unilateral approach, they were divided into success and failure groups, and these factors were collected, including Hunt-Hess grade, contralateral aneurysm orientation and maximum diameter, contralateral A1+M1 length, and contralateral ICA bifurcation angle. These parameters were analyzed using multivariate logistic regressions to identify the risk factors.

Results:

The prognosis of patients in the one-stage unilateral approach group did not differ significantly from that of other surgical approaches. However, patients in the one-stage unilateral approach group experienced shorter hospital stays and incurred lower hospital expenses. In the multivariate regressions, the length of the contralateral A1+M1 was identified as an independent risk factor.

Conclusions:

The one-stage unilateral pterional approach for clipping bilateral aneurysms is an effective method of treating MCA mirror aneurysms. However, in cases where patients have an excessive length of A1+M1 on the contralateral side, this approach may result in surgical failure.
Trans-Tragal Approach for Mandibular Neck and Head Condylar Fractures
Authors: Girotto Riccardo , Cirignaco Giulio , De Tomaso Silvia , Racano Carmine , Balercia Andrea , De Feudis Francesco , Balercia Paolo
Published: November 2024

This retrospective observational study evaluates the trans-tragal approach for the treatment of mandibular head and neck condylar fractures. From January 2009 to May 2024, 34 patients (20 males, 14 females, mean age 34 years) with 36 condylar fractures were treated using this approach. Surgical outcomes were assessed based on occlusal relationship, maximum mouth opening, and facial nerve function (House-Brackmann scale). Postoperative imaging included computed tomography scans, with follow-ups at 1, 3, 6 months, and 1 year. Complications such as wound infection, hematoma, and salivary fistula were also evaluated.

Results showed satisfactory postoperative outcomes, with 32 patients maintaining normal occlusion and a mean interincisal opening distance of 40 mm. Three patients experienced complications, including temporary facial nerve numbness in one case, with complete recovery in 2 weeks, and 2 cases requiring reoperation due to condylar segment displacement. No cases of permanent facial nerve damage, salivary fistula, or tragal cartilage necrosis were observed. Aesthetic outcomes were satisfactory, with scars hidden in natural folds.

The trans-tragal approach provides adequate surgical exposure to the posterior condylar region while minimizing the risk of facial nerve injury. Although the results of this study indicate favorable outcomes, further randomized controlled studies are required to validate these findings due to the non-randomized design and small sample size.
Unintentionally Retained Elevator Blade Left for 8 Years Causes Mild Chronic Pain
Authors: Raby Ian , Salas Gastón , Arroyo Carlos
Published: November 2024

Fracture of surgical instruments in dental practice is not usually reported in the literature. Management involves searching for and retrieving the fragment to avoid issues such as infection, swallowing, or aspiration. Although foreign bodies may not cause symptoms for years, some can cause chronic pain. The authors describe herein the unusual case of an unintentionally retained broken elevator blade left for 8 years before being found during an orthodontic evaluation. Panoramic radiography revealed a foreign body in the alveolar bone of the right mandibular third molar that was causing mild chronic pain. The patient was unaware whether routine radiographic examination had revealed its presence. Cone-beam computer tomography was performed to identify the position of the blade fragment, and surgery was performed to retrieve it. The mild chronic pain disappeared after removal. It is advisable to use high-quality surgical instruments and to perform routine checkups before and after surgery.
The American Academy of Emergency Nurse Practitioners
Authors: Dowling Evans Dian , Davis Wesley D.
Published: November 2024

In 2014, Dr. Elda Ramirez, alongside Dr. Arlo Weltge and Dr. Kyle Kincaid, founded the American Academy of Emergency Nurse Practitioners (AAENP) to support nurse practitioners working in emergency care. With initial support from 39 dedicated individuals, AAENP was incorporated in Texas and received pro bono management from an association management company. Over the years, AAENP has focused on defining the emergency nurse practitioner (ENP) role, developing a board certification examination, and creating standardized curricula for ENP programs. Strong collaborations with organizations such as the American Association of Nurse Practitioners (AANP) and the American College of Emergency Physicians (ACEP) have been pivotal. AAENP has grown significantly, now boasting over 1100 members, and has produced numerous evidence-based position statements and publications. This article highlights AAENP’s achievements, and the challenges faced in its formative years, showcasing its commitment to advancing the ENP profession and ensuring quality care in emergency settings.
Quantifying social media predictors of violence during the 6 January US Capitol insurrection using Granger causality
Authors: Li Qinghua , King Brayden G , Uzzi Brian
Published: November 2024

Protests involving brute force are growing in number and are viewed as a likely source of increased collective violence in industrialized nations. Yet, our scientific understanding of how violent protests are related to a leader’s social media communications during protests remains nascent. Here, we analyse new data from the 6 January ‘march on the US Capitol’ to quantify the links between leadership, social media and levels of violence. Using data on thousands of live footage videos, Trump’s tweets and rally speech, other rally speeches and #StopTheSteal tweets, we apply Granger regression methods to analyse the links between former President Trump’s tweets, #StopTheSteal tweets, rally speeches and the severity and duration of outbreaks of violence and weapons use during the riot. We find that Trump’s tweets predict bursts in rioters’ levels and duration of violence and weapons use. Trump’s tweets also predict changes in the volume and sentiments of #StopTheSteal tweets, which in turn explain additional variance in levels of violence and weapons use over the course of the riot. Our findings reveal new patterns of behaviour that link an authority figure’s online behaviour during a protest and the shift from peaceful protesting to violence.
Model-informed optimal allocation of limited resources to mitigate infectious disease outbreaks in societies at war
Authors: Srivastava Vaibhava , Sarkar Drik , Kadelka Claus
Published: November 2024

Infectious diseases thrive in war-torn societies. The recent sharp increase in human conflict and war thus requires the development of disease mitigation tools that account for the specifics of war, such as the scarcity of important public health resources. We developed a compartmental, differential equation-based disease model that considers key social, war and disease mechanisms, such as gender homophily and the replacement of soldiers. This model enables the identification of optimal allocation strategies that, given limited resources required for treating infected individuals, minimize disease burden, assessed by total mortality and final epidemic size. A comprehensive model analysis reveals that the level of resource scarcity fundamentally affects the optimal allocation. Desynchronization of the epidemic peaks among several population subgroups emerges as a desirable principle since it reduces disease spread between different subgroups. Further, the level of preferential mixing among people of the same gender, gender homophily, proves to strongly affect disease dynamics and optimal treatment allocation strategies, highlighting the importance of accurately accounting for heterogeneous mixing patterns. Altogether, the findings help answer a timely question: how can infectious diseases be best controlled in societies at war? The developed model can be easily extended to specific diseases, countries and interventions.
Metaharvesting: emergent energy harvesting by piezoelectric metamaterials
Authors: Patrick Ibrahim , Adhikari Sondipon , Hussein Mahmoud I.
Published: November 2024

Vibration energy harvesting is a technology that enables electric power generation by augmenting vibrating materials or structures with piezoelectric elements. In a recent work, we quantified the intrinsic energy-harvesting availability (EHA) of a piezoelectric phononic crystal (Piezo-PnC) by calculating its damping ratio across the Brillouin zone and subtracting off the damping ratio of the corresponding non-piezoelectric version of the phononic crystal. It was highlighted that the resulting quantity indicates the amount of useful energy available for harvesting and is independent of the finite structure size and boundary conditions and of any forcing conditions. Here, we investigate the intrinsic EHA of two other material systems chosen to be statically equivalent to a given Piezo-PnC: a piezoelectric locally resonant metamaterial (Piezo-LRM) and a piezoelectric inertially amplified metamaterial (Piezo-IAM). Upon comparing with the intrinsic EHA of the Piezo-PnC, we observe an emergence of energy-harvesting capacity, a phenomenon we refer to as metaharvesting. This is analogous to the concept of metadamping, except the quantity evaluated is associated with piezoelectric energy harvesting rather than raw dissipation. Our results show that the intrinsic EHA is enhanced by local resonances and enhanced further by inertial amplification. These findings offer a new paradigm for the design—at the fundamental level—of architectured piezoelectric materials with superior energy-harvesting capacity.
Hamiltonian integrable systems in a magnetic field and symplectic-Haantjes geometry
Authors: Kubů Ondřej , Reyes Daniel , Tempesta Piergiulio , Tondo Giorgio
Published: November 2024

We investigate the geometry of classical Hamiltonian systems immersed in a magnetic field in three-dimensional (3D) Riemannian configuration spaces. We prove that these systems admit non-trivial symplectic-Haantjes manifolds, which are symplectic manifolds endowed with an algebra of Haantjes (1,1)-tensors. These geometric structures allow us to determine separation variables for known systems algorithmically. In addition, the underlying Stäckel geometry is used to construct new families of integrable Hamiltonian models immersed in a magnetic field.
16S rRNA Gene Sequencing Reveals Bacterial Diversity in Khewra Salt Mine Walls
Authors: Noor Syeda Wardah , Arshad Sara , Abdullah Syed Muhammad , Kayani Bushra Khudadad , Fazal Sahar
Published: November 2024

The Khewra Salt Mine, also known as the source of Himalayan Pink Salt, is the second-largest salt mine in the world and a significant site for salt export. The mine's salt exhibits both amorphous and crystalline textures, with colors ranging from white to deep red, contributing to its distinctive pink hue. While previous research has extensively explored the mine's soil, plants, and brine samples, little attention has been given to the salt walls, which are a major tourist attraction. This study aimed to investigate the bacterial diversity within the salt walls from four distinct locations, including an under-construction area sampled for the first time.
From these four collection points, seven samples were gathered, yielding 19 isolates cultured on 2% NaCl nutrient agar. Bacterial isolates from the under-construction area (US1-1, US1-2, US2-1, and US2-2) and the museum walls (MS1-1 and MS1-2) underwent further biochemical, antibiotic sensitivity, and salt requirement testing, followed by 16S rRNA sequencing. Biochemical assays identified these isolates as gram positive, catalase and oxidase positive rods. All isolates were sensitive to chloramphenicol (30μg/ml). Salt tolerance tests classified them as slightly halophilic, thriving at 2-4% NaCl concentrations.
Molecular characterization revealed two strains from the under-construction area, US1-1 and US2-2, as uncultured Bacillus species and Bacillus thuringiensis, respectively, both with 94% sequence similarity. The phylogenetic results show monophyletic associations between these two strains which could be due to their shared salt location and common ancestors. The sequences of US1-2, US2-1, and MS1-1 were 100% identical to Bacillus licheniformis, while MS1-2 matched Staphylococcus saprophyticus with 100% similarity.
The results of this study point towards significant diversity of bacteria, slightly halophilic, cocci or bacillus shaped. These halophilic bacterial strains, possessing salt-tolerant genes, present the need for further identification of bacterial colonies in the mine and their evolutionary patterns, which could also help uncover the role these microbes play in the ecosystem of the salt mine. Additionally, they show promise for industrial enzyme production.
Characterization of psychrotrophic and thermoduric bacteria in raw milk using a multi-omics approach
Authors: Qin Xue , Cheng Jingqi , Qiu Yue , Guan Ning , Gupta Tanushree B. , Wu Shuyan , Jiang Yujun , Yang Xinyan , Man Chaoxin
Published: November 2024

Psychrotrophic and thermoduric bacteria are the main reasons for the spoilage of dairy products. This study aims to address the composition and function of psychrotrophic and thermoduric bacteria in eight groups of raw milk samples obtained from Heilongjiang Province and Inner Mongolia (China). Microbial enumeration showed an average total bacterial count of 4.63 log c.f.u. ml−1 and psychrotrophic bacterial counts of 4.82 log c.f.u. ml−1. The mean counts of mesophilic and thermophilic thermoduric bacteria were 3.68 log and 1.81 log c.f.u. ml−1, respectively. Isolated psychrotrophic bacteria (26 genera and 50 species) and mesophilic thermoduric bacteria (20 genera and 32 species) showed high microbial diversity. Through metagenomic and proteomic analyses, significant disparities in the concentration and community structure of psychrotrophic and thermoduric bacteria were observed among different locations. A large number of peptidases were annotated by metagenomics, which may result in milk spoilage. They mainly come from some typical psychrotrophic and thermoduric bacteria, such as Chryseobacterium, Epilithonimonas, Pseudomonas, Psychrobacter, Acinetobacter, Lactococcus, Escherichia and Bacillus. However, the main proteins detected in fresh raw milk were associated with bacterial growth, reproduction and adaptation to cold environments. This investigation provides valuable insights into the microbial communities and protein profiles of raw milk, shedding light on the microbial factors contributing to milk deterioration.
Positive impact of Type-A and -C response regulator genes on growth and panicle architecture in rice
Authors: Rong Chenyu , Zhang Renren , Xie Jing , Li Jieru , Yan Tiantian , Liu Ziyu , Liu Yuexin , Xu Ruihan , Shi Xi’an , Zhao Xuebin , Song Jiali , Meng Yayi , Chang Zhongyuan , Ding Yanfeng , Ding Chengqiang
Published: November 2024

Cytokinin signal transduction occurs through a "two-component system." Type-A and -C response regulators (RRs) are groups of proteins of similar structures constituting significant components of cytokinin signal transduction. In rice, 13 (Type-A) and two (Type–C)RRshave been identified to date; however, their functions remain partially known. In this study, we examined the expression patterns of Type-A and Type-C RRs in rice using RNA-Seq and confirmed their functions by constructing mutants of the 15 genes with CRISPR/Cas9. Almost all Type-ARRsplayed positive roles in the development of secondary branches and secondary spikelets, particularlyRR2andRR4. Notably,rr1 rr2andrr8 rr12 rr13higher-order mutants displayed small panicle sizes and decreased plant height. Additionally, both Type-CRRsplayed positive roles in regulating heading date. RNA-seq revealed several genes with significantly altered expression in therr2andrr4mutants, with almost half of the differentially expressed genes (DEGs) overlapping between the two mutants. Many of the DEGs were associated with the cytokinin and abscisic acid pathways. Our findings provide new insights into the functions of Type-A and -CRRsin rice growth and may serve as a foundation for future studies focusing on cytokinin signaling.
Effectiveness of mRNA COVID-19 vaccines and hybrid immunity in preventing SARS-CoV-2 infection and symptomatic COVID-19 among adults in the United States
Authors: Feldstein Leora R. , Ruffin Jasmine , Wiegand Ryan E. , James-Gist Jade , Babu Tara M. , Borkowf Craig B. , Briggs-Hagen Melissa , Chappell James , Chu Helen Y. , Englund Janet A. , Kuntz Jennifer L. , Lauring Adam S. , Lo Natalie , Carone Marco , Lockwood Christina , Martin Emily T. , Midgley Claire M. , Monto Arnold S. , Naleway Allison L. , Ogilvie Tara , Saydah Sharon , Schmidt Mark A. , Schmitz Jonathan E. , Smith Ning , Sohn Ine , Starita Lea , Talbot H. Keipp , Weil Ana A. , Grijalva Carlos G.
Published: November 2024

Background

Understanding protection against SARS-CoV-2 infection by vaccine and hybrid immunity is important for informing public health strategies as new variants emerge.

Methods

We analyzed data from three cohort studies spanning September 1, 2022–July 31, 2023, to estimate COVID-19 vaccine effectiveness (VE) against SARS-CoV-2 infection and symptomatic COVID-19 among adults with and without prior infection in the United States. Participants collected weekly nasal swabs, irrespective of symptoms, annual blood draws, and completed periodic surveys, which included vaccination status and prior infection history. Swabs were tested molecularly for SARS-CoV-2. VE was estimated using Cox proportional hazards models for the hazard ratios of infections, adjusting for covariates. VE was calculated considering prior infection and recency of vaccination.

Results

Among 3,343 adults, adjusted VE of bivalent vaccine against infection was 37.2% (95% CI: 11.4-58.5%) within 7-60 days of vaccination and 17.0% (95% CI: -3.7-33.2%) within 60-179 days of vaccination compared to participants who were unvaccinated/received an original monovalent vaccine dose ≥180 days prior. Overall, adjusted VE of bivalent vaccine, in conjunction with prior infection, was 62.2% (95% CI: 44.2-74.6%) within 7-179 days of vaccination and 39.4% (95% CI: 11.7-61.3%) ≥180 days compared to naïve participants who were unvaccinated/received a monovalent vaccine dose ≥180 days prior.

Conclusions

Adults with both prior infection and recent vaccination had high protection against infection and symptomatic illness. Recent vaccination alone provided moderate protection.