bluuebunny/crossref_metadata_2025 huggingface dataset:
Supporter or Rival: Developing a Network Governance Approach About the Role of Surrogate Inspectorates in Regulatory Governance
Authors: Wesdorp Julia , Klijn Erik Hans
Published: September 2024

Regulatory agencies work in a rapidly changing context: their activities are under increasing scrutiny, in which they intensively interact with societal stakeholders, such as media, labor associations, and grassroots organizations. In this article, we argue these (societal) stakeholders have the potential to take on the role of a surrogate inspectorate and contribute to making regulatory processes more network-like. These informal regulatory stakeholders have no formal authority, but criticize the regulatory agency or regulatee, advocate for other regulative actions, and set agendas for new regulatory issues. These activities make surrogate inspectorates an important actor in regulatory processes. This article defines the role of surrogate inspectorates, which strategies they employ, and how their presence and strategies affect the dynamics (and outcomes) of regulatory governance processes. Building on insights from theories of regulatory governance, network and collaborative governance, mediatization and blame theories, this article provides insights into how surrogate inspectorates can be understood and what angles can be taken to analyze their influence on regulatory processes.
A Scaling Relation, Zm-Type Deconfinement Phases, and Imaginary Chemical Potentials in Finite Temperature Large-N Gauge Theories
Authors: Azuma Takehiro , Morita Takeshi
Published: September 2024

We show that the effective potentials for the Polyakov loops in finite temperature SU$(N)$ gauge theories obey a certain scaling relation with respect to temperature in the large-N limit. This scaling relation strongly constrains the possible terms in the Polyakov loop effective potentials. Moreover, by using the effective potentials in the presence of imaginary chemical potentials or imaginary angular velocities in several models, we find that phase transitions to $Z_m$-type deconfinement phases ($Z_m$ phase) occur, where the eigenvalues of the Polyakov loop are distributed $Z_m$ symmetrically. Physical quantities in the $Z_m$ phase obey the scaling properties of the effective potential. The models include Yang–Mills (YM) theories, the bosonic BFSS matrix model, and ${\mathcal {N}}=4$ supersymmetric YM theory on $S^3$. Thus, the phase diagrams of large-N gauge theories with imaginary chemical potentials are very rich and the stable $Z_m$ phase would be ubiquitous. Monte-Carlo calculations also support this. As a related topic, we discuss the phase diagrams of large-N YM theories with real angular velocities in finite volume spaces.
Cognitive Functional Therapy for Chronic Low Back Pain: A Systematic Review and Meta-Analysis
Authors: Thiveos Lena , Kent Peter , Pocovi Natasha C , O’Sullivan Peter , Hancock Mark J
Published: September 2024

Objective

The objective was to investigate the effectiveness of cognitive functional therapy (CFT) in the management of people with chronic nonspecific low back pain (LBP) and explore the variability in available trials to understand the factors which may affect the effectiveness of the intervention.

Methods

A systematic review with meta-analyses was conducted. Four databases were searched from inception to October 12, 2023. Randomized controlled trials investigating CFT compared with any control group in patients with nonspecific LBP were included. Mean difference and 95% CIs were calculated for pain, disability, and pain self-efficacy. Certainty of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation approach.

Results

Seven trials were included. Low to moderate certainty of evidence was found that CFT was effective for disability at short, medium, and long term time points compared with alternate treatments, including usual care. Low to moderate certainty of evidence was found that CFT is effective for pain in the short and medium terms and probably in the long term. There was high certainty evidence CFT was effective in increasing pain self-efficacy in the medium and long terms. A single study found CFT was cost-effective compared with usual care. Variability was found in the training and implementation of CFT across the included trials, which may contribute to some heterogeneity in the results.

Conclusion

The results show promise in the use of CFT as an intervention likely to effectively manage disability, pain, and self-efficacy in people with chronic nonspecific LBP. The number of clinicians trained, their experience, and quality of training (including competency assessment) may be important in achieving optimal effectiveness.

Impact

This is the most comprehensive review of CFT to date and included investigation of between-trial differences. CFT is a promising intervention for chronic LBP and high-quality synthesis of evidence of its effectiveness is important for its clinical application.
Construction of a Theoretical Model of Chronic Disease Self-Management
Authors: Zuñiga Julie , Thurman Whitney , West Ohueri Chelsi , Cho Emma , Chineyemba Praise , Martin C. Andrew , Mathews William Christopher , Christopoulos Katerina , Davy-Mendez Thibaut , García Alexandra A.
Published: September 2024

The purpose of this article is to describe a model of chronic disease self-management that incorporates the complexity of social and environmental interactions experienced by people who self-manage chronic conditions. This study combines quantitative data from a large national research cohort and qualitative interviews to test and refine a self-management model. The self-management within a syndemic model depicts the contextual, psychological, and social factors that predict self-management behaviors and clinical and long-term outcomes.
Long-Term Loss of Alignment Following ASD Surgery in the Absence of Mechanical Complications
Authors: Haddad Sleiman , Jacobs Eva , Núñez Pereira Susana , Ruiz de Villa Aleix , Pupak Anika , Barcheni Maggie , Ramírez Valencia Manuel , Pizones Javier , Kleinstück Frank S. , Pérez Grueso Francisco Sánchez , Alanay Ahmet , Obeid Ibrahim , Pellisé Ferran ,   European Spine Study Group
Published: September 2024

Study Design:

Retrospective analysis of a prospective multicenter Adult Spinal Deformity (ASD) registry.

Objective:

Assess whether spinal alignment deteriorates post-surgery in absence of mechanical complications and evaluate the long-term outcomes of ASD surgery over a five-year period.

Summary of Background Data:

ASD is prevalent among older adults, leading to significant pain and disability. Surgical intervention, although increasingly popular, is associated with complications, high costs, and uncertain long-term outcomes beyond two years. Mechanical failure and alignment loss often necessitate revision surgeries, but the natural progression of spinal alignment post-surgery without complications remains unclear.

Methods:

Clinical and radiological data were analyzed from surgical patients in a multicenter ASD registry who maintained alignment within the instrumented region and completed a 5-year follow-up. The study evaluated patient demographics, surgical details, radiological parameters, and quality of life (QoL) outcomes. Sub-analyses were conducted to compare patients with different initial postoperative alignments and fixation levels.

Results:

The study included 79 patients (83.5% women, average age 61.9 years) with a mean of 10.7 fused levels. Of these, 29.1% underwent three-column osteotomies (3CO), and 88.6% had a posterior-only approach. While 65% showed favorable alignment at 6 weeks post-surgery, there was a progressive deterioration in global sagittal alignment (Global Tilt/RSA) and thoracic kyphosis over five years (P<0.05), along with increased pelvic compensation (PT SS/RPV). These changes did not correlate with worsening Health-Related Quality of Life outcomes (P>0.05). Older age was linked to greater progression in T2-T12 kyphosis, and osteoporosis was associated with increased SVA and RPV. Optimal immediate postoperative sagittal alignment did not prevent this “aging effect.”

Conclusions:

ASD surgery and achieving ideal postoperative alignment do not prevent the ongoing “aging” of the non-instrumented spine. Both thoracic and global sagittal alignments deteriorate over time. Although no functional decline has been observed, the implications of these changes for surgical planning remain uncertain.
The role of intravenous glutamine administration in critical care patients with acute kidney injury: a narrative review
Authors: Jonny Jonny , Larasati Astrid Devina , Ramadhani Bunga Pinandhita , Hernowo Bhimo Aji , Pasiak Taufiq Fredrik
Published: September 2024

The kidneys are complex organs responsible for waste removal and various regulatory functions. Critically ill patients often experience acute kidney injury (AKI). Although renal replacement therapy is used to manage AKI, nutritional therapy is crucial. Glutamine, an amino acid involved in cellular functions, has potential benefits when administered intravenously to critically ill patients. This administration is associated with reduced mortality rates, infectious complications, and hospitalization duration. However, its use in patients with AKI remains controversial. Glutamine is used by various organs, including the kidneys, and its metabolism affects several important pathways. Intravenous glutamine supplementation at specific doses can improve blood marker levels and restore plasma glutamine concentrations. Moreover, this supplementation reduces infections, enhances immune responses, decreases disease severity scores, and reduces complications in critically ill patients. However, caution is advised in patients with multiple organ failure, particularly AKI, as high doses of glutamine may increase mortality rates. Hyperglutaminemia can have adverse effects. Monitoring and appropriate dosing can help to mitigate these risks. Kidneys rely on glutamine for various essential functions. Thus, the use of intravenous glutamine in critically ill patients with AKI remains controversial. Despite its potential benefits in terms of infection reduction, immunomodulation, and improved outcomes, careful consideration of the patient’s condition, dosage, and treatment duration is necessary. Further research is needed to establish optimal guidelines for glutamine administration in this patient population.
Epigenetic modification of Castor zinc finger 1 (CASZ1) is associated with tumor microenvironments and prognosis of clear cell renal cell carcinoma
Authors: Li Fei , Liang Jiayu , Wei Xin
Published: September 2024

Background:

Clear cell renal cell carcinoma (ccRCC) represents the predominant and remarkably diverse form of renal cell carcinoma. The involvement of the Castor zinc finger 1 (CASZ1) gene in adverse prognostic outcomes has been observed across different cancer types. Nevertheless, the specific altered activities and associated multi-omics characteristics of CASZ1 in ccRCC remain unelucidated.

Method:

In order to explore the expression of CASZ1, evaluate its prognostic significance, and aid in the therapeutic decision-making process for patients with ccRCC, The Cancer Genome Atlas (TCGA), Gene expression omnibus (GEO), and The Human Protein Atlas (HPA) databases were utilized to gather data on clinicopathological data, prognostic information, genomic, methylomic and immunomic data. Additionally, the Genomics of Drug Sensitivity in Cancer (GDSC) database provided information on drug sensitivity.

Results:

CASZ1 expression was found to be significantly reduced in ccRCC and was associated with unfavorable pathological characteristics and a bleak prognosis. Diminished CASZ1 mRNA levels were notably correlated with heightened cytosine-phosphate-guanine (CpG) methylation, indicating a poorer prognosis for patients with increased methylation. Examination of RNA-seq data from TCGA indicated that the CASZ1-high expression subgroup displayed heightened immune cell infiltration and increased expression of immune checkpoint markers, potentially suggesting a more favorable response to immunotherapy. Furthermore, data from the GDSC database indicated that the CASZ1-low expression subgroup might exhibit greater sensitivity to anti-angiogenetic treatments, such as Sunitinib and Axitinib.

Conclusions:

These results indicate that CASZ1 may function as a biomarker for distinguishing various tumor microenvironment phenotypes, predicting prognosis, and assisting in treatment decisions for individuals with ccRCC.
Mechanism Linking Cigarette Pack Factors, Point-of-Sale Marketing and Individual Factors With Smoking Intention Among School-Going Adolescents
Authors: Jetly Kavita , Ismail Aniza , Hassan Noraryana , Nawi Azmawati Mohammed
Published: September 2024

Context:

Tobacco usage accounts for one of the most preventable causes of death.

Objective:

This study aimed to explore mechanisms linking cigarette pack factors, point-of-sale marketing, and individual factors (psychological reactant trait) to predict smoking intention among school-going adolescents.

Design, Setting, and Participants:

This was a cross-sectional study conducted among 6 urban secondary schools. A pretested and validated self-administered questionnaire was used. Data analysis for structural equation modeling was done using SMART-PLS v3.2.8.

Main Outcome Measure:

The main outcome measure was to determine the direct and indirect effects of cigarette pack factors, point-of-sale marketing, and individual factors (psychological reactant trait) to predict smoking intention among school-going adolescents in a theory-based model.

Results:

A total of 386 adolescents fulfilling the inclusion criteria participated. Pictorial warning message reactance (β = .153,P ≤ .001), pack receptivity of conventional pack (β = .297,P = .004), and psychological reactant trait (β = .174,P ≤ .001) were positively related to smoking intention. Pictorial warning negative affect (β = −.153,P = .001) was negatively related to smoking intention. The psychological reactant trait was positively related to message reactance (β = .340,P ≤ .001). However, recall exposure to point-of-sale marketing and pack appraisal of conventional pack was not positively related to smoking intention (β = .038,P = .22 and β = −.026,P = .39, respectively). Pictorial warning message reactance also positively mediates the relationship between psychological reactant trait and smoking intention (β = 0.05, p = .001). The model has strong predictive power.

Conclusion:

In conclusion, cigarette pack factors and psychological reactant traits are essential in predicting smoking intention. Hence, policymakers should consider these factors in developing smoking policies.
A Comparison of Los Angeles County Health Survey Outcomes After Transitioning From Telephone to a Primarily Web-Based, Self-Administration Data Collection Mode
Authors: Lewis Taylor , Freedner Naomi , Lee Nicole , Cui Yan , Rosales Monica , Shah Megha
Published: September 2024

Context:

As response rates to health surveys conducted by telephone continue to fall while data collection costs rise, practitioners are increasingly transitioning to address-based sample (ABS) designs with a self-administered, mail contact data collection mode.

Objective:

To compare differences in key health indicators produced from both the Adult Survey and Child Survey of the Los Angeles County Health Survey (LACHS), which transitioned from a telephone to primarily self-administered mode in the 2022-2023 administration.

Design:

Weighted survey estimates from the 2015, 2018, and 2022-2023 LACHS administrations are compared to investigate differences that may be attributable to LACHS’ recent mode transition.

Setting:

All survey data were collected of residents of Los Angeles County between 2015 and 2023.

Main Outcome Measures:

Response rates and key health indicators produced from the Los Angeles County Health Survey.

Results:

Introducing the self-administration mode led to modest response rate increases of approximately 10% to 16% for the Adult Survey and from 10% to 14% in the Child Survey. Key health indicator differences are mixed, but generally larger in magnitude across the mode transition, and also generally larger for the Adult Survey relative to the Child Survey.

Conclusions:

Transitioning a population health survey from a telephone mode to a primarily self-administration mode using an ABS design comes with tradeoffs. Increased response rates and a greater ability to target lower-level geographies and other population domains of interest may be offset by mode effects that cannot be compensated for by weighting adjustments.
Contemporary Management of Distal Radius Fractures: What All Plastic Surgeons Should Know
Authors: Hooper Rachel C. , Haase Steven C. , Mithani Suhail K. , Palazzo Michelle , Chung Kevin C.
Published: September 2024

Distal radius fractures are extremely common. Plastic surgery trainees and practicing surgeons who encounter these patients should be familiar with the various treatment options. Although the volar locking plate has revolutionized treatment of these fractures, we believe it is important to highlight the anatomy, diagnosis, and contemporary management of specific fracture patterns that may require techniques beyond volar plating.
Effects of Positive Psychological Interventions on Psychological Outcomes, Quality of Life, and Inflammation Biomarkers in Inflammatory Bowel Disease Patients
Authors: Liang Yongchun , Li Yunhua , Zhou Mingming
Published: September 2024

This meta-analysis aimed to systematically evaluate the effects of positive psychological interventions on anxiety, depression, stress, mindfulness, hope, quality of life, and disease activity, as well as inflammation biomarkers, in patients with inflammatory bowel disease. Databases such as Cochrane Library, PubMed, EBSCO, Embase, Web of Science, China Biomedical Literature Database, China Knowledge Network, and WANFANG DATA were searched by two researchers from the time of each database’s creation to November 2022. A total of 14 randomized controlled trials (RCTs) with 1,191 patients were included. The results showed that positive psychological interventions were effective in reducing anxiety (standardized mean difference [SMD] = −0.81, 95% confidence interval [CI] [−1.33, −0.30], p = .002), depression (SMD = −0.86, 95% CI [−1.32, −0.41], p = .0002), and stress (SMD = −0.68, 95% CI [−1.05, −0.31], p = .0003), and significantly increased the level of hope (weighted mean difference [WMD] = 3.26, 95% CI [0.84, 5.68], p = .008), mindfulness (SMD = 0.59, 95% CI [0.30, 0.88], p < .0001), and quality of life (SMD = 0.61, 95% CI [0.09, 1.14], p = .02) of patients with inflammatory bowel disease. This suggests that positive psychological interventions can significantly improve positive psychology and reduce negative emotions in patients with inflammatory bowel disease.
The Impact of HLA-DQαβ Heterodimer Mismatch on Living Donor Kidney Allograft Outcomes
Authors: Charnaya Olga , Ishaque Tanveen , Hallett Andrew , Morris Gerald P. , Coppage Myra , Schmitz John L. , Timofeeva Olga , Lázár-Molnár Eszter , Zhang Aiwen , Krummey Scott , Hidalgo Luis , Segev Dorry L. , Tambur Anat R. , Massie Allan B.
Published: September 2024

Background.

HLA-DQ mismatch has been identified as a predictor of de novo donor-specific HLA antibody formation and antibody-mediated rejection. There are insufficient data to guide the incorporation of DQ mismatch into organ allocation decisions.

Methods.

We used a retrospective longitudinal cohort of adult living donor kidney transplant recipients from 11 centers across the United States for whom high-resolution class II typing was available. HLA-DQαβ heterodimer allele mismatch was quantified for all donor-recipient pairs, and outcome data were obtained through linkage with the Scientific Registry of Transplant Recipients.

Results.

We studied 3916 donor-recipient pairs. Recipient characteristics were notable for a median age of 51 (38–61) y, primarily unsensitized, with 74.5% of the cohort having 0% calculated panel-reactive antibody, and 60.4% with private insurance, for a median follow-up time of 5.86 y. We found that the HLA-DQαβ allele and HLA-DR antigen mismatch were each individually associated with an increased hazard of all-cause graft failure (adjusted hazard ratio [aHR] DQ = 1.03 1.14 1.28; aHR DR = 1.03 1.15 1.328), death-censored graft failure (aHR DQ =1.01 1.19 1.40; aHR DR = 0.099 1.18 1.39), and rejection. Having 2 HLA-DQαβ allele mismatches further increased the hazard of rejection even when controlling for HLA-DR mismatch (aHR 1.03 1.68 2.74).

Conclusions.

HLA-DQαβ allele mismatch predicted allograft rejection even when controlling for HLA-DR antigen mismatch and were both independently associated with increased risk of graft failure or rejection in adult living kidney transplant recipients. Given the strong burden of disease arising from the HLA-DQ antibody formation, we suggest that HLA-DQαβ should be prioritized over HLA-DR in donor selection.
A case of pleural Mycobacterium tuberculosis infection with reversion of Quantiferon Gold Plus results from positive to negative
Authors: Goire N. , Suchard M.S. , Barling A. , Fernando R. , Dreyer L. , Mahony A.A.
Published: September 2024

Introduction.
Mycobacterium tuberculosis (MTB) infections continue to have a high mortality and morbidity burden globally. Interferon-gamma release assays such as Quantiferon Gold Plus (QFG-Plus) aid in diagnosis of latent TB but diagnosis of pleural TB remains challenging. We present a case of active pleural MTB infection with reversion from positive to negative of IGRA result as well as negative Xpert MTB/RIF Ultra PCR result from tissues obtained from pleural biopsy.

Case summary. A 52-year-old otherwise healthy male presented in August 2022 with a 2 week history of pleuritic chest pain associated with modest elevation in inflammatory markers. The patient had had a positive QFG-Plus result in 2018, however QFG-Plus during this admission was negative. Computed-tomography pulmonary angiogram and needle thoracocentesis showed an exudative left pleural effusion with predominant lymphocytes. The patient’s symptoms failed to resolve with empiric antimicrobial therapy for community-acquired pneumonia. Broncho-alveolar lavage as well as biopsies of pleural tissues via video-assisted thoracoscopic surgery from the left lower lobe yielded negative results on routine microbiological culture as well as Xpert Ultra PCR. Growth of acid-fast bacilli was noted from mycobacterial cultures of pleural tissues which was identified as MTB.

Conclusion. Despite significant technological advances, microbiological diagnosis of MTB infections remains challenging. We document QFG-Plus reversion during development from latent to active pleural TB. Decline in the ability of CD4+ and CD8+ T cells to produce interferon gamma in response to TB antigens (ESAT-6 and CFP-10) was likely associated with loss of host control of latent MTB. This case serves as a reminder that despite exhaustive testing with state-of-art diagnostic platforms, MTB infections can still elude discovery.
Risk of adverse pregnancy outcomes and impact of statin use in pregnant women with familial hypercholesterolemia
Authors: Svendsen Karianne , Christensen Jacob Juel , Igland Jannicke , Krogh Henriette Walaas , Mundal Liv J. , Jacobs David R. , Bogsrud Martin P. , Holven Kirsten B. , Retterstøl Kjetil
Published: September 2024

Background and aims

Sparse data exist on the possible risk of adverse pregnancy outcomes in women with familial hypercholesterolemia (FH). We investigated associations between having a FH diagnosis and adverse pregnancy outcomes, and between statin exposure in pregnancy and adverse pregnancy outcomes among women with FH.

Methods

This registry-based study included 3869 pregnancies among 1869 women with FH and 68225 pregnancies among 33661 women from the general population. Data on adverse pregnancy outcomes were obtained from the Medical Birth Registry of Norway with data from 1967-2018. Data on pharmacy-dispensed statins were obtained from the Norwegian prescription database (2004-2018) in 1051 women with FH. Associations were presented as odds ratio (OR) with 95% CI from logistic regression adjusted for mother’s age, parity, and offspring’s birth year.

Results

Women with FH had a higher risk of preeclampsia (OR 1.21 [1.00-1.46]), but lower risk for gestational diabetes (OR 0.58 [0.36-0.92]) and intrapartum hemorrhage during delivery (OR 0.81 [0.71-0.92]) compared to controls. No excess risk of adverse pregnancy outcome in offspring was observed for FH vs controls. Women with FH using statins in pregnancy (n=260) had a higher risk of having offspring with low (<2500 g) birth weight (OR 2.20 [1.11, 4.49]) compared to non-exposed women with FH (n=791).

Conclusions

Women with FH had lower risk of gestational diabetes and intrapartum hemorrhage during delivery and non-significantly higher risk of preeclampsia compared to controls. No difference in adverse pregnancy outcomes in the offspring was observed. Statin exposure in pregnancy was associated with a higher risk of having offspring with low birth weight among women with FH, and this association warrants further investigations.
Mutations in the U2 snRNA geneRNU2-2Pcause a severe neurodevelopmental disorder with prominent epilepsy
Authors: Greene Daniel , De Wispelaere Koenraad , Lees Jon , Katrinecz Andrea , Pascoal Sonia , Hales Emma , Codina-Solà Marta , Valenzuela Irene , Tizzano Eduardo F. , Atton Giles , Donnelly Deirdre , Foulds Nicola , Jarvis Joanna , McKee Shane , O’Donoghue Michael , Suri Mohnish , Vasudevan Pradeep , Stirrups Kathy , Morgan Natasha P. , Freson Kathleen , Mumford Andrew D. , Turro Ernest
Published: September 2024

The major spliceosome comprises the five snRNAs U1, U2, U4, U5 and U6. We recently showed that mutations inRNU4-2, which encodes U4 snRNA, cause one of the most prevalent monogenic neurodevelopmental disorders. Here, we report that recurrent germline mutations inRNU2-2P, a 191bp gene encoding U2 snRNA, are responsible for a related disorder. By genetic association, we implicated recurrentde novosingle nucleotide mutations at nucleotide positions 4 and 35 ofRNU2-2Pamong nine cases. We replicated this finding in six additional cases, bringing the total to 15. The disorder is characterized by intellectual disability, neurodevelopmental delay, autistic behavior, microcephaly, hypotonia, epilepsy and hyperventilation. All cases display a severe and complex seizure phenotype. Our findings cement the role of major spliceosomal snRNAs in the etiologies of neurodevelopmental disorders.
Co-circulation of Clade Ia and Ib monkeypox virus in Kinshasa Province, Democratic Republic of the Congo, July - August 2024
Authors: Wawina-Bokalanga Tony , Akil-Bandali Prince , Kinganda-Lusamaki Eddy , Lokilo Emmanuel , Jansen Daan , Amuri-Aziza Adrienne , Makangara-Cigolo Jean-Claude , Pukuta-Simbu Elisabeth , Ola-Mpumbe Rilia , Kacita Cris , Paku-Tshambu Princesse , Dantas Pedro-Henrique L.F. , Luakanda Gradi , Nkuba-Ndaye Antoine , Matondo Meris , Bulabula Junior , Hasivirwe Vakaniaki Emmanuel , O’Toole Áine , De Block Tessa , Ngandu Christian , Hoff Nicole A. , Low Nicola , Subissi Lorenzo , Merritt Sydney , Muyembe-Tamfum Jean-Jacques , Liesenborghs Laurens , Peeters Martine , Delaporte Eric , Kindrachuk Jason , Rimoin Anne W. , Ahuka-Mundeke Steve , Rambaut Andrew , Mwamba Dieudonné , Vercauteren Koen , Mbala-Kingebeni Placide
Published: September 2024

Mpox cases have been reported in nearly all provinces of the Democratic Republic of the Congo as of August 2024. Monkeypox virus positive samples from Kinshasa, collected between July and mid-August 2024, were sequenced using a probe-based enrichment or optimized tiling sequencing protocol. With multiple introductions of both Clade Ia (7/12) and Ib (5/12), marking Kinshasa, and its Limete health zone specifically, as an area with co-circulation of both Clade I, a unique observation illustrating the growing complexity of Clade I mpox outbreaks in DRC.
Adverse events affecting recovery from seasonal influenza vaccination in the hypertensive population: A population-based pharmacovigilance analysis
Authors: Wu Hao , He Xiaona , Cao Yu , Gao Wei
Published: September 2024

Seasonal influenza vaccination is crucial for preventing influenza and its complications. Data from the U.S. Vaccine Adverse Event Reporting System (VAERS) indicate a higher proportion of adverse events (AEs) after influenza vaccination in hypertensive people. However, there is limited evidence on AEs in hypertensive people following seasonal influenza vaccination. We collected a total of 4647 individuals on seasonal influenza vaccination and 6380 AEs from VAERS for hypertensive people aged 18 years or older from 1 January 2013 to 23 June 2023. We conducted propensity score matching (PSM) by adjusting for the demographic characteristics of the seasonal influenza-vaccinated hypertensive population and the season of onset. Cox regression analysis was used to calculate the risk ratio of reported adverse events (AEs) that affected recovery after seasonal influenza vaccination. Most AEs were nonserious and occurred within 48 hours. The most common AEs were general disorders and administration site conditions (therapeutic and non-therapeutic responses, inflammation) and musculoskeletal and connective tissue disorders (musculoskeletal and connective tissue pain and discomfort, bursal disorders, joint-related signs, and symptoms). All three types of seasonal influenza vaccines were associated with injection site reactions (47.07% trivalent influenza vaccine [TIA], hazard ratio, HR 2.04, 95% confidence interval, CI 1.22–3.40; 20.00% quadrivalent influenza vaccine [QIA], HR 2.81, 95% CI, 1.81–4.37; 67.48% influenza vaccine, unknown manufacturer [FLUX], HR 2.83, 95% CI, 1.12–7.15) and were the AEs affecting the largest proportion of delayed recoveries in the hypertensive population. Potential AEs following seasonal influenza vaccination may affect the recovery of the hypertensive population. The majority of AEs reported were general disorders, predominantly injection site reactions, and nonserious.
Women Empowerment and its Effect on Female Genital Mutilation in Sub-Sahara Africa: A study using Recent Demographic Health Surveys
Authors: Koray Munawar Harun , Mugisha John
Published: September 2024

Background

Women empowerment can enhance and improve women decsions and will power to negotiate and stand against sensitive issues that affect women’s health and sexuality. Practices such as Female Genital Mutilation (FGM) are generally sensitive issues that requires education and holistic interventions to enable its eradication, particularly in sub-Sahara Africa (SSA), where the practice is still pervasive. This study investigated the effect of women empowerment, using the Survey-base Women Empowerment (SWPER) Global index, on FGM in selected countries in SSA.

Methods

The study employed cross-sectional design using the most recent Demographic Health Survey (DHS) data from 10 SSA countries. A total of 49501 women who were either married or living with a partner and have a daughter age 0 – 14 years who is either circumcised or not. Pearson’s chi-square test was used to examine the association between women empowerment and daughter with FGM, and countries. Bivariate and multivariate logistic regressions were used to examine the predictors of FGM at a significance level of p ≤ 0.05 and 95% confidence interval. Complex survey design was considered in the analysis.

Results

49,501 participants were included in the study and 47.96% exhibited a positive attitude towards violence. Empowerment in SWPER domains were significantly associated with FGM (p < 0.0001), with Kenya and Tanzania exhibiting high levels of women empowerments and low prevalence of FGM. Medium and highly-empowered mothers had significantly lower odds of having a child with FGM in the bivariate regression models (p < 0.0001), compared to mothers with low empowerment levels. When adjusted for confounders, increasing age is associated with higher odds of FGM with mothers age 45-49 mothers having more than 4 times higher odds (AOR: 4.265, 95%CI: 3.466 – 5.248). Muslim mothers also had higher odds of having a child with FGM (AOR: 6.046; 95%CI: 5.605 – 6.521) compared to Christian mothers. An increase in the wealth index was also a protective factor against FGM (p < 0.0001). Circumcised mothers were more likely to have their female child circumcised (AOR: 5.527; 95%CI: 5.113 – 5.975) and female household heads were found to be protective factors against FGM (AOR: 0.846; 95%CI: 0.774 – 0.925).

Conclusion

The study highlights a connection between women’s empowerment and FGM prevalence in SSA, highlighting the need to promote women’s autonomy and reject violence. Traditional norms and cultural support for FGM persist, particularly in Western Africa. Targeted empowerment initiatives, education, and strengthening legal frameworks can help reduce FGM prevalence.
Understanding the primary healthcare context in rural South and Southeast Asia: a village profiling study
Authors: Chew Rusheng , Ibna Zaman Sazid , Ara Joly Mst. Asfat , Uddin Didar , Nurullah Md , Callery James J , Perrone Carlo , Peto Thomas J , Phommasone Koukeo , Phyo Aung Pyae , Roobsoong Wanlapa , Sen Aninda , Vanna Moul , Chandna Arjun , Pongvongsa Tiengkham , Dysoley Lek , Day Nicholas PJ , Lubell Yoel , Maude Richard J
Published: September 2024

The use of comprehensive village profiles is one way of characterising contextual factors important for the implementation of primary healthcare interventions and service planning in rural areas. However, there are few such data available at the village level in rural South and Southeast Asia. This study aimed to address this gap, as well as compare high-level data from representative under-served and understudied villages across seven sites in five countries (Thailand (n=3), Cambodia, Laos, Myanmar, and Bangladesh). A survey-based approach using key informants supplemented by other relevant information sources was used to collect data from 687 of 707 villages participating in the South and Southeast Asian Community-based Trials Network. Data on four key health and socio-economic indicators (literacy rate, percentage of attended deliveries, percentage of fully-immunised children, and percentage of latrine coverage) as well as access to health services, public utilities, and education were collected and analysed using descriptive statistics. There was considerable variation between sites in terms of health and socio-economic indicators given that the countries are at different stages of development, and also between the three sites in Thailand. Five of the seven sites were highly diverse ethno-culturally and linguistically, and all were reliant on primary health centres as well as village health workers/village malaria workers as the main providers of primary healthcare. These were generally bypassed by severely ill patients in favour of first-level referral hospitals and private sector facilities in towns. While >75% of villages at each site were near to a primary school, educational attainment was generally low. Over 70% of villages at each site had mobile phone coverage and availability of electricity was high (≥65% at all sites bar Myanmar). These results illustrate the wide diversity of villages in rural South and Southeast Asia that need to be considered in public health research and policymaking.
Risks and long-term prognosis of new-onset heart failure afterde novopermanent pacemaker implantation: nationwide cohort study
Authors: Park Young Jun , Lee Sungjoo , Hong Sungjun , Kim Kyunga , Kim Juwon , Kim Ju Youn , Park Kyoung-Min , On Young Keun , Park Seung-Jung
Published: September 2024

Background

Previous studies on pacemaker-associated heart failure (PaHF) have predominantly analyzed relatively small, single-center datasets, mainly focusing on incidence and predictors. However, the clinical implications of PaHF on mortality, particularly in relation to standard HF medications or upgrading to cardiac resynchronization therapy (CRT), has been underexplored.

Methods

Utilizing nationwide real-world data from the Korean National Health Insurance Service database, we analyzed 32,216 patients undergoing permanent pacemaker (PPM) implantation without preexisting HF between 2008 and 2019. The incidence, predictors, and mortality risk of PaFH were evaluated. To address potential immortal-time bias due to the time-dependent occurrence of PaHF, the time from the PPM implantation to the first diagnosis of PaHF was analyzed as a time-dependent covariate. For patients with PaHF, a propensity score-matched analysis was conducted based on CRT-upgrade status to explore the effect of CRT-upgrade on the risk of all-cause mortality.

Results

During the median 3.8-year follow-up period, PaHF and all-cause death occurred in 4170 (12.9%) and 6184 (19.2%) of the 32,216 PPM patients (42.3% male, mean age 70.6 years), respectively. PaHF development was closely associated with all-cause mortality, with a significantly higher mortality risk in the PaHF than in the non-PaHF group (hazard ratio [HR]=3.11, 95% confidence interval [CI]=2.93–3.32, P<0.001) after adjusting for immortal-time bias. The PaHF incidence and PaHF-associated mortality risk, although highest for the first six months post-PPM, did not disappear and increased again with follow-up time. In both the entire cohort (n=4170) and the propensity score-matched cohort (n=1685) of PaHF patients, CRT upgrade (HR=0.34, 95% CI=0.24–0.47, P<0.001), the use of beta-blockers (HR=0.75, 95% CI=0.61–0.93, P=0.010), and angiotensin receptor neprilysin inhibitor (ARNI) use (HR=0.28, 95% CI=0.14–0.54, P<0.001) were identified as potent protective factors against post-PaHF all-cause mortality.

Conclusions

PaHF development independently predicted post-PPM mortality, while upgrading to CRT and the use of beta-blockers or ARNI were identified as favorable prognostic factors for post-PaHF overall survival. Therefore, for PaHF patients, an immediate change into CRT or conduction system pacing, may be required along with optimal HF medications owing to the ongoing mortality risk.
Should women have lower blood pressure targets than men? Sex differences in blood pressure and cardiovascular disease in the UK Biobank
Authors: Kelly Rebecca K , Harris Katie , Carcel Cheryl , Muntner Paul , Woodward Mark
Published: September 2024

Background

Recent studies show that the risk of cardiovascular disease (CVD) increases from a lower nadir of systolic blood pressure (SBP) in women than men, and increases thereafter at a greater rate. This has led to a suggestion that sex-based SBP thresholds are required. We aimed to investigate sex differences in the associations of SBP and incident atherosclerotic CVD in a large prospective cohort.

Methods

420,649 UK Biobank participants with no prior history of CVD were included. Age-adjusted sex-specific risks, relative risks (RRs) and risk differences (RDs) relating SBP to CVD were estimated using Poisson and Cox regression.

Results

Over 13.2 years of follow-up there were 28,628 CVD events. CVD risks across BP levels showed a “J-shape”, and were higher in men than women at all BP levels. The lowest risks were at SBP 100-<105 mmHg (events per 10,000 person-years [95%CI]: 15.6 [11.8-23.1]) and 110-<115 (47.2 [41.8-53.0]) among women and men, respectively. Compared with SBP 100-<110, sex-specific RRs at above 120 were higher in women than men, but RDs were higher in men than women at all levels of SBP. Furthermore, compared to men at 100-<110 (i.e. the men with least risk), risks in women were lower at all levels of SBP below 170.

Conclusions

CVD risk is lowest for women at a slightly lower SBP than men and RRs for CVD increase with SBP at a slightly steeper rate in women. However, both risks and RDs in women are never greater than in men. This evidence suggests that women should not have lower BP thresholds.

Clinical Perspective

What is New?

While risks are higher at lower BP levels in women than men when both sexes are considered independently, consideration of the risks and sex-combined analyses do not support treating women at lower BP levels than men.

What are the Clinical Implications?

In line with 2017 ACC/AHA guideline, antihypertensive treatment thresholds should be based on absolute risk calculated from sex-specific algorithms, rather than BP level in isolation.

Both risks and relative risks must be taken into account to understand sex-differences in the relationship of BP-CVD and whether these differences are clinically meaningful.
Single-shot detection of microscale tactile features
Authors: Reschechtko Sasha , Pangan Wylianne R. , Zadeh Reza Zeinal , Pruszynski J. Andrew
Published: September 2024

Tactile detection of very small features requires relative motion between the fingertip and a surface. The specific movement strategies that people use may be critical to maximize detection ability but little is known about the movement strategies people employ to support such detection. Here, human participants actively scanned a fingertip across a pair of silica wafers to detect which of the two contained a microscale feature (2, 6, and 10 μm height and 525 μm diameter). We constrained fingertip movement to ensure that participants would always contact the feature and would only contact the feature once. These procedures encouraged participants to use strategies that optimized detection rather than search and thus allowed us to more directly link movement strategies to detection. We also investigated the effects of fingertip movement direction and the finger used on detection. We found that participants were able to consistently detect microscale features as small as 2 μm on the basis of a single contact event. The contact forces that participants used were substantially higher than those observed in previous studies focused on tactile search or geometric feature extraction. Scanning speeds were slower than those found during tactile search but faster than those reported during geometric feature extraction. Taken in conjunction with the associations between detection and finger used as well as scan direction, our results suggest that control and consistency of fingertip movement may be a primary consideration for movement strategies that optimize tactile detection.
Immediate Modulation of the Blood Oxygenation Level-Dependent Signals by Dual-Site Transcranial Alternating Current Stimulation Propagates Across the Whole Brain
Authors: Hiromitsu Kentaro , Asai Tomohisa , Kadota Hiroshi , Imaizumi Shu , Kamata Masashi , Imamizu Hiroshi
Published: September 2024

Transcranial alternating current stimulation (tACS) is assumed to target specific brain regions and modulate their activity. Recent discussions of tACS propose that, entraining the phase of brain activity to the stimulation current, stimulation effects extend globally across the whole brain based on phase differences. However, immediate online spatiotemporal propagation of resting-state blood oxygenation level-dependent (BOLD) signals within the brain due to multi-region stimulation remains unclear. The objectives of the present study were three-fold: 1) to elucidate the immediate online effect of tACS on BOLD signal, 2) to examine the extent of the influence on the brain when applying tACS, and 3) to explore whether variations in the phase difference between two brain regions result in differential effects on the stimulated areas and the whole brain. Through two experiments involving high-definition tACS with simultaneous measurements using a functional magnetic resonance imaging (fMRI), we revealed that the immediate online stimulation effects not only altered BOLD signals in the stimulated regions but also propagated across the whole brain in specific spatiotemporal patterns (functional networks). Stimulation effects were observed specifically in regions rich in neural fibres, including the grey and white matter, with no effect in regions containing cerebrospinal fluid. The timing of the signal value peaks depended on the stimulated region and functional networks, with a notable trend observed. Thus, tACS with a specific phase difference in two anatomically connected brain regions can immediately modulate online neural dynamics at both local and global scales.

Graphical abstract
Brain-Body Interactions Influence the Transition from Mind Wandering to Awareness of Ongoing Thought
Authors: Shinagawa Kazushi , Tanaka Yuto , Terasawa Yuri , Umeda Satoshi
Published: September 2024

Our thoughts are inherently dynamic and often wander far from our current situation (mind wandering, MW). Although previous research revealed that the ascending arousal system shapes neural dynamics to mediate awareness of ongoing thoughts, the physiological states and afferent signals altered by this activation and its effects on awareness are unknown. In this study, we examined electroencephalography (EEG), electrocardiography (ECG), and respiration data before participants were aware of MW during a task in which they focused on external or internal stimuli. We showed that the transition from MW to awareness was characterized by decreased alpha and beta activity and increased heartbeat-evoked potential (HEP) amplitudes. In addition, the participants were more likely to be in the exhalation phase becoming aware, and in the inhalation phase at the time of MW reports. Moreover, changes in cardiac activity and HEP accompanied this pattern when participants were asked to focus on respiration. Based on these findings, we suggest that the release from the increased cognitive load with sustained MW and catching these changes as physiological alterations supporting awareness of MW; moreover, the modulation of the respiratory cycle by focusing on breathing enhances these changes.
Computer vision guided rapid and precise automated cranial microsurgeries in rodents
Authors: Navabi Zahra S , Peters Ryan , Gulner Beatrice , Cherkkil Arun , Ko Eunsong , Dadashi Farnoosh , Brien Jacob O , Feldkamp Michael , Kodandaramaiah Suhasa B
Published: September 2024

Neuroscientists employ various experimental procedures to interface with the brain to study and perturb the neural activity during behavior. A common procedure that allows such physical interfacing is cranial microsurgery, wherein small to large craniotomies are performed in the overlying skull for insertion of neural interfaces or implantation of optically clear windows for long-term cranial observation. Performing craniotomies is, however, a skilled task that requires significant time and practice and further needs to be carried out precisely to ensure that the procedure does not cause damage to the underlying brain and dura. Here, we present a computer vision-guided craniotomy robot (CV-Craniobot) that utilizes machine learning to accurately estimate the dorsal skull anatomy from optical coherence tomography (OCT) images. Instantaneous information of the skull morphology is used by a robotic mill to rapidly and precisely remove the skull from a desired craniotomy location. We show that the CV-Craniobot can perform small (2 - 4 mm diameter) craniotomies with near 100% success rates within 2 minutes and large craniotomies encompassing most of the dorsal cortex in less than 5 minutes. Thus, the CV-Craniobot enables rapid and precise craniotomies, significantly reducing surgery time as compared to human practitioners and eliminating the need for long training.