bluuebunny/crossref_metadata_2025 huggingface dataset:
DROUGHT AND HOTTER TEMPERATURE IMPACTS ON SUICIDE: EVIDENCE FROM THE MURRAY–DARLING BASIN, AUSTRALIA
Authors: XU YING , WHEELER SARAH ANN , ZUO ALEC
Published: August 2023

The Murray–Darling Basin (MDB) is Australia’s prime agricultural region, where drought and hotter weather pose a significant threat to rural residents’ mental health – hence increasing their potential suicide risk. We investigate the impact of drought and hotter temperatures on monthly suicide within local areas in the MDB, from 2006–2016. Using Poisson fixed-effects regression modeling, we found that extreme drought and hotter temperatures were associated with increased total suicide rates. The effects of extreme drought and temperature on suicide were heterogeneous across gender and age groups, with younger men more vulnerable. Areas with higher percentages of Indigenous and farmer populations were identified as hot spots, and were vulnerable to increased temperatures and extreme drought. Green space coverage (and to some extent higher incomes) moderated the drought and suicide relationship. Providing targeted interventions in vulnerable groups and hot spot areas is warranted to reduce the suicide effect of climate change.
Active Bi layers of lead titanate for optoelectronic applications — computational full potential study
Authors: Jayalakshmi D. S. , Subhashree G. , Pooja R.
Published: August 2023

First principles investigation of PbTiO3 in bulk and layer phases has been performed using full potential-linear augmented plane wave method (FP-LAPW) implemented in WIEN2K code, based on the density functional theory (DFT) within the generalized gradient approximation (GGA) to explore the structural, electronic, thermoelectric and optical properties of PbTiO3. Total energy calculations, optimized structure, band structure, density-of-states (DoS), optical, and thermoelectric properties are computed and analyzed. The change in structural and electronic phases are observed. The optical properties of the compound can be studied by evaluating from the optical spectra and the changes in the properties such as complex dielectric function, absorption, energy loss function, refractive index and refractivity are studied. The thermoelectric properties are analyzed from Seebeck coefficient, power factor and thermoelectric figure of merit. The superior phase of PbTiO3 is analyzed from the observation of all the above-mentioned properties for optoelectronic applications.
Temperature effect on sulphur adsorption on iron surface: A molecular dynamics simulations study
Authors: Risanti Doty Dewi , Donna Yosiana Ria , Sahputra Iwan Halim
Published: August 2023

The effect of temperature on the adsorption of a sulphur atom on the Fe(110) surface has been investigated using molecular dynamics simulations at a temperature of 353[Formula: see text]K, 373[Formula: see text]K and 398[Formula: see text]K. The most favorable adsorption site for a sulphur atom on the Fe(110) is found at a hollow site. The perpendicular height of the sulphur atom position is 4.017[Formula: see text]Å above the Fe surface at a temperature of 398[Formula: see text]K. The Fe–S bonding strength was affected by temperature, it becomes weaker with increasing temperature. The adsorption energy is calculated to be −6.640[Formula: see text]eV, −6.579[Formula: see text]eV and −1.841[Formula: see text]eV for the system at a temperature of 353[Formula: see text]K, 373[Formula: see text]K and 398[Formula: see text]K, respectively. This condition is confirmed by experimental results where the corrosion rate of the samples began to appear at 353[Formula: see text]K, with darker physical characteristics of the corrosion.
Blockchain-Based Framework for Supply Chain Traceability
Authors: Korkmaz Elif Bağnu , Erkayman Burak
Published: August 2023

Alcohol counterfeiting, which negatively affects people’s lives in terms of economic, health, and social aspects, is one of the crucial problems that arise in many countries. For this reason, information should be made visible and traceable in all current flows of manufactured products from the raw material supplier to the retailer. In this study, a blockchain-based system architecture is proposed to ensure the traceability of raki (an anise-flavored Turkish drink), which is heavily counterfeited in Turkey. The information that adds value to the product is recorded in blocks in the blockchain, which is the building block of the system architecture, and this recorded information can be viewed by the relevant stakeholders. Product traceability is carried out with two smart contracts. With the Asset Registration Smart Contract (ARSC), assets are identified in the digital layer and the lot ID is assigned to the assets. The security of these smart contracts is ensured by storing recorded information in the blockchain, where it cannot be deleted or changed. Hyperledger Fabric, a blockchain platform, is used in the proposed architecture. In addition, QR codes integrated into the system act as a bridge between the physical and digital layers, directing consumers to the blockchain layer for traceability. Thus, the consumer will be able to see all the stages of the product that have transparently reached him and will be able to notice any counterfeiting event that may occur. In this context, it is foreseen that the proposed architecture will prevent raki counterfeiting as much as possible and provide transparency and traceability in all processes from raw material to bottle.

This paper is arranged as follows. In Sec.  1 , the problem is defined, the solution for the problem is explained, information is given about the technologies proposed for the solution, and current studies on the subject are discussed. In Sec.  2 , the system architecture created for traceability is explained in detail. Section  3 describes the results.
Analysis of Factors Influencing Entrepreneurial Intention among Indian Women in Computing Industry — An NVivo Approach
Authors: Khan Sameen , Tomar Sarika
Published: August 2023

Background: Entrepreneurial intention (EI) is the determination of the behavior that leads to entrepreneurship. The research study is mainly concerned with the factors that influence EI of women. And also to comprehend the constraints and hurdles women face towards starting an entrepreneurial venture. Azjen’s theory of planned behavior is being employed to comprehend the EI of Indian Muslim women. The theory contains the personal attitude, perceived behavioral control (PBC) and subjective norms (SN). Furthermore, intentions are also discussed in the context of religion.

Methods: A semi-structured interview schedule was carried out where a total of 7 Muslim women were interviewed in order to understand their intentions and motivations in starting a business. After gathering the data, the data were analyzed by NVivo software. This paper focused on the codes and themes generated by the software. The validity of the study was determined by content analysis, auto-coding and perusal of the themes by a subject matter expert.

Findings: The findings portray the importance of the role of family and society in deciding an entrepreneurial venture by Muslim women. The investigative outcomes of the study depict the unawareness of government schemes, limited role models and lack of training. One important factor that was discovered was the fear and insecurity Muslim women have due to their visible Muslim identity. All these features have a paramount influence on the EI of Muslim women.
Effect of π-Bridge in D–π–A Architecture and Adsorption of Phenothiazine Dyes on TiO2 Nanocrystalline for Dye-Sensitized Solar Cells: A DFT Approach
Authors: Kumar Vipin , Chetti Prabhakar
Published: August 2023

In this work, the impact of extending [Formula: see text]-bridge and the adsorption of dyes on the nanocrystalline surface of TiO2 on photovoltaic parameters in dye-sensitized solar cells (DSSCs) has been explored. The dyes comprise phenothiazine (donor), along with benzene, furan, thiophene and selenophene ([Formula: see text]-spacers), and cyanoacrylic acid anchoring group (acceptor). The dye geometries, charge transference, and electronic characteristics were investigated using density functional theory (DFT). The impact of extended [Formula: see text]-bridge in conjugated systems was explored in dyes along with dyes adsorbed on TiO2 nanocrystalline surface (dye@TiO[Formula: see text]. For the architecture D–[Formula: see text]–A in this work, the dyes are effectively adsorbed on the TiO2 nanocrystalline surface. The energy gap between HOMO and LUMO (HLG), ionization potential (IP), reorganization energies ([Formula: see text], electron affinity (EA), photovoltaic parameters, adsorption energy (AE), and total density of state (TDOS) are simulated theoretically. Additionally, our investigation illustrates that the studied organic photosensitizer dyes may have improved photovoltaic characteristics and are suitable applicants for efficient charge transportation in organic electronic materials.
In Silico Analysis of Phytocompounds from Aegle marmelos Against Potential Targets of Irritable Bowel Syndrome
Authors: Gopakumar Gopikrishna , Ramesh Bhavani , Michaelson Drose Ignatious Shane , Kunjiappan Selvaraj , Kabilan Shanmugampillai Jeyarajaguru , Pavadai Parasuraman
Published: August 2023

Irritable Bowel Syndrome (IBS) is a gastrointestinal disorder that affects 7-21% of the world’s population. People suffering from this illness can have a significant change in their quality of life and their productivity at work. Medicinal plants and their derived products have long been explored and used for their medicinal qualities throughout the world to cure numerous ailments, including gastrointestinal problems. The main aim of this study was to predict highly efficacies therapeutic molecules from the medicinal plant, Aegle marmelos to bind potential target against IBS and gastrointestinal protection, using in silico molecular modeling tools. A total of 16 phytocompounds were identified through the IMPPAT database from A. marmelos, and their structures were drawn by Chemsketch software. All the phytocompounds were docked against the chosen potential target protein, Motilin receptor (MLNR). The selected phytocompounds showed better binding affinities (–5 to –8.4 kcal × [Formula: see text]) against the target. Top-scored phytocompounds from A. marmelos, Aegeline (–8.4 kcal × [Formula: see text]), Alloimperatorin methyl (–8.2 kcal × [Formula: see text]), and Imperatorin (–8.2 kcal × [Formula: see text]) were selected for further evaluation and compared to the standard drug R093877 (–6.7 kcal × [Formula: see text]). Drug-likeness, ADME & T and other physicochemical properties of selected top scored phytocompounds were assessed to confirm their druggability. The molecular dynamics simulation studies of selected top scored phytocompounds showed stable binding affinities with the MLNR protein on entire period. Based on these findings, the top three scored phytocompounds might be used as potent and safe molecules against the MLNR protein and could potentially be used in the treatment of IBS.
Prognostic Implication of Pulmonary Arterial Pressure in Surgical Repair of Predominantly Congenital Mitral Valve Regurgitation-Based Intracardiac Abnormalities
Authors: Zhao Hong-lei , Tang Zhi-wei , Zheng Si-qiang , Chen Jun-quan , Diao Yi-fei , Zhang Wei , Qian Si-chong , Shao Yong-feng , Zhao Sheng , Liu Hong
Published: August 2023

Introduction: Knowledge is limited regarding the significance of pulmonary arterial pressure (PAP) in predominantly congenital mitral valve regurgitation (MR)-based intracardiac abnormalities. Methods: From a prospective cohort, we included 200 patients with congenital MR regardless of other associated intracardiac abnormalities (mean age 60.4 months, 67% female, systolic PAP (sPAP) 54.2 mm Hg) surgically repaired in 2012–2019 and followed up to 2020 (median 30.0 months). Significant pulmonary hypertension (PH) was defined as sPAP >50 mm Hg at rest or mean PAP >25 mm Hg on right heart catheterization. By perioperative sPAP changes, patients were stratified as group I (pre-normotension to post-normotension), group II (pre-hypertension to post-normotension), or group III (pre-hypertension to post-hypertension). Primary outcomes were the recurrence of MR (defined as the regurgitation grade of moderate or greater) and the progression of MR (defined as any increase in the magnitude of regurgitation grade after surgery). Cox proportional hazard and Kaplan-Meier curve were performed. Results: There was no association between preoperative PH and the recurrent MR (adjusted hazard ratios [aHR]: 1.146 [95% CI: 0.453–2.899]) and progressive MR (aHR: 1.753 [95% CI: 0.807–3.804]), respectively. There were no significant differences among group I, group II, and group III in the recurrent MR but in the progressive MR. A dose dependency was identified for preoperative sPAP with recurrent MR (aHR: 1.050 [95% CI: 1.029–1.071]) and progressive MR risks (aHR: 1.037 [95% CI: 1.019–1.055]), respectively. Conclusions: Preoperative higher sPAP is associated with worse outcomes, warranting heightened attention to the identification of perioperative sPAP.
Cardiac Troponin T and NT-proBNP for Prediction of 30-Day Readmission or Death in Patients with Acute Dyspnea: Data from the Akershus Cardiac Examination 2 Study
Authors: Bhatnagar Rahul , Berge Kristian , Røysland Ragnhild , Høiseth Arne Didrik , Brynildsen Jon , Christensen Geir , Omland Torbjørn , Røsjø Helge , Lyngbakken Magnus Nakrem
Published: August 2023

Introduction: N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac troponin T (cTnT) measurements are recommended in patients with acute dyspnea. We aimed to assess the prognostic merit of cTnT compared to NT-proBNP for 30-day readmission or death in patients hospitalized with acute dyspnea. Methods: We measured cTnT and NT-proBNP within 24 h in 314 patients hospitalized with acute dyspnea and adjudicated the cause of the index admission. Time to first event of readmission or death ≤30 days after hospital discharge was recorded, and cTnT and NT-proBNP measurements were compared head-to-head. Results: Patients who died (12/314) or were readmitted (71/314) within 30 days had higher cTnT concentrations (median: 32.6, Q1–Q3: 18.4–74.2 ng/L vs. median: 19.4, Q1–Q3: 8.4–36.1 ng/L; p for comparison <0.001) and NT-proBNP concentrations (median: 1,753.6, Q1–Q3: 464.2–6,862.0 ng/L vs. median 984, Q1–Q3 201–3,600 ng/L; for comparison p = 0.027) compared to patients who survived and were not readmitted. cTnT concentrations were associated with readmission or death within 30 days after discharge both in the total cohort (adjusted hazard ratio [aHR]: 1.64, 95% confidence interval [CI]: 1.30–2.05) and in patients with heart failure (HF) (aHR: 1.58, 95% CI: 1.14–2.18). In contrast, NT-proBNP concentrations were not associated with short-term events, neither in the total cohort (aHR: 1.10, 95% CI: 0.94–1.30) nor in patients with adjudicated HF (aHR: 1.06, 95% CI: 0.80–1.40). Conclusion: cTnT concentrations are associated with 30-day readmission or death in patients hospitalized with acute dyspnea, as well as in patients adjudicated HF.
Feasibility of robotic neuroendovascular surgery
Authors: Morrison Joseph D. , Joshi Krishna C. , Beer Furlan Andre , Kolb Bradley , Radaideh Yazan , Munich Stephan , Crowley Webster , Chen Michael
Published: August 2023

Background

Several recent reports of CorPath GRX vascular robot (Cordinus Vascular Robotics, Natick, MA) use intracranially suggest feasibility of neuroendovascular application. Further use and development is likely. During this progression it is important to understand endovascular robot feasibility principles established in cardiac and peripheral vascular literature which enabled extension intracranially. Identification and discussion of robotic proof of concept principals from sister disciplines may help guide safe and accountable neuroendovascular application.

Objective

Summarize endovascular robotic feasibility principals established in cardiac and peripheral vascular literature relevant to neuroendovascular application

Methods

Searches of PubMed, Scopus and Google Scholar were conducted under PRISMA guidelines 1 using MeSH search terms. Abstracts were uploaded to Covidence citation review (Covidence, Melbourne, AUS) using RIS format. Pertinent articles underwent full text review and findings are presented in narrative and tabular format.

Results

Search terms generated 1642 articles; 177, 265 and 1200 results for PubMed, Scopus and Google Scholar respectively. With duplicates removed, title review identified 176 abstracts. 55 articles were included, 45 from primary review and 10 identified during literature review. As it pertained to endovascular robotic feasibility proof of concept 12 cardiac, 3 peripheral vascular and 5 neuroendovascular studies were identified.

Conclusions

Cardiac and peripheral vascular literature established endovascular robot feasibility and efficacy with equivalent to superior outcomes after short learning curves while reducing radiation exposure >95% for the primary operator. Limitations of cost, lack of haptic integration and coaxial system control continue, but as it stands neuroendovascular robotic implementation is worth continued investigation.
Medicalisation of vaping in the UK? E-cigarette users’ perspectives on the merging of commercial and medical routes to vaping
Authors: Ward E , Dawkins L , Holland R , Pope I , Notley C
Published: August 2023

Background:

In the UK, most smokers choosing e-cigarettes to quit smoking will access vaping via commercial routes. In recent years, however, a shift towards medicalisation of vaping has become apparent, with public health guidance supporting e-cigarettes for smoking cessation and increased partnership working between healthcare professionals and the vaping industry. To achieve the UK’s Smokefree 2030 target, the UK Government has set out measures to use e-cigarettes in National Health Service (NHS) settings and to move towards streamlining processes to make e-cigarettes available to a million smokers. This article aims to understand acceptability of different approaches by seeking perspectives of people with lived experience of e-cigarette use for smoking cessation.

Methods:

Mixed methods data collected between March 2018 and March 2019 as part of a broader study of e-cigarette use trajectories (ECtra study). Data here relate to the views of partnership working and medicalisation of vaping extracted from 136 interviews/extended surveys of people who had used e-cigarettes to try to stop smoking. Qualitative data were thematically analysed. Participant ratings of interventions were presented descriptively, and differences in participant characteristics and ratings were reported.

Results:

Three qualitative themes were identified: pro-partnership, anti-partnership and medicalisation dissonance. Medicalisation was discussed for its potential to reassure smokers about e-cigarette harms and its potential to reach smokers from disadvantaged backgrounds. Concerns were raised about cost-effectiveness, quality of support, conflicts of interest and limiting product choice. Most participants rated interventions involving partnership working as potentially helpful in switching from smoking to vaping. There were no statistically significant associations between age, gender and socioeconomic status, and helpfulness ratings.

Conclusion:

Both commercial and medical routes to vaping offer perceived benefits to vapers and may complement and reinforce each other to support smoking cessation.
Fat Grafting Versus Implants: Who's Happier? A Systematic Review and Meta-analysis
Authors: AlGhanim Khalifa , Minkhorst Kathryn , Jaszkul Katrina M. , Keelan Stephen , Appleton Sarah , DeLyzer Tanya , Yazdani Arjang
Published: August 2023

Background: Breast implants were first introduced in the 1960s and have long been used for augmentation and reconstructive breast surgery. More recently, fat grafting for breast augmentation has gained popularity due to the ‘natural’ outcome and lack of implant-related complications. The aim of this study was to conduct a systematic review and meta-analysis comparing patient-related outcome measures between fat grafting and implant-based primary augmentation using the validated BREAST-Q questionnaire. Methods: A systematic review of the literature according to the PRISMA guidelines was conducted in PubMed®, Cochrane Library®, EMBASE®, MEDLINE®, and Scopus® databases. Papers were screened by two independent blinded reviewers. Quality was assessed using MINORS criteria. Results: Fourteen studies were included in the meta-analysis representing a total of 81 fat grafting augmentations and 1535 implant augmentations. The average overall patient satisfaction mean post-operative scores were 13.0 points higher in the implant group based on meta-regression (95% CI: 2.4-23.5; P = .016). There was no statistical difference in reported post-operative sexual well-being, psychosocial well-being, or physical well-being BREAST-Q scores. Conclusion: Although implant-based augmentation resulted in higher post-operative overall satisfaction scores, fat grafting remains a highly desirable alternative for augmentation in the right patient. This meta-analysis strongly highlights that careful patient selection and evaluation of patient goals must be assessed when selecting an augmentation method.
Exploring sensory sensitivity, cortical excitability, and habituation in episodic migraine, as a function of age and disease severity, using the pattern-reversal task
Authors: Marti-Marca Angela , Vilà-Balló Adrià , Cerda-Company Xim , Ikumi Nara , Torres-Ferrus Marta , Caronna Edoardo , Gallardo Victor J. , Alpuente Alicia , Torralba Cuello Mireia , Soto-Faraco Salvador , Pozo-Rosich Patricia
Published: August 2023

Background

Migraine is a cyclic, neurosensory disorder characterized by recurrent headaches and altered sensory processing. The latter is manifested in hypersensitivity to visual stimuli, measured with questionnaires and sensory thresholds, as well as in abnormal cortical excitability and a lack of habituation, assessed with visual evoked potentials elicited by pattern-reversal stimulation. Here, the goal was to determine whether factors such as age and/or disease severity may exert a modulatory influence on sensory sensitivity, cortical excitability, and habituation.

Methods

Two similar experiments were carried out, the first comparing 24 young, episodic migraine patients and 28 healthy age- and gender-matched controls and the second 36 middle-aged, episodic migraine patients and 30 healthy age- and gender-matched controls. A neurologist confirmed the diagnoses. Migraine phases were obtained using eDiaries. Sensory sensitivity was assessed with the Sensory Perception Quotient and group comparisons were carried out. We obtained pattern-reversal visual evoked potentials and calculated the N1-P1 Peak-to-Peak amplitude. Two linear mixed-effects models were fitted to these data. The first model had Block (first block, last block) and Group (patients, controls) as fixed factors, whereas the second model had Trial (all trials) and Group as fixed factors. Participant was included as a random factor in both. N1-P1 first block amplitude was used to assess cortical excitability and habituation was defined as a decrease of N1-P1 amplitude across Blocks/Trials. Both experiments were performed interictally.

Results

The final samples consisted of 18 patients with episodic migraine and 27 headache-free controls (first experiment) and 19 patients and 29 controls (second experiment). In both experiments, patients reported increased visual hypersensitivity on the Sensory Perception Quotient as compared to controls. Regarding N1-P1 peak-to-peak data, there was no main effect of Group, indicating no differences in cortical excitability between groups. Finally, significant main effects of both Block and Trial were found indicating habituation in both groups, regardless of age and headache frequency.

Conclusions

The results of this study yielded evidence for significant hypersensitivity in patients but no significant differences in either habituation or cortical excitability, as compared to headache-free controls. Although the alterations in patients may be less pronounced than originally anticipated they demonstrate the need for the definition and standardization of optimal methodological parameters.
Candida auris Blood stream infection- a descriptive study from Qatar
Authors: Koleri Junais , Petkar Hawabibee Mahir , Rahman S. Al Soub Hussam Abdel , Rahman S. AlMaslamani Muna A.
Published: August 2023

Background

Candida auris is an emerging yeast pathogen that can cause invasive infections, particularly candidemia, in healthcare settings. Candida auris is characterized by resistance to multiple classes of antifungal drugs and high mortality.

Objective

To describe the risk factors, clinical characteristics, antifungal susceptibility pattern and outcomes of Candida auris blood stream infection.

Methods

We conducted a retrospective review of electronic medical records of C. auris fungemia cases in the facilities under Hamad Medical corporation, Qatar from 1/11/2018 to 31/7/2021. Demographic data, risk factors, antibiogram and 30-day outcome are described.

Results

We identified 36 patients with C. auris fungemia. Most of the patients were in intensive care unit following severe COVID-19 pneumonia and had received steroids and broad-spectrum antibiotics. Most cases were central line related. Over 90% of isolates were non-susceptible to fluconazole, while amphotericin B resistance reached 85%. Factors associated with high mortality included initial SOFA score of 9 or above and absence of source control.

Conclusion

Our study reveals a concerning 41.6% mortality rate within 30 days of C. auris candidemia. Furthermore, the prevalence of amphotericin B resistance in Qatar exceeds what has been reported in the literature necessitating further exploration. Echinocandins retains nearly 100% susceptibility and should be prioritized as the treatment of choice. These findings emphasize the need for vigilant monitoring and appropriate management strategies to combat C. auris infections and improve patient outcomes.
Determinants of influenza and COVID-19 vaccine intent or uptake in Lebanon: a scoping review of the literature
Authors: Salam Mahmoud , Honein-AbouHaidar Gladys
Published: August 2023

Background

Vaccination is essential to protect from influenza and recently from COVID-19, yet uptake in Lebanon is suboptimal. Several factors determine uptake including knowledge, attitude and policies. We conducted a scoping review of the literature to explore the determinants of influenza and COVID-19 vaccine intent or uptake in Lebanon.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, thirty one peer reviewed studies indexed in six databases Pub Med, EMBASE, Scopus, CINAHL, Medline, and the Cochrane Library were screened. Two students, a senior Librarian and an Associate Professor in nursing searched for eligible studies. The library search strategy followed a combination of three broad concepts (viral influenzas; vaccines; Lebanon). The search timeframe was up till December 31, 2022. Determinants of influenza and COVID-19 vaccine intent or uptake were categorized following the constructs of the Theory of Planned Behavior.

Results

Nine studies investigated influenza vaccine intent or uptake among the public community, parents and healthcare workers. Twenty one studies investigated COVID-19 vaccine intent or uptake among the public community, older refugees, university students, patients with cancer, dentists, and social media users. One study investigated both types of vaccines. A conceptual model of the determinants of vaccine intent and uptake within the Lebanese context was developed. Various determinants included environmental factors, norms, knowledge, perceptions, attitudes, past experiences, behavioral control and hesitancy.

Conclusions

Research on vaccine intent and uptake in Lebanon is still in its infancy, while that of COVID-19 is on the rise. Multifaceted reasons behind the low vaccination rates were observed yet few attempts were made to target vulnerable groups. Further research studies are needed to target vulnerable groups.
Viral protein R (Vpr)-induced neuroinflammation and its potential contribution to neuronal dysfunction: a scoping review
Authors: Williams Monray Edward , Williams Aurelia A. , Naudé Petrus J.W.
Published: August 2023

HIV-associated neurocognitive disorders (HAND) are the result of the activity of HIV-1 within the central nervous system (CNS). While the introduction of antiretroviral therapy (ART) has significantly reduced the occurrence of severe cases of HAND, milder cases still persist. The persistence of HAND in the modern ART era has been linked to a chronic dysregulated inflammatory profile. There is increasing evidence suggesting a potential role of Viral protein R (Vpr) in dysregulating the neuroinflammatory processes in people living with HIV (PLHIV), which may contribute to the development of HAND. Since the role of Vpr in neuroinflammatory mechanisms has not been clearly defined, we conducted a scoping review of fundamental research studies on this topic. The review aimed to assess the size and scope of available research literature on this topic and provide commentary on whether Vpr contributes to neuroinflammation, as highlighted in fundamental studies. Based on the specified selection criteria, 10 studies (6 of which were cell culture-based and 4 that included both animal and cell culture experiments) were eligible for inclusion. The main findings were that (1) Vpr can increase neuroinflammatory markers, with studies consistently reporting higher levels of TNF-α and IL-8, (2) Vpr induces (neuro)inflammation via specific pathways, including the PI3K/AKT, p38-MAPk, JNK-SAPK and Sur1-Trpm4 channels in astrocytes and the p38 and JNK-SAPK in myeloid cells, and (3) Vpr-specific protein amino acid signatures (73R, 77R and 80A) may play an important role in exacerbating neuroinflammation and the neuropathophysiology of HAND. Therefore, Vpr should be investigated for its potential contribution to neuroinflammation in the development of HAND.
Antibiotic choices among healthcare professionals for enterococcal bacteremia with patterns of resistance and risk factors of mortality, in settings of poor antibiotic stewardship program — a five-year retrospective cohort study
Authors: Bhatti Jamil Muqtadir , Raza Syed Ali , Alam Ayesha Farooq , Khan Yameena Noman , Mala Ali , Batool Irshad , Sameeullah FNU
Published: August 2023

Background

Enterococcal bacteremia has become prevalent in the recent decade, especially in hospitalized patients. Moreover, the rise in resistance patterns against antibiotic drugs regarding enterococci infection, such as cephalosporins, ampicillin and vancomycin, is prevailing. The major driving force behind this is the incongruous use of antibiotics with a minor contribution from environmental stressors which calls for vigilant and prudent administration of evidence-based antibiotics.

Methods

A retrospective study was conducted from January 1 2017 until December 31 2021, at the tertiary care center, Dr Ziauddin Hospital in Karachi, Pakistan.

Results

Our research revealed ampicillin resistance in 87 (63.5%), with an estimated 25 (18.8%) mortality. Male gender 19 (76%) and vancomycin resistance 13 (52%) were associated with increased mortality. Furthermore, appropriate antibiotic therapy reduced the risk of death compared with inappropriate and excessive use of antibiotics 10 (40%) vs. 15 (60%) vs. 20 (80%) respectively. Targeted therapy with amoxicillin/clavulanic acid was associated with lower mortality 1 (4%) and higher discharge rates 34 (32.1%). On Kaplan-Meier survival, targeted therapy with amoxicillin/clavulanic acid was associated with shorter hospital stays and prolonged survival. UTI was found as the most common source of enterococcal bacteremia 57 (41.6%), followed by respiratory 21 (15.3%) and intra-abdominal 13 (9.5%). In 26 (19%) patients, no identifiable source of infection was found.

Conclusion

Vancomycin resistance and male gender were found independent risk factors for mortality. The use of inappropriate antibiotics significantly increases mortality in these patients. The appropriate antibiotic therapy reduces the risk of death. Furthermore, overuse of antibiotics didn’t reduce mortality; instead increased the financial burden and chances of developing multi-drug resistant strains of other organisms by increasing hospital stays of patients.
Cat-scratch disease manifesting as uveitis and binocular fundus nodular lesions: a case report
Authors: Hong Hao , Li Tianxi , Ying Ye , An Qi , Liu Hu , Liang Kang
Published: August 2023

Background

Cat-scratch disease typically presents with various ocular manifestations such as uveitis, vitritis, retinitis, retinochoroiditis, and optic neuritis. However, fundus nodular lesions was rarely reported. In our study, we reported a case of Cat-Scratch disease with binocular fundus nodular lesions.

Case presentation

An 11-year old male presented with uveitis in the right eye and bilateral fundus nodular lesions after indirect contact with unvaccinated cats. Comprehensive ancillary examinations including wide-angle fundus photography, ultrasonography, fluorescein fundus angiography, optical coherence tomography, and orbital magnetic resonance imaging were performed to elucidate the multidimensional features of the binocular lesions. Metagenomics next-generation sequencing was utilized to confirm the diagnosis of Cat-scratch disease. The patient’s condition showed improvement after a 6-month combination treatment regimen involving systemic administration of doxycycline hyclate and methylprednisolone tablets, as well as local application of mydriatic and corticosteroid eye drops.

Conclusions

We firstly reported a case of Cat-scratch disease presenting simultaneously with uveitis and fundus nodular lesions caused by Bartonella henselae infection in a child. Timely diagnosis and treatment with antibiotics and corticosteroids showed promising outcomes for the prognosis of these ocular disorders.
Accuracy of refractive outcomes using standard or total keratometry for intraocular lens power formulas in conventional cataract surgery
Authors: Zhao He , Chen Xu , Liu Bo , Liu Xi , Liu Yong
Published: August 2023

Purpose

To evaluate if total keratometry (TK) is better than standard keratometry (K) for predicting an accurate intraocular lens (IOL) refractive outcome in virgin eyes using four IOL power calculation formulas.

Methods

447 eyes that underwent monofocal intraocular lens implantation were enrolled in this study. IOLMaster 700 (Carl Zeiss Meditech, Jena, Germany) was used for optical biometry. Prediction error (PE), mean absolute prediction error (MAE), median absolute prediction error (MedAE), proportions of eyes within ± 0.25 diopters (D), ± 0.50 D, ± 0.75 D, ± 1.00 D, ± 2.00 D prediction error, and formula performance index (FPI) were calculated for each K- and TK-based formula.

Results

Overall, the accuracy of each TK and K formula was comparable. The MAEs and MedAEs showed no difference between most of the K-based and the TK-based formula; only the MAE of TK was significantly higher than that of K using the Haigis. The percent of eyes within ± 0.25 D PE for TK was not significantly different from that for K. The analysis of PE across various optical dimensions revealed that TK had no effect on the refractive results in eyes with different preoperative axial length, anterior chamber depth, keratometry, and lens thickness. The K-based Barrett Universal II formula performed excellently, showed the leading FPI score, and had the best refractive prediction outcomes among the four formulas.

Conclusion

TK and K can be used for IOL power calculation in monofocal IOL implantation cataract surgery in virgin eyes, as both are comparable. In all investigated formulas, the predictive accuracy of TK-based formulas is not superior to that of standard K-based formulas.
Insights from a cross-sectional binational study comparing obesity among nonimmigrant Colombians in their home country and Colombian immigrants in the U.S.
Authors: Devia Carlos , Flórez Karen R. , Costa Sergio A. , Huang Terry T-K
Published: August 2023

Background

Latinos in the United States (U.S.) represent a heterogeneous minority population disproportionally impacted by obesity. Colombians in the U.S. are routinely combined with other South Americans in most obesity studies. Moreover, most studies among Latino immigrants in the U.S. solely focus on factors in the destination context, which largely ignores the prevalence of obesity and contextual factors in their country of origin, and warrant transnational investigations.

Methods

Using 2013-17 data from the New York City Community Health Survey (NYC CHS, U.S.) and the National Survey of the Nutritional Situation (ENSIN, Colombia), Colombians that immigrated to the U.S. and are living in NYC (n = 503) were compared to nonimmigrant Colombians living in their home country (n = 98,829). Prevalence ratios (PR) for obesity (BMI ≥ 30 kg/m2) by place of residence were estimated using multivariable logistic regression adjusting for socio-demographic characteristics and daily consumption of sugar-sweetened beverages.

Results

The prevalence of obesity was 49% greater for immigrant Colombians living in NYC when compared to nonimmigrant Colombians living in in their home country (PR = 1.49; 95% CI 1.08, 2.07). Colombian immigrant men in NYC were 72% more likely to have obesity compared to nonimmigrant men living in their home country (PR = 1.72; 95% CI 1.03, 2.87). No significant differences were found in the adjusted models among women.

Conclusions

Colombian immigrants in NYC exhibit a higher prevalence of obesity compared to their nonimmigrant counterparts back home and sex strengthens this relationship. More obesity research is needed to understand the immigration experience of Colombians in the U.S. and the underlying mechanisms for sex difference. Public health action focused on women in Colombia and both Colombian men and women immigrants in the U.S. is warranted to avert the long-term consequences of obesity.
Initiation and duration of folic acid supplementation in preventing congenital malformations
Authors: Dong Jing , Yin Lin-Liang , Deng Xue-Dong , Ji Chun-Ya , Pan Qi , Yang Zhong , Peng Ting , Wu Jiang-Nan ,   for the Early Pregnancy Ultrasound Screening, Maternal Exposures and Congenital Malformation Risk collaborators, Wu Gui-Hua , Zhou Liu-Ying , Li Mei , Chen Yue-Qin , Yang Jia-Xiang , Liang Bai-Song , Ru Tong , Jing Chun-Li , Zhou Weng-Rong , Cao Li , Li Qin , Li Gui-Ping , Yang Tai-Zhu , Gao Xin-Ru , Shi Li-Ling , Zhou Yu-Qing , Ji Xue-Qin , Liang Bo , Han Qing , Ren Ling , Wang Wen-Rong , Tao Guo-Wei
Published: August 2023

Background

Folic acid (FA) supplementation is associated with a lower risk of the neural tube and heart defects and is recommended for women of childbearing age. Although there are detailed recommendations, differences in the initiation time and duration of FA supplementation remain poorly studied.

Methods

A multicentre prospective study of 17,713 women was conducted. The incidence of congenital malformations in women taking a recommended dosage (e.g. 0.4 or 0.8 mg/day) of FA was compared with that in women without supplementation. The predicted probability of malformations by the initiation time and duration of FA use was estimated to determine optimal options.

Results

Periconceptional FA supplementation was associated with a lower and insignificant risk of congenital malformations (1.59% vs. 2.37%; odds ratio [OR] 0.69; 95% confidence interval [CI]: 0.44–1.08), heart defects (3.8 vs. 8.0 per 1000 infants; OR, 0.47; 0.21–1.02), and neural tube defects (7.0 vs. 11.5 per 10,000 infants; OR, 0.64; 0.08–5.15). FA use after pregnancy provided greater protection against total malformations. Statistically significant associations were found in women who initiated FA supplementation in the first month of gestation (OR, 0.55; 95% CI: 0.33–0.91) and in those who supplemented for 1 to 2 months (OR, 0.59; 95% CI: 0.36–0.98). Similar results were found for heart defects. The optimal initiation time was 1.5 (optimal range: 1.1 to 1.9) months before pregnancy and a duration of 4.0 (3.7 to 4.4) months was reasonable to achieve the lowest risk of congenital malformations. Heart defect prevention required an earlier initiation (2.2 vs. 1.1 months before pregnancy) and a longer duration (4.7 vs. 3.7 months) than the prevention of other malformations.

Conclusions

The timely initiation of FA supplementation for gestation was associated with a decreased risk of congenital malformations, which was mainly attributed to its protection against heart defects. The initiation of FA supplementation 1.5 months before conception with a duration of 4 months is the preferred option for congenital malformation prevention.

Trial registration

Chictr.org.cn identifier: ChiCTR-SOC-17010976.
Net reclassification index in comparison of prognostic value of disseminated intravascular coagulation diagnostic criteria by Japanese Society on Thrombosis and Hemostasis and International Society on Thrombosis and Haemostasis: a multicenter prospective cohort study
Authors: Mori Hirotaka , Harada-Shirado Kayo , Kawano Noriaki , Hayakawa Mineji , Seki Yoshinobu , Uchiyama Toshimasa , Yamakawa Kazuma , Ishikura Hiroyasu , Irie Yuhei , Nishio Kenji , Yada Noritaka , Okamoto Kohji , Ikezoe Takayuki
Published: August 2023

Background

We compared the prognostic value of the Japanese Society on Thrombosis and Hemostasis (JSTH) disseminated intravascular coagulation (DIC) diagnostic criteria with that of the International Society on Thrombosis and Haemostasis (ISTH) DIC diagnostic criteria for 28-day in-hospital mortality.

Methods

We conducted a multicenter prospective cohort study involving two hematology departments, four emergency departments, and one general medicine department in Japan between August 2017 and July 2021. We assessed three ISTH DIC diagnostic criteria categories using low cutoff levels of D-dimer (low D-dimer), high cutoff levels of D-dimer (high D-dimer), and fibrinogen/fibrin degradation products (FDP) as fibrin-related markers. The main outcome was diagnosis-based category additive net reclassification index (NRI).

Results

A total of 222 patients were included: 82 with hematopoietic disorders, 86 with infections, and 54 with other diseases. The 28-day in-hospital mortality rate was 14% (n = 31). The DIC rates diagnosed by the JSTH, ISTH-low D-dimer, high D-dimer, and FDP DIC diagnosis were 52.7%, 47.3%, 42.8%, and 27.0%, respectively. The overall category additive NRI by JSTH DIC diagnosis vs. ISTH-low D-dimer, high D-dimer, and FDP DIC diagnosis were − 10 (95% confidence interval [CI]: −28 to 8, p = 0.282), − 7.8 (95% CI: −26 to 10, p = 0.401), and − 11 (95% CI: −26 to 3, p = 0.131), respectively.

Conclusions

JSTH criterion showed the highest sensitivity for DIC diagnosis that did not improve but reflected the same prognostic value for mortality evaluated using ISTH DIC diagnosis criteria. This finding may help clinicians to use JSTH DIC criterion as an early intervention strategy in patients with coagulopathy.
Naïve, uninformed and sexually abused: circumstances surrounding adolescent pregnancies in Malawi
Authors: Chamdimba Elita , Kabiru Caroline W. , Ushie Boniface Ayanbekongshie , Munthali Alister , Thakwalakwa Chrissie , Ajayi Anthony Idowu
Published: August 2023

Background

Pregnancy and childbearing in adolescence could negatively affect girls’ health and socio-economic wellbeing across the life course. Previous studies on drivers of adolescent pregnancy in Africa have not fully considered the perspectives of parents/guardians vis-à-vis pregnant and parenting adolescents. Our study addresses this gap by examining pregnant and parenting adolescents’ and parents/guardians’ narratives about factors associated with early and unintended pregnancy.

Methodology

The descriptive study draws on qualitative data collected as part of a larger mixed-methods cross-sectional survey on the lived experiences of pregnant and parenting adolescents. Data were collected between March and May 2021 in Blantyre, Malawi, using semi-structured interview guides. We interviewed 18 pregnant and parenting adolescent girls, 10 parenting adolescent boys, and 16 parents/guardians of pregnant and parenting adolescents. Recorded interviews were transcribed verbatim into the English language by bilingual transcribers. We used the inductive-thematic analytical approach to summarize the data.

Findings

The data revealed several interconnected and structural reasons for adolescents’ vulnerability to early and unintended pregnancy. These include adolescents’ limited knowledge and access to contraceptives, poverty, sexual violence, school dropout, COVID-19 school closures, and being young and naively engaging in unprotected sex. While some parents agreed that poverty and school dropout or COVID-19 related school closure could lead to early pregnancies, most considered stubbornness, failure to adhere to abstinence advice and peer influence as responsible for adolescent pregnancies.

Conclusion

Our findings contribute to the evidence on the continued vulnerability of girls to unintended pregnancy. It highlights how parents and adolescents hold different views on reasons for early and unintended pregnancy, and documents how divergent views between girls and their parents may contribute to the lack of progress in reducing adolescent childbearing. Based on these findings, preventing unintended pregnancies will require altering community attitudes about young people’s use of contraceptives and engaging parents, education sector, civil society organizations and community and religious leaders to develop comprehensive sexuality education programs to empower in- and out-of school adolescents.