bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing European national health information systems in peer review format: lessons learnt
Authors: Bogaert Petronille , Verschuuren Marieke , Abboud Linda , Lyshol Heidi , Schmidt Andrea E , Van Oyen Herman , van Oers Hans
Published: June 2023

Background

Systematic assessments of a country’s health information system (HIS) help identify strengths and weaknesses and may stimulate actions for improvement. They represent a capacity-building process for the country assessed as well as for the assessor. The joint action on HISs (InfAct) developed a peer-to-peer assessment methodology adapting an established WHO support tool. The aim of this study is to identify lessons learnt and the added value of the InfAct peer assessment for the assessors.

Methods

A qualitative evaluation of the peer HIS assessment was performed based on 12 semi-structured interviews: nine interviews were carried out with assessors from nine participating countries, and three with an observer (present during assessments). The interviews were carried out between May 2019 and January 2020. Interviews were analysed using qualitative content analysis.

Results

The interviews revealed the experiences of the assessors mainly occurred in five areas: assessors strengthened their understanding of what a population-based HIS is; they strengthened their understanding of how a HIS operates in different countries; they learnt how to carry out a HIS assessment; they strengthened their organization, communication, negotiation and reporting skills and they strengthened the networks in health information within and between countries.

Conclusion

Since the assessors are key personnel in their respective national health systems, the impact of the assessment is not limited to the assessor alone but may extend to stakeholders in their country. The deployment of the InfAct HIS peer assessment, anchored in systematic HIS capacity building across European countries, is recommended.
Assessing the availability and quality of COVID-19 mortality data in Europe: a comparative analysis
Authors: Marinković Ivan , Tramošljanin Ana , Galjak Marko
Published: June 2023

Researching mortality during the COVID-19 pandemic has been challenging due to methodological inconsistencies and the limited availability of vital statistics data. At the beginning of the pandemic, the World Health Organization recommended daily data publication to inform policy response, but these data were often poor. Final data on COVID-19 deaths in many countries are not yet available, especially for 2021. This report shows that many countries have significant inconsistencies between the preliminary number of deaths and what vital statistics and excess mortality indicate. The inconsistencies in the mortality data raise concerns about the reliability of analyses and public health recommendations.
Spatial and temporal variability of 21st century sea level changes
Authors: Roffman Jeremy , Gomez Natalya , Yousefi Maryam , Han Holly Kyeore , Nowicki Sophie
Published: June 2023

Mass loss from polar ice sheets is becoming the dominant contributor to current sea level changes, as well as one of the largest sources of uncertainty in sea level projections. The spatial pattern of sea level change is sensitive to the geometry of ice sheet mass changes, and local sea level changes can deviate from the global mean sea level change due to gravitational, Earth rotational and deformational (GRD) effects. The pattern of GRD sea level change associated with the melting of an ice sheet is often considered to remain relatively constant in time outside the vicinity of the ice sheet. For example, in the sea level projections from the most recent IPCC sixth assessment report (AR6), the geometry of ice sheet mass loss was treated as constant during the 21st century. However, ice sheet simulations predict that the geometry of ice mass changes across a given ice sheet and the relative mass loss from each ice sheet will vary during the coming century, producing patters of global sea level changes that are spatiotemporally variable. We adopt a sea level model that includes GRD effects and shoreline migration to calculate time-varying sea level patterns associated with projections of the Greenland and Antarctic Ice Sheets during the coming century. We find that in some cases, sea level changes can be substantially amplified above the global mean early in the century, with this amplification diminishing by 2100. We explain these differences by calculating the contributions of Earth rotation as well as gravitational and deformational effects to the projected sea level changes separately. We find in one case, for example, that ice gain on the Antarctic Peninsula can cause an amplification of up to 2.9 times the global mean sea level equivalent along South American coastlines due to positive interference of GRD effects. To explore the uncertainty introduced by differences in predicted ice mass geometry, we predict the sea level changes following end-member mass loss scenarios for various regions of the Antarctic Ice Sheet from the ISMIP6 model ensemblely, and find that sea level amplification above the global mean sea level equivalent differ by up to 1.9 times between different ice mass projections along global coastlines outside of Greenland and Antarctica. This work suggests that assessments of future sea level hazard should consider not only the integrated mass changes of ice sheets, but also temporal variations in the geometry of the ice mass changes across the ice sheets. As well, this study highlights the importance of constraining the relative timing of ice mass changes between the Greenland and Antarctic Ice Sheets.
Deletion of Endogenous Neuregulin-4 Limits Adaptive Immunity During Interleukin-10 Receptor–Neutralizing Colitis
Authors: Bernard Jessica K , Bucar Edie B , Liu Cambrian Y , Katada Kay , Washington Mary K , Schumacher Michael A , Frey Mark R
Published: June 2023

Background

Growth factors are essential for maintenance of intestinal health. We previously showed that exogenous neuregulin-4 (NRG4) promotes colonocyte survival during cytokine challenge and is protective against acute models of intestinal inflammation. However, the function(s) of endogenous NRG4 are not well understood. Using NRG4-/- mice, we tested the role of endogenous NRG4 in models of colitis skewed toward either adaptive (interleukin-10 receptor [IL-10R] neutralization) or innate (dextran sulfate sodium [DSS]) immune responses.

Methods

NRG4-/- and wild-type cage mate mice were subjected to chronic IL-10R neutralization colitis and acute DSS colitis. Disease was assessed by histological examination, inflammatory cytokine levels, fecal lipocalin-2 levels, and single cell mass cytometry immune cell profiling. Homeostatic gene alterations were evaluated by RNA sequencing analysis from colonic homogenates, with real-time quantitative polymerase chain reaction confirmation in both tissue and isolated epithelium.

Results

During IL-10R neutralization colitis, NRG4-/- mice had reduced colonic inflammatory cytokine expression, histological damage, and colonic CD8+ T cell numbers vs wild-type cage mates. Conversely, in DSS colitis, NRG4-/- mice had elevated cytokine expression, fecal lipocalin-2 levels, and impaired weight recovery. RNA sequencing showed a loss of St3gal4, a sialyltransferase involved in immune cell trafficking, in NRG4-null colons, which was verified in both tissue and isolated epithelium. The regulation of St3gal4 by NRG4 was confirmed with ex vivo epithelial colon organoid cultures from NRG4-/- mice and by induction of St3gal4 in vivo following NRG4 treatment.

Conclusions

NRG4 regulates colonic epithelial ST3GAL4 and thus may allow for robust recruitment of CD8+ T cells during adaptive immune responses in colitis. On the other hand, NRG4 loss exacerbates injury driven by innate immune responses.
Pheromone Perception in Fish: Mechanisms and Modulation by Internal Status
Authors: Bowers Jessica M , Li Cheng-Yu , Parker Coltan G , Westbrook Molly E , Juntti Scott A
Published: June 2023

Synopsis

Pheromones are chemical signals that facilitate communication between animals, and most animals use pheromones for reproduction and other forms of social behavior. The identification of key ligands and olfactory receptors used for pheromonal communication provides insight into the sensory processing of these important cues. An individual’s responses to pheromones can be plastic, as physiological status modulates behavioral outputs. In this review, we outline the mechanisms for pheromone sensation and highlight physiological mechanisms that modify pheromone-guided behavior. We focus on hormones, which regulate pheromonal communication across vertebrates including fish, amphibians, and rodents. This regulation may occur in peripheral olfactory organs and the brain, but the mechanisms remain unclear. While this review centers on research in fish, we will discuss other systems to provide insight into how hormonal mechanisms function across taxa.
The Impact of Whole Genome Duplication on the Evolution of the Arachnids
Authors: Sharma Prashant P
Published: June 2023

Synopsis

The proliferation of genomic resources for Chelicerata in the past 10 years has revealed that the evolution of chelicerate genomes is more dynamic than previously thought, with multiple waves of ancient whole genome duplications affecting separate lineages. Such duplication events are fascinating from the perspective of evolutionary history because the burst of new gene copies associated with genome duplications facilitates the acquisition of new gene functions (neofunctionalization), which may in turn lead to morphological novelties and spur net diversification. While neofunctionalization has been invoked in several contexts with respect to the success and diversity of spiders, the overall impact of whole genome duplications on chelicerate evolution and development remains imperfectly understood. The purpose of this review is to examine critically the role of whole genome duplication on the diversification of the extant arachnid orders, as well as assess functional datasets for evidence of subfunctionalization or neofunctionalization in chelicerates. This examination focuses on functional data from two focal model taxa: the spider Parasteatoda tepidariorum, which exhibits evidence for an ancient duplication, and the harvestman Phalangium opilio, which exhibits an unduplicated genome. I show that there is no evidence that taxa with genome duplications are more successful than taxa with unduplicated genomes. I contend that evidence for sub- or neofunctionalization of duplicated developmental patterning genes in spiders is indirect or fragmentary at present, despite the appeal of this postulate for explaining the success of groups like spiders. Available expression data suggest that the condition of duplicated Hox modules may have played a role in promoting body plan disparity in the posterior tagma of some orders, such as spiders and scorpions, but functional data substantiating this postulate are critically missing. Spatiotemporal dynamics of duplicated transcription factors in spiders may represent cases of developmental system drift, rather than neofunctionalization. Developmental system drift may represent an important, but overlooked, null hypothesis for studies of paralogs in chelicerate developmental biology. To distinguish between subfunctionalization, neofunctionalization, and developmental system drift, concomitant establishment of comparative functional datasets from taxa exhibiting the genome duplication, as well as those that lack the paralogy, is sorely needed.
Vitamin A deficiency among pregnant women in Ethiopia: a systematic review and meta-analysis
Authors: Eyeberu Addis , Getachew Tamirat , Tiruye Getahun , Balis Bikila , Tamiru Dawit , Bekele Habtamu , Abdurke Mohommed , Alemu Addisu , Dessie Yadeta , Shiferaw Kasiye , Debela Adera
Published: June 2023

Background

Vitamin A deficiency (VAD) during pregnancy is a public health challenge in low-income countries. There are inconsistent findings that can affect policy in planning appropriate intervention. This systematic review and meta-analysis were conducted to summarize the evidence in order to identify existing gaps and propose strategies to reduce VAD during pregnancy in Ethiopia.

Methods

This study included published and unpublished observational studies searched from different databases (PubMed, CINHAL [EBSCO], Embase, Google Scholar, Directory of Open Access Journals, Web of Sciences, MEDLINE, Cochrane Library, Scopus, Google Search and MedNar). Statistical analysis was conducted using Stata version 14 software. Heterogeneity and publication bias were assessed. Forest plots were used to present the pooled prevalence using the random effects model.

Results

A total of 37 618 pregnant women from 15 studies were included. The overall pooled prevalence of VAD was 29% (95% confidence interval 21 to 36) with I2=99.67% and p<0.001. Socio-economic and sociodemographic factors were identified as affecting vitamin A deficiencies among pregnant women.

Conclusions

Nearly one-third of pregnant women in Ethiopia had VAD. Strengthening intervention modalities that aimed to increase the uptake of vitamin A–rich foods can avert VAD among pregnant women in Ethiopia.
Lack of fitness costs in dsRNA-resistant Leptinotarsa decemlineata ([Coleoptera]: [Chrysomelidae])
Authors: Pinto M M D , Ferreira dos Santos R , De Bortoli S A , Moar W , Jurat-Fuentes J L
Published: June 2023

The Colorado potato beetle, Leptinotarsa decemlineata (Say) ([Coleoptera]: [Chrysomelidae]), is the most important defoliator of solanaceous plants worldwide. This insect displays a notorious ability in adapting to biological and synthetic insecticides, although in some cases this adaptation carries relevant fitness costs. Insecticidal gene silencing by RNA interference is a novel mode of action pesticide against L. decemlineata that is activated by ingestion of a double stranded RNA (dsRNA) targeting a vital L. decemlineata gene. We previously reported laboratory selection of a > 11,000-fold resistant strain of L. decemlineata to a dsRNA delivered topically to potato leaves. In this work, we tested the existence of fitness costs in this dsRNA-resistant colony by comparing biological parameters to the parental strain and an additional susceptible reference strain. Biological parameters included length of egg incubation period, number of eggs per clutch, egg viability, larval viability, length of larval and pupal periods, adult emergence, number of eggs laid per day, sex ratio, and adult longevity. Comparisons between the 3 beetle strains detected no fitness costs associated with resistance to dsRNA. This information is important to guide effective insect resistance management plans for dsRNA insecticides against L. decemlineata applied topically to potato leaves.
The MOSDEF-LRIS survey: detection of inflowing gas towards three star-forming galaxies at z ∼ 2
Authors: Weldon Andrew , Reddy Naveen A , Topping Michael W , Shapley Alice E , Du Xinnan , Price Sedona H , Sanders Ryan L , Coil Alison L , Mobasher Bahram , Kriek Mariska , Siana Brian , Rezaee Saeed
Published: June 2023

We report on the discovery of cool gas inflows towards three star-forming galaxies at  ∼ 2.30. Analysis of Keck Low-Resolution Imaging Spectrometer spectroscopy reveals redshifted low-ionization interstellar (LIS) metal absorption lines with centroid velocities of 60–130 km s−1. These inflows represent some of the most robust detections of inflowing gas into isolated, star-forming galaxies at high redshift. Our analysis suggests that the inflows are due to recycling metal-enriched gas from previous ejections. Comparisons between the galaxies with inflows and a larger parent sample of 131 objects indicate that galaxies with detected inflows may have higher specific star formation rates (sSFRs) and star-formation-rate surface densities (ΣSFR). However, when additional galaxies without robustly detected inflows based on centroid velocity but whose LIS absorption line profiles indicate large red-wing velocities are considered, galaxies with inflows do not show unique properties relative to those lacking inflows. Additionally, we calculate the covering fraction of cool inflowing gas as a function of red-wing inflow velocity, finding an enhancement in high-sSFR binned galaxies, likely due to an increase in the amount of recycling gas. Together, these results suggest that the low detection rate of galaxies with cool inflows is primarily related to the viewing angle rather than the physical properties of the galaxies.
GMRT H i mapping of mid-infrared bright blue compact dwarf galaxies W1016+3754 and W2326+0608
Authors: Chandola Y , Tsai C W , Li D , Sengupta C , Ma Y Z , Zuo P
Published: June 2023

We present the results from deep 21 cm H i mapping of two nearby Blue Compact Dwarf Galaxies (BCDGs), W1016+3754 and W2326+0608, using the Giant Metrewave Radio Telescope (GMRT). These BCDGs are bright in mid-infrared data and undergoing active star formation. With the GMRT observations, we investigate the role of cold neutral gas as the fuel resource of the current intensive star formation activity. Star formation in these galaxies is likely to be due to the infall of H i gas triggered by gravitational perturbation from nearby galaxies. The BCDG W2326+0608 and nearby galaxy SDSS J232603.86+060835.8 share a common H i envelope. We find star formation takes place in the high H i column density gas (≳1021 cm−2) regions for both BCDGs. The recent starburst and infall of metal-free gas have kept the metallicity low for the BCDG W1016+3754. The metallicity for W2326+0608 is higher, possibly due to tidal interaction with the nearby galaxy SDSS J232603.86+060835.8.
Extreme broad He ii emission at high and low redshifts: the dominant role of VMS in NGC 3125-A1 and CDFS131717
Authors: Wofford Aida , Sixtos Andrés , Charlot Stephane , Bruzual Gustavo , Cullen Fergus , Stanton Thomas M , Hernández Svea , Smith Linda J , Hayes Matthew
Published: June 2023

Super star cluster (SSC) A1 ($3.1\times 10^5\, \mathrm{M}_\odot$) in NGC 3125 has one of the strongest ($EW=4.6\pm 0.5\,$ Å) broad ($FWHM=1131\pm 40\,$ km s−1) He ii λ1640 emission lines in the nearby universe and constitutes an important template for interpreting observations of extreme He ii emitters out to redshifts of z ∼ 2 – 3. We use Cosmic Origins Spectrograph (COS) observations of A1 to show that there is no significant contamination of the He ii line with nebular emission and that the line is redshifted by 121 ± 17 km s−1 relative to ISM lines. We compare the COS G130M + G160M observations of A1 to recent binary BPASS and single-star Charlot & Bruzual (C&B) simple stellar population (SSP) models with very massive stars (VMS) of up to $300\, \mathrm{M}_\odot$. On the other hand, we suggest why BPASS models fail to reproduce A1’s He ii emission. On the other hand, a C&B model with Z = 0.008, age = 2.2 Myr, and VMS approaching the Eddington limit provides an excellent fit to the He ii emission and fits reasonably well C iii λ1175, N v λλ1238, 1241, and C iv λλ1548, 1551. We present O v λ1371 line-profile predictions showing that this line constitutes an important tracer of youth and VMS in galaxies. Finally, we discuss the presence of VMS in CDFS131717, a highly star-forming low-metallicity galaxy located at z = 3.071, which has a tentative detection of O v absorption and strong broad He ii emission. These features are rare and hint to the presence of short-lived VMS in the galaxy. Our results show the effect of the latest developments of stellar wind theory and the importance of accounting for VMS in models.
DenseLens – Using DenseNet ensembles and information criteria for finding and rank-ordering strong gravitational lenses
Authors: Nagam Bharath Chowdhary , Koopmans Léon V E , Valentijn Edwin A , Kleijn Gijs Verdoes , de Jong Jelte T A , Napolitano Nicola , Li Rui , Tortora Crescenzo
Published: June 2023

Convolutional neural networks (CNNs) are the state-of-the-art technique for identifying strong gravitational lenses. Although they are highly successful in recovering genuine lens systems with a high true-positive rate, the unbalanced nature of the data set (lens systems are rare), still leads to a high false positive rate. For these techniques to be successful in upcoming surveys (e.g. with Euclid) most emphasis should be set on reducing false positives, rather than on reducing false negatives. In this paper, we introduce densely connected neural networks (DenseNets) as the CNN architecture in a new pipeline-ensemble model containing an ensemble of classification CNNs and regression CNNs to classify and rank-order lenses, respectively. We show that DenseNets achieve comparable true positive rates but considerably lower false positive rates (when compared to residual networks; ResNets). Thus, we recommend DenseNets for future missions involving large data sets, such as Euclid, where low false positive rates play a key role in the automated follow-up and analysis of large numbers of strong gravitational lens candidates when human vetting is no longer feasible.
Nanopore sensing reveals a preferential pathway for the co-translocational unfolding of a conjugative relaxase–DNA complex
Authors: Valenzuela-Gómez Fernando , Arechaga Ignacio , Rodríguez-Larrea David , Cabezón Elena
Published: June 2023

Bacterial conjugation is the main mechanism for the dissemination of antibiotic resistance genes. A single DNA strand of the conjugative plasmid is transferred across bacterial membranes covalently bound to a large multi-domain protein, named relaxase, which must be unfolded to traverse the secretion channel. Two tyrosine residues of the relaxase (Y18 and Y26 in relaxase TrwC) play an important role in the processing of conjugative DNA. We have used nanopore technology to uncover the unfolding states that take place during translocation of the relaxase–DNA complex. We observed that the relaxase unfolding pathway depends on the tyrosine residue involved in conjugative DNA binding. Transfer of the nucleoprotein complex is faster when DNA is bound to residue Y18. This is the first time in which a protein–DNA complex that is naturally translocated through bacterial membranes has been analyzed by nanopore sensing, opening new horizons to apply this technology to study protein secretion.
Pancreatic Cancer and its Attributable Risk Factors in East Asia, Now and Future
Authors: Ren Kuiwu , Liu Chunlong , He Ziqiang , Wu Panpan , Zhang Jian , Yang Rui , Cui Tao , Song Kun , Cheng Di , He Kui , Yu Jiangtao
Published: June 2023

Background

The disease burden of pancreatic cancer in East Asia is at a high level, but the epidemiological characteristics of pancreatic cancer in the region have not been systematically studied.

Method

Joinpoint analysis was used to identify average annual percentage change (AAPC) and annual percentage change (APC) in mortality. Age-period-cohort models were used to analyze age-period cohort effects across countries. Bayesian age-period-cohort (BAPC) analysis was used to project the burden of disease for 2020-2030.

Results

Pancreatic cancer mortality in males in Japan (2012-2019, APC = −0.97) and Korea (2012-2019, APC = −0.91) has shown a decreasing trend since 2012 (P < .05). However, China (2016-2019, APC = 3.21), Mongolia (2015-2.019, APC = 2.37), and North Korea (2012-2019, APC = 0.47) showed a significant increase in pancreatic cancer in both genders (P < .05). Risk factors for pancreatic cancer in East Asia remained largely stable between 2010 and 2019. Mortality of pancreatic cancer due to smoking began to decline in areas with high socio-demographic index (SDI), and mortality of pancreatic cancer due to high body mass index and high fasting plasma glucose increased with SDI. The age-standardized mortality for pancreatic cancer in Chinese males is expected to exceed that of Japan and South Korea by 2030, but the disease burden of pancreatic cancer in Japan and South Korea remains at extremely high levels.

Conclusion

Economically developed countries are beginning to show a decreasing trend in the burden of pancreatic cancer disease, and developing countries are experiencing a rapid increase in the age-standardized death rate (ASDR) of pancreatic cancer.
Genome-wide association study unveils ascorbate regulation by PAS/LOV PROTEIN during high light acclimation
Authors: Aarabi Fayezeh , Ghigi Andrea , Ahchige Micha Wijesingha , Bulut Mustafa , Geigenberger Peter , Neuhaus H Ekkehard , Sampathkumar Arun , Alseekh Saleh , Fernie Alisdair R
Published: June 2023

Varying light conditions elicit metabolic responses as part of acclimation with changes in ascorbate levels being an important component. Here, we adopted a genome-wide association-based approach to characterize the response in ascorbate levels on high light (HL) acclimation in a panel of 315 Arabidopsis (Arabidopsis thaliana) accessions. These studies revealed statistically significant SNPs for total and reduced ascorbate under HL conditions at a locus in chromosome 2. Ascorbate levels under HL and the region upstream and within PAS/LOV PROTEIN (PLP) were strongly associated. Intriguingly, subcellular localization analyses revealed that the PLPA and PLPB splice variants co-localized with VITAMIN C DEFECTIVE2 (VTC2) and VTC5 in both the cytosol and nucleus. Yeast 2-hybrid and bimolecular fluorescence complementation analyses revealed that PLPA and PLPB interact with VTC2 and that blue light diminishes this interaction. Furthermore, PLPB knockout mutants were characterized by 1.5- to 1.7-fold elevations in their ascorbate levels, whereas knockout mutants of the cry2 cryptochromes displayed 1.2- to 1.3-fold elevations compared to WT. Our results collectively indicate that PLP plays a critical role in the elevation of ascorbate levels, which is a signature response of HL acclimation. The results strongly suggest that this is achieved via the release of the inhibitory effect of PLP on VTC2 upon blue light illumination, as the VTC2-PLPB interaction is stronger under darkness. The conditional importance of the cryptochrome receptors under different environmental conditions suggests a complex hierarchy underpinning the environmental control of ascorbate levels. However, the data we present here clearly demonstrate that PLP dominates during HL acclimation.
Women’s Words and the Words of Women in the Oxford English Dictionary
Authors: Williams David-Antoine
Published: June 2023

This article explores datasets curated from the citation evidence in successive editions and revisions of the Oxford English Dictionary (1884–2022), which have been annotated to reflect the gender of the authors and other bibliographical metadata. This exploration aims both to supplement the historical account of the dictionary’s uses of female-authored quotation sources, correcting and elaborating some figures which have previously been reported, and to provide a contemporary account of women’s representation in OED Online, using the revision published in June 2022. In seeking to establish a more objective and empirical basis for judging ‘representativeness’, I treat the OED both as a self-contained bibliographical and lexicographical work, and comparatively, against other comprehensive or very large bibliographical corpora, namely the Garside et al. surveys of early English novels, the Library of Congress Catalog, and the HathiTrust Digital Library. The OED data studied here represents a significant (if restricted) subset, rather than a representative sample, of the OED corpus as a whole: modern (post-1700) quotations from books appearing with their author’s name in the OED evidence are considered. While this approach does not claim to make an objectively complete tally of every woman-authored quotation collected in the OED, it does enable a more detailed and accurate account than has previously been possible, and allows for a number of consistent cross-comparisons. A companion document of Supplementary Data & Notes, available at The Review of English Studies online, describes in technical terms how the data was compiled and the processes and principles by which it was annotated.
An exploration of marks/injuries related to BDSM sexual experiences
Authors: Drouin Michelle , Hernandez Ellis , Machette Anthony , Garcia Justin R , Boyd Ryan L
Published: June 2023

Background

Despite its growing prevalence, BDSM practice (bondage, discipline, dominance, submission, and sadomasochism) is still stigmatized, and little is known about the physical marks and injuries that individuals sustain from consensual BDSM-related activities.

Aim

In this exploratory study, we examined BDSM sexual experiences and the physical marks and injuries resulting from these experiences in a convenience sample of 513 US adults.

Methods

We examined the extent to which individuals at various stages of BDSM exploration engage with different types of BDSM and kink behaviors, along with the frequency with which they communicate about, inflict, and receive physical marks from these activities.

Outcomes

Our main outcome measures were intentional and unintentional marks sustained from BDSM-related activities, BDSM experiences, and the use of safe words.

Results

Results revealed that BDSM marks and injuries are common and quite varied (from small scratches to very large bruises) and unintentional and intentional marks differ in terms of typical size, place on body, and severity of injury. Additionally, BDSM experience is positively associated with the use of safe words and marking behaviors.

Clinical Translation

Disclosure of marks and injuries, intentional and unintentional, may be improved if health care providers are aware of, and make efforts to reduce stigma surrounding, BDSM and rough sex activity.

Strengths and Limitations

The findings of this study must be interpreted with acknowledgment of the limitations that it was a survey study with a convenience sample. However, as one of the few studies exploring the marks and injuries sustained from BDSM activities, the exploration of intentional and unintentional marks sustained provides a critical starting point for future examination of BDSM consequences that intersect with health care and the law.

Conclusion

Marks and injuries from BDSM-related activities are common, and despite the greater use of safe words, practitioners with more BDSM experience inflict more marks than those with less BDSM experience.
Uses of Electronic Health Record Data to Measure the Clinical Learning Environment of Graduate Medical Education Trainees: A Systematic Review
Authors: Lees A. Fischer , Beni Catherine , Lee Albert , Wedgeworth Patrick , Dzara Kristina , Joyner Byron , Tarczy-Hornoch Peter , Leu Michael
Published: June 2023

Purpose

This study systematically reviews the uses of electronic health record (EHR) data to measure graduate medical education (GME) trainee competencies.

Method

In January 2022, the authors conducted a systematic review of original research in MEDLINE from database start to December 31, 2021. The authors searched for articles that used the EHR as their data source and in which the individual GME trainee was the unit of observation and/or unit of analysis. The database query was intentionally broad because an initial survey of pertinent articles identified no unifying Medical Subject Heading terms. Articles were coded and clustered by theme and Accreditation Council for Graduate Medical Education (ACGME) core competency.

Results

The database search yielded 3,540 articles, of which 86 met the study inclusion criteria. Articles clustered into 16 themes, the largest of which were trainee condition experience (17 articles), work patterns (16 articles), and continuity of care (12 articles). Five of the ACGME core competencies were represented (patient care and procedural skills, practice-based learning and improvement, systems-based practice, medical knowledge, and professionalism). In addition, 25 articles assessed the clinical learning environment.

Conclusions

This review identified 86 articles that used EHR data to measure individual GME trainee competencies, spanning 16 themes and 6 competencies and revealing marked between-trainee variation. The authors propose a digital learning cycle framework that arranges sequentially the uses of EHR data within the cycle of clinical experiential learning central to GME. Three technical components necessary to unlock the potential of EHR data to improve GME are described: measures, attribution, and visualization. Partnerships between GME programs and informatics departments will be pivotal in realizing this opportunity.
Technical aspects that may affect the outcomes of pediatric patients with both-bone forearm diaphyseal fractures treated using elastic stable intramedullary nails
Authors: Demirtaş İdris , Asfuroğlu Zeynel Mert , Çolak Mehmet
Published: June 2023

We assessed the radiological and functional results of pediatric both-bone forearm diaphyseal fractures treated using elastic stable intramedullary nails (ESINs), as well as factors affecting the results. In total, 36 patients (33 males and three females; mean age, 11.6 years) were included. The mean follow-up time was 41.5 (18–96) months. Patient demographic characteristics and the details of the surgical techniques were analyzed retrospectively. In addition to standard radiographic evaluations, the ratio between the nail diameter and medullary canal diameter (ND/MCD) was measured, as well as the maximal radial bowing. According to the criteria of Price and Flynn, 28 (77.8%) and eight (22.2%) patients had excellent and good results, respectively. There were no cases of nonunion or delayed union. There was no significant difference in functional or radiological results according to whether titanium nails (24 patients) or stainless steel nails (12 patients) were used (all P > 0.05). Nail prebending (performed in 19 patients) did not affect the functional or radiological results (P > 0.05). Loss of reduction was observed in four patients with an ND/MCD ratio <40%. The maximal radial bowing improved in all patients. The mean change was significantly greater in patients with diastases and 22D/4.1 fractures. Regardless of nail type or prebending status, surgery using ESIN placement effectively treats both-bone forearm diaphyseal fractures; radial bow remodeling outcomes are excellent. We recommend that the ND/MCD ratio should be 40–70%.
ESAIC focused guideline for the use of cardiac biomarkers in perioperative risk evaluation
Authors: Lurati Buse Giovanna , Bollen Pinto Bernardo , Abelha Fernando , Abbott Tom E.F. , Ackland Gareth , Afshari Arash , De Hert Stefan , Fellahi Jean-Luc , Giossi Laure , Kavsak Peter , Longrois Dan , M’Pembele Rene , Nucaro Anthony , Popova Ekaterine , Puelacher Christian , Richards Toby , Roth Sebastian , Sheka Mootii , Szczeklik Wojciech , van Waes Judith , Walder Bernhard , Chew Michelle S.
Published: June 2023

BACKGROUND

In recent years, there has been increasing focus on the use of cardiac biomarkers in patients undergoing noncardiac surgery.

AIMS

The aim of this focused guideline was to provide updated guidance regarding the pre-, post- and combined pre-and postoperative use of cardiac troponin and B-type natriuretic peptides in adult patients undergoing noncardiac surgery.

METHODS

The guidelines were prepared using Grading of Recommendations Assessment Development and Evaluation (GRADE) methodology. This included the definition of critical outcomes, a systematic literature search, appraisal of certainty of evidence, evaluation of biomarker measurement in terms of the balance of desirable and undesirable effects including clinical outcomes, resource use, health inequality, stakeholder acceptance, and implementation. The panel differentiated between three different scopes of applications: cardiac biomarkers as prognostic factors, as tools for risk prediction, and for biomarker-enhanced management strategies.

RESULTS

In a modified Delphi process, the task force defined 12 critical outcomes. The systematic literature search resulted in over 25,000 hits, of which 115 full-text articles formed the body of evidence for recommendations. The evidence appraisal indicated heterogeneity in the certainty of evidence across critical outcomes. Further, there was relevant gradient in the certainty of evidence across the three scopes of application. Recommendations were issued and if this was not possible due to limited evidence, clinical practice statements were produced.

CONCLUSION

The ESAIC focused guidelines provide guidance on the perioperative use of cardiac troponin and B-type natriuretic peptides in patients undergoing noncardiac surgery, for three different scopes of application.
Take it or leave it: oophorectomy at the time of benign hysterectomy
Authors: Haber Hilary R. , French Hannah M. , Movilla Peter R. , Isaacson Keith B. , Morris Stephanie N.
Published: June 2023

Purpose of review

Previous modeling data suggest ovarian conservation up to age 65 for women without adnexal disease and at average risk of ovarian cancer because of an increase in mortality associated with ovarian removal. Recent modeling data challenges this practice. This review of recent literature will update providers regarding consideration for oophorectomy at time of benign hysterectomy.

Recent findings

Oophorectomy at time of hysterectomy for women less than 50 years with estrogen supplementation and greater than 50 years without estrogen supplementation is not associated with increased mortality.

Although not associated with increased mortality, the decision to remove the ovaries at time of hysterectomy in women older than 50 years is nuanced and requires careful shared decision-making, considering unique patient factors.
The minimally invasive approach to abdominal cerclage: indications, complications, and techniques for placement
Authors: Waters Caitlin , Pinho Gabriella , Kim Sara , Blaber Jennifer , Lian Xun
Published: June 2023

Purpose of review

Laparoscopic abdominal cerclage placement has become the favored approach for management of refractory cervical insufficiency. There are special considerations with respect to surgical method, management of pregnancy loss, and delivery following placement. This review addresses current literature on transabdominal cerclage with a focus on up-to-date minimally invasive techniques.

Recent findings

Recent literature on abdominal cerclage has compared laparoscopic and open approaches, evaluated the effect of preconception placement on fertility, and explored the upper gestational limit for dilation and evacuation with an abdominal cerclage in situ.

The objective of this article is to help minimally invasive surgeons identify candidates for transabdominal cerclage placement, understand surgical risks, succeed in their laparoscopic approach, and appropriately manage patients postoperatively.
Fluorescence Lifetime Imaging Ophthalmoscopy (FLIO) in Macular Telangiectasia Type 2 (MacTel) Patients with and without Diabetes
Authors: Sauer Lydia , Vitale Alexandra S. , Jacoby Rachael S. , Hart Barbara , Bernstein Paul S.
Published: June 2023

Purpose:

Macular telangiectasia type 2 (MacTel) is a vision-altering retinal disease with a high prevalence of diabetes. Differences between MacTel patients with and without diabetes were investigated using fluorescence lifetime imaging ophthalmoscopy (FLIO).

Methods:

86 patients with MacTel (59±12 years) were included. 40 patients (46%) did not have diabetes, 16 patients (19%) were pre-diabetic, and 30 patients (35%) were diabetic. Of these, 7 had diabetic retinopathy (DR). 18 diabetic patients without MacTel and 42 age-matched healthy controls were included. FLIO lifetimes (FLTs) were obtained in short (SSC, 498-560nm) and long (LSC, 560-720nm) spectral channels from different areas of interest using a Heidelberg Engineering FLIO.

Results:

FLTs did not show significant differences when comparing diabetic to nondiabetic MacTel eyes (MacTel-zone, SSC, diabetic: 243±65 ps, nondiabetic: 232±51 ps, p=1.0; LSC, diabetic: 327±66ps, nondiabetic: 309±54ps, p=0.582). Longitudinal changes were similarly unrelated to diabetes status. A non-significant trend of increased FLT-progression with higher BMI was found. FLTs in diabetic patients without MacTel were significantly shorter within the MacTel zone and longer in the periphery compared to diabetic MacTel patients.

Conclusions:

Although MacTel has a high prevalence of diabetes, FLTs from the MacTel-zone are unrelated to diabetes. FLIO retains diagnostic abilities in patients with MacTel even in the presence of pre-diabetes, diabetes, and advanced DR. The lack of diabetic FLT changes in the periphery of diabetic MacTel patients is an interesting finding that needs further investigation.
Injectable Fluocinolone Implant for the Management of Chronic Postsurgical Cystoid Macular Edema in Vitrectomized Eyes
Authors: Patel Kishan G. , Flores Jessica , Abbey Ashkan M.
Published: June 2023

Purpose:

Long-acting injectable steroids are changing the treatment paradigm for patients with chronic intraocular inflammation and cystoid macular edema (CME). We report the use of the fluocinolone implant (FAI) 0.18 mg in patients with chronic postsurgical CME following pars plana vitrectomy (PPV).

Methods:

This is a retrospective case series of 24 vitrectomized eyes which received FAI for the management postsurgical CME. Clinical outcomes and requirement for rescue therapy were studied.

Results:

Median length of follow-up was 19.3 months (range 8.3-23.2 months). There was an improvement in median central subfield thickness from 412 μm (range 167-806 μm) to 311 μm (range 157-686 μm) following FAI (p < 0.001). The injection burden decreased significantly following study treatment (p < 0.001); however, there was no significant change in visual acuity (p = 0.334). Eighteen eyes had control of CME that did not require additional intravitreal therapy. Four eyes had initially controlled but recurrent CME requiring intravitreal steroid therapy at median of 7.8 months (range 7.6-15.4 months). One eye never attained sufficient inflammatory control despite rescue therapy.

Conclusion:

FAI can be an effective treatment in vitrectomized patients with chronic postsurgical CME and can help decrease the overall injection burden.
Validation of the PCL-5, PHQ-9, and GAD-7 in a Sample of Veterans
Authors: Ahmadi Aazi , Ponder Warren N. , Carbajal Jose , Schuman Donna L. , Whitworth James , Yockey R. Andrew , Galusha Jeanine M.
Published: June 2023

Objective

Veterans can present at nongovernment (Department of Defense, Department of Veterans Affairs) mental health agencies with complex symptom constellations that frequently include posttraumatic stress disorder, depression, and generalized anxiety. To date, no veteran study has validated these measures on a treatment-seeking sample of veterans outside the DoD and VA.

Methods

We used a treatment-seeking sample of veterans (N = 493) to validate measures that assess these constructs (PTSD Checklist 5, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7).

Results

The seven-factor posttraumatic stress disorder hybrid configuration was the best fit. The best fitting model of the depression measure was a two-factor structure, cognitive-affective, and somatic depression. The measure of generalized anxiety was a unidimensional model.

Limitations

Follow-up studies should validate these measures on nontreatment-seeking discharged veterans.

Conclusions

We interpret these findings within the veteran scholarship and explore clinical implications for providers.
The Dual Labor Market and Workers’ Health Inequality in South Korea
Authors: Choi Sookja , Jung Youn
Published: June 2023

Objective

We investigated how worker health inequality is potentially linked to the dual labor market in South Korea.

Methods

Using the data from the fifth Korean Working Conditions Survey, we analyzed the data from 21,088 paid workers. We used logistic regression analyses to assess whether employment type or company size had a significant effect on workers’ physical and mental health and work-related injuries.

Results

Workers’ health status was significantly associated with employment type and company size. Nonstandard workers had higher rates of musculoskeletal diseases or injuries, and their self-rated health and psychological well-being were lower than standard workers. Company size showed a significant correlation only for work-related injuries.

Conclusions

The structure of inequality in Korea’s labor market according to employment type and company size seems to be affecting the health and safety of workers.
Genomics of aging: Reactive oxidation and inefficient mitochondria
Authors: Wysocki Kenneth , Heuer Beth
Published: June 2023

Many things are associated with decreased health and lifespan, including cancer, diabetes, atherosclerosis, high blood pressure, and chronic inflammatory conditions. Clinicians may not be familiar with the role that mitochondrial mutations and associated mitochondrial dysfunction play in a shortened lifespan. This article, the fifth in the JAANP Genomics of Aging series, describes the role that mitochondrial dysfunction plays in the development of age-related diseases such as Alzheimer disease, Parkinson disease, cancer, heart disease, and stroke.
Disorders of Gut-brain Interaction on the US-Mexico Border
Authors: Bashashati Mohammad , Schmulson Max J. , Sarosiek Irene , Robles Alejandro , Casner Nancy , Espino Karina , Elhanafi Sherif E. , Zuckerman Marc J.
Published: June 2023

Background:

Disorders of gut-brain interaction (DGBI) cause a substantial health burden. Herein we studied the prevalence and characteristics of DGBI and symptoms of bloating/distension in El Paso, Texas on the US-Mexico border, providing a unique opportunity to study the effects of acculturation.

Methods:

Subjects from community centers completed the Rome IV questionnaire for DGBI, short acculturation scale for Hispanics questionnaire, and bloating/distention Pictograms. Data were presented as prevalence (95% CI) and compared using χ2.

Results:

Of 216 participants, 197 (127 Hispanics, 90 with English acculturation) were included and 177 completed the Pictograms. Fifty-one [25.9% (20 to 32.6)] subjects fulfilled the criteria for at least one DGBI. Globus and functional dyspepsia were the most common upper DGBI, each in [3.0% (1.1 to 6.5)]. Unspecified functional bowel disorders [8.6% (5.1 to 13.5)], followed by functional abdominal bloating/distention [8.1% (4.7 to 12.9], and irritable bowel syndrome [6.1% (3.2 to 10.4] were the most common functional bowel disorder. Ninety-one (51.4%) reported bloating and/or distension with Pictograms; more frequently in those with DGBI (80.9% vs 40.8%, P < 0.001). Bloating and/or distension were reported by Pictograms in 30% of those not reporting it in the Rome IV Questionnaire. There were no differences based on acculturation or in Hispanics versus non-Hispanics.

Conclusions:

On the US-Mexico border, we found a lower prevalence of DGBI than in the US or Mexico. Functional abdominal bloating/distention was more prevalent on the US-Mexico border than in either country. Bloating/distension was more commonly reported with Pictograms than with verbal descriptors. There were no differences between Hispanics and non-Hispanics, suggesting shared environmental/acquired including dietary factors as the underlying mechanisms.