bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of statins on melanoma survival: a systematic review and meta-analysis
Authors: McKechnie Tyler , Talwar Gaurav , Grewal Shan , Wang Austine , Eskicioglu Cagla , Parvez Elena
Published: September 2024

Statin use may decrease recurrence and improve survival in patients with melanoma. In this systematic review and meta-analysis, we examine the current body of literature concerning the use of statins as an adjunctive therapy in melanoma, Medline, EMBASE, CENTRAL, and PubMed were systematically searched from inception through to April 2023. Studies were included if they compared patients with melanoma receiving and not receiving statin therapy concurrently with their oncologic treatment in terms of long-term oncologic outcomes. The primary outcome was 5-year overall survival (OS). Meta-analyses was performed with DerSimonian and Laird random effects. Risk of bias was assessed with the ROBINS-I and GRADE was used to assess certainty of evidence. From 952 citations, eight non-randomized studies were identified. Included studies were conducted between 2007 and 2022. Random effects meta-analysis of adjusted hazard ratios from three studies suggested an improvement in 5-year OS with statin use with wide 95% confidence intervals (CIs) crossing the line of no effect (hazard ratio 0.87, 95% CI: 0.73–1.04, P = 0.12, I
2 = 95%, very-low certainty). Outcome reporting was heterogeneous across all other oncologic outcomes such that pooling of data was not possible. Risk of bias was serious for seven studies and moderate for one study. This systematic review of studies evaluating the impact of statin use on survival in patients with melanoma found a 13% reduction in risk of death at 5 years from diagnosis – a point estimate suggesting benefit. However, the wide 95% CIs and resultant type II error risk create significant uncertainty.
Hypoglycemia in Critically Ill Patients
Authors: Ma Terilyn , Chen Leon L.
Published: September 2024

Hypoglycemia in critical care is a well-documented phenomenon, linking both physiological and clinical evidence to harmful outcomes and an increased risk of mortality. Its implications span medical and non-medical consequences, such as cardiovascular and cerebrovascular complications, and escalated health care expenses and hospitalization duration. Mitigation measures for modifiable risk factors and education for both patients and health care providers on hypoglycemia can effectively prevent the onset of inpatient hypoglycemia. This concise clinical review offers a brief overview of hypoglycemia in critically ill patients, encompassing its pathophysiology, etiology, diagnosis, management, and prevention.
The Role of Work-Life Balance, Work Stress, and Work-Family Conflict in Creating Job Satisfaction and Their Impact on Turnover Intention in Nurses at Level I Health Facilities Hospital in Karawang
Authors: Hanoum Farah Chalida , Rizan Mohamad , Handaru Agung Wahyu
Published: September 2024

Turnover intention research with the addition of independent variables of work-life balance and work stress in nurses with health backgrounds is rarely found in type c public hospitals in Karawang city, where literature about this research needs to explain it. This research aims to ascertain how work-life balance, workplace stress, and work-family conflict affect nurses’ intentions to quit their jobs by using job satisfaction as a mediator. The sampling for this study was carried out using the probability sampling method known as proportionate stratified random sampling. A total of 550 nurses from 4 schools submitted responses. Work-life balance, work-related stress, and job happiness all significantly influence the likelihood of turnover. The desire to increase or reduce hospital turnover is significantly influenced by work-life balance, stress at work, and work-family conflict. This study has limitations that can lead to imperfect conclusions because the sample used is only the nurse division, so this study can only be generalized to some other districts. The variables studied still need to be reviewed to affect turnover intention by mediating job satisfaction.
The Effect of Regular Oral Care Protocol on Preventing or Decreasing Severity of Oral Mucositis in Acute Leukemia Patient
Authors: Alam Amany Sayed Hasaneen , Mohamed Mehany Mogedda , Elzaher Ahmed Refaat Abd , Mahran Ghada Shalaby Khalaf
Published: September 2024

This article reports a study designed to evaluate the effectiveness of regular oral care protocol developed specifically for adults in intensive care to prevent mucositis. Data were collected using oral mucositis assessment scale, oral cavity assessment tool, and the National Cancer Institute Common Toxicity Criteria. The results indicated that oral mucositis can be reduced through the practice of administering oral care in accordance with oral health care guidelines. Oral care implemented in line with an evidence-based oral care guide and frequent observation of patients is the most important step in preventing oral mucositis.
Combined Radial Incision and Steroid Injection for Refractory Colorectal Stenosis After Pull-Through Surgery in Hirschsprung Disease: An Innovative Conservative Treatment
Authors: Langeron Margaux , Montalva Louise , Mosca Alexis , Ali Liza , Pardessus Pierre , Bonnard Arnaud
Published: September 2024

BACKGROUND:

Anastomotic stenosis after pull-through surgery remains a challenge in the management of Hirschsprung disease. Based on the management of esophageal stenosis, we evaluated the efficacy of combined radial incision and steroid injection for the treatment of refractory colorectal anastomotic stenosis after pull-through.

IMPACT OF INNOVATION:

Combined radial incision and steroid injection is an alternative conservative treatment of refractory anastomotic stenosis after pull-through for Hirschsprung disease, avoiding a potential complicated redo pull-through surgery.

TECHNOLOGY, MATERIALS, AND METHODS:

We included patients with rectosigmoid Hirschsprung disease who developed a refractory anastomotic stenosis after a laparoscopic-assisted Swenson pull-through at Robert-Debré Children University Hospital in Paris, France. Refractory stenosis was defined as obstructive symptoms associated with an anastomotic stenosis on rectal examination without improvement after serial anal dilations. Under general anesthesia, an injection of 10-mg delayed-action steroid per quadrant was combined with a radial incision of the stenosis using monopolar cautery.

PRELIMINARY RESULTS:

Combined radial incision and steroid injection were performed in 4 children for either early or late refractory stenosis. This resulted in improved refractory anastomotic stenosis, avoiding a redo pull-through in 75% of patients. One child presented with transient improvement after a combined radial incision and steroid injection but developed recurrent stenosis despite additional combined radial incision and steroid injection and redo pull-through. The median follow-up was 29 months.

CONCLUSIONS:

We observed a clinical improvement in all the patients after combined radial incision and steroid injection.

FUTURE DIRECTIONS:

Steroid injection should be considered as a potential alternative therapy for anastomotic stenosis.
Daptomycin Dosage Optimization in Renal Impairment Using Model-Informed Precision Dosing
Authors: Sayadi Hamza , Fromage Yeleen , Labriffe Marc , Danthu Clément , Monchaud Caroline , Woillard Jean-Baptiste
Published: September 2024

Background:

Daptomycin's efficacy and toxicity are closely related to its exposure, which can vary widely among individuals. The patient, a 59-year-old male with an estimated glomerular filtration rate (eGFR) of 12 mL/min/1.73 m² and a weight of 64 kg, was treated with 850 mg of daptomycin every other day for infective endocarditis caused by methicillin-resistant Staphylococcus aureus (MRSA). For patients with an estimated glomerular filtration rate of less than 30 mL/min/1.73 m², the dosing recommendations are not explicitly defined in the endocarditis guidelines. Subsequently, the pharmacology department was contacted to adjust the dosage.

Methods:

A population pharmacokinetic model developed by Dvorchik et al. was used for Bayesian estimation of the patient’s pharmacokinetic parameters. The 24-hour area under the curve (AUC24) of daptomycin was calculated at steady state using peak and trough plasma samples.

Results:

The minimum inhibitory concentration (MIC) of the MRSA strain was 0.25 mg/L. An AUC24/MIC ratio below 666 is associated with higher mortality risk, while an AUC24 above 939 h·mg/L correlates with increased risk of muscular toxicity. Initial AUC24 estimation was 1091 h·mg/L. Following a dosage reduction to 700 mg every other day, the AUC24 increased to 1600 h·mg/L. Further reduction to 500 mg every other day brought the AUC24 down to 750 h mg/L, with two subsequent measurements showing consistent AUC24 values of 500 h·mg/L, which is within the target range.

Conclusions:

Daptomycin ended 6 weeks after the initial negative blood culture, with no adverse effects or recurrence of MRSA infection. This case underscores the need for therapeutic drug monitoring and a multidisciplinary approach to adjust daptomycin doses in patients with renal impairment.
Fat Necrosis in Single Perforator Deep Inferior Epigastric Artery and Superficial Epigastric Artery Perforator Free Flaps: A Prospective Randomized Study
Authors: Miller Rebecca L.R. , Nguyen Christopher M. , Peters Blair R. , Sigurdson Leif , Hayakawa Thomas E.J. , Spiwak Rae , Dalke Kimberly , Buchel Edward W.
Published: September 2024

Background:

The deep inferior epigastric perforator (DIEP) flap is the standard of care in autologous breast reconstruction. The superficial inferior epigastric artery perforator flap (SIEA) is an alternative reconstructive option, with the compromise of less donor-site morbidity but variable perfusion to subscarpal fat zones. Fat necrosis is a known complication from marginal perfusion variability. Volumetric analysis of fat necrosis has not been performed between the two reconstructive options, nor has the amount of flap necrosis following radiation. Our objective was to compare rates and volume of fat necrosis between single-perforator DIEP and SIEA flap techniques.

Methods:

A single-center, blinded, prospective cohort study of patients randomized between SIEA and DIEP breast reconstruction was conducted over 2 years (June 2011–July 2013). Inclusion criteria were women undergoing immediate reconstruction following mastectomy. Randomization protocols were strictly followed. Fat necrosis volumetric analysis was determined by an ultrasound-trained attending surgeon at 12 months postoperatively. Patient demographics and adjuvant/neoadjuvant cancer treatment were analyzed. Statistical analyses included Mann-Whitney U tests, chi square, and/or Fisher exact tests. P values of 0.05 or less were considered significant.

Results:

Fat necrosis was detected in 11 of 46 flaps (23.9%), with a median area of 17.9 cm2. There was no significant difference in prevalence of fat necrosis between the two flap types (P = 0.19). Postoperative radiation did not increase the prevalence (P = 0.30) or extent (P = 0.92) of fat necrosis.

Conclusion:

Single-perforator DIEP and SIEA flaps have comparable rates of fat necrosis. Postoperative radiation did not result in increased prevalence or extent of fat necrosis.
Kluyvera Cryocrescens Urinary Tract Infection in a Neonate: A Case Report and Literature Review
Authors: Alsuheili Abdullah Zeid , Alsubaie Mohammed Abdullah , Alnajjar Abeer A. , Al-Dajani Nawaf
Published: September 2024

This case report details the fourth documented case of urinary tract infection caused by Kluyvera cryocrescens and the first in a neonate. Including a brief literature review on urinary tract infections associated with this organism, the report highlights the importance of considering uncommon pathogens in neonatal infections and the necessity of a thorough diagnostic approach to initiate appropriate antimicrobial treatment.
Neurodevelopmental Outcomes in Children Vertically Exposed to Chikungunya Virus: A Two Years Follow-up Study
Authors: Quintans Maria D. S. , Vianna Renata A. de O. , Velarde Luis G. C. , de Oliveira Solange A. , Fernandes Alexandre R. , Bueno Arnaldo C. , Cardoso Claudete A. A.
Published: September 2024

Objectives:

To monitor by the first 24 months of life, children born to mothers with laboratory evidence of chikungunya virus (CHIKV) infection during pregnancy or up to 8 weeks before it, and to describe abnormalities in head circumference (HC), auditory and ophthalmological assessments and neuroimaging tests during the follow-up period.

Method:

This is a observational, descriptive, longitudinal and prospective study of children born to mothers who had a rash and a positive test for CHIKV during pregnancy or up to 8 weeks before it. They were admitted between November 2015 and May 2019 in the outpatient multidisciplinary clinic to investigate acute exanthematous disease. The exposed children were followed up by a multidisciplinary team and underwent periodic measurements of the HC. The Denver II test was applied, in addition to transfontanellar ultrasound (TU) to evaluate neurodevelopmental outcomes during the study period. Ophthalmological and auditory examinations, echocardiography and laboratory tests were also included.

Results:

We included in the study 27 children vertically exposed to CHIKV. All children had a negative polymerase chain reaction test for the virus collected at the first outpatient visit (mean age of 16.8 days and standard deviation of 8 days). No clinical condition compatible with congenital infection at birth was reported. A change in HC characterized by macrocephaly and mild global delay development was observed in a 1-year-old child whose mother was infected in the peripartum, but with normal TU. Changes in the TU were observed in 2 other children with nonspecific subependymal cystic malformation that was not evident by the cranial computed tomography. The other children monitored showed normal results in the Denver II test, in the HC and TU. No changes were identified on ocular ophthalmoscopy or auditory brainstem response test. Two children had an increase in serum ferritin levels during the first year of life, with the others’ inflammatory disease markers normal.

Conclusions:

Our study added knowledge about the neurodevelopment of children exposed to CHIKV during pregnancy by a longitudinal and prospective follow-up, throughout their first 24 months of life. We did not observe a negative impact of exposure to the virus on the neurological examination, global developmental test or measurements of the HC of these children.
Improving Provider Education and Overall Disease Management in Patients With Polycystic Ovarian Syndrome Presenting to a Dermatology Clinic
Authors: Gaudette Laura E. , Codier Louisa , Garcia-Albea Victoria
Published: September 2024

Aims

The aim of the study was to implement a quality improvement project using the Lean Six Sigma framework of Define, Measure, Analyze, Improve, and Control in an outpatient urban medical dermatology clinic; educate providers about polycystic ovarian syndrome; increase endocrinology referrals; and optimize spironolactone use in these patients ages 12–45 years old.

Background

Patients with polycystic ovarian syndrome experience delays in endocrinology referrals and often suboptimally treated with spironolactone because of lack of provider understanding.

Method

Lean Six Sigma was used to increase provider ability to diagnose and manage polycystic ovarian syndrome, improve spironolactone dosing, and increase endocrinology referral rates through education. Pre-intervention collection occurred July to September 2023. Intervention occurred from September to December 2023. Post-intervention occurred December 2023 to February 2024. Provider surveys were collected through Microsoft Forms, and endocrinology referral rates were collected through the electronic health record, Epic.

Results

Improved provider understanding of polycystic ovarian syndrome was demonstrated in survey results for rate of recognition, confidence, and awareness of diagnostic criteria. Referral rates increased by 90% via SlicerDicer tool within Epic.

Conclusion

Through further education, dermatology providers can improve identification of the polycystic ovarian syndrome, patient outcomes, and patient experience. With identification of the need in this department, there is a platform to incorporate a multidisciplinary clinic.
The effects of health beliefs and acculturation on the acceptance of human papillomavirus vaccination among Asian Indian parents in the United States
Authors: Mullassery Daisy , Posmontier Barabara
Published: September 2024

Background:

The available limited literature and Centers for Disease Control data suggest that human papillomavirus (HPV) vaccination acceptance is lower among Asian Indians than the general population in the United States.

Purpose:

The purpose of the study was to determine the effects of health beliefs, subjective norms, acculturation, and demographics on HPV vaccination acceptance among Asian Indian parents.

Methodology:

Using a comparative descriptive cross-sectional study design, immigrant and first-generation Asian Indian parents of 9- to 16-year-old children were recruited (N = 171). The survey comprised the Health Belief and Subjective Norms instrument and the Suinn-Lew Asian Self-Identity Acculturation Scale. The analysis included parametric and nonparametric tests.

Results:

Participants who expressed higher levels of perceived barriers were less likely to accept HPV vaccination (odds ratio [OR] = 0.47, p = .016). Spousal opinion negatively correlated with HPV vaccination acceptance (OR = 0.57, p = .006). However, subjective norms positively predicted HPV vaccination acceptance (OR = 1.69, p = .039). Participants who perceived that friends and family approved of the vaccination also had significantly higher rates of vaccination acceptance (OR = 11.99, p = .001).

Conclusions:

The results revealed unique factors in the acceptance of HPV vaccination in Asian Indians that were not examined or understood before. The applied Health Beliefs and Subjective Norms theoretical framework suggested that perceived barriers, subjective norms, and the opinions of spouses, friends, and family predicted HPV vaccination acceptance.

Implications:

Educational interventions targeting providers, spouses, family, and community members with influential effects on parents may positively affect HPV vaccination acceptance. Providers should note that this population welcomes the provider's recommendations.
Atypical Primary Sclerosing Cholangitis Findings on a 99mTc-Mebrofenin Scan
Authors: Maharaj Masha , Govender Trisha , Kashala Lusamba , Gounden Strinivasen , Sadhabiriss Dhiren , Chotey Nivesh , Korowlay Nisaar
Published: September 2024

We present an 80-year-old woman with cholestatic liver disease. Ultrasound, CT, and MR cholangiopancreatography showed no substantial findings. The patient was referred for a hepatobiliary scan to examine the physiological pathway of bilirubin and to determine for any level of obstruction. The findings on the hepatobiliary scan suggested intrinsic pathology affecting the entire biliary tree, and histology was recommended. Histology confirmed primary sclerosing cholangitis (PSC). Although hepatobiliary scintigraphy in biliary stasis is well-known and well-published, hepatobiliary scintigraphy in PSC in adults is not well-documented. The hepatobiliary scintigraphy provided the primary and definitive imaging technique in directing the management and diagnosis of PSC in our patient.
The Relationship Between Social Media Use, Nurse Characteristics, and Job Decision-Making
Authors: Nelson-Brantley Heather V. , Parchment Joy , Chipps Esther , Hedenstrom Lisa , Montgomery Aoyjai P. , Ruffin Asiah , Lyman Bret , McHugh Allison
Published: September 2024

OBJECTIVE

To describe nurses' use of social media and examine the relationship between social media use, nurse characteristics, and job decision-making.

BACKGROUND

Social media shares information, connects, and influences thought. A gap remains in understanding how nurses use social media for professional purposes.

METHODS

A national survey of RNs and advanced practice RNs included demographics, questions about which social media platforms respondents use personally and professionally, and engagement activities on each platform. Data analysis included descriptive statistics, Cramér's V test, and binomial logistic regression.

RESULTS

Eight hundred twelve nurses participated. Platforms and activities used by nurses varied significantly by age, job title, and employment. The majority (61%) of respondents were satisfied or highly satisfied with their job, yet about one-third intended to leave their position or organization within 1 to 12 months.

CONCLUSIONS

Nurse leaders should adopt a strategic, data-informed approach to leverage social media in attracting and retaining a diverse nursing workforce.
Evaluation of the Movement and Play Opportunities and Constraints Associated With Containers for Infants
Authors: Alghamdi Zainab S. , Orlando Julie M. , Lobo Michele A.
Published: September 2024

Purpose:

Containers (eg, strollers, bouncers) are an important part of infants’ environment but may negatively impact infant development and health. This study evaluated movement and play opportunities, constraints, and manufacturers’ developmental claims for infant containers.

Methods:

Containers were identified through Amazon.com. A content analysis of identified products was conducted to identify movement and visual-manual play opportunities, constraints, and developmental claims.

Results:

Content was analyzed for 460 containers. Containers varied in their movement and play opportunities; however, most did not incorporate toys and restricted trunk movement, self-directed locomotion, and independent head and trunk control. Containers, especially those with built-in toys, often had claims related to gross motor, sensory, and fine motor development.

Conclusion:

These findings demonstrate the variability of movement and play opportunities observed across and within categories of infant containers. General recommendations about container use may be less effective than more specific education to parents about selecting and implementing containers.
Development and Validation of Nosocomial Bacterial Infection Prediction Models for Patients With Systemic Lupus Erythematosus
Authors: Restrepo Escobar Mauricio , Jaimes Barragán Fabián , Vásquez Duque Gloria María , Aguirre Acevedo Daniel Camilo , Peñaranda Parada Édgar Alfonso , Prieto-Alvarado Johana , Mesa-Navas Miguel Antonio , Calle-Botero Estefanía , Arbeláez-Cortés Álvaro , Velásquez-Franco Carlos Jaime , Vergara-Serpa Óscar , Del-Castillo-Gil David Julián , Gordillo-González Camilo Andrés , Guzmán-Naranjo Luis Carlos , Granda-Carvajal Paula Andrea , Jaramillo-Arroyave Daniel , Muñoz-Vahos Carlos Horacio , Vélez-Marín Mariana , Hernández-Zapata Johanna , Eraso-Garnica Ruth , Vanegas-García Adriana Lucía , González-Naranjo Luis Alonso
Published: September 2024

Background

Hospital-acquired bacterial infections are associated with high morbidity and mortality rates in patients with systemic lupus erythematosus (SLE). This study aimed to develop and validate predictive models for the risk of hospital-acquired bacterial infections in patients with SLE.

Methods

A historical cohort study was designed for development, and another bidirectional cohort study was used for external validation. The risk of bacterial infection was assessed upon admission and after 5 days of hospitalization. Predictor selection employed the least absolute shrinkage and selection operator (LASSO) techniques. Multiple imputations were used to handle missing data. Logistic regression models were applied, and the properties of discrimination, calibration, and decision curve analysis were evaluated.

Results

The development cohort comprised 1686 patients and 237 events (14.1%) from 3 tertiary hospitals. The external validation cohort included 531 patients and 84 infection outcomes (15.8%) from 10 hospital centers in Colombia (secondary and tertiary level). The models applied at admission and after 120 hours of stay exhibited good discrimination (AUC > 0.74). External validation demonstrated good performance among patients from the same tertiary institutions where the models were developed. However, geographic validation at other institutions has been suboptimal.

Conclusions

Two predictive models for nosocomial bacterial infections in patients with SLE are presented. All infection prevention recommendations should be maximized in patients at moderate/high risk. Further validation studies in diverse contexts, as well as clinical impact trials, are necessary before potential applications in research and clinical care.
68Ga-FAPI Response Evaluation Pitfall in a Patient With Esophageal Cancer After Neoadjuvant Therapy
Authors: Liu Huipan , Liu Yuhong , Zhang Jianwen , Chen Yue
Published: September 2024

We report the 68Ga-FAPI PET/CT findings of inflammatory changes and fibrosis in a 55-year-old woman with a history of esophageal cancer after neoadjuvant therapy, which needs to be differentiated from other esophageal diseases during evaluation.
Journal Metrics of the Journal of Craniofacial Surgery: An Analysis Based on the Journal Citation Report 2024
Authors: Tekin Mustafa Said , Durna Yusuf M. , Bahşi İlhan
Published: September 2024

Objectives:

This study aims the analysis of the journal metrics of Journal of Craniofacial Surgery based on 2024 Journal Citation Reports (JCR) data.

Methods:

In the Journal Citation Reports 2024, shared by Clarivate Analytics on June 20, 2024, the journal metrics of the Journal of Craniofacial Surgery were examined in detail.

Results:

According to the reports published by Clarivate Analytics in 2024, the journal’s impact factor in 2023 was determined as 1.0 and the impact factor excluding self-citations was calculated as 0.8. These values show that the impact factor of the journal has increased in recent years. Also, it is seen that the Journal of Craniofacial Surgery, which has been in the fourth quartile (Q4) among the journals in the “Surgery” category for the last 10 years, has risen to the third quartile (Q3) this year.

Conclusions:

The increase in the impact factor and ranking of the Journal of Craniofacial Surgery shows that the journal has strengthened its position in the scientific field and is moving toward higher levels. However, it is suggested that other metrics should be taken into consideration in addition to the impact factor.
Treatment of Plagiocephaly With Orthotic Helmets: Prevalence, Costs, and Inequities in Massachusetts
Authors: Wood Jacob J. , Phan Quynh Anh , Phan Jaime , Farzan Jessica J. , Joo Alex , Geraghty Sara , Lalikos Janice F.
Published: September 2024

Positional plagiocephaly is a craniofacial condition resulting from infant positioning that applies pressure consistently to a part of the skull. This study analyzed the prevalence of, and costs associated with orthotic helmet treatment for positional plagiocephaly and assessed inequities in treatment between medically underserved areas (MUAs) and non-MUAs using health insurance claims data from the Center for Health Information and Analysis (CHIA) in Massachusetts for the years 2016–2021. The mean percentage of patients receiving orthotic helmet therapy was 4.3% (SD=0.49, 95% CI=3.88–4.91, P=0.44). MUAs contained 37.2% of patients with positional plagiocephaly and 2.9% of MUA patients were treated with helmets compared with 5.2% of non-MUA patients (P<0.01). There was a significant decline in the percentage of patients prescribed helmeting therapy over the course of the study (P<0.01). The average copay amount for public insurance was $0.00, and for private insurance, it was $559.8 (SD=160.7, 95% CI=529.1–590.5, P<0.01). Of 3295 claims for orthotic helmet treatment, 92 were fully denied (2.8%). Private insurers issued more fully denied claims (3.8%) than public insurance (1.1%) (P<0.01). We found that public insurance is favorable for patients seeking treatment due to a lower likelihood of full denial and lower copayments. In addition, we found that there is a significant disparity in the prevalence of helmet treatment in MUAs, and the percentage of patients treated with helmeting therapy has declined over time.
Spectral approaches to stress relaxation in epithelial monolayers
Authors: Cowley Natasha , Revell Christopher K. , Johns Emma , Woolner Sarah , Jensen Oliver E.
Published: September 2024

We investigate the viscoelastic relaxation to equilibrium of an isolated disordered planar epithelium described using the cell vertex model. In its standard form, the model is formulated as coupled evolution equations for the locations of vertices of confluent polygonal cells. Exploiting the model’s gradient-flow structure, we use singular-value decomposition to project modes of deformation of vertices onto modes of deformation of cells. Expressing the dynamics in terms of operators of a discrete calculus, we show how eigenmodes of discrete Laplacian operators (specified by constitutive assumptions related to dissipation and mechanical energy) provide a spatial basis for evolving fields, and demonstrate how the operators can incorporate approximations of conventional spatial derivatives. We relate the spectrum of relaxation times to the eigenvalues of the Laplacians, modified by corrections that account for the fact that the cell network (and therefore the Laplacians) evolve during relaxation to an equilibrium prestressed state, providing the monolayer with geometric stiffness. While dilational modes of the Laplacians capture rapid relaxation in some circumstances, showing diffusive dynamics, geometric stiffness is typically a dominant source of monolayer rigidity, as we illustrate for monolayers exposed to unsteady stretching deformations.
Isolation and genetic analysis of mycobacteria from suspect tuberculous lesions in slaughtered cattle from Wolaita, Ethiopia
Authors: Zaba Melese Yilma , Neway Sebsib , Farrell Damien , Denion Eva , Perets Viktor , Tilahun Melaku , Bobosha Kidist , Cassidy Joseph P. , Asmare Asefa , Gordon Stephen V.
Published: September 2024

Bovine tuberculosis (bTB), caused by Mycobacterium bovis and other members of the Mycobacterium tuberculosis complex (MTBC), is a significant concern for livestock and public health in Ethiopia. This study aimed to isolate and genetically characterise the causative agents of bTB in cattle from four abattoirs in the Wolaita zone of Ethiopia. A total of 2,251 cattle were examined postmortem, and suspect tuberculous lesions were identified in 122 animals. From these animals, 180 tissue samples were collected and processed for bacteriological culture and genetic analysis, including the LoopampTM commercial LAMP kit, PCR targeting RD4 and RD9 loci, and whole genome sequencing (WGS).
Bacteriological culture using MGIT and Lowenstein-Jensen media ultimately identified 18 culture positive samples, with WGS confirming M. bovis in lesions from four animals and M. tuberculosis in lesions from one animal. The M. bovis and M. tuberculosis isolates showed genetic similarity to previously identified MTBC lineages in Ethiopia. The presence of M. tuberculosis in cattle raises concerns about human-to-animal transmission. Additionally, non-tuberculous mycobacteria were isolated from lesions from multiple animals. Our study genetically characterised bacteria from suspect tuberculous lesions and provides the research community with new genome data for Ethiopian isolates of M. bovis and M. tuberculosis.
Deep learning detection of dynamic exocytosis events in fluorescence TIRF microscopy
Authors: Lachuer Hugo , Moebel Emmanuel , Macé Anne-Sophie , Masson Arthur , Schauer Kristine , Kervrann Charles
Published: September 2024

Segmentation and detection of biological objects in fluorescence microscopy is of paramount importance in cell imaging. Deep learning approaches have recently shown promise to advance, automatize and accelerate analysis. However, most of the interest has been given to the segmentation of static objects of 2D/3D images whereas the segmentation of dynamic processes obtained from time-lapse acquisitions has been less explored. Here we adapted DeepFinder, a U-net originally designed for 3D noisy cryo-electron tomography (cryo-ET) data, for the detection of rare dynamic exocytosis events (termed ExoDeepFinder) observed in temporal series of 2D Total Internal Reflection Fluorescent Microscopy (TIRFM) images. ExoDeepFinder achieved good absolute performances with a relatively small training dataset of 60 cells/∼12000 events. We rigorously compared deep learning performances with unsupervised conventional methods from the literature. ExoDeepFinder outcompeted the tested methods, but also exhibited a greater plasticity to the experimental conditions when tested under drug treatments and after changes in cell line or imaged reporter. This robustness to unseen experimental conditions did not require re-training demonstrating generalization capability of ExoDeepFinder. ExoDeepFinder, as well as the annotated training datasets, were made transparent and available through an open-source software as well as a Napari plugin and can directly be applied to custom user data. The apparent plasticity and performances of ExoDeepFinder to detect dynamic events open new opportunities for future deep-learning guided analysis of dynamic processes in live-cell imaging.
Advertising ultra-processed foods around urban and rural schools in Kenya
Authors: Karugu Caroline H. , Asiki Gershim , Wanjohi Milka , Ojiambo Veronica , Sanya Richard , Laar Amos , Holdsworth Michelle , Vandevijvere Stefanie , Agyemang Charles
Published: September 2024

Background

Marketing of ultra-processed foods (UPFs) can influence purchase intentions and consumption of such foods, especially among children. There is limited evidence on the extent to which UPFs are marketed around schools in low-and middle-income countries (LMICs), including Kenya. We assessed the extent, content, and type of advertising of ultra-processed/unhealthy foods around schools in urban and rural settings in Kenya.

Methods

This cross-sectional study assessed advertising of food and beverages within a 250m radius around schools in Kenya between June to July 2021. We conducted the study in three counties (Nairobi-urban, Mombasa-coastal urban city, and Baringo-rural). Each county was stratified into high and low socioeconomic status (SES) sub-counties. Within each, we randomly selected schools and collected detailed information on advertising around the schools. The information gathered included the location, type of food and beverage product advertised, and the promotional techniques used. We used the NOVA classification and International Network for Food and Obesity/NCDs Research Monitoring and Action Support (INFORMAS) methods to categorize the food and beverages advertised based on processing level and core (healthy)/non-core(unhealthy) groups. We determined the extent of advertisements using descriptive analysis frequencies, and median (interquartile ranges). Poisson regression was used to determine the factors associated with UPF advertisements.

Results

In total, 2300 food and beverage advertisements were mapped around the 500 schools. There was a higher median number of advertisements in urban areas (median=25, Interquartile range (IQR)=25,160) compared to rural areas (median=10, IQR= 4, 13). Of these advertisements, approximately 48.0% were UPFs. The most common promotional strategy used was cartoon and company-owned characters, while the most frequent premium offer was price discounts. In the multivariate analysis, there was a significantly higher rate of advertisements of UPFs in Baringo County (prevalence rate ratios (PRR): 1.17, 95% CI: 1.01-1.36) compared to the urban Nairobi County, and in lower compared to higher SES settings (PRR: 1.10, 95% CI: 1.01-1.20).

Conclusion

UPFs are frequently advertised around schools with promotional strategies that may be appealing to children. There is a need to restrict the marketing of unhealthy foods around schools to children in Kenya.
Co-developing a comprehensive disease policy model with stakeholders: the case of malaria during pregnancy
Authors: Fernandes Silke , Briggs Andrew , Hanson Kara
Published: September 2024

Introduction

Understanding the holistic impact of malaria during pregnancy is essential for improving maternal and child outcomes in malaria endemic settings. To be able to design appropriate research and conduct robust policy analyses, a comprehensive model of the underlying disease, representing the current understanding of mechanisms and consequences is essential. This study aimed to illustrate a methodology to co-develop a disease model with expert stakeholders using malaria during pregnancy as a case study.

Methods

An initial steering group was convened to develop a first model of malaria during pregnancy and its consequences for mother and child based on their understanding of the literature. Subsequently, this model was refined using a Delphi process to gain consensus amongst twelve experts, representing the disciplines of health economics, mathematical modelling, epidemiology and clinical medicine, working in the field of malaria during pregnancy. Experts reviewed drafts of the conceptual model and provided feedback in two rounds of semi-structured questionnaires with the aim of identifying the most important health outcomes and relationships in both mother and child as well as the most relevant stratifiers for the model. Consensus on any final disagreement was reached after two consensus meetings.

Results

The final model is a comprehensive disease model of malaria during pregnancy, including ten maternal and ten child outcomes with four stratifiers. The model developed in this study should be of value to malaria researchers, funders, evaluators and decision makers, though some adaptation will be required for each specific context and purpose. In addition, the methodology and process followed in this study is replicable and can guide researchers aiming to develop a conceptual model for other conditions.

Discussion & Conclusion

The model resulting from this study highlights the complexity required to depict appropriately the consequences of malaria during pregnancy for both the mother and the child. It also demonstrates how to conduct a rigorous process to develop a disease model. In addition the study has helped to identify a number of areas with scarce data and need for further research.

Funding

This study from part of the IMPROVE and IMPROVE-2 studies, which received financial support from the EDCTP2 programme under Horizon 2020 (TRIA.2015-1076, TRIA.2015-1076b); the UK Department of Health and Social Care, the UK Foreign Commonwealth and Development Office, the UK Medical Research Council, and Wellcome Trust, through the Joint Global Health Trials scheme (MR/P006922/1); and the Swedish International Development Cooperation Agency.
Past and present of registered nurse in China--descriptive analysis of longitudinal national statistics of registered nurse
Authors: Yin Lihong , Qiu Liwen , Zhang Guozhou
Published: September 2024

Background

China is now in the midst of period of large population aging, which coincides with a global nurse shortage. What added to this problem is the high turnover rate among nurses.

Methods

The longitudinal national statistics of registered nurses were analyzed in order to provide a broad background to understand and interpret the high turnover rate among nurses properly.

Results

A great number of beds, predominantly hospital-based beds, has been hurriedly prepared for potential inpatients in past two decades, and accordingly the increase of medical professionals especially registered nurses. The workload discrepancies of registered nurses among three tiers of hospitals may come from different sources.

Conclusion

This discrepancy is helpful in understanding of high nurse burnout and turnover rate though it seems as inherent systematic problems. A trend of high quality medical service attracting more inpatients has shown, this may cause concerns rather than an satisfied answer, were this trend continued.
Does the choice of stepping intensity metric influence dose-response associations with mortality? A UK population cohort study of 70,174 adults
Authors: Wei Le , Ahmadi Matthew N. , Blodgett Joanna M. , Aguiar Elroy J. , Biswas Raaj Kishore , Bozo Cruz Borja del , Stamatakis Emmanuel
Published: September 2024

Background

Research on the health effects of stepping intensity in free-living environments is limited and inconclusive. Inconsistent use of stepping intensity estimation metrics could explain current equivocal results. We aimed to examine and compare a range of different cadence-based metrics in terms of their multivariable-adjusted associations with all-cause (ACM) cardiovascular disease (CVD), cancer and physical-activity (PA)-related cancer mortality.

Methods

This prospective cohort study included participants with valid wrist-worn accelerometer data from the UK Biobank. We estimated stepping intensity using ten different cadence-based metrics, including eight peak-cadence metrics (defined as averaged steps / min of the highest but not necessarily consecutive minutes) that most of whom have appeared in prior literature, plus two non-peak-cadence metrics: 1) average daily cadence, defined as steps/accelerometer wearing mins, and 2) average cadence of purposeful steps, defined as averaged steps / min of minutes with ≥40 steps. We rescaled each metric into a standardised cadence scale with mean of 0 and standard deviation (SD) of 1, using (absolute–mean)/SD. We compared the dose-response associations of each stepping intensity estimation metrics with mortality outcomes using previously published modelling involving Cox-restricted-cubic-spline model, presented as overlay plots on standardised and absolute cadence scales.

Results

Among 70,336 participants (age [SD], 61.6 [7.8] years; female, 40,933 [58%]) followed up for a median of 8.0 years, all cadence-based metrics, besides the average cadence of purposeful steps, exhibited a comparable beneficial dose-response association with ACM/CVD/cancer mortality, with 95% CI largely overlapped (e.g., at −0.2 standardised steps/min, the hazard ratio (HR) of ACM for peak 1- and peak 30-min cadence were: 0.72, 95%CI [0.65, 0.82] and 0.66 [0.60, 0.73], respectively). The average cadence of purposeful steps only did not show dose-response associations with mortality outcomes (e.g., the HR that corresponds to the standardised median for the average cadence of purposeful steps in ACM was 0.98 [95% CI: 0.86, 1.12].

Conclusion

Besides the average cadence of purposeful steps, all stepping intensity estimation metrics demonstrated comparable beneficial dose-response associations with mortality of all-cause, CVD and cancer, suggesting these cadence-based metrics may be used interchangeably for estimating associations of free-living stepping intensity with health outcomes and applied in different research scenarios accordingly.
Maternal obesogenic diet disrupts mid-gestation decidual immune and vascular homeostasis without impairing spiral artery remodelling
Authors: Bellissimo Christian J. , Yeo Erica , Ribeiro Tatiane A. , Jazwiec Patrycja A. , Ellewela Chethana , Bains Jaskiran , Ashkar Ali A. , Beristain Alexander G. , Bowdish Dawn M.E. , Sloboda Deborah M.
Published: September 2024

Excess maternal adiposity (i.e., overweight and obesity) during pregnancy has been linked to impaired uteroplacental perfusion, compromised placental development, and a higher risk of adverse pregnancy outcomes. Owing to the nature of chronic inflammation and immune dysregulation accompanying excess adiposity, disruption of leukocyte-mediated tissue remodelling and immunoregulation within the decidua have emerged as likely drivers contributing to suboptimal placental function in pregnancies impacted by maternal overweight or obesity. However, the impacts of excess adiposity on major populations of innate lymphoid cells (ILCs) and macrophages which orchestrate these processes and the environment that these cells occupy remain vastly understudied. Here, we used a mouse model of chronic high-fat, high-sucrose (HFHS) diet-feeding to characterize the impacts of an obesogenic milieu on decidual immune dynamics during placental development at mid-gestation (E10.5). HFHS pregnancies exhibited marked increases in total decidual leukocyte abundance, driven by population-level increases in tissue-resident and conventional NK cells, and MHC-II+macrophages. This was not associated with abnormalities in implantation site morphology or decidual spiral artery remodelling but was coincident with histological patterns of local inflammation. In line with this, expression of canonical proinflammatory cytokines and chemokines were moderately upregulated in bulk decidual tissue of HFHS dams. This was accompanied by more potent elevations in multiple mediators of angiogenesis, endothelial activation, and coagulation in HFHS decidual tissue. Collectively, these findings point towards pathological vascular inflammation and possibly dysregulated decidual angiogenesis in the first half of pregnancy as factors predisposing to reduced placental efficiency, malperfusion, and inflammation seen in pregnancies affected by maternal overweight and obesity.
Measurable imaging-based changes in enhancement of intrahepatic cholangiocarcinoma after radiotherapy reflect physical mechanisms of response
Authors: De Brian , Dogra Prashant , Zaid Mohamed , Elganainy Dalia , Sun Kevin , Amer Ahmed M. , Wang Charles , Rooney Michael K. , Chang Enoch , Kang Hyunseon C. , Wang Zhihui , Bhosale Priya , Odisio Bruno C. , Newhook Timothy E. , Tzeng Ching-Wei D. , Cao Hop S. Tran , Chun Yun S. , Vauthey Jean-Nicholas , Lee Sunyoung S. , Kaseb Ahmed , Raghav Kanwal , Javle Milind , Minsky Bruce D. , Noticewala Sonal S. , Holliday Emma B. , Smith Grace L. , Koong Albert C. , Das Prajnan , Cristini Vittorio , Ludmir Ethan B. , Koay Eugene J.
Published: September 2024

Background

Although escalated doses of radiation therapy (RT) for intrahepatic cholangiocarcinoma (iCCA) are associated with durable local control (LC) and prolonged survival, uncertainties persist regarding personalized RT based on biological factors. Compounding this knowledge gap, the assessment of RT response using traditional size-based criteria via computed tomography (CT) imaging correlates poorly with outcomes. We hypothesized that quantitative measures of enhancement would more accurately predict clinical outcomes than size-based assessment alone and developed a model to optimize RT.

Methods

Pre-RT and post-RT CT scans of 154 patients with iCCA were analyzed retrospectively for measurements of tumor dimensions (for RECIST) and viable tumor volume using quantitative European Association for Study of Liver (qEASL) measurements. Binary classification and survival analyses were performed to evaluate the ability of qEASL to predict treatment outcomes, and mathematical modeling was performed to identify the mechanistic determinants of treatment outcomes and to predict optimal RT protocols.

Results

Multivariable analysis accounting for traditional prognostic covariates revealed that percentage change in viable volume following RT was significantly associated with OS, outperforming stratification by RECIST. Binary classification identified ≥33% decrease in viable volume to optimally correspond to response to RT. The model-derived, patient-specific tumor enhancement growth rate emerged as the dominant mechanistic determinant of treatment outcome and yielded high accuracy of patient stratification (80.5%), strongly correlating with the qEASL-based classifier.

Conclusion

Following RT for iCCA, changes in viable volume outperformed radiographic size-based assessment using RECIST for OS prediction. CT-derived tumor-specific mathematical parameters may help optimize RT for resistant tumors.