bluuebunny/crossref_metadata_2025 huggingface dataset:
Spine Surgeon Health and Well-being
Authors: Federico Vincent P. , Gabriel Samy , Roca Andrea , Anwar Fatima , Salazar Luis , Vucicevic Rajko , Sayari Arash
Published: December 2023

As spine surgeons continue to strive for high-quality patient care in an ever-changing health care environment, their individual health can often be put on the back burner. Under the stress of caring for and operating on the spine patient, surgeons must juggle additional hardships in the form of occupational exposures such as intraoperative radiation, degenerative conditions secondary to ergonomics and the inherent physical tax of spine surgery, and an increasing incidence of mental health disorders. In this review, we discuss the current body of literature as it relates to physical, mental, and occupational tolls placed on surgeons.
Addressing nursing shortages and patient safety using Maslow's hierarchy of needs
Authors: Giuffrida Patricia , Davila Shannon
Published: December 2023

Healthcare staffing shortages in the US were exacerbated by the COVID-19 pandemic. This article explores the multifaceted challenges and their impact on healthcare organizations, and proposes a framework rooted in Maslow's, hierarchy of needs to guide healthcare organizations in mitigating these shortages and improving patient safety and quality of care.
Integrated bioinformatics analysis identifies immune-related epithelial-mesenchymal transition prognostic biomarkers and immune infiltrates in patients with lung adenocarcinoma
Authors: Huang Yu , Zhang Peng , Zhou Shu-Chang , Liu Qing-Xu
Published: December 2023

Background

Lung cancer, particularly lung adenocarcinoma (LUAD), is highly lethal. Understanding the critical interaction between epithelial-mesenchymal transition (EMT) and the immune status of patients is imperative for clinical assessment.

Methods

We conducted bioinformatics analysis to identify potential immune-related EMT (iEMT) prognostic genes and explored the immune status in LUAD. Using data from The Cancer Genome Atlas and GSE68465, differentially expressed genes, were identified, and a risk model was constructed. Cluster analysis was conducted using the Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathways.

Results

Our findings revealed 69 differentially expressed iEMT genes, with risk values demonstrating independent prognostic significance for both The Cancer Genome Atlas and GSE68465 samples. The risk value was positively correlated with tumor stage. Immune cell infiltration analysis showed a significant decrease in resting dendritic cells and an increase in CD4 memory T cells in high-risk groups with poor survival prognoses. The immunotherapy analysis revealed weak immunotherapeutic effects in the high-risk group.

Conclusions

This study provides insights into potential aberrant differential iEMT genes and risk models and explores immune landscapes that inform personalized immunotherapy in patients with LUAD.
Eosinophil disorders: an update on diagnosis and management
Authors: Lu Chuanyi M.
Published: December 2023

Eosinophilia can be seen in almost all medical subspecialty patients. Delay in diagnostic workup and treatment is associated with significant morbidity and mortality. Clinical vigilance and timely referral for diagnostic evaluation are critical. Causes of hypereosinophilia (HE) are diverse and can be grouped under 3 categories: primary (neoplastic), secondary (reactive), and idiopathic. Advances in molecular genetic diagnostics have led to elucidation of the genetic basis for many neoplastic hypereosinophilic disorders. One common molecular feature is formation of a fusion gene, resulting in the expression of an aberrantly activated tyrosine kinase (TK). The World Health Organization endorsed a biologically oriented classification scheme and created a new major disease category, namely, myeloid/lymphoid neoplasms with eosinophilia and tyrosine kinase gene fusions. Rearrangement of other TK genes and activating somatic mutation(s) in TK genes have also been reported in eosinophilic neoplasms. Diagnostic evaluation of HE involves a combination of clinical, histopathologic, and immunophenotypic analyses, as well as molecular genetic testing, including next-generation sequencing–based mutation panels. The management of primary HE is largely guided by the underlying molecular genetic abnormalities. Good knowledge of recent advances in HE is necessary to ensure timely and accurate diagnosis and to help optimize patient care.
Immunotherapy for hepatocellular carcinoma: molecular pathogenesis and clinical research progress
Authors: Li Xuesong , Xia Feng
Published: December 2023

The treatment of hepatocellular carcinoma (HCC) is advancing rapidly in the 21st century. Although there are various treatment methods, the most promising breakthrough seems to be in immunotherapy. Recent guidelines from the American Society of Clinical Oncology and the European Association for the Study of the Liver have recommended immunotherapies with strong antitumor effects for HCC treatment. Emerging systemic therapeutic strategies, such as immune checkpoint inhibitors combined with targeted therapy or local treatment, are among the most promising for improving overall and tumor-free survival times in patients with HCC. This review analyzes the molecular mechanisms of existing immune checkpoint inhibitors, vaccines, and chimeric antigen receptor–T cells; summarizes the latest progress in relevant clinical research; and outlines future trends and opportunities for HCC immunotherapy.
Searches for beyond-standard-model physics with astroparticle physics instruments
Authors: Ackermann Markus , Helbing Klaus
Published: December 2023

Many instruments for astroparticle physics are primarily geared towards multi-messenger astrophysics, to study the origin of cosmic rays and to understand high-energy astrophysical processes. Since these instruments observe the Universe at extreme energies and in kinematic ranges not accessible at accelerators these experiments provide also unique and complementary opportunities to search for particles and physics beyond the standard model of particle physics. In particular, the reach of IceCube, Fermi and KATRIN to search for and constrain Dark Matter, Axions, heavy Big Bang relics, sterile neutrinos and Lorentz invariance violation will be discussed. The contents of this article are based on material presented at the Humboldt–Kolleg ‘Clues to a mysterious Universe—exploring the interface of particle, gravity and quantum physics’ in June 2022.

This article is part of the theme issue ‘The particle-gravity frontier’.
Dual-phase xenon time projection chambers for rare-event searches
Authors: Baudis Laura
Published: December 2023

In the past decade, dual-phase xenon time projection chambers (Xe-TPCs) have emerged as some of the most powerful detectors in the fields of astroparticle physics and rare-event searches. Developed primarily towards the direct detection of dark matter particles, experiments presently operating deep underground have reached target masses at the multi-tonne scale, energy thresholds of approximately 1 keV and radioactivity-induced background rates similar to those from solar neutrinos. These unique properties, together with demonstrated stable operation over several years, allow for the exploration of new territory via high-sensitivity searches for a plethora of ultra-rare interactions. These include searches for particle dark matter, for second-order weak decays, and the observation of astrophysical neutrinos. We first review some properties of xenon as a radiation detection medium and the operation principles of dual-phase Xe-TPCs together with their energy calibration and resolution. We then discuss the status of currently running experiments and of proposed next-generation projects, describing some of the technological challenges. We end by looking at their sensitivity to dark matter candidates, to second-order weak decays and to solar and supernova neutrinos. Experiments based on dual-phase Xe-TPCs are difficult and, like all good experiments, they are constantly pushed to their limits. Together with many other endeavours in astroparticle physics and cosmology they will continue to push at the borders of the unknown, hopefully to reveal profound new knowledge about our cosmos.

This article is part of the theme issue ‘The particle-gravity frontier’.
Balance laws as test of gravitational waveforms
Authors: Heisenberg Lavinia
Published: December 2023

Gravitational waveforms play a crucial role in comparing observed signals with theoretical predictions. However, obtaining accurate analytical waveforms directly from general relativity (GR) remains challenging. Existing methods involve a complex blend of post-Newtonian theory, effective-one-body formalism, numerical relativity and interpolation, introducing systematic errors. As gravitational wave astronomy advances with new detectors, these errors gain significance, particularly when testing GR in the nonlinear regime. A recent development proposes a novel approach to address this issue. By deriving precise constraints—or balance laws—directly from full nonlinear GR, this method offers a means to evaluate waveform quality, detect template weaknesses and ensure internal consistency. Before delving into the intricacies of balance laws in full nonlinear GR, we illustrate the concept using a detailed mechanical analogy. We will examine a dissipative mechanical system as an example, demonstrating how mechanical balance laws can gauge the accuracy of approximate solutions in capturing the complete physical scenario. While mechanical balance laws are straightforward, deriving balance laws in electromagnetism and GR demands a rigorous foundation rooted in mathematically precise concepts of radiation. Following the analogy with electromagnetism, we derive balance laws in GR. As a proof of concept, we employ an analytical approximate waveform model, showcasing how these balance laws serve as a litmus test for the model’s validity.

This article is part of the theme issue ‘The particle-gravity frontier’.
The profile of the Higgs boson: status and prospects
Authors: Jakobs Karl , Zanderighi Giulia
Published: December 2023

The Higgs boson, which was discovered at CERN in 2012, stands out as a remarkable elementary particle with distinct characteristics. Unlike any other observed particle, it possesses zero spin within the Standard Model (SM) of particle physics. Theoretical predictions had anticipated the existence of this scalar boson, postulating its interaction with the

W

and

Z

bosons as well as through Yukawa interactions with fermions. Furthermore, the Higgs boson can interact with itself, commonly referred to as the Higgs self-interaction. In this review, the current state of experimental and theoretical investigations of Higgs boson production at the Large Hadron Collider and the ongoing efforts to unravel its properties are described, and an up-to-date assessment of our understanding of the Higgs sector of the SM is provided. In addition, potential links between the Higgs boson and significant unresolved questions within the realm of particle physics are presented.

This article is part of the theme issue ‘The particle-gravity frontier’.
Experimental perspectives on the matter–antimatter asymmetry puzzle: developments in electron EDM and H¯ experiments
Authors: Comparat D. , Malbrunot C. , Malbrunot-Ettenauer S. , Widmann E. , Yzombard P.
Published: December 2023

In the search for clues to the matter–antimatter puzzle, experiments with atoms or molecules play a particular role. These systems allow measurements with very high precision, as demonstrated by the unprecedented limits down to

10

−
30

 e cm on electron EDM using molecular ions, and relative measurements at the level of

10

−
12

in spectroscopy of antihydrogen atoms. Building on these impressive measurements, new experimental directions offer potential for drastic improvements. We review here some of the new perspectives in those fields and their associated prospects for new physics searches.

This article is part of the theme issue ‘The particle-gravity frontier’.
Rare event searches with cryogenic detectors
Authors: Mokina Valentyna , Schieck Jochen
Published: December 2023

Cryogenic detectors can detect the smallest energy depositions via the scattering of the incoming particle with the detector material. The deposited energy leads to minimal temperature rises of a few

μ

K

, read out via transition edge sensors and SQUIDs. Using scintillating crystals as detector material offers the possibility of discriminating between nuclear recoils from dark matter scattering and electromagnetic background events. The CRESST experiment pioneered this technology and is still among the most sensitive experiments searching for sub-GeV dark matter particles. The technology is now also used by other experiments for dark matter searches (COSINUS) and for measuring coherent elastic neutrino-nucleus scattering (NUCLEUS). We discuss cryogenic detectors’ detection principle and their application. We present the latest dark matter results from CRESST, a new type of background, and the status of the COSINUS and NUCLEUS experiments.

This article is part of the theme issue ‘The particle-gravity frontier’.
The cosmological constant and scale hierarchies with emergent gauge symmetries
Authors: Bass Steven D.
Published: December 2023

Motivated by the stability of the electroweak Higgs vacuum we consider the possibility that the Standard Model might work up to large scales between about

10

10

 GeV and close to the Planck scale. A plausible scenario is an emergent Standard Model with gauge symmetries originating in some topological-like phase transition deep in the ultraviolet. In this case, the cosmological constant scale and neutrino masses should be of similar size, suppressed by factor of the large scale of emergence. The key physics involves a subtle interplay of Poincaré invariance, mass generation and renormalization group invariance. The Higgs mass would be environmentally selected in connection with vacuum stability. Consequences for dark matter scenarios are discussed.

This article is part of the theme issue ‘The particle-gravity frontier’.
Plasma neurofilament light chain is elevated in Niemann-Pick Type C but glial fibrillary acidic protein is not
Authors: Eratne Dhamidhu , Lewis Courtney , Kelso Wendy , Loi Samantha , Chiu Wei-Hsuan Michelle , Blennow Kaj , Zetterberg Henrik , Santillo Alexander F , Velakoulis Dennis , Walterfang Mark ,   And The MiND Study Group
Published: December 2023

OBJECTIVE

Niemann-Pick Type C (NPC) is a genetic neurodegenerative lysosomal storage disorder commonly associated with psychiatric symptoms and delays to accurate diagnosis and treatment. This study investigated biomarker levels and diagnostic utility of plasma neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) in NPC compared to healthy controls.

METHODS

Patients with NPC were recruited from a specialist assessment and management service. Data was available from an age and sex-matched healthy control group. NfL and GFAP were measured on Quanterix Simoa HD-X analysers and groups compared using genralised linear models. NfL levels were compared to, and percentiles derived from, recently developed NfL reference ranges.

RESULTS

Plasma NfL was significantly elevated in 11 patients with NPC compared to 25 controls (mean 17.1pg/mL vs 7.4pg/mL, p<0.001), and reference ranges (all >98thpercentile). NfL distinguished NPC from controls with high accuracy. GFAP levels were not elevated in NPC (66.6pg/mL vs 75.1pg/mL).

DISCUSSION

The study adds important evidence on the potential diagnostic utility of plasma NfL in NPC, extends the literature of NfL as a diagnostic tool to differentiate neurodegenerative from primary psychiatric disorders, and adds support to the pathology in NPC primarily involving neuronal, particularly axonal, degeneration.
Capture of Group A Streptococcus by Open-Microfluidic CandyCollect Device in Pediatric Patients
Authors: Tu Wan-chen , Robertson Ingrid H. , Blom Andrea , Alfaro Elena , Shinkawa Victoria A. M. , Hatchett Daniel B. , Sanchez Juan C. , McManamen Anika M. , Su Xiaojing , Berthier Erwin , Thongpang Sanitta , Wald Ellen R. , DeMuri Gregory P. , Theberge Ashleigh B.
Published: December 2023

State the purpose

Obtaining high-quality samples to diagnose streptococcal pharyngitis in pediatric patients is challenging due to discomfort associated with traditional pharyngeal swabs. This may cause reluctance to go to the clinic, inaccurate diagnosis, or inappropriate treatment for children with sore throat. Here, we determined the efficacy of CandyCollect, a lollipop-inspired open-microfluidic pathogen collection device, to capture Group A Streptococcus (GAS) and compare user preference for CandyCollect, conventional pharyngeal swabs, or mouth swabs in children with pharyngitis and their caregivers.

Results

All child participants (30/30) were positive for GAS by qPCR on both the mouth swab and CandyCollect. Caregivers ranked CandyCollect as a good sampling method overall (27/30), and all caregivers (30/30) would recommend CandyCollect for children 5 years and older. Twenty-three of 30 children “really like” the taste and 24/30 would prefer to use CandyCollect if a future test were needed. All caregivers (30/30) and most children (28/30) would be willing to use CandyCollect at home.

Conclusion

All participants tested positive for GAS on all three collection methods (pharyngeal swab, mouth swab, and CandyCollect). While both caregivers and children like CandyCollect, some caregivers would prefer a shorter collection time. Future work includes additional studies with larger cohorts presenting with pharyngitis of unknown etiology and shortening collection time while maintaining the attractive form of the device.

Translational Impact Statement

Obtaining oral samples for the diagnosis of streptococcal pharyngitis is of great importance for children. To address the challenges associated with traditional pharyngeal swab sampling, we developed the CandyCollect device, a lollipop-inspired open mesofluidic saliva sampling system. In this study, saliva samples were collected from children, aged 5-14 years, with CandyCollect and mouth swabs and analyzed via qPCR. The results show CandyCollect is the child preferred collection tool and had 100% concordance with the results from traditional diagnosis methods as part of their clinical care.
Integration of pharmacists’ knowledge into a predictive model for teicoplanin dose planning
Authors: Matsuzaki Tetsuo , Nakai Tsuyoshi , Kato Yoshiaki , Yamada Kiyofumi , Yagi Tetsuya
Published: December 2023

Teicoplanin is an important antimicrobial agent for methicillin-resistantStaphylococcus aureusinfections. To enhance its clinical effectiveness while preventing adverse effects, therapeutic drug monitoring (TDM) of teicoplanin trough concentration is recommended. Given the importance of the early achievement of therapeutic concentrations for treatment success, initial dosing regimens are deliberately designed based on patient information.

Considerable effort has been dedicated to developing an optimal initial dose plan for specific populations; however, comprehensive strategies for tailoring teicoplanin dosing have not been successfully implemented. The initial dose planning of teicoplanin is conducted at the clinician’s discretion and is thus strongly dependent on the clinician’s experience and expertise.

The present study aimed to use a machine learning (ML) approach to integrate clinicians’ knowledge into a predictive model for initial teicoplanin dose planning. We first confirmed that dose planning by pharmacists dedicated to TDM (hereafter TDM pharmacists) significantly improved early therapeutic target attainment for patients without an intensive care unit or high care unit stay, providing the first evidence that dose planning of teicoplanin by experienced clinicians enhances early teicoplanin therapeutic exposure. Next, we used a dataset of teicoplanin initial dose planning by TDM pharmacists to train and implement the model, yielding a model that emulated TDM pharmacists’ decision-making for dosing. We further applied ML to cases without TDM pharmacist dose planning and found that the target attainment rate of the initial teicoplanin concentration markedly increased. Our study opens a new avenue for tailoring the initial dosing regimens of teicoplanin using a TDM pharmacist-trained ML system.

Importance

Teicoplanin is used for treating methicillin-resistantStaphylococcus aureusinfections. Given the importance of early adequate teicoplanin exposure, initial dosing regimens are adjusted for patient characteristics. However, tailoring teicoplanin dosing is challenging for most clinicians. In this study, we first showed that initial dosing regimens by pharmacists dedicated to therapeutic drug monitoring significantly improved early achievement of targeted concentration. In addition, we leveraged machine learning approach to develop the predictive model that tailors initial dosing regimens at the levels of experienced pharmacists. The target attainment rate of patients without experienced pharmacists’ dose planning was significantly increased by applying the model. Therefore, machine learning approach may provide new avenues for tailoring initial teicoplanin dosing.
Impact of a multi-pronged cholera intervention in an endemic setting
Authors: Blake Alexandre , Walder Adam , Hanks Ephraim , Welo Placide Okitayembo , Luquero Francisco , Bompangue Didier , Bharti Nita
Published: December 2023

Cholera is a bacterial water-borne diarrheal disease transmitted via the fecal-oral route that causes high morbidity in sub-Saharan Africa and Asia. It is preventable with vaccination, and Water, Sanitation, and Hygiene (WASH) improvements. However, the impact of vaccination in endemic settings remains unclear. Cholera is endemic in the city of Kalemie, on the shore of Lake Tanganyika, in the Democratic Republic of Congo, where both seasonal mobility and the lake, a potential environmental reservoir, may promote transmission. Kalemie received a vaccination campaign and WASH improvements in 2013-2016. We assessed the impact of this intervention to inform future control strategies in endemic settings.

We fit compartmental models considering seasonal mobility and environmentally-based transmission. We estimated the number of cases the intervention avoided, and the relative contributions of the elements promoting local cholera transmission.

We estimated the intervention avoided 5,259 cases (95% credible interval: 1,576.6-11,337.8) over 118 weeks. Transmission did not rely on seasonal mobility and was primarily environmentally-driven. Removing environmental exposure or contamination could control local transmission.

Repeated environmental exposure could maintain high population immunity and decrease the impact of vaccination in similar endemic areas. Addressing environmental exposure and contamination should be the primary target of interventions in such settings.

Author summary

Cholera is a major global health concern that causes high morbidity. It is a bacterial water-borne disease that can be transmitted via the fecal-oral route or the ingestion of contaminated water. Hence, both population mobility and environmental exposure can promote cholera persistence. The primary tools to prevent cholera include vaccination and Water, Sanitation, and Hygiene (WASH) improvements. The effectiveness of these interventions is well understood in epidemic settings, but their impact in endemic settings is unclear. Achieving cholera elimination requires disentangling the contributors to transmission, specifically population mobility and aquatic reservoirs, and assessing the impact of interventions performed in endemic settings.

This study focuses on Kalemie, a cholera endemic city in the Democratic Republic of Congo, on shore of a lake that serves as a potential environmental reservoir. It quantifies the short-term impact of an intervention that used targeted vaccination and WASH. The study shows that the impact of vaccination was dampened by very high background immunity due to constant environmental exposure. This suggests that WASH improvements should be the primary intervention in such settings despite the time- and resource-intensive nature of implementation.
Evaluation of gastric electrophysiology, symptoms and quality of life after pancreaticoduodenectomy
Authors: Wang Tim Hsu-Han , Varghese Chris , Calder Stefan , Gharibans Armen , Schamberg Gabriel , Bartlett Adam , Srinivasa Sanket , O’Grady Greg
Published: December 2023

Background

Pancreaticoduodenectomy (PD) is an operation performed for several indications, including pancreatic and biliary malignancies. Delayed gastric emptying (DGE) is a common post-operative complication and the underlying pathophysiology remains poorly understood. This study aimed to evaluate the gastric electrophysiology, symptoms and quality of life following PD, using the novel non-invasive Gastric Alimetry System.

Methods

PD patients with index operations between 2017-2022 were assessed using the Gastric Alimetry System®, comprising a stretchable 8×8 electrode array, wearable Reader, and validated symptom logging app. A 30-minute pre-prandial and a 4-hour post-prandial recording was performed. Outcomes included Principal Gastric Frequency, BMI-adjusted amplitude, Gastric Alimetry Rhythm Index, meal response, symptoms, and quality of life (QOL) questionnaires (PAGI-SYM, PAGI-QOL). Data was compared to a validated reference range and matched healthy controls.

Results

19 patients and 19 matched controls were recruited. There were no differences in any gastric parameters between PD patients and matched controls (allp>0.05). Gastric electrophysiology parameters lay outside normative reference intervals in 8/19 cases, generally being only minor deviations, while significant symptoms occurred in 8/19 (42%); which did not correlate (p=0.43). PD patients had worse quality of life scores than controls (p<0.01), however, no correlations were identified between electrophysiological parameters and QOL.

Discussion

Moderate to severe upper GI symptoms are common after PD with worse QOL compared to the controls. Gastric electrical activity generally recovers well long-term following PD, indicating that other factors contribute to symptoms. Further studies should now assess acute changes in gastric function after PD.
Variations in Risk Factors across Different Periods of Stroke Recurrence
Authors: Lee Sang-Hun , Jung Jin-Man , Ryu Jae-Chan , Park Moon-Ho
Published: December 2023

Background and Purpose

Accurately discerning periods of heightened risk of stroke recurrence and managing modifiable risk factors are essential for minimizing overall recurrence risk. This study identified differences in the timing of stroke recurrence based on risk factors and patient characteristics to develop strategies for reducing recurrence in clinical practice.

Methods

We retrospectively selected patients with ischemic stroke or transient ischemic attack at the Korea University Ansan Hospital Stroke Center between March 2014 and December 2021 using the prospective institutional database of the Korea University Stroke Registry. We collected demographic, clinical, and stroke data and categorized participants by recurrence timing (early within 3 months or late after 3 months). Using multinomial logistic regression analysis, we examined variables associated with early and late recurrent strokes.

Results

The analysis included 3,646 patients, of whom 255 experienced a recurrent stroke and 3,391 experienced their first stroke. Multinomial logistic regression analysis revealed significant associations between early recurrent stroke and diabetes mellitus (OR 1.98, 95% CI 1.25–3.15), other determined etiologies in TOAST classification (OR 3.00, 95% CI 1.37– 6.61), and white matter changes (OR 1.97, 95% CI 1.17–3.33). Late recurrent stroke showed a significant correlation with transient ischemic attack (TIA) (OR 2.95, 95% CI 1.52–5.71) and cerebral microbleeds (OR 2.22, 95% CI 1.32–3.75).

Conclusion

Our study emphasizes substantial differences in factors contributing to stroke recurrence based on timing. Managing the risk of recurrence in clinical practice necessitates accurate identification of heightened risk periods and rigorous control of modifiable risk factors.
Adiposity and Sex Influence on SARS-CoV-2 Antibody Response in University Students. An ESFUERSO cross-sectional study
Authors: Perales-Torres Adriana L. , Perez-Navaro Lucia M. , Garcia-Oropesa Esperanza M. , Diaz-Badillo Alvaro , Martinez-Lopez Yoscelina Estrella , Rosas Marisol , Castillo Octelina , Ramirez-Quintanilla Laura , Cervantes Jacquelynne , Sciutto Edda , Cisneros Claudia X. Munguia , Ramirez-Pfeifer Carlos , Vela Leonel , Tapia Beatriz , Lopez-Alvarenga Juan C.
Published: December 2023

Introduction

Prior studies have identified various determinants of differential immune responses to COVID-19. This investigation delves into the Ig-G anti-RBD marker, scrutinizing its potential correlations with sex, vaccine type, body fat percentage, metabolic risk, perceived stress, and previous COVID-19 exposure.

Methods

In this study, data were obtained from 116 participants from the ESFUERSO cohort, who completed questionnaires detailing their COVID-19 experiences and stress levels assessed through the SISCO scale. Quantification of Ig-G anti-RBD concentrations was executed using an ELISA assay developed by UNAM. Multiple regression analysis was adeptly employed to control for covariates, including sex, age, body fat percentage, BMI, and perceived stress.

Results

This sample comprised young individuals (average age of 21.4 years), primarily consisting of females (70%), with a substantial proportion reporting a family history of diabetes, hypertension, or obesity. Most students had received the Moderna or Pfizer vaccines, and 91% displayed a positive anti-RBD response.

A noteworthy finding was the interaction between body fat percentage and sex. In males, increased adiposity was associated with a decrease in Ig-G anti-RBD concentration, while in females, the response increased. Importantly, this trend was consistent regardless of the vaccine received. No significant associations were observed for variables such as dietary habits or perceived stress.

Conclusions

In summation, this research reports the impact of both sex and body fat percentage on the immune response through Ig-G anti-RBD levels to COVID-19 vaccines. The implications of these findings offers a foundation for educational initiatives and the formulation of preventive policies aimed at mitigating health disparities.
Limitations in next-generation sequencing-based genotyping of breast cancer polygenic risk score loci
Authors: Baumann Alexandra , Ruckert Christian , Meier Christoph , Hutschenreiter Tim , Remy Robert , Schnur Benedikt , Döbel Marvin , Nkouamedjo Fankep Rudel Christian , Skowronek Dariush , Kutz Oliver , Arnold Norbert , Katzke Anna-Lena , Forster Michael , Kobiela Anna-Lena , Thiedig Katharina , Zimmer Andreas , Ritter Julia , Weber Bernhard H.F. , Honisch Ellen , Hackmann Karl ,   Bioinformatics Working Group of the German Consortium for Hereditary Breast & Ovarian Cancer, Schmidt Gunnar , Sturm Marc , Ernst Corinna
Published: December 2023

Considering polygenic risk scores (PRSs) in individual risk prediction is increasingly becoming the standard in genetic testing for hereditary breast cancer (BC). To calculate individual BC risks, the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) with inclusion of the BCAC 313 or the BRIDGES 306 BC PRS is commonly used. Meaningful incorporation of PRSs relies on reproducing the allele frequencies (AFs), and hence, the distribution of PRS values, expected by the algorithm. Here, the 324 loci of the BCAC 313 and the BRIDGES 306 BC PRS were examined in population-specific database gnomAD and in real-world data sets of five centers of the German Consortium for Hereditary Breast and Ovarian Cancer (GC-HBOC), to determine whether these expected AFs are achieved with next-generation sequencing-based genotyping. Four PRS loci were non-existent in gnomAD v3.1.2 non-Finnish Europeans, further 24 loci showed noticeably deviating AFs. In real-world data, between 16 and up to 22 loci were reported with noticeably deviating AFs, and were shown to have effects on final risk prediction. Deviations depended on sequencing approach, variant caller and calling mode (forced versus unforced) employed. Therefore, this study demonstrates the necessity to apply quality assurance not only in terms of sequencing coverage but also observed AFs in a sufficiently large sample, when implementing PRSs in a routine diagnostic setting. Furthermore, future PRS design should be guided by reproducibility of expected AFs in addition to the observed effect sizes.
Rapid resistance detection is reliable for prompt adaptation of isoniazid resistant tuberculosis management
Authors: Bahuaud Olivier , Genestet Charlotte , Hodille Elisabeth , Vallée Maxime , Testard Quentin , Tataï Caroline , Saison Julien , Rasigade Jean-Philippe , Lina Gérard , Ader Florence , Dumitrescu Oana
Published: December 2023

Objectives

Appropriate tuberculosis (TB) management requires anti-TB drugs resistance detection. We assessed the performance of rapid resistance detection assays and their impact on treatment adaptation, focusing on isoniazid resistant (HR) TB.

Methods

From 2016 to 2022, all TB cases enrolled in 3 hospitals were reviewed for phenotypic drug susceptibility testing (p-DST) and genotypic DST (g-DST) performed by rapid molecular testing, and next generation sequencing (NGS). Clinical characteristics, treatment and outcome were collected for HR-TB patients. The concordance between g-DST and p-DST results, and delay between treatment initiation and results of g-DST and p-DST were respectively recorded to assess the contribution of DST results on HR-TB management.

Results

Among 654 TB cases enrolled, 29 were HR-TB. Concordance between g-DST by rapid molecular methods and p-DST was 76.9%, whilst concordance between NGS-based g-DST and p-DST was 98.7%. Rapid resistance detection significantly fastened HR-TB treatment adaptation (median delay between g-DST results and treatment modification was 6 days). It consisted in fluoroquinolone implementation for 17/23 patients; outcome was favourable except for 2 patients who died before DST reporting.

Conclusion

Rapid resistance detection fastened treatment adaptation. Also, NGS-based g-DST showed almost perfect concordance with p-DST, thus providing rapid and safe culture-free DST alternative.
Emergence and predominance of novel influenza A (H3N2) subclade (3C.2a1b.2a.2a.3a.1) in Kenya and globally in 2023
Authors: Morobe John Mwita , Moraa Edidah , Lambisia Arnold W. , Mutunga Martin , Kiage Brenda , Katama Esther Nyadzua , Makori Timothy , Nyiro Joyce , Ndwiga Leonard , Nyagwange James , Sande Charles , Ochola-Oyier Lynette Isabella , Holmes Edward C. , Nokes D. James , Githinji George , Agoti Charles N.
Published: December 2023

We report emergence and predominance of the influenza A (H3N2)subclade 3C.2a1b.2a.2a.3a.1 in Kenya similar to the global clade in 2023. The Kenyan 3C.2a1b.2a.2a.3a.1 viruses have >15 amino acid differences in the HA and NA proteins relative to 2023/24 WHO recommended Northern/Southern Hemisphere influenza vaccine strains.
Cardiac abnormality detection with a tiny diagonal state space model based on sequential liquid neural processing units
Authors: Huang Zhaojing , Leung Wing Hang , Cui Jiashuo , Yu Leping , Herbozo Contreras Luis Fernando , Truong Nhan Duy , Nikpour Armin , Kavehei Omid
Published: December 2023

This manuscript presents and studies the performance of the Diagonal State Space Sequence (S4D) model based on the Closed-form Continuous-time (CfC) network in order to achieve a high-performing cardiac abnormality detection method that is robust, generalizable, and tiny in size. Our S4D-CfC model is evaluated on 12- and 1-lead electrocar-diogram (ECG) data from over 20,000 patients. The system exhibits validation results with strong average F1 score and average AUROC value of 0.88 and 98%, respectively. To demonstrate the tiny machine learning (tinyML) of our 242 KB size model, we deployed the system on relatively resource-constrained hardware to evaluate its training performance on the edge. Such on-device fine-tuning can enhance personalized solutions in this context, allowing the system to learn each patient’s data features. A comparison with a structured 2D Convolutional LSTM (ConvLSTM2D) CfC model (ConvCfC) demonstrates the S4D-CfC model’s superior performance. The size of the proposed model is also significantly small (25 KB) while maintaining reasonable performance on 2.5s data, 75% shorter than the original 10s data, making it suitable for resource-constrained hardware and reducing latency. In summary, the S4D-CfC model represents a groundbreaking advancement in cardiac abnormality detection, offering robustness, generalization, and practicality with the potential for efficient deployment on limited-resource platforms, revolutionizing healthcare technology.
Cognitive Therapy Approach For Post-Stroke Patients : A Review Of Literature
Authors: Manurung Sarida Surya , Rumambo Pandin Moses Glorino
Published: December 2023

Introduction

Stroke is a highly consequential medical condition, characterized by a substantial risk of death and disability. Based on the data of the World Health Organization (WHO), stroke was contibuted for 6.2 million of mortalities, the second cause of death globally. In particular, half of stroke survivors encounter challenges in performing daily activities, and the psychosocial aspects of their experience often lead to a diminished quality of life, contributing to conditions like depression. In addition for the impact of physical, stroke also can induce the cognitive barriers, impacted to an attention, orientation, retention, and cognitives functions. In addressing these cognitive challenges, particularly through cognitive therapy, was shown promising in reducing levels of anxiety and depression among post-stroke individuals. This literature research deals to examine research outcomes related to various post-stroke cognitive therapies. The objective is to describe the advantages and disadvantages of this therapeutic approaches, clarify the effectiveness in rehabilitate of cognitive and psychological consequences of stroke.

Method

Literature obtained through electronic media on Science Direct, Scopus and Google Scholar by used the keyword Cognitive Therapy Approach in Post Stroke Patients and it was found 5 articles that met with the criteria which had been published less than the last 10 years.

Results

this study shows that cognitive interventions that duplicate memory, processing speed and attention can produce significant improvements in several cognitive domains. This therapy teaches compensatory strategies such as using a notebook or daily planner and analyzing tasks logically until activities are carried out well in daily life which involves exercises to increase attention and requires internal neurological attention. The function of this training includes visual and auditory skills, both of which are important for everyday training and information processing designed to improve retention and recall of information and improve memory. Attention and executive skill function are interdependent and have a significant impact on daily functioning. Therefore, exercises that improve attention, working and short-term memory can improve general mental abilities and improve a persons ability to process information.

Conclusion

The results of this study indicate that cognitive therapy can help the patients to achieve the recovery optimally both in cognitive or emotional aspects.
Prevalence, risk factors and clinical presentations of post-COVID-19 condition: a follow-up study of reported COVID-19 infections in Montreal, Canada
Authors: Allard Robert , Balegamire Safari Joseph , Malloum Khadidja Boukar , Ribeiro Cantalino Juliana Leal , Signor Céline , Leclerc Pascale , Bergeron Geneviève , Mercure Sarah-Amélie , Cadieux Geneviève
Published: December 2023

Background

Meta-analyses suggest that post-COVID-19 condition (PCC) mostly takes three clinical presentations: fatigue, cognitive and respiratory. We sought to estimate the prevalence of these presentations and the strength of their associations with potential risk/protective factors, activity limitations and healthcare utilization.

Methods

Follow-up study by telephone re-interview, ≥5 months after initial interview, of a random sample of Montrealers aged 18 years or more, with a PCR-confirmed COVID-19 infection reported between July 18 and December 4, 2021. The re-interview covered age, sex, comorbidities, signs and symptoms (SS), activity limitations, healthcare utilization, perceived stigmatization and psychological distress.

Results

Of a sample of 2000 adults, 652 (39.1%) completed the questionnaire. Of 518 with only 1 acute episode of COVID-19, 32.2% met the WHO definition of PCC. Of these, 45.5% reported SS that fit the fatigue presentation, 24.6% the cognitive presentation and 16.8% the respiratory presentation. Neither age nor COVID-19 immunization was associated with PCC, compared to COVID-19 without PCC. However, being female (OR=2.28), hospitalization (OR=2.44) and intensive care (OR=3.21) for the acute COVID-19 episode were. Various activity limitations and types of healthcare utilization were also associated with PCC. All presentations were associated with serious psychological distress. The respiratory presentation was particularly associated with hospitalization for the acute episode (aOR=7.72) and was the only one associated with later hospitalization (aOR=23.6).

Interpretation

Our findings suggest that caring for patients with PCC requires adapted organizational models. If they favoured excellence in research, these models could help future studies meet the recommended methodological standards.
Functional Disability, Health Care Access, and Mental Health in Ukrainians Displaced by the 2022 Russian Invasion
Authors: Kang Tarandeep S. , Head Michael G , Brackstone Ken , Buchko Kateryna , Goodwin Robin
Published: December 2023

Armed conflict has negative mental health impacts on internally displaced people and refugees, however, much less is known of its effects upon the mental health of displaced people and refugees with disabilities. We use European data (N=9,679), collected via an internet health needs survey across April-July 2022, to examine the mental health impacts of the 2022 Russian invasion of Ukraine on the mental health of displaced people with disabilities during the first months of the war. Regression models separately examined associations between functional impairment (vision, walking, existing mental health condition), access to healthcare, welfare payments, and anxiety and sleep quality, controlling for a number of sociodemographic variables including preferred language spoken at home, as an indicator of Russian or Ukrainian cultural identity. The presence of pre-existing mental health condition, mobility and vision impairment were each associated with higher levels of anxiety and poorer sleep quality. The ability to access health services and social security payments was also associated with better sleep and lower levels of anxiety. Humanitarian and local authorities must ensure Ukrainian refugees and IDPs are reviewed for their mental health needs, with particular attention to those with known disabilities.
Disrupted balance between pro-inflammatory lipid mediators and anti-inflammatory specialized pro-resolving mediators is linked to hyperinflammation in patients with alcoholic hepatitis
Authors: Li Wei , Xia Ying , Yang Jing , Sanyal Arun J. , Shah Vijay H. , Chalasani Naga P. , Yu Qigui
Published: December 2023

Background

Chronic excessive alcohol consumption leads to a spectrum of alcohol-associated liver diseases (ALD), including alcoholic hepatitis (AH). AH is characterized by intense systemic and liver inflammation, posing significant risks of health complications and mortality. While inflammation is a crucial defense mechanism against injury and infection, its timely resolution is essential to prevent tissue damage and restore tissue homeostasis. The resolution of inflammation is an actively regulated process, primarily governed by specialized pro-resolving mediators (SPMs), lipid metabolites derived from ω-6 and ω-3 poly-unsaturated fatty acids (PUFAs). We investigated the balance between pro-inflammatory lipid mediators (PLMs) and SPMs in the ω-6 and ω-3 PUFA metabolic pathways and examined the impact of alcohol abstinence on rectifying the dysregulated biosynthesis of PLMs and SPMs in AH patients.

Methods

LC-MS/MS and ELISA were used to quantify levels of bioactive lipid mediators (LMs) and their precursors in the plasma samples from 58 AH patients, 29 heavy drinkers without overt liver diseases (HDCs), and 35 healthy controls (HCs). Subsequently, we assessed correlations of altered LMs with clinical parameters and various markers of inflammatory cascade andmicrobial translocation. Furthermore, we conducted a longitudinal study to track changes in levels of LMs over 6- and 12-month follow-ups in AH patients who underwent alcohol abstinence.

Results

AH patients exhibited significantly higher plasma levels of ω-6 PLMs (PGD2and LTB4) and SPM RvE1 compared to HDCs and/or HCs. Conversely, key SPMs such as LXA4, RvD1, and several precursors in the ω-3 pathway were significantly downregulated in AH patients. Some of these altered LMs were found to correlate with AH disease severity, clinical parameters, and various inflammatory cytokines. In particular, the LTB4/LXA4 ratio was substantially elevated in AH patients relative to HDCs and HCs. This altered ratio displayed a positive correlation with the MELD score, suggesting its potential utility as an indicator of disease severity in AH patients. Importantly, the majority of dysregulated LMs, particularly PLMs, were normalized following alcohol abstinence.

Conclusion

Our study reveals significant dysregulation in the levels of PLM metabolites and anti-inflammatory SPMs in both ω-6 and ω-3 PUFA pathways in AH patients. This disrupted biosynthesis, characterized by an overabundance of PLMs and a deficiency in SPMs, is linked to the heightened inflammation observed in AH patients. Importantly, our findings suggest an important role of alcohol abstinence in restoring the balance of these LMs and the potential therapeutic benefits of SPM supplements in alleviating the inflammatory cascade in AH patients.
Does community-based health insurance affect lifestyle and timing of treatment seeking behavior? Evidence from Ethiopia
Authors: Anteneh Zecharias Fetene , Mebratie Anagaw D. , Shigute Zemzem , Alemu Getnet , Bedi Arjun S.
Published: December 2023

There has been a growing concern about the financial sustainability of community-based health insurance (CBHI) schemes in developing countries recently. However, little empirical studies have been conducted to identify potential contributors including ex-ante and ex-post moral hazards. We respond to this concern by investigating the effects of being insured on household lifestyle -Preventive Care- and the timing of treatment seeking behavior in the context of Ethiopia’s CBHI scheme. Using three rounds of household panel data and a fixed-effects household model, we do not find a significant impact on preventive care activities. However, we find that participation in CBHI increases delay in treatment-seeking behavior for malaria, tetanus, and tuberculosis symptoms. This behavior is costly for the insurer. Therefore, it is essential to identify the primary causes of delays in seeking medical services and implement appropriate interventions aimed at encouraging insured individuals to seek early medical attention when signs of diseases emerge.