bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigation of the correlation between optical and γ-ray flux variations in the blazar Ton 599
Authors: Rajput Bhoomika , Mandal Amit Kumar , Pandey Ashwani , Stalin C S , Max-Moerbeck Walter , Mathew Blesson
Published: December 2023

The correlation between optical and γ-ray flux variations in blazars reveals a complex behaviour. In this study, we present our analysis of the connection between changes in optical and γ-ray emissions in the blazar Ton 599 over a span of approximately 15 yr, from 2008 August to 2023 March. Ton 599 reached its highest flux state across the entire electromagnetic spectrum during the second week of 2023 January. To investigate the connection between changes in optical and γ-ray flux, we have designated five specific time periods, labelled as epochs A, B, C, D, and E. During periods B, C, D, and E, the source exhibited optical flares, while it was in its quiescent state during period A. The γ-ray counterparts to these optical flares are present during periods B, C, and E; however, during period D, the γ-ray counterpart is either weak or absent. We conducted a broad-band spectral energy distribution (SED) fitting by employing a one-zone leptonic emission model for these epochs. The SED analysis unveiled that the optical–ultraviolet emission primarily emanated from the accretion disc in quiescent period A, whereas synchrotron radiation from the jet dominated during periods B, C, D, and E. Diverse correlated patterns in the variations of optical and γ-ray emissions, like correlated optical and γ-ray flares, could be accounted for by changes in factors such as the magnetic field, bulk Lorentz factor, and electron density. On the other hand, an orphan optical flare could result from increased magnetic field and bulk Lorentz factor.
Thrombotic thrombocytopenic purpura that developed 3 years after systemic lupus erythematosus had remitted with rituximab therapy
Authors: Tsuda Reina , Kido Toshiki , Okada Ikuma , Kobiyama Aoi , Kawataka Masatoshi , Yamazaki Miho , Asano Ryoko , Hounoki Hiroyuki , Shinoda Koichiro , Tobe Kazuyuki
Published: December 2023

Patients with systemic lupus erythematosus (SLE) occasionally develop thrombotic thrombocytopenic purpura (TTP), which can be fatal. Here, we report a case of TTP developing 3 years after SLE remitted with rituximab (RTX) therapy. A 50-year-old woman was treated with RTX for marked immune thrombocytopenic purpura and autoimmune haemolytic anaemia due to SLE relapse. After induction of remission, she was treated with prednisolone alone without maintenance therapy with RTX. Approximately 3 years later, she was readmitted with marked thrombocytopenia and severe renal dysfunction. On admission, she was diagnosed with TTP for the first time based on severe reduction in a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13) activity and detection of ADAMTS13 inhibitors. CD19+ B cells in the patient’s serum increased to 34%, suggesting that B cells had reactivated once the effect of RTX had subsided. The patient was successfully treated with plasmapheresis, glucocorticoid pulse therapy, and RTX. There are no previous reports of newly diagnosed TTP with ADAMTS13 inhibitor production after having achieved remission of SLE with RTX. Therefore, our report also discusses the potential mechanisms of production of new autoantibodies after B-cell depletion therapy.
Patterns of change in regulatory modules of chemical reaction systems induced by network modification
Authors: Hishida Atsuki , Okada Takashi , Mochizuki Atsushi
Published: December 2023

Cellular functions are realized through the dynamics of chemical reaction networks formed by thousands of chemical reactions. Numerical studies have empirically demonstrated that small differences in network structures among species or tissues can cause substantial changes in dynamics. However, a general principle for behavior changes in response to network structure modifications is not known. The chemical reaction system possesses substructures called buffering structures, which are characterized by a certain topological index being zero. It was proven that the steady-state response to modulation of reaction parameters inside a buffering structure is localized in the buffering structure. In this study, we developed a method to systematically identify the loss or creation of buffering structures induced by the addition of a single degradation reaction from network structure alone. This makes it possible to predict the qualitative and macroscopic changes in regulation that will be caused by the network modification. This method was applied to two reaction systems: the central metabolic system and the mitogen-activated protein kinases signal transduction system. Our method enables identification of reactions that are important for biological functions in living systems.
Evaluating and Characterizing the Scope of Care for Interventions Labeled as Manual Therapy in Low Back Pain Trials: A Scoping Review
Authors: Wenger Laura E , Barrett Dustin R , Rhon Daniel I , Young Jodi L
Published: December 2023

Objective

The purpose of this scoping review was to evaluate and characterize the scope of care for low back pain that falls under the specific label of manual therapy.

Methods

PubMed database, Ovid MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), and SPORTDiscus were searched from journal inception through May 2022 for randomized controlled trials that investigated the treatment of low back pain using manual therapy. Terminology used to define manual therapy was extracted and categorized by using only the words included in the description of the intervention. An expert consultation phase was undertaken to gather feedback.

Results

One hundred seventy-six trials met final inclusion criteria, and 169 unique terms labeled as manual therapy for the treatment of low back pain were found. The most frequent terms were mobilization (29.0%), manipulation (16.0%), and thrust (6.4%). Eight percent of trials did not define or specify what type of manual therapy was used in the study. After removing duplicates, 169 unique terms emerged within 18 categories.

Conclusions

Manual therapy intervention labels used in low back pain trials are highly variable. With such variation, the heterogeneity of the intervention in trials is likely large, and the likelihood that different trials are comparing the same interventions is low. Researchers should consider being more judicious with the use of the term manual therapy and provide greater detail in titles, methods, and supplementary appendices in order to improve clarity, clinical applicability, and usefulness of future research.

Impact

The ability to interpret and apply findings from manual therapy–related research for low back pain is challenging due to the heterogeneity of interventions under this umbrella term. A clear use of terminology and description of interventions by researchers will allow for improved understanding for the role of manual therapy in managing back pain.
Anatomical Substrates of Rapid Eye Movement Sleep Rebound in a Rodent Model of Post-sevoflurane Sleep Disruption
Authors: Atluri Navya , Dulko Elzbieta , Jedrusiak Michal , Klos Joanna , Osuru Hari P. , Davis Eric , Beenhakker Mark , Kapur Jaideep , Zuo Zhiyi , Lunardi Nadia
Published: December 2023

Background

Previous research suggests that sevoflurane anesthesia may prevent the brain from accessing rapid eye movement (REM) sleep. If true, then patterns of neural activity observed in REM-on and REM-off neuronal populations during recovery from sevoflurane should resemble those seen after REM sleep deprivation. In this study, the authors hypothesized that, relative to controls, animals exposed to sevoflurane present with a distinct expression pattern of c-Fos, a marker of neuronal activation, in a cluster of nuclei classically associated with REM sleep, and that such expression in sevoflurane-exposed and REM sleep–deprived animals is largely similar.

Methods

Adult rats and Targeted Recombination in Active Populations mice were implanted with electroencephalographic electrodes for sleep–wake recording and randomized to sevoflurane, REM deprivation, or control conditions. Conventional c-Fos immunohistochemistry and genetically tagged c-Fos labeling were used to quantify activated neurons in a group of REM-associated nuclei in the midbrain and basal forebrain.

Results

REM sleep duration increased during recovery from sevoflurane anesthesia relative to controls (157.0 ± 24.8 min vs. 124.2 ± 27.8 min; P = 0.003) and temporally correlated with increased c-Fos expression in the sublaterodorsal nucleus, a region active during REM sleep (176.0 ± 36.6 cells vs. 58.8 ± 8.7; P = 0.014), and decreased c-Fos expression in the ventrolateral periaqueductal gray, a region that is inactive during REM sleep (34.8 ± 5.3 cells vs. 136.2 ± 19.6; P = 0.001). Fos changes similar to those seen in sevoflurane-exposed mice were observed in REM-deprived animals relative to controls (sublaterodorsal nucleus: 85.0 ± 15.5 cells vs. 23.0 ± 1.2, P = 0.004; ventrolateral periaqueductal gray: 652.8 ± 71.7 cells vs. 889.3 ± 66.8, P = 0.042).

Conclusions

In rodents recovering from sevoflurane, REM-on and REM-off neuronal activity maps closely resemble those of REM sleep–deprived animals. These findings provide new evidence in support of the idea that sevoflurane does not substitute for endogenous REM sleep.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
ICU Utilization After Implementation of Minor Severe Pneumonia Criteria in Real-Time Electronic Clinical Decision Support
Authors: Carr Jason R. , Knox Daniel B. , Butler Allison M. , Lum Marija M. , Jacobs Jason R. , Jephson Al R. , Jones Barbara E. , Brown Samuel M. , Dean Nathan C.
Published: December 2023

OBJECTIVES:

To determine if the implementation of automated clinical decision support (CDS) with embedded minor severe community-acquired pneumonia (sCAP) criteria was associated with improved ICU utilization among emergency department (ED) patients with pneumonia who did not require vasopressors or positive pressure ventilation at admission.

DESIGN:

Planned secondary analysis of a stepped-wedge, cluster-controlled CDS implementation trial.

SETTING:

Sixteen hospitals in six geographic clusters from Intermountain Health; a large, integrated, nonprofit health system in Utah and Idaho.

PATIENTS:

Adults admitted to the hospital from the ED with pneumonia identified by: 1) discharge International Classification of Diseases, 10th Revision codes for pneumonia or sepsis/respiratory failure and 2) ED chest imaging consistent with pneumonia, who did not require vasopressors or positive pressure ventilation at admission.

INTERVENTIONS:

After implementation, patients were exposed to automated, open-loop, comprehensive CDS that aided disposition decision (ward vs. ICU), based on objective severity scores (sCAP).

MEASUREMENTS AND MAIN RESULTS:

The analysis included 2747 patients, 1814 before and 933 after implementation. The median age was 71, median Elixhauser index was 17, 48% were female, and 95% were Caucasian. A mixed-effects regression model with cluster as the random effect estimated that implementation of CDS utilizing sCAP increased 30-day ICU-free days by 1.04 days (95% CI, 0.48–1.59; p < 0.001). Among secondary outcomes, the odds of being admitted to the ward, transferring to the ICU within 72 hours, and receiving a critical therapy decreased by 57% (odds ratio [OR], 0.43; 95% CI, 0.26–0.68; p < 0.001) post-implementation; mortality within 72 hours of admission was unchanged (OR, 1.08; 95% CI, 0.56–2.01; p = 0.82) while 30-day all-cause mortality was lower post-implementation (OR, 0.71; 95% CI, 0.52–0.96; p = 0.03).

CONCLUSIONS:

Implementation of electronic CDS using minor sCAP criteria to guide disposition of patients with pneumonia from the ED was associated with safe reduction in ICU utilization.
Incorporation of quantitative imaging data using artificial intelligence improves risk prediction in veterans with liver disease
Authors: Su Grace L. , Zhang Peng , Belancourt Patrick X. , Youles Bradley , Enchakalody Binu , Perumalswami Ponni , Waljee Akbar , Saini Sameer
Published: December 2023

Background and Aims:

Utilization of electronic health records data to derive predictive indexes such as the electronic Child-Turcotte-Pugh (eCTP) Score can have significant utility in health care delivery. Within the records, CT scans contain phenotypic data which have significant prognostic value. However, data extractions have not traditionally been applied to imaging data. In this study, we used artificial intelligence to automate biomarker extraction from CT scans and examined the value of these features in improving risk prediction in patients with liver disease.

Approach and Results:

Using a regional liver disease cohort from the Veterans Health System, we retrieved administrative, laboratory, and clinical data for Veterans who had CT scans performed for any clinical indication between 2008 and 2014. Imaging biomarkers were automatically derived using the analytic morphomics platform. In all, 4614 patients were included. We found that the eCTP Score had a Concordance index of 0.64 for the prediction of overall mortality while the imaging-based model alone or with eCTP Score performed significantly better [Concordance index of 0.72 and 0.73 (p<0.001)]. For the subset of patients without hepatic decompensation at baseline (n=4452), the Concordance index for predicting future decompensation was 0.67, 0.79, and 0.80 for eCTP Score, imaging alone, or combined, respectively.

Conclusions:

This proof of concept demonstrates that the potential of utilizing automated extraction of imaging features within CT scans either alone or in conjunction with classic health data can improve risk prediction in patients with chronic liver disease.
Clinical Significance of Increased Skeletal Muscle Mass During Nab-Paclitaxel Plus Gemcitabine Treatment in Patients With Advanced Pancreatic Cancer
Authors: Iede Kiyotsugu , Yamada Terumasa , Ishida Tomo , Tsuda Yujiro , Nakashima Shinsuke , Tanida Tsukasa , Matsuyama Jin , Nakata Ken , Tominaga Shusei
Published: December 2023

Objectives

The clinical significance of increased skeletal muscle mass during nab-paclitaxel plus gemcitabine (AG) treatment in patients with advanced pancreatic cancer (APC) remains unknown. Therefore, we retrospectively investigated the characteristics of patients after AG treatment to evaluate the clinical significance of increased skeletal muscle mass during treatment.

Methods

From January 2015 to August 2021, 67 patients with APC received AG as first-line chemotherapy at Higashiosaka City Medical Center. Of these patients, 39 received second-line (2L) chemotherapy after AG therapy, and 28 received best supportive care. Patients' characteristics at the end of AG treatment were compared retrospectively between these 2 groups, and the relevant factors at the end of first-line treatment for 2L chemotherapy induction were analyzed.

Results

A performance status of 0 to 1 and increased skeletal muscle mass during AG therapy were independently associated with 2L chemotherapy induction in multivariate analysis. A high relative dose intensity (≥50%) in the first 8 weeks of AG treatment was more frequently found in patients with increased skeletal muscle mass during treatment (P = 0.037).

Conclusions

Increased skeletal muscle mass during AG treatment might contribute to the higher prevalence of 2L chemotherapy induction in patients with APC.
Use of Computed Tomography–Based Texture Analysis to Differentiate Benign From Malignant Salivary Gland Lesions
Authors: Jiang Shuqi , Su Yangfan , Liu Yanwen , Zhou Zewang , Li Maotong , Qiu Shijun , Zhou Jie
Published: December 2023

Objective

Salivary gland lesions show overlapping morphological findings and types of time/intensity curves. This research aimed to evaluate the role of 2-phase multislice spiral computed tomography (MSCT) texture analysis in differentiating between benign and malignant salivary gland lesions.

Methods

In this prospective study, MSCT was carried out on 90 patients. Each lesion was segmented on axial computed tomography (CT) images manually, and 33 texture features and morphological CT features were assessed. Logistic regression analysis was used to confirm predictors of malignancy (P < 0.05 was considered to be statistically significant), followed by receiver operating characteristics analysis to assess the diagnostic performance.

Results

Univariate logistic regression analysis revealed that morphological CT features (shape, size, and invasion of adjacent tissues) and 17 CT texture parameters had significant differences between benign and malignant lesions (P < 0.05). Multivariate binary logistic regression demonstrated that shape, invasion of adjacent tissues, entropy, and inverse difference moment were independent factors for malignant tumors. The diagnostic accuracy values of multivariate binary logistic models based on morphological parameters, CT texture features, and a combination of both were 87.8%, 90%, and 93.3%, respectively.

Conclusions

Two-phase MSCT texture analysis was conducive to differentiating between malignant and benign neoplasms in the salivary gland, especially when combined with morphological CT features.
A neural network for religious fundamentalism derived from patients with brain lesions
Authors: Ferguson Michael A , Asp Erik W , Kletenik Isaiah , Tranel Daniel , Boes Aaron , Nelson Jenae M , Schaper Frederic LWVJ , Siddiqi Shan H , Anderson J Seth , Nielsen Jared A , Bateman James R , Grafman Jordan , Fox Michael D
Published: December 2023

Religious fundamentalism, characterized by rigid adherence to a set of beliefs putatively revealing inerrant truths, is ubiquitous across cultures and has a global impact on society. Understanding the psychological and neurobiological processes producing religious fundamentalism may inform a variety of scientific, sociological, and cultural questions. Research indicates that brain damage can alter religious fundamentalism. However, the precise brain regions involved with these changes remain unknown. Here, we analyzed brain lesions associated with varying levels of religious fundamentalism in two large datasets from independent laboratories. Lesions associated with greater fundamentalism were connected to a specific brain network with nodes in the right orbitofrontal, dorsolateral prefrontal, and inferior parietal lobes. This fundamentalism network was strongly right hemisphere lateralized and highly reproducible across the independent datasets (r = 0.82) with cross-validations between datasets. To explore the relationship of this network to lesions previously studied by our group, we tested for similarities to twenty-one lesion-induced conditions. Lesions associated with confabulation and criminal behavior showed a similar connectivity pattern as lesions associated with greater fundamentalism. Moreover, lesions associated with poststroke pain showed a similar connectivity pattern as lesions associated with lower fundamentalism. These findings are consistent with hemispheric specializations in reasoning and lend insight into previously observed epidemiological associations with fundamentalism, such as cognitive rigidity and outgroup hostility.
The impact of higher uptake of plant-based diets in England: model-based estimates of health care resource use and health-related quality of life
Authors: Henderson Nadine , Sampson Chris
Published: December 2023

Plant-based diets have grown in popularity in recent years, in part because of the perceived health benefits; higher consumption of vegetables and other healthy foods is associated with better nutrition and reduced risk of disease. In this study, we estimate the potential impact of higher uptake of a 100% plant-based (vegan) diet in England from the perspective of the National Health Service (NHS). We estimate the impact in terms of quality-adjusted life years (QALYs), health care expenditure, and total net benefit compared to the current level of uptake.

This model-based analysis combines estimates for disease prevalence, the relative risk of disease associated with a vegan diet, and disease-specific health state utility values (HSUVs) and health care costs. We conducted a literature review to identify the most suitable inputs to the model, which included estimates for cancer, coronary heart disease, cataracts, diverticular disease, bone fractures, stroke, and type 2 diabetes. The model is open-source and implemented in an interactive online dashboard, allowing for further extension and exploration of the findings.

In our base case analysis with 100% adoption of a plant-based diet in England, the total health care cost savings across all considered diseases is around £6.7 billion per year, with 172,735 additional QALYs, and a total net benefit to the NHS of around £18.8 billion when QALYs are valued at £70,000. The majority of potential savings are realised through the avoidance of almost 1.3 million cases of type 2 diabetes.

Numerous challenges are associated with estimating the impact of widespread dietary changes in society. However, strong evidence shows that plant-based diets are associated with better health outcomes for some of England’s most significant causes of disease burden. Higher rates of plant-based diet adoption may bring considerable cost savings for the NHS and generate substantial health benefits for the population. Policymakers should consider the relevance of these estimates to their settings and the potential for interventions that support healthy dietary changes that contribute to population health. Future research should seek to identify the causal effects of plant-based diet adoption on health outcomes, and health care resource use across different populations.

Funding

This study was funded by a grant from The Vegan Society.

Author Declarations

The authors are employees of the Office of Health Economics, a registered charity and independent research organisation that receives funding from a variety of sources. Both authors identify as vegan. CS is a member of The Vegan Society.
Genetic Heterogeneity Across Dimensions of Alcohol Use Behaviors
Authors: Savage Jeanne E , Barr Peter B , Phung Tanya , Lee Younga H. , Zhang Yingzhe ,   COGA Investigators, Ge Tian , Smoller Jordan W. , Davis Lea K. , Meyers Jacquelyn , Porjesz Bernice , Posthuma Danielle , Mallard Travis T , Sanchez-Roige Sandra
Published: December 2023

Background

Increasingly large samples in genome-wide association studies (GWAS) for alcohol use behaviors (AUBs) have led to an influx of implicated genes, yet the clinical and functional understanding of these associations remains low. This is, in part, because most GWASs do not account for complex and varied manifestations of AUBs. This study applied a multidimensional framework to investigate the latent genetic structure underlying heterogeneous dimensions of AUBs.

Methods

Multi-modal assessments (self-report, interview, electronic health records) were obtained from approximately 400,000 UK Biobank participants. GWAS was conducted for 18 distinct AUBs, including consumption, drinking patterns, alcohol problems, and clinical sequelae. Latent genetic factors were identified and carried forward to GWAS using genomic structural equation modeling, followed by functional annotation, genetic correlation, and enrichment analyses to interpret the genetic associations.

Results

Four latent factors were identified:Problems, Consumption, BeerPref(declining alcohol consumption with a preference for drinking beer), andAtypicalPref(drinking fortified wine and spirits). The latent factors were moderately correlated (rg=.12-.57) and had distinct patterns of associations, withBeerPrefin particular implicating many novel genomic regions. Patterns of regional and cell type specific gene expression in the brain also differed between the latent factors.

Conclusion

Deep phenotyping and multi-modal assessment is an important next step to improve understanding of the genetic etiology of AUBs, in addition to increasing sample size. Further effort is required to uncover the genetic heterogeneity underlying AUBs using methods that account for their complex, multidimensional nature.
Unveiling the Epigenetic Impact of Vegan vs. Omnivorous Diets on Aging: Insights from the Twins Nutrition Study (TwiNS)
Authors: Dwaraka Varun B. , Aronica Lucia , Carreras-Gallo Natalia , Robinson Jennifer L , Hennings Tayler , Lin Aaron , Turner Logan , Smith Ryan , Mendez Tavis L. , Went Hannah , Ebel Emily R. , Carter Matthew M. , Sonnenburg Erica D. , Sonnenburg Justin L. , Gardner Christopher D.
Published: December 2023

Geroscience has emerged as a field focusing on interventions to attenuate molecular changes associated with aging. While lifestyle modifications, medications, and social factors are recognized influencers of the aging process, a comprehensive understanding of the intricate molecular mechanisms necessitates an in-depth exploration of the epigenetic landscape. Notably, the specific epigenetic clock and predictor effects of a vegan diet, compared to an omnivorous counterpart, remain inadequately explored, despite indications of potential impacts on aging-related outcomes. This study addresses this knowledge gap by examining the impact of an eight-week entirely plant-based or healthy omnivorous diet on blood DNA methylation in paired twins. Results show distinct responses, with the vegan cohort solely exhibiting significant decreases in overall epigenetic age acceleration (PC GrimAge, PC PhenoAge, DunedinPACE), including among specific systems (Inflammation, Heart, Hormone, Liver, and Metabolic), aligning with anti-aging effects of plant-based diets. Analyses of methylation surrogates of clinical, metabolite, and protein markers indicate diet-specific shifts, while exemplifying DNA methylation markers in predicting complex traits influenced by diet. Comprehensive epigenome-wide analysis unveils diet-specific differentially methylated loci, offering insights into influenced pathways. This study sheds light on the advantageous aging benefits of a healthy vegan diet, while providing a foundation for future personalized interventions using epigenetic age clocks in promoting overall well-being.
Cabergoline as a Preventive Migraine Treatment: An Investigator-Initiated Randomized Controlled Trial
Authors: Hjelholt Astrid Johannesson , Bach Flemming Winther , Kasch Helge , Støvring Henrik , Jensen Troels Staehelin , Jørgensen Jens Otto Lunde
Published: December 2023

Background

Beneficial effects of dopamine agonist treatment on migraine have been reported but remain to be properly tested.

Aim

to examine the effect of cabergoline as preventive treatment for migraine.

Primary endpoint

Change in monthly migraine days (MMD).

Methods

In a randomized, double-blind, placebo-controlled pilot study, 36 adults with episodic and chronic migraine were enrolled. Following a 28-days baseline period, participants received cabergoline 0.5 mg or placebo once weekly for 12 weeks as add-on treatment. An electronic headache diary was completed by the participant, and pertinent headache questionnaires and blood tests were collected at baseline and following the treatment period. The trial was registered withClinicalTrials.gov(NCT05525611).

Findings

Mean (SD) baseline MMD was 13.6 (4.1) in the cabergoline group and 14.0 (5.3) in the placebo group. In participants with episodic migraine (n= 20), the change in mean MMD (SE) from baseline to the last 28 days of the treatment period was -5.4 (1.3) (cabergoline) as compared to -1.8 (0.9) (placebo) [odds ratio: 0.79 (95% CI 0.65 - 0.95), p=0.014]. In participants with chronic migraine (n=13), the reduction in MMD with cabergoline was not significant (p=0.6). Patients’ global impression of change significantly improved after cabergoline as compared to placebo in the entire group of participants (p=0.006). The number of participants with episodic migraine achieving ≥ 50% reduction in MMD tended to increase after cabergoline (p=0.07). Seven participants receiving cabergoline and 4 participants receiving placebo experienced adverse effects, none of which were serious.

Interpretations

Preventive cabergoline treatment exhibited clinically meaningful improvement in episodic migraine without serious adverse effects. This provides proof-of-concept to justify a sufficiently powered phase 2 trial with different cabergoline dosing regimens as preventive treatment of episodic migraine.

Funding

This study has received no external funding.
The Effect of Mindfulness Based Stress Reduction on Glycemic Control and Psychological Well-being of Diabetes Mellitus Patients: A Review of Experimental Studies
Authors: Qona’ah Arina , Pandin Moses Glorino Rumambo , Nursalam Nursalam
Published: December 2023

Most diabetes mellitus patients experience psychological problems resulting from the disease, disease management, and complications. Inadequate management of psychological problems may place patients at greater risk for depression. This systematic review aims to identify the effects of mindful interventions in controlling glycemic levels and psychological well-being in diabetes mellitus patients. The systematic review conducted on the study used the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. This systematic review uses the Scopus, Web of Science, Science Direct, and Google Scholar databases. The keywords used are diabetes mellitus type 2, mindfulness-based stress reduction, AND/OR, glycemic control, blood glucose, glycated hemoglobin, and psychological well-being. The words used are adjusted to the Medical Subject Heading (MeSH). The articles used are published in English in 2014 – 2023, full-text, and are research articles. The search results showed that most mindfulness interventions used were MBSR (Mindfulness-Based Stress Reduction) for 8 weeks taught by professionals. Mindfulness is provided by trained professionals and taught again using communication media, namely CDs or mobile applications. Mindfulness has a significant effect on reducing fasting blood sugar levels and HbA1c in type 2 DM patients. Mindfulness improves psychological well-being and reduces depression, anxiety, resilience, and emotional health in diabetes patients. Mindfulness is a therapy that can be used to manage the psychological problems of DM patients where with good emotional control the patient can control glycemic levels to normal limits
Evaluating the Association between Routine Pneumococcal Vaccination and COVID-19 Severity among Older Adults in the United States
Authors: Prunas Ottavia , Tiu Andrew , Bansal Shweta , Weinberger Daniel M.
Published: December 2023

Background

The relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) andStreptococcus pneumoniaeremains uncertain. This study investigates the association between routine pneumococcal vaccination and the progression to severe COVID-19 outcomes in a cohort of older adults in the United States.

Methods

Our cohort study includes adults aged 65 and older from a subset of adults covered by Medicare in the United States with a documented COVID-19 diagnosis. Logistic regression models were employed to assess the association between pneumococcal vaccination (13-valent conjugate vaccine [PCV13] and 23-valent pneumococcal polysaccharide vaccine [PPSV23]) and COVID-19 severity.

Results

Among 90,070 Medicare enrollees with a COVID-19 diagnosis, 28,124 individuals exhibited severe respiratory symptoms or were admitted to the intensive care unit (ICU). The odds ratio (OR) for progression from non-severe symptoms to respiratory symptoms with or without ICU admission with prior PCV13 receipt was 0.91 (95% confidence interval [CI], 0.88, 0.93), the OR for progression from severe respiratory symptoms to ICU critical care with prior PCV13 receipt was 0.92 (95% CI, 0.88, 0.97), and the OR for progression from non-severe symptoms to ICU critical care with prior PCV13 receipt was 0.85 (95% CI, 0.81, 0.90). There was no association between PPSV23 received more than five years before the COVID-19 diagnosis and the COVID-19 outcomes.

Conclusions

Overall, our findings indicate moderate to no association between PCV vaccination and COVID-19 severity.
Predictors of Breast Self-Examination Practice Among Women Aged 20 and Above In Sidama Region, Southern Ethiopia. Health Belief Model Approach
Authors: Bekele Belayneh , Yunkura Ermias , Bogale Netsanet , Gemechu Lelisa , Gebretsadik Achamyelesh , Geleta Dereje
Published: December 2023

Introduction

Breast self-examination is a straightforward, affordable, and uncomplicated approach to identify any alteration in the breast. When conducted correctly, it aids in the early detection of breast cancer and diminishes its impact on health and mortality. It is advised that women aged 20 and above perform self-examinations monthly, consistently. However, the extent of breast self-examination practices in Ethiopia has not been thoroughly documented.

Objective

The aim of the study is to identify predictors of breast self-examination practices and associated factors among women aged 20 and above in Sidama Region, South Ethiopia.

Methods

A Cross-sectional study was conducted on 1000 women aged 20-70 years. The study employed a multistage sampling method. Data collection was performed using a structured and pretested interviewer administered questionnaire. The collected data were entered into Epi-data version 3.1 and analyzed by SPSS version 20. Descriptive statistics were used to describe the study population in relation to relevant variables. Bivariate and multivariable logistic regression analyses were conducted to assess the impact of independent variables on the dependent variable. Variables with p-value <0.25 were considered as candidates for multivariable logistic regression. Statistical significance was declared at P < 0.05 and 95% CI.

Result

The prevalence of breast self-examination was found to be 5.2%, with only 46.2% of participants performing it regularly. Factors significantly associated with the practice of BSE among women included were Good knowledge about breast cancer and breast self-examination (Adjusted odds ratio=4.5, 95%CI: 1.4, 14.7), high perceived susceptibility (Adjusted odds Ratio =2.7, 95%CI: 1.4, 5.2), high perceived barrier (Adjusted odds ratio=0.30, 95%CI: 0.11, 0.8) and high perceived self-efficacy (Adjusted odds ratio=3.9, 95%CI: 2.0, 7.7).

Conclusion

The study revealed a notably low prevalence of BSE practice among the study population compared to previous study conducted in Ethiopia. Factors such as knowledge about breast cancer and breast self-examination, high perceived susceptibility, and high perceived self-efficacy were identified as significant predictors of BSE practice. To address this issue, collaboration and efforts from various stakeholders including Zonal Health department, District health offices, Health workers, and other relevant parties are needed. It is crucial to focus on raising awareness and improving the perception of women regarding BSE to enhance the currently inadequate practice.
BIBLIOMETRIC ANALYSIS OF COMPLEMENTARY THERAPY TRENDS FOR MENSTRUATION PAIN
Authors: Pawestri  , Rumambo Pandin Moses Glorino , Yunitasari Esti
Published: December 2023

Background

Research interest in the topic of complementary interventions to treat menstrual pain is increasing. In future research, researchers need information about trends and new things on complementary interventions to treat menstrual pain.

Purpose

The research aims to determine trends in the number of publications, journals with the highest number of publications, which fields receive the most publication permits, network visualization, overlay visualization, and density visualization on complementary topics related to intervention dealing with menstrual pain.

Methods

A search for publications on trends in complementary interventions to treat primary menstrual pain in adolescents resulted in 23,935 articles, four grants, 2,427 patents, and 42 clinical trials. After filtering through specified criteria, the number of articles obtained was 3,214, 249 patents, and 19 clinical trials.

Results

A search for publications on trends in complementary interventions to treat primary menstrual pain in adolescents resulted in 23,935 articles, four grants, 2,427 patents, and 42 clinical trials. After filtering through criteria such as publication year, research categories, publication type, published between 2018-2023, focus in the field of Health sciences, nursing, public health, clinical sciences, and article publication type were included as inclusion criteria of this study. The study obtained 3,214 articles, 249 patents, and 19 clinical trials. The peak of publications regarding trends in complementary interventions to treat primary menstrual pain in adolescents occurred in 2018. Meanwhile, the lowest number was in 2023. Research on complementary intervention trends to overcome primary menstrual pain in adolescents is in medicine, public health, nursing, and other fields such as trade management, tourism and services, human society, law, and legal studies. In addition, there is currently a trend for complementary therapy interventions to treat menstrual pain. Complementary therapies that are still rarely researched are progressive muscle relaxation therapy or herbal ginger to ease menstrual pain.

Apart from that, progressive muscle relaxation therapy can also be used to treat anxiety in teenagers who experience menstrual pain, or the ginger herb has rarely been researched to treat menstrual pain.

Conclusion

Trends regarding complementary therapy interventions to treat menstrual pain need a review to find relevant alternative interventions for adolescent development and current digital developments. It is suggested that the next researcher choose a low visualization category theme to look for novelties in further research, one of which is ginger herbal therapy to overcome menstrual pain or interventions to overcome adolescent anxiety when experiencing menstrual pain.
Multi-contrast high-field quality image synthesis for portable low-field MRI using generative adversarial networks and paired data
Authors: Lucas Alfredo , Arnold T. Campbell , Okar Serhat V. , Vadali Chetan , Kawatra Karan D. , Ren Zheng , Cao Quy , Shinohara Russell T. , Schindler Matthew K. , Davis Kathryn A. , Litt Brian , Reich Daniel S. , Stein Joel M.
Published: December 2023

Introduction

Portable low-field strength (64mT) MRI scanners promise to increase access to neuroimaging for clinical and research purposes, however these devices produce lower quality images compared to high-field scanners. In this study, we developed and evaluated a deep learning architecture to generate high-field quality brain images from low-field inputs using a paired dataset of multiple sclerosis (MS) patients scanned at 64mT and 3T.

Methods

A total of 49 MS patients were scanned on portable 64mT and standard 3T scanners at Penn (n=25) or the National Institutes of Health (NIH, n=24) with T1-weighted, T2-weighted and FLAIR acquisitions. Using this paired data, we developed a generative adversarial network (GAN) architecture for low- to high-field image translation (LowGAN). We then evaluated synthesized images with respect to image quality, brain morphometry, and white matter lesions.

Results

Synthetic high-field images demonstrated visually superior quality compared to low-field inputs and significantly higher normalized cross-correlation (NCC) to actual high-field images for T1 (p=0.001) and FLAIR (p<0.001) contrasts. LowGAN generally outperformed the current state- of-the-art for low-field volumetrics. For example, thalamic, lateral ventricle, and total cortical volumes in LowGAN outputs did not differ significantly from 3T measurements. Synthetic outputs preserved MS lesions and captured a known inverse relationship between total lesion volume and thalamic volume.

Conclusions

LowGAN generates synthetic high-field images with comparable visual and quantitative quality to actual high-field scans. Enhancing portable MRI image quality could add value and boost clinician confidence, enabling wider adoption of this technology.
“Another world of pain” – Athlete and Sport Physiotherapist perspectives on the unique experience of pain in sport
Authors: Purcell Ciarán , Barry Walsh Caoimhe , Van Oirschot Garett , Fullen Brona M , Ward Tomás , Caulfield Brian M
Published: December 2023

Objectives

To explore athlete’s and sports physiotherapists’ experiences of sports-related pain in the upper and lower limb.

Methods

Using a constructivist and pragmatic perspective we carried out focus groups comprising a deliberate criterion sample of athletes and sports physiotherapists. We used a topic guide that moved from open exploratory questions to questions focusing on the phenomena of sports-related pain in athletes. We coded, developed candidate themes and refined finalised themes using reflexive thematic analysis. A member of our research team acted as a critical friend adding additional perspectives. We followed the Consolidated Criteria for Reporting Qualitative Research (COREQ).

Results

We completed five focus groups comprising twelve athletes (n=5 female, n=7 male) and four sports physiotherapists (n=4 male) including one initial pilot (two athletes). We developed four final themes (I-IV) and nine subthemes (a-i). I) Athlete Pain Lens ( a - pain is part of being an athlete, b - pain shapes the life of an athlete) II) Exploring And Navigating Pain (c- the sports-related pain spectrum, d- making sense of pain) III) The Emotional Toll of Pain (e - challenging emotions, f - the impact of time) IV) Coping, Community and Communication (g - coping with Pain, h - influence of community and support network, i - communication-the broken key).

Conclusion

We highlighted the distinct and challenging phenomenon of sports-related pain experienced by athletes and physiotherapists. Through effective communication members of the athlete’s community may recognize, and adjust to these challenges.
Dengue Vaccine Effectiveness: Results from a Six-Year Population-Based Cohort Study in Southern Brazil
Authors: Luhm Karin Regina , Shimakura Silvia Emiko , Raboni Sonia Mara , Vieira da Costa-Ribeiro Magda Clara , Diaz-Quijano Fredi Alexander , de Mello Angela Maron , Roberto da Silva Lineu , Buffon Marilene da Cruz Magalhães , Maluf Eliane Mara Cesário Pereira , Graeff Gabriel , Preto Clara , de Almeida Gustavo Araújo , de Sousa Gabriela Amanda , Krainski Elias Teixeira , Evans Allan Arnold , de Carvalho Denise Siqueira
Published: December 2023

The alarming growth of dengue worldwide and its social and economic impact have demanded more effective responses for its prevention and control. Currently, the first vaccine approved in Brazil for its prevention, Dengvaxia®, was administered to a target population of around 500,000 residents in southern Brazil. This study reports its effectiveness after a six-year follow-up period from August 2016 to July 2022. Dengue vaccination campaign was carried out in a target population of individuals aged 15–27 in 28 municipalities and 9–44 years in the other two. In this population-based cohort study, exposure to the vaccine included groups with different numbers of doses and adherence to the complete schedule. The primary outcome was probable dengue case. Other endpoints included laboratory- confirmed dengue, serotype, dengue with warning signs or severe illness, and hospitalization. Approximately 60.4% of the participants received at least one vaccine dose. A total of 50,658 probable dengue cases (PDC) were notified of which 15,131 were laboratory-confirmed dengue cases. Overall effectiveness for at least one dose was 33.7% (95% CI: 32.5–34.9) for PDC and 20.1% (95% confidence interval [CI]: 17.1–22.9) for laboratory-confirmed cases. Greater vaccine effectiveness was observed in older individuals and for the DENV-4 and DENV-1 serotypes. The vaccine showed no effectiveness against DENV-2; no DENV-3 cases occurred. A lower hospitalization rate was observed among the vaccinated group. Differences in the incidence of severe dengue cases and warning signs could not draw a definite conclusion. Vaccination was associated with a one-third reduction in the incidence of probable dengue cases. By serotypes, the reduction was significant only for DENV-1 and DENV-4.

Author Summaries

Outcomes resulting from dengue mass vaccination remains limited.

Study on Dengvaxia®’s effectiveness in a target population of 501,000 with unknown serostatus. Dengue risk reduction was significant for DENV-1 and DENV-4.
Changes in the medical admissions and mortality amongst children in four South African hospitals following the COVID-19 pandemic : A five-year review
Authors: Loganathan Naidoo Kimesh , Jienchi Dorward , Kogielambal Chinniah , Melissa Lawler , Yugendhree Nattar , Christian Bottomley , Moherndran Archary
Published: December 2023

Background

Vulnerable children from poor communities with high HIV and Tuberculosis(TB) burdens were impacted by COVID-19 lockdowns. Concern was raised about the extent of this impact and anticipated post-pandemic surges in mortality.

Methods

Interrupted time series segmented regression analyses were done using routinely collected facility-level data of children admitted for medical conditions at four South African referral hospitals. Monthly admission and mortality data over a 60-month period from 01 April 2018 to 31 January 2023 was analysed using models which included dummy lockdown level variables, a dummy post-COVID period variable, Fourier terms to account for seasonality, and excess mortality as a proxy for healthcare burden.

Results

Of the 45 015 admissions analysed, 1237(2·75%) demised with significant decreases in admissions during all the lockdown levels, with the most significant mean monthly decrease of 450(95%, CI=657·3, −244·3) p<0·001 in level 5 (the most severe) lockdown. There was evidence of loss of seasonality on a six-month scale during the COVID periods for all admissions (p=0·002), including under-one-year-olds (p=0·034) and under-five-year-olds (p=0·004). No decreases in mortality accompanied decreased admissions. Post-pandemic surges in admissions or mortality were not identified in children with acute gastroenteritis, acute pneumonia and severe acute malnutrition.

Conclusion

During the COVID-19 pandemic, paediatric admissions in 4 hospitals serving communities with high levels of HIV, TB and poverty decreased similar to global experiences however there was no change in in-hospital mortality. No post-pandemic surge in admissions or mortality were documented. Differences in the impact of pandemic control measures on transmission of childhood infections and access to health care may account for differing outcomes seen in our setting compared to the global experiences. Further studies are needed to understand the impact of pandemic control measures on healthcare provision and transmission dynamics and to better inform future responses amongst vulnerable child populations.