bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient Outcomes after Implementation of Transitional Care Protocols In Elective Neurosurgery: A systematic Review and Meta-Analysis
Authors: Aguilera Carlos , Wong Georgia , Khan Ziam , Pivazyan Gnel , Breton Jeffrey M. , Lynes John , Deshmukh Vinay R.
Published: July 2024

Objective
30-day readmissions are a significant burden on the healthcare system. Postoperative transitional care protocols (TCPs) for safe and efficient discharge planning are being more widely adopted to reduce readmission rates. Currently, little evidence exists to justify the utility of TCPs for improving patient outcomes in elective neurosurgery. The objective of this systematic review was to determine the extent to which TCPs reduce adverse outcomes in patients undergoing elective neurosurgical procedures.
Materials and Methods
A systematic review and meta-analysis was conducted after PROSPERO registration. Pubmed, Embase, and Cochrane review databases were searched through February 1, 2024. Keywords included: “transitional care AND neurosurgery”, “Discharge planning AND neurosurgery”. Articles were included if they assessed postoperative TCPs in an adult population undergoing elective neurosurgeries. Exclusion criteria were pediatric patients, implementation of Enhanced Recovery After Surgery (ERAS) protocols, or non-elective neurosurgical procedures. The primary outcome was readmission rates after implementation of TCPs.
Results
16 articles were included in this review. 2 articles found that patients treated with TCPs had significantly higher chances of home discharge. 7 articles found a significant association between implementation of TCP and reduced length of stay and intensive care unit stay. 3 articles reported an increase in patient satisfaction after implementation of TCPs. 3 found that TCP led to a significant decrease in readmissions. After meta-analysis, TCPs were associated with significantly decreased readmission rates (OR: 0.68, p < 0.0001), length of stay (mean difference: -0.57, p < 0.00001), and emergency department visits (OR: 0.33, p < 0.0001)
Conclusions
This systematic review and meta-analysis found that an overwhelming majority of the available literature supports the effectiveness of discharge planning on at least one measure of patient outcomes. However, the extent to which each facet of the TCP affects outcomes in elective neurosurgery remains unclear. Future efforts should be made to compare the effectiveness of different TCPs.
Leishmania infantum in a dog with lymphadenopathy and extensive cutaneous lesions: Hematological, biochemical, cytological and molecular findings
Authors: Yaghoobpour Tina , Rakhshandehroo Ehsan , Sharifiyazdi Hassan , Nematinejad Masoud
Published: July 2024

Leishmania spp., protozoal parasites belonging to the Trypanosomatidae family, are the cause of a common zoonotic illness. Dogs are the main reservoirs of the parasites, which play a considerable role in infecting humans and other hosts. This report explains lymph node involvement by amastigotes of the viscerotropic Leishmania species in a dog who suffered from ulcerative nodules and generalized eczematous and exfoliative dermatitis (erythroderma).
A 2-year-old male dog with evident acute skin lesions and ulcerative nodules on the face was referred to a small animal hospital in Mazandaran province, Iran. The animal had started showing signs ten days prior and was lethargic and lost appetite. In order to detect Leishmania parasites, the popliteal lymph node was sampled for the cytological examination and also polymerase chain reaction (PCR) based on the ITS-1 region of the ribosomal DNA gene. Also, a blood sample was collected to determine hematological and biochemical parameters. As a result, Leishman bodies were seen both inside and outside of macrophages when light microscopy was performed on the lymph node sample stained with Giemsa. Laboratory findings revealed mild leukocytosis, lymphocytosis, neutrophilia, low hematocrit. hyperglobulinemia, hyperproteinemia, hypoalbuminemia, declined albumin/globulin ratio, and hyperglycemia. The PCR and sequencing results confirmed the presence of Leishmania in the popliteal lymph node. According to the molecular analysis, L. infantum was the causative agent of leishmaniasis in this case.
Cutaneous leishmaniasis is prevalent in humans and dogs in Iran. In most cases, L. tropica and L. major are the major causative agents of this form of leishmaniasis, and the lesions are confined. In this report, a generalized skin disease was evident. In addition, hematological and biochemical parameters supported a visceral form of leishmania infection in the animal. Because L. infantum is a more dangerous species than the other types for dogs and specifically humans, our report should be considered to control the infection. This report is significant as this unusual form of visceral leishmaniasis in the dog raises concerns about the possibility of zoonotic transmission and may threaten public health.
Reliability of the biceps curl test and proposed percentiles in schoolchildren living at moderate altitude in Peru
Authors: Cossio-Bolaños Marco , Vidal-Espinoza Ruben , Sulla-Torres Jose , de Campos Luis Felipe Castelli Correia , De Arruda Miguel , Olivares Pedro R. , Gomez-Campos Rossana , Torres-Paz Luis Edwin
Published: July 2024

To verify the reliability of the biceps curl test in children and adolescents and to provide reference values according to chronological age and sex. A total of 1103 schoolchildren aged 6 to 17 years (500 boys and 603 girls) were evaluated. Weight and height were evaluated and Body Mass Index (BMI) and Tri Ponderal Index (TPI) were calculated. The right and left hand biceps curl was evaluated in 30 seconds. Children aged 6 to 11 years used a 1 kg dumbbell and those aged 12 to 17 years used a 2 kg dumbbell. Percentiles were calculated using the LMS method. The values of the relative Technical Error of Measurement (TEM%) of the biceps curl test of both hands ranged from 0.48 to 2.89%. The intraclass correlation coefficient (ICC) evidenced high values of 0.93 to 0.99. The Bland-Altman plot showed wide limits of agreement (-1.28 to 1.29 rep). It was verified that the biceps curl is a reliable test to evaluate strength endurance in children and adolescents. The values showed stability and wide limits of agreement. In addition, the proposed percentiles are useful to evaluate and monitor the strength endurance performance of both arms.
Comparison of ELAPSS score and computational fluid dynamics for predicting growth of small unruptured cerebral aneurysms
Authors: Tsuji Masanori , Ishida Fujimaro , Yasuda Ryuta , Miura Yoichi , Sato Takenori , Furukawa Kazuhiro , Okada Takeshi , Fukazawa Keiji , Umeda Yasuyuki , Toma Naoki , Suzuki Hidenori
Published: July 2024

Objective
ELAPSS score is commonly utilized for predicting growth of unruptured cerebral aneurysms. However, its application is unsuitable for small aneurysms with high demand for growth prediction. Consequently, we investigated the diagnostic accuracy of semi-quantitative assessment using the ELAPSS score and hemodynamic parameters using computational fluid dynamics (CFD) in small aneurysms.
Methods
A prospective observational study from January 2013 to February 2022 included 185 patients with 215 unruptured aneurysms with a maximum diameter of 3–5 mm. Aneurysms were classified into stable (186 aneurysms) and growth (29 aneurysms) groups based on repeated images. We calculated high shear area ratios (HSAR), high shear concentration ratio (HSCR), and flow concentration ratio (FCR) as hemodynamic parameters that we have already reported to be associated with small aneurysm growth in our previous study. The characteristics associated with the growth of small aneurysms were statistically investigated with morphological variables and hemodynamic parameters. The ELAPSS score was also calculated for the same aneurysm group to determine whether the growth risk was sufficiently assessed.
Results
In morphological variables, no significant differences were observed between the two groups. As for the hemodynamic parameters, the growth group had significantly lower FCR (0.61 vs 0.66, p = 0.016), lower HSAR (0.28 vs 0.33, p < 0.001), and higher HSCR (6.39 vs 5.01, p < 0.001). However, there were no significant differences in the ELAPSS scores between the two groups.
Conclusions
CFD may offer more enhanced predictive capabilities compared to the ELAPSS score for identifying growth tendencies in small aneurysms.
CT Imaging in Differentiating Non-Solid Lung Adenocarcinoma with cycstic airspaces: A Clinical and Diagnostic Study
Authors: Shi Hengfeng , Liang Beibei , liu yan , Yang Yang , Chen Hao , Wang Hui , Yang Dengfa , Xie Zongyu , Liu Qianqian , Zhu Juan , Wang Jian
Published: July 2024

Objective
To study the correlation between clinical data, CT image characteristics, and histopathology of patients with three types of nodular lung adenocarcinoma.
Methods
In total, 2146 patients with pathologically confirmed nodular lung adenocarcinoma in 3 hospitals in Anhui and Zhejiang were retrospectively analyzed from July 2017 to June 2023. The patients were divided into three groups according to their status of lung adenocarcinoma associated with cystic airspaces (LACA): the LACA0 group (no cystic airspaces, 1821 patients), the LACA1 group (cystic airspace diameter of < 5 mm, 208 patients), and the LACA2 group (cystic airspace diameter of ≥ 5 mm, 117 patients). The relationships between the patients’ clinical data (e.g., sex, age, and smoking status), CT image characteristics (e.g., location, lobulation, and long-axis diameter), and postoperative histopathology were evaluated by univariate and multivariate analyses.
Results
In the LACA2 group, 66(56.4%) patients were male, 57(48.7%) patients’ lesions occurred in the lower lobe, 45(38.5%) patients’ lesions were associated with pulmonary (e.g., emphysema/bullae, ventilation–perfusion imbalance)disease, 99(84.6%) patients had lobulation signs, and 50(42.8%) patients had postoperative histopathology findings of papillary, solid, or micropapillary adenocarcinoma. Multivariate logistic regression showed that sex, lobulation, long-axis diameter, location, and pulmonary disease were independent risk factors for LACA2.
Conclusion
Follow-up time should be shortened for smoking male patients with lung disease who have lung nodules containing large cystic cavities (cystic airspaces ≥ 5 mm in diameter). Once the lesion shows signs of malignancy, such as lobulation, it is recommended that follow-up be discontinued, and elective surgery be performed.
Clinical Analysis and Identification of Pediatric Patients with Colonic Ulceration
Authors: You Yaying , Tao Yijing , Xu Yanwen , Cao Yi , Feng Haixia , Wu Qingqing , Wang Ying , Weihui Yan
Published: July 2024

Background
A wide variety of diseases mimic inflammatory bowel disease (IBD). This study aimed to reduce the misdiagnosis among children with colonic ulcers, unfolding the pediatric disease profiles.
Methods
Eighty-six pediatric patients with colonic ulcers detected by colonoscopy were enrolled in the retrospective study. Children were divided into different groups according to the final diagnosis. The clinical characteristics, laboratory examinations and histopathological results were compared between the groups.
Results
IBD (n = 37) was just responsible for 43% of patients with colonic ulceration. Other diagnosis mainly included autoimmune diseases (n = 9), infectious enteritis (n = 13), gastrointestinal allergy (n = 8), and other diseases (n = 19). Comparing IBD and non-IBD groups, children with IBD had a higher frequency of symptoms like weight loss/failure to thrive (P < 0.001), perianal lesions (P = 0.001), and oral ulcers (P = 0.022), and higher expression levels of platelet (P = 0.006), neutrophil-to-lymphocyte (P = 0.001), erythrocyte sedimentation rate (P < 0.001), C-reactive protein (P < 0.001), Immunoglobulin G (P = 0.012), Interleukin-1β (P = 0.003), IL-6 (P = 0.024) and TNF-α (P = 0.026). Otherwise, expression levels of hemoglobin (P < 0.001) and albumin (P = 0.001) were lower in IBD patients. Besides, a wider ulcer range distribution in the lower gastrointestinal tract was found in the IBD group (P < 0.001).
Conclusions
We displayed potential indicators (like platelet, neutrophil-to-lymphocyte ratio and ulcer distribution character) to help diagnose pediatric IBD with colonic ulcers differentiating from other disorders more prudent.
Infrared spectroscopy and multivariate analysis applied to the differential diagnosis of leptospirosis and dengue
Authors: Zambrano Alejandra , Trilleras Jorge , Arana Victoria A. , Lima Kássio M. G. , Neves Ana C. O. , Morais Camilo L. M. , Romero Claudia , Falconar Andrew K. I. , Muñoz Boanegre S. , García Roberto , Carmona Carlos
Published: July 2024

Dengue and leptospirosis are considered systemic and very dynamic illnesses in which a patient can rapidly progress from mild to severe conditions. Both diseases present very similar acute initial symptoms, a fact that may result in a challenging differential diagnosis at the initial phases. Herein, we present the application of attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy combined with multivariate analysis to perform differential diagnosis of leptospirosis and dengue by analysing blood plasma. The spectra of 114 samples from patients in different phases of infection (n = 43 for leptospirosis and n = 71 for dengue) were analysed by either linear or quadratic discrimination in association with genetic algorithms, successive projection algorithms and principal component analysis for feature selection/extraction. The best model, GA-QDA, achieved outstanding results in terms of maximum (100%) sensitivity, specificity and accuracy for classifying both classes by using only 31 spectral variables. The ANOVA calculations, at a confidence level of 95%, highlighted a set of 10 variables selected by the GA-QDA model (1296 cm-1, 1612 cm-1, 1673 cm-1, 1677 cm-1, 1678 cm-1, 1689 cm-1, 1694 cm-1, 1711 cm-1, 1713 cm-1 and 1719 cm-1) with significant differences in the absorbance means between the Leptospirosis and Dengue classes. These specific wavenumbers represent the most useful spectral information accounting for the biochemical changes that mark a specific infection. These remarkable results obtained in this pilot study highlight the viability of this methodology to be applied in clinical practice to serve as a simple and accurate test for discriminating between the two illnesses.
Risk Identification Abstractly versus Concretely in Clinical Research in Japan: Randomized and Prospective Research on the Effect of Risk Reduction Activities in a Risk-based Approach
Authors: Kondo Hidenobu , Wei Chiu Shih , Hayashi Yukikazu , Takahashi Naoto , Yamaguchi Takuhiro
Published: July 2024

Background
The risk-based approach (RBA) was first introduced into studies in 2011–2012. As an RBA, it is important to implement risk reduction activities that are proportionate to risk to effectively reduce avoidable quality problems and ensure that they are well adapted to achieving desired goals. However, there is no consistent methodology for identifying and evaluating risks and planning risk reduction activities. Currently, no research has been performed on identifying and evaluating risks and risk reduction activities. We aimed to evaluate risk reduction activities and their effects by using two risk identification and evaluation methods.
Methods
Among the risk identification and evaluation methods, the one with the least number of categories or questions for identifying risks [risk assessment form (RAF)] and the one with the highest number [risk assessment tool (RAT)] were selected. Each method was used to identify and evaluate risks and plan risk reduction activities to conduct “research on the blood concentration of ponatinib and treatment outcome in patients with chronic phase chronic myelogenous leukemia (CP-CML).” RAF is a method of identifying risk from abstract questions, and RAT is a method of identifying risks from a list of concrete risks. The sites were randomized into two groups to implement planned risk reduction activities using RAF and RAT and to compare the number of errors and protocol deviations per participant visit between the RAF and RAT groups.
Results
The number of errors per participant visit was lower in the RAF group than in the RAT group, and the number of protocol deviations per participant was lower in the RAF group than in the RAT group.
Conclusions
Our study reveals that risk reductions can be successfully implemented by using a method to identify and evaluate risks in a small number of abstract categories that are critical to the quality of clinical research.
The use of echocardiography in the management of shock in critical care: a prospective, multi-centre, observational study
Authors: Flower Luke , Waite Alicia , Boulton Adam , Peck Marcus , Akhtar Waqas , Boyle Andrew , Gudibande Sandeep , Ingram Thomas E , Johnston Brian , Marsh Sarah , Miller Ashley , Nash Amy , Olusanya Olusegun , Parulekar Prashant , Wagstaff Daniel , Wilkinson Jonathan , Collaborators NEAT-ECHO , Proudfoot Alastair
Published: July 2024

Purpose
Echocardiography is an essential tool in the assessment of patients with shock. The current provision of echocardiography in critical care is poorly defined. We sought to evaluate the utilisation of echocardiography in patients presenting to critical care with undifferentiated shock and its impact on decision making.
Methods
We conducted a prospective, multi-centre, observational study in 178 critical care units across the United Kingdom and Crown Dependencies. The study was led by the UK’s Trainee Research in Intensive Care Network. Consecutive adult patients (≥ 18 years) admitted with shock were followed up for 72 hours to ascertain whether they received an echocardiogram, the nature of any scan performed, and its effect on critical treatment decision making.
Results
1015 patients with undifferentiated shock were included. An echocardiogram was performed on 545 (54%) patients within 72 hours and 463 (43%) within 24 hours of admission. Most scans were performed by the critical care team (n = 314, 58%). Echocardiography was reported to either reduce diagnostic uncertainty or change management in 291 (54%) cases. Patients with obstructive, cardiogenic, or mixed shock had their management altered numerically more often by echocardiography (n = 15 [71%], n = 100 [58%] and n = 67 [58%]). 24% of echocardiograms performed adhered to current national information governance and image storage guidance.
Conclusion
Use of echocardiography in the assessment of patients with shock remains heterogenous. When echocardiography is used, it improves diagnostic certainty or changes management in most patients. Future research should explore barriers to increasing use of echocardiography in assessing patients presenting with shock.
Prediction and monitoring of adaptive radiation therapy timing using two-dimensional X-ray image-based water equivalent thickness
Authors: Hirotaki Kouta , Moriya Shunsuke , Tomizawa Kento , Wakabayashi Masashi , Motegi Atsushi , Ito Masashi , Sakae Takeji
Published: July 2024

Background
This study aimed to predict and monitor the optimal timing for implementing adaptive radiation therapy (ART) using two-dimensional X-ray image-based water equivalent thickness (2DWET).
Methods
The study included 40 patients with oropharyngeal and hypopharyngeal cancer who underwent CT rescanning during the treatment period. An adaptive score (AS) was proposed as a quantitative indicator to facilitate the decision regarding when to implement ART. The AS was derived from changes in four key dose indices: target coverage, spinal cord dose, parotid gland dose, and over-dose volume. Delivered dose distributions were reviewed by two oncologists specializing in head and neck radiation therapy, and the need for ART was evaluated using a four-point score. Logistic regression analysis was used to determine the AS cutoff value, and receiver operating characteristic analysis was used to assess 2DWET as a predictor of ART timing.
Results
The AS strongly correlated with the decisions made by the radiation oncologists, with Pearson correlation coefficients of 0.74 and 0.64. An AS cutoff value of 7.5 was identified as an indicator of the optimal time to implement ART, predicting two oncologists' decisions with sensitivities of 79.2% and 89.5% and specificities of 87.5% and 81.0%, respectively. The 2DWET method detected AS = 7.5 with a sensitivity of 63.2% and a specificity of 81.0%.
Conclusions
An adaptive score of 7.5 strongly correlated with the radiation oncologists' decision to implement ART and could therefore be used as a surrogate marker. Two-dimensional WET detected AS = 7.5 with high sensitivity and specificity and could potentially be used as a highly efficient and low-exposure tool for predicting and monitoring the optimal timing of ART implementation.
Application of Model-informed Drug Development (MIDD) in Regulatory Submissions for Drug Approval in Japan
Authors: Sasaki Tomohiro , Katsube Takayuki , Hayato Seiichi , Yamaguchi Shingo , Tanaka Jun , Yoshimatsu Hiroki , Nakanishi Yushi , Kitamura Atsushi , Watase Hirotaka , Suganami Hideki , Matsuoka Nobushige , Hasegawa Chihiro
Published: July 2024

Model-informed drug development (MIDD) is an approach to improve the efficiency of drug development. To promote awareness and application of MIDD in Japan, the Data Science Expert Committee of the Drug Evaluation Committee in the Japan Pharmaceutical Manufacturers Association established a task force, which surveyed MIDD applications for approved products in Japan. This study aimed to reveal the trends and challenges in the use of MIDD by analyzing the survey results.
A total of 322 cases approved in Japan between January 2020 and March 2022 as medical products were included in the survey. Modeling analysis was performed in approximately half of the cases (47.8% [154/322]) and formed a major basis for the selection or justification of dosage and administration in approximately one-fourth of the cases [24.2% (78/322)]. Modeling analysis/model-based dose selection was frequently conducted in cases involving monoclonal antibodies, first indication, orphan drugs, and multi-regional trials. Moreover, the survey results indicated that modeling analyses contributed to dose optimization throughout the developmental phases, including changing dose levels from phase II to phase III and dose adjustment in special populations. Japanese data were included in most cases in which modeling analysis was used for dosage selection. Thus, modelling analysis may also address ethnic factors introduced in the ICH E5 and/or E17 guidelines. In summary, this survey is useful for understanding the current status of MIDD use in Japan and for future drug development.
Directional dependence of dysregulated eating, weight stigma, and psychological distress among children with overweight or obesity: a gaussian graphical model and Bayesian network approach
Authors: Shen Guanghui , Zou Fan , Wang Mengting , Pan Hong , Jian Wenqian , Chen Li , Zou Yang
Published: July 2024

Background
Childhood obesity is a pressing global health concern, with its etiology involving complex interactions among dysregulated eating, weight stigma, and psychological distress. Elucidating the directional dependencies and potential causal pathways among these factors is crucial for intervention development.
Method
In this study, 572 obese or overweight children aged 10-17completed self-report measures assessing weight stigma, internalized stigma, dysregulated eating (restrained, emotional, and external eating), depression, social anxiety, and school bullying. Gaussian graphical models (GGMs) and Bayesian networks were used to investigate the intricate directional relationships among these variables.
Results
GGMs revealed weight stigma as the most central node in the network, exhibiting the highest strength and expected influence. Bayesian networks indicated that school bullying was a significant antecedent, directly influencing both weight stigma and depression. Weight stigma emerged as a crucial mediator, transmitting the effects of school bullying to internalized stigma, emotional eating, and psychological distress. Internalized stigma was the sole direct predictor of restrained eating. Depression, influenced by school bullying and internalized stigma, directly affected social anxiety.
Conclusion
This study emphasizes the importance of addressing weight stigma to alleviate dysregulated eating and psychological distress in obese or over weight children. The findings suggest the need for targeted interventions to combat weight stigma and its negative effects. Comprehending these complex directional dependencies offers a foundation for devising more effective strategies to tackle childhood obesity and related psychological comorbidities.
Use of a personalised early warning decision support system for acute exacerbations of chronic obstructive pulmonary disease: results of the ‘Predict & Prevent’ phase III trial
Authors: Gkini Eleni , Mehta Rajnikant L , Tearne Sarah , Doos Lucy , Jowett Sue , Gale Nicola , Turner Alice M
Published: July 2024

Rationale Gold standard treatment for chronic obstructive pulmonary disease (COPD) includes a supported self-management plan to enable patients to recognise and treat acute exacerbations (AECOPD). The Predict & Prevent trial was designed to provide a definitive randomised clinical trial of a personalised early warning decision support system, COPDPredictTM.
Methods Adults with ≥1 AECOPD or COPD admission were randomly assigned in a 1:1 ratio to use of a personalised early warning decision support system (COPDPredictTM) or standard self-management plans with rescue medication (RM) (control). The primary outcome was number of hospital admissions for AECOPD at 12 months post-randomisation (intention to treat). Quality of life and healthcare utilisation were also assessed.
Results 789 patients were screened, of whom 90 were enrolled. Hospital admissions due to AECOPD at 12 months were lower with COPDPredictTM: Incidence rate ratio (IRR) 0.64 (95% CI 0.19 to 2.17) albeit with insufficient evidence of a treatment effect (p=0.48). Exploratory Bayesian analysis and sensitivity analyses saw similar results. No significant differences were seen in inpatient days, visits to accident & emergency visits, and number of exacerbations. COPD Assessment Test (CAT) score benefits occurred at 3 and 6 months with COPDPredictTM (adjusted mean difference -3.8 points, 95% confidence interval (CI) -6.3 to -1.2, p=0.004 and -3.0 points, 95% CI -5.7 to -0.4, p=0.025 respectively) but was non-significant at longer periods (p>0.22), though this could be observed by chance as indicated by the time-point by treatment interaction (p=0.269). There was not enough evidence to indicate a statistically significant treatment effect on the other outcomes
Conclusions The quality of life data (CAT scores) suggests that 6 months usage of COPDPredictTM period may be helpful to patients, with benefits exceeding the minimum clinically difference throughout that time.
Trial registration: NCT04136418
Psychological Impact and Clinical Correlates of Olfactory Dysfunction in Post- COVID-19 and Non-COVID-19 Patients: A Comparative Study
Authors: Yoo Jae Hyun , Kim Tae-Suk , Kim Ji Sun , Lee Seung Hoon , Seo Min Young
Published: July 2024

Olfactory dysfunction (OD) has been reported in individuals who have recovered from COVID-19. Those with OD after COVID-19 (COVID-19 group) exhibited more severe psychiatric symptoms than those with OD from other etiologies (non-COVID-19 group). This study aimed to investigate the differences in psychological symptoms and related clinical factors between the two groups. Fifty-two participants (26 COVID-19 group; 26 non-COVID-19 group) were recruited. Both objective and subjective olfactory function were assessed. Symptoms of depression, anxiety, and perceived stress were measured using self-report scales. There were no significant differences in objective and subjective olfactory function or psychological symptoms between the groups, except for age and the short version of the Questionnaire of Olfactory Disorders-negative statements (sQOD-NS). The sQOD-NS score was negatively correlated with the duration of OD only in the COVID-19 group. Both groups showed significant correlations between the sQOD-NS and the Patient Health Questionnaire-9 (PHQ-9) scores. Mediation analysis showed that the duration of OD indirectly affected PHQ-9 scores via sQOD-NS in the entire sample and particularly in the COVID-19 group. The findings suggest that subjective distress from OD may mediate the relationship between duration of OD and depressive symptoms in COVID-19 patients, highlighting the need for targeted psychiatric interventions after COVID-19.
XPCS at elevated pressure and cryogenic temperatures: Multicomponent dynamics in amorphous ice
Authors: Amann-Winkel Katrin , Karina Aigerim , Li Hailong , Eklund Tobias , Ladd-Parada Marjorie , Massani Bernhard , Filianina Mariia , Kondedan Neha , Rydh Andreas , Holl Klara , Trevorah Ryan , Huotari Simo , Bauer Robert , Goy Claudia , Striker Nele , Dallari Francesco , Westermeier Fabian , Sprung Michael , Lehmkühler Felix
Published: July 2024

Knowing the pressure dependence of glass forming liquids is important in various contexts. Here, we study the case of supercooled water, which has at least two different amorphous states with different densities. The pressure dependencies of the two glass transitions are predicted to show opposite behaviour, crossing in the P-T plane at elevated pressure. While the experimental identification of the glass transition at elevated pressure and cold temperatures is technically difficult, measurements on bulk water and amorphous ices are even more challenging, as the glass transition is interrupted by crystallization. We show the feasibility of performing X-ray photon correlation spectroscopy (XPCS) experiments at elevated pressure using a diamond anvil cell (DAC) at cryogenic temperatures. We observe two dynamic components when approaching the glass transition temperature. For high-density amorphous ice at a pressure of around 0.08 GPa we determine the glass transition to be at higher temperatures compared to ambient conditions.
Social protection for homeless individuals with tuberculosis from the perspective of Brazil's street clinic teams
Authors: Pavinati Gabriel , de Lima Lucas Vinícius , Hino Paula , Fernandes Hugo , Marcon Sonia Silva , Magnabosco Gabriela Tavares
Published: July 2024

Background
The homeless population in Brazil faces significant challenges in accessing healthcare services, especially concerning tuberculosis. High rates of loss to follow-up and unsatisfactory outcomes in disease control indicators underscore the urgent need to improve healthcare for this vulnerable group through adapted social protection strategies. Therefore, the aim of this study is to understand how these strategies are perceived and utilized by professionals, considering the specific challenges faced by this vulnerable population.
Method
Online qualitative research was conducted with twenty-four healthcare professionals from eleven Brazilian states. The study utilized the theoretical and analytical framework of social determinants of health and employed content analysis supported by lexical diagnostics to examine participants' perceptions of social protection strategies in tuberculosis treatment among homeless individuals.
Results
Participants highlighted the critical importance of social protection strategies in improving treatment adherence and achieving tuberculosis cure, despite the obstacles faced. Fragmentation of healthcare services and social disparities in the daily lives of the homeless population emerged as significant barriers to accessing and effectively utilizing available social protection measures.
Conclusion
Informants emphasized the urgent need for more comprehensive public policies that not only aim to eliminate tuberculosis but also promote social reintegration of homeless individuals, ensuring their full access to fundamental rights. It was concluded that a holistic approach with greater equity, considering clinical, contextual, and structural aspects, is essential for effectively managing the health of this vulnerable population.
Giant Pit Craters in Scotia Sea, off Antarctica: A Modern Analog for Seafloor Gas Ejection from Intrusive Magma Hydrothermal Vent Complexes
Authors: Somoza Luis , Andreassen Karin Marie , Plaza-Faverola Andreia , Medialdea Teresa , Gafeira Joana , González Francisco Javier , Dickens Gerald
Published: July 2024

Massive injection of 13C depleted carbon to the ocean and atmosphere coincided with major environmental upheaval multiple times in the geological record. For several events, the source of carbon has been attributed to explosive venting of thermogenic gas produced when volcanic sills intrude organic-rich sediment. The concept mostly derives from studies of sedimentary basins with ancient hydrothermal vent complexes (HTVCs), because good examples younger than the Early Eocene were not known. We present geophysical data documenting at least 150 large (km-scale) craters on the modern seafloor across ~148,000 km2 of Scan Basin in the southern Scotia Sea, offshore Antarctica. Seismic and bathymetric information further reveals the craters relate to saucer-shaped igneous sills and vertical fluid pipes. Magmatic intrusions produce thermogenic gas, where buoyant hydrothermal fluids migrate upwards from sill flanks through V-shaped gas chimneys. Dome-shaped gas reservoirs develop, deforming overlying sediment and forming forced-folds. Fluid expulsions, driven by excess pore pressure, generate vertical conduits that cause blow-out collapses on the seafloor. Age estimates for crater formation come from correlations of seismic reflectors with bore hole data from recently drilled IODP Expedition 382. Based on this, we suggest a minimum age of 900 ka (Early Pleistocene) for the onset of magma intrusion and first formation of V-shaped craters on the flanks of sills. Subsequent crater reactivations have occurred since, perhaps episodically. Importantly, numerous craters related to sills and gas chimneys populate the seafloor above a sedimentary basin but this does not necessitate rapid and massive release of gas. A crucially important result is that this modern oceanic HTVCs system showing giant craters as present-day seafloor expression needs consideration when interpreting ancient HTVCs and gas expulsion from the seafloor.
Global Trends and Disease Burden of Falls from 1990 to 2021: A Comprehensive Analysis across Regions and Countries
Authors: Wang Xiaoqiong , Jiang Yongpo , Zhang Wenyuan , Zhao Weili , Xu Yinghe , Wang Nan
Published: July 2024

Background
Falls are a common health issue and a major source of physical injuries, imposing significant burdens on individuals, families, and societies. This study aims to analyze the trends and associated disease burden of falls globally, across 21 regions, and in 204 countries from 1990 to 2021.
Methods
Utilizing the standardized Global Burden of Disease (GBD) methodology, we employed epidemiological data on the incidence, mortality, and disability-adjusted life years (DALYs) of falls to represent the health burden caused by falls. We further stratified the data by different regions, countries, ages, and genders for detailed analysis.
Results
As of 2021, the age-standardized incidence (ASIR), mortality rate(ASMR), and disability-adjusted life years rate(ASDR) of falls globally showed a declining trend. The ASIR, ASMR and ASDR of falls increased with age. The incident cases, death cases, and DALYs of falls were higher in males than females in the 55–59, 76–79, and 66–69 age groups, but this trend reversed in older age groups. The ASIR, ASMR, and ASDR of falls globally show an overall declining trend. The trends of ASIR for falls in different Socio-Demographic Index (SDI) regions vary across periods, with a slight increase in ASIR in middle SDI regions. Additionally, the ASIR in high SDI regions is consistently the highest across periods, while the ASMR is higher in low SDI regions, and the ASDR is highest in low middle SDI regions. The ASIR, ASMR, and ASDR of falls in males globally are higher than those in females. From 1990 to 2021, the ASIR of falls shows a positive correlation with SDI overall, while the ASMR and ASDR show a negative correlation with SDI overall.
Conclusion
The study results indicate an improvement in the global burden of falls in 2021 compared to 1990. Various burden-related indicators such as ASIR, ASMR, and ASDR showed a decreasing trend. However, this decline was uneven across different regions and countries, with higher ASIR in high SDI regions and higher ASMR in low SDI regions. The incidence of falls is higher in the elderly, with higher incidence rates in elderly females compared to males. Future fall prevention efforts should focus on the incidence rates in high SDI regions and death rates in low SDI regions, especially among the elderly.
Sample thickness and edge proximity influence spatial behavior of filaments and treatment uniformity of RF cold atmospheric pressure plasma jet
Authors: Polášková Kateřina , Nečas David , Dostál Lukáš , Klíma Miloš , Zajíčková Lenka
Published: July 2024

The ability of atmospheric pressure plasma jets to treat complex non-planar surfaces is often cited as their advantage over other atmospheric plasmas. However, the effect of complex surfaces on plasma parameters and treatment efficiency has seldom been studied. Herein, we investigate the interaction of the atmospheric pressure plasma slit jet (PSJ) with block polypropylene samples of different thicknesses (5 and 30 mm) moving at two different speeds. Even though the distance between the slit outlet and the sample surface was kept constant, the treatment efficiency of PSJ ignited in the Ar and Ar/O2 gas feeds varied with the sample thickness due to the plasma parameters such as filament count and speed being affected by the different distances of the ground (the closer the ground is, the higher the discharge electric field). On the other hand, the Ar/N2 PSJ diffuse plasma plumes were less affected by the changes in the electric field, and the treatment efficiency was the same for both sample thicknesses. Additionally, we observed a difference in the efficiency and uniformity of the PSJ treatment of the edges and the central areas in some working conditions. The treatment efficiency near the edges depended on the duration of the filament contact, i.e., how long the local electric field trapped the filaments. Conversely, the treatment uniformity near the edges and in the central areas was different if the number of filaments changed rapidly as the discharge moved on and off the sample (the 5 mm samples treated by easily sustained Ar PSJ).
QoALa: a comprehensive workflow for viral quasispecies diversity comparison using long-read sequencing data
Authors: Pamornchainavakul Nakarin , Schroeder Declan , VanderWaal Kimberly
Published: July 2024

The concept of viral quasispecies refers to a constantly mutating viral population occurring within hosts, which is essential for grasping the micro-evolutionary patterns of viruses. Despite its high error rate, long-read sequencing holds potential for advancing viral quasispecies research by resolving coverage limitations in next-generation sequencing. We introduce a refined workflow, QoALa, implemented in the longreadvqs R package. This workflow begins with nucleotide position-wise noise minimization of read alignments and sample size standardization, and extends to viral quasispecies comparison across related samples. Raw read samples from five studies of different viruses (HCV, HBV, HIV, SARS-CoV-2, and IAV), sequenced by major long-read platforms, were used to evaluate these approaches. The comparative results provide novel insights into intra- and inter-host diversity dynamics in various scenarios and unveil rare haplotypes not reported in the original study, underscoring the versatility and practicality of our methodology.
Nanostructured Zinc Carbonate Hydroxide Microflakes: Assessing the Toxicity Against Erythrocytes and L929 Cells in Vitro
Authors: Prokopiuk Volodymyr , Onishchenko Anatolii , Pazura Yuliia , Bespalova Iryna , Kökbaş Umut , Tryfonyuk Liliya , Mateychenko Pavlo , Kot Kateryna , Kurmangaliyeva Saulesh , Kot Yurii , Yefimova Svitlana , Tkachenko Anton
Published: July 2024

Introduction.
Nanostructured materials have been suggested to be used as a source of dietary zinc for livestock animals. In this study, we assessed the cytotoxicity of newly synthesized nanostructured zinc carbonate hydroxide (ZnCH) Zn5(CO3)(OH)6 microflakes.
Materials and methods.
Cytotoxicity of the microflakes was assessed against murine L929 cell line and rat mature erythrocytes. MTT and neutral red uptake assays, scratch assay, Annexin V-FITC/7-aminoactinomycin D staining, 2',7'-dichlorodihydrofluorescein diacetate (H2DCFDA) staining, Fura 2-AM staining, staining for reactive nitrogen species (RNS), detection of caspases, and lipid order-sensitive NR12S probe staining were employed to evaluate cell viability, motility, cell death pathways, implication of Ca2+, reactive oxygen species (ROS) and RNS signaling, caspases, and alterations of cell membranes following exposure to the microflakes, respectively. To assess hemocompatibility of the Zn-containing microflakes, osmotic fragility assay and hemolysis assay were performed, as well as multiple eryptosis parameters were evaluated.
Results.
Our findings indicate a dose-response cytotoxicity of ZnCH microflakes against L929 cells with no toxicity observed for low concentrations (10 mg/L and below). At high concentrations, ZnCH microflakes promoted oxidative stress, Ca2+- and caspase-dependent apoptosis and altered lipid membranes. Surprisingly, toxicity to enucleated mature erythrocytes was found to be lower compared to L929 cells. ZnCH microflakes induced eryptosis associated with oxidative stress, Ca2+ signaling and recruitment of caspases. Eryptosis assays were found to be more sensitive than evaluation of hemolysis.
Conclusions.
Zn5(CO3)(OH)6 microflakes show no cytotoxicity at low concentrations indicating their potential as a source of zinc for livestock animals.
Take the care to the patient: Co-designed principles for establishment of a virtual hospital
Authors: Fisher Olivia J. , Moshi Belinda , McGrath Kelly , Barron Andrew , Kanagarajah Shanthi , Smith Ian , Smith Sue-Ellen , Martin Elizabeth , Cockshaw Wendell , Grogan Caroline
Published: July 2024

We aimed to inform design and implementation of a new Australian private virtual hospital by establishing co-designed principles and themes to inform a ten-year vision. This qualitative pre-implementation co-design study used an implementation science approach informed by the PERCS framework. Three workshops were held, one face-to-face in Brisbane, Australia, and two online. In each workshop, results of a prior barriers/enablers/considerations study were presented and critiqued by participants, followed by activities in focus groups. Thirty-six stakeholders from metropolitan, regional and rural areas participated including consumers, carers, health and aged care leadership, nurses, allied health providers, general practitioners, researchers, and public health stakeholders. There was strong enthusiasm, with some reservations such as clinical safety concerns. Four strong themes emerged: 1) Take the care to the patient; 2) Virtual is the mechanism, the care is real; 3) Be ambitious, but build a strong foundation; 4) Build the right workforce. These themes were repeated across all workshops, indicating good reliability of results. The strongest overall messages were the need for authentically patient-centred care and safety. Participants agreed that “safety first” underpinned all principles. Using an implementation science-informed, pre-implementation co-design approach led to stakeholder enthusiasm and findings which will inform implementation of the virtual hospital.
Case Report: a Novel Reconstruction Method (Itihaas’s Anastomosis) for Proximal Gastrectomy
Authors: Kumar Sah Birendra , Zhenjia Yu , Chen Li , Zhenggang Zhu
Published: July 2024

This study introduces a novel reconstruction method (Itihaas’s Anastomosis) for the upper gastrointestinal (UGI) tract following proximal gastrectomy, designed to mitigate the severity of acid reflux syndrome, a frequent postoperative complication. The procedure comprises three side-to-side anastomoses: esophago-gastrostomy, gastro-jejunostomy, and jejuno-jejunostomy. The esophago-gastrostomy anastomosis aims to prevent direct reflux of gastric contents into the esophagus by creating a fundus-like structure, which also facilitates future endoscopic procedures. The gastro-jejunostomy reduces acid reflux by diverting gastric acid to the jejunum for further neutralization, while the jejuno-jejunostomy prevents bile and pancreatic juice reflux into the stomach.
A 75-year-old male with adenocarcinoma of the upper stomach underwent this surgical procedure. Postoperative outcomes showed no major complications, with smooth oral contrast passage and no evidence of anastomotic leaks. The patient was discharged after resuming semi-solid food and experienced no signs of reflux. Itihaas’s Anastomosis appears promising in reducing acid reflux and improving postoperative quality of life for patients undergoing proximal gastrectomy, balancing natural anatomical and physiological preservation with reflux reduction, potentially offering a better alternative to other conventional anastomoses. Further studies are needed to validate these findings and compare long-term outcomes with existing techniques.
Insulin Resistance and Gestational Diabetes Mellitus in Pregnancy – a Tertiary Care Hospital Based Study
Authors: Nigam Prashant , Gupta Aradhana , Singh Himanshi , Sahu Piyu , Minj Pragya Shalini , Jain Swarna , Paul Srikrishna
Published: July 2024

Background- Pregnancy triggers numerous changes in metabolism, biochemistry, physiology, hematology, and immunity. Healthy pregnant women may develop resistance to insulin's effects on glucose absorption and utilization. The TG/HDL has been advocated as a simple clinical indicator of insulin resistance. The relationship between lipid profiles, insulin resistance and gestational diabetes mellitus (GDM) remains controversial.
Aim- This research seeks to investigate the relationship between the ratio of Triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) as a marker for Insulin resistance and the association of IR and GDM in pregnancy.
Materials and methods- The study included 1040 pregnant mothers selected randomly attending for routine antenatal checkup. The study participants were in the age group of 18-40 years. OGTT is performed in pregnant women by measuring the plasma glucose after 2 hours of fasting or non-fasting after ingesting 75 grams of glucose. A single value of ≥140 mg/dl is diagnostic for Gestational Diabetes Mellitus according to Technical and operational guidelines of diagnosis and management of GDM by MOHFW, Govt of India. Lipid parameters and IR was also looked for.
Results- OGTT, IR, TC, TG, VLDL was found to be significantly elevated among GDM mothers. GDM and IR was found to increase as maternal age increases. OGTT has been found to be significantly positively correlated to IR. Also TC was found to be significantly correlated to LDL.
Conclusion- A positive correlation between total cholesterol, and insulin resistance shows that as cholesterol levels rise, insulin resistance also increases, elevating the risk of GDM. These correlations are crucial for understanding the metabolic health implications in pregnant women. It is concluded that due to alterations in lipid parameters, insulin resistance in pregnant women increases which causes a significant impact on Gestational Diabetes Mellitus.