bluuebunny/crossref_metadata_2025 huggingface dataset:
Acceptance and results of cryoablation for the treatment of early breast cancer in non-surgical patients
Authors: Graña-López Lucía L , Abelairas-López Laura L , Fernández-Sobrado Ignacio I , Verea-Varela Sabela S , Villares-Armas Ángeles A
Published: July 2024

Objectives

Evaluate acceptance of percutaneous cryoablation (PCA) treatment by patients with early breast cancer (BC) who choose not to have surgery and present our experience in the use of PCA for the local control of BC in this group of patients.

Methods

All biopsy-proven early BC diagnosed in our institution as non-surgical patients between January 2020 and December 2023 were retrospectively reviewed. We recorded if PCA was offered and if it was accepted by the patient. PCA was performed under ultrasound (US) guidance, using a liquid nitrogen-based system. Mammography and US or contrast-enhanced mammography follow-up was scheduled every 6 months for 5 years. Patient’s tolerance to the procedure, adverse effects, and results regarding local control of the disease were assessed.

Results

A total of 66 early BC were diagnosed in 63 patients who decided not to have surgery. Median age was 88 years (range 60-99 years). Forty-three (95.6%) of the 45 patients offered PCA accepted. Thirty-nine malignant tumours (median size 24 mm) underwent PCA. All cases were previously reviewed in a multidisciplinary tumour board. Complete tumour necrosis was achieved in 81.3% of the cases followed for ≥ 6 months. After a median follow-up of 16 months, the complete ablation rate in Luminal BC ≤ 25 mm was 100%. No major complications were seen.

Conclusions

Non-surgical patients with early BC accepted PCA when the treatment was offered. PCA is safe, effective, and well-tolerated outpatient procedure. The study outcomes suggest that PCA could be an alternative to surgery for the management of BC in this group of patients.

Advances in knowledge

Patients with early BC who choose not to have surgery accept PCA. This percutaneous approach probably allows local control of early BC, mainly in ≤25 mm Luminal tumours.
Cutaneous plasmacytosis treated with tocilizumab
Authors: Daftary Karishma , Figueredo Zamora Eliana , Malone Janine , Callen Jeffrey P
Published: July 2024

Cutaneous plasmacytosis (CP) is a rare disorder of unknown aetiology characterized by the proliferation of mature plasma cells in the skin and polyclonal hypergammaglobulinaemia. CP is associated with elevated IL-6. Anti-IL-6 therapy has not been reported as a treatment for idiopathic CP. We present the case of a woman with idiopathic CP who was treated successfully with tocilizumab, a monoclonal anti-IL-6 receptor antibody. The patient experienced improvement in cutaneous lesions and subjective symptoms after 2 months on tocilizumab.
Identification of neurotransmitter imbalances in the cingulate cortex of NMOSD patients using magnetic resonance spectroscopy
Authors: Zhao Min , Li Xiao , Li Fuyan , Hu Xin , Wang Jing , Liu Yuxi , Zhang Chuanchen , Bai Jie , Edden Richard A E , Gao Fei , Su Meixia , Ren Fuxin
Published: July 2024

Cognitive impairment affects 29–67% of patients with neuromyelitis optica spectrum disorder. Previous studies have reported glutamate homeostasis disruptions in astrocytes, leading to imbalances in gamma-aminobutyric acid levels. However, the association between these neurotransmitter changes and cognitive deficits remains inadequately elucidated. Point RESolved Spectroscopy and Hadamard Encoding and Reconstruction of MEGA-Edited Spectroscopy techniques were utilized to evaluate gamma-aminobutyric acid, glutamate, glutathione levels, and excitation/inhibition balance in the anterior cingulate cortex, posterior cingulate cortex, and occipital cortex of 39 neuromyelitis optica spectrum disorder patients and 41 healthy controls. Cognitive function was assessed using neurocognitive scales. Results showed decreased gamma-aminobutyric acid levels alongside increased glutamate, glutathione, and excitation/inhibition ratio in the anterior cingulate cortex and posterior cingulate cortex of neuromyelitis optica spectrum disorder patients. Specifically, within the posterior cingulate cortex of neuromyelitis optica spectrum disorder patients, decreased gamma-aminobutyric acid levels and increased excitation/inhibition ratio correlated significantly with anxiety scores, whereas glutathione levels predicted diminished executive function. The results suggest that neuromyelitis optica spectrum disorder patients exhibit dysregulation in the GABAergic and glutamatergic systems in their brains, where the excitation/inhibition imbalance potentially acts as a neuronal metabolic factor contributing to emotional disorders. Additionally, glutathione levels in the posterior cingulate cortex region may serve as predictors of cognitive decline, highlighting the potential benefits of reducing oxidative stress to safeguard cognitive function in neuromyelitis optica spectrum disorder patients.
Changes in functional connectivity and structural covariance between the fronto-parietal network and medial orbitofrontal cortex are associated with disinhibition in restrained eaters
Authors: Wang Shaorui , Han Jinfeng , Xiao Mingyue , Shi Pan , Chen Hong
Published: July 2024

Disinhibition, characterized by a loss of dietary control, is a significant risk factor for diet failure and the onset of eating disorders in restrained eaters. This study employs resting-state functional connectivity and structural covariance network analyses to explore the neural associations underlying this behavior. By analyzing functional MRI data from 63 female college students, we found that increased disinhibition correlates with enhanced functional connectivity between the medial orbitofrontal cortex and key components of the inhibition system, particularly within the fronto-parietal network. Moreover, we observed a relationship between the structural covariance of the medial orbitofrontal cortex and the inferior parietal lobule and the severity of disinhibition. Importantly, the functional connectivity between the medial orbitofrontal cortex and the inferior parietal lobule predicts the severity of binge eating symptoms in these individuals. These findings indicate that imbalances in the interaction between the brain’s reward and inhibition systems can lead to dietary failures and eating disorders, emphasizing the need for targeted interventions.
Saline suppression testing-induced hypocalcemia and implications for clinical interpretations
Authors: Parksook Wasita W , Brown Jenifer M , Milks Julia , Tsai Laura C , Chan Justin , Moore Anna , Niebuhr Yvonne , Honzel Brooke , Newman Andrew J , Vaidya Anand
Published: July 2024

Background

Extracellular calcium critically regulates physiologic aldosterone production. Moreover, abnormal calcium flux and signaling are involved in the pathogenesis of the majority of primary aldosteronism cases.

Methods

We investigated the influence of the saline suppression test (SST) on calcium homeostasis in prospectively recruited participants (n = 86).

Results

During SST, 100% of participants had decreases in serum calcium, with 48% developing frank hypocalcemia. Serum calcium declined from 2.30 ± 0.08 mmol/L to 2.13 ± 0.08 mmol/L (P < .001) with parallel increases in parathyroid hormone from 6.06 ± 2.39 pmol/L to 8.13 ± 2.42 pmol/L (P < .001). In contrast, serum potassium and bicarbonate did not change, whereas eGFR increased and serum glucose decreased (P < .001). Lower body surface area (translating to greater effective circulating volume expansion during SST) was associated with greater reductions in (β = .33, P = .001), and absolutely lower, serum calcium levels (β = .25, P = .001). When evaluating clinically-relevant diagnostic thresholds, participants with post-SST aldosterone levels <138 pmol/L had lower post-SST calcium and 25-hydroxyvitamin D levels (P < .05), and higher post-SST parathyroid hormone levels (P < .05) compared with those with post-SST aldosterone levels >277 pmol/L.

Conclusion

SST uniformly decreases serum calcium, which is likely to be due to the combination of variable dilution, increased renal clearance, and vitamin D status. These acute reductions in bioavailable calcium are associated with lower post-SST aldosterone. Given the critical role of extracellular calcium in regulating aldosterone production, these findings warrant renewed inquiry into the validity of SST interpretations for excluding primary aldosteronism.
Legal-Conflict Constellations. A Political Approach to the ‘Labour Rights-Human Rights’ Debate
Authors: Lobato Julieta
Published: July 2024

The shift towards human rights is a cornerstone of contemporary labour law scholarship. However, the debate primarily follows a naturalistic approach, heavily reliant on an orthodox account of human rights as universal moral claims for all individuals. This article challenges this approach, arguing that it frames the debate in an antagonistic and compartmentalized manner, where the two legal domains are seen as distinct and homogeneous. By adopting a political approach, the article proposes framing the interactions between these legal realms through the notion of legal-conflict constellations, wherein labour-capital conflicts manifest as specific social problems that may be addressed, wholly or partially, through rights discourse. These legal-conflict constellations are built around three interconnected processes: politicization, recentring class and the formation of productive resistance alliances. The article makes the following contributions. First, it situates the debate within the broader context of the reshaping of labour law under neoliberalism. Second, it sheds light on the prevailing naturalistic approach and its shortcomings. Third, it proposes a political approach to the debate, advancing a framework to explore the intricate links between these legal fields.
Energy Security, Climate Change, and Routines as Maladaptive Politics
Authors: Heinrichs Pauline Sophie
Published: July 2024

Energy transitions suffer from a central political challenge. Future costs of the energy transition are directly linked to investments in mitigation and adaptation measures today, yet governments continue to underinvest in decarbonization policies and are far from meeting legally binding targets. While interdisciplinary explanations trace multiple motives behind inaction, I argue that climate inaction must be embedded in political mechanisms that sustain it. Routines are one such mechanism. Building on literatures of temporality, normative change in international politics, critical energy security studies, and routines, I argue that moments of crises have so far not been transformative in the context of climate and energy security because of how actors construct the politics of crises temporally. The temporal construction of crisis engenders a selective reading of the timescales that are perceived to matter, which in turn gives way to reproducing dominant routines that have historically been thought to secure against crises. Such routines, however, no longer secure outcomes against crises; they reproduce the very cause of climate change, namely the dependence on fossil fuels. I illustrate the explanatory mechanism between crises and routines through a case study of Germany’s energy security response to the Russian invasion of Ukraine.
Cell motility empowers bacterial contact weapons
Authors: Booth Sean C , Meacock Oliver J , Foster Kevin R
Published: July 2024

Many bacteria kill competitors using short-range weapons, such as the Type VI secretion system and contact dependent inhibition (CDI). Although these weapons can deliver powerful toxins, they rely on direct contact between attacker and target cells. We hypothesized that movement enables attackers to contact more targets and thus greatly empower their weapons. To explore this, we developed individual-based and continuum models of contact-dependent combat which show that motility greatly improves toxin delivery through two underlying processes. First, genotypic mixing increases the inter-strain contact probability of attacker and sensitive cells. Second, target switching ensures attackers constantly attack new cells, instead of repeatedly hitting the same cell. We test our predictions with the pathogen Pseudomonas aeruginosa, using genetically engineered strains to study the interaction between CDI and twitching motility. As predicted, we find that motility works synergistically with CDI, in some cases increasing weapon efficacy up to 10,000-fold compared with non-motile scenarios. Moreover, we demonstrate that both mixing processes occur using timelapse single-cell microscopy and quantify their relative importance by combining experimental data with our model. Our work shows how bacteria can combine cell movement with contact-based weapons to launch powerful attacks on their competitors.
Unpacking Legitimacy Perceptions of Investment Dispute Settlement: Effects of Outcome and Procedure
Authors: Dotzauer Marius
Published: July 2024

How do citizens perceive different avenues for resolving investor–state disputes in case of an unfavorable decision? In this article, I argue that the interplay between procedure- and outcome-related considerations influences citizens’ legitimacy beliefs toward investor-state dispute settlement (ISDS) systems. First, an unfavorable ISDS ruling should decrease public legitimacy beliefs in the country that got sued. Second, the type of dispute settlement mechanism should influence legitimacy beliefs, leading to different assessments of the legal proceedings. I fielded a survey experiment in France, Germany, and the United States to test these theoretical expectations. The findings confirm that an unfavorable ISDS ruling has a strong negative effect on public perceptions of the legal proceeding, but further show that appropriate design choices can boost public legitimacy beliefs. These results have important implications for the debate about ISDS reform and the scholarship on legitimacy in global governance. The impact of unfavorable decisions on public legitimacy beliefs has been widely overlooked.
Designing (restorative) remedies for abuses of dominance by online platforms
Authors: Mandrescu Daniel
Published: July 2024

The debate surrounding the application of European Union competition law to online platforms so far has predominantly focused on identifying anti-competitive practices. The design of corresponding remedies has been far less explored, although it is of equal importance to practice. In the absence of effective remedies, the mere identification of anti-competitive practices can do little to protect competition. Given the difficulties associated with identifying competition law infringements by online platforms, there is no reason to assume that the design of remedies intended to tackle the effects of such infringements will be straightforward. Therefore, this article aims to show the intricacies of designing effective remedies for Article 102 TFEU infringements by online platforms based on the case study of tying and bundling practices. In this process, the article clarifies the importance of incorporating restorative measures in competition law remedies that may require opting for structural interventions, which are difficult to impose under the scope of Regulation 1/2003. The article offers three potential options to overcome such difficulties within the ambit of this regulation, namely through the strategic use of interim measures, the introduction of flexible remedies, and the incorporation of the regulatory restraints of the Digital Markets Act.
Bhakti, Equality, and Power: Temple Potters and Sacred Food (Mahaprasada) in Orissa
Authors: Chakrabarti Upal
Published: July 2024

This article analyses the relationship between Bhakti, power, and equality in South Asia, by studying the meanings of Mahaprasada, or the sacred food of the Jagannatha temple in Orissa, as represented in nineteenth-century European and Indian texts. The article further juxtaposes these textual meanings with the social practices of the low-caste potters of the temple who make the vessels where the sacred food is prepared. Despite missionary condemnations of the idolatry of the Jagannatha cult and administrative attacks on the cult’s rituals and practices, Mahaprasada was paradoxically celebrated by these same texts as embodying the potential of destroying caste hierarchies. The article critically examines such colonial framings of Mahaprasada, by bringing them into conversation with the community cosmologies, economic practices, and political strategies of the temple potters. The article argues that the potters’ entanglements with the temple revealed complex contingencies in the ways in which Mahaprasada determined relations of caste and market. As a low-caste, yet ritually significant, group instrumental in the making of Mahaprasada, the temple potters participated in a market of the sacred food, where ritual and economic values merged, and were shaped by other power relations of the temple. In matters of caste, the potters both upheld and challenged caste distinctions by both their ritual roles and heterogeneous sectarian inheritances. Put together, I examine how paradoxical subtleties of colonial constructions of Bhakti were defied by the economically complex and religiously multiple worlds of marginal communities.
A High-Quality Genome Assembly for Aureobasidium pullulans CG163, the Active Ingredient in Aureo Gold, a Bio-Bactericide Registered for Control of Bacterial Canker of Kiwifruit Caused by Pseudomonas syringae pv. actinidiae Biovar 3
Authors: de Jong Huub , Arshed Saadiah , Yu Janet , Cornish Deirdre , Vanneste Joel L. , Reglinski Tony , Elmer Philip A. G. , Templeton Matthew D.
Published: July 2024

Aureobasidium pullulans (de Bary) Arnaud (isolate CG163) is a recently commercialized biocontrol agent for the control of Pseudomonas syringae pv. actinidiae (Psa) on kiwifruit ( Actinidia spp.). A long-read nanopore assembly, polished with Illumina short reads, resulted in a telomere-to-telomere assembly of CG163. The completed genome has 12 chromosomes ranging from 0.9 to 4.6 Mb and a circular mitogenome of 37.5 kb. A second A. pullulans isolate, which did not inhibit Psa on Actinidia chinensis ‘Hayward’ potted plants (isolate HRY276), was also assembled from long reads for this study. Comparative genomic studies were performed between CG163 and HRY276 (both isolated in New Zealand) and the complete sequence of Aureobasidium pullulans isolate NBB 7.2.1 from Switzerland. There was extensive synteny between the respective chromosomes of all three isolates. The exception was chromosome 12 from CG163, which was not present in the other isolates and may be a dispensable mini chromosome. Mining of the genome of CG163 identified a variety of potential antimicrobial hydrolytic enzymes and secondary metabolite biosynthesis genes that may contribute to the ability of this isolate to suppress Psa on kiwifruit tissues. A complete highly accurate chromosome-scale assembly of CG163’s reference genome will be a valuable resource for future studies investigating the basic underlying molecular genetic mechanisms involved in the biocontrol of Psa, or other plant pathogens, by different isolates of A. pullulans.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Gene expression analysis identifies hub genes and pathways distinguishing fatal from survivor outcomes of Ebola virus disease
Authors: Mensah‐Bonsu Melvin , Doss Christopher , Gloster Clay , Muganda Perpetua
Published: July 2024

The Ebola virus poses a severe public health threat, yet understanding factors influencing disease outcomes remains incomplete. Our study aimed to identify critical pathways and hub genes associated with fatal and survivor Ebola disease outcomes. We analyzed differentially expressed hub genes (DEGs) between groups with fatal and survival outcomes, as well as a healthy control group. We conducted additional analysis to determine the functions and pathways associated with these DEGs. We found 13,198 DEGs in the fatal and 12,039 DEGs in the survival group compared to healthy controls, and 1873 DEGs in the acute fatal and survivor groups comparison. Upregulated DEGs in the comparison between the acute fatal and survivor groups were linked to ECM receptor interaction, complement and coagulation cascades, and PI3K‐Akt signaling. Upregulated hub genes identified from the acute fatal and survivor comparison (FGB, C1QA, SERPINF2, PLAT, C9, SERPINE1, F3, VWF) were enriched in complement and coagulation cascades; the downregulated hub genes (IL1B, 1L17RE, XCL1, CXCL6, CCL4, CD8A, CD8B, CD3D) were associated with immune cell processes. Hub genes CCL2 and F2 were unique to fatal outcomes, while CXCL1, HIST1H4F, and IL1A were upregulated hub genes unique to survival outcomes compared to healthy controls. Our results demonstrate for the first time the association of EVD outcomes to specific hub genes and their associated pathways and biological processes. The identified hub genes and pathways could help better elucidate Ebola disease pathogenesis and contribute to the development of targeted interventions and personalized treatment for distinct EVD outcomes.
Looking Back to Advance Equity in Psychiatric Nursing: Strategies for the Classroom and for Practice
Authors: Pfeiffer Katherine , Starks Shaquita , Kumar Aparna , Wofsy Avi , Johnson Kalisha Bonds , Smith Kylie
Published: July 2024

With deep historical roots in psychiatry, structural racism persists in psychiatric nursing today. Psychiatric nurses may hold implicit biases and stereotypical beliefs that influence how they perceive, assess, and interact with people from different racial backgrounds, leading to discrimination, poor treatment, and misdiagnosis. To eliminate discrimination in clinical care and diversify the workforce, there is an urgent need to integrate teaching and learning strategies that address influences of racism and racial identity in psychiatric nursing education. This article explores the historical context and proposes antiracist psychiatric nursing teaching and practice interventions to reduce the harms of racism.
A Post-COVID Population-Based Analysis of Mohs Micrographic Surgeon Distribution in the United States
Authors: Olsen Eric C. , Proffer Sydney L. , Donnelly Heidi B.
Published: July 2024

BACKGROUND

Policy changes to Mohs micrographic surgery board certification eligibility and population shifts in the wake of the COVID-19 pandemic have significant implications for the accessibility of Mohs micrographic surgeons across the United States.

OBJECTIVE

To examine the geographic distribution of micrographic surgery providers considering recent population trends and assess the impact of certification eligibility changes and population shifts on accessibility.

METHODS AND MATERIALS

Medicare claims data were utilized to identify micrographic surgery providers. Surgeon densities were calculated per 100,000 people by county and state. Population changes were analyzed using US census data.

RESULTS

Practicing micrographic surgeons were concentrated in metropolitan and nonmetropolitan areas. Overall, 80.4% of counties lacked micrographic surgery providers, with rural areas being the most underserved. Population changes varied among states.

CONCLUSION

Shifts in micrographic surgery certification requirements, US population distribution, and micrographic surgeon location emphasize challenges in accessibility, especially in rural areas across the United States.
The effect of progressive muscle relaxation exercises on postmenopausal sleep quality and fatigue: a single-blind randomized controlled study
Authors: Sucu Cansu , Çitil Elif Tuğçe
Published: July 2024

Objective

This single-blind, randomized controlled study aimed to determine the effect of progressive muscle relaxation exercises on sleep quality and fatigue in the postmenopausal period. Progressive muscle relaxation aims to relax the muscles in the body and includes breathing techniques.

Methods

This study was carried out between January 2022 and July 2022 with 63 postmenopausal women who applied to a district state hospital and had poor sleep quality. The women assigned to the experimental group (EG) (n = 31) applied progressive muscle relaxation exercises every day for 8 weeks. In contrast, the women in the control group (CG) (n = 32) continued their routine coping habits related to sleep problems and fatigue in the postmenopausal period. The EG and CG were reevaluated using the Piper Fatigue Scale and the Pittsburg Sleep Quality Index in the fourth and eighth weeks. The women applied progressive muscle relaxation exercises with a guide prepared by the researchers and the compact disc of the Turkish Psychologists Association. In the data analysis, the independent-samples t test, Fisher's exact test, and χ2 test were used to compare individual, obstetric, and medical characteristics between the groups. The difference between dependent groups at different times was evaluated by repeated-measures analysis of variance.

Results

There was an improvement in fatigue symptoms in the progressive muscle relaxation exercises-performing EG at the end of 8 weeks compared with the CG, and fatigue symptoms increased in the CG (P < 0.001). There was a greater improvement in the sleep quality of the progressive muscle relaxation exercises-performing EG at the end of 8 weeks compared with the CG (P < 0.001).

Conclusions

In our study, it was determined that progressive muscle relaxation exercises had an improving effect on sleep quality and fatigue.
Occupational Factors Associated With Burnout Among a Sample of 9-1-1 Public Safety Telecommunicators in Washington State
Authors: Meischke Hendrika , Lu Dave W. , Hatton Karl , Seixas Noah S. , Baker Marissa G. , Monsey Lily
Published: July 2024

Introduction

This study aimed to investigate occupational factors associated with burnout among a sample of 9-1-1 public safety telecommunicators (PSTs).

Methods

An online survey measuring organizational factors (ie, perceived visibility and inclusion in the agency, respectful culture, leadership support, perceived gratitude, and coworker conflict); job characteristics (ie, work-life integration, overtime, salary satisfaction, and job meaningfulness); and burnout, demographic, and call center characteristics was emailed to a sample of PSTs.

Analysis

Descriptive, bivariate, and multiple linear regression analyses were used to characterize the sample and investigate relationships among variables.

Results

PSTs (N = 324) completed the survey. Multivariate analysis showed that poor work-life integration and coworker conflict were associated with greater PST burnout, while job meaningfulness and perceptions of greater visibility and inclusion were linked to decreased levels of burnout

Conclusion

Occupational factors were associated with burnout among PSTs.
Assessing the inclusion of women of color in lichen sclerosus treatment studies: a scoping review
Authors: Evans Jessica C. , Ezenwa Ekene A. , Akinshemoyin Vaughn Olushola L.
Published: July 2024

Background:

Vulvar lichen sclerosus (VLS) is an underrecognized chronic inflammatory skin condition with significant clinical features and potential for malignant transformation. To date, there are no studies comparing the course of this disease in women of color to other racial groups.

Objective:

The objective of this study was to provide a scoping review examining racial demographic data in VLS treatment studies and specifically assessing for the inclusion of women of color.

Methods:

Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a primary literature search was conducted using 4 databases: Ovid Medline(R), Scopus, Cochrane, and Web of Science from all years to December 2022. We included published studies with adult women diagnosed with VLS and containing a treatment arm using topical corticosteroids. Single case reports, literature reviews, systemic reviews, meta-analyses, and reports not available in English were excluded.

Results:

Overall, 1340 nonduplicate studies were assessed for eligibility criteria. In total, 65 publications were included. Only 6 included racial demographic data. Black women made up at most 3.8% of the sample population and Latinx women made up at most 5.7%.

Limitations:

Our review focused on a specific intervention (ie, the use of topical corticosteroids for the treatment of VLS), which may restrict the generalizability of our findings to other interventions. No risk of bias assessment was done due to the scoping nature of the review.

Conclusion:

Women of color are underrepresented in studies of topical corticosteroid use in adult women with VLS. Intentional diversity in recruitment will enable the collection of data that is both more accurate and reflective of a broader spectrum of perspectives and life experiences.
The Use of Synthetic, Nonabsorbable Graft for Middle Fossa Repair in Patients With Spontaneous Cerebrospinal Fluid Leak: A Pilot, Prospective Study
Authors: Wales Rachel , Chakravarty Daragh , Gilmour Ethan , Kontorinis Georgios
Published: July 2024

Objective

To evaluate the efficacy of a nonabsorbable, synthetic graft for the reconstruction of spontaneous middle fossa (sMF) cerebrospinal fluid (CSF) leaks.

Patients

Six adult patients (age ≥16 yr) who had sMF CSF leaks surgically repaired within an 18-month period at a single university hospital using synthetic, nonbiological, nonabsorbable graft (Neuro-Patch) and a retrospective control group of five patients undergoing multilayer MF repair with autologous grafts.

Intervention(s)

MF repair through a combined transmastoid/MF approach using Neuro-Patch or multilayer autologous grafts.

Main Outcome Measure(s)

The incidence of postoperative leak within 6 months postoperatively was the main outcome measure; we also recorded the need for lumbar drain, additional hearing loss, length of inpatient stay, body mass index, previous meningitis, preoperative increased intracranial pressure, and age.

Results

In the Neuro-Patch group, there was no postoperative CSF leak without the need for lumbar drain. We observed no additional hearing loss; patients were monitored for 2 days without any readmissions. Increased intracranial pressure (four of six), previous episodes of meningitis (two of six) or obesity (five of six) did not affect patient outcomes. Demographic and prognostic factors were the same for the control group. However, one patient needed lumbar drain postoperatively because of residual leak; lumbar drain was used in one more case (two of five cases), whereas three of five patients had to stay for longer than 2 days (5 d).

Conclusions

Our pilot study suggests the use of Neuro-Patch via combined transmastoid/MF approach as an effective technique with minimum, if any morbidity; it could be of particular benefit for patients with larger MF dura defects. A larger number of patients are required to strengthen the evidence.
The Implantation and Transmission of Plague Culture by the Five Plague Gods in Shuilu Murals
Authors: YI Bao , ZHOU Qian , SHI Honglei
Published: July 2024

The Five Plague Immortals (五瘟神) in Shuilu murals in Ming and Qing dynasties is a kind of plague immortal image developed under the pedigree of Taoist immortals. As an important expel disaster immortal system in Shuilu, the modeling of Five plague Immortals shows a combination of human beings and livestocks. This shape, to a large extent, draws on the image of Nuo (儺). which is also an imagination of the host of plague pathogens. In terms of the quantities of immortals, it aligns with the conceptual framework of Wu Xing (五行the five elements), a foundational principle in traditional Chinese medicine. The internal connection of this culture reflects the means of plague preventions and controls in China, as well as the external reflection of plague culture. Through multi-dimensional interpretations with the double proof method, this article dissects the formation, core elements, and cultural characteristics of the beliefs in the Five Plague Immortals reflected in the Shuilu murals, and moves beyond from simplistic visual semantics.
Risk Factors of Acute Pancreatitis in Young Adults
Authors: Park Namyoung , Lee Jae Min , Park Jin Myung , Lee Sang Hyub , Han Kyung-Do , Joo Kwang Ro , Ryu Ji Kon , Kim Yong-Tae
Published: July 2024

Objectives

This study aimed to identify the risk factors for acute pancreatitis (AP) in young adults in their 20s based on data from the nationwide cohort in South Korea.

Materials and Methods

From the 2009 national health examination database of South Korea, a total of 471,098 individuals between the ages of 20 and 29 were analyzed. To identify the newly developed AP, the linked claims database was used.

Results

The incidence rates of AP were 18.8 and 9.8 per 100,000 person-years in male and female participants, respectively. Alcohol consumption and smoking were associated with the heightened risk of AP. The risk of AP development was increased as daily alcohol consumption increased. In addition, ex-smokers and current smokers showed higher AP risk than never smokers. Hypertriglyceridemia and obesity were associated with the increased AP risk as well. Compared with female participants, male participants showed a higher risk of AP in univariate analysis but showed a lower risk of AP in multivariate analysis.

Conclusions

In the young adult population, alcohol consumption, smoking, hypertriglyceridemia, and obesity were associated with an elevated risk of developing AP. It is important to identify and manage the modifiable AP risk factors in young adults to minimize the socioeconomic burden of AP.
Evidence-Based Practice Quality Improvement Critical Appraisal Tool
Authors: Waldrop Julee Briscoe , Dunlap Jayne Jennings , Reynolds Staci S.
Published: July 2024

Background:

Optimal quality improvement in health care is based on research and other types of evidence. Critical appraisal of evidence is a fundamental component of evidence-based practice (EBP) and is also needed to evaluate the quality of quality improvement (QI) projects.

Problem:

Currently available EBP or QI critical appraisal tools can be challenging for students learning the critical appraisal process and for practicing clinicians who desire access to a standardized EBPQI approach to inform health care decision-making. The currently available tools are incomplete, too brief, or too complicated for ease of use in education and practice.

Approach:

This article introduces the first combined EBP and QI (EBPQI) critical appraisal tool, which is aligned with the new EBPQI mountain model.

Conclusion:

This newly developed appraisal tool may be used in appraising evidence for an EBPQI initiative and to appraise the quality of disseminated EBPQI.
Does Delivery Format Matter? A Pilot Study Comparing Telehealth Versus Face-to-Face Movement Interventions for Children With Autism Spectrum Disorder
Authors: Su Wan-Chun , Cleffi Corina , Srinivasan Sudha , Bhat Anjana Narayan
Published: July 2024

Purpose:

Children with Autism Spectrum Disorder (ASD) have motor, social communication, and behavioral challenges. During the pandemic, children lost access to face-to-face (F2F) services and had to revert to telehealth (TH) options. We compared the efficacy, fidelity, acceptability, and feasibility of a general motor (GM) intervention using an F2F or telehealth (TH) format.

Methods:

Fifteen children with ASD participated in an 8-week program involving gross motor games to promote motor and social communication skills. Differences across TH and F2F formats for motor and socially directed verbalization as well as stakeholder feedback on formats were collected.

Results:

Gross motor and socially directed verbalization did not differ between the F2F and TH subgroups, and parents and trainers were satisfied with either format. However, TH interventions were longer, had more technological challenges, and required more parental effort.

Conclusions:

The findings of this study support the use of TH as a comparable and viable substitute for F2F interactions for children with ASD.
Strategic Workforce Analysis: Identifying Skills and Gaps Among Frontline Public Health Workers Amidst Transformation
Authors: Karnik Harshada , Zemmel Danielle J. , Kulik Phoebe K. G. , Power Laura E. , Leider Jonathon P.
Published: July 2024

Objective:

Recent shifts in public health (PH) include consistent budget cuts, workforce attrition, and loss of vital skills and institutional knowledge followed by heightened pandemic-driven attention, new responsibilities, and renewed funding. This study investigates whether frontline employees working in different types of public health departments have different educational characteristics and whether these characteristics are associated with differentials in skill gaps toward informing targeted interventions to nurture a competitive workforce.

Methods:

Utilizing 2021 Public Health Workforce Interests and Needs Survey (PH WINS) data, we document variations in educational qualifications, skill gaps, and workforce characteristics among frontline workers in different sizes of health departments and examine attributes associated with skill gaps: level and field of education, years of experience, program areas, and job classifications using a negative binomial model.

Results:

Skill gaps in resource management, systems and strategic thinking, and change management persist across all local health departments (LHDs), but the extent of these gaps is greater in small LHDs. Small LHDs also have few employees with graduate and public health degrees. Additionally, whereas public health degrees were not associated with fewer skill gaps, tenure in public health was, suggesting people learn on the job.

Conclusion:

The results highlight the role regional training centers can play in emphasizing the need for strategic skills and foundational public health concepts, as well as customizing training content by agency size and educational levels to improve accessibility, particularly for small LHDs with resource constraints.
Using Discourse Structure Analysis to Understand Communication Profiles of Members With Severe and Mild Aphasia in Facilitated Conversation Groups
Authors: Gulick Eleanor , Archer Brent , Leaman Marion C.
Published: July 2024

To support improved understanding of interaction among the heterogeneous people with aphasia who attend facilitated conversation groups we applied discourse structure analysis (DSA). We focused on group members with mild and severe aphasia. We identified the function of each communicative move, an utterance unit core to DSA, individuals made in conversation. We described the communication profiles of group members with mild and severe aphasia and analyzed the interactive patterns surrounding their contributions. The mild group demonstrated higher average percentages across each speech function and greater variability in their communication profiles. While they enacted communicative autonomy, the severe group used direct and indirect communication supports in the majority of their communication. Given these findings and prior research, we suggest a few ways that facilitators can interact to supporting members with severe aphasia. We also suggest continued work focused on support members with mild aphasia.
Demographic Trends in Liver Transplant Survivors After 3 Decades of Program Implementation: The Impact of Cohort and Period Effects on Life Expectancy
Authors: Romero-Cristóbal Mario , Díaz-Fontenla Fernando , Fernández-Yunquera Ainhoa , Caballero-Marcos Aranzazu , Conthe Andrés , Velasco Enrique , Pérez-Peña José , López-Baena José-Ángel , Rincón Diego , Bañares Rafael , Salcedo Magdalena
Published: July 2024

Background.

Demographic analyses may reveal current patterns of change in the outcomes of rapidly developing medical procedures because they incorporate the period perspective.

Methods.

We analyzed the changes in size, age structure, and hospitalizations in the population of liver transplantation (LT) survivors in our center during the last 30 y (n = 1114 patients) and generated projections, including life expectancy (LE), considering cohort and period effects. Life tables were used to project the complete LE (overall 1990–2020 experience), the cohort LE (according to the decade of surgery: 1990–2000, 2000–2010, and 2010–2020), and the period LE (current 2015–2020 experience).

Results.

The population of LT recipients in follow-up continued to experience progressive growth and aging since 1990 (492 patients [41.9% >65 y] in 2020), and the magnitude of these phenomena may double in the next 30 y. However, the number of admissions and days of admission has been decreasing. The complete LE at LT was 12.4 y, whereas the period LE was 15.8 y. The cohort LE (limited to 10 y) was 5.3, 6.3, and 7.3 y for the 1990–2000, 2000–2010, and 2010–2020 cohorts, respectively.

Conclusions.

The target population of our medical care after LT is growing and aging. The prevalence of both of these phenomena is expected to increase in the coming years and is associated with a current improvement in LE. However, the hospitalization burden associated with LT survivors is declining. The period effect should be considered for generating up-to-date information on these current trends, which are crucial when designing health policies for LT survivors.
Cortical Thickness Correlates of Go/No-go and Motor Sequencing in Mild Cognitive Impairment and Suspected Alzheimer Disease Dementia
Authors: Keith Cierra M. , Lindberg Katharine E. , Wilhelmsen Kirk , Mehta Rashi I. , Vieira Ligo Teixeira Camila , Miller Mark , Ward Melanie , Navia R. Osvaldo , McCuddy William T. , Miller Liv , Bryant Kirk , Coleman Michelle , D’Haese Pierre-François , Haut Marc W.
Published: July 2024

Background:

While the cognitive hallmark of typical Alzheimer’s disease (AD) is impaired memory consolidation, increasing evidence suggests that the frontal lobes and associated executive functions are also impacted.

Objective:

We examined two neurobehavioral executive function tasks and associations with cortical thickness in patients diagnosed with mild cognitive impairment (MCI), suspected AD dementia, and a healthy control group.

Methods:

First, we compared group performances on a go/no-go (GNG) task and on Luria’s Fist-Edge-Palm (FEP) motor sequencing task. We then examined correlations between neurobehavioral task performance and the thickness of frontal cortical regions, AD signature regions, broader unbiased brain regions, and white matter hyperintensities (WMH).

Results:

Participants with MCI performed worse than healthy controls, but better than participants with suspected AD dementia on both tasks. Both GNG and FEP (to a slightly greater extent) tasks showed diffuse associations with most AD signature regions and multiple additional regions within the temporal, parietal, and occipital cortices. Similarly, both tasks showed significant associations with all other cognitive tasks examined. Of the frontal regions examined, only the middle frontal gyrus and pars opercularis were associated with performance on these tasks. Interactions between the precuneus and transtemporal gyri were most predictive of GNG task performance, while the interaction between superior temporal and lingual gyri was most predictive of FEP task performance.

Conclusion:

This study replicates difficulties with both GNG and FEP tasks in participants with MCI and AD dementia. Both tasks showed widespread associations with the cortical thickness of various brain structures rather than localizing to frontal regions, consistent with the diffuse nature of AD.
Broadband surface wave manipulation by periodic barriers in unsaturated soil
Authors: Wu Liangliang , Shi Zhifei
Published: July 2024

Periodic wave barriers have been widely used to manipulate elastic waves propagating in saturated and single-phase soil due to their attenuation zone properties. However, it is difficult to promote application of periodic barriers in unsaturated soils due to their complex constitutive relationship. In this study, manipulation of surface waves by periodic in-filled trench barriers in unsaturated soil has been studied based on the periodic theory. The dispersion relations of a periodic structure for surface waves in unsaturated soil are determined. The attenuation mechanism of evanescent surface waves is revealed. Next, the effects of several key parameters of unsaturated soil on the attenuation zones of the periodic in-filled trench barriers are comprehensively discussed. It is found that in a particular range for material parameter, the surface waves are attenuated over the entire frequency range due to the viscosity of fluid. Finally, a periodic in-filled trench barrier is designed according to a field test of ground vibration induced by a train, and its performances in mitigating surface waves propagating in unsaturated and saturated soils are conducted and compared by conducting analysis in time domain. This investigation provides a new insight for manipulating surface waves by periodic barriers.

This article is part of the theme issue ‘Current developments in elastic and acoustic metamaterials science (Part 1)’.
Guiding near-source elastic waves in a semi-infinite medium
Authors: Cui Kemeng , Xu Zhao-Dong , Palermo Antonio , Marzani Alessandro , Pu Xingbo
Published: July 2024

In this work, we propose elastic metamaterials with phase discontinuities to steer the propagation of near-source bulk waves in a semi-infinite elastic medium. Our design exploits an array of embedded subwavelength resonators with tailored masses to attain a complete phase shift spanning

0
−
2
π

. This phase control allows for diverse wave functionalities, such as directional refraction and energy focusing. Through the use of dispersion diagrams and the generalized Snell’s law, along with a multiple scattering formulation, we analytically demonstrate the effectiveness of our design in achieving the desired wavefront manipulation. The proposed design has the potential to advance the field of guiding elastic waves using metamaterials and find practical applications in areas such as isolating ground-borne vibrations in densely urbanized regions and energy harvesting.

This article is part of the theme issue ‘Current developments in elastic and acoustic metamaterials science (Part 1)’.
Staphylococcus aureus biofilm: the role in disseminating antimicrobial resistance over the meat chain
Authors: Silva-de-Jesus Ana Carolina , Ferrari Rafaela Gomes , Panzenhagen Pedro , Conte-Junior Carlos Adam
Published: July 2024

Staphylococcus aureus

is responsible for severe skin and respiratory infections and food poisoning, resulting in hospitalizations and high morbidity worldwide. Staphylococci have extensive virulence mechanisms and antimicrobial resistance that pose a global challenge to contain the spread of infectious outbreaks. Antimicrobials are used as growth promoters, and for prevention and treatment of infections in animals that provide us with food. The improvement of animal health is undeniable, but the selection of multidrug-resistant strains that can spread resistance genes among microorganisms is undesirable. The administration of sublethal doses of antimicrobials in farm animals causes stress to Staphylococci inducing the formation of a complex extracellular polymeric structure called biofilm. Such a structure may favor the persistence of infection by disseminating antimicrobial-resistant strains that can be consumed in contaminated food of animal origin. In ruminant mastitis and hospitals, the potential of the biofilm structure in the persistence of infections, especially those caused by

S. aureus

, has already been demonstrated, as well as its role as a source of resistant genes. In the meat production chain, the potential for persistent contamination by biofilm structure is evidently a worrying health risk . This review brings together studies demonstrating that biofilm production facilitates the exchange of mobile genetic elements and random mutations in

S. aureus

strains within the structure. This contributes to the emergence of more resistant clonal complexes and, with biofilm support, persists in the meat production chain.