bluuebunny/crossref_metadata_2025 huggingface dataset:
The 2023 US National Seismic Hazard Model: Ground-motion characterization for the conterminous United States
Authors: Moschetti Morgan P , Aagaard Brad T , Ahdi Sean K , Altekruse Jason , Boyd Oliver S , Frankel Arthur D , Herrick Julie , Petersen Mark D , Powers Peter M , Rezaeian Sanaz , Shumway Allison M , Smith James A , Stephenson William J , Thompson Eric M , Withers Kyle B
Published: February 2024

We update the ground-motion characterization for the 2023 National Seismic Hazard Model (NSHM) for the conterminous United States. The update includes the use of new ground-motion models (GMMs) in the Cascadia subduction zone; an adjustment to the central and eastern United States (CEUS) GMMs to reduce misfits with observed data; an updated boundary for the application of GMMs for shallow, crustal earthquakes in active tectonic regions (i.e. western United States (WUS)) and stable continental regions (i.e. CEUS); and the use of improved models for the site response of deep sedimentary basins in the WUS and CEUS. Site response updates include basin models for the California Great Valley and for the Portland and Tualatin basins, Oregon, as well as long-period basin effects from three-dimensional simulations in the Greater Los Angeles region and in the Seattle basin; in the CEUS, we introduce a broadband (0.01- to 10-s period) amplification model for the effects of the passive-margin basins of the Atlantic and Gulf Coastal Plains. In addition, we summarize progress on implementing rupture directivity models into seismic hazard models, although they are not incorporated in the 2023 NSHM. We implement the ground-motion characterization for the 2023 NSHM in the US Geological Survey’s code for probabilistic seismic hazard analysis, nshmp-haz-v2, and present the sensitivity of hazard to these changes. Hazard calculations indicate widespread effects from adjustments to the CEUS GMMs, from the incorporation of Coastal Plain amplification effects, and from the treatment of shallow-basin and out-of-basin sites in the San Francisco Bay Area and Los Angeles region, as well as locally important changes from subduction-zone GMMs, and from updated and new WUS basins.
Introduction to a How I Treat series on hematologic complications in pregnancy
Authors: Ortel Thomas L.
Published: February 2024

Edited by Associate Editor Thomas Ortel, this How I Treat series on hematologic complications of pregnancy uses illustrative cases to discuss the management of thrombocytopenia, antiphospholipid syndrome, sickle cell disease, and myeloid proliferative neoplasms in the setting of pregnancy.
Severe asthma care trajectories: the French RAMSES cohort
Authors: Perotin Jeanne-Marie , Gauquelin Lisa , Just Nicolas , Devouassoux Gilles , Chenivesse Cécile , Bourdin Arnaud , Garcia Gilles , Saint Raymond Christel , Boudjemaa Amel , Bonniaud Philippe , Chanez Pascal , Barnig Cindy , Beurnier Antoine , Maurer Cyril , Freymond Nathalie , Didi Toufik , Tcherakian Colas , Russier Maud , Drucbert Mélanie , Guillo Sylvie , Estellat Candice , Taillé Camille
Published: February 2024

Background

The French RAMSES study is an observational prospective multicentre real-life cohort including severe asthmatic subjects. The objective of the study was to compare the characteristics of patients, in terms of phenotype and asthma care trajectories, between those managed by tertiary referral centres (TRCs) or secondary care centres (SCCs).

Methods

Patients were prospectively recruited and enrolled for a 5-year follow-up. Patients’ characteristics were analysed at inclusion and compared between TRCs and SCCs.

Results

52 centres (24 TRCs and 28 SCCs) included 2046 patients: 1502 (73.4%) were included by a TRC and 544 (26.6%) by a SCC. Patients were mainly women (62%), 53±15 years old, 67% with Asthma Control Test <20; at inclusion, 14% received oral corticosteroids (OCS) and 66% biologics. Compared with the SCC group, the TRC group had more frequent comorbidities and lower blood eosinophil counts (262versus340 mm−3; p=0.0036). OCS and biologics use did not differ between groups, but patients in the TRC group benefited more frequently from an educational programme (26%versus18%; p=0.0008) and received more frequently two or more sequential lines of biologics (33%versus24%; p=0.0105). In-depth investigations were more frequently performed in the TRC group (allergy tests: 74%versus62%; p<0.0001; exhaled nitric oxide fraction: 56%versus21%; p<0.0001; induced sputum: 6%versus3%; p=0.0390).

Conclusions

Phenotypes and care trajectories differed in the RAMSES cohort between SCCs and TRCs, probably related to different levels of asthma severity and differences in medical resources and practices among centres. This highlights the need for standardisation of severe asthma care.
Cluster analysis identifies novel real-world lung disease�pulmonary hypertension subphenotypes: implications for treatment response
Authors: Johnson Shelsey W. , Wang Rui-Sheng , Winter Michael R. , Gillmeyer Kari R. , Zeder Katarina , Klings Elizabeth S. , Goldstein Ronald H. , Wiener Renda Soylemez , Maron Bradley A.
Published: February 2024

Background

Clinical trials repurposing pulmonary arterial hypertension (PAH) therapies to patients with lung disease- or hypoxia-pulmonary hypertension (PH) (classified as World Health Organization Group 3 PH) have failed to show a consistent benefit. However, Group 3 PH clinical heterogeneity suggests robust phenotyping may inform detection of treatment-responsive subgroups. We hypothesised that cluster analysis would identify subphenotypes with differential responses to oral PAH therapy.

Methods

Two k-means analyses were performed on a national cohort of US veterans with Group 3 PH; an inclusive model (I) of all treated patients (n=196) and a haemodynamic model (H) limited to patients with right heart catheterisations (n=112). The primary outcome was organ failure or all-cause mortality by cluster. An exploratory analysis evaluated within-cluster treatment effects.

Results

Three distinct clusters of Group 3 PH patients were identified. In the inclusive model (C1
I
n=43, 21.9%; C2
I
n=102, 52.0%; C3
I
n=51, 26.0%), lung disease and spirometry drove cluster assignment. By contrast, in the haemodynamic model (C1
H
n=44, 39.3%; C2
H
n=43, 38.4%; C3
H
n=25, 22.3%), right heart catheterisation data surpassed the importance of lung disease and spirometry. In the haemodynamic model, compared to C3
H
, C1
H
experienced the greatest hazard for respiratory failure or death (HR 6.1, 95% CI 3.2�11.8). In an exploratory analysis, cluster determined treatment response (p=0.006). Conclusions regarding within-cluster treatment responses were limited by significant differences between select variables in the treated and untreated groups.

Conclusions

Cluster analysis identifies novel real-world subphenotypes of Group 3 PH patients with distinct clinical trajectories. Future studies may consider this methodological approach to identify subgroups of heterogeneous patients that may be responsive to existing pulmonary vasodilatory therapies.
Overcoming genetic and cellular complexity to study the pathophysiology of X-linked intellectual disabilities
Authors: Martinez Dayne , Jiang Evan , Zhou Zhaolan
Published: February 2024

X-linked genetic causes of intellectual disability (ID) account for a substantial proportion of cases and remain poorly understood, in part due to the heterogeneous expression of X-linked genes in females. This is because most genes on the X chromosome are subject to random X chromosome inactivation (XCI) during early embryonic development, which results in a mosaic pattern of gene expression for a given X-linked mutant allele. This mosaic expression produces substantial complexity, especially when attempting to study the already complicated neural circuits that underly behavior, thus impeding the understanding of disease-related pathophysiology and the development of therapeutics. Here, we review a few selected X-linked forms of ID that predominantly affect heterozygous females and the current obstacles for developing effective therapies for such disorders. We also propose a genetic strategy to overcome the complexity presented by mosaicism in heterozygous females and highlight specific tools for studying synaptic and circuit mechanisms, many of which could be shared across multiple forms of intellectual disability.
Characterization of indigenous populations of cannabis in Iran: a morphological and phenological study
Authors: Babaei Mehdi , Nemati Hossein , Arouiee Hossein , Torkamaneh Davoud
Published: February 2024

Background

Cannabis is a historically, culturally, and economically significant crop in human societies, owing to its versatile applications in both industry and medicine. Over many years, native cannabis populations have acclimated to the various environments found throughout Iran, resulting in rich genetic and phenotypic diversity. Examining phenotypic diversity within and between indigenous populations is crucial for effective plant breeding programs. This study aimed to classify indigenous cannabis populations in Iran to meet the needs of breeders and breeding programs in developing new cultivars.

Results

Here, we assessed phenotypic diversity in 25 indigenous populations based on 12 phenological and 14 morphological traits in male and female plants. The extent of heritability for each parameter was estimated in both genders, and relationships between quantitative and time-based traits were explored. Principal component analysis (PCA) identified traits influencing population distinctions. Overall, populations were broadly classified into early, medium, and late flowering groups. The highest extent of heritability of phenological traits was found in Start Flower Formation Time in Individuals (SFFI) for females (0.91) Flowering Time 50% in Individuals (50% of bracts formed) (FT50I) for males (0.98). Populations IR7385 and IR2845 exhibited the highest commercial index (60%). Among male plants, the highest extent of Relative Growth Rate (RGR) was observed in the IR2845 population (0.122 g.g− 1.day− 1). Finally, populations were clustered into seven groups according to the morphological traits in female and male plants.

Conclusions

Overall, significant phenotypic diversity was observed among indigenous populations, emphasizing the potential for various applications. Early-flowering populations, with their high RGR and Harvest Index (HI), were found as promising options for inclusion in breeding programs. The findings provide valuable insights into harnessing the genetic diversity of indigenous cannabis for diverse purposes.
Quality of life in young patients with acute type a aortic dissection in China: comparison with Marfan syndrome and non-Marfan syndrome
Authors: Lin Xin-fan , Xie Lin-feng , Zhang Zhao-feng , He Jian , Xie Yu-ling , Dai Xiao-fu , Chen Liang-wan
Published: February 2024

Background

There is a paucity of Chinese studies evaluating the quality of life (QoL) in young acute type A aortic dissection (AAAD) patients with Marfan syndrome.

Methods

Young adult AAAD patients (younger than 45 years old) underwent surgical treatment at our institution from January 2017 to December 2020 were consecutive enrolled. The hospital survivors completed 1 year of follow up. Patients were divided into two groups according to the presence or absence of Marfan syndrome (MFS). A 1:1 propensity score matching (PSM) with a caliper 0.2 was conducted to balance potential bias in baseline. The follow-up data were analyzed primarily for change in quality of life and anxiety status.

Results

After PSM, 32 comparable pairs were matched. The baseline data were comparable and postoperative complications were similar between groups. In terms of SF-36 scale, the role physical, bodily pain, role emotional and mental health subscales were no significantly improved in MFS patients over time. At 1 year after discharged, the subscale of mental health and bodily pain were significantly lower in the MFS group than in the non-MFS group. In terms of HADS assessments, the level of anxiety in MFS patients was significantly higher than in non-MFS patients at 1 year after discharged.

Conclusions

The QoL in young AAAD patients with MFS is lower than those without MFS after surgery. This may be associated with the uncontrollable persistent chronic pain and the uncertainty and concerns for the disease’s progression.
Consequences of heterogeneity in aging: parental age at death predicts midlife all-cause mortality and hospitalization in a Swedish national birth cohort
Authors: Thalén Anna , Ledberg Anders
Published: February 2024

Background

The processes that underlie aging may advance at different rates in different individuals and an advanced biological age, relative to the chronological age, is associated with increased risk of disease and death. Here we set out to quantify the extent to which heterogeneous aging shapes health outcomes in midlife by following a Swedish birth-cohort and using parental age at death as a proxy for biological age in the offspring.

Methods

We followed a nationwide Swedish birth cohort (N = 89,688) between the ages of 39 and 66 years with respect to hospitalizations and death. Cox regressions were used to quantify the association, in the offspring, between parental age at death and all-cause mortality, as well as hospitalization for conditions belonging to the 10 most common ICD-10 chapters.

Results

Longer parental lifespan was consistently associated with reduced risks of hospitalization and all-cause mortality. Differences in risk were mostly evident from before the age of 50 and persisted throughout the follow-up. Each additional decade of parental survival decreased the risk of offspring all-cause mortality by 22% and risks of hospitalizations by 9 to 20% across the 10 diseases categories considered. The number of deaths and hospitalizations attributable to having parents not living until old age were 1500 (22%) and 11,000 (11%) respectively.

Conclusions

Our findings highlight that increased parental lifespan is consistently associated with health benefits in the offspring across multiple outcomes and suggests that heterogeneous aging processes have clinical implications already in midlife.
Quality control and external quality assessment for the independent clinic-based evaluation of point-of-care testing to detect Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis in eight countries
Authors: Shephard Mark , Matthews Susan , Andrewartha Kelly , Dimech Wayne , Cabuang Liza , Barbara Christopher , Chen Xiang-Sheng , Cordioli Maddalena , Hançali Amina , Jiang Ting-Ting , Kularatne Ranmini , Meli Stephanie , Muller Etienne , Oumzil Hicham , Padovese Valeska , Sandri Angela , Vargas Silver , Zahra Graziella , Unemo Magnus , Blondeel Karel , Toskin Igor
Published: February 2024

Background

Sexually transmitted infections caused by Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) remain significant global health problems. The World Health Organization (WHO) has recently conducted a multi-faceted, multi-country validation study (ProSPeRo), which included an evaluation of the Xpert CT/NG and Xpert TV assays on the GeneXpert system (Cepheid, Sunnyvale, Ca., USA) in clinic-based settings across eight countries. To support the study, a training and quality management system was implemented and evaluated.

Methods

A comprehensive training program for the study was developed. Quality control (QC) and external quality assessment (EQA) samples were provided by an accredited quality assurance provider. QC testing was conducted at 14 point-of-care testing (POCT) clinics, while EQA samples were tested by the POCT sites and a reference laboratory supporting each clinic.

Results

For QC testing, concordance with the expected results for CT and NG was > 99% and rates of unsuccessful tests were < 4%. For TV testing, concordance was similar (97%), but rates of unsuccessful tests were high (18%), particularly in the ‘TV negative’ sample. For EQA testing initially conducted in 2018, concordance was 100% for CT and NG, and 90% for TV for the reference laboratory group (which used non-GeneXpert systems). Concordance for the POCT group was also high (> 94%) for all analytes, but this cohort (which used GeneXpert systems) exhibited a high rate of unsuccessful TV tests. All but one of these unsuccessful tests was subcategorised as ‘invalid’.

Conclusions

The high level of concordance for QC and EQA testing confirm that the trained operators at the POC clinical sites were competent to conduct POC testing and that the training and quality systems implemented for the ProSPeRo study were effective. The quality materials used were satisfactory for CT and NG but exhibited poor performance for TV testing on the GeneXpert system. The WHO should continue to work with industry and EQA providers to provide improved materials that are reliable, stable and cost effective for quality management, as it seeks to rollout molecular-based STI POCT in non-laboratory-based settings.

Trial registration

Ethics approval to conduct the ProSPeRo study was granted by the WHO Ethics Review Committee.
Gaps and inconsistencies in the current knowledge and implementation of biosafety and biosecurity practices for rickettsial pathogens
Authors: Blacksell Stuart D. , Le Khanh Kim , Rungrojn Artharee , Wongsantichon Jantana , Stenos John , Graves Stephen R. , Day Nicholas P.J.
Published: February 2024

Introduction

Rickettsia spp. and Orientia spp. are the causes of neglected infections that can lead to severe febrile and systemic illnesses in humans. Implementing proper biosafety practices when handling these pathogens is crucial to ensure a safe and sustainable work environment. It is essential to assess the current knowledge and identify any potential gaps to develop effective measures that minimise the risk of exposure to these pathogens. By doing so, we can establish a comprehensive framework that promotes safety, mitigates hazards, and safeguards the well-being of personnel and the surrounding community.

Methods and results

This review aimed to synthesise and determine the evidence base for biosafety precautions for Rickettsia spp. and Orientia spp. pathogens. Enhancing our understanding of the relative infectious risk associated with different strains of Rickettsia and Orientia spp. requires identifying the infectious dose of these pathogens that can cause human disease. The application of risk groups for Rickettsia and Orientia spp. is inconsistent across jurisdictions. There is also incomplete evidence regarding decontamination methods for these pathogens. With regards to Orientia spp. most of the available information is derived from experiments conducted with Rickettsia spp.

Conclusions

Rickettsia and Orientia spp. are neglected diseases, as demonstrated by the lack of evidence-based and specific biosafety information about these pathogens. In the case of Orientia spp., most of the available information is derived from Rickettsia spp., which may not be appropriate and overstate the risks of working with this pathogen. The advent of effective antibiotic therapy and a better understanding of the true hazards and risks associated with pathogen manipulation should inform decisions, allowing a sustainable and safe work environment.
Prevalence and adverse outcomes of twin pregnancy in Eastern Africa: a systematic review and meta-analysis
Authors: Getachew Tamirat , Negash Abraham , Debella Adera , Yadeta Elias , Lemi Magersa , Balis Bikila , Balcha Tegenu , Bekele Habtamu , Abdurke Mohammed , Alemu Addisu , Shiferaw Kasiye , Eyeberu Addis
Published: February 2024

Introduction

Multiple pregnancies are much more common today than they were in the past. Twin pregnancies occur in about 4% of pregnancies in Africa. Adverse pregnancy outcome was more common in twin pregnancy than in singleton pregnancy. There is no pooled evidence on the burden and adverse pregnancy outcome of twin pregnancy in eastern Africa. Thus, this systematic review and meta-analysis were conducted to assess the prevalence and adverse pregnancy outcomes of twin pregnancies.

Methods

This systematic review and meta-analysis covers published and unpublished studies searched from different databases (PubMed, CINAHL (EBSCO), EMBASE, DOAJ, Web of Sciences, MEDLINE, Cochrane Library, SCOPUS, Google Scholar, and Google search). Finally, 34 studies were included in this systematic review and meta-analysis. JBI checklist was used to assess the quality of included papers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Data synthesis and statistical analysis were conducted using STATA Version 14 software. Heterogeneity and publication bias were assessed. A forest plot was used to present the pooled prevalence using the random effect model.

Results

The prevalence of twin pregnancy in eastern Africa was 3% [95% CI: 2, 3]. The adverse pregnancy outcomes like neonatal intensive care unit admission (78%), low birth weight (44%), low APGAR score (33%), prematurity (32%), stillbirth (30%), neonatal mortality (12%) and maternal complications like hypertensive disorder of pregnancy (25%), postpartum hemorrhage (7%), Cesarean section (37%), premature rupture of membrane (12%) and maternal mortality are more common among twin pregnancy than singleton pregnancy.

Conclusion

One in every 33 children born a twin in east Africa; admission to neonatal intensive care unit, low birth weight, low APGAR score, prematurity, stillbirth, neonatal mortality and maternal complications are its associated adverse birth outcomes. Since twin pregnancy is a high-risk pregnancy, special care is needed during pregnancy, labor and delivery to reduce adverse pregnancy outcomes.
Experienced disrespect & abuse during childbirth and associated birth characteristics: a cross-sectional survey in the Netherlands
Authors: Leijerzapf Denise R. , van der Pijl Marit S. G. , Hollander Martine H. , Kingma Elselijn , de Jonge Ank , Verhoeven Corine J. M.
Published: February 2024

Background

Experiencing upsetting disrespect and abuse (D&A) during labour and birth negatively affects women’s birth experiences. Knowing in what circumstances of birth women experience upsetting situations of D&A can create general awareness and help healthcare providers judge the need for extra attention in their care to help reduce these experiences. However, little is known about how different birth characteristics relate to the experience of D&A. Previous studies showed differences in birth experiences and experienced D&A between primiparous and multiparous women. This study explores, stratified for parity, (1) how often D&A are experienced in the Netherlands and are considered upsetting, and (2) which birth characteristics are associated with these upsetting experiences of D&A.

Methods

For this cross-sectional study, an online questionnaire was set up and disseminated among women over 16 years of age who gave birth in the Netherlands between 2015 and 2020. D&A was divided into seven categories: emotional pressure, unfriendly behaviour/verbal abuse, use of force/physical violence, communication issues, lack of support, lack of consent and discrimination. Stratified for parity, univariable and multivariable logistic regression analyses were performed to examine which birth characteristics were associated with the upsetting experiences of different categories of D&A.

Results

Of all 11,520 women included in this study, 45.1% of primiparous and 27.0% of multiparous women reported at least one upsetting experience of D&A. Lack of consent was reported most frequently, followed by communication issues. For both primiparous and multiparous women, especially transfer from midwife-led to obstetrician-led care, giving birth in a hospital, assisted vaginal birth, and unplanned cesarean section were important factors that increased the odds of experiencing upsetting situations of D&A. Among primiparous women, the use of medical pain relief was also associated with upsetting experiences of D&A.

Conclusion

A significant number of women experience upsetting disrespectful and abusive care during birth, particularly when medical interventions are needed after the onset of labour, when care is transferred during birth, and when birth takes place in a hospital. This study emphasizes the need for improving quality of verbal and non-verbal communication, support and adequate decision-making and consent procedures, especially before, during, and after the situations of birth that are associated with D&A.
Factors influencing necrotizing enterocolitis in premature infants in China: a systematic review and meta-analysis
Authors: Zhao Shuliang , Jiang Huimin , Miao Yiqun , Liu Wenwen , Li Yanan , Liu Hui , Wang Aihua , Cui Xinghui , Zhang Yuanyuan
Published: February 2024

Background

Necrotizing enterocolitis (NEC) is a multifactorial gastrointestinal disease with high morbidity and mortality among premature infants. However, studies with large samples on the factors of NEC in China have not been reported. This meta-analysis aims to systematically review the literature to explore the influencing factors of necrotizing enterocolitis in premature infants in China and provide a reference for the prevention of NEC.

Methods

PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM), Wanfang and VIP databases were systematically searched from inception to February 2023. We used Stata14.0 software to perform the systematic review and meta-analysis. We used fixed or random effects models with combined odds ratios (ORs) and 95% confidence intervals (CIs), and quality was evaluated using the Newcastle‒Ottawa Scale (NOS).

Results

The total sample was 8616 cases, including 2456 cases in the intervention group and 6160 cases in the control group. It was found that 16 risk factors and 3 protective factors were related to necrotizing enterocolitis in premature infants. Septicemia (OR = 3.91), blood transfusion (OR = 2.41), neonatal asphyxia (OR = 2.46), pneumonia (OR = 6.17), infection (OR = 5.99), congenital heart disease (OR = 4.80), intrahepatic cholestasis of pregnancy (ICP) (OR = 2.71), mechanical ventilation (OR = 1.44), gestational diabetes mellitus (GDM) (OR = 3.08), respiratory distress syndrome (RDS) (OR = 3.28), hypoalbuminemia (OR = 2.80), patent ductus arteriosus (PDA) (OR = 3.10), respiratory failure (OR = 7.51), severe anemia (OR = 2.86), history of antibiotic use (OR = 2.12), and meconium-stained amniotic fluid (MSAF) (OR = 3.14) were risk factors for NEC in preterm infants in China. Breastfeeding (OR = 0.31), oral probiotics (OR = 0.36), and prenatal use of glucocorticoids (OR = 0.38) were protective factors for NEC in preterm infants.

Conclusions

Septicemia, blood transfusion, neonatal asphyxia, pneumonia, infection, congenital heart disease, ICP, GDM, RDS, hypoproteinemia, PDA, respiratory failure, severe anemia, history of antibiotic use and MSAF will increase the risk of NEC in premature infants, whereas breastfeeding, oral probiotics and prenatal use of glucocorticoids reduce the risk. Due to the quantity and quality of the included literature, the above findings need to be further validated by more high-quality studies.
Predictors of mental health among U.S. adults during COVID-19 early pandemic, mid- pandemic, and post-vaccine eras
Authors: Ramezani Niloofar , Taylor Bruce G. , Balawajder Elizabeth Flanagan , MacLean Kai , Pollack Harold A. , Schneider John A. , Taxman Faye S.
Published: February 2024

Background

A collective trauma like COVID-19 impacts individuals differently due to socio-contextual and individual characteristics. Younger adults, minorities, affiliates of certain political parties, and residents of some regions of the United States reported experiencing poorer mental health during the pandemic. Being diagnosed with COVID-19, or losing a friend/family to it, was related to more adverse mental health symptoms. While the negative impact of COVID-19 on health outcomes has been studied, mental health changes during this pandemic need further exploration.

Methods

In a study of 8,612 U.S. households, using three surveys collected from a nationally representative panel between May 2020 and October 2021, using a repeated cross-sectional design, a linear mixed effect regression model was performed to investigate factors associated with the mental health status, based on the Mental Health Inventory-5, of individuals throughout different phases of the COVID-19 pandemic, and whether an improvement over time, especially after vaccines became available, was observed.

Results

An overall improvement in mental health was observed after vaccines became available. Individuals with no COVID-related death in their household, those not wearing masks, those identifying as members of the Republican Party, race/ethnicities other than Asian, men, older adults, and residents of the South were less likely than others to report mental health challenges.

Conclusions

Our results highlight the need for widespread mental health interventions and health promotion to address challenges during the COVID-19 pandemic and beyond. Due to the worse mental health observed among Asians, younger adults, women, low-income families, those with a higher level of concern for COVID-19, people who lost someone to COVID-19, and/or individuals with histories of opioid use disorder and criminal legal involvement, over the period of this study, targeted attention needs to be given to the mental health of these groups.
Exploring patient perspectives on EQ-5D-5L data visualization within an individualized decision aid for total knee arthroplasty (TKA) in Alberta, Canada
Authors: Johnson Jeffrey A. , Itiola Ademola , Rahman Shakib , Smith Christopher , Soprovich Allison , Wozniak Lisa A. , Marshall Deborah A.
Published: February 2024

Background

Decision aids can help patients set realistic expectations. In this study, we explored alternative presentations to visualise patient-reported outcomes (EQ-5D-5L) data within an online, individualized patient decision aid for total knee arthroplasty (TKA) that, in part, generates individualized comparisons based on age, sex and body mass index, to enhance usability prior to implementation into routine clinical practice.

Methods

We used data visualization techniques to modify the presentation of EQ-5D-5L outcomes data within the decision aid. The EQ-5D-5L data was divided into two parts allowing patients to compare themselves to similar individuals (1) pre-surgery and (2) 1-year post-surgery. We created 2 versions for each part and sought patient feedback on comprehension, usefulness, and visual appeal. Patients from an urban orthopedic clinic were recruited and their ratings and comments were recorded using a researcher-administered checklist. Data were managed using Microsoft Excel, R version 3.6.1 and ATLAS.ti V8 and analyzed using descriptive statistics and directed content analysis.

Results

A total of 24 and 25 patients participated in Parts 1 and 2, respectively. Overall, there was a slight preference for Version 1 in Part 1 (58.3%) and Version 2 in Part 2 (64%). Most participants demonstrated adequate comprehension for all versions (range 50–72%) and commented that the instructions were clear. While 50–60% of participants rated the content as useful, including knowing the possible outcomes of surgery, some participants found the information interesting only, were unsure how to use the information, or did not find it useful because they had already decided on a treatment. Participants rated visual appeal for all versions favorably but suggested improvements for readability, mainly larger font and image sizes and enhanced contrast between elements.

Conclusions

Based on the results, we will produce an enhanced presentation of EQ-5D-5L data within the decision aid. These improvements, along with further usability testing of the entire decision aid, will be made before implementation of the decision aid in routine clinical practice. Our results on patients’ perspectives on the presentation of EQ-5D-5L data to support decision making for TKA treatments contributes to the knowledge on EQ-5D-5L applications within healthcare systems for clinical care.
Explaining the challenges of Iranian caregivers in provision of home health care to spinal cord injury patients: a qualitative study
Authors: Galehdar Nasrin , Heydari Heshmatolah
Published: February 2024

Background

The incidence of spinal cord injury (SCI) is increasing across the globe. The caregivers of patients with spinal cord injuries experience many problems during providing care to these patients. Identifying the problems experienced by caregivers can facilitate the process of care provision to these patients. So, the aim of this study was to explore the challenges of caregivers in provision of home health care to SCI patients.

Methods

This study was conducted by qualitative description approach in Iran from Apr 2021 to Dec 2022. The participants included the caregivers of SCI patients recruited by purposive sampling. The data were collected by face-to-face interviews and analyzed using the method proposed by Lundman and Graneheim.

Results

Two themes emerged from the data analysis, including burnout (with the categories of physical challenge and psychological challenges) and coping strategies (with the categories of social support and professional support).

Conclusion

Resolving the obstacles and problems faced by home caregivers can improve the circumstances of care provision so that they can be relieved of their own physical and psychological conundrums and deliver suitable home care to SCI patients.

Trial registration number

Not applicable.
Targeted deletion of CD244 on monocytes promotes differentiation into anti-tumorigenic macrophages and potentiates PD-L1 blockade in melanoma
Authors: Kim Jeongsoo , Kim Tae-Jin , Chae Sehyun , Ha Hyojeong , Park Yejin , Park Sunghee , Yoon Chul Joo , Lim Seon Ah , Lee Hyemin , Kim Jiyoung , Kim Jungwon , Im Kyungtaek , Lee Kyunghye , Kim Jeongmin , Kim Daham , Lee Eunju , Shin Min Hwa , Park Serk In , Rhee Inmoo , Jung Keehoon , Lee Jeewon , Lee Keun Hwa , Hwang Daehee , Lee Kyung-Mi
Published: February 2024

Background

In the myeloid compartment of the tumor microenvironment, CD244 signaling has been implicated in immunosuppressive phenotype of monocytes. However, the precise molecular mechanism and contribution of CD244 to tumor immunity in monocytes/macrophages remains elusive due to the co-existing lymphoid cells expressing CD244.

Methods

To directly assess the role of CD244 in tumor-associated macrophages, monocyte-lineage-specific CD244-deficient mice were generated using cre-lox recombination and challenged with B16F10 melanoma. The phenotype and function of tumor-infiltrating macrophages along with antigen-specific CD8 T cells were analyzed by flow cytometry and single cell RNA sequencing data analysis, and the molecular mechanism underlying anti-tumorigenic macrophage differentiation, antigen presentation, phagocytosis was investigated ex vivo. Finally, the clinical feasibility of CD244-negative monocytes as a therapeutic modality in melanoma was confirmed by adoptive transfer experiments.

Results

CD244fl/flLysMcre mice demonstrated a significant reduction in tumor volume (61% relative to that of the CD244fl/fl control group) 14 days after tumor implantation. Within tumor mass, CD244fl/flLysMcre mice also showed higher percentages of Ly6Clow macrophages, along with elevated gp100+IFN-γ+ CD8 T cells. Flow cytometry and RNA sequencing data demonstrated that ER stress resulted in increased CD244 expression on monocytes. This, in turn, impeded the generation of anti-tumorigenic Ly6Clow macrophages, phagocytosis and MHC-I antigen presentation by suppressing autophagy pathways. Combining anti-PD-L1 antibody with CD244−/− bone marrow-derived macrophages markedly improved tumor rejection compared to the anti-PD-L1 antibody alone or in combination with wild-type macrophages. Consistent with the murine data, transcriptome analysis of human melanoma tissue single-cell RNA-sequencing dataset revealed close association between CD244 and the inhibition of macrophage maturation and function. Furthermore, the presence of CD244-negative monocytes/macrophages significantly increased patient survival in primary and metastatic tumors.

Conclusion

Our study highlights the novel role of CD244 on monocytes/macrophages in restraining anti-tumorigenic macrophage generation and tumor antigen-specific T cell response in melanoma. Importantly, our findings suggest that CD244-deficient macrophages could potentially be used as a therapeutic agent in combination with immune checkpoint inhibitors. Furthermore, CD244 expression in monocyte-lineage cells serve as a prognostic marker in cancer patients.
IL6-STAT3-C/EBPβ-IL6 positive feedback loop in tumor-associated macrophages promotes the EMT and metastasis of lung adenocarcinoma
Authors: Hu Zhengyang , Sui Qihai , Jin Xing , Shan Guangyao , Huang Yiwei , Yi Yanjun , Zeng Dejun , Zhao Mengnan , Zhan Cheng , Wang Qun , Lin Zongwu , Lu Tao , Chen Zhencong
Published: February 2024

Background

Lung cancer is one of the most common tumors in the world, and metastasis is one of the major causes of tumor-related death in lung cancer patients. Tumor-associated macrophages (TAMs) are a major component of the tumor microenvironment (TME) and are frequently associated with tumor metastasis in human cancers. However, the regulatory mechanisms of TAMs in lung cancer metastasis remain unclear.

Methods

Single-cell sequencing analysis of lung cancer and normal tissues from public databases and from 14 patients who underwent surgery at Zhongshan Hospital was performed. In vitro co-culture experiments were performed to evaluate the effects of TAMs on lung cancer migration and invasion. Changes in the expression of IL-6, STAT3, C/EBPΒ, and EMT pathway were verified using RT-qPCR, western blotting, and immunofluorescence. Dual luciferase reporter assays and ChIP were used to reveal potential regulatory sites on the transcription factor sets. In addition, the effects of TAMs on lung cancer progression and metastasis were confirmed by in vivo models.

Results

TAM infiltration is associated with tumor progression and poor prognosis. IL-6 secreted by TAMs can activate the JAK2/STAT3 pathway through autocrine secretion, and STAT3 acts as a transcription factor to activate the expression of C/EBPβ, which further promotes the transcription and expression of IL-6, forming positive feedback loops for IL6-STAT3-C/EBPβ-IL6 in TAMs. IL-6 secreted by TAMs promotes lung cancer progression and metastasis in vivo and in vitro by activating the EMT pathway, which can be attenuated by the use of JAK2/STAT3 pathway inhibitors or IL-6 monoclonal antibodies.

Conclusions

Our data suggest that TAMs promote IL-6 expression by forming an IL6-STAT3-C/EBPβ-IL6 positive feedback loop. Released IL-6 can induce the EMT pathway in lung cancer to enhance migration, invasion, and metastasis. The use of IL-6-neutralizing antibody can partially counteract the promotion of LUAD by TAMs. A novel mechanism of macrophage-promoted tumor progression was revealed, and the IL6-STAT3-C/EBPβ-IL6 signaling cascade may be a potential therapeutic target against lung cancer.

Graphical Abstract

IL-6 secreted by TAM acts on itself to promote STAT3 phosphorylation, and pSTAT3 transfers into the nucleus, promotes the expression of C/EBPβ. C/EBPβ is able to further promote IL-6 expression, which forms positive feedback for IL-6 secretion. IL-6 secreted by TAMs acts on lung cancer to promote their metastasis through activation of EMT.
Scleritis following intravitreal brolucizumab injection: a case series
Authors: Takayama Takuya , Inoda Satoru , Takahashi Hidenori , Tsukii Rika , Yoshida Hana , Kasuya Yuka , Nagaoka Kosuke , Takahashi Ryota , Arai Yusuke , Kawashima Hidetoshi
Published: February 2024

Background

This study reports the first cases of scleritis following intravitreal brolucizumab (IVBr) injection for nAMD, emphasizing the need to be aware of the possibility of scleritis following IVBr injections.

Case presentation

Case 1. A 74-year-old Japanese man with nAMD complained of conjunctivitis and decreased vision in the right eye 8 days after his eighth IVBr injection. Examination revealed scleritis without anterior inflammation. Topical 0.1% betamethasone and 0.3% gatifloxacin eye drops were started. The scleritis worsened in the following 2 weeks and became painful. He underwent sub-Tenon’s capsule triamcinolone acetonide (STTA) injection. Two days later, he returned with a complaint of severe vision loss. Fundus examination revealed retinal artery occlusion, vasculitis, and vitreous opacity in the right eye. Vitreous surgery was performed. Case 2. An 85-year-old Japanese woman with nAMD in the right eye complained of reddening of the eye 27 days after her fifth IVBr injection. Examination showed conjunctivitis and scleritis without anterior inflammation in the right eye. She was started on 0.1% fluorometholone and 0.5% levofloxacin hydrate eye drops. The scleritis worsened in the following 3 weeks. Her treatment was switched to 0.1% betamethasone eye drops. One month later, the scleritis had improved and a sixth IVBr injection was administered. There was no worsening of the scleritis at that time. However, 1 month after a seventh IVBr injection, she complained of severe hyperemia and decreased vision. Fundus examination revealed vitreous opacification. She underwent STTA, and the vitreous opacity improved in 24 days. Case 3. A 57-year-old Japanese man with nAMD complained of pain and decreased vision in the right eye 21 days after a fourth IVBr injection. Examination revealed scleritis with high intraocular pressure but no anterior chamber or fundus inflammation. STTA and topical eye drops were performed. One month later, scleritis improved but visual acuity didn’t due to progression of nAMD.

Conclusions

Intraocular inflammation following IVBr injection may progress to the posterior segment. Scleritis can occur after IVBr injection, and topical eye drops alone may not be sufficient for initial treatment. Clinicians should consider the possibility of scleritis in patients with worsening inflammation after IVBr injection.
Optimal decay-in-time rates of solutions to the Cauchy problem of 3D compressible magneto-micropolar fluids
Authors: Cui Xinyu , Fu Shengbin , Sun Rui , Tian Fangfang
Published: February 2024

This paper focuses on the long time behavior of the solutions to the Cauchy problem of the three-dimensional compressible magneto-micropolar fluids. More precisely, we aim to establish the optimal rates of temporal decay for the highest-order spatial derivatives of the global strong solutions by the method of decomposing frequency. Our result can be regarded as the further investigation of the one in (Wei, Guo and Li in J. Differ. Equ. 263:2457–2480, 2017), in which the authors only provided the optimal rates of temporal decay for the lower-order spatial derivatives of the perturbations of both the velocity and the micro-rotational velocity.
Updates and future directions regarding hand hygiene in the healthcare setting: insights from the 3rd ICPIC alcohol-based handrub (ABHR) task force
Authors: Tartari Ermira , Bellissimo-Rodrigues Fernando , Pires Daniela , Fankhauser Carolina , Lotfinejad Nasim , Saito Hiroki , Suchomel Miranda , Kramer Axel , Allegranzi Benedetta , Boyce John , Sax Hugo , Stewardson Andrew J. , Pittet Didier ,   the ICPIC Alcohol-Based Handrub Task Force, Rodin Aeschbach , Yuichi Kumashita , Benjamin Alléard , Pamela Lee , Tingxu Lu , Jim Arbogast , Leonard Mermel , Chedly Azzouz , Emma Barrett , Ben Park , Lelyn Quan , Martina Bühler , Andreea Capilna , César Serna Jiménez , Nizam Damani , Sven Eggerstedt , Peter Teska , Nicole van Hall , Sonja Hansen , Margreet Vos , Thomas Hennig , Andreas Widmer , Loreen Herwaldt , Kazuko Yakata , Deborah Yokoe , Mike Bell , Noel Bertho Jean , Tcheun-How Borzykowski , John Conly , Carlos Da Silva , Kazuko Yakata , Ariel Geva , Tamas Haidegger , Loreen Herwaldt , Carolyn Holland , Bonnie Okeke , Kevin Ormandy , Pierre Parneix , Alexandra Peters , Vanessa Pouget , Lionel Robert , Cesar Serna Jimenez , Walter Zingg
Published: February 2024

Healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) pose threats to global health. Effective hand hygiene is essential for preventing HAIs and the spread of AMR in healthcare. We aimed to highlight the recent progress and future directions in hand hygiene and alcohol-based handrub (ABHR) use in the healthcare setting. In September 2023, 42 experts in infection prevention and control (IPC) convened at the 3rd International Conference on Prevention and Infection Control (ICPIC) ABHR Taskforce in Geneva, Switzerland. The purpose of this meeting was to provide a synthesis of recent evidence and formulate a research agenda on four critical areas for the implementation of effective hand hygiene practices: (1) ABHR formulations and hand rubbing techniques, (2) low-resource settings and local production of ABHR, (3) hand hygiene monitoring and technological innovations, and (4) hand hygiene standards and guidelines.
From bedside to recovery: exercise therapy for prevention of post-intensive care syndrome
Authors: Liu Keibun , Tronstad Oystein , Flaws Dylan , Churchill Luke , Jones Alice Y. M. , Nakamura Kensuke , Fraser John F.
Published: February 2024

Background

As advancements in critical care medicine continue to improve Intensive Care Unit (ICU) survival rates, clinical and research attention is urgently shifting toward improving the quality of survival. Post-Intensive Care Syndrome (PICS) is a complex constellation of physical, cognitive, and mental dysfunctions that severely impact patients’ lives after hospital discharge. This review provides a comprehensive and multi-dimensional summary of the current evidence and practice of exercise therapy (ET) during and after an ICU admission to prevent and manage the various domains of PICS. The review aims to elucidate the evidence of the mechanisms and effects of ET in ICU rehabilitation and highlight that suboptimal clinical and functional outcomes of ICU patients is a growing public health concern that needs to be urgently addressed.

Main body

This review commences with a brief overview of the current relationship between PICS and ET, describing the latest research on this topic. It subsequently summarises the use of ET in ICU, hospital wards, and post-hospital discharge, illuminating the problematic transition between these settings. The following chapters focus on the effects of ET on physical, cognitive, and mental function, detailing the multi-faceted biological and pathophysiological mechanisms of dysfunctions and the benefits of ET in all three domains. This is followed by a chapter focusing on co-interventions and how to maximise and enhance the effect of ET, outlining practical strategies for how to optimise the effectiveness of ET. The review next describes several emerging technologies that have been introduced/suggested to augment and support the provision of ET during and after ICU admission. Lastly, the review discusses future research directions.

Conclusion

PICS is a growing global healthcare concern. This review aims to guide clinicians, researchers, policymakers, and healthcare providers in utilising ET as a therapeutic and preventive measure for patients during and after an ICU admission to address this problem. An improved understanding of the effectiveness of ET and the clinical and research gaps that needs to be urgently addressed will greatly assist clinicians in their efforts to rehabilitate ICU survivors, improving patients’ quality of survival and helping them return to their normal lives after hospital discharge.