bluuebunny/crossref_metadata_2025 huggingface dataset:
Exposure to aircraft noise exacerbates cardiovascular and oxidative damage in three mouse models of diabetes
Authors: Mihalikova Dominika , Stamm Paul , Kvandova Miroslava , Pednekar Chinmayi , Strohm Lea , Ubbens Henning , Oelze Matthias , Kuntic Marin , Witzler Claudius , Bayo Jimenez Maria Teresa , Rajlic Sanela , Frenis Katie , Tang Qi , Ruan Yue , Karbach Susanne , Kleinert Hartmut , Hahad Omar , von Kriegsheim Alex , Xia Ning , Grune Tilman , Li Huige , Kröller-Schön Swenja , Gericke Adrian , Ruf Wolfram , Wild Philipp S , Lurz Philipp , Münzel Thomas , Daiber Andreas , Jansen Thomas
Published: October 2024

Aims

Epidemiology links noise to increased risk of metabolic diseases like diabetes and obesity. Translational studies in humans and experimental animals showed that noise causes reactive oxygen species (ROS)–mediated cardiovascular damage. The interaction between noise and diabetes, specifically potential additive adverse effects, remains to be determined.

Methods and results

C57BL/6 mice were treated with streptozotocin (i.p. injections, 50 mg/kg/day for 5 days) to induce type 1 diabetes mellitus, with S961 (subcutaneous osmotic mini-pumps, 0.57 mg/kg/day for 7 days) or fed a high-fat diet (HFD, 20 weeks) to induce type 2 diabetes mellitus. Control and diabetic mice were exposed to aircraft noise to an average sound pressure level of 72 dB(A) for 4 days. While body weight was unaffected, noise reduced insulin production in all diabetes models. The oral glucose tolerance test showed only an additive aggravation by noise in the HFD model. Noise increased blood pressure and aggravated diabetes-induced aortic, mesenteric, and cerebral arterioles’ endothelial dysfunction. ROS formation in cerebral arterioles, the aorta, the heart, and isolated mitochondria was consistently increased by noise in all models of diabetes. Mitochondrial respiration was impaired by diabetes and noise, however without additive effects. Noise increased ROS and caused inflammation in adipose tissue in the HFD model. RNA-sequencing data and alteration of gene pathway clusters also supported additive damage by noise in the setting of diabetes.

Conclusion

In all three models of diabetes, aircraft noise exacerbates oxidative stress, inflammation, and endothelial dysfunction in mice with pre-existing diabetes. Thus, noise may potentiate the already increased cardiovascular risk in diabetic patients.
Development and Validation of the Perceived Interpersonal Relevancy Scales: A New Measure of Perceived Threat, Opportunity, and Invisibility Appraisals for Use Across the Adult Life Course
Authors: Brady Brooke , Zheng Lidan , Eramudugolla Ranmalee , Anstey Kaarin J
Published: October 2024

Objectives

Interpersonal relevancy appraisals are a dynamic and understudied aspect of human social cognition. Despite their importance, there are no existing measures. This study developed and validated a new measure of self-perceived interpersonal threat, opportunity, and invisibility appraisals among a life-course sample of adults. We also explored the relationships between relevance appraisals, social connectedness, loneliness, age, and sex assigned at birth.

Methods

Items were developed based on a theoretical model of multidomain interpersonal relevance appraisals and refined following feedback from 5 experts in social psychology. Cross-sectional data were obtained online from a sample of 1,079 adults (age 18–90 years), recruited from the general population of Australia. Data were split into two pseudo-random samples used for (a) scale development and evaluation, and (b) assessment of internal consistency, construct validity, convergent validity with social connectedness and loneliness, and exploratory analysis with age and sex.

Results

Results support the factor structure and internal consistency of 17- and 9-item versions of the Perceived Interpersonal Relevancy Scales (PIRS) and measurement invariance across younger and older age groups. Higher self-perceived threat and invisibility appraisals were associated with decreased social network size, increased loneliness, younger age, and male sex. Higher self-perceived opportunity appraisals were associated with increased social network size and decreased loneliness.

Discussion

Results support this new measure of perceived interpersonal relevance appraisals, which shows relationships between the way we believe others perceive us, loneliness, and social isolation. The PIRS likely has wide utility for studies that seek to understand the intersections between human social cognition, well-being, and health across the lifespan.
Hessian Estimates for Dirichlet and Neumann Eigenfunctions of Laplacian
Authors: Cheng Li-Juan , Thalmaier Anton , Wang Feng-Yu
Published: October 2024

By methods of stochastic analysis on Riemannian manifolds, we develop an approach to determine an explicit constant $c(D)$ for an $n$-dimensional compact manifold $D$ with smooth boundary such that $\frac{\lambda }{n}\,\|\phi \|_{\infty } \leq \|\operatorname{Hess}\phi \|_{\infty } \leq c(D)\lambda \,\|\phi \|_{\infty } $ holds for any Dirichlet eigenfunction $\phi $ of $-\Delta $ on $D$ with eigenvalue $\lambda $. Our results provide the sharp Hessian estimate $\|\operatorname{Hess} \phi \|_{\infty }\lesssim \lambda ^{\frac{n+3}{4}}\|\phi \|_{L^{2}}$. Corresponding Hessian estimates for Neumann eigenfunctions are derived in the second part of the paper.
Susceptibility of Capsicum varieties to Thaumatotibia leucotreta (Lepidoptera: Tortricidae) infestation for production optimization
Authors: Adom Médétissi , Fening Ken O , Billah Maxwell K , Aigbedion-Atalor Pascal O , Acheampong Mavis A , Wilson David D
Published: October 2024

Thaumatotibia leucotreta Meyrick (Lepidoptera: Tortricidae) is a major threat to the production and marketing of pepper (Capsicum spp.) in Ghana. To reduce the damage of the pest on pepper farming, it is important to find appropriate control methods, which may include the use of resistant host plants. This study investigated the relative susceptibility of 6 pepper varieties commonly cultivated in Ghana: Legon 18, Bird’s eye, Scotch bonnet, Cayenne, KA2, and sweet pepper (Yolo wonder+ variety). Choice and no-choice ovipositional preference tests were conducted and the population growth rate of T. leucotreta was determined by establishing life table parameters including the net reproductive rates (R0), the mean generation time (G), intrinsic rate of natural increase (rm), the population doubling time (T), and the finite rate of increase (λ). In the no-choice test, females exhibited oviposition preference for sweet pepper (12.08 eggs/fruit), while Bird’s eye was the least preferred (5.00 eggs/fruit). The same results were observed in the choice test. However, the population growth rate of T. leucotreta was highest on the Scotch bonnet and Cayenne, with rm of 0.124 and 0.127, respectively, while the Bird’s eye and sweet pepper recorded the least rm of 0.116. Thus, the tested varieties had varying levels of susceptibility to T. leucotreta infestation. Bird’s eye was the least susceptible variety, while Cayenne and Scotch bonnet were the most susceptible varieties. These findings could direct farmers on the choices of pepper varieties for cultivation and proffer potential opportunities to breed new varieties resistant to T. leucotreta infestation.
Unsettling the Familiar: Experiential Human Rights Learning through Civic Monuments at the University of Winnipeg
Authors: Kenyon Kristi Heather , Khan Saad Ahmad , Vowell Fiona , Zienkiewicz Madison
Published: October 2024

Research shows that experiential learning improves student learning, engagement and retention and yet, despite growth in university undergraduate human rights programmes, relatively little is known about experiential learning in the human rights classroom. This article examines a low-cost and online-adaptable experiential learning assignment focused on civic statues and monuments in Winnipeg, Canada. The assignment and supporting activities, speakers and resources were implemented in thirteen sections (online and in-person) of a prerequisite-free undergraduate human rights course over two academic years. Surveys were circulated to students before and after the assignment examining their perspective on key concepts and their own skill and capacity. As a result of the activity students indicated a heightened understanding of the role of monuments and representation as human rights issues, a broadened interpretation of expertise in relation to monuments, and an increased self-perception of skills and capacity related to monument analysis. This article contributes to the emerging literature on human rights education in higher education and to the need for accessible, scalable, and online-adaptable forms of experiential learning. Human Rights is a growing field at the undergraduate level, and our project can usefully contribute to the literature and practice of human rights pedagogy.
Maximizing and sustaining the efficacy of tick tubes for management of Ixodes scapularis through optimized deployment strategies
Authors: Tiffin Hannah S , Green Kylie D , Burgess Edwin R , Machtinger Erika T
Published: October 2024

The number of tick-borne disease cases continues to rise in the United States, with Lyme disease the most frequently reported vector-borne disease nationally. Practical and effective tick control tools and strategies are needed to reduce tick encounters and tick-borne disease risk. Tick management tubes have shown varying efficacy when used as part of a tick management plan. To evaluate factors contributing to the efficacy of tick management tubes, this study assessed changes in tick tube deployment on tick burden on wild-caught Peromyscus mice, a primary reservoir for the bacterium causing Lyme disease, in Pennsylvania from 2021 to 2023. Over 2 years, tick tubes were deployed starting at different times of the year, with cotton removal from the tubes assessed every 2 weeks from April to November and tick burden on wild-caught mice assessed every 2 months from April to October of each year. The effect of distance between tick management tubes was assessed in year 3 of this study, with mouse tick burden assessed pre- and post-treatment with tick tubes at varying intervals in a field setting. There was a significant reduction in mouse tick burden between treated and control transects, and pre- and post-treatment transects. Tick tube distance did not affect cotton removal or tick burden on mice. Still, cotton removal was highest in September–October, and amount removed increased the longer tick tubes were deployed in the field, highlighting the long-term benefits of using tick tubes as part of an integrated tick management plan. Future investigations to evaluate the impact of tick management tubes on tick nymph density and infection would be valuable for assessing the effectiveness of tick management tubes in reducing tick bite risk.
Safety and Pharmacokinetics of Casirivimab and Imdevimab (CAS + IMD) in Pediatric Outpatients With COVID-19
Authors: Norton Thomas D , Thakur Mazhar , Ganguly Samit , Ali Shazia , Chao Jesse , Waldron Alpana , Xiao Jing , Turner Kenneth C , Davis John D , Irvin Susan C , Pan Cynthia , Atmodjo Dominique , Hooper Andrea T , Hamilton Jennifer D , Hussein Mohamed , Subramaniam Danise , Roque-Guerrero Lilia , Kohli Anita , Mylonakis Eleftherios , Geba Gregory P , Cox Edward , Braunstein Ned , Dakin Paula , Kowal Bari , Bhore Rafia , DiCioccio A Thomas , Hughes Diana , Herman Gary A ,   for the Trial Investigators
Published: October 2024

The safety of casirivimab + imdevimab (CAS + IMD) (anti-severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] monoclonal antibodies [mAbs]) in pediatric outpatients with coronavirus disease 2019 (COVID-19) was evaluated in a randomized phase 1/2/3 trial. Consistent with adults, CAS + IMD was generally well tolerated with low drug-induced immunogenicity rates. The findings support the development of next-generation anti-SARS-CoV-2 mAbs for at-risk pediatric patients.
What can AI learn from the history of statistics?
Authors: Láinez-Moreno Dídac , Lorenzo-Arribas Altea , Puig Pere
Published: October 2024

The history of statistical errors is repeating itself in some AI developments, despite the remarkable progress made by the discipline. Dídac Láinez-Moreno, Altea Lorenzo-Arribas and Pere Puig describe how previous lessons learnt might help us build fairer, more robust models
Intentions and Inquiry
Authors: Friedman Daniel C
Published: October 2024

This paper defends the Intention Account of Individual Inquiry. On this account, inquiry is best understood by appeal to a ‘question-directed intention’ (QDI), an intention to answer a question broadly construed. This account’s core commitments help meet recent challenges plaguing extant approaches to characterizing inquiry. First, QDIs are the type of mental state central to inquiry, not attitudes like curiosity or wonder. Second, holding a QDI towards a question and acting in service of it constitutes the start of inquiry. Third, controversial norms which mandate a rational inquirer’s ignorance towards the answer to her question can be reformulated and defended by appeal to rational constraints on intention. Fourth, instrumental pressures inquirers face are the standard pressures of plan-rationality. In defending these theses, I show that the Intention Account provides compelling explanations to standing challenges, in ways competitors cannot. It does so by advancing understanding of how our epistemic and practical agency are intertwined.
Trophic transfer of carbon-14 from algae to zebrafish leads to its blending in biomolecules and the dysregulation of metabolism via isotope effect
Authors: Dong Shipeng , Deng Renquan , Zeng Hang , Xue Pengfei , Lin Sijie , Zhou Dongmei , Mao Liang
Published: October 2024

Carbon-14 (C-14) has been a major contributor to the human radioactive exposure dose, as it is released into the environment from the nuclear industry in larger quantities compared to other radionuclides. This most abundant nuclide enters the biosphere as organically bound C-14 (OBC-14), posing a potential threat to public health. Yet, it remains unknown how this relatively low radiotoxic nuclide induces health risks via chemical effects, such as isotope effect. By establishing a trophic transfer model involving algae (Scenedesmus obliquus), daphnia (Daphnia magna) and zebrafish (Danio rerio), we demonstrate that rapid incorporation and transformation of inorganic C-14 by algae into OBC-14 facilitates the blending of C-14 into the biomolecules of zebrafish. We find that internalized C-14 is persistently retained in the brain of zebrafish, affecting DNA methylation and causing alterations in neuropathology. Global isotope tracing metabolomics with C-14 exposure further reveals the involvement of C-14 in various critical metabolic pathways, including one-carbon metabolism and nucleotide metabolism. We thus characterize the kinetic isotope effects for 12C/14C in the key reactions of these metabolic pathways through kinetic experiments and density functional theory computations, showing that the isotopic substitution of carbon in biochemicals regulates metabolism by disrupting reaction ratios via isotope effects. Our results suggest that inorganic C-14 discharged by the nuclear industry can be biotransformed into OBC-14 to impact metabolism via isotope effects, providing new insights into understanding the health risk of C-14, which is traditionally considered as a low radiotoxic nuclide.
Diagnostic Utility of SARS-CoV-2 Nucleocapsid Antigenemia: A Meta-analysis
Authors: Damhorst Gregory L , Martin Sydney E , Wilber Eli , Verkerke Hans , Goodman Michael , Lam Wilbur A
Published: October 2024

Background

Studies of the diagnostic performance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid antigen in blood (antigenemia) have reached variable conclusions. The potential utility of antigenemia measurements as a clinical diagnostic test needs clarification.

Methods

We performed a systematic review of Pubmed, Embase, and Scopus through July 15, 2023, and requested source data from corresponding authors.

Results

Summary sensitivity from 16 studies (4543 cases) sampled at ≤14 days of symptoms was 0.83 (0.75–0.89), and specificity was 0.98 (0.87–1.00) from 6 studies (792 reverse transcription polymerase chain reaction–negative controls). Summary sensitivity and specificity for paired respiratory specimens with cycle threshold values ≤33 were 0.91 (0.85–0.95) and 0.56 (0.39–0.73) from 10 studies (612 individuals). Source data from 1779 cases reveal that >70% have antigenemia 2 weeks following symptom onset, which persists in <10% at 28 days. The available studies suffer from heterogeneity, and Omicron-era data are scarce.

Conclusions

Nucleocapsid antigenemia currently has limited utility due to limitations of existing studies and lack of Omicron-era data. Improved study designs targeting potential clinical uses in screening, surveillance, and complex clinical decision-making—especially in immunocompromised patients—are needed.
Recent treatment patterns and real-world survival following first-line anti-PD-L1 treatment for extensive-stage small cell lung cancer
Authors: Shaw Jaime , Pundole Xerxes , Balasubramanian Akhila , Anderson Erik S , Pastel Malaika , Bebb D Gwyn , Jiang Tony , Martinez Pablo , Ramalingam Suresh S , Borghaei Hossein
Published: October 2024

Background

The landscape of small cell lung cancer (SCLC) has changed since the 2019 and 2020 approvals of anti-PD-L1 atezolizumab and durvalumab for first-line (1L) treatment in combination with chemotherapy. We studied treatment patterns and real-world overall survival (rwOS) following 1L-3L therapy.

Patients and Methods

A nationwide electronic health record (EHR)-derived de-identified database was used to describe treatment patterns, characteristics, and survival of patients with extensive-stage (ES)-SCLC by 1L anti-PD-L1 treatment. Patients with ES-SCLC who initiated ≥1 line of systemic therapy from 2013 to 2021, with potential follow-up through 2022, were included.

Results

Among 9952 patients with SCLC, there were 4308 patients with ES-SCLC treated during the study period who met eligibility criteria. Etoposide + platinum (EP) chemotherapy was most common in the 1L, with addition of anti-PD-L1 therapy to most regimens by 2019. Second-line regimens varied by platinum sensitivity status and shifted from topotecan to lurbinectedin over time. Median rwOS following 1L therapy was 8.3 months (95% CI, 7.9-8.8) in those treated with 1L anti-PD-L1 and 8.0 months (95% CI, 7.8-8.2) in those who were not. Following 2L and 3L, median rwOS was 5.6 (95% CI, 4.9-6.3) and 4.9 months (95% CI, 3.4-6.0), respectively, among 1L anti-PD-L1-treated, and 4.5 (95% CI, 4.2-4.9) and 4.0 months (95% CI, 3.7-4.5), respectively, among those who were not.

Conclusion

Despite the introduction of frontline anti-PD-L1 therapy, survival remains dismal among patients with ES-SCLC treated in the real-world setting.
The Critical Lens: It is time to start using the right test for febrile young infants
Authors: Marom Adiel , Papenburg Jesse , Burstein Brett
Published: October 2024

Fever among infants in the first months of life is a common clinical conundrum facing all clinicians who treat children. Most well-appearing febrile young infants have viral illnesses. However, it is critical to identify those at risk of invasive bacterial infections, specifically bacteremia and bacterial meningitis. Clinicians must balance the risks of missing these infections against the harms of over-investigation. Procalcitonin testing is currently the best diagnostic test available to help guide management, and the Canadian Paediatric Society Position Statement on the management of febrile young infants recommends procalcitonin-based risk stratification. However, in many clinical settings, procalcitonin is either unavailable or has a turnaround time that is too long to aid decision-making. Clinicians who care for febrile young infants must have rapid access to procalcitonin results to provide best-evidence, guideline-adherent care. The wider availability of this test is essential to reduce unnecessary invasive testing, hospitalizations, and antibiotic exposure and could reduce system-wide resource utilization.
Navigating Vulnerability and Integration: Refugee Resettlement from Rwanda to Third Countries under the Medical Needs Category
Authors: Bjørkhaug Ingunn , Bækkevold Kine Marie
Published: October 2024

Resettlement is a limited resource available to only a fraction of refugees. Selection criteria, set by the United Nations High Commissioner for Refugees and receiving States, may impose conflicting demands on refugees to exhibit both vulnerability and integration potential to be chosen, a phenomenon termed “promising victimhood”. Drawing on empirical data from interviews with 21 personnel from the United Nations High Commissioner for Refugees and Save the Children International in Rwanda, this article explores how medical needs criteria impact the inclusion or exclusion of refugees for resettlement. It finds that the selection criteria favour refugees with treatable conditions and favourable prognoses, thereby excluding those with chronic or fatal illnesses or patients with poor life expectancy. The article argues that such criteria potentially undermine the humanitarian objectives of the resettlement programme by marginalising some of the most vulnerable individuals. It discusses the implications of these findings for global burden-sharing strategies and calls for strengthening the medical infrastructure in asylum countries. The article concludes by questioning whether resettlement, in its current form, can truly serve as one of the three durable solutions for refugees with medical needs, given that it remains an option for only a select few.
Assessment of the toxic influence of locally formulated pesticides on hepatic and renal biomarkers in male Wistar rats
Authors: Adeyele Esther Itunuoluwa , Ayanyemi Esther Olutomilayo , Akomolafe Rufus Ojo , Sesan Olaoluwa Olukiran , Aladesanmi Omolara Titilayo , Adetutu Aderonke Okoya
Published: October 2024

Background

There is growing concern of the potential damage to vital organs after long term exposure to locally formulated pesticides in rural area of Nigeria. This study was designed to assessed the effects of the individual chemical compound and their combination on the kidney and liver of rats’ model.

Methodology

Fifty-four rats divided into six groups and three sub-groups were exposed to 25, 50 and 75% dose of each of the pesticide’s LD50 for 4 h at 3 days interval in an inhalation chamber for 28 days. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total bilirubin (TOT_BIL), creatinine and urea assay showed significant increase at the aforementioned doses in comparison to the control group. The red blood cell counts, hematocrit and hemoglobin concentrations were significantly altered in the rats administered varying doses of the pesticides when compared with the control. Similar result was obtained for the differential white blood cell counts. Histopathological examinations of the liver tissue of rats showed infiltrated sinusoids, traces of karypyknosis, vacuolar degeneration and microvesicular steatosis while that of the renal tissue showed glomeruli atrophy leading to widened Bowman’s spaces as well as few shrunken glomeruli and varied level of degenerative tubular changes to tubular necrosis.

Conclusion

This study established that individual pesticides and their mixture is toxic to the liver and kidney, as evidenced by the elevated markers of renal and liver functions and distortion of the structure of both organs as revealed by their photomicrographs. Therefore, it is a matter of public health significance to regularly monitor pesticide residues in foods and humans in order to assess the food safety risk and population exposure to pesticides.
Medication errors and mitigation strategies in obstetric anesthesia
Authors: Sharpe Emily E. , Corbett Lisa M. , Rollins Mark D.
Published: October 2024

Purpose of review

Medication administration errors represent a significant yet preventable cause of patient harm in the peripartum period. Implementation of best practices contained in this manuscript can significantly reduce medication errors and associated patient harm.

Recent findings

Cases of medication errors involving unintended intrathecal administration of tranexamic acid highlight the need to improve medication safety in peripartum patients and obstetric anesthesia.

In obstetric anesthesia, medication errors can include wrong medication, dose, route, time, patient, or infusion setting. These errors are often underreported, have the potential to be catastrophic, and most can be prevented. Implementation of various types of best practice cost effective mitigation strategies include recommendations to improve drug labeling, optimize storage, determine correct medication prior to administration, use non-Luer epidural and intravenous connection ports, follow patient monitoring guidelines, use smart pumps and protocols for all infusions, disseminate medication safety educational material, and optimize staffing models. Vigilance in patient care and implementation of improved patient safety measures are urgently needed to decrease harm to mothers and newborns worldwide.
Novel vaccines against lung cancer
Authors: Baka Sofia , Iraklis George , Papadopoulou Evanthia
Published: October 2024

Purpose of review

Despite recent advances in immunotherapy treatment for metastatic, early-stage nonsmall cell lung cancer (NSCLC), palliative, adjuvant, neoadjuvant, and perioperative treatment options, further development is needed. Exploring new frontiers of immuno-oncology is necessary. Researchers are interested in a therapeutic vaccination model.

Recent findings

In this paper, we provide a review of the latest lung cancer therapeutic vaccines.

We describe strategies for antigen selection and delivery platforms. As of 5th of August 2024, we have reviewed ongoing clinical trials and results.

We summarize most of the important clinical trials of novel vaccines, the way of action, and available clinical data. We also discuss the pros and cons of various types of therapeutic vaccines.

Until recently, clinical trial results were mixed regarding the efficacy of therapeutic vaccines in lung cancer.

Developing next-generation sequencing and bioinformatic technologies has helped identify suitable antigens. New personalized vaccines are based on neoantigens specific to unique tumor mutations.

Neoantigens, instead of tumor-associated antigens, better delivery systems and adjuvants will improve antigen presentation and immune system activation.

Combining these therapeutic vaccines with other therapeutic approaches will improve and prolong the response.
Improving Interprofessional Provider Perceptions About Opioid Use Disorder in the Acute Care Setting Through a Blended Educational Simulation Intervention
Authors: Murphy Christine A. , Lakatos Barbara E. , Shelly Colleen E. , Bentain-Melanson Maria , Salvio Genina F. , Ryan Mary Maggie , Weiner Scott G.
Published: October 2024

Background

The influx of patients in the acute care setting with opioid use disorder (OUD) has outpaced many hospitals’ ability to educate interprofessional staff. This creates distressing experiences for interprofessional staff and patients, leading to moral distress and burnout in staff and poor patient outcomes.

Objective

The purpose of this study was to improve interprofessional staff knowledge, attitudes, and perceptions toward working with patients who have OUD using a blended classroom-simulation–based curriculum.

Methods

A preintervention and postintervention design was selected. Interprofessional staff (n = 46) participated in a blended classroom-simulation educational intervention focused on the neurobiology of OUD, stigma reduction, pain management, and harm reduction principles, followed by 3 high-fidelity simulation scenarios. Participants completed the Drug and Drug Problems Perceptions Questionnaire to measure staff self-perceived knowledge, skills, and attitudes when working with patients who use drugs before, immediately after, and again 3 and 6 months postintervention.

Results

Most respondents were nurses with an average of 7.6 (SD, 9.6) years of experience. The majority did not have prior training in substance use disorder before (75.6%). There was a statistically significant decrease in mean Drug and Drug Problems Perceptions Questionnaire scores across the total score mean: 55.2 (95% confidence interval, 52.2-58.3) versus 45.5 (95% confidence interval, 43.9-47.1),P< .001. Decreased score indicates improved attitude and perception.

Discussion

A curriculum consisting of a blended classroom-simulation intervention was successful at improving several domains regarding perceptions of caring for patients with OUD. This educational intervention can serve as a model for health care systems with goal of improving patient outcomes and staff well-being.
Interarm systolic blood pressure difference is associated with left ventricular concentricity and concentric remodeling
Authors: Paiva Annelise M.G. , Gomes Maria I.C.M. , Gomes Alana C.M. , Gomes Lucca C.M. , Ramalho Saulo R. , Feitosa Audes D.M. , Malachias Marcus V.B. , Brandão Andréa A. , Sposito Andrei C. , Mota-Gomes Marco A. , Nadruz Wilson
Published: October 2024

Objective:

Interarm systolic blood pressure difference (IASD) values >15 mmHg (IASD > 15) are associated with increased cardiovascular risk, yet the underlying mechanisms remain unclear. This report evaluated whether IASD >15, assessed by different protocols [sequential or simultaneous; based on one or several blood pressure (BP) readings], was associated with adverse left ventricular (LV) remodeling.

Methods:

This cross-sectional study evaluated 605 individuals who underwent clinical and echocardiography evaluation and three pairs of simultaneous arm BP readings. IASD was estimated by seven distinct protocols (three simultaneous and four sequential BP measurements criteria).

Results:

The cohort had a mean age of 53.5 ± 15.4 years, with 51% being women, 23% with LV hypertrophy, 14% with LV concentricity, 69% with normal geometry, 8% with concentric remodeling, 17% with eccentric hypertrophy and 6% with concentric hypertrophy. Multivariable logistic regression revealed that IASD >15 defined by simultaneous measures of the last two pairs of BP readings (IASDsim2) and sequential arm BP readings (right-left-right arm sequence; IASDseq3) were related to LV concentricity (odds ratio [95% CI] = 3.24 [1.02–10.28], P = 0.046 and 2.56 [1.09–6.00], P = 0.030, respectively) and LV concentric remodeling (odds ratio [95% CI]  = 4.12 [1.08–15.78], P = 0.039 and 4.16 [1.61–10.76], P = 0.003, respectively). Conversely, IASD >15 defined by any criteria showed no association with LV hypertrophy.

Conclusion:

Individuals with IASD >15 defined by IASDsim2 and IASDseq3 are associated with adverse LV remodeling, namely LV concentricity and LV concentric remodeling. These findings suggest that both criteria might be potentially used to preferentially assess abnormal IASD in the setting of clinical practice.
Prediction of vaults in eyes with vertical implantable collamer lens implantation
Authors: Shimada Ryuichi , Katagiri Satoshi , Horiguchi Hiroshi , Nakano Tadashi , Kitazawa Yoshihiro
Published: October 2024

Purpose:

To design formulas for predicting postoperative vaults in vertical implantable collamer lens (ICL) implantation and to achieve more precise predictions using machine learning models.

Design:

Retrospective, observational study.

Setting:

Eye Clinic Tokyo

Methods:

We retrospectively reviewed the medical records of 720 eyes in 408 patients who underwent vertical ICL implantation. The data included age, sex, refractions, anterior segment biometric data, and surgical records. We designed 3 formulas (named V1 to V3 formulas) using multiple linear regression analysis and tested 4 machine learning models.

Results:

Predicted vaults by V1 to V3 formulas were 444.17 ± 93.83 μm, 444.08 ± 98.64 μm, and 444.27 ± 108.81 μm, with a mean absolute error of 127.97 ± 107.92 μm, 126.41 ± 105.86 μm, and 122.90 ± 103.00 μm, respectively. There were no significant differences in error among the V1 to V3 formulas, despite the fact that the V1 and V2 formulas referred to limited parameters (3 and 4, respectively) and the V3 formula referred to all 12 parameters. 2 of 4 machine learning models—Extreme Gradient Boosting and Random Forest Regressor—showed better performance in predicted vaults: 444.52 ± 120.51 μm and 446.00 ± 102.55 μm, and mean absolute error: 118.31 ± 100.55 μm and 118.63 ± 99.34 μm, respectively.

Conclusions:

This is the first study to design V1 to V3 formulas for vertical ICL implantation. The V1 and V2 formulas exhibited good performance despite the limited parameters. In addition, 2 of the 4 machine learning models predicted more precise results.
Clinical utility of extracorporeal shock wave therapy in restoring hand function of patients with nerve injury and hypertrophic scars due to burns: a prospective, randomized, double-blinded study
Authors: Lee Seung Yeol , Cho Yoon Soo , Seo Cheong Hoon , Seo Jisu , Joo So Young
Published: October 2024

Background:

Joint contractures and nerve injuries are common after hand burns. Extracorporeal shock wave therapy (ESWT) is effective not only for the regeneration of various tissues, including scar tissues, but also for reducing pain and pruritus in patients with burns. Researchers have attempted to explore the effects of ESWT on hand dysfunction caused by nerve injury following burns.

Materials and methods:

The authors evaluated the effects of ESWT (compared to sham stimulation) on hands with nerve injury and hypertrophic scars and, thereby, on hand function. The current study was a double-blind randomized controlled trial involving 120 patients. The ESWT parameters were as follows: energy flux density, 0.05–0.30 mJ/mm2; frequency, 4 Hz; 1000–3000 impulses per treatment; and 12 treatments, one/week for 12 weeks. Outcome measures were as follows: 10-point visual analog scale for pain, Jebsen-Taylor hand function test, grip strength, Purdue Pegboard test, ultrasound measurement of scar thickness, and skin characteristics before and immediately after 12 weeks of treatment.

Results:

No significant intergroup difference was noted after the initial evaluation (P>0.05). More significant improvements were found in the ESWT group than in the sham group in terms of the VAS score (P=0.004), extension ROMs of hand joints (P=0.02), the JTT scores (writing, small, and light) (P<0.001, P<0.001, and P=0.002), and skin characteristics (melanin, skin distensibility, and biologic skin elasticity) (P=0.004, P<0.001, and P<0.001). Other measured outcomes did not differ between the two groups after the treatment.

Conclusion:

The authors identified the clinically beneficial effects of ESWT in promoting hand function, improving scarring, and alleviating scarring-related pain, thereby highlighting its advantages in improving hand function that has been impaired due to nerve injury and hypertrophic scars after burns.
An interview with Pennsylvania State representative Tarik Khan, PhD, FNP-BC
Authors: Chen Leon , Buscemi Charlie P.
Published: October 2024

Nurse practitioners (NPs) take on diverse and essential roles. In an exclusive interview, Representative Tarik Khan, PhD, FNP-BC, highlights the impact NPs can have in the political arena. Transitioning from an NP to a legislator in Pennsylvania, Dr. Khan's journey reflects his commitment to health care reform, driven by hospital closures, lack of patient care access, and the COVID-19 pandemic. Elected in 2022, Dr. Khan leverages his health care background to address a wide range of legislative issues, passing significant bills. He advocates for NPs to engage politically, emphasizing their unique perspective and problem-solving skills. Dr. Khan's story underscores the transformative potential of NPs in shaping public policy and advancing systemic change.
Effects of cardiac telerehabilitation during COVID-19 on cardiac hemodynamic and functional responses and quality of life: a randomized controlled trial
Authors: Dehghani Mostafa , Cheraghi Mostafa , Shakarami Amir , Dehghani Morteza , Namdari Mehrdad
Published: October 2024

Purpose:

This study aimed to assess the effects of a home-based cardiac telerehabilitation (HBCT) on cardiac hemodynamic and functional responses and health-related quality (HRQOL) of the patients undergoing percutaneous coronary intervention (PCI).

Materials and methods:

In this randomized controlled clinical trial, single-blinded. One hundred-fifty-five patients (mean age: 50.41±7.3 years, 41 women and 39 men) who underwent PCI were randomized into the two groups of intervention and control. The HBCT program included supervised exercise training, walking, phone calls, and a pedometer for 8 weeks. Hemodynamic changes, including systolic blood pressure (SBP) and diastolic blood pressure (DBP), resting heart rate (HRrest), maximum heart rate (HRmax), ejection fraction (EF), and rate pressure product (RPP), and functional parameters including the distance walked and metabolic equivalents (METS), also HRQOL were measured in all patients before and after the 8-week HBCT program.

Results:

Our results showed significant reductions in SBPrest (126.82±9.17 vs. 131.27±10.24; P =0.044), DBPrest (87.4±5.39 vs. 89.17±7.33; P=0.027), HRrest (76.15±3.01 vs. 77.65±4.16; P=0.041), HRmax (143.1±5.24 vs. 147.57±8.63; P=0.011), and RPP (9.64±0.81 vs. 10.07±0.99; P=0.007) and significant elevations in (45.75±4.31 vs. 43.5±5.21; P=0.039), distance walked (514.95±214.5 vs. 368.04±221.43; P=0.019), Mets (7.41±0.84 vs. 6.89±1.28; P=0.018), as well as HRQOL in the MCS (50.62±10.45 vs. 46.25±7.74; P=0.037), and HRQOL in the PCS (46.75±8.73 vs. 42.37±9.99; P=0.040) in the intervention group compared to the control group.

Conclusion:

An HBCT program consisting of supervised exercise training significantly improved hemodynamic response, exercise performance capacity, and HRQOL in patients following PCI.
Squamous cell carcinoma involving the midline of the dorsum of the tongue: a case report
Authors: Sasaki Jun , Aoki Yoshihiko , Ito Yohei , Saito Terumi
Published: October 2024

Introduction:

Most cases of squamous cell carcinoma (SCC) of the tongue occur on the lateral surface; however, SCC of the dorsum is extremely rare.

Case presentation:

The authors describe the case of a 79-year-old man with SCC involving the midline of the dorsum of the tongue. The lesion was surgically resected. The patient was followed up for 1 year and 6 months, and no recurrence was noted.

Discussion:

SCC of the dorsal midline is even rarer and accounts for less than 1% of tongue carcinomas. SCC involving the dorsum may have a worse prognosis than SCC of the lateral or ventral surface. This report is the first to use submental flap reconstruction to treat cancer of the midline dorsum of the tongue.

Conclusion:

The authors encountered a case of SCC involving the midline of the dorsum of the tongue, which has rarely been reported in the literature. The authors attained a favorable outcome through surgical intervention.
Surgical approach to congenital nasal dermoid sinus cyst in adult with external rhinoplasty and endoscopic approach: a case report
Authors: Mostafa Kheder , Mostafa Rokiah , Nezam Sara , Nezam Nezam , Shaheen Fahed
Published: October 2024

Introduction and importance:

Nasal dermoid sinus cysts (NDSCs) are rare congenital nasal lesions which typically arise in early childhood. Complete surgical excision is the only therapy, and many approaches have been used according to the location and the extension of the mass. Several studies have advocated external rhinoplasty and endoscopy.

Case presentation:

A 21-year-old female presented with a mass on the root of the nose, which appeared since childhood, and enlarged after puberty. Investigations including imaging revealed a lobulated mass extending from the osteocartilaginous junction towards the nasion, affecting the left lateral nasal wall. And its upper pole was resting on the floor of the left frontal sinus. Complete resection was performed using external rhinoplasty and endoscopy approaches, which improved esthetic results. Lateral osteotomy was used to compensate for the lateral nasal bone loss by narrowing the width of the nose. After 10 weeks of follow-up, no complications occurred, and the patient was satisfied with the cosmetic results.

Clinical discussion:

Nasal dermoid sinus cysts are congenital midline nasal lesions that can present as an isolated mass, or associated with intracranial extension. External rhinoplasty and endoscopy approaches are recommended for complete excision of NDSCs extending to the anterior skull base, especially when there is no intracranial involvement or in case of small intracranial extension. These two methods allow for repairing bone defects of the anterior skull base and improve esthetic results. However, in cases of large intracranial extension, craniotomy is preferred.

Conclusion:

The surgical approach used in the treatment of nasal dermoid sinus cysts should be a minimally invasive technique that reduces bone morbidity and provides good cosmetic results.
Cachexia in tuberculosis in South-East Asian and African regions: knowledge gaps and untapped opportunities
Authors: Mistry Dhruv , Patil Prashant , Beniwal Shreya Singh , Penugonda Raghav , Paila Sushmitha , Deiveegan Dharani Swarna , Tibrewal Charu , Yousef Ghazal Kamal , Anveshak  , Nikhil Padakanti Suraj Sai , Chauhan Jugalkishor , Reddy A Likhitha , Sofia Cummings Kareema R. , Reddy Molakala Surya Simha , Saini Pulkit , Abdullahi Omar Mohamed , Vandara Mansi , Ijantkar Saakshi A.
Published: October 2024

Tuberculosis (TB) and cachexia are clinical entities that have a defined relationship, making them often found together. TB can lead to cachexia, while cachexia is a risk factor for TB. This article reviews cachexia in Tuberculosis patients in Southeast Asian and African regions by conducting a comprehensive literature search across electronic databases such as PubMed, Google Scholar, and Research Gate between 2013 and 2024 using keywords including ‘Africa’, ‘cachexia’, ‘prevalence’, ‘implications’, ‘tuberculosis’, and ‘Southeast Asia. This article utilized only studies that satisfied the inclusion criteria, revealing knowledge gaps and untapped opportunities for cachexia in TB across Southeast Asian and African regions. Many Southeast Asian and Western Pacific patients initially receive a tuberculosis diagnosis. Sub-Saharan African countries are among the 30 high TB burden nations, according to the WHO. Food inadequacy and heightened energy expenditure can impair the immune system, leading to latent TB and subsequently, active infection. Symptoms needing attention: shortness of breath, productive cough, hyponatremia at 131 mmol/l, hypoalbuminemia at 2.1 g/dl, elevated aspartate transaminase at 75 U/l, increased lactate dehydrogenase at 654, and normocytic anemia. Comorbidities, such as kidney disease, cardiovascular disease, and asthma, can influence the nutritional status of individuals with TB. While efforts like screening, contact tracing, and utilizing gene Xpert to detect TB cases were implemented, only a few proved effective. It is essential to conduct further studies, including RCTs, in Southeast Asia and Africa to evaluate and manage cachexia in TB patients.
Diagnosis and management of spontaneous coronary artery dissection: Two cases and a review of the literature
Authors: Ahmad Adeel , Arshad Khurram , Ali Farman , Latif Rabia , Mozaffari Mohammad Ali , Khan Muhammad Waqas
Published: October 2024

Introduction and importance:

Spontaneous coronary artery dissection (SCAD) is a rare but potentially fatal condition, often underdiagnosed despite its significance in acute coronary syndrome (ACS). The true prevalence remains uncertain due to diagnostic challenges. Identifying SCAD cases is crucial for reducing mortality and morbidity, especially considering the recurrence risk. The authors present two cases highlighting the importance of multimodality imaging in diagnosing and managing SCAD.

Case presentation:

Case 1: A 53-year-old man with a history of brain aneurysm presented with chest pain and shortness of breath. Despite negative EKGs and stress tests, coronary computed tomography angiography (CCTA) revealed non-obstructive dissection flaps. Medical management improved his condition.

Case 2: A 55-year-old woman with no significant medical history experienced recurrent chest pain. Initial tests were negative, but CCTA revealed SCAD. Further screening uncovered undiagnosed fibromuscular dysplasia.

Clinical discussion:

SCAD poses diagnostic challenges, often mimicking other cardiac conditions. Traditional tests may yield negative results, necessitating advanced imaging techniques like CCTA. Recognizing SCAD’s association with connective tissue disorders (CTD) is vital for comprehensive patient care. The authors’ cases emphasize the importance of a systematic approach to diagnosing chest pain, including noninvasive modalities and considering underlying etiologies.

Conclusion:

SCAD diagnosis requires a high index of suspicion, especially when traditional cardiac tests are inconclusive. Beyond treatment, patients should undergo further evaluation for CTDs, particularly in those with minimal risk factors for atherosclerosis. Increased awareness and a multimodal diagnostic approach are crucial for timely intervention and improved outcomes in SCAD patients.

Learning objectives:

The authors aim to increase awareness regarding different clinical presentations of SCAD to decrease the risk of missed or late diagnosis. The authors’ case series also signifies the multimodal imaging approach’s role in evaluating chest pain. Upon diagnosis of SCAD, it is imperative to go beyond treatment and implement a reverse algorithmic strategy to discover any underlying causes and risk factors for SCAD predisposition.
Clinical outcomes following hospitalization for COVID-19 in patients with cardiac sarcoidosis in the United States: a propensity-matched analysis from national inpatient sample database from April 2020 to December 2021
Authors: Mactaggart Sebastian , Ahmed Raheel , Riaz Asma , Tabassum Shehroze , Ramphul Kamleshun , Bilal Maham , Jamil Yumna , Dulay Mansimran Singh , Liu Alexander , Ahmed Mushood , Sawatari Hiroyuki , Pekyi-Boateng Prince K. , Azzu Alessia , Wells Athol , Kouranos Vasilis , Chahal Anwar , Sharma Rakesh
Published: October 2024

Background:

The highly arrhythmogenic nature of cardiac sarcoidosis (CS) leads to high morbidity and mortality, the rates of which may be higher in COVID-19 patients. This study aimed to evaluate the outcomes of CS patients admitted to hospitals with COVID-19.

Methods:

The study utilised the 2020–2021 National Inpatient Sample database, examining primary COVID-19 cases in adults aged older than or equal to 18 years. Those with CS were identified using ICD-10 code “D86.85” and compared with and without propensity matching (1:10) to those without CS for baseline characteristics and primary outcomes of acute kidney injury (AKI), use of mechanical ventilation, cardiac arrest and mortality.

Results:

In total, 2 543 912 COVID-19 cases were identified. Before propensity matching, CS patients were more likely to be younger (58.0 vs. 64.0 years, P<0.01), male (64.0% vs. 52.6%, P=0.011), of Black ethnicity (60.0% vs. 15.9%, P<0.01), exhibit higher Charlson Comorbidity Index (CCI) scores (3.00 vs. 1.00, P<0.01) and had a higher incidence of in-hospital cardiac arrest (aOR 2.649, 95% CI 1.366–5.134, P=0.004). After propensity matching (CS, N=95; non-CS, N=875), those with CS were at a statistically significant reduced risk of AKI (aOR 0.484, P=0.01); however, the outcomes of death, cardiac arrest, mechanical ventilation, length of stay (LOS) and healthcare costs did not reach significance.

Conclusion:

In a propensity-matched cohort admitted with COVID-19, CS patients had a reduced risk of AKI, but comparable LOS, rates of cardiac arrest, mechanical ventilator use, and mortality. Future research is warranted to develop evidence-based guidelines for managing COVID-19 in patients with CS.