bluuebunny/crossref_metadata_2025 huggingface dataset:
(182) A CHART REVIEW OF LOW-INTENSITY SHOCKWAVE THERAPY WITH UROGOLD 100™ MTS FOR HORMONALLY-MEDIATED VESTIBULODYNIA
Authors: Goldstein Sue W , Goldstein Irwin
Published: June 2024

Objectives

Low intensity shockwave therapy (LiSWT) is a non-pharmacologic, non-surgical treatment strategy FDA-cleared for pain amelioration. This chart review examines treatment outcome with the Urogold 100™MTS for hormonally-mediated vestibulodynia (HMV).

Methods

Patients diagnosed with HMV were offered LiSWT. Standard in our practice, patients completed Female Sexual Function Index (FSFI), Sexual Distress Scale (SDS), vulvoscopy with photography, and cotton-tipped swab testing at baseline. Pre-treatment hormonal blood tests included total testosterone and sex hormone binding globulin. Vulvoscopic vulvar/vestibular photographs were scored for Vulvar/Vestibular Tissue Appearance (Vul/VestTA) (0 = normal, 1 = minimal, 2 = moderate, 3 = severe) for the vulva, vestibule and urethral meatus. Cotton-tipped swab testing rated pain at the 1: 00, 3:00, 5:00, 6:00, 7:00, 9:00 and 11:00 positions (0 = no pain, 1 = minimal, 2 = moderate, 3 = severe). The LiSWT protocol involved 6 treatment sessions, 2100 shocks each (700 right/left lateral vestibule, 700 posterior vestibule), frequency 3/sec, membrane level 1, with energy varied from 0.07 – 0.13 mJ/mm2, based on patient tolerance. Patients underwent vulvar-vestibular photography and cotton-tipped swab testing prior to each set of LiSWT. Before the second and subsequent treatments, patients completed the Patient Global Impression of Improvement (PGI-I).

Results

19 patients with HMV, mean age 35 years, had low calculated free testosterone and elevated sex hormone binding globulin. Mean baseline scores were: FSFI 15.2/36; Sexual Distress Scale 31/52; cotton-tipped swab testing 2.4; and Vul/VestTA 2.6. Post-treatment, 11/19 (58%) of patients reported a PGI-I of 1-3, indicative of clinically relevant improvement. Post-treatment cotton-tipped swab testing score was diminished to 1.9 (consistent with mild pain), Vul/VestTA was 1.7 and vulvar/vestibular photographs revealed reduced vestibular pallor and erythema. One patient experienced transient worsening of symptoms.

Conclusions

This chart review supports the need for prospective, sham-controlled clinical trials of LiSWT with Urogold 100™MTS for HMV.

Conflicts of Interest

No conflicts of interest.
(148) SEXUAL ASSAULT REPORTING: A STUDY TO IMPROVE PREVENTION, INFORMATION, AND CARE OF VICTIMS IN EMERGENCY CARE SETTINGS
Authors: Cottler-Casanova Dr Sara , Lourenço Vera , Guillot Cécile , Poncet Antoine , Mathevet Prof Patrice , Petignat Prof Patrick , Yaron Priv-Doz Michal , Fracasso Prof Tony , Abdulcadir Priv-Doz Jasmine
Published: June 2024

Objectives

To assess the characteristics of all persons reporting sexual assault at the obstetrics and gynecology emergency departments of Geneva University Hospital and Lausanne University Hospitals (CHUV), between 2018 and 2021.

Methods

Retrospective analysis of medico-legal reports for all persons reporting sexual assault at the obstetrics and gynecology emergency departments of the HUG and CHUV between 2018 and 2021.

Results

962 sexual assault records during the 48-month study, 740 were retained for the analysis.

Conclusions

Such data have shaped the creation of the informatic medical file and prospective study to inform services after sexual assault, prevention and health education strategies for all.

Conflicts of Interest

No Conflicts of Interest to declare.
(107) NAVIGATING ENDOMETRIOSIS IN THE TRANSGENDER AND GENDER DIVERSE COMMUNITY: INSIGHTS FROM MULTIDISCIPLINARY FOCUS GROUPS
Authors: Giacomozzi Dr Maddalena , Bouwens Jip , Pieri Mara , Verdonk Prof Petra , Nap Prof Annemiek ,   This project is submitted on behalf of the “TRANSforming endometriosis research” commitee.
Published: June 2024

Objectives

The study aims to gain insights in endometriosis experiences among transgender and gender diverse (TGD) people living with endometriosis and the care they (do not) receive. The objective is to set an agenda to narrow gaps in literature, and to identify relevant recommendations regarding endometriosis care for this community for different disciplines.

Methods

Recruitment took place through a call on social media and professional network of the organizers. Patients and professionals were selected to guarantee a balance of senior/junior researchers, fair geographical distribution and a diversified personal and professional background.

Data was collected during a two-days event hosted at the Brocher Foundation. On the first day 12 presentations were held to ensure all participants had a common understanding of the topic. On the second day, three semi-structured focus groups were conducted. Data was analyzed following the six-step thematic analysis following Braun and Clarke (2006).

Results

Twenty-one participants were selected. These included patient representative and scholars from medicine, public health, social sciences, anthropology, psychology and sexology. Five clusters (research, diagnosis, treatment, HCP-related factors and social challenges) and twenty-one themes were identifies.

Conclusions

This study underscores the insufficiency of current literature leading to an oversimplified portrayal that does not reflect the lived experiences of many individuals. The current guidelines lack the sensitivity needed to address the unique healthcare challenges and barriers faced by this community. This disconnect manifests in delayed diagnosis, inappropriate treatments, and lack of culturally competent care, ultimately perpetuating health disparities in this already marginalized group.

This study emphasizes the pressing need for a multidisciplinary and inclusive approach to endometriosis research and care. The agenda for future research must prioritize a thorough understanding of the nuanced experiences of TGD individuals with endometriosis, considering factors such as hormone therapy, gender-affirming surgeries and minority stress. Healthcare guidelines must undergo an overhaul to incorporate specific needs of this community.

Conflicts of Interest

The event where the data was collected was kindly hosted by the Brocher Foundation. The Brocher foundation mission is to encourage a research on the ethical, legal and social implications of new medical technologies. Its main activities are to host visiting researchers and to organize workshops and summer academies. More information on the Brocher foundation program is available at www.brocher.ch.
(130) SHAEER’S HYDRO-DISSECTION OF THE NEURO-VASCULAR BUNDLE
Authors: Shaeer Prof Osama
Published: June 2024

Objectives

Neurovascular bundle mobilization (NVB) is a key-step of many reconstructive penile surgeries. This is a step that requires a lot of experience, patience, and meticulous surgical technique. Otherwise, the patient may end up with sensory deficit due to nerve injury, or arterial insufficiency due to injury of the dorsal artery of the penis. This work described hydro-dissection of the neurovascular bundle (h-NVBm) aiming at a safer and faster procedure.

Methods

H-NVBm was performed in 50 cases with congenital penile curvature or Peyronie’s deformity (h-NVB group, n=50). A matching group was operated upon without hydro-dissection (NVBm group, n=32). In H-NVBm cases, hydro-inflation of Buck’s fascia was performed prior to mobilization using 80% saline and 20% xylocaine (without adrenaline). The mixture was either injected into Buck’s fascia with a butterfly cannula inserted along the longitudinal axis of the shaft at several points, or with the blunt nozzle of a 20ml syringe, superficially applied to the surface of Buck’s fascia. In both groups, NVB was mobilized with alternating sharp and blunt dissection, aided with bipolar diathermy. Both groups were compared as regards time needed for mobilization, and post-operative sensitivity at the 6 month post-operative, subjectively evaluated on a 5-point scale.

Results

Average duration for NVB in the hNVBm group was 3.5 minutes ± 1.4, compared to a duration of 7.3 ± 2 for NVBm group (p<0.001). Sensitivity score was higher in the hNVBm group (4.7±0.5) compared to 4.3±1 in the NVBm group (p<0.001).

Conclusions

Hydro-dissection of the neurovascular bundle renders the procedure relatively safer and faster. While expert surgeons may be content with classic mobilization, hNVBm can be of particular importance to new entants to of penile surgery.

Conflicts of Interest

None.
Early detection of myocardial infarction with reference to baseline levels during health: impact on biological variation of high-sensitivity cardiac troponin
Authors: Wu Alan H B , Graglia Sally
Published: June 2024

A 78-year-old male was seen in the emergency department (ED) with chest pain. Fifteen months earlier, he had presented to the ED with shoulder and elbow pain. High-sensitivity cardiac troponin I (hs-cTnI) testing was conducted at that time, which produced normal results of 10 and 13 ng/L (cutoff <48 ng/L). During the current admission, his electrocardiogram was unremarkable, with a borderline prolonged PR interval noted. The patient’s hs-cTnI results were 25, 47, and 254 ng/L at 0, 1, and 7 hours, respectively. He was diagnosed with demand ischemia and admitted to the hospital. The detection of acute myocardial infarction in this case was made during the first sample collection (t = 0), despite the fact that this result was well within the normal range.
Effect of Pb, Cu and Zn on development and Wnt/β-catenin signaling pathway genes expression of Ctenopharyngodon idella
Authors: Tlenshieva A M , Shalakhmetova T M , Witeska M
Published: June 2024

Pollution of the aquatic environment with heavy metals is a serious environmental problem, since they accumulate in aquatic organisms and can affect their development and worsen their condition. According to the scheme of Fig. 1 zinc (Zn), copper (Cu) or lead (Pb) were studied when exposed to concentrations of: Zn (0.01; 0.1; 1 mg/L), Cu (0.001; 0.01; 0.1 mg/L), Pb (0.006; 0.06; 0.6 mg/L) for 144 h after fertilization (hpf) on the grass carp (Ctenopharyngodon idella), one of the important commercial fish species of Kazakhstan, the activity of superoxide dismutase (SOD) and the expression of genes of the Wnt/β-catenin signaling pathway involved in development. All metals significantly reduced survival, hatching rate, and changed biometric parameters and heart rate of cupid larvae. In addition, these metals (mainly Pb and Cu) inhibited superoxide dismutase (SOD) activity and mRNA transcription of genes encoding genes of the Wnt/β-catenin signaling pathway. These results showed that Pb, Cu and Zn not only affect the survival and development of fish at an early stage of life, but also cause oxidative stress and prevent fish detoxification.
Triple-isotope analysis in tree-ring cellulose suggests only moderate effects of tree species mixture on the climate sensitivity of silver fir and Douglas-fir
Authors: Charlet de Sauvage Justine , Treydte Kerstin , Saurer Matthias , Lévesque Mathieu
Published: June 2024

Disentangling the factors influencing the climate sensitivity of trees is crucial to understanding the susceptibility of forests to climate change. Reducing tree-to-tree competition and mixing tree species are two strategies often promoted to reduce the drought sensitivity of trees, but it is unclear how effective these measures are in different ecosystems. Here, we studied the growth and physiological responses to climate and severe droughts of silver fir and Douglas-fir growing in pure and mixed conditions at three sites in Switzerland. We used tree-ring width data and carbon (δ13C), oxygen (δ18O) and hydrogen (δ2H) stable isotope ratios from tree-ring cellulose to gain novel information on water relations and the physiology of trees in response to drought and how tree species mixture and competition modulate these responses. We found significant differences in isotope ratios between trees growing in pure and mixed conditions for the two species, although these differences varied between sites, e.g. trees growing in mixed conditions had higher δ13C values and tree-ring width than trees growing in pure conditions for two of the sites. For both species, differences between trees in pure and mixed conditions regarding their sensitivity to temperature, precipitation, climatic water balance and vapor pressure deficit were minor. Furthermore, trees growing in pure and mixed conditions showed similar responses of tree-ring width and isotope ratios to the past severe droughts of 2003, 2015 and 2018. Competition had only a significantly negative effect on δ13C of silver fir, which may suggest a decrease in photosynthesis due to higher competition for light and nutrients. Our study highlights that tree species mixture may have only moderate effects on the radial growth and physiological responses of silver fir and Douglas-fir to climatic conditions and that site condition effects may dominate over mixture effects.
Integration of a Community Opioid Treatment Program Into a Federally Qualified Health Center
Authors: Neeb Christine , McQuade Brianna M. , Lesondak Linda , Madrid Samantha , Schlaeger Judith M. , Watson Dennis P. , Karnik Niranjan , Huerta Noami , Bhatia Simar , Fleurimont Judes , Li Nicole , Hammerdahl Elsa , Pesantez Ricky , Gastala Nicole
Published: June 2024

Objectives

With the increasing rates of opioid overdose deaths in the United States, barriers to treatment access for patients seeking medications for opioid use disorder (OUD), and challenges of initiating buprenorphine in patients who use fentanyl, it is essential to explore novel approaches to expanding access to methadone treatment. An opioid treatment program (OTP) and a federally qualified health center (FQHC) partnered to develop and implement an innovative integrated methadone and primary care treatment model. The process for integrating an OTP and FQHC to provide methadone treatment in the primary care setting will be discussed.

Methods

An OTP methadone dispensing site was co-located in the FQHC, utilizing a staffing matrix built on the expertise of each stakeholder. The OTP managed DEA and state regulatory processes, whereas the FQHC physicians provided medical treatment, including methadone treatment protocols, treatment plans, and primary care. Patient demographics, medical history, and retention data for those who entered the program between January 2021 and February 2023 were collected through chart review and analyzed with descriptive statistics.

Results

A total of 288 OTP-FHQC patients were enrolled during the study. Retention rates in methadone treatment at 90 and 180 days were similar to partner clinics.

Conclusions

Collaboration between FQHCs and OTPs is operationally feasible and can be achieved utilizing the current staffing model of the FQHC and OTP. This model can increase access to treatment for OUD and primary care for an urban, underserved patient population.
Operative Treatment of Distal Tibial Fractures in Children Managed With Epiphyseal Screws: A Comparison of Outcomes When Screws Are Retained Versus Removed Following Fracture Union
Authors: Zimmerman Remy , Rupp Garrett , Barger Kurt , Fang William , Thomas Evelyn , Bastrom Tracey , Pennock Andrew , Schlechter John
Published: June 2024

Background:

Fractures of the distal tibial epiphysis in children are often accompanied by articular surface disruption. With increased displacement, internal fixation is frequently performed with an epiphyseal screw to close the fracture gap. Despite limited, high-level clinical evidence to support implant removal, epiphyseal screws are commonly removed after fracture healing due to potentially increased contact forces on the tibiotalar joint. The purpose of this study was to investigate and compare outcomes and complications in children that underwent surgical treatment of distal tibial epiphyseal fractures with placement of an epiphyseal screw(s) and had the implant(s) retained versus removed at a minimum of 2-year postoperative follow-up.

Methods:

Children younger than 18 years from two urban tertiary care centers who underwent operative management of distal tibia Salter-Harris III and IV fractures using epiphyseal screws (2013-2020) were divided into two cohorts: retained epiphyseal screws and implant removed. Demographics, intraoperative, postoperative, and radiographic data were collected. Patient-reported outcomes (PROs) using the Foot and Ankle Ability Measure (FAAM) and Single Assessment Numeric Evaluation (SANE) questionnaires were collected at the final follow-up. Statistical analysis, including power analysis, was performed.

Results:

Fifty-two children were included (30 males, 22 females) with a mean age of 13.3 years at the time of injury (range, 7.7-16.4 years). Thirty-five children retained the implants; seventeen had implants removed. All completed the FAAM questionnaires at a mean follow-up of 4.4 ± 1.9 years, while 29 completed the SANE questionnaire at a mean follow-up of 4.4 ± 1.7 years. No statistically significant difference in patient demographics, surgical variables, or PROs was observed. Six children experienced complications from the initial surgery, including infections and complex regional pain syndrome, with no difference in complication rates between the cohorts (P=0.08). Furthermore, no complication was observed as a result of implant removal.

Conclusions:

Children with retained epiphyseal implants have similar functional outcomes as compared with those who had implants removed after distal tibial epiphyseal fracture fixation and union.

Level of Evidence:

Level III—Retrospective comparative study.
Iron metabolism and arthritis: Exploring connections and therapeutic avenues
Authors: Zhuo Dachun , Xiao Wenze , Tang Yulong , Jiang Shuai , Geng Chengchun , Xie Jiangnan , Ma Xiaobei , Zhang Qing , Tang Kunhai , Yu Yuexin , Bai Lu , Zou Hejian , Liu Jing , Wang Jiucun
Published: June 2024

Iron is indispensable for the viablility of nearly all living organisms, and it is imperative for cells, tissues, and organisms to acquire this essential metal sufficiently and maintain its metabolic stability for survival. Disruption of iron homeostasis can lead to the development of various diseases. There is a robust connection between iron metabolism and infection, immunity, inflammation, and aging, suggesting that disorders in iron metabolism may contribute to the pathogenesis of arthritis. Numerous studies have focused on the significant role of iron metabolism in the development of arthritis and its potential for targeted drug therapy. Targeting iron metabolism offers a promising approach for individualized treatment of arthritis. Therefore, this review aimed to investigate the mechanisms by which the body maintains iron metabolism and the impacts of iron and iron metabolism disorders on arthritis. Furthermore, this review aimed to identify potential therapeutic targets and active substances related to iron metabolism, which could provide promising research directions in this field.
New Perspectives in The Management of Paroxysmal Atrial Fibrillation: Dual AntiArrhythmic Medications
Authors: Al-Jammali Safa , Al-Zakhari Rana , Mahtani Arun Umesh , Isber Nidal
Published: June 2024

Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered in clinical practice projected to affect 12.1 million individuals by the year 2030. Patients who are diagnosed with AF have an increased risk of morbidity and mortality. Although catheter ablation is a class I treatment recommendation in patients with symptomatic paroxysmal AF, antiarrhythmic medications (AAM) continue to be the mainstay of treatment in limited resource settings not offering ablation procedures. Currently, the most used AAMs are those which block either the sodium or potassium channels. We hypothesized that the use of selective dual AAM (sodium and potassium channel blockers) (DAAM) improves the chance of maintaining sinus rhythm and decreases the need for catheter ablation when compared with single AAM (SAAM). This retrospective observational study was conducted in 150 patients with paroxysmal AF over 5 years at Richmond University Medical Center in Staten Island, New York. The following data were collected: age, sex, comorbidities, electrocardiogram findings, ejection fraction by echocardiography, classes of AAM, duration, and response to treatments. The primary endpoint included the absence of symptoms and maintenance of sinus rhythm. The secondary endpoint included the requirement of electrical cardioversion or catheter ablation. A total of 86 patients met the inclusion criteria in our analysis. The average age of the patients was 71.06 years (SD = 7.66). About 45 patients were given DAAM of either amiodarone + flecainide or dronedarone + flecainide and were treated for an average of 15.4 months, followed by catheter ablation, if needed. Also, 41 patients received a SAAM followed by catheter ablation, if needed. A Mann–Whitney test indicated that electrical cardioversion and catheter ablation were greater for the SAAM group (Md = 1) than for the DAAM group (Md = 0) (U = 294.00, P value <0.001; U = 507.00, P value <0.001, respectively). No pro-arrhythmic side effects or death were encountered in either group. Treatment of paroxysmal AF with DAAM is effective compared with SAAM and is less likely to need catheter ablation or electrical cardioversion. Well-designed prospective studies are needed to further explore the use of DAAM in the management of paroxysmal AF and its clinical impact in limited resource settings.
Midperipheral retinal thickening on wide field OCT in a patient with a mutation in the NR2E3 gene
Authors: Pott Jan Willem R. , Huiskamp E. Angela , Verheij Joke B.G.M.
Published: June 2024

Purpose:

To report typical retinal findings in a girl with the presumed diagnosis of ESCS, attributed to the presence of a homozygous likely pathogenic variation in the NR2E3 gene.

Methods:

A retrospective case report with multimodal imaging studies

Results:

Wide field OCT examination at the age of 11 years showed increased thickening of the midperipheral retina. In the area of retinal thickening delineation of retinal architecture was coarse, and photoreceptor outer segments thinned and disrupted. The retinal pigment epithelium appeared to be normal on autofluorescence imaging. In retrospect the retinal thickening was already apparent on conventional OCT at the age of 3 years.

Conclusion:

Wide field OCT is a valuable new tool in assessing typical retinal abnormalities in patients with NR2E3 mutations, by showing an abnormal but very characteristic thickening of the midperipheral retina.
Child Maltreatment-Focused Intervention Research
Authors: Banerjee Rashida , Movahedazarhouligh Sara , Ghosh Ekta
Published: June 2024

Child maltreatment is a significant public health concern that affects children’s health and well-being throughout their life. Children who are maltreated are at an increased risk of developing a disability or delay and are more vulnerable to a range of mental health-related problems, including depression, anxiety, substance abuse, criminality, and other forms of poorly regulated emotional behavior. Children with disabilities are also at a higher risk for maltreatment, and their needs often go unmet. This systematic literature review aimed to identify, analyze, and summarize the preventive programs and intervention practices between 2009 and 2021, addressing maltreatment in children from birth through 8 years of age. The initial search identified 616 peer-reviewed articles on the topic. Seventeen intervention studies met inclusion criteria and were reviewed and coded using systematic procedures. The findings suggest that home visiting and parent education are the most highly investigated educational intervention programs, with parents and caregivers as the primary recipients of the interventions. Studies of maltreatment interventions in children with disabilities are limited, with inadequate methodological rigor. We recommend future robust and wide-ranging investigations to prevent and mitigate the effects of maltreatment of children, particularly children with disabilities, and replications of studies that show promise.
Predictors of Moderate-High Posttraumatic Growth in Parents of Children With Cancer
Authors: Meral Buket , Bulut Hacer Kobya
Published: June 2024

Background

Parents of children with cancer may experience posttraumatic growth (PTG). In clinical practice, this parental enhancement is more likely to be seen with a moderate-high PTG.

Objective

The aim of this study was to determine the moderate-high PTG prevalence of parents of children diagnosed with cancer at least 6 months and to investigate its relationship with hope, social support, and patient-parent characteristics.

Methods

This cross-sectional study was conducted with the parents of children with cancer admitted to the pediatric hematology-oncology unit using the Parent-Child Characteristic Questionnaire, Posttraumatic Growth Inventory, Multidimensional Scale of Perceived Social Support and Dispositional Hope Scale. Univariate and multivariate logistic regression analyses were performed to investigate the variables associated with moderate-high PTG.

Results

One hundred one parents were enrolled in this study, and the prevalence of the moderate-high PTG was 79.2%. There was a statistically significant difference between moderate-high PTG and children’s age (P = .037). Multivariate logistic regression analysis showed that social support from significant others (odds ratio = 1.138, 95% confidence interval = 1.030–1.257, P = .011) was a predictor of moderate-high PTG.

Conclusions

Moderate-high PTG is common among parents of children diagnosed with cancer. Perceived social support from healthcare professionals and other patient parents is a predictive factor.

Implications for Practice

Interventions that encourage the support of health professionals and interaction with the parents of other patients, such as peer counseling, group-based interventions, and expanding the social support network, seem to be clinically promising in helping parents to improve from the cancer experience.
Framingham Stroke Risk Profile Score and White Matter Disease Progression
Authors: Youssef Hossam , Demirer Mutlu , Middlebrooks Erik H. , Anisetti Bhrugun , Meschia James F. , Lin Michelle P.
Published: June 2024

Objectives:

To evaluate the relationship between Framingham Stroke Risk Profile (FSRP) score and rate of white matter hyperintensity (WMH) progression and cognition.

Methods:

Consecutive patients enrolled in the Mayo Clinic Florida Familial Cerebrovascular Diseases Registry (2011-2020) with 2 brain-MRI scans at least 1 year apart were included. The primary outcome was annual change in WMH volume (cm3/year) stratified as fast versus slow (above vs. below median). Cognition was assessed using a Mini-Mental State Exam (MMSE, 0-30). FSRP score (0 to 8) was calculated by summing the presence of age 65 years or older, smoking, systolic blood pressure greater than 130 mmHg, diabetes, coronary disease, atrial fibrillation, left ventricular hypertrophy, and antihypertensive medication use. Linear and logistic regression analyses were performed to examine the association between FSRP and WMH progression, and cognition.

Results:

In all, 207 patients were included, with a mean age of 60±16 y and 54.6% female. FSRP scores risk distribution was: 31.9% scored 0 to 1, 36.7% scored 2 to 3, and 31.4% scored ≥4. The baseline WMH volume was 9.6 cm3 (IQR: 3.3-28.4 cm3), and the annual rate of WMH progression was 0.9 cm3/year (IQR: 0.1 to 3.1 cm3/year). A higher FSRP score was associated with fast WMH progression (odds ratio, 1.45; 95% CI: 1.22-1.72; P<0.001) and a lower MMSE score (23.6 vs. 27.1; P<0.001). There was a dose-dependent relationship between higher FSRP score and fast WMH progression (odds ratios, 2.20, 4.64, 7.86, 8.03 for FSRP scores 1, 2, 3, and ≥4, respectively; trend P<0.001).

Conclusions:

This study demonstrated an association between higher FSRP scores and accelerated WMH progression, as well as lower cognition.
International Travel for Organ Transplantation: A Survey of Professional Experiences and Attitudes Toward Data Collection and Reporting
Authors: Irish Georgina L. , Fadhil Riadh A.S. , Rondeau Eric , Nagral Sanjay , Ahmadipour Mohammadali , Coates P. Toby , Martin Dominique E.
Published: June 2024

Background.

Lack of data regarding international travel for organ transplantation (ITOT) hampers efforts to evaluate, understand, and respond to trends in ITOT activities, such as those suggestive of organ trafficking or “transplant tourism.” This study aimed to assess transplant professionals’ experience of ITOT and their attitudes toward reporting ITOT data to a global registry.

Methods.

An international cross-sectional anonymous survey of transplant professionals was conducted online (from October to December 2022). The English language questionnaire assessed professional experiences in providing care to individuals who had traveled to or from a country for living donation or transplantation, and attitudes toward reporting of ITOT data. Data were analyzed with descriptive statistics.

Results.

Two hundred thirty-nine individuals from 68 countries completed the entire questionnaire, of whom 79% had provided care for ≥1 patient who had traveled internationally for donation or transplantation. Of these, 60.8% of individuals (n = 115) had cared for ≥1 person who engaged in ITOT between 2019 and 2022, with the most recent case experiences involving 89 countries and 157 unique routes of international travel. Predominant concerns regarding reporting of ITOT data to a global registry related to prevention of harm and protection of patient privacy; most (52.7%; n = 126) respondents expressed a preference for anonymous reporting of ITOT data.

Conclusions.

ITOT is a global phenomenon and transplant professionals’ experience with ITOT cases is more common than anticipated. Systems for the collection of ITOT activity data should be carefully designed to address potential ethical concerns of transplant professionals which may influence reporting practices.
Mycophenolate Dose Reduction in Tacrolimus-based Regimens and Long-term Kidney Transplant Outcomes in Australia and New Zealand
Authors: Lee Darren , Polkinghorne Kevan R. , Pilmore Helen , Mulley William R.
Published: June 2024

Background.

Mycophenolate dose reduction (MDR) is associated with acute rejection and transplant failure in kidney transplant recipients (KTRs). The optimal dose to prevent rejection and reduce complications remains poorly defined in tacrolimus-based regimens.

Methods.

We assessed adult KTRs from 2005 to 2017 initiated on mycophenolate mofetil 2 g/d, tacrolimus, and prednisolone from the Australia and New Zealand Dialysis and Transplant Registry. KTRs with rejection within the first 30 d posttransplant were excluded. The primary outcome was time to first rejection between 30 d and 2 y posttransplant. Mycophenolate dose was modeled as a time-varying covariate using Cox proportional hazards regression. Secondary outcomes included assessment of early MDR to <1.5 g/d within the first 6 mo posttransplant and subsequent patient and death-censored graft survival.

Results.

In the primary analysis, 3590 KTRs were included. Compared with mycophenolate dose of ≥2 g/d, both 1.0–<1.5 and <1 g/d were associated with an increased risk of rejection during the 2 y posttransplant (hazard ratio [HR] 1.67; 95% confidence interval [CI], 1.29-2.16; P < 0.001 and HR 2.06; 95% CI, 1.36-3.13; P = 0.001, respectively) but not 1.5–<2 g/d (HR 1.20; 95% CI, 0.94-1.53; P = 0.14). Early MDR to <1.5 g/d occurred in 45.3% of KTRs and was an independent risk factor for death-censored graft failure (HR 1.32; 95% CI, 1.05-1.66; P = 0.016) but not death (HR 1.18; 95% CI, 0.97-1.44; P = 0.10), during a median follow-up of 5.0 (interquartile range, 2.6–8.5) y.

Conclusions.

Early MDR was a risk factor for subsequent rejection and graft failure in KTRs receiving contemporary tacrolimus-based regimens.
Paenibacillus hexagrammi sp. nov., a novel bacterium isolated from the gut content of Hexagrammos agrammus
Authors: Jung Hyun-Kyoung , Kim Dong-Gyun , Zin Hyunwoo , Park Jungwook , Jung Hyejung , Kim Young-Ok , Kong Hee Jeong , Kim Ju-Won , Kim Young-Sam
Published: June 2024

A Gram-stain-positive, aerobic bacterium, designated as YPD9-1T, was isolated from the gut contents of a spotty belly greenling, Hexagrammos agrammus, collected near Dokdo island, South Korea. The rod-shaped cells were oxidase-positive, and catalase-negative. The major cellular fatty acids were anteiso-C15 : 0, iso-C15 : 0, C16 : 0, iso-C16 : 0 and iso-C17: 0. The major polar lipids were diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine and two unidentified lipids. The DNA G+C content was 47.6 mol% and the predominant respiratory quinone was menaquinone MK-7. The 16S rRNA gene sequence of YPD9-1T showed low sequence similarities to species of the genus Paenibacillus, Paenibacillus pocheonensis Gsoil 1138T (97.21 % of sequence similarity), Paenibacillus aestuarii CJ25T (97.12 %) and Paenibacillus allorhizoplanae JJ-42T (96.89 %). The results of phylogenetic analysis based on 16S rRNA gene sequences indicated that YPD9-1T formed a distinct branch among other species of the genus Paenibacillus. The digital DNA–DNA hybridisation, average nucleotide identity, and average amino acid identity values between YPD9-1T and the related species were in the ranges of 15.3–16.2 %, 74.1–78.4 %, and 71.1–71.9 %, respectively, which are below the species cutoff values. On the basis of the results of the polyphasic analysis, we conclude that strain YPD9-1T represents a novel species of the genus Paenibacillus, for which the name Paenibacillus hexagrammi sp. nov. is proposed. The type strain of Paenibacillus hexagrammi is YPD9-1T (=KCTC 43424T =LMG 32988T).
Deep Visual Proteomics Unveils Precision Medicine Insights in Composite Small Lymphocytic and Classical Hodgkin Lymphoma
Authors: Zheng Xiang , Pedersen Lars Møller , Bzorek Michael , Mund Andreas , Gjerdrum Lise Mette Rahbek , Mann Matthias
Published: June 2024

Coexistence of two cancer types in the same organ presents challenges for clinical decision-making, calling for personalized treatment strategies. Deep Visual Proteomics (DVP) combines AI driven single cell type analysis with laser microdissection and ultrasensitive mass spectrometry. In a composite case of classical Hodgkin lymphoma (cHL) and small lymphocytic lymphoma (SLL) in a single patient, we investigated the potential of DVP to inform precision oncology. We quantified the proteomic landscapes in the cHL and SLL to a depth of thousands of proteins. Our analysis revealed distinct proteome profiles in cHL and SLL populations, highlighting their clonal unrelatedness. Our data suggested standardized chemotherapy and interleukin-4 inhibition as potential strategies to manage chemo-resistance – instead of bone marrow transplantation. DVP highlighted minichromosome maintenance protein and proteasome inhibitors for cHL and H3K27 methylation and receptor tyrosine kinase inhibitors for SLL as subtype-specific treatments. Thus cell-type specific insights of DVP can guide personalized oncological treatments.
Deep Learning-Based Multimodal Clustering Model for Endotyping and Post-Arthroplasty Response Classification using Knee Osteoarthritis Subject-Matched Multi-Omic Data
Authors: Rockel Jason S. , Sharma Divya , Espin-Garcia Osvaldo , Hueniken Katrina , Sandhu Amit , Pastrello Chiara , Sundararajan Kala , Potla Pratibha , Fine Noah , Lively Starlee S. , Perry Kimberly , Mohamed Nizar N. , Syed Khalid , Jurisica Igor , Perruccio Anthony V. , Rampersaud Y. Raja , Gandhi Rajiv , Kapoor Mohit
Published: June 2024

Background

Primary knee osteoarthritis (KOA) is a heterogeneous disease with clinical and molecular contributors. Biofluids contain microRNAs and metabolites that can be measured by omic technologies. Deep learning captures complex non-linear associations within multimodal data but, to date, has not been used for multi-omic-based endotyping of KOA patients. We developed a novel multimodal deep learning framework for clustering of multi-omic data from three subject-matched biofluids to identify distinct KOA endotypes and classify one-year post-total knee arthroplasty (TKA) pain/function responses.

Materials and Methods

In 414 KOA patients, subject-matched plasma, synovial fluid and urine were analyzed by microRNA sequencing or metabolomics. Integrating 4 high-dimensional datasets comprising metabolites from plasma (n=151 features), along with microRNAs from plasma (n=421), synovial fluid (n=930), or urine (n=1225), a multimodal deep learning variational autoencoder architecture with K-means clustering was employed. Features influencing cluster assignment were identified and pathway analyses conducted. An integrative machine learning framework combining 4 molecular domains and a clinical domain was then used to classify WOMAC pain/function responses post-TKA within each cluster.

Findings

Multimodal deep learning-based clustering of subjects across 4 domains yielded 3 distinct patient clusters. Feature signatures comprising microRNAs and metabolites across biofluids included 30, 16, and 24 features associated with Clusters 1-3, respectively. Pathway analyses revealed distinct pathways associated with each cluster. Integration of 4 multi-omic domains along with clinical data improved response classification performance, with Cluster 3 achieving AUC=0·879 for subject pain response classification and Cluster 2 reaching AUC=0·808 for subject function response, surpassing individual domain classifications by 12% and 15% respectively.

Interpretation

We have developed a deep learning-based multimodal clustering model capable of integrating complex multi-fluid, multi-omic data to assist in KOA patient endotyping and test outcome response to TKA surgery.

Funding

Canada Research Chairs Program, Tony and Shari Fell Chair, Campaign to Cure Arthritis, University Health Network Foundation.
Correlations in microbial abundance data reveal host-bacteria and bacteria-bacteria interactions jointly shaping theC. elegansmicrobiome
Authors: Martini K. Michael , Boddu Satya Spandana , Taylor Megan N. , Nemenman Ilya , Vega Nic M.
Published: June 2024

Compositional structure of host-associated microbiomes is potentially affected by interactions among the microbes and between the microbes and the host. To quantify the relative importance of these contributions to the microbiome composition and variation, here we analyze absolute abundance (count) data for a minimal eight-species native microbiome in theCaenorhabditis elegansintestine. We find that a simple neutral model only considering migration, birth, death, and competition for space among the bacteria can capture the means and variances of bacterial abundance, but not the experimental bacteria-bacteria covariances. We find that either bacteria-bacteria interactions or correlations among bacterial population dynamics parameters induced by the host can qualitatively recapitulate the observed correlations among bacterial taxa. However, neither model is uniquely or completely sufficient to explain the data. Further, we observe that different interactions are required to explain (co)variance data in microbiota associated with different host genotypes, suggesting different community dynamics associated with these host types. Finally, we find that many of these signals are obscured when data are converted to proportions from counts, consistent with a growing literature on the limitations of compositional data for inference of population dynamics. We end with discussing the limitations of Lotka-Volterra type assumptions for microbial community data analysis revealed by our results.
Light-front model for the transition distribution amplitudes for backward timelike Compton scattering
Authors: Pasquini Barbara , Schiavi Andrea
Published: June 2024

To access information on the internal structure of the nucleon, data from a variety of scattering experiments can be analyzed in regimes where the information factorizes from an otherwise known scattering amplitude. A recent development, promising new insight, is the study of exclusive reactions in the backward kinematical region, where the information can be encoded in transition distribution amplitudes. We model the photon-to-nucleon transition distribution amplitudes, entering the factorized description of backward timelike Compton scattering, using techniques of light-front dynamics to integrate information from a quark model for the photon and the nucleon. We include the results of numerical predictions that could inform further experiments at Jefferson Lab and the future Electron-Ion Collider.

Published by the American Physical Society
2024
SO(5) Deconfined Phase Transition under the Fuzzy-Sphere Microscope: Approximate Conformal Symmetry, Pseudo-Criticality, and Operator Spectrum
Authors: Zhou Zheng , Hu Liangdong , Zhu W. , He Yin-Chen
Published: June 2024

The deconfined quantum critical point (DQCP) is an example of phase transitions beyond the Landau symmetry-breaking paradigm that attracts wide interest. However, its nature has not been settled after decades of study. In this paper, we apply the recently proposed fuzzy-sphere regularization to study the SO(5) nonlinear sigma model with a topological Wess-Zumino-Witten term, which serves as a dual description of the DQCP with an exact SO(5) symmetry. We demonstrate that the fuzzy sphere functions as a powerful microscope, magnifying and revealing a wealth of crucial information about the DQCP, ultimately paving the way toward its final answer. In particular, through exact diagonalization, we provide clear evidence that the DQCP exhibits approximate conformal symmetry. The evidence includes the existence of a conserved SO(5) symmetry current, a stress tensor, and integer-spaced levels between conformal primaries and their descendants. Most remarkably, we identify 23 primaries and 76 conformal descendants. Furthermore, by examining the renormalization group flow of the lowest symmetry singlet as well as other primaries, we provide numerical evidence in favor of DQCP being pseudo-critical, with the approximate conformal symmetry plausibly emerging from nearby complex fixed points. The primary spectrum we compute also has important implications, including the conclusion that the SO(5) DQCP cannot describe a direct transition from the Néel to valence bond solid phase on the honeycomb lattice.

Published by the American Physical Society
2024
Relationship between tourism development and the socioeconomic progress of tourist destinations
Authors: Marti Luisa , Puertas Rosa
Published: June 2024

Purpose

The purpose of this paper is to analyse whether tourism destination competitiveness is associated with human development using contingency tables. Also, by means of a cluster analysis, it seeks to identify homogeneous groups of tourists.

Design/methodology/approach

The analysis relies on the Travel and Tourism Development Index and Human Development Index for 2021 and is applied to 81 countries with a high/very high level of human progress and 36 countries with a medium/low level.

Findings

The results show that infrastructure is the tourism dimension that has the greatest influence on human development for all countries, while conditions for doing business and sustainability are relevant to residents’ quality of life only in destinations with a high/very high level of progress. Cluster analysis points to India as a tourist destination that is markedly different from the other countries in its human progress, presenting much higher values for price competitiveness, infrastructure and natural and cultural resources.

Originality/value

It analyses the association between each one of the dimensions of tourism development and the Human Development Index.
Avatars’ impacts in retail: a study within regulatory engagement theory
Authors: ben Saad Sihem , Choura Fatma
Published: June 2024

Purpose

This study aims to test the impact of avatars on consumer psychological states, engagement, and purchase intention in the online retail environment with reference to the Regulatory Engagement Theory.

Design/methodology/approach

One-factor between-subject experimental design was used to test research hypotheses. Two versions of an experimental merchant website have been designed for the purpose of the study: with and without the avatar. Participants were randomly assigned to experimental conditions and responded to an online questionnaire displayed during the visit. SEM analyses with AMOS 24 and SPSS Macro Conditional Process Analysis for bootstrapping were used to test the hypotheses.

Findings

The results confirm the avatar’s positive impact on perceived enjoyment and immersion, both positively affect consumer engagement and purchase intention. The mediating role of psychological states in the impact of avatars on consumer engagement is also confirmed.

Originality/value

This study advances the interactive marketing literature by focusing on avatars as an emerging interactive technology in the virtual retail context. Unlike previous studies on virtual agents, which primarily focused on their utilitarian role in online customer support, this study investigates how avatars influence consumers' psychological states, engagement, and purchase intention.
Why employees speak up: unveiling motives for constructive voice
Authors: Kiura Mary , Leach Rebecca B.
Published: June 2024

Purpose

The study empirically explores employees' motives for engaging in constructive voice behaviors.

Design/methodology/approach

The authors utilized qualitative research methods. The data were collected through individual semi-structured interviews with 26 workers in the renewable energy industry in Kenya. The data were analyzed using a phronetic iterative approach (Tracy, 2020).

Findings

The data revealed various motives that may drive constructive voice including, personal (e.g. material rewards and emotional gratification), relational (e.g. advocating for others and diluting opposition) and organizational motives (e.g. ensuring organizational survival and bolstering innovation). Additionally, the authors illustrated how these motives may evolve and/or jointly drive constructive voice.

Originality/value

Although voice scholars are beginning to recognize the existence of other motives besides prosocial, the knowledge of such motives has remained theoretical. This is one of the first studies to empirically examine motives for constructive voice. By unveiling the motives, the findings demonstrate different pathways through which a voice opportunity transforms into a constructive voice behavior.
Higher education pre- to post-COVID-19: student and faculty perceptions
Authors: Probst Gaby , Zizka Laura
Published: June 2024

Purpose

Higher education institutions (HEIs) seek innovative approaches to attract students. Since the COVID-19 pandemic, many HEIs have considered diversification through digitalization. From the initial urgency to implement technology at the start of the pandemic to a gradual acceptance over time, HEIs witnessed a shift in perceptions. This paper aims to explore the evolution of the use of technology in HEI classrooms from pre- to post-Covid-19 as seen through the eyes of students and faculty members.

Design/methodology/approach

Seven surveys were conducted from March 2020 to January 2023 with faculty members and students at one business HEI in Switzerland. This longitudinal study analyzed the perceptions of faculty and students regarding technology in the ever-changing HEI environments. These results have been used to make practical recommendations for future HEI classroom settings.

Findings

The findings reveal that the social aspect must be considered when implementing technology into HEIs. Faculty members and students need appropriate training and adequate resources to engage with the technology in and outside the classroom. The results suggest that one result of the pandemic was a greater acceptance of blended learning practices in traditional business education.

Originality/value

The pandemic has left long-lasting effects on teaching and learning. While many HEIs revert to traditional ways, the authors suggest the need to embrace technology that encourages engagement and authentic teaching and learning. HEIs must listen to their faculty members and students, to create more innovative learning environments.