bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship between processed meat, red meat, and risk of cardiovascular disease and Type 2 diabetes: a Mendelian randomization study
Authors: Li Guangling , Jiang Jiangang , Li Zeping
Published: March 2024

Aims

Numerous observational studies have indicated a potential association between the consumption of processed and red meat and an increased risk of cardiovascular disease and Type 2 diabetes mellitus (T2DM). However, the presence of a causal relationship remains uncertain. Therefore, the purpose of this study was to evaluate the impact of processed meat and red meat (pork, lamb, and beef) on the risk of cardiovascular disease, including coronary artery disease (CAD), hypertension, and stroke, and T2DM, using a two-sample Mendelian randomization (MR) analysis.

Methods and results

An MR analysis was conducted using the inverse-variance weighted, weighted median, and MR-Egger methods. To identify heterogeneity and pleiotropy, Cochrane’s Q test and MR-Egger test were employed. Additionally, the stability of the MR results was assessed using the leave-one-out method. Inverse-variance weighted analyses reveal no causal association between the consumption of processed and red meat and the incidence of CAD, hypertension, stroke, and T2DM (P > 0.05). When considering processed meat intake, heterogeneity is observed in hypertension and stroke outcomes (P < 0.05). For pork intake, heterogeneity is seen in hypertension, stroke, and T2DM (P < 0.05). Lamb intake shows heterogeneity in hypertension and T2DM (P < 0.05). However, other exposures and outcomes examined show no heterogeneity (P > 0.05). No significant pleiotropy is detected for all exposures through an MR-Egger test (P > 0.05). Furthermore, the leave-one-out test demonstrates the robustness of the results.

Conclusion

The study discerned no observable impact of red and processed meat consumption on CAD, hypertension, stroke, and T2DM. The findings of this study challenge the prevailing conventional perspective in the field.
Continuous stellate ganglion block for ventricular arrhythmias: case series, systematic review, and differences from thoracic epidural anaesthesia
Authors: Dusi Veronica , Angelini Filippo , Baldi Enrico , Toscano Antonio , Gravinese Carol , Frea Simone , Compagnoni Sara , Morena Arianna , Saglietto Andrea , Balzani Eleonora , Giunta Matteo , Costamagna Andrea , Rinaldi Mauro , Trompeo Anna Chiara , Rordorf Roberto , Anselmino Matteo , Savastano Simone , De Ferrari Gaetano Maria
Published: March 2024

Aims

Percutaneous stellate ganglion block (PSGB) through single-bolus injection and thoracic epidural anaesthesia (TEA) have been proposed for the acute management of refractory ventricular arrhythmias (VAs). However, data on continuous PSGB (C-PSGB) are scant. The aim of this study is to report our dual-centre experience with C-PSGB and to perform a systematic review on C-PSGB and TEA.

Methods and results

Consecutive patients receiving C-PSGB at two centres were enrolled. The systematic literature review follows the latest Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Our case series (26 patients, 88% male, 60 ± 16 years, all with advanced structural heart disease, left ventricular ejection fraction 23 ± 11%, 32 C-PSGBs performed, with a median duration of 3 days) shows that C-PSGB is feasible and safe and leads to complete VAs suppression in 59% and to overall clinical benefit in 94% of cases. Overall, 61 patients received 68 C-PSGBs and 22 TEA, with complete VA suppression in 63% of C-PSGBs (61% of patients). Most TEA procedures (55%) were performed on intubated patients, as opposed to 28% of C-PSGBs (P = 0.02); 63% of cases were on full anticoagulation at C-PSGB, none at TEA (P < 0.001). Ropivacaine and lidocaine were the most used drugs for C-PSGB, and the available data support a starting dose of 12 and 100 mg/h, respectively. No major complications occurred, yet TEA discontinuation rate due to side effects was higher than C-PSGB (18 vs. 1%, P = 0.01).

Conclusion

Continuous PSGB seems feasible, safe, and effective for the acute management of refractory VAs. The antiarrhythmic effect may be accomplished with less concerns for concomitant anticoagulation compared with TEA and with a lower side-effect related discontinuation rate.
Incorporating Climate Adaptation into a Forest Management Plan: A Case Study on the Research and Teaching Forest of Michigan Technological University
Authors: Rice Alex C , Froese Robert E
Published: March 2024

We incorporated climate adaptation into a forest management plan for Michigan Technological University’s Ford Forest, a 2,000-ha property in Michigan’s Upper Peninsula used for education, research, and timber revenues. Our process was an opportunity to test the existing climate adaptation literature, pulling from multiple sources to meet the diverse needs of the institution at the time the plan was created. We present outcomes as well as lessons learned summarized in a series of broad takeaway messages. (1) Climate adaptation is a means to an end. The end must be defined and is made up of critical values and an adapted state. (2) Given the instability inherent in climate change, achieving adaptation means adjusting forest attributes in response to change but also preparing for unforeseen outcomes via adaptive management. (3) Decisions surrounding goals affect the entire process. Considering climate change–driven constraints when setting goals will improve outcomes. (4) Flawed decision-making is a risk associated with certain organizational contexts and affects the identification of goals, vulnerabilities, and adaptation options. (5) Climate adaptation actions cannot be evaluated in the short term for efficacy because climate change is ongoing. However, the appropriateness of a plan in responding to anticipated change can be evaluated.

Study Implications: This work informs strategic planning for climate change adaptation in forests. We created a climate-informed forest management plan using adaptation frameworks for a university-owned forest in Upper Michigan at the confluence of the northern hardwoods and boreal forest ecotypes. We offer assessment of our plan outcomes and insights into how our decision-making context affected them. This case study expands on the ongoing scientific conversation, incorporating concepts from management science, on how best to adapt natural systems to climate change to protect human values derived from ecosystem services.
A genome sequence for the threatened whitebark pine
Authors: Neale David B , Zimin Aleksey V , Meltzer Amy , Bhattarai Akriti , Amee Maurice , Figueroa Corona Laura , Allen Brian J , Puiu Daniela , Wright Jessica , De La Torre Amanda R , McGuire Patrick E , Timp Winston , Salzberg Steven L , Wegrzyn Jill L
Published: March 2024

Whitebark pine (WBP, Pinus albicaulis) is a white pine of subalpine regions in the Western contiguous United States and Canada. WBP has become critically threatened throughout a significant part of its natural range due to mortality from the introduced fungal pathogen white pine blister rust (WPBR, Cronartium ribicola) and additional threats from mountain pine beetle (Dendroctonus ponderosae), wildfire, and maladaptation due to changing climate. Vast acreages of WBP have suffered nearly complete mortality. Genomic technologies can contribute to a faster, more cost-effective approach to the traditional practices of identifying disease-resistant, climate-adapted seed sources for restoration. With deep-coverage Illumina short reads of haploid megagametophyte tissue and Oxford Nanopore long reads of diploid needle tissue, followed by a hybrid, multistep assembly approach, we produced a final assembly containing 27.6 Gb of sequence in 92,740 contigs (N50 537,007 bp) and 34,716 scaffolds (N50 2.0 Gb). Approximately 87.2% (24.0 Gb) of total sequence was placed on the 12 WBP chromosomes. Annotation yielded 25,362 protein-coding genes, and over 77% of the genome was characterized as repeats. WBP has demonstrated the greatest variation in resistance to WPBR among the North American white pines. Candidate genes for quantitative resistance include disease resistance genes known as nucleotide-binding leucine-rich repeat receptors (NLRs). A combination of protein domain alignments and direct genome scanning was employed to fully describe the 3 subclasses of NLRs. Our high-quality reference sequence and annotation provide a marked improvement in NLR identification compared to previous assessments that leveraged de novo-assembled transcriptomes.
Invigorating human MSCs for transplantation therapy via Nrf2/DKK1 co-stimulation in an acute-on-chronic liver failure mouse model
Authors: Chen Feng , Che Zhaodi , Liu Yingxia , Luo Pingping , Xiao Lu , Song Yali , Wang Cunchuan , Dong Zhiyong , Li Mianhuan , Tipoe George L , Yang Min , Lv Yi , Zhang Hong , Wang Fei , Xiao Jia
Published: March 2024

Background

Since boosting stem cell resilience in stressful environments is critical for the therapeutic efficacy of stem cell-based transplantations in liver disease, this study aimed to establish the efficacy of a transient plasmid-based preconditioning strategy for boosting the capability of mesenchymal stromal cells (MSCs) for anti-inflammation/antioxidant defenses and paracrine actions in recipient hepatocytes.

Methods

Human adipose mesenchymal stem cells (hADMSCs) were subjected to transfer, either with or without the nuclear factor erythroid 2-related factor 2 (Nrf2)/Dickkopf1 (DKK1) genes, followed by exposure to TNF-α/H2O2. Mouse models were subjected to acute chronic liver failure (ACLF) and subsequently injected with either transfected or untransfected MSCs. These hADMSCs and ACLF mouse models were used to investigate the interaction between Nrf2/DKK1 and the hepatocyte receptor cytoskeleton-associated protein 4 (CKAP4).

Results

Activation of Nrf2 and DKK1 enhanced the anti-stress capacity of MSCs in vitro. In a murine model of ACLF, transient co-overexpression of Nrf2 and DKK1 via plasmid transfection improved MSC resilience against inflammatory and oxidative assaults, boosted MSC transplantation efficacy, and promoted recipient liver regeneration due to a shift from the activation of the anti-regenerative IFN-γ/STAT1 pathway to the pro-regenerative IL-6/STAT3 pathway in the liver. Importantly, the therapeutic benefits of MSC transplantation were nullified when the receptor CKAP4, which interacts with DKK1, was specifically removed from recipient hepatocytes. However, the removal of the another receptor low-density lipoprotein receptor-related protein 6 (LRP6) had no impact on the effectiveness of MSC transplantation. Moreover, in long-term observations, no tumorigenicity was detected in mice following transplantation of transiently preconditioned MSCs.

Conclusions

Co-stimulation with Nrf2/DKK1 safely improved the efficacy of human MSC-based therapies in murine models of ACLF through CKAP4-dependent paracrine mechanisms.
Plasma Ribonuclease Activity in Antiretroviral Treatment–Naive People With Human Immunodeficiency Virus and Tuberculosis Disease
Authors: Olsson Oskar , Søkilde Rolf , Tesfaye Fregenet , Karlson Sara , Skogmar Sten , Jansson Marianne , Björkman Per
Published: March 2024

Background

The role of ribonucleases in tuberculosis among people with human immunodeficiency virus (HIV; PWH) is unknown. We explored ribonuclease activity in plasma from PWH with and without tuberculosis.

Methods

Participants were identified from a cohort of treatment-naive PWH in Ethiopia who had been classified for tuberculosis disease (HIV positive [HIV+]/tuberculosis positive [tuberculosis+] or HIV+/tuberculosis negative [tuberculosis−]). Ribonuclease activity in plasma was investigated by quantification of synthetic spike-in RNAs using sequencing and quantitative polymerase chain reaction and by a specific ribonuclease activity assay. Quantification of ribonuclease 1, 2, 3, 6, 7, and T2 proteins was performed by enzyme-linked immunosorbent assay. Ribonuclease activity and protein concentrations were correlated with markers of tuberculosis and HIV disease severity and with concentrations of inflammatory mediators.

Results

Ribonuclease activity was significantly higher in plasma of HIV+/tuberculosis+ (n = 51) compared with HIV+/tuberculosis− (n = 78), causing reduced stability of synthetic spike-in RNAs. Concentrations of ribonucleases 2, 3, and T2 were also significantly increased in HIV+/tuberculosis+ compared with HIV+/tuberculosis−. Ribonuclease activity was correlated with HIV viral load, and inversely correlated with CD4 cell count, mid–upper arm circumference, and body mass index. Moreover, ribonuclease activity was correlated with concentrations of interleukin 27, procalcitonin and the kynurenine-tryptophan ratio.

Conclusions

PWH with tuberculosis disease have elevated plasma ribonuclease activity, which is also associated with HIV disease severity and systemic inflammation.
Development and Validation of Multiplex Assays for Mouse and Human IgG and IgA to Neisseria gonorrhoeae Antigens
Authors: Stover Erica L , Little Marguerite B , Connolly Kristie L , Li Lixin , Nicholas Robert A , Sikora Aleksandra E , Jerse Ann E , Hobbs Marcia M , Duncan J Alex , Macintyre Andrew N
Published: March 2024

There is an urgent need for vaccines against Neisseria gonorrhoeae, the causative agent of gonorrhea. Vaccination with an outer membrane vesicle–based Neisseria meningitidis vaccine provides some protection from N. gonorrhoeae; however, the mechanisms underlying this cross-protection are unknown. To address this need, we developed multiplexed bead-based assays for the relative quantification of human and mouse IgG and IgA against N gonorrhoeae antigens. The assays were evaluated for analyte independence, dilutional linearity, specificity, sensitivity, intra- and interassay variability, and robustness to sample storage conditions. The assay was then used to test samples from mice and humans immunized with an N meningitidis outer membrane vesicle vaccine.
Synergistic effects of ceftazidime/avibactam combined with meropenem in a murine model of infection with KPC-producing Klebsiella pneumoniae
Authors: Zheng Mei , Li Fu-Hao , Liu Juan , Li Wen-Jie , Yin Ruo-Xi , Cai Da-Tong , Andrey Diego O , Zheng Si-Lin , Gales Ana C , Zhang Wan-Jiang , Sun Jian , Liao Xiao-Ping , Yu Yang
Published: March 2024

Objectives

The emergence and expansion of carbapenem-resistant Klebsiella pneumoniae infections is a concern due to the lack of ‘first-line’ antibiotic treatment options. The ceftazidime/avibactam is an important clinical treatment for carbapenem-resistant K. pneumoniae infections but there is an increasing number of cases of treatment failure and drug resistance. Therefore, a potential solution is combination therapies that result in synergistic activity against K. pneumoniae carbapenemase: producing K. pneumoniae (KPC-Kp) isolates and preventing the emergence of KPC mutants resistant to ceftazidime/avibactam are needed in lieu of novel antibiotics.

Methods

To evaluate their synergistic activity, antibiotic combinations were tested against 26 KPC-Kp strains. Antibiotic resistance profiles, molecular characteristics and virulence genes were investigated by susceptibility testing and whole-genome sequencing. Antibiotic synergy was evaluated by in vitro chequerboard experiments, time-killing curves and dose–response assays. The mouse thigh model was used to confirm antibiotic combination activities in vivo. Additionally, antibiotic combinations were evaluated for their ability to prevent the emergence of ceftazidime/avibactam resistant mutations of blaKPC.

Results

The combination of ceftazidime/avibactam plus meropenem showed remarkable synergistic activity against 26 strains and restored susceptibility to both the partnering antibiotics. The significant therapeutic effect of ceftazidime/avibactam combined with meropenem was also confirmed in the mouse model and bacterial loads in the thigh muscle of the combination groups were significantly reduced. Furthermore, ceftazidime/avibactam plus meropenem showed significant activity in preventing the occurrence of resistance mutations.

Conclusions

Our results indicated that the combination of ceftazidime/avibactam plus meropenem offers viable therapeutic alternatives in treating serious infections due to KPC-Kp.
Injunctions and damages for patent infringement under the UPCA in light of the principle of proportionality—Part I: injunctions
Authors: Hofmann Franz , Raue Benjamin
Published: March 2024

This article examines the availability of injunctions and the award of damages for patent infringement under the Agreement on a Unified Patent Court, in light of the principle of proportionality. Part I focuses on the injunctive relief and analyses the application of the principle of proportionality to injunctions, outlining key factors and scenarios. Part II, which will be published in the next issue, discusses the principles and methods applicable to the calculation of damages, assessing their suitability in light of the principle of proportionality, as defined in European Union law and in the case law of select contracting states.
What does rally length tell us about player characteristics in tennis?
Authors: Epasinghege Dona Nirodha , Gill Paramjit S , Swartz Tim B
Published: March 2024

This article proposes increasingly complex models based on publicly available data involving rally length. The models provide insights regarding player characteristics involving the ability to extend rallies and relates these characteristics to performance measures. The analysis highlights some important features that make a difference between winning and losing, and therefore provides feedback on how players may improve.
Follicular fluid-derived exosomes rejuvenate ovarian aging through miR-320a-3p-mediated FOXQ1 inhibition
Authors: Liu Yu , Mu Hongbei , Chen Yu , Li Kexin , Mei Qiaojuan , Wang Lingjuan , Tang Tianyu , Shen Qiuzi , Li Huaibiao , Zhang Ling , Li Jing , Xiang Wenpei
Published: March 2024

Ovarian aging is mainly characterized by a progressive decline in oocyte quantity and quality, which ultimately leads to female infertility. Various therapies have been established to cope with ovarian aging, among which exosome-based therapy is considered a promising strategy that can benefit ovarian functions via multiple pathways. Here, we isolated and characterized exosomes derived from ovarian follicular fluid and profiled the differential expression patterns of noncoding exosomal RNAs in young and aged women. Treatment with young mouse-derived exosomes efficiently rescued ovarian function in aged mice. The follicular fluid exosomes from young mice and miR-320-3p can also promote the proliferation of ovarian granulosa cells and improve mitochondrial function from old mice in vitro. The mechanism may be involve that exosomes transfer miR-320-3p to granulosa cells, and inhibit the expression of FOXQ1. Exosomes also can increase the number of primordial and growing follicles, and improve the developmental ability of oocytes in the old mice in vivo. And hnRNPA2B1 controls miR-320-3p entry into exosomes. This work provides insights into the antiaging potential of follicular fluid-derived exosomes and the underlying molecular mechanisms, which may facilitate prevention of ovarian aging and an improvement in female fertility.
Comparison of Indicators of Dependence for Vaping and Smoking: Trends Between 2017 and 2022 Among Youth in Canada, England, and the United States
Authors: Gomes Makenna N , Reid Jessica L , Rynard Vicki L , East Katherine A , Goniewicz Maciej L , Piper Megan E , Hammond David
Published: March 2024

Introduction

The current study sought to examine trends in indicators of dependence for youth vaping and smoking during a period of rapid evolution in the e-cigarette market.

Aims and Methods

Data are from repeat cross-sectional online surveys conducted between 2017 and 2022 among youth aged 16–19 in Canada, England, and the United States (US). Participants were 23 145 respondents who vaped and/or smoked in the past 30 days. Four dependence indicators were assessed for smoking and vaping (perceived addiction, frequent strong urges, time to first use after waking, days used in past month) and two for vaping only (use events per day, e-cigarette dependence scale). Regression models examined differences by survey wave and country, adjusting for sex, age, race, and exclusive/dual use.

Results

All six indicators of dependence increased between 2017 and 2022 among youth who vaped in the past 30 days (p < .001 for all). For example, more youth reported strong urges to vape at least most days in 2022 than in 2017 (Canada: 26.5% to 53.4%; England: 25.5% to 45.4%; US: 31.6% to 50.3%). In 2017, indicators of vaping dependence were substantially lower than for smoking; however, by 2022, youth vaping was associated with a greater number of days used in the past month (Canada, US), shorter time to first use (all countries), and a higher likelihood of frequent strong urges (Canada, US) compared to youth smoking.

Conclusions

From 2017 to 2022, indicators of vaping dependence increased substantially. By 2022, vaping dependence indices were comparable to those of smoking.

Implications

Indicators of vaping dependence among youth have increased substantially since 2017 to levels that are comparable to cigarette dependence among youth who smoke. Future research should examine factors underlying the increase in dependence among youth who vape, including changes to the nicotine profile and design of e-cigarette products.
Microbiological Methods Used in the Enterics for Global Health Shigella Surveillance Study
Authors: Horne Bri’Anna , Badji Henry , Bhuiyan Md Taufiqur Rahman , Romaina Cachique Lucero , Cornick Jennifer , Hotwani Aneeta , Juma Jane , Ochieng John Benjamin , Abdou Mahamadou , Apondi Evans , Atlas Hannah E , Awuor Alex O , Baker Kate S , Ceesay Bubacarr E , Charles Mary , Cunliffe Nigel A , Feutz Erika , Galagan Sean R , Guindo Ibrehima , Hossain M Jahangir , Iqbal Junaid , Jallow Fatima , Keita Noumou Yakhouba , Khanam Farhana , Kotloff Karen L , Maiden Victor , Manzanares Villanueva Katia , Mito Oscar , Mosharraf Md Parvej , Nkeze Joseph , Ikumapayi Usman N , Paredes Olortegui Maribel , Pavlinac Patricia B , Pinedo Vasquez Tackeshy , Qadri Firdausi , Qamar Farah Naz , Qureshi Sonia , Rahman Nazia , Sangare Aminata , Sen Sunil , Peñataro Yori Pablo , Yousafzai Mohammad Tahir , Ahmed Dilruba , Jere Khuzwayo C , Kosek Margaret N , Omore Richard , Permala-Booth Jasnehta , Secka Ousman , Tennant Sharon M
Published: March 2024

Background

Shigella is a major cause of diarrhea in young children worldwide. Multiple vaccines targeting Shigella are in development, and phase 3 clinical trials are imminent to determine efficacy against shigellosis.

Methods

The Enterics for Global Health (EFGH) Shigella surveillance study is designed to determine the incidence of medically attended shigellosis in 6- to 35-month-old children in 7 resource-limited settings. Here, we describe the microbiological methods used to isolate and identify Shigella. We developed a standardized laboratory protocol for isolation and identification of Shigella by culture. This protocol was implemented across all 7 sites, ensuring consistency and comparability of results. Secondary objectives of the study are to determine the antibiotic resistance profiles of Shigella, compare isolation of Shigella from rectal swabs versus whole stool, and compare isolation of Shigella following transport of rectal swabs in Cary-Blair versus a modified buffered glycerol saline transport medium.

Conclusions

Data generated from EFGH using culture methods described herein can potentially be used for microbiological endpoints in future phase 3 clinical trials to evaluate vaccines against shigellosis and for other clinical and public health studies focused on these organisms.
The Enterics for Global Health (EFGH) Shigella Surveillance Study in Bangladesh
Authors: Khanam Farhana , Islam Md Taufiqul , Bhuiyan Taufiqur Rahman , Hossen Md Ismail , Rajib Md Nazmul Hasan , Haque Shahinur , Ireen Mahzabeen , Qudrat-E-Khuda Syed , Biswas Prasanta Kumar , Bhuiyan Md Amirul Islam , Islam Kamrul , Rahman Nazia , Alam Raz S M Azadul , Mosharraf Md Parvej , Shawon Bhuiyan Md Elias , Islam Sadia , Ahmed Dilruba , Ahmmed Faisal , Zaman Khalequ , Clemens John D , Qadri Firdausi
Published: March 2024

Background

Shigella is an important cause of diarrhea in Bangladeshi children <5 years of age, with an incidence rate of 4.6 per 100 person-years. However, the report was more than a decade old, and data on Shigella consequences are similarly outdated and heterogeneously collected.

Methods

Facility-based disease surveillance is planned to be carried out under the Enterics for Global Health (EFGH) Shigella Surveillance Study consortium for 2 years with aims to optimize and standardize laboratory techniques and healthcare utilization and coverage survey, clinical and anthropometric data collection, safety monitoring and responsiveness, and other related activities. The EFGH is a cohesive network of multidisciplinary experts, capable of operating in concert to conduct the study to generate data that will pave the way for potential Shigella vaccine trials in settings with high disease burden. The study will be conducted within 7 country sites in Asia, Africa, and Latin America.

Conclusions

We outline the features of the Bangladesh site as part of this multisite surveillance network to determine an updated incidence rate and document the consequences of Shigella diarrhea in children aged 6–35 months, which will help inform policymakers and to implement the future vaccine trials.
Population Enumeration and Household Utilization Survey Methods in the Enterics for Global Health (EFGH): Shigella Surveillance Study
Authors: Dodd Ryan , Awuor Alex O , Garcia Bardales Paul F , Khanam Farhana , Mategula Donnie , Onwuchekwa Uma , Sarwar Golam , Yousafzai Mohammad Tahir , Ahmed Naveed , Atlas Hannah E , Amirul Islam Bhuiyan Md , Colston Josh M , Conteh Bakary , Diawara Manan , Dilruba Nasrin , Elwood Sarah , Fatima Irum , Feutz Erika , Galagan Sean R , Haque Shahinur , Taufiqul Islam Md , Karim Mehrab , Keita Belali , Kosek Margaret N , Kotloff Karen L , Lefu Clement , Mballow Mamadou , Ndalama Maureen , Ndeketa Latif , Ogwel Billy , Okonji Caleb , Paredes Olortegui Maribel , Pavlinac Patricia B , Pinedo Vasquez Tackeshy , Platts-Mills James A , Qadri Firdausi , Qureshi Sonia , Rogawski McQuade Elizabeth T , Sultana Shazia , Traore Moussa Oumar , Cunliffe Nigel A , Jahangir Hossain M , Omore Richard , Qamar Farah Naz , Tapia Milagritos D , Peñataro Yori Pablo , Zaman K , McGrath Christine J
Published: March 2024

Background

Accurate estimation of diarrhea incidence from facility-based surveillance requires estimating the population at risk and accounting for case patients who do not seek care. The Enterics for Global Health (EFGH) Shigella surveillance study will characterize population denominators and healthcare-seeking behavior proportions to calculate incidence rates of Shigella diarrhea in children aged 6–35 months across 7 sites in Africa, Asia, and Latin America.

Methods

The Enterics for Global Health (EFGH) Shigella surveillance study will use a hybrid surveillance design, supplementing facility-based surveillance with population-based surveys to estimate population size and the proportion of children with diarrhea brought for care at EFGH health facilities. Continuous data collection over a 24 month period captures seasonality and ensures representative sampling of the population at risk during the period of facility-based enrollments. Study catchment areas are broken into randomized clusters, each sized to be feasibly enumerated by individual field teams.

Conclusions

The methods presented herein aim to minimize the challenges associated with hybrid surveillance, such as poor parity between survey area coverage and facility coverage, population fluctuations, seasonal variability, and adjustments to care-seeking behavior.
Isolated laryngeal tuberculosis complex infection: expect the unexpected
Authors: D’Aleo Canova Giulia C , Zeroli Chiara , Barberi Federico , Gorica Armela , Bignami Maurizio , Cattaneo Augusto
Published: March 2024

Laryngeal tuberculosis (LT), a rare but possible manifestation of extrapulmonary tuberculosis (TBC) and the most frequent granulomatous disease of the larynx, is slowly resurfacing due to the worldwide recrudescence of TBC. We present the case of a 59 y-o Caucasian woman, non-smoker, with no history of recent travels in endemic areas, affected by pulmonary sarcoidosis, that presented with a symptomatic vegetating lesion involving the left free margin of the epiglottic and a small, ulcerated lesion over the right arytenoid mucosa. While the patient’s profile would not lead to a primary suspect of laryngeal TBC, the diagnostic workup and histological examination confirmed the unusual finding, and the patient was started on standard antitubercular therapy, with a complete laryngeal response. Although isolated laryngeal tuberculosis is still a rare finding, it should be kept into consideration also in non-endemic areas, especially in patients with chronic disease requiring immunosuppressive drugs.
Metastatic progression of breast cancer along with decreased mitochondrial cell death priming of breast cancer cells: a case report
Authors: Aka Yeliz , Ozdemir Hulya , Torun Nese , Bolat Filiz Aka , Kutuk Ozgur
Published: March 2024

Metastatic breast cancer remains to be a major cause of cancer-related deaths in women. Exploring the molecular mechanisms to identify targetable alterations in progressing breast cancer and developing functional tools to predict therapy response in these patients are needed. In this report, we present a case of breast cancer patient who progressed following surgery and adjuvant endocrine therapy. Radiological and pathological analyses revealed metastasis to liver and brain. Paired liquid biopsies demonstrated acquired ERBB2 mutations in addition to TP53 and PIK3CA mutations, which were also present before progression. BH3 profiling test demonstrated decreased mitochondrial cell death priming in CTCs of the patient after progression. In conclusion, novel personalized treatment strategies are needed to monitor metastatic breast cancer patients for better clinical benefit.
Having a chat and then watching a movie: how social interaction synchronises our brains during co-watching
Authors: De Felice S , Hakim U , Gunasekara N , Pinti P , Tachtsidis I , Hamilton A
Published: March 2024

How does co-presence change our neural experience of the world? Can a conversation change how we synchronise with our partner during later events? Using fNIRS hyperscanning, we measured brain activity from 27 pairs of familiar adults simultaneously over frontal, temporal and parietal regions bilaterally, as they co-watched two different episodes of a short cartoon. In-between the two episodes, each pair engaged in a face-to-face conversation on topics unrelated to the cartoon episodes. Brain synchrony was calculated using wavelet transform coherence and computed separately for real pairs and shuffled pseudo) pairs. Findings reveal that real pairs showed increased brain synchrony over right Dorso-Lateral Pre-Frontal cortex (DLPFC) and right Superior Parietal Lobe (SPL), compared to pseudo pairs (who had never seen each other and watched the same movie at different times; uncorrected for multiple comparisons). In addition, co-watching after a conversation was associated with greater synchrony over right TPJ compared to co-watching before a conversation, and this effect was significantly higher in real pairs (who engaged in conversation with each other) compared to pseudo pairs (who had a conversation with someone else; uncorrected for multiple comparisons). The present study has shed the light on the role of social interaction in modulating brain synchrony across people not just during social interaction, but even for subsequent non-social activities. These results have implications in the growing domain of naturalistic neuroimaging and interactive neuroscience.
Effect of Pistacia Terebinthus (terebinth) resin extract on aggressive breast cancer cells
Authors: Fırat Kerim , Nisari Mehtap , Metin İrem , Fırat Yağmur Yaşar , Karatoprak Gökçe Şeker , Hamurcu Zühal
Published: March 2024

Breast cancer is one of the most common types of cancer causing high mortality rates among women worldwide. This study was aimed to evaluate the effect of Pistacia terebinthus (terebinth) resin extract (TRE) on the MDA-MB-231 breast cancer cell line. In the study, the cytotoxic dose of the resin extract in MDA-MB-231 cells was evaluated by MTS analysis. The effect of TRE on apoptosis was examined by Hoechst staining. Caspase-3 and cleaved caspase-3 protein expressions were determined by western blot analysis. Based on the outcomes of our MTS analysis, the IC50 dose of TRE was calculated at 56.54 μg/mL during a 24-h application period. With Hoechst staining analysis, an increase was observed in cells that underwent apoptotic change at 10 and 100 μg/ml TRE concentrations compared to the control. At 25 and 50 μg/mL TRE concentrations, no apoptotic change was found in comparison to the control; however, a significant drop in the number of viable cells was observed because 200, 300, and 500 μg/mL TRE concentrations were above the toxic dose. The caspase-3 protein expression level was significantly higher in cells treated with 100 μg/ml TRE compared to the control group, while there was no significant change in cleaved caspase-3 protein expression. It was thought that P. terebinthus resin might cause cell death in MDA-MB-231 cells via caspase-independent apoptosis pathway or other cell death pathways, and it was concluded that it could be a supportive treatment for breast cancer treatment.
Security rights in crypto-assets: an opportunity for uniform law?
Authors: Kostoula Theodora
Published: March 2024

As the market of crypto-assets grows, so does the demand for their use as collateral in cross-border lending transactions. Such a development, though, may pose significant challenges to the main pillars of security rights due to the distinctive features and the nature of crypto-assets. Accordingly, this article identifies and explores the core legal issues, offers guidance in the crypto-collateral area, and assesses the role of uniform law. In the absence of specific legislation, the analysis is conducted under the prism of the international secured transactions framework, as shaped by the International Institute for the Unification of Private Law (Unidroit) and the United Nations Commission on International Trade Law (UNCITRAL) legislative instruments. As such, the article examines whether the current framework suffices to address emerging challenges or contains gaps and limitations that require legislative intervention. The article argues that the increasing use of crypto-assets as collateral may constitute both an opportunity for uniform law to have a leading role in addressing the arising issues and shaping the field, and an opportunity to put new uniform rules in place. This would require both updating the existing legal instruments in line with new technological needs and creating new instruments where necessary. International fora like Unidroit and UNCITRAL would ideally offer the desirable degree of harmonization, or uniformization, in the area of security rights over crypto-assets. Rather than subjecting them to diverging legal rules, developing more uniform approaches would offer consistency, thus increasing legal certainty and supporting technological innovation.
Modified Extensor Indicis Proprius Opponensplasty
Authors: Wiboonthanasarn Nuttara , Limudomporn Kanon , Uerpairojkit Chairoj , Kittithamvongs Piyabuth , Siripoonyothai Sopinun , Anantavorasakul Navapong , Malungpaishrope Kanchai
Published: March 2024

Extensor indicis proprius (EIP) opponensplasty is one of the commonly used techniques to restore thumb abduction and opposition in patients with thenar muscle dysfunction from various causes of median nerve palsy. However, its subcutaneous route around the distal ulna may not represent a straight line of pull, and part of the extensor hood sometimes has to be harvested along with the EIP tendon to gain adequate length to reach the insertion. The purpose of the study is to present the alternative method of EIP opponensplasty and report the clinical outcomes. The modified EIP opponensplasty was performed on 16 patients with severe carpal tunnel syndrome. At the final follow-up examination, all patients were able to regain their desired level of activities. The Kapandji score, abduction angle, and the disabilities of the arm, shoulder, and hand score improved in all patients. There were no complications related to harvesting the EIP tendon. Two patients developed finger stiffness, which improved after rehabilitation. This technique is safe and effective for restoring thumb function and can solve the insufficient tendon length problem of the original EIP opponensplasty.
Brigatinib combined with cetuximab in the fifth-line treatment of non-small cell lung cancer with EGFR p.C797S mutation in critically ill patients: a report of two cases and literature review
Authors: Liu Juanjuan , Lei Hongtao , Zhang Ding , Zhang Ning
Published: March 2024

For critically ill patients with non-small cell lung cancer (NSCLC) in need of life-saving treatment, there is currently no reported evidence regarding the use of medication specifically targeting epidermal growth factor receptor (EGFR) p.C797S mutation, which is known to cause resistance to third-generation tyrosine kinase inhibitors (TKIs). Our report aims to investigate and explore treatment strategies to overcome resistance associated with EGFR p.C797S mutation in order to provide potential therapeutic options for these patients. Here, we reported two cases with NSCLC who initially harbored an EGFR-sensitive mutation and were both treated with osimertinib, a third-generation TKI. Next-generation sequencing tests conducted prior to the initiation of fifth-line therapy in critically ill patients revealed the presence of EGFR p.C797S mutations in both patients, suggesting acquired resistance. In the course of fifth-line therapy, the administration of a combination of brigatinib and cetuximab proved vital in saving critically ill patients, moderately extending their overall survival period. Our findings suggested that a combined regimen of brigatinib and cetuximab could serve as a potentially life-saving therapeutic strategy for critically ill patients with NSCLC, particularly those demonstrating EGFR p.C797S-mediated resistance. Further studies, however, are required to validate and expand upon these promising findings.
A Review and Discussion of Full-Time Equivalency and Appropriate Compensation Models for an Adult Intensivist in the United States Across Various Base Specialties
Authors: Nurok Michael , Flynn Brigid C. , Pineton de Chambrun Marc , Kazemian Mina , Geiderman Joel , Nunnally Mark E.
Published: March 2024

OBJECTIVES:

Physicians with training in anesthesiology, emergency medicine, internal medicine, neurology, and surgery may gain board certification in critical care medicine upon completion of fellowship training. These clinicians often only spend a portion of their work effort in the ICU. Other work efforts that benefit an ICU infrastructure, but do not provide billing opportunities, include education, research, and administrative duties. For employed or contracted physicians, there is no singular definition of what constitutes an intensive care full-time equivalent (FTE). Nevertheless, hospitals often consider FTEs in assessing hiring needs, salary, and eligibility for benefits.

DATA SOURCES:

Review of existing literature, expert opinion.

STUDY SELECTION:

Not applicable.

DATA EXTRACTION:

Not applicable.

DATA SYNTHESIS:

Not applicable.

CONCLUSIONS:

Understanding how an FTE is calculated, and the fraction of an FTE to be assigned to a particular cost center, is therefore important for intensivists of different specialties, as many employment models assign salary and benefits to a base specialty department and not necessarily the ICU.
Optimizing the Positioning of Detectors for Improved Counting Efficiencies Using Monte Carlo Simulations
Authors: Capello Kevin , Moffat Ryan , Schiebelbein Aryanna
Published: March 2024

The Human Monitoring Laboratory (HML) at Health Canada updated its whole-body counter with four new electrically cooled HPGe detectors. To optimize the counting efficiency of the new system, Monte Carlo simulation was used to model the whole-body counter using a reference BOMAB male phantom. The resulting modeled counting efficiencies showed that the best position to install the four new detectors could be obtained without performing laborious real measurements, thereby reducing the cost of preparing the BOMAB phantoms and reconfiguring the detector arrays in multiple geometries, saving time and energy.
Electron Paramagnetic Resonance (EPR) Biodosimetry with Human Teeth: A Crucial Technique for Acute and Chronic Exposure Assessment
Authors: Ghimire Lekhnath , Waller Edward
Published: March 2024

Radiation exposure is a primary concern in emergency response scenarios and long-term health assessments. Accurate quantification of radiation doses is critical for informed decision-making and patient care. This paper reviews the dose reconstruction technique using both X- and Q-bands, with tooth enamel as a reliable dosimeter. Tooth enamel, due to its exceptional resistance to alteration over time, offers a unique opportunity for assessing both acute and chronic radiation exposures. This review delves into the principles underlying enamel dosimetry, the mechanism of radiation interactions, and dose retention in tooth enamel. We explore state-of-the-art analytical methods, such as electron paramagnetic resonance (EPR) spectroscopy, that accurately estimate low and high doses in acute and chronic exposure. Furthermore, we discuss the applicability of tooth enamel dosimetry in various scenarios, ranging from historical radiological incidents to recent nuclear events or radiological incidents. The ability to reconstruct radiation doses from dental enamel provides a valuable tool for epidemiological studies, validating the assessment of health risks associated with chronic exposures and aiding in the early detection and management of acute radiation incidents. This paper underscores the significance of tooth enamel as an essential medium for radiation dose reconstruction and its broader implications for enhancing radiation protection, emergency response, and public health preparedness. Incorporating enamel EPR dosimetry into standard protocols has the potential to transform the field of radiation assessment, ensuring more accurate and timely evaluations of radiation exposure and its associated risks.
Relationship Between Subjective Questionnaires and Videofluoroscopy of Dysphagia Evaluation: A Systematic Review and Meta-Analysis
Authors: LAI Chih-Jun , JHUANG Jing-Rong , TU Yu-Kang , LIU Chih-Min , TSAI Ching-Ying , CHIEN Kuo-Liong
Published: March 2024

Background

Early detection of dysphagia is important for preventing aspiration pneumonia. Although videofluoroscopy is currently the primary diagnostic tool for dysphagia, access to this tool may be limited because of radiation exposure risk, high cost, and other factors.

Purpose

In this study, a meta-analysis was used to determine the strength of the correlation between dysphagia detection outcomes obtained using subjective questionnaires and videofluoroscopy.

Methods

The PubMed and Embase databases were searched for original articles up to December 2022. Studies published in English that used cross-sectional designs to assess the correlation between subjective questionnaires and videofluoroscopy were considered eligible for inclusion. The search terms used included “dysphagia,” “questionnaire,” and “videofluoroscopy.” Two reviewers critically appraised and extracted the correlation coefficient r values. In addition, a random-effects meta-analysis was conducted. The Q statistic was used to assess the heterogeneity among the included studies. Publication bias was checked using the funnel plot and Egger's tests. Multilevel analysis was used to determine sensitivity to consider within-study correlations. In addition, subgroup analyses were conducted based on type of questionnaire, head and neck cancer, and English-speaking regions.

Results

The meta-analysis included five studies and 856 patients using the Eating Assessment Tool-10 and one study and 27 patients using the Sydney Swallow Questionnaire. The results of the random-effects meta-analysis showed a moderate relationship between the subjective questionnaires and videofluoroscopy (r = .35, 95% CI [0.20, 0.48]). Similar results were also obtained using multilevel analysis (r = .34, 95% CI [0.25, 0.42]). No publication bias was found for any of the studies (p = .88). In the subgroup analyses, a moderate relationship between Eating Assessment Tool-10 and videofluoroscopy (r = .31, 95% CI [0.19, 0.42]) and an ultrahigh relationship between Sydney Swallow Questionnaire and video-fluoroscopy (r = .74, 95% CI [0.50, 0.87]) were found. Furthermore, moderate associations were observed within each head and neck cancer and English-speaking regions subgroup. However, no significant differences were found between these two subgroups.

Conclusions

These results indicate the subjective questionnaires considered in this study share a moderate relationship with videofluoroscopy. Subjective questionnaires may be used as an auxiliary tool by nurses and homecare givers for the early assessment of dysphagia risk in patients.
Relationship Between Chronic Health Conditions and Occupational Burnout in the Early Care and Education Workforce
Authors: Shreedar Priyanka , Pangalangan Julia M.L. , Puma Jini E. , Farewell Charlotte V.
Published: March 2024

Objective

The early care and education (ECE) workforce experiences high rates of poor mental and physical health outcomes, which impact staff well-being and burnout. This study aimed to assess the relationship between chronic health conditions and occupational burnout in ECE Head Start staff working in low-resourced locations.

Methods

This study administered an 89-item cross-sectional survey to 332 ECE staff employed in 42 Head Start centers in the United States. Staff self-reported on the following 10 chronic health conditions: arthritis, asthma, cancer, depression, diabetes, heart disease, high blood pressure, insomnia, lung disease, and musculoskeletal disorders.

Results

We found that multimorbidity of chronic conditions significantly predicted overall burnout (B = 2.39, P < 0.01), particularly related to emotional exhaustion (B = 2.04, P < 0.01).

Conclusions

Workplace interventions targeting emotional exhaustion related to chronic health conditions are recommended to effectively address occupational burnout among ECE staff.