bluuebunny/crossref_metadata_2025 huggingface dataset:
Temporal trends and spatial and spatiotemporal distribution of schistosomiasis mansoni in northeast Brazil between 2005 and 2016
Authors: Bezerra Alencar Vitória Jordana , Dantas Lima Pedro , Vieira Machado João Paulo , da Silva Lima Maria Wilma , da Conceição Gomes Sheilla , Silva da Paz Wandklebson , Santos Ramos Rosália Elen , Pereira Bezerra Letícia , Gomes de Amorim Santos Israel
Published: January 2024

Background

Schistosoma mansoni is a parasitic disease of great magnitude for Brazilian public health. We aimed to analyse the temporal trend and spatial and spatiotemporal distribution of positivity rates for schistosomiasis mansoni in northeast Brazil.

Methods

This is a descriptive study with an ecological approach, carried out between 2005 and 2016. We calculated the positivity rate for the disease and then performed a segmented trend analysis (Joinpoint). For spatial analysis, we smoothed the positivity rates using the local empirical Bayesian method. We checked for spatial autocorrelation using Moran’s global and local. Subsequently, we performed Kulldorff’s space time sweep analysis.

Results

In the period under review, 7 745 650 tests were performed in the northeast, of which 577 793 were positive for Schistosoma mansoni. In the historical series of positivities, it is noted that the highest rates were in Sergipe, Alagoas and Pernambuco. The states of Alagoas and Sergipe showed higher positivity in relation to the average positivity of the northeast and of Brazil. The spatial analysis maps identify clusters of high risk of schistosomiasis cases, mainly in coastal municipalities. There was also stability in positivity rates in some states and the maintenance of endemic areas.

Conclusions

Thus effective public health policies are needed in health education in order to reduce schistosomiasis positivity and improve the health conditions of the northeastern population.
Comparative anatomy of the vocal apparatus in bats and implications for the diversity of laryngeal echolocation
Authors: Brualla Nicolas L M , Wilson Laura A B , Tu Vuong Tan , Nojiri Taro , Carter Richard T , Ngamprasertwong Thongchai , Wannaprasert Thanakul , Doube Michael , Fukui Dai , Koyabu Daisuke
Published: January 2024

Most of over 1400 extant bat species produce high-frequency pulses with their larynx for echolocation. However, the debate about the evolutionary origin of laryngeal echolocation in bats remains unresolved. The morphology of the larynx is known to reflect vocal adaptation and thus can potentially help in resolving this controversy. However, the morphological variations of the larynx are poorly known in bats, and a complete anatomical study remains to be conducted. Here, we compare the 3D laryngeal morphology of 23 extant bat species of 11 different families reconstructed by using iodine contrast-enhanced X-ray microtomography techniques. We find that, contrary to previously thought, laryngeal muscle hypertrophy is not a characteristic of all bats and presents differential development. The larynges of Pteropodidae are morphologically similar to those of non-bat mammals. Two morphotypes are described among laryngeal echolocating bats, illustrating morphological differences between Rhinolophoidea and Yangochiroptera, with the main variations being the cricothyroid muscle volume and the shape of the cricoid and thyroid cartilages. For the first time we detail functional specialization for constant frequency echolocation among Rhinolophoidea. Lastly, the nasal-emitting taxa representing a polyphyletic group do not share the same laryngeal form, which raises questions about the potential modular nature of the bat larynx.
Screening of Triploid Banana Population Under Natural and Controlled Black Sigatoka Disease for Genomic Selection
Authors: Mbo Nkoulou Luther Fort , Nkouandou Yacouba Fifen , Ngalle Hermine Bille , Cros David , Martin Guillaume , Molo Thierry , Eya’a Clement , Essome Charles , Zandjanakou-Tachin Martine , Degbey Hervé , Bell Joseph , Achigan-Dako Enoch G.
Published: January 2024

Black sigatoka disease (BSD) is the most important foliar threat in banana production, and breeding efforts against it should take advantage of genomic selection (GS), which has become one of the most explored tools to increase genetic gain, save time, and reduce selection costs. To evaluate the potential of GS in banana for BSD, 210 triploid accessions were obtained from the African Banana and Plantain Research Center to constitute a training population. The variability in the population was assessed at the phenotypic level using BSD- and agronomic-related traits and at the molecular level using single-nucleotide polymorphisms (SNPs). The analysis of variance showed a significant difference between accessions for almost all traits measured, although at the genomic group level, there was no significant difference for BSD-related traits. The index of non-spotted leaves among accessions ranged from 0.11 to 0.8. The accessions screening in controlled conditions confirmed the susceptibility of all genomic groups to BSD. The principal components analysis with phenotypic data revealed no clear diversity partition of the population. However, the structure analysis and the hierarchical clustering analysis with SNPs grouped the population into four clusters and two subpopulations, respectively. The field and laboratory screening of the banana GS training population confirmed that all genomic groups are susceptible to BSD but did not reveal any genetic structure, whereas SNP markers exhibited clear genetic structure and provided useful information in the perspective of applying GS.
Assessment of Prickly Sida as a Potential Inoculum Source for Sida Golden Mosaic Virus in Commercial Snap Bean Farms in Georgia, United States
Authors: Codod Clarence B. , Severns Paul M. , Sparks Alton N. , Srinivasan Rajagopalbabu , Kemerait Robert C. , Dutta Bhabesh
Published: January 2024

Sida golden mosaic virus (SiGMV), an obligate pathogen that infects snap beans (Phaseolus vulgaris), is known to infect prickly sida (Sida spinosa L.), which is a common weed in agricultural farms in Georgia. Prickly sida has also been reported as a suitable host of sweetpotato whitefly (Bemisia tabaci), the vector of SiGMV. Despite being a host for both SiGMV and its vector, the role of prickly sida as a reservoir and inoculum source for SiGMV in snap bean farms has not been evaluated. This study was conducted to document the occurrence of SiGMV-infected prickly sida plants and to assess its potential role as a source of SiGMV inoculum in snap bean farms. A survey of 17 commercial snap bean farms conducted in spring 2021 confirmed the presence of SiGMV-infected prickly sida in southern Georgia. In fall 2021 and 2022, on-farm field trials were conducted in four commercial farms where SiGMV-infected prickly sida plants were documented earlier as a part of survey in spring 2021. The spatial distribution and temporal patterns of adult whiteflies and SiGMV on snap bean were compared between macroplots (13.7 × 30.5 m) “with prickly sida” or “without prickly sida” that were at least 232 m apart from each other. We did not observe any consistent differences in counts of adult whiteflies between macroplots with or without prickly sida in the four commercial farms. SiGMV infection was detected earlier and with higher incidences in snap bean macroplots “with prickly sida” compared with macroplots “without prickly sida.” An apparent disease gradient was observed in two of the four farms assessed. Higher SiGMV incidences were observed on the edges of macroplots “with prickly sida.” These findings indicate prickly sida as a potential natural reservoir and a source for SiGMV spread in snap bean farms in southern Georgia.
Induced pluripotent stem cell‐derived extracellular vesicles enriched with miR‐126 induce proangiogenic properties and promote repair of ischemic tissue
Authors: Kmiotek‐Wasylewska Katarzyna , Łabędź‐Masłowska Anna , Bobis‐Wozowicz Sylwia , Karnas Elżbieta , Noga Sylwia , Sekuła‐Stryjewska Małgorzata , Woźnicka Olga , Madeja Zbigniew , Dawn Buddhadeb , Zuba‐Surma Ewa K.
Published: January 2024

Emerging evidence suggests that stem cell‐derived extracellular vesicles (EVs) may induce pro‐regenerative effects in ischemic tissues by delivering bioactive molecules, including microRNAs. Recent studies have also shown pro‐regenerative benefits of EVs derived from induced pluripotent stem (iPS) cells. However, the underlying mechanisms of EV benefits and the role of their transferred regulatory molecules remain incompletely understood. Accordingly, we investigated the effects of human iPS‐derived EVs (iPS‐EVs) enriched in proangiogenic miR‐126 (iPS‐miR‐126‐EVs) on functional properties of human endothelial cells (ECs) in vitro. We also examined the outcomes following EV injection in a murine model of limb ischemia in vivo. EVs were isolated from conditioned media from cultures of unmodified and genetically modified human iPS cells overexpressing miR‐126. The iPS‐miR‐126‐EVs were enriched in miR‐126 when compared with control iPS‐EVs and effectively transferred miR‐126 along with other miRNAs to recipient ECs improving their functional properties essential for ischemic tissue repair, including proliferation, metabolic activity, cell survival, migration, and angiogenic potential. Injection of iPS‐miR‐126‐EVs in vivo in a murine model of acute limb ischemia promoted angiogenesis, increased perfusion, and enhanced functional recovery. These observations corresponded with elevated expression of genes for several proangiogenic factors in ischemic tissues following iPS‐miR‐126‐EV transplantation. These results indicate that innate pro‐regenerative properties of iPS‐EVs may be further enhanced by altering their molecular composition via controlled genetic modifications. Such iPS‐EVs overexpressing selected microRNAs, including miR‐126, may represent a novel acellular tool for therapy of ischemic tissues in vivo.
Folate supports IL‐25‐induced tuft cell expansion following enteroviral infections
Authors: Lyu Ruining , Wu Jing , He Yating , You Qiao , Qian Yajie , Jiang Na , Cai Yurong , Chen Deyan , Wu Zhiwei
Published: January 2024

Intestinal tuft cells, a kind of epithelial immune cells, rapidly expand in response to pathogenic infections, which is associated with infection‐induced interleukin 25 (IL‐25) upregulation. However, the metabolic mechanism of IL‐25‐induced tuft cell expansion is largely unknown. Folate metabolism provides essential purine and methyl substrates for cell proliferation and differentiation. Thus, we aim to investigate the roles of folate metabolism playing in IL‐25‐induced tuft cell expansion by enteroviral infection and recombinant murine IL‐25 (rmIL‐25) protein‐stimulated mouse models. At present, enteroviruses, such as EV71, CVA16, CVB3, and CVB4, upregulated IL‐25 expression and induced tuft cell expansion in the intestinal tissues of mice. However, EV71 did not induce intestinal tuft cell expansion in IL‐25−/− mice. Interestingly, compared to the mock group, folate was enriched in the intestinal tissues of both the EV71‐infected group and the rmIL‐25 protein‐stimulated group. Moreover, folate metabolism supported IL‐25‐induced tuft cell expansion since both folate‐depletion and anti‐folate MTX‐treated mice had a disrupted tuft cell expansion in response to rmIL‐25 protein stimulation. In summary, our data suggested that folate metabolism supported intestinal tuft cell expansion in response to enterovirus‐induced IL‐25 expression, which provided a new insight into the mechanisms of tuft cell expansion from the perspective of folate metabolism.
Dysfunction of specific auditory fibers impacts cortical oscillations, driving an autism phenotype despite near‐normal hearing
Authors: Marchetta Philine , Dapper Konrad , Hess Morgan , Calis Dila , Singer Wibke , Wertz Jakob , Fink Stefan , Hage Steffen R. , Alam Mesbah , Schwabe Kerstin , Lukowski Robert , Bourien Jerome , Puel Jean‐Luc , Jacob Michele H. , Munk Matthias H. J. , Land Rüdiger , Rüttiger Lukas , Knipper Marlies
Published: January 2024

Autism spectrum disorder is discussed in the context of altered neural oscillations and imbalanced cortical excitation–inhibition of cortical origin. We studied here whether developmental changes in peripheral auditory processing, while preserving basic hearing function, lead to altered cortical oscillations. Local field potentials (LFPs) were recorded from auditory, visual, and prefrontal cortices and the hippocampus of BdnfPax2 KO mice. These mice develop an autism‐like behavioral phenotype through deletion of BDNF in Pax2+ interneuron precursors, affecting lower brainstem functions, but not frontal brain regions directly. Evoked LFP responses to behaviorally relevant auditory stimuli were weaker in the auditory cortex of BdnfPax2 KOs, connected to maturation deficits of high‐spontaneous rate auditory nerve fibers. This was correlated with enhanced spontaneous and induced LFP power, excitation–inhibition imbalance, and dendritic spine immaturity, mirroring autistic phenotypes. Thus, impairments in peripheral high‐spontaneous rate fibers alter spike synchrony and subsequently cortical processing relevant for normal communication and behavior.
Effects of higher femoral tunnels on clinical outcomes, MRI, and second-look findings in double-bundle anterior cruciate ligament reconstruction with a minimal 5-year follow-up
Authors: Lin Lin , Wang Haijun , Wang Jian , Wang Yongjian , Chen Yourong , Yu Jiakuo
Published: January 2024

Background:

To perform anatomical anterior cruciate ligament reconstruction (ACLR), tunnels should be placed relatively higher in the femoral anterior cruciate ligament (ACL) footprint based on the findings of direct and indirect femoral insertion. But the clinical results of higher femoral tunnels (HFT) in double-bundle ACLR (DB-ACLR) remain unclear. The purpose was to investigate the clinical results of HFT and lower femoral tunnels (LFT) in DB-ACLR.

Methods:

From September 2014 to February 2016, 83 patients who underwent DB-ACLR and met the inclusion and exclusion criteria were divided into HFT-ACLR (group 1, n = 37) and LFT-ACLR (group 2, n = 46) according to the position of femoral tunnels. Preoperatively and at the final follow-up, clinical scores were evaluated with International Knee Documentation Committee (IKDC), Tegner activity, and Lysholm score. The stability of the knee was evaluated with KT-2000, Lachman test, and pivot-shift test. Cartilage degeneration grades of the International Cartilage Repair Society (ICRS) were evaluated on magnetic resonance imaging (MRI). Graft tension, continuity, and synovialization were evaluated by second-look arthroscopy. Return-to-sports was assessed at the final follow-up.

Results:

Significantly better improvement were found for KT-2000, Lachman test, and pivot-shift test postoperatively in group 1 (P >0.05). Posterolateral bundles (PL) showed significantly better results in second-look arthroscopy regarding graft tension, continuity, and synovialization (P <0.05), but not in anteromedial bundles in group 1. At the final follow-up, cartilage worsening was observed in groups 1 and 2, but it did not reach a stastistically significant difference (P >0.05). No statistically significant differences were found in IKDC subjective score, Tegner activity, and Lysholm score between the two groups. Higher return-to-sports rate was found in group 1 with 86.8% (32/37) vs. 65.2% (30/46) in group 2 (P = 0.027).

Conclusion:

The HFT-ACLR group showed better stability results, better PL, and higher return-to-sports rate compared to the LFT-ACLR group.
RNF213 in moyamoya disease: Genotype–phenotype association and the underlying mechanism
Authors: Fang Jianxun , Yang Xinzhuang , Ni Jun
Published: January 2024

Moyamoya disease (MMD) is a cerebrovascular disorder characterized by a steno-occlusive internal carotid artery and compensatory vascular network formation. Although the precise pathogenic mechanism remains elusive, genetic association studies have identified RNF213 as the principal susceptibility gene for MMD, with the single nucleotide polymorphism p.R4810K recognized as the founder variant predominantly in the Asian populations. Distinct genotype–phenotype correlations are observable in RNF213-related MMD. The clinical manifestations linked to p.R4810K bear commonalities within Asian cohort, including familial predisposition, earlier age of onset, ischemic episodes, and involvement of the posterior cerebral artery (PCA). However, despite these shared phenotypic characteristics, there is significant heterogeneity in RNF213-related MMD presentations. This diversity manifests as variations across ethnic groups, inconsistent clinical symptoms and prognosis, and occurrence of other vasculopathies involving RNF213. This heterogeneity, in conjunction with the observed low disease penetrance of RNF213 mutations, suggests that the presence of these mutations may not be sufficient to cause MMD, underscoring the potential influence of other genetic or environmental factors. Although the current research might not have fully identified these additional contributors, experimental evidence points toward the involvement of RNF213 in angiogenesis, lipid metabolism, and the immune response. Future research is required to unveil the molecular mechanisms and identify the factors that synergize with RNF213 in the pathogenesis of MMD.
COVID-19 Vaccine Acceptance Among Parents of Children With Multisystem Inflammatory Syndrome in Children
Authors: Blanchard-Rohner Geraldine , Sanchez Carlos , Andre Maya C. , Bressieux-Degueldre Sabrina , Grazioli Serge , Perez Marie-Helene , Wütz Daniela , Schöbi Nina , Welzel Tatjana , Atkinson Andrew , Schlapbach Luregn J. , Bielicki Julia A. , Trück Johannes ,   for the Swissped RECOVERY Trial Group
Published: January 2024

Data on COVID-19 vaccine acceptability among parents of children with multisystem inflammatory syndrome (MIS-C) are limited. In this cohort of children with MIS-C, enrolled in the Swissped RECOVERY trial (NCT 04826588), comparing intravenous immunoglobulins or methylprednisolone, who, in accordance with Swiss guidelines, were recommended for SARS-CoV-2 vaccination, 65% (73/112) of parents reported being vaccinated against SARS-CoV-2 before the MIS-C, while 70% were vaccinated after the MIS-C episode of their child. None of the children were vaccinated before the occurrence of the MIS-C, and only 9% (5/56) received the COVID-19 vaccine after the MIS-C. The predominant barriers to COVID-19 vaccination were concerns over potential side effects and insufficient support from their doctors. This emphasizes the crucial role of health care providers in promoting COVID-19 vaccination among children.
Epidemiology and Clinical Characteristics of Human Metapneumovirus Infections in Hospitalized Children in Two Consecutive Postpandemic Years
Authors: Steinberg Ruth , Marty Véronique , Korten Insa , Aebi Christoph , Latzin Philipp , Agyeman Philipp KA
Published: January 2024

We assessed human metapneumovirus infections in children hospitalized between 2011 and 2023 and compared the strongest pre- and postpandemic seasons. After the COVID-19 pandemic, we observed offseason cases and loss of the alternating pattern of the human metapneumovirus season magnitude. Incidence rate ratio of 0- to 11-month-old versus 12- to 23-month-old children was 2.1 (95% CI: 1.0–4.8) before and 1.3 (95% CI: 0.6–2.9) after the pandemic.
Asthma as a Risk Factor for Hospitalization in Children and Youth With COVID-19: A Retrospective Cohort Study
Authors: Lara Shana T. , Rein Lisa E. , Simanek Amanda M. , Totoraitis Michael F. , Rausch Darren J. , Weston Benjamin W. , Ahn Kwang Woo , Meurer John R. , Beyer Kirsten M. M.
Published: January 2024

Background:

Studies examining the association between asthma and hospitalization among children and youth with coronavirus disease 2019 (COVID-19) have yielded mixed results. Both asthma and COVID-19 hospitalization are characterized by racial, ethnic and socioeconomic disparities which also pattern geographically, yet no studies to date have adjusted for neighborhood context in the assessment of this association.

Methods:

Mixed effects logistic regression was used to estimate the association between asthma and hospitalization due to COVID-19 in a sample of 28,997 children and youth diagnosed with COVID-19 in Milwaukee County, Wisconsin, from March 1, 2020, to May 31, 2022. Models adjusted for individual-level sociodemographic factors (age, gender, race, ethnicity and city/suburb residence) and season of diagnosis were examined as moderators. Random intercepts by census tract accounted for geographic variation in neighborhood factors and census tract-level measures of education, health and environment, and social and economic factors were assessed via childhood opportunity indices.

Results:

Asthma history was statistically significantly associated with hospitalization due to COVID-19 among children and youth. Hospitalization rates varied statistically significantly by census tract, and results were unchanged after accounting for childhood opportunity indices and census tract. Season of diagnosis was not found to moderate the effect of asthma history on COVID-19 hospitalization.

Conclusion: 

Our study suggests that asthma history is a risk factor for hospitalization in the context of COVID-19 infection among children and youth, warranting observation and follow-up of children with asthma as well as continued measures to prevent COVID-19 in this population.
Liposomal-Associated Phospholipase A2 Is More Effective in Predicting Cardiac Risk in Law Enforcement Than Framingham Risk Score and Coronary Artery Calcium Score Calculation
Authors: Sheinberg Jonathan , Rajaram Pranav , Callaway Joshua
Published: January 2024

Objective

To clarify the methods for identifying officers at high risk for cardiac events.

Methods

This retrospective review included 3330 patient charts. Classic cardiovascular risk factors, coronary artery calcium (CAC) scores, and endothelial inflammatory biomarker levels were compared between civilians and law enforcement officers (LEOs). The Framingham Risk Score (FRS) was compared with risk assessment using inflammatory biomarkers.

Results

The FRS failed to identify more than 90% of LEOs at high risk of cardiovascular events. Similarly, the use of the CAC score was ineffective. Inflammatory biomarker analysis measuring the lipoprotein-associated phospholipase A2 activity was the most reliable method for identifying LEOs at high risk of cardiovascular events.

Conclusions

The use of the standard FRS and CAC scores is less effective than that of inflammatory biomarkers in identifying LEOs at high risk of cardiovascular events;
Improvements in Work Productivity and Activity Impairment Among Adults With Anxiety or Depressive Symptoms Participating in a Relational Agent–Delivered Digital Mental Health Intervention
Authors: Forman-Hoffman Valerie L. , Flom Megan , Montgomery Robert , Robinson Athena
Published: January 2024

Objectives

The study aimed to assess changes between baseline and end of treatment in work-related absenteeism, presenteeism, productivity, and nonwork-related activity impairment and estimate cost savings associated with observed improvements.

Methods

Data from 91 employed adult participants who enrolled in a single-arm, exploratory study of a relational agent–delivered digital mental health intervention and completed Work Productivity and Activity Impairment assessments were analyzed; overall work productivity improvement was multiplied by the overall and education-adjusted US median annual salary to arrive at potential cost savings estimates.

Results

Adjusted models indicated more than 20% improvements in presenteeism, work productivity impairment, and activity impairment, yielding cost-savings estimates between $14,000 and more than $18,000 annually.

Conclusions

Relational agent–delivered digital mental health interventions may be associated with improvements in work productivity and activity impairment, which could result in a sizable cost savings.
Work Disability Duration Among Mobile Workers
Authors: Macpherson Robert A. , Tamburic Lillian , Neis Barbara , McLeod Christopher B.
Published: January 2024

Objective

The aim of the study is to compare work disability duration of intraprovincially and interprovincially mobile workers with nonmobile workers in British Columbia, Canada.

Methods

Workers’ compensation claims were extracted for workers injured between 2010 and 2019. Employer and residential postal codes were converted to economic regions to define nonmobile, intraprovincially, and interprovincially mobile workers. Quantile regression models using matched cohorts were used to estimate differences in work disability days at different percentiles of the distribution.

Results

Compared with nonmobile workers, both mobile worker groups had longer work disability durations, particularly interprovincially mobile workers. Differences persisted in injury-stratified models and were partially or fully attenuated in some industry-stratified models.

Conclusions

Workers’ compensation systems, employers, and healthcare providers may need to tailor specific interventions for mobile workers who are from out-of-province as well as traveling between regions in the province.
Outcomes for a Heat Illness Prevention Program in Outdoor Workers
Authors: Perkison William B. , Schaefer Caroline M. , Green-McKenzie Judith , Roy Rachel White , Shofer Frances S. , McCarthy Ronda B.
Published: January 2024

Objective

To describe the outcomes effect of removing the medical surveillance component from a heat illness prevention program (HIPP) for outdoor workers from a Central Texas municipality.

Methods

Heat-related illness (HRI) frequency and workers’ compensation (WC) cost were assessed retrospectively in a cohort of 329 workers from 2011–2019. During 2011–2017, the HIPP included training, acclimatization, and medical surveillance. In 2018–2019, a modified (mHIPP) was implemented that included training and acclimatization, but without medical surveillance.

Results

The HRI rate during HIPP averaged 19.5 per 1000 workers during the first 4 years, dropped to 1.01 per 1,000 workers over the next 3 years, (2015-2017), and increased during mHIPP, to 7.6 per 1,000 workers.

Discussion

Although the case increase during the mHIPP was small, medical surveillance may be an important component in lowering workforce HRI.
Occupational Medicine Physicians Transition to Retirement
Authors: Stave Gregg M. , Burton Wayne N. , Heron Richard J.L. , Baase Cathy , Thirumalai Rajgopal
Published: January 2024

Objective

The aim of the study is to understand the needs and interests of occupational medicine physicians (OMPs) as they transition to retirement.

Methods

An electronic survey was distributed through member organizations in the United States (ACOEM), United Kingdom (SOM/FOM), India (IAOH), South Africa (SASOM), and Medichem.

Results

Four hundred ninety-seven OMPs at various career stages responded, including 282 from the United States, 97 from the United Kingdom, 36 from India, 30 from South Africa, and 52 from other countries. Two hundred seventy-eight work full-time, 160 part-time, and 58 are not doing paid work. Approximately 60% serve as volunteers. Sixty percent have a written financial plan. Thirty-five percent are very comfortable with their retirement plans. After leaving full-time work, 85% plan to work part-time. There is a high level of interest in learning about opportunities for part-time work and volunteering.

Conclusions

Occupational medicine physicians are very interested in learning more about compensated and uncompensated work in retirement.
Poor prognosis and risk factors of nonoperative treatment hip fracture patients with end-stage renal disease
Authors: Zhan Ping-Ying , Lu Yang-Zhen , Wang Li-Hong
Published: January 2024

This study aims to summarize the prognosis and risk factors of nonoperative treatment patients of hip fracture with end-stage renal disease (ESRD). A total of 113 individuals of hip fracture with nonoperative treatment were retrospectively enrolled, 38 patients with ESRD were defined as the observation group, and the other 75 patients without ESRD were served as the control group. The difference in 30-day and 1-year mortality rate between the 2 groups was compared. The effects of risk factors on survival were estimated by the Cox proportional-hazards model. The survival difference was estimated by the method of Kaplan–Meier. In the subsequent subgroup analysis of the observation group, as before, the Cox proportional-hazards model and the Kaplan–Meier method were used. The 1-year mortality rate of the observation group was considerably higher than that of the control group, which was 86.84% and 32.0%, respectively (P < .005). For nonoperative treatment hip fracture subjects, ESRD, age ≥ 82, BMI (BMI) < 20, high Charlson Comorbidity Index (CCI) and low Barthel Index (BI) were associated with a low survival curve (P < .05). In the subsequent multivariable subgroup analyses, for nonoperative treatment hip fracture subjects with ESRD, high CCI and low BI were also the independent risk factors of mortality. For nonoperative treatment hip fracture subjects, ESRD, old age, low BMI, high CCI and low BI were the independent risk factors of mortality. For hip fracture subjects with ESRD, nonoperative treatment was associated with excess high 1-year mortality rate, especially for patients with high CCI and low BI.
Effectiveness and safety of tendon-bone-setting in postpartum women with sacroiliac joint pain: A retrospective multicenter study
Authors: Long Min , Dong Yunan , Liu Huixian
Published: January 2024

Sacroiliac joint (SIJ) pain leads to abnormal joint loading, and is a key risk factor for joint degeneration. This study aimed to determine the effect of tendon-bone-setting on postpartum women with SIJ pain. Multicenter retrospective review of medical records and electroencephalography reports in 10 academic medical centers. 328 postpartum women with sacroiliac joint pain were divided into 2 groups according to the methods of therapy. Group (A) (n = 203) received acupuncture combined with tendon-bone-setting for twenty days, whereas group (B) (n = 125) received only the same acupuncture for twenty days. The outcome measures were the mean values of numeric pain rating scale (NPRS), present pain intensity (PPI) scale, visual analog scale (VAS) and Japanese orthopedic association (JOA) score to evaluate pain intensity, oswestry disability index (ODI), quebec back pain disability scale (QBPDS), active straight leg raise (ASLR) and back pain function scale (BPFS) to evaluate the functional disability, pressure pain thresholds (PPT) at 5 chosen points in the sacroiliac joint region to assess pain sensitivity. All of them were evaluated before and after treatment. The effectiveness from short to long term, as well as safety was assessed in this study. A comparison of the 2 groups after treatment showed statistically significant increases in the mean values of BPFS, JOA and PPT at the 5 chosen points (P < .05), as well as significant reductions in the scores of QBPDS, ODI, ASLR, NPRS, VAS and PPI (P < .05) in favor of group (B). In addition, after treatment for 2 weeks, the considered effective rate in the group (A) was significantly higher than that in the group (B) (P < .05). Also, the cumulative incidence of pain relief at 24 months in the group (A) was greater compared with the group (B) as determined by Kaplan–Meier analysis (P < .05). Interestingly, none serious adverse event for the participants was reported. Tendon-Bone-Setting is effective and safe in treating sacroiliac joint pain for the postpartum women patients in the short and long terms through decreasing pain sensitivity and intensity, as well as improving functional ability.
Recent advances in the management of immune thrombocytopenic purpura (ITP): A comprehensive review
Authors: Madkhali Mohammed Ali
Published: January 2024

Autoimmune disorders place a substantial burden on the healthcare system all over the world affecting almost 3% to 8% of the population. Immune thrombocytopenic purpura (ITP), also known as idiopathic thrombocytopenic purpura, is a blood disorder in which the body immune system destroys platelets, leading to low platelet counts in the blood (peripheral blood platelet count < 150 × 109/L). Although the pathophysiology of ITP is not fully understood, it is believed to result from a complex interplay between hereditary and environmental variables. Certain factors, such as a low platelet count, history of bleeding, and certain comorbidities can increase the risk of severe bleeding in patients with ITP. Corticosteroids, intravenous immunoglobulin (IVIG), immunosuppressants, rituximab, and thrombopoietin receptor agonists (TPO-RAs) are some of the advanced treatments for ITP. Although these therapies may be successful, they also carry the risk of negative effects. Recently, significant advancements have been made in the understanding and treatment of ITP. There is still much to learn about the disease, and new, more effective treatments are needed. This comprehensive review offers a comprehensive assessment of recent advancements in ITP management, with a focus on active research projects, novel therapeutic targets, new treatment modalities, and areas of uncertainty and unmet needs. According to research, it is crucial to develop individualized treatment plans for ITP patients based on their age, platelet count, risk of bleeding, and comorbidities. The article also looks at how future developments in gene editing, bispecific antibody therapies, and cellular therapy may completely change the treatment of ITP.
Sigmoid colonic metastasis from a squamous cell carcinoma of the cervix: A rare case report with literature review
Authors: Li Minhua , Zheng Weiping
Published: January 2024

Rationale:

As the third most common cancer in women, cervical cancer usually spreads to adjacent organs. Distant metastasis from the cervix to the gastrointestinal tract is an extremely rare occurrence.

Patient concerns:

Herein, we present a rare case of a 57-year-old woman who was treated by hysterectomy and bilateral salpingo-oophorectomy with pelvic lymphadenectomy for squamous cell carcinoma (SCC) of the uterine cervix. A metastatic location in the sigmoid colon was revealed after 8 years causing an acute intestinal obstruction in this patient.

Diagnoses:

Final surgical pathology showed an invasive lesion with squamous differentiation in full thickness of the colon wall from mucosa to serosa. Meanwhile, the results of immunohistochemistry (IHC) showed the cancer cells were positive for CK5/6, P63, P40, and P16 confirming the diagnosis of metastatic sigmoid colonic carcinoma originating from SCC of the uterine cervix.

Interventions:

Sigmoid colon resection with lymph node dissection followed by adjuvant chemotherapy (paclitaxel, carboplatin, and paprillizumab) was performed on the patient.

Outcomes:

The patient was disease-free 16 months after surgery.

Lessons subsections:

SCC is one of the rare malignant tumors of the gastrointestinal tract occurring as either a primary or secondary lesion. However, the secondary SCC of the colon has a poorer prognosis compared with the primary SCC. Therefore, colonic metastasis must be considered in the differential diagnosis of acute intestinal obstruction, especially in patients with the medical history of SCC in other organs.
Beyond the knife: strategic patient selection for cytoreductive nephrectomy
Authors: Brönimann Stephan , Ged Yasser , Singla Nirmish
Published: January 2024

Purpose of review

To evaluate the current role of cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) within the context of evolving treatment paradigms, focusing on implications for patient selection.

Recent findings

Two randomized trials failed to show significant benefits from CN for intermediate and poor-risk patients undergoing targeted therapy. Despite this, subgroup analysis and retrospective data suggest potential benefits for a subset of good and intermediate-risk patients. Although currently used risk stratification tools guide CN eligibility, they have limitations, including, subjectivity, perioperative variability, and missing validation. Deferred CN may benefit patients responding to systemic treatment, whereas other patients may benefit from upfront CN. Emerging data supports the value of CN with immune checkpoint inhibitors (ICI) in selected patients, emphasizing the need for ongoing trials in the ICI era.

The role and timing of CN in mRCC have evolved across therapeutic eras. Although awaiting prospective evidence in the current era of ICI, CN still has a role in the therapeutic approach for a subset of patients. The decision to recommend CN must be personalized and involve multidisciplinary discussions considering both patient- and tumor-related factors.
Effectiveness of perineural administration of dexamethasone with lidocaine on onset time of sensory block and early postoperative analgesia in axillary brachial plexus block: a prospective cohort study, Ethiopia
Authors: Mola Simeneh , Girma Betelihem
Published: January 2024

Introduction:

The axillary brachial plexus block is a popular nerve block for forearm, wrist, and hand surgery. The aim of this study was to assess the effectiveness of perineural administration of dexamethasone as an adjunct to lidocaine with adrenaline on the onset of sensory block and early postoperative analgesia in trans-arterial axillary brachial plexus block.

Methodology:

This single-centered prospective cohort study recruited 68 adult patients, 34 in each groups. The frequently used 8 mg dexamethasone combined with 1% lidocaine and adrenaline was investigated. The normality of the data was checked using the Shapiro–Wilk test. An independent t-test was used to compare the mean values of symmetric numeric data. Categorical variables between the two groups were analyzed using χ2. The Mann–Whitney U test and Kaplan–Meier method using the log-rank test were used to compare asymmetric numeric data, and a P-value of <0.05 was considered as significant.

Results:

The median onset time of sensory block was comparable between the nonexposed (24(6) min) and exposed group (24(6) min) (P=0.068). However, the duration of sensory block was significantly longer in the exposed group (235.5±37.51 min) than the nonexposed group (172.76±28.19 min) (P<0.001). The time to the first analgesic request was significantly longer in the exposed than the nonexposed group (P<0.01). Postoperative pain scores were significantly lower at 4 and 8 h in the exposed group (P<0.05).

Conclusion and recommendations:

The addition of 8 mg dexamethasone to 1% lidocaine with adrenaline solution in trans-arterial axillary brachial plexus block for ambulatory elective hand, wrist, and forearm surgeries prolonged the duration of sensory blockade and the first analgesic request time but did not reduce the onset time of sensory block. The authors recommend the addition of 8 mg dexamethasone to 1% lidocaine with adrenaline solution to prolong the duration of sensory block and the first analgesic request time.
The Use of Standardized Patients to Teach Communication Skills—A Systematic Review
Authors: Rutherford-Hemming Tonya , Herrington Alaina , Ngo Thye Peng
Published: January 2024

Objectives

The aim of this systematic review was to synthesize research completed between 2011 and 2021 to report the current state of the science on the use of standardized patients (SPs) to teach communication skills. The research question that guided this study was, “Among health care professionals, does the use of SP methodology as a means of teaching communication skills result in improved learner knowledge, skills, attitudes, and/or patient outcomes when compared with other simulation methodologies?”

Design

This review was reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

Data Sources

Four databases (CINAHL, Ovid Embase, Ovid Medline, and Scopus) were searched using a combination of medical subject headings, or Mesh terms, as well as keywords to retrieve nonindexed citations.

Review Methods

The inclusion criteria were broad to complete a comprehensive search of the literature. To be eligible for inclusion, a study had to be original research that compared simulation using an SP to another simulation methodology. The study had to evaluate communication knowledge, skill, attitude, and/or patient outcome with an academic or practicing health care professional.

Results

The initial database search strategy yielded 8058 citations. These results were narrowed down to 18 studies through an in-depth analysis of each article using identified inclusion criteria. The SPs were superior to role play in 1 (33%, n = 3) study where knowledge was evaluated, 6 (75%, n = 8) studies where skills were evaluated, and 1 (20%, n = 5) study where attitude was evaluated. The SPs were compared with a manikin in 5 studies. The SPs were superior to a manikin in 3 (60%, n = 5) studies where knowledge was measured and in 1 (100%, n = 1) study where attitude was measured. No study measured the outcome knowledge of an SP to a manikin. Finally, SPs were compared with a virtual SP in 3 studies. When knowledge was evaluated, SPs were superior to a virtual SP in 1 study (100%, n = 1). When skills were evaluated, SPs were superior to a virtual SP in 1 study (50%, n = 2), and when attitude was evaluated, SPs were superior to a virtual SP in no study (0%, n = 2). No study evaluated patient outcomes in the comparison of an SP to another simulation methodology.

Conclusions

Studies show a weak indication that SP-based education is superior to other simulation methodologies in most contexts. However more rigorous studies with larger sample sizes, validated instruments, and effects on patient outcomes are needed to definitively determine the optimal method/modality for teaching communication to health care professionals.
A Standardized Education Program on Deceased Organ and Tissue Donation for Premedical and Medial Students in Korea
Authors: Jeon Hee Jung , Lee Samuel , Seo Soohyeon , Yoo Byungmin , Kim Donguk , Yi Gaeun , Lee Jun Beom , Kim Suji , Oh Jieun , Han Hee Chul , Park Byungil , Lee Taerim , Moon In Sung , Kim Yeong Hoon , Ahn Curie , Yoon Hyun Bae
Published: January 2024

Background.

As the imbalance in organ demand and supply is getting worse, <1000 patients waiting for organ transplants die each year in South Korea. To enhance positive attitudes to deceased organ–tissue donation through systematic education, we developed an educational program with delivery pathways for premedical and medical students.

Methods.

Online and offline self-learning educational materials on deceased organ–tissue donation were generated and posted on the Vitallink Academy YouTube site. Thirty-two pre- and 15 posteducation questionnaires were developed using a web-based survey platform, and conducted before and immediately after the education process. The education proceeded in 3 steps: (1) group study sessions on selected topics, (2) poster submissions by each group and the selection of excellent poster by the organizing committee, and (3) excellent poster presentation and questions and answers.

Results.

A total of 141 students in the first year of premedical classes at the Seoul National University College of Medicine participated in this program. Only 24.2% of responders agreed that anyone who was diagnosed with brain death should donate. The proportion of students with positive attitudes toward organ–tissue donation increased from 74.7% to 97.7% (P < 0.001) with our education. Likewise, interest in deceased organ–tissue donation-related issues increased from 33.3% to 84.9% (P < 0.001). The expressed willingness for organ–tissue donation also increased from 76.8% to 96.5% (P < 0.001). The proportion of accepting brain death as the determination of death increased from 61.6% to 89.5% (P < 0.001). Moreover, 81.4% changed their approach and planned to register with an organ donor card.

Conclusions.

In this study, significant improvements were observed in knowledge, awareness, and attitude toward organ–tissue donation with our newly developed co-participatory education program for premedical students. Hence, target-specific education can be regarded as a valuable approach to enhancing public awareness of deceased organ–tissue donation.
The Association of Post–Lung Transplant Pulmonary Embolism With the Development of Chronic Lung Allograft Dysfunction
Authors: Magin Justin C. , Xu Chun , Peskoe Sarah , Dorry Michael , Frankel Courtney W. , Dahhan Talal , Snyder Laurie D.
Published: January 2024

Background.

Pulmonary embolism (PE) is a rare yet serious postoperative complication for lung transplant recipients (LTRs). The association between timing and severity of PE and the development of chronic allograft lung dysfunction (CLAD) has not been described.

Methods.

A single-center, retrospective cohort analysis of first LTRs included bilateral or single lung transplants and excluded multiorgan transplants and retransplants. PEs were confirmed by computed tomography angiography or ventilation/perfusion (VQ) scans. Infarctions were confirmed on computed tomography angiography by a trained physician. The PE severity was defined by the Pulmonary Embolism Severity Index (PESI) score, a 30-d post-PE mortality risk calculator, and stratified by low I and II (0–85), intermediate III and IV (85–125), and high V (>125). PE and PESI were analyzed in the outcomes of overall survival, graft failure, and chronic lung allograft dysfunction (CLAD).

Results.

We identified 57 of 928 patients (6.14%) who had at least 1 PE in the LTR cohort with a median follow-up of 1623 d. In the subset with PE, the median PESI score was 85 (75.8–96.5). Most of the PESI scores (32/56 available) were in the low-risk category. In the CLAD analysis, there were 49 LTRs who had a PE and 16 LTRs (33%) had infarction. When treating PE as time-dependent and adjusting for covariates, PE was significantly associated with death (hazard ratio [HR] 1.8; 95% confidence interval [CI], 1.3-2.5), as well as increased risk of graft failure, defined as retransplant, CLAD, or death (HR 1.8; 95% CI, 1.3-2.5), and CLAD (HR 1.7; 95% CI, 1.2-2.4). Infarction was not associated with CLAD or death. The PESI risk category was not a significant predictor of death or CLAD.

Conclusions.

PE is associated with decreased survival and increased hazard of developing CLAD. PESI score was not a reliable predictor of CLAD or death in this lung transplant cohort.
Twelve Thousand Kidney Transplants Over More Than 55 Y: A Single-center Experience
Authors: Parajuli Sandesh , Garonzik-Wang Jacqueline , Astor Brad C. , Aziz Fahad , Garg Neetika , Welch Bridget , Odorico Jon , Mezrich Joshua , Kaufman Dixon , Foley David P. , Mandelbrot Didier
Published: January 2024

Background.

Kidney transplant outcomes have dramatically improved since the first successful transplant in 1954. In its early years, kidney transplantation was viewed more skeptically. Today it is considered the treatment of choice among patients with end-stage kidney disease.

Methods.

Our program performed its first kidney transplant in 1966 and recently performed our 12 000th kidney transplant. Here, we review and describe our experience with these 12 000 transplants. Transplant recipients were analyzed by decade of date of transplant: 1966–1975, 1976–1985, 1986–1995, 1996–2005, 2006–2015, and 2016–2022. Death-censored graft failure and mortality were outcomes of interest.

Results.

Of 12 000 kidneys, 247 were transplanted from 1966 to 1975, 1147 from 1976 to 1985, 2194 from 1986 to 1995, 3147 from 1996 to 2005, 3046 from 2006 to 2015, and 2219 from 2016 to 2022 compared with 1966–1975, there were statistically significant and progressively lower risks of death-censored graft failure at 1 y, 5 y, and at last follow-up in all subsequent eras. Although mortality at 1 y was lower in all subsequent eras after 1986–1995, there was no difference in mortality at 5 y or the last follow-up between eras.

Conclusions.

In this large cohort of 12 000 kidneys from a single center, we observed significant improvement in outcomes over time. Kidney transplantation remains a robust and ever-growing and improving field.