bluuebunny/crossref_metadata_2025 huggingface dataset:
Innovative ultrasound-guided one-stop surgery for complex cardiovascular cases: a case report
Authors: Zhang Meng , Ma Xinyi , Li YanHui
Published: December 2023

Elderly patients with multiple comorbidities often face complex cardiac challenges, including aortic valve issues and atrial septal defects. Traditional open-heart surgery may not be viable for this demographic. Transcatheter aortic valve implantation (TAVI) emerges as a preferred alternative. In this case, a frail patient with multiple comorbidities, atrial septal defect, and significant aortic stenosis and regurgitation underwent a one-stop procedure, combining TAVI and atrial septal defect closure, guided by advanced imaging, including three-dimensional ultrasound. Ultrasound played a pivotal role in the perioperative phase, offering precise screening and guidance. This innovative technique, minimizing surgical trauma and recovery time, significantly improved the patient’s quality of life.
Children and teens must develop digital literacy skills to navigate complex and evolving food ecosystems
Authors: Kraak Vivica I
Published: December 2023

Ares et al 2023 discussed multisectoral strategies that practitioners could use to foster food literacy competencies (ie, relational, functional, and critical) across the lifespan. This letter encourages the authors to include digital food and nutrition literacy skills to help children and teens navigate a complex food ecosystem shaped by digital technologies. Existing digital food and nutrition literacy models and metrics could be adapted to enable young people to make healthy dietary choices within future sustainable food systems.
Understanding the challenges of the secondary-tertiary transition in mathematics for economics in higher education: a literature review
Authors: Landgärds-Tarvoll Ida
Published: December 2023

This review paper examines the issues identified by research regarding students transitioning from school mathematics to service mathematics modules within economics education at the tertiary level. Literature was gathered in four steps, mainly through hand-searching strategies from journals, books, conference proceedings and reports. The results show that existing research addresses the challenges of students to cope with changed roles of students and teachers, as well as with new approaches to teaching and assessment, in the transition phase between education levels. Special issues identified for service mathematics in economics education are (i) issues of heterogeneous mathematics background in the student group, (ii) of mismatch in expectations about mathematics level and demand and (iii) the issue of relevance of mathematics. This review helps practitioners gain deeper insights into these multifaceted issues of transition. Furthermore, several potential directions for further research in the field are recommended.
Possible Biological Control of Ash Dieback Using the Mycoparasite Hymenoscyphus Fraxineus Mitovirus 2
Authors: Shamsi Wajeeha , Mittelstrass Jana , Ulrich Sven , Kondo Hideki , Rigling Daniel , Prospero Simone
Published: December 2023

Invasive fungal diseases represent a major threat to forest ecosystems worldwide. As the application of fungicides is often unfeasible and not a sustainable solution, only a few other control options are available, including biological control. In this context, the use of parasitic mycoviruses as biocontrol agents of fungal pathogens has recently gained particular attention. Since the 1990s, the Asian fungus Hymenoscyphus fraxineus has been causing lethal ash dieback across Europe. In the present study, we investigated the biocontrol potential of the mitovirus Hymenoscyphus fraxineus mitovirus 2 (HfMV2) previously identified in Japanese populations of the pathogen. HfMV2 could be successfully introduced via co-culturing into 16 of 105 HfMV2-free isolates. Infection with HfMV2 had contrasting effects on fungal growth in vitro, from cryptic to detrimental or beneficial. Virus-infected H. fraxineus isolates whose growth was reduced by HfMV2 showed overall a lower virulence on ash ( Fraxinus excelsior) saplings as compared with their isogenic HfMV2-free lines. The results suggest that mycoviruses exist in the native populations of H. fraxineus in Asia that have the potential for biological control of ash dieback in Europe.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Pain management in primary care
Authors: Collins Andrea
Published: December 2023

In 2022, the CDC released an updated clinical practice guideline for prescribing opioids and managing pain in the outpatient setting. This article synthesizes the guideline recommendations and implementation considerations for clinical NP practice.
Developmental Delay and Behavior Challenges in an Internationally Adopted Child
Authors: Lipton Lianna R. , Prock Lisa , Camarata Stephen , Fogler Jason , Nyp Sarah S.
Published: December 2023

CASE:

Jay is a 6-year-old boy who was referred to a multidisciplinary developmental clinic for evaluation because of speech/language delays and challenging behaviors. He attends kindergarten with an Individualized Education Program (IEP) supporting developmental challenges with speech/language, motor, and academic skills.

Jay was reportedly born full-term after an uneventful pregnancy and lived with his biological family for several months before transitioning to institutional care. Shortly before his first birthday, he transitioned to the first of 3 foster homes. It is suspected that Jay experienced malnourishment, neglect, lack of appropriate supervision, and inappropriate levels of responsibility (e.g., providing care to an infant when he was a toddler) as well as limited language input while in foster care. Ages at which he attained developmental milestones are unknown, but he has displayed delays across all developmental domains, including speech/language development in his primary language, which is not English.

Jay's adoptive parents report that he is learning English vocabulary well but has been noted to have occasional word-finding difficulties and errors in verb conjugation, pronoun use, and syntax in English. Behavioral concerns include impulsivity, hyperactivity, and aggression exacerbated by new or loud environments and transitions. Socially, he seems to be typically engaged with peers but lacks understanding of personal space/boundaries. His adoptive parents have also noted that he is very sensitive to the emotions of others around him, more irritable in the morning, fascinated by “scary” things, and seems to fear abandonment. During the initial months in his adoptive home, he had frequent night awakenings, fear of the dark, and aggression at bedtime, but all these concerns have improved with time.

Neuropsychological testing was completed as part of the multidisciplinary developmental evaluation, and Jay demonstrated low-average cognitive abilities, delayed preacademic skills in all language-based areas, and receptive and expressive language delays. He was socially engaged during the evaluation. Ultimately, he was diagnosed with mixed receptive-expressive language disorder, attention-deficit/hyperactivity disorder, combined presentation, and unspecified trauma/stress-related disorder.

Given what is known about Jay's early history, what factors would you consider in addressing his parents' concerns regarding his speech/language development and behavior challenges?
Agreement Between Two Behavioral Rating Scales in Preschoolers Born Very Preterm
Authors: Camerota Marie , Bagley Jessica , McGowan Elisabeth C. , Carter Brian S. , Check Jennifer , Dansereau Lynne M. , DellaGrotta Sheri A. , Helderman Jennifer B. , Hofheimer Julie A. , Loncar Cynthia M. , Neal Charles R. , O'Shea T. Michael , Pastyrnak Steven L. , Smith Lynne M. , Everson Todd M. , Lester Barry M.
Published: December 2023

Objective:

Broadband parent rating scales are commonly used to assess behavioral problems in children. Multiple rating scales are available, yet agreement between them is not well-understood. The objective of this study was to evaluate agreement between the Behavior Assessment System for Children, Third Edition (BASC-3), and Child Behavior Checklist 1.5 to 5 years (CBCL) in a sample of children born very preterm.

Method:

We assessed 73 children born < 30 weeks' gestational age whose caregivers completed the BASC-3 and CBCL at age 4. We examined correlations, within-person differences, and agreement in clinical categorization for all corresponding subscales and composites.

Results:

Comparable subscales on the BASC-3 and CBCL were significantly correlated, albeit to differing magnitudes. Subscales indexing hyperactivity and attention problems were the most comparable across the 2 measures, evidenced by strong correlations and few to no differences in mean T-scores. Composite scores indexing internalizing, externalizing, and total problems were also strongly correlated, and there were no differences in the mean T-scores for externalizing or total problems across measures. Agreement in clinical classifications were weak to moderate, though again, the highest agreement was found for hyperactivity, attention, externalizing, and total problems.

Conclusion:

Agreement between BASC-3 and CBCL subscales was weak to moderate, with the exception of subscales related to attention and hyperactivity, as well as composite scores indicating overall behavior problems. Researchers and clinicians should consider these discrepancies when interpreting the results of behavior rating scales with preschool children because conclusions could differ based on the assessment that is used.
AUTOIMMUNE RETINOPATHY IN A PATIENT WITH STIFF-PERSON SYNDROME: A CASE REPORT
Authors: Shah Ronak M. , Maloney Maya H. , Gilbert Aubrey L. , Patel Amar P. , Vora Robin A.
Published: December 2023

Purpose:

The aim of this study was to describe a patient who developed retinal degeneration associated with autoimmune retinopathy and who was also found to have anti-glutamic acid decarboxylase (GAD65) autoantibodies and the diagnosis of stiff-person syndrome.

Methods:

Ophthalmologic workup consisted of clinical examination, multimodality retinal imaging, and electrophysiologic testing. Further neurologic assessment including relevant serum and cerebrospinal fluid studies was also conducted.

Results:

We highlight the case of a 45-year-old patient who developed subacute, sequential vision loss, along with bilateral lower extremity weakness. On initial presentation, optical coherence tomography of the left eye was notable for diffuse attenuation of the outer retinal bands. Fundus autofluorescence demonstrated a ring of hyperautofluorescence encircling the fovea of the left eye. At 15-month follow-up, the right eye also became similarly affected. He was found to have elevated serum and cerebrospinal anti-GAD65 autoantibodies and was diagnosed with both stiff-person syndrome and autoimmune retinopathy.

Conclusion:

There is a potential association of anti-GAD65 autoantibodies with the development of autoimmune retinopathy.
Nomogram for soiling prediction in postsurgery hirschsprung children: a retrospective study
Authors: Wang Pei , Fang Erhu , Zhao Xiang , Feng Jiexiong
Published: December 2023

Purpose:

The aim of this study was to develop a nomogram for predicting the probability of postoperative soiling in patients aged greater than 1 year operated for Hirschsprung disease (HSCR).

Materials and methods:

The authors retrospectively analyzed HSCR patients with surgical therapy over 1 year of age from January 2000 and December 2019 at our department. Eligible patients were randomly categorized into the training and validation set at a ratio of 7:3. By integrating the least absolute shrinkage and selection operator [LASSO] and multivariable logistic regression analysis, crucial variables were determined for establishment of the nomogram. And, the performance of nomogram was evaluated by C-index, area under the receiver operating characteristic curve, calibration curves, and decision curve analysis. Meanwhile, a validation set was used to further assess the model.

Results:

This study enrolled 601 cases, and 97 patients suffered from soiling. Three risk factors, including surgical history, length of removed bowel, and surgical procedures were identified as predictive factors for soiling occurrence. The C-index was 0.871 (95% CI: 0.821–0.921) in the training set and 0.878 (95% CI: 0.811–0.945) in the validation set, respectively. And, the AUC was found to be 0.896 (95% CI: 0.855−0.929) in the training set and 0.866 (95% CI: 0.767−0.920) in the validation set. Additionally, the calibration curves displayed a favorable agreement between the nomogram model and actual observations. The decision curve analysis revealed that employing the nomogram to predict the risk of soiling occurrence would be advantageous if the threshold was between 1 and 73% in the training set and 3–69% in the validation set.

Conclusion:

This study represents the first efforts to develop and validate a model capable of predicting the postoperative risk of soiling in patients aged greater than 1 year operated for HSCR. This model may assist clinicians in determining the individual risk of soiling subsequent to HSCR surgery, aiding in personalized patient care and management.
Clinical efficacy and biomarker analysis of neoadjuvant camrelizumab plus chemotherapy for early-stage triple-negative breast cancer: a experimental single-arm phase II clinical trial pilot study
Authors: Zheng Chunhui , Liu Yanbing , Wang Xue’er , Bi Zhao , Qiu Pengfei , Qiao Guangdong , Bi Xiang , Shi Zhiqiang , Zhang Zhaopeng , Chen Peng , Sun Xiao , Wang Chunjian , Zhu Shiguang , Meng Xiangjing , Song Yunjie , Qi Yingxue , Li Lu , Luo Ningning , Wang Yongsheng
Published: December 2023

Background:

Triple-negative breast cancer (TNBC) is associated with a dismal prognosis. Immune checkpoint inhibitors have shown promising antitumor activity in neoadjuvant settings. This single-arm, phase II trial aimed to evaluate the efficacy and safety of camrelizumab plus chemotherapy as the neoadjuvant therapy (NAT) in early TNBC.

Methods:

Patients received eight cycles of camrelizumab plus nonplatinum-based chemotherapy. The primary endpoint was total pathological complete response (pCR). Secondary endpoints included the breast pathological complete response (bpCR), adverse events (AEs). Multiomics biomarkers were assessed as exploratory objective.

Results:

Twenty of 23 TNBC patients receiving NAT underwent surgery, with the total pCR rate of 65% (13/20) and bpCR rate of 70% (14/20). Grade ≥3 treatment-related AEs were observed in 14 (60.9%) patients, with the most common AE being neutropenia (65.2%). Tumor immune microenvironment was analyzed between pCR and non-pCR samples before and after the NAT. Gene expression profiling showed a higher immune infiltration in pCR patients than non-pCR patients in pre-NAT samples. Through establishment of a predictive model for the NAT efficacy, TAP1 and IRF4 were identified as the potential predictive biomarkers for response to the NAT. Gene set enrichment analysis revealed the glycolysis and hypoxia pathways were significantly activated in non-pCR patients before the NAT, and this hypoxia was aggravated after the NAT.

Conclusion:

Camrelizumab plus nonplatinum-based chemotherapy shows a promising pCR rate in early-stage TNBC, with an acceptable safety profile. TAP1 and IRF4 may serve as potential predictive biomarkers for response to the NAT. Aggravated hypoxia and activated glycolysis after the NAT may be associated with the treatment resistance.
Pulmonary vagus nerve transection for chronic cough after video-assisted lobectomy: a randomized controlled trial
Authors: Zhang Qianqian , Ge Yong , Sun Teng , Feng Shoujie , Zhang Cheng , Hong Tao , Liu Xinlong , Han Yuan , Cao Jun-Li , Zhang Hao
Published: December 2023

Background:

Chronic cough is common after lobectomy. Vagus nerves are part of the cough reflex. Accordingly, transection of the pulmonary branches of vagus nerve may prevent chronic cough. And there are no clear recommendations on the management of the pulmonary branches of vagus in any thoracic surgery guidelines.

Methods:

This is a single-center, randomized controlled trial. Adult patients undergoing elective video-assisted thoracoscopic lobectomy and lymphadenectomy were randomized at a 1:1 ratio to undergo a sham procedure (control group) or transection of the pulmonary branches of the vagus nerve that innervate the bronchial stump plus the caudal-most large pulmonary branch of the vagus nerve. The primary outcome was the rate of chronic cough, as assessed at 3 months after surgery in the intent-to-treat population.

Results:

Between 1 February 2020 and 1 August 2020, 116 patients (59.6±10.1 years of age; 45 men) were randomized (58 in each group). All patients received designated intervention. The rate of chronic cough at 3 months was 19.0% (11/58) in the vagotomy group versus 41.4% (24/58) in the control group (OR=0.332, 95% CI: 0.143–0.767; P=0.009). In the 108 patients with 2-year assessment, the rate of persistent cough was 12.7% (7/55) in the control and 1.9% (1/53) in the vagotomy group (P=0.032). The two groups did not differ in postoperative complications and key measures of pulmonary function, for example, maximal voluntary ventilation, diffusing capacity of the lungs for carbon monoxide, and forced expiratory volume.

Conclusion:

Transecting the pulmonary branches of vagus nerve that innervate the bronchial stump plus the caudal-most large pulmonary branch decreased the rate of chronic cough without affecting pulmonary function in patients undergoing video-assisted lobectomy and lymphadenectomy.
Health-related quality of life trajectories up to 15 years after curative treatment for esophageal cancer: a prospective cohort study
Authors: Cheng Zhao , Johar Asif , Lagergren Jesper , Schandl Anna , Lagergren Pernilla
Published: December 2023

Background:

The differentiation of specific, long-term health-related quality of life (HRQL) trajectories among esophageal cancer survivors remains unclear. The authors aimed to identify potentially distinctly different HRQL-trajectories and uncover the underlying factors of such trajectories in patients having undergone surgery (esophagectomy) for esophageal cancer.

Materials and methods:

This nationwide, prospective, and longitudinal cohort study included 420 patients who underwent curative treatment for esophageal cancer, including esophageal cancer surgery, in Sweden from 2001to 2005. The main outcome was HRQL summary score trajectories, measured by the well-validated EORTC QLQ-C30 questionnaire at 6 months, 3, 5, 10, and 15 years after esophagectomy, and analyzed using growth mixture models. Potentially underlying factors for these trajectories (age, sex, education, proxy baseline HRQL, comorbidity, tumor histology, chemo(radio)therapy, pathological tumor stage, and postoperative complications) were analyzed using weighted logistic regression providing odds ratios (OR) with 95% CI.

Results:

Four distinct HRQL summary score trajectories were identified: Persistently good, improving, deteriorating, and persistently poor. The odds of belonging to a persistently poor trajectory were decreased by longer education (>12 years versus <9 years: OR 0.18, 95% CI: 0.05–0.66) and adenocarcinoma histology (adenocarcinoma versus squamous cell carcinoma: OR 0.37, 95% CI: 0.16–0.85), and increased by more advanced pathological tumor stage (III–IV versus 0–I: OR 2.82, 95% CI: 1.08–7.41) and postoperative complications (OR 2.94, 95% CI: 1.36–6.36).

Conclusion:

Distinct trajectories with persistently poor or deteriorating HRQL were identified after curative treatment for esophageal cancer. Education, tumor histology, pathological tumor stage, and postoperative complications might influence HRQL trajectories. The results may contribute to a more tailored follow-up with timely and targeted interventions. Future research remains to confirm these findings.
Hematopoietic Bone Marrow Transplant to Treat Systemic EBV-positive T-cell Lymphoma of Childhood
Authors: Manini Nicholas , Davidow Kimberly , Conard Katrina , Powell Jonathan
Published: December 2023

Systemic Epstein-Barr virus–positive T-cell lymphoma of childhood (S-EBV-TCL) is a rare disease for which there is no standard of care. S-EBV-TCL is often associated with hemophagocytic lymphohistiocytosis and is generally thought of on the spectrum of EBV-related disease. For the few reported cases of cure in the literature, hematopoietic stem cell transplant has been required because it is the only treatment that has induced complete remission in patients suffering from EBV-associated T-cell or natural killer cell lymphoproliferative diseases, except hemophagocytic lymphohistiocytosis. Here, we present the case of one patient who was successfully cured with a modified regimen of dose-adjusted EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin), followed by hematopoietic stem cell transplant using a reduced-intensity conditioning regimen.
Updated Magnet® Certification Requirements
Authors: Lal M. Maureen
Published: December 2023

In 1983, the original study “Magnet Hospitals: Attraction and Retention of Professional Nurses” identified professional development, continuing education, formal education, and career development as critical success factors in creating an environment that fosters nurse engagement. In alignment with the findings, the Magnet Recognition Program® requires organizations to have structures and processes to support nurse certification. In June of 2021, the Magnet Recognition Program announced only nursing and healthcare-related professional board certifications would be accepted as of January 1, 2024. The 2.5-year timeline allowed organizations the opportunity to prepare for the change.
An Interview With Susan Reinhard
Authors: Drenkard Karen
Published: December 2023

This column addresses how AARP, a consumer organization, is leading a Center for Health Equity through Nursing. The Center is working to support nursing to mitigate the nursing workforce crisis. Susan C. Reinhard is a senior vice president at AARP, directing its Public Policy Institute (PPI), the focal point for public policy research and analysis at the state, federal, and international levels. She leads PPI's family caregiving initiatives and serves as the chief strategist for the Center to Champion Nursing in America, a national resource center created to ensure that America has the highly skilled nurses it needs to provide care in the future. As a previous deputy commissioner of the New Jersey Department of Health and Senior Services, Reinhard led the development of policies and nationally recognized programs for family caregiving, consumer choice, and community-based care options. She is a fellow of the American Academy of Nursing, the Gerontological Society of America, and Salzburg Global. She holds a master's degree in nursing and a PhD in sociology.
Making the Case for Criticality
Authors: Jensen Lillian , Dobbs Julie , Updike Alisha
Published: December 2023

A newly integrated, large multistate healthcare system standardized its approach to nursing product education using a novel criticality process and forging collaborative partnerships with supply chain peers. The criticality assessment drives education interventions that align with expectations of modern learners, provide consistency, and improve stewardship of time and resources. Education is based on a product's complexity, impact to practice or workflows, and risk to the patient or nursing end user.
Cardiovascular Safety of Febuxostat in Patients With Gout or Hyperuricemia
Authors: Ghossan Roba , Aitisha Tabesh Ouidade , Fayad Fouad , Richette Pascal , Bardin Thomas
Published: December 2023

Introduction

To this date, a causal relationship between febuxostat and cardiovascular disease remains controversial as comparison between trials can be challenging and may lead to misleading conclusions, especially when facing heterogeneous cardiovascular outcomes. We aimed to compare the cardiovascular outcomes in the most pertinent trials of febuxostat compared with controls.

Methods

We searched electronic databases using a PICOS-style approach search strategy of randomized controlled trials (RCTs) on cardiovascular outcomes of febuxostat in patients with gout or hyperuricemia. We conducted a quality and risk of bias assessment of the included clinical trials. The definition of major adverse cardiovascular event as well as all reported cardiovascular outcomes were retrieved from every involved trial.

Results

Of the 1173 records identified from all sources, 20 RCTs were included in the analysis. The mean duration of follow-up was 69.7 ± 81.5 weeks, and febuxostat dose ranged from 10 to 240 mg with 80 mg being the most commonly used dosage. Overall, the quality of evidence deriving from all RCTs showed concerns in most studies (65%). Major adverse cardiovascular event was defined in 7 of the 20 RCTs (35%), and cardiovascular outcome reporting was very heterogeneous. Overall, the data of cardiovascular safety of febuxostat were reassuring.

Conclusions

Our systematic review showed high level of concerns in quality assessment domains as well heterogeneous cardiovascular outcomes across included studies. Cardiovascular outcomes in the majority of White males with gout treated with febuxostat were reassuring when compared with allopurinol. Further studies are needed to draw conclusions in patients with severe cardiovascular disease.
Gadolinium-Based Contrast Agents and Free Gadolinium Inhibit Differentiation and Activity of Bone Cell Lineages
Authors: Strunz Franziska , Stähli Christoph , Heverhagen Johannes T. , Hofstetter Willy , Egli Rainer J.
Published: December 2023

Objectives

Administration of gadolinium-based contrast agents (GBCA) in magnetic resonance imaging results in the long-term retention of gadolinium (Gd) in tissues and organs, including the bone, and may affect their function and metabolism. This study aims to investigate the effects of Gd and GBCA on the proliferation/survival, differentiation, and function of bone cell lineages.

Materials and Methods

Primary murine osteoblasts (OB) and osteoclast progenitor cells (OPC) isolated fromC57BL/6Jmice were used to test the effects of Gd3+(12.5–100 μM) and GBCA (100–2000 μM). Cultures were supplemented with the nonionic linear Gd-DTPA-BMA (gadodiamide), ionic linear Gd-DTPA (gadopentetic acid), and macrocyclic Gd-DOTA (gadoteric acid). Cell viability and differentiation were analyzed on days 4–6 of the culture. To assess the resorptive activity of osteoclasts, the cells were grown in OPC cultures and were seeded onto layers of amorphous calcium phosphate with incorporated Gd.

Results

Gd3+did not affect OB viability, but differentiation was reduced dose-dependently up to 72.4% ± 6.2%–73.0% ± 13.2% (average ± SD) at 100 μM Gd3+on days 4–6 of culture as compared with unexposed controls (P< 0.001). Exposure to GBCA had minor effects on OB viability with a dose-dependent reduction up to 23.3% ± 10.2% for Gd-DTPA-BMA at 2000 μM on day 5 (P< 0.001). In contrast, all 3 GBCA caused a dose-dependent reduction of differentiation up to 88.3% ± 5.2% for Gd-DTPA-BMA, 49.8% ± 16.0% for Gd-DTPA, and 23.1% ± 8.7% for Gd-DOTA at 2000 μM on day 5 (P< 0.001). In cultures of OPC, cell viability was not affected by Gd3+, whereas differentiation was decreased by 45.3% ± 9.8%–48.5% ± 15.8% at 100 μM Gd3+on days 4–6 (P< 0.05). Exposure of OPC to GBCA resulted in a dose-dependent increase in cell viability of up to 34.1% ± 11.4% at 2000 μM on day 5 of culture (P< 0.001). However, differentiation of OPC cultures was reduced on day 5 by 24.2% ± 9.4% for Gd-DTPA-BMA, 47.1% ± 14.0% for Gd-DTPA, and 38.2% ± 10.0% for Gd-DOTA (P< 0.001). The dissolution of amorphous calcium phosphate by mature osteoclasts was reduced by 36.3% ± 5.3% upon incorporation of 4.3% Gd/Ca wt/wt (P< 0.001).

Conclusions

Gadolinium and GBCA inhibit differentiation and activity of bone cell lineages in vitro. Thus, Gd retention in bone tissue could potentially impair the physiological regulation of bone turnover on a cellular level, leading to pathological changes in bone metabolism.
EXCHANGE TRANSFUSION WITH VS-101: A NEW PEGYLATED-HB DESIGNED TO RESTORE PERFUSION AND INCREASE O2 CARRYING CAPACITY
Authors: Nugent William H. , Sheppard Forest R. , Vandegriff Kim D. , Schindler William M. , Malavalli Ashok , Song Bjorn K.
Published: December 2023

Blood products are the current standard for resuscitation of hemorrhagic shock. However, logistical constraints of perishable blood limit availability and prehospital use, meaning alternatives that provide blood-like responses remain an area of active investigation and development. VS-101 is a new PEGylated human hemoglobin-based oxygen carrier that avoids the logistical hurdles of traditional blood transfusion. This study sought to determine the safety and ability of VS-101 to maintain circulatory function and capillary oxygen delivery in a severe (50%) exchange transfusion (ET) model. Anesthetized, male Sprague Dawley rats were prepared for cardiovascular monitoring and phosphorescence quenching microscopy of interstitial fluid oxygen tension (PISF
o
2) in the spinotrapezius muscle. Fifty-percent isovolemic ET of estimated total blood volume with either lactated Ringer’s solution (LRS, n = 8) or VS-101 (n = 8) at 1 mL/kg/min was performed, and animals were observed for 240 min. VS-101 maintained PISF
o
2 at baseline with a transient 18 ± 4 mm Hg decrease (P < 0.05) in mean arterial pressure (MAP). In contrast, ET with LRS decreased PISF
o
2 by approximately 50% (P < 0.05) and MAP by 74 ± 10 mm Hg (P < 0.05). All VS-101 animals survived 240 min, the experimental endpoint, while 100% of LRS animals expired by 142 min. VS-101 animals maintained normal tissue oxygenation through 210 min, decreasing by 25% (P < 0.05 vs. baseline) thereafter, likely from VS-101 vascular clearance. No arteriolar vasoconstriction was observed following VS-101 treatment. In this model of severe ET, VS-101 effectively maintained blood pressure, perfusion, and PISF
o
2 with no vasoconstrictive effects. Further elucidation of these beneficial resuscitation effects of VS-101 is warranted to support future clinical trials.
Third-Line Overactive Bladder Therapies on TikTok: What Does the Public Learn?
Authors: Tabakin Alexandra L. , Choi Sharon , Sandozi Arshia , Aibel Kelli , Weintraub Michael A. , Winkler Harvey A. , Shalom Dara F. , Tam Justina , Lee Wai
Published: December 2023

Importance

Millions of people rely on social media platforms, including TikTok, for health-related information. TikTok has not yet been evaluated as an information source for overactive bladder (OAB) third-line therapies.

Objectives

Our aim was to assess TikTok videos on third-line therapies for OAB for misinformation and quality.

Study Design

In this cross-sectional analysis, we abstracted the top 50 TikTok videos for keywords: “Axonics,” “sacral neuromodulation,” “Interstim,” “PTNS,” “posterior tibial nerve stimulation,” and “bladder Botox.” Videos were scored for quality by 3 independent reviewers using the Medical Quality Video Evaluation Tool (MQ-VET). Two reviewers determined if videos contained misinformation.

Results

Of 300 videos screened, 119 videos were included. Twenty-four (21%) were created by medical professionals (MPs). Medical professional videos were more frequently shared (5 vs 1, P < 0.01) but had similar views, likes, comments, and length. Although MP videos had significantly higher MQ-VET scores (43 vs 27, P < 0.01), there was no difference in the rate of misinformation between MP and non-MP videos (21% vs 18%). Twenty-two videos (18.4%) contained misinformation, which were 3 times longer (50.5 vs 15 seconds, P < 0.01) and had higher MQ-VET scores (34.5 vs 27, P = 0.03) than those without misinformation. Common themes of misinformation pertained to therapy indication, mechanism of action, and patient limitations after undergoing therapy.

Conclusions

Many TikTok videos on OAB third-line therapies contain misinformation. Most of these videos were not of high quality and created by the public. Medical professionals should be aware of misinformation permeating TikTok, given its large audience, and aim to promote or offer educational material of better accuracy and quality.
Revisiting Schrödinger’s fourth-order, real-valued wave equation and the implication from the resulting energy levels
Authors: Makris Nicos
Published: December 2023

In his seminal part IV,
Annalen der Physik
vol. 81, 1926 paper, Schrödinger has developed a clear understanding about the wave equation that produces the correct quadratic dispersion relation for matter-waves and he first presents a real-valued wave equation that is fourth-order in space and second-order in time. In the view of the mathematical difficulties associated with the eigenvalue analysis of a fourth-order, differential equation in association with the structure of the Hamilton–Jacobi equation, Schrödinger splits the fourth-order real operator into the product of two, second-order, conjugate complex operators and retains only one of the two complex operators to construct his iconic second-order, complex-valued wave equation. In this paper, we show that Schrödinger’s original fourth-order, real-valued wave equation is a stiffer equation that produces higher energy levels than his second-order, complex-valued wave equation that predicts with remarkable accuracy the energy levels observed in the atomic line spectra of the chemical elements. Accordingly, the fourth-order, real-valued wave equation is too stiff to predict the emitted energy levels from the electrons of the chemical elements; therefore, the paper concludes that quantum mechanics can only be described with the less stiff, second-order, complex-valued wave equation.
Are dark-eyed dogs favoured by humans? Domestication as a potential driver of iris colour difference between dogs and wolves
Authors: Konno Akitsugu , Aoki Hitomi , Suzuki Emiri , Furuta Seiya , Ueda Sayoko
Published: December 2023

Comparative studies have shown that the eye morphology of primates has been shaped by a variety of selection pressures (e.g. communication, environmental factors). To comprehensively elucidate the complex links between ocular morphology and its evolutionary drive, attention should be paid to other phylogenetic groups. Here, we address a new question regarding the evolution of eye colour patterns in the oldest domesticated animal, namely, the domestic dog (
Canis familiaris
). In this study, we conducted an image analysis of dogs and their closest relatives, grey wolves (
Canis lupus
), to compare the colours of their irises, with the aim of assessing whether eye colours of dogs affect how humans perceived dogs. We found that the irises of dogs were significantly darker than those of wolves. We also found that facial images of dark-eyed dogs were perceived as more friendly and immature, potentially eliciting caregiving responses from humans. Our findings are consistent with our expectation that humans favour dark-eyed dogs over light-eyed ones and provide an updated hypothesis that dogs with dark eyes may have evolved by acquiring a facial trait that sends a non-threatening gaze signal to humans.
Chirality and curvature determine the meandering of spirals in multilayer excitable media
Authors: Nezhad Hajian Dorsa , Parastesh Fatemeh , Rajagopal Karthikeyan , Jafari Sajad , Perc Matjaž , Klemenčič Eva
Published: December 2023

We study the emergence of meandering spiral waves in a multilayer structure where two spirals, originating independently, evolve in space–time. The FitzHugh-Nagumo model, enhanced with electromagnetic induction effects, defines the nodal dynamics. The layers are chemically coupled, and the drift of spirals is influenced by interlayer flux coupling. An external magnetic flux force is also necessary to destabilize and unpin spiral rotors. The effects of unique characteristics of spiral patterns, like chirality and tip curvature, are assessed. We find that spirals often drift within a bounded meandering area; however, determining the drift directions and overall meandering regions is complex. The forced spiral generally drifts a greater distance, except for identical co-rotating spirals, which drift synchronously. Spirals with opposite chirality exhibit asynchronous drift and wavefront asymmetry, even with identical tip curvature. Regardless of chirality, non-identical spirals are geometrically aligned and amplified before drifting. Stimulating the more loosely curved spiral ensures both spirals drift.
Characterization of the RofA regulon in the pandemic M1global and emergent M1UK lineages of Streptococcus pyogenes
Authors: Zhi Xiangyun , Vieira Ana , Huse Kristin K. , Martel Paulo J. , Lobkowicz Ludmila , Li Ho Kwong , Croucher Nick , Andrew Ivan , Game Laurence , Sriskandan Shiranee
Published: December 2023

The standalone regulator RofA is a positive regulator of the pilus locus in

Streptococcus pyogenes

. Found in only certain emm genotypes, RofA has been reported to regulate other virulence factors, although its role in the globally dominant emm1

S. pyogenes

is unclear. Given the recent emergence of a new emm1 (M1UK) toxigenic lineage that is distinguished by three non-synonymous SNPs in rofA, we characterized the rofA regulon in six emm1 strains that are representative of the two contemporary major emm1 lineages (M1global and M1UK) using RNAseq analysis, and then determined the specific role of the M1UK-specific rofA SNPs. Deletion of rofA in three M1global strains led to altered expression of 14 genes, including six non-pilus locus genes. In M1UK strains, deletion of rofA led to altered expression of 16 genes, including nine genes that were unique to M1UK. Only the pilus locus genes were common to the RofA regulons of both lineages, while transcriptomic changes varied between strains even within the same lineage. Although introduction of the three SNPs into rofA did not impact gene expression in an M1global strain, reversal of three SNPs in an M1UK strain led to an unexpected number of transcriptomic changes that in part recapitulated transcriptomic changes seen when deleting RofA in the same strain. Computational analysis predicted that interactions with a key histidine residue in the PRD domain of RofA would differ between M1UK and M1global. RofA is a positive regulator of the pilus locus in all emm1 strains but effects on other genes are strain- and lineage-specific, with no clear, common DNA binding motif. The SNPs in rofA that characterize M1UK may impact regulation of RofA; whether they alter phosphorylation of the RofA PRD domain requires further investigation.
Visual imagery vividness correlates with afterimage conscious perception
Authors: Kronemer Sharif I. , Holness Micah , Morgan A. Tyler , Teves Joshua B. , Gonzalez-Castillo Javier , Handwerker Daniel A. , Bandettini Peter A.
Published: December 2023

Afterimages are illusory, visual conscious perceptions. A widely accepted theory is that afterimages are caused by retinal signaling that continues after the physical disappearance of a light stimulus. However, afterimages have been reported without preceding visual, sensory stimulation (e.g., conditioned afterimages and afterimages induced by illusory vision). These observations suggest the role of top-down, brain mechanisms in afterimage conscious perception. Therefore, some afterimages may share perceptual features with sensory-independent conscious perceptions (e.g., imagery, hallucinations, and dreams) that occur without bottom-up, sensory input. In the current investigation, we tested for a link between the vividness of visual imagery and afterimage conscious perception. Participants reported their vividness of visual imagery and perceived sharpness, contrast, and duration of negative afterimages. The afterimage perceptual features were acquired using perception matching paradigms that were validated on image stimuli. Relating these perceptual reports revealed that the vividness of visual imagery positively correlated with afterimage contrast and sharpness. These behavioral results support shared neural mechanisms between visual imagery and afterimages. This study encourages future research combining neurophysiology recording methods and afterimage paradigms to directly examine the neural mechanisms of afterimage conscious perception.
The cascading impacts of attacks on health in Syria: A qualitative study of health system and community impacts
Authors: Haar Rohini J. , Rayes Diana , Tappis Hannah , Rubenstein Leonard , Rihawi Anas , Hamze Mohamed , Almhawish Naser , Wais Reham , Alahmad Hesham , Burbach Ryan , Abbara Aula
Published: December 2023

Introduction

Syria has experienced over a decade of armed conflict, characterized by targeted violence against healthcare. The impacts of these attacks have resulted in both direct and indirect attacks on the health system and reverberating effects on local communities. This study aims to explore the perspectives of health workers based in northern Syria who have experienced such attacks on health to understand the impacts on the health system as well as communities served.

Methods

In-depth interviews were conducted with health workers in the northern regions of Syria where attacks on health have been frequent. Participants were identified using purposive and snowball sampling. Interviews were coded and analyzed using the Framework Method. Our inductive and deductive codes aligned closely with the WHO Health System Building Blocks framework, and we therefore integrated this framing into the presentation of findings. We actively sought to include female and non-physician health workers as both groups have been under-represented in previous research in northern Syria.

Results

A total of 40 health workers (32.5% female, 77.5% non-physicians) who experienced attacks in northern Syria between 2013 and 2020 participated in interviews in 2020-2021. Participants characterized attacks on healthcare as frequent, persistent over years and strategically targeted. The attacks had both direct and indirect impacts on the health system and consequently the wider health of the community. For the health system, participants noted compounded impacts on the delivery of care, health system governance, and challenges to financing, workforce, and infrastructure. Reconstructing health facilities or planning services in the aftermath of attacks on health was challenging due to poor health system governance and resource challenges. These impacts had ripple effects on the health of the community, particularly the most vulnerable.

Discussion

The impacts of attacks on health in Syria are multiple, with both short- and long-term consequences for the health system(s) across Syria as well as the health of communities in these respective areas. Though such attacks against healthcare are illegal under international humanitarian law, this and other legal frameworks have led to little accountability in the face of such attacks both in Syria and elsewhere. Characterizing their impacts is essential to improving our understanding of the consequences of attacks as a public health issue and supporting protection and advocacy efforts.
Urinary Cell Gene Signature of Acute Rejection in Kidney Allografts
Authors: Salinas Thalia , Li Carol , Snopkowski Catherine , Sharma Vijay K. , Dadhania Darshana M. , Suhre Karsten , Muthukumar Thangamani , Suthanthiran Manikkam
Published: December 2023

Introduction

A kidney allograft biopsy may display acute T cell-mediated rejection (TCMR), antibody-mediated rejection (ABMR), or concurrent TCMR + ABMR (MR). Development of noninvasive biomarkers diagnostic of all three types of acute rejection is a useful addition to the diagnostic armamentarium.

Methods

We developed customized RT-qPCR assays and measured urinary cell mRNA copy number in 145 biopsy-matched urine samples from 126 kidney allograft recipients and calculated urinary cell three-gene signature score from log10-transformed values for the 18S-normalized CD3E mRNA, 18S-normalized CXCL10 mRNA and 18S rRNA. We determined whether the signature score in biopsy-matched urine specimens discriminates biopsies without rejection (NR, n=50) from biopsies displaying TCMR (n=47), ABMR (n=28) or MR (n=20).

Results

Urinary cell three-gene signature discriminated TCMR, ABMR or MR biopsies from NR biopsies (P <0.0001, One-way ANOVA). Dunnett’s multiple comparisons test yielded P<0.0001 for NR vs. TCMR; P <0.001 for NR vs. ABMR; and P <0.0001 for NR vs. MR. By bootstrap resampling, optimism-corrected area under the receiver operating characteristic curve (AUC) was 0.749 (bias-corrected 95% confidence interval [CI], 0.638 to 0.840) for NR vs. TCMR (P<0.0001); 0.780 (95% CI, 0.656 to 0.878) for NR vs. ABMR (P<0.0001); and 0.857 (95% CI, 0.727 to 0.947) for NR vs. MR (P<0.0001). All three rejection biopsy categories were distinguished from NR biopsies with similar accuracy (all AUC comparisons P>0.05).

Conclusion

Urinary cell three-gene signature score may serve as a universal diagnostic signature of acute rejection due to TCMR, ABMR or MR in human kidney allografts with similar performance characteristics.
The global burden of HIV among Long-distance truck drivers: A systematic review and meta-analysis
Authors: Mutie Cyrus , Otieno Berrick , Mwangi Elijah , Kawira Rosemary , Mutisya Albanus , Gachohi John , Mbuthia Grace
Published: December 2023

Long-distance truck drivers (LDTDs) endure a disproportionately high burden of HIV in various global settings. However, unlike other most at-risk populations, the global burden of HIV among LDTDs has not been documented so far. The result has been poor allocation and distribution of the limited HIV preventive resources for LDTDs in most parts of the world. Thus, a systematic review and meta-analysis were conducted to assess the global burden of HIV among LDTDs. A comprehensive electronic search was conducted in PubMed, ProQuest Central, PubMed Central, CINAHL, and Global Index Medicus to identify relevant information published in English on HIV prevalence among LDTDs from 1989 to the 16thof May 2023. A random-effects meta-analysis was conducted to establish the burden of HIV at global and regional levels. The Joanna Briggs Institute (JBI) and Newcastle-Ottawa Scale (NOS) tools were used to assess the quality of the included studies.

Of the 1787 articles identified, 43 were included. Most of the included studies were conducted in sub-Saharan Africa (44.19%, n=19), and Asia and the Pacific (37.21%, n=16). The pooled prevalence of HIV was 3.82%. The burden of HIV was highest in sub-Saharan Africa at 14.34%, followed by Asia and the Pacific at 2.14%, and lastly Western, Central Europe and North America at 0.17%. The overall heterogeneity score was (I2= 98.2%, p < 0.001).

The global burden of HIV among LDTDs is 3.82%, six times higher than that of the general population globally. Compared to other regions, the burden of HIV is highest in sub-Saharan Africa at 14.34%, where it’s estimated to be 3% in the general population. Thus, LDTDs endure a disproportionately high burden of HIV compared to other populations. Consequently, more LDTD-centred HIV research and surveillance is needed at national and regional levels to institute tailored preventive policies and interventions.

PROSPERO Number

CRD42023429390