bluuebunny/crossref_metadata_2025 huggingface dataset:
Relevance of the bacteriophage adherence to mucus model for
Pseudomonas aeruginosa
phages
Authors: Almeida Gabriel Magno de Freitas , Ravantti Janne , Grdzelishvili Nino , Kakabadze Elene , Bakuradze Nata , Javakhishvili Elene , Megremis Spyridon , Chanishvili Nina , Papadopoulos Nikolaos , Sundberg Lotta-Riina
Published: June 2024

Pseudomonas aeruginosa
infections are getting increasingly serious as antimicrobial resistance spreads. Phage therapy may be a solution to the problem, especially if improved by current advances on phage-host studies. As a mucosal pathogen, we hypothesize that
P. aeruginosa
and its phages are linked to the bacteriophage adherence to mucus (BAM) model. This means that phage-host interactions could be influenced by mucin presence, impacting the success of phage infections on the
P. aeruginosa
host and consequently leading to the protection of the metazoan host. By using a group of four different phages, we tested three important phenotypes associated with the BAM model: phage binding to mucin, phage growth in mucin-exposed hosts, and the influence of mucin on CRISPR immunity of the bacterium. Three of the tested phages significantly bound to mucin, while two had improved growth rates in mucin-exposed hosts. Improved phage growth was likely the result of phage exploitation of mucin-induced physiological changes in the host. We could not detect CRISPR activity in our system but identified two putative anti-CRISPR proteins coded by the phage. Overall, the differential responses seen for the phages tested show that the same bacterial species can be targeted by mucosal-associated phages or by phages not affected by mucus presence. In conclusion, the BAM model is relevant for phage-bacterium interactions in
P. aeruginosa
, opening new possibilities to improve phage therapy against this important pathogen by considering mucosal interaction dynamics.

IMPORTANCE

Some bacteriophages are involved in a symbiotic relationship with animals, in which phages held in mucosal surfaces protect them from invading bacteria.
Pseudomonas aeruginosa
is one of the many bacterial pathogens threatening humankind during the current antimicrobial resistance crisis. Here, we have tested whether
P. aeruginosa
and its phages are affected by mucosal conditions. We discovered by using a collection of four phages that, indeed, mucosal interaction dynamics can be seen in this model. Three of the tested phages significantly bound to mucin, while two had improved growth rates in mucin-exposed hosts. These results link
P. aeruginosa
and its phages to the bacteriophage adherence to the mucus model and open opportunities to explore this to improve phage therapy, be it by exploiting the phenotypes detected or by actively selecting mucosal-adapted phages for treatment.
Tracking the prevalence and emergence of SARS-CoV-2 variants of concern using a regional genomic surveillance program
Authors: Jung Ana , Droit Lindsay , Febles Binita , Fronick Catarina , Cook Lisa , Handley Scott A. , Parikh Bijal A. , Wang David
Published: June 2024

SARS-CoV-2 molecular testing coupled with whole-genome sequencing is instrumental for real-time genomic surveillance. Genomic surveillance is critical for monitoring the spread of variants of concern (VOCs) as well as discovery of novel variants. Since the beginning of the pandemic, millions of SARS-CoV-2 genomes have been deposited into public sequence databases. This is the result of efforts of both national and regional diagnostic laboratories. In this study, we describe the results of SARS-CoV-2 genomic surveillance from February 2021 to June 2022 at a metropolitan hospital in the United States. We demonstrate that consistent daily sampling is sufficient to track the regional prevalence and emergence of VOCs and recapitulate national trends. Similar sampling efforts should be considered a viable option for local SARS-CoV-2 genomic surveillance at other regional laboratories.

IMPORTANCE

In our manuscript, we describe the results of SARS-CoV-2 genomic surveillance from February 2021 to June 2022 at a metropolitan hospital in the United States. We demonstrate that consistent daily sampling is sufficient to track the regional prevalence and emergence of variants of concern (VOCs). Similar sampling efforts should be considered a viable option for local SARS-CoV-2 genomic surveillance at other regional laboratories. While the SARS-CoV-2 pandemic has evolved into a more endemic form, we still believe that additional real-world information about sampling, procedures, and data interpretation is valuable for ongoing as well as future genomic surveillance efforts. Our study should be of substantial interest to clinical virologists.
Future-ready healthcare leadership: the revised International Hospital Federation competency model
Authors: Basterrechea Sylvia , Frich Jan C , Garman Andrew N
Published: June 2024

Background

Major global trends are reshaping health services delivery, and preparing current and future healthcare leaders requires an understanding of these trends. A well-designed leadership competency model can provide guidance for individuals, as well as for system-level leadership development and integration programmes.

Objective

To describe the process of updating the International Hospital Federation’s (IHF) Global Healthcare Management Competency Directory.

Methods

Revisions were informed by a recent foresight study of major trends in health services delivery, and an evidence-informed framework of leadership competencies. The original framework competencies were reviewed by 45 subject-matter experts from 30 countries and regions, who provided feedback through electronic surveys and online interviews. We incorporated this iterative feedback to revise the framework design, competencies within the framework and their associated behavioural descriptions.

Results

A total of 45 subject-matter experts from 30 countries and regions participated in 1 or more phases of the survey process. The resulting leadership competency model includes 32 competencies organised into a framework of 6 domains: values, self-development, execution, relations, context management and transformation.

Conclusion

The updated IHF Leadership Model provides a robust, evidence-based and up-to-date resource for assessing and developing future-ready healthcare leaders.
Identifying priority groups for pre-exposure prophylaxis among sex workers in Flanders, Belgium: insights into routine HIV and sexually transmitted infection data in community-based clinics
Authors: Van Mieghem Heleen , Nöstlinger Christiana , Smekens Tom , De Cannière Anne-Sophie , Keersmaekers Kris , Scheerder Gert , De Baetselier Irith , Vuylsteke Bea
Published: June 2024

Objectives

The burden of HIV and other sexually transmitted infections (STIs) remains high in sex workers globally, calling for strengthening targeted prevention strategies, including HIV pre-exposure prophylaxis (PrEP). The study’s objective was to assess HIV and STI burden among female, male and transgender sex workers in Flanders, Belgium, to guide targeting of PrEP strategies for sex workers.

Methods

We conducted a retrospective analysis of routine data collected between January 2016 and December 2019 by community-based organisations providing sexual healthcare services for sex workers in Flanders. HIV prevalence stratified by gender was assessed and associations with sociodemographic characteristics were explored using bivariable and multivariable logistic regression. Positivity rates of chlamydia, gonorrhoea and syphilis tests were used as proxy indicators for STI burden.

Results

The study included a total of 6028 sex workers, comprising 5617 (93.2%) female, 218 (3.6%) male and 193 (3.2%) transgender sex workers. The HIV prevalence was 0.3% among female, 8.9% among male and 12.3% among transgender sex workers. Engaging in escort sex work and originating from South America or Sub-Saharan Africa were associated with a higher likelihood of having acquired HIV. The positivity rate for gonorrhoea was higher among male sex workers (5.2% vs 2.2%) and syphilis was more frequently detected among male and transgender sex workers (3.0% and 6.1% vs 0.5%), all compared with female sex workers.

Conclusions

HIV combination prevention, including improved access to PrEP, should be strengthened among sex workers in Flanders, with particular attention to male and transgender sex workers.
Advances in hepatitis delta research: emerging insights and future directions
Authors: Degasperi Elisabetta , Anolli Maria Paola , Lampertico Pietro
Published: June 2024

Objectives

Hepatitis delta virus (HDV) is a defective virus needing the envelope provided by hepatitis B virus (HBV) in order to enter liver cells and propagate. Chronic HDV infection is considered the most severe viral hepatitis, resulting in accelerated fibrosis progression until cirrhosis and its complications (hepatocellular carcinoma, liver decompensation) compared with HBV mono-infected patients. Off-label treatment with interferon has represented the only treatment option in the last 40 years, resulting in suboptimal virological response rates and being limited by safety issues especially in patients with advanced cirrhosis. Recently, the first HBV-HDV entry inhibitor Bulevirtide (BLV) has been approved by the European Medicines Agency (EMA) for treatment of chronic compensated HDV.

Methods

This review summarises most recent updates on HDV epidemiology, diagnosis and treatment, with a special focus both on clinical trials and real-life studies about BLV. An overview on new HDV compounds under development is also provided.

Results

BLV, the HBV-HDV entry inhibitor, has shown promising safety and efficacy data in clinical trials and in real-life studies, also in patients with advanced cirrhosis and portal hypertension. However, according to EMA label treatment is currently intended long-term until clinical benefit and predictors of responses are still undefined. The potential combination with PegIFNα seems to increase virological and clinical responses. New compounds are under development or in pipeline for treatment of HDV.

Conclusion

After more than 40 years since HDV discovery, new treatment options are currently available to provide efficient strategies for chronic hepatitis Delta.
Multiple risk factors for persistent HBV viraemia in an adult receiving nucleos/tide analogue therapy
Authors: Lumley Sheila , Barlow Maeve , Said Khadija , Martyn Emily , Waddilove Elizabeth , Delphin Marion , Jennings Daisy , Chai Haiting , Kemper Agnes , Ko Joy , Ansari Azim , Macdonald Douglas , Ghosh Indrajit , Ijaz Samreen , Flanagan Stuart , Matthews Philippa Clare
Published: June 2024

Diagnosing and treating chronic hepatitis B virus (HBV) infection are key interventions to support progress towards elimination of viral hepatitis by 2030. Although nucleos/tide analogue (NA) therapy is typically highly effective, challenges remain for viral load (VL) suppression, including medication access, incomplete adherence and drug resistance. We present a case of a long-term HBV and HIV coinfected adult prescribed with sequential NA therapy regimens, with episodes of breakthrough viraemia. Multiple factors contribute to virological breakthrough, including exposure to old NA agents, initial high HBV VL, therapy interruptions, intercurrent illnesses and potential contribution from resistance mutations. The case underscores the importance of individualised treatment approaches and adherence support in achieving HBV suppression. Furthermore, it emphasises the need for improved clinical pathways addressing education, support and access to care, particularly for marginalised populations. Comprehensive data collection inclusive of under-represented individuals is crucial for maintaining retention in the care cascade and informing effective interventions.
Gravitational waves with generalized holonomy corrections
Authors: Li Shulan , Wu Jian-Pin
Published: June 2024

The cosmological tensor perturbation equation with generalized holonomy corrections is derived in the framework of effective loop quantum gravity. This results in a generalized dispersion relation for gravitational waves, encompassing holonomy corrections. Furthermore, we conduct an examination of the constraint algebra concerning vector modes with generalized holonomy corrections. The requirement of anomaly cancellation for vector modes imposes constraints on the possible functional forms of the generalized holonomy corrections. What’s more, we estimate the theoretical value of the effective graviton mass and discuss the potential detectability of this effective mass in future observations.
Structure-preserving semi-convex-splitting numerical scheme for a Cahn–Hilliard cross-diffusion system in lymphangiogenesis
Authors: Jüngel Ansgar , Wang Boyi
Published: June 2024

A fully discrete semi-convex-splitting finite-element scheme with stabilization for a Cahn–Hilliard cross-diffusion system is analyzed. The system consists of parabolic fourth-order equations for the volume fraction of the fiber phase and solute concentration, modeling pre-patterning of lymphatic vessel morphology. The existence of discrete solutions is proved, and it is shown that the numerical scheme is energy stable up to stabilization, conserves the solute mass, and preserves the lower and upper bounds of the fiber phase fraction. Numerical experiments in two space dimensions using FreeFem illustrate the phase segregation and pattern formation.
Damping Performance and Optimal Design of Mid-Story Isolation System with Tuned Inerter Damper
Authors: Liu Liangkun , Luo Junxian , Qin Renyuan , Pan Zhaodong , Di Bo , Pang Shumeng
Published: June 2024

Tuned inerter damper (TID) has been introduced and investigated to improve the damping performance of the mid-story isolation system in this study. TID in this novel system is arranged into the mid-story isolation system to utilize its weak transition layer enhancing damping effects. To achieve the best results, the closed-form optimization solutions of TID based on vibration mode are proposed to present optimal design. As such, case studies have been conducted with the different arrangements of the isolation layer with TID and the damping effects of mid-story isolation system have been significantly improved. The presented random analysis results also show the superiority of the proposed novel system when compared with the traditional mid-story system in terms of multiple control indexes, e.g. the top displacement of the substructure, the relative displacement of the isolation layer and the top absolute acceleration of the superstructure. Mostly, the seismic peak responses of mid-story isolation system are significantly suppressed with the proposed optimal design parameters of TID, especially for the relative displacement of isolation layer.
A photo-triggered bioactive nanohydrogel loaded with niobium carbide for stem cell osteogenic differentiation
Authors: Li Ya , Zhang Yuanzhi , Xu Derong , Gao Ming , Su Kunpeng , Chen Yingjie , Wang Chen , Geng Xinming , Liu Youchang , Zhou Chuanli , Qiu Meng
Published: June 2024

Photo-Cross-Linkable hydrogel has attracted immense interest in the regeneration of bone repair and regeneration strategies due to its superior biocompatibility and tunable mechanical properties. Recently, Nb was reported to strongly promote the bone regeneration process via an accelerated osteoblast-modulated alkaline phosphatase activity mechanism. In particular, Nb2C MXenes have drawn widespread attention due to their excellent biocompatibility and ability to induce bone formation. However, the easy agglomeration of Nb2C nanosheets and subsequent low cell endocytosis efficacy greatly suppressed the osteogenesis effect. In this study, a subtractive nanopore-engineered Nb2C MXene was prepared through a microwave combustion method, gelatin methacrylate was used as the carrier hydrogel, and the photo-triggered Porous-Nb2C@GelMA hydrogel was fabricated by a photo-triggered process. The pore-forming strategy not only successfully improved the distribution of Nb2C and formed more homogenous Porous-Nb2C@GelMA hydrogels but also guided bone marrow mesenchymal stem cells (BMSCs) toward osteoblast differentiation. Porous Nb2C provided convenient cellular grasping and endocytosis for BMSCs, which further created a favorable environment for differentiation and osteogenesis. This, in turn, leads to an increase in the expression of osteogenic markers, such as ALP and ARS, as well as osteogenic factors, such as BMP-2, COL-1, OCN, and OPN. Consequently, enhancing the regenerative microenvironment by incorporating porous Nb2C composite hydrogels shows promise for application in bone regeneration.
The study of electrochemical stabilization mechanism of Pt, GC, SS304, Ti and Cu as current collectors for aqueous lithium-ion batteries by electrochemical approaches
Authors: Zhang Shenwei , Chen Dongrui , Guo Wenmin , Wang Xiaoming , Ding Zhibin , Tang Xiaofu , Zhang Junxia , Wu Haijiang , Zeng Diping , Wei Hongqing , Wang Wenjun , Ma Yi , Zhou Jinhua , Su Zaijun
Published: June 2024

This paper employs electrochemical methods (linear sweep voltammetry (LSV) and electrochemical impedance spectroscopy (EIS)) to investigate the electrochemical behavior of platinum, glassy carbon, 304 stainless steel, titanium, and copper in 21 and 1 M LiTFSI electrolytes. The LSV results indicate that the electrochemical stability window of the materials varies with the electrolyte concentration, and the stability window is wider in the high-concentration system. Through Tafel polarization curves and EIS analysis, the overpotential of the charge exchange process differs due to the type of material and the concentration of the electrolyte, mainly attributed to the influence of the proportion of free water, electrolyte viscosity, and SEI film formation on electrode process kinetics. After comparative analysis, glassy carbon exhibits a higher overpotential than other materials at both the cathode and anode, effectively suppressing water decomposition. These findings provide theoretical support for the development of high-performance aqueous lithium-ion battery current collector materials.
Restrained interfacial resistance Co5.47N@C derived from metal-organic frameworks for advanced Li-CO2 batteries cathodes
Authors: Li Chao , Zhang Sike , Deng Qinghua , Mao Chunfeng
Published: June 2024

Lithium–carbon dioxide (Li–CO2) batteries are novel high energy density energy storage devices that can simultaneously enrich and convert CO2, but their widespread implementation is hindered by the continuous accumulation of lithium carbonate at the cathode. Herein, we developed non-precious metal cobalt-based nitride matrix composite Co[Formula: see text]N@C based on metal-organic frameworks precursor for the catalytic cathode of advanced Li–CO2 batteries. The highly stable Co[Formula: see text]N achieves favorable adsorption and catalysis of CO2 molecules by virtue of the excellent electronic structure on the surface, while the nanoscale high dispersion also effectively promotes interfacial electron transfer. As expected, the assembled Li–CO2 battery exhibits excellent electrochemical performance in the discharge capacity of 10,000 mAh g[Formula: see text] and a cycling capability of about 400 h. Further density functional theory (DFT) calculations explored the relationship between electronic structure and electrochemical activity. This work promotes the development of catalytic materials for Li–CO2 batteries cathode.
Effectiveness of Iterative Learning Control for Vision-Based Tracking in Repeated Tasks Under Varying Lighting Conditions
Authors: Thurnim Lattapol , Panomruttanarug Benjamas
Published: June 2024

Among available techniques for lateral tracking in autonomous driving, none possesses the capability to learn from past behaviors and progressively reduce lateral errors. In contrast, our proposed iterative learning control (ILC) scheme significantly enhances tracking performance in vision-based classical control, particularly in challenging environmental conditions. Our vision-based control system incorporates real-time semantic segmentation using the ENet model for unconstructed road area extraction. Linear regression estimates steering adjustments, while a visual PID controller maintains the vehicle’s position at the road’s centerline. This control system’s performance varies with lighting conditions, notably in dense shade, where the vehicle tends to deviate from the desired path. To assess ILC’s potential in error reduction over successive trials, we examined various ILC structures and compared them with a pure PID controller. Despite challenges in directly comparing PID and ILC designs due to changing lighting conditions during experiments, ILC consistently reduced tracking errors and improved path alignment with each iteration. Notably, the degree of error reduction became more pronounced with a greater number of learning gains in the ILC design. Our experimental results underscore the overall effectiveness of ILC in tracking the desired path in autonomous driving scenarios, particularly in varying environmental conditions.
Development of Highly Sensitive and Selective Electrochemical Glucose Sensors Based on the Modification of the Surface, Structural, and Morphological Properties of ZnO Using Vitamin-B Complexes
Authors: Ali Feroz , Mari Riaz Hussain , Dawi Elmuez , Tahira Aneela , Halepoto Imran Ali , Mahar Ihsan Ali , Rind Nazir Ahmed , Nangraj Naveed Abbas , Bhatti Muhammad Ali , Almani Khalida Faryal , Nafady Ayman , Haj Ismail Abd Al Karim , Vigolo Brigitte , Qureshi Sadaf Tabasum , Ibupoto Zafar Hussain
Published: June 2024

Non-enzymatic electrochemical glucose sensors are particularly advantageous because of their simplicity, low cost, efficiency, and long storage life. ZnO structures were modified with water-soluble vitamin B12, B9, and B6 complexes in alkaline 0.1 M NaOH solutions to enhance glucose sensing. ZnO samples were hydrothermally synthesized using 5 mg fixed masses of B12, B9, and B6 complexes. X-ray diffraction, scanning electron microscopy, UV-visible spectrometry, and Fourier transform infrared spectroscopy were used to determine crystalline properties, morphology, and optical band gap. Zinc oxide obtained from vitamin B complexes had a hexagonal structure similar to wurtzite, modified nanorods on its surface, and a reduced optical band gap. The molecular weight, size, and number of functional groups vitamins also influenced surface and structural characteristics of ZnO. Zinc oxide from the B12 complex proved excellent for non-enzymatic glucose sensing in alkaline conditions. B12-derived ZnO glucose sensors have a linear range of 0.1 to 10 mM with a detection limit of 0.005 mM. In the glucose sensing process, a satisfactory level of stability, reproducibility, and selectivity was observed. Furthermore, it was found that ZnO derived from B12 had a high electrical conductivity, which facilitated electron transfer during glucose oxidation.
Antibody-drug conjugates as a novel therapeutic modality to treat recurrent refractory germ cell tumors
Authors: Udvorková Natália , Fekiačová Adriana , Majtánová Kristína , Mego Michal , Kučerová Lucia
Published: June 2024

This review provides a rationale for using the Food and Drug Administration (FDA)-approved antibody-drug conjugates (ADCs) for implementing as therapy in recurrent refractory germ cell tumors similar to their position in the treatment of other types of chemoresistant solid tumors. Germ cell tumors (GCTs) originate from germ cells; they most frequently develop in ovaries or in the testes, while being the most common type of malignancy in young men. GCTs are very sensitive to cisplatin-based chemotherapy, but therapeutic resistance occurs in a considerable number of cases, which is associated with disease recurrence and poor patient prognosis. ADCs are a novel type of targeted antitumor agents that combine tumor antigen-specific monoclonal antibodies with chemically linked chemotherapeutic drugs (payload) exerting a cytotoxic effect. Several FDA-approved ADCs use as targeting moieties the antigens that are also detected in the GCTs, offering a benefit of this type of targeted therapy even for patients with relapsed/refractory testicular GCTs (rrTGCT) unresponsive to standard chemotherapy.
Using Platelet‐Rich Fibrin to Remove Graphite Tattoos May Yield Excellent Long‐Term Result
Authors: Cho Young Joon , Jeong Yong Tak , Lee Tae Hee , Cho Hyun Woo
Published: June 2024

Graphite tattoos are rarely reported because they are mainly caused by an accidental injury or habits during childhood that cause a pencil to penetrate the oral mucosa. Unlike other pigmentations, it stains layers that are deeper than the subepithelial and mucosal layers, and in most cases, it takes the form of a grayish black macule. This case report describes depigmentation with the denudation technique that was followed by a novel approach of using platelet‐rich fibrin to cover exposed bone. A 41‐year‐old male patient presented with an aesthetic complaint from a grayish black staining on the labial gingiva near the maxillary central and lateral incisors. The lesion was diagnosed as a graphite tattoo due to the patient’s history of sticking his gum with pencils when he was young. The entire pigmented gingiva was surgically removed and covered with two layers of PRF membrane to protect the exposed bone surface and provide an extracellular matrix for migration of gingival fibroblasts. Healing patterns were observed at 1, 2, 4, and 8 weeks, and satisfactory clinical and aesthetic results were obtained. Creeping attachment was observed at 8 years postop, and there was no recurrence for a long‐term period of 13 years.
Development and Validation of the Portuguese Transcultural Nursing Leadership Questionnaire (QLTE‐PT)
Authors: Teixeira Gisela , Gaspar Filomena , Lucas Pedro
Published: June 2024

Introduction. This study introduces the Portuguese Transcultural Nursing Leadership Questionnaire (QLTE‐PT), a pioneering instrument designed to assess leadership behaviours in multicultural nursing work environments, addressing gaps in current leadership assessment tools. Aim. This study aimed to develop and validate the Portuguese Transcultural Nursing Leadership Questionnaire (QLTE‐PT). Methods. It was conducted as a sequential exploratory mixed‐method study, integrating DeVellis’s steps for instrument development. Items were formulated based on a literature review and a focus group study, and the content validity was evaluated by a panel of experts. A methodological approach involving nurses registered in the Portuguese Order of Nurses with leadership experience in multicultural nursing work environments was employed to further conduct an exploratory and a confirmatory factor analysis to assess the instrument’s structure and psychometric properties. Results. One hundred forty‐five items were initially generated, of which 39 were included in the QLTE‐PT following content validity assessment by a panel of experts. EFA revealed a factor structure of 25 items loading on six factors, explaining 64% of the total variance. The overall Cronbach’s α coefficient of the questionnaire was 0.90. This six‐factor structure was tested by CFA, revealing a final model of 23 items and six factors, with a good quality of adjustment (CFI = 0.980, TLI = 0.976, SRMR = 0.078, and RMSEA = 0.070). Both convergent and discriminant validity were confirmed. Conclusions. The QLTE‐PT demonstrates good psychometric properties and is suitable for assessing transcultural leadership behaviours of nurse managers and leaders in multicultural nursing work environments. Implications for Nursing Management. The QLTE‐PT can assist nurse managers to improve their leadership behaviours, promote supportive working environments for their multicultural nursing staff, and improve the quality of care provided to patients from different cultural backgrounds.
Carbon Monoxide Exposure and Risk of Cognitive Impairment Among Cooks in Africa
Authors: McCord Ryan , Parsons Stephanie , Bittner Ashley S. , Jumbe Charles B. L. , Kabwe Gillian , Pedit Joseph , Serenje Nancy , Grieshop Andrew P. , Jagger Pamela
Published: June 2024

We use air pollution exposure measurements and household survey data from four studies conducted across three countries in sub‐Saharan Africa (SSA) to analyze the association between carbon monoxide (CO) exposure from cooking with biomass and indicators of cognitive impairment. While there is strong evidence on the relationship between ambient air pollution exposure and cognitive impairment from studies in high‐income countries, relatively little research has focused on household air pollution (HAP) in low‐income country settings where risks of HAP exposure are high. This study is the first to our knowledge to focus on the association between HAP exposure (specifically CO exposure) and cognitive impairment across diverse settings in SSA. We use 24‐hour measurements of primary cooks’ exposure to CO across four study sites: urban Zambia (n = 493); urban Malawi (n = 130); rural Malawi (n = 102); and urban Rwanda (n = 2,576). We model the estimated percent carboxyhemoglobin (%COHb) of cooks and map values to a toxicological profile for risk of cognitive impairment. We find that across all study settings, cooks’ average %COHb levels are below levels of daily concern, but that cooks who use charcoal for preparing greater than 40% of meals are more likely to spend additional time at higher levels of risk. For the urban Zambia sample, we compare %COHb and frequency of charcoal use to a series of cognitive test scores and find no consistent relationships between %COHb and cognitive test scores. High levels of daily CO exposure from cooks across SSA highlight the potential for longer‐term negative cognitive (and other) health outcomes motivating additional research and efforts to characterize and mitigate risk.
Experimental and Numerical Investigation of a Real Four‐Story Building with an Open Ground Floor in a Seismic Region for Proper Strengthening
Authors: Iskhakov Iakov , Yehuda Sharon , Ribakov Yuri
Published: June 2024

Many existing buildings fail to meet the requirements of current earthquake resistance codes. Therefore, it is necessary to strengthen and/or upgrade such buildings. Strengthening and/or upgrading include adding new floors, parts, elements, etc. Modern codes usually do not reflect upgrading of existing buildings. These buildings may be damaged and require maintenance and repairs, which may change the original material and structural properties. Design of such buildings is based on dominant vibration periods obtained by empirical dependences according to the building codes or from dynamic numerical analysis using available software. In both cases, the results usually do not consider the present state of the structure, influence of nonstructural elements, and possible differences in material properties in various elements of the building due to construction problems, concrete creep, etc. Such evaluation can be done just based on dynamic analysis, experimental and numeric, whereas the first one is essential. Therefore, the present research is aimed at numerical and experimental investigation of an existing real multistory residential reinforced concrete building before its strengthening and/or upgrading according to the requirements of modern seismic codes. The present study is a first stage of the research. It is focused on obtaining the dynamic parameters of the building before its strengthening and upgrading. Experimental values of natural vibration periods and damping ratios are compared with those obtained numerically. Following these values, the design spectrum of the seismic code is updated and the building is designed using this updated spectrum. The findings of this study form a basis for the second research stage that will be aimed at monitoring and analyzing of this building at each stage of its strengthening and upgrading. This approach iaimed at improving the available techniques for strengthening and upgrading the building. It will also be the basis for further research in this direction.
Cardiopulmonary Protection of Modified Remote Ischemic Preconditioning in Mitral Valve Replacement Surgery: A Randomized Controlled Trial
Authors: Zhang Lianqin , Zhou Kang , Gu Tianchu , Xu Jingjing , Shi Mengzhu , Zhu Jiang , Liu Jindong
Published: June 2024

Background: Remote ischemic preconditioning (RIPC) is reported to have early‐phase and delayed‐phase organ‐protective effects. Previous studies have focused on the organ protection of a single RIPC protocol, and the clinical outcomes remain uncertain. Whether the modified RIPC (mRIPC) protocol performed repeatedly provides cardiopulmonary protection is still uncertain.

Methods: In this single‐center, randomized, controlled trial, 86 patients undergoing elective mitral valve replacement (MVR) surgery were randomized 1:1 to receive either mRIPC or no ischemic preconditioning (control). Three cycles of 5 min ischemia and 5 min reperfusion induced by a blood pressure cuff served as the RIPC stimulus. mRIPC was induced at the following three time points: 24 h, 12 h, and 1 h before surgery. Blood samples were withdrawn at 10 min after intubation (T0), at 1 h after aortic declamping (T1), and at 6 h (T2), 12 h (T3), and 24 h (T4) after surgery to measure the serum concentrations of myocardial enzymes and other biomarkers, including cardiac troponin I (cTnI), which was the primary endpoint of this study. Creatine kinase isoenzyme (CK‐MB), lactate dehydrogenase (LDH), inotropic score (IS), and inflammatory mediators were also measured. Blood gas analysis was conducted to calculate the PaO2/FiO2 ratio and A‐aDO2, and the incidence of acute lung injury (ALI) was also recorded.

Results: mRIPC significantly decreased the serum concentrations of cTnI, CK‐MB, and LDH at T2, T3, and T4 (p < 0.01), and the IS decreased compared with that in the control group (12.0 ± 1.0 vs. 14.2 ± 1.1, p < 0.01). In addition, the incidence of ALI in the mRIPC group was decreased (32.6% vs. 51.2%, p = 0.039), and the PaO2/FiO2 was higher at T4 (p < 0.05). Compared with those in the control group, the levels of interleukin‐6 (IL‐6) and tumor necrosis factor‐α (TNF‐α) were decreased at T1, T2, T3, and T4 (p < 0.05) in the mRIPC group, and the level of IL‐10 increased at the same time.

Conclusions: mRIPC decreased the incidence of myocardial and lung injury in MVR surgery, providing new evidence for the clinical application of RIPC in valve surgery.

Trial Registration: ClinicalTrials.gov (NCT01406678).
Navigating the Endodontic Challenge of a 40 mm Canine and Its Technical Adaptations
Authors: Moushekhian Siavash , Saeedi Pooya , Sahebnasagh Zoha
Published: June 2024

Aim. The aim of this case report is to present the successful endodontic management of an abnormally long right maxillary canine diagnosed with symptomatic irreversible pulpitis, highlighting the technical adaptations employed during treatment. Summary. Technical adaptations included modifying the handle of the endodontic hand file and utilizing a side‐vented microcannula for irrigation using positive and negative pressure technique. Despite the challenges posed by the abnormal tooth length, the procedure achieved a working length of 40.7 mm, and periapical radiography confirmed the master gutta‐percha reaching full working length. Notably, the patient remained asymptomatic during the six‐month follow‐up, highlighting the efficacy of the treatment. This article also reviews the current literature, examining comparable cases and techniques documented in scholarly sources.
Mechanical Thrombectomy Workshops Improve Procedural Knowledge and Skills Among Neurointerventional Teams in Low- to Middle-Income Countries
Authors: Inoa Violiza , Then Ryna , Cancelliere Nicole M. , Spiegel Gary R. , Fraser Justin F. , Hepburn Madihah , Martins Sheila C.O. , Guff Lauren , Strong Mindy , Elijovich Lucas , González Fernando , Guerrero Waldo R. , Eusebio Alex , Gayle Francene , Manosalva Alzate Herbert Alejandro , Villamán Cosme G. , Suazo Luis , de Souza Romnesh , Potter-Vig Jennifer , Hassan Ameer E. , Ortega-Gutierrez Santiago , Yavagal Dileep R. , Gordon Perue Gillian L.
Published: June 2024

BACKGROUND:

While mechanical thrombectomy (MT) is proven to be lifesaving and disability sparing, there remains a disparity in its access in low- to middle-income countries. We hypothesized that team-based MT workshops would improve MT knowledge and skills.

METHODS:

We designed a 22-hour MT workshop, conducted as 2 identical events: in English (Jamaica, January 2022) and in Spanish (Dominican Republic, May 2022). The workshops included participating neurointerventional teams (practicing neurointerventionalists, neurointerventional nurses, and technicians) focused on acute stroke due to large vessel occlusion. The course faculty led didactic and hands-on components, covering topics from case selection and postoperative management to device technology and MT surgical techniques. Attendees were evaluated on stroke knowledge and MT skills before and after the course using a multiple choice exam and simulated procedures utilizing flow models under fluoroscopy, respectively. Press conferences for public education with invited government officials were included to raise stroke awareness.

RESULTS:

Twenty-two physicians and their teams from 8 countries across the Caribbean completed the didactic and hands-on training. Overall test scores (n=18) improved from 67% to 85% (
P
<0.002). Precourse and postcourse hands-on assessments demonstrated reduced time to completion from 36.5 to 21.1 minutes (
P
<0.001). All teams showed an improvement in measures of good MT techniques, with 39% improvement in complete reperfusion. Eight teams achieved a Thrombolysis in Cerebral Infarction score of 3 on pre-course versus 15 of 18 teams on post-course. There was a significant reduction in total potentially dangerous maneuvers (70% pre versus 20% post;
P
<0.002). Universally, the workshop was rated as satisfactory and likely to change practice in 93% Dominican Republic and 75% Jamaica.

CONCLUSIONS:

A team-based hands-on simulation approach to MT training is novel, feasible, and effective in improving procedural skills. Participants viewed these workshops as practice-changing and instrumental in creating a pathway for increasing access to MT in low- to middle-income countries.
Discovering prominent differences in structural and functional connectomes using a multinomial stochastic block model
Authors: Iskov Nina Braad , Olsen Anders Stevnhoved , Madsen Kristoffer Hougaard , Mørup Morten
Published: June 2024

Understanding the differences between functional and structural human brain connectivity has been a focus of an extensive amount of neuroscience research. We employ a novel approach using the multinomial stochastic block model (MSBM) to explicitly extract components that characterize prominent differences across graphs. We analyze structural and functional connectomes derived from high-resolution diffusion-weighted MRI and fMRI scans of 250 Human Connectome Project subjects, analyzed at group connectivity level across 50 subjects. The inferred brain partitions revealed consistent, spatially homogeneous clustering patterns across inferred resolutions demonstrating the MSBM’s reliability in identifying brain areas with prominent structure-function differences. Prominent differences in low-resolution brain maps (K = {3, 4} clusters) were attributed to weak functional connectivity in the bilateral anterior temporal lobes, while higher resolution results (K ≥ 25) revealed stronger interhemispheric functional than structural connectivity. Our findings emphasize significant differences in high-resolution functional and structural connectomes, revealing challenges in extracting meaningful connectivity measurements from both modalities, including tracking fibers through the corpus callosum and attenuated functional connectivity in anterior temporal lobe fMRI data, which we attribute to increased noise levels. The MSBM emerges as a valuable tool for understanding differences across graphs, with potential future applications and avenues beyond the current focus on characterizing modality-specific distinctions in connectomics data.
Framework for personalized prediction of treatment response in relapsing-remitting multiple sclerosis: a replication study in independent data
Authors: Sakr Anna Maria , Mansmann Ulrich , Havla Joachim , Ön Begum Irmak , Ön Begum Irmak
Published: June 2024

Background

Individualizing and optimizing treatment of relapsing-remitting multiple sclerosis patients is a challenging problem, which would benefit from a clinically valid decision support. Stühler et al. presented black box models for this aim which were developed and internally evaluated in a German registry but lacked external validation.

Methods

In patients from the French OFSEP registry, we independently built and validated models predicting being free of relapse and free of confirmed disability progression (CDP), following the methodological roadmap and predictors reported by Stühler. Hierarchical Bayesian models were fit to predict the outcomes under 6 disease-modifying treatments given the individual disease course up to the moment of treatment change. Data was temporally split on 2017, and models were developed in patients treated earlier (n = 5517). Calibration curves, discrimination, mean squared error (MSE) and relative percentage of root MSE (RMSE%) were assessed by external validation of models in more-recent patients (n = 3768). Non-Bayesian fixed-effects GLMs were also applied and their outcomes were compared to these of the Bayesian ones. For both, we modelled the number of on-therapy relapses with a negative binomial distribution, and CDP occurrence with a binomial distribution.

Results

The performance of our temporally-validated relapse model (MSE: 0.326, C-Index: 0.639) is potentially superior to that of Stühler’s (MSE: 0.784, C-index: 0.608). Calibration plots revealed miscalibration. Our CDP model (MSE: 0.072, C-Index: 0.777) was also better than its counterpart (MSE: 0.131, C-index: 0.554). Results from non-Bayesian fixed-effects GLM models were similar to the Bayesian ones.

Conclusions

The relapse and CDP models rebuilt and externally validated in independent data could compare and strengthen the credibility of the Stühler models. Their model-building strategy was replicable.
Do symptoms and signs of temporomandibular disorders have an association with breathing pattern: a cross-sectional study on Turkish children and adolescents
Authors: Alpaydin Mehmed Taha , Alpaydin Tugce , Torul Damla
Published: June 2024

Background

This paper aimed to explore the prevalence of temporomandibular disorders (TMDs) signs/symptoms, and to investigate the possible link between signs/symptoms of TMDs and mouth breathing (MB) by evaluating along with other risk factors, in a Turkish subpopulation of children and adolescence.

Methods

This study was conducted with the archival data of the patients who applied with orthodontic complaints. Data on demographic characteristics, family-related factors, systemic status, occlusion, breathing patterns, oral habits, and bruxism were retrieved from the archival records.

Results

Nine hundred forty-five children and adolescents with a mean age of 14.82 ± 2.06 years were included in the study. Of the participants, 66% were girls, 60.4% were delivered by C-section, 8.4% of the participants had at least one systemic disease, 9.2% of the participants had allergy, and 4.3% of the participants’ parents were divorced, 18.7% have an oral habit, 6.6% have bruxism, 29.8% have malocclusion and 14.1% have MB. Eight-point-five percent of participants have signs/symptoms of TMD. Among them 2.9% have pain, 3.7% have joint sounds, 1.4% have deflection, and 3.9% have deviation. Evaluation of the risk factors revealed a significant relation between the signs/symptoms of TMD and bruxism (OR 8.07 95% CI 4.36–14.92), gender (OR 2.01 95% CI 1.13–3.59), marital status of parents (OR 2.62 95% CI 1.07–6.42), and MB (OR 3.26 95% CI 1.86–5.71).

Conclusions

According to the study’s findings, girls and those with bruxism, divorced parents, and MB behavior are more likely to have signs/symptoms of TMD. Age found to have significant effect on the occurrence of the signs/symptoms of TMD alone, but together with other factors the effect of the age is disappeared. Early screening and intervention of MB as well as the signs/symptoms of TMD can help to limit detrimental effects of these conditions on growth, and quality of life of children and adolescents.
Off-plane technique ultrasound-guided pericardiocentesis via anterior approach: short communication
Authors: Rodriguez Lima David Rene , Otálora González Laura , Noriega Acosta Felipe
Published: June 2024

The pericardiocentesis procedure is common, often performed via the subxiphoid approach, although other transthoracic approaches have been described. This short communication describes an off-plane technique ultrasound-guided pericardiocentesis using an anterior approach, performed using a linear transducer and guided in real-time by ultrasound, offering the advantage of continuous needle tracking to reduce complications associated with this approach such as pneumothorax, inadvertent cardiac puncture, and injury to the left internal mammary artery (LIMA).
A comprehensive database of human and livestock fecal microbiome for community-wide microbial source tracking: a case study in South Korea
Authors: Song Hokyung , Unno Tatsuya
Published: June 2024

Fecal waste from livestock farms contains numerous pathogens, and improperly managed waste may flow into water bodies, causing water-borne diseases. Along with the popularization of high-throughput technologies, community-wide microbial source-tracking methods have been actively developed in recent years. This study aimed to construct a comprehensive fecal microbiome database for community-wide microbial source tracking and apply the database to identify contamination sources in the Miho River, South Korea. Total DNA was extracted from the samples, and the 16 S rRNA gene was amplified to characterize the microbial communities. The fecal microbiome database was validated by developing machine-learning models that predict host species based on microbial community structure. All machine learning models developed in this study showed high performance, where the area under the receiver operating characteristic curve was approximately 1. Community-wide microbial source tracking results showed a higher contribution of fecal sources to the contamination of the main streams after heavy rain. In contrast, the contribution of fecal sources remained comparatively stable in tributaries after rainfall. Considering that farms are more concentrated upstream of tributaries compared to the main streams, this result implies that the pathway for manure contaminants to reach the main streams could be groundwater rather than surface runoff. Systematic monitoring of the water quality, which encompasses river water and groundwater, should be conducted in the future. In addition, continuous efforts to identify and plug abandoned wells are necessary to prevent further water contamination.