bluuebunny/crossref_metadata_2025 huggingface dataset:
Do social media epistemological beliefs and health perception impact parents’ vaccine hesitancy? A mediation analysis
Authors: Çevik Cahide , Yavuz Ebru , Çakmak Fatma , Ündere Reyhan , Doğan Cengiz Asiye
Published: October 2024

In recent years, there has been a notable increase in vaccine hesitancy among individuals. It is crucial to identify the factors contributing to vaccine hesitancy to effectively address this issue. This study aims to investigate the impact of social media-specific epistemological beliefs on vaccine hesitancy and the mediating role of health perception in this impact. This study is a cross-sectional study conducted with 444 parents. Data were collected using the Personal Information Form, the Social Media-Specific Epistemological Beliefs Scale, the Perception of Health Scale, and the Vaccine Hesitancy Scale. When there is no mediator variable, the total effect of social media-specific epistemological beliefs on vaccine hesitancy is statistically significant (β = −0.219, p < 0.001). However, it was found that health perception did not mediate the relationship between social media-specific epistemological beliefs and vaccine hesitancy (β = 0.0038, 95% confidence interval (−0.0090, 0.0205)). Furthermore, it was determined that social media-specific epistemological beliefs positively predicted health perception (β = 0.136, p < 0.01). Health perception was found to have no significant effect on vaccine hesitancy (β = 0.028, p > 0.05). It can be concluded that social media-specific epistemological beliefs negatively predict vaccine hesitancy, and this effect is independent of health perception. Primary healthcare professionals should consider incorporating interventions aimed at enhancing individuals’ social media-specific epistemological beliefs into their health education programs related to vaccines.
Practice Patterns of Biologics Prescriptions and Surgery in Chronic Rhinosinusitis With Nasal Polyps
Authors: Almarri Firas K. , Algahtani Saad , Alokby Ghassan , Alanazi Muteb , Alsaleh Saad
Published: October 2024

Background

Chronic rhinosinusitis with nasal polyps (CRSwNP) remains challenging to manage effectively, with high symptom recurrence rates and significant impacts on quality of life, prompting a need to evaluate the real-world use of biologics and optimize treatment strategies.

Objective

To assess the real-world application and perspectives of American Rhinologic Society (ARS) members on biologic treatments and surgical interventions for CRSwNP, focusing on clinical practice patterns, adoption of biologics, and their impact on surgical practices.

Methods

A standardized questionnaire evaluated clinical practice patterns of biologics prescriptions and surgery in treating CRSwNP between July 2022 and August 2023. Data collected from 162 ARS members were analyzed.

Results

Of 162 participants, a substantial majority (95.06%, n = 154) reported prescribing biologics in their practice. Notably, 45.45% ( n = 70) found biologics easily accessible, although accessibility challenges remained for some. The impact of biologics on surgical practices was significant, with 36.36% ( n = 56) observing a marked reduction in revision sinus surgeries. Among the participants, 47.16% ( n = 71) agreed that aspirin-exacerbated respiratory disease (AERD) was the highest phenotype that tended to increase the possibility of biological treatment by more than 20%. Adopting Patient-Reported Outcome Measures (PROMs) was prevalent, with 57.79% ( n = 89) utilizing them in patient management.

Conclusion

The study highlights the evolving landscape in managing CRSwNP, with a marked trend toward integrating biological treatments into clinical practice. It underscores the necessity for continued research, updates to clinical guidelines, and enhanced practitioner education to optimize treatment outcomes for CRSwNP patients.
Congenital ureterovaginal fistula and a duplicated left ectopic ureter: A rare case in Tanzania
Authors: Moshi Brenda , Gidion Daudi , Abeid Muzdalifat , Kaguta Munawar , Chapa James , Majinge Peter
Published: October 2024

This case report presents the clinical journey of a 28-year-old nulliparous woman from Dar es Salaam, Tanzania, who sought medical attention due to lifelong urinary leakage since birth, profoundly impacting her emotional well-being and sexual encounters. Clinical examination revealed urinary leakage from the vagina, with unremarkable abdominal and genital findings. Laboratory investigations were normal. Computed tomography intravenous urography revealed a left duplex collecting system with significant hydroureteronephrosis in the left upper moiety, suggestive of an ectopic ureter. Intraoperative exploration confirmed a duplicated left ureter, with the upper moiety implanted into the vaginal canal. Surgical re-implantation of both left ureters into the bladder was successfully performed, correcting the anatomical anomaly. Postoperative follow-up demonstrated marked improvement in urinary symptoms, restoring the patient’s confidence and alleviating emotional distress. This case underscores the complexity and rarity of congenital urinary tract anomalies, particularly in resource-constrained settings, and highlights the importance of a stepwise diagnostic and management approach.
Abdominal foreign body migration causing cardiac tamponade: A case report
Authors: Kammoun Neirouz , Guelbi Mohamed , Trabelsi Mohamed Mahdi , Bouasker Ibtissem , Jerraya Hichem , Nouira Ramzi
Published: October 2024

Chronic asymptomatic retention of an intragastric foreign body can pose a life-threatening scenario. In the event of migration, it may result in perforation, as shown in our unique case of pericardial perforation through the fundus.

Beyond illustrating a rare condition, this case prompts us to engage in a debate about whether to retain or remove asymptomatic foreign bodies in the gastrointestinal tract. It is a 28-year-old male patient, a prisoner, with a history of recurrent foreign body ingestion leading to five previous interventions, presented a year ago to our emergency department after ingesting four metal rods. Despite recommendations, the patient refused the intervention. After 1 year, he presented to our emergency department for respiratory distress. On examination, he had tachycardia, cardiac auscultation revealed a high-pitched sound signing a pericardial knock and abdominal palpation revealed epigastric tenderness. An abdominal X-ray revealed the presence of metallic foreign bodies located in the gastric area. An electrocardiogram showed a low voltage. Given these findings, there was a strong suspicion of rod migration from the stomach to the thoracic cavity with a cardiac tamponade. An emergency CT scan revealed that the rod had pierced through the stomach and pericardium, causing pericardial effusion. The patient was promptly transported to the operating room to discover the tip of the rod out of the stomach and penetrating the left diaphragm and the pericardial layer. The foreign body was removed.
First description of oesophageal melanoma in a cat and palliative treatment by endoscopic argon plasma coagulation laser
Authors: Ferriani Riccardo , Pagano Teresa Bruna , Bottero Enrico
Published: October 2024

Case summary

An 11-year-old castrated male domestic shorthair cat presented with chronic regurgitation and weight loss. Despite a 2-month history of weight loss, regurgitation intensified over 4 weeks, occurring with every food intake, even on a semi-liquid diet. Physical examination revealed thinness and dehydration, and a focal oval mass was noted in the middle mediastinum on thoracic radiography. Oesophagoscopy identified a 6 cm neoformation almost completely obstructing the oesophageal lumen. Biopsies were taken and histopathology, positivity to melanoma triple cocktail and PNL-2 by immunohistochemistry led to the diagnosis of melanocytic neoplasm. Palliative debulking with argon plasma coagulation (APC) was performed, significantly improving the cat’s quality of life for 2 months. The cat survived for 107 days after diagnosis.

Relevance and novel information

This case report describes the first report of melanocytic neoplasia originating from the oesophageal mucosa in a cat. In cats, melanomas outside the eyes are exceedingly rare and oesophageal neoplasms are exceptionally rare in veterinary medicine, particularly melanomas. The diagnosis relied on positive immunohistochemistry markers aligning with previous research. Treatment with APC emerged as a novel, potentially palliative approach, successfully alleviating regurgitation for 3 months. This underscores APC’s potential in feline oesophageal neoplasia palliative care, which deserves further investigation in a broader feline cohort to confirm its efficacy. Overall, this report provides valuable insights into the diagnosis and treatment of oesophageal melanoma in cats.
Toward a computational mixed methods framework to measure online deliberative discourse
Authors: Duncan Stuart , Dwyer Lauren , Smith Hanako , Vallesi Davis , Zeller Frauke , Davis Charles
Published: October 2024

This article proposes and tests a reproducible framework for a computational method to measure social media-based deliberative discourse by analyzing commentary surrounding the Canadian convoy protests of COVID-19 vaccine mandates and restrictions. Employing a combination of analytic calculations, alongside tools such as Google Perspective and Linguistic Inquiry and Word Count (LIWC), this article assesses the quality of online deliberative discourse using established measures of deliberation including the variables rationality, interactivity, equality, and civility. We propose computational approaches to measuring these variables, and work toward validating our approach by observing correlations between an established computational measure of online deliberation-cognitive complexity. This computational approach is tested using Twitter and Reddit commentary related to the convoy protests that took place in Ottawa, Canada, during February 2022, which influenced the emergence of similar protests around the world. In addition to testing our proposed online deliberative discourse measurement framework, this case study provides insight into the deliberative characteristics of the Twitter and Reddit social media platforms.
The Agribusiness Model in South African Land Reform? Land Use Implications for the Land Reform Beneficiaries
Authors: Rusenga Clemence
Published: October 2024

The land reform programme of the South African government aims, among other things, at generating large-scale employment, increasing rural incomes and combatting poverty. However, the programme equally enforces an agribusiness model that promotes large-scale production through failure to subdivide the large farms, and encouraging the beneficiaries to use the land in the manner that the former white landowners did. The article demonstrates the unsuitability of large-scale production for the land reform beneficiaries, given its unsustainable production costs. On the contrary, the limited costs associated with the small-scale model allow the beneficiaries, including those relying on off-farm income, to produce with better effect.
The Agrarian Question and Coffee in Costa Rica
Authors: Babin Nicholas
Published: October 2024

This article traces the agrarian transition to capitalism in Costa Rica to identify the factors and dynamics that have contributed to the current persistence of the coffee producing peasantry. The case study reveals that the agrarian transition to capitalism and the persistence of the coffee commodity producing peasantry are both products of certain historical and political circumstances. The pro-smallholder politics of the post-revolution Costa Rican state and its emphasis on a particular form of agro-input-substituting industrialization, combined with the unique and historically contingent relations that have developed between landed agrarian and industrial capitalist classes and the peasantry, have led to an agrarian class structure which lacks a substantial landed capitalist coffee producing class. Instead agrarian capital has relegated itself to the processing and input spheres where the ‘real’ subsumption of nature and the ‘formal’ subsumption of peasant labour to agrarian capital occurred.
Physicochemical and biocompatibility characterisation of a 3D lyophilised platelet-rich fibrin scaffold for cleft lip and palate repair
Authors: Ngah Nurul Aida , Ratnayake Jithendra , Dias George J , Tong Darryl C , Noor Siti Noor Fazliah Mohd , Cooper Paul R , Hussaini Haizal Mohd
Published: October 2024

Craniofacial bone defects result from various disorders such as trauma, congenital malformations and infections. Cleft lip and palate are the most prevalent congenital craniofacial birth defect in humans. Growth factors (GFs) are soluble proteins secreted by cells that regulate various cellular processes and tissue regeneration. At present, developing three-dimensional scaffolds for delivering GFs to the site of injury has become an important aspect in craniofacial bone regeneration. This study aims to develop a novel 3D bone substitute using lyophilized-platelet-rich fibrin (LyPRF) biocomposite scaffolds for potential application for CLP repair. Collagen (C), bioglass (BG), and LyPRF were used to fabricate a biocomposite (C-BG-LyPRF) scaffold. The physical, chemical, and biocompatibility properties of the scaffold were evaluated. The C-BG-LyPRF scaffold demonstrated a mean pore diameter of 146 µm within a porosity of 87.26%. The FTIR spectra verified the presence of am-ide I, II, and III functional groups. The inorganic phase of the C-BG-LyPRF scaffold was composed of sodium, calcium, silicon, and phosphorus, as determined by EDX analysis. Furthermore, C-BG-LyPRF scaffold was biocompatible with MC3T3-E1 cells in both the Live/Dead and prolif-eration assays. Data demonstrate the developed C-BG-LyPRF scaffold exhibits biomimetic and biocompatibility properties, establishing it as a promising biomaterial for craniofacial regeneration.
A Case of Cardiac Tamponade With Biventricular Heart Failure in the Setting of Systemic Lupus Erythematosus
Authors: Ozgur Sacide S. , Ansari Nida , Shamoon Yezin , Elkattway Sherif , Abboud Rachel , Shamoon Fayez
Published: October 2024

Systemic lupus erythematosus (SLE) is an autoimmune disease targeting multiple organs through immune complexes. Pericarditis and pericardial effusions are often encountered; however, cases of biventricular failure are notably less common in the setting of SLE. We report a 43-year-old male patient presenting with cardiac tamponade with biventricular failure in SLE. Our patient with known SLE, not on medication, presented with exertional dyspnea. He had decreased heart sounds, jugular venous distention, and right-sided inspiratory crackles on physical examination. On further investigation, he was found to have a reduced ejection fraction (EF) of 10% to 15% and moderate pericardial effusion. He was treated with immunosuppressive therapy and goal directed medical theraphy (GDMT), with improvement in his EF to 58% 3 months later. This case demonstrates the importance of early recognition of SLE-induced tamponade and the vitality of prompt medical therapy to reduce any further cardiac deterioration.
Fostering Teamwork Satisfaction in Competitive Project-Based Learning Environments
Authors: Phan The Anh , Phan Nhan
Published: October 2024

This 10-week study investigates the relationships between diversity beliefs, teamwork satisfaction, perceived classroom competitiveness, and attitudes toward project-based activities among 105 marketing students. Findings indicate that diversity beliefs enhance teamwork satisfaction, whereas performance-approach goals reduce it. Classroom competitiveness negatively moderates the impact of teamwork satisfaction on project attitudes, whereas teammate competitiveness has a positive moderating effect. These insights can help educators balance competition and collaboration to optimize learning environments.
Exploring Factors Influencing Orthopedic Patients’ Willingness to Recommend a Hospital: Insights From a Cross-Sectional Survey
Authors: Ben Natan Merav , Maman David , Avramov Milana , Shamilov Galina , Berkovich Yaron
Published: October 2024

Patient satisfaction and the willingness to recommend a hospital are critical for healthcare quality improvement. This study focuses on orthopedic patients, recognizing their unique healthcare experiences. We aimed to explore factors influencing orthopedic patients’ willingness to recommend the hospital, considering various demographic and clinical variables. A cross-sectional survey of 200 orthopedic patients hospitalized between July and December 2023 in north-central Israel was conducted. Results revealed a positive association between age and willingness to recommend (odds ratio [OR] = 2.44), while emergency department stay length showed a negative association (OR = 0.58). Satisfaction with hospital care positively influenced the willingness to recommend (OR = 1.96). Gender, comorbidities, and hospital stay length did not significantly impact willingness to recommend. The study highlights the role of satisfaction and the impact of extended emergency department stays, emphasizing the need for nuanced strategies to optimize orthopedic patient experiences. Valuable insights are offered for healthcare providers and policymakers.
The importance of body image and aesthetic medicine in systemic sclerosis
Authors: Orlandi Martina , Spinella Amelia , De Pinto Marco , Sandri Gilda , De Santis Giorgio , Giuggioli Dilia
Published: October 2024

Systemic sclerosis is a progressive fibrotic autoimmune disease which mainly affects young women causing fibrosis of the skin and internal organs. In systemic sclerosis patients, facial and hand alterations are significant as these may have an impact on body image. In fact, systemic sclerosis could cause disfigurement of the most visible parts of the body, hindering self-confidence and quality of life. Therefore, the assessment of body image in systemic sclerosis is crucial in order to optimize a tailored care of the patient. In the near future, the creation of a pathway involving dedicated specialists (psychologists, physiotherapists, dermatologists, and plastic surgeons) should become an integral part of the disease management.
Changes in Internet Search Behavior After a Direct-to-Consumer Advertising Campaign for Faricimab-svoa
Authors: Bloemhof Clarisa Marie P. , Lim Matthew J. , Hwang John C.
Published: October 2024

Purpose: To analyze changes in Google search volume after US Food and Drug Administration (FDA) approval and initiation of a direct-to-consumer marketing campaign for faricimab-svoa. Methods: Google Trends data between December 26, 2021, and June 17, 2023, were downloaded and searched for terms prominently featured in the marketing campaign, including “wet AMD”, “diabetic macular edema”, “Vabysmo”, and “faricimab-svoa”. Data were standardized to the week and the term with the highest search volume, resulting in weekly relative search volumes for each term. The mean relative search volume and percentage change in relative search volume were calculated for the time periods of interest. Results: The direct-to-consumer campaign was associated with an increase in relative search volume in the first month for the terms “Vabysmo” (2.5% to 18.0%) and “wet AMD” (3.0% to 77.3%) and was sustained in the second month ( P < .01). No significant changes in relative search volume were seen for the terms “diabetic macular edema” or “faricimab-svoa”. After FDA approval, “Vabysmo” had the only significant increase in relative search volume (0.3% to 2.8%; P = .02). Conclusions: A direct-to-consumer advertising campaign for faricimab-svoa was associated with a surge in Google search volume of 620% and 2475% for “Vabysmo” and “wet AMD,” respectively ( P < .01), without a corresponding increase for “diabetic macular edema”. Although FDA approval was associated with an increase in search volume for “Vabysmo” ( P = .02), the marketing campaign was more influential at driving internet search behavior.
‍《玉堂厘正海篇心鏡》与明代字书价值浅述
Authors: 静 安 , 三 河永
Published: October 2024

自《说文》以降，传统字典逐渐发展为四种类型。其中，“海篇”系字书产生于金代，明时多仿编。受《玉篇》和《集韵》影响，本类字书书名均含“篇海”或“海篇”。首先，代表之一的《海篇心镜》，是古代收字量最多的字书。其次，该书内容方面，原《序》反映的编纂理念，体例及与《说文》的比较值得总结。另外，明末该书在朝鲜地区的重辑和流传，对朝鲜汉字字书和篆书使用有较深远影响，故“汉字文化圈”视角下，其海外版本方面尚有研究空间。
“金”之俗变考察
Authors: 晓宇 熊 , 山 何
Published: October 2024

“金”为汉字家族的重要成员，也是重要的构字元素。书写使用中，“金”的字体发生变异，产生系列异体俗字。其过程伴随字形讹混、新字形孳生等特殊文字现象。本文全面考察“金”形体俗变的过程和状况，揭示字形之间的源流关系及传承规律，清理归纳新见字形，可为汉字发展史研究、辞书编纂、汉字编码等提供实证资料。
从壮族典籍看方块壮字同形字的形成机制
Authors: 魏 高
Published: October 2024

文章以壮族典籍为材料，全面整理了典籍中的同形字，归纳出方块壮字同形字的形成机制，即构字理据趋同、借字方式不严谨、书写变异、汉语方言差异、继承汉字同形现象、壮语词汇系统影响，从而更深入了解方块壮字的文字性质和特点。
How I treat blastic plasmacytoid dendritic cell neoplasm
Authors: Kharfan-Dabaja Mohamed A. , Lane Andrew A. , Pemmaraju Naveen
Published: October 2024

Historically, treatment options for blastic plasmacytoid dendritic cell neoplasm (BPDCN) were limited to conventional chemotherapy, adopted from regimens used to treat acute myeloid or acute lymphoblastic leukemias, or lymphomas. Nowadays, a novel therapy targeting CD123 is available to treat BPDCN. Yet, regardless of treatment choice, achieving a first complete remission represents the main goal of therapy, because it represents the best opportunity to prolong survival in BPDCN, if offered an allogeneic hematopoietic cell transplant (allo-HCT) as consolidative therapy. Although no specific conditioning regimen is considered standard of care in allo-HCT–eligible patients, recent data from 2 large registries reported a survival advantage when offering total body irradiation–based myeloablative conditioning (MAC) regimens. Unfortunately, applicability of MAC regimens is not feasible in patients who are older/unfit, which represents a considerable proportion of patients presenting worldwide. In such cases, reduced intensity conditioning regimens represent the next best option. Autologous HCT could be considered in patients who are older/unfit who did not have bone marrow involvement at initial presentation and at time of the procedure, albeit data supporting this option are less abundant. Future research is needed to decipher the interplay between clinical, genetic, and molecular features of the disease to personalize treatment accordingly, by enhancing efficacy and avoiding unnecessary toxicities.
Single-cell analysis of the multiple myeloma microenvironment after γ-secretase inhibition and CAR T-cell therapy
Authors: Coffey David G. , Ataca Atilla Pinar , Atilla Erden , Landgren Ola , Cowan Andrew J. , Simon Sylvain , Pont Margot J. , Comstock Melissa L. , Hill Geoffrey R. , Riddell Stanley R. , Green Damian J.
Published: October 2024

Chimeric antigen receptor (CAR) T cells and bispecific antibodies targeting B-cell maturation antigen (BCMA) have significantly advanced the treatment of relapsed and refractory multiple myeloma. Resistance to BCMA-targeting therapies, nonetheless, remains a significant challenge. BCMA shedding by γ-secretase is a known resistance mechanism, and preclinical studies suggest that inhibition may improve anti-BCMA therapy. Leveraging a phase 1 clinical trial of the γ-secretase inhibitor (GSI), crenigacestat, with anti-BCMA CAR T cells (FCARH143), we used single-nuclei RNA sequencing and assay for transposase-accessible chromatin sequencing to characterize the effects of GSI on the tumor microenvironment. The most significant impacts of GSI involved effects on monocytes, which are known to promote tumor growth. In addition to observing a reduction in the frequency of nonclassical monocytes, we also detected significant changes in gene expression, chromatin accessibility, and inferred cell-cell interactions after exposure to GSI. Although many genes with altered expression are associated with γ-secretase–dependent signaling, such as Notch, other pathways were affected, indicating GSI has far-reaching effects. Finally, we detected monoallelic deletion of the BCMA locus in some patients with prior exposure to anti-BCMA therapy, which significantly correlated with reduced progression-free survival (PFS; median PFS, 57 vs 861 days). GSIs are being explored in combination with the full spectrum of BCMA-targeting agents, and our results reveal widespread effects of GSI on both tumor and immune cell populations, providing insight into mechanisms for enhancing BCMA-directed therapies.
Asciminib plus dasatinib and prednisone for Philadelphia chromosome–positive acute leukemia
Authors: Luskin Marlise R. , Murakami Mark A. , Keating Julia , Flamand Yael , Winer Eric S. , Garcia Jacqueline S. , Stahl Maximilian , Stone Richard M. , Wadleigh Martha , Jaeckle Stella L. , Hagopian Ella , Weinstock David M. , Liegel Jessica , McMasters Malgorzata , Wang Eunice S. , Stock Wendy , DeAngelo Daniel J.
Published: October 2024

Dasatinib is an effective treatment for Philadelphia chromosome–positive (Ph+) acute leukemia, but some patients develop resistance. Combination treatment with dasatinib and asciminib, an allosteric inhibitor of BCR::ABL1, may deepen responses and prevent the emergence of dasatinib-resistant clones. In this phase 1 study (NCT03595017), 24 adults with Ph+ acute lymphoblastic leukemia (ALL; n = 22; p190, n = 16; p210, n = 6) and chronic myeloid leukemia in lymphoid blast crisis (n = 2) were treated with escalating daily doses of asciminib in combination with dasatinib 140 mg daily plus prednisone 60 mg/m2 daily to determine the maximum tolerated dose. After a 28-day induction, dasatinib and asciminib were continued indefinitely or until hematopoietic stem cell transplant. The median age was 64.5 years (range, 33-85; 50% aged ≥65 years). The recommended phase 2 dose of asciminib was 80 mg daily in combination with dasatinib and prednisone. The dose limiting toxicity at 160 mg daily was asymptomatic grade 3 pancreatic enzyme elevation without symptomatic pancreatitis. There were no vaso-occlusive events. Among patients with de novo ALL, the complete hematologic remission rates at days 28 and 84 were 84% and 100%, respectively. At day 84, 100% of patients achieved complete cytogenetic remission, 89% achieved measurable residual disease negativity (<0.01%) by multicolor flow cytometry, and 74% and 26% achieved BCR::ABL1 reverse transcription quantitative polymerase chain reaction <0.1% and <0.01%, respectively. Dual BCR::ABL1 inhibition with dasatinib and asciminib is safe with encouraging activity in patients with de novo Ph+ ALL. This trial was registered at www.clinicaltrials.gov as #NCT02081378.
Sex and 30-day survival following out-of-hospital cardiac arrest in Scotland 2011–2020
Authors: Bijman Laura A. E. , Wild Sarah H. , Clegg Gareth , Halbesma Nynke
Published: October 2024

Background

Differences in 30-day survival between males and females following out-of-hospital cardiac arrest (OHCA) are well documented. Biological sex does not appear to be responsible for this survival gap independently of potential mediating factors. We investigated the role of potential mediating factors in the association between sex and 30-day survival after OHCA in Scotland.

Methods

A retrospective cohort study of adult non-emergency medical services (EMS)-witnessed OHCA cases was conducted. We included incidents from the whole of Scotland where resuscitation was attempted by the Scottish Ambulance Service (SAS) between April 1, 2011 and March 1, 2020. Logistic regression was used to assess the contribution of age, socioeconomic status, urban–rural location of the incident, initial cardiac rhythm, bystander cardiopulmonary resuscitation (CPR) and location of the arrest (home or away from home).

Results

The cohort consisted of 20,585 OHCA cases (13,130 males and 7,455 females). Median (IQR) age was 69 years (22) for males versus 72 years (23) for females. A higher proportion of males presented with initial shockable rhythm (29.4% versus 12.4%) and received bystander CPR (56.7% versus 53.2%) compared with females. A higher proportion of females experienced OHCA at home (78.8% versus 66.8%). Thirty-day survival after OHCA was higher for males compared with females (8.2% versus 6.2%). Males had higher age-adjusted odds for 30-day survival after OHCA than females (OR, 1.26; (95% CI), 1.12–1.41). Mediation analyses suggested a role for initial cardiac rhythm and location of the arrest (home or away from home).

Conclusion

Males had higher age-adjusted 30-day survival after OHCA than females. However, after adjusting for confounding/mediating variables, sex was not associated with 30-day survival after OHCA. Our findings suggest that initial cardiac rhythm and location of the arrest are potential mediators of higher 30-day OHCA survival in males than females. Improving proportions of females who present with initial shockable rhythm may reduce sex differences in survival after OHCA.
Chromosome-level genome assembly of the sacoglossan sea slug Elysia timida (Risso, 1818)
Authors: Männer Lisa , Schell Tilman , Spies Julia , Galià-Camps Carles , Baranski Damian , Ben Hamadou Alexander , Gerheim Charlotte , Neveling Kornelia , Helfrich Eric J. N. , Greve Carola
Published: October 2024

Background

Sequencing and annotating genomes of non-model organisms helps to understand genome architecture, the genetic processes underlying species traits, and how these genes have evolved in closely-related taxa, among many other biological processes. However, many metazoan groups, such as the extremely diverse molluscs, are still underrepresented in the number of sequenced and annotated genomes. Although sequencing techniques have recently improved in quality and quantity, molluscs are still neglected due to difficulties in applying standardized protocols for obtaining genomic data.

Results

In this study, we present the chromosome-level genome assembly and annotation of the sacoglossan sea slug species Elysia timida, known for its ability to store the chloroplasts of its food algae. In particular, by optimizing the long-read and chromosome conformation capture library preparations, the genome assembly was performed using PacBio HiFi and Arima HiC data. The scaffold and contig N50s, at 41.8 Mb and 1.92 Mb, respectively, are approximately 30-fold and fourfold higher compared to other published sacoglossan genome assemblies. Structural annotation resulted in 19,904 protein-coding genes, which are more contiguous and complete compared to publicly available annotations of Sacoglossa with respect to metazoan BUSCOs. We found no evidence for horizontal gene transfer (HGT), i.e. no photosynthetic genes encoded in the sacoglossan nucleus genome. However, we detected genes encoding polyketide synthases in E. timida, indicating that polypropionates are produced. HPLC–MS/MS analysis confirmed the presence of a large number of polypropionates, including known and yet uncharacterised compounds.

Conclusions

We can show that our methodological approach helps to obtain a high-quality genome assembly even for a "difficult-to-sequence" organism, which may facilitate genome sequencing in molluscs. This will enable a better understanding of complex biological processes in molluscs, such as functional kleptoplasty in Sacoglossa, by significantly improving the quality of genome assemblies and annotations.
Characteristics of gene expression in epicardial adipose tissue and subcutaneous adipose tissue in patients at risk for heart failure undergoing coronary artery bypass grafting
Authors: Frisk Christoffer , Ekström Mattias , Eriksson Maria J , Corbascio Matthias , Hage Camilla , Persson Hans , Linde Cecilia , Persson Bengt
Published: October 2024

Background

Epicardial adipose tissue (EAT) surrounds the heart and is hypothesised to play a role in the development of heart failure (HF). In this study, we first investigated the differences in gene expression between epicardial adipose tissue (EAT) and subcutaneous adipose tissue (SAT) in patients undergoing elective coronary artery bypass graft (CABG) surgery (n = 21; 95% male). Secondly, we examined the association between EAT and SAT in patients at risk for HF stage A (n = 12) and in pre-HF patients, who show signs but not symptoms of HF, stage B (n = 9).

Results

The study confirmed a distinct separation between EAT and SAT. In EAT 17 clusters of genes were present, of which several novel gene modules are associated with characteristics of HF. Notably, seven gene modules showed significant correlation to measures of HF, such as end diastolic left ventricular posterior wall thickness, e’mean, deceleration time and BMI. One module was particularly distinct in EAT when compared to SAT, featuring key genes such as FLT4, SEMA3A, and PTX3, which are implicated in angiogenesis, inflammation regulation, and tissue repair, suggesting a unique role in EAT linked to left ventricular dysfunction. Genetic expression was compared in EAT across all pre-HF and normal phenotypes, revealing small genetic changes in the form of 18 differentially expressed genes in ACC/AHA Stage A vs. Stage B.

Conclusions

The roles of subcutaneous and epicardial fat are clearly different. We highlight the gene expression difference in search of potential modifiers of HF progress. The true implications of our findings should be corroborated in other studies since HF ACC/AHA stage B patients are common and carry a considerable risk for progression to symptomatic HF.
Animal and plant protein intake association with mental health, tryptophan metabolites pathways, and gut microbiota in healthy women: a cross-sectional study
Authors: Soveid Neda , Barkhidarian Bahareh , Samadi Mahsa , Hatami Mahsa , Gholami Fatemeh , Yekaninejad Mir Saeid , Saedisomeolia Ahmad , Karbasian Maryam , Siadat Seyed Davar , Mirzaei Khadijeh
Published: October 2024

Mental health is affected by tryptophane (TRP) metabolism regulation. Diet-influenced gut microbiome regulates TRP metabolism. Thus, the present study aimed to explore the relationship between type of dietary protein intake, gut microbiota, TRP metabolites homeostasis, and mental well-being in healthy women. 91 healthy females aged 18–50 were recruited based on the study protocol. Validate and reliable questionnaires assessed dietary intake and mental health. Biochemical tests and gut microbiota composition were analyzed following the manufacturer’s instructions for each enzyme-linked immune sorbent assay (ELISA) kit and Real-time quantitative polymerase chain reaction (qPCR) methods respectively. Regression methods were used to estimate the considered associations. The results show that in the fully adjusted model, plant protein consumption was partially inversely associated with depression risk (OR = 0.27; 95% CI: 0.06, 1.09; P = 0.06). Higher dietary animal protein intake was marginally associated with psychological distress (OR = 2.59; 95% CI: 0.91, 7.34; P = 0.07). KYN to serotonin ratio was inversely associated with animal protein consumption (ß = 1.10; 95% CI: -0.13, 2.33; P = 0.07). Firmicutes/Bacteriodetes ratio (β = -1.27 × 103, SE = 5.99 × 102, P = 0.03) was lower in the top tertile of plant protein. A partially negative correlation was found between dietary animal protein and Prevotella abundance (β = -9.20 × 1018, SE = 5.04 × 1018, P = 0.06). Overall, significant inverse associations were found between a diet high in plant protein with mental disorders, KYN levels, and Firmicutes to Bacteroidetes ratio while adhering to higher animal protein could predispose women to psychological stress.
Nucleated red blood cell distribution in critically ill patients with acute pancreatitis: a retrospective cohort study
Authors: Liu Huan-qin , Wang Guan-qun , Zhang Cheng-shuang , Wang Xia , Shi Ji-kui , Qu Feng , Ruan Hang
Published: October 2024

Objectives

This study examined the potential association between nucleated red blood cell (NRBC) levels and mortality in critically ill patients with acute pancreatitis (AP) in the intensive care unit, due to limited existing research on this correlation.

Methods

This retrospective cohort study utilized data from the MIMIC-IV v2.0 and MIMIC-III v1.4 databases to investigate the potential relationship between NRBC levels and patient outcomes. The study employed restricted cubic splines (RCS) regression analysis to explore non-linear associations. The impact of NRBC on prognosis was assessed using a generalized linear model (GLM) with a logit link, adjusted for potential confounders. Furthermore, four machine learning models, including Gradient Boosting Classifier (GBC), Random Forest, Gaussian Naive Bayes, and Decision Tree Classifier model, were constructed using NRBC data to generate risk scores and evaluate the potential of NRBC in predicting patient prognosis.

Results

A total of 354 patients were enrolled in the study, with 162 (45.8%) individuals aged 60 years or older and 204 (57.6%) males. RCS regression analysis demonstrated a non-linear relationship between NRBC levels and 90-day mortality. Receiver Operating Characteristic (ROC) analysis identified a 1.7% NRBC cutoff to distinguish survivor from non-survivor patients for 90-day mortality, yielding an Area Under the Curve (AUC) of 0.599, with a sensitivity of 0.475 and specificity of 0.711. Elevated NRBC levels were associated with increased risks of 90-day mortality in both unadjusted and adjusted models (all Odds Ratios > 1, P < 0.05). Assessment of various machine learning models with nine variables, including NRBC, Sex, Age, Simplified Acute Physiology Score II, Acute Physiology Score III, Congestive Heart Failure, Vasopressin, Norepinephrine, and Mean Arterial Pressure, indicated that the GBC model displayed the highest predictive accuracy for 90-day mortality, with an AUC of 0.982 (95% CI 0.970–0.994). Post hoc power analysis showed a statistical power of 0.880 in the study.

Conclusions

Elevated levels of NRBC are linked to an increased mortality risk in critically ill patients with AP, suggesting its potential for predicting mortality.
Role of interferon-gamma release assay for screening and monitoring of latent tuberculosis infection in kidney transplant recipients
Authors: Bruminhent Jackrapong , Treekajonsak Tanadon , Kantachuvesiri Surasak , Setthaudom Chavachol , Sukkasem Warawut , Kawamatawong Theerasuk
Published: October 2024

Background

The reactivation of tuberculosis (TB) among kidney transplant (KT) recipients in an endemic area is of general concern. However, the epidemiology of latent TB infection (LTBI) status and its dynamic change responses have not been explored.

Methods

Between September 2020 and August 2021, a prospective study was conducted to investigate the status of LTBI in KT recipients who received a 9-month isoniazid universal prophylaxis. This status was measured using the interferon-gamma release assay (IGRA) with T-SPOT.TB before transplant, as well as at one month and nine months post-transplant.

Results

Ninety-one KT recipients had a mean (SD) age of 45 (11) years, and 41% were female. Sixty-eight (75%) patients received a deceased donor allograft, and eighty-six (91%) patients received induction immunosuppressive therapy. The IGRA results were positive, borderline, negative, and indeterminate in 14 (15.4%), 6 (6.6%), 64 (70.3%), and 7 (7.8%) patients, respectively. Among 84 evaluable patients, 20 (23.8%) KT recipients were defined as having LTBI. Older age was significantly associated with LTBI (OR 1.06 [95% CI 1.01–1.12], p = 0.03). Among the 77 KT recipients who completed monitoring, 55 had negative IGRA results. Three (5.4%) KT recipients had conversion post-transplant. One of them developed pulmonary TB at 1 week after the transplant. Among the 13 patients with positive results, 8 (61.5%) remained positive, 1 (7.7%) had an indeterminate result at 1-month post-transplant and subsequently tested positive at 9 months post-transplant, and 4 (30.8%) experienced reversion to negative results throughout the study.

Conclusions

In a high TB-endemic area, one-quarter of KT recipients were reported to have LTBI, and the dynamic change of IGRA response in KT recipients is plausible post-transplant.
Localized Pneumocystis jirovecii pneumonia in a malnourished, non-HIV-infected man in the absence of any established or diagnosed immunosuppressive condition: a case report
Authors: Fallahi Mohammad Javad , Kouhi Pariya , Sadrzadeh Seyed Amir , Shokripour Mansoureh , Hosseinzadeh Massood
Published: October 2024

Background

Pneumocystis jirovecii infection is an opportunistic infection that mostly affects patients with immunosuppressive conditions like human immunodeficiency virus (HIV) infection or medications, like corticosteroids. This study reports a rare case of Pneumocystis Jiroveci infection in a relatively immunocompetent patient which presented with uncommon radiological findings.

Case presentation

A 46-year-old man with a malnourished appearance and a history of opium dependence presented with dry cough, dyspnea, and weight loss to the hospital. There was no evidence of an immunocompromised condition or use of any immunosuppressive medication in the history of the patient. A lung high-resolution computed tomography (HRCT) scan revealed a crazy-paving appearance and localized infiltration. Methenamine silver staining and the histopathological findings in the transbronchial lung biopsy confirmed the diagnosis of PJP. Antibiotics and bronchodilators were administrated and the patient was discharged after 6 days of hospitalization. HIV testing and immunoglobulin levels were normal in the hospital course as well as his follow-up visits. After a 2-month follow-up, the patient was in good condition despite of mild remaining infiltration in his lung.

Conclusions

PJP typically affects HIV-infected patients, but due to excessive use of immunosuppressive medications, its prevalence is increasing in non-HIV-infected patients. Malnutrition may predispose the patients to PJP, even in the absence of immunosuppressive conditions.
Evaluation of preoperative antibiotic prophylaxis in clean-wound general surgery procedures: a propensity score-matched cohort study at a regional hospital
Authors: Charernsuk Mai , Tunruttanakul Suppadech , Jamjumrat Leenawat , Chareonsil Borirak
Published: October 2024

Background

The administration of antibiotic prophylaxis for clean-wound surgeries is controversial among surgeons, despite guidelines suggesting its use. This study aimed to evaluate its effectiveness in preventing surgical site infections (SSIs) in clean-wound surgeries within a regional setting with varied practices regarding prophylaxis.

Materials and methods

This retrospective cohort study included four types of common general surgeries performed from March 2021 to February 2023 at a tertiary regional hospital in Thailand. The surgeries included skin/subcutaneous excision, thyroidectomy, inguinal hernia repair, and breast surgeries, all of which required regional or general anesthesia. Antibiotic prophylaxis was administered at the discretion of the attending surgeons. SSI diagnosis followed standard diagnostic criteria, involving reviewing medical records and the records of the infection control unit. Infection risk factors were examined. The primary outcome comparison used inverse probability treatment weighting of propensity scores, with covariate balance evaluated.

Results

Of the 501 surgeries identified, 84 were excluded, leaving 417 eligible for analysis. Among these patients, 233 received prophylactic antibiotics, for an SSI rate of 1.3%, while 184 did not receive antibiotics, for an SSI rate of 2.2%. A comparative analysis using propensity score weighting revealed no statistically significant difference in the incidence of SSI between the groups (risk ratio [95% confidence interval]: 0.54 (0.11, 2.50), p = 0.427).

Conclusion

In this practical setting, with the given study size, antibiotic prophylaxis in common general surgeries involving clean wounds did not significantly prevent SSIs. Routine use recommendations should be re-evaluated.

Trial registration

Not applicable as this study is a retrospective cohort study and not a clinical trial.
Is double-J stent mandatory in complete supine percutaneous nephrolithotomy for adult patients with staghorn renal stones?
Authors: Falahatkar Siavash , Esmaeili Samaneh , Kazemi Samira , Sheikhi Fatemeh , Norouzi Hosna
Published: October 2024

Background

It is controversial whether double-J (DJ) stent insertion is necessary in tubeless percutaneous nephrolithotomy (PCNL) for patients with staghorn stones. We compared the outcomes of using ureteral catheters and double-J stents in tubeless complete supine PCNL (csPCNL) of staghorn stones.

Methods

In this analytical cross-sectional study, from May 2008 to August 2022, 123 patients who underwent tubeless csPCNL were assessed. Patients were divided into two groups by either tubeless csPCNL with DJ stent (Group I; n = 23) or totally tubeless just with perioperative ureteral stent (Group II; n = 100). Demographic characteristics, stone-related factors, perioperative and postoperative parameters were compared in groups.

Results

Baseline characteristics were comparable in groups. The operative time in group I was significantly longer than group II (68.26 vs. 55.25 min, P = 0.05). However, the duration of hospitalization in Group I was shorter than the other group (1.81 vs. 2.37 days, P = 0.03). Stone free rate was notably higher in Group I (90.5% vs. 79.8.0%) with no statistically significant difference. No significant differences were found in major complications. Patients in Group II had a significantly shorter time to return to normal life (6.48 vs. 7.91 day; P = 0.043). Multivariable linear regression showed the preoperative creatinine level and stone size can affect the operative time (P = 0.02). In addition, stone number and underlying disease can affect the length of hospital stay (P = 0.007 & 0.030, respectively).

Conclusion

Although not inserting a double J stent after csPCNL has acceptable results, because of higher residual rate in staghorn stone which cause more incidence of renal colic, longer time of hospital stay and return to normal life, inserting DJ stent is recommended.