bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantifying azimuthal variations within the interstellar medium of z ~ 0 spiral galaxies with the TYPHOON survey
Authors: Chen Qian-Hui , Grasha Kathryn , Battisti Andrew J , Wisnioski Emily , Li Zefeng , Park Hye-Jin , Groves Brent , Torrey Paul , Mendel Trevor , Madore Barry F , Seibert Mark , Sextl Eva , Garcia Alex M , Rich Jeff A , Beaton Rachael L , Kewley Lisa J
Published: September 2024

Most star formation in the local Universe occurs in spiral galaxies, but their origin remains an unanswered question. Various theories have been proposed to explain the development of spiral arms, each predicting different spatial distributions of the interstellar medium. This study maps the star formation rate (SFR) and gas-phase metallicity of nine spiral galaxies with the TYPHOON survey to test two dominating theories: density wave theory and dynamic spiral theory. We discuss the environmental effects on our galaxies, considering reported environments and merging events. Taking advantage of the large field of view covering the entire optical disc, we quantify the fluctuation of SFR and metallicity relative to the azimuthal distance from the spiral arms. We find higher SFR and metallicity in the trailing edge of NGC 1365 (by 0.117 and 0.068 dex, respectively) and NGC 1566 (by 0.119 and 0.037 dex, respectively), which is in line with density wave theory. NGC 2442 shows a different result with higher metallicity (0.093 dex) in the leading edge, possibly attributed to an ongoing merging. The other six spiral galaxies show no statistically significant offset in SFR or metallicity, consistent with dynamic spiral theory. We also compare the behaviour of metallicity inside and outside the corotation radius (CR) of NGC 1365 and NGC 1566. We find comparable metallicity fluctuations near and beyond the CR of NGC 1365, indicating gravitational perturbation. NGC 1566 shows the greatest fluctuation near the CR, in line with the analytic spiral arms. Our work highlights that a combination of mechanisms explains the origin of spiral features in the local Universe.
Mechanism of BCDX2-mediated RAD51 nucleation on short ssDNA stretches and fork DNA
Authors: Akita Masaki , Girvan Paul , Spirek Mario , Novacek Jiri , Rueda David , Prokop Zbynek , Krejci Lumir
Published: September 2024

Homologous recombination (HR) factors are crucial for DSB repair and processing stalled replication forks. RAD51 paralogs, including RAD51B, RAD51C, RAD51D, XRCC2 and XRCC3, have emerged as essential tumour suppressors, forming two subcomplexes, BCDX2 and CX3. Mutations in these genes are associated with cancer susceptibility and Fanconi anaemia, yet their biochemical activities remain unclear. This study reveals a linear arrangement of BCDX2 subunits compared to the RAD51 ring. BCDX2 shows a strong affinity towards single-stranded DNA (ssDNA) via unique binding mechanism compared to RAD51, and a contribution of DX2 subunits in binding branched DNA substrates. We demonstrate that BCDX2 facilitates RAD51 loading on ssDNA by suppressing the cooperative requirement of RAD51 binding to DNA and stabilizing the filament. Notably, BCDX2 also promotes RAD51 loading on short ssDNA and reversed replication fork substrates. Moreover, while mutants defective in ssDNA binding retain the ability to bind branched DNA substrates, they still facilitate RAD51 loading onto reversed replication forks. Our study provides mechanistic insights into how the BCDX2 complex stimulates the formation of BRCA2-independent RAD51 filaments on short stretches of ssDNA present at ssDNA gaps or stalled replication forks, highlighting its role in genome maintenance and DNA repair.
Central nervous system tumors in adolescents and young adults: A Society for Neuro-Oncology Consensus Review on diagnosis, management, and future directions
Authors: Lim-Fat Mary Jane , Bennett Julie , Ostrom Quinn , Touat Mehdi , Franceschi Enrico , Schulte Jessica , Bindra Ranjit S , Fangusaro Jason , Dhall Girish , Nicholson James , Jackson Sadhana , Davidson Tom Belle , Calaminus Gabriele , Robinson Giles , Whittle James R , Hau Peter , Ramaswamy Vijay , Pajtler Kristian W , Rudà Roberta , Foreman Nicholas K , Hervey-Jumper Shawn L , Das Sunit , Dirks Peter , Bi Wenya Linda , Huang Annie , Merchant Thomas E , Fouladi Maryam , Aldape Kenneth , Van den Bent Martin J , Packer Roger J , Miller Julie J , Reardon David A , Chang Susan M , Haas-Kogan Daphne , Tabori Uri , Hawkins Cynthia , Monje Michelle , Wen Patrick Y , Bouffet Eric , Yeo Kee Kiat
Published: September 2024

Adolescents and young adults (AYAs; ages 15–39 years) are a vulnerable population facing challenges in oncological care, including access to specialized care, transition of care, unique tumor biology, and poor representation in clinical trials. Brain tumors are the second most common tumor type in AYA, with malignant brain tumors being the most common cause of cancer-related death. The 2021 WHO Classification for central nervous system (CNS) Tumors highlights the importance of integrated molecular characterization with histologic diagnosis in several tumors relevant to the AYA population. In this position paper from the Society for Neuro-Oncology (SNO), the diagnosis and management of CNS tumors in AYA is reviewed, focusing on the most common tumor types in this population, namely glioma, medulloblastoma, ependymoma, and CNS germ cell tumor. Current challenges and future directions specific to AYA are also highlighted. Finally, possible solutions to address barriers in the care of AYA patients are discussed, emphasizing the need for multidisciplinary and collaborative approaches that span the pediatric and adult paradigms of care, and incorporating advanced molecular testing, targeted therapy, and AYA-centered care.
Electron spins from a molecular perspective: an interview with Song Gao
Authors: Jiang Shang-Da , Zhu He
Published: September 2024

Spin chemistry has emerged as an interdisciplinary field that focuses on electron spins in molecules and related applications in physics, chemistry, biology, materials science and information science. It will play a crucial role in technological innovations. The chemistry of spins is deeply related to the essence of chemical bonds, chemical catalysis, enzyme catalysis, optical and electromagnetic properties, quantum computation and quantum precision measurements. The related research is intersectional, cutting-edge and has a wide range of application prospects.

National Science Review (NSR) recently interviewed Prof. Song Gao to discuss spin chemistry. Prof. Gao is a renowned inorganic chemist and an academician of Chinese Academy of Sciences. He is the president of Sun Yat-sen University and the founder of the Spin-X Institute of South China University of Technology. He is recognized as a leader in coordination chemistry and molecular magnetism, and has strong academic influence. Since 2008, he has served on the International Advisory Committee of International Conference on Molecule-Based Magnets, and organized and chaired its 2010 conference. Prof. Gao's primary research topics include molecular nanomagnets; the relationship between geometric structures, electronic structures and magnetism of molecules; and the spin states and reactivity of molecules.
Determinant of 30-Day Mortality of Pulmonary Legionellosis: Do Coinfections Matter?
Authors: Matsuo Takahiro , Wurster Sebastian , Jiang Ying , Tarrand Jeffrey , Evans Scott E , Kontoyiannis Dimitrios P
Published: September 2024

We retrospectively reviewed 64 cases of cancer with pulmonary legionellosis (Legionella pneumophila in 73%). Nearly all patients received Legionella-active antibiotics, yet 30-day mortality was 23%. Independent predictors of 30-day mortality were hyponatremia, bilateral lung involvement, and Sequential Organ Failure Assessment score ≥5. Lung coinfections were common (31%) but did not significantly increase mortality.
Unmasking bowel obstruction in a Parkinson’s patient: the influence of cognitive bias in frailty medicine
Authors: Stevenson Harvey , Ramsay Daniele , Jerjes Waseem
Published: September 2024

Recognising emergent acute pathology in the context of established chronic conditions can be challenging and is often overlooked due to cognitive biases in the physician’s decision making. In the context of Parkinson’s disease (PD), there is a large overlap between the non-motor symptoms of PD, common gastrointestinal symptoms amongst the elderly population, and symptoms associated with acute, severe GI pathology, which can result in diagnostic overshadowing. Here, a 68-year-old man with a background of PD reported nausea, constipation, and abdominal discomfort during routine frailty review by his general practitioner (GP). The patient reported these were common symptoms which usually resolved with laxatives. Aware of the potentially sinister nature of this presentation, the GP arranged transfer to the emergency department where CT subsequently revealed a closed-loop small bowel obstruction. This case highlights how frailty medicine is particularly susceptible to cognitive biases, which are commonly cited sources of medical errors.
Engineered FHA domains can bind to a variety of Phosphothreonine-containing peptides
Authors: Thota Srinivas S , Allen Grace L , Grahn Ashley K , Kay Brian K
Published: September 2024

Antibodies play a crucial role in monitoring post-translational modifications, like phosphorylation, which regulates protein activity and location; however, commercial polyclonal and monoclonal antibodies have limitations in renewability and engineering compared to recombinant affinity reagents. A scaffold based on the Forkhead-associated domain (FHA) has potential as a selective affinity reagent for this post-translational modification. Engineered FHA domains, termed phosphothreonine-binding domains (pTBDs), with limited cross-reactivity were isolated from an M13 bacteriophage display library by affinity selection with phosphopeptides corresponding to human mTOR, Chk2, 53BP1, and Akt1 proteins. To determine the specificity of the representative pTBDs, we focused on binders to the pT543 phosphopeptide (536-IDEDGENpTQIEDTEP-551) of the DNA repair protein 53BP1. ELISA and western blot experiments have demonstrated the pTBDs are specific to phosphothreonine, demonstrating the potential utility of pTBDs for monitoring the phosphorylation of specific threonine residues in clinically relevant human proteins.
Are Bankruptcy Professional Fees Excessively High?
Authors: Antill Samuel
Published: September 2024

Chapter 7 is the most popular bankruptcy system for U.S. firms and individuals. Chapter 7 professional fees are substantial. Theoretically, high fees might be an unavoidable cost of incentivizing professionals. I test this empirically. I study trustees, the most important professionals in chapter 7, who liquidate assets in exchange for legally mandated commissions. Exploiting kinks in the commission function, I estimate a structural model of moral hazard by trustees. I show that a policy change lowering trustee fees would harm trustee incentives, reducing liquidation values. Nonetheless, such a policy would dramatically improve creditor recovery, increasing small-business-lender recovery by 15.7%.
Incidence and risk of arterial and venous thrombotic events in Systemic Lupus Erythematosus patients: a population-based study
Authors: Ojeda-Fernandez Luisa , Calvisi Stefania , Torrigiani Ginevra , Tettamanti Mauro , Fortino Ida , Roncaglioni Carla , Baviera Marta
Published: September 2024

Objectives

Current data on arterial and venous thrombotic events (ATE & VTE) and cardiovascular (CV) risk management in European systemic lupus erythematosus (SLE) population are limited. This study aimed to investigate the incidence and risk of thrombotic events and all-cause death in an Italian SLE cohort over the past decade, along with its pharmacotherapy.

Methods

Incident SLE cases between 2010 and 2019 were identified using administrative health databases of the Lombardy Region. The association between SLE and outcomes, compared with age- and sex-matched controls, was reported as incidence rate per 1000 person-years and as adjusted hazard ratios with 95% confidence intervals.

Results

Overall, 2133 SLE patients and 21 283 no-SLE individuals were included. A higher incidence rate of ATE (4.22 vs 2.26 1000 PY), VTE (1.85 vs 0.67 1000 PY,) and all-cause death (15.18 vs 6.22 1000 PY) was reported in SLE patients than in those without (p< 0.0001) as well as an increased risk of ATE (HR, 1.65; 95% CI, 1.20–2.26), VTE (HR, 2.25; 95% CI, 1.35–3.74), and all-cause death (HR, 1.81; 95% CI, 1.52–2.15). After SLE diagnoses, hydroxychloroquine and glucocorticoids were prescribed for at least 60% of patients. Additionally, a higher exposure to cardiovascular medications was also seen in SLE patients.

Conclusion

Our findings confirmed higher risks of ATE, VTE and all-cause death in SLE patients. While increased CV medications use after SLE diagnoses suggests heightened awareness to CV risk profile, more attention is required to balance SLE disease activity with minimizing exposure to drugs associated with exacerbating CV risk.
International Commodity Prices Transmission to Consumer Prices in Africa
Authors: Lemaire Thibault , Vertier Paul
Published: September 2024

In this paper, global commodity prices pass-through to consumer prices are estimated in Africa. The estimation sample includes monthly data for 48 countries over the period 2002m02–2021m04. Sixteen commodity prices are considered separately, rather than aggregate indices that use weights unrepresentative of consumption in Africa. Using local projections in a panel data set, the maximum estimated pass-through is of 23 percent, and the long-run pass-through is of about 20 percent, higher than usually found in the literature. Country-specific regressions are also considered: in the latter, the estimated pass-through is lower for countries with a higher GDP per capita, a lower share of food and energy in the consumption basket, a better quality of transport infrastructure, and a higher openness to trade. Finally, commodity-specific pass-throughs are correlated with the share of corresponding goods in the consumer basket and with the import dependency ratio for this commodity.
The angiotensin‐(1‐7)/MasR axis improves pneumonia caused by Pseudomonas aeruginosa: Extending the therapeutic window for antibiotic therapy
Authors: Zaidan Isabella , Carvalho Antônio Felipe Silva , Grossi Laís C. , Souza Jéssica A. M. , Lara Edvaldo S. , Montuori‐Andrade Ana Clara M. , Cardoso Camila , Carneiro Fernanda S. , Lima Erick Bryan de Sousa , Monteiro Adelson Héric Alves , Augusto Isabella de Lacerda , Caixeta Rodrigo Severo , Igídio Carlos Eduardo Dias , de Brito Camila B. , de Oliveira Leonardo Camilo , Queiroz‐Junior Celso Martins , Russo Remo C. , Campagnole‐Santos Maria José , Santos Robson A. S. , Costa Vivian V. , de Souza Daniele da Glória , Fagundes Caio T. , Teixeira Mauro M. , Tavares Luciana P. , Sousa Lirlândia P.
Published: September 2024

Pseudomonas aeruginosa is a frequent cause of antimicrobial‐resistant hospital‐acquired pneumonia, especially in critically ill patients. Inflammation triggered by P. aeruginosa infection is necessary for bacterial clearance but must be spatially and temporally regulated to prevent further tissue damage and bacterial dissemination. Emerging data have shed light on the pro‐resolving actions of angiotensin‐(1‐7) [Ang‐(1‐7)] signaling through the G protein‐coupled receptor Mas (MasR) during infections. Herein, we investigated the role of the Ang‐(1‐7)/Mas axis in pneumonia caused by P. aeruginosa by using genetic and pharmacological approach and found that Mas receptor‐deficient animals developed a more severe form of pneumonia showing higher neutrophilic infiltration into the airways, bacterial load, cytokines, and chemokines production and more severe pulmonary damage. Conversely, treatment of pseudomonas‐infected mice with Ang‐(1‐7) was able to decrease neutrophilic infiltration in airways and lungs, local and systemic levels of pro‐inflammatory cytokines and chemokines, and increase the efferocytosis rates, mitigating lung damage/dysfunction caused by infection. Notably, the therapeutic association of Ang‐(1‐7) with antibiotics improved the survival rates of mice subjected to lethal inoculum of P. aeruginosa, extending the therapeutic window for imipenem. Mechanistically, Ang‐(1‐7) increased phagocytosis of bacteria by neutrophils and macrophages to accelerate pathogen clearance. Altogether, harnessing the Ang‐(1‐7) pathway during infection is a potential strategy for the development of host‐directed therapies to promote mechanisms of resistance and resilience to pneumonia.
eHealth in pediatric respiratory allergy
Authors: Pais-Cunha Inês , Jácome Cristina , Vieira Rafael , Sousa Pinto Bernardo , Almeida Fonseca João
Published: September 2024

Purpose of review

This review explores the relevance of eHealth technologies to address unmet needs in pediatric respiratory allergies, particularly allergic rhinitis (AR) and asthma. Given the increasing burden of these conditions, there is a pressing need for effective solutions to enhance disease surveillance, diagnosis, and management.

Recent findings

Recent literature highlights the potential of eHealth tools to transform pediatric respiratory allergy care. The use of digital data for infodemiology, application of machine learning models to improve diagnostic sensitivity, smartphone apps with digital patient reported outcome measure (PROMs) and embedded sensors to monitor disease, healthcare professional dashboards with real-time data monitoring and clinical decision support systems (CDSS) are advances emerging to optimize pediatric respiratory allergy care.

Integrating eHealth technologies into the pediatric respiratory allergy care pathway is a potential solution for current healthcare challenges to better meet the needs of children with AR and asthma. However, while the potential of eHealth is evident, its widespread implementation in real-world practice requires continued research, collaboration, and efforts to overcome existing barriers.
Allergen immunotherapy and eosinophilic esophagitis: friends or foes?
Authors: Pitsios Constantinos , Rossi Carlo Maria
Published: September 2024

Purpose of review

The connection between eosinophilic esophagitis (EoE) and food and airborne allergens is complex. Exposure to allergens (mainly food) is often the trigger for EoE flares. The development of EoE has been described as a side effect of allergen immunotherapy, especially oral immunotherapy (OIT, with food allergens), while isolated cases of EoE have been reported during sublingual immunotherapy (SLIT, with extracts of aeroallergens).

Recent findings

EoE is currently recognized as a common side effect of OIT, while a solid correlation between SLIT and EoE is missing. Animal models have been developed to study the pathophysiological link between sensitization to aeroallergens and the induction of EoE and will probably provide an interpretation of why there are cases of EoE developed during SLIT. Recent findings in animal models suggest a genetic connection to EoE development after sensitization and re-exposure to airborne allergens. Subcutaneous allergen immunotherapy does not have a causative effect on EoE; on the contrary, a beneficial effect on EoE has been reported. Moreover, epicutaneous immunotherapy with a vector containing milk has also been used to treat children with milk-induced EoE.

Discovering the immune links between allergens and EoE will further guide the proper use of allergen immunotherapy and help define future strategies for the management of EoE.
Umbilical Line Securement Bundle to Reduce Line Loss in the Neonate
Authors: Lepp Kirsten M. , Carter Brigit M. , Bain Lisa C. , Antonini Rachael E.
Published: September 2024

Background:

Umbilical line migration not only increases the risks of complications but also results in malposition and, ultimately, loss of the umbilical line.

Purpose:

To evaluate the use of an umbilical line securement bundle to reduce unintended line discontinuation after line adjustment in the neonate at a single 40-bed Level IV neonatal intensive care unit.

Methods:

A pre-post design of 75 neonates, preimplementation (n = 50) and postimplementation (n = 25), was analyzed using data collection from the electronic health record.

Results:

There was a 37.5% absolute reduction in removal of the umbilical line due to malposition after line adjustment utilizing the umbilical line bundle, standardizing the adjustment order, nursing process, and follow-up x-ray evaluation. This absolute reduction has clinical significance although not statistically significant. Provider compliance rates with line adjustment order bundle were 75%, decreasing with additional adjustments (50%). Nursing staff reported comfort with umbilical line management, ranging from 63% to 87% on different tasks.

Implications for Practice:

The use of umbilical line bundles reduces rates of line discontinuation due to malposition. The adoption of umbilical line bundles in neonatal intensive care unit practice may help to prevent unintended line discontinuation.

Implications for Research:

There is a need for continued research regarding the use of secondary securement devices for decreased rate of malposition and the timing and methods for surveillance of umbilical line position.
Utility of Skin Tone on Pulse Oximetry in Critically Ill Patients: A Prospective Cohort Study
Authors: Hao Sicheng , Dempsey Katelyn , Matos João , Cox Christopher E. , Rotemberg Veronica , Gichoya Judy W. , Kibbe Warren , Hong Chuan , Wong An-Kwok Ian
Published: September 2024

OBJECTIVE:

Pulse oximetry, a ubiquitous vital sign in modern medicine, has inequitable accuracy that disproportionately affects minority Black and Hispanic patients, with associated increases in mortality, organ dysfunction, and oxygen therapy. Previous retrospective studies used self-reported race or ethnicity as a surrogate for skin tone which is believed to be the root cause of the disparity. Our objective was to determine the utility of skin tone in explaining pulse oximetry discrepancies.

DESIGN:

Prospective cohort study.

SETTING:

Patients were eligible if they had pulse oximetry recorded up to 5 minutes before arterial blood gas (ABG) measurements. Skin tone was measured using administered visual scales, reflectance colorimetry, and reflectance spectrophotometry.

PARTICIPANTS:

Admitted hospital patients at Duke University Hospital.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Sao
2–Spo
2 bias, variation of bias, and accuracy root mean square, comparing pulse oximetry, and ABG measurements. Linear mixed-effects models were fitted to estimate Sao
2–Spo
2 bias while accounting for clinical confounders.

One hundred twenty-eight patients (57 Black, 56 White) with 521 ABG-pulse oximetry pairs were recruited. Skin tone data were prospectively collected using six measurement methods, generating eight measurements. The collected skin tone measurements were shown to yield differences among each other and overlap with self-reported racial groups, suggesting that skin tone could potentially provide information beyond self-reported race. Among the eight skin tone measurements in this study, and compared with self-reported race, the Monk Scale had the best relationship with differences in pulse oximetry bias (point estimate: –2.40%; 95% CI, –4.32% to –0.48%; p = 0.01) when comparing patients with lighter and dark skin tones.

CONCLUSIONS:

We found clinical performance differences in pulse oximetry, especially in darker skin tones. Additional studies are needed to determine the relative contributions of skin tone measures and other potential factors on pulse oximetry discrepancies.
PDE8 Inhibition and Its Impact on I Ca,L in Persistent Atrial Fibrillation: Evaluation of PDE8 as a Potential Drug Target
Authors: Ismaili Djemail , Petersen Johannes , Schulz Carl , Eschenhagen Thomas , Koivumäki Jussi T. , Christ Torsten
Published: September 2024

Atrial fibrillation (AF) poses a significant therapeutic challenge with drug interventions showing only limited success. Phosphodiesterases (PDE) regulate cardiac electrical stability and may represent an interesting target. Recently, PDE8 inhibition was proposed as an antiarrhythmic intervention by increasing L-type Ca2+ current (ICa,L) and action potential duration (APD). However, the effect size of PDE8 inhibition on ICa,L and APD seems discrepant and effects on force are unknown. We investigated the impact of PDE8 inhibition on force using PF-04957325 in right atrial appendages, obtained from patients in sinus rhythm (SR) and with persistent AF (peAF) undergoing cardiac surgery. A computational model was used to predict the effects of PDE8 inhibition on APD in SR and peAF. Results showed no increase in force after exposure to increasing concentrations of the PDE8 inhibitor PF-04957325 in either SR or peAF tissues. Furthermore, PDE8 inhibition did not affect the potency or efficacy of norepinephrine-induced inotropic effects in either group. Arrhythmic events triggered by norepinephrine were observed in both SR and peAF, but their frequency remained unaffected by PF-04957325 treatment. Computational modeling predicted that the reported increase in ICa,L induced by PDE8 inhibition would lead to substantial APD prolongation at all repolarization states, particularly in peAF. Our findings indicate that PDE8 inhibition does not significantly impact force or arrhythmogenicity in human atrial tissue.
Disparity landscapes of viral-induced structural variations in HCC: Mechanistic characterization and functional implications
Authors: Lyu Xueying , Sze Karen Man-Fong , Lee Joyce Man-Fong , Husain Abdullah , Tian Lu , Imbeaud Sandrine , Zucman-Rossi Jessica , Ng Irene Oi-Lin , Ho Daniel Wai-Hung
Published: September 2024

Background and Aims:

HCC is the most common type of primary liver cancer and is a common malignancy worldwide. About half of all new liver cancers worldwide each year occur in China, including Hong Kong, due to a high prevalence of HBV infection. HBV DNA integrates into the human genome, disrupting the endogenous tumor suppressors/regulatory genes or enhancing the activity of proto-oncogenes. It would be useful to examine the different NGS-based databases to provide a more unbiased and comprehensive survey of HBV integration.

Approach and Results:

We aimed to take advantage of publicly available data sets of different regional cohorts to determine the disparity landscapes of integration events among sample cohorts, tissue types, chromosomal positions, individual host, and viral genes, as well as genic locations. By comparing HCC tumors with non tumorous livers, the landscape of HBV integration was delineated in gene-independent and gene-dependent manners. Moreover, we performed mechanistic investigations on how HBV-TERT integration led to TERT activation and derived a score to predict patients’ prognostication according to their clonal disparity landscape of HBV integration.

Conclusions:

Our study uncovered the different levels of clonal enrichment of HBV integration and identified mechanistic insights and prognostic biomarkers. This strengthens our understanding of HBV-associated hepatocarcinogenesis.
INTDOSKIT: An R-Code for Calculation of Dose Coefficients and Studying Their Uncertainties
Authors: Breustedt Bastian , Chavan Niranjan , Makumbi Thomas
Published: September 2024

An R-code, which allows the calculation of the time dependent activity distribution based on ICRP reference models, the number of decays in a commitment period, and the dose coefficients for tissues and organs of the human body, has been developed. R Language was chosen due to its powerful mathematical and statistical modeling features, as well as its graphical capabilities. The developed set of functions and constants (called “INTDOSKIT”) can be sourced in R-scripts that define or import the models and calculations to be performed. The code has been tested on models of several radionuclides and was successfully validated against reference data taken from ICRP OIR Data Viewer software. Furthermore, the code has been tested and verified on the modeling of the radioactivity of decay chains using data of the 233Ra model presented by Höllriegl and colleagues. The results of calculations with INTDOSKIT demonstrated that the code is able to reproduce the ICRP bioassay data and dose coefficients. Deviations are a few percent only and are due mainly to rounding in the original data. Lastly, the code is able to handle uncertainty and sensitivity studies as demonstrated by the results in a pilot study of injection of 241Am, which estimated geometric standard deviations (GSD) for dose coefficients ranging between 1.25 (bone-surface) and 1.66 (testes); these results are consistent with those obtained from similar studies done by other researchers who reported GSD values ranging from 1.13 to 1.73.
The Future of Health Physics: Trends, Challenges, and Innovation
Authors: Ghimire Lekhnath , Waller Edward
Published: September 2024

This paper offers a comprehensive exploration of the future trajectory of health physics, examining influential factors in external and internal dimensions. External factors include an in-depth analysis of low-dose (10–100 mSv) measurement challenges and priorities, highlighting the transformative potential of biomarkers in solving radiation susceptibility following low-dose exposures. Cutting-edge technologies are at the forefront, with insights into emerging radiation detection tools like plastic scintillators with triple discrimination capabilities and sensors based on plastic scintillation microspheres (PSm) for estimating α and β emitting radionuclides in environmental samples. Remote detection systems using drones, robot dogs, and quantum sensors boasting heightened sensitivity and precision also are discussed. Integrating artificial intelligence (AI) and data analytics emerges as a pivotal element, promising to redefine health physics by minimizing radiation exposure risks. The exploration includes innovative materials for radiation shielding, advancements in virtual reality applications, preparation for radiological protection during armed conflicts, and the ever-evolving landscape of decommissioning health physics. Examining health effects from non-ionizing radiation and analyzing broader contextual factors such as regulatory shifts, geopolitics, and socioeconomic influences adds depth to understanding the external forces leading to the future of health physics. Internally, the paper focuses on the transformative dynamics of health physics education and training, encompassing expanded educational horizons, innovative delivery methods, targeted student outreach strategies, and insights into navigating health physics careers amid a dynamically evolving job market. The discussion unfolds further, focusing on new risk communication strategies, the collaborative potential of interdisciplinary approaches, and the significance of health physics summer schools and consortia for transformative educational paradigms. The objective of this paper is not only to unravel the multifaceted factors shaping the future of health physics but also to foster dialogue and collaboration for the unpredictable yet exciting journey ahead.
Feasibility of epidural catheter as primary anaesthesia in patients with hip fracture
Authors: Strange Gideon F. , Nielsen Christian V. , Nielsen Anne H. , Glassou Eva N. , Frandsen Christina F.
Published: September 2024

Introduction:

Danish national guidelines advocate preoperative optimization within 4 h and surgical intervention within 24 h for hip fracture patients, a goal often unmet. This study assesses the feasibility of universal epidural administration, aiming to achieve adherence to these guidelines.

Method:

Data from the Danish Interdisciplinary Registry of Hip Fractures (March–May and September–November 2022) at Gødstrup Hospital were analyzed. Patients aged 65 and above were included, with a focus on achieving 75% compliance for epidural administration as the primary surgical anesthesia. Journal audits explored patient characteristics, excluding those with epidural contraindications.

Results:

Out of 121 patients administered an epidural, 79% had it as their primary surgical anesthesia. Patient characteristics were comparable between those maintaining and altering the epidural method. Notably, 61% of epidural patients were ready for surgery within 4 h, and 91% underwent surgery within 24 h, aligning with guideline recommendations. However, adherence to the 4 h preoperative optimization guideline was incomplete.

Comparisons with alternative anesthesia approaches showed no significant differences in preoperative optimization and surgical intervention times.

Conclusion:

This study demonstrates the feasibility of a fast-track regime with a preoperative epidural catheter, with 79% adherence to the planned use of epidural as the primary surgical anesthesia. This approach allows for early optimal pain relief without delaying surgery, showcasing potential improvements in adhering to guideline recommendations, especially in achieving timely surgical interventions for hip fracture patients.
Protective Effects of Gastrodin Against Gentamicin-Induced Vestibular Damage by the Notch Signaling Pathway
Authors: Jiang Wen , Li Feifan , Xu Handong , Cao Maorong , Xiao Bin , Gong Ke , Ma Jingyu , Zhang Weiguo , Tang Xuxia , Liu Fenye , Yu Shudong
Published: September 2024

Purpose

Gentamicin is a broad-spectrum antibiotic commonly used in clinical practice. However, the drug causes side effects of ototoxicity, leading to disruption in balance functionality. This study investigated the effect of gastrodin, a prominent compound present in Gastrodia, and the underlying mechanism on the development of gentamicin-induced vestibular dysfunction.

Methods

Wild-type C57BL/6 mice were randomly assigned to three groups: control, gentamicin, and gentamicin + gastrodin groups. The extent of gentamicin-induced vestibular impairment was assessed through a series of tests including the swimming test, contact righting reflex test, and air-righting reflex. Alterations in vestibular hair cells were monitored through immunofluorescence assay, and cellular apoptosis was observed using TUNEL staining. The mRNA and protein expression of Notch1, Jagged1, and Hes1 was quantified through qRT-PCR, immunofluorescence, and western blot analyses.

Results

Gentamicin treatment led to pronounced deficits in vestibular function and otolith organ hair cells in mice. Nevertheless, pretreatment with gastrodin significantly alleviated these impairments. Additionally, the Notch signaling pathway was activated by gentamicin in the utricle, contributing to a notable increase in the expression levels of apoptosis-associated proteins. By contrast, gastrodin treatment effectively suppressed the Notch signaling pathway, thereby mitigating the occurrence of apoptosis.

Conclusion

Collectively, these findings underscore the crucial role of gastrodin in safeguarding against gentamicin-induced vestibular dysfunction through the modulation of the Notch signaling pathway. This study suggests the potential of gastrodin as a promising therapeutic agent for preventing vestibular injuries.
Performance After Cochlear Reimplantation Using a Different Manufacturer
Authors: Cottrell Justin , Spitzer Emily , Winchester Arianna , Dunn-Johnson Camille , Gantz Bruce , Rathgeb Susan , Shew Matthew , Herzog Jacques , Buchman Craig , Friedmann David , Jethanamest Daniel , McMenomey Sean , Waltzman Susan , Thomas Roland J.
Published: September 2024

Objective

To better understand cochlear implant (CI) performance after reimplantation with a different device manufacturer.

Study Design

Multisite retrospective review.

Setting

Tertiary referral centers.

Patients

Patients older than 4 years who received a CI and subsequently underwent CI reimplantation with a different manufacturer over a 20-year period

Intervention

Reimplantation.

Main Outcome Measure

The primary outcome was difference in the best CNC score obtained with the primary CI, compared with the most recent CNC score obtained after reimplantation.

Results

Twenty-nine patients met the criteria at three centers. The best average CNC score achieved by adult patients after primary cochlear implantation was 46.2% (n = 16), measured an average of 14 months (range: 3–36 mo) postoperatively. When looking at the most recent CNC score of adult patients before undergoing reimplantation, the average CNC score dropped to 19.2% (n = 17). After reimplantation, the average 3- to 6-month CNC score was 48.3% (n = 12), with most recent average CNC score being 44.4% (n = 17) measured an average of 19 months (range: 3–46 mo) postoperatively. There was no statistically significant difference (p= 0.321;t11= 0.48) identified in performance between the best CNC score achieved by adult patients after primary cochlear implantation, and the most recent score achieved after reimplantation (n = 12). Analysis of prerevision and postrevision speech performance was not possible in pediatric patients (<18 yr old) because of differences in tests administered.

Conclusion

Patients undergoing reimplantation with a different manufacturer achieved CNC score performance comparable to their best performance with their original device.
Portrayal of Sexually Transmitted Infections in Popular Films
Authors: Deaney Michael A. , McClure Kinsey M. , Jeffres Meghan N.
Published: September 2024

Background

Stigmatization of sexually transmitted infections (STIs) threatens provider-patient relationships and contributes to the underutilization of STI services. Media can shape public attitudes toward health care topics by perpetuating or reducing stigma. Given the high prevalence of STIs and the widespread consumption of media, it is essential for health care providers to be cognizant of factors influencing societal perceptions of STI symptoms, transmission, diagnosis, and treatment.

Methods

This study is a scoping review of popular films depicting STIs. Full-length English-language narrative films featuring characters with confirmed or suspected STIs were included. Descriptive statistics were used to determine the proportion of characters accurately portrayed with STI symptoms, transmission, diagnosis, and treatment.

Results

The final analysis comprised 128 characters from 77 films, with human immunodeficiency virusbeing the most frequently featured STI (42 films, 54.5%). The overall accuracy across all 4 clinical variables of symptoms, transmission, diagnosis, and treatment was 87.4%. Transmission was the most depicted clinical variable, represented in 74 characters (57.8%). All 4 clinical variables were simultaneously depicted in only 4 (3.1%) characters, with 2 characters portraying all 4 clinical variables accurately. Death occurred in 39 characters (30.5%), with human immunodeficiency virus accounting for the majority (82.1%).

Conclusions

Most films accurately portrayed STI clinical variables, including symptoms, transmission, diagnosis, and treatment. Rates of individual variable depiction were inconsistent, whereas death secondary to STIs was common. Understanding the portrayal of STIs in popular films can provide valuable insights for clinicians, enabling them to effectively address patient misconceptions and knowledge gaps.
Methods for Teaching Health Equity and Diversity, Equity Inclusion, and Accessibility to Public Health Practitioners: A Semisystematic Review of the Literature
Authors: Yassine Brianne Bostian , Graham Kaila , Sledge Sierra , Carvalho Michelle
Published: September 2024

Context:

Training developers and educators play a crucial role in building strategic skills among the public health workforce. They prepare the workforce to respond to and address emerging concerns and priorities, including on the topics of health equity and diversity, equity, inclusion, and accessibility (DEIA).

Objective:

The purpose of this semisystematic literature review was to identify current evidence-based methods that training developers and educators can apply when teaching DEIA and health equity principles to public health practitioners from various disciplines in the workforce.

Design:

We conducted a semisystematic literature review because this methodology’s purpose is to extract rich, in-depth descriptions that matched the aim to find evidence-based teaching methods to apply.

Results:

Six methods that hold promise for effective teaching health equity and DEIA principles emerged as themes: Critical Reflection, Service Learning, Case Studies, Peer-Learning/Dialogue, Workshops, and Simulation Learning.

Conclusions:

Considerations for best practice identified in this literature review include using multimodal approach to support different learning styles among diverse audiences, tailoring content based on training needs analysis recommendations, and considering onus placed on instructors and learners depending on the content and setting.
Impact of a University-Led COVID-19 Case Investigation and Contact Tracing Program
Authors: Siira Meron , Harrington Kristin R. V. , Lewis Kwardel , Rothschild Elizabeth , Graham Tracie , Rabinovitz Sharon R. , Shartar Samuel , Milazzo Theresa , Crubezy Monica , Olsen Aaron , Clark David , Isakov Alexander , Chamberlain Allison , Gelaye Enku , Xing Minzhi , Patimeteeporn Calvin , Cegielski J. Peter , Gandhi Neel R.
Published: September 2024

Context:

The coronavirus disease 2019 (COVID-19) pandemic devastated societies and economies worldwide. Given the major disruptions to higher education, reflection on university responses to the COVID-19 pandemic may provide insights for future outbreaks.

Objective:

Here, we describe the epidemiology of COVID-19 on the Emory University campus during the 2020-2021 academic year and provide an evaluation of the performance of a university-led program with the purpose of describing the effectiveness of efforts to augment the public health authority’s case investigation and contact tracing efforts during a public health emergency.

Design:

Evaluation of a case investigation and contact tracing program regarding operations, timeliness, and performance.

Main Outcome Measures:

We analyzed quality metrics to determine the proportion of cases and contacts interviewed and the time to completion of each step from case diagnosis to testing of contacts.

Results:

During the 2020-2021 academic year, 1267 COVID-19 cases among Emory students, faculty, and staff were confirmed by polymerase chain reaction, with 1132 reported close contacts. Among cases, the median test turnaround time was 1 day (interquartile range: 1, 2). Among both cases and close contacts, 98% were successfully interviewed. The team called a majority of cases on the same day as their test result was reported to the program (87%; n = 1052). Almost all (98%; n = 1247) cases completed isolation or were advised to isolate during the review period. Close to half (46%; n = 513) of contacts interviewed began quarantine before their interview. Among close contacts interviewed, 13% (n = 145) subsequently converted to an index case.

Conclusions:

The impact and performance of Emory’s program may provide useful and actionable data for future university-led infectious disease outbreak response programs. The program structure, performance metrics, and information collected via interviews provide practical implications and an organized structure to guide other programs during future outbreaks.
Progress on nonculture based diagnostic tests for invasive mould infection
Authors: White P. Lewis
Published: September 2024

Purpose of review

This review describes the current status of diagnosing invasive mould disease andPneumocystispneumonia using nonconventional diagnostics methods.

Recent findings

There has been significant development in the range of nonculture mycological tests. Lateral flow tests (LFTs) for diagnosing aspergillosis complement galactomannan ELISA testing, and LFTs for other fungal diseases are in development. Rapid and low through-put B-D-Glucan assays increase access to testing and there has been significant progress in the standardization/development of molecular tests. Despite this, no single perfect test exists and combining tests (e.g., antigen and molecular testing) is likely required for the optimal diagnosis of most fungal diseases.

Based on established clinical performance few mycological tests can be used alone for optimal diagnosis of fungal disease (FD) and combining tests, including classical approaches is the preferred route for confirming and excluding disease. Next-generation sequencing will likely play an increasing role in how we diagnose disease, but optimization, standardization and validation of the entire molecular process is needed and we must consider how host biomarkers can stratify risk. Given the burden of FD in low- and medium-income countries, improved access to novel but more so existing diagnostic testing is critical along with simplification of testing processes.
The Azygos Esophageal Recess Is Not to Be Missed in Screening Lung Cancer With LDCT
Authors: Mascalchi Mario , Cavigli Edoardo , Picozzi Giulia , Cozzi Diletta , De Luca Giulia Raffaella , Diciotti Stefano
Published: September 2024

Purpose:

Lesion overlooking and late diagnostic workup can compromise the efficacy of low-dose CT (LDCT) screening of lung cancer (LC), implying more advanced and less curable disease stages. We hypothesized that the azygos esophageal recess (AER) of the right lower lobe (RLL) might be an area prone to lesion overlooking in LC screening.

Materials and Methods:

Two radiologists reviewed the LDCT examinations of all the screen-detected incident LCs observed in the active arm of 2 randomized clinical trials: ITALUNG and national lung screening trial. Those in the AER were compared with those in the remainder of the RLL for possible differences in diagnostic lag according to the Lung-RADS 1.1 recommendations, size, stage, and mortality.

Results:

Six (11.7%) of 51 screen-detected incident LCs of the RLL were located in the AER. The diagnostic lag time was significantly longer (P=0.046) in the AER LC (mean 14±9 mo) than in the LC in the remaining RLL (mean 7.3±1 mo). Size and stage at diagnosis were not significantly different. All 6 subjects with LC in the AER and 16 (35.5%) of 45 subjects with LC in the remaining RLL (P=0.004) died of LC after a median follow-up of 12 years.

Conclusion:

Our retrospective study indicates that AER might represent a lung region of the RLL prone to have early LC overlooked due to detection or interpretation errors with possible detrimental consequences for the subject undergoing LC screening.
Comparing the EORTC QLQ-LC13, EORTC QLQ-LC29, and the FACT-L for assessment of quality of life in patients with lung cancer - an updated systematic review
Authors: Hircock Caroline , Wang Alyssa J. , Goonaratne Ethan , Sferrazza Dominic , Bottomley Andrew , Cella David , Lee Shing Fung , Chan Adrian W. , Chow Edward , Wong Henry C.Y.
Published: September 2024

Purpose of review

Two commonly used quality of life (QoL) questionnaires in lung cancer patients are the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Lung Cancer 13 (QLQ-LC13) and the Functional Assessment of Cancer Therapy-Lung (FACT-L). More recently, the EORTC QLQ-LC29 was developed. This systematic review compares the EORTC QLQ-LC29, EORTC QLQ-LC13 and FACT-L in terms of the content, validity and psychometric properties in assessing the QoL of lung cancer patients.

Recent findings

Fourteen studies were included. The EORTC QLQ-LC29 is a 29-item scale that serves as an update of the EORTC QLQ-LC13 to include symptoms from surgery and new targeted therapies. It shows validity, high internal consistency, test-retest reliability, and sensitivity. The FACT-L continues to assess general quality of life and lung cancer-specific symptoms.

The EORTC QLQ-LC29, EORTC QLQ-LC13, and FACT-L were reviewed to assess their validity in measuring QoL of lung cancer patients. All were found to be sufficiently validated, The choice of which to use should depend on the primary goals of the study.