bluuebunny/crossref_metadata_2025 huggingface dataset:
VIRTUAL REALITY FOR PALLIATIVE CARE COMMUNICATION TRAINING: A NOVEL DISSEMINATION STRATEGY
Authors: Ouchi Kei
Published: December 2023

Towards the end of life, 75% of older adults visit the emergency department (ED). During acute health decompensation, most older adults with serious illness (predicted survival of less than one year) do not have advance directives and are at risk of receiving care inconsistent with their goals. To deliver patient-centered care, palliative care communication skills are essential, especially during the shared decision-making for cardiopulmonary resuscitation (i.e., code status conversations). Facilitated by skilled faculty and trained actors playing the role of a seriously ill older adult in acute health decompensation, the traditional palliative care communication training combines role play and individual feedback to practice communication skills. These evidence-based, palliative care trainings have demonstrated to improve communication skills in trained clinicians with enduring skills 12-15 months later. However, these trainings take a minimum of four hours with highly trained faculty and professional actors to role play, which hinders wider dissemination. To improve nationwide dissemination of evidence-based practices in code status conversations, we have leveraged virtual reality technology to allow clinicians to experience in-person, palliative care communication training. In collaboration with a virtual reality company, a 360-degree view, virtual reality training content has been filmed in a real hospital environment. Using the same evidence-based, palliative care communication contents, clinicians in training can now experience the role play in a virtual reality environment in one hour instead of four. By leveraging virtual reality technology, evidence-based palliative care communication training can now be disseminated with much less institutional investment (e.g., training time, faculty resources, etc.).
EXAMINING THE PRELIMINARY EFFECTIVENESS OF THE SENIOR COMPANION PROGRAM PLUS FOR AFRICAN AMERICAN CAREGIVERS
Authors: Xu Ling , Fields Noelle , Williams Ishan , Gaugler Joseph , Lomelin Alan Kunz , Cipher Daisha , Feinhals Gretchen
Published: December 2023

Objectives

A culturally informed, peer-led, lay provider model, the Senior Companion Program (SCP) Plus, was implemented to decrease caregiving burden/stress and improve coping skills, and social support for African American ADRD caregivers. This study reported the preliminary effectiveness of this intervention.

Methods

An explanatory sequential mixed methods design was used in this study and a randomized control trial was conducted for the SCP Plus intervention among participants in three sites (N = 20). A sub-sample of participants (n = 7) consented to a qualitative interview about their experiences with the intervention. The Wilcoxon signed-rank tests, Friedman tests, and one-way repeated measures ANOVA were conducted for quantitative analyses. Thematic analysis was used for the qualitative interviews.

Results

Results demonstrated that knowledge of AD/dementia (KAD) and preparedness for caregiving were significantly improved for all senior companions in the intervention group. Results also showed that caregivers in the intervention group reported significantly decreased caregiving burden, as well as increased KAD, satisfaction with social support, and positive aspects of caregiving. Themes from the qualitative interviews included: learning new skills about caregiving, gaining knowledge about ADRD, and benefits for the dyad. Discussions: Findings from this study implied that SCP Plus was a promising model for African American family caregivers as it benefits both the SC volunteers and the African American ADRD family caregivers.
HOW DO FORMER DEMENTIA CAREGIVERS STRUCTURE HIGH- AND LOW-POINT NARRATIVES?
Authors: Matta-Singh Tara , Sharma Shubam , Ali Talha , Piechota Amanda , Abboud Anissa , Fried Terri , Monin Joan , Mroz Emily
Published: December 2023

Former caregivers of people living with dementia often develop and structure narratives of their lived experiences as caregivers in terms of subjective high and low points. We utilized thematic analysis to examine narratives of these high and low points in interviews with 32 former caregivers of a parent living with dementia. Across both high and low points, caregivers often structured their narratives using three types of “elaboration,” that is, points not necessary to recall a factual event, but which help convey deeper meaning. Caregivers who utilized comparisons contrasted their caregiving experiences with other individuals or caregiving situations to help make sense of their own experience. When participants made connections to earlier life, they linked caregiving to prior experiences such as growing up with their parents. Shifting the focal point occurred where caregivers moved the narrative towards or away from a certain positive or negative storyline, unprompted. We discuss how caregivers who utilize elaborations adaptively (e.g., to tell a fuller story that reinforces how their caregiving relationship is beneficial) may come to better make sense of their experience which can alleviate some distress. We also discuss how elaborations that emphasize incompetency or promote focus on difficult moments may threaten the caregivers’ sense of well-being, leading to psychological harm. We conclude by introducing concrete narrative strategies that can help former caregivers use elaborations in adaptive ways, such as comparing difficult caregiving experiences to other difficulties that they have overcome to re-write narratives surrounding personal incompetency in caregiving.
COMPARING COVID-19 CASES AND MORTALITY RATES: THE GREEN HOUSE VERSUS THE TRADITIONAL NURSING HOME IN THE UNITED STATES
Authors: Young Yuchi , Barnes Virgile , Perre Taylor , Hsu Wan-Hsiang , Shayya Ashley , O’Grady Thomas
Published: December 2023

Introduction

The COVID-19 pandemic has posed significant challenges to nursing home (NH) care. However, Green Houses (GH), with their small size and unique care model, may offer a solution for infection control and COVID-19 prevention. This study aims to compare COVID-19 case and mortality rates between GHs and traditional NHs in the United States.

Methods

Secondary data were used to compare COVID-19 case and mortality rates among three groups: GHs (n=19), traditional small NHs (n=266), and traditional large NHs (n=2932) located in 10 US states from June 2020 to September 2022. Poisson regressions using generalized estimating equations (GEE) were utilized to quantify differences in COVID-19 case and mortality rates while controlling for average age, gender, and ADL score.

Results

The study population had a mean age of 73.38 and was primarily female (57.8%) and white (78.2%). The GEE results indicated that small and large NHs have significantly higher relative risks (RR) of COVID-19 cases (RR = 1.61; 95% CI 1.25-2.08 and RR = 1.75; 95% CI 1.36-2.24, respectively) compared to GHs. For COVID-19 mortality rates, there is an increased risk in large NHs compared to GHs (RR = 1.67; 95% CI 1.01-2.77), but no difference between GHs and small NHs.

Conclusion

After adjusting for age, gender, and ADL disability, GHs have lower COVID-19 incidence and mortality rates than traditional NHs. These differences may be attributable to GHs having fewer beds, offering more resident privacy, and having a higher certified nursing assistant-to-resident ratio compared to traditional NHs.
FINANCIAL OUTCOMES ASSOCIATED WITH COVID-19 IN NURSING HOMES
Authors: Orewa Gregory , Weech-Maldonado Robert , Feldman Sue , Becker David , Davlyatov Ganisher , Lord Justin
Published: December 2023

Financial stability and well-being are critical for the success of any organization. COVID-19 put nursing homes (NH) in a financial bind, affecting their costs and revenues and mounting pressure on them despite government intervention. NHs have been one of the weak links in our care continuum for the U.S. healthcare system, and the pandemic caused havoc in the industry. Given the pandemic impact on NH operating cost and revenue, this study examined the level to which financial performance in NHs deteriorated. Six different datasets were merged for 2018–2021: Medicare cost reports, Payroll-Based Journal, NH Compare, Area Health Resource File, HHS Provider Relief Fund, and CDC COVID-19 Data Tracker. The data was modeled using random-effects regression. Dependent variables were operating revenue per patient day, operating cost per patient day, and operating margin. Independent variable was pre- and post-COVID-19. Organizational, community-level, and COVID-19-related variables were used as controls. Results suggest that the impact of COVID-19 was associated with an increase in operating cost per patient day (β=56.64, p< 0.05), and a decrease in operating margin (β=-8.04, p< 0.05), but the associated operating revenue per patient day (β=26.78, p< 0.05), did not increase at the rate at which the operating cost increased. The increase in operating cost per patient day compared to the operating revenue per patient day was double. Given the negative impact of the COVID-19 pandemic on NH’s financial performance, policymakers should monitor the financial health of NH. Further deterioration in financial performance may result in NH closures and reduced access to long-term care.
PALLIATIVE AND END-OF-LIFE CARE FOR OLDER ADULTS WITH EXPERIENCES OF HOMELESSNESS
Authors: Melekis Kelly , Melekis Kelly
Published: December 2023

Although palliative and end-of-life (PEOL) care offers many benefits to those with life-limiting illness, unhoused older adults face significant barriers in accessing these types of care. This symposium examines disparities in PEOL care, emerging services for disadvantaged older adults, and recommendations for capacity-building within healthcare, housing, and aging services. The first paper is an exploratory study of programs serving the PEOL care needs of unhoused adults with serious illnesses. The second paper is a mixed methods study that explores provider perspectives on approaches and challenges to addressing the PEOL care needs among unhoused individuals. The third paper uses the CBPR method photovoice to highlight the experiences of terminally ill patients accessing social model hospice care, a free option to facilitate access to hospice for unhoused older adults. In addition to well-established disparities in the prevalence of serious illness and access to palliative care among people with experiences of homelessness, limits and barriers to holistic support remain once housed. The fourth paper uses secondary data analysis of the Research and Supportive Care at Later-life for Unhoused People (RASCAL-UP) study to describe current practices, perceived barriers, and recommendations in permanent supportive housing for older residents with complex comorbidities. The final paper, also using secondary data analysis of the RASCAL-UP study, addresses the role of skilled nursing for palliative care patients with histories of homelessness. Together, findings illuminate challenges to providing PEOL care for unhoused older adults and those with prior experiences of homelessness, as well as opportunities to improve access to care. This is a Hospice, Palliative and End-of-Life Care Interest Group Sponsored Symposium.
COGNITIVE TRAINING APPROACHES TO IMPROVE COGNITION AND ASSOCIATED FUNCTIONS IN MID TO LATE LIFE
Authors: Curtis Ashley , Costa Amy , Musich Madison , Rzeppa Chloe , McCrae Christina
Published: December 2023

Cognitive Training (CT) has yielded inconsistent benefits in non-patient populations. Despite known cognition/sleep associations, limited studies have investigated CT’s impact on sleep. We examined cognitive and associated outcomes across three CT programs in older adult (OA) insomnia patients [with/without mild cognitive impairment (MCI)] and middle-aged adults (MA) with generalized anxiety disorder (GAD). In Study 1, OAs with insomnia (Mage=67.9±8.0; 16 women/8 men) completed 6-week CT (Nintendo DS-Big Brain Academy; 60 mins/day, 3x/week) and waitlist control (WLC) in a cross-over design. At baseline and post-CT/post-WLC, participants completed NIH toolbox-cognitive tasks. In Study 2, MAs with GAD (Mage=49.8±4.0; 29 women) underwent 8-week CT (Cognifit, n=14) or Trivia Training (TT, n=15), 45 mins/day, 3x/week and completed pre/post Inquisit-cognitive assessments. In Study 3, OAs with insomnia and MCI (Mage=67.6±8.0; 10 women/3 men) completed 8-week CT (Cognifit; 45 mins/day, 3x/week) and pre/post Cambridge Brain Sciences-cognitive and polysomnography-sleep assessments. In Study 1, proportional RAVLT-verbal memory improvement was larger [t(23)=2.01, p=.028] following CT(17%) versus WLC(9%). Similarly, proportional Flanker-inhibition improvement was larger [t(23)=1.71, p=.05] following CT(2%) versus WLC(-.3%). In Study 2, CT improved Posner-attention orienting more than TT [F(1,27)=5.25, p=.03]. In Study 3, CT improved Digit-span-working memory [t(12)=-1.84, p=.045], reduced number of awakenings [t(12)=2.70, p=.01), increased %REM [(t(12)=-1.77,p=.05], and showed trending improvement for spatial planning/reasoning [t(12)=1.70, p=.057] and %Lighter-sleep [t(12)=1.62,p=.066]. CT benefits non-trained cognition (transfer effects) in mid-to-late life individuals with insomnia, GAD and MCI, and shows promise for improving sleep in MCI. Follow-up in larger samples investigating mechanisms underlying CT effects (domain-specific training, sleep improvement) is warranted.
AGHE Faculty Award Presentations and Lectures
Authors: Bradley Dana
Published: December 2023

The AGHE Faculty Award Presentations and Lectures will feature an address by the 2023 recipient Lisa Borrero, PhD, FAGHE of the University of Indianapolis. The Distinguished Faculty Award recognizes persons whose teaching stands out as exemplary, innovative, of impact, or any combination thereof. The Rising Star Early-Career Faculty Award Lecture will feature an address by 2023 co-recipient Nasreen Sadeq, PhD of the University of Southern Florida. Co-recipient Berenice Benayoun, PhD, of the University Southern California will present their lecture at a later date. The Rising Star Early-Career Faculty Award acknowledges new faculty whose teaching and leadership stand out as influential and innovative.
SELF-REPORTED VERSUS DIAGNOSIS-BASED DISEASED LIFE EXPECTANCY AMONG OLDER COLOMBIANS
Authors: Osuna Margarita Maria , Crimmins Eileen , Ailshire Jennifer
Published: December 2023

The number of older adults in Colombia will soon double and it is essential to understand the disease burden in this population. Disease prevalence is often estimated from medical diagnoses, which can underestimate disease in populations with less health care access and low health literacy. We compare differences in diseased life expectancy (DLE) using self-reported vs. measured markers for diabetes and hypertension using data from the 2015 health and wellbeing survey of older adults in Colombia (SABE-Col), a nationally representative survey of Colombians ages 60+. Respondents reported whether they had ever been told by a doctor that they had either diabetes or hypertension. Using direct measures of glucose and blood pressure and clinical cut-points, we determined which respondents were considered to have diabetes or hypertension. We used the Sullivan method to estimate life expectancy with and without disease. Data from self-reports alone generally suggest lower DLE than from both self-reported and measured disease statuses. At age 60, women have a total life expectancy of 20.56 years. We find a lower DLE for hypertension using self-reported data (12.66 years) than measured (13.24 years). Conversely, reported diabetes is similar (4.18 years) to the measured (4.28 years) DLE. Men, at age 60, have a total life expectancy of 18.04 years. DLE for hypertension using self-reports is lower (8.78 years) than measured (9.61 years). Similarly, DLE for diabetes is lower for self-report (2.98 years) than measured (3.04). Our findings show the burden of disease in this rapidly aging population.
NONINVASIVE INTERVENTIONS IN HEALTHY AND AT-RISK OLDER ADULTS: THE CASE FOR SOCIAL DANCING
Authors: Blumen Helena
Published: December 2023

Physical and cognitive activities can induce neuroplasticity and lead to modest improvements on cognition in healthy and at-risk older adults. Yet, many unanswered questions remain – including what type of physical, cognitive, or combination of physical and cognitive activities, are most beneficial, and to whom (e.g., healthy, or at-risk older adults). This single-blind randomized clinical trial (RCT; NCT03475316) contrasted 6 months of social ballroom dancing with 6 months of treadmill-walking. Twenty-five dementia-at-risk older adults (mean age = 76.45 years; 66% women; 48% White/Caucasian; 24% Black/African American; 20% Hispanic/Latino) were randomized between June 2019 and March 2020. Sixteen participants completed this RCT prior to early study termination due to COVID-19 (8 in each study arm). Dementia-at-risk was defined as a memory impairment screen score of ≥3 to ≤6, and/or and AD-dementia screening interview of ≥1. A composite measure of executive function – generated from digit-symbol-substitution, flanker interference, and walking-while-talking tasks – improved following both social dancing and treadmill-walking. Yet, social dancing generated greater improvements than treadmill-walking on the digit symbol substitution task. No intervention-related differences were observed in brain activation. Less hippocampal atrophy, however, was observed in the social dancing arm than in the treadmill-walking arm. These preliminary findings partly support the hypothesis that social dancing may promote neuroplasticity and benefit cognition to a greater extent than traditional physical activities. This is presumably because social dancing is not only a physical demanding activity, but also a socially and cognitively challenging activity. Yet, these findings need to be confirmed in larger-scale RCTs
SARCOPENIA AND MOBILITY DYSFUNCTION AS INDICATORS OF INCREASED ADRD RISK IN ASYMPTOMATIC DISEASE
Authors: Tolea Magdalena , Besser Lilah , Galvin James
Published: December 2023

Sarcopenia, the age-related loss of muscle mass and function, affects up to 30% of older adults. In addition to being an established component of frailty and predictor of mobility dysfunction, sarcopenia is associated with cognitive decline and increased risk of cognitive impairment, with ~70% individuals with late-stage dementia having sarcopenia. In this study, we investigated whether sarcopenia differentiates high- vs low- ADRD risk among 141 community-dwelling, older adults who were healthy controls (HC) or had mild cognitive impairment (MCI) (65% female; mean Age=70±11yr; mean Educ=16±3yr). Using the Brain Health Platform (BHP) developed at the Comprehensive Center for Brain Health, we categorized participants based on measures of resilience, vulnerability, cognitive performance as: Low-risk HC (36.9%); High-risk HC (12.8%), and MCI (50.4%). Amyloid positivity increased across risk groups (20% in Low-risk HC; 33.3% in High-risk HC; 39.1% in MCI). Prevalence of sarcopenia was 26.7% and increased by ADRD risk (12.2% vs 18.8% vs 39.1%, p=0.004). The MCI group had lower flexibility compared to both the low-risk (p=0.024) and high-risk HC (p=0.039) groups. Timed Up and Go (TUG) score increased with risk group (p< 0.001MCI vs Low-risk HC; p=0.005MCI vs High-risk HC). Both mobility measures (i.e., flexibility, TUG) showed good discrimination for MCI vs Low-risk HC [AUC=0.77flexibility; AUC=0.78TUG] as well as for MCI vs High-risk HC [AUC=0.71flexibility; AUC=0.73TUG). Findings suggest that sarcopenia and other markers of mobility dysfunction have the potential to identify asymptomatic individuals at increased risk of ADRD, who could benefit from early intervention.
“OUR NATION’S DEMOCRACY IS AT A CRITICAL CROSSROAD”: OLDER ADULTS TAKING ACTION AND LEADING COMMUNITY ENGAGEMENT
Authors: Perry Tam , Rorai Vanessa , Whitney Sarah , Stringer Wilma , Swift Henry , Bridgforth James , Mullin Patricia
Published: December 2023

Launched by older Black adults from the Healthier Black Elders Center (HBEC) of the Michigan Center for Urban African American Aging Research, Critical Crossroads was created to engage older Detroiters in community conversations, advocacy, and strategies around issues of social injustice. Critical Crossroads provides older adults a space to discuss what concerns them at both national and local community levels, share their personal impact stories and experiences, and learn how these issues connect to social determinants of health. One important feature of this program has been attention to concerns of housing and its impact on older adults. This presentation will highlight two Critical Crossroads housing related segments (e.g., CDC moratorium on eviction, applying for FEMA aid for flooding). This presentation will share the This presentation will share the development of this community-led initiative, program goals, and lessons learned.
SO MANY STAKEHOLDERS, SO MANY CONTRACTS!
Authors: DeLiema Marguerite
Published: December 2023

Elder financial fraud is a growing challenge for adult protective services (APS), financial institutions, and state and federal law enforcement agencies that seek effective interventions to protect older adults from continued financial loss. One solution is temporary account holds that prevent suspicious withdrawals from an older or vulnerable adult’s account while investigation and additional interventions are put in place. With funding from the Administration for Community Living, this project seeks to understand the outcomes of temporary account holds on elder safety and financial autonomy in Minnesota. We first worked to improve communication between APS and other Minnesota state agencies to ensure that cases are properly referred and that protection activities are coordinated to achieve the best outcomes for the older adult. Like most collaborative research projects that involve university researchers and state agencies, significant legal agreements were necessary. Multiple subawards and cost share agreements were drafted, data use agreements were created, and IRB approvals from multiple entities were sought. In this presentation, Dr. DeLiema will share lessons learned about how researchers can better prepare for the administrative burden and delayed starts associated with completing these legal administrative processes. She will describe common areas of conflict and competing interests between state agencies and universities around data privacy and ownership, strategies for finding common ground, and possible workarounds to fulfill project aims. Dr. DeLiema will also highlight how to “pitch” a collaboration to community stakeholders using a value proposition that outlines the benefits of the project to the stakeholder.
CONTEXTUAL FACTORS THAT SHAPE EXPERIENCES OF SEXUAL INTIMACY AMONG LATER-LIFE COUPLES
Authors: Yorgason Jeremy , Wilson Stephanie , Liu Hui (Cathy)
Published: December 2023

Sexuality is an important aspect of romantic dyadic relationships. Although people experience physical changes with age that result in changes in sexual interactions, the sexual aspect of couple relationships remain important. Research examining sexuality among later life couples is maturing, allowing investigators to explore more nuanced questions about couple contexts that shape sexual experiences. The current group of papers address some of these important contextual factors that can impact the couple sexual relationship, including sexual motives among same and different sex couples, personality characteristics and how they relate to sexual interactions, how couples’ sexual interactions are affected by transitions such as menopause, and how sleep patterns among caregivers are related to sexual interactions. Presenters in this session draw upon national studies of older adults including NSHAP, MIDUS, and HARP. They used advanced statistical modeling to explore their questions. Findings suggest that self-determined sexual motives among same and different sex couples were associated with better marital quality and lower depression. The menopause transition, along with relationship transitions in later life, were associated with sexual interactions. Conscientiousness and neuroticism were associated with sexual pleasure and emotional satisfaction, along with preferences regarding physical touch within the relationship. Among caregivers, sleep duration was less important; sharing a bed with a care-recipient partner was associated with physical pleasure; and napping was negatively associated with sexual quality. In summary, various factors impact the sexual interactions of older couples in different ways. Findings from these papers given nuanced insight into a number of important contextual factors.
DataColor: unveiling biological data relationships through distinctive color mapping
Authors: He Shuang , Dong Wei , Chen Junhao , Zhang Junyu , Lin Weiwei , Yang Shuting , Xu Dong , Zhou Yuhan , Miao Benben , Wang Wenquan , Chen Fei
Published: December 2023

In the era of rapid advancements in high-throughput omics technologies, the visualization of diverse data types with varying orders of magnitude presents a pressing challenge. To bridge this gap, we introduce DataColor, an all-encompassing software solution meticulously crafted to address this challenge. Our aim is to empower users with the ability to handle a wide array of data types through an assortment of tools, while simultaneously streamlining parameter selection for rapid insights and detailed enhancements. DataColor stands as a robust toolkit, encompassing 23 distinct tools coupled with over 600 parameters. The defining characteristic of this toolkit is its adept utilization of the color spectrum, allowing for the representation of data spanning diverse types and magnitudes. Through the integration of advanced algorithms encompassing data clustering, normalization, squarified layouts, and customizable parameters, DataColor unveils an abundance of insights that lay hidden within the intricate relationships embedded in the data. Whether you find yourself navigating the analysis of expansive datasets or embarking on the quest to visualize intricate patterns, DataColor stands as the comprehensive and potent solution. We extend the availability of DataColor to all users at no cost, accessible through the following link: https://github.com/frankgenome/DataColor.
Guidance for reporting analyses of metadata on electronic health record use
Authors: Rule Adam , Kannampallil Thomas , Hribar Michelle R , Dziorny Adam C , Thombley Robert , Apathy Nate C , Adler-Milstein Julia
Published: December 2023

Introduction

Research on how people interact with electronic health records (EHRs) increasingly involves the analysis of metadata on EHR use. These metadata can be recorded unobtrusively and capture EHR use at a scale unattainable through direct observation or self-reports. However, there is substantial variation in how metadata on EHR use are recorded, analyzed and described, limiting understanding, replication, and synthesis across studies.

Recommendations

In this perspective, we provide guidance to those working with EHR use metadata by describing 4 common types, how they are recorded, and how they can be aggregated into higher-level measures of EHR use. We also describe guidelines for reporting analyses of EHR use metadata—or measures of EHR use derived from them—to foster clarity, standardization, and reproducibility in this emerging and critical area of research.
Using Computer Vision and Artificial Intelligence to Track the Healing of Severe Burns
Authors: Ethier Olivier , Chan Hannah O , Abdolahnejad Mahla , Morzycki Alexander , Fansi Tchango Arsene , Joshi Rakesh , Wong Joshua N , Hong Collin
Published: December 2023

Burn care management includes assessing the severity of burns accurately, especially distinguishing superficial partial-thickness burns from deep partial-thickness burns, in the context of providing definitive, downstream treatment. Moreover, the healing of the wound in the subacute care setting requires continuous tracking to avoid complications. Artificial intelligence (AI) and computer vision (CV) provide a unique opportunity to build low-cost and accessible tools to classify burn severity and track changes in wound parameters, both in the clinic by physicians and nurses and asynchronously in the remote setting by the patient themselves. Wound assessments can be achieved by AI–CV using the principles of image-guided therapy using high-quality 2D color images. Wound parameters can include wound 2D spatial dimension and the characterization of wound color changes, which demonstrates physiological changes such as the presentation of eschar/necrotic tissue, pustulence, granulation tissue, and scabbing. Here we present the development of AI–CV-based Skin Abnormality Tracking Algorithm pipeline. Additionally, we provide the results on a single localized burn tracked for a 6-week period in the clinic and an additional 2-week period of home monitoring.
In search of excellence
Authors: Field Richard E
Published: December 2023

A little while ago, I had the opportunity to spend some time in the operating room (theatre) of one of the world’s most experienced and technically skilful hip arthroscopists. How I wish I had made the effort to visit this surgeon earlier in my career and how I regret that there are still so many surgeons I have failed to visit. Every surgeon who has allowed me into their operating room has shown me something that has enhanced my practice and learning to execute their manoeuvres always adds to the pleasure of surgical practice.
The energy transition at a critical juncture
Authors: Hailes Oliver , Viñuales Jorge E
Published: December 2023

Amid the Ukraine war, the energy transition has reached a critical juncture: decisions taken by key governmental or commercial actors may irreversibly threaten efforts to limit the rise in global average temperature to 1.5°C. After defining the notions of ‘energy transition’ and ‘critical juncture’, this article describes how the ‘international law of energy’ may both entrench a socio-technical regime based on fossil fuels and promote the transition towards renewable energy. These categories serve to frame several contributions to a symposium, which assist in mapping the rules, processes, and institutions that organize the decisional options of key actors as they try to drive the energy transition through this critical juncture. We conclude by recalling the practical utility of this dynamic map and the pressing need for an authoritative compass to give interpretive direction to the legal organization of the entitlements, obligations, and decisional options of key actors in reorienting energy activities to avoid the catastrophic tipping points of climate change.
Cxcl1 monomer–dimer equilibrium controls neutrophil extravasation
Authors: León-Vega Iliana I , Vadillo Eduardo , Vargas-Robles Hilda , Rajarathnam Krishna , Schnoor Michael
Published: December 2023

The chemokine Cxcl1 plays a crucial role in recruiting neutrophils in response to infection. The early events in chemokine-mediated neutrophil extravasation involve a sequence of highly orchestrated steps including rolling, adhesion, arrest, and diapedesis. Cxcl1 function is determined by its properties of reversible monomer–dimer equilibrium and binding to Cxcr2 and glycosaminoglycans. Here, we characterized how these properties orchestrate extravasation using intravital microscopy of the cremaster. Compared to WT Cxcl1, which exists as both a monomer and a dimer, the trapped dimer caused faster rolling, less adhesion, and less extravasation. Whole-mount immunofluorescence of the cremaster and arrest assays confirmed these data. Moreover, the Cxcl1 dimer showed impaired LFA-1–mediated neutrophil arrest that could be attributed to impaired Cxcr2-mediated ERK signaling. We conclude that Cxcl1 monomer–dimer equilibrium and potent Cxcr2 activity of the monomer together coordinate the early events in neutrophil recruitment.
Spontaneous gastric perforation complicating acute laryngotracheobronchitis in an infant: a novel case report from Nepal
Authors: Paudyal Nabin , Devkota Yogendra , Shah Sanjay Kumar , Gami Barsha , Regmi Prakriti
Published: December 2023

Pediatric spontaneous gastric perforation is a rarely encountered condition with poorly understood causal mechanisms. We present a novel case of a two-month-old female infant from Nepal who previously experienced Croup and subsequently developed severe abdominal distention and vomiting. Abdominal X-ray findings confirmed pneumoperitoneum, prompting immediate laparotomy. Intraoperative examination revealed a substantial perforation along the posterior stomach wall, specifically along the lesser curvature. The surgical intervention involved gastrorrhaphy and omentopexy using 3-0 Vicryl sutures, leading to an uneventful postoperative recovery. This case report highlights the critical importance of early and efficient management of spontaneous gastric perforations in infants, emphasizing the need for timely intervention to achieve favorable outcomes. Pediatric spontaneous gastric perforation remains a rare condition, and reporting such cases contributes to our understanding and management of this unusual pathology.
A Catch-22—The Test–Retest Method of Reliability Estimation
Authors: Tufiş Paula A , Alwin Duane F , Ramírez Daniel N
Published: December 2023

This article addresses the problems with the traditional reinterview approach to estimating the reliability of survey measures. Using data from three reinterview (or panel) studies conducted by the General Social Survey, we investigate the differences between the two-wave correlational approach embodied by the traditional reinterview strategy, compared to estimates of reliability that take the stability of traits into account based on a three-wave model. Our results indicate that the problems identified with the two-wave correlational approach reflect a kind of “Catch-22” in the sense that the only solution to the problem is denied by the approach itself. Specifically, we show that the correctly specified two-wave model, which includes the potential for true change in the latent variable, is underidentified, and thus, unless one is willing to make some potentially risky assumptions, reliability parameters are not estimable. This article compares the two-wave correlational approach to an alternative model for estimating reliability, Heise’s estimates based on the three-wave simplex model. Using three waves of data from the GSS panels, which were separated by 2-year intervals between waves, this article examines the conditions under which the wave-1, wave-2 correlations which do not take stability into account approximate the reliability estimate obtained from three-wave simplex models that do take stability into account. The results lead to the conclusion that the differences between estimates depend on the stability and/or fixed nature of the underlying processes involved. Few if any differences are identified when traits are fixed or highly stable, but for traits involving changes in the underlying traits the differences can be quite large, and thus, we argue for the superiority of reinterview designs that involve more than 2 waves in the estimation of reliability parameters.
Modular-integrative modeling: a new framework for building brain models that blend biological realism and functional performance
Authors: Senden Mario , van Albada Sacha J , Pezzulo Giovanni , Falotico Egidio , Hashim Ibrahim , Kroner Alexander , Kurth Anno C , Lanillos Pablo , Narayanan Vaishnavi , Pennartz Cyriel , Petrovici Mihai A , Steffen Lea , Weidler Tonio , Goebel Rainer
Published: December 2023

This Perspective presents the Modular-Integrative Modeling approach, a novel framework in neuroscience for developing brain models that blend biological realism with functional performance to provide a holistic view on brain function in interaction with the body and environment.
Improved Assessment of Schistosoma Community Infection Through Data Resampling Method
Authors: Gurarie David , Mondal Anirban , Ndeffo-Mbah Martial L
Published: December 2023

Background

The conventional diagnostic for Schistosoma mansoni infection is stool microscopy with the Kato-Katz (KK) technique to detect eggs. Its outcomes are highly variable on a day-to-day basis and may lead to biased estimates of community infection used to inform public health programs. Our goal is to develop a resampling method that leverages data from a large-scale randomized trial to accurately predict community infection.

Methods

We developed a resampling method that provides unbiased community estimates of prevalence, intensity and other statistics for S mansoni infection when a community survey is conducted using KK stool microscopy with a single sample per host. It leverages a large-scale data set, collected in the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) project, and allows linking single—stool specimen community screening to its putative multiday “true statistics.”

Results

SCORE data analysis reveals the limited sensitivity of KK stool microscopy and systematic bias of single-day community testing versus multiday testing; for prevalence estimate, it can fall up to 50% below the true value. The proposed SCORE cluster method reduces systematic bias and brings the estimated prevalence values within 5%–10% of the true value. This holds for a broad swath of transmission settings, including SCORE communities, and other data sets.

Conclusions

Our SCORE cluster method can markedly improve the S mansoni prevalence estimate in settings using stool microscopy.
A rare entity of primary hydatid cyst located between the two layers of the intracranial dura in a child: a case report
Authors: Kadri Hassan , Dughly Mazen , Abouharb Raed , Bakleh Sameer , Mackieh Rostom
Published: December 2023

Introduction: Hydatid disease is a parasitic infection caused by the tapeworm Echinococcus granulosus. Intracranial locations are rare and account for less than 3% of all cases. Typically, these cysts are found in the intracerebral spaces. However, this study presents an extremely rare intradural hydatid cyst. To our knowledge no similar case has been previously reported. Case presentation: This study presents the case of an 8-year-old boy presented with a 3-month history of headache and vomiting without any neurological deficit. Full radiological investigations were performed, the brain MRI showed a large cerebral hydatid cyst located within the dura layers between the periosteal and the endosteal layers. Surgery was performed without cyst rupture, confirming the intracerebral intradural location. Conclusion: Early diagnosis and treatment for intracranial hydatid cysts are crucial to prevent complications such as neurological deficits, seizures, and even death. In this case, the intracerebral intradural location of the cyst is extremely rare.
Bilateral superficial temporal vein thrombosis after acute carbon monoxide poisoning and prolonged immobilisation: a case report
Authors: Hamdan Rémy , Bach Benoît , Asdrubal Jacques , Baldassini Anne Laure
Published: December 2023

A prolonged stay on the ground after acute carbon monoxide poisoning (COP) is a high-risk situation for venous thromboembolism (VTE), but unusual-site venous thrombosis is rare in this setting. An 81-year-old woman with no personal or family history of VTE who lied on the ground for several hours following massive COP had painful and oedematous temples, so a Doppler ultrasound was prompted and revealed a bilateral superficial temporal vein (STV) thrombosis. There was no heart failure, trauma, inflammatory disease, infection, or vascular malformation. The thrombosis regressed on fondaparinux 2.5 mg given as a daily subcutaneous injection for 45 days. Our observation emphasizes the need to look not only for arteritis but also for venous thrombosis before any temporal pain. STV thrombosis has been reported four times to date. We report the first case of bilateral STV thrombosis in the setting of massive COP and prolonged immobilisation in an elderly patient.
Concurrent trastuzumab deruxtecan-induced interstitial lung disease and COVID-19 in the treatment of advanced breast cancer
Authors: Yasuda Naoaki , Ikeo Satoshi , Sokai Akihiko , Sakai Yuki , Hayashi Yasuyuki , Kitano Sae , Itoi Naoko , Lee Tecchuu , Iwata Toshiyuki , Nishimura Takashi
Published: December 2023

Patients with cancer are at an increased risk of developing coronavirus disease 2019 (COVID-19) infection. Trastuzumab deruxtecan (T-DXd) is an antibody-drug conjugate (ADC) against epidermal growth factor receptor 2 (HER2)-positive cancer, known to cause drug-induced interstitial lung disease (DILD), including drug-induced pneumonitis. A 60-year-old woman with breast cancer developed a fever during treatment with T-DXd and was diagnosed with COVID-19. The fever persisted for approximately 3 weeks, and chest computed tomography showed multiple consolidations with bilateral peripheral predominance. Since the clinical course was atypical for COVID-19 due to the long duration of the fever and the CT pattern was frequently seen in T-DXd-induced ILD, the patient was diagnosed with T-DXd-induced ILD, following which, prednisolone was started, leading to improvement in the symptoms and fading of shadows. Even in patients suspected of COVID-19 pneumonia, physicians should consider the possibility of DILD, particularly in patients undergoing cancer treatment.
Atrial fibrillation caused by Daboia palestinae snakebite: a case report
Authors: Khaldy Marah , Arafat Hasan , Khaldi Yasmina
Published: December 2023

Background

snake envenomation is a serious healthcare issue. Daboia palaestinae is an endemic species to the Middle East that is responsible for the majority of envenomation cases with serious health issue consequences.

Case Presentation

we report a case of a 20-year-old Palestinian man who presented to emergency room following a snake bite. He developed atrial fibrillation which is a rare but serious complication of D. palaestinae snakebite. We reviewed the proper approach and management to such cases.

Conclusion

cardiac arrhythmias are a rare but serious, often fatal, complication of snake envenomation. Early detection and proper management is key to avoid morbidity and mortality.
Aging hallmarks of the primate ovary revealed by spatiotemporal transcriptomics
Authors: Lu Huifen , Jing Ying , Zhang Chen , Ma Shuai , Zhang Weiqi , Huang Daoyuan , Zhang Bin , Zuo Yuesheng , Qin Yingying , Liu Guang-Hui , Yu Yang , Qu Jing , Wang Si
Published: December 2023

The ovary is indispensable for female reproduction, and its age-dependent functional decline is the primary cause of infertility. However, the molecular basis of ovarian aging in higher vertebrates remains poorly understood. Herein, we apply spatiotemporal transcriptomics to benchmark architecture organization as well as cellular and molecular determinants in young primate ovaries and compare these to aged primate ovaries. From a global view, somatic cells within the non-follicle region undergo more pronounced transcriptional fluctuation relative to those in the follicle region, likely constituting a hostile microenvironment that facilitates ovarian aging. Further, we uncovered that inflammation, the senescent-associated secretory phenotype, senescence, and fibrosis are the likely primary contributors to ovarian aging (PCOA). Of note, we identified spatial co-localization between a PCOA-featured spot and an unappreciated MT2 (Metallothionein 2) highly expressing spot (MT2high) characterized by high levels of inflammation, potentially serving as an aging hotspot in the primate ovary. Moreover, with advanced age, a subpopulation of MT2high accumulates, likely disseminating and amplifying the senescent signal outward. Our study establishes the first primate spatiotemporal transcriptomic atlas, advancing our understanding of mechanistic determinants underpinning primate ovarian aging and unraveling potential biomarkers and therapeutic targets for aging and age-associated human ovarian disorders.
Human Rights Pragmatism: Problems of Structure and Agency
Authors: Snyder Jack
Published: December 2023

Mainstream human rights activists typically attribute the signature successes of their movement (e.g., antislavery, Gandhi, Martin Luther King) to their uncompromisingly principled stance on behalf of the weak and the exploited. Naming and shaming and ending impunity loom large in their lore. This attitude works well to recruit idealistic activists, but their moralism, legalism, and secular universalism miss the central role of the self-interest of the majority in powering the progress of human rights. A core of idealists has defined aspirational goals, but progress has depended on support from majority mass movements and reform parties that gained power through expedient compromise. The human rights enterprise is now facing fierce pushback from illiberal strongmen and populists who counter-shame the liberal order as decadent, degenerate, and threatening to deeply rooted values. Too often, contemporary rights rhetoric plays into the hands of these illiberal critics. Human Rights for Pragmatists explains how rights-based societies can recover a more accurate narrative of their past pragmatic successes, repair their tactical flaws, and withstand illiberal challenges.
Educating tomorrow’s public health professionals to utilize the arts for health
Authors: Harrison Annie , Waterson Hannah
Published: December 2023

Momentum has been building over the last few years around capitalizing on the arts for improving health and wellbeing. But how are public health professionals to develop the skills needed to utilize the arts? In this article, Annie Harrison and Hannah Waterson discuss the evidence for the use of arts in health and describe ‘Arts and Public Health’ an optional module of the University of Manchester: Master of Public Health designed to equip students to meet the arts and health challenge.
The successive emergence of ERVL-MaLRs in primates
Authors: Zuo Zheng
Published: December 2023

Although the ERVL-mammalian-apparent LTR retrotransposons (MaLRs) are the fourth largest family of transposable elements in the human genome, their evolutionary history and relationship have not been thoroughly studied. In this study, through RepeatMasker annotations of some representative species and construction of phylogenetic tree by sequence similarity, all primate-specific MaLR members are found to descend from MLT1A1 retrotransposon. Comparative genomic analysis, transposition-in-transposition inference, and sequence feature comparisons consistently show that each MaLR member evolved from its predecessor successively and had a limited activity period during primate evolution. Accordingly, a novel MaLR member was discovered as successor of MSTB1 in Tarsiiformes. At last, the identification of candidate precursor and intermediate THE1A elements provides further evidence for the previously proposed arms race model between ZNF430/ZNF100 and THE1B/THE1A. Taken together, this study sheds light on the evolutionary history of MaLRs and can serve as a foundation for future research on their interactions with zinc finger genes, gene regulation, and human health implications.