bluuebunny/crossref_metadata_2025 huggingface dataset:
The Keck-HGCA Pilot Survey – II. Direct imaging discovery of HD 63754 B, a ∼20 au massive companion near the hydrogen burning limit
Authors: Li Yiting , Brandt Timothy D , Franson Kyle , An Qier , Tobin Taylor , Currie Thayne , Chen Minghan , Wang Lanxuan , Dupuy Trent J , Bowens-Rubin Rachel , Salama Maïssa , Lewis Briley L , Gibbs Aidan , Bowler Brendan P , Jensen-Clem Rebecca , Faherty Jacqueline , Fitzgerald Michael P , Mazin Benjamin A
Published: August 2024

We present the joint astrometric and direct imaging discovery, mass measurement, and orbital analysis of HD 63754 B (HIP 38216 B), a companion near the stellar-substellar boundary orbiting $\sim$20 au from its Sun-like host. HD 63754 was observed in our ongoing high-contrast imaging survey targeting stars with significant proper-motion accelerations between Hipparcos and Gaia consistent with wide-separation substellar companions. We utilized archival High Resolution Echelle Spectrograph and High Accuracy Radial Velocity Planet Searcher radial velocity (RV) data, together with the host star’s astrometric acceleration extracted from the Hipparcos–Gaia Catalog of Accelerations, to predict the location of the candidate companion around HD 63754 A. We subsequently imaged HD 63754 B at its predicted location using the Near Infrared Camera 2 (NIRC2) in the $L^{\prime }$ band at the W. M. Keck Observatory. We then jointly modelled the orbit of HD 63754 B with RVs, Hipparcos–Gaia accelerations, and our new relative astrometry, measuring a dynamical mass of ${81.9}_{-5.8}^{+6.4} {M_{\rm Jup}}$, an eccentricity of ${0.260}_{-0.059}^{+0.065}$, and a nearly face-on inclination of $174.\!\!^\circ 81_{-0.50}^{+0.48}$. For HD 63754 B, we obtain an $L^{\prime }$-band absolute magnitude of $L^{\prime } = 11.39\pm 0.06$ mag, from which we infer a bolometric luminosity of $\rm{log(L_{\rm bol}/{\rm{L}_{\odot}})= -4.55 \pm 0.08}$ dex using a comparison sample of L and T dwarfs with measured luminosities. Although uncertainties linger in age and dynamical mass estimates, our analysis points towards HD 63754 B’s identity as a brown dwarf on the L/T transition rather than a low-mass star, indicated by its inferred bolometric luminosity and model-estimated effective temperature. Future RV, spectroscopic, and astrometric data such as those from JWST and Gaia Data Release 4 will clarify HD 63754 B’s mass, and enable spectral typing and atmospheric characterization.
Approximate analytical solutions of the homologous collapse’s radial evolution in time
Authors: Calvo Manuel , Elipe Antonio , Rández Luis
Published: August 2024

The homologous collapse of a uniform density sphere under its self-gravity is a well-known model in cosmological studies. In the analytical integration, the evolution of the radius of the sphere is defined in terms of a parameter that is related to the physical time through a transcendental equation. The aim of this note is to construct new approximate solutions of this transcendental equation. After close examination of the piecewise Padé approximation introduced in a recent paper by Zhou and collaborators, several modifications that improve the accuracy of this approximation with the same computational cost are proposed. This new approximation shows that the use of piecewise Hermite interpolation leads to approximate solutions with continuity and much higher accuracy than Padé interpolants. Numerical experiments that confirm the above results are also presented.
On the fate of the secondary white dwarf in double-degenerate double-detonation Type Ia supernovae – II. 3D synthetic observables
Authors: Pollin J M , Sim S A , Pakmor R , Callan F P , Collins C E , Shingles L J , Röpke F K , Srivastav S
Published: August 2024

A leading model for Type Ia supernovae involves the double-detonation of a sub-Chandrasekhar mass white dwarf. Double-detonations arise when a surface helium shell detonation generates shockwaves that trigger a core detonation; this mechanism may be triggered via accretion or during the merger of binaries. Most previous double-detonation simulations only included the primary white dwarf; however, the fate of the secondary has significant observational consequences. Recently, hydrodynamic simulations accounted for the companion in double-degenerate double-detonation mergers. In the merger of a 1.05 M$_{\odot }$ primary white dwarf and 0.7 M$_{\odot }$ secondary white dwarf, the primary consistently detonates while the fate of the secondary remains uncertain. We consider two versions of this scenario, one in which the secondary survives and another in which it detonates. We present the first 3D radiative transfer calculations for these models and show that the synthetic observables for both models are similar and match properties of the peculiar 02es-like subclass of Type Ia supernovae. Our calculations show angle dependencies sensitive to the companion’s fate, and we can obtain a closer spectroscopic match to normal Type Ia supernovae when the secondary detonates and the effects of helium detonation ash are minimized. The asymmetry in the width–luminosity relationship is comparable to previous double-detonation models, but the overall spread is increased with a secondary detonation. The secondary detonation has a meaningful impact on all synthetic observables; however, multidimensional nebular phase calculations are needed to support or rule out either model as a likely explanation for Type Ia supernovae.
Statistical properties of filaments in the cosmic web
Authors: Zhang Youcai , Guo Hong , Yang Xiaohu , Wang Peng
Published: August 2024

In the context of the cosmological and constrained Exploring the Local Universe with the reConstructed Initial Density field (ELUCID) simulation, this study explores the statistical characteristics of filaments within the cosmic web, focussing on aspects such as the distribution of filament lengths and their radial density profiles. Using the classification of the cosmic web environment through the Hessian matrix of the density field, our primary focus is on how cosmic structures react to the two variables $R_{\rm s}$ and $\lambda _{\rm th}$. The findings show that the volume fractions of knots, filaments, sheets, and voids are highly influenced by the threshold parameter $\lambda _{\rm th}$, with only a slight influence from the smoothing length $R_{\rm s}$. The central axis of the cylindrical filament is pinpointed using the medial-axis thinning algorithm of the COsmic Web Skeleton (COWS) method. It is observed that median filament lengths tend to increase as the smoothing lengths increase. Analysis of filament length functions at different values of $R_{\rm s}$ indicates a reduction in shorter filaments and an increase in longer filaments as $R_{\rm s}$ increases, peaking around $2.5R_{\rm s}$. The study also shows that the radial density profiles of filaments are markedly affected by the parameters $R_{\rm s}$ and $\lambda _{\rm th}$, showing a valley at approximately $2R_{\rm s}$, with increases in the threshold leading to higher amplitudes of the density profile. Moreover, shorter filaments tend to have denser profiles than their longer counterparts.
Parity-odd power spectra: concise statistics for cosmological parity violation
Authors: Jamieson Drew , Caravano Angelo , Hou Jiamin , Slepian Zachary , Komatsu Eiichiro
Published: August 2024

We introduce the parity-odd power (POP) spectra, a novel set of observables for probing parity violation in cosmological N-point statistics. POP spectra are derived from composite fields obtained by applying non-linear transformations, involving also gradients, curls, and filtering functions, to a scalar field. This compresses the parity-odd trispectrum into a power spectrum. These new statistics offer several advantages: they are computationally fast to construct, estimating their covariance is less demanding compared to estimating that of the full parity-odd trispectrum, and they are simple to model theoretically. We measure the POP spectra on simulations of a scalar field with a specific parity-odd trispectrum shape. We compare these measurements to semi-analytic theoretical calculations and find agreement. We also explore extensions and generalizations of these parity-odd observables.
An improved Tully–Fisher estimate of H0
Authors: Boubel Paula , Colless Matthew , Said Khaled , Staveley-Smith Lister
Published: August 2024

We propose an improved comprehensive method for determining the Hubble constant ($H_0$) using the Tully–Fisher relation. By fitting a peculiar velocity model in conjunction with the Tully–Fisher relation, all available data can be used to derive self-consistent Tully–Fisher parameters. In comparison to previous approaches, our method offers several improvements: it can be readily generalized to different forms of the Tully–Fisher relation and its intrinsic scatter; it uses a peculiar velocity model to predict distances more accurately; it can account for all selection effects; it uses the entire data set to fit the Tully–Fisher relation; and it is fully self-consistent. The Tully–Fisher relation zero-point is calibrated using the subset of galaxies with distances from absolute distance indicators. We demonstrate this method on the Cosmicflows-4 catalogue i-band and $W1$-band Tully–Fisher samples and show that the uncertainties from fitting the Tully–Fisher relation amount to only 0.2 km s$^{-1}$ Mpc$^{-1}$. Using all available absolute distance calibrators, we obtain $H_0=73.3$ $\pm$ 2.1 (stat) $\pm$ 3.5 (sys) km s$^{-1}$ Mpc$^{-1}$, where the statistical uncertainty is dominated by the small number of galaxies with absolute distance estimates. The substantial systematic uncertainty reflects inconsistencies between various zero-point calibrations of the Cepheid period–luminosity relation, the tip of the red giant branch standard candle, and the Type Ia supernova standard candle. However, given a reliable set of absolute distance calibrators, our method promises enhanced precision in $H_0$ measurements from large new Tully–Fisher samples such as the WALLABY survey.
TF-High-Evolutionary: In Vivo Mutagenesis of Gene Regulatory Networks for the Study of the Genetics and Evolution of the Drosophila Regulatory Genome
Authors: Li Xueying C , Srinivasan Vani , Laiker Ian , Misunou Natalia , Frankel Nicolás , Pallares Luisa F , Crocker Justin
Published: August 2024

Understanding the evolutionary potential of mutations in gene regulatory networks is essential to furthering the study of evolution and development. However, in multicellular systems, genetic manipulation of regulatory networks in a targeted and high-throughput way remains challenging. In this study, we designed TF-High-Evolutionary (HighEvo), a transcription factor (TF) fused with a base editor (activation-induced deaminase), to continuously induce germline mutations at TF-binding sites across regulatory networks in Drosophila. Populations of flies expressing TF-HighEvo in their germlines accumulated mutations at rates an order of magnitude higher than natural populations. Importantly, these mutations accumulated around the targeted TF-binding sites across the genome, leading to distinct morphological phenotypes consistent with the developmental roles of the tagged TFs. As such, this TF-HighEvo method allows the interrogation of the mutational space of gene regulatory networks at scale and can serve as a powerful reagent for experimental evolution and genetic screens focused on the regulatory genome.
Land snail assemblages along altitudinal gradients on Mount Semeru, the highest montane forest in Java, Indonesia
Authors: Nurhayati Putri Afin , Nurinsiyah Ayu Savitri , Atmowidi Tri , Priawandiputra Windra
Published: August 2024

We conducted research on land snail diversity on the highest volcanic mountain in Java, Mt Semeru. This research aimed to gain data on the land snail species diversity in the area as well as analyse environmental variables that affect the land snail assemblages along the altitudinal gradients. A total of 40 plots of 10 × 10 m2 were examined in the altitudinal gradient of 800–1,200, 1,201–1,600, 1,601–2,000 and 2,001–2,400 m asl using a timed search method. In total, 788 individuals of land snails were collected, belonging to 22 species from 14 families. Fifteen species were new records for the area. Five endemic species were recorded on Mt Semeru. A single introduced species, Bradybaena similaris was found abundantly on the mountain at an altitude of more than 2,000 m asl. Multiple linear regression analyses showed a unimodal response of species richness for altitude, temperature and precipitation sums on Mt Semeru. In addition to these environmental variables, species richness is influenced by land use type and soil pH. These findings suggest that species and ecosystem management at the altitude 2,001–2,400 m asl is necessary to conserve endemic land snail species, which were found most abundantly at this altitude.
Pregnancy and childbirth in Takayasu arteritis in Japan: A nationwide retrospective study
Authors: Miyamae Takako , Manabe Yusuke , Sugihara Takahiko , Umezawa Natsuka , Yoshifuji Hajime , Tamura Naoto , Abe Yoshiyuki , Furuta Shunsuke , Nagafuchi Hiroko , Ishizaki Jun , Nakano Naoko , Atsumi Tatsuya , Karino Kohei , Amano Koichi , Kurasawa Takahiko , Ito Shuichi , Yoshimi Ryusuke , Ogawa Noriyoshi , Banno Shogo , Naniwa Taio , Ito Satoshi , Hara Akinori , Hirahara Shinya , Uchida Haruhito A , Onishi Yasuhiro , Murakawa Yohko , Komagata Yoshinori , Nakaoka Yoshikazu , Harigai Masayoshi
Published: August 2024

Objectives

This study aimed to understand the status quo of medical treatments and pregnancy outcomes in patients with Takayasu arteritis (TAK) and children’s birth outcomes.

Methods

This study retrospectively enrolled patients with TAK who conceived after the disease onset and were managed at medical facilities participating in the Japan Research Committee of the Ministry of Health, Labour, and Welfare for Intractable Vasculitis.

Results

This study enrolled 51 cases and 68 pregnancies during 2019–21. Of these, 48 cases and 65 pregnancies resulted in delivery and live-born babies. The median age of diagnosis and delivery was 22 and 31 years, respectively. Preconception therapy included prednisolone (PSL) in 51 (78.5%, median 7.5 mg/day), immunosuppressants in 18 (27.7%), and biologics in 12 (18.5%) pregnancies. Six cases underwent surgical treatment before pregnancy. Medications during pregnancy included PSL in 48 (73.8%, median: 9 mg/day), immunosuppressants in 13 (20.0%), and biologics in 9 (13.8%) pregnancies. TAK relapsed in four (6.2%) and eight (12.3%) pregnancies during pregnancy and after delivery, respectively. Additionally, 13/62 (20.9%) preterm infants and 17/59 (28.8%) low-birth-weight infants were observed, and none had serious postnatal abnormalities.

Conclusions

Most pregnancies in TAK were manageable with PSL at ≤10 mg/day. Relapse during pregnancy and postpartum occurred in <20% of pregnancies.
Unveiling the arthritis divide: Exploring treatment response and impact in late-onset vs. young-onset rheumatoid arthritis
Authors: Hao Nariaki , Ishikawa Hajime , Abe Asami , Sudo Masanori , Takamura Sayuri , Otani Hiroshi , Ito Satoshi , Nakazono Kiyoshi , Murasawa Akira
Published: August 2024

Objectives

The impact of osteoarthritis (OA) on the initial treatment response of rheumatoid arthritis (RA) by treat-to-target practice was compared between the patients with an onset age of ≥65 years old [late-onset RA (LORA)] and those with an onset age of <65 years old [young-onset RA (YORA)].

Methods

A retrospective study was conducted on the patients with RA, who were referred to Department of Rheumatology, Niigata Rheumatic Center without treatment between January 2021 and July 2022. Patients with grade ≥3 OA according to the Kellgren–Lawrence (K–L) classification in either the knee or hand were classified in the OA (+) group and others were in the OA (−) group. The clinical data were compared at diagnosis and 1 year after the initial treatment between the groups for 74 LORA and 59 YORA patients, respectively.

Results

One year after starting treatment in the LORA patients, the OA (+) group had poorer disease activity control and greater disability in several activities of daily living than the OA (−) group. In the YORA patients, there were no differences in activities of daily living disability between the groups.

Conclusions

In the initial treatment of the LORA patients, the prevalence of OA was high, and the impact of OA on LORA was larger than on YORA.
Mitigating radiation-induced cognitive toxicity in brain metastases: More questions than answers
Authors: Simó Marta , Rodríguez-Fornells Antoni , Navarro Valentín , Navarro-Martín Arturo , Nadal Ernest , Bruna Jordi
Published: August 2024

The emergence of advanced systemic therapies added to the use of cranial radiation techniques has significantly improved outcomes for cancer patients with multiple brain metastases (BM), leading to a considerable increase in long-term survivors. In this context, the rise of radiation-induced cognitive toxicity (RICT) has become increasingly relevant. In this critical narrative review, we address the controversies arising from clinical trials aimed at mitigating RICT. We thoroughly examine interventions such as memantine, hippocampal avoidance irradiation during BM treatment or in a prophylactic setting, and the assessment of cognitive safety in stereotactic radiosurgery (SRS). Our focus extends to recent neuroscience research findings, emphasizing the importance of preserving not only the hippocampal cortex but also other cortical regions involved in neural dynamic networks and their intricate role in encoding new memories. Despite treatment advancements, effectively managing patients with multiple BM and determining the optimal timing and integration of radiation and systemic treatments remain areas requiring further elucidation. Future trials are required to delineate optimal indications and ensure SRS safety. Additionally, the impact of new systemic therapies and the potential effects of delaying irradiation on cognitive functioning also need to be addressed. Inclusive trial designs, encompassing patients with multiple BM and accounting for diverse treatment scenarios, are essential for advancing effective strategies in managing RICT and the treatment of BM patients.
Starch metabolism in guard cells: At the intersection of environmental stimuli and stomatal movement
Authors: Dang Trang , Piro Lucia , Pasini Carlo , Santelia Diana
Published: August 2024

Starch metabolism in guard cells plays a central role in regulating stomatal movement in response to light, elevated ambient CO2 and potentially other abiotic and biotic factors. Here, we discuss how various guard cell signal transduction pathways converge to promote rearrangements in guard cell starch metabolism for efficient stomatal responses, an essential physiological process that sustains plant productivity and stress tolerance. We suggest manipulation of guard cell starch dynamics as a previously overlooked strategy to improve stomatal behavior under changing environmental conditions.
Computerized Adaptive Testing for the Berg Balance Scale Improves Measurement Efficiency Without Compromising Precision in People With Stroke
Authors: Seamon Bryant A , Kautz Steven A , Velozo Craig A
Published: August 2024

Objective

The objectives of this study were to confirm the Berg Balance Scale’s (BBS) measurement properties and unidimensionality with an item response theory analysis in persons with subacute and chronic stroke and to examine the precision and efficiency of computerized adaptive testing (CAT).

Methods

Data were obtained from 519 ambulatory persons with subacute and chronic stroke in 2 retrospective databases. A principal component analysis (PCA) of residuals was used to evaluate unidimensionality. BBS fit to a rating scale model versus a partial credit model was examined, and item parameters were generated for CAT calibration. Person measures from all 14 items were defined as actual balance ability. BBS CAT simulations were used to examine changes in measurement precision with increasing number of items administered and a precision-based stopping rule (0.5 logit standard error [SE] threshold).

Results

A PCA of residuals supports the BBS unidimensionality and Rasch analysis supports using the rating scale model for measurement. Maximum precision for BBS CAT was SE = 0.40 logits when administering all items. BBS CAT estimated balance ability was highly correlated with actual ability when 4 or more items were administered (r > 0.9). Precision was within 0.5 logits when 5 or more items were administered (SE < 0.48 logits). BBS CAT estimated balance ability was highly correlated with actual ability (r = 0.952) using a precision-based stopping rule. The average number of items administered with the precision-based stopping rule was 5.43.

Conclusion

The BBS is sufficiently unidimensional, and the rating scale model can be used for measurement. BBS CAT is efficient and replicates the full instrument’s reliability when measuring balance ability in ambulatory persons with subacute and chronic stroke. Future work should aim to enhance the interpretability of measures to facilitate clinical decision-making.

Impact

BBS CAT provides an efficient way of measuring balance ability for individuals in stroke rehabilitation giving clinicians more time with patients.
Public health unit engagement in school mental health programs and adolescent mental health during the COVID-19 pandemic: COMPASS, 2018–2022
Authors: Benny Claire , Smith Brendan T , Patte Karen A , Leatherdale Scott T , Pabayo Roman
Published: August 2024

Background

Public health unit (PHU) engagement in schools is important for promoting wellness in students. We aimed to investigate if PHU engagement with schools may have provided protection against the risk of depression and anxiety in students during the COVID-19 pandemic.

Methods

We used longitudinal data from the Cannabis, Obesity, Mental health, Physical activity, Alcohol use, Smoking and Sedentary behaviour survey between the 2018/19 and 2020/21 academic years. Multilevel models were used to assess the association between PHU engagement with school mental health programs prior to the COVID-19 pandemic and depressive (Center for Epidemiologic Studies Depression scale Revised) and anxiety symptoms (Generalized Anxiety Disorder scale) during the COVID-19 pandemic.

Results

The sample included 23 894 students across 104 secondary schools in British Columbia, Alberta, Ontario and Quebec. In confounder-adjusted models, PHU engagement before the pandemic was not associated with student depressive symptoms (B = −0.01, 95% CI = −0.04, 0.02), but was protective against anxiety symptoms (B = −0.03, −0.06, 0.001) during the COVID-19 pandemic.

Discussion

The results highlight that PHU engagement with mental health programming in schools was protective against anxiety for students during the COVID-19 pandemic. The findings support the importance of PHU engagement for improving student mental health and pandemic recovery.
Effects of a Triage Checklist to optimize insomnia treatment outcomes and reduce hypnotic use: the RCT of the effectiveness of stepped-care sleep therapy in general practice study
Authors: Manber Rachel , Gumport Nicole B , Tully Isabelle A , Kim Jane P , Kim Bohye , Simpson Norah , Rosas Lisa G , Zulman Donna M , Goldhaber-Fiebert Jeremy D , Rangel Elizabeth , Dietch Jessica R , Tutek Joshua , Palaniappan Latha
Published: August 2024

Study Objectives

Evaluate a triaged stepped-care strategy among adults 50 and older with insomnia disorder.

Methods

Participants (N = 245) were classified at baseline by a Triage Checklist. Those projected to do better if they start treatment with therapist versus digitally delivered CBT-I (tCBT-I vs dCBT-I) constituted the YES stratum (n = 137); the rest constituted the NO stratum (n = 108). Participants were randomized within stratum to a strategy that utilized only dCBT-I (ONLN) or to a strategy that prospectively allocated the first step of care to dCBT-I or tCBT-I based on the Triage Checklist and switched dCBT-I nonresponders at 2-months to tCBT-I (STEP). Co-primary outcomes were the insomnia severity index (ISI) and the average nightly amount of prescription hypnotic medications used (MEDS), assessed at 2, 4, 6, 9, and 12 months postrandomization.

Results

Mixed effects models revealed that, compared to ONLN, participants in STEP had greater reductions in ISI (p = .001; η2 = 0.01) and MEDS (p = .019, η2 = 0.01). Within the YES stratum, compared to ONLN, those in STEP had greater reductions in ISI (p = .0001, η2 = 0.023) and MEDS (p = .018, η2 = 0.01). Within the ONLN arm, compared to the YES stratum, those in the NO stratum had greater reductions in ISI (p = .015, η2 = 0.01) but not in MEDS. Results did not change with treatment-dose covariate adjustment.

Conclusions

Triaged-stepped care can help guide the allocation of limited CBT-I treatment resources to promote effective and safe treatment of chronic insomnia among middle-aged and older adults. Further refinement of the Triage Checklist and optimization of the timing and switching criteria may improve the balance between effectiveness and use of resources.

Clinical Trial Information

Name: The RESTING Insomnia Study: Randomized Controlled Study on Effectiveness of Stepped-Care Sleep Therapy.

Trial registration ID

NCT03532282. URL: https://clinicaltrials.gov/study/NCT03532282
Exploring healthcare professionals’ perspectives on neglected tropical diseases in Eastern Uganda: a qualitative study with a focus on schistosomiasis and soil-transmitted helminths
Authors: Kihumuro Raymond Bernard , Atimango Lorna , Kintu Timothy Mwanje , Makai Conrad , Kanyike Andrew Marvin , Bazira Joel
Published: August 2024

Background

Neglected tropical diseases (NTDs), including soil-transmitted helminths (STHs) and schistosomiasis, continue to impose a heavy burden, especially in sub-Saharan Africa and Uganda, despite being preventable. Integration of NTD management into primary healthcare has been inadequate. While researchers have explored community perspectives, there is a notable gap in understanding the viewpoints of healthcare workers (HCW), which is crucial for effective NTD control strategies. This study explores HCW’ perspectives in Eastern Uganda, highlighting challenges in schistosomiasis and STH prevention and management.

Methods

In this qualitative descriptive study, we conducted semistructured interviews with 10 key informants who were HCW in Eastern Uganda with experience in managing STHs and schistosomiasis. Participants were selected purposively and interviewed through Zoom guided by a comprehensive interview guide. The data were transcribed, coded and analyzed thematically.

Results

We identified five key themes regarding the impact and management of NTDs: (i) the burden of NTDs, where schistosomiasis and STHs were notably prevalent among children and communities adjacent to water bodies; (ii) transmission of NTDs, emphasizing water bodies and poor sanitation as primary routes of disease spread; (iii) clinical manifestations of NTDs, detailing the symptomatic presentations that complicate diagnosis and management; (iv) challenges in managing and diagnosing NTDs, highlighting the shortages of essential medications and diagnostic tools, along with the under-prioritization of NTDs within healthcare systems; and (v) fatalities and complications arising from NTDs, reporting on the severe outcomes and under-reporting of deaths associated with NTDs due to misdiagnosis, delayed treatment and traditional healing preferences.

Conclusion

The interviewed Ugandan HCW demonstrated sufficient knowledge of schistosomiasis and STHs, but faced challenges due to inadequate diagnostic tools and medication shortages. The study underscores the need for NTD prioritization with direct funding and government involvement, alongside strategies that integrate continuous medical training, effective community outreach and an enhanced healthcare system response to reduce the burden of NTDs.
Virtual Compared With In-Office Postoperative Visits After Urogynecologic Surgery
Authors: Lua-Mailland Lannah L. , Nowacki Amy S. , Paraiso Marie Fidela R. , Park Amy J. , Wallace Shannon L. , Ferrando Cecile A.
Published: August 2024

OBJECTIVE:

To compare patient satisfaction, health care resource utilization, and adverse events among patients receiving a virtual video compared with in-office postoperative visit after urogynecologic surgery. We hypothesized that virtual video visits would be noninferior to in-office visits.

METHODS:

This was a randomized noninferiority clinical trial of patients undergoing surgery for pelvic organ prolapse and urinary incontinence at a single academic tertiary referral center. Participants were randomized to receive either a virtual video postoperative visit or a standard in-office postoperative visit. The primary outcome was patient satisfaction measured by the validated PSQ-18 (Patient Satisfaction Questionnaire-18) (noninferiority margin 5 points) at the 6-week postoperative visit. Secondary outcomes included PSQ-18 domain scores (noninferiority margin 0.5 points) and composite health care resource utilization and adverse events after the 6-week postoperative visit up to 12 weeks after surgery (noninferiority margin 10%). A sample size of 100 participants (50 per group) would allow 80% power to assess a 5-point noninferiority margin on the total PSQ-18 with an SD of 10 and α=0.05.

RESULTS:

From January 2023 to September 2023, 265 patients were screened for eligibility, and 104 were randomized. A total of 100 participants (50 per arm) completed the study and were included in the analysis. The mean±SD age of all participants was 57.0±13.2 years. The mean±SD PSQ-18 total score was 75.18±8.15 in the virtual group and 75.14±8.7 in the in-office group. The mean PSQ-18 total score was 0.04 points higher (ie, greater degree of satisfaction) in the virtual group, with a 95% CI of −2.75 to 2.83, which met the criterion for noninferiority. Between-group differences for all PSQ-18 domain scores likewise met criterion for noninferiority. Composite health care resource utilization was 14.0% lower in the virtual group than in the in-office group (20.0% vs 34.0%, 95% CI, −28.0% to 1.0%). For composite adverse events, the between-group difference was 2.0% (2.0% in virtual group vs 0.0% in in-office group, 95% CI,−3.0% to 8.0%).

CONCLUSION:

Virtual video postoperative visits were noninferior to in-office visits with regard to patient satisfaction, health care resource utilization, and adverse events and can be offered as an alternative to in-office visits for postoperative follow-up after urogynecologic surgery.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT05641077.
Standard Compared With Extended Red Blood Cell Antigen Matching for Prevention of Subsequent Hemolytic Disease of the Fetus and Newborn
Authors: Sugrue Ronan P. , Olsen Jaxon , Abi Antoun Marie Elise , Skalla Lesley A. , Cate Jennifer , James Andra H. , Stonehill Alexandra , Watkins Virginia , Telen Marilyn J. , Federspiel Jerome J.
Published: August 2024

OBJECTIVE:

To systematically review and meta-analyze alloimmunization among recipients of red blood cells (RBCs) matched for ABO blood type and Rhesus D (ABO+D) antigen compared with those also matched for c, E, and Kell (cEK).

DATA SOURCES:

Four online databases (Medline, Scopus, EMBASE, ClinicalTrials.gov) were searched from March 28, 2023, to April 1, 2024. The search protocol was peer reviewed and published on PROSPERO (CRD42023411620).

METHODS OF STUDY SELECTION:

Studies reporting alloimmunization as the primary outcome among recipients of RBCs matched for ABO+D or additional cEK matching were included. Patients transfused with unmatched RBCs or a mixture of matching regimens were excluded. Risk of bias was assessed with Cochrane Tool to Assess Risk of Bias in Cohort Studies and Tool for Risk of Bias. Random-effects meta-analysis was used to combine effect estimates.

TABULATION, INTEGRATION, AND RESULTS:

Ten studies met criteria. Risk of bias was low. Overall, 91,221 patients were transfused, of whom 40,220 (44.1%) received additional cEK-matched RBCs. The overall rate of alloimmunization was 6.2% (95% CI, 2.5–14.9%) for ABO+D–only matching and 1.9% (95% CI, 0.7–5.1%) when cEK was added. Time of follow-up antibody testing ranged from 6 to 18 months after transfusion. Additional cEK match was associated with significantly less alloimmunization compared with standard ABO+D match (odds ratio [OR] 0.37, 95% CI, 0.20–0.69). This association remained when chronically transfused patients were excluded (OR 0.65, 95% CI, 0.54–0.79) and for alloimmunization to c, E, or K antigens only (OR 0.29, 95% CI, 0.18–0.47).

CONCLUSION:

Additional cEK RBC matching protocols were associated with lower odds of recipient alloimmunization. Given severe sequelae of alloimmunization in pregnancy, routine cEK matching for transfusion in people with pregnancy potential younger than age 50 years in the United States merits consideration.

SYSTEMATIC REVIEW REGISTRATION:

PROSPERO, CRD42023411620.
HER2 exon 20 mutant non-small cell lung cancer with complete remission of intracranial metastases with trastuzumab deruxtecan: a case report
Authors: Güren Ali Kaan , Kocaaslan Erkam , Ağyol Yeşim , Majidova Nargiz , Sever Nadiye , Erel Pinar , Çelebi Abdussamet , Arikan Rukiye , Işik Selver , Sari Murat , Bayoğlu İbrahim Vedat , Köstek Osman
Published: August 2024

Trastuzumab deruxtecan (T-DXd) is a novel anti-HER2 antibody-drug conjugate formed by the combination of trastuzumab and deruxtecan. It is used in human epidermal growth factor 2 receptor (HER2) mutant breast, stomach and colorectal cancers as well as non-small cell lung cancer (NSCLC). The 58-year-old denovo metastatic NSCLC patient we will discuss here progressed with newly developing brain metastasis under first-line carboplatin/paclitaxel treatment. After next generation sequencing revealed a mutation in the ERBB2 gene located in exon 20, we administered T-DXd to our patient. While a significant improvement was observed in the clinical condition of the patient after one course of treatment, brain metastases were found to be in complete response in control screening after four courses of treatment. Systemic screening with PET/computed tomography showed nearly complete regression of the primary lesion, metastatic lymphadenopathies, and surrenal metastases. T-DXd may be successfully used in HER2 mutant metastatic NSCLC patients. In addition, it can also be successfully used in patients with central nervous system metastases with or without cranial radiotherapy.
The Combination of Valsartan and Spironolactone Mitigated Mitral Regurgitation–Induced Cardiac Dysfunction in a Novel Rat Model
Authors: Chang Wei-Ting , Lin Yu-Wen , Chen Chin-Yu , Hong Chon-Seng , Chen Zhih-Cherng , Lin You-Cheng , Shih Jhih-Yuan
Published: August 2024

Despite its high prevalence, effective treatment for degenerative mitral regurgitation (MR) remains elusive. Although the mineralocorticoid-receptor antagonist spironolactone, in conjunction with renin–angiotensin–aldosterone system inhibitors, has been shown to reduce mortality in patients with heart failure with reduced ejection fraction, its efficacy in managing degenerative MR is uncertain. In this study, we aimed to compare the effectiveness of valsartan (a renin–angiotensin system inhibitor), spironolactone, and combination therapy in mitigating MR-induced myocardial dysfunction. Using a mini-invasive model of degenerative MR, we administered valsartan (31 mg/kg/d), spironolactone (80 mg/kg/d), or a combination of both to rats over a 4-week period. Serial echocardiography and pressure–volume loops were utilized to assess cardiac function and hemodynamics. Rats with degenerative MR treated with valsartan or spironolactone alone did not show significant improvement in myocardial dysfunction. In contrast, combination therapy resulted in significant improvement. Similarly, the pressure–volume relationship was significantly improved in rats treated with the combination therapy compared with that in rats treated with a single therapy. Mechanistically, combination therapy effectively suppressed circulating and cardiac expression of aldosterone- and apoptosis-associated proteins. Overall, combination treatment with valsartan and spironolactone significantly attenuated the degenerative MR-induced myocardial stress and dysfunction, suggesting a potential therapeutic avenue for managing degenerative MR-induced heart failure.
Sodium–Glucose Cotransporter 2 Inhibitors, Malnutrition, Cachexia, and Survival in Patients With Heart Failure With a History of Anthracycline Treatment
Authors: Henson Benjamin D. , Bale-Neary Claudia A. , Mecaskey Ryan , Gbujie Ogechi , Zhan Michelle , Rao Krishnasree , Carbone Salvatore
Published: August 2024

Patients undergoing anthracycline-based cancer treatments have an increased risk of heart failure or worsening preexisting heart failure as well as adverse metabolic outcomes such as malnutrition and cachexia. This retrospective study explored the impact of sodium–glucose cotransporter 2 inhibitors (SGLT2i) on these outcomes in patients with heart failure previously treated with anthracyclines. Using the TriNetX research network, we identified 1545 patients with a history of SGLT2i use and 17,681 patients without a history of SGLT2i use. We then performed 1:1 propensity score matching resulting in 1323 patients within each cohort. Patients were analyzed over a 5-year period. SGLT2i use was associated with significantly reduced risks of cachexia {hazard ratio (HR) 0.453, 95% confidence interval (CI) [0.286–0.718]}, malnutrition (HR 0.702, 95% CI [0.547–0.900]), adult failure to thrive (HR 0.489, 95% CI [0.345–0.693]), and all-cause mortality (HR 0.490, 95% CI [0.423–0.568]). These findings call for additional research to determine whether SGLT2i may indeed improve nutritional status and survival in patients with heart failure receiving anthracycline therapy.
Community Integration Challenges of Men and Women After Traumatic Brain Injury: A Reflexive Thematic Analysis of Lived Experiences Through a Gender Lens
Authors: Lian Lulu , Coupland Rachael , Tylinski Sant’Ana Thaisa , Colantonio Angela , Mollayeva Tatyana
Published: August 2024

Objective:

To investigate community integration (CI) challenges following traumatic brain injury (TBI) through a gender lens.

Setting:

Rehabilitation research-teaching hospital.

Participants:

Adult participants (22 men and 20 women) with a primary diagnosis of mild or moderate-severe TBI, in the acute or chronic stages after injury, were recruited using purposive sampling.

Design:

Qualitative study. Data were collected through semistructured interviews, and thematic analysis was used to identify themes of CI challenges.

Results:

Three overarching themes emerged: (1) lack of a “graduated home plan”: difficulty enacting gendered roles and responsibilities at home, (2) “Something that I cannot handle”: mismatch between occupational demands and abilities, and (3) “Slipping away”: disrupted connections with self and others. Men consistently voiced struggles with and inability to fulfill household tasks, whereas women detailed ways of adapting domestic responsibilities because of postinjury limitations. Productivity challenges resonated with a substantial number of participants, and a gendered pattern was observed: More women reported an inability, whereas more men reported a limited ability to meet occupational demands. Both genders conveyed disruptions in recreational and leisure activities, although women predominantly discussed challenges relating to social activities and men a tendency to avoid social situations because of anticipated stigma and/or shame. Across all themes, a pervasive sense of diminished community contributions and disrupted identities was observed.

Conclusion:

The incongruence between preinjury roles and responsibilities and postinjury abilities resulted in difficulties across multiple CI domains for the study participants and did not go unnoticed by them. It is important for health care professionals to assist patients in addressing gendered challenges at home, work, and in the social circle for a smoother transition back into the community.
Association Between Adverse Childhood Experiences and Sleep Duration in US Children
Authors: Song MinKyoung , McHill Andrew W. , Dieckmann Nathan F. , Musil Carol M. , Hayman Laura L.
Published: August 2024

Background

Adverse childhood experiences (ACEs) and suboptimal sleep both negatively associate with cardiovascular health. Although an association between ACEs and suboptimal sleep in youth has been reported, there has been no investigation for differential effects among ACE subdomains.

Objective

We examined associations between total and subdomain ACEs and sleep duration, and age as a moderator.

Methods

Using the 2020–2021 National Survey of Children's Health and the American Heart Association Life's Essential 8 scoring algorithm, we created 3 sleep subgroups: (1) optimal, (2) suboptimal (≥1 to <2 hours below or ≥1 hour above optimal), and (3) very suboptimal (≥2 hours below optimal). We assessed association between ACEs (total and subdomains) and sleep duration using multinomial logistic regression, controlling for sex, age, race/ethnicity, caregiver's education, household income, habitual bedtime, and physical activity. We tested the interactions between ACEs and child's age.

Results

In children aged 6 to 17 years (N = 58 964), mean sleep duration score was 77.2 (95% confidence interval, 76.6–77.9). The mean number of ACEs was 0.89 (95% confidence interval, 0.87–0.91). Adjusting for covariates, each additional ACE increased the likelihood of falling into the suboptimal subgroup by 8% and the very suboptimal subgroup by 26%. There was an association between each subdomain of ACE and suboptimal sleep duration, with no significant interaction with age.

Conclusions

Our findings show a dose-response relationship between ACEs and suboptimal sleep duration—a new cardiovascular health indicator in Life's Essential 8. Healthcare providers should screen for ACEs and suboptimal sleep in children to reduce future cardiovascular disease risk.
A Fulbright International Exchange to Expand the Physician Assistant/Associate Curriculum in Geriatrics
Authors: Segal-Gidan Freddi , van den Brink Geert , Brouwers Marijn , Heerdink Gonneke
Published: August 2024

The international growth of the physician assistant/associate (PA) profession provides opportunities for global exchange that PA faculty and clinicians should seek out and cultivate. Physician assistant/associate programs can benefit from the experiences and expertise of faculty educators from different backgrounds and countries. The Fulbright International Scholars Program is a well-established and recognized organization dedicated to supporting international exchange in higher education. This study describes the experience of an American PA who received a Fulbright Specialist Program award that provided the opportunity to collaborate with a Dutch PA program on improvement of their geriatric medicine didactic curriculum.
Lessons Learned From Conducting Virtual Multiple Mini Interviews During the COVID-19 Pandemic
Authors: Coleman Veronica , Tran Bau , Wang Jijia , Sengupta Samarpita , Perez Isela Edna , Howell-Stampley Temple , Jones P. Eugene
Published: August 2024

Introduction

The COVID-19 pandemic caused disruptions in PA program admissions secondary to the need for social distancing. Therefore, traditional in-person interview processes required modifications. In this article, we determined whether significant differences were identified when comparing applicant demographics, cognitive and noncognitive interview data, as well as feedback from the applicants between in-person multiple mini interview (iMMI) and virtual MMI (vMMI) at UT Southwestern's PA program.

Methods

Virtual MMI was developed and implemented for the admission cycle for the Class of 2023, using telecommunication systems that permit real-time interactions between the interviewer and the interviewee. The following groups of data were collected and compared between iMMI and vMMI: (1) applicant demographics; (2) interviewee OGPA, SGPA, GRE scores (obtained from CASPA); (3) program decisions such as number of interviewees, admission offers, admission declines, students matriculated (program-specific data), and mean MMI scores (from MMI instrument); and (4) feedback surveys to determine satisfaction outcomes. The students in the 2020 and 2021 classes also participated in the feedback survey.

Results

There were no significant differences between the iMMI and vMMI cohorts when comparing applicant demographics and interviewee scores and decisions. In the feedback surveys, 12% of the vMMI cohort reported a lower score on their capacity to “present an accurate portrayal of their ability” during the interview sessions (vMMI Likert score mean of 3.93; MMI mean of 4.36).

Discussion

The outcomes between iMMI and vMMI were not significantly different. The authors determined that the vMMI is a comparable alternative to the iMMI and can be used in lieu of or to supplement in-person interviews.
Advancing Consistency in Education: A Reliability Analysis of the Clinical Reasoning Assessment Tool
Authors: Wolden Ben , Wolden Mitch , Furze Jennifer , McDevitt Amy
Published: August 2024

Introduction.

Clinical reasoning (CR) is a fundamental component of physical therapist practice in health care. The Clinical Reasoning Assessment Tool (CRAT) was developed to assess CR in Doctor of Physical Therapy (DPT) and residency education. However, the reliability of the CRAT has not been investigated. Our purpose was to investigate the interrater and intrarater reliability of the CRAT.

Review of Literature.

A range of assessment methods are available to assess CR, including didactic-based, simulation learning, and clinic-based assessments. The CRAT is designed to assess CR across learning environments. The CRAT assesses CR across 3 domains: (1) content knowledge, (2) procedural knowledge/psychomotor skills, and (3) conceptual reasoning.

Subjects.

Twenty-two faculty participated.

Methods.

Participants completed an electronic survey at 2 timepoints (T1, T2) that included training on use of the CRAT and 2 case videos of DPT students at different performance levels managing a standardized patient. Participants rated student performance with the CRAT for both case videos (T1) and repeated the sequence at least 30 days later (T2). Intraclass correlation coefficient (ICC) estimates and 95% confidence intervals were used to determine the interrater and intrarater reliability for each domain of the CRAT.

Results.

Video 1 was consistently rated higher for each CRAT domain (T1: 7.32–8.05; T2: 8.05–8.15) compared to video 2 (T1: 2.91–3.68; T2: 3.00–3.68). There were inverse relationships between CRAT ratings and number of years in DPT education, at an institution, and as a licensed physical therapist. At both timepoints, the interrater reliability for each domain was good to excellent (ICCs 0.60–0.79). The intrarater reliability was fair to excellent for all domains for each video (ICCs 0.45–0.75).

Discussion and Conclusion.

The CRAT is a reliable instrument for assessing DPT student CR during a simulated patient encounter. Implementation of the CRAT in DPT education may facilitate improved consistency of CR assessment across the learner continuum.
Ethical considerations in lung re-transplantation
Authors: Lester Lynette A. , Huang Valerie P. , Wightman Sean C. , Rosenberg Graeme M.
Published: August 2024

Purpose of review

Patients undergoing re-transplantation constitute a growing proportion of annual lung transplants. It is necessary to consider ethical considerations of re-transplantation in parallel with clinical progress.

Recent findings

Most clinical data demonstrate patients undergoing re-transplantation have worse survival outcomes; however, there is limited discussion of the ethical principles surrounding re-transplantation. Ethical guidance in re-transplantation trails clinical advancement.

The four-box model offers a valuable framework for assessing the ethical considerations in re-transplantation. This includes an analysis of medical indications, patient preferences, quality-of-life and contextual factors to support the ethical use of scarce donor lungs.