bluuebunny/crossref_metadata_2025 huggingface dataset:
Tranexamic Acid Subcutaneously Administered with Epinephrine and Lidocaine in Upper Blepharoplasty: A Randomized Double-Blind Control Trial
Authors: Chaichumporn Thitinan , Kanokkangsadal Puritat , Sarovath Achariya
Published: May 2024

Background

Eyelid surgery is one of the top five aesthetic procedures. It is performed to improve both appearance and function, but intraoperative bleeding leads to adverse events which perturb patients. The objective of this study was to demonstrate the efficacy of TXA combined with epinephrine in decreasing intraoperative blood loss and postoperative inflammation.

Methods

This prospective randomized control trial was performed on the 30 eyelids of 15 patients who underwent upper blepharoplasty. One of each patient’s eyes was randomly assigned to the TXA group, and the other eye was in the control group. Eyes in the TXA group were given 2% lidocaine with epinephrine (1:100000) mixed with TXA (50 mg/ml) in 1:1 mixture subcutaneously as a local anesthetic. The eyes in the control group received 2% lidocaine with epinephrine (1:100000) diluted with normal saline in 1:1 mixture. Intraoperative blood loss and postoperative swelling were compared between the two groups.

Results

Intraoperative blood loss was significantly higher in the TXA group [4.86 (1.83) ml] than it was in the control group [2.53 (1.49) ml] (p < 0.001). There was no statistically significant difference between the two groups in operative time (p = 0.645), pain score (p = 0.498), lid crease (p = 0.548), or MRD1 (p = 0.626). On postoperative day 7, there was no difference in lid crease (p = 0.879), MRD1 (p = 0.463), pain score (p = 0.934), or ecchymosis (p = 0.976) between two groups.

Conclusions

TXA in lidocaine with epinephrine was found to increase intraoperative bleeding compared to lidocaine with epinephrine alone, but there was no difference in postoperative swelling or ecchymosis. TXA combined with lidocaine and epinephrine injected subcutaneously should be avoided until additional relevant data are obtained. Further drug interaction study is needed.

Level of Evidence II

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Liquid crystalline structuring in dilute suspensions of high aspect ratio clay nanosheets
Authors: Trigueiro Neto Osvaldo , Rosenfeldt Sabine , Michels-Brito Paulo Henrique , Seljelid Konstanse Kvalem , Akanno Andrew , Ceccato Bruno Telli , Ravindranathan Rini Padinjakkara , Plivelic Tomás S. , Michels Leander , Breu Josef , Knudsen Kenneth D. , Fossum Jon Otto
Published: May 2024

Aqueous liquid suspensions of high aspect ratio 2D clay nanosheets were investigated using small angle X-ray scattering (SAXS). The high aspect ratio of synthetic fluorohectorite clays allows for investigation of liquid crystalline orientational order for relatively large nanosheet spacings, in the range which can produce structural coloration, thus providing two handles for determining the nanosheet spacings: SAXS and visible color. Various clay concentrations were investigated, and good agreement with previous work on structural coloration from such suspensions was obtained. Particular attention is given to the confinement caused by the container geometry, where both cylindrical and flat confinements were investigated. In both cases, the SAXS data suggest coherent regions that have a nematic inter-orientational distribution that surprisingly is linked to the container geometry, which apparently determines the efficiency of packing of the suspension. For both geometries, the analysis suggests that these coherent regions have a 1D lamellar periodic intra-structure with uniform nanosheet spacing determined by the clay concentration and a typical correlation length in the range of 200 to 500 nm.

Graphical abstract
Strategies to improve postpartum engagement in healthcare after high-risk conditions diagnosed in pregnancy: a narrative review
Authors: Whyler Naomi C. A. , Krishnaswamy Sushena , Price Sarah , Giles Michelle L.
Published: May 2024

Transition from antepartum to postpartum care is important, but often fragmented, and attendance at postpartum visits can be poor. Access to care is especially important for individuals diagnosed antepartum with conditions associated with longer-term implications, including gestational diabetes (GDM) and hypertensive disorders in pregnancy (HDP). Strategies to link and strengthen this transition are essential to support people to attend recommended appointments and testing. This narrative review evaluates what is known about postpartum transition of care after higher-risk antepartum conditions, discusses barriers and facilitators to uptake of recommended testing, and outlines strategies trialled to increase both postpartum attendance and testing. Barriers to attendance frequently overlap with general barriers to accessing healthcare. Specific postpartum challenges include difficulties with transport, coordinating breastfeeding and childcare access. Systemic challenges include inadequate communication to women around implications of health conditions diagnosed in pregnancy, and the importance of postpartum follow up. Uptake of recommended testing after a diagnosis of GDM and HDP is variable but generally suboptimal. Strategies which demonstrate promise include the use of patient navigators, focused education and specialised clinics. Reminder systems have had variable impact. Telehealth and technology are under-utilised in this field but offer promising options particularly with the expansion of virtual healthcare into routine maternity care. Strategies to improve both attendance rates and uptake of testing must be designed to address disparities in healthcare access and tailored to the needs of the community. This review provides a starting point to develop such strategies from the community level to the population level.
Prognostic impact and immunotherapeutic implications of NETosis-related prognostic model in clear cell renal cell carcinoma
Authors: Mao Xingjun , Huang Wen , Xue Qing , Zhang Xiaolei
Published: May 2024

Background

The ramifications of necroptosis on the prognostication of clear cell renal cell carcinoma (ccRCC) remain inadequately expounded.

Methods

A prognostic model delineating the facets of necroptosis in ccRCC was constructed, employing a compendium of algorithms. External validation was effectuated using the E-MTAB-1980 dataset. The exploration of immune infiltration scores was undertaken through the exploitation of multiple algorithms. Single-cell RNA sequencing data were procured from the GSE171306 dataset. Real-time quantitative PCR (RT-qPCR) was engaged to scrutinize the differential expression of SLC25A37 across cancer and paracancer tissues, as well as diverse cell lines. Assessments of proliferative and metastatic alterations in 769-P and 786-O cells were accomplished through Cell Counting Kit-8 (CCK8) and wound healing assays.

Results

The necroptosis-related signature (NRS) emerges as a discerning metric, delineating patients’ immune attributes, tumor mutation burden, immunotherapy response, and drug susceptibility. Single-cell RNA sequencing analysis unveils the marked enrichment of SLC25A37 in tumor cells. Concurrently, RT-qPCR discloses the overexpression of SLC25A37 in both ccRCC tissues and cell lines. SLC25A37 knockdown mitigates the proliferative and metastatic propensities of 769-P and 786-O cells, as evidenced by CCK8 and wound healing assays.

Conclusion

The NRS assumes a pivotal role in ascertaining the prognosis, tumor mutation burden, immunotherapy response, drug susceptibility, and immune cell infiltration features of ccRCC patients. SLC25A37 emerges as a putative player in immunosuppressive microenvironments, thereby providing a prospective avenue for the design of innovative immunotherapeutic targets for ccRCC.
The clinical practice and dosimetric outcome of the manual adaptive planning during definitive radiotherapy for cervical cancer
Authors: Wang Yi-Wei , Chen Min , Shen Wen-Tong , Xu Hao-Ping
Published: May 2024

Propose

To evaluate the advantage of the manual adaptive plans comparing to the scheduled plans, and explored clinical factors predicting patients suitable for adaptive strategy.

Methods and materials

Eighty two patients with weekly online cone-beam computed tomography (CBCT) were enrolled. The re-CT simulation was performed after 15 fractions and a manual adaptive plan was developed if a significant deviation of the planning target volume (PTV) was found. To evaluate the dosimetric benefit, D98, homogeneity index (HI) and conformity index (CI) for the planning target volume (PTV), as well as D2cc of the bowel, bladder, sigmoid and rectum were compared between manual adaptive plans and scheduled ones. The clinical factors influencing target motion during radiotherapy were analyzed by chi-square test and logistic regression analysis.

Results

The CI and HI of the manual adaptive plans were significantly superior to the scheduled ones (P = 0.0002, 0.003, respectively), demonstrating a better dose coverage of the target volume. Compared to the scheduled plans, D98 of the manual adaptive plans increased by 3.3% (P = 0.0002), the average of D2cc to the rectum, bladder decreased 0.358 Gy (P = 0.000034) and 0.240 Gy (P = 0.03), respectively. In addition, the chi-square test demonstrated that age, primary tumor volume, and parametrial infiltration were the clinical factors influencing target motion during radiotherapy. Multivariate analysis further identified the large tumor volume (≥ 50cm3, OR = 3.254, P = 0.039) and parametrial infiltration (OR = 3.376, P = 0.018) as the independent risk factors.

Conclusion

We found the most significant organ motion happened after 15 fractions during treatment. The manual adaptive plans improved the dose coverage and decreased the OAR doses. Patients with bulky mass or with parametrial infiltration were highly suggested to adaptive strategy during definitive radiotherapy due to the significant organ motion.
Acute kidney injury in lamotrigine-induced DRESS syndrome
Authors: Brüning Klara Kristin , Pelivan Elena , Heinrich Marie-Christine , Bufler Philip , Kaindl Angela , Thumfart Julia
Published: May 2024

We present a case of lamotrigine-triggered DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome with acute kidney injury stage 3. A 17-year-old girl with known epilepsy treated with lamotrigine presented with acute kidney injury as well as skin eruption, fever, and apathy. Extended diagnostics, considering infectious and autoimmune diseases, remained unremarkable. Lamotrigine blood levels were within the target range. Kidney biopsy showed acute interstitial nephritis with tubular necrosis. Methylprednisolone pulse therapy led to an improvement in kidney function; skin eruption and neurological symptoms resolved. During the hospital stay, the girl admitted to inconsistent and variable intake of lamotrigine, occasionally resulting in notable overdosing. This report demonstrates that acute kidney injury in lamotrigine-induced DRESS syndrome is an acute interstitial nephritis with tubular necrosis, an aspect that has not been deeply characterized so far. Additionally, we aim to elevate awareness towards non-adherence as cause of disease, especially among the adolescent population.
Phenotyping of chronic pain in breast cancer survivors: an original study using the cancer pain phenotyping (CANPPHE) Network multidisciplinary international guidelines
Authors: Saracoglu Ismail , Isintas Meltem , Turk Ali , Leysen Laurence , Nijs Jo
Published: May 2024

Purpose

The primary aim of this cross-sectional study is to examine the prevalence of pain phenotypes in breast cancer survivors (BCS). A secondary aim entails examining whether health related quality of life differs between the main pain phenotypes in BCS.

Methods

BCS who experienced chronic pain were asked to complete the numeric pain rating scale for pain, Margolis pain diagram, and short form 36 (SF-36). Following administration of questionnaires and quantitative sensory examinations were applied. To determine the prevalence of the predominant type of pain, a recently proposed classification system by the Cancer Pain Phenotyping (CANPPHE) Network was used.

Results

Of the 86 female participants, 19 (22.09%) had dominant neuropathic pain, 18 (20.93%) had dominant nociceptive pain and 14 (16.28%) had dominant nociplastic pain. 35 participants (40.70%) were classified as having mixed pain. One-way ANOVA revealed a significant difference between the four pain groups for the SF-36 general health (F = 3.205, p = 0.027), social functioning (F = 4.093, p = 0.009), and pain (F = 3.603, p = 0.017) subscale scores.

Conclusion

This study found that pain in BCS was mostly of mixed phenotype, followed by predominantly neuropathic and nociplastic pain. Furthermore, it was found that, compared to BCS with predominant neuropathic and nociceptive pain, BCS with predominant nociplastic pain have lower health related quality of life in the areas of bodily pain and social functioning.
Multicenter comparison of Etest, Vitek2 and BD Phoenix to broth microdilution for beta-lactam susceptibility testing of Streptococcus pneumonia
Authors: Martens Steven , Cuypers Lize , Bélik Florian , Briers Pieter-Jan , Ceyssens Pieter-Jan , Denis Olivier , Huang Te-Din , Magerman Koen , Strypens Thomas , Van den Abeele Anne-Marie , Desmet Stefanie ,   on behalf of the Belgian National Antibiogram Committee
Published: May 2024

Purpose

To assess performance of Etest®, Vitek®2 and BD Phoenix™ to determine the susceptibility of Streptococcus pneumoniae strains to penicillin, ampicillin and cefotaxime.

Methods

Sixty unique S. pneumoniae challenge strains were selected to cover a wide range of penicillin, ampicillin and cefotaxime minimal inhibitory concentrations (MICs). Strains were analyzed in four different Belgian laboratories. Etest® benzylpenicillin (BEN), ampicillin/amoxicillin (AMP) and cefotaxime (CTA) (bioMérieux), Vitek®2 AST-ST03 (bioMérieux) and BD Phoenix™ SMIC/ID-11 testing were each performed in two different labs. Results were compared to Sensititre® broth microdilution (BMD) (Thermo Fisher Scientific) results. MIC results were interpreted using EUCAST non-meningitis breakpoints (v 13.0).

Results

Essential agreement (EA) was ≥ 90% for all methods compared to BMD, except for Etest® BEN on Oxoid plate (58.3%), Etest® AMP (both on Oxoid (65.8%) and BD BBL plate (84.2%)). Categorical agreement (CA) for penicillin was only ≥ 90% for Vitek®2, for other methods CA ranged between 74 and 84%. CA for AMP was for all methods < 90% (range 75.8–88.3%) and CA for CTA was between 87 and 90% for all methods except for Etest on Oxoid plate (79.2%).

Conclusions

Our study indicates that Vitek®2 and BD Phoenix™ are reliable for providing accurate pneumococcal susceptibility results for BEN, AMP and CTA. Using Etest BEN or AMP on Oxoid plate carries a risk of underestimating the MIC and should be interpreted with caution, especially when the obtained MIC is 1 or 2 doubling dilutions below the S or R clinical breakpoint.
Clinical characteristics and factors affecting disease severity in hospitalized tick-borne encephalitis patients in Norway from 2018 to 2022
Authors: Skudal Hilde , Lorentzen Åslaug Rudjord , Stenstad Tore , Quist-Paulsen Else , Egeland Jens , Fevang Børre , Jaioun Keson , Hansen Bjørn Åsheim , Solheim Anne Marit , Tveten Yngvar , Veje Malin , Eikeland Randi , Kersten Hege
Published: May 2024

Purpose

To describe the clinical characteristics and factors associated with disease severity in a Norwegian cohort of hospitalized patients with tick-borne encephalitis (TBE).

Methods

This observational multicenter study included hospitalized patients with TBE in the endemic area in the southeastern region of Norway from 2018 to 2022. Clinical signs and findings from laboratory tests, EEG, CT and MRI scans were recorded. Patient characteristics were compared among those with mild, moderate, and severe TBE, and factors associated with disease severity were identified.

Results

Nearly all eligible patients were included in the final cohort (153/189 participants, 81%). The median age was 56 years, 63% were men, and 7% were vaccinated against TBE; no participants were fully vaccinated. TBE presented as mild (meningeal) disease in 31% of patients and as moderate or severe (encephalitic) disease in 54% and 14% of patients, respectively. We found that 46% of the patients had a monophasic course, 64% had hyponatremia, and 7% presented with central nervous system (CNS) symptoms without pleocytosis in cerebrospinal fluid (CSF). Dysesthesia, a symptom previously not described, was reported in 10% of the patients. Most objective findings were related to the CNS. Preexisting comorbidities, CRP and CSF protein levels were predictors of more severe disease.

Conclusion

This novel presentation of a large Norwegian cohort supports TBE as a serious disease in the southeastern region of Norway. The majority of hospitalized patients presented with encephalitis, and fewer presented with meningitis. Comorbidities, CRP and CSF protein levels were associated with more severe disease.

Trial registration

Prosjekt #2,296,959 – The Norwegian Tick-borne Encephalitis Study – NOTES. Acute phase characteristics and long-term outcomes. – Cristin.
Matching the scales of planning and environmental risk: an evaluation of Community Wildfire Protection Plans in the western US
Authors: Hamilton Matthew , Evers Cody , Nielsen-Pincus Max , Ager Alan
Published: May 2024

Theory predicts that effective environmental governance requires that the scales of management account for the scales of environmental processes. A good example is community wildfire protection planning. Plan boundaries that are too narrowly defined may miss sources of wildfire risk originating at larger geographic scales whereas boundaries that are too broadly defined dilute resources. Although the concept of scale (mis)matches is widely discussed in literature on risk mitigation as well as environmental governance more generally, rarely has the concept been rigorously quantified. We introduce methods to address this limitation, and we apply our approach to assess scale matching among Community Wildfire Protection Plans (CWPPs) in the western US. Our approach compares two metrics: (1) the proportion of risk sources encompassed by planning jurisdictions (sensitivity) and (2) the proportion of area in planning jurisdictions in which risk can originate (precision). Using data from 852 CWPPs and a published library of 54 million simulated wildfires, we demonstrate a trade-off between sensitivity and precision. Our analysis reveals that spatial scale match—the product of sensitivity and precision—has an n-shaped relationship with jurisdiction size and is maximal at approximately 500 km2. Bayesian multilevel models further suggest that functional scale match—via neighboring, nested, and overlapping planning jurisdictions—may compensate for low sensitivity. This study provides a rare instance of a quantitative framework to measure scale match in environmental planning and has broad implications for risk mitigation as well as in other environmental governance settings.
Sociotechnical imaginaries in academic medicine strategic planning: a document analysis
Authors: Rowland Paula , Brydges Madison , Kulasegaram Kulamakan
Published: May 2024

Purpose Along with other industries, healthcare is becoming increasingly digitized. Our study explores how the field of academic medicine is preparing for this digital future. Method Active strategic plans available in English were collected from faculties of medicine in Canada (n = 14), departments in medical schools (n = 17), academic health science centres (n = 23) and associated research institutes (n = 5). In total, 59 strategic plans were subjected to a practice-oriented form of document analysis, informed by the concept of sociotechnical imaginaries. Results On the one hand, digital health is discursively treated as a continuation of the academic medicine vision, with expansions of physician competencies and of research institutes contributions. These imaginaries do not necessarily disrupt the field of academic medicine as currently configured. On the other hand, there is a vision of digital health pursuing a robust sociotechnical future with transformative implications for how care is conducted, what forms of knowledge are prioritized, how patients and patienthood will be understood, and how data work will be distributed. This imaginary may destabilize existing distributions of knowledge and power. Conclusions Looking through the lens of sociotechnical imaginaries, this study illuminates strategic plans as framing desirable futures, directing attention towards specific ways of understanding problems of healthcare, and mobilizing the resources to knit together social and technical systems in ways that bring these visions to fruition. There are bound to be tensions as these sociotechnical imaginaries are translated into material realities. Many of those tensions and their attempted resolutions will have direct implications for the expectations of health professional graduates, the nature of clinical learning environments, and future relationships with patients. Sociology of digital health and science and technology studies can provide useful insights to guide leaders in academic medicine shaping these digital futures.
Advancing collaboration in health professions education in the general practice domain, developing a national research agenda
Authors: de Groot Esther , der Vossen Marianne Mak-van , Slootweg Irene , Çorum Meryem , Kramer Anneke , Muris Jean , Scherpbier Nynke , Thoonen Bart , Damoiseaux Roger
Published: May 2024

Background

Health professions education (HPE) research in the General Practice domain (GP-HPE) is vital for high-quality healthcare. Collaboration among GP-HPE researchers is crucial but challenging. Formulating a research agenda, involving stakeholders, and fostering inter-institutional collaboration can address these challenges and connect educational research and practice.

Methods

We used Q-methodology to explore perspectives on GP-HPE research of participants from all Dutch postgraduate GP training institutes. Participants individually sorted statements based on the relevance of future GP-HPE research for educational practice. Data analysis comprised inverted factor analysis, rotation, and qualitative interpretation of configurations of all statements. The National Meeting on Educational Research took a participatory approach.

Results

We included 73 participants with diverse involvement in GP-HPE research. We identified five distinct perspectives, each representing a research focus area for developing and innovating GP education: the clinician scientist, the socially engaged GP, the specific GP identity, the GP as an entrepreneur, and the GP engaged in lifelong learning.

Discussion

The resulting five perspectives align with General Practice hallmarks. Q-methodology and a participatory approach facilitated collaboration among stakeholders. Successful inter-institutional collaboration requires a common goal, neutral leadership, participant commitment, regular meetings, audit trail support, process transparency, and reflexivity. Future research should address evidence gaps within these perspectives.

Conclusion

Using Q-methodology turned out to be valuable for compiling a national research agenda for GP-HPE research. The research process helped to cross boundaries between researchers in different institutions, thus putting inter-institutional collaborative advantage center stage. Our approach could provide a conceivable procedure for HPE researchers worldwide.
The Role of Parental Verbal Threat Information in Children’s Fear Acquisition: A Systematic Review and Meta-analysis
Authors: Nimphy Cosima Anna , Mitrou Vasiliki , Elzinga Bernet M. , Van der Does Willem , Aktar Evin
Published: May 2024

Children can acquire fears of novel stimuli as a result of listening to parental verbal threat information about these stimuli (i.e., instructional learning). While empirical studies have shown that learning via parental information occurs, the effect size of parental verbal threat information on child fear of a novel stimulus has not yet been measured in a meta-analysis. We conducted a systematic review and meta analysis to assess the effect of parents’ verbal statements on their children’s fear acquisition. Additionally, we explored potential moderators of this effect, namely, parent and child anxiety levels, as well as child age. WebOfScience, Pubmed, Medline, and PsycINFO were used to identify eligible studies that assessed children’s (30 months to 18 years old) fear of novel stimuli after being exposed to parental verbal threat information. We selected 17 studies for the meta-analysis and 18 for the systematic review. The meta-analysis revealed a significant causal effect of parental verbal threat information on children’s fear reaction towards novel stimuli [g = 1.26]. No evidence was found for a moderation of verbal learning effects, neither by child or parent anxiety levels nor by child age. The effect of parents’ verbal threat information on children’s fear of novel stimuli is large and not dependent on anxiety levels or child age.
Are corporate social responsibility and environmental management ‘influencers’ of performance in companies of the energetic sector?
Authors: Ruiz-López Jesús , Para-González Lorena , Mascaraque-Ramírez Carlos
Published: May 2024

Prior research has suggested that Corporate Social Responsibility (CSR) may affect Environmental Management (EM). Nevertheless, there has been a lack of empirical studies that have examined these relationships, specially, in companies of the energetic field. This research empirically examines whether there is a positive relationship between the implementation of a CSR culture in a company and the obtaining of better Operational Performance, as well as between CSR and EM processes and also between EM and Operational Performance. The analysis of the results obtained through the Partial Least Squares (PLS) methodology concludes that there is a positive relationship between all of them, including this paper a main contribution to Literature as it is the fact that EM plays a mediator role increasing the CSR impact over Operational Performance. The major implication derived from this study is that investments in CSR and EM practices towards all the company stakeholders should positively affect performance. Therefore, both should be equally as important as other functions of a firm.
Nonlocality of three-qubit states of a nuclear spin-7/2
Authors: Furman Gregory , Sokolovsky Vladimir
Published: May 2024

Advances in quantum information processing can open a way for numerous applications of the processing in various fields of science and technology: communication, precision measurement, computing, nano-scale detectors, and sensors. Classical and various quantum correlations have been studied in real spin 1/2 systems. The nonlocality measures provide a novel classification scheme for bipartite states, highlighting that nonlocality is a quantum resource distinct from other types of quantum correlations. We first studied the temperature and field dependencies of nonlocality measure in the three fictitious spin 1/2 system, which represents a nuclear spin-7/2 placed in magnetic and inhomogeneous electric fields. The relationship between nonlocality and other quantum correlations (entanglement and geometric discord) was studied. The Hamiltonian and spin operators for a spin 7/2 are represented in the basis formed by the Kronecker products of the Pauli matrices. This transformation allows us to represent a spin 7/2 as a system of three coupled fictitious spins 1/2 and, from the quantum information point of view, as an equivalent system of three coupling qubits. Well-developed methods were used to calculate measures of quantum correlations. For example, we consider 59Co (spin 7/2) in the compounds [Co(NH3)5Cl]Cl2 and Ca3Co2O6. The interaction between the fictitious spins of 59Co nuclei depends on the magnitude and direction of the external magnetic field. Other potential cases of quantum correlations can be realized based on nuclear spins 7/2 in solid-state systems, for instance, such as 51V, 165Ho, or 123Sb.
Beneficial use of sediments, tools, pilot sites and measuring techniques developed and used within seven European Union INTERREG projects
Authors: Wijdeveld Arjan , Lemière Bruno , Coftier Aline , Laperche Valerie , Bataillard Philippe , Masson Eric , Lord Richard , Torrance Keith , Harrington Joe , Batel Brano , Wensveen Marco , Hamilton Alasdair , Debuigne Tristan
Published: May 2024

Purpose

The EU Water Framework Directive (European Union Off J Eur Comm 2000) and EU Waste Framework Directive (European Union Off J Euro Union 2008) impacted the Beneficial Use (BU) of sediments in Europe. INTERREG has supported initiatives to change the perception that sediments are a waste. In this paper we provide an overview of tools, pilot sites and measuring techniques developed and used for the BU of sediments within seven European Union INTERREG projects. We illustrate the lessons learned regarding barriers and enablers for BU of sediments.

Materials and methods

BU of sediments is a combination of factors. The following aspects are considered. The sediment must be suitable for use and be in engineering compliance. The sediment must also need to meet the end of waste criteria, as well as to be in environmental compliance. To check in the field if engineering and environmental compliance is feasible, on-site analyses and decision support tools are needed. When BU use is possible, there must be a benefit, either in an added socio-economic value or in ecosystem services. To define benefits the impact of Business as Usual (BAU) should also be expressed. Stakeholder perception and spatial restraints determine areas for BU of sediments with spatial consensus.

Results and discussion

The pilots and case studies described in this paper are examples of different applications of BU of sediments in northwest Europe. The tools, equipment, pilot tests and on-site monitoring techniques developed by the identified INTERREG projects are useful as BU enablers, for both citizens (an enabler is what is in it for me versus a barrier like residents opposing to proposed developments in their local area or the Not In My Back Yard (NIMBY) principle), and for regulators (what are the risks versus benefits as compared to BAU).

Conclusions

The main barriers for beneficial use of sediments are the social acceptance when sediments are used on land (often seen as waste disposal) and the extra direct cost versus the cost for disposal, while indirect benefits such as the potential for nature development, the impact on Gross Domestic Product (GDP) or more locally on the extra jobs created, are generally not considered. Also, the impact of BAU is often not explicitly considered.
Ethical Stakes for Past, Present, and Prospective Tuberculosis Isolate Research Towards a Multicultural Data Sovereignty Model for Isolate Samples in Research
Authors: Anderson A. , Meher M. , Maroof Z. , Malua S. , Tahapeehi C. , Littleton J. , Arcus V. , Wade J. , Park J.
Published: May 2024

Tuberculosis (TB) is a potentially fatal infectious disease that, in Aotearoa New Zealand (NZ), inequitably affects Asian, Pacific, Middle Eastern, Latin American, and African (MELAA), and Māori people. Medical research involving genome sequencing of TB samples enables more nuanced understanding of disease strains and their transmission. This could inform highly specific health interventions. However, the collection and management of TB isolate samples for research are currently informed by monocultural biomedical models often lacking key ethical considerations. Drawing on a qualitative kaupapa Māori–consistent study, this paper reports on preliminary discussions with groups of Māori, Pacific, and Afghan people in NZ, whose communities have been harmed by TB and TB stigma. Participants’ discussions highlight key concerns and meanings that ought to inform the development of guidelines and a more robust consultative process for the governance of how TB isolate samples are collected and used both retrospectively and in future research. We argue for ethical processes to be culturally nuanced and community-generated, flexible and meaningful, and situated in relation to the physical and symbolic effects of TB. We discuss the significance of Indigenous data sovereignty, rights, and kāwanatanga (governorship) in shaping a multicultural data sovereignty model.
Soziale und solidarische Ökonomie, ökosoziale Transformation und ihr potenzieller Beitrag für Gemeinwohl und Klimaschutz
Authors: Elsen Susanne
Published: May 2024

Im Mittelpunkt dieses Beitrags steht die Frage, ob und wie soziale und solidarische Ökonomien (SSE) zur ökosozialen Transformation beitragen können. Es geht um Ansätze diversen Wirtschaftens (Gibson-Graham et al. 2013), welche gleichzeitig positive soziale und ökologische Effekte erzielen können. Nicht berücksichtigt wird die Bandbreite kulturell eingebetteter solidarischer Ökonomien, die den Lebensunterhalt großer Teile der Bevölkerung des globalen Südens decken (Acosta 2012) oder die solidarökonomische Selbsthilfe von Migrant:innen aus dem globalen Süden in Europa (Tadesse 2023). Diese Varianten und die zugrundeliegenden Epistemologien sollten jedoch als postkoloniale und postkapitalistische Alternativen (Kothari et al. 2019; Sarr 2022) zur Entwicklung westlicher Prägung angesichts der multiplen Krise und der dringenden ökologischen Erfordernisse erkannt und geschützt werden. Sie sind, wie auch Formen der SSE in Wohlfahrtstaaten, potenzielle Elemente eines ökosozialen Gesellschaftsmodells.
The roles of the kynurenine pathway in COVID-19 neuropathogenesis
Authors: Dehhaghi Mona , Heydari Mostafa , Panahi Hamed Kazemi Shariat , Lewin Sharon R. , Heng Benjamin , Brew Bruce J. , Guillemin Gilles J.
Published: May 2024

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the highly contagious respiratory disease Corona Virus Disease 2019 (COVID-19) that may lead to various neurological and psychological disorders that can be acute, lasting days to weeks or months and possibly longer. The latter is known as long-COVID or more recently post-acute sequelae of COVID (PASC). During acute COVID-19 infection, a strong inflammatory response, known as the cytokine storm, occurs in some patients. The levels of interferon‐γ (IFN‐γ), interferon-β (IFN-β), interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α) are particularly increased. These cytokines are known to activate the enzyme indoleamine 2,3-dioxygenase 1 (IDO-1), catalysing the first step of tryptophan (Trp) catabolism through the kynurenine pathway (KP) leading to the production of several neurotoxic and immunosuppressive metabolites. There is already data showing elevation in KP metabolites both acutely and in PASC, especially regarding cognitive impairment. Thus, it is likely that KP involvement is significant in SARS-CoV-2 pathogenesis especially neurologically.
Effect of Cabergoline on weight and glucose metabolism in patients with acromegaly
Authors: Varaldo E. , Prencipe N. , Bona C. , Cuboni D. , Aversa L. S. , Sibilla M. , Bioletto F. , Berton A. M. , Gramaglia C. , Gasco V. , Ghigo E. , Grottoli S.
Published: May 2024

Purpose

Cabergoline (CAB) has shown to have benefic effects on the metabolism in different clinical settings but its metabolic role in acromegaly disease has not been studied yet. Aim of our study was to evaluate the impact of CAB on glucose metabolism and weight in patients with acromegaly.

Methods

All patients with acromegaly undergoing continuous treatment with CAB for at least 6 months were retrospectively screened. Exclusion criteria were discontinuation of CAB for more than one month, change of antidiabetic or other therapy for acromegaly, concomitant untreated hormonal deficiency, initiation of pregnancy and/or breastfeeding. All patients were evaluated in terms of biochemical disease control, glucose metabolism and weight at baseline (T0) and after the introduction of CAB therapy at 6 (T6) and 12 months (T12).

Results

Twenty-six patients (15 females and 11 males) were evaluated at T0 and T6 and 19 patients (12 females and 7 males) were also evaluated at T12. Insulin-like growth factor I (IGF-I) and prolactin (PRL) levels were significantly lower at T6 and T12 compared to baseline (p < 0.001 for IGF-I, p < 0.05 for PRL) even if no further differences were observed between T12 and T6. Considering the entire cohort, no differences were appreciated regarding the metabolic parameters but a significant reduction in weight and body mass index (BMI) was observed at both T6 (p = 0.009 for weight, p = 0.021 for BMI) and T12 (p = 0.014 for weight, p = 0.017 for BMI) compared to baseline.

Conclusion

Our results confirm the efficacy of CAB in providing a significant improvement in the biochemical disease control but do not demonstrate a marked benefit on glucose metabolism of acromegaly patients. In such patients, CAB appears to have a rapid effect on weight and BMI, with significant changes noticeable as early as 6 months and persisting for at least 12 months.
Multilayer quantile graph for multivariate time series analysis and dimensionality reduction
Authors: Silva Vanessa Freitas , Silva Maria Eduarda , Ribeiro Pedro , Silva Fernando
Published: May 2024

In recent years, there has been a surge in the prevalence of high- and multidimensional temporal data across various scientific disciplines. These datasets are characterized by their vast size and challenging potential for analysis. Such data typically exhibit serial and cross-dependency and possess high dimensionality, thereby introducing additional complexities to conventional time series analysis methods. To address these challenges, a recent and complementary approach has emerged, known as network-based analysis methods for multivariate time series. In univariate settings, quantile graphs have been employed to capture temporal transition properties and reduce data dimensionality by mapping observations to a smaller set of sample quantiles. To confront the increasingly prominent issue of high dimensionality, we propose an extension of quantile graphs into a multivariate variant, which we term “Multilayer Quantile Graphs”. In this innovative mapping, each time series is transformed into a quantile graph, and inter-layer connections are established to link contemporaneous quantiles of pairwise series. This enables the analysis of dynamic transitions across multiple dimensions. In this study, we demonstrate the effectiveness of this new mapping using synthetic and benchmark multivariate time series datasets. We delve into the resulting network’s topological structures, extract network features, and employ these features for original dataset analysis. Furthermore, we compare our results with a recent method from the literature. The resulting multilayer network offers a significant reduction in the dimensionality of the original data while capturing serial and cross-dimensional transitions. This approach facilitates the characterization and analysis of large multivariate time series datasets through network analysis techniques.
Associated factors of stress, urgency, and mixed urinary incontinence in a geriatric outpatient assessment of older women with hip fracture
Authors: Hellman-Bronstein Aino T. , Luukkaala Tiina H. , Ala-Nissilä Seija S. , Nuotio Maria S.
Published: May 2024

Purpose

Urinary incontinence (UI) is known to be common among older female hip fracture patients. Little is known about different subtypes of UI among these patients. Our aim was to identify factors associated with subtypes of UI in a cross-sectional design.

Methods

1,675 female patients aged ≥ 65 and treated for their first hip fracture in Seinäjoki Central Hospital, Finland, during 2007–2019, were included in a prospective cohort study. Of these, 1,106 underwent comprehensive geriatric assessment (CGA), including questions on continence, at our geriatric outpatient clinic 6 month post-fracture. A multivariable-adjusted multinomial logistic regression model was used to examine factors associated with UI subtypes.

Results

Of the 779 patients included, 360 (46%) were continent and 419 (54%) had UI 6-month post-fracture. Of the women with UI, 117 (28%) had stress UI, 183 (44%) had urgency UI and 119 (28%) had mixed UI, respectively. Mean age of the patients was 82 ± 6,91. In multivariable analysis, depressive mood and poor mobility and functional ability were independently associated with stress UI. Fecal incontinence (FI) and Body Mass Index (BMI) over 28 were independently associated with urgency UI. Mixed UI shared the aforementioned factors with stress and urgency UI and was independently associated with constipation.

Conclusions

Mixed UI was associated with most factors, of which depressive mood and impaired mobility and poor functional ability were shared with stress UI, and FI and higher BMI with urgency UI. CGA is key in assessing UI in older hip fracture patients, regardless of subtype.
Hybrid structured silk-rPET nanotechnical cloth for advanced air purification
Authors: Hossain Md. Tanvir , Shahid Md. Abdus
Published: May 2024

Air pollution has become a significant global issue due to its detrimental environmental and human health effects. In this study, a novel approach was taken to address these challenges by developing a recycled polyethylene terephthalate (rPET) nano-coated silk technical cloth embedded with green-synthesized silver nanoparticles (AgNPs) using a solution electrospinning technique. The filtration performance of the developed material was assessed through particle filtration efficiency (PFE) tests, while differential pressure (DP) tests were conducted to evaluate pressure drop. SEM, FTIR, tensile, antibacterial, radiative heat barrier performance, and moisture management properties of the developed samples were also performed. Maximum 96.58% of filtration performance was observed with corresponding low differential pressures of 29.1 Pa/cm2; maximum tensile force and elongation% were 157.47 N and 15.32%, respectively of the developed samples. FTIR analysis confirmed the presence of silk, rPET, sodium alginate, and AgNPs in the developed sample. Antibacterial assays demonstrated inhibition against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli). Moisture management property revealed water penetration resistance and radiative heat barrier testing showed good barrier performance. These results make the promising potential of the developed material as an advanced air filter.

Graphical Abstract
Aktualisierung der DEGAM-S1-Handlungsempfehlung zum chronischen, nichttumorbedingten Schmerz
Authors: Straßner Cornelia , Becker Annette
Published: May 2024

Hintergrund

Gemäß den Vorgaben der Arbeitsgemeinschaft Wissenschaftlicher Medizinischer Fachgesellschaften (AWMF) erforderte die S1-Handlungsempfehlung „Chronischer Schmerz“ der Deutschen Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM) eine Aktualisierung.

Methoden

Es erfolgte eine unsystematische selektive Literaturrecherche und eine Kommentierung durch die DEGAM-Leitlinienkommission.

Ergebnisse

Die inhaltlichen Aussagen der Vorversion können weitgehend aufrechterhalten werden. Es erfolgten inhaltliche Vertiefungen insbesondere in den Bereichen Assessment, nichtmedikamentöse Therapieansätze bzw. Self-Care- und Opioidmanagement. Die Kurzversion wurde um ein Dokument mit Erläuterungen und Implementierungshilfen ergänzt.

Schlussfolgerungen

Chronischer nichttumorbedingter Schmerz (CNTS) ist ein sehr häufiger Beratungsanlass in hausärztlichen Praxen. Handlungsempfehlungen und Instrumente speziell für das hausärztliche Setting werden dringend benötigt. Ein Upgrade der Handlungsempfehlung auf S2- oder S3-Leitlinien-Niveau und Praxishilfen für die gemeinsame Entscheidungsfindung zur individuellen Langzeitbegleitung von betroffenen Patient:innen sind für die Zukunft wünschenswert.
Recent efforts on investigating the effects of recycled rubber content on the mechanical properties of structural concrete
Authors: Eissa Mahmoud , Habib Ahed , AL Houri Ausamah , Alibrahim Bashar
Published: May 2024

Rubberized concrete effectively prevents brittle failures and enhances the ductility and energy absorption of concrete. It has been observed that the inclusion of rubber reduces the strength and abrasion resistance of concrete; however, the enhancement in energy absorption is significant. A vast number of tires end up as waste, posing a major environmental issue globally. The disposal of waste tires has become an acute environmental challenge, with billions discarded and buried worldwide, representing a significant ecological threat. Consequently, utilizing rubber in the concrete industry can be advantageous for both the environment and the industry. This study presents an extensive review of the effects of various rubber contents on the mechanical properties of concrete. The scope of the review encompasses an analysis of a diverse range of studies conducted over the past decade, focusing on the influence of rubber content on concrete's mechanical performance. The analysis revealed that the optimal amount of rubber to be used in concrete is in the range of 2–5% as a replacement for natural concrete aggregate. Furthermore, replacing aggregate with treated rubber may offer additional benefits, including improved energy absorption and sustainability. However, despite the promising benefits of rubberized concrete, there is a notable gap in the literature regarding the creep behavior of rubberized concrete, a crucial parameter for defining concrete performance, particularly in superstructures. This gap underscores the need for further research to comprehensively understand the long-term behavior of rubberized concrete under sustained loading conditions. Additionally, while coating or treating rubber could mitigate the reduction in mechanical properties associated with rubber inclusion, there remains a need for more investigation into the brittleness index and energy absorption of treated rubber. Addressing these gaps in knowledge will contribute to a more thorough understanding of the potential applications and limitations of rubberized concrete in various engineering contexts.
Clinical decision support menu for reducing unnecessary urine cultures
Authors: Stensgard Erik , Masoud Bobbie , Gravely Amy , Drekonja Dimitri
Published: May 2024

A clinical decision support menu requiring selection of urine culture (UC) indication within outpatient and inpatient settings of a large integrated health care system significantly reduced UC sample collection. Clear documentation of selected UC indication in most post-intervention cases affirms its potential as an effective diagnostic stewardship strategy.
Candida auris in the burn unit: a prolonged biphasic outbreak
Authors: Pedersen Laura , Mikesell Jake , Marcaccini Robert , Atkinson Connie , Cooper Kaila , Feldman Michael , Rittman Barry , Ching Patrick , Bryson Alexandra , Doll Michelle
Published: May 2024

Candida auris is an emerging pathogen responsible for healthcare-associated infections and outbreaks. This organism has a high tolerance to both high temperatures and high salinity. We describe our experience with a C. auris outbreak in an 8-bed inpatient burn unit at an academic medical center.
Proactive risk stratification and low-risk penicillin allergy delabeling by an antimicrobial stewardship pharmacist
Authors: Caturano Breana N. , Bjork Lauren L. , Lichtenberger Paola N. , Temiño Viviana M.
Published: May 2024

Penicillin (PCN) allergy delabeling is an important component of antimicrobial stewardship; however, widespread implementation has lagged. We found that most patients had low-risk PCN allergy histories eligible for delabeling without skin testing. Pharmacist-led risk stratification and drug challenge expanded access to delabeling independently from an Allergy/Immunology service.