bluuebunny/crossref_metadata_2025 huggingface dataset:
Cryo-EM structure of histidyl-tRNA synthetase-like domain reveals activating crossed helices at the core of GCN2
Authors: Solorio-Kirpichyan Kristina , Fan Xiao , Golovenko Dmitrij , Korostelev Andrei A , Yan Nieng , Korennykh Alexei
Published: November 2024

GCN2 is a conserved receptor kinase activating the integrated stress response (ISR) in eukaryotic cells. The ISR kinases detect accumulation of stress molecules and reprogram translation from basal tasks to preferred production of cytoprotective proteins. GCN2 stands out evolutionarily among all protein kinases due to the presence of a histidyl-tRNA synthetase-like (HRSL) domain, which arises only in GCN2 and is located next to the kinase domain (KD). How HRSL contributes to GCN2 signaling remains unknown. Here, we report a 3.2 Å cryo-EM structure of HRSL from thermotolerant yeast Kluyveromyces marxianus. This structure shows a constitutive symmetrical homodimer featuring a compact helical-bundle structure at the junction between HRSL and KDs, in the core of the receptor. Mutagenesis demonstrates that this junction structure activates GCN2 and indicates that our cryo-EM structure captures the active signaling state of HRSL. Based on these results, we put forward a GCN2 regulation mechanism, where HRSL drives the formation of activated kinase dimers. The remaining domains of GCN2 have the opposite role and in the absence of stress they help keep GCN2 basally inactive. This auto-inhibitory activity is relieved upon stress ligand binding. We propose that the opposing action of HRSL and additional GCN2 domains thus yields a regulated ISR receptor.
The Open Body Closed: A Rationale for the Abandonment of Bloodletting, Based on Nineteenth-Century Swedish Medicine
Authors: Drakman Annelie
Published: November 2024

This article contains an analysis of the use and abandonment of bloodletting in Sweden 1820–1900. Close readings of over 8,000 yearly reports by Swedish provincial doctors and popular medical handbooks, journals and notes from medical societies have been used, as well as key word searches meant to illustrate overarching tendencies. One result is that quantitative balance between humours was not an aim of therapeutic bleeding in this context. Rather, bloodletting was mainly used to reinstate regular flows in a hydraulic model of the body. It is argued that a shift from focusing on smooth flows to seeing bleeding as blood loss marked a transformation of the medical imagination from working with an ‘open’, malleable body to a ‘closed’, fixed body. This helps explain why therapeutic bleeding, for millennia the most important practice in medical practitioners’ arsenal, was silently abandoned decades before the breakthrough of bacteriology and scientific medicine.
Susceptibility of pruning wounds of apple trees to Diplodia mutila, D. seriata, Lasiodiplodia theobromae and Neofusicoccum arbuti infections and conidia release of Botryosphaeriaceae spp. in the Maule Region, Chile
Authors: Valdez-Tenezaca Adrián , Latorre Bernardo Antonio , Díaz Gonzalo A.
Published: November 2024

Studies on susceptibility of the age of the pruning wound and effect of pruning time on infection by Botryosphaeriaceae in apple trees is scarce. This work aimed to determine the susceptibility of different ages of pruning wound (1, 15, 30 or 45 days after pruning) and the effect of pruning time during early (June) and late pruning (August) in apples cvs. Fuji and Gala on the infection of Diplodia mutila, D. seriata, Neofusicoccum arbuti and Lasiodiplodia theobromae. Additionally, seasonal conidial release of Botryosphaeriaceae spp. was monitored using Vaseline-coated glass slides in two orchard cv. Fuji and Gala during two consecutive growing seasons (2020-2021) in Maule region, Central Chile. The analysis of the variance of each pruning wound age showed significant interaction between the factors, Botryosphaeria isolate × apple cultivar (P= 0.0001). The isolates of N. arbuti and D. seriata were significantly more aggressive than the other isolates of Botryosphaeria, with mean values of 45.2 mm (one day of age) to 7.9 mm (45 days of age) and 31.0 mm (one day of age) to 6.6 mm (45 days of age), respectively. Independently of the Botryosphaeriaceae species, the pruning wound susceptibility considerably decreased as the age of the pruning wound increased, where fresh pruning wounds (1 and 15 days) are more susceptible than older pruning wounds (30 and 45 days). Our results indicated significant (P < 0.0001) interaction between Botryosphaeria isolates and pruning time for both cultivars. Necrotic lesions varied among the Botryosphaeriaceae species, where lesion length was significantly greater in the isolates of N. arbuti, D. mutila, and D. seriata inoculated in early pruning than inoculations conducted in late pruning. This study demonstrated a strong relationship between conidial release and rainfall, where 70.3% and 86.3% of the total conidia of Botryosphaeriaceae spp. were released during rainfall periods between June and August (winter). This work suggests that a delay in pruning times may be justified to reduce the risk of Botryosphaeria canker and dieback in apple trees in Maule region, Chile, considering rain-free days.
An integrated rapid detection of Botryosphaeriaceae species in grapevine based on recombinase polymerase amplification, CRISPR/Cas12a, and lateral flow dipstick
Authors: Wang Baoyu , Fan Anran , Liu Mei , Zhou Ying , Zhang Wei , Yan Jiye
Published: November 2024

Grapevine Botryosphaeria dieback (GBD), caused by Botryosphaeriaceae species, is an important grapevine trunk disease that poses a threat to grape yield and quality in global viticultural regions. Pathogen diagnosis at the species level using morphological methods is difficult and time-consuming. Therefore, this study aimed to develop a rapid and accurate detection method for the pathogens causing GBD. Recombinase polymerase amplification (RPA) with CRISPR/Cas12a cleavage was combined for detecting pathogens associated with GBD and lateral flow dipsticks (LFD) were employed to monitor the outcomes. Based on the β-tubulin sequences of Botryosphaeriaceae and their related species, specific RPA primers and CRISPR/Cas12a CrRNA were designed and subsequently selected for specifically detecting pathogens associated with GBD. Under optimized reaction conditions and systems, the developed RPA/CRISPR-Cas12a detection system specifically detected Botryosphaeriaceae species within 30 min of RPA and 25 min of CRISPR/Cas12a reactions at 37°C. Specificity tests showed that specific fragments were amplified with the RPA primers in the DNA of six Botryosphaeriaceae species found in China, while none fragments were amplified in the other 22 non-target fungal pathogens species of grapevine. The detection sensitivity of this method was 1 pg μL-1, and which is equal to that of real-time PCR. In summary, our method is simple to perform, produces visual results, does not rely on expensive equipment, and therefore possesses high practical value, providing an efficient and robust detection platform to accelerate the field detection of pathogens associated with GBD.
Roles of Cep215/Cdk5rap2 in establishing testicular architecture for mouse male germ cell development
Authors: Kang Donghee , Shin Byungho , Kim Gyeong‐Nam , Hea Ji Hwa , Sung Young Hoon , Rhee Kunsoo
Published: November 2024

Cep215/Cdk5rap2 is a centrosome protein crucial for directing microtubule organization during cell division and morphology. Cep215 is a causal gene of autosomal recessive primary microcephaly type 3, characterized by a small brain size and a thin cerebral cortex. Despite previous attempts with Cep215 knockout (KO) mice to elucidate its developmental roles, interpreting their phenotypes remained challenging due to potential interference from alternative variants. Here, we generated KO mice completely lacking the Cep215 gene and investigated its specific contributions to male germ cell development. In the absence of Cep215, testis size decreased significantly, accompanied by a reduction in male germ cell numbers. Histological analyses unveiled the arrested development of male germ cells around the zygotene stage of meiosis. Concurrently, the formation of the blood‐testis barrier (BTB) was impaired in Cep215 KO testes. These findings suggest that BTB failure contributes, at least partially, to male germ cell defects observed in Cep215 KO mice. We propose that the deletion of Cep215 may disrupt microtubule organization in Sertoli cells with a delay in spermatogonial stem cell mitosis, thereby impeding proper BTB formation.
States Enact Policies Restricting Cell Phone Use in Schools
Authors: Roush Karen
Published: November 2024

Evidence of harm to learning and mental health is fueling the trend.
U.S. Heat-Related Deaths Have Surged
Authors: Roush Karen
Published: November 2024

They may also be vastly undercounted due to poor data collection.
A Case of Cardiac Resynchronization Therapy for Heart Failure with Reduced Ejection Fraction
Authors: Kupchik Nicole , Vance Sarah
Published: November 2024

Editor's note: This is the next installment in a series on electrocardiogram (ECG) interpretation. Nurses in all settings should know the basics, as medications and physiological changes can cause cardiac arrhythmias. Each article will start with a brief case scenario and an ECG strip and then take you step by step through analyzing the heart rhythm.
Treatment-resistant depression
Authors: McBroom Leesa A. , Timmons Melissa
Published: November 2024

In 2023, the percentage of people in the US who experienced depression in their lifetime was at an all-time high of 29%. Depression causes considerable distress and functional impairment affecting quality of life, employment, and interpersonal relationships. Many patients fail to respond to treatment with antidepressants and psychological-behavioral therapy, resulting in a condition known as treatment-resistant depression (TRD). TRD contributes to negative outcomes for patients and increased costs to the healthcare system. Recognizing TRD and understanding TRD interventions are important aspects of practice for clinicians in treating this patient population. This article reviews current and emerging TRD treatments, including electroconvulsive therapy, ketamine, esketamine, and transcranial magnetic stimulation, to inform NP practice.
Guidance on Use of Race, Ethnicity, and Geographic Origin as Proxies for Genetic Ancestry Groups in Biomedical Publications
Authors: Feero W. Gregory , Steiner Robert D. , Slavotinek Anne , Faial Tiago , Bamshad Michael J. , Austin Jehannine , Korf Bruce R. , Flanagin Annette , Bibbins-Domingo Kirsten
Published: November 2024

(Abstracted from Genet Med 2024;26:101118)

Genomic and biomedical research has traditionally used race, ethnicity, and geographic origin to group subjects by presumed shared genetic ancestry. However, evidence shows these descriptors are ineffective for genetic grouping and can reinforce harmful racial biases.
Smoking Does Not Negatively Impact Outcomes Following Cervical Laminoplasty
Authors: Hou Brian Q. , Croft Andrew , Chanbour Hani , Zakieh Omar , Nian Hui , Pennings Jacquelyn S. , Bowers Mitchell , Young Mason W. , Waddell William H. , Abtahi Amir M. , Gardocki Raymond J. , Lugo-Pico Julian G. , Zuckerman Scott L. , Stephens Byron F.
Published: November 2024

Study Design:

Retrospective cohort study.

Objective:

To assess the impact of smoking on outcomes following elective cervical laminoplasty for degenerative cervical myelopathy (DCM).

Summary of Background Data:

The detrimental effect of cigarette smoking on cervical spinal fusion surgery outcomes is well documented. However, the impact of smoking on outcomes following nonfusion cervical spine procedures is unknown. One commonly utilized nonfusion technique for cervical decompression is laminoplasty.

Methods:

Adult smokers or nonsmokers who underwent primary elective laminoplasty for DCM were included. The propensity score (PS) was constructed for being a current smoker based on covariates. Only patients contained in the PS overlapped region were included in the analysis set. Patient-reported outcomes (PROs) at baseline and 12 months postoperation included Visual Analog Scale (VAS) neck and arm pain, neck disability index (NDI)%, EuroQol-5 Dimension (EQ-5D), and modified Japanese Orthopedic Association (mJOA) scores. Other outcomes included perioperative complications, 3-month readmissions/reoperations, and patient satisfaction. Wilcoxon and Pearson tests were used to compare outcomes between smokers and nonsmokers.

Results:

The study included 132 patients: 30 were smokers (22.7%) and 102 were nonsmokers (77.3%). No significant differences were found at baseline between groups in demographics or medical history. Smokers had significantly worse baseline VAS neck pain (5.7±3.2 vs. 4.4±3.04, P=0.028) and arm pain (5.7±3.5 vs. 4.3±3.2, P=0.045) scores, but all other baseline PROs were not statistically different between groups. No differences were found between smokers and nonsmokers in any 12-month PRO, or in rates of perioperative complications, 3-month readmissions, or 3-month reoperations. On multivariable logistic regression analysis, smoking had no significant impact on any outcome of interest.

Conclusion:

Clinical and PROs following elective laminoplasty for DCM are not significantly different between smokers and nonsmokers. Laminoplasty should be considered a good surgical option in smokers presenting with DCM.
Ketamine Versus Etomidate for Rapid Sequence Intubation: A Systematic Review and Meta-Analysis of Randomized Trials
Authors: Greer Alisha , Hewitt Mark , Khazaneh Parsa T. , Ergan Begum , Burry Lisa , Semler Matthew W. , Rochwerg Bram , Sharif Sameer
Published: November 2024

OBJECTIVES:

To compare the safety and efficacy of ketamine and etomidate as induction agents to facilitate emergent endotracheal intubation.

DATA SOURCES:

We searched MEDLINE, Embase, Cochrane Clinical Trials Register, and ClinicalTrials.gov from inception to April 3, 2024.

STUDY SELECTION:

We included randomized controlled trials (RCTs) that compared ketamine to etomidate to facilitate emergent endotracheal intubation in adults.

DATA EXTRACTION:

Reviewers screened abstracts, full texts, and extracted data independently and in duplicate. We pooled data using a random-effects model, assessed risk of bias using the modified Cochrane tool and certainty of evidence using the Grading Recommendations Assessment, Development, and Evaluation approach. We pre-registered the protocol on PROSPERO (CRD42023472450).

DATA SYNTHESIS:

We included seven RCTs (n = 2384 patients). Based on pooled analysis, compared with etomidate, ketamine probably increases hemodynamic instability in the peri-intubation period (relative risk [RR], 1.29; 95% CI, 1.07–1.57; moderate certainty) but probably decreases the need for initiation of continuous infusion vasopressors (RR, 0.75; 95% CI, 0.57–1.00; moderate certainty) and results in less adrenal suppression (RR, 0.54; 95% CI, 0.45–0.66; moderate certainty). Ketamine probably has no effect on successful intubation on the first attempt (RR, 1.01; 95% CI, 0.97–1.05; moderate certainty) or organ dysfunction measured as the maximum Sequential Organ Failure Assessment (SOFA) score during the first 3 days in ICU (mean difference, 0.55 SOFA points lower; 95% CI, 1.12 lower to 0.03 higher; moderate certainty) and may have no effect on mortality (RR, 1.00; 95% CI, 0.83–1.21; low certainty) when compared with etomidate.

CONCLUSIONS:

Compared with etomidate, ketamine probably results in more hemodynamic instability during the peri-intubation period and appears to have no effect on successful intubation on the first attempt or mortality. However, ketamine results in decreased need for the initiation of vasopressor use and decreases adrenal suppression compared with etomidate.
Nursing Interventions to Prevent Posttraumatic Stress Disorders in People in Intensive Care
Authors: Andrade Débora de Fátima Sousa , da Silva Carla Regina Rodrigues , Moura Derek Braga , Soares-Pinto Igor Emanuel
Published: November 2024

Objective

To map nursing interventions that contribute to preventing posttraumatic stress in people hospitalized in the context of intensive care.

Design

Scoping review according to the Joanne Briggs Institute methodology.

Methods

The search was carried out in the databases PubMed, CINAHL via EBSCO, Joanna Briggs Institute Database of Systematic Reviews, COCHRANE Database of Systematic Reviews, Repositório Científico de Acesso Aberto de Portugal, Dans Easy, and Dart-Europe. Published and unpublished studies (gray literature) were considered. This review integrates articles focused on nursing interventions that contribute to preventing posttraumatic stress in people hospitalized in intensive care in English, Portuguese, and Spanish. Studies with quantitative, qualitative, or mixed designs are covered, as well as systematic reviews and guidelines. The research has 3 eligibility criteria, following the PPC mnemonic: participants (studies involving adults hospitalized in intensive care), concept (studies that address nursing interventions that prevent posttraumatic stress), and context (studies developed in any contextual settings).

Results

The present scoping review included 11 articles. Autonomous, nonpharmacologic, pharmacologic, and interdependent nursing interventions were identified, capable of contributing to prevent posttraumatic stress in people hospitalized in intensive care.

Conclusion

Identifying nursing interventions that prevent posttraumatic stress in people hospitalized in intensive care allows nurses to develop care plans that include these interventions in the context of intensive care, with a view to improving the quality of nursing care provided.

Implications for Clinical Practice

This scoping review demonstrated that nurses have a crucial role in the prevention of posttraumatic stress in the context of intensive care. It is intended to make nurses aware of this issue, specifically to obtain highly significant and clinically relevant results, sensitive to nursing interventions. It is hoped that this review will be the precursor of research studies, centered on evaluating the degree of effectiveness of the nursing interventions mapped in this review.
Role of Artificial Intelligence in Determining Ideal Nasal Tip Projection in Diverse Populations
Authors: Wiegmann Aaron L. , O’Neill Elizabeth S. , Taiberg Stephanie L. , Sinno Sammy , Rohrich Rod J.
Published: November 2024

Background:

Nasal tip projection ideals have been based on the Caucasian nose; however, many racial groups have underprojected tips. Several methodologies have been described to measure ideal nasal tip projection. This study aimed to compare various methods to racially diverse groups to elucidate those best suited for race-specific facial morphology.

Methods:

An openly accessible artificial intelligence image generator was used to generate images of Caucasian, Middle Eastern, and African American noses. Tip projection was manually measured using 5 different ideal tip projection methods. One-way analysis of variance with post hoc Tukey honest significant difference test evaluated differences between racial cohorts. One-sample t tests were used for comparisons to previously described aesthetic ideals, and a P value of less than 0.05 was considered statistically significant.

Results:

Twenty lateral images were analyzed per racial cohort (10 men and 10 women). All racial groups—except for male Middle Eastern noses (P = 0.01)—were measured as ideal using the Byrd nasal length proportion method. Caucasian and Middle Eastern noses measured ideal using the nasolabial tip projection method. African American female noses measured ideal using the nasofacial tip projection method. Only Caucasian noses were ideal using the lip tangent method.

Conclusions:

This study suggests that the ideal nasal length to tip length ratio of two-thirds (67%) has generalizability across these racial groups; the lip tangent is an excellent method for evaluating tip projection in Caucasians; and assessment of ideal tip projection in Middle Eastern and African American groups should use regional midface and lower face anatomy to account for differences in facial morphology.
Study on Blood Circulation Monitoring After the Tissue Transfer of Ultrathin or Conventional Anterolateral Thigh Flaps
Authors: Zhou Zhegang , Yu Longbiao , Meng Fanbin , Wen Jingjing , Xiao Yingfeng , Wan Shengxiang , Zeng Hui , Yu Fei
Published: November 2024

Background:

This study was conducted to compare the incidence of postoperative complications related to blood circulation in the treatment of skin defects through the transfer of ultrathin anterolateral thigh (ALT) flaps or conventional ALT flaps.

Methods:

Patients who received ultrathin ALT flap transfer (group A) and conventional ALT flap transfer (group B) due to skin defects at Peking University Shenzhen Hospital from January 2016 to January 2023 were included in this study. The postoperative incidence of ecchymosis, vascular crisis (artery or vein), and flap survival were compared between the 2 groups of patients.

Results:

In group A, 27 patients recovered and 8 patients reported ecchymosis. In addition, 32 patients achieved flap survival, 1 patient had partial flap necrosis, and 2 patients had complete flap necrosis. In group B, 61 patients recovered and 6 patients reported ecchymosis. In addition, 65 patients achieved flap survival, 1 patient had partial flap necrosis, and 1 patient had complete flap necrosis. Compared with group B, the incidence of ecchymosis was significantly higher in group A (P < 0.05).

Conclusions:

Postoperative blood circulation monitoring (especially ecchymosis) is an important part of postoperative nursing observation in the treatment of skin defects with ultrathin ALT flap transfer. There is no significant difference in the incidence of postoperative vascular crisis between ultrathin and conventional ALT flap transfer. However, the incidence of nonvenous crisis ecchymosis after ultrathin ALT flap transfer is significantly higher than that after conventional ALT flap transfer.
Audiologic Outcomes After Cochlear Implantation in Prelingually Deaf Children Who Have Combined Anomalies or Disabilities
Authors: Choi Yeonjoo , Lee Yun Ji , Joo Hye Ah , Kang Woo Seok , Ahn Joong Ho , Chung Jong Woo , Park Hong Ju
Published: November 2024

Objective

To evaluate the audiologic outcomes after cochlear implantation (CI) in prelingually deaf children with comorbid disorders.

Study Design

Retrospective study.

Setting

Tertiary care academic center.

Patients

We enrolled 85 deaf children (111 ears) with comorbid disorders who underwent CI surgery.

Main Outcomes and Measures

We selected the most common comorbid disorder and compared the categories of auditory performance (CAP) scores of each comorbidity group with those of the control group. Combined cochlear anomalies were also evaluated using temporal bone computed tomography.

Results

The most common comorbid disorder was CHARGE syndrome (n = 17), followed by developmental delay (n = 13), valvular heart disease (including septal defect) (n = 13), Waardenburg syndrome (n = 8), Down syndrome (n = 6), cerebral palsy (n = 5), and cryptorchidism (n = 5). The CAP scores differed significantly between all the groups and the control group after 6 months (p < 0.001). The differences in the CHARGE syndrome (p = 0.004), cerebral palsy (p = 0.001), and Down syndrome (p = 0.004) groups remained significant 2 years after CI. When comparing the presence or absence of anomalies within the syndromic and nonsyndromic groups, significantly poorer outcomes exist when cochlear anomalies with absent modiolus or cochlear nerve deficits were observed, regardless of the presence of syndromic disorders.

Conclusion

Compared with those in the control group, the CAP scores in the group with coexisting disabilities increased over time, but their final scores were relatively lower. Combined disabilities as well as the absent modiolus and cochlear nerve deficit may be clinical markers for poor CAP scores.
Validation of the G.LAB MD6300 upper arm blood pressure monitor in different positions according to the AAMI/ESH/ISO Universal Standard (ISO81060-2:2018+AMD1:2020)
Authors: Cheng Rui , Li Linyi , Chen Jinfeng , Ren Jie , Wan Yi
Published: November 2024

Objective

To validate the accuracy of the G.LAB MD6300 oscillometric upper arm blood pressure monitor in the sitting, supine, and right lateral decubitus position in the general population according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Universal Standard (ISO 81060-2 : 2018+AMD1 : 2020).

Methods

The qualified participants were recruited in the study and the same left-arm sequential method was used for blood pressure measurement according to the Universal Standard. The validation results were assessed for the three positions and the Bland–Altman scatter plot was used to show the difference between the test device and reference results.

Results

A total of 85 participants were included in the analysis. The mean differences between the test device and reference readings were 0.95 ± 6.76/0.47 ± 6.71 mmHg, 0.55 ± 6.73/−0.20 ± 6.72 mmHg, and −0.71 ± 7.11/−0.86 ± 7.06 mmHg for SBP and DBP for the validation criterion 1 in the sitting position, supine with upward palm position, and right lateral decubitus position with downward left palm flat on left side position, respectively. Furthermore, the mean differences and their standard deviations for SBP and DBP calculated according to criterion 2 in the ISO81060-2 : 2018+AMD1 : 2020 were acceptable in all three positions.

Conclusion

The G.LAB MD6300 upper arm blood pressure monitor fulfilled the validation criteria of the AAMI/ESH/ISO Universal Standard (ISO 81060-2 : 2018+AMD1 : 2020) in the sitting position, and its accuracy in the supine and right lateral decubitus position was acceptable and roughly equivalent to that in the sitting position. Therefore, it can be recommended for clinical use and self-measurement in the general population.
Built environment and chronic kidney disease: current state and future directions
Authors: Kim Byoungjun , Kanchi Rania , Titus Andrea R. , Grams Morgan E. , McAdams-DeMarco Mara A. , Thorpe Lorna E.
Published: November 2024

Purpose of review

Despite emerging studies on neighborhood-level risk factors for chronic kidney disease (CKD), our understanding of the causal links between neighborhood characteristics and CKD is limited. In particular, there is a gap in identifying modifiable neighborhood factors, such as the built environment, in preventing CKD, that could be targets for feasible place-based interventions.

Recent findings

Most published studies on neighborhood factors and CKD have focused on a single social attribute, such as neighborhood disadvantage, while research on the role of the built environment is more nascent. Early studies on this topic have yielded inconsistent results, particularly regarding whether food deserts are an environmental risk factor for CKD onset. International studies have shown that walkable neighborhoods – characterized by features such as urban design, park access, and green spaces – can be protective against both the onset and progression of CKD. However, these findings are inconclusive and understudied in the context of United States, where neighborhood environments differ from those in other countries.

Future research on modifiable neighborhood factors and CKD using advanced study designs and population-representative datasets can yield stronger evidence on potential causal associations and suggest feasible place-based interventions as strategies for preventing CKD. As an example, we demonstrated the potential of electronic health record-based studies to advance research in this area.
Human Trafficking and the Role of the Case Manager
Authors: Anderson Jennifer
Published: November 2024

Purpose:

Human trafficking (HT) is the fastest growing crime in the world and a major health concern for healthcare. There is a critical lack of healthcare provider targeted HT education, resulting in the failure to identify, rescue, and provide proper care for victims of HT in the United States. All healthcare professionals must be vigilant and proactive in identifying and assisting victims of HT. Recognizing this need, the aim of this paper is to improve case managers’ awareness and knowledge of their role in HT.

Primary Practice Settings:

The primary setting for purposes of this paper is the hospital as this is the most likely setting where a case manager would encounter a victim of HT. It has been reported that 87.8% of victims report they have been in contact with a healthcare professional at some point during their trafficking with 63.3% occurring in a hospital/emergency room.

Conclusion and Implications for Case Management Practice:

Given the prevalence of HT and the likelihood of numbers growing, case managers should proactively learn to identify, rescue, and provide patient-centered care for victims of HT. This can be achieved through the knowledge of tools that exist to assist case managers in the identification of victims, including the AMP and SOAR models. Additionally, it is important to know one’s role, debunk the myths, and recognize the signs associated with trafficking. Providing a collaborative, patient-centered care approach that supports and empowers the victim will lead to improved victim outcomes and may aid the successful prosecution of the trafficker.
Outcomes and Antithrombotic Regimens in Nonvalvular Atrial Fibrillation Patients With Acute Ischemic Stroke and Competing Large-Artery Atherosclerosis
Authors: Xue Sufang , Na Risu , Dong Jing , Qiu Xue , Wei Min , Kong Qi , Wang Qiujia , Li Fangyu , Wang Yan
Published: November 2024

Objectives:

This study aimed to investigate the outcomes and effectiveness of different antithrombotic regimens at discharge in nonvalvular atrial fibrillation (NVAF) patients with acute ischemic stroke (AIS) and competing large artery atherosclerosis (LAA) mechanisms.

Methods:

In an observational study, we retrospectively analyzed the clinical and follow-up data of NVAF patients with AIS from January 2018 to December 2021 (NCT04080830). The subjects were grouped into 2 groups based on the presence or absence of competing LAA mechanisms. Stroke severity, short-term prognosis, and ischemic recurrence (a composite of ischemic stroke/TIA, myocardial infarction, or systemic embolism after index stroke), were compared between the 2 groups. Antithrombotic regimens at discharge were further categorized into antiplatelet and anticoagulant subgroups to analyze their effectiveness.

Results:

Five hundred-one NVAF patients with AIS (129 with and 372 without competing LAA mechanisms) were included. Compared with the other group, the group with competing LAA mechanisms had a higher proportion of patients with a nondisabling mRS score (P<0.001), lower mortality rates at the 90-day follow-up (P=0.048), and higher 180-day ischemic outcomes (P=0.023). Subgroup analysis showed that the ischemic outcomes were not significantly different (P=0.166) between the anticoagulant and antiplatelet subgroups in patients with competing LAA mechanisms. In contrast, it was numerically higher in the anticoagulant subgroup.

Conclusion:

NVAF patients with AIS due to competing LAA mechanisms had mild severity and a comfortable short-term prognosis; however, these patients had a higher risk of ischemic events. The optimal antithrombotic regimens in these patients remain unclear, and stroke mechanisms should be considered.
Trends in Severe Maternal Morbidity, Obstetric Comorbidities, and Birth Complications in Illinois
Authors: Mokashi Mugdha , Yee Lynn , Feinglass Joseph
Published: November 2024

OBJECTIVE:

To analyze trends in severe maternal morbidity (SMM) and route-specific complications of birth in Illinois hospitals from January 2016 to June 2023.

METHODS:

This retrospective population-based cohort study analyzed birth admission data from 159 hospitals using the Illinois Hospital Association Comparative Health Care and Hospital Data Reporting Services database from January 2016 to June 2023. Primary outcomes were incidence of SMM and route-specific delivery complications. Secondary outcomes included incidence of chronic and pregnancy-related comorbidities. Poisson regression was used to estimate incidence rate ratios for SMM; logistic regression was used to estimate odds ratios for route-specific birth complications; and model SEs were adjusted for clustering of observations within hospitals.

RESULTS:

In this cohort of 988,480 births, the overall SMM rate was 1.6%; the rate of SMM rose from 1.4% in 2016 to 2.0% in 2023. The rate of SMM was 0.9% for people who underwent vaginal births and 3.2% for people who underwent for cesarean births. Vaginal birth complications (7.3% overall) increased 22.4%, and cesarean birth complications (10.9% overall) increased 48.9%. Hypertensive disorders of pregnancy and anemia, both of which increased over the study period, were significant risk factors for SMM and birth complications. Over the study period, there were also increases in International Classification of Diseases, Tenth Revision–coded gestational diabetes (4.2–5.5%), depression (2.5–6.6%), anxiety (3.1–10.4%), and other chronic comorbidities (4.7–7.4%). Non-Hispanic Black patients had more than double the SMM rate (2.6%) compared with non-Hispanic White patients (1.1%).

CONCLUSION:

From 2016 to 2023, the rates of SMM and birth complications in Illinois increased alongside increases in coding for chronic and prepregnancy and pregnancy-related comorbidities. This study demonstrates the burden of cesarean birth–associated adverse outcomes, including a higher rate of SMM, which increased over the study period.
Association of Insurance Changes With Postpartum Prescription Contraception Uptake
Authors: Schaefer Kimberly M. , Hacker Michele R. , Hawkins Summer S. , Molina Rose L.
Published: November 2024

OBJECTIVE:

To assess the association between postpartum insurance churn and postpartum contraception, with specific attention to race, ethnicity, language, and Medicaid expansion status.

METHODS:

We conducted a retrospective cohort study with Pregnancy Risk Assessment Monitoring System survey data (2012–2020) from 42 states. Insurance status, assessed more than 2 months after childbirth, was categorized as continuous insurance, insurance loss, discontinuous Medicaid-to-private, discontinuous private-to-Medicaid, continuous uninsurance, and gain of insurance. We used logistic regression to estimate odds ratios with 95% CIs for insurance status and use of prescription contraception methods, compared with nonprescription and no method, and adjusted for age, race and ethnicity, language, marital status, percent of federal poverty level, education, and birth year. We considered the interaction between state Medicaid expansion and insurance status and stratified analyses by race, ethnicity, and language.

RESULTS:

Of 223,430 respondents, 78.9% held continuous insurance from childbirth to more than 2 months postpartum and 10.2% lost insurance. Compared with continuous insurance, the adjusted odds ratio (95% CI) for prescription postpartum contraception was 0.74 (0.71–0.78) for insurance loss, 0.90 (0.84–0.97) for discontinuous private-to-Medicaid, and 1.04 (0.98–1.10) for discontinuous Medicaid-to-private. There was no evidence for an interaction between living in states with Medicaid expansion and insurance status. Of respondents without Medicaid expansion, 14.0% (95% CI, 13.6–14.3) experienced insurance loss compared with 6.8% (95% CI, 6.6–7.0) with Medicaid expansion. There was a significant interaction between insurance discontinuity and race, ethnicity, and language. Nearly half of the Hispanic Spanish-language respondents (47.5%) experienced insurance loss postpartum.

CONCLUSION:

Insurance loss more than 2 months postpartum was associated with decreased odds of prescription contraception. Populations that experience higher rates of insurance loss include respondents in states without Medicaid expansion and Hispanic Spanish-language respondents. Medicaid and insurance policies have important roles in enabling coverage for contraceptive access across racial and ethnic groups during the postpartum period.
A Contemporary View of Menopausal Hormone Therapy
Authors: Levy Barbara , Simon James A.
Published: November 2024

(Abstracted from Obstet Gynecol 2024;144:12–23)

Studies have shown that estradiol is an effective treatment for vasomotor symptoms and those connected with vulvovaginal atrophy, while preserving bone mineral density. This contemporary review addresses several aspects and issues surrounding estradiol therapy including flaws in previous research.
Subjective Long-Term Outcomes After Vaginal Native Tissue Hysteropexy: Cohort Study
Authors: Lange Sören , Carlin Greta , Zängle Roxana , Heinzl Florian , Umek Wolfgang , Bodner-Adler Barbara
Published: November 2024

(Abstracted from Urogynecology 2024;30:714–720)

The most common surgical technique for apical pelvic organ prolapse involves a hysterectomy, but uterine-preserving surgeries have become more common and studies have shown many women prefer them. Though uterine-preserving procedures are rising in popularity, long-term outcomes are still under-studied.
The occurrence of single-site pharyngeal Neisseria gonorrhoeae among female sex workers in the Netherlands
Authors: Evers Ymke J. , Peters Charlotte MM. , Wolffs Petra FG. , Horsten Dieuwertje L. , Weijzen Chantal. , Dukers-Muijrers Nicole HTM. , Hoebe Christian JPA.
Published: November 2024

Background

Female sex workers (FSW) have a higher burden of sexually transmitted infections (STI), including Neisseria gonorrhoeae (NG), than the non-sex worker population, mainly due to social vulnerability and work-related factors. This large study evaluated the anatomical site distribution of NG, and specifically the occurrence of single-site pharyngeal NG, among FSW visiting Dutch STI clinics in the Netherlands.

Methods

Coded STI clinic consultations from FSW attending any Dutch STI clinic between 2016 and 2021, in which tests were performed on all three anatomical sites, according to the Dutch testing policy for FSW, were included in analyses (n = 22,304). To compare the anatomical site distribution of NG among FSW with women in general, 15,494 consultations from women who were tested on three anatomical sites in clinics that performed standard testing at three anatomical sites were used. Descriptive statistics were used to compare the anatomical site distribution of NG and occurrence of single-site pharyngeal NG among FSW and universally tested women.

Results

NG was diagnosed among 3.5% (782/22,034) among FSW and 1.7% (271/15,494) among universally tested women (p < 0.001). Pharyngeal NG was diagnosed among 2.3% among FSW, versus 0.8% among universally tested women (p < 0.001). Single-site pharyngeal NG was diagnosed in 19.9% (156/782) of all NG infections, compared to 14.8% (40/271) of NG infections among universally tested women.

Conclusion

The substantial proportion pharyngeal NG and single-site pharyngeal NG among FSW, confirms the relevance of pharyngeal testing among this key population for optimal patient management, also in the context of the potential role of pharyngeal NG in antimicrobial resistance.
Risk-Based versus Universal Screening Practices for the Hepatitis C Virus at a Sexually Transmitted Infections Clinic
Authors: Martin Harrison , Fenn Natalie , Maguire-Wilkerson Amanda , Almonte Alexi , Nunn Amy , Chan Philip A.
Published: November 2024

We evaluated hepatitis C virus (HCV) screening practices at a sexually transmitted infections clinic in Rhode Island. Risk-based HCV screening generated fewer tests than universal screening but may have missed infections in men who have sex with men. Injection drug use was most strongly associated with positive HCV antibody tests.
A Cross-Biomeasure Study to Optimize Antiretroviral Adherence Estimation
Authors: Devanathan Aaron S. , Poliseno Amanda J. , White Nicole R. , Schauer Amanda P. , Sykes Craig , Weideman Ann Marie K. , Kilpatrick Kayla W. , Hudgens Michael G. , Gay Cynthia L. , Rosen Elias P. , Dumond Julie B. , Kashuba Angela D. M. , Cottrell Mackenzie L.
Published: November 2024

Background:

Incomplete adherence to daily tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) reduces effectiveness. Adherence biomeasures (ie, drug concentrations in biological specimen) are more accurate than self-report. TDF/FTC's intracellular active metabolites (tenofovir-diphosphate; TFVdp and FTC-triphosphate; FTCtp) can be quantified in different types of blood samples to estimate adherence. To optimize adherence estimation, we investigated approaches to measure TFVdp and FTCtp in 4 blood matrices.

Methods:

Twelve HIV-negative, healthy volunteers were enrolled in a single-center, open-label, 3-phase, directly observed therapy study. LC-MS/MS methods quantified TFVdp/FTCtp in dried blood spots, volumetrically accurate microsampling, upper layer packed cells, and peripheral blood mononuclear cells (PBMCs). Noncompartmental analysis estimated half-lives and accumulation ratios. Correlations characterized relationships between clinical variables and exposure. Regression models were fit to determine concentrations associated with <4 and ≥4 doses/week; correct classification percentages were determined.

Results:

Terminal half-life estimates of 3–4 vs 15–22 days distinguished between moderate-term (FTCtp in all samples; TFVdp in PBMCs) versus long-term (TFVdp in red blood cell–containing matrices) measures. Model-derived thresholds accurately categorized <4 and ≥4 doses/week when including both metabolites for 14- and 28-day dosing periods (81%–91% and 82%–85%, respectively). Within each classification and regression trees analyses containing both moderate- and long-term measures, dried blood spots exhibited highest accuracy to predict stable (74%–94%) and changing (42%–47%) adherence patterns.

Conclusions:

We demonstrate higher accuracy of moderate-term biomeasures to classify adherence over a 14-day period compared with long-term biomeasures to classify adherence over a 28-day period. Combined moderate- and long-term biomeasures predicted stable and changing adherence patterns, with dried blood spots exhibiting highest accuracy.
Makeup, An Attempt to Reach Eternal Beauty; Plastic Surgeon’s View
Authors: Hwang Se Won , Ashirbekovich Kerim , Hwang Kun
Published: November 2024

In this paper, the authors aim to explore the reasons behind human makeup from both medical and literary perspectives. In a PubMed search for “makeup and cosmetics,” 509 titles were identified. Of these, 64 abstracts were reviewed, and ultimately, 8 full texts were referenced. The poem “A Woman Young and Old” written by William Butler Yeats was analyzed. In Research Information Sharing Service (https://www.riss.kr), 4 full texts about the poem “A Woman Young and Old” were found and referenced. Common motivations for using makeup include enhancing natural features, boosting confidence, expressing creativity, covering imperfections, fulfilling cultural and social expectations, and meeting professional requirements. Makeup can make women appear younger. Makeup enhances the reward value of human facial appearance. Makeup can conceal blemishes, scars, dark circles, and other skin imperfections, resulting in a more even and flawless complexion. In a poem by Yeats “A Woman Young and Old,” he describes a young woman applying makeup and captures a moment in which she engages in the ritual of enhancing her beauty. The line “I’m looking for the face I had before the world was made” speaks to a longing for something beyond the mundane, a yearning for a deeper connection with existence. “Before this world was made” is a typical poetic turn of phrase that compares women to eternal beauty. The reasons why women use makeup are diverse and multifaceted, reflecting a combination of personal preferences, societal influences, and individual motivations. Makeup can be a powerful tool for expressing oneself, boosting one’s confidence, and enhancing one’s natural beauty.
Effects of frying temperature and time on the textural attributes and
sensory acceptability of fried Dioscorea alata mash
(Ojojo)
Authors: Awoyale Wasiu , Saliu Lateefat Oluwakemi , Sanni Lateef Oladimeji
Published: November 2024

Ojojo is a fried food made by grating Dioscorea
alata tuber, adding salt and spices, and deep-frying in hot oil.
However, the frying temperature and time have not been studied, as they affect
the textural attributes and consumer acceptability. In this, Dioscorea
alata tuber was processed into flour and then fried into
Ojojo with different frying temperatures and times
(180°C for 4 min, 160°C for 3 min, and 170°C for 5 min) and
fresh Ojojo was used as a control sample. The sensory and
instrumental texture attributes were assessed using a well-structured
questionnaire with 20 panelists and a texture analyzer, respectively. In
contrast, consumer acceptability was assessed in three locations (Safari,
Malete, and Ilorin) using 50 respondents per location. No significant
differences were found in the textural attributes of Ojojo
samples except for sensory gumminess. Consumer acceptability varied
significantly between the other two locations and Ilorin, with instrumental
adhesiveness and hardness being key factors. The consumer acceptability of the
Ojojo produced from 160°C for 3 min and 170°C
for 5 min was attributed to the instrumental adhesiveness and hardness. The
study suggests that fresh Dioscorea alata tuber can be
processed into flour and used for Ojojo production at frying
temperatures and times of 160°C for 3 min or 170°C for 5 min, to
reduce the drudgery involved in using fresh Dioscorea alata
tuber.
Optimization of the succinylation process of Anchomanes
diffformis starch and the impact of starch modification on
quality
Authors: Raji Akeem Olayemi , Aruna Tawakalitu Eniola , Sani Maimuna , Osunrinade Oludolapo Akinyemi
Published: November 2024

The recent increase in demand for starch in food industries necessitates research
into new sources of starch. The optimization process of
succilynated-Anchomanes difformis starch was carried out
using the standard method. The purified Anchomanes difformis
starch samples were succinylated using 0-12% succinic anhydride. The
FTIR, functional properties, pasting properties, chemical composition, enzymatic
activities and anti-nutritional properties of the samples were determined using
standard methods. The gelatinization temperature, solubility index, bulk
density, swelling power, oil absorption capacity and water absorption capacity
ranged from 62.55-80.50°C, 1.08-2.22%, 0.54-0.73%,
2.07-4.12%; 113-176% and 206-259%, respectively. The
pasting temperature, peak time, setback, final viscosity, breakdown, trough and
peak viscosity varied from 74.25-84.05°C, 4.17-5.00 min, 460-970.5 RVU,
1,692.5-2,339 RVU, 900.5-1,937.5 RVU, 102.71-114.04 RVU, and 189.08-270.58 RVU,
respectively. The moisture content, fat content, protein content, ash content,
crude fiber, and carbohydrates ranged from 7.17-12.5%, 0.92-1.51%,
3.37-3.77%, 0.57-3.67%, 0.85-1.37% and 75.44-86.10%,
respectively. The anti-nutritional contents were below the acceptable limit. The
amylopectin and amylose ranged from 82.82-88.23% and 11.77-17.18%,
respectively. The pancreatic lipase, α-amylase and α-glucosidase
activities varied from -11.52-45.02, -16.68-72.12 and 49.22-72.87, respectively.
Conclusively, succinylation at 11.19% would produce Anchomanes
difformis starch succinate of optimum quality for food
applications.