bluuebunny/crossref_metadata_2025 huggingface dataset:
A cross-regional analysis of red-backed shrike responses to agri-environmental schemes in Europe
Authors: Roilo Stephanie , Spake Rebecca , Bullock James M , Cord Anna F
Published: February 2024

Agri-environmental schemes (AES) are the main policy tool to counteract farmland biodiversity declines in Europe, but their biodiversity benefit varies across sites and is likely moderated by landscape context. Systematic monitoring of AES outcomes is lacking, and AES assessments are often based on field experiments encompassing one or few study sites. Spatial analysis methods encompassing broader areas are therefore crucial to better understand the context dependency of species’ responses to AES. Here, we quantified red-backed shrike (Lanius collurio) occurrences in relation to AES adoption in three agricultural regions: Catalonia in Spain, the Mulde River Basin in Germany, and South Moravia in the Czech Republic. We used pre-collected biodiversity datasets, comprising structured and unstructured monitoring data, to compare empirical evidence across regions. Specifically, in each region we tested whether occurrence probability was positively related with the proportion of grassland-based AES, and whether this effect was stronger in simple compared to complex landscapes. We built species distribution models using existing field observations of the red-backed shrike, which we related to topographic, climatic, and field-level land-use information complemented with remote sensing-derived land-cover data to map habitats outside agricultural fields. We found a positive relationship between AES area and occurrence probability of the red-backed shrike in all regions. In Catalonia, the relationship was stronger in structurally simpler landscapes, but we found little empirical support for similar landscape-moderated effects in South Moravia and the Mulde River Basin. Our results highlight the complexity of species’ responses to management across different regional and landscape contexts, which needs to be considered in the design and spatial implementation of future conservation measures.
Electronic conductivity in metal-graphene composites: the role of disordered carbon structures, defects, and impurities
Authors: Nepal K , Ugwumadu C , Gautam A , Kappagantula Keerti , Drabold D A
Published: February 2024

This paper explores the transport properties of aluminum-carbon composite material via ab initio methods. Interfacial and electronic dynamics of the aluminum-graphene interface structure were investigated using models of amorphous graphene added to an aluminum matrix. We examine the impact on electronic conduction caused by the presence of nitrogen impurities within the interfacial amorphous graphene layer. We elucidate the conduction mechanisms by using a projection of the electronic conductivity into space.
Smooth 𝐴_{∞}-form on a diffeological loop space
Authors: Iwase Norio
Published: February 2024

To construct an

A

∞

A_{\infty }

-form for a loop space in the category of diffeological spaces, we have two minor problems. Firstly, the concatenation of paths in the category of diffeological spaces needs a small technical trick, which apparently restricts the number of iterations of concatenations. Secondly, we do not know a smooth decomposition of an associahedron as a simplicial or a cubical complex. To resolve these difficulties, we introduce a notion of a

q
q

-cubic set which enjoys good properties on dimensions and representabilities, and show, using it, that the smooth loop space of a reflexive diffeological space is a h-unital smooth

A

∞

A_{\infty }

-space. In appendix, we show an alternative solution by modifying the concatenation to be stable without assuming reflexivity on spaces nor stability on paths.
Diffeological coarse moduli spaces of stacks over manifolds
Authors: Watts Jordan , Wolbert Seth
Published: February 2024

In this paper, we consider diffeological spaces as stacks over the site of smooth manifolds, as well as the “underlying” diffeological space of any stack. More precisely, we consider diffeological spaces as so-called concrete sheaves and show that the Grothendieck construction sending these sheaves to stacks has a left adjoint: the functor sending any stack to its diffeological coarse moduli space. As an application, we restrict our attention to differentiable stacks and examine the geometry behind the coarse moduli space construction in terms of Lie groupoids and their principal bundles. Within this context, we define a “gerbe”, and show when a Lie groupoid is such a gerbe (or when a stack is represented by one). Additionally, we define basic differential forms for stacks and confirm in the differentiable case that these agree (under certain conditions) with basic differential forms on a representative Lie groupoid. These basic differentiable forms in turn match the diffeological forms on the orbit space.
A survey on diffeological vector spaces and applications
Authors: Wu Enxin
Published: February 2024

Diffeological vector spaces arise naturally in the study of tangent bundles in geometry and operators in functional analysis. We give a concise survey on the current state of the art for the development of the theory of diffeological vector spaces, the relationship with topological vector spaces and fibre bundle theory, and some applications. We also present several new results, and propose many open questions.
A remark on stability and the D-topology of mapping spaces
Authors: Ahmadi Alireza
Published: February 2024

We discuss how stability is related to the D-topology of mapping spaces, equipped with the functional diffeology. Indeed, we show that the stable classes of mapping spaces are D-open. After a reformulation of the classical stability theorem of manifolds with respect to the D-topology, we prove a version of the stability theorem in the class of diffeological étale manifolds.
Smooth homotopy of diffeological spaces: theory and applications to infinite-dimensional 𝐶^{∞}-manifolds
Authors: Kihara Hiroshi
Published: February 2024

We present the basic notions and results of our smooth homotopy theory of diffeological spaces and its applications to infinite-dimensional

C
∞

C^\infty

-manifolds, focusing on the fundamental ideas. In particular, smoothing problems for maps, sections, principal bundles, and gauge transformations are discussed.
‘BrOthers in Arms’: France, the Anglosphere and AUKUS
Authors: Holland Jack , Staunton Eglantine
Published: February 2024

Important French foreign policy dyads, such as relations between France and the United Kingdom and France and the United States, have consistently been subject to empirical, historical and policy analysis. However, France's relationship with the broader Anglosphere is rarely considered or conceptualized. This article theorizes France's relationship with the Anglosphere at a pivotal historical juncture. The 2021 announcement of AUKUS, a security partnership between Australia, the UK and the US, spectacularly excluded France despite a shared proclivity to use military force in defence of liberal international order. To analyse this vital contemporary case, we undertake a comparative, computer-aided discourse analysis of 540 political and media texts, triangulated with thematic analysis of 37 elite interviews. First, contributing to constructivist and ontological security theory, we develop a novel theorization of alliance politics, generally, through the concept of ‘brOthers in arms’, whereby a double identity inscription binds allies antagonistically together. Second, contributing to critical studies of foreign policy and research on national identity, we locate France–Anglosphere relations, specifically, towards the thick end of an alliance identity spectrum, held together in mutual alterity by complementary, competing and co-constitutive exceptionalisms. Third, contributing to studies of foreign policy and alliance politics, our analysis situates AUKUS within the fractious longue durée of France–Anglosphere relations.
Acute purulent enteritis after appendectomy: report of a case
Authors: Yu Feng , Bu Xuefeng , Meng Nana , Xia Leizhou
Published: February 2024

Acute purulent enteritis is uncommon, which occasionally occurs in association with mechanical injuries from foreign bodies of helminth parasites and the contaminated food, leading to bacterial invasion. Herein we report a case of acute purulent enteritis after appendectomy. A 44-year-old male was diagnosed with right lower abdominal pain and vomiting. Acute appendicitis was diagnosed, and an open appendectomy was performed. Postoperatively, the patient developed symptoms of small intestine obstruction. A laparotomy revealed necrosis of the small intestine, and resection was performed. Pathological examination confirmed acute purulent enteritis. Acute purulent enteritis, which is a serious disease resulting in great disaster to patients, following appendectomy is uncommon. Prompt recognition and abdominal computerized tomography scanning are crucial for accurate diagnosis. Early intervention is necessary to prevent complications.
Thoracoscopic endoscopic cooperative surgery for gastric tube cancer after esophagectomy: a case report
Authors: Tsuji Toshikatsu , Okamoto Koichi , Saito Hiroto , Shimada Mari , Moriyama Hideki , Kinoshita Jun , Takatori Hajime , Inaki Noriyuki
Published: February 2024

The incidence of gastric tube cancer (GTC) is increasing due to the improved prognosis of patients after esophagectomy for esophageal cancer. Total resection of the gastric tube is expected to be curative for patients with GTC. However, several studies have reported that this procedure is associated with high mortality and morbidity rates. We here present a case of GTC without lymph node metastasis in a patient who underwent partial resection of a gastric tube via thoracoscopic-endoscopic cooperative surgery. No postoperative complications or recurrence was observed. This procedure is a favorable and minimally invasive procedure for GTC without lymph node metastasis.
Overestimation of Severe Acute Respiratory Syndrome Coronavirus 2 Household Transmission in Settings of High Community Transmission: Insights From an Informal Settlement Community in Salvador, Brazil
Authors: Aguilar Ticona Juan P , Nery Nivison , Hitchings Matt , Belitardo Emilia M M Andrade , Fofana Mariam O , Dorión Murilo , Victoriano Renato , Cruz Jaqueline S , Oliveira Santana Juliet , de Moraes Laise Eduarda Paixão , Cardoso Cristiane W , Ribeiro Guilherme S , Reis Mitermayer G , Khouri Ricardo , Costa Federico , Ko Albert I , Cummings Derek A T
Published: February 2024

Background

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant has spread globally. However, the contribution of community versus household transmission to the overall risk of infection remains unclear.

Methods

Between November 2021 and March 2022, we conducted an active case-finding study in an urban informal settlement with biweekly visits across 1174 households with 3364 residents. Individuals displaying coronavirus disease 2019 (COVID-19)–related symptoms were identified, interviewed along with household contacts, and defined as index and secondary cases based on reverse-transcription polymerase chain reaction (RT-PCR) and symptom onset.

Results

In 61 households, we detected a total of 94 RT-PCR–positive cases. Of 69 sequenced samples, 67 cases (97.1%) were attributed to the Omicron BA.1* variant. Among 35 of their households, the secondary attack rate was 50.0% (95% confidence interval [CI], 37.0%–63.0%). Women (relative risk [RR], 1.6 [95% CI, .9–2.7]), older individuals (median difference, 15 [95% CI, 2–21] years), and those reporting symptoms (RR, 1.73 [95% CI, 1.0–3.0]) had a significantly increased risk for SARS-CoV-2 secondary infection. Genomic analysis revealed substantial acquisition of viruses from the community even among households with other SARS-CoV-2 infections. After excluding community acquisition, we estimated a household secondary attack rate of 24.2% (95% CI, 11.9%–40.9%).

Conclusions

These findings underscore the ongoing risk of community acquisition of SARS-CoV-2 among households with current infections. The observed high attack rate necessitates swift booster vaccination, rapid testing availability, and therapeutic options to mitigate the severe outcomes of COVID-19.
The F-box protein RhSAF destabilizes the gibberellic acid receptor RhGID1 to mediate ethylene-induced petal senescence in rose
Authors: Lu Jingyun , Zhang Guifang , Ma Chao , Li Yao , Jiang Chuyan , Wang Yaru , Zhang Bingjie , Wang Rui , Qiu Yuexuan , Ma Yanxing , Jia Yangchao , Jiang Cai-Zhong , Sun Xiaoming , Ma Nan , Jiang Yunhe , Gao Junping
Published: February 2024

Roses are among the most popular ornamental plants cultivated worldwide for their great economic, symbolic, and cultural importance. Nevertheless, rapid petal senescence markedly reduces rose (Rosa hybrida) flower quality and value. Petal senescence is a developmental process tightly regulated by various phytohormones. Ethylene accelerates petal senescence, while gibberellic acid (GA) delays this process. However, the molecular mechanisms underlying the crosstalk between these phytohormones in the regulation of petal senescence remain largely unclear. Here, we identified SENESCENCE-ASSOCIATED F-BOX (RhSAF), an ethylene-induced F-box protein gene encoding a recognition subunit of the SCF-type E3 ligase. We demonstrated that RhSAF promotes degradation of the GA receptor GIBBERELLIN INSENSITIVE DWARF1 (RhGID1) to accelerate petal senescence. Silencing RhSAF expression delays petal senescence, while suppressing RhGID1 expression accelerates petal senescence. RhSAF physically interacts with RhGID1s and targets them for ubiquitin/26S proteasome-mediated degradation. Accordingly, ethylene-induced RhGID1C degradation and RhDELLA3 accumulation are compromised in RhSAF-RNAi lines. Our results demonstrate that ethylene antagonizes GA activity through RhGID1 degradation mediated by the E3 ligase RhSAF. These findings enhance our understanding of the phytohormone crosstalk regulating petal senescence and provide insights for improving flower longevity.
Association between testosterone levels and RigiScan parameters of patients with erectile dysfunction
Authors: Yuli Fu , Qi Zhang , Haojie Yu , Zedong Liao , Wenjie Huang , Runnana Xu , Tianhao Shi , Yanfei Feng , Bodong Lv
Published: February 2024

Background

It is difficult to diagnose hypogonadism because of the lack of objective assessments of erectile dysfunction (ED), which is caused by hypogonadism.

Aim

To provide a new approach for diagnosing hypogonadism, this study evaluated the efficacy of nocturnal penile tumescence and rigidity (NPTR) testing with RigiScan for patients with ED with and without hypogonadism.

Methods

From June 2021 to February 2023, 133 patients with ED (62 with hypogonadism and 71 without) underwent NPTR testing at the Department of Andrology. A detailed history of all participants was obtained. All participants also underwent a physical examination, sex hormone testing, and ultrasound examination of the cavernous vessels of the penis.

Outcomes

Patient characteristics, sex hormone serum levels, and RigiScan Plus data of NPTR testing of patients with ED were obtained and evaluated.

Results

Between the groups, there were no significant differences in age, body mass index, or erectile function score or in the prevalence of smoking, drinking, diabetes, hypertension, and hyperlipidemia. RigiScan data revealed differences in erection episodes per night, average event rigidity, erection durations, and percentage of tumescence greater than baseline, which were significantly lower in the testosterone-deficient group than in the normal testosterone group. The average event rigidity of the tip displayed the largest area under the curve value, with a sensitivity of 67.6%, a specificity of 85.5%, and a cutoff value of 52.50.

Clinical Implications

Our findings may allow appropriate patients to receive testosterone replacement therapy, which has been shown to be an effective treatment for hypogonadism.

Strengths and Limitations

This is the first study of its kind to perform a comprehensive review of the association between hypogonadism and RigiScan parameters. This study was limited by its small sample size.

Conclusion

RigiScan parameters of patients with ED and testosterone deficiency were significantly lower than those of patients with normal testosterone; therefore, RigiScan is useful for the differential diagnosis of patients with ED caused by hypogonadism.
Sleepy and grumpy go hand in hand for US Navy Sailors
Authors: McClernon Christopher K , Matsangas Panagiotis , Shattuck Nita Lewis
Published: February 2024

Study Objectives

The study explores how sleep, sleep-related practices, and behaviors, in addition to various demographic and occupational characteristics, are related to overall mood of US Navy sailors when they are underway.

Methods

Longitudinal assessment of US Navy sailors performing their underway duties (N = 873, 79.2% males, median age 25 years). Participants completed standardized questionnaires, wore wrist-worn actigraphs, and completed daily activity logs.

Results

Sailors who reported worse profile of mood states (POMS) total mood disturbance scores had shorter sleep duration, worse sleep quality, and more episodes of split sleep. The group with worse mood also reported more symptoms of excessive daytime sleepiness as well as more symptoms of insomnia. In addition to sleep results, sailors with worse mood also tended to be younger, more likely to use nicotine and tobacco products, and less likely to have an exercise routine when compared to sailors with better POMS scores. Finally, the group with worse POMS scores included more enlisted personnel, tended to work more hours per day, and were more likely to stand watch—especially on rotating watch schedules.

Conclusions

The results found significant associations between the sleep practices and mood of sailors aboard US Navy ships. Numerous other demographic and occupational factors were also strongly associated with mood. This paper is part of the Sleep and Circadian Rhythms: Management of Fatigue in Occupational Settings Collection.
Social Determinants of Health and Continuity of Medications for Opioid Use Disorder Among Patients Receiving Treatment in Rural Primary Care Settings
Authors: Pham Huyen , Ober Allison , Baldwin Laura-Mae , Mooney Larissa J. , Zhu Yuhui , Fei Zhe , Hser Yih-Ing
Published: February 2024

Objectives

Factors associated with treatment retention on medications for opioid use disorder (MOUD) in rural settings are poorly understood. This study examines associations between social determinants of health (SDoH) and MOUD retention among patients with opioid use disorder (OUD) in rural primary care settings.

Methods

We analyzed patient electronic health records from 6 rural clinics. Participants (N = 575) were adult patients with OUD and had any prescription for MOUD from October 2019 to April 2020. MOUD retention was measured by MOUD days and continuity defined as continuous 180 MOUD days with no more than a 7-day gap. Mixed-effect regressions assessed associations between the outcomes and SDoH (Medicaid insurance, social deprivation index [SDI], driving time from home to the clinic), telehealth use, and other covariates.

Results

Mean patient MOUD days were 127 days (SD = 50.7 days). Living in more disadvantaged areas (based on SDI) (adjusted relative risk [aRR]: 0.98; 95% confidence interval [CI], 0.98–0.99) and having more than an hour (compared with an hour or less) driving time from home to clinic (aRR: 0.95; 95% CI, 0.93–0.97) were associated with fewer MOUD days. Using telehealth was associated with more MOUD days (aRR: 1.23; 95% CI, 1.21–1.26). In this cohort, 21.7% of the participants were retained on MOUD for at least 180 days. SDoH and use of telehealth were not associated with having continuity of MOUD.

Conclusions

Addressing SDoH (eg, SDI) and providing telehealth (eg, improvements in public transportation, internet access) may improve MOUD days in rural settings.
Epidemiology, Clinical Characteristics, and Outcomes of 4546 Adult Admissions to High-Dependency and ICUs in Kenya: A Multicenter Registry-Based Observational Study
Authors: Njoki Carolyne , Simiyu Nabukwangwa , Kaddu Ronnie , Mwangi Wambui , Sulemanji Demet , Oduor Peter , Dona Dilanthi Gamage , Otieno Dorothy , Abonyo Teddy Thaddeus , Wangeci Patricia , Kabanya Thomas , Mutuku Selina , Kioko Annastacia , Muthoni Joy , Kamau Peter Mburu , Beane Abigail , Haniffa Rashan , Dondorp Arjen , Misango David , Pisani Luigi , Waweru-Siika Wangari
Published: February 2024

OBJECTIVES:

To describe clinical, management, and outcome features of critically ill patients admitted to ICUs and high-dependency units (HDUs) in Kenya.

DESIGN:

Prospective registry-based observational study.

SETTING:

Three HDUs and eight ICUs in Kenya.

PATIENTS:

Consecutive adult patients admitted between January 2021 and June 2022.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Data were entered in a cloud-based platform using a common data model. Study endpoints included case-mix variables, management features, and patient-centered outcomes. Patients with COVID-19 were reported separately. Of the 3892 of 4546 patients without COVID-19, 2445 patients (62.8%) were from HDUs, and 1447 patients (37.2%) were from ICUs. Patients had a median age of 53 years (interquartile range [IQR] 38–68), with HDU patients being older but with a lower severity (Acute Physiology and Chronic Health Evaluation II 6 [3–9] in HDUs vs. 12 [7–17] in ICUs; p < 0.001). One in four patients was postoperative with 604 (63.4%) receiving emergency surgery. Readmission rate was 4.8%. Hypertension and diabetes were prevalent comorbidities, with a 4.0% HIV/AIDS rate. Invasive mechanical ventilation was applied in 3.4% in HDUs versus 47.6% in ICUs (p < 0.001), with a duration of 7 days (IQR 3–21). There was a similar use of renal replacement therapy (4.0% vs. 4.7%; p < 0.001). Vasopressor use was infrequent while half of patients received antibiotics. Average length of stay was 2 days (IQR 1–5). Crude HDU mortality rate was 6.5% in HDUs versus 30.5% in the ICUs (p < 0.001). Of the 654 COVID-19 admissions, most were admitted in ICUs (72.3%) with a 33.2% mortality.

CONCLUSIONS:

We provide the first multicenter observational cohort study from an African ICU National Registry. Distinct management features and outcomes characterize HDU from ICU patients.
Trends in mortality due to tracheal, bronchial, and lung cancer across the BRICS: An age–period–cohort analysis based on the Global Burden of Disease Study 1990–2019
Authors: Bai Ruhai , Dong Wanyue , Chu Meng , Liu Bian , Li Yan
Published: February 2024

Background:

Tracheal, bronchus, and lung cancer (TBL) is a major cause of mortality and top contributor to productivity loss in large emerging economies such as the BRICS (Brazil, Russia, India, China, and South Africa). We examined the time trends of TBL mortality across the BRICS to better understand the disease burden in these countries and inform public health and healthcare resource allocation.

Methods:

TBL mortality-related data between 1990 and 2019 were obtained from the Global Burden of Disease Study 2019 and analyzed using age–period–cohort models. Net drift (local drift) was used to describe the expected age-adjusted TBL mortality rate over time overall (each age group); the longitudinal age curve was used to reflect the age effect; the period rate ratios (RRs) were used to reflect the period effect; and the cohort RR was used to reflect the cohort effect.

Results:

In 2019, there were 958.3 thousand TBL deaths across the BRICS, representing 46.9% of the global TBL deaths. From 1990 to 2019, the age-standardized mortality rate (ASMR) of TBL decreased in Russia, Brazil, and South Africa while increased in China and India, with the largest reduction reported in Russia (–29.6%) and the largest increase in China (+22.4%). India showed an overall increase (+15.7%) in TBL mortality but the mortality risk decreased among individuals born after 1990 (men) and 1995 (women). Although South Africa and Brazil experienced an overall decline in TBL mortality, their recent birth cohorts, such as Brazilian individuals born after 1985 (men) and 1980 (women), and South African men born after 1995, had an increasing TBL mortality risk. China has experienced an overall increase in TBL mortality, with the mortality risk rising among individuals born after 1995 for both men and women. Russia, which had the highest TBL mortality among the BRICS countries in 1990, has demonstrated significant improvement over the past three decades.

Conclusions:

Over the past 30 years, the BRICS accounted for an increasing proportion of global TBL mortality. TBL mortality increased in older women in all the BRICS countries except Russia. Among the recent birth cohort, the risk of TBL mortality increased in Brazil, China, and South Africa. More effective efforts are needed in the BRICS to reduce the burden of TBL and help achieve the United Nation’s Sustainable Development Goals.
The future of International Classification of Diseases coding in steatotic liver disease: An expert panel Delphi consensus statement
Authors: Hagström Hannes , Adams Leon A. , Allen Alina M. , Byrne Christopher D. , Chang Yoosoo , Duseja Ajay , Grønbæk Henning , Ismail Mona H. , Jepsen Peter , Kanwal Fasiha , Kramer Jennifer , Loomba Rohit , Mark Henry E. , Newsome Philip N. , Rinella Mary E. , Rowe Ian A. , Ryu Seungho , Sanyal Arun , Schattenberg Jörn M. , Serper Marina , Sheron Nick , Simon Tracey G. , Spearman C. Wendy , Tapper Elliot B. , Villota-Rivas Marcela , Wild Sarah H. , Wong Vincent Wai-Sun , Yilmaz Yusuf , Zelber-Sagi Shira , Åberg Fredrik , Lazarus Jeffrey V.
Published: February 2024

Background:

Following the adoption of new nomenclature for steatotic liver disease, we aimed to build consensus on the use of International Classification of Diseases codes and recommendations for future research and advocacy.

Methods:

Through a two-stage Delphi process, a core group (n = 20) reviewed draft statements and recommendations (n = 6), indicating levels of agreement. Following revisions, this process was repeated with a large expert panel (n = 243) from 73 countries.

Results:

Consensus ranged from 88.8% to 96.9% (mean = 92.3%).

Conclusions:

This global consensus statement provides guidance on harmonizing the International Classification of Diseases coding for steatotic liver disease and future directions to advance the field.
Management of long-term complications from immunosuppression
Authors: Russo Mark W. , Wheless William , Vrochides Dionisios
Published: February 2024

This review discusses long-term complications from immunosuppressants after liver transplantation and the management of these complications. Common complications of calcineurin inhibitors include nephrotoxicity and metabolic diseases. Nephrotoxicity can be managed by targeting a lower drug level and/or adding an immunosuppressant of a different class. Metabolic disorders can be managed by treating the underlying condition and targeting a lower drug level. Gastrointestinal adverse effects and myelosuppression are common complications of antimetabolites that are initially managed with dose reduction or discontinuation if adverse events persist. Mammalian targets of rapamycin inhibitors are associated with myelosuppression, proteinuria, impaired wound healing, and stomatitis, which may require dose reduction or discontinuation. Induction agents and agents used for steroid-refractory rejection or antibody-mediated rejection are reviewed. Other rare complications of immunosuppressants are discussed as well.
Reexamining Differences Between Black and White Veterans in Hospital Mortality and Other Outcomes in Veterans Affairs and Other Hospitals
Authors: Yoon Jean
Published: February 2024

Objectives:

To examine Black-White patient differences in mortality and other hospital outcomes among Veterans treated in Veterans Affairs (VA) and non-VA hospitals.

Background:

Lower hospital mortality has been documented in older Black patients relative to White patients, yet the mechanisms have not been determined. Comparing other hospital outcomes and multiple hospital systems may help inform the reasons for these differences.

Methods:

Repeated cross-sectional analysis of hospitalization records was conducted for Veterans discharged in VA and non-VA hospitals from January 1, 2013 to December 31, 2017 in 11 states. Hospital outcomes included 30-day mortality, 30-day readmissions, inpatient costs, and length of stay. Hospitalizations were for acute myocardial infarction, coronary artery bypass graft surgery, gastrointestinal bleeding, heart failure, pneumonia, and stroke. Differences in outcomes were estimated between Black and White patients for VA and non-VA hospitals and age groups younger than 65 years or 65 years and older in regression models adjusting for patient and hospital factors.

Results:

There were a total of 459,574 study patients. Older Black patients had lower adjusted mortality for acute myocardial infarction, gastrointestinal bleeding, heart failure, and pneumonia. Adjusted probability of readmission was higher and adjusted mean length of stay and costs were greater for older Black patients relative to White patients in non-VA hospitals for several conditions. Fewer differences were observed in younger patients and in VA hospitals.

Conclusion:

While older Black patients had lower mortality, other outcomes compared poorly with White patients. Differences were not fully explained by observable patient and hospital factors although social determinants may contribute to these differences.
[18F]-PSMA-1007 PET imaging optimization and inter-rater reliability – a comparison of three different reconstructions read by four radiologists
Authors: Jonmarker Olof , Nilsson Ted , Axelsson Rimma , Ericson Lovisa Hult , Tran Thuy A. , Tzortzakakis Antonios , Savitcheva Irina , Holstensson Maria
Published: February 2024

Objectives

To increase understanding of optimal imaging parameters [18F]PSMA-1007 when imaging patients with prostate cancer and to determine interrater agreement using [18F]PSMA-1007.

Methods

In this observational study, four independent physicians read reconstruction sets using bedtimes of 1, 2 and 3 minutes of patients undergoing [18F]PSMA-1007. positron emission topography. Clear and equivocal lesions and their locations were recorded. Image noise was rated on a four-point scale. Lesion counts were compared using inter-class correlation whereas noise ratings were compared using generalized estimating equations. Repeated cases were used to assess intra-rater agreement.

Results

Sixty reconstruction sets of 16 consecutively examined participants were included. Participants had a mean age of 71.5 years, six of them were examined prior to any treatment, three had a history of radiotherapy and seven of prostatectomy. Median Gleason score of primary tumors was 7. Imaging was performed after a mean of 132 min using a mean 3.95 MBq/Kg body weight of [18F] PSMA-1007. Neither the total number of lesions per location nor the proportion of equivocal lesions varied consistently between bedtimes. Inter-rater reliability scores varied depending on location from 0.40 to 1.0 and were similar for all bedtimes. Intra-rater reliability varied between 0.70 and 0.76 for the three different bedtimes. Noise ratings were significantly lower for 1 minute than 3 minutes per bed.

Conclusion

In the setting of [18F]PSMA-1007 PET CT, 1, 2 and 3 minutes per bed produce similar results unlikely to affect clinical interpretation. Image noise ratings favor 2 and 3 minutes per bed.
Health-related quality of life and related factors in patients with colorectal cancer in Iran: a systematic review
Authors: Naeimabadi Zahra , Bana Derakhshan Homayoon , Rassouli Maryam , Ebadi Abbas
Published: February 2024

Introduction:

This systematic review aims to examine the health-related quality of life (QOL) in Iranian patients with colorectal cancer (CRC) and its related factors.

Methods:

A thorough, systematic search was conducted in different international electronic databases, including Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords such as “Colorectal neoplasm”, “Colorectal tumors”, “Colorectal cancer”, “Quality of life”, and “Life quality” from the earliest to 17 October 2022. The quality of the studies included in this systematic review was evaluated using the appraisal tool for cross-sectional studies (AXIS tool).

Results:

There were 820 CRC patients in the five cross-sectional studies that made up this systematic review. The mean score of QOL in patients with CRC was 61.99 (SD=15.87) out of 100 based on EORTC-QLQ-C30, which indicates a moderate to good level of QOL. Factors such as age, gender, living conditions, level of education, occupation, monthly income, health insurance, physical activity, performance status, and comorbidities had a significant relationship with QOL in patients with CRC.

Conclusion:

In sum, the findings of the five studies that were a part of this systematic review revealed that Iranian patients with CRC had a moderate to good QOL. Therefore, managers and health policymakers can create psychological counseling programs with an emphasis on the factors affecting the QOL of patients in light of how crucial it is to raise patients’ understanding of the long-term impacts of CRC and how they affect their QOL.
Unplanned pregnancy and risk of peripartum depression: a prospective cohort study in Saudi pregnant women attending antenatal care clinic
Authors: Alsahafi Imtinan K. , Alblady Eman H. , Magliah Sultan F. , Alahmadi Layan S. , Alshareef Reem J. , Binmahfoodh Dina S. , Alsalem Moayyad S.
Published: February 2024

Background:

Few studies have been conducted on unintended pregnancies and peripartum depression in Saudi Arabia. This study aimed to evaluate the relationship between unplanned pregnancies and peripartum depression among pregnant women in Jeddah, Saudi Arabia.

Methods:

This prospective cohort study included pregnant women attending an antenatal care clinic in 2021. The London Measure of Unplanned Pregnancy was used to assess the prevalence of unplanned pregnancy, and the Edinburgh Postnatal Depression Scale (EPDS) was used to assess antenatal and postnatal depression.

Results:

A total of 236 participants were included, of which 25.8% had unplanned pregnancies, 36.0% had ambivalent pregnancies, and 38.1% had planned pregnancies. EPDS results revealed that 77.5% and 73.35% of the females were negative for antenatal and postnatal depression, respectively. A history of stressful events (P=0.001), husband (P=0.020), and family support (P=0.007) was significantly associated with antenatal EPDS score, whereas age (P=0.005), type of delivery (P=0.019), and family support (P=0.031) were significantly associated with the postnatal score.

Conclusion:

Unplanned pregnancies may affect the perinatal mental health of women. We demonstrated the importance of family or husbands’ support for women with perinatal depression. In addition, our research showed that pregnancy at an early age is a risk factor for postnatal depression. Therefore, these women should be closely monitored not only during their pregnancy but also during the first postpartum year.
Risk factor analysis and prediction model construction for surgical patients with venous thromboembolism: a prospective study
Authors: Pan Shucheng , Bian Lifang , Luo Huafang , Conway Aaron , Qiao Wenbo , Win Topatana , Wang Wei
Published: February 2024

Objective:

Patients undergoing surgery are at high risk of developing venous thromboembolism (VTE). This study aimed to determine the predictive value of risk factors for VTE in surgical patients and to develop a prediction model by integrating independent predictors.

Methods:

A total of 1,111 patients who underwent surgery at clinical departments in a tertiary general hospital were recruited between May and July 2021. Clinical data including patient-related, surgery-related, and laboratory parameters were extracted from the hospital information system and electronic medical records. A VTE prediction model incorporating ten risk variables was constructed using artificial neural networks (ANNs).

Results:

Ten independent factors (X1: age, X2: alcohol consumption, X3: hypertension, X4: bleeding, X5: blood transfusions, X6: general anesthesia, X7: intrathecal anesthesia, X8: D-dimer, X9: C-reactive protein, and X10: lymphocyte percentage) were identified as associated with an increased risk of VTE. Ten-fold cross validation results showed that the ANN model was capable of predicting VTE in surgical patients, with an area under the curve (AUC) of 0.89, a Brier score of 0.01, an accuracy of 0.96, and a F1 score of 0.92. The ANN model slightly outperformed the logistic regression model and the Caprini model, but a DeLong test showed that the statistical difference in the AUCs of the ANN and logistic regression models was insignificant (P>0.05).

Conclusion:

Ten statistical indicators relevant to VTE risk prediction for surgical patients were identified, and ANN and logistic regression both showed promising results as decision-supporting tools for VTE prediction.
Night time heart rate predicts next-day pain in fibromyalgia and primary back pain
Authors: Dudarev Veronica , Barral Oswald , Radaeva Mariia , Davis Guy , Enns James T.
Published: February 2024

Introduction:

Primary chronic pain is pain that persists for over 3 months without associated measurable tissue damage. One of the most consistent findings in primary chronic pain is its association with autonomic hyperactivation. Yet whether the autonomic hyperactivation causes the pain or results from it is still unclear. It is also unclear to what extent autonomic hyperactivation is related to experienced pain intensity in different subtypes or primary chronic pain.

Objectives:

Our first aim was to test lagged relationships between the markers of autonomic activation (heart rate) and pain intensity to determine its directionality. The main question here was whether autonomic biomarkers predict pain intensity or whether pain intensity predicts autonomic biomarkers. The second aim was to test whether this relationship is different between people with primary back pain and people with fibromyalgia.

Methods:

Sixty-six patients with chronic pain were observed over an average of 81 days. Sleep heart rate and heart rate variability were measured with a wearable sensor, and pain intensity was assessed from daily subjective reports.

Results:

The results showed a predictive relationship between sleep heart rate and next-day pain intensity (P < 0.05), but not between daily pain intensity and next night heart rate. There was no interaction with the type of chronic pain.

Conclusions:

These findings suggest that autonomic hyperactivation, whether stress-driven or arising from other causes, precedes increases in primary chronic pain. Moreover, the present results suggest that autonomic hyperactivation is a common mechanism underlying the pain experience in fibromyalgia and chronic back pain.
Publication Trends of Research on Adverse Event and Patient Safety in Nursing Research: A 8-Year Bibliometric Analysis
Authors: Lin Miaoyuan , Chen Bei , Xiao Leyao , Zhang Li
Published: February 2024

Background

Adverse events (AEs), which are associated with medical system instability, poor clinical outcomes, and increasing socioeconomic burden, represent a negative outcome of the healthcare system and profoundly influence patient safety. However, research into AEs remains at a developmental stage according to the existing literature, and no previous studies have systematically reviewed the current state of research in the field of AEs. Therefore, the aims of this study were to interpret the results of published research in the field of AEs through bibliometric analysis and to analyze the trends and patterns in the data, which will be important for subsequent innovations in the field.

Methods

A statistical and retrospective visualization bibliometric analysis was performed on July 28, 2022. The research data were extracted from the Web of Science Core Collection, and bibliometric citation analysis was performed using Microsoft Excel, VOSviewer 1.6.18, CiteSpace 6.1.R2, and the Online Analysis Platform of Literature Metrology (http://bibliometric.com/).

Results

A total of 1035 publications on AEs were included in the analysis. The number of articles increased annually from 2014 to 2022. Among them, the United States (n = 318) made the largest contribution, and Chung-Ang University (n = 20) was the affiliation with the greatest influence in this field. Despite notable international cooperation, a regional concentration of research literature production was observed in economically more developed countries. In terms of authors, Stone ND (n = 9) was the most productive author in the research of AEs. Most of the publications concerning AEs were cited from internationally influential nursing journals, and the Journal of Nursing Management (n = 62) was the most highly published journal. Regarding referencing, the article titled “Medical error—the third leading cause of death in the US” received the greatest attention on this topic (51 citations).

Conclusions

After systematically reviewed the current state of research in the field of AEs through bibliometric analysis, and AEs highlighted medication errors, patient safety, according reporting, and quality improvement as essential developments and research hotspots in this field. Furthermore, thematic analysis identified 2 new directions in research, concerned with psychological safety, nurse burnout, and with important research value and broad application prospects in the future.
Focused Ultrasound Blood-Brain Barrier Opening Arrests the Growth and Formation of Cerebral Cavernous Malformations
Authors: Fisher Delaney G. , Sharifi Khadijeh A. , Shah Ishaan M. , Gorick Catherine M. , Breza Victoria R. , Debski Anna C. , Hoch Matthew R. , Cruz Tanya , Samuels Joshua D. , Sheehan Jason P. , Schlesinger David , Moore David , Lukens John R. , Miller G. Wilson , Tvrdik Petr , Price Richard J.
Published: February 2024

BACKGROUND

Cerebral cavernous malformations (CCM) are vascular lesions within the central nervous system, consisting of dilated and hemorrhage-prone capillaries. CCMs can cause debilitating neurological symptoms, and surgical excision or stereotactic radiosurgery are the only current treatment options. Meanwhile, transient blood-brain barrier opening (BBBO) with focused ultrasound (FUS) and microbubbles is now understood to exert potentially beneficial bioeffects, such as stimulation of neurogenesis and clearance of amyloid-β. Here, we tested whether FUS BBBO could be deployed therapeutically to control CCM formation and progression in a clinically-representative murine model.

METHODS

CCMs were induced in mice by postnatal, endothelial-specificKrit1ablation. FUS was applied for BBBO with fixed peak-negative pressures (PNPs; 0.2-0.6 MPa) or passive cavitation detection-modulated PNPs. Magnetic resonance imaging (MRI) was used to target FUS treatments, evaluate safety, and measure longitudinal changes in CCM growth after BBBO.

RESULTS

FUS BBBO elicited gadolinium accumulation primarily at the perilesional boundaries of CCMs, rather than lesion cores. Passive cavitation detection and gadolinium contrast enhancement were comparable in CCM and wild-type mice, indicating thatKrit1ablation does not confer differential sensitivity to FUS BBBO. Acutely, CCMs exposed to FUS BBBO remained structurally stable, with no signs of hemorrhage. Longitudinal MRI revealed that FUS BBBO halted the growth of 94% of CCMs treated in the study. At 1 month, FUS BBBO-treated lesions lost, on average, 9% of their pre-sonication volume. In contrast, non-sonicated control lesions grew to 670% of their initial volume. Lesion control with FUS BBBO was accompanied by a marked reduction in the area and mesenchymal appearance ofKritmutant endothelium. Strikingly, in mice receiving multiple BBBO treatments with fixed PNPs,de novoCCM formation was significantly reduced by 81%. Mock treatment plans on MRIs of patients with surgically inaccessible lesions revealed their lesions are amenable to FUS BBBO with current clinical technology.

CONCLUSIONS

Our results establish FUS BBBO as a novel, non-invasive modality that can safely arrest murine CCM growth and prevent theirde novoformation. As an incisionless, MR image-guided therapy with the ability to target eloquent brain locations, FUS BBBO offers an unparalleled potential to revolutionize the therapeutic experience and enhance the accessibility of treatments for CCM patients.
Thalamic feedback shapes brain responses evoked by cortical stimulation in mice and humans
Authors: Russo Simone , Claar Leslie , Marks Lydia , Krishnan Giri , Furregoni Giulia , Zauli Flavia Maria , Hassan Gabriel , Solbiati Michela , d’Orio Piergiorgio , Mikulan Ezequiel , Sarasso Simone , Rosanova Mario , Sartori Ivana , Bazhenov Maxim , Pigorini Andrea , Massimini Marcello , Koch Christof , Rembado Irene
Published: February 2024

Cortical stimulation with single pulses is a common technique in clinical practice and research. However, we still do not understand the extent to which it engages subcortical circuits which contribute to the associated evoked potentials (EPs). Here we find that cortical stimulation generates remarkably similar EPs in humans and mice, with a late component similarly modulated by the subject’s behavioral state. We optogenetically dissect the underlying circuit in mice, demonstrating that the late component of these EPs is caused by a thalamic hyperpolarization and rebound. The magnitude of this late component correlates with the bursting frequency and synchronicity of thalamic neurons, modulated by the subject’s behavioral state. A simulation of the thalamo-cortical circuit highlights that both intrinsic thalamic currents as well as cortical and thalamic GABAergic neurons contribute to this response profile. We conclude that the cortical stimulation engages cortico-thalamo-cortical circuits highly preserved across different species and stimulation modalities.

Graphical abstract
A programmable arthritis-specific receptor for guided articular cartilage regenerative medicine
Authors: Walton Bonnie L. , Shattuck-Brandt Rebecca , Hamann Catherine A. , Tung Victoria W. , Colazo Juan M. , Brand David D. , Hasty Karen A. , Duvall Craig L. , Brunger Jonathan M.
Published: February 2024

Objective

Investigational cell therapies have been developed as disease-modifying agents for the treatment of osteoarthritis (OA), including those that inducibly respond to inflammatory factors driving OA progression. However, dysregulated inflammatory cascades do not specifically signify the presence of OA. Here, we deploy a synthetic receptor platform that regulates cell behaviors in an arthritis-specific fashion to confine transgene expression to sites characterized by cartilage degeneration.

Methods

An scFv specific for type II collagen (CII) was used to produce a synthetic Notch (synNotch) receptor that enables “CII-synNotch” mesenchymal stromal cells (MSCs) to recognize CII fibers exposed in damaged cartilage. Engineered cell activation by both CII-treated culture surfaces and on primary tissue samples was measured via inducible reporter transgene expression. TGFβ3-expressing cells were assessed for cartilage anabolic gene expression via qRT-PCR. In a co-culture with CII-synNotch MSCs engineered to express IL-1Ra, ATDC5 chondrocytes were stimulated with IL-1α, and inflammatory responses of ATDC5s were profiled via qRT-PCR and an NF-kB reporter assay.

Results

CII-synNotch MSCs are highly responsive to CII, displaying activation ranges over 40-fold in response to physiologic CII inputs. CII-synNotch cells exhibit the capacity to distinguish between healthy and damaged cartilage tissue and constrain transgene expression to regions of exposed CII fibers. Receptor-regulated TGFβ3 expression resulted in upregulation ofAcan andCol2a1in MSCs, and inducible IL-1Ra expression by engineered CII-synNotch MSCs reduced pro-inflammatory gene expression in chondrocytes.

Conclusion

This work demonstrates proof-of-concept that the synNotch platform guides MSCs for spatially regulated, disease-dependent delivery of OA-relevant biologic drugs.