bluuebunny/crossref_metadata_2025 huggingface dataset:
A rare dissecting anterior inferior cerebellar artery aneurysm treated with flow diversion using a silk vista baby device
Authors: Kass-Hout Omar , Darkhabani Ziad , Becske Tibor
Published: January 2024

Background

Dissecting intracranial pseudoaneurysms represent a challenge for treatment both endovascularly and surgically.

Methods

We review the treatment course of a ruptured anterior inferior cerebellar artery (AICA) dissecting pseudoaneurysm in a 50-year-old patient and review the history of dissecting aneurysms and AICA aneurysms treatment.

Results

An aneurysm cure was achieved using flow diversion in the AICA. The recent introduction of flow diversion devices that can be deployed through 0.017” microcatheters represents a new avenue for treatment of aneurysms.

Conclusion

To the best of our knowledge this is the first published case of flow diversion in the(?) AICA to treat a dissecting aneurysm. The introduction of Silk Vista Baby and similar future devices is likely to widen the scope of aneurysm treatment utilizing flow diversion in distal distribution with small parent arteries.
Potential protein tyrosine phosphatase 1B and α-glucosidase inhibitory flavonoids from Erythrina variegata: Experimental and computational results
Authors: Nguyen Phi-Hung , Trinh Ngoc-Thao-Vy , Do Thi-Thuy , Vu Thi-Ha , To Dao Cuong , Pham Hong Khuyen Thi , Truong Phu Chi Hieu , Pham Van Kim Thuong , Tran Manh Hung
Published: January 2024

Erythrina variegata L., a member of the Fabaceae family, is a valuable medicinal plant with a rich history of traditional medicinal uses. However, its potential as an antidiabetic agent has remained largely unexplored. In this study, three isoflavonoid compounds, namely eryvarin M (1), eryvarin H (2), and neobavaisoflavone (3), were isolated from E. variegata. These compounds displayed significant inhibitory effects on both protein tyrosine phosphatase 1B and α-glucosidase enzymes. The specific attachment position of the prenyl group to the isoflavonoid skeleton plays a pivotal role in determining the variation in their activity. Moreover, the results obtained from docking simulations corroborate the experimental findings, confirming the robust binding affinities of these metabolites toward the target proteins. The docking analysis further highlights that these compounds exhibit highly negative values of binding-free energies against proteins, indicative of their favorable binding affinities. In addition, the formation of hydrogen bonds in the binding region contributes to their binding interactions. These findings significantly enhance our understanding of the therapeutic potential of both E. variegata and its isoflavonoids as potential inhibitors for diabetes and related metabolic disorders, shedding light on their promising role in the field of diabetes research.
Stability of Piceatannol in Dulbecco's Modified Eagle's Medium by In Situ UPLC-MS/MS Analysis
Authors: Cheong Meng S. , Nahar Lutfun , Sarker Satyajit D. , Cao Hui , Cheang Wai S. , Xiao Jianbo
Published: January 2024

Piceatannol is a stilbenoid, which has shown bioactivities in various cell culture models. However, its stability in cell culture medium is not clear. Here, UPLC-MS/MS was applied in situ to analyze the degradation products of piceatannol in Dulbecco's Modified Eagle's Medium (DMEM) and cell culture to investigate the compound's stability in DMEM. During the incubation with cell culture medium (at 4 and 37 °C), several piceatannol derivatives, such as an oxidation product ( m/z 243.06), a reduction product ( m/z 247.09), dimers ( m/z 485.12 and 487.14) and trimers ( m/z 727.18) were detected, which demonstrated the instability of piceatannol in cell culture conditions. To confirm if the new products during the incubation were generated due to the instability of piceatannol, ascorbic acid was added. The presence of ascorbic acid could significantly slow the degradation rate of piceatannol and the generation of piceatannol derivatives, which proved that the new products were generated by the degradation of piceatannol and indicated that the instability of piceatannol might be related to its antioxidant activity.
Potential of 2-Hydroxyacetophenone Derivatives and Simple Phenol's for the control of Meloidogyne javanica
Authors: González López Luis Alberto , Andres Maria Fe , Quiñones Wiston , Echeverri Fernando , Gonzalez-Coloma Azucena
Published: January 2024

Objective: In this study, a series of synthetic hydroxylated (5-10) and prenylated (10-17) acetophenones, chalcones (18-20) and a flavone (21) have been synthesized and evaluated on the nematode Meloidogyne javanica. Additional phenolic compounds, including salicylic acid, isopropyl salicylate, thymol, carvacrol, cumic acid, eugenol, vanillin, and vanillic acid (22-29), were also tested. Methods: Compounds 5-21 have been synthesized by a sequence of reactions and were isolated and identified by 1H-NMR, 13C-NMR, and HRMS. The in vitro nematicidal effects of the compounds were tested on J2 juveniles. The nematicidal activity was confirmed by their egg hatching inhibition effects, tested at the minimum lethal concentration (minimum dose to give 100% J2 mortality). Results: Compounds 5-18 have been previously reported and 19-21 are described here for the first time. The 2´-hydroxylated acetophenones (5-9) showed strong nematicidal effects, being 7-9 the most active. Salicylic (22) and cumic (26) acids were effective compounds. Compounds 7, 12, 22-26, active on M. javanica J2 juveniles, were also egg hatching inhibitors. Conclusions: A C-2/C-4 dihydroxylation or C-2/C-4/C-3 trihydroxylation of the acetophenone moiety improved the activity, while introducing a hydrophilic isoprene chain (10-17) eliminated the effect, with only one prenylated acetophenone (12) being active. Among the additional phenolic compounds (22-29), these with a carboxyl group instead of the acyl side were better nematicides. These results generate molecular leads for developing new nematicidal phenolic compounds.
Are We Speaking the Same Language? Terminology Consistency in EBD
Authors: Golgolnia Tahere , Kevdzija Maja , Marquardt Gesine
Published: January 2024

Objective:

The aim of this study is to analyze the consistency, variability, and potential standardization of terminology used to describe architectural variables (AVs) and health outcomes in evidence-based design (EBD) studies.

Background:

In EBD research, consistent terminology is crucial for studying the effects of AVs on health outcomes. However, there is a possibility that diverse terms have been used by researchers, which could lead to potential confusion and inconsistencies.

Methods:

Three recent large systematic reviews were used as a source of publications, and 105 were extracted. The analysis aimed to extract a list of the terms used to refer to the unique concepts of AVs and health outcomes, with a specific focus on people with dementia. Each term’s frequency was calculated, and statistical tests, including the χ2 and the post hoc test, were employed to compare their distributions.

Results:

The study identified representative terms for AVs and health outcomes, revealing the variability in terminology usage within EBD field for dementia-friendly design. The comparative analysis of the identified terms highlighted patterns of frequency and distribution, shedding light on potential areas for standardization.

Conclusions:

The findings emphasize the need for standardized terminologies in EBD to improve communication, collaboration, and knowledge synthesis. Standardization of terminology can facilitate research comparability, enhance the generalizability of findings by creating a common language across studies and practitioners, and support the development of EBD guidelines. The study contributes to the ongoing discourse on standardizing terminologies in the field and provides insights into strategies for achieving consensus among researchers, practitioners, and stakeholders in health environmental research.
Industrial action in private international law
Authors: van Hoek Aukje A. H.
Published: January 2024

This contribution deals with both jurisdiction and applicable law with regard to cross-border collective actions in labour law. It demonstrates that the European conflicts rule embodied in Article 9 of the Rome II Regulation is open to diverging interpretations. This can, to a large extent, be explained by the very diverse legal characterisation of industrial action in the national systems of the EU Member States. The connecting factors used in the Rome II Regulation also create specific challenges when applied in the context of industrial action. As a result of these complications, Article 9 Rome II currently fails to fulfil its function of creating legal certainty around the legality and the legal consequences of industrial action with a cross-border element. A further clarification of the scope of Article 9 and the role played by the law of the country in which the industrial action is taken would help to reduce the current confusion and uncertainty. The uncertainty as to the applicable law is exacerbated by the rules on jurisdiction in the Brussels I bis Regulation which allow, to some extent, for forum shopping. Two provisions of the Brussels I bis Regulation might warrant revision to reduce their negative impact on the exercise of the right to industrial action: the rule on multiple defendants (Article 8(1)) and the rule granting jurisdiction to the place where the damage caused by the industrial action is sustained (Article 7(2)).
Assessment of nursing knowledge and practice toward prevention of acquired infections in the emergency department of King Faisal Medical Complex in Taif
Authors: Althiyabi Fahad Sulaiman , Khuded Fares Mabrok , Alzaidi Fawaz Mohammed , Alswat Abdulmjeed Saleh Greeb , Alotaibi Fahad Suwaylih B , Alotaibi Wael Suwaylih B , Alotaibi Khalid Ibrahim A , Alshehri Faisal Abdullah H , Almutairi Atallah Mesfer A , Alnathli Jamaan Aali Ahmed
Published: January 2024

Background:

Hospital-acquired infections constitute a significant source of morbidity and mortality for both patients and healthcare professionals. Nursing professionals constitute an integral component of any quality-related program in a hospital, given their oversight and provision of nearly all healthcare services. Nurses’ knowledge and attitudes play a significant role in healthcare delivery. Within Saudi Arabia, the prevalence of hospital-acquired infections in hospital settings has prompted a growing emphasis on evaluating nursing knowledge and adherence to practice standards aimed at hospital-acquired infection prevention.

Methods:

This single-center cross-sectional study was conducted at the emergency department of King Faisal Medical Complex, Taif, between October and December 2022, involving 168 nurses. The study utilized a pre-validated structured online questionnaire comprising three sections: demographics, knowledge assessment, and practice evaluation. Knowledge and practice levels were categorized as good, moderate, and poor using quartiles.

Results:

The study encompassed 168 nurses employed in the emergency department of the hospital, revealing their proficiency in standard practices for preventing hospital-acquired infections. Notably, 63.8% of participants demonstrated a commendable “Good” level of knowledge, while 10.6% exhibited a “Moderate” level and 25.5% manifested a “Poor” level in terms of knowledge. Similarly, concerning practice levels, 56.4% showcased a commendable “Good” practice level, 22.3% maintained a “Moderate” practice level, and 21.3% presented a “Poor” practice level. Chi-square analysis unveiled a significant association between age and knowledge levels ( p = 0.000). In addition, age ( p = 0.000) and years of clinical experience ( p = 0.000) were significantly linked to nurses’ practice levels The nurses aged 40–50 years (82%) and those with 10–15 years of clinical experience (83.3%) showed good levels of knowledge and practice, respectively. Overall, most of the nurses demonstrated effective knowledge and compliance with infection prevention practices.

Conclusion:

Sociodemographic factors such as age and clinical experience exert a notable impact on nurses’ knowledge and practices regarding hospital-acquired infections.
The development and validation of a digital biomarker for remote assessment of Alzheimer's diseases risk
Authors: Butler Joe , Watermeyer Tamlyn J , Matterson Ellie , Harper Emily G , Parra-Rodriguez Mario
Published: January 2024

Background

Digital cognitive assessment is becoming increasingly widespread in ageing research and care, especially since the COVID-19 pandemic. Remote online collection provides opportunities for ageing and dementia professionals to collect larger datasets, increase the diversity of research participants and patients and offer cost-effective screening and monitoring methods for clinical practice and trials. However, the reliability of self-administered at-home tests compared to their lab-based counterparts often goes unexamined, compromising the validity of adopting such measures.

Objective

Our aim is to validate a self-administered web-based version of the visual short-term memory binding task (VSTMBT), a potential digital biomarker sensitive to Alzheimer's disease processes, suitable for use on personal devices.

Methods

A final cross-sectional sample of 37 older-adult (51–77 years) participants without dementia completed our novel self-administered version of the VSTMBT, both at home on a personal device and in the lab, under researcher-controlled conditions.

Results

ANOVA and Bayesian t-test found no significant differences between the task when it was remotely self-administered by participants at home compared to when it was taken under controlled lab conditions.

Conclusions

These results indicate the VSTMBT can provide reliable data when self-administered at-home using an online version of the task and on a personal device. This finding has important implications for remote screening and monitoring practices of older adults, as well as supporting clinical practices serving diverse patient communities. Future work will assess remote administration in older adults with cognitive impairment and diverse socio-economic and ethno-cultural backgrounds as well as a bench-to-bedside application.
Racial and Ethnic Disparities in Blood Pressure and Glycemic Control in the US Community Health Center Patient Population
Authors: Alosi Brittany , Curtis David S.
Published: January 2024

Objective:

To describe blood pressure and glycemic control by racial/ethnic group in the US Community Health Center (CHC) patient population, and whether center characteristics, proxying for higher resource levels and better quality of care, were associated with greater rates of controlled cardiometabolic conditions.

Methods:

Data came from the Uniform Data System, representing aggregate patient clinical data for individual health centers in 2019. Descriptive analyses were conducted weighting by health center patient populations to produce race-specific national rates of blood pressure and glycemic control, and linear regression is used to test whether cardiometabolic control rates varied by center characteristics.

Results:

Hypertension was controlled for 67.2% of non-Hispanic White, 66.9% of Hispanic, and 56.7% of non-Hispanic Black patients. Diabetes was controlled for 70.7% of non-Hispanic White, 65.7% of Hispanic, and 66.1% of non-Hispanic Black patients. The rate of blood pressure control was 2.54 to 3.99 percentage points higher across racial/ethnic groups in health centers that adopted a patient-centered medical home (PCMH) model of care relative to non-PCMH centers, while glycemic control was 1.08 to 2.27 pp. higher as a function of PCMH certification. Results for other center characteristics did not show consistent patterns across racial groups or outcomes.

Conclusion:

This study documented racial and ethnic health disparities in the CHC patient population after major expansion of the CHC program. CHCs with PCMH certification have improved clinical outcomes among patients with hypertension and diabetes across racial/ethnic groups relative to centers without this certification.
A 15-Year Experience With Total Anomalous Pulmonary Venous Connection in Vietnam
Authors: Dinh Le-Thanh Q. , Do Giang T. C. , Ngo Thoi K. , Nguyen Tuan D. , Nguyen Hai M. , Nguyen Phat Q. , Khe Nguyen H. , Dang Hung P. , Nguyen Vu T. , Dao Nha H. , Truong Uy-Linh N. , Vu Phuc M.
Published: January 2024

Background

This article aims to demonstrate the morphology of 261 total anomalous pulmonary venous connection (TAPVC) cases operated at Children's Hospital 1 with in-hospital mortality of 19.5% (51/261).

Methods

All the surgical protocols of TAPVC cases repaired between 2008 and June 2023 were reviewed. The descriptions of TAPVC were based on operative findings by surgeons.

Results

A total of 261 TAPVC patients were operated, including 124 (47.5%) supra, 83 (31.8%) intra, 41 (15.7%) infra, and 13 (5%) mixed cases. The in-hospital mortality was 19.5% (51/261). Fifteen cases are associated with other anomalies of the heart. Four subtypes of 124 supra TAPVC were found, with 42 (33.9%) obstructed cases. The standard was all pulmonary veins (PVs) forming a common vein (CV) and draining into the innominate veins, then going to the superior vena cava (SVC) (100/124, 80.6%). Eleven supra TAPVC cases were vascular vise type. Ten cases had the vertical vein running from the right of the CV and draining directly into the SVC. Of 83 intracardiac TAPVCs with 9 (10.8%) obstructed cases, the most common was all PVs draining directly into the coronary sinus (60/83, 72.3%). The second was all PVs draining directly into the right atrium (RA) via separated ostia or forming a CV before entering the RA (17/83, 20.5%). Also, there were three cases with rare variants and 100% obstruction when the diagnosis was explored. The in-hospital mortality of intracardiac type was 13.3% (11/83) 41 infra TAPVC with obstructed rate of 61% (25/41) and in-hospital mortality of 29.3% (12/41). Thirteen mixed TAPVCs were repaired, with most cases having three PVs forming a CV.

Conclusion

This article provides valuable information about the morphology of TAPVC types in Asian patients.
Lumbar Total Disc Replacements for Degenerative Disc Disease: A Systematic Review of Outcomes With a Minimum of 5 years Follow-Up
Authors: Wen David J. , Tavakoli Javad , Tipper Joanne L.
Published: January 2024

Study Design

Systematic Review.

Objectives

To systematically review the clinical outcomes, re-operation, and complication rates of lumbar TDR devices at mid-to long-term follow-up studies for the treatment of lumbar degenerative disc disease (DDD).

Methods

A systematic search was conducted on PubMed, SCOPUS, and Google Scholar to identify follow-up studies that evaluated clinical outcomes of lumbar TDR in patients with DDD. The included studies met the following criteria: prospective or retrospective studies published from 2012 to 2022; a minimum of 5 years post-operative follow-up; a study sample size >10 patients; patients >18 years of age; containing clinical outcomes with Oswestry Disability Index (ODI), Visual Analog Scale (VAS), complication or reoperation rates.

Results

Twenty-two studies were included with data on 2284 patients. The mean follow-up time was 8.30 years, with a mean follow-up rate of 86.91%. The study population was 54.97% female, with a mean age of 42.34 years. The mean VAS and ODI pain score improvements were 50.71 ± 6.91 and 30.39 ± 5.32 respectively. The mean clinical success and patient satisfaction rates were 74.79% ± 7.55% and 86.34% ± 5.64%, respectively. The mean complication and reoperation rates were 18.53% ± 6.33% and 13.6% ± 3.83%, respectively. There was no significant difference when comparing mid-term and long-term follow-up studies for all clinical outcomes.

Conclusions

There were significant improvements in pain reduction at last follow-up in patients with TDRs. Mid-term follow-up data on clinical outcomes, complication and reoperation rates of lumbar TDRs were maintained longer term.
Institutions as Images of Political Authority and Power Hierarchies: Understanding Land Tenure Dynamics of State-making in Zimbabwe and Uganda
Authors: Kisekka-Ntale Fredrick
Published: January 2024

The intricate link between political power and land rights is a historical axiom and Zimbabwe and Uganda present two conflicting yet analogous situations of what happens in agrarian societies, where socio-economic life is organised around access to and use of land. In such communities, institutions of land tenure are powerful mediums that shape political relations, electoral choices and the whole landscape of political interactions that happen in rural communities. This article seeks to examine how the post-colonial state in Zimbabwe and Uganda deliberately and systematically manipulated ‘insecure’ land tenure regimes by deploying institutions as instruments of political control and relevance. We argue that while the British coloniser framed the two counties differently, that is Zimbabwe as a settler colony and Uganda as a native colony, post-colonial land tenure regimes in the two countries were framed as institutional configurations purposefully designed and redesigned by national leaders as instruments of building state authority, organising the rural masses politically and shaping state-citizen allegiances. In this context, we argue that the land reforms in both countries perpetuated economic and regional disparities, inherited from colonial economic policies, and the ethnic and racial divisions, as foundations of state-making. In that regard, the connection between land and political authority may appear delinked and far-fetched, yet, as the Ugandan and Zimbabwean cases illustrate, there is compelling evidence to confirm this contention.
Biomechanical Comparison of Coracoclavicular Fixation Using Metallic Versus All-Suture Anchors
Authors: Hong Chih-Kai , Kuan Fa-Chuan , Hsu Kai-Lan , Chen Yueh , Chiang Chen-Hao , Su Wei-Ren
Published: January 2024

Background:

A coracoclavicular (CC) fixation technique using an all-suture anchor with the assistance of fluoroscopy can prevent iatrogenic anterior deltoid detachment from the clavicle; however, soft anchor pullout has been reported as a complication.

Purpose:

To compare the biomechanical properties of conventional metallic and all-suture anchors for CC suture fixation.

Study Design:

Controlled laboratory study.

Methods:

A total of 24 fresh-frozen cadaveric specimens were divided into 2 groups: metal anchor group (group M) and all-suture anchor group (group A). In group M, 5.0-mm metallic suture anchors were used for CC fixation, whereas 2.8-mm all-suture anchors were used in group A. The prepared specimens were mounted on a materials testing machine. After preconditioning at 0 to 20 N for 10 cycles, the specimens were subjected to cyclic loading from 20 to 70 N for 1000 cycles. Finally, all the specimens were loaded to failure. Cyclic elongation, linear stiffness, ultimate load, and failure modes were recorded, and the Mann-Whitney U test was used to compare nonparametric parameters between the 2 groups.

Results:

All of the specimens completed the cyclic loading test. The elongation after cyclic loading in group M (1.6 ± 0.6 mm) was significantly smaller compared with that in group A (2.5 ± 1.2 mm) ( P = .02). No between-group differences were found in linear stiffness (42 ± 17 N/mm in group M and 41 ± 17 N/mm in group A). The ultimate failure load in group M (263 ± 66 N) was significantly greater than that in group A (177 ± 76 N) ( P = .02). All specimens failed because of suture anchor pullout.

Conclusion:

The use of all-suture anchors in CC fixation resulted in significantly greater cyclic displacement and smaller ultimate failure load than that of metallic anchors.

Clinical Relevance:

Understanding the most biomechanically sound suture anchor may assist in lowering the risk of clinical failure in CC fixation and repair.
Clinical and ultrasonographic evaluation of efficacy and safety of intralesional injection of autologous platelet-rich plasma in morphea: A comparative case series
Authors: Elnaquip Esraa , Makki Mahmoud , Mansour Mofreh , Moshrif Abdelhfeez
Published: January 2024

Objective:

To evaluate the efficacy and safety of platelet-rich plasma to restore skin changes in morphea by ultrasound and Localized Scleroderma Cutaneous Assessment Tool.

Methods:

Nine morphea patients (21 lesions) were diagnosed clinically and by histopathology. Intradermal platelet-rich plasma was injected into morphea lesion once weekly for 12 sessions. The disease severity and damage were evaluated at baseline, after the last session (3 months later), and at 6 months follow-up using the LoSCAT and a high-resolution ultrasound. The healthy corresponding side was considered as a control.

Results:

The Localized Scleroderma Cutaneous Assessment Tool score showed a significant improvement starting from 13 ± 7.28 up to 7.33 ± 6.82 after the therapeutic endpoint, reaching to 6.44 ± 7.09 after 6 months of follow-up with p value = 0.008 and 0.014, respectively. There was a significant positive correlation between the duration of the lesion and the improvement assessed by the ultrasound, with p value = 0.01. Regarding adverse effects, all patients reported having pain during platelet-rich plasma injection; transient edema of the face was reported by four patients (45%), and only two patients showed transient erythema.

Conclusion:

Autologous platelet-rich plasma is a safe technique with great aesthetic outcomes for filling up the contour defects and correcting both hyper and hypopigmentation, in addition to softening the indurated lesions.
PI3Kγ maintains the self-renewal of acute myeloid leukemia stem cells by regulating the pentose phosphate pathway
Authors: Gu Hao , Chen Chiqi , Hou Zhi-Shuai , He Xia-Di , Xie Shaozhen , Ni Jing , Qian Changli , Cheng Xin , Jiang Tao , Yang Ce , Roberts Thomas M. , Zheng Junke , Varner Judith A. , Armstrong Scott A. , Zhao Jean J.
Published: January 2024

Acute myeloid leukemia (AML) is an aggressive hematological malignancy originating from transformed hematopoietic stem or progenitor cells. AML prognosis remains poor owing to resistance and relapse driven by leukemia stem cells (LSCs). Targeting molecules essential for LSC function is a promising therapeutic approach. The phosphatidylinositol 3-kinase (PI3K)/AKT pathway is often dysregulated in AML. We found that although PI3Kγ is highly enriched in LSCs and critical for self-renewal, it was dispensable for normal hematopoietic stem cells. Mechanistically, PI3Kγ-AKT signaling promotes nuclear factor erythroid 2-related factor 2 (NRF2) nuclear accumulation, which induces 6-phosphogluconate dehydrogenase (PGD) and the pentose phosphate pathway, thereby maintaining LSC stemness. Importantly, genetic or pharmacological inhibition of PI3Kγ impaired expansion and stemness of murine and human AML cells in vitro and in vivo. Together, our findings reveal a key role for PI3Kγ in selectively maintaining LSC function by regulating AKT-NRF2-PGD metabolic pathway. Targeting the PI3Kγ pathway may, therefore, eliminate LSCs without damaging normal hematopoiesis, providing a promising therapeutic strategy for AML.
An LC–MS-based designated comparison method with similar performance to the Lp(a) reference measurement procedure to guide molar Lp(a) standardization
Authors: Diederiks Nina M. , Ruhaak L. Renee , Romijn Fred P. H. T. M. , Pieterse Mervin M. , Smit Nico P. M. , Cobbaert Christa M.
Published: January 2024

Background

The 2022 consensus statement of the European Atherosclerosis Society (EAS) on lipoprotein(a) (Lp(a)) recognizes the role of Lp(a) as a relevant genetically determined risk factor and recommends its measurement at least once in an individual’s lifetime. It also strongly urges that Lp(a) test results are expressed as apolipoprotein (a) (apo(a)) amount of substance in molar units and no longer in confounded Lp(a) mass units (mg/dL or mg/L). Therefore, IVD manufacturers should transition to molar units. A prerequisite for this transition is the availability of an Lp(a) Reference Measurement Procedure (RMP) that allows unequivocal molecular detection and quantification of apo(a) in Lp(a). To that end an ISO 17511:2020 compliant LC–MS based and IFCC-endorsed RMP has been established that targets proteotypic peptides of apolipoprotein(a) (apo(a)) in Lp(a). The RMP is laborious and requires highly skilled operators. To guide IVD-manufacturers of immunoassay-based Lp(a) test kits in the transition from mass to molar units, a Designated Comparison Method (DCM) has been developed and evaluated.

Methods

To assess whether the DCM provides equivalent results compared to the RMP, the procedural designs were compared and the analytical performance of DCM and RMP were first evaluated in a head-to-head comparison. Subsequently, apo(a) was quantified in 153 human clinical serum samples. Both DCM and RMP were calibrated using external native calibrators that produce results traceable to SRM2B. Measurement uncertainty (MU) was checked against predefined allowable MU.

Results

The major difference in the design of the DCM for apo(a) is the use of only one enzymatic digestion step. The analytical performance of the DCM and RMP for apo(a) is highly similar. In a direct method comparison, equivalent results were obtained with a median regression slope 0.997 of and a median bias of − 0.2 nmol/L (− 0.2%); the intermediate imprecision of the test results was within total allowable error (TEa) (CVa of 10.2% at 90 nmol/L).

Conclusions

The semi-automated, higher throughput, LC–MS-based method for Lp(a) meets the predefined analytical performance specifications and allowable MU and is hence applicable as a higher order Designated Comparison Method, which is ideally suited to guide IVD manufacturers in the transition from Lp(a) mass to molar units.
Anchor Clustering for million-scale immune repertoire sequencing data
Authors: Chang Haiyang , Ashlock Daniel A. , Graether Steffen P. , Keller Stefan M.
Published: January 2024

Background

The clustering of immune repertoire data is challenging due to the computational cost associated with a very large number of pairwise sequence comparisons. To overcome this limitation, we developed Anchor Clustering, an unsupervised clustering method designed to identify similar sequences from millions of antigen receptor gene sequences. First, a Point Packing algorithm is used to identify a set of maximally spaced anchor sequences. Then, the genetic distance of the remaining sequences to all anchor sequences is calculated and transformed into distance vectors. Finally, distance vectors are clustered using unsupervised clustering. This process is repeated iteratively until the resulting clusters are small enough so that pairwise distance comparisons can be performed.

Results

Our results demonstrate that Anchor Clustering is faster than existing pairwise comparison clustering methods while providing similar clustering quality. With its flexible, memory-saving strategy, Anchor Clustering is capable of clustering millions of antigen receptor gene sequences in just a few minutes.

Conclusions

This method enables the meta-analysis of immune-repertoire data from different studies and could contribute to a more comprehensive understanding of the immune repertoire data space.
Colony level fitness analysis identifies a trade-off between population growth rate and dauer yield in Caenorhabditis elegans
Authors: Chapman Hannah , Hsiung Kuei Ching , Rawlinson Isadora , Galimov Evgeniy R. , Gems David
Published: January 2024

Background

In the evolution from unicellular to multicellular life forms, natural selection favored reduced cell proliferation and even programmed cell death if this increased organismal fitness. Could reduced individual fertility or even programmed organismal death similarly increase the fitness of colonies of closely-related metazoan organisms? This possibility is at least consistent with evolutionary theory, and has been supported by computer modelling.Caenorhabditis eleganshas a boom and bust life history, where populations of nematodes that are sometimes near clonal subsist on and consume food patches, and then generate dauer larva dispersal propagules. A recent study of an in silico model ofC. eleganspredicted that one determinant of colony fitness (measured as dauer yield) is minimization of futile food consumption (i.e. that which does not contribute to dauer yield). One way to achieve this is to optimize colony population structure by adjustment of individual fertility.

Results

Here we describe development of aC. eleganscolony fitness assay, and its use to investigate the effect of altering population structure on colony fitness after population bust. Fitness metrics measured were speed of dauer production, and dauer yield, an indirect measure of efficiency of resource utilization (i.e. conversion of food into dauers). We find that with increasing founder number, speed of dauer production increases (due to earlier bust) but dauer yield rises and falls. In addition, some dauer recovery was detected soon after the post-colony bust peak of dauer yield, suggesting possible bet hedging among dauers.

Conclusions

These results suggest the presence of a fitness trade-off at colony level between speed and efficiency of resource utilization inC. elegans. They also provide indirect evidence that population structure is a determinant of colony level fitness, potentially by affecting level of futile food consumption.
Comparing the efficacy of intravenous morphine versus ibuprofen or the combination of ibuprofen and acetaminophen in patients with closed limb fractures: a randomized clinical trial
Authors: Nasr Isfahani Mehdi , Etesami Hossein , Ahmadi Omid , Masoumi Babak
Published: January 2024

Introduction

This study aims to investigate the effectiveness of intravenous ibuprofen or intravenous ibuprofen plus acetaminophen compared to intravenous morphine in patients with closed extremity fractures.

Methods

A triple-blinded randomized clinical trial was conducted at a tertiary trauma center in Iran. Adult patients between 15 and 60 years old with closed, isolated limb fractures and a pain intensity of at least 6/10 on the visual analog scale (VAS) were eligible. Patients with specific conditions or contraindications were not included. Participants were randomly assigned to receive intravenous ibuprofen, intravenous ibuprofen plus acetaminophen, or intravenous morphine. Pain scores were assessed using the visual analog scale at baseline and 5, 15, 30, and 60 min after drug administration. The primary outcome measure was the pain score reduction after one hour.

Results

Out of 388 trauma patients screened, 158 were included in the analysis. There were no significant differences in age or sex distribution among the three groups. The pain scores decreased significantly in all groups after 5 min, with the morphine group showing the lowest pain score at 15 min. The maximum effect of ibuprofen was observed after 30 min, while the ibuprofen-acetaminophen combination maintained its effect after 60 min. One hour after injection, pain score reduction in the ibuprofen-acetaminophen group was significantly more than in the other two groups, and pain score reduction in the ibuprofen group was significantly more than in the morphine group.

Conclusion

The study findings suggest that ibuprofen and its combination with acetaminophen have similar or better analgesic effects compared to morphine in patients with closed extremity fractures. Although morphine initially provided the greatest pain relief, its effect diminished over time. In contrast, ibuprofen and the ibuprofen-acetaminophen combination maintained their analgesic effects for a longer duration. The combination therapy demonstrated the most sustained pain reduction. The study highlights the potential of non-opioid analgesics in fracture pain management and emphasizes the importance of initiation of these medications as first line analgesic for patients with fractures. These findings support the growing trend of exploring non-opioid analgesics in pain management.

Trial registration

ClinicalTrials.gov Identifier: NCT05630222 (Tue, Nov 29, 2022). The manuscript adheres to CONSORT guidelines.
Estimation of place-based vulnerability scores for HIV viral non-suppression: an application leveraging data from a cohort of people with histories of using drugs
Authors: Nguyen Trang Quynh , Roberts Lavigne Laken C. , Brantner Carly Lupton , Kirk Gregory D. , Mehta Shruti H. , Linton Sabriya L.
Published: January 2024

The relationships between place (e.g., neighborhood) and HIV are commonly investigated. As measurements of place are multivariate, most studies apply some dimension reduction, resulting in one variable (or a small number of variables), which is then used to characterize place. Typical dimension reduction methods seek to capture the most variance of the raw items, resulting in a type of summary variable we call “disadvantage score”. We propose to add a different type of summary variable, the “vulnerability score,” to the toolbox of the researchers doing place and HIV research. The vulnerability score measures how place, as known through the raw measurements, is predictive of an outcome. It captures variation in place characteristics that matters most for the particular outcome. We demonstrate the estimation and utility of place-based vulnerability scores for HIV viral non-suppression, using data with complicated clustering from a cohort of people with histories of injecting drugs.
Ageing with HIV: challenges and coping mechanisms of older adults 50 years and above living with HIV in Uganda
Authors: Mbalinda Scovia Nalugo , Lusota Derrick Amooti , Muddu Martin , Nyashanu Mathew
Published: January 2024

Introduction

Globally, adults 50 years and older are an increasing proportion of persons living with HIV (PLHIV), accounting for 16% of the patient group globally. The long-term effects of antiretroviral use are still being discovered and have been associated with several comorbidities; Stigma presents challenges for those in need of services and health care and can significantly affect mental health and treatment adherence. Understanding the experiences and challenges of older PLHIV will inform the development of interventions to improve their care, health, and quality of life, which may help prevent the further spread of HIV. We explored the experiences and challenges of older PLHIV aged 50 years and above.

Methods

We conducted 40 in-depth interviews with elderly PLHIV aged 50 years and above who had lived with HIV for more than ten years. We also explored the experiences and challenges of ageing with HIV in two hospitals. We analysed the data thematically.

Results

The key themes that emerged included; late diagnosis of HIV, depression and fear at the time of diagnosis, acceptance of close family, stigma from community, polypharmacy, development of comorbidities, financial burden, resilience, and mastery of own care.

Conclusion

Older adults experience several challenges, and there is a need to develop special clinics providing appropriate care for the ageing and their social life. Prevention, Early diagnosis and appropriate treatment of HIV, and appropriate geriatric care are essential for the well-being of elderly PLHIV.
A case of bacteremia caused by Dialister micraerophilus with Enterocloster clostridioformis and Eggerthella lenta in a patient with pyometra
Authors: Kitagawa Hiroki , Tadera Kayoko , Omori Keitaro , Nomura Toshihito , Shigemoto Norifumi , Ohge Hiroki
Published: January 2024

Background

Infection by Dialister micraerophilus, an obligate anaerobic gram-negative bacillus, has rarely been described, and its clinical characteristics remain unclear.

Case presentation

We report a case of bacteremia caused by D. micraerophilus, Enterocloster clostridioformis, and Eggerthella lenta in a 47-year-old woman, associated with pyometra. D. micraerophilus was identified using 16S rRNA gene sequencing and matrix-assisted laser desorption ionization time-of-flight mass spectrometry. D. micraerophilus was detected by polymerase chain reaction using D. micraerophilus-specific primers and E. clostridioformis and E. lenta was isolated from the drainage pus sample obtained from the pyometra uterus. The patient achieved a cure after abscess drainage and 2-week antibiotic treatment.

Conclusions

To the best of our knowledge, this is the first report of D. micraerophilus bacteremia. D. micraerophilus may be associated with gynecological infections. Clinicians should consider both oral and gynecological sites when searching to identify the focus of D. micraerophilus infection.
Elective one-minute full brain multi-contrast MRI versus brain CT in pediatric patients: a prospective feasibility study
Authors: De Luca Francesca , Kits Annika , Martin Muñoz Daniel , Aspelin Åsa , Kvist Ola , Österman Yords , Diaz Ruiz Sandra , Skare Stefan , Falk Delgado Anna
Published: January 2024

Background

Brain CT can be used to evaluate pediatric patients with suspicion of cerebral pathology when anesthetic and MRI resources are scarce. This study aimed to assess if pediatric patients referred for an elective brain CT could endure a diagnostic fast brain MRI without general anesthesia using a one-minute multi-contrast EPI-based sequence (EPIMix) with comparable diagnostic performance.

Methods

Pediatric patients referred for an elective brain CT between March 2019 and March 2020 were prospectively included and underwent EPIMix without general anesthesia in addition to CT. Three readers (R1–3) independently evaluated EPIMix and CT images on two separate occasions. The two main study outcomes were the tolerance to undergo an EPIMix scan without general anesthesia and its performance to classify a scan as normal or abnormal. Secondary outcomes were assessment of disease category, incidental findings, diagnostic image quality, diagnostic confidence, and image artifacts. Further, a side-by-side evaluation of EPIMix and CT was performed. The signal-to-noise ratio (SNR) was calculated for EPIMix on T1-weighted, T2-weighted, and ADC images. Descriptive statistics, Fisher’s exact test, and Chi-squared test were used to compare the two imaging modalities.

Results

EPIMix was well tolerated by all included patients (n = 15) aged 5–16 (mean 11, SD 3) years old. Thirteen cases on EPIMix and twelve cases on CT were classified as normal by all readers (R1–3), while two cases on EPIMix and three cases on CT were classified as abnormal by one reader (R1), (R1–3, p = 1.00). There was no evidence of a difference in diagnostic confidence, image quality, or the presence of motion artifacts between EPIMix and CT (R1–3, p ≥ 0.10). Side-by-side evaluation (R2 + R4 + R5) reviewed all scans as lacking significant pathological findings on EPIMix and CT images.

Conclusions

Full brain MRI-based EPIMix sequence was well tolerated without general anesthesia with a diagnostic performance comparable to CT in elective pediatric patients.

Trial registration

This study was approved by the Swedish Ethical Review Authority (ethical approval number/ID Ethical approval 2017/2424-31/1). This study was a clinical trial study, with study protocol published at ClinicalTrials.gov with Trial registration number NCT03847051, date of registration 18/02/2019.
Feasibility of a clinical-radiomics combined model to predict the occurrence of stroke-associated pneumonia
Authors: Luo Haowen , Li Jingyi , Chen Yongsen , Wu Bin , Liu Jianmo , Han Mengqi , Wu Yifan , Jia Weijie , Yu Pengfei , Cheng Rui , Wang Xiaoman , Ke Jingyao , Xian Hongfei , Tu Jianglong , Yi Yingping
Published: January 2024

Purpose

To explore the predictive value of radiomics in predicting stroke-associated pneumonia (SAP) in acute ischemic stroke (AIS) patients and construct a prediction model based on clinical features and DWI-MRI radiomics features.

Methods

Univariate and multivariate logistic regression analyses were used to identify the independent clinical predictors for SAP. Pearson correlation analysis and the least absolute shrinkage and selection operator with ten-fold cross-validation were used to calculate the radiomics score for each feature and identify the predictive radiomics features for SAP. Multivariate logistic regression was used to combine the predictive radiomics features with the independent clinical predictors. The prediction performance of the SAP models was evaluated using receiver operating characteristics (ROC), calibration curves, decision curve analysis, and subgroup analyses.

Results

Triglycerides, the neutrophil-to-lymphocyte ratio, dysphagia, the National Institutes of Health Stroke Scale (NIHSS) score, and internal carotid artery stenosis were identified as clinically independent risk factors for SAP. The radiomics scores in patients with SAP were generally higher than in patients without SAP (P < 0. 05). There was a linear positive correlation between radiomics scores and NIHSS scores, as well as between radiomics scores and infarct volume. Infarct volume showed moderate performance in predicting the occurrence of SAP, with an AUC of 0.635. When compared with the other models, the combined prediction model achieved the best area under the ROC (AUC) in both training (AUC = 0.859, 95% CI 0.759–0.936) and validation (AUC = 0.830, 95% CI 0.758–0.896) cohorts (P < 0.05). The calibration curves and decision curve analysis further confirmed the clinical value of the nomogram. Subgroup analysis showed that this nomogram had potential generalization ability.

Conclusion

The addition of the radiomics features to the clinical model improved the prediction of SAP in AIS patients, which verified its feasibility.
Validation of the Levenson Self-Report Psychopathy (LSRP) scale in the non-institutionalized Lebanese population
Authors: Ghossoub Elias , Itani Hala , Touma Sawaya Rayah , Ghanime Pia Maria , Cherro Michele , Elbejjani Martine , Barakat Marc , El Asmar Khalil
Published: January 2024

Background

Psychopathy has been described as “the first personality disorder to be recognized in psychiatry”. It has three core features: affective, interpersonal, and behavioral. The Levenson Self-Report Psychopathy (LSRP) scale is used to screen for and measure psychopathy. Our study aims to validate the LSRP as a tool to measure psychopathy in the non-institutionalized Lebanese population.

Methods

We surveyed Lebanese individuals residing in Lebanon and aged 18 through 65. It was a convenience sample collected via an online survey. 534 Lebanese participants completed the survey and were included in our analyses. Nearly 80% were female, 90% were college educated, and 60% were employed. We used exploratory graph analysis and confirmatory factor analyses to measure internal validity of the LSRP. We also used the HEXACO Personality Inventory-Revised (HEXACO-PI-R), the Subtypes of Antisocial Behavior Questionnaire (STAB), and the Short version of the Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking, Positive Urgency, Impulsive Behavior Scale (S-UPPS-P) to measure external validity of LSRP.

Results

The exploratory graph analysis showed that the LSRP had a three-factor structure (Egocentric, Callous and Antisocial) in the Lebanese population. This three-factor structure (RMSEA = 0.05, CFI = 0.83, SRMR = 0.06) yielded a better fit than the two-factor, and three-factor Brinkley models. The LSRP was negatively correlated with the Honesty-Humility dimension of the HEXACO-PI-R and positively correlated with the STAB and S-UPPS-P subscales.

Conclusions

The LSRP scale is a valid measure of psychopathy in the Lebanese non-institutionalized population, adding to the currently limited literature addressing psychopathy in the Arab World.