bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations between education, information-processing skills, and job automation risk in the United States
Authors: Narine Donnette , Yamashita Takashi , Chidebe Runcie CW , Cummins Phyllis A , Kramer Jenna W , Karam Rita
Published: November 2023

Job automation is a topical issue in a technology-driven labor market. However, greater amounts of human capital (e.g., often measured by education, and information-processing skills, including adult literacy) are linked with job security. A knowledgeable and skilled labor force better resists unemployment and/or rebounds from job disruption brought on by job automation. Therefore, the purpose of this study was to advance understanding of the association between educational attainment and literacy, and job automation risk. Using the 2012/2014/2017 Program for the International Assessment of Adult Competencies (PIAAC) data, survey-weighted linear regression was used to model the risk of job automation as a function of education, and literacy proficiency. Higher educational attainment (college or higher vs. less than high school: b = −18.23, p < .05) and greater literacy proficiency (score 0–500 points: b = −.038, p < .05) were associated with a decrease in job automation risk among the U.S. workforce.
Pancreatic Ischemia-Reperfusion Injury Following Endovascular Treatment of Symptomatic Celiac and Superior Mesenteric Artery Stenosis
Authors: Mihatsch Patrick W. , Schmidt Alexander M. , Augustin Anne Marie , Thurner Annette , Peter Dominik , Kickuth Ralph
Published: November 2023

Ischemia-reperfusion injury occurring after endovascular treatment of chronic mesenteric ischemia and its effects on abdominal organs, especially the intestines, have been previously described in the literature. Here, we present a rare case of predominantly pancreatic ischemia-reperfusion injury following 2-vessel mesenteric artery revascularization in a patient with symptomatic chronic mesenteric ischemia.

Clinical Impact

With endovascular therapy becoming the first-line treatment for symptomatic chronic mesenteric ischemia, acute pancreatitis within the context of abdominal ischemia-reperfusion injury may be seen more often in cross-sectional imaging following this kind of interventions and should therefore be kept in mind by the reading physician.
Successful Revascularization, Angiosome Concept, and Multivessel Revascularization: Effects on Wound Healing: An Asian Perspective
Authors: Orrapin Saritphat , Siribumrungwong Boonying
Published: November 2023

Endovascular treatment for revascularization in patients with chronic limb-threatening ischemia (CLTI), which is commonly found in patients with diabetes mellitus demonstrates a variable result of vessel patency, wound healing rate, and limb salvage rate. The angiosome concept has been adopted to determine the best target arterial path (TAP) for revascularization for wound healing in CLTI patients. Recent publications demonstrated the benefit of angiosome-targeted revascularization to guide the endovascular treatment in patients CLTI. The best TAP under angiosome concept by direct revascularization with at least 2 of 3 below-the-knee arteries runoff to restore in-line pulsatile blood flow to the ischemic tissue shows the best patency and high rate of wound healing. However, the clinical evidence and application of the angiosome concept in daily practice are difficult and not well established. The vascular territories, collateral vessel, wound area, and locations which associated with angiosome are varied. This article review aims to summarize the concept of angiosome-targeted revascularization and multivessel revascularization for application to the real-world practice under the evidence-based data.
Consistent condom use among sexually active young adults in Ghana: an analysis of prevalence and associated factors
Authors: Oppong Asante Kwaku , Ampaw Samuel , Gyan Sylvia Esther
Published: November 2023

Consistent and proper condom use offers a safer, economically cheap and practically effective means of preventing HIV infection. Using the 2014 Ghana Demographic and Health Survey with a sample of 2779 sexually active youth (males = 682 and females = 2,097) in the age range 15–24, this study explored the prevalence of, and factors associated with consistent condom use among sexually active young adults in Ghana. Multivariate logistic regression was used to analyse the data. Our results showed that approximately 11% of the respondents reported consistent condom use in their previous sexual activity. Females were more likely than males to have used a condom consistently. The logistic regression results showed that females who had tested for HIV were less likely to use a condom consistently. However, those who have obtained family planning information from print media and those from the northern part of Ghana were more likely to practise consistent condom use. Furthermore, males who professed the Traditional African religion were less likely to use a condom consistently. In contrast, males in the rich wealth category were more likely to use a condom consistently. These findings underscore the need for behavioural change campaigns targeting young adults, particularly those who are sexually active, to encourage consistent condom use. These interventions should target young adults with less family planning knowledge, those who know their HIV status and those who profess the Traditional African religion.
The national consensus formation at the first stage of Russia’s Special military operation against Ukraine (February–August 2022)
Authors: Krivushin Ivan , Glaser Marina
Published: November 2023

The article begins with a definition of some contesting views about the reality of Russian support for the “Special military operation” (SMO), hypotheses, and research approach. Then we present the substantive arguments about the attitude of Russian residents to the SMO and the reliability of public opinion polls results. After this we provide suggestive analyzes of three key understandings of the “West” in Russian public opinion. The article ends with arguing that a national consensus in Russia on the necessity and legitimacy of the SMO has really been achieved. The polarization of opinions is increasing but it is not reflected in the public sphere because of the fears that this could cause negative uncontrolled consequences for the economic situation, social and political stability in the country. As for Anti-Western sentiments, they depended and continue to depend on two groups of factors: foreign policy ones, which provoked the strengthening of these sentiments, and internal ones, which contributed to their weakening.
Intravascular large cell B lymphoma presenting as central nervous system pseudo-vasculitis: A rare diagnostic challenge
Authors: Vandermeersch Denis , Mahsouli Amin , Willemart Mathilde , Scoppettuolo Pasquale , Van de Wyngaert Caroline , Van den Neste Eric , Camboni Alessandra , Lawson Morel , Onofrj Valeria , Pothen Lucie
Published: November 2023

Intravascular large B cell lymphoma (IVLBCL) is a very rare subtype of aggressive non-Hodgkin B cell lymphoma characterized by intravascular proliferation of clonal B lymphocytes, classically associated with pulmonary and cutaneous disease and, less frequently, with central nervous system (CNS) involvement. Brain imaging findings are usually non-specific, with evidence of multiple vascular occlusions and stroke as non-specific multifocal abnormalities. We present an exceptionally rare case of IVLBCL in a patient with unexplained inflammatory syndrome with B symptoms and rapidly progressive neurological impairment, with multifocal hemorrhagic and tumefactive brain lesions seen on MRI. We suggest that in this clinical setting, the presence of tumefactive and hemorrhagic lesions should raise suspicion for IVLBCL and lead to the decision to perform a biopsy, which, nonetheless, remains the diagnostic gold standard.
The LED’s right of access to one’s data: Loopholes on proper access, legality review and data protection authority Accountability
Authors: Dimitrova Diana , De Hert Paul
Published: November 2023

Directive 2016/680 (the Law Enforcement Directive (LED)) provides two procedures for the exercise of the rights of access to one’s data: a direct one under Article 14 LED (directly addressed to the law enforcement authority) and an ‘indirect’ one under Article 17 (3) LED, i.e., via the intermediary of the data protection authority (DPA). In the present paper we will argue that the latter procedure should be the exception and the Article 14 LED procedure should be seen as the default. We will analyse the weaknesses of the Article 17 (3) LED provision and then criticize its, in our opinion, flawed implementation into the national laws of Belgium, France and Germany. We will demonstrate that Article 17 (3) LED, as read in light of Article 15 LED on the restrictions to the right of access, might be interpreted incorrectly to allow for the ‘indirect’ access procedure to be evoked abusively. We will argue that it lacks the explicit language to guarantee the decision-making powers of DPAs when deciding what information to communicate to the concerned data subjects when answering their request. We will demonstrate how the examined Member State laws further restrict the powers of their DPAs, which endangers the effectiveness of the ‘indirect’ access procedure because they do not guarantee the accountability, transparency, and proper legality check by the DPAs which are called on to exercise the right of access indirectly.
ADHD and anxiety symptom comorbidity from an event segmentation lens
Authors: Ryan Julia , Burr Zoey , Rogers Maria A. , Coplan Robert J.
Published: November 2023

ADHD and anxiety present high comorbidity, including symptom overlap and related diagnostic and treatment challenges. The current study aimed to extend this area of research by investigating the event segmentation patterns of those with ADHD and anxiety symptoms. Event segmentation is the process of parsing a continuous flow of information into meaningful events, providing the opportunity to examine similarities and differences in how these groups organize their perception of daily experiences. Participants performed an event segmentation task consisting of watching four short movies and identifying large and small events. We used the total number of button presses and segmentation agreement scores in a multivariate analysis, and results indicated that the High ADHD group identified significantly more events in the large condition than the High Anxiety group and had significantly higher agreement scores than the Comorbid group. This study furthers our understanding of the cognitive overlap of ADHD and anxiety symptoms.
The relationship between loneliness and depression among college students: Mining data derived from passive sensing
Authors: Qirtas Malik Muhammad , Zafeiridi Evi , White Eleanor Bantry , Pesch Dirk
Published: November 2023

Background

While there is recognition of the relationship between loneliness and depression, specific behavioural patterns distinguishing both are still not well understood.

Objectives

Our objective is to identify distinct behavioural patterns of loneliness and depression from a passively collected dataset of college students, understand their similarities and interrelationships and assess their effectiveness in identifying loneliness and depression.

Methods

Utilizing the StudentLife dataset, we applied regression analysis to determine associations with self-reported loneliness and depression. Mediation analysis interprets the relationship between the two conditions, and machine learning models predict loneliness and depression based on behavioural indicators.

Results

Distinct behavioural patterns emerged: high evening screen time (OR = 1.45, p = 0.002) and high overall phone usage (OR = 1.50, p = 0.003) were associated with more loneliness, whereas depression was significantly associated with fewer screen unlocks (OR = 0.75, p = 0.044) and visits to fewer unique places (OR = 0.85, p = 0.023). Longer durations of physical activity (OR = 0.72, p = 0.014) and sleep (OR = 0.46, p = 0.002) are linked to a lower risk of both loneliness and depression. Mediation analysis revealed that loneliness significantly increases the likelihood of depression by 48%. The prediction accuracy of our XGBoost-based machine learning approach was 82.43% for loneliness and 79.43% for depression.

Conclusion

Our findings show that high evening screen time and overall phone usage are significantly associated with increased loneliness, while fewer screen unlocks and visits to fewer unique places are significantly related to depression. The findings can help in developing targeted interventions to promote well-being and mental health in students.
Mental Effort and Expressive Interaction in Expert and Student String Quartet Performance
Authors: Bishop Laura , Høffding Simon , Lartillot Olivier , Laeng Bruno
Published: November 2023

Resilience to changes in performance environments is a hallmark of expertise in music performance. Research has shown that skilled non-expert ensemble musicians maintain synchronization when visual interaction between them is disrupted, but that the quality of their expressive body motion changes. Our study extended these findings by testing how an expert string quartet responds to playing conditions that disrupt visual contact. We tested for potential effects on the musicians’ expressive head motion, sound quality, and mental effort. The Danish String Quartet (DSQ), a world-class classical ensemble, performed an excerpt from a Haydn piece five times without an audience, then once for an audience of about 20 people. During the performances without audience, their seating configuration was manipulated to disrupt their audiovisual interaction. Audio, head motion, eye-tracking, and pupillometry data were collected. The DSQ's data were compared to data from a student quartet who completed the same experiment. Our results show that the DSQ maintained the quality of their musical sound and interactive body motion across disruptive and non-disruptive conditions, but mental effort (indexed by pupil size) was greater in non-disruptive conditions. In contrast, the student quartet moved less overall than the DSQ, moved less when they could not see each other, and did not show differences in pupil size across conditions. The quartets spent a similar percentage of performance time watching their co-performers. These findings suggest that the quality of audio and visual components of the DSQ's performance do not require visual interaction to maintain; however, these musicians do interact visually when given the opportunity. This visual interaction stimulates greater mental effort, perhaps reflecting increased social engagement.
An Exploratory Study of Rural Parents’ Knowledge and Attitudes About HPV Vaccination Following a Healthcare Visit With Their Child’s Primary Care Provider
Authors: Dickinson Caitlin , Bumatay Sarah , Valenzuela Steele , Hatch Brigit A. , Carney Patricia A.
Published: November 2023

Introduction/Objectives:

Annually, HPV infections result in $775 million in direct medical costs and approximately 46 000 new cases of HPV-associated cancers. Safe and highly effective vaccines have been available to prevent HPV for children/adolescents since 2006. Vaccination rates remain low, especially in rural areas. Parental attitudes and beliefs affect HPV vaccination rates.

Methods:

We developed, tested, and administered a survey that asked how parents and healthcare providers interacted about the HPV vaccine following a healthcare visit with an age-eligible child, as part of a multicomponent randomized controlled trial designed to improve HPV vaccination rates in rural Oregon. The 21-item survey assessed parents’ information-seeking behavior, knowledge about HPV cancer risk reduction, the HPV vaccine series, and their vaccine confidence.

Results:

Forty-three participants (59.7%) were in the intervention group; 29 (40.3%) were controls. Over 90% of healthcare visits were illness, injury, sports physical, or well-child visits (n = 67 or 93.1%), and 6.9% of visits were vaccine-specific. No statistically significant differences were found between study groups for healthcare visits. Over half the parents reported having discussions about HPV and the HPV vaccine (54.5%) with their care providers, 31.3% had recently learned about HPV, HPV risks, and the HPV vaccine prior to the visit, 83.1% were knowledgeable about cancers associated with HPV, and 79.2% were considering vaccinating their child(ren), which did not differ between study groups.

Conclusions:

Knowledge about HPV-related cancers and consideration for vaccinating children was higher than expected, but not associated with the intervention tested.
Loneliness Factors in Older People and the Influence on Attitudes Toward Informal Care: A Study of Older Chinese People in Urban Areas
Authors: Zhang Zihan , Kato Chieko , Otsuka Yoshiomi
Published: November 2023

Objectives:

Loneliness is thought to be more likely to occur in older people and influences their lives. This study aimed to verify the influence of loneliness in older Chinese people on their attitudes toward informal care, as well as the demographic, social, and economic factors that may cause loneliness.

Methods:

Data was collected from older P (age: >60 years) using an online questionnaire. Hierarchical linear regression was used to analyze the associations between demographic, social, and economic factors, loneliness, and attitudes toward informal care.

Results:

Results have shown that cohabitation and family savings could significantly negatively influence loneliness. Educational background and cohabitation could significantly positively influence attitudes toward informal care. However, loneliness could significantly negatively influence attitudes toward informal care.

Conclusion:

Older people living alone and with worse economic conditions may need attention from the community and society because they are more likely to suffer from loneliness. Loneliness may also significantly impact older people’s attitudes toward long-term care. Older people are more likely to feel lonely may have more negative attitudes toward informal care. Communities need to make more efforts to improve community health services or formal care services for these older people to address situations where informal care is not sufficiently provided.
Integrating HIV Pre-Exposure Prophylaxis (PrEP) Education During Medical Residency: Training Outcomes and Suggestions for Learning Effectiveness
Authors: Ogundare Matilda Olajumoke , Allan Fiona , Desai Ankita P. , Dirajlal-Fargo Sahera , Minich Nori Mercuri , Gripshover Barbara M.
Published: November 2023

Human immunodeficiency virus (HIV) infection is now preventable with pre-exposure prophylaxis (PrEP) drugs, however, barriers to PrEP implementation include primary-care physician (PCP) knowledge-gap and lack of comfort prescribing and managing PrEP. We hypothesized that integrating HIV-PrEP education during medical-residency would help address these problems and developed a 40-minute case-based lecture focused on the 2021 United States Preventative Services Taskforce (USPSTF) oral HIV-PrEP guidelines and integrated this into our residency’s core curriculum. We analyzed data from physician-trainees who voluntarily completed a pre- and post-lecture survey measuring HIV-PrEP “knowledge” and “self-assessed readiness to independently initiate and manage PrEP.” Independent group analysis was completed via the Mann-Whitney U and Pearson Chi-square 2-sided test with P-value <0.05 deemed significant. Of the total of 189 residents invited to the lecture, 130 (69%) completed the pre-survey while 107 (57%) completed the post-survey. Per knowledge-assessment: the median number of correctly answered questions rose from a pre-lecture baseline of 4/9 (44%) to 8/9 (89%) following the education intervention ( P < .001). When asked about comfort initiating and managing HIV-PrEP on their own, 7/130 (5.4%) responded in agreement pre-lecture, but this rose to 55/107 (51.4%) post-lecture ( P < .001). Our study revealed PrEP training during residency was effective per stated objectives and may be an important tool to increase PrEP delivery/uptake to achieve the target goals for the National HIV/AIDS Strategy.
T-Remodeling of the Pulmonary Artery Bifurcation for Pulmonary Artery Origin Stenosis
Authors: Zheng Wayne C. , Buratto Edward , Caldaroni Federica , Ishigami Shuta , Konstantinov Igor E. , d’Udekem Yves
Published: November 2023

Background

Various surgical techniques are utilized for reconstructing hypoplastic pulmonary arteries (PAs) in patients with conotruncal anomalies and at times, may be susceptible to restenosis and reoperation. We reviewed our experience with a simple technique of T-shaped remodeling of the PA bifurcation.

Methods

Between 2005 and 2019, 31 patients underwent T-remodeling of central PAs by a single cardiac surgeon. The PA bifurcation was opened cranially, and the opening was augmented with an oval-shaped patch effectively transforming the V-shaped bifurcation into a T-shaped bifurcation. Both origins of the PAs were enlarged, even in the instance of single PA origin stenosis.

Results

Median age at time of T-remodeling was 17 months (range: 7 weeks to 14 years). The following cardiac morphologies were observed: tetralogy of Fallot (n = 12, 39%), pulmonary atresia with ventricular septal defect (VSD) and major aortopulmonary collateral arteries (n = 8, 26%), truncus arteriosus (n = 6, 19%), pulmonary atresia with VSD (n = 3, 9.7%), and transposition of the great arteries (n = 2, 6.5%). Thirteen patients (42%) had previous central shunt, and eight patients (26%) had previous modified Blalock-Taussig shunt. There were no operative mortalities. Immediately after T-remodeling, echocardiographic estimates of right ventricle to PA gradient decreased from 42 [interquartile range 28-58] mm Hg to 20 [12-36] mm Hg ( P = .03). Freedom from reoperation on the PA bifurcation for the entire cohort was 100% at one year, 88% (95% CI 68%-96%) at five years and 82% (57%-93%) at ten years.

Conclusions

T-remodeling for PA origin stenosis is a safe procedure with excellent freedom from reoperation that is easily reproducible and applicable to patients with all cardiac morphologies.
Medically Assisted Reproduction in the United States: A Focus on Parents 40 and Older
Authors: Tierney Katherine I. , Guzzo Karen Benjamin
Published: November 2023

As age at first birth continues to increase in the United States, the use of medically assisted reproduction (MAR) has likely increased. Using population-level data of births in the United States from the National Vital Statistics System from 2010 to 2021, the authors document the proportion of births due to MAR with a focus on parents 40 years or older, disaggregating by parental age combinations and parity. Although MAR-related births constitute a small proportion of all births, there is a growing and sizable proportion of first births to women 40 years or older due to MAR. Specifically, 28.2 percent, 21.5 percent, and 15.3 percent first births involved MAR among mothers 40 or older with an unknown father’s age, both parents 40 or older, and mothers 40 or older with fathers younger than 40, respectively. Thus, for some groups, MAR is a particularly important component of the pathway to parenthood.
The Myriad Living Arrangements of U.S. Single Men and Women in Midlife
Authors: Julian Christopher A. , Brown Susan L.
Published: November 2023

Attention to the living arrangements of singles has centered around young adults who increasingly reside with their parents. By comparison, midlife singles remain overlooked despite a substantial rise in singlehood during this life-course stage. Using the 2021 American Community Survey five-year estimates, the authors uncovered the disparate living arrangements of midlife single men and women household heads, defining midlife as those aged 30 to 49 and single as those who were neither cohabiting nor married. The findings revealed that the living arrangements of men and women were near inverses of each other, with most men living alone, whereas most women lived with someone else. Relative to men, a far greater share of women were residing with their children, whereas a larger share of men were in arrangements that did not include children. The distinctive living arrangements speak to the potential differences in familial obligations and available support sources.
Customers’ Motives to Engage in Social Media-based Product Idea Contests – Empirical Evidence from Germany
Authors: Geise Fabian A.
Published: November 2023

An empirical motive study based on the design science approach is presented. The aim of the study is to develop specific problem-solving knowledge in the form of artefacts that can be directly applied in marketing practice. The problem-solving knowledge relates to consumers’ motives for participating in product idea contests (PICs) in the fast-moving consumer goods sector. The research phases underlying the motive study are guided by a five-phase design science research process. As a result of this research process, two artefacts are developed: a multi-item motive scale and a factor analytic motive model. The motive model includes six participation motives – three intrinsic (enjoyment with creative tasks, altruism and search for new/better product solutions) and three extrinsic motives (material–financial reward, identification with the user community and positive feedback from participants/company). Finally, the motive model enables the derivation of recommendations for action for the PIC management.
A developmental case methodology to address new clinical questions
Authors: Crittenden Patricia M
Published: November 2023

Standard research designs, literature reviews, and case study methodologies do not meet the need for development of new clinically relevant hypotheses. To the contrary, these standard forms of publication have tended to promote conformity and stifle divergent research. This paper describes a method of producing empirically based clinical hypotheses that is more open-ended than standard methods, but also more empirical than clinical opinion. A developmental ordered set of cases, each with standardized assessments and set within its own family system across two or sometimes three generations can approximate the advantages of a sequential, cross-sectional longitudinal research design. A review of the literature suggests the need for more divergent approaches to research. This approach is described here and applied to sexual signs and behavior in children in the accompanying paper.
Interorganizational Design for Collaborative Governance in Co-Owned Major Projects: An Engaged Scholarship Approach
Authors: Brunet Maude , Petit Marie-Claude , Romero-Torres Alejandro
Published: November 2023

Co-ownership of major projects increases organizational complexity but remains underexplored in project studies. This article examines these complexities, employing an engaged scholarship approach with a group of practitioners facing a significant challenge regarding collaborative governance of a major project. This approach enables us to develop a framework for major projects, which includes four types of collaborative governance mechanism: sensemaking, structural, procedural, and relational. Our work has implications for interorganizational design, suggesting that a project management office (PMO) could play a leadership and integrative role in collaborative governance.
Non-target screening of surface water samples to identify exposome-related pollutants: a case study from Luxembourg
Authors: Aurich Dagny , Diderich Philippe , Helmus Rick , Schymanski Emma L.
Published: November 2023

Background

Non-target screening of surface water samples collected over an extended period can reveal interesting temporal patterns in exposome-related pollutants. Additionally, geographical data on pollution sources close to the sampling sites, chemical classification data and the consideration of flow paths can provide valuable information on the origins and potential threat of tentatively identified chemical compounds. In this study, 271 surface water samples from 20 sampling sites across Luxembourg were analysed using high-resolution mass spectrometry, complementing routine target monitoring efforts in 2019–2022. Data analysis was performed using the open source R-package patRoon, which offers a customizable non-target workflow. By employing open source workflows featuring scoring terms, like spectral match and applying identification levels, tentative identifications can be prioritized, e.g. based on spectral similarity. Furthermore, by utilizing supplementary database information such as PubChemLite annotation categories and classification software such as classyFire, an overall assessment of the potential threats posed by the tentatively identified chemicals was conducted, enabling the prioritization of chemicals for future confirmation through targeted approaches.

Results

The study tentatively identified 378 compounds associated with the exposome including benzenoids, organoheterocyclic compounds, and organic phosphoric acids and derivatives (11 classyFire superclasses, 50 subclasses). The classification analysis not only revealed temporal variations in agrochemicals, with the majority of identifications occurring in May to July, but also highlighted the prevalence of pharmaceuticals such as venlafaxine in surface waters. Furthermore, potential sources of pollutants, like metallurgic industry or household products were explored by considering common uses and geographical information, as commercial uses of almost 100% of the identified chemicals are known. 41 chemicals were suggested for potential inclusion to governmental monitoring lists for further investigation.

Conclusions

The findings of this study complement existing knowledge on the pollution status of surface water in Luxembourg and highlight the usefulness of non-target screening for identifying temporal and spatial trends in pollutant levels. This approach, performed in a complementary manner to routine monitoring, can help to tentatively identify chemicals of concern for potential inclusion in target monitoring methods following additional confirmation and quantification efforts.
Infections in the first year of living related kidney transplantation in a young transplant cohort
Authors: Khedr Lamis , Teama Nahla , El Sharkawy Magdy
Published: November 2023

Background

Infection after a kidney transplant is a serious cause of morbidity and mortality. Weighing the risks and benefits of immunosuppression is of paramount importance for patient wellbeing and transplant survival.

Methods

This is a prospective observational study exploring the variety of bacterial, viral and fungal infections occurring within the first year of living related kidney transplantation in a young transplant cohort. Fifty-one kidney transplant recipients (KTR) between the age of 18 and 45 who had a kidney transplant between Jan 2020 and Jan 2022 were enrolled and followed up for one year. Primary outcome was the occurrence of infection.

Results

Twenty-four patients (47%) recorded a collective 33 episodes of infection. Seven patients had repeated infections and 17 had single infections. Twenty-seven patients had an uneventful year with no infections recorded. Commonest infection was lower urinary tract infection (UTI) (27.3%) followed by SARS-COV2 and Herpes Zoster (15.2%). The commonest pathogens causing lower UTI were Escherichia coli (E coli) (21.2%) and Klebsiella (18.2%). Median Tacrolimus level was (7.8) ng/ml in KTR with infection and (8.95) ng/ml in KTR without infection, p = 0.21. Median Haemoglobin (IQR) was (10.2) g/dl (7.8–14) gm/dl in KTR with infection compared to (10.8) g/dl (7.3–15.3) in KTR without infection odds ratio (OR) = 0.78, confidence interval (CI) (0.5–1.1); p = 0.16.In KTR with infection 25% had donors above the age of 60 compared to 11% in KTR without infection ( OR 2.6,CI (0.5–12), p = 0.2). Post transplant diabetes (PTDM) occurred in (25%) in KTR with infection compared to those without, but that was not statistically significant p = 0. 365.In KTR without infection, 59.3% had a preemptive transplant compared to 20.8% in the group with infection (OR = 0.18; 95% CI: 0.052–0.631; p = 0.007). Median tacrolimus was 7.8 ng/ml in KTR with single infection compared to 7.7 ng/ml in KTR with repeated infections.

Conclusion

This study shows that the commonest infection occurring in the first-year post kidney transplant was lower urinary tract infection followed by SARS-COV2 and Herpes Zoster. There was no difference in trough tacrolimus or haemoglobin levels between KTR who developed infection with those who did not.
Unilateral adrenalectomy for a drug-resistant bilateral primary aldosteronism with heart failure: pathophysiology and surgical indication
Authors: Hoshi Seiji , Onagi Akifumi , Tanji Ryo , Honda-Takinami Ruriko , Matsuoka Kanako , Hata Junya , Sato Yuichi , Akaihata Hidenori , Kataoka Masao , Ogawa Soichiro , Kojima Yoshiyuki
Published: November 2023

Background

Patients with bilateral primary aldosteronism (PA) generally are treated with antihypertensive drugs, but optimal treatment for patients with complications due to refractory hypertension has not been established. In this report, we present a case with bilateral PA who presented with persistent hypertension, despite treatment with 6 drugs, and left-dominant heart failure, which was improved after unilateral adrenalectomy.

Case presentation

A 61-year-old man was admitted to our hospital because of severe left-dominant heart failure. His heart rhythm was atrial fibrillation and the left ventricle was diffusely hypertrophic and hypokinetic. Coronary arteries were normal on coronary arteriogram. Primary aldosteronism was suspected based on severe hypokalemia (2.5 mEq/L) and plasma aldosterone concentration (PAC; 1,410 pg/mL). Although computed tomography (CT) showed a single left cortical nodule, adrenal vein sampling (AVS) indicated bilateral PA. Early in the case, heart failure and hyperkalemia in this patient were improved by treatment with a combination of 6 antihypertensive drugs (spironolactone 25 mg/day, eplerenone 100 mg/day, azosemide 60 mg/day, tolvaptan 7.5 mg/day, enalapril 5 mg/day, and bisoprolol fumarate 10 mg/day); however, heart failure relapsed after four months of treatment. We hypothesized that hypertension caused by excess aldosterone was inducing the patient’s heart failure. In order to reduce aldosterone secretory tissue, a laparoscopic adrenalectomy was performed for the left adrenal gland, given the higher level of aldosterone from the left gland compared to the right. Following surgery, the patient’s heart failure was successfully controlled despite the persistence of high PAC. Treatment with anti-hypertensive medications was reduced to two drugs (eplerenone 100 mg/day and bisoprolol fumarate 10 mg/day). In order to elucidate the mechanism of drug resistance, immunohistochemistry (IHC) and real time-polymerase chain reaction (RT-PCR) assays were performed to assess the expression of steroidogenic factor 1 (SF-1), a regulator of steroid synthesis in adrenal tissue. IHC and RT-PCR demonstrated that the expression of SF-1 in this patient (at both the protein and mRNA levels) was higher than that observed in unilateral PA cases that showed good responsivity to drug treatment.

Conclusions

Unilateral adrenalectomy to reduce aldosterone secretory tissue may be useful for patients with drug-refractory, bilateral PA. Elevated expression of SF-1 may be involved in drug resistance in PA.
Development and validation of the Perceived Benefits of Team-Interaction Training Questionnaire (PBTITQ) among undergraduates
Authors: Chen Ming , Chen Hefang , Wu Yifan , Yang Ruijun , Guo Chaowei , Zhao Meizhen , Xin Chaoli , Zang Shuang
Published: November 2023

Background

The effectiveness of team-interaction training has been proven. However, there is a lack of objective and accurate evaluation tools for the impact and benefits of team-interaction training on participants. This study aims to develop and validate a tool for exploring undergraduates’ perception of benefits in team-interaction. It can further insight into the perceived benefits of team-interaction training for undergraduates and evaluates the effectiveness of the course, and provides a reference point for the development of university team-interaction training courses.

Methods

This study was conducted in three stages. Phase 1 consisted of item generation: A theoretical framework was crafted based on social cognitive theory, self-efficacy theory, and sports performance models. Fifty-two items were generated based on the theoretical framework, participant interviews, and literature review. After Delphi consultation and pilot tests, 39 items moved on to Phase 2. Phase 2 consisted of forming a preliminary questionnaire: the contents to be included were selected through item analysis and exploratory factor analysis (EFA). A total of 40 classes were selected for EFA. After EFA, a three-factor structure with 25 items was formed. The third stage tested psychometric properties through confirmatory factor analysis (CFA), test-retest reliability, criterion-related validity, and internal consistency.

Results

The final PBTITQ consisted of 23 items, each rated from “1” (fully disagree) to “5” (fully agree). EFA and CFA supported the three-factor structure of PBTITQ, which included Cohesion, Communication, and Efficiency. The Cronbach’s alpha of the PBTITQ was 0.90, the test-retest reliability was 0.88, and the split-half reliability was 0.81. PBTITQ significantly correlated with the GEQ (r = 0.808, p < 0.05) and the TDM (r = 0.796, p < 0.05).

Conclusion

The PBTITQ is an effective tool for assessing the perceived benefits of team-interaction training among undergraduates.
Association between vector-borne pathogen seroprevalence in shelter-housed and owned dog populations in the contiguous United States of America
Authors: Gettings Jenna R. , McMahan Christopher S. , Cleveland Christopher A. , Varela-Stokes Andrea , Hubbard Kris , Hamer Sarah A. , Walden Heather S. , Yabsley Michael J.
Published: November 2023

Domestic dogs are susceptible to numerous vector-borne pathogens that are of significant importance for their health. In addition to being of veterinary importance, many of these pathogens are zoonotic and thus may pose a risk to human health. In the USA, owned dogs are commonly screened for exposure to or infection with several canine vector-borne pathogens. Although the screening data are widely available to show areas where infections are being diagnosed, testing of owned dogs is expected to underestimate the actual prevalence in dogs that have no access to veterinary care. The goal of this study was to measure the association between the widely available data from a perceived low-risk population with temporally and spatially collected data from shelter-housed dog populations. These data were then used to extrapolate the prevalence in dogs that generally lack veterinary care. The focus pathogens included Dirofilaria immitis, Ehrlichia spp., Anaplasma spp., and Borrelia burgdorferi. There was a linear association between the prevalence of selected vector-borne pathogens in shelter-housed and owned dog populations and, generally, the data suggested that prevalence of heartworm (D. immitis) infection and seroprevalence of Ehrlichia spp. and B. burgdorferi are higher in shelter-housed dogs, regardless of their location, compared with the owned population. The seroprevalence of Anaplasma spp. was predicted to be higher in areas that have very low to low seroprevalence, but unexpectedly, in areas of higher seroprevalence within the owned population, the seroprevalence was expected to be lower in the shelter-housed dog population. If shelters and veterinarians make decisions to not screen dogs based on the known seroprevalence of the owned group, they are likely underestimating the risk of exposure. This is especially true for heartworm. With this new estimate of the seroprevalence in shelter-housed dogs throughout the USA, shelters and veterinarians can make evidence-based informed decisions on whether testing and screening for these pathogens is appropriate for their local dog population. This work represents an important step in understanding the relationships in the seroprevalences of vector-borne pathogens between shelter-housed and owned dogs, and provides valuable data on the risk of vector-borne diseases in dogs.

Graphical abstract
Abnormal expression of PRKAG2-AS results in dysfunction of cardiomyocytes through regulating PRKAG2 transcription by interacting with PPARG
Authors: Song Xiao-Wei , Su Ting , Li Bo , Huang Yun-Jie , He Wen-Xia , Jiang Li-Li , Li Chang-Jin , Huang Song-Qun , Li Song-Hua , Guo Zhi-Fu , Wu Hong , Zhang Bi-Li
Published: November 2023

The role of PRKAG2 in the maintenance of heart function is well established, but little is known about how PRKAG2 is regulated in cardiomyocytes. In this study, we investigated the role of the lncRNA PRKAG2-AS, which is present at the PRKAG2 promoter, in the regulation of PRKAG2 expression. PRKAG2-AS expression was predominantly nuclear, as determined by RNA nucleoplasmic separation and fluorescence in situ hybridization. Knockdown of PRKAG2-AS in the nucleus, but not the cytoplasm, significantly decreased the expression of PRKAG2b and PRKAG2d. Interestingly, we found that PRKAG2-AS and its target genes, PRKAG2b and PRKAG2d, were reduced in the hearts of patients with ischemic cardiomyopathy, suggesting a potential role for PRKAG2-AS in myocardial ischemia. Indeed, knockdown of PRKAG2-AS in the nucleus resulted in apoptosis of cardiomyocytes. We further elucidated the mechanism by which PRKAG2-AS regulates PRKAG2 transcription by identifying 58 PRKAG2-AS interacting proteins. Among them, PPARG was selected for further investigation based on its correlation and potential interaction with PRKAG2-AS in regulating transcription. Overexpression of PPARG, or its activation with rosiglitazone, led to a significant increase in the expression of PRKAG2b and PRKAG2d in cardiomyocytes, which could be attenuated by PRKAG2-AS knockdown. This finding suggests that PRKAG2-AS mediates, at least partially, the protective effects of rosiglitazone on hypoxia-induced apoptosis. However, given the risk of rosiglitazone in heart failure, we also examined the involvement of PRKAG2-AS in this condition and found that PRKAG2-AS, as well as PRKAG2b and PRKAG2d, was elevated in hearts with dilated cardiomyopathy (DCM) and that overexpression of PRKAG2-AS led to a significant increase in PRKAG2b and PRKAG2d expression, indicating that up-regulation of PRKAG2-AS may contribute to the mechanism of heart failure by promoting transcription of PRKAG2. Consequently, proper expression of PRKAG2-AS is essential for maintaining cardiomyocyte function, and aberrant PRKAG2-AS expression induced by hypoxia or other stimuli may cause cardiac dysfunction.
Causal relationship between gut microbiota and myasthenia gravis: a bidirectional mendelian randomization study
Authors: Su Tengfei , Yin Xiang , Ren Jiaxin , Lang Yue , Zhang Weiguanliu , Cui Li
Published: November 2023

Background

Observational studies have demonstrated an association between gut microbiota and myasthenia gravis; however, the causal relationship between the two still lacks clarity. Our goals are to ascertain the existence of a bidirectional causal relationship between gut microbiota composition and myasthenia gravis, and to investigate how gut microbiota plays a role in reducing the risk of myasthenia gravis.

Methods

We acquired gut microbiota data at the phylum, class, order, family, and genus levels from the MiBioGen consortium (N = 18,340) and myasthenia gravis data from the FinnGen Research Project (426 cases and 373,848 controls). In the two-sample Mendelian randomization analysis, we assessed the causal relationship between the gut microbiota and myasthenia gravis. We also conducted bidirectional MR analysis to determine the direction of causality. The inverse variance weighted, mendelian randomization-Egger, weighted median, simple mode, and weighted mode were used to test the causal relationship between the gut microbiota and severe myasthenia gravis. We used MR-Egger intercept and Cochran's Q test to assess for pleiotropy and heterogeneity, respectively. Furthermore, we utilized the MR-PRESSO method to evaluate horizontal pleiotropy and detect outliers.

Results

In the forward analysis, the inverse-variance weighted method revealed that there is a positive correlation between the genus Lachnoclostridium (OR = 2.431,95%CI 1.047–5.647, p = 0.039) and the risk of myasthenia gravis. Additionally, the family Clostridiaceae1 (OR = 0.424,95%CI 0.202–0.889, p = 0.023), family Defluviitaleaceae (OR = 0.537,95%CI  0.290–0.995, p = 0.048), family Enterobacteriaceae (OR = 0.341,95%CI  0.135–0.865, p = 0.023), and an unknown genus (OR = 0.407,95%CI  0.209–0.793, p = 0.008) all demonstrated negative correlation with the risk of developing myasthenia gravis. Futhermore, reversed Mendelian randomization analysis proved a negative correlation between the risk of myasthenia gravis and genus Barnesiella (OR = 0.945,95%CI  0.906–0.985, p = 0.008).

Conclusion

Our research yielded evidence of a causality connection in both directions between gut microbiota and myasthenia gravis. We identified specific types of microbes associated with myasthenia gravis, which offers a fresh window into the pathogenesis of this disease and the possibility of developing treatment strategies. Nonetheless, more studies, both basic and clinical, are necessary to elucidate the precise role and therapeutic potential of the gut microbiota in the pathogenesis of myasthenia gravis.
Delayed severe hemothorax caused by a staple line of a bullectomy performed 11 years earlier
Authors: Yamashita Takashi , Asai Katsuyuki
Published: November 2023

Background

At present, relatively few lung surgeries are performed without endostaplers. Although there are few staple-related adverse events, severe events must be shared to improve safety.

Case presentation

A 74-year-old male suddenly collapsed and was transferred to the Emergency Rescue department. He had shock vitals and contrast-enhanced CT revealed extensive right hemothorax with contrast leakage. He lost consciousness and tension massive hemothorax was suspected. We performed emergency thoracotomy at two sites and were able to achieve hemostasis and save the patient. Upon examining the patient's medical history after his condition stabilized, it was revealed that he was a lung cancer patient who was taking ramucirumab and cilostazol. In addition, the CT scan taken one month before onset revealed the bleeding site of the fifth intercostal artery were almost contact with the staple line from a prior right spontaneous pneumothorax surgery that was performed 11 years previously, which was seemed to damage the intercostal artery.

Conclusion

Despite the difficulty in achieving hemostasis due to drug administration history, we successfully treated a case of remote period massive hemothorax attributed to staples, thereby saving the patient. When using drugs that increase the risk of bleeding events, it may be important to consider the position of the staple line while assessing the risk. In the emergent or ICU setting, if the initial incision is not effective, the placement of a new second incision may be valuable.