bluuebunny/crossref_metadata_2025 huggingface dataset:
“Sponge pattern” of the spleen: a rarely described high-frequency ultrasound pattern in HIV-positive patients
Authors: Heller Tom , Taccari Francesco , Rambiki Kelvin , Kumwenda Tapiwa , Brunetti Enrico , Wallrauch Claudia
Published: February 2023

Background

The spleen is frequently scanned in workup of infections. Hypoechoic splenic micro-abscesses are known signs of disseminated tuberculosis in HIV co-infected patients. The spleen of HIV patients is thus often scanned using high-frequency transducers.

Methods and findings

We describe a reticulo-nodular “sponge pattern” in the spleen of an HIV-positive patient with Hodgkin’s lymphoma. Disseminated throughout the spleen, very small (1.5–2.0 mm) hypoechoic lesions having a branching reticulo-nodular distribution were seen. The lesions partly, but not entirely, follow splenic vasculature. Review of stored images of other patients identified 15 more cases showing a similar pattern. All patients were HIV positive, almost all with CD4 counts below 200 cells/mm3. Seven (44%) were additionally diagnosed with HHV-8-associated diseases, but the pattern was seen with various underlying opportunistic infections.

Discussion and conclusion

After comparison with spleen microscopic anatomy, we hypothesize that the white pulp of spleens in our patients is hyperplastic or otherwise changed in consistency to be better visible by high-frequency ultrasound. Concomitant human herpesvirus-8 infection may be another cause of this visible white pulp. While we can only speculate about the etiology of the splenic “sponge pattern,” it needs to be recognized as it may be misinterpreted as splenic micro-abscesses of disseminated infections, like tuberculosis in severely immune-compromised patients.
Machine learning-based prediction of COVID-19 mortality using immunological and metabolic biomarkers
Authors: Tulu Thomas Wetere , Wan Tsz Kin , Chan Ching Long , Wu Chun Hei , Woo Peter Yat Ming , Tseng Cee Zhung Steven , Vodencarevic Asmir , Menni Cristina , Chan Kei Hang Katie
Published: February 2023

COVID-19 mortality prediction

Background COVID-19 has become a major global public health problem, despite prevention and efforts. The daily number of COVID-19 cases rapidly increases, and the time and financial costs associated with testing procedure are burdensome.

Method To overcome this, we aim to identify immunological and metabolic biomarkers to predict COVID-19 mortality using a machine learning model. We included inpatients from Hong Kong’s public hospitals between January 1, and September 30, 2020, who were diagnosed with COVID-19 using RT-PCR. We developed three machine learning models to predict the mortality of COVID-19 patients based on data in their electronic medical records. We performed statistical analysis to compare the trained machine learning models which are Deep Neural Networks (DNN), Random Forest Classifier (RF) and Support Vector Machine (SVM) using data from a cohort of 5,059 patients (median age = 46 years; 49.3% male) who had tested positive for COVID-19 based on electronic health records and data from 532,427 patients as controls.

Result We identified top 20 immunological and metabolic biomarkers that can accurately predict the risk of mortality from COVID-19 with ROC-AUC of 0.98 (95% CI 0.96-0.98). Of the three models used, our result demonstrate that the random forest (RF) model achieved the most accurate prediction of mortality among COVID-19 patients with age, glomerular filtration, albumin, urea, procalcitonin, c-reactive protein, oxygen, bicarbonate, carbon dioxide, ferritin, glucose, erythrocytes, creatinine, lymphocytes, PH of blood and leukocytes among the most important biomarkers identified. A cohort from Kwong Wah Hospital (131 patients) was used for model validation with ROC-AUC of 0.90 (95% CI 0.84-0.92).

Conclusion We recommend physicians closely monitor hematological, coagulation, cardiac, hepatic, renal and inflammatory factors for potential progression to severe conditions among COVID-19 patients. To the best of our knowledge, no previous research has identified important immunological and metabolic biomarkers to the extent demonstrated in our study.
Single-session repair of multiple pressure ulcers in non-ambulatory patients
Authors: Aysal Bilge Kagan , Nisanci Mustafa
Published: February 2023

Objective:

Pressure ulcers (PUs) are highly prevalent and challenging wounds. In this study, patients with either tetraplegia or paraplegia, all of whom had multiple grade 4 PUs and who underwent single-session surgical treatment were included. In order to increase the mobility of the musculocutaneous flap, the gluteus maximus muscle, which cannot be used by immobile patients, was detached and inserted into the flap.

Method:

This was a retrospective case series and all PUs were reconstructed within the same surgical session.

Results:

A total of nine patients participated in the study, all of whom were male. Mean age was 33 years (range: 20–42 years). Mean follow-up period was 14.3 months (range: 9–24 months). All patients had a successful single-session repair of all PUs. Total or partial flap losses were not observed. Mean and total number of reconstructed PUs were 2.55 and 23, respectively. The mean area of reconstructed open wounds per patient was 174.6cm2 and the mean operation duration was 253 minutes. The level of blood loss was acceptable as the decrease in haemoglobin levels was not more than 2g/dl for each patient.

Conclusion:

Multiple PUs can be repaired in one session using gluteus maximus musculocutaneous flaps in immobile patients. Based on the fact that the gluteus maximus is an essential muscle for ambulation, our approach can only be used in the treatment of patients with irreversible paraplegia or tetraplegia. When all prerequsities are met, the amount of blood loss and operation duration are acceptable, and returning the patient to a wound-free state can be achieved more quickly compared to multi-session repairs. Air-fluidised beds are vital tools for accomplishing single session repairs of multiple PUs. The data shows that the approach is safe and can be used in patients with multiple PUs.
Circumcision wound dressing with octylcyanoacrylate tissue adhesive
Authors: Lau Weida , Teo Chang Peng Colin
Published: February 2023

Objective:

Circumcision wounds are commonly dressed with paraffin gauze dressings. Octylcyanoacrylate tissue adhesive (Dermabond; Ethicon, US) is increasingly being used for wound closure, as well as wound dressing. This study compared the outcomes of tissue adhesive dressing versus paraffin gauze dressing for circumcision wounds.

Method:

Adult male patients undergoing circumcision were randomised into two groups: tissue adhesive dressing (study group) or paraffin gauze dressing (control group). They were followed up at two weeks and at two months after surgery. The primary objective of this study was to determine the difference in patient-reported dressing satisfaction at two week follow-up. Our secondary outcomes included operation time, postoperative pain, postoperative complications, patient-reported cosmetic satisfaction, surgeon-reported cosmetic satisfaction, and surgeon-reported objective measure of cosmetic outcome using a validated scale.

Results:

A cohort of 40 patients was randomised into two equal groups, study and control. Tissue adhesive dressing was associated with a significantly better patient-reported dressing satisfaction, with a mean Likert scale score of 4.53±0.51 for the study group versus 3.20±1.24 for the control group (p<0.001). It was also associated with a significantly better patient-reported cosmetic satisfaction of 4.58±0.51 versus 4.00±1.12 (p<0.05), respectively. There was no difference in operation time, postoperative pain, postoperative complications or surgeon-reported cosmetic outcomes.

Conclusion:

Tissue adhesive dressing is an acceptable alternative to paraffin gauze dressing for circumcision wounds. This option should be offered to all patients undergoing circumcision.
Topical oxygen therapy in acute traumatic musculoskeletal wounds of the foot and ankle
Authors: Kamal Sushil , Sehgal Apoorv , Shahi Pratyush , Prakash Chaitanya , Saurav Shivam , Bansal Kuldeep
Published: February 2023

Objective:

To quantify the reduction in wound size and change in wound quality following low-cost topical oxygen therapy (TOT) in patients with acute traumatic musculoskeletal wounds of the foot and ankle.

Method:

This prospective interventional study included patients with acute traumatic musculoskeletal wounds of the foot and ankle of <3 weeks' duration after they had undergone debridement and required subsequent wound coverage. A sterile C-Arm cover was used to cover the wound and 100% oxygen was administered at 1 atm, at a rate of 10l/min for 90 minutes on each of four consecutive days, through a suction catheter connected to an oxygen cylinder. The cycle was repeated after a three-day break. Wound surface area (by plotting on graph paper) and wound quality (by modified wound infection checklist score and swabs for culture and Gram staining) were assessed before and after TOT application.

Results:

The study cohort included 20 patients ≥18 years of age. There was a statistically significant (p<0.001) reduction in mean wound surface area from 79.3cm2 at baseline to 69.6cm2 after two cycles of TOT. The mean modified wound infection checklist score was 13.6 and 0.8, respectively, before and after two cycles of TOT, suggesting statistically significant improvement (p=0.02) in wound quality. All patients showed no growth in their wound culture after TOT.

Conclusion:

TOT appears to be a promising and cost-effective alternative in the management of traumatic wounds. However, future studies with larger sample sizes and control groups for comparison are needed to establish the benefit of TOT in acute traumatic musculoskeletal wounds.
Continuous glucose monitoring for type 1 diabetes
Authors: Gordon Charlotte
Published: February 2023

Continuous glucose monitoring (CGM) is now a standard of care technology, which enables people living with type 1 diabetes to quickly monitor and manage their glucose levels without frequent, painful, finger-prick testing. This article will provide an overview of CGM technologies, including the most common types of devices, the data generated and information regarding access to these devices via NHS funding, alongside guidance for CGM use in clinical practice. Diabetes technologies are developing at pace, and so practice nurses will increasingly encounter people using CGM.

Continuous glucose monitoring is now available to all those living with type 1 diabetes. Charlotte Gordon provides an overview of the technology for nurses working in general practice
Exploring health care professionals’ experiences of supporting LGBTQ+ patients: a qualitative study
Authors: Pearce Chelsea , Di Lorito Claudio
Published: February 2023

Background:

Patients from the LGBTQ+ community report negative healthcare experiences, such as healthcare professionals (HCPs) making assumptions about their identities. Research shows that HCPs report not having enough knowledge to facilitate an open conversation with patients from the LGBTQ+ community, leading to patients feeling ignored.

Aims:

To explore HCPs’ experiences of supporting patients from the LGBTQ+ community.

Method:

Semi-structured interviews were conducted with HCPs recruited from the research teams’ professional network. Data were analysed using deductive thematic analysis.

Findings:

HCPs reported positive and negative experiences, as well as a variety of barriers and facilitators to effective communication, with patients from the LGBTQ+ community. HCPs discussed how clinical practice could improve, for example, by developing more inclusive training that is specific to the HCPs’ clinical group.

Conclusion:

HCP training needs to be more inclusive of LGBTQ+ identities. It should be tailored to the HCPs’ patient group as this better reflects the varied needs of different clinical groups. Chelsea Pearce and Claudio di Lorito explore health care professionals’ experiences of supporting LGBTQ+ patients
Type 2 diabetes and remission through diet
Authors: Winter George
Published: February 2023

George Winter explores recent evidence showing that type 2 diabetes can be reversed using dietary changes
Dynamic stable ring resonator for high-power continuous single-frequency lasers: conditions for a compact resonator
Authors: Bereczki Allan , Wetter Niklaus
Published: February 2023

When considering dynamically stable resonators, ring lasers are good choices because they have a twice larger stability interval when compared to linear resonators and sensitivity to misalignment decreasing with pump power, however literature does not provide easy design guidelines. A ring resonator utilizing Nd:YAG side pumped by diodes allowed single frequency operation. The output single-frequency laser had good output characteristics, however the overall length of resonator did not allow for building a compact device with low misalignment sensitivity and larger spacing between longitudinal modes which could improve single-frequency performance. Based on previously developed equations, which allow for ease of design of a ring DSR, we discuss how to build an equivalent ring resonator, aiming to building a shorter resonator with the same stability zone parameters. The study of the symmetric resonator containing a pair of lenses allowed finding the conditions to build the shortest possible resonator.
Segmentation of beating embryonic heart structures from 4-D OCT images using deep learning
Authors: Ling Shan , Blackburn Brecken , Jenkins Michael , Watanabe Michiko , Ford Stephanie , Lapierre-Landry Maryse , Rollins Andrew
Published: February 2023

Optical coherence tomography (OCT) has been used to investigate heart development because of its capability to image both structure and function of beating embryonic hearts. Cardiac structure segmentation is a prerequisite for quantification of embryonic heart motion and function using OCT. Since manual segmentation is time-consuming and labor-intensive, an automatic method is needed to facilitate high-throughput studies. The purpose of this study is to develop an image processing pipeline to facilitate the segmentation of beating embryonic heart structures from a 4-D OCT dataset. Sequential OCT images were obtained at multiple planes of a beating quail embryonic heart and reassembled to a 4-D dataset using image-based retrospective gating. Multiple image volumes at different time points were selected as key-volumes and their cardiac structures including myocardium, cardiac jelly, and lumen were manually labeled. Registration-based data augmentation was used to synthesize additional labeled image volumes by learning transformations between key-volumes and other unlabeled volumes. The synthesized labeled images were then used to train a fully convolutional network (U-Net) for heart structure segmentation. The proposed deep learning-based pipeline achieved high segmentation accuracy with only two labeled image volumes and reduced the time cost of segmenting one 4-D OCT dataset from a week to two hours. Using this method, one could carry out cohort studies that quantify complex cardiac motion and function in developing hearts.
Assembly of the 81.6 Mb centromere of pea chromosome 6 elucidates the structure and evolution of metapolycentric chromosomes
Authors: Macas Jiří , Ávila Robledillo Laura , Kreplak Jonathan , Novák Petr , Koblížková Andrea , Vrbová Iva , Burstin Judith , Neumann Pavel
Published: February 2023

Centromeres in the legume genera Pisum and Lathyrus exhibit unique morphological characteristics, including extended primary constrictions and multiple separate domains of centromeric chromatin. These so-called metapolycentromeres resemble an intermediate form between monocentric and holocentric types, and therefore provide a great opportunity for studying the transitions between different types of centromere organizations. However, because of the exceedingly large and highly repetitive nature of metapolycentromeres, highly contiguous assemblies needed for these studies are lacking. Here, we report on the assembly and analysis of a 177.6 Mb region of pea (Pisum sativum) chromosome 6, including the 81.6 Mb centromere region (CEN6) and adjacent chromosome arms. Genes, DNA methylation profiles, and most of the repeats were uniformly distributed within the centromere, and their densities in CEN6 and chromosome arms were similar. The exception was an accumulation of satellite DNA in CEN6, where it formed multiple arrays up to 2 Mb in length. Centromeric chromatin, characterized by the presence of the CENH3 protein, was predominantly associated with arrays of three different satellite repeats; however, five other satellites present in CEN6 lacked CENH3. The presence of CENH3 chromatin was found to determine the spatial distribution of the respective satellites during the cell cycle. Finally, oligo-FISH painting experiments, performed using probes specifically designed to label the genomic regions corresponding to CEN6 in Pisum, Lathyrus, and Vicia species, revealed that metapolycentromeres evolved via the expansion of centromeric chromatin into neighboring chromosomal regions and the accumulation of novel satellite repeats. However, in some of these species, centromere evolution also involved chromosomal translocations and centromere repositioning.
Sialokinin in mosquito saliva shifts human immune responses towards intracellular pathogens
Authors: Spencer Clinton Jennifer L. , Vogt Megan B. , Kneubehl Alexander R. , Hibl Brianne M. , Paust Silke , Rico-Hesse Rebecca
Published: February 2023

Mosquito saliva is a mix of numerous proteins that are injected into the skin while the mosquito searches for a blood meal. While mosquito saliva is known to be immunogenic, the salivary components driving these immune responses, as well as the types of immune responses that occur, are not well characterized. We investigated the effects of one potential immunomodulatory mosquito saliva protein, sialokinin, on the human immune response. We used flow cytometry to compare human immune cell populations between humanized mice bitten by sialokinin knockout mosquitoes or injected with sialokinin, and compared them to those bitten by wild-type mosquitoes, unbitten, or saline-injected control mice. Humanized mice received 4 mosquito bites or a single injection, were euthanized after 7 days, and skin, spleen, bone marrow, and blood were harvested for immune cell profiling. Our results show that bites from sialokinin knockout mosquitoes induced monocyte and macrophage populations in the skin, blood, bone marrow, and spleens, and primarily affected CD11c- cell populations. Other increased immune cells included plasmacytoid dendritic cells in the blood, natural killer cells in the skin and blood, and CD4+ T cells in all samples analyzed. Conversely, we observed that mice bitten with sialokinin knockout mosquitoes had decreased NKT cell populations in the skin, and fewer B cells in the blood, spleen, and bone marrow. Taken together, we demonstrated that sialokinin knockout saliva induces elements of a TH1 cellular immune response, suggesting that the sialokinin peptide is inducing a TH2 cellular immune response during wild-type mosquito biting. These findings are an important step towards understanding how mosquito saliva modulates the human immune system and which components of saliva may be critical for arboviral infection. By identifying immunomodulatory salivary proteins, such as sialokinin, we can develop vaccines against mosquito saliva components and direct efforts towards blocking arboviral infections.
Coursing hyenas and stalking lions: The potential for inter- and intraspecific interactions
Authors: Barker Nancy A. , Joubert Francois G. , Kasaona Marthin , Shatumbu Gabriel , Stowbunenko Vincent , Alexander Kathleen A. , Slotow Rob , Getz Wayne M.
Published: February 2023

Resource partitioning promotes coexistence among guild members, and carnivores reduce interference competition through behavioral mechanisms that promote spatio-temporal separation. We analyzed sympatric lion and spotted hyena movements and activity patterns to ascertain the mechanisms facilitating their coexistence within semi-arid and wetland ecosystems. We identified recurrent high-use (revisitation) and extended stay (duration) areas within home ranges, as well as correlated movement-derived measures of inter- and intraspecific interactions with environmental variables. Spatial overlaps among lions and hyenas expanded during the wet season, and occurred at edges of home ranges, around water-points, along pathways between patches of high-use areas. Lions shared more of their home ranges with spotted hyenas in arid ecosystems, but shared more of their ranges with conspecifics in mesic environments. Despite shared space use, we found evidence for subtle temporal differences in the nocturnal movement and activity patterns between the two predators, suggesting a fine localized-scale avoidance strategy. Revisitation frequency and duration within home ranges were influenced by interspecific interactions, after land cover categories and diel cycles. Intraspecific interactions were also important for lions and, important for hyenas were moon illumination and ungulates attracted to former anthrax carcass sites in Etosha, with distance to water in Chobe/Linyanti. Recursion and duration according to locales of competitor probabilities were similar among female lions and both sexes of hyenas, but different for male lions. Our results suggest that lions and spotted hyenas mediate the potential for interference competition through subtle differences in temporal activity, fine-scale habitat use differentiation, and localized reactive-avoidance behaviors. These findings enhance our understanding of the potential effects of interspecific interactions among large carnivore space-use patterns within an apex predator system and show adaptability across heterogeneous and homogeneous environments. Future conservation plans should emphasize the importance of inter- and intraspecific competition within large carnivore communities, particularly moderating such effects within increasingly fragmented landscapes.
Autonomy-supportive sexual health communication and sexual health behaviors for black and Latino MSM in the House Ball Community: Protocol for a social network analysis and exploratory structural equation model
Authors: Smith Martez D. R. , Leblanc Natalie M. , Nelson LaRon E. , McMahon James M.
Published: February 2023

Background

Black and Latino men who have sex with men (MSM) have the highest risk of HIV of any group in the U.S. Prevalence could be even higher among Black and Latino MSM belonging to the House Ball Community (HBC), an understudied community comprised primarily of Black and Latino sexual and gender minorities, with HIV prevalence from non-probability samples ranging from 4% to 38%.

Objectives

Basic Psychological Needs Theory will be utilized to understand how sexual health communication (SHC) influences sexual health behaviors of HBC-MSM. The proposed study will advance this goal by describing characteristics of SHC embedded within social and sexual networks, and identifying the effects of SHC on sexual health behaviors among a sample of Black and Latino HBC-MSM.

Methods

This study entails cross-sectional quantitative survey design with internet-based data collection to test a theory-driven model of the effects of autonomy supportive communication on sexual health behaviors. Respondent-driven sampling (RDS) and internet driven sampling (ID) will be used to recruit a sample of 200 HBC-MSM. We will utilize egocentric network analysis to describe (a) the HBC-specific social and/or sexual network members who provide SHC; (b) the degree of autonomy support provided by network members, and (c) the sexual health behaviors characterizing the sample of HBC-MSM. Structural equation modeling (SEM) will be performed to test associations between autonomy supportive sexual health communication (independent variable) and sexual health behaviors (outcome), with needs satisfaction and intrinsic motivation as intervening mediators.

Discussion

Such knowledge is necessary to expand understanding of how SHC impacts sexual health behaviors for HBC-MSM. The study provides an critical perspective on sexual health behaviors and motivations as participants operate in HBC. Knowledge generated from this study will help improve current HIV prevention interventions, as well as inform the development of future interventions, tailored to HBC-MSM.
Strategies to increase uptake of voluntary medical male circumcision among men aged 25–39 years in Nyanza Region, Kenya: Results from a cluster randomized controlled trial (the TASCO study)
Authors: Grund Jonathan M. , Onchiri Frankline , Mboya Edward , Ussery Faith , Musingila Paul , Ohaga Spala , Odoyo-June Elijah , Bock Naomi , Ayieko Benard , Agot Kawango
Published: February 2023

Introduction

Voluntary medical male circumcision (VMMC) for HIV prevention began in Nyanza Region, Kenya in 2008. By 2014, approximately 800,000 VMMCs had been conducted, and 84.9% were among males aged 15–24 years. We evaluated the impact of interpersonal communication (IPC) and dedicated service outlets (DSO) on VMMC uptake among men aged 25–39 years in Nyanza Region.

Materials and methods

We conducted a cluster randomized controlled trial in 45 administrative Locations (clusters) in Nyanza Region between May 2014 and June 2016 among uncircumcised men aged 25–34 years. In arm one, an IPC toolkit was used to address barriers to VMMC. In the second arm, men were referred to DSO that were modified to address their preferences. Arm three combined the IPC and DSO arms, and arm four was standard of care (SOC). Randomization was done at Location level (11–12 per arm). The primary outcome was the proportion of enrolled men who received VMMC within three months. Generalized estimating equations were used to evaluate the effect of interventions on the outcome.

Results

At baseline, 9,238 households with men aged 25–39 years were enumerated, 9,679 men were assessed, and 2,792 (28.8%) were eligible. For enrollment, 577 enrolled in the IPC arm, 825 in DSO, 723 in combined IPC + DSO, and 667 in SOC. VMMC uptake among men in the SOC arm was 3.2%. In IPC, DSO, and combined IPC + DSO arms, uptake was 3.3%, 4.5%, and 4.4%, respectively. The adjusted odds ratio (aOR) of VMMC uptake in the study arms compared to SOC were IPC aOR = 1.03; 95% CI: 0.50–2.13, DSO aOR = 1.31; 95% CI: 0.67–2.57, and IPC + DSO combined aOR = 1.31, 95% CI: 0.65–2.67.

Discussion

Using these interventions among men aged 25–39 years did not significantly impact VMMC uptake. These findings suggest that alternative demand creation strategies for VMMC services are needed to reach men aged 25–39 years.

Trial registration

clinicaltrials.gov identifier: NCT02497989.
Financial support failure and health results: The Peruvian case
Authors: Guillen Jorge
Published: February 2023

The paper shed the light in analyzing the efficiency of Peruvian Government Financial Support in comparison with some countries in the Latin American Region and worldwide. The Covid 19 Pandemic enforced governments to apply the “Hammer Blow” which affected negatively the economy producing recession and unemployment. Governments offset the latter effect by applying subsidy policies to the Poor and then reduce the negative economic consequences of the general lockdown without getting COVID. Our study performs a Difference and Difference Model (DID) to evaluate the effectiveness of the latter policy.
Digital technology and patient and public involvement (PPI) in routine care and clinical research—A pilot study
Authors: Chen Yang , Hosin Ali A. , George Marc J. , Asselbergs Folkert W. , Shah Anoop D.
Published: February 2023

Background

Patient and public involvement (PPI) has growing impact on the design of clinical care and research studies. There remains underreporting of formal PPI events including views related to using digital tools. This study aimed to assess the feasibility of hosting a hybrid PPI event to gather views on the use of digital tools in clinical care and research.

Methods

A PPI focus day was held following local procedures and published recommendations related to advertisement, communication and delivery. Two exemplar projects were used as the basis for discussions and qualitative and quantitative data was collected.

Results

32 individuals expressed interest in the PPI day and 9 were selected to attend. 3 participated in person and 6 via an online video-calling platform. Selected written and verbal feedback was collected on two digitally themed projects and on the event itself. The overall quality and interactivity for the event was rated as 4/5 for those who attended in person and 4.5/5 and 4.8/5 respectively, for those who attended remotely.

Conclusions

A hybrid PPI event is feasible and offers a flexible format to capture the views of patients. The overall enthusiasm for digital tools amongst patients in routine care and clinical research is high, though further work and standardised, systematic reporting of PPI events is required.
Cancer stem cell-derived extracellular vesicles preferentially target MHC-II–macrophages and PD1+ T cells in the tumor microenvironment
Authors: Gonzalez-Callejo Patricia , Guo Zihan , Ziglari Tahereh , Claudio Natalie Marcia , Nguyen Kayla Hoang , Oshimori Naoki , Seras-Franzoso Joaquim , Pucci Ferdinando
Published: February 2023

Immunotherapy is an approved treatment option for head and neck squamous cell carcinoma (HNSCC). However, the response rate to immune checkpoint blockade is only 13% for recurrent HNSCC, highlighting the urgent need to better understand tumor-immune interplay, with the ultimate goal of improving patient outcomes. HNSCC present high local recurrence rates and therapy resistance that can be attributed to the presence of cancer stem cells (CSC) within tumors. CSC exhibit singular properties that enable them to avoid immune detection and eradication. How CSC communicate with immune cells and which immune cell types are preferentially found within the CSC niche are still open questions. Here, we used genetic approaches to specifically label CSC-derived extracellular vesicles (EVs) and to perform Sortase-mediated in vivo proximity labeling of CSC niche cells. We identified specific immune cell subsets that were selectively targeted by EVCSC and that were found in the CSC niche. Native EVCSC preferentially targeted MHC-II–macrophages and PD1+ T cells in the tumor microenvironment, which were the same immune cell subsets enriched within the CSC niche. These observations indicate that the use of genetic technologies able to track EVs without in vitro isolation are a valuable tool to unveil the biology of native EVCSC.
The proportion of Thai postmenopausal women who would be eligible for anti-osteoporosis therapy
Authors: Chanidkul Piyachat , Sribenjalak Dueanchonnee , Charoenngam Nipith , Pongchaiyakul Chatlert
Published: February 2023

Purpose

To determine the proportion of postmenopausal Thai women who would be classified as having high risk of fracture and eligible for anti-osteoporosis therapy according to the National Osteoporosis Foundation (NOF) criteria.

Methods

Postmenopausal Thai women aged 40–90 years who had been screened for osteoporosis during 2014–2019 were recruited. Demographic data and osteoporosis risk factors were collected based on the Fracture Risk Assessment Tool (FRAX) questionnaire. Bone mineral density (BMD) at the femoral neck and lumbar spine measured using dual energy X-ray absorptiometry. Ten-year probabilities of hip and major osteoporotic fracture (MOF) were calculated based on the Thai FRAX model with BMD. The study’s protocol was approved by the Institutional Ethical Committee (HE581241).

Results

A total of 3,280 postmenopausal women were included. The mean ± SD age was 63.6 ± 10.1 years. A total of 170 (5.2%) participants had a history of hip and/or vertebral fracture. After excluding these participants with fracture history, 699 (21.3%) had osteoporosis, 355 (10.8%) had osteopenia with high risk of fracture (FRAX 10-year probability of hip fracture ≥ 3% and/or MOF ≥ 20%), 1192 (36.3%) had osteopenia with low risk of fracture (FRAX 10-year probability of hip fracture < 3% and MOF < 20%) and 864 (26.3%) had normal BMD. Taken together, a total of 1,224 (37.3%) participants would be eligible for anti-osteoporosis therapy (prior fracture, osteoporosis or osteopenia with high risk of fracture).

Conclusion

The prevalence of Thai postmenopausal women who would be eligible for anti-osteoporosis therapy was 37.3%.
Does prior vaccination affect the immune response to seasonal influenza vaccination among older adults? Findings from a prospective cohort study in a Northeastern Province of Thailand
Authors: Praphasiri Prabda , Prasert Kriengkrai , Shrestha Manash , Ditsungnoen Darunee , Chittaganpich Malinee , Chawalchitiporn Sutthinan , Dawood Fatimah S. , Sirilak Supakit , Mott Joshua A.
Published: February 2023

Background

We measured the immunogenicity of seasonal trivalent inactivated influenza vaccines (IIV3) among older Thai adults and the effect of one-year prior vaccination status on immune responses.

Method

Adults aged ≥65 years (n = 370) were vaccinated with Southern Hemisphere IIV3 in 2015. Hemagglutination inhibition assays were performed using goose red blood cells on sera collected from the participants at baseline and after 1, 6, and 12 months of vaccination. Prior year vaccination (in 2014) was verified with the national health security office database. We analyzed the associations between prior vaccination and geometric mean titers (GMT) at each time point using generalized linear regression on logged transformed titers, and seroprotection and seroconversion using Log-binomial regression.

Results

At baseline, previously vaccinated participants (n = 203) had a significantly higher GMT and seroprotection against all three influenza strains than those previously unvaccinated (n = 167) (all p-values <0.001). Seroprotection rates were similar after one month in both groups for A(H1N1)pdm09 (adjusted risk ratio [aRR] 1.10, 95% CI 0.97–1.25), and A(H3N2) (aRR 1.08, 95% CI 0.87–1.33), but higher in previously vaccinated persons for B (aRR 1.20, 95% CI 1.08–1.32). At 12 months, 50% or more had seroprotection in previously vaccinated group with no difference between previously vaccinated or unvaccinated persons. Seroconversion was lower in the previously vaccinated group for A(H1N1)pdm09 (aRR 0.62, 95% CI 0.43–0.89), but did not differ between the two groups for A(H3N2) (aRR 0.94, 95% CI 0.69–1.28) and B (aRR 0.85, 95% CI 0.60–1.20).

Conclusion

Influenza vaccination elicited good humoral response in older Thai adults. While seroconversion seemed attenuated in persons previously vaccinated for influenza A(H1N1)pdm09 (the only vaccine strain not to change), this was not apparent for influenza A(H3N2) and B, and prior vaccination was not associated with any inhibition in seroprotection.
Relationships between psychological flexibility and internet gaming disorder among adolescents: Mediation effects of depression and maladaptive cognitions
Authors: Yang Xue , Ebo Titus Oloruntoba , Wong Keiman , Wang Xin
Published: February 2023

Psychological flexibility may reduce addictive behaviours by adaptive and flexible emotional and cognitive processes. This study tested a mediation model of internet gaming disorder (IGD) in which psychological flexibility would reduce depression and maladaptive cognitions related to internet gaming and in turn lower the risk of IGD. A cross-sectional study surveyed 2102 secondary 1–4 students from seven schools during March to November 2021 in Hong Kong, China. The results showed that 12.7% and 52.2% of the students were classified as having probable IGD and depression, respectively. The proposed mediation model fitted the data well: χ2/df = 8.00, CFI = .99, NNFI = .99, RMSEA = .01. Psychological inflexibility was directly and positively associated with IGD (B = .01, β = .07, p = .003) and indirectly and positively associated with IGD via depressive symptoms (B = .01, β = .07, p = .001, PM = 23.7%) and maladaptive cognitions (B = .03, β = .15, p = .001, PM = 50.8%). Multi-group analyses showed that gender significantly moderated the associations between psychological inflexibility and maladaptive cognitions (Δχ2/Δdf = 8.69/1, p < .05), between maladaptive cognitions and IGD (Δχ2/Δdf = 4.33/1, p < .05), and between psychological inflexibility and IGD (Δχ2/Δdf = 5.46/1, p < .05). Depression and maladaptive cognitions may be significant mediators that could explain the relationship between psychological flexibility and IGD. Also, gender difference may exist. Based on the findings, intervention strategies for IGD reduction are discussed.
The genetic impact of heat stress on the egg production of Thai native chickens (Pradu Hang dum)
Authors: Loengbudnark Wipas , Chankitisakul Vibuntita , Boonkum Wuttigrai
Published: February 2023

Sustainable poultry production in adverse weather conditions is a widely debated issue, which has led to research into the development of breeds of poultry that are genetically resistant to heat. This study aimed to investigate the effects of heat stress on the genetics of monthly egg production and examine the threshold point of heat stress for preventing thermal stress and its effects on chicken productivity. The data of 5,965 monthly egg production records of 629 Thai native Pradu Hang dum chickens were used for analysis in combination with the temperature-humidity index (THI) calculated by meteorological data near the testing station. The average THI throughout the year was 76.6, and the highest was 82. The THI data were subsequently used to find the threshold point of heat stress. The THI equation used in this study was chosen by its highest correlation (-0.306) between THI values and monthly egg production. At a THI of 74, the lowest -2 logL was found and was considered the threshold point of heat stress. This means that monthly egg production would start decreasing when the THI was 74. Heritability was 0.15±0.03, and genetic and permanent environmental correlations were -0.29 and -0.48, respectively. The threshold point was used to estimate the estimated breeding values (EBVs) of the monthly egg production and heat stress individually, and EBVs were calculated into the selection index. The selection index values when the animal was selected for the replacement herd for all chickens (top 50%, 30%, 20%, and 10%) were 0.14, 0.90, 1.27, 1.53, and 1.91, respectively, and the genetic progress was 0.55, 0.60, 0.68, 0.75, and 0.77, respectively. This shows that the selection index values are lower if there are many selected animals. The recommendation for animal genetic selection is that the top 10% is appropriately because it seems to be most preferred. Therefore, using a selection index for high egg production and heat tolerance in Thai native chickens is possible to achieve genetic assessment in a large population.
A road map for action: recommendations of the Health Affairs Council on Health Care Spending and Value
Authors:   Health Affairs Council on Health Care Spending and Value, Tollen Laura , Keating Elizabeth
Published: February 2023

The Health Affairs Council on Health Care Spending and Value was charged with recommending ways that the United States can take a deliberate approach to moderating health care spending growth while maximizing value. The council is a nonpartisan, multidisciplinary, expert working group under the leadership of cochairs William Frist and Margaret Hamburg. This, the council’s final report, accomplishes two goals: through its supporting research, it synthesizes literature about how much the US spends on health care, the value of that spending, and the likely impact of various interventions; and it provides recommendations to public and private stakeholders on how to achieve higher-value health care spending and growth in the US.
Human Resource Development within the Sustainability Science Framework
Authors: El-Fekey Sherine Fathy , Mostafa Bassant Adel
Published: February 2023

The United Nations 2030 17 Sustainable Development Goals are anticipated to make a significant contribution to humanity's well-being (SDGs). The agenda is founded on the triple bottom line (TBL) idea, according to which social inclusion and environmental sustainability are essential for continued economic development. In order to determine the crucial role that human resource development (HRD) plays in sustainability, this study will review relevant academic literature and update the TBL model to include and emphasize the HRD dimension and the dynamism and resilience of the sustainability framework; and to fill the literature gap in relating HRD to sustainability. This paper takes a deductive approach and is based on reviewing state-of-the-art literature to develop a new conceptual framework integrating HRD into the sustainability model. Hence, relevant studies are selected; based on criteria, mainly from refereed journals in the fields of human resources and sustainability. These studies will be critically analyzed to highlight their main focus, findings, and key contributions to the proposed framework. The paper proposed a conceptual framework that is global, resilient, and dynamic in nature to face today’s challenges. This framework aims to capitalize on the previous researchers’ designed sustainability models, try to complement some of these models’ perceived limitations, and shed light on HRD multi-level incorporations in sustainability.

The paper proposed a “Global Dynamic Sustainable Humanity Framework” that stresses on (1) Integrating HRD into the TBL sustainability model; (2) Embedding the resilience concept in the framework; (3) Transforming the sustainability framework into a dynamic one; (4) take the sustainability framework to a global level. The paper also suggested raising “sustainable humanity” awareness by introducing a paradigm shift - from a traditional environment to a sustainable environment – as a prerequisite to the success and effectiveness of the proposed framework. The paper integrated rich theoretical perspectives and sustainability models of different studies into one coherent framework. It also filled the gap in the literature studying the HRD's crucial role in sustainable development. The proposed framework enriches and enables HRD practitioners to play an integral role in sustainable development on the individual, organizational and societal levels – nationally and globally. Their role as change catalysts is crucial in applying the proposed Global Dynamic Sustainable Humanity Framework, raising people's awareness of sustainability, help making a paradigm shift towards sustainability.

 Keywords: Human Resource Development; Sustainability; Triple Bottom Line; Global Sustainability Framework; Resilient; Dynamic
Distribution of Instructional Leadership Roles within a School Organization
Authors: Wolfe Zora , Knudsen Kim-Kathie , Mahaffey Abbie
Published: February 2023

Educational leaders are tasked with many managerial responsibilities as well as instructional leadership roles. However, effective instructional leadership is a critical factor in improving student achievement. The purpose of this study was to explore how instructional leadership is distributed within a school organization, specifically examining the perceptions of district, building, and teacher leaders in relation to their roles in instructional leadership and the barriers to effective instructional leadership. Qualitative interviews were conducted with district office leaders, building leaders, and instructional coaches, and their responses to the questions were reviewed, categorized, and coded using Crewell’s Data Analysis Spiral (2011).

Data from this study showed: 1) the definition and expectations of instructional leadership vary across different roles, and 2) challenges in the fulfillment of instructional leadership roles indicate systematic issues that could be addressed through changes in resource (staff and time) allocation. These findings suggest practical recommendations for districts to more efficiently and effectively provide instructional leadership, beginning with explicit conversations to determine a common understanding of instructional leadership, and examining how to build capacity in all staff to fulfill the responsibilities within a school, so instructional leadership can be prioritized by building leaders.
Thinking About Teaching: A rural social studies teacher's path to strive for excellence
Authors: Serure Dana F.
Published: February 2023

Thinking About Teaching: A rural social studies teacher's path to strive for excellence by Casey Jakubowski (2020) offers insights about the macros and micros of teaching. The book is geared toward educators and teacher candidates who seek to know more about the teaching profession. The book comprises four parts, including: 1) an introduction of practice which details twenty brief chapters of hot education topics, 2) curriculum and instruction, 3) rural education, and 4) a conclusion that pinpoints recommendations about teaching based on his experience that spans twenty years in the education field. Throughout the book Jakubowski expresses his professional journey by detailing his trials and tribulations as an educator. In addition, Jakubowski prioritizes rural education based on his own research (Jakubowski, 2019) and his professional practice as a social studies teacher, district administrator, state education department associate, and currently a teacher educator. Jakubowski describes exemplary authentic, student-centered learning and care-filled teaching methods. Thinking About Teaching is for growth-mindset educators who aim to improve their craft.
Continuing Medical Education Questions: February 2023
Authors: Gandhi Seema R.
Published: February 2023

Article Title: Application of the Latest Advances in Evidence-Based Medicine in Primary Biliary Cholangitis
Chronic Tracheoesophageal Fistula Successfully Treated Using an Amplatzer Closure Device Under Endoscopic Visualization
Authors: Stawinski Peter M. , Dziadkowiec Karolina N. , Henkes Nichole C. , McMillan Natasha , Rosenkranz Laura A.
Published: February 2023

In patients with severe comorbidities or those who are critically ill, chronic or recurrent tracheoesophageal fistulas may be successfully closed using an Amplatzer device. We present the case of a chronic tracheoesophageal fistula causing dysphagia and aspiration pneumonia, which was successfully repaired using an Amplatzer device.
Left-Sided Colonic Tuberculosis Presenting as Colonic Stricture: A Rare Presentation of a Common Disease
Authors: Abdul Jabbar Shabana , Selvakumar B. , Varshney Vaibhav Kumar , Sharma Indu , Khera Sudeep , Hussain Sabir
Published: February 2023

Gastrointestinal tuberculosis (TB) mainly presents as an ileocecal disease, and colonic TB is more often seen with terminal ileal involvement. Isolated involvement of the descending colon by TB is uncommon and usually presents with chronic colitis. An acute presentation as intestinal obstruction because of tubercular stricture of the descending colon has not been reported. We encountered a young woman who presented with features of acute bowel obstruction. On evaluation, she was diagnosed with a case of descending colon stricture with a provisional diagnosis of malignant colonic stricture. Left hemicolectomy was performed, and histopathology revealed it to be tubercular stricture. Antitubercular therapy was given for 9 months, and she is doing well at follow-up. A differential diagnosis of TB at an unusual location should always be considered even when presented with atypical symptoms, especially for patients from the endemic zone of TB.