bluuebunny/crossref_metadata_2025 huggingface dataset:
Oceans, Objects, and Infrastructures: Making Modern Piracy
Authors: Bueger Christian , Stockbruegger Jan
Published: September 2024

The agenda of objectual International Relations has shown why object matters, how they arise and with what effects. Far less attention has been paid to how objects are maintained and stabilized over time and how their coherence is achieved. To add this dimension to the debate, we suggest turning to the infrastructures of object maintenance. Infrastructures are social material arrangements that maintain objects and enable their use. We introduce a framework for the study of object infrastructures and illustrate it by drawing on the case of “maritime piracy”. Providing a historical reconstruction of the infrastructures that produce piracy as an international object, we show that the growing proliferation of these infrastructures does not lead to an internal coherence of the object over time, but rather objectual fracturing and instability. We reveal how objects are often multiple rather than unitary. The article adds an important new dimension to the study of objects in International Relations.
Drivers and consequences of microbial community coalescence
Authors: Liu Xipeng , Salles Joana Falcão
Published: September 2024

Microbial communities are undergoing unprecedented dispersion and amalgamation across diverse ecosystems, thereby exerting profound and pervasive influences on microbial assemblages and ecosystem dynamics. This review delves into the phenomenon of community coalescence, offering an ecological overview that outlines its four-step process and elucidates the intrinsic interconnections in the context of community assembly. We examine pivotal mechanisms driving community coalescence, with a particular emphasis on elucidating the fates of both source and resident microbial communities and the consequential impacts on the ecosystem. Finally, we proffer recommendations to guide researchers in this rapidly evolving domain, facilitating deeper insights into the ecological ramifications of microbial community coalescence.
Sinensetin interferes with Staphylococcus aureus infections by targeting staphylocoagulase and improves infection survival rates in mouse model of pneumonia
Authors: Ge Bin , Hu Chunjie , Qian Yimin , Tang Yating , Zhang Qiuyue , Jiang Shuang , Mu Zongyi , Zhang Maoyun
Published: September 2024

Aims

Coagulase (Coa), a crucial virulence factor of Staphylococcus aureus (S. aureus), is considered a vital target for anti-virulence strategies. The research aimed to discover a natural compound capable of inhibiting S. aureus infection by targeting the virulence factor Coa.

Methods and results

The study showed that sinensetin at a concentration of 128 μg mL−1 effectively inhibited both Coa-induced coagulation and biofilm formation in S. aureus. However, western blot results indicated that sinensetin did not impact the expression of Coa protein, suggesting that sinensetin may directly target Coa to counteract the virulence of S. aureus. Thermal shift assay results demonstrated that sinensetin enhanced the thermal stability of Coa, supporting the theory of direct binding. Molecular docking and point mutation experiments identified two key binding sites for sinensetin to Coa as R73A-Coa and R204A-Coa. In vivo studies on mice revealed that sinensetin not only reduced lung tissue damage caused by S. aureus infection, but also decreased inflammatory factors in the lung lavage fluid. Furthermore, combining sinensetin with oxacillin improved the survival rates of the Galleria mellonella and mice.

Conclusions

Sinensetin is a promising natural compound that acts as a direct inhibitor of Coa against S. aureus infections.
Burns During Pregnancy: Is the Outcome Still Gloomy? A Follow-up Case Series
Authors: Mabrouk Adel , Elfeky Alaa , Badawy Mohamed Samir , Hammad Mai Raafat , Mabrouk Amr
Published: September 2024

Despite the incidence of burns in pregnancy not being high, its occurrence leads to high morbidity and mortality for both mother and fetus. In 1997, we published a series of 27 cases of pregnant women who were managed and followed up for fetal and maternal outcomes at Ain Shams University’s burn unit and Maternity Hospital during the period from October 1995 to September 1996. Now, 2 decades later, we report on 7 cases of burns admitted to the burn unit and the Maternity Hospital at Ain Shams University, during the period from January 2019 through June 2022.

Pregnant patients admitted to the burn unit and the Maternity Hospital at Ain Shams University during the period from January 2019 through June 2022 were included in this case series. Demographic data and obstetric history were documented for each patient as well as total body surface area burned, degree, cause, and type of burn, maternal mortalities, fetal mortalities, obstetric interventions, and surgical interventions.

The total burned surface area ranged from 12% to 40%; no maternal mortalities occurred in this series, 3 miscarriages, 1 preterm labor, and 3 term pregnancies with 4 surviving neonates.
Moralizing Everyday Consumption: The Case of Self-Care
Authors: Hochstein Rachel E , Veresiu Ela , Harmeling Colleen M
Published: September 2024

Morality, appraisals of right and wrong, is central to consumers’ identities and decisions. Even everyday consumption choices can be subject to moral judgments and require moral justifications. When and how do consumers moralize formerly taken-for-granted consumption practices? Considering self-care consumption in the United States, which includes practices that range from bathing to dieting to meditating to vacationing, this article examines the moralization of everyday consumption practices. This research reveals that consumption is likely to be moralized when there are culturally contested meanings of its core constructs, like “self” and “care,” leading cultural authorities to prescribe alternative ways to pursue the same consumption goal (i.e., cultural scripts). Exposure to cultural scripts that clash with consumers’ moral intuitions about self-care consumption triggers moral introspection, an evaluation and re-calibration of those intuitions. Consumers then set moral boundaries of acceptable self-care consumption by (1) denouncing, such that they assume a position of moral righteousness; (2) positioning, to indicate moral inclusivity; (3) balancing, which implies moral licensing; or (4) ritualizing, in which case they express moral autonomy. This study advances consumer research by establishing that moral considerations intertwine with consumers’ identities and underlie the symbolic meanings of everyday consumption practices.
Administrative Lawfare at the European Union’s External Borders: Some Perspectives on Administrative Regulation of NGO Search and Rescue Activities in Italy and the Situation at the Polish-Belarusian Border
Authors: Dziedzic Lukasz
Published: September 2024

Violations of the rights of migrants by state actors at the EU’s external borders, including through the use of pushbacks and indiscriminate violence, both on land and sea, have resulted in NGOs, lawyers and citizen activists engaging in forms of humanitarian action and legal mobilization aimed at contesting inhumane state policies. State actors can similarly rely on various legal tools to create a chilling effect and a hostile environment for migrants’ rights activism. Such practices can be considered to constitute a form of lawfare against migrants’ rights activism, an instrumental and hegemonic use of the law in order to weaken support for migrants. The use of criminal law has been a common tool of lawfare at the European Union’s external borders. However, administrative law is increasingly being used to bring activists into compliance with states’ interests, creating compliant environments through the use of regulatory instruments and administrative sanctions. To critically assess the instrumental use of administrative law as a form of lawfare, it makes sense to review their application at the EU’s external borders. A good opportunity for such a review is being provided by looking at the administrative regulation of search and rescue (SAR) operations in the Mediterranean creating a hostile environment for SAR NGOs in the case of Italy, and the instrumental use of administrative regulations to limit access for activists to the Polish-Belarusian border in the case of Poland.
Thermal constraints and gender-related differences in the activity patterns of the monomorphic rodent Clyomys laticeps
Authors: Paixão Ingrid , Ferrando Claire , Leiner Natália
Published: September 2024

The daily activity pattern of animals can be classified as diurnal, nocturnal, crepuscular, and cathemeral reflecting strategic decisions to maximize mating and foraging while reducing predation risks and thermal constraints. Among monomorphic mammals, competition for resources and gender-related differences in physiology and reproductive strategies may translate into different activity patterns of males and females. Therefore, to understand the daily activity pattern both aboveground and belowground of the semifossorial rodent Clyomys laticeps, we tested the following hypotheses: (1) males and females differ in their diel activity patterns; (2) males are active for longer periods than females due to a promiscuous mating system and female site fidelity; and (3) higher maximum temperatures restrain C. laticeps activity. The study was carried out in the Serra de Caldas Novas State Park (Goiás, Brazil) in the Cerrado biome. The activity of C. laticeps was recorded using the telemetry technique over 5 days and nights (twice in each season, rainy and dry, between 2019 and 2021). Clyomys laticeps activity was bimodal, with 2 peaks around dawn and dusk, resembling a crepuscular pattern. Temporal segregation in male and female activity patterns was restricted to the dry season, when female activity was more diurnal than males who were mainly nocturnal. Intersexual competition for resources or male-avoidance behavior by females during the dry food scarcity season could contribute to this pattern, although it may also be explained by gender-related differences in thermal tolerances. Overall, males were active for longer periods than females, probably as a strategy to increase mating opportunities among the former and site fidelity in the latter. Finally, temperature imposed major constraints on C. laticeps activities who preferred milder temperatures and avoided being active in temperatures above their thermoneutral zone.
Neighborhood vulnerability and associations with poor health-related quality of life among adult survivors of childhood cancer
Authors: Choi Jaesung , Horan Madeline R , Brinkman Tara M , Srivastava D Kumar , Ness Kirsten K , Armstrong Gregory T , Hudson Melissa M , Huang I-Chan
Published: September 2024

Background

Few studies have investigated the relationship between neighborhood vulnerability and health-related quality of life (HRQOL) in the childhood cancer population. This study evaluated the impact of neighborhood vulnerability on HRQOL among adult survivors of childhood cancer.

Methods

This cross-sectional study included 4393 adult survivors of childhood cancer from the St Jude Lifetime Cohort Study. At the baseline (2007-2020), HRQOL was assessed using the SF36v2’s physical and mental components summaries (PCS and MCS). Neighborhood vulnerability was assessed using the overall, domain, and indicator-specific scores of the Social Vulnerability Index (SVI) and Minority Health SVI (MHSVI). Multivariable logistic regression was used to evaluate associations of neighborhood vulnerability (quartiles: Q1–Q4) with impaired HRQOL (1SD below the norm), adjusting for diagnosis, demographics, personal socioeconomic status (SES), lifestyle, and chronic health condition burden. Interactions of SVI and MHSVI with personal SES on impaired HRQOL were analyzed.

Results

Among survivors, 51.9% were male, averaging 30.3 years of age at evaluation and 21.5 years since diagnosis. Comparing neighborhoods with higher vs lower vulnerability (Q4 vs Q1), overall (odds ratio [OR] = 1.60, 95% confidence interval [CI] = 1.19 to 2.16) and domain-specific vulnerability (socioeconomic: OR = 1.59, 95% CI = 1.18 to 2.15; household composition: OR = 1.54, 95% CI = 1.16 to 2.06; housing and transportation: OR = 1.33, 95% CI = 1.00 to 1.76; medical vulnerability: OR = 1.60, 95% CI = 1.22 to 2.09) were significantly associated with impaired PCS, but not MCS. Residing in neighborhoods lacking urgent care clinics was significantly associated with impaired PCS (OR = 1.39, 95% CI = 1.08 to 1.78). Having lower vs higher personal education and living in higher vulnerability neighborhoods were associated with more impaired PCS (Pinteraction = .021).

Conclusions

Specific aspects of neighborhood vulnerability increase the risk for impaired physical HRQOL. Addressing these neighborhood factors is essential to enhance the HRQOL of survivors.
Renoprotective effect of liraglutide on diabetic nephropathy by modulation of Krüppel-like transcription factor 5 expression in rats
Authors: Bin Dayel Anfal F , Alrasheed Nouf M , Alonazi Asma S , Alamin Maha A , Al-Mutairi Nawal M , Alateeq Raghad A
Published: September 2024

Objectives

Diabetic nephropathy (DN) is a serious consequence of diabetes that can develop through the lysophosphatidic acid axis. The purpose of this study was to determine whether the antidiabetic drug liraglutide can slow the development of diabetic kidney damage by altering the lysophosphatidic acid axis via KLF5.

Methods

Wistar albino rats were divided into nondiabetic and diabetic rats (resulting from an intraperitoneal streptozotocin dose of 30 mg/kg and a high-fat diet). These rats were further divided into four groups: nondiabetic control, liraglutide-treated nondiabetic, diabetic control, and liraglutide-treated diabetic. The nondiabetic and diabetic control groups received normal saline for 42 days, while the liraglutide-treated nondiabetic and diabetic groups received normal saline for 21 days, followed by a subcutaneous dose of liraglutide (200 μg/kg/day) for 21 days. Subsequently, serum levels of DN biomarkers were evaluated, and kidney tissues were histologically examined. The protein expression of PCNA, autotaxin, and KLF5 was detected.

Key findings

Liraglutide treatment in diabetic rats decreased DN biomarkers, histological abnormalities in kidney tissues, and the protein expression of PCNA, autotaxin, and KLF5.

Conclusion

Liraglutide can slow the progression of DN by modulating KLF5-related lysophosphatidic acid axis. Thus, liraglutide may be an effective treatment for preventing or mitigating diabetes-related kidney damage.
Regulation of a novel circATP8B4/miR-31-5p/nestin ceRNA crosstalk in proliferation, motility, invasion and radiosensitivity of human glioma cells
Authors: Luo Dongdong , Luo Aiping , Ye Ganwei , Li Dan , Hu Su , Zhao Hailin , Peng Biao
Published: September 2024

Deregulation of circular RNAs (circRNAs) is frequent in human glioma. Although circRNA ATPase phospholipid transporting 8B4 (circATP8B4) is highly expressed in glioma, its precise action in glioma development is still not fully understood. The relationship of microRNA (miR)-31-5p and circATP8B4 or nestin (NES) was predicted by bioinformatic analysis and confirmed by RNA pull-down and Dual-luciferase reporter assays. CircATP8B4, miR-31-5p and NES were quantified by qRT-PCR or western blot. Cell functional behaviors were assessed by EdU, wound-healing and transwell invasion assays. Xenograft model experiments were performed to define circATP8B4’s activity in vivo. CircATP8B4, a true circular transcript, was upregulated in human glioma. CircATP8B4 downregulation weakened glioma cell growth, motility, and invasion and facilitated radiosensitivity. Mechanistically, circATP8B4 and NES 3′UTR harbored a shared miR-31-5p pairing site, and circATP8B4 involved the post-transcriptional NES regulation by functioning as a competing endogenous RNA (ceRNA). Furthermore, the miR-31-5p/NES axis participated in circATP8B4’s activity in glioma cell proliferation, motility, invasion and radiosensitivity. Additionally, circATP8B4 loss diminished tumor growth and enhanced the anticancer effect of radiotherapy in vivo. We have uncovered an uncharacterized ceRNA cascade, circATP8B4/miR-31-5p/NES axis, underlying glioma development and radiosensitivity. Targeting the ceRNA crosstalk may have potential to improve the outcome of glioma patients.
A deep learning-based method enables the automatic and accurate assembly of chromosome-level genomes
Authors: Jiang Zijie , Peng Zhixiang , Wei Zhaoyuan , Sun Jiahe , Luo Yongjiang , Bie Lingzi , Zhang Guoqing , Wang Yi
Published: September 2024

The application of high-throughput chromosome conformation capture (Hi-C) technology enables the construction of chromosome-level assemblies. However, the correction of errors and the anchoring of sequences to chromosomes in the assembly remain significant challenges. In this study, we developed a deep learning-based method, AutoHiC, to address the challenges in chromosome-level genome assembly by enhancing contiguity and accuracy. Conventional Hi-C-aided scaffolding often requires manual refinement, but AutoHiC instead utilizes Hi-C data for automated workflows and iterative error correction. When trained on data from 300+ species, AutoHiC demonstrated a robust average error detection accuracy exceeding 90%. The benchmarking results confirmed its significant impact on genome contiguity and error correction. The innovative approach and comprehensive results of AutoHiC constitute a breakthrough in automated error detection, promising more accurate genome assemblies for advancing genomics research.
G-quadruplexes in an SVA retrotransposon cause aberrant TAF1 gene expression in X-linked dystonia parkinsonism
Authors: Nicoletto Giulia , Terreri Marianna , Maurizio Ilaria , Ruggiero Emanuela , Cernilogar Filippo M , Vaine Christine A , Cottini Maria Vittoria , Shcherbakova Irina , Penney Ellen B , Gallina Irene , Monchaud David , Bragg D Cristopher , Schotta Gunnar , Richter Sara N
Published: September 2024

G-quadruplexes (G4s) are non-canonical nucleic acid structures that form in guanine (G)-rich genomic regions. X-linked dystonia parkinsonism (XDP) is an inherited neurodegenerative disease in which a SINE–VNTR–Alu (SVA) retrotransposon, characterised by amplification of a G-rich repeat, is inserted into the coding sequence of TAF1, a key partner of RNA polymerase II. XDP SVA alters TAF1 expression, but the cause of this outcome in XDP remains unknown. To assess whether G4s form in XDP SVA and affect TAF1 expression, we first characterised bioinformatically predicted XDP SVA G4s in vitro. We next showed that highly stable G4s can form and stop polymerase amplification at the SVA region from patient-derived fibroblasts and neural progenitor cells. Using chromatin immunoprecipitazion (ChIP) with an anti-G4 antibody coupled to sequencing or quantitative PCR, we showed that XDP SVA G4s are folded even when embedded in a chromatin context in patient-derived cells. Using the G4 ligands BRACO-19 and quarfloxin and total RNA-sequencing analysis, we showed that stabilisation of the XDP SVA G4s reduces TAF1 transcripts downstream and around the SVA, and increases upstream transcripts, while destabilisation using the G4 unfolder PhpC increases TAF1 transcripts. Our data indicate that G4 formation in the XDP SVA is a major cause of aberrant TAF1 expression, opening the way for the development of strategies to unfold G4s and potentially target the disease.
National politics ignites more talk of morality and power than local politics
Authors: Dillion Danica , Puryear Curtis , Li Longjiao , Chiquito Andre , Gray Kurt
Published: September 2024

Politics and the media in the United States are increasingly nationalized, and this changes how we talk about politics. Instead of reading the local news and discussing local events, people are more often consuming national media and discussing national issues. Unlike local politics, which can rely on shared concrete knowledge about the region, national politics must coordinate large groups of people with little in common. To provide this coordination, we find that national-level political discussions rely upon different themes than local-level discussions, using more abstract, moralized, and power-centric language. The higher prevalence of abstract, moralized, and power-centric language in national vs. local politics was found in political speeches, politician Tweets, and Reddit discussions. These national-level linguistic features lead to broader engagement with political messages, but they also foster more anger and negativity. These findings suggest that the nationalization of politics and the media may contribute to rising partisan animosity.
Cultural bias and cultural alignment of large language models
Authors: Tao Yan , Viberg Olga , Baker Ryan S , Kizilcec René F
Published: September 2024

Culture fundamentally shapes people’s reasoning, behavior, and communication. As people increasingly use generative artificial intelligence (AI) to expedite and automate personal and professional tasks, cultural values embedded in AI models may bias people’s authentic expression and contribute to the dominance of certain cultures. We conduct a disaggregated evaluation of cultural bias for five widely used large language models (OpenAI’s GPT-4o/4-turbo/4/3.5-turbo/3) by comparing the models’ responses to nationally representative survey data. All models exhibit cultural values resembling English-speaking and Protestant European countries. We test cultural prompting as a control strategy to increase cultural alignment for each country/territory. For later models (GPT-4, 4-turbo, 4o), this improves the cultural alignment of the models’ output for 71–81% of countries and territories. We suggest using cultural prompting and ongoing evaluation to reduce cultural bias in the output of generative AI.
Sowing the Seeds of Financial Crises: Endogenous Asset Creation and Adverse Selection
Authors: Caramp Nicolas
Published: September 2024

What sows the seeds of financial crises, and what policies can help avoid them? I model the interaction between the ex-ante production of assets and ex-post adverse selection in financial markets. Positive shocks that increase market prices exacerbate the production of low-quality assets and can increase the likelihood of a financial market collapse. The interest rate and the liquidity premium are endogenous and depend on the functioning of financial markets as well as the total supply of assets (private and public). Optimal policy balances the economy’s liquidity needs ex-post with the production incentives ex-ante, and it can be implemented with three instruments: government bonds, asset purchase programs, and transaction taxes. Public liquidity improves incentives but implies a higher deadweight loss than private market interventions. Optimal policy does not rule out private market collapses but mitigates the fluctuations in total liquidity.
Large orders in small markets: execution with endogenous liquidity supply
Authors: Capponi Agostino , J. Menkveld Albert , Zhang Hongzhong
Published: September 2024

We model the execution of a large uninformed sell order in the presence of strategic competitive market makers. We solve for the unique symmetric equilibrium of the model in closed form. Analysis of this equilibrium reveals that large orders unequivocally benefit market makers, while smaller investors stand to benefit only if the order trades with a sufficiently high intensity. The equilibrium results further provide a rationale for the empirically observed patterns of (1) shorter orders trading at higher intensities and (2) price pressures potentially subsiding before large orders stop executing.
Technology for advancing behavioral health integration: implications for behavioral health practice and policy
Authors: Simoun Alya , Fleet Alexa , Scharf Deborah , Pope Leah , Spaeth-Rublee Brigitta , Goldman Matthew L , Pincus Harold Alan
Published: September 2024

Behavioral health integration (BHI) encompasses the integration of general health, mental health, and substance use care. BHI has promise for healthcare improvement, yet several challenges limit its uptake and successful implementation. Translational Behavioral Medicine published the Continuum-Based Framework by Goldman et al., 2020 to create comprehensive guidance for BHI within primary care settings. Technology can help advance BHI and provide evidence to support it. This commentary describes challenges and illustrative use cases in which technology solutions help organizations achieve BHI through the Continuum-Based Framework domains. Two rounds of semi-structured interviews with field leaders, practice sites, and technology stakeholders identified key barriers in BHI amenable to technology solutions, applications of technologies, and how they facilitate BHI. Findings showed that technology can facilitate the implementation and scaling of BHI by reducing care fragmentation and improving patient engagement, accountability and financial sustainability, provider experience and support, and equitable access to culturally competent care. Continued efforts by stakeholders to address legacy policy and implementation issues (e.g. incentives, investment, privacy, and workforce) are needed to optimize the impact of technology on BHI.
The Use of Nitinol Staples as Reduction Aids in Fixation of Forearm Diaphyseal Fractures: Surgical Technique and Case Series
Authors: Song Ethan Y. , Emovon Emmanuel O. , Hollins Andrew W. , Saltzman Eliana B. , Mithani Suhail K. , Richard Marc J. , Pidgeon Tyler S.
Published: September 2024

Forearm diaphyseal fractures are common orthopedic injuries that typically require surgical intervention using various implants and approaches. Maintaining reduction while simultaneously achieving compression in radial and/or ulnar shaft fractures during compression plate application can be challenging, particularly with unstable segmental and/or transverse fracture patterns. Nitinol compression staples have become increasingly used as a reduction aid because of their ability to provide continuous compression between the staple legs at the fracture site, low profile, and ease of application. These staples have the potential to be an effective means of maintaining reduction and applying compression before definitive plate fixation for radial and ulnar shaft fractures. We present our surgical technique and an associated patient series detailing our institution’s experience, highlighting favorable outcomes and potential considerations when using nitinol compression staples for forearm fracture management.
Histopathologic Overlap Between Bullous Lupus Erythematosus and Linear IgA Bullous Dermatosis: A Comparative Study
Authors: Murugesu Lavanya , Tirumalae Rajalakshmi
Published: September 2024

Bullous lupus erythematosus (BLE) and linear IgA disease (LAD) are rare autoimmune subepidermal blistering diseases, with overlapping features despite different pathogenetic mechanisms. Diagnosis is based on immunofluorescence and serology. This retrospective study was undertaken to compare the histopathologic features of BLE and LAD (11 cases each). The mean age was 36 years in both groups, and female preponderance was noted in BLE. Clinically, all cases presented as tense, itchy blisters distributed over the trunk, face, and extremities. Subepidermal neutrophil-rich blisters were seen in 60% BLE and 54.54% LAD cases. Eosinophils in the blisters were noted in 4 cases (36.4%) of linear IgA bullous dermatosis, but not in any of the BLE cases. The adjacent epidermal changes noted include spongiosis (33%; 40%), papillary microabscesses (22%; 20%), and basal tagging by neutrophils (77%; 70%). Superficial perivascular inflammation was seen in all cases while deep perivascular inflammation was observed in 54% BLE and 36% LAD cases. Lymphocytes were the predominant infiltrate. Increased dermal mucin was seen in 60% BLE and 45% LAD cases. None of the histopathologic features showed a statistically significant difference between the 2 groups. Hence, histopathology alone is of limited value in distinguishing the 2 groups. Diagnosis rests on immunofluorescence and serologic findings, which should be used even in cases that seem to be classic LAD or patients without history of systemic lupus erythematosus.
A Combined Spindle Cell Melanoma and Sarcomatoid Squamous Cell Carcinoma: A Rather Unique Squamomelanocytic Tumor
Authors: Daruish Maged , Kerr Graeme , Taibjee Saleem
Published: September 2024

Squamomelanocytic tumor is a poorly defined term that indicates co-occurrence of malignant melanoma and squamous cell carcinoma within the same lesion. We present an unusual case of squamomelanocytic tumor in which both intermingling components showed predominantly spindle cell morphology and were confirmed with double staining for SOX-10 and AE1/AE3.
Increased levels of urine volatile organic compounds are associated with hypertension risk
Authors: Zheng Xialei , Zou Pu , Zeng Cheng , Liu Jing , He Yuhu
Published: September 2024

Background:

Individuals are exposed to various volatile organic compounds (VOCs) in their surroundings. VOCs were associated with some cardiovascular and metabolic diseases, but the effects on blood pressure (BP) have not yet been clarified. This study aimed to ascertain the relationship between the urine levels of VOCs and the prevalence of hypertension (HTN) in the general population.

Methods:

This analysis utilized data from 4156 participants aged from 20 to 79 years in 2013–2018 National Health and Nutrition Examination Survey (NHANES). Exposure to VOCs was assessed through measurements of urinary VOC metabolites, with 16 VOCs selected for analysis. The relationships between VOCs and the risk of HTN in patients were examined through the weighted logistic regression and the weighted linear regression models. Generalized additive models were employed to analyze potential nonlinear associations between VOCs and the risk of HTN. Additionally, subgroup analyses and intergroup interaction tests were conducted.

Results:

A total of 4156 participants with 16 VOCs were finally included for analysis. Multivariable logistic regression showed that ln-transformed urine levels of N-acetyl-S-(2-cyanoethyl)-L-cysteine (CYMA) [odds ratio (OR) 1.54; 95% confidence interval (CI) 1.18–2.02], N-acetyl-S-(3-hydroxypropyl)-L-cysteine (3HPMA; OR 1.33; 95% CI 1.03–1.74), N-acetyl-S-(4-hydroxy-2-butenyl)-L-cysteine (MHBMA3; OR 1.68; 95% CI 1.29–2.20), and N-acetyl-S-(1-phenyl-2-hydroxyethyl)-L-cysteine + N-acetyl-S-(2-phenyl-2-hydroxyethyl)-L-cysteine (PHEMA; OR 1.55; 95% CI 1.19–2.00) were significantly associated with an increased risk of HTN in US general population. A nonlinear relationship and a threshold effect were only observed between ln (N-acetyl-S-(2-hydroxypropyl)-L-cysteine or 2HPMA) and HTN. There was a significantly positive correlation between ln(2HPMA) and HTN when ln(2HPMA) at least 5.29. Sub-analysis revealed that there was a more pronounced association in the elderly group (age ≥60 years), the overweight group (BMI ≥25), and the alcohol consumption group.

Conclusion:

Our work presents novel epidemiological evidence supporting the establishment of the relationship between environmental pollutants and HTN, highlighting hitherto ignored positive correlations between nonoccupational VOC exposure and the entire population's risk of HTN.
The Interplay Between Schistosomiasis and Hepatitis C Virus: Battling on Two Fronts
Authors: Makhlouf Nahed A , Abu-Elfatth Ahmed , Khaled Tasneem , El-Kassas Mohamed
Published: September 2024

Schistosomiasis is a prevalent health issue in numerous countries in Africa, Asia, and South America. Data regarding the coinfection of schistosomiasis with hepatitis C virus (HCV) is limited, yet this coinfection is prevalent in regions where schistosomiasis is endemic. The extent of the coinfection issue is evident in countries with a high prevalence of both diseases, such as Egypt. Coinfections with schistosomiasis result in more pronounced liver damage compared with an HCV infection alone. Schistosomiasis has been found to disrupt HCV-specific T-cell responses, resulting in high viral load, increased likelihood of HCV chronicity, and accelerated development of comorbidities in individuals with coinfection. Introducing new, directly acting antivirals for HCV treatment resulted in a marked shift in the disease landscape. This shift may have an impact on the incidence of coinfection with schistosomiasis. This review emphasizes the notable influence of schistosomiasis on the vulnerability to HCV coinfection, the gravity of the consequent liver pathology, and the effectiveness of HCV antiviral therapy.
Design of Prototype Phantom to Measure Quality Control for Conventional X-ray Machine Using Quantitative Image Parameters
Authors: Abdallah Nedal Abdalaal , Gar-Elnabim Mohamed Elfadil Mohamed , Esmeal Mohamed Yagoub
Published: September 2024

A variety of phantoms that measure image quality parameters are commercially expensive and often complicated to use as they measure only one parameter of a particular x-ray machine, which leads to the difficulty of measuring the quality of x-ray image and thus increase the risk of radiation to the patient and society. The main objective of this study was to design a prototype phantom to measure quality control for conventional x-ray machine using quantitative image parameters. In this study, 5 conventional x-ray machines were investigated using wire phantom designed by the researcher, which consisted of variable thicknesses used to test variable exposure factors. This study introduced a more reliable method of measuring the resolution, which is modulation transfer function, which gives a complete description of the resolution instead of using full width at half maximum or the visibility method, which is more qualitative where modulation transfer function is a real quantitative method, by designing a prototype phantom that consisted of 5 wires with different thicknesses and kVp for 5 x-ray units and assessing the diagnostic x-ray machine resolution by the optimum kV found relative to machine type. This study showed that the one with the best machine resolution was Shimadzu (2011) for Khartoum Emergency Hospital, which had a high resolution of 97% at 46 kV for thickness of 1.4 mm compared with Toshiba 2011 for Almotkamil Hospital, which had 92% at 46 kVp. Also, the result showed that for the 2 types of x-ray machines the x-ray tubes do not produce the same exposure, and the output decreased with age of the x-ray unit; also, the resolution reduced when the thickness of the wires decreased.
Optimizing EHR Data
Authors: Adapala Vijay
Published: September 2024

Electronic health records (EHRs) contribute to quality-of-care delivery directly. With a comprehensive and effective use of EHR data, healthcare providers can create precise, personalized treatment plans and seamlessly communicate across departments. By optimizing the data in a health system, clinical engineers can improve these processes and, subsequently, patient flow. This article combines case studies and existing research to explore the challenges and opportunities in current EHR data systems, how evolving artificial intelligence tools can be used to improve data utilization, and the importance of interoperability.
Assessment of Conventional X-ray Machine Resolution, Using Designed Phantom
Authors: Abdalaal Abdallhah Nedal , Gar-elnabi Mohamed Elfadil Mohamed , Esmeal Mohamed Yagoub
Published: September 2024

The diagnostics x-ray machine produces electromagnetic radiation used to image the body in case of pathology; therefore, this exposure was justified. But if the exposure parameters were not chosen satisfactorily, imaging has to be repeated where the patient was subjected to a substantial amount of radiation. To determine the spatial resolution in order to find the optimum kV relative to machine type, the phantom is placed on the detector surface, and a uniform source of radiation is placed above the bar phantom, where the focus-to-film distance was 1 m. An image is acquired; the unit was set at 2 mAs and 40 kVp value. In this study, 3 conventional x-ray machines were investigated using point phantom designed by the researcher, which consisted of a variable diameter used to test variable exposure factors. The results showed that the best machine resolution was Toshiba model E7239X (2016) for Modern Medical Center that had a high resolution of 96% at 45 kV for a point of thickness of 1.4 mm.
Digital Certificate Management for Medical Devices
Authors: Molesky Monroe J. , Block Frank E. , Brown Cedric
Published: September 2024

As the healthcare environment becomes increasingly digitally connected and cyber threats to healthcare technologies evolve, cybersecurity controls are necessary to ensure the safety and effectiveness of medical devices. Digital certificates are one such security control commonly utilized to secure various technologies and systems including medical devices. However, few academic resources describe the use of digital certificates in the unique context of medical devices. Additionally, digital certificate issues have the potential to impact the safety and effectiveness of medical devices and to negatively hinder the delivery of patient care. This article provides an introduction on the role of digital certificates to secure and manage access to medical devices, including potential issues and digital certificate management considerations.
Questionnaire and polysomnographic evaluation of obstructive sleep apnea in a cohort of post-COVID-19 patients
Authors: Chibante Fernanda Oliveira , Faria Anamélia Costa , Ribeiro-Alves Marcelo , Costa Claudia Henrique da , Lopes Agnaldo José , Mafort Thiago Thomaz , Rufino Rogerio
Published: September 2024

To evaluate the efficiency of 5 screening questionnaires for obstructive sleep apnea (OSA), OSA frequency, and the association between OSA and COVID-19 severity in recent COVID-19 cases, and to compare the use of the oxygen desaturation index (ODI) as an alternative measure for the respiratory disturbance index (RDI). This open cohort study recruited patients with recent COVID-19 (within 30–180 days) diagnosed using reverse transcription polymerase chain reaction. Participants were screened for OSA using the following 5 sleep disorder questionnaires prior to undergoing type I polysomnography: the Sleep Apnea Clinical Score (SACS), Epworth Sleepiness Scale (ESS), STOP-Bang score, No-Apnea score, and Berlin questionnaire. Polysomnography revealed that 77.5% of the participants had OSA and that these patients exhibited higher COVID-19-related hospitalization (58%) than those exhibited by non-apneic patients. The Kappa coefficient showed reasonable agreement between RDI > 5/h and No-Apnea score, RDI > 15/h and Berlin questionnaire score, and Epworth Sleepiness Scale and STOP-Bang score, but only moderate agreement between RDI > 15/h and No-Apnea score. An OSA-positive No-Apnea score increased the specificity of the SACS to 100% when RDI > 5/h. The intraclass correlation coefficient showed 95.2% agreement between RDI > 5/h and ODI > 10/h. The sequential application of the No-Apnea score and SACS was the most efficient screening method for OSA, which had a moderately high incidence among the post-COVID-19 group. We demonstrated an association between OSA and COVID-19 related hospitalization and that ODI could be a simple method with good performance for diagnosing OSA in this population.
CICARE communication model and hierarchical responsibility nursing coordination in the application research of elderly patients with chronic heart failure
Authors: Zhao Yuhuan , Pang Mi , Xu Yuanle
Published: September 2024

The aim of this study was to evaluate the efficacy of implementing the CICARE communication model and hierarchical responsibility nursing coordination in managing chronic heart failure among elderly patients. From June 2021 to June 2023, 120 elderly patients diagnosed with chronic heart failure were admitted to our hospital. They were divided into 2 groups according to different treatment methods: the regular group and the observation group. Both groups of patients received nursing interventions for 3 months. Before and after the intervention, we assessed the levels of cardiac function indicators (left ventricular end-diastolic diameter, left ventricular ejection fraction, and B-type natriuretic peptide levels) and exercise tolerance (6-minute walk test) in both groups of patients. The time to clinical symptom relief, self-efficacy, and quality of life scores were compared between the 2 groups of patients. Before the intervention, there were no significant differences in cardiac function indicators between the 2 groups (P > .05). However, after the intervention, both groups exhibited improvements in left ventricular end-diastolic diameter and B-type natriuretic peptide levels, with the observation group demonstrating greater reductions compared to the control group. Furthermore, both groups showed increased left ventricular ejection fraction levels, with the observation group experiencing a significantly higher improvement. Although exercise tolerance did not differ significantly between the groups before the intervention, post-intervention analysis revealed a greater increase in 6-minute walk test distance in the observation group compared to the control group (P < .05). The time to relief of breathlessness and edema did not significantly differ between the groups (P > .05). Similarly, there were no significant differences in self-efficacy and quality of life scores between the groups before the intervention (P > .05); however, post-intervention analysis showed higher self-efficacy scores in the observation group. Application of the CICARE communication model and hierarchical responsibility nursing coordination in elderly patients with chronic heart failure can effectively improve the patients’ cardiac function levels and significantly enhance their exercise tolerance, self-efficacy, and quality of life.
Causal relationship between educational attainment and chronic pain: A Mendelian randomization study
Authors: Liu Shuning , Xu Debin
Published: September 2024

Educational attainment (EA) is often used as a symbol of socioeconomic status and is associated with several diseases. However, uncertainty remains regarding the potential relationship between EA and chronic pain. This study aimed to evaluate the potential causal association between EA and chronic pain. The primary method employed in Mendelian randomization (MR) analysis was inverse-variance weighted method. Additionally, MR-Egger intercept, Cochran Q, and MR-PRESSO statistical analyses were conducted to assess potential pleiotropy and heterogeneity. The MR analysis provided evidence that genetically predicted additional education significantly reduced the risk of chronic pain. Specifically, this genetic factor may reduce multisite chronic pain by 27.6%, and chronic widespread pain by 3.8%. The results of sensitivity analysis indicated the reliability of our causal estimates. Higher levels of EA may provide protection against chronic pain risk. Enhancing education, narrowing social and economic disparities may help alleviate the burden of chronic pain.
Transforming healthcare performance monitoring – A cutting-edge approach with generalized additive profiles: GAMs for healthcare quality monitoring
Authors: Waqas Muhammad , Xu Song Hua , Aslam Muhammad Usman , Hussain Sajid , Masengo Gilbert
Published: September 2024

Recent findings indicate a growing trend in data analysis within healthcare using statistical process control. However, the diversity of variables involved necessitates the expansion of new process control methodologies. This study examined control chart applications in cardiology by using generalized additive models (GAMs) to construct profiles while involving multiple healthcare variables (08). Two distinct statistics: deviation (D), and Hotelling (T
2) were employed for constructing control charts: a commonly used single-variable statistic for nonparametric profiles and an innovative multivariate statistic that assesses the contribution of each element to process changes. These statistics were tested for monitoring ischemic and hemorrhagic strokes in 1-year acute stroke (369) patients at the Faisalabad Institute of Cardiology. Demographic parameters (age, gender), vascular risk factors (diabetes, family history, sleep), socioeconomic variables (smoking, location), and blood pressure are included in the model. The research includes the computation of zero-state average run length (ARL) for assessing the performance of control charts. The characteristics of the proposed profile were analyzed, such as the T
2 control chart, performing better than the D chart for medium-to-large shifts (δ ≥ 0.50). On the other hand, for small δ = 0.25, the D control chart produces smaller ARL values but more significant standard deviations. While both statistics contribute to profile monitoring, T
2 is more effective at identifying and tracing medium and large shifts. In conclusion, such handy tools may aid healthcare performance monitoring, especially for complicated predictor–response relationships. Monitored profiles demonstrated that GAMs are useful for healthcare analysis and process monitoring.
Partial agenesis of the pectoralis major and minor muscle: A cadaveric case report
Authors: Bruna-Mejía Alejandro , Orellana-Donoso Mathias , Nova-Baeza Pablo , Suazo Santibañez Alejandra , Oyanedel-Amaro Gustavo , Valenzuela-Fuenzalida Juan José
Published: September 2024

Rationale:

The pectoralis major and minor muscles, located in the anterior chest wall, are crucial for upper limb movements.

Patient concerns:

Their nonsyndromic absence is rare but significant for surgical procedures involving the axillary and pectoral regions.

Diagnoses:

Ultrasound can confirm the diagnosis and delimit the extent of the muscular abnormality, detect abnormalities of the costal cartilages, among others.

Interventions:

This descriptive, cadaveric case report involves a formalin-fixed 57-year-old North American male, with no clinical or family history of similar conditions. The study was conducted at the Human Anatomy Laboratory of the School of Medicine of the Universidad Finis Terrae in Santiago, Chile, in August 2022.

Outcomes:

We present a cadaveric case of bilateral partial agenesis of the pectoralis muscles discovered during routine dissection. The pectoralis major muscle exhibited only the clavicular portion, with the sternocostal and abdominal portions absent and replaced by a thin layer of connective tissue bilaterally. The pectoralis minor muscle showed partial muscle fibers only in the most distal and inferior portions bilaterally.

Lessons:

This case report is significant due to the rarity of this condition without accompanying anatomical variations. Understanding this variant is valuable for clinical situations involving the shoulder and thorax region, such as trauma to the proximal third of the humerus, clavicular region, suprascapular region, and anterior chest wall. It may complicate conservative and/or surgical treatments due to different functional and irrigation patterns in the area and is also important for educating future professionals.