bluuebunny/crossref_metadata_2025 huggingface dataset:
Small Area Poverty Estimation Under Heteroskedasticity
Authors: Das Sumonkanti , Chambers Ray
Published: January 2024

Multilevel models with nested errors are widely used in poverty estimation. An important application in this context is estimating the distribution of poverty as defined by the distribution of income within a set of domains that cover the population of interest. Since unit-level values of income are usually heteroskedastic, the standard homoskedasticity assumptions implicit in popular multilevel models may not be appropriate and can lead to bias, particularly when used to estimate domain-specific income distributions. This article addresses this problem when the income values in the population of interest can be characterized by a two-level mixed linear model with independent and identically distributed domain effects and with independent but not identically distributed individual effects. Estimation of poverty indicators that are functionals of domain-level income distributions is also addressed, and a nonparametric bootstrap procedure is used to estimate mean squared errors and confidence intervals. The proposed methodology is compared with the well-known World Bank poverty mapping methodology for this situation, using model-based simulation experiments as well as an empirical study based on Bangladesh poverty data.
WHO Strategic Advisory Group of Experts on Immunization recommendations for use of a novel pentavalent meningococcal ACWXY vaccine: a critical step towards ending meningococcal epidemics in Africa
Authors: McNamara Lucy A , Neatherlin John
Published: January 2024

A new pentavalent meningococcal ACWXY vaccine is poised to have a dramatic impact on the burden of meningococcal disease in the meningitis belt of Africa. Implementation of this vaccine is a critical step towards the first visionary goal of WHO's roadmap to defeat meningitis by 2030: eliminating bacterial meningitis epidemics.
Rationale for Japanese encephalitis vaccination in short-term travellers to endemic areas
Authors: Charoensakulchai Sakarn , Singhasenee Pattaratida , Matsee Wasin , Caumes Eric , Pisutsan Phimphan
Published: January 2024

Although the Japanese encephalitis (JE) vaccine is typically strongly recommended for long-term high-risk travellers, some cases of JE infections have been reported amongst short-term travellers with seemingly low risk. This article underscores the advantages and reasoning behind JE vaccination for this particular group of travellers.
Measles, mumps, rubella and varicella antibodies among international and domestic university students
Authors: Dyda Amalie , Broome Audrey , Rawlinson William , Mahimbo Abela , Saha Amit , Kefalas Bill , Seale Holly , Macintyre C Raina , Zwar Nicholas , Gidding Heather F , Heywood Anita E
Published: January 2024

Background

Vaccine-preventable infections are generally well controlled in Australia. However, gaps in immunity can lead to outbreaks and are important to identify. Young adults are a highly mobile population and a potential source of imported infections. We aimed to evaluate anti- measles, mumps, rubella and varicella (MMR&V) IgG seroprevalence and explore factors relating to antibody seropositivity.

Methods

A cross-sectional online survey was conducted among students from a large Australian university to collect demographic, vaccination, infection and travel characteristics. Blood samples were collected to measure MMR&V seroprevalence. Logistic regression was used to identify factors associated with seropositivity.

Results

Among 804 university students, seroprevalence (positive or equivocal) for measles was 82.3% (95% CI 79.6–84.8%), mumps 79.5% (95% CI 76.7–82.3%), rubella 91.5% (95% CI 89.6–93.5%) and varicella 86.2% (95% CI 84.1–88.8%), with 452 (56.2%, 95% CI 52.8–59.6) seropositive to all four viruses. Varicella seropositivity was highest in the older birth cohort (born 1988–1991). Measles seropositivity was higher for international students compared to domestic students. Among international students, mumps seroprevalence was significantly lower than measles and rubella seroprevalence. International travel in the previous 12 months was reported by 63.1% of students, but only 18.2% of travellers reported seeking pre-travel health advice prior to most recent international travel.

Conclusions

Overall, this study suggests immunity to MMR&V is sub-optimal. We found the university student population to be highly mobile and unlikely to seek pre-travel advice; thus, they are a potential source of infection importation. The implementation of university immunization policies could address the gaps identified and our findings can inform the development of targeted vaccination campaigns.
Physical Fitness Tests in the Army—Legitimate Diversity or Randomness?
Authors: Tomczak Andrzej
Published: January 2024

In this article, I present my views on the diversified approaches to assess the physical fitness of soldiers within selected armies worldwide. I discussed the related common features and paradoxes associated with these approaches. For the comparative analysis, national diversity was taken into account and subjective selection of the physical fitness tests conducted in the armies of the United States, Finland, Germany, India, China, Israel, Netherlands, Sweden, Switzerland, United Kingdom, and Poland was done. An analysis of the physical fitness tests reveals significant variations, despite the purpose of the assessment being the same, that is, to evaluate a soldier’s physical preparedness for combat tasks. Based on the analysis, I categorize the variation in physical fitness tests of soldiers at four levels: (1) single-system function tests (e.g., push-ups, sit-ups) vs. multi-system tests (obstacle courses), (2) considering health aspects vs. not considering health aspects during physical fitness tests, (3) motor components vs. coordination components (e.g.,balance), and (4) tests differentiated by gender and age vs.tests not differentiated by gender and age. In conclusion, I am in favor of multi-system tests, comprised of obstacle courses mirroring potential situations in combat tasks. In my opinion, multi-system tests are superior compared to single-system function tests since they enable a comprehensive assessment of effort, coordination, and mental predispositions necessary for functioning in real-life conditions. I also support physical fitness evaluation that is not differentiated based on a soldier’s gender and age, as there is no logical justification for such distinctions.
The Knowledge Condition on Intentional Action in Its Proper Home
Authors: Makin Laura Tomlinson
Published: January 2024

In this paper, I argue against recent modifications of the Knowledge Condition on intentional action that weaken the condition. My contention is that the condition is best understood in the context of Anscombe’s Intention and, when so understood, can be maintained in its strongest form.
General theory of radiative transfer in a magnetized atmosphere with scattering by electrons
Authors: Silant’ev N A , Alekseeva G A , Ananjevskaja Yu K
Published: January 2024

Here, we consider the general radiative transfer theory in a magnetized atmosphere for any value of parameter $x=\omega _B/\omega \simeq 0.933\times 10^{-8}\lambda (\mu \mathrm{m}) B(\text{G})$, where ωB is the cyclotron frequency of electron rotation and ω is the angular frequency of considered monochromatic radiation. The main term of the radiative transfer equations $\textbf {J}_{\alpha \beta }$ for the Stokes parameters I, V, U, and Q describes the scattering of radiation coming from all directions and distances. All Stokes parameters of the incident radiation mutually transform into each other along their path due to interference and different cross-sections for them. To find this transformation of the Stokes parameters one has to solve the complex system of transfer equations without the sources and term $\textbf {J}_{\alpha \beta }$. This is done in our paper. First, we present the general solution and then give the solution for the case of a homogeneous magnetic field, where the formulas have clear algebraic form. We note that for small parameter x our formulas describe the known Faraday rotation. Our formulas allow us to derive an integral equation for the density of polarized radiation, multiple scattered in a magnetized atmosphere for any values of the parameter x. The obtained correct radiation transfer equation allows us to calculate the Stokes parameters of radiation emerging from an atmosphere, in particular, for the Milne problem.
Risk of Hepatitis B Reactivation in Patients Receiving Ibrutinib: The National Veterans Affairs Cohort
Authors: Chen Ting-Yi , Jacob David A , Coppin John D , Jinadatha Chetan
Published: January 2024

Background

Ibrutinib has been a first-line treatment for chronic lymphocytic leukemia since 2014. Case reports of hepatitis B virus (HBV) reactivation after ibrutinib initiation have been presented. The association between the risk of HBV reactivation and ibrutinib initiation remains unclear. This nationwide study aimed to estimate the incidence of HBV reactivation after ibrutinib initiation.

Method

This study included patients who received ibrutinib between 1 February 2014 and 31 October 2019. Possible reactivations were searched by (1) changes in HBV surface antigen or HBV DNA from no data or negative status to positive after ibrutinib initiation, (2) alanine aminotransferase levels that were at least 3 times the baseline value after ibrutinib initiation, and (3) new antiviral prescriptions against HBV after ibrutinib initiation. Individual chart reviews were conducted to identify HBV reactivation attributed to ibrutinib. The cumulative incidence of HBV reactivation was calculated.

Results

A total 4130 patients were eligible during the study period. Of these, patients with negative HBV core antibody (anti-HBcAb; n = 1670) and patients who were taking antivirals against HBV (n = 60) were excluded. There were 2219 patients without anti-HBcAb testing results. Among the remaining 181 patients with positive anti-HBcAb, 7 HBV reactivations were directly attributable to ibrutinib treatment after chart review, for a 3.9% cumulative incidence.

Conclusions

Our study revealed a low cumulative incidence of HBV reactivation after ibrutinib initiation among patients with previous anti-HBcAb positivity, indicating a moderate risk of HBV reactivation.
Increased Risk of Invasive Aspergillosis in Immunocompromised Patients With Persistent SARS-CoV-2 Viral Shedding >8 Weeks, Retrospective Case-control Study
Authors: Melenotte Cléa , Chavarot Nathalie , L’Honneur Anne-Sophie , Bodard Sylvain , Cheminant Morgane , Flahault Adrien , Nguyen Yann , Burgard Marianne , Dannaoui Eric , Bougnoux Marie-Elisabeth , Parize Perrine , Rouzaud Claire , Scemla Anne , Canouï Etienne , Lafont Emmanuel , Vimpere Damien , Zuber Julien , Charlier Caroline , Suarez Felipe , Anglicheau Dany , Hermine Olivier , Lanternier Fanny , Mouthon Luc , Lortholary Olivier
Published: January 2024

Background

Immunocompromised patients now represent the population most at risk for severe coronavirus disease 2019. Persistent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral shedding was reported in these patients ranging from several weeks up to 9 months. We conducted a bicentric retrospective case-control study to identify risk and prognostic factors associated with persistent viral shedding in immunocompromised patients.

Material and Methods

Symptomatic immunocompromised adults with persistent SARS-CoV-2 viral shedding >8 weeks were retrospectively included between 1 March 2020 and 24 April 2022 at 2 university hospitals in Paris, France, and matched with a control group consisting of symptomatic immunocompromised patients without persistent viral shedding.

Results

Twenty-nine immunocompromised patients with persistent viral shedding were compared with 40 controls. In multivariate analysis, fever and lymphocytopenia (<0.5 G/L) were associated with an increased risk of persistent viral shedding (odds ratio [OR]: 3.3; 95% confidence interval [CI], 1.01–11.09) P = .048 and OR: 4.3; 95% CI, 1.2–14.7; P = .019, respectively). Unvaccinated patients had a 6-fold increased risk of persistent viral shedding (OR, 6.6; 95% CI, 1.7–25.1; P = .006). Patients with persistent viral shedding were at risk of hospitalization (OR: 4.8; 95 CI, 1.5–15.6; P = .008), invasive aspergillosis (OR: 10.17; 95 CI, 1.15–89.8; P = .037) and death (log-rank test <0.01).

Conclusions

Vaccine coverage was protective against SARS-CoV-2 persistent viral shedding in immunocompromised patients. This new group of immunocompromised patients with SARS-CoV-2 persistent viral shedding is at risk of developing invasive aspergillosis and death and should therefore be systematically screened for this fungal infection for as long as the viral shedding persists.
Risk Stratification of Advanced Fibrosis in Patients With Human Immunodeficiency Virus and Hepatic Steatosis Using the Fibrosis-4, Nonalcoholic Fatty Liver Disease Fibrosis, and BARD Scores
Authors: Yendewa George A , Khazan Ana , Jacobson Jeffrey M
Published: January 2024

Background

Nonalcoholic fatty liver disease (NAFLD) and subsequent progression to fibrosis is increasingly prevalent in people with HIV (PWH). We used noninvasive methods to stratify risk and identify associated factors of advanced fibrosis in PWH with NAFLD.

Methods

We conducted a retrospective study of PWH in our clinic from 2005 to 2022. We used liver imaging or biopsy reports to identify cases of hepatic steatosis after excluding specified etiologies. We used the Fibrosis-4 (FIB-4), NAFLD Fibrosis (NFS), and body mass index, aspartate transaminase/alanine transaminase ratio, and diabetes score scores to stratify fibrosis. We used logistic regression to identify factors associated with advanced fibrosis.

Results

Among 3959 PWH in care, 1201 had available imaging or liver biopsies. After exclusions, 114 of 783 PWH had evidence of hepatic steatosis (14.6%). Most were male (71.1%), with a median age of 47 years, and median body mass index of 30.1 kg/m2. Approximately 24% had lean NAFLD (ie, body mass index < 25 kg/m2). Based on the FIB-4 and NFS, 34 (29.8%) and 36 (31.6%) had advanced fibrosis, whereas 1 in 4 had low risk of fibrosis based on FIB-4, NFS, and BARD scores. In adjusted analysis using FIB-4, advanced fibrosis was associated with age > 45 years (adjusted odds ratio, 6.29; 95% confidence interval, 1.93–20.50) and hypoalbuminemia (adjusted odds ratio, 9.45; 95% confidence interval, 2.45–32.52) in addition to elevated transaminases and thrombocytopenia, whereas using the NFS did not identify associations with advanced fibrosis.

Conclusions

We found 14.6% of PWH had NAFLD, with 1 in 3 having advanced fibrosis. Our study provides practical insights into fibrosis risk stratification in HIV primary care settings.
Patient Perspectives on Solid Organ Transplantation From Donors With Hepatitis C Viremia to Recipients Without Hepatitis C Viremia
Authors: Vanterpool Karen B , Diallo Kadiatou , Kim Ellie , Van Pilsum Rasmussen Sarah E , Johnson Morgan A , Predmore Zachary , Brundage Janetta , Barnaba Brittany , Desai Niraj , Levan Macey L , Sung Hannah C , Kates Olivia , Sugarman Jeremy , Durand Christine M
Published: January 2024

Background

Organ transplantation from donors with hepatitis C viremia (HCV) to recipients without HCV (HCV D+/R−) has excellent medical outcomes. Less is known about the psychosocial impact and experiences of HCV D+/R− recipients, particularly outside of clinical trials.

Methods

We conducted in-depth, semistructured interviews with 24 HCV D+/R− recipients (kidney, n = 8; lung, n = 7; liver, n = 5; heart, n = 3; simultaneous heart and kidney, n = 1) who received transplants outside of clinical trials and were treated for HCV after transplant to assess their experiences and perspectives. We used thematic analysis to analyze the interviews.

Results

Interviewees’ reasons for accepting an HCV D + organ were based on perceived benefits and confidence in the effectiveness of HCV treatment. The majority (62%) received HCV treatment within 1 month after transplant (range, 1 day–2 months). Most interviewees reported positive transplant outcomes, including reduced wait times and improved survival, health, physical activity, and quality of life. Overall, themes and experiences did not differ significantly between different organ transplant types. Generally, interviewees did not perceive stigma from those aware of the HCV D+ transplant; yet, disclosure was selective and a few recipients reported concerns from family members about posttransplant HCV transmission risk. Other common concerns included treatment costs and delays, which were not always anticipated by recipients.

Conclusions

Our findings suggest that HCV D+/R− kidney, liver, and heart and lung transplant recipients outside of clinical trials had overall positive experiences. However, HCV transmission risk, treatments costs, and treatment delays were a source of concern that might be mitigated with targeted pretransplant education.
Verification, Analytical Sensitivity, Cost-effectiveness, and Comparison of 4 Candida auris Screening Methods
Authors: Komorowski Adam S , Aftanas Patryk , Porter Vanessa , Katz Kevin , Kozak Robert A , Li Xena X
Published: January 2024

In this verification study, we compare and contrast the performance characteristics of chromogenic agar culture, direct polymerase chain reaction (PCR), and broth enrichment followed by culture or PCR for the detection of Candida auris colonization. We find that culture and PCR both offer excellent performance, with broth enrichment offering little performance advantage given its cost.
‘I see the high level of interpersonal support during the pandemic as proof that the good in people prevails’: the COVID-19 pandemic as a catalyst for building a caring community?
Authors: Strupp Julia , Valerius Lisa , Herrler Angélique , Kukla Helena , Eichberg Sabine , Schulz-Nieswandt Frank , Voltz Raymond
Published: January 2024

Background

The public health approach to end-of-life care has led to initiatives to promote caring communities, involving the community in supporting vulnerable dying people and their families. Our study aimed to explore how the COVID-19 pandemic affected the relevance of a caring community, whether the concept of a caring community took on a different meaning during and because of the pandemic, and how issues of death, dying and bereavement were perceived.

Methods

Qualitative online survey of people interested in the ‘Caring Community Cologne’ project. Participants in the survey attended the launch event for the Caring Community in Cologne. Direct invitations were sent to professionals and experts in various fields. Information about the event was also disseminated via social media and the city of Cologne’s website. Data were collected from June 2020 to August 2020 and analyzed using Braun & Clarke’s thematic analysis.

Results

N = 63 out of 121 people participated. The median age was 60 years; 65% of the participants were female. Most of them worked in the social sector (53%). Three respondents described positive changes brought about by the pandemic: Greater sense of community and solidarity, more confrontation with one’s own finiteness, strengthening of relationships, mindfulness and slowing down of the pace of life. Negative effects mentioned included a deterioration in mental health and well-being, with an increase in anxiety, social isolation but also forced togetherness, which can lead to conflict, and a lack of emotional closeness due to restricted contact.

Conclusions

Our study was conducted at the beginning of the pandemic and shows that the pandemic has raised awareness of the importance and potential benefits of community-based networks and the importance of adopting a public health palliative care approach to advocate for those most in need. The findings also highlight the role of community social capital in promoting engagement, resilience and well-being.
Exceeding radiation thresholds for cataract induction in diagnostic imaging: a paediatric case report
Authors: Perdomo Amanda Alison , Badawy Mohamed Khaldoun , Mignone Cristina , Forster Jake Cameron
Published: January 2024

This case report investigates the radiation dose received by a paediatric patient with a ventricular assist device who underwent four non-contrast brain computed tomography (CT) scans, two brain perfusion CT scans and two head angiographic CT scans. The total estimated absorbed dose to the lens of the eye is above the 500 mGy radiation-induced cataract threshold. It is recommended that this patient and those with similar imaging histories have routine follow-up with an ophthalmologist. It is also recommended that radiation dose tracking and an electronic medical alert program be implemented to allow the identification of patients who may exceed tissue reaction thresholds.
Can open peer review improve uptake of preprints into policies? Evidence from a causal inference
Authors: Xu Chuer , Zong Qianjin
Published: January 2024

The advantage of no publication time lag had led to the use of preprints as research evidence for public policy development that required a rapid response. However, the opposite side of the lack of publication time lag for preprints was their usual lack of peer review, which was the main reason why preprints were criticized as low quality and unreliable. This study aimed to investigate the effects of open peer review on the uptake of preprints into policies (measured by preprints being cited in policy documents). The coronavirus disease 2019 (COVID-19) preprints from bioRxiv and medRxiv were used as a sample (n = 20,959). A causal inference approach, namely, propensity score matching analysis, was used to examine the dataset. Our study found that open peer review significantly increased the uptake of preprints by policies. Limitations of this study were also discussed. This study could bring insights to researchers and preprint servers in improving the uptake of preprints into policies.
Narcolepsy Severity Scale-2 and Idiopathic Hypersomnia Severity Scale to better quantify symptoms severity and consequences in Narcolepsy type 2
Authors: Barateau Lucie , Chenini Sofiene , Denis Claire , Lorber Quentin , Béziat Séverine , Jaussent Isabelle , Dauvilliers Yves
Published: January 2024

Study Objectives

Narcolepsy type 2 (NT2) is an understudied central disorder of hypersomnolence sharing some similarities with narcolepsy type 1 and idiopathic hypersomnia (IH). We aimed: (1) to assess systematically the symptoms in patients with NT2, with self-reported questionnaires: Epworth Sleepiness Scale (ESS), Narcolepsy Severity Scale (NSS), IH Severity Scale (IHSS), and (2) to evaluate the responsiveness of these scales to treatment.

Methods

One hundred and nine patients with NT2 (31.4 ± 12.2 years old, 47 untreated) diagnosed according to ICSD-3 were selected in a Reference Center for Narcolepsy. They all completed the ESS, subgroups completed the modified NSS (NSS-2, without cataplexy items) (n = 95) and IHSS (n = 76). Some patients completed the scales twice (before/during treatment): 42 ESS, 26 NSS-2, and 30 IHSS.

Results

Based on NSS-2, all untreated patients had sleepiness, 58% disrupted nocturnal sleep, 40% hallucinations, and 28% sleep paralysis. On IHSS, 76% reported a prolonged nocturnal sleep, and 83% sleep inertia. In the independent sample, ESS and NSS-2 scores were lower in treated patients, with same trend for IHSS scores. After treatment, ESS, NSS-2, and IHSS total scores were lower, with a mean difference of 3.7 ± 4.1, 5.3 ± 6.7, and 4.1 ± 6.2, respectively. The minimum clinically important difference between untreated and treated patients were 2.1 for ESS, 3.3 for NSS-2, and 3.1 for IHSS. After treatment, 61.9% of patients decreased their ESS > 2 points, 61.5% their NSS-2 > 3 points, and 53.3% their IHSS > 3 points.

Conclusions

NSS-2 and IHSS correctly quantified symptoms' severity and consequences in NT2, with good performances to objectify response to medications. These tools are useful for monitoring and optimizing NT2 management, and for use in clinical trials.
The pathogenic role of the immune system in erectile dysfunction and Peyronie’s disease: focusing on immunopathophysiology and potential therapeutic strategies
Authors: Giagulli Vito Angelo , Lisco Giuseppe , De Tullio Anna , Guastamacchia Edoardo , Triggiani Vincenzo , Jirillo Emilio
Published: January 2024

Introduction

Erectile dysfunction (ED) represents the major cause of male sexual dysfunction, which is often associated with obesity, diabetes mellitus, atherosclerotic cardiovascular disease, and cigarette smoking. Peyronie’s disease is a chronic disorder associated with irreversible fibrotic damage of the tunica albuginea leading to ED, painful erection, coital disturbance, and physical and social complaints. Both conditions are characterized by chronic inflammation, oxidative stress, and significant changes in intracavernous hydrodynamics. In this scenario, oxidized lipoproteins, M1-polarized macrophages, proinflammatory cytokines (such as the tumor necrosis factor α), endothelial nitric oxide synthase, penile smooth muscle cells, and toll-like receptors represent the main triggers of the inflammatory process in ED. Phosphodiesterase-5 inhibitors are the most common treatment for ED. This treatment is used intermittently, as it is conceived as a symptomatic and not curative therapy. Moreover, not all patients respond to phosphodiesterase-5 inhibitors (35%-85%), particularly those with dysmetabolic phenotypes. Additional or alternative treatments are therefore desirable, mostly in refractory cases.

Objectives

In this review, we describe the immune-mediated pathogenesis of ED and Peyronie’s disease (PD). In our literature search we placed particular emphasis on potentially practical therapeutic approaches, including natural products (such as polyphenols), due to their anti-inflammatory and antioxidant activities, stem cell therapy, and platelet-derived preparations.

Methods

We searched PubMed/MEDLINE, Web of Science, Scopus, Cochrane Library, Google Scholar, and institutional websites. Original studies, narrative reviews, systematic reviews, and meta-analyses written in English were searched, screened, and selected.

Results

In animal models of ED and PD, therapeutic approaches, including anti-inflammatory and antioxidant agents, stem cell therapy, and platelet-derived preparations, have provided positive results, including improved penile function, reduced inflammation and oxidative stress, and promotion of tissue repair. However, clinical evidence of improvement in human patients is still insufficient.

Conclusion

Promising results for treating ED and PD have been shown in preclinical and pilot clinical studies, but specific clinical trials are needed to validate the efficacy of these therapeutic approaches in men with ED.
Red chili powder dietary supplementation regularized the performance, hematobiochemical indices, oxidative status, and 8-hydroxy-2’-deoxyguanosine of aflatoxin B1 exposed broiler chickens
Authors: Oloruntola Olugbenga David
Published: January 2024

The effects of red chili powder dietary supplementation on the performance, hematobiochemical indices, oxidative status, and DNA damage in broiler chickens fed aflatoxin B1 (AFB1) contaminated diets were studied. Two hundred and forty Cobb 500 breed day-old broiler chicks were randomly distributed into control group (CONT), 0.5 mg/kg AFB1-exposed group (AFTB), 0.5 g/kg red chili pericarp powder supplementation alongside the 0.5 mg/kg AFB1 exposed group (RCPA), and 0.5 g/kg red chili seed powder supplementation alongside the 0.5 mg/kg AFB1 exposed group (RCSA). The red chili supplementation, in both pericarp powder and seed powder, positively influenced broiler performance by improving (P < 0.05) weight gain, feed intake, and feed conversion ratio, with a reduction in mortality rates compared to the AFTB group. Hematological indices showed that AFB1 exposure decreased (P < 0.05) the red blood cell count, packed cell volume, and hemoglobin (Hb) concentration, but the red chili supplementation mitigated these reductions. Additionally, total white blood cell counts were maintained (P > 0.05) in red chili-supplemented groups compared to CONT. Red chili supplementation increased (P < 0.05) the total protein and globulin concentrations and reduced (P < 0.05) liver enzyme levels compared to the AFTB group. The oxidative enzyme levels in RCPA and RCSA were similar (P > 0.05) to CONT groups. The red chili supplementations counteracted DNA damage, as reflected by similar (P > 0.05) 8-hydroxy-2’-deoxyguanosine levels recorded in RCPA, RCSA, and CONT groups levels. These findings suggest that 0.5 g/kg red chili supplementation has the potential to ameliorate the adverse effects of AFB1 exposure on broiler chickens, improving their performance and health.
A Noise-Induced Hearing Loss Prediction Model Based on Asymmetric Convolution for Workers Exposed to Complex Industrial Noise
Authors: Tian Yu , Zhao Haoqi , Li Peixian , Zhou Tianshu , Qiu Wei , Li Jingsong
Published: January 2024

Objectives:

Current approaches for evaluating noise-induced hearing loss (NIHL), such as the International Standards Organization 1999 (ISO) 1999 prediction model, rely mainly on noise energy and exposure time, thus ignoring the intricate time-frequency characteristics of noise, which also play an important role in NIHL evaluation. In this study, an innovative NIHL prediction model based on temporal and spectral feature extraction using an asymmetric convolution algorithm is proposed.

Design:

Personal data and individual occupational noise records from 2214 workers across 23 factories in Zhejiang Province, China, were used in this study. In addition to traditional metrics like noise energy and exposure duration, the importance of time-frequency features in NIHL assessment was also emphasized. To capture these features, operations such as random sampling, windowing, short-time Fourier transform, and splicing were performed to create time-frequency spectrograms from noise recordings. Two asymmetric convolution kernels then were used to extract these critical features. These features, combined with personal information (e.g., age, length of service) in various configurations, were used as model inputs. The optimal network structure was selected based on the area under the curve (AUC) from 10-fold cross-validation, alongside the Wilcoxon signed ranks test. The proposed model was compared with the support vector machine (SVM) and ISO 1999 models, and the superiority of the new approach was verified by ablation experiments.

Results:

The proposed model had an AUC of 0.7768 ± 0.0223 (mean ± SD), outperforming both the SVM model (AUC: 0.7504 ± 0.0273) and the ISO 1999 model (AUC: 0.5094 ± 0.0071). Wilcoxon signed ranks tests confirmed the significant improvement of the proposed model (p= 0.0025 compared with ISO 1999, andp= 0.00142 compared with SVM).

Conclusions:

This study introduced a new NIHL prediction method that provides deeper insights into industrial noise exposure data. The results demonstrated the superior performance of the new model over ISO 1999 and SVM models. By combining time-frequency features and personal information, the proposed approach bridged the gap between conventional noise assessment and machine learning-based methods, effectively improving the ability to protect workers’ hearing.
The Effect of Lower Tidal Volume Ventilation Facilitated by Extracorporeal Carbon Dioxide Removal Compared With Conventional Lung Protective Ventilation on Cardiac Function
Authors: McGuigan Peter J. , Bowcock Emma M. , Barrett Nicholas A. , Blackwood Bronagh , Boyle Andrew J. , Cadamy Andrew J. , Camporota Luigi , Conlon John , Cove Matthew E. , Gillies Michael A , McDowell Clíona , McNamee James J. , O’Kane Cecilia M. , Puxty Alex , Sim Malcolm , Parsons-Simmonds Rebecca , Szakmany Tamas , Young Neil , Orde Sam , McAuley Daniel F.
Published: January 2024

OBJECTIVES:

Lower tidal volume ventilation (targeting 3 mL/kg predicted body weight, PBW) facilitated by extracorporeal carbon dioxide removal (ECCO2R) has been investigated as a potential therapy for acute hypoxemic respiratory failure (AHRF) in the pRotective vEntilation with veno-venouS lung assisT in respiratory failure (REST) trial. We investigated the effect of this strategy on cardiac function, and in particular the right ventricle.

DESIGN:

Substudy of the REST trial.

SETTING:

Nine U.K. ICUs.

PATIENTS:

Patients with AHRF (Pao
2/Fio
2 < 150 mm Hg [20 kPa]).

INTERVENTION:

Transthoracic echocardiography and N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurements were collected at baseline and postrandomization in patients randomized to ECCO2R or usual care.

MEASUREMENTS:

The primary outcome measures were a difference in tricuspid annular plane systolic excursion (TAPSE) on postrandomization echocardiogram and difference in NT-proBNP postrandomization.

RESULTS:

There were 21 patients included in the echocardiography cohort (ECCO2R, n = 13; usual care, n = 8). Patient characteristics were similar in both groups at baseline. Median (interquartile range) tidal volumes were lower in the ECCO2R group compared with the usual care group postrandomization; 3.6 (3.1–4.2) mL/kg PBW versus 5.2 (4.9–5.7) mL/kg PBW, respectively (p = 0.01). There was no difference in the primary outcome measure of mean (sd) TAPSE in the ECCO2R and usual care groups postrandomization; 21.3 (5.4) mm versus 20.1 (3.2) mm, respectively (p = 0.60). There were 75 patients included in the NT-proBNP cohort (ECCO2R, n = 36; usual care, n = 39). Patient characteristics were similar in both groups at baseline. Median (interquartile range [IQR]) tidal volumes were lower in the ECCO2R group than the usual care group postrandomization; 3.8 (3.3–4.2) mL/kg PBW versus 6.7 (5.8–8.1) mL/kg PBW, respectively (p < 0.0001). There was no difference in median (IQR) NT-proBNP postrandomization; 1121 (241–5370) pg/mL versus 1393 (723–4332) pg/mL in the ECCO2R and usual care groups, respectively (p = 0.30).

CONCLUSIONS:

In patients with AHRF, a reduction in tidal volume facilitated by ECCO2R, did not modify cardiac function.
Using a Microsurgical Robotic Platform for In-flap Anastomosis in Autologous Bipedicular Breast Reconstruction
Authors: Vollbach Felix H. , Bigdeli Amir K. , Struebing Felix , Weigel Jonathan L. , Gazyakan Emre , Kneser Ulrich
Published: January 2024

Autologous microsurgical breast reconstruction has become a standard of care. As techniques become more individualized and aim for less-invasive approaches, vessels ever smaller in diameter are considered for flap anastomosis. Robot-assisted surgery has great potential to reduce tremor and enhance precise motion. The Symani Surgical System (Medical Microinstruments, Inc., Wilmington, Del.) is a robotic platform designed for microsurgery. It was used for a microsurgical in-flap anastomosis of a bipedicular deep inferior epigastric artery flap for unilateral breast reconstruction. The procedure included fully robot-assisted anastomoses with significant size mismatches using a 3D-exoscope for magnification. Arterial and venous anastomoses were entirely robot-assisted completed in 23 minutes (seven stitches) and 28 minutes (eight stitches) using 9/0 nylon sutures. The intra- and postoperative course was uneventful. This robotic platform facilitates in-flap anastomoses of small vessels by increasing the precision of instrument handling and eliminating tremor. The combination of robotic platforms and exoscopes provides superior ergonomics in comparison with conventional (super)microsurgery. We expect robotic platforms to play a significant role in modern microsurgical breast reconstruction.
Clinical improvements due to specific effects and placebo effects in conservative interventions and changes observed with no treatment in randomized controlled trials of patients with chronic nonspecific low back pain: a systematic review and meta-analysis
Authors: Pedersen Julie Rønne , Strijkers Rob , Gerger Heike , Koes Bart , Chiarotto Alessandro
Published: January 2024

Little is known about the contribution of placebo effects and changes observed with no treatment in interventions for nonspecific low back pain (NSLBP). This systematic review assessed the proportions of the overall treatment effect that may be attributable to specific treatment effects, placebo effects, and changes observed with no treatment in randomized controlled trials (RCTs) in patients with NSLBP. Trials published before 2019 were identified from a published systematic review, and the search was updated in MEDLINE, Embase, and Cochrane Central for trials published between January 2019 and March 2023. Three-arm RCTs comparing the effects of experimental interventions vs placebo control vs no intervention reporting pain intensity, physical function, and/or health-related quality of life (HRQoL) were included. Sixteen RCTs with 1436 adults with chronic NSLBP testing conservative and mainly passive interventions were included. For pain intensity (16 studies), 33%, 18%, and 49% of the overall short-term treatment effect was attributable to specific treatment effects, placebo effects, and changes observed with no treatment, respectively. For physical function (11 studies) and HRQoL (6 studies), these proportions were 34%, 13%, and 53%, and 11%, 41%, and 48%, respectively. These results show that approximately half of the overall treatment effect of conservative and mainly passive interventions for patients with chronic NSLBP is attributable to changes observed with no treatment, rather than specific or placebo effects of treatments. However, the certainty of evidence was very low to low, suggesting that the true effects might be markedly different from the effect sizes underlying these estimates.
A back-translational study of descending interactions with the induction of hyperalgesia by high-frequency electrical stimulation in rats and humans
Authors: Patel Ryan , Taylor Joseph L. , Dickenson Anthony H. , McMahon Stephen B. , Bannister Kirsty
Published: January 2024

In humans and animals, high-frequency electrocutaneous stimulation (HFS) induces an “early long-term potentiation-like” sensitisation, where synaptic plasticity is underpinned by an ill-defined interaction between peripheral input and central modulatory processes. The relative contributions of these processes to the initial pain or nociceptive response likely differ from those that underpin development of the heightened response. To investigate the impact of HFS-induced hyperalgesia on pain and nociception in perception and neural terms, respectively, and to explore the impact of descending inhibitory pathway activation on the development of HFS-induced hyperalgesia, we performed parallel studies utilising identical stimuli to apply HFS concurrent to (1) a conditioned pain modulation paradigm during psychophysical testing in healthy humans or (2) a diffuse noxious inhibitory controls paradigm during in vivo electrophysiological recording of spinal neurones in healthy anaesthetised rats. High-frequency electrocutaneous stimulation alone induced enhanced perceptual responses to pinprick stimuli in cutaneous areas secondary to the area of electrical stimulation in humans and increased the excitability of spinal neurones which exhibited stimulus intensity–dependent coded responses to pinprick stimulation in a manner that tracked with human psychophysics, supporting their translational validity. Application of a distant noxious conditioning stimulus during HFS did not alter perceived primary or secondary hyperalgesia in humans or the development of primary or secondary neuronal hyperexcitability in rats compared with HFS alone, suggesting that, upon HFS-response initiation in a healthy nervous system, excitatory signalling escapes inhibitory control. Therefore, in this model, dampening facilitatory mechanisms rather than augmenting top-down inhibitions could prevent pain development.
Systematic Review and Critical Appraisal of Role Definition and Responsibility Within the Concussion Management Team for Secondary Schools
Authors: Fetta Joseph , Starkweather Angela , Huggins Robert , Van Hoof Thomas , Casa Douglas , Gill Jessica
Published: January 2024

BACKGROUND: Sports- and recreation-related concussions impact the cognitive function of secondary school students during the recovery process. They can cause symptoms such as headache, difficulty concentrating, and memory impairment, which pose a challenge for students during the return to learn (RTL) after injury. Concussion management teams (CMTs) assist the student in managing symptoms and develop an individualized RTL process; however, the ideal composition of professionals involved in the CMT has not been fully evaluated. METHODS: A systematic review was conducted to assess current research on CMTs in secondary schools. A search of the databases CINAHL, MEDLINE, and PsycINFO was conducted using the search terms “concussion management team” AND “school” OR “return to learn.” RESULTS: Twenty-four articles were included for review. The CMT structure was highly variable in all studies. Identified themes from the literature were confusion of role definition and function, and communication gaps among interdisciplinary team members. Half of the articles viewed the school nurse as the leader in coordinating the CMT and RTL process. CONCLUSION: Evidence from this review suggests further consensus in this field is needed to clarify the school nurse's role and standardize the CMT structure.
Racial, Ethnic, and Gender Composition Among Neonatal Nurse Practitioner Faculty Ranks
Authors: Bell Tracey , Newberry Desi M.
Published: January 2024

Background:

Despite increases in nursing faculty diversity, representation is lacking in positions of higher faculty rank. Challenges for minority faculty include decreased awareness of promotion standards, less mentoring, and increased stress from being the sole representative of their respective underrepresented population.

Methods:

The purpose of this study was to determine the racial, ethnic, and gender composition of neonatal nurse practitioner (NNP) faculty in the United States. A nonexperimental survey was sent to all accredited NNP programs to describe demographics of NNP faculty in the United State.

Results:

Of the 128 survey participants, 84% self-identified as White. Forty-eight of the participants ranked Professor or Associate professor were White. In contrast, all other races only had 8 respondents who were of the higher faculty ranks. There were only 2 male participants; one identified as full professor and one as associate professor.

Conclusion:

Limitations of this project included a small sample size leading to an inability to determine statistical significance. Previous evidence supports decreased diversity in higher faculty rank in other healthcare providers and the results of this study add to that body of literature. Barriers to increased diversification need to be rectified to ensure health equity to all patients.
A novel wire-guided prefenestration technique for patients with type B aortic dissection: A case report
Authors: Ge Shuxiong , Xu Zhongyou
Published: January 2024

Rationale:

Acute type B aortic dissection (ABAD) is a fatal and severe cardiovascular disease. There are various strategies for dissection involving the left subclavian artery, but limited by the variety and cost of stents, the treatment brings certain obstacles. The aim of this study is to evaluate the effectiveness and safety of the wire-guided prefenestration technique for treating left subclavian artery involvement in patients with arterial dissection.

Patient concerns:

A 48-year-old man was transferred to our hospital due to persistent chest and back pain that had lasted for 6 hours.

Diagnoses:

Preoperative computed tomography angiogram (CTA) of the thoracic and abdominal aorta diagnosed with ABAD that affected his left subclavian artery, who needed emergency endovascular treatment due to malperfusion of the lower limb arteries.

Interventions:

To perform the procedure, a guide wire was inserted through the left brachial artery, exited through the right femoral artery, and then entered the pre-fenestrated hole leading to the main stent. The stent was released while the guide wire was in position, and the left subclavian artery was reconstructed using viabahn.

Outcomes:

Thoracic endovascular aortic repair was successfully completed for ABAD. A follow-up CT angiogram of the thoracic and abdominal aorta revealed positive vascular remodeling and no signs of significant internal leakage after one month.

Lessons:

This innovative approach offers a secure and efficient treatment option for aortic dissection in individuals who have undergone left subclavian artery reconstruction.
Factors associated with self-perceived treatment-resistance in bipolar disorder
Authors: Fujimura Toshimasa , Taira Daiki , Uchida Yoshihiro , Takahashi Keitaro , Yamasuji Kanako , Shimizu Kentaro , Nagai Yasuhito , Yoshinari Naoto , Hirata Tomoe , Fujimoto Kazuma , Kurosawa Yui , Yasuda Seita , Yoshikawa Akane , Takeshita Yoshihide , Ito Masanobu , Kakiuchi Chihiro , Kato Tadafumi
Published: January 2024

Patients with bipolar disorder often report self-perceived treatment resistance. However, it is not known to what extent it is due to actual treatment resistance. The Juntendo University provides “Bipolar Disorder Treatment Rebuilding Program,” in which patients with self-reported treatment resistant bipolar disorder are hospitalized for 2 weeks and undergo detailed examinations. In this study, we report our experience with the initial 43 patients hospitalized during the one and half years after the launch of the program. Among the patients who underwent full assessment, only one was regarded as having genuine treatment-resistant bipolar disorder without comorbidity. In other cases, ten were not diagnosed with bipolar disorder, 3 had organic brain diseases, 12 had comorbid mental disorders and its symptoms were regarded as treatment-resistant bipolar symptoms by the patients, and 18 did not receive adequate treatment because attendant physicians did not adhere to the treatment guidelines or patients did not adhere to the treatment because of lack of insight. The number of participants was not large, and selection bias hampered the generalization of the findings. Insight and adherence were assessed without the use of validated tools. We could not verify recovery after adequate treatment because of the limited hospitalization period. The findings suggest that most patients with self-perceived treatment-resistant bipolar disorder may not have genuine treatment-resistant bipolar disorder. These results shed light on the difficulties of public education of bipolar disorder and importance of providing appropriate services for diagnosis and treatment of bipolar disorder in the community.
Global research trends in DNA methylation in rheumatoid arthritis: A bibliometric analysis and visual analysis
Authors: Huang Xin , Huang Longxiang , Gao Xiang , Liu Changhua
Published: January 2024

Rheumatoid arthritis (RA) is a prevalent autoimmune disorder with a significant global economic burden. Epigenetic modifications, particularly DNA methylation, play a crucial role in RA. This study conducted a bibliometric analysis to explore the evolving trends and predominant themes in RA and DNA methylation research over the past two decades. A total of 1800 articles met the inclusion criteria, and the analysis revealed consistent growth in the literature, with a notable increase in output after 2019. The research involved 70 countries, 2139 academic institutions, 23,365 unique authors, and 58,636 co-cited authors. The United States emerged as a dominant contributor in this research domain. The significance of DNA methylation in shaping research directions for RA management is increasingly evident. Recent investigations have shed light on the pivotal role of DNA methylation in RA, particularly in characterizing synovial tissue and exploring the underlying mechanisms of disease pathogenesis. This study provides valuable insights into the landscape of DNA methylation research in RA and highlights the importance of epigenetics in autoimmune diseases.