bluuebunny/crossref_metadata_2025 huggingface dataset:
Hydroelectric dam impacts shorten and delay the reproductive periods of female leaf-nosed bats in Western Amazonia
Authors: Bobrowiec Paulo Estefano D , da Cunha Tavares Valéria
Published: May 2024

The life cycles of bats are constrained by availability of resources such as food and shelter. Disruptions limiting otherwise naturally regulated access to these resources ultimately affect the fitness of bat populations and may eventually lead to local extinctions. We sampled bats before and after an Amazonian mega-dam water filling and retrieved data on their reproductive phenology, testing if and how sex ratio, seasonal abundance, and reproductive patterns respond to impacts of the newly operating hydroelectric dam. We analyzed data from 3,298 bat captures of 49 species. Females outnumbered males, previously and after the dam implementation, and we observed seasonal variations in the abundance of bats, which was lower after the implementation of the dam for most species. All species had at least 1 reproductive peak of pregnancy and/or lactation beginning at a variable time across seasons. Most species and functional ensembles were reproductively bimodal, with exceptions being the polymodal Artibeus obscurus and unimodal Phylostomus elongatus. Operations of the hydroelectric dam affected the abundance of both sexes equally, and effects were stronger in the rainy season, altering the timing of reproduction for females, delaying and shortening pregnancy and lactation. These changes expressed in female reproductive activity may be related to the shortfall of resources because of loss of irreplaceable vegetation caused by the dam filling. As we cannot predict the roles of variation of reproductive patterns observed after the filling in the long run we reinforce the importance of long-term, continuous monitoring and management to safeguard the reestablishment of reproductive patterns of females in order to repopulate and keep bat populations healthy in remaining areas along following dam construction.
Cancer control co-benefits of the climate-related provisions in the American Inflation Reduction Act
Authors: Ashad-Bishop Kilan C , Yabroff K Robin , Nogueira Leticia
Published: May 2024

The American Inflation Reduction Act (IRA) of 2022 contains climate-related provisions that may have noteworthy implications for cancer control and prevention. This commentary assesses the potential co-benefits of the IRA for cancer control efforts, specifically policies and programs to reduce carcinogen exposure via air quality monitoring and air pollution reduction. Allocations through the IRA for air quality improvement, paired with its environmental justice provisions, hold promise for advancing cancer prevention by targeting resources to communities most susceptible to environmental hazards. Moreover, climate resilience measures dictated by the IRA are crucial for oncology professionals grappling with the dual challenges of climate change and cancer care. Climate-driven extreme weather events can exacerbate carcinogen exposure and disrupt access to cancer care, underscoring the need for resilient health-care infrastructure. The IRA’s provisions for clean energy incentives and infrastructure upgrades offer oncology care institutions opportunities to mitigate emissions and bolster resilience against climate-related disruptions, ultimately improving cancer outcomes. Climate-related initiatives funded by the IRA present a unique and timely avenue to advance equitable cancer control efforts. This commentary underscores the critical intersection between climate resilience policy and oncology care, highlighting the potential to promote a healthier and more resilient future for all.
Zika infection among international students after five months in Thailand
Authors: Imad Hisham Ahmed , Garcia Guillem Joan Deus , Martinez Gemma Gomariz-Vilaldach , Asawapaithulsert Punyisa , Thippornchai Narin , Leaungwutiwong Pornsawan , Piyaphanee Watcharapong , Silachamroon Udomsak , Charunwatthana Prakaykaew
Published: May 2024

Zika virus outbreak was traced among international students in Thailand. Testing was prompted by a single symptomatic case, which revealed seropositivity in two students. These results highlight the potential risk of Zika and emphasize the importance of implementing preventive measures for those travelling to endemic regions such as Thailand.
Diagnostic accuracy of a novel lateral flow assay for histoplasmosis
Authors: Burrows Megan , Miller Janice , Liesman Rachael M , Bahr Nathan C
Published: May 2024

Antigen testing is an important diagnostic tool for histoplasmosis but has limited availability globally. We evaluated the OIDx urine lateral flow antigen assay among 204 persons suspected to have histoplasmosis. Among patients with proven histoplasmosis, sensitivity was 33.3% (3/9, 95% CI 7.5%–70.1%) and specificity 80.5% (157/195, 95% CI 74.3%–85.8%). The MiraVista urine antigen test had better specificity (96.9%) and equal sensitivity. The OIDx test demonstrated 33.3% (3/9) positive agreement and 84.0% (163/194) negative agreement with the MiraVista test. These results should be considered in the context of our low HIV prevalence population with a mixture of pulmonary and disseminated disease.
Quasi-equilibrium chemical evolution in starless cores
Authors: Rawlings J M C , Keto E , Caselli P
Published: May 2024

The chemistry of H2O, CO, and other small molecular species in an isolated pre-stellar core, L1544, has been assessed in the context of a comprehensive gas-grain chemical model, coupled to an empirically constrained physical/dynamical model. Our main findings are (i) that the chemical network remains in near equilibrium as the core evolves towards star formation and the molecular abundances change in response to the evolving physical conditions. The gas-phase abundances at any time can be calculated accurately with equilibrium chemistry, and the concept of chemical clocks is meaningless in molecular clouds with similar conditions and dynamical time-scales, and (ii) A comparison of the results of complex and simple chemical networks indicates that the abundances of the dominant oxygen and carbon species, H2O, CO, C, and C+ are reasonably approximated by simple networks. In chemical equilibrium, the time-dependent differential terms vanish, and a simple network reduces to a few algebraic equations. This allows rapid calculation of the abundances most responsible for spectral line radiative cooling in molecular clouds with long dynamical time-scales. The dust ice mantles are highly structured and the ice layers retain a memory of the gas-phase abundances at the time of their deposition. A complex (gas-phase and gas-grain) chemical structure therefore exists, with cosmic-ray induced processes dominating in the inner regions. The inferred H2O abundance profiles for L1544 require that the outer parts of the core and also any medium exterior to the core are essentially transparent to the interstellar radiation field.
An online framework for fitting fast transient light curves
Authors: Barna Tyler , Reed Brandon , Andreoni Igor , Coughlin Michael W , Dietrich Tim , Groom Steven L , du Laz Theophile Jegou , Pang Peter T H , Purdum Josiah N , Rusholme Ben
Published: May 2024

The identification of extragalactic fast optical transients (eFOTs) as potential multimessenger sources is one of the main challenges in time-domain astronomy. However, recent developments have allowed for probes of rapidly evolving transients. With the increasing number of alert streams from optical time-domain surveys, the next paradigm is building technologies to rapidly identify the most interesting transients for follow-up. One effort to make this possible is the fitting of objects to a variety of eFOT light curve models such as kilonovae and γ-ray burst (GRB) afterglows. In this work, we describe a new framework designed to efficiently fit transients to light curve models and flag them for further follow-up. We describe the pipeline’s workflow and a handful of performance metrics, including the nominal sampling time for each model. We highlight as examples ZTF20abwysqy, the shortest long gamma-ray burst discovered to date, and ZTF21abotose, a core-collapse supernova initially identified as a potential kilonova candidate.
FRBs from rapid spin-down neutron stars
Authors: Li Dongzi , Pen Ue-Li
Published: May 2024

A fast radio burst (FRB) localized to a globular cluster (GC) challenges FRB models involving ordinary young magnetars. In this paper, we examine the rapid spin-down millisecond neutron star (NS) scenario, which favours the dynamic environment in GCs. Fast spin-down corresponds to a larger magnetic field than regular millisecond pulsars, which empirically favours giant pulse (GP) emission. The kinetic energy in millisecond NSs can readily exceed the magnetic energy in magnetars. The high inferred isotropic luminosity of most FRBs is challenging to explain in spin-down powered pulsars. A recent observation of a GP from the Crab pulsar, on the other hand, suggests highly Doppler-beamed emission, making the required energy orders of magnitude smaller than estimated with isotropic assumptions. Considering this strong beaming effect, GPs from a recycled pulsar with a modest magnetic field could explain the energetics and burst rates for a wide range of FRBs. The short life span accounts for a paucity of bright FRBs in the Milky Way neighbourhood. We point out that tidal disruption spin-up from a main-sequence star can provide sufficient accretion rate to recycle an NS with mild magnetic field. It can also explain the observed source density and the spatial offset in the GC for FRB 20200120E. Frequency variation in the scattering tail for some of the brightest FRBs is expected in this scenario.
Repainting the colour–mass diagrams by unearthing the green mountain: dust-rich S0 galaxies in the colour–(galaxy stellar mass) diagram, and the colour–(black hole mass) relations for dust-poor versus dust-rich galaxies
Authors: Graham Alister W
Published: May 2024

Lenticular galaxies are notoriously misclassified as elliptical galaxies and, as such, a (disc inclination)-dependent correction for dust is often not applied to the magnitudes of dusty lenticular galaxies. This results in overly red galaxy colours, impacting their distribution in the colour–magnitude diagram. It is revealed how this has led to an underpopulation of the ‘green valley’ by hiding a ‘green mountain’ of massive dust-rich lenticular galaxies – known to be built from gas-rich major mergers – within the ‘red sequence’ of colour–(stellar mass) diagrams. Correcting for dust, a ‘green mountain’ appears at M*,gal ∼ 1011 M⊙, along with signs of an extension to lower masses producing a ‘green range’ or ‘green ridge’ on the green side of the ‘red sequence’ and ‘blue cloud.’ The ‘red sequence’ is shown to be comprised of two components: a red plateau defined by elliptical galaxies with a near-constant colour and by lower-mass dust-poor lenticular galaxies, which are mostly a primordial population but may include faded/transformed spiral galaxies. The presence of the quasi-triangular-shaped galaxy evolution sequence, previously called the ‘Triangal’, is revealed in the galaxy colour–(stellar mass) diagram. It tracks the speciation of galaxies and their associated migration through the diagram. The connection of the ‘Triangal’ to previous galaxy morphology sequences (Fork, Trident, and Comb) is also shown herein. Finally, the colour–(black hole mass) diagram is revisited, revealing how the dust correction generates a blue–green sequence for the spiral and dust-rich lenticular galaxies that is offset from a green–red sequence defined by the dust-poor lenticular and elliptical galaxies.
A search for non-transiting exoplanets with optical light phase curves from TESS Southern ecliptic sectors
Authors: Cullen Caitlyn J , Bayliss Daniel
Published: May 2024

Phased photometric variation provides a method for discovering potential non-transiting exoplanets in high-precision time-series photometry. Applying a Lomb–Scargle algorithm, we search for phased photometric variation in a selection of 140 000 bright dwarf stars with full-frame image light curves from the Southern ecliptic hemisphere of the Transiting Exoplanet Survey Satellite (TESS) mission. We fit the phased photometric variation signal for these candidates using a three-component model comprised of atmospheric reflection/emission, tidal ellipsoidal distortion, and Doppler beaming contributions. We find 27 candidate signals that can be attributed to short-period, massive planets. Our candidates have periods ranging from 0.74 to 1.98 d, and photometric variations with amplitudes ranging from 94 to 528 ppm. The host stars are all bright (9 < T < 11) F- and G-type dwarf stars. We estimate the radial velocity semi-amplitudes to be in excess of 60 m s−1 for each candidate, easily within reach of current high-precision spectrographs. If confirmed, these candidates would be the first non-transiting exoplanets discovered with TESS.
Callicebus oenanthe (Primates: Pitheciidae)
Authors: Shanee Sam , Aldrich Brooke C , Pacheco Victor , Serrano-Villavicencio José E
Published: May 2024

Callicebus oenanthe Thomas, 1924, commonly known as the San Martín Titi Monkey, is endemic to the northern portion of the department of San Martin, in the Alto Mayo and Huallaga river valleys. It lives in family groups, consisting of a monogamous pair and their offspring. It occurs at elevations between 200 and 1,000 m. Callicebus oenanthe feeds primarily on fruit, but includes other foods like leaves, flowers, and invertebrates in its diet. Although locally common, the species is listed as “Critically Endangered” (CR) both by the International Union for Conservation of Nature and under Peruvian legislation.
The impact of brain cancer care coordinators on healthcare utilization and outcomes in patients with glioblastoma
Authors: Hong Martin , Leigh Lucy , Ballinger Connor , Reeves Penny , Gooley Alisha , Nixon Sandy , Paul Chris , Lynam James
Published: May 2024

Background

Cancer care coordinators (CCCs) are recognized as having an important role in patients’ and carers’ cancer journey. However, there are no studies investigating the impact of CCCs on quantitative outcomes. We performed a retrospective cohort study investigating the impact of brain cancer care coordinators (BCCCs) on health service resource use and survival in patients with glioblastoma.

Methods

All patients diagnosed with glioblastoma between 2012 and 2019 in Hunter New England Local Health District, Australia (HNELHD) were included and the patients were divided into 2 cohorts: before and after the introduction of the BCCC. Any patient diagnosed in 2016, during the introduction of the BCCC, were excluded. The main outcomes assessed were overall survival, health service resource use, odds of being admitted to hospital after the emergency presentation, and cost-offset analysis to examine the economic implications of BCCCs.

Results

A total of 187 patients were included. There were no significant differences in overall survival between the 2 groups (mOS 12.0 vs 11.16 months, HR 0.95). However, there was a reduction in the number of ED presentations and admissions. This was associated with a 24% reduction in aggregate length of stay with the BCCC. There was no statistically significant difference in mean patient costs, however our hospital may have saved over AUD$500 000 with BCCCs.

Conclusions

The introduction of BCCC did not improve survival but appeared to be associated with reduced health resource utilization. This study provides economic justification, in addition to the established quality of life improvements, to support the presence of BCCCs.
‘Everything is Obstetric Violence Now’: Identifying the Violence in ‘Obstetric Violence’ to Strengthen Socio-legal Reform Efforts
Authors: Pickles Camilla
Published: May 2024

Since its global uptake, ‘obstetric violence’ is increasingly used to capture any/all violations during reproductive healthcare, with few conceptual limits. Consequently, it runs the risk of becoming an overgeneralised concept, making it difficult to operationalise in socio-legal reform efforts. This article draws on the Latin American origins of the concept and aims to provide a theoretical framework to support a focused and coherent socio-legal reform agenda. It offers a universal definition of violence, being the violation of physical or psychological integrity, and localises this definition using the ‘view from everywhere’. The article proposes that violence will qualify as ‘obstetric violence’ if the violation of integrity occurs in the context of antenatal, intrapartum and postnatal care. Further, the subject of the violence is the birthing woman, trans or non-binary person. Thinking in terms of a ‘continuum of violence’ in reproductive healthcare ensures that different forms of obstetric violence are recognised and helps envisage overlaps with other violences.
Osteoarthritis of zygapophysial joints as a cause of back pain and neck pain: a scoping review
Authors: Bogduk Nikolai , MacVicar John
Published: May 2024

Background

Zygapophysial joints (Z joints) can be a source of back pain and of neck pain, but the cause of pain is not known. Some authors attribute the pain to osteoarthritis but without citing evidence.

Objectives

The present review was undertaken to determine if there was sufficient evidence of association between spinal pain and osteoarthritis of Z joints to justify osteoarthritis being held to be the cause of pain. The null hypothesis was that osteoarthritis of Z joints does not cause back pain or neck pain.

Eligibility criteria

Relevant studies were ones that provided primary data on the association between pain and osteoarthritis of Z joints. These could be population studies, diagnostic studies, or case-control studies.

Sources of evidence

The database of PubMed was searched using the terms: Lumbar or cervical, zygapophysial or facet, pain, and osteoarthritis or degeneration or degenerative.

Charting methods

Data pertinent to the research question were extracted from original articles and tabulated for reporting. Odds ratios for associations were calculated, as were the prevalence rates of osteoarthritis in subjects with pain, and conversely the prevalence rates of pain in subjects with osteoarthritis.

Results

The searches retrieved 11 population studies, 4 diagnostic studies, and 3 cases control studies. No study showed any positive association between osteoarthritis of Z joints and pain. All studies found pain to be independent of the presence or severity of osteoarthritis. Osteoarthritis was as common in subjects with no pain as in subjects with pain. The null hypothesis was not refuted.

Conclusion

The published evidence does not support the belief that osteoarthritis causes Z joint pain. All the evidence contradicts this belief.
Citizens’ Communication Styles in Written Public Encounters
Authors: Gilad Sharon , Freedman Michael , Ben-Nun Bloom Pazit
Published: May 2024

Current studies of citizens’ coping behaviors in public encounters lack a direct examination of what citizens say and how they say it. Moreover, despite the ubiquity of citizens’ written communications with the state, such interactions are seldom studied. This article contributes a relational approach to studies of citizens’ coping behaviors by developing a taxonomy and detailed operationalization of citizens’ communication styles in written public encounters. This taxonomy is based on an abductive content analysis of over 1,000 citizen web contacts to an Israeli welfare agency, mostly during coronavirus disease 2019. We show that citizens’ written communications differ in their inclination to espouse demanding, pleading, civil, or neutral styles. Additionally, we tentatively show that citizens’ subjective experiences of administrative burdens and trust in government are correlated with the variation in their communication styles. The taxonomy, its operationalization, and preliminary findings open up new avenues for studying citizens’ coping behaviors in written encounters.
The impact of the COVID-19 pandemic on 397 631 elective dental admissions among the under-25s in England: a retrospective study
Authors: Faitna Puji , Hargreaves Dougal S , Neale Francesca K , Kenny Simon E , Viner Russell M , Aylin Paul P , Bottle Alex , Ashley Paul
Published: May 2024

Background

COVID-19 caused widespread disruptions to health services worldwide, including reductions in elective surgery. Tooth extractions are among the most common reasons for elective surgery among children and young people (CYP). It is unclear how COVID-19 affected elective dental surgeries in hospitals over multiple pandemic waves at a national level.

Methods

Elective dental tooth extraction admissions were selected using Hospital Episode Statistics. Admission trends for the first 14 pandemic months were compared with the previous five years and results were stratified by age (under-11s, 11–16s, 17–24s).

Results

The most socioeconomically deprived CYP comprised the largest proportion of elective dental tooth extraction admissions. In April 2020, admissions dropped by >95%. In absolute terms, the biggest reduction was in April (11–16s: −1339 admissions, 95% CI −1411 to −1267; 17–24s: −1600, −1678 to −1521) and May 2020 (under-11s: −2857, −2962 to −2752). Admissions differed by socioeconomic deprivation for the under-11s (P < 0.0001), driven by fewer admissions than expected by the most deprived and more by the most affluent during the pandemic.

Conclusion

Elective tooth extractions dropped most in April 2020, remaining below pre-pandemic levels throughout the study. Despite being the most likely to be admitted, the most deprived under-11s had the largest reductions in admissions relative to other groups.
Clinical diagnostic reference levels in neuroradiology based on clinical indication
Authors: Aly Antar , Tsapaki Virginia , Ahmed Ayman Zakaria , Own Ahmed , Patro Satya , Al Naemi Huda , Kharita Mohammad Hassan
Published: May 2024

This study focuses on patient radiation exposure in interventional neuroradiology (INR) procedures, a field that has advanced significantly since its inception in the 1980s. INR employs minimally invasive techniques to treat complex cerebrovascular diseases in the head, neck, and spine. The study establishes diagnostic reference levels (DRLs) for three clinical indications (CIs): stroke (S), brain aneurysms (ANs), and brain arteriovenous malformation (AVM). Data from 209 adult patients were analyzed, and DRLs were determined in terms of various dosimetric and technical quantities. For stroke, the established DRLs median values were found to be 78 Gy cm2, 378 mGy, 118 mGy, 12 min, 442 images, and 15 runs. Similarly, DRLs for brain AN are 85 Gy cm2, 611 mGy, 95.5 mGy, 19.5, 717 images, and 26 runs. For brain AVM, the DRL’s are 180 Gy cm2, 1144 mGy, 537 mGy, 36 min, 1375 images, and 31 runs. Notably, this study is unique in reporting DRLs for specific CIs within INR procedures, providing valuable insights for optimizing patient safety and radiation exposure management.
LGBTQ+ People’s Perceptions of Interactions with Outgroup Members: Implications for Social Work Education and Practice
Authors: Braganza Morgan E , Hodge David R
Published: May 2024

Engaging respectfully with individuals who identify as lesbian, gay, bisexual, transgender, queer, genderqueer, or gender-nonconforming (LGBTQ+) is an ethical imperative. To help social workers fulfill this obligation, this study explored the lived experiences of LGBTQ+ people regarding their interactions with people outside the LGBTQ+ community, and what LGBTQ+ people desire for future interactions. Narrative interviews were conducted with 11 LGBTQ+ social work graduate students and alumni to explore (a) their self-reported experiences engaging in one-on-one and small group interactions with outgroup members throughout their lives and (b) the meaning they gleaned from their life experiences across various domains (e.g., work, family, education) that might improve future interactions. Analysis produced six storylines that can be summarized as (1) unbalanced depictions of difference, (2) avoiding interactions, (3) managing positive treatment of an identity, (4) restricting certain perspectives, (5) focusing on differences, and (6) the importance of seeing humanity. The findings suggest several strategies for interacting with LGBTQ+ people in a more culturally sensitive way including discussing the LGBTQ+ community in a nuanced manner (as opposed to monolithically) and considering the level of attention paid to individuals’ sexual orientation and gender identity.
“The Air Is Being Sucked Out of the Room”: Experiences of Social Work Students of Color with Antiracism Education in the Classroom and Practicum
Authors: Lerner Justin E , Kim Angie
Published: May 2024

This study explores the experiences of social work students of color (SOC) and their antiracism education within a school of social work at a public university. Twenty-one SOC participated in focus groups where they described their experiences with antiracism education. Several key themes were identified: (a) finding community through affinity groups, (b) SOC interactions with White students, (c) differentiating internalized racism and anti-Black racism, (d) the impact of White instructors and the lack of mentors and supervisors of color, (e) microaggressions and incidents of racism, and (f) taking up space. As this is an exploratory study, authors make recommendations for social work schools to pilot in the future. These recommendations include assessing White students’ skill level with antiracism education and practice before placing them in classes with SOC, assessing faculty’s skill set with antiracist teaching and providing ongoing support, creating sustained affinity spaces for SOC as a way to booster wellness, designing and piloting antiracist outcomes for social work students, and developing simulation-based learning with simulated patients as a tool to measure antiracist practice competencies.
PLA2G12A protects against diet‐induced obesity and insulin resistance by enhancing energy expenditure and clearance of circulating triglycerides
Authors: Wu Min , Wang Qian , Li Hengchun , Tao Jiawang , Wang Zhi , Zhang Shengnan , Chen Longhui , Li Pingchao , Chen Ling , Qu Linbing
Published: May 2024

Secreted phospholipase A2s are involved in the development of obesity, type 2 diabetes mellitus (T2DM) and cardiovascular disease, which have become serious and growing health concerns worldwide. Integration of genome‐wide association study and gene co‐expression networks analysis showed that the secreted phospholipase A2 group XIIA (PLA2G12A) may participate in hepatic lipids metabolism. Nevertheless, the role of PLA2G12A in lipid metabolism and its potential mechanism remain elusive. Here, we used AAV9 vector carrying human PLA2G12A gene to exogenously express hPLA2G12A in the liver of mice. We demonstrated that the overexpression of hPLA2G12A resulted in a significant decrease in serum lipid levels in wild‐type mice fed with chow diet or high‐fat diet (HFD). Moreover, hPLA2G12A treatment protected against diet‐induced obesity and insulin resistance in mice fed a HFD. Notably, we found that hPLA2G12A treatment confers protection against obesity and hyperlipidemia independent of its enzymatic activity, but rather by increasing physical activity and energy expenditure. Furthermore, we demonstrated that hPLA2G12A treatment induced upregulation of ApoC2 and Cd36 and downregulation of Angptl8, which contributed to the increase in clearance of circulating triglycerides and hepatic uptake of fatty acids without affecting hepatic de novo lipogenesis, very low‐density lipoprotein secretion, or intestinal lipid absorption. Our study highlights the potential of PLA2G12A gene therapy as a promising approach for treating obesity, insulin resistance and T2DM.
Impact of coordinated care on adherence to antihypertensive medicines among adults experiencing polypharmacy in Australia
Authors: Lin Jialing , de Oliveira Costa Juliana , Pearson Sallie-Anne , Buckley Nicholas A. , Brieger David , Schutte Aletta E. , Schaffer Andrea L. , Falster Michael O.
Published: May 2024

Background:

Adherence to antihypertensives is key for blood pressure control. Most people with hypertension have several comorbidities and require multiple medicines, leading to complex care pathways. Strategies for coordinating medicine use can improve adherence, but cumulative benefits of multiple strategies are unknown.

Methods:

Using dispensing claims for a 10% sample of eligible Australians, we identified adult users of antihypertensives during July 2018–June 2019 who experienced polypharmacy (≥5 unique medicines). We measured medicine use reflecting coordinated medicine management in 3 months before and including first observed dispensing, including: use of simple regimens for each cardiovascular medicine; prescriber continuity; and coordination of dispensings at the pharmacy. We measured adherence (proportion of days covered) to antihypertensive medicines in the following 12 months, and used logistic regression to assess independent associations and interactions of adherence with these measures of care.

Results:

We identified 202 708 people, of which two-thirds (66.6%) had simple cardiovascular medicine regimens (one tablet per day for each medicine), two-thirds (63.3%) were prescribed >75% of medicines from the same prescriber, and two-thirds (65.5%) filled >50% of their medicine on the same day. One-third (28.4%) of people experienced all three measures of coordinated care. Although all measures were significantly associated with higher adherence, adherence was greatest among people experiencing all three measures (odds ratio = 1.63; 95% confidence interval: 1.55–1.72). This interaction was driven primarily by effects of prescriber continuity and dispensing coordination.

Conclusions:

Coordinating both prescribing and dispensing of medicines can improve adherence to antihypertensives, which supports strategies consolidating both prescribing and supply of patients’ medicines.
Occurrence of hypertension among patients with opioid use disorder in methadone maintenance treatment
Authors: Sason Anat , Adelson Miriam , Leshno Dahlia , Schreiber Shaul , Peles Einat
Published: May 2024

Background:

Patients in methadone maintenance treatment (MMT) may develop age-related medical problems, but hypertension (HTN) proportion and its occurrence during MMT have not been studied yet. We aimed to evaluate changes in blood pressure (BP) during MMT and characterize current HTN.

Methods:

Of all 1098 ever admitted MMT patients, those with ≥2 BP follow-up measures were included (n = 516), of them all current patients (N = 245) tested for HTN (systolic BP ≥140 mmHg or diastolic BP ≥90 were detected twice (one week apart) were considered as affected with HTN. Current and earliest during the first, and latest year in MMT of body mass index (BMI), BP, methadone dose and serum level, and drugs in urine were analyzed.

Results:

HTN was detected in 89(36.3%) of the current patients. The HTN and non-HTN groups did not differ by sex (P = 0.6), age (P = 0.2), and duration in MMT (P = 0.6), but had higher BMI (27.9 ± 5.2 vs. 25.6 ± 5.2, respectively, P = 0.001) and fewer had positive urine test findings for any substance (31.5% vs. 44.9%, P = 0.04). Comparing their earliest measures (before 11.9 ± 5.8 years), BP and BMI increased more among the hypertensive group, independent of methadone dose and serum levels, which significantly reduced over the years. No drug abuse was associated with increased BMI and BP.

Conclusions:

Weight gain was associated with BP elevation and characterized patients who succeeded in drug abstinence during MMT. Healthy nutrition education at admission to MMT may reduce the incidence of weight gain and HTN, therefore identifying HTN and offering treatment for this highly prevalent life-threatening condition among middle-age and older patients in MMT is recommended.
Acute Eye-Tracking Changes Correlated With Vestibular Symptom Provocation Following Mild Traumatic Brain Injury
Authors: Uyeno Caroline , Zhang Rachel , Cornwell Jordan , Teramoto Masaru , Boo Marie , Lumba-Brown Angela
Published: May 2024

Objectives:

To quantify norms and changes in eye-tracking proficiency, and determine vestibular symptom correlations in varsity college athletes following acute mild traumatic brain injury (mTBI). We hypothesized that mTBI impacts central coordination between the vestibular and oculomotor systems with resultant changes in eye-tracking proficiency that are correlated with vestibular symptom provocation.

Design:

Retrospective cohort study.

Setting:

Sports medicine care at a single institution.

Patients:

One hundred and nineteen college athletes diagnosed with mTBI by a physician between 2013 and 2019.

Interventions:

N/A.

Main Outcome Measures:

Standard deviation of tangential error, standard deviation of radian error, mean phase error, and horizontal gain from virtual reality-based, circular eye-tracking goggles used at baseline and within 72 hours post-mTBI. Headache, dizziness, nausea, and fogginess provocation after the Vestibular Ocular Motor Screening (VOMS) smooth pursuits subtest compared with pretest baseline, assessed within 72 hours post-mTBI.

Results:

One hundred and nineteen college athletes (N = 56 women and 63 men) aged 18 to 24 years sustained a total of 177 mTBI. Forty-four percent of athletes displayed abnormal eye-tracking on at least 1 eye-tracking measure following acute mTBI compared with their baseline. From the VOMS, horizontal gain showed medium-sized to large-sized positive correlations with headache (r = 0.34) and dizziness (r = 0.54), respectively. Mean phase error showed a medium-sized negative correlation with nausea (r = −0.32) on the VOMS.

Conclusions:

Eye-tracking proficiency was impaired and correlated with vestibular symptom provocation following acute mTBI in college athletes. Future research should examine eye-tracking proficiency testing in other acute care settings to support mTBI diagnosis.
Alpha-Gal syndrome as a novel food allergy: a case report study
Authors: Ghelichi-Ghojogh Mousa , Ghezeljeh Edris , Delavari Sahar , Aghapour Seyed Ali
Published: May 2024

Introduction and importance:

Alpha-Gal syndrome (AGS), a distinct form of mammalian meat allergy, presents unique characteristics that set it apart from typical IgE-mediated food hypersensitivities. AGS induces an allergic response typically 3–6 h post-ingestion of mammalian meat, such as beef, pork, or lamb. This prolonged reaction time differentiates AGS from other food allergies, which usually provoke a more immediate response.

Case presentation:

The authors present a case of a 35-year-old male patient who, unbeknownst to him, had been experiencing symptoms consistent with Alpha-Gal allergy for several years. His symptoms only subsided upon the complete elimination of mammalian meat from his diet. It was only then that the possibility of AGS was considered. Complete abstinence from mammalian meat, meat by-products, and other α-Gal containing foods is the most effective preventative strategy for AGS. No definitive cure for AGS has been established as of now. Treatment protocols for hypersensitivity reactions are contingent upon the severity of the reaction, with therapies ranging from antihistamine medications to the administration of epinephrine.

Conclusion:

There is considerable variability among AGS patients concerning the consumption of dairy products. Some individuals with AGS can safely consume dairy products without any adverse reactions, while others are advised to abstain due to potential allergenic responses. This variability in dairy tolerance among AGS patients warrants further investigation.
Association between bronchial asthma and TSLP gene polymorphism: a systematic review and meta-analysis
Authors: Shrestha Abhigan B. , Pokharel Pashupati , Singh Harendra , Shrestha Sajina , Shrestha Shubham , Sedhai Yub Raj
Published: May 2024

Aims:

This study entails an association between bronchial asthma and common single nucleotide polymorphisms (SNPs) in thymic stromal lymphopoietin (TSLP) gene; rs2289278, rs3806933, rs2289276, and rs1837253.

Methods:

The databases of PubMed, Embase, Web of Science, and Google Scholar were searched for studies reporting TSLP polymorphisms and asthma from inception to January 2022. Hardy–Weinberg equilibriums (HWE) for each polymorphism of the control group were checked using the χ
2 test. The association was estimated by means of odds ratio (OR) with 95% CI in both dominant and recessive modes of inheritance, respectively.

Results:

Altogether, 11 studies with 3121 asthma cases and 3041 healthy controls were added. Results from six studies showed that the SNP rs2289278 had a protective role in asthma development (OR=0.65, 95% CI: 0.44–0.97, P=0.04). Pooling of four studies showed that the SNP rs3806933 had higher odds of developing asthma (OR=1.32, 95% CI:1.14–1.54, P<0.01). However, the SNP rs2289276 and rs1837253 showed no significant association. From the subgroup analysis, SNPs rs2289278 and rs1837253 were protective against the development of asthma in Asia. However, SNP rs2289276 showed a risk association in Asia and in adults.

Conclusion:

This meta-analysis shows that the SNP rs2289278 has a protective effect on the development of asthma; whereas rs3806933 has a risk of asthma. Additionally, this study adds genomic-based support to the recent FDA approval of tezepelumab, an anti-TSLP agent.
The relationship between demographic factors and known risk factors with breast cancer in women aged 30–69
Authors: Jahani Mohammad-Ali , Ghasemi Behnaz , Soltani Seyed Amir , Naderi Malihe , Nikbakht Hossein-Ali , Hashemi Seyedeh Nikoo , Yazdani Charati Jamshid , Mahmoudi Ghahraman
Published: May 2024

Background:

Breast cancer is one of the most important causes of cancer deaths in women. The present study was conducted to determine the relationship between demographic factors and known risk factors with breast cancer in women aged 30–69.

Method:

This case–control study was conducted with two matched and unmatched control groups. Three hundred fifty women aged 30–69 with breast cancer, 350 age-matched women without cancer, and 350 not age-matched women were included in the study. Controls were selected from the records of women whose breast cancer screening results were normal. Study subjects were evaluated regarding the risk factors for breast cancer. The data collection tool was a checklist including the risk factors investigated in the integrated health system. The collected data were analyzed utilizing SPSS22 software at a significance level of less than 0.05.

Results:

The average age in the case group was 46.63±11.77 years and 49.61±8.39 in the unmatched control group. The average age of marriage in the case group was 21.54±4.31, and the average age of women at first pregnancy in the case group was 24.06±3.39 years. In the case group, 163 people (46.57%) lived in the city, 221 people (63.14%) were over 40 years old, and 337 people (96.28%) were married. In multivariate analysis, the variable ‘age of marriage’ 0.821 (0.691–0.976) and ‘age of first pregnancy’ 1.213 (1.020–1.443) showed a significant relationship with breast cancer which were observed as predictors of breast cancer in comparison to the unmatched control group (P-value <0.05).

Conclusion:

The age of the first pregnancy and the type of delivery were observed as predictors of breast cancer. Therefore, by performing breast cancer screening in women who are exposed to these risk factors, early diagnosis of the disease and increasing the speed of their treatment can be significantly helped.
Risk of Parkinson’s disease among users of alpha-adrenergic receptor antagonists: a systematic review and meta-analysis
Authors: Lamichhane Pratik , Tariq Alina , Akhtar Asfia Neshat , Raza Mehnahil , Lamsal Arun Batsa , Agrawal Anushka
Published: May 2024

Background:

Recent studies have tried to establish an association between the use of alpha-1-adrenergic receptor antagonists (A1ARAs) used in benign prostatic hyperplasia (BPH) and the risk of PD. The objective of the study is to compare the risk of Parkinson’s disease (PD) between terazosin/alfuzosin/doxazosin (TZ/AZ/DZ) users and tamsulosin users.

Methods:

PubMed, Google Scholar, and Embase were systematically searched from inception to April 2023. Observational studies comparing the risk of PD among patients using different types of A1ARAs were included in the meta-analysis. The primary outcome was the hazard ratio (HR) with a 95% CI for the risk of occurrence of PD among A1ARAs users of two different classes.

Results:

This study was based on a total of 678 433 BPH patients, out of which 287 080 patients belonged to the TZ/AZ/DZ cohort and 391 353 patients belonged to the tamsulosin cohort. The pooled incidence of PD was higher in tamsulosin users (1.28%, 95% CI: 1.04–1.55%) than in TZ/AZ/DZ drug users (1.11%, 95% CI: 0.83–1.42%). The risk of occurrence of PD was significantly lower in patients taking TZ/AZ/DZ than tamsulosin (n= 610,363, HR = 0.82, 95% CI = 0.71–0.94, P = 0.01; I2 = 87.4%).

Conclusion:

This meta-analysis demonstrated that patients with BPH who take TZ/AZ/DZ have a lower risk for developing PD than those who take tamsulosin.
The scientific knowledge of three large language models in cardiology: multiple-choice questions examination-based performance
Authors: Altamimi Ibraheem , Alhumimidi Abdullah , Alshehri Salem , Alrumayan Abdullah , Al-khlaiwi Thamir , Meo Sultan A. , Temsah Mohamad-Hani
Published: May 2024

Background:

The integration of artificial intelligence (AI) chatbots like Google’s Bard, OpenAI’s ChatGPT, and Microsoft’s Bing Chatbot into academic and professional domains, including cardiology, has been rapidly evolving. Their application in educational and research frameworks, however, raises questions about their efficacy, particularly in specialized fields like cardiology. This study aims to evaluate the knowledge depth and accuracy of these AI chatbots in cardiology using a multiple-choice question (MCQ) format.

Methods:

The study was conducted as an exploratory, cross-sectional study in November 2023 on a bank of 100 MCQs covering various cardiology topics that was created from authoritative textbooks and question banks. These MCQs were then used to assess the knowledge level of Google’s Bard, Microsoft Bing, and ChatGPT 4.0. Each question was entered manually into the chatbots, ensuring no memory retention bias.

Results:

The study found that ChatGPT 4.0 demonstrated the highest knowledge score in cardiology, with 87% accuracy, followed by Bing at 60% and Bard at 46%. The performance varied across different cardiology subtopics, with ChatGPT consistently outperforming the others. Notably, the study revealed significant differences in the proficiency of these chatbots in specific cardiology domains.

Conclusion:

This study highlights a spectrum of efficacy among AI chatbots in disseminating cardiology knowledge. ChatGPT 4.0 emerged as a potential auxiliary educational resource in cardiology, surpassing traditional learning methods in some aspects. However, the variability in performance among these AI systems underscores the need for cautious evaluation and continuous improvement, especially for chatbots like Bard, to ensure reliability and accuracy in medical knowledge dissemination.
Post-intubation tracheal rupture treated surgically using a muscle graft from the Latissimus Dorsi: a rare disorder and review of literature
Authors: Haddad Sultaneh , Haneyah Farah , Jwainat Mu’taz Nader Ibrahim , Bayat Ghassan , Zakka Amjad , Albekaai Emad , Al-Rashdan Omar Abd Elfattah Ali , Daradkeh Basil , Abo Dakka Yamama , Shbat Mohamad , Chaban Hussain
Published: May 2024

Introduction:

Post-intubation tracheal rupture (PiTR) is an extremely uncommon disorder. Pneumothorax, pneumomediastinum, hemorrhage, cutaneous emphysema, and sepsis are common clinical presentations that eventually result in organ failure and mediastinitis. Endoscopy and computed tomography (CT) are considered the gold standards for assessment and diagnosis.

Case presentation:

Here, the authors present a 96-year-old woman with asthma and ischemic heart disease presented to the Emergency Department with dyspnea following viral pneumonia. Despite initial treatment, her condition worsened, requiring tracheal intubation. Subsequent complications led to a diagnosis of tracheal rupture, requiring surgical repair. The procedure involved using a muscle graft from the Latissimus Dorsi muscle: which is a novel Surgical Technique as the authors have conducted a literature review.

Discussion:

Upon scrutinizing analogous cases delineated within the medical literature, it becomes evident that our patient manifests four distinct risk factors. These factors include gender, advanced age, asthma, and prolonged steroid use.

While the clinical manifestation and diagnostic methods for tracheal rupture are frequently consistent throughout cases, there is a significant variation in the surgical treatments used to treat the condition.

Conclusion:

More research should be conducted to investigate the use of muscle grafts as a treatment technique for tracheal rupture in the future.
Two cases of pituitary stalk interruption syndrome: importance of early detection and management
Authors: Zakkor Mohammed Deeb , Khana Firas , Abdulrazzak Mohammed , Kreid Sedra , Kayyali Alae , Al Hussein Hachem
Published: May 2024

Introduction and importance:

Pituitary stalk interruption syndrome (PSIS) is a rare congenital condition affecting the pituitary gland and its stalk, leading to hormonal imbalances. PSIS can present with a wide range of symptoms, including delayed puberty and short stature.

Case presentation:

This paper discusses two cases of PSIS in patients with a history of growth hormone deficiency. The first case is of a 26-year-old male presenting with fatigue and loss of appetite, while the second case is of a 14-year-old male presenting with delayed puberty. Blood tests revealed hormonal imbalances, and a subsequent MRI confirmed the diagnosis of PSIS. Hormonal supplements were prescribed to manage the condition, and follow-up appointments were scheduled to monitor progress.

Clinical discussion:

PSIS can present with a wide range of symptoms, and can be diagnosed at different ages. Early diagnosis and management of PSIS are crucial to prevent long-term complications such as short stature, impaired cognitive function, and infertility. The use of hormonal supplements, as seen in both cases, is essential to manage the hormonal imbalances associated with PSIS. Testosterone replacement therapy is used to treat hypogonadism, while thyroxine and hydrocortisone are used to manage hypothyroidism and adrenal insufficiency, respectively.

Conclusion:

Early diagnosis and management of PSIS through hormonal supplements are crucial to prevent long-term complications. It is essential to monitor patients’ progress through follow-up appointments to ensure optimal management of the condition.