bluuebunny/crossref_metadata_2025 huggingface dataset:
Water quality assessment using national Water Quality Index (WQI): a case study of the Song Be River, Bing Duong Province, Vietnam
Authors: Huynh An The , Dao Trung Minh , Nguyen Tuyet Anh Huynh
Published: September 2024

The Song Be River is a vital water source in Binh Duong Province, Vietnam, playing a crucial role in supplying water for domestic use and agriculture, as well as supporting local ecosystems. However, due to the recent rapid economic and industrial growth, the river’s water quality has encountered significant challenges, particularly from the improper discharge of untreated wastewater from various sources and activities. This study conducts a comprehensive analysis of the Song Be River’s water quality by employing the Water Quality Index (WQI) in conjunction with Geographic Information System (GIS) technology. Subsequently, several strategies are also proposed to effectively manage and enhance the water quality of the Song Be River. Over the period from March 2023 to March 2024, 52 samples were collected from four monitoring points (SB1, SB2, SB3, and SB4) along the Song Be River, with a frequency of once per month. All analytical parameters (such as NH4
+_N: 0.01–0.61 mg l−1, NO2
−_N: 0.014–0.03 mg l−1, Fe: 0.01–0.81 mg l−1, Chemical Oxygen Demand (COD): 4–26 mg l−1, Dessolved Oxygen (DO): 3.8–6.6 mg l−1, Suspendid Solids (SS): 5–69 mg l−1, Coliform: 1200–4300 MPN/100 ml, Total phosphorous: 0.01–0.08 mg l−1 and Total nitrogen: 1.16–4.5 mg l−1) fell within the permissible limits according to the Vietnamese National Standards. Furthermore, the WQI ranged from 73 to 100, indicating that the water quality of The Song Be River is good and suitable for domestic use.
Impact of the central-Pacific ENSO on the Tibetan Plateau precipitation in boreal spring
Authors: Wang Run , Ren Hong-Li , Liu Minghong , Zhou Fang , Du Jun
Published: September 2024

The importance of spring Tibetan Plateau (TP) precipitation is increasingly recognized. This study investigated the primary spatiotemporal features of spring Tibetan Plateau (TP) precipitation and revealed its pronounced impacts from El Niño–Southern Oscillation (ENSO). The spring TP precipitation anomalies are majorly featured by a west–east spatial pattern with interannual variations correlated with the spring central-Pacific (CP) ENSO. This west–east precipitation pattern leads to more precipitation in the western TP and less in the eastern TP under the spring CP El Niño, which is reversed under the spring CP La Niña. The ENSO-related Walker circulation variations and induced Indian Ocean warming that further excite anomalous zonal–vertical and meridional–vertical circulations south of TP are crucial to the spring TP precipitation through configuring the opposite anomalies of vertical motions and moisture convergence over western to eastern TP. The CP ENSO could be a potential precursor to the spring TP precipitation owing to its relatively long predictability and a summer persistence barrier.
Application of random forest algorithm in the study of microscopic features and visitor experience evaluation in gardens
Authors: Liu Wenjie , Li Huan , Huang Dengkai , He Fang , Liu Wenxue , Sun Qiaoyun
Published: September 2024

In the development of modern urban gardens, delving into visitor experience perception to address homogenization issues is a crucial means to enhance garden space characteristics and meet diverse demands. This study selected nine representative modern gardens in the Taihu Lake region as samples. Utilizing machine learning techniques combined with image semantic segmentation and principal component analysis, it systematically assessed various microscopic features of gardens and explored their relationship with actual visitor experience ratings. The aim is to reveal emotional resonance and aesthetic preferences during the touring process. The results indicate: (1) Comfort holds a primary position in influencing visitor touring experiences; (2) Microscopic features such as water features, tall vegetation, architecture, and ornametal elements significantly contribute to visitor comfort; (3) The random forest model unveils complex interactions between microscopic features and the overall visitor experience, indicating limitations in traditional linear model evaluations for such relationships. Through analyzing the relationship between microscopic garden features and visitor experiences in the selected cases, this study highlights the importance of adopting non-linear models to optimize garden landscape design and enhance the visitor touring experience.
Evaluation of long-term stability of L-asparaginase encapsulated PLL-g-PEG nanoparticles in solution to aid in therapeutic delivery
Authors: Goff Keri , Dean Dallas , Helms Isabella , Hatton Riley , Hines Reginald , Hikkaduwa Koralege Rangika S
Published: September 2024

L-asparaginase (L-ASNase) is a therapeutic enzyme that is widely used for the treatment of hematopoietic diseases such as acute lymphoblastic leukemia and lymphomas. L-ASNase destroys asparagine dependent tumors by degrading circulating L-asparagine and thereby destroying malignant cells. As a protein drug, L-ASNase carries a few inherent drawbacks including short circulating half-life, low stability, and low catalytic activity under physiological conditions. Moreover, due to the bacterial origin of L-ASNase used in treatments, there have been reports with high frequency of hypersensitivity reactions in patients. The use of this drug in adult cancer populations has largely been hindered not only due to its immunological side effects but also due to non-immunogenic toxicities such as pancreatitis, liver toxicities, coagulopathy, and neurotoxicity. Therefore, it is vital to find new methods to decrease its immunogenic/toxicity profile while increasing the stability and half-life. The purpose of this study is to achieve a new L-ASNase polymer nanocarrier to improve stability of the enzyme while masking it from the immune system of the host. We designed and characterized a nanoparticle (NP) where a poly-L-lysine-grafted-poly(ethylene) glycol co-polymer was used to encapsulate L-ASNase. The primary focus of the study was to evaluate the stability and encapsulation efficiency of this NP construct over time. There was no aggregation of NPs observed during the study period of 6 months in solution and NPs had a 0.436 mV surface charge. L-ASNase NPs showed a percent asparaginase activity of 31% compared to free L-ASNase. Under physiological conditions NPs were found to be intact and retained the encapsulated proteins for up to 6 months in solution. Together, these results demonstrate that L-ASNase loaded PLL-g-PEG NPs may serve as a fundamental platform to design nanocarriers to prolong stability in solution.
Time–frequency analysis using spiking neural network
Authors: Bensimon Moshe , Hadad Yakir , Ben-Shimol Yehuda , Greenberg Shlomo
Published: September 2024

Time–frequency analysis plays a crucial role in various fields, including signal processing and feature extraction. In this article, we propose an alternative and innovative method for time–frequency analysis using a biologically inspired spiking neural network (SNN), encompassing both a specific spike-continuous-time-neuron-based neural architecture and an adaptive learning rule. We aim to efficiently detect frequencies embedded in a given signal for the purpose of feature extraction. To achieve this, we suggest using an SN-based network functioning as a resonator for the detection of specific frequencies. We developed a modified supervised spike timing-dependent plasticity learning rule to effectively adjust the network parameters. Unlike traditional methods for time–frequency analysis, our approach obviates the need to segment the signal into several frames, resulting in a streamlined and more effective frequency analysis process. Simulation results demonstrate the efficiency of the proposed method, showcasing its ability to detect frequencies and generate a Spikegram akin to the fast Fourier transform (FFT) based spectrogram. The proposed approach is applied to analyzing EEG signals, demonstrating an accurate correlation to the equivalent FFT transform. Results show a success rate of 94.3% in classifying EEG signals.
Discussion on “LEAP: the latent exchangeability prior for borrowing information from historical data” by Ethan M. Alt, Xiuya Chang, Xun Jiang, Qing Liu, May Mo, H. Amy Xia, and Joseph G. Ibrahim
Authors: Campbell Harlan , Gustafson Paul
Published: September 2024

We commend Alt et al.’s innovative approach for analysis with a hybrid control arm while offering insights into two key considerations: the necessity for extrapolation and the potential benefits of curating historical control data before analysis.
Social Work and Aboriginal Australians: What Gets in the Way of Good Practice
Authors: Holl Karen , Fejo-King Christine , Frederico Margarita , MacLean Sarah J
Published: September 2024

The social work profession is rightly criticised for past and present wrongdoing against Aboriginal Australians. Non-Aboriginal social workers have significant contact with Aboriginal peoples but despite their guidance, social workers can struggle to engage effectively. Whilst this work is complex, little is known about the challenges non-Aboriginal social workers encounter, and how they might be navigated better. To address this gap, this article explores accounts from seventeen non-Aboriginal social workers who were interviewed about their practice with Aboriginal peoples in Australia, with framing and interpretation informed by interviews with thirteen Aboriginal Australians. Data were analysed using two approaches: a microanalysis and The Listening Guide. Participants insisted that their challenges are insignificant compared to those of Aboriginal Australians. Findings illustrate the complex nature of this experience for non-Aboriginal social workers, that is both highly valued and has the potential to distress. Implementing ethical practice against a backdrop of Australia’s history of invasion and colonisation and their on-going impacts such as the racist treatment of Aboriginal Australians can be difficult to navigate. Supervision is a recognised approach to managing challenges; however, we caution against adopting this strategy without recognising and addressing the contextual dimensions of these experiences.
For a Carnal Social Work: A Review of the Body in Social Work Literature
Authors: Bogue Kerr Stephanie
Published: September 2024

Social work practice is charged with concerns related to the body; health, age, gender, sexuality, race, abuse and violence, to name a few. Despite this, the body itself is strangely invisible in social work literature, its experiences often indirectly addressed. The present scoping review seeks to explore how the body is situated and conceptualised within the peer-reviewed social work literature between 2012 and 2022. The wide scope of this review captures a range of articles (n = 148) in many different journals (n = 56), with few tackling the same questions. Moreover, the stories of many bodies are not yet represented in social work literature. Seven broad relational categories were identified: relationship to oneself; interpersonal concerns in health; systemic and structural concerns in health; therapeutic relationships; the body in intervention; embodied structures; and the body in social work education. The results point to the need for a framework through which to see and interpret the body, promoting a more central position in research and practice. Wacquant’s carnal sociology (2015) is proposed as an appropriate scaffold for bringing the body into view within social work practice and research.
Halochromism of 2-indolinone fluorophore based on the deprotonation of an acidic C–H bond
Authors: Suzuki Naoya , Yagi Keita , Maeda Takeshi , Kodama Shintaro , Yagi Shigeyuki
Published: September 2024

We disclosed a new halochromic fluorescent dye based on the deprotonation from an acidic C–H bond. The dye consisting of a 2-indolinone skeleton and a benzothiazole ring exhibited an obvious red shift in its photoluminescence spectra in response to the presence of bases. Structural analyses with 1H NMR measurements and theoretical calculations suggested that the π-conjugated system of the dye was expanded by the deprotonation of the acidic C–H bond on the 2-indolinone skeleton. This structural change contributes to the red shift of photoluminescence and accelerates the radiative decay from the excited state.
Cerebrospinal Fluid Homovanillic and 5-Hydroxyindoleacetic Acids in a Large Pediatric Population; Establishment of Reference Intervals and Impact of Disease and Medication
Authors: Rodriguez-Gonzalez Helena , Ormazabal Aida , Casado Mercedes , Arias Angela Y , Oliva Clara , Barranco-Altirriba Maria , Casadevall Ricard , García-Cuyas Francesc , Nascimento Andrés , Ortez Carlos , Natera-de Benito Daniel , Armangué Thais , O’Callaghan Maria M , Juliá-Palacios Natalia , Darling Alejandra , Ortigoza-Escobar Juan Darío , Fons Carmen , García-Cazorla Angels , Perera-Lluna Alexandre , Artuch Rafael
Published: September 2024

Background

Cerebrospinal fluid (CSF) homovanillic (HVA), and 5-hydroxyindoleacetic acids (5-HIAA) are biomarkers of neurological diseases affecting the dopaminergic and serotoninergic pathways. Establishing reference intervals for these metabolites faces the challenges of a lack of healthy controls and a negative correlation with age, making stratified intervals unrealistic. We propose a pipeline to determine continuous reference intervals for HVA and 5-HIAA using an indirect method. We also studied the confounding effects of different variables and explored the impact of antiepileptic and neuroleptic treatments on HVA and 5-HIAA values.

Methods

The study used least squares regression to fit age–concentration curves from a cohort of pediatric patients (n = 1533), where the residuals represent metabolite values excluding age effect. Presuming that HVA and 5-HIAA primary deficiencies characterize a distinct subpopulation, we fitted a two-component finite mixture model in age-normalized data and set reference intervals at the central 95% of the nondeficient population.

Results

Patients with primary genetic deficiencies of HVA and/or 5-HIAA consistently fall outside the proposed continuous reference intervals. Using the new continuous reference intervals reduces the number of secondary deficiencies detected compared with using stratified values. No correlations were observed between CSF HVA and 5-HIAA values across the studied drug categories (antiseizure and neuroleptic medications). In addition, biopterin values positively influenced both metabolite concentrations.

Conclusion

The proposed continuous reference intervals caused a substantial reduction in the number of secondary deficiencies detected, most of which demonstrated no conclusive correlations between the diseases and altered HVA and 5-HIAA values.
Fortune may favor the flexible: Environment-dependent behavioral shifts in invasive coquí frogs
Authors: Soto Katharina M , Edmonds Devin , Colton Andrea L , Britton Michael R , Hardin Faith O , Fischer Eva K
Published: September 2024

Biological invasions are a major driver of global biodiversity loss, impacting endemic species, ecosystems, and economies. While the influence of life history traits on invasive success is well-established, the role of behavior in the invasive potential of animals is less studied. The common coquí frog, Eleutherodactylus coqui, is a highly successful invader in Hawai’i. We build on previous research characterizing changes in physiology and morphology to explore behavioral variation across the invasive range of coquí in Hawai’i. Coquí have expanded both outward and upward from their initial introduction site, and - by comparing frogs from different densities and elevations - we specifically asked how the physiological challenges of high-elevation living interact with the competitive challenge of high-densities at population centers. To investigate whether differences in the field represent local adaptation or behavioral plasticity, we additionally evaluated behavior following acclimation to a shared laboratory environment. While we identified only subtle behavioral variation among populations in the field, we found that individuals from all populations became less bold, active, and exploratory in the laboratory, converging on a similar behavioral phenotype. Alongside previous work, our results suggest that coquí adjust their behavior to local environmental conditions across their invasive range, and that behavioral flexibility may contribute to invasive success.
Patterns of occurrence, phenology, and phylogeny of Phloeosinus punctatus LeConte (Coleoptera: Curculionidae, Scolytinae) in giant sequoia
Authors: Foote Nathaniel E , Foote Gabriel G , Comai Nathan , Ibarra Caballero Jorge R , Stewart Jane E , Ambrose Anthony R , Baxter Wendy L , Davis Thomas S
Published: September 2024

Here, we describe patterns of reproduction and flight phenology of putative Phloeosinus punctatus in giant sequoia groves and compare morphology and genotypes of beetles from sympatric giant sequoia (Sequoiadendron giganteum) and California incense-cedar (Calocedrus decurrens). Surveys conducted in 2022 revealed that numerous branches fall from giant sequoia crowns (on average ~30 branches/tree), with 20%–50% of trees per site shedding branches, depositing breeding material for beetles on the forest floor that subsequently becomes colonized. When noninfested branches cut from mature giant sequoias were placed at the ground surface, they were colonized by P. punctatus and produced an average of 28 beetles/kg branch. Climbing and examination of sequoia crowns in 2023 showed that 75% of mature trees across 11 groves showed evidence of adult beetle entrance holes in their crowns. In 2021, tests with sticky traps showed that beetles alighted on fallen branches from 20th May to 20th August (peak landing: 2nd July); a logistic model developed from emergence data in 2021 and 2022 predicts the emergence of F1 offspring from branches between 10th July and 1st September (peak emergence: 8th August). Beetles emerging from giant sequoia preferred to settle on giant sequoia, did not reproduce in incense-cedar, and diverged morphologically from beetles emerging from incense-cedar. However, phylogenetic analysis of three genes (28S, CAD, and COI) revealed no clear pattern of sequence divergence, suggesting a single species (P. punctatus) that colonizes both hosts, though cryptic speciation may not be detectable with standard barcoding genes. Ecological and potential management implications are discussed.
Association of Pain With Falls and Fractures Among Middle-Aged Korean Community-Dwelling Adults
Authors: Yao Shaoli , Chen Xi-wen
Published: September 2024

Background

The relationship between pain and falls remains controversial. Therefore, this study explored the associations between pain and fall-related outcomes in 5 340 middle-aged (45–65 years) adults residing in the communities in Korea.

Methods

Pain was defined as pain at any location, pain-related activity restriction, and persistent pain. The outcome measures included fall injuries, recurrent falls, injurious falls, and fall-related hip fractures. A multivariate logistic regression model was used to examine the relationship between pain and fall outcome.

Results

Among the study participants, 54.0% reported having experienced pain. During a follow-up period of up to 14 years, those who reported pain and pain-related activity restriction at baseline exhibited a positive association with the occurrence of fall injury (odds ratio [OR] 1.79, 95% confidence interval [CI]: 1.27–2.53) and injurious falls (OR 1.72, 95% CI: 1.20–2.48) but not with recurrent falls (OR 1.90, 95% CI: 0.80–4.54). We also observed a positive association between persistent pain and the risk of fall injury (OR 1.41, 95% CI: 1.13–1.91), whereas no consistent conclusions were drawn regarding the risk of recurrent falls and injurious falls. We also did not identify any correlation between pain and hip fractures resulting from falls.

Conclusions

In conclusion, our findings of the positive correlations of pain and pain-related activity restriction at baseline with fall injuries and injurious falls but not recurrent falls during follow-up suggest that public health initiatives should prioritize pain screening, especially for participants reporting ankle and toe pain, and implement suitable interventions to mitigate the risk of falls and the associated adverse outcomes among middle-aged adults.
Drug-free remission of immune thrombocytopenic purpura following resection of perihilar cholangiocarcinoma: a case report
Authors: Sakuma Masayoshi , Takahashi Daigoro , Kamei Keitaro , Takayama Yuichi , Takahashi Takamasa , Aoyama Hiroki , Hosoi Takahiro , Maeda Atsuyuki
Published: September 2024

Immune thrombocytopenic purpura (ITP) is a rare autoimmune disorder. Although secondary ITP, caused by various underlying diseases, including some malignant tumors, has been reported, instances of ITP resolving after successful treatment of the underlying cause are uncommon and noteworthy. Herein, we present a case of a patient with perihilar cholangiocarcinoma (pCCA) and ITP who achieved drug-free remission of ITP following tumor resection. A 76-year-old man presented with pCCA complicated by ITP. Prednisolone treatment successfully managed his thrombocytopenia, allowing for a left hepatopancreatoduodenectomy. ITP relapse did not occur after discontinuation of prednisolone postoperatively. This case suggests that surgical resection of the underlying malignancy may induce remission of secondary ITP associated with pCCA.
Etiology of Leukemoid Reaction in Patients Undergoing Extracorporeal Membrane Oxygenation
Authors: Wells Christian B , Sobieszczyk Michal J , Marcus Joseph E
Published: September 2024

Introduction

Nosocomial infections are frequent in patients receiving extracorporeal membrane oxygenation (ECMO). Leukemoid reaction, defined as >50,000 white blood cells (WBCs) per microliter, has been associated with infections in some populations. As ECMO is associated with significant inflammation activation between the patient’s immune system and the circuit components, it is hypothesized that leukemoid reactions may have low specificity for identifying new infections in patients receiving ECMO.

Materials and Methods

A retrospective cohort study was performed on all adult patients admitted to the Brooke Army Medical Center who received ECMO for greater than 72 hours between 2018 and 2022. Maximum WBCs were obtained for all charts. For those with leukemoid reaction, demographic information and clinical management was obtained. This study was determined to be exempt by Brooke Army Medical Center Institutional Review Board.

Results

Among 182 patients receiving ECMO for greater than 72 hours, 15 (8%) developed a leukemoid reaction while on ECMO. The median (Interquartile range, IQR) WBC was 53.94 (50.98 to 62.55). Fourteen (93%) patients underwent an infectious evaluation. Patients had a median of 2 (IQR: 2 to 3) etiologies contributing to their leukemoid reaction. At the time of leukemoid reaction, 11 (73%) patients were receiving treatment for a known infection, 6 (40%) were found to have a new thrombus, and 4 (27%) were receiving glucocorticoids. Only 1 (7%) patient was found to have a new infection, an Acinetobacter baumannii bacteremia.

Conclusions

Leukemoid reactions occur infrequently in patients receiving ECMO and are generally multifactorial. In this cohort, leukemoid reactions rarely occurred in the setting of a new infection and suggest low utility to starting or broadening antimicrobials for these patients. Future studies identifying useful infectious markers are needed for patients receiving ECMO.
Human hnRNPA1 reorganizes telomere-bound replication protein A
Authors: Granger Sophie L , Sharma Richa , Kaushik Vikas , Razzaghi Mortezaali , Honda Masayoshi , Gaur Paras , Bhat Divya S , Labenz Sabryn M , Heinen Jenna E , Williams Blaine A , Tabei S M Ali , Wlodarski Marcin W , Antony Edwin , Spies Maria
Published: September 2024

Human replication protein A (RPA) is a heterotrimeric ssDNA binding protein responsible for many aspects of cellular DNA metabolism. Dynamic interactions of the four RPA DNA binding domains (DBDs) with DNA control replacement of RPA by downstream proteins in various cellular metabolic pathways. RPA plays several important functions at telomeres where it binds to and melts telomeric G-quadruplexes, non-canonical DNA structures formed at the G-rich telomeric ssDNA overhangs. Here, we combine single-molecule total internal reflection fluorescence microscopy (smTIRFM) and mass photometry (MP) with biophysical and biochemical analyses to demonstrate that heterogeneous nuclear ribonucleoprotein A1 (hnRNPA1) specifically remodels RPA bound to telomeric ssDNA by dampening the RPA configurational dynamics and forming a ternary complex. Uniquely, among hnRNPA1 target RNAs, telomeric repeat-containing RNA (TERRA) is selectively capable of releasing hnRNPA1 from the RPA–telomeric DNA complex. We speculate that this telomere specific RPA–DNA–hnRNPA1 complex is an important structure in telomere protection.
Has Ghana's Rotavirus Vaccine Switch Met Programmatic Expectations? An Analysis of National Surveillance Data; 2018–2022
Authors: Adjei Michael Rockson , Ofori Amoah Justice , Bonsu George , Okine Rafiq , Mohammed Naziru Tanko , Amponsa-Achiano Kwame , Asiedu-Bekoe Franklin , Kuma-Aboagye Patrick , Mwenda Jason Mathiu , Grobusch Martin Peter , Ohene Sally-Ann
Published: September 2024

Background

Ghana introduced a 2-dose schedule rotavirus vaccine, Rotarix, into childhood immunization in 2012 but switched to a 3-dose schedule vaccine, Rotavac, in 2020 on account of programmatic advantages offered by the latter, including lower cost per fully immunized child and lower cold chain volume requirement. The objective of the study was to assess the effect of the vaccine switch on the trends of rotavirus vaccine uptake and health facility outpatient department (OPD) attendance due to diarrhea among children aged 1–11 months.

Methods

A retrospective analysis was conducted on childhood immunization and diarrhea surveillance data for 2018–2022. The uptake of the different rotavirus vaccine products and the proportion of health facility OPD attendance attributed to diarrhea, respectively, were compared between the pre- and postswitch study periods.

Results

The uptake of rotavirus vaccine was sustained following the switch. There were no significant differences in vaccination coverages (rota1, Rotarix coverage [94.3%], vs rota1, Rotavac coverage [95.3%]; P = .757; rota2, Rotarix coverage [91.3%], vs rota2, Rotavac coverage [92.7%]; P = .789). The proportions of health facility OPD attendance due to diarrhea were comparable (preswitch [12.4%] vs postswitch [12.1%]; P = .838).

Conclusions

Ghana's rotavirus vaccine switch yielded expected programmatic benefits without any untoward effects. The trends of vaccine uptake and reduction in diarrhea morbidity were sustained. These experiences and lessons from the rotavirus vaccine switch are vital for potential switches for other vaccines in the current immunization schedule to mitigate the annual vaccine expenditure.
Nest-site selection and nest predation in a tropical passerine in relation to food, friends, and foes
Authors: van Eerden Arne Okko Kees , Komdeur Jan , Richardson David S , Dugdale Hannah L , Hammers Martijn
Published: September 2024

Nest-site selection is an important determinant of avian reproductive success, mainly through its effect on predation risk. However, which environmental and social factors affect nest-site selection and predation risk remains less well understood. Optimal nest positioning may depend on the balance of many distinct factors such as nest predation, food availability, extra-pair mating opportunities, presence of helpers, and interactions with neighboring conspecifics. We investigated how these factors affect nest-site selection and nest survival in Acrocephalus sechellensis (Seychelles Warbler), a facultative cooperative-breeding passerine that defends stable territories year-round. We found that daily nest survival increased by ~1% for each meter higher in the canopy that a nest was placed. Nests were more likely to be located in food-rich parts of the territory, especially in territories with low overall densities of arthropods. Further, we found that nests in territories with helpers, which reduce nest predation in A. sechellensis, were built in areas with higher food availability, whereas nests in territories without helpers were built in areas with fewer nest predators. Finally, we found that females build their nests 0.5 m closer to the border for each year the nearest neighboring male was older than their partner. Our results suggest that nest-site selection in A. sechellensis is affected by nest predation, food availability, helper presence, and possibly, the female’s opportunity for extra-pair copulations. Clarifying the relative importance of these different selective factors is key to the understanding of optimal nest-site selection to maximize reproductive success.
Characterization of Two Novel Viruses Within a Complex Virome from Flowering Ginger in Hawaii
Authors: Larrea-Sarmiento Adriana E. , Galanti Russell , Olmedo-Velarde Alejandro , Wang Xupeng , Al Rwahnih Maher , Borth Wayne , Lutgen Hannah , Fitch Maureen M. , Sugano Jari , Sewake Kelvin , Suzuki Jon , Wall Marisa M. , Melzer Michael , Hu John
Published: September 2024

Flowering ginger (Alpinia purpurata) is economically and culturally important in Hawaii. In the past decade, a slow decline syndrome has impacted the production of this crop in the state. RNA sequencing analyses and virus indexing surveys were done on samples collected from four of the Hawaiian Islands. Viral sequences corresponding to six viruses were recovered from transcriptomic data from samples with virus-like symptoms. Canna yellow mottle virus (CaYMV, genus Badnavirus) and two novel viruses, Alpinia vein clearing virus (ApVCV, genus Ampelovirus) and Alpinia vein streaking virus (ApVSV, genus Betanucleorhabdovirus), were found at a moderate incidence in diseased plants. Conversely, three other viruses, including the two potyviruses, banana bract mosaic virus and bean common mosaic virus, and a badnavirus, banana streak GF virus, were also found but at a low incidence. Virus detection in potential insect vectors and transmission assays identified the mealybug Planococcus citri as a vector of CaYMV and ApVCV, whereas the aphid Pentalonia caladii was identified as a vector of the novel ApVSV. Both P. citri and P. caladii are common pests of flowering ginger in Hawaii. Transmission of ApVSV was achieved using P. caladii colonies either established in the laboratory or naturally feeding on infected plants, although no transmission was obtained using viruliferous aphids originally reared on taro (Colocasia esculenta). Our study provides insights into the potential association between viral infections and the observed decline symptoms of flowering ginger in Hawaii. However, more definitive studies are needed to link single or mixed viral infections with decline symptoms.
5-Day Injectable Extended-release Buprenorphine Initiation in Non–opioid-tolerant Individuals in a Carceral Setting: A Case Series
Authors: Perdue Matt , Hosseini Ghomi Reza , Rees Paul , Arzubi Eric
Published: September 2024

Background

Injectable extended-release buprenorphine (XR-Bup) addresses several barriers to the implementation of treatment with medications for opioid use disorder (MOUD) in carceral settings due to lower risk of diversion and reduced operational procedures. However, there is no standardized approach or guideline for initiating sublingual buprenorphine (SL-Bup) and transitioning to XR-Bup in persons with opioid use disorder (OUD) who are not actively using opioids, a clinical scenario commonly encountered in carceral settings.

Methods

We conducted a retrospective case series of non–opioid-tolerant men with OUD at a Montana Department of Corrections facility who initiated XR-Bup using a 5-day induction protocol between May 1, 2023, and November 1, 2023. Primary outcome was receipt of the initial XR-Bup injection. Secondary outcomes were toleration of SL-Bup induction protocol and active continuation of XR-Bup at time of discharge.

Results

Sixteen individuals initiated the SL-Bup induction protocol, and all were successfully transitioned to XR-Bup with no severe adverse effects. There were no required dose changes or severe adverse effects from SL-Bup induction. Two (12%) elected to discontinue XR-Bup due to commonly reported adverse effects. Fourteen (88%) remained on XR-Bup at discharge.

Conclusions

Five-day induction of SL-Bup and transition to XR-Bup may be considered for non–opioid-tolerant individuals with OUD in carceral settings.
Considering the Cost-Effectiveness of Accredited Continuing Medical Education: A Landscape Analysis of Economic Concepts in Continuing Medical Education Research
Authors: Dietze Derek T. , Frimpter Jeff
Published: September 2024

Introduction:

In health care, cost-effectiveness analysis evaluates changes in health outcomes as a function of costs. The cost-effectiveness of continuing professional development for health care providers has not been historically well characterized despite substantial investment. This literature review identified publications considering the costs and cost-effectiveness of accredited continuing medical education activities.

Methods:

Searches were conducted for English language records in PubMed and the gray literature using a 10-year lookback period from March 10, 2023. Search terms included concepts related to continuing medical education, cost, effect, and utilization. One reviewer conducted title/abstract screening, full-text review, and data extraction, with direction and adjudication of search and screening concepts provided by the lead advisor. Publications were categorized as related to costs of an educational intervention (Concept 1) and/or the impact of education on health care costs (Concept 2). Results were summarized using descriptive statistics.

Results:

A total of 668 database records were screened, 125 (19%) underwent full-text review, and 25 of 125 (20%) were accepted; 7 of 351 (2%) gray literature sources were accepted for a total of 32 included records. The most common reason for rejection was not being an accredited activity. Of the 32 records, 27 (84%) were related to Concept 1 only, 3 (9%) to Concept 2 only, and 2 (6%) to both Concepts 1 and 2. Approximately half (n = 19, 59%) mentioned costs without supporting data.

Discussion:

These findings show that considerations of cost and cost-effectiveness are rare in the accredited continuing medical education literature, which may limit how the value of continuing medical education is characterized.
Antithrombotic Strategies After Transcatheter Aortic Valve Replacement in Patients Without an Indication of Oral Anticoagulants: A Network Meta-Analysis of Randomized Controlled Trials
Authors: Awad Ahmed K. , Abuelazm Mohamed , Adhikari Govinda , Amin Ahmed Mazen , Elhady Mahmoud M. , Awad Ayman K. , Mahmoud Abdelrahman , Gonnah Ahmed R. , Abdelazeem Basel
Published: September 2024

Single-antiplatelet therapy (SAPT) has been a standard of care posttranscatheter aortic valve replacement with no clear evidence exist using direct oral anticoagulants (DOACs), vitamin K antagonists (VKA), or dual antiplatelet agents (DAPT); thus we aim to compare the safety and efficacy of the various antithrombotic strategies after transcatheter aortic valve replacement. We performed a network meta-analysis using a frequentist framework, pooling dichotomous outcomes using risk ratio (RR), and continuous data using mean difference, along with the corresponding 95% confidence interval (CI). Nine randomized controlled trials with 4193 patients were included, 567 patients were in the VKA group, 591 patients in the SAPT group, 1571 patients in the DAPT group, and 1464 patients in the DOACs group. Only DOAC showed a statistically significant higher risk of all-cause mortality [RR of 1.88 (95% CI: 1.07–3.28)] with no statistically significant difference between our arms in terms of mortality. For minor bleeding, DAPT had a significant higher risk with RR of 1.53 (95% CI: 1.04–2.25), while for major bleeding, DAPT and DOAC had a significant higher risk with RR of 2.36 (95% CI: 1.27–4.40) and 4.74 (95% CI: 2.05–10.92), respectively. There was no significant difference in terms of stroke and life-threatening bleeding. Moreover, only DOAC showed a significantly lower risk for valve thrombosis, when compared to other strategies [RR: 0.24 (95% CI: 0.13–0.46)]. Overall, SAPT had lower major bleeding events compared to other arms. There were no differences in the outcomes of stroke, myocardial infarction, or life-threatening bleeding outcomes. However, DOACs significantly reduced valve thrombosis compared to VKAs.
Curbside Consults Salt-Free Potassium-Enriched Substitute Versus Salt-Free Diet in Hypertension: Which Is Better?
Authors: Desai Dev , Agrawal Siddharth Pravin , Maheta Darshilkumar , Abouarab Ahmed Gamal , Frishman William H. , Aronow Wilbert S.
Published: September 2024

This article examines the potential benefits of using potassium-enriched salt and following a salt-free diet to control hypertension, a prevalent global condition and a major risk factor for heart disease, stroke, and kidney disease. The article explores the impact of sodium on high blood pressure, explains what potassium-fortified salt is, and includes personal experiences. The article also examines the scientific proof backing potassium-fortified salt, evaluating its advantages and constraints. It subsequently assesses the advantages and disadvantages of a diet without salt, with the goal of providing readers with thorough information to help them make educated choices. The article emphasizes the significance of nutrition in averting noncommunicable diseases, especially heart-related issues associated with hypertension. The conversation focuses on the benefits of potassium-rich salt and salt-free diets for controlling high blood pressure and improving heart health. It acts as a stimulus for additional research and intervention tactics focused on reducing hypertension and its related health complications. Choosing potassium-enriched salts or embracing a salt-free diet is a wise decision to prevent hypertension, encouraging a collective effort to promote dietary awareness and optimize health.
Everolimus Personalized Therapy: Second Consensus Report by the International Association of Therapeutic Drug Monitoring and Clinical Toxicology
Authors: Masuda Satohiro , Lemaitre Florian , Barten Markus J. , Bergan Stein , Shipkova Maria , van Gelder Teun , Vinks Sander , Wieland Eberhard , Bornemann-Kolatzki Kirsten , Brunet Mercè , de Winter Brenda , Dieterlen Maja-Theresa , Elens Laure , Ito Taihei , Johnson-Davis Kamisha , Kunicki Pawel K. , Lawson Roland , Lloberas Nuria , Marquet Pierre , Millan Olga , Mizuno Tomoyuki , Moes Dirk Jan A. R. , Noceti Ofelia , Oellerich Michael , Pattanaik Smita , Pawinski Tomasz , Seger Christoph , van Schaik Ron , Venkataramanan Raman , Walson Phil , Woillard Jean-Baptiste , Langman Loralie J.
Published: September 2024

The Immunosuppressive Drugs Scientific Committee of the International Association of Therapeutic Drug Monitoring and Clinical Toxicology established the second consensus report to guide therapeutic drug monitoring (TDM) of everolimus (EVR) and its optimal use in clinical practice 7 years after the first version was published in 2016. This version provides information focused on new developments that have arisen in the last 7 years. For the general aspects of the pharmacology and TDM of EVR that have retained their relevance, readers can refer to the 2016 document. This edition includes new evidence from the literature, focusing on the topics updated during the last 7 years, including indirect pharmacological effects of EVR on the mammalian target of rapamycin complex 2 with the major mechanism of direct inhibition of the mammalian target of rapamycin complex 1. In addition, various concepts and technical options to monitor EVR concentrations, improve analytical performance, and increase the number of options available for immunochemical analytical methods have been included. Only limited new pharmacogenetic information regarding EVR has emerged; however, pharmacometrics and model-informed precision dosing have been constructed using physiological parameters as covariates, including pharmacogenetic information. In clinical settings, EVR is combined with a decreased dose of calcineurin inhibitors, such as tacrolimus and cyclosporine, instead of mycophenolic acid. The literature and recommendations for specific organ transplantations, such as that of the kidneys, liver, heart, and lungs, as well as for oncology and pediatrics have been updated. EVR TDM for pancreatic and islet transplantation has been added to this edition. The pharmacodynamic monitoring of EVR in organ transplantation has also been updated. These updates and additions, along with the previous version of this consensus document, will be helpful to clinicians and researchers treating patients receiving EVR.
Rhinoplasty Using Autologous Costal Cartilage in a Patient with Acrodysostosis
Authors: Kase Lilia , Akita Shinsuke , Onouchi Yoshihiro , Yamazaki Keiko , Mitsukawa Nobuyuki
Published: September 2024

Acrodysostosis, a rare congenital syndrome, is characterized by peripheral dysostosis, nasal hypoplasia, mental retardation, and other skeletal deformities. Although severe saddle nose associated with midfacial hypoplasia causes great distress to patients, no studies have reported conducting rhinoplasty. In our experience, we suspected a boy with a significant saddle nose as having acrodysostosis and conducted genetic testing on the boy and his parents. Genetic analyses revealed that the patient had a deleterious mutation in the PDE4D gene that was not seen in either of his parents. Thus, the patient was diagnosed with de novo acrodysostosis. Rhinoplasty of the saddle nose using autogenous costal cartilage was planned; however, a major concern in using costal cartilage is the distortion caused by warping. To prevent this problem, a counterbalancing technique was used. After the surgery, no warping was observed during follow-up, and the patient and his family were satisfied with the outcomes. To our knowledge, we present the first case of surgical treatment of a patient with a saddle nose caused by acrodysostosis.
Preservation of the Superficial Peroneal Nerve Does Not Compromise Lateral Supramalleolar Flap Viability
Authors: Lohasammakul Suphalerk , Saraswat Nirvana , Felder John Matthew
Published: September 2024

Background:

The lateral supramalleolar flap is a useful local flap for defects around the lateral malleolus. However, this flap is classically harvested subfascially, which requires superficial peroneal nerve (SPN) transection with loss of dorsal foot sensation and potential for chronic pain. We explore whether suprafascial harvest with nerve preservation results in a viable flap.

Methods:

Clinical cases include five patients who presented with a soft tissue defect at the lateral malleolar area. The etiologies included traumatic, decubitus, and chronic wounds. The suprafascial lateral supramalleolar flap was performed to reconstruct the defect while preserving the SPN.

Results:

Four flaps and one flap were performed as one-stage operation and delayed fashion, respectively. All flaps survived without complications. The SPN was identified and preserved in all cases. Postoperatively, the sensory distribution of the SPN was maintained in all patients.

Conclusion:

The lateral supramalleolar flap can be safely raised in the suprafascial plane, sparing the SPN.
Effectiveness Evaluation of Microneedling Therapy for Diabetic Ulcer: An Animal Model Study
Authors: Morinaga Eri , Sakata Naoaki , Kawakami Ryo , Naito Reiko , Yoshimatsu Gumpei , Takagi Satoshi , Kodama Shohta
Published: September 2024

Background:

Diabetic ulcer is an intractable complication seen in nearly 6% of diabetes patients. Some patients with diabetic ulcers cannot avoid femoral amputation by the current standard treatments. Therefore, a novel and effective radical cure therapy is needed. Microneedling is a widely applied wound-healing treatment in cosmetic medicine. In this study, we evaluated the therapeutic effects of microneedling on diabetic ulcers using an animal model.

Methods:

Nine- to 10-week-old male C57BL/6J mice with drug-induced diabetes received full-thickness skin removal on the back. The mice with and without microneedling were classified into microneedling and nontreatment groups, respectively. The therapeutic effects of microneedling were assessed by wound closure rate by 14 days after the treatment and histological assessments in the wound.

Results:

The wound closure rate was significantly higher in the microneedling group than in the nontreatment groups from 7 days after microneedling (wound closure rate: 63.0 ± 10.2% versus 36.6 ± 12.1%). Histological assessments revealed that microneedling induced infiltration of neutrophils and M1 macrophages into the microhemorrhage region within 12 hours. The macrophages shifted to M2 macrophages 4 days after microneedling. Hyperexpression of transforming growth factor beta 1 was confirmed 7 days after microneedling. After that, the promotion of collagen proliferation and neovascularization were seen 10 and 14 days after microneedling, respectively.

Conclusions:

Our data clarified that microneedling was effective for wound healing in an animal model of diabetic ulcer. This study has limitations correlated with small animal models and acute surgical wounds. Future clinical trials are recommended.
Lutetium-177 Therapy in Italy: Environmental Impact Assessment in Anticipation of Its Widespread Use in Prostate Cancer Treatment
Authors: Brusa Anna , Campi Fabrizio , Cavatorta Claudia , Porta Alessandro Antonio , Viganò Sofia
Published: September 2024

This article addresses the evolving state of lutetium-177 radiopharmaceutical therapies in Italy, focusing on the importance of the definition of patient management practices regarding the approved treatments based on [177Lu]Lu-DOTATATE for neuroendocrine tumors and [177Lu]Lu-PSMA-617 for metastatic castration-resistant prostate cancer. Italian medical facilities are facing new challenges with the increase in the demand for such therapies while transitioning from restrictive hospitalization requirements to more flexible outpatient options. Therefore, four management strategies are described here, varying from immediate discharge after the administration to 24-h hospitalization, and their environmental and radiation safety implications are evaluated through simple models aimed at assessing the effective doses on the local population and wastewater purification plant workers. Results show that, while higher effective doses may be caused by an immediate discharge-based modality, they remain within acceptable limits, particularly when dealing with a smaller number of patients. Prolonged hospitalizations guarantee superior radiation safety levels but might not be sustainable with the expected increase in patient volumes in the future.