bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypoxia-induced transcriptional stress is mediated by ROS-induced R-loops
Authors: Ma Tiffany S , Worth Katja R , Maher Conor , Ng Natalie , Beghè Chiara , Gromak Natalia , Rose Anna M , Hammond Ester M
Published: October 2023

Hypoxia is a common feature of solid tumors and is associated with poor patient prognosis, therapy resistance and metastasis. Radiobiological hypoxia (<0.1% O2) is one of the few physiologically relevant stresses that activates both the replication stress/DNA damage response and the unfolded protein response. Recently, we found that hypoxia also leads to the robust accumulation of R-loops, which led us to question here both the mechanism and consequence of hypoxia-induced R-loops. Interestingly, we found that the mechanism of R-loop accumulation in hypoxia is dependent on non-DNA damaging levels of reactive oxygen species. We show that hypoxia-induced R-loops play a critical role in the transcriptional stress response, evidenced by the repression of ribosomal RNA synthesis and the translocation of nucleolin from the nucleolus into the nucleoplasm. Upon depletion of R-loops, we observed a rescue of both rRNA transcription and nucleolin translocation in hypoxia. Mechanistically, R-loops accumulate on the rDNA in hypoxia and promote the deposition of heterochromatic H3K9me2 which leads to the inhibition of Pol I-mediated transcription of rRNA. These data highlight a novel mechanistic insight into the hypoxia-induced transcriptional stress response through the ROS–R-loop–H3K9me2 axis. Overall, this study highlights the contribution of transcriptional stress to hypoxia-mediated tumorigenesis.
Identifying Perspectives on Physical Therapist Residency Program Goals: Hallmarks of Success and Excellence
Authors: Moore James G , Hartley Gregory W , Osborne Raine , Harrington Kendra L , Rapport Mary Jane
Published: October 2023

Objective

The purpose of this study was to describe common perspectives important to achieving excellence and success in physical therapist residency education programs.

Methods

Individuals with direct responsibility for creating and revising physical therapist residency program goals participated in a mixed-methods study using Q-methodology. They sorted 31 goal topics based on the level of importance for achieving excellence and success in physical therapist residency education. By-participant factor analysis identified dominant perspectives, which were interpreted based on emergent themes from the topics identified as the most important. Participants’ rationale for selecting goal topics as the most important were extracted from the post-survey.

Results

Seventy-three individuals responded, representing 9 of the 11 clinical residency areas of practice. Three main perspectives emerged: resident behaviors, resident achievements, and program attributes. One shared perspective emerged across all 3 factors that emphasized the residents’ ability to become self-regulated, lifelong learners who integrate learning into practice: preparation for future learning.

Conclusions

Variability in weighting the importance of program goals associated with each perspective may include a program’s organization and mission, individual beliefs and experiences related to program leadership, and resource availability. Although respondent emphasis placed importance of some items over others, the findings do not suggest that items ranked lower were unnecessary or unimportant in achieving program excellence. The relative importance of items was weighted differently based on the perspective of program leadership and the individual completing the sorting activity.

Impact

The results of this study suggest that physical therapist residency programs should have at least 1 or 2 goals in each of the 3 distinct perspectives, as well as the 1 shared perspective identified in our findings. Some consistency in program goals based on the perspectives identified here may enable further research exploring excellence, value, and outcomes in physical therapist residency education.
Development of a Polygenic Risk Score to Predict Diverticulitis
Authors: Schaeffer H. David , Smelser Diane T. , Rao H. Shanker , Haley Jeremy S. , Long Kevin C. , Slipak Sasha H. , Carey David J. , Hoffman Rebecca L.
Published: October 2023

BACKGROUND:

Despite its prevalence and associated morbidity, we remain limited in our ability to predict the course of a patient with diverticular disease. While several clinical and genetic risk factors have been identified, we do not know how these factors relate to one another.

OBJECTIVE:

To determine if a polygenic risk score could improve risk prediction for diverticulitis and recurrent diverticulitis compared to a model using only clinical factors.

DESIGN:

An observational study.

SETTING:

Study examines the predictive ability of a polygenic risk score for diverticulitis developed using prior genome wide association studies and validated using the MyCode biobank.

PATIENTS:

Patients of European ancestry in the Geisinger Health System who were enrolled in the MyCode Community Health biobanking program.

MAIN OUTCOME MEASURES:

The ability of a polygenic risk score to predict diverticulosis, diverticulitis, and recurrent diverticulitis.

RESULTS:

A total of 60,861 patients were included, of which 9,912 (16.3%) had diverticulosis or diverticulitis (5,015 with diverticulosis and 4,897 with diverticulitis). When divided into deciles, our polygenic risk score stratified patients by risk of both diverticulosis and diverticulitis with a 2-fold difference in disease risk between the highest and lowest deciles for diverticulitis and a 4.8-fold difference for recurrent complicated diverticulitis. When compared to clinical factors alone, our polygenic risk score was able to improve risk prediction of recurrent diverticulitis.

LIMITATIONS:

Our population is largely located in a single geographic region and were classified by disease status using international classification of diseases codes.

CONCLUSIONS:

This predictive model stratifies patients based on genetic risk for diverticular disease. The increased frequency of recurrent disease in our high-risk patients suggests that a polygenic risk score, in addition to other factors, may help to guide the discussion regarding surgical intervention.
Mixed Dentition Period Follow-up of Primary Unilateral Cleft Nose Deformity Repair
Authors: Rossell-Perry Percy , Gavino-Gutierrez Arquimedes
Published: October 2023

Background:

Recently, there has been an increased acceptance of the primary cleft rhinoplasty providing acceptable outcomes. Nose reconstruction, and specifically cleft nose deformity, should be addressed based on this philosophy. The purpose of this study was to evaluate surgical outcomes during the mixed dentition period after primary surgery to address unilateral cleft lip nose deformity based on the proposed technique.

Methods:

This is a retrospective cohort study. Thirty-two primary complete unilateral cleft lip patients were operated on by a single surgeon using the V-Y-Z cleft rhinoplasty. This method combines a composite V-Y advancement flap with lateral Z-plasty. Data collection was accomplished by evaluation of nasal symmetry through anthropometric measurements performed under general anesthesia during primary cleft palatoplasty and alveolar bone graft. The outcomes were evaluated through anthropometric measurements of the repaired nose during the mixed dentition period of follow-up, and no type of presurgical management was performed for any of the patients.

Results:

Total nasal symmetry has been observed in 34.37% of patients at 7 years or more and 40.62% at 1-year follow-up. Nonstatistically significant differences were observed during follow-up, and major revision requirement (>3 mm of asymmetry in any of the nose measurements) was observed in 9.37% of patients.

Conclusions:

The proposed primary cleft rhinoplasty is a good approach to improve nasal appearance in patients with complete unilateral cleft lip and palate.
Determination of Appropriate Umbilicus Position during Abdominoplasty in Male Patients
Authors: Atiyeh Bishara S. , Emsieh Saif E. , Ibrahim Amir E. , Fadul Romeu R. , Hakim Christopher R.A. , Gnaedinger Anika G. , Oneisi Ahmad K. , Chalhoub Rawad S. , Beaineh Paul T.
Published: October 2023

Background:

Abdominoplasty techniques are well documented. The ideal position of the umbilicus has, however, received limited attention. Unfortunately, umbilicus position is not universally agreed upon in male cosmetic abdominoplasty. This study was conducted to determine the ideal umbilicus anthropometric measurements in young men, and the relationships between umbilical position and anterior trunk and torso reference points that may be applicable to intraoperative positioning. It is aimed also at investigating whether umbilicus position would be more accurately determined by considering nipple position instead of the abdominal crease, as recently proposed.

Methods:

Several anthropometric measurements of various anterior abdominal and thoracic landmarks were conducted on 60 young and middle-aged male volunteers and 30 cadavers at São Paulo city. All statistical analysis was completed using Stata software.

Results:

Of all the measured reference points, a much stronger correlation (0.513) was demonstrated between umbilicus-anterior axillary fold (U-AX) and inter-nipple (N-N) distances with a constant golden number ratio relationship (N-N = U-AX × 0.618) compared with the weak correlation of 0.034 between umbilicus-xiphisternum and umbilicus-abdominal crease. In 75% of volunteers, the calculated U-AX was within ±3 cm of actual measurement, and in 33.33% within ±1 cm.

Conclusions:

U-AX = 1.618 × N-N equation is more predictive of adequate umbilicus repositioning during abdominoplasty in male patients. Chest and abdomen of men are a single aesthetic unit. Proper positioning of the nipples and umbilicus, as well as harmonious abdominal and torso proportions are critical for an optimal final aesthetic outcome.
Comparative Analysis of a New Automatic System and Four Existing Techniques for Autologous Fat Grafting
Authors: Nelissen Xavier , Licciardi Séverine , Nizet Christophe , Delay Emmanuel , Roche Régis
Published: October 2023

Background:

Autologous fat grafting is increasingly used worldwide and is a very attractive technique in many ways. However, treatment duration and postinjection tissue resorption remain problematic elements, which are largely related to the preparation method used. Moreover, few scientific studies objectively compare different fat preparation methods. This study analyzes the efficiency and quality of lipoaspirates prepared with a new filtration/centrifugation system (Adipure) in comparison with several existing techniques.

Methods:

Patient lipoaspirates were processed by five different techniques: decantation, centrifugation, Macrofill, Puregraft, and Adipure. Adipose tissue was evaluated in vitro for tissue resorption and oil formation, as well as in vivo after subcutaneous injections in immunodeficient mice. Adipose grafts were collected after 1 month, weighed, and analyzed by histology with a detailed scoring method.

Results:

Decanting gives inferior results to all other techniques, in terms of amount of tissue and oil in vitro, or graft weight and histological analysis in vivo. Methods using classical Coleman centrifugation (1200g), or a modified one (400g) associated with washes (Macrofill) produce very similar results, both in vitro and in vivo. Techniques using filtration systems (Puregraft and Adipure) produce less oil overall and have a higher grafting efficiency. The best results regarding grafting efficiency and oil quantity are found with the Adipure device.

Conclusions:

A combination of filtration and very low-speed centrifugation potentiates the advantages of these techniques, in terms of graft efficiency. The adipose tissue purification being done in a few minutes, in an automatic way, undoubtedly provides a strong advantage for the use of this new system.
Oncoplastic Breast Reduction: A Systematic Review of Postoperative Complications
Authors: Benedict Katherine C. , Brown Madyson I. , Berry Hunter A. , Berry Scott M. , O’Brien Robert C. , Davis Jared M.
Published: October 2023

Background:

Breast-conserving therapy with oncoplastic reduction is a useful strategy for partial mastectomy defect reconstruction. The most recently published systematic review of oncoplastic breast reduction outcomes from 2015 showed wound dehiscence in 4.3%, hematoma in 0.9%, infection in 2.8%, and nipple necrosis in 0.9% of patients. We performed a systematic review of oncoplastic breast reduction literature, comparing outcomes and complication rates reported over the past 8 years.

Methods:

Studies describing the use of oncoplastic breast reduction and discussion of postoperative complications were included. The primary outcome assessed was the postoperative complication rate; secondary outcomes analyzed were rates of margin expansion, completion mastectomy, and delays in adjuvant therapy due to complications.

Results:

Nine articles met inclusion criteria, resulting in 1715 oncoplastic breast reduction patients. The mean rate of hematoma was 3%, nipple necrosis was 2%, dehiscence was 4%, infection was 3%, and seroma was 2%. The need for re-excision of margins occurred in 8% of patients, and completion mastectomy in 2%. Finally, delay in adjuvant treatment due to a postoperative complication occurred in 4% of patients.

Conclusions:

Oncoplastic breast reduction is an excellent option for many patients undergoing breast-conserving therapy; however, postoperative complications can delay adjuvant radiation therapy. Results of this systematic literature review over the past 8 years showed a slight increase in complication rate compared to the most recent systematic review from 2015. With increased popularity and surgeon familiarity, oncoplastic breast reduction remains a viable option for reconstruction of partial mastectomy defects despite a slight increase in complication rate.
Categorization and recommendations for outcome measures for lower limb absence by an expert panel
Authors: Kohler Friedbert , Halford Gregory R. J. , Lukin Martina , Hafner Brian J. , Boone David A. , Desmond Deirdre M. , Franchignoni Franco , Gailey Robert S. , Hagberg Kerstin , Major Matthew J. , Resnik Linda , Tan Jade M.
Published: October 2023

Background:

Understanding the psychometric strengths and limitations of outcome measures for use with people with lower limb absence (LLA) is important for selecting measures suited to evaluating patient outcomes, answering clinical and research questions, and informing health care policy. The aim of this project was to review the current psychometric evidence on outcome measures in people with LLA to determine which measures should be included in a stakeholder consensus process.

Methods:

An expert panel was assembled, and a 3-stage review process was used to categorize outcome measures identified in a systematic literature review into 3 distinct categories (recommended for measures with better than adequate psychometric properties; recommended with qualification; and unable to recommend). Panelists were asked to individually categorize measures based on results of a systematic review of identified measures’ psychometric properties. Each measure’s final categorization was based on ≥70% agreement by all panelists.

Results:

No outcome measure attained the ≥70% consensus threshold needed to achieve a rating of “recommend.” Hence, panelists suggested combining “recommend” and “recommend with qualifications” into a single category of “recommend with qualifications.” Using this approach, consensus was reached for 59 of 60 measures. Consensus could not be reached on 1 outcome measure (socket comfort score). Thirty-six outcome measures were categorized as “unable to recommend” based on available evidence; however, 23 (12 patient-reported measures and 11 performance-based measures) demonstrated adequate psychometric properties in LLA samples and were thus rated as “recommend with qualification” by the expert panel. The panel of experts were able to recommend 23 measures for inclusion in the subsequent stakeholder review. A key strength of this process was bringing together international researchers with extensive experience in developing and/or using LLA outcome measures who could assist in identifying psychometrically sound measures to include in a subsequent stakeholder consensus process.

Conclusion:

The above categorizations represent the current state of psychometric evidence on outcome measures for people with LLA and hence may change over time as additional research becomes available. The results will be used to achieve wider consensus from clinicians, health policymakers, health clinic managers, researchers, and end users (i.e., individuals with LLA) on outcome measures for the International Society of Prosthetics and Orthotics lower limb Consensus Outcome Measures for Prosthetic and Amputation ServiceS.
3D Acoustic Wave Sparsely Activated Localization Microscopy With Phase Change Contrast Agents
Authors: Riemer Kai , Tan Qingyuan , Morse Sophie , Bau Luca , Toulemonde Matthieu , Yan Jipeng , Zhu Jingwen , Wang Bingxue , Taylor Laura , Lerendegui Marcelo , Wu Qiang , Stride Eleanor , Dunsby Christopher , Weinberg Peter D. , Tang Meng-Xing
Published: October 2023

Objective

The aim of this study is to demonstrate 3-dimensional (3D) acoustic wave sparsely activated localization microscopy (AWSALM) of microvascular flow in vivo using phase change contrast agents (PCCAs).

Materials and Methods

Three-dimensional AWSALM using acoustically activable PCCAs was evaluated on a crossed tube microflow phantom, the kidney of New Zealand White rabbits, and the brain of C57BL/6J mice through intact skull. A mixture of C3F8 and C4F10 low-boiling-point fluorocarbon gas was used to generate PCCAs with an appropriate activation pressure. A multiplexed 8-MHz matrix array connected to a 256-channel ultrasound research platform was used for transmitting activation and imaging ultrasound pulses and recording echoes. The in vitro and in vivo echo data were subsequently beamformed and processed using a set of customized algorithms for generating 3D super-resolution ultrasound images through localizing and tracking activated contrast agents.

Results

With 3D AWSALM, the acoustic activation of PCCAs can be controlled both spatially and temporally, enabling contrast on demand and capable of revealing 3D microvascular connectivity. The spatial resolution of the 3D AWSALM images measured using Fourier shell correlation is 64 μm, presenting a 9-time improvement compared with the point spread function and 1.5 times compared with half the wavelength. Compared with the microbubble-based approach, more signals were localized in the microvasculature at similar concentrations while retaining sparsity and longer tracks in larger vessels. Transcranial imaging was demonstrated as a proof of principle of PCCA activation in the mouse brain with 3D AWSALM.

Conclusions

Three-dimensional AWSALM generates volumetric ultrasound super-resolution microvascular images in vivo with spatiotemporal selectivity and enhanced microvascular penetration.
FDG-Avid Granulomatous Lymphocytic Interstitial Lung Disease With Common Variable Immunodeficiency
Authors: van der Zant Friso M. , Knol Remco J. J.
Published: October 2023

A 26-year-old woman with known common variable immunodeficiency was referred for FDG PET/CT because of interstitial pulmonary abnormalities and enlarged mediastinal and hilar lymph nodes. FDG PET showed a combination of ground-glass abnormalities and pulmonary nodules, both displaying increased FDG uptake. In addition, multiple FDG-avid axillary, mediastinal, hilar, and inguinal lymph nodes were found. The abnormalities were diagnosed as granulomatous-lymphocytic interstitial lung disease. Cytology of mediastinal lymph nodes yielded only benign disease, without further specification, whereas histology of an excised axillary lymph node showed reactive changes, but no malignancy.
ECMO in Trauma Care: What You Need to Know
Authors: Flatley Meaghan , Sams Valerie G. , Biscotti Mauer , Deshpande Shyam J. , Usman Asad A. , Cannon Jeremy W.
Published: October 2023

Over the past ten years, extracorporeal membrane oxygenation (ECMO) use in trauma patients has increased significantly. This includes adult and pediatric trauma patients and even combat casualties. Most ECMO applications are in a venovenous (VV ECMO) configuration for acute hypoxemic respiratory failure or anatomic injuries that require pneumonectomy or extreme lung rest in a patient with insufficient respiratory reserve. In this narrative review, we summarize the most common indications for VV ECMO and other forms of ECMO support used in critically injured patients, underscore the importance of early ECMO consultation or regional referral, review the technical aspects of ECMO cannulation and management, and examine the expected outcomes for these patients. In addition, we evaluate the data where it exists to try to debunk some common myths surrounding ECMO management.
Evaluation of different methods for in vitro susceptibility testing of colistin in carbapenem resistant Gram-negative bacilli
Authors: Rout Bidyutprava , Dash Sumesh Kumar , Sahu Kundan kumar , Behera Birasen , Praharaj Ira , Otta Sarita
Published: October 2023

Introduction. The increasing antibiotic resistance like the advent of carbapenem resistant Enterobactarales (CRE), Carbapenem Resistant Acinetobacter baumanii (CRAB), and Carbapenem Resistant

Pseudomonas aeruginosa

(CRPA) has led to to the use of toxic and older drugs like colistin for these organisms. But worldwide there is an increase in resistance even to colistin mediated both by chromosomes and plasmids. This necessitates accurate detection of resistance. This is impeded by the unavailability of a user-friendly phenotypic methods for use in routine clinical microbiology practice. The present study attempts to evaluate two different methods – colistin broth disc elution and MIC detection by Vitek two in comparison to CLSI approved broth microdilution (BMD) for colistin for Enterobactarales,

Pseudomonas aeruginosa

, and Acinetobacter baumanii clinical isolates.

Methods. Colistin susceptibility of 6013 carbapenem resistant isolates was determined by BMD, Colistin Broth Disc Elution (CBDE), and Vitek two methods and was interpreted as per CLSI guidelines. The MIC results of CBDE, Vitek two were compared with that of BMD and essential agreement (EA), categorical agreement (CA), sensitivity, specificity, very major error (VME), major error (ME) and Cohen’s kappa (CK) was calculated. The presence of any plasmid-mediated colistin resistance (mcr-1, 2, 3, 4 and 5) was evaluated in all colistin-resistant isolates by conventional polymerase chain reaction.

Results. Colistin resistance was found in 778 (12.9 %) strains among the carbapenem resistant isolates.

Klebsiella pneumoniae

had the highest (18.9 %) colistin resistance by the BMD method. MIC of Vitek two had sensitivity ranging from 78.2–84.8% and specificity of >92 %. There were 171 VMEs and 323 MEs by Vitek two method, much more than CLSI acceptable range. The highest percentage of errors was committed for Acinetobacter baumanii (27.8 % of VME and 7.9 % ME). On the other hand, the CBDE method performed well with EA, CA, VME and ME within acceptable range for all the organisms. The sensitivity of the CBDE method compared to gold standard BMD varied from 97.5–98.8 % for different strains with a specificity of more than 97.6 %. None of the isolated colistin resistant organisms harboured mcr plasmids.

Conclusion. As BMD has many technical complexities, CBDE is the best viable alternative available for countries like India. A sensitive MIC reported by Vitek two needs to be carefully considered due high propensity for VMEs particularly for

Klebsiella

spp.
Brain tuberculoma: a 52-year-old woman case report
Authors: Shankar Gokul S. , Nair Sreeja , Jacob Teena , Idikula Mercy John
Published: October 2023

Introduction. One of the most serious extrapulmonary type of tuberculosis that affects people under the age of 40 is brain tuberculoma. They are space-occupying masses of granulomatous tissue that result from hematogenous spread from a distant focus of tuberculous infection by

Mycobacterium tuberculosis

. Symptoms and radiologic features being nonspecific usually leads to misdiagnosis and mimics a variety of other infectious diseases. Anti-tubercular drugs are essential for the successful treatment of cerebral tuberculomas.

Case Report. The authors present a case report of a 52-year-old diabetic woman, who presented to the Emergency Department of a tertiary care hospital and was diagnosed with brain tuberculomas with a brain biopsy. Brain tuberculomas are rare and could be overlooked. Therefore, this is an important consideration in cases with higher suspicions, given the rapid decline in patient condition.

Conclusion. Due to their rarity, ambiguous symptoms, and radiographic characteristics, intracranial tuberculomas continue to provide a clinical challenge and must always be considered in the differential diagnosis of cerebral space occupying lesions. As CSF may not yield positivity for both CBNAAT and smear examination, a brain biopsy specimen for culture should always be kept in mind for detecting tuberculoma and initiating anti-tubercular treatment at the earliest.
Adolescent chronic sleep restriction promotes alcohol drinking in adulthood: evidence from epidemiological and preclinical data
Authors: Faniyan Oluwatomisin O. , Marcotulli Daniele , Simayi Reyila , Del Gallo Federico , De Carlo Sara , Ficiarà Eleonora , Caramaschi Doretta , Richmond Rebecca , Franchini Daniela , Bellesi Michele , Ciccocioppo Roberto , Vivo Luisa de
Published: October 2023

Epidemiological investigations have indicated that insufficient sleep is prevalent among adolescents, posing a globally underestimated health risk. Sleep fragmentation and sleep loss during adolescence have been linked to concurrent emotional dysregulation and an increase in impulsive, risk-taking behaviors, including a higher likelihood of substance abuse. Among the most widely used substances, alcohol stands as the primary risk factor for deaths and disability among individuals aged 15-49 worldwide. While the association between sleep loss and alcohol consumption during adolescence is well documented, the extent to which prior exposure to sleep loss in adolescence contributes to heightened alcohol use later in adulthood remains less clearly delineated.

Here, we analyzed longitudinal epidemiological data spanning 9 years, from adolescence to adulthood, including 5497 participants of the Avon Longitudinal Study of Parents And Children cohort. Sleep and alcohol measures collected from interviews and questionnaires at 15 and 24 years of age were analyzed with multivariable linear regression and a cross-lagged autoregressive path model. Additionally, we employed a controlled preclinical experimental setting to investigate the causal relationship underlying the associations found in the human study and to assess comorbid behavioral alterations. Preclinical data were collected by sleep restricting Marchigian Sardinian alcohol preferring rats (msP, n=40) during adolescence and measuring voluntary alcohol drinking concurrently and in adulthood. Polysomnography was used to validate the efficacy of the sleep restriction procedure. Behavioral tests were used to assess anxiety, risky behavior, and despair.

In humans, after adjusting for covariates, we found a cross-sectional association between all sleep parameters and alcohol consumption at 15 years of age but not at 24 years. Notably, alcohol consumption (Alcohol Use Disorder Identification Test for Consumption) at 24 years was predicted by insufficient sleep at 15 years whilst alcohol drinking at 15 years could not predict sleep problems at 24. In msP rats, adolescent chronic sleep restriction escalated alcohol consumption and led to increased propensity for risk-taking behavior in adolescence and adulthood.

Our findings demonstrate that adolescent insufficient sleep causally contributes to higher adult alcohol consumption, potentially by promoting risky behavior.
Ischemic Stroke after Bivalent COVID-19 Vaccination: A Self-Controlled Case Series Study
Authors: Xu Stanley , Sy Lina S. , Hong Vennis , Holmquist Kimberly J. , Qian Lei , Farrington Paddy , Bruxvoort Katia J. , Klein Nicola P. , Fireman Bruce , Han Bing , Lewin Bruno J.
Published: October 2023

Introduction

The potential association between bivalent COVID-19 vaccination and ischemic stroke remains uncertain, despite several studies conducted thus far. The purpose is to evaluate the risk of ischemic stroke following bivalent COVID-19 vaccination.

Methods

A self-controlled case series study was conducted among members aged ≥12 years who experienced ischemic stroke between September 1, 2022 and March 31, 2023 in a large California health care system. Ischemic strokes were identified using ICD-10 codes in Emergency Department and inpatient settings. Exposures were Pfizer-BioNTech or Moderna bivalent COVID-19 vaccination. Risk intervals were pre-specified as 1–21 days and 1–42 days after bivalent COVID-19 vaccination; all non-risk-interval person-time served as control interval. We conducted overall and subgroup analyses by age, history of SARS-CoV-2 infection, and co-administration of influenza vaccine. When an elevated risk was detected, we performed chart review of ischemic strokes, and re-evaluated the risk.

RESULTS

With 4933 cases, we found no increased risk within 21-day risk interval across vaccines and by subgroups. However, an elevated risk emerged within 42-day risk interval among individuals <65 years who received co-administration of Pfizer-BioNTech bivalent vaccine and influenza vaccine on the same day; relative incidence (RI) was 2.14 (95% CI, 1.02–4.49). Among those who also had history of SARS-CoV-2 infection, RI was 3.94 (95% CI, 1.10–14.16). After chart review, RIs were 2.35 (95% CI, 0.98–5.65) and 4.33 (95% CI, 0.98–19.11), respectively. Among individuals <65 years who received Moderna bivalent vaccine and had history of SARS-CoV-2 infection, RI was 2.62 (95% CI, 1.13–6.03) before chart review and 2.24 (95% CI, 0.78–6.47) after chart review.

CONCLUSIONS

The potential association between bivalent COVID-19 vaccination and ischemic stroke in the 1-42-day analysis warrants further investigation among individuals <65 years with influenza vaccine co-administration and prior SARS-CoV-2 infection.
Longitudinal viscosity of blood plasma for rapid COVID-19 prognostics
Authors: Illibauer Jennifer , Clodi-Seitz Tamara , Zoufaly Alexander , Aberle Judith H. , Weninger Wolfgang J. , Foedinger Manuela , Elsayad Kareem
Published: October 2023

Blood Plasma Viscosity (PV) is an established biomarker for numerous diseases. While PV colloquially refers to theshear viscosity, there is a second viscosity component--thebulk viscosity--that describes the irreversible fluid compressibility on short time scales. The bulk viscosity is acutely sensitive to solid-like suspensions, and obtainable via the longitudinal viscosity from acoustic attenuation measurements. Whether it has diagnostic value remains unexplored yet may be pertinent given the association of diverse pathologies with the formation of plasma suspensions, such as fibrin-microstructures in COVID-19 and long-COVID. Here we show that the longitudinal PV measured using Brillouin Light Scattering (BLS) can serve as a proxy for the shear PV of blood plasma, and exhibits a temperature dependence consistent with increased suspension concentrations in severe COVID-patient plasma. Our results open a new avenue for PV diagnostics based on the longitudinal PV, and show that BLS can provide a means for its clinical implementation.
Socioeconomic Factors Influencing Breastfeeding Duration in Bangladesh:An Analysis of the Bangladesh Demographic and Health Survey
Authors: Alam Bashirul , Rony Mohammad Abu Tareq , Islam Md Aminul , Hasan Md Khalid , Khan Kanamik Kani
Published: October 2023

Background

This cross-sectional survey aimed to investigate the socioeconomic factors influencing the Duration of Breastfeeding in Bangladesh, using data from the Bangladesh Demographic and Health Survey (BDHS) 2017-18, with a sample of 4,881 mothers having children under two years old. The mean Duration of exclusive Breastfeeding was 15.23 months, with a standard deviation of 9.83 months.

Methods

The study utilized statistical tests such as independent sample t-test and one-way analysis of variance (ANOVA) to identify significant differences in the Duration of Breastfeeding between different groups. Pearson’s correlation coefficient was used to explore the linear relationship between the Duration of Breastfeeding and other continuous variables. At the same time, multinomial logistic regression analysis was employed to determine the predictors of breastfeeding duration.

Result

The study revealed significant variations in the Duration of exclusive Breastfeeding based on various demographic, health-related, socioeconomic, and anthropometric factors. Women who received antenatal care had a significantly shorter duration of exclusive breastfeeding compared to those who did not receive such care. However, no significant differences were observed in breastfeeding duration between male and female children or between those born via cesarean section versus vaginal delivery. Also, mothers who gave birth in a hospital or clinic breastfed exclusively for a shorter period than those who gave birth at home. Moreover, mothers who worked outside the house had a longer duration of exclusive Breastfeeding than homemakers.

The study also noted substantial differences in exclusive breastfeeding duration based on religion and mothers’ body mass index (BMI). Women in the Barisal region breastfed exclusively for a shorter time than those in other regions. Additionally, women classified as underweight (BMI <18.5 kg/m2) breastfed exclusively longer than those with average weight or obese mothers.

Conclusion

Policymakers and program implementers can use these findings to work with specific groups of mothers, mainly those less educated, residing regions, or possessing distinct health or socioeconomic characteristics, to promote optimal infant feeding practices and improve overall child health outcomes by breastfeeding practices in Bangladesh.

Ethics and consent

This study does not contain personal identifiable information (PII), so ethical approval is not required. Data collection has been done by obtaining consent.
Characteristics of patients with myofascial pain syndrome of the low back
Authors: Tsai Pao-Feng , Edison Joseph L. , Wang Chih-Hsuan , Gramlich Michael W. , Manning Kailea , Deshpande Gopikrishna , Bashir Adil , Soften JoEllen
Published: October 2023

Objective

Identify characteristics of patients with myofascial pain syndrome (MPS) of the low back.

Methods

Twenty-five subjects with myofascial trigger point(s) [MTrP(s)] on the low back participated in this cross-sectional study. The location, number and type (active or latent) of MTrPs were verified by ultrasound; additionally, data on pain pressure threshold, physical function, quality of life, disability, pain catastrophizing, pain self-efficacy, kinesiophobia, emotional health, exercise motivation and pain were collected. Descriptive statistics, Chi-square, one-way ANOVAs and factorial ANCOVA were used to achieve study objectives.

Results

No statistically significant differences in variables were found between types of MTrPs: Group 1 (Active, n=13), 2 (Latent, n=5) 3 (Atypical, no twitching but with spontaneous pain, n=2) and 4 (Atypical, no twitching and no spontaneous pain, n=5) except the number of MTrPs, current pain, and worst pain (p=.01-.001). There were interaction effects between spontaneous pain and twitching response on reports of physical function, current pain level, and worst pain level (p=.04-.002). Participants in Group 3 reported lower levels of physical function, higher levels of current pain, and higher levels of worst pain compared to those in Group 4. Participants in Group 1 and 2 had similar levels of physical function, current pain and worst pain.

Discussion

Number of MTrPs is most closely associated with the level of pain. Spontaneous pain report seems to be a decisive factor associated with poor physical function; however, twitching response is not.
Sequential gentle hydration increases encapsulation in model protocells
Authors: Gehlbach Emma M. , Robinson Abbey O. , Engelhart Aaron E. , Adamala Katarzyna P.
Published: October 2023

Small, spherical vesicles are a widely used chassis for the formation of model protocells and investigating the beginning of compartmentalized evolution. Various methods exist for their preparation, with one of the most common approaches being gentle hydration, where thin layers of lipids are hydrated with aqueous solutions and gently agitated to form vesicles. An important benefit to gentle hydration is that the method produces vesicles without introducing any organic contaminants, such as mineral oil, into the lipid bilayer. However, compared to other methods of liposome formation, gentle hydration is much less efficient at encapsulating aqueous cargo. Improving the encapsulation efficiency of gentle hydration would be of broad use for medicine, biotechnology, and protocell research. Here, we describe a method of sequentially hydrating lipid thin films to increase encapsulation efficiency. We demonstrate that sequential gentle hydration significantly improves encapsulation of water-soluble cargo compared to the traditional method, and that this improved efficiency is dependent on buffer composition. Similarly, we also demonstrate how this method can be used to increase concentrations of oleic acid, a fatty acid commonly used in origins of life research, to improve the formation of vesicles in aqueous buffer.
Political decentralisation and political-administrative relation in the local councils in Tanzania
Authors: Lameck Wilfred Uronu
Published: October 2023

Purpose

This paper analyses the degree of political decentralisation and its relation to the local councils in Tanzania. It explores the institutional and political set-up of the local councils originating from the degree of political decentralisation and how it influences the tension between the bureaucrats and local politicians.

Design/methodology/approach

Qualitative approach by a comparative case study is adopted to investigate the phenomenon in two local governments in Tanzania. The data were collected through interviews with 37 senior local government officials and eight focus group discussions with 48 administrators and councillors.

Findings

The findings indicate that the two local governments are subjected to a similar political system guided by similar rules and guidelines from the central government bureaucracy for implementing the party manifesto and central government priorities. Thus, the local politicians have little room for negotiation in adopting local agenda to reflect the preferences of the local community. Any attempt to challenge this status quo creates political tensions between bureaucrats and the administrators.

Originality/value

The findings provide invaluable insights to different stakeholders such as political scientists, government officials, and policymakers with interests in research or practice of political decentralization and political-administrative relation.
Critical success factors of Public-Private Partnerships in the education sector
Authors: Sajida  , Kusumasari Bevaola
Published: October 2023

Purpose

This paper aims to identify the factors affecting the implementation of Public-Private Partnerships (PPPs) in the education sector.

Design/methodology/approach

Based on Scopus and adopting the protocol of Staples and Niazi (2007), this systematic literature review examined 21 articles on PPPs in the education sector. Content analysis is adopted to identify research gaps and provide information on critical issues in the cases.

Findings

The findings have identified the critical success factors of PPPs in the education sector in 12 countries, revealing varying degrees of success and implementation challenges. They reflect the importance of clear objectives, effective communication, and robust partnerships between the public and private sectors to achieve success. These insights contribute to an in-depth understanding of PPP implementation in education, which can guide future projects.

Originality/value

The critical success factors identified in PPPs implementation in education across various countries may provide a comprehensive worldwide perspective for researchers, practitioners and policymakers.
JAVA Memory Care program: Facilitating social and occupational engagement for older adults living with advanced dementia
Authors: du Toit Sanetta Henrietta Johanna , Jessup Glenda Madeleine
Published: October 2023

Background and Objectives

Residents in aged care homes often report lack of life purpose and meaning and limited opportunities to contribute to their community. The JAVA Memory Care program is designed to facilitate engagement for older adults with advanced dementia. This study explored whether JAVA Memory Care engaged such adults meaningfully, on social and occupational levels, within one Australian residential care home.

Methods

A mixed method design guided this exploration. Trained staff facilitated six JAVA groups over 2 months. Three sources of data were utilised. Observational data (qualitative and quantitative) were obtained using a narratively enhanced Assessment Tool for Social and Occupational Engagement (ATOSE). The other two data sources were qualitative and analysed thematically: reflections by the lead JAVA facilitator and data generated by a research discussion group.

Results

The quantitative data comprised 564 ATOSE behaviour markers. Participants were categorised as being engaged in 93% of these markers. Two of the three qualitative themes focused on the collective and self‐expressive nature of participant engagement. The third theme focused on practicalities such as time pressures, facilitator training, resident selection, and resource preparation. For residents, the groups provided a context for relating meaningfully to others.

Conclusion

The JAVA program achieved a high level of engagement. However, it was a time intensive intervention and required a person‐centred philosophy, appropriate staff training, organisational support, and a suitable quiet space. The program had positive benefits, but practical issues identified needed to be considered before implementation.
PENet: A phenotype encoding network for automatic extraction and representation of morphological discriminative features
Authors: Zhao Zhengyu , Lu Yuanyuan , Tong Yijie , Chen Xin , Bai Ming
Published: October 2023

Digitalized natural history collections serve as vital ecological and evolutionary research resources. Specimen retrieval based on morphological features allows for the rapid acquisition of similar specimens from these collections, aiding in maximizing the utilization of their resources and catering to the requirements of related research. However, achieving this objective requires effective feature extraction and representation techniques.

We developed a phenotype encoding network (PENet), a deep learning‐based model that combines hashing methods to automatically extract and encode discriminative features into hash codes.

We evaluated the performance of PENet on six data sets, including a newly constructed beetle data set (6566 images), which covers over 60% of the genera within the six subfamilies of Scarabaeidae. Phenotype encoding network showed high performance in feature extraction and image retrieval, allowing users to input an image of a specimen and efficiently retrieve all specimens with similar morphology. Two visualization methods, t‐SNE and Grad‐CAM, were used to evaluate the representation ability of the hash codes. Additionally, by using the hash codes generated from PENet, a phenetic distance tree was constructed based on the beetle data set. The result indicated that the hash codes could reveal the phenetic distances and relationships among categories to a certain extent.

PENet provides an automatic and efficient method to extract and represent morphological discriminative features. The generated hash code can be used as a low‐dimensional carrier of these features, enabling efficient specimen retrieval. Moreover, the distance information carried by these hash codes suggests their potential in systematics, deserving further exploration.
Integrated multicomponent interventions to support healthy aging of the whole person
Authors: Langevin Helene M. , Weber Wendy , Chen Wen
Published: October 2023

Healthy aging is an integrated “whole person” process that involves an individual's biology, behavior, and social/physical environment. With the recent development of antiaging drugs, careful consideration of the respective roles of pharmacologic and nonpharmacologic approaches to both health and aging is in order. Recent advances in understanding the cellular and molecular mechanisms of aging are providing new measures that can be used as clinical outcomes in studying the impact of antiaging interventions in humans. This paper outlines the strategic interest of the National Center for Complementary and Integrative Health (NCCIH) in supporting the development, testing, and implementation of effective, scalable, and integrated multicomponent interventions to support healthy aging of the whole person.
The effects of transcutaneous spinal cord stimulation delivered with and without high‐frequency modulation on spinal and corticospinal excitability
Authors: Massey Sarah , Konig Danielle , Upadhyay Pratham , Evcil Zehra Beril , Melin Rebbekha , Fatima Memoona , Hannah Ricci , Duffell Lynsey
Published: October 2023

Transcutaneous spinal cord stimulation (TSCS) has been shown to improve motor recovery in people with spinal cord injury (SCI). Some groups deliver TSCS modulated with a kHz‐frequency (TSCS–kHz); the intensity used for TSCS–kHz is usually set based on the motor threshold for TSCS, even though TSCS–kHz threshold is considerably higher than TSCS. As a result, TSCS–kHz interventions tend to be delivered at low intensities with respect to the motor threshold (~40%). In this study, we compared the effects of sub‐threshold TSCS and TSCS–kHz, when delivered at similar intensity relative to their own motor threshold. Experiment I compared the after‐effects of 20 min of sub‐threshold (40% threshold) TSCS and TSCS–kHz on spinal and corticospinal excitability in able‐bodied participants. Experiment II assessed the dose–response relationship of delivering short (10‐pulse) trains of TSCS and TSCS–kHz at three different current intensities relative to the threshold (40%, 60%, and 80%). Experiment I found that 20 min of TSCS–kHz at a 40% threshold decreased posterior root reflex amplitude (p < 0.05), whereas TSCS did not. In experiment II, motor‐evoked potential (MEP) amplitude increased following short trains of TSCS and TSCS–kHz of increasing intensity. MEP amplitude was significantly greater for TSCS–kHz compared with TSCS when delivered at 80% of the threshold (p < 0.05). These results suggest that TSCS and TSCS–kHz have different effects when delivered at similar intensity relative to their own threshold; both for immediate effects on corticospinal excitability and following prolonged stimulation on spinal excitability. These different effects may be utilized for optimal rehabilitation in people with SCI.