bluuebunny/crossref_metadata_2025 huggingface dataset:
Critical Emergency Department Interventions and Clinical Deterioration in Children With Nonsevere Traumatic Intracranial Hemorrhage
Authors: Chaudhari Pradip P. , Durham Susan , Bachur Richard G. , Goodhue Catherine J. , Levitt Danielle , Semple-Hess Janet , Gao Leland , Pineda Jose , Khemani Robinder G.
Published: September 2023

Objective

Substantial practice variation exists in the management of children with nonsevere traumatic intracranial hemorrhage (tICH). A comprehensive understanding of rates and timing of clinically important tICH, including critical interventions and deterioration, along with associated clinical and neuroradiographic characteristics, will inform accurate risk stratification.

Methods

We conducted a single-center retrospective cohort study of children aged younger than 18 years evaluated in the emergency department (ED) from May 1, 2014 to February 28, 2020 with tICH and initial Glasgow Coma Scale (GCS) score of higher than 8. We determined rates of clinically important tICH after injury and within 96 hours of ED arrival, defined as immediate ED interventions (intubation, hyperosmotic agents, or neurosurgery within 4 hours of arrival) or clinically important deterioration (signs/symptoms with change in management). Associations between outcome and clinical and neuroradiographic characteristics were calculated using individual logistic regression models.

Results

Our sample included 135 children. Clinically important tICH was observed in 13.3% (n = 18); 9 (6.7%) underwent immediate ED interventions and 9 (6.7%) developed deterioration. Most (93.3%, n = 127) presented with an initial GCS ≥ 14, including all children who later deteriorated. Initial GCS (P = 0.001) and nonaccidental trauma (P = 0.024) mechanism were associated with the outcome. None of the 71 (52.6%) children with initial GCS ≥ 14, isolated, nonepidural hemorrhage after accidental injury developed clinically important tICH.

Conclusions

Clinically important tICH occurred in 13% of children with nonsevere tICH, and 7% of children who did not undergo immediate ED interventions later deteriorated, all of whom had an initial GCS ≥ 14. However, a subgroup of children was identified as low risk based on clinical and neuroradiographic characteristics.
Wrist-Level Tendon Repairs Utilizing a Novel Tendon Stapler Device: An Efficiency and Biomechanical Study
Authors: Reed Evelyn R. , Hendrycks Russell , Graham Emily M. , Rosales Megan , Mendenhall Shaun D.
Published: September 2023

Background:

A novel tendon stapler device (TSD) to improve the strength and consistency of primary tendon repairs was recently approved by the U.S. Food and Drug Administration. The authors hypothesized that this TSD would demonstrate faster and superior biomechanical properties compared with a standard suture coaptation. The authors also hypothesized that the TSD biomechanical properties would be consistent across participants with differing tendon repair experiences.

Methods:

Participants included a novice, intermediate, and expert in tendon repairs. Timed comparisons were performed in flexor zones IV and V and extensor zones VI and VII on human cadaver arms. Suture repairs were performed with a modified Kessler technique with a horizontal mattress. TSD repairs were performed on the matched donor arms. Biomechanical testing included 2-mm gap force, ultimate failure load, and mode of failure.

Results:

In total, 228 tendon coaptations from 12 donor arms were performed and analyzed. TSD coaptations were 3 times faster and withstood nearly 50% higher forces on 2-mm gap testing and roughly 30% higher forces on ultimate failure testing. These findings did not change when the repair times were analyzed by participant. Suture coaptations failed owing to suture pull-through, suture breakage, or knot failure. TSD coaptation failures only occurred from device pull-through.

Conclusions:

The TSD produces significantly faster and stronger primary tendon coaptations compared with a standard 4-strand core suture repair in human donor arms. The findings demonstrated minimal variability among participants with differing tendon repair experience. Although further investigation is needed, this device has potential to revolutionize tendon repairs.
Reduction Mammaplasty in Younger Patients: An Evidence-Based Approach to Treatment
Authors: White Ava G. , McNamara Catherine T. , Nuzzi Laura C. , Hwang Charles D. , Labow Brian I.
Published: September 2023

Macromastia is a common condition that can lead to physical pain, emotional burden, and behavioral impairment, with significant decrements in quality of life. Reduction mammaplasty offers the only effective treatment of symptomatic macromastia, and patients experience significant improvements in their physical and psychosocial health through surgical correction. Although symptoms typically arise during adolescence, most women seeking surgical intervention do not undergo reduction mammaplasty until their fifth decade of life. Providers often delay surgery due to speculative concerns about emotional immaturity, postoperative breast regrowth, and future lactation performance. The strict guidelines related to age and body mass index imposed by insurance companies further restrict the options available to younger patients with macromastia. This review offers an evidence-based approach to treating macromastia in younger patients. After more than 15 years of treatment and research centered on adolescents and young adults with macromastia led by the senior author (B.I.L.), a pediatric plastic surgeon, we have found that reduction mammaplasty is a safe and effective treatment option for this patient population. It is our hope that our work will enable care providers to make data-supported decisions when treating younger patients with symptomatic macromastia.
Increasing the Safety of Patients Undergoing Breast Implant Surgery Using an Electronic Health Record Enhancement
Authors: Prothe Jessica , Kozak Brenda , Rozovics Paul , Sykes Robyn , Taccona Michael
Published: September 2023

Breast implant surgery is a popular plastic surgery procedure performed worldwide. Despite its global popularity, patients undergoing breast implant surgery are at risk for systemic illness and more than one form of cancer. We conducted a nursing workflow analysis at our facility and determined that it is not standard practice to screen patients for the presence or absence of breast implant devices at every health care encounter. This lack of screening for breast implant devices may adversely affect patient safety by hindering the rapid identification of systemic illness or cancer related to breast implant devices and delaying effective medical intervention. Based on the results of the workflow analysis, we initiated a formal call for nursing action. We identified a nursing workflow process to increase patient safety and developed a universal screening tool for implantable devices. We defined universal screening for implantable devices as assessing all patients for the presence or absence of an implantable device, specifically breast implant devices, at every health care encounter. Implementing a universal process for screening patients for implantable devices at every health care encounter can be easily formulated into a policy and procedure and/or an electronic health record (EHR) update or enhancement. This article discusses how we utilized a workflow process map to translate universal screening for implantable devices into an EHR enhancement.
Are Antiperspirants Safe? Shedding Light on the Distribution of Aluminum Compounds in Sweat Glands
Authors: Ho Wen-Tsao
Published: September 2023

The safety of antiperspirants has been a subject of intense debate, with conflicting perspectives and research findings. This study aimed to contribute to the discussion by investigating the distribution of aluminum chloride (AlCl3), a common ingredient in antiperspirants, within the sweat glands. We enrolled a total of 10 patients seeking surgery for bromhidrosis in our study. Before surgery, we instructed the study participants to apply a specially formulated AlCl3 staining antiperspirant to their underarms using a surgical pen with ink that resists easy removal. We excised the apocrine glands, fragmented them finely, and examined them microscopically. We did not detect any stained aluminum compounds. These results are consistent with previous research, which suggests that aluminum compounds do not enter the apocrine glands. Consequently, concerns regarding the potential absorption of aluminum into the human body appear to be unfounded, particularly regarding cancer risks such as breast cancer.
The role of corticosteroids in the palliation of dyspnea in cancer patients: an evidence-based review
Authors: Hui David , Yennurajalingam Sriram
Published: September 2023

Purpose of review

To provide an evidence-based review on the use of corticosteroids for dyspnea in cancer patients.

Recent findings

Corticosteroids are commonly used for palliation of dyspnea; however, there is wide variation in how they are prescribed due to the paucity of high-quality evidence. Some clinicians would offer corticosteroids routinely regardless of the causes of dyspnea, while others would only prescribe corticosteroids selectively for specific indications, such as lymphangitic carcinomatosis, upper airway obstruction, superior vena cava obstruction, and cancer treatment-induced pneumonitis. Few mechanistic studies have been conducted to support the use of corticosteroids in cancer patients. Two double-blind, placebo-controlled randomized trials have examined the routine use of high-dose dexamethasone for dyspnea in cancer patients. A pilot study suggested some benefits, but the larger confirmatory trial revealed no improvement compared to the placebo and significantly more adverse events. The selective use of corticosteroids use is only based on observational studies such as case series.

The unfavorable risk:benefit ratio of high-dose dexamethasone suggests that it should not be routinely prescribed for dyspnea in cancer patients. More research is needed to assess the selective use of corticosteroids and identify patients most likely be benefit from corticosteroid use.
Alternative Defibrillation Strategies for Refractory Ventricular Fibrillation: A Systematic Review and Meta-Analysis
Authors: Perna Benedetta , Guarino Matteo , De Fazio Roberto , Esposito Ludovica , Portoraro Andrea , Rossin Federica , Remelli Francesca , Trevisan Caterina , Raparelli Valeria , Marasco Giovanni , Barbara Giovanni , Petrini Stefano , Vason Milo , Spampinato Michele Domenico , Giorgio Roberto De
Published: September 2023

Background

Cardiac arrest with refractory ventricular fibrillation (rVF) represents a dramatic medical emergency. Despite recent advances, its treatment is challenging and burdened by limited evidence. This systematic review and meta-analysis aims at establishing whether alternative defibrillation strategies (ADS), i.e. double sequential external defibrillation (DSED) or vector-change defibrillation (VCD), improve survival among patients with rVF compared to standard defibrillation (SD).

Methods

Randomized clinical trials (RCTs), prospective and retrospective studies were included if: (1) compared ADS with SD in rVF; (2) conducted on patients ≥ 18 years old; (3) reported survival to hospital admission. English-language papers from MEDLINE, Google Scholar, Cochrane Library, World Health Organization, EMBASE and CINAHL, published from inception to December 2022, were retrieved. The risk of bias was assessed following the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the revised Cochrane risk of bias tool for randomized trials, as appropriate. A random-effects meta-analysis was performed to estimate the pooled Odds Ratio (pOR) with 95% Confidence Interval (95%CI) of ADS and survival to hospital admission. Furthermore, a subgroup analysis was performed to compare SD with each type of ADS. The protocol was registered on PROSPERO (CRD42022379049).

Results

Eight studies (2 RCTs, 5 retrospective and 1 case-control study) were retrieved for qualitative and quantitative analyses. The study population included 1405 patients (ADS = 493 vs. SD = 912) with a pooled mean age of 61.9 ± 1.1 years; among them, 277 (19.7%) were female. The random-effect meta-analysis did not show differences in survival to hospital admission among ADS vs. SD (pOR = 1.12, 95%CI: 0.62-2.01). The subgroup analysis confirmed that neither DSED (pOR = 1.20, 95%CI: 0.56-2.58) nor VCD (pOR = 1.66, 95%CI: 0.10-27.02) were associated with improved survival to hospital admission. Main limitations were: i) few numbers of studies included with small sample size; and ii) female under-representation.

Conclusion

The present manuscript did not show any difference on survival to hospital admission between the considered defibrillation strategies in rVF. This result highlights the need for furtherad hocclinical trials assessing the actual role of ADS.
Whole-brain analysis of CO2chemosensitive regions and identification of the retrotrapezoid and medullary raphé nuclei in the common marmoset (Callithrix jacchus)
Authors: Turk Ariana Z. , Millwater Marissa , SheikhBahaei Shahriar
Published: September 2023

Respiratory chemosensitivity is an important mechanism by which the brain senses changes in blood partial pressure of CO2(PCO2). It is proposed that special neurons (and astrocytes) in various brainstem regions play key roles as CO2central respiratory chemosensors in rodents. Although common marmosets (Callithrix jacchus), New-World non-human primates, show similar respiratory responses to elevated inspired CO2as rodents, the chemosensitive regions in marmoset brain have not been defined yet. Here, we used c-fos immunostainings to identify brain-wide CO2-activated brain regions in common marmosets. In addition, we mapped the location of the retrotrapezoid nucleus (RTN) and raphé nuclei in the marmoset brainstem based on colocalization of CO2-induced c-fos immunoreactivity with Phox2b, and TPH immunostaining, respectively. Our data also indicated that, similar to rodents, marmoset RTN astrocytes express Phox2b and have complex processes that create a meshwork structure at the ventral surface of medulla. Our data highlight some cellular and structural regional similarities in brainstem of the common marmosets and rodents.
Tuning electrical spiking ofSchizophyllumcommune with light
Authors: Browner Davin , Adamatzky Andrew , Schunselaar Ella , Wösten Han A. B. , Ayres Phil
Published: September 2023

When studying the split-gill fungusSchizophyllum commune, we observed that the growing colonies displayed endogenous spikes of electrical potential similar to the action potentials of neurons. In order to investigate the impact of light on the electrical activities of these colonies, we exposed them to intermittent stimulation with cold light (5800k) and later with blue (c. 470nm), red (c. 642nm) and green (c. 538nm) light. Our findings revealed spiking activity can be influenced using this input including observable responses with patterns of spiking at relatively high average amplitudes (>1mV) appearing consistently upon illumination of the sample. The response is likely related to the activity of fungal photoreceptors, including potential sensitisation to blue light in the cellular signalling pathways facilitated by white collar proteins (WC-1, WC-2) inS. commune. Based on these findings, we suggest that fungal photosensors and photonic computing substrates have the potential to enable applications beyond the scope of conventional electronics via relatively fast spiking responses to light tuned by external input stimulation. Further work should focus on identifying the signal transduction pathway for responses to different wavelengths of light and its role in translation into engineered ELMs to extend existing studies in fungal photobiology.
Characterizing patterns of selection pressure on mammalian antiviral immune response
Authors: Hawash Mohamed B.F.
Published: September 2023

Immune response is known to be under constant pressure evolutionary pressure from different factors including pathogens. Although different selection regimes are expected to act on the magnitude of immune response, there are limited studies that investigated the different patterns of selection pressures on the immune response quantitatively. I employed evolutionary models (Ornstein-Uhlenbeck models) to identify different patterns of selection on the antiviral immune response of fibroblasts derived from 18 mammalian species and one vertebrate stimulated by viral ligand, poly I:C, or Interferon alpha cytokine. I found stabilizing selection to be the dominant form of selection on the immune response. Out of 59 genes that were found to be responding in at least 15 species, 50 genes were found to be under stabilizing selection. Moreover, evolutionary variance was found to differ among these conservatively responding genes implicated in fighting viruses. For instance, ADAR was found to have low evolutionary variance while TRIM14 response showed opposite trend suggesting different evolutionary pressures acting on the magnitude of response. Directional selection was also detected specific infraorders of primates such as apes and old-world monkeys on response of innate immune effectors.
Evaluating community knowledge, attitude, and practices toward implementation of telemedicine in Saudi Arabia
Authors: Mustafa Mustafa Mohammed , Al-Mohaithef Mohammed
Published: September 2023

Background

The urgent need to provide fast, low-cost, affordable, and high-quality medical services is one of the requirements of today’s modern world, which is characterized by a fast pace and search for the best services, especially regarding medical consultation and treatment. These demands have led to the invention of new ways that medical services can be provided to patients in their homes.

Methods

A cross-sectional study, conducted in February 2022 and ended in June 2023 with a representative sample of different categories of citizens. The study population included 281 (81.9%) males and 62 (18.1%) females (SD.385, mean 1.18). The study aimed to assess the knowledge, attitudes, and practices of Saudi citizens in the Riyadh region regarding telemedicine.

Results

The study revealed that only 30.3% of respondents were able to select the correct definition of the term telemedicine from three alternatives, which may reflect poor knowledge about telemedicine. A total of 19.5% of our participants said that they used telemedicine services only for medical consultations, while 13.7 said they used it for diagnosis and treatment. A total of 104 (88.9) out of 117 of the respondents believed that telemedicine has a positive impact on reducing costs and saving time.

Conclusion

The study concluded that the main barriers that limit the use of telemedicine services are a lack of confidence in accessing telemedicine, difficulty in communicating due to the use of different languages and dialects, and the fact that services are not suitable for uneducated people.
Cereal Weevil’s Antimicrobial Peptides: At the Crosstalk between Development, Endosymbiosis and Immune Response
Authors: Galambos N. , Vincent-Monegat C. , Vallier A. , Parisot N. , Heddi A. , Zaidman-Rémy A.
Published: September 2023

Interactions between animals and microbes are ubiquitous in nature and strongly impact animal physiology. These interactions are shaped by the host immune system, which responds to infections and contributes to tailor the associations with beneficial microorganisms. In many insects, beneficial symbiotic associations not only include gut commensals, but also intracellular bacteria, or endosymbionts. Endosymbionts are housed within specialised host cells, the bacteriocytes, and are transmitted vertically across host generations. Host-endosymbiont co-evolution shapes the endosymbiont genome and host immune system, which not only fights against microbial intruders, but also ensures the preservation of endosymbionts and the control of their load and location. The cereal weevilSitophilusspp. is a remarkable model to study the evolutionary adaptation of the immune system to endosymbiosis since its binary association with a unique, relatively recently acquired nutritional endosymbiont,Sodalis pierantonius. This Gram-negative bacterium has not experienced the genome size shrinkage observed in long-term endosymbioses and has retained immunogenicity. We focus here on the 16 antimicrobial peptides (AMPs) identified in theSitophilus oryzaegenome and their expression patterns in different tissues, along host development or upon immune challenges, to address their potential functions in the defensive response and endosymbiosis homeostasis along the insect life cycle.
Modeling Thick Filament Activation Suggests a Molecular Basis for Force Depression
Authors: Liu Shuyue , Marang Chris , Woodward Mike , Joumaa Venus , Leonard Tim , Scott Brent , Debold Edward , Herzog Walter , Walcott Sam
Published: September 2023

Multiscale models aiming to connect muscle’s molecular and cellular function have been difficult to develop, in part, due to a lack of self-consistent multiscale data. To address this gap, we measured the force response from single skinned rabbit psoas muscle fibers to ramp shortenings and step stretches performed on the plateau region of the force-length relationship. We isolated myosin from the same muscles and, under similar conditions, performed single molecule and ensemble measurements of myosin’s ATP-dependent interaction with actin using laser trapping and in vitro motility assays. We fit the fiber data by developing a partial differential equation model that includes thick filament activation, whereby an increase in force on the thick filament pulls myosin out of an inhibited state. The model also includes a series elastic element and a parallel elastic element. This parallel elastic element models a titin-actin interaction proposed to account for the increase in isometric force following stretch (residual force enhancement). By optimizing the model fit to a subset of our fiber measurements, we specified seven unknown parameters. The model then successfully predicted the remainder of our fiber measurements and also our molecular measurements from the laser trap and in vitro motility. The success of the model suggests that our multiscale data are self-consistent and can serve as a testbed for other multiscale models. Moreover, the model captures the decrease in isometric force observed in our muscle fibers after active shortening (force depression), suggesting a molecular mechanism for force depression, whereby a parallel elastic element combines with thick filament activation to decrease the number of cycling cross-bridges.

SIGNIFICANCE

Connecting the molecular and cellular scales of muscle contraction would assist in, e.g., the treatment of genetic muscle diseases, the development of heart drugs, and the design of prostheses. The history dependence of muscle contraction, having no clear molecular basis, has remained an obstacle in making this connection for the seventy years since its discovery. We measured the force- and motion-generating capacity of rabbit psoas muscle from the scale of single molecules to single cells. We developed a mathematical model that, when fit to some of the cellular measurements, predicted the remaining cellular measurements and also the molecular measurements. The model’s ability to capture muscle’s history dependence suggests a unified description of muscle contraction from the molecular to cellular scale.
Usage of Mineralocorticoids and Isotonic Crystalloids in Subarachnoid Hemorrhage Patients in the United States
Authors: Mistry Akshitkumar M. , Naidugari Janki , Craven Jocelyn , Williams Logan , Beall Jonathan , Khatri Pooja , Broderick Joseph P. , Rice Todd W. , Kamel Hooman , Mack William
Published: September 2023

Background

The usage rates of mineralocorticoids (fludrocortisone) to treat hyponatremia and isotonic crystalloids (saline and balanced crystalloids) to maintain intravascular volume in patients with aneurysmal subarachnoid hemorrhage (aSAH) patients across the United States are unknown.

Methods

We surveyed National Institute of Neurologic Disorders and Stroke (NINDS) StrokeNet sites, which are mostly large, tertiary, academic centers, and analyzed subarachnoid hemorrhage encounters in the Premier Healthcare Database that is representative of all types of hospitals and captures about 20% of all acute inpatient care in the United States.

Results

Although mineralocorticoids are used by 70% of the NINDS StrokeNet sites in aSAH patients, it is used in less than 25% of the aSAH encounters in the Premier Database. Although saline is ubiquitously used, balanced crystalloids are increasingly used for fluid therapy in aSAH patients. Its use in the NINDS StrokeNet sites and the Premier Healthcare Database is 41% and 45%, respectively.

Conclusions

The use of mineralocorticoids remains low, and balanced crystalloids are increasingly used as fluid therapy in aSAH patients. The effectiveness of mineralocorticoids and balanced crystalloids in improving outcomes for aSAH patients must be rigorously tested in randomized clinical trials.
The Role of ACT Score in Mepolizumab Discontinuation
Authors: Solanki Neha , Beck Brittany , Labadia Monica , Smith Kevin , Peterson Laura , King Stephanie , Micklewright Sarah , Pennington Emily , Farooq Sobia , Zhang Peng , Aronica Mark , Zein Joe , Khatri Sumita , Comhair Suzy , Erzurum Serpil
Published: September 2023

Background

Mepolizumab is a therapy for severe asthma. However, studies on mepolizumab with external validity and diverse population from the US are lacking. There is little knowledge of the characteristics of people that discontinue mepolizumab in clinical care.

Objective

To investigate the real-world efficacy and time to clinical discontinuation of mepolizumab, we evaluated individuals with asthma started on mepolizumab at the Cleveland Clinic. We hypothesized that there are characteristics that distinguish which patients would remain on mepolizumab and which patients would discontinue the medication.

Methods

Between 2016 and 2022, patients who started on mepolizumab consented to be assessed over 18 months. At baseline, a questionnaire including demographic and medical history was collected. Laboratory findings such as ACT score, FENO (Fractional Excretion of Nitric Oxide), and spirometry were recorded. At the conclusion of the observation period, the participants were divided into two categories: Group A and Group B.

Results

Group B [N=28] discontinued mepolizumab (P< 0.05) at an average of 5.8 months (SD 4.2 months). Group A [N=129] stayed on the therapy for at least 1 year. A participant with an ACT score less than 13 has an odds ratio of 6.64 (95% CI, 2.1 – 26.0) of discontinuing mepolizumab therapy. For a male, the odds of discontinuing mepolizumab therapy is 3.39 (95% CI, 1.1 – 11.2).

Conclusion

In this real-world study, we find that high eosinophil count may not be adequate in screening which individuals will benefit from mepolizumab. Up to 17% of patients fail therapy within 6 months, with male sex and low ACT score increasing risk of mepolizumab discontinuation at Cleveland Clinic.
Efficient inhibition of fusion inhibitor HY3000 peptide to SARS-CoV-2 emerging EG.5, EG.5.1 and BA.2.86 variants
Authors: Wu Lili , Zheng Anqi , Tang Yangming , Wang Xiaoyun , Gao Yue , Lei Wenwen , Wu Guizhen , Wang Qihui , Gao George Fu
Published: September 2023

SARS-CoV-2 continues to evolve and spread. Recently, the Omicron EG.5 lineage, bearing an additional F456L mutation in spike (S) protein compared to its ancestor XBB.1.9.2, and its sub-variant EG.5.1, which carries a further Q52H mutation, have raised concerns due to their increased prevalence and extended immune escape properties. Additionally, an alarming variant, BA.2.86, has also garnered global concern because it contains over 30 amino acid mutations in its S protein compared to BA.2, including more than 10 changes in receptor-binding domain (RBD), reminiscent of the appearance of the Omicron variant in late 2021. Therefore, there is an urgent need to assess the effectiveness of current vaccines and therapeutics against EG.5, EG.5.1 and BA.2.86. In our previous work, we reported the design and broad-spectrum antiviral activity of a peptide fusion inhibitor HY3000 against SARS-CoV-2 and its variants including XBB.1.5. Here, we continued to evaluate the inhibitory potency of the HY3000 peptide against the prevailing EG.5 and EG.5.1, as well as XBB.1.16, FL.1.5.1, FY.3 and BA.2.86. Our data indicated that the peptide retained its potent inhibitory activities against these variants, indicating its potential as a good virus fusion inhibitor with broad-spectrum therapeutic effect against current and future SARS-CoV-2 variants. Currently, the HY3000 has been finished in Phase II clinical trial in China and has also been approved to conduct clinical investigation by U.S. Food and Drug Administration (FDA), suggesting a good application prospect against the ongoing COVID-19.
Influence of age, sex, body habitus, vaccine type and anti-S serostatus on cellular and humoral responses to SARS-CoV-2 vaccination
Authors: Chambers Emma S , Cai Weigang , Vivaldi Giulia , Jolliffe David A , Perdek Natalia , Li Wenhao , Faustini Sian E , Gibbons Joseph M. , Pade Corinna , Richter Alex G. , Cousens Anna K , Martineau Adrian R
Published: September 2023

Vaccine development targeting SARS-CoV-2 in 2020 was of critical importance in reducing COVID-19 severity and mortality. In the U.K. during the initial roll-out most individuals either received two doses of Pfizer COVID-19 vaccine (BNT162b2) or the adenovirus-based vaccine from Oxford/AstraZeneca (ChAdOx1-nCoV-19). There are conflicting data as to the impact of age, sex and body habitus on cellular and humoral responses to vaccination, and most studies in this area have focused on determinants of mRNA vaccine immunogenicity. Here we studied a cohort of participants in a population-based longitudinal study (COVIDENCE UK) to determine the influence of age, sex, body mass index (BMI) and pre- vaccination anti-Spike (anti-S) antibody status on vaccine-induced humoral and cellular immune responses to two doses of BNT162b2 or ChAdOx-n-CoV-19 vaccination.

Younger age and pre-vaccination anti-S seropositivity were both associated with stronger antibody responses to vaccination. BNT162b2 generated higher neutralising and anti-S antibody titres to vaccination than ChAdOx1-nCoV-19, but cellular responses to the two vaccines were no different. Irrespective of vaccine type, increasing age was also associated with decreased frequency of cytokine double-positive CD4+ T cells. Increasing BMI was associated with reduced frequency of SARS-CoV-2-specific TNF+ CD8% T cells for both vaccines.

Together, our findings demonstrate that increasing age and BMI associate with attenuated cellular and humoral responses to SARS-CoV-2 vaccination. Whilst both vaccines induced T cell responses, BNT162b2 induced significantly elevated humoral immune response as compared to ChAdOx-n-CoV-19.
Association between insecticide-treated bed net use and Burkitt lymphoma incidence in children in sub-Saharan Africa: a systematic review and population-level analysis
Authors: Schmit Nora , Kaur Jeevan , Aglago Elom K.
Published: September 2023

Background

Burkitt lymphoma (BL) is one of the most common childhood cancers in sub-Saharan Africa and aetiologically linked to malaria. However, evidence for an effect of malaria interventions on BL is limited. The aim of this study was to investigate the potential population-level association between large-scale rollout of insecticide-treated bednets (ITNs) in sub-Saharan Africa in the 2000s and BL incidence.

Methods

We conducted a systematic review in Embase, Global Health and MEDLINE to assemble all available data on BL incidence rates in children aged 0-15 years in malaria-endemic sub-Saharan African countries between Jan 1, 1990 and Feb 27, 2023. We calculated pooled estimates of BL incidence in sub-Saharan Africa for the time periods before and after ITN introduction. We used model estimates of sub-national ITN use to assess the association between average population ITN use and childhood BL incidence rates in a negative binomial regression model.

Results

We included 23 studies comprising 66 datapoints on BL incidence based on 5,226 cancer cases from locations with large-scale ITN use in 17 countries. BL rates were 44% (95% CI 12-64%) lower in the time period after ITN introduction compared to before. The pooled incidence rate of BL was 1.36 (95% CI 0.88-2.10) and 0.76 (95% CI 0.50-1.16) per 100,000 person-years before and after introduction of ITNs, respectively. After adjusting for potential confounders, a 1% increase in average ITN use in the population in the 10 years before BL data collection was associated with a 2% (95% CI 1-4%) reduction in BL incidence.

Conclusion

These findings suggest that large-scale rollout of ITNs in the 2000s was associated with a reduction in childhood BL burden in sub-Saharan Africa. Although published data may not be representative of all incidence rates across sub-Saharan Africa, our study highlights a potential additional benefit of malaria control programmes.
The relationship of artificial intelligence (AI) with fake news detection (FND): a systematic literature review
Authors: Iqbal Abid , Shahzad Khurram , Khan Shakeel Ahmad , Chaudhry Muhammad Shahzad
Published: September 2023

Purpose

The purpose of this study is to identify the relationship between artificial intelligence (AI) and fake news detection. It also intended to explore the negative effects of fake news on society and to find out trending techniques for fake news detection.

Design/methodology/approach

“Preferred Reporting Items for the Systematic Review and Meta-Analysis” were applied as a research methodology for conducting the study. Twenty-five peer-reviewed, most relevant core studies were included to carry out a systematic literature review.

Findings

Findings illustrated that AI has a strong positive relationship with the detection of fake news. The study displayed that fake news caused emotional problems, threats to important institutions of the state and a bad impact on culture. Results of the study also revealed that big data analytics, fact-checking websites, automatic detection tools and digital literacy proved fruitful in identifying fake news.

Originality/value

The study offers theoretical implications for the researchers to further explore the area of AI in relation to fake news detection. It also provides managerial implications for educationists, IT experts and policymakers. This study is an important benchmark to control the generation and dissemination of fake news on social media platforms.
Cultivating a culture of inquiry: exploring the factors influencing the integration of research and teaching in higher education institutions
Authors: Devesh Sonal , Nanjundaswamy Abhishek
Published: September 2023

Purpose

To determine the factors influencing the perception of undergraduate students toward research–teaching nexus and also to examine its impact on the attitude of the students.

Design/methodology/approach

The study used a quantitative design to examine the perceptions of students in higher education institutions in India. Descriptive and inferential statistics were used to describe the data and test the hypothesis. The data was collected using a structured questionnaire for a sample of 188 students from higher education institutions (HEIs). Further, in line with the purpose of the study and to test the hypotheses, the study used descriptive statistics, exploratory factor analysis and multivariate regression analysis.

Findings

The study demonstrates that the factors influencing the perception of undergraduate students toward research teaching nexus were identified using principal component analysis (PCA) with varimax rotation, conducted on 27 measurement items. In addition, the results of the multivariate regression analysis indicated that research-based, research-tutored and research motivation dimensions, significantly impact the graduate students' perception of research–teaching nexus.

Practical implications

The outcomes of this research may become valid input to HEI regulators, researchers and teachers while framing the policies and implementation of the same about the pertinent issues discussed in the paper. Further, it contributes to the existing theory that teaching–research quality and level of motivation are also the predominant factors influencing the teaching–research nexus among students. In addition, the outcome of this paper also supports HEIs to achieve the United Nations Sustainable Development Goals (UNSDGs) at large.

Originality/value

This study contributes to the ongoing debate and scarce literature on research–teaching nexus at the higher education level. The factors derived in this paper propose a framework for aligning teaching and research in academic programs to create high-quality human resource in the nation.
Evolution of laparoscopic pancreaticoduodenectomy at Westmead Hospital
Authors: Chen Ji , Pham Helen , Li Crystal , Nahm Christopher B. , Johnston Emma , Hollands Michael John , Pang Tony , Pleass Henry , Lam Vincent , Richardson Arthur , Yuen Lawrence
Published: September 2023

Background

Despite its proposed benefits, laparoscopic pancreaticoduodenectomy (LPD) has not been widely adopted due to its technical complexity and steep learning curve. The aim of this study was to report a single surgeon's experience in the stepwise implementation of LPD and evolution of technique over a nine‐year period in a moderate‐high volume unit.

Methods

Carefully selected patients underwent LPD initially by hybrid approach (laparoscopic resection and open reconstruction), which evolved into a total LPD (laparoscopic resection and reconstruction). Data was prospectively collected to include patient characteristics, intraoperative data, evolution of technique and postoperative outcomes.

Results

A total of 25 patients underwent hybrid LPD (HLPD) and 20 patients underwent total LPD (TLPD). There was no 90‐day mortality. Three patients developed a postoperative pancreatic fistula (POPF), all of which occurred in patients undergoing HLPD. There was no POPF in 20 consecutive TLPD. There was no evidence of anastomotic strictures in the hepaticojejunostomy in patients undergoing TLPD at long term follow up.

Conclusion

A gradual and cautious progression from HLPD to TLPD is essential to ensure safe implementation into a unit. LPD should only be considered in carefully selected patients, with outcomes subjected to regular and rigorous independent audit.
Efficacy and safety of esketamine nasal spray in addition to standard of care in patients with major depressive disorder who have active suicidal ideation with intent: A subgroup analysis of the Asian cohort of ASPIRE I (a randomized, double‐blind, placebo‐controlled study)
Authors: Hong Jin Pyo , Malek Akramul Zikri Abd , Li Cheng‐Ta , Paik Jong‐Woo , Sulaiman Ahmad Hatim , Madriaga Gilbert , Zhuo Jianmin , Siggins Sarah , Fu Dong‐Jing , Ju Po‐Chung
Published: September 2023

This post‐hoc analysis evaluated the efficacy and safety of intranasal esketamine in the Asian subgroup from ASPIRE I. Patients with major depressive disorder and suicidal ideation with intent received intranasal esketamine (n = 26) or placebo (n = 27), plus standard of care for 25 days. The primary endpoint was the change in Montgomery‐Åsberg Depression Rating Scale (MADRS) total score from baseline to Day 2. The MADRS score improved in favor of esketamine (least squares mean difference: −3.8). No unexpected safety concerns were noted. The Asian subgroup showed a similar efficacy and safety profile as the total ASPIRE I cohort.
An Alternative View of Sri Lanka's Debt Crisis
Authors: Nicholas Howard , Nicholas Bram
Published: September 2023

This article questions the validity of widely promulgated claims that Sri Lanka's debt crisis is the result of a combination of Chinese debt diplomacy and economic mismanagement in the form of fiscal and monetary excesses. The authors argue that if Sri Lanka has fallen into any kind of debt trap, it is an international sovereign bond debt trap. They further argue that the fundamental cause of the country's debt crisis is the failure of successive Sri Lankan administrations to transition towards an export‐oriented manufacturing economy focused on producing increasingly technologically sophisticated manufactured products, and lay the blame for this failure on a combination of external and domestic forces operating in tandem with one another. Since the remedial action taken by the Sri Lankan government in the context of an extended fund facility arrangement with the International Monetary Fund is premised on the contention that the source of the crisis is the protracted fiscal and monetary excesses of successive Sri Lankan administrations, this action is unlikely to offer a permanent solution to Sri Lanka's debt problem — just as similar attempts to remedy previous debt and currency crises have failed.
Beyond genocide: Towards an improved analysis and understanding of the Syrian regime's mass atrocity crimes in the Syrian Civil War
Authors: Bakkour Samer
Published: September 2023

In the course of the Syrian Civil War, prominent former Syrian Regime politicians, human rights observers, and foreign observers have accused the Syrian Regime of committing genocide against the country's Sunni majority. This article views these accusations as part of a wider politicization of genocide, and instead progresses beyond them to outline the case for an alternative “framing” of large‐scale atrocities committed against civilians. It accordingly proposes strategic displacement, or the deliberate large‐scale uprooting and dispersal of established communities for tactical and strategic purposes, as a preferable and more sustainable framework of engagement and analysis, and seeks to more clearly distinguish it from “ethnic cleansing” with the aim of demonstrating and underlining its unique contribution to the analysis and understanding of violent conflict. This has two benefits—first, it provides a different basis for conceptual and theoretical engagement that makes it possible to view mass atrocity as a tactical innovation in response to conflict exigencies; and second, it draws attention to internal displacement, an aspect of the conflict that has been repeatedly overlooked by international observers.
Mutations in alpha‐B‐crystallin cause autosomal dominant axonal Charcot–Marie–Tooth disease with congenital cataracts
Authors: Cortese Andrea , Currò Riccardo , Ronco Riccardo , Blake Julian , Rossor Alex M. , Bugiardini Enrico , Laurà Matilde , Warner Tom , Yousry Tarek , Poh Roy , Polke James , Rebelo Adriana , Dohrn Maike F. , Saporta Mario , Houlden Henry , Zuchner Stephan , Reilly Mary M.
Published: September 2023

Background and purpose

Mutations in the alpha‐B‐crystallin (CRYAB) gene have initially been associated with myofibrillar myopathy, dilated cardiomyopathy and cataracts. For the first time, peripheral neuropathy is reported here as a novel phenotype associated with CRYAB.

Methods

Whole‐exome sequencing was performed in two unrelated families with genetically unsolved axonal Charcot–Marie–Tooth disease (CMT2), assessing clinical, neurophysiological and radiological features.

Results

The pathogenic CRYAB variant c.358A>G;p.Arg120Gly was segregated in all affected patients from two unrelated families. The disease presented as late onset CMT2 (onset over 40 years) with distal sensory and motor impairment and congenital cataracts. Muscle involvement was probably associated in cases showing mild axial and diaphragmatic weakness. In all cases, nerve conduction studies demonstrated the presence of an axonal sensorimotor neuropathy along with chronic neurogenic changes on needle examination.

Discussion

In cases with late onset autosomal dominant CMT2 and congenital cataracts, it is recommended that CRYAB is considered for genetic testing. The identification of CRYAB mutations causing CMT2 further supports a continuous spectrum of expressivity, from myopathic to neuropathic and mixed forms, of a growing number of genes involved in protein degradation and chaperone‐assisted autophagy.
New bag of features using reinforcement Aquila optimization and weighted Bayesian Gaussian mixture modelling for dental images
Authors: Vijh Surbhi , Gupta Neetu , Kumar Sumit , Bansal Priti
Published: September 2023

Dentistry diseases are worldwide concern with the fact that 5% of medical budget is spent on it. Dental diagnosis requires frequent visits to clinic and multiple personal check‐ups by an expert. This delays the process of diagnosis as well as introduces the danger of oral infection spread. Automation is boon to speed up the process of diagnosis, reduce expert's involvement and help in handling volume of patients. In situations like pandemic as seen in this decade, computer based automatic systems in health have proven their importance and necessity. For dental diagnosis, images are useful tool for better anatomical views and accurate decision of treatment. However, manual dental analysis increases load on dentists for initial check‐up that can be easily performed with automated systems or self‐kits. Oral cavity is a dental illness, if not identified and treated on time may lead to other serious ailments. This work presents a framework that performs tooth image classification for cavity and non‐cavity with new bag of features (NBoF) method. NBoF method is an attempt to improve the performance of bag of features (BoF) using the proposed reinforcement Aquila optimization (RAO) and weighted Bayesian Gaussian mixture modelling (WBGMM). An analysis of the performance of the NBoF using the proposed RAO and WBGMM is conducted using standard metrics. The comparative study of results proves that the proposed NBoF method outperforms the existing state‐of‐the‐art algorithms.
Trophic roles of tadpoles in tropical Australian streams
Authors: Schmidt Katrin , Blanchette Melanie L. , Pearson Richard G. , Alford Ross A. , Davis Aaron M.
Published: September 2023

Tadpoles can be abundant consumers in stream ecosystems, and may influence the structure and function of streams through their feeding activities and interactions with other organisms. To understand the contribution of tadpoles to stream functioning, and the potential impact of their loss, it is necessary to determine their diets and how they might influence food‐web structure.

Using gut‐content analysis and stable‐isotope analysis of N and C, we determined the main food sources and trophic positions of tadpoles of five native frog species, invertebrates, and fish in upland and lowland Australian Wet Tropics streams.

Omnivory was prevalent among the tadpoles and invertebrates. Tadpoles consumed different food according to availability and nutrient quality, but assimilated mainly biofilm and algae. Most tadpoles and invertebrates assimilated the same high‐quality foods.

Food webs in upland riffles were simplified by local extinction of tadpoles, and were probably simplified in pools in the cooler months by seasonal decline in tadpole abundance. Food‐web complexity was increased in some pools by the presence of predatory fish and a greater number of basal sources.

As tadpoles are important seasonal components in stream food webs, their local extinction can greatly alter food‐web structure and complexity and, possibly, processes such as leaf litter breakdown and sediment accumulation.