bluuebunny/crossref_metadata_2025 huggingface dataset:
Research priorities to support the development of integrated national strategies to control skin-neglected tropical diseases
Authors: Simpson Hope , Mengiste Asrat , Mbonigaba Jean Bosco , Kollie Karsor , Nganda Motto , Dean Laura , Argaw Daniel , Davey Gail , Semrau Maya
Published: September 2022

Background

Skin-presenting neglected tropical diseases (skin-NTDs) impose large burdens on affected people, families and communities. The NTD Roadmap 2021–2030 presents a strategic plan to guide collaborative, multisectoral action to overcome these burdens, defining targets to control, eliminate and/or eradicate skin-NTDs by 2030. One of its targets is for 40 countries to adopt integrated skin-NTD strategies. Despite this high-level support for integration, only four countries were implementing integrated skin-NTD strategies in 2020.

Methods

We hosted workshops at the 2021 annual meeting of the Coalition for Operational Research on NTDs, to discuss the operationalisation of Roadmap goals into national strategies and interventions for skin-NTD control. Speakers included NTD Programme Managers from NTD-endemic countries, technical experts and researchers of different aspects of skin-NTDs.

Results

Challenges include community perceptions of interventions, demonstrating the cost-effectiveness of integrated care, availability and accessibility of community-based and primary healthcare services, the quality of data on skin-NTD morbidity and changes to operational structures required for integration. Research priorities included the identification of optimal case detection platforms, evaluation of integrated care, understanding the impacts of integration on community members and community health staff and development of point-of-care diagnostics.

Conclusions

The operational research priorities are intended to support the scale-up of integrated skin-NTDs programmes.
New Directions for Measurement in the Field of Work, Aging and Retirement
Authors: Fasbender Ulrike , Baltes Boris , Rudolph Cort W
Published: September 2022

Research on work, aging and retirement has reached a level of maturity as indicated by an established base of empirical findings and an increasing number of empirical studies on these and related phenomena. Given the development of the field, it is a good time to critically reflect on the measurement of core theoretical constructs that inform our understanding of work and aging and of retirement-related processes. Moreover, given the increasing popularity of studying aging at work and retirement, refocusing attention on the measurement of core constructs will help further advance these areas of research. The purpose of this special issue is to challenge the use of existing measures and measurement techniques and provide new advancements and directions for measurement, broadly defined, in the field of work, aging and retirement. This special issue features 8 scholarly articles that focus on: (1) innovative measurement instruments, (2) applying new techniques to address old problems, and (3) improving existing measures. In this special issue editorial, we derive key lessons learned from each of the 8 articles. We also offer practical recommendations for ways that these lessons may be incorporated into the design and execution of future research.
Incidence of and predictors for serious opioid-related adverse drug events
Authors: Denke Linda , Atem Folefac D. , Khazzam Michael
Published: September 2022

Purpose:

To determine the incidence of and predictors for serious opioid-related adverse drug events (ORADEs) in postoperative inpatients.

Methods:

A retrospective cohort study design of serious ORADEs in surgical inpatients between 2015 and 2017, who were abstracted from the electronic health record, in an 800-bed academic medical health center.

Results:

A total of 27,942 surgery patients met the inclusion criteria. Of those, 25,208 patients (90%) were exposed to opioids after surgery. A total of 25,133 (99.7%) patients exposed to opioids did not experience a serious ORADE while 75 (0.3%) patients did experience a serious ORADE and required naloxone. The predictors for ORADEs include age (OR = 1.040, P-value < .0001); gender (OR = 0.394, P-value = .0006); psychiatric disorder (OR = 4.440, CI: 2.435, 8.095); morphine level with respect to hydrocodone-acetaminophen (OR = 5.841, P-value = .0384); and were almost six times more likely to experience a serious ORADE when morphine is prescribed and 4.44 times more likely in patients with a psychiatric disorder (P-value < .0001).

Conclusion:

Once a baseline incidence is known, predictors for serious ORADEs in surgical inpatients are useful in guiding medical-surgical nurses' opioid safety practices, with more frequent focused respiratory assessments before opioid dosing and closer monitoring when opioids are prescribed postoperatively, especially in higher-risk surgical inpatients.
Validation of a Deep Learning–based Automatic Detection Algorithm for Measurement of Endotracheal Tube–to–Carina Distance on Chest Radiographs
Authors: Huang Min‑Hsin , Chen Chi-Yeh , Horng Ming-Huwi , Li Chung-I , Hsu I-Lin , Su Che-Min , Sun Yung-Nien , Lai Chao-Han
Published: September 2022

Background

Improper endotracheal tube (ETT) positioning is frequently observed and potentially hazardous in the intensive care unit. The authors developed a deep learning–based automatic detection algorithm detecting the ETT tip and carina on portable supine chest radiographs to measure the ETT–carina distance. This study investigated the hypothesis that the algorithm might be more accurate than frontline critical care clinicians in ETT tip detection, carina detection, and ETT–carina distance measurement.

Methods

A deep learning–based automatic detection algorithm was developed using 1,842 portable supine chest radiographs of 1,842 adult intubated patients, where two board-certified intensivists worked together to annotate the distal ETT end and tracheal bifurcation. The performance of the deep learning–based algorithm was assessed in 4-fold cross-validation (1,842 radiographs), external validation (216 radiographs), and an observer performance test (462 radiographs) involving 11 critical care clinicians. The performance metrics included the errors from the ground truth in ETT tip detection, carina detection, and ETT–carina distance measurement.

Results

During 4-fold cross-validation and external validation, the median errors (interquartile range) of the algorithm in ETT–carina distance measurement were 3.9 (1.8 to 7.1) mm and 4.2 (1.7 to 7.8) mm, respectively. During the observer performance test, the median errors (interquartile range) of the algorithm were 2.6 (1.6 to 4.8) mm, 3.6 (2.1 to 5.9) mm, and 4.0 (1.7 to 7.2) mm in ETT tip detection, carina detection, and ETT–carina distance measurement, significantly superior to that of 6, 10, and 7 clinicians (all P < 0.05), respectively. The algorithm outperformed 7, 3, and 0, 9, 6, and 4, and 5, 5, and 3 clinicians (all P < 0.005) regarding the proportions of chest radiographs within 5 mm, 10 mm, and 15 mm error in ETT tip detection, carina detection, and ETT–carina distance measurement, respectively. No clinician was significantly more accurate than the algorithm in any comparison.

Conclusions

A deep learning–based algorithm can match or even outperform frontline critical care clinicians in ETT tip detection, carina detection, and ETT–carina distance measurement.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
The Incidence of Posterolateral Tibial Plateau and Central Lateral Femoral Condylar Impaction Fractures in a Pediatric and Young Adult Population
Authors: Bernholt David L. , Buchman Jessica M. , Baessler Aaron M. , Eason Robert R. , Witte Dexter A. , Spence David D. , Throckmorton Thomas W. , Brolin Tyler J. , Azar Frederick M.
Published: September 2022

Background:

Posterolateral tibial plateau and central lateral femoral condylar impaction fractures are known to occur in the setting of anterior cruciate ligament (ACL) tears. There have been no prior investigations into the incidence and morphology of posterolateral tibial plateau impaction fractures in the setting of ACL injury in a pediatric population.

Methods:

Patients between 9 and 22 years of age with knee magnetic resonance imagings (MRIs) performed demonstrating complete or partial ACL tear were included in this study. MRI reports were reviewed to denote the presence of posterior cruciate ligament, medial collateral ligament, or lateral collateral ligament injury, meniscus tears, cartilage lesions. MRIs were reviewed by 2 fellowship-trained orthopaedic surgeons to denote the presence of posterolateral tibial plateau and central lateral femoral condylar impaction fractures and physeal status of femoral and tibial physes. Statistical analysis performed included χ2analysis and the Studentttesting.

Results:

A total of 328 patients with a primary ACL tear were identified. The mean age of patients included was 16.5 years (range: 9.0-21.5). The incidence of posterolateral tibial plateau impaction fractures was 83/328 (25.3%) while the incidence of lateral femoral condylar impaction fractures was 119/328 (36.3%). Bipolar impaction fractures occurred in 37/328 (11.3%). Of the 83 tibial impaction fractures identified, 82 were low-grade morphologic subtypes. Patients with lateral tibial plateau impaction fractures were older than those with no fracture (17.2±2.2 vs. 16.3±2.1,P=0.001). Only 3/38 (7.9%) patients with an open tibial physis sustained a tibial plateau impaction fracture compared with 80/290 (27.6%) with a closed tibial physis (χ2value: 6.9,P=0.009). There was no difference in proportion of patients with lateral femoral condylar impaction fractures based on femoral physeal status (P=0.484).

Conclusion:

The incidence of posterolateral tibial plateau impaction fractures in the setting of ACL tear in a pediatric and young adult patient population appears to be lower while lateral femoral condylar impaction fractures occur more frequently when comparing to previously reported incidences found in adult populations in the literature. Furthermore, posterolateral tibial plateau impaction fractures occur less frequently in those with an open proximal tibial physis and high-grade posterolateral tibial plateau bone loss is exceedingly rare in pediatric and young adult patients. Lateral femoral condylar impaction fractures are associated with lateral meniscal tears and medial meniscal ramp lesions.

Level of Evidence:

Level IV—cross-sectional study.
The Impact of Upper Instrumented Vertebra Orientation on Proximal Junctional Kyphosis: A Novel and Fixed Parameter, Fused Spinopelvic Angle
Authors: Im Sang-Kyu , Lee Ki Young , Lee Jung-Hee
Published: September 2022

Study Design.

A retrospective study.

Objectives.

To evaluate the impact of upper instrumented vertebra (UIV) orientation including the fused spinopelvic angle (FSPA) on proximal junctional kyphosis (PJK).

Summary of Background Data.

PJK is a challenging complication after adult spinal deformity (ASD) surgery. Some studies proposed UIV orientation act as a risk factor of PJK, but there remain debates because UIV orientation is changed by position. Therefore, we investigated the relationship between the FSPA, a novel parameter for the relationship between UIV and pelvis which did not change by position, and PJK.

Materials and Methods.

ASD patients who underwent long-segment fusion to the pelvis and followed up for more than two years were included. Comparative analysis was performed on spinopelvic parameters including UIV orientation parameters (UIV slope angle and FSPA) between PJK and non-PJK group. Binary regression analysis was conducted to find out the risk factors for PJK. And correlation analysis was conducted to find out the parameters that affect the FSPA.

Results.

A total of 190 patients were included. PJK incidence was 13.2% (25/190). PJK group showed a significantly greater postoperative UIV slope (21.3° vs. 18.8°, P=0.041) and significantly lesser postoperative FSPA (−0.9° vs. 4.5°, P<0.001). In binary regression analysis, only FSPA acted as a risk factor of PJK (odds ratio=0.920, P=0.004). The FSPA has strong positive correlation with pelvic incidence (PI)-lumbar lordosis (LL) (r=0.666, P<0.001) and negative correlation with lordosis distribution index (LDI) (r=−0.228, P=0.004).

Conclusion.

The FSPA is a fixed parameter which is not dependent on position. A reduction of the FSPA increases the risk for PJK. The FSPA can be adjusted through PI-LL and LDI. Thus, surgeons should increase the FSPA by adjusting the PI-LL and LDI during ASD surgery to prevent PJK.
miR-4478 Accelerates Nucleus Pulposus Cells Apoptosis Induced by Oxidative Stress by Targeting MTH1
Authors: Zhang Jiafang , Liu Ruiduan , Mo Ling , Liu Caijun , Jiang Jianming
Published: September 2022

Objectives.

Low back pain is the leading cause of disability in the elderly population and is strongly associated with intervertebral disk degeneration (IVDD). However, the precise molecular mechanisms regulating IVDD remain elusive. This study aimed to investigate the role of differentially expressed miRNAs in the pathogenesis of IVDD.

Materials and Methods.

We analyzed miRNA microarray datasets to identify differentially expressed miRNAs in IVDD progression and conducted quantitative real-time polymerase chain reaction and fluorescence in situ hybridization analysis to further confirm the differential expression of miR-4478 in nucleus pulposus (NP) tissues of patients diagnosed with IVDD. Using public databases of miRNA-mRNA interactions, we predicted the target genes of miR-4478, and subsequent flow cytometry and western blot analyses demonstrated the effect of MTH1 in H2O2-induced nucleus pulposus cells (NPCs) apoptosis. Finally, miR-4478 inhibitor was injected into NP tissues of the IVDD mouse model to explore the effect of miR-4478 in vivo.

Results.

miR-4478 was upregulated in NP tissues from IVDD patients. Silencing of miR-4478 inhibits H2O2-induced NPCs apoptosis. MTH1 was identified as a target gene for miR-4478, and miR-4478 regulates H2O2-induced NPCs apoptosis by modulating MTH1. In addition, downregulation of miR-4478 alleviated IVDD in a mouse model.

Conclusions.

In summary, our study provides evidence that miR-4478 may aggravate IVDD through its target gene MTH1 by accelerating oxidative stress in NPCs and demonstrates that miR-4478 has therapeutic potential in IVDD treatment.
MRSA Prophylaxis in Spine Surgery Decreases Postoperative Infections
Authors: Conaway William , Lambrechts Mark J. , D’Antonio Nicholas D. , Karamian Brian A. , DiMaria Stephen , Mao Jennifer , Canseco Jose A. , Rihn Jeffrey , Kurd Mark F. , Woods Barrett I. , Kaye I. David , Hilibrand Alan S. , Kepler Christopher K. , Vaccaro Alexander R. , Schroeder Gregory D.
Published: September 2022

Study Design:

Retrospective cohort study.

Objective:

To compare infection rates before and after the implementation of a quality improvement protocol focused on methicillin-resistant Staphylococcus aureus (MRSA) screening and decolonization in patients undergoing lumbar fusion and/or decompression.

Summary of Background Data:

Prior studies have demonstrated MRSA infections comprise a sizable portion of SSIs. Additional studies are required to improve our understanding of the risks and benefits of MRSA decolonization with vancomycin prophylaxis.

Methods:

A retrospective cohort analysis was conducted on patients who underwent spinal fusion or laminectomy before (2008–2011) and after (2013–2016) the implementation of an MRSA screening and treatment protocol. Odds ratios for MRSA, methicillin-sensitive Staphylococcus aureus (MSSA), and Vancomycin-resistant Enterococcus (VRE) infection before and after screening was calculated. Multivariate analysis assessed demographic characteristics as potential independent predictors of infection.

Results:

A total of 8425 lumbar fusion and 2558 lumbar decompression cases met inclusion criteria resulting in a total cohort of 10,983 patients. There was a significant decrease in the overall rate of infections (P <0.001), MRSA infections (P<0.001), and MSSA infections (P<0.001) after protocol implementation. Although VRE infections after protocol implementation were not significantly different (P=0.066), VRE rates as a percentage of all postoperative infections were substantially increased (0 vs. 3.36%, P=0.007). On multivariate analysis, significant predictors of the infection included younger age (OR=0.94[0.92–0.95]), shorter length of procedure (OR=1.00[0.99–1.00]), spinal fusion (OR=18.56[8.22–53.28]), higher ASA class (OR=5.49[4.08–7.44]), male sex (OR=1.61[1.18–2.20]), and history of diabetes (OR=1.58[1.08–2.29]).

Conclusion:

The implemented quality improvement protocol demonstrated that preoperative prophylactically treating MRSA colonized patients decreased the rate of overall infections, MSSA infections, and MRSA infections. In addition, younger age, male sex, diabetic status, greater ASA scores, and spinal fusions were risk factors for postoperative infection.
Considerations for Optimal Blood Pressure Target of Hypertension
Authors: Ling Qianhui , Cai Jun
Published: September 2022

Hypertension is a major risk factor for cardiovascular morbidity and mortality that has led to a huge public health burden. The optimal target of blood pressure (BP) to prevent cardiovascular complications remains unclear. Based on the results of the Systolic BP Intervention Trial (SPRINT) in 2015, the 2017 American College of Cardiology /American Heart Association guidelines for diagnosis and management of high BP in adults has changed the diagnostic threshold from 140/90 to 130/80 mmHg, and the target BP to 130/80 mmHg for nearly all hypertensive patients diagnosed using the new criteria. However, the findings from the SPRINT trial were to an extent contrasting with the results of previous large randomized controlled trials, namely Action to Control Cardiovascular Risk in Diabetes (ACCORD) and Secondary Prevention of Small Subcortical Strokes (SPS3). Besides, the 2018 European Society of Cardiology/European Society of Hypertension guidelines and the 2018 Chinese guidelines have maintained the conventional threshold and recommended target of 140/90 mmHg for most hypertensive patients. Given the special measurement of BP in the SPRINT trial and using an automated measurement system, the intensive systolic BP target of 120 mmHg provided by the SPRINT trial was not widely adopted. Most recently, the Strategy of BP Intervention in the Elderly Hypertensive Patients (STEP) trial, with a higher systolic BP target of 110 to 130 mmHg in the intensive group, confirmed the benefit and safety of intensive BP control in patients with hypertension, in accordance with the SPRINT trial. Here, the results from randomized controlled trials, meta-analyses, and other observational research studies, have been reviewed to evaluate the optimal target of BP treatment and the threshold of diagnostic criteria for hypertension.
Non-invasive continuous cardiac output monitoring in thoracic cancer surgery
Authors: Fellahi Jean-Luc , Abraham Paul , Tiberghien Nicolas , Coelembier Clément , Maury Jean-Michel , Bendjelid Karim
Published: September 2022

BACKGROUND

Patients scheduled for thoracic cancer surgery are eligible for goal-directed fluid therapy, but cardiac output monitoring remains challenging in that specific setting.

OBJECTIVE

We aimed to compare cardiac output as measured with chest bioreactance with that measured by calibrated pulse contour analysis; the hypothesis being that both methods would be interchangeable.

DESIGN

A prospective monocentre observational study.

SETTING

A tertiary university hospital.

PATIENTS

Fifty adult patients undergoing thoracic cancer surgery over a one year period.

MAIN OUTCOME MEASURES

Simultaneous measurements of cardiac index (CI) with bioreactance (CI-NICOM) and arterial pulse contour analysis calibrated by transthoracic echocardiography (CI-PCA) were performed at eight pre-specified intra-operative time points and following fluid challenge and/or vasoactive agents. Relationships between absolute values and changes in CI were assessed by linear regression. Interchangeability was tested with Bland–Altman analysis and percentage error calculation. A four quadrant plot was used to evaluate trending ability.

RESULTS

There was a significant difference between CI-PCA and CI-NICOM: 2.4 ± 0.8 (range: 0.9 to 5.8) l min−1 m−2 vs. 2.9 ± 0.9 (range: 0.9 to 7.2) l min−1 m−2, respectively (P < 0.001). A positive relationship was found between both techniques: y = 0.29x + 2.19; r
2 = 0.08 (P < 0.001). Taking CI-PCA as the reference method, there was a systematic overestimation of CI-NICOM by 21% (0.5 l min−1 m−2) and limits of agreement were large: -2.49 to 1.47 l min−1 m−2. The percentage error was 77% and concordance rates were 75 and 70% with and without an exclusion zone of 0.5 l min−1 m−2.

CONCLUSION

Chest bioreactance is feasible and well tolerated in patients undergoing thoracic surgery for cancer. When compared with calibrated PCA over a wide range of CI values, the technique is moderately correlated, not interchangeable, and provides moderate trending ability.

TRIAL REGISTRATION

NCT04251637.
Volumetric Absorptive Microsampling for the Therapeutic Drug Monitoring of Everolimus in Patients Who Have Undergone Liver Transplant
Authors: Yoo Seungji , Kim Giseob , Kim Soyeon , Ha Jungeun , Cho Beom Sik , Joo Dong Jin , Lee Jangik I.
Published: September 2022

Background:

Therapeutic drug monitoring (TDM) of everolimus is required to prevent organ rejection in patients who have undergone transplant. Volumetric absorptive microsampling (VAMS) is a minimally invasive method for accurately collecting a small amount of blood from a patient's fingers. This study aimed to assess the applicability of VAMS for TDM of everolimus.

Methods:

VAMS and venous blood samples were collected from 45 liver transplant recipients who had been receiving stable everolimus doses for at least 7 days. Whole blood everolimus concentrations were measured using ultrahigh performance liquid chromatography with tandem mass spectrometry. Deming regression and Bland–Altman analysis were performed to compare everolimus concentrations measured using VAMS (CVAMS) and venous blood samples (CIV). The regression coefficient (r2) between CVAMS and CIV was calculated using a linear regression. The effects of the hematocrit and blood sampling time on the difference between CVAMS and CIV were investigated.

Results:

Thirty-two participants were included in the final analysis. The Deming regression line was CIV = 1.04 × CVAMS + 0.55 [95% confidence interval (CI) of slope, 0.91–1.18; 95% CI of intercept, −0.05 to 1.16]. CVAMS and CIV were strongly correlated (r2 = 0.92), with no proportional or constant bias. The mean difference between CVAMS and CIV was −0.79 ng/mL, with the 95% limit of agreement ranging from −2.55 to 0.97 ng/mL in a Bland–Altman plot. No effect of the hematocrit or blood sampling time was observed.

Conclusions:

VAMS and venous blood sampling showed good agreement for the measurement of whole blood everolimus concentrations. Less invasive VAMS can substitute for more invasive venous blood sampling in the TDM of everolimus in liver transplant patients.
Two Adjacent Capillary Perforator Flaps? A Reconstruction of a Full-thickness Alar Defect
Authors: Gunnarsson Gudjon Leifur
Published: September 2022

Any aspect of nasal reconstruction poses a worthy challenge for every plastic surgeon. Most skin tumors affect older patients who also happen to have surplus skin. This is certainly a blessing in disguise for the reconstructive surgeon, enabling the use of local flaps to reconstruct the lost skin, like with like. We present a simple case of full thickness alar and partial lateral nasal defect for malignant melanoma, and how we were fortunate to reconstruct the defect successfully in a single operation using two adjacent local capillary perforator flaps: one for inner lining and the other for outer lining. A touch-up was performed after 3 months for improved cosmesis. A successful reconstruction is displayed with a video showing key steps of the procedure and results before and after a simple touch-up correction for improved appearance. This is a case of successful reconstruction of a full-thickness alar defect using a combination of two adjacent capillary perforator flaps. It is the first case to our knowledge where this combination is applied and displayed in a video demonstration.
Cryopreserved Amniotic Membrane Using the TissueTuck Technique: A Sutureless Approach for Pterygium Surgery
Authors: Desai Neel R. , Adams Bryan
Published: September 2022

Purpose:

The purpose of this study was to evaluate the clinical outcomes of the TissueTuck technique in the management of pterygium.

Methods:

This was a single-center, retrospective review of patients with primary or recurrent pterygium that underwent surgical excision followed by application of cryopreserved amniotic membrane (AM) using the TissueTuck technique. All patients underwent surgery between January 2012 and May 2019. Patient profile, surgical time, complications, and rates of pterygium recurrence were analyzed.

Results:

A total of 582 eyes of 453 patients (328 female patients; 65.1 ± 13.9 years) were included for analysis and initially presented with primary (92%) pterygium. The average duration of pterygium excision surgery was 14.7 ± 5.2 minutes (median: 14, range: 4–39 minutes) with mitomycin C administration in 257 (45%) eyes. At the last follow-up of 30.2 ± 22.2 months (median: 24.5, range: 3–94 months), BCVA significantly improved from logMAR 0.23 at baseline to logMAR 0.19 (P< 0.0001). Recurrence rate was 2.3% but only 0.7% (2/274) in those cases with primary, single-headed pterygium without mitomycin C treatment. Other postoperative complications in that cohort included granuloma (7.9%), scarring (3.8%), and diplopia in extreme lateral gaze (2.5%). The AM remained secured to the ocular surface throughout the postoperative period.

Conclusions:

The TissueTuck surgical technique with cryopreserved AM can be performed in minimal time and result in a low recurrence and complication rate after pterygium surgery.
Percutaneous screw fixation of the pubic symphysis versus plate osteosynthesis: a biomechanical study
Authors: O'Neill David E. , Bradley Hallie R. , Hull Brandon , Pierce William , Grewal Ishvinder S. , Starr Adam J. , Sathy Ashoke
Published: September 2022

Objectives: To compare the stability of screw fixation with that of plate fixation for symphyseal injuries in a vertically unstable pelvic injury (AO/Tile 61-C1) associated with complete disruption of the sacroiliac joint and the pubic symphysis.

Methods: Eight fourth-generation composite pelvis models with sacroiliac and pubic symphyseal disruption (Sawbones, Vashon Island, WA) underwent biomechanical testing simulating static single-leg stance. Four were fixed anteriorly with a symphyseal screw, and 4 with a symphyseal plate. All had single transsacral screw fixation posteriorly. Displacement and rotation were monitored at both sacroiliac joint and pubic symphysis.

Results: There was no significant difference between the 2 groups for mean maximum force generated. There was no significant difference in net displacement at both sacroiliac joint and pubic symphysis. There was significantly less rotation but more displacement in the screw group in the Z-axis. The screw group showed increased stiffness compared with the plate group.

Conclusions: This is the first biomechanical study to compare screw versus plate symphyseal fixation in a Tile C model. Our biomechanical model using anterior and posterior fixation demonstrates that symphyseal screws may be a viable alternative to classically described symphyseal plating.
Outcomes following severe acute respiratory syndrome coronavirus 2 infection among individuals with and without HIV in Denmark
Authors: Rasmussen Line D. , Cowan Susan , Gerstoft Jan , Kronborg Gitte , Johansen Isik S. , Larsen Carsten S. , Weise Lothar , Dalager-Pedersen Michael , Leth Steffen , Nielsen Lars N. , Lunding Suzanne , Omland Lars H. , Obel Niels
Published: September 2022

Objective:

To compare the risk of a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test and coronavirus disease 2019 (COVID-19) outcomes in people with HIV (PWH) with the general population, and estimate the association with vaccination status.

Design:

A nationwide, population based, matched cohort study

Methods:

We included all Danish PWH ≥18 years (n = 5276) and an age and sex-matched general population cohort (n = 42 308). We used Cox regression analyses to calculate (adjusted) incidence rate ratios [(a)IRR] and further stratified and restricted the analyses.

Results:

We observed no major difference in risk of first positive SARS-CoV-2 test [aIRR: 0.8 (95% confidence interval (CI): 0.8–0.9)], but a higher risk of first hospital contact with COVID-19 and hospitalization with severe COVID-19 for PWH vs. controls [IRR: 2.0; (1.6–2.5), 1.8 (1.4–2.3)]. Risk of first hospitalization decreased substantially in PWH with calendar time [first half of year 2022 vs. 2020 IRR: 0.3; (0.2–0.6)], whereas the risk compared to population controls remained almost twofold increased. We did not observe increased risk of death after SARS-CoV-2 infection [aIRR: 0.7 (95% CI: 0.3–2.0)]. Compared to PWH who had received two vaccines PWH who receiving a third vaccine had reduced risk of first positive SARS-CoV-2 test, death (individuals ≥60years) and hospitalization [aIRR: 0.9 (0.7–1.0); 0.2 (0.1–0.7); 0.6 (0.2–1.2)].

Conclusion:

PWH have almost the same risk of a positive SARS-CoV-2 test as the general population. Although risk of hospital contacts and severe outcomes following SARS-CoV-2 infection is increased, the risk of death does not seem to be substantially increased. Importantly, a third vaccine is associated with reduced risk of infection, and death.
A Bayesian modelling framework to quantify multiple sources of spatial variation for disease mapping
Authors: Lee Sophie A. , Economou Theodoros , Lowe Rachel
Published: September 2022

Spatial connectivity is an important consideration when modelling infectious disease data across a geographical region. Connectivity can arise for many reasons, including shared characteristics between regions and human or vector movement. Bayesian hierarchical models include structured random effects to account for spatial connectivity. However, conventional approaches require the spatial structure to be fully defined prior to model fitting. By applying penalized smoothing splines to coordinates, we create two-dimensional smooth surfaces describing the spatial structure of the data while making minimal assumptions about the structure. The result is a non-stationary surface which is setting specific. These surfaces can be incorporated into a hierarchical modelling framework and interpreted similarly to traditional random effects. Through simulation studies, we show that the splines can be applied to any symmetric continuous connectivity measure, including measures of human movement, and that the models can be extended to explore multiple sources of spatial structure in the data. Using Bayesian inference and simulation, the relative contribution of each spatial structure can be computed and used to generate hypotheses about the drivers of disease. These models were found to perform at least as well as existing modelling frameworks, while allowing for future extensions and multiple sources of spatial connectivity.
From the divergence of senescent cell fates to mechanisms and selectivity of senolytic drugs
Authors: L'Hôte Valentin , Mann Carl , Thuret Jean-Yves
Published: September 2022

Senescence is a cellular stress response that involves prolonged cell survival, a quasi-irreversible proliferative arrest and a modification of the transcriptome that sometimes includes inflammatory gene expression. Senescent cells are resistant to apoptosis, and if not eliminated by the immune system they may accumulate and lead to chronic inflammation and tissue dysfunction. Senolytics are drugs that selectively induce cell death in senescent cells, but not in proliferative or quiescent cells, and they have proved a viable therapeutic approach in multiple mouse models of pathologies in which senescence is implicated. As the catalogue of senolytic compounds is expanding, novel survival strategies of senescent cells are uncovered, and variations in sensitivity to senolysis between different types of senescent cells emerge. We propose herein a mechanistic classification of senolytic drugs, based on the level at which they target senescent cells: directly disrupting BH3 protein networks that are reorganized upon senescence induction; downregulating survival-associated pathways essential to senescent cells; or modulating homeostatic processes whose regulation is challenged in senescence. With this approach, we highlight the important diversity of senescent cells in terms of physiology and pathways of apoptosis suppression, and we describe possible avenues for the development of more selective senolytics.
Risk-taking neonates do not pay a survival cost in a free-ranging large mammal, the fallow deer (Dama dama)
Authors: Amin Bawan , Verbeek Laura , Haigh Amy , Griffin Laura L. , Ciuti Simone
Published: September 2022

Recent debate has focused on whether variation in personality primarily reflects variation in resource allocation or resource acquisition of individuals. These two mechanisms predict different relationships between personality and survival. If personality mainly reflects variation in resource allocation, then bold (i.e. risk-taking) individuals are expected to live shorter lives, whereas the opposite pattern is expected with resource acquisition. Here we studied the relationship between neonate personality and early-life survival in 269 juveniles of a population of fallow deer (Dama dama). We found that bolder individuals paid no apparent survival cost. Interestingly, among-individual differences in the physiological response at capture (heart rates, which covary with the behavioural response, i.e. latency to leave) were linked to survival, where individuals with lower heart rates when handled by humans had a higher probability of early-life survival. This suggests that bolder individuals may be of higher state than their shyer counterparts. As the first study linking neonate personality to survival in a free-ranging mammal, we provide novel insights into drivers behind early-life individual variation.
Towards breath sensors that are self-powered by design
Authors: Fitzgerald Lucy , Lopez Ruiz Luis , Zhu Joe , Lach John , Quinn Daniel
Published: September 2022

Piezoelectric materials are widely used to generate electric charge from mechanical deformation or vice versa. These strategies are increasingly common in implantable medical devices, where sensing must be done on small scales. In the case of a flow rate sensor, a sensor’s energy harvesting rate could be mapped to that flow rate, making it ‘self-powered by design (SPD)’. Prior fluids-based SPD work has focused on turbulence-driven resonance and has been largely empirical. Here, we explore the possibility of sub-resonant SPD flow sensing in a human airway. We present a physical model of piezoelectric sensing/harvesting in the airway, which we validated with a benchtop experiment. Our work offers a model-based roadmap for implantable SPD sensing solutions. We also use the model to theorize a new form of SPD sensing that can detect broadband flow information.
Blood RNA and protein biomarkers are associated with vaping and dual use, and prospective health outcomes
Authors: Gregory Andrew , Xu Zhonghui , Pratte Katherine , Berman Seth , Lu Robin , Suryadevara Rahul , Chase Robert , Yun Jeong H. , Saferali Aabida , Hersh Craig P. , Silverman Edwin K. , Bowler Russell P. , Alexander Laura E. Crotty , Boueiz Adel , Castaldi Peter J.
Published: September 2022

Background

Electronic nicotine delivery systems (ENDS) are driving an epidemic of vaping. Identifying biomarkers of vaping and dual use (concurrent vaping and smoking) will facilitate studies of the health effects of vaping. To identify putative biomarkers of vaping and dual use, we performed association analysis in an observational cohort of 3,892 COPDGene study participants with blood transcriptomics and/or plasma proteomics data and self-reported current vaping and smoking behavior.

Methods

Biomarkers of vaping and dual use were identified through differential expression analysis and related to prospective health events over six years of follow-up. To assess the predictive accuracy of multi-biomarker panels, we constructed predictive models for vaping and smoking categories and prospective health outcomes.

Results

We identified three transcriptomic and three proteomic associations with vaping, and 90 transcriptomic and 100 proteomic associations to dual use. Many of these vaping or dual use biomarkers were significantly associated with prospective health outcomes, such as FEV1 decline (three transcripts and 62 proteins), overall mortality (18 transcripts and 73 proteins), respiratory mortality (two transcripts and 23 proteins), respiratory exacerbations (13 proteins) and incident cardiovascular disease (24 proteins). Multimarker models showed good performance discriminating between vaping and smoking behavior and produced informative, modestly powerful predictions of future FEV1 decline, mortality, and respiratory exacerbations.

Conclusions

In summary, vaping and dual use are associated with RNA and protein blood-based biomarkers that are also associated with adverse health outcomes.
Industrialized complementary food for infants and young children: a systematic review protocol of their nutrient profile and impact on health outcomes
Authors: de Sousa Juliana Morais , Oliveira Priscila Gomes , da Silva Elisa Maria Rodrigues , de Oliveira Nicolie Mattenhauer , da Silva Ribeiro Karla Danielly
Published: September 2022

Complementary feeding plays an important role in the patterns of growth, development and formation of eating habits. Although the consumption of complementary foods (CF) with an inadequate Nutrient Profile (NP) is considered a risk factor for morbidities, there are still few studies that assess its repercussions on children’s diet and health. This review aims to identify the participation of industrialized CF consumption in children’s diet, the NP of these foods, and their impact on quality diet and on health of children under two years of age. This is a protocol study for systematic review registered in the International Prospective Register of Systematic Reviews (PROSPERO) CDR 42022321891, following recommendations of the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P). We will seek out cross-sectional or cohort studies investigating the NP of industrialized CF recommended for children up to two years and/or that evaluated the association between the CF consumption and the children’s diet and health. The search for records will be conducted on PubMed/Medline, Scopus, Embase, Web of Science, and Scielo. Two independent reviewers will perform all steps of the systematic review. The methodological quality will be analyzed using the Newcastle–Ottawa scale (NOS) and Risk of Bias 2 (RoB 2). Results will be presented by means, medians, confidence interval (95%), standard deviation for the NP of foods, and to assess the health impact, comparisons of outcome measures, effect sizes (ORs and RRs) will be extracted. The high consumption of industrialized CF and the negative impact on children’s health, in addition to the gap in the literature of studies assessing the NP and consumption of these foods by children under 24 months, justify the importance of a review on this subject focusing on that age group.
An Optimised Monophasic Faecal Extraction Method for LC-MS Analysis and its Application in Gastrointestinal Disease
Authors: Kelly Patricia E. , Ng H Jene , Farrell Gillian , McKirdy Shona , Russell Richard K. , Hansen Richard , Rattray Zahra , Gerasimidis Konstantinos , Rattray Nicholas J.W.
Published: September 2022

Liquid chromatography coupled with mass spectrometry (LC-MS) metabolomic approaches are widely used to investigate underlying pathogenesis of gastrointestinal disease and mechanism of action of treatments. However, a standardised method for extracting metabolites from faecal samples for large-scale metabolomic studies is yet to be defined. Current methods often rely on biphasic extractions using harmful halogenated solvents, making automation and large-scale studies challenging. The present study reports an optimised monophasic faecal extraction protocol that is suitable for untargeted and targeted LC-MS analyses. The impact of several experimental parameters, including sample weight, extraction solvent, cellular disruption method, and sample-to-solvent ratio were investigated. It is suggested that a 50 mg freeze-dried faecal sample should be used in a methanol extraction (1:20) using bead beating as the means of cell disruption. This is revealed by a significant increase in number of metabolites detected, improved signal intensity, and wide metabolic coverage given by each of the above extraction parameters. Finally, we addressed the applicability of the method on faecal samples from patients with Crohn’s disease (CD) and coeliac disease (CoD), two distinct chronic gastrointestinal diseases involving metabolic perturbations. Untargeted and targeted metabolomic analysis demonstrated the ability of the developed method to detect and stratify metabolites extracted from patient groups and healthy controls (HC), highlighting characteristic changes in the faecal metabolome according to disease. The method developed is therefore suitable for the analysis of patients with gastrointestinal disease and can be used to detect and distinguish differences in the metabolomes of CD, CoD, and HC.
Development and Clinical Validation of Swaasa AI Platform for screening and prioritization of Pulmonary TB
Authors: Yellapu Gayatri Devi , Rudraraju Gowrisree , Sripada Narayana Rao , Mamidgi Baswaraj , Jalukuru Charan , Firmal Priyanka , Yechuri Venkat , Varanasi Sowmya , Peddireddi Venkata Sudhakar , Bhimarasetty Devi Madhavi , Kanisetti Sidharth , Joshi Niranjan , Mohapatra Prasant , Pamarthi kiran
Published: September 2022

Acoustic signal analysis has been employed in various medical devices. However, studies involving cough sound analysis to screen the potential Pulmonary Tuberculosis (PTB) suspects are very few. The main objective of this cross-sectional validation study was to develop and validate the Swaasa AI platform to screen and prioritize at risk patients for PTB based on the signature cough sound as well as symptomatic information provided by the subjects. The voluntary cough sound data was collected at Andhra Medical College-India. An Algorithm based on multimodal Convolutional Neural Network (CNN) architecture and Feedforward Artificial Neural Network (FFANN) (tabular features) was built and validated on a total of 567 subjects, comprising 278 positive and 289 negative PTB cases. The output from these two models was combined to detect the likely presence (positive cases) of PTB. In the clinical validation phase, the AI-model was found to be 86.82% accurate in detecting the likely presence of PTB with 90.36% sensitivity and 84.67% specificity. The pilot testing of model was conducted at a peripheral health care centre, RHC Simhachalam-India on 65 presumptive PTB cases. Out of which, 15 subjects truly turned out to be PTB positive with a Positive Predictive Value of 75%. The validation results obtained from the model are quite encouraging. This platform has the potential to fulfil the unmet need of a cost-effective PTB screening method. It works remotely, presents instantaneous results, and does not require a highly trained operator. Therefore, it could be implemented in various inaccessible, resource-poor parts of the world.
Posterior white matter hyperintensities are associated with reduced medial temporal lobe subregional integrity and long-term memory in older adults
Authors: Rizvi Batool , Sathishkumar Mithra , Kim Soyun , Márquez Freddie , Granger Steven J. , Larson Myra S. , Miranda Blake A. , Hollearn Martina K. , McMillan Liv , Nan Bin , Tustison Nicholas J. , Lao Patrick J. , Brickman Adam M. , Greenia Dana , Corrada Maria M. , Kawas Claudia H. , Yassa Michael A.
Published: September 2022

White matter hyperintensities are a marker of small vessel cerebrovascular disease that are strongly related to cognition in older adults. Similarly, medial temporal lobe atrophy is well-documented in aging and Alzheimer’s disease and is associated with memory decline. Here, we assessed the relationship between lobar white matter hyperintensities, medial temporal lobe subregional volumes, and hippocampal memory in older adults.

We collected MRI scans in a sample of 139 older adults without dementia (88 females, mean age (SD) = 76.95 (10.61)). Participants were administered the Rey Auditory Verbal Learning Test (RAVLT). Regression analyses tested for associations among medial temporal lobe subregional volumes, regional white matter hyperintensities and memory, while adjusting for age, sex, and education and correcting for multiple comparisons.

Increased occipital white matter hyperintensities were related to worse RAVLT delayed recall performance, and to reduced CA1, dentate gyrus, perirhinal cortex (Brodmann area 36), and parahippocampal cortex volumes. These medial temporal lobe subregional volumes were related to delayed recall performance. The association of occipital white matter hyperintensities with delayed recall performance was fully mediated statistically only by perirhinal cortex volume.

These results suggest that white matter hyperintensities may be associated with memory decline through their impact on medial temporal lobe atrophy. These findings provide new insights into the role of vascular pathologies in memory loss in older adults and suggest that future studies should further examine the neural mechanisms of these relationships in longitudinal samples.
Food Insecurity During the First Year of COVID-19: An Analysis of Employment and Sociodemographic Factors Among a Longitudinal Cohort (CHASING COVID)
Authors: Ng Yvette , Chang Mindy , Robertson McKaylee , Grov Christian , Maroko Andrew , Zimba Rebecca , Westmoreland Drew , Rane Madhura , Mirzayi Chloe , Parcesepe Angela M. , Kulkarni Sarah , Salgado-You William , Cohen Nevin , Nash Denis
Published: September 2022

Objectives

While much has been reported about the impact of COVID-19 on U.S. food insecurity, longitudinal data and the variability experienced by people working in different industries are limited. This study aims to further characterize individuals experiencing food insecurity during the pandemic in terms of employment and sociodemographic characteristics and degree of food insecurity.

Methods

The study sample consisted of people enrolled in a U.S. prospective cohort study (CHASING COVID) who completed all food insecurity questionnaires from Visit 1 (April-July 2020) through Visit 7 (May-June 2021). Descriptive statistics and logistic regression models were used to determine employment and sociodemographic correlates of food insecurity (using a screening question from the USDA HFSS). Patterns of food insecurity and utilization of food benefit programs were also examined.

Results

Thirty-one percent (1251/4019) of the sample were food insecure. Black and Hispanic respondents, households with children, and those with lower income and education levels had a higher odds of food insecurity. People employed in construction, leisure/hospitality and trade/transportation industries had the highest burden of both food insecurity and income loss. Among those reporting food insecurity, 40% were persistently food insecure (≥4 consecutive visits), and 46% did not utilize any food benefit programs.

Conclusions

The pandemic resulted in widespread food insecurity in our cohort, much of which was persistent. In addition to addressing sociodemographic disparities, future policies should focus on the needs of those working in vulnerable industries and ensure those experiencing food insecurity can easily participate in food benefit programs for which they are eligible.