bluuebunny/crossref_metadata_2025 huggingface dataset:
X-ray scatter in projection radiography
Authors: Ylimaula Satu , Räsänen Lasse , Hurskainen Miia , Peuna Arttu , Julkunen Petro , Nieminen Miika Tapio , Hanni Matti
Published: November 2023

Projection radiography is the most common radiological modality, and radiation safety of it concerns both radiation workers and the public. We measured and generated a series of scattered radiation maps for projection radiography and estimated effective doses of the supporting person during exposure. Measured adult patient protocols included chest posterior–anterior, chest lateral, pelvis anterior–posterior (AP), abdomen AP and bedside chest AP. Maps concretise spatial distribution and the scattered radiation dose rates in different imaging protocols. Highest and lowest rates were measured in abdomen AP and bedside chest AP protocols, respectively. The effective dose of supporting person in abdomen AP examination at distance of 0.5 m was 300 nSv and in bedside supine chest AP examination at distance of 0.7 m was 0.5 nSv. The estimated annual effective dose of emergency unit radiographer was 0.11 mSv. The obtained effective dose values are small compared to annual dose limits of radiation workers and the public.
Rotational Changes Following Use of Direct Vertebral Rotation in Adolescent Idiopathic Scoliosis
Authors: Kim Hong Jin , Chang Dong-Gune , Lenke Lawrence G. , Pizones Javier , Castelein René , Trobisch Per D. , Watanabe Kota , Yang Jae Hyuk , Suh Seung Woo , Suk Se-Il
Published: November 2023

Study Design.

A retrospective cohort study.

Objective.

To evaluate long-term rotational changes in the vertebrae of patients with adolescent idiopathic scoliosis (AIS) who underwent direct vertebral rotation (DVR).

Summary of Background Data.

DVR using thoracic pedicle screws, a rotational corrective maneuver used in the surgical treatment of AIS, was introduced in 2004. Although DVR is considered to be the main axial corrective maneuver, the long-term rotational changes of vertebrae following this treatment are not well understood.

Materials and Methods.

A total of 135 vertebrae that underwent DVR using thoracic pedicle screws with a minimum five-year follow-up were retrospectively assessed for the vertebral rotation angle. The vertebral rotation of the apical vertebra (AV) and distal end vertebra (EV) was evaluated using the Nash-Moe scale, the rotational angle to the sacrum (RAsac), and the Aaro and Dahlborn method. The Student ttest (paired means) was used for continuous variables, and the χ2 test was used for categorical variables, as appropriate. A comparison of two and three groups used a one-way repeated measures analysis of variance, and the post hoc analysis used the Bonferroni test.

Results.

The mean Nash-Moe scale of distal EV showed statistically significant differences between preoperative and postoperative values (P=0.034) and no statistically significant difference between postoperative and last follow-up values (P=1.000). The last follow-up RAsac of AV did not differ significantly from the preoperative RAsac of AV (P=0.515). The last follow-up RAsac of distal EV was significantly lower than the preoperative RAsac of distal EV (P=0.001). The Pearson correlation analysis showed that the last follow-up RAsac of distal EV was correlated with the Cobb angle of the main curve (r=0.459, P=0.004), loss of correction (r=0.541, P=0.001), and lowest instrumented vertebra tilt angle (r=0.504, P=0.001)

Conclusions.

The rotation regression phenomenon in AV and rotation maintenance in distal EV were observed after DVR over an average 10-year follow-up. These findings suggest that the DVR in the surgical treatment of AIS has a positive long-term effect on the stabilization of distal EV from the point of view of axial rotation.

Level of Evidence.

4.
Does Reinforcement Learning Improve Outcomes for Critically Ill Patients? A Systematic Review and Level-of-Readiness Assessment
Authors: Otten Martijn , Jagesar Ameet R. , Dam Tariq A. , Biesheuvel Laurens A. , den Hengst Floris , Ziesemer Kirsten A. , Thoral Patrick J. , de Grooth Harm-Jan , Girbes Armand R.J. , François-Lavet Vincent , Hoogendoorn Mark , Elbers Paul W.G.
Published: November 2023

OBJECTIVE:

Reinforcement learning (RL) is a machine learning technique uniquely effective at sequential decision-making, which makes it potentially relevant to ICU treatment challenges. We set out to systematically review, assess level-of-readiness and meta-analyze the effect of RL on outcomes for critically ill patients.

DATA SOURCES:

A systematic search was performed in PubMed, Embase.com, Clarivate Analytics/Web of Science Core Collection, Elsevier/SCOPUS and the Institute of Electrical and Electronics Engineers Xplore Digital Library from inception to March 25, 2022, with subsequent citation tracking.

DATA EXTRACTION:

Journal articles that used an RL technique in an ICU population and reported on patient health-related outcomes were included for full analysis. Conference papers were included for level-of-readiness assessment only. Descriptive statistics, characteristics of the models, outcome compared with clinician’s policy and level-of-readiness were collected. RL-health risk of bias and applicability assessment was performed.

DATA SYNTHESIS:

A total of 1,033 articles were screened, of which 18 journal articles and 18 conference papers, were included. Thirty of those were prototyping or modeling articles and six were validation articles. All articles reported RL algorithms to outperform clinical decision-making by ICU professionals, but only in retrospective data. The modeling techniques for the state-space, action-space, reward function, RL model training, and evaluation varied widely. The risk of bias was high in all articles, mainly due to the evaluation procedure.

CONCLUSION:

In this first systematic review on the application of RL in intensive care medicine we found no studies that demonstrated improved patient outcomes from RL-based technologies. All studies reported that RL-agent policies outperformed clinician policies, but such assessments were all based on retrospective off-policy evaluation.
Finding our Voice: Evaluation of Goal Setting Using the Habits of Preceptors Rubric in Terms of Focus, “SMARTness,” and Impact
Authors: Wolken Maura J. , Larson Suzanne , Raney Erin C. , Pogge Elizabeth K. , Afolabi Titilola M. , Storjohann Tara , Fairman Kathleen A. , Davis Lindsay E.
Published: November 2023

Introduction:

Effective leadership propels teams from effectiveness to greatness and is accomplished when everyone achieves and contributes their full potential, or “voice.” The Clinician Educators Program Teaching and Learning Curriculum fosters preceptor development using the Habits of Preceptors Rubric (HOP-R) to guide participants in finding their precepting “voice.” After the HOP-R self-assessment, participants select a habit of focus (HOF) and craft a SMART (specific/measurable/achievable/relevant/time-bound) goal. This report describes a pilot rubric, SMART-EP (emotional intelligence(EI)/professionalism), exploring goal “SMARTness” alongside change (impact) in participants' perceived precepting capabilities.

Methods:

HOP-R self-ratings (2018–2020) and HOF/SMART goals (2019–2020) were retrospectively reviewed by two raters. Perceived preceptor capabilities were measured by analyzing the change in self-assessed habit level ratings between the first/fourth-quarter surveys. SMART goals were categorized by HOF and inclusion of SMART-EP components. Participants were guided in the inclusion of SMART, but not -EP, components.

Results:

In aggregate, 120 participants completed HOP-R surveys (2018–2020). Within-subject changes across all 11 habits were significant (P < .001). For the SMART-EP rubric analysis (2019–2020), 71 participants had an average “SMARTness” score of 3.92 (of 5) with corresponding interrater reliability of 0.91. Goals included 2.77 (of 4) EI traits and 1.72 (of 3) professionalism components.

Discussion:

The SMART-EP rubric provided insights into preceptor development opportunities among participants. Beyond SMART components, participants often included elements of EI and professionalism. Ratings confirm and support the consistency of the HOP-R as a tool to assess precepting habits.
Resolvin D1 attenuates Ang II-induced hypertension in mice by inhibiting the proliferation, migration and phenotypic transformation of vascular smooth muscle cells by blocking the RhoA/mitogen-activated protein kinase pathway
Authors: Wei Cheng , Zhang Jishou , Peng Shanshan , Liu Jianfang , Xu Yao , Zhao Mengmeng , Xu Shuwan , Pan Wei , Yin Zheng , Zheng Zihui , Qin Juan-Juan , Wan Jun , Wang Menglong
Published: November 2023

The proliferation, migration and phenotypic transformation of vascular smooth muscle cells contribute to vascular remodeling and hypertension. Resolvin D1 (RvD1) is a specialized pro-resolving lipid mediator that has been shown to have anti-inflammatory effects and can protect against different cardiovascular diseases. However, the role and mechanism of RvD1 in hypertension are not clear. The current study investigated the role of RvD1 in Ang II-induced hypertensive mice and Ang II-stimulated rat vascular smooth muscle cells. The results showed that RvD1 treatment significantly attenuated hypertension and vascular remodeling, as indicated by decreases in blood pressure, aortic media thickness and collagen deposition. In addition, RvD1 inhibited the proliferation, migration and phenotypic transformation of vascular smooth muscle cells (VSMCs) in vivo and in vitro. Notably, the protective effects of RvD1 were mediated by the Ras homolog gene family member A (RhoA)/mitogen-activated protein kinase (MAPK) signaling pathway. In conclusion, our findings demonstrated the potential benefits of RvD1 as a promising therapeutic agent in the treatment of vascular remodeling and hypertension.
Treatment decision based on unilateral index from nonadrenocorticotropic hormone-stimulated and adrenocorticotropic hormone-stimulated adrenal vein sampling in primary aldosteronism
Authors: Zhang Xizi , Shu Xiaoyu , Wu Feifei , Yang Jun , Cheng Qingfeng , Du Zhipeng , Song Ying , Yang Yi , Hu Jinbo , Wang Yue , Li Qifu , Yang Shumin ,   the Chongqing Primary Aldosteronism Study (CONPASS) Group†
Published: November 2023

Objective:

Adrenal venous sampling (AVS) is recommended for identifying the subtype of primary aldosteronism before making a surgical treatment decision, but failed cannulation of one adrenal vein is common. To evaluate whether using results of one adrenal vein during AVS could accurately predict unilateral primary aldosteronism.

Methods:

A retrospective study was conducted in primary aldosteronism patients receiving bilaterally or unilaterally successful AVS. The aldosterone–cortisol ratio from the adrenal vein divided by the aldosterone–cortisol ratio from the inferior vena cava (IVC) was calculated as the AV/IVC index.

Results:

The study examined 455 patients with primary aldosteronism, including 347 patients with unilateral primary aldosteronism. Among them, 250 and 125 patients received non- adrenocorticotropic hormone (ACTH) and ACTH-stimulated AVS, respectively, and 80 patients received both forms of AVS. Under non-ACTH-stimulated AVS, AUC of the AV/IVC index to diagnose ipsilateral and contralateral primary aldosteronism were 0.778 and 0.924, respectively. The specificity was 100% for both, with sensitivities of 5 and 26%, respectively, when using cutoffs of 17.05 to diagnose ipsilateral primary aldosteronism and 0.15 to diagnose contralateral primary aldosteronism. When using cutoffs of 3.60 and 0.70, the specificity decreased, but if combined with CT results (ipsilateral or contralateral adrenal nodules larger than 10 mm), the specificity could be maintained at 99%, with sensitivities of 33 and 45%, respectively. Under ACTH-stimulated AVS, the AV/IVC index showed similar accuracy to diagnose ipsilateral and contralateral primary aldosteronism.

Conclusion:

The unilateral AV/IVC index can be used to diagnose unilateral primary aldosteronism during AVS. Combining CT results can increase the accuracy further.
Decreased toll-like receptor 4 and CD11b/CD18 expression on peripheral monocytes of hypertensive patients correlates with a lesser extent of endothelial damage: a preliminary study
Authors: Budzyń Magdalena , Gryszczyńska Bogna , Begier-Krasińska Beata , Kaja Elżbieta , Mikołajczak Przemysław , Kujawski Radosław , Grupińska Joanna , Iskra Maria , Tykarski Andrzej , Kaczmarek Mariusz
Published: November 2023

Background:

Low-grade chronic inflammation is recognized to contribute to the physiopathology of arterial hypertension. Therefore, this study aimed to assess the pro-inflammatory phenotype of peripheral monocytes of hypertensive patients by analyzing Toll-like receptor 4 (TLR4) and CD11b/CD18 surface expression. In the second part, the influence of phenotypic alterations of monocytes on the endothelial status reflected by circulating endothelial cells (CECs) was evaluated.

Patients:

The study included 60 patients with arterial hypertension, who were divided into two subgroups based on the disease severity according to the applicable criteria. The mild hypertension and resistant hypertension groups included 30 patients each. The control group consisted of 33 normotensive volunteers matched for age and sex.

Results:

Both in the entire group of patients and individual subgroups, reduced surface expression of TLR4 and CD11b/CD18 was found compared to normotensive volunteers. A reduced percentage of monocytes with the CD14+TLR4+ immunophenotype was correlated with a lower MFI level of CD18 and CD11b in the entire group of patients and after division only in the mild hypertension group. Reduced surface expression of TLR4 in hypertensive patients correlated with a lower number of CECs. This relationship was not observed in the resistant hypertension group; instead, an independent effect of reduced CD11b/CD18 expression on the reduction of CEC number was demonstrated.

Conclusion:

Our preliminary study showed for the first time that hypertension of varying severity is accompanied by phenotypic changes in monocytes, manifested by reduced surface expression of both TLR4 and CD11b/CD18. These phenotypic changes were associated with a reduced degree of endothelial injury. Our study opens a new, unexplored area of research on the protective features of peripheral monocytes in hypertension.
RDT-FSDet: Few-shot Object Detection for Rapid Antigen Test
Authors: Duan Yaofei , Wang Rongsheng , Tan Tao , Jin Xiaoyan , Lam Chan-Tong , Im Sio-Kei
Published: November 2023

Objective:

Manual verification of rapid diagnostic test (RDT) results is a time-consuming task; therefore, it is essential to introduce an object detection model into RDT result recognition to reduce the time involved. To address these problems, a detector that can rapidly adapt to different RDT results in various regions is important.

Methods:

We employed the few-shot object detection strategy and trained the Faster R-CNN detector with the mainland data set as the base class, followed by fine-tuning with the few-shot approach on the Macau RDT result data set. Moreover, we introduced 2 novel data augmentation methods, namely the “light simulation mask method” and “synthetic positive samples” for an unbalanced data set, to increase the sample size and balance the data set of the RDT detection task.

Result:

Compared with LightR-YOLOv5, RDT-few-shot detector (FSDet) achieved an mean average precision of 91.18 and a recall of 93.59 on the Macau RDT data set, demonstrating that this model can rapidly adapt to RDT results in different regions. The inference time of RDT-FSDet for each RDT result was 0.14 seconds, which can save ~90% of the detection time compared with manual screening.

Conclusion:

In addition to its application in the context of the coronavirus disease 2019 pandemic, this model can also be used as a general small-sample detection model. RDT-FSDet can be applied to the detection tasks of other small data sets, such as managing and analyzing detection results in other or future epidemics.
The association of C-reactive protein with major depressive symptoms in nonmetastatic renal cell carcinoma
Authors: Nicaise Edouard , Schmeusser Benjamin N. , Biermann Henry , Ali Adil , Ambadi Sriram , Patil Dattatraya H. , Armas-Phan Manuel , Vashi Khushali , Palacios Arnold R. , Midenberg Eric , Petrinec Benjamin , Nazha Bassel , Bilen Mehmet A. , Ogan Kenneth , Master Viraj A.
Published: November 2023

Introduction and Objective:

Patients with kidney cancer experience higher rates of depression compared with other cancer subtypes. Inflammation has been shown to contribute to depression associated with malignancy. Here, we assess the association between preoperative C-reactive protein (CRP) and major depression, as screened by the eight-item Patient Health Questionnaire (PHQ-8) depression scale, in patients undergoing nephrectomy for nonmetastatic renal cell carcinoma (RCC).

Methods:

Retrospective review of prospectively administered PHQ-8 surveys in patients who underwent nephrectomy for nonmetastatic RCC was conducted. Patients with available PHQ-8 within 180 days before and after surgery were included. The association of major depressive symptoms on preoperative PHQ-8 and clinical improvement on postoperative survey with patient/tumor characteristics and CRP levels was determined by the generalized chi-square test for categorical variables and analysis of variance for continuous variables. Multivariable logistic regression was used to analyze variables associated with major depression on PHQ-8 and postoperative survey improvement.

Results:

Two hundred forty-five patients were analyzed. Most were male (66%). Median age and body mass index were 65 and 28.9 kg/m2, respectively. 64.5% of patients were White, and 29.0% were Black. 30.2% had an elevated CRP (≥10 mg/L). 45 (18.4%) patients screened positive for major depressive symptoms on PHQ-8 (≥10 points). Patients with elevated CRP were more likely to have positive preoperative depression screening (odds ratio [OR] 2.66, 95% CI 1.08–6.52, P = .033) but had higher probability of demonstrating meaningful change on PHQ-8 after nephrectomy (OR 3.50, 95% CI 1.04–11.85, P = .044).

Conclusion:

In nonmetastatic RCC, patients with elevated preoperative CRP had higher scoring for major depressive symptoms on PHQ-8 and were more likely to demonstrate clinical improvement in depressive symptomatology after nephrectomy.
Survivorship representation at IPOS World Congress: abstract review and analysis
Authors: Gitonga Isaiah , Thornton Clifton P. , Schulte Fiona , Jefford Michael , Luigjes-Huizer Yvonne , Ruble Kathy
Published: November 2023

Background:

Advancements in cancer treatments have enabled more people worldwide to survive cancer, but many experience lasting impacts. The International Psycho-Oncology Society (IPOS) is a global professional organization which hosts an annual World Congress. This study reviewed survivorship content from the World Congress meetings to understand areas of focus, apparent strengths and weaknesses, and global representation.

Methods:

Peer-reviewed abstracts presented in 2017, 2018, 2019, and 2021 were reviewed. Abstracts were identified by searching for “survivor.” Identified abstracts were read in full to extract content of interest (population of interest, cancer type, number of participants, study design, study topic, first author/country, and international collaboration). Coding was defined a priori. Data were extracted using REDCap. Inter-rater reliability checks were performed.

Results:

A total of 1813 abstracts were identified and reviewed. The proportion of survivorship-focused abstracts ranged from 13.2%–20.7% annually. Breast cancer dominated survivorship work. The most frequently addressed topics included distress/anxiety/depression (36.6%), quality of life (28.6%), and health behaviors (15.5%). Nearly three-quarters (73%) of abstracts focused on adult populations, and there was apparent international collaboration in 12%–20%. Authorships and abstracts were primarily from high-income countries (91%). Most studies were observational (44%); few were randomized controlled trials (4%).

Conclusions:

This study found overrepresentation of authorship from some countries. Many topics, patient populations, and countries were not highly represented. IPOS might consider efforts to remedy this imbalance with the ultimate goal of improving psychosocial care for those affected by cancer, globally.
Establishing a HOPE Program in a Real-life Setting: A Brazilian Case Series
Authors: Boteon Amanda P.C.S. , Lima Marisa R.D. , Della Guardia Bianca , Carvalho Mauricio F. , Schlegel Andrea , Boteon Yuri L.
Published: November 2023

Background.

Although hypothermic oxygenated perfusion (HOPE) improves posttransplant outcomes, setting up machine perfusion programs may be subjected to specific obstacles under different conditions. This study aims to describe the establishment of HOPE in a real-life setting in Brazil.

Methods.

Extended criteria donors in donation after brain death organs preserved by HOPE were accepted for higher-risk candidates needing expedited transplantation, perceived as those who would benefit most from the technique because of its limited availability. Extended criteria donors was defined by the Eurotransplant criteria. High-risk transplant candidates were characterized by suboptimal surgical conditions related to the recipient or the procedure.

Results.

Six HOPE-preserved grafts were transplanted from February 2022 to August 2022. The mean donor risk index was 1.7 (SD 0.5). One organ was severely steatotic, and 3 had an anticipated cold ischemia time above 12 h. Recipients’ mean model for end-stage liver disease was 28.67 (SD 6.79), with 1 case of retransplant, 1 of refractory ascites, and 1 of acute-on-chronic liver failure. The mean cold ischemia time was 5 h 42 min (SD 82 min), HOPE 6 h 3 min (SD 150 min), and total preservation time 11 h 46 min (SD 184 min). No case had early allograft dysfunction. The mean length of hospital stay was 10 d with 100% graft and patient survival and no ischemic cholangiopathies at a median follow-up of 15 mo (min 12, max 18). Costs and country-specific legal regulations for device utilization were the major hurdles to implementing the program.

Conclusion.

We presented a pathway to introduce and rationalize the use of HOPE in a scenario of challenging donor-recipient matching with good results. These findings may aid in implementing machine perfusion programs, especially in settings with limited resources or complex transplant logistics.
A Rapid, Portable, and Electricity-Free Sample Extraction Method for Enhanced Molecular Diagnostics in Resource-Limited Settings
Authors: Pennisi Ivana , Cavuto Mathew L. , Miglietta Luca , Malpartida-Cardenans Kenny , Stringer Oliver W , Mantikas Katerina-Theresa , Reid Ruth , Frise Rebecca , Moser Nicolas , Randell Paul , Davies Frances , Bolt Frances , Barclay Wendy , Holmes Alison , Georgiou Pantelis , Rodriguez-Manzano Jesus
Published: November 2023

The COVID-19 pandemic has highlighted the need for rapid and reliable diagnostics that are accessible in resource-limited settings. To address this pressing issue, we have developed a rapid, portable, and electricity-free method for extracting nucleic acids from respiratory swabs (i.e.nasal, nasopharyngeal and buccal swabs),successfully demonstrating its effectiveness for the detection of SARS-CoV-2 in residual clinical specimens. Unlike traditional approaches, our solution eliminates the need for micropipettes or electrical equipment, making it user-friendly and requiring little to no training. Our method builds upon the principles of magnetic bead extraction and revolves around a low-cost plastic magnetic lid, called SmartLid, in combination with a simple disposable kit containing all required reagents conveniently pre-aliquoted. Here, we clinically validated the SmartLid sample preparation method in comparison to the gold standard QIAamp Viral RNA Mini Kit from QIAGEN, using 406 clinical isolates, including 161 SARS-CoV-2 positives, using the SARS-CoV-2 RT-qPCR assays developed by the US Centers for Disease Control and Prevention (CDC). The SmartLid method showed an overall sensitivity of 95.03% (95% CI: 90.44%–97.83%) and a specificity of 99.59% (95% CI: 97.76%–99.99%), with a positive agreement of 97.79% (95% CI: 95.84%–98.98%) when compared to QIAGEN’s column-based extraction method. There are clear benefits to using the SmartLid sample preparation kit: it enables swift extraction of viral nucleic acids, taking less than 5 minutes, without sacrificing significant accuracy when compared against more expensive and time-consuming alternatives currently available on the market. Moreover, its simplicity makes it particularly well-suited for the point-of-care where rapid results and portability are crucial. By providing an efficient and accessible means of nucleic acid extraction, our approach aims to introduce a step-change in diagnostic capabilities for resource-limited settings.
A Genomics England haplotype reference panel and the imputation of the UK Biobank
Authors: Shi Sinan , Rubinacci Simone , Hu Sile , Moutsianas Loukas , Stuckey Alex , Need Anna C ,   The Genomics England Research Consortium, Caulfield Mark , Marchini Jonathan , Myers Simon
Published: November 2023

The choice of reference panels significantly impacts phasing, imputation and GWAS results. In this study, we built a haplotype reference panel using the Genomics England (GEL) high-coverage sequencing dataset, one of the largest genetic variation resources ever collected in the UK. The resulting reference panel consists of 156,390 haplotypes and 342 million autosomal variants. The GEL reference panel demonstrates reliable imputation of variants as rare as 1 in 10,000 within the White British population, with an imputation r2value of 0.75. The resulting imputed UKB data (GEL-UKB) contains three times more variants, predominantly rare variants, compared to the UKB data previously imputed using the HRC and UK10K reference panel. The GEL-UKB presents a unique opportunity for the reliable discovery of rare associations across the whole genome, especially within the regions not covered by the exome sequencing data. Rare variant signals with high confidence are predominantly from rare coding variants, implying firstly, a probable tendency for existing rare non-coding mutations to not reach a disruptive level comparable to that of coding variants. Secondly, it raises the possibility that the current sample size of UK Biobank may be insufficient for detecting rare variants with a moderate effect size, even with the whole genome sequencing. The resulting GEL phased haplotype reference panel has been made available on the GEL platform and widely used by GEL users. Our GEL imputed UKB data has been adopted as one of the UKB official imputed data resources (Data Field 21008).
Triglyceride and Glucose Index and Sex Differences in Relation to Cognitive Impairment in Hypertensive Patients without Diabetes
Authors: Liu Rufei , Cheng Wenli
Published: November 2023

Background

Previous observational studies in patients with diabetes have examined the relationship between insulin resistance (IR) and cognitive outcomes and failed to find that IR is associated with cognitive function. And the triglyceride-glucose (TyG) index, which measured serum triglyceride (TG) and fasting blood glucose (FBG), has been suggested as a surrogate reliable marker of IR and widely used due to its convenience and cost-effectiveness.However, to the best of our knowledge, the relationship between IR and intensive blood pressure control in specific cognitive outcomes has never been investigated.

Methods

To fill this knowledge gap, we analyzed the relationship between TYG levels and cognitive outcomes in hypertensive patients within the Systolic Blood Pressure Intervention Trial (SPRINT). The SPRINT evaluated the impact of intensive blood pressure control (systolic blood pressure < 120 mmHg) versus standard blood pressure control (systolic blood pressure < 140 mmHg). The Cox proportional risk regression was used to investigate the association between different TYG status and clinical outcomes. Additional stratified analyzes were performed to evaluate the robustness of gender difference.

Results

A total of 9,323 participants (6016 [64.53%] males and 3307 [35.47%] females) with hypertension from the SPRINT research were included in the analysis. The median follow-up period was 3.26 years. Our population was divided into three groups according to the size of the TyG index. The low TyG group was the reference. Sensitivity analyzes showed that in the SPRINT, the TyG index was significantly associated with the risk of cognitive outcomes across various subgroups. There was no significant interaction in the confounders.

Conclusions

In this cohort study, results suggest that patients with TyG levels higher had lower risk of probable dementia, but this study tested association, not causation. Our results demonstrated that in patients with hypertension, the association between TyG and risk of probable dementia is L-shaped.
Exploring Access to Social Protection for People with Disabilities in Bangladesh
Authors: Rahman Mizanur , Rana Md Shohel , Rahman Md Mostafizur , Khan Md Nuruzzaman
Published: November 2023

Purpose

This study aimed to assess the accessibility of social protection programs for individuals with disabilities in Bangladesh and identify factors at the individual, household, and community levels influencing this accessibility.

Methods

We analyzed data from 4,293 respondents in the 2021 National Survey on Persons with Disabilities. We categorized participation in social protection programs as follows: no assistance (0), support received within six months (1), and support received beyond six months (2). Explanatory variables were considered at individual, household, and community levels. A multilevel multinomial logistic regression model assessed associations, with two age groups: 0-17 and 18+.

Results

Only 38% reported inclusion in social protection programs within six months, rising to 48% for support beyond six months. Disability allowances were the most common, followed by old age allowances and VGD/VGF assistance. Inclusion was likelier for older, unmarried, widowed, divorced, or separated individuals with disabilities. Conversely, those with higher education, wealthier households, and residing in Dhaka division were less likely to be included. Among children aged 0-17, multiple disabilities increased the likelihood of inclusion.

Conclusion

These findings underscore the urgent need for more comprehensive and inclusive social protection policies and programs to support the well-being of individuals with disabilities in Bangladesh.
Single-cell analysis reveals an active and heterotrophic microbiome in the Guaymas Basin deep subsurface with significant heterotrophic inorganic carbon fixation
Authors: Meyer Nicolette R. , Morono Yuki , Dekas Anne E
Published: November 2023

The marine subsurface is a long-term sink of atmospheric carbon dioxide with significant implications for climate on geologic timescales. Subsurface microbial cells can either enhance or reduce the potential for the subsurface to sequester carbon, depending on their metabolic activity. However, the activity of subsurface microbes is rarely measured, leaving their role in biogeochemical cycling poorly characterized. Here, we used nanoscale secondary ion mass spectrometry to quantify anabolic activity in 3,203 individual cells from the thermally altered deep subsurface in the Guaymas Basin, Mexico (3–75 m below the seafloor, 0-14 C). We observed that a large majority of cells were active (83–100%), although rates of biomass generation were low, suggesting cellular maintenance rather than doubling. Mean single-cell activity decreased with increasing sediment depth and temperature, and was most strongly correlated with porewater sulfate concentrations. Intracommunity heterogeneity in cell-specific activity decreased with increasing sediment depth and age. Using a dual-isotope labelling approach we determined that all active cells analyzed at all depths were heterotrophic. We detected and quantified inorganic carbon assimilation by heterotrophs and found that it contributes on average at least 5% of total heterotrophic biomass carbon in this community. Our results therefore suggest that the deep marine biosphere at Guaymas Basin is largely active and contributes to subsurface carbon cycling primarily by assimilating organic carbon but also by mediating heterotrophic inorganic carbon fixation. Heterotrophic assimilation of inorganic carbon may be a small yet significant and widespread underappreciated source of labile carbon in the global subsurface.

Importance

The global subsurface is the largest reservoir of microbial life on the planet yet remains poorly characterized. The activity of life in this realm has implications for long-term elemental cycling, particularly of carbon, as well as how life survives in extreme environments. Here, we recovered cells from the deep subsurface of the Guaymas Basin and investigated the level and distribution of activity, the physicochemical drivers of activity, and the relative significance of organic versus inorganic carbon to subsurface biomass. Using a sensitive single-cell assay we find that the majority of cells are active, that activity is likely driven by availability of energy, and that while organic carbon supplies most cellular carbon, inorganic carbon also contributes. We additionally find that the inorganic carbon assimilation observed was mediated by heterotrophs, not autotrophs, highlighting the importance of this often overlooked mode of carbon assimilation in the subsurface and beyond.
Factors affecting macromolecule orientations in thin films formed in cryo-EM
Authors: Yadav Swati , Vinothkumar Kutti R.
Published: November 2023

The formation of a vitrified thin film embedded with randomly oriented macromolecules is an essential prerequisite for cryogenic sample electron microscopy. Most commonly, this is achieved using the plunge freeze method described nearly 40 years ago. Although this is a robust method, the behaviour of different macromolecules shows great variation upon freezing and often needs to be optimized to obtain an isotropic, high-resolution reconstruction. For a macromolecule in such a film, the probability of encountering the air-water interface in the time between blotting and freezing and adopting preferred orientations is very high. 3D reconstruction using preferentially oriented particles often leads to anisotropic and uninterpretable maps. Currently, there are no general solutions to this prevalent issue, but several approaches largely focusing on sample preparation with the use of additives and novel grid modifications have been attempted. In this study, the effect of physical and chemical factors on the orientations of macromolecules was investigated through an analysis of select well-studied macromolecules and important parameters that determine the behaviour of proteins on cryo-EM grids were revealed. These insights highlight the nature of interactions that cause preferred orientations and can be utilized to systematically address orientation bias for any given macromolecule and provide a framework to design small-molecule additives to enhance sample stability and behaviour.
Real-world effectiveness of non-pharmaceutical interventions in containing COVID-19 pandemic after the roll-out of coronavirus vaccines: A systematic review
Authors: He Xiaona , Chen Huiting , Zhu Xinyu , Gao Wei
Published: November 2023

Background

Non-pharmaceutical interventions (NPIs) have been widely used to control the transmission of infectious diseases. However, the current research evidence on the policy mechanisms of NPIs is still limited. This study aims to systematically identify, describe, and evaluate the existing literature for the real-world effectiveness of NPIs in containing COVID-19 pandemic after the roll-out of coronavirus vaccines, in order to search for optimal strategies for implementing NPIs.

Methods

We conducted a comprehensive search of relevant studies from January 1, 2021, to June 4, 2023 in PubMed, Embase, Web of science and MedRxiv. Two authors independently assessed eligibility and extracted data. Risk of bias assessment tool was used to evaluate the study design, statistical methodology, and quality of reporting. Data were collected, synthesised and analyzed through quantitative and qualitative approaches. The findings were presented using summary tables and figures, including information on the target countries and regions of the study, types of NPIs, and evidence quality.

Results

The review included a total of seventeen studies that examined the real-world effectiveness of NPIs in containing the COVID-19 pandemic after the vaccine roll-out. These studies used five composite indicator that combined multiple NPIs and fourteen individual NPIs. The studies had an average quality assessment score of 13 (range: 10-16), indicating moderately high quality. Among the included studies, nine assessed the effectiveness of the composite indicator, with four of them also evaluating individual NPIs. Additionally, twelve studies investigated the effectiveness of individual NPIs. The most frequently evaluated individual NPIs were testing policy, restrictions on gathering, facial covering, and school closure. Workplace closures and stay-at-home requirements were also assessed. The effectiveness of NPIs varied depending on time frames, countries and regions.

Conclusion

In summary, the research evidence suggests that NPIs remain effective in curbing the spread of COVID-19 even after the roll-out of vaccines. Studies based on different contexts had different viewpoints or conclusions regarding the effectiveness of NPIs in containing the COVID-19 pandemic. Further research is needed to understand the policy mechanisms and address potential future challenges.
Childhood adverse life events and skeletal muscle mitochondrial function
Authors: Duchowny Kate A. , Mau Theresa , Diaz-Ramierz L. Grisell , Lui Li-Yung , Marcinek David J. , Toledo Frederico G. S. , Cawthon Peggy M. , Hepple Russell T. , Kramer Philip A. , Newman Anne B. , Kritchevsky Stephen B. , Cummings Steven R. , Coen Paul M. , Molina Anthony J. A.
Published: November 2023

Social stress experienced in childhood is associated with adverse health later in life. Mitochondrial function has been implicated as a mechanism for how stressful life events “get under the skin” to influence physical wellbeing. Using data from the Study of Muscle, Mobility and Aging (n=879, 59% women), linear models examined whether adverse childhood events (i.e., physical abuse) were associated with two measures of skeletal muscle mitochondrial energetics in older adults: (1) maximal adenosine triphosphate production (ATPmax) and (2) maximal state 3 respiration (Max OXPHOS). Forty-five percent of the sample reported experiencing 1+ adverse childhood event. After adjustment, each additional event was associated with -0.07 SD (95% CI= - 0.12, -0.01) lower ATPmax. No association was observed with Max OXPHOS. Adverse childhood events are associated with lower ATP production in later life. Findings indicate that mitochondrial function may be a mechanism in understanding how early social stress influences health in later life.
Water fluoridation : A bibliometric study from 1950 to 2020
Authors: Liu Anqi , Yuan Changyong , Xu Ling , Zhao Li
Published: November 2023

Water fluoridation (WF) is considered by the Centers for Disease Control and Prevention (CDC)to be one of the top ten public health achievements of the 20th century. However, discussions about WF have been ongoing. The purpose of this study is to collect and analyze the scientific literature for WF and understand the keyword network of the entire field, important articles, high-yield countries, institutions and authors, and the mutual cooperation between them. The data of this research are extracted from the Web of Science (WoS) from 1950 to 2020. In total, 1,008 articles were published. The United States published the largest number of papers. Australia’s University of Adelaide ranks first among the top 20 institutions. Seven scholars, including AJ Spencer, constitute the largest author collaboration network. Community Dentistry and Oral Epidemiology had the most publications, with 107 articles. Keywords density map found that the main keywords were dental caries, fluoride, children, drinking water, prevalence, and dental fluorosis. Keywords clusters mainly related to dental caries, fluoride, epidemiology research, and dental fluorosis. In the highly cited literature, we found that the research also focused on the relationship between stopping WF and caries and the systemic effects of WF.
Risky Sexual Behavior and its Determinants among Undergraduate Hostellers of Kathmandu Metropolitan City
Authors: Chaudhary Ram Kumar , Chalise Anisha , Pandey Saloni , Paudel Shishir
Published: November 2023

Background

Risky sexual behavior (RSB) includes practices of unprotected sex, sex with multiple partners, and/or sex under substance abuse, increasing vulnerability to reproductive health problems. This study explored the risky sexual behavior and its associated factors among Nepalese undergraduates.

Methods

A cross-sectional study was executed among 361 undergraduates residing in hostels of Kathmandu Metropolitan. The data was collected through a self-administered questionnaire. Pearson’s chi-square test and multivariable logistic regression analysis was performed to determine factors associated with risky sexual behavior at 5% level of significance.

Result

The prevalence of risky sexual behavior among undergraduates was found to be 64.3% (95% CI: 59.8-69.8%). Risky sexual behavior was found to be associated with higher age (aOR: 3.938; 95% CI: 1.707-8.673), male gender (aOR: 3.233; 95% CI: 1.623-6.439), being in past/current relationship (aOR: 3.914, 95% CI: 2.099-7.012), lower education of mother (aOR: 3.655; 95% CI: 1.189-9.237), and peer pressure to have a sexual relationship (aOR: 2.356; 95% CI: 1.260-4.349). Notably, bivariate analysis illustrated problematic pornographic consumption to have a statistical relation with risky sexual behavior. However, this association weakened and became non-significant after accounting for other factors in the adjusted model (aOR:1.213, 95% CI: 0.331-4.442).

Conclusion

The study highlights a significant prevalence of risky sexual behaviour among undergraduate students, linked to the factors such as age, gender, relationship status, parental education, and peer pressure. These findings suggest the need for comprehensive sex education programs that equip students with the knowledge and skills to navigate healthy relationships, make safe choices, and embrace responsible sexual practices.

Key Messages

What is already known on this topic

Nepalese adolescents and youth have scant knowledge about sexual and reproductive health.

Despite Nepal’s commitments to adolescent health, a gap persisted in the utilization of sexual and reproductive health services among youths and very little is known about their sexual practice.

What this study adds

Issues such as early sexual engagement, unprotected sex, multiple partners, and engagement in commercial sex work are prominent concerns among Nepalese youths.

Despite existing laws and programs, risky sexual behaviors persist, emphasizing the urgency for effective interventions tailored to Nepalese adolescents.

How this study might affect research, practice or policy

The findings underscore urgent necessity for targeted interventions such as comprehensive sex education to address the concerning prevalence of RSB among Nepalese undergraduates.
The dynamics of protein-RNA interfaces using all-atom molecular dynamics simulations
Authors: Sabei Afra , Hognon Cécilia , Martin Juliette , Frezza Elisa
Published: November 2023

Facing the current challenges raised by human health diseases requires the understanding of cell machinery at a molecular level. The interplay between proteins and RNA is key for any physiological phenomenon, as well protein-RNA interactions. To understand these interactions many experimental techniques have been developed, spanning a very wide range of spatial and temporal resolutions. In particular, the knowledge of tridimensional structures of protein-RNA complexes provides structural, mechanical and dynamical pieces of information essential to understand their functions. To get insights into the dynamics of protein-RNA complexes, we carried out all-atom molecular dynamics simulations in explicit solvent on nine different protein-RNA complexes with different functions and interface size by taking into account the bound and unbound forms. First, we characterized structural changes upon binding and for the RNA part the change in the puckering. Second, we extensively analyzed the in-terfaces, their dynamics and structural properties, and the structural waters involved in the binding, as well as the contacts mediated by them. Based on our analysis, the interfaces rearranged during the simulation time showing alternative and stable residue-residue contacts with respect to the experimental structure.
Alk1/Endoglin dependent increases in vein endothelial cell sizes precipitate arteriovenous malformations
Authors: Diwan Zeenat , Siekmann Arndt F.
Published: November 2023

Aberrations in blood vessel diameters can disrupt the hierarchical patterning of the vasculature and cause congenital vascular anomalies, such as arteriovenous malformations (AVMs). Despite the identification of the Bone Morphogenetic Protein (BMP) pathway as a major driver in AVM pathology, we still lack an understanding of the early embryonic events regulating vessel hierarchy and arteriovenous shunt formationin vivo. We therefore studied blood vessel diameter control of the dorsal aorta (DA) and posterior cardinal vein (PCV) in zebrafish embryos. Our findings reveal that increases in blood flow during embryonic development result in increases in arterial endothelial cell (EC) sizes, ultimately enlarging DA diameters. By contrast, anterior regions of the PCV did not respond to changes in blood flow, while caudal regions, close to the artery-vein junction, responded to changes in flow like the DA, but to a lesser extent. To unravel the mechanisms underlying the reduced response of PCV ECs to flow, we studied zebrafish embryos mutant for the BMP pathway componentsendoglinandalk1. Through the generation of genetic mosaics, we discovered that both Endoglin and Alk1 were required cell autonomously in PCV cells to restrict EC sizes and thereby limit venous diameter increases in response to flow. We further revealed that initial increases in the diameter of the caudal PCV secondarily led to increased DA diameters and cell sizes. Therefore, Alk1/Endoglin signaling prevents vein ECs from behaving like arterial ECs. This differential response of arterial and venous EC cells to increases in flow is necessary to prevent the development of AVMs. This study thus offers insights into the spatiotemporal regulation of vessel hierarchy during early development and identifies changes in EC shapes as an important contributor in determining blood vessel diameters. Failure in this mechanism underlies the vein-specific initiation of AVMs in vertebrate models of HHT.