bluuebunny/crossref_metadata_2025 huggingface dataset:
Imipenem Pharmacokinetics/Pharmacodynamics in Preclinical Hollow Fiber Model, Dose Finding in Virtual Patients, and Clinical Evidence of Efficacy for Mycobacterium abscessus Lung Disease
Authors: Singh Sanjay , Gumbo Tawanda , Wang Jann-Yuan , Boorgula Gunavanthi D , Burke Andrew , Huang Hung-Ling , McShane Pamela J , Amaro-Galvez Rodolfo , Gross Jane E , Aryal Santosh , Heysell Scott K , Srivastava Shashikant
Published: December 2024

Background

Guideline-based therapy (GBT) for Mycobacterium abscessus (Mab) lung disease achieves sputum culture conversion (SCC) rates of 35%. This poor GBT efficacy is mirrored in the hollow fiber system model of Mab (HFS-Mab). While imipenem is part of GBT, its biologic effect, with or without β-lactamase inhibitors, is unproven.

Methods

We performed imipenem-relebactam minimum inhibitory concentration (MIC) in 122 Mab isolates, and an exposure-response study in the HFS-Mab using human intrapulmonary pharmacokinetics. The percentage of time that concentration persisted above the MIC (TMIC), mediating maximal effect in the HFS-Mab, was used as the exposure target for dose finding in a Monte Carlo experiment including 10 000 virtual patients. For real-world evidence, we performed a patient, intervention (imipenem), comparison (no β-lactam), and outcome (SCC) (PICO) analysis.

Results

Imipenem killed 1.32 log10 colony-forming units/mL below the day 0 level in HFS-Mab. The average target exposure for imipenem was a TMIC of 47.9% (SD, 9.77%). Infusion of 1 g every 6 hours achieved the target in >90% of virtual patients in Monte Carlo experiments. The pharmacokinetic-pharmacodynamic MIC break point was 1 mg/L. In PICO analyses, the median time to SCC was 470 days in comparators, 311 days for imipenem added on to a failing regimen, and 37 days in newly treated patients (P = .049). The odds ratio for SCC when imipenem was part of the initial regimen, versus comparators, was 12.5 (95% confidence interval, 1.47­–84.55). No patients receiving imipenem experienced treatment-limiting adverse events, compared with 2 of 7 comparators (P = .046). Middlebrook 7H9 broth MIC distribution, read at 24 hours, was better correlated with patient responses than cation-adjusted Mueller-Hinton broth.

Conclusions

Imipenem demonstrated biologic effect in the HFS-Mab and in patients. Imipenem-relebactam doses of 1 g every 6 hours are recommended.
Phylodynamics for Human Immunodeficiency Virus Prevention: A Miami-Dade County Case Study
Authors: Mehta Sanjay R , Wells Alan B , Cohen Colby , Campbell Angela , Truong Michelle , Little Susan J , Chaillon Antoine
Published: December 2024

Background

To date, human immunodeficiency virus (HIV) molecular epidemiology has been primarily used to identify clusters of related infections (cluster detection and response) and then address interventions to these clusters. Community groups have raised concern regarding cluster detection and response related to privacy and ethical concerns. Here we demonstrate how an alternative approach to HIV molecular epidemiology can provide public health benefit.

Methods

A limited data set for Miami-Dade County provided by the Florida Department of Health was curated and annotated by neighborhood health district (NBHD) and genetic linkage (using a genetic distance threshold of ≤0.5%) and phylodynamic analyses were performed. Phylodynamic analyses were used to infer viral transmissions into Miami-Dade County and between NBHDs within the county.

Results

A total of 7274 HIV sequences from unique persons collected between 1 January 2015 and 31 December 2021 were analyzed, including 50% of the 7894 new diagnoses during this period. The proportion of sequences in local clusters increased over time. Higher ratios of local introductions, compared to viral egress (ie, source of local clusters in other NBHDs) were observed in 3 NBHDs in North Miami (range, 1.9–2.5), suggesting earlier diagnosis, but high numbers of susceptible persons not receiving preexposure prophylaxis. South Dade/Homestead had a low ratio (0.3) of local introductions compared with egress, suggesting later diagnosis and less durable suppression.

Conclusions

Phylodynamic and genetic linkage analyses can highlight populations and geographic regions that might benefit more from particular types of HIV prevention interventions. These findings will need to be explored by evaluating the impact of scaling up interventions informed by these analyses.
Islands, Enclaves, and the Offshoring of Clerical Sexual Abuse
Authors: O’Neill Kevin Lewis
Published: December 2024

Between 1952 and 1968, a Roman Catholic religious order known as the Servants of the Paraclete sought, bought, and finally sold several small islands in the Caribbean for priests said to be unable to stop “sin[ning] repeatedly with little children.” This article, in response, details the Servants of the Paraclete’s mid-twentieth-century efforts at offshoring sexually abusive priests in and then beyond the Caribbean. It is an historical account that pushes scholars of clerical sexual abuse to engage the interstitial spaces that Church leaders have long sought for its perpetrators while at the same time flagging for students of sovereignty and the nation-state that mid-century practices of offshoring shaped not only the history of capitalism but also the history of the Roman Catholic Church.
Intrinsic cues guiding changes in division orientation in the Arabidopsis root meristem: a formative experience
Authors: Konstantinova Nataliia , von der Mark Claudia , De Rybel Bert
Published: December 2024

The orientation of cell division is crucial for normal development of all plant organs throughout their life cycle. Despite the importance of understanding the intricate molecular mechanisms guiding this process, relatively few pathways have been characterized to date. Here we want to outline what is known about the molecular regulation guiding changes in division orientation in the root apical meristem of the model plant Arabidopsis thaliana, from the upstream transcriptional modules to the downstream executors that lead to division plane establishment. We specifically focus on the gaps in our knowledge about this highly coordinated process and propose that a new approach should be taken to characterize how changes in division orientation are controlled in more holistic detail.
Perceptions of Children and Young People in England on the Smokefree Generation Policy: A Focus Group Study
Authors: Davies Nathan P , Murray Rachael L , Langley Tessa , Morling Joanne R , Bains Manpreet
Published: December 2024

Background

Modeling shows smokefree generation (SFG) policies could effectively reduce smoking rates by banning tobacco sales to those born after a specific year. Little is known about how young people perceive the legitimacy and impact of the planned SFG policy in England.

Methods

We conducted seven semi-structured focus groups with 36 participants aged 12–21 (mean = 15) in England over video call and in person. Twenty-one participants were female and 15 male. Participants were purposively sampled to include those from areas of greater deprivation and for use of tobacco or e-cigarettes. Data was analyzed using the framework approach.

Results

Participants expressed broadly negative perceptions toward tobacco and its manufacturers. Most participants supported SFG policy goals and its focus on freedom from addiction and harm; some believed it should also encompass electronic cigarettes. Many believed the law would only be successful if it included stringent enforcement, accompanying tobacco licensing, and input from young people. A minority raised concerns about the loss of freedom to purchase tobacco.

Conclusions

Communication of the freedom-giving nature of SFG is likely to resonate with many young people. Enforcement, communication, and involvement of young people in SFG should be considered carefully to maximize policy impact.

Implications

The smokefree generation (SFG) policy’s potential to offer freedom from addiction and disease can resonate with young people. Its effectiveness could be maximized through targeted enforcement in areas with high youth smoking rates and low adherence to age-of-sale laws, and through the introduction of additional policies that offer restrictive licensing of tobacco retailers. A phased approach to SFG, initially covering tobacco and later incorporating e-cigarettes as smoking prevalence declines, could balance reducing youth vaping and harm reduction; future research could investigate optimal policy conditions for this approach.
Identification and characterization of PpUGT91BP1 as a trillin synthase from Paris polyphylla
Authors: Li Shuyu , Chen Sa , Fu Chunjin , Zhang Jingjing , Xing Jiale , Chai Xin , Zhang Qian , Zhou Jie , Lyu Haining , Xu Chengchao , Liao Jingjing
Published: December 2024

Polyphyllins are the active ingredients of the medicinal plant Paris polyphylla. The biosynthesis of different types of polyphyllins all requires the catalysis of glycosyltransferases. Even though significant efforts have been made to identify PpUGTs capable of catalyzing the initial glycosylation reaction, the specific glycosyltransferases responsible for the synthesis of trillin have not been reported in P. polyphylla. Here, we identified a new trillin synthase, named PpUGT91BP1, which was highly expressed in the rhizome. Importantly, PpUGT91BP1 could specifically glycosylate diosgenin but not pennogenin. To improve its catalytic efficiency, we introduced random mutations through error-prone PCR and conducted an activity-based screening. Three mutants with significantly enhanced trillin synthase activity were identified. Finally, we successfully reconstituted trillin biosynthesis in Nicotiana benthamiana, achieving a yield of 3.69 mg/g of plant dry weight using the mutant PpUGT91BP1. Taken together, our results deepen the understanding of the PpUGT91 family’s role in polyphyllin biosynthesis in P. polyphylla, facilitating rational selection of better P. polyphylla cultivars and guiding future studies in the metabolic engineering of polyphllins.
Nutrient limitation determines biological interactions between a mixotrophic Chrysophyte and toxin-producing Microcystis
Authors: Princiotta Sarah D , Hiripitiyage Yasawantha , Holen Dale , Kellogg Joshua J , Sturm Belinda , Harris Ted D
Published: December 2024

Blooms of toxigenic cyanobacteria pose a mounting risk to aquatic ecosystems. Relative to abiotic drivers of cyanobacteria success, biotic processes have received less attention. Mixotrophic nanoflagellates that combine heterotrophic ingestion of particulate prey with photoautotrophy are among the eukaryotes that can resist cyanotoxins. We used laboratory experiments in culture to integrate top-down (herbivory) and bottom-up (nitrogen and phosphorus limitation) controls on the growth and production of microcystin-LR, including biodegradation products, of Microcystis by Ochromonas (mixotroph) and Spumella (heterotroph). A notable reduction in the growth rate of toxic Microcystis was evident in co-culture with either Ochromonas or Spumella under P-limitation. Under P-limitation, the co-culture of toxic Microcystis with Ochromonas also led to a reduction in concentration of microcystin-LR (MC-LR and an increase in biodegradation products. Grazing rates up to 31 and 50 cell−1 day−1 on toxic Microcystis were recorded for Ochromonas and Spumella, respectively. The highest grazing rates by Ochromonas were observed on toxic Microcystis under N-limitation. Hence, it is likely that Ochromonas is an herbivore of toxic Microcystis under N-limitation and a competitor for nutrients under P-limitation. Collectively, these results suggest a role of eukaryotic nanoflagellates in decreasing the biomass and toxicity associated with cyanobacteria blooms that vary with nutrient availability.
Integrating dynamical modeling and phylogeographic inference to characterize global influenza circulation
Authors: Parino Francesco , Gustani-Buss Emanuele , Bedford Trevor , Suchard Marc A , Trovão Nídia S , Rambaut Andrew , Colizza Vittoria , Poletto Chiara , Lemey Philippe
Published: December 2024

Global seasonal influenza circulation involves a complex interplay between local (seasonality, demography, host immunity) and global factors (international mobility) shaping recurrent epidemic patterns. No studies so far have reconciled the two spatial levels, evaluating the coupling between national epidemics, considering heterogeneous coverage of epidemiological, and virological data, integrating different data sources. We propose a novel-combined approach based on a dynamical model of global influenza spread (GLEAM), integrating high-resolution demographic, and mobility data, and a generalized linear model of phylogeographic diffusion that accounts for time-varying migration rates. Seasonal migration fluxes across countries simulated with GLEAM are tested as phylogeographic predictors to provide model validation and calibration based on genetic data. Seasonal fluxes obtained with a specific transmissibility peak time and recurrent travel outperformed the raw air-transportation predictor, previously considered as optimal indicator of global influenza migration. Influenza A subtypes supported autumn–winter reproductive number as high as 2.25 and an average immunity duration of 2 years. Similar dynamics were preferred by influenza B lineages, with a lower autumn–winter reproductive number. Comparing simulated epidemic profiles against FluNet data offered comparatively limited resolution power. The multiscale approach enables model selection yielding a novel computational framework for describing global influenza dynamics at different scales—local transmission and national epidemics vs. international coupling through mobility and imported cases. Our findings have important implications to improve preparedness against seasonal influenza epidemics. The approach can be generalized to other epidemic contexts, such as emerging disease outbreaks to improve the flexibility and predictive power of modeling.
Comorbidity in incident rheumatoid arthritis—a nationwide case-control study with bidirectional follow-up
Authors: Batko Bogdan , Szeląg Mateusz , Krajewska-Włodarczyk Magdalena , Żuber Zbigniew , Orleański Michał , Podwójcic Krzysztof , Sowiński Jakub , Świderek Maria , Maluchnik Michał , Batko Krzysztof , Śmiglewska Agata , Brzosko Marek , Stajszczyk Marcin , Kwiatkowska Brygida
Published: December 2024

Objectives

To investigate the association between risk of different co-morbidities and diagnosis of rheumatoid arthritis (RA) using a temporal approach.

Methods

Retrospective, case-control study. Data were extracted from all healthcare claims for Poland between 2011-2021. Prevalent RA(n = 262 265) patients were examined to evaluate morbidity patterns. Incident RA(n = 15 879) and age-, sex- and region-matched controls were sampled 1:10 from the general population (GP). Exposure was new-onset RA identified by interspaced, repeat claims and prescription. Follow-up was performed in a bidirectional, five-year timeframe from RA diagnosis(Dx).

Results

RA is associated with enhanced risk of multiple organ system disorders both pre- and post-Dx, especially hematologic (IRR 1.80, 95% CI 1.58, 2.05), pulmonary (IRR 1.57, 95% CI 1.53, 1.62), gastrointestinal (IRR 1.53, 95% CI 1.46, 1.60), and cardiovascular (IRR 1.25, 95% CI 1.22, 1.27) conditions. RA appears strongly associated with interstitial lung disease (pre-Dx IRR 2.97, 95% CI 2.20, 4.02; post-Dx IRR 4.66, 95% CI 3.91, 5.56) and inflammatory bowel disease (pre-Dx IRR 1.61, 95% CI 1.25, 2.07; post-Dx IRR 2.12, 95% CI 1.70, 2.63). Enhanced post-Dx risk of thyroid cancer (IRR 1.29, 95% CI 1.00, 1.66) and lymphoma (IRR 1.50, 95% CI 1.20, 1.88) was observed, in contrast to reduced risk of colon cancer (IRR 0.77, 95% CI 0.62, 0.94).

Conclusion

Enhanced risk of multiple comorbidities was observed both pre- and post-RA Dx, with varying patterns across different organ systems. These data highlight the multisystem nature of RA and warrant research into causal, bidirectional relationships.
Biomechanics of venom delivery in South America’s first toxungen-spraying scorpion
Authors: Laborieux Léo
Published: December 2024

Venom is a metabolically expensive secretion used sparingly in a variety of ecological contexts, most notably predation and defence. Accordingly, few animals employ their toxins from a distance, and venom-squirting behaviour is only known from select taxa. In scorpions, species belonging to two genera are known to spray venom when threatened, and previous work in Parabuthus transvaalicus shows that venom delivery depends on perceived levels of threat. Here, I describe Tityus (Tityus) achilles sp. nov., a new species of buthid scorpion from Cundinamarca, Colombia. Remarkably, this species is capable of venom spraying, a first for both the genus and the South American continent. Using frame-by-frame video analysis and ballistic equations, I show that T. (Tityus) achilles sp. nov. employs not one, but two types of airborne defences with dramatic differences in reach and venom expenditure. Further, the new species uses an unusually large reserve of prevenom-like secretion for spraying, as opposed to the costly venom used by other spraying scorpions. In light of these key specializations, I propose that toxungen spraying convergently evolved in response to different selection pressures, laying the groundwork for future investigation.
Validity Evidence for Using Virtual, Interactive Patient Encounters to Teach and Assess Clinical Reasoning for First-Year Medical Students
Authors: Roberts John K. , Weigle Nancy , Fox James W. , Natesan Sreeja , Gordon David , Chudgar Saumil M.
Published: December 2024

Purpose

Despite universal agreement on the importance of clinical reasoning skills, inadequate curricular attention to these skills remains a problem. To facilitate integration of clinical reasoning instruction and assessment into the preclerkship phase, the authors created a clinical reasoning curriculum using technology-enhanced patient simulations.

Method

In 2023, first-year medical students at Duke University School of Medicine were enrolled in a biomedical science course using diagnostic reasoning sessions and 16 virtual, interactive patient (VIP) encounters to teach and assess clinical reasoning. The encounters were enhanced with interactive pop-in windows that assessed multiple clinical reasoning domains. Student responses were independently evaluated by faculty. Cumulative VIP clinical reasoning composite (CRC) scores were calculated, and growth mixture modeling was used to define students by growth trajectory. Clinical reasoning was assessed in a summative objective structured clinical examination (OSCE).

Results

Of the 118 students who participated in the curriculum, 1 was excluded from analysis for inadequate participation in the VIP encounters, leaving 117 students. The aggregate VIP encounter response rate was 95% (1,783 of 1,872 assessments completed). Clinical reasoning was assessed through cumulative performance across multiple domains. The mean (SD) scores were 58 (13) for information gathering, 46 (13) for illness script identification, 64 (14) for hypothesis generation, 59 (12) for differential diagnosis, and 77 (21) for management and plan. To identify latent classes of growth in cumulative VIP-CRC scores, growth mixture modeling was performed for 1-, 2-, and 3-class models. The 2-class model showed the best fit due to having the lowest bayesian information criterion (11,765.17) and Akaike information criteria (11,737.55).

Conclusions

Integrated clinical reasoning instruction and deliberate, formative practice through authentic simulations were effective at teaching and assessing clinical reasoning in the preclerkship phase. VIP and OSCE can be used to identify students at risk of low performance in the clerkship year.
Oral GLP-1 Receptor Agonists for Weight Loss
Authors: Krinsky Dana , Marcucci Avraham , Mullally Jamie A. , Frishman William H.
Published: December 2024

With the increasing prevalence of obesity and the advent of new and highly effective antiobesity medications, there is renewed interest in novel antiobesity pharmacotherapy. Currently, the most effective medications for obesity are injectable medicines. There is a need to develop equally efficacious oral drugs to increase availability to patients. Oral semaglutide was approved by the Food and Drug Administration for type 2 diabetes in 2019. Herein, we review the current literature regarding the use of oral GLP-1 receptor agonists specifically for obesity including semaglutide, danuglipron, and orforglipron, with a focus on oral semaglutide as it is Food and Drug Administration-approved, although not for obesity alone. We also examine the future directions and impacts it will have on patients with obesity and overweight related to weight loss and cardiovascular disease.
Anaesthesia practice in Europe
Authors: Pinelli Fulvio , Romagnoli Stefano , Singh Sweta , Albaladejo Pierre , Nau Carla , Bilotta Federico
Published: December 2024

BACKGROUND

Similar to other continents, Europe is experiencing a shortage of anaesthesia workforce, which profoundly impacts the national healthcare systems of affected countries.

OBJECTIVE

To assess the current landscape of the anaesthesia workforce, organisational practices, rules and responsibilities of anaesthesiologists and other anaesthesia providers in operating rooms.

DESIGN

Survey.

SETTING

Thirty-nine out of 41 European countries were surveyed between April 2022 and April 2023.

PARTICIPANTS

Delegates of the National Anaesthesiologists Societies Committee (NASC) of the European Society of Anaesthesiology and Intensive Care (ESAIC).

INTERVENTION

A faculty of experts from France, Germany and Italy, selected by the Chair of NASC, developed a survey consisting of 16 questions, which was sent to the NASC delegates of all European countries.

MAIN OUTCOME MEASURES

Responses from the NASC delegates.

RESULTS

The anaesthesia workforce, composition, roles and duties of anaesthesia teams vary significantly among European countries. The majority of respondents reported a workforce shortage, with variable trends, exacerbated in some cases by an increased loss of anaesthesiologists following the COVID-19 pandemic. Significant differences in anaesthesiologists’ salaries exist across countries. A one-to-one anaesthesiologist-to-patient ratio during general anaesthesia maintenance, neuraxial and peripheral blocks is the most common; however, in a notable number of cases, this ratio decreases to one-to-two or even less. In such instances, residents or nonphysician anaesthesia personnel (NPAs) play a crucial role, enabling anaesthesiologists to supervise more than one patient simultaneously. Differences in the training of anaesthesia team members, as well as rules regulating anaesthesia team composition and the autonomy of its members, were also evident.

CONCLUSION

The survey provides data on the current anaesthesia practice in Europe. The availability, composition and organisation of anaesthesia team members differ among European countries. The study highlights areas for further focus in operating room organisation and anaesthesia team composition, particularly regarding safety, efficacy and cost-effectiveness.
The association between metabolic dysfunction–associated steatotic liver disease diagnosis and vasomotor symptoms in midlife women
Authors: Aldhaleei Wafa A. , Kapoor Ekta , Shufelt Chrisandra , Wallace Michael B. , Kling Juliana M. , Cole Kristin , Winham Stacey J. , Hedges Mary S. , Faubion Stephanie S.
Published: December 2024

Objective

Metabolic dysfunction–associated steatotic liver disease (MASLD) and vasomotor symptoms (VMS) are associated with increased cardiovascular disease risk. Although visceral adiposity has been linked to MASLD and VMS independently, this study aimed to evaluate associations between the two in midlife women.

Methods

A cross-sectional study of women aged 45-60 years receiving primary care at one of four sites was conducted from March 1 through June 30, 2021. MASLD diagnosis was obtained utilizing the International Classification of Diseases, Ninth Revision and Tenth Revision codes. VMS burden was evaluated with the Menopause Rating Scale and categorized as severe/very severe versus none/mild/moderate. Logistic regression models were used to assess the association between VMS and diagnosed MASLD both univariately and after individually adjusting for several risk factors.

Results

A total of 4,599 women were included in the final analysis, 304 (7%) of whom had an MASLD diagnosis. On univariate analysis, women with an MASLD diagnosis were more likely to have severe/very severe VMS (odds ratio [OR], 1.50; 95% CI, 1.08-2.08; P = 0.015). However, the association between MASLD diagnosis and severe/very severe VMS was no longer statistically significant after individually adjusting for body mass index (adjusted OR, 1.36; 95% CI, 0.97-1.92) and hypertension (adjusted OR, 1.38; 95% CI, 0.99-1.93).

Conclusions

The relationship between MASLD and VMS appears to be best explained by other variables including BMI and hypertension. Although they do not appear to be directly linked, given the prevalence of bothersome VMS in midlife women, addressing VMS may enable greater adherence to lifestyle modifications as part of MASLD management.
A single session of slow-paced breathing improved cognitive functions and postural control among middle-aged women: a randomized single blinded controlled trial
Authors: Masmoudi Karama , Chaari Fatma , Ben Waer Fatma , Rebai Haithem , Sahli Sonia
Published: December 2024

Objective

The aim of the study was to explore the immediate effects of slow-paced breathing (SPB) on cognitive performance and postural control in middle-aged postmenopausal women.

Methods

Thirty-four middle-aged women were recruited and assigned to either an experimental group (EG), who practiced SPB, or a control group (CG), who watched an educational video. Both groups had their cognitive functions and postural control assessed using validated tools during both pre-intervention and post-intervention sessions.

Results

Simple reaction time, congruent reaction time, incongruent reaction time, and incongruent reaction accuracy improved (P ≤ 0.01) in the EG in the post-intervention compared to the pre-intervention. The incongruent reaction time improved (P ≤ 0.05) among the EG compared to the CG in the post-intervention session. Postural control improved (P ≤ 0.05) post-intervention compared to pre-intervention in the EG, on a firm surface in the eyes closed condition. On the foam surface, postural control improved (P ≤ 0.001) in the post-intervention compared to pre-intervention in the EG irrespective of the vision conditions.

Conclusions

Our findings highlight the potential benefits of SPB as a nonpharmacological, cost-effective, and easily accessible intervention to improve cognitive performance and postural control among postmenopausal women. Hence, this technique should be taken into consideration when designing preventive and therapeutic strategies for these women. Additionally, women are encouraged to incorporate this exercise into their daily activities to enhance their quality of life.
Coronary vasomotor response incidence to intracoronary acetylcholine provocation test according to the severity of insignificant coronary artery stenosis in Korean population
Authors: Park Tae Shik , Ahn Woo Jin , Rha Seung-Woon , Choi Se Yeon , Cha Jinah , Hyun Sujin , Sinurat Markz RMP , Park Soohyung , Choi Cheol Ung , Park Chang Gyu , Oh Dong Joo , Choi Byoung Geol
Published: December 2024

Background

Coronary artery spasm (CAS) is a cause of variant angina. However, the understanding of CAS patterns in the presence of mild-to-moderate coronary artery stenosis is limited. This study aimed to evaluate the incidence and patterns of CAS in patients with insignificant coronary artery stenosis using intracoronary acetylcholine (ACH) provocation test.

Methods

In this study, 6513 patients without significant coronary artery stenosis who underwent intracoronary ACH provocation test were enrolled. Patients were divided into three groups, based on the severity of coronary artery stenosis: the non group (stenosis <30%, n = 2833), the mild group (30–49%, n = 3278) and the moderate group (50–69%, n = 402). Vasomotor responses were observed among three different groups.

Results

The baseline characteristics of the patients in the mild and moderate groups were worse than in the non group. They were older, had higher prevalence of hypertension, diabetes, dyslipidemia, and smoking habit. During the ACH test, CAS was observed in 58.1% of the overall population. The mild group (60.1%) and the moderate group (60.9%) showed a higher incidence than the non group (55.3%, P < 0.001). In addition, among cases of CAS, the mild group (3.2%) and the moderate group (8.5%) responded more at a lowest dose of ACH than the non group (3.1%, P < 0.001).

Conclusion

In patients with chest pain without significant coronary artery stenosis, CAS was observed in over half of the cases. Furthermore, CAS was found to be more frequent and more susceptible in patients with mild-to-moderate coronary artery stenosis compared with those without fixed stenosis.
The kidney under heat stress: a vulnerable state
Authors: Amorim Fabiano , Schlader Zachary
Published: December 2024

Purpose of review

This review examines the effects of occupational heat stress on kidney health. It focuses on the role of hyperthermia in the development of acute kidney injury (AKI) and its potential progression to chronic kidney disease of nontraditional etiology (CKDnt). We highlight the physiological mechanisms by which hyperthermia affects kidney function and discuss emerging preventive strategies.

Recent findings

Hyperthermia places the kidneys in a vulnerable state. As body temperature increases, blood flow is directed toward the skin to aid in cooling, diverting it away from internal organs like the kidneys to support blood pressure regulation. At the same time, hyperthermia and dehydration increases energetic demand to promote fluid and electrolyte conservation. Collectively, this can create a localized supply-demand mismatch, resulting in tissue hypoxia that can damage kidney tissues. These findings highlight that heat hyperthermia can lead to subclinical kidney damage, with potential long-term implications for kidney health.

Heat-induced AKI is a growing public health concern. Individuals engaged in manual labor with prolonged exposure are at risk of CKDnt. Interventions aimed to prevent hyperthermia show promise in mitigating the risk of AKI. Further research is necessary to refine these strategies and establish evidence-based guidelines for reducing heat-related kidney injuries.
Out-of-Pocket Expenses and Postoperative Therapy After Open Reduction Internal Fixation of a Distal Radius Fracture
Authors: Spencer Mark , Chan Pui Man (Pamela) , Liu Jialiang , Yang Donghan M. , Peterson Eric D. , Billig Jessica I.
Published: December 2024

Background:

Postoperative hand therapy after surgery for distal radius fractures is associated with improved functional outcomes. However, financial impediments can be a potential barrier to adherence to postoperative care requirements. The aim of this study is to evaluate the relationship among the surgical and therapy out-of-pocket (OOP) expenses and therapy visits after operative treatment of a distal radius fracture.

Methods:

We performed a retrospective cohort study of surgically treated patients with a distal radius fracture using the Merative MarketScan Research Databases (2019-2021). Multivariable logistic regression and multivariable negative binomial regression were used to assess the association of patient-level variables, OOP expenses, and postoperative hand therapy visits.

Results:

In our cohort of 17,405 patients, 1,158 (6.7%) had inpatient surgery and 16,247 (93.4%) had outpatient surgery. Additionally, 27% had no therapy visits in the six-month postoperative period. Surgical OOP costs were not associated with a minimum of one therapy visit postoperatively. However, the highest quartile of surgical OOP expenses was associated with fewer therapy visits (IRR: 0.92, 95%CI: 0.88-0.96), and the highest average therapy OOP expenses were associated with fewer therapy visits in the inpatient (IRR: 0.79, 95%CI: 0.65-0.96) and outpatient cohort (IRR: 0.86, 95%CI: 0.82-0.89).

Conclusion:

One in four patients undergoing open reduction internal fixation of a distal radius fracture did not receive therapy. Increasing surgical and therapy OOP expenses were associated with fewer therapy visits. Given the importance of therapy for functional outcomes, policy changes such as bundling therapy visits into the global period are needed to promote therapy post-injury.
Missed Opportunities: A Mixed-Methods Assessment of Disparities in Treatment for Fecal Incontinence
Authors: Seitz Vienne , Calata Jed , Mei Ling , Davidson Emily R. W.
Published: December 2024

Importance

Previous work identified racial disparities in access to fecal incontinence (FI) treatments. However, less is known about patient perspectives of these barriers.

Objectives

This study assessed differences in FI symptom severity and treatment utilization between Black and White patients.

Study Design

This mixed-methods assessment studied adult non-Hispanic Black and White women treated for FI who either did not respond to medical therapy nor received sacral neuromodulation or did not follow up after medical therapy. Structured interviews queried patients about treatments offered and symptom severity.

Results

Of the 118 patients in the retrospective evaluation, 59 (50%, 24 Black and 35 White) were interviewed. Black patients were more likely than White patients to report occasional, weekly, or daily solid and stool incontinence (75.0% vs 48.6%, P = 0.042; 87.5% vs 51.4%, P = 0.004, respectively) and flatal incontinence (83.3% vs 62.9%, P = 0.088).

Of those prescribed fiber supplements and antidiarrheal medications, Black patients were less likely to report symptom improvement (25.0% vs 70.0%, P = 0.013; 57.1% vs 87.5%, P = 0.092, respectively, for each medication type) and ongoing regimen adherence (25.0% vs 63.3%, P = 0.013; 28.6% vs 87.5%, P = 0.035, respectively).

Black patients were more likely to report impairment in daily functioning secondary to FI (83.3% vs 57.1%, P = 0.034) and were more likely to seek a follow-up visit with a health care professional that performs sacral neuromodulation (79.2% vs 28.6%, P < 0.001).

Conclusions

Black patients were more likely to have severe symptoms and poorer treatment outcomes and desire future follow-up, highlighting the importance of addressing racial differences in patient preferences in FI management strategies.
Integral identities and universal relations for solitons
Authors: Adam Christoph , Martin-Caro Alberto Garcia , Naya Carlos , Wereszczyński Andrzej
Published: December 2024

We show that any nonlinear field theory giving rise to static solutions with finite energy like, e.g., topological solitons, allows us to derive an infinite number of integral identities which any such solution has to obey. These integral identities can always be understood as being generated by field transformations and their related Noether currents. We also explain why all integral identities generated by coordinate transformations become trivial for Bogomolnyi-Prasad-Sommerfield (BPS) solitons, i.e., topological solitons which saturate a topological energy bound. Finally, we consider applications of these identities to a broad class of nonlinear scalar theories, including the Skyrme model. More concretely, we find nontrivial integral identities that can be seen as model-independent relations between certain physical properties of the solitons in such theories, and we comment on the possible connection between these new relations and those already found in the context of astrophysical compact objects. We also demonstrate the usefulness of said identities to estimate the precision of the numerical calculation of soliton observables.

Published by the American Physical Society
2024
Constraining dark energy with the integrated Sachs-Wolfe effect
Authors: Seraille Emeric , Noller Johannes , Sherwin Blake D.
Published: December 2024

We use the integrated Sachs-Wolfe (ISW) effect, by now detectable at ∼5σ within the context of Λ cold dark matter (ΛCDM) cosmologies, to place strong constraints on dynamical dark energy theories. Working within an effective field theory (EFT) framework for dark energy we find that including ISW constraints from galaxy–cosmic microwave background (CMB) cross-correlations significantly strengthens existing large-scale structure constraints, yielding bounds consistent with ΛCDM and approximately reducing the viable parameter space by ∼70%. This is a direct consequence of O(1) changes induced in these cross-correlations by otherwise viable dark energy models, which we discuss in detail. We compute constraints by adapting the ΛCDM ISW likelihood from Stölzner [] for dynamical dark energy models using galaxy data from 2 MASS, wide-field infrared survey explorer (WISE) × SuperCOSMOS, Sloan Digital Sky Survey Data Release 12, the catalog of photometric quasars and NRAO Very Large Array Sky Survey, CMB data from Planck 18, and baryon acoustic oscillation and redshift space distortion large-scale structure measurements from BOSS and 6dF. We show constraints both in terms of EFT-inspired αi and phenomenological μ/Σ parametrizations. Furthermore we discuss the approximations involved and related aspects of bias modeling in detail and highlight what these constraints imply for the underlying dark energy theories.

Published by the American Physical Society
2024
QCD axion: Some like it hot
Authors: Bianchini Federico , di Cortona Giovanni Grilli , Valli Mauro
Published: December 2024

We compare the quantum chromodynamics (QCD) axion phase-space distribution from unitarized next-to-leading order chiral perturbation theory with the one extracted from pion-scattering data. We derive a robust bound by confronting momentum-dependent Boltzmann equations against up-to-date observations of the cosmic microwave background, of the baryonic acoustic oscillations and of primordial abundances. These datasets imply ma≤0.16  eV for the 95% credible interval, i.e., ∼30% stronger bound than what previously found. We present forecasts using dedicated likelihoods for future cosmological surveys and the sphaleron rate from unquenched lattice QCD.

Published by the American Physical Society
2024
Effect of thickness and noise on angular correlation analysis from scanning electron nanobeam diffraction of disordered carbon
Authors: Klemmt Rebekka , Liu Amelia C. Y. , Hu Cheng , Biggs Mark J. , Petersen Timothy C. , Bøjesen Espen D.
Published: December 2024

Disordered carbons are of significant scientific and industrial interest for modern applications. To understand the differences in the performance of disordered carbons, it is crucial to elucidate their structure, but this is challenging due to the variation and complexity of structures they can possess: for example, different hybridizations of the carbon atoms, and significant extended-range order composed of connected rings, curved sheets and stacks. This study establishes the useful information that can be obtained from angular correlation analysis of scanning electron nanobeam diffraction patterns for disordered carbons and other materials with extended-range order. The effects of sample thickness and experimental noise are investigated, showing that it is crucial to consider their impact when interpreting the results. Furthermore, opportunities for analyzing different ranges of scattering angles are explored, for example, to access structural information about the intralayer structure of disordered carbons. These approaches could be used to access novel quantitative measures to probe the structural differences of disordered carbons and understand their properties.
Error evaluation of partial scattering functions obtained from contrast-variation small-angle neutron scattering
Authors: Mayumi Koichi , Oda Tatsuro , Miyajima Shinya , Obayashi Ippei , Tanaka Kazuaki
Published: December 2024

Contrast-variation small-angle neutron scattering (CV-SANS) is a powerful tool to evaluate the structure of multi-component systems by decomposing the scattering intensities I measured with different scattering contrasts into partial scattering functions S of self- and cross-correlations between components. The measured I contains a measurement error ΔI, and ΔI results in an uncertainty in the partial scattering functions ΔS. However, the error propagation from ΔI to ΔS has not been quantitatively clarified. In this work, we have established deterministic and statistical approaches to determine ΔS from ΔI. We have applied the two methods to (i) computational data for a core–shell sphere, and experimental CV-SANS data of (ii) clay/polyethylene glycol aqueous solutions and (iii) polyrotaxane solutions, and have successfully estimated the errors in S. The quantitative error estimation in S offers a strategy to optimize the combination of scattering contrasts to minimize error propagation.
A new technical solution to the problem of increasing the resolution of X-ray diffraction methods
Authors: Drmeyan H. R. , Mkhitaryan S. A. , Mkrtchyan A. H.
Published: December 2024

A new technical solution to the problem of increasing the resolution of X-ray diffraction methods has been proposed and implemented, based on linearly enlarging the X-ray topographic patterns. For implementation of the suggested method, a novel device has been developed, created and tested that makes it possible to scan synchronously the slit for transmitting separate parts of the X-ray diffraction pattern and the X-ray film with a predetermined speed ratio. The possibility of significantly increasing the resolution of X-ray diffraction patterns with the suggested new scanning method has been experimentally proven. It was shown that if individual parts of the diffracted beam are passed successively through a narrow slit, which is synchronously scanned along with the X-ray detecting film, we obtain an enlargement in topographic patterns. A proposed scheme for enlarging the image in parts and a description and the operating principle of the scanning device are also presented. The relationship between the ratio of the speeds of the slit and the X-ray film movement and the parameters of the scanning device and the sample (slit width, total thickness of thin crystals, thickness of a thick crystal etc.) was revealed. The speeds of the reciprocating motion of the slit and the X-ray film were calculated. It has been experimentally proven that the scanning process does not introduce new information into the interference pattern but only enlarges it, since these patterns in sectional topograms differ only in size in the scattering plane.
The ESG performance of companies and their outward foreign direct investment: evidence from China
Authors: Wang Feng , Han Huadan , Zeng Lei
Published: December 2024

Purpose

Environmental, social and governance (ESG) performance has received significant attention around the world. Could robust ESG performance become a new advantage for supporting companies’ outward foreign direct investment (OFDI) in emerging markets? Prior studies have not articulated the nexus between ESG performance and OFDI. This paper aims to conduct both theoretical and empirical work to clarify the effect, especially the mechanisms of ESG performance on companies’ OFDI.

Design/methodology/approach

Using the data of A-share listed companies in China from 2010 to 2020, this paper empirically tests the effect and the mechanisms of ESG performance on companies’ OFDI.

Findings

Firstly, robust ESG performance increases the likelihood of companies engaging in OFDI and also augments the scale of such investments. Within the realm of ESG, environmental performance, social performance and governance performance all play important roles in fostering OFDI. Secondly, strong ESG performance promotes OFDI by enhancing the competitive edge and alleviating financial constraints. Also, environmental performance, social performance and governance performance individually contribute to supporting competitiveness and mitigating financial constraints. Thirdly, the effect of ESG performance on OFDI is particularly pronounced for companies targeting developed countries, those operating in heavily polluting sectors and those with significant institutional investor presence.

Originality/value

This study advances the applicability of the stakeholder theory in the realm of firm internationalization. Moreover, the findings of this paper provide new strategies for promoting the OFDI of companies in emerging market economies.
Unlocking the power of meaningful work: elevating engagement and satisfaction in the realm of decent jobs
Authors: Russo Angela , Zammitti Andrea , Catania Carlotta , Magnano Paola , Santisi Giuseppe
Published: December 2024

Purpose

Sustainable development must address the challenge of ensuring decent work for all (SDG 8) and promoting good health and well-being (SDG 3). This study aims to assess the relationship between decent and meaningful work and their impact on work engagement and job satisfaction among adult workers. Decent work goes beyond mere employment, encompassing standards for a fulfilling life, including fair compensation and workplace security, while fostering personal development and social integration. Following the psychology of working theory (PWT), decent work is a prerequisite to the attainment of meaningful work, viewed as a positive belief system about one’s work and its potential positive impact on life and the world.

Design/methodology/approach

A sample of 276 adult workers, aged 21–70 years (M = 43.55, SD = 11.76), was surveyed to explore the association between decent and meaningful work and the following impact on work engagement and job satisfaction. Structural equation modelling was employed.

Findings

The study identified meaningful work as a crucial mediator between decent work and the outcomes of work engagement and job satisfaction.

Practical implications

The findings highlight the importance of cultivating meaningful work experiences to enhance workplace well-being.Organisations should prioritize interventions to promote both decent and meaningful work to align with sustainable development goals and improve employee satisfaction and engagement.

Originality/value

Our findings emphasize the pivotal role of decent work and, consequently, meaningful work in shaping employees’ well-being.