bluuebunny/crossref_metadata_2025 huggingface dataset:
The bitumen development effect on the pore structure and electrical resistivity of carbonate reservoirs in the Sinian Dengying Formation
Authors: Wu Yuyu , Lai Qiang , Wang Haitao , Yin Rong , Wang Zeyu , Chen Li , Lai Fuqiang
Published: January 2024

In the Sichuan Basin, bitumen widely distributes in the carbonate reservoir, and the bitumen occurrence morphology affects the pore structure and petrophysics. Two types of bitumen, boundary-filled and centre-filled, were reconstructed using a pore morphology-based method based on dolomite carbonate digital cores from X-ray computerized tomography. The pore structures of the reconstructed bitumen-filled digital core models were determined using an extracted pore network model. The finite element method simulated the electrical resistivity of the digital core model. The investigation showed that (i) boundary-developed bitumen increases the pore size whereas centre-developed bitumen decreases the pore size, and bitumen development increases the shape factor while reducing the coordination number; (ii) for electrical resistivity, boundary-filled bitumen increases the porosity exponent with increasing pore size, whereas centre-filled bitumen decreases the porosity exponent. Bitumen development caused a negative correlation between the porosity exponent and pore shape factor, a logarithmic increase between the porosity exponent and coordination number, and a power increase between the porosity exponent and porosity. Subsequently, a new porosity exponent model related to porosity was proposed based on the curve-fitting method. This new porosity exponent combines the Archie equations to calculate the saturation of the carbonate reservoir in the Sinian Dengying Formation in the Penglai gas area on the northern slope of the central Sichuan paleo-uplift, which fits the sealed core plug saturation well and provides the basis for further reservoir evaluation and fluid identification in the Penglai gas area.
The treatment of electronic games copyright protection in Brazil: analysis of copyright law and software law application
Authors: da Cruz Douglas Aleixo Santos , Junior Jucimar Maia da Silva , Freitas Silvia Regina Sampaio , de Oliveira Raimundo Correa , Barboza Ricardo da Silva
Published: January 2024

Brazil is currently the 5th largest game industry market by number of players, with expected year-by-year revenue growth of 5 per cent. The electronic games industry has been growing exponentially in Brazil and globally, and a specific regulation that meets the sector’s unique needs has become increasingly necessary. The lack of a regulatory framework in the Brazilian legal system directly impacts the legal security of businesses involving electronic games, especially in relation to the IP rights vesting in such assets. Intense debates have been conducted about the legal nature of electronic games, whether they are audiovisual works, works of art, computer programs or all of them combined, and what legal framework applies to these works under Brazilian law. There are several approaches to this subject; apparently, more consensus has yet to be reached. The abundance of regulatory gaps and the patchwork of different legal documents undermine the legal categorization and, consequently, the protection of these assets under IP laws. Using a methodology of bibliographic review and exploratory research, this considers the current position of electronic games in Brazil. It also proposes a specific framework for this type of work that is not simply that of audiovisual work or software, thus seeking a point of intersection between the two.
The impact of primordial black holes on the stellar mass function of ultra-faint dwarf galaxies
Authors: Esser Nicolas , De Rijcke Sven , Tinyakov Peter
Published: January 2024

If primordial black holes (PBHs) constitute the dark matter (DM), stars forming in dark-matter dominated environments with low velocity dispersions, such as ultra-faint dwarf galaxies, may capture a black hole at birth. The capture probability is non-negligible for PBHs of masses around 1020 g, and increases with stellar mass. Moreover, infected stars are turned into virtually invisible black holes on cosmologically short time-scales. Hence, the number of observed massive main-sequence stars in ultra-faint dwarfs should be suppressed if the DM was made of asteroid-mass PBHs. This would impact the measured mass distribution of stars, making it top-light (i.e. depleted in the high-mass range). Using simulated data that mimic the present-day observational power of telescopes, we show that already existing measurements of the mass function of stars in local ultra-faint dwarfs could be used to constrain the fraction of DM composed of PBHs in the – currently unconstrained – mass range of 1019–1021 g.
Identifying 850 δ Scuti pulsators in a narrow Gaia colour range with TESS 10-min full-frame images
Authors: Read Amelie K , Bedding Timothy R , Mani Prasad , Montet Benjamin T , Crawford Courtney , Hey Daniel R , Li Yaguang , Murphy Simon J , Pedersen May Gade , Kruger Joachim
Published: January 2024

We use TESS 10-min full-frame images (Sectors 27–55) to study a sample of 1708 stars within 500 pc of the Sun that lie in a narrow colour range in the centre of the δ Scuti instability strip (0.29 < GBP − GRP < 0.31). Based on the Fourier amplitude spectra, we identify 848 δ Scuti stars, as well as 47 eclipsing or contact binaries. The strongest pulsation modes of some δ Scuti stars fall on the period–luminosity relation of the fundamental radial mode but many correspond to overtones that are approximately a factor of two higher in frequency. Many of the low-luminosity δ Scuti stars show a series of high-frequency modes with very regular spacings. The fraction of stars in our sample that show δ Scuti pulsations is about 70 per cent for the brightest stars (G < 8), consistent with results from Kepler. However, the fraction drops to about 45 per cent for fainter stars and we find that a single sector of TESS data only detects the lowest amplitude δ Scuti pulsations (around 50 ppm) in stars down to about G = 9. Finally, we have found four new high-frequency δ Scuti stars with very regular mode patterns, and have detected pulsations in λ Mus that make it the fourth-brightest δ Scuti in the sky (G = 3.63). Overall, these results confirm the power of TESS and Gaia for studying pulsating stars.
The untapped potential of phage model systems as therapeutic agents
Authors: Romeyer Dherbey Jordan , Bertels Frederic
Published: January 2024

With the emergence of widespread antibiotic resistance, phages are an appealing alternative to antibiotics in the fight against multidrug-resistant bacteria. Over the past few years, many phages have been isolated from various environments to treat bacterial pathogens. While isolating novel phages for treatment has had some success for compassionate use, developing novel phages into a general therapeutic will require considerable time and financial resource investments. These investments may be less significant for well-established phage model systems. The knowledge acquired from decades of research on their structure, life cycle, and evolution ensures safe application and efficient handling. However, one major downside of the established phage model systems is their inability to infect pathogenic bacteria. This problem is not insurmountable; phage host range can be extended through genetic engineering or evolution experiments. In the future, breeding model phages to infect pathogens could provide a new avenue to develop phage therapeutic agents.
Implementation of a Competency-Based Clinical Tracking Document in an Undergraduate Nursing Program
Authors: Reaves Crista , Martel Michael
Published: January 2024

New nurse graduates are ill prepared to fulfill the roles and responsibilities of being competent, practice-ready registered nurses. This article describes one college of nursing’s journey in the creation of a clinical tracking document (CTD) to track, in real time, essential subbehavior actions that assist students in achieving the four main competencies of assessment, communication, critical thinking, and safety listed on the Creighton Competency Evaluation Instrument. The CTD is an innovative tracking tool used to ensure students are practice-ready and competent upon completion of their nursing program.
Being a “Good Parent” to a NICU Infant With a Major Congenital Anomaly
Authors: Uveges Melissa K. , Hamilton Jill B. , Pados Britt F. , Thayer Winter M. , Hinds Pamela S. , Nolan Marie T.
Published: January 2024

Background:

In the United States, up to one-third of infants with a congenital anomaly require neonatal intensive care unit (NICU) hospitalization. Parents of these infants may have different decision-making priorities, which may be influenced by the timing of the infant's diagnosis.

Purpose:

(1) To compare the ranked importance of decision-making beliefs for parents of infants who received a prenatal versus postnatal congenital diagnosis and (2) explore how parents describe their decision-making beliefs.

Methods:

A cross-sectional, sequential mixed-methods pilot design was applied to collect quantitative data using the Good Parent Ranking Exercise and further explore parents' decision-making beliefs through qualitative interviews. Maximum difference scaling/hierarchical Bayes estimation and content analysis were used to analyze the quantitative and qualitative data, respectively.

Results:

Forty mothers completed the Good Parent Ranking Exercise and 20 mothers completed qualitative interviews. Four of the top 5 ranked parenting beliefs were shared by mothers in the prenatal and postnatal groups. Mothers in the postnatal group ranked “focusing on my child's quality of life” higher. Qualitative interviews revealed that previously identified decision-making beliefs were consistent in this NICU parent population, with 1 additional belief identified. Mixed-methods analysis revealed high concordance between the prenatal and postnatal groups.

Implications for Practice:

NICU nurses need to know that decision-making beliefs for parents who receive a prenatal versus postnatal congenital diagnosis, while largely similar, may have differences.

Implications for Research:

Future research should explore decision-making beliefs in demographically diverse parent groups (ie, fathers, partnered vs nonpartnered couples) and effective strategies for promoting NICU parents' decision-making beliefs.
Associations Between Auditory Working Memory, Self-Perceived Listening Effort, and Hearing Difficulty in Adults With Mild Traumatic Brain Injury
Authors: Lander Devan M. , Liu Shuang , Roup Christina M.
Published: January 2024

Objectives:

Mild traumatic brain injury (TBI) can have persistent effects in the auditory domain (e.g., difficulty listening in noise), despite individuals having normal pure-tone auditory sensitivity. Individuals with a history of mild TBI often perceive hearing difficulty and greater listening effort in complex listening situations. The purpose of the present study was to examine self-perceived hearing difficulty, listening effort, and performance on an auditory processing test battery in adults with a history of mild TBI compared with a control group.

Design:

Twenty adults ages 20 to 53 years old participated divided into a mild TBI (n = 10) and control group (n = 10). Perceived hearing difficulties were measured using the Adult Auditory Processing Scale and the Hearing Handicap Inventory for Adults. Listening effort was measured using the National Aeronautics and Space Administration-Task Load Index. Listening effort ratings were obtained at baseline, after each auditory processing test, and at the completion of the test battery. The auditory processing test battery included (1) dichotic word recognition, (2) the 500-Hz masking level difference, (3) the Listening in Spatialized Noise-Sentences test, and (4) the Word Auditory Recognition and Recall Measure (WARRM).

Results:

Results indicated that individuals with a history of mild TBI perceived significantly greater degrees of hearing difficulty and listening effort than the control group. There were no significant group differences on two of the auditory processing tasks (dichotic word recognition or Listening in Spatialized Noise-Sentences). The mild TBI group exhibited significantly poorer performance on the 500-Hz MLD and the WARRM, a measure of auditory working memory, than the control group. Greater degrees of self-perceived hearing difficulty were significantly associated with greater listening effort and poorer auditory working memory. Greater listening effort was also significantly associated with poorer auditory working memory.

Conclusions:

Results demonstrate that adults with a history of mild TBI may experience subjective hearing difficulty and listening effort when listening in challenging acoustic environments. Poorer auditory working memory on the WARRM task was observed for the adults with mild TBI and was associated with greater hearing difficulty and listening effort. Taken together, the present study suggests that conventional clinical audiometric battery alone may not provide enough information about auditory processing deficits in individuals with a history of mild TBI. The results support the use of a multifaceted battery of auditory processing tasks and subjective measures when evaluating individuals with a history of mild TBI.
Efficacy of Botulinum Toxin in the Treatment of Cutaneous Flushing: A Systematic Review and Meta-Analysis
Authors: Vincent Natalie , Ravipati Advaitaa , Reynolds John M. , Kaufman Joely
Published: January 2024

BACKGROUND

Flushing is a common dermatologic complaint and can be resistant to many treatments. As the utility of botulinum toxin continues to expand, recent data suggest that it may also be a therapeutic option for flushing.

OBJECTIVE

To evaluate the efficacy of botulinum toxin for the treatment of cutaneous flushing.

MATERIALS AND METHODS

A systematic search of Medline, Embase, Cochrane CENTRAL, CINAHL, Scopus, and Web of Science databases was conducted to identify studies evaluating the effect of botulinum toxin on flushing 1 month after treatment. Prespecified outcome measures included a clinical flushing score, dermatology life quality index (DLQI), and erythema index (EI). Meta-analysis was performed to calculate the mean differences in these outcomes before and after treatment at 1-month follow-up.

RESULTS

Nine studies (132 patients) were included in the analysis of this study (2 randomized controlled trials and 7 nonrandomized studies). All studies had a low risk of bias (high quality). The most frequent outcome reported was a clinical flushing score, which significantly decreased by 1.25 points overall (95% confidence interval [CI]: −2.47; −0.04) 1 month after treatment with botulinum toxin. Mean DLQI scores decreased (i.e., improved) by 9.02 points (95% CI: −19.81; 1.77) 1 month after botulinum toxin injections. The EI (measured by Mexameter) before and after botulinum toxin was evaluated in 2 studies; however, not enough statistical information was provided to analyze with meta-analytic techniques.

CONCLUSION

Based on this meta-analysis, botulinum toxin significantly improves clinical flushing scores 1 month after treatment.
C-C chemokine receptor type 7 (CCR7) regulates hepatic CD8+ T cell homeostasis and response to acute liver injury
Authors: Niemietz Patricia , Peiseler Moritz , Kohlhepp Marlene , Horn Paul , Matchett Kylie , Wang Yuting , Haas Leon , Zhang Tianjiao , Bruneau Alix , Guillot Adrien , Berger Hilmar , Liepelt Anke , Warzecha Klaudia , Demske Catharina , Möckel Diana , Lammers Twan , Henderson Neil , Heymann Felix , Tacke Frank
Published: January 2024

Background and Aims:

Acute liver failure (ALF) is a rare but life-threatening condition, and DILI, particularly acetaminophen toxicity, is the leading cause of ALF. Innate immune mechanisms further perpetuate liver injury, while the role of the adaptive immune system in DILI-related ALF is unclear.

Approach and Results:

We analyzed liver tissue from 2 independent patient cohorts with ALF and identified hepatic T cell infiltration as a prominent feature in human ALF. CD8+ T cells were characterized by zonation toward necrotic regions and an activated gene expression signature. In murine acetaminophen-induced liver injury, intravital microscopy revealed zonation of CD8+ but not CD4+ T cells at necrotic areas. Gene expression analysis exposed upregulated C-C chemokine receptor 7 (CCR7) and its ligand CCL21 in the liver as well as a broadly activated phenotype of hepatic CD8+ T cells. In 2 mouse models of ALF, Ccr7

−/−
mice had significantly aggravated early-phase liver damage. Functionally, CCR7 was not involved in the recruitment of CD8+ T cells, but regulated their activation profile potentially through egress to lymphatics. Ccr7

−/−
CD8+ T cells were characterized by elevated expression of activation, effector, and exhaustion profiles. Adoptive transfer revealed preferential homing of CCR7-deficient CD8+ T cells to the liver, and depletion of CD8+ T cells attenuated liver damage in mice.

Conclusions:

Our study demonstrates the involvement of the adaptive immune system in ALF in humans and mice. We identify the CCR7-CCL21 axis as an important regulatory pathway, providing downstream protection against T cell–mediated liver injury.
Successful Case of Teprotumumab Treatment in an Adolescent Patient With Thyroid Eye Disease
Authors: Radulovich Nicholas , Van Brummen Alexandra , Chambers Christopher , Zhang Matthew
Published: January 2024

A 16-year-old black female presented with a 4-month history of significant proptosis and diplopia in the setting of diagnosed Graves disease. The patient underwent 8 infusions of teprotumumab. She had migraines and diplopia that were resolved with treatment. There was also a dramatic improvement in her proptosis. The authors present the first reported case of successful teprotumumab treatment in an adolescent patient, describing outcomes and proposing a mechanism for her transient side effects.
Modified Conjoint Fascial Sheath and Levator Muscle Complex Suspension for the Correction of Simple Severe Congenital Ptosis in Pediatrics and the Effect on Refractive Status
Authors: Li Jing , Yu Xinyue , Wang Kerui , Meng Ziwei , Liang Xuanwei , Chen Rongxin
Published: January 2024

Purpose:

To evaluate the outcomes of modified combined fascia sheath and levator muscle complex suspension to correct severe congenital ptosis in pediatrics and the effect on refractive status.

Methods:

This prospective, case series study enrolled patients (aged ≤18 years) with simple severe congenital ptosis at Zhongshan Ophthalmic Center. All patients were treated with combined fascia sheath + levator muscle suspension and followed up for 3 months. Preoperative and postoperative cycloplegic refraction and the best-corrected visual acuity were performed. The types of astigmatism include with-the-rule, against-the-rule, and oblique.

Results:

Thirty-six patients (50 eyes) were enrolled. The mean age was 7.11 ± 3.72 years. The surgery success rate was 90.0%. Following surgery, the eyelid contour of all eyes exhibited natural symmetry and satisfactory curvature. The eyelid height difference in OUs was ≤1 mm for 42 eyes. For 47 eyes, the eyelid crease was symmetry. Two eyes had conjunctival prolapse, and 1 eye developed trichiasis. After surgery, cylinder power changed from mean −1.14 ± 1.27 D to −1.54 ± 1.25 D (p < 0.001) and best-corrected visual acuity improved from mean 0.205 ± 0.217 logarithm of the minimum angle of resolution to 0.168 ± 0.176 logarithm of the minimum angle of resolution (p = 0.048). The quantities of with-the-rule increased from 35 eyes to 41 eyes, oblique from 4 eyes to 6 eyes, while against-the-rule decreased from 11 eyes to 3 eyes (p = 0.01).

Conclusions:

Combined fascia sheath + levator muscle suspension under general anesthesia is effective and safe for severe congenital ptosis in pediatrics. However, astigmatism increased and the types of astigmatism changed after surgery.
Consistently Exploring Nurse Staffing and Neurocritical Care Unit Turnover
Authors: Doyle Brittany R. , Smith Lisa M. , Marshall Jade L. , Carlisle Byron A. , Perera Anjali C.
Published: January 2024

BACKGROUND: Staffing models within nursing units have long been a hot topic of discussion. The COVID-19 pandemic exacerbated this discussion by straining the national nursing environment and workforce. Before the pandemic, the neuroscience intensive care unit (NSICU) primarily used an acuity-adjusted staffing model and aimed for a nurse-to-patient ratio of 1:1.5. During and after the pandemic, the NSICU was forced to primarily use a centralized staffing model because of the increased turnover in the hospital at large and a rise in patient census. METHODS: Unit census data in an NSICU were tracked before, during, and after the pandemic alongside utilization of a centralized staffing model in the hospital at large. RESULTS: During this time, the NSICU saw a statistically significant increase in average nurse-to-patient ratio and incidences of both floating and tripled assignments. The NSICU simultaneously saw a 180% increase in nursing turnover. CONCLUSION: Although we cannot prove that a centralized staffing model is directly responsible for higher nursing turnover, its utilization led to greater incidence of poor staffing—reflected in deviation from the nurse-to-patient ratio goal of the unit. Nurse staffing concerns play a large role in nurse satisfaction in the workforce: staffing shortages have been described both as a precursor to and as a consequence of increased nursing turnover.
Characteristics of late preterm infant readmissions: A systematic review
Authors: Joyner Jennifer A. , Papermaster Amy E. , Champion Jane Dimmitt
Published: January 2024

Background:

Prematurity represents a critical health disparity. It is important to note that late preterm (LPT) infants comprise the majority of preterm births, yet they are the least studied within the premature population. Evidence-based practice guidelines are now a decade old, indicating the potential need for review and revision.

Objectives:

This systematic review proposed the assessment of sociodemographic characteristics of LPT infants, clinical practice standards, and associated hospital readmission rates, mortality, and morbidity to determine the need for revision of evidence-based practice guidelines for these infants.

Data Sources:

The Preferred Reporting System Items for Systematic Reviews and Meta Analysis methodology provided the framework for the completion of this review. Literature searches of PubMed/Medline (Ovid), Web of Science, Cumulative Index of Nursing, and Allied Health Literature Plus databases and citation searches included articles published after 2012 using the search terms “late preterm infants,” “readmissions,” and “readmission rates.”

Conclusions:

The literature search identified 11 studies meeting search criteria. These studies included quasi experimental, retrospective, and prospective cohort studies. These studies highlighted the characteristics of LPT infants that potentially contribute to increased readmission rates, morbidity and mortality rates, health care costs, and long-term health inequities. Overall findings indicate the need for review and revision of evidence-based practice guidelines for these infants.

Implications for practice:

This systematic review manifests the vulnerability of LPT infants and the accompanying need for up-to-date clinical practice guidelines to effectively reduce their morbidity and mortality rates, hospital readmissions rates, and burden of health care costs.
Variability in Occult Injury Screening Among Siblings/Household Contacts of Physical Abuse Victims
Authors: Deutsch Stephanie Anne , Einspahr Samantha , Almeida Deeanne , Vandergrift Dawn , Loiselle Claire , De Jong Allan
Published: January 2024

Objective

The objective of this study is to examine radiologic occult injury screening performance/yield among contacts presenting for precautionary medical assessments and assess factors associated with deferred screening.

Methods

Data were collected retrospectively from charts of contacts younger than 8 years presenting for precautionary evaluation to a level 1 pediatric emergency department January 1, 2018 to March 31, 2023. Demographics, radiologic performance/yield, physical examination, social work-based psychosocial assessment, reasons for deferred imaging, and diagnostic codes were abstracted. Descriptive statistics and χ2 analysis are reported.

Results

Three hundred ninety contacts were identified; 364 (93.3%) were biological siblings. Most (276, 70.8%) were 2 to 8 years old. Statistically significant relationships were identified with age, insurance, and hospital social work assessment and screening. Thirty-four infants (54%) underwent neuroimaging; no studies were abnormal. Of 114 contacts, <2 years old, 97 (85%) underwent skeletal survey (SS); 9 (9%) SS were abnormal. Twenty-seven (24%) returned for follow-up SS; 4 (14.8%) were abnormal. For 2 contacts, an abnormal initial SS was refuted by follow-up imaging. Physical examinations were abnormal for 11% of contacts. Reasons for deferred imaging included contact well appearance, caregiver concerns, and clinician disagreement with indications. Encounter International Classification of Diseases codes varied, commonly reflecting nonspecific screening assessments.

Conclusions

Despite national clinical practice guidelines, studies of abusive injury prevalence and radiologic yield among at-risk contacts exposed to unsafe environments are few. Screening evaluations inclusive of physical examination and radiologic studies identify abuse concerns among at-risk contacts. Further study of factors impacting radiologic screening decisions is needed. Considerations to advance epidemiologic research include standardized diagnostic coding and prospective assessment of radiologic yield.
Parental Beliefs About the Motor Development of Dutch Infants Born Very Preterm: A Cohort Study
Authors: Suir Imke , Boonzaaijer Marike , Oudgenoeg-Paz Ora , van Schie Petra E. M. , Nuysink Jacqueline , Jongmans Marian J.
Published: January 2024

Purpose:

To explore the influence of preterm birth on parental beliefs about gross motor development and parents' supportive role in infants' motor development.

Methods:

Prospective cohort study: Parents of infants born very preterm (VPT) (gestation ≤32 weeks, birth weight <1500 g, without perinatal complications) and parents of healthy infants born full-term (FT) completed the Parental Beliefs on Motor Development questionnaire.

Results:

Questionnaires from 37 parents of infants born VPT, aged 3.5 to 7.5 months (corrected), and 110 parents of infants born FT, aged 3.5 months, were analyzed. Parents of infants born VPT believed stimulating motor development to be more important than parents of infants born FT (F = 5.22; P = .024; ηp
2 = 0.035). Most parents of infants born VPT (82.4%) and FT (85.2%) acknowledged their role in supporting motor development. More parents of infants born VPT (41.2% vs 12.0%) believed they should follow their infant's natural developmental pace.

Conclusion:

Knowledge of parental beliefs and parents' supporting role in motor development is relevant for tailoring pediatric physiotherapists' interventions with families.
Therapeutic Play Gym: Feasibility of a Caregiver-Mediated Exercise System for NICU Graduates with Neuromuscular Weakness—A Case Series
Authors: Lammers Jenna , Smith Barbara
Published: January 2024

Purpose:

To describe the feasibility and effect of caregiver-mediated exercise training using a novel Therapeutic Play Gym in 3 neonatal intensive care unit (NICU) graduates with rare neuromuscular diseases.

Summary of Key Points:

Caregivers of 3 medically complex, technology-dependent NICU graduates could not access community-based rehabilitation services after discharging from lengthy initial hospitalizations. These children, diagnosed with spinal muscular atrophy type 0, untreated X-linked myotubular myopathy, and untreated nemaline myopathy 3 (NEM3), completed monthly consultations with a pediatric clinical specialist and 3 assessment appointments. The caregivers agreed to administer a progressive Therapeutic Play Gym home exercise program at a minimum frequency of 3×/wk for 6 months.

Conclusion:

A monthly consultative approach was both feasible and effective to safely progress caregiver-mediated home exercise training using a novel Therapeutic Play Gym. Positive training effects emerged in fitness, function, and caregiver-reported quality of life domains.

Recommendations for Clinical Practice:

A strong therapist-caregiver alliance can empower families to perform guided training when community resources are limited. More research is needed to see whether this training model is feasible for children with other conditions; for use in hospital, outpatient, or educational settings; and as an adjuvant exercise treatment for children receiving disease-modifying interventions.
The invisible scars: Unseen financial complications worsen every aspect of long-term health in trauma survivors
Authors: Ilkhani Saba , Naus Abbie E. , Pinkes Nathaniel , Rafaqat Wardah , Grobman Ben , Valverde Madeline D. , Sanchez Sabrina E. , Hwabejire John O. , Ranganathan Kavitha , Scott John W. , Herrera-Escobar Juan P. , Salim Ali , Anderson Geoffrey A.
Published: January 2024

BACKGROUND

Trauma survivors are susceptible to experiencing financial toxicity (FT). Studies have shown the negative impact of FT on chronic illness outcomes. However, there is a notable lack of data on FT in the context of trauma. We aimed to better understand prevalence, risk factors, and impact of FT on trauma long-term outcomes.

METHODS

Adult trauma patients with an Injury Severity Score (ISS) ≥9 treated at Level I trauma centers were interviewed 6 months to 14 months after discharge. Financial toxicity was considered positive if patients reported any of the following due to the injury: income loss, lack of care, newly applied/qualified for governmental assistance, new financial problems, or work loss. The Impact of FT on Patient Reported Outcome Measure Index System (PROMIS) health domains was investigated.

RESULTS

Of 577 total patients, 44% (254/567) suffered some form of FT. In the adjusted model, older age (odds ratio [OR], 0.4; 95% confidence interval [95% CI], 0.2–0.81) and stronger social support networks (OR, 0.44; 95% CI, 0.26–0.74) were protective against FT. In contrast, having two or more comorbidities (OR, 1.81; 95% CI, 1.01–3.28), lower education levels (OR, 1.95; 95% CI, 95%, 1.26–3.03), and injury mechanisms, including road accidents (OR, 2.69; 95% CI, 1.51–4.77) and intentional injuries (OR, 4.31; 95% CI, 1.44–12.86) were associated with higher toxicity. No significant relationship was found with ISS, sex, or single-family household. Patients with FT had worse outcomes across all domains of health. There was a negative linear relationship between the severity of FT and worse mental and physical health scores.

CONCLUSION

Financial toxicity is associated with long-term outcomes. Incorporating FT risk assessment into recovery care planning may help to identify patients most in need of mitigative interventions across the trauma care continuum to improve trauma recovery. Further investigations to better understand, define, and address FT in trauma care are warranted.

LEVEL OF EVIDENCE

Prognostic and Epidemiological; Level III.
A decade of firearm injuries: Have we improved?
Authors: Hatfield Sarah A. , Medina Samuel , Gorman Elizabeth , Barie Philip S. , Winchell Robert J. , Villegas Cassandra V.
Published: January 2024

BACKGROUND

Firearm injuries are a growing public health issue, with marked increases coinciding with the coronavirus disease 2019 (COVID-19) pandemic. This study evaluates temporal trends over the past decade, hypothesizing that despite a growing number of injuries, mortality would be unaffected. In addition, the study characterizes the types of centers affected disproportionately by the reported firearm injury surge in 2020.

METHODS

Patients 18 years and older with firearm injuries from 2011 to 2020 were identified retrospectively using the National Trauma Data Bank (NTDB®). Trauma centers not operating for the entirety of the study period were excluded to allow for temporal comparisons. Joinpoint regression and risk-standardized mortality ratios (SMR) were used to evaluate injury counts and adjusted mortality over time. Subgroup analysis was performed to describe centers with the largest increases in firearm injuries in 2020.

RESULTS

A total of 238,674 patients, treated at 420 unique trauma centers, met inclusion criteria. Firearm injuries increased by 31.1% in 2020, compared to an annual percent change of 2.4% from 2011 to 2019 (p= 0.01). Subset analysis of centers with the largest changes in firearm injuries in 2020 found that they were more often Level I centers, with higher historic trauma volumes and percentages of firearm injuries (p< 0.001). Unadjusted mortality decreased by 0.9% from 2011 to 2020, but after controlling for demographics, injury characteristics and physiology, there was no difference in adjusted mortality over the same time period. However, among patients with injury severity scores ≥25, adjusted mortality improved compared with 2011 (SMR of 0.950 in 2020; 95% confidence interval, 0.916–0.986).

CONCLUSION

Firearm injuries pose an increasing burden to trauma systems, with Level I and high-volume centers seeing the largest growth in 2020. Despite increasing numbers of firearm injuries, mortality has remained unchanged over the past decade.

LEVEL OF EVIDENCE

Prognostic and Epidemiological; Level III.
Application of Suggestive Biomarkers in Dementia With Lewy Bodies With Masking of Typical Clinical Symptoms by Alzheimer Disease-type Pathology
Authors: Kobayashi Ryota , Morioka Daichi , Kawakatsu Shinobu , Sakamoto Kazutaka , Suzuki Akihito
Published: January 2024

Dementia with Lewy bodies (DLB) is strongly associated with Alzheimer disease (AD)-type pathology and tends to mask the core clinical features of DLB. Therefore, there may be cases of undiagnosed DLB without suggestive biomarkers of DLB. We describe the case of a 63-year-old woman who was initially diagnosed as having AD and later diagnosed with DLB based on suggestive biomarkers of DLB. In this case, transient sleep talking with physical movements for several days led to the assessment of suggestive biomarkers for DLB in the absence of the core clinical features of DLB. For clinicians, diagnosing DLB in patients with AD-type pathology is challenging. However, the application of biomarkers suggestive of DLB to all patients with dementia is not realistic. To overcome the difficulties of clinical diagnosis of DLB, further research is needed regarding strategies for the application of suggestive biomarkers for DLB to appropriately diagnose DLB.
Recent advances in clinical electroencephalography
Authors: Frauscher Birgit , Rossetti Andrea O. , Beniczky Sándor
Published: January 2024

Purpose of review

Clinical electroencephalography (EEG) is a conservative medical field. This explains likely the significant gap between clinical practice and new research developments. This narrative review discusses possible causes of this discrepancy and how to circumvent them. More specifically, we summarize recent advances in three applications of clinical EEG: source imaging (ESI), high-frequency oscillations (HFOs) and EEG in critically ill patients.

Recent findings

Recently published studies on ESI provide further evidence for the accuracy and clinical utility of this method in the multimodal presurgical evaluation of patients with drug-resistant focal epilepsy, and opened new possibilities for further improvement of the accuracy. HFOs have received much attention as a novel biomarker in epilepsy. However, recent studies questioned their clinical utility at the level of individual patients. We discuss the impediments, show up possible solutions and highlight the perspectives of future research in this field. EEG in the ICU has been one of the major driving forces in the development of clinical EEG. We review the achievements and the limitations in this field.

This review will promote clinical implementation of recent advances in EEG, in the fields of ESI, HFOs and EEG in the intensive care.
Longitudinal trajectories of cognitive aging
Authors: Lobo Elena , Gracia-García Patricia , Lobo Antonio
Published: January 2024

Purpose of review

This review summarizes recent evidence related to the cognitive trajectories of aging, the factors associated with the different trajectories, and the effect of sex on cognitive decline.

Recent findings

Trajectories of cognitive aging identified in different studies vary in number, in the proportion of individuals falling into each of the classes and in the predictors of class membership. Trajectories observed include types with ‘rapid decline’, those with ‘gradual decline’ and those with ‘maintenance of high level’ of cognitive performance. Predictors of decline and predictors of maintenance of cognitive performance may be different. While factors such as education were in general associated with high performance, and reversely with low performance, other factors, such as depression were predictors only for some groups, particularly the declining ones. Sex differences in cognitive trajectories and the associated predictive factors have also been identified.

The findings on education may be particularly important in populations with low educational level, especially among women and the findings on depression have special interest in preventing cognitive decline in women. Further work is required to explain intriguing inconsistencies observed in the literature.
Deep learning applications in vascular dementia using neuroimaging
Authors: Dong Chao , Hayashi Shizuka
Published: January 2024

Purpose of review

Vascular dementia (VaD) is the second common cause of dementia after Alzheimer's disease, and deep learning has emerged as a critical tool in dementia research. The aim of this article is to highlight the current deep learning applications in VaD-related imaging biomarkers and diagnosis.

Recent findings

The main deep learning technology applied in VaD using neuroimaging data is convolutional neural networks (CNN). CNN models have been widely used for lesion detection and segmentation, such as white matter hyperintensities (WMH), cerebral microbleeds (CMBs), perivascular spaces (PVS), lacunes, cortical superficial siderosis, and brain atrophy. Applications in VaD subtypes classification also showed excellent results. CNN-based deep learning models have potential for further diagnosis and prognosis of VaD.

Deep learning neural networks with neuroimaging data in VaD research represent significant promise for advancing early diagnosis and treatment strategies. Ongoing research and collaboration between clinicians, data scientists, and neuroimaging experts are essential to address challenges and unlock the full potential of deep learning in VaD diagnosis and management.
Long-Term Effect of Maintenance Electroconvulsive Therapy in Patients With Depression—Data From a Small Randomized Controlled Trial
Authors: Brus Ole , Cao Yang , Carlborg Andreas , Engström Ingemar , von Knorring Lars , Nordenskjöld Axel
Published: January 2024

Objectives

This study aimed to compare the long-term effects of maintenance electroconvulsive therapy (M-ECT) with medication and medication only in patients with depression.

Methods

A randomized controlled trial of 1 year of M-ECT with medication or medication only investigated relapse/recurrence among 56 patients in remission after electroconvulsive therapy (ECT) for depression was conducted. The results of the first year are published already and showed a significant advantage of M-ECT with medication.

The current study was a long-term follow-up. When the randomized treatment allocation ended, medication was continued in both groups but M-ECT was terminated. Patients were followed for up to 10 years via Swedish national registers until the study endpoint of a new psychiatric diagnosis as an inpatient, suicide, suspected suicide, or death of another cause. Time to relapse was compared between the M-ECT with medication group and the medication-only group using Kaplan-Meier estimates.

Results

The median follow-up time was 6.5 years for the M-ECT and medication group and 3.1 years for the medication-only group. One year after randomization 22 patients remained in the M-ECT and medication group, and 14 patients remained in the medication-only group. Relapse patterns between the treatment groups after the completion of M-ECT seemed to be similar according to visual inspection.

Conclusions

This long-term follow-up study suggests that most of the benefit achieved during the treatment period with M-ECT is maintained over several years, but the small sample size, with accompanying large statistical imprecision, makes the results uncertain. More long-term studies of M-ECT are required.

Trial registration: ClinicalTrials.gov identifier: NCT00627887
Aninvitroagent-based modelling approach to optimization of culture medium for generating muscle cells
Authors: Hardman David , Hennig Katharina , Gomes Edgar R. , Roman William , Bernabeu Miguel O.
Published: January 2024

Methodologies for culturing muscle tissue are currently lacking in terms of quality and quantity of mature cells produced. We analyse images fromin vitroexperiments to quantify the effects of culture media composition on mouse-derived myoblast behaviour and myotube quality. Metrics of early indicators of cell quality were defined. Images of muscle cell differentiation reveal that altering culture media significantly affects quality indicators and myoblast migratory behaviours. To study the effects of early-stage cell behaviours on mature cell quality, metrics drawn from experimental images or inferred by approximate Bayesian computation (ABC) were applied as inputs to an agent-based model (ABM) of skeletal muscle cell differentiation with quality indicator metrics as outputs. Computational modelling was used to inform furtherin vitroexperiments to predict the optimum media composition for culturing muscle cells. Our results suggest that myonuclei production in myotubes is inversely related to early-stage nuclei fusion index and that myonuclei density and spatial distribution are correlated with residence time of fusing myoblasts, the age at which myotube–myotube fusion ends and the repulsion force between myonuclei. Culture media with 5% serum was found to produce the optimum cell quality and to make muscle cells cultured in a neuron differentiation medium viable.
The longitudinal effect of disseminating handwashing public health education to children in India via co-created, culturally relevant resources
Authors: Crosby Sapphire , Younie Sarah , Ujenia Harnesh Vijay , Laird Katie
Published: January 2024

Infectious diseases are a leading cause of death for children from low- and middle-income countries (LMICs), often due to inadequate hand-hygiene. This study evaluates culturally relevant educational resources as a vehicle to disseminate the importance of handwashing amongst children in India. Employing a participatory action research (PAR) model and mixed methods, this follow-up longitudinal study evaluates a set of innovate educational handwashing resources and workshops specifically co-created for use in the State of Gujarat, and how they aid teachers in the teaching of hand-hygiene over a 3 year period. Working alongside local NGOs on-the-ground, teacher questionnaires (n=58) and focus groups including a brief questionnaire with teachers (n=35) were conducted to assess the impact of trainer workshops. In addition, pre- and post-workshop worksheets were conducted with children (n=98). Percentage change was calculated between children’s pre-and post-worksheet scores and a cumulative frequency of responses to each questionnaire criterion was measured. Data from the focus group found that the resources had been used in over 200 schools by more than 5000 children. In addition, 92.28 % of teachers said they would use the resources within their classrooms in India, with 58.16 % of pupils having an increased understanding of germs/handwashing directly after the workshop. Teachers reported that they are able to teach microbiology and handwashing more effectively. Furthermore, following a focus group, 100 % of teachers noted a reduction in childhood vomiting and diarrhoeal illnesses linked with insufficient hand-hygiene across 46 schools in the State of Gujarat since using the Germ’s Journey resources.
Lack of detection of SARS-CoV-2 in Wildlife from Kerala, India in 2020-21
Authors: Zachariah Arun , Krishnankutty Sajesh P , Manazhi Jishnu , Omanakuttan Vishnu , Santosh Sam , Blanchard Adam , Tarlinton Rachael
Published: January 2024

Spillover of SARS-CoV-2 into a variety of wild and domestic animals has been an ongoing feature of the human pandemic. The establishment of a new reservoir in white tailed deer in North America and increasing divergence of the viruses circulating in them from those circulating in the human population has highlighted the ongoing risk this poses for global health. Some parts of the world have seen more intensive monitoring of wildlife species for SARS-CoV-2 and related coronaviruses but there are still very large gaps in geographical and species-specific information. This paper reports negative results for SARS-CoV-2 PCR based testing using a pan coronavirus end point RDRP PCR and a Sarbecovirus specific E gene qPCR on lung and or gut tissue from wildlife from the Indian State of Kerala. These animals included: 121 Rhinolophus rouxii (Rufous Horsehoe Bat), 6 Rhinolophus bedommei (Lesser Woolly Horseshoe Bat), 15 Rossettus leschenaultii (Fulvous Fruit Bat), 47 Macaca radiata (Bonnet macaques), 35 Paradoxurus hermaphroditus (Common Palm Civet), 5 Viverricula indica (Small Indian Civet) , 4 Herpestes edwardsii (Common Mongoose), 10 Panthera tigris (Bengal Tiger), 8 Panthera pardus fusca ( Indian Leopard), 4 Prionailurus bengalensis (Leopard cats), 2  Felis chaus (Jungle cats), 2 Cuon alpinus (Wild dogs)  and 1 Melursus ursinus (sloth bear).
Comparison of antioxidant activities of aronia vinegar
(Aronia melanocarpa) accroding to fermentation
time
Authors: Lee Nan-Hee , Jang Hyeock-Soon , Choi Ung-Kyu
Published: January 2024

This study investigated the antioxidant activity of Aronia vinegar during acetic
acid fermentation. As a result of acetic acid fermentation at 30°C for 30
days with different initial ethanol contents, it was found that adjusting the
initial ethanol content to 6% was optimal, at which 4.1% of acetic
acid was produced. During fermentation under optimal conditions, the total
polyphenol content decreased, but the content was higher than that of the
control brown rice vinegar but lower than that of grape vinegar. The contents of
flavonoids and tannins showed a decreasing pattern as acetic acid fermentation
progressed, but they were higher than those of brown rice vinegar and grape
vinegar. The DPPH scavenging activity was higher than 95.7% in all test
groups, indicating that it would be possible to produce high-quality Aronia
vinegar using the acetic acid fermentation method.