bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship Between Patient-reported Outcome Measures and Accelerometer-measured Physical Activity and Sleep in Patients With Postherpetic Neuralgia
Authors: Takai Hiromichi , Nozaki-Taguchi Natsuko , Shono Koyo , Sato Yasunori , Isono Shiroh
Published: July 2024

Objective:

Available treatment for chronic neuropathic pain is still limited, and the positive effects are modest. Thus, clinicians aim to improve activity and quality of life despite pain. The objective monitoring of activity is attracting attention in chronic pain assessments. Therefore, we objectively evaluated daytime activity and sleep in patients with postherpetic neuralgia (PHN), using actigraphy to determine risk factors for decreased activity.

Methods:

Participants with PHN wore an actigraph (a wristwatch-like accelerometer) on the nondominant hand. The actigraph measured day-time activity and sleep, which were compared with participant-reported subjective pain and sleep assessments.

Results:

Fifty-four individuals with PHN who visited our outpatient clinic completed questionnaires and a week of actigraph monitoring. Subjective scores of pain intensity, neuropathic pain, disability in daily life, pain-catastrophizing thoughts, and insomnia were all well correlated. However, the actigraph-monitored activity levels, using 2 equations, and sleep quality were not associated with any pain or sleep-related subjective scores.

Conclusion:

The discrepancy between the subjective and objective scores in this study may be due to (1) features of PHN, an archetype of peripheral neuropathic pain affecting no motor nerves, (2) actigraph measurement limitations regarding the sedentary life of the elderly, or (3) activity misperception, a new proposition explaining the discrepancy between subjective and objective measures of activity, similar to the sleep state misperception. In patients with PHN, high pain intensity may be reported in those with highly maintained activity, in which treatment must be selected cautiously to prevent interruption of their physical abilities.
The Utility of the Surgical Apgar Score in Assessing the Risk of Perioperative Complications Following Spinal Fusion Surgery for Pediatric Patients With Scoliosis and Cerebral Palsy
Authors: Shinohara Kensuke , Bryan Tracey P. , Bartley Carrie E. , Kelly Michael P. , Upasani Vidyadhar V. , Newton Peter O.
Published: July 2024

Study Design.

Cohort study.

Objective.

Validate the Surgical Apgar Score (SAS) as a means of predicting perioperative major complications occurring within 30 days after scoliosis surgery in pediatric patients with cerebral palsy (CP).

Summary of Background Data.

A patient’s SAS, which is composed of three commonly recorded intraoperative variables, predicts postoperative complications after various types of spine surgery. This has not; however, been studied in pediatric patients with scoliosis and CP, a population that experiences a high incidence of complications after corrective spinal surgery.

Methods.

Pediatric CP patients who underwent spinal correction surgery were included in this study. Patient background, surgical variables, and perioperative complications occurring within 30 days after surgery were collected. Patients were divided into 4 groups based on their SAS: SAS 0 to 4, SAS 5 to 6, SAS 7 to 8, and SAS 9 to 10. The incidences of perioperative complications for each group were compared using a receiver operating characteristic analysis. The area under the curve (AUC) is reported.

Results.

A total of 111 patients met the inclusion criteria. There were no death cases. There were 44 (39.6%) perioperative major complications in 37 (33.3%) patients that occurred within 30 days after spine surgery. The most frequent perioperative complications were pulmonary issues (13.5%). The incidence of perioperative major complication in each SAS group was as follows: SAS 0 to 4; 51.6%, SAS 5 to 6; 30.2%, SAS 7 to 8; 18.5%, SAS 9 to 10; 0/0. When the SAS 7 to 8 group was set as the reference, there was no significant difference compared to SAS 5 to 6 (P=0.34), while the incidence rate was significantly increased in SAS 0 to 4 (P=0.02). The AUC was 0.65 (95% CI: 0.54–0.75)

Conclusions.

Overall, there were 37 (33.3%) patients with CP who had a major complication within 30 days after spinal surgery. Lower SAS, with the 0 to 4 group being the cutoff, were associated with significantly higher complication rates than higher SAS groups.
Future of sentinel node biopsy in ovarian cancer
Authors: Bizzarri Nicolò , Nero Camilla , Di Berardino Stefano , Scambia Giovanni , Fagotti Anna
Published: July 2024

Purpose of review

The rationale on the use of sentinel lymph node (SLN) biopsy in the surgical staging of apparent early-stage ovarian cancer (OC) is supported by the fact that diagnostic and prognostic role of systematic staging lymphadenectomy has been determined but its therapeutic significance is still matter of controversy. Moreover, SLN biopsy represents an option to decrease intra- and postoperative morbidity. The present review aims to provide an overview on the current and future role of SLN in OC.

Recent findings

Most recent evidence shows that the overall mean per patient SLN detection rate in case of indocyanine green (ICG) alone was 58.6% compared with 95% in case of ICG + technetium, and with 52.9% in case of technetium alone or in combination with blue dye (P < 0.001). Site of injection has been reported to be in both ovarian ligaments in majority of studies (utero-ovarian ligament and infundibulo-pelvic ligament), before or after ovarian mass removal, at time of primary or re-staging surgery and by minimally invasive or open approach. Cervical injection has been recently proposed to replace utero-ovarian injection. SLN detection rate in patients with confirmed ovarian malignancy varied across different studies ranging between 9.1% and 91.3% for the injection in the utero-ovarian ligament and migration to pelvic lymph nodes and between 27.3% and 100% for the injection in the infundibulo-pelvic ligament and migration to para-aortic lymph nodes. No intra- or postoperative complication could be attributed directly to SLN biopsy. The sensitivity and the accuracy of SLN in detecting lymphatic metastasis ranged between 73.3–100% and 96–100%, respectively. In up to 40% of positive SLNs, largest metastatic deposit was classified as micro-metastasis or isolated tumor cells, which would have been missed without ultrastaging protocol.

SLN biopsy represents a promising tool to assess lymph node status in apparent early-stage OC. The type and volume of injected tracer need to be considered as appear to affect SLN detection rate. Ultrastaging protocol is essential to detect low volume metastasis. Sensitivity and accuracy of SLN biopsy are encouraging, providing tracer injection in both uterine and ovarian ligaments.
Nutritional Status, Eating Behaviors, and Gastrointestinal Symptom Cluster Among Children Receiving Cancer Chemotherapy in Thailand: A Descriptive Study
Authors: Kamkhoad Donruedee , Patoomwan Autchareeya , Santacroce Sheila J.
Published: July 2024

Background:

Most children undergoing chemotherapy for cancer experience gastrointestinal (GI) tract symptoms that affect their eating habits, nutritional status, and quality of life (QOL). Previous research on the connections between these factors has primarily focused on Western countries. As a result, there is limited understanding of these issues among Thai children.

Objective:

To describe GI symptoms, eating, nutritional status, and QOL for Thai children with cancer.

Methods:

This descriptive study used multiple methods. Quantitative data were collected through (1) standardized measures of GI symptoms and QOL and (2) extraction of medical history and clinical data from the child’s medical records, then analyzed using descriptive statistics. Qualitative data were collected with semistructured interviews with each child, then their parent, and analyzed using a directed content analysis.

Results:

Sixteen child-parent dyads participated in this study. Most children exhibited reduced food intake and weight loss, primarily attributed to GI symptoms and environmental factors. Underreporting of symptoms was identified, contributing to suboptimal symptom management. Clinician-recommended low-bacterial diets posed challenges to maintaining children’s food intake. Additionally, hospital food with repetitive menus and plain flavors was generally undesirable for children during hospitalization.

Conclusions:

Multifaceted factors influencing the nutritional status and QOL of children with cancer within the unique care context of Thailand were identified.

Implications for Practice:

The study findings inform the development of multi-level interventions targeting to optimize eating, nutritional status, and QOL for children with cancer.

What is Foundational:

The model, informed by cultural considerations, could be adapted for research in other countries with distinctive cultures.
Efficacy and Safety of Autologous Nanofat Injection in the Treatment of Postburn Scars Using Optical Skin Imaging Analysis
Authors: Rageh Mahmoud A. , Fathi Mostafa Khairy , Ibrahim Shady Mahmoud Attia
Published: July 2024

BACKGROUND

Burn scars are considered one of the challenging issues that can affect the quality of life by causing aesthetic and functional problems. Injecting nanofat particles, which are considered a source of stem cells, into the dermis and/or subcutis of the burned area is considered a promising procedure for the treatment of scars and the correction of volume shortage and skin renewal.

OBJECTIVE

To assess the safety and effectiveness of using autologous nanofat injections to treat burn scars.

METHODS

Thirty patients with postburn scars participated in the trial. Each patient received one session of liposuction, which was then converted into nanofat and injected back into the scar tissue. Four months after the session, the evaluation was conducted both objectively using the Antera camera 3D imaging and subjectively using the Vancouver scar scale (VSS).

RESULTS

Because there were statistically significant improvements in the treated scars' height, color, vascularity, and pliability, the total VSS scores differed significantly before and after treatment. Furthermore, the Antera 3D imaging revealed a statistically significant variation in the treated scars' indentations, erythema, and pigmentation scores.

CONCLUSION

The study findings demonstrated that nanofat is a successful postburn scar treatment option that improves patients' quality of life.
Midterm Survival Results of Preserflo in a Real-World Setting
Authors: Lima-Cabrita Afonso , Santos Miguel , José Patrícia , Barão Rafael , Barata André , Abegão Pinto Luís
Published: July 2024

Précis:

Preserflo surgery is a safe procedure, effective in reducing intraocular pressure into the “low teens,” surgical survival is greatest in cases of high baseline intraocular pressure (above 21 mm Hg) and when performed as a standalone procedure.

Purpose:

To evaluate midterm surgical survival and safety profile of Preserflo filtering surgery.

Methods:

In this retrospective, cohort study, consecutive patients who underwent standardized Preserflo implantation with mitomycin C from December 2019 to April 2021 were included. Clinical data were retrieved from patient charts. The primary outcome was surgical survival at 24 months in accordance with World Glaucoma Association guidelines. Survival was evaluated using Kaplan-Meier statistics. Analysis was performed at the eye level and as intention to treat.

Results:

Ninety-five eyes were included in this study (18 cases combined with cataract surgery). More than half of cases (n=51) were primary open angle glaucoma, with over a fifth having a prior filtering glaucoma procedure. Intraocular pressure at 24 months was significantly decreased from baseline (22.4±6.28 vs. 12.0±3.43 mm Hg), as well as the need for IOP-lowering medication [2.88 (±0.92) vs. 0.79 (±1.3), P<0.001 all comparisons]. Standalone Preserflo achieved a qualified survival (irrespective of medication) of 71% (95% CI, 62%–83%) and 44% (95% CI, 27%–75%) in the combined procedure subgroup (P<0.05 when considering absolute survival). Eyes with baseline intraocular pressure ≥21 mm Hg showed a greater qualified survival when compared with eyes with baseline ≤18 mm Hg [80% (95% CI, 65%–100%) vs. 50% (95% CI, 32%–76%); P<0.05]. Intra and early operative complications were few, self-limited, and did not require surgical management. The reoperation rate was low (18%).

Conclusions:

Preserflo filtering surgery was effective in reducing intraocular pressure into the “low teens” and presents an adequate surgical survival and safety profile. Surgical survival appeared greatest when performed as standalone and when preoperative intraocular pressure was high.
First Evidence of Streptococcus pyogenes M1UK Clone in Pediatric Invasive Infections in Italy by Molecular Surveillance
Authors: Vrenna Gianluca , Rossitto Martina , Agosta Marilena , Cortazzo Venere , Fox Valeria , De Luca Maia , Lancella Laura , Gargiullo Livia , Granaglia Annarita , Fini Vanessa , Yu La Rosa Katia , Argentieri Marta , Pansani Laura , Sisto Annamaria , Raponi Massimiliano , Villani Alberto , Perno Carlo Federico , Bernaschi Paola
Published: July 2024

Invasive group A streptococci infections are increasing worldwide, mainly due to the emm1 lineage M1UK emergence. Although this variant has recently been described in adult Italian patients, its circulation in children has not yet been established. Characterizing by whole genome sequencing 6 invasive group A streptococci strains isolated between 2022 and 2023, we highlighted M1UK lineage circulation in pediatric patients in Italy.
Bibliographic analysis of psychiatric publications in Taiwan: An analysis of Web of Science subject category from 1970 to 2023
Authors: Huang Isabel Mei-Hsuan , Tsai Faug-Ju , Chen Yu-Chun , Tsai Shih-Jen , Hwang Shinn-Jang
Published: July 2024

Background:

Mental diseases continue to rank among the top 10 leading causes of global burden. Psychiatric research is a crucial avenue through which mental healthcare can be enhanced. Taiwanese academics have constantly concentrated their efforts on psychiatric research and published their findings. A systematic examination of these papers will provide an assessment of the present state and contribute to the formulation of future policies for psychiatric research in Taiwan. We assessed psychiatric papers from Taiwan using the Web of Science (WoS) database.

Methods:

Academic papers in the Psychiatry category of the WoS database from Taiwan were retrieved and evaluated. The analysis included papers published in Science Citation Index-Expanded and Social Science Citation Indexed journals between 1970 and 2023, excluding meeting abstracts and corrections.

Results:

Of the 1 049 281 papers published globally in the Psychiatry category of the WoS system between 1970 and 2023, 6117 (0.58%) were published in Taiwan. Taiwan ranked 26th globally in terms of number of papers published. These publications have received 150 519 citations. Over the past 53 years, both the annual number of psychiatric papers from Taiwan and their citations received have significantly and rapidly increased. However, the average impact factor of publications remained constant over time.

Conclusion:

Over the last five decades, the number of psychiatric publications from Taiwan has increased. However, the average impact factor of these published papers did not increase over time. Investing in advanced research infrastructure and interdisciplinary projects may improve the quality and relevance of Taiwanese psychiatric research publications, potentially increasing their global citations and impact.
Therapeutic efficacy of platelet-rich plasma in the management of rib fractures
Authors: Lin Yi-Han , Hsu Han-Shui
Published: July 2024

Background:

This study aimed to investigate the therapeutic efficacy of platelet-rich plasma (PRP) therapy in patients with rib fractures.

Methods:

This study retrospectively collected data from patients with acute rib fractures at Ming-Sheng General Hospital from 2020 to 2022 and excluded those who underwent surgical intervention or with severe extrathoracic injuries. PRP was extracted using the patient’s blood and injected via ultrasound guidance near the fracture site. Patients self-assessed pain levels and medication usage at 0, 1, 2, 4, and 8 weeks. Pulmonary function tests were conducted at 4 weeks.

Results:

This study included 255 patients, with 160 and 95 patients in the conservative (only pain medications administered) and PRP groups (PRP and analgesics administered), respectively. The PRP group reported lower pain levels than the conservative group at 2 and 4 weeks. No substantial differences in medication usage were observed between the groups. The PRP group demonstrated lower pain levels and medication usage than the conservative group in severe rib fractures (≥3 ribs) and better lung function improvement at 4 weeks. After propensity score matching, the PRP group still had a better treatment outcome in pain control and lung function recovery.

Conclusion:

PRP demonstrated considerable therapeutic efficacy in patients with severe rib fractures, resulting in reduced pain, decreased medication usage, and improved lung function but with no substantial benefits in patients with mild rib fractures.
Risks of Kawasaki disease and multisystem inflammatory syndrome in pediatric patients with COVID-19 infection: A TriNetX based cohort study
Authors: Chien Kuang-Jen , Wei Cheng-Chung James , Huang Shih-Hui , Chen Chun-Yu , Kuo Ho-Chang , Hung Yao-Min , Liao Pei-Lun , Huang Jing-Yang , Cheng Ming-Fang , Weng Ken-Pen
Published: July 2024

Background:

The associations of coronavirus disease (COVID-19) with Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C) remain unclear. Few large-scale studies have estimated the cumulative incidence of MIS-C and KD after COVID-19 in children.

Methods:

Data were obtained from TriNetX. After propensity score matching was completed, data from 258 645 patients with COVID-19 (COVID-19 group) and 258 645 patients without COVID-19 (non-COVID-19 group) were analyzed using Cox regression. Hazard ratio (HR), 95% CI, and cumulative incidence of MIS-C and KD were calculated for both groups. A stratified analysis was performed to validate the results.

Results:

After matching for age at baseline and sex, the risks of MIS-C and KD were higher in the COVID-19 group than in the non-COVID-19 group (HR: 3.023 [95% CI, 2.323-3.933] and 1.736 [95% CI, 1.273-2.369], respectively). After matching for age at baseline, sex, race, ethnicity, and comorbidities, the risks of MIS-C and KD remained significantly higher in the COVID-19 group than in the non-COVID-19 group (HR: 2.899 [95% CI, 2.173-3.868] and 1.435 [95% CI, 1.030-2.000]). When stratified by age, the risk of MIS-C was higher in the COVID-19 group—for patients aged >5 years and ≤5 years (HR: 2.399 [95% CI, 1.683-3.418] and 2.673 [95% CI, 1.737-4.112], respectively)—than in the non-COVID-19 group. However, the risk of KD was elevated only in patients aged ≤5 years (HR: 1.808; 95% CI, 1.203-2.716). When stratified by COVID-19 vaccination status, the risks of MIS-C and KD were elevated in unvaccinated patients with COVID-19 (HR: 2.406 and 1.835, respectively).

Conclusion:

Patients with COVID-19 who are aged <18 and ≤5 years have increased risks of MIS-C and KD, respectively. Further studies are required to confirm the role of COVID-19 in the pathogenesis of MIS-C and KD.
Health Care Workers’ Reflections, Experiences, and Sequela throughout the COVID-19 Pandemic
Authors: Casagrande Yolee , Newton Kim , Strum Earl , Unger Jennifer B.
Published: July 2024

Objective

Health care workers (HCW) experienced significant stress during the COVID-19 pandemic. This qualitative study describes how they contextualized the experience several years later.

Methods

In August 2023, 1832 HCW at an academic medical center completed a confidential electronic survey; 443 of them responded to an open-ended question about their experiences during the pandemic. The statements were analyzed qualitatively, using a grounded theory approach to allow themes to emerge from the data.

Results

Common themes included fear/anxiety (22%), burnout (15%), protecting family from risk (11%), lack of employer support (11%), fear of illness (8%), increased appreciation for life (8%), and exposure to death/illness (5%).

Conclusion

HCW experienced substantial stress during the pandemic. Mental health services and structural changes in the health care system are needed to protect HCW during future public health emergencies.
Medical Evaluation for Respirator Use—Updated Approaches
Authors: Harber Philip , Beckett William S.
Published: July 2024

Objective

Respirator medical evaluations are an important component of occupational health practice. Concepts and practices were established 25–50 years ago.

Method

We suggest analysis and discussion of three areas warranting update.

Results

a) Shift from disease-based decisions to evaluating the following 12 specific domains: cardiopulmonary, sudden change in condition, thermal, work interference, exacerbating existing condition, donning/doffing, dermatologic, proper utilization, fit testing interference, cultural/religious, arms/legs, and subjective responses. Two distinct evaluation processes are advised—“algorithmic” for the frequent straightforward evaluations and “specialist” for the more complex. b) Acknowledging the importance of subjective responses and clarifying the underlying causes—external stimulus, sensation, perception, interpretation, acceptability, and emotional response. c) Optimizing the organizational structures by explicitly defining the scope of evaluations, modifying the sequencing of assessment, and specifying qualifications of clinicians performing assessments.

Conclusions

Reassessing respirator medical evaluation methods is needed.
Ambient Air Pollution and Incident Cardiovascular Disease in People With Type 2 Diabetes Mellitus
Authors: Khajavi Alireza , Hashemi-Madani Nahid , Hassanvand Mohammad Sadegh , Naddafi Kazem , Khamseh Mohammad E.
Published: July 2024

Objectives

We aimed to assess the effect of air pollution on incident cardiovascular disease (CVD) in people with type 2 diabetes mellitus (T2DM).

Methods

We tracked 486 T2DM patients from 2012 to 2021. Cox regression models were applied to assess the hazard of exposure to particulate matter, carbon monoxide (CO), ozone, nitrogen dioxide, and sulfur dioxide (SO2) on incident CVD, revealing hazard ratios (HRs).

Results

CVD incidents occurred in 73 individuals. Among men, each 1-ppm increase in CO levels raised the risk of CVD (HR: 2.66, 95% CI: 1.30–5.44). For women, a 5-ppb rise in SO2 increased CVD risk (HR: 1.60, 95% CI: 1.11–2.30). No notable impact of particulate pollutants was found.

Conclusions

Persistent exposure to gaseous air pollutants, specifically CO and SO2, is linked to the development of CVD in men and women with T2DM.
Associations Between Running Mechanics, Functional Lower Extremity Strength, and Stress Urinary Incontinence in Parous Female Runners
Authors: Ron Nicole J. , Dolbinski Sarah C. , Hodonicky Elizabeth G. , Middlebrook Darby O. , Olmstead Sally R. , Olsen Sandra L. , Ron Eyal D. , Hollman John H.
Published: July 2024

Background:

Women with stress urinary incontinence (SUI) may have altered running mechanics and reduced hip muscle strength compared with women without SUI. Little research has examined running metrics and functional lower extremity strength of parous runners.

Objective:

To determine whether SUI severity correlates with running metrics and lower extremity muscle strength among parous women.

Study Design:

This was a cross-sectional observational study of 22 parous participants (mean age 39.8 years, with a mean of 3.4 pregnancies and 8.1-year interval since last delivery).

Methods:

Participants completed the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI), Urinary Distress Inventory-6 (UDI-6), Colorectal-Anal Distress (CRAD) Inventory-8, and Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6), and Questionnaire for Urinary Incontinence Diagnosis (QUID) and provided demographic, relevant running, and obstetric/gynecologic history information. After a brief warm-up, participants completed 30-second single-leg sit-to-stand tests bilaterally and a standardized 10-minute treadmill run with pod cadence assessment. Pearson-product moment correlation coefficients were calculated (α = .05).

Results:

Prolonged ground contact times were associated with higher ICIQ-UI SF (r= 0.523, P= .015), POPDI-6 (r= 0.694, P< .001), and UDI-6 scores (r= 0.577, P= .006), while lower cadences were associated with higher POPDI-6 (r=−0.550, P= .010) and UDI-6 scores (r=−0.444, P= .044).

Conclusions:

Parous female runners with more severe SUI and prolapse symptoms demonstrate altered running mechanics characterized by prolonged ground contact times and slower cadences.
Insights into the clinical impact of complete blood cell inflammatory markers on body composition variations and fatty liver grading in Iranian adults undergoing bariatric surgery: a retrospective longitudinal study
Authors: Radkhah Hanieh , Alirezaei Ali , Parhizkar Peyvand , Khalooeifard Razieh , Khoundabi Batoul , Najjari Khosrow , Talebpour Mohammad , Hajabi Reza
Published: July 2024

Background:

In bariatric surgery, inflammatory biomarkers predict outcomes. Limited research on complete blood cell (CBC) markers stresses the need for correlation study. This research explores links between CBC inflammatory markers, body changes, and fatty liver grades in Iranian bariatric patients.

Materials and methods:

This retrospective longitudinal study examined 237 bariatric surgery patients who satisfied the inclusion criteria and were deemed eligible for participation. These criteria encompassed patients who had undergone sleeve or mini-bypass surgery and were aged between 18 and 65 years. The study gathered demographic data, pre and post-surgery changes in CBC inflammatory biomarkers [neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), mean platelet volume (MPV), MPV-to-platelet count ratio (MPV/PC), and red cell distribution width (RDW)] and fatty liver grades. Additionally, it recorded pre and post-surgery changes in body composition, such as weight, muscle mass (MM), fat mass (FM), and fat-free mass (FFM).

Results:

The pre-surgery RDW marker significantly associated with FM changes, highlighting its predictive nature. While no significant association was found between changes in patients’ fatty liver grade and baseline marker values, it’s worth noting that individuals with higher MM at 3 months achieved a fatty liver grade of zero. Also, at 6 months, higher FFM and MM were also associated with reaching a fatty liver grade of zero.

Conclusions:

While the retrospective design of this study limits its findings to existing clinical data, future prospective research should collect additional samples, extend the observation time, and examine the long-term predictive value of these markers.
Parent Perspectives on Social Risk Screening in the PICU*
Authors: Asp Rebecca A. , Paquette Erin T.
Published: July 2024

OBJECTIVE:

Health inequities are widespread and associated with avoidable poor health outcomes. In the PICU, we are increasingly understanding how health inequities relate to critical illness and health outcomes. Experts recommend assessing for health inequities by screening for social determinants of health (SDOH) and adverse childhood experiences (ACEs); however, guidance on screening is limited and screening has not been universally implemented. Our study aimed to understand parent perspectives on screening for SDOH/ACEs in the PICU, with the primary objective of determining whether screening would be acceptable in this setting.

DESIGN:

We conducted a qualitative study using semistructured interviews with a convenience sample of eleven PICU parents between November 2021 and January 2022.

SETTING:

Urban, quaternary free-standing children’s hospital.

SUBJECTS:

Parents of children with a PICU hospitalization between November 2020 and October 2021.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Domains of interest included experience with and attitudes toward SDOH/ACEs screening, perspectives on addressing needs with/without resources and their relationship to health, and recommendations for screening. Interviews were transcribed verbatim and coded with an inductive approach using thematic analysis and constant comparative methods. Ann & Robert H. Lurie Children’s Institutional Review Board approved this study (2021- 4781, Approved September 13, 2021). Ten participants found SDOH/ACEs screening to be acceptable and valuable in the PICU, even for topics without a readily available resource. Participants did not have broad experience with ACEs screening, though all believed this provided the medical team with valuable context regarding their child. Ten participants recommended screening occur after their child has been stabilized and that they are notified that screening is universal.

CONCLUSIONS:

Participants found screening for SDOH/ACES to be acceptable and valuable in the PICU. Families have important insight that should be leveraged to improve the support of unmet needs through the development of strengths-based, parent-informed screening initiatives.
Multimodal Imaging Approach for Tumor Treatment Response Evaluation in the Era of Immunotherapy
Authors: Lee Geewon , Moon Seung Hwan , Kim Jong Hoon , Jeong Dong Young , Choi Jihwan , Choi Joon Young , Lee Ho Yun
Published: July 2024

Immunotherapy is likely the most remarkable advancement in lung cancer treatment during the past decade. Although immunotherapy provides substantial benefits, their therapeutic responses differ from those of conventional chemotherapy and targeted therapy, and some patients present unique immunotherapy response patterns that cannot be judged under the current measurement standards. Therefore, the response monitoring of immunotherapy can be challenging, such as the differentiation between real response and pseudo-response. This review outlines the various tumor response patterns to immunotherapy and discusses methods for quantifying computed tomography (CT) and 18F-fluorodeoxyglucose positron emission tomography (PET) in the field of lung cancer. Emerging technologies in magnetic resonance imaging (MRI) and non-FDG PET tracers are also explored. With immunotherapy responses, the role for imaging is essential in both anatomical radiological responses (CT/MRI) and molecular changes (PET imaging). Multiple aspects must be considered when assessing treatment responses using CT and PET. Finally, we introduce multimodal approaches that integrate imaging and nonimaging data, and we discuss future directions for the assessment and prediction of lung cancer responses to immunotherapy.
Three Molecular Developmental Pathways of Remnant Pancreatic Cancer after Resection
Authors: Suzuki Shuji , Omori Yuko , Ono Yusuke , Hirose Katsuya , Itoh Taito , Karasaki Hidenori , Shimoda Mitsugi , Nagakawa Yuichi , Higuchi Ryota , Endo Itaru , Rikiyama Toshiki , Unno Michiaki , Fujii Tsutomu , Sunagawa Yuki , Eguchi Hidetoshi , Sasanuma Hideki , Akahori Takahiro , Okano Keiichi , Tani Masaji , Hirano Satoshi , Shimizu Yasuhiro , Kitago Minoru , Mizuno Shugo , Yamamoto Tomohisa , Furukawa Masayuki , Ohtsuka Masayuki , Sugimoto Motokazu , Matsushita Akira , Hakamada Kenichi , Igarashi Hisato , Kuroki Tamotsu , Tanno Satoshi , Tsuji Yoshihisa , Masamune Atsushi , Mizumoto Kazuhiro , Hirooka Yoshiki , Yamaue Hiroki , Okazaki Kazuichi , Satoi Sohei , Takeyama Yoshifumi , Mizukami Yusuke , Furukawa Toru
Published: July 2024

Objective:

This study aimed to clarify the molecular mechanism of remnant pancreatic cancer (PC) development after primary PC resection.

Summary Background Data:

Molecular mechanisms of the development of remnant PCs following primary PC resection are largely unknown.

Methods:

Forty-three patients undergoing remnant PC resection after primary PC resection between 2001 and 2017 at 26 institutes were retrospectively analyzed. Clinicopathological features and molecular alterations detected by targeted amplicon sequencing of 36 PC-associated genes were evaluated.

Results:

These patients showed significantly lower body mass indices and higher hemoglobin A1c values at remnant PC resection than at primary PC resection. A comparison of the molecular features between primary and remnant PCs indicated that remnant PCs were likely to develop via three different molecular pathways: successional, showing identical and accumulated alterations (n=14); phylogenic, showing identical and distinct alterations (n=26); and distinct, showing independent distinctive alterations (n=3). The similarity of gene alterations was associated with time to the remnant PC development (r=－0.384, P=0.0173). Phylogenic pathways were significantly associated with the intraductal spread of carcinoma (P=0.007). Patient survival did not differ significantly depending on these molecular pathways.

Conclusion:

Molecular profiling uncovered three pathways for the development of remnant PCs, namely, successional, phylogenic, and distinct pathways. The vast majority of remnant PCs are likely to be molecularly associated with primary PCs either in the successional or phylogenic way. This information could impact the design of a strategy for monitoring and treating remnant PCs.
Geographic Access to Urogynecology Care in the United States
Authors: Schmidt Eleanor M. , Ward Lucy , Gregory W. Thomas , Cichowski Sara B.
Published: July 2024

Importance

Although access to urogynecologic care is known to influence patient outcomes, less is known regarding geographic access to care and how it may vary by population characteristics.

Objective

The primary objective of this study was to estimate geographic accessibility of urogynecologic services in terms of drive time and by population demographics.

Study Design

We performed a descriptive study using practice location data by zip code for all board-certified urogynecologists who are American Urogynecologic Society members (n = 497) and pelvic floor physical therapists (n = 985). Drive times from each zip code to the nearest health care professional zip code were calculated. These data were then overlaid onto a map of the continental United States. Race/ethnicity, age, education, poverty status, disability status, health insurance coverage, and rurality were compared across travel times.

Results

Of the 31,754 zip codes of the continental United States, 389 (1.23%) had at least 1 urogynecologist, and 785 (2.47%) had at least 1 pelvic floor physical therapist; 92.29 million women older than 35 years were represented in the demographic analyses. Seventy-nine percent of the studied population live within 1 hour of a urogynecologist, and 85% live within 1 hour of a pelvic floor physical therapist. Seven percent and 3% live >2 hours from urogynecologic services, respectively. Values for drive times to all health care professionals indicate that American Indian/Alaska Native individuals have a much greater travel burden than other racial/ethnic groups.

Conclusions

There are population groups with limited geographic access to urogynecologic services. Pelvic floor physical therapists are more geographically accessible to the population studied than urogynecologists.
Elastic jump propagation across a blood vessel junction
Authors: Spelman Tamsin A. , Onah Ifeanyi S. , MacTaggart David , Stewart Peter S.
Published: July 2024

The theory of small-amplitude waves propagating across a blood vessel junction has been well established with linear analysis. In this study, we consider the propagation of large-amplitude, nonlinear waves (i.e. shocks and rarefactions) through a junction from a parent vessel into two (identical) daughter vessels using a combination of three approaches: numerical computations using a Godunov method with patching across the junction, analysis of a nonlinear Riemann problem in the neighbourhood of the junction and an analytical theory which extends the linear analysis to the following order in amplitude. A unified picture emerges: an abrupt (prescribed) increase in pressure at the inlet to the parent vessel generates a propagating shock wave along the parent vessel which interacts with the junction. For modest driving, this shock wave divides into propagating shock waves along the two daughter vessels and reflects a rarefaction wave back towards the inlet. However, for larger driving the reflected rarefaction wave becomes transcritical, generating an additional shock wave. Just beyond criticality this new shock wave has zero speed, pinned to the junction, but for further increases in driving this additional shock divides into two new propagating shock waves in the daughter vessels.
Archaeological evidence for long-term human impacts on sea turtle foraging behaviour
Authors: Guiry Eric , Kennedy J. Ryan , Malcom Corey , Miller Mariah , Hall Olivia , Buckley Michael , Szpak Paul
Published: July 2024

Early conservation efforts to prevent the loss of green sea turtles (
Chelonia mydas
) from the Caribbean Sea jumpstarted marine habitat and biodiversity protection. However, even there, limitations on historical observations of turtle ecology have hampered efforts to contextualize foraging behaviours for conservation management. We integrate isotopic and zooarchaeological evidence from green sea turtles harvested at the Miskito Cays (Nicaragua) to assess foraging behaviour before and after a step change in harvesting intensity. Highly structured isotopic evidence shows greater foraging adaptability in earlier populations. This provides a counterpoint to recent synthesis, suggesting the ecological non-exchangeability of sea turtles, which complicates conservation planning focused on genetic-stock-based repopulation. In contrast, our results suggest future populations would have a capacity for higher degrees of ecological exchangeability than current perspectives allow. This highlights a need to consider the kinds of longer term perspectives, such as those offered by archaeological materials, when planning for future sea turtle recovery.
Through an animal’s eye: the implications of diverse sensory systems in scientific experimentation
Authors: Brebner Joanna S. , Loconsole Maria , Hanley Daniel , Vasas Vera
Published: July 2024

‘Accounting for the sensory abilities of animals is critical in experimental design.’ No researcher would disagree with this statement, yet it is often the case that we inadvertently fall for anthropocentric biases and use ourselves as the reference point. This paper discusses the risks of adopting an anthropocentric view when working with non-human animals, and the unintended consequences this has on our experimental designs and results. To this aim, we provide general examples of anthropocentric bias from different fields of animal research, with a particular focus on animal cognition and behaviour, and lay out the potential consequences of adopting a human-based perspective. Knowledge of the sensory abilities, both in terms of similarities to humans and peculiarities of the investigated species, is crucial to ensure solid conclusions. A more careful consideration of the diverse sensory systems of animals would improve many scientific fields and enhance animal welfare in the laboratory.
Contrasting seasonal responses to wind in migrating songbirds on a globally important flyway
Authors: Schekler Inbal , Levi Yoav , Sapir Nir
Published: July 2024

During spring migration, nocturnal migrants attempt to minimize their travel time to reach their breeding grounds early. However, how they behave and respond to unfavourable conditions during their springtime travels is much less understood. In this study, we reveal the effects of atmospheric factors on nocturnal bird migration under adverse conditions during spring and autumn, based on one of the most detailed bird migration studies globally, using radar data from 13 deployments over a period of seven years (2014–2020) in the Levant region. Using ERA5 reanalysis data, we found that migratory birds maintain similar ground speeds in both autumn and spring migrations, but during spring, when encountering unfavourable winds, they put more effort into maintaining their travel speed by increasing self-powered airspeed by 18%. Moreover, we report for the first time that spring migrants showed less selectivity to wind conditions and migrated even under unfavourable headwind and crosswind conditions. Interestingly, we discovered that temperature was the most important weather parameter, such that warm weather substantially increased migration intensities in both seasons. Our results enhance our understanding of bird migration over the Levant region, one of the world’s largest and most important migration flyways, and the factors controlling it. This information is essential for predicting bird migration, which—especially under the ongoing anthropogenic changes—is of high importance.
Pesticide exposure triggers sex-specific inter- and transgenerational effects conditioned by past sexual selection
Authors: Castano-Sanz Veronica , Gomez-Mestre Ivan , Rodriguez-Exposito Eduardo , Garcia-Gonzalez Francisco
Published: July 2024

Environmental variation often induces plastic responses in organisms that can trigger changes in subsequent generations through non-genetic inheritance mechanisms. Such transgenerational plasticity thus consists of environmentally induced non-random phenotypic modifications that are transmitted through generations. Transgenerational effects may vary according to the sex of the organism experiencing the environmental perturbation, the sex of their descendants or both, but whether they are affected by past sexual selection is unknown. Here, we use experimental evolution on an insect model system to conduct a first test of the involvement of sexual selection history in shaping transgenerational plasticity in the face of rapid environmental change (exposure to pesticide). We manipulated evolutionary history in terms of the intensity of sexual selection for over 80 generations before exposing individuals to the toxicant. We found that sexual selection history constrained adaptation under rapid environmental change. We also detected inter- and transgenerational effects of pesticide exposure in the form of increased fitness and longevity. These cross-generational influences of toxicants were sex dependent (they affected only male descendants), and intergenerational, but not transgenerational, plasticity was modulated by sexual selection history. Our results highlight the complexity of intra-, inter- and transgenerational influences of past selection and environmental stress on phenotypic expression.
Phylogenomic and genomic analysis reveals unique and shared genetic signatures of Mycobacterium kansasii complex species
Authors: Machado Edson , Vasconcellos Sidra , Gomes Lia , Catanho Marcos , Ramos Jesus , de Carvalho Luciana , Goldenberg Telma , Redner Paulo , Caldas Paulo , Campos Carlos , Dalcolmo Margareth , Lourenço Maria Cristina , Lasunskaia Elena , Mussi Vinicius , Spinassé Lizania , Vinhas Solange , Rigouts Leen , Cogneau Sari , de Rijk Pim , Utpatel Christian , Kaustova Jarmila , van der Laan Tridia , de Neeling Han , Rastogi Nalin , Levina Klavdia , Kütt Marge , Mokrousov Igor , Zhuravlev Viacheslav , Makhado Ndivhu , Žolnir-Dovč Manca , Jankovic Vera , de Waard Jacobus , Sisco Maria Carolina , van Soolingen Dick , Niemann Stefan , de Jong Bouke C. , Meehan Conor J. , Suffys Philip
Published: July 2024

Species belonging to the Mycobacterium kansasii complex (MKC) are frequently isolated from humans and the environment and can cause serious diseases. The most common MKC infections are caused by the species M. kansasii (sensu stricto), leading to tuberculosis-like disease. However, a broad spectrum of virulence, antimicrobial resistance and pathogenicity of these non-tuberculous mycobacteria (NTM) are observed across the MKC. Many genomic aspects of the MKC that relate to these broad phenotypes are not well elucidated. Here, we performed genomic analyses from a collection of 665 MKC strains, isolated from environmental, animal and human sources. We inferred the MKC pangenome, mobilome, resistome, virulome and defence systems and show that the MKC species harbours unique and shared genomic signatures. High frequency of presence of prophages and different types of defence systems were observed. We found that the M. kansasii species splits into four lineages, of which three are lowly represented and mainly in Brazil, while one lineage is dominant and globally spread. Moreover, we show that four sub-lineages of this most distributed M. kansasii lineage emerged during the twentieth century. Further analysis of the M. kansasii genomes revealed almost 300 regions of difference contributing to genomic diversity, as well as fixed mutations that may explain the M. kansasii’s increased virulence and drug resistance.
Structural comparisons of human and mouse fungiform taste buds
Authors: High Brigit , Finger Thomas E.
Published: July 2024

Taste buds are commonly studied in rodent models, but some differences exist between mice and humans in terms of gustatory mechanisms and sensitivities. Whether these functional differences are reflected in structural differences between species is unclear. Using immunofluorescent image stacks, we compared morphological and molecular characteristics of mouse and human fungiform taste buds. The results suggest that while the general features of fungiform taste buds are similar between mice and humans, several characteristics differ significantly. Human taste buds are larger and taller than those of mice, yet they contain similar numbers of taste cells. Taste buds in humans are more heavily innervated by gustatory nerve fibers expressing the purinergic receptor P2X3 showing a 40% higher innervation density than in mice. Like Type II cells of mice, a subset (about 30%) of cells in human taste buds is immunoreactive for PLCβ2. These PLCβ2-immunoreactive cells display CALHM1-immunoreactive puncta closely apposed to gustatory nerve fibers suggestive of channel-type synapses described in mice. These puncta, used as a measure of synaptic contact, are however significantly larger in humans compared to mice. Altogether these findings suggest that while many similarities exist in the structural organization of murine and human fungiform taste buds, significant differences do exist in taste bud size, innervation density, and size of synaptic contacts that may impact gustatory signal transmission.
Improving rigor and reproducibility in chromatin immunoprecipitation assay data analysis workflows with Rocketchip
Authors: Haghani Viktoria , Goyal Aditi , Zhang Alan , Sharifi Osman , Mariano Natasha , Yasui Dag , Korf Ian , LaSalle Janine
Published: July 2024

As genome sequencing technologies advance, the accumulation of sequencing data in public databases necessitates more robust and adaptable data analysis workflows. Here, we present Rocketchip, which aims to offer a solution to this problem by allowing researchers to easily compare and swap out different components of ChIP-seq, CUT&RUN, and CUT&Tag data analysis, thereby facilitating the identification of reliable analysis methodologies. Rocketchip enables researchers to efficiently process large datasets while ensuring reproducibility and allowing for the reanalysis of existing data. By supporting comparative analyses across different datasets and methodologies, Rocketchip contributes to the rigor and reproducibility of scientific findings. Furthermore, Rocketchip serves as a platform for benchmarking algorithms, allowing researchers to identify the most accurate and efficient analytical approaches to be applied to their data. In emphasizing reproducibility and adaptability, Rocketchip represents a significant step towards fostering robust scientific research practices.