bluuebunny/crossref_metadata_2025 huggingface dataset:
Haitian Revolution (1789–1804)
Authors: Geggus David
Published: August 2024

The revolution of 1789–1803 in the French colony of Saint-Domingue exhibited two contrasting types of armed conflict. Uprisings in 1791 by the enslaved and free colored sectors of colonial society gave rise to a long spate of irregular warfare often fought in mountainous and forested terrain. Unprecedented in their scale and outcome, these insurrections led in the period 1791–1793 to the abolition of slavery and of legalized racial inequality, and thereafter evolved into struggles for local autonomy and, in 1803, national independence. At the same time, Saint-Domingue was drawn into the French Revolutionary War and became a participant (and the major prize) in the last of the colonial wars of the Old Regime, in which the armies and navies of European powers had long fought one another for American territory. Both the revolutionary, internal conflict and the traditional, imperial conflict profoundly affected each other’s development, and they came to overlap a good deal in fighting styles and personnel. The revolution in Saint-Domingue is most easily understood as the pursuit of three political goals (freedom, equality, independence) by three social groups (the enslaved, free people of color, white colonists). It began as a struggle for self-government within the white community (1789–1791). This period saw very little armed conflict, although some soldiers mutinied or played political roles. The term Saint-Domingue Revolution, long favored by French writers, acknowledges the event’s multi-class nature and that national independence emerged only belatedly as a central issue. The Anglophone term “Haitian Revolution” and its coupling with the year 1791 is a fairly recent phenomenon; it stresses the primacy of the revolution of the enslaved and its links to the creation of the Haitian state in 1804. The global significance of Haiti’s revolution derives partly from its achievements (its precedence in the histories of antiracism, antislavery, and decolonization) but also because of where it took place. Europe’s main source of tropical produce, Saint-Domingue was a dynamo of the Atlantic economy, a major source of French government revenue, and an important stimulus to the growth of France’s navy.
Fatal occupational injuries in fishing, farming and forestry 2010–2015
Authors: Nazarihaghighipashaki M , Moen B E , Bråtveit M
Published: August 2024

Background

Every year, 2.3 million people worldwide succumb to work-related accidents and illnesses. The primary industries have long been acknowledged with elevated accident risks. Recent levels and trends of injury and associated fatalities in these sectors are uncertain. An enhanced understanding of these risks in these industries is required for effective injury prevention in the future.

Aims

This study aimed to describe registered fatalities in the primary industries worldwide, exploring potential disparities between countries and identifying trends in injury rates.

Methods

Data were obtained on fatal occupational injuries per 100,000 workers in farming, fishing and forestry for the years 2010–2015 from the International Labour Organization ILO-STAT database. Descriptive statistics and mixed-model regression analyses were conducted. Fatal occupational injuries in upper- and middle-income countries were compared.

Results

The study incorporated data from 32 countries: 21 from Europe. America had the highest mean occupational fatality injury rate (76.9). The highest recorded rates for individual countries occurred in Colombia in 2014 (265.2) and Lithuania in 2015 (75.0), and the lowest in Greece in 2012 (0.2). Significant variation in injury rates was evident among the countries. There was no trend in the incidence of fatal injuries from 2010 to 2015, neither for all countries, nor Europe. Middle-income countries had higher occupational fatality injury rate than upper-income countries.

Conclusions

The occupational fatality injury rate exhibited considerable variation, ranging from 0.9 to 265.2, and the injury rate was lowest in upper-income countries. There was no trend in the figures 2010–2015.
Upper gastrointestinal bleed secondary to large right hepatic artery pseudoaneurysm: a case report
Authors: Gautam Swotantra , Neupane Aakash , Singh Gurdeep , Sharbatji Mohamad
Published: August 2024

Hepatic artery pseudoaneurysm (HAP) is a serious rare life-threatening complication of Gastrointestinal surgeries that is often overlooked in diagnostic evaluation due to its rarity. We present a case of 71 years female, with a surgical history of gastric sleeve surgery, Roux-en-Y gastric bypass, and cholecystectomy, presenting with features of upper GI bleeding. Multiple diagnostic modalities were used and finally Magnetic Resonance Mesenteric Angiogram was able to pinpoint the location of the GI bleed as a hepatic artery pseudoaneurysm. Primary surgical repair used to be the mainstay treatment option for managing visceral aneurysms. However, due to advances in technology, embolization as well as implantation of covered stent grafts have become the preferred treatment for such lesions.
Treatment of Acute Myeloid Leukemia in the Community Setting
Authors: Al-Juhaishi Taha , Dela Cruz Servillano , Gupta Rohan , Keiffer Gina , Morrison Vicki A , Shapira Iuliana , Woods Ashley , Norsworthy Kelly , de Claro Romeo Angelo , Theoret Marc R , Garg Ravin , Pulte Elizabeth Dianne
Published: August 2024

The treatment landscape for acute myeloid leukemia (AML) is rapidly changing. Many new agents and lower-intensity regimens have been approved and can be safely used by hematologists and oncologists in both academic and community settings. The US Food and Drug Administration (FDA) held a virtual symposium on AML treatment in the community in November 2022. Several members of the FDA, along with practicing hematologists and oncologists in both academic and community settings, participated in the symposium. The goal of the symposium was to discuss challenges and opportunities in the treatment of patients with AML in community oncology settings. A summary of these discussions and key considerations are presented here.
Senescence-Associated Sugar Transporter1 affects developmental master regulators and controls senescence in Arabidopsis
Authors: Cheng Jintao , Arystanbek Kyzy Meerim , Heide Adrian , Khan Azkia , Lehmann Martin , Schröder Laura , Nägele Thomas , Pommerrenig Benjamin , Keller Isabel , Neuhaus H Ekkehard
Published: August 2024

Sugar transport across membranes is critical for plant development and yield. However, an analysis of the role of intracellular sugar transporters in senescence is lacking. Here, we characterized the role of Senescence-Associated Sugar Transporter1 (SAST1) during senescence in Arabidopsis (Arabidopsis thaliana). SAST1 expression was induced in leaves during senescence and after the application of abscisic acid (ABA). SAST1 is a vacuolar protein that pumps glucose out of the cytosol. sast1 mutants exhibited a stay-green phenotype during developmental senescence, after the darkening of single leaves, and after ABA feeding. To explain the stay-green phenotype of sast1 mutants, we analyzed the activity of the glucose-induced master regulator TOR (target of rapamycin), which is responsible for maintaining a high anabolic state. TOR activity was higher in sast1 mutants during senescence compared to wild types, whereas the activity of its antagonist, SNF1-related protein kinase 1 (SnRK1), was reduced in sast1 mutants under senescent conditions. This deregulation of TOR and SnRK1 activities correlated with high cytosolic glucose levels under senescent conditions in sast1 mutants. Although sast1 mutants displayed a functional stay-green phenotype, their seed yield was reduced. These analyses place the activity of SAST1 in the last phase of a leaf's existence in the molecular program required to complete its life cycle.
Critical tasks and errors associated with intercostal chest drain insertion
Authors: Kuan Samuel , Lynch Richard , Dea Angela O
Published: August 2024

Introduction

To describe critical tasks and errors associated with intercostal chest drain insertion, in order to develop enhanced procedural guidelines for task performance and training.

Methods

Expert emergency medicine physicians participated in a three-phased study. First, hierarchical task analyses was used to identify tasks, sub-tasks, and the sequence of tasks. Second, systematic human error reduction and prediction approach was used to identify and classify the errors associated with each sub-task culminating in a probability, criticality, and detectability rating for each error. Third, failure modes, effects and criticality analysis technique was used to convert probability and criticality estimates to occurrence and severity scores. Criticality index score, a measure of the propensity for the error to cause harm or procedural failure for each error, was calculated and the top 20 errors most likely to cause harm were ranked.

Results

Thirteen tasks and 61 sub-tasks were identified and yielded 86 potential errors. Error classification included errors of action, checking, and selection. The error with the highest criticality score was ‘identifying a point of entry lower than the fifth intercostal space’. The top four ranked errors all relate to the identification and correct marking of the location site for the intercostal drain within the safe triangle.

Conclusions

Tasks and sub-tasks associated with intercostal chest drain insertion was described and evaluated for criticality. The most critical task was the correct identification of a safe insertion point. Applications include development of procedural guidelines with tasks vulnerable to error highlighted and training interventions that promotes safe task performance.
Anti-oxidant activity of coenzyme Q10 against AlCl3/D-galactose in albino rat induced cognitive dysfunctions: Behavioral, biochemical, and BACE-1/GSK-3β alterations
Authors: Nawar Nagat Fawzy , Beltagy Doha Mohammad , Mohamed Tarek Mostafa , Tousson Ehab Mostafa , El-Keey Mai Mahmoud
Published: August 2024

The relationship between amyloid beta (Aβ) and oxidative stress (OS), both prominent factors in Alzheimer’s disease-related neural degeneration, is deeply interconnected. The cleavage of the extracellular domain of Amyloid precursor protein (APP) and phosphorylating different substrates, respectively, the β-site amyloid precursor protein cleaving enzyme-1 (BACE-1) and Glycogen synthase kinase-3-beta (GSK-3β) enzymes initiate the synthesis of Aβ, which causes cognitive deficits in AD. This study aimed to explore the protective potential of Coenzyme Q10 (CoQ10). It also sought to uncover any synergistic effects when combined with donepezil, an acetylcholinesterase inhibitor, in treating Alzheimer’s disease in male albino rats, focusing on the modulation of the BACE-1/GSK-3β pathway. The experiment involved 70 rats categorized into different groups: control, donepezil alone, CoQ10 alone, AD-model, donepezil co-treatment, CoQ10 co-treatment, and CoQ10 + donepezil combination. Various assessments, such as cholinesterase activity, oxidative stress, serum iron profile, Brain Derived Neurotrophic Factor (BDNF), Tau protein, β-site amyloid precursor protein cleaving enzyme-1 (BACE-1), phosphatase and tensin homolog (Pten), and Glycogen synthase kinase-3-beta (GSK-3β), were conducted on behavioral and biochemical aspects. CoQ10 treatment demonstrated memory improvement, enhanced locomotion, and increased neuronal differentiation, mainly through the inhibition of the dual BACE-1/GSK-3β. These findings were substantiated by histological and immunohistological examinations of the hippocampus.

Highlights Alzheimer’s disease (AD) led to the alteration of BACE-1/GSK-3β. Coenzyme Q10 (CoQ10) alleviated D-Gal and AlCl3-induced passive avoidance memory deficits in rats. CoQ10 counteracts Alzheimer’s disease by inhibiting acetylcholine esterase. CoQ10 significantly increases levels of BDNF and diminishes Tau burden. CoQ10 acts as a dual BACE1/GSK3β inhibitor. The combination of CoQ10 treatment and donepezil demonstrated potential as a therapeutic approach.
How not to describe a species: lessons from a tangle of anacondas (Boidae: Eunectes Wagler, 1830)
Authors: Wüster Wolfgang , Kaiser Hinrich , Hoogmoed Marinus S , Ceríaco Luis M P , Dirksen Lutz , Dufresnes Christophe , Glaw Frank , Hille Axel , Köhler Jörn , Koppetsch Thore , Milto Konstantin D , Shea Glenn M , Tarkhnishvili David , Thomson Scott A , Vences Miguel , Böhme Wolfgang
Published: August 2024

A recent revision of the anacondas (Serpentes: Boidae: Eunectes), with the description of a new species of green anaconda, generated extensive publicity, but also provoked considerable controversy due to inadequacies of the evidence used and errors in nomenclature. We here use the case of this problematic publication to: (i) highlight common issues affecting species delimitations, especially an over-reliance on mitochondrial DNA data, and reiterate best practices; (ii) reanalyse the data available for anacondas to establish the true current state of knowledge and to highlight lines of further research; and (iii) analyse the nomenclatural history and status of the genus. While our analysis reveals significant morphological variation in both green and yellow anacondas, denser sampling and an analysis of informative nuclear markers are required for meaningful species delimitation in Eunectes. Tracing the history of name-bearing types establishes Trinidad as the type locality for Boa murina Linnaeus, 1758 and allows identification of the extant lectotype for the species. Finally, we emphasize the responsibility of both journals and authors to ensure that published taxonomic work meets the burden of evidence required to substantiate new species descriptions and that species are named in compliance with the rules of zoological nomenclature.
Activation of nociception‐sensitive ionotropic glutamate receptor‐expressing rostroventrolateral medulla neurons by stimulation of cardiac afferents in rats
Authors: Zahner Matthew R. , Oculam Cade C. , Beaumont Eric
Published: August 2024

Myocardial ischemia causes the release of bradykinin, which activates afferent nerve endings in the ventricular epicardium. This elicits a sympathetically mediated increase in arterial pressure and heart rate, referred to as the cardiogenic sympathetic afferent reflex. The rostroventrolateral medulla (RVLM) is a key sympathetic brain stem site for regulating cardiovascular activity. This study aimed to determine the importance of non‐barosensitive nociception sympathetic activity and the role of glutamate receptor activation of RVLM neurons in the cardiogenic sympathetic afferent reflex. We tested the hypothesis that inhibition of barosensitive sympathetic activity attenuates but does not abolish the reflex response to cardiac visceral afferents. Renal sympathetic nerve activity (RSNA), arterial pressure, and heart rate responses to epicardial bradykinin application were recorded in anesthetized rats before and after bilateral RVLM microinjection of either GABAA agonist muscimol, ionotropic glutamate receptor antagonist kynurenic acid, N‐methyl‐d‐aspartate (NMDA) receptor antagonist 2‐amino‐5‐ phosphonopentanoic acid (AP5), or non‐NMDA antagonist 6‐cyano‐7‐nitroquinoxaline‐2,3‐dione (CNQX). Baroreceptor loading‐induced inhibition of barosensitive activity attenuated the bradykinin‐induced RSNA response (93 ± 14% increase) and tachycardia (18 ± 3 bpm). While RVLM muscimol microinjection abolished the RSNA response (1.6 ± 4.2% from baseline, 0.49 ± 0.38 μV*s), surprisingly, it did not abolish the tachycardia (27 ± 4 bpm). Kynurenic acid microinjection blocked the arterial pressure and RSNA responses, while AP5 or CNQX only attenuated the responses. These data suggest that nociception‐sensitive sympathetic activity that does not appear to be barosensitive is also involved in the cardiogenic sympathetic afferent reflex. Importantly, while muscimol and kynurenic acid abolished the arterial pressure and RSNA response, neither affected the tachycardia, suggesting an alternate cardiac pathway independent of RVLM.
Maternal History of Childhood Maltreatment and Pregnancy Weight Outcomes
Authors: Mason Susan M. , Farkas Kriszta , Bodnar Lisa M. , Friedman Jessica K. , Johnson Sydney T. , Emery Tavernier Rebecca L. , MacLehose Richard F. , Neumark-Sztainer Dianne
Published: August 2024

Background:

Childhood maltreatment is associated with elevated adult weight. It is unclear whether this association extends to pregnancy, a critical window for the development of obesity.

Methods:

We examined associations of childhood maltreatment histories with prepregnancy body mass index (BMI) and gestational weight gain among women who had participated for >20 years in a longitudinal cohort. At age 26–35 years, participants reported childhood maltreatment (physical, sexual, and emotional abuse; emotional neglect) and, 5 years later, about prepregnancy weight and gestational weight gain for previous pregnancies (n = 656). Modified Poisson regression models were used to estimate associations of maltreatment history with prepregnancy BMI and gestational weight gain z-scores, adjusting for sociodemographics. We used multivariate imputation by chained equations to adjust outcome measures for misclassification using data from an internal validation study.

Results:

Before misclassification adjustment, results indicated a higher risk of prepregnancy BMI ≥30 kg/m2 in women with certain types of maltreatment (e.g., emotional abuse risk ratio = 2.4; 95% confidence interval: 1.5, 3.7) compared with women without that maltreatment type. After misclassification adjustment, estimates were attenuated but still modestly elevated (e.g., emotional abuse risk ratio = 1.7; 95% confidence interval: 1.1, 2.7). Misclassification-adjusted estimates for maltreatment associations with gestational weight gain z-scores were close to the null and imprecise.

Conclusions:

Findings suggest an association of maltreatment with prepregnancy BMI ≥30 kg/m2 but not with high gestational weight gain. Results suggest a potential need for equitable interventions that can support all women, including those with maltreatment histories, as they enter pregnancy.
Parent Experiences of Empowerment
Authors: Grafft Natalie , Gago Cristina , Garcia Evelin , Aftosmes-Tobio Alyssa , Jurkowski Janine M. , Blaine Rachel E. , Davison Kirsten K.
Published: August 2024

Background:

Establishing healthy behaviors during a child’s first 5 years is essential for healthy growth. Parents are targeted as agents of change because they serve as primary models of behavior during this period. Although parent-focused interventions often target empowerment as a driver of change, our understanding of how parents experience the process of empowerment in the context of child health promotion remains limited.

Objective:

This qualitative study explored the process by which parents gain empowerment through participation in a health promotion intervention.

Methods:

Semi-structured interviews were conducted with 37 low-income parents who participated in Parents Connect for Healthy Living (PConnect), a 10-week empowerment-centered obesity prevention intervention. Data were analyzed using inductive-deductive thematic analysis and guided by empowerment theories.

Results:

Most parents were Hispanic/Latino (41%) and female (97%). Five themes emerged that correspond to the process by which parents gained empowerment: (1) friendships formed and relationships strengthened during PConnect, (2) parents strengthened relationships with their children and believed in their ability to parent successfully, (3) the experience of knowledge led to behavior change, (4) parents used new resources to improve family health, and (5) parents took action.

Conclusion:

Empowerment theory should be a component of health promotion programs.
Proceedings of EIMN’s 1st European Immunometabolism Conference
Authors: Ketelhuth Daniel F. J. , Desler Claus , Cordes Thekla , Corrrado Mauro , Argüello Rafael J. , Everts Bart , Van den Bossche Jan ,   on behalf of the European Immunometabolism Network (EIMN)
Published: August 2024

The 1st European Immunometabolism Conference was organized by the European Immunometabolism Network (EIMN) in Køge near Copenhagen, Denmark from June 26 to June 28, 2024. This conference and network aims to serve as a platform for presenting and discussing the latest and most significant advances in European immunometabolism research. Our vision includes promoting collaboration, training, networking opportunities, and diversity in science, especially for early career and upcoming scientists. Here, we summarize the immunometabolism-related work that was presented during the meeting by members of the network, selected early career researchers, session speakers, and keynote speakers. Additionally, we provide an overview of the discussion points from the round table session and conclude with future aims and planned initiatives of the EIMN.
Surgical Challenges in the Management of Respiratory Epithelial Cyst Involving the Lacrimal Sac
Authors: Sreekumar Sruthi Rethy , Jakati Saumya , Ali Mohammad Javed
Published: August 2024

Respiratory epithelial cysts are uncommon lesions that can be congenital or acquired cystic malformations. Beyond the respiratory system, the location of the respiratory epithelial cyst has been described in the central nervous system, orbits, and the maxillofacial region. The common etiology is believed to be sequestration or entrapment of the epithelial cells of the paranasal sinus. To the best of the authors’ knowledge, there are no prior reports on respiratory epithelial cyst involving the lacrimal sac. The present case reports the computed tomography-dacryocystography and endoscopic features and surgical challenges in the management of one such exceptionally rare case.
Association Between Social Jetlag and Components of Metabolic Syndrome: A Systematic Review and Meta-Analysis
Authors: LIN Mei-Yu , KANG Yi-No , APRILIYASARI Renny Wulan , TSAI Pei-Shan
Published: August 2024

Background

A mismatch between biological and social time, often referred to as social jetlag (SJL), can lead to inadequate sleep and activities or taking meals at times that do not align with our biological rhythms, increasing the risk of metabolic abnormalities. Although the association between sleep and metabolic syndrome (MetS) is well established, the effects of SJL on MetS and the components of MetS in adults remain unclear.

Purpose

This study was designed to explore the relationship between SJL and MetS components in adults.

Methods

A systematic review and meta-analysis was conducted on studies registered in PubMed, Cochrane, Web of Science, and Embase between the inception of each database until November 15, 2023. We focused on studies designed to evaluate the relationship between SJL and either MetS or its components. Only studies using cross-sectional, prospective, or retrospective designs were considered for inclusion. The relationship between SJL and MetS was depicted as an odds ratio with a corresponding 95% confidence interval (CI). We determined the mean differences and 95% CIs to estimate the associations between SJL and MetS components. The Joanna Briggs Institute Critical Appraisal Checklist was used to evaluate the methodological rigor of the selected studies. Data were analyzed using RevMan software Version 5.4.

Results

The systematic review included 16 studies, with five analyzed via a meta-analysis covering four outcomes, each based on two to three studies. When comparing SJL of less than 1 hour with SJL of 2 hours or more, the latter showed a higher likelihood of MetS (pooled odds ratio: 1.52). Although a significant decrease in systolic blood pressure (pooled mean differences = −3.52 mmHg, 95% CI [−6.41, −0.64]) and a significant increase in waist circumference (pooled mean differences = 2.17 cm, 95% CI [0.61, 3.73]) were observed, the correlation between SJL and diastolic blood pressure failed to reach statistical significance.

Conclusions/Implications for Practice

The meta-analysis conducted in this study found an association between SJL and MetS. Healthcare practitioners should prioritize the management of sleep quality and duration, especially for individuals exhibiting substantial SJL. Improving sleep can aid in controlling blood pressure and managing weight and should form part of MetS management strategies.
Breaking up Sitting Time With Isometric Wall Squat Exercise During Occupational Activities
Authors: Silva Jefferson Maxwell , Cavalcante Anderson , Rêgo Theo Victor Alves Soares , Henriques Dayanne Kerollyn Sousa , Cucato Gabriel Grizzo , Ritti-Dias Raphael Mendes , Farah Breno Quintella
Published: August 2024

Objective

The aim of to analyze the feasibility of isometric wall squat exercise (IWSE) over a 12-week period as a method of breaking up sitting time during occupational activities in sedentary adults.

Methods

This feasibility randomized study involved sedentary adults. Participants in the IWSE group (n = 12) performed isometric wall squats, while participants in the STAND group (n = 12) were recommended to stand up for 12 weeks. Feasibility was assessed through online questionnaires in the eighth week regarding adherence, safety, satisfaction, and acceptability.

Results

Adherence to weekly breaks was similar between groups (P > 0.05). No serious side effects have been reported in the groups. Dropout rates (IWSE: 40% vs STAND: 40%, P = 1.000), satisfaction (IWSE +3.4 [1.2] vs STAND +3.0 [1.7], P = 0.709), and intention to continue with the intervention (IWSE: 75% vs STAND: 83%, P = 0.368) were similar between groups.

Conclusions

The IWSE is as feasible as stand up as a strategy to breaking up sedentary time in workplace.
The reporting of social determinants of health in pediatric dermatology clinical trials: a systematic review
Authors: Nwankwo Christy , Livinski Alicia A. , Heath Candrice R. , Castelo-Soccio Leslie
Published: August 2024

Background:

Despite the acknowledgment of the importance of social determinants of health (SDOH) on clinical outcomes, few clinical trials provide information about SDOH. Including these markers in pediatric dermatologic clinical trials may lead to improved care and novel observations about the disease.

Objective:

Using a systematic review, assess the use of SDOH in pediatric dermatology clinical trials.

Methods:

CINAHL Plus, Cochrane: CENTRAL, Embase, PubMed, and Scopus were searched. English language randomized controlled trials about pediatric dermatology diseases published from January 2011 to May 2022 were included. Two authors independently screened all records using Covidence at 2 levels. Two authors independently collected data using Covidence and Microsoft Excel and assessed study quality. A protocol was registered at Open Science Framework: https://doi.org/10.17605/OSF.IO/B93VY.

Results:

A total of 6463 records were retrieved and 4298 were screened at title/abstract. Next, 1738 records were screened at full text and 1085 were included. Of these, 119 reported an SDOH factor for a pediatric dermatology disease. Income or socioeconomic status was the factor most reported followed by social support, location, and health insurance. Most of the studies were conducted outside of the United States.

Limitations:

There are a limited number of dermatology clinical trials that include a pediatric population.

Conclusion:

Despite including over 1000 pediatric dermatology clinical trials, only 119 used SDOH. Pediatric dermatology researchers must prioritize including and reporting additional SDOH in clinical trials if the goal is to impact and improve clinical care and innovate for diverse populations of patients.
The Diagnostic Performance of the Visitect Advanced Disease Point-Of-Care CD4 Platform: A Pragmatic, Mixed-Methods, Multisite Validation, Costing, and Qualitative Analysis
Authors: Nalintya Elizabeth , Sekar Preethiya , Namakula Olive L. , Tadeo Kiiza Kandole , Kwizera Richard , Apeduno Lucy , Naluyima Diana Rose , Nanano Rachel , Mujungu Lilian , Lehman Alice , Adzemovic Tessa , Amperiize Mathius , Kavuma Paul , Kasone Viola , Fieberg Ann , Nerima Patricia , Dai Biyue , Meya David B. , Boulware David R. , Rajasingham Radha
Published: August 2024

Background:

The Visitect CD4 Advanced Disease test (AccuBio, Alva, United Kingdom) is a rapid, semiquantitative assay that estimates CD4 results above or below 200 cells per microliter. We evaluated the performance of the Visitect CD4 assay in semiurban laboratories in Uganda.

Methods:

We performed a pragmatic laboratory validation of the Visitect CD4 platform in 4 routine HIV clinics in Uganda, nested within a cluster randomized trial evaluating an enhanced package of screening and treatment for persons with advanced HIV disease (NCT05085171). As part of the clinical trial, samples processed on the Visitect CD4 platform were confirmed using another CD4 testing method. We compared the diagnostic performance of the Visitect CD4 platform against the confirmatory method by evaluating the sensitivity, specificity, and positive and negative predictive values.

Results:

Of 1495 venous blood samples that were processed both by the Visitect CD4 test and another confirmatory CD4 platform at clinics in Kampala, Uganda, specificity was 81% [95% confidence interval (CI): 79% to 84%] and the positive predictive value was 69% (95% CI: 66% to 73%). There were no samples for which the Visitect test was >200 cells per microliter and the confirmatory test was ≤200 cells per microliter, resulting in a sensitivity of 100%. Among Visitect CD4 tests that were read as ≤200 cells per microliter with confirmatory results >200 cells per microliter, the median confirmatory CD4 result was 397 (IQR, 281–590) cells per microliter. Specificity varied by clinic ranging from 63% to 99%.

Conclusions:

Given variable specificity of the Visitect CD4 Advanced Disease platform, successful implementation will require consideration of clinic context and laboratory staffing.
Beyond the Conventional Structural MRI
Authors: Choi Yangsean , Ko Ji Su , Park Ji Eun , Jeong Geunu , Seo Minkook , Jun Yohan , Fujita Shohei , Bilgic Berkin
Published: August 2024

Recent technological advancements have revolutionized routine brain magnetic resonance imaging (MRI) sequences, offering enhanced diagnostic capabilities in intracranial disease evaluation. This review explores 2 pivotal breakthrough areas: deep learning reconstruction (DLR) and quantitative MRI techniques beyond conventional structural imaging. DLR using deep neural networks facilitates accelerated imaging with improved signal-to-noise ratio and spatial resolution, enhancing image quality with short scan times. DLR focuses on supervised learning applied to clinical implementation and applications. Quantitative MRI techniques, exemplified by 2D multidynamic multiecho, 3D quantification using interleaved Look-Locker acquisition sequences with T2 preparation pulses, and magnetic resonance fingerprinting, enable precise calculation of brain-tissue parameters and further advance diagnostic accuracy and efficiency. Potential DLR instabilities and quantification and bias limitations will be discussed. This review underscores the synergistic potential of DLR and quantitative MRI, offering prospects for improved brain imaging beyond conventional methods.
Assessment of the Change in the Nasal Septum and Nasal Profile After Le Fort I With Cone Beam Computed Tomography
Authors: Canbaz Barış , Yılancı Hilal
Published: August 2024

Objective

This study aimed to determine the relationship between nasal changes and the amount of advancement, impaction, and downward movement of the maxilla after Le Fort I osteotomy.

Methods

The study included 48 patients who underwent Le Fort I surgery and had pre- and postoperative cone-beam computed tomography records. Changes in the nasal septum were evaluated by measuring septal deviation angles and volumes. In addition, nasolabial angle and width of nasal and alar base were examined. Groups were determined according to the movement of point A (the deepest point on the curvature of the maxillary alveolar process), using a threshold of 1.5 mm for vertical movements and 4 mm for sagittal movements. This resulted in the comparison of 6 groups of 8 people each. Results are presented as mean and standard deviation or median and range depending on the data distribution. Significance level was accepted as P < 0.05.

Result

There were no significant differences for each group on its own septal deviation volume or angle values pre/postoperatively. Groups 3 and 5, which both had at least 1.5 mm of impaction, showed significant changes in both deviation angle and volume between the preoperative and postoperative measurements. Nasolabial angle did not show significant changes between groups. Alar base width and nasal width increase was significantly highest in Group 1, which has more than 4 mm sagittal movement and less than 1.5 mm vertical movement.

Conclusions

Le Fort I osteotomy may lead to undesirable changes in the spatial positioning of the nasal septum. The results of this study suggest that maxillary advancement does not significantly impact septal deviation, whereas maxillary impaction increases the amount of deviation. In addition, nasal width and alar base width tended to increase, and the nasolabial angle tended to decrease slightly, regardless of the direction of movement of the maxilla after orthognathic surgery.

Clinical Relevance

Surgeons should consider increased nasal septal deviation risks when planning impaction of the maxilla. The soft tissue changes in the nose vary according to different directions and amounts of Le Fort I surgery.
FACTORS INFLUENCING LATE PROGNOSIS IN PATIENTS WITH ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION TREATED WITH DIRECT PERCUTANEOUS CORONARY INTERVENTION
Authors: Li Yonghong , Cao Guangke
Published: August 2024

Objective: To investigate factors influencing the late prognosis of patients with acute ST-segment elevation myocardial infarction treated by direct percutaneous coronary intervention. Methods: We retrospectively analyzed 349 ST-segment elevation myocardial infarction patients treated with direct percutaneous coronary intervention. Patients were categorized based on catheter laboratory activation time (CLAT) (≤15 or >15 min), time of arrival (working hours or out-of-hours), and mode of arrival (emergency medical services transportation or self-presentation). The primary endpoint was the 2-year major adverse cardiovascular events (MACEs), defined as all-cause death, nonfatal myocardial infarction, and target vessel revascularization. Results: Patients with CLAT ≤15 min showed significant differences in oxygen saturation, FMC-to-device time, symptom-to-device time, symptom-to-FMC time, presentation mode, presentation duration, and MACEs (all P < 0.005). Self-presentation (odds ratio = 0.593, 95% confidence interval = 0.413–0.759) and out-of-hours presentation (odds ratio = 0.612, 95% confidence interval = 0.433–0.813) were risk factors for CLAT >15 min. The working-hours group showed significant differences in FMC-to-device time, activation-to-arrival time at the catheter laboratory, and the number of cases with activation time ≤15 min (all P < 0.005). The emergency medical services and self-presentation groups differed significantly in age, blood pressure, FMC-to-device time, and electrocardiography-to-CLAT (all P < 0.005). Conclusion: Reducing CLAT to 15 min significantly lowers the 2-year MACE rate. Self-presentation and out-of-hours presentation are risk factors for delayed catheter laboratory activation.
CLINICAL APPLICATION OF EARLY POSTOPERATIVE NUTRITIONAL SUPPORT IN PATIENTS WITH HIGH-RISK VALVULAR HEART DISEASE
Authors: Xu Xiangyang , Zhang Boyao , Tan Mengwei , Fan Xingli , Chen Qian , Xu Zhiyun , Tang Yangfeng , Han Lin
Published: August 2024

Background: The treatment strategy of early nutritional support after cardiac surgery has gradually been adopted. However, there are no scientific guidelines for the timing and specific programs of early nutritional support. Methods: A retrospective, single-center analysis (2021–2023) was carried out including elderly patients who were admitted for valvular heart disease and received open-heart valve replacement surgery. We designated patients who started the optimized nutritional support after surgery as the optimized enteral nutritional support strategy TN (EN) group and those who received traditional nutritional support as the traditional nutritional support strategy (TN) group. The nutritional and immune indexes, postoperative complications, length of hospital stay, and hospitalization cost of the two groups were compared and analyzed. Results: We identified 378 eligible patients, comprising 193 (51%) patients in the EN group and 185 (49%) patients in the TN group. There was no significant difference in hospital mortality between the two groups, but the proportion of nosocomial pneumonia was significantly lower in the EN group than in the TN group (P < 0.001). In the Poisson regression analysis, EN was not associated with an increase in gastrointestinal complications (P = 0.549). The EN group also seemed to have shorter hospital stays and lower hospitalization expenses (P < 0.001). In the comparison of postoperative gastrointestinal complications, fewer patients experienced diarrhea (P = 0.021) and abdominal distension (P = 0.033) in the EN group compared with the TN group. Conclusion: The optimal nutritional support strategy could effectively improve the clinical outcome of high-risk patients with valvular heart disease.
THE IMPACT OF SCHISTOCYTE DETECTION ON MORTALITY AND ORGAN FAILURE IN PATIENTS WITH SEPSIS
Authors: Tanaka Tomoki , Fujino Kazunori , Tsujita Yasuyuki , Matsumoto Yugo , Fujino Mitsuhiro , Miyatake Hidemitsu , Mizumura Naoto , Kato Takayuki , Shimizu Junji , Kishimoto Takuma , Shiomi Naoto
Published: August 2024

Purpose: This study aimed to investigate the presence of schistocytes in patients with sepsis and its association with mortality and organ failure. Methods: We conducted a retrospective observational study at Shiga University of Medical Science Hospital, Japan, from January 2015 to April 2021. This study included patients diagnosed with sepsis or septic shock. Schistocytes were identified through daily hematological examinations. Moreover, data on mortality rates and organ failure based on Sequential Organ Failure Assessment scores were systematically collected and analyzed. Results: Schistocytes were detected in 41 of the 330 patients with sepsis. The presence of schistocytes was associated with significantly high 90-day and 1-year mortality rates (48.7% and 68.2%, respectively; P < 0.001). Patients with schistocytes exhibited higher Sequential Organ Failure Assessment scores, particularly in the coagulation and renal components, indicating more severe organ failure than that observed in patients without schistocytes. These findings persisted even after adjusting for confounding factors, such as age, sex, and baseline comorbidities. Additionally, we observed that patients with schistocytes required frequent red blood cells, further highlighting the severity of their conditions. Conclusion: Schistocytes are significantly associated with increased long-term mortality and organ failure in patients with sepsis. Their detection may provide crucial insights into disease severity, guide targeted therapeutic strategies, and potentially improve the long-term outcomes of sepsis management.
RESEARCH PROGRESS ON THE ROLE OF GUT MICROBIOTA AND ITS METABOLITES IN THE OCCURRENCE AND DEVELOPMENT OF SEPTIC-ASSOCIATED LIVER INJURY
Authors: Chen Jiangtao , Song Yu , Zeng Wenqing , Wang Lei , Qin Jinyan , Fang Lexin , Ding Yueping
Published: August 2024

Sepsis is a life-threatening organ dysfunction that occurs due to a dysregulated host response to infection. Septic-associated liver injury (SALI) has been closely linked to the prognosis and mortality of sepsis. Recent investigations have delved into the gut-liver axis and its association with SALI, identifying its pivotal role in the gut microbiota. Bacterial translocation and the onset of SALI can occur due to an imbalance in the gut microbiota, impairing the function of the gut barrier. Moreover, their metabolites might exacerbate or initiate SALI by modulating immune responses. Nevertheless, interventions to restore the balance of the gut microbiota, such as the administration of probiotics, fecal microbiota transplantation, or dietary adjustments, may ameliorate SALI and enhance the prognosis and survival rates of septic patients. This review aimed to elucidate the function of the gut microbiota in the genesis and procession of SALI and its potential therapeutic value, offering a deeper understanding of the pathogenesis and therapeutic avenues for SALI.
THE DELIVERY OF PD-L1 SIRNA BY NEUTROPHIL-TARGETED LIPID NANOPARTICLES EFFECTIVELY AMELIORATES SEPSIS
Authors: Zhu Cheng-long , Wang Yi , Ren Shi-chun , Yu Chang-meng , Sun Xiao-yang , Liu Zhi-li , Li Qian-qian , Guo De-zhi , Chen Yu , You Jia , Wang Jia-feng
Published: August 2024

Background: Sepsis, a complex and life-threatening disease, poses a significant global burden affecting over 48 million individuals. Recently, it has been reported that programmed death-ligand 1 (PD-L1) expressed on neutrophils is involved in both inflammatory organ dysfunction and immunoparalysis in sepsis. However, there is a dearth of strategies to specifically target PD-L1 in neutrophils in vivo. Methods: We successfully developed two lipid nanoparticles (LNPs) specifically targeting neutrophils by delivering PD-L1 siRNA via neutrophil-specific antibodies and polypeptides. In vivo and in vitro experiments were performed to detect lipid nanoparticles into neutrophils. A mouse cecal ligation and puncture model was used to detect neutrophil migration, neutrophil extracellular traps level, and organ damage. Result: The PD-L1 siRNA-loaded LNPs that target neutrophils suppressed inflammation, reduced the release of neutrophil extracellular traps, and inhibited T-lymphocyte apoptosis. This approach could help maintain homeostasis of both the immune and inflammatory responses during sepsis. Furthermore, the PD-L1 siRNA-loaded LNPs targeting neutrophils have the potential to ameliorate the multiorgan damage and lethality resulting from cecal ligation and puncture. Conclusions: Taken together, our data identify a previously unknown drug delivery strategy targeting neutrophils, which represents a novel, safe, and effective approach to sepsis therapy.
The Reliability of 3-Dimensional Endoanal Ultrasonography Early and Late Postpartum
Authors: Gräs Søren , Starck Marianne , Jangö Hanna , Lose Gunnar , Klarskov Niels
Published: August 2024

Importance

There is no consensus on how to define obstetric anal sphincter defects detected by 3-dimensional endoanal ultrasonography (3D-EAUS), and the reported rates vary significantly in the postpartum period.

Objective

The objective of this study was to establish a diagnostic strategy with a high and clinically relevant interrater reliability both early and late postpartum.

Study Design

The study was prospective and observational, and 3D-EAUS was performed 10–14 days and 9–12 months postpartum in an unselected cohort of primiparous women with vacuum-assisted deliveries. Two experienced examiners evaluated the ultrasonographic results, which were divided into the categories intact, inconclusive, small, moderate, and large defects based on Starck scores. Three different diagnostic strategies were validated, and the prevalence- and bias-adjusted kappa (PABAK) values calculated.

Results

Of 334 eligible women, 184 (55.1%) completed both examinations. Disagreements involving small defects were predominant and observed in 34 and 39 cases, respectively, at the 2 time points. The highest overall agreement rates (91.3% and 92.4%, respectively) and PABAK values (0.83 and 0.85, respectively) were reached when the disagreements were minimized by dichotomizing the results into Starck scores >4 (designated a significant defect) versus Starck scores 0–4 (all others).

Conclusions

The interrater reliability of detecting small anal sphincter defects by 3D-EAUS was low at both time points for the 2 experienced raters. In contrast, the interrater reliability of detecting a significant defect was classified as almost perfect agreement at both time points.
Anthropofabrication and the redressing of memory: an embodied approach to comparative cognition
Authors: Van Woerkum Bas , Barrett Louise
Published: August 2024

On what basis do researchers posit that humans and other animals share cognitive capacities? We argue that such claims are not based on inherent, pre-existing similarities, but rather emerge through a two-step process, which we will call ‘anthropofabrication’. In the initial stage, embodied action-based strategies and environmental context in human studies are ignored owing to the need for measurement and quantification. Consequently, cognitive terms become disconnected from the context to which we apply them, and human classificatory cognitive terms are transformed into broad explanatory terms, assumed to be ‘species-neutral’. The second phase entails translating and applying these generalized explanatory terms to specific nonverbal animals in ways that serve to further cloak differences between animals and other species. Here, again, researchers selectively discard contextual information to facilitate the comparison with humans. To limit anthropofabrication, we should (re)acknowledge that cognitive abilities are not species-neutral and cannot be detached from embodied action, perception and their context of occurrence. We illustrate our points about anthropofabrication using the example of memory research.

This article is part of the theme issue ‘Minds in movement: embodied cognition in the age of artificial intelligence’.
Embodiment in the enfacement illusion is mediated by self–other overlap
Authors: Payne Bryony , Catmur Caroline
Published: August 2024

The enfacement illusion is a facial version of the rubber hand illusion, in which participants experience tactile stimulation of their own faces synchronously with the observation of the same stimulation applied to another’s face. In previous studies, participants have reported experiencing an illusory embodiment of the other’s face following synchronous compared to asynchronous stimulation. In a series of three experiments, we addressed the following three questions: (i) how does similarity between the self and the other, operationalized here as being of the same or different gender to the other, impact the experience of embodiment in the enfacement illusion; (ii) does the experience of embodiment result from alterations to the self-concept; and (iii) is susceptibility to the experience of embodiment associated with interoceptive processing, i.e. perception of the internal state of the body? Results indicate that embodiment is facilitated by the similarity between the self and the other and is mediated by the incorporation of the other into the self-concept, but sensitivity to one’s own internal states does not impact upon embodiment within the enfacement illusion.

This article is part of the theme issue ‘Minds in movement: embodied cognition in the age of artificial intelligence’.