bluuebunny/crossref_metadata_2025 huggingface dataset:
Load carriage changes tibiofemoral arthrokinematics during ambulatory tasks in recruit-aged women
Authors: Johnson Camille C. , Dzewaltowski Alex C. , Dever Dennis E. , Krajewski Kellen T. , Rai Ajinkya , Ahamed Nizam U. , Allison Katelyn F. , Flanagan Shawn D. , Graham Scott M. , Lovalekar Mita , Anderst William J. , Connaboy Chris
Published: April 2024

The introduction of women into U.S. military ground close combat roles requires research into sex-specific effects of military training and operational activities. Knee osteoarthritis is prevalent among military service members; its progression has been linked to occupational tasks such as load carriage. Analyzing tibiofemoral arthrokinematics during load carriage is important to understand potentially injurious motion and osteoarthritis progression. The study purpose was to identify effects of load carriage on knee arthrokinematics during walking and running in recruit-aged women. Twelve healthy recruit-aged women walked and ran while unloaded (bodyweight [BW]) and carrying additional + 25%BW and + 45%BW. Using dynamic biplane radiography and subject-specific bone models, tibiofemoral arthrokinematics, subchondral joint space and center of closest contact location between subchondral bone surfaces were analyzed over 0–30% stance (separate one-way repeated measures analysis of variance, load by locomotion). While walking, medial compartment contact location was 5% (~ 1.6 mm) more medial for BW than + 45%BW at foot strike (p = 0.03). While running, medial compartment contact location was 4% (~ 1.3 mm) more lateral during BW than + 25%BW at 30% stance (p = 0.04). Internal rotation was greater at + 45%BW compared to + 25%BW (p < 0.01) at 30% stance. Carried load affects tibiofemoral arthrokinematics in recruit-aged women. Prolonged load carriage could increase the risk of degenerative joint injury in physically active women.
Ecological inferences on invasive carp survival using hydrodynamics and egg drift models
Authors: Xu Ruichen , Chapman Duane C. , Elliott Caroline M. , Call Bruce C. , Jacobson Robert B. , Wang Binbin
Published: April 2024

Bighead carp (Hypophthalmichthys nobilis), silver carp (H. molitrix), black carp (Mylopharyngodon piceus), and grass carp (Ctenopharyngodon idella), are invasive species in North America. However, they hold significant economic importance as food sources in China. The drifting stage of carp eggs has received great attention because egg survival rate is strongly affected by river hydrodynamics. In this study, we explored egg-drift dynamics using computational fluid dynamics (CFD) models to infer potential egg settling zones based on mechanistic criteria from simulated turbulence in the Lower Missouri River. Using an 8-km reach, we simulated flow characteristics with four different discharges, representing 45–3% daily flow exceedance. The CFD results elucidate the highly heterogeneous spatial distribution of flow velocity, flow depth, turbulence kinetic energy (TKE), and the dissipation rate of TKE. The river hydrodynamics were used to determine potential egg settling zones using criteria based on shear velocity, vertical turbulence intensity, and Rouse number. Importantly, we examined the difference between hydrodynamic-inferred settling zones and settling zones predicted using an egg-drift transport model. The results indicate that hydrodynamic inference is useful in determining the ‘potential’ of egg settling, however, egg drifting paths should be taken into account to improve prediction. Our simulation results also indicate that the river turbulence does not surpass the laboratory-identified threshold to pose a threat to carp eggs.
Association between Baltic sea diet and healthy Nordic diet index with risk of non-alcoholic fatty liver disease: a case–control study
Authors: Rasoulizadeh Zahra , Namazi Abolfazl , Sohouli Mohammad Hassan , Rohani Pejman , Hekmatdoost Azita , Hosseinzadeh Mahdieh
Published: April 2024

Recent evidence shows the beneficial effects of Baltic Sea diet score (BSDS) and healthy Nordic diet index (HNDI) on chronic diseases, however, there is no evidence to investigate them on the risk of non-alcoholic fatty liver disease (NAFLD). The purpose of this study was to investigate the associations between BSDS and HNDI with the risk of NAFLD. In this case–control study, 552 people in good health and 340 people with NAFLD over the age of 18 took part. The evaluation of BSDS and HNDI employed a validated 168-item semi-quantitative food frequency questionnaire (FFQ). Binary logistic regression was used to determine how OBS and NAFLD are related. The mean BSDS and HNDI were 16.00 ± 2.49 and 11.99 ± 2.61, respectively. The final model's confounder adjustment revealed that greater HNDI adherence scores gave protection against the occurrence of NAFLD (odds ratio [OR]: 0.42; 95% confidence interval [CI] 0.18–0.98; P for trend = 0.043). In addition, those with the highest BSDS scores had significantly lower risks of developing NAFLD compared to subjects with the lowest scores (OR = 0.48, 95% CI 0.32–0.89; p for trend = 0.003). Our findings showed that following a healthy Nordic diet can significantly prevent the risk of developing NAFLD, and suggest that the highly nutritious components of the Nordic diet are beneficial for the prevention of NAFLD.
Janus structure hydrogels: recent advances in synthetic strategies, biomedical microstructure and (bio)applications
Authors: Zhu Taifu , Wan Lei , Li Ruiqi , Zhang Mu , Li Xiaoling , Liu Yilong , Cai Dingjun , Lu Haibin
Published: April 2024

Janus structure hydrogels (JSHs) are novel materials. Their primary fabrication methods and various applications have been widely reported.
The molecular diversity of dissolved organic matter in forest streams across central Canadian boreal watersheds
Authors: Mangal V. , Lam W. Y. , Emilson E. J. S. , Mackereth R. W. , Mitchell C. P. J.
Published: April 2024

Small headwater streams can mobilize large amounts of terrestrially derived dissolved organic matter (DOM).
Fabrication and characterization of a novel magnetic nanostructure based on pectin–cellulose hydrogel for in vitro hyperthermia during cancer therapy
Authors: Ahmadpour Farnoush , Ganjali Fatemeh , Radinekiyan Fateme , Eivazzadeh-Keihan Reza , Salimibani Milad , Bahreinizad Hossein , Mahdavi Mohammad , Maleki Ali
Published: April 2024

The graphical abstract of the design and synthesis of a new magnetic nanobiocomposite based on cross-linked pectin–cellulose hydrogel substrate for in vitro hyperthermia of cancer therapy.
An efficient catalysis for the synthesis of pyrimido[1,2-a]benzimidazoles and 1-(benzothiazolylamino)methyl-2-naphthols using ZnO@SO3H@Tropine
Authors: Rahimizadeh Fatemeh , Mazloumi Masoumeh , Shirini Farhad
Published: April 2024

An efficient, green method for one-pot three-component synthesis of pyrimido[1,2-a]benzimidazole and 1-(benzothiazolylamino)methyl-2-naphthol derivatives using a new nanoporous catalyst ZnO@SO3H@Tropine is reported. Advantages include, but are not limited to, simple work-up and high yields.
Revisiting the phosphonium salt chemistry for P-doped carbon synthesis: toward high phosphorus contents and beyond the phosphate environment
Authors: André Rémi F. , Gervais Christel , Zschiesche Hannes , Jianu Teodor , López-Salas Nieves , Antonietti Markus , Odziomek Mateusz
Published: April 2024

Calcination of THPC–urea in metal chloride hydrate salt affords porous P/N-doped carbonaceous materials (up to 18 wt% [P]), used as oxidative dehydrogenation catalysts.
2D nature of magnetic states at SnO2 surfaces: a combined experimental and theoretical study
Authors: Hong Nguyen Hoa , Friák Martin , Pazourek Petr , Pham Nguyen Sy , Nhu Tran Quynh , Kiaba Michal , Gazdová Kristýna , Pavlů Jana
Published: April 2024

Calculated magnetic moments for the (101) rutile-structure SnO2 surface.
Phase separation kinetics and cluster dynamics in two-dimensional active dumbbell systems
Authors: Caporusso C. B. , Cugliandolo L. F. , Digregorio P. , Gonnella G. , Suma A.
Published: April 2024

Growth kinetics of MIPS clusters in a model of self-propelled dumbbells in 2D. A dynamical scaling regime is identified, with a non-universal scaling exponent. While growing, clusters perform a rigid-body roto-translational motion.
Triphenylamine-containing dihydrophenazine copolymers with adjustable multi-electron redox characteristics and their application as cathodes in lithium-organic batteries
Authors: Xu Lihuan , Fei Qiang , Yao Lin , Su Chang
Published: April 2024

Arylamine p-type cathode materials have high redox potentials and rate capabilities, which have attracted increasing attention recently.
Pyrophosphate interlayer improves performance of semi-transparent perovskite solar cells
Authors: Yoo Jason J. , Lee Jin-Won , Ju Yeonkyeong , Kang Bong Joo , Kim Youngwoong , Kim Beom-Soo , Kim Young Yun , Shin Seong Sik , Shin Tae Joo , Jeon Nam Joong
Published: April 2024

Hybrid perovskite solar cells (PSCs) with high average visible transmission (AVT) are applicable to building-integrated photovoltaics (BIPV) and windows.
Air conditioning reliability analysis based on dynamic Bayesian network and Markov model
Authors: Xu Jiaqi , Wang Qiang , Zhou Juan , Wu Linlin , Chen Jiayan , Zhou Haiting
Published: April 2024

With the popularization of the air conditioning, its reliability during operation has gradually become a focus of attention. However, due to the uncertainty in the reliability analysis process, the accuracy of the results will be affected. To overcome this challenge, a method for air conditioner reliability analysis combining Dynamic Bayesian Network (DBN) and Markov Model (MM) is proposed. Firstly, orthogonal defect classification (ODC) is used to statistic and analyze the defect data of the air conditioning system, and the network structure of the DBN is determined based on the results of the analysis. Then, the state transfer probability of each node is obtained by MM, and then the reliability, steady state availability, and maintainability of the air conditioning system are analyzed. Finally, the effectiveness of the method is verified by a case study of air conditioning failure data. The results show that the steady state availability of the air conditioning system in this case is 0.996.
FDG-PET in HIV-Positive Patient with Extranodal Diffuse Large B-Cell Lymphoma
Authors: Mashriqi Faizullah , Keir Graham , Vijayashankar Akarsh , Glaser Joseph E. , Franceschi Ana M.
Published: April 2024

Extranodal diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease process and an aggressive form of non-Hodgkin's lymphoma. We present a case of multiorgan involvement of DLBCL in a patient with documented risk factors, including [18F] fluorodeoxyglucose positron emission tomography/magnetic resonance imaging findings highlighting striking perineural spread involving intracranial and extracranial segments of the bilateral trigeminal nerves.
Dynamics of seaweed-inspired piezoelectric plates for energy harvesting from oscillatory cross flow
Authors: Zhu Qiang , Xiao Qing
Published: April 2024

Inspired by the vibrations of aquatic plants such as seaweed in the unsteady flow fields generated by free-surface waves, we investigate a novel device based on piezoelectric plates to harvest energy from oscillatory cross flows. Towards this end, numerical studies are conducted using a flow-structure-electric interaction model to understand the underlying physical mechanisms involved in the dynamics and energy harvesting performance of one or a pair of piezoelectric plates in an oscillatory cross flow. In a single-plate configuration, both periodic and irregular responses have been observed depending on parameters such as normalized plate stiffness and Keulegan–Carpenter number. Large power harvesting is achieved with the excitation of natural modes. Besides, when the time scale of the motion and the intrinsic time scale of the circuit are close to each other the power extraction is enhanced. In a two-plate configuration with tandem formation, the hydrodynamic interaction between the two plates can induce irregularity in the response. In terms of energy harvesting, two counteracting mechanisms have been identified, shielding and energy recovery. The shielding effect reduces plate motion and energy harvesting, whereas with the energy recovery effect one plate is able to recovery energy from the wake of another for performance enhancement. The competition between these mechanisms leads to constructive or destructive interactions between the two plates. These results suggest that for better performance the system should be excited at its natural period, which should be close to the intrinsic time scale of the circuit. Moreover, using a pair of plates in a tandem formation can further improve the energy harvesting capacity when conditions for constructive interaction are satisfied.
Random maps with sociological flavor
Authors: Krapivsky P L
Published: April 2024

A map of a set to itself admits a representation by a graph with vertices being the elements of the set and an edge between every vertex and its image. Communities defined as the maximal connected components are uni-cyclic. The distributions of the sizes of communities and lengths of cycles for unconstrained random maps is a classical subject. We call experts the images and followers the remaining vertices, and we further define prophets, egocentrics, and introverts. We introduce and analyze classes of random maps with sociological flavor.
Applicability of a new composite amusement ride safety device based on acoustic emission monitoring technology
Authors: Liu Ran , Liang Yu-Jiao , Liu Shuo , Zhang Peng-Fei , Qiao Shuai , Li Qing , Ma Lian-Hua , Zhou Wei
Published: April 2024

Under the premise of ensuring safety, it is of great significance to realize the lightweight of the non-main load-bearing parts of amusement facilities. The purpose of this study is to study the failure process of a newly designed carbon fiber bumper by using acoustic emission technology. First of all, the design of carbon fiber anti-collision bar can effectively restrain passengers, and its weight is reduced by nearly two-thirds compared to traditional metal materials. Subsequently, the load-bearing capacity of the bumper was tested and acoustic emission monitoring was carried out. The test results show that this new type of combined structure of amusement facility has high reliability, which exceeds the safety factor of 3.5 required by the steel structure of amusement facility. In addition, Renyi entropy was used to select the best window function of short-time Fourier transform, and the frequency domain characteristics of acoustic emission signals of typical damage modes were discussed through appropriately selected windows function. A classifier based on supervised machine learning is established by combining frequency features and acoustic emission feature parameters. Furthermore, the use of classifiers helps to understand the damage behaviour of composite structures.
The pharmacist’s role in optimizing medication management before, during, and after minimally invasive and bariatric surgery
Authors: Ebbitt Laura M , Kassel Lynn E , McKenzie Jeffrey J , Palm Nicole M , Smith April N
Published: April 2024

Purpose

Minimally invasive surgery (MIS) with integrated enhanced recovery pathways (ERPs) helps reduce length of stay and improve surgical outcomes. As these procedures have become more prevalent over time, pharmacists are in key positions to manage medications in the perioperative space to help optimize transitions of care and reduce safety events. Here we identify several clinical areas across phases of care for these procedures in which the knowledge and guidance of pharmacists, as members of the interprofessional team, are paramount.

Perioperative pharmacy expertise is often required for MIS procedures in the areas of acid suppression, antithrombotic management, blood glucose control, drug formulation, immunosuppressant optimization, pain mitigation, and postoperative nausea and vomiting prevention and treatment. For each MIS procedure, pharmacists should identify and consider diet and anatomical changes as well as patient- and surgery-specific risk factors. Pharmacists can then utilize their knowledge of the pharmacokinetics and pharmacodynamics of individual medications along with evidence-based medicine to recommend selection of appropriate agents.

Conclusion

Pharmacist contributions to perioperative medication management for MIS procedures can improve care as surgical patients navigate transitions through the perioperative setting. Pharmacists can further incorporate medication expertise through development and implementation of institutional MIS protocols within the context of ERPs. As such, any pharmacist should feel empowered to aid in the care of surgical patients.
Against God of the truth-value gaps
Authors: Parent T
Published: April 2024

Beall and Cotnoir propose that ‘God can create an unliftable stone’ is a truth-value gap (neither true nor false). However, this yields a revenge paradox on whether God can eschew gaps. Can God avoid gappy ascriptions of power? Either way, God’s power seems to have limits. In response, it may be said that ascribing God the power to avoid gaps is itself gappy – it concerns a power that God neither has nor lacks. Yet this ends up being inconsistent, for it implies that God definitely lacks that power. Following Aquinas, perhaps Beall and Cotnoir could accept this lack and still uphold omnipotence, suggesting that the power to avoid gaps is impossible for God. Yet the Aquinian stratagem is enough to block the original paradox, which saps the motivation to proffer truth-value gaps in addition. I conclude that the gappy solution is either inadequate or insufficiently motivated.
Long-term weight gain in children with craniopharyngioma
Authors: Rovani Sibylle , Butler Victoria , Samara-Boustani Dinane , Pinto Graziella , Gonzalez-Briceno Laura , Nguyen Quoc Adrien , Vermillac Gaëlle , Stoupa Athanasia , Besançon Alix , Beltrand Jacques , Thalassinos Caroline , Flechtner Isabelle , Dassa Yamina , Viaud Magali , Arrom-Branas Maria Beatriz , Boddaert Nathalie , Puget Stéphanie , Blauwblomme Thomas , Alapetite Claire , Bolle Stéphanie , Doz François , Grill Jacques , Dufour Christelle , Bourdeaut Franck , Abbou Samuel , Guerrini-Rousseau Léa , Leruste Amaury , Beccaria Kévin , Polak Michel , Kariyawasam Dulanjalee
Published: April 2024

Objective

Adamantinomatous craniopharyngioma mainly affects children. Excessive weight gain is a major long-term complication. The primary objective of this study was to assess long-term weight changes in children treated for craniopharyngioma. The secondary objectives were to identify risk factors for excessive weight gain and to look for associations with hypothalamic damage by the tumour or treatment.

Design

Single-centre retrospective cohort study.

Method

Children managed for craniopharyngioma at our centre between 1990 and 2019 were included. The body mass index (BMI) standard deviation scores (SDS) at baseline and at last follow-up were compared. Univariate and multivariate analyses were performed in order to identify variables associated with the long-term BMI-SDS variation.

Results

The 108 patients had a mean follow-up of 10.4 years. The mean BMI-SDS increase over time was 2.11 (P < .001) overall, 1.21 (P < .001) in the group without hypothalamic involvement by the tumour, and 1.95 (P < .001) in the group managed using intended hypothalamus-sparing surgery. The absence of hypothalamic involvement by the tumour or treatment was significantly associated with less weight gain (P = .046 and P < .01, respectively). After adjustment, factors associated with a BMI-SDS change greater than 2 were female sex (P = .023), tumour involving the hypothalamus (P = .04), and higher baseline BMI (P < .001).

Conclusion

Clinically significant weight gain occurred in nearly all children treated for craniopharyngioma, including those whose hypothalamus was spared by the tumour and intentionally by treatment. However, hypothalamus integrity was associated with less weight gain. Despite hypothalamus-sparing strategies, hypothalamic obesity remains a major concern, indicating a need for novel treatment approaches.
Empirical Asset Pricing with Score-Driven Conditional Betas
Authors: Giroux Thomas , Royer Julien , Zerbib Olivier David
Published: April 2024

We develop a novel empirical asset pricing framework to estimate time-varying risk premia, building upon score-driven conditional betas models. First, we extend the theory by establishing the asymptotic distribution of standard test statistics, allowing us to assess the significance of a given factor in the regression. Additionally, we introduce a bootstrap procedure and establish its validity. Second, we propose a two-step estimation procedure to recover time-varying risk premia. We illustrate the performance of our tests and risk premia estimation through simulations. Third, we estimate a time-varying premium associated with a carbon risk factor in the cross-section of U.S. industry portfolios.
Spatial distribution, activity patterns, and influence of roads on mammals in the Qinling Mountains of China
Authors: Sun Yuting , Yang Dongdong , Gong Congran , Hu Han , Su Lina , Li Peiwei , Li Yinhu , Liu Yan , Wu Xiaomin , Zhang Hongfeng
Published: April 2024

Species distribution and activity patterns vary across regions, and these patterns reveal key information about the biology of a given species. However, such data in Niubeiliang National Nature Reserve located in the Qinling Mountains, Shaanxi Province, China, are inadequate due to limited monitoring studies. From September 2017 to December 2019, 57 infrared cameras were installed to monitor species distribution relative to distance from National Highway 210, and spatial and temporal activity patterns in Niubeiliang National Nature Reserve (elevation range 1,100 to 2,802 m). Sixteen species of mammals were recorded in our survey. The 4 most frequently detected species were Reeves’s Muntjac (Muntiacus reevesi), Wild Boar (Sus scrofa), Pere David’s Rock Squirrel (Sciurotamias davidianus), and Golden Takin (Budorcas taxicolor bedfordi). Daily patterns of these species indicated that Reeves’s muntjacs and golden takins were more active at dawn and dusk, whereas wild boars and Pere David’s rock squirrels were more active during the day. The relative abundance index of these mammals varied seasonally. Wild boars and Pere David’s rock squirrels showed no obvious preference in elevation distribution, Reeves’s muntjacs preferred low-elevation habitats (1,300 to 1,600 m), and golden takins mainly inhabited high-elevation areas (1,900 to 2,100 m). Golden takins showed obvious avoidance of roads, with avoidance distance from the road of >300 m. In contrast, Reeves’s muntjacs were remarkably abundant within 200 m of the road. For both wild boars and Pere David’s rock squirrels, there was no significant difference in RAI among 5 highway ranges. These findings help describe the distribution and activity patterns of these species in Qinling, to monitor their population dynamics, and to develop tailored conservation strategies for the 4 species and sympatric wildlife.
Recognizing the agency of forced migrants with diverse sexual orientations, gender identities and expressions, and sex characteristics
Authors: Ongwech Onen David , Schulz Philipp , Erdem Zeynep Pınar
Published: April 2024

In recent years, scholarship and policy reports have slowly attended to the lived realities of forced migrants with diverse sexual orientations, gender identities and expressions, and sex characteristics (SOGIESC). However, these emerging discourses are typically characterized by a violation-centric view that focuses on queer migrants’ vulnerabilities and experiences of victimization. Yet, what remains strikingly absent from existing research and advocacy engagement is how refugees with diverse SOGIESC across different settings also actively seek out services and build support networks; how they engage with their experiences on their own terms; how they resist violence; or in other words, how they exercise various forms of agency. In this field reflection, we emphasize the importance to recognize how and under what conditions forced migrants with diverse SOGIESC exercise agency. We put forward illustrative examples based on field reflections of working with refugees with diverse SOGIESC, opening up new perspectives for research, policy, and activism.
Delineating patient errors in an intracavernosal injection program
Authors: Furtado Thiago P , Teloken Patrick E , Ortega Yanira , Narus Joseph , Wolchasty Natalie P , Mulhall John P
Published: April 2024

Background

Intracavernosal injection therapy (ICI) is a well-established therapeutic strategy for men with erectile dysfunction. Complications are often related to patient error when performong ICI.

Aim

The objective of this study was to examine patient errors in an established patient training program for performing ICI and identify factors that could predict major errors.

Methods

Patients enrolled in our ICI program are trained on technical aspects, and dose titration is begun. Patients are given explicit instructions during training, both verbally and in written form. Records were reviewed for men using ICI for ≥6 months. Multivariable analysis was used to define predictors of major errors.

Outcomes

Errors were listed as minor (zero-response injection, penile bruising, expired medication) and major (errors potentially leading to priapism: dose self-titration, double injecting).

Results

Overall, 1368 patients met the inclusion criteria and were included in the analysis. The mean patient age was 66 ± 22 (range 29-91) years. Regarding education, 41% of patients had graduate-level education, 48% had college education, and 11% high school education. Mean follow-up was 3.2 ± 7.6 (range 0.5-12) years. The agents used were trimix (62%), bimix (35%), papaverine (2%), and prostaglandin E1 monotherapy (1%). At least 1 error occurred during self-administration in 42% of patients during their time in the program. Errors included zero response to medication due to technical error (8% of patients), penile bruising (34%), use of an expired bottle (18%), self-titration (5%), and double injecting (4% of patients); 12% of men committed ≥1 error during their time in the program. On multivariable analysis, independent predictors of the occurrence of a major error included: young age, graduate-level education, and <12 months of injection use.

Clinical implications

To the best of our knowledge, this is the first reported study to investigate ICI errors and risk factors. The identification of factors predictive of major errors allows for more tailored and intensive training in this subset of patients.

Strengths and limitations

Strengths of this study include a large patient population (1386 men) with a considerable follow-up time. Additionally, the rigorous training, education, and monitoring of the participants, as well as the use of formal definitions, enhances the accuracy and reliability of the results. Despite the strengths of the study, recall bias may be a limitation concern.

Conclusion

The majority of patients were error free, and the majority of the errors were minor in nature. Major errors occurred in <10% of patients. Younger age, graduate-level education, and less experience with ICI were independent predictors of major errors.
Safety and Short-term Efficacy of a Single Dose of 2 mg Moxidectin in Loa loa–Infected Individuals: A Double-Blind, Randomized Ivermectin-Controlled Trial With Ascending Microfilarial Densities
Authors: Wafeu Guy S , Lepage Tristan M , Campillo Jeremy T , Efon-Ekangouo Arnauld , Nana-Djeunga Hugues-Clotaire , Nzune-Toche Narcisse , Domche André , Sumo Laurentine , Njitchouang Guy-Roger , Tsasse Martine Augusta Flore , Bopda Jean , Balog Yves Aubin , Niamsi-Emalio Yannick , Mbickmen-Tchana Stève , Talla Gervais Kamga , Kana Yannick Sédrick Nguedia , Messina Félicité Diane Maga , Pion Sébastien D , Kuesel Annette C , Kamgno Joseph , Boussinesq Michel , Chesnais Cedric B
Published: April 2024

Background

In 2018, the US Food and Drug Administration approved the macrocylic lactone moxidectin (MOX) at 8 mg dosage for onchocerciasis treatment in individuals aged ≥12 years. Severe adverse reactions have occurred after ivermectin (IVM), also a macrocyclic lactone, in individuals with high Loa microfilarial density (MFD). This study compared the safety and efficacy of a 2 mg MOX dose and the standard 150 µg/kg IVM dose in individuals with low L loa MFD.

Methods

A double-blind, randomized, ivermectin-controlled trial of a 2 mg moxidectin dose was conducted in Cameroon between May and July 2022. It enrolled 72 adult men with L loa MFD between 5 and 1000 microfilariae/mL. Outcomes were occurrence of adverse events (AEs) and L loa MFD reduction rate during the first month off treatment.

Results

No serious or severe AEs occurred among the 36 MOX- or the 36 IVM-treated individuals. Forty-nine AEs occurred in the MOX arm versus 59 AEs in the IVM arm. Grade 2 AE incidence was higher among IVM- than MOX-treated participants (38.5% and 14.3%, respectively, P = .043). Median MFD reduction rates were significantly higher after IVM than MOX at day 3 (70.2% vs 48.5%), day 7 (76.4% vs 50.0%), and day 30 (79.8% vs 48.1%).

Conclusions

A single 2 mg MOX dose is as safe as 150 µg/kg IVM in patients with low L loa MFD. Further studies with higher MOX doses and in patients with higher MFD are warranted.

Clinical Trials Registration

NCT04049851.
Gauge Coupling Unification and Proton Decay via 45 Higgs Boson in SU(5) GUT
Authors: Haba Naoyuki , Nagano Keisuke , Shimizu Yasuhiro , Yamada Toshifumi
Published: April 2024

We study the gauge coupling unification (GCU) and proton decay in a nonsupersymmetric SU(5) grand unified theory (GUT) incorporating a 45-representation Higgs field. Our analysis is based on the assumption that Georgi–Jarlskog-type mass matrices for fermions are responsible for explaining the mass ratio of the strange quark and the muon. We examine the conditions of GCU, taking into account the possibility that certain components of the 45 Higgs field have masses much smaller than the GUT scale. We have found that to satisfy the GCU conditions, at least two components of the 45 Higgs field should have such small masses. We search the parameter space to identify regions where the GCU conditions are satisfied, in the scenarios where two or three components of the 45 Higgs boson are hierarchically light. If the colored Higgs component of the 45 Higgs boson has a mass much smaller than the GUT scale, proton decay via colored Higgs boson exchange can occur with an observably large rate. We estimate the mass bounds for the colored Higgs component from the proton decay search at Super-Kamiokande and thereby further restrict the parameter space.
The Social Origins of Alcoholism: Abraham Myerson and the Significance of Drinking Norms in Alcohol Addiction, 1938–1946
Authors: McLaughlin Matthew J
Published: April 2024

In the 1940s, Abraham Myerson’s work on drinking norms in the USA was central to reorienting the approach medical and scientific experts adopted when studying and treating alcoholism. A leading psychiatrist and neurologist from Boston, Myerson argued that tensions between alcohol’s ability to satisfy a pleasure-seeking drive and the rise of asceticism had generated ambivalent social attitudes, traditions and expectations towards drinking. This article explores how Myerson identified and employed social factors to uncover the relationship between ambivalent drinking norms, one’s gender, ethnic or religious background, and whether one would drink to excess. In doing so, it will illuminate how Myerson’s innovative efforts to highlight the role of social attitudes and traditions in alcoholism ultimately helped shape the approach of medical science to the alcohol problem.
Transgender People Report Satisfaction with Their Lives
Authors: Roush Karen
Published: April 2024

Most say they don't regret transitioning, despite stigma.
Cannabis Nursing
Authors: King Kim
Published: April 2024

Care for those seeking guidance in the therapeutic use of cannabis
Clinical Inquiry and Problem Identification
Authors: Hays Deana , Milner Kerry A. , Farus-Brown Susan , Zonsius Mary C. , Fineout-Overholt Ellen
Published: April 2024

This is the second article in a new series designed to provide readers with insight into educating nurses about evidence-based decision-making. It builds on AJN's award-winning previous series—Evidence-Based Practice, Step by Step and EBP 2.0: Implementing and Sustaining Change (to access both series, go to http://links.lww.com/AJN/A133). This follow-up series will address how to teach and facilitate learning about the evidence-based practice (EBP) and quality improvement (QI) processes and how they impact health care quality. This series is relevant for all nurses interested in EBP and QI, especially DNP faculty and students. The brief case scenario included in each article describes one DNP student's journey.
Improving Medication Management for Inpatients with a Secondary Diagnosis of Parkinson Disease
Authors: Boudreaux Arlene , Schell Ryan F. , Nelson Scott D. , Phibbs Fenna , Stroh Jessica , Depp Amanda Fraley
Published: April 2024

Patients who have Parkinson disease require individualized medication regimens to optimize care. A review of the medication management of patients admitted to a tertiary care hospital with a secondary diagnosis of Parkinson disease found significant departures from the patients' home regimen. Medication regimens are often altered by health care teams unfamiliar with Parkinson disease–specific care in order to conform to standard hospital medication orders and administration times, potentially resulting in increased patient falls, delirium, and mortality.

A nurse-led multidisciplinary team consisting of pharmacy, nursing, informatics, neurology, and quality personnel implemented a quality improvement (QI) project between July 2020 and July 2022 to identify patients with Parkinson disease, including those with a secondary diagnosis and those undergoing deep brain stimulation, and customize medication management in order to reduce length of stay, mortality, falls, falls with harm, and 30-day readmissions. The QI project team also evaluated patient satisfaction with medication management.

Among patients with a secondary diagnosis of Parkinson disease, the proportion who had medication histories conducted by a pharmacy staff member increased from a baseline of 53% to more than 75% per month. For all patients with Parkinson disease, those whose medication history was taken by a pharmacy staff member had orders matching their home regimen 89% of the time, whereas those who did not had orders matching the home regimen only 40% of the time. Among patients with a secondary diagnosis of Parkinson disease, the length-of-stay index decreased from a baseline of 1 to 0.94 and observed-to-expected mortality decreased from 1.03 to 0.78. The proportion of patients experiencing a fall decreased from an average of 5% to 4.08% per quarter, while the proportion of patients experiencing a fall with harm decreased from an average of 1% to 0.75% per quarter. The rate of 30-day readmissions decreased from 10.81% to 4.53% per quarter. Patient satisfaction scores were 1.95 points higher for patients who had medication histories taken by pharmacy than for those who did not (5 versus 3.05).
Two Symptom Clusters Identified in Patients with Acute Heart Failure
Authors: Rosenberg Karen
Published: April 2024

According to this study:

Two distinct symptom clusters were identified in patients with acute heart failure: one with severe congestion and the other with mild congestion.

Identification of these symptom clusters in the ED could help with symptom management, patient triage, diagnosis, and self-care at home.
Higher Sugar Intake Associated with Higher Risk of Depression
Authors: Rosenberg Karen
Published: April 2024

According to this study:
Functional Limitations Persist After Mild Sports-Related Traumatic Brain Injury
Authors: Rosenberg Karen
Published: April 2024

According to this study:
Factors impacting quality of life for breast cancer survivors
Authors: Davis Stephanie C. , Snyder Elizabeth
Published: April 2024

According to the World Health Organization, breast cancer became the most common cancer in the world in 2020 and accounted for 685,000 deaths globally. In this article, breast cancer risk factors, considerations for genetic testing for BRCA1 and BRCA2 variants, signs and symptoms, and treatment are briefly discussed. Factors that impact the well-being and quality of life of women who have or have had breast cancer are also explored in depth, and practice implications for primary care providers are noted.
Interprofessional collaboration to improve care for patients with diabetes
Authors: Gulley Tauna , Cole Randall , Subbanna Maya , Ratliff Chris CJ , Hill-Collins Paula , Tyson Teresa
Published: April 2024

Background:

The COVID-19 pandemic resulted in decreased access to routine diabetes care in rural areas and adversely affected self-management of diabetes.

Methods:

This article describes a descriptive pretest-posttest study conducted to assess efficacy in managing hemoglobin A1C (A1C) among patients with type 2 diabetes mellitus (T2DM) using a continuous glucose monitoring (CGM) system for 1 year.

Results:

A total of 14 participants completed the Diabetes Mellitus Self-Efficacy Scale survey. Of those 14, 11 used CGM for 1 year; of the 11 who maintained CGM use, A1C levels improved in 9.

Conclusions:

Results indicate that CGM combined with medication management positively impacts self-efficacy in managing A1C levels among patients with T2DM. Interdisciplinary collaboration optimizes patient outcomes.
The rostral ventromedial medulla modulates pain and depression-related behaviors caused by social stress
Authors: Pagliusi Marco , Amorim-Marques Anna P. , Lobo Mary Kay , Guimarães Francisco S. , Lisboa Sabrina F. , Gomes Felipe V.
Published: April 2024

The rostral ventromedial medulla (RVM) is a crucial structure in the descending pain modulatory system, playing a key role as a relay for both the facilitation and inhibition of pain. The chronic social defeat stress (CSDS) model has been widely used to study stress-induced behavioral impairments associated with depression in rodents. Several studies suggest that CSDS also causes changes related to chronic pain. In this study, we aimed to investigate the involvement of the RVM in CSDS-induced behavioral impairments, including those associated with chronic pain. We used chemogenetics to activate or inhibit the RVM during stress. The results indicated that the RVM is a vital hub influencing stress outcomes. Rostral ventromedial medulla activation during CSDS ameliorates all the stress outcomes, including social avoidance, allodynia, hyperalgesia, anhedonia, and behavioral despair. In addition, RVM inhibition in animals exposed to a subthreshold social defeat stress protocol induces a susceptible phenotype, facilitating all stress outcomes. Finally, chronic RVM inhibition—without any social stress stimulus—induces chronic pain but not depressive-like behaviors. Our findings provide insights into the comorbidity between chronic pain and depression by indicating the involvement of the RVM in establishing social stress–induced behavioral responses associated with both chronic pain and depression.
Laparoscopic heller myotomy versus peroral endoscopic myotomy for the treatment of achalasia
Authors: Patti Marco G. , Herbella Fernando A.
Published: April 2024

Purpose of review

To compare different therapeutic modalities and determine their role in the treatment of esophageal achalasia.

Recent findings

The last 3 decades have seen a significant improvement in the diagnosis and treatment of esophageal achalasia. Conventional manometry has been replaced by high-resolution manometry, which has determined a more precise classification of achalasia in three subtypes, with important treatment implications. Therapy, while still palliative, has evolved tremendously. While pneumatic dilatation was for a long time the main choice of treatment, this approach slowly changed at the beginning of the nineties when minimally invasive surgery was adopted, initially thoracoscopically and then laparoscopically with the addition of partial fundoplication. And in 2010, the first report of a new endoscopic technique – peroral endoscopic myotomy (POEM) – was published, revamping the interest in the endoscopic treatment of achalasia.

This review focuses particularly on the comparison of POEM and laparoscopic Heller myotomy (LHM) with partial fundoplication as primary treatment modality for esophageal achalasia. Based on the available data, we believe that LHM with partial fundoplication should be the primary treatment modality in most patients. POEM should be selected when surgical expertise is not available, for type III achalasia, for the treatment of recurrent symptoms, and for patients who had prior abdominal operations that would make LHM challenging and unsafe.
Update on extraesophageal manifestations of gastroesophageal reflux
Authors: Fernandez Annel M. , Chan Walter W.
Published: April 2024

Purpose of review

Symptoms/complications related to extraesophageal reflux (EER) are increasingly prevalent presentations and pose significant challenges for clinicians. We summarize and discuss clinical advances and developments in pathophysiology, testing and treatment algorithms of upper/lower airway manifestations of EER.

Recent findings

Growing evidence supports likely multifactorial causes of laryngeal symptoms, including EER, oropharyngeal pathologies, allergic conditions, and cognitive-affective processes (brain-larynx interaction). Diagnostic paradigm for laryngopharyngeal reflux (LPR) is shifting towards a personalized approach with noninvasive strategies/prediction tools to risk-stratify patients for upfront reflux testing over empiric acid suppression trials. Management should be multipronged to include antireflux therapies and treatments targeting other causes. Lower airway complications of EER may result in lung dysfunction and poor transplant outcomes. Esophageal symptoms are often absent and routine esophageal/reflux testing to guide timely antireflux therapies may lead to improved outcomes. Modalities that leverage impedance technology may be important, given the potential role of nonacidic reflux. Novel impedance-based metrics such as mean nocturnal baseline impedance and postreflux swallow-induced peristaltic wave index may provide adjunctive diagnostic values.

Standardized approach to diagnosis/management of EER should include multidisciplinary care teams and consider different phenotypes, nonreflux contributors, and the complex gut-airway relationships. Prompt antireflux therapies after careful candidate selection may improve outcomes of these airway complications.
Radiologic Manifestations of Mycobacterium chimaera Infection After Open Heart Surgery
Authors: Moore Andrew E. , Ngo Tuan , Donald Joseph , Shorey Samira , Sivakumar Ram , Velagapudi Vivek , Walker Christopher M.
Published: April 2024

Purpose:

The objective of this study is to identify and detail the radiologic manifestations of surgical site and disseminated Mycobacterium chimaera (MC) infection. The aim is to facilitate early identification and diagnosis of MC, considering its indolent nature and the challenges involved in clinically and pathologically establishing the diagnosis.

Patients and Methods:

This was a retrospective cohort study reviewing computed tomography (CT), positron emission tomography (PET)/CT, and magnetic resonance imaging examinations in patients over the age of 18 years with a history of open heart surgery and a clinical or pathologic diagnosis of MC. Two radiology residents, a fellowship-trained nuclear medicine radiologist, and a fellowship-trained cardiothoracic radiologist performed consensus reads to determine the imaging findings seen in MC infection.

Results:

Twenty-five patients were included. Localized, surgical site infection was more common than disseminated disease. Typical CT findings included peristernal soft tissue thickening, sinus tracts often extending to the cutaneous surface, slowly enlarging fluid collections, and sternal osteolysis. PET/CT findings demonstrated hypermetabolic activity in nearly all patients localized to sites of infection. Imaging findings for disseminated infection included hepatosplenomegaly, lymphadenopathy, involvement of the central nervous system, discitis/osteomyelitis, and distant abscesses.

Conclusions:

Imaging plays a vital role in suggesting possible surgical sites and disseminated MC infection acquired from open heart surgery. Radiologists must keep a high index of suspicion given the indolent nature and subtle imaging change over time. PET/CT is most useful in diagnosis and helps in differentiating between a sterile postoperative fluid collection or scarring and active MC infection and helps provide a target for debridement.
SALVIANOLIC ACID A ATTENUATES ANGIOTENSIN II-INDUCED CARDIAC FIBROSIS THROUGH REGULATING THE TXNIP SIGNALING PATHWAY
Authors: Ye Huaqing , Wang Kaiyi , Ma Jiaxin , Cui Sumei , Guo Jialin , Yang Kehui , Lyu Linmao
Published: April 2024

Cardiac fibrosis, characterized by excessive collagen accumulation in heart tissues, poses a significant clinical challenge in various heart diseases and complications. Although salvianolic acid A (Sal A) from Danshen (Salvia miltiorrhiza) has shown promise in the treatment of ischemic heart disease, myocardial infarction, and atherosclerosis, its effects on cardiac fibrosis remain unexplored. Our study investigated the efficacy of Sal A in reducing cardiac fibrosis and elucidated its underlying molecular mechanisms. We observed that Sal A demonstrated significant cardioprotective effects against Angiotensin II (Ang II)-induced cardiac remodeling and fibrosis, showing a dose-dependent reduction in fibrosis in mice and suppression of cardiac fibroblast proliferation and fibrotic protein expression in vitro. RNA sequencing revealed that Sal A counteracted Ang II-induced upregulation of Txnip, and subsequent experiments indicated that it acts through the inflammasome and ROS pathways. These findings establish the antifibrotic effects of Sal A, notably attenuated by Txnip overexpression, and highlight its significant role in modulating inflammation and oxidative stress pathways. This underscores the importance of further research on Sal A and similar compounds, especially regarding their effects on inflammation and oxidative stress, which are key factors in various cardiovascular diseases.