bluuebunny/crossref_metadata_2025 huggingface dataset:
Identifying the genetic association between the cerebral cortex and fibromyalgia
Authors: Liu Aihui , Wang Jing , Jin Tianyu , Jiang Zhaoyu , Huang Shan , Li Shinan , Ying Zhenhua , Jiang Hongyang
Published: August 2024

Fibromyalgia (FM) is a central sensitization syndrome that is strongly associated with the cerebral cortex. This study used bidirectional two-sample Mendelian randomization (MR) analysis to investigate the bidirectional causality between FM and the cortical surface area and cortical thickness of 34 brain regions. Inverse variance weighted (IVW) was used as the primary method for this study, and sensitivity analyses further supported the results. The forward MR analysis revealed that genetically determined thinner cortical thickness in the parstriangularis (OR = 0.0567 mm, PIVW = 0.0463), caudal middle frontal (OR = 0.0346 mm, PIVW = 0.0433), and rostral middle frontal (OR = 0.0285 mm, PIVW = 0.0463) was associated with FM. Additionally, a reduced genetically determined cortical surface area in the pericalcarine (OR = 0.9988 mm2, PIVW = 0.0085) was associated with an increased risk of FM. Conversely, reverse MR indicated that FM was associated with cortical thickness in the caudal middle frontal region (β = −0.0035 mm, PIVW = 0.0265), fusiform region (β = 0.0024 mm, SE = 0.0012, PIVW = 0.0440), the cortical surface area in the supramarginal (β = −9.3938 mm2, PIVW = 0.0132), and postcentral regions (β = −6.3137 mm2, PIVW = 0.0360). Reduced cortical thickness in the caudal middle frontal gyrus is shown to have a significant relationship with FM prevalence in a bidirectional causal analysis.
Using overlapping methods to counter adversaries in community detection
Authors: Miller Benjamin A , Chan Kevin , Eliassi-Rad Tina
Published: August 2024

When dealing with large graphs, community detection is a useful data triage tool that can identify subsets of the network that a data analyst should investigate. In an adversarial scenario, the graph may be manipulated to avoid scrutiny of certain nodes by the analyst. Robustness to such behaviour is an important consideration for data analysts in high-stakes scenarios such as cyber defense and counterterrorism. In this paper, we evaluate the use of overlapping community detection methods in the presence of adversarial attacks aimed at lowering the priority of a specific vertex. We formulate the data analyst’s choice as a Stackelberg game in which the analyst chooses a community detection method and the attacker chooses an attack strategy in response. Applying various attacks from the literature to nine real network datasets, we find that, when the attacker has a sufficient budget, overlapping community detection methods outperform non-overlapping methods, often overwhelmingly so. This is the case when the attacker can only add edges that connect to the target and when the capability is added to add edges between neighbours of the target. We also analyze the tradeoff between robustness in the presence of an attack and performance when there is no attack. Our extensible analytic framework enables network data analysts to take these considerations into account and incorporate new attacks and community detection methods as they are developed.
Comparative analysis of new mScarlet-based red fluorescent tags in Caenorhabditis elegans
Authors: Cao Wen Xi , Merritt Daniel M , Pe Karinna , Cesar Michael , Hobert Oliver
Published: August 2024

One problem that has hampered the use of red fluorescent proteins in the fast-developing nematode Caenorhabditis elegans has been the substantial time delay in maturation of several generations of red fluorophores. The recently described mScarlet-I3 protein has properties that may overcome this limitation. We compare here the brightness and onset of expression of CRISPR/Cas9 genome-engineered mScarlet, mScarlet3, mScarlet-I3, and GFP reporter knock-ins. Comparing the onset and brightness of expression of reporter alleles of C. elegans golg-4, encoding a broadly expressed Golgi resident protein, we found that the onset of detection of mScarlet-I3 in the embryo is several hours earlier than older versions of mScarlet and comparable to GFP. These findings were further supported by comparing mScarlet-I3 and GFP reporter alleles for pks-1, a gene expressed in the CAN neuron and cells of the alimentary system, as well as reporter alleles for the pan-neuronal, nuclear marker unc-75. Hence, the relative properties of mScarlet-I3 and GFP do not depend on cellular or subcellular context. In all cases, mScarlet-I3 reporters also show improved signal-to-noise ratio compared to GFP.
Speciation and Extinction
Authors: Lomolino Mark V. , Riddle Brett R. , Whittaker Robert J.
Published: August 2024

This chapter examines the processes of speciation and extinction. It shows that dispersal has highly influenced processes of evolution and extinction. It argues that it has a strong geographic context. If the rate of extinction exceeds the rate of speciation, the group diversity decreases, and all or nearly all of its representatives go extinct. Essentially, the living and extinct organisms on Earth have been produced through repeated cycles of rapid bursts of speciation following an abrupt mass extinction with the underlying dynamics of the Earth's geographic, geological, and climatic templates. The chapter also covers the notions of macroevolution and microevolution identifying changes of contrasting magnitudes and scales of time in line with the change of species level.
The Geography of Diversification and Regionalization
Authors: Lomolino Mark V. , Riddle Brett R. , Whittaker Robert J.
Published: August 2024

This chapter explores the geography of diversification and regionalization. It explains the fundamental biogeographic patterns that emerge from a history of the dispersal, diversification, and extinction of lineages and biotas. Moreover, the diversity of life on Earth reflects the outcome of opposing forces promoting both convergence and divergence among biotas. The chapter explains that evolutionary conservatism, phylogenetic constraints, gene flow, and similar environments limit the rates and directions of diversification. They also maintain similarities among biotas. The directions of divergence and diversification tend to promote differences among biotas. The chapter also examines provincialism, the quantification of similarity among biotas, and biotic interchange.
An orbital strategy for regulating the Jahn–Teller effect
Authors: Shang Tongtong , Gao Ang , Xiao Dongdong , Zhang Qinghua , Rong Xiaohui , Tang Zhexin , Lin Weiguang , Lin Ting , Meng Fanqi , Li Xinyan , Wen Yuren , Wang Xuefeng , Su Dong , Chen Zhen , Hu Yong-Sheng , Li Hong , Yu Qian , Zhang Ze , Wu Lijun , Gu Lin , Zuo Jian-Min , Zhu Yimei , Chen Liquan , Nan Ce-Wen
Published: August 2024

The Jahn–Teller effect (JTE) arising from lattice–electron coupling is a fascinating phenomenon that profoundly affects important physical properties in a number of transition-metal compounds. Controlling JT distortions and their corresponding electronic structures is highly desirable to tailor the functionalities of materials. Here, we propose a local coordinate strategy to regulate the JTE through quantifying occupancy in the ${{d}_{{{z}^2}}}$ and ${{d}_{{{x}^2} - {{y}^2}}}$ orbitals of Mn and scrutinizing the symmetries of the ligand oxygen atoms in MnO6 octahedra in LiMn2O4 and Li0.5Mn2O4. The effectiveness of such a strategy has been demonstrated by constructing P2-type NaLixMn1–xO2 oxides with different Li/Mn ordering schemes. In addition, this strategy is also tenable for most 3d transition-metal compounds in spinel and perovskite frameworks, indicating the universality of local coordinate strategy and the tunability of the lattice–orbital coupling in transition-metal oxides. This work demonstrates a useful strategy to regulate JT distortion and provides useful guidelines for future design of functional materials with specific physical properties.
Scalable Bayesian uncertainty quantification with data-driven priors for radio interferometric imaging
Authors: Liaudat Tobías I , Mars Matthijs , Price Matthew A , Pereyra Marcelo , Betcke Marta M , McEwen Jason D
Published: August 2024

Next-generation radio interferometers like the Square Kilometer Array have the potential to unlock scientific discoveries thanks to their unprecedented angular resolution and sensitivity. One key to unlocking their potential resides in handling the deluge and complexity of incoming data. This challenge requires building radio interferometric (RI) imaging methods that can cope with the massive data sizes and provide high-quality image reconstructions with uncertainty quantification (UQ). This work proposes a method coined quantifAI to address UQ in RI imaging with data-driven (learned) priors for high-dimensional settings. Our model, rooted in the Bayesian framework, uses a physically motivated model for the likelihood. The model exploits a data-driven convex prior potential, which can encode complex information learned implicitly from simulations and guarantee the log-concavity of the posterior. We leverage probability concentration phenomena of high-dimensional log-concave posteriors to obtain information about the posterior, avoiding MCMC sampling techniques. We rely on convex optimization methods to compute the MAP estimation, which is known to be faster and better scale with dimension than MCMC strategies. quantifAI allows us to compute local credible intervals and perform hypothesis testing of structure on the reconstructed image. We propose a novel fast method to compute pixel-wise uncertainties at different scales, which uses three and six orders of magnitude less likelihood evaluations than other UQ methods like length of the credible intervals and Monte Carlo posterior sampling, respectively. We demonstrate our method by reconstructing RI images in a simulated setting and carrying out fast and scalable UQ, which we validate with MCMC sampling. Our method shows an improved image quality and more meaningful uncertainties than the benchmark method based on a sparsity-promoting prior.
Structural and molecular characteristics of weight‐bearing volar skin can be reconstituted by micro skin tissue column grafting
Authors: Fuchs Christiane , Wang Ying , Wise Emma , Farinelli William A. , Anderson R. Rox , Cho Sunghun , Meyerle Jon H. , Tam Joshua
Published: August 2024

For patients with lower limb amputations, prostheses are immensely helpful for mobility and the ability to perform job‐related or recreational activities. However, the skin covering the amputation stump is typically transposed from adjacent areas of the leg and lacks the weight‐bearing capacity that is only found in the specialized skin covering the palms and soles (a.k.a. volar skin). As a result, the skin tissue in direct contact with the prosthesis frequently breaks down, leading to the development of painful sores and other complications that limit, and often preclude, the use of prostheses. Transplanting volar skin onto amputation stumps could be a solution to these problems, but traditional skin transplantation techniques cause substantial morbidity at the donor site, such as pain and scarring, which are especially problematic for volar skin given the critical functional importance of the volar skin areas. We previously developed the technology to collect and engraft full‐thickness skin tissue while avoiding long‐term donor site morbidity, by harvesting the skin in the form of small (~0.5 mm diameter) cores that we termed “micro skin tissue columns” (MSTCs), so that each donor wound is small enough to heal quickly and without clinically appreciable scarring or other long‐term abnormalities. The goal of this study was to establish whether a similar approach could be used to confer the structural and molecular characteristics of volar skin ectopically to other skin areas. In a human‐to‐mouse xenograft model, we show the long‐term persistence of various human plantar MSTC‐derived cell types in the murine recipient. Then in an autologous porcine model, we harvested MSTCs from the bottom of the foot and transplanted them onto excision wounds on the animals' trunks. The healing processes at both the donor and graft sites were monitored over 8 weeks, and tissue samples were taken to verify volar‐specific characteristics by histology and immunohistochemistry. The volar donor sites were well‐tolerated, healed rapidly, and showed no signs of scarring or any other long‐term defects. The graft sites were able to maintain volar‐specific histologic features and expression of characteristics protein markers, up to the 8‐week duration of this study. These results suggest that MSTC grafting could be a practical approach to obtain autologous donor volar skin tissue, confer volar skin characteristics ectopically to nonvolar skin areas, improve the load‐bearing capacity of amputation stump skin, and ultimately enhance mobility and quality‐of‐life for lower limb amputees.
Supporting Mental Health Well-Being in the Most Vulnerable Future Nurses
Authors: Stubin Catherine A. , Dahan Thomas A.
Published: August 2024

AIM

The aim of the study was to explore relationships between perceived faculty support and prevalence of severe/extremely severe depression, anxiety, and stress levels among undergraduate baccalaureate nursing students.

BACKGROUND

Emerging research supports nursing students suffering from extreme psychological distress. Educational success and mental health wellness are influenced by external support.

METHOD

A mixed-methods design was used for this descriptive, cross-sectional study. A national convenience sample of 1,163 undergraduate baccalaureate nursing students completed the Depression, Anxiety and Stress Scale-21, Perceived Faculty Support Scale, and a demographic questionnaire. Emerging themes in the qualitative data were identified.

RESULTS

Nearly 54 percent of nursing students suffered from severe/extremely severe depression, anxiety, or stress. Faculty support was critical to nursing student mental health well-being.

CONCLUSION

This multisite study provides a better understanding of the enormity of psychological distress among undergraduate baccalaureate nursing students and emphasizes the immediate need for faculty to provide necessary support to this vulnerable student population.
Trauma Prevalence and Its Association With Health-related Quality of Life in Pregnant Persons With Opioid Use Disorder
Authors: Winhusen T. John , Kropp Frankie , Greenfield Shelly F. , Krans Elizabeth E. , Lewis Daniel , Martin Peter R. , Gordon Adam J. , Davies Todd H. , Wachman Elisha M. , Douaihy Antoine , Parker Kea , Xin Xie , Jalali Ali , Lofwall Michelle R.
Published: August 2024

Objectives

Trauma screening is recommended for pregnant persons with opioid use disorder (OUD), but there is limited literature on screening results from buprenorphine treatment. This study’s objectives were to 1) describe the types, and severity, of traumatic events reported and 2) evaluate the associations between trauma and health-related quality of life (HRQoL).

Methods

Baseline data from an ongoing trial were analyzed. Participants were 155 pregnant persons with OUD receiving, or enrolling in, buprenorphine treatment at one of 13 sites. The experience, and relative severity, of 14 high magnitude stressors were assessed with the trauma history screen. The Patient-Reported Outcomes Measurement Information System-29+2 was used to assess 8 HRQoL domains.

Results

Traumatic stressors were reported by 91% of the sample (n = 155), with 54.8% reporting a lifetime persisting posttraumatic distress (PPD) event and 29.7% reporting a childhood PPD event. The most prevalent lifetime PPD event was sudden death of a close family/friend (25.8%); physical abuse was the most prevalent childhood PPD event (10.3%). Participants with lifetime PPD, relative to no PPD, reported significantly greater pain interference (P = 0.02). Participants with childhood PPD, relative to no PPD, had significantly worse HRQoL overall (P = 0.01), and worse pain intensity (P = 0.002), anxiety (P = 0.003), depression (P = 0.007), fatigue (P = 0.002), and pain interference (P < 0.001).

Conclusions

A majority of pregnant persons enrolled/enrolling in buprenorphine treatment reported persisting posttraumatic distress with sudden death of close family/friend being the most prevalent originating event; clinicians should consider the impact that the opioid-overdose epidemic may be having in increasing trauma exposure in patients with OUD.
Pulling Back the Curtain: A Cross-Sectional Analysis of Medical Spas in Missouri
Authors: Ferrante Amanda M. , Malik Ali M. , Council M. Laurin , Michalski-McNeely Basia M.
Published: August 2024

BACKGROUND

There is very little legislation defining the degree of supervision and training required to perform cosmetic procedures in Missouri. The medical spa industry, particularly the volume and complexity of cosmetic procedures offered by medical spas, has seen significant growth in recent years.

OBJECTIVE

To better understand the medical spa workforce, depth, and breadth of aesthetic procedures offered by medical spas in Missouri.

MATERIALS AND METHODS

Cross-sectional study based on standardized telephone interviews, supplemented by website data. Survey responses were recorded, streamlined, and analyzed.

RESULTS

Although 94.59% of medical spas in Missouri are affiliated with a physician, only 22.52% of medical spas have a physician on-site for administration of cosmetic treatments. Nonphysician staff members who administer cosmetic services generally outnumber physician affiliates at Missouri medical spas, with the average ratio of nonphysician staff who administer cosmetic services to MD/DO affiliates per spa being 2.1:1.

CONCLUSION

There is significant variability in the level of training and supervision of medical spa staff performing cosmetic treatments in Missouri. As the medical spa industry continues to grow and high-risk cosmetic procedures become more commonplace, consistent statewide regulation of medical spas is needed to prevent harmful patient outcomes.
Return to Driving Following Moderate-to-Severe Traumatic Brain Injury: A TBI Model System Longitudinal Investigation
Authors: Novack Thomas A. , Zhang Yue , Kennedy Richard , Marwitz Jennifer , Rapport Lisa J. , Mahoney Elaine , Bergquist Thomas , Bombardier Charles , Tefertiller Candy , Walker William , Watanabe Thomas K. , Brunner Robert
Published: August 2024

Objective:

To examine longitudinal patterns of return to driving (RTD), driving habits, and crash rates associated with moderate-to-severe traumatic brain injury (TBI).

Setting:

Eight TBI Model System sites.

Participants:

Adults (N = 334) with TBI that required inpatient acute rehabilitation with follow-up of 197 and 218 at 1 and 2 years post-injury, respectively. Data collection at 2 years occurred almost exclusively during the pandemic, which may have affected results.

Design:

Longitudinal and observational.

Main Measures:

Driving survey completed during rehabilitation and at phone follow-up 1 and 2 years after injury.

Results:

The rate of RTD was 65% at 1-year follow-up and 70% at 2-year follow-up. RTD at both follow-up time points was positively associated with family income. The frequency of driving and distance driven were diminished compared to before injury. Limitation of challenging driving situations (heavy traffic, bad weather, and at night) was reported at higher rates post-injury than before injury. Crash rates were 14.9% in the year prior to injury (excluding crashes that resulted in TBI), 9.9% in the first year post-injury, and 6% during the second year.

Conclusion:

RTD is common after TBI, although driving may be limited in terms of frequency, distance driven, and avoiding challenging situations compared to before injury. Incidence of crashes is higher than population-based statistics; however, those who sustain TBI may be at higher risk even prior to injury. Future work is needed to better identify characteristics that influence the likelihood of crashes post-TBI.
ASSESSMENT OF THE EFFECTS OF TWO COMMONLY USED MYDRIATICS ON THE MACULAR AND PERIPAPILLARY MICROVASCULAR SYSTEMS OF HEALTHY CHILDREN
Authors: Seyyar Sevim Ayca , Gürbostan Soysal Gizem , Balyemez Burçak
Published: August 2024

Purpose:

To evaluate the effects of pupil dilation caused by topical applications of 2.5% phenylephrine and 0.5% tropicamide on retinal microvascularization using optical coherence tomography angiography (OCTA).

Methods:

Healthy children were included in this prospective observational study. Baseline OCTA measurements were taken for all children before dilatation. Then they were randomly divided into two groups, the tropicamide group given 0.5% tropicamide solution and the phenylephrine group given 2.5% phenylephrine solution. After dilation, OCTA images were taken for the second time from all children.

Results:

The effect of dilation using two different mydriatic agents caused a decrease in mean radial peripapillary capillary density (RPC-VD) and superior RPC-VD (P = 0.008 and P = 0.001). Remarkably, this reduction because of dilatation was also determined to be caused by the combined effect of both mydriatic agents (P = 0.016 and P = 0.013). Although phenylephrine showed a slightly greater decrease than tropicamide, the effects of the two mydriatic drugs were not superior to each other (P = 0.166 and P = 0.167).

Conclusion:

Dilation with 2.5% phenylephrine or 0.5% tropicamide significantly decreased mean RPC-VD and superior RPC-VD. Although there was no statistically significant difference between the two mydriatic agents, phenylephrine caused a greater reduction than tropicamide. This effect of dilation and phenylephrine on VD should be considered in studies using OCTA and focusing on peripapillary areas.
The Epidemiologic and Clinical Features of Radiographic-Confirmed Community–acquired Pneumonia Among Chinese Children: A Retrospective Hospital-based Study
Authors: Li Yudan , Liu Changpeng , Shi Ting , Sheng Mao , Chen Qinghui , Zhu Jun , He Na , Zhao Genming , Tian Jianmei , Zhang Tao
Published: August 2024

Background:

To help understand the disease burden of vaccine-preventable bacterial disease, we delineated the epidemiologic and clinical characteristics of radiographic-confirmed community–acquired pneumonia (CXR-CAP) among Chinese children.

Methods:

We retrospectively screened the electronic database of the hospital information system to identify all pediatric CAP cases admitted to the Children’s Hospital of Soochow University between 2010 and 2014. Radiographic findings and clinical data were extracted from the medical charts through individual chart reviews. CXR-CAP cases were defined as the presence of consolidation or pleural effusion noted on chest radiograph reports. We employed a multivariate logistic regression model to identify the potential risk factors associated with CXR-CAP.

Results:

Among the 27,485 hospitalized CAP cases with radiologic data, 6322 (23.00%) were identified as CXR-CAP cases, while 21,163 (77.00%) were categorized as non-CXR-CAP cases. Children with CXR-CAP were notably older than those without CXR-CAP (non-CXR-CAP; χ2 = 1313.22; P < 0.01). CXR-CAP cases exhibited a higher rate of intensive care unit admission (3.55% vs. 1.94%; P < 0.01), extended hospital stays (73.87% vs. 63.79%; P < 0.01) and increased mortality rates (0.19% vs. 0.04%; P < 0.01). The factors associated with CXR-CAP included age (>12 months), season (summer and autumn), fever, abnormal breath sounds, C-reactive protein (>8 mg/L) and alanine transaminase (>40 U/L).

Conclusions:

CXR-CAP cases consisted of a substantial proportion of hospitalized patients with CAP and had more severe clinical manifestations than in-patients without CXR-CAP among Chinese children.
Validation of the JAMR upper-arm pressure monitor B23 according to the AAMI/ESH/ISO Universal Standard (ISO 81060- 2:2018/AMD 1:2020)
Authors: Li Jing , Han Li-Hong , Feng Ru , Wu Li-Hao , Cai Jie , Zeng Tian-Ying , Liu Hui , Wang Lei , Li Ju-Yun , Zhan Zhong-Qun
Published: August 2024

The aim of this study was to evaluate the accuracy of the JAMR upper-arm blood pressure monitor B23 in the general population according to the AAMI/ESH/ISO Universal Standard (ISO 81060-2 : 2018/AMD 1 : 2020). The study recruited participants who met the criteria of the AAMI/ESH/ISO Universal Standard in terms of their number, sex, age, limb size, and blood pressure (BP) distribution. The study involved measuring BP, including both SBP and DBP, using both the test device and a standard mercury sphygmomanometer in sequential measurements. Of 90 participants, 85 qualified participants were analyzed. A total of 255 sets of comparison data (three sets for each subject) were obtained and analyzed. For the validation criterion 1, the mean ± SD of the differences between the JAMR B23 and mercury sphygmomanometer BP readings was −0.24 ± 6.52/−2.67 ± 5.6 mmHg (SBP/DBP). For criterion 2, the SD of the averaged BP (SBP/DBP) differences between the JAMR B23 and reference BP (SBP/DBP) per participant was 5.61/5.13 mmHg (the requirement was ≤6.95/6.43 mmHg by calculation). The JAMR B23 passed all the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2 : 2018/AMD 1 : 2020) and can be recommended for clinical and self/home use in the general population.
Investigating sex, race, and geographic disparities in bronchus and lung cancer mortality in the United States: a comprehensive longitudinal study (1999–2020) utilizing CDC WONDER data
Authors: Alim Ur Rahman Hafsah , Ahmed Ali Fahim Muhammad , Salman Afia , Kumar Sateesh , Raja Adarsh , Raja Sandesh , Advani Damni , Devendar Raja , Khanal Anuva
Published: August 2024

Background:

Lung and bronchus cancer has become the leading cause of cancer-related mortality in the United States. Understanding the patterns of mortality is an absolute requirement.

Methods:

This study analyzed Lung and Bronchus cancer-associated mortality rates from 1999 to 2020 using death certificate data from the Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research (CDC WONDER). Age-adjusted mortality rates (AAMRs), per 100 000 people, and annual percentage change (APCs) were also calculated.

Results:

3 599 577 lung and bronchus cancer-related deaths occurred in patients aged younger than 1–85+ years between 1999 and 2020. Overall AAMRs declined from 59.1 in 1999 to 58.9 in 2001 (APC: −0.1364) then to 55.9 in 2005 (APC: −1.4388*) 50.5 by 2010 (APC: −2.0574*) 44.7 by 2014 (APC: −2.9497*) and 35.1 by 2020 (APC: −4.1040*). Men had higher AAMRs than women (overall AAMR men: 61.7 vs. women: 38.3). AAMRs were highest among non-Hispanic (NH) Black or African American (52.7) patients followed by NH White (51.8), NH American Indian or Alaska Native (38.6), NH Asian or Pacific Islander (24.7) and Hispanic or Latino race (20.2). AAMRs varied in region (overall AAMR; South: 52.4; Midwest: 52.3; Northeast: 46.3; West: 39.1). Non-metropolitan areas had a higher AAMR (55.9) as compared to metropolitan areas (46.7). The top 90th percentile states of Lung and Bronchus cancer AAMR were Arkansas, Kentucky, Mississippi, Tennessee, and West Virginia.

Conclusion:

An overall decreasing trend in AAMRs for lung and bronchus cancer was seen. Public health measures to regulate risk factors and precipitating events are needed.
Strangulated pericardial hernia presenting as a case of STEMI; when the disease misleads the physician: a very rare case report
Authors: Omar Asaad Shareef , Musa Dildar Haji , Sgery Azri Salih Haji
Published: August 2024

Introduction and importance:

The pericardial hernia is a rarely encountered clinical condition characterized by the herniation of the abdominal viscera into the pericardial cavity. Trauma precedes the development of these hernias in most cases, yet iatrogenic intervention and congenital defects are other potential causes.

Case presentation:

A male aged 60 years, with no history of previous trauma, presented with epigastric pain and was diagnosed with a case of STEMI. After the treatment, the patient continued to deteriorate and developed repeated vomiting. Surgical consultation was counseled which recommended a plain erect abdominal radiograph that revealed air-fluid levels. During surgery, the surgeon noticed a strangulated jejunum protruding into the pericardium, and the case was diagnosed as a pericardial hernia.

Clinical discussion:

Pericardial hernias could be congenital or acquired and trauma is regarded as the commonest cause in adults. According to the history and clinical presentation the cause could be an old-forgotten trauma that has led to the small defect formation and protrusion of the jejunum. Trauma is regarded as the commonest cause; however, cases can pass unnoticed. The clinical presentation of this patient was initially related to acute coronary syndrome and was treated with primary coronary intervention, later a co-existing cause or probably the initiating cause was found to be a pericardial hernia.

Conclusion:

The diagnosis of the case makes a significant challenge that requires a high index of suspicion due to the rarity of the condition, variable clinical presentation, and the delayed development of symptoms.
Bile acid modulation by gut microbiota: a bridge to understanding cognitive health
Authors: Sabahat Syeda Elezeh , Saqib Muhammad , Talib Muneeba , Shaikh Taha Gul , Khan Tooba , Kailash Sejal Jain
Published: August 2024

The gut microbiota plays an important role in regulating the body’s physiological system, and more recently its impact on bile acid metabolism and cognitive function has been investigated by many studies. In addition to their conventional function in fat digestion and absorption, bile acids are now considered crucial signaling molecules that control several metabolic processes and immunological responses. For this purpose, the authors conducted comprehensive research using relevant terms in an attempt to understand more about the gut microbiota and its impact on bile acid metabolism and cognitive health. The gut-brain axis refers to the network of routes through which gut bacteria communicate with the brain. Through its capacity to bio-transform primary bile acids into secondary bile acids, the gut microbiota plays a significant role in bile acid metabolism. Bile acids function as signaling molecules and act on the brain through nuclear and membrane-bound receptors, influencing neurotransmitter production, neuroinflammation, and neuroplasticity to modify this communication. Any dysregulation in this axis can result in cognitive dysfunction. The link between gut microbiota, bile acids, and cognitive health cannot be ignored. It is imperative to explore this link further by conducting large-scale trials to improve the cognitive health of patients with multiple comorbidities, especially those involving the gastrointestinal tract and nervous system.
Determining the Effects of Complex Education on Primary Care Nurse Practitioners' Self-efficacy in Advance Care Planning for Healthy Adults
Authors: Geiler Yelena , Bowen Brady Helene
Published: August 2024

Advance care planning is a process in which capable adults communicate their preferences for medical care in case of incapacitation. Regardless of health status, most adults are interested in advance care planning conversations and prefer providers to initiate these discussions. Primary care nurse practitioners are ideally positioned to lead these conversations but lack knowledge, confidence, and communication skills to do so. This project aimed to develop, implement, and evaluate an educational program for primary care nurse practitioners regarding leading advance care planning conversations with healthy adults. This evidence-based practice project used the Advance Care Planning Self-Efficacy Scale to measure primary care nurse practitioners' self-efficacy after completing a complex educational program. The educational program was developed based on a nationally recognized program incorporating didactic, observational, and role-play learning. The findings of this project indicated that providing complex education was an effective intervention immediately and after 3 months (P = .018 and P = .023, respectively). The results indicate that educating nurse practitioners is an effective intervention for increasing their self-efficacy in leading advance care planning conversations with healthy adults over 3 months, recommending additional intervention at least earlier than 6 months.
Predictors of Supportive Care Needs During Serious Illness
Authors: Nelson Katie E. , Runsabove Kassie , Saylor Martha Abshire , Adams Kathleen , Davidson Patricia M. , Perrin Nancy , Werk Alicia , Wright Rebecca , Brockie Teresa N.
Published: August 2024

Native Americans (Indigenous Americans) have high rates of serious illness in the United States. Informal caregivers are heavily relied on in caring for patients in low-resource settings. The needs of caregivers residing on reservations are sorely underreported. Therefore, our objective was to examine relationships between facilitators (communal mastery, cultural identity, and spirituality) and barriers (depression, anxiety, stress, and burden) with supportive care needs among adult informal caregivers in 1 reservation-based community. A cross-sectional survey was distributed in July and August 2022 as part of a larger multimethod, community-based participatory research study. We used descriptive statistics and linear regression models to examine relationships against the primary outcome, the Supportive Care Needs Assessment Tool for Indigenous People. Overall, 127 participants were included; most were female (n = 92, 72.4%), were between 30 and 49 years (n = 57, 44.9%), and had 6 months or less of caregiving experience (n = 41, 32.5%). Higher depression, anxiety, stress, and burden were significantly associated with higher Supportive Care Needs Assessment Tool for Indigenous People scores. Overall, mental health is a significant barrier that may indicate greater supportive care needs among informal caregivers, although further work is needed to differentiate symptoms and their impact on caregiving from a cultural perspective.
Randomized Controlled Trial of Interventions Used by Midwives to Treat Fear of Childbirth
Authors: Mies Padilla Sergio , González de la Torre Héctor , López Alcaide Elena , Verdú Soriano José , Martín Martínez Alicia
Published: August 2024

Background

Fear of childbirth affects women worldwide and can have adverse consequences. Midwives have implemented a number of interventions, autonomously or as part of a professional team. However, midwives have been unable to identify the most appropriate intervention for ensuring the reduction or alleviation of this fear to provide the best perinatal outcomes.

Objective

This study aimed to evaluate the effectiveness of a prenatal educational intervention followed by specific support during childbirth, designed and delivered exclusively by midwives for women with a high fear of childbirth.

Method

This randomized controlled trial was performed with two arms in two phases: an online prenatal education phase followed by a support phase during childbirth. Participating women with a high fear of childbirth, which was determined using the Wijma Delivery Expectancy Questionnaire A–Spanish version, were assigned to the experimental group or the usual care control group at a 1:1 ratio.

Results

Women showed a reduction in fear of childbirth in both phases of the study. According to the intention-to-treat analysis, a significant mean difference was observed in the prenatal stage in favor of the intervention group, and a nonsignificant difference was observed in favor of this same group after delivery.

Discussion

The effectiveness of continuous specific prenatal education with preferential support during childbirth by midwives was indicated by improvements in the level of fear of childbirth.
Differences in Self-Reported Stress Versus Hair and Nail Cortisol Among Adolescent and Young Adult Males
Authors: Schnall Rebecca , Liu Jianfang , Cordoba Evette , Brin Maeve , Garofalo Robert , Kuhns Lisa M. , Jandev Vikrant , Careem Fathima Raviya , Hidoyatov Muhammadzohir , Padilla Janeth Juarez , Pearson Cynthia , Batey D. Scott , Norful Allison A. , Bendinskas Kestutis
Published: August 2024

Background

Chronic stress causes harmful physiological responses that yield increased inflammation and subsequent health conditions. Stress is an important measure among minoritized populations who face social situations that predispose risk to developing mental health problems. Hair and fingernail cortisol have been studied as retrospective measures of chronic stress and to demonstrate biological response to social situations.

Objectives

The objective of this study was to compare the Perceived Stress Scale (PSS) with hair and nail cortisol concentrations and assess the risk factors associated with stress levels among heterosexual and sexual and gender-minoritized adolescent males.

Methods

We recruited a cohort of adolescents who were assigned male sex at birth. Approximately half of our cohort consisted of sexual and gender-minoritized people, and half consisted of heterosexual cisgender males. Participants provided hair and nail samples and completed a survey that included demographic and hair hygiene questions and the PSS. Hair and nail samples were processed in a laboratory, and survey results were analyzed descriptively.

Results

Several samples were not provided or received, and some survey data were missing. Hair and nail cortisol values were significantly associated. There was no significant relationship between the PSS and hair and nail cortisol values. No significant differences were found between the heterosexual and sexual minoritized groups. Black participants reported lower perceived stress scores compared to White participants. Participants whose gender was nonbinary or genderqueer had higher hair cortisol values compared to those who identified as male. Older participants had higher hair cortisol values compared to younger participants.

Discussion

Previous researchers have similarly found no correlation between self-report stress scales and cortisol values, increased stress experience among nonbinary or genderqueer individuals compared to cisgender individuals, and a positive correlation between aging and stress. Yet, our finding that Black participants reported lower stress levels than White participants is unexpected. Our study demonstrates a high correlation between hair and nail cortisol values, suggesting the potential to substitute these markers as needed.
Estimating the Relationship Between Nurse Staffing and Medication Pass Workload Using National Barcode Data
Authors: Eck Chase S. , Knox Melissa K. , Mehta Paras D. , Petersen Laura A.
Published: August 2024

Background

Measuring and assessing the relationship between inpatient nurse staffing and workload across a national health system is difficult because of challenges in systematically observing inpatient workload at the unit level.

Objective

The objective of this study was to apply a novel measure of inpatient nurse workload to estimate the relationship between inpatient nurse staffing and nurse workload at the unit level during a key nursing activity: the peak-time medication pass.

Methods

A retrospective observational study was conducted in the Veterans Health Administration, the largest employer of nurses in the United States. The sample included all patients (n = 1,578,399 patient days) admitted to 311 non-intensive care unit inpatient acute care units in 112 hospitals in 2019 (104,588 unit days). Staffing was measured as the unit-level, nurse-to-patient ratio, and workload was measured using average time (duration) for RNs to complete the peak-time medication pass.

Results

We found a negative relationship between the RN-to-patient ratio and average peak-time medication pass duration after adjusting for unit-level patient volume and average patient severity of illness and other unit-level factors. This relationship was nonlinear: The marginal effect of staffing on workload decreased as staffing increased.

Discussion

As unit-level nurse staffing increased, average RN workload decreased. This result suggests that interventions to improve nurse staffing may have larger nonlinear effects for units with lower staffing levels. Understanding the effect of differing staffing decisions on variations in nursing workload is critical for adopting models of care that effectively use scarce staffing resources and contribute to retaining nurses in the inpatient workforce. This work provides evidence that peak-time medication pass duration is a valid process-based measure of workload and highlights the potential diminishing returns to increasing staffing.
Intervention Fidelity in a Virtual Community Participatory Research Trial
Authors: Jones Holly J. , Bakas Tamilyn , Bacchus Patricia , Yildiz Vedat O. , Kovacic Melinda Butsch
Published: August 2024

Background

Midlife Black women (ages 45–64 years) suffer disproportionately from cardiovascular disease, yet there remains a paucity of programs tailored to this at-risk subpopulation. The Midlife Black Women’s Stress Reduction and Wellness (B-SWELL) program was codeveloped with community representatives to provide culturally tailored materials and content designed to increase adoption of healthier lifestyle behaviors and improve cardiovascular health. Few reports highlight the methods used to monitor fidelity in community participatory research.

Objective

The objective of this report is to describe approaches used to ensure fidelity in the B-SWELL feasibility trial.

Methods

A virtual randomized feasibility trial was conducted. Intervention fidelity was evaluated in accordance with Borrelli’s five principles of fidelity: design, training, delivery, receipt, and enactment. In addition to the rigorous oversight by the research team, tools were developed or adapted for the virtual trial. Tools used in the trial included a Visual Analog Attendee Engagement Tool, weekly feedback surveys, audio recordings, a facilitator’s checklist, an overall satisfaction survey, and a technology survey.

Results

Using Borrelli’s framework for treatment fidelity, the researchers noted high ratings from the overall satisfaction survey, designed to assess ongoing participant satisfaction with the intervention materials and continued enactment. The tools successfully guided the intervention process from design to enactment.

Discussion

Adherence to Borrelli’s principles of fidelity enables rigorous oversight of an intervention and its delivery. The growing use of technology to deliver programmed interventions requires that tools be adapted and created to monitor fidelity. Validation of the research-developed and -adapted tools is recommended in a larger trial.
Spinal Cord Astroblastoma With EWSR1-BEND2 Fusion in Female Patients
Authors: Fu Lingyi , Lao I. Weng , Huang Liyun , Ou Liqiong , Yuan Lei , Li Ziteng , Li Shuo , Hu Wanming , Xi Shaoyan
Published: August 2024

Astroblastoma is an extremely rare central nervous system tumor characterized by astroblastic pseudorosettes and vascular hyalinization. Despite these histologic hallmarks, its morphology can vary, occasionally resembling other central nervous system tumors such as ependymoma. A novel tumor entity, astroblastoma, meningioma 1 (MN1)-altered, has been identified, featuring MN1 gene rearrangements typically involving BEN-domain containing 2 (BEND2) as a fusion partner. Most astroblastomas arise in the cerebral hemisphere. Here, we report 4 cases of spinal cord astroblastoma in female patients, all showing Ewing sarcoma RNA-binding protein 1 fusion with BEND2, rather than MN1. These tumors displayed growth patterns akin to traditional intracranial astroblastomas, with three cases demonstrating high-grade histology, including elevated mitotic activity and necrosis. Interestingly, some cases exhibited positive staining for pan-cytokeratin and hormone receptors. DNA methylation profiling clustered three of the four cases with the reference “AB_EWSR,” whereas one case exhibited an independent methylation signature near the reference methylation group “AB_EWSR” and “pleomorphic xanthoastrocytoma.” Together with the existing literature, we summarized a total of eleven cases, which predominantly affected children and young adults with female predilection. Eight of 10 patients experienced recurrence, underscoring the aggressive nature of this disease. We suggest recognizing a new molecular subgroup of spinal astroblastoma and recommend testing newly diagnosed infratentorial astroblastomas for Ewing sarcoma RNA-binding protein 1-BEND2 fusion.
Diagnostic Validation of the Updated Pediatric Sepsis Biomarker Risk II for Acute Kidney Injury Prediction Model in Pediatric Septic Shock*
Authors: Stanski Natalja L. , Zhang Bin , Cvijanovich Natalie Z. , Fitzgerald Julie C. , Bigham Michael T. , Jain Parag N. , Schwarz Adam J. , Lutfi Riad , Allen Geoffrey L. , Thomas Neal J. , Baines Torrey , Haileselassie Bereketeab , Weiss Scott L. , Atreya Mihir R. , Lautz Andrew J. , Zingarelli Basilia , Standage Stephen W. , Kaplan Jennifer , Goldstein Stuart L.
Published: August 2024

OBJECTIVES:

We previously derived the updated Pediatric Sepsis Biomarker Risk for Acute Kidney Injury (PERSEVERE-II AKI) prediction model, which had robust diagnostic test characteristics for severe AKI on day 3 (D3 severe AKI) of septic shock. We now sought to validate this model in an independent cohort of children to the one in which the model was developed.

DESIGN:

A secondary analysis of a multicenter, prospective, observational study carried out from January 2019 to December 2022.

SETTING:

Ten PICUs in the United States.

PATIENTS:

Children with septic shock 1 week to 18 years old admitted to the PICU.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Seventy-nine of 363 patients (22%) had D3 severe AKI, defined as Kidney Disease Improving Global Outcomes stage 2 or higher. Patients were assigned a probability of D3 severe AKI using the PERSEVERE-II AKI model. The model predicted D3 severe AKI with an area under the receiver operating characteristic curve of 0.89 (95% CI, 0.85–0.93), sensitivity of 77% (95% CI, 66–86%), specificity of 88% (95% CI, 84–92%), positive predictive value of 65% (95% CI, 54–74%), and negative predictive value of 93% (95% CI, 89–96%). These data represent an increase in post-test probability of D3 severe AKI with a positive test from 22% to 65%, and a prevalence threshold of 28%. On multivariable regression, the PERSEVERE-II AKI prediction model demonstrated greater adjusted odds ratio (aOR) for D3 severe AKI (aOR, 11.2; 95% CI, 4.9–25.3) and lesser aOR for failure of D3 renal recovery from early AKI (aOR, 0.31; 95% CI, 0.13–0.69).

CONCLUSIONS:

The PERSEVERE-II AKI model demonstrates consistently robust performance for prediction of new or persistent D3 severe AKI in children with septic shock. A major limitation is that actual D3 severe AKI prevalence is below the prevalence threshold for the test, and thus future work should focus on evaluating use in enriched populations.