bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations of Adipokine Levels With Levels of Remnant Cholesterol: The Multi‐Ethnic Study of Atherosclerosis
Authors: Quispe Renato , Sweeney Ty , Martin Seth S. , Jones Steven R. , Allison Matthew A. , Budoff Matthew J. , Ndumele Chiadi E. , Elshazly Mohamed B. , Michos Erin D.
Published: September 2024

Background

The metabolic syndrome phenotype of individuals with obesity is characterized by elevated levels of triglyceride‐rich lipoproteins and remnant particles, which have been shown to be significantly atherogenic. Understanding the association between adipokines, endogenous hormones produced by adipose tissue, and remnant cholesterol (RC) would give insight into the link between obesity and atherosclerotic cardiovascular disease.

Methods and Results

We studied 1791 MESA (Multi‐Ethnic Study of Atherosclerosis) participants who took part in an ancillary study on body composition with adipokine levels measured (leptin, adiponectin, and resistin) at either visit 2 or visit 3. RC was calculated as non–high‐density lipoprotein cholesterol minus low‐density lipoprotein cholesterol, measured at the same visit as the adipokines, as well as subsequent visits 4 through 6. Multivariable‐adjusted linear mixed‐effects models were used to assess the cross‐sectional and longitudinal associations between adipokines and log‐transformed levels of RC. Mean±SD age was 64.5±9.6 years; mean±SD body mass index was 29.9±5.0 kg/m
2
; and 52.0% were women. In fully adjusted cross‐sectional models that included body mass index, diabetes, low‐density lipoprotein cholesterol, and lipid‐lowering therapy, for each 1‐unit increment in adiponectin, there was 14.6% (95% CI, 12.2–16.9) lower RC. With each 1‐unit increment in leptin and resistin, there was 4.8% (95% CI, 2.7–7.0) and 4.0% (95% CI, 0.2–8.1) higher RC, respectively. Lower adiponectin and higher leptin were also associated with longitudinal increases in RC levels over median follow‐up of 5 (interquartile range, 4–8) years.

Conclusions

Lower adiponectin and higher leptin levels were independently associated with higher levels of RC at baseline and longitudinal RC increase, even after accounting for body mass index and low‐density lipoprotein cholesterol.
Effect of Denosumab or Alendronate on Vascular Calcification: Secondary Analysis of SALTIRE2 Randomized Controlled Trial
Authors: Geers Jolien , Bing Rong , Pawade Tania A. , Doris Mhairi K. , Daghem Marwa , Fletcher Alexander J. , White Audrey C. , Forsyth Laura , Evans Emily , Kwieciński Jacek , Williams Michelle C. , van Beek Edwin J. R. , Kwak Soongu , Peeters Frederique E.C.M. , Tzolos Evangelos , Slomka Piotr J , Lucatelli Christophe , Ralston Stuart H. , Prendergast Bernard , Newby David E. , Dweck Marc R.
Published: September 2024

Background

Patients with osteoporosis demonstrate increased vascular calcification but the effect of osteoporosis treatments on vascular calcification remains unclear. The present study aimed to examine whether coronary or aortic calcification are influenced by denosumab and alendronic acid treatment.

Methods and Results

In a double‐blind randomized controlled SALTIRE2 (Study Investigating the Effect of Drugs Used to Treat Osteoporosis on the Progression of Calcific Aortic Stenosis) trial, patients with aortic stenosis were randomized 2:1:2:1 to denosumab, placebo injection, alendronic acid, or placebo capsule. Participants underwent serial imaging with computed tomography and 18F‐sodium fluoride positron emission tomography for the assessment of vascular calcium burden and calcification activity, respectively. We report the prespecified secondary analyses of 24‐month change in coronary calcium score, and 12‐month changes in thoracic aorta calcium score, coronary and aortic 18F‐sodium fluoride activity. One hundred fifty patients with aortic stenosis (72±8 years; 21% female) were randomized to denosumab (n=49), alendronic acid (n=51), and placebo (injection n=25, capsule n=25). There were no differences in change in coronary calcium scores between placebo (16 [−64 to 148] Agatston units) and either denosumab (94 [0–212] Agatston units,
P
=0.24) or alendronic acid (34 [−62 to 134],
P
=0.99). There were no differences in change in thoracic aorta calcium scores between placebo (132 [22–512] Agatston units) and either denosumab (118 [11–340],
P
=0.75) or alendronic acid (116 [26–498] Agatston units,
P
=0.62). There were no differences in changes in coronary or aortic 18F‐sodium fluoride activity between treatment groups.

Conclusions

Neither alendronic acid nor denosumab are associated with changes in the activity or progression of coronary or aortic calcification. Osteoporosis treatments do not appear to have major impact on vascular calcification of atherosclerosis.

registration

https://www.clinicaltrials.gov
; Unique identifier: NCT02132026.
Microbial Heterogeneity Identification of Cerebral Thrombi Via Metagenomic Next‐Generation Sequencing‐Based Strategy
Authors: Chen Xi , He Yuxuan , Zhou Linke , Li Xingtong , Jiang Meiling , Wu Min , Li Jing , Chen Li , Xu Huan , Gui Li , Zhou Zhenhua
Published: September 2024

Background

Diagnosis of the cause of cerebral thrombi is vital for recurrence prevention but also challenging. The presence of the microbiome has recently been confirmed in thrombus, suggesting a novel approach to distinguish cerebral thrombi of different origins. However, little is known about whether there is heterogeneity in microbiological colonization of cerebral thrombi of different sources.

Methods and Results

Forty patients experiencing acute ischemic stroke were included and clinical data were collected. Metagenomic next‐generation sequencing was adopted to detect bacterial and genomic signatures of human cerebral thrombi samples. We found similar species diversity between the large‐artery atherosclerosis thrombi and cardioembolic thrombi but different species composition and distribution of cerebral thrombus microbiota. Compared with the group with cardioembolism, the group with large‐artery atherosclerosis showed a significantly higher relative abundance of
Ralstonia insidiosa
among the top 10 bacterial species in cerebral thrombi. Twenty operational taxonomy units were correlated with 11 clinical indicators of ischemic stroke. The Gene Ontology enrichment analysis revealed 9 different enriched biological processes (translation and carbohydrate metabolic process, etc). The enriched Kyoto Encyclopedia of Genes and Genomes pathways included ribosome, butanoate metabolism, and sulfur metabolism.

Conclusions

This study, based on the approach of metagenomic next‐generation sequencing, provides a diagnostic microbiological method to discriminate individuals with cardioembolic thrombi from those with large‐artery atherosclerosis thrombi with human cerebral thrombi samples. Our findings provide a fresh perspective on microbial heterogeneity of cerebral thrombi and demonstrate biological processes and pathway features of cerebral thrombi.
Computed Tomography Imaging Measurements as a Surrogate for Clinical Outcomes After Surgical Management of Acute Type A Aortic Dissection: A Systematic Review
Authors: Vo Thin X. , Rahmouni Kenza , Visintini Sarah , Guo Ming H. , Ouzounian Maral , Chu Michael W. A. , Boodhwani Munir , Appoo Jehangir J. , Tucker Katherine , Al‐Atassi Talal ,   the Canadian Thoracic Aortic Collaborative (CTAC)
Published: September 2024

Background

Postoperative computed tomography imaging surveillance is an essential component of care after acute type A aortic dissection (ATAAD) repair. Prognostic imaging factors after ATAAD repair have not been systematically reviewed.

Methods and Results

We performed a systematic review to summarize postoperative computed tomography measurements including aortic diameter, cross‐sectional area, volume, growth rate, and false lumen thrombosis in addition mid‐ to long‐term clinical outcomes after ATAAD repair. Searches were conducted in Medline, Embase, and CENTRAL in October 2022. Studies were included if they reported clinical outcomes such as mortality or aortic reintervention after 1 year and included aforementioned computed tomography findings. Studies of chronic aortic dissection and studies of exclusive patient populations such as those with connective tissue diseases were excluded. Risk of bias was assessed with the Newcastle‐Ottawa Scale. Searches retrieved 6999 articles. Sixty‐eight studies met inclusion criteria (7885 patients). Extended repairs were associated with improved false lumen thrombosis, decreased aortic growth rate, and decreased rates of reintervention but not improved survival. Growth rates of the aorta post‐ATAAD repair were highest in the descending thoracic aorta. The most frequent prognostic imaging factors reported were a patent/partially thrombosed false lumen and postoperative aortic diameter >40 to 45 mm.

Conclusions

Established measurements of positive aortic remodeling, including complete false lumen thrombosis and stabilization of postoperative aortic diameter and growth are the most studied prognostic indicators for improved clinical outcomes after ATAAD repair. Growth rate of the aorta remains significant after ATAAD repair. Future studies should prospectively evaluate and compare prognostic factors for improved surveillance and management.
Significance of an Early Repeat Troponin Measurement Upon Presentation to the Hospital for Acute Heart Failure
Authors: Horiuchi Yu , Maisel Alan S. , van Veldhuisen Dirk J. , Mueller Christian , Hogan Christopher , Kontos Michael C. , Cannon Chad M. , Müller Gerhard A. , Taub Pam , Vilke Gary M. , Duff Stephen , McDonald Kenneth , Mahon Niall , Nuñez Julio , Briguori Carlo , Passino Claudio , Murray Patrick T. , Wettersten Nicholas
Published: September 2024

Background

Higher cardiac troponin is associated with worse outcomes in patients with acute heart failure. The significance of repeat measurements over hours remains unclear. We assessed whether a repeat measurement and the Δ between measurements of high‐sensitivity cardiac troponin I (hs‐cTnI) were associated with outcomes in hypervolemic patients with acute heart failure without acute coronary syndrome.

Methods and Results

We analyzed 582 individuals from AKINESIS (Acute Kidney Injury Neutrophil Gelatinase‐Associated Lipocalin Evaluation of Symptomatic Heart Failure Study) with hs‐cTnI measured ≤12 hours from admission and repeated ≤6 hours thereafter. Associations between hs‐cTnI levels and their Δ with short‐term (death, intensive care unit admission, receipt of inotropes, or positive pressure ventilation during hospitalization) and long‐term (death or heart failure readmission within 1 year) outcomes were assessed. The average age was 69±13 years, 62% were men, 65% were White, 46% had coronary artery disease, and 22% had chest pain. Median hs‐cTnI levels were 27 (interquartile range [IQR], 13–62) ng/L initially and 28 (IQR, 14–68) ng/L subsequently, with a Δ of 0 [IQR, −2 to 4] ng/L over 3.4±1 hours. Only the second measurement was associated with short‐term outcomes (odds ratio, 1.14 per 2‐fold higher [95% CI, 1.02–1.28]). Both individual measurements and the Δ were associated with long‐term outcomes (hazard ratios, 1.09, 1.12, and 1.16 for first, second, and Δ, respectively). Associated risk for the first and second measurements were not constant over the year but highest early after being measured and decreased over 1 year.

Conclusions

Repeat measurements of hs‐cTnI over hours can identify individuals with acute heart failure without acute coronary syndrome at risk for short‐ and long‐term outcomes.
Investigating the Relative Contribution from Tropical Indo-Pacific SST to Asian Monsoon Precipitation Variability Using LIM
Authors: Guderian Erin , Han Weiqing , Webster Peter , Zhang Lei , Di Lorenzo Emanuele
Published: September 2024

A critical issue is determining the factors that control the year-to-year variability in precipitation over southern Asia. In this study, we employ a cyclostationary linear inverse model (CS-LIM) to quantify the relative contribution of tropical Pacific and Indian Ocean sea surface temperature anomalies (SSTAs) to the interannual variability of the Asian monsoon, especially Indian summer monsoon rainfall (ISMR). Through a series of CS-LIM experiments, we isolate the impacts of the direct forcing from Pacific SSTAs, Indian Ocean SSTAs, and their interaction on Asian monsoon rainfall variability. Our results reveal distinct patterns of influence with the direct forcing from the Pacific (Indian) Ocean tending to enhance (reduce) the magnitude of precipitation variability, while the Indo-Pacific interaction acts to strongly damp the variability of Asian monsoon precipitation, especially over India. We further investigate these specific impacts on ISMR by analyzing the relationship between tropical Indo-Pacific SSTAs and the leading three empirical orthogonal functions (EOFs) of ISMR. The results from our CS-LIM experiments indicate that the direct forcing from El Niño–Southern Oscillation (ENSO) enhances the variability of the first and third EOFs, while the Indian Ocean SSTA opposes ENSO’s effects, which is consistent with previous studies. Our new results show that the tropical Indo-Pacific interaction strongly damps ISMR variability, which is due to the ENSO-induced Indian Ocean dipole (IOD) opposing the direct impacts from ENSO on ISMR. Additionally, reduced ENSO amplitude and duration associated with the Indo-Pacific interaction may also contribute to the damping effect on ISMR, but this requires further study to understand the relevant mechanisms.
A Systematic Local View of the Long-Term Changes in the Atmospheric Energy Cycle
Authors: Liu Zhen , Franzke Christian L. E. , Novak Lenka , Tailleux Remi , Lembo Valerio
Published: September 2024

The global climatology and long-term changes in the atmospheric energy cycle in the boreal winter are analyzed using a local available potential energy framework using the fifth-generation ECMWF reanalysis data during 1979–2021. In contrast to the classic Lorenz energy cycle, this local framework provides the local information of available potential energy (APE) and its interactions with kinetic energy (KE), allowing the systematic study of barotropic and baroclinic processes. A further systematic decomposition of the APE and KE reservoirs into high- and low-frequency components is conducted to investigate the source and sink terms that account for their spatial variations and long-term changes. The climatology of the local energetic budget terms shows that the interplay between low-frequency APE and KE is mostly over the tropical and polar regions associated with the thermally direct circulation there. Interactions involving high-frequency components are mainly located in the storm-track regions. We show that under recent global warming, a prominent dipolar trend of changes is present over the Asia–Pacific region for all energy forms. The long-term changes in the energy budget reveal how high-frequency APE intensification is due to a stronger conversion from low-frequency APE upstream of the storm track and that this intensification can be compensated by eddy advection away from the storm track, rather than conversion to kinetic energy in the proximity of the mean jet. This provides evidence that a warmer climate substantially affects the energy cycle and, thus, the atmospheric circulation.

Significance Statement

Potential and kinetic energies are major components of atmospheric circulation. Those energies and their generation, dissipation, and conversions provide insight into the dynamics of atmospheric circulation. The Lorenz energy cycle, based on a global framework, has been fundamental in deepening our understanding of the atmosphere. However, here we use a systematic local framework to gain a better understanding of atmospheric circulation changes and how global warming has affected them. Our study finds a general intensification of the local energy cycle over the last few decades.
Estimating the In Situ Stratification via Remotely Sensed Internal Wave Speeds
Authors: Fang Chufan , Simpson Alexandra J. , Lerczak James A. , Haller Merrick C.
Published: September 2024

This work tests a methodology for estimating the ocean stratification gradient using remotely sensed, high temporal and spatial resolution field measurements of internal wave propagation speeds. The internal wave (IW) speeds were calculated from IW tracks observed using a shore-based, X-band marine radar deployed at a field site on the south-central coast of California. An inverse model, based on the work of Kar and Guha, utilizes the linear internal wave dispersion relation, assuming a constant vertical density gradient is the basis for the inverse model. This allows the vertical gradient of density to be expressed as a function of the internal wave phase speed, local water depth, and a background average density. The inputs to the algorithm are the known cross-shore bathymetry, the background ocean density, and the remotely sensed cross-shore profiles of IW speed. The estimated density gradients are then compared to the synchronously measured vertical density profiles collected from an in situ instrument array. The results show a very good agreement offshore in deeper water (∼50–30 m) but more significant discrepancies in shallow water (20–10 m) closer to shore. In addition, a sensitivity analysis is conducted that relates errors in measured speeds to errors in the estimated density gradients.

Significance Statement

The propagation speed of ocean internal waves inherently depends on the vertical structure of the water density, which is termed stratification. In this work, we evaluate and test with real field observations a technique to infer the ocean density stratification from internal wave propagation speeds collected from remote sensing images. Such methods offer a way to monitor ocean stratification without the need for extensive in situ measurements.
Preparing Adults with Cerebral Palsy to Move from Assisted to Independent Living
Authors: Rosenberg Lori , Zecharia Shira , Gilboa Yafit , Golos Anat
Published: September 2024

Background. To evaluate effectiveness of The Greenhouse for autonomy and independence to prepare adults with severe cerebral palsy (CP) for the transition from assisted to independent living. The intervention combines weekly individual sessions using Pathways and Resources for Engagement and Participation together with weekly group sessions. Method. Seven adults with severe CP ages 23–45 years (M = 35; SD = 10) participated in the 20-week program. An Interrupted Time Series quasi-experimental design was used, assessing the intervention effect over time. The Canadian Occupational Performance Measure was administered bi-weekly from baseline to post-intervention to assess activity performance. Functional Independence Measure (FIM), Wheelchair use Confidence scale (WheelCon) and Impact on Participation and Autonomy (IPA) were administered baseline (4 weeks pre-intervention), mid and post-intervention, using Freidman test. Interviews were conducted four weeks after intervention. Findings. All participants’ activity performance improved over time with significant clinical improvement in 95% of COPM goals. Significant improvement was seen in FIM (χ2 = 8.07, p = .018) and WheelCon (χ2 = 7.18, p = .028) though not in IPA. Participants described being better prepared, however more aware of challenges. Conclusion. The findings suggest the program may be effective to help adults with severe CP attain goals related to independent living and enhance function.
The impact of the 2023 Türkiye-Syria earthquakes on the mental health of children
Authors: Ahmed Sirwan Khalid , Saied AbdulRahman A , Nashwan Abdulqadir J
Published: September 2024

The seismic events that struck southern Turkey and Syria in February 2023, with magnitudes of 7.8 and 7.6 respectively, have significantly impacted the well-being of millions, particularly children and adolescents. This correspondence highlights the psychological repercussions faced by minors in the aftermath of the earthquakes, including anxiety, PTSD, and depression. Despite efforts to provide humanitarian aid, there remains a critical gap in addressing the psychosocial needs of affected children. With limited mental health resources in both countries, innovative approaches such as Psychological First Aid (PFA) interventions and telepsychiatry are advocated for efficient and scalable support. Additionally, safeguarding children from abuse and ensuring access to education and stable environments are paramount in post-disaster recovery efforts. This correspondence underscores the urgency for a holistic response to mitigate the long-term impact of seismic events on the vulnerable population in Turkey and Syria.
“I need to be strong”: Refugee women embody resilience within personal, host, and faith communities
Authors: Sanchez Jamie N , Dryjanska Laura , Hagues Rachel
Published: September 2024

This basic qualitative study sought to understand resilience from the perspective of women refugees. In June 2023, semi-structured interviews were conducted with 13 women refugees from Ukraine living in Teplice, Czech Republic. Findings demonstrated that participants embodied resilience within the context of their personal, host, and faith communities. First, family members were motivation to make the journey out of Ukraine and friends were helpful resources of information and meeting practical needs. Host communities included volunteers at international borders, churches on the journey, the Czech government, and various strangers as factors in their resilience. Finally, within faith communities, participants described their own personal Christian faith, “miracles,” and churches that were place to belong. This study is situated in the broad academic literature about resilience and refugees studies. Yet, the research findings add empirical data to corroborate conceptual and theoretical literature. Additionally, this research relies on data from refugee women themselves.
The Death of the Author: The Case of art Market
Authors: Pimenov Arsenii , Kolycheva Valeria , Semenov Alexander , Grigoriev Dmitry
Published: September 2024

Recent evidence suggests that the artwork of an experienced artist is usually more expensive than that of a beginner. Additionally, the artwork of a man is often more expensive than that of a woman, and a painting is typically more expensive than graphics. However, this research aims to contrast the influence of the author's age and sex on the price with the influence of the artwork's material and technique. This idea is based on Roland Barthes’ famous philosophical doctrine about the death of the author, which appeared in 1968 and remains relevant today. In our article, this doctrine is tested for the art market. The research question posed is whether the author's influence dies in relation to their artwork after its creation or whether the artwork begins to live its own life without the author. To answer this question, a study was conducted comparing the impact on auction prices of the artist's biography and the characteristics of the artwork. The artist's biography inevitably determines their creativity and affects their art, while the characteristics of the artwork are not directly related to the personality of the author but are important from a consumption standpoint. Several dozen features were identified and divided into author and artwork characteristics. For author characteristics, demographic features such as sex and nationality were used, as well as biographical features such as education and migration. Artwork characteristics included size, material, technique, provenance, author's signature and frame, mentions in scientific literature, etc. By applying hedonic regression on a unique collected dataset of more than 15,000 artworks by the most expensive authors sold at world-famous auction houses such as Sotheby's and Christie's, it was determined which characteristics have the greatest influence on price and which specific features are most important.
Variable angle tow-steered fibres based rotating composite beam with rotary oscillations – Parametric excitation/instability analysis
Authors: Haboussi Mohamed , Di Cara Girolamo , Naik Sudarshan , Polit Olivier , Manickam Ganapathi
Published: September 2024

This study is concerned with the stability analysis for various vibrational motions of tow-steered variable angle fibres based composite rotating beam with time varying speed. The formulation combines a higher order theory introducing sine function along with finite element methodology. It satisfies the plane stress condition in width direction of beam. The displacement kinematics are generic in the sense it includes various possible vibrational motions like chord and flap wise motions, torsional and axial vibration behaviours. The equilibrium equations for the proposed problem evolved adopting virtual dynamic work are then transformed into the equations of Mathieu-Hill type considering time varying harmonic rotational speed. Using Bolotin’s procedure coupled with C1 continuity-based beam element, the parametric resonance zones along with boundary limits are numerically evaluated. The eigenvalue type of solution methodology applied for the detailed study is validated for accuracy and computational efficiency against the time domain dynamic response analysis. Based on in-depth analysis, dynamic instability characteristics in terms of resonance range and origin of instability of composite beam subjected to the chord and flap wise, torsional and axial motions are studied considering curvilinear fibre path angles, beam cross section, hub radius, thickness ratio and mean rotary speed.
About Research - Qualitative Data Collection: Photo Elicitation
Authors: Gill Sara L.
Published: September 2024

Photo elicitation is a qualitative data collection technique in which the researcher includes photographs or other visual images as part of participant interviews. The researcher might provide the photographs or might ask the participants to bring photographs to the interview. This technique enhances the breadth and depth of verbal qualitative interviews. The use of photo elicitation can enhance the rigor of a qualitative study. There are both advantages and disadvantages of this data collection technique. Ethical issues warrant special consideration.
Lived-in Experience Among Caregivers of Autistic Children: A Qualitative Study from South India
Authors: Ray Aishwarya , Alphonsa K. K.  , Chandran Suhas
Published: September 2024

Background:

Autism is a developmental disorder that impairs the skills related to behavior, communication, interaction, and learning. This study was undertaken to understand the difficulties faced by caregivers in various aspects of life while taking care of children with autism and their unique life experiences.

Methods:

After obtaining ethical approval, the study was conducted in a tertiary care hospital in Bangalore, India. An informed consent and a subject information sheet were taken to obtain permission from the subjects. A baseline proforma was prepared for collecting the demographic data for both autistic children and the caregivers. An in-depth, face-to-face, semi-structured interview that consisted of around 10 questions was conducted for 30 minutes. The interview was recorded, later transcribed verbatim, and extracted into specific themes and subthemes.

Results:

The lived-in experiences throw light on many emotional, social, psychological, and physical distress the caregivers go through on a day-to-day basis. The daily hassles of every caregiver are unique and challenging. Five themes and corresponding subthemes were extracted as follows: emotional meltdown, change in family dynamics, spiritual transition, perceived social burden, and perception of a child’s future.

Conclusion:

The caregivers of children with autism faced various challenges such as physical and emotional turmoil, financial constraints, and the deprivation of a healthy social life almost every day. Interventional measures such as nurse-led clinics, counseling measure, and planning training sessions for nurses to deal with the various issues faced by the caregivers could be taken up to address the growing concerns of caregivers of children with autism.
The Evaluation of Content Relevance and Representativeness of the New Stroke Risk Screening Scales
Authors: Ruksakulpiwat Suebsarn , Voss Joachim G. , Challa Abhilash K , Kudlowitz Aaron
Published: September 2024

Stroke is a leading cause of death and disability worldwide. Early and comprehensive risk identification is essential for identifying individuals at high risk for stroke. This study aimed to evaluate each question in the new Stroke Risk Screening Scales (SRSS) and assess the domains for content relevance and representativeness. Initially, six stroke experts were invited to evaluate the SRSS questions. The content validity index (CVI), including the item-CVI (I-CVI) and the average-CVI (Ave-CVI), was then calculated. In our study, the acceptable standards for I-CVI and Ave-CVI were ≥0.78 and ≥0.9, respectively. The results showed that all invited experts accepted the invitation and evaluated the SRSS questions. The previous version of the SRSS consisted of 33 questions. Of these, 30 questions reached an I-CVI of ≥0.78, indicating good content validity. Three questions had an I-CVI of 0.67 and were considered invalid; thus, they were deleted. The overall instrument achieved an Ave-CVI of 0.95. Comprehensive SRSS are essential for effective stroke prevention planning. By facilitating the early identification of individuals at high risk for stroke, these scales help reduce the incidence and impact of stroke. The high content validity found in this study supports the reliability of the SRSS as a screening tool. In the future, implementing such validated scales in clinical practice can improve early intervention strategies, ultimately enhancing health outcomes and optimizing the use of healthcare resources.
Bullying Vulnerability among Adolescents Reporting Food Allergies: A Nationwide US Study
Authors: Kalra Saurabh , Kalra Deepak
Published: September 2024

Adolescents with food allergies (FA) face unique challenges, including an increased risk of bullying, yet comprehensive national studies on this intersection are lacking. Our study examines the prevalence and association between FA and bullying among US high-school adolescents, utilizing Youth Risk Behavior Survey (2015–2019) data. Analyzing responses from 27,781 adolescents, we found that 19.1% reported on-campus bullying, and 14.9% reported electronic bullying, while 15.8% reported FA. Food allergy was significantly more common among those who reported bullying (23% vs. 13.9%, p < .001). Logistic regressions revealed that adolescents with FA were more likely to experience on-campus (adjusted odds ratio [AOR] 1.51, 95% CI 1.35–1.69) and electronic bullying (AOR 1.42, 95% CI 1.27–1.58) compared to their peers without FA. These findings underscore the vital role of school nurses in identifying and addressing bullying among FA adolescents, thereby ensuring supportive environments, promoting well-being, and fostering academic success.
Strategies to Improve Access to Care for Patients With Opioid Use Disorder
Authors: Liu Ligang , Zhang Chen , Bonny Andrea E. , Nahata Milap C.
Published: September 2024

Treatment of opioid use disorder (OUD) faces several challenges, including restricted access to medications, geographical and logistical barriers, and variability in treatment availability across different communities. This article outlines several strategies aimed at improving access to medications. Pharmacy-based care could potentially extend access to medications but would require regulatory changes to empower pharmacists. In addition, telemedicine has shown promise in improving access by mitigating geographic and transportation barriers. Mobile health clinics also offer a direct approach to delivering medication-based treatments to underserved communities. Furthermore, integrating OUD treatment into primary care settings could facilitate early detection and treatment. Policy changes have increased access to take-home medications and buprenorphine initiation at home. Community engagement would be crucial for tackling the social determinants of health to offer equitable care for patients. The implementation of these strategies has the potential to significantly enhance the accessibility and delivery of effective, timely and equitable treatment to patients with OUD.
Improving Mental Health Literacy and Stigma Among the Hmong
Authors: Vang-Kue Mayche , McNeill Cynthera , Stephens Umeika
Published: September 2024

Introduction:

One in five adults in the United States suffers from mental illness. Negative social influences in the Hmong community stigmatize those who have mental health challenges and mental health outcomes are impacted by poor mental health literacy. Language barriers, conflicting traditional beliefs, and Western concepts of health contribute to low mental health literacy and willingness to seek professional mental health services among the Hmong.

Aims:

The aim of this project was to successfully implement Mental Health First Aid (MHFA) to a group of 30 or more Hmong adult church leaders in a faith-based setting.

Methods:

A pretest posttest project design was used. The project implementation process was guided by the Plan-Do-Study-Act (PDSA) model and took place from June 2023 to August 2023. Participants were recruited from three local Detroit Hmong churches. Indicator measures included the Mental Health Literacy Scale (MHLS) and Community Attitudes toward Mental Illness (CAMI) Scale before and immediately after training. One final survey was administered at 6 weeks post MHFA training to measure information retention, stigma, and utilization of MHFA skills.

Results:

Results reflect the existing body of literature regarding MHFA and the positive impacts on mental health literacy, confidence level, mental health awareness, and decreasing stigma.

Conclusion:

MHFA continues to demonstrate successful implementation across many settings and populations, especially for this project among Hmong adult church leaders. More research is needed to expand on mental health and the Hmong.
Deep Learning Based Micro-RNA Analysis of Lipopolysaccharide Exposed Periodontal Ligament Stem Cells Exosomes Reveal Apoptotic and Inflammasome Derived Pathway Activation
Authors: Yadalam Pradeep Kumar , Anegundi Raghavendra Vamsi , Thilagar Sivasankari , Arumuganainar Deepavalli , Shrivastava Deepti , Heboyan Artak
Published: September 2024

Background:

The production of inflammatory factors in periodontium is increased by LPS, particularly from P. gingivalis, and the damage to periodontal tissues is exacerbated. Exosomes from periodontal ligament stem cells change regeneration and repair brought on by bacterial LPS. MiRNAs are carried by exosomes to recipient cells to affect epigenetic functions. Thus, this study aims to utilize deep learning algorithms to uncover novel micro-RNA biomarkers in bacterial LPS-exposed PDLSC stem cells to understand the activation pathway.

Methods:

Using NCBI GEO DATA SET GSE163489, the most differentially expressed micro RNAs were found to differ between healthy and LPS-induced PDLSC cells. Deep learning analysis, employing a Random Forest, Artificial Neural Network c, a Support Vector Machine (SVM), and a Linear Regression model implemented within the orange data mining toolkit, identified novel microRNA biomarkers. The orange data mining toolkit was utilized for deep learning analysis of microRNA expression data, providing a user-friendly environment for machine learning tasks like classification, regression, and clustering.

Results:

Random Forest emerged as the superior model, achieving the highest R2 score (.985) and the lowest RMSE (0.189) compared to Neural Networks ( R2 = .952, RMSE = 0.332), Linear Regression ( R2 = .949, RMSE = 0.343), and SVM ( R2 = .931, RMSE = 0.398). This suggests its superior ability to capture the underlying patterns in the microRNA expression data. Given its robust performance, Random Forest holds promise for identifying novel biomarkers, developing more accurate diagnostic tools, and potentially guiding the stratification of patients for targeted therapeutic interventions in periodontal disease.

Conclusion:

The current study utilizes deep learning analysis of microRNA expression data to identify novel biomarkers associated with inflammasome activation and anti-apoptotic pathways. These findings hold promise for guiding the development of novel therapeutic strategies for periodontal disease. However, future studies are warranted to validate these biomarkers using independent datasets and experimental methods.
Experimental and numerical analysis of ballistic impact and material characterization of GFRP and Kevlar 29/epoxy composite laminate
Authors: Biswas Krishna , Datta Debasis
Published: September 2024

Through experimental testing and numerical simulations, this study examines the effects of ballistic events on thin FRP composite laminated plates fabricated using a hand lay-up method. Experimental ballistic impact tests using a pneumatic gun are conducted on composite plates reinforced with woven glass and woven Kevlar 29 fibers. An advanced three-dimensional finite element model programed in Ansys/Autodyn v19.1 is employed to verify the experimental findings and analyze the ballistic perforation characteristics of the target. The crucial material constants needed for the constitutive material model used in the simulation are acquired through precise experimentation on samples prepared from the fabricated laminates. Significant agreement is observed between the FE simulations and experimental findings, particularly concerning the assessment of residual velocities of the projectile and damage pattern in the laminates. The results of this study show that when subjected to ballistic impact by a flat-ended cylindrical projectile, the thin woven FRP composite primarily experiences damage characterized by delamination, fiber breakage and matrix cracking. Additionally, based on current simulations, it is observed that the ballistic limit velocity of the Kevlar 29/epoxy laminate exceeds that of GFRP by 25.64% when both materials have an equal thickness of 2.8 mm.
Assessment of Public Health Agency and Utility Training Needs for CDC National Wastewater Surveillance System Jurisdictions in the United States
Authors: Schneider Rebecca , Weisbeck Kirsten , Sheth Komal , Sikes Porter , Domakonda Kaavya , Stadler Lauren , Ensor Katherine B. , Shaw Rachel , Berkobien Cody , Wheeler Allison , Johnson Catherine D. , Lengsfeld Corinne , Hopkins Loren
Published: September 2024

Since the start of the COVID-19 pandemic, wastewater surveillance hasemerged as a critical tool for tracking the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus and other pathogens in communities throughout the United States. In 2020, the Centers for Disease Control and Prevention (CDC) launched the National Wastewater Surveillance System (NWSS), which partners with state, local, tribal, and territorial health departments to develop and implement wastewater collection and analysis systems and to share data. In 2022, the CDC established the first two NWSS Centers of Excellence to lead its implementation and coordination efforts—one in Colorado (Colorado CoE) and one in Houston (Houston CoE). As the NWSS expands, it is becoming more important to support the training needs of jurisdictions at different stages of developing their wastewater surveillance infrastructure. To evaluate these needs, the Colorado CoE and Houston CoE conducted a needs assessment study of NWSS-funded public health agencies and public utilities departments located in the United States using surveys developed by the Colorado CoE. The results of the surveys showed that although some training needs were universal, it will be most beneficial to develop training modules tailored to the needs of entities that operate wastewater surveillance programs of various sizes, workforce experience levels, and at different stages in the infrastructure development process.
EEG Findings in a Patient with Holmes Tremor after AVM Surgery: A Case Report and Literature Review
Authors: Wang Yang , Jiang Bingjie
Published: September 2024

Background: Holmes tremor (HT) is a rare motor disorder characterized by high-amplitude and low-frequency resting, intentional, and postural tremors. HT typically arises from disruptions in neural pathways, including the dopaminergic system. Its causes include cerebrovascular incidents, neoplasms, demyelination, and infections. Diagnosis involves thorough clinical, neurophysiological, and neuroimaging assessments. Our report details the clinical profile, neuroimaging and EEG results and levodopa treatment response of an HT patient after cerebral arteriovenous malformation (AVM) surgery. Case Report: A female patient who underwent AVM surgery developed head tremor and dystonia. Neuroimaging revealed left thalamus involvement. Video electroencephalography (EEG) revealed high-amplitude, low-frequency tremors. The patient responded well to levodopa treatment. Conclusions: Involuntary rhythmic or non-rhythmic movements are a primary clinical feature of HT. A differential diagnosis of epilepsy and HT can be achieved through neurophysiological monitoring, avoiding the overuse of antiepileptic drugs. Symptoms can be alleviated with levodopa intervention.
Raising the Floor or Lowering the Ceiling: Challenges to Instructional Leadership at Scale
Authors: McCluskey Matthew S.
Published: September 2024

In an effort to scale success, many schools codify various practices to replicate them across schools. While such codification and replication can help scale success, scaling success often comes with numerous negative externalities such as a reduction of autonomy and burdens on successful educators. Based on real events and educators, this case follows an instructional coach through his career at a charter school as it attempts to scale a successful small charter school to a larger Charter Management Organization (CMO).
Promoting Physical Activity Among Health Professional Students, Faculty, and Staff Members: A Competition-Based Intervention
Authors: Zou Chenyu , Hollingsworth Joshua C. , Farrell Robin Gosdin , Fox Brent I.
Published: September 2024

This program review presents data for the Deans’ Fit Family Challenge (DFFC) and proposes future directions for improvement, informed by the Social Cognitive Theory. The DFFC is a multi-week physical activity competition held annually between three health professional programs, focusing on the development of self-efficacy, self-regulation, and social support of health-related fitness. Participants competed in teams of two and tracked their activity minutes weekly using the ChallengeRunner app or through manual entry. Weekly winners were announced, and the winning college was determined from a composite score of active minutes and weight loss. Since 2019, 1164 participants reported an average of 217.1 weekly minutes of physical activity during the DFFC. An average of 94.0% of participants reported minutes in week 1, compared to 56.3% in week 8. The DFFC is an important initiative to potentially promote physical activity levels among participating programs. While motivational strategies are being incorporated and executed in the DFFC, there is a need for ongoing exploration and improvement to enhance future competition-based interventions among health professional students, faculty, and staff.
Comparative outcomes between cryopreserved cadaveric saphenous vein and spliced autogenous vein for infrainguinal bypass
Authors: Montoya Christopher , Yuan Fang , Tordjman Lea , Challa Akashara , Chow Christopher , Kang Naixin , Shao Tony , Kenel-Pierre Stefan , Rey Jorge , Bornak Arash
Published: September 2024

Objective

Cryopreserved greater saphenous vein (CV) and spliced autogenous veins (SV) serve as alternative conduits for lower extremity revascularization when a single-segment autogenous saphenous vein is not available. This study compares the outcomes of infrainguinal bypasses using CV and two-segment SV as conduits.

Methods

We conducted a retrospective review of data on all lower extremity bypasses performed using CV or SV at our institution. Patients undergoing revascularization for atherosclerotic occlusive disease were included in the statistical analysis, while those with primary acute embolic and/or traumatic causes were excluded. Primary outcomes included limb loss. Secondary outcomes included primary, primary assisted, and secondary patency at one and 3 years.

Results

56 patients were included in the analysis, 25 had CV bypass and 31 had SV. The groups did not significantly differ in demographics and comorbidities except for age (mean age 68 CV vs 62 SV, p = .03), and prior coronary artery bypass graft (32% CV vs 6.5% SV, p = .01). There was no statistically significant difference between CV and SV at one- and three-years in limb salvage (54.4% CV vs 61.7% SV, p = .96 and 48.3% CV vs 50.2% SV, p = .94), and bypass abandonment (44.2% CV vs 61.7% SV, p = .83 and 44.2% CV vs 44% SV, p = .85). Despite lower one and 3-year primary patency for CV compared to SV (33.3% CV vs 54.9% SV, p = .29, and 27.7% CV vs 48% SV, p = .27), the difference was statistically not significant. CV and SV had also similar one and 3-year primary assisted (41.8% CV vs 57.8% SV, p = .72 and 41.8% CV vs 44.9% SV, p = .71), and secondary patency (43.9% CV vs 61.7% SV, p = .8 and 43.9% CV vs 44% SV, p = .88), with no statistically significant difference.

Conclusion

In patients for whom single-segment autologous saphenous vein bypass is not an option, CV and SV show comparable limb salvage up to 3 years. SV may be a more durable option with higher patency, this was however not statistically significant in our cohort likely due to sample size.
Distant time and the spatio-temporalities of statecraft
Authors: Kitchin Rob
Published: September 2024

The value in Ayona Datta's notion of distant time is that the spatialisation of temporal power and its resistance is made explicit. As she demonstrates, the temporal tactics and techniques of statecraft are expressed in the landscape; in the case of Shimla, literally contoured onto the hillside, reproducing spatio-temporal divides. In this commentary, I tease out the contoured temporal relations of the smart and subaltern city and argue that Datta's notion of distant time be extended by creating a typology of the temporal techniques and mechanisms of statecraft and resistance, considering further the temporalities of politics and policies of statecraft, and charting further the multi-scalar nature of statecraft temporalities.
A Case of Breast Cancer Patient with  Li–Fraumeni Syndrome: Psychosocial  Implications and Literature Review
Authors: deSouza Rebecca , Kulkarni Shriniwas Subhas , Nag Shona , Dongare Atul , Dhar Aparna , Patra Abhilash , Pant Hira B. , Agiwal Varun , A. Y. Nirupama , Chaudhuri Sirshendu , Kumar Yashaswini , Murthy G. V. S.
Published: September 2024

Li–Fraumeni syndrome (LFS) is defined by the early emergence of tumors and is associated with mutations in the tumor suppression gene known as tumor protein 53 ( TP53). Information is scarce regarding the psychosocial challenges encountered by individuals with LFS and how it affects their treatment decisions. A 21-year-old woman developed multiple breast tumors over a period of nine years. Genetic testing identified a heterozygous missense substitution in exon 6 of the TP53 gene, specific variant chr17:7578190T>C c.659A>G (p.Tyr220Cys) listed in the dbSNP database. The report also highlights the psychosocial implications of the diagnosis at a young age and the patient’s reluctance to undergo the recommended bilateral mastectomy. The patient exhibited a significantly higher incidence of secondary tumors, underscoring the importance of comprehensive screening and timely diagnosis for managing LFS. This case highlights the challenges faced and the importance of emotional and psychological support after the diagnosis of hereditary syndromes, especially among young women.