bluuebunny/crossref_metadata_2025 huggingface dataset:
Combination of High-Dose Parenteral Ascorbate (Vitamin C) and Alpha-Lipoic Acid Failed to Enhance Tumor-Inhibitory Effect But Increased Toxicity in Preclinical Cancer Models
Authors: Chen Ping , Lamson Davis , Anderson Paul , Drisko Jeanne , Chen Qi
Published: November 2024

Background:

Intravenous vitamin C (IVC, ascorbate [Asc]) and alpha-lipoic acid (ALA) are frequently coadministered in integrative oncology clinics, with limited understanding of combination effects or drug-drug interactions. As high-dose IVC has anticancer activity through peroxide (H2O2), it is hypothesized that IV ALA, a thiol antioxidant, might have untoward effects when combined with IVC.

Methods:

In vitro combination index (CI) was investigated in 6 types of human cancer cells, using clinically relevant concentrations of Asc (0.625-20 mM) and ALA (0.25, 0.5, and 1 mM) evaluated by nonconstant ratio metrics. Cellular H2O2 was measured using HeLa cells expressing a fluorescent probe HyPer. Mouse xenografts of the metastatic breast cancer MDA-MB-231 were treated with intraperitoneal injections of ALA (10, 20, and 50 mg/kg) and Asc (0.2, 0.5, and 4 g/kg) at various dose levels.

Results:

Cancer cell lines were sensitive to Asc treatment but not to ALA. There is no evidence ALA becomes a prooxidant at higher doses. The CIs showed a mixture of synergistic and antagonistic effects with different ALA and Asc combination ratios, with a “U” shape response to Asc concentrations. The ALA concentrations did not influence the CIs or cellular H2O2 formation. Adding ALA to Asc dampened the increase of H2O2. Toxicity was observed in mice receiving prolonged treatment of ALA at all doses. The Asc at all doses was nontoxic. The combination of ALA and Asc increased toxicity. The ALA at all doses did not inhibit tumor growth. The Asc at 4 g/kg inhibited tumor growth. Adding ALA 50 mg/kg to Asc 4 g/kg did not enhance the effect, but lower doses of ALA (10 or 20 mg/kg) dampened the inhibitory effect of Asc.

Conclusions:

These data do not support the concurrent or relative concurrent use of high-dose intravenous ALA with prooxidative high-dose IVC in clinical oncology care with potentially increased toxicity.
Inequalities in the Risk of Multidimensional Downward Mobility From the Most Advantaged Backgrounds
Authors: de Vries Robert
Published: November 2024

Relatively little research has explored socio-demographic inequalities in downward mobility from advantaged backgrounds, with such work focusing solely on class or income. This neglects the multi-dimensional nature of social position and particularly overlooks the importance of social status as a reward obtained via occupation. In this study, I use detailed data from a large, representative UK sample to examine inequalities in multidimensional destinations among workers from the most advantaged class and status backgrounds. I find evidence of significant socio-demographic inequalities both in the overall risk of downward mobility and in the pattern of class versus status mobility. Notably, women from privileged families have a higher risk of downward mobility than men, but this difference is driven exclusively by class, rather than status mobility. Black workers have a higher risk of downward mobility than White workers in both class and status terms, while those of Indian ethnicity are at lower risk, particularly of downward class mobility. The study’s findings have important implications for social mobility research and policy – with specific patterns of multidimensional mobility potentially requiring different explanations (and therefore policy interventions) than the patterns revealed by previous unidimensional analyses.
Beyond Mental and Manual: Investigating the Historical and Contemporary Borderlands Between Working-Class and Middle-Class Masculinities
Authors: Stahl Garth , Asplund Stig-Börje
Published: November 2024

Historically, upwardly mobile working-class men have navigated the binary distinctions between a cerebral middle-class masculinity and a manual working-class masculinity. However, within an increasingly globalised world, the boundaries between the two are increasingly blurred and, therefore, distinctions between the two can often be quite complex. Part of the reason for this is the onset of post-industrialisation and increases in low-skilled service work which require certain facets of working-class masculinity to be readjusted. This conceptual article draws on existing historical and contemporary scholarship to delineate aspects of the borderlands between a working and middle-class manhood. We are interested in the identity work that occurs at the borderlands and what this may mean for upwardly mobile working-class men. The article acknowledges the role of sociological theory but instead foregrounds a social anthropological approach where we consider what the conceptual lens of liminality has to offer in light of historic and contemporary research.
Sequences of sickness absence, disability pension and unemployment four years before and five years after musculoskeletal diagnosis among Swedish twins
Authors: Ropponen Annina , Pettersson Emma , Narusyte Jurgita , Svedberg Pia
Published: November 2024

Aims:

To investigate sustainable working life via identification of time-related sequences of sickness absence (SA), disability pension (DP) and unemployment four years before and five years after the first musculoskeletal diagnosis in a Swedish twin cohort. Other aims were to account for familial confounding and to examine the associations between sequences and sociodemographic characteristics.

Methods:

Among 28,474 Swedish twins, the patterns of interruptions of working life four years before the first M00-M99 diagnosis (MSD) and five years after MSD diagnosis were investigated with a sequence analysis in a seven-element state space consisting of sustainable working life, unemployment >90 days, moderate SA/DP (30–179 days), almost full year of SA/DP (180–365 days), full year of SA/DP (⩾ 365 days), death, and old-age pension.

Results:

The six-cluster solution had the best fit to the data. Five clusters had varying patterns of interruptions of sustainable working life (Clusters 2–6, n = 537–1949 with SA/DP, unemployment, but also accounting death and old-age pension) compared with the largest cluster with primarily sustainable working life ( n = 23,316). Age, sex and familial factors affected the likelihood of belonging to the clusters with SA/DP.

Conclusions:

Most Swedish twins with or without MSD diagnosis have a sustainable working life, although MSD was both prevalent and a strong risk factor for belonging to the clusters with SA/DP. Thus, early prevention of MSD and prevention of recurrent or long sickness absences due to any cause would be merited while paying special attention to women also.
Research on the application mechanism of water mist curtain smoke blocking and heat blocking in tunnels
Authors: Zhong Wei , Zhang Zhanming , Wu Yinghao , Gao Zihe
Published: November 2024

As tunnel fires can easily cause numerous casualties, the effectiveness of water mist curtain in smoke blocking has garnered significant interest. Therefore, it is of great scientific significance and application value to study the mechanism of smoke blocking and heat blocking by water mist curtain. This study establishes vertical distribution formulas for smoke temperature and velocity, derives formulas for smoke momentum and explores the smoke blocking and heat blocking mechanisms of water mist curtains using the momentum ratio between the water mist curtain system and smoke. Employing numerical simulations and theoretical analyses, this study determines the optimal momentum ratio. The results indicate that during tunnel fires, there exists an optimal momentum ratio between the water mist curtain system and smoke. Within this optimal ratio, water mist curtains exhibit a relatively effective capability in smoke deposition and the simulation results are quantitatively validated.
Thermal, sensorial, and mechanical characterization of hemp woven crepe fabrics; investigating conventional variants for modern applications
Authors: Mahmood Baitab Danish , Abbas Adeel , Rasool Muhammad Bilal , Suhail Baig Daniyal , Shaker Khubab , Umair Muhammad
Published: November 2024

Crepe weave fabrics, known for their pebbly or crinkled (rough) surface, are widely used in clothing and bedding applications. Crinkled appearance for crepe weave can be achieved by different interlacement patterns. Generally, six methods/interlacement patterns are commercially used for fabricating crepe woven fabrics. However, there isn’t any significant study reporting clothing comfort and mechanical attributes of crepe variants. In this study, crepe fabrics were developed by these six methods i.e., Base sateen (BS), Reversing method (R), Superimpose (SI), Subset (SS), Quarter turn (QT), and Plain base (P) methods. The yarn linear density, fabric density, and other fabric parameters were kept the same to determine the best development method for fabricating crepe woven fabric having higher thermal, sensorial, and mechanical properties. Characterization data revealed that each crepe variation possesses unique structural and physical parameters making performance differences i.e., the BS specimen exhibited the highest air permeability owing to higher porosity, the R specimen had superior Overall moisture management capability (OMMC) index due to compact yarn linkage, and the SS specimen showed best thermal conductivity performance due to its sophisticated crinkled appearance. Among mechanical attributes QT exhibited higher tensile and puncture strengths due to its compact structure with higher interlacements however, sateen interlacement governing yarn slippage made the tear strength higher for the BS specimen.
One Month Whole Food Plant-Based Nutrition Educational Program Lowers LDL, A1C, and Decreases Inflammatory Markers
Authors: Musial Sandra , Burns Zachary , Bertman Jack , Fitzgibbon Molly , Mashek Rachel , Risica Patricia Markham
Published: November 2024

Lifestyle-related chronic disease increases in the United States have led to the need for innovative programs targeting dietary choices. Based on growing evidence supporting whole food plant-based (WFPB) nutrition to improve overall health, we devised a one-month WFPB intervention program, Jumpstart Your Health! (JYH), to introduce and encourage adoption of the WFPB dietary lifestyle. This paper investigates its effects on various health indicators associated with cardiovascular and metabolic diseases. Among the total of 150 participants, before and after physical measurements and blood chemistries demonstrate significant (p< 0.05) decreases in weight (−4.2 pounds), cholesterol (−25.3 mg/dl), LDL (−19.0 mg/dl), HDL (−5.6 mg/dl), hemoglobin A1c (−0.2%), and hsCRP (−1.9 mg/L). Among the high-risk participants, we found significant decreases in systolic blood pressure (−10 mmHg), diastolic blood pressure (−8.7 mmHg), weight (−4.3 pounds), cholesterol (−38.8 mg/dl), LDL (−22.7 mg/dl), HDL (−2.8 mg/dl), hemoglobin A1c (−0.2 %), and hsCRP (−2.3 mg/L). We demonstrate that a simple WFPB intervention implemented over one month resulted in significant reductions in physical measurements and blood chemistries that could translate to lowered risk or improvement for obesity, cardiovascular disease, and type-2 diabetes.
Effect of increased systemic oxygen delivery on postoperative outcomes and quality of life in elderly undergoing major abdominal surgery: A randomised controlled trial
Authors: Madhangopal Kishore Kumar , Jha Ajay Kumar , Mishra Sandeep Kumar , Lata Suman , Padala Sri Ram Anant Nagabhushnam
Published: November 2024

Studies comparing the intentional increase in oxygen delivery and normal oxygen delivery during general anaesthesia in elderly patients undergoing major abdominal surgery are limited and have reported contradictory findings. Therefore, the study aimed to evaluate the effect of intraoperative increase in systemic oxygen delivery on postoperative outcomes and quality of life in elderly patients undergoing major abdominal surgery. This randomised, blinded, parallel-arm, pragmatic clinical trial included elderly patients of >60 years of age undergoing major abdominal surgery. The patients in the intervention arm received noradrenaline or increased fractional inspiration of oxygen to augment central venous oxygen saturation ⩾75%. The primary outcome measure was composite of in-hospital mortality and major organ complications. The secondary outcome measure included comparison of quality of life. A total of 160 patients were assessed for eligibility, and 146 were randomised in the study groups. The mean arterial and central venous oxygen saturation increased and were significantly higher in the intervention arm. The composite primary outcome occurred in 49.31% in the intervention arm and 57.53% in the usual care arm (relative risk; 95% confidence interval: 0.85; 0.63-1.16; absolute risk reduction; 8.22%; p = 0.32). Furthermore, quality of life at the end of three months was similar (0.658 ± 0.19 versus 0.647 ± 0.19; p = 0.771). In conclusion, central venous oxygen saturation–guided increase in systemic oxygen delivery during the intraoperative period of major abdominal surgery in elderly patients did not reduce predefined composite outcome of in-hospital mortality or organ-specific complications.
Accidents de la voie publique et inégalités sociales de santé à Cotonou en 2021
Authors: Koukponou Djokpon Césaire , Goukodadja Oswald , Houeto David
Published: November 2024

Au Bénin, les accidents de la voie publique sont préoccupants et causent des décès et des blessures graves, surtout chez les motocyclistes. Les inégalités sociales de santé aggravent cette situation en affectant davantage les populations défavorisées. L’objectif de notre étude était de montrer que ces accidents suivent un gradient social, et d’orienter les interventions et les politiques visant à réduire les disparités en matière de sécurité routière. Il s’agissait d’une étude transversale, descriptive et analytique qui a porté sur 185 patients hospitalisés pour des lésions consécutives à un accident de la voie publique et en mesure de répondre à un questionnaire. Les données ont été collectées à partir des dossiers médicaux des patients et d’entretiens individuels. L’étude a révélé que les traumatismes de la voie publique étaient fréquents parmi les admissions (24,97 %), avec une prédominance chez les jeunes hommes (70,81 %). Parmi les sujets, 57,84 % des traumatisés avaient un niveau socio-économique bas. Les parties du corps les plus touchées étaient la tête et le cou, et les extrémités des membres. Les fractures étaient les lésions les plus fréquentes (62,70 %). Les accidents impliquant une moto représentaient 83,06 % des cas. La fréquence des fractures était plus élevée dans le groupe des accidentés ayant un niveau socio-économique bas et un niveau d’instruction bas. L’amélioration des conditions socioéconomiques et la promotion de moyens de transport alternatifs sûrs pourraient réduire les accidents de la voie publique et les inégalités sociales de santé. L’État pourrait y jouer un rôle clé.
Individualized Healthcare Plans: A School Nurse Primer
Authors: Bochenek Jeanie M. , Schaumleffel Carol
Published: November 2024

According to the 2017 U.S. Census, 74.3 million children younger than 18 years of age live in the United States. Of this group, 14.6 million children and adolescents have special health care needs or a chronic illness. Students who attend school with complex health conditions, including mental and physical diagnoses, require comprehensive planning by a professional school nurse. School nurses should write an individualized healthcare plan (IHP) for these students. An IHP is written by the school nurse in collaboration with the parent/guardians, student, and health care providers. This plan serves as a tool to guide health care for a student throughout the school day and in mandated school-sponsored events.
Exploring the Experiences of Florida Elementary School Counselors Implementing the Parental Rights in Education Act
Authors: Davis Eric S. , Gomez Bonnie C. , Toomey Thomas M. , Putnam Sarah K. , Belavilas Antonio
Published: November 2024

Anti-LGBTQ+ school legislation has proliferated across the United States in recent years, with potential consequences for both students and school counselors. Florida’s controversial 2022 Parental Rights in Education Act offers one such example. In this descriptive, phenomenological, qualitative study, we examined the experiences of 10 Florida elementary school counselors regarding the implementation of the Parental Rights in Education Act. We identified three distinct themes from the participants that related to understanding, implementation, and impact of the Act. We discuss these themes and implications for training, practice, and advocacy in the school counseling profession.
Assessing Barriers and Facilitators to Participation in a Nurse-Driven, Opt-Out HIV Screening Program in the Emergency Department
Authors: Montgomery Jackson M. C. , Bouris Alida , Stanford Kimberly A.
Published: November 2024

Emergency department (ED) HIV screening is a key component of the strategy to end the HIV epidemic, reaching populations with limited access to care for screening and early diagnosis. Many screening programs rely primarily on participation from ED nurses; however, little is known about the factors affecting nurse participation in screening. Guided by the Consolidated Framework for Implementation Research, 20 semi-structured interviews were conducted with ED nurses to explore perceptions of HIV screening, barriers and facilitators to participation, and implementation insights. Nurses were categorized as either high adopters or low adopters based on the number of HIV tests ordered 3 months prior to interviews. The Stanford Lightning Report Method, a rapid qualitative analysis approach, was used to analyze field notes. All participants generally agreed that the ED was an appropriate location for screening and that frequent, multimodal education about screening was needed. Integration of screening into standard workflows, education about the public health impact of screening, and the use of peer champions and mentors were identified as important strategies to increase participation. By incorporating these findings into implementation strategies, EDs may be able to increase nurse participation in screening, addressing important health equity issues in HIV diagnosis.
What is civic participation in artificial intelligence?
Authors: Sieber Renée , Brandusescu Ana , Sangiambut Suthee , Adu-Daako Abigail
Published: November 2024

There are increasing calls across disciplines and sectors that the public should participate in decisions about the use of artificial intelligence (AI). Public input in governmental decision-making is particularly crucial to promoting a well-functioning democracy and mitigating harms from AI. However, AI’s opacity, mutability, and resource requirements impede meaningful civic engagement particularly in urban environments. Many prior systematic reviews of civic participation and AI draw on the smart city literature. However, several other disciplines influence civic participation in AI so a siloed disciplinary focus offers only partial guidance for participation’s future role in AI. Our multi-disciplinary analysis blends works in smart cities, and in public policy, communication and, importantly, computer science to reveal distinct and highly variable pathways for civic participation. We use a sequence of manual and automated steps to conduct a structured literature analysis beginning with over 3,000 articles. We categorize authors’ work on participation in AI into five themes: participation as a natural byproduct of automating government, participation facilitated through the medium of AI, participation in AI as quantification, participation as a technocracy of trust, and participation as meaningful. With few exceptions, authors seemed not to challenge the status quo nor diminish the authority of the experts. Authors focused on the processual without the influence and AI aided in that process orientation. We conclude that the future of public participation in AI requires careful attention to become meaningful including recognition of neoliberal intent and power differentials.
Barrier islands, liminality, and the carnivalesque: Symbolic landscapes of New Jersey's coastal tourist attractions
Authors: Zalot Michael C.
Published: November 2024

This article examines some of the cultural symbolism and narratives supporting the tourism activities along the New Jersey coastline. Existing in part as a series of coastal barrier islands in need of regular maintenance, the Jersey shore hosts entertainment activities on strips of sand just off the mainland, including boardwalk rides, foods, games, and a general atmosphere of the carnivalesque. This liminal zone between the water and the land offers a sense of tension and uncertainty from its location, as well as a local history of fires, floods, storms, and shipwrecks. Some area attractions with nautical themes resonate with the tension; others offer subversive dissonance against it, such as thrill rides and haunted houses. This juxtaposition of unstable landscape and amusement activities is not unique to the Jersey shore, as there is no causal or deterministic relationship between physical geography and cultural symbolism. Yet places do collect meanings over time, symbols and stories, forming a symbolic landscape overlaid on local geography. New Jersey claims credit for inventing the boardwalk, and its shore remains a point of state pride and identity, representing an exemplar of both coastal conquest of rough frontier terrain via civil engineering technology, and the American seaside vacation experience. The carnivalesque subverts the liminal tension and serves to create emotional attachment memory that helps drive visitor motivation across generations. In particular, the pace of continual change creates nostalgia for older attractions, and creates a sense of loss, which serves as a seldom-acknowledged driver of visitor activity.
Refined ELN 2024 risk stratification improves survival prognostication following venetoclax-based therapy in AML
Authors: Lachowiez Curtis A. , Ravikumar Vishvaas I. , Othman Jad , O’Nions Jenny , Peters Daniel T. , McMahon Christine , Swords Ronan , Cook Rachel , Saultz Jennifer N. , Tyner Jeffrey W. , Dillon Richard , Zeidner Joshua F. , Pollyea Daniel A.
Published: November 2024

The European LeukemiaNet 2024 risk-stratification guidelines for patients with acute myeloid leukemia receiving hypomethylating agents combined with venetoclax were recently published. This analysis demonstrates reclassification and incorporation of new gene mutations in the present model can further improve and individualize prognostication.
Convergence insufficiency as a predictor of poor prognosis after acute mild traumatic brain injury
Authors: Devani Kavya , Kapoor Neera , Ganti Latha
Published: November 2024

Background

Mild traumatic brain injury (mTBI) is becoming a more common emergency department (ED) presentation. Towards this end, many types of testing in the acute setting are being investigated. One of these is screening for convergence insufficiency (CI) symptoms. These are common problems reported by patients with mTBI, but such oculomotor testing is rarely performed in the ED.

Objective

To assess the feasibility of convergence insufficiency screening in the ED and investigate whether CI is associated with adverse events such as post-concussive symptoms or hospital admission.

Methods

Written informed consent was obtained from patients age 18 years or older who experienced a mild head injury from any mechanism resulting in an mTBI. Patients underwent screening for CI symptoms using a standardized instrument of 15 questions, known as the convergence insufficiency symptom survey (CISS), with responses based on the Likert scale. These data were correlated to outcomes of hospital admission, occurrence of post-concussive symptoms, and 30-day hospital re-admission.

Results

A total of 116 patients were prospectively enrolled, of which 58 were male. The median age was 31 years, with a range of 18 to 95 years of age. The median CISS score was 13, with an interquartile range (IQR) of 6 to 21 and an overall range of 0 to 53. Females presented with a median CISS score of 14, which was higher compared to the male median score of 10. The higher the CISS score, the more likely the patient was to be admitted to the hospital (p = 0.0378), develop symptoms of post-concussive syndrome at 30-day follow up (p = 0.0322), and be readmitted within 30 days (p = 0.0098).

Conclusions

Screening for CI symptoms using the CISS can be a solid adjunct in the evaluation of mTBI in the ED. The CISS is easy and fast to administer, and it is a useful tool to stratify patients in terms of who is at the highest risk of developing complications related to the mTBI.
SARS-CoV-2 seroprevalence among people living with HIV in the German HIV-1 Seroconverter Cohort, 2020–2022
Authors: Hohn Oliver , Meixenberger Karolin , Volkwein Alexander , Körner Kyra , Icli Suheda , Koppe Uwe , Hower Martin , Bremer Viviane , Gunsenheimer-Bartmeyer Barbara , Bannert Norbert ,   the German HIV-1 Seroconverter Study Group, Knechten Heribert , Panstruga Petra , Schühlen Helmut , Isner Caroline , Wesselmann Hans , Schürmann Dirk , Bohr Ulrich , Jessen Heiko , Jessen Arne B. , Grunwald Stephan , Gumprecht Jan , Weninger Beate , Hillenbrand Heribert , Karcher Heiko , Rausch Michael , Reineke Thomas , Grimm Roland , Schoor Sarah , Rittweger Michael , Schranz Dietmar , Glaunsinger Tobias , Cordes Christiane , Schulbin Hubert , Brand Sascha , Berger Andreas , Lindemann Sinah , Krznaric Ivanka , Weinberg Gordon , Bruhy Manuel , Potthoff Anja , Skaletz-Rorowski Adriane , Grünewald Thomas , Neumann Julia , Spornraft-Ragaller Petra , Jenke Andreas , Pursche Stefan , Jensen Bjoern , Hüttig Falk , Esser Stefan , Schenk-Westkamp Pia , Haberl Annette , Stephan Christoph , Usadel Susanne , Müller Matthias , Trauth Janina , Buggisch Peter , Wiemer Dorothea , Biemann Lavinia , Rieke Ansgar , Schneeweiß Stephan , Scholten Stefan , Haars Ulrike , Weidemann Jeannine , Ruck Ines , Ebert Matthias P. , Vogelmann Roger , Bogner Johannes , Sonntag Barbara , Mück Birgit , Pauli Ramona , Spinner Christoph D. , Schneider Jochen , Postel Nils , Schübel Niels , Berning Christiane , Roll Clemens , Marquardt Simone , Rößler Steve , Güler Cengiz
Published: November 2024

Objectives

People living with HIV (PLWH) are a risk group for severe symptoms and higher mortality during COVID-19. We analyzed the dynamic rise of SARS-CoV-2 seroprevalence induced by coinfections and vaccinations in PLWH in the first three years of the pandemic in Germany and compared it with corresponding data available for the general population.

Methods

Each month on average 93 blood samples from the German HIV-1 Seroconverter Cohort, a prospective longitudinal multicenter study that includes PLWH whose date of seroconversion is well defined, were received. The samples from 1569 PLWH were tested for the presence of anti-S1 and if positive, also for anti-N antibodies.

Results

In 2020 the number of anti-S1 positive cases/month was between 0.0 and 6.9% (average 1.6%). Since then the anti-S1 prevalence increased reaching already 35% (33/94) in May 2021. At that time 3.2% of the cases were also anti-N positive. In 2022 the average anti-S1 seroprevalence reached 97.5%. In the vaccination era a positive anti-N response was associated with a younger age and females were overrepresented among anti-S1/anti-N negative samples (assuming no vaccination or infection).

Conclusions

The average 1.6% anti-S1 seroprevalence in the cohort in 2020 was comparable to that in the general population (1.3%). The increase in anti-S1 seroprevalence in the first half of 2021 occurred slightly earlier. This increase was likely caused by the prioritization of PLWH at the early stage of the vaccination campaign and by infections during the third wave of the pandemic.
Infertility treatments and risk of breast benign diseases: a case‒control study
Authors: Moini Ashraf , Alipour Sadaf , Zandi Zahra , Maleki-Hajiagha Arezoo , kashani Ladan , Shakki katouli Fatemeh , Mojtahedi Maryam Farid , Bayani Leila , Abedi Mahboubeh
Published: November 2024

Background

Theoretically, endocrine fluctuations occurring during infertility treatments, including ovulation induction (OI) and assisted reproductive techniques (ART), could be associated with an increased risk of benign breast diseases (BBDs). To date, no studies have been conducted on this association. Therefore, the present study investigated the association between different types of infertility treatments and BBDs.

Methods

This case‒control study was conducted in Arash Women’s Hospital, Tehran, Iran. The case group included infertile women diagnosed with BBDs without atypia, and the control group included infertile women without breast disease. Breast imaging studies (mammography/ultrasound) were performed for BBD screening, and the diagnosis was confirmed by histopathological examination. Study variables were collected retrospectively from medical records, hospital databases, and questionnaires.

Results

Finally, 154 infertile women, including 50 cases (BBDs) and 104 controls (no BBDs), were compared. Our data showed that 66% of cases and 61.4% of controls had undergone at least one course of infertility treatment. There was no association between BBD risk and previous infertility treatments (OR = 1.21; 95% CI = 0.59–2.46), ART (OR = 1.14; 95% CI = 0.90–1.44), or OI cycles (OR = 1.13; 95% CI = 0.98–1.32). Stratification by confounding variables did not change these results.

Conclusions

It seems that there is no association between BBDs in infertile women and the type, duration, or number of prior infertility treatments; however, considering the small sample size of the study, the clinical significance of this finding should not be neglected. Therefore, we consider it essential to carry out more extensive, detailed, and prospective studies to distinguish the association of BBDs with different infertility treatments and medications.
Integrating community health workers into HIV care clinics: a qualitative study with health system leaders and clinicians in the Southern United States
Authors: Fuller Shannon M. , Arnold Emily A. , Xavier Jessica , Ibe Chidinma A. , Steward Wayne T. , Myers Janet J. , Rebchook Greg , Koester Kimberly A.
Published: November 2024

Background

Community health workers (CHWs) can support patient engagement in care for a variety of health conditions, including HIV. This paper reports on the experiences of HIV clinics and health departments that integrated CHWs into their health systems as part of a capacity-building initiative to address HIV-related disparities in the United States.

Methods

Semi-structured interviews were conducted with key informants (n = 14) in two Ryan White HIV/AIDS program jurisdictions: Mississippi (jurisdiction covers the entire state) and the city of New Orleans, Louisiana. This work was part of a larger evaluation of an initiative that used a Learning Collaborative model to facilitate the implementation of evidence-informed interventions to address HIV care continuum gaps in four jurisdictions. The two jurisdictions that focused on integrating CHWs into HIV care clinics and support service agencies were selected for this sub-analysis. Interview participants included HIV clinic leaders and staff, health department leaders, and other Learning Collaborative leaders. Interview transcripts were coded and analyzed for themes related to the acceptability, feasibility, and perceived impact of CHW integration.

Results

Overall, participants expressed interest in having support from CHWs at HIV clinics and service agencies to assist with patient retention and engagement efforts. However, there were challenges integrating CHWs into existing systems (e.g., gaining access to electronic health records, changing policies to conduct home visits, and clarifying roles and scope of work). Negotiating contracts and accessing funding for CHW positions presented major challenges that often contributed to turnover and conflicts around scope of practice. When health departments leveraged existing funding streams to support CHW positions, the clinics and agencies where the CHWs worked had limited flexibility over the hiring process.

Conclusions

Our findings reinforce the value and acceptability of CHWs as part of the workforce in HIV clinical and support service settings; however, integrating CHWs into clinics and service agencies required effort. Training the CHWs was not sufficient; other staff and clinicians had to understand the role of CHWs to facilitate their integration into health systems. Resources are needed to support organizations in incorporating CHWs effectively, and long-term, flexible sources of funding are necessary for these positions.
Virtual connection and real community: the qualitative experience of participating in a videoconferencing-based psychotherapy group for postpartum depression and anxiety
Authors: Hussain-Shamsy Neesha , Shah Amika , Wasserman Lori , Cook Greer Slyfield , Macdonald Kaeli , Greene Keisha , Mukerji Geetha , Vigod Simone N. , Zaheer Juveria , Seto Emily
Published: November 2024

Background

Group psychotherapy, an effective treatment for common postpartum mental disorders (e.g. depression, anxiety), has increasingly been delivered virtually since the pandemic. This study aims to understand experiential aspects of participating in videoconferencing-based group psychotherapy in the postpartum period.

Methods

Our urban academic ambulatory hospital has delivered group psychotherapy for women (cis and trans) and non-binary individuals of female sex with postpartum depressive and anxiety symptomatology via videoconferencing since 2020. One therapist-facilitator conducts weekly 60-min group therapy sessions with 5-6 participants for eight weeks. Group participants were invited to complete a semi-structured qualitative interview on their experience. Using an interpretive description approach, we conducted reflexive thematic analysis to code anonymized transcripts and construct themes. Facilitator interviews were used for triangulation and additional context.

Results

Of 134 patients in video psychotherapy groups over 11 months, 14 completed an interview, as did all group facilitators (n = 3). Overall, participants felt the experience with videoconferencing group therapy was beneficial for their mental health. Three themes were constructed: (1) “Moving Towards a New Normal”: The group helped participants normalize feelings and experiences around transition to parenthood, and accessing health care virtually was now considered to be normal practice, although some wanted an element of choice. (2) “Virtual Connection, Real Community”: Connections were made virtually, yet participants felt a real sense of community. Facilitators played an important role fostering an environment in which participants could create lasting bonds. Participants noted challenges with feeling comfortable virtually and provided pragmatic and structural suggestions for enhancing the creation of community. (3) “Trade-offs to Virtual Engagement”: Participants made positive and negative trade-offs (e.g. no informal interactions, travel, isolation at home, childcare challenges) to maximize their experience and were able to be more authentic in their self-presentation to the group.

Conclusions

People with postpartum depression and anxiety who participated in videoconferencing-based group psychotherapy appreciated the sense of community within their groups to normalize their experience transitioning to parenthood. Participants had to make trade-offs to access virtual groups, but felt the experience was worthwhile and helped improve their mental health. Findings will help inform continued delivery of virtual group mental health services.
Upper respiratory tract detection of Mycoplasma ovipneumoniae employing nasopharyngeal swabs
Authors: Herndon David R. , Grossman Paige C. , Hwang Julianne K. , Piel Lindsay M.W.
Published: November 2024

Background

Flock-level prevalence and characterization of Mycoplasma ovipneumoniae is determined almost exclusively using nasal swabbing followed by molecular detection with either quantitative PCR or multi-locus sequence typing. However, the diagnostic performance and efficiency of swabbing the nasal passage compared to other anatomical locations has not been determined within sheep populations. The goal of this research was to assess the diagnostic capability of nasopharyngeal swabs in comparison to nasal swabs for the detection of Mycoplasma ovipneumoniae.

Results

Nasal and nasopharyngeal swabs were collected during a controlled exposure study of domestic sheep with Mycoplasma ovipneumoniae. Both swab types were then analyzed via conventional and quantitative PCR. This dataset showed that the use of nasopharyngeal swabs in lieu of nasal swabs resulted in higher sensitivity, reduced inhibition during quantitative PCR, and higher bacterial copy numbers per swab. Moreover, it was demonstrated that diagnostic sensitivity could be further increased during quantitative PCR via ten-fold dilution of the extracted DNA. To confirm these observations in naturally infected animals, we conducted a field study employing a production flock of domestic sheep using both nasal and nasopharyngeal swabbing techniques. Extracted DNA was assessed using the same molecular techniques, where detection of Mycoplasma ovipneumoniae was confirmed by sequencing of either the rpoB or 16S rRNA gene. Similar improvements were observed for nasopharyngeal swabs and template treatment methods within the naturally infected flock.

Conclusions

Results demonstrate increased diagnostic sensitivity and specificity when sampling with nasopharyngeal swabs as compared to nasal swabs. Therefore, alternate field-testing strategies employing nasopharyngeal swabs should be considered for diagnosis of the presence of M. ovipneumoniae. Importantly, sample treatment following acquisition was found to affect the sensitivity of quantitative PCR, where dilution of eluted DNA template doubled the calculated sensitivity. This demonstrates that, in addition to anatomical location, the presence of inhibitory components in swab extracts also strongly influences diagnostic performance.
Plasma N-terminal pro-B-type natriuretic peptide and urinary aldosterone-to-creatinine ratio in healthy Chihuahuas
Authors: Galizzi Alberto , Dossi Greta , Pocar Paola , Borromeo Vitaliano , Locatelli Chiara
Published: November 2024

Background

Chihuahua represents an increasingly widespread breed predisposed to cardiac disease. N-terminal pro-B-type natriuretic peptide (NT-proBNP) might be a useful point-of-care biomarker for dogs suspected of having heart disease, but breed differences have been reported. The urinary aldosterone-to-creatinine ratio (UAldo: C) appears to be a good indicator of renin-angiotensin-aldosterone system activity in dogs, but Chihuahuas showed significantly higher UAldo: C than other breeds. The objective of this study was to assess preliminary breed-specific reference intervals for NT-proBNP and UAldo: C in healthy Chihuahuas and evaluate sex differences in these parameters.

Results

Forty-three healthy Chihuahuas dogs were enrolled. The median NT-proBNP was 347 (125–515) pmol/L, and the median UAldo: C was 2.59 (1.57–4.61) µg/g. The NT-proBNP reference interval was 125 (90% CI 125–125) – 2121.4 (90% CI 941.6–2248) pmol/L. 91% of the Chihuahuas were below the nonbreed-specific cut-off (900 pmol/L). The UAldo: C reference interval was 0.6 (90% CI 0.5–0.9) – 16.8 (90% CI 10.9–27.4) µg/g. No significant sex differences in NT-proBNP or UAldo: C were found.

Conclusions

The median value, interindividual coefficient of variation and reference interval of NT-proBNP were in line with those reported for other small breeds. In contrast to previous studies, no sex differences in NT-proBNP were detected. As previously suggested, Chihuahuas seem to be characterized by higher values of UAldo: C than other breeds.
Influence and distinctions of particulate matter exposure across varying etiotypes in chronic obstructive pulmonary disease (COPD) mouse model
Authors: Hur Jung , Rhee Chin Kook , Yoon Hyoung Kyu , Park Chan Kwon , Lim Jeong Uk , An Tai Joon , Choi Joon Young , Jo Yong Suk
Published: November 2024

Background

Air pollution, notably particulate matter (PM), significantly impacts chronic respiratory disease such chronic obstructive pulmonary disease (COPD). Although asthma-COPD overlap (ACO), considered one of the COPD etiotype, is associated with greater severity in both symptoms and outcomes, effects of PM exposure remain unclear. Thus, this study aimed to evaluate impact of PM on chronic airway disease animal models.

Methods

We established two distinct COPD etiotypes, cigarette smoking-related COPD (COPD-C) and COPD with asthma (COPD-A), using porcine pancreatic elastase (PPE) for COPD-C and a combination of PPE with ovalbumin for COPD-A. To reflect smoking influence, cigarette smoking extract was administered to both disease models. To assess impact of PM exposure, bronchoalveolar lavage fluid (BALF), proinflammatory cytokines, lung histology, and cellular damage mechanisms were analyzed.

Results

In the COPD-A model, cell counts and type 2 cytokines were elevated in BALF independent of PM exposure. All models exhibited increased lung inflammation and emphysema due to PM exposure. Expression levels of apoptosis-related protein B-cell lymphoma protein 2 (Bcl-2) associated X (Bax) showed an inclination to increase with PM exposure. In the COPD-A model, decreased expression of basal nuclear factor erythroid-derived 2-like 2 (Nrf-2) and increased production of reactive oxygen species (ROS) due to PM exposure were noted.

Conclusion

We developed two distinct models for the etiotypes of COPD and found increased vulnerability to cell damage in COPD-A after PM exposure. Moreover, the control group displayed escalated airway inflammation and emphysema due to PM exposure, substantiating the risk of respiratory diseases.
Evaluating the impact of the universal infant free school meal policy on the ultra-processed food content of children’s lunches in England and Scotland: a natural experiment
Authors: Parnham Jennie C. , Chang Kiara , Rauber Fernanda , Levy Renata B. , Laverty Anthony A. , Pearson-Stuttard Jonathan , White Martin , von Hinke Stephanie , Millett Christopher , Vamos Eszter P.
Published: November 2024

Background

The Universal Infant Free School Meal (UIFSM) policy was introduced in 2014/15 in England and Scotland for schoolchildren aged 4–7 years, leading to an increase in school meal uptake. UK school meals are known to be healthier and less industrially processed than food brought from home (packed lunches). However, the impact of the UIFSM policy on the quantity of ultra-processed food (UPF) consumed at school during lunchtime is unknown. This study aimed to evaluate the impact of the UIFSM policy on lunchtime intakes of UPF in English and Scottish schoolchildren.

Methods

Data from the UK National Diet and Nutrition Survey (2008–2019) were used to conduct a difference-in-difference (DID) natural experiment. Outcomes included school meal uptake and the average intake of UPF (% of total lunch in grams (%g) and % total lunch in Kcal (%Kcal)) during school lunchtime. The change in the outcomes before and after the introduction of UIFSM (September 2014 in England, January 2015 in Scotland) in the intervention group (4–7 years, n = 835) was compared to the change in an unexposed control group (8–11 years, n = 783), using linear regression. Inverse probability weights were used to balance characteristics between intervention and control groups.

Results

Before UIFSM, school meal uptake and consumption of UPFs were similar in the intervention and control groups. The DID model showed that after UIFSM, school meal uptake rose by 25%-points (pp) (95% CI 14.2, 35.9) and consumption of UPFs (%g) decreased by 6.8pp (95% CI -12.5,-1.0). Analyses indicated this was driven by increases in minimally processed dairy and eggs, and starchy foods, and decreases in ultra-processed salty snacks, bread and drinks. The differences were larger in the lowest-income children (-19.3 UPF(%g); 95% CI -30.4,-8.2) compared to middle- and high-income children. Analyses using UPF %Kcal had similar conclusions.

Conclusions

This study builds on previous evidence suggesting that UIFSM had a positive impact on dietary patterns, showing that it reduced consumption of UPFs at school lunchtime, with the greatest impact for children from the lowest-income households. Universal free school meals could be an important policy for long term equitable improvements in children’s diet.
Alzheimer’s disease-associated protective variant Plcg2-P522R modulates peripheral macrophage function in a sex-dimorphic manner
Authors: Staley Hannah A. , Jernigan Janna E. , Bolen MacKenzie L. , Titus Ann M. , Neighbarger Noelle , Cole Cassandra , Menees Kelly B. , Wallings Rebecca L. , Tansey Malú Gámez
Published: November 2024

Genome-wide association studies have identified a protective mutation in the phospholipase C gamma 2 (PLCG2) gene which confers protection against Alzheimer’s disease (AD)-associated cognitive decline. Therefore, PLCG2, which is primarily expressed in immune cells, has become a target of interest for potential therapeutic intervention. The protective allele, known as P522R, has been shown to be hyper-morphic in microglia, increasing phagocytosis of amyloid-beta (Aβ), and increasing the release of inflammatory cytokines. However, the effect of this protective mutation on peripheral tissue-resident macrophages, and the extent to which sex modifies this effect, has yet to be assessed. Herein, we show that peripheral macrophages carrying the P522R mutation do indeed show functional differences compared to their wild-type (WT) counterparts, however, these alterations occur in a sex-dependent manner. In macrophages from females, the P522R mutation increases lysosomal protease activity, cytokine secretion, and gene expression associated with cytokine secretion and apoptosis. In contrast, in macrophages from males, the mutation causes decreased phagocytosis and lysosomal protease activity, modest increases in cytokine secretion, and induction of gene expression associated with negative regulation of the immune response. Taken together, these results suggest that the mutation may be conferring different effects dependent on sex and cell type, and highlight the importance of considering sex as a biological variable when assessing the effects of genetic variants and implications for potential immune system-targeted therapies.