bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of four risk assessment scales in predicting the risk of intraoperative acquired pressure injury in adult surgical patients: a prospective study
Authors: Chen Yuan , Wang Wei , Qian QianJian , Wu BeiWen
Published: October 2023

Objective

To develop and compare four predictive models for intraoperative acquired pressure injury (IAPI) in surgical patients.

Methods

One hundred patients undergoing various surgeries (hepatobiliary, pancreas, spleen, gastrointestinal, and cardiac surgeries) at Ruijin Hospital from November 2021 to September 2022 were included in this prospective cohort study. Four pressure injury risk assessment scales were used to measure the pressure injury risk: the Braden scale, Munro Pressure Injury Risk Assessment Scale, Scott Triggers tool, and CORN Intraoperative Acquired Pressure Injury Risk Assessment Scale. The patients were divided into the IAPI group and non-IAPI group.

Results

In total, 37% of patients (37/100) developed class I/stage pressure injury (erythema) after surgery, which resolved within 2 hours after surgery in 86.49% of cases and further progressed to class II/stage or higher pressure injury within 6 days in 15.63% of cases. The application effects of the four commonly used risk assessment tools were compared with the sensitivity, specificity, and area under the receiver operating characteristic curve. The Munro Scale showed the best sensitivity and area under the receiver operating characteristic curve among the four tools for postoperative assessment, but its specificity was only 20.63.

Conclusions

More appropriate assessment tools are required for IAPI risk evaluation.
Hedgehog Activation for Enhanced Rotator Cuff Tendon-to-Bone Healing
Authors: Luzzi Andrew J. , Ferrer Xavier , Fang Fei , Golman Mikhail , Song Lee , Marshall Brittany P. , Lee Andy J. , Kim Jieon J. , Hung Clark T. , Thomopoulos Stavros
Published: October 2023

Background:

Rotator cuff repair is a common orthopaedic procedure, yet the rate of failure to heal after surgery is high. Repair site rupture is due to poor tendon-to-bone healing and lack of regeneration of the native fibrocartilaginous enthesis. During development, the enthesis is formed and mineralized by a pool of progenitors activated by hedgehog signaling. Furthermore, hedgehog signaling drives regenerative enthesis healing in young animals, in contrast to older animals, in which enthesis injuries heal via fibrovascular scar and without participation of hedgehog signaling.

Hypothesis:

Hedgehog activation improves tendon-to-bone healing in an animal model of rotator cuff repair.

Study Design:

Controlled laboratory study.

Methods:

A total of 78 adult Sprague-Dawley rats were used. Supraspinatus tendon injury and repair were completed bilaterally, with microsphere-encapsulated hedgehog agonist administered to right shoulders and control microspheres administered to left shoulders. Animals were sacrificed after 3, 14, 28, or 56 days. Gene expression and histological, biomechanical, and bone morphometric analyses were conducted.

Results:

At 3 days, hedgehog signaling pathway genes Gli1 (1.70; P = .029) and Smo (2.06; P = .0173), as well as Runx2 (1.69; P = .0386), a transcription factor of osteogenesis, were upregulated in treated relative to control repairs. At 14 days, transcription factors of tenogenesis, Scx (4.00; P = .041), and chondrogenesis, Sox9 (2.95; P = .010), and mineralized fibrocartilage genes Col2 (3.18; P = .031) and Colx (1.85; P = .006), were upregulated in treated relative to control repairs. Treatment promoted fibrocartilage formation at the healing interface by 28 days, with improvements in tendon-bone maturity, organization, and continuity. Treatment led to improved biomechanical properties. The material property strength (2.43 vs 1.89 N/m2; P = .046) and the structural property work to failure (29.01 vs 18.09 mJ; P = .030) were increased in treated relative to control repairs at 28 days and 56 days, respectively. Treatment had a marginal effect on bone morphometry underlying the repair. Trabecular thickness (0.08 vs 0.07 mm; P = .035) was increased at 28 days.

Conclusion:

Hedgehog agonist treatment activated hedgehog signaling at the tendon-to-bone repair site and prompted increased mineralized fibrocartilage production. This extracellular matrix production and mineralization resulted in improved biomechanical properties, demonstrating the therapeutic potential of hedgehog agonism for improving tendon-to-bone healing after rotator cuff repair.

Clinical Relevance:

This study demonstrates the therapeutic potential of hedgehog agonist treatment for improving tendon-to-bone healing after rotator cuff injury and repair.
Development and evaluation of biodegradable starch-based films containing cellulose nanocrystals/titanium dioxide nanoparticles as an alternative for food packaging
Authors: Picolotto Aluisie , Rossa Beltrami Lilian Vanessa , Dallé Danielli , Ornaghi Júnior Heitor Luiz , Zattera Ademir José , Catto Andre Luis , Borsoi Cleide
Published: October 2023

Biodegradable starch-based films are an environmentally friendly solution to reduce the use of petroleum-derived polymers. Thus, this work aims to obtain corn starch films by incorporating 5% w/w of cellulose nanocrystals (CNC), different concentrations of titanium dioxide nanoparticles (TiO2) (0, 0.25, 0.5, 1, and 2% w/w), and 40% w/w of glycerol and sorbitol (plasticizers), in a 1:1 ratio. The films showed a high potential for UV-light barrier, with an increase of 307% incorporating only 2 wt% of TiO2 in relation to the film without incorporation of TiO2. The use of TiO2 increased the white pigmentation capacity of the samples and decreased the lower water solubility – a reduction of approximately 28% using 0.5 wt% TiO2 compared to the CNC control sample was observed. The incorporation of TiO2 nanoparticles increased the tensile strength by adding 1 wt% of TiO2 nanoparticles with 34% increase in the tensile strength of the film without incorporation of TiO2. The thermal stability of the films with 1 wt% TiO2 and 5 wt% CNC increased by 85°C. Thus, the addition of CNC and TiO2 enabled an improvement in the physical/thermal/chemical properties of the films, making them possible alternatives for use in food packaging.
A feedheat-integrated energy storage system for nuclear-powered steam plant
Authors: Lazenby James W , Shwageraus Eugene , White Alexander J
Published: October 2023

The paper provides thermodynamic analysis of an energy storage concept in which thermal stores are coupled with the feedwater heating train of nuclear-powered steam plant. This allows the electrical output of the plant to be flexed whilst maintaining constant reactor power, thereby providing the equivalent of an electricity storage system and facilitating the adoption of a load-following role for nuclear plant. The concept falls under the umbrella of ‘generation-integrated energy storage’, which exploits existing hardware required for generation to reduce storage costs, and benefits also from fewer energy transformations when compared to ‘electricity-in-electricity-out’ forms of storage. This means that a high (effective) round-trip efficiency can be achieved at low cost. An important feature of the proposed system is that the turbine bleed flows (at their various pressures and temperatures) automatically provide good thermal matching with the feedwater temperature profile, so that heat can ultimately be transferred to and from sensible-heat thermal-storage media with high exergetic efficiency. Various options are discussed for the thermal stores, including pressurised water tanks, thermal oils and packed beds. The analysis also includes consideration of the off-design behaviour of cycle components.
Real-World Experience With CMV inSIGHT T Cell Immunity Testing in High-Risk Kidney and Pancreas Transplant Recipients
Authors: Descourouez Jillian L. , Smith Jeannina A. , Saddler Christopher M. , Mandelbrot Didier A. , Odorico Jon S. , Jorgenson Margaret R.
Published: October 2023

Background:

Cytomegalovirus (CMV)-specific cell-mediated immunity is important for control of CMV after transplant. Assays exist to measure this, but their place in therapy is unclear, particularly in CMV high-risk recipients, without pretransplant exposure.

Objective:

The objective of this study was to evaluate predictive potential of a positive assay to determine freedom from DNAemia and describe subsequent 3-month CMV outcomes.

Methods:

Adult CMV high-risk kidney and/or pancreas transplant recipients were included if a CMV inSIGHT T Cell Immunity Panel (TCIP, Eurofins Viracor) was ordered and resulted between 1 August, 2019 and 30 July, 2022.

Results:

Seventy-six patients were included in our study; 49 tested during prophylaxis and 27 during treatment. Most TCIP assays obtained in the prophylaxis cohort were negative (n = 46, 93.9%). Rate of post-TCIP CMV infection was 10.2%. In those tested during treatment, 33.3% were positive and rate of post-TCIP CMV recurrence was 22.2%. The positive predictive value of the assay to successfully predict immunity was 66.7% during both prophylaxis and treatment. There were 4 cases of TCIP predictive failure with progressive CMV replication. At time of replication, 2 patients had concomitant clinical confounders thought to influence immune control of viral replication. All patients had intensification of immunosuppression prior to recurrent replication, but after TCIP was collected.

Conclusion and Relevance:

The data obtained from the TCIP are not static, immune control of CMV in latency can change and must be evaluated in clinical context. Timing of TCIP after transplant is significant, and patient-specific factors remain important to assess the likelihood of CMV in each unique patient-specific scenario. A CMV stewardship program can aid in application and interpretation of results.
Outside of the Old Boys Club? Gender Differences in Outside Groups’ Advertising Support for U.S. Senate Candidates
Authors: English Ashley , Branton Regina , Friesenhahn Amy
Published: October 2023

Since 2010, televised campaign ads have proliferated, raising questions about gender differences in the number of ads outside groups air. Assuming incumbent Democratic women and Democratic women with prior office-holding experience run with support from their party and interest groups, we expect Democratic-leaning groups air more favorable ads supporting Democrats in races that include experienced or incumbent Democratic women than they do in races that include experienced or incumbent Democratic men. Conversely, we assume Republican women receive less support from their party and interest groups. We expect outside groups air more favorable ads supporting Republicans in races featuring experienced or incumbent Republican men than races including experienced or incumbent Republican women. Given the potential for backlash to attack ads, we expect Democratic- and Republican-leaning groups air more ads in races including experienced or incumbent male opponents than in races that include experienced or incumbent female opponents. We test these hypotheses by focusing on 2010–2018 U.S. Senate races and combining original data with data from the Wesleyan Media Project, the U.S. Census, and the Cook Political Report. Democratic- and Republican-leaning groups both sponsor significantly fewer ads in races featuring experienced female Democratic candidates compared to races including experienced male Democratic candidates.
Is Authenticity the New Luxury? Examining the Components and Dynamics of the Luxury Accommodation Experience
Authors: Hanks Lydia , Mody Makarand , Dogru (Dr. True) Tarik
Published: October 2023

The nature of luxury experiences has been evolving, with the focus shifting from objective criteria of luxury to understanding customers’ perceptions of luxury experiences. Moreover, in the context of an emerging homesharing sector, there remains a gap in our understanding of what comprises the luxury accommodation experience. The present study develops a model to capture the components and dynamics of the evolving nature of luxury in the accommodations industry. Consistent with our hypotheses, we find that authenticity serves as the primary antecedent of extraordinary experiences in the luxury accommodations industry. It leads to memorable accommodation experiences via the secondary antecedents of Pine and Gilmore’s dimensions of the experience economy and the dimensions of “new luxury,” including digital disconnection and ethical consumerism. Our findings are validated in a second, independent sample of luxury consumers, and have important theoretical and practical implications in the fields of hospitality, luxury, branding, and services management.
Study on the failure behavior of Nomex honeycomb sandwich panels under three-point bending load: Experiments and meso-scale simulation
Authors: Ma Mingze , Li Piao , Ye Ti , Gao Daiyang
Published: October 2023

The failure behavior and load-carrying capacity of Nomex honeycomb sandwich panels under three-point bending are experimentally and numerically studied. The failure modes observed in experiments are core shear failure and face-sheet/core debonding. A detailed model considering Nomex paper and resin coating is built with Abaqus/explicit simulation. The Hill 1948 quadratic anisotropic yield criteria are adopted to describe the plastic behavior of Nomex paper and the principal stress criteria are used for predicting the failure of resin coating. The effectiveness of the proposed meso-scale model is validated by comparing the experimental and the numerical results. The effects of geometric parameters on the bending behaviors are discussed in detail. It is shown that the ultimate force and bending stiffness of Nomex honeycomb sandwich panels is significantly influenced by the core orientation, resin thickness and cell size. The cutting position has no effect on the ultimate force and bending stiffness.
Dynamic compressive response of gradient truss–core sandwich structure subjected to underwater shock loading
Authors: Yang Lihong , Zhang Zexu , Dong Yalun , Qu Jia , Wu Linzhi
Published: October 2023

The dynamic compressive responses of a multi–layer sandwich structures with the truss core were studied experimentally and numerically under the underwater explosion shock loading. A three–layer truss-core sandwich specimen was designed and fabricated from the stainless steel. The density gradient between core layers is realized by changing the cross-sectional size of the truss members in the core layer. A water tank explosion testing device was employed to carry out the underwater explosion experiment. The finite element method was used to investigate the influences of the layered strategy of structures and the density gradient between core layers on the dynamic response. The results reveal that the density–decreasing sandwich panels CBA has the optimal underwater explosion resistance, and the explosion resistance increases as the decrease of the density gradient ratio.
Water, earth, fire, air: Banal nationalism and Avatar: The Last Airbender
Authors: Kerr William
Published: October 2023

This article argues that children’s media can be a powerful source for embedding nationalist assumptions from an early age, by looking at Avatar: The Last Airbender and its sequel The Legend of Korra. In the shows, the world is divided into four discrete nations. Drawing on Billig’s concept of banal nationalism, I intend to explore how, despite being critical of nationalism, they nevertheless reinforce and communicate core tenets of national ideology: that nations are the natural way of organising the world. This then leads to wider conclusions about how children’s media can communicate and embed these ideas.
Display of battery items in web and mail surveys: Grids versus item-by-item and radio versus wide buttons
Authors: Olson Kristen , Smyth Jolene D , Phillips Angelica
Published: October 2023

How to display questions that are part of a battery in self-administered surveys is an important decision. Battery items may be displayed in a grid in a mail survey or computer web survey, but are often displayed as individual items on mobile devices. Although past research has compared grids to item-by-item displays in computer and mobile web surveys, almost no work has compared these displays in mail surveys. Additionally, many web survey templates use wide rectangular buttons to select response options in individual items using a mobile-optimized design, different from the standard round answer space format typically used in mail surveys. In this study, we experimentally test grid versus item-by-item displays and round radio buttons versus wide rectangular buttons for battery items in a probability-based general population mixed-mode mail + web survey of adults in Nebraska. Consistent with past research, we find that item-by-item displays reduce straightlining rates compared to grid designs. We also find that respondents are less likely to select the last two response categories in the item-by-item displays than in the grid displays. Smartphone and computer web respondents have higher item nonresponse rates than mail respondents, and web respondents have lower straightlining rates than mail respondents, accounting for respondent characteristics. Reassuringly, there is no difference in data quality outcomes across radio button versus wide button formats. These findings replicate past research that item-by-item displays reduce straightlining but may shift answer categories. These findings suggest that questionnaire designers can combine round radio button answer spaces on mail surveys with wide buttons on web surveys on battery items with little difference in data quality.
Do Social Service Interventions for Human Trafficking Survivors Work? A Systematic Review and Meta-Analysis
Authors: Schroeder Elyssa , Yi Hui , Okech David , Bolton Claire , Aletraris Lydia , Cody Anna
Published: October 2023

Human trafficking leaves victims with long-term social, psychological, and health effects. Research in this area is still nascent, and there are limited studies that show the effectiveness of existing services for survivors. This study fills the gaps in knowledge of the effectiveness of existing programs through a comprehensive systematic review and meta-analysis. Inclusion and exclusion criteria retained 15 studies using the preferred reporting items for systematic reviews and meta-analyses method, containing 16 populations. Included studies examined programs and/or interventions providing direct services to human trafficking survivors using quantitative pre- and post-intervention measurements published from January 2010 to June 2022. Outcomes among survivors were grouped into five categories: (a) mental health, (b) physical health, (c) social support or social behavior, (d) personal development, and (e) other. Roughly half ( n = 31, 51.66%) of the outcomes across the 15 studies were statistically significant. Most measured constructs showed a moderate effect size (E.S.; n = 31, 51.67%). In all, 21 constructs (27.91%) met high E.S. levels, and eight (13.33%) met the criteria for a low-level effect. Analyzing different intervention types, physical-based interventions represented the smallest subset and the largest mean effect size ( n = 5, g = 1.632, 95% CI [0.608, 2.655]) followed by standardized therapy ( n = 23, g = 1.111, 95% CI [0.624, 1.599]), wrap-around services ( n = 14, g = 0.594, 95% CI [0.241, 0.947]), and peer and support group modalities ( n = 18, g = 0.440, 95% CI [0.310, 0.571]). A meta-regression showed that non-U.S.-based interventions were significantly more effective than U.S.-based interventions ( z = −2.25, p = 0.025). While only 15 studies contributed to this analysis, the current study ushered in new avenues regarding future research, policies, and practice in services for survivors of human trafficking.
Telemedicine Use Following Onset of the COVID-19 Pandemic Was Associated With Youth and White Race but Not With Socioeconomic Deprivation: A Retrospective Cohort Study of Orthopedic Patients
Authors: Navarro Brendan J. , Chen Ling , Dy Christopher J.
Published: October 2023

Background:

The use of telemedicine increased greatly following the onset of the COVID-19 pandemic. It is unclear whether and how sociodemographic factors have affected orthopedics patients’ use of this technology in the pandemic.

Purpose:

The aim of this study was to determine how patient demographic variability in telemedicine use is influenced by the Area Deprivation Index (ADI) and distance to clinical site among patients seeking care for hip and knee arthritis from orthopedic surgeons.

Methods:

Demographic data and visit type were collected from the electronic medical record for patients seen in our academic medical center either before or during the COVID-19 pandemic by orthopedic surgeons who specialize in hip and knee arthroplasty. Univariate and multivariate analyses were performed regarding age, race, insurance status, ADI, and distance to a clinical site.

Results:

In the COVID era, among 4901 visits with 3124 unique patients, those using telemedicine were younger and more likely to be White compared to those who did not use telemedicine. There was no significant difference in telemedicine use based on ADI, distance to a clinical site, or insurance status.

Conclusions:

This retrospective analysis suggests that orthopedic patients who were White and of younger age were more likely to use telemedicine in the first year of the COVID-19 pandemic. There was no statistically significant relationship between distance from a clinical site or ADI and telemedicine use, suggesting that factors other than these are greater contributors to telemedicine utilization in our cohort. Further information is needed to determine how telemedicine may disproportionately limit access to orthopedic care according to these and other patient factors.
Combining Culinary Medicine With Integrative Medicine in Medical Curriculum: A Novel Community-Centric Approach
Authors: Nguyen An-Thu , Faraj Merwan , Ward Gabriel , Hopkins Elijah , DeMutis Alyssa , Stroupe Amber , DiMucci-Ward JuliSu
Published: October 2023

Context

Historically, medical school curriculums have not addressed applications of medical nutrition therapy (MNT) in patient care plans. In 2020, an elective pilot lifestyle medicine course, “Food and Nutrition as Medicine (FANAM),” was implemented at Edward Via College of Osteopathic Medicine Carolinas (VCOM-Carolinas) using a community-centric model.

Objective

Teach medical students skills in nutrition education, culinary techniques, patient-centered care through intersectional lenses of culture, available resources, and health literacy.

Methods

FANAM’s founders were a multidisciplinary team of physicians, a registered dietitian, a nurse and a dietetic technician. Twenty students were in the initial cohort. FANAM utilized physicians and community leaders as mentors who taught through hands-on and didactic exercises. Pre- and post-Likert scales assessed FANAM’s impact on students’ confidence in implementing patient-centered nutrition education. Wilcoxon Signed Rank Tests analyzed survey results with calculated P-value <.05.

Results

Qualitative assessments demonstrated that 100% of participants believed nutrition education beyond the standard curriculum was necessary. 95% of participants felt confident in their understanding of nutrition and ability to counsel standardized patients after course completion.

Conclusion

These results indicate that FANAM provided opportunities for students to enhance both knowledge of MNT and practical applications of nutrition education to benefit patients.
Usability of a mobile phone application to enhance activities of daily living in occupational therapy services for breast cancer survivors
Authors: Romero-Ayuso Dulce , García-López Raquel , Lozano-Villena Carmen , Martínez José R , Parga-Amado Paula , García-Ferreiro Paula , Gallud José A , Lozano María , Triviño-Juárez José-Matías
Published: October 2023

Background/Objective: The use of new technologies in rehabilitation to evaluate and improve occupational performance and quality of life is increasing. Technological applications in the health field could help meet the needs of patients, including those of women breast cancer survivors. The main aim of this study was to design a mobile phone application “MAIA” focused on the perceived needs of women who have had breast cancer to achieve optimal performance in their daily lives in a meaningful way.

Methods: A cross-sectional usability study using an online questionnaire was designed. Sociodemographic and occupational performance data were collected. System Usability Scale, Engagement in Meaningful Activities Survey, Occupational Balance Questionnaire, General Self-Efficacy Scale, Functional Assessment of Cancer Therapy - General and Disabilities of the Arm, Shoulder and Hand were administered. Descriptive statistics were used to describe categorical (frequencies and percentages) and quantitative variables (mean and standard deviation).

Results: The sample was composed of seventy-eight women diagnosed with breast cancer. Nine activities of daily living were affected in more than 20% of women with breast cancer. The most affected were sleep and rest and functional mobility.

Conclusions: Women survivors of breast cancer showed difficulties in daily life performance and participation. The MAIA App could be useful as a new online resource in occupational therapy for the rehabilitation of breast cancer survivors.
Intersectional Principles of Community Partnership and Social Justice in Qualitative Research in Migration
Authors: Fernández-Sánchez Higinio
Published: October 2023

This article examines the methodological implications of employing intersectional principles in qualitative health research conducted in migration contexts, specifically focusing on a doctoral research project on return migration and reunited couples in Mexico. The article highlights the integration of social justice and community-based research perspectives within an intersectional lens. Five key areas are examined, including recognizing diversity and agency among women who stay behind, navigating intersectional identities, understanding positionality, and advocating for populations made vulnerable by inadequate policies, navigating power dynamics and multiple social locations, and empowering the community through intersectional research. The application of intersectionality challenges homogenizing narratives, emphasizing the agency and resilience of women who stay behind. Reflexivity is crucial in mitigating biases and deepening insights, while collaboration with a local researcher enhances understanding of power dynamics. By empowering the community through advisory committees and culturally relevant dissemination, I aimed to amplify community member voices and promote social justice. This article serves as a valuable resource for researchers conducting intersectional qualitative health research in rural settings, offering guidance on integrating a strength-based approach, fostering intersectional reciprocity, and navigating positionalities.
Application of the positive and negative affect scale in Chinese children with intellectual disability
Authors: Song Xiaoyu , Ma Minjie , Ma Xue , Zhao Ke , Gao Long , Wang Tingzhao
Published: October 2023

The purpose is to test the applicability of the Positive and Negative Affect Scale (PANAS) to Chinese children with intellectual disabilities. The study was done by distributing the questionnaire to the parents through teachers online. Asked the parents to fill out the scale based on their observations of their children's daily life. The correlation coefficients between each item and the total score of the corresponding dimension ranged from 0.52 to 0.77. Factor analysis confirmed the establishment of the PA-NA two-factor structure of affect. A significant positive correlation existed between the NA and the challenging behavior. The Cronbach's α coefficient and split-half reliability of the PA scale were 0.87 and 0.85, and the Cronbach's α coefficient and split-half reliability of the NA scale were 0.85 and 0.83, respectively, higher than 0.80. It was concluded that PANAS has good applicability in Chinese children with intellectual disabilities.
Effect of abnormal body weight on mortality and functional recovery in adults after stroke: An umbrella review
Authors: Holland Stephanie A , Wellwood Ian , Kuys Suzanne
Published: October 2023

Background:

Several published systematic reviews have drawn conflicting conclusions on the effect of abnormal body weight (i.e. being underweight, overweight or obese) on outcomes following stroke. The ‘obesity paradox’ seen in several diseases (wherein obesity, often associated with mortality and morbidity, appears to be protective and improve outcomes) may be evident after stroke, but inconsistent results of existing reviews, and the issue of being underweight, are worth investigating further.

Aims:

To better understand the impact of body weight on prognosis after stroke, we aimed to answer the following research question: What is the effect of abnormal body weight (underweight, overweight, or obesity) on mortality and functional recovery in adults after stroke?

Summary of review:

We conducted an umbrella review to synthesize existing evidence on the effects of abnormal body weight on stroke outcomes. We searched Cumulated Index to Nursing and Allied Health Literature (CINAHL) Complete, COCHRANE Database of Systematic Reviews, PubMed, Medline, PEDro, and EMBASE Classic + EMBASE, from inception until 28 February 2023. Seven systematic reviews (1,136,929 participants) from 184 primary studies (counting duplicates) were included. While the risk of mortality increases with being underweight (body mass index (BMI) < 18.5 kg/m2), excess body weight (being overweight (BMI = 25–29.9 kg/m2) or obese (BMI > 30 kg/m2)) is associated with reduced mortality. The impact of abnormal body weight on functional recovery is less clear; data from studies of being underweight are associated with poor functional outcomes while those from studies of excess body weight are inconclusive.

Conclusion:

Abnormal body weight effects post-stroke outcomes and should be considered in clinical decision-making, prognostic research, and clinical trials of rehabilitation interventions. The “obesity paradox” is evident after stroke, and excess body weight is associated with reduced mortality compared to normal body weight. It is recommended that body weight is routinely recorded for stroke patients, and further research, including well-designed cohort studies with reliable weight data, is needed to further investigate the impact of body weight and distribution on post-stroke outcomes.
Awkwardness sells, but who’s buying? How students navigate awkward TV comedy series
Authors: Kirschbaum Iván , Berkers Pauwke
Published: October 2023

Drawing on in-depth interviews, this study examines how students engage with awkwardness in television comedies. The article contributes to studies of awkwardness, its configuration in popular culture, and audiences’ response to awkward-comic texts. Our findings show typical sequences and resources for producing awkward scenes. Participants tend to evaluate awkward scenes in terms of ‘realism’, i.e., whether they could relate the scene to their personal lives and/or imagine themselves in that situation. Furthermore, awkward sequences and feelings of awkwardness from the characters increases the evaluation of scenes as realistic. Finally, in line with Kotsko’s (2010) characterisation of awkwardness as a social feeling, awkwardness spreads from the television screen when participants perceive if the character is feeling awkward or imagine themselves feeling awkward in that situation.
Assessing Micro-habitat Preferences of Hill Partridge (Arborophila torqueola) in the Central Himalayan landscape of India
Authors: Thapa Avantika , Joshi Bheem Dutt , Thakur Mukesh , Sharma Lalit Kumar
Published: October 2023

Ground-dwelling birds are one of the most vulnerable taxa. These birds are also under-studied and therefore constitute the lesser-known group of aves. Understanding their patterns of resource selection and their relationship with the composites of their habitat is a prerequisite for ensuring the effectiveness of future conservation efforts. Hill partridge ( Arborophila torqueola) is distributed in a vast range throughout the Himalayas to South-East Asia but knowledge about its micro-habitat is provided by only a single short term study from China. Their sulking behavior and inconspicuous habitat type make it extremely challenging to study them closely. However, with the advent of camera traps, it was possible to observe them meticulously during this study. We attempted to discern the patterns of its habitat selection, and its relationship with various vegetative and non-vegetative components. This study revealed a complex pattern of habitat selection by hill partridge. They preferred habitat with a greater canopy and bamboo cover. It inhabited forests dominated by oak trees in combination with other trees. They were virtually absent from the sites that showed higher bare-ground percentages.
AMPK activation induces immunogenic cell death in AML
Authors: Mondesir Johanna , Ghisi Margherita , Poillet Laura , Bossong Robert A. , Kepp Oliver , Kroemer Guido , Sarry Jean-Emmanuel , Tamburini Jérôme , Lane Andrew A.
Published: October 2023

Survival of patients with acute myeloid leukemia (AML) can be improved by allogeneic hematopoietic stem cell transplantation (allo-HSCT) because of the antileukemic activity of T and natural killer cells from the donor. However, the use of allo-HSCT is limited by donor availability, recipient age, and potential severe side effects. Similarly, the efficacy of immunotherapies directing autologous T cells against tumor cells, including T-cell recruiting antibodies, chimeric antigen receptor T-cell therapy, and immune checkpoint inhibitors are limited in AML because of multiple mechanisms of leukemia immune escape. This has prompted a search for novel immunostimulatory approaches. Here, we show that activation of adenosine 5′-monophosphate–activated protein kinase (AMPK), a master regulator of cellular energy balance, by the small molecule GSK621 induces calreticulin (CALR) membrane exposure in murine and human AML cells. When CALR is exposed on the cell surface, it serves as a damage-associated molecular pattern that stimulates immune responses. We found that GSK621-treated murine leukemia cells promote the activation and maturation of bone marrow–derived dendritic cells. Moreover, vaccination with GSK621-treated leukemia cells had a protective effect in syngeneic immunocompetent recipients bearing transplanted AMLs. This effect was lost in recipients depleted of CD4/CD8 T cells. Together, these results demonstrate that AMPK activation by GSK621 elicits traits of immunogenic cell death and promotes a robust immune response against leukemia. Pharmacologic AMPK activation thus represents a new potential target for improving the activity of immunotherapy in AML.
Aspacytarabine for the treatment of patients with AML unfit for intensive chemotherapy: a phase 2 study
Authors: Altman Jessica K. , Zuckerman Tsila , Koprivnikar Jamie , McCloskey James , Kota Vamsi , Keng Michael , Frankfurt Olga , Abaza Yasmin , Bixby Dale L. , Emadi Ashkan , Burch Micah , Bhatnagar Bhavana , Luger Selina M. , Percival Mary-Elizabeth , Wolach Ofir , Craig Michael , Ganzel Chezi , Roboz Gail , Levi Itai , Gourevitch Anna , Flaishon Liat , Tessler Shoshi , Blumberg Chen , Gengrinovitch Stela , Ben Yakar Ruth , Rowe Jacob M.
Published: October 2023

High-dose cytarabine is associated with gastrointestinal and cerebellar toxicity, precluding its use for older or unfit patients with acute myeloid leukemia (AML). Aspacytarabine, an inactive prodrug of cytarabine, was evaluated as monotherapy in a phase 2b study of patients unfit for intensive chemotherapy (NCT03435848). Sixty-five patients with AML were treated with aspacytarabine 4.5 g/m2 per day (equimolar to 3 g/m2 per day cytarabine) for 6 doses per treatment. The median age was 75 years; 60.6% of patients had de novo AML, 28.8% had AML secondary to myelodysplastic syndrome, and 10.6% had therapy-related AML. Overall, 36.9% achieved complete remission (CR) with full count recovery. CR rates in patients with secondary AML, patients with prior treatment with hypomethylating agents, and patients with TP53 mutation were 26.7%, 25%, and 36%, respectively. Median overall survival was 9 months (range, 6-15.9) and was not reached among responders. Hematologic recovery was observed in all responding patients by day 26 without prolonged cytopenias. Adverse events typically precluding the use of high-dose cytarabine in older or unfit patients were not observed. These data suggest that aspacytarabine may be an effective regimen with a reduction in the attendant toxicities associated with high-dose cytarabine, an important consideration when treating AML and other hematologic disorders that use high-dose cytarabine. This trial was registered at www.clinicaltrials.gov as #NCT03435848.
Design of low-threshold photonic-crystal surface-emitting lasers with confined gain regions by using selective area intermixing
Authors: Chang Chia-Jui , Chen Lih-Ren , Hong Kuo-Bin , Lu Tien-Chang
Published: October 2023

Photonic-crystal surface-emitting lasers have many promising properties over traditional semiconductor lasers and are regarded as the next-generation laser sources. However, the minimum achievable lasing threshold of PCSELs is still several times larger than that of VCSELs, and limiting its applications especially if the required power is small. Here, we propose a new design that reduces the gain region in the lateral plane by using selective quantum-well intermixing to reduce the threshold current of PCSELs. By performing theoretical calculations, we confirmed that the threshold current can be lowered by a factor of two to three while keeping the PCSEL’s advantage of small divergence angle.
Picky with peakpicking: assessing chromatographic peak quality with simple metrics in metabolomics
Authors: Kumler William , Hazelton Bryna J. , Ingalls Anitra E.
Published: October 2023

Background

Chromatographic peakpicking continues to represent a significant bottleneck in automated LC–MS workflows. Uncontrolled false discovery rates and the lack of manually-calibrated quality metrics require researchers to visually evaluate individual peaks, requiring large amounts of time and breaking replicability. This problem is exacerbated in noisy environmental datasets and for novel separation methods such as hydrophilic interaction columns in metabolomics, creating a demand for a simple, intuitive, and robust metric of peak quality.

Results

Here, we manually labeled four HILIC oceanographic particulate metabolite datasets to assess the performance of individual peak quality metrics. We used these datasets to construct a predictive model calibrated to the likelihood that visual inspection by an MS expert would include a given mass feature in the downstream analysis. We implemented two novel peak quality metrics, a custom signal-to-noise metric and a test of similarity to a bell curve, both calculated from the raw data in the extracted ion chromatogram, and found that these outperformed existing measurements of peak quality. A simple logistic regression model built on two metrics reduced the fraction of false positives in the analysis from 70–80% down to 1–5% and showed minimal overfitting when applied to novel datasets. We then explored the implications of this quality thresholding on the conclusions obtained by the downstream analysis and found that while only 10% of the variance in the dataset could be explained by depth in the default output from the peakpicker, approximately 40% of the variance was explained when restricted to high-quality peaks alone.

Conclusions

We conclude that the poor performance of peakpicking algorithms significantly reduces the power of both univariate and multivariate statistical analyses to detect environmental differences. We demonstrate that simple models built on intuitive metrics and derived from the raw data are more robust and can outperform more complex models when applied to new data. Finally, we show that in properly curated datasets, depth is a major driver of variability in the marine microbial metabolome and identify several interesting metabolite trends for future investigation.
Immunized mice naturally process in silico-derived peptides from the nucleocapsid of SARS-CoV-2
Authors: Campos-Ruíz Mario Aldair , Illades-Aguiar Berenice , Del Moral-Hernández Oscar , Romo-Castillo Mariana , Salazar-García Marcela , Espinoza-Rojo Mónica , Vences-Velázquez Amalia , Cortés-Sarabia Karen , Luna-Pineda Victor M.
Published: October 2023

Background

The nucleocapsid (N) protein of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is an excellent immunogen that promotes the production of high-titer antibodies. N protein-derived peptides identified using a bioinformatics approach can potentially be used to develop a new generation of vaccines or diagnostic methods for detecting SARS-CoV-2 and its variants. However, further studies must demonstrate their capacity to be naturally processed by the immune system.

Objective

We aimed to examine the in vivo processing and recognition of in silico-identified peptides using the serum of immunized animals with the complete protein.

Methods

Recombinant N (Nrec) protein was subcutaneously administered to six Balb/c mice. Enzyme-linked immunosorbent assay (ELISA), western blotting, dot blotting, and immunoprecipitation were performed to evaluate the recognition of the complete protein and in silico-derived peptides.

Results

The serum of immunized mice recognized ~ 62.5 ng/µL of Nrec with high specificity to linear and conformational epitopes. Dot blot analysis showed that peptides Npep2 and Npep3 were the most reactive.

Conclusion

Our data confirm the high immunogenicity of the SARS-CoV-2 N protein and provide evidence on the antigenicity of two peptides located in the N-arm/RNA-binding domain (Npep2) and oligomerization domain/C-tail (Npep3), considered the biologically active site of the N protein.
Entomological longitudinal surveys in two contrasted eco-climatic settings in Cameroon reveal a high malaria transmission from Anopheles funestus associated with GSTe2 metabolic resistance
Authors: Natchema S. Fonkou Brice , Tchouakui Magellan , Menze Benjamin D. , Mugenzi Leon M. J. , Fofie Derrick , Nguiffo-Nguete Daniel , Nkengazong Lucia , Tombi Jeannette , Wondji Charles S.
Published: October 2023

Background

The impact of metabolic resistance to insecticides on malaria transmission remains poorly characterised notably through application of entomological parameters. The lack of resistance markers has been one of the limiting factors preventing a robust assessment of such impact. To this end, the present study sought to investigate how the L119F-Gste2 metabolic gene influences entomological parameters underpinning mosquitos’ propensity to transmit Plasmodium spp.

Methods

Longitudinal studies were carried out in Mibellon and Elende, two different eco-climatic settings in Cameroon and mosquitoes were collected using Human Landing Catch (HLC), Centre for Disease Control Light Trap (CDC-LT) and Pyrethrum Spray Catch (PSC) technics. Plasmodium sporozoite parasites were detected by TaqMan and Nested PCR, and blood meal origin by ELISA. The allele-specific PCR (AS-PCR) method was used to genotype the L119F-GSTe2 marker and association with malaria transmission was established by comparing key transmission parameters such as the Entomological Inoculation Rate (EIR) between individuals with different L119F-GSTe2 genotypes.

Results

An. funestus s.l was the predominant malaria vector collected during the entomological survey in both sites (86.6% and 96.4% in Elende and Mibellon, respectively) followed by An. gambiae s.l (7.5% and 2.4%, respectively). Sporozoite infection rates were very high in both collection sites (8.7% and 11% in Elende and Mibellon, respectively). An. funestus s.s exhibited a very high entomological inoculation rate (EIR) (66 ib/h/month and 792 ib/h/year) and was responsible for 98.6% of all malaria transmission events occurring in both sites. The Human Blood Index was also high in both locations (HBI = 94%). An. funestus s.s. mosquitoes with both 119 F/F (RR) and L119F (RS) genotypes had a significantly higher transmission intensity than their susceptible L/L119 (SS) counterparts (IRR = 2.2, 95%CI (1.1–5.2), p = 0.03; IRR = 2.5, 95% CI (1.2–5.8), p = 0.01 respectively).

Conclusion

This study highlights the major role that An. funestus s.s plays in malaria transmission in Cameroon with an aggravation from GSTe2-based metabolic resistance.
Reducing the rate of central line-associated bloodstream infections; a quality improvement project
Authors: Odada David , Munyi Hellen , Gatuiku Japhet , Thuku Ruth , Nyandigisi Jared , Wangui Anne , Ashihundu Emilie , Nyakiringa Beatrice , Kimeu Jemimah , Musumbi Martin , Adam Rodney D.
Published: October 2023

Background

The burden of central line-associated bloodstream infections is significant and has negative implications for healthcare, increasing morbidity and mortality risks, increasing inpatient hospital stays, and increasing the cost of hospitalization. Efforts to reduce the incidence of central line-associated bloodstream infections have utilized quality improvement projects that implement, measure, and monitor outcomes. However, variations in location, healthcare organization, patient risks, and practice gaps are key to the success of interventions and approaches. This study aims to evaluate interventions of a quality improvement project on the reduction of central line-associated bloodstream infection rates at a university teaching hospital.

Methods

This was a retrospective review of a quality improvement project that was implemented using the Plan-Do-Study-Act quality improvement cycle. Active surveillance of processes and outcomes was performed in the critical care areas; compliance to central line care bundles, and central line-associated bloodstream infections. Interrupted time series was used to analyze trends pre and post-intervention and regression modeling to estimate data segments preceding and succeeding the interventions.

Results

There were 350 central line insertions, 3912 catheter days, and 20 central line-associated bloodstream infection events during the intervention period. Compliance with central line care bundles was at 94%. There was a trend in the reduction of central line-associated bloodstream infections by 18% that did not reach statistical significance (p = 0.252).

Conclusions

Improvement projects to reduce central line-associated bloodstream infections face challenges and complexities associated with implementing interventions in real-world healthcare settings. There is a great need to continuously monitor, evaluate, readjust, and adapt interventions to achieve desired results, sustain improvements in patient outcomes, and investigate reasons for non-adherence as keys to achieving desired outcomes.