bluuebunny/crossref_metadata_2025 huggingface dataset:
A dynamic variant of Takotsubo cardiomyopathy mimicking apical hypertrophic cardiomyopathy: a case report
Authors: Seyani Chitsa , Adam Robert , Gant David , Shambrook James , Flett Andrew
Published: August 2024

Background

Takotsubo cardiomyopathy usually presents with acute reversible left ventricular apical hypokinesia and apical ballooning with basal hyperdynamic function. We describe an underreported case of Takotsubo cardiomyopathy (TCM), misinterpreted as apical hypertrophic cardiomyopathy (HCM) due to transient apical oedema in the recovery phase of the condition.

Case summary

A 74-year-old Caucasian woman, presented to the emergency department complaining of retrosternal chest pain following, emotional stress. Her electrocardiogram (ECG) demonstrated poor R-wave progression in the right precordial leads raising the possibility of an anterior non-ST elevation myocardial infarction. High sensitivity troponin was elevated at 2232 ng/L, echocardiography demonstrating apical ballooning and left ventricular ejection fraction of 45%. Computed tomography coronary angiography revealed unobstructive coronary arteries. Cardiac magnetic resonance imaging (cMRI) demonstrated morphological features consistent with apical HCM. However, subsequent cMRI examination, illustrated resolution of the hypertrophic segments, with T1 parametric mapping and extracellular volume (ECV) favouring TCM over apical HCM.

Discussion

Following emotional stress, takotsubo cardiomyopathy is understood caused by various mechanisms: catecholamine surge, inflammation, or transient ischaemia event leading to dysregulated cellular mechanisms. This results in myocardial oedema and increased wall stiffness leading to non-type 1 coronary plaque event-related regional wall motion abnormalities.

In this instance, the initial two cMRI studies reported morphological features consistent with apical HCM, however, a subsequent examination demonstrated resolution of these features. The key to delineating these distinct pathologies lies in myocardial T1 times that exceeded what is normally observed in HCM, the absence of late gadolinium enhancement and ECV values which favour takotsubo cardiomyopathy.
Can Social Health Insurance Improve Mental Health? An Analysis of Supplementary High-Cost Illness Insurance in China
Authors: Zhang Yaru , Yang Wei , Zhang Siqian , Yu Zexuan , Li Jiajia
Published: August 2024

Objectives

China introduced an innovative Supplementary High-Cost Illness Insurance (SHCII) program to enhance existing social health insurance by providing extra financial support for individuals facing catastrophic illnesses in 2015. The SHCII has notably increased access to healthcare and alleviated financial strain for economically disadvantaged individuals. However, there is a lack of information regarding the program’s impact on the mental health of its beneficiaries. This study aims to assess the impact of SHCII on the mental well-being of middle-aged and older individuals.

Methods

Using data from the China Health and Retirement Longitudinal Study (2011, 2013, 2015, and 2018), this study examined how SHCII affects mental health among middle-aged and older individuals in China using propensity score matching with the time-varying difference-in-differences method.

Results

We found that SHCII implementation can significantly reduce the Center for Epidemiologic Studies—Depression Scale scores of middle-aged and older individuals. This reduction was more pronounced among older individuals with poor self-rated health, chronic disease, and low household wealth when compared to their counterparts.

Discussion

The implementation of SHCII has had a significant and positive impact on mental health outcomes. We recommend that governments consider expanding the program to other areas within China, focusing especially on the most economically disadvantaged segments of the population.
Effects of Somatosensory Games on Heart Rate Variability and Sleep-Related Biomarkers in Menopausal Women With Poor Sleep Quality
Authors: Lin Yi-Yuan , Liao Yi-Hung , Ting Hua , Masodsai Kunanya , Chen Chi
Published: August 2024

Background and Objectives

The aim of this study was to investigate the effects of 12-week somatosensory games on heart rate variability and sleep-related biomarkers in middle-aged women with poor sleep quality.

Research Design and Methods

Twenty-nine women with poor sleep quality were recruited as participants randomly assigned into ring fit adventure exergame group (RFA, n = 15) and control group (CON, n = 14). The RFA group received ring fit adventure exergame for 60 min each time, 2 times a week, for 12 weeks. The CON group was not allowed to participate in intervention activities during the study period. Heart rate variability, sleep quality, cortisol, serotonin, and high-sensitive C-reactive protein were measured before and after the 12-week intervention.

Results

The Pittsburgh Sleep Quality Index total score in the RFA group was significantly lower compared with the CON group. The value of the standard deviation of normal NN intervals and the root mean square of the successive RR Differences were significantly increased in the RFA group, when compared with the CON group. The change in the logarithm of high frequency (log HF) was significantly higher and change in the logarithm of low frequency to high frequency ratio (log LF/HF) was significantly lower in the RFA group, when compared to the CON group. The change level of serotonin in the RFA group was significantly higher compared with the CON group.

Discussion and Implications

The results suggest that somatosensory games might improve sleep quality, increase serotonin level, and decrease sympathetic nerve activities in middle-aged women with poor sleep quality.
O03 Scale and spread of a quality improvement initiative promoting metronidazole IV to oral switch (IVOST) in the acute hospital setting: antimicrobial stewardship, patient safety, workforce and environmental sustainability benefits
Authors: Rodger R , Robertson A , Thompson E , Downie K , Thompson S , Ray G , Chisholm L , Hillson R
Published: August 2024

Background

In-hospital promotion of the oral route and IV to oral switch (IVOST)1 are key antimicrobial stewardship (AS) initiatives providing benefits for patients, staff and the environment, including reduced risk of line infections, medicine costs, nursing workload and plastic waste.1,2 A recent quality improvement (QI) initiative highlighting the environmental sustainability benefits of switching to oral metronidazole (bioavailability >90%) in surgical wards at the Royal Alexandra Hospital (RAH) resulted in a 45% median reduction in IV administrations.3

Objectives

To scale and spread this QI initiative to all inpatient wards in NHSGGC Clyde hospitals (RAH, Inverclyde Royal and Vale of Leven) and measure the impact on AS, drug costs, nursing workload and environmental sustainability.

Methods

A QI scale and spread approach was used including: targeted pharmacist/pharmacy technician prospective audit and feedback; presentations to medical, nursing and pharmacy teams; eye-catching posters on wards/electronic guideline platform; staff champions; and HEPMA IVOST prompts when prescribing or administering IV metronidazole.4 Oral and IV metronidazole usage data was calculated at baseline and for 36 months post-change. Benefits in terms of reduced IV administrations, drug costs and nursing time saved5 were calculated. Plastic waste reduction (giving sets, single use plastic containers, cannula, safety needles, gloves and aprons) associated with switching from IV to oral metronidazole was calculated in terms of carbon dioxide equivalent (CO2e) emissions using a hybrid carbon footprinting methodology and emissions factor databases.6,7

Results

There was a 64% median reduction in IV metronidazole defined daily doses (DDDs) (Figure 1) equating to 1977 and 23 724 fewer IV metronidazole administrations monthly and annually, respectively. The equivalent nursing time saved was 659 h per month and 7908 h per year. There was a 26% median shift in percentage IV metronidazole of total (IV plus oral) use (Figure 2). There was a 38% median reduction in metronidazole drug cost (Figure 3). The carbon footprint saving achieved from switching from IV to oral metronidazole was calculated as 1.48111 kg CO2e per dose, equating to 2928 kg CO2e per month and an annual carbon footprint saving of 35.1 tonnes CO2e; refer to Table 1 for equivalents.

Conclusions

A QI scale and spread approach to raise awareness of the multidisciplinary team to the benefits of appropriate switch from IV to oral metronidazole resulted in a change in prescribing behaviour and a significant reduction in IV administrations. This is important in terms of improved AS, patient safety, workforce cost and efficiency and environmental sustainability.
P10 Risk management of clinical false positives with multiplex PCR blood culture panels: a lesson in diagnostic stewardship for microbiology trainees
Authors: Gregg S , Mulrooney C , Leonard M , Flanagan M , Nashev D , Cormican M
Published: August 2024

Background

The processing of blood cultures is technically difficult and time consuming. Nucleic acid amplification tests (NAATs) can supplement this process, with some commercial systems offering NAAT for multiple pathogens simultaneously. These platforms also present distinct challenges, including managing false positive identifications. The use of broad multiplex NAAT in cases of low pre-test probability carries an inherent risk of low positive predictive value. We describe a series of detections of Candida tropicalis targets from positive blood cultures where C. tropicalis was not present and subsequent management.

Incident

Biofire Filmarray BCID2 was introduced in May 2022 in a General Hospital to aid laboratory workflow. The BCID2 panel is used 5–10 times weekly on positive blood cultures. BC specimens are then sent to an associated hospital for sub-culture, identification and antimicrobial susceptibility testing. In August 2023 a blood culture with Gram-positive cocci on Gram stain was positive for C. tropicalis and Staphylococcus spp. targets on BFBCID2. The consultant microbiologist did not advise antifungal treatment based on Gram stain and assessment of patient clinical features. Only Staphylococcus spp. was identified on culture. bioMérieux UK Ltd subsequently released a Field Safety Notice in August 2023 highlighting the risk of false positive identification of C. tropicalis and other organisms using BCID and BCID2 panels. This may be related to yeast DNA in the culture media. C. tropicalis has been detected from 18 additional blood cultures up to March 2024 from multiple batches of blood culture bottles and multiple BCID and BCID2 panels.

Risk management

Laboratory practices were reviewed to address the possibility of sample contamination. Of note, C. tropicalis was not cultured from blood in the laboratory in the year prior August 2023. All scientific and medical staff in the laboratory were alerted to the issue. Use of the BCID and BCID2 panels was continued because of the clinical value of rapid on-site identification of key pathogens such as S. aureus and differentiation from CoNS. In each case of C. tropicalis identification, the Gram stain and clinical features were reviewed. No patients received inappropriate antifungal treatment.

Lessons for trainees

(i) The combination of two technologies (blood culture and multiplex NAAT) can generate unanticipated challenges. (ii) Use of NAATs in samples with a low pre-test probability is associated with the risk of low positive predictive value. (iii) Potential risk can be mitigated by correlation of results of molecular testing with Gram stain and assessment of clinical features.

Conclusions

Learning for microbiology trainees relates to the need for caution in interpretation of new technologies and the importance of pre-test probability in interpreting a positive result in any assay.
P16 Analysis of antibiotic resistance in wounded servicemen with infectious complications
Authors: Viltsaniuk Oksana , Syvak Viktor , Tkachuk Nataliia
Published: August 2024

Background

The problem of antibiotic resistance has now become a global challenge. Infectious complications are the cause of death in 80% of wounded soldiers whose deaths occur late after a military injury. This confirms that the fight against wound infection is one of the priority tasks in the treatment of combat trauma.

Objectives

To investigate the species composition and susceptibility of microorganisms in servicemen with gunshot wounds and severe infectious complications.

Materials and methods

The study analysed 34 case histories of wounded servicemen with infectious complications (sepsis, pneumonia).

Results

Sixty-eight samples of materials were taken, of which 56 samples of biomaterial were isolated from wounds, blood and sputum, and pathogens were isolated. A monoculture was isolated in 85% of cases, in 10% of cases there was a combination of Staphylococcus aureus and Klebsiella pneumoniae, and in 5% of cases different triple combinations of S. aureus with Staphylococcus lentus, Enterobacter, Proteus or Lelliottia amnigena were identified. Most commonly detected were K. pneumoniae (43%) and S. aureus (21%), followed by equal proportions of Enterobacter and Proteus (both 9%), Bacillus spp. (7%) and, in rare cases, L. amnigena, S. epidermidis, S. haemolyticus and S. lentus were isolated (1% each, respectively). Considering that S. aureus and K. pneumoniae were the most frequently isolated pathogens, we analysed their susceptibility. K. pneumoniae was resistant to cefazolin in all cases, and the highest resistance was found to amikacin, amoxicillin, ciprofloxacin, cefepime and piperacillin/tazobactam. The highest levels of susceptibility were found for levofloxacin and meropenem. Susceptibility analysis of S. aureus revealed that this pathogen was not susceptible to azithromycin, amoxicillin, levofloxacin, moxifloxacin, ofloxacin, piperacillin/tazobactam or cefazolin. Linezolid had the highest susceptibility of 90%.

Conclusions

The choice of antibiotic therapy for wounded soldiers should take into account the possibility of infection with highly virulent pathogens that can cause secondary purulent complications. In addition, it should be noted that due to the phasing of care from the battlefield to tertiary care, the risk of developing resistance increases as pathogens constantly migrate and change their susceptibility to antibiotics.
P25 Pharmacovigilance assessment of Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) with antibacterial drugs using FDA adverse event reporting system data
Authors: Radhakrishnan Sriram , Velmani Vaishnavi , Shailaja K
Published: August 2024

Background

Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe and potentially life-threatening skin reactions associated with certain medications, including antibacterial drugs. This study outlines a comprehensive pharmacovigilance study using the US FDA Adverse Event Reporting System (FAERS) data to assess this association.

Methods

All SJS/TEN cases of antibacterial drugs as primary suspected drugs were extracted from the US FDA FAERS from 2004 to 2023. Descriptive analyses were performed to evaluate the prevalence of SJS/TEN among antibacterial drug users. Disproportionate analyses were conducted by estimating the reporting odds ratio (ROR) and the information component (IC).

Results

Out of a total of 38 185 cases of SJS/TEN reported in the FAERS, 16 104 (42.17%) cases are due to antibacterial drug use suspects. 332 cases of SJS/TEN overlap from the year 2019 reported. Gender analysis of SJS/TEN shows females (51.2%) are more prone than males (39.29%) and not specified (9.51%). Mortality rate of SJS/TEN due to drug adverse reaction is 21% (7995). The SJS/TEN signal was detected majorly in cotrimoxazole, amoxicillin, ciprofloxacin, vancomycin, levofloxacin, piperacillin sodium/tazobactam sodium, amoxicillin/clavulanate potassium and clarithromycin. The ROR (95% CI) of cotrimoxazole, amoxicillin, ciprofloxacin, vancomycin, levofloxacin, piperacillin sodium/tazobactam sodium, amoxicillin/clavulanate potassium and clarithromycin were 53.74 (57.62–50.12), 0.67 (0.72–0.63), 0.54 (0.58–0.50), 0.85 (0.91–0.79), 0.30 (0.32–0.27), 0.89 (0.96–0.82), 11.27 (12.39–10.25) and 0.50, (0.55–0.46), respectively.

Conclusions

This pharmacovigilance assessment of FAERS shows 42.17% association of antibacterial drugs in suspected cases of SJS/TEN. This reminds the medical workers to pay attention to the severe adverse effects of antibacterial drugs leading to SJS/TEN.
P28 An analysis of the appropriateness of antimicrobial prescribing at a tertiary centre: reflections from the National Point Prevalence Survey
Authors: Salih Dylan Zeki , Bedford Luke , Enoch David , Wong Vanessa , Burrows Susannah , Santos Reem , Cooke Fiona , Gouliouris Theodore
Published: August 2024

Background

Between 18 September 2023 and 27 October 2023, Cambridge University Hospitals NHS Foundation Trust (CUH) partook in the UK Health Security Agency (UKHSA) National Point Prevalence Survey (PPS) of healthcare-associated infections, antimicrobial use and stewardship. This survey was the first to assess the appropriateness of individual antimicrobial prescriptions.

Objectives

To use the data collected during the PPS to identify antimicrobial agents associated with inappropriate prescribing at CUH and investigate the factors contributing to this trend.

Methods

Using the UKHSA PPS protocol, data pertaining to antimicrobial prescriptions at CUH during the survey period were collected. All prescriptions captured in the PPS with an associated appropriateness score were analysed. Grouping prescriptions by individual antimicrobial agent allowed identification of antimicrobial agents with a statistically significant proportion of ‘inappropriate’ prescriptions. Further analysis of the prescriptions of these agents, using the PPS data, permitted identification of factors which contributed to this association.

Results

A total of 1064 patient reviews were conducted on 51 wards. Overall, 477/1064 (45%) of patients were on antimicrobials (mean number of antimicrobial prescriptions per patient=0.7, SD=0.7). Of the 52 agents used, co-amoxiclav (n=147, 19%), piperacillin/tazobactam (n=86, 11%), fluconazole (n=45, 6%) and sulfamethoxazole/trimethoprim (n=44, 6%) were the commonest. Appropriateness was assessed for 565 (79.5%) of the 711 antimicrobial prescriptions with 488 (86.4%) considered appropriate and 77 (13.6%) inappropriate. Co-amoxiclav was identified as the only antimicrobial agent with a statistically significant association with inappropriate prescribing (P<0.001, OR 2.9, 95% CI 1.7–4.8). Further analysis revealed that co-amoxiclav prescriptions for treatment were, relative to other antimicrobials, less likely to adhere to either national or local guidelines (P=0.006, OR 0.4, 95% CI 0.2–0.8) and significantly more likely to be prescribed to treat a condition which does not require antimicrobials (P=0.004, OR 0.3, 95% CI 0.1–0.7) and to treat an infection which required a broader spectrum agent (P<0.001, OR 0.2, 95% CI 0.1–0.5).

Conclusions

Co-amoxiclav was most commonly associated with misuse/overuse and efforts to improve prescribing at CUH should focus on this agent. Further work is required to understand the factors that drive this association in order to improve prescribing.
Insights of temperature-dependent fluid characteristics on micropolar material in a rotating frame with cubic autocatalysis chemical reaction
Authors: Khattak Shahzad , Khan Muhammad Naveed , Riaz Muhammad Bilal , Lu Dianchen , Hussien Mohamed , Albalwi M Daher , Jhangeer Adil
Published: August 2024

The diverse use of heat and mass transport mechanisms on three-dimensional rotating systems has been discovered to improve the efficiency of several physiological and industrial processes. These include, for example, fiber technology, the process of extrusion, and polymer extraction. The purpose of this dissertation is to investigate the transportation of mass and heat in the flow of non-Newtonian fluid processing vortex viscosity and micro-inertial features along two horizontal plates in a rotating scenario. The thermal transport process is influenced by physical parameters such as irregular heat generation/absorption rate, linear radiative heat flow, variable thermal conductivity, and mass diffusion with cubic autolysis chemical reaction. After enforcing conservation laws, a simple constitutive equations are modelled in a rotating system. The mathematical formulation is converted into a dimensionless format by applying comparable variables. The bvp4c process is used to execute numerical experiments to arrive at the numerical solution for the governing problem. Through sketching, the related distribution (velocity, micro rotation, velocity, and concentration) is presented concerning the various parameters. Tabular data provides insights into relevant quantities against different parameters. The credibility of computed results is assumed by agreeing with previous studies.
Effects of surface type and distance traveled on the efficacy of a Beauveria bassiana (Hypocreales:Cordycipitaceae)-based biopesticide (Aprehend) for bed bug (Hemiptera: Cimicidae) control
Authors: Principato Simona , DeVries Zachary C
Published: August 2024

The cryptic behavior that characterizes bed bugs (Cimex lectularius L.) makes them one of the most difficult indoor pests to control. Thus, the use of products with long residual efficacy is a key component of successful bed bug management. Aprehend is a biopesticide for bed bug control, whose active ingredient is the entomopathogenic fungus, Beauveria bassiana. This product shows promise for extended bed bug control against pyrethroid-resistant bed bugs, causing mortality days after contact with the treated surface. However, it is unclear how surface type and distance traveled by bed bugs over a treated surface impact efficacy. Therefore, we evaluated the efficacy of different Aprehend band widths applied to different substrates commonly encountered by bed bugs, looking specifically at average time to mortality and overall mortality. Our findings indicate that exposure to fresh applications of Aprehend resulted in high mortality when bed bugs traveled very short distances (1 cm) over some Aprehend-treated surfaces (vinyl tile and cotton jersey fabric), while exposure to other treated surfaces (unfinished pinewood and painted drywall) resulted in comparatively lower mortality even over longer distances (5 cm). Furthermore, we found that bed bugs crawling on cotton jersey fabric picked up a significantly higher number of spores compared to unfinished pinewood. These results indicate that applications of Aprehend as 5 cm (2 inches) bands according to label recommendations can be effective, although surface type is an important determinator of efficacy. This information will help guide pest management professionals in their use of B. bassiana for bed bug control.
Identifying novel metrics of operative performance in surgical training: protocol for a Delphi consensus study
Authors: Dick Lachlan , Skipworth Richard J E , Tallentire Victoria R , Yule Steven
Published: August 2024

Introduction: Acquiring the technical and non-technical skills necessary to perform operations safely requires time and dedication. The learning curve is steep and regular feedback on operative performance is needed to help trainees identify strengths and development needs. Traditional methods of assessment are time consuming, prone to bias and lack reliability and scalability. Advances in digital technology in surgery have allowed for more objective measures of operative performance to be generated. Objective performance metrics can provide insights void of opinion and can complement and strengthen traditional methods of feedback. This protocol outlines a study that aims to reach consensus on which performance metrics are most relevant to surgical trainees and how they should be applied in training. Methods and analysis: A three-round electronic Delphi study will be used. Participants will be asked to rate the importance of statements relating to objective performance metrics in surgical training and the ways in which they could be applied. Statements will be created from extensive searches of the literature, discussion with experts and through a pilot. A panel consisting of trainees, trainers, researchers and institutions will be formed to participate in the study. Ethics and dissemination: Formal ethical approval has been granted for this study. Dissemination will be at surgical and education meetings, in addition to publication following peer review.
Inference of Host–Pathogen Interaction Matrices from Genome-Wide Polymorphism Data
Authors: Märkle Hanna , John Sona , Metzger Lukas ,   STOP-HCV Consortium, Barnes Eleanor , Hudson Emma , Klenerman Paul , Simmonds Peter , Holmes Chris , Cooke Graham , Dusheiko Geoffrey , McLauchlan John , Harris Mark , Irving William , Troke Philip , Brainard Diana , McHutchinson John , Gore Charles , Halford Rachel , Foster Graham R , Herath Cham , Ansari M Azim , Pedergnana Vincent , Tellier Aurélien
Published: August 2024

Host–pathogen coevolution is defined as the reciprocal evolutionary changes in both species due to genotype × genotype (G×G) interactions at the genetic level determining the outcome and severity of infection. While co-analyses of hosts and pathogen genomes (co-genome-wide association studies) allow us to pinpoint the interacting genes, these do not reveal which host genotype(s) is/are resistant to which pathogen genotype(s). The knowledge of this so-called infection matrix is important for agriculture and medicine. Building on established theories of host–pathogen interactions, we here derive four novel indices capturing the characteristics of the infection matrix. These indices can be computed from full genome polymorphism data of randomly sampled uninfected hosts, as well as infected hosts and their pathogen strains. We use these indices in an approximate Bayesian computation method to pinpoint loci with relevant G×G interactions and to infer their underlying interaction matrix. In a combined single nucleotide polymorphism dataset of 451 European humans and their infecting hepatitis C virus (HCV) strains and 503 uninfected individuals, we reveal a new human candidate gene for resistance to HCV and new virus mutations matching human genes. For two groups of significant human–HCV (G×G) associations, we infer a gene-for-gene infection matrix, which is commonly assumed to be typical of plant–pathogen interactions. Our model-based inference framework bridges theoretical models of G×G interactions with host and pathogen genomic data. It, therefore, paves the way for understanding the evolution of key G×G interactions underpinning HCV adaptation to the European human population after a recent expansion.
A case of immunoglobulin G4–related disease complicated by atopic dermatitis responsive to upadacitinib treatment
Authors: Kusaka Katsuhide , Nakayamada Shingo , Hanami Kentaro , Nawata Aya , Tanaka Yoshiya
Published: August 2024

Immunoglobulin G4–related disease (IgG4-RD) is mainly treated with glucocorticoids. In many cases, this disease is resistant to glucocorticoids, and their toxicity can be a problem. We encountered a patient with IgG4-RD affecting multiple organs (such as the skin, lung, and lacrimal gland), who had comorbidities, including atopic dermatitis and diabetes. In this case, while glucocorticoid tapering was difficult, the introduction of upadacitinib resulted in the remission of both atopic dermatitis and IgG4-RD without glucocorticoid dose escalation. Peripheral blood flow cytometry analysis showed that the proportions of activated non-Th1/Th17 cell subset (Th2 cells), follicular helper T cells, and plasmocytes were increased before upadacitinib therapy, but all normalised after treatment. Interleukin-4 and interleukin-21 signals are important for the differentiation of CD4+ T cells into type 2 helper T or B cells in the peripheral blood. Our case suggested that inhibition of Janus kinase 1, which mediates these signals, might have contributed to improved pathological conditions in IgG4-RD.
The Neutron Skin-Thickness of 208Pb Determined by Electron and Proton Scattering
Authors: Suzuki Toshio , Danjo Rika , Suda Toshimi
Published: August 2024

Electron as well as proton elastic scattering is not able to determine the point proton and point neutron densities, $\rho _\tau (r), (\tau =p,n)$, separately. If both scatterings are analyzed consistently, those densities would be determined uniquely, since the two densities are observed by different combinations from each other. Previous experiments have not provided $\rho _\tau (r)$ uniquely, but the values of the mean square radii of $\rho _p(r)$, $\langle \, r^2\, \rangle _p$, and of $\rho _n(r)$, $\langle \, r^2\, \rangle _n$, are shown to be determined consistently through the fourth moment of the observed charge density, $\langle \, r^4\, \rangle _c$, in 208Pb. The previous analyses of $(\gamma , \pi ^0)$ and $\bar{p}$-nucleus obtained a similar value of $\langle \, r^2\, \rangle _n$, but they do not yield the experimental value of $\langle \, r^4\, \rangle _c$ observed in electron scattering.
Mannan oligosaccharides as a prebiotic for laying hens: effects on fertility, hatchability, productive performance, and immunity
Authors: Youssef Islam M , Aldhalmi Ahmed K , Felemban Shatha G , Elsherbeni Ahmed I , Khalil Hassan A , Hassan Magdy S , Abd El Halim Haiam S , Abd El-Hack Mohamed E , Youssef Khaled M , Swelum Ayman A , Tufarelli Vincenzo , Abo-Samra Maher A
Published: August 2024

This experiment examined how adding mannan-oligosaccharides (MOS) to the diet affected fertility, hatching rates, egg production, carcass characteristics, cost-effectiveness, and immune function in laying hens. One hundred and twenty Mandarah chickens (30 hens and 3 roosters per group) were randomly chosen between 34 and 50 wk old and divided into four groups. The first group was the control group, which was given just the basal diet. The basal diet was given to the second, third, and fourth experimental groups along with three different levels of MOS (0.1, 0.2, and 0.5 g/kg diet, respectively). Results found that hens fed MOS at various levels laid eggs at a significantly higher rate, enhanced egg number, egg mass and feed conversion ratio than the control group (P < 0.05). MOS seemed to improve carcass quality. The best results for egg quality (Haugh unit) and testosterone levels were seen with a dose of 0.5 g/kg of MOS compared to the control birds (P < 0.05). All MOS levels led to higher estradiol-17β (E2) levels and better economic efficiency (EE). MOS also improved the hens’ immune systems as compared to the control group. Hens-fed MOS had significantly greater levels of antibodies against Influenza viruses (H9N2) and Infectious Bronchitis Virus (P < 0.05). Also, the spleen and thymus gland, both crucial immune system components, were slightly larger (P < 0.05). It’s important to note that fertility rates, hatchability, and embryo mortality rates remained similar across all groups. So, our findings suggest that incorporating MOS into the birds’ diet enhances their productivity, strengthens their immune system, improves EE, and contributes to the overall health of the hens.
Identification of Genetic Loci for Grain Traits and Disease Resistance Reveals a Potential Trade-Off in Rice
Authors: Jia Yulin , Jia Melissa H. , Box Heather
Published: August 2024

Understanding how plants utilize limited resources for reproductivity and disease resistance can improve the efficiency of plant breeding. In the present study, we mapped genes for grain traits, including grain length and width and thousand grain weight (TGW). A previously constructed linkage map of a recombinant inbred line population (MHM) was used, which was derived from a cross between an indica restorer rice variety (Minghui 63) and a temperate japonica rice variety (M-202). The MHM population was grown in replicated field plots, and grain trait data were collected. Upon a 3-year field evaluation, a total of 16 loci were mapped on 9 of 12 chromosomes, including 7 for grain length, 4 for grain weight, and 5 for TGW. A TGW locus ( qTGW2) and a grain width locus ( qWIG2.2) were mapped at the known blast resistance locus qBLAST2 on chromosome 2 that harbors a major blast resistance allele Pi-b. Another TGW locus ( qTGW3.3) and a grain length locus ( qLNG3.3) were mapped at qBLAST3 on chromosome 3. These results reveal potential trade-offs between disease resistance and productivity, which are important for breeders to develop high-yielding and disease-resistant rice varieties.

[Formula: see text] The author(s) have dedicated the work to the public domain under the Creative Commons CC0 “No Rights Reserved” license by waiving all of his or her rights to the work worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law, 2024.
Standing strong: War‐related challenges in Ukrainian biomedical research and opportunities for support
Authors: Hondermarck Hubert , Finiuk Nataliya , Jiang Chen Chen , Stoika Rostyslav
Published: August 2024

The prolonged war in Ukraine is having a strong impact on all sectors of the Ukrainian society, including biomedical research. Although the material and psychological conditions are challenging, the country and its researchers are courageously managing to continue their activities. This perspective paper describes the multiple challenges faced by Ukrainian biomedical researchers during wartime and outlines strategies to support and enhance collaboration with the global scientific community. Ukraine has a rich scientific history and modern expertise in biomedical research, and developing more international collaborations with Ukraine can have mutual benefits for all involved parties.
Racial and Ethnic Patient Care Disparities in Anesthesiology: History, Current State, and a Way Forward
Authors: Mergler BD , Toles AO , Alexander A , Mosquera DC , Lane-Fall MB , Ejiogu NI
Published: August 2024

(Anesth Analg. 2023. doi: 10.1213/ANE.0000000000006716)

The literature on disparities in racial and ethnic patient care in anesthesiology is increasing but more can be done to advance the field. This review paper examines research findings and offers potential solutions to eliminate structural racism and implicit and explicit bias. The focus is on disparities in perioperative care, labor and delivery, pain clinics, and intensive care units. The review focuses on US studies and does not include studies in pediatric anesthesia or palliative care.
Pregnancy-Associated Stroke and the Recurrence of Stroke and Other Complications in Subsequent Pregnancies: Population-Based Retrospective Cohort Study
Authors: Verho L , Tikkanen M , Äyräs O , Aarnio K , Rantanen K , Korhonen A , Richardt A , Laivuori H , Gissler M , Ijäs P
Published: August 2024

(BJOG. 2023;130(11):1421–1429. doi: 10.1111/1471-0528.17503)

The incidence of pregnancy-associated stroke (PAS) is rare, estimated at 30 per 100,000 live births and potentially life threatening for mother and child. In recent years, the incidence of PAS is rising, thought to be a result of advancing maternal age and more frequent comorbidities. Although serious, patients may recover from PAS and even become pregnant again. There is a lack of published research on the risks of stroke recurrence during pregnancy and the early postpartum period in this population. This study aimed to further understand the risks to support family planning and decision making in women with history of PAS.
Real-Time Imaging as Visual Biofeedback in Active Second Stage of Labor Among Nulliparas: A Randomized Controlled Trial
Authors: Hamid NA , Hong JGS , Hamdan M , Vallikkannu N , Adlan AS , Tan PC
Published: August 2024

(Am J Obstet Gynecol. 2023;229(4):443.e1–443.e9. doi:10.1016/j.ajog.2023.04.049)

Extended second-stage labor heightens the chances of severe perineal tears, postpartum bleeding, operative deliveries, and low Apgar scores, especially among first-time mothers. Maternal exertion during this stage aids the natural expulsion of the fetus. Biofeedback, a mind-body technique, empowers individuals to regulate their bodily functions for holistic well-being. Utilizing mirrors or monitors for real-time visual feedback enhances self-awareness. In a previous study, 88.5% of women who used a mirror during the second stage of labor felt that it motivated them to push, albeit with some clarity limitations. Similarly, in 2 additional small studies, visual aids like cameras or ultrasound shorten the second stage by inspiring effective pushing. The current study aimed to compare real-time introitus visualization (InV) against maternal face (MF) viewing (control) during pushing in first-time mothers, assessing its impact on delivery time and maternal satisfaction.
Impact of Discontinuing Oxytocin in Active Labor on Neonatal Morbidity: An Open-Label, Multicenter, Randomized Trial
Authors: Girault A , Sentilhes L , Desbrière R , Berveiller P , Korb D , Bertholdt C , Carrara J , Winer N , Verspyck E , Boudier E , Barjat T , Levy G , Roth GE , Kayem G , Massoud M , Bohec C , Guerby P , Azria E , Blanc J , Heckenroth H , Rousseau J , Garabedian C , Le Ray C ,   collaborators of the STOPOXY trial and the Groupe de Recherche en Obstétrique et Gynécologie (GROG)
Published: August 2024

(Lancet. 2023;402(10417)2091–2100. doi: 10.1016/S0140-6736(23)01803-2)

Oxytocin is a widely used drug worldwide, employed in either labor induction or labor augmentation. However, ambiguities persist regarding the ideal length of oxytocin delivery and its potential impact on neonatal and maternal outcomes. A previous clinical trial conducted in 2021 found a trivial rise in cesarean deliveries when oxytocin was discontinued, although this difference lacked both clinical and statistical significance. The current study sought to assess the effects of discontinuing oxytocin during the active phase of labor on neonatal morbidity and maternal complications.
Early Metformin in Gestational Diabetes: A Randomized Clinical Trial
Authors: Dunne F , Newman C , Alvarez-Iglesias A , Ferguson J , Smyth A , Browne M , O’Shea P , Devane D , Gillespie P , Bogdanet D , Kgosidialwa O , Egan A , Finn Y , Gaffney G , Khattak A , O’Keeffe D , Liew A , O’Donnell M
Published: August 2024

(JAMA. 2023;330(16):1547–1556. doi: 10.1001/jama.2023.19869)

Gestational diabetes (gDM) is a common pregnancy complication, affecting up to nearly 3 million pregnancies globally every year. It is known to be associated with adverse pregnancy outcomes, including weight gain, cesarean delivery, preeclampsia, birth injuries, respiratory distress, and neonatal ICU admission. Optimal management of gDM is unclear. Current guidelines recommend lifestyle modifications with nutrition and exercise, and subsequent insulin administration if hyperglycemia persists. Although effective in improving outcomes, insulin is linked to increased hypoglycemia events, weight gain, cesarean delivery, and neonatal ICU admission. Metformin in pregnancy is also associated with improved maternal and fetal outcomes compared to insulin, although there are concerns relating to spontaneous preterm birth and small for gestational age infants. Though metformin is considered safe during pregnancy, it is currently only prescribed after lifestyle management failure; this study was designed to test the hypothesis that earlier administration of metformin upon diagnosis of gDM would be beneficial to the outcomes of mothers and babies, primarily assessing the effect on the composite of insulin initiation and fasting hyperglycemia at 32 or 38 weeks of gestation.
Metformin for Diabetes in Pregnancy: Are We Closer to Defining its Role?
Authors: Feig DS
Published: August 2024

(JAMA. 2023;330(22):2167–2169. doi: 10.1001/jama.2023.18589)

Gestational (gDM) and type 2 (T2DM) diabetes mellitus during pregnancy are increasingly common, and adverse outcomes related to these conditions are likely. Recent randomized clinical trials (RCTs) have been conducted to find ways of improving outcomes in patients with these conditions. This article is an opinion editorial in response to recent trials published in JAMA that evaluate metformin during pregnancy to mitigate negative outcomes, with one trial in women with gDM and one in women with T2DM.
Trends in Perinatal Mental Health Within a Tertiary Institution From 2013 to 2022
Authors: Bertram G , Becuzzi N , Wilson E
Published: August 2024

(Aust N Z J Obstet Gynaecol. 2023;63(6):821–824. doi: 10.1111/ajo.13720)

There is a high risk of developing mood and other psychiatric disorders during the perinatal period, which can be detrimental to the morbidity and mortality of women and their offspring. The rate of perinatal mental health (PMH) that has been reported is likely to be between 10% and 20% for the Australian population. The Royal Australian and New Zealand College of Obstetrics and Gynaecology recommends that the psychological well-being of pregnant women and new mothers should be attended to as part of regular antenatal and postnatal care and should be regarded as just as vital as their physical health needs.
Pregestational Maternal Risk Factors for Preterm and Term Preeclampsia: A Population-based Cohort Study
Authors: Sande AK , Dalen I , Torkildsen EA , Sande RK , Morken N-H
Published: August 2024

(Acta Obstet Gynecol Scand. 2023;102(11):1549-1557. doi: 10.1111/aogs.14642)

Preeclampsia represents a large proportion of global maternal and neonatal morbidity and mortality. Through evidence and careful study, it has been classified into preterm and term preeclampsia, but few population-based studies have made this distinction in diagnosis. The only curative treatment for preeclampsia is delivery, and all other treatments known for this disease are preventive. In addition to differences in timing and presentation, preterm preeclampsia has several risk factors that do not apply to individuals with term preeclampsia, such as chronic hypertension, type 1 diabetes, and maternal allergy. This study was designed to assess the associations of prepregnancy conditions (diabetes types 1 and 2, chronic kidney disease, asthma, epilepsy, rheumatoid arthritis, and chronic hypertension) with preterm versus term preeclampsia at a population level.
Developmental Anesthesia Neurotoxicity: Lessons From the Heart
Authors: Ing C , Vutskits L
Published: August 2024

(Anesthesiology. 2023;139(4):371–373. doi: 10.1097/ALN.0000000000004648)

The topic of whether anesthetics affect neurodevelopment outcomes or not is still unsettled among many medical professionals in the field. Several studies have already been performed resulting in negligible or no differences for single or short exposures to anesthetics in healthy children, but additional research is needed for longer anesthetic exposures or in children who have more elaborate medical issues that require surgery.
Calculation of Effective Dose of Phenylephrine Bolus for Treatment of Post–Spinal Hypotension in Preeclamptic Patients Undergoing Caesarean Section—A Nonrandomized Controlled Trial
Authors: Mohta M , Kumari S , Malhotra RK , Tyagi A , Agarwal R
Published: August 2024

(Int J Obstet Anesth. 2023;56:103929. doi: 10.1016/j.ijoa.2023.103929)

Preeclampsia (PEC), a condition marked by high blood pressure during pregnancy, poses risks for both mother and fetus. Although post–spinal hypotension is rare in PEC, if it occurs (especially for over two minutes), it can worsen fetal health by impacting blood flow to the placenta and increasing oxygen free radicals. Prompt treatment of hypotension is crucial to mitigate maternal symptoms and improve outcomes for both mother and baby.
Neuraxial Buprenorphine for Postcesarean Delivery Analgesia: A Case Series
Authors: Sorabella LL , Ende HB , Bellenger SR , Stewart MF , French B , McIlroy DR , Raymond BL
Published: August 2024

(Int J Obstet Anesth. 2023;56:103906. doi: 10.1016/j.ijoa.2023.103906)

Neuraxial morphine is standard for postcesarean pain relief, yet morphine shortages lead to off-label use of alternative opioids. Buprenorphine, considered since the 1980s, lacks robust studies but shows promise. This study assesses buprenorphine's efficacy and side effects in current practice. After institutional approval, a retrospective analysis was conducted on women receiving neuraxial buprenorphine at a Tennessee community hospital from November 2019 to September 2020. All received intrathecal or epidural buprenorphine 0.3 mg. Exclusions included certain medical conditions.
Successful Outcome of VASER Liposuction Followed by Keto Diet in a 35-year-old Man with Class III Obesity
Authors: Ali Hasan
Published: August 2024

Obesity is a widespread health concern worldwide, necessitating diverse interventions for effective weight management. Despite prior unsuccessful attempts at weight loss through conventional methods, including dietary restrictions and physical exercises, this case underscores the challenges faced by individuals with morbid obesity. This case report presents the successful outcome of VASER liposuction followed by a 6-month postoperative ketogenic diet regimen in a 35-year-old man with a body mass index (BMI) of 40. The patient, initially weighing 127 kg with a BMI of 40.9 kg/m² and significant fatty deposition primarily on the chest, abdomen, and flanks, underwent tumescent VASER liposuction, removing 5 L of fat. Subsequently, adhering to a modified ketogenic diet plan led to a notable reduction in weight (from 127 kg to 97 kg) and BMI (from 40 to 31.5) over the 6-month follow-up period. Effective pain management postoperatively and improvements in skin retraction and energy levels were observed. The combined approach of VASER liposuction and a ketogenic diet yielded favorable outcomes, including significant weight loss, improved BMI, and enhanced body contouring. Importantly, minimal loose skin was observed despite substantial weight reduction, highlighting the synergistic effects of the intervention. This case highlights the potential synergistic effects of VASER liposuction and a ketogenic diet in addressing obesity, offering a promising approach for weight management in morbid obese individuals. The synergistic effects included enhanced skin tightening, safety, faster recovery, minimal pain, and substantial weight loss.