bluuebunny/crossref_metadata_2025 huggingface dataset:
Organized crime, gangs, and gangster fiction
Authors: Evans Lucy
Published: October 2024

This chapter locates Marlon James’s A Brief History of Seven Killings (2014) and Desmond Hall’s Your Corner Dark (2021) within a global tradition of gangster fiction and film. A Brief History is set in Kingston, Montego Bay, New York, and Miami in the 1970s, 1980s, and 1990s, tracing the global expansion of politically affiliated Jamaican gangs. Your Corner Dark is set in the rural Jamaican parish of Trelawny, and depicts a twenty-first-century Jamaica riven by politicized inter-gang warfare. The chapter explores how James’s and Hall’s novels convey the local complexities and transnational scope of gangs and organized crime in Jamaica. Research on gangs in the Caribbean has critiqued the glorification of violence in popular culture, presenting this as a factor contributing to high levels of gang-related crime. This chapter highlights the capacity of fiction and other forms of cultural production to contest rather than endorse the glorification of violence.
Towards a third option
Authors: Cross Richard
Published: October 2024

This chapter explores the development of a mereological Christology, according to which the Word and the human nature are parts of the person of Christ. The view originates in Anselm of Laon and was developed by Peter Abelard during the 1120s and 1130s, motivated by concerns about the compatibility of Christology with divine simplicity. Initially, Abelard drew the conclusion that the divine Word ceased to be a person on the assumption of the human nature. Later in the 1130s, Abelard kept the mereological language but drew back from the conclusion that the Word ceased to be a person. But he persistently rejected the homo assumptus view, which he regarded as unintelligible. Abelard’s mereological position, along with Abelard himself, was condemned by Pope Innocent II at the instigation of Bernard of Clairvaux at the Council of Sens (1141).
The subsistence theory in the late twelfth century
Authors: Cross Richard
Published: October 2024

During the 1180s and 1190s, after the condemnation of the non-aliquid Christology and the general abandonment of the homo assumptus Christology, a group of theologians began to provide theoretical developments to Chalcedonian Christology. Most important is the work of Peter Chanter. Peter incorporates Robert of Melun’s insight that the union might be explained by the possession of the Son’s personal property by the assumed nature. He also sees the Christological relevance of Richard of St Victor’s incorporation of the term ‘incommunicable’ into the definition of ‘person’. The human nature fails to be a person because it is in some sense communicated to the divine person. Peter was followed in various respects by Praepositinus of Cremona. Stephen Langton deals with the same set of issues but focuses more on semantic than metaphysical matters.
Pulmonary embolism detection without intravenous contrast using electron density and Z-effective maps from dual-energy CT
Authors: D’Angelo Tommaso , Barbera Simone , Ascenti Velio , Cicero Giuseppe , Terrani Simone , Caruso Damiano , Laghi Andrea , Fontana Federico , Venturini Massimo , Piacentino Filippo , Booz Christian , Vogl Thomas J , Yel Ibrahim , Marino Maria Adele , Mazziotti Silvio , Ascenti Giorgio
Published: October 2024

Purpose

This study aims to evaluate the feasibility of using electron density (ED) maps combined with Z-effective (Zeff) images obtained from unenhanced dual-layer dual-energy CT (dl-DECT) scans of the chest for the detection of pulmonary embolism (PE).

Materials and methods

A retrospective analysis was conducted on consecutive patients who underwent for contrast-enhanced chest CT (CECT) clinically suspected of PE or acute aortic syndrome. These scans were performed on a single dl-DECT scanner between October 2021 and November 2023. To distinguish emboli from circulating blood, color-coded maps were generated from the ED dataset superimposed on Zeff images, which were acquired from the unenhanced phase. Two radiologists with different levels of expertise independently assessed the presence of PE in the generated ED-Zeff maps, blinded to CECT results, which served as the reference standard. Diagnostic accuracy of ED-Zeff maps was assessed for each reader.

Results

The final study cohort comprised 150 patients, with 92 males (mean age: 68 ± 10 years, range: 47-93 years) and 58 females (mean age: 66 ± 15 years, range 38-89 years). ED-Zeff maps demonstrated high diagnostic performance, yielding accuracy, sensitivity, and specificity, respectively, of 86.67% (113/150, 95% CI, 80.16%-91.66%), 85% (17/20, 95% CI, 79.89%-92.19%), and 86.92% (113/130, 95% CI, 79.89%-92.19%). Ed-Zeff maps were able to identify PE in 85% of positive cases. Cohen’s kappa coefficient indicated excellent intra- and interobserver agreement (κ ≥ 0.9).

Conclusion

ED maps combined with Zeff images from unenhanced dl-DECT scans represent a feasible tool for detecting PE and may prove useful in evaluating patients with contraindications to iodinated contrast.
No Place Like Home? Local Crime and Older Adults’ Time at Home
Authors: Goldman Alyssa W , Cai Liang , Browning Christopher
Published: October 2024

Home is a locus of everyday activity among a growing population of Americans who are “aging in place,” and for whom leaving the home is generally thought to benefit quality of life and well-being. Sociological and criminological theory has often assumed that higher levels of local crime constrain individuals’ activities to the residential environment, although few studies have empirically tested this assumption. We use longitudinal smartphone-based GPS data and ecological momentary assessments from 409 older adults in the Chicago Health and Activity Space in Real-Time study, linked with administrative crime data, to test this relationship through a series of multilevel linear regression models. Our findings suggest that older adults living in higher crime areas spend less time at home, on average, compared to older adults who live in lower crime areas. This association is especially evident among older adults who experience higher levels of unsafety at home. We discuss the implication that neighborhood characteristics can permeate the boundaries of the home, adversely affecting an already vulnerable population in ways that may exacerbate inequality in community engagement, collective efficacy, and health. Our findings prompt a more nuanced understanding of what leaving the home represents among the aging population.
Benefits of Dual Appointments in Academic Research and Bedside Nursing
Authors: Hobensack Mollie , Turi Eleanor , Sochalski Julie
Published: October 2024

Research and clinical practice can inform and improve each other.
Evaluation of a Novel Mechanical Compression Device
Authors: Davis Carmen R. , Beeson Terrie , Porter Haley M. , Giuliano Karen K.
Published: October 2024

Background:

Venous thromboembolism (VTE) is a leading preventable cause of death in hospitalized patients. Current intermittent pneumatic compression (IPC) devices used to provide external mechanical compression for VTE prevention are associated with a multitude of clinical challenges that often result in subtherapeutic use. A comparative study was conducted of the real-world clinical use of a novel mechanical compression device (MCD) and a current IPC device.

Purpose:

The purpose of this quality improvement project was to compare use of the novel MCD and the standard IPC device on three clinical inpatient hospital units. Comparisons were based on the following patient outcome measures: evaluation of wear time, adherence to optimal wear time, evaluation of both patient comfort and device satisfaction, and perceived impact on mobility goals. Nurses' satisfaction with the clinical usability for mobility was also measured.

Methods:

This project used a pre–post design. A convenience sample of 89 surgical patients on the three clinical study units and 63 nursing staff members were recruited for the study. Data were collected using electronic health records, MCD data records, patient surveys, and nursing staff surveys. Data were analyzed using descriptive statistics and independent sample t tests. In the preintervention period, data were collected using the current IPC device. Nursing staff were then trained on use of the MCD. In the postintervention period, the MCDs were used in place of the IPC devices.

Results:

MCD patients had significantly longer (P ≤ 0.001) wear time (mean, 19.3 hours/day) compared with IPC patients (mean, 12.9 hours/day). MCD patients also reported significantly better sleep (P = 0.04), fewer problems with sweaty legs (P ≤ 0.001), and improved assistance with mobility goals (P ≤ 0.001) than IPC patients. Nursing staff reported significantly improved accuracy of mobility documentation (P ≤ 0.001) with the MCD, but no differences in their perception of patient satisfaction with meeting mobility goals.

Conclusions:

Use of the MCD device for VTE prophylaxis resulted in actual and perceived improvements from the perspective of both patients and nurses. While these results provide initial data in support of a potentially promising system, more research is needed.
Limited Value of Motivational Interviewing in Promoting Physical Activity
Authors: Rosenberg Karen
Published: October 2024

According to this study:
Cardiac Manifestations of Lyme Disease
Authors: Maliha Maisha , Abittan Nathaniel , Frishman William H. , Aronow Wilbert S. , Harburger Joseph
Published: October 2024

Lyme disease (LD) is an inflammatory disorder caused by an infectious bacterial agent and is the most common tick-borne illness in the United States and Europe. About 1.5–10% of adults infected with LD develop cardiac complications. This review summarizes the current knowledge of the epidemiology, pathophysiology, and diagnosis of Lyme carditis (LC), as well as the different manifestations of LD in the cardiovascular system. This review will primarily highlight the effect of LD on the cardiac conduction system and also discuss its effect on the myocardium, pericardium, valves, and coronary arteries. The management and prognosis of LC will be reviewed here as well. While this is a comprehensive review of the current literature on LC, there remain many questions regarding the complex relationship between LD and the heart.
Challenging Case: Family Navigation for Autism Spectrum Disorder
Authors: Lin Ingrid Y. , Stahmer Aubyn C. , Feinberg Emily , Feldman Heidi M. , Deras Melisa , Augustyn Marilyn
Published: October 2024

CASE:

Leo is a 28-month-old boy from a monolingual Spanish-speaking family who was referred to a developmental-behavioral pediatrics (DBP) clinic for concerns regarding autism. His parents migrated to the United States 8 years ago and currently live and work on a farm. He was born in a US hospital after an uncomplicated pregnancy and has been generally healthy. His parents first became concerned about his development when he was 16 months old. He stopped saying mama/dada in Spanish and started lining up random objects. He had frequent temper tantrums and was difficult to console during unexpected changes in his routine. He screened positive on the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) at his 18-month well-child visit, and his pediatrician referred him to the local early intervention program. Calls from the early intervention program to his parents were unanswered. At his 24-month well-child visit, he again screened positive on the M-CHAT-R/F, and his pediatrician placed a referral for a DBP consultation. During the DBP visit at 28 months of age, developmental testing indicated his receptive and expressive language skills to be in the extremely low range, with significant scatter in his cognitive and adaptive skills. Behavioral observations were consistent with parental history and showed differences in social communication and interaction, the presence of repetitive behaviors, and extreme distress with transitions. He was diagnosed with autism spectrum disorder. Recommendations, including referral to early intervention, applied behavior analysis therapy, speech and language therapy, audiology evaluation, and genetic testing, were discussed with his parents through an interpreter. An autism packet, written in Spanish, with detailed information about autism and community resources was given to the family. By the time of a follow-up DBP visit 6 months later, Leo had not started on any early intervention or therapeutic services. Where do you go from here?
Association between fine particulate matter (PM2.5) and infant mortality in a North Carolina birth cohort (2003–2015)
Authors: Jampel Sonya M. , Kaufman Joel , Enquobahrie Daniel A. , Wilkie Adrien A. , Gassett Amanda J. , Luben Thomas J.
Published: October 2024

Background:

While the association between fine particulate matter (PM2.5) and adult mortality is well established, few studies have examined the association between long-term PM2.5 exposure and infant mortality.

Methods:

We conducted an unmatched case–control study of 5992 infant mortality cases and 60,000 randomly selected controls from a North Carolina birth cohort (2003–2015). PM2.5 during critical exposure periods (trimesters, pregnancy, first month alive) was estimated using residential address and a national spatiotemporal model at census block centroid. We fit adjusted logistic regression models and calculated odds ratios (ORs) and 95% confidence intervals (CIs). Due to differences in PM2
.5 over time, we stratified analyses into two periods: 2003–2009 (mean = 12.1 µg/m3, interquartile range [IQR]: 10.8–13.5) and 2011–2015 (mean = 8.4 µg/m3, IQR: 7.7–9.0). We assessed effect measure modification by birthing parent race/ethnicity, full-term birth, and PM2.5 concentrations.

Results:

For births 2003–2015, the odds of infant mortality increased by 12% (95% CI: 1.06, 1.17) per 4.0 µg/m3 increase in PM2.5 exposure averaged over the pregnancy. After stratifying, we observed an increase of 4% (95% CI: 0.95, 1.14) for births in 2003–2009 and a decrease of 15% (95% CI: 0.72, 1.01) for births in 2011–2015. Among infants with higher PM2.5 exposure (≥12 µg/m3) during pregnancy, the odds of infant mortality increased (OR: 2.69; 95% CI: 2.17, 3.34) whereas the lower exposure (<8 µg/m3) group reported decreased odds (OR: 0.50; 95% CI: 0.28, 0.89).

Conclusions:

We observed differing associations of PM2.5 exposure with infant mortality across higher versus lower PM2.5 concentrations. Research findings suggest the importance of accounting for long-term trends of decreasing PM2.5 concentrations in future research.
Comparative analysis of testicular and nontesticular choriocarcinoma: a population-based study
Authors: Alshwayyat Sakhr , Soudi Maen S. , Qaddoura Marwa T. , Alshwayyat Tala A. , Ababneh Obada , Hanifa Hamdah , Odat Ramez M. , AlAzab Rami S.
Published: October 2024

Background:

Germ cell tumors (GCTs) are common solid tumors in young men, originating in the testicles or outside the gonads. Choriocarcinoma, a rare and aggressive subtype, primarily affects females but can also occur in males. Treatment options depend on the stage and location of the tumor, with early recognition being crucial for better outcomes. Comparative studies between testicular and nontesticular choriocarcinoma are crucial for understanding distinct features and prognoses.

Methods:

The study utilized SEER*Stat software to extract data and applied statistical methods such as χ
2 analysis and Kaplan–Meier method. Inclusion criteria focused on patients diagnosed with choriocarcinoma between 2000 and 2018, while exclusion criteria eliminated cases without histological confirmation or with other tumors.

Results:

Among 363 patients, 270 (74.4%) had testicular CC, and 93 (25.6%) had nontesticular CC. Notably, testicular CC was more common in white patients, which could indicate demographic or environmental factors at play. Patients with testicular CC were more likely to undergo surgery, suggesting a significant treatment trend. It is worth exploring whether patient preferences or observed postsurgery improvements contribute to this pattern. Testicular CC had a higher 5-year OS rate of 54% versus 29%, and a higher 5-year CSS rate of 56.3% versus 31.9%, respectively.

Conclusion:

This study reveals distinct characteristics and treatment responses in testicular and nontesticular choriocarcinoma, emphasizing the need for personalized management based on subtype. Our findings highlight racial disparities in incidence and the efficacy of surgical intervention for both types, while chemotherapy benefits extragonadal cases and radiotherapy’s role requires further evaluation.
Social media adoption and utilization by Physical Medicine & Rehabilitation residency programs and implications for remote resident recruitment.
Authors: Lewis Christopher W. , Appavu Alethea J. , Holland Tiffany , Witt Oksana , Ngo Katrina , Uhlig-Reche Hannah , Afifi Toqa , Galibov Michael , Fry Alexandra , Verduzco-Gutierrez Monica
Published: October 2024

We aim to investigate the association of Instagram and Twitter (rebranded X) adoption by Physical Medicine & Rehabilitation (PM&R) residencies with the number of National Resident Matching Program (NRMP) applications received in the 2020-2021 application cycle. Among 88 PM&R residency programs, 67 (77%) had Instagram accounts, 45 (51%) had Twitter accounts, and 41 (47%) had both. Forty (60%) Instagram accounts and 19 (42%) Twitter accounts were opened during the 2020-2021 application cycle, correlating with the introduction of virtual interviews and the COVID-19 pandemic. Residency programs with active Instagram or Twitter accounts had more NRMP applications (F(2,85) = 7.49, P = 0.001). Simple main effects analysis showed that programs with an Instagram account (P = 0.03) or a Twitter account (P = 0.03) received more residency applications. In multivariate linear regression analysis including presence of an Instagram account, program size, program setting, and program region, the presence of a Twitter account (coefficient 37.3, P = 0.04, 95% CI 1.71-72.96) and ≥ 16 residents in the residency program (coefficient 77.9, P < 0.001, 95% CI 44.43-111.31) were positively correlated with the number of residency applications. In conclusion, residency programs that were larger and adopted Twitter had more applicants in 2020-2021. Future research is needed to determine how social media activity impacts residency applicant decision-making.
Physical Medicine & Rehabilitation Residents’ Experiences and Perspectives on Teaching Medical Students: A National Survey
Authors: Villanueva Eric W. , Rydberg Leslie
Published: October 2024

Resident teaching of medical students is integral to medical education; however, there are few studies surveying residents, especially U.S. Physical Medicine and Rehabilitation (PM&R) residents, about their perspectives on teaching medical students. This descriptive survey study consisted of a 23-item cross sectional survey to elicit the current state of medical student teaching by PM&R residents and formal education for PM&R residents on teaching medical students. During an eight-week period, 103 PM&R residents completed a web-based survey, which was distributed to residents via emails to PM&R residency program directors and coordinators. Ninety-seven (94.1%) respondents reported teaching medical students. A majority of these respondents (81.4%) reported favoring formalized education on medical student teaching; however, little more than half (51.5%) reported having that education. Majorities of residents with and without formal education on teaching medical students reported employing multiple teaching techniques to teach students in the clinical and non-clinical environments. The most commonly reported barrier to teaching students was time. While limited by study design and sample size, this study suggests that the availability of formalized education for PM&R residents on medical student teaching may not meet the needs or desires of residents.
Comparison of Diagnostic Accuracies of Commonly Used Trial of Void Parameters
Authors: Shinnick Julia K. , Raker Christina A. , Geller Elizabeth J. , Rardin Charles R. , Cooper Anne C.
Published: October 2024

Importance

Understanding the diagnostic accuracy of postoperative trial of void (TOV) parameters is important for decision making related to postoperative catheterization.

Objective

The aim of the study was to compare the diagnostic accuracies of common postoperative TOV parameters.

Design

The study population comprised a prospective cohort undergoing outpatient urogynecologic procedures at a tertiary referral center from September 2018 to June 2021. Participants recorded their postvoid residual volume (PVR), voided volume, and subjective force of stream (sFOS) for all postoperative voids until meeting criteria to stop. The primary outcome was the sensitivity of TOV parameters in predicting postoperative urinary retention, defined as PVR ≥1/2 voided volume on the first 2 postoperative voids. Sample size was set at 183 to detect a 20% difference (α = 0.05, β = 0.2, up to 20% with missing data) in sensitivity between TOV parameters. Diagnostic accuracies were compared with McNemar’s test for paired proportions, with Youden’s index calculated to determine optimal thresholds.

Results

The 160 participants had a mean age of 52.1 ± 11.4 years and a mean body mass index of 28.9 ± 5.8 kg/m2 (calculated as weight in kilograms divided by height in meters squared). Mean preoperative PVR was 25.8 ± 29.9 mL. Most participants had surgery that included a midurethral sling (137/160, 85.6%). Thirty-four (34/160, 21.3%) participants met criteria for postoperative urinary retention. The optimal recovery room TOV thresholds to predict postoperative urinary retention were PVR ≥87 mL (sensitivity 96.8%, specificity 60.0%), voided volume ≤ 150 mL (sensitivity 83.9%, specificity 72.3%), and sFOS ≤60% (sensitivity 100%, specificity 50.8%). Voided volume ≤ 150 mL had greater diagnostic accuracy than PVR ≥100 mL (156.2 vs 151.8).

Conclusions

In this cohort, PVR ≥87 mL, voided volume ≤ 150 mL, and sFOS ≤60% had optimal diagnostic accuracy for postoperative urinary retention.
Improving midwives’ management of occiput-posterior fetal positions: a best practice implementation project
Authors: Gutierrez-Martin Maria Jesus , del Campo-Sanz Yolanda , Conde-Sanz Almudena , Fernadez-Gamazo Maria Montserrat , Garcimartin-Galica Virginia , Gomez De Enterria-Cuesta Maria Eugenia , Gonzalez-Hernandez Maria , Lobo-Perez Ernesto , Sanchez-Peña Maria Inmaculada
Published: October 2024

Introduction:

The occiput-posterior (OP) fetal position is the most frequent form of labor dystocia. This position has been associated with delaying the second stage of labor and adverse outcomes.

Objectives:

This project aimed to improve the quality of intrapartum care provided by midwives for OP fetal positions during the second stage of labor.

Methods:

This best practice implementation project was conducted at the Río Hortega University Hospital in Valladolid, Spain. The project followed the JBI Evidence Implementation Framework, which is based on an audit, feedback, and re-audit process. Current practices were compared against best practices in a baseline audit using 13 audit criteria. Barriers to compliance with best practices were identified and improvement strategies were implemented. An initial follow-up audit was carried out after 4 months to avoid secondary bias. After another 4 months, a second follow-up audit was conducted. Data were collected and compared using the JBI Practical Application of Clinical Evidence System (JBI PACES).

Results:

The results revealed an improvement in all structure criteria (1–3), five of the process criteria (4-6, 8, 10), and all results criteria (11–13). One process criterion (8) reached maximum compliance in all audits. A key finding was the inadequate recording of upright positions (criterion 7) and the interpretation of cardiotocography (criterion 9).

Conclusions:

Evidence-based interventions for managing OP labor improved the quality of care and underlined the importance of ongoing training for midwives. Additional studies are required on positions and fetal monitoring during labor.

Spanish abstract:

http://links.lww.com/IJEBH/A279
Remedial angioplasty or stenting for acute basilar artery occlusion: A Post Hoc Analysis of the ATTENTION Trial
Authors: Guo Zhiliang , Liu Xuehan , Yu Shuhong , Tao Chunrong , Xu Pengfei , Zhang Chao , Hu Wei , Xiao Guodong
Published: October 2024

BACKGROUND

Whether remedial angioplasty or stenting (RAS) improves clinical outcomes of patients with basilar artery occlusion (BAO) undergoing endovascular treatment (EVT) is controversial. This study aimed to investigate the impact of RAS on prognosis in acute BAO.

METHODS

This post-hoc analysis derived from the ATTENTION study. Patients undergoing EVT were categorized in the RAS group if they received balloon angioplasty, stent implantation, or balloon plus stenting. The primary outcome was favorable outcome (modified Rankin Scale score of 0–3) at 90 days. Safety outcomes included death within 90 days and any intracranial hemorrhage within 24 h. Control of confounders using inverse probability processing weighting (IPTW).

RESULTS

A total of 221 patients with BAO experiencing EVT were included, of whom 104 (47.06%) received RAS. Multivariate analysis by IPTW adjustment showed that there was no significant difference in favorable outcome between the two groups (OR, 0.81, 95% CI, 0.55, 1.19;P=0.282). But RAS was associated with decreased risk of excellent outcome (OR, 0.67; 95% CI, 0.45-0.98;P=0.042) and functional independence (OR, 0.64; 95% CI, 0.42-0.98;P=0.043). Regarding safety outcomes, the RAS group had a significantly lower incidence of any intracranial hemorrhage within 24 h (OR, 0.52; 95% CI, 0.28-0.92;P=0.027). However, there was little difference in 90-day mortality between the two groups. In non-atherosclerotic populations, RAS is usually associated with a worse clinical prognosis; however, this phenomenon has not been found in atherosclerotic populations (allP<0.05 for the stroke etiology×RAS interaction). In RAS patients, we find that there was no difference in functional or safety outcomes between only balloon angioplasty (52 patients) compared with other remedy group (52 patients).

CONCLUSIONS

Despite the fact that RAS is secure, it didn’t further improve favorable outcomes of patients with BAO undergoing EVT; particularly in the non-atherosclerotic population. In patients with RAS, balloon angioplasty alone is an appropriate remedial technique, additional stent implantation may not be required.
Contextual factors and implementation strategies for a multi-level community-based sodium reduction intervention in Chicago’s South Side: A qualitative study
Authors: Sanuade Olutobi A. , Carroll Allison J. , Watson Ricky , Ye Jiancheng , Hill Jennie , Chipman Jonathan , Wilson Fernando , King Andy J. , Kho Abel , Del Fiol Guilherme , Davis Paris , Smith Justin D.
Published: October 2024

Background

Excessive sodium intake exacerbates rates of hypertension. African American adults have higher rates of hypertension in part due to a higher-sodium diet. The multi-level Communication for Behavioral Impact for Sodium Reduction (COMBI-SR) community-based intervention effectively reduces sodium intake in international settings, but it has not yet been implemented and tested in the U.S. This study explored the contextual factors (barriers/facilitators) and implementation strategies for COMBI-SR in Chicago’s South Side neighborhood–an area with high rates of hypertension.

Methods

Data were gathered between May and November 2023, through qualitative interviews and focus groups with 40 local participants, including community members, faith-based leaders, and healthcare professionals. The Consolidated Framework for Implementation Research (CFIR) 2.0 guided the development of semi-structured interview guides. Thematic analysis was performed with coding based on CFIR 2.0 constructs (contextual factors) and the Expert Recommendations for Implementing Change (ERIC) compilation of implementation strategies.

Results

Key barriers included a lack of awareness of sodium content in foods, socioeconomic disparities limiting access to healthy options, and cultural dietary traditions. Facilitators included strong community partnerships, engaged faith-based organizations, and openness to integrating technology, such as a mobile app, to help monitor and reduce sodium intake. Specific strategies to support sodium reduction involved simplifying public health messages, offering low sodium cooking demonstrations, promoting healthier food options through community outreach, and providing personalized education on reading nutrition labels and managing sodium intake.

Conclusion

Successful implementation of COMBI-SR in Chicago’s South Side requires addressing financial, educational, and cultural barriers while leveraging trusted community structures to promote sustainable sodium reduction. These findings will guide future efforts to implement COMBI-SR in the U.S. and improve cardiovascular health.
Tissue-adapted Tregs harness inflammatory signals to promote intestinal repair from therapy-related injury
Authors: Fischer Julius C. , Göttert Sascha , Heinrich Paul , Walther Caroline N. , Fan Kaiji , Eisenkolb Gabriel , Nefzger Sophie M. , Giller Maximilian , Khalid Omer , Timnik Vincent Ruben , Jarosch Sebastian , Klostermeier Lena , Engleitner Thomas , Strieder Nicholas , Gebhard Claudia , Diederich Sarah , Schmid Nicole Alisa , Rotgerink Laura Lansink , Joachim Laura , Ghimire Sakhila , Remke Marianne , Steiger Katja , Öllinger Rupert , Rad Roland , Wolff Daniel , Feuerer Markus , Hoffmann Petra , Edinger Matthias , Rehli Michael , Tschurtschenthaler Markus , Kepp Oliver , Kroemer Guido , Orberg Erik Thiele , Combs Stephanie E. , Herr Wolfgang , Bassermann Florian , Busch Dirk H. , Holler Ernst , Heidegger Simon , Poeck Hendrik
Published: October 2024

Intestinal stem cells (ISC) promote tissue repair after genotoxic or immune-mediated injury. However, ISCs are particularly sensitive to various stressors and primary targets of overwhelming immune responses such as interferon-γ (IFNγ)-mediated killing. In mouse models of gut damage and biopsies from patients having undergone allo-hematopoietic stem cell transplantation, we observed IFNy expression by intestinal Tregcells. Tregcells leverage combined IFNγ and interleukin 10 (IL-10) stimulation of ISCs to nurture the growth of intestinal organoids through the activation of the mTORC1 and Myc pathways. Similarly, Tregcells or the combined addition of recombinant IFNγ and IL-10 promote the regeneration of organoids after irradiation. Exposure of organoids to Wnt- or EGF-free culture conditions revealed distinct growth factor-like properties of IFNγ and IL-10. While IFNγ induced epithelial proliferation and differentiation, combined addition of IFNγ and IL-10 led to balanced proliferation, ensuring ISC maintenance. Our results uncover a context-dependent role of inflammatory signaling in ISC, through which Tregcells promote epithelial repair.
Dantrolene inhibition of ryanodine receptor 1 carrying the severe malignant hyperthermia mutation Y522S visualized by cryo-EM
Authors: Iyer Kavita A. , Kobayashi Takuya , Murayama Takashi , Samsó Montserrat
Published: October 2024

Mutations in the skeletal isoform of the ryanodine receptor (RyR1) pose grave risks during anesthesia or treatment with succinylcholine muscle relaxants. These can trigger a potentially lethal malignant hyperthermia (MH) episode via intracellular calcium increase mainly from RyR1 channel leakage. Dantrolene is the primary antidote to prevent death. The main target of dantrolene is RyR1, however little is known about the mechanism of inhibition. Cryo-EM of dantrolene bound to the severe MH Y522S RyR1 mutant in the closed and open states at 2.5-3.3 Å resolution revealed that the drug binds to the channel’s cytoplasmic assembly, far from the ion gate, interacting with residues W882, W996 and R1000 in the P1 domain. The finding was validated by Ca2+imaging and [3H]ryanodine binding in WT and alanine mutants. Dantrolene reduced channel opening probability by restricting the central activation module, “cooling down” the primed conformation caused by the mutation. These findings shed light on dantrolene’s mechanism against MH and suggest avenues for developing more effective therapeutics.
Spatiotemporal lineage tracing reveals the dynamic spatial architecture of tumor growth and metastasis
Authors: Jones Matthew G. , Sun Dawei , Min Kyung Hoi (Joseph) , Colgan William N. , Tian Luyi , Weir Jackson A. , Chen Victor Z. , Koblan Luke W. , Yost Kathryn E. , Mathey-Andrews Nicolas , Russell Andrew J.C. , Stickels Robert R. , Balderrama Karol S. , Rideout William M. , Chang Howard Y. , Jacks Tyler , Chen Fei , Weissman Jonathan S. , Yosef Nir , Yang Dian
Published: October 2024

Tumor progression is driven by dynamic interactions between cancer cells and their surrounding microenvironment. Investigating the spatiotemporal evolution of tumors can provide crucial insights into how intrinsic changes within cancer cells and extrinsic alterations in the microenvironment cooperate to drive different stages of tumor progression. Here, we integrate high-resolution spatial transcriptomics and evolving lineage tracing technologies to elucidate how tumor expansion, plasticity, and metastasis co-evolve with microenvironmental remodeling in aKras;p53-driven mouse model of lung adenocarcinoma. We find that rapid tumor expansion contributes to a hypoxic, immunosuppressive, and fibrotic microenvironment that is associated with the emergence of pro-metastatic cancer cell states. Furthermore, metastases arise from spatially-confined subclones of primary tumors and remodel the distant metastatic niche into a fibrotic, collagen-rich microenvironment. Together, we present a comprehensive dataset integrating spatial assays and lineage tracing to elucidate how sequential changes in cancer cell state and microenvironmental structures cooperate to promote tumor progression.
Overcoming artificial structures in resolution-enhanced Hi-C data by signal decomposition and multi-scale attention
Authors: Li Qinyao , Li Kelly Yichen , Nicoletti Chiara , Puri Pier Lorenzo , Cao Qin , Yip Kevin Y.
Published: October 2024

Computational enhancement is an important strategy for inferring high-resolution features from genome-wide chromosome conformation capture (Hi-C) data, which typically have limited resolution. Deep learning has been highly successful in this task but we show that it creates prevalent artificial structures in the enhanced data due to the need to divide the large contact matrix into small patches. In addition, previous deep learning methods largely focus on local patterns, which cannot fully capture the complexity of Hi-C data. Here we propose Smooth, High-resolution, and Accurate Reconstruction of Patterns (SHARP) for enhancing Hi-C data. It uses the novel approach of decomposing the data into three types of signals, due to one-dimensional proximity, contiguous domains, and other fine structures, and applies deep learning only to the third type of signals, such that enhancement of the first two is unaffected by the patches. For the deep learning part, SHARP uses both local and global attention mechanisms to capture multi-scale contextual information. We compare SHARP with state-of-the-art methods extensively, including application to data from new samples and another species, and show that SHARP has superior performance in terms of resolution enhancement accuracy, avoiding creation of artificial structures, identifying significant interactions, and enrichment in chromatin states.
Unveiling Shared Genetic Links between Blood Cell Traits and Cardiovascular Diseases
Authors: Kong Luke , Yao Kaixin , Zheng Leilei , Zhao Yuhui , Chen Miaoran , Han Ziyi , Wang Qian , Feng Qifan , Lv Yongqiang , Zhang Biyun , Li Feng
Published: October 2024

Previous studies have linked blood cell traits (BCTs) to cardiovascular diseases (CVDs) risks, but the common genetic mechanisms underlying heritable phenotypes remain unclear. Our study used multiple analytical approaches including single nucleotide polymorphisms, genes, pathways, and protein targets to reveal common genetic elements. We confirmed both genome-wide and local genetic associations between BCTs and CVDs, identifying key pleiotropic loci and genes contributing to these links. Specifically, ALDH2, MAPKAPK5, and ACAD10, all located at 12q24.1, are associated with leukocyte-CVD traits. TNFSF12 at 17p13.1 and ABO at 9q34.2 correlate with platelet-CVD traits, while ZNF664 and CCDC92, also at 12q24.1, are linked to erythrocyte-CVD traits. Our findings also highlight multiple key trait-specific pathways mediating these phenotypic associations and potential therapeutic targets that may inform future clinical interventions. These insights significantly advance our understanding of the genetic interplay between BCTs and CVDs, underscoring the importance of focusing on BCTs to prevent cardiovascular conditions.
Optimizing Research Data Acquisition with Smart Pill Bottles (SPBs), the ORDAS Trial: A Feasibility and Implementation Study Protocol
Authors: Daccache Nicolas , Zako Joe , Burey Julien , Verdonck Olivier , Carrier François Martin , Morisson Louis , Laferrière-Langlois Pascal
Published: October 2024

Introduction

Clinical trials are fundamental to advancing all areas of medicine. Despite their importance, trials are often expensive and time-consuming due to the need for extensive human resources, with limitations in cohort sizes and potential biases from loss of follow-up. Smart pill bottles (SPBs) offer a promising innovation by automating data collection, which could reduce costs and improve the granularity and accuracy of data. This technology may provide a more efficient alternative to traditional methods, streamlining data acquisition in clinical research.

Objectives

This proof-of-concept study aims to assess the feasibility of using smart pill bottles (SPBs) to collect data on opioid consumption in a postoperative setting, comparing their cost- efficiency and data quality to traditional methods. We hypothesize that SPBs will be readily adopted by users and enable the collection of highly granular data with fewer missing data points, while reducing the costs associated with human resource-based data collection.

Material and Methods

This single-center, single-arm trial will enroll 69 patients aged 18 and above undergoing major abdominal surgery via laparotomy. Following recruitment, patients will complete web-based questionnaires assessing pain, comorbidities, and quality of life. Postoperatively, patients will receive an SPB, the Thess Therapy Smart System manufactured by Thess Corporate (France) and provided by AppMed Inc. (Canada) to monitor opioid consumption at home for up to 90 days. At the end of the study period, participants will use the web-based platform to complete the same questionnaires, an opioid compliance checklist and a product satisfaction survey. The primary outcome will be the percentage of patients who successfully use the SPB throughout the study period. Secondary outcomes will include the extent of automated data collection, data granularity, project costs, the incidence of persistent opioid consumption, and patient satisfaction with the SPB.

Trial registration

clinicaltrials.gov(July 25th, 2024). Unique protocol ID: 2025-3801. NCT number:NCT06522698.
Vaginal estrogen therapy initiation after breast cancer and oncological outcomes: a nationwide population-based target trial emulation.
Authors: Dumas Elise , Hamy Anne-Sophie , Gougis Paul , Laas Enora , Jochum Floriane , Hill Diane , Rousset-Jablonski Christine , El Ferjaoui Sophie , Bousquet Philippe-Jean , Houzard Sophie , Le Bihan-Benjamin Christine , Reyal Fabien , Wanis Kerollos Nashat , Stensrud Mats Julius , Coussy Florence
Published: October 2024

Background: Genitourinary syndrome of menopause (GSM) frequently occurs after breast cancer (BC), leading to symptoms that can severely affect quality of life. Vaginal estrogen therapies (VETs), including compounds like promestriene and estriol, are recommended for GSMs. However, there is concern that VETs might affect the risk of BC relapse in women with a history of BC. Material and Methods: Utilizing data from the French National Health Data System, we emulated target trials to investigate the effect of VET initiation (promestriene or estriol) on disease-free survival (DFS) in women with a history of non-metastatic BC. Trials were emulated sequentially at 12, 24, 36, and 48 months after BC diagnosis. We estimated survival probabilities at three and five years and used inverse probability weights to adjust for confounders. Results: Of the 136,408 unique patients meeting the inclusion criteria for at least one the emulated trials, 1,737 (1.3%) initiated VET. In patients with hormone receptor (HR)-positive tumors treated with tamoxifen, the estimated difference in DFS for VET initiation versus no initiation was 0.2 percentage-point at five years (95% CI -4.1; 3.6), while it was -2.9 (95% CI -6.5; 0.0) in patients with HR-positive tumors treated with aromatase inhibitors. In this subgroup, the estimated difference in DFS for promestriene initiation versus no VET initiation was -2.5 percentage-points at five years (95% CI -6.7; 1.1) while it was -3.7 (95% CI -10.1; 1.8) for estriol initiation versus no VET initiation; and the differences between the two molecules were even more pronounced at three years. Discussion: Our results do not find evidence that VET decreases DFS in patients with HR-positive tumor treated with tamoxifen. However, VET initiation might decrease DFS in patients treated with aromatase inhibitors, with estriol leading to a more pronounced decrease in DFS than promestriene.
Cortical GABAergic neuron dysregulation in schizophrenia is age dependent
Authors: Kiss Daniel , Zhou Xiaolin , Arbabi Keon , Gonzalez Segura Alex , Endresz Nicole , Felsky Daniel , Diaconescu Andreea O. , Sibille Etienne , Tripathy Shreejoy J
Published: October 2024

Cortical GABAergic neuron dysregulation is implicated in schizophrenia (SCZ), but it remains unclear if these changes are due to altered cell proportions or per-cell mRNA changes. We analyzed bulk and cell type-specific RNAseq data from 1,302 individuals to assess SCZ- and age-associated changes in GABAergic interneurons across two neocortical regions. We found that younger SCZ cases (age < 70) showed reduced parvalbumin (PVALB) and somatostatin (SST) cell proportions, while older SCZ cases showed increased proportions compared to controls. Earlier onset SCZ, associated with more severe clinical symptoms, was linked to greater reductions in these cell types. Additionally, there was cohort-specific evidence for reduced per-cell PVALB and SST mRNA in SCZ. Our findings underscore the importance of age-stratified analyses in SCZ, suggesting that distinct pathological processes underlie GABAergic neuron dysregulation across different age- and symptom-severity groups and warranting tailored therapeutic approaches.
Lower respiratory tract C. albicans induces lung injury in mice and associates with worse lung injury endpoints in humans
Authors: Tolman Nathanial J. , Choi Wonseok , Alder Jonathan K. , Tabary Mohammadreza , Qin Shulin , Wang Xiaohong , Zhang Yingze , Tu Yizeng , Sharma Lokesh , Bon Jessica , Robinson Keven , Snyder Mark , Cruz Charles Dela , Nguyen Minh Hong , Morris Alison , Biswas Partha , Bain William , Kitsios Georgios D.
Published: October 2024

The recovery ofCandidaspecies (spp.) from lower respiratory tract (LRT) secretions in critically ill patients has traditionally been considered benign. However, emerging evidence suggests thatCandidain the LRT may be associated with adverse clinical outcomes during mechanical ventilation. To investigate the impact ofCandidaon lung injury in mice, we performed intratracheal inoculation ofC. albicansand assessed for lung barrier function. We found that intratrachealC. albicanspotentiated lung barrier disruption by lipopolysaccharide. Furthermore, intratrachealC. albicansalone was sufficient to induce lung injury, marked by neutrophil airspace recruitment and barrier disruption. IntratrachealC. albicansexposure in neutrophil depleted mice (PMNDTR) exacerbated lung injury and led to fungal dissemination. In lung epithelial cell culture,C. albicanscaused significant lung epithelial cytotoxicity, which was attenuated with heat-killed and yeast-locked (TNRG1)C. albicansstrains. Human data corroborated our murine model findings, demonstrating elevated biomarkers of epithelial lung injury and worse lung injury endpoints among patients with LRTCandidaspp. Our study challenges the dogma that LRTCandidais harmless, suggesting thatC. albicanscan both directly cause lung injury and exacerbate lung injury from other insults. Elucidating these host-pathogen interactions may uncover new therapeutic targets in the management of acute respiratory failure in critically ill patients.
NINJ1 is activated by calcium-driven plasma membrane lipid scrambling during lytic cell death
Authors: Borges Jazlyn P. , Wang Yongqian , David Liron , Volchuk Allen , Martins Brunna , Cai Ruiqi , Wu Hao , Freeman Spencer A. , Goldenberg Neil M. , Salter Michael W. , Steinberg Benjamin E.
Published: October 2024

NINJ1 is the terminal executioner of cellular rupture in multiple lytic cell death pathways through its clustering in the plasma membrane. Its activation trigger, however, remains unknown. We found that NINJ1-mediated plasma membrane rupture depends on calcium influx into the cell, which suffices to induce NINJ1-mediated rupture. Using genetic and pharmacologic approaches in macrophages, we show calcium drives membrane rupture through phospholipid scrambling by the calcium-activated scramblase TMEM16F. We next tested whether this calcium-activated NINJ1 mechanism is the elusive pathway by which extracellular ATP stimulates cellular rupture. We show that ATP-stimulation of P2X7R induces NINJ1-mediated cell lysis via calcium influx and TMEM16F lipid scrambling, independently of inflammasomes, pannexins and gasdermin D. Our work reveals the mechanism of NINJ1 activation and solves the long-standing mystery of ATP-induced cytolysis.

Elevated cytosolic calcium drives NINJ1-mediated cellular rupture during lytic cell death through plasma membrane lipid scrambling.
XPRS: A Tool for Interpretable and Explainable Polygenic Risk Score
Authors: Kim Na Yeon , Lee Seunggeun
Published: October 2024

The polygenic risk score (PRS) is an important method for assessing genetic susceptibility to diseases; however, its clinical utility is limited by a lack of interpretability tools. To address this problem, we introduce eXplainable PRS (XPRS), an interpretation and visualization tool that decomposes PRSs into genes/regions and single nucleotide polymorphism (SNP) contribution scores via Shapley additive explanations (SHAPs), which provide insights into specific genes and SNPs that significantly contribute to the PRS of an individual. This software features a multilevel visualization approach, including Manhattan plots, LocusZoom-like plots and tables at the population and individual levels, to highlight important genes and SNPs. By implementing with a user-friendly web interface, XPRS allows for straightforward data input and interpretation. By bridging the gap between complex genetic data and actionable clinical insights, XPRS can improve communication between clinicians and patients.