bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk Factors and Outcomes of Perioperative Extracorporeal Membrane Oxygenation in Neonates and Infants Undergoing Truncus Arteriosus Repair
Authors: Suh Lily , Buckley Jason R. , Hook Jessica E. , Delany Dennis R. , Kavarana Minoo N. , Chowdhury Shahryar M. , Hollinger Laura E. , Costello John M.
Published: October 2024

Background: Despite surgical advances, neonatal truncus arteriosus repair remains high risk and approximately 10% of patients receive perioperative extracorporeal membrane oxygenation (ECMO). We aimed to assess factors and outcomes associated with the use of perioperative ECMO in infants undergoing truncus arteriosus repair. Methods: We conducted a retrospective cohort study of patients who underwent truncus arteriosus repair between 2004 and 2019, using administrative data from the Pediatric Health Information System database. Results: We identified 1,645 neonates and infants who underwent truncus arteriosus repair at 49 centers, of which 141 (8.6%) received ECMO. Prematurity (adjusted odds ratio [aOR], 2.06; 95% CI, 1.38-3.06; P < .001), truncal valve intervention (aOR, 4.69; 95% CI, 2.56-8.59; P < .001), and interrupted aortic arch repair (aOR, 1.80; 95% CI, 0.96-3.38; P = .07) were associated with perioperative ECMO. Hospital mortality occurred in 87 of 141 (62%) patients who received ECMO compared with 77/1504 (5.1%) who did not require ECMO(aOR, 13.39; 95% CI, 8.70-20.61; P < .001). In the 1,481 patients who survived to hospital discharge, ECMO was associated with higher rates of postoperative length of stay >30 days (63% [34/54] vs 28% [400/1427]; aOR 2.65; 95% CI, 1.24-5.64, P = .012) and hospital readmission within 90 days (61% [33/54 [ vs 33% [474/1427] [; aOR, 2.66; 95% CI, 1.47-4.82; P = .001). Conclusions: Prematurity, truncal valve intervention, and interrupted aortic arch repair are important risk factors that could help predict the use of perioperative ECMO. Extracorporeal membrane oxygenation utilization is strongly associated with greater odds of hospital mortality, prolonged postoperative length of stay, and higher rates of hospital readmission in surviving patients.
Unmasking the Aversive Stigmatizer: Integrating Deliberate and Automatic Cognition in the Study of Mental Health Stigma and Perceived Dangerousness
Authors: Felix Elizabeth
Published: October 2024

Scholars posit that mental health stigma may be the product of both deliberate (i.e., intentional and conscious) and automatic (i.e., effortless and nonconscious) cognitive processes. Yet, few sociological studies have empirically tested this theoretical assumption with valid measures of automatic cognition. This study integrates explicit and implicit stigma measures to investigate the presence of a potentially unique actor in the stigma process, the aversive stigmatizer: individuals who deliberately reject negative cultural stereotypes but still hold implicit mental illness-related biases that may inadvertently influence discriminatory behaviors. Findings suggest that a substantial portion of the sample are aversive stigmatizers and that these actors are disproportionately present among certain social groups. Thus, this study sheds light on a previously hidden population that likely contributes to prejudice and discrimination, as well as advances our theoretical understanding of both public stigma and self-stigma.
From Sucre to Santo Domingo (1972-1992)
Authors: Dussel Enrique , Di Trolio Coakley Stephen
Published: October 2024

This piece will deal with the History of the Church in Latin America from 1972 to 1992. This period covers twenty years that unite the XIV Assembly of the Consejo Episcopal Latinoamericano (CELAM) in Sucre (Bolivia) to the IV General Conference of the Latin American Episcopate in Santo Domingo (Dominican Republic).2 From 1968 to 1972, the Latin American Church was led by CELAM, which had undergone an enormous process of prophetic renewal. In Sucre, CELAM would change its path forward and, with this, begin a period of conflict that continues into the beginning of the twenty-first century.
From winding tower to Eiffel Tower (of the ruhr area): The symbolic economy of industrial signs
Authors: Kosatica Maida , Ziegler Evelyn , Buchstaller Isabelle
Published: October 2024

In the last few decades, the Ruhr Area in Germany has undergone a structural transformation that changed the landscapes of its towns and cities. Nowadays, the remnants of heavy industry are integral parts of urban semiotics articulating the cities’ industrial “soul” and heritage. In this paper, we illustrate how an analysis of residual industrial structures opens up ways of thinking about reinvented spaces that anchor cultural memory, regional identity and nostalgia. Our analytical focus is the Winding Tower of Shaft 12, preserved at Zollverein UNESCO World Heritage Site in Essen – a landmark called the “Eiffel Tower of the Ruhr Area”. Our semiotic landscape study is inspired by the framework of multimodality. We trace the industrial Tower resemiotized and remediated into visuals and material artefacts (e.g. art, logos, objects). We show how the Tower emerges as post-industrial capital which carries on the reinvention ideas and ideals that fabricate the area’s symbolic economy, allowing people to continue consuming its authenticity. Ultimately, we demonstrate how this specific example of resemiotized industrial structures has a key multimodal role in the construction and consumption of the city (image).
Remote sensing and feminist critique: Reappropriations of sensing across distance
Authors: Kroth Lilian
Published: October 2024

Remote sensing technologies and Geographic Information Systems (GIS) have sparked diverse conceptual and critical responses, with feminist approaches in particular undergoing notable transformations. This article traces and contextualizes these changes, emphasizing the re-evaluation of the concept of “distance” in feminist critiques of remote sensing (RS) and GIS from the 1990s onwards. It highlights a shift from outright rejection of GIS/RS technologies as tools of masculinist, positivistic science to a redefinition of remotely sensed information and imbricated understandings of distance and proximity. The article argues that researchers view issues of masculinism from markedly different perspectives and re-evaluate the role of technology-mediated seeing and imagining, resulting in a re-evaluation of physical distance in its relationship to infrastructure, access, and care. What has transformed is what it means to be “critical” toward as well as the possibility to be “critical” with remote sensing from a feminist point of view.
Patients with Waldenström macroglobulinemia have impaired platelet and coagulation function
Authors: Brysland Simone A. , Talaulikar Dipti , Hicks Sarah M. , Hearn James I. , Ali Sidra A. , Maqbool Muhammad Gohar , Mokoonlall Mridula , Bhoopalan Vijay , Kaur Amandeep , Thong Yee Lin , Andrews Robert K. , Whisstock James C. , Crispin Philip J. , Gardiner Elizabeth E.
Published: October 2024

Clinical features in patients with the B-cell lymphoma, Waldenström macroglobulinemia (WM), include cytopenias, immunoglobulin M (IgM)–mediated hyperviscosity, fatigue, bleeding, and bruising. Therapeutics such as Bruton's tyrosine kinase inhibitors (BTKis) exacerbate bleeding risk. Abnormal hemostasis arising from platelet dysfunction, altered coagulation or vascular impairment have not yet been investigated in patients with WM. Therefore, this study aimed to evaluate hemostatic dysfunction in samples from these patients. Whole blood (WB) samples were collected from 14 patients with WM not receiving therapy, 5 patients receiving BTKis and 15 healthy donors (HDs). Platelet receptor levels and reticulation were measured by flow cytometry, plasma thrombin generation with or without platelets by fluorescence resonance energy transfer assay, WB clotting potential by rotational thromboelastometry, and plasma soluble glycoprotein VI (sGPVI) and serum thrombopoietin (TPO) by enzyme-linked immunosorbent assay. Donor platelet spreading, aggregation, and ability to accelerate thrombin generation in the presence of WM-derived IgM were assessed. WM platelet receptor levels, responses to physiological agonists, and plasma sGPVI were within normal ranges. WM platelets had reduced reticulation (P = .0012) whereas serum TPO levels were increased (P = .0040). WM plasma displayed slower thrombin generation (P = .0080) and WM platelets contributed less to endogenous thrombin potential (ETP; P = .0312). HD plasma or platelets incubated with IgM (50-60 mg/mL) displayed reduced spreading (P = .0002), aggregation (P < .0001), and ETP (P = .0081). Thus, alterations to thrombin potential and WB coagulation were detected in WM samples. WM IgM significantly impaired hemostasis in vitro. Platelet and coagulation properties are disturbed in patients with well-managed WM.
Skeletal myotubes expressing ALS mutant SOD1 induce pathogenic changes, impair mitochondrial axonal transport, and trigger motoneuron death
Authors: Martínez Pablo , Silva Mónica , Abarzúa Sebastián , Tevy María Florencia , Jaimovich Enrique , Constantine-Paton Martha , Bustos Fernando J. , van Zundert Brigitte
Published: October 2024

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by the loss of motoneurons (MNs), and despite progress, there is no effective treatment. A large body of evidence shows that astrocytes expressing ALS-linked mutant proteins cause non-cell autonomous toxicity of MNs. Although MNs innervate muscle fibers and ALS is characterized by the early disruption of the neuromuscular junction (NMJ) and axon degeneration, there are controversies about whether muscle contributes to non-cell-autonomous toxicity to MNs. In this study, we generated primary skeletal myotubes from myoblasts derived from ALS mice expressing human mutant SOD1G93A (termed hereafter mutSOD1). Characterization revealed that mutSOD1 skeletal myotubes display intrinsic phenotypic and functional differences compared to control myotubes generated from non-transgenic (NTg) littermates. Next, we analyzed whether ALS myotubes exert non-cell-autonomous toxicity to MNs. We report that conditioned media from mutSOD1 myotubes (mutSOD1-MCM), but not from control myotubes (NTg-MCM), induced robust death of primary MNs in mixed spinal cord cultures and compartmentalized microfluidic chambers. Our study further revealed that applying mutSOD1-MCM to the MN axonal side in microfluidic devices rapidly reduces mitochondrial axonal transport while increasing Ca2 + transients and reactive oxygen species (i.e., H2O2). These results indicate that soluble factor(s) released by mutSOD1 myotubes cause MN axonopathy that leads to lethal pathogenic changes.
Modelling interrelations between C-ITS impact categories: a system-dynamics approach using causal loop diagrams
Authors: Walch Manuel , Neubauer Matthias , Schildorfer Wolfgang , Schirrer Alexander
Published: October 2024

The growing number of connected vehicles has led to an increased focus on Vehicle-to-Everything (V2X) communication in the field of transport research. This communication paradigm facilitates cooperation between vehicles and infrastructure to address traffic challenges such as efficiency, sustainability and safety. The development and standardisation of such Cooperative Intelligent Transport Systems (C-ITS) has been pursued in several projects. Beyond technical considerations, assessing the effect of these applications in terms of various impact categories is of paramount importance. However, existing research tends to examine impact categories such as efficiency, sustainability, safety, psychological or socioeconomic impacts separately, often overlooking potential interactions and interdependencies. This approach is inadequate as impacts on one category can have both cascading effects on others and rebound effects. To address this gap, this paper proposes a system dynamics approach using Causal Loop Diagrams (CLD) to illustrate the interconnectedness of impact categories and the potential impacts of C-ITS services. By depicting general relationships, interdependencies and feedback loops between impact category elements, the model accommodates the introduction of single or multiple C-ITS services as separate modules, allowing an analysis of their combined effects on the overall system. To this end, two use cases demonstrate the applicability of the developed CLD and illustrate some of the multiple interrelations between the effects of C-ITS services. The results of this paper support road operators and researchers when setting up the impact assessment of C-ITS services by revealing the dynamic and intertwined nature of different impact categories.
Burden of vaccine-preventable diseases in adults (50+) in the United States: a retrospective claims analysis
Authors: Hartmann Maximilian , Servotte Nathalie , Aris Emmanuel , Doherty T. Mark , Salem Ahmed , Beck Ekkehard
Published: October 2024

Background

In adults aged 50 + years, vaccine-preventable diseases (VPDs) pose a significant health burden and can lead to additional ‘downstream effects’ of infection beyond the acute phase e.g., increasing the risk for non-communicable disease and exacerbating chronic conditions. The aim was to understand and quantify the burden of VPD downstream effects in hospitalised adults in the United States.

Methods

This retrospective observational study analysed hospitalisation claims data (2016–2019) with 1-year follow-up, in adults with a VPD diagnosis versus matched controls (using Optum’s de-identified Clinformatics Data Mart Database). Outcomes included mortality; increase in Charlson Comorbidity Index (CCI) score; new diagnosis of comorbidities; and loss of independence (defined by need for home health/home care and/or move to long-term facility).

Results

Mortality was significantly increased in VPD cases versus controls at 30-day (risk ratio [RR] of 4.08 [95% CI 3.98–4.18]) and 1-year follow-up (RR 2.76 [2.73–2.80]). Over a 1-year follow-up period, morbidity increased following VPD hospitalisation: 65–86% of VPD cases had new comorbidities diagnosed (versus 13–41% of controls); with a significantly higher mean increase in CCI score versus baseline (3.23 in VPD cases versus 0.89 in controls, p < 0.001). Adults were observed to experience a worsening of their health status and were less likely to return to their original health state. In addition, 41% of VPD cases had a loss of independence following hospitalisation versus 12% of controls; as seen by an increased need for home assistance (in 25% versus 9% of controls) and/or a move to a long-term care facility (in 29% versus 6% of controls).

Conclusions

This analysis suggests that VPD hospitalised cases suffer significantly worse clinical outcomes than controls, with downstream effects that include increased mortality and morbidity, and greater loss of independence. Evidence on potential downstream effects of infection is relatively new, and this additional burden is generally not considered in vaccine decision-making. More research is needed to disentangle the effect of VPDs on new comorbidities versus the natural course of the condition. Increasing awareness among adults, healthcare providers and decision makers could help to increase adult vaccination coverage, and reduce the clinical burden of VPDs.
Evaluating suicide prevention gatekeeper training designed to identify and support people from asylum-seeking and refugee backgrounds
Authors: Hart Steven MacDonald , Colucci Erminia , Marzano Lisa
Published: October 2024

Background

Suicide-related behaviours and individual risk factors for suicide differ between ethnicities and demonstrate additional variation based on voluntary and forced migration. People forcibly displaced by violence and conflict, such as those seeking asylum and refugees, are likely to face stressors that can increase suicide risk. Research into evidenced-based suicide prevention strategies among people from asylum-seeking and refugee backgrounds is scarce. However, early, contextually-appropriate, identification and intervention may be a promising way to facilitate support for people in these groups. This research proposes that a contextually-responsive gatekeeper training is an appropriate strategy to increase the identification and support for people from asylum-seeking and refugee backgrounds.

Methods

The present article relates to the statistical findings of a larger mixed-method study used to validate and refine a contextually-responsive gatekeeper training program. The qualitative results of this research will be published separately. The outcome measures – knowledge about suicide in multicultural contexts, attitudes towards suicide and prevention, and self-efficacy to intervene were measured quantitatively, adopting a similar pre- and post-training procedure used in previous training evaluations. Using Generalised Estimating Equations, statistical comparisons were made between three identical self-report surveys completed by participants across three consecutive time points – pre-training, immediately post-training, and three months following training completion – known in this investigation as time-point zero (T0), time-point one (T1), and time-point two (T2). Lastly, during the T2 follow-up, additional open-ended questions were included to understand which areas of training they feel prepared them effectively and how the program could have better prepared them to intervene.

Results

A total of 28 participants took part in the study. Quantitative analysis indicated the program’s capacity to exert a significant favourable and lasting influence on knowledge about suicide and self-efficacy to intervene. In addition, follow-up measurements suggest that the content delivered to participants transferred effectively into real-world suicide prevention behaviours.

Conclusions

Findings suggest that tailored suicide prevention training can have a significant influence on knowledge about suicide in multicultural contexts, self-efficacy to intervene in a crisis, and that course content translates effectively into real-world suicide prevention behaviour. Modifying training practices, based on feedback from contextually-experienced attendees, appears to be a pivotal factor in promoting the support of people from asylum-seeking and refugee backgrounds.
Impact of low dose inhaled nitric oxide treatment in spontaneously breathing and intubated COVID-19 patients: a retrospective propensity-matched study
Authors: Isha Shahin , Balasubramanian Prasanth , Hanson Abby J. , Jonna Sadhana , Raavi Lekhya , Khadka Subekshya , Vasudhar Ananya , Sinclair De Frias Jorge , Jenkins Anna , Balavenkataraman Arvind , Tekin Aysun , Bansal Vikas , Reddy Swetha , Caples Sean M. , Khan Syed Anjum , Jain Nitesh K. , LaNou Abigail T. , Kashyap Rahul , Cartin-Ceba Rodrigo , Milian Ricardo Diaz , Venegas Carla P. , Shapiro Anna B. , Bhattacharyya Anirban , Chaudhary Sanjay , Kiley Sean P. , Quinones Quintin J. , Patel Neal M. , Guru Pramod K. , Moreno Franco Pablo , Sanghavi Devang K.
Published: October 2024

Background

The benefit of Inhaled nitric oxide (iNO) therapy in the setting of COVID-19-related ARDS is obscure. We performed a multicenter retrospective study to evaluate the impact of iNO on patients with COVID-19 who require respiratory support.

Methods

This retrospective multicenter study included COVID-19 patients enrolled in the SCCM VIRUS COVID-19 registry who were admitted to different Mayo Clinic sites between March 2020 and June 2022 and required high-flow nasal cannula (HFNC), non-invasive ventilation (NIV), or invasive mechanical ventilation (IMV). Patients were included in the ‘spontaneously breathing’ group if they remained non-intubated or were initiated on an HFNC (± NIV) before intubation. Patients who got intubated without prior use of an HFNC (± NIV) were included in the ‘intubated group.’ They were further divided into categories based on their iNO usage. Propensity score matching (PSM) and inverse propensity of treatment weighting (IPTW) were performed to examine outcomes.

Results

Among 2767 patients included in our analysis, 1879 belonged to spontaneously breathing (153 received iNO), and 888 belonged to the intubated group (193 received iNO). There was a consistent improvement in FiO2 requirement, P/F ratio, and respiratory rate within 48 h of iNO use among both spontaneously breathing and intubated groups. However, there was no significant difference in intubation risk with iNO use among spontaneously breathing patients (PSM OR 1.08, CI 0.71–1.65; IPTW OR 1.10, CI 0.90–1.33). In a time-to-event analysis using Cox proportional hazard model, spontaneously breathing patients initiated on iNO had a lower hazard ratio of in-hospital mortality (PSM HR 0.49, CI 0.32–0.75, IPTW HR 0.40, 95% CI 0.26–0.62) but intubated patients did not (PSM HR: 0.90; CI 0.66–1.24, IPTW HR 0.98, 95% CI 0.73–1.31). iNO use was associated with longer in-hospital stays, ICU stays, ventilation duration, and a higher incidence of creatinine rise.

Conclusions

This retrospective propensity-score matched study showed that spontaneously breathing COVID-19 patients on HFNC/ NIV support had a decreased in-hospital mortality risk with iNO use in a time-to-event analysis. Both intubated and spontaneously breathing patients had improvement in oxygenation parameters with iNO therapy but were associated with longer in-hospital stays, ICU stays, ventilation duration, and higher incidence of creatinine rise.
The fixed-effects model for robust analysis of stepped-wedge cluster trials with a small number of clusters and continuous outcomes: a simulation study
Authors: Lee Kenneth Menglin , Cheung Yin Bun
Published: October 2024

Background

Stepped-wedge cluster trials (SW-CTs) describe a cluster trial design where treatment rollout is staggered over the course of the trial. Clusters are commonly randomized to receive treatment beginning at different time points in this study design (commonly referred to as a Stepped-wedge cluster randomized trial; SW-CRT), but they can also be non-randomized. Trials with this design regularly have a low number of clusters and can be vulnerable to covariate imbalance. To address such covariate imbalance, previous work has examined covariate-constrained randomization and analysis adjustment for imbalanced covariates in mixed-effects models. These methods require the imbalanced covariate to always be known and measured. In contrast, the fixed-effects model automatically adjusts for all imbalanced time-invariant covariates, both measured and unmeasured, and has been implicated to have proper type I error control in SW-CTs with a small number of clusters and binary outcomes.

Methods

We present a simulation study comparing the performance of the fixed-effects model against the mixed-effects model in randomized and non-randomized SW-CTs with small numbers of clusters and continuous outcomes. Additionally, we compare these models in scenarios with cluster-level covariate imbalances or confounding.

Results

We found that the mixed-effects model can have low coverage probabilities and inflated type I error rates in SW-CTs with continuous outcomes, especially with a small number of clusters or when the ICC is low. Furthermore, mixed-effects models with a Satterthwaite or Kenward-Roger small sample correction can still result in inflated or overly conservative type I error rates, respectively. In contrast, the fixed-effects model consistently produced the target level of coverage probability and type I error rates without dramatically compromising power. Furthermore, the fixed-effects model was able to automatically account for all time-invariant cluster-level covariate imbalances and confounding to robustly yield unbiased estimates.

Conclusions

We recommend the fixed-effects model for robust analysis of SW-CTs with a small number of clusters and continuous outcomes, due to its proper type I error control and ability to automatically adjust for all potential imbalanced time-invariant cluster-level covariates and confounders.
A genome-based survey of invasive pneumococci in Norway over four decades reveals lineage-specific responses to vaccination
Authors: Eldholm Vegard , Osnes Magnus N. , Bjørnstad Martha L. , Straume Daniel , Gladstone Rebecca A.
Published: October 2024

Background

Streptococcus pneumoniae is a major cause of mortality globally. The introduction of pneumococcal conjugate vaccines (PCVs) has reduced the incidence of the targeted serotypes significantly, but expansion of non-targeted serotypes, serotype replacement, and incomplete vaccine-targeting contribute to pneumococcal disease in the vaccine era. Here, we characterize the changing population genetic landscape of S. pneumoniae in Norway over a 41-year period (1982–2022).

Methods

Since 2018, all cases of invasive pneumococcal disease have undergone whole-genome sequencing (WGS) at the Norwegian Institute of Public Health. In order to characterize the changing population over time, historical isolates were re-cultured and sequenced, resulting in a historical WGS dataset. Isolates were assigned to global pneumococcal sequence clusters (GPSCs) using PathogenWatch and assigned to serotypes using in silico (SeroBA) and in vitro methods (Quellung reaction). Temporal phylogenetic analyses were performed on GPSCs of particular interest.

Results

The availability of WGS data allowed us to study capsular variation at the level of individual lineages. We detect highly divergent fates for different GPSCs following the introduction of PCVs. For two out of eight major GPSCs, we identified multiple instances of serotype switching from vaccine types to non-vaccine types. Dating analyses suggest that most instances of serotype switching predated the introduction of PCVs, but expansion occurred after their introduction. Furthermore, selection for penicillin non-susceptibility was not a driving force for the changing serotype distribution within the GPSCs over time.

Conclusions

PCVs have been major shapers of the Norwegian disease-causing pneumococcal population, both at the level of serotype distributions and the underlying lineage dynamics. Overall, the introduction of PCVs has reduced the incidence of invasive disease. However, some GPSCs initially dominated by vaccine types escaped the effect of vaccination through expansion of non-vaccine serotypes. Close monitoring of circulating lineages and serotypes will be key for ensuring optimal vaccination coverage going forward.
Intrauterine adhesions repair with menstrual blood-derived mesenchymal stem cells via CXCL13-CXCR5 signal axis and its mechanism
Authors: Luo Bing , Zeng Xun , Luo Li
Published: October 2024

Backgroud

Intrauterine Adhesions (IUA) is a common gynecological disease which is seriously endangers the reproductive function of women without any ideal treatment. Some researchers found Menstrual Blood-derived Mesenchymal Stem Cells (MenSCs) can repair of damaged endometrium, however, has not been fully clarified. This study aims to evaluate the therapeutic effects of MenSCs in IUA and the repair mechanism in vivo.

Methods

This study is Laboratory-based study. To evaluate the therapeutic effects of MenSCs in IUA, We cultivated MenSCs, established mouse endometrial injury model, observed the uterine morphology and degree of endometrial fibrosis and compared the expression of CXC chemokine ligand-13 (CXCL13)、CXC chemokine receptor-5 (CXCR5)、Plasmin Activating Inhibitor-1(Pai-1), Transforming Growth Faction-β1(TGF- β1) and Matrix Metalloproteinase-9 (Mmp-9) among each groups. GraphPad Prism 8.0 was used for statistical processing. Data were expressed as mean ± SD. Statistical comparisons among groups were performed with one-way ANOVA. P < 0.05 were considered statistically significant.

Results

We successfully cultured and identified MenSCs and established mice model of uterine adhesion. After treatment with MenSCs, endometrial morphology of mice was partially restored, endometrial thickness was increased, and glands were multipiled. The concentrations of CXCL13 and CXCR5 were significantly increased by immunofluorescence detection compared with the control group. The results of RT-qPCR showed that the expressions of Pai-1 and Mmp-9 were significantly lower than those of the control group.

Conclusions

MenSCs may reduce endometrial fibrosis and the down-regulating expression of Pai-1、Mmp-9 and CXCL13-CXCR5 axis were involved in the process of MenSCs repaired IUA.
Using EMS data to explore community-level factors associated with firearm violence in North Carolina
Authors: Tang Yuni , Taylor Nandi L. , Neuroth Lucas M. , Higgins Kathleen A. , Waller Anna E. , Marshall Stephen W. , Harmon Katherine J.
Published: October 2024

Background

Firearm violence is a significant public health issue. However, it is unclear if there is an association between the Social Vulnerability Index (SVI) and the intent of both fatal and nonfatal firearm injuries, and if these associations are modified by community race and ethnic composition. This study examines the association between community-level social vulnerability and firearm injury incidence in North Carolina (NC) using 2021–2022 emergency medical services (EMS) data. Additionally, it investigates how these associations vary by the intent of injury (assault, self-inflicted, and unintentional), and whether they are modified by community racial/ethnic composition.

Methods

This cross-sectional study utilized NC EMS data, capturing firearm incidents from January 1, 2021, to December 31, 2022. The SVI from the Centers for Disease Control and Prevention (CDC) was used to assess community-level vulnerability. The SVI’s racial/ethnic minority status component was removed for stratification analysis. Firearm injury rates were calculated per 100,000 population, and negative binomial regression models were used to estimate Incidence Rate Ratios (IRRs) for different SVI levels and intents of firearm injuries.

Results

During the study period, we identified 7,250 EMS encounters at non-healthcare locations related to firearm injuries, encompassing 2,648 NC census tracts. Assault was the leading cause of firearm injuries (n = 3,799), followed by self-inflicted (n = 1,498), and unintentional injuries (n = 722). High-SVI communities had significantly higher rates of firearm injuries compared to low-SVI communities, particularly for assault-related injuries. When the minority status component was excluded from SVI, racial/ethnic minority status emerged as a significant modifier, with higher rates of firearm injuries being observed in communities with larger racial/ethnic minority populations.

Conclusion

Community-level social vulnerability is significantly associated with firearm injury incidence, with the effect being more pronounced in racial/ethnic minority communities. These findings underscore the need for targeted public health interventions that address underlying social determinants of health (e.g., access to education) to reduce firearm violence. Future research should further explore the intersection of social vulnerability and racial/ethnic composition to develop effective prevention strategies.
Ultrasound-guided intra-tumoral administration of directly-injected therapies: a review of the technical and logistical considerations
Authors: Bitar George Gabriel , Persad Melissa , Dragan Alina , Alade Adebayo , Jiménez-Labaig Pablo , Johnston Edward , Withey Samuel J , Fotiadis Nicos , Harrington Kevin J. , ap Dafydd Derfel
Published: October 2024

Background

Directly-injected therapies (DIT) include a broad range of agents within a developing research field in cancer immunotherapy, with encouraging clinical trial results in various tumour subtypes. Currently, the majority of such therapies are only available within clinical trials; however, more recently, talimogene laherparepvec (T-VEC, Imlygic) has been approved as the first oncolytic virus therapy in the USA and Europe. Our institution contributes to multiple different trials exploring the efficacy of DIT, the majority of which are performed by oncologists in clinic. However, specific, challenging cases – mainly neck tumours – require image-guided administration.

Main body

This review article addresses the technical and logistical factors relevant to the incorporation of image-guided DIT into an established ultrasound service. Image-guidance (usually with ultrasound) is frequently needed for certain targets that cannot be palpated or are in high-risk locations, e.g. adjacent to blood vessels. A multi-disciplinary approach is essential to facilitate a safe and efficient service, including careful case-selection. Certain protocols and guidance need to be followed when incorporating such a service into an established ultrasound practice to enhance efficiency and optimise safety. Key learning points are drawn from the literature and from our early experience at a tertiary cancer centre following image guided DIT for an initial cohort of 22 patients (including 11 with a neck mass), addressing trial protocols, pre-procedure work-up, organisation, planning, consent, technical aspects, procedure tolerability, technical success, and post-procedure considerations.

Conclusion

With appropriate planning and coordination, and application of the learning points discussed herein, image-guided administration of DIT can be safely and efficiently incorporated into an established procedural ultrasound list. This has relevance to cancer centres, radiology departments, individual radiologists, and other team members with a future role in meeting the emerging need for these procedures. This paper provides advice on developing such an imaging service, and offers certain insights into the evolving remit of radiologists within cancer care in the near future.
Differentiation of pathological subtypes and Ki-67 and TTF-1 expression by dual-energy CT (DECT) volumetric quantitative analysis in non-small cell lung cancer
Authors: Wu Yuting , Li Jingxu , Ding Li , Huang Jianbin , Chen Mingwang , Li Xiaomei , Qin Xiang , Huang Lisheng , Chen Zhao , Xu Yikai , Yan Chenggong
Published: October 2024

Background

To explore the value of dual-energy computed tomography (DECT) in differentiating pathological subtypes and the expression of immunohistochemical markers Ki-67 and thyroid transcription factor 1 (TTF-1) in patients with non-small cell lung cancer (NSCLC).

Methods

Between July 2022 and May 2024, patients suspected of lung cancer who underwent two-phase contrast-enhanced DECT were prospectively recruited. Whole-tumor volumetric and conventional spectral analysis were utilized to measure DECT parameters in the arterial and venous phase. The DECT parameters model, clinical-CT radiological features model, and combined prediction model were developed to discriminate pathological subtypes and predict Ki-67 or TTF-1 expression. Multivariate logistic regression analysis was used to identify independent predictors. The diagnostic efficacy was assessed by the area under the receiver operating characteristic curve (AUC) and compared using DeLong’s test.

Results

This study included 119 patients (92 males and 27 females; mean age, 63.0 ± 9.4 years) who was diagnosed with NSCLC. When applying the DECT parameters model to differentiate between adenocarcinoma and squamous cell carcinoma, ROC curve analysis indicated superior diagnostic performance for conventional spectral analysis over volumetric spectral analysis (AUC, 0.801 vs. 0.709). Volumetric spectral analysis exhibited higher diagnostic efficacy in predicting immunohistochemical markers compared to conventional spectral analysis (both P < 0.05). For Ki-67 and TTF-1 expression, the combined prediction model demonstrated optimal diagnostic performance with AUC of 0.943 and 0.967, respectively.

Conclusions

The combined predictive model based on volumetric quantitative analysis in DECT offers valuable information to discriminate immunohistochemical expression status, facilitating clinical decision-making for patients with NSCLC.
Sarcopenia in the foot on magnetic resonance imaging in patients with diabetes mellitus – a systematic review
Authors: Ahmad Manal , Mohamed Abdulla , Amiras Dimitri , Siracusa Francesca , Shalhoub Joseph , Davies Alun Huw
Published: October 2024

Introduction

Sarcopenia is defined by low measures of muscle quantity, quality and reduced physical performance. It is associated with higher levels of frailty. Individuals with diabetes mellitus (DM) undergo sarcopenia at an accelerated rate resulting in structural changes potentially culminating in limb loss.

Aims

To review the evidence on methods of detecting and measuring sarcopenic changes on magnetic resonance imaging (MRI) in the foot in patients with diabetes.

Methods

A literature review was conducted in accordance with PRISMA guidelines. We searched Embase and Medline (via Ovid), CINAHL (via Ebsco Host), Web of Science and Scopus as well as the grey literature. The MeSH terms “sarcopenia” AND “diabetes mellitus” AND “magnetic resonance imaging” were employed in the primary search string.

Results

874 studies were identified. 404 articles were excluded in the title and abstract screening. 33 studies were assessed for eligibility after abstract and title screening was completed by two reviewers. 7 studies evaluating sarcopenia in the foot were included in the final review.

Conclusion

Sarcopenic changes are evident on MRI of the foot in patients with diabetes and is profound in patients with diabetic neuropathy. The general extent and severity of sarcopenia seems to correlate with clinical scores to assess neuropathy and is implicated in the development of diabetic foot disease.
“Catch me if you can” - locating the “Black Sheep” neurons after early-life seizures
Authors: Tang Yingying , Guo Xiongfeng , Yan Mengqi , Xu Cenglin
Published: October 2024

Unprovoked seizures in early life are one of the most severe conditions in pediatric neurology, and are often associated with long-lasting cognitive and behavioral deficits, as well as pharmacoresistant epilepsy in adulthood in some conditions. Unillustrated mechanisms greatly restrict the development of preventive strategies for early-life seizures (ELSs) related neuronal impairments. The recent groundbreaking study published in The Journal of Clinical Investigation represents a giant leap forward in understanding the complex pathogenesis mechanism and developing targeted therapies for ELS related neuronal impairments. The authors conducted elegant experiments to locate the activated pyramidal neuron subpopulation in the hippocampus and demonstrated the altered functions of (α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid)-type glutamate receptors (AMPARs). And we believe that the conclusions of this study may assist in further translational efforts to identify preventive targets for neurological disorders associated with early life seizures and propose new avenues for further exploration in this field.
VvD14c-VvMAX2-VvLOB/VvLBD19 module is involved in the strigolactone-mediated regulation of grapevine root architecture
Authors: Xu Yan , Lv Zhengxin , Manzoor Muhammad Aamir , Song Linhong , Wang Maosen , Wang Lei , Wang Shiping , Zhang Caixi , Jiu Songtao
Published: October 2024

The D14 protein, an alpha/beta hydrolase, is a key receptor in the strigolactone (SL) signaling pathway. However, the response of VvD14 to SL signals and its role in grapevine root architecture formation remain unclear. This study demonstrated that VvD14c was highly expressed in grapevine tissues and fruit stages than other VvD14 isoforms. Application of GR24, an SL analog, enhanced the elongation and diameter of adventitious roots but inhibited the elongation and density of lateral roots (LRs) and increased VvD14c expression. Additionally, GR24 is nested within the VvD14c pocket and strongly bound to the VvD14c protein, with an affinity of 5.65 × 10−9 M. Furthermore, VvD14c interacted with grapevine MORE AXILLARY GROWTH 2 (VvMAX2) in a GR24-dependent manner. Overexpression of VvD14c in the d14 mutant and VvMAX2 in the max2 Arabidopsis mutant reversed the increased LR number and density, as well as primary root elongation. Conversely, homologous overexpression of VvD14c and VvMAX2 resulted in reduced LR number and density in grapevines. VvMAX2 directly interacted with LATERAL ORGAN BOUNDARY (VvLOB) and VvLBD19, thereby positively regulating LR density. These findings highlight the role of SLs in regulating grapevine root architecture, potentially via the VvD14c-VvMAX2-VvLOB/VvLBD19 module, providing new insights into the regulation of root growth and development in grapevines.
Outcomes of ST-Segment Elevation Myocardial Infarction in Patients With Adrenal Insufficiency
Authors: Abdallah Nadhem , Mohamoud Abdilahi , Ismayl Mahmoud , Aronow Herbert D , Abdallah Meriam , Goldsweig Andrew M
Published: October 2024

Context

Patients with adrenal insufficiency (AI) have both increased risk of cardiovascular disease and adverse outcomes with many medical emergencies. However, limited data exist specifically regarding ST-segment elevation myocardial infarction (STEMI) in the context of AI.

Objective

To evaluate associations between AI and in-hospital outcomes of patients with STEMI.

Methods

Admissions for STEMI were identified in the 2016-2019 National Inpatient Sample. In-hospital outcomes were compared between patients with and without AI. The primary outcome was in-hospital mortality. Secondary outcomes included percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), intervention, acute kidney injury (AKI), vasopressor use, mechanical circulatory support (MCS), mechanical ventilation, ventricular tachycardia (VT), hospital length of stay (LOS), and total charges. Multivariable regression models were used to adjust for potential confounders.

Results

Among 690 430 STEMI hospitalizations, 1382 (0.2%) had a diagnosis of AI. AI was associated with higher odds of in-hospital mortality (adjusted OR [aOR] 1.51, 95% CI 1.03-2.2), lower odds of PCI (aOR 0.73, 95% CI 0.55-0.98), higher odds of CABG (aOR 2.8, 95% CI 1.89-4.2) and, AKI (aOR 2.38, 95% CI 1.72-3.3), VT (aOR 1.55, 95% CI 1.1-2.2), need for vasopressors (aOR 2.34, 95% CI 1.33-4.1), mechanical ventilation (aOR 2.11, 95% CI 1.54-2.89), and MCS (aOR 2.18, 95% CI 1.57-3.03). Patients with AI also had a longer LOS (10 days vs 4.2 days, P < .001) and higher charges ($258 475 vs $115 505, P < .001).

Conclusion

Patients with AI admitted for STEMI had higher in-hospital mortality, nonfatal adverse outcomes, and resource utilization than patients without AI.
Developing a clinician-friendly rubric for assessing history-taking skills in medical undergraduates speaking English as a foreign language
Authors: Oshimi Takayuki
Published: October 2024

Background The Occupational English Test (OET) is a globally recognized test for healthcare professionals who speak English as a foreign language (EFL). Although its speaking sub-test criteria are publicly accessible, practical application demands specialized assessor training. The aim of the study was to create a physician-friendly rubric for assessing the English history-taking skills of EFL medical undergraduates inspired by the OET speaking sub-test. Methods Informed by the OET criteria, a rubric was tailor-made to assess the English history-taking skills of EFL medical undergraduates studying in Japan. Using this rubric, 14 physicians assessed the English history-taking skills of 134 sixth-year medical undergraduates. We used exploratory factor analysis to ascertain its construct validity, evaluated the instrument’s reliability through Cronbach’s α and inter-rater reliability with chi-squared tests, and conducted a multiple regression analysis, ensuring adherence to key regression assumptions. Results Three key factors were found: linguistic-clinical distinction, communication dynamics, and medical comprehension. The rubric’s internal consistency was verified, achieving a Cronbach’s α of 0.799. Discrepancies in assessor scores highlighted the need for calibration. Four criteria emerged as vital in assessing the students’ performance. Conclusions The tailored rubric effectively assesses the English history-taking skills of EFL medical undergraduates.
Harvestmen (Arachnida: Opiliones) from the Atlantic Forest-Cerrado transition zone of Luminárias, southern Minas Gerais state, Brazil
Authors: Silva Maria Luiza Simões , Alvarenga Maria Julia da Costa , Rubim Luis Gustavo Talarico , Pádua Thiago Henrique dos Reis , Castro Igor Rodrigues de , Vilela Diogo Silva , Jacques Gabriel de Castro , Souza Marcos Magalhães de
Published: October 2024

The Cerrado and Atlantic Forest biomes are global biodiversity hotspots. However, these environments still face large knowledge gaps concerning fauna inventory studies, such as those on harvestmen. Our study aimed to sample harvestmen species in a transition area between the Atlantic Forest and Cerrado, contributing to future biodiversity assessments and conservation efforts in Brazil. The surveys were conducted in the municipality of Luminárias, southern Minas Gerais state, between May 2023 and March 2024. We collected 185 individuals from six species and three morphospecies with a wide geographical distribution, but whose conservation status has not been assessed, which may affect their protection. Additionally, loss of native vegetation may lead to reductions in their populations. Our study supports current literature, which suggests the need for more inventories and the creation of a Conservation Unit in the Luminárias region.
Consumption of cranberry and probiotics as a natural remedy for urinary tract infections
Authors: Orłowska Dominika , Zalewa Karolina , Olszak Joanna , Bartoszek Lidia , Kapłan Wojciech
Published: October 2024

Introduction and PurposeUrinary tract infections (UTIs) are a prevalent health issue caused primarily by uropathogenic Escherichia coli (UPEC) and other pathogens, affecting millions annually. These infections encompass lower (cystitis) and upper (pyelonephritis) tract manifestations, presenting with symptoms ranging from dysuria to severe complications like sepsis. Traditional antibiotic treatments, while effective, are increasingly challenged by resistance and adverse effects, necessitating exploration of alternative therapies. Cranberry-derived compounds, particularly proanthocyanidins (PACs), are known for their ability to inhibit bacterial adhesion to uroepithelial cells, a critical step in UTI pathogenesis. Clinical studies suggest that cranberry products may reduce UTI incidence, especially in vulnerable populations such as women and catheterized patients. Probiotics, specifically lactobacilli, contribute to urogenital health by competing with uropathogens for epithelial cell binding sites and producing antimicrobial substances. Emerging research highlights the potential synergistic benefits of combining cranberry extracts with probiotics in UTI prevention strategies.
Material and MethodsThis review is based on articles from the PubMed database, covering the years 2004-2023, using keywords: urinary tract infections, cranberry, probiotics, E. Coli, antibiotics
ConclusionsCranberry products and probiotics offer promising non-antibiotic approaches for UTI prevention, targeting fundamental aspects of bacterial pathogenesis. While preliminary studies indicate promising outcomes, rigorous clinical trials are essential to validate these combinations and optimize therapeutic protocols. Further research is warranted to identify specific bioactive compounds within cranberries, standardize probiotic formulations, and establish comprehensive guidelines for their clinical use in UTI management.