bluuebunny/crossref_metadata_2025 huggingface dataset:
Mindfulness-based group intervention for adolescents with type 1 diabetes: initial findings from a pilot and feasibility randomized controlled trial
Authors: Basch Molly , Lupini Francesca , Ho Sally , Dagnachew Mesgana , Gutierrez-Colina Ana M , Patterson Kelly Katherine , Shomaker Lauren , Streisand Randi , Vagadori Jack , Mackey Eleanor
Published: August 2024

Objective

To evaluate feasibility/acceptability of a virtual, group mindfulness-based intervention (MBI) adapted for pediatric type 1 diabetes (T1D).

Methods

This two-way controlled trial randomized adolescents 1:1 to MBI (n = 20) or health education (HE; n = 22) groups lasting 6–7 weeks. Eligibility included 12–17 years, T1D ≥ 1 year, and elevated scores on PROMIS depression or anxiety measures. Recruitment, retention, and session attendance were tracked to measure feasibility. Acceptability was measured via youth-reported post-session surveys. Adolescents completed depression, anxiety, and diabetes-specific surveys at baseline, immediately post-program, and 3 months post-program completion. HbA1c values approximating these timeframes were obtained from chart review.

Results

55% of screened participants were eligible to participate, and 100% of eligible youth enrolled. There was 93% study retention and 96% session attendance rates. Survey data were 100% complete at baseline, and 93% complete at post-program and 3-month follow-ups; 83% and 78% of MBI participants rated sessions as at least somewhat enjoyable and helpful, respectively, and 91% and 82% of HE participants rated sessions as at least somewhat enjoyable and helpful, respectively. Mean scores showed declines in depression, anxiety, disordered eating, diabetes distress, and HbA1c in both groups across time, with trends toward potential greater reductions in depression and HbA1c in MBI.

Conclusions

This pilot provides preliminary evidence that virtual MBI and HE groups adapted for adolescents with T1D are feasible to deliver and acceptable, with potential improvement in psychosocial, behavioral, and diabetes-specific outcomes. Whether MBI is more effective for targeting negative affect and glycemic control in the context of adolescent T1D requires testing in a full-scale efficacy trial.
Prostate carcinoma mimicking rectal cancer: a case report
Authors: Hassine Hajer , Azouz Sarra B , Debbabi Habiba , Cherif Dhouha , Yacoub Haythem , Chelly Beya , Kchir Hela , Maamouri Nadia
Published: August 2024

In the pre-prostate specific antigen era, patients with prostate cancer (PC) commonly presented with symptoms. Currently, most PC are diagnosed at an asymptomatic stage with abnormal digital rectal examination or raised prostate specific antigen. In rare cases, PC may infiltrate the rectum and cause symptoms mimicking rectal cancer. It is difficult to differentiate between the two based on clinical features alone. We here report our experience in managing an 86-year-old male, with no significant personal pathological history, who presented with diarrhea and occasional rectal bleeding without any lower urinary tract symptoms. Investigations concluded to a PC invading the rectum and the patient was referred to urology department.
Anatomic, isolated complete caudate lobectomy using an anterior transhepatic approach with glissonian pedicle approach and indocyanine green fluorescence guidance: a case report
Authors: Endo Yutaka , Abe Yuta , Kitago Minoru , Hasegawa Yasushi , Hori Shutaro , Tanaka Masayuki , Nakano Yutaka , Shimazu Motohide , Kitagawa Yuko
Published: August 2024

Hepatocellular carcinoma (HCC) in the caudate lobe presents surgical challenges due to the lack of distinct anatomical landmarks. This case report introduces a novel surgical approach combining Takasaki’s classification and indocyanine green negative counterstaining for precise anatomical caudate lobectomy. A 78-year-old patient with hepatocellular carcinoma in the caudate lobe underwent surgery following preoperative volumetric assessment. The method involved a glissonian approach for both left and right pedicles, coupled with meticulous dissection of hepatic pedicles of the caudate lobe guided by taping of left and right glissonian pedicles, followed by indocyanine green administration for improved visualization of caudate lobe boundaries. The procedure enabled complete tumor resection with minimal blood loss. At 50 months postsurgery, the patient maintains favorable liver function and performance status. This innovative approach offers a promising solution for precise resection of caudate lobe hepatocellular carcinoma, potentially improving surgical outcomes and long-term prognosis.
Misdiagnosed as a perianal abscess: case report of perianal endometriosis
Authors: Ding Xuejiao , Tao Yichao , Hu Cong , Wu Xiaofeng
Published: August 2024

Perianal endometriosis represents a rare form of endometriosis occurring outside the pelvic cavity. Owing to its infrequency in clinical practice, this condition is highly susceptible to misdiagnosis and inappropriate treatment. This case report details a young female patient who was erroneously diagnosed with a perianal abscess. We conducted a para-anal mass resection under spinal anesthesia, and subsequent histopathological examination definitively confirmed the diagnosis of perianal endometriosis.
Left gastric vein to adrenal vein anastomosis: intraoperative solution for gastric venous congestion following extended distal pancreatectomy
Authors: Fernández-Placencia Ramiro Manuel , Luque-Vásquez Vásquez Carlos , Belón-Supo José , Ruiz Eloy , Berrospi Francisco , Celis-Zapata Juan
Published: August 2024

Extended distal pancreatectomy often requires resection of vascular structures and adjacent organs, potentially leading to gastric venous congestion. This case report describes a 49-year-old female who underwent radical antegrade modular pancreatosplenectomy for pancreatic ductal adenocarcinoma. During the procedure, segmental gastric venous congestion was observed and resolved by anastomosing the left gastric vein to the left adrenal vein. The in-hospital postoperative recovery was initially uneventful; however, the patient was readmitted because of intra-abdominal fluid collection that was managed with antibiotics. Pathological examination confirmed moderately differentiated ductal adenocarcinoma with lymphovascular invasion. The patient received adjuvant mFOLFIRINOX therapy and remains disease-free 12 months after surgery with adequate patency of the anastomosis. This case highlights the importance of recognizing and addressing gastric venous congestion during radical antegrade modular pancreatosplenectomy to prevent complications, such as delayed gastric emptying or gastric necrosis, and proposes left gastric vein to left adrenal vein anastomosis as an effective intraoperative solution.
Adhesive duodenal obstruction: a report of a previously undescribed pathology
Authors: Baker Akil , Walcott-Bremmer Michelle , Harriott John , Mitchell Derek
Published: August 2024

Adhesive small bowel obstruction is thought to be a disorder limited to the jejunum and ileum. As a result, the list of aetiologies for duodenal obstruction does not include adhesions. We report the case of a patient who presented with gastric outlet obstruction (GOO), but with no lesions identified on cross-sectional imaging or endoscopy. Laparoscopy revealed duodenal adhesions as the cause of her GOO. Kockerization of the duodenum led to resolution of her symptoms. This previously undocumented finding leads us to suggest that laparoscopy should be considered in patients who have features highly suspicious for GOO, but have no cause identified on investigation.
A road to surgical success: a case report of huge retroperitoneal idiopathic non-pancreatic cyst in a 6-year-old child at tertiary hospital, Muhimbili National Hospital
Authors: Ibrahim Maimuna , Chibwae Alfred , Magoda Benard , Philipo Ayubu , Ramadhan Shafii , Salim Mohamed
Published: August 2024

In most reported cases, pancreatic pseudocysts are the most commonly reported cases and mostly occur in adults. Idiopathic non-pancreatic pseudocyst is rarely reported among children. We are reporting a rare case of retroperitoneal pseudocyst in a 6-year-old male with a 4-week history of abdominal swelling. He had asymmetrical abdominal distention on the right lumber and iliac regions with a smooth surface measuring 12 × 22 cm in its largest dimension. CT scan showed a mesenteric cyst, ipsilateral hydronephrosis, and intrahepatic duct dilatations. Intraoperatively, a retroperitoneal cystic mass was completely excised histologically confirmed pseudocyst. The patient was discharged home after fully recovery after 4 days of surgery. Surgical interventions remain to be the stay management of retroperitoneal pseudocysts with an earlier full recovery. Open surgical technique remains to be a preferred approach, especially for the large and complex retroperitoneal cysts.
Fatal journeys: causes of death in international travellers in South America
Authors: Allel Kasim , Cabada Miguel M , Kiani Behzad , Martin Beatris Mario , Tanabe Melinda , Restrepo Angela Cadavid , De Souza Dos Santos Gabriela , Lloveras Susana , Shiferaw Wondimeneh , Sartorius Benn , Mills Deborah J , Lau Colleen L , Furuya-Kanamori Luis
Published: August 2024

Background

Understanding mortality among travellers is essential for mitigating risks and enhancing travel safety. However, limited evidence exists on severe illnesses and injuries leading to death among travellers, particularly in low- and middle-income countries and remote regions.

Methods

We conducted a retrospective census study using country-level observational data from death certificates of travellers of seven South American countries (Argentina, Brazil, Chile, Colombia, Ecuador, Peru and Uruguay) from 2017 to 2021. Causes of death were evaluated using ICD-10 codes, categorized into non-communicable diseases (NCDs), communicable diseases and injuries. We quantified causes of death by demographic characteristics (e.g. age, sex) and geographical variables. Chi-square tests were used to assess differences between categories. We calculated crude mortality rates and incidence rate ratios (IRRs) per country’s subregions.

Results

A total of 17 245 deaths were reported. NCDs (55%) were the most common cause of death, followed by communicable diseases (23.4%) and injuries (18.1%). NCD-associated deaths increased after age 55 years and were highest among ≥85 years. Communicable diseases were more common at younger age (<20 years). Injury-associated deaths were more common in men (79.9%) and 25–29-year-olds (17.1%). Most deaths (68.2%) could have been avoided by prevention or treatment. Mortality risk was higher among travellers in bordering regions between countries. In Roraima (Brazil) and Norte de Santander (Colombia), locations bordering Venezuela, the death IRR was 863 and 60, respectively. These countries’ reference mortality rates in those regions were much lower. More than 80% of the deaths in these border regions of Brazil and Colombia involved Venezuelan citizens.

Conclusion

The study identified risk factors and high-risk locations for deaths among travellers in seven countries of South America. Our findings underscore the need for specific health interventions tailored to traveller demographics and destination to optimize prevention of avoidable deaths in South America.
Optimization of Parameters for Atom Probe Tomography Analysis of β-Tricalcium Phosphates
Authors: Torkornoo Selase , Bohner Marc , McCarroll Ingrid , Gault Baptiste
Published: August 2024

The biocompatibility and resorption characteristics of β-tricalcium phosphate (β-TCP, Ca3(PO4)2) have made it a coveted alternative for bone grafts. However, the underlying mechanisms governing the biological interactions between β-tricalcium phosphate and osteoclasts remain elusive. It has been speculated that the composition at grain boundaries might vary and affect β-TCP resorption properties. Atom probe tomography (APT) offers a quantitative approach to assess the composition of the grain boundaries, and thus advance our comprehension of the biological responses within the microstructure and chemical composition at the nanoscale. The precise quantitative analysis of chemical composition remains a notable challenge in APT, primarily due to the influence of measurement conditions on compositional accuracy. In this study, we investigated the impact of laser pulse energy on the composition of β-TCP using APT, aiming for the most precise Ca:P ratio and consistent results across multiple analyses performed with different sets of analysis conditions and on two different instruments.
Professional Boundaries
Authors: Curry Saundra
Published: August 2024

Professional boundaries are something that all healthcare providers have to deal with on a daily basis. They are part of the caring professions’ professionalism skills, and most practitioners rarely think about the issues involved. However, there are situations which occur that can test any healthcare practitioner’s skills. Because each patient encounter is unique, hard and fast rules do not always work, and a clinician needs to know how the rules should help in making decisions. The following scenarios are a review of some of these situations with a discussion about the consequences that can ensue.
An Overview of the Legal Process, Depositions, and Testifying in Court
Authors: Hicks James S. , Street Jeffrey R.
Published: August 2024

The occurrence of a medical event resulting in an adverse outcome often results in civil litigation. The stages of this process and its effect on the involved physician are illuminated in this chapter as the physician becomes the defendant in a case where there was no indication at the time of the incident that any permanent harm had occurred. The steps involved in proving a tort (the patient’s allegations of injury) are enumerated along with detailed explanations of each and a description of the oft-delayed elements of the legal process. The roles of attorneys, judges, experts, and insurance carriers are described. No physician considers the ordeal of a lawsuit as anything but devastating, even when there is a jury finding of no negligence or a dismissal of the suit by the plaintiff. The role the defense attorney must play is to be both expert in the law and a comforting advocate for his client.
Paediatric Cardiology
Authors: Day Thomas , Bell Aaron , Quyam Sadia , Simpson John
Published: August 2024

Paediatric cardiology is a fascinating and varied area of medicine but can be a source of confusion to medical professionals. This handbook aims to clearly outline the fundamentals of the specialty, including approaches to clinical assessment, investigations, and treatment. It is aimed at paediatric cardiology trainees, general paediatricians, and nurses working in the field. The handbook includes a guide to the often-misunderstood morphological principles underlying the speciality. It also outlines the major congenital heart lesions and includes sections on acquired heart disease, as well as investigations and treatments of both. The handbook spans the full lifespan of the paediatric cardiology patient, from fetal life through to adolescence and transition to adult services. It also includes a guide to commonly used medications, and a quick guide to common cardiological emergencies.
Feasibility of Nurse-Facilitated Advance Care Planning Among Older Veterans in a Dialysis Unit and an Oncology Infusion Center
Authors: Yamarik Rebecca Liddicoat , Cacciata Marysol , Chen Joline L T , Ballard-Hernandez Jennifer , Gupta Pankaj , Pirverdian Ateena , Tonthat Sam , Fernandez Jocell , Sudore Rebecca L
Published: August 2024

Introduction

Many veterans with serious illnesses, such as end-stage kidney disease requiring dialysis and advanced cancer requiring treatment infusions, must make complex decisions about their current and future medical care. Advance care planning (ACP) is a process where individuals identify, express, and communicate their personal values, life goals, and preferences for care. ACP may be feasible in chemotherapy infusion centers or chronic dialysis centers during patient treatment.

Materials and Methods

We assessed the feasibility of a licensed vocational nurse (LVN) facilitator to help veterans review the PREPARE for Your Care program (www.prepareforyourcare.org) and complete an advance directive (AD) in an outpatient hemodialysis unit or a chemotherapy infusion center. PREPARE For Your Care is an evidence-based online program with written pamphlets and ADs that prepares patients to participate with clinicians in making medical decisions. We measured the time to complete a session and the level of assistance required from LVNs via LVN self-report. Self-reported ease-of-use, comfort, and helpfulness were assessed on a 10-point Likert scale from 1 (not at all) to 10 (very).

Results

Twenty-eight patients were enrolled (mean age ± SD: 67 ± 11 years); all (100%) completed PREPARE and the AD within 1 session. The mean completion time was 100 (±40) minutes. Most of the patients required considerable assistance from the LVN. The mean scores were 8.0 of 10 for ease-of-use (±2.3), 7.7 of 10 (±2.8) for comfort, and 8.2 of 10 (±2.3) for helpfulness.

Conclusions

This pilot study demonstrates that using PREPARE as an ACP tool for veterans may be feasible for patients during hemodialysis and chemotherapy infusion. Patients required considerable assistance from the LVN to complete PREPARE. Hemodialysis and chemotherapy infusion are opportunities when patients have time and space to consider ACP.
Rossby wave instability and substructure formation in 3D non-ideal MHD wind-launching discs
Authors: Hsu Chun-Yen , Li Zhi-Yun , Tu Yisheng , Hu Xiao , Lin Min-Kai
Published: August 2024

Rings and gaps are routinely observed in the dust continuum emission of protoplanetary discs (PPDs). How they form and evolve remains debated. Previous studies have demonstrated the possibility of spontaneous gas rings and gaps formation in wind-launching discs. Here, we show that such gas substructures are unstable to the Rossby wave instability (RWI) through numerical simulations. Specifically, shorter wavelength azimuthal modes develop earlier, and longer wavelength ones dominate later, forming elongated (arc-like) anticyclonic vortices in the rings and (strongly magnetized) cyclonic vortices in the gaps that persist until the end of the simulation. Highly elongated vortices with aspect ratios of 10 or more are found to decay with time in our non-ideal magnetohydrodynamic (MHD) simulation, in contrast with the hydro case. This difference could be caused by magnetically induced motions, particularly strong meridional circulations with large values of the azimuthal component of the vorticity, which may be incompatible with the columnar structure preferred by vortices. The cyclonic and anticyclonic RWI vortices saturate at moderate levels, modifying but not destroying the rings and gaps in the radial gas distribution of the disc. In particular, they do not shut-off the poloidal magnetic flux accumulation in low-density regions and the characteristic meridional flow patterns that are crucial to the ring and gap formation in wind-launching discs. Nevertheless, the RWI and their associated vortices open up the possibility of producing non-axisymmetric dust features observed in a small fraction of PPDs through non-ideal MHD, although detailed dust treatment is needed to explore this possibility.
A quantitative comparison between velocity dependent SIDM cross-sections constrained by the gravothermal and isothermal models
Authors: Yang Shengqi , Jiang Fangzhou , Benson Andrew , Zhong Yi-Ming , Mace Charlie , Du Xiaolong , Zeng Zhichao Carton , Peter Annika H G , Fischer Moritz S
Published: August 2024

One necessary step for probing the nature of self-interacting dark matter (SIDM) particles with astrophysical observations is to pin down any possible velocity dependence in the SIDM cross-section. Major challenges for achieving this goal include eliminating, or mitigating, the impact of the baryonic components and tidal effects within the dark matter halos of interest – the effects of these processes can be highly degenerate with those of dark matter self-interactions at small scales. In this work, we select 9 isolated galaxies and brightest cluster galaxies (BCGs) with baryonic components small enough such that the baryonic gravitational potentials do not significantly influence the halo gravothermal evolution processes. We then constrain the parameters of Rutherford and Møller scattering cross-section models with the measured rotation curves and stellar kinematics through the gravothermal fluid formalism and isothermal method. Cross-sections constrained by the two methods are consistent at $1\sigma$ confidence level, but the isothermal method prefers cross-sections greater than the gravothermal approach constraints by a factor of $\sim 3$.
General non-linear fragmentation with discontinuous Galerkin methods
Authors: Lombart Maxime , Bréhier Charles-Edouard , Hutchison Mark , Lee Yueh-Ning
Published: August 2024

Dust grains play a significant role in several astrophysical processes, including gas/dust dynamics, chemical reactions, and radiative transfer. Replenishment of small-grain populations is mainly governed by fragmentation during pair-wise collisions between grains. The wide spectrum of fragmentation outcomes, from complete disruption to erosion and/or mass transfer, can be modelled by the general non-linear fragmentation equation. Efficiently solving this equation is crucial for an accurate treatment of the dust fragmentation in numerical modelling. However, similar to dust coagulation, numerical errors in current fragmentation algorithms employed in astrophysics are dominated by the numerical overdiffusion problem – particularly in three-dimensional hydrodynamic simulations where the discrete resolution of the mass-density distribution tends to be highly limited. With this in mind, we have derived the first conservative form of the general non-linear fragmentation with a mass flux highlighting the mass transfer phenomenon. Then, to address cases of limited mass density resolution, we applied a high-order discontinuous Galerkin scheme to efficiently solve the conservative fragmentation equation with a reduced number of dust bins. An accuracy of $0.1{\!-\!}1~{{\ \rm per\ cent}}$ is reached with 20 dust bins spanning a mass range of 9 orders of magnitude.
Magma Evolution and Storage Conditions in an Andesite–Dacite Volcanic System, Whakaari (White Island), New Zealand
Authors: Jiang Wei-Cheng , Adam John , Firth Chris , Turner Simon , Rushmer Tracy , Cronin Shane
Published: August 2024

Whakaari (White Island) is an active andesite–dacite volcano located on New Zealand’s northernmost continental shelf. During a series of Strombolian eruptions in 1976–2000 it produced high-Mg andesite magmas (Mg#: 65–74; SiO2: 55–58 wt %). It has already been suggested that the production of these magmas involved complex interaction between stored and ascending magmas in a mid-crustal magma chamber that forms part of a larger trans-crustal plumbing system. Here we re-examine this proposal by employing Rhyolite-MELTS 1.2.0 and Magma Chamber Simulator to simulate liquidus relationships for one of the 1976 to 2000 high-Mg andesites from Whakaari (P41600). It was found that production of the main phenocryst assemblage (olivine + Cr-spinel + orthopyroxene + clinopyroxene + plagioclase + magnetite), mineral compositions, and liquid line of descent (as determined from matrix glasses) requires 30–60% fractional crystallisation at comparatively low pressures (< 100 MPa) and melt-H2O concentrations (< 2 wt %) with moderate fO2 (from Ni–NiO to one log unit above Ni–NiO) and temperatures of 1140°C to 1000°C. At least 0.5 wt % water is required to stabilise olivine at 60 MPa although original magmatic water concentrations may have been significantly higher. The early loss of magmatic water is a predictable consequence of both the low pressures of fractionation and the partitioning of H2O into a CO2-rich vapour phase. Polybaric crystallisation does not improve the simulations when compared to the isobaric model. Considering these observations, it is unlikely that evolution of the Whakaari high-Mg andesites involved significant fractionation within the mid- to lower-crust. However, there are aspects of magma evolution (particularly for FeOT and TiO2) that are not well modelled by any of our simulations. This may be because our model could not accurately simulate the effects of mixing between magmatic products or interaction between evolved melts and earlier crystallized mineral phases.
Addressing gaps in research on the impact of the Taliban’s ban on female education on mental health and quality of life in Afghanistan
Authors: Prasetya Yovian Yustiko , Darmawan Ilham Akbar , Wijayanto Arif
Published: August 2024

This article presents a series of constructive critiques and proposes a series of potential solutions to address the identified gaps. These include the utilization of experimental or longitudinal designs and the integration of qualitative data in order to gain a more profound understanding of subjective experiences.
‘Brother Albert’: Albert Erskine, Malcolm Lowry, and the Editing of Under the Volcano
Authors: King Daniel Robert
Published: August 2024

In this essay, I draw on a range of archival sources to examine the working relationship between the modernist author Malcolm Lowry and the literary editor Albert Erskine. I examine Erskine’s editing of Lowry’s Under the Volcano (1947) at the firm Reynal and Hitchcock and unpack Erskine’s input into the final shape of the novel. Erskine worked with Lowry extensively on the manuscript of Under the Volcano in 1946 and 1947 and oversaw several significant changes to the text. In this essay, I examine Erskine’s approach to literary editing, exploring its origins in the New Criticism of Robert Penn Warren and Cleanth Brooks, and Erskine’s negotiations between the practicalities and demands of commercial postwar publishing and Lowry’s exacting and experimental approach to his work. In doing so, I explore firstly how Erskine’s literary editing was shaped by his training in a particularly American form of New Criticism and, secondly, how these editorial principles were carried out and shaped the final form of Under the Volcano.
The Challenge of Evaluating the Impact of NGOs on the Human Capital and Life Satisfaction of Syrian Refugees in Turkey
Authors: Kırkıç Ayşe Perihan
Published: August 2024

The number of projects designed by non-governmental organisations (NGOs) to meet refugees’ needs in Turkey has steadily increased since the arrival of Syrian refugees. In existing studies, the projects of NGOs working with Syrian refugees have not been evaluated from a lens of human capital and life satisfaction. Given the crucial role of NGOs in implementing social policies within host countries, it becomes imperative to conduct thorough analyses of the effects of their projects on the target groups. The objective of this study is to evaluate the significance of human capital and life satisfaction within NGO projects, as perceived by NGO employees. Semi-structured interviews were conducted with national and international NGO representatives in Istanbul to probe the impact of the projects on Syrian refugees. Based on the findings, despite the considerable number of projects carried out with Syrian refugees, the absence of a dedicated methodology to measure changes in participants’ human capital and life satisfaction poses significant challenges in evaluating project outcomes. In this research, I propose a five-step method for assessing the impacts of NGO-applied projects. This method acknowledges existing limitations and promotes the improvement of the evaluation process.
Static and Dynamic Dysconnectivity in Early Psychosis: Relationship With Symptom Dimensions
Authors: Cattarinussi Giulia , Grimaldi David Antonio , Aarabi Mohammad Hadi , Sambataro Fabio
Published: August 2024

Background and Hypothesis

Altered functional connectivity (FC) has been frequently reported in psychosis. Studying FC and its time-varying patterns in early-stage psychosis allows the investigation of the neural mechanisms of this disorder without the confounding effects of drug treatment or illness-related factors.

Study Design

We employed resting-state functional magnetic resonance imaging (rs-fMRI) to explore FC in individuals with early psychosis (EP), who also underwent clinical and neuropsychological assessments. 96 EP and 56 demographically matched healthy controls (HC) from the Human Connectome Project for Early Psychosis database were included. Multivariate analyses using spatial group independent component analysis were used to compute static FC and dynamic functional network connectivity (dFNC). Partial correlations between FC measures and clinical and cognitive variables were performed to test brain-behavior associations.

Study Results

Compared to HC, EP showed higher static FC in the striatum and temporal, frontal, and parietal cortex, as well as lower FC in the frontal, parietal, and occipital gyrus. We found a negative correlation in EP between cognitive function and FC in the right striatum FC (pFWE = 0.009). All dFNC parameters, including dynamism and fluidity measures, were altered in EP, and positive symptoms were negatively correlated with the meta-state changes and the total distance (pFWE = 0.040 and pFWE = 0.049).

Conclusions

Our findings support the view that psychosis is characterized from the early stages by complex alterations in intrinsic static and dynamic FC, that may ultimately result in positive symptoms and cognitive deficits.
Schizophrenia and Neurodevelopment: Insights From Connectome Perspective
Authors: Sun Xiaoyi , Xia Mingrui
Published: August 2024

Background

Schizophrenia is conceptualized as a brain connectome disorder that can emerge as early as late childhood and adolescence. However, the underlying neurodevelopmental basis remains unclear. Recent interest has grown in children and adolescent patients who experience symptom onset during critical brain development periods. Inspired by advanced methodological theories and large patient cohorts, Chinese researchers have made significant original contributions to understanding altered brain connectome development in early-onset schizophrenia (EOS).

Study Design

We conducted a search of PubMed and Web of Science for studies on brain connectomes in schizophrenia and neurodevelopment. In this selective review, we first address the latest theories of brain structural and functional development. Subsequently, we synthesize Chinese findings regarding mechanisms of brain structural and functional abnormalities in EOS. Finally, we highlight several pivotal challenges and issues in this field.

Study Results

Typical neurodevelopment follows a trajectory characterized by gray matter volume pruning, enhanced structural and functional connectivity, improved structural connectome efficiency, and differentiated modules in the functional connectome during late childhood and adolescence. Conversely, EOS deviates with excessive gray matter volume decline, cortical thinning, reduced information processing efficiency in the structural brain network, and dysregulated maturation of the functional brain network. Additionally, common functional connectome disruptions of default mode regions were found in early- and adult-onset patients.

Conclusions

Chinese research on brain connectomes of EOS provides crucial evidence for understanding pathological mechanisms. Further studies, utilizing standardized analyses based on large-sample multicenter datasets, have the potential to offer objective markers for early intervention and disease treatment.
Where are inequalities produced? Comparing the variations of graduate employment between the UK’s districts and universities
Authors: Yu Yang
Published: August 2024

This study presents the first set of estimates of inequalities in high-status employment between UK districts and universities. Making use of graduate data from the Higher Education Statistics Agency, this study compares how graduates’ employment and social mobility vary based on their place of origin and the university attended. Inequality and social mobility are measured by the chance of entering a higher professional occupation 15 months after graduation. The results showed that the occupation inequalities between universities were much larger than those between local authority districts, indicating that our higher education system is evidently (re)producing an even greater amount of inequality than spatial disparities. These findings contribute to the emerging academic and policy narrative regarding the social and geographic inequalities in the UK, addressing the inequalities in graduate employment across universities may be crucial in meeting the demands of the labor market and driving upward mobility throughout the country.
A molecular mechanism for angiotensin II receptor blocker‐mediated slit membrane protection: Angiotensin II increases nephrin endocytosis via AT1‐receptor‐dependent ERK 1/2 activation
Authors: Königshausen Eva , Zierhut Ulf M. , Ruetze Martin , Rump Lars C. , Sellin Lorenz
Published: August 2024

Albuminuria is characterized by a disruption of the glomerular filtration barrier, which is composed of the fenestrated endothelium, the glomerular basement membrane, and the slit diaphragm. Nephrin is a major component of the slit diaphragm. Apart from hemodynamic effects, Ang II enhances albuminuria by β‐Arrestin2‐mediated nephrin endocytosis. Blocking the AT1 receptor with candesartan and irbesartan reduces the Ang II‐mediated nephrin‐β‐Arrestin2 interaction. The inhibition of MAPK ERK 1/2 blocks Ang II‐enhanced nephrin‐β‐Arrestin2 binding. ERK 1/2 signaling, which follows AT1 receptor activation, is mediated by G‐protein signaling, EGFR transactivation, and β‐Arrestin2 recruitment. A mutant AT1 receptor defective in EGFR transactivation and β‐Arrestin2 recruitment reduces the Ang II‐mediated increase in nephrin β‐Arrestin2 binding. The mutation of β‐Arrestin2K11,K12, critical for AT1 receptor binding, completely abrogates the interaction with nephrin, independent of Ang II stimulation. β‐Arrestin2K11R,K12R does not influence nephrin cell surface expression. The data presented here deepen our molecular understanding of a blood‐pressure‐independent molecular mechanism of AT‐1 receptor blockers (ARBs) in reducing albuminuria.
Association Between Clubfoot and Neonatal Abstinence Syndrome in the United States, 2018–2022
Authors: Dhodapkar Meera M. , Jonnalagadda Anshu , Socci Adrienne R. , Franklin Corinna
Published: August 2024

Purpose:

The United States has seen an increase in opioid use and misuse over the last 2 decades. Infants have been impacted by the opioid epidemic, with a reported 5-fold increase in the incidence of neonatal abstinence syndrome (NAS) over the last 2 decades. There are many conditions associated with NAS, and thus, the current study sought to examine the association between NAS and clubfoot.

Methods:

The study was retrospective, utilizing patient data from the Pediatric Hospital Information System (PHIS) database. Neonates presenting to any PHIS hospital between 2018 and 2022 were identified and included in the study. Patients with NAS and clubfoot were identified utilizing the International Classification of Diseases (ICD)-9 and 10 codes. Univariable and multivariable analyses were performed to investigate associations between clubfoot, race, ethnicity, insurance type, gestational age, length of stay, NAS, and comorbidity burden.

Results:

A total of 458,274 patients were identified, of whom 2337 (0.5%) had a clubfoot diagnosis and 5431 (1.2%) had a diagnosis of NAS. Multivariable logistic regression revealed higher independent odds of clubfoot among patients with a diagnosis of NAS [odds ratio (OR): 1.49], patients with a greater number of comorbidities (OR: 4.75 for 1 comorbidity vs. none, and 21.19 for 2+ comorbidities, vs. none), patients with a greater gestational age (OR: 1.01 per week increase), and those with an increased length of stay (OR: 1.00 per day increase). A lower independent odds of clubfoot was observed among patients of Asian race (OR: 0.66), Hispanic/Latino ethnicity (OR: 0.80), non-Hispanic Black (OR: 0.75), and multiracial (OR: 0.80) ethnicity/race relative to non-Hispanic/Latino White patients (P<0.05 for all).

Conclusion:

Patients with a diagnosis of NAS demonstrated higher odds of clubfoot, in addition to sociodemographic factors, as well as comorbidity burden.
Long-term Outcomes of Intramedullary Nails in Osteogenesis Imperfecta: Fewer Surgeries and Longer Survival Times With Telescoping Rods in Patients With Over Ten Years Follow-up
Authors: Nguyen Cynthia V. , Makarewich Christopher A. , Poon Selina C. , Cho Robert H. , Hennessey Theresa A.
Published: August 2024

Objective:

Intramedullary rodding of lower extremity long bones in patients with osteogenesis imperfecta (OI) is a widely accepted technique for fracture treatment and prevention. Previous small studies with short to medium-term follow-up have shown that telescoping rods have longer survival times compared with static rods. However, there are no long-term studies (10 or more years) longitudinally evaluating the results of these procedures. The purpose of this study was to compare the rod survival duration and number of procedures in patients treated with static versus telescoping rods with 10 years minimum follow-up.

Methods:

This was a multicenter retrospective comparative study of patients with a diagnosis of OI who had intramedullary nailing of the femur and/or tibia. Each bone included in the study had a 10-year minimum follow-up, only one type of rod utilized over the follow-up period, and no rod replacement surgeries outside of the primary hospital system. Patient demographics, clinical data, and details of each procedure were obtained. Groups were compared using univariate analysis with a 2-independent samples t test for continuous variables, χ2 for categorical variables, and the Kaplan-Meier method for survival analysis.

Results:

A total of 119 bones in 52 patients met inclusion criteria. Average follow up was 13.1 (range: 10.2 to 18.4) years. There were no differences between groups in follow-up length, Sillence type, bisphosphonate use, or age at first-rod placement. There were significantly more tibias treated in the static rod group compared with the telescopic rod group. The average survival length was significantly longer for telescopic rods, 5.8 ± 3.9 years versus 4.0±3.6 years for static rods. On average, bones treated with telescopic rods had significantly fewer surgeries compared with static rods (2.2 ± 0.8 vs 3.3 ± 1.6).

Conclusion:

At long term follow up, bone segments in patients with OI treated with telescopic rods required fewer surgeries and had longer implant survival times compared with those treated with static rods. When available, surgeons should consider telescopic rods as the initial implant choice in this patient population.
Association of Plasma Cabozantinib Concentration With Treatment Response and Adverse Events in Japanese Patients With Advanced Renal Cell Carcinoma
Authors: Maruyama Shinichi , Kobayashi Hiroaki , Hiraga Tatsuru , Anno Tadatsugu , Sanjo Tansei , Arai Masashi , Ishida Masaru , Kanno Hiroshi , Kato Masaru
Published: August 2024

Background:

Cabozantinib is highly effective against advanced renal cell carcinoma (RCC). However, approximately 60% of the patients require a dose reduction due to severe adverse events. Although associations between trough concentrations of cabozantinib and its efficacy and safety have been reported in other countries, reports on Japanese patients are unavailable. Therefore, we investigated the association of cabozantinib trough concentration with therapeutic efficacy and adverse events in Japanese patients with RCC and evaluated the usefulness of therapeutic drug monitoring.

Methods:

In this prospective observational study, we measured the trough concentrations of cabozantinib in 10 Japanese patients with RCC enrolled between May 2022 and September 2023. The associations of trough concentration with treatment response, as determined by RECIST 1.1, and the occurrence of grade 2 or higher adverse events were assessed.

Results:

Trough concentration was higher in patients with controlled cancer than in those with progressive cancer (1024 ± 352 versus 457 ± 216 ng/mL, P = 0.035). In addition, patients with grade 2 or higher adverse events showed a significantly higher trough concentration than those without (1560 ± 513 versus 807 ± 319 ng/mL, P = 0.032). In particular, grade 2 or higher dysgeusia, anorexia, fatigue, and dyspepsia significantly correlated with trough concentrations.

Conclusions:

This is the first clinical study to demonstrate a correlation between cabozantinib trough concentration, therapeutic efficacy, and adverse events in Japanese patients with RCC. The therapeutic drug monitoring of cabozantinib could be useful for improving therapeutic efficacy and avoiding serious adverse events.
Perspectives and Factors Related to Pre-exposure Prophylaxis Use Among Young Men Who Have Sex With Men in the United States: A Mixed-Methods Study on the Role of History of PrEP Use
Authors: Ma Junye , Soberano Zach , Stamp Bryce F. , Rosso Matthew , Hightow-Weidman Lisa , Powers Kimberly A. , Stocks Jacob Benjamin , Hosek Sybil , Horvath Keith J.
Published: August 2024

This study quantitatively examined factors related to young men who have sex with men (YMSM)'s decisions to use pre-exposure prophylaxis (PrEP) by their history of PrEP use and qualitatively elicited their perspectives on PrEP options. Higher proportions of YMSM who had never used (vs. ever used) PrEP considered the following factors as important in their decisions to use PrEP: (a) Returning to PrEP follow-up visits (p = .02), (b) having to talk about sex/PrEP with providers (p = .013), (c) people assuming they are infected with HIV (p = .021), (d) family finding out about their PrEP use (p = .001), and (e) friends finding out about their PrEP use (p = .008). Through inductive content analysis, qualitative data showed that a higher proportion of YMSM who had never used PrEP (vs. ever used) expressed concerns about HIV stigma from nonaffirming health care providers and the potential risk of inadvertently revealing their LGBTQ+ identity to others, which were described as potential barriers to PrEP use. Overall, our findings suggest that future interventions may consider tailoring PrEP messaging to YMSM's history of PrEP use, which may ultimately increase PrEP uptake and adherence.
Return on Investment
Authors: Smith Todd B. , Welch Teresa D. , Hultquist Teresa Barry , Crider Nancy Manning , McHugh Allison
Published: August 2024

Nurses are uniquely positioned to significantly impact organizational and system improvement through improving quality and reducing costs. Using an evidenced based tool to identify costs and the financial benefit involved in any quality improvement project is invaluable in developing and evaluating proposals and allocation of resources to support the organization’s financial health and viability. The return on investment analysis is an essential accounting tool that will provide nurse leaders with critical information quantifying costs and benefits of both financial and nonfinancial metrics to identify the feasibility, efficacy, risk or efficiency of a proposed project.
Botryoid-type Embryonal Rhabdomyosarcoma
Authors: Sharma Aarti E. , Dermawan Josephine K. , Chiang Sarah , Wexler Leonard H. , Antonescu Cristina R.
Published: August 2024

Embryonal rhabdomyosarcoma (ERMS) is the most common subtype of RMS, occurring in soft tissue and visceral sites of young children, and is associated with favorable outcomes. A subset occurs in mucosal-lined luminal structures, displaying a unique grape-like growth termed as “botryoid-type.” To further delineate the differences between conventional (cERMS) and botryoid-type (bERMS) RMS, we performed a comparative histologic review and comprehensive molecular profiling of 48 cases (25 bERMS and 23 cERMS). All tumors were subjected to a hybridization capture-based targeted matched tumor-normal DNA NGS assay. The mean age was 17 and 7 years for bERMS and cERMS, respectively. Most bERMS were female with a predilection for the gynecologic tract (75%), while cERMS had a slight male predominance and were preferentially located in abdominopelvic and paratesticular sites (30%, each). All bERMS exhibited an exophytic, bulbous architecture accompanied by a subepithelial “cambium layer.” Distinctive germline alterations were detected, with DICER1 (18%) and FH (6%) mutations only in bERMS, and rare TP53, VHL, and APC mutations in cERMS. Similarly, contrasting somatic genomic landscapes were observed, with frequent DICER1 (52%, P**<0.0001) and TP53 (36%, P*<0.05) alterations exclusively in bERMS. Cartilaginous differentiation was only observed in DICER1-mutated bERMS. All patients had longitudinal follow-up. bERMS patients with somatic/germline DICER1 mutations showed significantly improved recurrence-free survival compared with that of DICER1-wild type patients (P*<0.05). Moreover, bERMS showed improved disease-specific survival compared with that of cERMS, with 8% versus 30% (P*<0.05) dead of disease, respectively. In summary, we compare the molecular underpinnings of the largest cohort of bERMS and cERMS with targeted DNA sequencing and long-term follow-up data. Our findings reveal divergent genomic topographies between the 2 groups, with bERMS showing unique germline and somatic abnormalities, including enrichment in DICER1 and TP53 alterations, and a trend towards improved survival.
Distinct features of immune activation and exhaustion markers in people with perinatally acquired HIV
Authors: Taramasso Lucia , Dentone Chiara , Cama Isabella , Fenoglio Daniela , Altosole Tiziana , Parodi Alessia , Campi Cristina , Piana Michele , Mora Sara , Giacomini Mauro , Labate Laura , Garbarino Sara , Bruzzone Bianca , Filaci Gilberto , Bassetti Matteo , Di Biagio Antonio
Published: August 2024

Objective:

The aim of this study was to characterize T-cell activation, exhaustion, maturation and Treg frequencies in individuals who acquire perinatal HIV (PHIV), in individuals who acquired HIV as adult (AHIV), and in healthy controls.

Design:

This cross-sectional study included people with HIV at least 14 and younger than 40 years, HIV-RNA less than 50 copies/ml on antiretroviral therapy for at least 6 months, and HC.

Methods:

We assessed the expression of PD-1, TIM-3, EOMES, CD38+ DR+, maturation status by CD4+ and CD8+ T cells and the frequency of CD4+ and CD8+ Treg cells. Principal component analysis (PCA) and k-means cluster analysis investigated which combination of immunological parameters better associated with each group.

Results:

Twenty-six PHIV and 18 AHIV with median ages of 26 (8.0) and 28 (6.8) years were consecutively enrolled. PHIV showed significant higher frequency of naive and lower frequency of terminal effector memory CD4+ and CD8+ T cells than AHIV. AHIV exhibited higher expression of exhaustion and activation markers. The statistical analysis returned two clusters with 94% of specificity and 88% of sensitivity identifying PHIV vs. AHIV. The nine healthy controls had a lower expression of exhaustion markers on both CD4+ and CD8+ T lymphocytes than PHIV and AHIV.

Conclusion:

These data may exclude major alterations of lymphopoiesis in PHIV, with even lower state of immune-activation and exhaustion compared with AHIV. This suggests that recent lack of virological control, may affect immune activation and exhaustion of CD4+ and CD8+ T cells.