bluuebunny/crossref_metadata_2025 huggingface dataset:
Phase II randomized glioma study to evaluate efficacy and satisfaction of rolapitant plus ondansetron in preventing chemoradiation-induced nausea and vomiting
Authors: Affronti Mary Lou , Patel Mallika P , Severance Erin K , Loughlin Charles , Bradbury Claire , Herndon II James E , Boyd Kendra , Lipp Eric S , Friedman Henry S , Desjardins Annick , Johnson Margaret O , Peters Katherine B
Published: January 2025

Background

Nausea and vomiting remain feared cancer treatment-related side-effects. Antiemetic guideline trials exclude malignant glioma patients. In patients receiving radiation with concurrent temozolomide, chemoradiation-induced nausea; vomiting (cRINV) rates are 35%; 26%, respectively, which reduce quality of life, treatment adherence, and cancer control.

Methods

This randomized phase-II open-label trial, evaluated efficacy, patient preference and satisfaction of ondansetron (short-acting 5HT3-RA; 3h-half-life) monotherapy vs. rolapitant (long-acting NK1-RA; 180h-half-life) plus ondansetron in preventing cRINV during 6-weeks of temozolomide (75 mg/m2/dX42d) with radiation. Fifty-three eligible patients were randomized to Sequence-A (ondansetron-8mg Days:1-42, Day-22 rolapitant-180mg) or Sequence-B (rolapitant Day-1 plus daily ondansetron). Primary endpoint was percentage achieving cRINV-complete response (CR; no vomiting/antiemetic rescue) during the first 2-weeks of radiation. Secondary endpoints: cRIN/cRIV rates, preference/satisfaction for rolapitant/ondansetron, toxicity and adherence.

Results

Forty-eight (Sequence-A:25; Sequnce-B:23) initiated chemoradiation. Mean age=53, 58% male, 73%, KPS >90%, 73% glioblastoma. During first 2-weeks of radiation, cRINV-CR was 57% with ondansetron and 74% receiving rolapitant/ondansetron (p=0.27). Patient-reported 6-week cRINV-CR was 55% for both arms. First 2-week cRIN rates (38% Sequence-A; 32% Sequence-B) were more than cRIV rates (19% Sequence-A; 0% Sequence-B). Patients receiving ondansetron alone vomited more overall, and the first 2-weeks (26%) than with rolapitant/ondansetron (11%). Among 35 completers, 20% preferred rolapitant/ondansetron, 60% preferred ondansetron, 20% had no preference (p=0.0004). Adverse-events attributable to antiemetics were grade 1-2.

Conclusions

No difference was found in cRINV-CRs between first 2-week treatments or overall satisfaction. Although not a positive study, less vomiting occurred with rolapitant/ondansetron. While patients prefer ondansetron monotherapy, most perceived better effectiveness with rolapitant/ondansetron.
Differences in Combustible Cigarette Smoking-Related Biomarkers by Hormonal Contraceptive Use: An Exploratory Study
Authors: Allen Alicia M , Cao Qing , Stayer Lori G , Luo Xianghua , Jensen Joni , Pang Raina D , Allen Sharon , Donny Eric C , Benowitz Neal , Smith Tracy , Hatsukami Dorothy
Published: January 2025

Introduction

Hormonal contraceptives (HCs), which contain synthetic forms of estrogen (ie, ethinyl estradiol) and/or progesterone (ie, progestin), are commonly used by women who smoke combustible cigarettes. Prior research has demonstrated that HCs containing ethinyl estradiol influence nicotine metabolism, though less is known about the role of progestins. We sought to examine the association between HC use and smoking-related biomarkers.

Methods

This exploratory secondary-data analysis included females, ages of 18-45, who currently smoked classified into three groups based on current HC use: (1) combination HCs (C-HC; contains ethinyl estradiol and progestin), (2) progestin-only HCs (P-HC; contains progestin only with no ethinyl estradiol), and (3) no use of hormonal contraceptives (no-HC; no current use of ethinyl estradiol nor progestins). Group differences in expired carbon monoxide, urinary total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol) (NNAL), nicotine metabolite ratio (NMR), total nicotine equivalent (TNE), and the ratio of TNE to cigarettes/day were assessed.

Results

The C-HC (n = 22), P-HC (n = 67), and no-HC (n = 59) groups did not vary by age or race. Smoking-related biomarkers did not vary between the P-HC and no-HC groups. In adjusted analyses, the C-HC group had a lower TNE level (median = 41.22, interquartile range [IQR]: 32.10, 60.93) versus the P-HC group (median = 59.70, IQR = 44.89, 83.19; adjusted p-value = .006) and the no-HC group (median = 65.90, IQR = 57.55, 85.92; adjusted p-value = .010).

Conclusion

Smoking-related biomarkers were comparable between those who used progestin-only hormonal contraceptives to those who did not use any hormonal contraceptive. In contrast, TNE varied in those who used hormonal contraceptives with ethinyl estradiol. Additional research is needed to replicate these observations.
People With HIV Are More Likely to Clear Hepatitis C: Role of Ryan White Services, Philadelphia, Pennsylvania, United States
Authors: Tan Marissa , Kuncio Danica , Addish Eman , Nassau Tanner , Higgins Dana , Miller Melissa , Brady Kathleen
Published: January 2025

Background

HIV coinfection worsens health outcomes for persons with chronic hepatitis C virus (HCV) infection; however, access to comprehensive Ryan White (RW) HIV care may improve the health of persons with HIV and HCV.

Methods

In a retrospective cohort study, we used surveillance data from Philadelphia's hepatitis and HIV registries for newly reported HCV infections from November 2015 to October 2021. We plotted Kaplan-Meier curves and performed Cox regressions on time to HCV clearance by HIV coinfection status, adjusting for demographic characteristics and HCV report year.

Results

A total of 10 251 persons with newly reported HCV infection were included, of whom 9898 (96.6%) had HCV monoinfection and 353 (3.4%) had HIV coinfection. HCV reports were mostly among residents who were non-Hispanic/Latine White (n = 3609, 35.2%) and non-Hispanic/Latine Black (n = 3221, 31.4%) and assigned male sex at birth (n = 6931, 67.8%). At every month of follow-up, having HIV was associated with a higher likelihood of HCV clearance as compared with HCV monoinfection (adjusted hazard ratio, 1.2; 95% CI, 1.1–1.4; P < .05). For persons with HIV coinfection, participation in RW support services 2 to 6 times monthly was associated with an increased likelihood (adjusted hazard ratio, 1.7–3.1) of HCV clearance at every month of follow-up as compared with persons without RW participation (P < .05).

Conclusions

Among newly reported HCV infections, the likelihood of HCV clearance was higher among persons with HIV coinfection who participated in RW support services. Frequent receipt of supportive services, such as those provided by the national, federally funded RW system, is crucial for HCV elimination.
Performance of α-Defensins in Diagnosing Nosocomial Ventriculitis
Authors: Jacobs Max W , Doub James B
Published: January 2025

Nosocomial ventriculitis can be an extremely difficult infectious disease process to diagnose, thereby exposing patients to increased morbidity and unwarranted aggressive antibiotics. Thus, novel ventriculitis diagnostics are drastically needed. In this study, we demonstrate excellent sensitivity and specificity of cerebral spinal fluid α-defensins to aid in diagnosing ventriculitis.
An InDel variant in the promoter of the NAC transcription factor MdNAC18.1 plays a major role in apple fruit ripening
Authors: Yue Qianyu , Xie Yinpeng , Yang Xinyue , Zhang Yuxin , Li Zhongxing , Liu Yunxiao , Cheng Pengda , Zhang Ruiping , Yu Yue , Wang Xiaofei , Liao Liao , Han Yuepeng , Zhao Tao , Li Xuewei , Zhang Hengtao , Ma Fengwang , Guan Qingmei
Published: January 2025

A complex regulatory network governs fruit ripening, but natural variations and functional differentiation of fruit ripening genes remain largely unknown. Utilizing a genome-wide association study (GWAS), we identified the NAC family transcription factor MdNAC18.1, whose expression is closely associated with fruit ripening in apple (Malus × domestica Borkh.). MdNAC18.1 activated the transcription of genes related to fruit softening (Polygalacturonase, PG) and ethylene biosynthesis (1-aminocyclopropane-1-carboxylic acid synthase, ACS), thereby promoting fruit ripening of apple and tomato (Solanum lycopersicum). There were two single-nucleotide polymorphisms (SNP-1,545 and SNP-2,002) and a 58-bp insertion–deletion (InDel-58) in the promoter region of MdNAC18.1. Among these, InDel-58 serves as the main effector in activating the expression of MdNAC18.1 and driving fruit ripening. InDel-58 determines the binding affinity of the class D MADS-box protein AGAMOUS-LIKE 11 (MdAGL11), a negative regulator of fruit ripening. The InDel-58 deletion in the early-ripening genotype reduces the inhibitory effect of MdAGL11 on MdNAC18.1. Moreover, MdNAC18.1 and its homologous genes originated from a common ancestor across 61 angiosperms, with functional diversification attributed to tandem replications that occurred in basal angiosperms. In summary, our study revealed how a set of natural variations influence fruit ripening and explored the functional diversification of MdNAC18.1 during evolution.
Does enumerating undocumented residents in the U.S. census affect congressional apportionment?
Authors: Warren John Robert , Warren Robert E
Published: January 2025

In recent years American political figures, media pundits, and others have argued that undocumented residents in the United States should not be included in census data used for congressional apportionment. They argue that including them unfairly benefits some states ─ especially politically Democratic leaning (or “blue”) states, according to most arguments ─ at the expense of others. Some people have speculated that many more House seats and Electoral College votes would have been apportioned to politically Republican leaning (or “red”) states and that many fewer would have been apportioned to politically “blue” states if undocumented residents were excluded from apportionment data. The only systematic empirical examinations of this question occurred prior to the 2020 Census and projected ─ mostly inaccurately ─ how apportionment would differ after the 2020 Census under this hypothetical. Does including undocumented residents in U.S. census data used for congressional apportionment alter (a) political party representation in the House of Representatives or (b) presidential electoral college votes? We use annual state-level estimates of the undocumented resident population at each census date to examine the consequences of including them in official apportionment data since 1980. If undocumented residents had been entirely excluded from census data used for apportionment, no more than two House seats and three electoral college votes would have shifted between political parties in any year since 1980; this would have had no bearing on party control of the House or the outcome of presidential elections.
A thomistic argument for the containment view of pregnancy
Authors: Toner Patrick
Published: January 2025

The ‘containment view’ of pregnancy is widely held, but it has recently been subjected to sustained criticism by Elselijn Kingma. According to the containment view, human foetuses (among others) are animals in their own right, contained within their mothers. Kingma's alternative to this is the ‘parthood view,’ according to which a foetus is a maternal part. Despite the prevalence of the containment view, there are not a great many arguments in its favour, and Kingma has searchingly criticized several of these. In this paper, I defend an argument for the containment view, which I think is not undermined by Kingma-type considerations.
On the Fiscal Sustainability of Swiss Cantons, 1905–2017
Authors: Bury Yannick , Feld Lars P , Koehler Ekkehard A
Published: January 2025

Do Swiss cantonal governments run sustainable fiscal policies? Despite a growing literature on subnational fiscal sustainability, evidence on the Swiss case is largely missing. Drawing on a novel data set that stretches back to 1905, we test for stationarity of cantonal public debt, revenue, and spending and for cointegration between cantonal revenues and expenditures. Based on time series properties, we estimate individual fiscal reaction functions for each canton and for the panel of cantons as a whole. Using second-generation panel modeling—and thus accounting for heterogeneity in cantonal fiscal policy, structural breaks, and cross-sectional dependence (CD) among the cantons—our results show that the cantons run sustainable policies. Moreover, our results provide evidence that fiscal rules explain part of the heterogeneity in cantonal fiscal reactions to increased debt.
Sceptics and champions: participant insights on the use of partial randomization to allocate research culture funding
Authors: Davies Catherine , Ingram Holly
Published: January 2025

As part of the shift towards a more equitable research culture, funders are reconsidering traditional approaches to peer review. In doing so, they seek to minimize bias towards certain research ideas and researcher profiles, to ensure greater inclusion of disadvantaged groups, to improve review quality, to reduce burden, and to enable more transformative research. This paper presents the rationale and findings from a trial of partially randomized funding allocation (PRA) used to internally distribute Research England’s Enhancing Research Culture fund at the University of Leeds. Of 26 eligible applications, six fell in the upper midfield on quality assessment and were randomized. Of this subset, one received the available funding. Qualitative data from applicants, reviewers, and moderators in the trial suggest modest gains regarding the reduction or perception of bias and efficiency of peer review. There were variable benefits of the feedback that PRA provides. A range of concerns emerged about PRA’s perceived fairness, bluntness, and threat to quality. Based on the behavioural responses we captured, we present strategic and operational recommendations for professionals working in research evaluation who are interested in adopting PRA as a way of improving research culture. For example, we highlight the importance of (1) sharing data on the role of chance in traditional peer review, and (2) considering the benefits and risks of PRA at both group and individual applicant levels.
The assessment of the sexuality of patients with a borderline personality disorders based on their 2D:4D digit ratio
Authors: Holka-Pokorska Justyna , Kucharski Adam
Published: January 2025

Background

The hormonal composition of amniotic fluid during prenatal development, particularly the androgen-to-estrogen ratio, may influence neuronal differentiation related to sexual response patterns and the capacity to control impulsive sexual behaviors in later life.

Aim

This study aims to assess sexual behaviors and characterize sexual responses in women with borderline personality disorder (BPD) compared to a control group.

Methods

The study included 33 women diagnosed with BPD and 56 women in a control group. BPD diagnoses were based on clinical psychiatric evaluation and the Structured Clinical Interview for DSM-IV. Elements of sexual response were measured using the Arizona Sexual Experience Scale (ASEX). The digit ratio (2D:4D) served as a biomarker for testosterone and estrogen exposure during early prenatal development.

Main outcomes

ASEX results were analyzed in the categories of “desire,” “arousal,” and “vaginal lubrication” subscales, along with the 2D:4D digit ratio for both hands.

Results

Lower values for the right–hand digit ratio were observed in the BPD group compared to the control group (0.989, SD = 0.034 vs. 1.016, SD = 0.039; P = 0.0014), potentially indicating higher prenatal testosterone levels. Significant correlations were found in the BPD group between the right–hand digit ratio and scores on the ASEX subscales, specifically “sexual arousal” (r = 0.406, P = 0.019) and “vaginal lubrication” (r = 0.362, P = 0.038).

Clinical implications

These results may support biological hypotheses regarding the origins of sexual dysfunction in women with BPD.

Strengths and limitations

This study is a pioneering attempt to explore the indirect impact of early amniotic hormone composition on the neurobiological conditioning of sexual response and behavior in women with BPD. Limitations include the preliminary nature of the findings, a small sample size, and results that may not be generalizable across all genders.

Conclusions

Physiological aspects of sexual response, such as arousal and vaginal lubrication, in women with BPD appear to be significantly correlated with prenatal testosterone levels, as indicated by the 2D:4D digit ratio.
Prevalence of Mutations Associated with QoI, QiI, QioSI and CAA Fungicide Resistance Within Plasmopara viticola in North America and a Tool to Detect CAA Resistant Isolates
Authors: Sharma Nancy , Heger Lexi , Combs David B. , McFadden Smith Wendy , Holland Leslie A. , Brannen Phillip M. , Gold Kaitlin M. , Miles Timothy
Published: January 2025

Grape downy mildew, caused by Plasmopara viticola poses a threat to grape cultivation globally. Early detection of fungicide resistance is critical for effective management. This study aimed to assess the prevalence and distribution of mutations associated with resistance to Quinone oxide inhibitors (QoI, FRAC 11), Quinone inside inhibitors (QiIs, FRAC 21, cyazofamid), Carboxylic acid amides (CAA, FRAC 41), and Quinone inside and outside inhibitor, stigmatellin binding mode (QioSI, FRAC 45, ametoctradin) in P. viticola populations in the eastern United States and Canada; and evaluate whether these mutations are linked to fungicide resistance correlate with specific P. viticola clades. A total of 658 P. viticola samples were collected from commercial vineyards across different states and years in the eastern United States and Canada and sequenced for the PvCesA3 and cytb genes and the ITS1 region. Results showed P. viticola clades aestivalis, vinifera, and riparia were prevalent in the eastern United States and Canada. QoI resistance was widespread, with the A-143 resistant genotype prevalent in P. viticola clades aestivalis and vinifera. CAA resistance, associated with the G1105S mutation, was mainly identified in P. viticola clade aestivalis from Georgia, New York, and Ontario. A TaqMan-probe based assay was developed to detect G1105S mutation in P. viticola conferring CAA fungicide resistance. The TaqMan assay demonstrated sensitivity at even low DNA concentrations and specificity in distinguishing between sensitive and resistant genotypes. This study provides insights into geographic distribution of fungicide resistance in P. viticola populations and presents a reliable method for detecting CAA resistance in P. viticola.
Pyoderma Gangrenosum Improved with Dapsone and Prednisone: A Case Report
Authors: Merilleno Arbie Sofia P. , Ang-Tiu Charlene Marie
Published: January 2025

Pyoderma gangrenosum is a rare ulcerative condition that poses diagnostic and therapeutic challenges. Diagnosis and appropriate management are often delayed due to its rarity and the presence of numerous clinical variants. In this case report, the authors present the case of a 36-year-old man who had long-standing and nonhealing ulcers that did not respond to multiple antibiotics and serial wound debridement. The patient was promptly initiated on oral corticosteroids and dapsone as an adjunctive steroid agent. After 6 months, the patient reported complete resolution of the lesions. This rare case underscores the potential value of combining prednisone and dapsone as a treatment option for pyoderma gangrenosum, particularly in resource-limited settings.
Chloroplast genome characterization and divergence time estimation of Persicaria capitata
Authors: Zeng Xianfa , Liu Chang , Yang Xiaoying , Wang Xinyue , Luo Jiangli , Zhou Ying , Zhang Liyan , Gao Zengjie , Pu Xiang
Published: January 2025

Objective:

With Persicaria capitata as test materials, we compared and analyzed the chloroplast genome characteristics as well as their phylogenetic relationships and evolutionary history with related species of Persicaria nepalensis, Persicaria japonica, Persicaria chinensis, Persicaria filiformis, Persicaria perfoliata, Persicaria pubescens, Persicaria hnydropiper.

Methods:

The Illumina HiSeq high-throughput sequencing platform was used for the first time for P. capitata chloroplast (cp) genome sequencing. NOVOPlasty and CpGAVAS2 were used for assembly and annotation, and Codon W, DnaSP, and MISA were used to conduct a series of comparative genomic analyses between the plant and seven species of the same genus. A phylogenetic tree was constructed using the maximum likelihood (ML) and neighbor-joining (NJ) methods, and divergence time was estimated using BEAST.

Results:

The total length of P. capitata cp genome was 158,821 bp, with a GC content of 38.0%, exhibiting a typical circular tetrad structure. The genome contains 127 annotated genes, including 82 protein-coding and 45 tRNA-encoding genes. The cp genome harbors single sequence repeat (SSR) loci primarily composed of A/T. The conserved species structure of this genus is reinforced by the expansion and contraction of the inverted repeat (IR) region. The non-coding regions of the cp genomes exhibited significant differences among the genera. Six different mutation hotspots (psbK-psbI, atpI-rps2, petN-psbD, atpB-rbcL, cemA-petA, ndhI-ndhA-ycf1) were screened from the non-coding regions of genes with high nucleotide variability (pI). These hotspots were expected to define the phylogenetic species of Persicaria. Furthermore, phylogenetic analysis of Polygonaceae plants showed that P. capitata was more closely related to P. chinensis than P. nepalensis. Analysis of divergence time indicated that Polygonaceae originated in the Late Cretaceous (~180 Ma) and began to differentiate during the Middle Miocene. Persicaria differentiated ~66.44 million years ago, during the Miocene.

Conclusions:

Our findings will serve as a scientific basis for further research on species identification and evolution, population genetics, and phylogenetic analysis of P. capitata. Further, we provide valuable information for understanding the origin and evolution of Persicaria in Polygonaceae and estimating the differentiation time of Persicaria and its population.

Graphical abstract: http://links.lww.com/AHM/A140.
One-Year Real-World Outcomes of Ab-Externo Gel Stent Placement From the EXPAND Study
Authors: Francis Brian A. , Vera Vanessa , Kim Joshua , Basha Mahdi M. , Lum Bryant , Grayson Douglas , Vold Steven , Balaram Mini , Simonyi Susan , Ansari Husam , Nayak Kolomeyer Natasha
Published: January 2025

Précis:

In the real-world, retrospective, EXPAND study of consecutive adults with glaucoma, ab-externo gel stent implantation effectively lowered intraocular pressure (34%) and the medication burden (61%), with transient/self-resolving hypotony as the most frequent adverse event (28%).

Purpose:

To assess effectiveness and safety of ab-externo gel stent (GS) implantation in glaucoma.

Methods:

Multicenter, real-world, retrospective study. Consecutive adults with glaucoma and ab-externo GS implantation (with/without phacoemulsification or open/closed conjunctiva) ≥12 months before study entry. Data were extracted between the baseline/preoperative and last follow-up visit or date of secondary surgical intervention (SSI). Primary effectiveness endpoint: proportion of primary eyes (first eye in bilaterally implanted patients) at Month 12 (M12) achieving ≥20% intraocular pressure (IOP) reduction from baseline without medication increase, clinical hypotony, vision loss to counting fingers, or SSI. Secondary effectiveness endpoints included complete success (IOP ≤18 mmHg and ≥20% IOP reduction from medicated baseline without medication, clinical hypotony, or SSI); qualified success (same but without medication increase); and needling rate. Key safety endpoints (all eyes): intraoperative complications, postoperative adverse events (AEs), and SSIs.

Results:

The safety population included 466 eyes; 80.7% received the GS alone and 85.0% were implanted with closed conjunctiva. At M12, 39.1% of all primary eyes (N=413) and 54.9% of primary eyes with IOP and medication data at baseline and M12 (N=213) achieved the primary endpoint. At M12 among all primary eyes, the complete success, qualified success, and needling rates were 33.5%, 56.5%, and 28.6%. Most eyes (97.9%) had no intraoperative complications. The most frequent postoperative AE was transient/self-resolving hypotony (IOP<6 mmHg; 28.1%). Sixty-nine (14.8%) eyes required an SSI.

Conclusions:

Ab-externo GS placement effectively lowered IOP and the medication count without unexpected complications/AEs, expanding implantation options based on patients’ needs and surgeons’ preferences.
Cognitive Impairment in Primary Open Angle Glaucoma: A Case Control Study
Authors: Garg Muskan , Midha Neha , Verma Rohit , Gupta Vivek , Angmo Dewang , Velpandian Thirumurthy , Maharana Prafulla Kumar , Satapathy Sujata , Sharma Namrata , Dada Tanuj
Published: January 2025

Précis:

Cognitive impairment in multiple domains was observed in primary open angle glaucoma patients as compared to age and gender matched healthy controls.

Objective:

Evaluation of cognitive impairment in individuals with Primary Open Angle Glaucoma (POAG).

Methods:

In this case-control study, individuals with POAG (cases, n=70) were compared with age- and sex-matched healthy individuals (controls, n=70) using detailed ophthalmological evaluation, cognitive assessment and serum cortisol level. A multitude of tests were employed to comprehensively assess various domains of cognitive function: Addenbrooke Cognitive Examination (ACE-III; attention/orientation, memory, language, verbal fluency, and visuospatial skills), Post Graduate Institute Memory Scale (PGIMS; verbal and non verbal memory), Wisconsin Card Sorting Test (WCST; nonverbal executive functions), Go No-Go task (GNG; inhibitory control), and Trail Making Test (TMT; attention and working memory).

Results:

Intraocular pressure and cup disc ratio were significantly higher (P <0.001) while retinal nerve fibre layer (RNFL) thickness and mean deviation were significantly lower in cases as compared to controls. Cases had significantly lower scores on ACE-III and PGIMS (P<0.001) and longer test completion time in TMT-A (P=0.001). The performance of cases was also significantly worse on most parameters of the WCST and GNG tasks. Serum cortisol level was significantly higher in cases (11.75±7.41 mcg/dl) compared to controls (7.93±2.39 mcg/dl; P=0.02). A significant correlation was observed between serum cortisol level and WCST correct response (P=0.04), WCST error response (P=0.002) and total time taken in TMT-A (P=0.03).Visual field mean deviation also exhibited a significant correlation with serum cortisol level (P<0.001) and total time taken on WCST (P=0.03) and TMT-A (P=0.03).

Conclusion:

Individuals with POAG exhibited higher cognitive impairment and raised serum cortisol levels than age-matched healthy controls. Early recognition and management of cognitive impairment are pivotal for enhancing the quality of life and implementing comprehensive glaucoma care.
Phenomenological Description of the Experiences of Teenagers With Critically Ill Parents
Authors: BARR Maya , THAKUR Aishwarya , THVAR Varun K. , DUPEE David , VASAN Nina
Published: January 2025

Background

Critical illness not only threatens the life of the patient but also may profoundly impact the lives of their loved ones. For teenagers with a critically ill parent, these impacts may have significant, developmentally impactful effects. A descriptive understanding of these effects may advance scholarly understanding of the challenges these teenagers face.

Purpose

In this study, we sought to understand this overlooked population, i.e., teenagers with a critically ill parent, using a descriptive analysis of their experiences.

Methods

Individual and group interviews were conducted with the participants (n = 9). Interviewers presented standardized semistructured interview questions to all of the participants. The questions explored situational, emotional, relational, and dynamic phenomena related to the experience of having a critically ill parent.

Results

Themes describing the participants' lived experiences related to having a parent with a critical illness were examined using a three coding framework. Four themes emerged, including parental health interference on teenagers—fallout, worsening, and interference; emotional experience and how emotions were processed—emotions, cognitive strategies, and behavioral strategies; relationships with others—sharing feelings, company, and relationships; and information and secrecy—learning, secrecy, and history.

Conclusions/Implications for Practice

All of the teenagers in this study were found to suffer from both situational and emotional interference. Parentification, use of selective distraction as an emotion regulation skill, and reliance on support from others were also observed. These results shed light on the overall experience of teenagers who have a critically ill parent. The fallout effects of a parent's health can encompass situational, logistical, emotional, and relationship aspects. Importantly, attention must be paid to how teenagers cope with the emotions experienced during a parent's critical illness. This framework may inform how to more effectively support teenagers through strategies such as providing peer support opportunities.
Use of Job Exposure Matrices to Inform COVID-19 Vaccine Promotion among Non-Health care Workers in Chicago, Illinois
Authors: Lendacki Frances R. , Forst Linda , Mehta Supriya D. , Kerins Janna L.
Published: January 2025

BACKGROUND

Occupation, a risk factor for SARS-CoV-2 exposure, is excluded from immunization records. Identifying under-vaccinated workers could optimize interventions to protect vulnerable populations.

METHODS

We analyzed health department case interviews (June 2021-May 2022) to describe 3,763 non-health care workers with COVID-19 in Chicago. Job exposure matrices categorized SARS-CoV-2 exposure risk through frequency of indoor work, proximity to the public and to coworkers. Logistic regression quantified associations between occupational risk and vaccination status.

RESULTS

Pre-Omicron vaccination rates were lower among high-risk vs. lower-risk workers (41% vs. 49%). Post-Omicron rates did not differ (75%). Under-vaccinated groups had disproportionately high occupational risk: 66% of Black-non-Latinx, 57% of 18–29-year-olds. Demographically-adjusted models found no associations between occupational risk and vaccination.

CONCLUSIONS

Given demographic patterns of employment, workplace-based COVID-19 vaccine promotion can help reach under-vaccinated communities. To inform interventions, immunization records must include occupation.
Central arterial stiffness in young adults with perinatal HIV exposure & infection
Authors: Urbina Elaine M. , Yu Wendy , Williams Paige L. , Sawyer George , Van Dyke Russell , Colan Steven , Lipshultz Steven E.
Published: January 2025

Objective:

To compare arterial stiffness between young adults with perinatally acquired HIV (YAPHIV) and young adults perinatally HIV exposed but uninfected (YAPHEU).

Design:

Cross-sectional analysis of pulse wave velocity (PWV) measures among participants with echocardiography in the PHACS Cardiac Toxicity Substudy.

Methods:

A total of 150 participants (95 YAPHIV, 55 YAPHEU, mean 23.4 years, 60% female, 72% Black, 24% Hispanic) had echocardiography and PWV measured. We compared PWV between groups. Among YAPHIV, we fit linear regression models to evaluate the association of measures of HIV disease severity and antiretroviral treatment (ART) with PWV. We computed correlations between PWV and measures of left ventricular structure and function.

Results:

Mean PWV did not differ by group (YAPHIV 5.63 vs YAPHEU 5.39 m/s; P = 0.50). HIV control was good (82% with viral load <400 copies/ml); 91% used combination ART. Mean PWV was normal, but 3 of 95 YAPHIV (3%) had values above 11.8 m/s (level associated with cardiovascular events in adults). Weak correlations (<0.20) were observed between PWV and echocardiographic measures. Among YAPHIV, current and historical HIV severity measures were not associated with PWV. YAPHIV on protease inhibitor (PI)-based ART had higher mean PWV than those on integrase strand inhibitors (1.68 m/s higher, 95% CI -0.36, 3.72) or nonnucleoside transcriptase inhibitors (1.58 m/s higher, 95% CI −0.94, 4.11).

Conclusions:

Our data shows no difference in PWV between those perinatally exposed to and perinatally infected with HIV. Therefore, CV risk reduction guidelines should be followed to prevent CV disease in all young adults.
Adipose tissue transcriptome in patients switching efavirenz or a protease inhibitor to raltegravir compared to people without HIV
Authors: Hanttu Anna M. , Muniandy Maheswary , van der Kolk Birgitta W. , Lindgren Hanna , Yadav Bhagwan , Sutinen Jussi , Pietiläinen Kirsi H.
Published: January 2025

Objective:

To study the subcutaneous adipose tissue (SAT) transcriptome in people with HIV (PWH) switching efavirenz (EFV) or a protease inhibitor (PI) to raltegravir and to compare the transcriptome of PWH to those of people without HIV (PWoH).

Design:

PWH (n = 36) on EFV (n = 22) or a PI (n = 14) based ART regimen were randomized to switch to RAL (n = 15) or to continue unchanged medication (n = 17). PWoH (n = 10), comparable in age and body mass index, were included for comparison.

Methods:

SAT gene expression was analyzed via RNA sequencing (Illumina Stranded mRNA library prep).

Results:

At baseline, only 51 out of 19930 genes showed differential expression (FDR <0.05) between PWH and PWoH. Differentially expressed genes in PWH were identified as being HIV host factors or were associated with immune response, lipid metabolism, adipogenesis, apoptosis regulation, DNA/RNA metabolism, and cell structures. Mitochondria-encoded genes were consistently downregulated in PWH. Intergroup variations among PWH using different ART (EFV, PI, RAL) were not significant, and switching EFV or a PI to RAL did not induce substantial changes in the SAT transcriptome.

Conclusions:

While some specific genes linked to HIV are differentially expressed in PWH compared to PWoH, the overall SAT transcriptome remains relatively stable across various antiretroviral treatments and upon switching from EFV/PI to RAL. These findings enhance our understanding of the molecular landscape on SAT in the context of HIV and ART.
Outcomes of 100 Squamous Cell Carcinomas of the Upper Limb
Authors: Page Felicity , Chester Darren
Published: January 2025

Background

Rates of recurrence, metastases, and mortality for squamous cell carcinoma (SCC) of the upper limb have not been clearly defined.

Objective

We aimed to characterize these tumors and assess the long-term outcomes, comparing with current literature.

Methods and Materials

A retrospective review was performed on 100 consecutive primary cutaneous upper limb SCCs managed surgically by a single hand surgeon between 2012 and 2019. Data collection included patient demographics and tumor factors from the electronic patient records.

Results

One hundred SCCs were identified in 93 patients. Sixty-six percent of patients were male, and the median age was 80 years. Median follow-up was 25 months. Ninety-seven percent of cases were completely excised. The local recurrence rate was 1%, 2% presented with metastases, 4% developed metastases during follow-up, and the mortality related to SCC was 3% with a 33% overall mortality rate.

Conclusions

SCCs of the upper limb behave in a similar manner to those located elsewhere. The local recurrence, metastases, and mortality rates were all low, as such the majority of upper limb SCCs can be managed effectively with a single, low morbidity procedure.

Deep margin clearance can be particularly challenging to achieve and an acceptable margin should be considered on an individual basis.
Comparative Postoperative Complications of Acellular Dermal Matrix and Mesh Use in Prepectoral and Subpectoral One-Stage Direct to Implant Reconstruction
Authors: Diffley Michael , Tang Amy , Sawar Kinan , Al-Saghir Tala , Gonte Madeleine R. , Hall Jamie , Tepper Donna , Darian Vigen , Evangelista Maristella , Atisha Dunya
Published: January 2025

Background

One-stage direct-to-implant (DTI) breast reconstruction is increasingly popular with the use of prepectoral reconstruction leading to increased demand for structural scaffolds. It is vital to determine if differences in safety profiles exist among scaffolds.

Methods

We performed a retrospective cohort study of consecutive patients in our breast cancer center undergoing DTI reconstruction. Outcomes relating to postoperative infections, wound complications, and implant related complications were extracted. Outcomes were grouped into major, minor, and long-term complications. Univariate and multivariate analysis determined outcome differences and accounted for confounding variables.

Results

Two hundred forty-two patients (404 breasts) underwent DTI reconstruction. One hundred ninety-two breasts were reconstructed with FlexHD Pliable Preformed (PP; MTF Biologics, Edison, NJ), 122 with AlloDerm Ready To Use (RTU; Allergan Aesthetics, Irvine, CA), 22 with DermACELL (LifeNet Health, Virginia Beach, VA), 21 with Galaflex (Galatea Surgical, Lexington, MA), 22 with Meso BioMatrix (MTF Biologics), and 25 with autologous dermal flaps alone. Univariate analysis demonstrated statistically significant differences among scaffolds in the incidence of cellulitis treated with oral antibiotics, capsular contracture, explantation for capsular contracture, seroma requiring operative drainage, minor complications, and long-term complications. On multivariate regression, FlexHD PP had reduced rates of capsular contracture, explantation for capsular contracture, minor complications, and long-term complications compared to AlloDerm RTU. Reconstruction with Galaflex had increased rates of capsular contracture when compared to FlexHD PP.

Conclusions

Certain structural scaffolds have differing safety profiles that should be considered when selecting, which product to use in DTI reconstruction.
Correlation Between Rumination, Symptom Clusters, and Quality of Life in Patients With Inflammatory Bowel Disease
Authors: Li Ping , Tao Yuxiu , Liu Jun , Lv Aili , Ni Chunping
Published: January 2025

Previous studies have demonstrated that individuals with inflammatory bowel disease (IBD) experience distinct symptom clusters and generally have a lower quality of life compared to the general population. Rumination refers to the persistent and repetitive contemplation of the causes, consequences, and intricate details of a negative and stressful event. The multiple symptom clusters of IBD cause great distress, physical and financial stress, and thus may increase the level of rumination in patients. However, the relationship between rumination, symptom clusters, and quality of life in IBD patients remains unclear. Therefore, the objective of this study was to assess the state of rumination and examine its association with symptom clusters and quality of life among individuals with IBD. This study found a significant positive correlation between rumination and symptom clusters, while a significant negative correlation between rumination and quality of life in IBD patients (p < .001). Patients with higher levels of rumination in IBD exhibited more severe symptoms and poorer quality of life. Reducing rumination levels may prove beneficial in alleviating symptoms and improving the quality of life for IBD patients. In daily nursing practice, timely evaluation of rumination and appropriate interventions are essential to achieve better therapeutic outcomes.
Detection of ERG11 gene mutation in coding and non-coding region of clinical Candida glabrata isolates from Pakistan, a short communication
Authors: Memon Saba , Ghanchi Najia Karim , Zafar Urooj , Farooqi Joveria , Zaka Sadaf , Jabeen Kauser
Published: January 2025

Azoles inhibit cytochrome P450 dependent enzyme lanosterol-14α-demethylase (CYP51) that is encoded by ERG11gene. Mutations in the ERG11gene confer azole resistance in Candida species through different mechanisms, like ERG11 overexpression, CDR1,2 overexpression, tolerance to methylation, biofilm formation and import of host cholesterol. We sequenced ERG11 gene to determine mutations in coding and non-coding region of ERG11 in clinical isolates of Candida glabrata from Pakistan. Eight C. glabrata strains with fluconazole minimum inhibitory concentrations ranging from 2-256 mg/L were included in this study. The ERG11 gene was amplified by PCR, sequenced using Sanger methodology, and analyzed using bioinformatic tools. We identified mutation at position I166S in non-coding region of ERG11gene in C. glabrata. Two novel synonymous mutations at position I100 and D278, and previously reported synonymous mutations D256, L341, P519 and R527 were also observed. This is the first study evaluating ERG11 mutations in C. glabrata species from Pakistan. Such ERG11 gene mutations which are unique to geographical regions should be investigated through resistance and genotypic surveillance.
Draft genome sequences of four potential new species of the genus Bradyrhizobium isolated from root nodules of native legumes in Costa Rican forests
Authors: Fernández-Vargas Rachelle , Jiménez-Alpízar Sara , Leandro-Arce Valeria , Mendoza Bradd , Rojas-Jimenez Keilor
Published: January 2025

Here we report the draft genome sequences of four Bradyrhizobium spp. isolates obtained from root nodules of the native legumes Pentaclethra macroloba, Chamaecrista nictitans, Erythrina fusca, and Zygia engelsingii in tropical forests of Costa Rica. Genomes ranged from 8.6 to 9.8 Mb with GC contents between 62.8% and 63.8%. Phylogenomic analysis, along with Average Nucleotide Identity (ANI) and digital DNA-DNA hybridization (dDDH) comparisons, confirmed these isolates represent potential new species. ANI values ranged from 88.3% to 90.3%, and dDDH values from 28.8% to 41.8%, compared to their closest Bradyrhizobium sp. references. Functional annotation revealed some genes related to nitrogen fixation (nifA, nifB, nifH) and nodulation capacity (nodB, nodC, nodJ). These results provide insights into the diversity and symbiotic capabilities of Bradyrhizobium in tropical ecosystems.
Description of six novel species Bacillus bruguierae sp. nov., Bacillus kandeliae sp. nov., Bacillus yunxiaonensis sp. nov., Metabacillus rhizosphaerae sp. nov., Metabacillus sediminis sp. nov. and Psychrobacillus mangrovi sp. nov., isolated from mangrove ecosystem
Authors: Liu Guo-Hong , Narsing Rao Manik Prabhu , Shi Huai , Chen Qian-Qian , Quadri Syed Raziuddin , Li Wen-Jun
Published: January 2025

Six Gram-stain-positive and rod-shaped strains, designated FJAT-51614T, FJAT-51639T, FJAT-52054T, FJAT-52991T, FJAT-53654T and FJAT-53711T, were isolated from a mangrove ecosystem. The condition for growth among the strains varied (pH ranging 5.0–11.0 and temperature 15–45 °C). These strains showed the highest 16S rRNA gene sequence similarity to the genera Bacillus, Metabacillus and Psychrobacillus. Menaquinone MK-7 (100%) was present in all strains except strain FJAT-51614T, which contained MK-7 (32%) and MK-8 (68%). The major fatty acids (>10%) in strains FJAT-52054T and FJAT-51614T were anteiso-C15 : 0 and iso-C14 : 0. The major fatty acid (>10%) in strain FJAT-53654T was anteiso-C15 : 0, while in strain FJAT-51639T were iso-C15 : 0 and iso-C17 : 0. The major fatty acids in strains FJAT-52991T and FJAT-53711T were iso-C15 : 0 and iso-C16 : 0. The major polar lipids in strains FJAT-51639T, FJAT-52991T and FJAT-51614T were diphosphatidylglycerol, phosphatidylglycerol and phosphatidylethanolamine, while strains FJAT-53711T, FJAT-52054T and FJAT-53654T consist of diphosphatidylglycerol and phosphatidylglycerol. The genome-relatedness values among the present study strains and the closest species were below the recognized cutoff levels for species delineation. The polyphasic analysis comparison results represent six strains as novel species for which the names Bacillus bruguierae sp. nov. (FJAT-51639T=GDMCC 1.3073T=JCM 35615T), Bacillus kandeliae sp. nov. (FJAT-52991T=GDMCC 1.3069T=JCM 35619T), Bacillus yunxiaonensis sp. nov. (FJAT-53711T=GDMCC 1.3068T=JCM 35616T), Metabacillus rhizosphaerae sp. nov. (FJAT-53654T=GDMCC 1.3075T=JCM 35614T), Metabacillus sediminis sp. nov. (FJAT-52054T=GDMCC 1.3074T=JCM 35620T) and Psychrobacillus mangrovi sp. nov. (FJAT-51614T=GDMCC 1.3072T=JCM35478T) are proposed.
Prevalence, aetiology and antimicrobial resistance profile of diabetic individuals suffering from community-acquired urinary tract infection
Authors: Priyadarshini Ankita , Kalola Priyal , Patadia Hemantkumar , Shah Janvi , Gangawane Ajit
Published: January 2025

Introduction. The rise in antimicrobial resistance poses a significant threat to global health, particularly among diabetic patients who are prone to urinary tract infections (UTIs).

Hypothesis. Pathogens that cause UTI among diabetic patients exhibit significant multidrug resistance (MDR) patterns, necessitating more precise empirical treatment strategies.

Aim. This study aimed to determine the prevalence of UTI among diabetic patients and study the antimicrobial susceptibility profiles of uropathogens, detected and identified the potential differences in age groups and between genders, focusing on MDR and gender-based variations, causing a global concern in deciding empirical treatment.

Methodology. A prospective study was conducted from August 2021 to December 2023 in Gujarat, India. During the period, 1023 diabetic patients with symptoms of UTI were diagnosed by urine culture and 280 individuals tested positive for UTIs. Antibiotic susceptibility testing was carried out on these 280 micro-organism isolates.

Results. Among the 280 UTI-positive patients, 166 (59.29%) were females and 114 (40.71%) were males, with the prevalence of UTI in diabetic females being 27.34% (166/607) and males being 27.40% (114/416). Among the isolated uropathogens, Escherichia coli (56.78%) was the predominant organism followed by Pseudomonas aeruginosa (13.57%) and Klebsiella (13.21%). High resistance was noted to various antibiotics in Gram-negative bacteria including both genders. In E. coli, resistance was predominantly high against the penicillin sub-class of the beta-lactam group (70.23%, 69.58%), cephalosporins (66.23%, 76.52%) and least against nitrofurans (30.10%, 40%) in males and females, respectively. Klebsiella has shown higher resistance to cephalosporins (66.23%, 76.52%) and aminoglycosides (60.92%, 62.66%) and least resistance to carbapenem (41.67%) and phosphonic (33.33%) in males and females, respectively. A high proportion of isolates, ~82.5%, exhibited MDR. Among these MDR isolates, those from female patients accounted for a higher percentage (58.44%) compared with males (41.55%). The highest prevalence of MDR was observed in the 41–60-year age group. This pattern highlights notable differences in MDR prevalence across gender and age groups.

Conclusion. The high prevalence of UTI caused by MDR organisms based on gender and age group highlights the need for clinicians to choose antibiotics more judiciously for empirical treatment, thereby reducing misuse and overuse in the community. For diabetic UTI patients in this region, nitrofurantoin may be recommended for uncomplicated cases due to low resistance in E. coli, while fosfomycin could be a viable alternative for Klebsiella-related infections. Carbapenems may be reserved for severe cases with MDR pathogens, and combination therapy could be considered for complicated infections, particularly in high-risk age groups.