bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization and topographical analysis of choroidal caverns in young and healthy individuals
Authors: Fragiotta Serena , Toto Lisa , Parravano Mariacristina , Quarta Alberto , Di Noia Michele , Sacconi Riccardo , Dobovsek Divjak Darja , Rissotto Federico , Polito Maria Sole , Costanzo Eliana , Querques Giuseppe
Published: October 2024

Purpose

To describe and clarify a possible pathogenetic origin for choroidal caverns in young healthy individuals through a topographical analysis using swept-source optical coherence tomography angiography (SS-OCTA).

Methods

A cross-sectional evaluation of 44 healthy volunteers (44 eyes), aged 20–32 years with no systemic or ocular comorbidities. The topographical analysis of choroidal caverns was performed through a 15 × 15 mm volumetric scan cube using SS-OCTA (PLEX Elite 9000). The number, topographic localization within the perifovea and midperipheral retina, as well as the density of choroidal caverns in the area with the highest number, were analyzed. Factors influencing the presence of choroidal caverns were identified using a logistic regression model.

Results

The overall prevalence of choroidal caverns was 18.2% in our cohort. The subjects exhibiting choroidal caverns presented a greater AXL (+1.19 mm, 95%CI: 0.09, 2.29). Areas with the highest density of caverns presented an average of 1.98 ± 1.01 caverns/mm2. On a qualitative evaluation, the area with the highest density was along the inferior vascular arcade in 6/8 (75%) eyes. The main predictor of choroidal cavern development was represented by AXL (adjusted risk ratio of 2.13, P = 0.02).

Conclusion

Choroidal caverns in young, healthy individuals may form due to mechanical stress in predisposed eyes, where an increased lateral and anteroposterior choroidal stretching due to globe elongation can result in the formation of these cavities. Future longitudinal studies are encouraged to understand their prognostic implications.
Subthreshold micropulse laser treatment for autosomal recessive bestrophinopathy complicated by macular neovascularization
Authors: Buonamassa Rosa , Palumbo Francesca , Boscia Giacomo , Scotti Giacomo , Ferrara Andrea , De Vitis Fabio , Pignataro Mariagrazia , Termite Alba Chiara , Landini Luca , Alessio Giovanni , Boscia Francesco , Viggiano Pasquale
Published: October 2024

Purpose

To present a case of autosomal recessive bestrophinopathy (ARB) complicated by intraretinal fluid and subretinal fluid, successfully managed with navigated subthreshold micropulse laser (SML) treatment.

Obervations

A 25-year-old female was referred to our clinic by her ophthalmologist due to a diagnosis of reduced vision in both eyes. The patient presented with a visual acuity of 0.9 logMAR in both eyes. Structural optical coherence tomography (OCT) revealed bilateral intraretinal fluid (IRF) and subretinal fluid (SRF), while OCT angiography (OCT-A) demonstrated bilateral macular neovascularization (MNV). Following the initiation of intravitreal therapy with anti-VEGF agents, administered via monthly injections for one year, we observed no improvement in visual acuity or resolution of IRF and SRF. SML treatment was administered to both eyes in the macular region. At the 3-month follow-up visit, OCT revealed complete resolution of IRF in the right eye and partial resolution of IRF in the left eye, and best-corrected visual acuity (BCVA) improved from 0.9 logMAR to 0.7 logMAR.

Conclusions and importance

In our case, SML emerges as a promising treatment modality for patients with ARB complicated by MNV who exhibit poor response to anti-VEGF therapy. However, further prospective studies with longer follow-up periods and larger cohorts are warranted to confirm the optimal treatment strategy in ARB.
Treatment with a self-expanding endoprosthesis in patients with stenosis or occlusion at the arteriovenous graft: 6-Month outcomes of a post-marketing surveillance study
Authors: Haruguchi Hiroaki , Fukasawa Mizuya , Ikeda Kiyoshi , Suemitsu Kotaro , Sato Takashi , Miyamoto Masahito , Murakami Masaaki , Nakamura Junichi , Noguchi Tomonaga , Eguchi Daihiko , Kamimura Taro , Aikawa Kiyoshi
Published: October 2024

Purpose:

To assess 6-month safety and efficacy of a self-expanding stent graft placement to treat stenotic or thrombosed synthetic arteriovenous access graft at the venous anastomoses.

Material and methods:

This prospective, multicenter, post-market surveillance study assessed the GORE® VIABAHN® Endoprosthesis (stent graft) in Japanese patients with stenotic or thrombosed vascular access grafts. Key efficacy and safety outcomes were primary patency (PP) and secondary patency (SP) of the target lesion and the vascular access circuit, repeat interventions, technical and clinical success, incidence of adverse and serious adverse events, and device deficiencies through 6 months.

Results:

The 103 enrolled patients (mean age 71.8 years; 57.3% female) had stent grafts placed in the venous anastomosis of arteriovenous access grafts (on-label). The majority of lesions were stenotic (77.1%) and located in the upper arm (91.4%). Mean lesion length was 42.9 ± 23.6 mm and diameter was 6.7 ± 1.9 mm; 28 patients (27.2%) had elephant trunk placements. Technical and clinical success rates were 100%. At 6 months, Kaplan-Meier estimates of target lesion and circuit PP were 75.1% (95% CI: 65.2, 82.6) and 66.8% (95% CI: 56.4, 75.3), and SP rates were 93.8% (95% CI: 86.7, 97.2) and 93.8% (95% CI: 86.7, 97.2), respectively. Mean cumulative number of reinterventions (0.36; 95% CI: 0.20, 0.51) and incidence of device- or procedure-related adverse events were low (⩽3%). No device deficiencies were reported.

Conclusions:

The 6-month outcomes of the self-expanding stent graft to treat thrombosed venous anastomoses of synthetic hemodialysis vascular access grafts with stenosis demonstrated safety and effectiveness.
Assessing electoral coordination: A quasi-experimental design of changes in district magnitude over time
Authors: Lago Ignacio , Martínez i Coma Ferran
Published: October 2024

This paper examines the impact of district magnitude, defined as the number of representatives elected per district, on the number of political parties. Conventional wisdom, supported by cross-national and within-country studies, indicates a positive and curvilinear relationship between district magnitude and the number of parties, with diminishing returns in larger-magnitude districts. However, this relationship is complicated by the increasing regionalization of party systems and the distinct socio-economic compositions of districts correlated with district magnitude. To address these limitations and obtain an appropriate counterfactual, we employ a quasi-experimental design using data from Spain, where district magnitude changes by only one seat in some districts and elections. Our findings align with previous research, confirming that the number of electoral parties increases with district magnitude, particularly in low-magnitude districts.
Analyzing narrative contagion through digital storytelling in social media conversations: An AI-powered computational approach
Authors: Zhao Xinyan , Ma Zexin , Ma Rong
Published: October 2024

Despite the growing popularity of digital narratives, research on digital storytelling and its spread through social media interactions remains limited. Inspired by the social contagion theory, we introduce the concept of narrative contagion—where a story shared by a person or organization prompts others to share their stories—and investigate its process and outcome in online cancer communities. Utilizing a large dataset of 849 Facebook posts, 47,291 comments, and 14,466 replies, our artificial intelligence (AI)-based computational analysis provides evidence for narrative contagion among individual users in organization-hosted cancer communities on Facebook. It also reveals different organizational message characteristics, such as emotional arousal, post topic, and request for storytelling, that affect user storytelling and emotional support in comments and replies. Our results contribute to a deeper understanding of digital storytelling and its collective dynamics in online communities.
Beyond dislike counts: How YouTube users react to the visibility of social cues
Authors: Zhang Maggie Mengqing , Ng Yee Man Margaret
Published: October 2024

This study investigates the impact of YouTube’s 2021 policy, which hides dislike counts and limits a form of negative social feedback. It examines how this change affects social media herding behavior—the tendency of users to align with the majority opinion. We adopted a mixed-method approach, incorporating an online experiment that simulates the YouTube interface and an Interrupted Time Series analysis of real-world user reactions, to assess how the policy affects user engagement. Specifically, we looked at how the absence of one-sided digital cues, combined with content characteristics and individual user predispositions, influences user behavior. Our findings suggest that YouTube’s initiative to boost platform positivity had limited success: user responses were more influenced by their ideological leanings than by visible digital cues; Hiding dislikes reduced commenting frequencies and inadvertently increased negative expression. These results highlight the stronger role of ideological beliefs over social cues in shaping engagement, challenging the presumed impact of audience conformity and the negativity bias on social media dynamics.
Transformative Learning Among Organ Procurement Organization Donor Family Volunteers
Authors: Henry Nicholas R. , Coryell Joellen E.
Published: October 2024

Introduction: Some family members who previously made the decision to donate a family member's organs support the organ procurement organization (OPO) through volunteer work. Volunteers were asked to describe their family's organ donation story to educate the general and medical communities about organ donation. This study explored the transformative learning experienced by volunteers during and following the organ donation consent process and throughout their volunteer work. Methods/Approach: A narrative inquiry research methodology and transformative learning theoretical framework was used and 6 volunteers were recruited to participate. Two semistructured virtual interviews were conducted. Interviews were transcribed, radically reduced, and subjected to holistic-content and holistic-form narrative analysis. Findings: Participants experienced strong emotional responses during and after the loss of their family member, characterized as a period of disorientation, which lasted for an extended period preventing transformative learning. After the OPO contacted participants regarding the opportunity to volunteer, participants experienced a period of self-examination when they reengaged with the topic of organ donation. Critical reflection occurred through the act of storytelling about their family's organ donation story during their volunteer work. Storytelling to the community facilitated making meaning of their loss and transformations. Conclusion: Volunteering for an OPO played an important role by initiating self-examination and critical reflection of their prior assumptions. Through storytelling, participants reflected on their roles and made meaning of their organ donation experiences. The act of inviting donor families to reengage with the topic of organ donation through volunteer work fostered positive permanent meaningful transformations.
Key Associations Found in the Struggle With Sleep in Lung Transplant Recipients
Authors: Simanovski Jane , Ralph Jody , Morrell Sherry
Published: October 2024

Introduction

Gaps exist in the understanding of the etiology of poor sleep quality after lung transplantation. Research Question: What factors are associated with poor sleep quality in lung transplant recipients?

Design

A quantitative, single-site, cross-sectional study used an anonymous survey based on 3 scales. The Pittsburgh Sleep Quality Index scale with scores dichotomized to poor versus good sleepers based on the cutoff score > 8. The Hospital Anxiety and Depression Scale evaluated symptoms of anxiety and depression, and the Short Form-12 measured health-related quality of life using the mental and physical component scores. Additional self-reported data included demographic and transplant-related variables.

Results

The response rate was 38.4% (61/158), and 52.5% of the sample (32/61) evidenced a Pittsburgh Sleep Quality Index score > 8, suggestive of poor sleep quality. Bivariate analyses demonstrated that poor sleep was significantly related to symptoms of depression ( P < .01), anxiety ( P < .01), stressors of hospitalization ( P < .05), and treatment of acute rejection ( P < .05). Multivariate analysis demonstrated that anxiety was significantly associated with poor sleep (odds ratio = 1.34, P < .05).

Conclusion

Poor subjective sleep quality remains prevalent in lung transplant recipients. Individuals with anxiety symptoms were at a greater risk for poor sleep. Guidance for strategies to improve sleep quality requires further in-depth exploration before implementation of interventions.
Few-shot bearing fault diagnosis method based on an EEMD parallel neural network and a relation network
Authors: Zhao Cunsheng , Tong Bo , Zhou Chao , Fan Qingrong
Published: October 2024

Bearing fault diagnosis presents challenges, such as insufficient fault samples and significant fault data distribution variation in different bearing operating conditions. These problems cause traditional deep learning models to show poor generality and accuracy during bearing fault diagnosis. To address these challenges, this paper proposed a few-shot bearing fault diagnosis method based on an Ensemble Empirical Mode Decomposition (EEMD) parallel neural network and a relation network (RN). First, the original bearing fault vibration signal was decomposed by EEMD, while the decomposed signal components were processed via Short Time Fourier Transfor (STFT) to obtain a two-dimensional time-frequency feature map. Then, a parallel neural network was used for initial fault feature extraction, after which the extracted features were fused to construct a more accurate multi-dimensional fault feature map. A more precise fault feature vector was generated via the feature embedding module of the RN, and the fault features of the support and query sets were stitched to create a fault feature vector set. Finally, the relation module of the RN was used for the nonlinear distance determination of the fault feature vector set and to generate the relation score for the few-shot variable condition bearing fault diagnosis. In this paper, EEMD module is introduced into RN to construct multi-dimensional fault characteristics of the original fault signal. Original signal decomposition, STFT transformation and splicing effectively improve the randomness and blindness of convolution operations, improve the accuracy of fault feature extraction in RN, and thus improve the overall diagnostic performance of the model. The experimental results showed that the proposed model obtained higher diagnostic accuracy than the matching network (MN) and RN meta-learning fault diagnosis (MLFD) methods. The accuracy of fault diagnosis of the model in 5Way-Nshot is >80%, and the accuracy of fault diagnosis in 5Way-10shot is the highest at 95.2%.
Pregnancy-associated pulmonary embolism (PA-PE): catheter-directed thrombolysis as first-line rescue
Authors: Luong Suzanne , Mak Wei-Yun , Rolnik Daniel L. , Hodges Ryan , Yang Yang , Chieng Yen , Crozier Timothy
Published: October 2024

Pregnancy-associated pulmonary embolism (PA-PE) is a life-threatening presentation however literature surrounding its optimal management is limited. This case describes a case of PA-PE treated with catheter-directed thrombolysis after clinical deterioration despite standard anticoagulation therapy. Careful multidisciplinary planning is required to successfully manage the deteriorating patient with PA-PE with catheter-directed thrombolysis being considered as potential first-line therapy in these patients.
Neurological Complications and Outcomes in Critically Ill Patients With COVID-19: Results From International Neurological Study Group From the COVID-19 Critical Care Consortium
Authors: Ahmad Syed Ameen , Mayasi Yunis , Kelly Thu-Lan , White Nicole , Suen Jacky , Battaglini Denise , Bassi Gianluigi Li , Fraser John F. , Premraj Lavien , Arora Rakesh C. , Bastos Diego , Whitman Glenn , Griffee Matthew , Fanning Jonathon P. , Robba Chiara , Cho Sung-Min ,   the COVID-19 Critical Care Consortium
Published: October 2024

Background

In this COVID-19 Critical Care Consortium (CCCC) sub-study, we qualified neurological complications associated with SARS-CoV2 infection.

Methods

The CCCC is an international, multicenter study. Eligible patients were COVID-19 patients admitted to intensive care units (ICU) across 23 centers between 1/7/2020 to 6/23/2022. Incidence of neurological complications was estimated as number of events per hospital days and per admission using Poisson regression. Associations between neurological complications and risk factors were assessed using multivariable Poisson regression.

Results

713 patients were included. Median age = 56 years (interquartile range (IQR) = 45-65). Neurological complications reported in 61/480 patients (12.7%) with the majority being ischemic stroke (2.9%), intracranial hemorrhage (ICH) (2.8%), and seizures (2.6%). Multivariable analysis for neurological complications per admitted days showed comorbid neurological conditions (incidence rate ratio (IRR) = 6.35, 2.57-15.7) were an independent risk factor for ischemic stroke. Extracorporeal membrane oxygenation (IRR = 5.32, 1.52-18.6), low-middle income countries (LMIC) vs high income countries (HIC) (IRR = 4.70, 1.62-13.7), and age >55 (IRR = 3.66, 1.23-10.9) were independent risk factors for ICH. Co-morbid neurological conditions (IRR = 3.43, 1.11-10.6), LMIC vs HIC (IRR = 8.69, 2.15-35.2), July-December 2020 vs January-June 2020 (IRR = 0.17, 0.04-0.69) and age >55 (IRR = 4.05, 1.15-14.3) were independent risk factors for seizure.

Conclusions

Decision-making should incorporate salient risk factors to inform management of SARS-CoV2 infection and avoid neurological complications.
Reproductive Health Status in India: Comparison of NFHS-IV and NFHS-V Findings
Authors: Pasa Kamal , Singh Neel Mani , Bharali Nitamoni , Hmar Tlanglawmkim , Schaschl Helmut , Baruah Tiluttoma , Adak Dipak Kumar
Published: October 2024

Background

This study investigates the disparities in reproductive health and the underlying causes in various Indian states. Based on a large-scale population-based, nationally representative data set, this study aims to track the changes between National Family Health Survey (NFHS)-IV and NFHS-V in the status of reproductive health and examine the factors contributing to it in various regions of India for women aged 15–49 years in 29 states (NFHS-IV and V).

Methods

According to claims, in India’s states’ reproductive health status is gauged by the reproductive health index (RHI). The total fertility rate, infant mortality rate, childbirth order, mother-and-child delivery care and female educational attainment rate are the five variables that make up this composite index.

Results

In NFHS-IV, India’s RHI score was 61.5, and in NFHS-V, it was 67.8. Although there has been progress in RHI, it has not been at the level that was anticipated. Eleven NFHS-IV states and eight NFHS-V states have index values below India’s RHI threshold.

Conclusion

To move the situation forward, desires for using contraception should be given more weight. The level of educational achievement of women should also be raised, as should their passionate participation in economic activity.
Exploring attachment and couple relationships in endometriosis: A pilot study
Authors: Sechi Cristina , Ahmad Monica , Rosas Ilaria , Vismara Laura
Published: October 2024

Introduction:

Endometriosis is the therapeutic and clinical complexity extends beyond its effects on the body’s organic system, with psychological and social impacts. However, studies analyzing the quality of attachment and couple adjustment, beyond the effects on sexuality and fertility, are currently lacking.

Methods:

The main objective of this study was to investigate the quality of past attachment by means of the Parental Bonding Instrument, current attachment through the Relationship Questionnaire, and the perception of couple quality and satisfaction by means of the Dyadic Adjustment Scale, in a sample of 68 women aged between 23 and 54 years.

Results:

The analysis revealed that women with endometriosis reported experiencing greater paternal and maternal control, and less paternal care compared to those in the control group. Moreover, women in the endometriosis group exhibited a higher degree of insecure attachment in adult intimate relationships when compared to the predominantly secure control group. Regarding the DAS, women with endometriosis reported lower scores than the control group.

Conclusion:

Despite the limitations of a pilot study, it provides a foundational basis for future research aiming to explore endometriosis within the context of women’s relationships. It also contributes to the planning of prevention and support programs for significant figures in women’s lives.
What Generative AI Means for the Media Industries, and Why it Matters to Study the Collective Consequences for Advertising, Journalism, and Public Relations
Authors: Guzman Andrea L. , Lewis Seth C.
Published: October 2024

How should scholars make sense of the rapid growth of generative artificial intelligence in media work? In this commentary, we argue that researchers can begin by stepping outside of their intellectual silos to see how the challenges and opportunities posed by generative AI are commonly shared across the media industries. We focus on three primary mass communication domains—advertising, journalism, and public relations—to illustrate how media professionals across these fields are adopting similar AI technologies (e.g., machine learning, natural language processing, and recommender systems) for often similar purposes (e.g., content creation, audience engagement, and business operations). Even more, the uptake of AI has profound consequences—for ethical norms as well as roles and relationships of humans and machines—that may be best understood across media industries more so than within them in isolation. Ultimately, a more cross-industry approach to scholarship could develop a more encompassing picture about AI's impact on media work and media consumption.
‘It felt very underground’: Uncovering the characteristics and meanings of the underground within Liverpool’s club culture scenes
Authors: Anderson Richard
Published: October 2024

This article examines the concept of the term underground and its association with a range of dance music parties and venues that emerged in Liverpool, UK between 2008 and 2023. Drawing on a critical review of literature relating to the term, underground is positioned as a cultural signifier exhibiting three core characteristics: (1) as secretive resistance; (2) as a countercultural antithesis to mainstream; and (3) as a social imaginary. Using ethnographic material from scene practitioner interviews (n = 35) and an online survey of clubbers (n = 194), the article analyses discourses towards the underground as a concept, and how underground characteristics influence scene cultural practices. The findings reveal participants’ use of the term as a descriptor of experiential feelings within temporal spaces. Drawing on the work of Gopaldas, these feelings as situated as sentiments which inform the shared intentions and practices within a local dance music scene.
Pulmonary hypertension associated with lung diseases
Authors: Shlobin Oksana A. , Adir Yochai , Barbera Joan A. , Cottin Vincent , Harari Sergio , Jutant Etienne-Marie , Pepke-Zaba Joanna , Ghofrani Hossein-Ardeschir , Channick Richard
Published: October 2024

Pulmonary hypertension (PH) associated with chronic lung disease (CLD) is both common and underrecognised. The presence of PH in the setting of lung disease has been consistently shown to be associated with worse outcomes. Recent epidemiological studies have advanced understanding of the heterogeneity of this patient population and shown that defining both the specific type of CLD as well as the severity of PH (
i.e.
deeper phenotyping) is necessary to inform natural history and prognosis. A systematic diagnostic approach to screening and confirmation of suspected PH in CLD is recommended. Numerous uncontrolled studies and one phase 3 randomised, controlled trial have suggested a benefit in treating PH in some patients with CLD, specifically those with fibrotic interstitial lung disease (ILD). However, other studies in diseases such as COPD-PH showed adverse outcomes with some therapies. Given the expanding list of approved pharmacological treatments for pulmonary arterial hypertension, developing a treatment algorithm for specific phenotypes of CLD-PH is required. This article will summarise existing data in COPD, ILD and other chronic lung diseases, and provide recommendations for classification of CLD-PH and approach to the diagnosis and management of these challenging patients.
Pulmonary capillary recruitment and distention in mammalian lungs: species similarities
Authors: Langleben David , Fox Benjamin D. , Orfanos Stylianos E. , Giovinazzo Michele , Catravas John D.
Published: October 2024

Pulmonary arterial pressure rises minimally during exercise. The pulmonary microcirculation accommodates increasing blood flowviarecruitment of pulmonary capillaries and, at higher flows, by distention of already perfused capillaries. The flow transition range between recruitment and distention has not been studied or compared across mammalian species, including humans. We hypothesised that the range would be similar. Functional pulmonary capillary surface area (FCSA) can be estimated using validated metabolic techniques. We reviewed data from previous studies in three mammalian species (perfused rabbit lungs and dog lung lobes, and exercising humans) and generated blood flow–FCSA curves over a range of flows. We noted where the curves diverged from the theoretical line of pure recruitment (Recruitment) and determined the flow where the curve slope equalled 50% that of Recruitment, or equalled that of a theoretical curve representing full capillary distention (Distention). The three mammalian species have similar flow ranges for the transition from predominantly recruitment to predominantly distention, with dogs having the highest transition point. Within the physiological range of most daily activity, the species are similar and accommodate increasing blood flow mainlyviarecruitment, with progressive distention at higher flows. This is highly relevant to pulmonary physiology during exercise.
A systematic review of sample size estimation accuracy on power in malaria cluster randomised trials measuring epidemiological outcomes
Authors: Biggs Joseph , Challenger Joseph D. , Hellewell Joel , Churcher Thomas S. , Cook Jackie
Published: October 2024

Introduction

Cluster randomised trials (CRTs) are the gold standard for measuring the community-wide impacts of malaria control tools. CRTs rely on well-defined sample size estimations to detect statistically significant effects of trialled interventions, however these are often predicted poorly by triallists. Here, we review the accuracy of predicted parameters used in sample size calculations for malaria CRTs with epidemiological outcomes.

Methods

We searched for published malaria CRTs using four online databases in March 2022. Eligible trials included those with malaria-specific epidemiological outcomes which randomised at least six geographical clusters to study arms. Predicted and observed sample size parameters were extracted by reviewers for each trial. Pair-wise Spearman’s correlation coefficients (rs) were calculated to assess the correlation between predicted and observed control-arm outcome measures and effect sizes (relative percentage reductions) between arms. Among trials which retrospectively calculated an estimate of heterogeneity in cluster outcomes, we recalculated study power according to observed trial estimates.

Results

Of the 1889 records identified and screened, 108 articles were eligible and comprised of 71 malaria CRTs. Among 91.5% (65/71) of trials that included sample size calculations, most estimated cluster heterogeneity using the coefficient of variation (k) (80%, 52/65) which were often predicted without using prior data (67.7%, 44/65). Predicted control-arm prevalence moderately correlated with observed control-arm prevalence (rs: 0.44, [95%CI: 0.12,0.68], p-value < 0.05], with 61.2% (19/31) of prevalence estimates overestimated. Among the minority of trials that retrospectively calculated cluster heterogeneity (20%, 13/65), empirical values contrasted with those used in sample size estimations and often compromised study power. Observed effect sizes were often smaller than had been predicted at the sample size stage (72.9%, 51/70) and were typically higher in the first, compared to the second, year of trials. Overall, effect sizes achieved by malaria interventions tested in trials decreased between 1995 and 2021.

Conclusions

Study findings reveal sample size parameters in malaria CRTs were often inaccurate and resulted in underpowered studies. Future trials must strive to obtain more representative epidemiological sample size inputs to ensure interventions against malaria are adequately evaluated.

Registration

This review is registered with PROSPERO (CRD42022315741).
An estimate of burnout prevalence among oncology nurses
Authors: Helaß Madeleine , Maatouk Imad
Published: October 2024

Background

Registered nurses (RNs) in oncology must cope with the suffering of patients, the inevitability of death and their own transience. This poses a possible risk for the development of burnout, which can result in low job satisfaction and ultimately an increased intention to leave the job. Our aim was to assess psychological distress in registered nurses working in oncology.

Objective and method

A cross-sectional survey with the Oldenburger Burnout Inventory was presented to nurses within the German Cancer Society. It collected data on psychological distress via two subscales, exhaustion and disengagement. Socio-demographic data were assessed.

Results

Among 83 participating nurses, we found a prevalence of high disengagement in 17 oncology nurses (20.48%) and high exhaustion (MExh>2.5 = burnout) in 44 (53.00%). Looking at the highest values of both scales, 18.08% of respondents were at high risk for psychological distress. There was a low correlation between disengagement and age (r = 0.331, p < 0.01). The risk of high disengagement among nurses older than 50 (n = 9, 52.94%) was three times higher than for those who were 50 or younger (n = 8, 47.06%) (RR = 8.642, 95% CI: 1.475–5.749, p < 0,01).

Conclusion

This survey highlights a high rate of burnout among German oncology nurses. Interventions should be developed, implemented, and delivered in an age-appropriate manner. To ensure high-quality care and patient safety, oncology nurses should be offered preventive mental healthcare services later in their careers.

Clinical trial registration number

The study was registered with the German Clinical Trials Register (DRKS500018851).
Isolation and characterization of Streptococcus agalactiae inducing mass mortalities in cultured Nile tilapia (Oreochromis niloticus) with trials for disease control using zinc oxide nanoparticles and ethanolic leaf extracts of some medicinal plants
Authors: Abdallah Ebtsam Sayed Hassan , Metwally Walaa Gomaa Mohamed , Bayoumi Soad Abdel Latief Hassan , Abdel Rahman Moataz Ahmed Mohamed , Mahmoud Mahmoud Mostafa
Published: October 2024

Background

Streptococcus agalactiae (Group B streptococcus, GBS) induces a serious infection that can harm not only aquatic life but also humans and other animals. In a fish farm in southern Egypt, Nile tilapia (Oreochromis niloticus) has developed an epidemic with clinical symptoms resembling piscine streptococcosis.

Results

Initial microscopic inspection of the affected fish brain and kidney indicated the presence of Gram-positive cocci. S. agalactiae was effectively isolated and identified using nucleotide homology of the 16S rRNA and species-specific PCR. The partial 16S rRNA sequence was deposited in the GenBank database at the NCBI and given the accession number MW599202. Genotyping using RAPD analysis indicated that the isolates in the present study belonged to the same genotypes and had the same origin. The challenge test, via immersion (9.2 × 107, 9.2 × 106, and 9.2 × 105 CFU/ml for 1 h) or intraperitoneal injection (4.6 × 107, 4.6 × 106, and 4.6 × 105 CFU/fish), elicited clinical symptoms resembling those of naturally infected fish with a mortality rate as high as 80%. The ability to create a biofilm as one of the pathogen virulence factors was verified. Zinc oxide nanoparticles and the ethanolic leaf extracts of nine medicinal plants demonstrated considerable antibacterial activities against the tested S. agalactiae strain with low minimum bactericidal concentrations (MBC) and minimum inhibitory concentrations (MIC). The ethanolic leaf extracts from Lantana camara and Aberia caffra showed potent antibacterial activity with MBC values of 0.24 and 0.485 mg/ml, and MIC values of 0.12 & 0.24 mg/ml, respectively.

Conclusion

This study isolated S. agalactiae from O. niloticus mortalities in a fish farm in Assiut, Egypt. The pathogen persists in fish environments and can escape through biofilm formation, suggesting it cannot be easily eliminated. However, promising findings were obtained with in vitro control employing zinc oxide nanoparticles and medicinal plant extracts. Nevertheless further in vivo research is needed.
Will mpox disease caused by the human Mpox virus (MPXV) result in a pandemic-like situation similar to the COVID-19 pandemic
Authors: Kandi Venkataramana
Published: October 2024

The threat of the emergence of potential pandemics in the future has been looming ever since the world witnessed the worst-ever public health catastrophe following the coronavirus disease 2019 (COVID-19) pandemic caused by the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The COVID-19 pandemic affected billions of people killing millions of people throughout the world. Now, we have been noticing an alarming rise in the cases of mpox disease caused by Mpox virus (MPXV). Although discovered in 1958, mpox was largely confined to monkeys before causing the first human infection in 1970. The MPXV is demonstrating a complex transmission behavior as noted by its discovery first in Denmark in monkeys imported from Singapore (Asia) and later spreading to humans causing repeated re-emergence. The virus was confined to the African nations including the Democratic Republic of Congo (DRC) before reemerging in the United States of America in 2003 affecting several people who had a history of contact with animals. Following scattered reports from endemic regions, the virus appears to have remerged after approximately two decades in 2022 involving the United States of America (USA) and European countries. The virus has been spreading across the globe as evidenced by its discovery in 60 countries in 2022 to more than 120 countries in the current year. It is therefore essential to improve the understanding of the MPXV, its epidemiology, pathogenicity and virulence, clinical features, and control and preventive measures and increase preparedness to efficiently tackle any future public health emergency.
PSAT1 is upregulated by METTL3 to attenuate high glucose-induced retinal pigment epithelial cell apoptosis and oxidative stress
Authors: Du Xiaofeng , Wang Yanting , Gao Fan
Published: October 2024

Background

Diabetic retinopathy (DR) is a major ocular complication of diabetes mellitus, and a significant cause of visual impairment and blindness in adults. Phosphoserine aminotransferase 1 (PSAT1) is an enzyme participating in serine synthesis, which might improve insulin signaling and insulin sensitivity. Furthermore, it has been reported that the m6A methylation in mRNA controls gene expression under many physiological and pathological conditions. Nevertheless, the influences of m6A methylation on PSAT1 expression and DR progression at the molecular level have not been reported.

Methods

High-glucose (HG) was used to treat human retinal pigment epithelial cells (ARPE-19) to construct a cell injury model. PSAT1 and Methyltransferase-like 3 (METTL3) levels were detected by real-time quantitative polymerase chain reaction (RT-qPCR). PSAT1, B-cell lymphoma-2 (Bcl-2), Bcl-2 related X protein (Bax), and METTL3 protein levels were examined by western blot assay. Cell viability and apoptosis were detected by Cell Counting Kit-8 (CCK-8) and TUNEL assays. Reactive oxygen species (ROS), malondialdehyde (MDA), and Glutathione peroxidase (GSH-Px) levels were examined using special assay kits. Interaction between METTL3 and PSAT1 was verified using methylated RNA immunoprecipitation (MeRIP) and dual-luciferase reporter assay.

Results

PSAT1 and METTL3 levels were decreased in DR patients and HG-treated ARPE-19 cells. Upregulation of PSAT1 might attenuate HG-induced cell viability inhibition and apoptosis and oxidative stress promotion in ARPE-19 cells. Moreover, PSAT1 was identified as a downstream target of METTL3-mediated m6A modification. METTL3 might improve the stability of PSAT1 mRNA via m6A methylation.

Conclusion

METTL3 might mitigate HG-induced ARPE-19 cell damage partly by regulating the stability of PSAT1 mRNA, providing a promising therapeutic target for DR.
Predictors for prolonged and escalated perioperative antibiotic therapy after microvascular head and neck reconstruction: a comprehensive analysis of 446 cases
Authors: Schuderer Johannes G. , Hoferer Florian , Eichberger Jonas , Fiedler Mathias , Gessner André , Hitzenbichler Florian , Gottsauner Maximilian , Maurer Michael , Meier Johannes K. , Reichert Torsten E. , Ettl Tobias
Published: October 2024

Literature suggests that intravenous prophylaxis exceeding 48 h offers no additional benefit in preventing surgical site infections (SSI) in patients with microvascular head and neck reconstruction. However, protocols for antibiotic therapy duration post-reconstruction are not standardized. This study identifies factors predicting prolonged intravenous antibiotic use and antibiotic escalation in patients receiving free flap head neck reconstruction.

A retrospective analysis of 446 patients receiving free flap reconstruction was conducted, examining predictors for antibiotic therapy > 10 days and postoperative escalation. 111 patients (24.8%) experienced escalation, while 159 patients (35.6%) received prolonged therapy. Multivariate regression analysis revealed predictors for escalation: microvascular bone reconstruction (p = 0.008, OR = 2.0), clinically suspected SSI (p < 0.001, OR = 5.4), culture-positive SSI (p = 0.03, OR = 2.9), extended ICU stay (p = 0.01, OR = 1.1) and hospital-acquired pneumonia (p = 0.01, OR = 5.9). Prolonged therapy was associated with bone reconstruction (p = 0.06, OR = 2.0), preoperative irradiation (p = 0.001, OR = 1.9) and culture-positive SSI (p < 0.001, OR = 3.5).

The study concludes that SSIs are a primary factor driving the escalation of perioperative antibiotic use. Clinical suspicion of infection often necessitates escalation, even in the absence of confirmed microbiological evidence. Microvascular bone reconstruction was a significant predictor for both the escalation and extension of antibiotic therapy beyond 10 days. Furthermore, preoperative radiation therapy, hospital-acquired pneumonia, and prolonged ICU stay were associated with an increased likelihood of escalation, resulting in significantly extended antibiotic administration during hospitalization. Antibiotic stewardship programmes must be implemented to reduce postoperative antibiotic administration time.

Trial registration The study was registered approved by the local Ethics Committee (Nr: 18-1131-104).
A series of cases of transthyretin amyloid cardiomyopathy with negative bone scintigraphy but a confirmed positive endomyocardial biopsy
Authors: Fraix Antoine , Itti Emmanuel , Zaroui Amira , Kharoubi Mounira , Poullot Elsa , Lerman Lionel , Guendouz Soulef , Huttin Olivier , Damy Thibaud , Galat Arnault
Published: October 2024

Background

Bone scintigraphy (BS) is established as an accurate, non-invasive method for the diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM). In a real-life setting, however, some patients with no cardiac uptake on BS turn out to have cardiac-biopsy-confirmed ATTR-CM. We retrospectively included all patients diagnosed at the French Referral Center for ATTR-CM and who had data for BS and a cardiac biopsy.

Results

Of 271 patients with positive cardiac biopsy, 14 (5%) had no cardiac uptake on 99mTc-hydroxymethylene diphosphonate BS. Cardiac uptake was found in four of the seven patients who had a second BS assessment with 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD). A retrospective review of the BS data found low cardiac uptake in four patients (two with HMDP and two with both radiotracers). Ultimately, six of the 14 patients with a biopsy-confirmed diagnosis of ATTR-CM did not show any cardiac radiotracer uptake.

Conclusions

An endomyocardial biopsy may be necessary for confirming the diagnosis of ATTR-CM in patients with clinical and imaging signs of cardiac amyloidosis but no cardiac radiotracer uptake in BS.
Comparison of 75 mg versus 150 mg aspirin for the prevention of preterm preeclampsia in high-risk women at a tertiary level hospital: study protocol for a randomized double-blind clinical trial
Authors: Saxena Upma , Lachyan Abhishek , Goyal Chanchal , Kapoor Garima , Agarwal Kavita , Prasad Sidarrth
Published: October 2024

Background

Hypertensive disorders of pregnancy (HDP) pose significant risks to maternal and fetal health, with substantial mortality and morbidity rates globally, particularly in developing countries. Pre-eclampsia (PE) accounts for a notable portion of maternal morbidity and mortality, with varied prevalence across regions within countries like India. Despite advancements, disparities in healthcare access persist, influencing outcomes. PE not only affects maternal health during pregnancy but also predisposes women to long-term cardiovascular complications, emphasizing the need for early screening and preventive measures.

Methods

This prospective randomized double-blind clinical trial aims to compare the efficacy and safety of 75 mg versus 150 mg aspirin for preventing preterm pre-eclampsia in high-risk women. Screen-positive women aged 18–45 years with singleton pregnancies between 12 and 16 weeks of gestational age will be enrolled. They will be randomized in a 1:1 ratio to receive either 75 mg or 150 mg of aspirin nightly until 37 weeks of pregnancy or earlier if preterm pre-eclampsia develops. Feto-maternal outcomes, including preterm pre-eclampsia incidence and neonatal and maternal complications, will be assessed. The sample size calculation based on expected proportions of preterm pre-eclampsia in both groups indicates a total of 370 participants (185 per group) accounting for 20% attrition.

Discussion

This prospective randomized double-blind clinical trial aims to compare the effectiveness and safety of two doses of aspirin (75 mg vs 150 mg) in preventing preterm pre-eclampsia in high-risk women. The potential implications of this study are significant, including the optimization of aspirin prophylaxis, the development of evidence-based guidelines, and comprehensive assessment of maternal and fetal outcomes. In conclusion, the results of this study have the potential to significantly impact clinical practice by enhancing maternal and perinatal health outcomes and contributing to evidence-based obstetric care.

Trial registration

Clinical Trials Registry-India CTRI/2023/12/060983. Trial was registered prospectively on 29 December 2023. Acknowledgement Number REF/2023/12/076358. https://acrobat.adobe.com/id/urn:aaid:sc:AP:15870322-f1f4-4460-900c-6e056ab83a44.
Engineered reduction of S-adenosylmethionine alters lignin in sorghum
Authors: Tian Yang , Gao Yu , Turumtay Halbay , Turumtay Emine Akyuz , Chai Yen Ning , Choudhary Hemant , Park Joon-Hyun , Wu Chuan-Yin , De Ben Christopher M. , Dalton Jutta , Louie Katherine B. , Harwood Thomas , Chin Dylan , Vuu Khanh M. , Bowen Benjamin P. , Shih Patrick M. , Baidoo Edward E. K. , Northen Trent R. , Simmons Blake A. , Hutmacher Robert , Atim Jackie , Putnam Daniel H. , Scown Corinne D. , Mortimer Jenny C. , Scheller Henrik V. , Eudes Aymerick
Published: October 2024

Background

Lignin is an aromatic polymer deposited in secondary cell walls of higher plants to provide strength, rigidity, and hydrophobicity to vascular tissues. Due to its interconnections with cell wall polysaccharides, lignin plays important roles during plant growth and defense, but also has a negative impact on industrial processes aimed at obtaining monosaccharides from plant biomass. Engineering lignin offers a solution to this issue. For example, previous work showed that heterologous expression of a coliphage S-adenosylmethionine hydrolase (AdoMetase) was an effective approach to reduce lignin in the model plant Arabidopsis. The efficacy of this engineering strategy remains to be evaluated in bioenergy crops.

Results

We studied the impact of expressing AdoMetase on lignin synthesis in sorghum (Sorghum bicolor L. Moench). Lignin content, monomer composition, and size, as well as biomass saccharification efficiency were determined in transgenic sorghum lines. The transcriptome and metabolome were analyzed in stems at three developmental stages. Plant growth and biomass composition was further evaluated under field conditions. Results evidenced that lignin was reduced by 18% in the best transgenic line, presumably due to reduced activity of the S-adenosylmethionine-dependent O-methyltransferases involved in lignin synthesis. The modified sorghum features altered lignin monomer composition and increased lignin molecular weights. The degree of methylation of glucuronic acid on xylan was reduced. These changes enabled a ~20% increase in glucose yield after biomass pretreatment and saccharification compared to wild type. RNA-seq and untargeted metabolomic analyses evidenced some pleiotropic effects associated with AdoMetase expression. The transgenic sorghum showed developmental delay and reduced biomass yields at harvest, especially under field growing conditions.

Conclusions

The expression of AdoMetase represents an effective lignin engineering approach in sorghum. However, considering that this strategy potentially impacts multiple S-adenosylmethionine-dependent methyltransferases, adequate promoters for fine-tuning AdoMetase expression will be needed to mitigate yield penalty.