bluuebunny/crossref_metadata_2025 huggingface dataset:
Pandemic and Older Adults’ Social Structure of Shared Time
Authors: Chen Jen-Hao
Published: October 2023

Objectives

Shared time with family and friends is crucial for older adults’ health and well-being. This study examines how a public health crisis affects older adults’ social connectedness through their shared time with known persons.

Methods

The study used data from the 2019–2020 American Time Use Survey (N = 9,697) to assess older adults’ (aged 50+) social structure of shared time before and during the coronavirus disease 2019 pandemic. Logistic regression and hurdle model with state-fixed effects were used to estimate the relationships between state-level pandemic severity and measures of older adults’ shared time while controlling for sociodemographic characteristics.

Results

There were small, statistically significant effects of pandemic severity on older adults’ shared time. State-level incidence rates and policy stringency indexes were correlated with a lower likelihood of, and a decline in, older adults’ shared time in public places and interactions with individuals outside their immediate family. State policy stringency was associated with more shared time in immediate family interactions. Furthermore, pandemic severity was not associated with a decrease in likelihood and older adults’ shared time with nonresident immediate family. Policy stringency was more consequential than the incidence rate for older adults’ social structure of shared time during the pandemic.

Discussion

Results indicate a place-based and role-based restructuring of older adults’ daily shared time during the pandemic. Despite small effect sizes, the substantial old age population implies significant changes in shared time and patterns of daily connection at the population level. Theoretical and policy implications of the findings are discussed.
metaGOflow: a workflow for the analysis of marine Genomic Observatories shotgun metagenomics data
Authors: Zafeiropoulos Haris , Beracochea Martin , Ninidakis Stelios , Exter Katrina , Potirakis Antonis , De Moro Gianluca , Richardson Lorna , Corre Erwan , Machado João , Pafilis Evangelos , Kotoulas Georgios , Santi Ioulia , Finn Robert D , Cox Cymon J , Pavloudi Christina
Published: October 2023

Background

Genomic Observatories (GOs) are sites of long-term scientific study that undertake regular assessments of the genomic biodiversity. The European Marine Omics Biodiversity Observation Network (EMO BON) is a network of GOs that conduct regular biological community samplings to generate environmental and metagenomic data of microbial communities from designated marine stations around Europe. The development of an effective workflow is essential for the analysis of the EMO BON metagenomic data in a timely and reproducible manner.

Findings

Based on the established MGnify resource, we developed metaGOflow. metaGOflow supports the fast inference of taxonomic profiles from GO-derived data based on ribosomal RNA genes and their functional annotation using the raw reads. Thanks to the Research Object Crate packaging, relevant metadata about the sample under study, and the details of the bioinformatics analysis it has been subjected to, are inherited to the data product while its modular implementation allows running the workflow partially. The analysis of 2 EMO BON samples and 1 Tara Oceans sample was performed as a use case.

Conclusions

metaGOflow is an efficient and robust workflow that scales to the needs of projects producing big metagenomic data such as EMO BON. It highlights how containerization technologies along with modern workflow languages and metadata package approaches can support the needs of researchers when dealing with ever-increasing volumes of biological data. Despite being initially oriented to address the needs of EMO BON, metaGOflow is a flexible and easy-to-use workflow that can be broadly used for one-sample-at-a-time analysis of shotgun metagenomics data.
‘An inferior technician’? African American signallers in the First World War
Authors: Hall Brian N
Published: October 2023

In the literature on the struggles of African Americans during the First World War, there has been a failure to examine the experiences of the 325th Field Signal Battalion, the first Black signal unit in the U.S. Army. Drawing upon a range of archival sources, unpublished letters, official documents and newspapers, this article assesses the experiences of the battalion’s Black officers and men before, during and after the war, arguing that they defied not only traditional notions of specialism within the army, threatening to destabilize unambiguous racial boundaries by challenging what had long been viewed as an intrinsically white soldiers’ sphere of influence, but also some of the fundamental principles underpinning Jim Crow ideology. In so doing, they made an important, albeit subtle, contribution to the ‘long civil rights movement’.
The contribution of the parliamentary press to Oliver Cromwell’s image as a military hero of the first English Civil War
Authors: Macadam Joyce
Published: October 2023

This article examines the parliamentary press’s role in promoting Oliver Cromwell’s heroic image during the first civil war, a topic that has received relatively little scholarly attention. Based on a detailed study of contemporary pamphlets and newsbooks, it suggests three phases of press coverage that correspond to the conflict’s campaigning seasons. It shows that Cromwell’s image in print was greatly assisted by his close relationship with the Independent leadership at Westminster, and their expertise in the manipulation of the press. For them, Cromwell’s successes in the field were essential for securing victory. His military reputation, initially nurtured by the civil war press, laid the foundations for his eventual role as lord protector.
Black American women’s attitudes toward seeking mental health services and use of mobile technology to support the management of anxiety
Authors: McCall Terika , Foster Meagan , Tomlin Holly R , Schwartz Todd A
Published: October 2023

Objectives

This study aimed to understand Black American women’s attitudes toward seeking mental health services and using mobile technology to receive support for managing anxiety.

Methods

A self-administered web-based questionnaire was launched in October 2019 and closed in January 2020. Women who identified as Black/African American were eligible to participate. The survey consisted of approximately 70 questions and covered topics such as, attitudes toward seeking professional psychological help, acceptability of using a mobile phone to receive mental health care, and screening for anxiety.

Results

The findings of the study (N = 395) showed that younger Black women were more likely to have greater severity of anxiety than their older counterparts. Respondents were most comfortable with the use of a voice call or video call to communicate with a professional to receive support to manage anxiety in comparison to text messaging or mobile app. Younger age, higher income, and greater scores for psychological openness and help-seeking propensity increased odds of indicating agreement with using mobile technology to communicate with a professional. Black women in the Southern region of the United States had twice the odds of agreeing to the use of mobile apps than women in the Midwest and Northeast regions.

Discussion

Black American women, in general, have favorable views toward the use of mobile technology to receive support to manage anxiety.

Conclusion

Preferences and cultural appropriateness of resources should be assessed on an individual basis to increase likelihood of adoption and engagement with digital mental health interventions for management of anxiety.
Determination of the optimal dietary zinc content for pigs between 10 and 30 kg body weight
Authors: Hansen Sally Veronika , Graffagnino Aurégane , Hedemann Mette Skou , Nielsen Tina Skau , Woyengo Tofuko Awori
Published: October 2023

The Zn requirement of pigs immediately after weaning is more investigated compared to the Zn requirement in the growth period between 10 and 30 kg. Unabsorbed and excessive dietary Zn is excreted mainly through feces, and spreading pig slurry to fields can cause environmental issues because high levels of Zn can impair plant growth and contribute to the development of antimicrobial resistance genes in microorganisms. Therefore, more precise knowledge of Zn requirements and dietary Zn recommendations is important. The present study investigated the optimal dietary Zn content for 10- to 30-kg pigs. The study used 150 pigs weaned at 28 d of age (day 0) and supplied with 1,474 mg dietary Zn/kg the first 2 wk post-weaning. After 2 wk, pigs were randomly distributed according to body weight (BW; 10.1 ± 0.3 kg) and sex, to individually housing, and fed a diet supplemented with either 0, 30, 60, 120, or 240 mg Zn/kg (from ZnO), resulting in total dietary Zn contents of 80, 92, 117, 189, and 318 mg/kg until week 6 post-weaning. BW, feed intake, and fecal scores were recorded, and samples of blood (weeks 2, 3, 5, and 6) and tissues (week 6) were collected. The feed intake, growth, feed efficiency, relative weight of the pancreas and liver, Zn concentration in the liver, and pancreatic digestive enzyme activity were unaffected by dietary Zn content (P > 0.12). The serum Zn level decreased (P < 0.01) by up to 24% from weeks 2 to 3. The serum Zn concentrations in weeks 5 and 6 were similar to in week 2 when 117, 189, and 318 mg Zn/kg were provided, while with 80 and 92 mg Zn/kg the serum Zn concentration was lower (P < 0.01) than in week 2. The serum Zn concentration reached a plateau in weeks 5 and 6, and breakpoints were calculated at 126 ± 17 and 102 ± 6 mg Zn/kg, respectively. Bone Zn status was greater (P < 0.01) with 189 than 80 mg Zn/kg and a breakpoint was calculated at 137 ± 19 mg Zn/kg. According to performance, the Zn requirement for 10- to 30-kg pigs can be fulfilled with 80 mg total Zn/kg, but based on serum and bone Zn status, the optimal total dietary Zn content is 102 to 137 mg/kg. The latter corresponds to a daily Zn intake (requirement) of 103 to 138 mg when calculated from the average feed intake during weeks 3 to 6 (1,005 g/d). Importantly, the presented results are obtained in pigs supplied with 1,474 mg Zn/kg from ZnO the first 2 wk post-weaning and a high level of phytase (1,000 phytase units) in the diet throughout the experiment.
Sand cat arithmetic optimization algorithm for global optimization engineering design problems
Authors: Chen Shuilin , Zheng Jianguo
Published: October 2023

Sand cat swarm optimization (SCSO) is a recently introduced popular swarm intelligence metaheuristic algorithm, which has two significant limitations – low convergence accuracy and the tendency to get stuck in local optima. To alleviate these issues, this paper proposes an improved SCSO based on the arithmetic optimization algorithm (AOA), the refracted opposition-based learning and crisscross strategy, called the sand cat arithmetic optimization algorithm (SC-AOA), which introduced AOA to balance the exploration and exploitation and reduce the possibility of falling into the local optimum, used crisscross strategy to enhance convergence accuracy. The effectiveness of SC-AOA is benchmarked on 10 benchmark functions, CEC 2014, CEC 2017, CEC 2022, and eight engineering problems. The results show that the SC-AOA has a competitive performance.
Mechanistic aspects of IPTG (isopropylthio-β-galactoside) transport across the cytoplasmic membrane of Escherichia coli—a rate limiting step in the induction of recombinant protein expression
Authors: Simas Rodrigo G , Pessoa Junior Adalberto , Long Paul F
Published: October 2023

Coupling transcription of a cloned gene to the lac operon with induction by isopropylthio-β-galactoside (IPTG) has been a favoured approach for recombinant protein expression using Escherichia coli as a heterologous host for more than six decades. Despite a wealth of experimental data gleaned over this period, a quantitative relationship between extracellular IPTG concentration and consequent levels of recombinant protein expression remains surprisingly elusive across a broad spectrum of experimental conditions. This is because gene expression under lac operon regulation is tightly correlated with intracellular IPTG concentration due to allosteric regulation of the lac repressor protein (lacY). An in-silico mathematical model established that uptake of IPTG across the cytoplasmic membrane of E. coli by simple diffusion was negligible. Conversely, lacY mediated active transport was a rapid process, taking only some seconds for internal and external IPTG concentrations to equalize. Optimizing kcat and KM parameters by targeted mutation of the galactoside binding site in lacY could be a future strategy to improve the performance of recombinant protein expression. For example, if kcat were reduced whilst KM was increased, active transport of IPTG across the cytoplasmic membrane would be reduced, thereby lessening the metabolic burden on the cell and expediating accumulation of recombinant protein. The computational model described herein is made freely available and is amenable to optimize recombinant protein expression in other heterologous hosts.

One-Sentence Summary

A computational model made freely available to optimize recombinant protein expression in Escherichia coli other heterologous hosts.
High-grade appendiceal mucinous neoplasm presenting as renal colic; a case report and review of literature
Authors: Amir Baraa , Amir Amaar , Sheikh Salwa
Published: October 2023

High-grade appendiceal mucinous neoplasms (HAMN) are rare mucinous appendiceal tumors that are mostly incidentally discovered and histologically show marked cytoplasmic atypia. We report a 62-year-old female patient who was diagnosed with acute right flank pain mimicking renal colic. Abdominal and pelvis CT scans showed no calculi or hydronephrosis. Incidentally, a markedly distended retrocecal appendix was identified and an appendectomy was performed. Histopathology revealed an HAMN of size 5.8 cm. HAMN are one of the rare and somewhat recently described epithelial appendiceal tumors. The latest 2019 classification is based on histologic appearance and on the consensus for classification and pathologic reporting of Pseudomyxoma peritonei and associated appendiceal neoplasia (Peritoneal Surface Pathology Group International, modified Delphi process). Histologically, appendiceal mucinous lesions are classified as nonneoplastic/mucocele and neoplastic lesions with separate subcategorization. Despite its rarity, it is crucial for clinicians to be aware of HAMN to distinguish it from other clinical differentials.
Delayed presentation of isolated grade III pancreatic injury—a case report
Authors: Ferreira Maria João , Gallardo Gabriel , Vigia Emanuel , Filipe Edite , Marques Hugo Pinto
Published: October 2023

Because of their vague and subtle indications and symptoms, pancreatic injuries are frequently misdiagnosed. It’s crucial to have a high level of clinical suspicion. The presence of other organ solid lesions and vascular injuries, as well as the patient’s hemodynamic condition, will determine how these injuries are treated. A surgical approach is mandatory when a ductal disruption occurs. The case of a 32-year-old man who experienced an upper abdominal blunt trauma is presented. He was admitted to our hospital with an acute abdomen 48 hours later. A complete transection of the major pancreatic duct was discovered during surgical investigation, and a distal pancreatectomy with en bloc splenectomy was performed. Even in a delayed context, distal pancreatectomy can be safely performed and is the best option.
Avoidance of offshore wind farms by Sandwich Terns increases with turbine density
Authors: van Bemmelen Rob S A , Leemans Jacco J , Collier Mark P , Green Ros M W , Middelveld Robert P , Thaxter Chris B , Fijn Ruben C
Published: October 2023

The expanding use of wind farms as a source of renewable energy can impact bird populations due to collisions and other factors. Globally, seabirds are one of the avian taxonomic groups most threatened by anthropogenic disturbance; adequately assessing the potential impact of offshore wind farms (OWFs) is important for developing strategies to avoid or minimize harm to their populations. We estimated avoidance rates of OWFs—the degree to which birds show reduced utilization of OWF areas—by Sandwich Terns (Thalasseus sandvicensis) at 2 breeding colonies in western Europe: Scolt Head (United Kingdom) and De Putten (the Netherlands). The foraging ranges of birds from each colony overlapped with multiple OWFs. We modeled GPS tracking data using integrated step selection functions (iSSFs) to estimate the relative selection of habitats at the scale of time between successive GPS relocations—in our case, 10 min, in which Sandwich Terns traveled ~2 km on average. Besides the effects of OWFs and the direct surroundings of OWFs, iSSFs considered distance from the colony and habitat characteristics (water depth and sediment grain size) as well as movement characteristics. Macro-avoidance rates, where 1 means complete avoidance, were estimated at 0.54 (95% CI: 0.35, 0.7) for birds originating from Scolt Head and 0.41 (95% CI: 0.21, 0.56) for those from De Putten. Estimates for individual OWFs also indicated avoidance but were associated with considerable uncertainty. Our results were inconclusive with regard to the behavioral response to the areas directly surrounding OWFs (within 1.5 km); estimates suggested indifference and avoidance, and were associated with large uncertainty. Avoidance rate of OWFs significantly increased with turbine density, suggesting that OWF design may help to reduce the impact of OWFs on Sandwich Terns. The partial avoidance of OWFs by Sandwich Terns implies that the species will experience risks of collision and habitat loss due to OWFs constructed within their foraging ranges.
Characterizing the breakpoint of stomatal response to vapor pressure deficit in an angiosperm
Authors: Binstock Benjamin R , Manandhar Anju , McAdam Scott A M
Published: October 2023

Vapor pressure difference between the leaf and atmosphere (VPD) is the most important regulator of daytime transpiration, yet the mechanism driving stomatal responses to an increase in VPD in angiosperms remains unresolved. Here, we sought to characterize the mechanism driving stomatal closure at high VPD in an angiosperm species, particularly testing whether abscisic acid (ABA) biosynthesis could explain the observation of a trigger point for stomatal sensitivity to an increase in VPD. We tracked leaf gas exchange and modeled leaf water potential (Ψl) in leaves exposed to a range of step-increases in VPD in the herbaceous species Senecio minimus Poir. (Asteraceae). We found that mild increases in VPD in this species did not induce stomatal closure because modeled Ψl did not decline below a threshold close to turgor loss point (Ψtlp), but when leaves were exposed to a large increase in VPD, stomata closed as modeled Ψl declined below Ψtlp. Leaf ABA levels were higher in leaves exposed to a step-increase in VPD that caused Ψl to transiently decline below Ψtlp and in which stomata closed compared with leaves in which stomata did not close. We conclude that the stomata of S. minimus are insensitive to VPD until Ψl declines to a threshold that triggers the biosynthesis of ABA and that this mechanism might be common to angiosperms.
Function of iron-stress-induced protein A in cyanobacterial cells with monomeric and trimeric photosystem I
Authors: Akhtar Parveen , Balog-Vig Fanny , Kuntam Soujanya , Tóth Szilvia Z , Lambrev Petar H
Published: October 2023

The acclimation of cyanobacteria to iron deficiency is crucial for their survival in natural environments. In response to iron deficiency, many cyanobacterial species induce the production of a pigment–protein complex called iron-stress-induced protein A (IsiA). IsiA proteins associate with photosystem I (PSI) and can function as light-harvesting antennas or dissipate excess energy. They may also serve as chlorophyll storage during iron limitation. In this study, we examined the functional role of IsiA in cells of Synechocystis sp. PCC 6803 grown under iron limitation conditions by measuring the cellular IsiA content and its capability to transfer energy to PSI. We specifically tested the effect of the oligomeric state of PSI by comparing wild-type (WT) Synechocystis sp. PCC 6803 with mutants lacking specific subunits of PSI, namely PsaL/PsaI (PSI subunits XI/VIII) and PsaF/PsaJ (PSI subunits III/IX). Time-resolved fluorescence spectroscopy revealed that IsiA formed functional PSI3-IsiA18 supercomplexes, wherein IsiA effectively transfers energy to PSI on a timescale of 10 ps at room temperature—measured in isolated complexes and in vivo—confirming the primary role of IsiA as an accessory light-harvesting antenna to PSI. However, a notable fraction (40%) remained unconnected to PSI, supporting the notion of a dual functional role of IsiA. Cells with monomeric PSI under iron deficiency contained, on average, only 3 to 4 IsiA complexes bound to PSI. These results show that IsiA can transfer energy to trimeric and monomeric PSI but to varying degrees and that the acclimatory production of IsiA under iron stress is controlled by its ability to perform its light-harvesting function.
Secondary phallic prosthesis placement in transgender patients postmetoidioplasty: a case report on technique and outcome
Authors: Claeys Wietse , Weynants Laurens , Jamaer Caroline , Van der Jeugt Jolien , Hoebeke Piet , Spinoit Anne-Françoise
Published: October 2023

Introduction

Gender affirming surgery is common among transgender and gender-nonconforming individuals. Genital gender-affirming surgery is a form of surgery that involves transformation and reconstruction of the genitalia while maintaining urologic and sexual function. Masculinizing genital gender-affirming surgery can involve the removal of the female genital and reproductive organs and the creation of a more masculine appearance by using phalloplasty or metoidioplasty techniques. While metoidioplasty has advantages such as limited scarring and preserved genital sensation and clitoral erection, it may not always guarantee the ability to void while standing or even penetrate a sexual partner.

Aim

To describe our method of secondary phallic enhancement after metoidioplasty with a phallic prosthesis.

Methods

Our case is based on a 39-year-old transgender male who underwent metoidioplasty with vaginectomy, scrotoplasty, and urethral lengthening. However, the original surgery was complicated by extensive hematoma formation in the suprapubic area and neoscrotum, leading to a buried position of the neophallus. Subsequent surgery was performed to reduce the prepubic fat pad and penoscrotal interposition, but it too was complicated by hematoma formation and wound dehiscence. To maximize phallic elongation, the tethering urethra was removed, and perineal urethrostomy was performed but could not sufficiently alleviate the buried phallus. As a further step to improve the outcome, we proposed the implantation of a specific phallic prosthesis designed for metoidioplasty with testicular prosthesis placement. Surgery was performed as a single procedure through a penoscrotal incision and greatly enhanced genital appearance.

Results

Three months after surgery, the patient had good sensation of the phallus and was able to have satisfactory sexual activity with his partner. However, he remained dissatisfied with the amount of prepubic tissue and opted to undergo further liposuction.

Conclusion

Phallic prosthesis implantation can be a procedure to improve the condition of multioperated cases of metoidioplasty with resistant phallic burying. Reconstruction with a phallic prosthesis was performed successfully in this case. However, long-term complications and functional outcomes, such as the ability to void while standing or penetrate a sexual partner, remain uncertain. Further experience is needed to determine the efficacy and safety of using a phallic prosthesis as a secondary procedure in patients undergoing metoidioplasty.
Lactococcus lactisCNCM I‐5388 versus NCDO2118 by its GABA hyperproduction ability, counteracts faster stress‐induced intestinal hypersensitivity in rats
Authors: Gomes Pedro , Laroute Valérie , Beaufrand Catherine , Daveran‐Mingot Marie‐Line , Aubry Nathalie , Liebgott Chloé , Ballet Nathalie , Legrain‐Raspaud Sophie , Theodorou Vassilia , Mercier‐Bonin Muriel , Cocaign‐Bousquet Muriel , Eutamene Hélène
Published: October 2023

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by its main symptom, visceral hypersensitivity (VH), which is aggravated by stress. Gut–brain interactions and gut bacteria may alleviate IBS symptoms, including VH. γ‐amino butyric acid (GABA), produced notably by lactic acid bacteria (LAB), shows promising result in IBS symptoms treatment. In bacteria, GABA is generated through glutamate decarboxylase (GAD) metabolism of L‐glutamic acid, maintaining intracellular pH. In mammals, GABA acts as an inhibitory neurotransmitter, modulating pain, stress, and anxiety. Therefore, utilizing GABA‐producing LAB as a therapeutic approach might be beneficial. Our previous work showed that a GABA‐producing Lactococcus lactis strain, NCDO2118, reduced VH induced by acute stress in rats after a 10‐day oral treatment. Here, we identified the strain CNCM I‐5388, with a four‐fold higher GABA production rate under the same conditions as NCDO2118. Both strains shared 99.1% identical GAD amino acid sequences and in vitro analyses revealed the same optimal pH for GAD activity; however, CNCM I‐5388 exhibited 17 times higher intracellular GAD activity and increased resistance to acidic pH. Additionally, in vivo experiments have demonstrated that CNCM I‐5388 has faster anti‐VH properties in rats compared with NCDO2118, starting from the fifth day of treatment. Finally, CNCM I‐5388 anti‐VH effects partially persisted after 5‐day treatment interruption and after a single oral treatment. These findings highlight CNCM I‐5388 as a potential therapeutic agent for managing VH in IBS patients.
Outpatient Rapid Titration of Slow Release Oral Morphine for the Treatment of Opioid Use Disorder in a Canadian Setting: A Case Series
Authors: Brooks Olivia , Ng Joan C.Y. , Ickowicz Sarah
Published: October 2023

Introduction

In the midst of unprecedented opioid overdose deaths, opioid agonist therapy induction strategies that allow for rapid titration to therapeutic doses for individuals at high risk of overdose are needed. Slow release oral morphine (SROM) is an effective treatment for opioid use disorder; however, current guideline-recommended titration strategies require weeks to achieve therapeutic dose for individuals with high opioid tolerance. Individuals may be lost to care or experience overdose due to ongoing use of unregulated opioids during this time. After years of experience titrating SROM doses rapidly in the inpatient setting, we developed a protocol using short-acting morphine (MOS) to allow for rapid SROM titration in the outpatient setting.

Cases

Patients (n = 4) were eligible if they met the criteria for opioid use disorder and had evidence of high opioid tolerance. Patients received supervised MOS doses in the outpatient setting, which were consolidated into a 12-hour extended-release morphine dose (to a maximum of 500 mg) on the evening of the titration. The total titration-day MOS and 12-hour extended-release morphine were summed into the post–titration-day SROM dose, to a maximum of 1000 mg.

Discussion

In the cases described, substantial reductions in unregulated fentanyl use and social gains, such as obtaining housing, employment, and enrollment in inpatient treatment programs, were observed after rapid SROM titration. No overdoses occurred during rapid SROM titration or during SROM treatment. More research is needed to determine the role for rapid SROM titrations as a stabilization option for outpatients.
Maternal Vertical Microbial Transmission During Skin-to-Skin Care
Authors: Hamidi Maryam , Cruz-Lebrón Angelica , Sangwan Naseer , Blatz Mary Ann , Levine Alan D.
Published: October 2023

Background:

Skin-to-skin (STS) care may contribute to mother-to-infant vertical microbial transmission by enriching the preterm infant's microbiome.

Purpose:

The purpose of this observational study was to define the impact of increased STS care duration on vertical microbial transmission and consequently modulate oral and intestinal microbial balance.

Methods:

Postpartum women and their preterm infants, 31 to 34 weeks' gestation (n = 25), were recruited for this study. Using 16S rRNA sequencing, we compared α- and β-diversity with the Shannon and Chao indexes and nonmetric multidimensional scaling, respectively, and relative abundance of microbial communities, which refers to the percentage of specific organisms in a community, from mother's chest skin, preterm infant's oral cavity, and preterm infant's stool samples. Effects of STS care on vertical transmission were determined by comparing oral and stool microbial population of preterm infants who received low exposure (<40 minutes) with that of preterm infants who received high exposure (>60 minutes).

Results:

Microbial composition, diversity, and relative abundance were different across the 3 sites. Oral microbial richness was less and stool richness was greater among the preterm infants in the high STS care group. Oral and intestinal microbial diversity and composition were different between the groups, with the relative abundance of Gemella and Aggregatibacter genera and Lachnospiraceae family significantly greater in the stool of the high STS care group.

Implications for practice:

Results suggest that STS care may be an effective method to enhance microbial communities among preterm infants.
Associations of hypertensive disorders of pregnancy with cognition, dementia, and brain structure: a Mendelian randomization study
Authors: Li Mingxi , Qu Kang , Wang Yueyuan , Wang Yongchun , Sun Li
Published: October 2023

Background:

Observational studies have found associations between hypertensive disorders of pregnancy and an increased risk of cognitive dysfunction and reduced brain volume. However, the results of observational studies may have been influenced by confounding factors. This study applied two-sample Mendelian randomization (MR) to explore the causal associations of hypertensive disorders of pregnancy with cognition, dementia, and brain structure.

Methods:

Summary data on hypertensive disorders of pregnancy and their main subtypes, cognition, dementia, and brain structure were obtained from recent European genome-wide association studies. We computed the inverse-variance weighted, MR-Egger, and weighted median MR estimates. Cochran's Q statistics and the MR-Egger intercept test were used to quantify the heterogeneity and horizontal pleiotropy of the instrumental variables.

Results:

Genetically predicted preeclampsia or eclampsia was inversely associated with gray matter volume [beta = -0.072; 95% confidence interval (CI) = -0.131 to −0.014; P = 1.53 × 10−2]; possibly with brain volume (beta = −0.064; 95% CI = −0.117 to −0.012; P = 1.68 × 10−2). However, the association of hypertensive pregnancy disorders or gestational hypertension with brain structure was not significant. We did not find any significant association between hypertensive disorders of pregnancy, gestational hypertension, or preeclampsia or eclampsia and cognition and dementia-related outcomes.

Conclusion:

This study provided genetic evidence supporting an association between preeclampsia or eclampsia and reduced brain volume. This supports the view of PE as a risk factor for gray matter volume reduction.
Measurement of 238U, 232Th, 222Rn and 220Rn Contents in Optical Contact Lenses: Resulting Alpha and Beta Equivalent Doses to the Eye Tissues of Adult Patients
Authors: Misdaq M. A. , Elouardi B.
Published: October 2023

To estimate equivalent doses received by eye tissues of patients, contents of uranium (238U), thorium (232Th), radon (222Rn), and thoron (220Rn) were determined inside various optical contact lenses used for vision correction. 238U, 232Th, 222Rn, and 220Rn contents varied between (3.44 ± 0.24) mBq kg−1 and (18.3 ± 1.28) mBq kg−1, (0.57 ± 0.04) mBq kg−1 and (3.53 ± 0.25) mBq kg−1, (3.44 ± 0.24) mBq kg−1 and (18.3 ± 1.28) mBq kg−1, and (0.57 ± 0.04) mBq kg−1 and (3.53 ± 0.25) mBq kg−1, respectively. New external dosimetric models, depending on the cornea eye surface of patients, 238U, 232Th, and 222Rn concentrations inside optical contact lenses, half-life of the emitting radionuclides, and exposure time of patients, have been developed. It has been shown that alpha-particles emitted by the 238U and 232Th series inside the studied optical lenses transfer their energies essentially to the cornea tissues whereas the emitted beta-particles may reach and lose their energies in the crystalline lens of eyes of patients. Alpha-equivalent doses received by eye tissues of patients due to the diffusion of 222Rn and 220Rn gases present in the considered optical lenses were determined. The higher value of the total (alpha plus beta) equivalent dose to the left and right eyes of adult patients wearing optical contact lenses (14 hours per day) has been found equal to 1.32 mSv y−1 cm − 2. It is recommended for patients to reduce the wearing period of optical contact lenses to reduce eye disease risks such as cataract.
Numeric rating scale for pain should be used in an ordinal but not interval manner. A retrospective analysis of 346,892 patient reports of the quality improvement in postoperative pain treatment registry
Authors: Stijic Marko , Messerer Brigitte , Meißner Winfried , Avian Alexander
Published: October 2023

To assess postoperative pain intensity in adults, the numeric rating scale (NRS) is used. This scale has shown acceptable psychometric features, although its scale properties need further examination. We aimed to evaluate scale properties of the NRS using an item response theory (IRT) approach. Data from an international postoperative pain registry (QUIPS) was analyzed retrospectively. Overall, 346,892 adult patients (age groups: 18-20 years: 1.6%, 21-30 years: 6.7%, 31-40 years: 8.3%, 41-50 years: 13.2%, 51-60 years: 17.1%, 61-70 years: 17.3%, 71-80 years: 16.4%, 81-90 years: 3.9%, >90: 0.2%) were included. Among the patients, 55.7% are female and 38% had preoperative pain. Three pain items (movement pain, worst pain, least pain) were analyzed using 4 different IRT models: partial credit model (PCM), generalized partial credit model (GPCM), rating scale model (RSM), and graded response model (GRM). Fit indices were compared to decide the best fitting model (lower fit indices indicate a better model fit). Subgroup analyses were done for sex and age groups. After collapsing the highest and the second highest response category, the GRM outperformed other models (lowest Bayesian information criterion) in all subgroups. Overlapping categories were found in category boundary curves for worst and minimum pain and particularly for higher pain ratings. Response category widths differed depending on pain intensity. For female, male, and age groups, similar results were obtained. Response categories on the NRS are ordered but have different widths. The interval scale properties of the NRS should be questioned. In dealing with missing linearity in pain intensity ratings using the NRS, IRT methods may be helpful.
High-Dose Methylphenidate and Carboxylesterase 1 Genetic Variability in Patients With Attention-Deficit/Hyperactivity Disorder
Authors: Westerkamp Andrie C. , Pereira Rob Rodrigues , Huitema Vera R. , Kouwert Ester A.M. , Matic Maja , van Schaik Ron H.N. , Punt Nieko , Schoevers Robert A. , Touw Daan J.
Published: October 2023

Purpose/Background

Methylphenidate (MPH) is widely used to reduce symptoms of attention-deficit/hyperactivity disorder. Methylphenidate is metabolized by the carboxylesterase 1 (CES1) enzyme. Some patients need a very high dose of MPH to reach desired clinical effects, without having adverse effects. This may be due to differences in MPH pharmacokinetics (PK), potentially caused by DNA variants in CES1, the gene encoding the enzyme that metabolizes MPH. Here we describe 3 patients requiring high-dose MPH and investigated the CES1 gene.

Methods/Procedures

The 3 patients were using short-acting MPH in a dose of 180 to 640 mg instead of the maximum advised dose of around 100 mg MPH in the Netherlands. Plasma concentrations of MPH were determined at scheduled time points (day-curve). Methylphenidate plasma concentrations were used for PK analysis using an earlier published 2-compartment PK population model of MPH. Individual data of the 3 patients were compared with simulated population data, when equivalent doses were used. In addition, CES1 was genotyped (number of gene copies and single nucleotide polymorphisms) using real-time polymerase chain reaction.

Findings/Results

Pharmacokinetic analysis in all 3 patients showed lower plasma concentrations of MPH in comparison with the population data. The mean absorption time and volume of distribution of the central compartment were equal, but the elimination clearance was higher. However, CES1 genotyping revealed no variations that could explain a higher metabolism of MPH.

Implications/Conclusions

In these 3 cases, we could not demonstrate a correlation between MPH clearance and known genetic variants of the CES1 gene.
Rectal sensitivity and associated factors in patients with different subtypes of functional defecation disorder
Authors: Zhang Yi-Bing , Huang Zhi-Yang , Jin Jian-Wei , Yuan Yu-Ping , Xu Li-Yuan , Jin Jie
Published: October 2023

Objective

To investigate rectal sensitivity and associated factors in patients with different subtypes of functional defecation disorder (FDD).

Methods

We segregated individuals diagnosed with FDD into two groups based on their defecation patterns: those with dyssynergic defecation and those with inadequate defecatory propulsion. We gathered general information through questionnaires and assessed rectal sensitivity using anorectal manometry. The rectal sensitivity performances of the two groups were compared; the factors related to rectal sensitivity were analyzed to determine the factors associated with rectal sensitivity, and the effect of biofeedback therapy on rectal sensitivity was clarified.

Results

Rectal sensitivity in different subtypes of FDD decreased, and the difference between the two groups was not statistically significant (P > 0.05). There were no statistically significant differences in the first constant sensation volume, defecatory desire volume, and maximum tolerable volume between the different subtypes of FDD (P > 0.05). Multi-factor binary logistic regression analysis showed that age, constipation symptom score, and diabetes were all independent risk factors for decreased rectal sensitivity (P < 0.05). There were no statistically significant differences between the prior- and post-biofeedback therapy in the first constant sensation volume, defecatory desire volume, and maximum tolerable volume (P > 0.05).

Conclusion

Rectal sensitivity in different subtypes of FDD decreased. Age, constipation symptom score, and diabetes were independent risk factors for decreased rectal sensitivity. Short-term biofeedback therapy did not improve rectal hyposensitivity in patients with FDD.
The Index of Engagement in PrEP Care: Evaluation of Psychometric Properties and Predictive Potential
Authors: Meyers Kathrine , Quigee Daniela , Zucker Jason , Carnevale Caroline , Klein Joshua , Kim Tae Y. , Sobieszczyk Magdalena E.
Published: October 2023

Background:

The Index of Engagement in HIV Care is a psychometrically valid 10-item self-report measure with predictive power to classify individuals to higher and lower odds of disengaging from HIV care. Given high rates of disengagement from preexposure prophylaxis (PrEP) care, we adapted the HIV Index to PrEP.

Methods:

We evaluated the psychometric properties of the PrEP-Index in a cross-sectional validation among PrEP-eligible persons seen in an HIV Prevention Program and conducted exploratory analysis to assess its potential utility as a prognostic tool. The PrEP Index contains 10 items with answers ranging from (1) not at all to (5) extremely. Possible PrEP-Index scores ranged from 10 to 50, with higher sum scores representing higher levels of engagement.

Results:

Study participants were cisgender men who have sex with men, and racially and ethnically diverse (non-Hispanic White = 39.2%). Factor analyses supported the 1-factor structure. Among 347 respondents, 118 individuals (34.0%) were available for predictive validity analysis. The PrEP Index score was positively associated with visit constancy at 6 months (

= 0.2261; 95% confidence interval: 0.0363 to 0.4051). Finally, a patient scoring

45 on the PrEP-Index will be classified as not returning within 6 months (sensitivity = 0.73, specificity = 0.65).

Conclusions:

The PrEP-Index is a psychometrically valid and reliable scale that demonstrates potential utility in identifying individuals at elevated risk of falling out of PrEP care by 6 months, the time point by which the majority of PrEP discontinuations occur. The PrEP-Index could be a useful clinical prognostic tool to allow for efficient resource targeting by clinics to improve engagement in PrEP care.
Association of Alcohol Consumption With CD4 Recovery After Antiretroviral Therapy Initiation in St. Petersburg, Russia
Authors: McLaughlin Angela , Lin Nina , Jiang Wenqing , Lodi Sara , Lioznov Dmitry , Patts Gregory , Gnatienko Natalia , Blokhina Elena , Bendiks Sally , Freiberg Matthew S. , Tindle Hilary A. , Krupitsky Evgeny , Hahn Judith A. , Samet Jeffrey H. , So-Armah Kaku
Published: October 2023

Background:

Delayed CD4 recovery after initiating antiretroviral therapy (ART) is a novel potential mechanism by which alcohol consumption leads to increased morbidity and mortality in people with HIV. We hypothesized that alcohol consumption at ART initiation is associated with slower CD4 recovery.

Methods:

We retrospectively analyzed 2 pooled longitudinal alcohol/HIV cohorts (2014–2019) in St. Petersburg, Russia. Eligible participants initiated the first ART during parent studies; had alcohol consumption assessed by the blood biomarker, phosphatidylethanol (PEth), at the last research visit before ART initiation; and had ≥1 CD4 count measurement before and after initiating ART. Participants were stratified by low, moderate, and high PEth (<8, 8–80, and >80 ng/mL, respectively). We used random-effects piecewise linear regression models to estimate CD4 recovery, defined as CD4 count change per 30 days after ART initiation, by the alcohol group.

Results:

Of 60 eligible participants, median age was 34 years and 28% were female. The median pre-ART PEth in the low, moderate, and high PEth groups were <8, 23, and 232 ng/mL, respectively. After starting ART, the CD4 count increased by 13.60 cells/mm3/mo (95% CI: 0.33 to 26.87) with low PEth, 0.93 cells/mm3/mo (95% CI: −6.18 to 8.04) with moderate PEth, and 2.33 cells/mm3/mo (95% CI: −3.44 to 8.09) with high PEth.

Conclusions:

Among Russians with HIV, we observed faster CD4 recovery after ART initiation in those with low alcohol consumption compared with those with moderate and high alcohol consumption, as assessed by PEth. This analysis provides further evidence for the possible value of alcohol reduction interventions for people with HIV who are initiating ART.
Integrating a Resilience Framework to Assess Implementation of a Novel HIV Care Re-Engagement Model in NYC
Authors: Baim-Lance Abigail , Addison Diane , Archer Norman , Gordon Peter , Duke Sharen , Shubert Virginia , Nash Denis , Robertson McKaylee
Published: October 2023

Background:

The Bottom Up Project, a collaboration of clinical, community, and academic partners, consists of 7 major steps that leverage a health information exchange, a system for sharing patient health information, with real-time alerts to mobilize peer outreach workers to find and re-engage persons with HIV disconnected from care. Bottom Up faced implementation challenges in its start-up phase and produced effective responses leading to Project maturation, which we explore using a novel implementation science framework incorporating resilience.

Methods:

We conducted semistructured interviews with implementation staff (N = 6) and meeting minutes and protocols document reviews (N = 35). The Consolidated Framework for Implementation Research and a novel resilience framework guided thematic and process analyses. The resilience framework consisted of the following 3 resilience types: absorptive to cope with adversity, adaptive to adjust as short-term solutions, and transformative to structurally change.

Results:

The Project experienced 20 major challenges, 2–5 challenges per step. Challenges were multilevel and of chronic and crisis intensities. Implementers overcame challenges by leveraging multilevel factors that were absorptive, adaptive (most common), and transformative.

Discussion:

Bottom Up matured by practicing consistency and flexibility. The Project maintained core operations while under crisis-level stress by strategically simplifying or “downshifting” activities. Transformational responses suggest that specific initiatives can catalyze organizational change.

Conclusions:

Bottom Up implementation demonstrates using diverse tactics to respond to challenges, thereby shaping Project development and in turn organizations. Applying resilience to Consolidated Framework for Implementation Research helps build awareness of active and dynamic processes promoting or impeding the growth and success of intervention-oriented Projects.
Secure key distribution exploiting error rate criticality for radio frequency links
Authors: Stevens Christopher J. , Allen Ben , Brown Anthony K.
Published: October 2023

We propose a method by which two radio frequency (RF) communication terminals exchange encryption keys or other data securely. This method draws on the approach developed for quantum key distribution (QKD) for detecting eavesdroppers but our method does not use any quantum properties at all. Instead, by exploiting the effects an eavesdropper has on channel stability, we explore a line-of-sight link radio in which data transfer rates are so high as to approach the Shannon limit. With very steep rises in bit error rate accompanying a small degradation of signal-to-noise limits for certain forward error correction codes, it becomes possible to infer the existence of an eavesdropper before they are able to obtain a complete key. We describe our method and analyse one possible implementation using low density parity check codes with quadrature phase shift keying modulation. The proposed technique is in principle far easier to implement than quantum-based approaches for RF and optical wireless links since the required hardware is readily available and the basic principles are well known and well understood. Finally, we show our method to have a higher key rate and spectral efficiency than those of QKD.