bluuebunny/crossref_metadata_2025 huggingface dataset:
Clarification of the transverse orbital angular momentum of spatiotemporal optical vortices
Authors: Porras Miguel A
Published: July 2024

Advances in the generation and the application of spatiotemporal optical vortices (STOV) are proceeding fast, but fundamental aspects of their nature remain obscure. Bliokh (2023 Phys. Rev. A 107 L031501) (PRA) and Porras (2023 Prog. Electromagn. Res.
177 95) (PIER) provide contradictory results on the transverse orbital angular momentum (OAM) carried by STOVs. We show that the results by Porras in PIER and by Bliokh in PRA refer to different STOVs and are all correct. In PIER, STOVs are elliptical at given cross section and time, or in space-time, but not in three-dimensional space. In PRA, STOVs are elliptical in space but not in space-time. This is evidenced from two dual, equivalent theories on the transverse OAM where a wave packet is seen in space-time evolving with propagation distance or in space evolving in time, that account for all values of the total, intrinsic and extrinsic OAM in PIERS and PRA. However, the intrinsic OAM with respect to the photon wave function center in PRA is not generally conserved, which advocates for the energy center in PIER as the STOV center. We argue that STOVs are generated in experiments to purportedly have elliptical symmetry in space-time. The values provided in PIER should then be taken as the reference for elliptical STOVs, and the theory therein to evaluate the transverse OAM of other wave packets. Hancock et al (2021 Phys. Rev. Lett.
127 193901; 2024 Phys. Rev. X 14 011031) erroneously attribute the transverse OAM of elliptical STOVs in space to the elliptical STOVs in space-time that they consider theoretically and can generate in their experiments.
Non-unique detailed constructions of Curzon-Ahlborn cycle on thermodynamic plane
Authors: Izumida Yuki
Published: July 2024

The Curzon-Ahlborn (CA) cycle is a paradigmatic model of endoreversible heat engines, which yields the so-called CA efficiency as the efficiency at maximum power. Due to the arbitrariness of the relationship between the steady temperature and the time taken for the isothermal process of the CA cycle, the constructions of the CA cycle on the thermodynamic plane are not unique. Here, we give some of the detailed constructions of the CA cycle on the thermodynamic plane, using an ideal gas as a working substance. It is shown that these constructions are equal to each other in the maximum power regime in the sense that they achieve the best trade-off between the work and the inverse cycle-time, known as the Pareto front in multi-objective optimization problems.
The African Regional Courts
Authors: Stone Sweet Alec , Sandholtz Wayne
Published: July 2024

This chapter examines the evolution of the African Union, the Economic Community of West African States, the East African Community, and the Southern African Development Community (SADC). The founding states did not establish these organizations as complete systems of transnational justice. Rather, international human rights courts have sought to render them more complete through their rulings. They have enforced rights in politically sensitive contexts, finding violations in cases involving torture and inhumane treatment, slavery, the incarceration of newspaper editors, the stifling of elections, among other violations. The African courts have engaged in continuous struggles to build their own effectiveness in the face of state resistance and indifference, which have, nonetheless, provoked backlash, regime exit, and attempts to curtail judicial authority. Indeed, states terminated the operations of the SADC, after only one ruling and finding of violation. Thus, the African courts perpetually confront the dilemma of effectiveness.
The Dilemma of Effectiveness
Authors: Stone Sweet Alec , Sandholtz Wayne
Published: July 2024

The states that founded human rights courts did not create fully fledged systems of transnational justice (STJs). The courts themselves have steadily sought to build complete STJs. Some of the human rights courts have consolidated their status as Trustees, while others are engaged in doing so. Judges place their reputations as good human rights jurists ahead of comforting the short-term interests of state officials in specific cases. The courts have embraced the objective of building effectiveness, perpetuating ongoing tensions with governments subject to their rulings. In response, member states have sometimes sought to constrain the courts or shut them down altogether. Still, the international human rights courts have sought to build the capacity to withstand backlash. Within each regime, courts have established dialogic relationships with domestic courts and other actors, which have become the foundation of a global commons for rights protection, with shared norms and techniques of adjudication.
The Role of Attention in Placebo and Nocebo Effects
Authors: Barbiani Diletta , Camerone Eleonora M , Grosso Francesca , Geers Andrew L , Pagnini Francesco
Published: July 2024

Background

Although some existing models propose that attention may be crucially implicated in placebo/nocebo effects, empirical research on this aspect remains limited and scattered.

Purpose

This systematic review aims to provide an inclusive overview of studies that have either directly manipulated or assessed attention within the context of placebo and nocebo procedures so to gain a synthetized picture of the role of this variable in placebo/nocebo effects. Importantly, only studies in which attention represented a mechanism or mediator of the placebo/nocebo response, and not a primary outcome, were included.

Methods

A systematic search was conducted across multiple databases, including PubMed, Scopus, PsycINFO, Web of Science, and Embase, to identify peer-reviewed studies. These studies were subjected to methodological evaluation and eligibility criteria for inclusion.

Results

We identified and classified 12 studies into three categories based on their focus: (i) those that directly assessed attention, (ii) those that directly manipulated participants’ attention, and (iii) those that combined both a direct manipulation and assessment of attention. In all selected studies attention acted as a mechanism or mediator of the placebo/nocebo response, and was not considered a primary outcome of the placebo/nocebo manipulation.

Conclusions

The synthesis of the included studies reveals that the role of attention in placebo and nocebo effects is still a topic of debate, marked by variations in how attention is conceptualized and measured. Results suggest that attention has significant clinical implications, particularly in optimizing therapeutic efficacy by directing patients’ focus toward signs of healing and away from indicators of illness or distress. To advance our understanding, future research should explore these attentional mechanisms, in conjunction with neurophysiological correlates.
Prospective transitions in hemoglobin A1c following gestational diabetes using multistate Markov models
Authors: McCarthy Katharine J , Liu Shelley H , Kennedy Joseph , Chan Hiu Tai , Mayer Victoria L , Vieira Luciana , Glazer Kimberly B , Van Wye Gretchen , Janevic Teresa
Published: July 2024

We characterized the state-to-state transitions in postpartum hemoglobin A1c levels after gestational diabetes, including remaining in a state of normoglycemia or transitions between prediabetes or diabetes states of varying severity. We used data from the APPLE Cohort, a postpartum population-based cohort of individuals with gestational diabetes between 2009 and 2011, and linked A1c data with up to 9 years of follow-up (n = 34 171). We examined maternal sociodemographic and perinatal characteristics as predictors of transitions in A1c progression using Markov multistate models. In the first year postpartum following gestational diabetes, 45.1% of people had no diabetes, 43.1% had prediabetes, 4.6% had controlled diabetes, and 7.2% had uncontrolled diabetes. Roughly two-thirds of individuals remained in the same state in the next year. Black individuals were more likely to transition from prediabetes to uncontrolled diabetes (adjusted hazard ratio [aHR] = 2.32; 95% CI, 1.21-4.47) than White persons. Perinatal risk factors were associated with disease progression and a lower likelihood of improvement. For example, hypertensive disorders of pregnancy were associated with a stronger transition (aHR = 2.06; 95% CI, 1.39-3.05) from prediabetes to uncontrolled diabetes. We illustrate factors associated with adverse transitions in incremental A1c stages and describe patient profiles that may warrant enhanced postpartum monitoring.
Impact of a new state law and electronic health record prompt on naloxone prescribing in an academic medical center
Authors: Dugovich Anna , Robert Sophie , Hatton James , Jewett Amanda
Published: July 2024

Purpose

To evaluate the impact of a best-practice advisory (BPA) and South Carolina legislation on naloxone prescribing patterns. The primary objective was to assess the change in naloxone prescription rates following BPA implementation. The secondary objective was to analyze the performance of the BPA.

Methods

Naloxone prescriptions generated before (July 28, 2020, through July 27, 2021) and after (July 28, 2021, through July 28, 2022) BPA implementation were analyzed via retrospective chart review. Lists of patients at risk for opioid overdose and patients for whom the BPA fired were generated for March 2022. The BPA’s effectiveness was evaluated based on the proportion of at-risk patients missed by the alert, the frequency with which the BPA resulted in a naloxone prescription, and the reasons for not prescribing naloxone when the BPA fired.

Results

Following BPA implementation, there was a significant increase in the average monthly naloxone prescribing rate from 66.1 to 625.5 prescriptions per month. Overall, 2,086 patients were considered at risk for opioid overdose and 1,101 had a BPA alert during March 2022, with 32.7% of BPA alerts resulting in naloxone prescribing. The most common reasons selected for not prescribing naloxone were “patient refusal” and “criteria not met.” Only 354 patients (17.1%) at risk for opioid overdose also had a BPA alert.

Conclusion

State legislation and implementation of the BPA significantly increased naloxone prescribing rates. However, a significant proportion of patients identified as being at risk did not have a BPA alert and most BPA alerts did not result in naloxone prescribing, suggesting a need for improvement of the BPA.
Positive pressure in bamboo is generated in stems and rhizomes, not in roots
Authors: Michaud Joseph M , Mocko Kerri , Schenk H Jochen
Published: July 2024

Bamboos stand out among other tall plants in being able to generate positive pressure in the xylem at night, pushing water up to the leaves and causing drops to fall from leaf tips as guttation that can amount to a steady nocturnal ‘bamboo rain’. The location and mechanism of nocturnal pressure generation in bamboos are unknown, as are the benefits for the plants. We conducted a study on the tall tropical bamboo species Bambusa oldhamii (giant timber bamboo) growing outdoors in southern California under full irrigation to determine where in the plant the nocturnal pressure is generated, when it rises in the evening, and when it dissipates in the morning. We hypothesized that the build-up of positive pressure would be triggered by the cessation of transpiration-driven sap flow and that resumption of sap flow in the morning would cause the pressure to dissipate. Nocturnal pressure was observed in mature stems and rhizomes, but never in roots. The pressure was episodic and associated with stem swelling and was usually, but not always, higher in rhizomes and basal stems than in stems at greater height. Time series analyses revealed that dry atmospheric conditions were followed by lower nocturnal pressure and rainfall events by higher stem pressure. Nocturnal pressure was unrelated to sap flow and even was generated for a short time in isolated stem pieces placed in water. We conclude that nocturnal pressure in bamboo is not ‘root pressure’ but is generated in the pseudo-woody rhizomes and stems. It is unrelated to the presence or absence of sap flow and therefore must be created outside of vessels, such as in phloem, parenchyma, or fibres. It is unlikely to be a drought adaptation and may benefit the plants by maximizing stem water storage for daytime transpiration or by transporting nutrients to the leaves.
A Bibliometric Analysis of the 100 Most-Cited Articles on Otoplasty
Authors: Arif Fizzah , Rehman Saif ur , Shahzad Zenab , Rahman Mohammad Fazlur , Shaikh Safdar Ali
Published: July 2024

A bibliometric analysis was conducted in April 2024 to review the current trends in otoplasty. It involved a literature search of the Scopus database for original articles with the query terms “otoplasty” and “pinnaplasty,” without restricting publication dates or selecting journals in the database. The top 100 articles with the highest citations were reviewed. Bibliometric analysis was performed with the Scimago journal impact factor. The screening was done following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to extract the top 100 most-cited articles in otoplasty. We excluded articles not focused on otoplasty, those involving other surgical procedures, and non-English articles. With Scopus and manual screening, we performed citation analysis of selected articles. Mean values were calculated for the number of citations and citations per year. Of the 951 studies identified, 100 (10.5%) were analyzed in detail. The studies were published between 1941 and 2024, with a mean of 36 ± 23.7 citations per paper. The journal Plastic and Reconstructive Surgery reported the highest number (23%, n = 23) of articles, followed by the Journal of Plastic, Reconstructive and Aesthetic Surgery with 13% (n = 13) articles. The highest number of articles originated from the United States (38%, n = 38), followed by the United Kingdom (15%, n = 15). Our bibliometric analysis provides a comprehensive overview of the landscape of otoplasty research, highlighting key publications, authors, and journals. This study contributes to the understanding of the evolution and impact of otoplasty literature, laying the groundwork for further research and innovation in this field.

Level of Evidence: 3
Managing Trouble Along a Continuum of Accountability: On Police Practices for Dealing with Less-Than-Competent Subjects
Authors: Buscariolli André
Published: July 2024

This article uses conversation analysis to examine recordings of police encounters, focusing on how officers respond to routine forms of trouble emerging from civilians’ failure to comprehend and cooperate with their initiating actions. The analysis demonstrates how officers improvise methods to deal with their subjects’ troublesome responses to their queries and directives, treating civilians along a continuum from being purposefully uncooperative to lacking the interactional competence to comply with their projects. In the latter case, officers treat noncompliance as related to one’s status as “mentally disordered,” adopting practices to progressively carve out islands of competence within which civilians are competent to cooperate or accountable for not doing so. Thus, officers’ orientation to a continuum of accountability shapes the encounter’s interactional trajectory toward more punitive or instructive outcomes.
COVID-19 and the New Pains of Imprisonment
Authors: Horowitz Veronica L , Andersen Synøve N , Hyatt Jordan M
Published: July 2024

As the COVID-19 pandemic upended life worldwide, prisons gained attention as epicentres for the virus. The focus was primarily on infections and death rates, often omitting the impact on incarcerated people. This study draws on semi-structured interviews (n = 58) with men imprisoned throughout the pandemic. Using and extending classic and contemporary theorizations of ‘the pains of imprisonment’, we find that official pandemic responses meant that (1) new, pandemic-related pains developed, (2) established pains changed in severity and took new manifestations, and (3) pains were experienced simultaneously and interactively. Thus, the pandemic amplified, diversified and compounded the pains of imprisonment. While most visible in the context of a large-scale crisis, these concepts provide an expanded, broadly applicable framing for future carceral scholarship.
Chondroitin sulfate proteoglycan 4 increases invasion of recessive dystrophic epidermolysis bullosa-associated cutaneous squamous cell carcinoma by modifying transforming growth factor-β signalling
Authors: Macaulay Allison R K , Yang Jianbo , Price Matthew A , Forster Colleen L , Riddle Megan J , Ebens Christen L , Albert Frank W , Giubellino Alessio , McCarthy James B , Tolar Jakub
Published: July 2024

Background

Recessive dystrophic epidermolysis bullosa (RDEB) is a rare genetic skin-blistering disorder that often progresses to metastatic cutaneous squamous cell carcinoma (cSCC) at chronic wound sites. Chondroitin sulfate proteoglycan 4 (CSPG4) is a cell-surface proteoglycan that is an oncoantigen in multiple malignancies, where it modulates oncogenic signalling, drives epithelial-to-mesenchymal transition (EMT) and enables cell motility.

Objectives

To evaluate CSPG4 expression and function in RDEB cSCC.

Methods

RDEB cSCC cell lines were used to assess CSPG4-dependent changes in invasive potential, transforming growth factor (TGF)-β1-stimulated signal activation and clinically relevant cytopathology metrics in an in vitro full-thickness tumour model. CSPG4 expression in RDEB cSCC and non-RDEB cSCC tumours was analysed via immunohistochemistry and single-cell RNA sequencing (scRNA-Seq), respectively.

Results

Inhibiting CSPG4 expression reduced invasive potential in multiple RDEB cSCC cell lines and altered membrane-proximal TGF-β signal activation via changes in SMAD3 phosphorylation. CSPG4 expression was uniformly localized to basal layer keratinocytes in fibrotic RDEB skin and tumour cells at the tumour–stroma interface at the invasive front in RDEB cSCC tumours in vivo. Analysis of published scRNA-Seq data revealed that CSPG4 expression was correlated with an enhanced EMT transcriptomic signature in cells at the tumour–stroma interface of non-RDEB cSCC tumours. Cytopathological metrics, for example nucleus : cell area ratio, were influenced by CSPG4 expression in in vitro tumour models.

Conclusions

We determined that CSPG4 expression in RDEB cSCC cell lines enhanced the invasive potential of tumours. Mechanistically, CSPG4 was found to enhance membrane-proximal TGF-β-stimulated signalling via SMAD3, which is a key mediator of EMT in RDEB cSCC. The implication of these studies is that CSPG4 may represent a therapeutic target that can be leveraged for the clinical management of patients with RDEB cSCC.
Reduction of sacsin levels in peripheral blood mononuclear cells as a diagnostic tool for spastic ataxia of Charlevoix–Saguenay
Authors: De Ritis Daniele , Ferrè Laura , De Winter Jonathan , Tremblay-Desbiens Clémence , Blais Mathieu , Bassi Maria Teresa , Dupré Nicolas , Baets Jonathan , Filippi Massimo , Maltecca Francesca
Published: July 2024

Autosomal recessive spastic ataxia of Charlevoix–Saguenay is a rare neurodegenerative disease caused by biallelic variants in the SACS gene encoding for sacsin. More than 200 pathogenic variants have been identified to date, most of which are missense. It is likely that the prevalence of autosomal recessive spastic ataxia of Charlevoix–Saguenay is underestimated due to the lack of an efficient diagnostic tool able to validate variants of uncertain significance. We have previously shown that sacsin is almost absent in fibroblasts of patients with autosomal recessive spastic ataxia of Charlevoix–Saguenay regardless of the type of SACS variant, because sacsin carrying missense variants is cotranslationally degraded. In this work, we aimed to establish the pathogenicity of SACS variants by quantifying sacsin protein in blood samples, with relevant implications for autosomal recessive spastic ataxia of Charlevoix–Saguenay diagnosis. We developed a protocol to assess sacsin protein levels by western blot using small amounts of peripheral blood mononuclear cells, which can be propagated in culture and cryopreserved. The study involves eight patients with autosomal recessive spastic ataxia of Charlevoix–Saguenay (including a novel case) carrying variants of different types and positions along the SACS gene and two parents who are carriers of heterozygous missense variants. We show that patients with autosomal recessive spastic ataxia of Charlevoix–Saguenay (carrying either missense or truncating variants) almost completely lacked sacsin in peripheral blood mononuclear cells. Moreover, both carriers of a SACS missense variant showed 50% reduction in sacsin protein levels compared to controls. We also describe a patient with uniparental isodisomy carrying a homozygous nonsense variant near the 3′ end of the SACS gene. This resulted in a stable sacsin protein lacking the last 202 amino acids, probably due to escape of nonsense-mediated decay of mRNA. In conclusion, we have optimized a minimally invasive diagnostic tool for autosomal recessive spastic ataxia of Charlevoix–Saguenay in blood samples based on sacsin protein level assessment. Indeed, our results provide definite evidence that sacsin carrying missense pathogenic variants undergoes cotranslational degradation. The quantitative reduction in sacsin levels in the case of missense variants of uncertain significance allows defining them as pathogenic variants, something which cannot be predicted bioinformatically with high certainty.
Recalcitrant lipodermatosclerosis with ulceration treated with oxandrolone and pentoxifylline
Authors: Mei Angela , Chen Jacqueline , Chan Jonathan J
Published: July 2024

Herein we describe the case of a 73-year-old woman with a 15-year history of advanced lipodermatosclerosis with progressive ulceration despite extensive multidisciplinary treatment with compression therapy, surgical venous ablation, topical corticosteroids, antibiotics and hyperbaric oxygen therapy. She was commenced on oxandrolone and pentoxifylline. After 5 months, complete healing of the ulcer was observed without significant adverse effects or hepatotoxicity. Oxandrolone may serve as an effective and safe treatment for ulcerated wounds secondary to advanced lipodermatosclerosis.
Unexpected journey with the ketogenic diet: a patient’s experience with prurigo pigmentosa
Authors: Liu Ze-Hu
Published: July 2024

Prurigo pigmentosa is also known as ‘keto rash’. Because of the growing interest in adopting a ketogenic diet, awareness of prurigo pigmentosa is essential to ensure an early and accurate diagnosis.
Human genetic and immunological determinants of SARS-CoV-2 infection and multisystem inflammatory syndrome in children
Authors: Kholaiq Halima , Abdelmoumen Yousra , Moundir Abderrahmane , El Kettani Assiya , Ailal Fatima , Benhsaien Ibtihal , Adnane Fatima , Drissi Bourhanbour Asmaa , Amenzoui Naima , El Bakkouri Jalila , Bousfiha Ahmed Aziz
Published: July 2024

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces pneumonia and acute respiratory failure in coronavirus disease 2019 (COVID-19) patients with inborn errors of immunity to type I interferon (IFN-I). The impact of SARS-CoV-2 infection varies widely, ranging from mild respiratory symptoms to life-threatening illness and organ failure, with a higher incidence in men than in women. Approximately 3–5% of critical COVID-19 patients under 60 and a smaller percentage of elderly patients exhibit genetic defects in IFN-I production, including X-chromosome-linked TLR7 and autosomal TLR3 deficiencies. Around 15–20% of cases over 70 years old, and a smaller percentage of younger patients, present with preexisting autoantibodies neutralizing type I interferons. Additionally, innate errors affecting the control of the response to type I interferon have been associated with pediatric multisystem inflammatory syndrome (MIS-C). Several studies have described rare errors of immunity, such as XIAP deficiency, CYBB, SOCS1, OAS1/2, and RNASEL, as underlying factors in MIS-C susceptibility. However, further investigations in expanded patient cohorts are needed to validate these findings and pave the way for new genetic approaches to MIS-C. This review aims to present recent evidence from the scientific literature on genetic and immunological abnormalities predisposing individuals to critical SARS-CoV-2 infection through IFN-I. We will also discuss multisystem inflammatory syndrome in children (MIS-C). Understanding the immunological mechanisms and pathogenesis of severe COVID-19 may inform personalized patient care and population protection strategies against future serious viral infections.
Distal but not local auditory information supports spatial representations by place cells
Authors: Dolón Vera Laura , Dietz Birte , Manahan-Vaughan Denise
Published: July 2024

Sound is an important navigational cue for mammals. During spatial navigation, hippocampal place cells encode spatial representations of the environment based on visual information, but to what extent audiospatial information can enable reliable place cell mapping is largely unknown. We assessed this by recording from CA1 place cells in the dark, under circumstances where reliable visual, tactile, or olfactory information was unavailable. Male rats were exposed to auditory cues of different frequencies that were delivered from local or distal spatial locations. We observed that distal, but not local cue presentation, enables and supports stable place fields, regardless of the sound frequency used. Our data suggest that a context dependency exists regarding the relevance of auditory information for place field mapping: whereas locally available auditory cues do not serve as a salient spatial basis for the anchoring of place fields, auditory cue localization supports spatial representations by place cells when available in the form of distal information. Furthermore, our results demonstrate that CA1 neurons can effectively use auditory stimuli to generate place fields, and that hippocampal pyramidal neurons are not solely dependent on visual cues for the generation of place field representations based on allocentric reference frames.
Prevalence, Clinical Severity, and Serotype Distribution of Pneumococcal Pneumonia Among Adults Hospitalized With Community-Acquired Pneumonia in Tennessee and Georgia, 2018–2022
Authors: Self Wesley H , Johnson Kelly D , Resser J Jackson , Whitney Cynthia G , Baughman Adrienne , Kio Mai , Grijalva Carlos G , Traenkner Jessica , Johnson Jakea , Miller Karen F , Rostad Christina A , Yildirim Inci , Salazar Luis , Tanios Ralph , Swan Sydney A , Zhu Yuwei , Han Jin H , Weiss Thomas , Roberts Craig , Rouphael Nadine ,   For the PNEUMO Study Investigators, Self Wesley H , Resser J Jackson , Baughman Adrienne , Grijalva Carlos G , Johnson Jakea , Miller Karen F , Swan Sydney A , Zhu Yuwei , Han Jin H , Shipman Sabrina , Rouphael Nadine , Whitney Cynthia , Kio Mai , Traenkner Jessica , Rostad Christina , Yildirim Inci , Bristow Laurel , Salazar Luis , Al-Husein Zayna , Anderson Evan , Benyeogor Ifeyinwa K , Cheng Andrew , Choi Jong-Ha , De Castro Khalel , Drobeniuc Ana , Hellmeister Kieffer , Kay Ariel , Lee Matthew , Patel Vikash , Reese Olivia D , Smith Veronica , Tanios Ralph , Taylor Elizabeth Grace , Taylor Megan , Washington Wesley , Zhang Cecilia , Johnson Kelly D , Weiss Thomas , Roberts Craig , Ruggieri Madelyn
Published: July 2024

Introduction

Understanding the pneumococcal serotypes causing community-acquired pneumonia (CAP) is essential for evaluating the impact of pneumococcal vaccines.

Methods

We conducted a prospective surveillance study of adults aged ≥18 years hospitalized with CAP at 3 hospitals in Tennessee and Georgia between 1 September 2018 and 31 October 2022. We assessed for pneumococcal etiology with cultures, the BinaxNOW urinary antigen detection test, and serotype-specific urinary antigen detection assays that detect 30 pneumococcal serotypes contained in the investigational pneumococcal conjugate vaccine V116, as well as licensed vaccines PCV15 and PCV20 (except serotype 15B). The distribution of pneumococcal serotypes was calculated based on serotype-specific urinary antigen detection results.

Results

Among 2917 hospitalized adults enrolled with CAP, 352 (12.1%) patients had Streptococcus pneumoniae detected, including 51 (1.7%) patients with invasive pneumococcal pneumonia. The 8 most commonly detected serotypes were: 3, 22F, 19A, 35B, 9N, 19F, 23A, and 11A. Among 2917 adults with CAP, 272 (9.3%) had a serotype detected that is contained in V116, compared to 196 (6.7%) patients with a serotype contained in PCV20 (P < .001), and 168 (5.8%) patients with a serotype contained in PCV15 (P < .001). A serotype contained in V116 but not PCV15 or PCV20 was detected in 120 (4.1%) patients, representing 38.0% of serotype detections.

Conclusions

Approximately 12% of adults hospitalized with CAP had S. pneumoniae detected, and approximately one-third of the detected pneumococcal serotypes were not contained in PCV15 or PCV20. Development of new pneumococcal vaccines with expanded serotype coverage has the potential to prevent a substantial burden of disease.
SARS-CoV-2 Plasma Antibody and Nucleocapsid Antigen Status Predict Outcomes in Outpatients With COVID-19
Authors: Jilg Nikolaus , Giganti Mark J , Chew Kara W , Shaw-Saliba Katy , Ritz Justin , Moser Carlee , Evering Teresa H , Daar Eric S , Eron Joseph J , Currier Judith S , Hughes Michael D , Lane H Cliff , Dewar Robin , Smith Davey M , Li Jonathan Z
Published: July 2024

Background

Reliable biomarkers of coronavirus disease 2019 (COVID-19) outcomes are critically needed. We evaluated associations of spike antibody (Ab) and plasma nucleocapsid antigen (N Ag) with clinical outcomes in nonhospitalized persons with mild-to-moderate COVID-19.

Methods

Participants were nonhospitalized adults with mild-to-moderate COVID-19 enrolled in ACTIV-2 between January and July 2021 and randomized to placebo. We used quantitative assays for severe acute respiratory syndrome coronavirus 2 spike Ab and N Ag in blood and determined numbers of hospitalization/death events within 28 days and time to symptom improvement.

Results

Of 209 participants, 77 (37%) had quantifiable spike Ab and 139 (67%) quantifiable N Ag. Median age was 50 years; 111 (53%) were female, 182 (87%) White, and 105 (50%) Hispanic/Latino. Higher risk of hospitalization/death was seen with unquantifiable (22/132 [16.7%]) versus quantifiable (1/77 [1.3%]) spike Ab (risk ratio [RR], 12.83 [95% confidence interval {CI}, 1.76–93.34]) and quantifiable (22/139 [15.8%]) vs unquantifiable (1/70 [1.4%]) N Ag (RR, 11.08 [95% CI, 1.52–80.51]). Increasing risk of hospitalizations/deaths was seen with increasing N Ag levels. Time to symptom improvement was longer with unquantifiable versus quantifiable spike Ab (median, 14 [interquartile range {IQR}, 8 to >27] vs 8 [IQR, 4–22] days; adjusted hazard ratio [aHR], 0.66 [95% CI, .45–.96]) and with quantifiable versus unquantifiable N Ag (median, 12 [7 to >27] vs 10 [5–22] days; aHR, 0.79 [95% CI, .52–1.21]).

Conclusions

Absence of spike Ab and presence of plasma N Ag predicted hospitalization/death and delayed symptom improvement in COVID-19 outpatients.

Clinical Trials Registration

NCT04518410
Urine metabolite changes after cardiac surgery predict acute kidney injury
Authors: Zeng Qi , Feng Jinghan , Zhang Xinni , Peng Fangyuan , Ren Ting , Zou Zhouping , Tang Chao , Sun Qian , Ding Xiaoqiang , Jia Ping
Published: July 2024

Background

Acute kidney injury (AKI) is a serious complication in patients undergoing cardiac surgery, with the underlying mechanism remaining elusive and a lack of specific biomarkers for cardiac surgery-associated AKI (CS-AKI).

Methods

We performed an untargeted metabolomics analysis of urine samples procured from a cohort of patients with or without AKI at 6 and 24 h following cardiac surgery. Based on the differential urinary metabolites discovered, we further examined the expressions of the key metabolic enzymes that regulate these metabolites in kidney during AKI using a mouse model of ischemia–reperfusion injury (IRI) and in hypoxia-treated tubular epithelial cells (TECs).

Results

The urine metabolomic profiles in AKI patients were significantly different from those in non-AKI patients, including upregulation of tryptophan metabolism– and aerobic glycolysis–related metabolites, such as l-tryptophan and d-glucose-1-phosphate, and downregulation of fatty acid oxidation (FAO) and tricarboxylic acid (TCA) cycle–related metabolites. Spearman correlation analysis showed that serum creatinine was positively correlated with urinary l-tryptophan and indole, which had high accuracy for predicting AKI. In animal experiments, we demonstrated that the expression of rate-limiting enzymes in glycolysis, such as hexokinase II (HK2), was significantly upregulated during renal IRI. However, the TCA cycle–related key enzyme citrate synthase was significantly downregulated after IRI. In vitro, hypoxia induced downregulation of citrate synthase in TECs. In addition, FAO-related gene peroxisome proliferator-activated receptor alpha (PPARα) was remarkably downregulated in kidney during renal IRI.

Conclusion

This study presents urinary metabolites related to CS-AKI, indicating the rewiring of the metabolism in kidney during AKI, identifying potential AKI biomarkers.
CardioTwins: case report of a transcatheter mitral and tricuspid valve implantation in one patient
Authors: Schmidt Tobias , Kuck Karl-Heinz , Marquetand Christoph , Eitel Ingo , Frerker Christian
Published: July 2024

Background

Besides transcatheter edge-to-edge repair (TEER), there are new interventional treatment options for mitral and tricuspid regurgitation in evaluation, such as a complete replacement of the valve through a prosthesis.

Case summary

A 78-year-old previous coronary artery bypass graft-operated patient with symptomatic severe mitral regurgitation and tricuspid regurgitation was sequentially treated by a transfemoral transcatheter mitral and tricuspid valve prosthesis (Cardiovalve; Cardiovalve Ltd, Israel) due to unfavourable mitral valve anatomy. The transcatheter mitral valve implantation (TMVI) was performed first and after progression of the tricuspid regurgitation, a second transcatheter valve prosthesis was implanted in tricuspid position (TTVI) 1.5 years later. Imaging showed a twin look-alike picture of a mitral and tricuspid prosthesis and showing the possibility of a complete transcatheter based replacement of the mitral and tricuspid valve.

Discussion

This case shows the possibility of a Cardiovalve prosthesis being used for TMVI and TTVI in a single patient. Especially in TEER ineligible patients, it might be a good treatment option after device approval.
Agricultural Technological Change, Female Earnings and Fertility: Evidence from Brazil
Authors: Moorthy Vivek S
Published: July 2024

I study how agricultural technological change affects labour market opportunities and fertility in a developing country context. Exploiting plausibly exogenous variation in the adoption of genetically engineered soy across municipalities in Brazil, I show that this labour-saving technology reduced female agricultural earnings and employment without inducing any female sectoral reallocation. Furthermore, this technology adoption increased fertility due to increases in overall household earnings and substitution effects driven by the reduction in female labour demand. These results suggest that technological progress in developing countries may not improve female economic opportunities or lower fertility unless substitution effects are negative and sufficiently large.
Oral anticoagulants and cognitive disease progression in atrial fibrillation
Authors: Wood K A , Ko Y A , Han F , Wharton W
Published: July 2024

Background

Atrial fibrillation (AF) is associated with cognitive decline and dementia. Use of oral anticoagulant (OAC) medications has been reported to offer a lower risk of dementia, but whether differences exist in risk of cognitive decline between types of OAC agents is unclear.

Purpose

We explored whether the progression from normal cognition to mild cognitive impairment (MCI) or MCI to dementia differs between adults with AF on warfarin versus non-Vitamin K inhibitors (NOACs) in the National Alzheimer’s Coordinating Center (NACC) clinical case series.

Methods

Data freeze/extraction of NACC data (N= 48,605) took place June 2023. The presence of AF was derived using both clinician-reported health information and self-reported medical history. Subjects with AF who reported use of OACs, had normal cognition and no history of stroke at baseline, and had at least one follow-up visit were included. OAC usage was calculated based on follow-up time and reported OAC use in previous visits. Continuation ratio models (with subject-specific random intercepts) were used to examine the association between OAC type and cognitive diagnosis controlling for cognitive diagnosis from previous visit. Interactions with sex were examined in all models.

Results

Among 1,475 eligible participants, 478 reported taking OACs including either warfarin (N=396) or NOACs (N=82) at baseline (mean age 79 years, 51% females, 84% White). Individuals on NOACs were either on dabigatran (N=24, 29%) or rivaroxaban (N=58, 71%). The median follow-up time was 4 (interquartile range 2-7) years. About 63% continued using either warfarin or NOACs, 44% switched from warfarin to NOACs, and 2% switched from NOACs to warfarin. After adjusting for age, sex, education, race, hypertension, diabetes, hyperlipidemia, smoking history, and depression in the past two years, no significant association was found between OAC type and cognitive decline (p=0.14).

Conclusions

In this study of older patients with AF on OACs, we found similar risks of cognitive decline between those on NOACs or warfarin. Future studies should consider effects of patient age, provider prescribing practices, and OAC adherence on this risk.
Experiences of patients and nurses with thirst in advanced chronic heart failure: a mixed methods study
Authors: Wefer F , Moehler R , Calo S , Koepke S
Published: July 2024

Background

Many patients with chronic heart failure (CHF) express thirst. Perceptions of thirst and strategies for reducing this symptom can differ between patients and nurses.

Purpose

As part of a study to develop and evaluate a nurse-based counselling intervention on thirst in patients with advanced CHF waiting for heart transplantation, we aimed to assess patients' and nurses' perceptions on thirst, possible strategies, as well as information needs and information transfer.

Methods

Mixed methods study consisting of semi-structured interviews with hospitalized patients waiting for a heart transplantation in Germany. Interviews focussed on experiences with thirst, needs and requirements, and experiences with the information provided by healthcare professionals. We also conducted focus groups and an online survey with German nurses with experiences in the care of cardiac patients. Topics of the focus groups were the perceptions and handling of the symptom in nursing practice as well as the provision of information and counselling. The survey was based on the results of the focus groups and current research findings. In addition to work-related data, we asked questions about the relevance of thirst, the causes of this symptom, recommended interventions and the need for counselling. We analysed quantitative data descriptively and qualitative data using content analysis.

Results

We conducted 10 interviews with patients (mean age: 43.5 years; 30% female; duration of CHF: 25 days to 21 years; length of stay: 7 to 116 days). All participants had a prescribed fluid restriction. Perceived thirst markedly differed between patients, with some reporting thirst to be very distressing. Most patients described that the feeling of thirst increased especially at mealtimes. Individual strategies for reducing thirst also differed between patients depended on disease durations and their therapeutic regiment. Some patients rated the information provision by healthcare professionals concerning thirst as insufficient. In addition, we conducted two focus groups with respectively 5 nurses from two university hospitals in Germany. 59 nurses participated in the survey. Nurses (81.4% working in a hospital; 54.2% already have at least 5 years of experience in care of cardiac patients) stated that the feeling of thirst in patients with CHF is of great importance in nursing practice, but only 44.1% specified to regularly assess thirst. The perceived most common cause of thirst was a prescribed fluid restriction (93.2%) and diuretics (79.7%). Among others, most nurses recommended ice cubes as intervention to reduce thirst and considered counselling interventions as important.

Conclusion(s)

The occurrence of thirst is an important issue for patients with advanced CHF. The perception of the symptom varies greatly. Individualised, evidence-based strategies for symptom management are required.
Pre - and post- COVID era: how did the pandemic impact the number of cardiovascular examinations?
Authors: Dimishkovska S D , Lazeska M L , Alii N A , Tasevska V T , Josevska I J , Zafirovska D Z , Klincheva M K , Mitrev Z M
Published: July 2024

Introduction

A lot of evidence suggests a close link between COVID-19 and cardiovascular diseases. Recent data indicate that COVID-19 may increase the risk of cardiovascular diseases in the future, to an extent similarly observed in reference to the more traditional cardiovascular risk factors.

Health practitioners, nurses, and doctors have a hypothesis that, since COVID began, more and more younger patients seek cardiovascular examinations.

The Purpose of this study is to compare the number of cardiovascular examinations before and after the beginning of the COVID pandemic, by gender and age.

Materials and Methods

We examined the total number of cardiovascular examinations performed at the diagnostic center, Zan Mitrev clinic, Skopje, R. Macedonia, for a period of three years before COVID-19, i.e., from January 2017 to March 2020, and three years after the start of the pandemic, i.e. from March 2020 to March 2023. We structured the comparison by gender and age of the patients before and after COVID. Cardiovascular examination in our hospital comprises electrocardiography, echocardiography and cardiologic consultation. All of the collected data came from the Hospital Information System.

Results

A total of 24,496 cardiovascular examinations were performed between January 2017 and March 2020. The cohort of patients comprised 13,374 men (55%) and 11,121 (45%) women. The average age was 53±30 years. During the period from March 2020 to March 2023 a total of 33,825 cardiovascular examinations were performed, and the patients comprised 18,137 (54%) men and 15,687 (46%) women. The average age was 55±43 years.

Conclusions

Although there seems to be an upward trend of the number of cardiovascular examinations after the COVID pandemic started, there is no statistically significant difference between the data categorized by age and gender before and after the COVID era.
A generic logic model for physical activity interventions for the cardiac population using intervention mapping
Authors: Marcos T A , Kulnik S , Crutzen R
Published: July 2024

Introduction

Regular physical activity is important in the secondary prevention of cardiovascular disease. But many cardiac patients have difficulty establishing lifelong physical activity habits, even after completion of an exercise-based cardiac rehabilitation programme. There is a need for effective interventions to support cardiac patients' physical activity. Such interventions are often complex behaviour change interventions whose design should be grounded in programme theory, i.e., a description of how the intervention is expected to lead to its effects and under what conditions. A logic model is often used to communicate programme theory [1].

Purpose

The purpose of this work was to describe a generic logic model for behaviour change interventions to increase and maintain physical activity among patients who have had an acute cardiac event.

Methods

We applied the Intervention Mapping approach [2] to develop a generic logic model that is both data- and theory-driven, i.e. informed by research evidence and behaviour change theory. The at-risk behaviour for the individual cardiac patient was defined as "insufficient independent long-term maintenance of heart-healthy physical activity", compounded by the environmental factor "lack of support provision for long-term independent physical activity" from the healthcare providers and people in the patient’s interpersonal environment. We defined performance objectives by asking the questions: "What do people who had an acute cardiac event need to do to increase and maintain their heart-healthy physical activity?" and "What do the healthcare providers and people in the patient’s interpersonal environment need to do to encourage and support the patient in being physically active?" The performance objectives specify what actions are required of the individuals targeted in the intervention. We selected determinants corresponding to performance objectives based on empirical evidence from systematic reviews and based on behaviour change theory such as the Reasoned Action Approach (RAA) and the Health Action Process Approach (HAPA).

Results

Central elements of the logic model are presented in table 1. The logic model includes 18 performance objectives and 13 determinants, supported by empirical evidence from 40 scientific publications.

Conclusion

The generic logic model serves as a collection of current knowledge regarding increasing and maintaining physical activity among the cardiac population and can be used for a number of purposes: as a foundation for developing new interventions; as a blueprint against which to compare and/or solidify the programme theory of existing interventions; as a conceptual framework for designing evaluations of interventions; as a current evidence map from which to identify research gaps; and as a point of reference for reflecting on one’s own health behaviour.Table 1.Elements of the logic model.