bluuebunny/crossref_metadata_2025 huggingface dataset:
Sickle Cell Disease in East African Countries: Prevalence, Complications and Management
Authors: Kawuki Joseph , Musa Taha Hussein , Obore Nathan , Papabathini Shireen Salome
Published: September 2019

Sickle cell disease (SCD) is one of the most common life-threatening monogenic disorders affecting millions of people worldwide. The disease has a high prevalence in malaria-endemic tropics, especially in sub-Saharan Africa. Although sickle-cell trait (SCT) offers protective advantage against malaria, it does not apply to homozygous individuals with sickle cell anemia but instead makes them more susceptible to not only malaria but to also other infections, causing a great deal of under-five mortality. Despite the fatal risks and high incidence rates of SCD, little attention is given, in terms of funding, management and surveillance, especially among East African countries. In addition, few works of literature exist, and less has been documented about the disease. This minireview aimed to report the current situation in terms of prevalence, mortality, diagnosis and management of SCD among East African countries; Uganda, Kenya, Tanzania, Rwanda and Burundi.

SCD is characterised by retarded growth, chronic pain attacks and severe organ damage leading to fatal complications. This, coupled with limited resources in East African countries, reduces the survival of SCD patients and most die before five years. SCD is detected through a blood test usually by Haemoglobin electrophoresis, and Hydroxyurea therapy, antibiotics and blood transfusion are used to prevent complications. Early childhood detection through comprehensive newborn screening programmes has been implemented in some countries and is key in the management of the disease.
Patient Gowns and Dehumanization During Hospital Admission
Authors: Punchihewa Gehani Chamilka , Broadbent Elizabeth
Published: December 2024

This parallel-design double-blind randomized clinical trial examines the effects of patient gowns on feelings of dehumanization among individuals undergoing simulated hospital admission interviews in New Zealand.
Processing, Isolation, Detection, and Interpretation of Aerobic Bacteriology Cultures
Authors: Harrington Amanda T. , Yarbrough Melanie L.
Published: December 2024

This chapter focuses on processing of specimens for aerobic bacteriology and interpretation and rapid identification of bacterial growth on primary culture media. The initial processing of clinical specimens for aerobic bacteriology is a multifaceted endeavor involving a number of decision‐making steps, including assessing the need for processing the specimen for anaerobic bacteriology, mycology, virology, and parasitology, depending on the nature of the specimen and requests from clinicians. First, one must consider the specimen type and its anatomic origin. The second step is the selection of primary isolation medium to be used for each specimen type. The initial interpretation of aerobic bacterial growth on primary culture media is an opportunity for the medical laboratory scientist or clinical microbiologist to make a preliminary identification and decide what additional tests and procedures must be performed to arrive at a definitive identification. The chapter presents a list of commonly used primary plating media.
Cerebrospinal Fluid Cultures
Authors: Selvarangan Rangaraj
Published: December 2024

Bacterial meningitis is the result of infection of the meninges. Identification of the infecting agents is one of the most important functions of the diagnostic microbiology laboratory because acute meningitis is life‐threatening. Cerebrospinal fluid (CSF) from a patient suspected of having meningitis is an emergency specimen that requires immediate processing to determine the etiologic agent. CSF is obtained by transcutaneous aspiration, and therefore, all organisms recovered from the culture are potential pathogens and must be reported to the physician immediately. Aerobic bacteria commonly cause bacterial meningitis, but anaerobes may be present in CSF when a meningeal abscess or a similar infectious process is adjacent to the meninges. These include traumatic head injury or prostheses, such as metal cranial plates and shunt drains. The chapter focuses on specimen collection, transport, and handling, quality control, procedure, interpretation and limitations of the procedure.
Fecal and Other Gastrointestinal Cultures
Authors: Pillai Dylan R. , Griener Thomas
Published: December 2024

Fecal cultures should not be performed for patients being treated with broad‐spectrum antimicrobial agents, because it is likely that the antimicrobial therapy is responsible for the diarrhea.
Campylobacter
is the most commonly identified bacterial pathogen isolated from fecal cultures.
Campylobacter
,
Arcobacter
, and
Helicobacter
species are Gram‐negative curved, gull‐winged, or spiral‐shaped bacilli which are motile by polar flagella and exhibit diverse growth requirements that can make them difficult to culture by routine methods.
Arcobacter
organisms are considered emerging enteropathogens and identified as the causative agents in outbreaks of gastroenteritis, though they can be isolated from stool of asymptomatic people and their significance as human pathogens has not been definitively established. For pediatric patients admitted with gastroenteritis and on bowel rest, it may take several days to collect a stool specimen.
Introduction
Authors: Schuetz Audrey N.
Published: December 2024

Anaerobic bacteria are a significant component of the normal microbiota of the human host. There are anaerobes present on most body surfaces and mucous membranes; they exist in large numbers throughout the entire gastrointestinal tract, from the mouth to the colon; and they are found in large numbers in the female genitourinary tract. Anaerobic bacteria can cause a wide variety of infections, including wound infections as a result of trauma or surgery; abscesses of the liver, brain, lung, and other local sites; appendicitis; peritonitis; chronic otitis media and sinusitis; endophthalmitis; bacteremia; endocarditis; myonecrosis; gas gangrene; and dental and oral infections. This chapter discusses resurgence of Lemierre's syndrome and the increased association of newly named and emerging anaerobes with many types of infections. It describes acceptable specimen collection, transport, and inoculation for anaerobe recovery. The chapter provides situational examples outlining the extent to which anaerobe work‐up should be followed.
A Practical Guide to the Workup of Anaerobic Cultures
Authors: Shannon Samantha K. , Pence Morgan A.
Published: December 2024

This chapter provides a practical guidance to the workup of anaerobic cultures. When a specimen is sent to the laboratory in an appropriate container and from an appropriate site with a request for anaerobe testing, a Gram stain should be performed and reported. All specimens for which anaerobe culture is requested should undergo simultaneous aerobic culture. Workup of anaerobic cultures should be completed while taking into account the corresponding aerobic culture. In cultures with three or more organisms, workup may focus on the bacteria with the highest potential to be pathogenic. The extent of workup of anaerobes may vary based on whether the specimen was collected from a nonsterile site or a sterile site. The chapter provides the information of identification of anaerobic bacteria isolated from nonsterile sites. Identification procedures that require a week or more to complete may be of academic interest only.
Continuous‐Monitoring Blood Culture Systems for Detection of Aerobic and Anaerobic Bacteria
Authors: Hilt Evann E.
Published: December 2024

This chapter provides preanalytical considerations and postanalytical considerations of continuous‐monitoring blood culture systems for detection of aerobic and anaerobic bacteria. Continuous‐monitoring blood culture systems (CMBCS) are the most widely used methods for blood culture in the laboratory today. Several manufacturers produce CMBCS. Each has a proprietary computer algorithm to detect gas production or consumption in relation to microbial growth. The Versa TREK system has a higher blood‐to‐broth ratio and a larger headspace in the bottle, which allows the system to monitor pressure changes due to consumption and/or production of gas. Blood culture bottles designed for the recovery of bacteria are also capable of recovery of many yeasts, primarily
Candida
species, which are associated with invasive disease. The chapter provides a list of different bottle formulations available for each commercial system that support the isolation of aerobic and anaerobic bacteria and yeast from clinical specimens.
Staining, Culture, and Identification Methods for Acid‐Fast Bacilli and Fungi Recovered from Positive Blood Cultures
Authors: Lainhart William D. , Luethy Paul M.
Published: December 2024

Fungemia is often a result of disseminated fungal infections in immunosuppressed patients and can be a significant cause of mortality.
Candida
spp. are the most common cause of fungemia, with filamentous fungi causing fewer cases. Very few filamentous fungi are generally recoverable from blood culture bottles; the most common fungi include
Histoplasma capsulatum
,
Blastomyces
spp.
Fusarium
spp., and
Trichosporon
spp.
Aspergillus
spp. are rarely recovered from blood and associated with true fungemia, with the rare exception of
Aspergillus terreus
. Bloodstream infections with acid fast bacilli typically occur as a result of disseminated disease in immunocompromised individuals. Culture methods of positive blood cultures for acid‐fast bacilli and fungal blood cultures are similar to those followed for bacterial blood cultures. After the blood culture instrument detects growth in the bottle, the appropriate stain(s) is performed and examined and the broth is plated to agar media to allow microorganism growth and identification.
Specialized Processing of Blood
Authors: Chamberland Robin R.
Published: December 2024

Transfusable blood components, including platelets, red blood cells, and plasma, pose a risk of transfusion‐transmitted bacterial infection (TTBI). Platelet products are associated with the highest risk of TTBI of all transfusable blood components, with an overall rate of 1.95 per 10
5
units transfused. This chapter focuses on the microbiologic evaluation of transfusion reaction. In cases of suspected TTBI, the transfusion should be stopped, and the port should be covered or the tubing clamped. The component bag containing any residual product should be placed in a sealed plastic bag and transported to the laboratory immediately for culture. Culture of transfused blood products should always be accompanied by concurrent blood cultures performed for the patient experiencing a transfusion reaction. The chapter focuses on the specimen collection, transport, and handling, materials, quality control, interpretation, reporting results and limitations of procedure.
MALDI‐TOF MS for Bacterial and Yeast Identification
Authors: Fisher Mark A. , Powers‐Fletcher Margaret
Published: December 2024

This chapter presents the procedure of MALDI‐TOF MS for bacterial and yeast identification. Identification of bacteria and yeasts in the clinical microbiology laboratory has traditionally relied on a combination of phenotypic characteristics, including Gram stain results, colony morphology, growth characteristics, and biochemical reactions. Sequencing of genes with both conserved and variable regions, such as rRNA genes, has enhanced the laboratory's capacity to accurately identify microorganisms with greater resolution for species‐level identification. The FDA‐cleared MALDI‐TOF mass spectrometry databases for bacteria and yeasts are largely composed of aerobic species with much smaller subsets of anaerobes and yeasts. This procedure describes protocols for the application of MALDI‐TOF MS to routine bacterial and yeast identification in the clinical microbiology laboratory. The chapter also covers proper quality control principles for analytical tests. With postanalytical considerations, it provides attention to common test limitations, interpretive challenges, and results reporting.
Oxacillin Salt Agar Test to Detect Methicillin (Oxacillin)‐Resistant
Staphylococcus aureus
Authors: Simner Patricia J.
Published: December 2024

The oxacillin salt agar test is an optional test for detecting
mec
A‐mediated methicillin (oxacillin) resistance in
Staphylococcus aureus
. A standard number of bacteria are inoculated onto Mueller‐Hinton agar containing 6 µg of oxacillin per ml and 4% NaCl. Following overnight incubation, the appearance of growth indicates that the
S. aureus
isolate is resistant to oxacillin, all other penicillins, carbapenems, beta‐lactam–beta‐lactamase inhibitor combinations, and cephems with the exception of ceftaroline. The chapter covers proper quality control principles for analytical tests. With postanalytical considerations, it provides attention to common test limitations, interpretive challenges, and results reporting.
Introduction: Traditional Methods for Laboratory Diagnosis of Viral and Chlamydial Infections
Authors: Hodinka Richard L.
Published: December 2024

This part introduction presents an overview of the key concepts discussed in the subsequent chapters. The part focuses on some of the more traditional culture and rapid immunologic methods for the detection and identification of viruses in a diagnostic laboratory. It includes
Chlamydia
culture given that this method is virtually always performed in a clinical virology laboratory or a distinct section of the clinical microbiology laboratory due to the need for a cell culture system and appropriate facilities. Traditional methods continue to have a place in regional and national reference laboratories to help identify and characterize new viruses or variants of well‐recognized viruses not detected by molecular methods, for active surveillance to detect and monitor disease outbreaks, and in support of research activities for antiviral drug and vaccine development.
Generalizability of consensus regarding standardized letters of evaluation competitiveness: A validity study in a national sample of emergency medicine faculty
Authors: Bord Sharon , Sehdev Morgan , Pelletier‐Bui Alexis , Alvarez Al'ai , Schnapp Benjamin , Dubosh Nicole , Schrepel Caitlin , Park Yoon Soo , Shappell Eric
Published: December 2024

Background

Standardized letters of evaluation (SLOEs) are an important part of residency recruitment, particularly given the limited availability of other discerning factors in residency applications. While consensus regarding SLOE competitiveness has been studied within a small group of academic faculty, it remains unexplored how a more diverse group of letter readers interpret SLOEs in terms of competitiveness.

Methods

A sample of 50 real SLOEs in the new SLOE format (2022 eSLOE 2.0) were selected to match the national rating distribution and anonymized. These SLOEs were ranked in order of competitiveness by 25 faculty members representing diverse demographics, geographic regions, and practice settings. Consensus levels were assessed using previously defined criteria and compared to prior results using a cutoff of ±10% to define a significant difference in consensus levels. Two models were tested to determine their ability to predict consensus rankings: a point‐based system and a linear regression model.

Results

Faculty consensus in this diverse cohort was slightly below the level measured among academic emergency medicine faculty in the prior study, though no differences were greater than the ±10% cutoff. Prediction models also performed similarly to a previous study except at the tight level of agreement, where consensus was stronger in this study compared to previous results. There is greater consensus among faculty at academic institutions than at community institutions, and years of experience was not correlated with higher consensus.

Conclusions

The degree of consensus regarding competitiveness using real SLOEs was similar in this diverse national sample compared to a prior study in a smaller and more homogenous group ranking mock SLOEs. Consensus ranks were predicted with good accuracy using both the point system and the regression model.
Designing and screening single‐atom alloy catalysts for CO2 reduction to CH3OH via DFT and machine learning
Authors: Zhou Wenyu , Feng Haisong , Zhou Shihong , Wang Mengxin , Chen Yuping , Lu Chenyang , Yuan Hao , Yang Jing , Li Qun , Tan Luxi , Dong Lichun , Zhang Yong‐Wei
Published: December 2024

Carbon dioxide (CO2) utilization technology is of great significance for achieving carbon neutrality, in which the catalytic materials play crucial roles, and among them, single‐atom alloys (SAAs) are of particular interests. In this study, density functional theory (DFT) calculations and machine learning are employed to assess the effectiveness of Cu‐, Ag‐, and Ni‐host SAAs as catalysts for electrochemical CO2 reduction to CH3OH. The Gibbs free energies of 477 elementary reactions across 35 SAAs involved in CO2 reduction are calculated, and by utilizing this dataset, a trained gradient boosting regression model is established with an excellent accuracy. Subsequently, the properties of 46 unknown SAAs are predicted, including their pathways, products, potential‐determining steps (PDS), and corresponding Gibbs free energies of the PDS (GPDS). Three promising candidates, ZnCu, AuAg and MoNi, stand out due to their lowest GPDS among Cu‐, Ag‐ and Ni‐ hosted SAAs, respectively.
73 Meter lange integrale Holz‐Carbonbeton‐Verbundbrücke
Authors: Frede Julian , Krämer Timo , Rempel Sergej , Kasic Slobodan
Published: December 2024

Der Bau der „Brücke über den Seeblickweg“ zeichnet sich aus durch die Verwendung innovativer Bauweisen und unkonventioneller Materialien. Die zweifeldrige Fuß‐ und Radwegbrücke vereint einen Holz‐Beton‐Verbundquerschnitt in den Feldbereichen mit einem Carbonbetonplattenbalken im Stützbereich und an den Widerlagern. Durch den Einsatz der nichtmetallischen Bewehrung kann die Betondeckung reduziert und auf eine zusätzliche Schutzschicht verzichtet werden. Im vorliegenden Aufsatz werden die carbonbetontechnologischen Details aufgezeigt. Die Bemessung erfolgte anhand der mittlerweile bauaufsichtlich eingeführten Richtlinie „Betonbauteile mit nichtmetallischer Bewehrung“. Im Bauteilbiegeversuch wurden Rissbreiten gemessen und daraus die zulässigen Spannungen der Carbonlängsbewehrung ermittelt. Diese wurde für ein verbessertes Verbundverhalten besandet. Die Querkraftbewehrung kombiniert Steckbügel aus Carbon sowie Stäbe aus glasfaserverstärktem Kunststoff. Die Herausforderungen im Umgang mit den innovativen Baustoffen bei der Herstellung der Brücke werden beschrieben sowie erste Ergebnisse aus einem Rissmonitoring mittels faseroptischer Messstränge vorgestellt.
Novel Schiff Base Sulfonate Derivatives as Carbonic Anhydrase and Acetylcholinesterase Inhibitors: Synthesis, Biological Activity, and Molecular Docking Insights
Authors: Yaşar Ümit , Demir Yeliz , Gönül İlyas , Özaslan Muhammet Serhat , Çelik Gizem Gümüşgöz , Türkeş Cüneyt , Beydemir Şükrü
Published: December 2024

Sulfonate derivatives are an essential class of compounds with diverse pharmacological applications. This study presents the synthesis and detailed characterization of six novel Schiff base sulfonate derivatives (L1–L6) through spectroscopic techniques (FT‐IR and NMR). Their inhibitory potential was evaluated against human carbonic anhydrase isoenzymes (hCA I and hCA II) and acetylcholinesterase (AChE), which are crucial therapeutic targets for diseases such as glaucoma, epilepsy, and Alzheimer's disease. The KI values for the compounds concerning AChE, hCA I, and hCA II enzymes were in the ranges of 106.10 ± 14.73 to 422.80 ± 17.64 nM (THA: 159.61 ± 8.41 nM), 116.90 ± 24.40 to 268.00 ± 35.84 nM (AAZ: 439.17 ± 9.30 nM), and 177.00 ± 35.03 to 435.20 ± 75.98 nM (AAZ: 98.28 ± 1.69 nM), respectively. Molecular docking analyses revealed key interactions within the active sites of the enzymes, including hydrogen bonding with critical residues and π–π stacking interactions. Notably, L3 demonstrated superior inhibition against hCA I (KI: 116.90 ± 24.40 nM) and AChE (KI: 106.10 ± 14.73 nM), positioning it as a promising lead compound. This comprehensive investigation contributes to the development of isoform‐specific inhibitors for therapeutic use and provides valuable insights into their binding mechanisms. The findings underscore the potential of Schiff base sulfonates as scaffolds in drug discovery for neurodegenerative and metabolic disorders.
Higher Assemblies of Coordination Cage‐Catenanes Linked by Copper(II) Chloride Clusters: Networks and Transformations
Authors: Snelgrove Matthew P. , Sergeeva Natalia N. , Hardie Michaele J.
Published: December 2024

Cage‐catenanes are chemical constructs where two or more cage‐like molecules or assemblies are mechanically interlocked together. We report a new class of cage‐catenanes where dimeric metal‐organic cage‐catenanes are linked into larger assemblies through additional bridging metal chloride links. These crystalline materials are obtained from the reaction of tris(nicotinoyl)cyclotriguaiacylene (L1) with Cu(II) salts, and all feature a tetramer of cages where two {Cu3(L1)2(X)6} cages (X=anion) are mechanically interlocked, and link to each other and to another {Cu3(L1)2(X)6}2 cage‐catenane through a planar, linear tetranuclear {Cu4(μ‐Cl)6Cl2} cluster. The complex of discrete tetrameric {Cu3(L1)2(X)6}4 assemblies (dimers of cage‐catenanes) transforms through solvent‐exchange processes to 1D coordination chain structures through additional {Cu2(μ‐Cl)2} bridges between the tetrameric {Cu3(L1)2(X)6}4 assemblies. Complex [Cu6(L1)4Cl12(H2O)3] ⋅ (H2O) ⋅ 15(DMF) C2 features a 2D coordination network of 63 topology linked through three different Cu(II) clusters, namely {Cu4(μ‐Cl)6}, {Cu2(μ‐Cl)2} and a rare linear {Cu2(μ‐Cl)} linkage. Break‐down of C2 in water likely proceeds through hydrolysis of this unusual linear Cu‐Cl‐Cl bond.
High survival promotes bunchgrass persistence in old‐growth savannas under different fire regimes
Authors: Fill Jennifer M. , Crandall Raelene M.
Published: December 2024

Clonal perennial grasses are a key functional group in fire‐prone, old‐growth grasslands and savannas. They are flammable and can resist extinction for decades. Although clonal grasses as a functional group are considered resilient to fire regime variation, data‐based research on clonal grass dynamics under multiple different fire regimes is still lacking. We modeled the population dynamics of wiregrass (Aristida beyrichiana), an endemic perennial bunchgrass, under very different long‐term, frequent fire regimes within the historical range of variation, in two southeastern US pine savanna environments. All wiregrass populations had similar and stable population growth rates. As expected for a long‐lived species, survival was nearly 100% in all populations. Given that flowering in wiregrass is fire‐stimulated, there was high variability in flowering and seed production between fire and non‐fire years. The consistency of results between our study populations lends data‐driven support to wiregrass' resilience under fire regimes that differ in frequency and seasonality. The patterns we observed in wiregrass mirror inferences from other studies of dominant grass dynamics in old‐growth tropical savannas and support the inclusion of old‐growth US pine savannas in global savanna ecology.
Pollination deficits increase with urbanization in Chicago
Authors: Zink Alexandra , CaraDonna Paul J. , Larsen Kelly , Iler Amy M.
Published: December 2024

Urban growth is occurring rapidly, and the land use changes associated with urbanization may have consequences for pollinators and the plants that rely on them. Despite its importance in the face of pollinator declines and expanding urban ecosystems, our understanding of the effects of urbanization on pollination mutualisms is scant. There is both evidence that urban areas support diverse pollinator communities and evidence that they degrade them. The influence of urbanization on the pollination of urban plants is even less understood. Urban agriculture relies on plant–pollinator interactions for crop production, providing a relevant framework to study pollination in an urban context. We therefore grew 240 plants across six sites at varying levels of urbanization in Chicago, Illinois, to investigate how urbanization relates to pollination of Cucurbita pepo (squash) and the buzz‐pollinated Solanum lycopersicum (tomato). We used a pollen limitation experiment to test whether the reproduction of plants at urban farms is pollen‐limited and whether the magnitude of pollen limitation varies with the extent of urbanization (quantified as the percent of surrounding impervious surface around each site). We also examined how pollinator visitation rates vary with urbanization. In S. lycopersicum but not C. pepo, the pollen addition treatment had a consistent and significant positive effect on reproductive success, indicating that plants of S. lycopersicum are pollen‐limited in our study area. The magnitude of pollen limitation increased with greater impervious surface, illustrating that S. lycopersicum plants at more urban sites are more pollen‐limited. For C. pepo, there was only evidence of pollen limitation at the most urban site, and a weak trend of pollen limitation of fruit set (but not seed set) increasing with impervious surface. Our results demonstrate that urban plants are likely experiencing deficits in pollination services but in ways that vary with both the type of pollination system and the level of urbanization in the surrounding area.
Effects of multiple transcranial magnetic stimulation sessions on pain relief in patients with chronic neuropathic pain: A French cohort study in real‐world clinical practice
Authors: Thomas Joy , Fauchon Camille , Oriol Nicolas , Vassal François , Créac'h Christelle , Quesada Charles , Peyron Roland
Published: December 2024

Background

Current clinical trials indicate that repetitive transcranial magnetic stimulation (rTMS) is effective in reducing drug‐resistant neuropathic pain (NP). However, there is a lack of studies evaluating the long‐term feasibility and clinical efficacy of rTMS in large patient cohorts in real‐world conditions.

Methods

In this retrospective cohort study, we analysed 12 years of clinical data to assess the long‐term analgesic effects of 20 Hz rTMS over the primary motor cortex in patients with NP. Subgroup analyses were conducted to identify predictive factors and assess the potential role of epidural motor cortex stimulation (eMCS) as a sustained solution.

Results

In total, 193 patients completed test period of 4 rTMS sessions and 42% of them reported a pain relief (PR) greater than 30%, with concurrent improvement in their most disabling symptom. Iterative rTMS sessions maintained analgesic effects over 10 years in certain patients identified as responders (≥10% PR) without adverse effects. Success probability was higher in patients with central NP compared to peripheral NP (OR = 2.03[1.04;4.00]), and among those with central post‐stroke pain, this probability was higher in ischemic versus hemorrhagic strokes (OR = 3.36[1.17;10.05]). PR obtained with iterative rTMS sessions was an excellent predictor of eMCS efficacy.

Conclusions

While rTMS shows promise as a therapeutic option for some patients with drug‐resistant NP, it does not benefit all patients. Efficacy varies by NP aetiology, aiding patient selection. For responders, eMCS may offer a permanent solution. These findings support a tailored approach to rTMS in NP management, while recognizing both its potential and limitations across diverse patient profiles.

Significance Statement

Multiple rTMS sessions demonstrate long‐term efficacy and safety in treating drug‐resistant neuropathic pain. Extending session numbers for the test period can enhance responder identification, especially in patients with initial low pain relief. This identification refines patient selection for neurosurgery, reducing non‐responders. Central neuropathic pain shows higher success rates than peripheral. For post‐stroke central pain, patients with ischemic stroke are more likely to respond than those with hemorrhagic stroke. These results support integrating rTMS into clinical practice for managing neuropathic pain.
Improvement of Concrete Construction Work Performance Through Employment of Lean Logistics Principles
Authors: Strukova Zuzana , Kozlovska Maria , Tazikova Alena
Published: December 2024

In logistics systems, the use of methods, approaches, and management procedures with the aim of optimizing all activities has increasingly been promoted. In the case studies, the logistics of the concrete construction work during the implementation of concrete frame structures of residential building projects is analyzed. The examination of the logistics of concrete construction work was carried out using a combination of monitoring, measurement, comparison, and modeling methods. In addition to obtaining real data on the mentioned logistics of concrete construction work, by applying the Just in Time method, as one of the methods of lean logistics, the optimal logistics of ready‐mix concrete transport to construction sites was simulated. In order to reveal the most significant wastages during concrete construction work, the essential parameters of real logistics were compared with the parameters of simulated optimal logistics of ready‐mix concrete transport. The goal of the research is to evaluate the intensity of the application of logistics and its elements in the implementation of construction and to point out the importance of the involvement of lean production methods and thus also lean logistics in the construction industry. Based on this study results from construction projects in Slovakia and also based on the experience of the authors of this work, it can be concluded that the use of logistic management in the supply of the main construction material in the production of monolithic concrete structures is poor, and this causes a lot of unnecessary waste, having an adverse effect not only on the construction time, but also on the management of individual construction resources. It has been proven that investment in planning and management of logistics can lead to increased overall efficiency of the construction and can bring profit in the form of system, synchronization of construction process resources.
Using Learning Health System Principles to Embed Patient Experience Data in Primary Care: A Qualitative Investigation
Authors: Ellis Louise A. , Fisher Georgia , Churruca Kate , Saba Maree , Schroeder Tanja , Mahadeva Janani , Vagholkar Sanjyot , Lee Mark Yang , Harrison Reema , Willcock Simon , Braithwaite Jeffrey
Published: December 2024

Background

Though an important component of high‐quality healthcare, the routine collection of patient experience data is limited in primary care, as is the evidence for how this data is being used for quality improvement. This study used a learning health system (LHS) framework to describe how a university‐affiliated community general practice is integrating patient experience data into service and quality improvement efforts, and to identify barriers and facilitators.

Methods

A co‐designed qualitative case study was conducted with academic researchers and staff from a university‐affiliated general practice in Australia. Semi‐structured interviews were conducted in April 2024 with practice staff, and transcripts were deductively coded according to a five‐domain learning health systems framework, and with additional codes capturing barriers and facilitators.

Results

Eighteen (53%) practice staff were interviewed, including general practitioners (n = 11), a practice nurse (n = 1), and administrative staff (n = 6). Participants identified multiple methods through which the practice captured the patient experience that spanned all domains of the LHS framework. However, there was less evidence of a coherent quality improvement strategy being employed, with associated barriers identified around staff workloads, training, and existing government funding policies. Key facilitators to the use of patient experience data included: membership of a larger health organisation and university; key dedicated administrative and clinical roles; and effective leadership, governance structures and policies to support continuous learning and drive service improvement.

Conclusion

This study presents a case example of how patient experience data is being integrated into general practice and identifies key barriers and facilitators to initiating and translating this data for continuous healthcare improvement. By mapping the use of patient experience data to a LHS framework, this study shows how LHS principles can be applied to primary care to facilitate the capture and use of patient experience data on an ongoing basis.
Serum Level of RIPK1/3 Correlated With the Prognosis in ICU Patients With Acute Ischemic Stroke
Authors: Dong Jianhong , Xiong Xinli
Published: December 2024

Background

Acute ischemic stroke (AIS) is a common cerebrovascular disease with high mortality. AIS patients in the intensive care unit (ICU) often have severe conditions that require close monitoring and timely treatment. Receptor‐interacting protein kinase 1 (RIPK1) and RIPK3 play important roles in cell apoptosis and inflammation. However, the relevance of serum RIPK1/3 to AIS patients in the ICU has not been clarified.

Objective

To explore the correlation of serum RIPK1 and RIPK3 with the prognosis of AIS patients in the ICU.

Methods

One hundred and twenty AIS patients were selected as the research subjects for the retrospective analysis. The subjects were grouped based on the volume of cerebral infarction and the score of the National Institute of Health Stroke Scale (NIHSS) and mRS. The correlation was explored using Pearson analysis. The predictive value was valued using the ROC curve.

Results

The content of serum RIPK1 and RIPK3 was gradually elevated with increased cerebral infarction volume and the severity of the disease (p < 0.05). Patients with poor prognosis had a higher content of serum RIPK1 and RIPK3 than those with good prognosis (p < 0.05). Serum RIPK1 and RIPK3 levels were positively correlated with infarct volume, NHISS, and mRS scores (p < 0.001). The area under the curve (AUC) of RIPK1 and RIPK3 for predicting the severity of AIS was 0.703, 0.883, and 0.912, respectively. The AUC for predicting poor prognosis of AIS was 0.797, 0.721, and 0.893, respectively. The cooperative detection of RIPK1 and RIPK3 had higher clinical value.

Conclusion

AIS patients in the ICU had abnormally elevated content of serum RIPK1 and RIPK3, which was closely related to the volume of cerebral infarction, severity, and prognosis. Combined detection of RIPK1 and RIPK3 might help to early identify the severity and evaluate the prognosis, providing a reference basis for clinical doctors to develop treatment strategies.
Laparoscopic ventral mesh uterorectopexy (VMUR) for simultaneously treating rectal prolapse and uterine prolapse: A minimally invasive approach with a single mesh
Authors: Liu Yiran , Hu Pan , Liu Lubin
Published: December 2024

Synopsis

Laparoscopic ventral mesh uterorectopexy (VMUR) is an innovative surgical technique designed to correct both rectal and uterine prolapse simultaneously.
Impact of an intern‐supported antiviral stewardship program for cytomegalovirus prophylaxis and management in high‐risk abdominal solid organ transplant recipients
Authors: Mahn Lindsey , Chandran Mary Moss , Doligalski Christina Teeter , Chargualaf Laura Mincemoyer
Published: December 2024

Introduction

Cytomegalovirus (CMV) infection is associated with increased graft loss and mortality after solid organ transplantation (SOT). CMV infection risk is highest among seronegative recipients of seropositive donors (D+/R‐). Careful monitoring is imperative to ensure appropriate care.

Objectives

This study investigates the impact of intern‐supported pharmacist‐driven monitoring on CMV outcomes in D+/R‐ abdominal SOT recipients.

Methods

A single‐center retrospective cohort study was conducted in CMV D+/R‐ abdominal SOT recipients transplanted between August 1, 2021, and July 31, 2023 to compare recipients undergoing pharmacy intern review versus standard monitoring. A pharmacy student intern reviewed a list of recipients maintained in the electronic health record weekly to ensure proper CMV prophylaxis and management. Following institutional protocols, the intern identified and recommended interventions to the pharmacists for implementation. Primary outcomes included the incidence of CMV infection within 9 months posttransplant and time to CMV eradication after infection. Secondary outcomes included the incidence of antiviral resistance, viral breakthrough, allograft loss, and recipient death.

Results

69 D+/R‐ SOT recipients were included (36 control, 33 intervention). Baseline demographics were similar. There was a nonsignificant decrease in CMV infection within 9 months posttransplant in the intervention group. However, the mean time to CMV eradication after infection was significantly shorter in the intervention group (63 days vs. 24 days, p = 0.004). No differences in secondary outcomes were observed.

Conclusions

CMV infection rates remained elevated in D+/R‐ SOT recipients after transplant despite frequent reviews of prophylaxis and laboratory monitoring, which is likely a result of seronegative status and global immunosuppression. However, eradication of CMV infection can be significantly impacted by close monitoring, such as that provided by a pharmacy student intern, to reduce the time of active infection. This dramatic reduction in time to eradication has the potential to reduce the risk for negative allograft and recipient outcomes associated with CMV infection.
Exploring how personal and program characteristics inform the experiences of engineering students abroad
Authors: Davis Kirsten A. , Knight David B.
Published: December 2024

Background

As more universities seek to offer international experiences for engineering students, it is important to design such programs to effectively support student learning abroad. Previous research on study abroad has focused on a limited number of outcomes and therefore failed to consider the diversity of experiences students may have in the same program and the range of learning outcomes they may develop while abroad.

Purpose

We explored student experiences across multiple types of engineering study abroad programs to address the research question: How do the types of significant experiences students highlighted from their time abroad differ based on student and/or program characteristics?

Method

We interviewed 79 engineering students after completing their study abroad programs using the critical incident technique to identify significant experiences from their time abroad. We used multiple rounds of coding to characterize the critical incidents identified by students and then compared the frequency of our main themes across student and program characteristics.

Results

We found that student experiences differed across both personal and program characteristics, in particular students' prior travel experiences, program duration, and the destination's cultural distance from the United States.

Conclusions

Our findings can inform the design of global engineering programs, which should consider the impact of program characteristics on student experiences and employ a variety of pedagogies to accommodate differences in students' needs and prior experiences. We also argue that it is important to consider students' experiences more holistically in research and evaluation of global engineering programs.
Things We Do for No Reason™: Avoiding naltrexone for alcohol use disorder in liver disease
Authors: Kee Dustin P. , Buyske John J. , Calcaterra Susan L.
Published: December 2024

Hospitalizations related to alcohol use disorder (AUD) are common. Yet, few patients receive pharmacotherapy consistent with guideline recommendations. Previous concerns over the potential hepatotoxicity of naltrexone have been disproven and recent studies have shown its safety and efficacy in patients with cirrhosis. Naltrexone is an effective therapy to reduce heavy alcohol consumption, however, lack of knowledge among prescribers inhibits greater uptake. Hospitalization is an opportune time for change—naltrexone can promote the reduction or cessation of unhealthy alcohol consumption, as well as subsequent readmissions or progression of alcohol‐related liver disease. Hospitalists should stop avoiding naltrexone in the treatment of AUD.
Tibetan Plateau Vortex Activity and Its Relationship With the Tibetan Plateau Summer Monsoon and Precipitation
Authors: Wang Guantian , Hu Zeyong , Yu Haipeng , Sun Genhou , Fan Weiwei , Niu Ruijia , Zhang Bofei
Published: December 2024

The unique topography and location of the Tibetan Plateau (TP) often result in extreme weather events, which have led to disastrous consequences for the TP and its downstream regions. The TP summer monsoon (TPSM) and the TP vortex (TPV) play key roles in the transfer and redistribution of water vapour during the summer months on the TP and are increasingly active in summer and disappear in winter. However, it remains uncertain if a relationship between these systems. Understanding the relationship between these two systems is crucial for uncovering precipitation patterns on the TP, improving weather forecasting accuracy and reducing socioeconomic losses resulting from weather‐related disasters. On the basis of GLDAS and ERA5 reanalysis data from 1996 to 2022, the relationships between TPVs and the TPSM were explored in terms of their intensity and spatial characteristics, and their impacts on the spatial distributions of precipitation across the TP were examined in this study. The results indicated that the monthly mean TPSM index agreed very well with the TPV in terms of the annual number formed, duration and intensity, especially in July and August. The investigation of the movement of the center of the TPSM from May to October revealed that the center of the TPSM moves westward when the TPV is active and moves eastward when the TPV is less active. In years with a strong TPSM, the precipitation location generated by TPVs was biased toward the east. This finding could be attributed to the greater number of TPV events and the fact that the TPVs in years with a stronger TPSM moved eastward across a greater distance than those in years with a weaker TPSM. These findings highlightthe contribution of the joint relationship between the TPSM and TPV to seasonal circulation changes and could provide a new perspective for the study and prediction of precipitation distributions on the TP.
Observed Variability and Future Projections of Urban Heatwaves in Romania
Authors: Cheval Sorin , Amihăesei Vlad Alexandru , Dumitrescu Alexandru , Micu Dana Magdalena , Smău Raluca‐Ioana
Published: December 2024

The crossroad between built‐up areas and extreme heat generates severe consequences on both socio‐ecological systems and the natural environment, and the cities are the most vulnerable. The impact is already significant in the present climate and it will be exacerbated under climate change in many regions, including Romania and especially its southern part. The heatwaves (HWs) are a major risk for our cities as they put constant pressure on population, infrastructure and services for several consecutive days. The urban HWs in 41 Romanian cities are analysed in terms of magnitude, amplitude, duration, number and frequency, as well as the variability of the yearly occurrence of the first and last HW events. The study focuses on the warm season (May–September) and refers to the observed variability (1961–2020) and future projections (2021–2050). The main findings reveal that the occurrence of HWs is not conditioned by geographical and climatic conditions and the cities in any region may experience public health risks associated with extreme heat. This requires permanent monitoring of the phenomena, including the present characteristics and estimating future variations according to different scenarios. Considering the increasing frequency and intensity of extreme heat events expected soon, there is a clear need for region‐specific adaptation, and policymakers should prioritise strategies to protect vulnerable people.
Enhancing Histology Detection in MASH Cirrhosis for Artificial Intelligence Pathology Platform by Expert Pathologist Training
Authors: Goodman Zachary , Akbary Kutbuddin , Noureddin Mazen , Ren Yayun , Chng Elaine , Tai Dean , Boudes Pol , Garcia‐Tsao Guadalupe , Harrison Stephen , Chalasani Naga
Published: December 2024

This study addresses the need for precise histopathological assessment of liver biopsies in Metabolic dysfunction‐Associated Steatohepatitis (MASH) cirrhosis, where assessing nuanced drug effects on fibrosis becomes pivotal. The study describes a framework for the development and validation of an Artificial Intelligence (AI) model, leveraging SHG/TPE microscopy along with insights from an expert hepatopathologist, to precisely annotate fibrous septa and nodules in liver biopsies in MASH cirrhosis. A total of 25 liver biopsies from the Belapectin trial (NCT04365868) were randomly selected for training, and an additional 10 for validation. Each biopsy underwent three sections: Smooth Muscle Actin (SMA) and Sirius Red (SR) staining for septa and nodule annotation by pathologists and an unstained section for SHG/TPE imaging and AI annotation using qSepta and qNodule algorithms. Re‐training of qSepta and qNodule algorithms was executed based on pathologist annotations. Sensitivity and positive predictive value (PPV) were employed to evaluate concordance with pathologist annotations, both pre‐ and post‐training and during validation. Post‐re‐training by pathologist annotations, the AI demonstrated improved sensitivity for qSepta annotations, achieving 91% post‐training (versus 84% pre‐training). Sensitivity for qSepta in the validation cohort also improved to 91%. Additionally, PPV significantly improved from 69% pre‐training to 85% post‐training and reached 94% during validation. For qNodule annotations, sensitivity increased from 82% post‐training to 90% in the validation cohort, while the PPV was consistent at 95% across both training and validation cohorts.This study outlines a strategic framework for developing and validating an AI model tailored for precise histopathological assessment of MASH cirrhosis, using pathologist training and annotations. The outcomes emphasise the crucial role of disease‐specific customisation of AI models, based on expert pathologist training, in improving accuracy and applicability in clinical trials, marking a step forward in understanding and addressing the histopathological evaluation of MASH cirrhosis.