bluuebunny/crossref_metadata_2025 huggingface dataset:
The Center for Health Outcomes in Medicine Scholarship and Service (HOMES): Fostering and Supporting Physician-Initiated Research
Authors: Bose-Brill Seuli , Riley Sean R. , Fried Martin , Childerhose Janet E. , Hanks Christopher , Moss Karen O. , Miles Laura , Xu Wendy , Schnell Patrick M. , Hyer J. Madison , Fernandez Soledad , Retchin Sheldon , Jonas Daniel E.
Published: November 2024

Problem

The U.S. physician scholar workforce, currently comprising less than 1.5% of U.S. physicians, continues to decrease, threatening national status as a global biomedical research leader. Academic medical center (AMC) trends away from tenure-track physician faculty appointments toward clinical faculty appointments have contributed to this decrease, but AMCs have limited strategies to equip clinical faculty to conduct research. Infrastructure fostering clinical faculty research may establish new mechanisms for expanding physician scholar workforce and supporting academic goals of clinical faculty. This article presents one such model, the Center for Health Outcomes in Medicine Scholarship and Service (HOMES), from the Department of Internal Medicine, The Ohio State University College of Medicine.

Approach

Established in 2019, HOMES provides research infrastructure, support, and mentorship tailored to clinical faculty needs. Multidisciplinary core faculty support research across 5 cores: clinical networks, biostatistics and secondary data, qualitative methods, mixed methods, and research ethics. HOMES services include research consultation, mentorship, microgrants, a training toolkit, and symposia.

Outcomes

In 4 years, HOMES supported 50 faculty on 99 projects. Forty-five (90%) of these faculty have reported scholarly output, including 127 national presentations, authorship on 41 peer-reviewed articles, and 53 grant submissions. Forty HOMES-supported grant submissions have received funding, and 4 HOMES-supported physicians in training have pursued or plan to pursue AMC research careers.

Next Steps

HOMES has fostered scholarly productivity among AMC physicians, competitive grant applications, and research focus among physicians in training. As demand for HOMES services increases, HOMES will prioritize projects based on their innovation and research skill development potential. Academic medical centers can apply HOMES lessons through fostering clinical faculty collaboration with multidisciplinary research teams and increasing research training opportunities for residents and fellows. National expansion of funding opportunities dedicated to building biomedical research capacity and expertise among clinical faculty can facilitate sustainable scaling of HOMES-like models.
Preoperative Challenges for Pediatric Ambulatory Surgery
Authors: Vogt Peggy , Abdullah Claude , Tran Stephanie , Yalamanchili Vidya , Patel Chhaya
Published: November 2024

The demand for ambulatory anesthesia in pediatric surgery has been increasing, reflecting a significant shift over recent decades toward performing a growing number of procedures in an outpatient setting.1 The growing shortage of pediatric anesthesiologists, coupled with an increase in pediatric ambulatory surgery volumes, will require general anesthesiologists to deliver anesthesia care to children. Children with prematurity, hypotonia, upper respiratory tract infections (URTI), obesity, and congenital heart disease (CHD) are frequently encountered in the ambulatory setting and present significant challenges for ambulatory anesthesiologists. In addition, the management of preoperative fasting, pregnancy testing, and perioperative anxiety further complicates the care of a pediatric patient. This review will examine the existing evidence and provide guidance for ambulatory anesthesiologists on preoperative considerations for pediatric patients undergoing ambulatory surgical procedures.
Effect of smoking on meibomian gland among Nepalese population
Authors: Koirala Bipin , Chandan Aayush , Mahat Manoj , Mishra Sanjeeb , Bhattarai Sanjeev , Gyawali Parash , Sitaula Sanjeeta
Published: November 2024

Purpose of study:

To investigate the effects of cigarette smoking on meibomian gland and tear function test.

Methods:

It was a hospital-based cross-sectional study, which enrolled examined 30 subjects with a smoking history of at least 1 year (study group) alongside 25 healthy non-smokers (control group). Each participant’s symptoms were assessed using the Ocular Surface Disease Index (OSDI) questionnaire. A comprehensive ophthalmological evaluation followed, which included the non-invasive tear breakup time (NITBUT) and Schirmer test (with anesthesia). Additionally, we conducted a detailed analysis of the meibomian glands in both the upper and lower eyelids using meibography, employing the advanced Sirius anterior segment analysis system.

Results:

Participants in the study group averaged a smoking history of 6.94 ± 6.73 pack years. The mean OSDI score was 36.45 ± 10.60 in the study group, compared to 31.41 ± 8.12 in the control group (P = 0.05). For the NITBUT and Schirmer test, the study group recorded values of 9.54 ± 5.89 seconds and 14.77 ± 9.39 mm, respectively, while the control group showed 9.95 ± 6.15 seconds and 19.08 ± 7.08 mm (P = 0.85 and P = 0.03, respectively). Upper lid meibography revealed a 55.40 ± 10.10% gland loss in the study group, significantly higher than the 46.33 ± 14.70% observed in the control group (P = 0.01). However, no statistically significant difference was found in lower lid meibomian gland loss between the groups, with the study group at 54.08 ± 9.71% and the control group at 51.41 ± 17.24% (P = 0.49).

Conclusion:

Smoking results in meibomian gland damage which may be a risk factor for dry eye. In cases of ocular surface disorders related to chronic smoking, meibomian gland damage should be taken into consideration.
Sphingosine kinase 2 (SphK2) depletion alters redox metabolism and enhances inflammation in a diet-induced MASH mouse model
Authors: Jackson Kaitlyn G. , Zhao Derrick , Su Lianyong , Lipp Marissa K. , Toler Cameron , Idowu Michael , Yan Qianhua , Wang Xuan , Gurley Emily , Wu Nan , Puri Puneet , Chen Qun , Lesnefsky Edward J. , Dupree Jeffrey L. , Hylemon Phillip B. , Zhou Huiping
Published: November 2024

Background:

Sphingosine-1 phosphate (S1P) is a bioactive lipid molecule that modulates inflammation and hepatic lipid metabolism in MASLD, which affects 1 in 3 people and increases the risk of liver fibrosis and hepatic cancer. S1P can be generated by 2 isoforms of sphingosine kinase (SphK). SphK1 is well-studied in metabolic diseases. In contrast, SphK2 function is not well characterized. Both sphingolipid and redox metabolism dysregulation contribute to MASLD pathologic progression. While SphK2 localizes to both the nucleus and mitochondria, its specific role in early MASH is not well defined.

Methods:

This study examined SphK2 depletion effects on hepatic redox metabolism, mitochondrial function, and inflammation in a 16-week western diet plus sugar water (WDSW)-induced mouse model of early MASH.

Results:

WDSW-SphK2

−/−
mice exhibit increased hepatic lipid accumulation and hepatic redox dysregulation. In addition, mitochondria-localized cholesterol and S1P precursors were increased. We traced SphK2

−/−
-mediated mitochondrial electron transport chain impairment to respiratory complex-IV and found that decreased mitochondrial redox metabolism coincided with increased oxidase gene expression and oxylipin production. Consistent with this relationship, we observed pronounced increases in hepatic inflammatory gene expression, prostaglandin accumulation, and innate immune homing in WDSW-SphK2

−/−
mice compared to WDSW-wild-type mice.

Conclusions:

These studies suggest SphK2-derived S1P maintains hepatic redox metabolism and describe the potential consequences of SphK2 depletion on proinflammatory gene expression, lipid mediator production, and immune infiltration in MASH progression.
Management of primary sclerosing cholangitis: Current state-of-the-art
Authors: Cançado Guilherme Grossi Lopes , Hirschfield Gideon M.
Published: November 2024

Primary sclerosing cholangitis is a chronic liver disease characterized by progressive inflammation and fibrosis of medium-large bile ducts, most commonly in association with inflammatory bowel disease. Most patients have a progressive disease course, alongside a heightened risk of hepatobiliary and colorectal cancer. Medical therapies are lacking, and this, in part, reflects a poor grasp of disease biology. As a result, current management is largely supportive, with liver transplantation an effective life-prolonging intervention when needed, but not one that cures disease. Emerging therapies targeting disease progression, as well as symptoms such as pruritus, continue to be explored. The trial design is increasingly cognizant of the application of thoughtful inclusion criteria, as well as better endpoints aimed at using surrogates of disease that can identify treatment benefits early. This is hoped to facilitate much-needed advances toward developing safe and effective interventions for patients.
The Impact of Leadership Training on Burnout and Fulfillment Among Direct Reports
Authors: Briggs Selena E. , Heman-Ackah Sabrina M. , Hamilton Felicia
Published: November 2024

Goal

Burnout, decreased professional fulfillment, and resultant attrition across the medical professions are increasingly recognized as threats to sustainable and cost-effective healthcare delivery. While the skill level of leaders as perceived by their direct reports has been correlated with rates of burnout and fulfillment, no studies, to our knowledge, have directly evaluated whether intervention via leadership training impacts burnout and fulfillment among direct reports. The goal of this study was to evaluate the effectiveness of a leadership training intervention on direct reports’ perceptions of the leadership skills of supervising residents and subsequently on the well-being of the direct reports.

Methods

We implemented a leadership training program with supervising (i.e., chief) resident volunteers in two surgical residency programs. The leadership training included two sessions of approximately 2 hours each that consisted of interactive didactic and small group activities. The training focused on the following themes: defining leadership (i.e.,characteristics and behaviors), team building, fostering trust, managing conflict, navigating difficult conversations, and feedback. We administered pretraining and posttraining surveys to the direct reports (i.e., junior residents) to assess the perceived leadership skills of supervising residents, as well as burnout and professional fulfillment.

Principal Findings

Leadership scores significantly improved following the leadership training intervention. Additionally, improvement in leadership scores following training was positively correlated with professional fulfillment among the junior residents (direct reports).

Practical Applications

The results of this study suggest that incorporating leadership training into residency programs may serve as an appropriate initial intervention to improve the leadership skills of supervising residents, and in turn, improve professional fulfillment and retention among medical professionals. This intervention involved minimal cost and time investment, with potentially significant returns in combating the well-being and attrition crisis. These findings may be applicable across the healthcare field to tackle the impending healthcare worker crisis.
Returning to work after childbirth and women’s mental health: the place of work-family conflict and of social supports in a population of working mothers in Paris area
Authors: Radauceanu Anca , Grzebyk Michel , Demange Valérie , Dziurla Mathieu , Lafon Dominique , Goujon Emmanuelle , Ralison Fara , Gros Anne-Christine , Huygue Laurence , Pradeau Peggy , Breton Christine , Boini Stéphanie
Published: November 2024

Objective

Analyzing in a cross-sectional study the factors associated with mental health in 1511 recently delivered women returning to work, the mediating role of work-family interface and the moderating role of social supports.

Methods

Data were collected at 3 months after returning to work to assess work characteristics (COPSOQ), work-family conflict (SWING), anxiodepressive symptoms (HADS), commuting, childcare, household demands, social supports.

Results

Anxiety and to lesser extent depressive symptoms were associated with work factors, the opposite for the non work demands. The mediation by work-family conflict and the moderation of social supports were present especially for anxiety symptoms. Taking into account the parental constraints by the hierarchy, family/friends support and paid personnel reduced anxiodepressive symptoms.

Conclusions

Promoting mental health at returning to work of new mothers needs the assessment of total workload and resources.
Clinical and demographic characteristics of frontal fibrosing alopecia in a dermatology referral center in Bogota, Colombia: a descriptive cross-sectional study
Authors: Gallego-Vidales Leydi Y. , Palacios-Ariza María A. , Macías-Arias Paola A. , Morales-Cardona Camilo A.
Published: November 2024

Background:

Frontal fibrosing alopecia (FFA) is a type of scarring alopecia that is characterized by a symmetrical recession of the frontal/temporal hairline. Despite growing interest in this pathology, there is scarce data on its epidemiology in Latin American countries such as Colombia.

Objective:

To estimate the frequency and describe the clinical manifestations and factors associated with FFA.

Methods:

This descriptive cross-sectional study reviewed the electronic health records of adult patients diagnosed with FFA at a referral center in the city of Bogota, Colombia, between 2018 and 2021.

Results:

Of the 1506 patients diagnosed with scarring alopecia, 213 fully met the selection criteria (14.14%). Patients had a median age at diagnosis of 60 years (Q1–Q3: 49–67 years) and were more frequently female (95.31%). Concurrent eyebrow alopecia was the most frequent clinical presentation (56.34%). Perifollicular desquamation was present in 114 patients (53.52%), perifollicular erythema in 56 (26.29%), and both features simultaneously in 35 (16.43%). Sunscreen use was reported by 116 (54.46%) and facial moisturizers by 38 (17.84%), both of which have been reported as risk factors.

Limitations:

The small sample size and the lack of racial and geographical diversity in the subjects.

Conclusion:

This study provides baseline epidemiological data in a Colombian sample. Sex, location of alopecia, and symptoms were consistent with those reported in the literature, but age at presentation, tobacco use, use of wigs, and dyes differed from those reported in other countries.
Initiation of home noninvasive ventilation in hypercapnic chronic obstructive pulmonary disease: when, where, and how?
Authors: Fortis Spyridon , Sarmiento Kathleen F.
Published: November 2024

Purpose of review

This review aims to highlight the importance of timely initiation of home noninvasive ventilation (homeNIV) for patients with chronic hypercapnic respiratory failure (CHRF) due to chronic obstructive pulmonary disease (COPD). As emerging evidence continues to show substantial benefits in reducing mortality and hospitalizations, it's crucial to identify which patients will benefit most and to provide clear guidance on implementing homeNIV effectively.

Recent findings

Recent research supports the use of high intensity homeNIV for CHRF secondary to COPD, showing marked reductions in hospitalizations and mortality. However, despite its proven benefits, homeNIV is underutilized, often due to significant barriers related to payor policies and gaps in knowledge by those most likely to be evaluating and managing patients with advanced COPD. The literature also reveals ongoing debate about the optimal timing and setting for starting homeNIV, whether in outpatient clinics or directly after hospital discharge.

The evidence suggests that homeNIV should be more widely used, with a focus on early initiation and careful titration to normalize PaCO2 over time. By addressing the barriers to its broader use, we can improve outcomes for patients with CHRF due to COPD.
Microbiological characterization of KPC-producing Klebsiella pneumoniae belonging to the international epidemic clone ST258 in Asia: a systematic review
Authors: Esmaeil Amini Mohammad , Malekzadegan Yalda , Khashei Reza , Bagheri Fatemeh , Halaji Mehrdad , Asl Yeganeh Sadeghi , Ebrahim-Saraie Hadi Sedigh
Published: November 2024

Klebsiella pneumoniae infection because of international epidemic clone ST258 constitutes a major health threat because of limiting efficient therapies. Hence, this study aimed to analyze the microbiological profiles of circulating of K. pneumoniae carbapenemase (KPC)-producing K. pneumoniae belonging to ST258 clone in Asia. A systematic search was prepared and reported through searching the Web of Science, PubMed, Scopus, Embase, and Google Scholar electronic databases to find all available articles that are pertinent to our design from January 2000 to December 2019. Afterward, 10 publications meeting the inclusion criteria were included for data extraction and analysis. The majority of included studies were from the eastern region including China, South Korea, Japan, Taiwan, and Hong Kong, and only one report from the western region was reported in Turkey. The earliest report was in 2010 from Korea and the late one in 2017 from China. All of those studies that performed a carbapenemase detection method indicated positive results. Except for one isolate, which containing bla
KPC–3, all of the isolates harbor bla
KPC–2. The minimum inhibitory concentration (MIC) of colistin against ST258 isolates was estimated ranging from 0.094 to 4 μg/ml. The plasmid investigation showed a marked heterogeneity toward the studied isolates; however, IncFII type plasmids were the most prevalent plasmid. Our findings highlighted that despite the growing concern regarding the potential distribution of KPC-producing K. pneumoniae in Asia, strains belonged to the ST258 clone are not the main suspects. However, more clinical studies should be performed in the future to support our findings.
Factors affecting blood culture contamination rates and effective reduction measures
Authors: Sacchetti Brianna , Webb Ginny
Published: November 2024

Blood culture collection is a crucial procedure used universally in hospital settings to identify bloodstream infections. A false positive culture arises when contamination occurs during culture collection or when handling the culture in the laboratory. These contaminated cultures cause inaccurate diagnoses resulting in longer hospital stays, increased cost, and unnecessary antimicrobial treatments. It is therefore vital to limit the rate of blood culture contamination. Here we discuss various factors that play roles in blood culture contamination rates. The roles of phlebotomy teams, the coronavirus disease 2019 pandemic, blood draw location, and hospital department on blood culture contamination rates will be discussed. Potential methods that can be deployed to decrease blood culture contamination rates will be compared.
Staphylococcus aureus: a bacterial candidate for multiple sclerosis incidence and progression
Authors: Sheykhsaran Elham , Abbasi Amin , Baghi Hossein Bannazadeh , Ghotaslou Reza , Sharifi Yaghoub , Sefidan Fatemeh Yeganeh , Laghousi Delara , Hosainzadegan Hasan , Hasani Alka , Sadeghi Javid
Published: November 2024

Multiple sclerosis (MS) has nowadays developed in the human population, and according to the existing evidence, the main cause is not well understood. In addition to the genetic factors, scientists propose the infections like other autoimmune diseases as the strong environmental hypothesis. By the last decade, microorganisms were supposed neglected in autoimmune disorders. Staphylococcus aureus has been recognized as an exacerbating agent in the development of MS. The various virulence factors enable this bacterium to cause complications from a mild skin infection to life-threatening meningitis and septicemia. Although there are not enough comprehensive studies about the role of microorganisms and MS, the reports reveal that microbial components presumably induce the auto reactions in the cells and antibody production. On the other hand, these interactions occur either in healthy individuals. Surveys also suggest no specific microorganism as the etiologic agent for MS, and other bacteria (Chlamydia pneumoniae), viruses (Herpesviridae and Retroviridae) are also involved. Until now, many investigations have been conducted to find out the MS triggering, progression, and other influencing factors, however, decoding the main contributor is not completely elucidated. The current review assesses the role of Staphylococcus aureus as the well known bacterial candidate in MS incidence.
Aggressive abscesses in the head and neck region of probable odontogenic origin – two case reports
Authors: Suska Anna , Wiatr Maciej , Lara Martyna , Czepiel Jacek , Składzień Jacek , Sadowski Piotr , Szpor Joanna , Czerniuk Maciej Rafał
Published: November 2024

Odontogenic infections are the most common type of infections of the head and neck among adults. They usually spread continuously from the mandible and/or maxilla into the sublingual, submandibular or masticatory spaces, then directly into the parapharyngeal space. They require comprehensive diagnostic and therapeutic management, as they may potentially lead to life-threatening complications. We present two clinical manifestations of aggressive abscesses in the head and neck region of probable odontogenic origin and discuss different therapeutic approaches. The first patient, a 31-year-old man, was admitted because of a tumor-like lesion within the right maxillary sinus. He complained of purulent nasal discharge of two weeks duration despite antibiotic therapy. In the Caldwell-Luc operation a cyst filled with puss was displayed, the sac of the cyst and the polypoid mass were removed. The second patient, a 28-year-old man, was admitted due to an abscess of the left half of the neck and viscerocranium, with a large edema of this area, neck pain, fever, dyspnea and lockjaw. The patient was qualified for surgery. During intubation, a purulent collection emptied into the oral cavity and throat. In both cases, simultaneously with the surgery, an empirical broad-spectrum antibiotic therapy was administered. Microbiological analysis of the material collected during the operations revealed Prevotella melaninogenica in the first case, and Streptococcus group C in the second. Treatment of aggressive odontogenic infections must take a comprehensive approach, including both surgical intervention and antibiotic therapy covering Gram-positive as well as Gram-negative aerobic and anaerobic pathogens.
Severe acute respiratory syndrome coronavirus 2 and Legionella co-infection in a child with sleep disorder: a case report
Authors: Dashtbin Shirin , Jalalifar Saba , Bayazian Gholamreza , Irajian Gholamreza , Nateghian Alireza
Published: November 2024

Background:

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has plagued worldwide. Although it is known that in some cases, coronavirus disease 2019 (COVID-19) has a high mortality rate, but the simultaneous bacterial infection can increase the severity of the disease and the risk of death, and on the other hand, it is difficult to diagnose bacterial co-infections with COVID-19.

Case presentation:

We report a case of COVID-19 with Legionella co-infection manifesting with pneumonia and sleep disorder for the first time. The case highlights the importance of differential diagnosis during the COVID-19 pandemic.

Conclusion:

Due to the abundant presence of opportunistic bacteria, the source of simultaneous Legionella infection cannot be identified, therefore, more prevention and control should be considered.
Molecular detection of blaTEM, blaCTX-M and blaSHV genes in ESβL harboring uropthogenic Escherichia coli (UPEC) isolated from UTIs in Baghdad, Iraq
Authors: Hussein Nadheema Hammood
Published: November 2024

Background:

Recently, extended spectrum β-lactamase (ESβL) genes including blaTEM, blaCTX-M and blaSHV genes have shown rapid spread among Enterobacteriaceae and they become the most prevalent genes in many parts of the world.

Methods:

This study is aimed to detect ESβL producers among Escherichia coli isolates from urine specimens. Sixty-six uopathogenic E. coli (UPEC) strains were isolated at the National Center for Teaching Laboratories of Medical City in Baghdad. The phenotypic detection of ESβL was achieved by Vitek-2 system with AST-N204 card and the results revealed that among the 66 uropathogenic E. coli strains, 48 (72.7%) were ESβL producing and 18 (27.3%) were ESβL non-producing (significant difference at P < 0.05).

Results:

The presence of genes encoding TEM, CTX-M and SHV was tested by all ESβL producing uropathogenic E. coli phenotypically by conventional PCR. The result showed that blaTEM, blaCTX-M and blaSHV genes were 46 (95.83%), 42 (87.5%) and 39 (81.25%), respectively. In addition, the data showed the coexistence of blaTEM, blaCTX-M and blaSHV genes in 44 out of 48 strains (91.67%) while only 4 (8.33%) of UPEC strains harbored a single ESβL gene (significant difference at P < 0.05).

Conclusions:

This study showed that blaTEM was the widespread gene in ESβLs-producing uropathogenic E. coli strains in Baghdad/Iraq and there was a high percentage of blaTEM, blaCTX-M and blaSHV genes distribution among local strains under study and this may attribute to the indiscriminate use of antibiotics. Phylogenetic analyses based on the sequences of blaTEM, blaCTX-M and blaSHV genes were done with closely related blaTEM, blaCTX-M and blaSHV genes in the GenBank by using MEGA6 software.
Identification of norA, qacAB and smr genes and determination of antibiotic and biocide resistance patterns in methicillin-resistant Staphylococcus aureus isolated from Isfahan-Iran
Authors: Jafari Kondori Nafise , Mansury Davood
Published: November 2024

Background:

Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of nosocomial infections, which have become a serious problem due to antibiotic resistance. In addition to antibiotic resistance, biocide resistance is also increasing due to the high use of these substances. The aim of this study was to investigate the pattern of antibiotic resistance and the prevalence of biocide resistance genes norA, qacA/B and smr, and to determine the minimum inhibitory concentration of chlorhexidine digluconate (CHG) and benzalkonium chloride (BKC) in MRSA isolates taken from teaching hospitals in Isfahan city, Iran.

Materials and Methods:

This study was conducted on 63 MRSA isolates collected from teaching hospitals in Isfahan city, Iran. MRSA isolates were identified by performing phenotypic testing and then confirmed by using PCR. The resistance pattern was determined by using disc diffusion method. Broth microdilution method was performed to determine the minimum inhibitory concentration (MIC) of CHG and BKC according to the Clinical and Laboratory Standards Institute (CLSI). The presence of biocide resistance genes was determined by using PCR and the Time kill assay was performed to investigate the lethality of biocides.

Results:

MRSA isolates had MIC values of 0.5–4 μg/ml for BKC and 0.125–4 μg/ml for CHG. norA was the most common biocide resistance gene among 63 isolates (88.9%), followed by qacAB and smr with 28.6% and 22.2%, respectively. Among the isolates, the highest percentage of resistance belonged to penicillin, erythromycin and doxycycline, respectively.

Conclusion:

Due to the high prevalence of MRSA isolates in hospitals and the role of this pathogen in nosocomial infections, continuous monitoring of antimicrobial resistance for appropriate antibiotic administration and continuous evaluation of biocide resistance due to the high prevalence of resistance genes and appropriate use of biocides for disinfection, allows us to minimize further prevalence of resistant strains in hospital environments.
Immunization of BALB/c mice against virulent Brucella abortus and Brucella melitensis by vaccination with recombinant OrF
Authors: Valizadeh Saeed , Mirkalantari Shiva , Moghadam Majid Taati
Published: November 2024

Brucellosis is a zoonotic disease that remains challenging despite the development of numerous vaccines. Several problems with existing live attenuated vaccines have led researchers to develop new vaccines. To determine if inducing immune responses against virB12 proteins can offer protection against brucellosis, this study evaluated the production of immune responses against virB12 proteins. The purification of orf gene was accomplished using cloning, expression, and western blot evaluation. Six-week-old female BALB/C mice were subcutaneously injected with 16 g of roprf three times at intervals of 10 days. Blood samples were examined for specific total serum immunoglobulin (IgG)1, IgG, and IgG2a levels via indirect ELISA. Cell-free culture media were assayed by specific ELISAs to assess interleukin (IL)-10, IL-4, IL-12, and interferon gamma (IFN-γ) levels. This method resulted in significantly higher yields of recombinant Orfs (rOrfs), measured at 3.4 mg from 1 l of induced culture. Mice immunized with rOprF produced significantly higher levels of IL-12, IL-4, and IFN-γ, but no significant differences in IL-10 production compared to other groups of mice. On the other hand, mice immunized with rOrfs developed significantly higher levels of IgG1, IgG, and IgG2a compared to other groups. Overall, the findings imply that rOrfs stimulates defense against Brucella melitensis and Brucella abortus and may be a candidate for subunit brucellosis vaccine development.
COVID-19 omicron variant: variation from other variants, immune response, and vaccination against this rapidly spreading pandemic
Authors: Mahmoud Yasmen , Hathout Amira , Amen Radwa Abdallnasser , Desouky Sara , Shady Rawan Muhammad , Fahmy Heba Mohamed
Published: November 2024

The world is standing up to new emergencies caused by viral infections. These viral strains have been verified to be the causative agents of pneumonia diseases. Coronavirus disease 2019 (COVID-19) viral infection was the world's most recent pandemic. After 2 years of examining its warnings, infection mechanisms, and the improvement of second and third-generation vaccines, these strategies were relatively significant against it. COVID-19 gives rise to multiple variations in its genetic code to develop numerous exotic variants with the genetic code of the COVID-19 class. Omicron strain is a vastly recent and dangerous strain. It is the most rapidly spreading strain, bringing de novo mutagenesis mechanisms into the world in its spike proteins and receptor-binding domain. The well known mutations perceive that the vaccinations attained against COVID-19 will not be significant against Omicron. Our work reviews the mutagenesis mechanism of Omicron and its symptoms after the infection, immunogenicity against Omicron, and the booster dose utilized against it.
Molecular identification of Streptococcus mutans and Streptococcus sobrinus from un-stimulated saliva and their association with dental caries and orthodontic appliances
Authors: Mohammed Rabab S. , Dhahi Maysaa A. , Khelkal Intesar N.
Published: November 2024

Background:

Oral streptococci, particularly Streptococcus mutans (S. mutans), have been associated with several diseases affecting multiple anatomical sites. Streptococcus mutans and Streptococcus sobrinus (S. sobrinus), which belong to the Mutans streptococci group, are examples of Gram-positive bacteria that demonstrate facultative anaerobic growth characteristics. These bacteria are frequently seen as members of the native oral microbiota and are largely recognized as the primary causative agents of dental caries.

Objective:

To molecularly identify S. mutans and S. sobrinus using PCR and investigate their relationship with the caries status and orthodontia appliances.

Method:

The cross-sectional study, which was conducted in Baghdad from February 2021 to November 2022, involved 359 un-stimulated saliva samples from 340 participants were collected and processed immediately by culturing anaerobically (37°C/72 h) on Mitis Salivarius Bacitracin Agar (MSB-Agar). Morphological characteristics of the colonies, Gram stain were achieved for the bacterial growth. DNA extracted from cultured bacteria. S. mutans and S. sobrinus were identified molecularly by amplifying gtfB and gtfI, respectively, from DNA samples using conventional PCR.

Results:

From 279/ 336 (83.04%) bacterial DNA samples, 118/279 (42.29%) were positive for S. mutans gtfB and/or S. sobrinus gtfI; S. mutans 84/118 (71.2%), S. sobrinus 6/118 (5.1%) and mixed S. mutans/S. sobrinus 28/118 (23.7%). The results of association between molecular identification of S. mutans with dental caries and missing teeth features of individuals were statically not significant (0.068 and 0.323 > 0.05, respectively), while was significant with filling teeth and orthodontic appliance (0.020, 0.027 < 0.05, respectively). The relationship between molecular identification of S. sobrinus and dental caries, missing, filling teeth and orthodontic were statistically not significant (0.069, 0.975, 0.845 and 0.458 > 0.05), respectively. The relationship between molecular identification of mixed S. mutans/S. sobrinus with dental caries was statically significant (0.042 < 0.05).

Conclusion:

S. mutans was more prevalence; identification and discrimination for S. mutans/S. sobrinus (depending on gtfB and gtfI) by PCR was more efficacy. Mixed S. mutans/S. sobrinus in a reasonable percentage were related with the hard dental caries status. Identification by colony morphology alone was not achievable in this study. Mitis Salivarius agar with Bacitracin (MSB) is extremely selective for S. mutans and S. sobrinus but cannot distinguish them morphologically.
A review of SARS-CoV-2 virology, vaccines, variants and their impact on the COVID-19 pandemic
Authors: Hirahata Tetsuyuki , Quraish Reeshan ul , Quraish Afraz ul , Quraish Shahan ul
Published: November 2024

A novel coronavirus, named severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has spread in Wuhan, China, and caused the global pandemic infectious disease. This disease has been known as coronavirus disease 2019 (COVID-19). It continued to spread around the world and created outrageous effects on the healthcare and economic system throughout the world. Various strategies have been designed to diminish the morbidity and mortality of this infectious disease. Among them, the development of vaccines is the most effective method to prevent and treat the viral infection. Novel vaccines have been developed and proved to be effective in multiple clinical reports indicating a significant decline in the risk of COVID-19 infection. However, the emergence of new variants of SARS-CoV-2 with immune-evasive characteristics raised questions concerning the effectiveness of the vaccines. This review provides a brief introduction to developed vaccines, as well as emerging variant strains and vaccine effectiveness against these variants. In this article, we also reviewed the general biological features of SARS-CoV-2 and its pathogenesis and explained the clinical symptoms, transmission, diagnostic and treatment approaches to monitor and control emerging COVID-19 infection.
A Typology of US Public Health Work-Education Programs
Authors: White Karen M. , Drainoni Mari-Lynn , Elliott Patricia , Hurley Meredith , Cunnington Stacey , Greece Jacey
Published: November 2024

Objective:

A pipeline is required to build a qualified and diverse public health workforce. Work-education programs offer public health students experiential learning, training, and a pathway to public health professions. However, there is a gap in the literature to guide public health practice on the types of programs, their components, and their potential impact. By defining and differentiating work-education programs, we aim to provide public health practitioners a useful tool to advance public health careers.

Design:

We conducted a scoping review of US-based public health work-education programs and performed a content analysis to extract, analyze, and synthesize data to develop a typology of programs in the US. We searched CINAHL, ERIC, PsycInfo, PubMed and Web of Science databases for papers published between January 1, 2012, and December 31, 2022.

Eligibility Criteria:

Inclusion criteria included programs with a description, intervention design, student characteristics, setting characteristics, and program outcomes if available. Exclusion criteria included programs with no description, that focused on the expansion of a specific clinical profession (ie, dentistry), that were implemented outside of the US, and that targeted exclusively high school students.

Study Selection:

The search resulted in 650 references, which yielded 35 articles from 33 interventions.

Main Outcome Measure(s):

The main outcome measures were qualitative and included program design, features, and implementation.

Results:

We identified 3 types of programs: those that (1) expose students to public health (n = 6), (2) guide students to specific public health professions (n = 12), and (3) connect students with organizations for public health practice (n = 15). Program types were influenced by student participants, setting, and program components.

Conclusions:

This typology illustrates the spectrum of work-education programs and their variability in design and implementation. The typology has utility for practitioners to identify programmatic aspects that may be feasible and desirable in the context of their practice.
Substance use during pregnancy and postpartum among individuals with perinatally-acquired HIV in the United States
Authors: Yee Lynn M. , Powis Kathleen M. , Jao Jennifer , Haddad Lisa B. , Yao Tzy-Jyun , Barr Emily A. , Siminski Suzanne , Broadwell Carly , Chadwick Ellen G. , Kacanek Deborah
Published: November 2024

Use of cannabis and alcohol were common during pregnancy and the first year postpartum among people with HIV in the United States (2007–2019), but there were no major differences in substance use during pregnancy based on mode of HIV acquisition. The relatively high prevalence of substance use in this population, particularly postpartum alcohol and cannabis use, warrants further attention.
Deep Learning Reconstruction for Enhanced Resolution and Image Quality in Breath-Hold MRCP: A Preliminary Study
Authors: Shiraishi Kaori , Nakaura Takeshi , Yoshida Naofumi , Matsuo Kensei , Kobayashi Naoki , Hokamura Masamichi , Uetani Hiroyuki , Nagayama Yasunori , Kidoh Masafumi , Morita Kosuke , Yamashita Yuichi , Tanaka Yasuhito , Baba Hideo , Hirai Toshinori
Published: November 2024

Objective

This preliminary study aims to assess the image quality of enhanced-resolution deep learning reconstruction (ER-DLR) in magnetic resonance cholangiopancreatography (MRCP) and compare it with non-ER-DLR MRCP images.

Methods

Our retrospective study incorporated 34 patients diagnosed with biliary and pancreatic disorders. We obtained MRCP images using a single breath-hold MRCP on a 3T MRI system. We reconstructed MRCP images with ER-DLR (matrix = 768 × 960) and without ER-DLR (matrix = 256 × 320). Quantitative evaluation involved measuring the signal-to-noise ratio (SNR), contrast, contrast-to-noise ratio (CNR) between the common bile duct and periductal tissues, and slope. Two radiologists independently scored image noise, contrast, artifacts, sharpness, and overall image quality for the 2 image types using a 4-point scale. Results are expressed as median and interquartile range (IQR), and we compared quantitative and qualitative scores employing the Wilcoxon test.

Results

In quantitative analyses, ER-DLR significantly improved SNR (21.08 [IQR: 14.85, 31.5] vs 15.07 [IQR: 9.57, 25.23], P < 0.001), CNR (19.29 [IQR: 13.87, 24.98] vs 11.23 [IQR: 8.98, 15.74], P < 0.001), contrast (0.96 [IQR: 0.94, 0.97] vs 0.9 [IQR: 0.87, 0.92], P < 0.001), and slope of MRCP (0.62 [IQR: 0.56, 0.66] vs 0.49 [IQR: 0.45, 0.53], P < 0.001). The qualitative evaluation demonstrated significant improvements in the perceived noise (P < 0.001), contrast (P = 0.013), sharpness (P < 0.001), and overall image quality (P < 0.001).

Conclusions

ER-DLR markedly increased the resolution, SNR, and CNR of breath-hold-MRCP compared to cases without ER-DLR.
Validating a Practical Correction for Intravenous Contrast on Computed Tomography–Based Muscle Density
Authors: Lortie Jevin , Ufearo Deborah , Hetzel Scott , Pickhardt Perry J. , Szczykutowicz Timothy P. , Kuchnia Adam J.
Published: November 2024

Objective

Computed tomography (CT) measured muscle density is prognostic of health outcomes. However, the use of intravenous contrast obscures prognoses by artificially increasing CT muscle density. We previously established a correction to equalize contrast and noncontrast muscle density measurements. While this correction was validated internally, the objective of this study was to obtain external validation using different patient cohorts, muscle regions, and CT series.

Methods

CT images from 109 patients with kidney tumors who received abdominal CT scans with a multiphase intravenous contrast protocol were analyzed. Paraspinal muscle density measurements taken during noncontrast, venous phase, and delayed phase contrast scans were collected. An a priori correction of −7.5 Hounsfield units (HU) was applied to muscle measurements. Equivalence testing was utilized to determine statistical similarity.

Results

In the sample of 109 patients (mean age: 63 years [SD: 14.3]; 41.3% female), densities in smaller regions of interest within the paraspinal muscles and the entire paraspinal muscle density (PS) in venous and delayed phase contrast scans were higher than in noncontrast. Equivalence testing showed that average corrected contrast and noncontrast muscle densities were within 3 HU for both muscle measures for the total patient sample, and for a majority of male and female subsamples. The correction is suitable for regions of interests of venous contrast (90% CI: −1.90, −0.69 HU) and delayed contrast scans (90% CI: 0.075, 1.29 HU) and within the PS measures of venous contrast (90% CI: −2.04, −0.94 HU) and delayed contrast scans (90% CI: −0.11, 0.89 HU)

Conclusions

The previously established correction for contrast of −7.5 HU was applied in a new patient population, axial muscle region, muscle measurement size, and expanded on previously studied contrast phases. The correction produced contrast-corrected muscle densities that were statistically equivalent to noncontrast muscle densities. The simplicity of the correction gives clinicians a tool that seamlessly integrates into practice or research to improve harmonization of data between contrast and noncontrast scans.
The Utility of Cardiac Computed Tomographic Angiography in Differentiating Between Papillary Fibroelastoma, Infective Endocarditis, and Degeneration of the Aortic Valve
Authors: Hsu Wen-Chi , Kamona Aws , Oncel Dilek , Fishman Elliot K. , Lin Cheng Ting
Published: November 2024

Purpose

Cardiac computed tomography angiography (CCTA) has significantly advanced the visualization of cardiac structures, particularly valves. We assessed the diagnostic performance of CCTA in diagnosing the most common disorders affecting the aortic valves requiring surgery—papillary fibroelastoma, infective endocarditis, and degeneration.

Methods

This retrospective study included patients who underwent aortic valve resection between 2016 and 2023 and had a preceding CCTA. Pathologic diagnoses were categorized into the following 3 groups: papillary fibroelastoma, infective endocarditis, and degeneration. Each case was independently evaluated by 3 cardiac-trained radiologists.

Results

The study group consisted of 50 patients with aortic valvular disorder—14 papillary fibroelastoma, 13 endocarditis, and 23 degeneration. Diagnostic accuracy varied from 70% to 74% among the 3 readers, with a pooled accuracy of 71% and consensus accuracy of 76%. Most errors involved small (≤7 mm) papillary fibroelastomas. Both papillary fibroelastomas and endocarditis-related vegetations typically presented with nodules on CT; however, nodule stalks were only observed with papillary fibroelastomas. Echocardiography aided in distinguishing between the disorders by detecting leaflet perforation and aortic regurgitation in cases of infective endocarditis.

Conclusions

This study evaluated cardiac CTA for noninvasive characterization of aortic valvular disorders prior to resection. Reader accuracy ranged from 70% to 74%, improving to 76% with consensus interpretations. Small papillary fibroelastomas (≤7 mm) and overlapping imaging features, such as nodular lesions and leaflet thickening, were diagnostic challenges. Greater awareness of these CT characteristics is essential for accurate diagnosis and clinical management.
Thread-Filler: A Standardized Combination Therapy
Authors: Öztürk Bilkay Özge , Yeğin Mehmet Emre , Bilkay Ufuk
Published: November 2024

Advanced technology and increasing knowledge about aging faces have combined to create the illusion of thread lifting to replace surgical interventions. However, results that came far beyond expectations led to a heavy suspicion of these tools. However, combined treatments with fillers would have better outcomes with a synergetic effect. In this study, 52 patients were treated with a specific thread, whereas soft tissue support was added to supervene the lifting effect of the threads. With a mean age of 48 years, these patients were treated with 3 pairs of mid and lower facial areas, and one for eyebrows. With a median amount of 5 mL fillers were added simultaneously at the same treatment plan. The follow-up period was 32 months. Assessment with a Likert Scale questionnaire revealed most of the patients (n = 42) were delighted, whereas only one patient was unsatisfied. The only unsatisfied patient experienced the most frustrating complication, which was thread removal due to infection. The literature shows unauthorized, unspecialized applications of such medical devices cause failure and loss of reliability. Therefore, the most important point of this technique is the sterile setting. Other issues that are discussed in this paper also aim to direct the reader to achieve the most benefit of these 2 techniques.
Artificial intelligence and stroke imaging
Authors: Rondina Jane , Nachev Parashkev
Published: November 2024

Purpose of review

Though simple in its fundamental mechanism – a critical disruption of local blood supply – stroke is complicated by the intricate nature of the neural substrate, the neurovascular architecture, and their complex interactions in generating its clinical manifestations. This complexity is adequately described by high-resolution imaging with sensitivity not only to parenchymal macrostructure but also microstructure and functional tissue properties, in conjunction with detailed characterization of vascular topology and dynamics. Such descriptive richness mandates models of commensurate complexity only artificial intelligence could plausibly deliver, if we are to achieve the goal of individually precise, personalized care.

Recent findings

Advances in machine vision technology, especially deep learning, are delivering higher fidelity predictive, descriptive, and inferential tools, incorporating increasingly rich imaging information within ever more flexible models. Impact at the clinical front line remains modest, however, owing to the challenges of delivering models robust to the noisy, incomplete, biased, and comparatively small-scale data characteristic of real-world practice.

The potential benefit of introducing AI to stroke, in imaging and elsewhere, is now unquestionable, but the optimal approach – and the path to real-world application – remain unsettled. Deep generative models offer a compelling solution to current obstacles and are predicted powerfully to catalyse innovation in the field.