bluuebunny/crossref_metadata_2025 huggingface dataset:
Do Black Birthing Persons Prefer a Black Health Care Provider During Birth? Race Concordance in Birth
Authors: Bogdan-Lovis E. , Zhuang J. , Goldbort J. , Shareef S. , Bresnahan M. , Kelly-Blake K. , Elam K.
Published: February 2024

(Birth. 2023;50(2):310–318)

There is discussion in the United States regarding the impact of race concordance between health care providers and patients on health outcomes. While there is evidence that provider-patient communication can benefit from concordance, there’s limited proof that concordance significantly improves health outcomes.
Association Between Influenza Vaccination During Pregnancy and Infant Influenza Vaccination
Authors: Zhou F. , Lindley M.C. , Lee J.T. , Jatlaoui T.C.
Published: February 2024

(Obstet Gynecol. 2023;141:563–569)

Vaccines are safe and effective in preventing illness, including in mildly immunosuppressed individuals such as pregnant women. Influenza vaccines have been in use for decades and have been shown to be safe and effective at preventing illness in both mother and child, providing protection through the transplacental transfer of antibodies to infants too young to receive their own vaccination. Influenza presents increased risks to pregnant individuals as well as adverse outcomes for fetuses and infants. Annual influenza vaccinations are recommended for everyone 6 months and older, but rates of annual vaccinations are chronically low. This study was designed to evaluate the association between influenza vaccination during pregnancy and infant influenza vaccination.
Median Effective Dose of Ropivacaine for Prophylactic Cervical Cerclage in Chinese Women: A Dose-Finding Study
Authors: Liu K. , Zhao P. , Ding M. , Ji H. , Tao B.
Published: February 2024

(Reg Anesth Pain Med. 2023;48:168–172. doi: 10.1136/rapm-2022-104242)

Complications in pregnancy leading to preterm labor or miscarriage can occur for a variety of reasons. One reason that represents a significant public health burden is cervical incompetence or insufficiency. Current treatment guidelines focus on cervical cerclage as an effective treatment to prevent or arrest the effects of cervical insufficiency. Performing this procedure requires surgery, and therefore different anesthetic methods can be used to minimize pain and adverse outcomes for the patients, namely general or neuraxial anesthesia. One local anesthetic used for spinal neuraxial blocks in obstetrics is ropivacaine, but research has not explored its effect when used for cervical cerclage. This study from China was designed to find the median effective dose of intrathecal ropivacaine for cervical cerclage placement in 50% of patients (ED50). Secondary to this, the effective dose of intrathecal ropivacaine in 95% of patients (ED95) was also calculated. Other outcome measures included the duration of the sensory and motor blocks.
A Retrospective Multicenter Analysis of Patient and Hospital-Level Factors Predicting the Use of General Anesthesia for Cesarean Deliveries
Authors: Tangel V.E. , Abramovitz S. , Aaronson J. , Jiang S.Y. , Pryor K.O. , White R.S.
Published: February 2024

(Int J Obstet Anesth. 2023:54:103638)

A recent study reported that as parturient comorbidity increased, there was an increasing likelihood of receiving general anesthesia (GA) compared with neuraxial anesthesia (NA) for cesarean delivery (CD). This study expands on that research, and the authors theorize that in addition to patient factors, there may be hospital-level factors that increase the likelihood of GA for CD in certain patients.
Sequential Extracorporeal Therapy of Pathogen Removal Followed by Cell-Directed Extracorporeal Therapy in Streptococcal Toxic Shock Syndrome Refractory to Venoarterial Extracorporeal Membrane Oxygenation: A Case Report
Authors: Amerson Stephen J. , Hoffman McKenna , Abouzahr Fadi , Ahmad Mohammad , Sterling Rachel K. , Gidwani Hitesh , Sousse Linda E. , Dellavolpe Jeffrey D.
Published: February 2024

BACKGROUND:

Streptococcal toxic shock syndrome (STSS) is a fulminant complication of predominantly invasive group A streptococcal infections. STSS is often characterized by influenza-like symptoms, including fever, chills, and myalgia that can quickly progress to sepsis with hypotension, tachycardia, tachypnea, and multiple organ failure (kidney, liver, lung, or blood). Mortality can exceed 50% depending on the severity of symptoms.

CASE SUMMARY:

Here, we describe a novel, multi-extracorporeal intervention strategy in a case of severe septic shock secondary to STSS. A 28-year-old woman 5 days after cesarean section developed STSS with respiratory distress, hypotension, and multiple organ failure. Despite conventional therapy with intubation, antibiotics, vasopressors, and fluid resuscitation, her condition worsened. She was placed on venoarterial extracorporeal membrane oxygenation (VA-ECMO) with subsequent initiation of pathogen hemoperfusion using the Seraph 100 blood filter, followed by immunomodulation with the selective cytopheretic device (SCD). No device-related adverse events were observed. The patient’s condition gradually stabilized with discontinuation of vasopressors after 4 days, ECMO decannulation after 6 days, evidence of renal recovery after 7 days, and extubation from mechanical ventilation after 14 days. She was transferred to conventional hemodialysis after 13 days and discontinued all kidney replacement therapy 11 days later.

CONCLUSIONS:

This is the first reported use of VA-ECMO, Seraph 100 hemoperfusion, and cell-directed immunomodulation with SCD. This multimodal approach to extracorporeal support represents a promising therapeutic strategy for the most refractory critical care cases. Further studies are needed to assess the safety and efficacy of this sequential approach.
A High-biocompatibility Interface for the Breast Implant: First Report of a Novel Biological Matrix–assisted Technique in Aesthetic Revision Surgery
Authors: Muccioli Casadei Renato , Corezzola Maria Elena , Monticelli Andrea
Published: February 2024

Development of human-compatible tissues is an active field of research that is leading to the production of optimized biological scaffolds to support regenerative medicine. Xenogenic acellular matrices are known to have strongly influenced the field of breast surgery, playing an integral role in wound healing and in preventing the foreign body reaction to silicone implants. Here, we present our experience in using a biological matrix for aesthetic revision surgery with malposition and severe capsular contracture. Revisions were performed using the new MASQUE equine acellular-pericardium-matrix (APM) as an anterior cover for the synthetic prosthesis. Acting as an internal support, the thin APM layer provides a biological and biocompatible interface between the synthetic implant and living tissues, exerting a protective function against fibrotic responses and capsular contracture. The role of an APM in matrix-assisted mammoplasty has yet to be fully established. Our early experience of APM-assisted aesthetic revision surgery shows promising results, laying the foundations for equine biological matrices as a valid tool for the management of capsular contracture-susceptible patients.
Endothelial YAP/TEAD1-CXCL17 signaling recruits myeloid-derived suppressor cells against liver ischemia-reperfusion injury
Authors: Zhang Sitong , Sun Zhongquan , Chen Zhenhua , Bi Yanli , Wei Shenyu , Mao Zhengwei , Jin Jin , Ding Yuan , Wang Weilin
Published: February 2024

Background and Aims:

Liver ischemia-reperfusion injury (IRI) is a common complication of liver transplantation and hepatectomy and causes acute liver dysfunction and even organ failure. Myeloid-derived suppressor cells (MDSCs) accumulate and play immunosuppressive function in cancers and inflammation. However, the role of MDSCs in liver IRI has not been defined.

Approach and Results:

We enrolled recipients receiving OLT and obtained the pre-OLT/post-OLT blood and liver samples. The proportions of MDSCs were significantly elevated after OLT and negatively associated with liver damage. In single-cell RNA-sequencing analysis of liver samples during OLT, 2 cell clusters with MDSC-like phenotypes were identified and showed maturation and infiltration in post-OLT livers. In the mouse model, liver IRI mobilized MDSCs and promoted their infiltration in the damaged liver, and intrahepatic MDSCs were possessed with enhanced immunosuppressive function by upregulation of STAT3 signaling. Under treatment with αGr-1 antibody or adoptive transfer MDSCs to change the proportion of MDSCs in vivo, we found that intrahepatic MDSCs alleviated liver IRI-induced inflammation and damage by inhibiting M1 macrophage polarization. Mechanistically, bulk RNA-sequencing analysis and in vivo experiments verified that C-X-C motif chemokine ligand 17 (CXCL17) was upregulated by YAP/TEAD1 signaling and subsequently recruited MDSCs through binding with GPR35 during liver IRI. Moreover, hepatic endothelial cells were the major cells responsible for CXCL17 expression in injured livers, among which hypoxia-reoxygenation stimulation activated the YAP/TEAD1 complex to promote CXCL17 transcription.

Conclusions:

Endothelial YAP/TEAD1-CXCL17 signaling recruited MDSCs to attenuate liver IRI, providing evidence of therapeutic potential for managing IRI in liver surgery.
Recombinant Deoxyribonuclease I Eye Drops for Ocular Graft Versus Host Disease: Results of a Randomized Clinical Trial
Authors: Mun Christine S. , Surenkhuu Bayasgalan , Chen Yi-Fan , Atassi Nour , Mun Jessica , Kim Christian , Sheth Tanya , Sarwar Monazzah Akbar , Pradeep Anubhav , Jain Sandeep
Published: February 2024

Objective:

We have previously shown that neutrophil extracellular traps (NETs) are present on the ocular surface of patients with ocular graft versus host disease (oGVHD), contributing to inflammation and surface disease. Therefore, we performed a clinical trial using deoxyribonuclease I (DNAase) eye drops to test the hypothesis that reducing the abundance of NETs from the ocular surface will reduce signs and symptoms of oGVHD.

Methods:

A prospective, phase I or II, randomized, placebo-controlled, double-masked clinical trial was performed to determine the safety and preliminary efficacy of DNAase (0.1%) eye drops four times daily for 8 weeks in patients with oGVHD (n=58). Intent-to-treat analysis was performed to determine the change in safety outcome measures (drug tolerability and proportion of adverse events) and efficacy outcome measures (ocular surface disease index [OSDI] score and corneal staining) between baseline and week 8.

Results:

Tolerability and adverse events were similar in the vehicle and DNAase groups. Within the DNAase group (but not the vehicle group), corneal staining showed a statistically significant and clinically meaningful reduction at week 8 (3.50 [2.75; 5.00]) compared with baseline (5.00 [3.00; 7.00]). The OSDI score also showed a statistically significant clinically meaningful reduction of 18.4 (9.16; 33.1) (P<0.001) at week 8 compared with baseline (45.5 [31.8; 50.0]) within the DNAase group. The proportion of eyes that had improvement in subjective global assessment (SGA) and mucous discharge was significantly greater in the DNAase group (55.6% and 57.7% at weeks 4 and 8, respectively; P<0.0001 at both time points) as compared with the vehicle group (35.7% and 34.0% at weeks 4 and 8, respectively).

Conclusions:

Treatment of patients with oGVHD using DNAase eye drops is safe and demonstrates preliminary efficacy. Deoxyribonuclease I eye drops can potentially reduce the severity of signs and symptoms of ocular surface disease in patients with oGVHD.
The Impact of Text Messaging to Promote Patient Reported Outcome Measures (PROMs) Completion in Orthopedic Practice: Findings From a Randomized Controlled Study
Authors: Ziegenfuss Jeanette Y. , Asche Stephen E. , Dehmer Steven P. , Reams Megan , Grossman Elizabeth S. , Solberg Leif I.
Published: February 2024

It is difficult to achieve high response rates to Patient Reported Outcome Measures (PROMs) surveys collected as part of clinical care. However, they are operationally and clinically important. To understand the impact of text message reminders on response rates to PROMs collected via email as part of routine care for hip or knee replacement surgery, initial nonresponders were randomized to receive a text reminder or not at 7 and 12 days, if needed. At day 7, the overall survey response rate was 63%. Model-derived estimates for survey return after this point were 51.1% (95% confidence interval [CI], 48.0%–54.2%) in the text arm compared to 34.5% (95% CI, 31.6%–37.6%) in the no text arm. The effect of text messages on response rates did not vary by subpopulations considered nor were there differences in rates of key outcomes between the 2 groups, suggesting that it did not impact any underlying response bias. Given the relative low cost of text messages, they can be an efficient means to increase response rates.
Using an Equity in Research Framework to Develop a Community-Engaged Intervention to Improve Preexposure Uptake Among Black Women Living in the United States South
Authors: Randolph Schenita D. , Jeter Elizabeth , Johnson Ragan
Published: February 2024

In the U.S. South, over half of new HIV diagnoses occur among Black Americans with research lagging for women who face increased HIV rates and low PrEP uptake, among other health inequities. Community engaged research is a promising method for reversing these trends with established best practices for building infrastructure, implementing research, and translating evidence-based interventions into clinical and community settings. Using the 5Ws of Racial Equity in Research Framework (5Ws) as a racial equity lens, the following paper models a review of a salon-based intervention to improve PrEP awareness and uptake among Black women that was co-developed with beauty salons, stylists, and Black women through an established community advisory council. In this paper we demonstrate how the 5Ws framework was applied to review processes, practices, and outcomes from a community-engaged research approach. The benefits of and challenges to successful collaboration are discussed with insights for future research and community impact.
Digitized Electrocardiography Measurements Support the Biological Plausibility of the Pathological Significance of ST Segments in Athletes
Authors: Montalvo Samuel , Froelicher Victor F. , Hadley David , Wheeler Matthew T.
Published: February 2024

Objective:

ST segment deviations around the isoelectric line are common findings in manifest cardiovascular disease. In athletes, ST elevation is common, while ST depression is considered rare. However, clinical studies in athletes have associated ST depression with myocardial fibrosis and fatty infiltration and ST elevation with pericarditis and myocarditis. This study aims to explore the association between resting ST segment deviations and resting heart rate, an indicator of training and autonomic tone and electrocardiography (ECG) markers of exercise training effect and cardiovascular health R and T wave amplitude.

Design:

Retrospective analysis of digitized ECG data.

Setting:

Institutional setting.

Participants:

Seven thousand eight hundred thirty-six (male athletes = 4592, female athletes = 3244) healthy asymptomatic athletes (14-35 years).

Main Outcome Measures:

A series of correlations and regressions were conducted between ST depression (<0.0 µV) and ST elevation (>0.0 µV), on R and T wave amplitudes, and heart rate in leads V2, V5, and aVF.

Results:

Positive correlations between ST elevation and R and T wave (S wave in V2) amplitudes and leads V5, V2, and aVF in male and female athletes (range of r = 0.1-0.54). In addition, there was a negative correlation between ST elevation and HR for male and female athletes. Finally, there was a negative correlation between ST depression and R wave and HR for male and female athletes in V5 (P < 0.01).

Conclusions:

In athletes, ST segment elevation is correlated with R and T wave amplitudes and negatively correlated with HR. In addition, ST segment elevation is correlated with low heart rate, consistent with its higher prevalence in athletes. ST segment depression is not influenced by HR but is negatively associated with R and T wave amplitudes.
Parents' Experiences with Postpartum Support Groups using Videoconferencing
Authors: Price Sheri , Aston Megan , MacLeod Anna , Stone Kathryn , Jack Susan , Benoit Britney , Ollivier Rachel , Joy Phillip , Iduye Damilola
Published: February 2024

Purpose:

To explore new parents' experiences with web-based videoconferencing as a mechanism of offering postpartum virtual support groups.

Study Design and Methods:

Virtual support sessions and individual interviews were conducted to explore participants' experiences with virtual postpartum groups.

Results:

Thirty-seven parents participated in seven virtual support sessions and 19 participated in individual interviews. Participant narratives centered on perceptions of safety when engaging in virtual support groups. Tools within the virtual space (camera; mute) created a relational paradox which provided safeguards but also hindered the building of trust. Participants described negotiating the fear of harm and judgment within virtual spaces alongside feelings of security in connecting from the safety of their homes.

Clinical Implications:

The virtual environment provides a forum for new parents to access information and support and an avenue for engagement with maternal child nurses and care providers. Awareness of how parents perceive safety in the virtual environment is an important part of facilitating and structuring parent groups on videoconferencing platforms. Nurses should be familiar with videoconferencing technology and be able to guide parents. Experience facilitating virtual groups to ensure safety and security while providing needed support is a valuable nursing skill.
A Participatory Approach to Identifying Gaps in and Recommendations for Sexually Transmitted Infection and Preexposure Prophylaxis Clinical Services in Pierce County, Washington
Authors: Zinsli Kaitlin , Means Arianna Rubin , Barbee Lindley A. , Rodriguez Evelyn Manley , Kerani Roxanne P.
Published: February 2024

Background

Pierce County, Washington, has a high burden of sexually transmitted infections (STIs) relative to Washington State and the United States. We used a participatory approach to identify gaps in STI and preexposure prophylaxis (PrEP) service provision in Pierce County and generate recommendations to address these gaps.

Methods

In collaboration with the Tacoma-Pierce County Health Department (TPCHD), we conducted 14 key informant interviews with local STI/PrEP providers from varied clinical settings. Using rapid qualitative analysis, we identified key gaps and strengths in service provision. Local, state, and national HIV/STI subject matter experts (SMEs) prioritized the gaps and recommendations to address them via an online survey.

Results

The primary 6 gaps ranked by SMEs (N = 32) in order of importance included the following: (1) inadequate availability of STI and PrEP services, (2) lack of awareness of STI and PrEP services, (3) need for free/low cost STI and PrEP care, (4) need for stronger relationships among providers and TPCHD, (5) reduced accessibility related to geographically distributed population and centralized services, and (6) frequent referrals pose a service barrier. Subject matter experts prioritized recommendations for each gap as follows: (1) create an STI specialty clinic, (2) implement an STI/PrEP service availability outreach campaign, (3) strengthen referral relationships between TPCHD and free/low-cost providers, (4) develop a provider support network, (5) create a mobile STI clinic, and (6) develop an STI specialty clinic.

Conclusions

Sexually transmitted infection specialty clinics were prioritized by SMEs to improve access to STI and PrEP care in Pierce County, and to serve as a resource for local providers.
Association of mild traumatic brain injury, post-traumatic stress disorder, and other comorbidities on photosensitivity
Authors: Jotie Jenalyn M. , Gustafson Jennifer A. , Fonda Jennifer R. , Fortier Catherine B. , Milberg William P. , Fortenbaugh Francesca C.
Published: February 2024

SIGNIFICANCE

Photosensitivity is common after mild traumatic brain injury. However, this study demonstrates that photosensitivity is also impacted by common comorbidities that often occur with mild traumatic brain injury. Understanding how physical and psychological traumas impact photosensitivity can help improve provider care to trauma survivors and guide novel therapeutic interventions.

PURPOSE

This study aimed to characterize the association between mild traumatic brain injury and common comorbidities on photosensitivity in post-9/11 veterans.

METHODS

Existing data from the Translational Research Center for TBI and Stress Disorders cohort study were analyzed including traumatic brain injury history and post-traumatic stress disorder clinical diagnostic interviews; sleep quality, anxiety, and depression symptoms self-report questionnaires; and photosensitivity severity self-report from the Neurobehavioral Symptom Inventory. Analysis of covariance and multiple ordinal regression models were used to assess associations between mild traumatic brain injury and common comorbidities with photosensitivity severity.

RESULTS

Six hundred forty-one post-9/11 veterans were included in this study. An initial analysis showed that both mild traumatic brain injury and current post-traumatic stress disorder diagnosis were independently associated with higher photosensitivity ratings compared with veterans without either condition, with no interaction observed between these two conditions. Results of the ordinal regression models demonstrated positive associations between degree of photosensitivity and the number of mild traumatic brain injuries during military service and current post-traumatic stress disorder symptom severity, particularly hyperarousal symptoms, even when controlling for other factors. In addition, the degree of sleep disturbances and current anxiety symptoms were both positively associated with photosensitivity ratings, whereas depression symptoms, age, and sex were not.

CONCLUSIONS

Repetitive mild traumatic brain injury, post-traumatic stress disorder, anxiety, and sleep disturbances were all found to significantly impact photosensitivity severity and are therefore important clinical factors that eye care providers should consider when managing veterans with a history of deployment-related trauma reporting photosensitivity symptoms.
Clinical report: Virtual reality enables comparable contrast sensitivity measurements to in-office testing (pilot study)
Authors: Cheng Christopher P. , Serafini Randal A. , Labkovich Margarita , Warburton Andrew J. , Navarro Vicente , Shaik Neha , Reddy Harsha , Chelnis James G.
Published: February 2024

SIGNIFICANCE

Vision health disparities largely stem from inaccessibility to vision specialists. To improve patient access to vision tests and to expedite clinical workflows, it is important to assess the viability of virtual reality (VR) as a modality for evaluating contrast sensitivity.

PURPOSE

This study aimed to assess the validity of a VR version of the Pelli-Robson contrast sensitivity test by comparing its results with those of the corresponding in-office test.

METHODS

Twenty-eight participants (mean ± standard deviation age, 37.3 ± 20.5 years) with corrected vision were recruited for testing on a voluntary basis with randomized administration of the in-office test followed by the VR analog or vice versa. Nineteen participants took each test twice to assess test-retest consistency in each modality. Virtual reality tests were conducted on a commercial Pico Neo Eye 2 VR headset, which has a 4K screen resolution. The environment for both tests was controlled by the participant for location and lighting.

RESULTS

Similar sensitivity scores were obtained between testing modalities in both the right (n = 28 participants; Wilcoxon match-paired signed rank [SR], p=0.7) and left eyes (n = 28 participants; Wilcoxon match-paired SR, p=0.7). In addition, similar test-retest scores were found for VR (n = 19 participants; Wilcoxon match-paired SR, p=1.0) or in-office (n = 19 participants; Wilcoxon match-paired SR, p=1.0) tests. Virtual reality Pelli-Robson results correlated well with in-office test results in variably diseased participants (n = 14 eyes from 7 participants, R
2 = 0.93, p<0.0001).

CONCLUSIONS

In this pilot trial, we demonstrated that VR Pelli-Robson measurements of corrected vision align with those of in-office modalities, suggesting that this may be a reliable method of implementing this test in a more interactive and accessible manner.
Cannabis oil extracts for chronic pain: what else can be learned from another structured prospective cohort?
Authors: Pud Dorit , Aamar Suhail , Schiff-Keren Bareket , Sheinfeld Roee , Brill Silviu , Robinson Dror , Fogelman Yaakov , Habib George , Sharon Haggai , Amital Howard , Boltyansky Boris , Haroutounian Simon , Eisenberg Elon
Published: February 2024

Introduction:

The use of medicinal cannabis for managing pain expands, although its efficacy and safety have not been fully established through randomized controlled trials.

Objectives:

This structured, prospective questionnaire-based cohort was aimed to assess long-term effectiveness and safety of cannabis oil extracts in patients with chronic pain.

Methods:

Adult Israeli patients licensed to use cannabis oil extracts for chronic pain were followed prospectively for 6 months. The primary outcome measure was change from baseline in average weekly pain intensity, and secondary outcomes were changes in related symptoms and quality of life, recorded before treatment initiation and 1, 3, and 6 months thereafter. Generalized linear mixed model was used to analyze changes over time. In addition, “responders” (≥30% reduction in weekly pain at any time point) were identified.

Results:

The study included 218 patients at baseline, and 188, 154, and 131 at 1, 3, and 6 months, respectively. At 6 months, the mean daily doses of cannabidiol and Δ9-tetrahydrocannabinol were 22.4 ± 24.0 mg and 20.8 ± 30.1 mg, respectively. Pain decreased from 7.9 ± 1.7 at baseline to 6.6 ± 2.2 at 6 months (F(3,450) = 26.22, P < 0.0001). Most secondary parameters also significantly improved. Of the 218 participants, 24% were “responders” but could not be identified by baseline parameters. “Responders” exhibited higher improvement in secondary outcomes. Adverse events were common but mostly nonserious.

Conclusion:

This prospective cohort demonstrated a modest overall long-term improvement in chronic pain and related symptoms and a reasonable safety profile with the use of relatively low doses of individually titrated Δ9-tetrahydrocannabinol and cannabidiol.
Mortality Among HIV-Infected Adults on Antiretroviral Therapy in Southern Uganda
Authors: Nabukalu Dorean , Yiannoutsos Constantin T. , Semeere Aggrey , Musick Beverly S. , Murungi Teddy , Namulindwa Jane Viola , Waswa Francis , Nakigozi Gertrude , Sewankambo Nelson K. , Reynolds Steven J. , Lutalo Tom , Makumbi Fredrick , Kigozi Godfrey , Nalugoda Fred , Wools-Kaloustian Kara
Published: February 2024

Background:

Monitoring and evaluation of clinical programs requires assessing patient outcomes. Numerous challenges complicate these efforts, the most insidious of which is loss to follow-up (LTFU). LTFU is a composite outcome, including individuals out of care, undocumented transfers, and unreported deaths. Incorporation of vital status information from routine patient outreach may improve the mortality estimates for those LTFU.

Settings:

We analyzed routinely collected clinical and patient tracing data for individuals (15 years or older) initiating antiretroviral treatment between January 2014 and December 2018 at 2 public HIV care clinics in greater Rakai, Uganda.

Methods:

We derived unadjusted mortality estimates using Kaplan–Meier methods. Estimates, adjusted for unreported deaths, applied weighting through the Frangakis and Rubin method to represent outcomes among LTFU patients who were successfully traced and for whom vital status was ascertained. Confidence intervals were determined through bootstrap methods.

Results:

Of 1969 patients with median age at antiretroviral treatment initiation of 31 years (interquartile range: 25–38), 1126 (57.2%) were female patients and 808 (41%) were lost. Of the lost patients, 640 patient files (79.2%) were found and reviewed, of which 204 (31.8%) had a tracing attempt. Within the electronic health records of the program, 28 deaths were identified with an estimated unadjusted mortality 1 year after antiretroviral treatment initiation of 2.5% (95% CI: 1.8% to 3.3%). Using chart review and patient tracing data, an additional 24 deaths (total 52) were discovered with an adjusted 1-year mortality of 3.8% (95% CI: 2.6% to 5.0%).

Conclusions:

Data from routine outreach efforts by HIV care and treatment programs can be used to support plausible adjustments to estimates of client mortality. Mortality estimates without active ascertainment of vital status of LTFU patients may significantly underestimate program mortality.
Three-dimensional Measurement of the Zygomatic-maxillary Complex in the Class III Malocclusion Patients with Maxillary Retrusion
Authors: Zheng Yilue , Wang Binqing , Ma Hengyuan , Tong Haizhou , Song Tao
Published: February 2024

This study investigated the anatomic features of the zygomatic-maxillary complex in patients with maxillary retrusion without clefts. Individuals were grouped, and craniofacial measurements were performed for 21 individuals with skeletal Class III malocclusion with maxillary retrusion (CIII) and 48 individuals from the control group (CG). We evaluated the predetermined hard-tissue and soft-tissue points of the facial profile in each group. Independent sample t-tests were performed to determine the differences between groups (significance set at P<0.05). Multiple points on the midface, including the most posterior point on the contour of the maxillary alveolar process, lowest point of the zygomaticomaxillary suture, furthest point to the zygomatic self-base plane, superior point in the infraorbital foramen, and lowest point of the inferior margin of the orbit to the coronal plane were smaller in CIII than in CG (all P<0.05). The soft tissue thickness in these regions was significantly increased compared with that in the normal group. In summary, for class III malocclusion patients with maxillary retrusion, the deficiency in the midface gradually decreased going upward, with the deficiency at the maxillary alveolar level being the most serious. To some extent, soft tissues compensate for the deficiencies in the facial skeleton, and standard Le Fort I osteotomy advancement was sufficient to achieve a harmonious appearance.
Interpretable machine learning for predicting risk of invasive fungal infection in critically ill patients in the intensive care unit: A retrospective cohort study based on MIMIC-IV database
Authors: Cao Yuan , Li Yun , Wang Min , Wang Lu , Fang Yuan , Wu Yiqi , Liu Yuyan , Liu Yixuan , Hao Ziqian , Gao Hengbo , Kang Hongjun
Published: February 2024

The delayed diagnosis of invasive fungal infection (IFI) is highly correlated with poor prognosis in patients. Early identification of high-risk patients with invasive fungal infections and timely implementation of targeted measures is beneficial for patients. The objective of this study was to develop a machine learning-based predictive model for invasive fungal infection in patients during their Intensive Care Unit (ICU) stay. Retrospective data was extracted from adult patients in the MIMIC-IV database who spent a minimum of 48 hours in the ICU. Feature selection was performed using LASSO regression, and the dataset was balanced using the BL-SMOTE approach. Predictive models were built using six machine learning algorithms. The Shapley additive explanation (SHAP) algorithm was employed to assess the impact of various clinical features in the optimal model, enhancing interpretability. The study included 26,346 ICU patients, of whom 379 (1.44%) were diagnosed with invasive fungal infection. The predictive model was developed using 20 risk factors, and the dataset was balanced using the borderline-SMOTE (BL-SMOTE) algorithm. The BL-SMOTE random forest model demonstrated the highest predictive performance (AUC 0.88, 95% CI: 0.84-0.91). SHAP analysis revealed that the three most influential clinical features in the BL-SMOTE random forest model were dialysis treatment, APSIII scores, and liver disease. The machine learning model provides a reliable tool for predicting the occurrence of IFI in ICU patients. The BL-SMOTE random forest model, based on 20 risk factors, exhibited superior predictive performance and can assist clinicians in early assessment of IFI occurrence in ICU patients.

Importance

Invasive fungal infections are characterized by high incidence and high mortality rates characteristics. In this study, we developed a clinical prediction model for invasive fungal infections in critically ill patients based on machine learning algorithms. The results show that the machine learning model based on 20 clinical features has good predictive value.
A Core Outcome Set for Acute Necrotizing Pancreatitis: an Eastern Association for the Surgery of Trauma Modified Delphi Method Consensus Study
Authors: Farrell Michael , Alseidi Adanan , Byerly Saskya , Fockens Paul , Giberson Frederick A. , Glaser Jeffrey , Horvath Karen , Jones David , Luckhurst Casey , Mowery Nathan , Robinson Bryce R.H. , Rodriguez Allie , Singh Vikesh K. , Siriwardena Ajith K. , Vege Santhi Swaroop , Trikudanathan Guru , Visser Brendan C. , Voermans Rogier P. , Yeh Daniel Dante , Gelbard Rondi B.
Published: February 2024

Background

The management of acute necrotizing pancreatitis (ANP) has changed dramatically over the past 20 years including the use of less invasive techniques, the timing of interventions, nutritional management, and anti-microbial management. This study sought to create a core outcome set (COS) to help shape future research by establishing a minimal set of essential outcomes that will facilitate future comparisons and pooling of data, while minimizing reporting bias.

Methods

A modified Delphi process was performed though involvement of ANP content experts. Each expert proposed a list of outcomes for consideration and the panel anonymously scored the outcomes on a 9-point Likert scale. Core outcome consensus defined a priori as >70% of scores receiving 7-9 points and < 15% of scores receiving 1-3 points. Feedback and aggregate data were shared between rounds with inter-class correlation trends used to determine the end of the study.

Results

A total of 19 experts agreed to participate in the study with 16 (84%) participating through study completion. Forty-three outcomes were initially considered with 16 reaching consensuses after four rounds of the modified Delphi process. The final COS included outcomes related to mortality, organ failure, complications, interventions/management, and social factors.

Conclusion

Through an iterative consensus process, content experts agreed on a COS for the management of ANP. This will help shape future research to generate data suitable for pooling and other statistical analyses that may guide clinical practice.

Study Type

Diagnostic Tests or Criteria

Level of Evidence

Diagnostic test or criteria, V
Spliced CEACAM1: A Potential Novel Biomarker and Target for Ameliorating Liver Ischemia–reperfusion Injury
Authors: Yazdani Hamza O. , Geller David A. , Tohme Samer
Published: February 2024

Hepatic ischemia–reperfusion injury remains a significant challenge in liver transplantation potentially leading to delayed graft function, primary nonfunction, and sometimes rejection. Understanding the underlying mechanisms and implementing mitigation strategies are essential for improving transplant outcomes and patient survival. A recent study published by Dery et al shows that alternative splicing of carcinoembryonic antigen–related cell adhesion molecule 1 regulated by hypoxia inducible factor 1 alpha under stress enhances hepatic ischemia tolerance in mice and humans. The authors identified a direct binding of hypoxia inducible factor 1 alpha to the promoter region of polypyrimidine tract-binding protein 1 splicing enzyme, resulting in carcinoembryonic antigen–related cell adhesion molecule 1-short induction and improved posttransplant outcomes. This study has notably elucidated a potential biomarker pertaining to the quality of liver transplant donor grafts.
Discovering significant topics from legal decisions with selective inference
Authors: Soh Tsin Howe Jerrold
Published: February 2024

We propose and evaluate an automated pipeline for discovering significant topics from legal decision texts by passing features synthesized with topic models through penalized regressions and post-selection significance tests. The method identifies case topics significantly correlated with outcomes, topic-word distributions which can be manually interpreted to gain insights about significant topics, and case-topic weights which can be used to identify representative cases for each topic. We demonstrate the method on a new dataset of domain name disputes and a canonical dataset of European Court of Human Rights violation cases. Topic models based on latent semantic analysis as well as language model embeddings are evaluated. We show that topics derived by the pipeline are consistent with legal doctrines in both areas and can be useful in other related legal analysis tasks.

This article is part of the theme issue ‘A complexity science approach to law and governance’.
AI and the nature of disagreement
Authors: Niblett Anthony , Yoon Albert
Published: February 2024

Litigation is a creature of disagreement. Our essay explores the potential of artificial intelligence (AI) to help reduce legal disagreements. In any litigation, parties disagree over the facts, the law, or how the law applies to the facts. The source of the parties' disagreements matters. It may determine the extent to which AI can help resolve their disputes. AI is helpful in clarifying the parties’ misunderstanding over how well-defined questions of law apply to their facts. But AI may be less helpful when parties disagree on questions of fact where the prevailing facts dictate the legal outcome. The private nature of information underlying these factual disagreements typically fall outside the strengths of AI's computational leverage over publicly available data. A further complication: parties may disagree about which rule should govern the dispute, which can arise irrespective of whether they agree or disagree over questions of facts. Accordingly, while AI can provide clarity over legal precedent, it often may be insufficient to provide clarity over legal disputes.

This article is part of the theme issue 'A complexity science approach to law and governance'.
Opposing roles of physiological and pathological amyloid-β on synapses in live human brain slice cultures
Authors: McGeachan Robert I. , Meftah Soraya , Taylor Lewis W. , Catterson James H. , Negro Danilo , Tulloch Jane , Rose Jamie L. , Gobbo Francesco , Liaquat Imran , Spires-Jones Tara L. , Booker Sam A. , Brennan Paul M. , Durrant Claire S.
Published: February 2024

In Alzheimer’s disease, it is theorised that amyloid beta (Aβ) and tau pathology contribute to synapse loss. However, there is limited information on how endogenous levels of tau and Aβ protein relate to patient characteristics, or how manipulating physiological levels of Aβ impacts synapses, in living adult, human brain. Here, we employed live human brain slice cultures as a translational tool to assess endogenous tau and Aβ release, pathology, and response to experimental manipulation. We found that the levels of Aβ1-40and tau detected in the culture medium depend on donor age, and brain region, respectively. Pharmacologically raising physiological Aβ concentration enhanced levels of synaptic transcripts. Treatment of slices with Aβ-containing Alzheimer’s disease brain extract resulted in postsynaptic Aβ uptake and loss of presynaptic puncta. These data indicate that physiological and pathological Aβ can have opposing effects on synapses in living human brain tissue.
Lysine Demethylase 4A is a Centrosome Associated Protein Required for Centrosome Integrity and Genomic Stability
Authors: Chowdhury Pratim , Wang Xiaoli , Love Julia F. , Vargas-Hernandez Sofia , Nakatani Yuya , Grimm Sandra L. , Mezquita Dereck , Mason Frank M. , Martinez Elisabeth D. , Coarfa Cristian , Walker Cheryl L. , Gustavsson Anna-Karin , Dere Ruhee
Published: February 2024

Centrosomes play a fundamental role in nucleating and organizing microtubules in the cell and are vital for faithful chromosome segregation and maintenance of genomic stability. Loss of structural or functional integrity of centrosomes causes genomic instability and is a driver of oncogenesis. The lysine demethylase 4A (KDM4A) is an epigenetic ‘eraser’ of chromatin methyl marks, which we show also localizes to the centrosome with single molecule resolution. We additionally discovered KDM4A demethylase enzymatic activity is required to maintain centrosome homeostasis, and is required for centrosome integrity, a new functionality unlinked to altered expression of genes regulating centrosome number. We find rather, that KDM4A interacts with both mother and daughter centriolar proteins to localize to the centrosome in all stages of mitosis. Loss ofKDM4Aresults in supernumerary centrosomes and accrual of chromosome segregation errors including chromatin bridges and micronuclei, markers of genomic instability. In summary, these data highlight a novel role for an epigenetic ‘eraser’ regulating centrosome integrity, mitotic fidelity, and genomic stability at the centrosome.
Genomic origin, fragmentomics, and transcriptional properties of long cell-free DNA molecules in human plasma
Authors: Che Huiwen , Jiang Peiyong , Choy L.Y. Lois , Cheng Suk Hang , Peng Wenlei , Chan Rebecca W.Y. , Liu Jing , Zhou Qing , Lam W.K. Jacky , Yu Stephanie C.Y. , Lau So Ling , Leung Tak Y. , Wong John , Wong Vincent Wai-Sun , Wong Grace L.H. , Chan Stephen L. , Chan K.C. Allen , Lo Y.M. Dennis
Published: February 2024

Recent studies have revealed an unexplored population of long cell-free DNA (cfDNA) molecules in human plasma using long-read sequencing technologies. However, the biological properties of long cfDNA molecules (>500 bp) remain largely unknown. To this end, we have investigated the origins of long cfDNA molecules from different genomic elements. Analysis of plasma cfDNA using long-read sequencing reveals an uneven distribution of long molecules from across the genome. Long cfDNA molecules show overrepresentation in euchromatic regions of the genome, in sharp contrast to short DNA molecules. We observe a stronger relationship between the abundance of long molecules and mRNA gene expression levels, compared with short molecules (Pearson'sr= 0.71 vs. −0.14). Moreover, long and short molecules show distinct fragmentation patterns surrounding CpG sites. Leveraging the cleavage preferences surrounding CpG sites, the combined cleavage ratios of long and short molecules can differentiate patients with hepatocellular carcinoma (HCC) from non-HCC subjects (AUC = 0.87). We also investigated knockout mice in which selected nuclease genes had been inactivated in comparison with wild-type mice. The proportion of long molecules originating from transcription start sites are lower inDffb-deficient mice but higher inDnase1l3-deficient mice compared with that of wild-type mice. This work thus provides new insights into the biological properties and potential clinical applications of long cfDNA molecules.
Spectrum of the molecular tetraquarks: Unraveling the
Tcs0(2900)
and
Tcs¯0a(2900)
Authors: Wang Bo , Chen Kan , Meng Lu , Zhu Shi-Lin
Published: February 2024

We relate the interactions of the D¯(*)K* and D(*)K* systems to those of D(*)D(*) and D(*)D¯(*) respectively, considering the residual strong interactions at the near-threshold energy is too weak to excite the strange quarks inside the hadrons. We propose an effective model to describe the low-energy S-wave interactions that are undertaken by the light u, d quarks between two separated heavy hadrons. We find that the existence of molecules in the heavy-(anti)heavy sectors will naturally lead to the emergence of molecular states in D¯(*)K* and D(*)K* systems. The recently observed Tcs0(2900) and Tcs¯0a(2900) can be well identified as the 0(0+) and 1(0+) partners of Tcc(3875) and Zc(3900) in the charmed strange sector, respectively. We also predict their members under the (c and s) quark symmetry and SU(2) flavor symmetry. Most of them are very good molecule candidates, for example, (i) the 0(1+) states in D*D*, D¯K*, D¯*K*; (ii) the 0(+)(2+(+)) states in D*D¯*, D¯*K*, D*K*; (iii) the 1−(0++) state in D*D¯* and 1(1+) state in D*K*. The 0+(0++) state in DD¯ and the 0(1+) state in DK* might also exist as virtual states, and the 0(1+) DK* can serve as a key to infer the existence of 0+(0++) DD¯. The Dsπ invariant mass spectrum of Tcs¯0a(2900) is also studied within the coupled-channel approach, and the molecular interpretation of Tcs¯0a(2900) is consistent with the experimental data. Searching for the predicted states in experiments is crucial to discriminate the different pictures for interpreting these near-threshold exotica.

Published by the American Physical Society
2024
Resummation schemes for high-electric-charge objects leading to improved experimental mass limits
Authors: Alexandre Jean , Mavromatos Nick E. , Mitsou Vasiliki A. , Musumeci Emanuela
Published: February 2024

High-electric-charge compact objects (HECOs) appear in several theoretical particle physics models beyond the Standard Model, and are actively searched for in current colliders, such as the Large Hadron Collider at CERN. In such searches, mass bounds of these objects have been placed, using Drell-Yan and photon-fusion processes at tree level so far. However, such mass-bound estimates are not reliable, given that, as a result of the large values of the electric charge of the HECO, perturbative quantum electrodynamics calculations break down. In this work, we perform a Dyson-Schwinger resummation scheme (as opposed to lattice strong-coupling approach), which makes the computation of the pertinent HECO-production cross sections reliable, thus allowing us to extract improved mass bounds for such objects from ATLAS and MoEDAL searches.

Published by the American Physical Society
2024
2P
-wave charmed baryons from QCD sum rules
Authors: Yang Hui-Min , Chen Hua-Xing
Published: February 2024

We conduct an investigation on the 1P- and 2P-wave charmed baryons using the methods of QCD sum rules and light-cone sum rules within the framework of heavy quark effective theory. Our results suggest that the Λc(2910)+, Λc(2940)+, and Ξc(3123)+ can be well interpreted as the 2P-wave charmed baryons of JP=1/2− and 3/2−, belonging to the SU(3) flavor 3¯F representation. Moreover, the Ξc(3123)+ possesses a partner state characterized by JP=1/2−, denoted as Ξc(1/2−,2P). Our analysis predicts its mass and width to be mΞc(1/2−,2P)−mΞc(3123)+=−18±7  MeV and ΓΞc(2P,1/2−)=31−27+170  MeV, with mΞc(3123)+=3122.9±1.3  MeV. We propose to search for it in the Ξc(1/2−,2P)→ΣcK decay channel.

Published by the American Physical Society
2024