bluuebunny/crossref_metadata_2025 huggingface dataset:
Rethinking the Right to Freedom of Thought: A Multidisciplinary Analysis
Authors: Ligthart Sjors , Bublitz Christoph , Douglas Thomas , Forsberg Lisa , Meynen Gerben
Published: November 2022

In recent years, there has been increased academic interest in the human right to freedom of thought (RFoT). Scholars from various disciplines are currently debating the content and scope of this right. In his annual thematic report of 2021, the United Nations Special Rapporteur on Freedom of Religion or Belief paid explicit and comprehensive attention to the RFoT, encouraging further clarification of the content and scope of the right. This paper aims to contribute to this end, setting the stage for further research, by offering a multidisciplinary analysis of the RFoT’s scope, relation to other rights, practical significance and moral foundations.
Introducing the global antimicrobial stewardship partnership hub (GASPH): creating conditions for successful global partnership collaboration
Authors: Sneddon Jacqueline , Guise Tracey , Jenkins David , Mpundu Mirfin , Van Dongen Maarten , Schouten Jeroen , Xiao Jonghong , Cordoba Gloria , Nathwani Dilip
Published: November 2022

In 2015, 196 countries formally committed to a Global Action Plan to address antimicrobial resistance (AMR). However, translating policy into practice is not happening at pace and the recent Global Research on AntiMicrobial resistance (GRAM) Project report confirms the burden of AMR is increasing. Despite progress in establishing surveillance data and investment in new antimicrobials, education and training including use of behavioural science approaches to change practice is lagging. To contribute to addressing this, we have invited organizations to join us as founding members of the Global Antimicrobial Stewardship Partnership Hub (GASPH) (https://global-asp-hub.com/). We will work together to share education resources and foster collaboration to meet the needs of learners and of partner organizations working on tackling AMR. Membership is open to all—professional societies, academic institutes, nongovernmental organizations/civil society, philanthropists and commercial partners interested in supporting a multi-stakeholder global antimicrobial stewardship (AMS) education platform and network.
Ubiquitin-mediated mitochondrial regulation by MITOL/MARCHF5 at a glance
Authors: Nagashima Shun , Ito Naoki , Shiiba Isshin , Shimura Hiroki , Yanagi Shigeru
Published: November 2022

Mitochondria are involved in various cellular processes, such as energy production, inflammatory responses and cell death. Mitochondrial dysfunction is associated with many age-related diseases, including neurological disorders and heart failure. Mitochondrial quality is strictly maintained by mitochondrial dynamics linked to an adequate supply of phospholipids and other substances from the endoplasmic reticulum (ER). The outer mitochondrial membrane-localized E3 ubiquitin ligase MITOL/MARCHF5 is responsible for mitochondrial quality control through the regulation of mitochondrial dynamics, formation of mitochondria-ER contacts and mitophagy. MITOL deficiency has been shown to impair mitochondrial function, cause an excessive inflammatory response and increase vulnerability to stress, resulting in the exacerbation of the disease. In this study, we overview the ubiquitin-mediated regulation of mitochondrial function by MITOL and the relationship between MITOL and diseases.
The attitude of fully vaccinated individuals towards COVID-19 vaccine booster dose: a transverse study from Jordan
Authors: Abuhammad Sawsan , Alzoubi Karem H , Khabour Omar F , Hamaideh Shaher , El-zubi Maryam K
Published: November 2022

Objectives

COVID-19 vaccines are efficient against serious infections, and those initiated by the various variants. Many high- and middle-income countries have decided to offer third-dose boosters to ensure their populations remain protected against novel COVID-19 variants before additional waves of COVID-19. This study aims to assess individuals’ attitudes towards COVID-19 booster vaccination dose and to determine predictors of this attitude.

Methods

This study used a cross-sectional descriptive design. The inclusion criteria for participants were Jordanian adults who had been fully vaccinated against COVID-19. A quota sampling strategy based on the participant’s, age and gender was used to ensure that the sample was broadly representative of the general population in Jordan. The instrument was distributed across popular social networking sites such as Facebook and WhatsApp. The study was conducted in October 2021.

Key findings

The response rate of this study was 63.5% (n = 952). The mean score of attitudes towards a booster dose of COVID-19 was 47.1 ± 8.2, indicating that about half of the sample was supportive to the booster dose. There were differences in the acceptability of a booster dose for COVID-19 according to the demographic and clinical characteristics of the participants. Individuals with high income (B = 0.210, P = 0.000), high educational level (B = −0.076, P = 0.026), those who have suffered vaccine side effects (B = −0.081, P = 0.013) and follow the news about COVID-19 (B = 0.076, P = 0.043) were more likely to accept the booster dose than the other groups.

Conclusions

Participants had mixed attitudes towards the booster dose with about half of the participants willing to take the booster. Some factors associated with such attitude were identified. The findings are useful in developing and implementing effective vaccination strategies that target people who are not ready to take a booster dose.
A case of sigmoid colon volvulus with transanal ileus tube placement and Sharon’s operation performed safely
Authors: Minagawa Yume , Ishiyama Yasuhiro , Fukuda Toshiyuki , Mochizuki Ichitaro , Ito Shingo , Oneyama Masataka , Amiki Manabu , Hara Yoshiaki , Narita Kazuhiro , Tachimori Yuji , Goto Manabu
Published: November 2022

Although endoscopic repair is often performed for sigmoid colon volvulus without intestinal necrosis, surgery is the common choice of treatment due to recurrence. With no established treatment, Hartmann’s operation or sigmoid colon resection is often performed. We report a case of a 65-year-old man with transanal ileus tube placement before surgery for sigmoid colon volvulus to prevent recurrence and achieve intestinal decompression followed by Sharon’s operation to achieve one-stage anastomosis. The patient showed good postoperative course, with no recurrence 3 months after surgery. This report discusses the usefulness of the transanal ileus tube and Sharon’s operation for sigmoid colon volvulus without intestinal necrosis along with a review of the literature.
Glutathione and neodiosmin feedback sustain plant immunity
Authors: Lu Chongchong , Jiang Yanke , Yue Yingzhe , Sui Yurong , Hao Mingxia , Kang Xiaojing , Wang Qingbin , Chen Dayin , Liu Baoyou , Yin Ziyi , Wang Lulu , Li Yang , Dong Hansong , Li Xugang , Xin Xiufang , Liu Yinggao , Ding Xinhua
Published: November 2022

Plants have evolved a two-layer immune system comprising pattern-triggered immunity (PTI) and effector-triggered immunity (ETI) that is activated in response to pathogen invasion. Microbial patterns and pathogen effectors can be recognized by surface-localized pattern-recognition receptors (PRRs) and intracellularly localized nucleotide-binding leucine-rich repeat receptors (NLRs) to trigger PTI and ETI responses, respectively. At present, the metabolites activated by PTI and ETI and their roles and signalling pathways in plant immunity are not well understood. In this study, metabolomic analysis showed that ETI and PTI induced various flavonoids and amino acids and their derivatives in plants. Interestingly, both glutathione and neodiosmin content were specifically up-regulated by ETI and PTI, respectively, which significantly enhanced plant immunity. Further studies showed that glutathione and neodiosmin failed to induce a plant immune response in which PRRs/co-receptors were mutated. In addition, glutathione-reduced mutant gsh1 analysis showed that GSH1 is also required for PTI and ETI. Finally, we propose a model in which glutathione and neodiosmin are considered signature metabolites induced in the process of ETI and PTI activation in plants and further continuous enhancement of plant immunity in which PRRs/co-receptors are needed. This model is beneficial for an in-depth understanding of the closed-loop mode of the positive feedback regulation of PTI and ETI signals at the metabolic level.
TESS uncloaks the secondaries in hydrogen-deficient binaries
Authors: Jeffery C Simon
Published: November 2022

υ  Sgr is the prototype of four known hydrogen-deficient binary (HdB) systems. These are characterized by a hydrogen-deficient A-type primary, variable hydrogen emission lines, and a normally unseen secondary presumed to be an upper main-sequence star. Orbital periods range from tens of days to 360 d. TESS observations of all four HdBs show a flux variation with well-defined period in the range 0.5–0.9 d, too short to be associated with the supergiant primary, and more likely to be the rotation period of the secondary and associated with a chemical surface asymmetry or a low-order non-radial oscillation. The observed rotation period supports a recent analysis of the υ Sgr secondary. The observations give a direct glimpse of the secondary in all four systems, and should help to explain how the primary has been stripped to become a low-mass hydrogen remnant.
Surveillance for Avocado Sunblotch Viroid Utilizing the European Honey Bee (Apis mellifera)
Authors: Roberts John M. K. , Jooste Anna E. C. , Pretorius Lara-Simone , Geering Andrew D. W.
Published: November 2022

Avocado is one of the world's fastest growing tropical fruit industries, and the pathogen avocado sunblotch viroid (ASBVd) is a major threat to both production and access to international export markets. ASBVd is seed transmissible, with infection possible via either the male (pollen) or female gametes. Surveillance for ASBVd across commercial orchards is a major logistical task, particularly when aiming to meet the stringent standards of evidence required for a declaration of pest freedom. As with many fruit crops, insect pollination is important for high avocado yields, and honey bee ( Apis mellifera) hives are typically moved into orchards for paid pollination services. Exploiting the foraging behavior of honey bees can provide a complementary strategy to traditional surveillance methods. High-throughput sequencing (HTS) of bee samples for plant viruses shows promise, but this surveillance method has not yet been tested for viroids or in a targeted plant biosecurity context. Here, we tested samples of bees and pollen collected from pollination hives in two ASBVd orchard locations, one in Australia, where only four trees in a block were known to be infected, and a second in South Africa, where the estimated incidence of infection was 10%. Using real-time RT-PCR and HTS (total RNA-seq and small RNA-seq), we demonstrated that ASBVd can be confidently detected in bees and pollen samples from hives within 100 m of infected trees. The potential for using this approach in ASBVd surveillance for improved orchard management and supporting market access is discussed.
Herpes zoster
Authors: Kelley Angela
Published: November 2022

Herpes zoster, or shingles, caused by a reactivation of the chickenpox virus, can occur in patients of any age, but is more common in older adults. Patient history is critical in reaching a diagnosis, not only to manage the outbreak effectively, but also to prevent severe complications such as dissemination of the virus into the central nervous system. This article describes recent changes in diagnostic testing, treatment, prevention, and practice guidelines as well as the approach clinicians should take when evaluating patients with herpes zoster and assessing risk for complications.
The Dobbs Decision and Undergraduate Medical Education: The Unintended Consequences and Strategies to Optimize Reproductive Health and a Competent Workforce for the Future
Authors: Stephenson-Famy Alyssa , Sonn Tammy , Baecher-Lind Laura , Bhargava Rashmi , Chen Katherine T. , Fleming Angela , Kang Morgan Helen , Morosky Christopher M. , Schaffir Jonathan A. , Madani Sims Shireen , Sutton Jill M. , Royce Celeste S. ,   for the Undergraduate Medical Education Committee of the Association of Professors of Gynecology and Obstetrics
Published: November 2022

The June 2022 U.S. Supreme Court decision on Dobbs v Jackson Women’s Health Organization resulted in state-specific differences in abortion care access across the country. The primary concern in the obstetrics and gynecology education community has been the impact on resident and fellowship training programs. However, the impact on undergraduate medical education and the broad implications for future generations of physicians are crucial to address. It is estimated that 48% of matriculants to MD-granting medical schools will receive their medical education in the 26 states with significant abortion restrictions or bans. Undergraduate medical educators need to continue to adequately teach the basic science, clinical care, and population health outcomes of reproductive medicine, including pregnancy and abortion. In addition, students in states with more restrictions on abortion will have less or no clinical exposure, and those in states with few restrictions may be excluded due to overcrowding of learners from restricted states. Students’ own health care also needs to be considered, as access to abortion care for themselves or their partners may create applicant pool demographic shifts by state as applicants consider options for where to pursue their medical education. It is important to ensure that teaching of foundational science of pregnancy, abortion, and reproductive health continues throughout the United States. Undergraduate and graduate medical educators will need to closely monitor the downstream impact of decreased clinical exposure of abortion. Further study of the personal health impact of abortion care access for medical students and awareness of the changing applicant pool demographics by state is needed.
Mortality patterns of soft-tissue sarcomas worldwide up to 2018, with predictions for 2025
Authors: Pizzato Margherita , Collatuzzo Giulia , Santucci Claudia , Malvezzi Matteo , Boffetta Paolo , Comandone Alessandro , Levi Fabio , La Vecchia Carlo , Bertuccio Paola , Negri Eva
Published: November 2022

Objective

The epidemiological evidence on soft-tissue sarcoma (STS) mortality is inconsistent in geographic and time coverage. This study provides mortality trends for STSs in selected countries worldwide over the last 2 decades, together with predicted figures for 2025.

Methods

We extracted official numbers of certified deaths coded as C47 (i.e. malignant neoplasm of peripheral nerves and autonomic nervous system) and C49 (i.e. malignant neoplasm of other connective and soft tissue) according to the 10th Revision of the International Classification of Disease and population estimates from the WHO and the Pan American Health Organization databases. We computed age-standardized (world standard population) mortality rates (ASMRs). We used joinpoint regression analysis to identify significant changes in trends and to predict death numbers and rates for 2025.

Results

The pattern emerging from the number of deaths and ASMRs up to 2018 shows an increase in most countries in both sexes. Around 2015 to 2018, ASMRs differed by 2.5-fold in both sexes with the highest rates being registered in Central-Eastern Europe, North America and Australia, while the lowest ones in Latin America, Japan, and Korea. In 2025, the number of STS deaths is predicted to increase in most countries and both sexes, and unfavourable rates are predicted in Central Europe in both sexes.

Conclusion

In addition to improvements in STSs registration, unfavourable mortality rates reported in this study reflect inadequate referral of patients with STSs to high-volume multidisciplinary centres, as well as insufficient advancements in STS prevention, diagnosis, and treatments.
Prospective Associations Between Preschool Exposure to Violent Televiewing and Psychosocial and Academic Risks in Early Adolescent Boys and Girls
Authors: Pagani Linda S. , Bernard Jessica , Fitzpatrick Caroline
Published: November 2022

Objective:

Risks of early exposure to media violence remain unclear. This study examines typical early childhood violent media exposure and subsequent psychosocial and academic risks.

Methods:

Our longitudinal birth cohort comprised 978 girls and 998 boys. Child-reported and teacher-reported measures of adjustment at age 12 years were linearly regressed on parent-reported televised violence exposure at ages 3.5 and 4.5 years while adjusting for individual/family confounders.

Results:

For girls, preschool violent televiewing was associated with increases in emotional distress (b = 0.31; 95% confidence interval [CI], 0.13–0.49) and decreases in classroom engagement (b = −0.97; 95% CI, −1.55 to −0.40), academic achievement (b = −2.60; 95% CI, −3.48 to −1.72), and academic motivation (b = −0.58; 95% CI, −1.09 to −0.07) at age 12 years. For boys, preschool violent televiewing was associated with increases in emotionally distressed (b = 0.33; 95% CI, 0.13–0.53), inattentive (b = 0.25; 95% CI, 0.06–0.45), conduct disordered (b = 0.11; 95% CI, 0.00–0.21), and socially withdrawn behavior (b = 0.23; 95% CI, 0.05–0.40), as well as decreases in classroom engagement (b = −0.84; 95% CI, −1.57 to −0.12), academic achievement (b = −1.19; 95% CI, −2.15 to −0.23), and academic motivation (b = −0.58; 95% CI, −1.13 to −0.03) at age 12 years.

Conclusion:

Compared with no preschool exposure, violent televiewing is associated with distinct and enduring psychosocial risks by early adolescence. Acknowledging such risks remains a pertinent health literacy target for pediatric professionals, parents, and communities.
Public Perceptions of Breast Implant Complications and the FDA Boxed Warning on Implants
Authors: Hyland Colby J. , Gadiraju Goutam , Parikh Neil , Dey Tanujit , Broyles Justin M.
Published: November 2022

Background:

The US Food and Drug Administration (FDA) issued a boxed warning on breast implants in October 2021, requiring communication of certain risks to patients. This study assessed how this boxed warning may impact public perceptions of breast implants.

Methods:

A cross-sectional survey was administered to adult women in the United States in December 2021 using Amazon Mechanical Turk to assess perceptions of breast implant risks communicated in the FDA-issued guidance. Sociodemographic predictors of responses were identified using multivariable models.

Results:

There were 494 complete responses. Respondents had a mean age of 36.9 years, and 80% had an associate’s degree or higher. At baseline, most would consider receiving implants for reconstructive or cosmetic purposes (65%). Some were unsure or indicated that it is not possible to undergo mammograms after receiving implants (42%). After provided information in the FDA guidance, the majority strongly agreed or agreed that they were less likely to receive implants knowing the risk of anaplastic large cell lymphoma (75%), because implants contain chemicals/heavy metals (74%), and because implants are not lifetime devices (68%), with greater odds among Hispanic respondents (OR, 2.35; P < 0.01) and lower odds among higher-income respondents (OR, 0.64; P = 0.03).

Conclusions:

There are misconceptions with regard to breast implant-associated risks. Despite most laywomen indicating that they would consider receiving implants at baseline, the risks communicated in the 2021 FDA boxed warning may make patients less likely to receive implants, with variability among different sociodemographic populations.
Benefits, Facilitators, and Barriers of Alternative Models of Cardiac Rehabilitation
Authors: Platz Katherine , Kools Susan , Howie-Esquivel Jill
Published: November 2022

Purpose:

Cardiac rehabilitation (CR) improves health outcomes and quality of life for patients with cardiovascular disease, yet only a quarter of eligible patients enroll. A myriad of CR models that use either an alternative location (ie, home-based) and/or an alternative exercise have been developed to overcome known attendance and physical limitation barriers; however, patient experiences with these models have not been systematically reviewed. Our aim is to review patient experiences with these models of CR.

Review Methods:

We conducted a systematic review and thematic analysis of qualitative studies published between 2009 and January of 2022 from CINAHL, PubMed, Web of Science, and PsycINFO.

Twenty-five studies were included, representing the perspectives of 487 individuals who participated in an alternative model of CR. Exercises included walking, tai chi, yoga, aquatic exercise, exergaming, chair-based exercises, aerobics, physical activity trackers, and individualized exercise plans. Nineteen of 25 studies used home-based models and two used live video. Twelve studies included patients with heart failure. Patient perspectives comprised three central themes: exercise benefits, exercise facilitators, and participation barriers. Some thematic categories were reported variably by particular model/study design (eg, home-based) than by others. All alternative models of CR were found to be physically, psychologically, and/or socially beneficial to patients. Participants described facilitators and barriers that were influential in the decision to initiate or continue exercise. These patient insights are critical for innovative delivery of CR that is appealing, accommodates physical limitations, and broadens access to improve health equity.
Test-Based Strategy to Follow up an Immunocompromised Patient Diagnosed With COVID-19
Authors: Roseta Luis , Carmo Anália , Mota Vanda , Janeiro Cláudia , Araújo Lucília , Paiva Artur , Costa Fátima , Raposo Maria Helena , Chaves Catarina , Rodrigues Fernando
Published: November 2022

Immunocompromised patients frequently present a prolonged viral severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detection in respiratory samples and are unrecognized sources of transmission. It is therefore important to determine their infectivity potential to establish the adequate follow-up and quarantine measures. We present a test-based strategy to follow up an immunocompromised patient fully vaccinated for SARS-CoV-2, diagnosed with COVID-19 that 3 months after reaching the clinical criteria of cure presented a reduced cycle threshold value in a real-time polymerase chain reactive SARS-CoV-2 test and a positive antigen SARS-CoV-2 test, while being asymptomatic.
Combining prostate health index and multiparametric magnetic resonance imaging may better predict extraprostatic extension after radical prostatectomy
Authors: Huang Yu-Pin , Lin Tzu-Ping , Shen Shu-Huei , Cheng Wei-Ming , Huang Tzu-Hao , Huang I-Shen , Fan Yu-Hua , Lin Chih-Chieh , Huang Eric Y. H. , Chung Hsiao-Jen , Lu Shing-Hwa , Chang Yen-Hwa , Lin Alex T. L. , Huang William J.
Published: November 2022

Background:

In patients undergoing radical prostatectomy (RP) for prostate cancer (PCa), preoperative prediction of extraprostatic extension (EPE) can facilitate patient selection for nerve-sparing procedures. Since both multiparametric magnetic resonance imaging (mpMRI) and prostate health index (PHI) have shown promise for the diagnosis and prognostication of PCa, we investigated whether a combination of mpMRI and PHI evaluations can improve the prediction of EPE after RP.

Methods:

Patients diagnosed with PCa and treated with RP were prospectively enrolled between February 2017 and July 2019. Preoperative blood samples were analyzed for PHI (defined as [p2PSA/fPSA] × √tPSA), and mpMRI examinations were performed and interpreted by a single experienced uroradiologist retrospectively. The area under the receiver operating characteristic curve (ROC) was used to determine the performance of mpMRI, PHI, and their combination in predicting EPE after RP.

Results:

A total of 163 patients were included for analysis. The pathological T stage was T3a or more in 59.5%. Overall staging accuracy of mpMRI for EPE was 72.4% (sensitivity and specificity: 73.2% and 71.2%, respectively). The area under the ROC of the combination of mpMRI and PHI in predicting EPE (0.785) was higher than those of mpMRI alone (0.717; p = 0.0007) and PHI alone (0.722; p = 0.0236). mpMRI showed false-negative non-EPE results in 26 patients (16%), and a PHI threshold of >40 could avoid undiagnosed EPE before RP in 21 of these 26 patients.

Conclusion:

The combination of PHI and mpMRI may better predict the EPE preoperatively, facilitating preoperative counseling and tailoring the need for nerve-sparing RP.
Factors Associated With Depression and Anxiety for Community-Dwelling Patients With Heart Failure
Authors: Helal Sameera I. , Murrells Trevor , Grealish Annmarie , Evans Catherine J.
Published: November 2022

Background

Depression and anxiety are common comorbidities in heart failure (HF) and are associated with adverse outcomes including unplanned hospitalization. However, there is insufficient evidence on the factors associated with depression and anxiety for community patients with HF to inform optimal assessment and treatment in this population.

Aim

The aim of this study was to examine the prevalence of and factors associated with depression and anxiety in community-dwelling patients with HF.

Methods

A retrospective cohort study of 302 adult patients given a diagnosis of HF referred to United Kingdom's largest specialist cardiac rehabilitation center, from June 2013 to November 2020. Main study outcomes were symptoms of depression using Patient Health Questionnaire-9 and anxiety using the General Anxiety Disorder 7-item scale. Explanatory variables included demographic and clinical characteristics and functional status from the Dartmouth COOP questionnaire: quality of life, pain, level of social activity and daily activities, and being bothered by emotional problems (feelings). Logistic regressions were performed to evaluate the association between demographic and clinical characteristics and depression and anxiety.

Results

Of the sample, 26.2% reported depression and 20.2% had anxiety. Higher depression and anxiety were associated with difficulty in performing daily activities (95% confidence interval, 1.11–6.46 and 1.13–8.09, respectively) and being bothered by feelings (95% confidence interval, 4.06–21.77 and 4.25–22.46, respectively). Depression was associated with limitations in social activity (95% confidence interval, 1.06–6.34) and anxiety with distressing pain (95% confidence interval, 1.38–7.23).

Conclusion

Findings indicate the importance of psychosocial interventions for patients with HF to minimize and manage depression and anxiety. Patients with HF may benefit from interventions targeted to maintain independence, promote participation in social activities, and optimally manage pain.
Resonantly Coupled High-Efficiency Sensors for Assessment of Ventricular Chamber Size for Autonomous Control of Left Ventricular Assist Device
Authors: Palagani Yellappa , Sorkin Eldar , Bonde Riya , Bahel Piyush , Bonde Pramod
Published: November 2022

Current left ventricular assist devices (LVADs) are set to a fixed rpm and are unable to adjust to physiological demands irrespective of preload or afterload. Autonomous control of LVADs has the potential to reduce septal shift, preserve right ventricle function, and meet physiological demands. A highly innovative resonantly coupled regimen is presented which can achieve this goal.

We introduce sensors based on a highly sensitive relationship between transmission coefficient and spatial separation in a resonantly coupled regimen. This relationship represents a polynomial regression. A regimen of an apical sensor and multiple outflow sensors is investigated. A range of separations varying from 50–200 mm was systematically investigated. These ranges consider anatomical & physiological variation(s) in cardiac chamber size. Validation was obtained in porcine heart preparation.

The polynomial regression model predicted distance between the sensors with a mean absolute percentage error of 0.77%, 1.07%, and 5.75% for the thr ee putative positions of the outflow sensors and apical sensor when compared with experimental results. A high degree of accuracy (95%) between the predicted and observed distance was obtained. Continuous measurements were done over 90 days to examine drift, with no statistically detectable change in measurements over million sampling cycles.

We have demonstrated a reliable sensor methodology without drift for assessing ventricular chamber size in an LVAD setup. This has the potential to allow autonomous control of LVAD based on ventricular chamber size to address some of the adverse events.
Optimizing input parameter of the randomized singular value decomposition algorithm for compressing technetium-99m L,L, ethylenedicysteine renal dynamic study in minimum time preserving clinical information
Authors: Chaudhary Jagrati , Pandey Anil Kumar , Sharma Param D , Patel Chetan , Kumar Rakesh
Published: November 2022

Objective

The SVDsketch [MATLAB function which implements a randomized singular value decomposition (rSVD) algorithm] uses tolerance (tol) to adaptively determine the rank of the matrix sketch approximation. As the tol gets larger, fewer features of input image matrix are used in the matrix sketch. The objective of this study was to optimize the value of tol for compressing technetium-99m (Tc-99m) L,L, ethylenedicysteine (LLEC) renal dynamic (RD) study in minimum time preserving clinical information.

Materials and methods

At different values of tol [0.00012(default), 0.1, 0.01, and 0.05] 50 Tc-99m LLEC RD studies were compressed. Two nuclear medicine (NM) physicians compared compressed images at tol = 0.1 with its input images. The SVD computation time and compression factor were calculated for each study. The image quality metrics: Error, structural similarity index for measuring image quality, brightness, global contrast factor (GCF), contrast per pixel (CPP), and blur were used for objective assessment of image quality. Percentage error in split function estimated from compressed and original images was calculated. Wilcoxon signed-rank test was applied to find statistically significant difference between renal split function, blur, GCF, CPP, and brightness of the compressed image and the original image at

.

Results

As per NM physicians, compressed images estimated with tol = 0.1 were identical to the original images. Based on image quality metrics, compressed images were significantly less noisy, brighter, and have better contrast compared with its input images. There was insignificant difference in split renal function estimated from compressed RD study at tol = 0.1 and its original study. The SVD computation and percentage compression per study were found to be 0.04725 s and up to 74.53%.

Conclusion

The optimized value of tol for compressing Tc-99m LLEC RD study preserving clinical information was found to be 0.1, and SVD computation time: 0.04725 s.
The prognostic value of positron emission tomography/computed tomography-based parameters in locally advanced esophageal squamous cell carcinoma treated with chemoradiation therapy
Authors: Zhang Wei , Jia Hongyuan , Cheng Zhuzhong , Diao Wei , Wang Yi , Cao Bangrong , Kou Ying , Wang Qifeng
Published: November 2022

Objectives

To assess the prognostic value of PET/computed tomography-based parameters in patients with locally advanced esophageal squamous cell carcinoma (ESSC).

Methods

Sixty-seven patients with ESSC undergoing definitive chemoradiotherapy (dCRT) were retrospectively enrolled. PET/CT parameters (maximum standardized uptake value (SUVmax) metabolic tumor volume (MTV), and total glycolysis (TLG) were obtained from 18F-fluorodeoxyglucose (18F-FDG) PET/CT studies. The correlation between overall survival and PET/CT parameters was analyzed using a Cox proportional hazards model.

Results

There were no differences in TLG, MTV, and SUVmax values across age, sex, tumor location, and lymph node status. However, for patients with cT3-4 disease, TLG and SUVmax were significantly higher (P = 0.019 and P = 0.018, respectively), and MTV showed an increasing trend (P = 0.068). There were significant correlations among TLG, MTV and SUVmax. According to the receiver-operating curve, the cutoff values of TLG, MTV and SUVmax dichotomized by survival status at 2 years were 64.00 g, 9.63 ml and 9.97 g/ml, respectively. In univariate analysis, increased TLG, MTV and SUVmax were significant negative prognostic factors for OS. However, in multivariate analysis, only SUVmax was an independent prognostic factor for overall survival (hazard ratios = 2.857, 95% confidence intervals: 1.837–4.442; P = 0.017).

Conclusions

PET/CT is a useful tool for predicting the prognoses in patients with locally advanced ESSC treated with dCRT. Future prospective studies with a large number of samples should be conducted to confirm these results.
The utility of technetium-99m pertechnetate thyroid scintigraphy assessing thyroid/salivary ratio as an alternative to thyroid uptake percentage in evaluation of thyroid function, with establishing normal reference values of both parameters: single Egyptian center study
Authors: Abdelhamed Heba M. , Abdo Soliman Mohamed S. , Mahmoud Amira A. , Mohamed Ramadan , Ali Ismail M. , Abdelhai Shaimaa F.
Published: November 2022

Background/Objective

Management of thyroid disorders depends on accurate clinical assessment, appropriate investigations and radionuclide imaging, which plays an established important role either qualitatively or quantitatively. The aim of this study was to assess the utility of the thyroid/salivary ratio (TSR) as an alternative to technetium-99m (Tc99m) pertechnetate thyroid uptake (TcU) percentage in the evaluation of thyroid function and in the same time to establish reference range for the thyroid uptake of Tc99m-pertechnetate and TSR among Egyptian populations.

Patients and methods

This retrospective study enrolled 270 patients, out of which 250 with different thyroid disorders and 20 without thyroid diseases, as a control group who all underwent full clinical examination, thyroid function tests and Tc99m pertechnetate thyroid scintigraphy. The TcU percentage and TSR were calculated and then correlated to the thyroid hormonal profile.

Results

The normal reference ranges of TcU and TSR were 0.75–3.5% and 1.25–4.8%, respectively. The sensitivity and specificity of TSR to diagnose hyperthyroidism were slightly lower compared with TcU (84.5 and 92.3% vs. 86.2 and 98.3%, respectively) at TSR cutoff value of more than 4.8 and TcU cutoff value of more than 3.5. Meanwhile, they had comparable sensitivity and specificity to diagnose hypothyroidism (86.0 and 93.3% vs. 86.5 and 94.5%) at cutoff values <0.75 and <1.25, respectively.

Conclusion

The current study established a reference range for TcU and TSR in our institution. TSR is comparable to TcU in the evaluation of thyroid function among hyper-and hypothyroid patients and TSR can be used in doubtful cases of mal-thyroid function for confirmation of the diagnosis.
Bone metastases in prostate cancer – Gallium-68–labeled prostate-specific membrane antigen or Fluorine 18 sodium fluoride PET/computed tomography – the better tracer?
Authors: Agrawal Archi , Natarajan Aravintho , Mithun Sneha , Bakshi Ganesh , Joshi Amit , Murthy Vedang , Menon Santosh , Purandare Nilendu , Shah Sneha , Puranik Ameya , Choudhury Sayak , Prakash Gagan , Pal Mahendra , Maitre Priyamvada , Prabhash Kumar , Noronha Vanita , Rangarajan Venkatesh
Published: November 2022

Objective

The objective was to assess the roles of 68Ga-PSMA PET/CT and 18F-NaF PET/CT in evaluation of skeletal metastatic lesions in prostate cancer.

Methods

Two hundred consecutive prostate cancer patients who had undergone 68Ga-PSMA PET/CT and 18F-NaF PET/CT at baseline evaluation (n = 80) and following suspected recurrence or disease progression (restaging) (n = 120) were analyzed retrospectively.

Results

PSMA and NAF scans were positive for skeletal metastatic lesions in 67% (134 patients) and negative in 33% (66 patients). The scans were concordant in 80% (160 patients: 66 negative and 94 positive) and discordant in 20% (40 patients). Among 40 discordant results, 14 were baseline and 26 were restaging studies. PSMA detected more number of lesions in 11 (nine baseline and two restaging). These were true positive marrow or lytic metastatic lesions. NaF revealed more number of lesions in 29 (5 initial and 24 restaging). These were false positive on follow-up imaging. No statistical difference (P value = 0.7 by McNemar test) between the two scans for identifying absence or presence of at least one skeletal lesion was noted at baseline staging.

Conclusion

Though, both 18F-NaF and 68Ga-PSMA are excellent tracers for evaluation of skeletal metastases in prostate cancer, there is a distinct advantage of 68Ga-PSMA PET/CT due to detection of additional skeletal lesions and absence of false positive lesions. In addition, absence of PSMA avidity in healed metastases in the restaging setting opens up new avenue for assessment of response of skeletal metastases.
How to use new antibiotics in the therapy of serious multidrug resistant Gram-negative infections?
Authors: Windham Samuel , Kollef Marin H.
Published: November 2022

Purpose of review

Multidrug resistant Gram-negative infections are becoming more common and pose a serious threat to both individual patients and the population as a whole. Treatment of these infections can be difficult and result in significant morbidity and mortality. The purpose of this review is to discuss information and strategies for using new antibiotics to combat these infections.

Recent findings

Eight new antibiotics represent possible means to treat multidrug resistant Gram-negative infections. Although no new mechanisms of action are present amongst these new antibiotics, novel additions to previously utilized mechanisms have been shown to be viable options for treatment of highly resistant organisms.

The novel antibiotics considered in this review have varying data on their use as empiric treatment of patients at high risk for multidrug resistant organisms and as final therapy for identified multidrug resistant organisms. Cefiderocol, ceftazidime-avibactam, ceftolozane-tazobactam, meropenem-vaborbactam, and imipenem-relabactam have the best support evidence for use in this patient population.
Epidemiology of Gram-negative bacteria during coronavirus disease 2019. What is the real pandemic?
Authors: Brink Adrian J. , Richards Guy , Tootla Hafsah , Prentice Elizabeth
Published: November 2022

Purpose of review

Bacterial infections play a key role in hospital outcomes during the coronavirus disease 2019 (COVID-19) pandemic. Nonetheless, the global impact on the epidemiology of Gram-negative bacteria (GNB) and antibiotic resistance has not been clearly established.

Recent findings

Multiple limitations exist in the current literature, in that substantial variability was observed with regard to methodology. Notwithstanding the heterogeneity, the evidence suggests that the COVID-19 pandemic had a substantial negative impact on global epidemiology with an increase in hospital-onset infections, associated with GNB. Similarly, an alarming increase in resistant GNB compared to prepandemic rates, was apparent. This was most evident for carbapenemase-producing Klebsiella pneumoniae (bloodstream infections), carbapenem-resistant Pseudomonas aeruginosa (ventilator-associated pneumonia), and carbapenem-resistant Acinetobacter baumannii (all infections). Significant variations were most apparent in the large, system-wide regional or national comparative assessments, vs. single-centre studies. Categorizing concurrent bacteria as co- or secondary-infections may be paramount to optimize standard of care.

The data from most studies signal the probability that COVID-19 accelerated resistance. However, multiple limitations intrinsic to interpretation of current COVID-19 data, prevents accurately quantifying collateral damage on the global epidemiology and antibiotic resistance amongst GNB. It is likely to be substantial and renewed efforts to limit further increases is warranted.
Molecular patterns of clinically important fluoroquinolone resistance in multidrug-resistant Klebsiella pneumoniae isolates during nosocomial outbreaks in Shanghai, PR China
Authors: Cai Guoping , Wang Yan
Published: November 2022

Introduction. The soaring resistance of

Klebsiella pneumoniae

to fluoroquinolones in PR China has substantially limited the application of these antimicrobials, especially in those clinical settings that were threatened by persistent carbapenem-resistant

K. pneumoniae

(CRKP), necessitating strict implementation of antimicrobial stewardship and active enhanced surveillance of infection control.

Hypothesis. There is interplay between plasmid-mediated quinolone resistance (PMQR) determinants and quinolone resistance-determining region (QRDR) mutations during the acquisition of a clinically important fluoroquinolone resistance (CI-FR) profile in multidrug-resistant

K. pneumoniae

(MDR-KP) isolates.

Aim. To investigate the high-risk CRKP clones responsible for nosocomial spread and analyse the molecular patterns of CI-FR in MDR-KP isolates in a tertiary hospital in Shanghai, PR China.

Methodology. A total of 34 isolates, including 30 CRKPs, were molecularly characterized. Investigations included antimicrobial susceptibility tests, multilocus sequence typing (MLST) and wzi genotyping, PCR sequencing and phylogenetic analysis for resistance-associated genes, and clinical information retrieval from medical records.

Results. Two high-risk CRKP clones, ST11-wzi64 and ST15-wzi19/wzi24, were identified as being responsible for nosocomial outbreaks in the intensive care unit (ICU) and the neurosurgery department, potentially by the respiratory route. QRDR mutations of both gyrA and parC were detected in isolates of ST15 (S83F/D87A/S80I), ST11 (S83I/D87G/S80I) and ST218 (D87A/S80I), respectively. The PMQR genes, qnrS1, aac(6′)-Ib-cr and oqxAB, were present in 32 (94.1 %) of the isolates alone or in combination, co-occurring with genes (bla) encoding β-lactamases, 16S rRNA methylases and putrescine ABC permeases. AcrR, an AcrAB transcriptional repressor, was insertion-inactivated by the IS5-like element in ST11 isolates. The encoding sequences of OmpK35 and OmpK36 genes were associated with specific STs and wzi alleles. ST11, ST15-wzi19 and ST218 isolates had frameshift disruptions in OmpK35 and specific GD insertions at position 134–135 in OmpK36. The 27 isolates with clinically important ciprofloxacin resistance (MICs ≥2 mg l−1) included 25 isolates (ST15, ST11, ST218) with multiple QRDR mutations, plus 1 with only 2 PMQR determinants (ST290-wzi21) and another with an unknown resistance mechanism (ST65-wzi72). Ciprofloxacin-susceptible isolates maintained intact ompK36 genes, including two CRKPs each with ST13-wzi74 (KPC-2 and NDM-1 coproducers) and ST65-wzi72, plus carbapenem-susceptible isolates (ST15-wzi24, ST65-wzi72, ST107-wzi173).

Conclusions. Under selective pressures, the accumulation of mutations of three types (QRDR, acrR, ompK36) and the acquisition of resistance-conferring genes have continuously contributed to CI-FR in MDR-KP isolates.
Views on sharing mental health data for research purposes: A qualitative study with people with mental illness
Authors: Watson E. , Fletcher-Watson S. , Kirkham E.J.
Published: November 2022

Background

Improved data sharing could have extensive benefits for mental health research and treatment. However, it is vital that data are shared in a way that aligns with the views of people with mental health conditions. Whilst previous research has examined public views of health data sharing, few studies have focused specifically on people with mental illness.

Methods

Semi-structured online interviews were conducted with twelve people with a range mental health conditions, including schizophrenia, anxiety, depression, eating disorder and addiction. Interview questions focussed on the risks and benefits of sharing mental health data, how data should be kept safe, and the sensitivity of different types of data.

Results

The overarching themes identified were: benefits of sharing mental health data, concerns about sharing mental health data, safeguards, and data types. There was a high level of support for the use of data sharing to facilitate improved knowledge of and treatment for mental health conditions. Concerns included the potential for misuse of data, such as by insurance companies or employers, and the risk of mental health stigma from researchers and healthcare professionals who accessed the data. There was a focus on appropriate safeguards, such as secure storage access procedures.

Conclusions

There was a strong sense across participants that more should be done to combat the suffering caused by mental illness, and that appropriate health data sharing could facilitate this. The mental health research community could build on this generally positive attitude to mental health data sharing by ensuring that they follow rigorous best practice which accounts for the specific concerns of people with mental illness.
Stress, coping, and quality of life in the United States during the COVID-19 pandemic
Authors: Wakeel Fathima , Hannah Jacelyn , Gorfinkel Leah
Published: November 2022

While research has widely explored stress, coping, and quality of life (QOL) individually and the potential links between them, there is a critical dearth in the literature regarding these constructs in the context of the COVID-19 pandemic. Our study aims to identify the salient stressors experienced, describe the coping strategies used, and examine the relationships between stress, coping, and current QOL among individuals during the pandemic. Data are from a nationally representative sample of 1,004 respondents who completed an online survey. Key measures included stressful life events (SLEs), coping strategies, and the physical and psychological health domains of QOL. Staged multivariate linear regression analyses examined the relationships between the two QOL domains and SLEs, controlling for sociodemographic and pre-existing health conditions and testing for the effects of coping strategies on these relationships. The most common SLEs experienced during the pandemic were a decrease in financial status, personal injury or illness, and change in living conditions. Problem-focused coping and emotion-focused coping were significantly related to higher levels of QOL, whereas avoidant coping was associated with lower QOL. Avoidant coping partially mediated the relationship between experiencing SLEs and reduced physical and psychological QOL. Our study informs clinical interventions to help individuals adopt healthy behaviors to effectively manage stressors, especially large-scale traumatic events like the pandemic. Our findings also call for public health and clinical interventions to address the long-term impacts of the most prevalent stressors experienced during the pandemic among vulnerable groups.