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A retrospective study of an irradiation-based conditioning regimen and chidamide maintenance therapy in T-ALL/LBL
Wang X, Deng Y, He G, Lai S, Li Y, Zhang S, He Y, Han Y, Zhang L, Su Y, Liu F and Yi H
T-cell acute lymphoblastic leukemia/lymphoblastic lymphoma (T-ALL/LBL) are highly malignant and aggressive hematologic tumors for which there is no standard first-line treatment. Chidamide, a novel histone deacetylase inhibitor, shows great promise. We assessed the efficacy and safety of an irradiation-containing conditioning regimen for allogeneic hematopoietic stem cell transplantation (allo-HSCT) and post-transplantation chidamide maintenance in patients with T-ALL/LBL.
Association of salivary testosterone levels during the post-awakening period with age and symptoms suggestive of late-onset hypogonadism in men
Park JY, Seok JH, Cho KS, Kang DH, Kim JS, Do SH, Na HS, Jang SA and Ahn RS
The lack of association between serum testosterone levels and symptoms suggestive of hypogonadism is a significant barrier in the determination of late-onset hypogonadism (LOH) in men. This study explored whether testosterone levels increase after morning awakening, likewise the cortisol awakening response (CAR) in the hypothalamic-pituitary-adrenal (HPA) axis, and whether testosterone levels during the post-awakening period are associated with age and symptoms suggestive of late-onset hypogonadism (LOH) in men.
Hyperbaric oxygen therapy improves the efficacy of conventional supportive treatment for late-onset hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation
Qu Y, Zhao P, Ding X, Qiao X, Wang L and Li Y
This study aims to investigate the efficacy and safety of hyperbaric oxygen therapy (HBOT) in the treatment of late-onset hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation.
Associations Between Ultra-Processed Food Consumption and Adverse Brain Health Outcomes
Bhave VM, Oladele CR, Ament Z, Kijpaisalratana N, Jones AC, Couch CA, Patki A, Garcia Guarniz AL, Bennett A, Crowe M, Irvin MR and Kimberly WT
Ultra-processed foods (UPFs) are linked to cardiometabolic diseases and neurologic outcomes, such as cognitive decline and stroke. However, it is unclear whether food processing confers neurologic risk independent of dietary pattern information. We aimed to (1) investigate associations between UPFs and incident cognitive impairment and stroke and (2) compare these associations with other commonly recommended dietary patterns in the REasons for Geographic and Racial Differences in Stroke study. This prospective, observational cohort study enrolled Black and White adults in the United States from 2003 to 2007.
Predicting Driving Cessation Among Cognitively Normal Older Drivers: The Role of Alzheimer Disease Biomarkers and Clinical Assessments
Babulal GM, Chen L, Murphy SA, Carr DB and Morris JC
With the aging US population and increasing incidence of Alzheimer disease (AD), understanding factors contributing to driving cessation among older adults is crucial for clinicians. Driving is integral for maintaining independence and functional mobility, but the risk factors for driving cessation, particularly in the context of normal aging and preclinical AD, are not well understood. We studied a well-characterized community cohort to examine factors associated with driving cessation.
Launching an International Community of Practice in Hematology/Oncology Medical Education
Walsh K, Manochakian R, Schwartz J and Brondfield S
A community of practice (CoP) is a group of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly. While the field of hematology/oncology has historically prioritized clinical care and biomedical research, medical education has received increasing attention within hematology/oncology in recent years. In 2018, ASCO launched the Education Scholars Program to train hematology/oncology clinicians in the science of teaching and learning. However, the number of hematology/oncology educators nationally and internationally far exceeds the capacity of the Education Scholars Program to train them. In addition, hematology/oncology educators often lack sufficient mentorship and guidance at their own institutions to pursue their chosen career path effectively. To ensure high-quality clinical care and research for generations to come, attention must be paid to improving support for hematology/oncology educators. Therefore, supported by ASCO, we developed an international medical education (Med Ed) CoP for hematology/oncology educators with the purpose of providing them with support, community, mentorship, resources, and scholarly opportunities in medical education. In this article, we describe the development of the Med Ed CoP using a three-stage framework (Establish-Grow-Sustain) including successes, challenges, and reflections. By supporting the needs of hematology/oncology educators, the Med Ed CoP will serve as a home for all who contribute to the field of hematology/oncology.
Use of Natural Language Understanding to Facilitate Surgical De-Escalation of Axillary Staging in Patients With Breast Cancer
Carleton N, Saadawi G, McAuliffe PF, Soran A, Oesterreich S, Lee AV and Diego EJ
Natural language understanding (NLU) may be particularly well equipped for enhanced data capture from the electronic health record given its examination of both content-driven and context-driven extraction.
Sexual dimorphism of Dyschiriini (Coleoptera, Carabidae): Comparative morphological SEM study of palpi sensilla and its possible role in intraspecific chemical communication
Muñoz-Santiago J and Ortuño VM
Sexual dimorphism in Dyschiriini (Coleoptera, Carabidae) consists of the presence of an autapomorphic sensory area in apical palpomeres of males, here named as Male Palpi Sensory Area (MPSA). In this work, microstructure of palpi, with focus on MPSA, is characterized and formally described using Scanning Electron Microscopy (SEM). Interspecific variability among 13 species and three subgenera of Dyschirius Bonelli, 1810 and one species of Reicheiodes Ganglbauer, 1891 is assessed. Palpi of studied Dyschiriini presented up to 4 sensilla classes (coeloconica, basiconica, digitiformia, trichodea) in both sexes, while males had one more class (sensilla placodea) found grouped in MPSA. Measurements of sensilla and MPSA are provided. Differences among taxa corresponded to development grade of MPSA and its number of sensilla placodea. The MPSA of Dyschirius (Dyschirius) thoracicus Rossi, 1790 were clearly different to the rest of the studied subgenera and species of Dyschirius and Reicheiodes, whose MPSA were similar and had slight intraspecific variability. We suggest that function of MPSA is likely detection of female pheromones, which would evidence chemical communication between sexes. We hypothesize that evolution of MPSA could be related to burrowing habits of Dyschiriini and its possible sexual behavior in soil tunnels. Study of MPSA may help to elucidate phylogenetic relationships among members of the tribe.
Young adults' personal and relationship memories: recollections of self, siblings, and family
Kara D, Bauer PJ and Şahin-Acar B
We investigated the phenomenological and narrative characteristics of young adults' self- and other-related memories within the context of significant relationships. We also examined whether participants' gender and/or gender concordance between participants and their siblings was associated with autobiographical memory characteristics. We collected data from 108 college students who had only one sibling. All participants provided narratives in response to three memory prompts (i.e., self-related, sibling-related, and family-related) and rated their memories along dimensions such as significance, emotional valence, clarity etc. The narratives were coded on thematic content, transformativeness, mentions of others, and event type dimensions. Results revealed differences between self-related memories and sibling- and family-related memories across several dimensions. However, sibling-related and family-related memories were mostly similar to each other. No statistically significant gender or gender concordance differences were observed. Further exploratory analysis showed that memory narratives describing extended events were more transformative than single event narratives. The findings enhance our understanding about the to others through relationship memories.
Have a Little Faith: Overcoming Pandemic-Related Challenges to Designing and Implementing a COVID-19 Testing Trial in African American Churches
Berkley-Patton J, Thompson CB, Templeton T, Finocchario-Kessler S, Williams E, Wainright C, Materia FT, Dennis L, Catley D, Burgin T, Derose KP, Bradley-Ewing A, Geyer A, Ellison SR and Allsworth JE
Patients and Stakeholders' Perspectives Regarding the Privacy, Security, and Confidentiality of Data Collected via Mobile Health Apps in Saudi Arabia: Protocol for a Mixed Method Study
Alhammad N, Alajlani M, Abd-Alrazaq A, Arvanitis T and Epiphaniou G
There is data paucity regarding users' awareness of privacy concerns and the resulting impact on the acceptance of mobile health (mHealth) apps, especially in the Saudi context. Such information is pertinent in addressing users' needs in the Kingdom of Saudi Arabia (KSA).
Community Partner Perceptions of Equitable Implementation Practices for a Intervention: A Qualitative Assessment
Mauricio AM, Garcia Y, Merelas S, Cioffi CC, McWhirter EH, Budd EL, Mueller MV, De Anda S, Rodriguez E and Leve LD
We conducted focus groups with staff from 5 community-based organizations (21 participants; 86% female, 52% Hispanic/Latino/a/x and 24% Mexican/Mexican American) between August and October 2021. Results highlighted community partner perceptions of practices congruent (e.g., communication that built trust and dismantled power dynamics, a shared mission) and incongruent (e.g., intervention-community misalignment, research driven decision-making) with equitable implementation in the development, implementation, and evaluation of a intervention to increase COVID-19 testing and preventive behaviors among Latinx communities in Oregon. (. 2024;114(S5):S377-S383. https://doi.org/10.2105/AJPH.2024.307686).
Root Canal Disinfection in Permanent Molars with Apical Lesion by Antimicrobial Photodynamic Therapy: Protocol for a Blind Randomized Clinical Trial
Alves N, Deana NF, Abarca J, Monardes H, Betancourt P and Zaror C
The proposed study aims to compare the effectiveness of conventional endodontic treatment (ET) with that of ET associated with antimicrobial photodynamic therapy (aPDT) in patients with apical lesion. Controlled, double-blind, randomized clinical trial (RCT); superiority study with three parallel arms. Randomization will be conducted in exchange blocks of six, with allocation 1:1:1. The control group will receive conventional ET, while experimental group 1 (EG1) will receive conventional ET + aPDT with laser at 660 nm, fluence of 600 J/cm; EG2 will receive conventional ET + aPDT with laser at 660 nm, fluence of 1200 J/cm. The primary outcome will be canal disinfection before treatment, measured by analysis of colony formation (CFU/mL) and the success rate measured after 6 months on the clinical and radiographic evaluations. The mean and standard deviation will be calculated for continuous outcomes, and the CFU/mL mean between groups will be evaluated by ANOVA test. The Chi-squared test will be calculated for binary outcomes. A logistic regression analysis will be performed to assess differences in the success rate between groups, adjusted for the covariates. The Stata 18 software will be used, with a significance threshold of 5%. Few RCTs have evaluated the effectiveness of aPDT in root canal disinfection in patients with permanent dentition presenting apical lesion. New RCTs with larger numbers of participants are needed to support using aPDT as an adjuvant to conventional ET in root canal disinfection for routine use in clinical practice. The trial was registered prospectively in ClinicalTrials.gov (NCT05916859).
Impact of an Automated Population-Level Cirrhosis Screening Program Using Common Pathology Tests on Rates of Cirrhosis Diagnosis and Linkage to Specialist Care (CAPRISE): Protocol for a Pilot Prospective Single-Arm Intervention Study
Flores JE, Trambas C, Jovanovic N, Thompson AJ and Howell J
People with compensated cirrhosis receive the greatest benefit from risk factor modification and prevention programs to reduce liver decompensation and improve early liver cancer detection. Blood-based liver fibrosis algorithms such as the Aspartate Transaminase-to-Platelet Ratio Index (APRI) and Fibrosis-4 (FIB-4) index are calculated using routinely ordered blood tests and are effective screening tests to exclude cirrhosis in people with chronic liver disease, triaging the need for further investigations to confirm cirrhosis and linkage to specialist care.
Reducing Carbon Dioxide Laser-Induced Postinflammatory Hyperpigmentation with Prophylactic Photobiomodulation: A Case Study
Barolet AC and Barolet D
This study aimed to investigate the effectiveness of prophylactic photobiomodulation (PBM) in reducing postinflammatory hyperpigmentation (PIH) induced by carbon dioxide (CO) laser resurfacing in a patient with periorbital syringomas. PIH is a common condition characterized by abnormal skin pigmentation after an inflammatory process occurring in up to 20-30% of patients undergoing CO laser resurfacing. The patient was treated with PBM using a pulsed home-use device at 630 nm before and after CO laser treatment. The patient was asked to treat the right periorbital area before and after the CO laser treatment, which was continued once a day for 2 consecutive weeks. At 12 weeks, PIH was significantly reduced on the treated side compared with the contralateral untreated side (leading to persistent erythema at 6 months). This is the first report of prophylactic treatment of CO laser-induced dyschromia using PBM.
Discovery of first-in-class highly selective TRPV1 antagonists with dual analgesic and hypoglycemic effects
Liu C, Wang W, Zhao S, Chen S, Chen H, Wang S, Li Z, Qian H and Tian X
Analgesia and blood sugar control are considered as two main unmet clinical needs for diabetes related neuropathic pain patients. Transient receptor potential vanilloid type-1 (TRPV1) channel is a highly validated target for pain perception, while no TRPV1 antagonists have been approved due to hyperthermia side effects. Herein, two series of new TRPV1 antagonists with flavonoid skeleton were designed by the structure-based drug design (SBDD) strategy. After comprehensive evaluation, compound CX-3 was identified as a promising TRPV1 antagonist. CX-3 exhibited equivalent TRPV1 antagonistic activity with classical TRPV1 antagonist BCTC in vitro, and exerted better analgesic activity in vivo than that of BCTC in the formalin induced inflammatory pain model without hyperthermia risk. Moreover, CX-3 exhibited robust glucose-lowering effects and showed high selectivity over other ion channels. Overall, these findings identified a first-in-class highly selective TRPV1 antagonist CX-3, which is a promising candidate to target the pathogenesis of diabetes related neuropathic pain.
Dynamics of polycomb group marks in Arabidopsis
Baile F and Calonje M
Polycomb Group (PcG) histone-modifying system is key in maintaining gene repression, providing a mitotically heritable cellular memory. Nevertheless, to allow plants to transition through distinct transcriptional programs during development or to respond to external cues, PcG-mediated repression requires reversibility. Several data suggest that the dynamics of PcG marks may vary considerably in different cell contexts; however, how PcG marks are established, maintained, or removed in each case is far from clear. In this review, we survey the knowns and unknowns of the molecular mechanisms underlying the maintenance or turnover of PcG marks in different cell stages.
Reaching Vulnerable and Underserved Communities in the US Southwest Through a Successful COVID-19 Community-Academic Partnership
Marsiglia FF, Oh H, León T and Gonzalez E
This article describes a community-academic partnership designed and implemented to address disparities in accessing COVID-19 testing in Arizona, from November 2020 through March 2023. An equitable community-academic partnership, the involvement of local leaders, and the engagement of community health workers were critical for the success of the intervention. More than 5000 previously underserved patients were tested and received COVID-19 related services. A profile comparison with a matched group documents the success of the program in reaching the targeted population. (. 2024;114(S5):S388-S391. https://doi.org/10.2105/AJPH.2024.307684).
Environmental impact of dietary patterns in 10 European countries; a cross-sectional analysis of nationally representative dietary surveys
Alves R, Perelman J, Chang K and Millett C
Changing dietary patterns is essential to reducing the substantial environment impact of agriculture and food production systems. We performed a cross-country comparison of dietary patterns and their associated environmental impact in Europe, including by sociodemographic factors.
Partnering With Churches to Address COVID-19 Vaccine Hesitancy and Uptake in Trustworthy Contexts
Bateman LB, Hall A, Hannon L, Ryan M, Osborne T, Whitfield S, Okoro G, Stager C, Driggers S, Jones V, Rhinehart J and Fouad MN
The Black church has long been seen as a crucial partner in addressing public health issues. This paper describes the development, implementation, and evaluation of a community-engaged church intervention addressing COVID-19 vaccine hesitancy in underserved Black communities in Jefferson County, Alabama. We partnered with churches to implement and evaluate the intervention between March and June of 2022 and found that our church partners were capable of significant messaging reach, particularly through electronic means. (. 2024;114(S5):S392-S395. https://doi.org/10.2105/AJPH.2024.307683).
Methodological considerations in the study of perceived discrimination at work and its association with workers health and occupational outcomes: A scoping review
Bravo G, Fuentes-Garcia A, Arriagada M and Castellucci H
Perceived workplace discrimination is a complex phenomenon involving unfair treatment in the workplace based on personal characteristics such as age, ethnicity, gender, or disability. The objective of this study is to explore the association of perceived workplace discrimination with health and occupational outcomes.
A Translational Case Study of a Multisite COVID-19 Public Health Intervention Across Sequenced Research Trials: Embedding Implementation in a Community Engagement Phased Framework
García JIR, Oro V, Budd EL, Mauricio AM, Cioffi CC, Anda S, McWhirter EH, DeGarmo DS and Leve LD
Through a COVID-19 public health intervention implemented across sequenced research trials, we present a community engagement phased framework that embeds intervention implementation: (1) consultation and preparation, (2) collaboration and implementation, and (3) partnership and sustainment. Intervention effects included mitigation of psychological distress and a 0.28 increase in the Latinx population tested for SARS-CoV-2. We summarize community engagement activities and implementation strategies that took place across the trials to illustrate the value of the framework for public health practice and research. (. 2024;114(S5):S396-S401. https://doi.org/10.2105/AJPH.2024.307669).
Validation of the Approach-Avoidance Temperament Questionnaire in Individuals with Anxiety and Depression
Rassaby M, Rogers JM and Taylor CT
The Approach-Avoidance Temperament Questionnaire (ATQ) is a well-established measure assessing heightened sensitivity and reactivity to reward/positive stimuli (approach temperament) and to punishment/negative stimuli (avoidance temperament). These basic dimensions of personality are believed to be important for understanding the etiology and maintenance of anxiety and depressive disorders. Despite the ATQ's potential utility in clinical psychology research, its psychometric properties and factor structure have yet to be examined in a psychiatric sample. The aims of the present study were to 1) conduct confirmatory factor analysis to replicate the ATQ's factor structure in individuals diagnosed with an anxiety or depressive disorder ( = 244), 2) assess internal consistency and convergent and divergent validity, and 3) explore differences in approach and avoidance temperaments in individuals with versus without a diagnosis of anxiety or depression. Results confirmed the original two-factor structure of the ATQ in a clinical sample, with approach and avoidance temperaments representing orthogonal dimensions. The measure demonstrated strong internal consistency, convergent and divergent validity, and predictive validity. Individuals with anxiety and depression scored higher on avoidance items and lower on approach items compared to those without clinical diagnoses. This study supports the use of the ATQ in clinical populations.
Tailoring the Best Positive End-Expiratory Pressure Through Invasive Right Ventricular Pressure-Volume Loops in a Patient Supported by Veno-Arterial Extracorporeal Membrane Oxygenation
Protti I, van den Enden A, Meani P, Ter Horst M, Van Mieghem NM and Meuwese CL
Patients undergoing veno-arterial extracorporeal membrane oxygenation (VA-ECMO) typically suffer from cardiogenic pulmonary edema and lung atelectasis, which can exacerbate right ventricular (RV) dysfunction through an increase in lung elastance and RV afterload. Invasive mechanical ventilation settings, and positive end-expiratory pressure (PEEP) in particular, can help to improve RV performance by optimizing lung recruitment and minimizing alveolar overdistention. In this report, we present a VA-ECMO supported patient in whom in vivo RV pressure-volume (PV) loops were measured during a decremental PEEP trial, leading to the identification of an optimum PEEP level from a cardio-respiratory viewpoint. This innovative approach of tailoring mechanical ventilation settings according to cardio-respiratory physiology through in vivo RV PV loops may provide a novel way to optimize hemodynamics and patient outcomes.
Integrated analysis of blood DNA methylation, genetic variants, circulating proteins, microRNAs, and kidney failure in type 1 diabetes
Chen Z, Satake E, Pezzolesi MG, Md Dom ZI, Stucki D, Kobayashi H, Syreeni A, Johnson AT, Wu X, Dahlström EH, King JB, Groop PH, Rich SS, Sandholm N, Krolewski AS and Natarajan R
Variation in DNA methylation (DNAmet) in white blood cells and other cells/tissues has been implicated in the etiology of progressive diabetic kidney disease (DKD). However, the specific mechanisms linking DNAmet variation in blood cells with risk of kidney failure (KF) and utility of measuring blood cell DNAmet in personalized medicine are not clear. We measured blood cell DNAmet in 277 individuals with type 1 diabetes and DKD using Illumina EPIC arrays; 51% of the cohort developed KF during 7 to 20 years of follow-up. Our epigenome-wide analysis identified DNAmet at 17 CpGs (5'-cytosine-phosphate-guanine-3' loci) associated with risk of KF independent of major clinical risk factors. DNAmet at these KF-associated CpGs remained stable over a median period of 4.7 years. Furthermore, DNAmet variations at seven KF-associated CpGs were strongly associated with multiple genetic variants at seven genomic regions, suggesting a strong genetic influence on DNAmet. The effects of DNAmet variations at the KF-associated CpGs on risk of KF were partially mediated by multiple KF-associated circulating proteins and KF-associated circulating miRNAs. A prediction model for risk of KF was developed by adding blood cell DNAmet at eight selected KF-associated CpGs to the clinical model. This updated model significantly improved prediction performance (c-statistic = 0.93) versus the clinical model (c-statistic = 0.85) at = 6.62 × 10. In conclusion, our multiomics study provides insights into mechanisms through which variation of DNAmet may affect KF development and shows that blood cell DNAmet at certain CpGs can improve risk prediction for KF in T1D.
Fertility and pregnancy complications in female orthopaedic surgeons
Frenkel Rutenberg T, Daglan E, Shadmi N, Iordache SD, Kosashvili Y and Eylon S
While the number of female medical graduates continues to increase, only a few pursue an orthopaedic career. This is related to challenges regarding pregnancy and the peripartum period during orthopaedic training.
Interplay between histone variants and chaperones in plants
Wu J, Liu B and Dong A
Histone chaperones and histone variants play crucial roles in DNA replication, gene transcription, and DNA repair in eukaryotes. Histone chaperones reversibly promote nucleosome assembly and disassembly by incorporating or evicting histones and histone variants to modulate chromatin accessibility, thereby altering the chromatin states and modulating DNA-related biological processes. Cofactors assist histone chaperones to target specific chromatin regions to regulate the exchange of histones and histone variants. In this review, we summarize recent progress in the interplay between histone variants and chaperones in plants. We discuss the structural basis of chaperone-histone complexes and the mechanisms of their cooperation in regulating gene transcription and plant development.
Development of the Psychotherapist Character Virtues (PCV) Interview
Lehtovuori P, Lindfors O, Tolvanen A and Heinonen E
To develop an interview-based rating method for assessing therapists' beneficial character traits and evaluate its reliability and validity.
Targeted gene regulation through epigenome editing in plants
Cheng Y, Zhou Y and Wang M
The precise targeted gene regulation in plants is essential for improving plant traits and gaining a comprehensive understanding of gene functions. The regulation of gene expression in eukaryotes can be achieved through transcriptional and epigenetic mechanisms. Over the last decade, advancements in gene-targeting technologies, along with an expanded understanding of epigenetic gene regulation mechanisms, have significantly contributed to the development of programmable gene regulation tools. In this review, we will discuss the recent progress in targeted plant gene regulation through epigenome editing, emphasizing the role of effector proteins in modulating target gene expression via diverse mechanisms, including DNA methylation, histone modifications, and chromatin remodeling. Additionally, we will also briefly review targeted gene regulation by transcriptional regulation and mRNA modifications in plants.
Costs and Impact of Disease in Adults with Sickle Cell Disease: A Pilot Study
Lanzkron S, Crook N, Wu J, Hussain S, Curtis R, Robertson D, Baker JR, Nugent D, Soni A, Roberts JC, Ullman M, Kanter J and Nichol M
Limited data are available to characterize sickle cell disease (SCD) related disease burden and outcomes. We assessed the feasibility of collecting data to estimate illness burden in adults with SCD; investigated factors associated with health-related quality of life (HRQoL); and estimated societal burden. We recruited 32 adults with SCD. We collected data on fatigue, HRQoL and the Work Productivity and Activity Impairment via patient survey. Healthcare utilization was abstracted for the 12 months prior to enrollment using medical chart review. Mean (standard deviation) age was 36.7 (10.6) years, 84.4% had hemoglobin (Hb)SS/Sthal0 disease, and 81.3% reported chronic pain (experiencing pain on ≥3 days per week in the past 6 months). Mean EQ-5D-3L VAS was 63.4, index score was 0.79. The mean fatigue score was 57.9 (range 33.7-75.9). Higher fatigue score was correlated with lower EQ-5D index score (correlation coefficient r=-0.35, p=0.049), and ASCQ-Me scores, including pain (r=-0.47, p=0.006), sleep (r=-0.38, p=0.03), and emotion (r=-0.79, p<0.0001). The number of hospitalizations was negatively correlated with HRQoL (all p<0.05). Patients who reported chronic pain had significantly lower mean ASCQ-Me sleep scores (48.3 vs. 57.1, p=0.04) and EQ-5D index scores (0.72 vs. 0.89, p=0.002) than those without chronic pain. Mean estimated annual per-person costs were $51,779 (median: $36,366) for total costs, $7,619 ($0) for indirect costs (estimated from lost earnings of participants), and $44,160 ($31,873) for medical costs. Fatigue, SCD complications, hospitalization and chronic pain negatively impact HRQoL in this cohort. This sample experienced a high economic burden, largely from outpatient doctor visits.
Synchronous Well-Differentiated Papillary Mesothelioma and Endometrioid Adenocarcinoma Arising From Endometriosis
Lewis CR, Uchic-Boccella J, Zimmerman J, Miller E, Liang S and Wagner PL
Well-differentiated papillary mesothelioma (WDPM) is a rare mesothelial tumor of uncertain malignant potential. We present a unique case of a woman with synchronous WDPM and well-differentiated endometrioid adenocarcinoma (EA) arising from extraovarian endometriosis. A 56-year-old postmenopausal woman presented with a several-month history of right lower quadrant abdominal pain. She had a history of supracervical hysterectomy and bilateral salpingo-oophorectomy secondary to endometriosis. Imaging reported a mass in the right lower quadrant originating from the distal ileum. At laparotomy, the patient underwent a right colectomy with resection of the terminal ileum and excision of a solitary peritoneal nodule. Pathology was consistent with a diagnosis of well-differentiated EA (arising from extraovarian endometriosis) and WDPM. Further treatment consisted of complete surgical staging/debulking and adjuvant chemotherapy directed toward metastatic well-differentiated EA. Surgeons should be familiar with WDPM as a potential finding in women of reproductive age undergoing abdominal surgery for any indication.
"I" versus "the author": The power of first-person voice when writing about science
Brennan EB
Internet of Things-Enabled Patch With Built-in Microsensors and Wireless Chip: Real-Time Remote Monitoring of Patch Treatment
Hwang J, Jo KS, Kim MS, Choi S, Lee J, Kim A and Yoo YJ
We aimed to design, develop, and evaluate an internet of things-enabled patch (IoT patch) for real-time remote monitoring of adherence (or patch wear time) during patch treatment in child participants in clinical trials. This study provides healthcare providers with a tool for objective, real-time, and remote assessment of adherence and for making required adjustments to treatment plans.
Do Australians use the prescription pathway when using nicotine vaping products to quit smoking?
Borland R, Le Grande M, Gartner C and Morphett K
In Australia, nicotine vaping products (NVPs) are only legally available to those with a prescription from a doctor. We investigated the proportion of people using NVPs to quit smoking who had a prescription, and whether this increased following regulatory changes in 2021 that strengthened the prescription requirement.
Biomechanical Correlations Between the Cornea and the Optic Nerve Head
Pan M, Kwok S, Pan X and Liu J
A thin cornea is a potent risk factor for glaucoma. The underlying mechanisms remain unexplained. It has been postulated that central corneal thickness (CCT) may be a surrogate for biomechanical parameters of the posterior eye. In this study, we aimed to explore correlations of biomechanical responses between the cornea and the optic nerve head (ONH) and the peripapillary sclera (PPS) to elevated intraocular pressure (IOP), the primary risk factor of glaucoma.
Measuring Signs of Atopic Dermatitis in Clinical Practice: A HOME-CP Consensus Statement
Jacobson ME, Leshem YA, Apfelbacher C, Spuls PI, Gerbens LAA, Thomas KS, Williams HC, Katoh N, Howells L, Schmitt J, Deckert S, Seshadri R, Simpson EL and
Outcome measurement is an essential component of value-based health care and can aid patient care, quality improvement, and clinical effectiveness evidence generation. The Harmonising Outcome Measures for Eczema Clinical Practice initiative aims to identify a list of validated, feasible, outcome measurement instruments recommended to measure atopic dermatitis (AD) in the clinical practice setting. The clinical practice set is a list of instruments that clinicians can pick and choose from to suit their needs in the context of clinical care.
Age-Related Macular Degeneration and Extramacular Drusen: Genetic Associations in the Coimbra Eye Study
Farinha C, Barreto P, Coimbra R, Machado MB, Figueiredo I, Cachulo ML, Cunha-Vaz J and Silva R
To explore the association between the genetics of age-related macular degeneration (AMD) and extramacular drusen (EMD) in patients with and without AMD.
Same-day discharge after large-bore access in percutaneous coronary intervention of chronic total coronary occlusions
Somsen YBO, Wilgenhof A, Hoek R, Schumacher SP, Pizarro Perez CS, van Diemen PA, Jukema RA, Stuijfzand WJ, Twisk JWR, Danad I, Verouden NJ, Nap A, de Winter RW, Henriques JP and Knaapen P
Same-day discharge (SDD) in patients undergoing percutaneous coronary intervention (PCI) of a chronic total occlusion (CTO) is appealing because of the increased patient comfort. However, data on SDD following large-bore vascular access are scarce.
Impact of coronary calcium morphology on intravascular lithotripsy
McInerney A, Travieso A, Jerónimo Baza A, Alfonso F, Del Val D, Cerrato E, Garcia de Lara J, Pinar E, Perez de Prado A, Jimenez Quevedo P, Tirado-Conte G, Nombela-Franco L, Brugaletta S, Cepas-Guillén P, Sabaté M, Cubero Gallego H, Vaquerizo B, Jurado A, Varbella F, Jimenez M, Garcia Escobar A, de la Torre JM, Amat Santos I, Jimenez Diaz VA, Escaned J and Gonzalo N
Coronary calcification negatively impacts optimal stenting. Intravascular lithotripsy (IVL) is a new calcium modification technique.
Congressional Expansion of Enhancing Breast Cancer Screening and Care at the Veterans Health Administration
Wu J, Zullig LL, Aditi H and Moss HA
Despite high screening rates, breast cancer disparities persist among women veterans because of occupational risks and barriers to access. Three essential bills recently passed in Congress seek to expand access to breast cancer screenings and cancer care within the Veterans Health Administration. The Making Advances in Mammography and Medical Options for Veterans Act expands screening via partnerships with the National Cancer Institute, integrating telescreening and upgrading imaging technology. The Dr. Kate Hendricks Thomas Supporting Expanded Review for Veterans In Combat Environments Act broadens eligibility for those exposed to toxins and personalized risk assessments. The bipartisan Sergeant First Class Health Robinson Honoring our Promise to Address Comprehensive Toxics Act extends benefits for toxin-exposed veterans with presumptive conditions, including breast cancer. Further programs such as National TeleOncology, the Breast & Gynecologic Oncology System of Excellence, and research collaborations between the Veterans Health Administration, National Cancer Institute, and Surveillance, Epidemiology and End Results Program seek to improve access, enhance understanding and care for women veterans with cancer, and mark significant progress in comprehensive care.
One- versus three-month dual antiplatelet therapy in high bleeding risk patients undergoing percutaneous coronary intervention for non-ST-segment elevation acute coronary syndromes
Cao D, Vranckx P, Valgimigli M, Sartori S, Angiolillo DJ, Bangalore S, Bhatt DL, Feng Y, Ge J, Hermiller J, Makkar RR, Neumann FJ, Saito S, Picon H, Toelg R, Maksoud A, Chehab BM, Choi JW, Campo G, De la Torre Hernandez JM, Krucoff MW, Kunadian V, Sardella G, Spirito A, Thiele H, Varenne O, Vogel B, Zhou Y, Windecker S and Mehran R
A short dual antiplatelet therapy (DAPT) duration has been proposed for patients at high bleeding risk (HBR) undergoing drug-eluting coronary stent (DES) implantation. Whether this strategy is safe and effective after a non-ST-segment elevation acute coronary syndrome (NSTE-ACS) remains uncertain.
Low MBOAT7 expression, a genetic risk for MASH, promotes a pro-fibrotic pathway involving hepatocyte TAZ upregulation
Moore MP, Wang X, Kennelly JP, Shi H, Ishino Y, Kano K, Aoki J, Cherubini A, Ronzoni L, Guo X, Chalasani NP, Khalid S, Saleheen D, Mitsche MA, Rotter JI, Yates KP, Valenti L, Kono N, Tontonoz P and Tabas I
The common genetic variant rs641738 C>T is a risk factor for metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH), including liver fibrosis, and is associated with decreased expression of the phospholipid-remodeling enzyme MBOAT7 (LPIAT1). However, whether restoring MBOAT7 expression in established MASLD dampens the progression to liver fibrosis and, importantly, the mechanism through which decreased MBOAT7 expression exacerbates MASH fibrosis remain unclear.
Men's Suicide in Bangladesh: Impressions From the Socio-Ecological System Theory
Rahman Khan A and Shimul SMAK
Suicide is a multilayered social behaviour containing overlapping components from individual to social spheres. This article discusses the findings of the context of male suicide in Bangladesh based on Bronfenbrenner's socio-ecological theory. The socio-ecological perspective allows to determine the risk factors of suicide at multiple levels. Fifteen male suicide cases were purposively selected from several rural areas of the Jhenaidah district which is known for high rates of suicide. Qualitative in-depth interviews (three for each case) with persons who are significant others to the deceased delineate the interactive context of suicide. While the analysis deductively hinges on four major themes (e.g., individual/micro, interpersonal/meso, community/exo, and societal/macro factors) in consonance with socio-ecological theory, ten sub-themes were inductively identified from the intriguing meanings of the interviews. Considering the integrative nature of suicide, the study underscores the necessity to introduce a multi-sectoral approach to effectively prevent suicide in Bangladesh.
Introducing a machine learning algorithm for delirium prediction-the Supporting SURgery with GEriatric Co-Management and AI project (SURGE-Ahead)
Benovic S, Ajlani AH, Leinert C, Fotteler M, Wolf D, Steger F, Kestler H, Dallmeier D, Denkinger M, Eschweiler GW, Thomas C and Kocar TD
Post-operative delirium (POD) is a common complication in older patients, with an incidence of 14-56%. To implement preventative procedures, it is necessary to identify patients at risk for POD. In the present study, we aimed to develop a machine learning (ML) model for POD prediction in older patients, in close cooperation with the PAWEL (patient safety, cost-effectiveness and quality of life in elective surgery) project.
RedCDR: Dual Relation Distillation for Cancer Drug Response Prediction
Xu M, Zhu Z, Zhao Y, He K, Huang Q and Zhao Y
Based on multi-omics data and drug information, predicting the response of cancer cell lines to drugs is a crucial area of research in modern oncology, as it can promote the development of personalized treatments. Despite the promising performance achieved by existing models, most of them overlook the variations among different omics and lack effective integration of multi-omics data. Moreover, the explicit modeling of cell line/drug attribute and cell line-drug association has not been thoroughly investigated in existing approaches. To address these issues, we propose RedCDR, a dual relation distillation model for cancer drug response (CDR) prediction. Specifically, a parallel dual-branch architecture is designed to enable both the independent learning and interactive fusion feasible for cell line/drug attribute and cell line-drug association information. To facilitate the adaptive interacting integration of multi-omics data, the proposed multi-omics encoder introduces the multiple similarity relations between cell lines and takes the importance of different omics data into account. To accomplish knowledge transfer from the two independent attribute and association branches to their fusion, a dual relation distillation mechanism consisting of representation distillation and prediction distillation is presented. Experiments conducted on the GDSC and CCLE datasets show that RedCDR outperforms previous state-of-the-art approaches in CDR prediction. The source code is available at https://github.com/mhxu1998/RedCDR.
Age-associated changes in multimodal pain perception
Zhi Y, Zhang Y, Zhang Y, Zhang M and Kong Y
Pain sensitivity varies across multimodal somatosensory stimuli that can rely on different conductive fibres, which, when damaged, will lead to neuropathies. However, there is limited research examining the characteristics of perceived pain, particularly as affected by the ageing process, as induced by various somatosensory stimuli that may rely on small or large fibres.
Effectiveness of dance interventions for falls prevention in older adults: systematic review and meta-analysis
Lazo Green K, Yang Y, Abaraogu U, Eastaugh CH, Beyer FR, Norman G and Todd C
Fall prevention is a global health priority. Strength and balance exercise programmes are effective at reducing falls. Emerging literature suggests dance is an enjoyable and sociable form of exercise. However, there is little evidence that dance reduces fall incidence.
Prediction of Visual Outcome After Rhegmatogenous Retinal Detachment Surgery Using Artificial Intelligence Techniques
Guo H, Ou C, Wang G, Lu B, Li X, Yang T and Zhang J
This study aimed to develop artificial intelligence models for predicting postoperative functional outcomes in patients with rhegmatogenous retinal detachment (RRD).
Major surgical conditions of childhood and their lifelong implications: comprehensive review
Cullis PS, Fouad D, Goldstein AM, Wong KKY, Boonthai A, Lobos P, Pakarinen MP and Losty PD
In recent decades, the survival of children with congenital anomalies and paediatric cancer has improved dramatically such that there has been a steady shift towards understanding their lifelong health outcomes. Paediatric surgeons will actively manage such conditions in childhood and adolescence, however, adult surgeons must later care for these 'grown-ups' in adulthood. This article aims to highlight some of those rare disorders encountered by paediatric surgeons requiring long-term follow-up, their management in childhood and their survivorship impact, in order that the adult specialist may be better equipped with skills and knowledge to manage these patients into adulthood.
Incidence, Risk Factors, and Outcomes of Left Atrial Enlargement in Patients Requiring Right Ventricular Pacing: A Retrospective Study of 461 Cases from 2012 to 2020
Lee WC, Chang WT, Fang HY, Chen HC, Chen MC and Liu PY
BACKGROUND Long-term right ventricular (RV) pacing has been linked to left atrial enlargement (LAE). The incidence and risk factors associated with significant LAE after RV pacing remain unknown. This retrospective study included 461 patients requiring RV pacing at 2 centers between 2012 and 2020 and aimed to evaluate the incidence, risk factors, outcomes, and complications of LAE. MATERIAL AND METHODS A total of 461 patients with normal-sized pre-implant left atrial dimension and dual-chamber pacing pacemaker implantation for complete atrioventricular block were enrolled. Patients were grouped based on a ≥20% increase from their baseline left atrial dimension by echocardiography, indicating significant LAE, and initial characteristics, echocardiographic data, and outcomes were compared. RESULTS During a mean 7.0±4.9 years follow-up period, 96 patients (20.8%) developed significant LAE, whereas 365 patients did not. In multivariate logistic regression analysis, smaller pre-implant left atrial dimension (OR, 0.776; 95% CI, 0.728-0.828; P<0.001), lower post-implant left ventricular ejection fraction (OR, 0.976; 95% CI, 0.957-0.995; P=0.014), post-implant development of moderate to severe mitral regurgitation (OR, 2.357; 95% CI, 1.172-4.740; P=0.016), and RV pacing duration ≥3.3 years (OR, 1.576; 95% CI, 1.039-2.646; P=0.045) were independent predictors of significant LAE after RV-dependent pacing. There was a significant difference in the incident stroke events between patients without and with significant LAE (9.9% vs 17.7%; log-rank P=0.047). CONCLUSIONS Long-term RV pacing was linked to significant LAE in 20.8% of patients with complete atrioventricular block, with those affected experiencing a higher stroke rate during follow-up.
Clinical evaluation of a novel digital microfluidic based point-of-care test platform for detection of SARS-Cov-2 and influenza A/B
Huang H, Long D, Lin Y, Dong C, Huang W, Zhang M, Wan L, Gou H, Chen T and Li F
Respiratory pathogens, such as SARS-CoV-2 and influenza A/B, can cause severe illnesses in susceptible individuals. This research evaluated a novel digital microfluidic point-of-care testing platform designed to detect 23 pathogens, comparing its performance to conventional laboratory-based nucleic acid tests. The platform integrates nucleic acid extraction and amplification processes for rapid detection with only 2 min of hands-on time. Performance assays demonstrated that the platform has high sensitivity (87 %-100 %) and specificity (99 %-100 %) for the detection of the evaluated 3 viruses. Additionally, the platform can be adapted for the detection of other respiratory pathogens, aiding in the early diagnosis of respiratory diseases, identifying the source of an outbreak or epidemic, and curbing the spread of the disease.
Critical roles of the miR-17∼92 family in thymocyte development, leukemogenesis, and autoimmunity
Liao K, Chen P, Zhang M, Wang J, Hatzihristidis T, Lin X, Yang L, Yao N, Liu C, Hong Y, Li X, Liu H, Zúñiga-Pflücker JC, Love PE, Chen X, Liu WH, Zhao B and Xiao C
Thymocyte development requires precise control of PI3K-Akt signaling to promote proliferation and prevent leukemia and autoimmune disorders. Here, we show that ablating individual clusters of the miR-17∼92 family has a negligible effect on thymocyte development, while deleting the entire family severely impairs thymocyte proliferation and reduces thymic cellularity, phenocopying genetic deletion of Dicer. Mechanistically, miR-17∼92 expression is induced by Myc-mediated pre-T cell receptor (TCR) signaling, and miR-17∼92 promotes thymocyte proliferation by suppressing the translation of Pten. Retroviral expression of miR-17∼92 restores the proliferation and differentiation of Myc-deficient thymocytes. Conversely, partial deletion of the miR-17∼92 family significantly delays Myc-driven leukemogenesis. Intriguingly, thymocyte-specific transgenic miR-17∼92 expression does not cause leukemia or lymphoma but instead aggravates skin inflammation, while ablation of the miR-17∼92 family ameliorates skin inflammation. This study reveals intricate roles of the miR-17∼92 family in balancing thymocyte development, leukemogenesis, and autoimmunity and identifies those microRNAs (miRNAs) as potential therapeutic targets for leukemia and autoimmune diseases.
Understanding exercise referrals in primary care: a qualitative study of General Practitioners and Physiotherapists
Dunphy R and Blane DN
Physical inactivity is estimated to cost the UK National Health Service over £7.4 billion per year. Healthcare practitioners have a key role in supporting increases in physical activity (PA) levels, including referring to exercise referral schemes. To date, there has been little research into practitioner perspectives on referrals to exercise schemes.
Cancer-related pain experienced in daily life is difficult to communicate and to manage - for patients and for professionals
Ikander T, Raunkiær M, Voetmann C, Pedersen CV and Jarlbaek L
The aim of this study was to gain qualitative insight into cancer patients' experiences, explanations, and management strategies regarding their cancer-related pain (CP).
Acute and long-term outcomes of SARS-CoV-2 infection in school-aged children in England: Study protocol for the joint analysis of the COVID-19 schools infection survey (SIS) and the COVID-19 mapping and mitigation in schools (CoMMinS) study
Looker KJ, McClenaghan E, Judd A, Pierotti L, Downing H, Phelan J, Warren-Gash C, Ngozi K, Dawe F, Relton C, Christensen H, Hay AD, Mangtani P, Nguipdop-Djomo P and Denholm R
The symptom profiles of acute SARS-CoV-2 infection and long-COVID in children and young people (CYP), risk factors, and associated healthcare needs, are poorly defined. The Schools Infection Survey 1 (SIS-1) was a nationwide study of SARS-CoV-2 infection in primary and secondary schools in England during the 2020/21 school year. The Covid-19 Mapping and Mitigation in Schools (CoMMinS) study was conducted in schools in the Bristol area over a similar period. Both studies conducted testing to identify current and previous SARS-CoV-2 infection, and recorded symptoms and school attendance. These research data have been linked to routine electronic health record (EHR) data.
Neurophysiological, balance and motion evidence in adolescent idiopathic scoliosis: A systematic review
Paramento M, Passarotto E, Maccarone MC, Agostini M, Contessa P, Rubega M, Formaggio E and Masiero S
Adolescent idiopathic scoliosis (AIS) is a spinal deformity that affects approximately 4% of the world's population. Several hypotheses regarding the etiology of AIS have been investigated. In the last decades, impaired visual-spatial perception, alterations in spatial body orientation and sensory integration deficits have been documented.
Cohort profile: The Social media, smartphone use and Self-harm in Young People (3S-YP) study-A prospective, observational cohort study of young people in contact with mental health services
Bye A, Carter B, Leightley D, Trevillion K, Liakata M, Branthonne-Foster S, Cross S, Zenasni Z, Carr E, Williamson G, Vega Viyuela A and Dutta R
The Social media, Smartphone use and Self-Harm (3S-YP) study is a prospective observational cohort study to investigate the mechanisms underpinning associations between social media and smartphone use and self-harm in a clinical youth sample. We present here a comprehensive description of the cohort from baseline data and an overview of data available from baseline and follow-up assessments.
Climate change: A pointer to increased small-scale fisher drowning deaths
Rasolofoson RA, Onyango HO, Awuor FJ, Aura CM and Fiorella KJ
Drowning is an overlooked public health concern and drowning risk is dependent on environmental risk factors. The preponderance of drowning deaths occurs in low- and middle-income countries. Small-scale fishers face high occupational risk of drowning. Climate change increases the frequency and intensity of storms, thereby exacerbating fishers' risks and creating a need to examine the contribution of storms to fisher drowning deaths for the development of mitigation strategies. We examined this relationship between weather and fisher drowning deaths in Lake Victoria, which is Africa's largest lake, a site of high fishing pressure, and where climate change is predicted to increase thunderstorms. We conducted a verbal autopsy with people knowledgeable about recent fatal fisher drowning incidents to collect information about the deceased fishers and circumstances surrounding the incidents across 43 landing sites in the Kenyan shore of Lake Victoria. Semi-structured interviews with stakeholders also elucidated community perspectives on drowning risks. Fatal drownings were often attributed to bad weather (41.8%). Other risk factors, such as non-use of life jacket and navigation equipment, co-occurred with bad weather at high rates (69.5% and 67.8%, respectively) to jointly contribute to fatal drowning incidents. Such co-occurrence of risk factors indicates that actions across multiple risk factors can help mitigate the issue. Stakeholder analysis revealed a range of opportunities for improved communication of risks and action to mitigate risks across boat operators and manufacturers, as well as multiple levels of management. Across global small-scale fisheries, limited use of safety equipment and intensive fishing pressure may coincide with increases in extreme weather events, necessitating action to address current and mitigate future drowning risks to small-scale fishers.
Changes in substance use, recovery, and quality of life during the initial phase of the COVID-19 pandemic
Lewandowski ME, Delawalla CN, Butcher TJ and Oberlin BG
The COVID-19 pandemic disrupted lives on a massive scale. While the pandemic appeared to worsen mental health outcomes broadly, its effects on alcohol/substance use and recovery are unclear. Many studies convolved the sociopolitical unrest beginning in May 2020 with the pandemic. We assessed pandemic-related changes in substance use, recovery involvement, and quality of life among US adults at two specified time periods that isolated pandemic effects from potentially confounding sociopolitical factors.
Longitudinal and regional association between dietary factors and prevalence of Crohn's disease in Japan
Kodama M, Okano S, Nojri S, Abe K, Fukata M, Nagase Y and Kodama H
Although a Western diet has been identified as a risk factor for Crohn's disease (CD), there is still controversy surrounding the specific foods that may contribute to the development of the disease. In this study, we examined the association between food intake and the prevalence of CD in Japan, as Japanese patients with CD are known to have limited genetic involvement. We identified changes in food intake associated with an increase in the number of patients with CD by analyzing the per capita consumption of food types from 1981 to 2014. Additionally, we examined the association between CD prevalence and food intake in each prefecture. Finally, the relationship between food intake and estimated age at CD onset was also investigated. Between 1981 and 2014, we observed Increased consumption of meat, eggs, milk and dairy products, oil, and potatoes and decreased consumption of grains, beans, vegetables, fruit, fish, sugar, and seaweed. The annual incidence of CD increased by 1388% over the same period. We found that meat consumption was significantly associated with CD prevalence (β = 0.503, p = 0.0003), while a significant negative correlation was observed between CD prevalence and fruit and vegetable consumption (fruit, β = 0.464, p = 0.0012; vegetables, β = 0.404, p = 0.0023). Furthermore, we estimated that the peak consumption of more meat and less fruit and vegetables and the peak age of CD onset occurred within the age range of 20-24 years. Our study identified a clear correlation between the consumption of meat, fruits, and vegetables and the prevalence of CD in Japan. Additionally, we found an association between meat, fruit, and vegetable consumption and the age at CD onset.
Barriers and facilitators to self-care practices for sexual and reproductive health among women of reproductive age
Timilsina A, Bhandari B, Johns A and Thapa S
Sexual and Reproductive Health and Rights (SRHR) have been promoted globally, yet sexual and reproductive health (SRH) interventions are seldom evaluated from the perspective of service users and service providers. Very little is known about whether and why various target groups including general women are (or are not) practicing SRH -related self-care practices. This study explored SRH self-care practices and facilitators and barriers to the adoption of SRH self-care among reproductive-age women of Nepal.
Associations between co‑exposure to heavy metals and vertebral compression fracture, as well as femoral neck bone mineral density: A cross-sectional study from NHANES data
Yang X, Li L and Nie L
Accumulating evidence showed that exposure to heavy metals was harmful to human health. Little is known regarding the mixing effects of multiple metal exposures on vertebral compression fracture (VCF) and femoral neck bone mineral density (BMD). This study aimed to explore the individual and joint effects of four heavy metals [manganese (Mn), lead (Pb), cadmium (Cd) and mercury (Hg)] on VCF risk and femoral neck BMD.
A situational assessment of treatments received for childhood diarrhea in the Federal Republic of Nigeria
Gayawan E, Cameron E, Okitika T, Egbon OA and Gething P
We assess progress towards improved case management of childhood diarrhea in Nigeria over a period of targeted health systems reform from 2013 to 2018. Individual and community data from three Demographic and Health Survey rounds are leveraged in a geospatial model designed for stratified estimation by venue of treatment seeking and State. Our analysis reveals a highly regionalised health system undergoing rapid change. Nationally, there have been substantial increases in the proportion of children under 5 years old with diarrhea receiving the recommended oral rehydration therapy after seeking treatment at either a health clinic (0.57 [0.44-0.69; 95% CI] in 2008; 0.70 [0.54-0.83] in 2018) or chemist/pharmacy (0.28 [0.17-0.42] in 2008; 0.48 [0.31-0.64] in 2018). Yet State-level variations in venue attendance and performance by venue have conspired to hold the overall proportion receiving this potentially life-saving therapy (0.45 [0.35-0.55] in 2018) to well-below ideal coverage levels. High performing states that have demonstrated significant improvements include Kano, Jigawa and Borno, while under-performing states that have suffered declines in coverage include Kaduna and Taraba. The use of antibiotics is not recommended for mild cases of childhood diarrhea yet remains concerningly high nationally (0.27 [0.19-0.36] in 2018) with negligible variation between venues. Antibiotic use rates are particularly high in Enugu, Kaduna, Taraba, Kano, Niger and Kebbi, yet welcome reductions were identified in Jigawa, Adamawa and Osun. These results support the conclusions of previous studies and build the strength of evidence that urgent action is needed throughout the multi-tiered health system to improve the quality and equity of care for common childhood illnesses in Nigeria.
Fathers' involvement in raising children with intellectual disabilities: Mothers' ratings of the contribution of their spouses
Mohamed A, Opoku MP, Safi M, Belbase S, Al Mughairbi F, Xie Q, Al Shatheli M and Almarzooq S
Intellectual disability (ID) is a lifelong condition characterized by individuals' inability to perform cognitive tasks and participate in daily living activities. While parenting children with ID has been reported to be demanding, studies draw mainly on mothers. In contexts such as the United Arab Emirates (UAE), there is little literature on fathers' involvement in raising children with IDs.
'Experiencing one thing and saying another'-Ecological Momentary Assessment (EMA) of nursing students' competence and challenge during clinical placements compared with retrospective interviews
Karlgren K, Andersson Franko M and Kilström D
Clinical placements are essential to nursing education and understanding students' challenges in the clinical context is important for educators. Nevertheless, few studies have investigated students' experiences in the clinical context itself but rely on methods which ask participants to generalize their clinical experiences retrospectively.
Targeting skeletal muscle health with exercise in people with type 1 diabetes: A protocol for HOMET1D, a prospective observational trial with matched controls
Rebalka IA, Noguchi KS, Bulyovsky KR, Badour MI, Juracic ES, Barrett K, Brahmbhatt A, Al-Khazraji B, Punthakee Z, Perry CGR, Kumbhare DA, MacDonald MJ and Hawke TJ
Individuals with type 1 diabetes (T1D) experience a complex set of alterations to skeletal muscle metabolic, neuromuscular, and vascular health; collectively referred to as diabetic myopathy. While the full scope of diabetic myopathy is still being elucidated, evidence suggests that even when individuals with T1D are physically active, indices of myopathy still exist. As such, there is a question if adherence to current physical activity guidelines elicits improvements in skeletal muscle health indices similarly between individuals with and without T1D. The objectives of this trial are to: 1) compare baseline differences in skeletal muscle health between adults with and without T1D, 2) examine the association between participation in a home-based exercise program, detraining, and retraining, with changes in skeletal muscle health, and 3) examine the roles of age and sex on these associations.
A study protocol for predictors of post-discharge mortality among children aged 5-14 years admitted to tertiary hospitals in Tanzania: A prospective observational cohort study
Meleki ER, Mongella S and Furia FF
Globally, millions of children and adolescents die every year from treatable and preventable causes. Sub-Saharan Africa accounted for 55% of deaths of children aged 5-14 years in 2017. Despite this high burden, minimal effort has been directed toward reducing mortality among older children and adolescents in comparison to under-fives. Mortality rates of children post-discharge vary between 1-18% in limited-resource countries and are reported to exceed in-hospital mortality. In Tanzania, there is limited data regarding post-discharge mortality and its predictors among children aged 5-14 years.
Using a standardized sound set to help characterize misophonia: The International Affective Digitized Sounds
Trumbull J, Lanier N, McMahon K, Guetta R and Rosenthal MZ
Misophonia is a condition characterized by negative affect, intolerance, and functional impairment in response to particular repetitive sounds usually made by others (e.g., chewing, sniffing, pen tapping) and associated stimuli. To date, researchers have largely studied misophonia using self-report measures. As the field is quickly expanding, assessment approaches need to advance to include more objective measures capable of differentiating those with and without misophonia. Although several studies have used sounds as experimental stimuli, few have used standardized stimuli sets with demonstrated reliability or validity. To conduct rigorous research in an effort to better understand misophonia, it is important to have an easily accessible, standardized set of acoustic stimuli for use across studies. Accordingly, in the present study, the International Affective Digitized Sounds (IADS-2), developed by Bradley and Lang (Bradley MM et al., 2007), were used to determine whether participants with misophonia responded to certain standardized sounds differently than a control group. Participants were 377 adults (132 participants with misophonia and 245 controls) recruited from an online platform to complete several questionnaires and respond to four probes (arousal, valence, similarity to personally-relevant aversive sounds, and sound avoidance) in response to normed pleasant, unpleasant, and neutral IADS-2 sounds. Findings indicated that compared to controls, participants with high misophonia symptoms rated pleasant and neutral sounds as significantly more (a) arousing and similar to trigger sounds in their everyday life, (b) unpleasant and (c) likely to be avoided in everyday life. For future scientific and clinical innovation, we include a ranked list of IADS-2 stimuli differentiating responses in those with and without misophonia, which we call the IADS-M.
Levelling up health in the early years: A cost-analysis of infant feeding and healthcare
Ajetunmobi O, McIntosh E, Stockton D, Tappin D and Whyte B
Although breastfeeding is recommended as the optimal form of nutrition in the first six months, it is not sustained as the predominant mode of feeding infants in Scotland. This study estimated the impact of infant feeding choices on primary and secondary healthcare service costs in a 13-year birth cohort.
Combining sentiment analysis and text mining with content analysis of farm vet interviews on mental wellbeing in livestock practice
Duncan AJ, Henry MK and Lamont K
The aim of the How Farm Vets Cope project was to co-design, with farm veterinary surgeons, a set of web-based resources to help them and others deal with the different situations that they can face. As part of the wider project, participants were recruited for one-to-one semi-structured phone interviews. These interviews focused on elements of job satisfaction and how the participants coped during periods of poor mental wellbeing or with setbacks and failure.
Exploring concurrent validity of the CLN2 Clinical Rating Scale: Comparison to PedsQL using cerliponase alfa clinical trial data
Specchio N, Gissen P, de Los Reyes E, Olaye A, Camp C, Curteis T, Griffiths A, Butt T, Cohen-Pfeffer J, Slasor P, Sisic Z, Jain M and Schulz A
The CLN2 Clinical Rating Scale evaluates disease progression in CLN2 disease, an ultra-rare, neurodegenerative disorder with late infantile onset. To validate the Clinical Rating Scale, a comparison with the Pediatric Quality of Life Inventory (PedsQL) was conducted utilising clinical trial data investigating cerliponase alfa use in CLN2 disease.
Which students skip school? A comparative study of sociodemographic factors and student absenteeism using PISA data
Fredriksson U, Rasmusson M, Backlund Å, Isaksson J and Kreitz-Sandberg S
This article explores which students-with regard to gender, socio-economic background and migration background-skip school in Germany, Japan, Sweden and the United Kingdom (UK) according to PISA data. Students who skip school are observed in many countries, but there is not much systematic research that studies this across countries. Comparable data is to a large extent missing. PISA data offers an opportunity to use comparable data. In PISA, students were asked in 2018, 2015 and 2012 whether they had skipped school a whole day in the last two weeks prior to their completion of the PISA student questionnaire. Patterns of how absence relates to sociodemographic factors vary in countries and school systems. In the comparison between the four countries the UK stands out as having a higher percentage of students who have reported that they have skipped school than in the other countries. This does not seem to be related to any specific group of students. Japan also stands out with a lower percentage of students who have reported that they have skipped school. According to PISA data, skipping school is more related to socio-economic background than any other of the variables studied. The socio-economic background seems to be related to skipping school in all three PISA studies in Sweden and the UK. Gender seems not to be an important factor in the four countries. In Sweden and Germany there is a lower percentage of non-immigrant students who report that they have skipped school than first-and second-generation immigrant students. In the UK the figures are more ambiguous. When the percentages of students skipping school are compared over time and in the countries, it is difficult to find any trends, but the data only covered three measurements during a period of six years, which may be too short a time span to see trends.
An epidemiological study of season of birth, mental health, and neuroimaging in the UK Biobank
Viejo-Romero M, Whalley HC, Shen X, Stolicyn A, Smith DJ and Howard DM
Environmental exposures during the perinatal period are known to have a long-term effect on adult physical and mental health. One such influential environmental exposure is the time of year of birth which affects the amount of daylight, nutrients, and viral load that an individual is exposed to within this key developmental period. Here, we investigate associations between season of birth (seasonality), four mental health traits (n = 137,588) and multi-modal neuroimaging measures (n = 33,212) within the UK Biobank. Summer births were associated with probable recurrent Major Depressive Disorder (β = 0.026, pcorr = 0.028) and greater mean cortical thickness in temporal and occipital lobes (β = 0.013 to 0.014, pcorr<0.05). Winter births were associated with greater white matter integrity globally, in the association fibers, thalamic radiations, and six individual tracts (β = -0.013 to -0.022, pcorr<0.05). Results of sensitivity analyses adjusting for birth weight were similar, with an additional association between winter birth and white matter microstructure in the forceps minor and between summer births, greater cingulate thickness and amygdala volume. Further analyses revealed associations between probable depressive phenotypes and a range of neuroimaging measures but a paucity of interactions with seasonality. Our results suggest that seasonality of birth may affect later-life brain structure and play a role in lifetime recurrent Major Depressive Disorder. Due to the small effect sizes observed, and the lack of associations with other mental health traits, further research is required to validate birth season effects in the context of different latitudes, and by co-examining genetic and epigenetic measures to reveal informative biological pathways.
Intermuscular coherence as an early biomarker for amyotrophic lateral sclerosis: The protocol for a prospective, multicenter study
Issa NP, Aydin S, Polley E, Carberry N, Garret MA, Smith S, Habib AA, Baumgartner NW, Soliven B and Rezania K
To describe the protocol of a prospective study to test the validity of intermuscular coherence (IMC) as a diagnostic tool and biomarker of upper motor neuron degeneration in amyotrophic lateral sclerosis (ALS).
Innovation and adaptation: The rise of a fentanyl smoking culture in San Francisco
Ciccarone D, Holm N, Ondocsin J, Schlosser A, Fessel J, Cowan A and Mars SG
Illicitly manufactured fentanyls and stimulants are implicated in the escalating US mortality from drug overdose. San Francisco, California (SF) has seen declining fentanyl injection while smoking has increased. Beliefs and behaviors surrounding this development are not well understood.
Analysis of Greek prehistoric combat in full body armour based on physiological principles: A series of studies using thematic analysis, human experiments, and numerical simulations
Flouris AD, Petmezas SB, Asimoglou PI, Vale JP, Mayor TS, Giakas G, Jamurtas AZ, Koutedakis Y, Wardle K and Wardle D
One of the oldest complete suits of European armour was discovered in 1960 near the village of Dendra, in Southern Greece, but it remained unknown whether this armour was suitable for extended use in battle or was purely ceremonial. This had limited our understanding of the ancient Greek-Late Bronze Age-warfare and its consequences that have underpinned the social transformations of prehistoric Europe and Eastern Mediterranean. In a series of archeo-physiological studies, merging knowledge in archaeology, history, human physiology, and numerical simulation, we provide supporting evidence that the Mycenaean armour found at Dendra was entirely compatible with use in extended combat, and we provide a free software enabling simulation of Late Bronze Age warfare. A group of special armed-forces personnel wearing a replica of the Dendra armour were able to complete an 11-hour simulated Late Bronze Age combat protocol that we developed from a series of studies based on the available evidence. Numerical simulation of the thermal exchanges in Late Bronze Age warfare extended this conclusion across different environmental conditions and fighting intensities. Our results support the notion that the Mycenaeans had such a powerful impact in Eastern Mediterranean at least partly as a result of their armour technology.
A prospective study of mental wellbeing, quality of life, human-animal attachment, and grief among foster caregivers at animal shelters
Powell L, Ackerman R, Reinhard CL, Serpell J and Watson B
Foster care programs at animal shelters have emerged as an important tool for promoting animal welfare and supporting shelter life-saving efforts. Preliminary evidence suggests that foster caregiving may also be health-promoting for humans. The goals of this study were to investigate the experiences of foster caregivers at animal shelters based on measures of positive and negative affect, quality of life, and grief, and to describe human-animal attachment among foster populations. Between March 2022 and 2023, 131 foster caregivers from five shelters in the United States completed three online surveys before, during and after providing foster care to a shelter animal. Positive affect decreased significantly from baseline to post-foster (F = 5.71, p<0.01), particularly among dog caregivers (F = 6.17, p<0.01). Negative affect remained unchanged (F = 0.47, p = 0.63). Foster caregivers perceived their foster animal provided companionship, affection and emotional support, although dog foster caregivers reported significantly higher emotional (U = 313.50, p<0.01) and social/physical quality of life (t = 4.42, p<0.01) than cat foster caregivers. Caregivers reported low mean avoidant and anxious attachment, suggesting they were able to develop secure bonds with their foster animals. Retention of fosters was also strong, with 86% of caregivers reporting they were likely to provide foster care in the future. Our findings suggest that fostering at animal shelters may serve as a One Health intervention to offer companionship, affection and emotional support to human caregivers while promoting animal welfare. However, these benefits did not translate to improvements in caregiver mental wellbeing, so caution should be applied when considering foster caregiving as a potential mental health promotion tool.
Sleep duration and its association with constipation in patients with diabetes: The fukuoka diabetes registry
Ohkuma T, Iwase M and Kitazono T
Shorter and longer sleep durations are associated with adverse health consequences. However, available evidence on the association of sleep duration with constipation is limited, especially in patients with diabetes, who are at a high risk of both conditions. This study aimed to examine the association between sleep duration and constipation in patients with type 2 diabetes.
Identifying and characterizing superspreaders of low-credibility content on Twitter
DeVerna MR, Aiyappa R, Pacheco D, Bryden J and Menczer F
The world's digital information ecosystem continues to struggle with the spread of misinformation. Prior work has suggested that users who consistently disseminate a disproportionate amount of low-credibility content-so-called superspreaders-are at the center of this problem. We quantitatively confirm this hypothesis and introduce simple metrics to predict the top superspreaders several months into the future. We then conduct a qualitative review to characterize the most prolific superspreaders and analyze their sharing behaviors. Superspreaders include pundits with large followings, low-credibility media outlets, personal accounts affiliated with those media outlets, and a range of influencers. They are primarily political in nature and use more toxic language than the typical user sharing misinformation. We also find concerning evidence that suggests Twitter may be overlooking prominent superspreaders. We hope this work will further public understanding of bad actors and promote steps to mitigate their negative impacts on healthy digital discourse.
The effects of two different fatigue protocols on movement quality during anticipated and unanticipated change of directions in female soccer players
Alimoradi M, Hosseini E, Sahebozamani M, Dos'Santos T, Sheikhbahaie S, Bigtashkhani R and Kabiri A
This study compared neuromuscular control under two fatigue protocols during anticipated and unanticipated change of direction (COD) maneuvers and evaluated their effects on the risk of non-contact ACL injuries.
Middle-schoolers' reading and lexical-semantic processing depth in response to digital and print media: An N400 study
Froud K, Levinson L, Maddox C and Smith P
We report the first use of ERP measures to identify text engagement differences when reading digitally or in print. Depth of semantic encoding is key for reading comprehension, and we predicted that deeper reading of expository texts would facilitate stronger associations with subsequently-presented related words, resulting in enhanced N400 responses to unrelated probe words and a graded attenuation of the N400 to related and moderately related words. In contrast, shallow reading would produce weaker associations between probe words and text passages, resulting in enhanced N400 responses to both moderately related and unrelated words, and an attenuated response to related words. Behavioral research has shown deeper semantic encoding of text from paper than from a screen. Hence, we predicted that the N400 would index deeper reading of text passages that were presented in print, and shallower reading of texts presented digitally. Middle-school students (n = 59) read passages in digital and print formats and high-density EEG was recorded while participants completed single-word semantic judgment tasks after each passage. Following digital text presentation, the N400 response pattern to moderately-related words indicated shallow reading, tracking with responses to words that were unrelated to the text. Following print reading, the N400 responses to moderately-related words patterned instead with responses to related words, interpreted as an index of deeper reading. These findings provide evidence of differences in brain responses to texts presented in print and digital media, including deeper semantic encoding for print than digital texts.
The excessive celebrity worship behavior questionnaire: Chinese scale development and validation
He Y and Liu Q
To develop a scale to assess the excessive behavior of superfans in celebrity worship and to test its reliability and validity in China.
Prevalence and causes of blindness and visual impairment in Kogi state, Nigeria-Findings from a Rapid assessment of avoidable blindness survey
Penzin S, Jolley E, Ogundimu K, Mpyet C, Ibrahim N, Owoeye JF, Isiyaku S, Shu'aibu J and Schmidt E
To determine the prevalence and causes of blindness and visual impairment among adults in Kogi, Nigeria.
Impact of Mindfulness on sleep quality in innovative corporate employees: A chain mediation of Social Interaction Anxiety and bedtime procrastination
Zheng J, Zang X, Xu X, Zhang H and Shah WUH
In the context of innovative enterprises in China, the significance of sleep quality for employees' physical and mental well-being cannot be understated. This study explores the complex relationship between Mindfulness and sleep quality and examines the potential interaction between Social Interaction Anxiety and prolonged sleep behavior. To this end, a thorough evaluation involving the administration of the Mindfulness scale, Social Interaction Anxiety scale, sleep delay scale, and the Pittsburgh Sleep Quality Index (PSQI) was conducted among a significant sample of innovative enterprise employees (N = 1648). The findings reveal that a notable proportion of these employees, 31.1% to be precise (as per PSQI 8), grapple with compromised sleep quality. Subsequent analyses shed light on compelling patterns, underscoring a robust negative correlation between Mindfulness and factors like Social Interaction Anxiety, sleep delay, and sleep quality (β = -0.71, -0.37, -0.35; P < 0.01). Conversely, a significant positive correlation emerges connecting Social Interaction Anxiety, sleep delay, and sleep quality (β = 0.23, 0.37, 0.32; P < 0.01). Interestingly, mediation analysis demonstrates that Mindfulness significantly negatively influences sleep quality, independent of demographic factors such as sex and age. This impact is mediated by sleep delay, which also interacts with Social Interaction Anxiety. In summary, the research emphasizes the predictive function of Mindfulness in improving sleep quality among employees in innovative enterprises, achieved through its reduction of Social Interaction Anxiety and bedtime procrastination tendencies.
A novel machine learning-based prediction method for patients at risk of developing depressive symptoms using a small data
Yun M, Jeon M and Yang H
The prediction of depression is a crucial area of research which makes it one of the top priorities in mental health research as it enables early intervention and can lead to higher success rates in treatment. Self-reported feelings by patients represent a valuable biomarker for predicting depression as they can be expressed in a lower-dimensional network form, offering an advantage in visualizing the interactive characteristics of depression-related feelings. Furthermore, the network form of data expresses high-dimensional data in a compact form, making the data easy to use as input for the machine learning processes. In this study, we applied the graph convolutional network (GCN) algorithm, an effective machine learning tool for handling network data, to predict depression-prone patients using the network form of self-reported log data as the input. We took a data augmentation step to expand the initially small dataset and fed the resulting data into the GCN algorithm, which achieved a high level of accuracy from 86-97% and an F1 (harmonic mean of precision and recall) score of 0.83-0.94 through three experimental cases. In these cases, the ratio of depressive cases varied, and high accuracy and F1 scores were observed in all three cases. This study not only demonstrates the potential for predicting depression-prone patients using self-reported logs as a biomarker in advance, but also shows promise in handling small data sets in the prediction, which is critical given the challenge of obtaining large datasets for biomarker research. The combination of self-reported logs and the GCN algorithm is a promising approach for predicting depression and warrants further investigation.
Prevalence of yaws and syphilis in the Ashanti region of Ghana and occurrence of H. ducreyi, herpes simplex virus 1 and herpes simplex virus 2 in skin lesions associated with treponematoses
Boaitey YA, Owusu-Ofori A, Anyogu A, Aghakhanian F, Arora N, Parr JB, Bosshard PP, Raheem S and Gerbault P
Yaws affects children in tropical regions, while syphilis primarily affects sexually active adults worldwide. Despite various campaigns towards the eradication of yaws and elimination of syphilis, these two diseases are still present in Ghana. The aetiological agents of both diseases, two Treponema pallidum subspecies, are genetically similar. This study aimed to assess the prevalence of these treponematoses and the occurrence of pathogens causing similar skin lesions in the Ashanti region of Ghana. A point-of-care test was used to determine the seroprevalence of the treponematoses. Both yaws and syphilis were identified in the Ashanti region of Ghana. Multiplex PCR was used to identify treponemes and other pathogens that cause similar skin lesions. The results indicated that the seroprevalences of T. pallidum in individuals with yaws-like and syphilis-like lesions were 17.2% and 10.8%, respectively. Multiplex PCR results showed that 9.1%, 1.8% and 0.9% of yaws-like lesions were positive for Haemophilus ducreyi, herpes simplex virus-1 (HSV-1) and T. pallidum respectively. Among syphilis-like lesions, 28.3% were positive for herpes simplex virus -2 (HSV-2) by PCR. To our knowledge, this is the first time HSV-I and HSV-2 have been reported from yaws-like and syphilis-like lesions, respectively, in Ghana. The presence of other organisms apart from T. pallidum in yaws-like and syphilis-like lesions could impede the total healing of these lesions and the full recovery of patients. This may complicate efforts to achieve yaws eradication by 2030 and the elimination of syphilis and warrants updated empirical treatment guidelines for skin ulcer diseases.
Dialectical Behavior Therapy as an intervention for Treatment Resistant Depression in adults: A protocol for systematic review and meta-analysis
Junkes L, Gherman BR, Appolinario JC and Nardi AE
Major Depressive Disorder is a long-term, recurring, and very common illness that is associated with a significant decline in functional ability. The gold-standard method of treating depression is pharmacotherapy, which involves the use of antidepressant medications either alone or in various combinations. However, approximately 30% of Major Depressive Disorder patients suffer from Treatment Resistant Depression, a more severe condition that has a profound impact on patients' lives. Our study aims to conduct the first comprehensive review and meta-analysis to assess the effectiveness and safety of adding Dialectical Behavior Therapy to antidepressant medications compared to groups using pharmacotherapy alone as an intervention for adults with Treatment Resistant Depression.
KLRG1-expressing CD8+ T cells are exhausted and polyfunctional in patients with chronic hepatitis B
Wang L, Liao F, Yang L, Jiang L, Duan L, Wang B, Mu D, Chen J, Huang Y, Hu Q and Chen W
Killer cell lectin-like receptor G1 (KLRG1) has traditionally been regarded as an inhibitory receptor of T cell exhaustion in chronic infection and inflammation. However, its exact role in hepatitis B virus (HBV) infection remains elusive. CD8+ T cells from 190 patients with chronic hepatitis B were analyzed ex vivo for checkpoint and apoptosis markers, transcription factors, cytokines and subtypes in 190 patients with chronic hepatitis B. KLRG1+ and KLRG1- CD8+ T cells were sorted for transcriptome analysis. The impact of the KLRG1-E-cadherin pathway on the suppression of HBV replication mediated by virus-specific T cells was validated in vitro. As expected, HBV-specific CD8+ T cells expressed higher levels of KLRG1 and showed an exhausted molecular phenotype and function. However, despite being enriched for the inhibitory molecules, thymocyte selection-associated high mobility group box protein (TOX), eomesodermin (EOMES), and Helios, CD8+ T cells expressing KLRG1 produced significant levels of tumour necrosis factor (TNF)-α, interferon (IFN)-γ, perforin, and granzyme B, demonstrating not exhausted but active function. Consistent with the in vitro phenotypic assay results, RNA sequencing (RNA-seq) data showed that signature effector T cell and exhausted T cell genes were enriched in KLRG1+ CD8+ T cells. Furthermore, in vitro testing confirmed that KLRG1-E-cadherin binding inhibits the antiviral efficacy of HBV-specific CD8+ T cells. Based on these findings, we concluded that KLRG1+ CD8+ T cells are not only a terminally exhausted subgroup but also exhibit functional diversity, despite inhibitory signs in HBV infection.
Incidence of lost to follow up among HIV-positive children on antiretroviral therapy in Ethiopia: Systematic review and meta-analysis
Girma D, Abita Z, Lemu LG, Asmelash D, Bambo GM, Alie MS and Abebe GF
At the end of 2022, globally, only 46% of children (aged 0-14 years) on ART had suppressed viral loads. Viral load suppression is crucial to reduce HIV-related deaths. To suppress the viral load at the expected level, children must be retained in ART treatment. Nevertheless, lost to follow-up from ART treatment continues to be a global challenge, particularly, in developing countries. Previously, primary studies were conducted in Ethiopia to assess the incidence of lost to follow-up among HIV-positive children on ART treatment. However, variations have been seen among the studies. Therefore, this systematic review and meta-analysis aimed to estimate the pooled incidence of lost to follow-up among HIV-positive children on ART and identify its associated factors in Ethiopia.
Clinical study on the safety and feasibility of AiWalker-K for lower limbs exercise rehabilitation in children with cerebral palsy
Zhang Y, Hui Z, Qi W, Zhang J, Wang M and Zhu D
Robotic-assisted gait training (RAGT) devices are effective for children with cerebral palsy (CP). Many RAGT devices have been created and put into clinical rehabilitation treatment. Therefore, we aimed to investigate the safety and feasibility of a new RAGT for children with CP.
Orienteering combines vigorous-intensity exercise with navigation to improve human cognition and increase brain-derived neurotrophic factor
Waddington EE, Allison DJ, Calabrese EM, Pekos C, Lee A, Walsh JJ and Heisz JJ
Exercise enhances aspects of human cognition, but its intensity may matter. Recent animal research suggests that vigorous exercise, which releases greater amounts of lactate, activates more brain-derived neurotrophic factor (BDNF) in the hippocampus and, thus, may be optimal for supporting cognitive function. The cognitive benefits of exercise may be further augmented when combined with cognitive training. The sport of orienteering simultaneously combines exercise with spatial navigation and, therefore, may result in greater cognitive benefits than exercising only, especially at vigorous intensities. The present study aimed to examine the effects of an acute bout of orienteering at different intensities on cognition and BDNF compared to exercising only. We hypothesized that vigorous-intensity orienteering would increase lactate and BDNF and improve cognition more than moderate-intensity orienteering or vigorous exercise alone. Sixty-three recreationally active, healthy young adults (Mage = 21.10±2.75 years) with no orienteering experience completed a 1.3 km intervention course by navigating and exercising at a vigorous (80-85% of heart rate reserve) or moderate (40-50% of heart rate reserve) intensity or exercising vigorously without navigation. Exercise intensity was monitored using peak lactate, heart rate and rating of perceived exertion. Serum BDNF was extracted immediately before and after the intervention. Memory was assessed using the Mnemonic Similarity Task (high-interference memory) and the Groton Maze Learning Test (spatial memory). Both exercising and orienteering at a vigorous intensity elicited greater peak lactate and increases in BDNF than moderate-intensity orienteering, and individuals with higher peak lactate also had greater increases in BDNF. High-interference memory improved after both vigorous-intensity interventions but did not improve after the moderate-intensity intervention. Spatial memory only increased after vigorous-intensity orienteering, suggesting that orienteering at a vigorous intensity may particularly benefit spatial cognition. Overall, the results demonstrate the benefits of vigorous exercise on human cognition and BDNF.
Ergonomic benefit using heads-up display compared to conventional surgical microscope in Japanese ophthalmologists
Kamei M, Suzuki H, Terayama H, Ghafouri R, Ainslie-Garcia MH, Ferko NC, Cheng H, O'Boyle D and Nakamura M
Occupational musculoskeletal disorders are prevalent in ophthalmic surgeons and can impact surgeons' well-being and productivity. Heads-up displays may reduce ergonomic stress compared to conventional microscopes. This cross-sectional, non-interventional study compared ergonomic experience between heads-up display and conventional ocular microscopes.
Investigating the neural effects of typicality and predictability for face and object stimuli
Ficco L, Li C, Kaufmann JM, Schweinberger SR and Kovács GZ
The brain calibrates itself based on the past stimulus diet, which makes frequently observed stimuli appear as typical (as opposed to uncommon stimuli, which appear as distinctive). Based on predictive processing theory, the brain should be more "prepared" for typical exemplars, because these contain information that has been encountered frequently, allowing it to economically represent items of that category. Thus, one could ask whether predictability and typicality of visual stimuli interact, or rather act in an additive manner. We adapted the design by Egner and colleagues (2010), who used cues to induce expectations about stimulus category (face vs. chair) occurrence during an orthogonal inversion detection task. We measured BOLD responses with fMRI in 35 participants. First, distinctive stimuli always elicited stronger responses than typical ones in all ROIs, and our whole-brain directional contrasts for the effects of typicality and distinctiveness converge with previous findings. Second and importantly, we could not replicate the interaction between category and predictability reported by Egner et al. (2010), which casts doubt on whether cueing designs are ideal to elicit reliable predictability effects. Third, likely as a consequence of the lack of predictability effects, we found no interaction between predictability and typicality in any of the four tested regions (bilateral fusiform face areas, lateral occipital complexes) when considering both categories, nor in the whole brain. We discuss the issue of replicability in neuroscience and sketch an agenda for how future studies might address the same question.
Optimizing test and treat options for vivax malaria: An options assessment toolkit (OAT) for Asia Pacific national malaria control programs
Acharya S, Shrestha M, Thang ND, Wini L, Habib MN, Neukom J, Lhazeen K, Lynch CA and Thriemer K
Designing policy in public health is a complex process requiring decision making that incorporates available evidence and is suitable to a country's epidemiological and health system context. The main objective of this study was to develop an options assessment toolkit (OAT) to provide a pragmatic and evidence-based approach to the development of policies for the radical cure (prevention of relapse) of vivax malaria for national malaria control programs in the Asia-Pacific region. The OAT was developed using participatory research methods and a Delphi process using a sequential multi-phase design, adapted with a pre-development phase, a development phase, and a final development phase. In the pre-development phase, a literature review was conducted to inform the toolkit development. Data collection in the development phase consisted of core research team discussions, multiple rounds of consultation with participants from National Malaria Control Programs (NMP) (online and in person), and two separate modified e-Delphi processes with experts. The final development phase was the piloting of the toolkit during the annual meeting of the Asia Pacific Malaria Elimination Network (APMEN) Vivax Working Group. We developed a tool kit containing the following elements: i) Baseline Assessment Tool (BAT) to assess the readiness of NMPs for new or improved coverage of radical cure, ii) eight scenarios representative of Asia Pacific region, iii) matching test and treat options based on available options for G6PD testing and radical cure for the given scenarios, iv) an approaches tool to allow NMPs to visualize considerations for policy change process and different implementation strategies/approaches for each test and treat option. The OAT can support vivax radical cure policy formulation among NMPs and stakeholders tailoring for their unique country context. Future studies are needed to assess the utility and practicality of using the OAT for specific country context.
Mindfulness and inhibitory control: Insights from the stop signal task with neutral and reward-associated stimuli
Logemann-Molnár Z, Veres-Székely A, Demetrovics Z and Logemann HNA
Mindfulness has been linked to enhanced inhibitory control, yet the dynamics of this relationship, especially in reward situations, are not well understood. Our cross-sectional study aimed to explore the relationship between trait mindfulness and a performance measure of inhibitory control as a function of reward context operationalized by stimuli characteristics, and temporal inhibitory demands. Thirty-six individuals aged 19 to 41 filled out the Mindful Attention Awareness Scale (MAAS) and performed a stop signal task (SST), that included both neutral (stone images) and reward-related (money images) stimuli. The SST encompassed four conditions: neutral go/neutral stop, neutral go/reward stop, reward go/neutral stop, and reward go/reward stop, requiring participants to suppress reactions either during or after encountering reward-related stimuli. The relevant index of inhibitory control is the stop signal reaction time (SSRT), a performance measure of inhibitory control. Our findings showed no notable variation in the relationship between the MAAS score and SSRT across the different conditions. However, there was an overall significant effect of MAAS score on SSRT, irrespective of condition. Results may reflect the benefit of mindfulness on inhibitory control after generalized reward exposure.
Supporting patient self-management: A cross-sectional and prospective cohort study investigating Patient Activation Measure (PAM) and Clinician Support for PAM scores as part of a multi-centre haemodialysis breakthrough series collaborative
Keriakos M, Lee S, Stannard C, Ariss S, Dunn L, Wilkie M and Fotheringham J
Patient self-management, measured by the Patient Activation Measure (PAM), is associated with reduced healthcare utilisation and better health-related quality of life. Self-management in haemodialysis (HD) is challenging and may require support from clinicians with positive attitudes towards self-management, measured by the Clinician Support for PAM (CSPAM).
Test-retest reliability and concurrent validity of knee extensor strength measured by a novel device incorporated into a weight stack machine vs. handheld and isokinetic dynamometry
Sahu PK, Goodstadt N, Ramakrishnan A and Silfies SP
The current clinical gold standard for assessing isometric quadriceps muscle strength is an isokinetic dynamometer (IKD). However, in clinics without an IKD, clinicians default to using handheld dynamometers (HHD), which are less reliable and accurate than the IKD, particularly for large muscle groups. A novel device (ND) was developed that locks the weight stack of weight machines, and measures forces applied to the machine, turning this equipment into an isometric dynamometer. The objectives of this study were to characterize the test-retest reliability of the ND, determine the within-day and between-days inter-rater reliability and concurrent validity compared with that of the HHD, in healthy volunteers (HV) and individuals with knee osteoarthritis (OA) for measuring knee extensors isometric muscle force.
Electrophysiological grading scale for polyneuropathy severity
Abraham A and Bril V
To establish a simple electrophysiological scale for patients with distal symmetric axonal polyneuropathy, in order to promote standardized and informative electrodiagnostic reporting, and understand the complex relationship between electrophysiological and clinical polyneuropathy severity.
Comparison of 2D and 3D oxygen-enhanced MRI of the placenta
Hubbard Cristinacce PL, Patel M, Oh A, Naish JH, Johnstone ED and Ingram E
Oxygen-Enhanced Magnetic Resonance Imaging (OE-MRI) of the human placenta is potentially a sensitive marker of in vivo oxygenation. This methodological study shows that full coverage of the placenta is possible using 3D mapping of the change in longitudinal relaxation rate (ΔR1), in a group of healthy pregnant subjects breathing elevated levels of oxygen. Twelve pregnant subjects underwent a comparison of 2D and 3D OE-MRI. ΔR1 was mapped for a single 2D slice (ss-2D), a single matched-slice from the 3D volume (ss-3D) and the full 3D volume (vol-3D). The group-average median ΔR1 values for ss-3D (0.023 s-1) and vol-3D (0.022 s-1) do not differ significantly from ss-2D (0.020 s-1), when compared using a two-tailed paired t-test (ss-3D (p = 0.58) and vol-3D (p = 0.70)). However, median baseline T1 (T1b) for ss-2D was higher (1603 ms) than T1b for ss-3D (1540 ms, p = 0.07) and significantly higher than vol-3D (1515 ms, p = 0.02), when compared using a two-tailed paired t-test. In contrast with previous studies, no correlation of median ΔR1 with gestation age at scan for the normal group (N = 10) was observed for ss-2D, likely due to the smaller gestational range. Full volume OE-MRI maps reveal sensitivity to changes in ΔR1, with some participants showing an enhanced gradient in the intermediate space between the fetal and maternal sides of the placenta in the 3D data. This study shows that it is feasible to acquire whole placental volume OE-MRI data in women with healthy pregnancy.
Ultrasound-guided percutaneous biopsy for focal liver lesions: Adverse events and diagnostic yield in a single-centre analysis
Pöschel T, Blank V, Schlosser T, Lingscheidt T, Böhlig A, Wiegand J and Karlas T
Ultrasound-guided biopsy of focal liver lesions (FLL) is a well-established procedure with crucial impact on therapeutic decisions. The safety and accuracy depend on needle type, tumour location and comorbidities. Modern oncological concepts often require large tumour specimens which may increase the procedural risk.
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