Conectar
by Mohammad K. Siddiqui, Shagufta Khan, Rinchenla Bhutia, Vivek Nair, Ashok Rai, Nirmal Gurung, Tseten Yamphel, Peggy K. Dadul, Debya S. Kerongi, Karma Doma Bhutia, Jagat Pradhan, Kabita Khati, Sreenivas A. Nair, Shamim Mannan, Kiran K. Rade, Dinesh Gupta, Pawan Malhotra, L. Masae Kawamura, Shikha Dhawan, Asif Mohmmed
BackgroundMonasteries in India house individuals from childhood to advanced age. These congregate settings amplify tuberculosis (TB) transmission and exposure when the disease is present, especially in the high burden areas like Sikkim, India. However, the prevalence of active-TB disease (ATB), tuberculosis infection (TBI), and their associated risk factors have not been studied. The diagnosis and treatment of TBI remain a major bottleneck in eradicating TB. ATB and TBI risk among residents living in the congregate setting of monasteries in Sikkim, India, a high-TB burden area, may be high due to high-density living quarters, public interaction and their frequent travel history but has never been illustrated.
MethodA cross-sectional screening of the monks and residents of Rumtek Monastery (Sikkim, India) was carried out to assess extent of ATB and TBI in a congregate setting. TrueNat MTB and GeneXpert MTB/Rif systems were utilized for ATB diagnosis, whereas QuantiFERON-TB Gold Plus (QFT-plus) Interferon-gamma release assay (IGRA) analysis was used for TBI detection. Follow-up sputum testing by TrueNat MTB was performed on IGRA-positive individuals to exclude ATB.
ResultsAmong the 350 inhabitants of the monastery, 7% (25/350) were found to be symptomatic for TB, whereas 93% (325/350) were asymptomatic. Out of them, 189 participants, including symptomatic cases, agreed to participate in the study and were screened for TBI; however, 15 participants were excluded from the study due to result discrepancies. None of the participant were diagnosed with active tuberculosis (ATB), although, 44.2% (77/174) were found to be positive for TBI; however, none of those with TBI progressed to ATB during one year follow-up. Risk factors for TBI included: advancing age, frequent travel history, family history of TB or having contacts with TB patients and abnormal Body Mass Index (BMI) ≤18.5- ≥ 25.
ConclusionThis study confirms the high prevalence of TBI among residents in the congregate setting of monasteries, and justify TB prevention strategies by targeted screening, TBI testing and preventive treatment in congregate settings of high TB burden areas.
by Andrea C. Aplasca, Peter B. Johantgen, Christopher Madden, Kilmer Soares, Randall E. Junge, Vanessa L. Hale, Mark Flint
Amphibian skin is integral to promoting normal physiological processes in the body and promotes both innate and adaptive immunity against pathogens. The amphibian skin microbiota is comprised of a complex assemblage of microbes and is shaped by internal host characteristics and external influences. Skin disease is a significant source of morbidity and mortality in amphibians, and increasing research has shown that the amphibian skin microbiota is an important component in host health. The Eastern hellbender (Cryptobranchus alleganiensis alleganiensis) is a giant salamander declining in many parts of its range, and captive-rearing programs are important to hellbender recovery efforts. Survival rates of juvenile hellbenders in captive-rearing programs are highly variable, and mortality rates are overall poorly understood. Deceased juvenile hellbenders often present with low body condition and skin abnormalities. To investigate potential links between the skin microbiota and body condition, we collected skin swab samples from 116 juvenile hellbenders and water samples from two holding tanks in a captive-rearing program. We used 16s rRNA gene sequencing to characterize the skin and water microbiota and observed significant differences in the skin microbiota by weight class and tank. The skin microbiota of hellbenders that were housed in tanks in close proximity were generally more similar than those housed physically distant. A single taxa, Parcubacteria, was differentially abundant by weight class only and observed in higher abundance in low weight hellbenders. These results suggest a specific association between this taxa and Low weight hellbenders. Additional research is needed to investigate how husbandry factors and potential pathogenic organisms, such as Parcubacteria, impact the skin microbiota of hellbenders and ultimately morbidity and mortality in the species.by Xinyu Zhang, Yoo Jung Oh, Yunhan Zhang, Jianfeng Zhu
The digital age has fueled a surge in ADHD self-diagnosis as people turn to online platforms for mental health information. However, the relationship between validation-seeking behaviors and self-perception in these online communities and users’ self-perception has received limited scholarly focus. Drawing on self-verification theory and utilizing natural language processing to analyze 452,026 posts from the r/ADHD subreddit, our study uncovers distinct patterns in validation-seeking behaviors. Results show that (a) self-diagnosed individuals with ADHD are more likely to seek social validation and media validation and to report higher levels of negative self-image and internalized stigma than clinically diagnosed individuals, (b) social validation was strongly associated with both positive and negative self-perceptions; and (c) diagnosis status significantly moderated these relationships, such that the effects of social validation on self-image and stigma were consistently weaker for the self-diagnosed group. Theoretically, this study extends self-verification theory by demonstrating that professional verification hierarchically moderates self-verification effectiveness. This implies a practical need for clinicians to acknowledge online validation seeking and for digital communities to affirm user experiences while mitigating stigma.by Dong Min Jung, Yong Jae Kwon, Yong Wan Cho, Jong Geol Baek, Dong Jae Jang, Yongdo Yun, Seok-Ho Lee, Gahee Son, Hyunjong Yoo, Min Cheol Han, Jin Sung Kim
Volumetric modulated arc therapy (VMAT) for lung cancer involves complex multileaf collimator (MLC) motion, which increases sensitivity to interplay effects with tumour motion. Current dynamic conformal arc methods address this issue but may limit the achievable dose distribution optimisation compared with standard VMAT. This study examined the clinical utility of a VMAT technique with monitor unit limits (VMATliMU) to mimic conformal arc delivery and reduce interplay effects while maintaining plan quality. VMATliMU was implemented by applying monitor unit limitations during VMAT reoptimisation to minimise MLC encroachment into target volumes. Using mesh-type reference computational phantom CT images, treatment plans were generated for a simulated stage I lung cancer case prescribed to 45 Gy in three fractions. VMATliMU, conventional VMAT, VMAT with leaf speed limitations, dynamic conformal arc therapy, and constant dynamic conformal arc therapy were compared. Plans were optimised for multiple isodose line prescriptions (50%, 60%, 70%, 80%, and 90%) to investigate the impact of dose distribution. Evaluation parameters included MLC positional accuracy using area difference ratios, dosimetric indices, gradient metrics, and organ-at-risk doses. VMATliMU prevented MLC encroachment into the internal target volume across 60%–90% isodose lines, showing superior MLC accuracy compared with other methods. At the challenging 50% isodose line, VMATliMU had 4.5 times less intrusion than VMAT with leaf speed limits. VMAT plans had better dosimetric indices than dynamic conformal arc plans. VMATliMU reduced monitor units by 5.1%–19.2% across prescriptions. All plans met the clinical dose constraints, with the aortic arch below tolerance and acceptable lung doses. VMATliMU combines VMAT’s dosimetric benefits with the dynamic conformal arcs’s simplicity, minimising MLC encroachment while maintaining plan quality. Reduced monitor units lower low-dose exposure, treatment time, and interplay effects. VMATliMU is usable in existing planners with monitor unit limits, offering a practical solution for lung stereotactic body radiation therapy.by Cheyenne R. Wagi, Renee McDowell, Anyssa Wright, Kathleen L. Egan, Christina S. Meade, April M. Young, Madison N. Enderle, Angela T. Estadt, Kathryn E. Lancaster
BackgroundHepatitis C virus (HCV) and injection drug use among young women are dramatically rising in the rural United States. From 2004 to 2017, heroin use among non-pregnant women increased 22.4% biennially, mirroring increases in HCV cases, especially among younger populations. Young women who inject drugs (YWID, ages 18–35) face elevated HCV risk due to biological, behavioral, and socio-cultural factors. Barriers to HCV testing and treatment services further delay diagnoses, fuel transmission, and limit access to harm reduction services. This study applies the Theoretical Domains Framework (TDF) to identify factors influencing HCV testing and treatment among YWID in rural Appalachia Ohio.
MethodsWe conducted in-depth interviews with YWID (n = 30) in 2023 to understand their HCV testing and treatment experiences in rural Appalachia Ohio. Interviews were transcribed, inductively coded, and analyzed using grounded theory. Identified themes were mapped onto the TDF domains.
ResultsKey TDF domains influencing HCV care included knowledge, beliefs about consequences, and intentions. While YWID knew where to get tested, they expressed uncertainty about treatment value and access while actively using drugs. Social influences, stigma, and mistreatment by healthcare providers created barriers to treatment. Environmental context and resources, such as transportation, also influenced access to care.
ConclusionsYWID in rural Appalachia face barriers to HCV care, such as gaps in knowledge about HCV treatment, which is compounded by gendered stigma, and logistical challenges. Rapidly changing treatment restrictions led to misinformation about treatment access. These gaps highlight the need for interventions specifically designed to address YWID lived experiences.
by Minjung Lee
Efficient and effective public health surveillance during epidemics relies heavily on active and voluntary public participation, including timely COVID-19 testing and disclosure of results to contacts. This study aimed to investigate predictors of COVID-19 testing and disclosure hesitancy, with a focus on the role of responsibility attribution during the early stages of the Omicron epidemic in South Korea. A cross-sectional survey was conducted with 1,000 participants between February 25 and March 2, 2022. Chi-square tests and multivariable logistic regression models were used for analysis. Findings showed that 41.5% of participants expressed hesitancy toward COVID-19 testing, and 59.4% expressed hesitancy toward disclosing test results to contacts. Greater attribution of responsibility to individuals was significantly associated with increased hesitancy toward testing (OR = 0.75, 95% CI = 0.63–0.90, pby Nipaporn Butsing, Nalinrat Thongniran, Jesada Keandoungchun
BackgroundStrokes are the major cause of disability. Functional recovery following an acute stroke is time-dependent and varies depending on several factors. This study aimed to investigate changes in functional outcomes after stroke from discharge to six months post-discharge and to identify factors associated with changes in functional outcomes during this six-month period.
MethodsThe study included 155 consecutive patients with a first stroke and were hospitalized in an acute stroke unit at an advanced tertiary hospital in Bangkok between April 2020 and August 2021. The patients’ functional outcomes were evaluated using the modified Rankin Scale (mRS) and the Barthel Index (BI) before hospital discharge and at one-, three-, and six-month post-discharge. Friedman tests were used to assess changes in mRS scores over six months. Linear mixed effect regression was applied to identify the change in BI scores during the six months post-discharge.
ResultsOf the participants, 62.6% were men, and the mean age was 64.0 (SD = 12.5). The median mRS scores ranged from 3.0 at discharge to 0.0 at six months post-discharge. Significant changes in mRS scores were identified within three months post-discharge, and differences by stroke subtype and severity (P Conclusion
The time after discharge, gender, stroke subtype, and stroke severity are significant factors affecting functional outcomes after a stroke. The most significant improvement in functional outcomes occurred within one month post-discharge.
by Okkeun Jung, Angelene Soto, Andrew L. Wolfe, Shahana S. Mahajan
KRAS mutations, which induce proliferative signaling driving many human cancers, are detectable in a small subset of osteosarcoma patients. The recently developed pan-KRAS inhibitor daraxonrasib, also known as RMC-6236, is capable of targeting a wide array of KRAS mutations and shows promise against pancreatic and lung cancers. However, the efficacy and mechanisms of action of daraxonrasib in osteosarcoma (OS) remain unclear. We evaluated the effects of daraxonrasib on the viability, proliferation, and metastatic potential of wild-type and KRAS mutant OS cells. We assayed the effects of treatment on downstream targets using qPCR, immunoblotting, and activity assays to explore the underlying mechanism by which daraxonrasib selectively suppresses the metastatic potential of KRAS mutant osteosarcoma. Finally, we investigated how the increased prevalence of GTP-bound KRAS enhanced the sensitivity of KRAS wild-type osteosarcoma cells to daraxonrasib using siRNA targeting RASA1. Daraxonrasib selectively attenuated the proliferation and migratory ability of KRAS mutant HOS-143B cells without affecting KRAS wild-type controls. Additionally, daraxonrasib suppressed the expression of the matrix metalloproteases MMP9 and MMP1, which promote cell motility and metastasis. Daraxonrasib selectively inhibited the AKT/ETS1 pathway in HOS-143B cells, whereas no such effect was observed in HOS cells. HOS cells were sensitized to daraxonrasib by knocking down the GTPase-activating protein RASA1. In osteosarcoma, KRAS inhibition decreased MMP1, MMP9, and AKT/ETS1 signaling. Daraxonrasib is a promising agent for treating osteosarcoma with KRAS mutations.by Jun Sang Yoo, Jae Hyun Choi, Jae Young Park, Jeong Yun Song, Jun Young Chang, Dong-Wha Kang, Sun U. Kwon, Hang Jin Jo, Bum Joon Kim
BackgroundLipohyalinotic degeneration (LD) and branch atheromatous disease (BAD) can contribute to subcortical infarctions in the lenticulostriate artery (LSA) territory. This study aimed to identify the association between the proximal and distal middle cerebral artery (MCA) diameter ratio and the two different pathomechanisms of LSA infarction.
MethodsPatients with acute LSA infarctions categorized as small vessel occlusive disease were included. Demographic and clinical data, along with MCA geometrical variables, were collected. LD and BAD were differentiated based on the length of the infarction diameter and number of axial slices. The proximal/distal M1 diameter ratio was calculated. MCA geometrics between LD and BAD were compared. Independent factors associated with LD were investigated. Computational fluid dynamics (CFD) analysis was used to evaluate hemodynamic parameters.
ResultsA total of 117 patients were included, of whom 64 (54.7%) and 53 (45.3%) were classified as BAD and LD, respectively. LD was associated with hypertension and favorable prognosis. MCA geometric variables revealed that LD had a higher proximal/distal M1 diameter ratio, indicating a potential distinguishing factor. Multivariate analysis confirmed the independent association between LD and the proximal/distal M1 diameter ratio. The proximal/distal M1 diameter ratio also showed a positive correlation with the number of ipsilesional lacunes. CFD analysis showed that the LD model had faster, greater blood influx into LSAs and higher wall shear stress and pressure gradient compared with the BAD model.
ConclusionsThis study suggests MCA geometry, particularly the proximal/distal M1 diameter ratio, may serve as an independent factor for identifying LD.
by Sewon Lim, Hajin Kim, Youngjin Lee, for the Alzheimer’s Disease Neuroimaging Initiative
Longitudinal studies that analyze the changes in the axial diffusivity (AxD) and radial diffusivity (RD) values over time can elucidate the progression of white matter damage and its causal relationship with cognitive decline. This study aimed to investigate the longitudinal changes in white matter integrity based on AxD and RD and their association with cognitive decline in patients with mild cognitive impairment (MCI) that progressed to Alzheimer’s disease (AD). Eighteen participants diagnosed with MCI at baseline and AD at the follow-up examination were selected from the AD Neuroimaging Initiative and included in this 2-year study Tract-based spatial statistics (TBSS) was used to assess longitudinal changes in WM. Voxel-wise and region-of-interest (ROI) analyses were conducted, and statistical models controlled for age, sex, education, and APOE ε4 status. Correlation and multiple regression analyses were performed to examine the association between AxD/RD changes and changes in clinical dementia rating (CDR) scores. Significant increases in AxD and RD were observed over 2 years in widespread WM tracts, including the corpus callosum, internal capsule, corona radiata, cingulum, superior longitudinal fasciculus, and fornix. AxD changes, particularly in the left retrolenticular internal capsule, left posterior corona radiata, left fornix, and right superior longitudinal fasciculus, showed significant correlations with cognitive decline. In contrast, RD changes were not significantly associated with CDR changes in any region. Multivariate regression analysis identified AxD in the left retrolenticular internal capsule as a significant independent predictor of CDR changes. AxD was sensitive to microstructural alterations in WM associated with cognitive decline during the transition from MCI to AD and may serve as a valuable biomarker for early detection and monitoring of AD progression. Longitudinal DTI analyses provide critical insights into the temporal dynamics of WM degeneration and its role in clinical deterioration.by Diane C. Lim, Cheng-Bang Chen, Ankita Paul, Yujie Wang, Jinyoung Kim, Soonhyun Yook, Emily Y. Kim, Edison Q. Kim, Anup Das, Medhi Wangpaichitr, Virend K. Somers, Chi Hang Lee, Phyllis C. Zee, Toshihiro Imamura, Hosung Kim
ObjectiveTo quantitate hypoxemia severity.
MethodsWe developed the Weighted Hypoxemia Index to be adapted to different clinical settings by applying 5 steps to the oxygen saturation curve: (1) Identify desaturation/resaturation event i by setting the upper threshold; (2) Exclude events as artifact by setting a lower threshold; (3) Calculate weighted area for each i, as (Δi × Φi); (4) Calculate a normalization factor Ω for each subject; (5) Calculate the Weighted Hypoxemia Index as the summation of all weighted areas multiplied by Ω. We assessed the Weighted Hypoxemia Index predictive value for all-cause mortality and cardiovascular mortality using the Sleep Heart Health Study (enrollment 1995–1998, 11.1 years mean follow-up).
ResultsWe set varying upper thresholds at 92%, 90%, 88%, and 86%, a lower threshold of 50%, calculated area under the curve and area above the curve, with and without a linear weighted factor (duration of each event i), and used the same normalization factor of total sleep time Conclusion
The Weighted Hypoxemia Index offers a versatile and clinically relevant method for quantifying hypoxemia severity, with potential applications to evaluate mechanisms and outcomes across various patient populations.
by Yilin Zhang, Zitong Zhang, Yunyun Peng, Wanting Zhang, Guiyuan Ma, Sulan Lin, Carmen W.H. Chan, Ankie Tan Cheung, Jianhui Xie, Can Gu
ObjectiveThis systematic review aimed to examine the impact of technology- and parent-based psychosocial interventions on family factors among children with cancer, focusing on family dynamics.
MethodsData were sourced from ten databases (CNKI, Wanfang, VIP, Sinomed, the Cochrane Library, Embase, PubMed, Web of Science, Scopus, and CINAHL) up to August 2024. The PRISMA statement guidelines, the Cochrane risk bias assessment tool, and the non-randomized controlled trial risk bias assessment tool were used in this study and experimental and quasi-experimental studies were included. The review protocol is registered in PROSPERO (CRD42023435402).
ResultsTwelve studies, including seven randomized controlled trials and five quasi-experimental studies, involving 1,309 parents of children with cancer, were included in the review. These studies utilized various theoretical models and delivered interventions through different modes, such as Internet-based platforms and telehealth. Overall, technology- and parent-based interventions have demonstrated positive effects on family dynamics factors, including family function, communication, coping ability, and family burden.
ConclusionsTechnology- and parent-based psychosocial interventions showed promise in enhancing family dynamics factors although intervention methods varied across studies. This review recommends larger-scale randomized controlled trials to evaluate the effectiveness of technology- and parent-based psychosocial interventions on family dynamics factors among this vulnerable population and highlights the potential of such interventions to improve care quality, treatment outcomes, and resource allocation in pediatric oncology.
by Rhonda M. Merwin, Patrick J. Smith, J.A. Riley, Jordan Infield, Christine O’Connell, Dorothy Mayo, Ashley A. Moskovich, Lauren Hill, Hilary Winthrop, Amy Bush, Ernaya Johnson, Francesca Scheiber, Anthony D. Sung
Introduction: Allogeneic hematopoietic stem cell transplant (HCT) has the potential to cure patients with hematologic malignancies, but treatment-related morbidity and mortality is high. Transplant outcomes are optimized by patients maintaining physical activity. The aim of the current study was to examine whether a brief Acceptance and Commitment Therapy (ACT) intervention is acceptable to HCT patients and caregivers and helps patients engage in healthy behavior despite physical and emotional discomfort. Methods: Patients ≥ 18 years of age who were undergoing allogenic HCT for any cancer or non-cancer illness and their caregivers were invited to complete six ACT sessions between transplant day − 30 and day + 90. Multiple small cohorts of n = 3 dyads were enrolled, and the protocol content was iterated after each cohort to reflect the experiences and breadth of concerns of individuals undergoing HCT. Acceptability was indexed by session completion rates and acceptability surveys. Pre-post 6-minute walk distance was collected as an index of physical function as part of standard care. Results: Sixteen HCT dyads enrolled in the study; 12 continued to treatment. Most participants completed all assigned sessions. Participants perceived ACT to be helpful and 70% (5 of 7) of the patients with pre-post 6-minute walk test data showed improvement. Conclusion: ACT is an acceptable and potentially useful intervention for individuals undergoing HCT. Additional controlled studies are warranted.by Khomsan Ruangrit, Kittiya Phinyo, Sahassawat Chailungka, Kritsana Duangjan, Apitchaya Naree, Jearanai Thasana, Wassana Kamopas, Senoch Seanpong, Jeeraporn Pekkoh, Nuttapol Noirungsee
This study investigates the effectiveness of biochar immobilized with algicidal Bacillus sp. AK3 and denitrifying Alcaligenes sp. M3 in mitigating harmful algal blooms (HABs) and reducing nitrate pollution in aquatic environments. Over a six-day period, we analyzed changes in algal bloom-forming Microcystis density, chlorophyll-a levels (indicative of algal biomass), nitrate concentration, and microbial community composition in water treated with biochar and Bacillus sp. AK3 and Alcaligenes sp. M3-immobilized biochar. In water treatment using the AK3 and M3-immobilized biochar, Microcystis density decreased from 600,000 cells/mL to 80,000 cells/mL, and chlorophyll-a concentrations also substantially reduced, from 85.7 µg/L initially to 42.8 µg/L. Nitrate concentrations in the AK3 and M3-immobilized biochar treatment significantly decreased from approximately 23 mg/L to around 14 mg/L by Day 6, demonstrating the enhanced denitrification capabilities of the immobilized Alcaligenes sp. M3 and associated bacterial communities. The results also showed significant shifts in bacterial communities, with a decrease in Microcystis, highlighting the specific algicidal activity of Bacillus sp. AK3. The study underscores the potential of biochar-based treatments as a sustainable and effective approach for improving water quality and mitigating the environmental impacts of nutrient pollution and HABs.by Ian C. Lock, Nathan H. Leisenring, Warren Floyd, Eric S. Xu, Lixia Luo, Yan Ma, Erin C. Mansell, Diana M. Cardona, Chang-Lung Lee, David G. Kirsch
BackgroundThe tumor suppressor p53 (Trp53), also known as p53, is the most commonly mutated gene in cancer. Canonical p53 DNA damage response pathways are well characterized and classically thought to underlie the tumor suppressive effect of p53. Challenging this dogma, mouse models have revealed that p53-driven apoptosis and cell cycle arrest are dispensable for tumor suppression. Here, we investigated the inverse context of a p53 mutation predicted to drive the expression of canonical targets but is detected in human cancer.
MethodsWe established a novel mouse model with a single base pair mutation (GAG>GAT, p53E221D) in the DNA-Binding domain that has wild-type function in screening assays, but is paradoxically found in human cancer in Li-Fraumeni syndrome. Using mouse p53E221D and the analogous human p53E224D mutants, we evaluated expression, transcriptional activation, and tumor suppression in vitro and in vivo.
ResultsExpression of human p53E224D from cDNA translated to a fully functional p53 protein. However, p53E221D/E221D RNA transcribed from the endogenous locus is mis-spliced resulting in nonsense-mediated decay. Moreover, fibroblasts derived from p53E221D/E221D mice do not express a detectable protein product. Mice homozygous for p53E221D exhibited increased tumor penetrance and decreased life expectancy compared to p53WT/WT animals.
ConclusionsMouse p53E221D and human p53E224D mutations lead to splice variation and a biologically relevant p53 loss of function in vitro and in vivo.
by Hansol Park, Young-Sik Yoo, Eunhae Shin, Won Seok Song, Yeokyoung Won, Tae-Young Chung, Dong Hui Lim
BackgroundTo evaluate the ocular biometry agreement and prediction of postoperative refractive outcomes obtained using two swept-source optical coherence tomography (SS-OCT) biometers: Anterion (Heidelberg Engineering, Heidelberg, Germany) and Argos (Alcon, Fort Worth, TX, USA).
MethodsAmbispective analysis was conducted on 105 eyes at the Samsung Medical Center, Seoul, Republic of Korea, between June 2021 and March 2022. Biometric values were assessed using both devices before cataract surgery. Intraocular lens (IOL) power, mean arithmetic error (ME), and mean absolute error (MAE) were calculated using the Barrett Universal II, Haigis, and Hoffer Q formulas.
ResultsAnterion showed statistically significantly greater axial length (AL), central corneal thickness (CCT), and lens thickness (LT) than Argos (p = 0.03, p 0.05). Anterion showed flatter corneal curvature measurements than Argos (p Conclusion
Although the differences are not clinically significant, the measurements of AL, CCT, and LT obtained with Anterion were greater compared to those measured with Argos, while the keratometry (K) and corneal diameter (CD) values were smaller. Consequently, this resulted in a minor difference in refractive predictability, with Anterion showing a slight tendency toward more myopic refractive errors. However, there were no significant differences in MAE or the percentage of eyes within ± 0.5D.
by Jaeyoung Choi, Esther Park, Hyejeong Park, Danbee Kang, Jeong Hoon Yang, Hyunsoo Kim, Juhee Cho, Joongbum Cho
BackgroundHigh-flow nasal cannula (HFNC) therapy has gained popularity in the pediatric intensive care unit (PICU). However, the nationwide effect of HFNC on mechanical ventilation duration has not been studied.
MethodsWe retrospectively analyzed pediatric patients (28 days to 17 years old) admitted to tertiary ICUs for respiratory support from 2012 to 2019 using the Korean National Health Insurance database. Pre-/post-HFNC periods were defined as the 12 months before and after the application of HFNC in any hospital, respectively, allowing a 6-month transition period. Mechanical ventilation duration and ventilator-free days during these two periods were compared using a multivariable regression model.
ResultsUsing data from 46 hospitals, 4,705 and 4,864 respective pre-/post-HFNC period patients were evaluated. During the post-HFNC period, 14.8% of patients were treated by HFNC, and 67.1% were treated using invasive mechanical ventilation. In adjusted analysis, mechanical ventilation duration was reduced by 0.99 days (confidence interval [CI]: -1.86, -0.12). The duration was significantly reduced by 17.81 days (CI: -35.46, -0.16) among patients whose ventilation duration was longer than 28 days. In subgroup analysis, mechanical ventilation duration was reduced by 1.49 days (CI: -2.78, -0.19) in the overall surgical group and 6.71 days (CI: -11.71, - 1.71) in the neurologic subgroup. Ventilator-free days were increased only in the overall surgical group, by 0.31 days (CI: 0.01, 0.61).
ConclusionsApplication of HFNC to PICU patients could reduce mechanical ventilation duration, especially in patients requiring prolonged mechanical ventilator support or in post-operative patients.
by Daeyun Seo, Seongsoo Lim, Beomkwan Namgoong, Heesung Uhm, Hyeajeong Hong, Nanju Lee, Isong Kim, Seunghun Heo, Ji Hwan Kang, Cheyoun Kim, Hayoung Shin, Jiwoong Her, Min Su Kim
ObjectiveLiver compression (LC) has been proposed to predict fluid responsiveness in human pediatric patients. Because the evaluation of fluid responsiveness through LC depends on the mechanism of increased intra-abdominal pressure (IAP), understanding the impact of LC on IAP, cardiac output (CO), and respiratory parameters is essential. Thus, this study aimed to investigate the effects of LC on these parameters.
MethodsThe present study used six healthy beagles. All dogs were anesthetized with isoflurane and allowed to breathe spontaneously in dorsal recumbency. After instrumentation, LC was performed at four different pressures in a sequential, non-randomized manner: (1) 10 mmHg, approximately half of the minimum value within the range; (2) 22 mmHg, a commonly used pressure within the range; (3) 44 mmHg, twice the pressure of the minimum value within the range; and (4) 60 mmHg, twice the pressure of the maximum value within the range. At each pressure, CO via transthoracic echocardiography, IAP, and cardiorespiratory parameters were measured before, during, and after LC.
ResultsOverall, our results showed that the IAP was significantly increased at all pressures during LC (P Conclusions
This is the first study to evaluate the effects of LC on IAP, CO, and respiratory parameters in healthy, anesthetized, and spontaneously breathing dogs. Our findings indicate that applying LC with a commonly used pressure may have a low risk of inducing intra-abdominal hypertension and related complications. Further studies are required to explore the use of LC in various clinical settings.
by Nam-Yi Kim, Sung-Jung Kwak
At present, patient safety nursing by nurses is important and the risk of patient safety incidents is high. However, the comprehensive nursing service ward in Korea has no guardians. To prevent patient safety incidents and its recurrence, it is necessary to accurately report patient safety incidents. Patient safety incident reporting may be different depending on an individual’s critical thinking disposition and patient safety culture (organization, department, individual). This study was a descriptive survey and aimed to suggest ways to improve the reporting of patient safety incidents in Korea. The study participants were 130 nurses working in the comprehensive nursing service ward of a Korean university hospital. From October 5–18, 2023, we conducted a survey of nurses’ critical thinking dispositions, patient safety culture, and patient safety incident reporting. The mediating effect of patient safety culture on the relationship between critical thinking disposition and patient safety incident reporting was analyzed using PROCESS Macro Model 4. The results show that the patient safety incident report of nurses in the comprehensive nursing service ward was related to nurses’ critical thinking disposition and the nursing department’s patient safety culture. In particular, it was found that the department’s patient safety culture had a mediating effect (β = 0.11, 95% CI = 0.01~0.22) on the relationship between critical thinking disposition and patient safety incident reports. To encourage patient safety incident reports in nurses in the comprehensive nursing service ward, it is necessary to improve the organizational culture of the department (presenting free opinions or problems) and to develop strategies to promote critical thinking among nurses.by Samer Al-Battawi, Mohd Talib Latif, Vivien How, Karuppiah Thilakavathy, Haris Hafizal Abd Hamid, Chung Keat Tan, Yu Bin Ho
Motor vehicles emit most Malaysian PAHs in particulate matter of 2.5 μm (PM2.5-bound PAHs). Although traffic-related air pollution harms healthy people, there is a knowledge gap regarding PAHs’ effects on Malaysians. This study examines PM2.5-bound PAH concentrations, distribution, sources, and health risks in Malaysia’s high and low-traffic zones. Kuala Lumpur (KL) and Hulu Langat (HL) exhibit Malaysia’s high- and low-traffic areas. The high-volume air sampler collected 40 ambient PM2.5 samples at both locations. Solid-phase extraction and gas chromatography-mass spectrometry (GC-MS) assessed PAHs. The mean PM2.5-bound PAH concentrations in KL (5.85 ng m-3) were significantly higher than in HL (0.55 ng m-3) (p-3) and eleven times more high-molecular-weight PAHs (HMW-PAHs) (3.22 vs. 0.28 ng m-3) than HL. Over 51% of PM2.5 air samples at both sites included HMW-PAHs. Source apportionment tools (Diagnostic ratio, positive matrix factorization, and principal component analysis) showed that fossil fuel combustions (petrol and diesel) produced the greatest PAHs in both locations. Moreover, PAH exposure impinged higher carcinogenic health risks in KL than in HL. In conclusion, traffic and automobile pollution account for the short- and long-term health risks posed by PAHs in both regions.
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