Tag: pubmed

Prehosp Emerg Care. 2024 Jul 23:1-9. doi: 10.1080/10903127.2024.2379872. Online ahead of print.

ABSTRACT

Objectives: The American Board of Emergency Medicine (ABEM) Emergency Medical Services Medicine (EMS) was approved by the American Board of Medical Specialties on September 23, 2010. Subspecialty certification in EMS was contingent on two key elements-completing Accreditation Council for Graduate Medical Education (ACGME)-accredited EMS training and passing the subspecialty certification examination developed by ABEM. The first EMS certification examination was offered in October 2013. Meaningful certification requires rigorous assessment. In this instance, the EMS certification examination sought to embrace the tenets of validity, reliability, and fairness. For the purposes of this report, the sources of validity evidence were anchored on the EMS core content, the examination development process, and the association between fellowship training and passing the certification examination.Methods: We chose to use validity evidence that included: 1) content validity (based on the EMS core content); 2) response processes (test items require intended cognitive processes); 3) internal structure supported by the internal relationships among items; 4) relations to other variables, specifically the association between examination performance and ACGME-accredited fellowship training; and 5) the consequences of testing.Results: There is strong content validity evidence for the EMS examination based on the core content and its detailed development process. The core content and supporting job-task analysis was also used to define the examination blueprint. Internal structure support was evidenced by Cronbach’s coefficient alpha, which ranged from 0.82 to 0.92. Physicians who completed ACGME-accredited EMS fellowship training were more likely to pass the EMS certification examination (chi square, p < 0.0001; Cramér’s, V = 0.24). Finally, there were two sources of consequential validity evidence-use of test results to determine certification and use of the resulting certificate.Conclusions: There is substantial and varied validity evidence to support the use of the EMS certifying examination in making summative decisions to award certification in EMS. Of note, there was a statistically significant association between ACGME-accredited fellowship training and passing the examination.

PMID:39042827 | DOI:10.1080/10903127.2024.2379872

J Complement Integr Med. 2024 Jul 23. doi: 10.1515/jcim-2024-0183. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this study was to evaluate and compare the antibacterial efficacy of licorice gel and tetracycline gel against Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia.

METHODS: An indigenously prepared 50 μL licorice and tetracycline gel was subjected to antibacterial sensitivity test (thrice) against Aa, Pg, Pi by agar well diffusion method using Brain Heart Infusion media. Colonies of Aa, Pg, Pi was transferred into broth and incubated at 37 °C for 24 h and diameter of inhibition zone was measured.

RESULTS: The drug release profile of licorice gel at six regular intervals was higher when compared to tetracycline. MIC of licorice gel (50 μg/mL) against Aa (14 mg), Pg (7 mg), Pi (7 mg) respectively. The diameter of inhibition zone of licorice gel was significant against Aa when compared to tetracycline gel. However, tetracycline gel exhibited significant diameter of inhibition zone against Pg and Pi when compared to licorice gel. There was a statistical significance difference between licorice and tetracycline gel against Aa (p=0.043*), Pg (p=0.037*), Pi (p=0.046*) while assessing antibacterial sensitivity test.

CONCLUSIONS: Licorice gel has anti-inflammatory and anti-microbial properties which can act against periodontal pathogens and can be considered in treating periodontal disease at low concentrations. Therefore, it can be used as an adjunctive local drug delivery agent to non-surgical periodontal therapy (NSPT) in treating periodontal disease.

PMID:39042815 | DOI:10.1515/jcim-2024-0183

Phys Rev Lett. 2024 Jul 5;133(1):010201. doi: 10.1103/PhysRevLett.133.010201.

ABSTRACT

It is well known that the set of statistics that can be observed in a Bell-type experiment is limited by quantum theory. Unfortunately, tools are missing to identify the precise boundary of this set. Here, we propose to study the set of quantum statistics from a dual perspective. By considering all Bell expressions saturated by a given realization, we show that the Clauser-Horne-Shimony-Holt expression can be decomposed in terms of extremal Tsirelson inequalities that we identify. This brings novel insight into the geometry of the quantum set in the (2,2,2) scenario. Furthermore, this allows us to identify all the Bell expressions that are able to self-test the Tsirelson realization.

PMID:39042799 | DOI:10.1103/PhysRevLett.133.010201

Transplantation. 2024 Aug 1;108(8):1782-1792. doi: 10.1097/TP.0000000000004985. Epub 2024 Jul 20.

ABSTRACT

BACKGROUND: Focal segmental glomerulosclerosis (FSGS) is a common cause of end-stage kidney disease and frequently recurs after kidney transplantation. Recurrent FSGS (rFSGS) is associated with poor allograft and patient outcomes. Bleselumab, a fully human immunoglobulin G4 anti-CD40 antagonistic monoclonal antibody, disrupts CD40-related processes in FSGS, potentially preventing rFSGS.

METHODS: A phase 2a, randomized, multicenter, open-label study of adult recipients (aged ≥18 y) of a living or deceased donor kidney transplant with a history of biopsy-proven primary FSGS. The study assessed the efficacy of bleselumab combined with tacrolimus and corticosteroids as maintenance immunosuppression in the prevention of rFSGS >12 mo posttransplantation, versus standard of care (SOC) comprising tacrolimus, mycophenolate mofetil, and corticosteroids. All patients received basiliximab induction. The primary endpoint was rFSGS, defined as proteinuria (protein-creatinine ratio ≥3.0 g/g) with death, graft loss, or loss to follow-up imputed as rFSGS, through 3 mo posttransplant.

RESULTS: Sixty-three patients were followed for 12 mo posttransplantation. Relative decrease in rFSGS occurrence through 3 mo with bleselumab versus SOC was 40.7% (95% confidence interval, -89.8 to 26.8; P = 0.37; absolute decrease 12.7% [95% confidence interval, -34.5 to 9.0]). Central-blinded biopsy review found relative (absolute) decreases in rFSGS of 10.9% (3.9%), 17.0% (6.2%), and 20.5% (7.5%) at 3, 6, and 12 mo posttransplant, respectively; these differences were not statistically significant. Adverse events were similar for both treatments. No deaths occurred during the study.

CONCLUSIONS: In at-risk kidney transplant recipients, bleselumab numerically reduced proteinuria occurrence versus SOC, but no notable difference in occurrence of biopsy-proven rFSGS was observed.

PMID:39042770 | DOI:10.1097/TP.0000000000004985

Holist Nurs Pract. 2024 Jul 23. doi: 10.1097/HNP.0000000000000667. Online ahead of print.

ABSTRACT

The physical and psychological health management of nurses is very important not only for individual nurses but also for organizations and patients. However, nurses are exposed to high stress, sleep problems, and high presenteeism. Therefore, this study aimed to examine the effects of auricular acupressure (AA) on nurses’ stress, sleep problems, and presenteeism. This randomized controlled trial encompassed 60 nurses divided into an experimental group (n = 30) and a control group (n = 30). Auricular acupressure using AA stickers with small magnets attached was performed in the experimental group, and a placebo AA using simple AA stickers (without the small magnets) was performed in the control group. The treatment lasted 7 weeks. To confirm the results, stress, sleep quality, and presenteeism were measured at pre- and posttest. There was a statistically significant difference in scores for sleep quality (t = -1.98, P = .047), health problems (z = -2.38, P = .017), and work impairment (t = -4.46, P < .001) between the experimental and control groups at posttest. Auricular acupressure increased sleep quality scores and decreased presenteeism. Auricular acupressure using AA stickers with small magnets attached was effective in improving sleep quality and reducing presenteeism in nurses.

PMID:39042725 | DOI:10.1097/HNP.0000000000000667

Proc Natl Acad Sci U S A. 2024 Jul 30;121(31):e2322834121. doi: 10.1073/pnas.2322834121. Epub 2024 Jul 23.

ABSTRACT

We developed a generally applicable method, CRISPR/Cas9-targeted long-read sequencing (CTLR-Seq), to resolve, haplotype-specifically, the large and complex regions in the human genome that had been previously impenetrable to sequencing analysis, such as large segmental duplications (SegDups) and their associated genome rearrangements. CTLR-Seq combines in vitro Cas9-mediated cutting of the genome and pulse-field gel electrophoresis to isolate intact large (i.e., up to 2,000 kb) genomic regions that encompass previously unresolvable genomic sequences. These targets are then sequenced (amplification-free) at high on-target coverage using long-read sequencing, allowing for their complete sequence assembly. We applied CTLR-Seq to the SegDup-mediated rearrangements that constitute the boundaries of, and give rise to, the 22q11.2 Deletion Syndrome (22q11DS), the most common human microdeletion disorder. We then performed de novo assembly to resolve, at base-pair resolution, the full sequence rearrangements and exact chromosomal breakpoints of 22q11.2DS (including all common subtypes). Across multiple patients, we found a high degree of variability for both the rearranged SegDup sequences and the exact chromosomal breakpoint locations, which coincide with various transposons within the 22q11.2 SegDups, suggesting that 22q11DS can be driven by transposon-mediated genome recombination. Guided by CTLR-Seq results from two 22q11DS patients, we performed three-dimensional chromosomal folding analysis for the 22q11.2 SegDups from patient-derived neurons and astrocytes and found chromosome interactions anchored within the SegDups to be both cell type-specific and patient-specific. Lastly, we demonstrated that CTLR-Seq enables cell-type specific analysis of DNA methylation patterns within the deletion haplotype of 22q11DS.

PMID:39042694 | DOI:10.1073/pnas.2322834121

Proc Natl Acad Sci U S A. 2024 Jul 30;121(31):e2401162121. doi: 10.1073/pnas.2401162121. Epub 2024 Jul 23.

ABSTRACT

Nonequilibrium states in soft condensed matter require a systematic approach to characterize and model materials, enhancing predictability and applications. Among the tools, X-ray photon correlation spectroscopy (XPCS) provides exceptional temporal and spatial resolution to extract dynamic insight into the properties of the material. However, existing models might overlook intricate details. We introduce an approach for extracting the transport coefficient, denoted as [Formula: see text], from the XPCS studies. This coefficient is a fundamental parameter in nonequilibrium statistical mechanics and is crucial for characterizing transport processes within a system. Our method unifies the Green-Kubo formulas associated with various transport coefficients, including gradient flows, particle-particle interactions, friction matrices, and continuous noise. We achieve this by integrating the collective influence of random and systematic forces acting on the particles within the framework of a Markov chain. We initially validated this method using molecular dynamics simulations of a system subjected to changes in temperatures over time. Subsequently, we conducted further verification using experimental systems reported in the literature and known for their complex nonequilibrium characteristics. The results, including the derived [Formula: see text] and other relevant physical parameters, align with the previous observations and reveal detailed dynamical information in nonequilibrium states. This approach represents an advancement in XPCS analysis, addressing the growing demand to extract intricate nonequilibrium dynamics. Further, the methods presented are agnostic to the nature of the material system and can be potentially expanded to hard condensed matter systems.

PMID:39042671 | DOI:10.1073/pnas.2401162121

PLoS Comput Biol. 2024 Jul 23;20(7):e1012264. doi: 10.1371/journal.pcbi.1012264. Online ahead of print.

ABSTRACT

The role of direct cell-to-cell spread in viral infections-where virions spread between host and susceptible cells without needing to be secreted into the extracellular environment-has come to be understood as essential to the dynamics of medically significant viruses like hepatitis C and influenza. Recent work in both the experimental and mathematical modelling literature has attempted to quantify the prevalence of cell-to-cell infection compared to the conventional free virus route using a variety of methods and experimental data. However, estimates are subject to significant uncertainty and moreover rely on data collected by inhibiting one mode of infection by either chemical or physical factors, which may influence the other mode of infection to an extent which is difficult to quantify. In this work, we conduct a simulation-estimation study to probe the practical identifiability of the proportion of cell-to-cell infection, using two standard mathematical models and synthetic data that would likely be realistic to obtain in the laboratory. We show that this quantity cannot be estimated using non-spatial data alone, and that the collection of a data which describes the spatial structure of the infection is necessary to infer the proportion of cell-to-cell infection. Our results provide guidance for the design of relevant experiments and mathematical tools for accurately inferring the prevalence of cell-to-cell infection in in vitro and in vivo contexts.

PMID:39042664 | DOI:10.1371/journal.pcbi.1012264

PLoS One. 2024 Jul 23;19(7):e0307141. doi: 10.1371/journal.pone.0307141. eCollection 2024.

ABSTRACT

BACKGROUND: Internal migration is an important part of the transition to adulthood for many young people in sub-Saharan Africa. This study examines how migration, in relation to marriage and parenthood, impacts modern contraceptive use and health facility visits amongst young urban women.

METHODS: We draw on Performance Monitoring for Action (PMA) surveys conducted in Burkina Faso, Côte d’Ivoire, Democratic Republic of Congo, Kenya, Nigeria, and Uganda (2019-2022). Our analysis is unique in being able to adjust for whether women wanted to get pregnant soon. Our sample includes women ages 15-24 years currently residing in urban areas (n = 6,225). We conducted logistic regression models clustered by village level identifier to explore the sequence of life events and the timing of migration in relation to current modern contraceptive use and recent health facility visit, a proxy for engagement with formal health services.

RESULTS: The timing of migration matters more than the sequence of these life events. Young urban women who experienced both migration and a birth, regardless of the order, had increased contraceptive use and recent health facility visit, compared to women who had only experienced one event or neither. Young women who migrated in the past year had 24% lower odds of using a modern method (Odds Ratio = 0.76; 95% confidence interval 0.63, 0.91), adjusting for demographic factors and adjusting for fertility preference (Wanting to get pregnant soon). Having had a birth was highly significant for health facility visit and among women who had had a birth, those who migrated in the last year had lower odds of a recent visit (OR = 0.68, 95% CI 0.41, 0.89). Results suggest an initially disruptive effect of migration.

DISCUSSION: Our results suggest young women who recently migrated to urban areas may need additional support in accessing contraception and formal health services for themselves or their children.

PMID:39042650 | DOI:10.1371/journal.pone.0307141

PLoS One. 2024 Jul 23;19(7):e0301319. doi: 10.1371/journal.pone.0301319. eCollection 2024.

ABSTRACT

BACKGROUND: Heart failure (HF) is becoming a growing public health concern. Diagnostic tests for determining the severity of HF often come with high costs and require specialized expertise, which makes it difficult to assess HF severity, especially in low-income countries or at primary healthcare facilities. Recently, red blood cell distribution width (RDW) has emerged as a promising, easily accessible marker associated with HF severity. The study aimed to assess changes in RDW levels in HF patients and the diagnostic value of RDW in detecting acute heart failure (AHF) among HF patients.

METHODS: We conducted a cross-sectional examination involving 351 participants divided into HF and non-HF cohorts. HF was defined and categorized according to the diagnostic and treatment guidelines for AHF and chronic heart failure (CHF) set forth by the European Society of Cardiology (2021). Univariate and multivariate analysis of factors associated with AHF was performed.

RESULTS: The study revealed that HF patients displayed higher median RDW levels (14.90% [13.70-17.00]) compared to non-HF individuals (13.00% [12.23-13.78]). RDW was notably elevated in HF patients with left ventricular ejection fraction < 50% compared to those with left ventricular ejection fraction ≥ 50%. ROC curve analysis of RDW for AHF detection identified a cutoff value of 13.85%, with a sensitivity of 86.05% and specificity of 47.18%, statistically significant at p < 0.001. RDW > 13.85% was identified as an independent risk factor for AHF in patients with HF, with odds ratios of 2.644 (95% CI, 1.190-5.875; p = 0.017).

CONCLUSION: The study revealed significant RDW variations in patients with CHF and AHF compared to the control group. These findings suggest that RDW could be a biomarker for detecting HF severity.

PMID:39042640 | DOI:10.1371/journal.pone.0301319