bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of billing reforms on academic hospitalist physician and advanced practice provider collaboration: A qualitative study
Authors: Westergaard Sara , Bowden Kasey , Astik Gopi J. , Bowling Greg , Keniston Angela , Linker Anne , Sakumoto Matthew , Schwatka Natalie , Auerbach Andrew , Burden Marisha
Published: April 2024

Background

Medicare previously announced plans for new billing reforms for inpatient visits that are shared by physicians and advanced practice providers (APPs) whereby the clinician spending the most time on the patient visit would bill for the visit.

Objective

To understand how inpatient hospital medicine teams utilize APPs in patient care and how the proposed billing policies might impact future APP utilization.

Design, Setting and Participants

We conducted focus groups with hospitalist physicians, APPs, and other leaders from 21 academic hospitals across the United States. Utilizing rapid qualitative methods, focus groups were analyzed using a mixed inductive and deductive method at the semantic level with templated summaries and matrix analysis. Thirty‐three individuals (physicians [n = 21], APPs [n = 10], practice manager [n = 1], and patient representative [n = 1]) participated in six focus groups.

Results

Four themes emerged from the analysis of the focus groups, including: (1) staffing models with APPs are rapidly evolving, (2) these changes were felt to be driven by staffing shortages, financial models, and governance with minimal consideration to teamwork and relationships, (3) time‐based billing was perceived to value tasks over cognitive workload, and (4) that the proposed billing changes may create unintended consequences impacting collaboration and professional satisfaction.

Conclusions

Physician and APP collaborative care models are increasingly evolving to independent visits often driven by workloads, financial drivers, and local regulations such as medical staff rules and hospital bylaws. Understanding which staffing models produce optimal patient, clinician, and organizational outcomes should inform billing policies rather than the reverse.
Valorization of cell wall polysaccharides extracted from Liubao brick tea residues: chemical, structural, and hypoglycemic properties
Authors: Wang Li , Chi En‐Zhong , Zhao Xin‐Huai
Published: April 2024

BACKGROUND

Tea dregs, typically generated during the production of instant tea or tea beverages, have conventionally been regarded as waste material and routinely discarded. Nevertheless, contemporary research endeavors are concentrating on discovering efficient methods for utilizing the potential of this discarded resource.

RESULTS

In this study, we employed a sequential extraction method using chemical chelating agents to extract and isolate four distinct cell wall polysaccharides, designated as CWTPS‐1 through CWTPS‐4, from the tea dregs of Liubao brick tea. A comprehensive investigation into their physicochemical, structural, and hypoglycemic properties was conducted. The analysis of chemical composition and physicochemical characteristics revealed that all four CWTPSs were characterized as acidic polysaccharides, albeit with varying chemical compositions and physicochemical attributes. Specifically, the xyloglucan fractions, CWTPS‐3 and CWTPS‐4, were found to be rich in glucose and xylose, displaying a more uniform molecular weight distribution, greater structural stability, and a more irregular surface compared to the others. Moreover, they exhibited a higher diversity of monosaccharide residues. Importantly, our research unveiled that all four CWTPSs exhibited the capacity to modulate key glucose‐regulated and antioxidant enzyme activities within HepG2 cells via the IRS‐1‐PI3K/AKT signaling pathway, thereby ameliorating cellular insulin resistance. Furthermore, our correlation analysis highlighted significant associations between monosaccharide composition and neutral sugar content with the observed hypoglycemic activity of CWTPSs.

CONCLUSION

This study highlights the potential of utilizing tea dregs as a valuable resource, making a significant contribution to the advancement of the tea industry. Furthermore, CWTPS‐4 exhibits promising prospects for further development as a functional food ingredient or additive. © 2024 Society of Chemical Industry.
Lip necrosis caused by methicillin‐resistant Staphylococcus aureus (MRSA)
Authors: Khayat Saad , Agea Martínez Marc , Tousidonis Rial Manuel , Diez Montiel Alberto , Ochandiano Caicoya Santiago
Published: April 2024

Labial necrosis is a rare condition with diverse causes, posing challenges for diagnosis and treatment. Methicillin‐resistant Staphylococcus aureus (MRSA) strains, particularly those positive for Panton‐Valentine leukocidin (PVL), further complicate management due to antibiotic resistance and heightened virulence. We present three cases of labial necrosis caused by MRSA, two of which resulted positive for PVL. The first case involved a 35‐year‐old male with persistent lip edema and inflammation, which progressed despite various treatments. MRSA was isolated, and the patient responded to daptomycin and clindamycin therapy. The second case featured a 38‐year‐old male with intense lip pain and swelling, initially misdiagnosed as angioedema. The patient improved after treatment with daptomycin and clindamycin, along with nasal decolonization. The third case involved a 19‐year‐old male with rapid upper lip swelling following manipulation of a boil. Prompt drainage and antibiotic treatment led to complete resolution. These cases underscore the importance of considering MRSA and PVL‐positive S. aureus as potential etiologies in labial necrosis, especially in young individuals without underlying medical conditions. Effective management involves incision and drainage, complemented by antibiotic therapy tailored to drug resistance and virulence factors.
Urease stabilization in urea–urease–H+ system and its influence on the clock reaction dynamics
Authors: Yang Dan , Zhang Hua , Cao Fengyi , Chang Sijia , Tan Guihao , Ji Lin
Published: April 2024

The inherent autocatalytic kinetics of the urea–urease–H+ system positions it as a promising candidate for the design of dynamic materials with time‐domain programmable functions. Nevertheless, the stability of the enzyme can markedly influence the temporal evolution dynamics of the system and curtail its widespread applicability. This work employs several kinds of enzyme stabilization methods, including chemical cross‐linking, physical coating, solvent stabilization, and solvent‐physical coating co‐modification, to systematically explore the impact of enzyme stabilization on clock reaction dynamics. Extensive experimental tests and analysis indicate that solvent and chemical cross‐linking stabilization methods can better preserve clock dynamics with sensitive switching ability. Nevertheless, due to significant pH changes in the reacting system, the reusability of the enzyme is better retained in the physical coating and solvent‐physical coating co‐modification methods.
Unraveling the nexus of academic founders and innovation performance: The suppression effect of ownership structure within Sci‐Tech enterprises
Authors: Li Zhiguang , Li Yaokuang , Li Xiao
Published: April 2024

This paper aims to examine the influence of academic founders on firm innovation performance from the perspective of equity distribution in entrepreneurial teams. Based on the prospectus data of 466 science and technology enterprises that applied for registration on the STAR Market from 2016 to 2020, we use textual analysis to classify founder identities into academic founder, technical founder, and business founder. Our results show that the performance of technical innovation in Sci‐Tech enterprises is optimal for academic founder‐led firms, followed by technical founders, and finally business founders. Ownership structure suppresses the positive direct relationship between the academic founder and innovation performance.
Overview of application of automated SEM/EDS measurements for inclusion characterization in steelmaking
Authors: Babu Shashank Ramesh , Michelic Susanne K.
Published: April 2024

The scanning electron microscope equipped with an energy dispersive spectroscopy (SEM/EDS) is considered as a state‐of‐the‐art characterization tool to determine the morphological features and the chemical composition of non‐metallic inclusions in steel. Such a characterization is pivotal to assessing the steel quality, which influences the properties of end products. This paper offers a comprehensive review of the SEM/EDS system, tracing its historical developments and methodological advancements by various research groups which have contributed to non‐metallic inclusion analysis. Then the discussions transition to developments that have matured the SEM/EDS platform. The paper highlights selected examples utilizing the SEM/EDS to examine inclusions across various steel grades and at different stages of the metallurgical process. Finally, latest advancements in integrating machine learning techniques to expedite the analysis process were discussed.
Technical note: Visual, rapid, scintillation point dosimetry for in vivo MV photon beam radiotherapy treatments
Authors: Decker Savannah M. , Bruza Petr , Zhang Rongxiao , Williams Benjamin B. , Jarvis Lesley A. , Pogue Brian W. , Gladstone David J.
Published: April 2024

Background

While careful planning and pre‐treatment checks are performed to ensure patient safety during external beam radiation therapy (EBRT), inevitable daily variations mean that in vivo dosimetry (IVD) is the only way to attain the true delivered dose. Several countries outside the US require daily IVD for quality assurance. However, elsewhere, the manual labor and time considerations of traditional in vivo dosimeters may be preventing frequent use of IVD in the clinic.

Purpose

This study expands upon previous research using plastic scintillator discs for optical dosimetry for electron therapy treatments. We present the characterization of scintillator discs for in vivo x‐ray dosimetry and describe additional considerations due to geometric complexities.

Methods

Plastic scintillator discs were coated with reflective white paint on all sides but the front surface. An anti‐reflective, matte coating was applied to the transparent face to minimize specular reflection. A time‐gated iCMOS camera imaged the discs under various irradiation conditions. In post‐processing, background‐subtracted images of the scintillators were fit with Gaussian‐convolved ellipses to extract several parameters, including integral output, and observation angle.

Results

Dose linearity and x‐ray energy independence were observed, consistent with ideal characteristics for a dosimeter. Dose measurements exhibited less than 5% variation for incident beam angles between 0° and 75° at the anterior surface and 0–60 at the posterior surface for exit beam dosimetry. Varying the angle between the disc surface and the camera lens did not impact the integral output for the same dose up to 55°. Past this point, up to 75°, there is a sharp falloff in response; however, a correction can be used based on the detected width of the disc. The reproducibility of the integral output for a single disc is 2%, and combined with variations from the gantry angle, we report the accuracy of the proposed scintillator disc dosimeters as ±5.4%.

Conclusions

Plastic scintillator discs have characteristics that are well‐suited for in vivo optical dosimetry for x‐ray radiotherapy treatments. Unlike typical point dosimeters, there is no inherent readout time delay, and an optical recording of the measurement is saved after treatment for future reference. While several factors influence the integral output for the same dose, they have been quantified here and may be corrected in post‐processing.
Highly Transparent and Flexible Multiwalled Carbon Nanotube–Polyimide Films with Enhanced Electrical Performance as Promising Electrodes
Authors: Oh Yoonju , Song Seunghyun , Li Man , Bae Joonho
Published: April 2024

Transparent and light films with high electrical conductivity are preferred for flexible electronic applications. Here, a film exhibiting high transparency, electrical conductivity, and flexibility is produced using a polyimide (PI) substrate and multiwalled carbon nanotubes (MWCNTs) through spray coating. Cost‐effective MWCNTs are used instead of other electrically conductive materials, including silver nanowire ink, single‐walled carbon nanotubes (SWCNTs), and other carbon materials. The average sheet resistance of the prepared MWCNT–PI film is 520.2 Ω □−1 (infinite for the bare PI film), which is lower than the sheet resistances of the SWCNT–PI film reported by another group. This can be attributed to the increase in electrical conductivity of the highly transparent PI film due to the use of MWCNTs. The transparency of the MWCNT–PI film is 71.834% at 550 nm. When MWCNTs and PI are combined, MWCNTs protrude from the surface of the PI film, creating networks and increasing electrical conductivity. Atomic force microscopy analysis reveals that MWCNT networks form on the surface of the MWCNT–PI film. This study suggests the possibility that MWCNTs can also be used as carbon materials for flexible and highly transparent films.
Optical design and bandgap engineering in ultrathin multiple quantum well solar cell featuring photonic nanocavity
Authors: Meddeb Hosni , Gehrke Kai , Vehse Martin
Published: April 2024

Ultrathin solar cells are efficient and captivating devices with unique technological and scientific features in terms of minimal material consumption, fast fabrication processes, and good compatibility with semi‐transparent applications. Such photovoltaic (PV) technologies can enable effective synergy between optical and electronic confinements with large tuning capabilities of all the optoelectronic characteristics. In this work, the implications of the optical design and the bandgap engineering in ultrathin hydrogenated amorphous Si/Ge multiple quantum well (MQW) solar cells featuring photonic nanocavity are analyzed based on experimental measurements and optoelectronic modelling. By changing the period thicknesses and the positions of QWs inside the deep‐subwavelength nanophotonic resonator, the spatial and spectral distributions of the optical field and the local absorption are strongly affected. This leads to a modulation of the absorption resonance condition, the absorption edge and the resulting photocurrent outputs. Because of quantum confinement effect, the change of MQW configurations with different individual QW periods while keeping similar total thickness of about 20 nm alters both the bandgap energy and the band offset at the QW/barrier heterojunctions. This in turn controls the photovoltage as well as the carrier collection efficiency in solar cells. The highest open circuit voltage and fill factor values are achieved by employing MQW device configuration with 2.5 nm‐thin QWs. A record efficiency above 5.5% is reached for such emerging ultrathin Si/Ge MQW solar cell technology using thinner QWs with sufficient number, because of the optimum trade‐off between all the optoelectronic characteristic outputs. The presented design rules for opaque ultrathin solar cells with quantum‐confined nanostructures integrated in a photonic nanocavity can be generalized for the engineering of relevant multifunctional semitransparent PV devices.
Metabolite profiling of foslevodopa/foscarbidopa in plasma of healthy human participants by LC‐HRMS indicates no major differences compared to administration of levodopa/carbidopa intestinal gel
Authors: Savaryn John P. , Smith Richard L. , Rosebraugh Matthew , Neenan Melina , Burton Richard , Marsh Kennan , Wagner David
Published: April 2024

Analysis was conducted to compare levodopa/carbidopa pharmacokinetics and drug‐related material in plasma of healthy participants after receiving a continuous infusion of Levodopa/Carbidopa Intestinal Gel (LCIG) to a continuous subcutaneous infusion of foslevodopa/foscarbidopa. Study samples were from a randomized, open‐label, 2‐period crossover study in 20 healthy participants. Participants received either 24‐h foslevodopa/foscarbidopa SC infusion to the abdomen or LCIG delivered for 24 h to the jejunum through a nasogastric tube with jejunal extension. Serial blood samples were collected for PK. Comparability of the LD PK parameters between the two treatment regimens was determined. Selected plasma samples were pooled per treatment group and per time point for metabolite profiling. LC–MSn was performed using high‐resolution mass spectrometry to identify drug‐related material across the dosing regimens and time points. The LD PK parameter central values and 90% confidence intervals following the foslevodopa/foscarbidopa subcutaneous infusion were between 0.8 and 1.25 relative to the LCIG infusion. With LCIG administration, LD, CD, 3‐OMD, DHPA, DOPAC, and vanillacetic acid were identified in plasma at early and late time points (0.75 and 24 h); the metabolic profile after administration of foslevodopa/foscarbidopa demonstrated the same drug‐related compounds with the exception of the administered foslevodopa. 3‐OMD and vanillacetic acid levels increased over time in both treatment regimens. Relative quantification of LC–MS peak areas showed no major differences in the metabolite profiles. These results indicate that neither the addition of monophosphate prodrug moieties nor SC administration affects the circulating metabolite profile of foslevodopa/foscarbidopa compared to LCIG.
Neutron Reflectivity for Testing Graphene Oxide Films Sorption of EuCl3 in Ethanol Solution
Authors: Nordenström Andreas , Boulanger Nicolas , Vorobiev Alexey , Amidani Lucia , Bauters Stephen , Galanzew Jurij , Kvashnina Kristina , Talyzin Alexandr
Published: April 2024

Neutron reflectivity (NR) was used to study the sorption of Eu(III) by graphene oxide (GO) films exposed to ethanol solution of EuCl3. Most of the earlier sorption studies have been performed using GO dispersed in solution. In contrast, layered structure of GO films imposes limitations for penetration of ions between individual sheets. The analysis of NR data recorded before and after sorption under vacuum demonstrates an increase of GO film thickness due to sorption by 35–40%. The characterization of chemical state of Eu(III) sorbed by GO films by X‐ray absorption near‐edge structure (XANES) in high‐energy resolution fluorescence detection (HERFD) method at the Eu L3 edge reveals that it remains the same as in anhydrous EuCl3. Analysis of all collected data including reference experiments with bulk GO samples allows to conclude that EuCl3 penetrates into GO interlayers with ethanol solution and remains trapped in interlayers after evaporation of ethanol. Sorption of EuCl3 results in nearly complete amorphization of film and likely formation of voids, thus making NR models based on specific volume of unit cell not valid for quantitative evaluation of Eu sorption. Limitations of NR method must be taken into account in future studies of sorption by thin films.
Adaptive tracking control of nonlinear systems with unknown time‐varying parameters via a monotonically increasing function
Authors: Liu Guoqing , Chen Yang‐Yang
Published: April 2024

This article considers the adaptive tracking control problem of a class of strict feedback nonlinear systems with unknown time‐varying parameters. Note that the recent adaptive method, that is, congelation of variables, is built upon the assumption that the known basis functions are zeros as zero states. To remove this assumption, a novel monotonically increasing function is designed to transform the output tracking error and the backstepping tracking errors into increasing forms, which is integrated into the congelation of variables to design the ‐modification adaptive tracking control law. It is noted that the proposed form of monotonically increasing function is general, which includes positive proportional functions, exponential functions, and logarithmic functions and so on. To yield the boundedness of increasing tracking errors, a barrier Lyapunov function is designed. The asymptotic convergence of the resulting adaptive tracking system is analyzed in detail. Simulations demonstrate the effectiveness of the proposed method.
Creation of Quasi‐DNA Origami at the Air/Water Interface Using the Collapsed Mechanism of Langmuir Monolayer
Authors: Maeda Momo , Shioda Yoshiki , Fujimori Atsuhiro
Published: April 2024

It has achieved the preparation of quasi‐deoxyribonucleic acid (DNA) origami using the techniques of organized molecular films. After the adsorption of DNA from the subphase onto a Langmuir monolayer of polymers containing diamino‐s‐triazine rings, the monolayer collapses owing to high surface pressure, resulting in the formation of a three‐dimensional folded structure of DNA. A homopolymer featuring a diamino‐s‐triazine ring and a copolymer containing 20 % long alkyl chains are used to form the Langmuir monolayer. A‐T base pairs of salmon testis‐derived DNA from the subphase are hydrogen‐bonded and adsorbed onto each Langmuir monolayer. Following the collapse of the Langmuir monolayer, the film height almost doubles, indicating the formation of a bilayer structure consisting of a bioadsorbed polymer monolayer, especially evident in copolymer‐collapsed films. During this period, the bioconjugated bilayer structure adopts a mesoscopic linear morphology within the plane. In this quasi‐DNA origami structure, the chirality in the DNA molecule is maintained, as evidenced by the circular dichroism (CD) spectra displaying a positive Cotton effect. These results correspond to the proposal of a new DNA morphology control technology.
Dual‐Track Multifunctional Bimetallic Metal‐Organic Frameworks for Antibiotic Enrichment and Detection
Authors: Dong Yiming , Feng Niu , Liu Puyue , Wei Qiaoling , Peng Xuewen , Jiang Feng , Chen Yiping
Published: April 2024

The improper use and overuse of antibiotics have led to significant burdens and detrimental effects on the environment, food supply, and human health. Herein, a magnetic solid‐phase extraction program and an optical immunosensor based on bimetallic Ce/Zr‐UiO 66 for the detection of antibiotics are developed. A magnetic Fe3O4@SiO2@Ce/Zr‐UiO 66 metal‐organic framework (MOF) is prepared to extract and enrich chloramphenicol from fish, wastewater, and urine samples, and a horseradish peroxidase (HRP)‐Ce/Zr‐UiO 66@bovine serum protein‐chloramphenicol probe is used for the sensitive detection of chloramphenicol based on the dual‐effect catalysis of Ce and HRP. In this manner, the application of Ce/Zr‐UiO 66 in integrating sample pretreatment and antibiotic detection is systematically investigated and the associated mechanisms are explored. It is concluded that Ce/Zr‐UiO 66 is a versatile dual‐track material exhibiting high enrichment efficiency (6.37 mg g−1) and high sensitivity (limit of detection of 51.3 pg mL−1) for chloramphenicol detection and serving as a multifunctional MOF for safeguarding public health and hygiene.
The Nanoscale Structure and Stability of Organic Photovoltaic Blends Processed with Solvent Additives
Authors: Kilbride Rachel C. , Spooner Emma L. K. , Burg Stephanie L. , Oliveira Bárbara L. , Charas Ana , Bernardo Gabriel , Dalgliesh Robert , King Stephen , Lidzey David G. , Jones Richard A. L. , Parnell Andrew J.
Published: April 2024

Controlling the nanomorphology in bulk heterojunction photoactive blends is crucial for optimizing the performance and stability of organic photovoltaic (OPV) technologies. A promising approach is to alter the drying dynamics and consequently, the nanostructure of the blend film using solvent additives such as 1,8‐diiodooctane (DIO). Although this approach is demonstrated extensively for OPV systems incorporating fullerene‐based acceptors, it is unclear how solvent additive processing influences the morphology and stability of nonfullerene acceptor (NFA) systems. Here, small angle neutron scattering (SANS) is used to probe the nanomorphology of two model OPV systems processed with DIO: a fullerene‐based system (PBDB‐T:PC71BM) and an NFA‐based system (PBDB‐T:ITIC). To overcome the low intrinsic neutron scattering length density contrast in polymer:NFA blend films, the synthesis of a deuterated NFA analog (ITIC‐d52) is reported. Using SANS, new insights into the nanoscale evolution of fullerene and NFA‐based systems are provided by characterizing films immediately after fabrication, after thermal annealing, and after aging for 1 year. It is found that DIO processing influences fullerene and NFA‐based systems differently with NFA‐based systems characterized by more phase‐separated domains. After long‐term aging, SANS reveals both systems demonstrate some level of thermodynamic induced domain coarsening.
Deprotonated of layered double hydroxides during electrocatalytic water oxidation for multi‐cations intercalation
Authors: Jin Bowen , Gao Jianxiong , Zhang Yunqi , Shao Mingfei
Published: April 2024

Aqueous rechargeable batteries using abundant multi‐ion cations have received increasing attention in the energy storage field for their high safety and low cost. Layered double hydroxides (LDHs) possess a two‐dimensional structure and exhibit great potential as cathodes for multi‐ion intercalation. However, the insufficient active sites of LDHs result in low capacities in the discharging process. Interestingly, the LDHs after the deprotonation process exhibit favorable electrochemical performance of multi‐cation intercalation. The deprotonation process of LDHs has been widely found in the oxygen evolution reaction and energy storage field, where LDHs lose H in laminates and converts to deprotonated γ‐phase MOOHs (MOOs). Herein, we take a comprehensive overview of the dynamics structure transformation of the deprotonation process of LDHs. Furthermore, the development of advanced aqueous battery cathode and metal battery anode based on deprotonated LDHs for energy storage is explored and summarized. Finally, the perspective of deprotonated LDHs in the energy storage field is discussed.
Phosphorus recycling and loss from compost‐amended urban gardens: Results from a 7‐year study
Authors: Small Gaston E. , Shrestha Paliza , Zeiner Carolyn , Barabás György , Metson Geneviève Suzanne
Published: April 2024

Urban vegetable gardens provide an opportunity to recycle nutrients from food waste back into the human food system through the application of compost. However, a reliance on compost for soil fertility can lead to excess phosphorus (P) inputs that can build up in garden soil and potentially be exported via leachate or runoff. We report the results of a 7‐year experiment in a campus research garden in which replicated raised‐bed garden plots received manure‐based compost or municipal compost that was applied at a higher rate targeted to meet crop nitrogen demand or a lower rate targeted to meet crop P demand. Control plots received either no soil inputs or targeted synthetic fertilizer. Higher input treatments for both types of composts showed steadily increasing concentrations of soil plant‐available P, with a corresponding increase in leachate phosphate concentration. For both higher input compost treatments, approximately 30% of P added as compost was recovered in harvested crops over the 7‐year period, compared to >88% in the lower input compost treatments. In both high‐ and low‐input manure compost treatments, export of P as leachate accounted for approximately 10% of total P input, compared to 4% for the municipal compost. Over the 7‐year study period, P exported as leachate ranged from 0.8 g P/m2 in the no‐input treatments to 6.5 g P/m2 in the higher input manure compost treatments. These results show that tradeoffs are not inevitable as targeted compost applications can lead to high yield and low leachate export.
Seasonal investigation of the macroscopic and microscopic structure of the sinus interdigitalis in Hamdani crossbred sheep (Ovis aries)
Authors: Işbilir Fatma , Özgüden Akkoç Cansel Güzin , Kirman Günsel , Özöner Özgür , Özöner Merve Pekince , Işbilir Ihsan , Gülendağ Erman , Gülaydin Ali , Arican İlker
Published: April 2024

Background

The odours of different body parts and structures, such as external genitalia, female urine, ventral tail radix, infraorbital sinus and interdigital sinus, have a strong attractiveness for rams. The sinus interdigitalis is considered an important trail gland for sexual behaviour, as its odour is included in the list of strongly attractive structures for male animals during the breeding season, being important in pheromone production.

Objectives

In the present study, the effects of sex and breeding season on the morphological and histological structure of the interdigital gland were investigated in Hamdani crossbred sheep (Ovis aries).

Methods

Sinus interdigitalis glands located on the forelimbs and hind limbs were collected from 10 male and 10 female sheep during both breeding and non‐breeding seasons. The gland's position in the forelimbs and hind limbs was determined radiographically. The glands were examined macroscopically, histologically and immunohistochemically in both seasons.

Results

In all animals, the topographic location of the gland between the digits was determined to be distal to the phalanx proximalis and at the level of the phalanx media. The mean weight of the gland in male and female animals was 1.07 ± 0.03 and 1.4 ± 0.11 g, respectively. In general, the results of morphometric measurements were higher during the breeding season, and the increase was more pronounced in female animals. In histological examinations, it was determined that both neck and body parts of the tissues consisted of a structure consisting of a connective tissue capsule at the outermost, dermis, epidermis and lumen underneath. Immunohistochemically staining revealed that oestrogen receptors showed positive immunoreactions only in the intracytoplasmic localization of apocrine sweat glands. In terms of morphological, histological and oestrogen receptors, it was thought that the gland may play a role in sexual communication.
Suspected multiple autoimmune syndrome in a Kelpie with hypoadrenocorticism
Authors: Cleary Kimberly
Published: April 2024

An 8‐year‐old, female, spayed Kelpie cross presented with hyporexia, pica, vomiting, collapse and seizures. It was diagnosed with eunatraemic, eukalaemic hypoadrenocorticism, immune‐mediated anaemia and immune‐mediated thrombocytopenia, possibly representing an example of multiple autoimmune syndrome type 3. All abnormalities resolved and the patient was alive nearly 3 years later, maintained on physiological doses of prednisolone. This case serves as a reminder of the variable presentations of eunatraemic, eukalaemic hypoadrenocorticism and the potential for concurrent immune‐mediated disease.
Pregnancy and infertility in orthopedics: A review of the current state
Authors: Kermanshahi Nazanin , Hartman Hayden , Matzkin Elizabeth , Gianakos Arianna L.
Published: April 2024

Background

Orthopedic surgery continues to have one of the lowest rates of female trainees among all medical specialties in the United States. Barriers to pursuing a surgical residency include the challenges of family planning and work–life balance during training.

Methods

A systematic literature search of articles published between June 2012 and December 2022 in the MEDLINE, EMBASE, and Cochrane databases was performed in January 2023 according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analysis). Studies were included if they evaluated pregnancy and peripartum experience and/or outcomes amongst orthopedic surgeons or trainees.

Results

Eighteen studies were included. Up to 67.3% of female orthopedic surgeons and trainees and 38.7% of their male counterparts delayed childbearing during residency. The most reported reasons for this delay included career choice as an orthopedic surgeon, residency training, and reputational concerns among faculty or co‐residents. Infertility ranged from 17.0% to 30.4% in female orthopedic surgeons and up to 31.2% suffered obstetric complications. Assisted Reproductive Technology (ART) resulted in 12.4%–56.3% of successful pregnancies. Maternity and paternity leaves ranged from 1 to 11 weeks for trainees with more negative attitudes associated with maternal leave.

Conclusions

Female orthopedic trainees and attending delay childbearing, experience higher rates of obstetric complications, and more stigma associated with pregnancy compared to their male colleagues. Program and institutional policies regarding maternity and paternity leave are variable across programs, and therefore, attention should be directed toward standardizing policies.
Bone Marrow Harvesting for HCT
Authors: Gorin Norbert Claude , Carreras Enric , Fernández-Sojo Jesús , Villa Juliana
Published: April 2024

This chapter analyses the technique of bone marrow (BM) collection, major and minor complications of this procedure as well as advantatges and disadvantatges of bone marrow over peripheral blood (PB) stem cells.
Nutritional Support
Authors: Baumgartner Annic , Schuetz Philipp
Published: April 2024

Patients undergoing HCT, particularly allo-HCT, are at risk for malnutrition (Fuji et al., Food Nutr Sci 3:417–421, 2012).

Based on “Supportive Care” in EBMT Handbook, 2009, by Tamás Masszi and Arno Mank.
Infection Control and Isolation Procedures
Authors: Mikulska Malgorzata
Published: April 2024

Infection control is defined as a set of measures aimed at preventing or stopping the spread of infections in healthcare settings. Isolation procedures are a set of standard recommendations designed to reduce the risk of transmission of different infectious agents from body fluids or environmental surfaces.
General Management of the Patient: Specific Aspects of Infectious Disease Supportive Care in Children
Authors: Castagnola Elio , Groll Andreas H.
Published: April 2024

Many of the conditions requiring allogeneic HCT and related complications are similar in adults and children and are covered in other chapters of this handbook. However, there are a few exceptions where approaches to management can be different.
Registries: A Bridge Between Donor and Recipient
Authors: Evseeva Irina , Foeken Lydia , Villa Juliana
Published: April 2024

Registries strive for a world where access to life-saving cellular therapies for all patients is assured and donors’ rights and safety are protected. Through the World Marrow Donor Association (WMDA), registries work together to ensure reliable provision of cells and are crucial partners for the clinical community in facilitating HCT and other cellular therapies.
Ethical Issues in HCT
Authors: El-Ghariani Khaled , Dalle Jean-Hugues
Published: April 2024

Ethics is a branch of philosophy, and, like mathematics, moral philosophy does not give ready-made answers to questions but teaches how one could systematically analyse and resolve a problem.
Quality of Life Assessment After HCT for Pediatric and Adults
Authors: Barata Anna , Jim Heather
Published: April 2024

Methodological advances in the HCT field have increased the population of survivors worldwide. However, HCT is associated with significant morbidity that impairs survivors’ recovery and adversely affects their quality of life (QoL).
Secondary Neoplasia (Other Than PTLPS)
Authors: Tichelli André , Rovó Alicia
Published: April 2024

Secondary Neoplasia (SN) after HCT belong to the most feared long-term complications. They include any malignant disorder occurring after HCT. There are three types of SN: therapy-related myeloid neoplasms, occurring mainly after auto-HCT; donor-derived malignancies after allo-HCT; and second solid neoplasms after either auto- or allo-HCT. Many of these SN have a higher incidence compared to the general population. In this chapter, pathophysiology issues, risk factors, screening and management recommendations are discussed. Since SN can occur even decades after HCT, life-long surveillance is needed.
Endocrine Disorders, Fertility, and Sexual Health
Authors: Salooja Nina , Rovó Alicia , Dalle Jean-Hugues
Published: April 2024

Increasing numbers of HCT are being performed annually and outcomes continue to improve. As a result, survivorship issues are assuming increasing importance. Chemotherapy and radiotherapy remain cornerstones of HCT treatment, but, while lifesaving, they threaten endocrine function, fertility, and sexual function.
Photopheresis in Adults and Pediatrics
Authors: Greinix Hildegard
Published: April 2024

Extracorporeal photopheresis (ECP) is a leukapheresis-based treatment that has been used during the last decades by many clinicians.
HCT in Elderly Patients
Authors: Duarte Rafael F. , Sánchez-Ortega Isabel
Published: April 2024

The hematological malignancies, which are the most common indications for auto- and allo-HCT (e.g., AML/MDS, NHL, MM, and others), are diagnosed at a median age greater than 65 years. Thus, if classical chronological age exclusion criteria were followed, a majority of patients with these malignancies would not be offered a HCT, despite it being their treatment of choice and in many cases their only curative option (Snowden et al. 2022). While elderly patients are more likely to face toxic effects from HCT, this risk must be considered and balanced against the poor outcome of transplant candidates with these malignancies who do not proceed to HCT (Dohner et al. 2022).
Myeloproliferative Neoplasms
Authors: Kröger Nicolaus , McLornan Donal P. , Chalandon Yves
Published: April 2024

Polycythemia vera (PV) and essential thrombocythemia (ET) have a favorable outcome without need for allo-HCT unless the disease has progressed to post-ET/PV myelofibrosis or secondary AML (Lussana et al. 2014).
Fanconi Anemia and Other Hereditary Bone Marrow Failure Syndromes
Authors: Diaz-de-Heredia Cristina , Bierings Marc , Dalle Jean-Hugues , Fioredda Francesca , Strahm Brigitte
Published: April 2024

Inherited bone marrow failure syndromes (IBMFS) are a heterogeneous group of rare blood disorders due to hematopoiesis impairment, with different clinical presentations and pathogenic mechanisms. Some patients present with congenital malformations, may progress through clonal evolution (myelodisplasia, MDS and acute leukemia, AL) and are at risk for solid tumors at early ages. With the rapid evolution of diagnostic accuracy, the number of identified genetic defects rises annually. HCT is a curative treatment for these congenital disorders. However, it should be well understood that it will only correct the hematopoietic deficiency and will not cure the congenital malformations or reduce the risk of solid tumors. Moreover, HCT per se may increase this risk additionally. Consequently, the decision to transplant a patient should be taken by a multidisciplinary team. HCT must be performed at specialized centers owing to patient susceptibilities to toxicity and the need for specific management during and after the procedure. The general recommendations for management of IBMFS are included in the key points at the end of the chapter.
Systemic Light Chain Amyloidosis
Authors: Minnema Monique , Schönland Stefan
Published: April 2024

Systemic light chain (AL) amyloidosis is a rare protein misfolding and deposition disorder. Clonal plasma cells or rarely B cells produce immunoglobulin light chains with the potential to misfold. Treatment is clone directed with the goal to achieve a complete or at least very good hematological remission. AutoHCT is an option in a selected group of patients. Results from cellular therapies are encouraging and will play an important role in the future.
Hydrodynamization in hybrid Bjorken flow attractors
Authors: Mitra Toshali , Mondkar Sukrut , Mukhopadhyay Ayan , Rebhan Anton , Soloviev Alexander
Published: April 2024

Abstract

Hybrid fluid models, consisting of two sectors with more weakly and more strongly self-interacting degrees of freedom coupled consistently as in the semi-holographic framework, have been shown to exhibit an attractor surface for Bjorken flow. Retaining only the simple viscid fluid descriptions of both sectors, we find that, on the attractor surface, the hydrodynamization times of both subsectors decrease with increasing total energy density at the respective point of hydrodynamization following a conformal scaling, reach their minimum values, and subsequently rise rapidly. The minimum values are obtained when the respective energy densities are of the order of the inverse of the dimensionful inter-system coupling. Restricting to attractor curves which can be matched to glasma models at a time set by the saturation scale for both p-p and Pb-Pb collisions, we find that the more weakly coupled sector hydrodynamizes much later, and the strongly coupled sector hydrodynamizes earlier in p-p collisions, since the total energy densities at the respective hydrodynamization times of these sectors fall inside and outside of the conformal window. This holds true also for phenomenologically relevant solutions that are significantly away from the attractor surface at the time we match to glasma models.
Elliptic deformations of the AdS3 × S3 × T4 string
Authors: Hoare Ben , Retore Ana L. , Seibold Fiona K.
Published: April 2024

Abstract

With the aim of investigating the existence of an integrable elliptic deformation of strings on AdS3 × S3 × T4, we compute the tree-level worldsheet S-matrix of the elliptically-deformed bosonic sigma model on AdS3 × S3 in uniform light-cone gauge. The resulting tree-level S-matrix is compatible with the integrability of the model and has interesting features, including a hidden U(1) symmetry not manifest in the Lagrangian. We find that it cannot be embedded in the known exact integrable R-matrices describing deformations of the undeformed AdS3 × S3 × T4 light-cone gauge S-matrix including fermions. Therefore, we construct embeddings of the deformed 6-d metric in type II supergravity with constant dilaton and homogeneous fluxes. The simplicity of these solutions suggests they are promising candidates to lead to an integrable string sigma model including fermions.
Function-guided differences of arcuate fascicle and inferior fronto-occipital fascicle tractography as diagnostic indicators for surgical risk stratification
Authors: Kram Leonie , Schroeder Axel , Meyer Bernhard , Krieg Sandro M. , Ille Sebastian
Published: April 2024

Background

Several patients with language-eloquent gliomas face language deterioration postoperatively. Persistent aphasia is frequently associated with damage to subcortical language pathways. Underlying mechanisms still need to be better understood, complicating preoperative risk assessment. This study compared qualitative and quantitative functionally relevant subcortical differences pre- and directly postoperatively in glioma patients with and without aphasia.

Methods

Language-relevant cortical sites were defined using navigated transcranial magnetic stimulation (nTMS) language mapping in 74 patients between 07/2016 and 07/2019. Post-hoc nTMS-based diffusion tensor imaging tractography was used to compare a tract’s pre- and postoperative visualization, volume and fractional anisotropy (FA), and the preoperative distance between tract and lesion and postoperative overlap with the resection cavity between the following groups: no aphasia (NoA), tumor- or previous resection induced aphasia persistent pre- and postoperatively (TIA_P), and surgery-induced transient or permanent aphasia (SIA_T or SIA_P).

Results

Patients with NoA, TIA_P, SIA_T, and SIA_P showed distinct fasciculus arcuatus (AF) and inferior-fronto-occipital fasciculus (IFOF) properties. The AF was more frequently reconstructable, and the FA of IFOF was higher in NoA than TIA_P cases (all p ≤ 0.03). Simultaneously, SIA_T cases showed higher IFOF fractional anisotropy than TIA_P cases (p < 0.001) and the most considerable AF volume loss overall. While not statistically significant, the four SIA_P cases showed complete loss of ventral language streams postoperatively, the highest resection-cavity-AF-overlap, and the shortest AF to tumor distance.

Conclusion

Functionally relevant qualitative and quantitative differences in AF and IFOF provide a pre- and postoperative pathophysiological and clinically relevant diagnostic indicator that supports surgical risk stratification.
Economic evaluation of intensive home treatment in comparison to care as usual alongside a randomised controlled trial
Authors: Barakat Ansam , Cornelis Jurgen E. , Dekker Jack J. M. , Lommerse Nick M. , Beekman Aartjan T. F. , Blankers Matthijs
Published: April 2024

Background

There is a dearth of research on the cost-effectiveness of intensive home treatment (IHT), an alternative to psychiatric hospitalisation for patients experiencing psychiatric crises. We therefore present a health economic evaluation alongside a pre-randomised controlled trial of IHT compared to care as usual (CAU).

Method

Patients were pre-randomised to IHT or CAU using a double-consent open-label Zelen design. For the cost-utility analysis, the EuroQol 5-dimensional instrument was used. The cost-effectiveness was assessed using the Brief Psychiatric Rating Scale (BPRS).

Results

Data of 198 patients showed that each additional QALY gained from offering IHT instead of CAU was on average associated with an extra cost of €48,003. There is a 38% likelihood that IHT will lead to more QALYs at lower costs compared to CAU. An improvement of one additional point on the BPRS by offering IHT instead of CAU was associated with an extra cost of €19,203. There is a 38% likelihood that IHT will lead to higher BPRS score improvements at lower costs. Based on the NICE willingness-to-pay threshold of £30,000 (€35,000) per QALY, IHT could potentially be considered cost-effective with a likelihood of 55–60% when viewed from a societal perspective, and > 75% from a health care perspective.

Conclusions

IHT appears slightly more attractive in terms of cost-utility and cost-effectiveness than CAU, although differences in both costs and effects are small especially when viewed from the societal costs perspective. From the health care sector costs perspective, IHT has a higher probability of being cost-effective compared to CAU.

Trials registration

Netherlands Trial Register: NTR6151.
Wie nützlich sind Genexpressionsanalysen des Endometriums für die Bestimmung der endometrialen Rezeptivität in der klinischen Praxis?
Authors: Edimiris Philippos , Scheliga Iwona , Baston-Büst Dunja-Maria , Krüssel Jan-Steffen , Bielfeld Alexandra P.
Published: April 2024

Hintergrund

Die Synchronisierung zwischen der Embryonalentwicklung und dem rezeptiven Zustand des Endometriums beeinflusst den Erfolg von Techniken der assistieren Reproduktion erheblich. Die endometriale Genexpressionsanalyse wurde eingeführt, um den optimalen Zeitpunkt für den Embryotransfer molekularbiologisch zu bestimmen.

Fragestellung

Verbessert eine endometriale Genexpressionsanalyse das reproduktive Ergebnis und ist die pauschale Anwendung in der klinischen Praxis gerechtfertigt?

Material und Methoden

Übersicht relevanter Publikationen zum Thema endometriale Rezeptivitätsanalyse.

Ergebnisse

Die bisher publizierten Studien zu den reproduktiven Ergebnissen eines personalisierten im Vergleich zum standardisierten Embryotransfer haben zumeist ein retrospektives Design. Unter den publizierten prospektiven Studien erwies sich eine Studie von Doyle et al. als aussagekräftig: Hier zeigte sich, dass die Anwendung eines personalisierten Embryotransfers in einem Kollektiv bestehend aus Patientinnen mit guter Prognose keine Verbesserung des reproduktiven Ergebnisses bringt. Qualitativ hochwertige Daten für die Beantwortung der Frage, ob dies auch auf ein Kollektiv mit wiederholtem Implantationsversagen zutrifft, fehlen.

Schlussfolgerung

Aufgrund der bisherigen Forschungsergebnisse muss von einer routinemäßigen Anwendung einer endometrialen Genexpressionsanalyse abgeraten werden. Möglicherweise ergibt eine für 2026 angekündigte prospektive Studie neue Evidenz, die die Anwendung bei Patientinnen mit wiederholtem Implantationsversagen zulässt.