bluuebunny/crossref_metadata_2025 huggingface dataset:
Venous Thromboembolism Incidence, Risk Factors, and Prophylaxis in Burn Patients: A National Trauma Database Study
Authors: Stanton Eloise W , Manasyan Artur , Thompson Callie M , Patel Gourang P , Lacey Alexandra M , Travis Taryn E , Vrouwe Sebastian Q , Sheckter Clifford C , Gillenwater Justin
Published: September 2024

Comprehensive studies on the incidence, risk factors, and prophylactic measures related to venous thromboembolism (VTE) are lacking in burn care. This study characterizes VTE risk and existing prevention measures to improve and inform overall patient care in the field of burn care on a national scale. The US National Trauma Data Bank was queried from 2007 to 2021 to identify burn-injured patients. Descriptive statistics and multivariate regression analyses were used to explore the association between demographic/clinical characteristics and VTE risk as well as compare various VTE chemoprophylaxis types. There were 326 614 burn-injured patients included for analysis; 5642 (1.7%) experienced a VTE event during their hospitalization. Patients with VTE were significantly older, had greater body mass indexes and % total body surface area, and were more likely to be male (P < .001). History of smoking, hypertension or myocardial infarction, and/or substance use disorder were significant predictors of VTE (P < .001). Patients who received low molecular weight heparin were less likely to have VTE compared to patients treated with heparin when controlling for other VTE risk factors (odds ratio [OR]: 0.564, 95% confidence interval [95% CI]: 0.523-0.607, P < .001). Longer time to VTE chemoprophylaxis (>6 h) initiation was significantly associated with VTE (OR = 1.04, 95% CI: 1.03-1.07, P < .001). This study sheds light on risk factors and chemoprophylaxis in VTE to help guide clinical practice when implementing prevention strategies in patients with burns. This knowledge can be leveraged to refine risk stratification models, inform evidence-based prevention strategies, and ultimately enhance the quality of care for patients with burns at risk of VTE.
Rocking the BOAT: the ups and downs of the long-term radio light curve for GRB 221009A
Authors: Rhodes L , van der Horst A J , Bright J S , Leung J K , Anderson G E , Fender R , Fernandez J F Agüí , Bremer M , Chandra P , Dobie D , Farah W , Giarratana S , Gourdji K , Green D A , Lenc E , Michałowski M J , Murphy T , Nayana A J , Pollak A W , Rowlinson A , Schussler F , Siemion A , Starling R L C , Scott P , Thöne C C , Titterington D , de Ugarte Postigo A
Published: September 2024

We present radio observations of the long-duration gamma-ray burst (GRB) 221009A that has become known to the community as the Brightest Of All Time or the BOAT. Our observations span the first 475 d post-burst and three orders of magnitude in observing frequency, from 0.15 to 230 GHz. By combining our new observations with those available in the literature, we have the most detailed radio data set in terms of cadence and spectral coverage of any GRB to date, which we use to explore the spectral and temporal evolution of the afterglow. By testing a series of phenomenological models, we find that three separate synchrotron components best explain the afterglow. The high temporal and spectral resolution allows us to conclude that standard analytical afterglow models are unable to explain the observed evolution of GRB 221009A. We explore where the discrepancies between the observations and the models are most significant and place our findings in the context of the most well-studied GRB radio afterglows to date. Our observations are best explained by three synchrotron-emitting regions that we interpret as a forward shock, a reverse shock, and an additional shock potentially from a cocoon or wider outflow. Finally, we find that our observations do not show any evidence of any late-time spectral or temporal changes that could result from a jet break but note that any lateral structure could significantly affect a jet break signature.
Groundwater sustainability in India through nonrice-dominated cropping pattern
Authors: Dangar Swarup , Mishra Vimal
Published: September 2024

Over-exploitation of groundwater for irrigation caused rapid groundwater depletion in north India, leading to food and water security challenges. However, the crucial role of changing cropping patterns on groundwater savings under the observed and projected warming climate remains unexplored. Here, we show that altering the existing rice-dominated cropping systems in India can be a potential solution for groundwater sustainability under the current and future climate. Satellite and model-based estimates show that north India lost ∼336 and 297 km3 of groundwater, respectively during 2002–2022. We developed optimized crop switching scenarios for groundwater savings considering nutritional requirements, farmers’ profit, and crop production. Crop switching considering all the three targets (crop switch one: CSI) and allowing rice replacement with alternate crops (crop switch two: CSII) could save 45 and 91 km3 groundwater, respectively in north India during the observed climate (2002–2022) compared with the current cropping pattern. Altering the current cropping pattern can lead to substantial groundwater savings under the projected future climate without comprising nutritional targets and farmers’ profit at the state level. Replacing 37% area of rice with other crops (CSII) can recover 61 to 108 km3 groundwater compared with −13 to 43 km3 with current cropping pattern under the 1.5–3 °C global warming levels. Similarly, under the CSI scenario, 36 to 86 km3 groundwater can be recovered in the future warming world. Moreover, the benefits of crop switching in groundwater saving are higher during the prolonged dry periods compared with the baseline under the warming climate. Therefore, crop switching offers substantial benefits for groundwater sustainability under the current and projected future climate in India.
Focal adhesion kinase regulates tendon cell mechanoresponse and physiological tendon development
Authors: Leahy Thomas P. , Chenna Srish S. , Soslowsky Louis J. , Dyment Nathaniel A.
Published: September 2024

Tendons enable locomotion by transmitting high tensile mechanical forces between muscle and bone via their dense extracellular matrix (ECM). The application of extrinsic mechanical stimuli via muscle contraction is necessary to regulate healthy tendon function. Specifically, applied physiological levels of mechanical loading elicit an anabolic tendon cell response, while decreased mechanical loading evokes a degradative tendon state. Although the tendon response to mechanical stimuli has implications in disease pathogenesis and clinical treatment strategies, the cell signaling mechanisms by which tendon cells sense and respond to mechanical stimuli within the native tendon ECM remain largely unknown. Therefore, we explored the role of cell–ECM adhesions in regulating tendon cell mechanotransduction by perturbing the genetic expression and signaling activity of focal adhesion kinase (FAK) through both in vitro and in vivo approaches. We determined that FAK regulates tendon cell spreading behavior and focal adhesion morphology, nuclear deformation in response to applied mechanical strain, and mechanosensitive gene expression. In addition, our data reveal that FAK signaling plays an essential role in in vivo tendon development and postnatal growth, as FAK‐knockout mouse tendons demonstrated reduced tendon size, altered mechanical properties, differences in cellular composition, and reduced maturity of the deposited ECM. These data provide a foundational understanding of the role of FAK signaling as a critical regulator of in situ tendon cell mechanotransduction. Importantly, an increased understanding of tendon cell mechanotransductive mechanisms may inform clinical practice as well as lead to the discovery of diagnostic and/or therapeutic molecular targets.
Evidence for platelet‐derived transforming growth factor β1 as an early inducer of liver regeneration after hepatectomy in mice
Authors: Frick Johanna , Frobert Aurelien , Quintela Pousa Ana Maria , Balaphas Alexandre , Meyer Jeremy , Schäfer Katrin , Giraud Marie‐Noelle , Egger Bernhard , Bühler Leo , Gonelle‐Gispert Carmen
Published: September 2024

Platelets play a crucial role in tissue regeneration, and their involvement in liver regeneration is well‐established. However, the specific contribution of platelet‐derived Transforming Growth Factor Beta 1 (TGFβ1) to liver regeneration remains unexplored. This study investigated the role of platelet‐derived TGFβ1 in initiating liver regeneration following 2/3 liver resection. Using platelet‐specific TGFβ1 knockout (Plt.TGFβ1 KO) mice and wild‐type littermates (Plt.TGFβ1 WT) as controls, the study assessed circulating levels and hepatic gene expression of TGFβ1, Platelet Factor 4 (PF4), and Thrombopoietin (TPO) at early time points post‐hepatectomy (post‐PHx). Hepatocyte proliferation was quantified through Ki67 staining and PCNA expression in total liver lysates at various intervals, and phosphohistone‐H3 (PHH3) staining was employed to mark mitotic cells. Circulating levels of hepatic mitogens, Hepatocyte Growth Factor (HGF), and Interleukin‐6 (IL6) were also assessed. Results revealed that platelet‐TGFβ1 deficiency significantly reduced total plasma TGFβ1 levels at 5 h post‐PHx in Plt.TGFβ1 KO mice compared to controls. While circulating PF4 levels, liver platelet recruitment and activation appeared normal at early time points, Plt.TGFβ1 KO mice showed more stable circulating platelet numbers with higher numbers at 48 h post‐PHx. Notably, hepatocyte proliferation was significantly reduced in Plt.TGFβ1 KO mice. The results show that a lack of TGFβ1 in platelets leads to an unbalanced expression of IL6 in the liver and to strongly increased HGF levels 48 h after liver resection, and yet liver regeneration remains reduced. The study identifies platelet‐TGFβ1 as a regulator of hepatocyte proliferation and platelet homeostasis in the early stages of liver regeneration.
TIPE2 inhibits the migration and invasion of epithelial ovarian cancer cells by targeting Smad2 to reverse TGF‐β1‐induced EMT
Authors: Tang Zhongyun , Zhang Derui , Yao Chenchen , Jiang Mengmeng , Wang Chongli , Chen Zhen , Yu Huayun , Xue Chenyue , Liu Yuqiu , Shi Yongyu , Zhang Lining , Wang Xiaoyan , Wei Zengtao
Published: September 2024

Epithelial ovarian cancer is the deadliest gynecologic malignancy, characterized by high metastasis. Transforming growth factor‐β1 (TGF‐β1) drives epithelial‐ mesenchymal transformation (EMT), a key process in tumor metastasis. Tumor necrosis factor‐α‐induced protein 8 (TNFAIP8)‐like 2 (TIPE2) acts as a negative regulator of innate and adaptive immunity and involves in various cancers. However, its relationship with TGF‐β1 in ovarian cancer and its role in reversing TGF‐β1‐induced EMT remain unclear. This study examined TIPE2 mRNA and protein expression using quantitative RT‐PCR (qRT‐PCR), western blot and immunohistochemistry. The effects of TIPE2 overexpression and knockdown on the proliferation, migration and invasion of epithelial ovarian cancer cells were assessed through 5‐ethynyl‐2‐deoxyuridine, colony‐forming, transwell migration and invasion assays. The relationship between TIPE2 and TGF‐β1 was investigated using qRT‐PCR and enzyme‐linked immunosorbent assay, while the interaction between TIPE2 and Smad2 was identified via co‐immunoprecipitation. The results revealed that TIPE2 protein was significantly down‐regulated in epithelial ovarian cancer tissues and correlated with the pathological type of tumor, patients' age, tumor differentiation degree and FIGO stage. TIPE2 and TGF‐β1 appeared to play an opposite role to each other during the progression of human ovarian cancer cells. Furthermore, TIPE2 inhibited the metastasis and EMT of ovarian cancer cells by combining with Smad2 in vitro or in an intraperitoneal metastasis model. Consequently, these findings suggest that TIPE2 plays a crucial inhibitory role in ovarian cancer metastasis by modulating the TGF‐β1/Smad2/EMT signaling pathway and may serve as a potential target for ovarian cancer, providing important direction for future diagnostic and therapeutic strategies.
Music Perception and Music-Related Quality of Life in Adult Cochlear Implant Users: Exploring the Need for Music Rehabilitation
Authors: Akbulut Ahmet Alperen , Karaman Demirel Ayşenur , Çiprut Ayça
Published: September 2024

Objectives:

Cochlear implant (CI) users face difficulties in accurately perceiving basic musical elements such as pitch, melody, and timbre. Music significantly affects the quality of life (QoL) of CI users. Individually and culturally influenced music perception exceeds psychophysical measures in capturing the subjective music enjoyment of CI users. Understanding the music perception, enjoyment, and habits of CI users is crucial for approaches to improve music-related QoL (MuRQoL). Therefore, this study aims to investigate music perception skills, experiences, and participation in music activities in a large group of adult CI users, and to understand the importance of these factors and their impact on QoL of CI users.

Design:

This study included 214 CI recipients with diverse auditory experiences who were aged between 18 and 65 years and were unilateral, bimodal, or bilateral users for at least 1 year and 193 normal hearing (NH) controls. All participants completed the information forms and the MuRQoL questionnaire. To assess the impact of music on QoL and identify personalized rehabilitation needs, the scores for each question in both parts of the questionnaire were intersected on a matrix. Data were presented in detail for the CI group and compared between CI and NH groups.

Results:

A statistically significant difference was found between the matched CI and NH groups in favor of the NH group in terms of music perception and music engagement. Participants who received music education at any point in their lives had significantly higher MuRQoL questionnaire scores. There was no significant relationship found between the duration of auditory rehabilitation, pre-CI hearing aid usage, music listening modality, and MuRQoL questionnaire scores. Unilateral CI users had significantly lower scores in music perception and music engagement subsections compared with bimodal and bilateral CI users. Also, it was found that music had a strong negative impact on QoL in 67/214 of the CI users.

Conclusions:

Although CI users scored significantly lower than NH individuals on the first part of the questionnaire, which asked about musical skills, enjoyment, and participation in musical activities, findings suggest that CI users value music and music enjoyment just as much. The study reveals the influence of factors such as education level, age, music education, type of hearing loss and auditory rehabilitation on music perception, music enjoyment, and participation in music activities through self-report. The results indicate that for many CI users, music has a strong negative impact on QoL, highlighting the need for personalized music interventions, the inclusion of self-report questionnaires, and music perception tests in clinical evaluations.
T1 Pelvic and Lumbar Pelvic Angles Normative Values
Authors: Pelletier-Roy Rémi , Ludwig Taryn , Birk Manjot , Smith Victoria , Asmussen Michael , Nicholls Fred
Published: September 2024

Study Design.

Cross-sectional analysis of a prospectively enrolled cohort.

Objective.

Determine the normative values of the T1 Pelvic Angle (TPA) and Lumbar Pelvic Angle (LPA) in an asymptomatic cohort of volunteers.

Summary of Background Data.

The TPA and LPA have been introduced as sagittal spino-pelvic parameters to guide correction of adult spinal deformity. Suggested values for these parameters were derived from linear regressions based on Oswestry Disability Index scores from adult spinal deformity patients. While a few studies have evaluated the normative value of TPA, none have evaluated the LPA in asymptomatic individuals.

Methods.

TPA and LPA were measured on radiographs of 472 asymptomatic volunteers between 20 and 40 years old. TPA and LPA were calculated as originally described from the centroid of T1 and L1 respectively, to the center of the femoral head to the midpoint of the sacral endplate. TPA and LPA were also evaluated using the midpoint of the superior endpoint as a surrogate to the centroid of the vertebra to compare these two measurement techniques.

Results.

TPA and LPA normative values were respectively 7.3 [6.8-7.8] and 6.3o [5.9-6.7]. There was no statistically significant difference between using the centroid of T1 or L1 versus using the midpoint of the superior endplate with respective results of 7.5o [7.0-8.0] (P=0.55) and 6.1o [5.6-6.5] (P=0.43). TPA was significantly different between Roussouly types 1-2-3 versus type 4 with respective results of of 6.7o, 7.2o, 6.5o and 9.2o (P<0.001). The same difference was observed for the LPA with normative results of 3.8o, 5.1o, 5.8o and 9.3o (P<0.001), respectively, for Roussouly types 1,2,3 and 4.

Conclusions.

TPA and LPA normative values are 7o and 6o, respectively, and vary between Roussouly morphotypes 1,2 and 3 versus type 4. Using the midpoint of the superior endplate of T1 and L1 versus the centroid yielded similar results and therefore could be easier to use intraoperatively.
The Discover In-Hospital Cardiac Arrest (Discover IHCA) Study: An Investigation of Hospital Practices After In-Hospital Cardiac Arrest
Authors: Andrea Luke , Herman Nathaniel S. , Vine Jacob , Berg Katherine M. , Choudhury Saiara , Vaena Mariana , Nogle Jordan E. , Halablab Saleem M. , Kaviyarasu Aarthi , Elmer Jonathan , Wardi Gabriel , Pearce Alex K. , Crowley Conor , Long Micah T. , Herbert J. Taylor , Shipley Kipp , Bissell Turpin Brittany D. , Lanspa Michael J. , Green Adam , Ghamande Shekhar A. , Khan Akram , Dugar Siddharth , Joffe Aaron M. , Baram Michael , March Cooper , Johnson Nicholas J. , Reyes Alexander , Denchev Krassimir , Loewe Michael , Moskowitz Ari ,   on behalf of Society of Critical Care Medicine’s Discovery, the Critical Care Research Network DISCOVER In-Hospital Cardiac Arrest (DISCOVER IHCA): Investigator Group
Published: September 2024

IMPORTANCE:

In-hospital cardiac arrest (IHCA) is a significant public health burden. Rates of return of spontaneous circulation (ROSC) have been improving, but the best way to care for patients after the initial resuscitation remains poorly understood, and improvements in survival to discharge are stagnant. Existing North American cardiac arrest databases lack comprehensive data on the post-resuscitation period, and we do not know current post-IHCA practice patterns. To address this gap, we developed the Discover In-Hospital Cardiac Arrest (Discover IHCA) study, which will thoroughly evaluate current post-IHCA care practices across a diverse cohort.

OBJECTIVES:

Our study collects granular data on post-IHCA treatment practices, focusing on temperature control and prognostication, with the objective of describing variation in current post-IHCA practice.

DESIGN, SETTING, AND PARTICIPANTS:

This is a multicenter, prospectively collected, observational cohort study of patients who have suffered IHCA and have been successfully resuscitated (achieved ROSC). There are 24 enrolling hospital systems (23 in the United States) with 69 individual enrolling hospitals (39 in the United States). We developed a standardized data dictionary, and data collection began in October 2023, with a projected 1000 total enrollments. Discover IHCA is endorsed by the Society of Critical Care Medicine.

INTERVENTIONS, OUTCOMES, AND ANALYSIS:

The study collects data on patient characteristics including pre-arrest frailty, arrest characteristics, and detailed information on post-arrest practices and outcomes. Data collection on post-IHCA practice was structured around current American Heart Association and European Resuscitation Council guidelines. Among other data elements, the study captures post-arrest temperature control interventions and post-arrest prognostication methods. Analysis will evaluate variations in practice and their association with mortality and neurologic function.

CONCLUSIONS:

We expect this study, Discover IHCA, to identify variability in practice and outcomes following IHCA, and be a vital resource for future investigations into best-practice for managing patients after IHCA.
Inability to Sit-to-Stand in Medical ICUs Survivors: When and Why We Should Care*
Authors: Siao Shu-Fen , Wang Tyng-Guey , Ku Shih-Chi , Wei Yu-Chung , Chen Cheryl Chia-Hui
Published: September 2024

OBJECTIVES:

To investigate the prevalence and association with mortality of inability to perform sit-to-stand independently in critically ill survivors 3 months following medical ICU (MICU) discharge.

DESIGN:

Prospective cohort study.

SETTING:

Six MICUs at a tertiary care hospital.

PATIENTS:

MICU survivors who could sit-to-stand independently before the index hospitalization.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Inability to sit-to-stand (yes/no) was measured at four points following MICU discharge: upon ICU discharge, 1, 2, and 3 months afterward. Mortality was evaluated at 6- and 12-month post-MICU discharge. Among 194 participants, 128 (66%) had inability to sit-to-stand upon MICU discharge. Recovery occurred, with rates decreasing to 50% at 1 month, 38% at 2 months, and 36% at 3 months post-MICU discharge, plateauing at 2 months. Inability to sit-to-stand at 3 months was significantly associated with 21% mortality at 12 months and a 4.2-fold increased risk of mortality (adjusted hazard ratio, 4.2; 95% CI, 1.61–10.99), independent of age, Sequential Organ Failure Assessment score, and ICU-acquired weakness. Notably, improvement in sit-to-stand ability, even from “totally unable” to “able with assistance,” correlates with reduced mortality risk.

CONCLUSIONS:

Inability to sit-to-stand affects about 36% of MICU survivors even at 3 months post-ICU discharge, highlighting rehabilitation challenges. Revisiting sit-to-stand ability post-ICU discharge is warranted. Additionally, using sit-to-stand as a screening tool for interventions to improve return of its function and mortality is suggested.
Characteristics and Outcomes of Children and Young Adults With Sepsis Requiring Continuous Renal Replacement Therapy: A Comparative Analysis From the Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK)*
Authors: Stanski Natalja L. , Gist Katja M. , Hasson Denise , Stenson Erin K. , Seo JangDong , Ollberding Nicholas J. , Muff-Luett Melissa , Cortina Gerard , Alobaidi Rashid , See Emily , Kaddourah Ahmad , Fuhrman Dana Y. ,   on behalf of the Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) Investigators
Published: September 2024

OBJECTIVES:

Pediatric sepsis-associated acute kidney injury (AKI) often requires continuous renal replacement therapy (CRRT), but limited data exist regarding patient characteristics and outcomes. We aimed to describe these features, including the impact of possible dialytrauma (i.e., vasoactive requirement, negative fluid balance) on outcomes, and contrast them to nonseptic patients in an international cohort of children and young adults receiving CRRT.

DESIGN:

A secondary analysis of Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK), an international, multicenter, retrospective study.

SETTING:

Neonatal, cardiac and PICUs at 34 centers in nine countries from January 1, 2015, to December 31, 2021.

PATIENTS:

Patients 0–25 years old requiring CRRT for AKI and/or fluid overload.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Among 1016 patients, 446 (44%) had sepsis at CRRT initiation and 650 (64%) experienced Major Adverse Kidney Events at 90 days (MAKE-90) (defined as a composite of death, renal replacement therapy [RRT] dependence, or > 25% decline in estimated glomerular filtration rate from baseline at 90 d from CRRT initiation). Septic patients were less likely to liberate from CRRT by 28 days (30% vs. 38%; p < 0.001) and had higher rates of MAKE-90 (70% vs. 61%; p = 0.002) and higher mortality (47% vs. 31%; p < 0.001) than nonseptic patients; however, septic survivors were less likely to be RRT dependent at 90 days (10% vs. 18%; p = 0.011). On multivariable regression, pre-CRRT vasoactive requirement, time to negative fluid balance, and median daily fluid balance over the first week of CRRT were not associated with MAKE-90; however, increasing duration of vasoactive requirement was independently associated with increased odds of MAKE-90 (adjusted OR [aOR], 1.16; 95% CI, 1.05–1.28) and mortality (aOR, 1.20; 95% CI, 1.1–1.32) for each additional day of support.

CONCLUSIONS:

Septic children requiring CRRT have different clinical characteristics and outcomes compared with those without sepsis, including higher rates of mortality and MAKE-90. Increasing duration of vasoactive support during the first week of CRRT, a surrogate of potential dialytrauma, appears to be associated with these outcomes.
Lung cancer screening in never smokers
Authors: Lai Gillianne G.Y. , Tan Daniel S.W.
Published: September 2024

Purpose of review

Low-dose computed tomography (LDCT) lung cancer screening has been established in smokers, but its role in never smokers remains unclear. The differences in lung cancer biology between smokers and nonsmokers highlight the importance of a discriminated approach. This overview focuses on the emerging data and implementation challenges for LDCT screening in nonsmokers.

Recent findings

The first LDCT screening study in nonsmokers enriched with risk factors demonstrated a lung cancer detection rate double that of the phase 3 trials in smokers. The relative risk of lung cancer detected by LDCT has also been found to be similar amongst female never smokers and male ever smokers in Asia. Majority of lung cancers detected through LDCT screening are stage 0/1, leading to concerns of overdiagnosis. Risk prediction models to enhance individual selection and nodule management could be useful to enhance the utility of LDCT screening in never smokers.

With appropriate risk stratification, LDCT screening in never smokers may attain similar efficacy as compared to smokers. A global effort is needed to generate evidence surrounding optimal screening strategies, as well as health and economic benefits to determine the suitability of widespread implementation.
Needs for rehabilitation in China: Estimates based on the Global Burden of Disease Study 1990–2019
Authors: Tian Tian , Zhu Lin , Fu Qingzhen , Tan Shiheng , Cao Yukun , Zhang Ding , Wang Mingxue , Zheng Ting , Gao Lijing , Volontovich Daria , Wang Yongchen , Zhang Jinming , Jiang Zhimei , Qiu Hongbin , Wang Fan , Zhao Yashuang
Published: September 2024

Background:

As an essential part of health services, rehabilitation is of great significance to improve the health and quality of life of the whole population. Accelerating aging calls for a significant expansion of rehabilitation services in China, but rehabilitation needs remain unclear. We conducted the study to explore the rehabilitation needs in China and project the trend of rehabilitation needs from 2020 to 2034.

Methods:

The data of health conditions that might potentially benefit from rehabilitation were obtained from Global Burden of Disease (GBD) study. Estimated annual percentage changes (EAPCs) were calculated to quantify the trends of the age-standardized rates. Projections of rehabilitation needs were made until 2034 using Bayesian age–period–cohort analysis (BAPC).

Results:

Approximately 460 million persons (33.3% of the total population) need rehabilitation in China, contributing to 63 million years lived with disabilities (YLDs) in 2019. The number of prevalent cases that need rehabilitation increased from around 268 (95% uncertainty interval [UI]: 257–282) million in 1990 to almost 460 (95% UI: 443–479) million in 2019, representing an increase of 71.3%. The highest contribution to the need for rehabilitation was musculoskeletal disorders with about 322 (95% UI: 302–343) million persons in seven aggregate disease and injury categories, and hearing loss with over 95 (95% UI: 84–107) million people among 25 health conditions. Based on the projection results, there will be almost 636 million people (45% of the total population) needing rehabilitation services in China by 2034, representing an increase of 38.3%. The rehabilitation needs of neoplasms, cardiovascular diseases, and neurological disorders are expected to increase significantly from 2019 to 2034, with increases of 102.3%, 88.8% and 73.2%, respectively.

Conclusions:

The need for rehabilitation in China substantially increased over the last 30 years. It is predicted that over two in five people will require rehabilitation by 2034, thus suggesting the need to develop rehabilitation services that meet individuals’ rehabilitation needs.
Clinical Efficacy and Safety of a Thermomechanical Fractional Injury Device for Neck Rejuvenation
Authors: Wang Jordan V. , Jairath Neil , Tao Joy , Hashemi David A. , Bajaj Shirin , Geronemus Roy G.
Published: September 2024

BACKGROUND

Neck rejuvenation has consistently become a popular cosmetic procedure. While various treatment modalities have been used, a novel fractional thermomechanical skin rejuvenation system was recently developed to create dermal coagulation through direct heat transfer with subsequent neocollagenesis.

OBJECTIVE

A prospective clinical trial evaluated the efficacy and safety of a thermomechanical fractional injury device (Tixel 2, Novoxel, Netanya, Israel) for neck rhytides.

MATERIALS AND METHODS

Subjects with moderate to severe neck rhytides were enrolled for 4 monthly treatments.

RESULTS

Twenty-six subjects were enrolled and completed all study visits. The mean age was 58.4 years, and 100.0% were women. Fitzpatrick skin types I to IV were included. For Fitzpatrick Wrinkle Classification System (FWCS), the mean baseline score was 6.3. As per investigator, there was a mean 1.5-grade improvement in FWCS at 1-month follow-up (p < .00001) and 1.4-grade improvement in FWCS at 3-month follow-up (p < .00001). For physician Global Aesthetic Improvement Scale, all subjects (100%) had improvement at both 1- and 3-month follow-up visits. There were no severe adverse events, and subjects experienced minimal pain.

CONCLUSION

A novel thermomechanical fractional injury device is effective and safe for the treatment of neck rhytides.
Bivalirudin in Extracorporeal Membrane Oxygenation
Authors: Dunham Sabrina , Wieruszewski Patrick M. , Gerrald James E.
Published: September 2024

Extracorporeal membrane oxygenation (ECMO) is a mechanical support treatment modality used in patients with refractory cardiac and/or pulmonary failure. Bleeding and thrombotic complications associated with ECMO are inherent concerns that require careful management. Anticoagulation optimization may help mitigate these risks by providing more adequate therapeutic anticoagulation and lessen the bleed risk. Heparin, the most used anticoagulant, carries concerns for heparin-induced thrombocytopenia and possible resistance given its dependence on cofactors and circulating proteins to exert its pharmacologic effect. In contrast, bivalirudin, a direct thrombin inhibitor, exerts its effect independent of cofactors or plasma proteins, and possesses thrombin-binding and metabolism features that may confer advantages in ECMO management. This review of the evidence for bivalirudin utilization in ECMO suggests favorable outcomes in circuit-related thrombosis, bleeding, and dosing reliability. In addition, blood product utilization, circuit interventions, and success in ECMO decannulation and survival were positive findings associated with bivalirudin that merit consideration. Common questions and concerns relative to bivalirudin utilization, including laboratory monitoring, utilization in low-flow states, dosing considerations in renal replacement therapy, reversibility, and cost are also discussed in this review. Moreover, this review suggests that bivalirudin utilization presents the opportunity for ECMO management simplification.
Severe Invasive Pneumococcal Disease Caused by Serotype 19A in Children Under Five Years in Tāmaki Makaurau Auckland, Aotearoa New Zealand
Authors: Burton Cameron , Webb Rachel , Anglemyer Andrew , Humphrey Alexander , Tuato’o Amelie , Best Emma
Published: September 2024

Background:

Increases in childhood invasive pneumococcal disease (IPD) have been reported in several countries following the easing of COVID-19 pandemic mitigations. In Aotearoa New Zealand (AoNZ), a surge in IPD is occurring in young children concurrent with changes in pneumococcal vaccines and declining immunization coverage. We sought to examine epidemiologic and clinical features of IPD among children under 5 years in a large urban region of AoNZ in the 3 years post-COVID-19.

Methods:

Demographic, clinical and laboratory data were collated from children under 5 years with Streptococcus pneumoniae identified from normally sterile sites between January 1, 2021, and December 31, 2023, in Tāmaki Makaurau Auckland, AoNZ.

Results:

We identified 93 episodes of IPD (annual incidence of 18–40 cases per 100,000 population per year). Serotype was identified in 68 episodes and 46 (68%) were serotype 19A. Incidence was higher in Pacific children compared with non-Māori, non-Pacific children (incidence rate ratio: 2.3; 95% confidence interval: 1.4–3.7). Bacteremia occurred in 65 (70%) episodes, empyema in 47 (51%), meningitis in 11 (12%) and hemolytic uremic syndrome in 7 (7.5%). All cases of hemolytic uremic syndrome and empyema were only among children with serotype 19A. Two children died, both had serotype 19A, and 13/91 survivors (14%) experienced serious sequelae.

Conclusions:

The use of the pneumococcal conjugate vaccine with lower valency and easing of COVID-19 containment measures each may have contributed to an increase in IPD in AoNZ. Serotype 19A is associated with empyema and causes severe disease in young children. Urgent efforts are required to improve PCV13 coverage in AoNZ.
Factors Associated With Hospitalization, Length of Stay, and Hospital Expenditures for Respiratory Syncytial Virus Infection in Japanese Infants and Children According to Palivizumab-indicated Underlying Conditions: The LIFE Study
Authors: Inoue Masako , Maeda Megumi , Murata Fumiko , Fukuda Haruhisa
Published: September 2024

Background:

Respiratory syncytial virus (RSV) is a major cause of pediatric respiratory tract infections. In Japan, children with specific underlying conditions are eligible to receive palivizumab to prevent severe RSV disease. However, the association between palivizumab eligibility and RSV infection severity remains unclear. This study examined RSV infection severity and hospitalization outcomes in Japanese infants and children according to palivizumab eligibility and identified their associated factors.

Methods:

Using insurance claims data from 12 municipalities, we identified RSV cases in children ≤24 months of age between April 2017 and March 2022. The patients’ characteristics and hospitalization status were analyzed according to the presence of palivizumab-indicated underlying conditions. Regression models were used to identify factors associated with hospitalization, length of stay (LOS), and hospital expenditures.

Results:

We analyzed 1025 first-time RSV cases (860 infants <12 months and 165 children 12–24 months old). There were 777 (90.3%) palivizumab-ineligible infants and 83 (9.7%) palivizumab-eligible infants. Only 13 (15.7%) palivizumab-eligible infants had received palivizumab in the month before RSV infection, and 8 required hospitalization. RSV hospitalization was significantly associated with age (odds ratio: 0.84, 95% confidence interval: 0.79–0.88), palivizumab-indicated underlying conditions (1.82, 1.13–2.89), and non-indicated high-risk conditions (4.87, 2.28–10.99). These factors were also associated with LOS. Hospital expenditures were associated with age, high-risk conditions and LOS.

Conclusions:

Palivizumab-indicated underlying conditions, high-risk conditions, and younger age are risk factors for RSV hospitalization. Most hospitalized patients did not receive palivizumab in the month before RSV infection despite being eligible, suggesting that some hospitalizations were preventable through appropriate palivizumab use.
11th revision of the International Classification of Diseases chronic primary pain diagnoses in children and adolescents: representation of pediatric patients in the new classification system
Authors: Rau Lisa-Marie , Korwisi Beatrice , Barke Antonia , Frosch Michael , Zernikow Boris , Wager Julia
Published: September 2024

Chronic pain is common among children and adolescents; however, the diagnoses in the newly developed 11th revision of the International Classification of Diseases (ICD-11) chronic pain chapter are based on adult criteria, overlooking pediatric neurodevelopmental differences. The chronic pain diagnoses have demonstrated good clinical applicability in adults, but to date, no field study has examined these diagnoses to the most specific diagnostic level in a pediatric sample. The current study aimed to explore pediatric representation within the ICD-11, with focus on chronic primary pain. Healthcare professionals (HCPs) at a specialized pediatric pain center documented the symptoms of and assigned both ICD-10 and ICD-11 diagnoses to N = 402 patients. Using criteria-based computer algorithms, specific ICD-11 pain diagnoses were allocated for each documented pain location, with residual diagnoses (ie, “unspecified”) assigned if criteria were not (fully) met. Within the ICD-11, the algorithms assigned specific pain diagnoses to most patients (73.6%). In ICD-10, HCPs could not specify a diagnosis for 5.2% of patients; the ICD-11 algorithm allocated a residual chronic primary pain diagnosis in 51.2%. Residual categories were especially prevalent among younger children, boys, patients with headaches, and those with lower pain severity. Overall, clinical utility of the ICD-11 was high, although less effective for chronic back pain and headache diagnoses. The latter also exhibited the lowest agreement between HCPs and algorithm. The current study underscores the need for evidence-based improvements to the ICD-11 diagnostic criteria in pediatrics. Developing pediatric coding notes could improve the visibility of patients internationally and improve the likelihood of receiving reimbursement for necessary treatments through accurate coding.
Sarcopenia in the era of precision health: Toward personalized interventions for healthy longevity
Authors: Chen Liang-Kung
Published: September 2024

Sarcopenia, characterized by the progressive loss of skeletal muscle mass and function, significantly impacts health outcomes in older adults. This review explores the evolving landscape of sarcopenia research, with a particular focus on its unique characteristics in Asian populations and emerging pharmaceutical interventions. Recent studies have revealed distinct patterns of muscle mass decline in Asian adults, particularly in women, challenging the universal application of global sarcopenia diagnostic criteria. The Asian Working Group for Sarcopenia has proposed region-specific diagnostic criteria, acknowledging these ethnic variations. Prevalence estimates of sarcopenia vary widely, ranging from 10% to 40% in community-dwelling older adults. For specific chronic conditions, the prevalence of sarcopenia is notably higher, reaching 35% for cardiovascular diseases and 24.5% for chronic kidney disease. Sarcopenia is strongly associated with various chronic conditions, increasing the risk of falls by 1.5 to 3 times and significantly increasing mortality risk by 29% to 51%. Current management strategies primarily involve resistance exercise and nutritional interventions, with a recommended daily protein intake of at least 1.2 g/kg to maintain muscle health. Pharmaceutical development has gained significant momentum, with over 20 compounds in various stages of clinical trials. These include myostatin inhibitors, selective androgen receptor modulators, ghrelin receptor agonists, mesenchymal stem cell therapy, and follistatin gene therapy. However, the unique dietary patterns, cultural contexts, and potentially distinct drug responses in Asian populations necessitate tailored interventions and Asia-specific clinical trials. Future directions include refining Asian-specific diagnostic criteria, conducting large-scale epidemiological studies across multiple Asian countries, developing culturally appropriate interventions, integrating sarcopenia management into chronic disease care, and advancing pharmaceutical research with a focus on Asian populations. In conclusion, sarcopenia emerges as a critical nexus in the aging process, intricately linked with multiple organ systems and chronic conditions, underscoring the imperative for its recognition as a cornerstone in person-centered care and the holistic management of age-related health challenges.
How Do Virtual Communities of Practice Enhance Professional Connections and Social Capital?
Authors: Becker Betsy J. , Jewell Jennifer , Stejskal Lisa , Browning Karen , Labosky Beverly , Berry Justin W.
Published: September 2024

Introduction.

Communities of Practice (CoP) were created to up-skill educators and to mitigate the disruption to physical therapist assistant (PTA) education because of the COVID-19 pandemic. Understanding CoP involves considering individuals and their interactions, making this project significant for pioneering CoP among PTA educators, and using social network analysis (SNA). The research question for this mixed-methods concurrent triangulation study was “To what extent did the network structure of virtual CoP reflect PTA educators' perceptions of participation and mentorship?”

Subjects.

Forty of 60 CoP members participated in this study.

Methods.

We analyzed 8 virtual PTA educator CoP that met over 4 months. Study participants completed a questionnaire about their experiences, engagement, and network connections. Individual and group-level friendship and mentorship network measures were studied using SNA. Qualitative responses were analyzed using the case study design approach. All results were integrated to draw out the complexity of the PTA educator CoP.

Results.

There was high engagement, with 97.5% (n = 39) reporting they would participate again, and 80% (n = 32) resolved an immediate issue affecting their role. Moreover, 92.5% (n = 37) reported a perception of encouragement with the environment. Study participants reported being mentored by an average of 1.2 individuals (median 0, range 0–5) and serving as mentors to an average of 1.4 individuals (median 0, range 0–7). Two themes, unity and knowledge, emerged through the qualitative analysis.

Discussion and Conclusion.

Participation by PTA educators in CoP, whether focused on administration, teaching methods, or clinical education, brings valuable outcomes. Our research supports existing literature in physical therapy education. We discovered that participant engagement, nurturing mentor relationships, encouraging knowledge sharing, and promoting a sense of unity among educators are all important factors.
To precept or not to precept: Perspectives from nurse practitioners
Authors: DeClerk Leonie , Chasteen Steven , Wells Cheryl , Baxter Jonathan , Rojo Martha
Published: September 2024

Background:

Nurse practitioner (NP) preceptors are crucial to clinical education. Recent increases in the required direct patient care hours for NP students may worsen the current preceptor shortage. However, most studies of preceptorship only include NPs who are current preceptors and are therefore missing vital information from nonpreceptors. It is imperative to understand facilitators and barriers to preceptorship from the perspective of NPs who have stopped being or have never been preceptors.

Purpose:

The purpose of this study was to understand the factors influencing NPs' decisions whether to precept.

Methodology:

This was a descriptive, phenomenological study. Semistructured interviews were recorded in Zoom, transcribed verbatim, deidentified, and analyzed using thematic analysis.

Results:

Sixty NPs participated in the study: 23 current preceptors, 22 previous preceptors, and 15 who had never been preceptors. Facilitators to preceptorship included institutional support of preceptorship, positive student characteristics, clear expectations from the educational facility, and incentives. Barriers to preceptorship included time constraints, specialty, negative student characteristics, no institutional support, and being uncomfortable in the clinical role.

Conclusions:

Preceptors and nonpreceptors shared similar themes—positive student characteristics and clear expectations as facilitators to preceptorship, and time as a barrier. However, other themes were unique to one preceptorship group. This provides new evidence for practice and research.

Implications:

Nurse practitioner programs can facilitate preceptorship by ensuring that students are well prepared and providing clear expectations. Strategies should be developed to manage the time burden of preceptorship. In addition, support for preceptorship by health care organizations and systems should be studied.
Statistically Significant Associations Between HPV33, HPV35, and HPV56 With Anal HSIL in a Population of MSMLWH
Authors: Jair Kamwing , Abbott Stephen E. , Aldous Annette , Rivas Karina I. , Connors Kaleigh A. , Klein David A. , Hoke Elizabeth S. , Jordan Jeanne A.
Published: September 2024

Objective

The aim of the study is to determine the prevalence of high-risk human papillomavirus (hrHPV) genotypes in men who have sex with other men and are living with HIV and the factors associated with anal high-grade squamous intraepithelial lesions (HSIL).

Methods

Anal swabs were collected for hrHPV genotyping from a cross-sectional group (N = 163) of eligible men who have sex with other men and are living with HIV attending a high-resolution anoscopy clinic. Persistent hrHPV infections were studied in a longitudinal subset (n = 37). Association of anal HSIL with specific hrHPV genotype(s) and with HIV-1 suppression was assessed. Pearson's χ2 test with continuity correction or Fisher's exact test was used to determine statistical significance (alpha = 0.05).

Results

Overall prevalence of hrHPV anal infections was 93.3% (152/163). Higher numbers of hrHPV genotypes were detected per sample in the HSIL group compared with less than or low-grade squamous intraepithelial lesion (≤LSIL) group (p < .001). Proportion of participants infected with HPV33 was higher in the HSIL group (66.7%) than in ≤LSIL group (33.3%, p < .001), as was HPV35 (61.1% vs. 38.9%, p = .001) and HPV56 (56.7% vs. 43.3%, p = .022). HPV33 persistence was highly associated with HSIL (100%; 8/8) compared with ≤LSIL (0%; 0/8) (p < .001). Proportion of HIV-1 suppression (<200 cp/mL) was significantly lower among the HSIL group (80%; 48/60) compared with ≤LSIL group (95.1%; 97/102) (p = .006).

Conclusions

Statistically significant associations existed between anal HSIL and HPV33, HPV35, and HPV56 infections, with HPV33 persistence, and with the lack of HIV-1 suppression. These findings emphasize the critical need for genotyping assays that differentiate more than just HPV16, HPV18 and a pool of “other” hrHPV genotypes and that have an intended use with anal specimens. Globally, this highest-risk population would benefit from the 9-valent vaccine to prevent infections and reduce anal cancer risk.