bluuebunny/crossref_metadata_2025 huggingface dataset:
The Original US Public Land Survey Records: Their Use and Limitations in Reconstructing Presettlement Vegetation
Authors: Schulte L.A. , Mladenoff D.J.
Published: April 2024

Studies of pre-European-settlement vegetation frequently use the original Public Land Survey (PLS) records from the US General Land Office. Like all other sources of data, this historical source poses both advantages and limitations. We review spatial and temporal issues concerning the quality of the PLS data for vegetation studies, including surveyor preference for witness tree characteristics and the duration of survey data collection. We present methods to capitalize on the advantages of the PLS data while minimizing their limitations.
Commentary: Opportunity Knocks
Authors: Dennis N.L.
Published: April 2024

Public concern over catastrophic wildfire presents an important opportunity for foresters to lead the effort to reduce fire hazards and restore resilience to western forest ecosystems.…
Book Review: Forests under Fire: A Century of Ecosystem Mismanagement in the Southwest
Authors: Covington W.W.
Published: April 2024

Forests under Fire: A Century of Ecosystem Mismanagement in the Southwest, edited by christopher J. Huggard and Arthur R. Gómez, is a well-balanced, scholarly anthology that addresses the history of forest management in the Southwest.
Plantation Certification and Genetic Engineering: FSC's Ban on Research Is Counterproductive
Authors: Strauss S.H. , Campbell M.M. , Pryor S.N. , Coventry P. , Burley J.
Published: April 2024

Genetic engineering, also called genetic modification (GM), is the isolation, recombinant modification, and asexual transfer of genes. It has been banned in forest plantations certified by the Forest Stewardship Council (FSC) regardless of the source of genes, traits imparted, or whether for research or commercial use. We review the methods and goals of tree genetic engineering research and argue that FSC's ban on research is counterproductive because it makes it difficult for certified companies to participate in the field research needed to assess the value and biosafety of GM trees. Genetic modification could be important for translating new discoveries about tree genomes into improved growth, quality, sustainability, and pest resistance.
Commentary: Ending the Cold War
Authors: Heissenbuttel J.F.
Published: April 2024

For those of you fortunate enough to attend the 2000 SAF National Convention, I'm sure you will all agree it was truly a monumental event. Overall attendance exceeded expectations, but it was the student participation that was really encouraging: More than 400 students attended. The energy and drive of these young professionals - our future - was something to behold...
Commentary: Bringing People and Science Together
Authors: Friedman S.T.
Published: April 2024

The beginning of the year traditionally is a time to appreciate what has gone before and look forward to the future. As I write this, at the beginning of January, I'd like to express my appreciation to the SAF staff, members of the Forest Science and Technology Board (FSTB), and the working group officers...
Evaluating the Effectiveness of the Forest Stewardship Program in West Virginia
Authors: Egan A. , Gibson D. , Whipkey R.
Published: April 2024

A mail survey was conducted of West Virginia forestland owners who had a written forest stewardship plan on file for a minimum of five years. Along with sociodemographic information for each respondent, the survey requested information on the types of forest management activities prescribed by the plan and any forest management activities implemented since the plan was filed. Respondents were also asked to describe their levels of satisfaction or dissatisfaction with various aspects of the forest stewardship planning process.
Supply Contract and Portfolio Insurance: Applying Financial Engineering to Institutional Timberland Investment
Authors: Yin R. , Izlar B.
Published: April 2024

The long-term growth of institutional timberland investments depends on the ability of timberland investment management organizations (TIMO) to deal effectively with securitization, leveraging, arbitraging, supply contracting, portfolio insurance, tax efficiency enhancement, and other issues. Financial engineering holds great promise for many of these issues. This study applies financial engineering techniques to two cases–supply contract and portfolio insurance. We believe that the potential benefits of these and other applications can be great.
Commentary: We Stand for Sustainability
Authors: Banzhaf W.H.
Published: April 2024

The SAF Council recently adopted as one of SAF's core values a statement on sustainability. I believe this statement reflects what the profession of forestry has always been about, and what it must continue to be about if we are to provide direction to both public and private policymakers.…
Managing Forests within a Watershed: The Importance of Stewardship
Authors: Tyson C.B. , Worthley T.E.
Published: April 2024

Four years after its inception an outreach campaign promoting forest stewardship in south-central Connecticut was carefully evaluated. Results emphasize that efforts may be directed to promoting a simpler and more autonomous form of resource inventory and forest stewardship planning than many forestry specialists might originally envision. Evaluation methods used to measure the success of outreach efforts should recognize a continuum of possible outcomes, not simply the ideal.
Forestry Students, Employers, and the Implied Contract: Expectations and Obligations
Authors: Michael J.H. , Dasmohapatra S.
Published: April 2024

Recently graduated forestry majors will start their jobs with preexisting perceptions regarding the reciprocal obligations between themselves and their employers. These perceptions will form a type of implied contract between the two parties. To investigate the problems that can arise when a new employee perceives an employer to have broken that contract, we surveyed senior forestry majors (before and after they found jobs) and employers. Results indicate that agency and industry employers create significantly different expectations for their new employees. Moreover, negative outcomes related to turnover, performance, and satisfaction will result when new employees perceive that employers have not fulfilled their obligations.
The radius variations of accreting main-sequence stars and mass transfer instability
Authors: Zhao Zi-Qi , Li Zhen-Wei , Xiao Lin , Ge Hong-Wei , Han Zhan-Wen
Published: April 2024

Many previous works studied the dynamical time-scale mass transfer stability criteria based on the donor response with neglecting the stellar structure of the accretor. In this letter, we investigate the radial response of accretors with mass accumulation and its effect on the binary mass transfer stability. We perform a series of detailed stellar evolution simulations with different types of accretors and obtain the radial variations of stars accreting at different rates. Since the time within which the donor loses half of the original mass has a correlation with the donor mass, we approximately obtain the mean mass transfer rate as a function of mass ratio. Assuming that the common envelope (CE) phase occurs if the accretor radius exceeds the outer Roche lobe radius, we obtain the critical mass ratio of dynamically unstable mass transfer. We find the critical mass ratios for donors filling their Roche lobes at the Main Sequence (MS) and Hertzsprung Gap (HG) stages are smaller than that derived from the radial response of the donor in the traditional way. Our results may suggest that the binary is easier to enter into the CE phase for a donor star at the MS or HG stage than previously believed.
Geriatric cutaneous leishmaniasis: a retrospective analysis of 622 cases
Authors: Doni Nebiye Yentur , An İsa
Published: April 2024

Background

Cutaneous leishmaniasis (CL) is most common in childhood because children are exposed to the parasite early and, unlike adults, do not have immunity to CL. Since CL is less common in geriatric patients, clinical and epidemiological data in this age group are limited. This study aims to compare the clinical and demographic characteristics of geriatric patients diagnosed with CL with young patients.

Methods

In this retrospective study, 622 patients aged 65 and over and 6350 patients aged 19–64, who applied to Şanlıurfa Oriental Boil Diagnosis and Treatment Center between January 2013 and February 2024 and were diagnosed with CL by parasitological examination, were included. Clinical and demographic characteristics of patients diagnosed with CL, such as age, gender, location of the lesion, lesion size, duration of the lesion, and treatments applied due to the diagnosis of CL, were recorded. Clinical and demographic characteristics of geriatric and young patients were compared.

Results

The mean age of elderly CL cases was 72.95 ± 6.54 years, and 65.2% were female. The most common clinical forms were ulcers (51.9%) and plaques (41%), respectively, in young and elderly patients. The most common locations of the lesions were upper limbs (54.8%) in all patients. The most preferred treatment method was intralesional (IL) meglumine antimoniate (MA) treatment (98.3%) in all patients. There were no difference between young and elderly CL cases in terms of mean number of lesions, average lesion duration, average lesion size, lesion location, clinical forms of lesions, and treatments options (P > 0.05).

Conclusions

Based on the results of our study, it can be said that the clinical and demographic characteristics of CL are similar in young and old patients and systemic MA treatment shows similar clinical benefit in both age groups. In addition, it can be said that systemic MA therapy can be used safely in young patients and elderly patients without contraindications. IL MA therapy can be used in elderly patients where systemic MA therapy is contraindicated.
Comprehensively evaluating the relationships between marital status and other family factors with cardiovascular disease and long-term overall mortality in the elderly: a study of 48 510 Chinese individuals
Authors: Liao Guang-zhi , Huang Yan , Guan Jing-yuan , Luo Man-qing , Huang Li-yan , Feng Jia-yu , Zhang Yu-hui , Zhang Jian
Published: April 2024

Background

Marital status is associated with cardiovascular disease (CVD) incidence and overall mortality, yet limited research on this topic in elderly individuals is available. Our aim was to comprehensively assess the impact of marital status and other family factors on CVD incidence and long-term mortality among elderly people.

Methods

Data from the Chinese Longitudinal Healthy Longevity Survey (2002/2005/2008–2018) for participants aged ≥60 years were analysed. A cross-sectional study initially examined the correlation between spouses, offspring, living arrangements, and CVD using logistic regression. Subsequently, a retrospective cohort study investigated the long-term associations of these factors with overall mortality via Kaplan–Meier and Cox regression analyses.

Results

The study involved 48 510 subjects (average age: 87 years). The cross-sectional analysis revealed a correlation between living with a spouse and an increased incidence of heart disease (adjusted OR 1.27, 95% CI 1.04–1.55) and cerebrovascular disease/stroke (adjusted OR 1.26, 95% CI 1.11–1.42). According to the retrospective cohort analysis, living with a spouse significantly reduced overall mortality (adjusted HR 0.84, 95% CI 0.80–0.87), irrespective of marital relationship quality. Conversely, living with offspring (adjusted HR 1.12, 95% CI 1.08–1.16), having more children (adjusted Pnonlinearity = 0.427) or cohabitants (adjusted Pnonlinearity < 0.0001) were associated with increased overall mortality.

Conclusion

In the elderly population, being married and living with a spouse were not significantly associated with a decrease in CVD incidence but were associated with a reduction in long-term overall mortality. Living with offspring, having more children, or having a larger family size did not replicate the protective effect but indicated greater overall mortality.
The epigenetic landscape in intestinal stem cells and its deregulation in colorectal cancer
Authors: Larue Axelle E M , Atlasi Yaser
Published: April 2024

Epigenetic mechanisms play a pivotal role in controlling gene expression and cellular plasticity in both normal physiology and pathophysiological conditions. These mechanisms are particularly important in the regulation of stem cell self-renewal and differentiation, both in embryonic development and within adult tissues. A prime example of this finely tuned epigenetic control is observed in the gastrointestinal lining, where the small intestine undergoes renewal approximately every 3-5 days. How various epigenetic mechanisms modulate chromatin functions in intestinal stem cells (ISCs) is currently an active area of research. In this review, we discuss the main epigenetic mechanisms that control ISC differentiation under normal homeostasis. Furthermore, we explore the dysregulation of these mechanisms in the context of colorectal cancer (CRC) development. By outlining the main epigenetic mechanisms contributing to CRC, we highlight the recent therapeutics development and future directions for colorectal cancer research.
Recognizing professional development of mathematics and statistics learning support staff
Authors: O’Sullivan Ciaran , Grove Michael , Bhaird Ciarán Mac an , Mulligan Peter , Pfeiffer Kirsten
Published: April 2024

Tutors play an important role in effective Mathematics Learning Support, and ensuring good initial training and development is key. Typically, in the UK and Ireland, tutors do not gain any formal recognition for the training they receive. This paper details a four competences model of training for tutors and presents the analysis of feedback from 11 tutors and two staff involved in piloting the model at two institutions. The model, which is informed by professional development guidelines, consultation across the mathematical sciences community, and enabled by a national Mathematics Learning Support Network, provides immediate recognition of the professional development undertaken and is amenable to formal accreditation. A structure of four digital badges is used to assign immediate value to the training and development of tutors. To add further value for tutors, a capstone tutor badge has been established for those completing all four competences. Thematic analysis of feedback from the piloting of the model identifies three overarching themes: the importance of community, developing as a professional, and motivating and enabling professional development. Although primarily of interest to those involved in Mathematics Learning Support, the innovative structure of the model and the insights gained from its piloting are such that it offers potential for genuine transferability across other subject disciplines.
Molecular-Phylogenetic Characterization of Xanthomonas hortorum pv. pelargonii Strains Causing Leaf Spot of Geraniums in Iran
Authors: Haghshenas Iman , Taghavi S. Mohsen , Zarei Sadegh , Osdaghi Ebrahim
Published: April 2024

Bacterial blight and leaf spot of geraniums is a destructive disease of cultivated Pelargonium species around the world. During 2020 to 2021, surveys were conducted in seven geranium-growing provinces of Iran to monitor the status of bacterial blight and leaf spot disease. The disease was observed in six surveyed provinces varying in the extent of occurrence and severity. Twenty-two gram-negative pale-yellow bacterial strains resembling members of Xanthomonas were isolated from symptomatic leaves and stems. Pathogenicity and host range assays showed that the bacterial strains were pathogenic on Pelargonium grandiflorum, P. graveolens, P. peltatum, and P. zonale. All strains were positive for a PCR test using the primer pair XcpM1/XcpM2, which is specific for X. hortorum pv. pelargonii. Phylogenetic analysis using the sequences of gyrB and lepA genes showed that the 22 strains clustered in a clade among the sequences of X. hortorum pv. pelargonii strains retrieved from GenBank but were distinct from the other pathovars of X. hortorum. BOX-PCR-based fingerprinting using BOX-A1R primer revealed that the strains isolated in this study were grouped into two clusters, while no distinct correlation was observed between the host/area of isolation and BOX-PCR fingerprinting. None of the strains obtained in this study nor the reference strain of the pathogen produced bacteriocin against each other. Results obtained in this study shed light on the geographic distribution, taxonomic status, and host range of the bacterial blight and leaf spot pathogen of geraniums in Iran, paving the path for further research on disease management.
Non-contrast MRI and post-mastectomy silicone breast implant rupture: preventing false positive diagnoses
Authors: Mazzocconi Luca , De Lorenzi Francesca , Carbonaro Riccardo , Lorenzano Valerio , Rotili Anna , Pesapane Filippo , Signorelli Giulia , Caldarella Pietro , Corso Giovanni , Cassano Enrico , Veronesi Paolo
Published: April 2024

Background

Breast implants are not lifelong, with implant rupture being the third leading cause of revisional surgery in augmented women. Noncontrast MRI is a reliable tool to assess implant integrity; however, false positive and false negative diagnoses have been reported due to an incorrect interpretation of MRI signs. This study aims to investigate the incidence of these misleading results, comparing MRI findings with intraoperative surgical observations and exploring signs of nonunivocal interpretation.

Materials and methods

Between March 2019 and October 2022, our hospital, a referral center for breast cancer care, conducted 139 breast MRI examinations to evaluate implant integrity. Surgical intervention was deemed necessary for patients diagnosed with suspected or confirmed implant rupture at MRI. Those patients who did not undergo any surgical procedure (63 cases) or had surgery at different institutes (11 cases) were excluded.

Results

Among the 65 patients who underwent preoperative MRI and subsequent surgery at our institute, surgical findings confirmed the preoperative MRI diagnosis in 48 women. Notably, 17 women exhibited a discordance between MRI and surgical findings: three false negatives, 11 false positives and three possible ruptures not confirmed. Signs of nonunivocal or misleading interpretation were assessed on a patient-by-patient basis. The importance of obtaining detailed information about a patient’s breast implant, including fill materials, number of lumens, manufacturer and shape, proved immensely beneficial for interpreting MRI signs accurately.

Conclusion

Pre-MRI knowledge of implant details and a meticulous evaluation of non-univocal signs can aid radiologists in accurately assessing implant integrity, reducing the risk of unnecessary revisional surgeries, and potentially averting allegations of medical malpractice.
Cancer mortality predictions for 2024 in selected Asian countries and Australia with focus on stomach cancer
Authors: Santucci Claudia , Mignozzi Silvia , Levi Fabio , Malvezzi Matteo , Bertuccio Paola , Odone Anna , Camargo M. Constanza , La Vecchia Carlo , Negri Eva
Published: April 2024

Introduction

We estimated cancer mortality figures in five major Asian countries and Australia for 2024, focusing on stomach cancer, a leading cause of cancer-related deaths in Eastern Asia.

Methods

We computed country- and sex-specific annual age-standardized rates (ASRs) for total cancers and the 10 most common cancer sites, using WHO and the United Nations Population Division databases from 1970 to 2021 or the latest available year. We predicted figures for 2024 and estimated the number of avoided cancer deaths in 1994–2024.

Results

All cancers combined ASR declined between 2015–2019 and 2024 across considered countries and sexes. In 2024, the lowest predicted male rate is in the Philippines (75.0/100 000) and the highest in Australia (94.2/100 000). The Republic of Korea is predicted to have the lowest female ASR (42.1/100 000) while the Philippines the highest (74.5/100 000). Over the last three decades, 121 300 deaths were estimated to be avoided in Hong Kong SAR, 69 500 in Israel, 1 246 300 in Japan, 653 300 in the Republic of Korea, 303 300 in Australia, and 89 700 among Philippine men. Mortality from stomach cancer has been decreasing since 1970 in all considered countries and both sexes. Significant decreases are at all age groups Male rates remain, however, high in Japan (8.7/100 000) and the Republic of Korea (6.2/100 000).

Conclusion

Declining cancer mortality is predicted in the considered countries, notably reducing stomach cancer burden. Stomach cancer, however, remains a major public health issue in East Asia.
Current applications of artificial intelligence in assisted reproductive technologies through the perspective of a patient's journey
Authors: Pavlovic Zoran J. , Jiang Victoria S. , Hariton Eduardo
Published: April 2024

Purpose of review

This review highlights the timely relevance of artificial intelligence in enhancing assisted reproductive technologies (ARTs), particularly in-vitro fertilization (IVF). It underscores artificial intelligence's potential in revolutionizing patient outcomes and operational efficiency by addressing challenges in fertility diagnoses and procedures.

Recent findings

Recent advancements in artificial intelligence, including machine learning and predictive modeling, are making significant strides in optimizing IVF processes such as medication dosing, scheduling, and embryological assessments. Innovations include artificial intelligence augmented diagnostic testing, predictive modeling for treatment outcomes, scheduling optimization, dosing and protocol selection, follicular and hormone monitoring, trigger timing, and improved embryo selection. These developments promise to refine treatment approaches, enhance patient engagement, and increase the accuracy and scalability of fertility treatments.

The integration of artificial intelligence into reproductive medicine offers profound implications for clinical practice and research. By facilitating personalized treatment plans, standardizing procedures, and improving the efficiency of fertility clinics, artificial intelligence technologies pave the way for value-based, accessible, and efficient fertility services. Despite the promise, the full potential of artificial intelligence in ART will require ongoing validation and ethical considerations to ensure equitable and effective implementation.
Use of menopausal hormone therapy beyond age 65 years and its effects on women's health outcomes by types, routes, and doses
Authors: Baik Seo H. , Baye Fitsum , McDonald Clement J.
Published: April 2024

Objectives

The study aims to assess the use of menopausal hormone therapy beyond age 65 years and its health implications by types of estrogen/progestogen, routes of administration, and dose strengths.

Methods

Using prescription drug and encounter records of 10 million senior Medicare women from 2007-2020 and Cox regression analyses adjusted for time-varying characteristics of the women, we examined the effects of different preparations of menopausal hormone therapy on all-cause mortality, five cancers, six cardiovascular diseases, and dementia.

Results

Compared with never use or discontinuation of menopausal hormone therapy after age 65 years, the use of estrogen monotherapy beyond age 65 years was associated with significant risk reductions in mortality (19% or adjusted hazards ratio, 0.81; 95% CI, 0.79-0.82), breast cancer (16%), lung cancer (13%), colorectal cancer (12%), congestive heart failure (CHF) (5%), venous thromboembolism (3%), atrial fibrillation (4%), acute myocardial infarction (11%), and dementia (2%). For the use of estrogen and progestogen combo-therapy, both E+ progestin and E+ progesterone were associated with increased risk of breast cancer by 10%-19%, but such risk can be mitigated using low dose of transdermal or vaginal E+ progestin. Moreover, E+ progestin exhibited significant risk reductions in endometrial cancer (45% or adjusted hazards ratio, 0.55; 95% CI, 0.50-0.60), ovarian cancer (21%), ischemic heart disease (5%), CHF (5%), and venous thromboembolism (5%), whereas E+ progesterone exhibited risk reduction only in CHF (4%).

Conclusions

Among senior Medicare women, the implications of menopausal hormone therapy use beyond age 65 years vary by types, routes, and strengths. In general, risk reductions appear to be greater with low rather than medium or high doses, vaginal or transdermal rather than oral preparations, and with E2 rather than conjugated estrogen.
Distinguishing Characteristics of Admissions to Various Types of Posthospital Brain Injury Rehabilitation Programs
Authors: Salisbury David B. , Parrott Devan , Altman Irwin M. , Eicher Vicki , Logan Daniel M. , McGrath Claire , Walters G. Joseph , Malec James F.
Published: April 2024

Objective:

Describe and compare the demographic characteristics and disability profiles of individuals admitted to 6 types of posthospital brain injury rehabilitation (PHBIR) programs.

Setting:

Data from Residential Neurobehavioral, Residential Neurorehabilitation, Home and Community Neurorehabilitation, Day Treatment, Outpatient Neurorehabilitation, and Supported Living programs serving individuals with acquired brain injury (ABI).

Participants:

Two thousand twenty-eight individuals with traumatic brain injury (TBI), stroke, or other ABI.

Main Measures:

Sex, age, time since injury, and Mayo-Portland Adaptability Inventory, 4th edition (MPAI-4).

Design:

Retrospective analyses of demographic variables and MPAI-4 Total, Index, and subscale Rasch-derived T-scores on admission comparing diagnostic categories and program types within diagnostic categories.

Results:

Participants with TBI were predominantly male, and those with stroke were generally older. Admissions to more intensive and supervised programs (residential neurobehavioral and residential neurorehabilitation) generally showed greater disability than admissions to home and community programs who were more disabled than participants in day treatment and outpatient programs. Residential neurobehavioral and supported living program participants generally were male and had TBI. Home and community admissions tended to be more delayed than residential neurorehabilitation admissions. The majority of those with other ABI were admitted to outpatient rather than more intensive programs. Additional analyses demonstrated significant differences in MPAI-4 profiles among the various program types.

Conclusions:

Admissions with TBI, stroke, and other ABI to PHBIR differ in demographic factors and disability profiles. When examined within each diagnostic category, demographic features and disability profiles also distinguish among admissions to the various program types. Results provide insights about decision-making in referral patterns to various types of PHBIR programs, although other factors not available for analysis (eg, participant/family preference, program, and funding availability) likely also contribute to admission patterns.
Healthy Days at Home Among Older Medicare Beneficiaries With Traumatic Brain Injury Requiring Inpatient Rehabilitation
Authors: Kumar Raj G. , Evans Emily , Albrecht Jennifer S. , Gardner Raquel C. , Dams-O’Connor Kristen , Thomas Kali S.
Published: April 2024

Objective: The objectives of this study were to characterize and identify correlates of healthy days at home (HDaH) before and after TBI requiring inpatient rehabilitation. Setting: Inpatient hospital, nursing home, and home health services. Participants: Average of n= 631 community-dwelling fee-for-service age 66+ Medicare beneficiaries across 30 replicate samples who were hospitalized for traumatic brain injury (TBI) between 2012 and 2014 and admitted to an inpatient rehabilitation facility (IRF) within 72 hours of hospital discharge. Design: Retrospective study using data from Medicare claims supplemented with data from the National Trauma Databank. Main measures: The primary outcome, HDaH, was calculated as time alive not using inpatient hospital, nursing home, and home health services in the year before TBI hospitalization and after IRF discharge. Results: We found HDaH declined from 93.2% in the year before TBI hospitalization to 65.3% in the year after IRF discharge (73.6% among survivors only). Most variability in HDaH was: (1) in the first 3 months after discharge and (2) by discharge disposition, with persons discharged from IRF to another acute hospital having the worst prognosis for utilization and death. In negative binomial regression models, the strongest predictors of HDaH in the year after discharge were rehabilitation Functional Independence Measure mobility score (β = 0.03; 95% CI, 0.002-0.06) and inpatient Charlson Comorbidity Index score (β = − 0.06; 95% CI, −0.13 to 0.001). Dual Medicaid eligible was associated with less HDaH among survivors (β = − 0.37; 95% CI, −0.66 to −0.07). Conclusion: In this study, among community-dwelling older adults with TBI, we found a notable decrease in the proportion of time spent alive at home without higher-level care after IRF discharge compared to before TBI. The finding that physical disability and comorbidities were the biggest drivers of healthy days alive in this population suggests that a chronic disease management model is required for older adults with TBI to manage their complex health care needs.
Late iris cerclage suture cheese-wiring
Authors: Ladki Malik S. , Snyder Michael E.
Published: April 2024

Purpose:

To describe a case series of cerclage failures due to cheese-wiring; iris repair can develop late cheese-wiring of cerclage sutures with resultant loss of benefits.

Setting:

Cincinnati Eye Institute, Cincinnati, Ohio.

Design:

Retrospective single-surgeon case series.

Methods:

A retrospective chart review sought patients who underwent iris cerclage at the Cincinnati Eye Institute who later developed suture cheese-wiring. The patient symptoms, demographics, cerclage size, suture type, knot type, iris status, and suture status at final follow-up were ascertained.

Results:

6 cases of cerclage suture cheese-wiring with loss of the original surgical benefit were identified. 10-0 polypropylene suture and a 3-1-1 knot were used in each case. The suture remained intact with an intact knot and suture loop in all cases.

Conclusions:

Cheese-wiring with return of mydriasis is a potential long-term outcome of iris cerclage suture placement, with return of preoperative symptoms. Awareness of this potential eventuality provides physicians and patients a broader perspective when selecting between cerclage suture, iris prosthesis placement, or other surgical and nonsurgical options.
Nociplastic pain mechanisms and toll-like receptors as promising targets for its management
Authors: Rodríguez-Palma Erick J. , Huerta de la Cruz Saul , Islas-Espinoza Ana M. , Castañeda-Corral Gabriela , Granados-Soto Vinicio , Khanna Rajesh
Published: April 2024

Nociplastic pain, characterized by abnormal pain processing without an identifiable organic cause, affects a significant portion of the global population. Unfortunately, current pharmacological treatments for this condition often prove ineffective, prompting the need to explore new potential targets for inducing analgesic effects in patients with nociplastic pain. In this context, toll-like receptors (TLRs), known for their role in the immune response to infections, represent promising opportunities for pharmacological intervention because they play a relevant role in both the development and maintenance of pain. Although TLRs have been extensively studied in neuropathic and inflammatory pain, their specific contributions to nociplastic pain remain less clear, demanding further investigation. This review consolidates current evidence on the connection between TLRs and nociplastic pain, with a specific focus on prevalent conditions like fibromyalgia, stress-induced pain, sleep deprivation–related pain, and irritable bowel syndrome. In addition, we explore the association between nociplastic pain and psychiatric comorbidities, proposing that modulating TLRs can potentially alleviate both pain syndromes and related psychiatric disorders. Finally, we discuss the potential sex differences in TLR signaling, considering the higher prevalence of nociplastic pain among women. Altogether, this review aims to shed light on nociplastic pain, its underlying mechanisms, and its intriguing relationship with TLR signaling pathways, ultimately framing the potential therapeutic role of TLRs in addressing this challenging condition.
Association of Heart Failure With Cognitive Decline and Development of Mild Cognitive Impairment and Dementia
Authors: Jung Miyeon , Apostolova Liana G. , Gao Sujuan , Burney Heather N. , Lai Dongbing , Saykin Andrew J. , Pressler Susan J.
Published: April 2024

Background

Incidence of cognitive impairment and its consequences have not been fully examined in heart failure (HF).

Objective

The aim of this study was to examine associations of HF with cognitive decline, frequencies and risks of, and time-to-develop mild cognitive impairment (MCI) or dementia during 15-year follow-up.

Methods

For this retrospective cohort study, data were retrieved from the National Alzheimer's Coordinating Center. Cognitive decline was assessed using the Uniform Data Set neuropsychological battery. Development of MCI and dementia was assessed using clinically diagnosed cognitive status.

Results

Compared with participants without HF (n = 12 904), participants with HF (n = 256) had more decline in attention, executive function, and memory while controlling for covariates including apolipoprotein E4. Participants with HF developed MCI or dementia more frequently (44.9% vs 34.4%), developed dementia faster from normal cognition, and had a lower risk of dementia from MCI after controlling for covariates (hazard ratio, 0.71) than participants without HF.

Conclusions

Heart failure was associated with accelerated cognitive decline.
Predictors of Health-Related Quality of Life Among Women Participating in an Appointment-Based Cardiac Rehabilitation Program
Authors: Wright Catherine X. , Fournier Sean , Deng Yanhong , Meng Can , Tucker Katherine , Spatz Erica S. , Lichtman Judith H. , Zhu Cenjing , Dreyer Rachel P. , Oen-Hsiao Joyce M.
Published: April 2024

Background

An alternative patient-centered appointment-based cardiac rehabilitation (CR) program has led to significant improvements in health outcomes for patients with cardiovascular disease. However, less is known about the effects of this approach on health-related quality of life (HRQoL), particularly for women.

Objective

We examined the effects of a patient-centered appointment-based CR program on HRQoL by sex and examined predictors of HRQoL improvements specifically for women.

Methods

Data were used from an urban single-center CR program at Yale New Haven Health (2012–2017). We collected information on patient demographics, socioeconomic status, and clinical characteristics. The Outcome Short-Form General Health Survey (SF-36) was used to measure HRQoL. We evaluated sex differences in SF-36 scores using t tests and used a multivariate linear regression model to examine predictors of improvements in HRQoL (total SF-36 score) for women.

Results

A total of 1530 patients with cardiovascular disease (23.7% women, 4.8% Black; mean age, 64 ± 10.8 years) were enrolled in the CR program. Women were more likely to be older, Black, and separated, divorced, or widowed. Although women had lower total SF-36 scores on CR entry, there was no statistically significant difference in CR adherence or total SF-36 score improvements between sexes. Women who were employed and those with chronic obstructive pulmonary disease were more likely to have improvements in total SF-36 scores.

Conclusion

Both men and women participating in an appointment-based CR program achieved significant improvements in HRQoL. This approach could be a viable alternative to conventional CR to optimize secondary outcomes for patients.
Improving Access and Quality of Behavioral Health Services for Health Care Employees
Authors: Morgenstern Jon , Levak Svetlana , Madden Sean P. , Moon Khatiya C. , Muench Frederick , Koroly Lindsy , Bancroft Courtney , Grella Megan , Romano Robert J. , Katechia Manavi , Sapra Manish
Published: April 2024

Objective

To describe key features and the initial implementation of an employer-sponsored program designed to increase access to quality mental health treatment for employees of a large health care system. Methods: Retrospective data were collected on employer’s efforts to develop a programmatic solution to address barriers to accessing quality mental health treatment among its employees and on initial program implementation. Results: Data from the initial cohort (N = 1049) of program participants support the use of low threshold digital tools to enhance access to care, the importance of care navigation and a robust curated provider network in matching employees to appropriate care options, and the value of providing online, evidence-based psychotherapy to facilitate high rates of treatment engagement. Conclusions: Findings can help inform employers about approaches to improve access to quality mental health treatment for their employees.
An Ecological Association Between Air Pollution and Adolescent Obesity Study
Authors: Treister-Goltzman Yulia
Published: April 2024

Objectives

The purposes of this study were to assess the association between exposure to particulate matter (PM2.5) and adolescent obesity and to identify and visualize the world areas where the problems of adolescent obesity and air pollution by fine PM are more severe.

Methods

This is an ecological study, based on publicly available data from a World Health Organization site.

Results

For each increase in air pollution there was an increase in the probability of being in the higher prevalence obesity group (OR = 1.18 (95% CI, 1.06–1.31). High prevalence rates for both adolescent obesity and air pollution by PM2.5 were identified in several countries, including Venezuela, Algeria, Libya, Saudi Arabia, Iraq, and Oceania islands.

Conclusions

Efforts by local authorities and world organizations should be focused on the countries with the highest prevalence rates for both conditions.
Perceived Workplace Discrimination on the Basis of Parent Status in Australia
Authors: Cooklin Amanda , Mason Simon , Widiss Deborah , Leach Liana , Hokke Stacey , Bennetts Shannon K. , Allen-Leap Molly , Oakman Jodi
Published: April 2024

Objective

This study focused on employees’ perceived discrimination due to parenthood; and mental health, occupational stress and turnover intention.Methods:Survey (2016) of an Australian convenience sample of employed parents: women (n= 2950) and men (n= 1318).Results:Forty-two percent of all mothers reported missing out on promotion (n= 1234/2950); one-third reported negative comments from managers (n= 805/2950, 27%) or colleagues (n= 832/2950, 28%). One in five fathers reported these forms of discrimination. In adjusted analyses, perceived discrimination was associated with poorer mental health (β = 0.23,P< 0.001); higher occupational stress (β = 0.30,P< 0.001); and increased odds of turnover intention (adjusted odds ratio = 1.5,P< 0.001) for mothers; and poorer mental health (β = 0.34,P< 0.001); stress (β = 0.35,P< 0.001); and increased odds of turnover intention (adjusted odds ratio = 1.7,P< 0.001) for fathers.Conclusions:Experiences of negativity and hostility at work are common and link to employee health and well-being.
One-year results of the Flowdynamics Dense Mesh Stent for residual dissection after proximal repair of stanford type A or type B aortic dissection: a multicenter, prospective, and randomized study
Authors: Lu Chen , Duan Weixun , Li Zhen , Wang Chenhao , Yang Peng , Liu Yu , Zuo Jian , Hu Jia
Published: April 2024

Objective:

Negative remodeling of the distal aorta following proximal repair for acute aortic dissection has garnered growing attention. This clinical scenario has spurred the development of techniques and devices. A multicenter, prospective, and randomized controlled study was conducted with the aim of confirming the safety and effectiveness of a newly-designed flowdynamics dense mesh stent for the treatment of residual dissection after proximal repair.

Methods:

Patients with nonchronic residual dissection affecting visceral branches were prospectively enrolled at three centers and randomly allocated to either the FDMS group or the control group. Primary endpoints encompassed all-cause and aortic-related mortality, while the patency of branch arteries is indeed a key focal metric. Morphological changes (diameter, area, and volume) were analyzed to demonstrate the therapeutic effect.

Results:

One hundred twelve patients were recruited in the clinical trial, and 103 patients completed the 12-month follow-up. The rate of freedom from all-cause and aortic-related death in the FDMS group was 94.64 and 100%, respectively. All visceral branches remained patent. The FDMS group exhibited a substantial expansion in TL and a notable shrinkage in FL at the planes below renal arteries (ΔArea TL: FDMS vs. Control, 0.74±0.46 vs. 0.34±0.66 cm2, P<0.001; ΔArea FL: FDMS vs. Control, −0.72±1.26 vs. −0.12±0.86 cm, P=0.01) and 5 cm below renal arteries (ΔArea TL: FDMS vs. Control, 1.06±0.75 vs. 0.16±0.63 cm2, P<0.001; ΔArea FL: FDMS vs. Control, −0.53±1.43 vs. −0.25±1.00 cm, P=0.27). Meanwhile, the FDMS group demonstrated an increase of 22.55±11.14 cm3 in TL (P<0.001) and a corresponding reduction of 21.94±11.77 cm3 in FL (P=0.08).

Conclusions:

This newly-designed FDMS for endovascular repair of residual dissection following the proximal repair is demonstrated to be safe and effective at 12 months.
Surgical modifications to the conventional kidney transplant technique: the Miami Transplant Institute approach in a retrospective cohort study
Authors: Ciancio Gaetano , Tabbara Marina M. , Gonzalez Javier , Alvarez Angel , Gaynor Jeffrey J.
Published: April 2024

Background:

At our center, surgical modifications to the conventional kidney transplant technique were developed with two goals in mind: to minimize the risk of developing post-transplant urologic/vascular/other surgical complications, and to simultaneously eliminate the need for initial ureteral stent placement and surgical drainage.

Methods:

Here, the authors describe these modifications along with (what we believe are) their advantages over the conventional technique: creating an abdominal flap for easier abdominal closure (reflecting the parietal peritoneum from the abdominal wall), mobilizing the bladder before transplant (creating more space for bladder dissection, allowing it to move upward during abdominal wall closure), minimizing the dissection of iliac vessels to only anterior lymphatic tissue (attempting to minimize the incidence of fluid collections), using plastic arterial vascular bulldog clamps (causing less trauma to the iliac artery), performing vascular anastomosis of the renal artery first (making it easier for the surgeon to perform the anastomoses), creating longer ureteral spatulation, and inclusion of bladder mucosa along with some detrusor muscle layer in performing the ureteral anastomosis (attempting to minimize the incidence of urologic complications). Of note, no initial ureteral stent placement or surgical drainage was used. The authors report our experience during the first 12 months post-transplant of a single transplant surgeon who used each of these modifications among 707 consecutive recipients of kidney-alone transplants at our center since 2014.

Results:

During the first 12 months post-transplant, 2.3% (16/707) of patients developed a urologic complication; only 1.0% (7/707) required surgical repair of their original ureteroneocystostomy. Additionally, 2.7% (19/707) developed a vascular complication; 8.8% (62/707) developed some other type of surgical complication (wound complication, lymphocele development, or development of a peri-renal hematoma or peri-renal collection). These overall results were advantageous when compared with other studies.

Conclusion:

The authors believe that this modified kidney transplant technique clearly helped in reducing post-transplant risks of developing urologic/vascular/other surgical complications. Importantly, these results were achieved without initial ureteral stent placement or surgical drainage.
Influence of the Outflow Graft Angular Position on the Outcomes in Patients With a Left Ventricular Assist Device
Authors: Zijderhand Casper F. , Peek Jette J. , Sjatskig Jelena , Manintveld Olivier C. , Bekkers Jos A. , Bogers Ad J. J. C. , Caliskan Kadir
Published: April 2024

This study aimed to explore the potential impact of the angular position of the outflow graft on thromboembolic events and aortic valve regurgitation in people with a left ventricular assist device (LVAD). We analyzed contrast computed tomography (CT) data of patients with LVAD implantation between 2016 and 2021. Three-dimensional reconstructions of the outflow graft and aortic arch were performed to calculate the horizontal (azimuth) angle and vertical (polar) angle, as well as the relative distance between the outflow graft, aortic valve, and brachiocephalic artery. Among 59 patients (median age 57, 68% male), a vertical angle ≥107° correlated significantly with increased cerebrovascular accidents (hazard ratio [HR]: 5.8, 95% confidence interval [CI]: 1.3–26.3, p = 0.022) and gastrointestinal bleeding (HR: 3.4, 95% CI: 1.0–11.2, p = 0.049) during a median 25 month follow-up. No significant differences were found between the vertical angle and aortic valve regurgitation or survival. The horizontal angle and relative distance did not show differences regarding clinical adverse events. This study emphasizes the importance of the LVAD outflow graft angular position to prevent life-threatening thromboembolic events. This study suggests the need for prospective research to further validate these findings.
The correlation between subendocardial viability ratio and the degree of coronary artery stenosis in patients with coronary heart disease and its predictive value for the incidence of short-term cardiovascular events
Authors: Fan Tingting , Li Yao , Li Mengli , Zhu Ningjun , Zhang Chaohui , Wang Xiaochen
Published: April 2024

Objectives

This study aimed to analyze the ability of subendocardial viability ratio (SEVR) to predict the degree of coronary artery stenosis and the relationship between SEVR and the incidence of short-term cardiovascular endpoint events.

Method

The indexes of 243 patients with chest pain were collected.. Binary logistic regression analyses were performed using the dichotomous outcome of high and non-high SYNTAX scores. Receiver operating characteristic curves were employed to comparatively analyze the diagnostic efficiencies of the indices and models. A survival analysis combined with the Cox regression analysis was performed using the Kaplan–Meier method to understand the relationship between the SEVR and the incidence of cardiovascular events within 1 year in patients with coronary heart disease (CHD).

Results

SEVR was significantly lower (P < 0.05) in the high-stenosis group than control and low-stenosis groups. The diagnostic efficacy of SEVR [area under the curve (AUC) = 0.861] was better than those of age (AUC = 0.745), ABI (AUC = 0.739), and AIx@HR75 (AUC = 0.659). The cutoff SEVR was 1.105. In patients with confirmed CHD who had been discharged from the hospital for 1 year, only SEVR affected survival outcomes (hazard ratio = 0.010; 95% confidence interval: 0.001–0.418; P = 0.016).

Conclusion

A significant decrease in SEVR predicted severe coronary artery stenosis, with a cutoff value of 1.105 and an accuracy of 0.861. In patients with CHD, the lower the SEVR, the higher was the rate of cardiovascular events at 1 year after hospital discharge.