bluuebunny/crossref_metadata_2025 huggingface dataset:
Using Bioprinting to Tissue Engineer Microvascularized Constructs for Skeletal Muscle Repair
Authors: Bour Rachel , Presnell Sharon , Shepherd Benjamin , Christ George , Peirce Shayn
Published: June 2021

Introduction

One challenge in tissue engineering (TE) is designing a construct which ensures adequate oxygen diffusion and removal of waste throughout the implanted tissue. In native tissue, the maximum distance between any cell and capillary is limited to the diffusion distance of oxygen, or 100–200 μm1. Mimicking this dense microvasculature in TE constructs is critical to cell viability and function, particularly in thick implants, such as those for skeletal muscle repair2. There have been many recent advancements in using TE to develop skeletal muscle constructs for the treatment of volumetric muscle loss (VML) in injuries incurred by soldiers and civilians. We have developed a tissue engineered muscle repair (TEMR) technology which consists of myoblasts seeded onto a porcine bladder acellular matrix (BAM). While TEMR has previously been reported to result in 60–70% functional recovery in rodent models within 2 months after implantation3,4, we hypothesize that incorporating endothelial cells (ECs) and pericytes in the TEMR will accelerate the rate and magnitude of functional recovery by facilitating anastomosis with the recipient microcirculation and increasing perfusion into the construct.

Objective

Use bioprinting to position endothelial cells and pericytes with myoblasts on the BAM to “pre‐vascularize” the TEMR construct.

Results

Decellularized microvasculature basement membrane remains intact in some areas of the BAM (Figure 1A). Using the Organovo NovoGen Bioprinter®, we have developed a novel bioprinting method to pattern ECs and myoblasts on the acellular bladder matrix (BAM). ECs seeded onto the BAM begin to form network‐like structures after just 24 hours (Figure 1B). EC viability was shown to be high (>90%) for two bioprinting needle diameters (250 μm vs 500 μm). (Figure 1C).

Conclusions

The presence of ECM from microvasculature on the BAM suggests that the BAM is a promising scaffold for pre‐vascularization. This is further supported by the formation of endothelial network‐like formations on the BAM after just 24 hrs. It is also encouraging that the 250 μm bioprinting needle does not reduce cell viability, as a smaller diameter allows for more precise patterning of cells. Together, these preliminary results suggest that it is feasible to “pre‐vascularize” the TEMR construct by bioprinting.

Future Work

We will further investigate EC viability and network formation in co‐culture with myoblasts. We also plan to incorporate bioprinted pericytes to further encourage and support the formation of pre‐vascularized microvascular networks in TEMR.

Support or Funding Information

NIH T32 GM008715, Organovo, Inc., and the UVA Center for Advanced Biomanufacturing

This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.
Adverse Effects of Chemotherapy on Human Microvascular Function
Authors: Norwood Toro Laura E , Hader Shelby N , Kong Amanda , Rui Hallgeir , Beyer Andreas M
Published: June 2021

Rational

One of the most devastating side effects of cancer treatment is chemotherapy (CT)‐induced heart failure, which results in significant morbidity for patients. Cardiovascular (CV)‐related side effects of CT are known to involve excess reactive oxygen species. However, the underlying mechanisms are disputed. To date little to no evidence exists that describe the direct effect of CT on the microcirculation, and none of these studies were performed in humans. Microvascular (MV) dysfunction is a known early indicator of numerous CV disease phenotypes. The goal of this study was to evaluate whether CT treatment affects human MV function.

Methods

To study the effect of CT on the MV system, flow mediated dilation (FMD) was evaluated in freshly isolated human microvessels from healthy patients that were ex vivo treated with various CT drugs (trastuzumab ‐ TZ, doxorubicin ‐ Dox, lapatinib ‐ Lb, or imatinib ‐ Ib). Mitochondrial DNA (mtDNA) damage was assessed using semi‐quantitative PCR comparing amplification of a small fragment to a large fragment in the mitochondrial genome.

Results

Ex vivo treatment of microvessels with any of the four CT drugs reduced nitric oxide (NO)‐mediated dilation compared to untreated controls. TZ decreased FMD, and Dox treatment eliminated endothelial dilator capacity. TZ, Lb, and Ib treatments maintained MV dilation via a compensatory increase in mitochondrial H2O2‐mediated dilation. Smooth muscle dependent dilation to papaverine was not affected by any of the treatments. Analysis of mtDNA damage from HUVEC cells treated with Dox showed an increase in mtDNA damage, and mitochondria‐targeted Endo III treatment prevented Dox‐mediated loss of dilation. These studies suggest a role for mtDNA damage in the Dox phenotype.

Conclusions

Our studies demonstrate for the first time the effect of CT drugs on human MV function and may lead to methods of preventing additional adverse CV side effects from CT.

Support or Funding Information

This work was supported by NIH R01 HL133029, We Care Foundation Grant; MCW‐Cardiovascular Center Pre‐PPG grant, Advancing a Healthier Wisconsin – Redox Biology Grant.

This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.
Endothelial Function is Attenuated Following Total Sleep Deprivation in Healthy Young Adults
Authors: Holmer Brady J , Lapierre Stephanie , Alviar Carlos L , Lim Jisok , Sakarya Yasemin , New William , Eagle Michael , Schwartz Cody , Bhattal Gurjaspreet , Maharrey Phillip , Handberg Eileen M , Christou Demetra D
Published: June 2021

Insufficient sleep has been linked to an increased risk for cardiovascular disease, but the underlying mechanisms have not been fully elucidated. Endothelial function, an independent predictor of future cardiovascular events and mortality, may be detrimentally affected by sleep deprivation but this has not been tested.

Purpose

We investigated the influence of total sleep deprivation (TSD) on endothelial function in healthy young men.

Methods

Twelve men free of sleep disorders, 18 to 27 years of age (22 ± 1 years; mean ± SEM), participated in this study. Endothelial function was assessed using brachial artery flow‐mediated dilation (FMD) via ultrasonography in response to reactive hyperemia following 5‐min forearm occlusion. FMD was measured at the same time in the morning following a night of: 1) regular sleep (CON) and 2) TSD. Subjects completed TSD under supervision while resting quietly and after abstaining ≥ 20 hrs from caffeine.

Results

The duration of sleep deprivation ranged from 24.8 to 28.5 hrs (mean: 26.3 ± 1.3 hrs). TSD resulted in a ~42% attenuation in FMD (6.22 ± 1.10 vs. 3.62 ± 0.46 %; P = 0.016; CON vs. TSD). However, brachial artery diameter (4.43 ± 0.11 vs. 4.41 ± 0.11 mm; P = 0.4) and systolic and diastolic blood pressure (117 ± 2 vs. 117 ± 3 mmHg; P = 0.8 and 60 ± 1 vs. 64 ± 3 mmHg; P = 0.1, respectively) remained unchanged.

Conclusions

Brachial artery endothelial function is attenuated following TSD in healthy young men. Strategies to mitigate the detrimental effects of sleep deprivation on endothelial function may be important for individuals who routinely undergo extended periods of sleep deprivation.

Support or Funding Information

This work was supported by the Gatorade Trust through funds distributed by the University of Florida, Department of Medicine.

This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.
Hispidulin attenuates atopic dermatitis‐like skin inflammation features in mice
Authors: Kang Jinjoo , Kim Sang‐Hyun
Published: June 2021

Background

Hispidulin (Scutellarein 6‐methyl ether or dinatin, HPD) is a flavone derivative found in plant exhibiting anti‐oxidant, anti‐inflammatory, anti‐mutagenic, and anti‐epileptic properties. This work explored the anti‐inflammatory activity of HPD focusing on the skin.

Objective

This study demonstrated the beneficial effects of hispidulin in atopic dermatitis (AD)‐like skin inflammation and underlying mechanisms of action.

Methods

For AD‐like skin inflammation, female BALB/c mice were challenged with 2, 4‐dinitrochlorobenzene (DNCB) and house dust mite extract (Dermatophagoides farinae extract, DFE) for 4 weeks. HPD was orally administered (0.1, 1 or 10 mg/kg) for 5 consecutive days during 3 weeks. For in vitro study, keratinocytes (HaCaT) were pre‐treated with HPD (0.1, 1 or 10 μM) and then stimulated with tumor necrosis factor (TNF)‐α and interferon (IFN)‐γ.

Results

In mouse model, oral administration of HPD reduced the redness, ear thickness, keratinization, infiltration of cells (tissue eosinophils and mast cells), and immunoglobulin (IgE, DFE‐specific IgE and IgG2a) levels in a dose‐dependent manner compared to AD‐like skin inflammation. In HaCaT, pre‐treatment of HPD significantly suppressed the expression of TNF‐α/IFN‐γ‐induced cytokines such as interleukin (IL)‐1β, IL‐6, IL‐8 and chemokine C‐C motif ligand 17, 22 in a concentration dependent manner. Furthermore, HPD inhibited the activation of signal transducer and activator of transcription 1 and nuclear translocation of nuclear factor‐κB.

Conclusion

Based on the anti‐inflammatory activities of HPD on AD‐like skin inflammation, we propose that HPD would be a helpful candidate for AD treatment.

This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.
Neuro‐Physio Quanta Coherence‐Congruence Energy Regulation using Meditation for Exploring Etiology of Chronic Pain
Authors: Einstein George P , Rahman Michael S , Konyk Carla M , Tulp Orien L
Published: June 2021

Evidence in the last few decades have supported claim that meditation can reduce stress and promote health; the effects of which are on physical and mental health, and cognitive performance. There is more evidence about the specific parts of the brain involved in producing these positive influences. The neuronal pathways are not fully understood; the model of chronic pain however may provide better evidence also indicating that mindfulness meditation has both immediate and long‐term effects on cortical structures and activity involved in attention, emotional responding and pain. This is an important topic as chronic pain is so pervasive, and the available treatments do not provide adequate relief for most patients. Neuro‐endocrine influences such as in cortisol homeostasis is important for cognitive and affective functions that depend on cortisol‐sensitive brain regions including the hippocampus and prefrontal cortex. A review of these relationships is evidence of the systems‐based nature of the organism and the integrated nature of the biology involved. The Orien L. Tulp/G.P. Einstein/Michael S. Rahman model of Neuro‐Physio‐Quanta, Coherence‐Congruence, is a dynamic model and framework used to understand the mathematical and quanta relationships within the biochemical and biophysical aspects of the human organism it allows the understanding and prediction of non‐invasive neuromodulatory therapeutics like meditation. This study will also explore case studies in literature and clinical practice in support of the G. P Einstein model.

Support or Funding Information

Institutional Resources of USAT, UHH, and EMI

This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.
Novel Sigma Receptor Ligand Enhances Memory and Mitigates Microglia Proliferation
Authors: Bhandari Suyesha , Farr Susan , Silwal Ashok , Crider Albert , House Austin , Umbaugh David , Sandoval Karin , Witt Ken
Published: June 2021

Sigma receptor 1 (Sig1R) and 2 (Sig2R) are expressed in central nervous system, in neurons and microglia. Modulation of these receptors has been identified for the treatment of inflammatory and neurodegenerative disorders, including Alzheimer's disease (AD). This research evaluated the impact of BBZI, a novel pan‐selective Sig1R‐Sig2R ligand in mouse models of Alzheimer's disease and microglia activation.

BBZI has high affinity Sig1R‐Sig2R (Sig1R: Ki=0.8nM; Sig2R: Ki=2.5nM), with 100‐fold selectivity over a panel of 30 other receptors. Twelve‐month old Senescence Accelerated Mouse Prone‐8 (SAMP8) and 3xTg AD mice were treated with BBZI (i.c.v.) across a dosing range (0, 0.001, 0.01, 0.1, 1.0μg), and assessed for memory response via T‐maze. BBZI was also evaluated in BV2 microglia cells concurrent with inflammatory activation via lipopolysaccharide (LPS). After plating for 24hrs, cells were treated for 24hrs with BBZI (0, 10, 100, 1000nM) against LPS (0, 10, 100ng/mL). Alamar Blue (cellular proliferation) and nitrite (surrogate of nitric oxide) output in media.

BBZI significantly enhanced memory in SAMP8 mice at both 0.001μg and 0.01μg doses (p<0.01), and in 3xTg mice at 0.01μg dose (p<0.05), compared to vehicle controls. The mean percent reduction of alamar blue decreased with increasing concentrations of BBZI (p<0.05). The mean percent reduction of alamar blue was significantly lower for 1000nM BBZI compared to 0nM BBZI (p<0.05). No significant difference in nitrite level was observed with increasing concentrations of BBZI (p=0.65).

These results identify pan‐selective Sig1R‐Sig2R ligand capacity to enhance memory in two age mouse models of AD, with further capacity to impact of microglial proliferation. Such a pan‐selective ligand shows viability for treatment of cognitive and neurodegenerative conditions.

Support or Funding Information

This work was supported by the School of Pharmacy, Southern Illinois University Edwardsville.

This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.
Plasma beta‐hydroxybutyrate and glucose after ingestion of a high fat meal in patients on ketogenic therapy for seizures
Authors: Jones Lauren L. , Borum Peggy R.
Published: June 2021

Ketogenic therapy is a treatment for intractable epilepsy involving a high fat, adequate protein, and low carbohydrate diet. A prospective study was conducted to examine serum beta‐hydroxybutyrate (BHB) and glucose (Glu) response at fasting, 30 min, 1 hr, and 2 hr after the ingestion of a ketogenic meal. Patients were stratified by age and route of feeding and comparisons were made for BHB/Glu and percent change from fasting. Data were available for 23 patients with mean age of 10.2±5 years and time on diet of 51.4±38 months. Mean percent changes at 30 min, 1 hr, and 2 hr for both BHB and Glu were less than 10%. Regression analyses were performed for BHB/Glu and percent changes and ratio, Cal/kg/day, fat, carbohydrate, and protein % of calories, fat and carbohydrate in g/kg/day and all correlations (r) were found to be less than 0.5 and r2 less than 0.3. Time on diet correlated to percent change of BHB at 30 min (r=0.5, r2=0.3, p=0.01). Fasting BHB/Glu was negatively correlated with age (r= ‐0.5, r2=0.2, p=0.03). Overall, BHB and Glu levels are maintained relatively constant. Stabilization of energy metabolism may be a factor in the mechanism of action against seizures.

Effect of time after meal and age on BHB/Glu

*p<0.05, #p=0.09 comparing <10yr and >10yr

Grant Funding Source

NIH ‐ General Clinical Research Center
Red Blood Cell Flux in Isolated Capillary Bifurcations
Authors: Fraser Graham Mathew , Dias Gemma Marie , Goldman Daniel , Ellis Christopher
Published: June 2021

Capillary red blood cell (RBC) flux is the most important determinant of oxygen delivery to tissue. Simultaneous experimental measurement of flow throughout a microvascular network is impractical and necessitates predicting flow using computer simulations. Our existing model uses an empirically derived bifurcation rule (Pries et al., 1989) to determine RBC distribution between daughter branches. Our objective is to validate the existing model of microvascular blood flow on capillary networks versus in vivo measurements. Capillary networks in rat skeletal muscle were recorded and 4 capillary bifurcations were randomly selected for analysis (diameter 5.9±0.27 ?m, segment length 107.7±28.8 ?m). Custom vascular mapping software was used to reconstruct the real geometry of each bifurcation. Each capillary was analyzed to measure RBC velocity, tube hematocrit and RBC flux. The error in measured RBC flux in the parent compared to the sum of daughters was 1.9±8.3%. Discrete fluctuations of cell distribution over time were seen to have a significant impact on measured flux fraction (FF). Measured RBC FF in the higher flow daughters were 9±6.3% lower than the bifurcation rule predicted at equivalent flow rates. The stochastic nature of the bifurcation rule makes precise predictions of RBC distribution difficult where alternating cells paths can drastically impact measured FF.

Supported by CIHR grant to DG and CGE.
Effect of intermittent hypoxia on atherosclerosis and cardiovascular function in apolipoprotein E‐deficient mice
Authors: Jun Jonathan C , Bedja Djahida , Berkowitz Dan , Barouch Lili , Bevans‐Fonti Shannon , Li Jianguo , Myers Allen , Polotsky Vsevolod Y
Published: June 2021

Obstructive sleep apnea causes intermittent hypoxia (IH) during sleep and contributes to cardiovascular disease. To determine the effect of IH on atherosclerosis, we exposed ApoE−/− mice fed a high cholesterol diet to 4 or 12 weeks of IH or intermittent air (IA) control and measured atherosclerotic lesions, blood pressure, cholesterol, pulse wave velocity (PWV), oxidative stress, and left ventricular (LV) function. The IH regimen consisted of a 5% O2 nadir once per minute for 12 hours/day during the light phase. At 4 weeks, IH doubled plaque size at the aortic root (197,215±24,832 vs. 89,125±25,638 µm2, p<0.05) without affecting lesions in the descending aorta. IH also increased LDL cholesterol, PWV, and LV dimensions. At 12 weeks, IH did not affect lesions at the aortic root (610,287±27,341 vs. 553,600±51,113 µm2, p=NS) but doubled plaque in the descending aorta (32.0±2.8% vs. 14.4±1.6%, p<0.01%). Cholesterol and PWV remained elevated. In addition, LV ejection fraction decreased while triglycerides and cardiac oxidative stress increased. We conclude that IH accelerates atherosclerosis in ApoE−/− mice, initially at the aortic root and later in the descending aorta. This finding is accompanied by exacerbation of dyslipidemia, impaired arterial vasomotion, and the development of LV dysfunction. Funding sources: NIH R01 HL080105, T32 HL07534, SF‐78568‐N, AHA 0765293U.
A computational model of the role of presenilin‐1 and glycogen synthase kinase‐3 in familial Alzheimer's disease
Authors: Glaw Lydia S. , Skalak Thomas C.
Published: June 2021

Familial Alzheimer's disease (FAD) has been linked to mutations in presenilin‐1 (PS1), presenilin‐2 (PS2), and amyloid precursor protein (APP). Also, interest has recently developed in the possibility of a role for glycogen synthase kinase‐3 (GSK‐3) as a mediator of both amyloid beta (Aβ) plaque and neurofibrillary tangle development, the two hallmarks of Alzheimer's. We constructed a computational model of key signaling pathways to quantitatively examine the roles of both PS1 and GSK‐3 in the development of FAD pathology. This model consists of a series of kinetic equations describing the interactions of proteins and complexes including gamma secretase, APP, phosphoinositide kinase‐3 (PI3K), and tau, with outputs of the ratios of Aβ42 to Aβ40 and phosphorylated to unphosphorylated tau. Model predictions for the non‐disease state are in good agreement with experimental data. Notably, the interaction of PS1 with the PI3K‐Akt pathway is not predicted to significantly affect the rate of tau phosphorylation by GSK‐3. Findings produced by this model should provide an experimental roadmap for researchers in the field.
Enhanced ENaC and KCa3.1 expression by hydrocortisone increases Na+ absorption in human mammary epithelial cells.
Authors: O'Grady Scott M , Schiller Katherine R , Maniak Peter J
Published: June 2021

Immortalized human mammary epithelial cells express apical ENaC sodium channels and basolateral KCa3.1 potassium channels. Treatment of monolayers with hydrocortisone (0.5 μg/ml) for 48 hours enhanced mRNA expression for α, β and γ ENaC subunits by 7.3, 10.5 and 9.6 fold as determined by quantitative RT‐PCR. Additionally, KCa3.1 mRNA expression was enhanced by hydrocortisone by 8.1 fold, however no increase in mRNA expression was detected for the BK (Slo1) potassium channel, which had a higher basal level of expression than KCa3.1 (Slo1 CT = 23.8; KCa3.1 CT = 27.7). Hydrocortisone also increased expression of the P2Y6 receptor by 5.5 fold without significantly altering P2Y1, P2Y2 or P2Y4 receptor expression. Basolateral stimulation of hydrocortisone pretreated monolayers with UTP (10 μM) resulted in a significantly greater increase in short circuit current (Isc) compared to untreated control monolayers (peak ΔIsc + hydrocortisone = 20 ± 1 μA, control = 9.5 ± 2 μA). In addition, the duration of the Isc response was significantly lower in the absence of hydrocortisone with less oscillation. These results indicate that KCa3.1 and P2Y6 receptor expression are up‐regulated in parallel with ENaC channels in the presence of hydrocortisone resulting in enhanced electrogenic Na+ absorption following basolateral stimulation with UTP.
The Robots Are Coming
Authors: Fauteux Nicole
Published: June 2021

Are nurses prepared?
Abuse or Misuse of OTC Decongestant Produces Serious Adverse Effects
Authors: Aschenbrenner Diane S.
Published: June 2021

A rising number of cases of misuse and abuse of propylhexedrine (Benzedrex), an over-the-counter nasal decongestant, have been documented. Misuse of this drug can lead to serious and potentially fatal cardiac and psychiatric adverse effects.
New Indication for Rilonacept
Authors: Aschenbrenner Diane S.
Published: June 2021

Rilonacept (Araclyst) has been approved to treat recurrent pericarditis and to reduce the risk of recurrence in adults and children 12 years of age and older. The drug is given subcutaneously.
Pembrolizumab Approved for Esophageal or Gastroesophageal Cancer
Authors: Aschenbrenner Diane S.
Published: June 2021

Pembrolizumab (Keytruda) has been approved to treat metastatic or locally advanced esophageal or gastroesophageal junction cancer. It is used in combination with platinum- and fluoropyrimidine-based chemotherapy.
Maternity Nursing Stops Too Soon
Authors: Todd Betsy
Published: June 2021

Editor's note: From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses' work and lives over more than a century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but also reveal prevailing societal attitudes about women, health care, and human rights. Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. To this end, From the AJN Archives highlights articles selected to fit today's topics and times.

In this article from October 1975, Reva Rubin provides a fascinating historical overview of maternity nursing. She recounts the social and medical transformation of maternity care in the 20th century, emphasizing the nearly nonexistent support for pregnant, laboring, and postpartum women during much of that time.

Rubin ends her article with a passionate plea to nurses for attention to “our big failure . . . the postpartum period.” She hints at the causes of what we now know to be postpartum depression, calling the postpartum period “unbelievably cruel,” and noting that “tissue recovery is fairly simple. Recovery of the whole person, however, is much more complex and requires much more skilled nursing.”

In this issue, Barbara Marie Alba carries on the work of Rubin and other maternity nursing pioneers, providing a detailed overview of this subject in “Postpartum Depression: A Nurse's Guide.”—Betsy Todd, MPH, RN
Crisis Standards of Care
Authors: Brous Edie
Published: June 2021

Nursing considerations during states of emergency.
Aggressive End-Of-Life Care for Ovarian Cancer Continues Despite Guideline Recommendations
Authors: Rosenberg Karen
Published: June 2021

According to this study:

Many women who have ovarian cancer still receive aggressive end-of-life care despite recommendations emphasizing early palliative care.

Nonwhite women are more likely to receive aggressive care.
Changes in Ed use During the Pandemic
Authors: Rosenberg Karen
Published: June 2021

According to this study:

Shifts in the pattern of ED visits during the COVID-19 pandemic highlight the need for mental health, substance abuse, and violence risk screening and prevention during public health crises.
Deprescribing is a Challenge for Clinicians and Patients
Authors: Rosenberg Karen
Published: June 2021

According to this study:

Both clinician and patient perceptions of potentially inappropriate medications and deprescribing in patients with a history of falls suggests that multifaceted, multilevel approaches are needed to overcome common barriers.
Eliminating Hospital-Acquired Pressure Injuries Caused by Graduated Compression Stockings
Authors: Siby Tessy , Smith Uniqua , Shajimon Alice
Published: June 2021

Purpose:

The purpose of this evidence-based practice project was to reduce the incidence of pressure injuries (PIs) from the use of graduated compression stockings in patients on a gastrointestinal (GI) sarcoma surgery unit. Before this project, the standard of care for preventing deep vein thrombosis (DVT) included the use of graduated compression stockings, anticoagulation therapy, and intermittent pneumatic compression devices. We sought to examine the impact on PI and DVT risk of using only anticoagulation therapy and intermittent pneumatic compression devices.

Methods:

The pilot phase of the project began in June 2017 when nurses on the GI sarcoma surgery unit initiated a practice change in which graduated compression stockings were removed during the 7 AM shift change and put back on the patient before bedtime. Data on the incidence of DVTs and PIs were already being collected in our institution's electronic health record and safety intelligence reporting system. The project team monitored the incidence of PIs and DVTs throughout the project. After the pilot project concluded in August 2017, the GI sarcoma surgery unit staff continued the practice of taking off graduated compression stockings during the day, until on June 2018 the use of graduated compression stockings was formally discontinued for all surgical patients, both during the day and night.

Results:

Data collected during the pilot phase revealed that no PIs or DVTs occurred among the 497 study patients on the GI sarcoma surgery unit. From June to October 2017, the unit cared for a total of 856 patients and PI and DVT rates remained at zero. From the start of the pilot project in June 2017 to October 2018 (five months after the discontinuation of graduated compression stockings on all surgical units) the unit cared for 3,141 patients—an average of 174 patients per month—and had a zero rate of PIs and DVTs.

Conclusions:

We found that the use of graduated compression stockings confers more risks than benefits for patients. Our findings prompted the discontinuation of graduated compression stockings use in postoperative patients throughout our institution. In the 17 months after the pilot project was initiated, no PIs occurred among patients in the GI sarcoma surgery unit, which also maintained a zero rate of DVTs.
Examining the Influence of Academic Nurse Educator Doctoral Degree Preparation on National League for Nursing Core Competency Skill Acquisition
Authors: Sebach Aaron M.
Published: June 2021

AIM

The purpose of the study was to examine the influence of academic nurse educator doctoral degree preparation on National League for Nursing (NLN) core competency skill acquisition.

BACKGROUND

Doctor of nursing practice (DNP) and doctor of philosophy (PhD) graduates frequently seek faculty positions, yet neither degree exclusively prepares graduates for careers in academia.

METHOD

A descriptive, correlational design was utilized to examine the influence of doctoral degree preparation on NLN core competency skill acquisition. A randomized, nationwide sample (N = 160) of full-time nurse educators teaching in American Association of Colleges of Nursing member schools across the United States completed the Nurse Educator Skill Acquisition Assessment.

RESULTS

PhD-prepared educators reported higher NLN core competency skill acquisition scores than DNP-prepared nurse educators. There were statistically significant differences in overall skill acquisition scores between DNP- and PhD-prepared nurse educators and for the “use assessment and evaluation” and “engage in scholarship” domains.

CONCLUSION

These findings provide opportunities for NLN core competency skill acquisition among DNP- and PhD-prepared faculty.
How Nursing Faculty Experience the Effects of Workplace Incivility
Authors: Sherrod Jayme Trocino , Lewallen Lynne Porter
Published: June 2021

AIM

The purpose of this study was to describe nursing faculty experiences with workplace incivility and the effect it has on their health. This article reports results of the qualitative portion of a larger study.

BACKGROUND

Nursing faculty have reported the physical and psychological impact of incivility on their lives. The negative effects that workplace incivility, specifically, has on nursing faculty require ongoing research and attention.

METHOD

Using an electronic survey, 249 nursing faculty from one Southeastern US state responded to two open-ended questions about workplace incivility and its effects. Data were analyzed using qualitative content analysis.

RESULTS

Four categories related to experiences with workplace incivility emerged: the experience; personal and professional impact; a reciprocal, organizational culture problem; and survival.

CONCLUSION

Nursing faculty experiences with workplace incivility constitute an organizational culture problem with both personal and professional implications.
Exploring the accuracy and precision of BP measurements
Authors: Herrera Fatima Claire , Siaron Kathrina B. , Stutzman Sonja E. , Wilson Jennifer , Olson DaiWai
Published: June 2021

Accurate and precise BP measurements are crucial to clinical decision-making and interventions as healthcare professionals aim to prevent complications from hypertension, yet the literature provides no gold standard for measuring BP. This article discusses the additional research necessary to develop best practices and improve patient outcomes.
International networking guidelines for nurses
Authors: Gaisser D'Arcy J. , David Tamala , Rath Logan , Clancy Gráinne , Lawrence Constance , Munoz-Rojas Derby , Jones Uletha , Smalls Jennifer
Published: June 2021

Basic guidelines are necessary for international networking in nursing. This article outlines the benefits of and strategies for networking, highlights the social and behavioral considerations of social networking, and presents potential guidelines for further discourse.
Role of tissue-resident memory T cells in the pathophysiology of allergic contact dermatitis
Authors: Lefevre Marine-Alexia , Vocanson Marc , Nosbaum Audrey
Published: June 2021

Purpose of review

We bring updated knowledge on tissue-resident memory T cells (TRM), underlining their major role in the recurrence and the severity of allergic contact dermatitis (ACD).

Recent findings

ACD is a frequently encountered skin disease. It is defined as a delayed-type hypersensitivity reaction initiated by the recruitment of antigen-specific T cells into the skin of sensitized patients. ACD lesions tend to develop on already-exposed areas and worsen over time. That clinical observation has raised questions on the contribution of TRM to ACD recurrence and severity. TRM are memory T cells that persist in peripheral tissues, such as the skin, without recirculating through the blood. These cells provide effective immune memory against pathogens, but they may also participate in the development or exacerbation of numerous inflammatory diseases, including skin allergies. Recent works have demonstrated a major role for TRM in ACD pathophysiology.

In ACD, TRM accumulate preferentially at the allergen contact site during the sensitization phase. Thereafter, these cells cause a rapid and intense response to any new allergen exposure. They also play a key role in flare-ups of ACD and the chronicity and severity of the disease. These aspects suggest that TRM may have an interest as therapeutic targets.
A Cosmetic Surgical Approach Effectively Reconstructed Facial Nerve Paralysis
Authors: Nomoto Shunichi , Umezawa Hiroki , Ogawa Rei
Published: June 2021

In general, facial nerve palsy is treated by reconstructive surgeons, and the role of cosmetic surgeons is largely seen as secondary. The present report describes a case of refractory facial nerve palsy that arose after malignant parotid-tumor resection and high-dose radiotherapy, and that we reconstructed with a combination of cosmetic and reconstructive procedures. The procedures consisted of facelift techniques (lateral SMASectomy, creation of a nasolabial fold with three suture loops anchored at the temporal fascia, and frontal lift), a new wrinkle-removing technique wherein the frontal-muscle function was disrupted, and excision of surplus skin to rejuvenate the face. The outcomes were good, including at 1 year after surgery, and the 71-year-old patient expressed considerable satisfaction. The frontalis muscle resection effectively removed the wrinkles, helped balance the left and right sides, and permitted anti-aging surgery. This procedure has permanent effects, unlike other methods (eg, botulinum-toxin injections) that serve to weaken facial muscle function. It is notable that despite the high-dose radiotherapy the patient had received and the resulting extensive subcutaneous-tissue adhesion, our surgical protocol was relatively easy to perform as well as highly effective. Thus, even static reconstruction can give great hope and satisfaction to patients with facial nerve palsy.
Medical Documentation in Low- and Middle-income Countries: Lessons Learned from Implementing Specialized Charting Software
Authors: Ferry Andrew M. , Davis Matthew J. , Rumprecht Ewa , Nigro Alexander L. , Desai Priya , Hollier Larry H.
Published: June 2021

Background:

The implementation of electronic health record (EHR) software at healthcare facilities in low- and middle-income countries (LMICs) is limited by financial and technological constraints. Smile Train, the world’s largest cleft charity, developed a cleft treatment EHR system, Smile Train Express (STX), and distributed it to their partnered institutions. The purpose of this study was to investigate trends in medical documentation practices amongst Smile Train-partner institutions to characterize the impact that specialized EHR software has on medical documentation practices at healthcare facilities in LMICs.

Methods:

Surveys were administered electronically to 843 Smile Train-partnered institutions across 68 LMICs. The survey inquired about institutions’ internet connection, documentation methods used during patient encounters, rationale for using said methods, and documentation methods for cloud-based storage of healthcare data. Institutions were grouped by economic and geographic subgroups for analysis.

Results:

A total of 162 institutions (19.2%) responded to the survey. Most institutions employed paper charting (64.2%) or institutional EHR software (25.9%) for data entry during a patient encounter with the latter’s use varying significantly across geographical subgroups (P = 0.01). STX was used by 18 institutions (11.1%) during a patient encounter. Workflow was the most frequently cited reason for institutions to employ their entry method during a patient encounter (51.4%).

Conclusions:

The provision of STX to partnered institutions influenced medical documentation practices at several institutions; however, regulations and guidelines have likely limited its complete integration into clinical workflows. Further studies are needed to characterize trends in medical documentation in LMICs at a more granular level.
Planned and Unplanned Delayed Anterolateral Thigh Flap Phalloplasty
Authors: Santucci Richard A. , Linder Emma R. , Wachtman Galen S. , Crane Curtis N.
Published: June 2021

Background:

Pedicled anterolateral thigh (ALT) flap phalloplasty can be limited by inadequate perfusion. Vascular delay increases perfusion, as delay causes blood vessel formation by limiting the blood supply available to a flap before transfer. We hypothesized that delayed ALT flap phalloplasty would decrease rates of partial flap or phallus loss and other postoperative complications when compared with previously reported complication rates of undelayed single-stage ALT phalloplasty in our practice.

Methods:

A retrospective medical record review was performed on all phalloplasty patients in our practice between January 2016 and September 2019. We found those patients who had completed delayed ALT flap phalloplasty with at least 6 months of delay and 12 months of follow-up. For these patients, we recorded postoperative complications, simultaneous surgeries, subsequent surgeries, and demographic characteristics.

Results:

Five female-to-male transsexuals underwent delayed ALT flap phalloplasty (two were unplanned procedures, three were planned). Planned delay: The average time between Stage 1 and Stage 2 was 6.5 months. Complications for the planned delay cohort were as follows: partial loss of the neophallus not requiring repair (33%), urethral stricture requiring surgical repair (33%). Unplanned delay: The average time between Stage 1 and Stage 2 was 9.1 months. The following complication was seen in the unplanned delay cohort: urethral stricture requiring surgical repair (50%).

Conclusions:

Vascular delay of ALT flap phalloplasty is a successful emergency salvage procedure. Planned delay of ALT flaps provided similar results compared with those previously reported by our practice with standard single-stage approach.
Impact of COVID-19 on Elective Cleft Surgery in Low- and Middle-income Countries
Authors: Vander Burg Richard , Agrawal Karoon , Desai Priya , Desalu Ibironke , Donkor Peter
Published: June 2021

Background:

The COVID-19 pandemic disrupted health systems worldwide, including in low- and middle-income countries (LMICs). Many countries limited the delivery of elective surgery. To date, COVID-19’s impact on elective surgery in LMICs has been unquantified. We use operative data from a large international non-government cleft organization to compare case volume for 2019 and 2020 to quantify the impact of COVID-19.

Methods:

Smile Train supports a partner network of over 1100 partners globally to deliver treatment to children with cleft lip and cleft palate (CLP). Treatment data is documented into a proprietary digital platform, Smile Train Express. We compared monthly treatment data for 2019 to 2020, by country, and by World Bank Income group to describe the effect that the COVID-19 pandemic has had on CLP surgery in LMICs.

Results:

Our analysis shows 25,444 (31.4%) fewer primary operations performed between January and December 2020 than in the same period in 2019 with the most significant decline in procedures observed in April 2020. Many countries resumed elective surgery for CLP procedures from May onward and volume approximated that of pre-pandemic baseline by November of 2020.

Conclusions:

The emergence of the COVID-19 pandemic had a large impact on health systems and service delivery across the world. We find that this is evident in the delivery of CLP surgery in LMICs. The impact is characterized by a dramatic decrease in surgery rates in April of 2020 with a recovery of surgical volume from July 2020 onwards. The rate of surgical rate recovery is consistent across World Bank Income groups.
Do Triphasic Waves and Nonconvulsive Status Epilepticus Arise From Similar Mechanisms? A Computational Model
Authors: Ligtenstein Sophie , Song Jiangling , Jin Jin , Sun Haoqi , Paixao Luis , Zafar Sahar , Westover M. Brandon
Published: June 2021

Purpose:

Triphasic waves arising in patients with toxic metabolic encephalopathy (TME) are often considered different from generalized periodic discharges (GPDs) in patients with generalized nonconvulsive status epilepticus (GNCSE). The primary objective of this study was to investigate whether a common mechanism can explain key aspects of both triphasic waves in TME and GPDs in GNCSE.

Method:

A neural mass model was used for the simulation of EEG patterns in patients with acute hepatic encephalopathy, a common etiology of TME. Increased neuronal excitability and impaired synaptic transmission because of elevated ammonia levels in acute hepatic encephalopathy patients were used to explain how triphasic waves and GNCSE arise. The effect of gamma-aminobutyric acid-ergic drugs on epileptiform activity, simulated with a prolonged duration of the inhibitory postsynaptic potential, was also studied.

Results:

The simulations show that a model that includes increased neuronal excitability and impaired synaptic transmission can account for both the emergence of GPDs and GNCSE and their suppression by gamma-aminobutyric acid-ergic drugs.

Conclusions:

The results of this study add to evidence from other studies calling into question the dichotomy between triphasic waves in TME and GPDs in GNCSE and support the hypothesis that all GPDs, including those arising in TME patients, occur via a common mechanism.
Atypical or Typical Triphasic Waves—Is There a Difference? A Review
Authors: Fernández-Torre José L. , Kaplan Peter W.
Published: June 2021

The entity of triphasic waves (TWs) and TW encephalopathy has derived from the subjective art of EEG interpretation. Indeed, there are few if any guidelines regarding many different aspects of TWs. The authors seek to shed light on the nature and the diagnostic characteristics of various types of TWs, differentiating “typical” from “atypical” forms. The authors conclude that morphologies in the form of bursts of well-formed, smoothly contoured, negative–positive–negative, bilateral, symmetrical and synchronous, regular, reactive, periodic or rhythmic, 1.5 to 2.0 Hz, fronto-central, triphasic complexes with fronto-occipital lag meet the criteria for typical TWs and are highly suggestive of toxic–metabolic encephalopathies. These are most frequently hepatic, uremic, or sepsis-associated encephalopathies with multi-organ failure. In such cases, atypical TWs (frontopolar or parieto-occipital maximum, negative–positive or negative–positive–negative, asymmetric and asynchronous, unreactive, irregular, multifocal, continuous with spatiotemporal evolution, sharper and without fronto-occipital/occipito-frontal lag, or triphasic delta waves) are rarely seen. Atypical TWs are encountered in Angelman syndrome, toxic encephalopathies, hyperthyroidism/hypothyroidism, Hashimoto encephalopathy, nonconvulsive status epilepticus, dementia, sepsis-associated encephalopathy, cerebrovascular disorders, and certain boundary syndromes. Investigations describing TWs with uncommon etiologies revealed few with typical TWs, suggesting that the term “TWs” has been overused in the past. Triphasic waves arise from the interaction of multiple factors including toxic, metabolic, infectious, and structural disorders that affect circuits between thalamus and cortex. The patient's metabolic status, presence of potentially neurotoxic drugs, cerebral atrophy, white matter disease, dementia, or seizures help differentiate typical from typical TWs. Future studies will determine whether this dichotomy is heuristically and clinically helpful.
Foraging zebra finches (
Taeniopygia guttata
) are public information users rather than conformists
Authors: van Leeuwen Edwin J. C. , Morgan Thomas J. H. , Riebel Katharina
Published: June 2021

Social learning enables adaptive information acquisition provided that it is not random but selective. To understand species typical decision-making and to trace the evolutionary origins of social learning, the heuristics social learners use need to be identified. Here, we experimentally tested the nature of majority influence in the zebra finch. Subjects simultaneously observed two demonstrator groups differing in relative and absolute numbers (ratios 1 : 2/2 : 4/3 : 3/1 : 5) foraging from two novel food sources (black and white feeders). We find that demonstrator groups influenced observers' feeder choices (social learning), but that zebra finches did not copy the majority of individuals. Instead, observers were influenced by the foraging activity (pecks) of the demonstrators and in an anti-conformist fashion. These results indicate that zebra finches are not conformist, but are public information users.
REPAIR OF ABDOMINAL WALL DEFECTS WITH ACELLULAR BOVINE PERICARDIUM MATRIX A MULTICENTRE PROSPECTIVE STUDY
Authors: Frascino Luiz Fernando , De Campos Severi Jonas Dias , Funes Lorenzzato Fernanda Ribeiro , Xavier Funes Hamilton Luiz
Published: June 2021

Background

The association of prosthetic meshes in the abdominal wall repair, reducing the recurrence rates in an impactful way, has become an almost mandatory routine for the success of these surgeries. After decades using non-biological synthetic implants, from the 90s onwards biological membranes of animal or human origin were introduced – the so called acellular biological matrices - beginning a new era in abdominal wall defects correction.

Methods

Thirty patients underwent repair for different abdominal wall deformities, with acellular matrices of bovine pericardium, in a total of 40 anatomically individualized implants. The median follow-up was 22 months, with patients evaluated clinically and radiologically. In three cases, biopsies of the implanted areas were performed, allowing histological analysis of the material.

Results

There was no recurrence of hernias in any of the cases, both clinically and radiologically. There was also no record of hematomas, infections or any phenomenon of a local or systemic reaction nature. Radiologically, it was not possible to visualize the matrices at the implantation site in any of the analysed postoperative periods. Biopsies showed important tissue neoformation replacing the implanted membranes, with important deposition of collagen, normal-looking cellularized tissue, and absence of foreign body reactions.

Conclusions

The analysed matrices showed similarity to other biological membranes described in the international literature. Representing an important update and conceptual evolution, biological matrices must be incorporated into the therapeutic arsenal in abdominal wall repairs.