bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of superfine grinding mulberry leaves (Morus alba Linn.) powder on biscuit properties
Authors: Gan Lu‐Jing , Chen Weili , Chen Shutian , Rong Han , Zhang Guoquan , LYU Jingmei
Published: September 2024

Superfine and regular grinding methods were used to mill mulberry leaves (ML), and the chemical composition and physical characteristics of the powders were investigated. Compared to regular grinding, superfine grinding reduced particle size from 121.44 μm to 18.69 μm. Compared to coarse mulberry leaf (CML), the fine mulberry leaf (FML) powder had a greater water solubility index, soluble dietary fibre content and 1‐deoxynojirimycin (DNJ) content. Both types of ML powders were substituted for flour at various percentages (3%, 6%, 9% and 12%), and their effects on the biscuits' textural qualities and sensory assessment were examined. The adhesiveness, cohesiveness and springiness of biscuit doughs were all reduced by ML powder addition, while their hardness was raised. The inclusion of ML powders increased the hardness of the biscuits significantly, whereas only the addition of FML powders decreased their fracturability. Additionally, the DNJ contents in FML biscuits were significantly higher than that in CML biscuits. The sensory assessment revealed that biscuits containing 9% FML powder received the best rating.
Fc gamma receptors: Their evolution, genomic architecture, genetic variation, and impact on human disease
Authors: Frampton Sarah , Smith Rosanna , Ferson Lili , Gibson Jane , Hollox Edward J. , Cragg Mark S. , Strefford Jonathan C.
Published: September 2024

Fc gamma receptors (FcγRs) are a family of receptors that bind IgG antibodies and interface at the junction of humoral and innate immunity. Precise regulation of receptor expression provides the necessary balance to achieve healthy immune homeostasis by establishing an appropriate immune threshold to limit autoimmunity but respond effectively to infection. The underlying genetics of the FCGR gene family are central to achieving this immune threshold by regulating affinity for IgG, signaling efficacy, and receptor expression. The FCGR gene locus was duplicated during evolution, retaining very high homology and resulting in a genomic region that is technically difficult to study. Here, we review the recent evolution of the gene family in mammals, its complexity and variation through copy number variation and single‐nucleotide polymorphism, and impact of these on disease incidence, resolution, and therapeutic antibody efficacy. We also discuss the progress and limitations of current approaches to study the region and emphasize how new genomics technologies will likely resolve much of the current confusion in the field. This will lead to definitive conclusions on the impact of genetic variation within the FCGR gene locus on immune function and disease.
Nurses' Experiences and Perspectives Caring for People With Substance Use Disorder and Their Families: A Qualitative Descriptive Study
Authors: Kitt‐Lewis Erin , Adam Marianne T.
Published: September 2024

Substance use disorder is a public health crisis that is a financial strain to many healthcare systems and communities, but more importantly, it costs lives. Nurses interact with people experiencing substance use disorders and their families in many settings. Nurses can provide insights into the experiences of working with this population. This descriptive qualitative study aimed to examine nurses' experiences and perspectives on caring for people with substance use disorder and their families. After receiving institutional review approval, purposive sampling was used to recruit registered nurses (n = 16) who worked in a variety of settings, and interviews were conducted. Constant comparison analysis was conducted concurrently with data collection until saturation was reached. Code development and refinement was an iterative process. Three themes were generated from the data. Personal Experiences Affect Professional Practice represented participants varied personal experiences and included two subthemes: Reflecting on Personal Experiences and Seeing the Person Beyond the Substance Use Disorder. A second theme is Professional Experiences Affect Professional Practice, which included two subthemes: Professional Experiences are Stressful and Rewarding and Substance Use Disorder Education Increases Confidence. Finally, Stigma Affects Substance Use Disorder Care is the third theme. Future implications range from the individual engaging in self‐reflection, to nursing leadership establishing a framework to incorporate reflection and creating a culture that supports and reinforces these activities. The findings of this study support the need for stigma awareness/reduction education starting in undergraduate nursing programmes, throughout practice, with extension to inter‐professional groups and the community.
A qualitative study on Turkey's earthquakes, the century's catastrophe: Perspectives and coping methods of surviving nursing students
Authors: Sönmez Sari Ebru , Terzi Handan
Published: September 2024

Aim

To understand the experiences and coping strategies of nursing students who were impacted by Turkey's once‐in‐a‐century catastrophic earthquakes in 2023.

Background

Nursing students rarely experience a disaster in person, and their imagination can be limited.

Methods

This study used a descriptive‐qualitative study design. It was conducted with 17 first‐year nursing students, studying at a university in the northeastern part of Turkey, who survived the earthquake. A personal information form and a semistructured questionnaire were used to collect the data. The data were collected between March and April 2023 and analyzed using the content analysis method and the MaXQDA programme.

Results

The data were grouped into three main themes—“What ‘earthquake’ was and what it is now?,” “Am I aware of the ‘earthquake’ now?,” and “Coping mechanisms and supporting systems”—and categorized into seven subthemes.

Conclusions

The experiences of earthquake‐affected nursing students emphasized the importance of being prepared for disasters and meeting their emotional needs.

Implications for nursing practice and policies

Including specific courses and case studies regarding disasters, whether natural or human‐made, in education programs can ensure better prepared nurses. Also, the integration of content about management and coping with such crises into nursing curricula is considered vital.
Renal functional consequences of kidney donation: A long‐term follow‐up study
Authors: Bohannon Lawrence L. , Norman Douglas J. , Barry John M. , Bennett William M.
Published: September 2024

The effects of unilateral donor nephrectomy were evaluated in 11 living related donors studied before and a mean of 13.3 years after surgery. The mean blood pressure increased from 121.6/73.8 to 130.0/85.6 mmHg. The mean serum creatinine increased from 1.05 to 1.16 mg/dl. The inulin, PAH, and creatinine clearances were 66.6, 359.1, and 82.9 ml/min/173 m2, respectively. The residual renal function (current creatinine clearance/pre‐nephrectomy creatinine clearance) was approximately 80%. Only 1 patient had abnormal (> 150 mg/24 h) proteinuria. Urinary concentrating and acidifying capacity were intact. There was no major impairment of renal function in this group more than 13 yr after 50% reduction in nephron mass.
Heart transplantation in end‐stage doxorubicin‐induced cardiomyopathy
Authors: Lindberg Harald , Frøysaker Tor , Øvrum Elvind , Geiran Odd
Published: September 2024

Cardiomyopathy following treatment with doxorubicin is a well‐known complication which is often fatal. Two cases successfully treated with heart transplantation are reported. Case 1: An 8‐yr‐old boy was treated with doxorubicin for a primary hepatocellular carcinoma involving both lobes with a total dose of 680 mg/m2. During this treatment he developed cardiomyopathy and doxorubicin was discontinued. Eight years later he was a candidate for heart transplantation, which took place with an uneventful primary course. Case 2: An 8‐yr‐old girl was operated upon for a tumor of the urinary bladder revealing rhabdomyosarcoma with local metastasis in the pelvic region. She was treated with doxorubicin, total dose 555 mg/m2, during 11 months. Seven years later she was in terminal cardiac failure. She was transplanted with an uneventful primary course. Both patients were treated with triple immunosuppression regimen. Heart transplantation represents the only therapeutic alternative for doxorubicin‐induced end‐stage cardiomyopathy, and seems indicated when there is a complete remission of the malignant disease for more than 5 yr. Primary results are encouraging.
Post‐sclerotherapy esophageal perforations in liver transplant patients
Authors: Merhav Hadar , Bron Klaus , Pinna Antonio , Mieles Luis , Ramos Hector , Linden Peter , Fung John J.
Published: September 2024

Esophageal perforations in liver transplant patients are associated with high morbidity and mortality (1). We describe 2 cases of esophageal perforations following sclerotherapy for variceal bleeding. Diagnosis was made 20 and 6 days post‐sclerotherapy and 16 and 4 days post‐liver transplant. Both cases were treated with pharyngeal drainage or diversion, pleural drainage, gastrostomy, intravenous hyperalimentation, enteral feeding, antibiotics, withdrawal of steroids and reduction of immunosuppressive drugs. In both cases closure of the fistula occurred within 10 to 14 days after detection and with no sign of esophageal stricture formation. We believe this approach to esophageal perforations may be used safely in liver transplantation patients if close monitoring of potential complications is adhered to. This approach obviates the risks of thoracotomy without compromising the basic surgical principles of exclusion and drainage.
Toward a more equitable and utilitarian distribution of kidneys
Authors: Halasz Nicholas A.
Published: September 2024

A new point system for the allocation of kidneys is proposed. It balances equity and medical utility considerations for this era of organ shortage.
OKT3 for treatment of rejection in renal transplantation
Authors: DeMattos Angelo M. , Norman Douglas J.
Published: September 2024

OKT3 is highly effective both as an initial treatment for renal allograft rejection and as a treatment for rejection episodes resistant to other agents. When compared both prospectively and retrospectively with high‐dose steroids, OKT3 was reported to be more effective in the first‐line treatment of renal allograft rejection. In a large multicenter randomized trial, OKT3 reversed rejection episodes in a significantly greater number of patients and produced significantly better 1‐yr graft survival than did steroids. Both agents were associated with similar numbers of infections. Acute adverse reactions attributable to cytokine release followed initial doses of OKT3. In uncontrolled trials, OKT3 reversed 50% to 100% of steroid‐resistant rejections; and in a comparative study, it reversed a greater number of steroid‐resistant rejection episodes than did polyclonal antilymphocyte globulins. Successful first‐line and second‐line (steroid‐resistant) OKT3 reversal of acute severe rejection has been shown to be associated with these factors: initiation of OKT3 therapy within 7 d of rejection diagnosis and cyclosporin levels above 150 ng/ml prior to initiation of treatment. Second‐line treatment of steroid‐resistant rejection also was shown to be most effective in histopathologically pure acute cellular rejection episodes (lacking interstitial fibrosis). As third‐line therapy, OKT3 reversed rejection episodes in 74% to 84% of patients. It is unclear whether, during OKT3 treatment, cyclosporine should be discontinued to lessen its potential for nephrotoxicity and over‐immunosuppression or its dosage reduced to maintain additional immunosuppression and suppression of anti‐OKT3 antibody production. OKT3 has been successfully administered for the treatment of rejection on an outpatient basis, offering considerable cost savings over continued hospitalization.
Consent for organ donation: Time for a change
Authors: Spital Aaron
Published: September 2024

The present worldwide shortage of organs is not due simply to a lack of potential donors, but also to a failure to turn many potential donors into actual donors. At least part of this failure can be traced to problems with the two major systems presently used for obtaining consent for cadaveric organ donation: “opting‐in” and “opting‐out”. Mandated choice has been proposed as an alternative system for obtaining consent designed to combine the benefits of its predecessors while avoiding their shortcomings. Under this proposal, all adults would be required to decide for themselves whether or not they wish to become organ donors upon their deaths and their decisions would be controlling. This approach would preserve altruism and voluntarism while eliminating the need to obtain family consent, which is a major barrier to organ retrieval. To see if the public would support mandated choice. I contracted the Gallup Organization to poll 1000 randomly selected U.S. adults regarding this proposal. Nearly two‐thirds of respondents said they would support such a system and three‐quarters believe that the family should not be able to override their loved one's wishes. Mandated choice appears to be an acceptable method for obtaining consent for donation which, by eliminating the family consent barrier, might well increase the supply of organs available for transplantation.
Long‐term soluble interleukin‐2 receptor level of heart transplant recipients
Authors: Olson Peter R. , Manack Leo M. , Miller Lynnette L. , Youngblood Angela M. , Magovern George J. , Hsia Shyuan
Published: September 2024

We studied the plasma soluble interleukin 2 receptor (SIL‐2R) levels of 16 heart transplant recipients without infections and 3 recipients with infections for a minimum of 6 months post‐transplantation (PoTx) to establish their long‐term SIL‐2R profiles and to investigate the relationships between SIL‐2R levels and rejection, infection, and immunosuppressive therapy. Heart transplant recipients without infections could be placed into three groups based upon their SIL‐2R profiles. Four recipients had no episodes of rejection and reached a peak SIL‐2R level within 1 to 2 months PoTx followed by a trough level over the next 4 months. The second group, with 8 recipients, had rejection episodes after reaching the peak SIL‐2R level within the first 2 months, but the levels became variable before reaching a stable trough level. The third group, with 4 recipients, experienced early rejection within 2 months of transplantation, showed rather variable SIL‐2R levels, and none had a characteristic peak. Rejection episodes, especially mild ones, did not correlate with SIL‐2R levels. Elevated SIL‐2R levels were associated with opportunistic infections; however, this alteration was not specific enough to distinguish infection from rejection. In addition, response to immunosuppressive therapy could not be reliably predicted by changes in SIL‐2R levels. We conclude that SIL‐2R levels can neither be used as an indicator of myocardial rejection or infection nor as a guide for immunosuppressive therapy in cardiac transplant patients.
Improvement in the accuracy and precision of creatinine clearance as a measure of glomerular filtration rate with oral cimetidine in renal transplant recipients
Authors: Hirata‐Dulas Cheryl A. I. , Halstenson Charles E. , Kasiske Bertram L.
Published: September 2024

The accuracy of the standard 24‐hour creatinine clearance (CCr) measurement of glomerular filtration rate (GFR) in renal transplant recipients is limited because tubular secretion of creatinine causes CCr to overestimate GFR. We investigated whether cimetidine, a know blocker of tubular creatinine secretion, improves the accuracy and precision of CCr as a measure of GFR. Cimetidine (600–1200 mg/day p.o.) was administered for 3 days to 16 renal transplant recipients who had different levels of allograft function. The CCr and inulin clearance (CIn) were simultaneously measured before the first dose and after the last dose of cimetidine. Cumulative urine collections were obtained daily before, during, and for 3 days after cimetidine administration to evaluate the effects of cimetidine on creatinine excretion and standard CCr measurements. Cimetidine improved the accuracy of CCr as a measure of GFR. as indicated by a reduction in the ratio of simultaneously measured CCr,/CIn from 1.50 ± 0.55 to 1.23±0.29 (mean±SD) after 3 days (p<0.01). The precision of the CCr was also improved by cimetidine. as indicated by a reduction in the coefficient of variation of the CCr/CIn ratio from 0.36 to 0.23. The ratio of the 24‐hour CCr/CIn (not measured simultaneously) was reduced from 1.13 + 0.25 to 0.97±0.14 after only 1 day on cimetidine therapy (p<0.01). Although the cimetidine‐modified CCr may not completely eliminate the problem of GFR overestimation, it offers a practical measure of renal allograft function that may be more accurate and precise than currently used serum creatinine and CCr determinations.
The ethicist's role on the transplant team: A study of heart, lung, and liver transplantation programs in the United States
Authors: Finder Stuart G. , Fox Mark D. , Frist William H. , Zaner Richard M.
Published: September 2024

Transplantation raises numerous social and ethical issues and is an area in which ethicists might assist. To determine how many individuals nationwide with recognized ethics training serve on transplant teams and to determine the specific nature of the role they assume, all heart, lung, and liver transplantation programs listed in the United Network for Organ Sharing Directory in 1991 were contacted: 165 programs (67%) responded. One‐hundred‐six programs reported that ethical judgments are used in decision making. Seventeen reported having an individual with ethics training regularly participating on the team. No programs had “clinical ethicists” who focus on the moral framework and issues presented by patients and families as well as those already internal to the practice of medicine and who do not attempt to impose moral principles externally developed. That most ethicists lack clinical access, and hence clinical appreciation, may explain why few assist in ethical deliberation related to transplantation.
Markers for pancreatic allograft rejection: Comparison of serum anodal trypsinogen, serum amylase, serum creatinine and urinary amylase
Authors: Douzdjian Viken , Cooper Jane L. , Abecassis Michael M. , Corry Robert J.
Published: September 2024

Currently, the markers of acute rejection in pancreas allografts are not consistently reliable. The purpose of this study was to evaluate the ability of sAT to predict acute rejection as compared to serum creatinine (sCr), urinary amylase (uAmy) and serum amylase (sAmy). Eleven first‐time acute rejection episodes in bladder‐drained SPK recipients were studied. All rejection episodes were biopsy‐proven (core kidney 9, fine needle kidney 2, fine needle pancreas 5). Sera obtained from days ‐7 to – 1 (pre–treatment), day 0 (start of anti‐rejection treatment), and +1 to + 7 (post–treatment) periods were analyzed. Peak median sAT and sAmy levels occurred at day 0 compared to day 1 for sCr. uAmy trough levels occurred on days −4,–5 and +2. The difference between pre‐treatment levels and those on day 0 were significant for sAT, sAmy and sCr but not for uAmy. Only in the case of sAT was the difference between day 0 levels and post‐treatment levels significant. Both sAmy (0.87) and sCr (0.85) demonstrated positive correlation when compared to sAT whereas uAmy demonstrated a weak negative correlation (−0.24). This study confirms that sAT accurately predicts rejection after SPK transplantation.
Calcium channel blockers in kidney transplantation
Authors: Ladefoged Soren D. , Andersen Claus B.
Published: September 2024

Purpose

To review the question as to whether treatment with a calcium channel blocker (CCB) influences the course and outcome of cadaveric renal transplantation in recipients treated with cyclosporin A.

Methods

Computer‐assisted search (Medline) and manual search of the literature. Odds ratio, Mantel‐Haenszel test, Fischer's test and Chi2 test.

Results

Two Randomised, placebo‐controlled studies, 12 randomised, open studies, 3 retrospective studies, 1 study using a historic control group and 3 studies only reported in abstract form were identified. In the randomised, open studies treatment with CCB reduced the rate of delayed graft function but had no effect on the rate of rejection and graft survival. The effect on graft function was equivocal. In the blind, placebo‐controlled studies no beneficial effects of treatment with CCB were found. Treatment with CCB reduced the dose of CyA needed to reach target whole blood level of CyA in nearly all studies.

Conclusion

Results are conflicting. Further studies are needed.
Development of Sang‐35: a cyclosporine formulation bioequivalent to Neoral1
Authors: First M Roy , Alloway Rita , Schroeder Timothy J
Published: September 2024

During a research program, SangStat Medical Corporation developed more than 270 oral cyclosporine formulations. On the basis of animal and clinical trials, Sang‐35 was chosen for clinical development, and bioequivalence with the cyclosporine microemulsion Neoral was established.

In a cross‐over study involving 36 healthy male volunteers, single 500 mg cyclosporine doses of Sang‐35 (AUC0: 13900±2470 μg h L. mean ± standard deviation (SD)) and of Neoral (AUC0 14000 ± 2900 μg g.h L‐1) resulted in equal areas‐under‐the‐time‐concentration curve (AUC0‐∞). Sang‐35 and Neoral were also bioequivalent in healthy male subjects after high‐fat meals as well as in female and African‐American subjects. In stable kidney transplant patients (n = 12) receiving a mean (±SD) cyclosporine dose of mg/d (3.6 ± 1.6 mg/ kg/d), AUC0‐12 h after Sang‐35 was, as expected, significantly higher than that after Sandimmune (4550±858 vs 3468±1402 μg h L‐1, p<0.01). Sang‐35 and Neoral resulted in equivalent cyclosporine AUC0‐12 h h values (4120±1508 and 4377±1579 μg h L1, respectively) in stable kidney transplant patients (dose: 293±114 mg/d or 3.7±1.5 mg/kg/d, n = 32). In an additional study, 42 stable kidney graft patients were switched from Sandimmune to Sang‐35. Based on a conversion strategy targeting AUC equivalence, only one dose adjustment was required in 55% of the patients, and 95% of patients (40 of 42) needed three or fewer dose adjustments. The mean Sang‐35 dose was 7% lower than the mean Sandimmune dose.

During the studies, Sang‐35 and Neoral exhibited similar safety and tolerability profiles. It is concluded that Sang‐35 and Neoral are bioequivalent and that patients can safely and easily be switched from Neoral or, in combination with dose adjustment, from Sandimmune to Sang‐35.
Giving and taking – to whom and from whom?
Authors: Sanner Margareta A
Published: September 2024

The aims of the study were: 1) to describe the willingness of the public to receive material of different origins in one's own body; 2) to compare the willingness to donate and receive body material; 3) to compare the willingness to donate while alive and after death; 4) to compare the willingness to donate to a next‐of‐kin and unknown recipients. A random sample of 1500 inhabitants, 18 to 70 yr old, in the county of Uppsala, Sweden, were sent a questionnaire asking about their opinion on transplantation and transfusion issues. The response rate was 71%. Ninety‐five percent accepted to receive blood transfusion, 89% bone‐marrow transplantation, and 85% transplantation of a solid organ. Organs from living donors were preferred (77%), then organs from deceased donors (69%), then artificial organs (63%), and last animal organs (40%). More than half of those accepting transplants made exceptions for some types of organs. The youngest and those with higher education were more positive toward receiving all types of organs than the older ones and those with lower education. Women were less prepared than men to accept animal organs. Those who accepted organs from animals usually also accepted all other types of organs, and were willing to donate organs and tissue more often than those who did not accept to receive animal organs. The readiness to support a sick family member by giving bone‐marrow and even a kidney was considerable, 89 and 81%, respectively. The attitudes were less positive with regard to giving blood and bone‐marrow to unknown recipients, 54 and 41%, respectively. Sixty‐one percent of the respondents were positive toward donating their own organs after death. Of those who were positive, 10% made exceptions for special organs that they did not want to donate, mostly heart, eyes, and brain. Individuals with higher education and young people were more often positive than those with lower education and old people regarding donation of blood and organs, and bone‐marrow donation to a relative. Women were somewhat more accepting to donate while alive than males. Thirty‐one percent, more often women than men, had signed a donor card and/or registered with the Swedish Organ Donation Registry. The results with regard to receiving organs and tissue are discussed in terms of two different sets of explanations, which can be seen as different sides of the same coin, and mutually strengthening the reactions. The great readiness to donate to a family member as well as the discrepancy between giving in life and after death is commented upon.
Glipizide treatment of post‐transplant diabetes does not interfere with cyclosporine pharmacokinetics in renal allograft recipients
Authors: Sagedal S , Ásberg A , Hartmann A , Bergan S , Berg KJ
Published: September 2024

Background

Glipizide is an oral antidiabetic drug that has been used in the treatment of post‐transplant diabetes mellitus (PTDM). However, a published case report has indicated a possible interaction of glipizide with cyclosporine (CSA) pharmacokinetics in two renal transplant (tx) patients. The aim of this open prospective study was to investigate whether glipizide interacts with CSA pharmacokinetics in renal tx patients with PTDM.

Methods

Eleven renal tx patients (29‐74 years of age) with PTDM who received Sandimmun Neoral® as part of their immunosuppressive therapy were investigated. No patients had suffered any significant rise in serum creatinine (20%) from any cause over the last 2 wk before the study. Mean S‐creatinine was 137 μmol/L (87‐220). The mean CSA dose and whole blood concentration remained unchanged during the study. CSA whole blood concentrations were monitored over 12 h in all patients in random order, both on and off glipizide treatment. Blood samples were drawn immediately before the morning dose of CSA was given (trough) and 0.5, 1, 1.5, 2, 3, 4, 6 and 12 h after administration.

Results

Whole blood trough CSA concentration was not altered by glipizide treatment, 256±76 μg/L off and 242 ± 73 μg/L (mean ± SD) with glipizide coadministration. The area under the curve (AUC) and terminal half‐life of CSA remained unchanged with glipizide treatment: 6391±1483 μg/L per h and 7.3±1.5 h without; and 6279±1601 μg/L per h and 7.1 ± 1.8 h with glipizide, respectively. No change in the CSA peak concentration (Cmax) was observed: 1507±406 μg/L without and 1469±538 μg/L with glipizide coadministration.

Conclusion

CSA pharmacokinetics is not significantly altered by glipizide coadministration.
Immunosuppressive therapy with microemulsion cyclosporine A shortens the hospitalization of pediatric liver transplant recipients
Authors: Arumugam Ramalingam , Soriano Humberto E , Scheimann Ann O , Reid Barbara S , Gopalakrishna GS , Barakat Omar , Ozaki Claire F , Wood Patrick R
Published: September 2024

Intravenous administration of cyclosporine (Sandimmune®) to rapidly and effectively achieve therapeutic serum levels in transplant recipients has been the treatment standard in many transplantation centers. With the development of microemulsion cyclosporine (Neoral®), that standard is changing. Neoral has greater bioavailability than the oral form of Sandimmune and, consequently, can be more efficacious and cost‐effective. To test this hypothesis, we undertook a retrospective study of Sandimmune and Neoral in the treatment of 66 children who underwent uncomplicated orthotopic liver transplantation in the Texas Medical Center between April 1991 and December 1997. Both forms of cyclosporine were evaluated in terms of in‐patient treatment cost, recuperative time in the intensive care unit and duration of hospitalization. Twenty‐two patients were treated orally with Neoral, and 44 patients were treated intravenously with Sandimmune for a mean time of 14 d. Once the blood concentration of Sandimmune reached a steady state, as confirmed by daily measurements of the trough level, the patients in the Sandimmune group were converted to oral cyclosporine. None of the 22 patients treated with Neoral required intravenous treatment. The mean time spent in the intensive care unit was 4 d for the Neoral group and 5.5 d for the Sandimmune group. The mean duration of hospitalization from the date of transplantation to discharge was 12 d for the Neoral group and 20 d for the Sandimmune group (p<0.001). Based on these results, we determined that the overall cost per patient in the Neoral group was $3598 less than that per patient in the Sandimmune group.
Central venus cannulation during cardiac surgery as a possible new additional risk factor for late post‐operative atrial fibrillation insurgence
Authors: Mastroiacovo Giorgio , Pirola Sergio , Sciarra Luigi , Rosati Fabrizio , Petrungaro Mattia , Nanci Giuseppe , Fileccia Daniele , Bonomi Alice , Tondo Claudio , Polvani Gianluca ,   VARIATION Study Group
Published: September 2024

Background

Postoperative atrial fibrillation (POAF) is the most frequent cardiac arrhythmia following cardiac operations. It has been associated with an increased risk of postoperative cerebrovascular complications, morbidity and mortality. The aim of this study is to evaluate if the type of venous cannulation to institute the cardiopulmonary bypass (CPB) during major cardiac surgery procedures can influence the rate of POAF and late FA onset.

Methods

We collected data from 2087 consecutive patients who have been operated at our Institution from January 2016 to December 2018. To obtain two homogenous groups we performed a propensity match analyzes: Group 1 for whom the blood drain of the CPB has been granted via peripheral cannulation (PC) through the right common femoral vein and Group 2 with patients who underwent central cannulation (CC) with insertion of a drainage cannula in the right atrium or in the superior and inferior vein cava.

Results

POAF has been observed as statistically similar between the two groups. At 1250‐day follow‐up, While the incidence of POAF was 2.9% and 8.7% in the PC and CC groups, respectively (p = .04).

Conclusions

our data seems to show that the two groups do not differ in terms of POAF, while the CC group may have a significantly higher rate of atrial fibrillation in the follow‐up period.
Comparing complication rates between Abbott Tendril 2088 and competitive manufacturer leads: Novel real‐world data approach
Authors: Ahmed Aamir , Wilkoff Bruce L. , Kim Jeeyun A. , Nabutovsky Yelena , Kim Grant , Desmond Matthew , Ganz Leonard , Curtis Anne B.
Published: September 2024

Introduction

While several studies have reported on the reliability of cardiac pacing leads, there are limited comparative data on lead performance. We compared long‐term performance of Abbott Tendril™ STS 2088TC (Tendril 2088) leads with competitive manufacturer (CM) pacing leads using novel real‐world data analytic methods.

Methods

Medicare fee‐for‐service (FFS) claims and Abbott device registration databases were linked to identify patients implanted with single‐chamber or dual‐chamber pacemakers with the Abbott Tendril 2088 lead from January 1, 2014 to December 31, 2019 and were followed through December 31, 2021. Medicare pacemaker patients who did not link to Abbott devices were assumed to have CM leads. Patients in both groups had to be enrolled in Medicare FFS at least 1 year before implant date and have an initial pacemaker and associated lead(s) implanted on the same date. Lead complications were identified based on a diagnosis code for a mechanical lead complication and a procedure code for a lead‐related surgery on the same claim. Kaplan‐Meier curves for lead intervention‐free survival rates for up to 7 years of follow‐up were compared between groups at the device level using a log‐rank test.

Results

The study cohort had 89 629 Tendril 2088 and 433 481 CM lead patients. Groups were comparable in age (79.7 ± 8.6 years), sex (52.2% male), race/ethnicity, and baseline comorbidities. At 7 years, there was no significant difference in intervention‐free survival rates between groups (97.48% Tendril 2088 vs. 97.52% CM, p = .3435).

Conclusion

In this large Medicare population, there was no significant difference in lead complication rates between Tendril 2088 and CM pacing leads over 7 years of follow‐up.
AI‐Driven Realtime Monitoring of Early Indicators for Ichthyophthirius multifiliis Infection of Rainbow Trout
Authors: Bonnichsen Rikke , Nielsen Glenn Gunner Brink , Dam Jeppe Seidelin , Schrøder‐Petersen Dorte , Buchmann Kurt
Published: September 2024

A novel video‐based real‐time system based on AI (artificial intelligence) was developed to detect clinical signs in fish exposed to pathogens. We selected a White Spot Disease model involving rainbow trout as the experimental animal and the parasitic ciliate Ichthyophthirius multifiliis as a pathogen. We compared two identical fish tank systems: one tank was infected by co‐habitation, whereas the other tank was kept non‐infected (sham infection). The two fish tanks were separately video monitored (full top and side view) during the course of infection, during which fish were removed whenever they developed clinical signs (direct visual inspection by the observer). Image analysis (object detection, classification and tracking) was used to track behavioural changes in fish (in every recorded video frame), focusing on movement patterns and spatial localisation. Initially, the two fish groups (infected and non‐infected) exhibited similar behaviour and non‐infected fish did not change behaviour during the 15 d observation period (from 5 d before infection until 10 dpi). At 4, 7, 8, 9 and 10 dpi some infected fish showed clinical signs (equilibrium disturbance, gasping and lethargy) and were removed from the experiment. Anorexia occurred from 5 dpi and a gradual progression of gasping behaviour was noted, whereas the frequency of fish flashing (rubbing/scratching against objects) was low. Equilibrium disturbances and the development of white spots in the skin appeared to be a much later (8–10 dpi at this temperature) indicator of infection. The video analysis showed a general distribution of non‐infected fish in all parts of the fish tank during the entire experiment, whereas infected fish already at 4–5 dpi moved towards higher water currents in the top and bottom positions. This change of fish positioning within the tank appeared as a promising early indicator of infection. The study suggests that continuous monitoring of fish behaviour using AI can potentially optimise the timing of humane endpoints, indicate disease signs earlier and thereby improve animal welfare in both animal experimentation and in aquaculture settings.
RNA‐binding protein Trx regulates alternative splicing and promotes metastasis of HCC via interacting with LINC00152
Authors: Teng Xiangnan , Shang Jin , Du Lingyao , Huang Wei , Wang Yonghong , Liu Miao , Ma Yuanji , Wang Ming , Tang Hong , Bai Lang
Published: September 2024

Background

Epithelial‐mesenchymal transition (EMT) is central to HCC metastasis, in which RNA‐binding proteins (RBPs) play a key role.

Methods

To explore the role of RBPs in metastasis of hepatocellular carcinoma (HCC), whole transcriptome sequencing was conducted to identify differential RBPs between HCC with metastasis and HCC without metastasis. The influence of RBPs on metastasis of HCC was verified by in vitro and in vivo experiments. The interaction of RBPs with non‐coding RNAs was evaluated by RNA immunoprecipitation and pull‐down assays. RNA sequencing, whole‐genome sequencing, and alternative splicing analysis were further performed to clarify post‐transcriptional regulation mechanisms.

Results

Whole transcriptome sequencing results showed that expression of thioredoxin (Trx) was significantly upregulated in HCC patients with metastasis. Trx was also found to be associated with poor prognosis in HCC patients. Overexpression of Trx could promote migration and invasion of HCC cells in vitro and increase the rate of lung metastasis of HCC cells in vivo. Moreover, binding assays showed that Trx could bind to LINC00152. As a result, LINC00152 was verified to determine the pro‐metastasis function of Trx by knockdown assay. Furthermore, we revealed that Trx could regulate metastasis‐associated alternative splicing program. Specifically, angiopoietin 1 (ANGPT1) was the splicing target; the splicing isoform switching of ANGPT1 could activate the PI3K–Akt pathway, upregulate EMT‐associated proteins, and promote migration and invasion of HCC cells.

Conclusions

We found that Trx could interact with LINC00152 and promote HCC metastasis via regulating alternative splicing, indicating that Trx may serve as a novel therapeutic target for HCC treatment.
Do hematologic malignancies cause a barrier for sentinel lymph node mapping in endometrial cancer? A case report
Authors: Unal Ceren , Çekiç Sebile Güler , Bulutay Pınar , Topkara Şevval Berfin , Giray Burak
Published: September 2024

Sentinel lymph node (SLN) mapping has changed the way of lymph node assessment and provided a minimal invasive option that lessens the negative effects of a full lymphadenectomy, has become a crucial tool in the treatment of endometrial cancer. Chronic lymphocytic leukemia (CLL) and endometrial cancer diagnosis at the same is a rare condition. This case report presents a 66‐year‐old woman admitting to the hospital with the complaint of postmenopausal bleeding. After hysteroscopic evaluation and Magnetic Resonance imaging confirming the endometrial cancer, total laparoscopic hysterectomy and bilateral salphingo‐ooferectomy with SLN mapping operation was planned. In the preoperative preparation she was also diagnosed with CLL. Considering the possible lymphatic obstruction, the risk of SLN mapping failure was foreseen, yet still the operation was performed as planned. This report will highlight a case where endometrial cancer and CLL were identified simultaneously, along with successful SLN mapping.
Color of Wine: Development of Reference Grids/Templates for Sensory Analysis With Trained Assessors
Authors: Gomis‐Bellmunt Anna , Claret Anna , Pérez Elortondo Francisco José , Guerrero Luis
Published: September 2024

Color of wine gives information on many aspects of the product, and it is one of the main parameters defining wine quality. Consequently, color is an important attribute described in the Designations of Origin (PDO)'s technical specifications. In this paper, color reference grids for color sensory evaluation of white, rosé and red wines (linked to a specific methodology and controlled illumination) are developed, presented, and validated. The color intensity and color hue parameters of 2353 wines of different types have been analyzed using these reference grids during the period 2021–2023. Considering the results obtained, the usefulness of having a double color measurement (color intensity and color hue) is questioned and discussed.
Recovered or Not Recovered? A First Person Narrative Case for Non‐Abstinent Recovery
Authors: Tomlinson Peter
Published: September 2024

Purpose

The purpose of this paper was to explore interlocking questions relating to how we deal with drugs and medication in crisis residential mental health settings. In particular, it examines issues related to overly medical and simplistic explanations of the relationship between cannabis and psychosis, the positive effects of drugs, the effects of having standard rules for diverse groups of people and the concept of non‐abstinent recovery.

Background

I have used mental health and addiction services for 25 years and I have 6 years' experience as a peer worker, working with many people who use drugs.

Method

This is an opinion piece built around a first‐person narrative.

Keypoints

Drugs can have positive effects and an appreciation and understanding of these effects is essential to understanding persistent drug use. How can we integrate non‐abstinent recovery as a valid and positive choice of recovery pathway?
Novel phylogenetic analysis of the Mesozoic common gymnosperm Xenoxylon Gothan reveals close affinity with extant Podocarpaceae (Coniferales)
Authors: Xie Aowei , Low Shook Ling , Wang Yongdong , Tian Ning , Uhl Dieter
Published: September 2024

Fossil wood is one of the crucial proxies for understanding terrestrial vegetation composition and development in the Earth's history. The gymnosperm wood taxon Xenoxylon Gothan is a significant member of the Mesozoic flora. To date, more than 20 species of Xenoxylon have been described. However, its botanical affinities have remained enigmatic ever since it was described, over a century ago. Here we perform a phylogenetic analysis of Xenoxylon to understand the systematic relationship with extant conifers. Data come from four nucleotide regions (trnL‐F, trnK‐matK, rbcL, psbA‐trnH), xylological characters, and biomolecular composition of five extant conifer families; for Xenoxylon, no nucleotide data are available. Using maximum parsimony in Tree Analysis using New Technology, Xenoxylon appeared basal to Araucariaceae in the data set combining genes and xylological characters, whereas Xenoxylon is placed next to Podocarpaceae in the data set combining genes and biomolecular characters. To find a reliable systematic placement of Xenoxylon, a combined data set of genes, xylological and biomolecular characters is analyzed. Our results and interpretations indicate that Xenoxylon is closely related to Podocarpaceae. This first phylogenetic analysis of Xenoxylon fills the knowledge gap of the systematic relationship of this taxon and contributes to a better understanding of the evolution of extant Podocarpaceae.
“Another Kid on the Block”: Testing the Effects of Artificial Substrates on the Recruitment of Juvenile Fishes in the Northwestern Gulf of Mexico
Authors: Salinas Stefany , Cintra‐Buenrostro Carlos E.
Published: September 2024

Most artificial reefs (ARs) in the Gulf of Mexico are considered intermediate to high vertical relief structures which have recruited large predatory species indicating a lack of juvenile habitat. Small, inexpensive ARs, standard monitoring units for the recruitment of reef fishes (SMURFs), were deployed at eight treatment stations at −20 m as habitat for juvenile fishes to understand and determine the effects of substrate type on the recruitment of juvenile fishes. Each treatment station contained four SMURFs with four treatments: small and large concrete rubble (~10 and ~20 cm), oyster shells, and bare. Surveys conducted from July 2017 to July 2019 yielded 39 different juvenile species, including one of the most economically important species, Lutjanus campechanus, present across all replicates. There were 5238 individual fishes collected, and the family Lutjanidae accounted for ~49% of these. The highest species richness and diversity occurred in SMURFs containing oysters or small concrete rubble while bare treatment had the lowest. Both concrete rubble and oyster shells might offer shelter to numerous body shapes and sizes of juvenile fishes as a result from a variety of crevice sizes. This study suggests that the deployment of low‐relief structures with different substrate materials might affect recruitment of select species and provide further information useful to designing ARs, aiding fisheries production. Because enhancing fisheries is one of the goals of the Texas Parks and Wildlife Department Artificial Reef Program it is here recommended to continue developing other designs of low‐relief to be allocated in between existing high‐relief ARs that should serve as stepping stones for the survival of species of fisheries interest (e.g., L. campechanus).
Using formative research to enhance our understanding of implementation contexts: Preparing for a trial of maternal nutrition interventions
Authors: Thorne‐Lyman Andrew L. , Kalbarczyk Anna , Tumilowicz Alison , Christian Parul , Afsana Kaosar
Published: September 2024

Key messages

Formative research to understand the sociocultural and economic context into which interventions are introduced can help to maximize the uptake of interventions both in the context of effectiveness trials and ultimately for nutrition programs.

Findings from the formative research study were used to inform different facets of the design of the effectiveness trial including providing evidence of the acceptability of the product, informing the decision to deliver the product to women's homes, and developing strategies to support adherence.
Global Insights and Trends in Research on Dermatophytes and Dermatophytosis: A Bibliometric Analysis
Authors: Ortiz Bryan , Ballesteros‐Monrreal Manuel G. , Rosales‐Tamashiro Juan , Bush Michelle , Salmanton‐García Jon , Fontecha Gustavo
Published: September 2024

Background

Dermatophytosis, caused by dermatophytes, affects up to 25% of people globally, with higher rates observed in Africa and Asia. While these infections are usually superficial, they can become severe in immunocompromised individuals. Despite their high prevalence, scientific research on dermatophytes is limited and the epidemiological data available are insufficient. In addition, diagnostic methods are not standardised and there are challenges with resistance to antifungals.

Objectives

This study aimed to conduct a bibliometric analysis of scientific publications related to dermatophytes and dermatophytosis to assess research output and trends.

Methods

A bibliometric analysis of publications from 2000 to 2023 in Web of Science and Scopus examined trends, citation counts, publication types, key journals, top authors and institutions and funding sources.

Results

The analysis revealed a significant increase in dermatophyte‐related publications, with 15,868 articles retrieved from the Web of Science and 23,189 from Scopus. Research articles dominated the output, constituting 76.2% in Web of Science and 80% in Scopus. Peak publication years were 2019, 2021 and 2022 in Web of Science, and 2020, 2021 and 2023 in Scopus, with lower output between 2000 and 2002. The United States and India were the leading contributors, followed by Brazil and China, though citation metrics varied. Although there has been a rise in the number of publications, the amount of research conducted on dermatophytes is still very limited in comparison with other types of fungal diseases.

Conclusions

Dermatophyte‐related research has increased over the past 2 decades. However, research gaps remain, particularly compared with other fungal diseases. Advances in diagnostics, antifungal testing and taxonomic classification are urgently needed. The study underscores the need for continued research and global collaboration to address these issues.