bluuebunny/crossref_metadata_2025 huggingface dataset:
Human tracheal transplantation: A systematic review of case reports
Authors: Verzeletti Vincenzo , Mammana Marco , Zambello Giovanni , Dell'Amore Andrea , Rea Federico
Published: January 2024

Background

Patients with long‐segment airway stenosis not amenable to conventional surgery may benefit from tracheal transplantation. However, this procedure has been only anecdotally reported, and its indications, techniques, and outcomes have not been extensively reviewed.

Methods

We conducted a systematic Literature search to identify all original articles reporting attempts at tracheal transplantation in humans.

Results

Of 699 articles found by the initial search, 11 were included in the systematic review, describing 14 cases of tracheal transplantation. Patients underwent transplantation for benign stenosis in nine cases, and for malignancies in five cases. In 12 cases blood supply to the trachea was provided by wrapping the graft in a vascularized recipient's tissue, while in 2 cases the trachea was directly transplanted as a vascularized composite allograft. The transplantation procedure was aborted before orthotopic transplantation in two patients. Among the remaining 12 patients, there was 1 operative mortality, while 4 patients experienced complications. Immunosuppressants drugs were administered to the majority of patients postoperatively, and only one group of authors attempted their withdrawal, in five patients. At the end of follow‐up, all 11 patients surviving the operation were alive, but 2 had a recurrent tracheal stenosis requiring an airway appliance for breathing.

Conclusion

Human tracheal transplantation is still at an embryonic phase. Studies available in the Literature report different surgical techniques, and information on long‐term outcomes is still limited. Future research is needed in order to understand the clinical value of this procedure.
Mechanisms and timing of brain injury among persons with cerebral palsy
Authors: O'Shea T. Michael
Published: January 2024

This commentary is on the original article by Reid et al. on pages 892–901
A core outcome set for trials evaluating self‐management interventions in people with severe mental illness and coexisting type 2 diabetes
Authors: Carswell Claire , Taylor Jo , Holt Richard I. G. , Brown Jennifer V. E. , Ajjan Ramzi , Böhnke Jan R. , Doran Tim , Kellar Ian , Shiers David , Wright Judy , Siddiqi Najma
Published: January 2024

Background

People with severe mental illness (SMI), such as schizophrenia, have higher rates of type 2 diabetes and worse outcomes, compared to those without SMI and it is not known whether diabetes self‐management interventions are effective for people who have both conditions. Research in this area has been impeded by a lack of consensus on which outcomes to prioritise in people with co‐existing SMI and diabetes.

Aims

To develop a core outcome set (COS) for use in effectiveness trials of diabetes self‐management interventions in adults with both type 2 diabetes and SMI.

Methods

The COS was developed in three stages: (i) identification of outcomes from systematic literature review of intervention studies, followed by multi‐stakeholder and service user workshops; (ii) rating of outcomes in a two‐round online Delphi survey; (iii) agreement of final ‘core’ outcomes through a stakeholder consensus workshop.

Results

Seven outcomes were selected: glucose control, blood pressure, body composition (body weight, BMI, body fat), health‐related quality of life, diabetes self‐management, diabetes‐related distress and medication adherence.

Conclusions

This COS is recommended for future trials of effectiveness of diabetes self‐management interventions for people with SMI and type 2 diabetes. Its use will ensure trials capture important outcomes and reduce heterogeneity so findings can be readily synthesised to inform practice and policy.
Sodium‐glucose co‐transporter 2 inhibitor therapy reduces the administration frequency of anti‐vascular endothelial growth factor agents in patients with diabetic macular oedema with a history of anti‐vascular endothelial growth factor agent use: A cohort study using the Japanese health insurance claims database
Authors: Ishibashi Ryoichi , Inaba Yosuke , Koshizaka Masaya , Takatsuna Yoko , Tatsumi Tomoaki , Shiko Yuki , Kashiwagi Yusuke , Maezawa Yoshiro , Kawasaki Yohei , Kawakami Eiryo , Yamamoto Shuichi , Yokote Koutaro
Published: January 2024

Aim

We assessed the effectiveness of sodium‐glucose co‐transporter 2 inhibitors (SGLT2is) in reducing the administration frequency of anti‐vascular endothelial growth factor (VEGF) agents in patients with diabetic macular oedema (DMO) using a health insurance claims database.

Materials and Methods

This retrospective cohort study analysed health insurance claims data covering 11 million Japanese patients between 2005 and 2019. We analysed the frequency and duration of intravitreal injection of anti‐VEGF agents after initiating SGLT2is or other antidiabetic drugs.

Results

Among 2412 matched patients with DMO, the incidence rates of anti‐VEGF agent injections were 230.1 per 1000 person‐year in SGLT2i users and 228.4 times per 1000 person‐year in non‐users, respectively, and the risk ratio for events was unchanged in both groups. Sub‐analysis of each baseline characteristic of the patients showed that SGLT2is were particularly effective in patients with a history of anti‐VEGF agent use [p = .027, hazard ratio (HR): 0.44, 95% confidence interval (CI): 0.22‐0.91]. SGLT2is reduced the risk for the first (p = .023, HR: 0.45, 95% CI: 0.22‐0.91) and second (p = .021, HR: 0.39, 95% CI: 0.17‐0.89) anti‐VEGF agent injections.

Conclusions

There was no difference in the risk ratio for the addition of anti‐VEGF therapy between the two treatment groups. However, the use of SGLT2is reduced the frequency of anti‐VEGF agent administration in patients with DMO requiring anti‐VEGF therapy. Therefore, SGLT2i therapy may be a novel, non‐invasive, low‐cost adjunctive therapy for DMO requiring anti‐VEGF therapy.
Association of Lipoprotein(a) with arterial stiffness: A Mendelian randomization study
Authors: Simistiras Alexandros , Georgiopoulos Georgios , Delialis Dimitrios , Mavraganis Georgios , Oikonomou Ermioni , Maneta Eleni , Loutos Christos , Evangelou Evangelos , Stamatelopoulos Kimon
Published: January 2024

Background

In this study we used Mendelian randomization (MR) to investigate the potential causal association of lipoprotein (a) [Lp(a)] levels with pulse wave velocity (PWV).

Methods

Genetic variants associated with Lp(a) were retrieved from the UK Biobank GWAS (N = 290,497). A non‐ overlapping GWAS based on a European cohort (N = 7,000) was used to obtain genetic associations with PWV (outcome) and utilized two different measures for the same trait, brachial–ankle (baPWV) and carotid–femoral (cfPWV) PWV. We applied a two‐sample MR using the inverse variance weighting method (IVW) and a series of sensitivity analyses for 170 SNPs that were selected as instrumental variables (IVs).

Results

Our analyses do not support a causal association between Lp(a) and PWV for neither measurement [βiwv(baPWV) = −.0005, p = .8 and βiwv(cfPWV) = −.006, p = .16]. The above findings were consistent across sensitivity analyses including weighted median, mode‐based estimation, MR‐Egger regression and MR‐PRESSO.

Conclusion

We did not find evidence indicating that Lp(a) is causally associated with PWV, the gold standard marker of arterial stiffness.
In‐depth analysis of data from the RAS‐ALS study reveals new insights in rasagiline treatment for amyotrophic lateral sclerosis
Authors: Schuster Joachim , Dreyhaupt Jens , Mönkemöller Karla , Dupuis Luc , Dieterlé Stéphane , Weishaupt Jochen H. , Kassubek Jan , Petri Susanne , Meyer Thomas , Grosskreutz Julian , Schrank Berthold , Boentert Matthias , Emmer Alexander , Hermann Andreas , Zeller Daniel , Prudlo Johannes , Winkler Andrea S. , Grehl Torsten , Heneka Michael T. , Johannesen Siw , Göricke Bettina , Witzel Simon , Dorst Johannes , Ludolph Albert C. ,   the RAS‐ALS Study Group
Published: January 2024

Background and purpose

In 2016, we concluded a randomized controlled trial testing 1 mg rasagiline per day add‐on to standard therapy in 252 amyotrophic lateral sclerosis (ALS) patients. This article aims at better characterizing ALS patients who could possibly benefit from rasagiline by reporting new subgroup analysis and genetic data.

Methods

We performed further exploratory in‐depth analyses of the study population and investigated the relevance of single nucleotide polymorphisms (SNPs) related to the dopaminergic system.

Results

Placebo‐treated patients with very slow disease progression (loss of Amyotrophic Lateral Sclerosis Functional Rating Scale–Revised [ALSFRS‐R] per month before randomization of ≤0.328 points) showed a per se survival probability after 24 months of 0.85 (95% confidence interval = 0.65–0.94). The large group of intermediate to fast progressing ALS patients showed a prolonged survival in the rasagiline group compared to placebo after 6 and 12 months (p = 0.02, p = 0.04), and a reduced decline of ALSFRS‐R after 18 months (p = 0.049). SNP genotypes in the MAOB gene and DRD2 gene did not show clear associations with rasagiline treatment effects.

Conclusions

These results underline the need to consider individual disease progression at baseline in future ALS studies. Very slow disease progressors compromise the statistical power of studies with treatment durations of 12–18 months using clinical endpoints. Analysis of MAOB and DRD2 SNPs revealed no clear relationship to any outcome parameter. More insights are expected from future studies elucidating whether patients with DRD2CC genotype (Rs2283265) show a pronounced benefit from treatment with rasagiline, pointing to the opportunities precision medicine could open up for ALS patients in the future.
Managing liquidity along the supply chain: Supplier‐base concentration and corporate cash policy
Authors: Di Lulu , Jiang Wei , Mao Ju , Zeng Yeqin
Published: January 2024

We find that customer firms with more concentrated supplier bases tend to hold higher levels of cash reserves. The positive relation between supplier‐base concentration and cash holdings is more pronounced for firms with nonstate ownership, higher market competition, worse inventory efficiency, more relationship‐specific investment, central positions in the production networks, and headquarters located in regions with lower levels of financial development. Furthermore, we show that debt issuance enhances firms' cash holdings when they have concentrated suppliers, and supplier‐base concentration increases firms' cash spending on R&D investment. Our study highlights the importance of supplier structure in shaping corporate cash policy.
Joint bleeds in mild hemophilia: Prevalence and clinical characteristics
Authors: Chiari John B. , Prozora Stephanie , Feinn Richard , Louizos Evangelia , Gallagher Patrick G. , Bona Robert
Published: January 2024

Introduction

Joint bleeds are a common and frequent complication associated with hemophilia, increasing the risk of hemophilic arthropathy. It is important to define and characterize the presence of joint complications in mild hemophilia to develop strategies to mitigate disease burden.

Aims

To characterize the prevalence, clinical characteristics of joint bleeds, and risk factors that may lead to hemarthrosis in people with mild hemophilia.

Methods

Following Institutional Review Board approval, a retrospective chart review was conducted for patients with mild hemophilia seen at the Yale Hemophilia Treatment Center or Classical Hematology Program.

Results

The medical records of 70 patients were reviewed. Eighty one percent were male and 19 percent were female. Twenty individuals with mild hemophilia had a history of joint bleeding, 13 were traumatic bleeds, 7 were spontaneous. The age of first joint bleed ranged from 4 to 58 years old, with an average age of 20.8‐years old. Ten patients developed joint bleeds between the ages of 10 and 20 years old. The most common locations of joint bleeding were the knee (n = 11) and ankle (n = 7). Eight of 70 patients had hepatitis C (HCV), 6 experienced joint bleeding.

Conclusions

In this study, almost one third of patients with mild hemophilia experienced joint bleeding, often without history of trauma. Joint range of motion was abnormal in more than a third of the patients with mild hemophilia regardless. These data highlight the need for ongoing evaluation and characterization of joint health in individuals with mild hemophilia.

Highlights

Twenty‐nine percent of individuals with mild hemophilia had history of joint bleed.

PwH and mild diseases with previous or current hepatitis C had higher likelihood of joint bleeding.

Approximately 15% of PwH and mild diseases had abnormal joint examinations without a confirmed history of joint bleeding.
Exploring the link between gut microbiota and alopecia areata: a two‐sample Mendelian randomization analysis
Authors: Xu Wen , Zhang Li , Song Xiuzu
Published: January 2024

Background

While observational studies have suggested a link between gut microbiota diversity and alopecia areata (AA), the causal relationship remains unclear.

Methods

We leveraged data from the MiBioGen and FinnGen consortiums' Genome‐wide association studies (GWAS) encompassing gut microbiota (n = 13,266) and AA (n = 211,428) datasets. A comprehensive Mendelian randomization (MR) and reverse MR approach were employed, utilizing five statistical methods to evaluate causality. Sensitivity analyses were also conducted to corroborate the MR results.

Results

Inverse variance weighted (IVW) analysis indicated a protective effect against AA from Butyricimonas (OR = 0.37, 95% CI: 0.18–0.77, P = 0.01), Enterorhabdus (OR = 0.40, 95% CI: 0.16–0.95, P = 0.04), Eubacterium (xylanophilum group) (OR = 0.36, 95% CI: 0.15–0.84, P = 0.02), and Phascolarctobacterium (OR = 0.37, 95% CI: 0.15–0.91, P = 0.03), while Ruminococcaceae UCG003 posed as a risk factor (OR = 2.79, 95% CI: 1.27–6.14, P = 0.01). Reverse MR showed no significant causal link between AA and gut microbiota, with no significant heterogeneity or horizontal pleiotropy.

Conclusions

Our analysis suggests probable causality between certain gut microbiota and AA, shedding light on its pathogenesis and potential intervention strategies.
The harmful effects of overlooking acute bacterial prostatitis
Authors: Yang Youngmin , Shigemura Katsumi , Maeda Koki , Moriwaki Michika , Chen Kuan‐Chou , Nakano Yuzo , Fujisawa Masato
Published: January 2024

Prostatitis is a major urological disease affecting 25%–50% of men over their lifetime. However, prostatitis is often overlooked in nonurologic departments due to its sometimes indeterminate symptoms. In this review, we describe how to recognize and treat acute bacterial prostatitis, which manifests as a clinical problem in other departments as well as urology, to help prevent this disease from being overlooked. There are several possible negative effects of not recognizing acute bacterial prostatitis (ABP). First, initial treatment can fail. In the hyperacute phase, common antibiotics are often effective, but in rare cases, such antibiotics may not be effective. In addition, once ABP progresses to form a prostate abscess, potentially avoidable surgical interventions are often needed. A second issue is the transition to chronic prostatitis. If chronic bacterial prostatitis progresses, treatment requires long‐term antibiotic administration and the response rate is not high. Some patients may have to deal with urinary tract infections for the rest of their lives. Finally, there is the problem of overlooking the underlying disease. ABP is rare in healthy adult men without underlying disease, including sexually transmitted diseases as well as benign prostatic hyperplasia, urinary stones, and malignant tumors, and may not be obvious. When examining patients with fever of unknown origin, it is necessary to exclude not only infectious diseases but also collagen diseases and malignant tumors. If there are any doubts, we recommend a rectal exam and consultation with a urologist.
Prognostic outcomes in patients with metastatic renal cell carcinoma receiving second‐line treatment with tyrosine kinase inhibitor following first‐line immune‐oncology combination therapy
Authors: Matsushita Yuto , Kojima Takahiro , Osawa Takahiro , Sazuka Tomokazu , Hatakeyama Shingo , Goto Keisuke , Numakura Kazuyuki , Yamana Kazutoshi , Kandori Shuya , Fujita Kazutoshi , Ueda Kosuke , Tanaka Hajime , Tomida Ryotaro , Kurahashi Toshifumi , Bando Yukari , Nishiyama Naotaka , Kimura Takahiro , Yamashita Shimpei , Kitamura Hiroshi , Miyake Hideaki ,   the Japanese Urological Oncology Group
Published: January 2024

Objectives

This study aimed to assess the prognostic outcomes in mRCC patients receiving second‐line TKI following first‐line IO combination therapy.

Methods

This study retrospectively included 243 mRCC patients receiving second‐line TKI after first‐line IO combination therapy: nivolumab plus ipilimumab (n = 189, IO–IO group) and either pembrolizumab plus axitinib or avelumab plus axitinib (n = 54, IO–TKI group). Oncological outcomes between the two groups were compared, and prognostication systems were developed for these patients.

Results

In the IO–IO and IO–TKI groups, the objective response rates to second‐line TKI were 34.4% and 25.9% (p = 0.26), the median PFS periods were 9.7 and 7.1 months (p = 0.79), and the median OS periods after the introduction of second‐line TKI were 23.1 and 33.5 months (p = 0.93), respectively. Among the several factors examined, non‐CCRCC, high CRP, and low albumin levels were identified as independent predictors of both poor PFS and OS by multivariate analyses. It was possible to precisely classify the patients into 3 risk groups regarding both PFS and OS according to the positive numbers of the independent prognostic factors. Furthermore, the c‐indices of this study were superior to those of previous systems as follows: 0.75, 0.64, and 0.61 for PFS prediction and 0.76, 0.70, and 0.65 for OS prediction by the present, IMDC, and MSKCC systems, respectively.

Conclusions

There were no significant differences in the prognostic outcomes after introducing second‐line TKI between the IO–IO and IO–TKI groups, and the histopathology, CRP and albumin levels had independent impacts on the prognosis in mRCC patients receiving second‐line TKI, irrespective of first‐line IO combination therapies.
Defining desired genetic gains for Pacific white shrimp (Litopenaeus vannamei) breeding objective using participatory approaches
Authors: Rahbar Mina , Safari Roghieh , Perez‐Rostro Carlos I.
Published: January 2024

The objective of this study was to define desired genetic gains from economically important traits of Pacific white shrimp (Litopenaeus vannamei) using participatory approaches. Two questionnaires were sent out to 100 Pacific white shrimp farmers in all five Iranian shrimp farming provinces. Questionnaire A (Q‐A) includes management factors and farming environments. Moreover, in this questionnaire, farmers were asked to rank the fourth most important traits in shrimp among 10 economic traits in the list for genetic improvement. In questionnaire B (Q‐B), priorities of the four traits with the highest value were obtained using pairwise comparison. The results showed that the four most important traits were white spot syndrome virus resistance (WSSV), growth rate before 4 months (GR), acute hepatopancreatic necrosis disease resistance (AHPND), and female total weight at ablation (FTW). Medians of the best individual preference values were WSSV (0.222), GR (0.173), AHPND (0.157), and FTW (0.053). Most disagreements were found between the social group preference values in the commercial products and water salinity categories. Desired genetic gains were 1.71%, 1.57%, 0.53% and 0.31% for GR, AHPND, WSSV and FTW, respectively. This study highlighted that despite environmental and management differences, participatory approaches can achieve desired genetic results for Pacific white shrimp breeding programme.
LINC00707 impairs the Natural Killer cell antitumour activity in hepatocellular carcinoma through decreasing YTHDF2 stability
Authors: Wei Mingwei , Lu Libai , Ma Jiasheng , Luo Zongjiang , Tan Xijuan , Wang Jianchu
Published: January 2024

Hepatocellular carcinoma (HCC) is the fifth most frequently diagnosed cancer and ranks third in cancer‐related fatalities. The recognized involvement of long noncoding RNAs (lncRNAs) in several cancer types, including HCC, inspired this study to explore a novel lncRNA's functional importance in the progression of HCC. To achieve this, lncRNA microarray analysis was conducted on three distinct sets of HCC tissues, revealing LINC00707 as the most significantly upregulated lncRNA. Further research into its biological functions has revealed that LINC00707 acts as an oncogene, driving HCC progression by enhancing the proliferation, migration and invasion of HCC cells. Mechanistic insights were provided, demonstrating that LINC00707 interacts with YTH N6‐methyladenosine RNA‐binding protein 2 (YTHDF2), thus facilitating the ubiquitination‐dependent degradation of the YTHDF2 protein. Furthermore, LINC00707 was found to influence the cytotoxicity of NK‐92MI cells against HCC cells through its interactions with YTHDF2. These findings significantly contribute to a deeper understanding of the role played by LINC00707 in the progression of HCC.
Mendelian‐randomization study revealed causal relationship between nonalcoholic fatty liver disease and osteoporosis/fractures
Authors: Pei Xiong , Jiang Wei , Li Lianchi , Zeng Qingmin , Liu Chang‐Hai , Wang Ming , Chen Enqiang , Zhou Taoyou , Tang Hong , Wu Dongbo
Published: January 2024

Background

Patients with nonalcoholic fatty liver disease (NAFLD) are reported to have a higher risk of osteoporosis/fractures; however, the causal relationship remains unclear.

Methods

Publicly available genome‐wide association studies (GWASs) were used for Mendelian randomization (MR) analysis. GWASs of NAFLD and fractures were obtained from the FinnGen Consortium. GWASs of bone mineral density (BMD) were derived from a meta‐analysis. GWASs of obesity, diabetes, liver function, and serum lipid‐related metrics were used to clarify whether the accompanying NAFLD symptoms contributed to fractures. Moreover, two additional GWASs of NAFLD were applied.

Results

A causal association was not observed between NAFLD and BMD using GWASs from the FinnGen Consortium. However, a causal relationship between NAFLD and femoral neck‐BMD (FN‐BMD), a suggestive relationship between fibrosis and FN‐BMD, and between NAFLD and osteoporosis were identified in replication GWASs. Genetically proxied body mass index (BMI), high‐density lipoprotein (HDL), and hip circumference increased the likelihood of lower limb fractures. The waist‐to‐hip ratio decreased, whereas glycated hemoglobin (HbA1C) and homeostasis model assessment of β‐cell function (HOMA‐B) increased the risk of forearm fractures. Low‐density lipoprotein (LDL) reduced, whereas HbA1C increased the incidence of femoral fractures. Alkaline phosphatase (ALP) raised the risk of foot fractures. However, after a multivariate MR analysis (adjusted for BMI), all the relationships became insignificant.

Conclusions

NAFLD caused reduced BMD, and genetically predicted HDL, LDL, HbA1C, HOMA‐B, ALP, hip circumference, and waist‐to‐hip ratio causally increased the risk of fractures. BMI may mediate causal relationships. Larger GWASs are required to verify this finding.
Circulating leptin in patients with nonalcoholic fatty liver disease‐related liver fibrosis: a systematic review and a meta‐analysis
Authors: Makri Evangelia S. , Evripidou Kleo , Polyzos Stergios A.
Published: January 2024

Background and Aim

Clinical data on the association between leptin levels and nonalcoholic fatty liver disease (NAFLD)‐related liver fibrosis are conflicting. This meta‐analysis aimed to compare circulating leptin between NAFLD patients with versus without liver fibrosis or non‐NAFLD controls.

Methods

A systematic search was conducted in PubMed, Scopus, and the Cochrane Library. Fifteen studies were included, reporting data from 964 individuals (422 NAFLD patients with fibrosis, 297 NAFLD patients without fibrosis, 245 no‐NAFLD controls).

Results

Leptin standardized mean difference (SMD) was higher in NAFLD patients with fibrosis (F1–F4) than in controls (SMD: 2.27; 95% confidence interval [CI]: 0.81–3.73); however, this association did not remain robust after the exclusion of studies with morbidly obese individuals. No difference was observed in leptin SMD between NAFLD patients with fibrosis and those without fibrosis (F0), and NAFLD patients without fibrosis versus controls. Heterogeneity was high (I2: 66–98%) among studies. Meta‐regression analysis revealed a positive association of leptin SMD with homeostasis model assessment‐insulin resistance, when comparing NAFLD patients with fibrosis versus NAFLD patients without fibrosis (beta: 0.53; 95% CI: 0.04–1.03), and a negative association of leptin SMD with age, when comparing NAFLD patients with fibrosis versus controls (beta: −0.29; 95% CI: −0.53 to −0.05).

Conclusion

Circulating leptin was higher in NAFLD patients with liver fibrosis than non‐NAFLD controls, an association, however, attenuated after the exclusion of a study with morbidly obese individuals. Circulating leptin was not different between NAFLD patients with and without fibrosis, or NAFLD patients without fibrosis and controls.
Interactions that support older inpatients with cognitive impairments to engage with falls prevention in hospitals: An ethnographic study
Authors: Mcvey Lynn , Alvarado Natasha , Zaman Hadar , Healey Frances , Todd Chris , Issa Basma , Woodcock David , Dowding Dawn , Hardiker Nicholas R. , Lynch Alison , Davison Eva , Frost Tina , Abdulkader Jamil , Randell Rebecca
Published: January 2024

Aims

To explore the nature of interactions that enable older inpatients with cognitive impairments to engage with hospital staff on falls prevention.

Design

Ethnographic study.

Methods

Ethnographic observations on orthopaedic and older person wards in English hospitals (251.25 h) and semi‐structured qualitative interviews with 50 staff, 28 patients and three carers. Findings were analysed using a framework approach.

Results

Interactions were often informal and personalised. Staff qualities that supported engagement in falls prevention included the ability to empathise and negotiate, taking patient perspectives into account. Although registered nurses had limited time for this, families/carers and other staff, including engagement workers, did so and passed information to nurses.

Conclusions

Some older inpatients with cognitive impairments engaged with staff on falls prevention. Engagement enabled them to express their needs and collaborate, to an extent, on falls prevention activities. To support this, we recommend wider adoption in hospitals of engagement workers and developing the relational skills that underpin engagement in training programmes for patient‐facing staff.

Implications for Profession and Patient Care

Interactions that support cognitively impaired inpatients to engage in falls prevention can involve not only nurses, but also families/carers and non‐nursing staff, with potential to reduce pressures on busy nurses and improve patient safety.

Reporting Method

The paper adheres to EQUATOR guidelines, Standards for Reporting Qualitative Research.

Patient or Public Contribution

Patient/public contributors were involved in study design, evaluation and data analysis. They co‐authored this manuscript.
Evaluating the sensory properties of hybrid (meat and plant‐based) burger patties
Authors: Chin Shu Wei , Baier Stefan K. , Stokes Jason R. , Smyth Heather E.
Published: January 2024

Consumer interest in alternative plant‐based foods is growing, including products where plant proteins are isolated and reformulated to mimic meat. This study aims to investigate the fundamental changes in sensorial (textural) properties between meat and plant proteins using a hybrid protein burger matrix. Burger patties were used as a model, prepared with a range of protein composition (beef: plant‐based protein; 100:0, 75:25, 50:50, 25:75, and 0:100) with identical added fat (17%) and at two salt (0 and 0.6%) contents. Conventional sensory descriptive profiling elicited 21 sensory attributes and profiles of samples were obtained to explore relationship(s) with composition. Early‐stage oral processing texture attributes were well‐differentiated across the sample space, while less discrimination was observed across samples for latter stage mastication texture attributes. Animal meat content increased scores for saltiness and flavor intensity indicating that plant‐based meat analogues require a higher salt content to achieve similar levels of salt and flavor perception. These findings provide key insights into the impact of meat and/or plant‐based protein composition on sensory properties in a hybrid burger patty model system. Future work should consider the mechanical properties of such products with the objective of finetuning ingredients and processing to obtain meat analogues with desirable sensorial attributes.
Prothrombin time predicts steroid response in severe alcohol‐related hepatitis
Authors: Tarli Claudia , Mannucci Sergio , Vecchione Michele , Antonelli Mariangela , Sestito Luisa , Mancarella Francesco Antonio , Tosoni Alberto , Dionisi Tommaso , Maccauro Valeria , Sario Giovanna Di , Burra Patrizia , Germani Giacomo , Gasbarrini Antonio , Addolorato Giovanni
Published: January 2024

Background and Aims

Alcohol‐related hepatitis (AH) is the most severe form of acute alcohol‐related liver disease. Maddrey's discriminant function ≥32 defines the severe form of AH, which is associated with a high mortality. Steroid therapy represents the main medical treatment that may reduce short‐term mortality. Lille score at day 7 assesses the therapeutic response to steroid therapy. At present, no parameters able to predict the response to steroid therapy have been highlighted. The aim of the present study was to evaluate if baseline prothrombin time (BPT) could predict the response to steroid in severe AH (sAH).

Methods

Patients consecutively admitted in two Italian Liver Units, from 2017 to 2022, suffering from sAH were included. Data were collected prospectively. In order to evaluate if BPT could predict steroid response, we assessed the correlation between BPT using the Lille score at day 7.

Results

A total of 52 patients received steroid treatment were enrolled in the study. The response to therapy was assessed by Lille score at day 7. Responders were 34 patients (65%), non‐responders 18 patients (34%). BPT significantly predicted the steroid response (p < .001). The likelihood of not responding to the steroid therapy was significantly higher in patients with higher BPT (OR = 2.954).

Conclusions

BPT value predicted steroid response in patients with sAH. BPT could quickly identify non‐responder patients to steroid therapy, reducing the risk of infections and it could allow the early evaluation for liver transplantation.
Multimetric socio‐ecological assessment of water hyacinth (Eichhornia crassipes (Mart) solms) invasion of an urban Ramsar wetland lake
Authors: Wijeyaratne W. M. Dimuthu Nilmini , Liyanage Uditha Prabhath
Published: January 2024

Water hyacinth (Eichhornia crassipes (Mart) solms), a widely distributed invasive aquatic plant in Sri Lanka, has invaded the Diyawannawa wetland lake located in Colombo city, which is the first Ramsar wetland city in South Asia. The present study was conducted to assess the water quality parameters that influence the distribution of water hyacinth and to identify the environmental, economic, and social consequences of its invasion of the Diyawannawa wetland. Five sampling sites were selected from the Diyawannawa lake, and the water pH, temperature, conductivity, total dissolved solids (TDS), salinity, dissolved oxygen concentration (DO), nitrate concentration, and total phosphorus concentration were measured at monthly intervals in the rainy and dry seasons of 2020. The abundance of water hyacinth was recorded at each site at each sampling event. Interviews and focus group discussions (FGDs) were conducted with the representatives of the community associated with the wetland to assess the ecological, economic and social effects of water hyacinth invasion. Principal component analysis of the water quality parameters revealed that phosphorus and nitrate concentrations in water significantly influenced the abundance of water hyacinth. Further, the water quality index (WQI) indicated poor water quality in the sites invaded by water hyacinth. The interviews and FGDs revealed that water hyacinth invasion has adversely affected the lake's fisheries and navigation pathways and increased the frequency of flooding, resulting in an increased mosquito population. The results of the present study highlighted the importance of implementing water quality management programmes in the Diyawannawa wetland to control the invasion of water hyacinth. Further, we recommend increasing community participation in water hyacinth control programmes and providing opportunities for the community to engage in self‐employment activities associated with the uses of water hyacinth.
High‐Speed Centrifugation Efficiently Removes Immunogenic Elements in Osteochondral Allografts
Authors: Ma Yongsheng , Lin Qitai , Yang Wenming , Liu Yang , Xing Yugang , Ren Zhiyuan , Wang Xueding , Zhou Raorao , Wu Gaige , Li Pengcui , Duan Wangping , Zhang Xiaoling , Wei Xiaochun
Published: January 2024

Objectives

The current clinical pulse lavage technique for flushing fresh osteochondral allografts (OCAs) to remove immunogenic elements from the subchondral bone is ineffective. This study aimed to identify the optimal method for removing immunogenic elements from OCAs.

Methods

We examined five methods for the physical removal of immunogenic elements from OCAs from the femoral condyle of porcine knees. We distributed the OCAs randomly into the following seven groups: (1) control, (2) saline, (3) ultrasound, (4) vortex vibration (VV), (5) low‐pulse lavage (LPL), (6) high‐pulse lavage (HPL), and (7) high‐speed centrifugation (HSC). OCAs were evaluated using weight measurement, micro‐computed tomography (micro‐CT), macroscopic and histological evaluation, DNA quantification, and chondrocyte activity testing. Additionally, the subchondral bone was zoned to assess the bone marrow and nucleated cell contents. One‐way ANOVA and paired two‐tailed Student's t‐test are used for statistical analysis.

Results

Histological evaluation and DNA quantification showed no significant reduction in marrow elements compared to the control group after the OCAs were treated with saline, ultrasound, or VV treatments; however, there was a significant reduction in marrow elements after LPL, HPL, and HSC treatments. Furthermore, HSC more effectively reduced the marrow elements of OCAs in the middle and deep zones compared with LPL (p < 0.0001) and HPL (p < 0.0001). Macroscopic evaluation revealed a significant reduction in blood, lipid, and marrow elements in the subchondral bone after HSC. Micro‐CT, histological analyses, and chondrocyte viability results showed that HSC did not damage the subchondral bone and cartilage; however, LPL and HPL may damage the subchondral bone.

Conclusion

HSC may play an important role in decreasing immunogenicity and therefore potentially increasing the success of OCA transplantation.
Risk Index Predicts Pediatric Heart Allograft Non‐Utilization
Authors: Lynn Jake , Malik Tahir , Montgomery Ashley , Lang Anna , Shamapant Nikhil , Miggins John , Kamepalli Spoorthi , Goss John , Rana Abbas
Published: January 2024

Background

Children listed for heart transplantation face the highest waitlist mortality among all solid organ transplant patients (14%). Attempts at decreasing donor allograft non‐utilization (41.5%) could potentially decrease waitlist mortality for pediatric heart transplant patients. Our aim was to quantify the non‐utilization risk of pediatric donor heart allografts at the time of initial offering.

Methods

Using the United Network of Organ Sharing (UNOS) database, we retrospectively analyzed 8823 deceased donors (≤18 years old) data through univariable and multivariable analysis and logistic regression models. These factors were divided into a training (n = 5882) and validation set (n = 2941). Donor clinical characteristics and laboratory values were used to predict non‐utilization of donor hearts. The multivariable analysis used factors that were significant from the univariable analysis (p‐value < .05), and the pediatric non‐utilization risk index (pDRSI) included significant factors from the multivariable analysis, producing an overall risk score for non‐utilization. With these data, we created a non‐utilization risk index to predict likelihood of donor allograft non‐utilization.

Results

From the 24 potential factors that were identified from univariable analysis, 17 were significant predictors (p < .05) of pediatric heart non‐utilization in the multivariable analysis. Low left ventricular ejection fraction (odds ratio (OR)‐35.3), hepatitis C positive donor (OR‐23.3), high left ventricular ejection fraction (OR‐3.29), and hepatitis B positive donor (OR‐3.27) were the most significant risk factors. The phDSRI has a C‐statistic of 0.80 for the training set and 0.80 for the validation set.

Conclusion

Using over 8000 donors, the phDSRI uses 17 significant risk factors to predict risk of pediatric heart donor allograft non‐utilization.
Unrecognized opportunities: The landscape of pediatric kidney‐paired donation in the United States
Authors: Verbesey Jennifer , Thomas Alvin G. , Waterman Amy D. , Karhadkar Sunil , Cassell Victoria R. , Segev Dorry L. , Hogan Julien , Cooper Matt
Published: January 2024

Background

Pediatric (age < 18 years) kidney transplant (KT) candidates face increasingly complex choices. The 2014 kidney allocation system nearly doubled wait times for pediatric recipients. Given longer wait times and new ways to optimize compatibility, more pediatric candidates may consider kidney‐paired donation (KPD). Motivated by this shift and the potential impact of innovations in KPD practice, we studied pediatric KPD procedures in the US from 2008 to 2021.

Methods

We describe the characteristics and outcomes of pediatric KPD recipients with comparison to pediatric non‐KPD living donor kidney transplants (LDKT), pediatric LDKT recipients, and pediatric deceased donor (DDKT) recipients.

Results

Our study cohort includes 4987 pediatric DDKTs, 3447 pediatric non‐KPD LDKTs, and 258 pediatric KPD transplants. Fewer centers conducted at least one pediatric KPD procedure compared to those that conducted at least one pediatric LDKT or DDKT procedure (67, 136, and 155 centers, respectively). Five centers performed 31% of the pediatric KPD transplants. After adjustment, there were no differences in graft failure or mortality comparing KPD recipients to non‐KPD LDKT, LDKT, or DDKT recipients.

Discussion

We did not observe differences in transplant outcomes comparing pediatric KPD recipients to controls. Considering these results, KPD may be underutilized for pediatric recipients. Pediatric KT centers should consider including KPD in KT candidate education. Further research will be necessary to develop tools that could aid clinicians and families considering the time horizon for future KT procedures, candidate disease and histocompatibility characteristics, and other factors including logistics and donor protections.
The impact of phototherapy on itch intensity and itch‐related quality of life amongst different skin diseases, skin phototypes and genders – A prospective study with 102 patients
Authors: Merkel Tamara , Navarini Alexander , Mueller Simon
Published: January 2024

Background

Phototherapy is a mainstay to treat itchy conditions. However, only little is known about differences in the antipruritic effect of phototherapy amongst different skin conditions, phototypes and genders.

Methods

In this prospective, single‐center study, we analyzed the effect of phototherapy on itch intensity and itch‐related quality of life amongst these subgroups after a treatment duration of 4 weeks, while on‐demand treatment with topical corticosteroids, topical calcineurin inhibitors and/or antihistamines was allowed.

Results

Of 102 patients (age 53.0 ± 18.7, 56 females [54.9%]), 72 (78.3%) reported a significant reduction of itch intensity by Δ −2.76 on a 0–10 Numerical Rating Scale (NRS), p = <.001, 95% CI [2.2; 3.3] paralleled by a significant improvement of itch‐related quality of life as measured by the German version of the ItchyQoL by Δ 7.3, p = <.001, 95% CI [4.4; 11.6]. The best improvement of itch intensity and itch‐related QoL was reported by patients with pruritus on non‐diseased skin (ΔNRS −3.5; Δ 9.7 Ger‐ItchyQoL points), followed by patients with atopic dermatitis and psoriasis. We found no statistical differences in the response to phototherapy amongst Fitzpatrick phototypes I–VI. Women had higher itch intensities at baseline but itch‐related quality of life impairment at baseline and phototherapy treatment response did not significantly differ between genders.

Conclusion

Phototherapy appears to induce a meaningful itch reduction in various itchy skin conditions, all phototypes and both genders within 4 weeks that directly translates into improvement of itch‐related quality of life.
Multinational R&D decentralization in emerging markets: subsidiary evolution, autonomy, and influence in global innovation
Authors: Dividino Vania , Cahen Fernanda , Berte Erica
Published: January 2024

This study examined how multinational enterprises (MNEs) decentralized research and development (R&D) strategy impacts different evolution paths of R&D centers in emerging markets (EMs). We analyzed the centers' evolution paths in relation to subsidiary autonomy and influence in the MNE's global innovation. We conducted an inductive, in‐depth case study on the Volkswagen Group. We collected data from the headquarters and R&Ds centers of five subsidiaries in EMs. Our study revealed that Volkswagen adopted a decentralized R&D strategy, giving more autonomy to the EMs R&D centers, increasing the subsidiaries' innovation opportunities and their strategic role in the global innovation strategy. We compared two different evolution paths in EMs subsidiary R&D centers. The first path was a traditional one – found in Brazil, Mexico, and the Czech Republic – in which the R&D centers evolved from adapting products from the headquarters to launching innovative products for local markets and, later, becoming a global R&D center. In the second path, observed in China and India subsidiaries, the R&D centers evolved from offshoring units to technology units and finally to global R&D centers. This happened due to EMs' abundance of highly qualified, low‐cost labor and location‐specific technological capabilities. We advanced previous MNE R&D research by explaining how EMs R&D centers with different evolution paths gained more autonomy, increasing their sphere of influence in the multinational's global innovation strategy. We also provided insights on how to manage R&D in EMs.
Effects of a remotely supervised resistance training program on muscle strength and body composition in adults with cystic fibrosis: Randomized controlled trial
Authors: Sosa‐Pedreschi Alicia , Donadio Márcio Vinícius Fagundes , Iturriaga‐Ramírez Tamara , Yvert Thomas , Pérez‐Salazar Fernanda , Santiago‐Dorrego Catalina , Barceló‐Guido Olga , Sanz‐Santiago Verónica , Girón Rosa , Punter Rosa Mar Gómez , Rubio‐Alonso Margarita , Pérez‐Ruiz Margarita
Published: January 2024

Introduction

Among the limited studies on physical exercise interventions in adults with cystic fibrosis (CF), few have specifically addressed the improvement of peripheral muscle strength and body fat‐free mass. The aim of this study was to examine the impacts of a remotely supervised, individualized 8‐week resistance training program of moderate to high intensity on strength and body composition in these subjects.

Methods

This was a randomized controlled trial performed in adults with CF. The exercise group (EX) performed three 1‐h resistance training sessions per week over 8 weeks. The control group (CON) followed the physical activity recommendations of their physician. The main outcomes were muscle strength and body composition, with secondary measures including pulmonary function and quality of life. Two‐way repeated measures analysis was used.

Results

In 23 participants (age 32.13 ± 7.72 years), the intervention showed a significant beneficial effect on leg press strength, with a large effect size, both in absolute (p = 0.011;  = 0.281) and relative (p = 0.007;  = 0.310) terms. Large intervention effects were observed on total fat mass (p < 0.001;  = 0.415), body adiposity index (p < 0.001;  = 0.436), and fat mass index (p < 0.001;  = 0.445), all showing reduction in the EX group. In addition, significant large size effects were detected on total fat‐free mass (p = 0.046;  = 0.177), trunk fat‐free mass (p = 0.039;  = 0.188), and fat‐free mass index (p = 0.048;  = 0.174), all favoring exercise. No significant effects were observed on pulmonary function and quality of life.

Conclusions

An 8‐week remotely supervised resistance training program, with moderate to high intensity, effectively improved lower limb muscle strength and body composition.
Are analytical performance specifications derived from reference intervals of any use in the veterinary clinical laboratory? A preliminary study on the empirical biological variation model
Authors: Manzocchi Simone , van Rooyen Liesl J.
Published: January 2024

Background

Analytical performance specifications (APS) are vital for method evaluation and quality control validation. However, the limited availability of biological variation (BV) data, regulatory guidelines, and expert opinion (EO) may present challenges in veterinary medicine. The empirical biological variation (EBV) approach, based on population reference intervals (pRI), has emerged as an alternative method to derive APS in human medicine.

Objectives

This study aimed to assess the practicality and usefulness of the EBV approach in deriving performance limits for various measurands in dogs and cats.

Methods

Eight hematology and 13 biochemistry measurands were analyzed in dogs and cats. Estimates of combined biologic variation based on traditional biological (CVB) and EBV‐derived (CVE*) formulas were calculated and assessed for evidence of correlation. Performance limits for expanded uncertainty/total error and imprecision were compared among EO, BV, and EBV.

Results

Strong and significant correlations were found between CVB and CVE* for both dogs (r = .86, p < .00001) and cats (r = 0.95, p < .00001). The EBV‐derived APS were generally comparable to EO and BV, with a subjective criterion of 1.5% difference for imprecision and 3% for total error/expanded uncertainty.

Conclusion

The EBV approach, using pRI, shows promise as a surrogate marker for biological variation and as a practical tool for determining performance limits in dogs and cats. Assuming accurate pRI generated on analyzers with stable analytical performance, this approach could offer benefits when expert recommendations or robust BV studies are lacking or yield conflicting results. Further research is needed to explore the applicability and advantages of the EBV in veterinary medicine.