bluuebunny/crossref_metadata_2025 huggingface dataset:
American Shadows
Authors: Nancarrow Conlon , Carter Elliott , Babbitt Milton
Published: January 2025

This chapter highlights composers Conlon Nancarrow, Elliott Carter, and Milton Babbitt. Nancarrow’s player piano music, we learn in this chapter, was of tremendous significance to both Carter and Babbitt. This combination of composers, however, reveals the inequities of legacy and reception as they each entered the later stages of their careers. In companion to Elliott Carter’s and Milton Babbitt’s seemingly self-assured place as fixtures in American music, Nancarrow’s self-consciousness of his music without a home country frames Freeman’s musicales as a space where legacies were not determined but positioned, an intergenerational space mediated less by establishment of influence than by the power of the music itself.
A Universe of Sounds
Authors: Boulez Pierre
Published: January 2025

Pierre Boulez appeared at the Music Room twice, preferring to talk rather than present any music. Although five years separate his visits to Freeman’s home, this chapter includes both conversations in order to show Boulez’s developed thinking regarding his technomusical center, IRCAM, and his indebtedness to his American counterpart John Chowning, at that time the head of Stanford University’s Center for Computer Research in Music and Acoustics. Both the magnitude and intensity of Boulez’s conversations here have no counterpart. This chapter focuses mostly on Boulez, whose outsized place in the book attests to Freeman’s role in attracting the most significant composers of the era and from around the world to be part of her salons.
In Memoriam
Authors: Cage John , Braxton Anthony , Larsen Libby
Published: January 2025

Two months after his death, John Cage was memorialized at the Music Room. Cage and Freeman maintained a rich and lasting friendship, and her support for him departed in many ways from her normal methods of patronage. Following the memorial, Anthony Braxton and Libby Larsen presented their respective work, their wildly different musical styles a testament to both Cage’s and Freeman’s wide reach into various pockets of new music. This chapter presents the entirety of that salon, the only chapter of its kind in this book. Also included in this chapter is the transcription of John Cage’s 1982 appearance at the Music Room, where he delivered, among other philosophical musings, a mesostic on the word “method.”
West Coast Undertow
Authors: Harrison Lou , Oliveros Pauline , Feldman Morton , Salonen Esa-Pekka
Published: January 2025

This chapter draws together composers Morton Feldman, Pauline Oliveros, Lou Harrison, and Esa-Pekka Salonen. While united by a proximity to cultural institutions in California, none of the composers included in this chapter could claim the state as the place of their birth. Rather, these composers represent, in a span of several decades and generations, the thrust of creative minds upon the West Coast. Large funding organizations such as the NEA and the Ford Foundation are placed in conversation with Betty Freeman. No single institution, no matter how large or important, seemed to be able to provide the interpersonal connection and spirit of Freeman’s patronage. In the summation of this study, then, it seems fitting to reflect on the necessity and scope of Freeman’s patronage despite—or maybe because of—the changing course of institutional and corporate takeover of cultural philanthropy in America.
The End
Authors: Johnson Jake
Published: January 2025

This concluding chapter contextualizes the ending of Freeman’s salon series in 1994 which also signals an end to how salon culture and patronage operated in America. The fate of salon culture more broadly is recalled from the introductory chapter, as is the relationship Freeman’s salons shared with the neighboring Hollywood and Disney industries. Salons operating in a politically dynamic era, in the shadow of massive entertainment industries, raise questions about where and how new music survives in the decades ahead. Adorno and Horkheimer’s critique toward the “culture industry” likewise is placed in conversation with the purpose of salons to exclude and to be set apart from the world.
2656 Healthcare professionals’ views on optimising pain services for older adults living with frailty: preliminary findings from the POPPY study
Authors: Wright A , Harrison N , Brown L
Published: January 2025

Introduction

Frailty and persistent pain are both common among older adults (OAs) and together contribute to disability and emotional distress. The impact of pain on everyday life is potentially modifiable with appropriate pain management techniques, but current services do not always take account of the needs of frail OAs. The Pain in Older People with Frailty Study (POPPY) is a mixed-method study to develop the content and implementation strategies for services to optimise the support available for OAs living with frailty and pain. Initial objectives of the POPPY study included seeking views from healthcare professionals (HCPs) and commissioners on existing local services including their experiences of the barriers faced by OAs with frailty accessing these services, and views on how resources might be best deployed to support OAs with frailty.

Methods

In-depth qualitative interviews were conducted with HCPs from across England, based in specialist, secondary care and community services. Interviewees included commissioners, GPs, physiotherapists, occupational therapists, psychologists, nurses, doctors, and health coaches. A thematic approach to data analysis was used.

Results

Forty-two HCPs and 2 commissioners from 9 pain services and 2 generic community services were interviewed. HCPs recognised that OAs living with frailty and pain formed a distinct group, experiencing shared facilitators and barriers to engagement. Meeting the needs of this group was challenging for services. Most HCPs thought a dedicated pain service for frail OAs was impractical and disagreed with the concept of age-based pain services. HCPs thought the needs of frail OAs were most likely to be met by community-based services, staffed with appropriately skilled multi-disciplinary teams, interacting effectively with other specialist services, and delivering holistic individualised approaches.

Conclusion

Pain services need to be responsive to the specific needs of OAs with frailty and recognise the importance of adapting content and delivery of interventions to reflect this.
2833 Quality improvement project on increasing antimicrobial stewardship and patient safety
Authors: Tarkas T , Suthahar Y
Published: January 2025

Introduction

National surveillance shows an estimated 58,224 people in England had antibiotic-resistant infections in 2022, a rise of 4% since 2021 (ESPAUR report). Between 2022–23, our Trust had 2nd highest C.difficile rates in the country. Geriatric population is particularly vulnerable to inappropriate antimicrobial prescribing, leading to prolonged hospital stays. As part of anti-microbial stewardship (AMS), a Quality improvement project was carried out between February–May 2024.

Methods

Six geriatric wards (n = 168) were audited between 14-16th February 2024. Indication, route, duration, choice of antibiotic and compliance to Microguide was measured. Interventions included introducing weekly microbiology consultant led ward rounds, junior doctor, nurse and consultant education (individual and group) and streamlining IT access to Microguide were implemented. AMS meetings were introduced, which included lead microbiology consultants, chair of medicines safety group, lead antimicrobial pharmacist, geriatric consultants and incorporating prescribing into simulation sessions were sought. Plan-do-study-act (PDSA) cycle was carried out, with repeat cycle carried out in June 2024.

Results

In total, 99 patients were on antibiotics with compliance to Microguide ranging from 39–65% (mean = 53%) in 1st cycle. Co-amoxiclav (n = 45) and Tazocin (n = 14) were the most used antibiotics. After the PDSA cycle with interventions implemented, compliance increased from range 70 to 90% (mean = 83%m n = 71). Areas such as prescribing of co-amoxiclav for UTI, Tazocin use without micro approval were targeted. There was increase in the indications and duration mentioned on drug charts (89 to 95%).

Conclusion

Local drivers of change with existing resources can significantly improve AMS. This ultimately leads to less C.difficile infections and improved patient safety. Junior doctor education and weekly ward rounds can be implemented in other areas of our trust to improve AMS.
2849 Managing acute hyperkalaemia in frail individuals using a modern potassium binder sodium zirconium Cyclosilicate (Lokelma®)
Authors: Suman S , Debnath V
Published: January 2025

Background

Hyperkalemia is a common life-threatening electrolyte abnormality present in acutely unwell frail patient, often in context of Acute Kidney Injury (AKI), background of Chronic Kidney Disease (CKD) and a variety of medications such as renin-angiotensin-aldosterone system (RAAS) inhibitors. NICE TA 599 guidance recommends the use of a modern K+ binder such as Sodium Zirconium Cyclosilicate (SZC) in the acute setting alongside standard of care. This case series was carried out with a view to gain clinical experience specifically in acutely unwell frail older individuals presenting to a District General Hospital in UK.

Methods

Eight patients presenting to ED at Medway NHS Foundation Trust over 3-week period between 7th June—11th July 2023 with Hyperkalemia were treated with SZC, data was collected retrospectively.

Results

AKI present in 6/8, Sepsis present in 4/8.

Management

SZC 10 g tds was managed to correct hyperkalemia alongside established standard of care measures for acute hyperkalemia management. Fluid resuscitation, antibiotics and discontinuation of culprit medications was carried out where indicated.

Effectiveness of SZC

Conclusions
2625 Navigating morally challenging scenarios in advance care planning: a survey study
Authors: Yu CC , Tang JY , Goh SF , Low JAYH , Ng CJ , Chong R , Cheung KYK , Ho AHY , Menon S , Cruz MT , Ng R
Published: January 2025

Introduction

There are abundant anecdotal reports of healthcare professionals undergoing strain, specifically moral distress, in advance care planning (ACP) related work. This study measured perceptions of morally challenging scenarios (MCS) faced by ACP facilitators and frontline clinicians.

Method

An online survey, which is currently ongoing, was sent to the ACP community and also frontline clinicians in Singapore. Purposive and snowballing sampling approaches were employed.

Result

Participants rated their opinions on 23 MCS in ACP-related work that were earlier identified from 30 interviews. Findings showed that the top three MCS perceived to go against one’s conscience were: (i) providing treatment not in concordance with wishes of patient, (ii) being uncertain if decisions by family members were driven by ulterior motives and (iii) taking the view of dominant family members as the final decision. Most commonly encountered MCS were dilemmas related to (i) perceived medical best interest, (ii) honouring of patient’s preferred place of death, and (iii) having to deal with collusion. Each of 14 MCS were encountered by at least 50% of our participants and 66% of all who had encountered at least one MCS agreed that their psychological health was affected. Guidance from mentors and support from peers were rated most favourably out of the 15 coping strategies to deal with moral dilemma in ACP work. Coping strategies were largely positive with only a minority favouring the use of alcohol or giving in to demands of patients and families.

Conclusion

Findings show those who engaged in ACP-related work encountered a wide variety of MCS and perceived their psychological health as being affected. There is a pressing need to address the sources and risk factors of moral distress in such work, and to enhance the protective factors which can help ACP facilitators and frontline clinicians cope with moral distress successfully.
2644 Falls and physical function in older patients with benign paroxysmal positional Vertigo (BPPV)
Authors: Huang X , De KCW , Shi SMP , Yuen HW , Min DLY , Poongkulali A , Iqbal A , Rosario BH
Published: January 2025

Introduction

Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo in older adults. Due to the high incidence of BPPV in older adults presenting with falls, vestibular assessment, and diagnosis of BPPV and other vestibular disorders has become a recommendation in the World Guidelines for Falls Prevention. There has been a paucity of evidence in well conducted randomised controlled trials (RCTs) to evaluate vitamin D for prevention of BPPV recurrence and its relation to falls and function.

Method

This is a Phase IIa single centre, placebo controlled, double blind RCT to evaluate vitamin D supplementation together with diet and Canalith Repositioning Procedure [Group A] or diet alone combined with CRP [Gorup B] can reduce recurrence rates of BPPV. Post hoc analyses were performed evaluating BPPV recurrence, falls and function.

53 participants were recruited. 14 were vitamin D replete at baseline [Group C- diet alone], the remaining 39 were randomised into Groups A and B. Group A was associated with 0.75 fewer clinical BPPV recurrences per one person year (IRD -0.75, 95% CI -1.18 to −0.32, P = 0.035).

Findings

Older adults in the study who suffered a fall during the 12 month follow up had lower Activities of Daily Living scores. They also had poorer Short Physical Performance Battery scores at baseline. Participants in Group A had better 5x sit to stand time compared to Group B even accounting for underlying frailty scores. 25% of participants who fell in the 12 month follow up reported fear of falling compared to 43% in those with no falls in the 12 month follow up.

Vitamin D supplementation improved physical performance in 5xchair stand test.

Conclusion

In this study population, more participants without an incident fall during follow up experience fear of falling, prompting further consideration into the complex concept that is fear of falling.
2891 Persistent drop in haemoglobin after the insertion of an intramedullary nail following a neck of femur fracture
Authors: Thangaraj L , Seedher A , Titiloye A
Published: January 2025

An 85-year-old male presented with a hip fracture following an accidental fall. His background included chronic kidney disease, hypertension, high cholesterol, and type 2 diabetes mellitus. He underwent a intramedullary nail for a subtrochanteric fracture. Post-op he had 4 units of red blood cells for post-op anaemia. Despite multiple transfusions, his haemoglobin levels gradually decreased and there was no evidence of visible bleeding from the wound or other sites. He complained of persistent swelling and pain limiting his mobility. Pelvic x-rays revealed stable fixation. Patient developed a deep vein thrombosis and was started on low molecular weight heparin. Further acute drop in his haemoglobin prompted for an ultrasound of his hip, which identified an intramuscular haematoma. This was confirmed on a CT angiogram which revealed an active haemorrhage within the right vastus intermedius muscle with associated haematoma, which appeared to arise from a branch of the profunda femoris. The patient underwent coil embolization under radiological guidance which successfully achieved complete haemostasis. It was also revealed that he had a large pseudoaneurysm arising from the descending branch of the right lateral circumflex artery. Post-procedure his haemoglobin remained stable, pain controlled adequately and tolerating anticoagulation without further drop in haemoglobin. Furthermore, his mobility improved and he was deemed medically fit to be discharged to rehabilitation. Although pseudoaneurysms are very rare, persistent drop in haemoglobin, pain, swelling and poor a stable fixation of an intrameduallary nail should raise suspicion of a haematoma, and requires further investigations with a CT angiogram.
2835 Evaluation of Paceycuff as a novel treatment for male stress urinary incontinence: the first UK experience
Authors: Musabyimana C , Yang B
Published: January 2025

Background

Prostate cancer and bladder outlet obstruction, often treated surgically, are increasing in the ageing population, leading to more cases of stress urinary incontinence (SUI). While implantable continence devices are beneficial for many, a growing number of frail patients are unsuitable for surgery and rely on incontinence pads or penile clamps, which are limited to three-hour use to prevent tissue ischaemia. We present the first UK evaluation of the new PaceyCuff penile clamp, designed for 24-hour wear while maintaining blood flow, to assess its efficacy, safety, and impact on patient quality of life.

Method

Men with urodynamically-proven SUI were identified. Baseline penile and finger peripheral oxygen saturation (SpO2), three-hour pad weight, 24-hour pad count and patient-reported outcomes (ICIQ-UI, QoL) were measured. Participants were then fitted with the PaceyCuff, and reassessed immediately, at three hours post-application and (via telephone) after two weeks.

Results

13 men (average age 74, range 62–82) were recruited. ICIQ-UI scores decreased from 17 to 10, and QoL scores from 13 to 9. Average three-hour pad weight dropped from 94 g to 10 g and daily pad usage decreased from 4 to 0.9 pads. Participants reported good tolerance, with an average pain score of 1.8/10 and only 2 minor adverse effects (skin abrasion, transient pain). Penile SpO2 remained stable before, immediately after, and three hours post-use (76%, 82%, and 81% respectively). Sub-group analysis of patients over the age of 80 (n = 4) confirmed equal effectiveness. (ICIQ-UI decreased 18 to 10, QoL decreased 13 to 9, three-hour pad weight decreased 77 g to 9 g, daily pad usage decreased 4 to 1.5 pads, average pain 1.5/10).

Conclusions

The PaceyCuff has demonstrated both efficacy and tolerability in managing SUI in a UK cohort for the first time and offers a potential treatment option for elderly patients who are ineligible for surgical intervention.
2678 Small vessel disease contributions to acute delirium: a pilot feasibility MRI study
Authors: Clancy U , Jardine C , Doubal F , Maclullich A , Wardlaw J
Published: January 2025

Background and aims

Delirium carries an eightfold risk of future dementia. Small vessel disease (SVD), best seen on MRI, increases delirium risk, yet delirium is understudied in MRI research. We aimed to determine MRI feasibility, tolerability, image usability, and prevalence of acute and chronic SVD lesions in acute delirium.

Methods

This case–control feasibility study performed MRI (3D T1/T2-weighted, FLAIR, Susceptibility-weighted, and Diffusion-weighted imaging (DWI) on 20 medical inpatients >65 years: 10 with delirium ≥3 weeks and 10 without delirium, matched for vascular risk, Clinical Frailty Scale (CFS), and cognitive status. We excluded acute stroke, agitation necessitating sedation, assistance of >2 staff to mobilise, and MRI contraindications. We measured scan duration, tolerability, image usability, acute infarcts on DWI, and chronic SVD features. Six months later, we recorded CFS and cognitive diagnoses.

Results

Mean age was 83.5 years (delirium 78.7 vs non-delirium 88.4); 13/20 were female; 17/20 had premorbid cognitive decline/impairment or dementia. Acquisition took mean 26.8 minutes. MRI was well-tolerated in 16/20 (7/10 in delirium arm; 9/10 in non-delirium arm). 4/20 had early scan termination but 20/20 had clinically interpretable images. We detected DWI-hyperintense lesions in 3/10 (33.3%) with delirium (2/10 small subcortical and 1/10 cortical) and in 3/10 (33.3%) without delirium (2/10 small subcortical; 1/10 cortical). Mean SVD score was 2.4 in delirium vs 3.3 without.

Conclusions

MRI is feasible, usable, and tolerable in delirium, and we detected DWI hyperintense lesions in one third of patients overall. This study indicates acute vascular contributions, including SVD, to delirium, supporting the need for larger studies.
2839 Decision aids for the Care of Patients with multimorbidity: a systematic review
Authors: Chen Y , He R , Chen Z , Huang J , Bai Y , Yang C
Published: January 2025

Introduction

Clinical decision making for older adults with multimorbidity can be complex and demanding. When facing complex decision-making, patients may experience decisional conflicts, leading to low treatment adherence, adverse health outcomes, and increased utilisation of health services, etc. To address these issues, patient decision aids (DAs) have been developed and utilised in the decision-making process to facilitate informed decisions. The aim of this study is to identify DAs developed for patients with multimorbidity and assess their quality.

Method

We searched full-text papers on nine databases. Any article utilising a DA for patients with multimorbidity was eligible and DAs for making medical decisions at any point were eligible. We used the International Patient Decision Aid Standards (IPDAS) checklist to assess the quality of DAs.

Results

In total, ten articles including six DAs were included. Two DAs targeted for the older patients with multimorbidity. Most DAs didn’t focus on specific treatment choices but rather aimed at improving the overall quality of life for patients with multimorbidity. The targets of these DAs are including setting goals about health care, preparing for conversation with doctors and taking ownership for the decisions. IPDAS checklist revealed that only one DA met all qualifying criteria and provided comprehensive choice. Three DAs were deemed to have poor quality due to their failure to provide the pros and cons of decisions. The quality of the remaining DAs was difficult to judge due to incomplete versions.

Conclusions

DAs for patients with multimorbidity were few and had poor quality. Designing DAs for this patient population presents challenges given the complex nature of multimorbidity and its lack of specific treatment options. Future development should focus on adhering to the IPDAS checklist, provide more information and possibility, and aim at improving the quality of life for patients with multimorbidity.
2483 Hyponatremia In elderly: a systematic review and Meta-analysis
Authors: Shah S , Barot A
Published: January 2025

Introduction

Hyponatremia is the most common electrolyte imbalance caused by serum sodium level of less than 135 mmol/L, prevailing 15 and 30% among hospitalised patients.

Methods

PRISMA guidelines were followed for this study. Pubmed was searched with the search term: (hyponatremia) AND (treatment OR control OR management [MeSH]) AND (elderly [MeSH]) with filters, timeline: 2000 to 21/07/2023, free full text articles and human species. Data extraction was done using Covidence app and depicted in PRISMA Flow diagram. Quality assessment was done by Cochrane Risk of Bias version 1. Odd’s ratio with 95% confidence interval was calculated for dichotomous outcomes. Mantel–Haenszel statistical method along with random effects model was used. Cochrane Q test was employed and I2 index was computed. Forest and Funnel plots were plotted. The analysis was done by Cochrane Review Manager.

Results

Out of 3222 results, 9 studies were included with total 980 patients. Eight were of vaptans and 1 of empagliflozin. Three studies had low risk of bias and were included in meta-analysis. Mean age and BMI were 70.55(SD = 14.5) years and 24.73(SD = 3.95) kg/m2 respectively. Most frequently occuring aetiology, comorbidity and symptom were congestive heart failure, hypertension and fatigue/malaise respectively. Mean baseline serum sodium was 124.89 mmol/L and mean rise was 9.142 mmol/L. Meta-analysis showed that placebo was significantly associated with achieving normonatremia as compared to treatment group (OR = 2.5, 95%CI:1.54,4.04, p = 0.0002,I2 = 0%). The most frequent reported side effects were nausea, dry mouth, pyrexia and thirst. Side effects both mild/moderate (OR = 1.12, 95%CI:0.69,1.81, p = 0.65, I2 = 0%) and serious (OR = 1.51, 95%CI: 0.77,2.98, p = 0.23, I2 = 0%) showed no difference between treatment and placebo groups. Treatment was not associated with rapid risk of overcorrection (OR = 1.65, 95% CI:0.57,4.81, p = 0.36, I2 = 0%). None showed osmotic demyelination syndrome.

Conclusion

We conclude that vaptans and Empagliflozin, although safe, show limited efficacy in hyponatremia treatment.

Reference

1. Zhang X, Li XY. Eur Geriatr Med. 2020;11(4):685–692.
2629 A feasibility study examining the use of wearable technology among older delirious adults recovering from acute illness
Authors: Stoodley I , Cheston H , Hogan P , Tsui A
Published: January 2025

Introduction

Wearable technology that continuously monitors physiological metrics has become increasingly popular and allows remote patient monitoring in virtual ward settings. Wearable technology has been shown to be effective in disease monitoring among younger adults. However, its use among older adults, including those with cognitive impairment, is yet to be explored.

Aim

We aim to explore the acceptability of remote monitoring using wearable technology among older adults with delirium.

Methods

Participants were recruited from an in-patient rehabilitation unit. Inclusion criteria included documented delirium and age over 65 years. Participants were enrolled until delirium resolved or until discharge. Wearable technology was worn continuously, except when being charged or the patient was washing. Device data was recorded every minute. Premorbid Barthel index and Hierarchical Assessment of Balance and Mobility (HABAM) was collected for each participant. Participants were assessed daily for delirium and mobility using the Memorial Delirium Assessment Scale and HABAM respectively. At point of discharge from the study, participants completed a questionnaire to gather feedback on their experience.

Results

20 participants were included, with a mean age of 83.0 years and an average premorbid Barthel’s index of 72. 6. Mean data capture from the wearable technology was 44.1% (12.8–65.8). None of the participants could independently manage the device. Three participants stated that the device interfered with their normal activities with five reporting the device uncomfortable to wear. However, nine participants stated they would wear the device again if asked to by a healthcare professional.

Conclusions

Our findings demonstrate that wearable devices are tolerated by delirious older adults with delirium. We found that this group cannot manage these devices independently and need support from either a carer or healthcare professional. These results provide useful information to help pilot these devices among older adults with delirium in virtual ward settings.
2526 Web-based compassion interventions for family caregivers’ mental well-being
Authors: Zhang Q , Zhu M , Chen R
Published: January 2025

Introduction

The ageing population has increased the demand for family caregivers, who often suffer from psychological distress, especially compassion fatigue. This systematic review and meta-analysis evaluate the effectiveness of web-based compassion interventions in improving the mental well-being of family caregivers.

Methods

MEDLINE, Embase, PsycINFO, Web of Science, Cochrane Library, and Proquest were searched from database inception until manuscript submission date. Eligible studies included family caregivers participating in web-based compassionate interventions with reported mental wellness indicators, such as self-compassion. Two independent researchers conducted a literature review, extracted data, and assessed the quality of each study using the Risk of Bias 2 tool. Random effects meta-analysis was performed to pool the data, followed by subgroup analyses, sensitivity analyses and Egger’s tests.

Results

Out of 1095 studies evaluated, eight randomised controlled trials (encompassing 1978 participants) were included, with 75% exhibiting low risk of bias and high-quality evidence. Meta-analysis results indicated positive effects of web-based compassion interventions on family caregivers’ self-compassion (SMD = 0.33, 95% CI 0.08 to 0.58, P = 0.009) and mindfulness (SMD = 0.46, 95% CI 0.03 to 0.90, P = 0.04). These interventions also demonstrated a positive impact on reducing stress (SMD: -0.32, 95% CI -0.59 to −0.04, P = 0.02) and anxiety (SMD: -0.28, 95% CI -0.47 to −0.09, P = 0.003). Subgroup analyses highlighted superior self-compassion outcomes for caregivers supporting individuals with mental illness and cancer compared to those caring for individuals with Alzheimer’s disease. Interventions lasting ≥8 weeks were the most common and effective.

Conclusions

Web-based compassion interventions benefit family caregivers by enhancing self-compassion, mindfulness, and reducing anxiety and stress. More well-designed studies are suggested for future clinical applications.
Decoding the Intricate Metabolic and Biochemical Changes in Plant Senescence: a focus on chloroplasts and mitochondria
Authors: Carillo Petronia , Ferrante Antonio
Published: January 2025

Background

Plant senescence is a genetically controlled process that results in the programmed death of plant cells, organs, or the entire plant. This process is essential for nutrient recycling and supports the production of plant offspring. Environmental stresses such as drought and heat can hasten senescence, reducing photosynthetic efficiency and significantly affecting crop quality and yield.

Scope

This mini-review seeks to clarify the complex metabolic and biochemical transformations involved in plant senescence by explaining the mechanisms in a straightforward and connected manner. It focuses on key cellular processes such as genetically programmed or stress-induced senescence, chlorophyll metabolism and nutrient recycling, while also exploring the roles of signaling molecules and pathways.

Conclusions

Understanding the complexities of plant senescence may help manage crop aging, address climate change, and cut post-harvest losses. Enhancing crop resilience to stress and decelerating aging can reduce the need for overproduction, thereby decreasing pollution and conserving resources. Tackling food waste, which constitutes about one-third of global supplies, is crucial for ensuring food security and fostering environmental sustainability.
METTL7A improves bovine IVF embryo competence by attenuating oxidative stress
Authors: Zhu Linkai , Ming Hao , Scatolin Giovanna N , Xiao Andrew , Jiang Zongliang
Published: January 2025

In vitro fertilization is a widely used assisted reproductive technology to achieve a successful pregnancy. However, the acquisition of oxidative stress in embryo in vitro culture impairs its competence. Here, we demonstrated that a nuclear coding gene, methyltransferase-like protein 7A, improves the developmental potential of bovine embryos. We found that exogenous methyltransferase-like protein 7A modulates expression of genes involved in embryonic cell mitochondrial pathways and promotes trophectoderm development. Surprisingly, we discovered that methyltransferase-like protein 7A alleviates mitochondrial stress and DNA damage and promotes cell cycle progression during embryo cleavage. In summary, we have identified a novel mitochondria stress eliminating mechanism regulated by methyltransferase-like protein 7A that occurs during the acquisition of oxidative stress in embryo in vitro culture. This discovery lays the groundwork for the development of methyltransferase-like protein 7A as a promising therapeutic target for in vitro fertilization embryo competence.
Human-in-the-loop machine learning-based quantitative assessment of hemifacial spasm based on volumetric interpolated breath-hold examination MR
Authors: Huang Zengan , Wang Xinyi , Liu Xiaoming , Li Jingwen , Hu Xinyu , Yu Qinwei , Kuang Guiying , Xiong Nian , Gao Yi
Published: January 2025

Objective

The purpose of this study was to assess the severity of hemifacial spasm (HFS) through quantitative measures that associated it with neurovascular contact (NVC).

Methods

We enrolled 108 HFS patients (63 severe and 45 mild cases) and implemented a human-in-the-loop approach to develop a quantitative NVC feature package. This process involved using interactive segmentation on three-dimensional volumetric interpolated breath-hold examination (VIBE) MR images to delineate vascular and nerve structures. From these segmentations, we extracted quantitative NVC features, forming an NVC feature package, and applied a support vector machine model to assess HFS severity.

Results

Our interactive segmentation technique achieved high accuracy (Dice similarity coefficients of 0.905 ± 0.030 for vascular structures and 0.922 ± 0.086 for nerves). The NVC feature package, comprising distance between vascular structures and nerves, vascular diameter, their ratio, and clinical characteristics, enabled our model to assess HFS severity with an AUC of 0.823 (95% CI: 0.714-0.932, p < 0.001).

Conclusion

This study introduced a quantitative approach to understanding the relationship between HFS severity and NVC, using VIBE MR imaging. Our model offers a promising tool for enhancing clinical decision-making and offers deeper insights into the impact of NVCon HFS, aiming to improve patient outcomes.

Advances in knowledge

Microvascular decompression is well-established as a safe and effective treatment for HFS. However, there is a gap assessing the severity of HFS using quantitative measures that directly link it to NVC. Our method introduced a quantitative and objective alternative for assessing the severity of HFS to addressing this gap.
CSF production rate, resistance to reabsorption, and intracranial pressure: a systematic review and meta-analysis
Authors: Olakorede Ihsane , Bögli Stefan Y , Czosnyka Zofia , Czosnyka Marek , Smielewski Peter
Published: January 2025

Davson’s equation relates the state of stable intracranial pressure (ICP) to the production rate of CSF (IF) and resistance to CSF outflow (ROUT). Both parameters are assumed to be independent of ICP, but results are conflicting. The objective is to define the relationship between ICP, IF and ROUT using a systematic literature review. Medline and Embase were searched from inception up to 12 February 2024. Experimental studies exploring the association between ICP, IF, and ROUT were included. Individual measurements of ICP, IF and/or ROUT were extracted from tables or graphs, alongside descriptive parameters (population, ICP measurement site, disease, and computational method). Linear regression and mixed effects models were applied. From 1304 references, 25 articles were included in our meta-analysis. IF is approximately constant across all pathologies independent of the ICP level, population, disease, ICP measurement site and the measurement/estimation method. Conversely, ICP was positively correlated with ROUT. The intercorrelation, however, differed by population, disease, ICP measurement site and estimation method. Additionally, IF derived from Davson’s Equation compared with the measured IF were similar for patients with hydrocephalus but differed for patients with acute brain injury. Davson’s Equation describes the various components of cerebrospinal fluid dynamics. The results underline important caveats for its use in patients with acute brain injury wherein the estimated values differ from the measured ones. Overall, additional metrics describing the cerebrovascular system or the underlying disease have to be taken into account for more accurate estimations.
The recent change in the BNF topical corticosteroid potency classification is not evidence-based
Authors: Affleck Andrew , Dawe Robert , Albrecht Joerg
Published: January 2025

The potency classification of topical steroids has been changed to the ATC system which is purely based on the steroid molecule and is not aimed for clinical use. Previously the BNF used a clinical potency grading which was based on formulation as well as the steroid molecule. Prediluted proprietary formulations are now classed as the same potency as their undiluted formulations which will cause confusion.
Enhancing retrieval capacity of the predictive brain through dorsolateral prefrontal cortex intervention
Authors: Szücs-Bencze Laura , Vékony Teodóra , Pesthy Orsolya , Kocsis Krisztián , Kincses Zsigmond Tamás , Szabó Nikoletta , Nemeth Dezso
Published: January 2025

Extracting spatial or temporal patterns across experiences is essential for skill acquisition and predictive processes. The prefrontal cortex plays a central role in regulating competitive cognitive systems, with a particular influence on executive functions, often opposing statistical learning. This regulatory function may account for observed improvements in the acquisition and consolidation of statistical regularities following inhibition of the dorsolateral prefrontal cortex via repetitive transcranial magnetic stimulation. However, whether access to previously acquired statistical knowledge can similarly benefit from dorsolateral prefrontal cortex inhibition remains unclear. This preregistered study investigated the dorsolateral prefrontal cortex’s role in retrieving pre-existing statistical knowledge of temporal regularities. Healthy human participants engaged in an implicit probabilistic sequence learning task followed by a 24-h consolidation period. Before retesting, they received either 1 Hz repetitive transcranial magnetic stimulation or sham stimulation over the left, right, or bilateral dorsolateral prefrontal cortex for 10 min. We observed that retrieval of statistical regularities was enhanced in the Bilateral dorsolateral prefrontal cortex group compared to the Sham group. Our findings suggest that dorsolateral prefrontal cortex inhibition may facilitate access to statistical knowledge, particularly when interhemispheric compensatory mechanisms are limited. These insights advance our understanding of the dynamic neural background of statistical learning and may inform strategies for cognitive enhancement.
Lysophosphatidylcholine-Induced Aberrant Adipogenesis in Mesenchymal Stem Cells and Impaired Antibacterial Function in Adipocytes of Creeping Fat
Authors: Wu Fangting , Xie Wenting , Yu Anqi , Lin Xiaoxia , Ouyang Ting , Fei Jieying , Liu Xi , Yang Hui , Zhang Da , Shi Jintao , Wang Weidong , Huang Miaoxing , Chen Guiquan , Xie Fang , Wu Fengfei , Bai Lan
Published: January 2025

Background and aim

Creeping fat (CF) in Crohn's disease (CD) is characterized by hyperplastic mesenteric adipose tissue (MAT) encasing fibrotic intestinal segments. CF exhibits disruptions in microbiota and lipid metabolism, particularly in lysophospholipids (LPC). This study aims to elucidate the impact of LPC on adipogenic differentiation of mesenchymal stem cells in CF and its effects on immune defense functions in the differentiated adipocytes.

Methods

Isolated adipocytes of MAT from CD and Non-CD patients were analyzed for bacterial counts and composition using AQ-PCR and 16S rRNA. RNA sequencing was performed on isolated adipocytes to assess functionality. LPC levels in CD patients and their effects on adipocyte immune defense were measured using lipidomics, ELISA, and bacterial killing assays. A TNBS-induced colitis model was used to measure LPC levels in plasma and gene expression in MAT.

Results

Significant shifts in microbial diversity and bacterial load were observed in CF-derived adipocytes, characterized by increased colonization by pathogenic bacteria and diminished antibacterial capabilities. Sequencing analysis revealed downregulation of antimicrobial genes, including SAA1/2, and upregulation of lipid metabolism-related genes. Lipidomic analysis of CF showed elevated LPC levels, a pro-inflammatory lipid also found in plasma of CD patients. In vitro experiments demonstrated LPC promotes adipogenesis through EGR2, while impairing adipocytes' antibacterial immunity. These findings were consistent in the TNBS-treated mouse model, where increased LPC levels in the blood, and a significant reduction in SAA1/2-positive adipocytes were noted.

Conclusions

LPC-induced aberrant adipogenesis in CF is a newly identified pathological feature in CD patients and a potential therapeutic target.
The effect of first intervention on cardiac parameters in patients with acromegaly: a systematic review
Authors: Huynh Kevin A , Al-Gully Jin , Montero-Cabezas José M , Scheffers Linda E , Verstegen Marco J T , Biermasz Nienke R , Coopmans Eva C
Published: January 2025

Objective

Cardiovascular disease in acromegaly patients remains a major cause of morbidity and all-cause mortality. This systematic review investigates the effect of the first growth hormone-lowering intervention on cardiac parameters.

Design

Systematic review.

Methods

Studies evaluating cardiac parameters following the first intervention in acromegaly published up to February, 25, 2022 were included in this systematic review. Risk of bias was assessed using a modified Newcastle–Ottawa Scale and Joanna Briggs Institute Critical Appraisal Checklist. Primary treatment modalities included (transsphenoidal) surgery and medical treatment with first-generation somatostatin receptor ligands. Cardiac outcome measures were divided into cardiac structure (left ventricular hypertrophy [LVH], [indexed] left ventricular mass [LVM/LVMi]) and cardiac function (left ventricular ejection fraction [LVEF] and E/A ratio).

Results

Twenty-six studies (17 cohort studies and 9 case reports) were included out of 2541 potential studies. The risk of bias analysis categorized, 24 studies as low risk and 2 studies as intermediate risk. Disease-associated changes in cardiac structure and function generally improved in most studies following primary treatment. Left ventricular mass/left ventricular mass index significantly decreased in 9/15 studies and the prevalence of LVH in 3/13 studies. Left ventricular ejection fraction significantly increased in 9/14 studies and the E/A ratio in 6/7 studies. Despite the limited number of studies, cardiac structure improved more in patients achieving biochemical remission than in those failing to achieve biochemical remission.

Conclusions

Acromegaly associated structural and functional myocardial changes improve with both medical and surgical treatment. Normalizing or even reducing growth hormone/insulin-like growth factor 1 levels may be key in the prevention of further progression of cardiac involvement in acromegaly and adverse cardiac outcomes.
Medicaid-covered health care visits during the postpartum year: Variation by enrollee characteristics and state
Authors: Smith Laura Barrie , O’Brien Claire , Wei Keqin , Waidmann Timothy A , Kenney Genevieve M
Published: January 2025

Extending pregnancy-related Medicaid eligibility from 60 days to 12 months postpartum represents an important opportunity to reduce maternal mortality and racial inequities in maternal health outcomes. However, patterns of health care service use after 60 days postpartum among Medicaid enrollees are not well understood. We use Medicaid claims data representing Medicaid-covered live births in 46 states in 2018 to examine outpatient visits during the postpartum year. We find that more than three-quarters of enrollees with full-year Medicaid coverage have at least one outpatient visit between 61 days and 12 months postpartum. The share of enrollees with visits varies from 51.5% to 88.0% across states and is higher among enrollees with diagnosed physical or mental/behavioral health conditions or pregnancy/delivery complications. We also find that visits including mental/behavioral health care are more common for non-Hispanic white enrollees than non-Hispanic Black and Hispanic enrollees and for rural enrollees than urban enrollees during the postpartum year, controlling for other characteristics. These findings suggest that many Medicaid enrollees who maintain Medicaid coverage beyond 60 days postpartum will receive outpatient care but also suggest that there may be inequities in receipt of postpartum health care across and within states.
Generalizability of Randomized Controlled Trials to Routine Clinical Care in Ulcerative Colitis
Authors: Chhibba Tarun , Frolkis Alexandra , Stein Levi R , Lee Sangmin , Schill Kaela , Mitevska Elena , Judge Allap K , Martin Marie-Louise , Martin Meaghan , Novak Kerri L , Lu Cathy , Ingram Richard J M , Chan Melissa M , Shukla Tushar , Seow Cynthia H , Kaplan Gilaad G , Ananthakrishnan Ashwin N , Panaccione Remo , Ma Christopher
Published: January 2025

Background

Historically, randomized controlled trials (RCTs) have been criticized for being poorly generalizable to patients with ulcerative colitis (UC) evaluated in routine care. We aimed to evaluate the proportion of patients with UC starting an advanced therapy who would be eligible to participate in phase 3 registrational UC RCTs.

Methods

We conducted a retrospective cohort analysis of UC patients starting vedolizumab, ustekinumab, or tofacitinib at 2 IBD clinics at the University of Calgary. Patient charts, endoscopy reports, and laboratory results were reviewed, and compared against the inclusion and exclusion criteria from 5 RCTs (GEMINI-I, UNIFI, OCTAVE, ELEVATE, and LUCENT). The proportion of patients who would have been deemed eligible versus ineligible for trial participation at the time of starting a new advanced therapy was determined.

Results

A total of 125 patients with UC were included: 78 (62.4%) would have been eligible for at least one of the considered RCTs. Trial-eligible patients were younger, less likely to be exposed to prior immunosuppressants, and had higher C-reactive protein and fecal calprotectin. The most common reason for trial ineligibility was having inadequate disease activity at baseline (Mayo endoscopy subscore <2 or absence of rectal bleeding). A significantly greater proportion of patients would have been eligible for LUCENT (45.6%) compared to GEMINI-I (24.8%), OCTAVE (35.2%), or ELEVATE (35.2%) (P < .01 for all comparisons).

Conclusions

Half of patients with UC starting advanced therapy in routine care may be eligible for participation in phase 3 RCTs. Disease activity is the primary reason for trial exclusion.
Krill swarm biomass, energetic density, and species composition drive humpback whale distribution in the Northern California Current
Authors: Kaplan Rachel L , Bernard Kim S , Derville Solène , Fisher Jennifer L , Phillips Elizabeth M , Daly Elizabeth A , Warren Joseph D , Torres L G
Published: January 2025

Prey abundance and quality are dynamic in time and space, impacting predator ecology. We examine variation in species-specific krill quantity and quality as prey for humpback whales in the Northern California Current region, using generalized additive models to assess metrics including biomass and energy density derived from an integrated dataset of concurrent active acoustics, net tows, and marine mammal observations (2018–2022). Overall, prey metrics were positively correlated with humpback whale presence, with increasing trends modified by seasonal (early versus late foraging season) and spatial (continental shelf versus offshore) variation (model deviance explained 36.3%–40.8%). Biomass and energy density had strong positive effects on humpback whale presence, suggesting whales target high-quality swarms that offer more energy per lunge. Elevated Thysanoessa spinifera abundance near humpback whales suggests that they target this species, particularly in the late season when they are energetically richer than Euphausia pacifica, the region’s other abundant krill species. Environmental change may decrease krill abundance and quality, impacting humpback whales’ ability to meet energetic requirements and potentially driving changes in their distributions and exposure to anthropogenic threats. Clarifying drivers of humpback whale krill patch selection can improve species distribution models and aid managers in mitigating risk to whales.