bluuebunny/crossref_metadata_2025 huggingface dataset:
Overcoming walls and voids: Responsive practices that enable frontline workers to feel heard
Authors: Kerrissey Michaela , Satterstrom Patricia , Pae James , Albert Nancy M.
Published: February 2024

Background

There is increasing recognition that beyond frontline workers’ ability to speak up, their feeling heard is also vital, both for improving work processes and reducing burnout. However, little is known about the conditions under which frontline workers feel heard.

Purpose

This inductive qualitative study identifies barriers and facilitators to feeling heard among nurses in hospitals.

Methodology

We conducted in-depth semistructured interviews with registered nurses, nurse managers, and nurse practitioners across four hospitals (N = 24) in a U.S. health system between July 2021 and March 2022. We coded with the aim of developing new theory, generating initial codes by studying fragments of data (lines and segments), examining and refining codes across transcripts, and finally engaging in focused coding across all data collected.

Findings

Frontline nurses who spoke up confronted two types of challenges that prevented feeling heard: (a) walls, which describe organizational barriers that lead ideas to be rejected outright (e.g., empty solicitation), and (b) voids, which describe organizational gaps that lead ideas to be lost in the system (e.g., structural mazes). We identified categories of responsive practices that promoted feeling heard over walls (boundary framing, unscripting, priority enhancing) and voids (procedural transparency, identifying a navigator). These practices appeared more effective when conducted collectively over time.

Conclusion

Both walls and voids can prevent frontline workers from feeling heard, and these barriers may call for distinct managerial practices to address them. Future efforts to measure responsive practices and explore them in broader samples are needed.

Practice Implications

Encouraging responsive practices may help ensure that frontline health care workers feel heard.
Postlumpectomy imaging: is there a role for the study of the contralateral breast?—a retrospective cohort
Authors: Pires André M. , Rodrigues Jéssica R. , Pereira Helena G.
Published: February 2024

Background:

Some patients with breast cancer submitted to breast-conserving surgery might benefit from a postlumpectomy imaging examination previously to radiation therapy. This aims to document the complete removal of cancer and might be accomplished using mammogram with breast and axillary ultrasonography. These modalities study not only the affected side but also the contralateral side. In fact, it is well-documented that women with breast cancer have an increased risk for contralateral breast cancer. Thus, we intended to evaluate the value of postlumpectomy imaging undertaken before adjuvant radiotherapy regarding the evaluation of the contralateral breast and axilla.

Methods:

In this retrospective study, medical records for patients with breast cancer submitted to breast-conserving surgery and referred to our radiotherapy unit between 2018 and 2019 were reviewed. All patients had to be submitted to bilateral mammogram with breast and axillary ultrasonography previously to radiotherapy. Patients with bilateral disease or with a history of breast cancer were excluded.

Results:

One thousand two hundred forty patients were analyzed. 19 (1.5%) had suspicious findings for contralateral breast disease, and 8 (0.6%) had a re-excision positive for residual malignancy. Higher age, invasive lobular carcinoma associated or not with lobular carcinoma in situ, and presence of lobular carcinoma in situ were associated with an increased risk for residual disease.

Conclusion:

Contralateral evaluation as part of postlumpectomy imaging revealed itself useful at detecting contralateral cancer, with some demographic and clinical features being associated with an increased risk for residual disease.
The Effect of Distance Education on Self-care in Patients With Heart Failure in the Chronic or Stable Phase
Authors: Sun Binbin , Wang Jianhui , Dong Jianxiu , Qin Lu , Xu Yuexuan , Tian Beibei
Published: February 2024

Background

Health education is important for self-care in patients with heart failure. However, the evidence for the effect of distance education as an intervention to deliver instruction for patients after discharge through digital devices on self-care is limited.

Objectives

In this study, our aim was to explore the effect of distance education on self-care in patients with heart failure.

Methods

We searched 11 electronic databases and 3 trial registries for randomized controlled trials with low risk of bias and high-quality evidence to compare the effect of usual and distance education on self-care. Quality appraisal was performed using the Cochrane Risk of Bias Tool. Using the Review Manager 5.4 tool, a meta-analysis was conducted. Certainty of the evidence was rated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).

Results

Fifteen articles were eligible for this study. Compared with usual education, distance education improved self-care maintenance (mean difference [MD], 6.62; 95% confidence interval [CI], 3.93–9.31; GRADE, moderate quality), self-care management (MD, 5.10; 95% CI, 3.25–6.95; GRADE, high quality), self-care confidence (MD, 6.66; 95% CI, 4.82–8.49; GRADE, high quality), heart failure knowledge (MD, 0.78; 95% CI, 0.01–1.56; GRADE, moderate quality), and quality of life (MD, −5.35; 95% CI, −8.73 to −1.97; GRADE, moderate quality). Subgroup analysis revealed distance education was more effective than usual education in self-care when the intervention was conducted for 1 to 6 months, more than 3 times per month, and a single intervention lasting more than 30 minutes.

Conclusions

This review shows the benefits of distance education on self-care, heart failure knowledge, and quality of life of patients with heart failure. The intervention duration, frequency, and duration of a single intervention could have affected the intervention effect.
Bridge to Weight Loss: A Case Series
Authors: Solomon Robert A. , Kerrigan Dennis J. , Keteyian Steven J. , Cowger Jennifer A.
Published: February 2024

Durable left ventricular assist devices (LVADs) are a well-established therapeutic option for patients with advanced heart failure. These devices are often used to “bridge” patients to an orthotopic heart transplantation (HT). Unfortunately, many patients on LVAD support with a body mass index (BMI) above a certain value are not eligible for HT due a lack of suitable donors and the association between obesity and poor outcomes after HT. This case series describes three individuals on LVAD support who were able to successfully lose enough weight to qualify to be listed for an HT. We highlight a systematic, multidisciplinary approach to implementing guideline-driven weight loss strategies, including some aggressive methods (ie, meal replacements, weight loss medications, and bariatric surgery). In addition to describing the weight loss outcomes, we also discuss barriers and medical challenges during weight loss that are unique to this population.
Upper Extremity Surgery in Cervical Spinal Cord Injury: A Prospective Comparative Mixed-Methods Study
Authors: Skladman Rachel , Francoisse Caitlin A. , L’Hotta Allison J. , Novak Christine B. , Curtin Catherine M. , Ota Doug , Stenson Katherine C. , Tam Katharine , Kennedy Carie R. , James Aimee , Fox Ida K.
Published: February 2024

Background:

Cervical spinal cord injury (SCI) has a devastating effect on health and independence. Restoring upper extremity function is a top priority and can be accomplished by tendon transfer (TT) and nerve transfer (NT) surgery. The purpose of this prospective comparative study was to assess long-term changes in upper extremity function between surgical (TT or NT) and nonsurgical groups through a comprehensive mixed-methods approach.

Methods:

This multicenter cohort study compared data among 3 groups: those undergoing no surgery, TT surgery, or NT surgery. Quantitative data from the Spinal Cord Independence Measure (SCIM) and 36-item Short Form Health Survey were collected at baseline and long-term follow-up (6 to 24 months). Qualitative semistructured interview data were also obtained from these participants and their identified caregivers at baseline, early follow-up (1 month), and long-term follow-up (6 to 24 months).

Results:

Thirty-one participants had quantitative data across all time points: no surgery (n = 14), TT (n = 7), and NT (n = 10). SCIM scores improved in TT and NT groups compared with the no-surgery group (P < 0.05). The 36-Item Short Form Health Survey scores did not differ among groups. Qualitative data analysis (n = 168 interviews) corroborated SCIM findings: surgical participants and their caregivers reported improvement in transfers and ability to perform activities of daily living, including grooming and self-catheterization. Improved use of electronics and ability to operate a motor vehicle were also reported. Postoperative therapy was identified as a critical component of achieving gains.

Conclusions:

TT and NT surgery lead to quantitative and qualitative functional gains when compared to no surgery. This comparative information should be used to help surgeons discuss treatment options.

CLINICAL QUSETION/LEVEL OF EVIDENCE:

Therapeutic, II.
Alar Base Lining Graft: A New Technique to Prevent and Correct Alar Retraction in Primary and Secondary Rhinoplasty
Authors: Pozzi Mirco , Susini Pietro , Murante Andrea , Bolletta Alberto , Cuomo Roberto , Roxo Carlos Weck
Published: February 2024

Background:

Rhinoplasty traditionally presents a challenge for plastic surgeons. The aim of this article is to describe a new alar base lining graft (ABLG) in augmentation rhinoplasty to prevent and treat alar retraction.

Methods:

In this study, the authors retrospectively reviewed patients treated with ABLG at their institution between July of 2019 and April of 2022. The authors describe their technique and graft. At a minimum follow-up time of 1 year, postoperative photographs were taken, and patients were reassessed, evaluating aspects such as global symmetry, shape, and contour of the nose. Patient satisfaction was investigated according to the rhinoplasty outcomes evaluation questionnaire.

Results:

A total of 42 patients were included in the study. They reported significant satisfaction with the aesthetic results, as demonstrated by the mean postoperative rhinoplasty outcomes evaluation score. Alar contracture in secondary rhinoplasty was treated successfully. None of the grafts was extruded or collapsed. Wounds healed without reported major infection.

Conclusion:

This study demonstrates that ABLG is safe, contributes to improved functional and aesthetic outcomes, results in a high patient satisfaction rate, and has a low rate of postoperative complications.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Fulfilled Mind, Healthy Gut? Relationships of Eudaimonic Psychological Well-Being With the Gut Microbiome in Postmenopausal Women
Authors: Guimond Anne-Josee , Ke Shanlin , Tworoger Shelley S. , Huang Tianyi , Chan Andrew T. , Kubzansky Laura D. , Liu Yang-Yu
Published: February 2024

Objective

Eudaimonic facets of psychological well-being (PWB), like purpose in life and sense of mastery, are associated with healthy aging. Variation in the gut microbiome may be one pathway by which mental health influences age-related health outcomes. However, associations between eudaimonic PWB and the gut microbiome are understudied. We examined whether purpose in life and sense of mastery, separately, were associated with features of the gut microbiome in older women.

Methods

Participants were from the Mind-Body Study (N = 206, mean age = 61 years), a substudy of the Nurses’ Health Study II cohort. In 2013, participants completed the Life Engagement Test and the Pearlin Mastery Scale. Three months later, up to two pairs of stool samples were collected, 6 months apart. Covariates included sociodemographics, depression, health status, and health behaviors. Analyses examined associations of PWB with gut microbiome taxonomic diversity, overall community structure, and specific species/pathways. To account for multiple testing, statistical significance was established using Benjamini-Hochberg adjusted p values (i.e., q values ≤0.25).

Results

We found no evidence of an association between PWB and gut microbiome alpha diversity. In multivariate analysis, higher purpose levels were significantly associated with lower abundance of species previously linked with poorer health outcomes, notably Blautia hydrogenotrophica and Eubacterium ventriosum (q values ≤0.25). No significant associations were found between PWB and metabolic pathways.

Conclusions

These findings offer early evidence suggesting that eudaimonic PWB is linked with variation in the gut microbiome, and this might be one pathway by which PWB promotes healthy aging.
The Impact of Adding a 2-Way Video Monitoring System on Falls and Costs for High-Risk Inpatients
Authors: Sosa Marie Anne , Soares Marcio , Patel Samira , Trujillo Kimberly , Ashley Doreen , Smith Elizabeth , Shukla Bhavarth , Parekh Dipen , Ferreira Tanira , Gershengorn Hayley B.
Published: February 2024

Objectives

We aimed to investigate the value of adding a video monitoring (VM) system with falls and costs for patients at high risk.

Methods

We conducted a retrospective, historically controlled study of adults (≥18 y old) at high risk of fall admitted at the University of Miami Hospital and Clinics from January 1 to November 30, 2020 (pre-VM) and January 1 to November 30, 2021 (post-VM); in-person sitters were available in both periods. Fall risk assessment was conducted on admission and at every nursing shift; we defined patients as high risk if their Morse Fall Scale was ≥60. We conducted a multivariable logistic regression model to evaluate the association of period (pre- versus post-VM) with falls and performed a cost analysis.

Results

Our primary cohort consisted of 9,034 patients at high risk of falls, 4,207 (46.6%) in the pre-VM and 4,827 (53.4%) in the post-VM period. Fall rates were higher in the pre- than the post-VM periods (3.5% versus 2.7%, P = 0.043). After adjustment, being admitted during the post-VM period was associated with a lower odds of fall (odds ratio [95% confidence interval], 0.49 [0.37–0.64], P < 0.001). The median adjusted hospital cost (in 2020 dollars) was $1,969 more for patients who fell than for patients who did not (interquartile range, $880–$2,273). Considering start-up and ongoing costs, we estimate VM implementation to partly replace in-person monitoring has potential annual cost savings of >$800,000 for a hospital similar to ours.

Conclusions

Video monitoring to augment in-person sitters is an effective fall prevention initiative for patients at high risk of falls, which is likely also cost-effective.
Working-Age Caregivers of Stroke Survivors: Needs, Concerns, and Quality of Life
Authors: Rose Dixie , Newman Susan D. , Mueller Martina , Magwood Gayenell S. , Lutz Barbara J.
Published: February 2024

Purpose

The purpose of this study was to characterize the unmet needs and concerns of working-age caregivers of stroke survivors and to explore the relationships between these unmet needs and concerns and factors such as stroke survivor functional independence, caregiver strain, caregiver self-efficacy, caregiver perceived social support, and caregiver quality of life (QoL).

Design

Cross-sectional descriptive design was used in this study.

Methods

Participants (N = 103) completed an online survey. Descriptive statistics, bivariate Pearson correlation, and linear regression analysis was performed.

Results

Negative correlations were found between caregiver needs and concerns and both stroke survivor functional independence and caregiver self-efficacy. Positive correlations were identified between caregiver needs and concerns and caregiver strain. In multiple regression models, stroke survivor functional independence, caregiver self-efficacy, race, and gender were statistically significantly associated with caregiver QoL.

Clinical Relevance to the Practice of Rehabilitation Nursing

Results of this study can inform nurses as they collaborate with informal caregivers and researchers in optimizing the rehabilitation and discharge process and aiding in the support of caregiver QoL.

Conclusion

Working-age caregivers of stroke survivors expressed many needs and concerns. These needs, along with other factors, can affect outcomes including QoL in caregivers and stroke survivors.
Comparison of Fibroscan, Shear Wave Elastography, and Shear Wave Dispersion Measurements in Evaluating Fibrosis and Necroinflammation in Patients Who Underwent Liver Biopsy
Authors: Seyrek Sinan , Ayyildiz Hakan , Bulakci Mesut , Salmaslioglu Artur , Seyrek Fatmatuzzehra , Gultekin Burak , Cavus Bilger , Berker Neslihan , Buyuk Melek , Yuce Servet
Published: February 2024

Objective

Our aim was to predict these stages of hepatic fibrosis and necroinflammation using measurements from two-dimensional shear wave elastography (2D-SWE), transient elastography (Fibroscan, TE), and shear wave dispersion (SWD).

Materials and Methods

In this prospectively designed study, chronic liver patients with nonspecific etiology whose biopsy was performed for up to 1 week were included. Two-dimensional SWE, SWD, and TE measurements were performed. The METAVIR and F-ISHAK classification was used for histopathological evaluation.

Results

Two-dimensional SWE and TE were considered significant for detecting hepatic fibrosis. In distinguishing ≥F2, for 2D-SWE, area under the receiver operating characteristics (AUROC) was 0.86 (confidence interval [CI], 0.75–0.96) for the cutoff value of 8.05 kPa (P= 0.003); for TE, AUROC was 0.79 (CI, 0.65–0.94) for the cutoff value of 10.4 kPa (P< 0.001). No significance was found for TE in distinguishing ≥F3 (P= 0.132). However, for 2D-SWE, a cutoff value of 10.45 kPa (P< 0.001), with AUROC = 0.87 (CI, 0.78–0.97) was determined for ≥F3. Shear wave dispersion was able to determine the presence of necroinflammation (P= 0.016) and a cutoff value of 15.25 (meter/second)/kiloHertz ([m/s]/kHz) (P= 0.006) and AUROC of 0.71 (CI, 0.57–0.85) were calculated for distinguishing ≥A2. In addition, a cutoff value of 17.25 (m/s)/kHz (P= 0.023) and AUROC = 0.72 (CI, 0.51–0.93) were found to detect severe necroinflammation. The cutoff value for SWD was 15.25 (m/s)/kHz (P= 0.013) for detecting ≥A2 in the reversible stage of fibrosis (F0, F1, and F2), and AUROC = 0.72 (CI, 0.56–0.88).

Conclusions

Two-dimensional SWE and TE measurements were significant in detecting the irreversible stage and the stage that should be treated in hepatic fibrosis noninvasively. Shear wave dispersion measurements were significant in detecting necroinflammation noninvasively.
Efficacy of Immediate Postoperative Single Fractional 10 Gy Radiotherapy for Earlobe Keloids
Authors: Han Seung Hoon , Ha Boram , Chang Choong Hyun , Park Tae Hwan
Published: February 2024

Background:

The ear is a common site for keloid formation, typically due to ear piercing or trauma. Auricular keloids are always difficult to treat and pose a challenging situation. The purpose of this study is to present our experience treating earlobe keloids through complete surgical excision followed by immediate postoperative single fraction 10 Gy radiation therapy either on the same day or the next day.

Methods:

The authors retrospectively evaluated 48 patients with 71 earlobe keloids treated with complete surgical excision followed by single‐fractional 10 Gy radiotherapy within 24 hours from May 2021 to December 2022. The outcome was reported with a recurrence‐free rate and side effects.

Results:

The mean follow‐up period was 20.8 months. All patients tolerated the treatments well. The overall recurrence‐free rate was 100%. There were only 2 grade III radiation dermatitis. There were no reports of second malignancies or severe complications.

Conclusions:

The authors have obtained excellent outcomes from treating earlobe keloids through complete excision followed by postoperative radiotherapy with a single fractional dose of 10 Gy on the same day or the next day.
Ptosis Caused by Local Injection of Human Rabies Immunoglobulin
Authors: Deng Jiaping , Li Shuangle
Published: February 2024

Rabies is a fatal zoonotic disease. Patients with grade III injuries after exposure need timely injection of rabies vaccine and human rabies immunoglobulin treatment. This article introduces the diagnosis and therapy of ptosis caused by local injection of human rabies immunoglobulin in a patient bitten by a dog.
Experiences of Simulated Patients Involved in Difficult Conversations With Undergraduate and Postgraduate Health Professionals
Authors: Wiechula Laura A. , Chur-Hansen Anna , Davies Ellen L.
Published: February 2024

Introduction

Simulated patients (SPs) are trained to simulate real patient scenarios for health professionals' education and training. The value of including SPs in simulated scenarios, particularly in relation to difficult and complex conversations, has been studied in various contexts, with a focus on learner experiences and outcomes. What has not been as extensively explored is the impact of difficult and complex conversations on the SPs. The aim of this study was to explore the perspectives, motivations, and experiences of SPs, particularly regarding difficult or complex conversations.

Methods

A qualitative approach was taken to gather and interpret SP experiences. Open-ended interviews were the primary means of obtaining data. Thematic analysis guided the interpretation of interview data to generate key themes that encapsulated the SP experience.

Results

Twelve participants shared their experiences of working as SPs in scenarios that involved difficult or complex conversations. From these data, 4 major themes were determined: Care for Students, Pedagogical Focus, Emotional Regulation, and Organizational Environment. The importance of empathy and safe design and support for simulations was apparent.

Conclusions

This study presents insights into the experiences and perspectives of SPs regarding difficult and complex conversations. Participants highlighted the necessity of uniformity in standards of practice in simulation and the need for advocacy for awareness of simulation-based practices.
Radiation therapy options in kidney cancer
Authors: Zaorsky Nicholas G. , Louie Alexander V. , Siva Shankar
Published: February 2024

Purpose of review

In this review, the authors discuss the use of stereotactic body radiation therapy (SBRT) for the treatment of primary and metastatic renal cell carcinoma (RCC).

Recent findings

For primary RCC treated with SBRT, local control is estimated at >95%, and grade 3–4 toxicity is limited at ≤5%. The difference in glomerular filtration rate pretreatment versus posttreatment was about 7.7 ml/min. For metastatic RCC treated with SBRT, the 1-year local control is ~90%. The incidence of any grade 3–4 toxicity is ~1%. Several ongoing trials are evaluating SBRT in combination or in lieu of systemic therapy. There are many unknowns remaining in the treatment of RCC, including tumor prognostication, treatment selection, and treatment delivery.

Stereotactic body radiation therapy is a safe and effective treatment option for patients with primary and metastatic RCC.
Comprehensive quality evaluation of Magnolia officinalis leaves based on wavelength fusion fingerprint, content determination, and antioxidant activity analysis
Authors: Lan Xuemei , Lin Lujie , Yang Lixin , Wang Yunhong , Ke Xiumei , Yang Rongping , Li Hua , Yang Bin
Published: February 2024

A valid, novel, and comprehensive evaluation method for assessing the quality of Magnolia officinalis leaves (MOLs) from different origins has been established based on multiwavelength fusion fingerprint, quantitative analysis, and antioxidant activity screening. The four wavelength fingerprints for MOL samples at 258, 266, 290, and 327 nm were collected by high performance liquid chromatography, and then data fusion was conducted. In addition, the content of multiple components was determined by high performance liquid chromatography at four wavelengths. 1,1-Diphenyl-2-pyridyl hydrazine scavenging assay was applied to study in vitro antioxidant activity. The effective distinction of 18 batches of MOLs was realized based on hierarchical cluster analysis, principal component analysis, and orthogonal partial least squares discriminant analysis combined with multiwavelength fusion fingerprint. The orthogonal partial least squares discriminant analysis model exhibited huge advantages in distinguishing among different samples and screening three quality markers of the tested samples, including rutin, isoquercitrin, and chlorogenic acid. This established method of multitechnology fusion is simple, reliable, and efficient for the qualitative and quantitative bioactivity evaluation of MOLs. This study aims to investigate the development of new medicinal parts of traditional Chinese medicines (TCMs), so as to enhance the efficiency of utilizing TCM resources and promote the high-quality development of the TCM industry.
The dilemma of valuing geodiversity: geoconservation versus geotourism
Authors: Anougmar S. , Meesters A. , van Ree D. , Compernolle T.
Published: February 2024

Geodiversity and geosystem services are confronting global threats. However, the majority of conservation strategies tend to overlook the geological component within ecosystems. The existing literature centres on biodiversity, ecosystem services and their economic valuation. In this paper, we conduct a systematic literature review to identify the gap in the assessment of geological diversity, pinpointing areas where scientific contributions are needed to safeguard geological resources. Our findings reveal a concentration of studies assessing geodiversity in European and Asian countries. While the majority of the reviewed papers emphasizes the recreational features and associated values of geological resources, promoting geotourism and recognizing its potential for economic growth, there is a significant oversight concerning the impact of tourism on geological resources. Existing assessments predominantly focus on visitors' perceptions and preferences, sidelining the inhabitants’ perspective and their crucial roles in the conservation of geodiversity.

This article is part of the Theo Murphy meeting issue ‘Geodiversity for science and society’.
Geoconservation at the International Union for Conservation of Nature (IUCN)
Authors: Monge-Ganuzas Manu , Guillén-Mondéjar Francisco , Díaz-Martínez Enrique , Herrero Nadia , Brilha José
Published: February 2024

This work describes the achievements made towards geoconservation within the International Union for Conservation of Nature (IUCN) from the 1990s onwards. The key milestones in the recognition of geoconservation within the IUCN are presented. Initially, the IUCN's geoconservation efforts were focused on refining the criteria for World Heritage (WH) designation. Subsequently, the actions focused on spreading the geoconservation framework within the IUCN World Conservation Congresses (WCCs), the establishment of an expert group on geoconservation within the IUCN World Commission on Protected Areas (IUCN-WCPA) and the publication of guidelines for geoconservation. We describe how the inclusion within the IUCN membership of three organizations—two of them Spanish: The Geological Society of Spain (SGE) and the Society for the Defence of Geological and Mining Heritage (SEDPGYM); and one international, ProGEO—has been a key factor. These organizations have achieved the adoption of resolutions in which geoconservation, its vision, its principles and its definitions have been taken into account in the IUCN WCC (2008–2020 period), and have promoted the geoconservation conceptual framework among nature conservationists. We also analyse the progress made and offer a series of recommendations to improve geoconservation in the future adopting a more integrated approach to nature conservation within the IUCN.

This article is part of the Theo Murphy meeting issue ‘Geodiversity for science and society’.
Geodiversity in the Amazon drainage basin
Authors: Alsbach Cécile M. E. , Seijmonsbergen Arie C. , Hoorn Carina
Published: February 2024

The Amazon is the largest drainage basin on Earth and contains a wide variety of abiotic landscape features. In spite of this, the geodiversity in this basin has not yet been objectively evaluated. We address this knowledge gap by combining a meta-analysis of an existing global geodiversity map and its components with a systematic literature review, to identify the key characteristics of geodiversity in the Amazon drainage basin (ADB). We also evaluate how these global geodiversity component maps, that are based on the geology, geomorphology, soils and hydrology, could be refined to better reflect geodiversity in the basin. Our review shows that geology—through lithological diversity and geological structures—and hydrology—through hydrological processes that influence geomorphology and soil diversity—are the main determinants of geodiversity. Based on these features, the ADB can be subdivided into three principal regions: (i) the Andean orogenic belt and western Amazon, (ii) the cratons and eastern Amazon, and (iii) the Solimões-Amazon river system. Additional methods to map geomorphological and hydrological diversity have been identified. Future research should focus on investigating the relationship between the geodiversity components and assess their relationship with biodiversity. Such knowledge can enhance conservation plans for the ADB.

This article is part of the Theo Murphy meeting issue ‘Geodiversity for science and society’.
Chronic alcohol exposure induces cerebral microbleeds by TGF-β1/Smad signaling pathway mediated remodeling of cerebral small vessels
Authors: Lu Hengjian , Wang Hongxuan , Li Xiangpen , Lin Xinrou , Li Chenguang , Chen Wanru , Zou Lubin , Pan Jingrui , Zhang Xiaoni , He Lei , Rong Xiaoming , Peng Ying
Published: February 2024

Background

Long-term heavy drinking is a major risk factor for cerebral microbleeds(CMBs), which are increasingly gaining attention as a pathological phenotype of cerebral small vessel diseases(CSVD). Under pathological conditions, remodeling of the extracellular matrix(ECM) on the walls of small vessels causes disarray in the structure and function of these vessels, leading to cerebral small vessel sclerosis and consequent rupture and bleeding. This can result in cognitive and emotional disorders, abnormal gait and increased risk of falling. However, the mechanisms underlying how long-term alcohol consumption leads to CMBs and decline in motor function remain unknown.

Methods

We constructed a chronic alcohol exposure mouse model and measured the deposition of ECMs on the small vessels in motor-related brain regions. The presence of microbleeds was confirmed through Prussian blue staining and Magnetic Resonance Imaging. We also extracted primary cerebral microvascular smooth muscle cells (CMVSMCs) from the newborn mice and explored the effects of alcohol on the phenotypic transformation and substance synthesis function. Additionally, we conducted interventional experiments on the cell and animal models with an anti-fibrotic drugs Pirfenidone(PFD).

Results

We found that mice with long-term alcohol exposure showed decreased motor function. In their motor-related brain regions, such as the motor cortex(MC), thalamus/basal ganglia(Tha/BG), and cerebellum(CB), we observed microbleeds. On the small vessels in these areas, we detected excessive deposited ECM proteins. In vitro experiments with primary CMVSMCs revealed that after alcohol treatment, the cells underwent a transformation into fibroblast-like phenotypes, and excessive production of the aforementioned ECM proteins, which is regulated by upstream TGFβ1/Smad signaling pathway. Additionally, PFD applied on cell and animal models could reverse the above processes to some extent.

Conclusions

Our study found that the remodeling of ECM accompanied by activation of TGF-β1/Smad signaling pathway may be involved in alcohol-induced CMBs. It could be a potential therapeutic target for CMBs or CSVD.
Causal relationship between mental disorders and abdominal aortic aneurysm: insights from the genetic perspective
Authors: Deng Ming-Gang , Chai Chen , Wang Kai , Zhao Zhi-Hui , Nie Jia-Qi , Liu Fang , Liang Yuehui , Liu Jiewei
Published: February 2024

Objective

This study investigated the genetic link between mental disorders—depression, schizophrenia (SCZ), and bipolar disorder (BIP)—and abdominal aortic aneurysm (AAA).

Methods

We used global/local genetic correlation analyses and identified shared genomic loci. Bidirectional univariable Mendelian Randomization (UMR) assessed causal directions, with multivariable MR (MVMR) refining the analysis. Mediation analyses examined if known AAA risk factors influenced this relationship.

Results

Global correlations showed positive links between depression, SCZ, and AAA, but not BIP. Local analyses identified specific genomic regions of correlation. We found 26, 141, and 10 shared loci for AAA with depression, SCZ, and BIP, respectively. UMR indicated significant associations between genetically predicted depression (OR 1.270; 95% CI 1.071-1.504;p= 0.006) and SCZ (OR 1.047; 95% CI 1.010-1.084;p= 0.011) with AAA, but not BIP. These results were confirmed by MVMR analyses. Mediation analyses showed that smoking, hypertension, hyperlipidemia, and coronary atherosclerosis mediated the impact of depression on AAA while smoking mediated SCZ’s impact.

Conclusion

This study provides evidence that genetically predicted depression and SCZ are linked to an increased risk of AAA, mediated by traditional AAA risk factors.
Improving Adherence to Pulmonary Embolism Evaluation Consensus Guidelines: A Multimodal Approach
Authors: D’Silva E Ethan , Zaidi Syed , Ramis Phil , Rohren Eric M.
Published: February 2024

Objective

Despite the publication of multiple widely accepted guidelines, Computed Tomography pulmonary angiography (CTPA) remains overutilized in the emergency (ED) setting for evaluating suspected pulmonary embolism (PE). We developed and evaluated a multimodal program that aimed to improve ordering provider adherence to CTPA use guidelines, and consequently positivity rate.

Methods

We retrospectively identified all CTPA studies ordered for suspected PE over three years for each provider at a single-center ED, and reviewed radiology reports to determine PE positivity. We then implemented a program that included an education session, individualized performance feedback, and discussion of possible incentives to improve guideline adherence. We prospectively collected CTPA results for the following year. Our primary outcome was the difference in positivity rate between the final preintervention year and the post-intervention year. Our secondary outcome was individual provider positivity rate between the pre-intervention and post-intervention period. We compared the primary outcome using chi-squared testing, defining statistical significance as P<0.05.

Results

We identified 4265 CTPA studies performed during the pre-intervention period, ordered by 25 providers. 1582 studies were ordered during the final year, with an 11.00% positivity rate (174/1582). In the post-intervention year, 1339 studies were ordered, with a significantly greater positivity rate of 13.67% (183/1339, P = 0.028). For our secondary outcome, mean provider positivity rate was 11.49% during the preintervention period, and increased to 14.24% in the post-intervention period.

Discussion

We successfully implemented a multimodal program for ED providers that significantly increased the positivity rate of CTPAs ordered for suspected PE evaluation.
A Prodrug Strategy to Reposition Atovaquone as a Long-Acting Injectable for Malaria Chemoprotection
Authors: Gupta Anil K. , Eliasen Anders M. , Andahazy Wil , Zhou Fei , Henson Kerstin , Chi Victor , Woods Ashley K. , Joseph Sean B. , Kuhen Kelli L. , Wisler John , Ramachandruni Hanu , Duffy James , Burrows Jeremy N. , Vadas Elizabeth , Slade Andrew , Schultz Peter G. , McNamara Case W. , Chatterjee Arnab K.
Published: February 2024

Recent malaria drug discovery approaches have been extensively focused on the development of oral, smallmolecule inhibitors for disease treatment whereas parenteral routes of administration have been avoided due to limitations in deploying a shelf-stable injectable even though it could be dosed less frequently. However, an updated target candidate profile from Medicines for Malaria Venture (MMV) and stakeholders have advocated for long-acting injectable chemopreventive agents as an important interventive tool to improve malaria prevention. Here, we present strategies for the development of a long-acting, intramuscular, injectable atovaquone prophylactic therapy. We have generated three prodrug approaches that are contrasted by their differential physiochemical properties and pharmacokinetic profiles: mCBK068, a docosahexaenoic acid ester of atovaquone formulated in sesame oil, mCKX352, a heptanoic acid ester of atovaquone formulated as a solution in sesame oil, and mCBE161, an acetic acid ester of atovaquone formulated as an aqueous suspension. As a result, from a single 20 mg/kg intramuscular injection, mCKX352 and mCBE161 maintain blood plasma exposure of atovaquone above the minimal efficacious concentration for >70 days and >30 days, respectively, in cynomolgus monkeys. The differences in plasma exposure are reflective of the prodrug strategy, which imparts altered chemical properties that ultimately influence aqueous solubility and depot release kinetics. On the strength of the pharmacokinetic and safety profiles, mCBE161 is being advanced as a first-in-class clinical candidate for first-in-human trials.
In Silico designed cell-penetrating anti-cancer peptide specifically inhibits VEGF-A expression
Authors: Banerjee Nilanjan , Roy Laboni , Panda Suman , Roychowdhury Tanaya , Chatterjee Subhrangsu
Published: February 2024

Vascular Endothelial Growth Factor-A (VEGF-A), a pluripotent cytokine and angiogenic growth factor mediates the switch to an angiogenic phenotype in cancer cells. The interaction of VEGF-A protein with the VEGF receptors (VEGFR-1and VEGFR-2) starts downstream effect that promotes angiogenesis by mediating migration and increasing the permeability of endothelial cells. A cis-regulatory elements consisting of a polypurine/polypyrimidine (pPu/pPy) tract in the proximal 36-bp region (–85 to −50), can participate in the formation of a stable higher order G-quadruplex structure (G4) which is essential for VEGF promoter activity. During cancer progression the VEGF-A G4 succumbs to cellular pressure and fails to maintain the stable structure. This shifts the balance to form duplex structure thereby increasing the rate of transcription. Earlier research has tried to develop small-molecule ligands to target and stabilize G4, however they either lack specificity or non-toxicity. Peptide on the other hand are very less studied. Here we used bioinformatics in-silico tool to develop peptides which can successfully bind and stabilize the VEGF-A G4 while reducing its gene expression. This further alters the expression fate of the VEGF-A signalling cascade and prevents angiogenesis in cancer cells. We used high resolution Nuclear magnetic resonance and molecular dynamics simulation to map the chemistry of the interaction while the qPCR and western blot allowed us to check the expression pattern of the molecules of VEGF-A signalling cascade. In this investigation, we navigate the complex interplay between peptides and quadruplex structures, unravelling valuable insights that can enhance the crafting of pharmacophores directed at the dynamic quadruplex structure. The outcomes of our study are promising, paving the way for progress in the realms of research, characterization, and optimization of peptides binding to G-quadruplexes, with potential implications for therapeutic applications.
mbctools: A User-Friendly Metabarcoding and Cross-Platform Pipeline for Analyzing Multiple Amplicon Sequencing Data across a Large Diversity of Organisms
Authors: Barnabé Christian , Sempéré Guilhem , Manzanilla Vincent , Millan Joel Moo , Amblard-Rambert Antoine , Waleckx Etienne
Published: February 2024

We developed a python package calledmbctools, designed to offer a cross-platform tool for processing amplicon data from various organisms in the context of metabarcoding studies. It can handle the most common tasks in metabarcoding pipelines such as paired-end merging, primer trimming, quality filtering, sequence denoising, zero-radius operational taxonomic unit (ZOTU) filtering, and has the capability to process multiple genetic markers simultaneously.mbctoolsis a menu-driven program that eliminates the need for expertise in command-line skills and ensures documentation of each analysis for reproducibility purposes. The software, designed to run in a console, offers an interactive experience, guided by keyboard inputs, assisting users along the way through data processing and hiding the complexity of command lines by letting them concentrate on selecting parameters to apply in each step of the process. In our workflow, VSEARCH is utilized for processingfastqfiles derived from amplicon-based Next-Generation Sequencing data. This software is a versatile open-source tool for processing amplicon sequences, offering advantages such as high speed, efficient memory usage, and the ability to handle large datasets. It provides functions for various tasks such as dereplication, clustering, chimera detection, and taxonomic assignment. VSEARCH is thus very efficient in retrieving the overall diversity of a sample. To adapt to the diversity of projects in metabarcoding, we facilitate the reprocessing of datasets with the possibility to adjust parameters.mbctoolscan also be launched in a headless mode, making it suited for integration into pipelines running on High-Performance Computing environments.mbctoolsis available athttps://github.com/GuilhemSempere/mbctools,https://pypi.org/project/mbctools/.
Transcriptomic Signatures of WNT-Driven Pathways and Granulosa Cell-Oocyte Interactions during Primordial Follicle Activation
Authors: Takase Hinako M. , Mishina Tappei , Hayashi Tetsutaro , Yoshimura Mika , Kuse Mariko , Nikaido Itoshi , Kitajima Tomoya S.
Published: February 2024

Primordial follicle activation (PFA) is a pivotal event in female reproductive biology, coordinating the transition from quiescent to growing follicles. This study employed comprehensive single-cell RNA sequencing to gain insights into the detailed regulatory mechanisms governing the synchronized dormancy and activation between granulosa cells (GCs) and oocytes with the progression of the PFA process.Wntless(Wls) conditional knockout (cKO) mice served as a unique model, suppressing the transition from pre-GCs to GCs, and disrupting somatic cell-derived WNT signaling in the ovary. Our data revealed immediate transcriptomic changes in GCs post-PFA inWlscKO mice, leading to a divergent trajectory, while oocytes exhibited modest transcriptomic alterations. Subpopulation analysis identified the molecular pathways affected by WNT signaling on GC maturation, along with specific gene signatures linked to dormant and activated oocytes. Despite minimal evidence of continuous up-regulation of dormancy-related genes in oocytes, the loss of WNT signaling in (pre-)GCs impacted gene expression in oocytes even before PFA, subsequently influencing them globally. The infertility observed inWlscKO mice was attributed to compromised GC-oocyte molecular crosstalk and the microenvironment for oocytes. Our study highlights the pivotal role of the WNT-signaling pathway and its molecular signature, emphasizing the importance of intercellular crosstalk between (pre-)GCs and oocytes in orchestrating folliculogenesis.

Author summary

In mammalian ovaries, primordial follicles protect dormant oocytes from wasteful consumption. We explored the complex molecular dynamics of the critical process of primordial follicle activation (PFA) that underlies female reproductive health, with a focus on the role of WNT signaling. By utilizing a unique mouse model with disrupted WNT signaling, our study reveals novel insights into the regulatory dynamics of granulosa cells (GCs) and oocytes during PFA. Single-cell transcriptome profiling uncovered distinct cell populations and highlighted the impact of WNT signaling on ovarian cell types. This study reveals distinct transcriptomic changes in GCs post-PFA, which affects their differentiation trajectories and highlights the critical role of WNT signaling in establishing GC function. We further examined the consequences of disrupted microenvironments on oocytes and GC-oocyte interactions, which elucidated altered oocyte subclusters and potential links to infertility. These findings provide a foundation for understanding the connections between WNT signaling and ovarian function. Our comprehensive analysis contributes valuable knowledge to reproductive biology, emphasizing the clinical relevance of WNT signaling in female fertility.
Exploring the impact of interthalamic adhesion on human cognition: insights from healthy subjects and thalamic stroke patients
Authors: Vidal Julie P. , Rachita Kévin , Servais Anaïs , Péran Patrice , Pariente Jérémie , Bonneville Fabrice , Albucher Jean-François , Danet Lola , Barbeau Emmanuel J.
Published: February 2024

Background and Objectives

Interthalamic adhesion (IA), also known as the massa intermedia, is a structure that connects the median borders of both thalami across the third ventricle. Given it is difficult to identify on routine neuroimaging, its anatomical variants and function remain poorly studied. The main objective of this study was to clarify the role of IA on cognition. Our main hypothesis was that thalamus stroke patientswithan IA would show better performance on neuropsychological tests than individualswithoutan IA through possible compensatory mechanisms.

Methods

The study comprised a group of healthy subjects and a cohort of patients with isolated thalamic strokes at the chronic stage. All participants underwent 3T research T1w and FLAIR MRI as well as a neuropsychological assessment. The presence or absence of an IA and type of IA anatomical variant were evaluated by two independent reviewers.

Results

42 healthy subjects (mean age= 49) and 40 patients (mean age= 51) were finally included. 76% of participants had an IA, with a higher prevalence among women (92%) than men (61%). The presence or absence of an IA did not effect the neuropsychological performance of healthy subjects nor did the type of IA variant. Across all the tests, patientswithan IA (n = 18) showed the lowest BF10(157) while thosewithoutan IA (n = 10) exhibited the highest BF10(10648) when compared to healthy subjects using a Bayesian rmANOVA. More specifically, patientswithoutan IA performed more poorly in the verbal memory or Stroop task versus healthy subjects than patientswithan IA. This effect was not explained by age, laterality of the infarct, volume or, localization of the lesion. Patients with an IA and lesions extending into the IA presented a similar trend to non-IA subjects which could however be explained by a greater volume of lesions.

Discussion

IA does not appear to have a major role in cognition for healthy subjects but could play a compensatory part in patients with thalamic lesions.