bluuebunny/crossref_metadata_2025 huggingface dataset:
Occurrence and Distribution of Meloidogyne spp. in Fields Rotated with Sweetpotato and Host Range of a North Carolina Population of Meloidogyne enterolobii
Authors: Wong TW. S. , Ye Weimin , Thiessen Lindsey D. , Huseth Anders S. , Gorny Adrienne , Quesada-Ocampo Lina M.
Published: May 2024

Root-knot nematodes (RKNs, Meloidogyne spp.) are some of the most economically important and common plant parasitic nematodes in North Carolina (NC) cropping systems. Soil samples collected from fields planted with crops rotated with sweetpotato (Ipomoea batatas [L.] Lam.) in 39 NC counties in 2015 to 2018 were processed at the NC Nematode Assay Laboratory. The occurrence of second-stage juvenile (J2) RKN populations was examined based on collection year, month, county, and previous planted crop. The highest number of RKN-positive samples originated from Cumberland (53%), Sampson (48%), and Johnston (48%) counties. The highest average RKN population density was detected in Sampson (147 J2/500 cm3 of soil) and Nash (135 J2/500 cm3 of soil) counties, while Wayne (7 J2/500 cm3 of soil) and Greene (11 J2/500 cm3 of soil) counties had the lowest average RKN population density. Meloidogyne enterolobii is a new invasive species that is impacting sweetpotato growers of NC. The host status of an NC population of M. enterolobii, the guava RKN, was determined by examining eggs per gram of fresh root (ER) and the final nematode egg population divided by the initial population egg count (reproductive factor, RF) in greenhouse experiments. This included 18 vegetable, field, and cover crops and weed species. The tomato ‘Rutgers’ was used as a susceptible control. Cabbage ‘Stonehead’, pepper ‘Red Bull’, and watermelon ‘Charleston Gray’ and ‘Fascination’ were hosts and had similar mean ER values to the positive control, ranging from 64 to 18,717. Among field crops, cotton, soybean ‘P5018RX’, and tobacco were hosts with ER values that ranged from 185 to 706. Members of the Poaceae family such as sweet corn (Zea mays) and sudangrass (Sorghum × drummondii) were nonhosts to M. enterolobii, and the mean ER values ranged from 1.85 to 7. The peanut ‘Tifguard’ and winter wheat (Triticum aestivum) also had lower ER values than the vegetable hosts. Growers should consider planting less susceptible hosts or nonhosts such as peanut, sudangrass, sweet corn, and winter wheat in 2- to 3-year crop rotations to lower populations of this invasive nematode.
Identification of the Coexisting Virus-Derived siRNA in Maize and Rice Infected by Rice Black-Streaked Dwarf Virus
Authors: Wang Feifei , Xu Zhennan , Li Ronggai , Zhou Zhiqiang , Hao Zhuanfang , Wang Liwei , Li Mingshun , Zhang Degui , Song Wei , Yong Hongjun , Han Jienan , Li Xinhai , Weng Jianfeng
Published: May 2024

Rice black-streaked dwarf virus is transmitted by small brown planthoppers, which causes maize rough dwarf disease and rice black-streaked dwarf disease. This virus leads to slow growth or death of the host plants. During the coevolutionary arms race between viruses and plants, virus-derived small interfering RNAs (vsiRNAs) challenge the plant’s defense response and inhibit host immunity through the RNA silencing system. However, it is currently unknown if rice black-streaked dwarf virus can produce the same siRNAs to mediate the RNA silencing in different infected species. In this study, four small RNA libraries and four degradome libraries were constructed by extracting total RNAs from the leaves of the maize (Zea mays) inbred line B73 and japonica rice (Oryza sativa) variety Nipponbare exposed to feeding by viruliferous and nonviruliferous small brown planthoppers. We analyzed the characteristics of small RNAs and explored virus-derived siRNAs in small RNA libraries through high-throughput sequencing. On analyzing the characteristics of small RNA, we noted that the size distributions of small RNAs were mainly 24 nt (19.74 to 62.00%), whereas those of vsiRNAs were mostly 21 nt (41.06 to 41.87%) and 22 nt (39.72 to 42.26%). The 5′-terminal nucleotides of vsiRNAs tended to be adenine or uracil. Exploring the distribution of vsiRNA hot spots on the viral genome segments revealed that the frequency of hotspots in B73 was higher than those in Nipponbare. Meanwhile, hotspots in the S9 and S10 virus genome segments were distributed similarly in both hosts. In addition, the target genes of small RNA were explored by degradome sequencing. Analyses of the regulatory pathway of these target genes unveiled that viral infection affected the ribosome-related target genes in maize and the target genes in the metabolism and biosynthesis pathways in rice. Here, 562 and 703 vsiRNAs were separately obtained in maize and rice and 73 vsiRNAs named as coexisting vsiRNAs (co-vsiRNAs) were detected in both hosts. Stem-loop PCR and real-time quantitative PCR confirmed that co-vsiRNA 3.1 and co-vsiRNA 3.5, derived from genome segment S3, simultaneously play a role in maize and rice and inhibited host gene expression. The study revealed that rice black-streaked dwarf virus can produce the same siRNAs in different species and provides a new direction for developing new antiviral strategies.
Perspectivism and Health Professions Assessment
Authors: Pearce Jacob , Tavares Walter
Published: May 2024

This article aims to outline perspectivism and perspectival thinking by drawing on established scholarship from the philosophy of science and to demonstrate its relevance to health professions education. Perspectivism embraces the notion that knowledge inherently arises from particular perspectives. “Truth” always depends on an evaluative background. Perspectivism is a form of epistemic humility that sees epistemic claims (relating to knowledge) as fundamentally historically and contextually situated. This article contends that perspectivism is a fruitful and relevant lens to apply to health professions assessment. It is a way of thinking that is all around us, even if we do not realize it. It extends discourse around the value of subjectivity in assessment and may cut through many prevailing debates on assessment practice. Perspectivism is a sort of middle ground that is not meant to be another idea or “-ism” to add to a list of ideas, but it constitutes a shift in how philosophy can be applied by adopting a broader, more holistic perspective. Applying a perspectival lens to health professions education embraces the imperative to make interpretive processes in assessment philosophically explicit. This opens the possibility of adopting multiple philosophical stances concurrently and allows actors to appreciate different methodological viewpoints with more charity. This scholarly perspective encourages the assessment community to continue to innovate through an appreciation of the importance of a wide range of assessment perspectives by uncovering the drivers of specific commitments to philosophical positions. Although the focus is on assessment in the health professions, perspectival thinking has the potential to advance medical education discourse and practice more generally beyond assessment. The hope with this essay is that by encouraging more critical reflection, this description of perspectival thinking will further aid researchers and practitioners in health professions education to better understand what is happening philosophically with more frequency.
Teaching Opportunities for Postgraduate Trainees in Primary Care
Authors: Babenko Oksana , LaPlante Gabriel , Szafran Olga , Turner Nathan , Gentilini Shannon , Kang Liane , Koppula Sudha
Published: May 2024

The purpose of this AM Last Page is to help faculty and postgraduate medical trainees (residents) identify resident teaching opportunities and foster teaching skill development. The Fundamental Teaching Activities (FTA) framework1 includes three domains in which physicians teach: Clinical Preceptor; Teacher Outside the Clinical Setting; and Educational Leader.
Opportunities and Risks for Telehealth in Advancing Health Equity in Academic Medicine
Authors: King Sarah L. , Rodriguez Jorge A. , Shipman Scott A.
Published: May 2024

Academic medical centers (AMCs) have a long history of providing care to underserved communities. As telehealth has rapidly grown, AMCs are exploring how it can improve health care access and equity. Yet there is a risk that telehealth exacerbates existing disparities and has done so already with the growing “digital divide.”1 To achieve the promise of telehealth while avoiding the risks, it must be implemented with a health equity focus.
Change in Lumbar Lordosis After Decompressive Surgery in Lumbar Spinal Stenosis Patients and Associations With Patient-Related Outcomes Two Years After Surgery: Radiologic and Clinical Results From the NORDSTEN Spinal Stenosis Trial
Authors: Åkerstedt Josefin , Wänman Johan , Banitalebi Hasan , Myklebust Tor Åge , Weber Clemens , Storheim Kjersti , Hellum Christian , Indrekvam Kari , Hermansen Erland , Brisby Helena
Published: May 2024

Study design.

A prospective cohort study.

Objective.

The aim was to investigate changes in lumbar lordosis (LL) and its association to changes in patient-reported outcome measures (PROMs) after decompressive surgery for lumbar spinal stenosis (LSS).

Summary of background.

Few studies have addressed change in LL after decompression surgery for LSS in relation to outcomes.

Materials and Methods.

Preoperative and postoperative data from 310 patients having standing x-ray both before and two years after surgery were included. The patients were grouped based on the change in LL preoperatively to two years after surgery; group 1: <5° (n=196), group 2: ≥5 <10° (n=55), or group 3: ≥10° (n=59) of change in LL. The changes in function, disability and pain were assessed by the Oswestry disability index (ODI), numeric rating scale (NRS), and the Zurich claudication questionnaire (ZCQ). The three groups were compared regarding baseline variables using the ANOVA test for continuous variables and the χ2 test for categorical variables. The groups were further compared with a likelihood ratio test in relation to changes in PROMs two years after surgery and outcomes were adjusted for respective baseline PROMs, age, sex, smoking, BMI, Schizas, and Pfirrmann scores.

Results.

LL was significantly changed at group level two years after surgery with a mean difference of 2.2° (SD: 9.4°) (P=0.001). The three LL change groups did not show any significant differences in patient characteristics, function, disability, and pain at baseline. The two groups with a change of more than 5° in LL two years after surgery (group 2 and 3) had significantly greater improvements in ODI (P=0.022) and ZCQ function (P=0.016) in the adjusted analyses, but was not significant for back and leg pain

Conclusion.

Changed LL after decompressive surgery for LSS was associated with improved ODI and physical function.

Level of Evidence. Level III.
Codesigning an E-Health Intervention for Surgery Preparation and Recovery
Authors: Williams Cory , Woods Lee , Stott Adam , Duff Jed
Published: May 2024

Surgery is a significant part of healthcare, but its demand is increasing, leading to challenges in managing patient care. Inefficient perioperative practices and traditional linear models contribute to adverse outcomes and patient anxiety. E-health interventions show promise in improving surgical care, but more research is needed. The purpose of this study was to involve patients and healthcare workers during the design phase of an e-health intervention that aims to support the perioperative care of elective surgery preparation and recovery. This study used an Information Systems Research Framework to guide collaborative codesign through semistructured interviews and cocreation workshops. Semistructured interviews collected insights on the perioperative journey and e-health needs from healthcare workers and consumers, resulting in the creation of a patient surgery journey map, experience map, and a stakeholder needs table. Collaborative work between consumers and healthcare workers in the cocreation workshops identified priority perioperative journey issues and proposed solutions, as well as prioritizing application software needs, guiding the development of the wireframe. The development of an e-health application aimed at supporting surgery preparation and recovery is a significant step toward improving patient engagement, satisfaction, and postsurgical health outcomes.
Development and validation of a novel criterion of histologic healing in ulcerative colitis defined by inflammatory cell enumeration in lamina propria mucosa: A multicenter retrospective cohort in China
Authors: Gao Han , Peng Kangsheng , Shi Yadi , Zhu Shenshen , Sun Ruicong , Xu Chunjin , Liu Ping , Pang Zhi , Zhu Lanxiang , Chen Weichang , Feng Baisui , Wu Huili , Zhou Guangxi , Li Mingsong , Li Junxiang , Ding Baijing , Liu Zhanju
Published: May 2024

Background:

Histological healing is closely associated with improved long-term clinical outcomes and lowered relapses in patients with ulcerative colitis (UC). Here, we developed a novel diagnostic criterion for assessing histological healing in UC patients.

Methods:

We conducted a retrospective cohort study in UC patients, whose treatment was iteratively optimized to achieve mucosal healing at Shanghai Tenth People’s Hospital of Tongji University from January 2017 to May 2022. We identified an inflammatory cell enumeration index (ICEI) for assessing histological healing based on the proportions of eosinophils, CD177+ neutrophils, and CD40L+ T cells in the colonic lamina propria under high power field (HPF), and the outcomes (risks of symptomatic relapses) of achieving histological remission vs. persistent histological inflammation using Kaplan–Meier curves. Intrareader reliability and inter-reader reliability were evaluated by each reader. The relationships to the changes in the Nancy index and the Geboes score were also assessed for responsiveness. The ICEI was further validated in a new cohort of UC patients from other nine university hospitals.

Results:

We developed an ICEI for clinical diagnosis of histological healing, i.e., Y = 1.701X1 + 0.758X2 + 1.347X3 − 7.745 (X1, X2, and X3 represent the proportions of CD177+ neutrophils, eosinophils, and CD40L+ T cells, respectively, in the colonic lamina propria under HPF). The receiver operating characteristics curve (ROC) analysis revealed that Y <−0.391 was the cutoff value for the diagnosis of histological healing and that an area under the curve (AUC) was 0.942 (95% confidence interval [CI]: 0.905–0.979) with a sensitivity of 92.5% and a specificity of 83.6% (P <0.001). The intraclass correlation coefficient (ICC) for the intrareader reliability was 0.855 (95% CI: 0.781–0.909), and ICEI had good inter-reader reliability of 0.832 (95% CI: 0.748–0.894). During an 18-month follow-up, patients with histological healing had a substantially better outcome compared with those with unachieved histological healing (P <0.001) using ICEI. During a 12-month follow-up from other nine hospitals, patients with histological healing also had a lower risk of relapse than patients with unachieved histological healing.

Conclusions:

ICEI can be used to predict histological healing and identify patients with a risk of relapse 12 months and 18 months after clinical therapy. Therefore, ICEI provides a promising, simplified approach to monitor histological healing and to predict the prognosis of UC.

Registration:

Chinese Clinical Trial Registry, No. ChiCTR2300077792.
Effects of the COVID-19 Pandemic on Patient Navigation for Health-Related Social Needs
Authors: Payne Julianne , DePriest Kelli , Clayton Megan L. , Berzin Olivia K.G. , Renaud Jeanette M.
Published: May 2024

Background and Objectives:

This paper uses data from the Center for Medicare & Medicaid Innovation’s Accountable Health Communities (AHC) Model to assess the effects of the COVID-19 pandemic on patient navigation (PN) for health-related social needs.

Methods:

We analyzed evaluation data from 28 organizations implementing the Center for Medicare & Medicaid Innovation’s AHC Model. We first distilled themes from 81 stakeholder interviews conducted in 2021. We then analyzed quantitative beneficiary-level data on acceptance of navigation among 133,173 unique Medicare and Medicaid beneficiaries who were eligible for navigation between January 2019 and March 2021.

Results:

During the pandemic, interview participants described greater complexity of patients’ cases and uncertainty regarding community service availability. Changes to navigation staffing and mode led to improvements in navigation quality and efficiency, but also challenges such as reduced rapport with patients. The pandemic increased navigator stress and burnout but also deepened appreciation for navigation among navigators and their patients. Beneficiaries were more likely to accept navigation during the pandemic than before the pandemic (P < .05).

Conclusions:

Changes in PN during the pandemic were perceived as both good and bad. Future work is needed to assess the long-term implications of pandemic-related changes to navigation for patients and navigators.
MASLD/MetALD and mortality in individuals with any cardio-metabolic risk factor: A population-based study with 26.7 years of follow-up
Authors: Kwak Minsun , Kim Hyun-seok , Jiang Zhenghui Gordon , Yeo Yee Hui , Trivedi Hirsh D. , Noureddin Mazen , Yang Ju Dong
Published: May 2024

Background and Aims:

A new term, metabolic dysfunction–associated steatotic liver disease (MASLD), has been proposed by a multi-society expert panel. However, it remains unclear whether hepatic steatosis per se in MASLD contributes to an increased risk of mortality in individuals with any cardio-metabolic risk factor (CMRF), which is also a significant risk factor for increased mortality. This study aimed to compare all-cause and cause-specific mortality between the “MASLD/MetALD” and “no steatotic liver disease (SLD)” groups in individuals with any CMRF.

Approach and Results:

A population-based cohort study was conducted using 10,750 participants of the Third National Health and Nutrition Examination Survey. All-cause and cause-specific (cardiovascular, cancer, diabetes, and liver) mortality risks were compared between the “MASLD,” “MetALD,” and “no SLD” groups using the Cox proportional hazards model with complex survey design weights, adjusted for confounders. Over 26 years, the “MASLD” group did not show significantly increased all-cause (adjusted HR 1.04[95% CI: 0.95–1.14], p = 0.413), cardiovascular (0.88 [0.75–1.04], p = 0.139), or cancer (1.06[0.84–1.33], p = 0.635) mortality risk compared to the “no SLD” group in individuals with any CMRF. The MetALD group was associated with increased all-cause (1.41 [1.05–1.89], p = 0.022), cancer (2.35 [1.33–4.16], p = 0.004), and liver (15.04 [2.96–76.35], p = 0.002) mortality risk compared with the no SLD group. This trend was more pronounced in the MetALD group with advanced fibrosis assessed by Fibrosis-4 (FIB-4).

Conclusions:

In individuals with CMRF, the presence of steatotic liver disease (MASLD) alone did not increase the risk of mortality, except in cases with more alcohol consumption (MetALD). Therefore controlling metabolic risk factors and reducing alcohol consumption in people with MASLD or MetALD will be crucial steps to improve long-term health outcomes.
Estimating hepatitis C prevalence in the United States, 2017–2020
Authors: Hall Eric W. , Bradley Heather , Barker Laurie K. , Lewis Karon C. , Shealey Jalissa , Valverde Eduardo , Sullivan Patrick , Gupta Neil , Hofmeister Megan G.
Published: May 2024

Background and Aims:

The National Health and Nutrition Examination Survey (NHANES) underestimates the true prevalence of HCV infection. By accounting for populations inadequately represented in NHANES, we created 2 models to estimate the national hepatitis C prevalence among US adults during 2017–2020.

Approach and Results:

The first approach (NHANES+) replicated previous methodology by supplementing hepatitis C prevalence estimates among the US noninstitutionalized civilian population with a literature review and meta-analysis of hepatitis C prevalence among populations not included in the NHANES sampling frame. In the second approach (persons who injected drugs [PWID] adjustment), we developed a model to account for the underrepresentation of PWID in NHANES by incorporating the estimated number of adult PWID in the United States and applying PWID-specific hepatitis C prevalence estimates. Using the NHANES+ model, we estimated HCV RNA prevalence of 1.0% (95% CI: 0.5%–1.4%) among US adults in 2017–2020, corresponding to 2,463,700 (95% CI: 1,321,700–3,629,400) current HCV infections. Using the PWID adjustment model, we estimated HCV RNA prevalence of 1.6% (95% CI: 0.9%–2.2%), corresponding to 4,043,200 (95% CI: 2,401,800–5,607,100) current HCV infections.

Conclusions:

Despite years of an effective cure, the estimated prevalence of hepatitis C in 2017–2020 remains unchanged from 2013 to 2016 when using a comparable methodology. When accounting for increased injection drug use, the estimated prevalence of hepatitis C is substantially higher than previously reported. National action is urgently needed to expand testing, increase access to treatment, and improve surveillance, especially among medically underserved populations, to support hepatitis C elimination goals.
THE PROGNOSTIC SIGNIFICANCE OF ACUTE HENLE FIBER LAYER HYPERREFLECTIVITY IN PLACOID DISEASES
Authors: Cicinelli Maria Vittoria , Menean Matteo , Marchese Alessandro , Ramtohul Prithvi , Bandello Francesco , Miserocchi Elisabetta
Published: May 2024

Purpose:

To investigate the pathophysiology and prognostic significance of acute Henle fiber layer (HFL) hyperreflectivity in placoid diseases by examining its relationship with impaired choroidal flow and persistent photoreceptor disruption.

Methods:

Retrospective–prospective observational study on patients with placoid diseases. Indocyanine green angiography and optical coherence tomography were performed during the acute phase and follow-up. Impaired choroidal flow, HFL hyperreflectivity, and persistent ellipsoid zone disruption, their colocalization index, and their associations with initial and final visual acuity were explored.

Results:

Sixteen eyes from eight patients (mean age, 25.3 ± 6.44 years) were included (median follow-up, 13.5 months). Quantitative analysis revealed significant correlations between areas of impaired choroidal flow, HFL hyperreflectivity, and persistent ellipsoid zone disruption (correlation coefficients of 0.69, 0.63, and 0.46, respectively). Impaired choroidal flow area exceeded HFL hyperreflectivity (P = 0.002) and ellipsoid zone disruption (P = 0.003). A noteworthy 94% nonrandom overlap between HFL hyperreflectivity and ellipsoid zone disruption was observed. Worse initial visual acuity correlated with foveal involvement (P = 0.0002), thicker choroid (P = 0.001), larger impaired choroidal flow areas (P = 0.02), and thinner outer retina post lesion inactivation (P = 0.04).

Conclusion:

Henle fiber layer hyperreflectivity predicted photoreceptor recovery potential in placoid diseases. If HFL hyperreflectivity corresponds to acute HFL damage, it may suggest more severe involvement of the entire photoreceptor length.
Surgical Management of Overgrowth Syndrome With Bilateral Vision-Threatening Ptosis
Authors: Linaburg Taylor J. , Lahaie-Luna Gabriela , Pradeep Tejus , Bhatti Trisha , Katowitz William
Published: May 2024

We describe the first case reported in ophthalmological literature of the surgical management of a 17-month-old boy with bilateral vision-threatening ptosis, tarsomegaly, ectropion, and euryblepharon secondary to suspected overgrowth syndrome. We elaborate on the major challenges associated with surgical management including the natural and asymmetric growth of oversized tissue, the high likelihood of scarring and formation of disorganized tissue, and risks of frequent intubation in these patients who may have lesions that compromise critical structures such as the airway. Ultimately, surgical intervention is encouraged primarily if vision or ocular health is threatened and secondarily to achieve good cosmesis.
Orbital Giant Cell Reparative Granuloma: A Case Report
Authors: Wang Nan , Li Jing , Ma Jianmin
Published: May 2024

Giant cell reparative granuloma has a very low incidence and is thought to be a response to trauma. While there have been only a few reported cases of orbital giant cell reparative granuloma, we recently observed such a case and analyzed 16 previously reported cases of this type. It is important to note that further investigation is necessary to fully understand the relationship between giant cell reparative granuloma and trauma.
Using Failure Mode and Effects Analysis to Decrease Risk When Developing a Home Health Nurse Residency Program
Authors: Pennington Gwen
Published: May 2024

Background:

New graduate nurses are traditionally not recruited for home health care (HHC).

Local Problem:

Due to staffing shortages, a HHC agency was interested in hiring graduate nurses, but there was concern about associated risks.

Methods:

The purpose of this quality improvement project was to develop a nurse residency program to safely transition graduate nurses to the HHC setting. After initial program design, analysis using a failure mode effects analysis (FMEA) was conducted, and risk mitigation strategies were applied.

Results:

The overall risk of onboarding graduate nurses in HHC was reduced by 42% after applying harm reduction tactics identified from the FMEA.

Conclusion:

The FMEA was found to be a useful tool to prospectively identify areas of concern and apply harm reduction tactics prior to nurse residency implementation.
Availability of Pediatric Services and Equipment in Emergency Departments
Authors: Shawahna Ramzi , Mukhaimer Yara , Hawwari Hiba , Barham Mo'men , Jaber Mohammad , Maqboul Iyad , Hijaz Hatim
Published: May 2024

Objective

This study was conducted to assess the availability of equipment and supplies in the emergency departments of the hospitals in the West Bank of Palestine.

Methods

This study was conducted in a cross-sectional design using a data collection form that was specifically developed for this study. The standardized data collection form contained a detailed list of all essential pediatric emergency equipment and supplies.

Results

This study was conducted in a total of 30 hospitals all across the West Bank of Palestine. The median number of patients visiting the emergency department per day was 115.0, the median number of patients admitted to the hospital per day was 14.5, and the median number of pediatric patients visiting the emergency department per day was 6.0. The median number of pediatricians in the hospital was 4.0, the median number of pediatricians in the emergency department was 1.0, the median number of nurses in the hospital was 75.0, and the median number of nurses in the emergency department was 8.5. Both governmental and private hospitals lacked the equipment and supplies needed for monitoring, gaining vascular access, airway management, resuscitation medications, cervical immobilization equipment, and other equipment and supplies.

Conclusions

Decision and policymakers might use the findings reported in this study to allocate resources to restock and increase the availability of pediatric emergency equipment and supplies. More studies are still needed to compare the outcomes of patients before and after restocking and increasing the availability of pediatric emergency equipment and supplies.
Development and Evaluation of Patient Safety Interventions: Perspectives of Operational Safety Leaders and Patient Safety Organizations
Authors: Gomes Kylie M. , Handley Jessica , Pruitt Zoe M. , Krevat Seth , Fong Allan , Ratwani Raj M.
Published: May 2024

Objectives

The purpose of this study is to understand how patient safety professionals from healthcare facilities and patient safety organizations develop patient safety interventions and the resources used to support intervention development.

Methods

Semistructured interviews were conducted with patient safety professionals at nine healthcare facilities and nine patient safety organizations. Interview data were qualitatively analyzed, and findings were organized by the following: patient safety solutions and interventions, use of external databases, and evaluation of patient safety solutions.

Results

Development of patient safety interventions across healthcare facilities and patient safety organizations was similar and included literature searches, internal brainstorming, and interviews. Nearly all patient safety professionals at healthcare facilities reported contacting colleagues at other healthcare facilities to learn about similar safety issues and potential interventions. Additionally, less than half of patient safety professionals at healthcare facilities and patient safety organizations interviewed report data to publicly available patient safety databases. Finally, most patient safety professionals at healthcare facilities and patient safety organizations stated that they evaluate the effectiveness of patient safety interventions; however, they mentioned methods that may be less rigorous including audits, self-reporting, and subjective judgment.

Conclusions

Patient safety professionals often utilize similar methods and resources to develop and evaluate patient safety interventions; however, many of these efforts are not coordinated across healthcare organizations and could benefit from working collectively in a systematic fashion. Additionally, healthcare facilities and patient safety organizations face similar challenges and there are several opportunities for optimization on a national level that may improve patient safety.
Optimizing Esthetic Outcomes and Bone Stability: Chin Advancement Through Inverted V Osteotomy
Authors: Kang Kyo Joon , Kim Kenneth K. , Han Jinho , Park Bumjin
Published: May 2024

Traditional horizontal osteotomies for small and short chins often yield suboptimal results due to limited bone advancement, resulting in deep labiomental folds and heightened bone resorption risks. This study investigates the effectiveness of an innovative inverted V-shaped osteotomy technique in enhancing esthetic outcomes for patients with such chin concerns. Thirty-eight patients who underwent inverted V-shaped osteotomy for recessed chins between January 2018 and June 2022 were included. Excluding cases involving simultaneous mandibular contouring surgery, patients were followed up for a median duration of 1.2±0.5 years. Preoperation and postoperation soft tissue pogonion (Pg’) and labiomental fold depth (LMF) changes were measured. IBM SPSS (version 27.0) was used for statistical analysis, with significance defined as P<0.05. Patient satisfaction was assessed using a visual analog scale. Successful advancement genioplasty was performed on all patients without any severe complications. The average change in soft tissue pogonion (Pg’) measured 6.2 (1.9) mm, and the mean alteration in labiomental depth was 0.42 (0.4) mm. The procedure achieved a bone to soft tissue movement ratio of 1:0.96. Patient satisfaction was notably high, with a mean VAS score of 8.7. An inverted V-shaped osteotomy enables greater bone advancement for small and short chins, leading to improved esthetic outcomes and offering a mechanically advantageous condition for bone segments.
Clinical and Anthropological Analyses of a Case From 19th Century South Africa With a Confluence of Uncommon Cranial Pathological Conditions
Authors: Kotze Daniël , Gunston Geney D. , Harris Tashneem , He Letian , Gibbon Victoria E.
Published: May 2024

This study combines clinical and anthropological analyses to investigate the complex cranial pathology of a South African individual from the 19th century. The cranium was examined macroscopically and radiographically. Conducting a standard differential diagnosis was challenging given the complexity and uncommon nature of the pathology and required drawing on relatively sparse paleopathological and clinical case reports. Multiple conditions were identified including biparietal thinning, basilar invagination, platybasia, and complicated chronic frontal sinusitis, where the intracranial extension of sinus infection may likely have contributed to the individual’s death. The authors urge for awareness of these uncommon conditions, as their presence can easily be overlooked or confound skeletal assessments. This clinical study contributes to the authors’ understanding of uncommon and poorly described paleopathological diseases and will help to better facilitate their diagnosis in future research. It represents one of the first studies describing such an unusual cooccurrence of uncommon pathologies in an archeological individual.
Percutaneous Endoscopy and Image-guided Retrieval of Dropped Gallstones – A Case Series
Authors: Husnain Ali , Reiland Allison , Nemcek Albert A. , Salem Riad , Nagle Alexander P. , Teitelbaum Ezra , Riaz Ahsun
Published: May 2024

Background:

Recurrent abscesses can happen due to dropped gallstones (DGs) after laparoscopic cholecystectomy (LC). Recognition and appropriate percutaneous endoscopy and image-guided treatment options can decrease morbidity associated with this condition.

Materials and Methods:

We report a minimally invasive endoscopy and image-guided technique for retrieval of dropped gallstones in a series of 6 patients (M/F=3/3; median age: 75.5 years [68 to 82]) presenting with recurrent or chronic intra-abdominal abscesses secondary to dropped gallstones. Technical success was defined as the visualization and retrieval of all stones. DGs were identified on pre-procedure imaging. Number of abscesses recurrence was 12 (1/6), 1 (3/6), and 0 (2/6) with a median interval of 2 months (1 to 21) between cholecystectomy and abscess development.

Results:

Percutaneous endoscopy and fluoroscopy guidance were utilized in all cases. Technical success was achieved in 4 patients (66%). The median procedure time was 65.8 minutes (39 to 136). The median fluoroscopy time and dose were 12.6 min (3.3 to 67) and 234 mGy (31 to 1457), respectively. There were no intraprocedure and postprocedure complications. No abscess recurrence was reported among successful procedures during a median follow-up of 193 days (51 to 308).

Conclusion:

Percutaneous image and endoscopy-guided lithotripsy/lithectomy are safe and effective. This technique is a suitable alternative to open surgery for dropped gallstones.

Level of Evidence:

Level 4, Case Series
Improving malignant fungating wound management among oncology nurses: a best practice implementation project
Authors: Chang Shing-Li , Chung Chi Feng , Liou Yueh Guo , Lo Shu Fen , Hu Sophia H.
Published: May 2024

Introduction:

Appropriate malignant fungating wound (MFW) care is challenging for oncology nurses, leading to increased stress, compromised care quality, and poor patient outcomes.

Objective:

This study aimed to address best practice barriers and develop evidence-based guidelines for MFW care.

Methods:

This project was guided by the JBI Evidence Implementation Framework, which follows a seven-phase process. Both nurses’ skills and patient charts were audited to determine compliance with best practices for comprehensive MFW assessment, wound photo records, use of validated wound assessment tools, appropriate wound care, and patient pain and satisfaction. Bandura's social learning theory was used to guide the development of an online education program and an objective structured clinical examination for skill improvement to prompt behavior change in nurses. A follow-up audit was conducted to measure improvements in knowledge, skills, and self-efficacy among nurses to validate the effectiveness of the intervention.

Results:

The project resulted in improvements in all four evidence-based practice criteria: (1) comprehensive MFW assessments increased from 27% to 98%; (2) the inclusion of wound photos in medical records increased from 50% to 100%; (3) use of a validated wound assessment tool increased from 0% to 100%; and (4) appropriate interventions to manage wounds and maintain patients’ quality of life increased from 50% to 90%.

Conclusions:

The project integrated a flexible education program, multidisciplinary collaboration, and leadership support to empower nurses to effectively manage MFWs. In addition, Bandura's social learning theory was used to influence nurses’ behavior and bring about sustainable changes to organizational culture and practices.

Spanish abstract:

http://links.lww.com/IJEBH/A205
The unresolved mystery of dust particle swarms within the magnetosphere
Authors: Sommer Max
Published: May 2024

Early-generation
in situ
dust detectors in near-Earth space have reported the occurrence of clusters of sub-micron dust particles that seemed unrelated to human spaceflight activities. In particular, data from the impact ionization detector onboard the HEOS-2 satellite indicate that such swarms of particles occur throughout the Earth’s magnetosphere up to altitudes of 60 000 km—far beyond regions typically used by spacecraft. Further account of high-altitude clusters has since been given by the GEO-deployed GORID detector, however, explanations for the latter have so far only been sought in GEO spaceflight activity. This perspective piece reviews dust cluster detections in near-Earth space, emphasizing the natural swarm creation mechanism conjectured to explain the HEOS-2 data—i.e. the electrostatic disruption of meteoroids. Highlighting this mechanism offers a novel viewpoint on more recent near-Earth dust measurements. We further show that the impact clusters observed by both HEOS-2 and GORID are correlated with increased geomagnetic activity. This consistent correlation supports the notion that both sets of observations stem from the same underlying phenomenon and aligns with the hypothesis of the electrostatic breakup origin. We conclude that the nature of these peculiar swarms remains highly uncertain, advocating for their concerted investigation by forthcoming dust science endeavours, such as the JAXA/DLR DESTINY
+
mission.

This article is part of the theme issue ‘Dust in the Solar System and beyond’.
Variability in reported midpoints of (in)activation of cardiac INa
Authors: Clerx Michael , Volders Paul G.A. , Mirams Gary R.
Published: May 2024

Electrically active cells like cardiomyocytes show variability in their size, shape, and electrical activity. But should we expect variability in the properties of their ionic currents? In this brief review we gather and visualise measurements of two important electrophysiological parameters: the midpoints of activation and inactivation of the cardiac fast sodium current, INa. We find a considerable variation in reported mean values between experiments, with a smaller cell-to-cell variation within experiments. We show how the between-experiment variability can be decomposed into a correlated and an uncorrelated component, and that the correlated component is much larger and affects both midpoints almost equally. We then review biological and methodological issues that might explain the observed variability, and attempt to classify each as within-experiment or correlated and uncorrelated between-experiment factors. Although the existence of some variability in measurements of ionic currents is well-known, we believe that this is the first work to systematically review it and that the scale of the observed variability is much larger than commonly appreciated, which has implications for modelling and experimental design.
Spatially Resolved Tumor Ecosystems and Cell States in Gastric Adenocarcinoma Progression and Evolution
Authors: Ma Haoran , Srivastava Supriya , Ong Xuewen , Tay Su Ting , Xu Chang , Sheng Taotao , Ho Shamaine Wei Ting , Lian Benedict Shi Xiang , Huang Kie Kyon , Goh Yeek Teck , Joseph Craig Ryan Cecil , Lum Jeffrey Huey Yew , Tan Angie Lay Keng , Zhang Yanrong , NG Michelle Shu Wen , Zhu Feng , Zhao Joseph J , Teh Ming , Yeong Joe , Yong Wei Peng , So Jimmy Bok Yan , Sundar Raghav , Tan Patrick
Published: May 2024

Gastric cancer (GC) is a major cause of global cancer mortality with high heterogeneity levels. To explore geospatial interactions in tumor ecosystems, we integrated 1,563 spatial transcriptomic regions-of-interest (ROIs) with 152,423 single-cell expression profiles across 130 GC samples from 70 patients. We observed pervasive expression-based intratumor heterogeneity, recapitulating tumor progression through spatially localized and functionally ordered subgroups with specific immune microenvironments and immune checkpoint profiles. Evolutionary phylogenetic analysis revealed two different evolutionary trajectories (branched evolution and diaspora evolution) associated with distinct molecular subtypes, clinical prognoses, stromal neighborhoods includingVWF+ACKR1+ endothelial cells, and genetic drivers such asSOX9. Spatial analysis of tumor-stromal interfaces across multiple GCs highlighted new ecosystem states not attributable to mere tumor/stroma admixture, landmarked by increasedGREM1expression. Our results provide insights into how the cellular ecosystems of individual GCs are sculpted by tumor intrinsic and extrinsic selective pressures, culminating in individualized patient-specific cancer cartographies.
Lateral Flow Assay Sensitivity and Signal Enhancement via Laser µ-Machined Constrains in Nitrocellulose Membrane
Authors: Khatmi Gazy , Klinavičius Tomas , Simanavičius Martynas , Silimavičius Laimis , Tamulevičienė Asta , Rimkutė Agnė , Kučinskaitė-Kodzė Indrė , Gylys Gintautas , Tamulevičius Tomas
Published: May 2024

Multiplex lateral flow assay (LFA) is a handful diagnostic technology that can identify severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other common respiratory viruses in one strip, which can be tested at the point-of-care without the need for equipment or skilled personnel outside the laboratory. Although its simplicity and practicality make it an appealing solution, it remains a grand challenge to substantially enhance the colorimetric LFA sensitivity. The local flow rate constraints imposed in nitrocellulose (NC) membranes via a number of vertical femtosecond laser micromachined microchannels are important for prolonged specific binding interactions. Porous NC membrane surfaces were structured with different widths and densities μ-channels employing a second harmonic of the Yb:KGW femtosecond laser and sample XYZ translation over a microscope objective-focused laser beam. The influence of the microchannel parameters on the vertical wicking speed was evaluated from the video recordings. The obtained results indicated that μ-channel length, width, and density in NC membranes controllably increased the immunological reaction time between the analyte and the labeled antibody by 950%. Image analysis of the colorimetric indicators confirmed that the flow rate delaying strategy enhanced the signal sensitives by 40% compared with pristine NC LFA.

Graphical abstract
The universal labeling and sorting of avian primordial germ cell utilizingLycopersicon Esculentumlectin
Authors: Iikawa Hiroko , Morita Mizuki , Nishina Aika , Atsuta Yuji , Hayashi Yoshiki , Saito Daisuke
Published: May 2024

Avian species serve as vital resources in human society, with the preservation and utilization of these species heavily reliant on primordial germ cells (PGCs). However, methods for effectively isolating these rare cells alive from embryos remain elusive in avian species beyond chickens. Even within chicken species, existing techniques have shown limited efficiency. In our study, we present a rapid, simple, and cost-effective method for labeling and sorting circulating-stage PGCs across various avian species, including Carinatae and Ratitae, utilizingLycopersicon Esculentumlectin. Significantly, this method demonstrates high sorting efficiency by identifying a wide range of PGC subtypes while preserving the proliferative potential of chicken PGCs. This approach is anticipated to make a significant contribution to the conservation, research, and agricultural industries related to birds worldwide.
SYNY: a pipeline to investigate and visualize collinearity between genomes
Authors: Julian Alexander Thomas , Pombert Jean-François
Published: May 2024

Investigating collinearity between chromosomes is often used in comparative genomics to help identify gene orthologs, pinpoint genes that might have been overlooked as part of annotation processes and/or perform various evolutionary inferences. Collinear segments, also known as syntenic blocks, can be inferred from sequence alignments and/or from the identification of genes arrayed in the same order and relative orientations between investigated genomes. To help perform these analyses and assess their outcomes, we built a simple pipeline called SYNY (for synteny) that implements the two distinct approaches and produces different visualizations. The SYNY pipeline was built with ease of use in mind and runs on modest hardware. The pipeline is written in Perl and Python and is available on GitHub (https://github.com/PombertLab/SYNY) under the permissive MIT license.
Y chromosome shredding inAnopheles gambiae: insight into the cellular dynamics of a novel synthetic sex ratio distorter
Authors: Vitale Matteo , Kranjc Nace , Leigh Jessica , Kyrou Kyrous , Courty Thomas , Marston Louise , Grilli Silvia , Crisanti Andrea , Bernardini Federica
Published: May 2024

Despite efforts to explore the genome of the malaria vectorAnopheles gambiae, the Y chromosome of this species remains enigmatic. The large number of repetitive and heterochromatic DNA sequences makes the Y chromosome exceptionally difficult to fully assemble, hampering the progress of gene editing techniques and functional studies for this chromosome. In this study, we made use of a bioinformatic platform to identify Y-specific repetitive DNA sequences that served as a target site for a CRISPR/Cas9 system. The activity of Cas9 in the reproductive organs of males caused damage to Y-bearing sperm without affecting their fertility, leading to a strong female bias in the progeny. Cytological investigation allowed us to identify meiotic defects and investigate sperm selection in this new synthetic sex ratio distorter system. In addition, alternative promoters enable us to target the Y chromosome in specific tissues and developmental stages of male mosquitoes, enabling studies that shed light on the role of this chromosome in male gametogenesis. This work paves the way for further insight into the poorly characterised Y chromosome ofAnopheles gambiae. Moreover, the sex distorter strain we have generated promises to be a valuable tool for the advancement of studies in the field of developmental biology, with the potential to support the progress of genetic strategies aimed at controlling malaria mosquitoes and other pest species.

Author summary

Genetic elements known as sex ratio meiotic drive can manipulate the sex ratio of offspring, favouring the male or female sex. This fascinating phenomenon has inspired the development of synthetic sex ratio distorter systems in several organisms. In species where females and males harbour XX and XY sex chromosomes respectively, the X-chromosome can be ‘shredded’ during male gametogenesis, leading to the production of non-functional X-bearing sperm, while Y-bearing sperm are left intact and able to fertilise the eggs. These systems can produce offspring that are extremely biased towards males, which can be used as genetic tools to control harmful insect populations. In our study, we applied this molecular strategy to target the Y chromosome ofAnopheles gambiae. Our aim was to investigate the cellular consequences of the shredding of this chromosome, the impact on meiosis and sperm selection, and the potential to achieve strong female bias in the offspring. The outcome of this study enhances our understanding of the molecular and biological mechanisms behind synthetic sex-ratio distorters in Anopheles mosquitoes, which could inform the development of vector control strategies that target sex ratio. Additionally, we present a genetic sexing strain able to produce mostly females, providing a valuable genetic tool for fundamental studies on this deadly vector.