bluuebunny/crossref_metadata_2025 huggingface dataset:
Prehospital and emergency department airway management of severe penetrating trauma in Sweden during the past decade
Authors: Renberg Mattias , Dahlberg Martin , Gellerfors Mikael , Rostami Elham , Günther Mattias
Published: November 2023

Background

Prehospital tracheal intubation (TI) is associated with increased mortality in patients with penetrating trauma, and the utility of prehospital advanced airway management is debated. The increased incidence of deadly violence in Sweden warrants a comprehensive evaluation of current airway management for patients with penetrating trauma in the Swedish prehospital environment and on arrival in the emergency department (ED).

Methods

This was an observational, multicenter study of all patients with penetrating trauma and injury severity scores (ISSs) ≥ 15 included in the Swedish national trauma register (SweTrau) between 2011 and 2019. We investigated the frequency and characteristics of prehospital and ED TI, including 30-day mortality and patient characteristics associated with TI.

Result

Of 816 included patients, 118 (14.5%) were intubated prehospitally, and 248 (30.4%) were intubated in the ED. Patients who were intubated prehospitally had a higher ISS, 33 (interquartile range [IQR] 25, 75), than those intubated in the ED, 25 (IQR 18, 34). Prehospital TI was associated with a higher associated mortality, OR 4.26 (CI 2.57, 7.27, p < 0.001) than TI in the ED, even when adjusted for ISS (OR 2.88 [CI 1.64, 5.14, p < 0.001]). Hemodynamic collapse (≤ 40 mmHg) and low GCS score (≤ 8) were the characteristics most associated with prehospital TI. Traumatic cardiac arrests (TCAs) occurred in 154 (18.9%) patients, of whom 77 (50%) were intubated prehospitally and 56 (36.4%) were intubated in the ED. A subgroup analysis excluding TCA showed that patients with prehospital TI did not have a higher mortality rate than those with ED TI, OR 2.07 (CI 0.93, 4.51, p = 0.068), with OR 1.39 (0.56, 3.26, p = 0.5) when adjusted for ISS.

Conclusion

Prehospital TI was associated with a higher mortality rate than those with ED TI, which was specifically related to TCA; intubation did not affect mortality in patients without cardiac arrest. Mortality was high when airway management was needed, regardless of cardiac arrest, thereby emphasizing the challenges posed when anesthesia is needed. Several interventions, including whole blood transfusions, the implementation of second-tier EMS units and measures to shorten scene times, have been initiated in Sweden to counteract these challenges.
Perceived dyspnea and experience of hospitalized patients with acute decompensated heart failure undergoing an early MObilization protocol with immersive Virtual rEality: MOVE study protocol for a parallel superiority randomized clinical trial
Authors: Fraga Iasmin Borges , Caballero Larissa Gussatschenko , Lago Pedro Dal , de Oliveira João Lucas Campos , Scherer Marina , Haeffner Mauren Porto , Rabelo-Silva Eneida Rejane
Published: November 2023

Background

Immersive virtual reality (VR) is an innovative strategy for inpatient rehabilitation programs. Using immersive VR in early mobilization protocols has not yet been investigated in the setting of hospitalized patients with acute decompensated heart failure (ADHF), especially to improve perceived dyspnea, a common symptom of heart failure (HF).

Methods

This is a single-center parallel superiority randomized clinical trial. The study will be conducted at a public teaching hospital in Brazil from January 2023 to January 2024. The sample will include adult patients with ADHF hospitalized for at least 24 h, randomly assigned in a 1:1 ratio to the control (standard early mobilization protocol conducted in the intensive care unit (ICU)) or intervention group (the same standard early mobilization protocol but associated with immersive VR). The primary outcome will be assessing perceived dyspnea, and the secondary outcome will be assessing patient experience.

Discussion

Using immersive VR in early mobilization protocols in the ICU is expected to improve perceived dyspnea in patients with ADHF as well as patient experience regarding care. This study has the potential to increase patient adherence to early mobilization protocols in the setting of ADHF as well as to promote a positive patient experience. Filling this gap could promote the rational incorporation of technologies in health care.

Trial registration

This study protocol is in its first version. ClinicalTrials.gov NCT05596292. Registered on 1 December 2022.
Predominant audio source separation in polyphonic music
Authors: Reghunath Lekshmi Chandrika , Rajan Rajeev
Published: November 2023

Predominant source separation is the separation of one or more desired predominant signals, such as voice or leading instruments, from polyphonic music. The proposed work uses time-frequency filtering on predominant source separation and conditional adversarial networks to improve the perceived quality of isolated sounds. The pitch tracks corresponding to the prominent sound sources of the polyphonic music are estimated using a predominant pitch extraction algorithm and a binary mask corresponding to each pitch track and its harmonics are generated. Time-frequency filtering is performed on the spectrogram of the input signal using a binary mask that isolates the dominant sources based on pitch. The perceptual quality of source-separated music signal is enhanced using a CycleGAN-based conditional adversarial network operating on spectrogram images. The proposed work is systematically evaluated using the IRMAS and ADC 2004 datasets. Subjective and objective evaluations have been carried out. The reconstructed spectrogram is converted back to music signals by applying the inverse short-time Fourier transform. The intelligibility of separated audio is enhanced using an intelligibility enhancement module based on an audio style transfer scheme. The performance of the proposed method is compared with state-of-the-art Demucs and Wave-U-Net architectures and shows competing performance both objectively and subjectively.
Dispersed DNA variants underlie hearing loss in South Florida’s minority population
Authors: Peart LéShon , Gonzalez Joanna , Morel Swols Dayna , Duman Duygu , Saridogan Turcin , Ramzan Memoona , Zafeer Mohammad Faraz , Liu Xue Zhong , Eshraghi Adrien A. , Hoffer Michael E. , Angeli Simon I. , Bademci Guney , Blanton Susan , Smith Carson , Telischi Fred F. , Tekin Mustafa
Published: November 2023

Background

We analyzed the genetic causes of sensorineural hearing loss in racial and ethnic minorities of South Florida by reviewing demographic, phenotypic, and genetic data on 136 patients presenting to the Hereditary Hearing Loss Clinic at the University of Miami. In our retrospective chart review, of these patients, half self-identified as Hispanic, and the self-identified racial distribution was 115 (86%) White, 15 (11%) Black, and 6 (4%) Asian. Our analysis helps to reduce the gap in understanding the prevalence, impact, and genetic factors related to hearing loss among diverse populations.

Results

The causative gene variant or variants were identified in 54 (40%) patients, with no significant difference in the molecular diagnostic rate between Hispanics and Non-Hispanics. However, the total solve rate based on race was 40%, 47%, and 17% in Whites, Blacks, and Asians, respectively. In Non-Hispanic Whites, 16 different variants were identified in 13 genes, with GJB2 (32%), MYO7A (11%), and SLC26A4 (11%) being the most frequently implicated genes. In White Hispanics, 34 variants were identified in 20 genes, with GJB2 (22%), MYO7A (7%), and STRC-CATSPER2 (7%) being the most common. In the Non-Hispanic Black cohort, the gene distribution was evenly dispersed, with 11 variants occurring in 7 genes, and no variant was identified in 3 Hispanic Black probands. For the Asian cohort, only one gene variant was found out of 6 patients.

Conclusion

This study demonstrates that the diagnostic rate of genetic studies in hearing loss varies according to race in South Florida, with more heterogeneity in racial and ethnic minorities. Further studies to delineate deafness gene variants in underrepresented populations, such as African Americans/Blacks from Hispanic groups, are much needed to reduce racial and ethnic disparities in genetic diagnoses.
Effectiveness of virtually delivered Body Project groups to prevent eating disorders in young women at risk: a protocol for a randomized controlled trial
Authors: Wisting Line , Stice Eric , Ghaderi Ata , Dahlgren Camilla Lindvall
Published: November 2023

Background

Eating disorders (EDs) are a group of mental illnesses associated with significant psychological and physiological consequences. Overall, only about one-fifth of individuals with EDs receive treatment and treatment is effective for only about one-third for those who receive care. The development and implementation of effective prevention approaches for those at risk is therefore pivotal. The Body Project is the most effective ED prevention program for at-risk women according to several meta-analyses, but reach is limited since delivery, traditionally, has been in-person. Moreover, peer-led Body Project groups have been reported to produce stronger effects than clinician-led Body Project groups when delivered in-person. This has not yet been examined for virtually delivered Body Project groups. This study therefore seeks to investigate the effect of virtual Body Project groups delivered by peers versus clinicians on ED risk factors, ED symptoms, and prospective ED onset.

Methods

Young women with body image concerns aged 16–25 years (N = 441) will be included in the study and randomized to three conditions: (i) virtually delivered Body Project groups led by clinicians; (ii) virtually delivered Body Project groups led by peers; and (iii) psychoeducational control group. Participants will complete assessments at five timepoints over two years (pretest, posttest, 6-months, 1-year, and 2-years).

Discussion

Further research is needed to examine approaches to increase the potential for broad implementation of prevention of EDs. The virtual modality of the Body Project could markedly expand the reach for young women at risk. If findings confirm that peers can deliver virtual Body Project groups as effectively as clinicians, this will further enhance the implementation potential.

Trial registration: The present study has been registered on clinicaltrials.gov (NCT05993728).
Evaluation of a carepartner-integrated telehealth gait rehabilitation program for persons with stroke: study protocol for a feasibility study
Authors: Blanton Sarah , Cotsonis George , Brennan Kayla , Song Robert , Zajac-Cox Laura , Caston Sarah , Stewart Heather , Jayaraman Arun , Reisman Darcy , Clark Patricia C. , Kesar Trisha
Published: November 2023

Background

Despite family carepartners of individuals post-stroke experiencing high levels of strain and reduced quality of life, stroke rehabilitation interventions rarely address carepartner well-being or offer training to support their engagement in therapeutic activities. Our group has developed creative intervention approaches to support families during stroke recovery, thereby improving physical and psychosocial outcomes for both carepartners and stroke survivors. The purpose of this study is to test the feasibility of an adapted, home-based intervention (Carepartner Collaborative Integrative Therapy for Gait-CARE-CITE-Gait) designed to facilitate positive carepartner involvement during home-based training targeting gait and mobility.

Methods

This two-phased design will determine the feasibility of CARE-CITE-Gait, a novel intervention that leverages principles from our previous carepartner-focused upper extremity intervention. During the 4-week CARE-CITE-Gait intervention, carepartners review online video-based modules designed to illustrate strategies for an autonomy-supportive environment during functional mobility task practice, and the study team completes two 2-h home visits for dyad collaborative goal setting. In phase I, content validity, usability, and acceptability of the CARE-CITE-Gait modules will be evaluated by stroke rehabilitation content experts and carepartners. In phase II, feasibility (based on measures of recruitment, retention, intervention adherence, and safety) will be measured. Preliminary effects of the CARE-CITE-Gait will be gathered using a single-group, quasi-experimental design with repeated measures (two baseline visits 1 week apart, posttest, and 1-month follow-up) with 15 carepartner and stroke survivor dyads. Outcome data collectors will be blinded. Outcomes include psychosocial variables (family conflict surrounding stroke recovery, strain, autonomy support, and quality of life) collected from carepartners and measures of functional mobility, gait speed, stepping activity, and health-related quality of life collected from stroke survivors.

Discussion

The findings of the feasibility testing and preliminary data on the effects of CARE-CITE-Gait will provide justification and information to guide a future definitive randomized clinical trial. The knowledge gained from this study will enhance our understanding of and aid the development of rehabilitation approaches that address both carepartner and stroke survivor needs during the stroke recovery process.

Trial registration

ClinicalTrials.gov, NCT 05257928. Registered 25 February 2022.

Trial status

This trial was registered on ClinicalTrials.gov (NCT 05257928) on March 25, 2022. Recruitment of participants was initiated on May 18, 2022.
Metal-organic framework-based photodynamic combined immunotherapy against the distant development of triple-negative breast cancer
Authors: Liang Xiaoyan , Mu Min , Chen Bo , Fan Rangrang , Chen Haifeng , Zou Bingwen , Han Bo , Guo Gang
Published: November 2023

Background

Triple-negative breast cancer (TNBC) is an aggressive, metastatic and apparently drug-resistant subtype of breast cancer with a higher immune response compared to other types of breast cancer. Photodynamic therapy (PDT) has been gaining popularity for its non-invasive nature, minimal side effects, and spatiotemporally controlled benifits. The use of metal-organic frameworks (MOFs) loaded with programmed death-ligand 1 inhibitors (iPD-L1) offers the possibility of combining PDT with immunotherapy.

Method

Here, we construct PCN-224, a MOFs with good biocompatibility and biodegradability for the delivery of the PD-L1 small molecule inhibitor BMS-202 to achieve a synergistic anti-tumor strategy of PDT and immunotherapy. Hyaluronic acid (HA) modified PEG (HA-PEG) was synthesized for the outer layer modification of the nanocomplex, which prolongs its systemic circulation time.

Results

In vitro cellular experiments show that the nanocomplexes irradiated by 660 nm laser has a strong ability to produce singlet oxygen, which effectively induce PDT. PDT with strong immunogenicity leads to tumor necrosis and apoptosis, and induces immunogenic cell death, which causes tumor cells to release danger associated molecular patterns. In combination with iPD-L1, the combination therapy stimulates dendritic cell maturation, promotes T-cell activation and intratumoral infiltration, and reshapes the tumor immune microenvironment to achieve tumor growth inhibition and anti-distant tumor progression.

Conclusions

MOFs-based nano-systems as a platform for combination therapy offer a potentially effective strategy for the treatment of TNBC with high metastatic rates.

Graphical Abstract
Broken epidural catheter: individualize your management
Authors: Kumar Sanjay , Mahajan Shalvi , Kumar Vishal , Gandhi Komal Anil
Published: November 2023

Background

Epidural anaesthesia is one of the most used neuraxial anaesthesia techniques. It has been utilized as the principal anaesthesia modality involving lower limb surgery. Breakage of epidural catheters is an unusual occurrence whose subsequent therapy lacks uniformity due to the absence of a consensus and defined standards.

Case presentation

A 39-year-old male with no comorbidities was scheduled for right lower limb reconstruction surgery due to non-union of the tibia. Combined spinal-epidural anaesthesia was planned. During epidural catheter insertion, there was difficulty threading the catheter, and upon its removal, a long segment of catheter (8 cm) was left inside the body. Following informed consent from the patient, the retained fragment was surgically extracted in the same sitting under general anaesthesia.

Conclusions

Even when faced with such a circumstance, it is best to explore surgically and remove a long segment broken catheter to allay patient anxiety.
ABA guides stomatal proliferation and patterning through the EPF-SPCH signaling pathway in Arabidopsis thaliana
Authors: Mohamed Deka , Vonapartis Eliana , Corcega Dennedy Yrvin , Gazzarrini Sonia
Published: November 2023

Adaptation to dehydration stress requires plants to coordinate environmental and endogenous signals to inhibit stomatal proliferation and modulate their patterning. The stress hormone abscisic acid (ABA) induces stomatal closure and restricts stomatal lineage to promote stress tolerance. Here, we report that mutants with reduced ABA levels, xer-1, xer-2 and aba2-2, developed stomatal clusters. Similarly, the ABA signaling mutant snrk2.2/2.3/2.6, which lacks core ABA signaling kinases, also displayed stomatal clusters. Exposure to ABA or inhibition of ABA catabolism rescued the increased stomatal density and spacing defects observed in xer and aba2-2, suggesting that basal ABA is required for correct stomatal density and spacing. xer-1 and aba2-2 displayed reduced expression of EPF1 and EPF2, and enhanced expression of SPCH and MUTE. Furthermore, ABA suppressed elevated SPCH and MUTE expression in epf2-1 and epf1-1, and partially rescued epf2-1 stomatal index and epf1-1 clustering defects. Genetic analysis demonstrated that XER acts upstream of the EPF2-SPCH pathway to suppress stomatal proliferation, and in parallel with EPF1 to ensure correct stomatal spacing. These results show that basal ABA and functional ABA signaling are required to fine-tune stomatal density and patterning.
FRL and DAAM are required for lateral adhesion of interommatidial cells and patterning of the retinal floor
Authors: Gazsó-Gerhát Gabriella , Gombos Rita , Tóth Krisztina , Kaltenecker Péter , Szikora Szilárd , Bíró Judit , Csapó Enikő , Asztalos Zoltán , Mihály József
Published: November 2023

Optical insulation of the unit eyes (ommatidia) is an important prerequisite of precise sight with compound eyes. Separation of the ommatidia is ensured by pigment cells that organize into a hexagonal lattice in the Drosophila eye, forming thin walls between the facets. Cell adhesion, mediated by apically and latero-basally located junctional complexes, is crucial for stable attachment of these cells to each other and the basal lamina. Whereas former studies have focused on the formation and remodelling of the cellular connections at the apical region, here, we report a specific alteration of the lateral adhesion of the lattice cells, leaving the apical junctions largely unaffected. We found that DAAM and FRL, two formin-type cytoskeleton regulatory proteins, play redundant roles in lateral adhesion of the interommatidial cells and patterning of the retinal floor. We show that formin-dependent cortical actin assembly is crucial for latero-basal sealing of the ommatidial lattice. We expect that the investigation of these previously unreported eye phenotypes will pave the way toward a better understanding of the three-dimensional aspects of compound eye development.
In toto imaging of glial JNK signaling during larval zebrafish spinal cord regeneration
Authors: Becker Clayton J. , Cigliola Valentina , Gillotay Pierre , Rich Ashley , De Simone Alessandro , Han Yanchao , Di Talia Stefano , Poss Kenneth D.
Published: November 2023

Identification of signaling events that contribute to innate spinal cord regeneration in zebrafish can uncover new targets for modulating injury responses of the mammalian central nervous system. Using a chemical screen, we identify JNK signaling as a necessary regulator of glial cell cycling and tissue bridging during spinal cord regeneration in larval zebrafish. With a kinase translocation reporter, we visualize and quantify JNK signaling dynamics at single-cell resolution in glial cell populations in developing larvae and during injury-induced regeneration. Glial JNK signaling is patterned in time and space during development and regeneration, decreasing globally as the tissue matures and increasing in the rostral cord stump upon transection injury. Thus, dynamic and regional regulation of JNK signaling help to direct glial cell behaviors during innate spinal cord regeneration.
Το παιδί με την κινηματογραφική κάμερα και η αναπαράσταση του πρόσφυγα
Authors: Βαλσαμίδης Παύλος
Published: November 2023

Η έρευνα αφορά στην μελέτη της αναπαράστασης του πρόσφυγα σε μαθητικά οπτικοακουστικά κείμενα της βαθμίδας του δημοτικού σχολείου. Το δείγμα ανάλυσης είναι δέκα βραβευμένες οπτικοακουστικές δημιουργίες του ετήσιου μαθητικού διαγωνισμού Ένας Πλανήτης…μια Ευκαιρία, που μετονομάστηκε σε Cinema διάβασες; (2011/12 -2018). Η οπτικοακουστική παιδεία δίνει τη δυνατότητα στους μαθητές να μιλήσουν για τις δικές τους εμπειρίες και να αρθρώσουν το δικό τους λόγο. Στόχος να μελετήσουμε την οπτική ρητορική των μαθητών πάνω στην αναπαράσταση του προσφυγικού υποκειμένου. Στο πλαίσιο αυτό εξετάζεται, αν υιοθετούνται οπτικές τυπολογίες από τα Μ.Μ.Ε. και τον κινηματογράφο, όπως, επίσης, στοιχεία θεωρίας (Ρατσισμός, homo sacer, θεωρίες για τον «ξένο» και οριενταλισμός) στην αποτύπωση του πρόσφυγα. Αν υπάρχει ρητή / άρρητη πόλωση μεταξύ του «εμείς» του τόπου υποδοχής και της προσφυγικής ετερότητας και αν, εντέλει, διαφοροποιείται και με ποιο τρόπο η προσφυγική αναπαράσταση στην περίοδο 2011/2012-2018. Με κομβικό έτος το 2015, έτος μαζικών προσφυγικών αφίξεων στην Ελλάδα χωρίσαμε το δείγμα σε δύο περιόδους 2011/2012-2015 και 2015-2018. Η έρευνα είναι ποιοτική και στηρίζεται στην ανάλυση των οπτικοακουστικών κειμένων, υιοθετώντας την κοινωνική σημειωτική, τις απόψεις του R. Barthes και στοιχεία κινηματογραφικού ύφους. Τα πορίσματα της έρευνας κατέστησαν σαφές ότι η προσφυγική αναπαράσταση είναι αμφίσημη και αλλάζει στην πορεία του χρόνου, εξαιτίας της επικαιρότητας και του εκάστοτε ηγεμονικού αφηγήματος. Οι μαθητές δημιουργοί αντλούν από τις οπτικές τυπολογίες των Μ.Μ.Ε. και του κινηματογράφου, για να αποτυπώσουν τον πρόσφυγα άλλοτε ως «εισβολέα» και άλλοτε ως «θύμα/ homo sacer». Ο πρόσφυγας είναι ο «ξένος», που έρχεται να ταράξει τη σχολική ηρεμία και να πολώσει συγκρούσεις. Ωστόσο, επισημάνθηκαν γνωρίσματα όπως για παράδειγμα η ανάγκη οπτικής προσέγγισης με τον πρόσφυγα, η οπτική στηλίτευση των συγκρούσεων και η προβολή της αναπαράστασης του πρόσφυγα, ως μίας δυναμικής παρουσίας, που κερδίζει την αποδοχή, τα οποία διαμορφώνουν μια ιδιαίτερη μαθητική «μεταναστευτική» οπτική ρητορική.
Disparities in dosing, drug reduction, and drug discontinuation among US FDA approved tyrosine kinase inhibitors
Authors: Reddy Neha , Coleman Niamh , Andersen Clark , Yuan Ying , Subbiah Vivek
Published: November 2023

Background: Tyrosine kinase inhibitors (TKIs) have altered the therapeutic landscape of multiple hematological and solid malignancies. FDA approved starting doses of TKIs are based on the recommended phase 2 dose (RP2D) in clinical trials. However, patients are started on lower doses in practice. We assessed the dosing, drug reduction rates, and drug discontinuation rates among FDA approved TKIs and observed the disparity among study populations to understand if there was adequate representation of diversity in race.

Methods: We established a database of all FDA approved TKIs from the FDA online label repository. We extracted descriptive data for indications and usage, type of approval, approval dosage, dose reduction recommendation, median age, race, dose reduction rates, drug discontinuation rates, dose modification, warnings, adverse reactions, clinical trial experience, and geriatric use above 65 yrs and 75 yrs.

Results: Among all TKIs, median dose was 200 mg and average dose was 307.7 mg; 36 (24%) were approved bid vs 107 (72%) qd. Among approved indications, median rates of dose reduction rate (DRR), drug interruption rate (DIR), drug discontinuations rate (DDR) were 31%, 52%, and 10% respectively. Reasons for DRR, DIR, and DDR were diarrhea, fatigue, nausea, vomiting, hepatotoxicity, rash, and hypertension. Black and Hispanic races are consistently underrepresented among the TKI studies.

Conclusions: TKIs have a variable dose reduction and drug discontinuation rate but these studies were done mostly in White individuals. Clinical trials should evaluate multiple dosing regimens and schedules to lessen the toxicity burden and improve QOL in patients while broadening the study population so that the studies will be generalizable to patients in clinical practice. Future studies are warranted to increase representation in the studies to address the disparities.
Structural, electrical, and electrochemical studies of the olivine LiMPO4 (M=Fe, Co, Cr, Mn, V) as cathode materials for lithium-ion rechargeable batteries based on the intercalation principle
Authors: Manfo Theodore Azemtsop
Published: November 2023

Despite significant efforts to identify other substituents, carbon remains the only economically viable negative electrode (anode) material for Li-ion batteries (LIBs). The current state of knowledge on the understanding, characterization, and improvement of carbon anode materials is reviewed. A brief history of developments in carbon host lattices is provided. The methodologies used to characterize the lithium insertion and de-insertion processes and a wide spectrum of carbon materials, from amorphous to highly oriented graphitic materials, are described. The basic studies of the electrochemical process on natural graphite and highly oriented pyrolitic graphite materials are then thoroughly examined. Following that, the issues and opportunities of several hard carbon compounds that boost battery capacity are examined. Several innovative carbon materials and carbon-based composites are also introduced. The electrochemical interaction of anode material with lithium could produce an intercalation product, which serves as the foundation for a novel battery system. Structural retention causes this reaction to proceed quickly and with a high degree of reversibility at room temperature. Titanium disulfide is one of the latest solid cathode materials. In this context, the paper presents a comprehensive theoretical comparison of the electrochemical electrical and physical properties of iron (Fe)-, cobalt (Co)-, manganese (Mn)-, chromium (Cr)-, and vanadium (V)-based LiMPO4 materials for cathode design in lithium (Li)-ion battery applications using the intercalation principle. The work highlighted many material and performance aspects of the cathode design, such as the cohesive energy of the material, Li-intercalation energy in olivine structure, and physical, electrochemical, and electrical analyses of LiMPO4 for rechargeable Li-ion batteries. We also examine the evolution of LIB technology based on the olive cathode materials, which are also evaluated.
Developing the University of Tartu in Estonia into a well-networked Patient Safety Research Centre (PATSAFE): A study protocol
Authors: PÕLLUSTE Kaja , Calsbeek Hiske , Orrego Carola , Ballester Marta , Suñol Rosa , Vall-Roqué Helena , Kangasniemi Mari , Läänelaid Siim , Starkopf Joel , van Tuijl Anne , Wollersheim Hub , Freimann Tiina , Mägi Liisi , Bañeres Joaquim , Fernández-Maillo María del Mar , Emond Yvette , Lember Margus
Published: November 2023

Background Patient safety (PS) is a serious global public health problem affecting all countries. Estimates show that around 10 percent of the patients are harmed during hospital care, resulting in 23 million disability-adjusted life years lost per year. Experts emphasize research advancements as a key precondition for safer care. Aim The Patient Safety Research Centre (PATSAFE) project enhances the Institute of Clinical Medicine of the University of Tartu’s (ICM-UT) research potential and capacities in PS in order to improve and strengthen knowledge and skills in methods, techniques and experience for PS research. Methods A strategic partnership with Avedis Donabedian Research Institute in Spain, and IQ Healthcare in the Netherlands, both international leaders in PS research, enables the development of a long-lasting knowledge exchange, allowing the ICM-UT to capitalise on its current achievements and to overcome gaps in scientific excellence in the field of PS research. These twining activities will strengthen and raise the research profile of the ICM-UT academic staff and early-stage researchers (ESRs), by implementing the hands-on training on methods, techniques, and experience in PS research. The project also encourages the active participation of ESRs in PS research by increasing their soft skills, to ensure the continuity and sustainability of PS research in ICM-UT. Finally, development of the research strategy on PS contributes to the long-term sustainability of PS research in Estonia. To implement these activities, PATSAFE foresees a comprehensive strategy consisting of knowledge exchange, soft research skills capacity building, strategic planning, and strong dissemination and exploitation efforts. Expected results As a result of the project, ICM-UT will have the capacity to carry out PS research using the appropriate methodology and the competences to apply state-of-the-art evidence-based strategies for PS research.
Proceso de diseño participativo con colectivos a partir del método Livingston: el caso de la cooperativa de viviendas colaborativas El Ciempiés.
Authors: García Molina Ricardo , Miralles Jori Roger , Díaz García Vicente J.
Published: November 2023

Introducción: El objetivo es describir y analizar la primera etapa del proceso de diseño participativo aplicado en un proyecto de viviendas colaborativas o cohousing, basado en el método Livingston. La cooperativa El Ciempiés decidió iniciar un proceso participativo de diseño para su edificio en marzo del 2020, al inicio del confinamiento por COVID-19 en España, lo que precisó reconsiderar las técnicas y herramientas del proyecto. Método: Estudio de caso basado en el análisis de documentos, memorias y grupos focales. Resultados: Se describe y analiza el proceso de diseño participativo de la cooperativa El Ciempiés. Discusión: El orden lógico y las técnicas del método Livingston se adaptaron al contexto complejo y cambiante del proyecto, respondiendo a las demandas manifiestas y latentes del colectivo. Conclusiones: Los procesos de diseño participativo se adecúan a las expectativas y necesidades de las personas participantes en proyectos de viviendas colaborativas. El método Livingston proporciona las bases para generar una estrategia de transformación espacial en procesos autogestionados de viviendas colaborativas y permite adaptar sus herramientas a contextos complejos como el trabajo con colectivos en una situación de pandemia
El cooperativismo de vivienda argentino y español: dos casos para pensar alternativas para la reapropiación de comunes urbanos.
Authors: Cecilia Zapata María
Published: November 2023

El proceso de extractivismo global que impone la reestructuración capitalista de las últimas décadas encuentra en las ciudades posibilidades predilectas para la acumulación mediante especulación inmobiliaria y, al mismo tiempo, desposesión de amplios sectores de la población. Tanto en Argentina como en España, este proceso condujo a una enorme cantidad de familias a tener que resolver sus situaciones de inaccesibilidad a la vivienda mediante procesos alternativos de producción de hábitat, desligados de la lógica mercantil o estatal. En algunos casos habilitó la gestación de cooperativas que impulsaron brechas para la reapropiación de comunes urbanos que implicaron una disputa en materia productiva, comunitaria y cultural. A partir de una metodología cualitativa que recupera trabajos de campo en cooperativas de la Ciudad de Buenos Aires, Madrid y Barcelona, este artículo reflexiona sobre las características que asume estas experiencias alternativas de hábitat, prestando atención a los efectos del despliegue de prácticas productivas alternativas y las formas que asume la vida comunitaria. Se pondrá en discusión en qué medida estas prácticas productivas de hábitat ponen en cuestión el modelo urbano neoliberal vigente, disputando nuevas formas de re(ex)sistencias a partir de nuevas prácticas de comunitarización creadas desde abajo.
El papel de la vivienda en la revitalización de ámbitos rurales en situación de declive demográfico. Identificación de Buenas Prácticas en España.
Authors: Donadei Marta , Gutiérrez Barbarrusa Virginia , Mendes Leal Luciane
Published: November 2023

En los últimos años a nivel europeo y nacional se está centrando la atención en abordar problemas y retos a los cuales se enfrentan las zonas rurales en situación de declive demográfico: en junio de 2022 se celebró la primera Conferencia del Pacto Rural, en la cual se reunieron políticos de la UE, nacionales y regionales, junto a autoridades locales, agentes sociales y económicos, para adoptar compromisos orientados a avanzar en la definición de una visión a largo plazo para la revitalización de las áreas rurales. A nivel nacional, ya en 2019 se aprobaron las Directrices Generales para una Estrategia Nacional frente al Reto Demográfico; sucesivamente, en marzo de 2021 se publicó el Plan de Medidas correspondiente, en el cual se incluyen medidas específicas para las zonas rurales en declive demográfico. Aunque en estas medidas se reconozca de alguna forma la importancia de la vivienda para una revitalización de estas áreas, se detecta la falta de un conocimiento con suficiente profundidad en torno a esta temática, así como su débil vinculación con los otros objetivos del Plan y una consecuente falta de instrumentos específicos para abordar estas
Problemy uchodźców i udzielona pomoc – studium przypadku na podstawie badań ankietowych przeprowadzonych w Olkuszu / powiecie olkuskim
Authors: Bujwid-Kurek Ewa , Siatka Jakub
Published: November 2023

The main research objective of the chapter titled ‘Problems of Refugees and the Assistance Provided – a Case Study Based on a Survey Conducted in Olkusz/Olkusz County’ was to reach out to the Ukrainian population who had arrived in Olkusz/Olkusz County and conduct a survey of the refugees to explore their opinions on the nature of the assistance they have received. Therefore, a questionnaire was constructed, and its structure was divided into three parts regarding three main issues: arrival, assistance, and safety. 22 research hypotheses were established for the study. Nine of these related to arrival, five to assistance provided and eight to safety (including social security). Survey questions were derived from the explicated hypotheses. 16 hypotheses were verified as correct. These were in line with the predictions of the research team. Six hypoth eses were verified as incorrect. Overall, the results of the research clearly confirmed the considerable assistance provided to the Ukrainian population by the Olkusz County Starost’s Office. Several important problems affecting the Ukrainian population emerged from the analysis. These include: the Polish labor market, the planned settlement in the area, trust issues with newly met people, and longing for the home country.
A peer educator-based community project for pre-dialysis patients
Authors: Jain Neerja , Baharani Jyoti
Published: November 2023

This article outlines an innovative pilot project that shows the impact that peer educators can have on improving the process of dialysis decision-making
Idiosyncratic DILI: Immunology in Cases with Evidence Based on RUCAM
Authors: Teschke Rolf
Published: November 2023

Idiosyncratic drug induced liver injury (iDILI) is a multifaceted and fairly well described liver disease, but there is yet some uncertainty on the role of immune systems triggering the liver injury and speculation on the cascade of immune events. Many conclusions were so far based on narratives or cases of iDILI, which did not receive the benefit of a robust causality assessment like by the Roussel Uclaf Causality Assessment Method (RUCAM). This analysis aims to clarify the cascade of immune events that lead to the liver injury by conventional drugs. For this approach, the search focused on iDILI cases with verified diagnosis by RUCAM. Most promising were parameters obtained from the blood as mirror of what happened in the liver during the injurious processes.The focus of this present analysis is on patients with RUCAM based iDILI and concomitant immune-related parameters in the blood. As an example, compelling evidence for a role of immune systems in iDILI was found for circulating mediators in the blood secreted by liver immune cells in patients under a therapy for tuberculosis, detected were also serum anti-cytochrome P450 (CYP) antibodies in patients after anesthesia with sevoflurane or desflurane and thereby reflecting their metabolism by the CYP 2E1 isoform, the occurrence of serum of autoantibodies in patients with drug induced autoimmune hepatitis (DIAIH) due to many drugs, and the role of blood and liver monocytes, which provide direct evidence for the activation of the hepatic innate immune system to the adapted immune system. In essence, patients with RUCAM based iDILI show various immunology features in the blood compatible with the role of the hepatic immune systems in patients with suspected iDILI caused by some but not all drugs.
IMPACT OF POSITIVE CULTURES DURING THE SECOND STAGE OF A TWO-STAGE REPLACEMENT: A SYSTEMATIC REVIEW
Authors: Martos Marta Sabater , Boadas Laia , Trebse Rihard , Marais Leonard , Ruiz Pablo Sanz , Vaznaisiene Danguole , Grenho André , Ferrari Matteo Carlo , Soriano Alex
Published: November 2023

Aim

Two-stage replacement is a frequent procedure in patients with chronic PJI. However, results in the literature after this procedure differ, ranging from 54% to 100% of infection eradication. Positive cultures at reimplantation, when performing the second stage, are perceived as a risk factor for reinfection. This study aims to determine the impact of positive cultures during the second stage on the outcome of patients undergoing a 2-stage septic replacement and the impact of antibiotic holidays between the first and the second stage.

Method

We systematically searched four databases from inception to May 31, 2022. We combined terms related to PJI, joint replacement and culture results. We analysed the risk of failure when positive cultures at second stage and performed a subgroup analysis by antibiotic holiday period.

Results

We included 24 studies with 2387 patients of which 432 had positive cultures during second stage (18.09%). Global failure rate was 18.01% (430 patients). When dividing failure by culture results during second stage, we found that failure in positive group was 37.01% (161/432 patients) and failure in negative group was 13.7% (269/1953 patients). In the meta-analysis (MA) the odds ratio (OR) was 4.047 (95% CI: 2.954–5.544). When performing the subgroup analysis by antibiotic holidays we found that the rate of positive cultures without and with holidays was 21.3% and 16.05%, respectively. Failure rate without holidays was 15% (90/600 patients) and with holidays was 17.3% (202/1165 patients) (p=0.21). Failure in each group was higher when cultures were positive (without holidays, 25% vs 12.2%, p=0.0003, and with holidays 41.1% vs 12.7%, p<0.0001). In the MA we found that those studies in which antibiotic holiday was reported had higher risk of failure when cultures were positive during second stage (OR 4.798 95%IC 3.142–7.325). When studies reported no antibiotic holidays also had a higher risk of failure when cultures where positive (OR 2.225 95%CI 1.103–4.489), though it was lower.

Conclusions

There exists a higher risk of failure after a two-stage septic replacement when cultures are positive during reimplantation. Patients who followed no antibiotic holidays or antibiotic holidays before reimplantation have similar failure rate when cultures are negative. In both groups they have a higher risk of failure when cultures are positive, having higher risk those positive patients in the antibiotic holidays group. Therefore, importance in detecting these patients before reimplantation is crucial to ensure higher survival rates.
THE INFECTED POLYPROPYLENE MESH: WHICH ANTISEPTIC SOLUTION MOST EFFECTIVELY REMOVES BIOFILM?
Authors: Jo Suenghwan , Chao Christina , Khilnani Tyler , Bostrom Mathias , Carli Alberto
Published: November 2023

Aim

Polypropylene (PPE) synthetic mesh is increasingly used in knee arthroplasty surgery to salvage a disrupted extensor mechanism. Despite its clinical success, it is associated with a high rate of periprosthetic joint infection (PJI), which is hypothesized to be caused by bacterial biofilm. The purpose of the current study is to describe the progression of PPE-based biofilm formation over time and to determine if intraoperative antiseptic solutions could be used to effectively remove biofilm when treating PJI.

Method

Commercially available knotted monofilament PPE mesh1 was cut into 10mm circular shape, immersed in tryptic soy broth (TSB) with methicillin-sensitive staphylococcus aureus and cultured individually in 48-well plates for 10 days to elucidate the biofilm grown on mesh over time. At every 24 hours, a triplicate of samples was retrieved and biofilm on the mesh was dislodged by sonicating at 52 kHz for 15 minutes and quantified by counting colony-forming units (CFUs) after overnight growth. The biofilm growth was also verified using scanning electron microscopy.

The effect of saline and antiseptic solutions was verified by exposing 1) 0.05% chlorohexidine gluconate2, 2) acetic acid-based mixture3, 3) diluted povidone-iodine (0.35%), 4) undiluted povidone-iodine (10%)4, and 5) 1:1 combination of 10% povidone-iodine & 3% hydrogen peroxide on immature and mature biofilms for 3 minutes, created by culturing with bacteria for 24 hours and 72 hours respectively. All experiments were performed in quintuples and repeated. Antiseptic treatments that produced a three-log reduction in CFU counts compared to controls were considered clinically significant.

Results

PPE-mesh produced reliable CFU counts at 24 hours and reached peak growth at 72 hours. For immature biofilm, all formulations of povidone-iodine produced significant reductions in CFU counts compared to controls. Although not meeting the established threshold, saline irrigation removed 86.5% of CFUs, while formulation based on chlorohexidine and acetic acid removed 99.2% and 99.7% respectively. For mature biofilm, formulations based on povidone-iodine and acetic acid produced significant reductions in CFU counts.

Conclusions

Our findings suggest biofilm may form on mesh as early as 24 hours after bacterial exposure. Povidone-iodine formulations were consistently the most effective in removing biofilm on mesh surfaces. We recommend that surgeons consider using an antiseptic solution, preferably povidone-iodine-based, in addition to regular saline lavage when attempting to salvage a PPE mesh in the setting of PJI.

1Marlex mesh (CR Bard, Davol Inc, Warwick, RI), 2Irrisept (Irrimax Corp, Gainesville, FL), 3Bactisure (Zimmer-Biomet, Warsaw, IN), 4Aplicare (Inc, Meriden, CT)
NOBLE METAL-BASED ANTIBACTERIAL IMPLANT COATINGS FOR ARTICULATING IMPLANT SURFACES
Authors: van Hoogstraten Sanne , Samijo Steven , Geurts Jan , Arts Chris
Published: November 2023

Aim

Prosthetic joint infections pose a major clinical challenge. Developing novel material surface technologies for orthopedic implants that prevent bacterial adhesion and biofilm formation is essential. Antimicrobial coatings applicable to articulating implant surfaces are limited, due to the articulation mechanics inducing wear, coating degradation, and toxic particle release. Noble metals are known for their antimicrobial activity and high mechanical strength and could be a viable coating alternative for orthopaedic implants [1]. In this study, the potential of thin platinum-based metal alloy coatings was developed, characterized, and tested on cytotoxicity and antibacterial properties.

Method

Three platinum-based metal alloy coatings were sputter-coated on medical-grade polished titanium discs. The coatings were characterized using optical topography and scanning electron microscopy with energy dispersive spectroscopy (SEM/EDS). Ion release was measured using inductively coupled plasma optical emission spectrometry (ICP-OES). Cytotoxicity was tested according to ISO10993-5 using mouse fibroblasts (cell lines L929 and 3T3). Antibacterial surface activity, bacterial adhesion, bacterial proliferation, and biofilm formation were tested with gram-positive Staphylococcus aureus ATCC 25923 and gram-negative Escherichia coli ATCC 25922. Colony forming unit (CFU) counts, live-dead fluorescence staining, and SEM-EDS images were used to assess antibacterial activity.

Results

Three different platinum-based metal alloys consisting of platinum-iridium, platinum-copper, and platinum-zirconium. The coatings were found 80 nm thick, smooth (roughness average < 60 nm), and non-toxic. The platinum-copper coating showed a CFU reduction larger than one logarithm in adherent bacteria compared to uncoated titanium. The other coatings showed a smaller reduction. This data was confirmed by SEM and live-dead fluorescence images, and accordingly, ICP-OES measurements showed low levels of metal ion release from the coatings.

Conclusions

The platinum-copper coating showed low anti-adhesion properties, even with extremely low metal ions released. These platinum-based metal alloy coatings cannot be classified as antimicrobial yet. Further optimization of the coating composition to induce a higher ion release based on the galvanic principle is required and copper looks most promising as the antimicrobial compound of choice.

Acknowledgments

This publication is supported by the DARTBAC project (with project number NWA.1292.19.354) of the research program NWA-ORC which is (partly) financed by the Dutch Research Council (NWO); and the AMBITION project (with project number NSP20–1-302), co-funded by the PPP Allowance made available by Health-Holland, Top Sector Life Sciences & Health to ReumaNederland.
RISK ANALYSIS OF PERIPROSTHETIC KNEE JOINT INFECTION (PJI) IN TOTAL KNEE ARTHROPLASTY AFTER PREOPERATIVE CORTICOSTEROID INJECTION: A SYSTEMATIC REVIEW
Authors: Pérez-Prieto Daniel , Baums Mike , Aquilina Julian , Sleiman Obeida , Geropoulos Georgious , Totlis Trifon
Published: November 2023

Purpose

Intra-articular corticosteroid injection is widely used for symptomatic relief of knee osteoarthritis. However, if pain is not improved which consequences a total knee arthroplasty (TKA), there is a potential risk of post-operative periprosthetic joint infection (PJI). The aim of this study is to investigate whether the use of preoperative intra-articular corticosteroid injection increases the risk of PJI and to investigate a time frame in which the risk of subsequent infection is significantly increased.

Methods

A systematic search was performed in PubMed (Medline), Scopus, and the Cochrane Library. Inclusion criteria were original studies investigating the rate of PJI in patients receiving pre-operative intra-articular corticosteroid injection compared to controls.

Results

A total of 380 unique articles were screened. Six studies met the inclusion criteria with 255,627 patients in total. Overall, no statistical significance was observed in the intra-articular infection rate in corticosteroid compared to controls groups. However, intra-articular corticosteroid injections within 3 months prior to TKA were associated with a significantly increased risk of infection (OR: 1.52, 95% CI 1.37–1.67, p < 0.01); this was not observed in the 6-month period (OR: 1.05, 95% CI 0.80–1.39, p = 0.72).

Conclusions

Performing an intra-articular corticosteroid injection within 3 months prior to TKA is associated with a significantly increased risk of PJI. The current evidence supports the safe use of intra-articular corticosteroid injection more than 6 months before TKA. However, additional studies are needed to clarify the risk of PJI after TKA implantation between 3 and 6 months after the last corticoid injection.