bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of leukocytes in myeloproliferative neoplasm thromboinflammation
Authors: Liu Yu , Wang Yingying , Huang Gang , Wu Sanyun , Liu Xiaoyan , Chen Shuo , Luo Ping , Liu Chang , Zuo Xuelan
Published: March 2024

Classic myeloproliferative neoplasms lacking the Philadelphia chromosome are stem cell disorders characterized by the proliferation of myeloid cells in the bone marrow and increased counts of peripheral blood cells. The occurrence of thrombotic events is a common complication in myeloproliferative neoplasms. The heightened levels of cytokines play a substantial role in the morbidity and mortality of these patients, establishing a persistent proinflammatory condition that culminates in thrombosis. The etiology of thrombosis remains intricate and multifaceted, involving blood cells and endothelial dysfunction, the inflammatory state, and the coagulation cascade, leading to hypercoagulability. Leukocytes play a pivotal role in the thromboinflammatory process of myeloproliferative neoplasms by releasing various proinflammatory and prothrombotic factors as well as interacting with other cells, which contributes to the amplification of the clotting cascade and subsequent thrombosis. The correlation between increased leukocyte counts and thrombotic risk has been established. However, there is a need for an accurate biomarker to assess leukocyte activation. Lastly, tailored treatments to address the thrombotic risk in myeloproliferative neoplasms are needed. Therefore, this review aims to summarize the potential mechanisms of leukocyte involvement in myeloproliferative neoplasm thromboinflammation, propose potential biomarkers for leukocyte activation, and discuss promising treatment options for controlling myeloproliferative neoplasm thromboinflammation.
The EU’s normative justifications of refugee resettlement
Authors: Welfens Natalie
Published: March 2024

The UNHCR promotes resettlement as an important protection tool to express solidarity with vulnerable refugees and countries of refuge. Yet, as resettlement is discretionary, its guiding principles and objectives are not binding and can be reinterpreted by states and supranational organizations. Against the background of UNHCR’s resettlement guidelines, this article examines the EU’s justifications of resettlement. Advancing theories of pragmatic sociology and based on an in-depth qualitative analysis, it teases out justifications of (1) humanitarianism, (2) border security, and (3) assimilability in EU discourses and policies. Revisiting EU policy advancements from the early 2000s until 2023, it shows that these justifications increasingly interlace and present resettlement as an instrument to protect refugees as well as EU borders and access to EU polities. The article argues for the need to understand the EU as a resettlement actor in its own right, with significant power to reshape resettlement as a protection tool.
Dental implant placement with simultaneous localized ridge augmentation using L-shaped titanium mesh in the esthetic zone: a case report
Authors: Albash Ziad , Hnaino Eva , Khalil Ali
Published: March 2024

The aim of this case report is to illustrate a successful technique for dental implant placement in the esthetic zone using simultaneous localized ridge augmentation with L-shaped titanium mesh. A 35-year-old patient presented with a single missing tooth in the esthetic zone requiring dental implant placement. The treatment plan was made to place a dental implant in conjunction with a guided bone regeneration procedure using a prefabricated L-shaped titanium mesh. The procedure achieved successful reconstruction of the deficient ridge, providing ample volume and contour for implant placement. Implant osteointegration was achieved, resulting in a satisfactory functional and esthetically pleasing outcome. The use of L-shaped titanium mesh offers superior stability and biocompatibility, ensuring optimal support and containment of graft material. This case report highlights the feasibility and clinical effectiveness of dental implant placement with simultaneous localized ridge augmentation using L-shaped titanium mesh in the esthetic zone. Further studies are warranted to assess the long-term success and esthetic outcomes of this technique.
Liver impalement with an antique African iron barbed spear. A case report
Authors: Cervantes Barbara Y H , Gavor Samuel E , Jiagge Nuna E , Lopez Duniesky M , Lambert Radisnay G , Almaguer Acevedo Fernando M
Published: March 2024

Impalement injuries happen when an object penetrates a body cavity or organ and remains in situ. We present a case of a 35-year-old fisherman whose act of violence resulted in the lodging of an antique iron spear in segment V of the liver, which was then referred to our institution on the day after the accident. Despite the challenges posed by patient transfer, diagnosis, resuscitation, and, most importantly, handling in the operating room, the object was successfully removed via hepatotomy, and the patient is now in good health. Impalement by an ancient African iron spear, repurposed as a fishing tool in modern times, remains undocumented in the literature, necessitating reporting and a call for further research by the medical community into managing impalement injuries of varying severity.
Telemedicine for Potential Application in Austere Military Environments: Neurosurgical Support for a Decompressive Craniectomy
Authors: Stark Pieter W , van Waes O J F , Soria van Hoeve John S , Borger van der Burg Boudewijn L S , Hoencamp Rigo
Published: March 2024

Introduction

The main goal of this study was to assess the feasibility of a head-mounted display (HMD) providing telemedicine neurosurgical support during a decompressive craniectomy by a military surgeon who is isolated from readily available neurosurgical care. The secondary aim was to assess the usability perceived by the military surgeon and to evaluate technical aspects of the head-mounted display.

Materials and Methods

After a standard concise lecture, 10 military surgeons performed a decompressive craniectomy on a AnubiFiX-embalmed post-mortem human head. Seven military surgeons used a HMD to receive telemedicine neurosurgical support. In the control group, three military surgeons performed a decompressive craniectomy without guidance. The performance of the decompressive craniectomy was evaluated qualitatively by the supervising neurosurgeon and quantified with the surgeons’ operative performance tool. The military surgeons rated the usability of the HMD with the telehealth usability questionnaire.

Results

All military surgeons performed a decompressive craniectomy adequately directly after a standard concise lecture. The HMD was used to discuss potential errors and reconfirmed essential steps. The military surgeons were very satisfied with the HMD providing telemedicine neurosurgical support. Military surgeons in the control group were faster. The HMD showed no hard technical errors.

Conclusions

It is feasible to provide telemedicine neurosurgical support with a HMD during a decompressive craniectomy performed by a non-neurosurgically trained military surgeon. All military surgeons showed competence in performing a decompressive craniectomy after receiving a standardized concise lecture. The use of a HMD clearly demonstrated the potential to improve the quality of these neurosurgical procedures performed by military surgeons.
Transcription factor FveMYB117a inhibits axillary bud outgrowth by regulating cytokinin homeostasis in woodland strawberry
Authors: Han Yafan , Qu Minghao , Liu Zhongchi , Kang Chunying
Published: March 2024

Shoot branching affects plant architecture. In strawberry (Fragaria L.), short branches (crowns) develop from dormant axillary buds to form inflorescences and flowers. While this developmental transition contributes greatly to perenniality and yield in strawberry, its regulatory mechanism remains unclear and understudied. In the woodland strawberry (Fragaria vesca), we identified and characterized 2 independent mutants showing more crowns. Both mutant alleles reside in FveMYB117a, a R2R3-MYB transcription factor gene highly expressed in shoot apical meristems, axillary buds, and young leaves. Transcriptome analysis revealed that the expression of several cytokinin pathway genes was altered in the fvemyb117a mutant. Consistently, active cytokinins were significantly increased in the axillary buds of the fvemyb117a mutant. Exogenous application of cytokinin enhanced crown outgrowth in the wild type, whereas the cytokinin inhibitors suppressed crown outgrowth in the fvemyb117a mutant. FveMYB117a binds directly to the promoters of the cytokinin homeostasis genes FveIPT2 encoding an isopentenyltransferase and FveCKX1 encoding a cytokinin oxidase to regulate their expression. Conversely, the type-B Arabidopsis response regulators FveARR1 and FveARR2b can directly inhibit the expression of FveMYB117a, indicative of a negative feedback regulation. In conclusion, we identified FveMYB117a as a key repressor of crown outgrowth by inhibiting cytokinin accumulation and provide a mechanistic basis for bud fate transition in an herbaceous perennial plant.
Methyltransferase TaSAMT1 mediates wheat freezing tolerance by integrating brassinosteroid and salicylic acid signaling
Authors: Chu Wei , Chang Shumin , Lin Jingchen , Zhang Chenji , Li Jinpeng , Liu Xingbei , Liu Zehui , Liu Debiao , Yang Qun , Zhao Danyang , Liu Xiaoyu , Guo Weilong , Xin Mingming , Yao Yingyin , Peng Huiru , Xie Chaojie , Ni Zhongfu , Sun Qixin , Hu Zhaorong
Published: March 2024

Cold injury is a major environmental stress affecting the growth and yield of crops. Brassinosteroids (BRs) and salicylic acid (SA) play important roles in plant cold tolerance. However, whether or how BR signaling interacts with the SA signaling pathway in response to cold stress is still unknown. Here, we identified an SA methyltransferase, TaSAMT1 that converts SA to methyl SA (MeSA) and confers freezing tolerance in wheat (Triticum aestivum). TaSAMT1 overexpression greatly enhanced wheat freezing tolerance, with plants accumulating more MeSA and less SA, whereas Tasamt1 knockout lines were sensitive to freezing stress and accumulated less MeSA and more SA. Spraying plants with MeSA conferred freezing tolerance to Tasamt1 mutants, but SA did not. We revealed that BRASSINAZOLE-RESISTANT 1 (TaBZR1) directly binds to the TaSAMT1 promoter and induces its transcription. Moreover, TaBZR1 interacts with the histone acetyltransferase TaHAG1, which potentiates TaSAMT1 expression via increased histone acetylation and modulates the SA pathway during freezing stress. Additionally, overexpression of TaBZR1 or TaHAG1 altered TaSAMT1 expression and improved freezing tolerance. Our results demonstrate a key regulatory node that connects the BR and SA pathways in the plant cold stress response. The regulatory factors or genes identified could be effective targets for the genetic improvement of freezing tolerance in crops.
Auxin resistant 2 and short hypocotyl 2 regulate cotton fiber initiation and elongation
Authors: Jin Fei , Zhu Liping , Hou Liyong , Li Hongbin , Li Ling , Xiao Guanghui
Published: March 2024

Auxin, a pivotal regulator of diverse plant growth processes, remains central to development. The auxin-responsive genes auxin/indole-3-acetic acids (AUX/IAAs) are indispensable for auxin signal transduction, which is achieved through intricate interactions with auxin response factors (ARFs). Despite this, the potential of AUX/IAAs to govern the development of the most fundamental biological unit, the single cell, remains unclear. In this study, we harnessed cotton (Gossypium hirsutum) fiber, a classic model for plant single-cell investigation, to determine the complexities of AUX/IAAs. Our research identified 2 pivotal AUX/IAAs, auxin resistant 2 (GhAXR2) and short hypocotyl 2 (GhSHY2), which exhibit opposite control over fiber development. Notably, suppressing GhAXR2 reduced fiber elongation, while silencing GhSHY2 fostered enhanced fiber elongation. Investigating the mechanistic intricacies, we identified specific interactions between GhAXR2 and GhSHY2 with distinct ARFs. GhAXR2's interaction with GhARF6-1 and GhARF23-2 promoted fiber cell development through direct binding to the AuxRE cis-element in the constitutive triple response 1 promoter, resulting in transcriptional inhibition. In contrast, the interaction of GhSHY2 with GhARF7-1 and GhARF19-1 exerted a negative regulatory effect, inhibiting fiber cell growth by activating the transcription of xyloglucan endotransglucosylase/hydrolase 9 and cinnamate-4-hydroxylase. Thus, our study reveals the intricate regulatory networks surrounding GhAXR2 and GhSHY2, elucidating the complex interplay of multiple ARFs in AUX/IAA-mediated fiber cell growth. This work enhances our understanding of single-cell development and has potential implications for advancing plant growth strategies and agricultural enhancements.
Macrophages suppress cardiac reprogramming of fibroblasts in vivo via IFN-mediated intercellular self-stimulating circuit
Authors: Wang Hao , Yang Junbo , Cai Yihong , Zhao Yang
Published: March 2024

Direct conversion of cardiac fibroblasts (CFs) to cardiomyocytes (CMs) in vivo to regenerate heart tissue is an attractive approach. After myocardial infarction (MI), heart repair proceeds with an inflammation stage initiated by monocytes infiltration of the infarct zone establishing an immune microenvironment. However, whether and how the MI microenvironment influences the reprogramming of CFs remains unclear. Here, we found that in comparison with cardiac fibroblasts (CFs) cultured in vitro, CFs that transplanted into infarct region of MI mouse models resisted to cardiac reprogramming. RNA-seq analysis revealed upregulation of interferon (IFN) response genes in transplanted CFs, and subsequent inhibition of the IFN receptors increased reprogramming efficiency in vivo. Macrophage-secreted IFN-β was identified as the dominant upstream signaling factor after MI. CFs treated with macrophage-conditioned medium containing IFN-β displayed reduced reprogramming efficiency, while macrophage depletion or blocking the IFN signaling pathway after MI increased reprogramming efficiency in vivo. Co-IP, BiFC and Cut-tag assays showed that phosphorylated STAT1 downstream of IFN signaling in CFs could interact with the reprogramming factor GATA4 and inhibit the GATA4 chromatin occupancy in cardiac genes. Furthermore, upregulation of IFN-IFNAR-p-STAT1 signaling could stimulate CFs secretion of CCL2/7/12 chemokines, subsequently recruiting IFN-β-secreting macrophages. Together, these immune cells further activate STAT1 phosphorylation, enhancing CCL2/7/12 secretion and immune cell recruitment, ultimately forming a self-reinforcing positive feedback loop between CFs and macrophages via IFN-IFNAR-p-STAT1 that inhibits cardiac reprogramming in vivo. Cumulatively, our findings uncover an intercellular self-stimulating inflammatory circuit as a microenvironmental molecular barrier of in situ cardiac reprogramming that needs to be overcome for regenerative medicine applications.
A whale of a tale: whale cells evade the driving mechanism for hexavalent chromium-induced chromosome instability
Authors: Lu Haiyan , Toyoda Jennifer H , Wise Sandra S , Browning Cynthia L , Speer Rachel M , Croom-Pérez Tayler J , Bolt Alicia , Meaza Idoia , Wise John Pierce
Published: March 2024

Chromosome instability, a hallmark of lung cancer, is a driving mechanism for hexavalent chromium [Cr(VI)] carcinogenesis in humans. Cr(VI) induces structural and numerical chromosome instability in human lung cells by inducing DNA double-strand breaks and inhibiting homologous recombination repair and causing spindle assembly checkpoint (SAC) bypass and centrosome amplification. Great whales are long-lived species with long-term exposures to Cr(VI) and accumulate Cr in their tissue, but exhibit a low incidence of cancer. Data show Cr(VI) induces fewer chromosome aberrations in whale cells after acute Cr(VI) exposure suggesting whale cells can evade Cr(VI)-induced chromosome instability. However, it is unknown if whales can evade Cr(VI)-induced chromosome instability. Thus, we tested the hypothesis that whale cells resist Cr(VI)-induced loss of homologous recombination repair activity and increased SAC bypass and centrosome amplification. We found Cr(VI) induces similar amounts of DNA double-strand breaks after acute (24 h) and prolonged (120 h) exposures in whale lung cells, but does not inhibit homologous recombination repair, SAC bypass, or centrosome amplification, and does not induce chromosome instability. These data indicate whale lung cells resist Cr(VI)-induced chromosome instability, the major driver for Cr(VI) carcinogenesis at a cellular level, consistent with observations that whales are resistant to cancer.
Emissions from plastic incineration induce inflammation, oxidative stress, and impaired bioenergetics in primary human respiratory epithelial cells
Authors: Rogers Keith , WaMaina Elisa , Barber Andrew , Masood Syed , Love Charlotte , Kim Yong Ho , Gilmour M Ian , Jaspers Ilona
Published: March 2024

Inhalation exposure to plastic incineration emissions (PIEs) is a problem of increasing human relevance, as plastic production and waste creation have drastically increased since mainstream integration during the 20th century. We investigated the effects of PIEs on human nasal epithelial cells (HNECs) to understand if such exposures cause damage and dysfunction to respiratory epithelia. Primary HNECs from male and female donors were cultured at air–liquid interface (ALI), and 16HBE cells were cultured on coverslips. Smoke condensates were generated from incineration of plastic at flaming (640°C) and smoldering (500°C) temperatures, and cells were subsequently exposed to these materials at 5–50 μg/cm2 concentrations. HNECs were assessed for mitochondrial dysfunction and 16HBE cells for glutathione oxidation in real-time analyses. HNEC culture supernatants and total RNA were collected at 4-h postexposure for cytokine and gene expression analysis, and results show that PIEs can acutely induce inflammation, oxidative stress, and mitochondrial dysfunction in HNECs, and that incineration temperature modifies biological responses. Specifically, condensates from flaming and smoldering PIEs significantly increased HNEC secretion of cytokines IL-8, IL-1β, and IL-13, as well as expression of xenobiotic metabolism pathways and genes such as CYP1A1 and CYP1B1 at 5 and 20 μg/cm2 concentrations. Only 50 μg/cm2 flaming PIEs significantly increased glutathione oxidation in 16HBEs, and decreased respiration and ATP production in HNEC mitochondria. Impact Statement: Our data reveal the impact of incineration temperatures on biological outcomes associated with PIE exposures, emphasizing the importance of temperature as a factor when evaluating respiratory disease associated with PIEs exposure.
Repeated exposure to eucalyptus wood smoke alters pulmonary gene and metabolic profiles in male Long-Evans rats
Authors: Cochran Samuel J , Dunigan-Russell Katelyn , Hutton Grace M , Nguyen Helen , Schladweiler Mette C , Jones Dean P , Williams Wanda C , Fisher Anna A , Gilmour M Ian , Dye Janice A , Smith M Ryan , Miller Colette N , Gowdy Kymberly M
Published: March 2024

Exposure to wildfire smoke is associated with both acute and chronic cardiopulmonary illnesses, which are of special concern for wildland firefighters who experience repeated exposure to wood smoke. It is necessary to better understand the underlying pathophysiology by which wood smoke exposure increases pulmonary disease burdens in this population. We hypothesize that wood smoke exposure produces pulmonary dysfunction, lung inflammation, and gene expression profiles associated with future pulmonary complications. Male Long-Evans rats were intermittently exposed to smoldering eucalyptus wood smoke at 2 concentrations, low (11.0 ± 1.89 mg/m3) and high (23.7 ± 0.077 mg/m3), over a 2-week period. Whole-body plethysmography was measured intermittently throughout. Lung tissue and lavage fluid were collected 24 h after the final exposure for transcriptomics and metabolomics. Increasing smoke exposure upregulated neutrophils and select cytokines in the bronchoalveolar lavage fluid. In total, 3446 genes were differentially expressed in the lungs of rats in the high smoke exposure and only 1 gene in the low smoke exposure (Cd151). Genes altered in the high smoke group reflected changes to the Eukaryotic Initiation Factor 2 stress and oxidative stress responses, which mirrored metabolomics analyses. xMWAS-integrated analysis revealed that smoke exposure significantly altered pathways associated with oxidative stress, lung morphogenesis, and tumor proliferation pathways. These results indicate that intermittent, 2-week exposure to eucalyptus wood smoke leads to transcriptomic and metabolic changes in the lung that may predict future lung disease development. Collectively, these findings provide insight into cellular signaling pathways that may contribute to the chronic pulmonary conditions observed in wildland firefighters.
Towards enhanced control of mycetoma: a roadmap to achieve the UN's sustainable development goals by 2030
Authors: Fahal Ahmed , Smith Dallas J , Nyaoke Borna , Asiedu Kingsley , Falves Fabiana , Warusavithanas Supriya , Argaw Daniel , Hay Roderick
Published: March 2024

Mycetoma is a neglected tropical disease (NTD) with devastating morbidity and stigma. Despite increased awareness and international collaboration, the burden of mycetoma is largely unknown and diagnosis and treatment are difficult. Addressing mycetoma globally aligns with several United Nation's Sustainable Development Goals (SDGs). Little progress has been made since the WHO’s NTD roadmap publication in 2020. The Global Mycetoma Working Group proposes an enhanced mycetoma-control roadmap to meet the SDGs, stimulate progress and improve the lives of patients experiencing mycetoma. By aligning mycetoma management with the goals and targets of this enhanced roadmap, it becomes possible to leverage existing resources, infrastructure and partnerships to improve the lives of affected individuals and communities. This updated assessment is designed for the benefit of health workers and providers in mycetoma-endemic areas, NTD government officials, civil society and funding and implementing agencies.
A New ToxA Haplotype in the Wheat Fungal Pathogen Bipolaris sorokiniana
Authors: See Pao Theen , Iagallo Elyce M. , Marathamuthu Kalai A. , Wood Blake , Aboukhaddour Reem , Moffat Caroline S.
Published: March 2024

The necrotrophic effector ToxA is a well-studied virulence factor produced by several fungal necrotrophs. Initially cloned from the wheat tan spot pathogen Pyrenophora tritici-repentis in 1996, ToxA was found almost a decade later in another fungal pathogen, Parastagonospora nodorum, and its sister species, Parastagonospora pseudonodorum. In 2018, ToxA was detected in a third wheat fungal pathogenic species, Bipolaris sorokiniana, which causes spot blotch disease. However, unlike the case with P. tritici-repentis and P. nodorum, the ToxA in B. sorokiniana has only been investigated in recent years. In this report, five Australian B. sorokiniana isolates were assessed for the presence of ToxA. Four isolates were found to contain ToxA. While one isolate harbored the previously reported ToxA haplotype sequence ( ToxA19), three isolates contain a different haplotype, designated herein as ToxA25, which has a nonsynonymous mutation resulting in an amino acid change of glycine to arginine at position 168. Both B. sorokiniana ToxA isoforms, when heterologously expressed in Escherichia coli, exhibited the classic ToxA necrosis-inducing activity on ToxA-sensitive Tsn1 cultivars. Preliminary analysis of the B. sorokiniana isolates in Australian wheat cultivars showed that isolates with ToxA19, ToxA25, or ToxA-deficient displayed various degrees of virulence, with the most aggressive isolates observed for those producing ToxA. Differences in spot blotch disease severity between Tsn1 and tsn1 cultivars were observed; however, this was not limited to the ToxA-producing isolates. The overall results suggest that the virulence of the Australian B. sorokiniana isolates is diverse, with the significance of ToxA− Tsn1 interactions depending on individual isolates.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Robotic Assistance in Percutaneous Liver Ablation Therapies: A Systematic Review and Meta-Analysis
Authors: Uribe Rivera Ana K. , Seeliger Barbara , Goffin Laurent , García-Vázquez Alain , Mutter Didier , Giménez Mariano E.
Published: March 2024

Objective:

The aim of this systematic review and meta-analysis is to identify current robotic assistance systems for percutaneous liver ablations, compare approaches, and determine how to achieve standardization of procedural concepts for optimized ablation outcomes.

Background:

Image-guided surgical approaches are increasingly common. Assistance by navigation and robotic systems allows to optimize procedural accuracy, with the aim to consistently obtain adequate ablation volumes.

Methods:

Several databases (PubMed/MEDLINE, ProQuest, Science Direct, Research Rabbit, and IEEE Xplore) were systematically searched for robotic preclinical and clinical percutaneous liver ablation studies, and relevant original manuscripts were included according to the Preferred Reporting items for Systematic Reviews and Meta-Analyses guidelines. The endpoints were the type of device, insertion technique (freehand or robotic), planning, execution, and confirmation of the procedure. A meta-analysis was performed, including comparative studies of freehand and robotic techniques in terms of radiation dose, accuracy, and Euclidean error.

Results:

The inclusion criteria were met by 33/755 studies. There were 24 robotic devices reported for percutaneous liver surgery. The most used were the MAXIO robot (8/33; 24.2%), Zerobot, and AcuBot (each 2/33, 6.1%). The most common tracking system was optical (25/33, 75.8%). In the meta-analysis, the robotic approach was superior to the freehand technique in terms of individual radiation (0.5582, 95% confidence interval [CI] = 0.0167–1.0996, dose-length product range 79–2216 mGy.cm), accuracy (0.6260, 95% CI = 0.1423–1.1097), and Euclidean error (0.8189, 95% CI = –0.1020 to 1.7399).

Conclusions:

Robotic assistance in percutaneous ablation for liver tumors achieves superior results and reduces errors compared with manual applicator insertion. Standardization of concepts and reporting is necessary and suggested to facilitate the comparison of the different parameters used to measure liver ablation results. The increasing use of image-guided surgery has encouraged robotic assistance for percutaneous liver ablations. This systematic review analyzed 33 studies and identified 24 robotic devices, with optical tracking prevailing. The meta-analysis favored robotic assessment, showing increased accuracy and reduced errors compared with freehand technique, emphasizing the need for conceptual standardization.
Borderline Case in Reconstructive Plastic Surgery of the Lower Limb Treated with Bone Drilling and Use of Dermal Regeneration Template
Authors: Verdura Vincenzo , Cagiano Luigi , Molle Marcello , Bisceglia Pasquale , Fini Nicola , Annacontini Luigi , Mazzarella Vincenzo , Parisi Domenico , Portincasa Aurelio
Published: March 2024

The traumatic pathology of the lower limb represents a very complex branch of medicine, which, despite the wide presence of guidelines, aimed at regulating the various therapeutic procedures, and is still greatly influenced by random variables and by the multiple responses to treatments. In this report, we present our experience with a borderline case, where the timing of the trauma and the patient’s characteristics made it difficult to use the most recommended procedures in trauma management.
High reliability pediatric heart centers: Always working toward getting better
Authors: Torzone Andrea , Birely Alexandra
Published: March 2024

Purpose of review

The purpose of this review is to examine high reliability through the lens of a contemporary pediatric heart center, noting that continuous improvement, rather than perfection, should be embraced. Aiming to elevate topics with lesser attention, this review elaborates on key concepts and proposed considerations for maintaining a high reliability heart center.

Recent findings

As provision of care reaches a new complexity, programs are called upon to evaluate how they can bring their teams into the future of pediatric cardiac care. Although much has been written about high reliability in healthcare, it has not been explored within pediatric heart centers. Practical application of high reliability enables a shared mental model and aligns teams toward eliminating patient harm. Suggested facilitators of high reliability within heart center teams include interprofessional collaboration, recognition of nursing expertise, psychological safety, and structural empowerment void of hierarchy.

As the pediatric cardiac population evolves, care becomes more complex with a narrow margin of error. High reliability can guide continuous improvement. Acknowledging culture as the underpinning of all structure and processes allows teams to rebound from failure and supports the mission of rising to exceptional patient challenges.
Scleral fixation of the Smaller-Incision New-Generation Implantable Miniature Telescope (SING IMT ™) using GoreTex suture
Authors: Savastano Alfonso , Sammarco Leonardo Andrea , Francione Giuseppe , Sasso Paola , Rizzo Stanislao
Published: March 2024

Purpose:

In this case report we describe a surgical technique for scleral fixation of the Smaller-Incision New-Generation Implantable Miniature Telescope (SING-IMT). Using this surgical technique, patient’s eye which receive surgery for the SING-IMT, could still have a safe SING IMT implant despite the anatomical conditions of the capsular bag or in cases of intraoperative complications.

Methods:

The surgery was performed at Policlinico A. Gemelli, Rome, Italy. The patient’s eye underwent a first surgery for artificial intraocular lens (IOL) explant and SING-IMT implant at the same time. We observed SING IMT dislocation into the vitreous chamber 90 days after surgery. We therefore carried out a 23-gauge vitrectomy and after SING IMT recovery from the vitreous chamber, we fixed one of its haptic to the sclera using a 8.0 GoreTex suture.

Conclusion:

Scleral fixation of SING-IMT haptics might be useful in eyes with dislocated or not stable SING IMT. We believe that reporting our experience can help surgeons to fix SING IMT in complicated cases where a capsular bag rupture o disinsertion (like our case) can cause SING IMT decentration or worse its drop into the vitreous chamber. We speculate that GoreTex suture could assure firm fixation of the SING IMT and could reduce the risk of recurrent dislocations.
Predicting intraocular lens tilt using a machine learning concept
Authors: Waser Klemens , Honeder Andreas , Hirnschall Nino , Khalil Haidar , Pomberger Leon , Laubichler Peter , Mariacher Siegfried , Bolz Matthias
Published: March 2024

Purpose:

To use a combination of partial least squares regression and a machine learning approach to predict intraocular lens (IOL) tilt using preoperative biometry data.

Setting:

Kepler University Clinic Linz, Linz, Austria.

Design:

Prospective single-center study.

Methods:

Optical coherence tomography, autorefraction, and subjective refraction were performed at baseline and 8 weeks after cataract surgery. In analysis I, only 1 eye per patient was included and a tilt prediction model was generated. In analysis II, a pairwise comparison between right and left eyes was performed.

Results:

In analysis I, 50 eyes of 50 patients were analyzed. Difference in amount, orientation, and vector from preoperative to postoperative lens tilt was −0.13 degrees, 2.14 degrees, and 1.20 degrees, respectively. A high predictive power (variable importance for projection [VIP]) for postoperative tilt prediction was found for preoperative tilt (VIP = 2.2), pupil decentration (VIP = 1.5), lens thickness (VIP = 1.1), axial eye length (VIP = 0.9), and preoperative lens decentration (VIP = 0.8). These variables were applied to a machine learning algorithm resulting in an out of bag score of 0.92 degrees. In analysis II, 76 eyes of 38 patients were included. The difference of preoperative to postoperative IOL tilt of right and left eyes of the same individual was statistically relevant.

Conclusions:

Postoperative IOL tilt showed excellent predictability using preoperative biometry data and a combination of partial least squares regression and a machine learning algorithm. Preoperative lens tilt, pupil decentration, lens thickness, axial eye length, and preoperative lens decentration were found to be the most relevant parameters for this prediction model.
Serum 25-Hydroxyvitamin D Level Might Be a Useful Indicator of Disease Severity in Obese Children With Atopic Dermatitis: A Case-Control Study
Authors: Chen Jing-Jing , Fang Xiao-Kai , Liu Xiu-Mei , Liu Xiao-Chun , Yao Xu
Published: March 2024

Objective:

To assess the relationship between the severity of atopic dermatitis (AD) in children of varying weight categories and their serum 25-hydroxyvitamin D [25(OH)D] levels.

Methods:

The study population comprised 899 patients with AD and 854 age- and sex-matched controls. The Mann-Whitney U test and Kruskal-Wallis H tests were used to assess differences between groups, and Spearman correlation analysis was used to test correlation.

Results:

The 25(OH)D level in the AD group was M (Q
25, Q
75), 24.0 (19.7, 28.4) ng/mL, which was significantly lower than the control group (26.4 [23.6, 29.9] ng/mL; Z = −3.34, P = 0.001). 25(OH)D levels in children with AD were negatively correlated with body mass index (r = −0.30, P < 0.001), Severity scoring of Atopic Dermatitis (SCORAD; r = −0.14, P < 0.001), total immunoglobulin E (r = −0.13, P < 0.001), and eosinophil (r = −0.08, P = 0.017). There were statistically significant differences in 25(OH)D (H = 18.46, P < 0.001), total immunoglobulin E (H = 9.13, P = 0.010), eosinophil (H = 67.17, P < 0.001), and SCORAD (H = 10.49, P = 0.005) among groups with different body mass index classification. The 25(OH)D levels were 22.3 (17.5, 27.1) ng/mL in the overweight AD group and 22.3 (17.6, 25.7) ng/mL in the obese AD group, which were significantly lower than those in the normal-weight AD group (24.7 [20.4, 25.5] ng/mL; P = 0.003, P = 0.004). 25(OH)D levels were negatively correlated with SCORAD in obese AD patients (r = −0.25, P = 0.010).

Conclusion:

Vitamin D insufficient or deficient is obvious in children AD patients. The 25(OH)D levels in the overweight/obese AD group are significantly lower than those in the normal-weight AD group. Vitamin D level is negatively correlated with SCORAD in obese children with AD.
Active TriCROS: A Simultaneous Stimulation With a (Bi)CROS System and a Hearing Aid in the Worst Ear for Severely Asymmetrical Hearing Loss
Authors: Lefeuvre Jérome , Gargula Stéphane , Boulet Marc , Potier Morgan , Ayache Denis , Daval Mary
Published: March 2024

Objective

Severely asymmetrical hearing loss (SAHL) is characterized by a moderately severe or severe hearing loss in one side and normal or mildly impaired controlateral hearing in the other. The Active tri-CROS combines the Contralateral Routing-of-Signal System (CROS, or BiCROS if the best ear is stimulated) and the stimulation of the worst ear by an in-the-canal hearing aid. This study aims to evaluate the benefit of the Active tri-CROS for SAHL patients.

Study Design

This retrospective study was conducted from September 2019 to December 2020.

Setting

Ambulatory, tertiary care.

Patients

Patients were retrospectively included if they had received the Active tri-CROS system after having used a CROS or BiCROS system for SAHL for at least 3 years.

Main outcome measures

Audiometric gain, signal-to-noise ratio, spatial localization, and the Abbreviated Profile of Hearing Aid Benefit and Tinnitus Handicap Inventory questionnaires were performed before equipment and after a month with the system.

Results

Twenty patients (mean, 62 yr old) with a mean of 74.3 ± 8.7 dB HL on the worst ear were included. The mean tonal hearing gain on the worst ear was 20 ± 6 dB. Signal-to-noise ratio significantly rose from 1.43 ± 3.9 to 0.16 ± 3.4 dB (p = 0.0001). Spatial localization was not significantly improved. The mean Tinnitus Handicap Inventory test score of the eight patients suffering from tinnitus rose from 45.5 ± 18.5 to 31 ± 25.2 (p = 0.016).

Conclusions

The Active tri-CROS system is a promising new therapeutically solution for SAHL.
Microdrill Versus Diode Laser in Endoscopic Stapedotomy: A Comparative Study
Authors: Wang Dan , Peng Fan , Lin Nina , Wang Wuqing
Published: March 2024

Background

Microdrill and diode laser are two different methods used in endoscopic stapedotomy for otosclerosis. These two methods have not been compared in endoscopic stapedotomy.

Aims/Objectives

To analyze the differences between microdrill and diode laser in endoscopic stapedotomy for otosclerosis.

Materials and Methods

This is a randomized clinical trial; patients with otosclerosis were randomly divided into microdrill group (group A: n = 69) and diode laser group (group B: n = 62). Differences between the two groups were then compared.

Results

The preoperative air–bone gap (ABG) was 25.40 ± 10.88 dBHL in group A and 24.84 ± 12.23 dBHL in group B, with no significant between-group difference (p > 0.05). The postoperative ABG in group A was 13.27 ± 9.91 dBHL versus 11.79 ± 10.82 dBHL in group B, and there was no significant difference between the groups (p > 0.05). The surgical time in group B (64 ± 31.23 minutes) was significantly longer than that in group A (48 ± 25.62 minutes) (p = 0.02). There were no significant between-group differences in basic patient-related data, preoperative air conduction (AC), preoperative bone conduction (BC), postoperative AC, distribution of postoperative ABG, preoperative ABG at different frequencies, and postoperative ABG at different frequencies. There was also no significant between-group difference in the average bleeding volume or number of patients with postoperative dizziness.

Conclusion and Significance

The postoperative improvement in hearing level in the two group was equivalent, but group A had the advantage of a shorter operation time.

Level of evidence

4
Intraoperative Use of Intra-Aortic Balloon Pump to Generate Pulsatile Flow During Heart Transplantation: A Single-Center Experience
Authors: James Les , Dorsey Michael P. , Kilmarx Sumner E. , Yassin Sallie , Shrivastava Shashwat , Menghani Neil , Bajaj Vikram , Grossi Eugene A. , Galloway Aubrey C. , Moazami Nader , Smith Deane E.
Published: March 2024

The physiologic impact of pulsatile flow (PF) on end-organ perfusion during cardiopulmonary bypass (CPB) is controversial. Using an intra-aortic balloon pump (IABP) to maintain PF during CPB for patients undergoing heart transplantation (HT) may impact end-organ perfusion, with implications for postoperative outcomes. A single-center retrospective study of 76 patients bridged to HT with IABP was conducted between January 2018 and December 2022. Beginning in May 2022, patients received IABP-generated PF during CPB at an internal rate of 80 beats/minute. Fifty-eight patients underwent HT with the IABP turned off (IABP-Off), whereas 18 patients underwent HT with IABP-generated PF (IABP-On). The unmatched IABP-On group experienced shorter organ ischemia times (180 vs. 203 minutes, p = 0.015) and CPB times (104 vs. 116 minutes, p = 0.022). The cohort was propensity matched according to age, organ ischemia time, and CPB time. Elevations in postoperative lactates in the immediate (2.8 vs. 1.5, p = 0.062) and 24 hour (4.7 vs. 2.4, p = 0.084) postoperative periods trended toward significance in the matched IABP-Off group. There was no difference in postoperative vasoactive inotropic score (VIS), postoperative creatinine, or length of stay. This limited preliminary data suggest that maintaining counterpulsation to generate PF during CPB may improve end-organ perfusion in this patient population as suggested by lower postoperative lactate levels.
Differences in Plasma Fatty Acid Composition Related to Chronic Pancreatitis
Authors: Gumpper-Fedus Kristyn , Crowe Olivia , Hart Phil A. , Pita-Grisanti Valentina , Velez-Bonet Ericka , Belury Martha A. , L. Ramsey Mitchell , Cole Rachel M. , Badi Niharika , Culp Stacey , Hinton Alice , F. Lara Luis , Krishna Somashekar G. , Conwell Darwin L. , Cruz-Monserrate Zobeida
Published: March 2024

Objectives

Chronic pancreatitis (CP) is an inflammatory disease affecting the absorption of fat-soluble nutrients. Signaling in pancreatic cells that lead to inflammation may be influenced by fatty acids (FAs) through diet and de novo lipogenesis. Here, we investigated the relationship between plasma FA composition in CP with heterogeneity of etiology and complications of CP.

Materials and Methods

Blood and clinical parameters were collected from subjects with CP (n = 47) and controls (n = 22). Plasma was analyzed for FA composition using gas chromatography and compared between controls and CP and within CP.

Results

Palmitic acid increased, and linoleic acid decreased in CP compared with controls. Correlations between age or body mass index and FAs are altered in CP compared with controls. Diabetes, pancreatic calcifications, and substance usage, but not exocrine pancreatic dysfunction, were associated with differences in oleic acid and linoleic acid relative abundance in CP. De novo lipogenesis index was increased in the plasma of subjects with CP compared with controls and in calcific CP compared with noncalcific CP.

Conclusions

Fatty acids that are markers of de novo lipogenesis and linoleic acid are dysregulated in CP depending on the etiology or complication. These results enhance our understanding of CP and highlight potential pathways targeting FAs for treating CP.
Multicenter Prospective Cohort Study of Neoadjuvant Chemotherapy for Borderline Resectable Pancreatic Cancer (YPB-001)
Authors: Matsui Hiroto , Ioka Tatsuya , Takahashi Tsuyoshi , Kawaoka Toru , Maeda Yoshinari , Yahara Noboru , Kubo Hidefumi , Nishimura Taku , Inokuchi Toshihiro , Harada Eijiro , Shindo Yoshitaro , Tokumitsu Yukio , Nakajima Masao , Takami Taro , Ito Katsuyoshi , Tanaka Hidekazu , Hamano Kimikazu , Nagano Hiroaki
Published: March 2024

Objectives

The present multicenter prospective observational study investigated the effectiveness and safety of neoadjuvant chemotherapy (NAC) for patients with borderline resectable pancreatic cancer (BRPC) and those with RPC contacting major vessels, with respect to a historical control of upfront surgery.

Materials and Methods

Patients with BRPC and RPC contacting major vessels were prospectively registered and administered NAC with durations and regimens determined by the corresponding treating physician. Our primary aim was to assess the R0 resection rate, and secondary aim was to evaluate safety, resection rate, time to treatment failure, overall survival, and response rate.

Results

Fifty of 52 enrolled patients were analyzed; 2 with serious comorbidities died during treatment. Thirty-one patients underwent resection, with R0 resection being achieved in 26 (52% of total and 84% of all resected cases). Univariate and multivariate analyses indicated age (≥75 years) as the only independent predictor of nonresection. Median progression-free survival and median survival time were longer in the prospective cohort than in the historical cohort.

Conclusions

Overall, NAC for BRPC in real-world setting might yield R0 resection rates similar to those reported in previous clinical studies. Development of safe regimens and management strategies that can maintain treatment intensity in geriatric patients is warranted.
A Nurse Practitioner–Driven Palliative and Supportive Care Service in Nursing Homes
Authors: Carpenter Joan G. , Murthi Julianne , Langford Molly , Lopez Ruth Palan
Published: March 2024

This article describes a quality improvement project implemented by a national postacute long-term care organization aimed at enhancing the provision of palliative care to nursing home residents. The project focused on improving advance care planning, end-of-life care, symptom management, and care of people living with serious illness. Both generalist and specialist palliative care training were provided to nurse practitioners in addition to implementing a system to identify residents most likely to benefit from a palliative approach to care. To evaluate the nurse practitioner experiences of the program, survey data were collected from nurse practitioners (N = 7) involved in the project at 5 months after implementation. Nurse practitioners reported the program was well received by nursing home staff, families, and residents. Most nurse practitioners felt more confident managing residents' symptoms and complex care needs; however, some reported needing additional resources for palliative care delivery. Most common symptoms that were managed included pain, delirium, and dyspnea; most common diagnoses cared for were dementia and chronic organ failure (eg, cardiac, lung, renal, and neurological diseases). In the next steps, the project will be expanded throughout the organization, and person- and family-centered outcomes will be evaluated.
Orthopaedic Nurse Navigators and Total Joint Arthroplasty Preoperative Optimization
Authors: Kebeh Martha , Dlott Chloe C. , Kurek Donna , Morris Jensa C. , Wiznia Daniel H.
Published: March 2024

Obesity and malnutrition affect many patients with osteoarthritis and can predispose patients to worse outcomes after total joint arthroplasty (TJA). However, these modifiable risk factors can be addressed in preoperative optimization programs driven by nurse navigators. Our aim is to provide resources and recommendations for nurse navigators when addressing obesity and malnutrition among TJA patients. In addition to discussions with nurse navigators regarding obesity and malnutrition, a literature review was conducted to assess the current practice standards for management. Nurse navigators often had difficulty implementing long-term interventions, but interventions in the literature included medical and bariatric treatments for obesity and more targeted assessment of nutrition status. These findings are incorporated into our recommendations for nurse navigators. Addressing obesity and malnutrition in preoperative optimization can contribute to improved outcomes, as has been demonstrated in current practice and in the literature.
Navigating the Litigation Experience
Authors: Kosar Caitlin M. , Cleveland Kimberly
Published: March 2024

Healthcare is a highly regulated industry whose practitioners are responsible for adhering to laws, regulations, policies, and standards of care. When poor outcomes occur, a malpractice case can arise, thus beginning the litigation process. Because nurses are leaders in the delivery of care, they may become involved in legal claims. The purpose of this article is to provide information, as a foundation for nurses who are unfamiliar with navigating the litigation process in a legal claim, and to help nurses build confidence in the process. An overview of the litigation process, nursing licensure, and essential legal terms is provided. A case scenario is introduced that addresses the role of a nurse in an orthopaedic medical malpractice case.