bluuebunny/crossref_metadata_2025 huggingface dataset:
777 Improving Parent Communication With Family Rounds In The Pediatric Critical Care Unit (PICU)
Authors: Arredondo Olivia , Day Mary , Martens Sally A , Romanowski Kathleen S , Sen Soman , Palmieri Tina L , Greenhalgh David G
Published: March 2022

Introduction

Effective communication between pediatric burn patients, their family members and the health care team is crucial to developing a "working alliance" and improving their overall experience in the Pediatric Intensive Care Unit (PICU). The aim of the project is to standardize and improve patient and parent communication through the implementation of weekly inter-disciplinary family rounds.

Methods

Our nursing team developed the innovate PICU survey which is a 9 question Likert scale survey that evaluates patient and family satisfaction. All pediatric patients being discharged or transferred from the PICU received the PICU survey. After reviewing baseline data, communication between patient/parents and the health care team was identified as a potential targeted area for improving satisfaction scores. Aimed at improving communication, we established weekly inter-disciplinary family rounds. Each family was designated a specific day of the week for inter-disciplinary family rounds and staff provided families with a pre-printed standardized flyer explaining the process and were encouraged to write down questions for discussion. Survey scores from burn patients who received inter-disciplinary family rounds were compared to baseline scores, as well as to the scores of other pediatric patients of services that do not utilize family rounds.

Results

Prior to implementing family rounds, our PICU survey average score was 4.9/5 out of 6 surveys. After implementing inter-disciplinary family rounds, our average score for pediatric burn patients was 4.9/5 out of 10 surveys. The average scores of pediatric patients of services that did not utilize family rounds 4.7/5 out of 19 surveys.

Conclusions

Scheduled inter-disciplinary family rounds can improve communication and over patient care satisfaction in pediatric patients with complex critical care issues related to burn injuries. Scheduled family rounds may also be beneficial for other non-burn pediatric ICU patients.
783 Use of Multidisciplinary Collaboration to Establish a Standardized Endotracheal Tube Wiring Guideline
Authors: Shostrand Lisa M , Hartman Brett C , Zieger Madeline , Ealy Aimee , Meadors Diana M
Published: March 2022

Introduction

Pediatric patients with facial burns and advanced airway needs precipitate acute situations requiring multidisciplinary team member collaboration. Significant facial burns, particularly involving considerable edema or smoke inhalation, may warrant dental or circum-mandibular endotracheal tube (ETT) wiring for stabilization. Guidelines were created, trialed, and revised based on patient outcomes and clinician feedback at a pediatric verified burn center.

Methods

The guideline was created by the burn team in 2019. This standard work was utilized with pediatric burn cases presenting to the burn center. Guideline variances, such as prolonged time from door to ETT wiring, prompted a gap analysis need to improve the process. Through two case review sessions held in 2020, a multidisciplinary team consisting of the burn providers, emergency department providers, nursing, and respiratory therapists revealed process knowledge deficits, unclear role expectations, and supply issues. Literature was reviewed and a myAmeriburn listserv inquiry of current practice was made to seek additional guidance.

Results

Based on feedback from the multidisciplinary group and data gathered from the literature and collegial burn community, action plans and guideline modifications were developed in 2021. The respiratory therapy department developed education for their staff highlighting use of twill tape and taping. The use of ETT suturing was removed from the guidelines.

Conclusions

Multidisciplinary contribution and engagement was necessary to produce, execute, and evaluate the pediatric endotracheal tube wiring guidelines. Through dialogue, patient trial, and constructive feedback, guidelines were amended to produce a smoother team process and better patient experience. The standard work is currently being evaluated in its modified version.
784 A Burn Resting Hand Orthosis Fit Checklist
Authors: Warthman Renee , Martinez Andria , Murray Derek , Richey Karen , Foster Kevin N
Published: March 2022

Introduction

Resting hand orthoses (RHO) are often used to manage hand burns but can be difficult for inexperienced clinicians to fabricate, assess, and utilize without causing complications to the patient. Previously we had shared data on how we reduced RHO related complications by utilizing burn and hand certified staff to fabricate RHOs.

Methods

Advanced clinicians certified in either hand, burn, or both were queried to describe the methodology they utilized to fabricate an effective RHO. From this query, a list of conditions was created. These conditions were presented to the entire group of certified clinicians and re-examined. Conditions were recorded if consensus was reached on their inclusion for a guide to fabricate a successful RHO.

Results

A 14-condition checklist, with 8 essential items, was developed. It is intended that this checklist can be utilized by less experienced clinicians to guide safe and effective RHO management.

Conclusions

The checklist is a straightforward way to assess commonly identified issues with RHO and offers a potential resource to manage effective fabrication for novice or inexperienced clinicians.
785 Assessing The Kinematics Of Virtual Reality Gaming As Physical Therapy In Burn Patients
Authors: Qiu Cecil S , Vocke Scott , Rodriguez Joshua , Roemmich Ryan , Andre Gregory , Dean Brooke , Caffrey Julie
Published: March 2022

Introduction

Virtual reality (VR) gaming offers an immersive experience that can enrich physical therapy for the burn patient by introducing variability, enjoyment, and reward during functional motions of the upper extremities. In this study, we aim to support a proof-of-concept for VR gaming in upper extremity burn rehabilitation by characterizing shoulder and elbow kinematics during VR gaming in a healthy volunteer.

Methods

A healthy volunteer without burn injuries played two games, a virtual rhythmic baton and virtual boxing game, on a commercially available VR gaming platform. Kinematics during play were assessed using two external cameras placed orthogonally, to the player’s front and left, so that 3-dimensional motion of the player’s left arm could be captured. Video of each gaming session was processed using an open-source perceptual computing software that dynamically tracks the user’s upper extremity during play. Kinematics at the left shoulder and elbow were characterized with respect to range of motion (ROM) and time spent in composite positions.

Results

During the rhythmic baton game, the player achieved 157 degrees of elbow flexion ROM and 90 degrees shoulder elevation ROM. During the boxing game, the player achieved 156 degrees of elbow flexion ROM and 123 degrees shoulder elevation ROM. The baton game was associated with more time spent in the “rest” position (elbow extended with shoulder adducted, 60% of the game) while boxing was associated with more time in the “Guard” position (elbow flexed with shoulder elevated, 79% of the game) (Figure 1). Both games demonstrated simultaneous movement at both the shoulder and elbow during play.

Conclusions

The two VR games investigated in this kinematic assessment challenged players to achieve a wide range of motion at the upper extremity with functional, multi-joint movements. These findings support a potential role for commercial VR gaming in burn rehabilitation and future research in burn patients is required to demonstrate its therapeutic value.
792 Exoskeleton Robot Using 3-Dimensional Modeling in Burn Patient
Authors: Seo Cheong Hoon , Joo So Young
Published: March 2022

Introduction

Hands are the part of the body that are most commonly involved in burns, and the main complications are finger joint contractures and nerve injuries. Hypertrophic scarring cannot be avoided despite early management of acute hand burn injuries, and some patients may need application of an exoskeleton robot to restore hand function. To do this, it is essential to individualize the customization of the robot for each patient. Three-dimensional (3D) technology, which is widely used in the field of implants, anatomical models, and tissue fabrication, makes this goal achievable.

Methods

Therefore, this report is a study on the usefulness of an exoskeleton robot using 3D technology for patients who lost bilateral hand function due to burn injury. Five burn patients with upper limb dysfunction after a flame and chemical burn injury, with resultant impairment of manual physical abilities.

Results

After wearing an exoskeleton robot made using 3D printing technology, the patients could handle objects effectively and satisfactorily.

Conclusions

This innovative approach provided considerable advantages in terms of customization of size and reduction in manufacturing time and costs, thereby showing great potential for use in patients with hand dysfunction after burn injury.
802 A retrospective study: rapid removal of biofilm and necrosis with a hygroscopic chemical debriding compound
Authors: Hermans Michel H
Published: March 2022

Introduction

Removing necrosis and biofilm is an essential step in the treatment of all lesions. A new debriding compound (TDA) uses a hygroscopic mechanism to reach this goal: when in contact with biofilm and necrosis this causes desiccation, with subsequent dissolution of these compounds.

Methods

In a retrospective proof-of-principle study the results of a one-time application of TDA in 54 serious foot and leg lesions, mainly diabetic and venous ulcers, were analyzed.

Results

Outcomes were positive: at study end: 50 out of 54 lesions (92.5%) showed complete granulation and in 40 out of 54 lesions (74.0%) complete reepithelialization was reached.

TDA efficacy is represented by three cases. In the first one, an 83-year-old diabetic female with sever peripheral arterial disease and status post-toes-amputation suffered from a gangrenous lesion of the left foot. A second case involved a 77-year-old female who had a non-healing, post-trauma lesion over the Achilles tendon, and the last case entails an 81-year-old male with a non-healing lesion on the left lower leg. All patients showed very rapid debridement and subsequent healing and reepithelialization

Conclusions

Typically, diabetic, and venous ulcers require repeated debridement and treatment of the biofilm is notoriously difficult. It also takes a long time before the woundbed is healthy enough to start to granulate and, subsequently, epithelialize. The results, obtained in this study, indicate that a one-time application of TDA is highly effective for “jumpstarting” wound healing.
804 Catastrophic Burn Management: A case series using autologous skin cell suspension
Authors: Deeter Lyndsay
Published: March 2022

Introduction

Catastrophic thermal injury treatment is complex due to the lack of autologous donor site, which is imperative for permanent wound closure. Historically, our burn unit has relied on application of cultured epithelial autografts for wound closure in this patient population. Lab grown skin requires a significant time investment. Therefore, in our most recent subset of large burn injuries, we have transitioned to the use of autologous skin cell suspension over widely meshed autograft utilization almost exclusively.

Methods

A case series of four thermally injured patients with injuries greater than 75% TBSA was reviewed. Patient length of stay, operative interventions, skin coverage, mortality and cost were examined.

Results

Burn size ranged from 75-85% TBSA in four patients. Early excision was implemented for all four patients in the case study. One of the four patients was treated with a combination of lab grown skin and autologous skin cell suspension. The three other patients were treated exclusively with autologous skin cell suspension for wound coverage. All patients underwent widely meshed autograft with the autologous cell suspension for wound coverage. All four patients survived to discharge and their initial follow up. Cost of operative interventions were less expensive for autologous skin cell suspension than for cultured epithelial autografts. Length of stay varied from 66-179 days. Discharge location varied from acute rehabilitation, to a homeless shelter, to another burn facility with inpatient psychiatric services.

Conclusions

Autologous skin cell suspension is a safe and efficient treatment modality to obtain permanent wound closure in catastrophic thermal injuries.
808 Combination of Adipose Micro Fragments and Liquid Scaffold Improve Wound Healing Outcomes
Authors: Sheikh-Oleslami Sara , Hassanpour Ida , Amiri Nafise , Jalili Reza B , Kilani Ruhangiz Taghi , Ghahary Aziz
Published: March 2022

Introduction

In full-thickness wounds, high levels of inflammation, lack of matrix deposition and paucity of progenitor cells delays normal healing processes. One major problem with commercially available solid (sheet) scaffolds is their inability to conform to wounds of varying shapes and sizes. To overcome this, we previously generated a liquid, injectable skin substitute which can fill wounds of any shape and depth from bottom up and has all the necessary ingredients for skin cells to be nourished, proliferate, and migrate in. In combination with adipose micro fragments as a viable source of progenitor cells, a composite, in situ forming skin substitute was tested for treatment of silicon ring splinted wounds in rats.

Methods

The in vitro survival and migratory capacity of adipocytes derived from rat micro-fragmented fat when cultured in our 3D nutritional scaffold was examined with a Live/Dead assay. The efficacy of our combined liquid scaffold alone (MF) or with adipose micro fragments (MFA) in treating full thickness splinted wounds in rats was compared to a standard dressing protocol (NT). The healing process was monitored for 10 days. Following wound measurements, histological and immunofluorescent analyses were performed and compared.

Results

Adipose-derived cells migrated within the 3D nutritional liquid scaffold after 7 and 14 days. The number of red (dead) cells was negligent, indicating cell viability. In vivo, both MFA and MF showed both accelerated and ameliorated wound healing, including complete epithelialization and less immune cell infiltration, compared to the NT control. No significant differences were observed between the MF and MFA groups for any outcome.

Conclusions

Our findings show that a 3D nutritional liquid skin scaffold is a rich environment for adipocyte viability and migration and that addition of adipose micro fragments to this scaffold can be used as a rich source of cells.
813 Histologic Changes of Skin Biopsies After Autologous Skin Cell Suspension
Authors: Lennard Shana , Carter Jeffrey E , Kopari Nicole M , Cook Michael , Paige John , Hodgdon Ian , Phelan Herb A , Hickerson William L
Published: March 2022

Introduction

Over 10,000 cases of autologous skin cell suspension have been performed around the world for the treatment of burn and soft tissue injuries. A key component of the procedure is the harvest of skin biopsies which are exposed to enzymatic degradation. In some regions, epidermal graft harvest has been attempted manually without enzymatic degradation. Our study goal was to examine the histologic changes of the skin biopsies in manual versus enzymatic degradation.

Methods

Our study was an IRB-approved, prospective controlled analysis of residual skin harvested from 10 patients undergoing hernia repair. Two specimens from each patient were procured intraoperatively with each measuring 2x3cm. Each specimen produced two 4mm punch biopsies from three regions (control, mechanical, and enzymatic) for a total of 12 specimens per patient. Enzymatic specimens were prepared using the Avita Medical ReCell® system per manufacture instructions for use. Mechanical specimens were prepared using an abrasive pad until epidermis was macroscopically removed. Histologic analysis was performed with hematoxylin and eosin stain and whole slide scanning. Two or more investigators reviewed each biopsy concurrently with consensus agreement on the remaining epidermis and evidence of degraded reticular dermis. Descriptive statistics were used to assess the variances in the three groups.

Results

The mean residual epidermis was 9% in the enzymatic group, 35% in the mechanical, and 98% in the control. Epidermal harvest was higher in the enzymatic group relative to the mechanical group (two tailed t-test = 0.0008). Reticular dermis was degraded in 10% of the mechanical specimens and none of the enzymatic specimens.

Conclusions

Epidermal harvest was more consistent in the enzymatic group with less trauma to the dermis. Our study suggest that mechanical harvest requires larger donor sites given the decreased epidermal harvest. Further research is needed to determine impact of cell isolation technique on autograft cell suspension viability and distribution of cell types harvested.
Missing Masters: Causes, Consequences and Corrections for States’ Disengagement from the Investment Treaty System
Authors: Mehranvar Ladan , Johnson Lise
Published: March 2022

Proponents of the international investment law system have treated the concept of depoliticization as a key justification of the investor–state arbitration mechanism. However, this rationale has been increasingly questioned. The system is itself a reflection of the asymmetrical power relations that exist among various actors. We examine data on states’ exercise of their interpretive powers through unilateral interpretations, as a potential means of shifting power away from capital, and identify the factors that may make such engagement more or less likely. What emerges is the asymmetrical patterns of engagement and influence in shaping the law, tilting the balance not just away from states generally, but from Global South states in particular. We propose various reforms that seek to recognize and address the enduring role of politics in the system, produce more just outcomes, and be more inclusive of all state parties in the development of international investment law.
Numerical study of hydrodynamic herringbone-grooved journal bearings combined with thrust bearings considering thermal effects
Authors: Wang Chin-Cheng , Lin Jyun-Ting
Published: March 2022

Hydrodynamic herringbone-grooved journal bearings (HGJBs) are analyzed by solving Navier–Stokes and energy equations. It is well known that the load capacity of hydrodynamic bearings may be affected by high temperatures and low oil viscosity. Therefore, the main objective of this study is to understand the pressure distribution of hydrodynamic HGJBs under different oil viscosity and eccentricity ratios. In this paper, 3 different configurations are studied, namely, a HGJB, a combined HGJB and thrust bearing, and a combined HGJB and grooved thrust bearing. The bearing characteristics, such as load capacity and attitude angle that vary with different eccentricity ratios, are also discussed. The results show that the load capacity of the bearing decreases with increasing temperature. The pressure difference also increases as the eccentricity ratio increases. The high-pressure region is concentrated at the tip of the groove for the HGJB. In addition, the combined HGJB and grooved thrust bearing can be used to stabilize the journal because of the low attitude angle. These findings may help and facilitate the design of hydrodynamic bearings suitable for working in warm and hot environments in the future.
Pancreatic rest disguised as inflammatory bowel disease in young adult
Authors: Curfman Karleigh , Linders Megan , Poola Ashwini , O’Bryant Larry , Rashidi Laila
Published: March 2022

Pancreatic rest, otherwise known as aberrant, ectopic or heterotopic pancreas, occurs when the pancreatic tissue does not have an anatomical or vascular connection to the normal body of the pancreas. This rare congenital anomaly was first described in 1727 by Hunt and Bonesteel, and it is now known to be found predominantly within the stomach or proximal small bowel. Most of the time, pancreatic rest is asymptomatic and is found incidentally. When symptomatic, the most common presentations tend to be: abdominal pain, nausea, gastrointestinal bleeding, obstruction and symptoms of pancreatitis. We report a case of a 21-year-old female with symptomatic pancreatic rest noted in two locations: antrum of the stomach and the proximal jejunum just distal to the ligament of Treitz.
Traumatic diaphragmatic injury along with ruptured gastrothorax: case report
Authors: Hordiychuk Andriy , Elston Timothy
Published: March 2022

Accidental fall was the 11th leading cause of death in Australia in 2020. It is essential to promptly diagnose traumatic diaphragmatic injury as a complication of thoracoabdominal blunt trauma and make a decision about an urgent surgical intervention, especially if there is a suspected herniation of internal organs into the thoracic cavity. This case report describes the clinical, intraoperative and computed tomography findings of traumatic diaphragmatic injury and ruptured gastrothorax.
Large bowel obstruction caused by a colonic polyp
Authors: Ishimaru Naoki , Fujikawa Hirohisa , Kobayashi Yoshifumi
Published: March 2022

A large bowel obstruction (LBO) is an emergency condition that requires early diagnosis and prompt treatment, and it is also crucial to identify the cause of the obstruction. Here, we describe a 76-year-old woman who presented to the hospital with a 1-day history of abdominal pain and vomiting and was diagnosed with LBO. Endoscopic findings showed that the cause of the LBO was initially determined to be a Bormann Type I tumour in the sigmoid colon. However, the surgery was performed later; the pathological findings led to the diagnosis of colonic obstruction caused by a colonic polyp in the sigmoid colon narrowed by chronic diverticulitis. Colonic polyps rarely cause LBO. Poor observation due to colonic stenosis can mask the morphology of the lesion. In cases of LBO, colonic polyps should be differentially diagnosed in addition to colon cancer.
The antimicrobial resistance travel tool, an interactive evidence-based educational tool to limit antimicrobial resistance spread
Authors: Arieti Fabiana , Savoldi Alessia , Rejendran Nithya Babu , Sibani Marcella , Tebon Maela , Pezzani Maria Diletta , Gorska Anna , Wozniak Teresa M , Tacconelli Evelina
Published: March 2022

Background

International travel has been recognized as a risk factor contributing to the spread of antimicrobial resistance (AMR). However, tools focused on AMR in the context of international travel and designed to guide decision-making are limited. We aimed at developing an evidence-based educational tool targeting both healthcare professionals (HCPs) and international travellers to help prevent the spread of AMR.

Methods

A literature review on 12 antimicrobial-resistant bacteria (ARB) listed as critical and high tiers in the WHO Pathogen Priority List covering four key areas was carried out: AMR surveillance data; epidemiological studies reporting ARB prevalence data on carriage in returning travellers; guidance documents reporting indications on screening for ARB in returning travellers and recommendations for ARB prevention for the public. The evidence, catalogued at country-level, provided the content for a series of visualizations that allow assessment of the risk of AMR acquisition through travel.

Results

Up to January 2021, the database includes data on: (i) AMR surveillance for 2.018.241 isolates from 86 countries; (ii) ARB prevalence of carriage from 11.679 international travellers and (iii) 15 guidance documents published by major public health agencies. The evidence allowed the development of a consultation scheme for the evaluation of risk factors, prevalence of carriage, proportion and recommendations for screening of AMR. For the public, pre-travel practical measures to minimize the risk of transmission were framed.

Conclusions

This easy-to-use, annually updated, freely accessible AMR travel tool (https://epi-net.eu/travel-tool/overview/), is the first of its kind to be developed. For HCPs, it can provide a valuable resource for teaching and a repository that facilitates a stepwise assessment of the risk of AMR spread and strengthen implementation of optimized infection control measures. Similarly, for travellers, the tool has the potential to raise awareness of AMR and outlines preventive measures that reduce the risk of AMR acquisition and spread.
Accretion regions of meteorite parent bodies inferred from a two-endmember isotopic mixing model
Authors: Shuai Kang , Hui Hejiu , Zhou Liyong , Li Weiqiang
Published: March 2022

The diverse isotopic anomalies of meteorites demonstrate that the protoplanetary disc was composed of components from different stellar sources, which mixed in the disc and formed the planetary bodies. However, the origin of the accretion materials of different planetary bodies and the cosmochemical relationship between these bodies remain ambiguous. The noncarbonaceous (NC) planetary bodies originate from the inner solar system and have isotopic compositions distinct from those of the carbonaceous (CC) bodies. We combined Ca, Ti, Cr, Fe, Ni, Mo, and Ru isotopic anomalies to develop a quantitative two-endmember mixing model of the NC bodies. Correlations of the isotopic anomalies of different elements with different cosmochemical behaviors originate from the mixing of two common endmembers. Using this mixing model, we calculated the isotopic anomalies of NC bodies for all the considered isotopes, including the isotopic anomalies that are difficult to measure or have been altered by spallation processes. The mixing proportion between the two endmembers in each NC body has been calculated as a cosmochemical parameter, which represents the compositional relationship of the accretion materials between the NC bodies. Using the calculated mixing proportions, the feeding zones of the NC bodies could be estimated. The estimated feeding zones of NC bodies indicate a large population of interlopers in the main asteroid belt and an indigenous origin of Vesta. The feeding zones estimated in different planet formation scenarios indicate that the orbits of Jupiter and Saturn during formation of terrestrial planets were likely to be more circular than their current ones.
Survey of Current Financial Needs of Undergraduate Music Therapy Students
Authors: Thorn Austin C , Iwamasa Dawn A , Gooding Lori F
Published: March 2022

Students attending college rely on a variety of social and financial resources to cover the personal and academic costs of higher education. The most common tool for students is financial aid, which may include loans, needs-based grants, and work–study. Federal financial aid is designed to increase accessibility for individuals to pursue a college degree and is generally determined by their family’s assets or socioeconomic status. Research has suggested positive and negative relationships between students’ socioeconomic status and their academic outcomes. As this relationship has yet to be explored in music therapy, the primary purpose of this study was to explore the current financial needs and economic diversity of American undergraduate music therapy students. A survey was sent in April of 2020 for dissemination to undergraduate music therapy majors. Students from across the United States (n = 346) completed the questionnaire. Key findings included (a) most music therapy students (61.7%) took out student loans during the 2019–2020 academic year and expect substantial levels of debt upon graduation (>$10,000); (b) about one-third (34.4%) of respondents received the Pell Grant, a needs-based grant, in the past year; (c) a considerable majority (77.5%) were employed during school; and (d) 97% of students received additional financial assistance from their families. This study also compared the needs between BIPOC (Black, indigenous, people of color) and white students. Implications of findings as they relate to music therapy education and further research regarding the financial need and socioeconomic status are also discussed.
Two pathways drive meiotic chromosome axis assembly in Saccharomyces cerevisiae
Authors: Heldrich Jonna , Milano Carolyn R , Markowitz Tovah E , Ur Sarah N , Vale-Silva Luis A , Corbett Kevin D , Hochwagen Andreas
Published: March 2022

Successful meiotic recombination, and thus fertility, depends on conserved axis proteins that organize chromosomes into arrays of anchored chromatin loops and provide a protected environment for DNA exchange. Here, we show that the stereotypic chromosomal distribution of axis proteins in Saccharomyces cerevisiae is the additive result of two independent pathways: a cohesin-dependent pathway, which was previously identified and mediates focal enrichment of axis proteins at gene ends, and a parallel cohesin-independent pathway that recruits axis proteins to broad genomic islands with high gene density. These islands exhibit elevated markers of crossover recombination as well as increased nucleosome density, which we show is a direct consequence of the underlying DNA sequence. A predicted PHD domain in the center of the axis factor Hop1 specifically mediates cohesin-independent axis recruitment. Intriguingly, other chromosome organizers, including cohesin, condensin, and topoisomerases, are differentially depleted from the same regions even in non-meiotic cells, indicating that these DNA sequence-defined chromatin islands exert a general influence on the patterning of chromosome structure.
Mechanistic insights into tRNA cleavage by a contact-dependent growth inhibitor protein and translation factors
Authors: Wang Jing , Yashiro Yuka , Sakaguchi Yuriko , Suzuki Tsutomu , Tomita Kozo
Published: March 2022

Contact-dependent growth inhibition is a mechanism of interbacterial competition mediated by delivery of the C-terminal toxin domain of CdiA protein (CdiA–CT) into neighboring bacteria. The CdiA–CT of enterohemorrhagic Escherichia coli EC869 (CdiA–CTEC869) cleaves the 3′-acceptor regions of specific tRNAs in a reaction that requires the translation factors Tu/Ts and GTP. Here, we show that CdiA–CTEC869 has an intrinsic ability to recognize a specific sequence in substrate tRNAs, and Tu:Ts complex promotes tRNA cleavage by CdiA–CTEC869. Uncharged and aminoacylated tRNAs (aa-tRNAs) were cleaved by CdiA–CTEC869 to the same extent in the presence of Tu/Ts, and the CdiA–CTEC869:Tu:Ts:tRNA(aa-tRNA) complex formed in the presence of GTP. CdiA–CTEC869 interacts with domain II of Tu, thereby preventing the 3′-moiety of tRNA to bind to Tu as in canonical Tu:GTP:aa-tRNA complexes. Superimposition of the Tu:GTP:aa-tRNA structure onto the CdiA–CTEC869:Tu structure suggests that the 3′-portion of tRNA relocates into the CdiA–CTEC869 active site, located on the opposite side to the CdiA–CTEC869 :Tu interface, for tRNA cleavage. Thus, CdiA–CTEC869 is recruited to Tu:GTP:Ts, and CdiA–CT:Tu:GTP:Ts recognizes substrate tRNAs and cleaves them. Tu:GTP:Ts serves as a reaction scaffold that increases the affinity of CdiA–CTEC869 for substrate tRNAs and induces a structural change of tRNAs for efficient cleavage by CdiA–CTEC869.
SARS-CoV-2 Humoral and Cellular Immune Responses of Patients With HIV After Vaccination With BNT162b2 mRNA COVID-19 Vaccine in the Tel-Aviv Medical Center
Authors: Tau Luba , Turner Dan , Adler Amos , Marom Rotem , Ahsanov Svetlana , Matus Natasha , Levi Inbar , Gerber Gal , Lev Shir , Ziv-Baran Tomer , Hagin David , Freund Tal , Grupper Ayelet , Halperin Tamar
Published: March 2022

Background

Little is known about vaccine efficacy and sustainability among people with HIV (PWH). We estimated humoral and cellular immune responses postvaccination with BNT162b2 mRNA coronavirus disease 2019 (COVID-19) vaccine among PWH in Tel-Aviv Medical Center.

Methods

The vaccine humoral response was evaluated by measuring immunoglobulin G (IgG) titers of antispike receptor-binding domain antibodies (anti-RBD IgG). Cellular response was assessed by stimulating donor peripheral blood mononuclear cells with pooled complete S-peptide mix.

Results

One hundred thirty-six PWH who completed 2 doses of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine were tested for anti-RBD IgG and compared with 61 vaccinated health care workers (HCWs). The antibody titers were similar between the groups (median, 118 BAU/mL for PWH and 101.4 BAU/mL for HCWs; P = .231), although the mean time from second vaccine was 4.5 months in PWH and 6.7 months in HCWs (P < .0001). Longer time from second vaccine dose was associated with decreased antibody level, as were CD4 counts <300 cells/µL compared with higher CD4 counts (25.1 BAU/mL vs 119.3 BAU/mL, respectively; P = .047). There was no difference in cellular immune response between vaccinated PWH, convalescent unvaccinated PWH, and vaccinated HCWs.

Conclusions

The humoral immune response of PWH was comparable to that of HCWs after BNT162b2 mRNA vaccination. Cellular immune response did not differ between vaccinated PWH, convalescent PWH, and vaccinated HCWs. PWH with CD4 counts <300 cells/µL (n = 9) had lower antibody titers compared with patients with counts >300 cells/µL (n = 127).
High and Rapid Increase in Seroprevalence for SARS-CoV-2 in Conakry, Guinea: Results From 3 Successive Cross-Sectional Surveys (ANRS COV16-ARIACOV)
Authors: Soumah Abou Aissata , Diallo Mamadou Saliou Kalifa , Guichet Emilande , Maman David , Thaurignac Guillaume , Keita Alpha Kabinet , Bouillin Julie , Diallo Haby , Pelloquin Raphael , Ayouba Ahidjo , Kpamou Cece , Peeters Martine , Delaporte Eric , Etard Jean-Francois , Toure Abdoulaye
Published: March 2022

We conducted 3 successive seroprevalence surveys, 3 months apart, using multistage cluster sampling to measure the extent and dynamics of the severe acute respiratory syndrome coronavirus 2 epidemic in Conakry, the capital city of Guinea. Seroprevalence increased from 17.3% (95% CI, 12.4%–23.8%) in December 2020 during the first survey (S1) to 28.9% (95% CI, 25.6%–32.4%) in March/April 2021 (S2), then to 42.4% (95% CI, 39.5%–45.3%) in June 2021 (S3). This significant overall trend of increasing seroprevalence (P < .0001) was also significant in every age class, illustrating a sustained transmission within the whole community. These data may contribute to defining cost-effective response strategies.
Singing Is a Risk Factor for Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A Case-Control Study of Karaoke-Related Coronavirus Disease 2019 Outbreaks in 2 Cities in Hokkaido, Japan, Linked by Whole Genome Analysis
Authors: Nakashita Manami , Takagi Yuta , Tanaka Hiroyuki , Nakamura Haruna , Serizawa Yusuke , Ukai Tomohiko , Azuma Kotaro , Chiba Hiroko , Terada Kensaku , Nakanishi Kaori , Fujikawa Tomoko , Saito Kayoko , Yamaguchi Ryo , Mitsuhashi Yuu , Yano Koichi , Shibuma Tomoko , Kuzuma Akemi , Tsuda Shinichiro , Sadamoto Terukazu , Ishii Yasuhiko , Ohara Tsukasa , Hitomi Yoshiaki , Hiroshima Takashi , Yamagishi Takuya , Kamiya Hajime , Samuel Anita , Yahata Yuichiro , Shimada Tomoe , Arima Yuzo , Suzuki Motoi , Sekizuka Tsuyoshi , Kuroda Makoto , Sunagawa Tomimasa
Published: March 2022

Background

Singing in an indoor space may increase the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We conducted a case-control study of karaoke-related coronavirus disease 2019 (COVID-19) outbreaks to reveal the risk factors for SARS-CoV-2 infection among individuals who participate in karaoke.

Methods

Cases were defined as people who enjoyed karaoke at a bar and who tested positive for SARS-CoV-2 by reverse-transcription polymerase chain reaction between 16 May and 3 July 2020. Controls were defined as people who enjoyed karaoke at the same bar during the same period as the cases and tested negative. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. ORs of key variables adjusted for each other were also estimated (aOR).

Results

We identified 81 cases, the majority of whom were active elderly individuals (median age, 75 years). Six cases died (case fatality ratio, 7%). Among the cases, 68 (84%) were guests, 18 of whom had visited ≧2 karaoke bars. A genome analysis conducted in 30 cases showed 6 types of isolates within 4 single-nucleotide variation difference. The case-control study revealed that singing (aOR, 11.0 [95% CI, 1.2–101.0]), not wearing a mask (aOR, 3.7 [95% CI, 1.2–11.2]), and additional hour spent per visit (aOR, 1.7 [95% CI, 1.1–2.7]) were associated with COVID-19 infection.

Conclusions

A karaoke-related COVID-19 outbreak that occurred in 2 different cities was confirmed by the results of genome analysis. Singing in less-ventilated, indoor and crowded environments increases the risk of acquiring SARS-CoV-2 infection. Wearing a mask and staying for only a short time can reduce the risk of infection during karaoke.
Temperature Sensing in Plants: On the Dawn of Molecular Thermosensor Research
Authors: Noguchi Minoru , Kodama Yutaka
Published: March 2022

Although many studies on plant growth and development focus on the effects of light, a growing number of studies dissect plant responses to temperature and the underlying signaling pathways. The identity of plant thermosensing molecules (thermosensors) acting upstream of the signaling cascades in temperature responses was elusive until recently. During the past six years, a set of plant thermosensors has been discovered, representing a major turning point in the research on plant temperature responses and signaling. Here, we review these newly discovered plant thermosensors, which can be classified as sensors of warmth or cold. We compare between plant thermosensors and those from other organisms and attempt to define the subcellular thermosensing compartments in plants. In addition, we discuss the notion that photoreceptive thermosensors represent a novel class of thermosensors, the roles of which have yet to be described in non-plant systems.
Review of Eye Injuries Associated With Dermatologic Laser Treatment
Authors: Flegel Lisa , Kherani Femida , Richer Vincent
Published: March 2022

BACKGROUND

The eye is susceptible to damage during dermatologic laser treatments.

OBJECTIVE

Discuss the anatomy of the eye related to these procedures, the principles of laser–eye interactions, and ocular injuries reported with dermatologic laser treatments.

METHODS

PubMed and Embase searches were conducted to identify cases of eye injuries associated with dermatologic laser treatments.

RESULTS

One hundred nineteen cases of eye injury associated with dermatologic laser treatments were identified. Fifty-nine cases targeted the eyelid during resurfacing and caused ectropion, while 60 cases resulted from direct injury of ocular structures. In most of the cases of the latter, improper eye protection was used (44 of 60, 73%). In nearly all these cases, it was the patient who sustained a potentially avoidable ocular injury (52 of 60, 87%). Thirty-one patients had persistent ocular symptoms at follow-up (52%). The most common procedure in this context was laser hair removal of the face (35 of 60, 58%). Most of the cases developed injuries specific for the particular laser based on its wavelength and affinity to target certain ocular chromophores (59 of 60, 98%).

CONCLUSION

Most of the dermatologic laser–associated eye injury cases have occurred in the context of laser resurfacing or laser hair removal and are potentially preventable.
Patient Preferences Regarding Virtual Visits in Cutaneous Surgery in the Era of COVID-19
Authors: Barilla Steven , Burshtein Joshua , Strunk Andrew , Yan Bernice Y. , Sharon Victoria R.
Published: March 2022

BACKGROUND

The COVID-19 pandemic has caused an increasing shift toward the utilization of telehealth services. There are limited data on patient preferences for these services in dermatologic surgery.

OBJECTIVE

To evaluate patient preferences regarding telehealth in dermatologic surgery for pre- and postsurgical care.

METHODS

A survey was administered to patients in an academic dermatology practice.

RESULTS

Two hundred twenty-four patients participated. An in-person presurgical consultation was preferred by 62.1%, and a postsurgical in-person visit was preferred by 67.7%. The most commonly cited reason was desire for physical interaction with their surgeon. For each 10-year increase in age, there was a 1.26-fold and 1.12-fold increase in preference for in-person consultation and follow-up, respectively. Eighty-seven percent felt safe during office visit, and 41% reported no anxiety regarding fear of contracting COVID-19. The proportion of patients preferring in-person pre- or postsurgical visits was similar regardless of sex, presence of an immunocompromising condition, prior dermatologic surgery, anxiety level for contracting COVID-19, and perceived level of office safety.

CONCLUSION

A majority of patients prefer in-person visits for pre- and postsurgical care. Older patients have a greater preference for in-person care. Anxiety level regarding COVID-19 and perceived level of office safety were not related to preference for in-person visits.
Effect of corneal epithelial remodeling on visual outcomes of topography-guided femtosecond LASIK
Authors: Saleh Solin , Epp Liam J. , Manche Edward E.
Published: March 2022

Purpose:

To assess the effect of epithelial remodeling on visual outcomes over a 9 mm diameter corneal surface after topography-guided laser in situ keratomileusis (LASIK) for myopia correction using spectral-domain anterior segment optical coherence tomography (AS-OCT).

Setting:

Outpatient clinical practice at the Stanford University Byers Eye Institute in Palo Alto, California.

Design:

Prospective nonrandomized observational study.

Methods:

Visual acuity, including uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), 5% and 25% contrast sensitivity CDVA, manifest refraction, and corneal epithelial thickness after topography-guided femtosecond LASIK were analyzed. Corneal epithelial thickness was mapped across 13 sections and 3 concentric zones using AS-OCT preoperatively and at 1 month, 3 months, 6 months, and 12 months postoperatively.

Results:

60 eyes of 30 patients with a mean age of 32.8 years (range 23 to 52 ± 7.03 years) undergoing myopic LASIK correction were assessed. In eyes with complete follow-up data (n = 30), mean preoperative UDVA was logMAR 1.48 ± 0.45 and logMAR −0.11 ± 0.08 at postoperative 12 months. Mean preoperative CDVA was logMAR −0.08 ± 0.11 and logMAR −0.13 ± 0.07 at 12 months. Linear mixed modeling demonstrated a significant correlation between improvement in UDVA and decreased superior and nasal corneal epithelial thickness and between improvement in CDVA and increased central epithelial thickness 12 months postoperatively.

Conclusions:

Improvement in UDVA and CDVA at 12 months after topography-guided femtosecond LASIK was correlated with nonuniform epithelial remodeling, including epithelial thickening in the central zone and thinning in the superior and nasal sections as measured by AS-OCT.
Effect of small-incision sutureless cataract surgery on the natural course of astigmatism over 10 to 20 years
Authors: Inoue Yasushi , Takehara Hiroyasu , Sugita Toru , Kaneko Tsutomu , Miyata Kazunori , Honbou Masato , Miyoshi Teruyuki , Fujie Shuhei , Oshika Tetsuro
Published: March 2022

Purpose:

To retrospectively assess astigmatic changes over 10 years and 20 years after small-incision cataract surgery.

Setting:

5 ophthalmic surgical sites in Japan.

Design:

Retrospective case series.

Methods:

Data were collected from patients who had undergone phacoemulsification and implantation of an intraocular lens through a 2.2 to 2.4 mm incision. Preoperative corneal and postoperative manifest astigmatism were converted to power vector notations: horizontal/vertical (J0) and oblique (J45) astigmatism components.

Results:

422 eyes of 422 patients were followed for 10 years, and data preoperatively and at 1 month and at 1 year, 3 years, 5 years, 8 years, and 10 years postoperatively were analyzed. The mean J0 decreased significantly (P < .001, repeated measures analysis of variance) with an against-the-rule (ATR) shift of 0.363 ± 0.433 diopter (D) over 10 years, but the mean J45 did not change significantly (P = .150). Double-angle plot analyses also showed similar ATR shifts in all astigmatism groups. In the subgroup analysis conducted in 34 patients who were followed for 20 years, J0 declined significantly (P < .001) by 0.649 ± 0.576 D, whereas J45 did not (P = .516). The postoperative changes in J0 and J45 were not significantly different between eyes with preoperative with-the-rule, ATR, or oblique astigmatism.

Conclusions:

Postoperative astigmatism continued to shift toward ATR during the follow-up period of 20 years after small-incision cataract surgery, which seems to reflect the natural course of corneal astigmatic changes that commonly occur with aging. ATR astigmatic shifts were similar in both pattern and magnitude regardless of the type of preoperative astigmatism.
“God Hey, Now I’ve Been Through Something”
Authors: Jacobs Gaby
Published: March 2022

Moral distress arises in the dynamic relationship between personal factors and the organizational and political contexts of care work. Whether moral distress actually leads to a reduced well-being of health care workers or a reduced quality of care in the sector depends to a large extent on how moral tensions are dealt with, also called moral resilience, and the protective conditions available. Research about moral distress and moral resilience within the field of health care has concentrated on staff nurses and physicians. Studies into palliative terminal care and/or about the role of coordinating staff are scarce. A study was conducted to gain insight into the moral challenges that coordinators in voluntary palliative terminal care encounter in their ambition to realize good care, how they deal with these challenges, and the individual and organizational characteristics that foster or hamper moral resilience. Interviews were conducted with 20 coordinators and were qualitatively analyzed. The results brought forward 3 moral challenges in working with volunteers and in collaborating with professional care, namely, striving for connection, negotiating autonomy, and struggling with open communication. However, coordinators seemed to face these challenges effectively. In conclusion, the relational narrative strategies used by coordinators to deal with these challenges, in combination with personal and organizational conditions, foster moral resilience.