bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing the Sustainability of Eco-Friendly Potentiometric Ion-Selective Electrodes for Stability-Indicating Measurement of Ethamsylate: Application in Bulk and Pharmaceutical Formulations
Authors: Monir Hany H , Mohamed Heba A , Badawy Amr M , Nebsen Marianne , Nessim Christine K
Published: April 2024

Background

Through the use of sustainable and green chemistry concepts, scientists need to decrease waste, conserve energy, and develop safe substitutes for hazardous compounds, all for protecting and benefiting society and the environment.

Objective

Four novel eco-friendly ion selective electrodes (ISE) were generated to determine Ethamsylate (ETM) in bulk powder and different pharmaceutical formulations. The present electrodes were fabricated to clearly distinguish ETM from a variety of inorganic, organic ions, sugars, some common drug excipients and the degradation product, hydroquinone (HQ) of ETM, and thus used for stability-indicating methods.

Methods

The electrodes fabrication was based on 2-nitrophenyl octyl ether (NPOE) that was employed as a plasticizer in electrodes 1, 2, and 3 within a polymeric matrix of polyvinyl chloride (PVC) except for electrode 4, in which dibutyl sebacate was used as a plasticizer. Electrodes 1 and 2 were fabricated using tetradodecylammonium bromide as an anionic exchanger, adding 4-sulfocalix-8-arene as an ionophore only to electrode 2 and preparing electrode 1 without incorporation of an ionophore. The fabrication of electrodes 3 and 4 was based on ethamsylate–tetraphenylborate (ETM–TPB) as an ion-association complex in a PVC matrix. The environmental sustainability was assessed using the green analytical procedure index (GAPI), and analytical greenness metric for sample preparation (AGREEprep).

Results

Electrodes 1 and 2 had linear dynamic ranges of 10−1–10−5 mol/L and 10−1–10−4 mol/L, respectively, with a Nernstian slope of 49.6 and 53.2 mV/decade, respectively. Electrodes 3 and 4 had linear dynamic ranges of 10−1–10−4 mol/L, with a Nernstian slope of 43.9 and 40.2 mV/decade, respectively.

Conclusion

The electrodes' selectivity coefficients showed good selectivity for ETM. The utility of 4-sulfocalix-8-arene as an ionophore had a significant influence on increasing the membrane sensitivity and selectivity of electrode 2 compared to other electrodes.

Highlights

Four novel eco-friendly ISEs were used for determination of ETM in bulk powder and different pharmaceutical formulations. Different experimental parameters were performed to optimize the determination conditions such as solvent mediators, dynamic response time, effect of pH, and temperature. Stability-indicating measurement of ETM in the presence of its degradate HQ and co-formulated drug tranexamic acid. Using new ecological assessment tools to determine whiteness and greenness profiles.
Effects of dietary iron supplementation on reproductive performance of sows and growth performance of piglets
Authors: Xiong Wenyu , Nie Jiawei , Luo Jinxi , Ma Kaidi , Cui Zhijuan , Ye Hongxuan , Tan Chengquan , Yin Yulong
Published: April 2024

This experiment aimed to investigate the effects of dietary iron supplementation from different sources on the reproductive performance of sows and the growth performance of piglets. A total of 87 sows with similar farrowing time were blocked by body weight at day 85 of gestation, and assigned to one of three dietary treatments (n = 29 per treatment): basal diet, basal diet supplemented with 0.2% ferrous sulfate (FeSO4), and basal diet supplemented with 0.2% iron sucrose, respectively, with 30% iron in both FeSO4 and iron sucrose. Compared with the control (CON) group, iron sucrose supplementation reduced the rate of stillbirth and invalid of neonatal piglets (P < 0.05), and the number of mummified fetuses was 0. Moreover, it also improved the coat color of newborn piglets (P < 0.05). At the same time, the iron sucrose could also achieve 100% estrus rate of sows. Compared with the CON group, FeSO4 and iron sucrose supplementation increased the serum iron content of weaned piglets (P < 0.05). In addition, iron sucrose increased serum transferrin level of weaned piglets (P < 0.05) and the survival rate of piglets (P < 0.05). In general, both iron sucrose and FeSO4 could affect the blood iron status of weaned piglets, while iron sucrose also had a positive effect on the healthy development of newborn and weaned piglets, and was more effective than FeSO4 in improving the performance of sows and piglets.
6 A Multicenter Outcome Analysis of Vancomycin Dosing Strategies in Burn Patients
Authors: Boyd Allison N , Hill David M , Santos Richard M
Published: April 2024

Introduction

Current guidelines support an area under the curve (AUC)-based dosing strategy for vancomycin. Previous literature evaluating dosing in burn patients consistently reports that higher doses and/or more frequent intervals are required in patients with thermal injury. However, optimal empiric dosing recommendations and monitoring are not well defined and burn patients are often excluded from studies driving guideline recommendations. The objective of this study was to evaluate both AUC and non-AUC-guided dosing strategies in a multicenter analysis. The primary hypothesis was that therapeutic drug monitoring via AUC-guided dosing would result in 25% higher clinical success compared to trough-based dosing (TR) in patients with burn or inhalation injury.

Methods

This was a multicenter, retrospective study including 14 burn centers. Patients admitted to one of the study sites from 1/1/17 through 8/31/22 with a cutaneous burn or inhalation injury who received intravenous vancomycin for at least 48 hours were included. Patients were excluded if they lacked at least one steady state trough concentration, experienced an acute kidney injury within 24 hours of vancomycin initiation, were treated for an infection with a known vancomycin MIC greater than or equal to 2, or received continuous infusion vancomycin. Patients were evaluated for clinical success and grouped according to method of monitoring: AUC vs. TR. Clinical success was defined as a composite of absence of 5 criteria: 1) AKI 2) lack of resolution 3) relapse 4) therapy change or 5) death.

Results

A total of 486 patients receiving 517 courses of vancomycin were included. Select patient demographics are included in Table 1. Primary and secondary outcomes are included in Table 2. There was no difference in clinical success between dosing strategies. This remained true after controlling for center, burn severity, and primary infection source. There was no difference in target attainment. The TR group had significantly higher rates of AKI, with concomitant piperacillin/tazobactam remaining significant after multivariate regression analysis.

Conclusions

No differences in clinical success were seen between AUC vs. TR dosing strategies and both groups had high attainment of therapeutic concentrations. AUC-guided dosing may reduce rates of AKI in burn patients with a history of kidney disease, kidney injury on admission, or when vancomycin is being administered with concomitant nephrotoxic medications.

Applicability of Research to Practice

To our knowledge, this is the first multicenter study to evaluate vancomycin dosing strategies in patients with thermal or inhalation injury.
66 Mental Health Support Is an Unmet Need for Long-Term Burn Survivors
Authors: Cobler-Lichter Michael D , Ramsey Walter A , O'Neil Christopher F , Ishii Mary , Satahoo Shevonne S , Kaufman Joyce I , Pizano Louis R , Koru-Sengul Tulay , Szapocznik Jose , Schulman Carl I
Published: April 2024

Introduction

A National Trauma Research Action Plan identified the involvement of burn survivors as critical informants to determine the direction of research and clinical progress in the field. This study surveyed a nationwide sample of burn survivors to identify gaps in care and assess the importance of long-term challenges reported by survivors.

Methods

We prospectively surveyed burn survivors ages ≥18 from around the United States from March-June 2023. Survivors were reached through social media and email contact with the Phoenix Society for Burn Survivors. We elicited demographic info, burn history, continued impact of various symptoms on quality of life, treatments used, long-term difficulties faced, unmet needs, and advice for other survivors. Statistical analysis was performed to test our hypothesis that lack of access to mental health support/professionals would be identified as an unmet need in long-term burn survivors.

Results

Of 178 survey respondents (60% Female, 78% White) the majority were at least ten years removed from the date of their burn injury (n=94, 53%). Compared to those with less than 3 years from their burn injury date, individuals with greater than 10 years, were at least 5 times more likely to note lack of access to mental health support [11-20 years OR 8.7, p< 0.001; >20 years OR 5.7, p=0.001] (See Table 1). Of note, despite a small number of Spanish speaking respondents, 60% of Spanish speakers reported lack of access to support groups was among their greatest unmet needs, compared to 37% of English speakers (p=0.184).

Conclusions

This study highlights the need for ongoing access to mental health resources throughout the entire lifespan of burn survivors. Our findings emphasize that burn injury is not just an acute ailment, but a complex condition that evolves into a chronic, multifaceted disease. Additional studies should focus on the experiences of Spanish-speaking burn survivors, as this group has a clinically meaningful lack of access to support groups and was poorly represented in our sample.

Applicability of Research to Practice

This research calls for increased mental health support for long-term burn survivors. Providers must consider the chronic physical and psychological aspects of burn injury, striving to better equip patients for the future.
99 Empowering Emergency Responders to Treat on Scene Alleviates Hospital Strain During Disaster Events
Authors: Ivanko Anastasiya , Schoen Jonathan E , Lacy Elizabeth , Flores Carl A , Kearns Randy D , Phelan Herb A , Carter Jeffrey E
Published: April 2024

Introduction

Disaster events can cause prolonged losses of electricity, leaving individuals to utilize alternative sources of energy such as fossil fuel generators, which in turn can lead to burn injuries and/or carbon monoxide (CO) exposure. The purpose of this study was to examine the impact of generator-related burn injury and CO poisoning (COP) following a region-wide disaster, and the effects of empowering EMS providers to treat many of these injuries on-scene.

Methods

Utilizing data gathered from Emergency Medical Services (EMS) provider agencies, we constructed three cohorts related to Hurricane Ida’s landfall: PRE-IDA (07/08/21 - 08/25/21), MID-IDA (08/26/21 – 09/08/21) and POST-IDA (09/09/21 – 10/31/21). We analyzed EMS calls, dispatches, and transports for primary complaints indicating COP or burn injury during these time periods. Statewide emergency response network representatives were contacted regarding and pre-hospital care and coordination during disaster responses.

Results

PRE-IDA EMS averaged 15.4 calls per day indicating COP or burn injury. 1.4 (9%) of these calls were due to burn injury (61% of which were transported to nearest ED), while 13 (91%) were due to suspicion of COP (98% of which were transported to nearest ED). The mean turnaround time from dispatch to EMS being back in service was 63 (±36) minutes. MID-IDA EMS averaged 20.9 calls per day. 3.3 (16%) of these calls per day were due to burn injury, and 16.7 (84%) of these calls per day were due to COP. Of the MID-IDA calls, 73% of burn patients and 78% of COP patients were transported to the nearest ED. The mean turnaround time from dispatch to EMS being back in service was 64 (±31) minutes during MID-IDA. During POST-IDA, the mean calls per day to EMS decreased to 10.6 (16% of which were burn injury, 84% of which were suspected COP). Of the POST-IDA dispatches, 61% of burn patients and 97% of COP patients were transported to the nearest area hospital. The mean turnaround time from dispatch to EMS being back in service was 69 (± 49) minutes. Lastly, there were no fatalities from COP in patients transported to the burn center and only one patient required hyperbaric therapy for isolated COP.

Conclusions

At the peak, EMS had 90 calls each day per parish for COP requiring implementation of disaster plan. Our data shows an increase in CO related EMS dispatches during MID-IDA with fewer patients transported to regional area hospitals, but overall stable transport times from household to area hospitals amongst the three time periods. This study demonstrates the collaboration of a verified burn center and the EMS community when responding a to natural disaster.

Applicability of Research to Practice

This study demonstrates that empowering EMS to treat smaller burn injuries, and clinically mild CO exposures, on scene during a disaster event decreases strain on area hospitals’.
529 Laser Scanner Size Effect on Treatment Time
Authors: Muir Cassidy , Mittal Rohit , Kahn Steven A
Published: April 2024

Introduction

Patients may develop debilitating scars that cause psychological trauma, chronic pain, hypersensitivity, or limit function following burns or other soft tissue trauma. CO2 laser treatment improves the function and appearance of scars and is an integral step in reconstruction. These treatments are performed under sedation or general anesthesia. Decreasing operative time without compromising outcomes potentially reduces cost and anesthesia related complications, while increasing the number of patients treated. This study compares the treatment time per surface area for two CO2 lasers with 10mm and 15mm scanner sizes. The authors hypothesize that the 15mm scanner size laser is faster and treats more square centimeters per second than the 10mm scanner size laser.

Methods

A single institution, retrospective study of prospectively collected data looked at time to perform laser treatment for an area with 15mm or 10mm lasers by two experienced burn surgeons over 7 months. Injury characteristics, total area treated, and time elapsed during treatment were tabulated. Next, this information was used to calculate the speed of treatment in cm²/s, and the median speeds between lasers compared. A subgroup analysis was performed on a subset of patients who were treated with both lasers and served as internal controls. A two-tailed Mann-Whitney U statistical analysis (p< 0.05) was utilized to compare medians of the two cohorts.

Results

There were 18 and 16 patients treated with the 15mm laser and 10mm laser, respectively. The average speed of the 15mm laser was 3.2 cm²/s while the 10mm was 1.2cm²/s (p < 0.00001). Five patients had the same wounds treated with both lasers, with a median speed of 2.39 cm²/s using the 15mm laser and 0.93 cm²/s with the 10 mm (p< 0.01208). The average energy used with the 10mm laser was 144.1mJ vs 190.2mJ for the 15mm laser (p = 0.05614) while the average density was 2.6 and 3.3 respectively (p< 0.00001).

Conclusions

Using the 15mm laser as compared to the 10mm laser resulted in a 2.67-fold faster operative time per cm² treated while there was no significant difference in energy. As one might anticipate, the larger scanner size was faster.

Applicability of Research to Practice

This information offers information to support decision making for hospital systems to create, support, and expand laser-scar programs. Future studies will be focused on determining the efficacy of the two lasers. These will focus on differences in scar outcomes based on objective scar measurements and identify any differences in depth of penetration, energy and density between the two lasers.
555 Implementing BNCI Guided Burn Nurse Competency Education at Kessler Burn Trauma Step down Unit
Authors: Palacio Rhoda M , Moynihan Holly
Published: April 2024

Introduction

The Burn Nurse Competency Initiative (BNCI) at the American Burn Association developed a robust Burn Nurse competency national standard that shaped the culture and competence of burn nurses across the country. Upon close analysis of our current practice, it was determined that there are no competency guidelines specific to burn nursing care available for nursing staff during the on-boarding process as well as annual nursing competency assessment available to maintain and sustain staff’s learning needs. The development and implementation EBP Burn Nurse Competencies (BNC) education and its application into our current practice is an important quality improvement initiative that will greatly improve the current standard of care, provide standardization in the process of orientation, and enable sustainable learning opportunities to all nurses in a verified burn center, as well as improve treatments and therapies from admission to discharge that will allow the best possible outcomes for our burn patients.

Methods

The initial needs assessment survey was sent out to our current staff prior implementation of BNC education. The result has shown 76% of staff feels that they received sufficient education on the care of burn patients. The BNC education was also developed through utilization of the cumulative input from the burn program interdisciplinary team and integration of their individual department’s standard of care for burn patients. The BNC was created with two parts: a comprehensive burn/wound care management and the BNC education which defines the specific domain of BNCI competency standard. All of the eleven domains were also integrated in the performance criteria assessment tool. This tool was developed and utilized to ascertain knowledge gained and also as a means to validate competence and confidence level of nurses as they apply the skills/knowledge gain in our clinical setting. The BNC education was implemented to the current staff and is also currently being used to onboard newly hired nurses as the foundation of their orientation process.

Results

The results of this evidence-based practice quality improvement project will be gathered and analyzed at the end of this year when all current newly hired RN will be off orientation.

Conclusions

The conclusion of this quality improvement project will be analyzed at the end of the year for our new hired RN’s orientation process. A survey will be sent out to these group of nurses to ascertain the effectiveness of the BNC education which was implemented July of this year.

Applicability of Research to Practice

Research studies have shown the significance of identifying practice gap related to nursing competencies in practice, assessing the need of nursing competencies, the development of accompanying educational tool and evaluating the effectiveness of nursing competencies as crucial in preventing poor patient outcome, near-miss events, and preventable hospital-acquired conditions.
607 Cultured Epidermal Autografts versus Spray Keratinocytes for Massive Burns—a Cost Effectiveness Analysis
Authors: Yesantharao Pooja , Patel Heli , Gunturi Aditya , Nazerali Rahim , Sheckter Clifford C
Published: April 2024

Introduction

Massive burn injuries are challenging to treat surgically due to limited donor skin. Autologous epidermal grafts such as cultured epidermal autografts (CEAs) and spray keratinocyte suspensions are successful strategies for wound closure when donor sites are limited. There are no investigations to date that describe the differential outcomes or costs between these competing strategies. Cost-effectiveness analysis is required to guide payors, hospitals, and policy makers in determinations of care.

Methods

A cost-effectiveness analysis compared CEAs with spray keratinocytes in adult burn patients with >50% total body surface area deep partial thickness burns. Hybrid Monte Carlo simulation and Markov modeling studied cost-utility from the payer perspective. Study data were derived from randomized clinical trials and cohort investigations of CEAs and spray keratinocytes. The time horizon was 1 year with 1 month cycling. Model costs included the product, surgery (both physician and facility fees), and hospitalization. Surgical costs were derived from Medicare reimbursement fee schedules. Costs of epidermal autografts were determined using currently available marketing material. All costs were inflated to 2023 US dollars, with a standard 3% discounting rate. Model utilities were derived from the Vancouver Scar Scale (VSS) with 1 as the best outcome and 0 as the worst outcome. The incremental cost-effectiveness ratio (ICER) was derived from the cost difference between the two strategies divided by the difference in adjusted VSS. Deterministic and probabilistic sensitivity analyses were performed varying all model parameters.

Results

CEAs achieved successful wound closure in 73% of simulations compared to 88% for spray keratinocytes. Compared to treatment with CEAs, treatment with spray keratinocytes resulted in cost savings of $254,743, with no compromise in overall utility of treatment based on VSS. As such, spray keratinocyte treatment was the dominant strategy. This finding was robust upon sensitivity analyses.

Conclusions

Spray keratinocyte suspensions were a dominant strategy to CEAs (i.e. cost saving without compromising utility).

Applicability of Research to Practice

Payers and providers should consider the cost utility of spray keratinocytes as the dominant treatment strategy for massive burn epidermal grafting. CEA manufactures may want to consider cost reductions to be more economically competitive with alternative strategies.
724 Palliative Care Consultation in an Urban Burn Center
Authors: Haslam Miranda , Anderson Jeffrey
Published: April 2024

Introduction

There is growing evidence supporting early palliative care consultation in many surgical patient populations; however, current literature regarding palliative care consultation in the burn population is limited. Given the significant morbidity and potential mortality associated with burn injuries, especially large total body surface area (TBSA) burn injuries, there is likely benefit to increased utilization of specialty palliative care in the burn patient population. In this study, we investigated current practice patterns of palliative care consultation at our burn center.

Methods

A retrospective chart review was performed at our American Burn Association verified burn center of patients admitted from 2020 to 2023. Inclusion criteria included patients who presented with greater than or equal to 30% TBSA burns or experienced in-hospital mortality. Comparison was made between patients who did and did not receive palliative care consultation during their hospitalization. Student’s T-Test and Chi-Square Test were used for categorical and continuous variables, respectively.

Results

A total of 38 patients met our inclusion criteria. 13 of the 38 patients (34%) received a palliative care consult during their admission, with an average of 10.2 days between admission and consultation. There was a trend towards older age and higher TBSA in patients who received a palliative care consultation (52.9 years vs. 49.2 years, 53.4% TBSA vs. 50.4% TBSA), though these differences were not statistically significant (p = 0.56, 0.33). There was no significant difference in likelihood of palliative care consultation based on presentation characteristics of intubation or inhalation injury. There was also no significant difference identified between patients who did and did not receive palliative care consultation in transition to comfort directed care, in-hospital death, or length of stay. In a subgroup analysis of patients who survived hospitalization, rates of home discharge were higher in those patients who did not receive palliative care consultation (p= 0.005).

Conclusions

Opportunities exist for increased integration of specialty palliative care in the burn patient population. This study represents one of the first reviews of palliative care consultation utilization in an urban burn center patient population. Understanding of current practice patterns relating to palliative care consultation is an essential first step in developing practices to increase utilization of palliative care in the burn patient population.

Applicability of Research to Practice

Significant opportunities exist for improved integration of specialty palliative care in the burn patient population. This research will be used to inform development of triggers for palliative care consultation at our burn center.
728 REsource Support to Optimize REcovery (RESTORE) Study Scoping Review: Care Transition Resources for Burn Survivors
Authors: Velasquez-Cano Mariana , Carnevale Camille , Shepler Lauren , Tenney Diana L , Kazis Lewis E , Ryan Colleen M , Schneider Jeffrey C , Slavin Mary D
Published: April 2024

Introduction

Burn survivors report limited available resources to assist in their transition to the community after hospital discharge. This literature scoping review is designed to increase our understanding of the current burn aftercare landscape. Aims were to identify resources as well as assess barriers and facilitators available to burn survivors and their families aftercare.

Methods

The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) served as a guideline to examine the following databases: PubMed, EMBASE and Web of Science. The search terms used included: burn(s), health resources, aftercare, after treatment, follow-up care, patient discharge, delivery of health care, ambulatory care, mental health and functional status. Criteria for inclusion were: burn injury diagnosis, outpatient or inpatient resources related to post-discharge burn recovery, location of resource delivery (burn center, outpatient clinic or other hospital setting), adult population, publications from 2012 to 2023 and in the English language. The International Classification of Functioning, Disability and Health (ICF) provided a conceptual framework to organize findings.

Results

Of the 385 articles that were screened, 27 met inclusion criteria (Figure 1). Studies reported health resources within the following ICF Component (domains): Body Function (emotional function), Activities and Participation (work and employment, mobility), Environmental Factors (family and societal attitudes, social security and health services, education, general products related to technology such as telehealth. Implementation strategies included early planning and coordination of a multidisciplinary burn team to connect family and burn survivors with available resources. Educational materials to engage patients with outpatient care were also recommended. Examples of successful resources and services include: work accommodation, telehealth, peer support, web-based community online chat rooms and aftercare reintegration programs.

Conclusions

This review provided an overview of current practices used to support burn survivors following discharge. Classification of these resources using the ICF framework fosters an understanding of the bio-psycho-social needs of the population and outlines an approach to design comprehensive aftercare services. This literature review is the initial step to develop a map of the resources currently offered to burn survivors and their families. Future qualitative work will build upon these findings and expand our understanding of the barriers and facilitators to meet the long term needs of people living with burn injury.

Applicability of Research to Practice

This review highlights the breadth of post discharge resources currently described in the literature, providing a foundation for future long-term care recommendations.
Evaluating the Effects of Food Deserts and Food Swamps in an Urban Burn Patient Population
Authors: Donovan Brienne , Wiese Daniel , Henry Kevin A , Wu Jingwei , Rae Lisa , Anderson Jeffrey
Published: April 2024

Poverty is a known risk factor for burn injury and is associated with residency in food deserts and food swamps. Our aim was to determine the prevalence of residency in food deserts and food swamps and to investigate the relationship between food environment, comorbidities, and wound healing in patients with burns. We performed a retrospective chart review of all patients with burns aged ≥ 18 seen in the emergency department or admitted to the burn service at an American Burn Association-verified urban academic center between January 2016 and January 2022. Patient GeoIDs were used to classify residency in food deserts and food swamps, and comorbidities and demographics were recorded. A subset of patients with <20% total body surface area burns who underwent single-operation split-thickness skin grafting was identified for wound healing analysis. A total of 3063 patients were included, with 206 in the heal time analysis. In total, 2490 (81.3%) lived in food swamps and 96 (3.1%) lived in food deserts. Diabetes, hypertension, and tobacco smoking were more prevalent in food swamps than in food deserts or good access areas. While there was no significant effect of the food environment on wound healing, diabetes was associated with longer healing times. Most patients with burns reside in food swamps, which are associated with a higher prevalence of hypertension, diabetes, and smoking. The food environment was not significantly associated with wound healing. Not having diabetes was associated with a shorter time for wound healing.
Virtual Visiting Professorship Program as an Opportunity for Academic and Clinical Advancement Beyond the COVID-19 Pandemic: A Survey of Participants
Authors: Elezaby Mai A , Al-Jabbari Esraa H , Mao Lu , Legha Ravinder S , Schacht David , Whitman Gary , Dodelzon Katerina , Omofoye Toma S
Published: April 2024

Objective

To identify structure, benefits, and shortcomings of a multi-institutional virtual visiting professorship (VVP) program from 2020 to 2022, 2 years after inception and after gradual resumption of an in-person, prepandemic academic environment.

Methods

An IRB-exempt, 70-question survey about structure, benefits, and shortcomings of the VVP program was distributed to its participants (14 breast imaging departments across the U.S.), using the snowball sampling technique.

Results

A total of 72 responses were received; 54.2% (32/59) radiologists >5 years of experience, 18.6% (11/59) radiologists <5 years of experience, 15.3% (9/59) residents, and 8.5% (5/59) fellows. Radiologists’ attendance increased from 8% (5/59) to 53% (31/59) over 2 years, with 69% (41/59) of respondents supporting continued participation. The most important factors for attendance were expanding breast imaging knowledge (86.4% [51/59]) and the virtual format (76.2% [45/59]). The number of presented lectures increased from 1 to 3 lectures in 43.7% (7/16) of programs in year 1 and from 4 to 9 lectures in 50% (8/16) of programs in year 2. The greatest professional benefits were collaborations on publications for organizers (56.3% [9/16]) and building academic portfolios for presenters (50% [7/14]). For trainees, attending the program increased their knowledge (64.3% [9/14]) and enthusiasm for breast imaging (50% [7/14]).

Conclusion

The VVP program facilitated scholarly collaboration among breast imaging radiologists, promoted academic portfolios for junior faculty, and increased enthusiasm for breast imaging for trainees. These accomplishments extended beyond the COVID-19 pandemic, as evidenced by the growth of the program after resumption of an in-person academic environment. Future expansion to other programs would benefit more practicing radiologists.
Diagnosis and therapeutic decisions of osteoporosis in chronic kidney disease
Authors: Jørgensen Hanne Skou , Moe Sharon , Nickolas Thomas L
Published: April 2024

Vignette

A 63-yr-old woman with end-stage CKD secondary to glomerulonephritis, on hemodialysis therapy, presented with scoliosis, back pain, and progressive loss of physical function for which corrective surgery was planned. Optimization of bone health was requested by the surgeon as a DXA scan had revealed osteoporosis at spine, hip, and forearm. Due to previous subtotal parathyroidectomy and normal parathyroid hormone and bone-specific alkaline phosphatase levels, a low bone turnover state was suspected. An iliac bone biopsy was performed and revealed low bone turnover, a mineralization defect, and severe osteoporosis. The patient was treated with calcium and intensified vitamin D supplementation, followed by a 2-yr course of teriparatide. Monitoring of bone turnover markers indicated a bone anabolic response to therapy, and a repeat DXA showed increases in BMD at spine and hip. A repeat biopsy at end of treatment showed normal bone turnover and mineralization. This case demonstrates the complicated bone health of patients with advanced CKD. As there are no randomized trials for fracture pretention in patients with CKD, care must be individualized and is often based on expert opinion. The use of bone biopsy is safe and informative in guiding therapy.
Osteoporosis treatments for intervertebral disc degeneration and back pain: a perspective
Authors: Bhadouria Neharika , Holguin Nilsson
Published: April 2024

Low back pain derived from intervertebral disc (IVD) degeneration is a debilitating spinal condition that, despite its prevalence, does not have any intermediary guidelines for pharmacological treatment between palliative care and invasive surgery. The development of treatments for the IVD is complicated by the variety of resident cell types needed to maintain the regionally distinct structural properties of the IVD that permit the safe, complex motions of the spine. Osteoporosis of the spine increases the risk of vertebral bone fracture that can increase the incidence of back pain. Fortunately, there are a variety of pharmacological treatments for osteoporosis that target osteoblasts, osteoclasts and/or osteocytes to build bone and prevent vertebral fracture. Of particular note, clinical and preclinical studies suggest that commonly prescribed osteoporosis drugs like bisphosphonates, intermittent parathyroid hormone, anti-sclerostin antibody, selective estrogen receptor modulators and anti-receptor activator of nuclear factor-kappa B ligand inhibitor denosumab may also relieve back pain. Here, we cite clinical and preclinical studies and include unpublished data to support the argument that a subset of these therapeutics for osteoporosis may alleviate low back pain by also targeting the IVD.
Diet quality and cardiovascular disease risk among breast cancer survivors in the Pathways Study
Authors: Ergas Isaac J , Cheng Richard K , Roh Janise M , Kushi Lawrence H , Kresovich Jacob K , Iribarren Carlos , Nguyen-Huynh Mai , Rana Jamal S , Rillamas-Sun Eileen , Laurent Cecile A , Lee Valerie S , Quesenberry Charles P , Greenlee Heather , Kwan Marilyn L
Published: April 2024

Background

Women with breast cancer are at higher risk of cardiovascular disease (CVD) compared with women without breast cancer. Whether higher diet quality at breast cancer diagnosis lowers this risk remains unknown. We set out to determine if higher diet quality at breast cancer diagnosis was related to lower risk of CVD and CVD-related death.

Methods

This analysis included 3415 participants from the Pathway Study, a prospective cohort of women diagnosed with invasive breast cancer at Kaiser Permanente Northern California between 2005 and 2013 and followed through December 31, 2021. Scores from 5 diet quality indices consistent with healthy eating were obtained at the time of breast cancer diagnosis. Scores were categorized into ascending quartiles of concordance for each diet quality index, and multivariable adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated. P values were 2-sided.

Results

The Dietary Approaches to Stop Hypertension diet quality index was associated with lower risk of heart failure (HR = 0.53, 95% CI = 0.33 to 0.87; Ptrend = .03), arrhythmia (HR = 0.77, 95% CI = 0.62 to 0.94; Ptrend = .008), cardiac arrest (HR = 0.77, 95% CI = 0.61 to 0.96; Ptrend = .02), valvular heart disease (HR = 0.79, 95% CI = 0.64 to 0.98; Ptrend = .046), venous thromboembolic disease (HR = 0.75, 95% CI = 0.60 to 0.93; Ptrend = .01), and CVD-related death (HR = 0.70, 95% CI = 0.50 to 0.99; Ptrend = .04), when comparing the highest with lowest quartiles. Inverse associations were also found between the healthy plant-based dietary index and heart failure (HR = 0.60, 95% CI = 0.39 to 0.94; Ptrend = .02), as well as the alternate Mediterranean dietary index and arrhythmia (HR = 0.74, 95% CI = 0.60 to 0.93; Ptrend = .02).

Conclusion

Among newly diagnosed breast cancer patients, higher diet quality at diagnosis was associated with lower risk of CVD events and death.
Derazantinib alone and with atezolizumab in metastatic urothelial carcinoma with activating FGFR aberrations
Authors: Necchi Andrea , Ramlau Rodryg , Falcón González Alejandro , Chaudhry Arvind , Todenhöfer Tilman , Tahbaz Rana , Fontana Elisa , Giannatempo Patrizia , Deville Jean-Laurent , Pouessel Damien , Yoon Shinkyo , Powles Thomas , Bernat Mathieu , Häckl Manuel , Marszewska Michalina , McKernan Phil , Saulay Mikael , Scaleia Federica , Engelhardt Marc , Loriot Yohann , Siefker-Radtke Arlene , De Santis Maria
Published: April 2024

Background

This Phase 1b/2 study assessed the efficacy in terms of objective response rate (ORR) of the FGFR1/2/3 kinase inhibitor derazantinib as monotherapy or in combination with atezolizumab in patients with metastatic urothelial cancer (mUC) and FGFR1-3 genetic aberrations (FGFR1-3GA).

Methods

This multicenter, open-label study comprised 5 substudies. In Substudies 1 and 5, patients with mUC with FGFR1–3GA received derazantinib monotherapy (300 mg QD in Substudy 1, 200 mg BID in Substudy 5). In Substudy 2, patients with any solid tumor received atezolizumab 1200 mg every 3 weeks plus derazantinib 200 or 300 mg QD. In Substudy 3, patients with mUC harboring FGFR1–3GA received derazantinib 200 mg BID plus atezolizumab 1200 mg every 3 weeks. In Substudy 4, patients with FGFR inhibitor-resistant mUC harboring FGFR1–3GA received derazantinib 300 mg QD monotherapy or derazantinib 300 mg QD plus atezolizumab 1200 mg every 3 weeks.

Results

The ORR for Substudies 1 and 5 combined was 4/49 (8.2%, 95% confidence interval = 2.3% to 19.6%), which was based on 4 partial responses. The ORR in Substudy 4 was 1/7 (14.3%, 95% confidence interval = 0.4% to 57.9%; 1 partial response for derazantinib 300 mg monotherapy, zero for derazantinib 300 mg plus atezolizumab 1200 mg). In Substudy 2, derazantinib 300 mg plus atezolizumab 1200 mg was identified as a recommended dose for Phase 2. Only 2 patients entered Substudy 3.

Conclusions

Derazantinib as monotherapy or in combination with atezolizumab was well-tolerated but did not show sufficient efficacy to warrant further development in mUC.

Clinicaltrials.gov NCT04045613, EudraCT 2019-000359-15
Effect of an upper body exoskeleton for surgeons on postoperative neck, back, and shoulder complaints
Authors: Nutz Elisa , Jarvers Jan-Sven , Theopold Jan , Kleber Christian , Osterhoff Georg
Published: April 2024

Objectives

Surgeons are exposed to high levels of physical stress while working in the operating room. In industry, so-called exoskeletons are used to support the back and shoulder area. The aim of this study was to investigate the feasibility and effects of an upper body exoskeleton on postoperative physical complaints of surgeons.

Methods

Surgeons from a university hospital in the fields of orthopedics, trauma, and visceral surgery performed 2 operations of the same type and planned length on 2 different days. The first operation was performed without an exoskeleton, the second with an exoskeleton. The participants completed questionnaires on shoulder pain (Shoulder Pain and Disability Index [SPADI]), neck pain (Visual Analogue Scale [VAS] and Neck Disability Index [NDI]), and back pain (VAS and Oswestry Disability Index [ODI]) before and after the procedure.

Results

A total of 25 participants were included and performed 50 surgeries with a mean surgery duration of 144 minutes without and 138 minutes with the exoskeleton. Without the exoskeleton, the activity of the operation resulted in a significant increase of the VAS neck by 1.0 point (SD 1.2; P < .001), NDI by 4.8 (SD 8.6; P = .010), VAS back by 0.7 (SD 1.0; P = .002), and ODI by 2.7 (SD 4.1; P = .003). With the exoskeleton the participants reported significantly fewer complaints after the surgery (VAS neck: P = .001; NDI: P = .003; VAS back: P = .036; ODI: P = .036; SPADI: P = .016).

Conclusion

An upper body exoskeleton can significantly reduce the discomfort in the neck, shoulder, and back caused to surgeons by surgery.
The Efficacy of Propensity Score Matching for Separating Selection and Measurement Effects Across Different Survey Modes
Authors: Kibuchi Eliud , Sturgis Patrick , Durrant Gabriele B , Maslovskaya Olga
Published: April 2024

Effective evaluation of data quality between data collected in different modes is complicated by the confounding of selection and measurement effects. This study evaluates the utility of propensity score matching (PSM) as a method that has been proposed as a means of removing selection effects across surveys conducted in different modes. Our results show large differences in estimates for the same variables between parallel face-to-face and online surveys, even after matching on standard demographic variables. Moreover, discrepancies in estimates are still present after matching between surveys conducted in the same (online) mode, where differences in measurement properties can be ruled out a priori. Our findings suggest that PSM has substantial limitations as a method for separating measurement and selection differences across modes and should be used only with caution.
Are Digital Humanities platforms facilitating sufficient diversity in research? A study of the Transkribus Scholarship Programme
Authors: Nockels Joseph , Gooding Paul , Terras Melissa
Published: April 2024

To what extent do Digital Humanities (DH) platforms support access to diverse user cohorts? We take, as a case study, the Automated Text Recognition (ATR) platform Transkribus and its Transkribus Scholarship Programme (TSP), which provides free processing credits to eligible users. Using a mixed methods approach we address the following questions: What are the demographics of those using the TSP scheme? What work is enabled by such a scheme? How can this inform more equitable access to DH platforms? The findings demonstrate how ATR tools are currently used and made accessible. TSP applicants are overwhelmingly students (n = 111/156, 71.15 per cent) drawn from universities and research institutes, mostly in Europe, but are globally distributed; representing institutions that do not hold shares in Transkribus, and indicating a diverse user pipeline. Further work is required to increase potential benefits of the scholarship and to ensure sustainability. Increased dialogue between the Recognition and Enrichment of Archival Document-COOP and applicants would assist in the calculation of processing costs. We show financial—or in-kind—support is necessary to increase access to paid-for platforms, ensuring a diversity of DH research. We also provide recommendations for platform providers and funding bodies regarding access and the impact this can have, including locating a sustainable balance between absorbing the costs of maintaining DH or digital scholarship tools and providing sufficient support and training to further enable diverse research.
The CluMPR galaxy cluster-finding algorithm and DESI legacy survey galaxy cluster catalogue
Authors: Yantovski-Barth M J , Newman Jeffrey A , Dey Biprateep , Andrews Brett H , Eracleous Michael , Golden-Marx Jesse , Zhou Rongpu
Published: April 2024

Galaxy clusters enable unique opportunities to study cosmology, dark matter, galaxy evolution, and strongly lensed transients. We here present a new cluster-finding algorithm, CluMPR (Clusters from Masses and Photometric Redshifts), that exploits photometric redshifts (photo-z’s) as well as photometric stellar mass measurements. CluMPR uses a 2D binary search tree to search for overdensities of massive galaxies with similar redshifts on the sky and then probabilistically assigns cluster membership by accounting for photo-z uncertainties. We leverage the deep DESI Legacy Survey grzW1W2 imaging over one-third of the sky to create a catalogue of $\sim 300\, 000$ galaxy cluster candidates out to z = 1, including tabulations of member galaxies and estimates of each cluster’s total stellar mass. Compared to other methods, CluMPR is particularly effective at identifying clusters at the high end of the redshift range considered (z = 0.75–1), with minimal contamination from low-mass groups. These characteristics make it ideal for identifying strongly lensed high-redshift supernovae and quasars that are powerful probes of cosmology, dark matter, and stellar astrophysics. As an example application of this cluster catalogue, we present a catalogue of candidate wide-angle strongly lensed quasars in Appendix C. The nine best candidates identified from this sample include two known lensed quasar systems and a possible changing-look lensed QSO with SDSS spectroscopy. All code and catalogues produced in this work are publicly available (see Data Availability).
Spinach genomes reveal migration history and candidate genes for important crop traits
Authors: Nguyen-Hoang An , Sandell Felix L , Himmelbauer Heinz , Dohm Juliane C
Published: April 2024

Spinach (Spinacia oleracea) is an important leafy crop possessing notable economic value and health benefits. Current genomic resources include reference genomes and genome-wide association studies. However, the worldwide genetic relationships and the migration history of the crop remained uncertain, and genome-wide association studies have produced extensive gene lists related to agronomic traits. Here, we re-analysed the sequenced genomes of 305 cultivated and wild spinach accessions to unveil the phylogeny and history of cultivated spinach and to explore genetic variation in relation to phenotypes. In contrast to previous studies, we employed machine learning methods (based on Extreme Gradient Boosting, XGBoost) to detect variants that are collectively associated with agronomic traits. Variant-based cluster analyses revealed three primary spinach groups in the Middle East, Asia and Europe/US. Combining admixture analysis and allele-sharing statistics, migration routes of spinach from the Middle East to Europe and Asia are presented. Using XGBoost machine learning models we predict genomic variants influencing bolting time, flowering time, petiole color, and leaf surface texture and propose candidate genes for each trait. This study enhances our understanding of the history and phylogeny of domesticated spinach and provides valuable information on candidate genes for future genetic improvement of the crop.
ChimericFragments: computation, analysis and visualization of global RNA networks
Authors: Siemers Malte , Lippegaus Anne , Papenfort Kai
Published: April 2024

RNA–RNA interactions are a key feature of post-transcriptional gene regulation in all domains of life. While ever more experimental protocols are being developed to study RNA duplex formation on a genome-wide scale, computational methods for the analysis and interpretation of the underlying data are lagging behind. Here, we present ChimericFragments, an analysis framework for RNA-seq experiments that produce chimeric RNA molecules. ChimericFragments implements a novel statistical method based on the complementarity of the base-pairing RNAs around their ligation site and provides an interactive graph-based visualization for data exploration and interpretation. ChimericFragments detects true RNA–RNA interactions with high precision and is compatible with several widely used experimental procedures such as RIL-seq, LIGR-seq or CLASH. We further demonstrate that ChimericFragments enables the systematic detection of novel RNA regulators and RNA–target pairs with crucial roles in microbial physiology and virulence. ChimericFragments is written in Julia and available at: https://github.com/maltesie/ChimericFragments.