bluuebunny/crossref_metadata_2025 huggingface dataset:
Peirce on Truth
Authors: Howat Andrew
Published: February 2024

This chapter provides a brief introduction to Peirce’s conception of truth. It includes a guide to the most relevant primary sources; brief summaries of three recent, influential interpretations of those sources; and discussion of several ongoing controversies regarding these interpretations and common objections to Peirce’s view. It suggests that the best interpretations and defenses of Peirce’s view tend to carry commitments to other substantive and controversial views. This makes it difficult to defend Peirce’s view without first addressing broader issues of meaning (e.g., debate over representationalism, as discussed by Huw Price, for example) and/or metaphysics (e.g., Peirce’s “scholastic realism” as discussed by Robert Lane).
Powdery Scab of Potato: A Diagnostic Guide
Authors: Balendres Mark Angelo , Woodhall James , Whitworth Jonathan L. , Cumagun Christian Joseph R.
Published: February 2024

Powdery scab, caused by Spongospora subterranea, is a soil- and tuber-borne disease of potato. The fungus-like protozoan pathogen can be found around the world and in almost every large potato-producing state across the United States. Initial signs of infection in the eyes and lenticels of tubers are slightly sunken, purple-brown lesions. When a tuber lesion reaches maturity, the periderm bursts, releasing masses of tiny, powdery balls. The objective of this diagnostic guide is to provide detailed information on the isolation, sampling, pathogenicity testing, and detection of the pathogen in the soil and tubers using classical and molecular techniques to facilitate the identification of the disease in the laboratory and field.
Application of Biotechniques for In Vitro Virus and Viroid Elimination in Pome Fruit Crops
Authors: Bettoni Jean Carlos , Wang Min-Rui , Li Jing-Wei , Fan Xudong , Fazio Gennaro , Hurtado-Gonzales Oscar P. , Volk Gayle M. , Wang Qiao-Chun
Published: February 2024

Sustainable production of pome fruit crops is dependent upon having virus-free planting materials. The production and distribution of plants derived from virus- and viroid-negative sources is necessary not only to control pome fruit viral diseases but also for sustainable breeding activities, as well as the safe movement of plant materials across borders. With variable success rates, different in vitro-based techniques, including shoot tip culture, micrografting, thermotherapy, chemotherapy, and shoot tip cryotherapy, have been employed to eliminate viruses from pome fruits. Higher pathogen eradication efficiencies have been achieved by combining two or more of these techniques. An accurate diagnosis that confirms complete viral elimination is crucial for developing effective management strategies. In recent years, considerable efforts have resulted in new reliable and efficient virus detection methods. This comprehensive review documents the development and recent advances in biotechnological methods that produce healthy pome fruit plants.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
ROCK1 deficiency preserves caveolar compartmentalization of signaling molecules and cell membrane integrity
Authors: Shi Jianjian , Wei Lei
Published: February 2024

In this study, we investigated the roles of ROCK1 in regulating structural and functional features of caveolae located at the cell membrane of cardiomyocytes, adipocytes, and mouse embryonic fibroblasts (MEFs) as well as related physiopathological effects. Caveolae are small bulb‐shaped cell membrane invaginations, and their roles have been associated with disease conditions. One of the unique features of caveolae is that they are physically linked to the actin cytoskeleton that is well known to be regulated by RhoA/ROCKs pathway. In cardiomyocytes, we observed that ROCK1 deficiency is coincident with an increased caveolar density, clusters, and caveolar proteins including caveolin‐1 and ‐3. In the mouse cardiomyopathy model with transgenic overexpressing Gαq in myocardium, we demonstrated the reduced caveolar density at cell membrane and reduced caveolar protein contents. Interestingly, coexisting ROCK1 deficiency in cardiomyocytes can rescue these defects and preserve caveolar compartmentalization of β‐adrenergic signaling molecules including β1‐adrenergic receptor and type V/VI adenylyl cyclase. In cardiomyocytes and adipocytes, we detected that ROCK1 deficiency increased insulin signaling with increased insulin receptor activation in caveolae. In MEFs, we identified that ROCK1 deficiency increased caveolar and total levels of caveolin‐1 and cell membrane repair ability after mechanical or chemical disruptions. Together, these results demonstrate that ROCK1 can regulate caveolae plasticity and multiple functions including compartmentalization of signaling molecules and cell membrane repair following membrane disruption by mechanical force and oxidative damage. These findings provide possible molecular insights into the beneficial effects of ROCK1 deletion/inhibition in cardiomyocytes, adipocytes, and MEFs under certain diseased conditions.
Mitochondrial function and reactive oxygen species production during human sperm capacitation: Unraveling key players
Authors: Irigoyen Pilar , Mansilla Santiago , Castro Laura , Cassina Adriana , Sapiro Rossana
Published: February 2024

Sperm capacitation is a critical process for male fertility. It involves a series of biochemical and physiological changes that occur in the female reproductive tract, rendering the sperm competent for successful fertilization. The precise mechanisms and, specifically, the role of mitochondria, in sperm capacitation remain incompletely understood. Previously, we revealed that in mouse sperm mitochondrial activity (e.g., oxygen consumption, membrane potential, ATP/ADP exchange, and mitochondrial Ca2+) increases during capacitation. Herein, we studied mitochondrial function by high‐resolution respirometry (HRR) and reactive oxygen species production in capacitated (CAP) and non‐capacitated (NC) human spermatozoa. We found that in capacitated sperm from normozoospermic donors, the respiratory control ratio increased by 36%, accompanied by a double oxygen consumption rate (OCR) in the presence of antimycin A. Extracellular hydrogen peroxide (H2O2) detection was three times higher in CAP than in NC sperm cells. To confirm that H2O2 production depends on mitochondrial superoxide () formation, we evaluated mitochondrial aconitase (ACO2) amount, activity, and role in the metabolic flux from the sperm tricarboxylic acid cycle. We estimated that CAP cells produce, on average by individual, (59 ± 22)% more in the steady‐state compared to NC cells. Finally, we analyzed two targets of oxidative stress: lipid peroxidation by western blot against 4‐hydroxynonenal and succinate dehydrogenase (SDH) activity by HRR. We did not observe modifications in lipoperoxidation nor the activity of SDH, suggesting that during capacitation, the increase in mitochondrial H2O2 production does not damage sperm and it is necessary for the normal CAP process.
The Future of Disparities Research in Obstetric Anesthesia
Authors: McCullough D.
Published: February 2024

(Can J Anaesth. 2023;70(6):936–941)

In recent years, the stark racial disparities in maternal mortality have captured headlines, causing deep concern, particularly within minority communities. Black patients face a significantly higher risk of peripartum death compared with their White counterparts. As a Black female obstetric anesthesiologist practicing at a prominent academic center, the author has engaged in numerous conversations with Black patients who are fearful of these troubling statistics. The study conducted by Lee and colleagues, focusing on racial and ethnic disparities in obstetric anesthesia, is a significant step toward empowering clinicians with the knowledge needed to address this issue.
Management of Primary Immune Thrombocytopenia in Pregnancy
Authors: Bussel J.B. , Hou M. , Cines D.B.
Published: February 2024

(N Engl J Med. 2023;389:540–548)

Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by immunoglobulin G antiplatelet antibodies that lead to reduced platelet production and increased platelet clearance. It affects 1 in 3 people per 10,000 in the United States. ITP is more common in women of childbearing age, and during pregnancy, platelet counts may decrease, requiring special medical attention. Immunoglobulin G antiplatelet antibodies can also affect the fetus. The clinical variability of ITP complicates diagnosis and treatment, and uncertainty remains for many aspects of management. This article focuses on recent research on the risk assessment and management of primary ITP.
Perioperative Considerations in Management of the Severely Bleeding Coagulopathic Patient
Authors: Erdoes G. , Faraoni D. , Koster A. , Steiner M.E. , Ghadimi K. , Levy J.H.
Published: February 2024

(Anesthesiology. 2023; 138:535–560)

This clinical review explored coagulopathy in severely bleeding patients after major surgery (eg, cardiac surgery with cardiopulmonary bypass or CPB), serious trauma, and postpartum hemorrhage. There are a multitude of surgical and nonsurgical factors, or a mix of both, that can cause perioperative bleeding in patients. This includes fibrinolysis, metabolic acidosis, platelet impairment, thrombocytopenia, coagulation factor deficiency, activation of inflammatory pathways, hemodilution, hypothermia, and hypovolemia. Bleeding patients can often have previous hemostatic issues because of oral anticoagulants or antiplatelet therapy.
Risk Factors and Pregnancy Outcomes After SARS-CoV-2 in Pregnancy According to Disease Severity: A Nationwide Cohort Study With Validation of the SARS-CoV-2 Diagnosis
Authors: Aabakke A.J.M. , Petersen T.G. , Wøjdemann K. , Ibsen M.H. , Jonsdottir F. , Rønneberg E. , Andersen C.S. , Hammer A. , Clausen T.D. , Milbak J. , Burmester L. , Zethner R. , Lindved B. , Thorsen-Meyer A. , Khalil M.R. , Henriksen B. , Jønsson L. , Andersen L.L.T. , Karlsen K.K. , Pedersen M.L. , Hedermann G. , Vestgaard M. , Thisted D. , Fallesen A.N. , Johansson J.N. , Møller D.C. , Dubietyte G. , Andersson C.B. , Farlie R. , Skaarup Knudsen A.K. , Hansen L. , Hvidman L. , Sørensen A.N. , Rathcke S.L. , Rubin K.H. , Petersen L.K. , Jørgensen J.S. , Krebs L. , Bliddal M.
Published: February 2024

(Acta Obstet Gynecol Scand. 2023;102:282–293)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown to increase a patient’s risk of preterm labor, pre-eclampsia, the need for cesarean delivery, and stillbirth. This study aimed to analyze and better understand the risk factors and complications that relate to SARS-CoV-2 during pregnancy and delivery.
Combined Uterorelaxant Effect of Magnesium Sulfate and Terbutaline: Studies on Late Pregnant Rat Uteri In Vitro and In Vivo
Authors: Barna T. , Szucs K.F. , Schaffer A. , Mirdamadi M. , Hajagos-Toth J. , Gaspar R.
Published: February 2024

(Acta Obstet Gynecol Scand. 2023;102:457–464)

Preterm birth is a common and impactful complication of pregnancy and is defined as the delivery of a fetus between 20 and 37 weeks of gestation. It can lead to further complications and even developmental problems for the child that can be long term. Standard treatment for symptoms of preterm labor involves tocolytic drugs to stop contractions and delay delivery long enough for interventions to occur, minimizing effects on the infant. Although many different drugs are used, the efficacy and side effects of many are not well characterized or understood. This study was designed to assess the effectiveness and side effects of a combination of drugs: β2-agonist terbutaline and magnesium sulfate (MgSO4). This was done by examining the combined administration of the drugs in an isolated organ bath and performing in vivo smooth muscle electromyographic studies in pregnant rats.
The Acceptability of Implementing Patient-Reported Measures in Routine Maternity Care: A Systematic Review
Authors: Chen A. , Vayrynen K. , Leskela R.L. , Torkki P. , Heinonen S. , Tekay A. , Acharya G.
Published: February 2024

(Acta Obstet Gynecol Scand AOGS. 2023; 102: 406–419)

Patient-reported measures (PRMs) can be an important tool in assessing and capturing a patient’s perspective care in maternal medicine. By using PRMs, health care providers can measure the overall health and well-being of patients while they receive obstetric treatment, allowing more patient-centered care.
Association Between High Levels of Comorbid Anxiety and Depressive Symptoms and Decreased Likelihood of Birth Without Intervention: A Longitudinal Prospective Cohort Study
Authors: Hulsbosch L.P. , Boekhorst M.G.B.M. , Lodder P. , Potharst E.S. , Nyklíček I. , Bergink V. , Oei S.G. , Verhoeven C.J.M. , Pop V.J.M.
Published: February 2024

(BJOG. 2023;130(5):495–505)

Many factors contribute to postpartum mental health difficulties. Positive experiences during childbirth are associated with better postpartum mental health outcomes. It is unknown, however, how comorbid symptoms of anxiety and depression affect birth experiences or how poor mental health before delivery affects birth experiences. The aim of this study was to assess whether symptom trajectories of comorbid anxiety and depression were negatively associated with unassisted vaginal delivery.
Undergraduate Anesthesia Skills for a Global Surgery Agenda: Students’ Self-Reported Competence
Authors: Spijkerman S. , Manning D.M. , Green-Thompson L.P.
Published: February 2024

(Anesth Analg. 2023. doi: 10.1213/ANE.0000000000006375)

To address the lack of clear guidelines for undergraduate anesthesia training, this study assessed the self-perceived competence of medical students in South Africa. Maternal mortality is a concern, with a significant portion of deaths attributed to anesthesia. The country faces a shortage of specialist anesthesiologists, putting the responsibility on nonspecialist medical officers, including newly qualified community service officers. The study investigates the readiness of medical students to provide anesthesia services, with varying exposure to training during internships. The findings aim to support South Africa’s health needs and may guide the goals of global surgery in other developing nations.
Global Issues in Obstetric Anesthesia: Perspectives From South Africa, Japan, China, Latin America, and North America
Authors: Bishop D.G. , Fernandes N.L. , Dyer R.A. , Sumikura H. , Okada H. , Suga Y. , Shen F. , Xu Z. , Liu Z. , Vasco M. , George R.B. , Guasch E.
Published: February 2024

(Int J Obstet Anesth. 2023:54:103648)

Anesthesia provision varies worldwide, and obstetric anesthesia in particular is highly variable. The first country discussed in this article is South Africa, which is classified as a low-income to middle-income country. South Africa has high patient mortality related to cesarean delivery. The epidural rates for labor in South Africa are <5%, which is considered extremely low. Approximately one-third of maternal deaths investigated occurred following the administration of spinal anesthesia. In South Africa, it is 3 times more likely for maternal mortality to occur following cesarean delivery than vaginal birth. The mortality rates following a cesarean delivery in South Africa are also 50 times higher than in other regions of the world. Training has been implemented to reduce these statistics, although the level of preparedness following this training has been questioned.
Systematic Review of the Effectiveness of Remifentanil in Term Breech Pregnancies Undergoing External Cephalic Version
Authors: Lomas S. , Minton Z. , Daniels J.P.
Published: February 2024

(Int J Obstet Anesth. 2023:54:103649)

Approximately 3% to 4% of pregnancies involve a fetus in the breech position. External cephalic version (ECV) is supported and recommended to reduce the cesarean delivery rate. Neuraxial analgesia for ECV can improve the success rate; however, there are associated risks with the use of neuraxial analgesia in these cases. Remifentanil has recently been proposed as an alternative to neuraxial analgesia for ECV. This study aimed to assess and analyze the use of remifentanil in cases where ECV is necessary, as well as compare it to outcomes in ECV with other forms of analgesia.
Rates and Clinical Implications of Transplacental Transfer of Neuraxial Fentanyl to Neonate
Authors: Mark K. , LeBeau O.
Published: February 2024

(Am J Obstet Gynecol. 2023;228(4):478–479)

Epidural analgesia is widely used and accepted as a safe and effective method for pain management during labor and delivery. Though there is substantial research supporting this, there is also concern that some drugs can cross the placenta into the fetal blood stream. The main concern is the transmission of opioids across the placenta to the fetus during labor and before birth, thereby resulting in residual effects after birth. This study aimed to examine the frequency with which newborns test positive for fentanyl in their urine after the use of epidural analgesia, as well as assess factors that increase the likelihood of a positive test and the association between fentanyl positivity and clinical outcomes for the newborn.
The Use of Processed Electroencephalography (pEEG) in Obstetric Anesthesia: A Narrative Review
Authors: Corner H. , Barley M. , Metodiev Y.
Published: February 2024

(Int J Obstet Anesth. 2023:54:103650)

Accidental awareness while one is under general anesthesia is a large concern that can lead to long-term psychological side effects. One in 670 patients undergoing general anesthesia for cesarean delivery will experience accidental awareness. This is related to inaccurate anesthesia dosages due to pregnancy-related factors. Neuraxial analgesia during cesarean delivery is often considered the best way to avoid accidental awareness; however, this is not always possible. This review aimed to assess and analyze the use of processed electroencephalography (pEEG) during cesarean delivery.
Effect of Dexmedetomidine as an Adjuvant in Quadratus Lumborum Block in Patient Undergoing Caesarean Section: A Randomized Controlled Study
Authors: Singh N. , Anandan V. , Ahmad S.R.
Published: February 2024

(J Clin Anesth. 2022:81:110892)

Pain must be managed properly in surgical patients, especially those undergoing cesarean delivery (CD). Regional nerve blocks are used to relieve pain in postoperative patients as a part of multimodal analgesia. Ultrasound-guided blocks employed for abdominal surgeries include the transverse abdominis plane block and the quadratus lumborum (QL) block.
Whose Line Is It Anyway? Undergraduate Nursing Simulation for Breaking Bad News
Authors: Wiles Lynn L. , Mahoney Ingrid , Hutton Sarah
Published: February 2024

Breaking bad news regarding health care traditionally falls within the scope of practice of the provider. However, now that lab and diagnostic results are uploaded directly to smart devices, patients often receive results before they can be explained. The nurse or nursing student may be the first person the patient sees after reading results and the first to respond to patient questions about bad news. This article describes a simulation where senior baccalaureate students utilize the SPIKES protocol to become better prepared to field questions and break bad news should they find themselves in this situation.
Redefining Wound Healing Using Near-Infrared Spectroscopy
Authors: Andersen Charles , Reiter Homer-Christian J. , Marmolejo Valerie L.
Published: February 2024

OBJECTIVE

No standard definition for a completely healed wound currently exists; it is recommended that providers use a reliable wound assessment tool to determine healing. The objective of this feasibility study was to determine if a point-of-care, noncontact, near-infrared (NIR) imaging device could provide an objective measure of wound resolution and guide clinical decision-making for the optimal time to transition from protective wound dressings and gradual return to full activity.

METHODS

In this single-center feasibility study, adult patients 18 years and older with a lower extremity wound of any size and etiology were seen weekly for wound assessment and standard-of-care treatment. The researchers performed serial imaging with a point-of-care, noncontact, NIR imaging device (SnapshotNIR; Kent Imaging Inc) to assess the wound and surrounding skin and evaluated the difference in time to 100% reepithelialization on visual inspection and homogeneous tissue oxygen saturation levels at the wound site and surrounding closed skin envelope.

RESULTS

An average time difference of 13.5 ± 10 days (median, 12 days; range, 0–35 days) was observed between 100% reepithelialization on visual wound inspection and imaging assessment. Further, NIR imaging could determine when a patient was at risk for recurrent wound breakdown.

CONCLUSIONS

The addition of point-of-care, noncontact, NIR imaging may help guide clinical decision-making for the optimal time to transition from protective wound dressings with gradual return to full activity and minimize wound recurrence.
Primary Pelvic Anteversion
Authors: Baroncini Alice , Boissiere Louis , Yilgor Caglar , Larrieu Daniel , Alanay Ahmet , Pellisé Ferran , Kleinstueck Frank , Pizones Javier , Charles Yann Philippe , Roscop Cecile , Bourghli Anouar , Obeid Ibrahim ,   On behalf of the European Spine Study Group (ESSG)
Published: February 2024

Study Design.

Retrospective analysis of prospectively collected data.

Objective.

To identify the best definition of primary anteverted pelvis in the setting of adult spine deformity (ASD), and to investigate whether this is a pathologic setting that requires surgical correction.

Summary of Background Data.

While pelvic retroversion has been thoroughly investigated, pelvic anteversion (AP) is a far lesser discussed topic. Four different AP definitions have been proposed, and AP has been described as a normal or pathologic entity by different authors.

Methods.

All patients consulting for ASD at the five participating sites were included. Firstly, the four definitions of AP were compared with descriptive statistics (anatomic method – Pelvic Tilt <0°; Relative Pelvic Version method - RPV >5°; Roussouly method - Pelvic Incidence (PI)<50° and Sacral Slope (SS)>35°); low PT method - PT/PI <25th percentile). Secondly a subgroup analysis among operated AP patients with a two-year follow-up was performed. Complication rate, radiographic parameters and clinical scores (ODI, SF-36) were compared in a multivariate analysis between patients who did and did not maintain an AP at the 2-year follow-up.

Results.

1163 patients were available for the first analysis. The RPV method appeared to be the most appropriate to define AP in ASD patient. For the second analysis, data on 410 subjects were available, and most of them were young adults with idiopathic scoliosis that did not require pelvic fixation. AP patients who maintained an AP after ASD surgery presented comparable radiographic and clinical outcomes to the patients who presented a normo/retroverted pelvis after surgery.

Conclusions.

According to the results of the presented study, the RPV method is the most appropriate to define primary AP, which is not a pathologic condition and is most often observed in young adults with idiopathic scoliosis. Anteverted pelvis does not require direct surgical correction in this patient group.
COVID-19 and Pulmonary Hypertension: An Interesting Dynamic
Authors: Foroshani Saam , Airo Michael , Levine Avi , Frishman William H. , Aronow Wilbert S. , Lanier Gregg M.
Published: February 2024

The dynamic between pulmonary hypertension (PH) and COVID-19 has been under investigation since 2020, early in the pandemic. Although the pathophysiology of PH has been well-studied, new discoveries regarding the multisystemic effects of COVID-19 are still being uncovered. The cardiopulmonary effects of COVID-19 have led investigators to inquire about the interplay between these 2 conditions. Several factors are suggested to contribute to an increased risk of developing PH after infection with SARS-CoV-2. This includes cytokine storm, acute respiratory distress syndrome, and fibrotic changes seen in post-COVID-19 lung disease. Additionally, it has been proposed that certain medications used to treat PH may be applied to patients suffering from the cardiopulmonary complications of COVID-19. This review will focus on the interplay between COVID-19 and PH, with a special focus on the risk of developing PH after SARS-CoV-2 infection and the outcomes of patients with preexisting PH who are diagnosed with COVID-19. The potential benefits of utilizing off-label PH medications for COVID-19 patients will also be discussed.
Prehabilitation Using a Cardiac Rehabilitation Program for a Patient With a Total Artificial Heart Prior to Heart Transplantation
Authors: Racodon Michaël , Hermand Éric , Lemahieu Jean-Michel , Blairon Pauline , Vanhove Pierre , Secq Amandine
Published: February 2024

Introduction:

The last few decades have been marked by significant advances in mechanical cardiocirculatory support. A total artificial heart (TAH) became a viable therapeutic option for numerous patients as a bridge to heart transplantation, particularly for those in end-stage heart failure. This technology aims to address the various subsequent shortfalls of organs. This report reviews the impact of a prehabilitation on a patient with an Aeson TAH (Carmat).

Discussion:

We assessed improvements in functional capacity and quality of life (QoL) in a newly implanted patient following standard cardiac rehabilitation as a prehabilitation program, using 6-min walk test and the Short Form-12 (SF-12) health survey, respectively. Similar functional improvements were observed over a short period of 2 wk compared with a longer protocol for patients with a heart transplant, and superior effects on QoL. The patient was successfully transplanted 5 mo after the TAH implantation.

Prehabilitation of a patient with a TAH increased both their physical capacity and QoL.
NOS3 prevents MMP-9, and MMP-13 induced extracellular matrix proteolytic degradation through specific microRNA-targeted expression of extracellular matrix metalloproteinase inducer in hypertension-related atherosclerosis
Authors: Ramírez-Carracedo Rafael , Hernández Ignacio , Moreno-Gómez-Toledano Rafael , Díez-Mata Javier , Tesoro Laura , González-Cucharero Claudia , Jiménez-Guirado Beatriz , Alcharani Nunzio , Botana Laura , Saura Marta , Zamorano Jose L. , Zaragoza Carlos
Published: February 2024

Background:

Endothelial nitric oxide synthase (NOS3) elicits atheroprotection by preventing extracellular matrix (ECM) proteolytic degradation through inhibition of extracellular matrix metalloproteinase inducer (EMMPRIN) and collagenase MMP-13 by still unknown mechanisms.

Methods:

C57BL/6 mice lacking ApoE, NOS3, and/or MMP13 were fed with a high-fat diet for 6 weeks. Entire aortas were extracted and frozen to analyze protein and nucleic acid expression. Atherosclerotic plaques were detected by ultrasound imaging, Oil Red O (ORO) staining, and Western Blot. RNA-seq and RT-qPCR were performed to evaluate EMMPRIN, MMP-9, and EMMPRIN-targeting miRNAs. Mouse aortic endothelial cells (MAEC) were incubated to assess the role of active MMP-13 over MMP-9. One-way ANOVA or Kruskal–Wallis tests were performed to determine statistical differences.

Results:

Lack of NOS3 in ApoE null mice fed with a high-fat diet increased severe plaque accumulation, vessel wall widening, and high mortality, along with EMMPRIN-induced expression by upregulation of miRNAs 46a-5p and 486-5p. However, knocking out MMP-13 in ApoE/NOS3-deficient mice was sufficient to prevent mortality (66.6 vs. 26.6%), plaque progression (23.1 vs. 8.8%), and MMP-9 expression, as confirmed in murine aortic endothelial cell (MAEC) cultures, in which MMP-9 was upregulated by incubation with active recombinant MMP-13, suggesting MMP-9 as a new target of MMP-13 in atherosclerosis.

Conclusion:

We describe a novel mechanism by which the absence of NOS3 may worsen atherosclerosis through EMMPRIN-induced ECM proteolytic degradation by targeting the expression of miRNAs 146a-5p and 485-5p. Focusing on NOS3 regulation of ECM degradation could be a promising approach in the management of atherosclerosis.
Volume overload is a major characteristic in primary aldosteronism: a 3-year follow-up study
Authors: Kokko Eeva , Choudhary Manoj Kumar , Mutanen Aapo , Honkonen Milja , Tikkakoski Antti , Koskela Jenni K. , Hämäläinen Mari , Moilanen Eeva , Viukari Marianna , Matikainen Niina , Nevalainen Pasi I. , Pörsti Ilkka
Published: February 2024

Objectives:

We examined haemodynamics, focusing on volume balance and forward and backward wave amplitudes, before and after 2.8 years of targeted treatment of primary aldosteronism. Patients with essential hypertension and normotensive individuals were examined for comparison (n = 40 in each group).

Methods:

Recordings were performed using radial artery pulse wave analysis and whole-body impedance cardiography. Unilateral aldosteronism was treated with adrenalectomy (n = 20), bilateral aldosteronism with spironolactone-based medication (n = 20), and essential hypertension with standard antihypertensive agents.

Results:

Aortic SBP and DBP, forward and backward wave amplitudes, and systemic vascular resistance were equally elevated in primary aldosteronism and essential hypertension. All these haemodynamic variables were similarly reduced by the treatments. Primary aldosteronism presented with 1 litre (∼10%) extracellular water excess (P < 0.001) versus the other groups, and this excess was normalized by treatment. Initial pulse wave velocity (PWV) was similarly increased in primary aldosteronism and essential hypertension, but final values remained higher in primary aldosteronism (P < 0.001). In regression analyses, significant explanatory factors for treatment-induced forward wave amplitude reduction were decreased systemic vascular resistance (β = 0.380) and reduced extracellular water volume (β = 0.183). Explanatory factors for backward wave amplitude reduction were changes in forward wave amplitude (β = 0.599), heart rate (β = −0.427), and PWV (β = 0.252).

Conclusion:

Compared with essential hypertension, the principal haemodynamic difference in primary aldosteronism was higher volume load. Volume excess elevated forward wave amplitude, which was subsequently reduced by targeted treatment of primary aldosteronism, along with normalization of volume load. We propose that incorporating extracellular water evaluation alongside routine diagnostics could enhance the identification and diagnosis of primary aldosteronism.
Pupil size measurements with a multifunctional aberrometer/coherence interferometer/tomographer and two infrared-based pupillometers
Authors: Davidova Petra , Biller Marvin , Ademmer Vanessa , Kohnen Thomas
Published: February 2024

Purpose:

To compare precision of pupil size measurements of a multifunctional device (Pentacam AXL Wave [Pentacam]) and 2 infrared-based pupillometers (PupilX, Colvard) and to compare repeatability of Pentacam and PupilX.

Setting:

Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany.

Design:

Prospective, comparative trial.

Methods:

Pupil diameter of healthy eyes was measured with Colvard once and Pentacam without glare (WO) and with glare (WG), PupilX in 0, 1, and 16 lux 3 times each. In a second series, measurements with Pentacam WO and PupilX in 0.06 and 0.12 lux were assessed.

Results:

36 eyes of participants aged 21 to 63 years were included. Mean pupil diameter was 6.05 mm with Colvard, 5.79 mm (first series), 5.50 mm (second series) with Pentacam WO, 3.42 mm WG, 7.26 mm PupilX in 0, 4.67 mm 1, 3.66 mm 16, 6.82 mm in 0.06, and 6.39 mm in 0.12 lux. Measurements with Pentacam WO were significantly different to PupilX in 0, 0.06, 0.12, and 1 lux (all P < .001), but not to Colvard (P = .086). Pupil size measured with Pentacam WG and PupilX in 16 lux was not significantly different (P = .647). Consecutive measurements with Pentacam WO and WG had mean SD of 0.23 mm and 0.20 mm, respectively, and with PupilX 0.11 in 0, 0.24 mm 1, and 0.20 mm in 16 lux.

Conclusions:

Pentacam provided good assessment of pupil size but was not equivalent to PupilX in low lighting conditions. Repeatability was more favorable for Pentacam.
Clozapine Use in 22q11.2 Deletion Syndrome
Authors: Colijn Mark Ainsley
Published: February 2024

Background

22q11.2 deletion syndrome confers significant risk for the development of schizophrenia. While current recommendations regarding the management of psychotic symptoms in affected individuals are generally in keeping with treatment guidelines for general schizophrenia populations, evidence for the use of clozapine has come from case reports and retrospective observational data. As no reviews on the topic currently exist, a systematic review of clozapine use in 22q11.2 deletion syndrome was completed.

Methods

In November 2023, a literature search was completed using both PubMed and Scopus to identify English-language articles that reported the use of clozapine in humans with 22q11.2 deletion syndrome.

Results

Twenty-six articles describing 57 individuals were deemed eligible for inclusion. Most individuals had a diagnosis of treatment-resistant schizophrenia. Where reported, the mean or median dose of clozapine was relatively low, and the majority of individuals exhibited a good response (approximately 65.5% across individual case reports/series). While seizures were unsurprisingly the most commonly reported serious adverse effect, the majority of individuals were able to remain on (or be restarted on) clozapine by having their dose decreased and/or by adding an anticonvulsant (most commonly valproate).

Conclusions

This review reaffirms that individuals with 22q11.2 deletion syndrome may benefit from clozapine therapy even at a low dose, assuming they meet criteria for treatment-resistant schizophrenia and provided no contraindications exist. However, given the increased incidence of seizures in 22q11.2 deletion syndrome, the use of prophylactic anticonvulsant therapy should be considered, and hypoparathyroidism/hypocalcemia screened for and corrected before the initiation of clozapine. It is also recommended that clozapine blood levels be monitored.
Reflections on 3 Years of Innovation: Recognizing the Need for Innovation Beyond the Clinical Care Pathway
Authors: Bardach Shoshana H. , Perry Amanda N. , Cavanaugh Evan T. , Mulley Albert G.
Published: February 2024

The Susan and Richard Levy Healthcare Delivery Incubator is designed to bring about rapid, sustainable, scalable, and transformational health care redesign. All 10 projects in the initial 3 cohorts of teams embraced the Incubator process—forming diverse teams and following a design-thinking informed curriculum—and each successfully implemented improvements or innovations by the end of their project. The purpose of this article is to identify the key features of teams’ work that may help account for projects’ success. For the 10 projects completed, findings from debrief interviews and staff observations were examined to identify processes key to project’s success. Analysis highlighted cross-project learnings that indicate nonclinical aspects of care delivery that play a critical role in project innovation success. Innovating health care delivery requires considering social and political determinants of health. The Incubator’s process and structures enable teams to identify and respond to a broad range of health determinants.
Improving Compliance with Preoperative Nasal Povidone-Iodine to Prevent Surgical Site Infection in Vascular and Neurosurgery Services in a Community Teaching Hospital
Authors: Ugwummadu Chizoba , Schmidt Eric , Hoeprich Mark , Bonta Alyssa , Ridgway Kay , Walker Luella , Witkowski Julia , Weinstein Jeffrey , Cooper Mary Reich
Published: February 2024

Surgical site infections (SSI) remain a cause of morbidity, prolonged hospitalization, surgical readmission, and death. Nasal colonization with methicillin-resistant Staphylococcal aureus is a frequent cause of device-related SSI and nasal mupirocin has been used for prevention. More recently, povidone-iodine nasal swabs have become an alternative. It is cheaper, ensures compliance and there are no concerns regarding antimicrobial resistance. However, its adoption was suboptimal in a community hospital system in southwestern Ohio, especially in neurosurgery and vascular surgery. Quality improvement techniques, including solicitation of stakeholder input, surgeons and perioperative nurses’ education, and the use of reminders to order and administer the povidone-iodine nasal swabs improved physician ordering and nurse administration compliance, leading to fewer infections. The interventions continued after the project was completed, sustaining decreases in neurosurgery and vascular surgery, and fewer SSI through the first years of the pandemic. Despite the complexity of these surgeries, simple interventions were effective in addressing the problem.
A 2-Year, Randomized, Clinical Trial Examining the Effects of Speed of Processing Cognitive Training on Quality-of-Life Indicators in Adults With HIV-Associated Neurocognitive Disorder in Birmingham, Alabama: Results of the Think Fast Study
Authors: Vance David E. , Fazeli Pariya L. , Azuero Andres , Frank Jennifer S. , Wadley Virginia G. , Raper James L. , Pope Caitlin N. , Jacob Alexandra , Ball Karlene K.
Published: February 2024

Speed of processing (SOP) cognitive training may improve indicators of the quality of life (QoL) in people living with HIV. In this 2-year, longitudinal, randomized, controlled trial, 216 participants ages 40 years and older with HIV-associated neurocognitive disorder or borderline HIV-associated neurocognitive disorder were assigned to one of three groups: (a) 10 hr of SOP training (n = 70); (b) 20 hr of SOP training (n = 73), or (c) 10 hr of internet navigation control training (a contact control group; n = 73). Participants completed several QoL measures at baseline, posttest, and Year 1 and Year 2 follow-ups. Using linear mixed-effect models, no strong pattern of training effects across QoL outcomes was apparent, with small-magnitude, nonsignificant, between-group differences in depression, locus of control, and Medical Outcomes Study-HIV scales. In conclusion, despite prior work showing some transfer of SOP cognitive training improving QoL, that was not observed. Implications for research and practice are posited.
The role of donor sex on the post-liver transplant outcomes in patients with primary sclerosing cholangitis
Authors: Lee David Uihwan , Harmacinski Ashton , Kolachana Sindhura , Bahadur Aneesh , Lee KeeSeok , Lee Ki Jung , Pu Alex , Chou Harrison , Fan Gregory Hongyuan , Malik Raza
Published: February 2024

Background and aims:

Primary sclerosing cholangitis (PSC) can result in hepatic decompensation and require liver transplantation (LT). This study investigates the effect of the sex of the donor and recipient as a prognostic risk factor for adverse outcomes after LT in patients with PSC.

Methods:

UNOS registry was used to select LT patients with PSC from 1987 to 2019. The study cohort was stratified based on the sex of the recipient and further subdivided based on the sex of the donor. The primary endpoints of this study were all-cause mortality and graft failure, which were evaluated using a sequential Cox regression analysis.

Results:

This study included 2829 patients; 906 female recipients were transplanted from 441 male donors and 465 female donors. 1923 male recipients were transplanted from 1194 male donors and 729 female donors. Within the mismatch analyses, the male-to-male recipients also had a significantly reduced hazard ratio of graft failure compared to female-to-male transplants [aHR 0.51, 95% confidence interval (CI) 0.33–0.79, P = 0.003]. No difference in graft failure was observed in the mismatched female recipient subgroup. The mismatched male recipient group also showed a decreased hazard ratio of mortality from graft rejection and respiratory causes. No differences in specific mortality causes were identified in the mismatched female recipient group.

Conclusion:

This study demonstrated an increase in the risk of graft failure and mortality secondary to graft failure in male recipients of female donor livers. No differences in mortality or graft failure were identified in female recipients of male livers.
Prevalence and risk factors for cirrhotic cardiomyopathy: a prospective cross-sectional study
Authors: Xu Huawei , Zhang Yu , Gao Yanjing
Published: February 2024

Background

This study aimed to assess cardiac structure and function in patients with cirrhosis, to investigate the prevalence of cirrhotic cardiomyopathy (CCM) in patients with cirrhosis of different etiologies and to analyze the risk factors for the development of CCM.

Methods

This study selected cirrhotic patients aged 18–75 years who were hospitalized in Qilu Hospital of Shandong University. Patients with known heart disease, chronic lung disease, severe renal insufficiency, malignancy, thyroid disease, hypertension, diabetes or pregnancy were excluded. A total of 131 patients with cirrhosis were finally included. Based on the results of echocardiography, patients who met the diagnostic definition of CCM were included in the CCM group, otherwise, they were classified as the non-CCM group. The demographic and clinical data of the two groups were compared, and the clinical characteristics and risk factors of CCM were evaluated.

Results

The overall prevalence of CCM was 24.4%, and the occurrence of CCM was not related to the etiology of liver cirrhosis. The prevalence of CCM was significantly higher among cirrhotic patients complicated with ascites (31.4% vs. 16.4%; P = 0.046) or with portal vein thrombosis (PVT) (42.9% vs. 17.1%; P = 0.003). Older age [odds ratio (OR) = 1.058; 95% confidence interval (CI), 1.005–1.113; P = 0.032] and PVT (OR = 2.999; 95% CI, 1.194–7.533; P = 0.019) were independent risk factors for the development of CCM.

Conclusion

The prevalence of CCM in cirrhotic patients was 24.4%, and the occurrence of CCM was not related to the etiology of cirrhosis. The prevalence of CCM was higher in cirrhotic patients with ascites or PVT. Older age and PVT are independent risk factors for CCM, but validation in larger sample studies is still needed.
Comparative effectiveness and safety of ustekinumab at different intervals of maintenance phase in inflammatory bowel disease: a systematic review and meta-analysis
Authors: Bai Yaqing , Sun Yinghao , He Qi , Bai Xiaoyin , Yang Hong
Published: February 2024

Ustekinumab has two alternative drug maintenance intervals for inflammatory bowel disease (IBD), every 8 weeks (Q8W) and every 12 weeks (Q12W). The current study aimed at evaluating the comparative efficacy and safety of the two maintenance intervals in patients with IBD. A systematic search on PubMed, Web of Science, Cochrane Library, and EMBASE was carried out. The relative risk (RR) was pooled for efficacy and safety outcomes between the two intervals at various follow-up time points, categorized as short term (less than 44 weeks), medium term (about 92 weeks), and long term (about 152 weeks). A total of 14 studies with 1448 patients were included. Q8W didn’t result in a remarkably higher proportion of clinical remission compared to Q12W at short term (RR, 0.99; 95% CI, 0.83–1.16), medium term (RR, 1.05; 95% CI, 0.91–1.20), and long term (RR, 1.07; 95% CI, 0.91–1.26). Similarly, no substantial differences exist at short term in clinical response (RR, 1.00; 95% CI, 0.85–1.17), endoscopic remission (RR, 0.97; 95% CI, 0.26–3.69), and histologic improvement (RR, 1.13; 95% CI, 0.93–1.36) between the two intervals. For safety outcomes, the RR values for any adverse events in the short, medium, and long term were 1.10 (95% CI, 1.00–1.21), 1.14 (95% CI, 1.08–1.20), and 1.12 (95% CI, 1.07–1.17) for Q8W versus Q12W. Finally, we conclude that ustekinumab maintenance therapy administered every 8 and 12 weeks showed similar effectiveness in achieving efficacy outcomes in IBD patients, and most safety outcomes were significantly better for Q12W during the maintenance phase.
Evaluation of chronic hepatitis B patients who voluntarily discontinued oral antiviral therapy: is there an answer to the controversial topic?
Authors: Arslan Eyüp , Yildiz Yeşim , Karaşahin Ömer , Demir Yakup , Tümbül Mermutluoğlu Çiğdem , Ünlü Gülten , Kuşçu Ferit , Kaya Şafak , Akgül Fethiye , Damar Çakirca Tuba , Yilmaz Karadağ Fatma , Altunişik Toplu Sibel , Nazik Selçuk , Akdemir İrem , Özer Balin Şafak , Kandemir Fatma Özlem , İnan Dilara , Bayindir Yaşar , Taşova Yeşim , Çelen Mustafa Kemal
Published: February 2024

Objective

The uncertain treatment duration for nucleos(t)ide analogues (NA) used in the treatment of chronic hepatitis B (CHB) is an important problem for both patients and physicians. The aim of this study was to evaluate the determinants of virologic relapse (VR) and the optimum time of treatment discontinuation in the follow-up of CHB patients who voluntarily discontinued treatment after virological suppression was achieved under NA use.

Methods

Data from 138 patients from 11 centers were included in this registry-based study. Factors associated with VR were investigated using multivariate Cox regression analysis.

Results

Ninety-nine (71.7%) of the patients were HBeAg (Hepatitis B e antigen) negative. During the 24-month follow-up period after treatment discontinuation, VR occurred in 58.7% (n = 81) of all patients and 57.6% (n = 57) of HBeAg-negative patients. The duration of NA treatment was significantly shorter (cutoff 60 months) in HBeAg-negative patients who later developed VR. In addition, the duration of virologic remission achieved under NA treatment was significantly shorter (cutoff 52 months) in those who later developed VR. In the Cox multivariate regression model of HBeAg-negative patients, having less than 60 months of NA treatment (HR = 2.568; CI:1.280–5.148; P = 0.008) and the levels of alanine aminotransferase being equal to or higher than twice the upper level of normal at the beginning of treatment (HR = 3.753; CI:1.551–9.081; P = 0.003) were found to be statistically significant and independently associated with VR.

Conclusion

The findings of this study may provide clinical guidance in terms of determining the most appropriate discontinuation time for NA.
Receiving a Prenatal or Postnatal Diagnosis of (Dis)Ability
Authors: MacNeil Morgan , Campbell-Yeo Marsha
Published: February 2024

The phenomenon of carrying and birthing an infant with a (dis)ability is complex and emotionally driven for parents. Infants with (dis)abilities are at risk for long-term health and developmental challenges, which may cause fear and stress in families. Parents report dissatisfaction with their experience of learning of their infant's (dis)ability diagnosis. After unexpected news is given to expecting or new parents prenatally or postnatally, it is the nurse who is often left with parents during an extremely emotional and vulnerable time. Although nurses play a pivotal role in supporting parents through this vulnerable time, their specific role is not well defined. This narrative synthesis reviews the role of the nurse during complex family situations and applies findings to their role in supporting families through receiving the diagnosis of a (dis)ability for their infant either prenatally or postnatally. Nurses can assist parents through this process of adaptation by using a compassionate and empathetic approach in their care, facilitating opportunities for parent–infant bonding, speaking with person-first language, clarifying complex information, and assisting with allocation of various internal and external resources. Future research dedicated to the creation of best practice clinical guidelines on communicating with families during the diagnosis of (dis)ability would assist nurses and other health care professionals in meeting the multifaceted and sensitive needs of parents and families, ultimately contributing to improved health outcomes for the parents, family, and infant.