bluuebunny/crossref_metadata_2025 huggingface dataset:
Venoarterial Extracorporeal Membrane Oxygenation Implementation in Septic Shock Rat Model
Authors: Wang Tianlong , Zhang Mingru , Dong Wenhao , Wang Jing , Zhang Han , Wang Yuefu , Ji Bingyang
Published: February 2024

Septic shock, a global health concern, boasts high mortality rates. Research exploring the efficacy of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in septic shock remains limited. Our study aimed to establish a rodent model employing VA-ECMO in septic shock rats, assessing the therapeutic impact of VA-ECMO on septic shock. Nineteen Sprague–Dawley rats were randomly assigned to sham, septic shock, and (septic shock + VA-ECMO; SSE) groups. Septic shock was induced by intravenous lipopolysaccharides, confirmed by a mean arterial pressure drop to 25–30% of baseline. Rats in the SSE group received 2 hours of VA-ECMO support and 60 minutes of post-weaning ventilation. Sham and septic shock groups underwent mechanical ventilation for equivalent durations. Invasive mean arterial pressure monitoring, echocardiographic examinations, and blood gas analysis revealed the efficacy of VA-ECMO in restoring circulation and ensuring adequate tissue oxygenation in septic shock rats. Post-experiment pathology exhibited the potential of VA-ECMO in mitigating major organ injury. In summary, our study successfully established a stable septic shock rat model with the implementation of VA-ECMO, offering a valuable platform to explore molecular mechanisms underlying VA-ECMO’s impact on septic shock.
The Prevalence and Associated Factors of Peripheral Intravenous Complications in a Thai Hospital
Authors: Kaphan Kraiwan , Auypornsakul Siriporn , Somno Jenjira , Wongwattananan Watsaporn , Jamsittikul Kamonthip , Baicha Wilaiporn , Somsri Saowanuch , Sawatrak Thanyanan
Published: February 2024

Complications of peripheral intravenous catheters (PIVCs) remain a major contributor to health care costs and are a patient safety problem. The objective of this cross-sectional descriptive study was to examine the prevalence of complications and factors associated with complications from peripheral intravenous fluid administration. The study was conducted at a tertiary care hospital in Thailand. The instruments were developed from the literature review. Data were analyzed using SPSS statistics, version 22. The study examined 441 patients with a total of 497 PIVC sites. Phlebitis (level 1 and 2 only) occurred at 2.41% of all sites; infiltration (level 1 and 2 only) occurred at 1.01% of all sites, and extravasation (mild and moderate only) occurred at 0.60% of all sites. Factors associated with the occurrence of infiltration complications included receiving intravenous (IV) crystalloids (P = .03) and receiving IV analgesic drugs (P = .001). Age was statistically significantly related to extravasation complications (P = .001). Nurses should be aware of possible complications from peripheral intravenous fluid administration, especially in older patients and those receiving IV crystalloids or analgesic drugs.
Evaluating Nursing Students' Venipuncture and Peripheral Intravenous Cannulation Knowledge, Attitude, and Performance
Authors: Hernon Orlaith , McSharry Edel , Simpkin Andrew J. , MacLaren Iain , Carr Peter J.
Published: February 2024

Peripheral intravenous cannulation and venipuncture are among the most common invasive procedures in health care and are not without risks or complications. The aim of this study was to evaluate the current training provided to nursing and midwifery undergraduate students. Student knowledge, attitude, practice, and performance regarding these procedural skills were assessed. A knowledge, attitude, and practices survey was disseminated to final year nursing and midwifery students as the first phase of this study. For the second phase of the study, nursing students were video recorded and then observed performing the skill of peripheral intravenous cannulation in a simulated environment. Thirty-eight nursing and midwifery students completed the survey, and 66 nursing students participated in the observation study. Descriptive statistics were performed. The mean knowledge score was 7.2 out of 15.0, (standard deviation [SD] = 2.4), and the mean attitude score was 10.20 out of 18.00 (SD = 4.79). Qualitative data from the survey were categorized to demonstrate specific areas of focus for improving the training. The mean performance score was 16.20 out of 28.00 (SD = 2.98). This study provides valuable input to developing and enhancing evidence-based curricula. It can help educators and supervisors, in both academic and clinical settings, identify areas where clinical performance and education could be enhanced.
Phlebitis in Medical-Surgical Units
Authors: Antequera Isabela Granado , Saba Amanda , Furlan Maryana da Silva
Published: February 2024

The most commonly used vascular access is the peripheral intravenous catheter (PIVC). However, it can trigger complications and the occurrence of adverse events, such as phlebitis. This study evaluated the variables that are associated with the occurrence of phlebitis in medical and surgical inpatient units. This is an observational, retrospective, case-control study in medical and surgical hospitalization units of a private general hospital in the city of São Paulo. Participants were an average age of 66.3 years, and 71% were hospitalized in medical units. The risk variables associated with phlebitis were medical hospitalization (odds ratio [OR] = 4.36; P = .002), presence of comorbidity (OR = 10.73; P < .001), and having 5 or more PIVCs (OR = 53.79; P = .001). Regarding intravenous therapy, the use of contrast was a risk variable (OR = 2.23; P = .072). On the other hand, patient education regarding PIVCs was a protective measure against the development of phlebitis. The nursing team plays an essential role in the care of patients with PIVCs, inpatient guidance, planning, and device choice, taking into account the risk factors for phlebitis to maintain the preservation of vascular health and reduce adverse events.
The Lived Experience of Parents of Children and Youth With Special Healthcare Needs on Public and Private Insurance
Authors: Reaves Régine Placide , Chiang-Hanisko Lenny , Liehr Patricia , Gattamorta Karina
Published: February 2024

Purpose of the Study:

The number of children and youth with special health care needs (CYSHCN) is steadily growing in the United States. There are significant differences between private and public health plans in terms of cost, adequacy, and parent satisfaction. The purpose of this study was to understand the experiences of parents with CYSHCN enrolled in public and private insurance with or without a nurse care coordinator. This study also sought to understand parents' experience of support.

Primary Practice Setting:

The primary practice setting was participants' choice of location.

Methodology and Sample:

A qualitative descriptive design was used with 16 parents of children and young adults aged 2 to 21 years. Semistructured interviews were used, and Colaizzi's (1978) eight steps was the selected interpretive method.

Results:

Five themes emerged for parents navigating their child's insurance in the presence or absence of a nurse care coordinator: (1) Struggle with Self-Preservation, (2) Abandonment and Isolation, (3) Self-Reliance and Advocacy, (4) Interdependence, and (5) Lifeline. These themes were also dependent on the type of insurance and sources of support available.

Implications for Case Management Practice:

Models centered on care coordination can also be used as a mechanism to guide nurse care coordinators in practice. Providing care coordination support could help lessen the caregiver burden especially while navigating public or private insurance. Results highlighted how insurance companies can make potential changes within the health plan infrastructure. Incorporating nursing care coordination activities not only results in health care savings for the health plan but also improved health outcomes for its enrollees.
How SWAT Changed the Conversation
Authors: Lenhard Amanda , Daoud Majd , Donahue Lisa , Jones Sherri , Kip Paula L. , Zapf Rachel L. , Minnier Tamra E.
Published: February 2024

Purpose of Study:

Hospital overcrowding and delays in discharge are serious issues in the modern health care landscape and can lead to poor patient outcomes and health care personnel (HCP) burnout. The goal of this project was to develop a collaborative forum where HCP representing the entire spectrum of the inpatient care team, including case management team members, could connect to discuss challenges and barriers to patient discharge. The following describes the development, implementation, and outcomes of the discharge SWAT (Solutions, Wins, Actions, and Tactics) team, which is a 30-min virtual daily meeting where discussion is primarily centered around challenges in discharging individual patients and addressing case manager needs. The primary aim of SWAT meetings is fostering a positive atmosphere to address barriers to discharge while prioritizing patient care and outcomes.

Primary Practice Setting:

This study was conducted in a 40-hospital academic health system in the United States.

Methodology and Sample:

SWAT meetings were first implemented at a representative flagship facility in a health system. HCP at this first facility were surveyed to assess satisfaction with SWAT meetings. SWAT meetings then were implemented at the majority of facilities in a 40-hospital academic health system. During SWAT implementation, average inpatient length of stay (LOS) and patient care transitions were monitored for participating and nonparticipating service lines.

Results:

Among surveyed HCP, the majority view SWAT meetings favorably and reported that it was a valuable use of their time and positively impacted their work in the patient discharge space. Nonprovider and case management staff in particular valued the SWAT meetings and found them beneficial. LOS remained stable for patients under the care of participating providers, despite the upheaval of the ongoing COVID-19 pandemic, and the research team also observed a positive impact of SWAT meetings on appropriate inpatient care transitions.
Longing for a Voice
Authors: Soyaslan Bilge Dilek , Alıncak Gamze , Ilkaz Neslihan , Zengin Hilal
Published: February 2024

Tracheostomy involves a challenging care process in which both patients and caregivers have difficulty communicating. Loss of speaking ability negatively affects caregivers as well as patients. The objective of this study was to examine the experiences of caregivers of patients with tracheostomy during care and after the first vocal exercise. This is a qualitative interview study using in-depth interviews. We used Colaizzi's method of data analysis. The interviews were carried out with 17 caregivers from March to July 2023. Two main themes were identified: the communication process and the first time hearing the patient's voice. In addition, communication techniques, difficulty in communication, providing motivation, and emotions were considered as subthemes. A better quality of care can be provided by understanding the experiences of caregivers of patients with tracheostomy, by sharing feelings and thoughts, and by using patient-specific communication methods.
Specific Instructions Are Important
Authors: van Dellen Florian , Aurich(-Schuler) Tabea , Burkhardt Carla , Labruyère Rob
Published: February 2024

Objective

The aim of the study is to evaluate how gait kinematics and muscle activity during robot-assisted gait training are affected by different combinations of parameter settings and a number of instruction types, ranging from no instructions to goal-specific instructions.

Design

Robots for gait therapy provide a haptic guidance, but too much guidance can limit the active participation. Therapists can stimulate this active participation either with instructions or by adapting device parameters. How these two factors interact is still unknown. In the present study, we test the interaction of three different parameter settings and four instruction types in a cross-sectional study with 20 children and adolescents without impairment. Gait kinematics and surface electromyography were measured to evaluate the immediate effects.

Results

We found that only goal-specific instructions in combination with a low guidance led to a moderate but significant change in gait kinematics. The muscle activity was altered by all instructions, but the biggest effect was found for goal-specific instructions with a 2.5 times higher surface electromyography amplitude compared to no instruction.

Conclusions

Goal-specific instructions are a key element of robot-assisted gait therapy interventions and device parameter adjustments may be used to modulate their effects. Therapists should pay close attention to how they instruct patients.
Clinical Research Fellowship Fosters Mentorship, Teamwork, and Productivity: Our 11-Year Experience With a Craniofacial Research Fellowship
Authors: Romeo Dominic J. , Du Steven , Massenburg Benjamin B. , Ng Jinggang J. , Wu Meagan , Villavisanis Dillan F. , Fischer John P. , Swanson Jordan W. , Bartlett Scott P. , Taylor Jesse A.
Published: February 2024

Introduction:

This study describes the development and explores the academic impact of a cleft and craniofacial research fellowship.

Materials and Methods:

Research and career outcomes from 3 cleft and craniofacial surgeons, 14 clinical fellows, and 25 research fellows between 2010 and 2023 were examined. Academic productivity was measured by the number of peer-reviewed publications indexed in PubMed and podium presentations at national/international meetings. Residency match statistics were recorded for eligible research fellows.

Results:

Over this 14-year period (11 with research fellows), the team produced 500 publications in 96 peer-reviewed journals, with 153 (31%) in Plastic and Reconstructive Surgery, 117 (23%) in the Journal of Craniofacial Surgery, and 32 (6%) in The Cleft Palate-Craniofacial Journal. Yearly publications increased from 15.3±7.6 per year (before fellowship) to 23.0±5.3 (with 1 fellow) to 38.3±12.9 (2 fellows) to 81.0±5.7 (3 fellows; P<0.001). There was a strong annual linear growth in publications since the beginning the research fellowship position (r=0.88, P<0.001). All (100%) clinical research fellows developed strong relationships with senior surgeons, and all who applied to plastic surgery residency matched a significantly higher success rate than the national average (P<0.05).

Conclusion:

Implementing a structured cleft and craniofacial clinical research fellowship was associated with a broad impact across all cleft and craniofacial team members, as reflected by increased academic output and high match rates among fellows. The fellowship also strengthens the talent pipeline into plastic surgery by fostering meaningful mentor/mentee relationships and provides a model that can be adopted in both surgical and nonsurgical fields.
The Evaluation of Objective and Subjective Fate of Teeth in the Mandible Fracture Line and the Management—A Center’s Experience
Authors: Gao Minghua , Li Fangjie , Wang Zhonghua
Published: February 2024

Objective:

The decision to retain or extract teeth in the line of mandibular fractures has been a subject of debate in much of the scientific literature, and there is a need for further evidence to clear this issue. Thus, the aim of this study was to investigate both the positive and negative effects of teeth in the line of mandibular fractures provide more evidence in this field, as well as take into consideration patients’ quality of life after the surgery.

Methods:

Patients after trauma with teeth in the line of mandibular fractures were included in this study. Open reduction and rigid internal fixation, elastic intermaxillary reduction were expected to achieve a satisfactory occlusion and/or anatomical reduction in the fragments as assessed by orthopantomogram, computed tomography scans, and clinical examination. The remaining cases had maxillomandibular fixation (MMF) with an arch bar and bridle wire. All the patients included in this study will take the Visual Analog Scale score evaluation before and after surgery subjectively to further verify the impact on their life qualify, as well as the further treatment needed.

Results:

A total of 78 patients with teeth in the line of mandibular fractures were included in this study. Open reduction and rigid internal fixation was used in 37 patients, whereas another 35 patients accepted elastic intermaxillary reduction. Six cases underwent MMF. The number of involved teeth was 83. Three of the 83 teeth involved in the fracture lines healed with complications. In the cases where the teeth had been removed before fracture treatment, or in cases of delayed extractions, no complications were noted. The majority of the patients felt good about the whole treatment, however, 4 in the MMF group complained about worry about their oral health due to MMF leading to mouth open limitation.

Conclusion:

The factors that should be considered for removal include the condition of the teeth and alveolar bone, the timing and the type of treatment, as well as the patients’ desire, if possible. This is an individual-based decision that needs to consider more objective and subjective potential risks to avoid complications.
Polyetheretherketone Implant Cranioplasty for Large Cranial Defects: A Seven-Year Follow-Up
Authors: Sanchez Cristina V. , Krag Andreas E. , Barnett Sam , Welch Babu G. , Rozen Shai M.
Published: February 2024

Background:

Goals of a cranioplasty include protection of the brain, restoration of normal appearance, and neurological function improvement. Although choice of materials for cranial remodeling has changed through the years, computer-designed polyetheretherketone (PEEK) implant has gained traction as a preferred material used for cranioplasty. However, long-term outcomes and complications of PEEK implants remain limited. The goal of this study was to report long-term clinical outcomes after PEEK implant cranioplasty.

Methods:

A retrospective chart review was performed on patients undergoing PEEK cranioplasty between January 2007 and February 2023. Preoperative, intraoperative, and postoperative data were collected and analyzed.

Results:

Twenty-two patients were included in this study. Mean postoperative follow-up time was 83.45 months (range: 35.47–173.87). Before PEEK implant cranioplasty, patients with multiple cranial procedures had undergone a mean of 2.95 procedures. PEEK implant cranioplasty indications were prior implant infection (14) and secondary reconstruction of cranial defect (8). The mean implant size was 180.43 cm2 (range: 68.00–333.06). Four patients received a 2-piece implant. Postoperative complications included: perioperative subgaleal self-resolving fluid collection in 1 patient, hematoma in another, and 3 infections resulting in explantations with successful reinsertion in 2 patients. Four of 5 patients with preoperative history of seizures reported improved seizures and all 4 patients with preoperative syndrome of the trephined reported improved symptoms and neurological function.

Conclusion:

At a mean follow-up of 7 years, most PEEK implants continued to provide protection to the brain and consistent symptom relief in patients suffering from prior postcraniectomy/craniotomy sequelae of seizures and syndrome of the trephined.
Evaluation of Bone Thickness and Density Values in Resistance Regions in Rapid Maxillary Expansion Using Computed Tomography
Authors: Lale Bekir , Yildirim Mücahid , Altindağ Ali , Aydoğdu Demet
Published: February 2024

Objectives:

This study used computed tomography (CT) to compare the bone thickness and density values around the zygomaticomaxillary, zygomaticotemporal, and pterygomaxillary sutures that are resistant to rapid maxillary expansion (RME) treatment according to age, sex, and cervical vertebrae maturation (CVM) stage.

Methods:

The study included 200 paranasal sinus records obtained for medical diagnosis and examination in a radiology clinic. The records provided data on 110 males and 90 females aged between 4 and 28 years. Bone thickness and density values around the zygomaticomaxillary, zygomaticotemporal, and pterygomaxillary sutures were measured using CT imaging. The correlations of bone thickness and density values with the variables of age, sex, and CVM stage were evaluated.

Results:

No statistically significant difference was revealed between the bone thickness values around the zygomaticomaxillary and zygomaticotemporal sutures and age, sex, CVM stage, and the right and left regions of the same individual (P>0.05). A strong correlation was identified between Hounsfield units (Hu) values on bone density in all 3 regions and age and sex (P<0.001). No correlation was found between the CVM stage and density values around the zygomaticomaxillary, zygomaticotemporal, and pterygomaxillary sutures (P>0.05).

Conclusions:

The Hu values of the records from females were higher than those of males in all age groups. It was observed that with increasing age, bone density values increased in all 3 regions, and thus circummaxillary region’s Hu value increased.
Survival and Quality of Life after Isolated Hepatic Perfusion with Melphalan as a Treatment for Uveal Melanoma Liver Metastases – Final Results from the Phase III Randomized Controlled Trial SCANDIUM
Authors: Olofsson Bagge Roger , Nelson Axel , Shafazand Amir , All-Eriksson Charlotta , Cahlin Christian , Elander Nils , Gustavsson Anders , Helgadottir Hildur , Kiilgaard Jens Folke , Kinhult Sara , Ljuslinder Ingrid , Mattsson Jan , Rizell Magnus , Sternby Eilard Malin , Ullenhag Gustav J. , Nilsson Jonas A. , Ny Lars , Lindnér Per
Published: February 2024

Objective:

To investigate overall survival (OS) and health-related quality of life (HRQOL) of first-line isolated hepatic perfusion (IHP) compared to best alternative care (BAC) for patients with uveal melanoma liver metastases.

Summary Background Data:

Approximately half of patients with uveal melanoma develop metastatic disease, most commonly in the liver and systemic treatment options are limited. Isolated hepatic perfusion (IHP) is a locoregional therapy with high response rates but with unclear effect on overall survival (OS).

Methods:

In this phase III randomized controlled multicenter trial (the SCANDIUM trial) patients with previously untreated isolated uveal melanoma liver metastases were included between 2013-2021, with at least 24 months of follow-up. The planned accrual was 90 patients randomized 1:1 to receive a one-time treatment with IHP or BAC. Crossover to IHP was not allowed. The primary endpoint was the 24-month OS rate, with the hypothesis of a treatment effect leading to a 50% OS rate in the IHP group compared to 20% in the control group. HRQOL was measured by the EuroQol 5-domains 3-levels (EQ-5D-3L) questionnaire over 12 months.

Results:

The intention-to-treat (ITT) population included 87 patients randomized to the IHP group (43 patients; 41 [89%] received IHP) or the control group (44 patients). The control group received chemotherapy (49%), immunotherapy (39%), or localized interventions (9%). In the ITT population, the median PFS was 7.4 months in the IHP group compared with 3.3 months in the control group, with a hazard ratio of 0.21 (95% CI, 0.12-0.36). The 24-month OS rate was 46.5% in the IHP group versus 29.5% in the control group (P=0.12). The median OS was 21.7 months versus 17.6 months, with a hazard ratio of 0.64 (95% CI, 0.37-1.10). EQ-5D-3L showed a sustained high health status for the IHP group over 12 months, compared to a deteriorating trend in the control group.

Conclusions:

For patients with liver metastases from uveal melanoma, IHP offers high response rates translating to a benefit in PFS including a trend of better HRQOL compared to the control group. However, the primary endpoint of OS at 24 months was not met.
Basiliximab Induction and Postoperative Steroid-free Immunosuppression With Tacrolimus in Pediatric Liver Transplantation: A Randomized Clinical Trial
Authors: Dong Chong , Song Zhuolun , Sun Chao , Wang Kai , Zhang Wei , Chen Jing , Zheng Weiping , Yang Yang , Wang Zhen , Han Chao , Jiao Lijun , Zhang Guofeng , Xie Enbo , Gao Wei , Shen Zhongyang
Published: February 2024

Background.

Optimizing the immunosuppressive regimen is essential to improve the long-term outcomes of pediatric liver transplant recipients.

Methods.

We conducted a prospective, randomized, open-label study to compare the safety and efficacy of 2 treatment approaches during pediatric liver transplantation: tacrolimus monotherapy following basiliximab induction (the study group) and a dual regimen of tacrolimus plus steroids (the control group). A total of 150 patients were enrolled, with 75 patients allocated to each group.

Results.

In both groups, recipients achieved graft and recipient overall survival rates exceeding 93%, with no statistically significant differences between them. However, the study group exhibited a significantly lower incidence of acute cellular rejection (ACR), delayed occurrence of ACR, and an improved ACR-free survival rate at 2 y compared with the control group. Notably, the study group also showed a significant reduction in the incidence of de novo donor-specific antibodies at 3-mo and 2-y posttransplant. Furthermore, 6 mo after the transplant, the study group demonstrated significant improvements in weight-for-age Z score and height-for-age Z score. No notable differences were observed in postoperative complications or the incidence of liver fibrosis between the 2 groups.

Conclusions.

Basiliximab induction combine with tacrolimus (TAC) monotherapy is a safe and effective immunosuppressive regimen to reduce the episodes of ACR without influencing the development of liver fibrosis and graft and recipient survival rate after pediatric liver transplantation.
Localized Liver Injury During Normothermic Ex Situ Liver Perfusion Has No Impact on Short-term Liver Transplant Outcomes
Authors: Martin Jack L. , Rhodes Freya , Upponi Sara , Udeaja Yagazie , Swift Lisa , Fear Corina , Webster Rachel , Webb Gwilym James , Allison Michael , Paterson Anna , Gaurav Rohit , Butler Andrew J. , Watson Christopher J. E.
Published: February 2024

Background.

Normothermic ex situ liver perfusion (NESLiP) has the potential to increase organ utilization. Radiological evidence of localized liver injury due to compression at the time of NESLiP, termed cradle compression, is a recognized phenomenon but is poorly characterized.

Methods.

A retrospective analysis of a prospectively collected database was performed of transplanted livers that underwent NESLiP and subsequently had a computed tomography performed within the first 14 d posttransplant. The primary study outcome was 1-y graft survival.

Results.

Seventy livers (63%) were included in the analysis. Radiological evidence of cradle compression was observed in 21 of 70 (30%). There was no difference in rate of cradle compression between donor after circulatory death and donated after brain death donors (P = 0.37) or with duration of NESLiP. Univariate analysis demonstrated younger (area under the receiver operating characteristic, 0.68; P = 0.008; 95% confidence interval [CI], 0.55-0.82) and heavier (area under the receiver operating characteristic, 0.80; P < 0.001; 95% CI, 0.69-0.91) livers to be at risk of cradle compression. Only liver weight was associated with cradle compression on multivariate analysis (odds ratio, 1.003; P = 0.005; 95% CI, 1.001-1.005). There was no difference in 1-y graft survival (16/17 [94.1%] versus 44/48 [91.6%]; odds ratio, 0.69; P = 0.75; 95% CI, 0.07-6.62).

Conclusions.

This is the first study assessing the impact of cradle compression on outcome. We have identified increased donor liver weight and younger age as risk factors for the development of this phenomenon. Increasing utilization of NESLiP will result in the increased incidence of cradle compression but the apparent absence of long-term sequelae is reassuring. Routine postoperative axial imaging may be warranted.
Outcomes and Management of Re-Establishing Bariatric Patients
Authors: Medhati Pourya , Saleh Omnia S , Nimeri Abdelrahman , Apovian Caroline , Thompson Christopher , Jirapinyo Pichamol , Sheu Eric G , Tavakkoli Ali
Published: February 2024

BACKGROUND:

Lifelong follow-up after metabolic and bariatric surgery (MBS) is necessary to monitor for patient outcomes and nutritional status. However, many patients do not routinely follow-up with their MBS team. We studied what prompted MBS patients to seek bariatric care after being lost to follow-up and the subsequent treatments they received.

STUDY DESIGN:

A retrospective cohort study of patients after MBS who had discontinued regular MBS follow-up but represented to the MBS clinic between July 2018 and December 2022 to re-establish care. Patients with a history of a sleeve gastrectomy (SG), Roux-En-Y gastric bypass (RYGB), and adjustable gastric banding (AGB) were included.

RESULTS:

We identified 400 patients (83.5% women, mean age 50.3 ± 12.2 years at the time of re-establishment of bariatric care), of whom 177 (44.3%) had RYGB, 154 (38.5%) had SG, and 69 (17.2%) had AGB. Overall, recurrent weight gain was the most common reason for presentation for all three procedures (81.2% in SG, 62.7% in RYGB, and 65.2% in AGB; p < 0.001). Patients who underwent SG were more likely to undergo a revision MBS compared with patients who underwent RYGB (16.9% vs 5.8%, p < 0.001), whereas patients who underwent RYGB were more likely to undergo an endoscopic intervention than patients who underwent SG (17.5% vs 7.8%, p < 0.001). The response to antiobesity medication agents, specifically glucagon-like peptide-1 receptor agonists drugs, was better in patients who underwent RYGB, than that in patients who underwent SG.

CONCLUSIONS:

This study highlights recurrent weight gain as the most common reason for patients after MBS seeking to re-establish care with the MBS team. SG had a higher rate of revision MBS than RYGB, whereas endoscopic interventions were performed more frequently in the RYGB group. Antiobesity medication agents, especially glucagon-like peptide-1 receptor agonists drugs, were more effective in patients who underwent RYGB.
Evaluating the Safety and Efficacy of Topical Insulin for Ocular Disease: A Systematic Review
Authors: de Oliveira Andrade Luís Jesuino , Matos de Oliveira Gabriela Correia , Santos França Caroline , Matos de Oliveira Luís
Published: February 2024

Introduction

Ocular surface disorders are prevalent, impacting millions worldwide and causing significant morbidity. Conventional treatments often fall short in addressing refractory cases. Topical insulin has emerged as a potential therapeutic option.

Objective

This systematic review aimed to evaluate the safety and efficacy of topical insulin for ocular diseases.

Methods

We conducted a systematic review in major databases including the PubMed, MEDLINE, and EMBASE for studies published from (1976 Jan - 2024 Feb) investigating topical insulin for ocular conditions. Studies were screened and selected based on predefined inclusion/exclusion criteria. Data on safety and efficacy were extracted and analyzed.

Results

Ten studies (1 case-control, 3 randomized prospective, 3 retrospective, and 3 double-blind designs) met the inclusion criteria. Studies explored various indications, including neurotrophic corneal ulcers, persistent epithelial defects, recurrent epithelial erosions, dry eye disease, and postoperative corneal wound healing in diabetic patients. Overall, findings suggested promising outcomes with topical insulin: promoting healing of refractory neurotrophic corneal ulcers, accelerating reepithelialization in persistent epithelial defects, reducing recurrence of recurrent epithelial erosions, improving symptoms and reducing corneal staining in dry eye disease, enhancing postoperative corneal epithelial wound healing in diabetic patients. Adverse events were minimal and primarily reported as transient stinging or discomfort.

Conclusion

This review provides encouraging evidence for the therapeutic potential of topical insulin in diverse ocular diseases. While methodological limitations exist, particularly in non-randomized studies, the current body of literature suggests topical insulin may offer a safe and effective treatment option for patients with refractory corneal disorders.
Mitigating Stress: Exploring how our feet change shape with size
Authors: Treherne Paige , Lee Erin CS , Rainbow Michael J , Kelly Luke A
Published: February 2024

If human skeletal shape increases proportionally with size (isometric scaling) this can produce exponential increases in joint contact stresses. However, if skeletal shape changes as a function of size (allometric scaling) this can mitigate increases in joint contact stress by changing the surface area to volume ratio. Here we explored whether human foot bones scale with allometry and, if so, to identify the shape features that are associated with bone size. Computed tomography scans of the two largest foot bones (talus, calcaneus) were obtained from 36 healthy individuals. We implemented a scaling analysis for each joint surface area and bone. We performed a Procrustes ANOVA to establish the shape features associated with bone size. In line with our hypothesis, articular surfaces on the talus and the posterior facet of the calcaneus all scaled with positive allometry. Interestingly, the calcaneus scaled with negative allometry, appearing more cube-like with increasing size. This may be important for mitigation of internal bone stresses with increasing skeletal size. Our findings suggest distinct, but varied scaling strategies within the foot. This may reflect the requirement to maintain healthy joint contact and internal bone stresses with increasing size.
STCC: consensus clustering enhances spatial domain detection for spatial transcriptomics data
Authors: Hu Congcong , Wei Nana , Yang Jiyuan , Wu Hua-Jun , Zheng Xiaoqi
Published: February 2024

The rapid advance of spatially resolved transcriptomics technologies has yielded substantial spatial transcriptomics data. Deriving biological insights from these data poses non-trivial computational and analysis challenges, of which the most fundamental step is spatial domain detection (or spatial clustering). Although a number of tools for spatial domain detection have been proposed in recent years, their performance varies across datasets and experimental platforms. It is thus an important task to take full advantage of different tools to get a more accurate and stable result through consensus strategy. In this work, we developed STCC, a novel consensus clustering framework for spatial transcriptomics data that aggregates outcomes from state-of-the-art tools using a variety of consensus strategies, including Onehot-based, Average-based, Hypergraph-based and wNMF-based methods. Comprehensive assessments on simulated and real data from distinct experimental platforms show that consensus clustering significantly improves clustering accuracy over individual methods under varied input parameters. For normal tissue samples exhibiting clear layered structure, consensus clustering by integrating multiple baseline methods leads to improved results. Conversely, when analyzing tumor samples that display scattered cell type distribution patterns, integration of a single baseline method yields satisfactory performance. For consensus strategies, Average-based and Hypergraph-based approaches demonstrated optimal precision and stability. Overall, STCC provides a scalable and practical solution for spatial domain detection in spatial transcriptomic data, laying a solid foundation for future research and applications in spatial transcriptomics.
Blind individuals’ enhanced ability to sense their own heartbeat is related to the thickness of their occipital cortex
Authors: Stroh Anna-Lena , Radziun Dominika , Korczyk Maksymilian , Crucianelli Laura , Henrik Ehrsson H. , Szwed Marcin
Published: February 2024

Blindness is associated with heightened sensory abilities, such as improved hearing and tactile acuity. Moreover, recent evidence suggests that blind individuals are better than sighted individuals at perceiving their own heartbeat, suggesting enhanced interoceptive accuracy. Structural changes in the occipital cortex have been hypothesized as the basis of these behavioral enhancements. Indeed, several studies have shown that congenitally blind individuals have increased cortical thickness within occipital areas compared to sighted individuals, but how these structural differences relate to behavioral enhancements is unclear. This study investigated the relationship between cardiac interoceptive accuracy and cortical thickness in 23 congenitally blind individuals and 23 matched sighted controls. Our results show a significant positive correlation between performance in a heartbeat counting task and cortical thickness only in the blind group, indicating a connection between structural changes in occipital areas and blind individuals’ better ability to perceive heartbeats.
Long-access heroin self-administration induces region specific reduction of grey matter volume and microglia reactivity in the rat
Authors: Cannella Nazzareno , Tambalo Stefano , Lunerti Veronica , Scuppa Giulia , de Vivo Luisa , Abdulmalek Sarah , Kinen Analia , Mackle James , Kuhn Brittany , Solberg Woods Leah C. , Chung Dongjun , Kalivas Peter , Soverchia Laura , Ubaldi Massimo , Hardiman Gary , Bifone Angelo , Ciccocioppo Roberto
Published: February 2024

In opioid use disorder (OUD) patients, a decrease in brain grey matter volume (GMV) has been reported. It is unclear whether this is the consequence of prolonged exposure to opioids or is a predisposing causal factor in OUD development. To investigate this, we conducted a structural MRI longitudinal study in NIH Heterogeneous Stock rats exposed to heroin self-administration and age-matched naïve controls housed in the same controlled environment. Structural MRI scans were acquired before (MRI1) and after (MRI2) a prolonged period of long access heroin self-administration resulting in escalation of drug intake. Heroin intake resulted in reduced GMV in various cortical and sub-cortical brain regions. In drug-naïve controls no difference was found between MRI1and MRI2. Notably, the degree of GMV reduction in the medial prefrontal cortex (mPFC) and the insula positively correlated with the amount of heroin consumed and the escalation of heroin use. In a preliminary gene expression analysis, we identified a number of transcripts linked to immune response and neuroinflammation. This prompted us to hypothesize a link between changes in microglia homeostasis and loss of GMV. For this reason, we analyzed the number and morphology of microglial cells in the mPFC and insula. The number of neurons and their morphology was also evaluated. The primary motor cortex, where no GMV change was observed, was used as negative control. We found no differences in the number of neurons and microglia cells following heroin. However, in the same regions where reduced GMV was detected, we observed a shift towards a rounder shape and size reduction in microglia, suggestive of their homeostatic change towards a reactive state. Altogether these findings suggest that escalation of heroin intake correlates with loss of GMV in specific brain regions and that this phenomenon is linked to changes in microglial morphology.
Heterogeneity and evolution of DNA mutation rates in microsatellite stable colorectal cancer
Authors: Grassi Elena , Vurchio Valentina , Cresswell George D. , Catalano Irene , Lupo Barbara , Sassi Francesco , Galimi Francesco , Borgato Sofia , Ferri Martina , Viviani Marco , Pompei Simone , Urgese Gianvito , Chen Bingjie , Zanella Eugenia R. , Cottino Francesca , Bardelli Alberto , Cosentino Lagomarsino Marco , Sottoriva Andrea , Trusolino Livio , Bertotti Andrea
Published: February 2024

DNA sequence mutability in tumors with chromosomal instability is conventionally believed to remain uniform, constant, and low, based on the assumption that further mutational accrual in a context of marked aneuploidy is evolutionarily disadvantageous. However, this concept lacks robust experimental verification. We adapted the principles of mutation accumulation experiments, traditionally performed in lower organisms, to clonal populations of patient-derived tumoroids and empirically measured the spontaneous rates of accumulation of new DNA sequence variations in seven chromosomally unstable, microsatellite stable colorectal cancers (CRCs) and one microsatellite unstable CRC. Our findings revealed heterogeneous mutation rates (MRs) across different tumors, with variations in magnitude within microsatellite stable tumors as prominent as those distinguishing them from microsatellite unstable tumors. Moreover, comparative assessment of microsatellite stable primary tumors and matched synchronous metastases consistently documented a pattern of MR intensification during tumor progression. Therefore, wide-range diversity and progression-associated evolvability of DNA sequence mutational instability emerge as unforeseen hallmarks of microsatellite stable CRC, complementing karyotype alterations as selectable traits to increase genetic variation.

One sentence summary

Tumors with chromosomal instability accrue DNA sequence mutations at highly variable rates, which increase during metastatic progression.
Stable sequential dynamics in prefrontal cortex represents subjective estimation of time
Authors: Li Yiting , Yin Wenqu , Wang Xin , Li Jiawen , Zhou Shanglin , Ma Chaolin , Yuan Peng , Li Baoming
Published: February 2024

Time estimation is an essential prerequisite underlying various cognitive functions. Previous studies identified “sequential firing” and “activity ramps” as the primary neuron activity patterns in the medial frontal cortex (mPFC) that could convey information regarding time. However, the relationship between these patterns and the timing behavior has not been fully understood. In this study, we utilizedin vivocalcium imaging of mPFC in rats performing a timing task. We observed cells that showed selective activation at trial start, end, or during the timing interval. By aligning long-term time-lapse datasets, we discovered that sequential patterns of time coding were stable over weeks, while cells coding for trial start or end showed constant dynamism. Furthermore, with a novel behavior design that allowed the animal to determine individual trial interval, we were able to demonstrate that real-time adjustment in the sequence procession speed closely tracked the trial-to-trial interval variations. And errors in the rats’ timing behavior can be primarily attributed to the premature ending of the time sequence. Together, our data suggest that sequential activity maybe a stable neural substrate thatrepresentstime under physiological conditions.Furthermore, our results imply the existence of a unique cell type in the mPFC that participates in the time-related sequences. Future characterization of this cell type could provide important insights in the neural mechanism of timing and related cognitive functions.
Causal inference with observational data and unobserved confounding variables
Authors: Byrnes Jarrett E. K. , Dee Laura E.
Published: February 2024

Experiments have long been the gold standard for causal inference in Ecology. Observational data has been primarily used to validate experimental results or to find patterns that inspire experiments – not for causal inference. As ecology tackles progressively larger problems, we are moving beyond the scales at which randomized controlled experiments are feasible. Using observational data for causal inference raises the problem of confounding variables, those affecting both a causal variable and response of interest. Unmeasured confounders lead to statistical bias, creating spurious correlations and masking true causal relationships. To combat this Omitted Variable Bias, other disciplines have developed rigorous approaches for causal inference from observational data addressing the problems of confounders. We show how Ecologists can harness some of these methods: identifying confounders via causal diagrams, using nested sampling designs, and statistical designs that address omitted variable bias for causal inference. Using a motivating example of warming effects on intertidal snails, we show how current methods in Ecology (e.g., mixed models) produce incorrect inferences, and how methods presented here outperform them, reducing bias and increasing statistical power. Our goal is to enable the widespread use of observational data as tool for causal inference for the next generation of Ecological studies.
Both environmental conditions and intra- and interspecific interactions influence the movements of a marine predator
Authors: Mourier Johann , Soria Marc , Silk Matthew , Demichelis Angélique , Dagorn Laurent , Hattab Tarek
Published: February 2024

Animal movements are typically influenced by multiple environmental factors simultaneously and individuals vary in their response to this environmental heterogeneity. Therefore, understanding how environmental aspects, including biotic, abiotic and anthropogenic factors, influence the movements of wild animals is an important focus of wildlife research and conservation. We apply Exponential Random Graph Models (ERGMs) to analyse movement networks of a bull shark population in a network of acoustic receivers and identify the effects of environmental, social or other types of covariates on their movements. We found that intra- and interspecific factors often had stronger effects on movements than environmental variables. ERGMs proved to be a potentially useful tool for studying animal movement network data especially in the context of spatial attribute heterogeneity.
NF-κB/NLRP3 Translational Inhibition by Nanoligomer Therapy Mitigates Ethanol and Advanced Age-Related Neuroinflammation
Authors: Anton Paige E. , Nagpal Prashant , Moreno Julie , Burchill Matthew A. , Chatterjee Anushree , Busquet Nicolas , Mesches Michael , Kovacs Elizabeth J. , McCullough Rebecca L.
Published: February 2024

Binge alcohol use is increasing among aged adults (>65 years). Alcohol-related toxicity in aged adults is associated with neurodegeneration, yet the molecular underpinnings of age-related sensitivity to alcohol are not well described. Studies utilizing rodent models of neurodegenerative disease reveal heightened activation of Nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and Nod like receptor 3 (NLRP3) mediate microglia activation and associated neuronal injury. Our group, and others, have implicated hippocampal-resident microglia as key producers of inflammatory mediators, yet the link between inflammation and neurodegeneration has not been established in models of binge ethanol exposure and advanced age. Here, we report binge ethanol increased the proportion of NLRP3+microglia in the hippocampus of aged (18-20 months) female C57BL/6N mice compared to young (3-4 months). In primary microglia, ethanol-induced expression of reactivity markers and NLRP3 inflammasome activation were more pronounced in microglia from aged mice compared to young. Making use of an NLRP3-specific inhibitor (OLT1177) and a novel brain- penetrant Nanoligomer that inhibits NF-κB and NLRP3 translation (SB_NI_112), we find ethanol- induced microglial reactivity can be attenuated by OLT1177 and SB_NI_112 in microglia from aged mice. In a model of intermittent binge ethanol exposure, SB_NI_112 prevented ethanol-mediated microglia reactivity, IL-1β production, and tau hyperphosphorylation in the hippocampus of aged mice. These data suggest early indicators of neurodegeneration occurring with advanced age and binge ethanol exposure are NF-κB- and NLRP3-dependent. Further investigation is warranted to explore the use of targeted immunosuppression via Nanoligomers to attenuate neuroinflammation after alcohol consumption in the aged.