bluuebunny/crossref_metadata_2025 huggingface dataset:
Physiological profiling of cannabidiol reveals profound inhibition of sensory neurons
Authors: Chahyadinata Gracesenia , Nam Joo Hyun , Battenberg Ashley , Wainger Brian J.
Published: May 2024

Cannabidiol (CBD), the main nonpsychoactive cannabinoid of cannabis, holds promise for nonaddictive treatment of pain. Although preclinical studies have been encouraging, well-controlled human trials have been largely unsuccessful. To investigate this dichotomy and better understand the actions of CBD, we used high-content calcium imaging with automated liquid handling and observed broad inhibition of neuronal activation by a host of ionotropic and metabotropic receptors, including transient receptor potential (Trp) and purinergic receptors, as well as mediators of intracellular calcium cycling. To assess the effect of CBD on overall nociceptor electrical activity, we combined the light-activated ion channel channelrhodposin in TRPV1-positive nociceptors and a red-shifted calcium indicator and found that 1 µM CBD profoundly increased the optical threshold for calcium flux activation. Experiments using traditional whole-cell patch-clamp showed increase of nociceptor activation threshold at submicromolar concentrations, but with unusually slow kinetics, as well as block of voltage-activated currents. To address a more integrated capacity of CBD to influence nociceptor sensitization, a process implicated in multiple pain states, we found that submicromolar concentrations of CBD inhibited sensitization by the chemotherapeutic drug vincristine. Taken together, these results demonstrate that CBD can reduce neuronal activity evoked by a strikingly wide range of stimuli implicated in pain signaling. The extensive effects underscore the need for further studies at substantially lower drug concentrations, which are more likely to reflect physiologically relevant mechanisms. The slow kinetics and block raise biophysical questions regarding the lipophilic properties of CBD and its action on channels and receptors within membranes.
Relationship Between Unit Characteristics and Fall Incidence: A Cross-Sectional Survey Using Administrative Data in Japan
Authors: MORIWAKI Mutsuko , TANAKA Michiko , TOBA Mikayo , OZASA Yuka , OGATA Yasuko , OBAYASHI Satoshi
Published: May 2024

Background

Falls are the most frequent accident experienced by inpatients in hospitals. As falls affect patient outcomes, high fall risk factors should be studied to prevent falls and improve patient safety. However, the relationship between hospital unit characteristics and fall risk has never been assessed.

Purpose

This study was designed to identify the unit characteristics significantly related to fall risk.

Methods

A cross-sectional study was conducted on the medical records of patients hospitalized in a Japanese academic hospital between 2018 and 2019. This study quantified unit activities and utilized Diagnosis Procedure Combination data to examine unit characteristics related to falls based on unit day.

Results

Data on 16,307 patients were included in the analysis, and 355 unit days were certified as fall events. Based on patient condition and medical treatment, the results identified antineoplastic injections, radiation therapy, aseptic treatment room, and functional status of partly assisted transfers, meals, and oral care as unit characteristics associated with increased fall events. Decreased nursing time per patient at night (odds ratio [OR] = 0.75, p = .04) and higher numbers of partially assisted transfer patients were also identified as unit characteristics associated with higher fall incidence rates (OR = 5.56, p = .01).

Conclusions

The results of this study are expected to assist nurses to predict falls based on unit characteristics; reducing nursing time in the units was found to be a factor associated with higher fall risk. Nurse managers must understand the unit-related fall risk factors, appropriately assign nurse staffing numbers, and demonstrate nursing leadership to prevent falls in their units.
Nomogram for predicting intolerable postoperative early enteral nutrition following definitive surgery for small intestinal fistula: a cohort study
Authors: Tian Weiliang , Luo Lei , Xu Xin , Zhao Risheng , Tian Tao , Li Wuhan , Zhao Yunzhao , Yao Zheng
Published: May 2024

Background:

This study was designed to develop and validate a nomogram for predicting intolerable early enteral nutrition (EEN) following definitive surgery (DS) for small intestinal fistula.

Methods:

A total of 377 patients, recruited from January 2016 to September 2023, was randomly allocated into development (n=251) and validation (n=126) groups in a 2:1 ratio. Risk factors were identified using the nomogram. Its performance was assessed based on calibration, discrimination, and clinical utility, with validation confirming its effectiveness.

Results:

Of the 377 patients, 87 (23.1%) were intolerant to EEN, including 59 (23.1%) in the development cohort and 28 (22.1%) in the validation cohort (P=0.84). Four factors were identified as predictive of intolerable EEN: severe abdominal adhesion, deciliter of blood loss during DS, human serum albumin (Alb) input >40 g during and within 48 h post-DS, and the visceral fat area (VFA)/total abdominal muscle area index (TAMAI) ratio. The model demonstrated excellent discrimination, with a C-index of 0.79 (95% CI: 0.74–0.87, including internal validation) and robust calibration. In the validation cohort, the nomogram showed strong discrimination (C-index=0.77; 95% CI: 0.64–0.87) and solid calibration. Decision curve analysis affirmed the nomogram’s clinical utility.

Conclusion:

This research introduces a nomogram that enables the individualized prediction of intolerable EEN following DS for small intestinal fistula, demonstrating a possible clinical utility.
Short-term (1–3 months) versus standard (12 months) dual antiplatelet therapy following new-generation drug-eluting stent implantation: A meta-analysis of randomized controlled trials
Authors: Xiong Penghui , Zheng Chunhua , Fan Jianfeng , Zhang Hongyu , Li Can
Published: May 2024

Background:

Patients undergoing percutaneous coronary intervention mainly receive antiplatelet therapy. However, limited data are available regarding the optimal dual antiplatelet therapy (DAPT) following the implantation of new-generation drug-eluting stent (DES).

Objective:

This study aimed to compare the clinical outcomes of short-term (1–3 months) DAPT and standard (12 months) DAPT after the implantation of a new-generation of DES.

Methods:

We systematically searched PubMed, The Cochrane Library Database, Embase for trials that compared short-term (1–3 months) and standard DAPT after the implantation of next-generation DES were retrieved from all published studies in English until December 31, 2021. The primary endpoint was major bleeding. The secondary endpoints included all-cause mortality, cardiac death, myocardial infarction, stroke, stent thrombosis, and all bleeding.

Results:

This study included a total of 7 randomized controlled trials, comprising 28,344 subjects. Regarding primary endpoints, short-term DAPT exhibited a significantly lower incidence of major bleeding compared with standard DAPT [relative risk (RR): 0.66, 95% confidence interval (CI): (0.54, 0.81), P < .0001]. For secondary endpoints, there were significant differences between short-term and standard DAPT in all bleeding [RR: 0.59, 95% CI: (0.50, 0.69), P < .00001]. However, no significant differences were identified in all-cause mortality [RR: 0.96, 95% CI: (0.77, 1.18), P = .27], myocardial infarction [RR: 0.98, 95% CI: (0.82, 1.18), P = .86], cardiac death [RR: 0.83, 95% CI: (0.63, 1.10), P = .20], stroke [RR: 1.08, 95% CI: (0.79, 1.47), P = .63], cerebrovascular [RR: 1.08, 95% CI: (0.79, 1.47), P = .63], and stent thrombosis [RR: 1.13, 95% CI: (0.80, 1.57), P = .49] between the 2 groups.

Conclusion:

In patients undergoing implantation of a new-generation of DES, short-term (1–3 months) DAPT exhibited no inferiority compared with standard (12 months) DAPT in terms of all-cause mortality, cardiac death, myocardial infarction, stroke, and definite or probable stent thrombosis compared with standard (12 months) DAPT. However, short-term DAPT appeared superior to standard DAPT in terms of major bleeding and all bleeding.
Visual training for the treatment of retinal photoreceptor inner and outer segment connection (IS/OS) fracture: A case report
Authors: Jiang Peng-Fei , Xu Shan , Chen Qing , Pan Bing-Xin
Published: May 2024

Background:

The inner segments and outer segments (IS/OS) of the retinal photoreceptors are the areas that receive light signals and are the most initial sites for generating visual impulses, and the integrity of the IS/OS has a direct impact on visual sensitivity.

Methods:

We performed OCT on a 6-year-old child with vision loss and found that the cause of his vision loss was a retinal IS/OS fracture, and the child underwent some treatments to improve microcirculation and nourish the retina at a higher-level hospital, but his vision never improved. Our examination of this child revealed that this child not only had decreased visual acuity, but also hypermetropia, but his near stereopsis was normal. The symptoms were similar to those of amblyopia, so we tried to use visual training as a treatment.

Results:

First, 6 sessions of fine visual stimulation were given, followed by 3 sessions of accommodation training, and we followed the 4 stages of accommodation training: perception of accommodation, amplitude of accommodation, sensitivity of accommodation, and autonomic accommodation. After 9 consecutive visual training sessions, the child’s visual acuity was stabilized at 0.6, and then we added eye movement training, and after the child’s visual acuity was improved to 0.7, we suppressed the visual acuity of the left eye to 0.6, so as to make the visual acuity of both eyes similar, which would promote the establishment of binocular stereo vision, and then we carried out 9 more visual training sessions, and the patient’s visual acuity was stabilized at 0.8 gradually. OCT review showed that the child’s retinal IS/OS fracture was basically closed.

Conclusion subsections:

In conclusion, our study found that visual training can restore visual acuity in children with monocular IS/OS fracture and also promote repair of IS/OS fracture, which increases our understanding and knowledge of the treatment of retinal IS/OS fracture, and this case may provide some lessons for the treatment of retinal IS/OS fracture in children. We hope to have more samples of retinal IS/OS fracture in the future to evaluate the efficacy of visual training for retinal IS/OS fracture.
Influence of intelligent management mode based on Internet of Things on self-management ability and prognosis of elderly patients with hypertensive heart disease: An observational study
Authors: Xu Yaning , Zai Wenxin , Yang Ming , Zhu Lei , Zhang Yun , Fu Xin , Dai Ting
Published: May 2024

Hypertensive heart disease was difficult to cure with drugs, and most patients had poor compliance, leading to recurrent disease and poor quality of life. The intelligent management mode based on the Internet of Things avoided the excessive dependence of the elderly patients on medical institutions in the traditional medical model and enabled patients to monitor themselves. This study aimed to explore the impact on self-management ability and prognosis of elderly patients with hypertensive heart disease. A total of 150 elderly patients with hypertensive heart disease who received treatment from April 2020 to April 2022 were selected and divided into control group (n = 75 cases) and observation group (n = 75 cases) by random number table method. The control group was given routine intervention, and the observation group was given intelligent management mode based on the Internet of Things. Blood pressure fluctuation, self-management ability, and prognosis of the 2 groups were compared after intervention. After the intervention of the intelligent management mode based on the Internet of Things, the systolic and diastolic blood pressure levels in the observation group were lower than those in the control group (P < .05). After intervention, the scores of self-management ability in diet control, self-care skills, rehabilitation exercise, and self-monitoring in observation group were higher than those in control group (P < .05). After intervention, the total incidence of chest tightness, dyspnea, arrhythmia, edema, and nausea in the observation group was 5 (6.67%), which was significantly lower than that in the control group 12 (16.00%) (P < .05). The application of intelligent management mode based on the Internet of Things could effectively improve patients’ blood pressure level, improve patients’ self-management ability, and significantly improve the prognosis, which was worthy of popularization and application.
Discussion on the mechanism of Tiaoqi Xiaowei decoction in the treatment of chronic atrophic gastritis based on network pharmacology and molecular docking: An observational study
Authors: Yang Ruwen , Ouyang Jun , Jiang Jiawei , Zhao Yuanpei , Wu Defeng , Chen Dongmei , Xi Biao
Published: May 2024

To explore the mechanism of Tiaoqi Xiaowei decoction in the treatment of chronic atrophic gastritis by network pharmacology and molecular docking. The main active components and targets of Tiaoqi Xiaowei decoction were obtained from TCMSP database. The databases of Disgenet, GeneCards, and OMIM were used to obtain chronic atrophic gastritis-related targets. The component–target–disease network was constructed by Cytoscape 3.7.1 software, and the protein–protein interaction network was constructed by String database. The core targets were screened by CytoNCA plug-in. Gene ontology analysis and Kyoto Encyclopedia of Genes and Genome pathway enrichment analysis were performed using the Metascape database. The core components and targets were subjected to molecular docking verification using AutoDock Tools 1.5.6 software, and the binding score was obtained. A total of 48 active components were identified, involving 82 action targets. Core active components such as quercetin, beta-sitosterol, kaempferol, luteolin, and naringenin, and core targets such as AKT1, TP53, VEGFA, TNF, IL6, and PTGS2 were obtained. A total of 188 signaling pathways were screened out, including cancer pathway, PI3K-Akt, IL-17, and TNF signaling pathway. Molecular docking results showed that the key components of Tiaoqi Xiaowei decoction had a favorable binding affinity with key targets. Tiaoqi Xiaowei decoction acts on multiple targets such as AKT1, TP53, VEGFA, TNF, IL6, PTGS2, and synergistically treats chronic atrophic gastritis by regulating inflammatory responses and tumor-related signaling pathways.
The value of umbilical artery blood gas analysis in the rapid diagnosis of fetomaternal hemorrhage
Authors: Meng Shan , Jia Qiucheng , Tang Huimin , Chen Jiming , Chang Qing
Published: May 2024

As a rare obstetric disease, fetomaternal hemorrhage (FMH) often causes severe fetal anemia, edema and even death, easily to be confused with severe neonatal asphyxia. Currently, there are several ways to detect or predict FMH, however, most of them are flawed and time-consuming, as well as unsuitable for rapid diagnosis and timely intervention of FMH. To explore the values of umbilical artery blood gas analysis in the rapid diagnosis of FMH, providing basis for rapid guidance of newborn rescue. Five cases of neonates with FMH from the First Affiliated Hospital of Army Military Medical University (Chongqing Southwest Hospital) from January 2013 to January 2016 were selected as the study group. Another 9 cases of severe asphyxia neonates were chosen into the control group. The difference in Apgar score and umbilical artery blood gas analysis between the 2 groups at birth was compared, and the treatments and clinical outcomes of the 2 groups were analyzed. The PH value of umbilical artery blood gas analysis in the study group was higher than that of the control group, but the difference was not statistically significant (P > .05). In the study group, cases with pH value < 7.0 accounted for 0%, whereas the cases with pH < 7.0 accounted for 66.67% in the control group, and the difference between the 2 groups was statistically significant (P < .05). Compared with the control group, the arterial oxygen partial pressure (PO2), the absolute value of (PCO2), lactic acid (lac) and alkali were not significantly different from those of the control group (P > .05), while the total hemoglobin (tHb) and hematocrit (Hct) were significantly lower than the control group (P < .0001). In the study group, tHb in the umbilical cord blood of 2 newborns with FMH death was significantly lower than 40 g/L. FMH should be highly suspected when there is an expression of severe asphyxia in neonates, indicated by significantly lower tHb levels in umbilical cord blood. It is helpful to improve the neonatal outcome by FMH neonatal resuscitation as soon as possible.
Mendelian randomization reveals the causal association between gout and hearing impairment in older adults
Authors: Fu Xiaopeng , Zhao Xin
Published: May 2024

With the global aging trend escalating, the holistic well-being of the elderly has become a paramount concern within public health. Traditional observational studies often struggle with confounding factors and establishing causality, leaving the relationship between age-related hearing loss (ARHL) and gout largely unexplored. Employing bidirectional two-sample Mendelian randomization (MR) analysis, this investigation elucidated the genetic underpinnings associated with age-related hearing impairment, gout, and urate levels within the IEU Open-GWAS database, thereby uncovering potential causal connections that underlie the intricate interplay between gout, serum urate concentrations, and auditory decline in the geriatric demographic. In the forward MR phase, a cohort of 30 single nucleotide polymorphisms was leveraged to dissect the causal dynamics between ARHL and both gout and urate concentrations. Conversely, in the reverse MR phase, gout and urate levels were posited as the exposome to delineate their impact on hearing acuity, employing an array of models for rigorous validation and sensitivity scrutiny. In the forward MR analysis, a statistically significant correlation was discerned between ARHL and gout (P = .003, odds ratio = 1.01, 95% confidence interval: 1.00–1.02), alongside a notable association with serum urate levels (P = .031, odds ratio = 1.39, 95% confidence interval: 1.03–1.88), intimating that ARHL could potentially influence the incidence of gout and urate concentrations. Conversely, the reverse MR investigation revealed that neither gout nor serum urate levels exerted significant impact on auditory degradation (P > .05), insinuating that these factors might not predominantly contribute to hearing loss. Sensitivity analyses concurred with this inference. This study enriches the comprehension of geriatric health intricacies and unveils that ARHL potentially influences gout and serum urate concentrations. This suggests that monitoring ARHL may play a crucial role in the early identification and management of gout and hyperuricemia, potentially contributing to a comprehensive approach to improving geriatric health outcomes.
Smoking cessation and risk of metabolic syndrome: A meta-analysis
Authors: Kim Hyun Ji , Cho Yoon Jeong
Published: May 2024

Background:

Smoking is an important risk factor for various metabolic and cardiovascular disorders, and smoking cessation reduces the risk of these conditions. However, weight gain is commonly observed when individuals quit smoking, which often leads to hesitation in pursuing smoking cessation. Weight gain increases the risk of metabolic syndrome (MS). However, previous studies that investigated the relationship between smoking cessation and MS have yielded inconsistent results. Therefore, we conducted a meta-analysis to evaluate the association between smoking cessation and MS.

Methods:

Medline, Embase, Cochrane Library and CINAHL databases, were comprehensively searched from inception to April 2023, to identify relevant studies examining the relationship between smoking cessation and MS, comparing such relationship to that with active smoking. The methodological quality of the selected studies was assessed using the Newcastle–Ottawa Quality Assessment Scale. A random-effects model was used for meta-analysis.

Results:

Of 495 identified studies, 24 were reviewed. The risk of selection bias was identified in all the studies. The overall analysis of 14 studies, including data of combined results for both men and women, revealed an increased risk of MS among ex-smokers compared with that among active smokers (pooled relative risk [RR] 1.18, 95% confidence interval [CI]: 1.08–1.29). From the selected studies, 13 studies analyzing men were extracted for subgroup analysis. Among men, no significant difference in the risk of developing MS was observed between ex-smokers and smokers (pooled RR: 1.05, 95% CI: 0.95–1.17). In men, the risk of MS increased if the cessation period was ≤15 years in men (pooled RR 1.26, 95% CI: 1.01–1.56) and slightly decreased if the cessation period was > 15 years (RR 0.84, 95% CI: 0.70–1.00) in ex-smokers compared with that in current smokers.

Conclusion:

An increased risk of MS was observed in the early stages of smoking cessation compared with current smoking. As the longer duration of smoking cessation, the risk of MS becomes less significant.
Development and validation of nomograms for predicting the prognosis of early and late recurrence of advanced gastric cancer after radical surgery based on post-recurrence survival
Authors: Liu Chenming , Lu Jialiang , An Liang
Published: May 2024

In this study, we aimed to explore the risk factors influencing post-recurrence survival (PRS) of early recurrence (ER) and late recurrence (LR) in stage advanced gastric cancer (AGC) patients after radical surgery, respectively, and to develop predictive models in turn. Medical records of 192 AGC patients who recurred after radical gastrectomy were retrospectively reviewed. They were randomly divided into the training and validation set at a ratio of 2:1. Nomograms were built based on risk factors influencing PRS of ER and LR explored by Cox regression analyses, respectively. Concordance index (C-index) values and calibration curves were used to evaluate predictive power of nomograms. Body mass index < 18.5 kg/m2, prealbumin level < 70.1 mg/L, positive lymph nodes ratio ≥ 0.486 and palliative treatment after recurrence were independent risk factors for the prognosis of ER. In contrast, prealbumin level < 170.1 mg/L, CEA ≥ 18.32 μg/L, tumor diameter ≥ 5.5 cm and palliative treatment after recurrence were independent risk factors for the prognosis of LR. The C-index values were 0.801 and 0.772 for ER and LR in the training set, respectively. The calibration curves of validation set showed a C-index value of 0.744 and 0.676 for ER and LR, respectively. Nomograms which were constructed to predict the prognosis of ER and LR of AGC after surgery showed great predictive power and could provide reference for clinicians’ treatment strategies to some extent.
Identification of key regulatory genes in the pathogenesis of COVID-19 and sepsis: An observational study
Authors: Chen Xing , Yang Fengbo , Luo Guoping
Published: May 2024

Patients with severe COVID-19 and those with sepsis have similar clinical manifestations. We used bioinformatics methods to identify the common hub genes in these 2 diseases. Two RNA-seq datasets from the Gene Expression Omnibus were used to identify common differentially expressed genes (DEGs) in COVID-19 and sepsis. These common genes were used for analysis of functional enrichment; pathway analysis; identification of associated transcription factors, metabolites, and miRNAs; and mapping of protein–protein interaction networks. The major hub genes of COVID-19 and sepsis were identified, and validation datasets were used to assess the value of these hub genes using receiver operating characteristic (ROC) curves. Analysis of the 800 common DEGs for COVID-19 and sepsis, as well as common transcription factors, miRNAs, and metabolites, demonstrated that the immune response had a key role in both diseases. DLGAP5, BUB1, CDK1, CCNB1, and BUB1B were the most important common hub genes. Analysis of a validation cohort indicated these 5 genes had significantly higher expression in COVID-19 patients and sepsis patients than in corresponding controls, and the area under the ROC curves ranged from 0.832 to 0.981 for COVID-19 and 0.840 to 0.930 for sepsis. We used bioinformatics tools to identify common DEGs, miRNAs, and transcription factors for COVID-19 and sepsis. The 5 identified hub genes had higher expression in validation cohorts of COVID-19 and sepsis. These genes had good or excellent diagnostic performance based on ROC analysis, and therefore have potential use as novel markers or therapeutic targets.
A Hidden Cause of Hypertransaminasemia: Liver Toxicity Caused by Chelidonium Majus L.: Report of Two Cases of Herb-Induced Liver Injury and Literature Review
Authors: Ciornolutchii Vera , Ismaiel Abdulrahman , Sabo Cristina Maria , Al Hajjar Nadim , Seicean Andrada , Dumitrascu Dan L.
Published: May 2024

Background:

In instances where individuals manifest elevated transaminase levels without a clearly discernible cause, a comprehensive patient history proves invaluable in unveiling latent triggers. In this report, we present 2 cases of herb-induced liver injury (HILI) characterized by severe hypertransaminasemia attributed to the consumption of Chelidonium majus L. (also known as greater celandine [GC]), an agent considered an alternative therapeutic remedy.

Areas of Uncertainty:

Exploring the occurrence and range of clinical manifestations in HILI linked to Chelidonium majus L., while also investigating the potential triggers and predisposing factors for hepatotoxic reactions post Chelidonium majus L. usage, remains challenging due to the absence of definitive laboratory tests to identify the causative agent.

Data Sources:

Two case reports were detailed, and a systematic literature review using PubMed was conducted including published literature till March 2023. Moreover, a manual search of reference lists of pertinent articles was performed to identify any additional relevant missed publications.

Results:

In the first case, a 64-year-old woman presented with jaundice, revealing a 1-month history of using GC capsules to manage gallstones. Diagnostic assessment identified HILI, gallstones, and choledocolithiasis, with transaminase levels exceeding 1000 IU/L. After discontinuing GC and receiving intravenous therapy with amino acids and phospholipids, the patient's condition significantly improved. Subsequently, she underwent endoscopic common bile duct stone removal and cholecystectomy. In the second case, a 66-year-old woman presented with elevated liver function test results discovered incidentally during musculoskeletal pain evaluation. Upon further questioning, the patient disclosed regular consumption of GC tea for "health promotion." Following intravenous therapy using amino acids and phospholipids, her transaminase levels returned to normal. The literature review identified 38 cases of HILI associated with GC preparations, primarily in adult women aged 27–77 years, with a predominant reporting location in Germany. Various forms of GC were used, with treatment durations ranging from 1 week to a year. Discontinuation of GC generally led to recovery in these cases.

Conclusion:

Chelidonium majus L., a potent herb often used in alternative medicine, has significant hepatotoxic potential, requiring physicians to be vigilant in cases of unexplained liver injury.
Sustainable practices in hospital and operating theaters
Authors: Anract Julien , Pradere Benjamin , Pinar Ugo
Published: May 2024

Purpose of review

This review aims to provide an update on the results of studies published in the last two years involving the development of sustainable practices in hospital and operating theaters (OT)

Recent findings

Recently, many studies evaluated various initiatives to better understand the environmental impact of the OT but also to minimize its environmental impact. Many trials evidenced the positive impact of the instrument's reuse using an appropriate reprocessing procedure. Better waste segregation is associated with a reduction of produced waste and contributes to a significant reduction in CO2 equivalent emissions. Regarding anaesthetic gas, Desflurane is known to have the worst environmental impact and the majority of the study evidenced that its reduction permits to drastically reduce greenhouse gas emission of the OT.

Greening the OT necessitates climate-smart actions such as waste reduction, the improvement of reusable instruments, recycling of our waste and better anaesthetic gas management. Within the last two years, many efforts have been made to reduce and better segregate waste produced in the OT and also to better understand the environmental impact of disposable and reusable devices.
Self-injurious unnatural death among Veterans with HIV
Authors: Smith Alexandria C. , Goulet Joseph L. , Vlahov David , Justice Amy C. , Womack Julie A.
Published: May 2024

Objective:

People with HIV (PWH) are at an increased risk of suicide and death from unintentional causes compared with people living without HIV. Broadening the categorization of death from suicide to self-injurious unnatural death (SIUD) may better identify a more complete set of modifiable risk factors that could be targeted for prevention efforts among PWH.

Design:

We conducted a nested case–control study using data from the Veterans Aging Cohort Study (VACS), a longitudinal, observational cohort of Veterans from 2006–2015. A total of 5036 Veterans with HIV, of whom 461 died by SIUD, were included in the sample.

Methods:

SIUD was defined using the International Classification of Disease 10th revision cause of death codes. Cases (n = 461) included individuals who died by SIUD (intentional, unintentional, and undetermined causes of death). Controls (n = 4575) were selected using incidence density sampling, matching on date of birth ± 1 year, race, sex, and HIV status. SIUD and suicide was estimated using conditional logistic regression.

Results:

A previous suicide attempt, a diagnosis of an affective disorder, recent use of benzodiazepines, psychiatric hospitalization, and living in the western US significantly increased the risk of suicide and SIUD. Risk factors that appear more important for SIUD than for suicide included a drug use disorder, alcohol use disorder, Hepatitis C, VACS Index 2.0, current smoking, and high pain levels (7–10).

Conclusion:

Limiting studies to known suicides obscures the larger public health burden of excess deaths from self-injurious behavior. Our findings demonstrate the benefit of expanding the focus to SIUD for the identification of modifiable risk factors that could be targeted for treatment.
Absence and Duplicate Foramen Spinosum in the Same Patient: An Extremely Rare Variation
Authors: Özdemir Ayşe , İnceoğlu Ayşenur , Cihan Ömer Faruk , Bahşi İlhan
Published: May 2024

The foramen spinosum, one of the important openings at the base of the cranium, is the opening through which the middle meningeal artery enters the cranium. The variations of the foramen spinosum should be well known to be an important landmark in middle fossa surgeries and to understand better the clinical conditions related to the middle meningeal artery passing through it. A total of 35 bones (32 cranial base and 3 separate sphenoid bones) of individuals of unknown age, sex, and ethnicity in the Laboratory of the Department of Anatomy, Gaziantep University, Faculty of Medicine were examined bilaterally in this study. One of the 35 bones was found to have a duplicated foramen spinosum on the left side and an absence foramen spinosum on the right side. Foramen spinosum variations should be considered in middle fossa approaches and procedures involving the middle meningeal artery.
A Radial Approach Combined With a Contralateral Vertebral Retrograde Approach for Stenting and Coil Embolization of a Large Posterior Inferior Cerebellar Artery Aneurysm
Authors: Fan Guangliang , Ma Yonggang , Wang Chao
Published: May 2024

Background:

Wide-neck aneurysm embolism is a technically demanding procedure. Stent device deployment is challenging intraoperatively, especially in parent arteries with acute angles.

Case description:

The authors describe the case of a 74-year female with an unruptured right posterior inferior cerebellar artery aneurysm. The acute angle of the arteries proximal to the posterior inferior cerebellar artery complicated the condition, and the distal end of the guidewire failed to enter the posterior inferior cerebellar artery despite several maneuvers. The wide neck of the aneurysm was located in the posterior inferior cerebellar artery, so a stent was needed. The stent was deployed from the left vertebral artery retrograde to the right vertebral artery.

Conclusions:

The authors report the successful application of a rare strategy, the radial approach combined with a contralateral vertebral retrograde approach, for stent deployment.
Competency-Based Virtual Clinical Practicum in Response to COVID-19 Pandemic
Authors: Netsch Debra , Rolstad Bonnie Sue , Ermer-Seltun JoAnn , Bruch Sue
Published: May 2024

PURPOSE:

The purpose of the quality improvement (QI) project was to provide a learner and faculty preceptor high quality virtual clinical practicum (VCP) for Wound, Ostomy, Continence (WOC) Nurse learners during the COVID-19 pandemic and disseminate findings.

PARTICIPANTS AND SETTING:

Project participants were registered nurses post-bachelor’s degree or higher with a minimum of 1-year clinical experience who had completed and passed the didactic portion of a Wound Ostomy Continence Nursing Education Program (WOCNEP). Learners completing the WOCNEP’s VCP and the faculty preceptors were the subjects for this QI report. The setting was a virtual platform allowing live time visibility and interactions between learners and faculty preceptors including the ability to share documents and procedural videos. An initial group of 62 learners were asked open-ended questions after completion of the VCP; the most frequently recurring themes were converted into 5-point Likert scale questions as the evaluation tool completed by an additional 234 learners. In total, 296 learners completing the VCP evaluated this novel 100% simulation virtual practicum.

APPROACH:

This QI project evaluated a 100% simulation-based practicum at a WOCENP based in the United States. A competency based VCP used the Competency Outcomes and Performance Assessment (COPA) model. Learners were taught competencies via a preparatory virtual lab and then had to prepare documents and videos or pictures with step-by-step instructions prior to attending a Live Competency Assessment Lab with faculty preceptors and a small group of peer learners.

OUTCOMES:

Appraisal of the VCP was based on course evaluations anonymously completed by each of the 296 learners. Faculty preceptors were queried regarding their VCP evaluation and certification exam pass rates were tallied. Findings indicate positive outcomes of the VCP competency-based practicum from student and faculty preceptor perspectives along with higher certification pass rates; specifically, wound care pass rates increased by 16%, ostomy care increased by 18% and continence care pass rates increased by 13%.

IMPLICATIONS FOR PRACTICE:

Our reported experiences strongly suggest a VCP offers an attractive option for fulfilling practicum requirements while reducing barriers of the in-person split option practicum.
Case-specific selection of batch correction methods for integrating single-cell transcriptomic data from different sources
Authors: Hu Xiaoyue , Li He , Chen Ming , Qian Junbin , Jiang Hangjin
Published: May 2024

Integrating single-cell RNA-sequencing datasets from different sources is a common practice to empower in-depth interrogation for biological insights, where batch effect correction (BEC) is of vital importance. However, an inappropriate BEC may lead to overcorrection and report misleading results on downstream analyses including cell annotation, trajectory inference and cell-cell communication. Hence, we develop the Reference-based Batch Effect Testing (RBET), a novel statistical framework for evaluating the performance of different BEC methods by leveraging housekeeping-gene inspired reference genes and MAC statistics for distribution comparison. Comparing with existing methods, RBET is more powerful on detecting batch effect, overcorrection sensitive, computationally efficient, and robust to large batch effect sizes. Furthermore, extensive multi-scenario real examples show that RBET selects optimal BEC tools for consistent downstream analysis results, which confirm prior biological knowledge. This comprehensive BEC decision-making tool is available as an R package.
Mechanism of RSL3-Induced Ferroptotic Cell Death in HT22 Cells: Crucial Role of Protein Disulfide Isomerase
Authors: Hou Ming-Jie , Huang Xuanqi , Zhu Bao Ting
Published: May 2024

Protein disulfide isomerase (PDI) was recently shown to be an upstream mediator of erastin-induced, glutathione depletion-associated ferroptosis through its catalysis of nitric oxide synthase (NOS) dimerization and nitric oxide (NO) accumulation. A recent study reported that RSL3, a known ferroptosis inducer and glutathione peroxidase 4 (GPX4) inhibitor, can inhibit thioredoxin reductase 1 (TrxR1). The present study seeks to test a hypothesis that RSL3 may, through its inhibition of TrxR1, facilitate PDI activation (i.e., in a catalytically-active, oxidized state), thereby enhancing RSL3-induced ferroptosis through NOS dimerization and NO accumulation. Using the HT22 mouse neuronal cells as anin-vitromodel, we show that treatment of these cells with RSL3 can strongly increase NOS protein level, and the PDI-mediated NOS dimerization is activated by RSL3, resulting in NO accumulation. Mechanistically, we find that PDI is activated in cells treated with RSL3 resulting from its inhibition of TrxR1, and the activated PDI then catalyzes NOS dimerization, which is followed by accumulation of cellular NO, ROS and lipid-ROS, and ultimately ferroptotic cell death. Genetic or pharmacological inhibition of PDI or TrxR1 partially abrogates RSL3-induced NOS activation and the subsequent accumulation of cellular NO, ROS/lipid-ROS, and ultimately ferroptosis in HT22 cells. The results of this study clearly show that PDI activation resulting from RSL3 inhibition of the TrxR1 activity contributes crucially to RSL3-induced ferroptosis in a cell culture model through the PDIl7NOSl7NOl7ROS/lipid-ROS pathway, in addition to its known inhibition of the GPX4 activity.
Investigating Workplace Bullying, Intention to Quit and Depression Among Nurses in the Upper West Region of Ghana
Authors: Dapilah Emmanuel , Druye Andrews Adjei
Published: May 2024

Background

Intention to quit among nurses is increasingly recognized as a serious predictor of voluntary turnover. Voluntary turnover on the other hand is a significant factor fueling the shortage of nurses globally which could partly be blamed on negative workplace behaviors including but not limited to workplace bullying. Even though the relationship between workplace bullying and the intention to quit has been studied extensively, little is known about these concepts among nurses in Ghana.

Aim

The purpose of this study was to establish the relationship between workplace bullying among nurses and their intention to quit the profession in the Upper West Region of Ghana. We also determined the relationship between workplace bullying and depression among nurses.

Methods

We employed a cross-sectional design with 323 nurses recruited through a multistage sampling technique. Data were collected using a structured questionnaire with a 98.5% (N=318) response rate.

Results

Initial descriptive statistics indicate that 64.4% (n=203) of the nurses had intentions of quitting the job while 52.1% (n=164) were depressed at various degrees based on scores on the DASS-21. Further analysis shows a positive linear relationship between WPB and intentions to quit. WPB was also correlated positively with depression among the nurses. This implies that an increased incidence of bullying at work is associated with increased intention to quit and depression among the nurses.

Conclusions

With over 50% of the nurses in this study having intentions of quitting the job, it would be incumbent on nurse managers and other leaders at these health facilities to reconsider the work environment, policies, and leadership to prevent actual voluntary turnover. Managers must also fashion out pragmatic strategies aimed at reducing stress and promoting the health and well-being of the nurses.
HIF1α controls adipose tissue growth through metabolic rechanneling
Authors: Zhu Chaonan , Wu Meiqian , Pham Minh Duc , Wang Yue , Das Arka Provo , Mao Yijie , Mirtschink Peter , Yuan Ting , Krishnan Jaya
Published: May 2024

Excessive expansion of white adipose tissue occurs when energy intake exceeds demand. It creates a state of relative hypoxia that is directly linked to activation of the hypoxia-inducible factor (HIF) in obese human subjects and mouse models of obesity. Whether HIF1α function is important for the development of basal adiposity and diet-induced obesity remains unclear. In the present study, we genetically ablated Hif1α in adipocytes and analyzed the corresponding mice for both basal and diet-induced obesity-associated visceral white adipose tissue mass as well as parameters of systemic glucose homeostasis and peripheral insulin sensitivity. We found that inactivation of Hif1α in mouse adipocytes inhibited basal adiposity and suppressed nutrient-overload-induced adipose tissue growth. These changes in adiposity were associated with improved systemic glucose homeostasis and peripheral insulin sensitivity. Mechanistically, Hif1α mediated effects on adipocyte metabolism by re-routing glycolytic intermediates into the glycerolipid shunt, leading to increased de novo triacylglyceride synthesis in hypertrophic adipocytes. Our results have established key roles for HIif1α in controlling adipocyte growth and metabolism and adipose tissue expansion under basal conditions and in response to a high-fat diet, highlighting the central role of hypoxia and HIF1α in the development of obesity.

Article Highlights

Hif1α function is critical for basal adipose tissue mass expansion, and is also required for fat accumulation in response to high fat diet.

Co-option and co-activation of the glycerolipid biosynthetic pathway by glycolysis is an important modulator of visceral adiposity.

These findings reveal an important role of Hif1α in the adipose tissue through the coupling of glycolysis and lipid anabolism in response to HFD, which may provide a potential therapeutic target for type 2 diabetes in the future.
A corpus of GA4GH Phenopackets: case-level phenotyping for genomic diagnostics and discovery
Authors: Danis Daniel , Bamshad Michael J , Bridges Yasemin , Cacheiro Pilar , Carmody Leigh C , Chong Jessica X , Coleman Ben , Dalgleish Raymond , Freeman Peter J , Graefe Adam S L , Groza Tudor , Jacobsen Julius O B , Klocperk Adam , Kusters Maaike , Ladewig Markus S , Marcello Anthony J , Mattina Teresa , Mungall Christopher J , Munoz-Torres Monica C , Reese Justin T , Rehburg Filip , Reis Bárbara C S , Schuetz Catharina , Smedley Damian , Strauss Timmy , Sundaramurthi Jagadish Chandrabose , Thun Sylvia , Wissink Kyran , Wagstaff John F , Zocche David , Haendel Melissa A , Robinson Peter N
Published: May 2024

The Global Alliance for Genomics and Health (GA4GH) Phenopacket Schema was released in 2022 and approved by ISO as a standard for sharing clinical and genomic information about an individual, including phenotypic descriptions, numerical measurements, genetic information, diagnoses, and treatments. A phenopacket can be used as an input file for software that supports phenotype-driven genomic diagnostics and for algorithms that facilitate patient classification and stratification for identifying new diseases and treatments. There has been a great need for a collection of phenopackets to test software pipelines and algorithms. Here, we present phenopacket-store. Version 0.1.12 of phenopacket-store includes 4916 phenopackets representing 277 Mendelian and chromosomal diseases associated with 236 genes, and 2872 unique pathogenic alleles curated from 605 different publications. This represents the first large-scale collection of case-level, standardized phenotypic information derived from case reports in the literature with detailed descriptions of the clinical data and will be useful for many purposes, including the development and testing of software for prioritizing genes and diseases in diagnostic genomics, machine learning analysis of clinical phenotype data, patient stratification, and genotype-phenotype correlations. This corpus also provides best-practice examples for curating literature-derived data using the GA4GH Phenopacket Schema.
Molecular and circuit determinants in the globus pallidus mediating control of cocaine-induced behavioral plasticity
Authors: Tian Guilian , Bartas Katrina , Hui May , Chen Lingxuan , Vasquez Jose J. , Azouz Ghalia , Derdeyn Pieter , Manville Rían W. , Ho Erick L. , Fang Amanda S. , Li Yuan , Tyler Isabella , Setola Vincent , Aoto Jason , Abbott Geoffrey W. , Beier Kevin T.
Published: May 2024

The globus pallidus externus (GPe) is a central component of the basal ganglia circuit, receiving strong input from the indirect pathway and regulating a variety of functions, including locomotor output and habit formation. We recently showed that it also acts as a gatekeeper of cocaine-induced behavioral plasticity, as inhibition of parvalbumin-positive cells in the GPe (GPePV) prevents the development of cocaine-induced reward and sensitization. However, the molecular and circuit mechanisms underlying this function are unknown. Here we show that GPePVcells control cocaine reward and sensitization by inhibiting GABAergic neurons in the substantia nigra pars reticulata (SNrGABA), and ultimately, selectively modulating the activity of ventral tegmental area dopamine (VTADA) cells projecting to the lateral shell of the nucleus accumbens (NAcLat). A major input to GPePVcells is the indirect pathway of the dorsomedial striatum (DMSD2), which receives DAergic innervation from collaterals of VTADA→NAcLat cells, making this a closed-loop circuit. Cocaine likely facilitates reward and sensitization not directly through actions in the GPe, but rather in the upstream DMS, where the cocaine-induced elevation of DA triggers a depression in DMSD2cell activity. This cocaine-induced elevation in DA levels can be blocked by inhibition of GPePVcells, closing the loop. Interestingly, the level of GPePVcell activity prior to cocaine administration is correlated with the extent of reward and sensitization that animals experience in response to future administration of cocaine, indicating that GPePVcell activity is a key predictor of future behavioral responses to cocaine. Single nucleus RNA-sequencing of GPe cells indicated that genes encoding voltage-gated potassium channels KCNQ3 and KCNQ5 that control intrinsic cellular excitability are downregulated in GPePVcells following a single cocaine exposure, contributing to the elevation in GPePVcell excitability. Acutely activating channels containing KCNQ3 and/or KCNQ5 using the small molecule carnosic acid, a key psychoactive component ofSalvia rosmarinus(rosemary) extract, reduced GPePVcell excitability and also impaired cocaine reward, sensitization, and volitional cocaine intake, indicating its potential as a therapeutic to counteract psychostimulant use disorder. Our findings illuminate the molecular and circuit mechanisms by which the GPe orchestrates brain-wide changes in response to cocaine that are required for reward, sensitization, and self-administration behaviors.