bluuebunny/crossref_metadata_2025 huggingface dataset:
Density jump as a function of magnetic field strength for perpendicular collisionless shocks with anisotropic upstream pressure
Authors: Bret Antoine
Published: July 2023

Shock waves are common in astrophysical environments. On many occasions, they are collisionless, which means they occur in settings where the mean free path is much larger than the dimensions of the system. For this very reason, magnetohydrodynamic (MHD) is not equipped to deal with such shocks, be it because it assumes binary collisions, hence temperature isotropy, when such isotropy is not guaranteed in the absence of collisions. Here, we solve a model capable of dealing with perpendicular shocks with anisotropic upstream pressure. The system of MHD conservation equations is closed assuming the temperature normal to the flow is conserved at the crossing of the shock front. In the strong shock sonic limit, the behaviour of a perpendicular shock with isotropic upstream is retrieved, regardless of the upstream anisotropy. Generally speaking, a rich variety of behaviours is found, inaccessible to MHD, depending on the upstream parameters. This work can be viewed as the companion paper of MNRAS 520, 6083-6090 (2023), where the case of a parallel shock was treated. Differences and similarities with the present case are discussed.
Optimization of the SVOM satellite strategy for the rapid follow-up of gravitational wave events
Authors: Ducoin J -G , Desoubrie B , Daigne F , Leroy N
Published: July 2023

The SVOM satellite, to be launched in early 2024, is primarily devoted to the multiwavelength observation of gamma-ray bursts and other higher-energy transients. Thanks to its onboard Microchannel X-ray Telescope and Visible-band Telescope, it is also very well adapted to the electromagnetic follow-up of gravitational wave events. We discuss the SVOM rapid follow-up strategy for gravitational wave trigger candidates provided by LIGO-Virgo-KAGRA. In particular, we make use of recent developments of galaxy catalogues adapted to the horizon of gravitational wave detectors to optimize the chance of counterpart discovery. We also take into account constraints specific to the SVOM platform. Finally, we implement the production of the SVOM observation plan following a gravitational wave alert and quantify the efficiency of several optimizations introduced in this work.
The Grounding Mystique
Authors: Sidelle Alan
Published: July 2023

Grounding has become all the rage in recent philosophical work and metaphilosophical discussions. While I agree that the concept of ground marks something useful, I am skeptical about the metaphysical weight many imbue it with, and the picture of ‘worldly layering’ that grounding talk inspires. My skepticism centers around the fact that grounding involves necessitation, combined with reasons for thinking matters of necessity are matters of logical or conceptual (semantic, psychological) relations. I sketch an argument for deflationism about ground based on this sort of deflationism about necessity and essence. I also note that in at least some cases, the considerations supporting modal deflationism directly support deflationism about whatever grounding relations may obtain in these cases.
A case of immunoglobulin G4–related retroperitoneal fibrosis and hypophysitis with antecedent respiratory disease followed by spontaneous remission and recurrence
Authors: Sakai Masato , Ohno Yuta , Kozuki Nana , Kawasaki Yuki , Yoshida Michiko , Ikeda Hiroyuki , Konishi Junji , Maeda Toshiki , Sugano Motoki , Kawakami Satoshi , Ito Isao , Yamaguchi Aina , Naiki Hironobu , Notohara Kenji , Akamizu Takashi , Kawano Mitsuhiro , Yoshida Haruyoshi
Published: July 2023

A 65-year-old man presented with apparent bronchopneumonia. After treatment with antibiotics, he showed eosinophilia. Computed tomography (CT) imaging revealed bilateral consolidation, ground-glass opacities with nodular consolidations, and pleural effusion. Lung biopsy showed organising pneumonia with lymphoplasmacytic infiltration in the alveolar septa and in the thickened pleura and interlobular septa. All pulmonary abnormalities spontaneously went into remission within 12 months. At 73 years old, a follow-up CT scan revealed small nodules in both lungs and the review of the head CT scan showed thickening of the pituitary stalk in studying prolonged headache. Two years later, he visited the hospital complaining of severe oedema on the lower extremities with high serum immunoglobulin (Ig)G4 186 mg/dl. A whole-body CT scan showed retroperitoneal mass surrounding aortic bifurcation and compressing inferior vena cava, pituitary stalk thickening and gland swelling, and enlarged pulmonary nodules. Anterior pituitary stimulation tests showed central hypothyroidism, central hypogonadism, and adult growth hormone deficiency with partial primary hypoadrenocorticism. Retroperitoneal mass biopsy showed storiform fibrosis and obliterative phlebitis with marked lymphoplasmacytic infiltration with moderate IgG4-positivity. Immunostaining of the former lung specimen revealed dense interstitial infiltration of IgG4-positive cells. These findings indicated metachronous development of IgG4-related disease in lung, hypophysis, and retroperitoneum, according to the recent comprehensive diagnostic criteria of IgG4-related disease. Glucocorticoid therapy ameliorated oedema, on the other hand, unmasked partial diabetes insipidus at the initial dose of the treatment. Hypothyroidism and retroperitoneal mass regressed at 6 months of the treatment. This case warns us that long-term follow-up from prodromal to remission is necessary for the treatment of IgG4-related disease.
Aligning Kitwood’s Model of Person-Centered Dementia Care with Music Therapy Practice
Authors: Kelly Lisa , Ahessy Bill , Richardson Ita , Moss Hilary
Published: July 2023

Person-centered dementia care has been extensively integrated into music therapy practice; its central aim being to meet the core psychological needs of people with dementia, uphold personhood, and contribute to enhanced quality of life. Furthermore, Kitwood’s model has been widely referenced as the theoretical framework underpinning multiple studies with people with dementia. However, few studies explore it in more concrete terms, expand on how it is implemented in practice, or describe how “positive person work” can be facilitated in music therapy with this population. This paper aims to address these lacunae, by presenting a comprehensive overview of Kitwood’s model; identifying how it has informed music therapy practice, and highlighting current applications of “person-centered music therapy” in relation to meeting the core psychological needs of people with dementia. Furthermore, the authors present practical considerations on facilitating “positive person work” in music therapy, drawing on their experiences of providing music therapy in dementia care.
Prediction of cognitive scores by joint use of movie-watching fMRI connectivity and eye tracking via Attention-CensNet
Authors: Gao Jiaxing , Zhao Lin , Zhong Tianyang , Li Changhe , He Zhibin , Wei Yaonei , Zhang Shu , Guo Lei , Liu Tianming , Han Junwei , Jiang Xi , Zhang Tuo
Published: July 2023

Background

Brain functional connectivity under the naturalistic paradigm has been shown to be better at predicting individual behaviors than other brain states, such as rest and doing tasks. Nevertheless, the state-of-the-art methods have found it difficult to achieve desirable results from movie-watching paradigm functional magnetic resonance imaging (mfMRI) -induced brain functional connectivity, especially when there are fewer datasets. Incorporating other physical measurements into the prediction method may enhance accuracy. Eye tracking, becoming popular due to its portability and lower expense, can provide abundant behavioral features related to the output of human's cognition, and thus might supplement the mfMRI in observing participants’ subconscious behaviors. However, there are very few studies on how to effectively integrate the multimodal information to strengthen the performance by a unified framework.

Objective

A fusion approach with mfMRI and eye tracking, based on convolution with edge-node switching in graph neural networks (CensNet), is proposed in this article.

Methods

In this graph model, participants are designated as nodes, mfMRI derived functional connectivity as node features, and different eye-tracking features are used to compute similarity between participants to construct heterogeneous graph edges. By taking multiple graphs as different channels, we introduce squeeze-and-excitation attention module to CensNet (A-CensNet) to integrate graph embeddings from multiple channels into one.

Results

The proposed model outperforms those using a single modality and single channel, and state-of-the-art methods.

Conclusions

The results indicate that brain functional activities and eye behaviors might complement each other in interpreting trait-like phenotypes.
Development and application of a scoring system for septum injuries in beef calves with and without a nose flap
Authors: Kirk A A , Tucker C B
Published: July 2023

The weaning period is a stressful time for beef calves because they must quickly gain independence from their dam. Gradual methods of weaning, such as when the calf is fitted with a nose flap to prevent suckling, are known to reduce the behavioral and physiological indicators of stress. Nose flaps are held in place by the nasal septum and are worn for 4 to 7 d. In the present study, the objectives were to 1) identify if a plastic nose flap worn for 7 d caused nasal injuries, (2) identify if factors like calf body weight or septum size predict injuries or flap loss, and (3) create a scoring system that could reliably score wound characteristics. Eighty-two (N = 82) Angus and Angus–Hereford crossbred beef calves were randomly assigned to ‘Flap’ or ‘No Flap’ treatments. Calves weighed 247 ± 29 kg and those with a flap had septums that were 39 ± 2 mm (mean ± SD). Images were taken of each nostril before flap insertion, on the day of removal, and 6 d after removal. Wounds were scored for the presence/absence of three characteristics in either nostril: damage (tissue where the flap rested was a different color than surrounding nostril), impression (edges of the wound were clearly raised or sunken), and blood. One trained observer scored a subset of photos (N = 64) twice, in a consistent manner for all three characteristics (damage, impression, and blood; 97%, 91%, and 100% agreement between 1st and 2nd evaluations, respectively), indicating that our system is repeatable. Thirty-two percent of calves in the Flap treatment lost their flap before the day of removal. No calves in the No Flap treatment were injured. All animals that kept their flap in for 7 d had damage and impressions in at least one nostril and 86% of calves had blood present immediately after nose flap removal (P ≤ 0.001 compared to No Flap) indicating that the flaps altered the nasal tissue and created open wounds. Six d after flap removal, 100% still had visible damage, 64% had impressions, and 29% had blood, indicating that while damage is longer lasting, wounds can start to repair after the flap is removed. Injuries were prevalent in all calves, thus there was no relationship between calf size (body weight or septum width) on these wounds (P ≥ 0.374). Body weight or septum size did not differ (P ≥ 0.489) between calves that kept or lost their flap. Injuries inflicted from a nose flap may counteract the previously documented benefits of this method of weaning, making it less advantageous than alternatives and raise concerns about other uses of these devices in other contexts.
Automatization of metabolite extraction for high-throughput metabolomics: case study on transgenic isoprene-emitting birch
Authors: Bertić Marko , Zimmer Ina , Andrés-Montaner David , Rosenkranz Maaria , Kangasjärvi Jaakko , Schnitzler Jörg-Peter , Ghirardo Andrea
Published: July 2023

Metabolomics studies are becoming increasingly common for understanding how plant metabolism responds to changes in environmental conditions, genetic manipulations and treatments. Despite the recent advances in metabolomics workflow, the sample preparation process still limits the high-throughput analysis in large-scale studies. Here, we present a highly flexible robotic system that integrates liquid handling, sonication, centrifugation, solvent evaporation and sample transfer processed in 96-well plates to automatize the metabolite extraction from leaf samples. We transferred an established manual extraction protocol performed to a robotic system, and with this, we show the optimization steps required to improve reproducibility and obtain comparable results in terms of extraction efficiency and accuracy. We then tested the robotic system to analyze the metabolomes of wild-type and four transgenic silver birch (Betula pendula Roth) lines under unstressed conditions. Birch trees were engineered to overexpress the poplar (Populus × canescens) isoprene synthase and to emit various amounts of isoprene. By fitting the different isoprene emission capacities of the transgenic trees with their leaf metabolomes, we observed an isoprene-dependent upregulation of some flavonoids and other secondary metabolites as well as carbohydrates, amino acid and lipid metabolites. By contrast, the disaccharide sucrose was found to be strongly negatively correlated to isoprene emission. The presented study illustrates the power of integrating robotics to increase the sample throughput, reduce human errors and labor time, and to ensure a fully controlled, monitored and standardized sample preparation procedure. Due to its modular and flexible structure, the robotic system can be easily adapted to other extraction protocols for the analysis of various tissues or plant species to achieve high-throughput metabolomics in plant research.
From vaccine to pathogen: Modeling Sabin 2 vaccine virus reversion and evolutionary epidemiology in Matlab, Bangladesh
Authors: Wong Wesley , Gauld Jillian , Famulare Michael
Published: July 2023

The oral poliovirus vaccines (OPVs) are one of the most effective disease eradication tools in public health. However, the OPV strains are genetically unstable and can cause outbreaks of circulating, vaccine-derived Type 2 poliovirus (cVDPV2) that are clinically indistinguishable from wild poliovirus (WPV) outbreaks. Here, we developed a Sabin 2 reversion model that simulates the reversion of Sabin 2 to reacquire a WPV-like phenotype based on the clinical differences in shedding duration and infectiousness between individuals vaccinated with Sabin 2 and those infected with WPV. Genetic reversion is informed by a canonical reversion pathway defined by three gatekeeper mutations (A481G, U2909C, and U398C) and the accumulation of deleterious nonsynonymous mutations. Our model captures essential aspects of both phenotypic and molecular evolution and simulates transmission using a multiscale transmission model that consolidates the relationships among immunity, susceptibility, and transmission risk. Despite rapid Sabin 2 attenuation reversal, we show that the emergence of a revertant virus does not guarantee a cVDPV2 outbreak. When simulating outbreaks in Matlab, Bangladesh, we found that cVDPV2 outbreaks are most likely in areas with low population-level immunity and poor sanitation. In Matlab, our model predicted that declining immunity against Type 2 poliovirus following the cessation of routine OPV vaccination was not enough to promote cVDPV2 emergence. However, cVDPV2 emergencedepended on the average viral exposure dose per contact, which was modeled as a combination of the viral concentration per fecal gram and the average fecal–oral dose per contact. These results suggest that cVDPV2 emergence risk can be mitigated by reducing the amount of infectious fecal material individuals are exposed to. Thus, a combined strategy of assessing and improving sanitation levels in conjunction with high-coverage vaccination campaigns could limit the future cVDPV2 emergence.
Quiescent Infection of Flowers by the Causal Agents of Loquat Fruit Rot, Neopestalotiopsis sp. and Pestalotiopsis sp.
Authors: Nozawa Shunsuke , Komine Masayuki , Takata Yoshiki , Uchikawa Keisuke , Suga Yasuhiro , Watanabe Kyoko
Published: July 2023

Loquat fruit rot, caused by Pestalotiopsis sensu lato, is a key problem for loquat producers in Nagasaki Prefecture, the area with the highest loquat fruit production in Japan. In a previous study, it was postulated that fruit rot pathogens latently infect flowers, with the corresponding disease symptoms occurring in wounded fruits. To reveal whether the pathogens responsible for the development of fruit rot disease are found in the asymptomatic flowers and immature fruits of loquat trees, we sprayed a conidial suspension of nitrate-nonutilizing mutants, containing strains derived from pathogenic Neopestalotiopsis sp. (TAP18N004) and Pestalotiopsis sp. (TAP18N010), onto the flowers of “Mogi” and “Nagasaki-wase” trees. Both inoculated mutants were reisolated using selective media (minimal media with chlorate) from the part of the asymptomatic immature fruit that includes the flower apex. Symptoms were observed in the mature fruits of both cultivars, and mutants were specifically detected in the symptomatic tissues of all rotted fruits. Additionally, all reisolated mutants were reconfirmed by assessing corresponding nitrate auxotrophy characteristics. Thus, it was revealed that both fruit rot pathogens that latently infect loquat flowers can cause fruit rot after maturation.

[Formula: see text] The author(s) have dedicated the work to the public domain under the Creative Commons CC0 “No Rights Reserved” license by waiving all of his or her rights to the work worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law, 2023.
False-Positive Human Immunodeficiency Virus Screening Results in Pregnancy During the Coronavirus Disease 2019 (COVID-19) Pandemic
Authors: Miller Madison , Cevigney Rachel , Ayyash Mariam , Shaman Majid , Kole Monica
Published: July 2023

False-positive human immunodeficiency virus (HIV) test results are rare but have been documented in the setting of certain underlying conditions such as Epstein-Barr virus, metastatic cancer, and certain autoimmune conditions. A retrospective cohort study in a large hospital system was conducted to compare the occurrence of false-positive HIV fourth-generation test results before and after the coronavirus disease 2019 (COVID-19) pandemic in a population of pregnant patients (N=44,187; 22,073 pre-COVID and 22,114 during COVID). The COVID cohort had a significantly higher frequency of false-positive HIV test results compared with the pre-COVID cohort (0.381 vs 0.676, P=.002). Within the COVID cohort, 25% of patients had a positive polymerase chain reaction test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) preceding their false-positive HIV test results. When this subgroup was excluded, the difference in frequency of false-positive HIV test results between the cohorts was no longer significant (0.381 vs 0.507, P=.348). Our findings suggest that SARS-CoV-2 seropositivity was associated with an increased frequency of false-positive HIV test results in the pregnant population.
Changes in Pelvic Floor Symptoms After Procedural Interventions for Uterine Leiomyomas
Authors: Gupta Ankita , Balk Ethan M. , Lenger Stacy M. , Yang Linda C. , Misal Meenal , Balgobin Sunil , Chang Olivia H. , Sharma Vidya , Stuparich Mallory , Behbehani Sadikah , Nihira Mikio , Alas Alexandriah , Jampa Alekhya , Sheyn David , Meriwether Kate , Antosh Danielle D.
Published: July 2023

OBJECTIVE:

To conduct a systematic review to evaluate the effect of procedural interventions for leiomyomas on pelvic floor symptoms.

DATA SOURCES:

PubMed, EMBASE, and ClinicalTrials.gov were searched from inception to January 12, 2023, searching for leiomyoma procedures and pelvic floor disorders and symptoms, restricted to primary study designs in humans.

METHODS OF STUDY SELECTION:

Double independent screening for studies of any study design in all languages that reported pelvic floor symptoms before and after surgical (hysterectomy, myomectomy, radiofrequency volumetric thermal ablation) or radiologic (uterine artery embolization, magnetic resonance-guided focused ultrasonography, high-intensity focused ultrasonography) procedures for management of uterine leiomyomas. Data were extracted, with risk-of-bias assessment and review by a second researcher. Random effects model meta-analyses were conducted, as feasible.

TABULATION, INTEGRATION, AND RESULTS:

Six randomized controlled trials, one nonrandomized comparative study, and 25 single-group studies met criteria. The overall quality of the studies was moderate. Only six studies, reporting various outcomes, directly compared two procedures for leiomyomas. Across studies, leiomyoma procedures were associated with decreased symptom distress per the UDI-6 (Urinary Distress Inventory, Short Form) (summary mean change −18.7, 95% CI −25.9 to −11.5; six studies) and improved quality of life per the IIQ-7 (Incontinence Impact Questionnaire, Short Form) (summary mean change −10.7, 95% CI −15.8 to −5.6; six studies). There was a wide range of resolution of urinary symptoms after procedural interventions (7.6–100%), and this varied over time. Urinary symptoms improved in 19.0–87.5% of patients, and the definitions for improvement varied between studies. Bowel symptoms were inconsistently reported in the literature.

CONCLUSION:

Urinary symptoms improved after procedural interventions for uterine leiomyomas, although there is high heterogeneity among studies and few data on long-term outcomes or comparing different procedures.

SYSTEMATIC REVIEW REGISTRATION:

PROSPERO, CRD42021272678.
Society of Anesthesia and Sleep Medicine and the Society for Obstetric Anesthesia and Perinatology Consensus Guideline on the Screening, Diagnosis, and Treatment of Obstructive Sleep Apnea in Pregnancy
Authors: Dominguez Jennifer E. , Cantrell Sarah , Habib Ashraf S. , Izci-Balserak Bilgay , Lockhart Ellen , Louis Judette M. , Miskovic Alice , Nadler Jacob W. , Nagappa Mahesh , O'Brien Louise M. , Won Christine , Bourjeily Ghada
Published: July 2023

The Society of Anesthesia and Sleep Medicine and the Society for Obstetric Anesthesia and Perinatology tasked an expert group to review existing evidence and to generate recommendations on the screening, diagnosis, and treatment of patients with obstructive sleep apnea during pregnancy. These recommendations are based on a systematic review of the available scientific evidence and expert opinion when scientific evidence is lacking. This guideline may not be appropriate for all clinical situations and patients, and physicians must decide whether these recommendations are appropriate for their patients on an individual basis. We recognize that not all pregnant people may identify as women. However, data on non–cisgendered pregnant patients are lacking, and many published studies use gender-binary terms; therefore, depending on the study referenced, we may refer to pregnant individuals as women. This guideline may inform the creation of clinical protocols by individual institutions that consider the unique considerations of their patient populations and the available resources.
Directed Versus non-directed Standing Postures in Adolescent Idiopathic Scoliosis: Its Impact on Curve Magnitude, Alignment and Clinical Decision Making
Authors: Cheung Prudence Wing Hang , Wong Hei Lung , Lau Damian S L , Cheung Jason Pui Yin
Published: July 2023

Study Design:

Prospective study.

Objective:

To investigate the difference in major curve Cobb angle and alignment between directed and non-directed positioning for adolescent idiopathic scoliosis (AIS) and to evaluate implications on treatment decision-making.

Summary of Background Data:

Proper positioning of patients with spinal deformities is important for assessing usual functional posture in standing, so management strategies can be customized accordingly. Whether postural variability affects coronal and sagittal radiological parameters and the impact of posture on management decisions remain unknown.

Methods:

Patients with AIS presenting for initial consultation at the tertiary scoliosis clinic were recruited. They were asked to stand in two positions: passive, non-directed position; and directed position by the radiographer. Radiological assessment included major and minor Cobb angle, coronal balance, spinopelvic parameters, sagittal balance and alignment. Cobb angle difference >5⁰ between directed and non-directed positioning was considered clinically impactful. Patients with or without such difference were compared. Over- or under-estimation of the major curve (at 25⁰ or 40⁰) by non-directed positioning were examined due to relevance to bracing and surgical indications.

Results:

This study included 198 patients, with 22.2% experiencing Cobb angle difference (>5⁰) between positioning. The major curve Cobb angle was smaller in non-directed than directed positioning (median difference: −6.0⁰, upper and lower quartile: −7.8, 5.8), especially for curves ≥30⁰. Patients with a Cobb angle difference had changes in shoulder balance (P=0.007) when assuming a directed position. Non-directed positioning had 14.3% of major Cobb 25⁰ underestimated and 8.8% overestimated, whereas 11.1% of curves >40⁰ were underestimated.

Conclusion:

Strict adherence to a standardized radiographic protocol is mandatory for reproducing spine radiographs reliable for curve assessment, as a non-directed position demonstrates smaller Cobb angles. Postural variation may lead to over-, or under-estimation, of the curve size relevant for both bracing and surgical decision-making.

Level of Evidence:

II.
The experience of the COMRE group (REctal COMmittee): can magnetic resonance imaging and endosonography really help the clinical pathway after NCRT in rectal cancer?
Authors: Scabini Stefano , Romana Chiara , Sartini Marina , Attieh Ali , Marrone Ciro , Cristina Maria L. , Parodi Maria C.
Published: July 2023

Background:

MRI and rectal endosonography (EUS) are routinely used for preoperative tumor staging and assessment of response to therapy in patients with rectal cancer. This study aimed to evaluate the accuracy of the two techniques in predicting the pathological response compared to the resected specimen and the agreement between MRI and EUS and to define the factors that could affect the ability of EUS and MRI to predict pathological responses.

Materials and methods:

This study included 151 adult patients with middle or low rectal adenocarcinoma treated with neoadjuvant chemoradiotherapy, followed by curative intent elective surgery in the Oncologic Surgical Unit of a hospital in the north of Italy between January 2010 and November 2020. All patients underwent MRI and rectal EUS.

Results:

The accuracy of EUS to evaluate the T stage was 67.48%, and for the N stage was 75.61%; the accuracy of MRI to evaluate the T stage was 75.97%, and that for the N stage was 51.94%. The agreement in detecting the T stage between EUS and MRI was 65.14% with a Cohen’s kappa of 0.4070 and that for the evaluation of the lymph nodes between EUS and MRI was 47.71% with a Cohen’s kappa of 0.2680. Risk factors that affect the ability of each method to predict pathological response were also investigated using logistic regression.

Conclusions:

EUS and MRI are accurate tools for rectal cancer staging. However, after RT-CT, neither method is reliable for establishing the T stage. EUS seems significantly better than MRI for assessing the N stage. Both methods can be used as complementary tools in the preoperative assessment and management of rectal cancer, but their role in the assessment of residual rectal tumors cannot predict the complete clinical response.
Concomitant Mental Illnesses Diagnoses and Likelihood of Trauma Recidivism
Authors: Bauer Molly A. , Mayo Ann M. , Bush Ruth A.
Published: July 2023

BACKGROUND:

Trauma is the leading cause of death among persons aged 1–44 years. Trauma recidivism occurs when an individual experiences more than one significant injury in a 5-year period. The relationship between a trauma recidivist's perception of recurrent injury has been unclear.

OBJECTIVE:

To describe the association between select sociodemographic and clinical variables, threat orientation, and the perceived likelihood of recurrent injury of individuals recently experiencing a significant injury.

METHODS:

A prospective cross-sectional study was conducted with Level II trauma inpatients (n = 84) in Southern California from October 2021 to January 2022. Participants completed surveys prior to discharge. Clinical variables were extracted from the electronic health record.

RESULTS:

The trauma recidivism rate was 31%. Mental illness and length of hospital stay were associated with trauma recidivism. In individuals with two or more mental illness diagnoses, the odds of trauma recidivism were approximately 6.5 times higher than in those with no mental illness (odds ratio = 6.48, 95% confidence interval: 1.7–24.6).

CONCLUSION:

Trauma is a preventable health care concern with timely recognition of risk factors and intervention. This study confirms mental illness as a predominant factor in injury and should be addressed in clinical practice. This study builds upon previous research and emphasizes the necessity of targeting injury prevention and education in the mentally ill. Trauma providers seeking to practice with an upstream mentality have a responsibility in screening patients for mental illness to help prevent further injury and death.
Postintensive Care Syndrome: Feasibly Bridging Care at a Tertiary Trauma Center
Authors: Stevens Timothy J. , Lee Donna B.
Published: July 2023

Background:

Advancements in critical care management have improved mortality rates of trauma patients; however, research has identified physical and psychological impairments that remain with patients for an extended time. Cognitive impairments, anxiety, stress, depression, and weakness in the postintensive care phase are an impetus for trauma centers to examine their ability to improve patient outcomes.

Objective:

This article describes one center's efforts to intervene to address postintensive care syndrome in trauma patients.

METHODS:

This article describes implementing aspects of the Society of Critical Care Medicine's liberation bundle to address postintensive care syndrome in trauma patients.

Results:

The implementation of the liberation bundle initiatives was successful and well received by trauma staff, patients, and families. It requires strong multidisciplinary commitment and adequate staffing. Continued focus and retraining are requirements in the face of staff turnover and shortages, which are real-world barriers.

Conclusions:

Implementation of the liberation bundle was feasible. Although the initiatives were positively received by trauma patients and their families, we identified a gap in the availability of long-term outpatient services for trauma patients after discharge from the hospital.
The role of Erzhi Tiangui formula in expected poor ovarian responders undergoing in vitro fertilization-embryo transfer: A multicenter, randomized, double-blind, placebo-controlled trial
Authors: Han Qiao-Song , Zhou Yue , Chen Wen , Song Jing-Yan , Sun Zhen-Gao
Published: July 2023

Introduction:

Advanced age is one of the primary risk factors for infertility. Poor ovarian response (POR) to exogenous gonadotropin is a prominent characteristic of advanced-age women undergoing in vitro fertilization and embryo transfer (IVF-ET), which results in fewer retrieved oocytes and poor pregnancy outcomes. Traditional Chinese medicine (TCM) has been shown to improve female fertility. Erzhi Tiangui (EZTG) formula, in the form of granules with 10 herbal ingredients, demonstrated potential benefits in improving oocyte and embryo quality and ovarian reserve. Thus, this study aims to evaluate the efficacy and safety of EZTG formula.

Method:

The study is a multicenter, double-blind, placebo-controlled, randomized controlled trial (RCT), which will be conducted at 10 reproductive centers of tertiary hospitals. This study will enroll 480 women with expected POR of advanced age (≥35 years old) who fulfill the 2011 Bologna criteria. Participants will be assigned to either the EZTG group or the placebo group at random in an equal ratio. Each individual will receive conventional IVF-ET with EZTG granules or placebo as a complementary treatment. The primary outcome is the number of oocytes retrieved. Adverse events and safety assessments will be also conducted.

Discussion:

This study aims to provide robust evidence of the efficacy and safety of EZTG formula as a complementary treatment for advanced-age women with expected POR undergoing IVF-ET.
Could real-time sonoelastography-measured placental strain ratio (PSR) value be a soft marker for the diagnosis of intrahepatic cholestasis of pregnancy?: A case-control study and short reviews
Authors: Şen Selim Halime , Şengül Mustafa
Published: July 2023

Diagnosis of intrahepatic cholestasis of pregnancy (ICP) is often decided upon with typical pruritus supported by elevated serum bile acid levels. However, there is confusion regarding the absolute reference range for serum bile acid. To confirm the utility of Placental Strain Ratio (PSR) measurement as a marker for the diagnosis of ICP and to reveal the extent to which it is correlated with serum bile acid concentration. A case-control study was conducted. The case group included 29 patients who were admitted to our hospital in the second or third trimester of pregnancy with typical itching and were clinically diagnosed with ICP with >10 mmol/L serum bile acid. The first 45 pregnant women were assigned to a control group. Real-time tissue elastography software was used for ultrasound assessment of all pregnant placentas. Software was used to estimate the SR values. Biochemical liver function parameters, hemograms, serum bile acid levels, and SR values were compared between these groups. PSR was found to predict the development of cholestasis with poor discrimination (area under the curve [AUC] = 0.524; 95% CI = 0.399–0.646). The optimal threshold value with the best sensitivity and specificity rates was calculated to be 0.46 PSR. ICP developed significantly more frequently in the low PSR group than in the high PSR group (60% vs 29.3%, P = .05, odds ratios [OR] = 0.276, 95% CI = 0.069–1.105). No correlation was found between the PSR and bile acid levels (rho = −0.029, P = .816). PSR values can support the diagnosis of ICP, predict serum bile acid levels, and can be used as soft markers.
The efficacy of Fuke Qianjin tablets combined with clomiphene citrate on infertility patients with polycystic ovary syndrome: A retrospective analysis
Authors: Zhang Yu , Cao Shan , Liang Jun-Xia , Ge Xin , Hu Shu-Hong , Li Ya-Xue , Li Li-Hui
Published: July 2023

Purpose:

Clinical efficacy of Fuke Qianjin tablets combined with clomiphene citrate on infertility patients with polycystic ovary syndrome (PCOS) was expected to be retrospectively analyzed in this study.

Methods:

In this paper, 100 infertility patients with PCOS were selected and divided into the observation and control groups based on different medications. Firstly, clinical data of both groups of patients were acquired. Then, the uterine receptivity and ovarian status, the levels of sex hormones, inflammation and oxidative stress, and the pregnancy outcomes between the 2 groups were compared and analyzed before and after treatment.

Results:

After a variety of comparisons and analyses, Fuke Qianjin tablets combined with clomiphene citrate were confirmed to improve the uterine receptivity and ovarian status, levels of sex hormone, inflammation and oxidative stress, and pregnancy outcomes in infertility patients with PCOS.

Conclusions:

Overall, Fuke Qianjin tablets + clomiphene citrate treatment shows good clinical efficacy and is worth promotion in clinical practice.
Case report: Acute submandibular sialadenitis in poorly controlled diabetes mellitus patient fed twenty days by enteral tube
Authors: Iwamoto Yuichiro , Anno Takatoshi , Koyama Katsumasa , Tomoda Koichi , Kimura Tomohiko , Kaneto Hideaki
Published: July 2023

Introduction:

Enteral tube feeding is an effective method of providing nutrients for patients who are unable to meet their nutritional requirements, and patients with parenteral nutrition are at an increased risk of infection. The submandibular gland is one of the major salivary glands and sialadenitis are often caused by obstruction of the salivary outflow tract.

Patient concerns:

A 91-year-old woman had parenteral nutrition with nasogastric tube feeding. Her history includes angina pectoris, myocardial infarction, type 2 diabetes mellitus (T2DM), heart failure, atrial fibrillation, sick sinus syndrome, and she recently had a pacemaker implanted. She was continued parenteral nutrition with nasogastric tube feeding for 20 days, and her fasting blood glucose ranged from 200 to 400 mg/dL. In the midst of poor glycemic control, she suddenly had high fever and elevated infection markers under poorly glycemic control.

Diagnoses:

She had neck swelling with a feeling of heat. We performed cervical computed tomography, and it revealed swelling of the bilateral submandibular glands and fluffing of surrounding tissue. She was diagnosed with acute submandibular glanditis.

Interventions:

We treated her with antibiotics therapy, extubation, daily massage of the submandibular gland and strict glycemic control.

Outcomes:

Her neck swelling disappeared about 11 days after such treatment.

Lessons:

We reported acute submandibular glanditis induced by nasogastric tube feeding under poorly controlled diabetes mellitus. We have to keep good oral hygiene and also pay attention to glycemic control in subjects under parenteral nutrition with tube feeding management.
A novel method of assessment of BMD using CBCT for implant placement: A retrospective study
Authors: AlQahtani Saad Mohammed
Published: July 2023

Nowadays, dental implant evolves as an alternative treatment modality for oral rehabilitation. The success of dental implants is largely dependent on bone density; Cone-beam computed tomography (CBCT) is a well-known modus operandi for the volumetric measurement of bone mineral density (BMD), which measures Grayscale values on 3-D images. This study was conducted with the aim to analyze bone density with CBCT and also test its reliability and reproducibility using Galileos Sirona CBCT Viewer Software and Philips digital imaging and communications in medicine (DICOM) Viewer. A total of 75, CBCT images were obtained from the Department of Oral Radiology, retrospectively, and, BMD in Hounsfield units (HUs) was evaluated in a standardized implant area superimposed on the images. Bone density was also calculated by 2 different independent observers. The estimation of sample size was achieved to attain a power of 90% with 0.5 alpha error and 0.2 effect size as per a previous study. Statistical analysis was performed by statistical package for the social sciences version 22.0; data were presented as mean and standard deviation and Kappa correlation test was applied to check the reproducibility of values. The mean and standard deviation of grayscale values and HUs attained from the interdental area of front teeth were 1837 (288.76) and 270 (125.4), respectively, with a conversion factor of 6.8. Whereas the mean and standard deviation of grayscale values and HUs acquired from posterior interdental spaces were 2880 (489.99) and 640 (204.6), respectively, with a conversion factor of 4.5. To verify the reproducibility Kappa correlation test was applied, which showed correlation values of 0.68 and 0.79. The conversion or exchange factors for grayscale values to HUs determined at the frontal, posterior interdental space area and from the highly radio-opaque area were exceedingly reproducible and consistent. Hence, CBCT can be used as one of the valuable techniques in the estimation of bone density.
Effects of team leaders’ position in cardiopulmonary resuscitation teams on leadership behavior and team performance: A prospective randomized interventional cross-over simulation-based trial
Authors: Kern Peter , Tschan Franziska , Semmer Norbert K. , Marsch Stephan
Published: July 2023

Background:

Leadership is an important performance factor in resuscitation teams. Medical guidelines for cardiopulmonary resuscitation (CPR) advise team leaders to keep hands off patients. There is little evidence for this recommendation that is based purely on observational data. Accordingly, the aim of this trial was to investigate the effect of leaders’ position during CPR on leadership behavior and team performance.

Method:

This is a prospective randomized interventional crossover simulation-based single center trial. Teams of 3 to 4 physicians each, representing a rapid response team, were confronted with a simulated cardiac arrest. Team leaders were randomly assigned and assigned team leaders were 1:1 randomized to 2 leadership positions: position at the patient’s head; and hands-off position. Data analysis was performed from video-recordings. All utterances during the first 4 minutes of CPR were transcribed and coded based on a modified “Leadership Description Questionnaire.” The primary endpoint was the number of leadership statements. Secondary outcomes included CPR related performance markers like hands-on time and chest compression rate, and the behavioral related endpoints Decision Making, Error Detection, and Situational Awareness.

Results:

Data from 40 teams (143 participants) was analyzed. Leaders in hands-off position made more leadership statements (28 ± 8 vs 23 ± 8; P <.01) and contributed more to their team’s leadership (59 ± 13% vs 50 ± 17%; P = .01) than leaders in the head position. Leaders’ position had no significant effect on their teams’ CPR performance, Decision Making, and Error Detection. Increased numbers of leadership statements lead to improved hands-on time (R = 0.28; 95% confidence interval 0.05–0.48; P = .02).

Conclusions:

Team leaders in a hands-off position made more leadership statements and contributed more to their teams’ leadership during CPR than team leaders actively involved in the head position. However, team leaders’ position had no effect on their teams’ CPR performance.
The effect of being married on heart rate variability, an indicator of autonomic dysfunction: A retrospective study
Authors: Akgümüş Alkame , Balun Ahmet , Peker Tezcan , Boyraz Bedrettin
Published: July 2023

Heart rate variability (HRV) is a noninvasive assessment that reflects the autonomic functions of the heart and is known to be impaired in many diseases. In our study, we aimed to investigate the relationship between HRV and being married. The study included 104 patients, between the aged 20 to 40 years were included in the study. The patients were divided into 2 groups as 53 healthy married (group 1) and 51 healthy unmarried (group 2). 24-hour rhythm Holter recordings were performed on all married and unmarried patients. Group 1 had a mean age of 32 ± 5 years and 47.2% men, and group 2 had a mean age of 30 ± 5 years and 54.9% men. Standard deviation of normal to normal (SDNN) was 150 ± 40 versus 128 ± 30 (P = .003), SDNN index was 66 ± 20 versus 56 ± 12 (P = .004), the square root of the mean of the squares of the differences of the adjacent root mean square of successive differences (RMSSD) was 37 ± 10 versus 30 ± 10 (P < .001), percentage of successive R-R intervals that differ by more than 50 milliseconds (PNN50) was 13.5 ± 7 versus 8.5 ± 7 (P = .001), HF was 450 ± 270 versus 225 ± 130 (P < .001) found to be significantly less in the group 2. LF/HF ratio was 1.68 ± 0.65 versus 3.31 ± 1.56 (P < .001) found to be significantly higher in the group 2. In our study, it is possible to say that the sympathetic system effect on the heart was more dominant and the HRV was lower in the unmarried group.
Effectiveness of traditional Chinese medicine formulas combined with acupuncture in the treatment of ovulation dysfunction infertility: A systematic review and meta-analysis
Authors: Mo Jingwen , Zhang Yiyi , Jin Ni , Zhou Yi
Published: July 2023

Background:

To evaluate the efficacy and safety of traditional Chinese medicine formulas combined with acupuncture for the treatment of ovulation dysfunction infertility (ODI).

Methods:

From January 1, 2018 to March 12, 2023, 7 electronic databases, PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, Wanfang Database, and CBM, were systematically searched to identify eligible randomized controlled trial studies.

Results:

Meta analysis showed that traditional Chinese medicine combined with acupuncture can more effectively improve sex hormone levels compared to Western medicine alone, including follicle stimulating hormone (FSH) in older patients (standardized mean difference [SMD]: 3.00; 95% confidence interval [CI]: 2.35–3.66; P = .024, I2 = 28%), FSH in younger patients (SMD: 0.45; 95% CI: −0.15, 1.05; P = .03, I2 = 71%), estradiol (E2) (SMD: 7.50; 95% CI: v0.47, 15.48; P < .00001, I2 = 99%), and progesterone (P) (SMD: 2.20; 95% CI: 2.07–2.33; P < .00001, I2 = 29%). Compared to Western medicine alone, traditional Chinese medicine combined with acupuncture also had a better effect to increase ovulation rate (risk ratio [RR]: 2.46; 95% CI: 1.72–3.52; P < .00001, I2 = 0%), pregnancy rate (RR: 2.50; 95% CI: 1.96–3.18; P < .00001, I2 = 0%), maximum follicle diameter (MFD) (SMD: 2.27; 95% CI: 1.37–3.16; P < .00001, I2 = 91%), and endometrial thickness (SMD: 1.71; 95% CI: 1.31–2.11; P < .00001, I2 = 87%). The combination of traditional Chinese medicine and acupuncture also had better effects on quality of life (RR: 0.19; 95% CI: 0.15–0.23; P < .00001, I2 = 0%) and reduced adverse reactions (RR: 0.15; 95% CI: 0.05–0.48; P = .001, I2 = 0%), compared to Western medicine alone.

Conclusion:

This study shows evidence that traditional Chinese medicine formulas combined with acupuncture are an effective and safe treatment approach. However, this conclusion requires further confirmation due to the insufficient quality of the included trials.
Cardiac Hospice Care—A Collaborative Approach to Managing Heart Failure
Authors: Parker Sharon , Browning Sarah Via
Published: July 2023

As treatments for end-stage heart failure (ESHF) have become more available, patients with ESHF may encounter decisional dilemmas as their condition progresses and they seek more comfort-based care. Those who want to continue therapeutic treatments such as inotropic therapy, may face the challenge of finding a hospice agency willing to integrate this therapy into the hospice benefit model. This article highlights one hospice agency's willingness to explore common barriers to admitting patients receiving inotropic therapy, and addresses the trajectory of patient care when hospice collaboratively partners with cardiology services. It outlines operational development for providing cardiac focused care in hospice, and speaks to next steps for expanding these services. Most importantly, it acknowledges the profound effect on patients who are offered the choice to return home with hospice while receiving cardiac therapeutic care.