bluuebunny/crossref_metadata_2025 huggingface dataset:
Grasslands in the Northern Prairie region support a diverse assemblage of migrant birds and facilitate fattening during migratory stopover
Authors: West Amy C , Swanson David L
Published: September 2024

Grasslands have been reduced as a result of conversion to agriculture and other anthropogenic uses. Consequently, grassland migrant birds may have limited options for migration stopover. In addition, the simple presence of birds in grassland fragments during migration periods does not imply that the habitat is providing the food resources necessary for birds to replenish fat stores and continue migration. We examined (1) the diversity of birds using grasslands during migration stopovers in southeastern South Dakota and (2) whether a reconstructed prairie can provide the resources necessary for a successful stopover. To accomplish these goals, we conducted line transect surveys on plots dominated by either cool- (primarily non-native) or warm-season (primarily native) grasses and captured birds on a reconstructed tallgrass prairie to determine plasma levels of triglycerides, an indicator of fat deposition, and β-hydroxybutyrate, an indicator of fat depletion. Grassland, woodland/shrub, and habitat generalist bird species were all present in the study grasslands during spring and fall migration seasons. Overall, species-richness tended to be greater at warm-season dominated sites during spring migration, but richness differences between sites varied by year during fall migration. Overall bird densities, however, were roughly similar between the 2 habitat types in both seasons, although some differences for individual bird species occurred. Plasma triglyceride and β-hydroxybutyrate levels of migrant birds using the reconstructed tallgrass prairie were consistent with those from birds in known high-quality stopover habitats. These findings suggest that grasslands that have a diversity of plant species and structural heterogeneity may be important for stopover sites for a variety of migratory birds using grasslands as stopover sites, including declining grassland species. These data further suggest that the creation and management of restored and reconstructed prairies throughout the migratory routes for grassland birds may provide quality stopovers for these species.
The transcriptional integration of environmental cues with root cell type development
Authors: Gouran Mona , Brady Siobhan M
Published: September 2024

Plant roots navigate the soil ecosystem with each cell type uniquely responding to environmental stimuli. Below ground, the plant's response to its surroundings is orchestrated at the cellular level, including morphological and molecular adaptations that shape root system architecture as well as tissue and organ functionality. Our understanding of the transcriptional responses at cell type resolution has been profoundly enhanced by studies of the model plant Arabidopsis thaliana. However, both a comprehensive view of the transcriptional basis of these cellular responses to single and combinatorial environmental cues in diverse plant species remains elusive. In this review, we highlight the ability of root cell types to undergo specific anatomical or morphological changes in response to abiotic and biotic stresses or cues and how they collectively contribute to the plant's overall physiology. We further explore interconnections between stress and the temporal nature of developmental pathways and discuss examples of how this transcriptional reprogramming influences cell type identity and function. Finally, we highlight the power of single-cell and spatial transcriptomic approaches to refine our understanding of how environmental factors fine tune root spatiotemporal development. These complex root system responses underscore the importance of spatiotemporal transcriptional mapping, with significant implications for enhanced agricultural resilience.
Phosphorylation of the transcription factor SlBIML1 by SlBIN2 kinases delays flowering in tomato
Authors: Zhang Siwei , Deng Rui , Liu Jianwei , Luo Dan , Hu Miaomiao , Huang Shuhua , Jiang Meng , Du Jia , Jin Tong , Liu Dehai , Li Yuchao , Khan Maqsood , Wang Shufen , Wang Xiaofeng
Published: September 2024

Brassinosteroids (BRs) are well known for their important role in the regulation of plant growth and development. Plants with deficiency in BR signaling show delayed plant development and exhibit late flowering phenotypes. However, the precise mechanisms involved in this process require investigation. In this study, we cloned homologs of BRASSINOSTEROID-INSENSITIVE 2 (SlBIN2), the GSK3-like protein kinase in tomato (Solanum lycopersicum). We characterized growth-related processes and phenotypic changes in the transgenic lines and found that SlBIN2 transgenic lines have delayed development and slow growing phenotypes. SlBIN2s work redundantly to negatively regulate BR signaling in tomato. Furthermore, the transcription factor SlBIN2.1-INTERACTING MYB-LIKE 1 (SlBIML1) was identified as a downstream substrate of SlBIN2s that SlBIN2s interact with and phosphorylate to synergistically regulate tomato developmental processes. Specifically, SlBIN2s modulated protein stability of SlBIML1 by phosphorylating multiple amino acid residues, including the sites Thr266 and Thr280. This study reveals a branch of the BR signaling pathway that regulates the vegetative growth phase and delays floral transition in tomato without the feedback affecting BR signaling. This information enriches our understanding of the downstream transduction pathway of BR signaling and provides potential targets for adjusting tomato flowering time.
Developmental responses of roots to limited phosphate availability: Research progress and application in cereals
Authors: Lu Hong , Ren Meiyan , Lin Rongbin , Jin Kangming , Mao Chuanzao
Published: September 2024

Phosphorus (P), an essential macronutrient, is crucial for plant growth and development. However, available inorganic phosphate (Pi) is often scarce in soil, and its limited mobility exacerbates P deficiency in plants. Plants have developed complex mechanisms to adapt to Pi-limited soils. The root, the primary interface of the plant with soil, plays an essential role in plant adaptation to Pi-limited soil environments. Root system architecture significantly influences Pi acquisition via the dynamic modulation of primary root and/or crown root length, lateral root proliferation and length, root hair development, and root growth angle in response to Pi availability. This review focuses on the physiological, anatomical, and molecular mechanisms underpinning changes in root development in response to Pi starvation in cereals, mainly focusing on the model monocot plant rice (Oryza sativa). We also review recent efforts to modify root architecture to enhance P uptake efficiency in crops and propose future research directions aimed at the genetic improvement of Pi uptake and use efficiency in crops based on root system architecture.
Socioeconomic resources in youth are linked to divergent patterns of network integration/segregation across the brain's transmodal axis
Authors: Michael Cleanthis , Taxali Aman , Angstadt Mike , Kardan Omid , Weigard Alexander , Molloy M Fiona , McCurry Katherine L , Hyde Luke W , Heitzeg Mary M , Sripada Chandra
Published: September 2024

Socioeconomic resources (SER) calibrate the developing brain to the current context, which can confer or attenuate risk for psychopathology across the lifespan. Recent multivariate work indicates that SER levels powerfully relate to intrinsic functional connectivity patterns across the entire brain. Nevertheless, the neuroscientific meaning of these widespread neural differences remains poorly understood, despite its translational promise for early risk identification, targeted intervention, and policy reform. In the present study, we leverage graph theory to precisely characterize multivariate and univariate associations between SER across household and neighborhood contexts and the intrinsic functional architecture of brain regions in 5,821 youth (9–10 years) from the Adolescent Brain Cognitive Development Study. First, we establish that decomposing the brain into profiles of integration and segregation captures more than half of the multivariate association between SER and functional connectivity with greater parsimony (100-fold reduction in number of features) and interpretability. Second, we show that the topological effects of SER are not uniform across the brain; rather, higher SER levels are associated with greater integration of somatomotor and subcortical systems, but greater segregation of default mode, orbitofrontal, and cerebellar systems. Finally, we demonstrate that topological associations with SER are spatially patterned along the unimodal–transmodal gradient of brain organization. These findings provide critical interpretive context for the established and widespread associations between SER and brain organization. This study highlights both higher-order and somatomotor networks that are differentially implicated in environmental stress, disadvantage, and opportunity in youth.
Association between non-neoplastic bladder diseases and bladder cancer risk: insights from Mendelian randomization studies
Authors: Zhang Yi , Li Rongkang , Zhang Shaohua , Li Hangxu
Published: September 2024

Purpose

Our aim is to explore the relation between non-neoplastic bladder diseases and bladder cancer (BC) from a genetic level utilizing Mendelian randomization (MR).

Methods

Single nucleotide polymorphisms (SNPs) related to cystitis, bladder stones, and neuropathic bladder were gathered from the IEU genome-wide association studies database. Quality control on SNPs was performed via stringent screening criteria. The relation between non-neoplastic bladder diseases and BC risk was evaluated using inverse-variance weighted, MR-Egger, weighted median, simple mode, and weighted mode methods. Cochran’s Q test was conducted to assess the heterogeneity of SNPs; in addition, the MR-Egger intercept test was employed to examine the horizontal pleiotropy of SNPs. Exposure and outcomes were validated using a validation database. Finally, BC was used as the exposure and non-neoplastic bladder diseases as the outcome to evaluate reverse causality.

Results

The outcomes showcased that genetically predicted cystitis is significantly correlated to a raised risk of BC (inverse-variance weighted: odds ratio [95%] = 1.1737 [1.0317, 1.3352], P = .0149), consistent with the BC validation cohort in the MR analysis. Nevertheless, no causal relation was found between bladder stone and neuropathic bladder with BC risk (P > .05). In this study, sensitivity analysis indicated no heterogeneity or horizontal pleiotropy.

Conclusion

The study presents proof of a genetic-level causal relation between cystitis and increased BC risk, while bladder stones and neuropathic bladder do not show similar associations.
Addressing Health Care Access Disparities Through a Public Health Approach to Physical Therapist Practice
Authors: McKinney Jessica , Kelm Nicole , Windsor Brett , Keyser Laura E
Published: September 2024

As the field evolves as a doctoring profession, the role and scope of physical therapist practice must also grow to meet important and urgent public health needs. Scalable, population-level interventions must be prioritized to the same degree as tailored, individual-level care. Drawing from public health frameworks, this perspective proposes an approach to population–level physical therapist care delivery that aims to mitigate disease and disability and improve health outcomes by expanding access, decreasing cost, and improving quality of care for those facing the greatest health disparities. Application of these frameworks prompts the development of novel approaches to rehabilitation service delivery to advance twin goals of promoting access to care and reducing health disparities. This paper describes how a population health framework and public health approach can be used to support necessary evolution and innovation within the field of physical therapy and to improve rehabilitation service delivery. Rapid developments in the digital and virtual health space have created a unique opportunity for physical therapists to lean into a new vision of their role as clinicians within the broader health ecosystem. This paper will provide clinicians with a broader perspective of physical therapist expertise and describe opportunities for the development and application of a physical therapist skill set toward driving population health outcomes. Real-world examples will guide clinicians to consider opportunities in their own practice for implementing this public health approach and potentially addressing various contributors to persistent health disparities.
Fibroblast activation protein inhibitor positron emission tomography imaging in muscles of patients with idiopathic inflammatory myopathy
Authors: Zhang Yuying , Zhang Bing , Niu Yuanyuan , Long Yali , He Qiao , Luo Guangxi , Xu Hanshi , Zhang Xiangsong , Zhan Zhongping , Chen Dongying
Published: September 2024

Objectives

Mesenchymal stromal cells in muscles participate in regeneration following muscle injury. This study explored the potential of [18F]fibroblast activation protein inhibitor (FAPI)-42 PET targeting mesenchymal stromal cells to evaluate disease activity of idiopathic inflammatory myopathy (IIM).

Methods

Patients with IIM (n = 26) were prospectively included and underwent [18F]FAPI-42 PET/CT and whole-body MRI between January 2023 and July 2023. Patients with malignancies were retrospectively included in the control group and only underwent [18F]FAPI-42 PET/CT (n = 28). [18F]FAPI-42 PET/CT images were evaluated using for avid-FAPI uptake and the target-to-background ratio (TBR). Whole-body MRI was evaluated for oedema, fatty infiltration and atrophy in 42 muscles in the IIM group. The global FAPI- and MRI-derived parameters were calculated for each patient. Clinical assessment of disease activity and muscle strength were collected.

Results

Patients with IIM had significantly higher global FAPI-avid muscle ratios (0.68 [IQR: 0.45, 0.79] vs 0.06 [IQR: 0, 0.11], P < 0.001) and global muscle TBR (2.26 [IQR: 1.71, 2.75] vs 1.23 [IQR: 1.02, 1.52], P < 0.001) compared with controls. In the IIM group, the median TBR was higher in muscles with oedema than in those without (2.44 [IQR: 1.46, 3.27] vs 1.31 [IQR: 0.95, 1.99], P < 0.001). Global FAPI-avid muscle ratios significantly correlated with global oedema score (r = 0.833), muscle strength (r = −0.649), serum creatine kinase (r = 0.456) and disease activity index (r = 0.495–0.621).

Conclusion

Increased [18F]FAPI-42 uptake was associated with muscle oedema in IIM. FAPI-derived parameters correlated with IIM disease activity. [18F]FAPI-42 is a promising PET tracer for evaluating IIM disease activity.
A spectrum of altered non-rapid eye movement sleep in schizophrenia
Authors: Kozhemiako Nataliia , Jiang Chenguang , Sun Yifan , Guo Zhenglin , Chapman Sinéad , Gai Guanchen , Wang Zhe , Zhou Lin , Li Shen , Law Robert G , Wang Lei A , Mylonas Dimitrios , Shen Lu , Murphy Michael , Qin Shengying , Zhu Wei , Zhou Zhenhe , Stickgold Robert , Huang Hailiang , Tan Shuping , Manoach Dara S , Wang Jun , Hall Mei-Hua , Pan Jen Q , Purcell Shaun M
Published: September 2024

Multiple facets of sleep neurophysiology, including electroencephalography (EEG) metrics such as non-rapid eye movement (NREM) spindles and slow oscillations, are altered in individuals with schizophrenia (SCZ). However, beyond group-level analyses, the extent to which NREM deficits vary among patients is unclear, as are their relationships to other sources of heterogeneity including clinical factors, aging, cognitive profiles, and medication regimens. Using newly collected high-density sleep EEG data on 103 individuals with SCZ and 68 controls, we first sought to replicate our previously reported group-level differences between patients and controls (original N = 130) during the N2 stage. Then in the combined sample (N = 301 including 175 patients), we characterized patient-to-patient variability. We replicated all group-level mean differences and confirmed the high accuracy of our predictive model (area under the receiver operating characteristic curve [AUC] = 0.93 for diagnosis). Compared to controls, patients showed significantly increased between-individual variability across many (26%) sleep metrics. Although multiple clinical and cognitive factors were associated with NREM metrics, collectively they did not account for much of the general increase in patient-to-patient variability. The medication regimen was a greater contributor to variability. Some sleep metrics including fast spindle density showed exaggerated age-related effects in SCZ, and patients exhibited older predicted biological ages based on the sleep EEG; further, among patients, certain medications exacerbated these effects, in particular olanzapine. Collectively, our results point to a spectrum of N2 sleep deficits among SCZ patients that can be measured objectively and at scale, with relevance to both the etiological heterogeneity of SCZ as well as potential iatrogenic effects of antipsychotic medication.
Identifying Professional Goals and Promoting Career Development in Nursing Students Through Reflection and Simulation
Authors: Abbate Santina , Gambino Kathleen M. , Timoney Paula M. , Wellins Anna-Marie , Savoca Marianna , Zalewski Urszula
Published: September 2024

Career planning is an important but often neglected component of a nursing program curriculum. To increase retention and encourage professional advancement at the school of nursing of a large, public university in the Northeast, a virtual simulated career development day was established to provide students with the tools needed to navigate the job acquisition process and secure appropriate employment. Course outcomes and student feedback indicated that a successful transition to practice and advancement to higher levels of professional nursing can be promoted through the development of superior interviewing skills, a strong resume, and insight regarding one’s professional goals and values.
The Cervical Intervertebral Foramen
Authors: Caballo Jesse , Darden Austin , Ahmad Shahjehan , Boody Barrett
Published: September 2024

Study Design:

This is an evidence-based narrative review article.

Objective:

We hope to provide a primer on cervical intervertebral foramen (cIVF) anatomy for spine surgeons, interventionalists, and physiatrists who regularly treat cervical spine pathology, and encourage further exploration of this topic.

Background:

This corridor for exiting cervical nerve roots is characterized by its intricate microanatomy involving ligamentous, nervous, and vascular structures. Degenerative changes such as facet hypertrophy and disc herniations alter these relationships, potentially leading to nerve root compression and cervical radiculopathy.

Methods:

This review synthesizes existing knowledge on the cIVF. Key imaging, cadaveric, and clinical studies serve as a foundation for this anatomic review.

Results:

We explore topics such as dynamic changes that affect foraminal size and their implications for nerve root compression, the relationship of the dorsal root ganglion to the cervical foramen, and the function and clinical significance of foraminal ligaments, arteries, and veins.

Conclusions:

Changes in the cIVF are frequently the basis of cervical degenerative pathologies. A comprehensive understanding of its microanatomical structure will allow the practitioner to better treat the underlying disease process causing their symptoms and signs.
Histopathologic Analysis of Chronic Cutaneous Graft-Versus-Host Disease
Authors: Alvarado Savannah M. , Cohen Olivia G. , Lattanzio Katherine , Haun Paul , Gelfand Joel M. , Loren Alison W. , Chung Jina , Baumrin Emily
Published: September 2024

Chronic graft-versus-host disease (cGVHD) is the leading cause of morbidity and nonrelapse mortality after allogeneic hematopoietic cell transplantation. Skin biopsy of cGVHD is recommended when clinical features are not diagnostic, yet the histopathologic features of skin cGVHD are not well described. The objective of this study is to describe the histopathologic features of skin cGVHD in epidermal, sclerotic, and combination cGVHD. Of 49 patients with skin cGVHD, 30 of 49 (61.2%) were male, and mean age was 55 years (SD 11.1). Clinically, 33 of 49 (67.3%) had epidermal cGVHD (E-cGVHD), 1 of 49 (2.1%) had sclerotic cGVHD (S-cGVHD), and 15 of 49 (30.6%) had combination disease. The 49 patients corresponded to 83 unique pathologic specimens with 67 of 83 (80.7%) taken from E-cGVHD, and 16 of 83 (19.3%) from S-cGVHD lesions. Nearly all biopsy specimens from E-cGVHD showed minimal features of active GVHD, including apoptosis in the epidermal basal layer (n = 63, 94.0%), vacuolar change (n = 62, 92.5%), and lymphocyte satellitosis (n = 57, 85.1%). The predominant histologic pattern of E-cGVHD was lichen planus/interface dermatitis (n = 31, 47.0%). S-cGVHD specimens also showed minimal features of active GVHD with apoptosis of the epidermal basal layer (n = 11, 68.8%) and vacuolar change (n = 8, 50.0%). In addition, S-cGVHD showed sclerosis of the papillary and reticular dermis and subcutaneous septae (n = 8, 50.0%; n = 11, 68.8%; n = 5, 31.2%, respectively). The predominant histologic pattern of S-cGVHD was lichen sclerosus/morphea-like pattern (n = 10, 62.5%). Although minimal pathologic features of active GVHD are common, the majority of cGVHD biopsies share features with the inflammatory skin diseases that they clinically resemble. Complete histologic reporting is recommended with implications for disease endotyping and personalized therapy.
Bacterial contamination and greenhouse gas emissions
Authors: Karlsson Snorri Laxdal , Edman-Wallér Jon , Gudmundsson Magni Vidar , Bentzer Peter , Moller Per Werner
Published: September 2024

BACKGROUND

Reusing anaesthesia infusion-set components may reduce the climate impact from plastic waste and discarded medications. Infusion-set contents can be shielded from patient contact by single use of an infusion line fitted with dual antireflux valves, preventing retrograde entry of microorganisms, and eliminating the risk for patient-to-patient cross-contamination. However, infusion-set contamination from compromised aseptic handling could affect quality of care.

INTERVENTIONS

To determine the prevalence of infusion-set bacterial contamination and compare the climate effects, we randomised operating rooms scheduled for total intravenous anaesthesia to handle procedures by infusion-set reuse or single-use. Both methods used dual single-use antireflux valves.

OUTCOMES

The primary outcome was infusion-set bacterial contamination assessed by aerobic culture of infusion-set fluid collected after each procedure. The secondary outcome was CO2 emissions (CO2-eq) estimated by life cycle assessment of component and medication use. To assess feasibility of detecting an inter-method difference in bacterial contamination, an interim analysis was planned after including at least 150 procedures per group.

RESULTS

After allocating 54 operating rooms per method, 189 and 159 procedures of reuse and single use were included. Reuse permitted a median of three procedures per infusion set (range 1 to 8). Positive cultures occurred in two procedures per method [mean (95% CI)]; prevalence 1.15% (0.03 to 2.27); relative risk of reuse versus single use 0.84 (0.12 to 5.93), P = 0.861. As prespecified, inclusion was stopped due to futility. The median (95% CI) per-procedure climate emissions were 0.43 (0.41 to 0.47) and 1.39 (1.37 to 1.40) kg CO2-eq for reuse and single-use respectively; difference -0.96 (-0.99 to -0.93), P < 0.0005. The main sources for climate emissions were production of infusion-set components and waste handling.

CONCLUSIONS

We conclude that the prevalence of bacterial contamination was low for both methods. A much larger study would be needed to detect an inter-method difference. Reuse of infusion-set components allowed significantly reduced intravenous anaesthesia climate emissions.
AGTR1 variant rs2638355 is associated with increased salt sensitivity of blood pressure: a female-specific effect in individuals from the HyperPath cohort
Authors: Tchio Cynthia , Heydarpour Mahyar , Pojoga Luminita , Taylor Herman , Williams Gordon , Williams Jonathan S. , Seely Ellen W.
Published: September 2024

Objective:

Salt-sensitive hypertension (SSH) affects approximately half of the hypertensive population, increasing the risk of vascular complications. The underlying pathophysiological mechanisms of SSH remain complex and need to be fully elucidated. Our prior research has identified genetic factors contributing to the salt sensitivity of blood pressure (SSBP), particularly involving genes regulating volume and blood pressure. We also observed enhanced peripheral vascular response to angiotensin II in humans with salt-sensitive hypertension. Given the pivotal role of the angiotensin II receptor type-1 (AT1R or AGTR1) in blood pressure and intravascular volume regulation, we hypothesized a genetic association between AGTR1 and SSBP.

Methods:

Our study involved 240 individuals of European ancestry from the HyperPATH cohort, examined under restricted and high dietary salt conditions. We employed a tagging single nucleotide variant approach to genotype participants at AGTR1.

Results:

Our regression model revealed a significant association between the rs2638355 (A/G) variant and salt-sensitive systolic blood pressure (SS-SBP), and rs2638355 increased AGTR1 gene expression. Notably, carriers of the risk-allele of the noncoding regulatory variant rs2638355 exhibited higher systolic blood pressure under high salt diet conditions than nonrisk allele individuals. A sex-stratified analysis showed this salt-driven effect on systolic blood pressure was significant only in females, underscoring the role of dietary salt in modulating genetic effects in this group. Furthermore, a restricted salt diet in these individuals diminished blood pressure and negated the blood pressure phenotype–genotype association.

Conclusion:

Overall, our findings could aid in pinpointing individuals with salt-sensitive blood pressure among hypertensive patients, especially considering dietary and sex-specific factors.
Further evidence that peritraumatic 17β-estradiol levels influence chronic posttraumatic pain outcomes in women, data from both humans and animals
Authors: Son Esther , Gaither Rachel , Lobo Jarred , Zhao Ying , McKibben Lauren A. , Arora Rhea , Albertorio-Sáez Liz , Mickelson Jacqueline , Wanstrath Britannia J. , Bhatia Simran , Stevens Jennifer S. , Jovanovic Tanja , Koenen Karestan , Kessler Ronald , Ressler Kerry , Beaudoin Francesca L. , McLean Samuel A. , Linnstaedt Sarah D.
Published: September 2024

Chronic posttraumatic pain (CPTP) is common after traumatic stress exposure (TSE) and disproportionately burdens women. We previously showed across 3 independent longitudinal cohort studies that, in women, increased peritraumatic 17β-estradiol (E2) levels were associated with substantially lower CPTP over 1 year. Here, we assessed this relationship in a fourth longitudinal cohort and also assessed the relationship between E2 and CPTP at additional time points post-TSE. Furthermore, we used a well-validated animal model of TSE to determine whether exogenous E2 administration protects against mechanical hypersensitivity. Using nested samples and data from the Advancing Understanding of RecOvery afteR traumA study (n = 543 samples, 389 participants), an emergency department–based prospective study of TSE survivors, we assessed the relationship between circulating E2 levels and CPTP in women and men using multivariate repeated-measures mixed modeling. Male and ovariectomized female Sprague Dawley rats were exposed to TSE and administered E2 either immediately after or 3 days post-TSE. Consistent with previous results, we observed an inverse relationship between peritraumatic E2 and longitudinal CPTP in women only (β = −0.137, P = 0.033). In animals, E2 protected against mechanical hypersensitivity in female ovariectomized rats only if administered immediately post-TSE. In conclusion, peritraumatic E2 levels, but not those at post-TSE time points, predict CPTP in women TSE survivors. Administration of E2 immediately post TSE protects against mechanical hypersensitivity in female rats. Together with previous findings, these data indicate that increased peritraumatic E2 levels in women have protective effects against CPTP development and suggest that immediate post-TSE E2 administration in women could be a promising therapeutic strategy for reducing risk of CPTP.
Medical Equipment Aging: Part III—An Aging Model for Maintenance and Replacement Plannings
Authors: Wang Binseng , Rui Torgeir , Skinner Scott , Ayers-Comegys Morgan , Gibson Jason , Williams Steve
Published: September 2024

The first article of this series demonstrated that some medical equipment exhibits clear, progressive deterioration with age, whereas some others do not. The second article showed that although most equipment remains safely and reliably deployed well over its respective depreciation period and the end-of-life or end-of-support dates declared by the respective manufacturers, some equipment needs to be replaced sooner. Because it is not practical to wait for the collection and analysis of large amounts of data to better plan for maintenance and replacement, a simple, quantitative model for equipment aging is introduced in this article to help improve both types of planning. The model was tested on professionals not directly involved in its formulation and applied to 34 equipment types. The results show this aging model can be used by professionals experienced in medical equipment maintenance and management, with only some basic instructions. Furthermore, it can be used to update the traditional “risk-based criteria” for planned maintenance and turning it into a risk management method fully compliant with the ISO 14971 standard.
Crothall Healthcare Clinical Engineering Information Technology at the University of Cincinnati Health
Authors: Kerr Alyssa , Zecevic Tarik
Published: September 2024

This article highlights the critical role of Crothall Healthcare’s clinical engineering information technology (CEIT) department in ensuring cybersecurity and efficiency in healthcare facilities focusing on its partnership with UCHealth in Cincinnati, Ohio. It underscores the importance of cybersecurity in healthcare, outlines CEIT’s responsibilities, and addresses the multifaceted challenges they encounter. CEIT’s work is essential in safeguarding patient safety and healthcare data integrity in an increasingly technology-driven healthcare landscape.
Are there any benefits of prolonged hypothermic oxygenated perfusion?: Results from a national retrospective study
Authors: De Carlis Riccardo , Lauterio Andrea , Schlegel Andrea , Gringeri Enrico , Patrono Damiano , Camagni Stefania , Dondossola Daniele , Pezzati Daniele , Olivieri Tiziana , Pagano Duilio , Bongini Marco , Montanelli Paolo , Ravaioli Matteo , Bernasconi Davide , Valsecchi Maria Grazia , Baccarani Umberto , Cescon Matteo , Andorno Enzo , Mazzaferro Vincenzo , Gruttadauria Salvatore , Di Benedetto Fabrizio , Ghinolfi Davide , Caccamo Lucio , Pinelli Domenico , Romagnoli Renato , Cillo Umberto , De Carlis Luciano ,   Italian HOPE Collaborator Group
Published: September 2024

Dual hypothermic oxygenated perfusion (DHOPE) is increasingly being used to extend liver preservation to improve transplant logistics. However, little is known about its benefits in high-risk liver grafts. This study aimed to investigate whether prolonged DHOPE provides benefits other than improved logistics in all liver types. We performed a national retrospective cohort study of 177 liver transplants from 12 Italian centers preserved with DHOPE for ≥4 hours between 2015 and 2022. A control group of 177 DHOPEs of <4 hours during the same period was created using 1:1 propensity score matching. The impact of risk profiles and preservation times on the outcomes was assessed using univariable and multivariable regression models. No significant differences in posttransplant outcomes were found between prolonged and short DHOPEs. However, the prolonged group had a significantly lower incidence of posttransplant acute kidney injury (AKI) compared to the short group (30.5% vs. 44.6%, p = 0.008). Among prolonged DHOPEs, no differences in transplant outcomes were observed according to donor risk index, Eurotransplant definition for marginal grafts, and balance of risk score. DHOPE duration was associated with a lower risk of AKI in multivariable models adjusted for donor risk index, Eutrotransplant marginal grafts, and balance of risk score. Prolonged hypothermic oxygenated perfusion confirmed its protective effect against AKI in a multivariable model adjusted for donor and recipient risk factors [OR: 0.412, 95% CI: 0.200–0.850, p = 0.016]. Prolonged DHOPE is widely used to improve transplant logistics, provides good results with high-risk grafts, and appears to be associated with a lower risk of posttransplant AKI. These results provide further insight into the important role of DHOPE in preventing posttransplant complications.
A case report of bilateral persistent sciatic artery: Bilateral aneurysm with thromboembolism of the right lower extremity
Authors: Mao Yi , Chen Li , Liu Zhi-Xing
Published: September 2024

Rationale:

Persistent sciatic artery (PSA) is a rare congenital vascular anomaly. The sciatic artery, which normally regresses to become the inferior gluteal artery during fetal development, persists as a direct branch of the internal iliac artery.

Patient concern:

We report a 78-year-old female who was admitted due to sudden pain, numbness, and loss of sensation in the right lower limb.

Diagnoses:

Acute thromboembolism in the right leg, bilateral PSA, and bilateral aneurysm.

Interventions:

After the super-selective embolization, lower limb arterial thrombolysis treatment was performed. After symptom relief, a computed tomography angiography was conducted to clarify the vascular variations.

Outcomes:

After relief of lower limb embolism, long-term antiplatelet therapy was administered.

Lessons:

When performing an ultrasound examination of PSA, careful identification of the arterial anatomy, evaluation of blood flow, assessment of surrounding structures, comparison between sides, and correlation with clinical symptoms are crucial to accurately diagnose this rare vascular anomaly.
Factors associated with postoperative discharge readiness and continuing care needs in patients with lung cancer undergoing fast-track surgery: A prospective cohort study
Authors: Zhang Na , Zhang Huan-Huan , Liu Yan
Published: September 2024

To investigate and analyze the characteristics and factors associated with readiness for hospital discharge and continuing care needs of postoperative patients with lung cancer undergoing fast-track surgery (FTS). FTS aims to reduce the body’s stress response to surgery and improve patient outcomes. The study included adult patients with confirmed lung cancer who underwent lung cancer surgery under FTS management and were discharged from the Cancer Institute and Hospital, Chinese Academy of Medical Sciences, between June 2020 and September 2020. Patients with severe illnesses, comorbidities, disturbance of consciousness, cognitive disorders, or communication impairments were excluded. One-hundred-and-eighty patients were included, and 167 (92.8%) indicated that they were discharge-ready. Multivariable regression analysis showed that age 60 years or older (β = 16.29, 95% confidence interval (CI): 4.11–28.46, P = .009) and living alone (β = 37.07, 95% CI: 16.30–45.84, P < .001) were associated with the discharge readiness scores. In addition, those who were able to take care of themselves (β = 43.57, 95% CI: 19.60–67.54, P < .001) and needed little assistance at home (β = 28.39, 95% CI: 5.52–51.26, P = .015) had higher discharge readiness scores than those who needed a lot of assisted care. Patients who were cared for at home by children (β = 40.32, 95% CI: 4.91–75.73, P = .026), parents (β = 56.68, 95% CI: 12.33–101.03, P = .013), or spouses (β = 35.92, 95% CI: 2.45–69.38, P = .036), had higher discharge readiness scores than nursemaid. The discharge readiness scores of patients requiring continuing care were 146.5 ± 39.3, while patients who had no need scored 179.8 ± 36.5 (P < .01). Most patients with lung cancer undergoing FTS are discharge-ready. Discharge readiness is influenced by living conditions and self-care ability. This study identified factors influencing discharge readiness, and that could be used to identify patients who could benefit from help to improve discharge readiness.
Clinical efficacy and adverse effects of LMWH combined with ASA in the treatment of RSA: A meta-analysis and systematic review
Authors: Liu Fang , Shi Dongmei , Jin Rui , Yu Xinyou
Published: September 2024

Background:

The incidence of recurrent spontaneous abortion (RSA) in the clinic shows an increasing trend year by year, and the coagulation status of this group of patients is mostly relatively abnormal. Currently, commonly used drugs in clinical practice include Aspirin (ASA) and low molecular weight heparin (LMWH), but their optimal treatment remains controversial. We aimed to evaluate the clinical efficacy and adverse effects of LMWH combined with ASA in the treatment of RSA.

Methods:

Randomized controlled trials of LMWH combined with ASA for RSA were searched in the databases of PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wanfang, VIP, and Chinese Biomedical Literature Service System from the construction of the database to June 2024. Data were analyzed using Review Manager 5.3 and Stata software. Dichotomous variables were analyzed using relative risk (RR) and 95% confidence interval (CI) as their statistics. The included literature was assessed for bias and risk of bias of eligible studies using Cochrane risk of bias tool. The risk of bias was evaluated based on the evaluation criteria recommended by the Cochrane Guidance Manual for Systematic Evaluation.

Results:

A total of 32 papers with a total of 3397 patients with RSA were finally included. LMWH combined with ASA treatment significantly improved the live birth rate (RR = 1.31, 95% CI: [1.19, 1.45], P < .00001), the rate of preterm stillbirths (RR = 0.23, 95% CI: [0.13, 0.40], P < .00001), rate of term delivery (RR = 1.55, 95% CI: [1.43, 1.67], P < .00001), rate of miscarriage (RR = 0.42, 95% CI: [0.36, 0.48], P < .00001), incidence of petechiae (RR = 0.44, 95% CI: [0.26, 0.72], P = .001), and incidence of thrombocytopenia (RR = 0.61, 95% CI: [0.39, 0.96], P = .03). In contrast, the incidence of preterm live births (RR = 1.07, 95% CI: [0.90, 1.28], P = .44), adverse reactions (RR = 0.77, 95% CI: [0.59, 1.00], P = .05), gingival bleeding (RR = 1.12, 95% CI: [0.65, 1.93], P = .69), and gastrointestinal reactions (RR = 0.87, 95% CI: [0.64, 1.17], P = .35) were not significant.

Conclusion:

LMWH combined with ASA treatment might improve pregnancy outcomes and reduces the incidence of adverse events in patients with RSA.
The value analysis of high-resolution thin-layer CT in the identification of early lung adenocarcinoma: An observation study
Authors: Zhao Zhiwei , Yang Hao , Wang Wenxuan
Published: September 2024

The aim of this study was to explore the clinical value of high-resolution thin-layer computed tomography (CT) for the identification of early lung adenocarcinoma. Ninety patients with early lung adenocarcinoma who were diagnosed and treated in our hospital were selected as study subjects and divided into noninvasive (NIG, n = 51) and invasive (IG, n = 39) groups according to their pathological findings. Both groups underwent high-resolution target scanning. Differences in lesion size, density, and distribution between the 2 groups were compared. Intergroup differences in the CT signs were examined. A receiver-operating characteristic curve was established to calculate the diagnostic efficacy of high-resolution, thin-layer CT for early lung adenocarcinoma infiltration. The maximum diameter and density of the tumors were significantly higher in the IG than in the NIG (P < .05). The proportions of CT signs of lobulation, spicule, and vessel convergence were higher in the IG patients compared to the NIG (P < .05). High-resolution thin-layer CT for the diagnosis of lung adenocarcinoma infiltration had an AUC of 0.6702 (P < .05), a diagnostic sensitivity of 64.10%, and a diagnostic specificity of 60.78%. High-resolution thin-layer CT had certain differential diagnostic efficacy for early lung adenocarcinoma, which clearly presents various CT signs of early lung adenocarcinoma lesions.
Correlation between serum hemoglobin levels and bone mineral density in adults: A cross-sectional study
Authors: Cheng Xiaosong , Zhang Liangliang , Cao Bo , Zhao Chengjin
Published: September 2024

Serum hemoglobin plays an important role in bone metabolism. However, the association between serum hemoglobin levels and bone mineral density (BMD) remains unclear. Therefore, this study aimed to explore the relationship between serum hemoglobin levels and lumbar spine BMD in adults. We conducted a cross-sectional study by utilizing data from the National Health and Nutrition Examination Survey from 2011 to 2018. The serum hemoglobin level was examined as an independent variable, while the lumbar spine BMD was utilized as the dependent variable. Weighted multivariate linear regression models and stratified analysis by age, sex, and race/ethnicity were applied after controlling for confounding factors to assess the relationship between serum hemoglobin levels and the lumbar spine BMD. Additionally, smooth curve fitting and threshold effect analyses were utilized to depict the nonlinear relationship between the 2 variables. A total of 11,658 participants (6004 men and 5654 women) aged ≥ 18 years were included in this study. When the serum hemoglobin level was represented as a continuous variable and fully adjusted in the regression model, the hemoglobin level was significantly negatively correlated with the lumbar spine BMD (β = ‐0.0035, 95% confidence interval: ‐0.0065 to ‐0.0004, P = .024555); this significant negative correlation persisted when the serum hemoglobin level was transformed into a categorical variable, except in the Q2 group (β = ‐0.0046, 95% confidence interval: ‐0.0142 to ‐0.0050, P = .348413). When different confounding factors were used including sex, age, and race/ethnicity, the stratified subgroups exhibited a negative correlation between the serum hemoglobin level and the lumbar spine BMD. Additionally, smooth curve fitting and threshold effect analyses showed a negative correlation between the serum hemoglobin level and the lumbar spine BMD, with a saturation effect at 15 g/dL. Our findings demonstrated an association between hemoglobin levels and the lumbar spine BMD in adults, characterized by a nonlinear relationship. Thus, monitoring the serum hemoglobin level could aid in the early detection of risks associated with bone metabolic disorders such as osteoporosis.
Antipsychotic prescription patterns among schizophrenia patients in Guangdong Province, China’s 686 program: A retrospective study
Authors: Hu Yingji , Su Jinghua , Xu Xuanyu , Li Junyu , Zhang Shujia , Chen Xiaodong
Published: September 2024

Schizophrenia is a severe mental disorder. However, there is limited data on the prescribing patterns of patients under China’s Central Government Support for the Local Management and Treatment of Severe Mental Illnesses Program, known as the “686 program.” This study aimed to investigate the use of antipsychotic medications and associated factors among discharged schizophrenia patients in Guangdong Province, within the 686 Program. This study encompassed schizophrenia patients who were discharged from the Affiliated Brain Hospital, Guangzhou Medical University and enrolled in the 686 Program between January 2019 and December 2019. A total of 1645 hospitalized schizophrenia patients were included in the analysis. Clinical and sociodemographic data were acquired from medical records upon discharge. A total of 15 unique antipsychotic medications were utilized, comprising 4 first-generation (FGAs) and 11 second-generation (SGAs) options. FGAs were prescribed at a rate of 8.3%, while SGAs dominated at 98.8%. Risperidone (40.8%), olanzapine (30.2%), clozapine (24.6%), and amisulpride (15.4%) emerged as the top 4 prescribed medications. Additionally, mood stabilizers were used by 20.4%, antidepressants by 14.8%, sedative-hypnotics by 33.6%, anticholinergics by 26.9%, and other internal medicine drugs by 46.4%. Notably, 60.5% received antipsychotic monotherapy (AMT), while 39.5% underwent antipsychotic polypharmacy (APP). Predictors of polypharmacy included multiple hospital admissions, longer hospital stays, and undergoing modified Electroconvulsive Therapy (mECT) during hospitalization. In Guangdong Province, China’s 686 Program, hospitalized patients commonly receive multiple antipsychotic medications simultaneously. Due to the varying outcomes in current studies on the benefits and risks of polypharmacy, it’s vital to educate psychiatrists about the importance of AMT to reduce APP. Additionally, randomized, controlled trials are essential to identify the safest and most effective antipsychotic combinations, as well as to understand which patient profiles may benefit from these combinations.
Post-craniopharyngioma surgery hypocalcemia due to denosumab use for osteoporosis: A case report
Authors: Jia Liangliang , Hu Yueqin , Jin Guilan
Published: September 2024

Rationale:

Denosumab, a fully humanized IgG monoclonal antibody, is commonly employed in the management of different types of osteoporosis. Up to now, hypocalcemia linked with denosumab has been predominantly reported in dialysis patients suffering from chronic kidney disease. Interestingly, there have been no reports of hypocalcemia following craniopharyngioma surgery with the use of denosumab.

Patient concerns:

A 65-year-old male received a subcutaneous injection of denosumab (60 mg) as a treatment for osteoporosis following the resection of a craniopharyngioma. Remarkably, the patient developed hypocalcemia within 4 days post-injection. However, 6 months subsequent to the initial treatment, the patient underwent another subcutaneous injection of desmuzumab and once again experienced hypocalcemia.

Diagnoses:

Hypocalcemia.

Interventions:

The hypocalcemia was successfully managed with intravenous calcium gluconate and oral calcium carbonate D3 tablets, leading to the alleviation of symptoms.

Outcomes:

Hypocalcemia following the use of denosumab after craniopharyngioma surgery is rare, and its occurrence may be associated with the primary disease and concomitant medications.

Lessons:

It underscores the necessity for clinicians to perform a thorough evaluation of the patient’s overall health status, complete all requisite testing, pay particular attention to those in high-risk categories, and ensure serum calcium levels are monitored, along with conducting other essential tests, prior to and following each administration of denosumab.
Causal links between 13 autoimmune diseases and graft dysfunction: A Mendelian randomization study
Authors: Pan Ziwen , Zhong Lin
Published: September 2024

Previous studies have suggested a possible link between autoimmune diseases and graft dysfunction; however, a causal link remains unclear. Exposure factors were set as 13 autoimmune diseases, and outcomes were set as graft dysfunction. Mendelian randomization was used to analyze the causal link between exposure and outcome. Alopecia areata and asthma were linked to graft dysfunction (odds ratio 0.828; 95% confidence interval 0.699–0.980; P = .029; odds ratio 1.79; 95% confidence interval 1.069–2.996; P = .027). At the same time, primary sclerosing cholangitis was found to be heterogeneous as an exposure factor (P = .009), but no heterogeneity or pleiotropy was found in other exposure factors. Our preliminary findings show 2 autoimmune diseases as risk factors for graft dysfunction, 1 autoimmune disease as a protective factor for graft dysfunction and the mechanisms remain to be understood.