bluuebunny/crossref_metadata_2025 huggingface dataset:
3-D Simulations of earthquakes rupture jumps: 1. Homogeneous pre-stress conditions
Authors: Kroll Kayla A , Dieterich James H , Richards-Dinger Keith B , Oglesby David D
Published: February 2023

Observational and modelling studies indicate that earthquake ruptures can jump between fault sections as large as ∼3 and ∼5 km for compressional and extensional offsets, respectively. Here, we compare characteristics of the rupture jump process on parallel but offset fault sections from traditional 3-D dynamic rupture simulations governed by slip weakening friction using the finite element code, FaultMod, to those from quasi-dynamic simulations governed by rate- and state-dependent friction (rate-state friction) using the code RSQSim. These simulations use spatially uniform initial stresses. For a variety of measures the rupture renucleation position on the offset fault, the rate-state friction and slip weakening friction models produce very similar results. The principal difference is the additional occurrence of delayed rupture jumps that arise from the time- and stress-dependent nucleation that is characteristic of rate-state friction. For immediate rupture jumps, models with slip weakening friction span greater offsets than those with rate-state friction. However the jump distances are nearly identical when delayed rupture jumps are included in the comparisons. We propose that delayed rupture jumps are the likely mechanism for adjacent large-earthquake pairs and clusters. Based on the similarity of renucleation positions with both dynamic and quasi-dynamic models, we conclude that the renucleation positions for rupture initiation on the receiver fault (separated by less than ∼3 km from the source fault) are primarily controlled by static stress changes induced by slip on the initiating fault. However, in light of the slightly greater maximum jump distances (>3 km) seen with the dynamic slip weakening friction model, dynamic stress changes from seismic waves play an increasingly important role as offset distances increase.
Dynamics of Anti-influenza Mucosal IgA Over a Season in a Cohort of Individuals Living or Working in a Long-term Care Facility
Authors: Hitchings Matt D T , Borgert Brooke A , Shir Adam , Yang Bingyi , Grantz Kyra H , Ball Jacob , Moreno Carlos A , Rand Kenneth , Small Parker A , Fowke Keith R , Cummings Derek A T
Published: February 2023

Background

Serological surveys are used to ascertain influenza infection and immunity, but evidence for the utility of mucosal immunoglobulin A (IgA) as a correlate of infection or protection is limited.

Methods

We performed influenza-like illness (ILI) surveillance on 220 individuals living or working in a retirement community in Gainesville, Florida from January to May 2018, and took pre- and postseason nasal samples of 11 individuals with polymerase chain reaction (PCR)-confirmed influenza infection and 60 randomly selected controls. Mucosal IgA against 10 strains of influenza was measured from nasal samples.

Results

Overall, 28.2% and 11.3% of individuals experienced a 2-fold and 4-fold rise, respectively, in mucosal IgA to at least 1 influenza strain. Individuals with PCR-confirmed influenza A had significantly lower levels of preseason IgA to influenza A. Influenza-associated respiratory illness was associated with a higher rise in mucosal IgA to influenza strains of the same subtype, and H3N2-associated respiratory illness was associated with a higher rise in mucosal IgA to other influenza A strains.

Conclusions

By comparing individuals with and without influenza illness, we demonstrated that mucosal IgA is a correlate of influenza infection. There was evidence for cross-reactivity in mucosal IgA across influenza A subtypes.
Edge effect of wide spectrum denoising in super-resolution microscopy
Authors: Cheng Tao , Wang Yingshan
Published: February 2023

During the stochastic optical reconstruction microscope (STORM) raw image acquisition in super-resolution microscopy, noise is inevitable. Noise not only reduces the temporal and spatial resolution of the super-resolution image but also leads to the failure of super-resolution image reconstruction. Wide spectrum denoising (WSD) can effectively remove various random noises (such as Poisson noise and Gaussian noise) from the STORM raw image to improve the super-resolution image reconstruction. We found that there is an obvious edge effect in WSD, and its influence on STORM raw image denoising and super-resolution image reconstruction is studied. We then proposed the method of restraining edge effect. The simulation and real experiment results show that edge trimming can effectively suppress the edge effect, thus leading to better super-resolution image reconstruction.
Increased RSV-A Bronchiolitis Severity in RSV-Infected Children Admitted to a Reference Center in Catalonia (Spain) Between 2014 and 2018
Authors: Vila Jorgina , Lera Esther , Peremiquel-Trillas Paula , Andrés Cristina , Martínez Laia , Barceló Irene , Carsi Ariadna , Balcells Joan , Ángel Rodrigo-Pendás José , Soler-Palacín Pere , Rodrigo Carlos , Antón Andrés
Published: February 2023

Between 2014 and 2018, we evaluated the severity of 687 cases of bronchiolitis caused by respiratory syncytial virus (RSV) in Catalonia, Spain. Compared to RSV-B, RSV-A cases required intensive care (adjusted relative risk (aRR) = 1.44, p < 0.01) and respiratory support (aRR = 1.07, p < 0.01) more often; hospital stay was one day longer (p < 0.01). Subgroup identification may aid clinical evaluation and seasonal healthcare planning.
Millimeter-wave spectrum of 2-propanimine
Authors: Zou Luyao , Guillemin Jean-Claude , Belloche Arnaud , Jørgensen Jes K , Margulès Laurent , Motiyenko Roman A , Groner Peter
Published: February 2023

Up to date, only six imines have been detected in the interstellar medium. The 3-carbon imine, 2-propanimine ((CH3)2C = NH), is predicted to be the structural isomer with the lowest energy in the C3H7N group, and appears to be a good candidate for astronomical searches. Unexpectedly, no microwave or millimeter wave spectrum is available for 2-propanimine. In this work, we provide the first high-resolution millimeter wave spectrum of 2-propanimine and its analysis. With the guide of this laboratory measurement, we aim to search for 2-propanimine in two molecule-rich sources Sgr B2(N) and IRAS 16293–2422 using observations from the Atacama Large Millimeter/submillimeter Array (ALMA). Starting from a synthesized sample, we measured the spectrum of 2-propanimine from 50 to 500 GHz, and the ground state lines are successfully assigned and fitted using XIAM and ERHAM programs with the aid of theoretical calculations. The barriers to internal rotation of the two CH3 tops are determined to be 531.956(64) cm−1 and 465.013(26) cm−1 by XIAM. These data are able to provide reliable prediction of transition frequencies for astronomical search. Although a few line matches exist, no confirmed detection of 2-propanimine has been found in the hot molecular core Sgr B2(N1S) and the Class 0 protostar IRAS 16293B. Upper-limits of its column density have been derived, and indicate that 2-propanimine is at least 18 times less abundant than methanimine in Sgr B2(N1S), and is at most 50 – 83  per cent of methanimine in IRAS 16293B.
Hickson-like compact groups inhabiting different environments
Authors: Taverna A , Salerno J M , Daza-Perilla I V , Díaz-Giménez E , Zandivarez A , Martínez H J , Ruiz A N
Published: February 2023

Although compact groups (CGs) of galaxies have been envisioned as isolated extremely dense structures in the Universe, it is accepted today that many of them could be not as isolated as thought. In this work, we study Hickson-like CGs identified in the Sloan Digital Sky Survey Data Release 16 to analyse these systems and their galaxies when embedded in different cosmological structures. To achieve this goal, we identify several cosmological structures where CGs can reside: nodes of filaments, loose groups, filaments, and cosmic voids. Our results indicate that 45 per cent of CGs do not reside in any of these structures, i.e. they can be considered non-embedded or isolated systems. Most of the embedded CGs are found inhabiting loose groups and nodes, while there are almost no CGs residing well inside cosmic voids. Some physical properties of CGs vary depending on the environment they inhabit. CGs in nodes show the largest velocity dispersions, the brightest absolute magnitude of the first-ranked galaxy, and the smallest crossing times, while the opposite occurs in non-embedded CGs. When comparing galaxies in all the environments and galaxies in CGs, CGs show the highest fractions of red/early-type galaxy members in most of the absolute magnitudes ranges. The variation between galaxies in CGs inhabiting one or another environment is not as significant as the differences caused by belonging or not to a CG. Our results suggest a plausible scenario for galaxy evolution in CGs in which both large-scale and local environments play essential roles.
Accretion-modified stellar-mass black hole distribution and milli-Hz gravitational wave backgrounds from galaxy centre
Authors: Wang Mengye , Ma Yiqiu , Wu Qingwen
Published: February 2023

Gas accretion of embedded stellar-mass black holes (sBHs) or stars in the accretion disc of active galactic nuclei  (AGNs) will modify the mass distribution of these sBHs and stars, which will also affect the migration of the sBHs/stars. With the introduction of the mass accretion effect, we simulate the evolution of the sBH/star distribution function in a consistent way by extending the Fokker–Planck equation of sBH/star distributions to the mass-varying scenario, and explore the mass distribution of sBHs in the nuclear region of the galaxy centre. We find that the sBHs can grow up to several tens solar mass and form heavier sBH binaries, which will be helpful for us to understand the black-hole mass distribution as observed by the current and future ground-based gravitational wave detectors (e.g. LIGO/Virgo, ET and Cosmic Explorer). We further estimate the event rate of extreme mass-ratio inspirals (EMRI) for sBH surrounding the massive black hole and calculate the stochastic gravitational wave (GW) background of the EMRIs. We find that the background can be detected in future space-borne GW detectors after considering the sBHs embedded in the AGN disc, while the mass accretion has a slight effect on the GW background.
The Double Dividend of a Joint Tariff and VAT Reform: Evidence from Iran
Authors: Yousefi Kowsar , Vesal Mohammad
Published: February 2023

This paper provides empirical evidence on a novel complementarity between VAT and trade taxes. Downstream domestic firms require VAT receipts from importers to claim VAT on purchases, increasing incentives for honest reporting of imports. Trade gap, the difference between mirror and domestic trade reports in Iran at 6-digit HS disaggregation, is used to measure this complementarity. Iran introduced VAT in 2008 and, since then, has increased its rate from 3 to 9 percent. Difference-in-differences estimates show that a 1 percentage point increase in the VAT rate reduces the trade gap by about 2 percent. Consistent with the compliance mechanisms for VAT, a smaller effect for consumer products that have a shorter value chain is observed. Findings suggest that replacing tariffs with VAT results in a double dividend. Tax revenue might increase due to better tariff compliance and a broader VAT base.
Genome Sequence Resource of Fusarium oxysporum Strain PkF01: The Causative Agent of Rhizome Rot of Polygonatum kingianum
Authors: Su Jianyun , Dong Xian , Dong Jiahong , Ji Pengzhang , Zhang Lei
Published: February 2023

Fusarium oxysporum strain PkF01 is the causal agent of Polygonatum kingianum rhizome rot. Here, we report, for the first time, the genome assemblies of the F. oxysporum strain PkF01 using the PacBio Sequel system. We obtained a total base number of 51.27 Mb in 87 contigs. The number of scaffolds and scaffold N50 were 86 and 2.46 Mb, with a 47.55% GC content. The number of coding sequences was 17,265, with total length of 36.61 Mb, average length of 1.77 kb, and a gene density of 0.34 kb. A total of 11,447, 14,734, 10,759, and 4,434 genes were annotated using the Pfam, COG, GO, and KEGG databases, respectively. A total of 764, 335, 1,572, 216, 4,245, 1,591, 2,242, and 1,926 genes were annotated using the CAZy, CYP450, DFVF, CARD, PHI, SignalP, TCDB, and TMHMM databases, respectively. Collinearity analysis showed that the PkF01 genome shared more homologous genomic regions with F. oxysporum f. sp. lilii strain Fol39 than with F. oxysporum f. sp. lycopersici strain Fol4287, indicating that the PkF01 genome is more closely related to the Fol39 rather than the Fol4287 genome. The high-quality genome sequences of PkF01 will provide a valuable resource for not only investigating both the pathogenicity mechanism and host specificity in F. oxysporum but also exploring disease control measures.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Psychiatric sequelae and interventions in critically ill trauma survivors
Authors: Chow Jarva , Lancman Benn
Published: February 2023

Purpose of review

Psychiatric disorders following trauma impact functional recovery in trauma survivors and are a significant source of disability. Although research has traditionally focused on the physical sequelae of trauma, more attention is being directed towards the significant morbidity and mortality associated with the psychologic sequelae of trauma. This review evaluates the existing literature.

Recent findings

Use of multidisciplinary collaborative programmes in combination with psychiatric treatment and pharmacotherapy may be necessary to improve the care of trauma patients with psychiatric sequelae. Improving identification of vulnerable patients may help in the prevention and treatment of psychiatric disorders and is an area of current research initiatives.

There are few interventions that have demonstrated efficacy in managing the psychiatric sequelae of trauma. The development of strategies to guide early identification of at-risk patients and recommend prevention and treatment may improve the care of trauma survivors.
Acute pain management and long term outcomes
Authors: Delande Simon , Lavand’homme Patricia
Published: February 2023

Purpose of review

The acute inflammatory reaction induced by tissue trauma causes pain but also promotes recovery. Recovery is highly variable among peoples. Effective acute pain (AP) management is very important but remains suboptimal what could affect long term outcomes. The review questions the impact of either failure or effectiveness of AP treatments and the choice of analgesic drugs on different long-term outcomes after tissue trauma.

Recent findings

Pain control during mobilization is mandatory to reduce the risk of complications which exacerbate and prolong the inflammatory response to trauma, impairing physical recovery. Common analgesic treatments show considerable variability in effectiveness among peoples what argues for an urgent need to develop personalized AP management, that is, finding better responders to common analgesics and targeting challenging patients for more invasive procedures. Optimal multimodal analgesia to spare opioids administration remains a priority as opioids may enhance neuroinflammation, which underlies pain persistence and precipitates neurocognitive decline in frail patients. Finally, recent findings demonstrate that AP treatments which modulate nociceptive and inflammatory pain should be used with caution as drugs which inhibit inflammation like nonsteroidal antiinflammatory drugs and corticoids might interfere with natural recovery processes.

Effective and safe AP management is of far greater importance than previously realized. Evidence of suboptimal AP management in many patients and recent reports pointing out the impact of current treatments on long term outcomes argue for further research in the field.
The anesthetic approach to a patient with placenta accreta spectrum
Authors: Ioscovich Alexander , Weiss Adina , Shatalin Daniel
Published: February 2023

The Purpose of This Review

Placenta accreta poses significant risk of morbidity and mortality to a laboring patient. Here we review available treatment options, highlight in bleeding prevention and diagnosis that have been shown to improve patient outcome, and provide best practice suggestions. We also discuss the decision-making process for choice of anesthesia, as it is not based on a gold-standard paradigm.

Recent findings

The use of resuscitative endovascular balloon occlusion of the aorta has been gaining popularity around the world. It has been shown to cause an equivocal reduction in perioperative bleeding in placenta accreta spectrum (PAS), reduce the rate of hysterectomies, and is a safe and relatively easy technique. There are other invasive radiology techniques that have also proven to be beneficial in bleeding prevention: balloon occlusion of hypogastric arteries intraoperatively, internal iliac artery embolization, and intraoperative ligation of the hypogastric or uterine arteries.

Optimal management of PAS begins with early and definitive diagnosis. A multidisciplinary approach along with preparation of special equipment and the use of a check-list maximize the chance for success. Anesthesia could be done with all types of regional or under general, considering case-by-case factors but most importantly choosing according to the institutions best facility and skill.
Paediatric pain management: from regional to virtual
Authors: Heydinger Grant , Karthic Anitra , Olbrecht Vanessa A.
Published: February 2023

Purpose of review

Due to increased interest in opioid-sparing multimodal analgesic strategies both inside and outside of the operating room, anaesthesiologists have started to look towards regional anaesthesia as well as nonpharmacological pain-reducing techniques. The purpose of this article is to discuss current trends and recent developments in regional anaesthesia and virtual reality for paediatric pain management.

Recent findings

The development of novel fascial plane blocks has expanded regional options for anaesthesiologists, especially when neuraxial anaesthesia is not a viable or straightforward option. Other regional techniques, such as spinal anaesthesia and continuous epidural analgesia for infants and neonates, are becoming more popular, as more paediatric anaesthesiologists become familiar with these techniques. Virtual reality for paediatric pain management is a relatively new area of study that has shown promise, but more research needs to be done before widespread adoption of this practice becomes a reality. Various preexisting pain-reducing strategies such as distraction and biofeedback are being integrated with virtual reality to help optimize its effect on pain and anxiety for paediatric patients.

Regional anaesthesia and virtual reality are valuable tools that serve to alleviate pain in paediatric patients. Advances are being made within both fields in various healthcare settings for different types of pain. Over the next few years, they will likely both play an increasing role in paediatric pain management.
Anaesthesia role in enhanced recovery after surgery: a revolution in care outcomes
Authors: de Boer Hans D. , Scott Michael J. , Fawcett William J.
Published: February 2023

Purpose of review

Enhanced recovery after surgery (ERAS) has revolutionized care outcomes. The purpose of this review is to provide an overview of how ERAS changed healthcare outcomes.

Recent findings

Development of multidisciplinary evidence-based ERAS guidelines for specific surgical specialties and systematic implementation of these guidelines resulted in improved healthcare outcomes, reduction in length of stay, reduction in complications and improved survival. The value of audit of the outcomes is essential for implementation and to improve healthcare. Healthcare economics analysis related to the implementation of ERAS showed significant cost savings up to a return to investment ratio of more than seven.

ERAS has revolutionized healthcare by developing evidence-based ERAS guidelines and systematic implementation of these guidelines. Audit of outcomes is essential, not only to improve healthcare but also to significantly save healthcare expenditures.
A Brief Screening and Assessment Tool for Opioid Use in Adults: Results from a Validation Study of the Tobacco, Alcohol, Prescription Medication, and Other Substances Tool
Authors: Bunting Amanda M. , Schwartz Robert P. , Wu Li-Tzy , Wahle Aimee , Kline Margaret , Subramaniam Geetha , McNeely Jennifer
Published: February 2023

Objectives

This secondary analysis evaluated opioid-specific validation results of the Tobacco, Alcohol, Prescription Medication, and Other Substances (TAPS) tool for screening in primary care.

Methods

This study is a secondary data analysis of the TAPS validation study. Performance of the TAPS tool for screening for unhealthy opioid use (with a score of 1+ for heroin and/or prescription opioids representing a positive screen) was evaluated. Discriminative ability was examined in comparison with reference standard measures across the spectrum of unhealthy opioid use: timeline follow-back with and without oral fluid testing identifying past-month use and the modified Composite International Diagnostic Interview for past-year problem use, opioid use disorder (OUD), and moderate-severe OUD.

Results

In a sample of 2000 primary care patients, 114 screened positive for opioids on the TAPS tool. With a TAPS cutoff equal to 1+, the TAPS accurately identified past-month use, problem use, any OUD, and moderate-severe OUD (sensitivities = 68%–85%, specificities = 97%–98%, area under the curve = 0.80–0.91). When past-month use was expanded to include timeline follow-back with oral fluid testing, accuracy declined (52% sensitivity [95% confidence interval, 43%–60%], 98% specific [95% confidence interval, 97%–98%]).

Conclusions

While further testing in a larger population sample may be warranted, given their brevity, simplicity, and accuracy when self-administered, the TAPS opioid items can be used in primary care settings for a spectrum of unhealthy opioid use; however, self-disclosure remains an issue in primary care settings.
Hooks Versus Pedicle Screws at the Upper Instrumented Level
Authors: Colantonio Donald F. , Le Anthony H. , Pisano Alfred J. , Chung Joon M. , Wagner Scott C. , Fredericks Donald R. , Roach William B. , Schlaff Cody , Dill Andrew , Mauntel Timothy C. , Hendershot Brad D. , Helgeson Melvin D.
Published: February 2023

Study Design.

Controlled laboratory study.

Objective.

The aim was to compare motions at the upper instrumented vertebra (UIV) and supra-adjacent level (UIV+1) between two fixation techniques in thoracic posterior spinal fusion constructs. We hypothesized there would be greater motion at UIV+1 after cyclic loading across all constructs and bilateral pedicle screws (BPSs) with posterior ligamentous compromise would demonstrate the greatest UIV+1 range of motion.

Summary of Background Data.

Proximal junctional kyphosis is a well-recognized complication following long thoracolumbar posterior spinal fusion, however, its mechanism is poorly understood.

Materials and Methods.

Twenty-seven thoracic functional spine units were randomly divided into three UIV fixation groups (n=9): (1) BPS, (2) bilateral transverse process hooks (TPHs), and (3) BPS with compromise of the posterior elements between UIV and UIV+1 (BPS-C). Specimens were tested on a servohydraulic materials testing system in native state, following instrumentation, and after cyclic loading. functional spine units were loaded in flexion-extension (FE), lateral bending, and axial rotation.

Results.

After cyclic testing, the TPH group had a mean 29.4% increase in FE range of motion at UIV+1 versus 76.6% in the BPS group (P<0.05). The BPS-C group showed an increased FE of 49.9% and 62.19% with sectioning of the facet joints and interspinous ligament respectively prior to cyclic testing.

Conclusion.

BPSs at the UIV led to greater motion at UIV+1 compared to bilateral TPH after cyclic loading. This is likely due to the increased rigidity of BPS compared to TPH leading to a “softer” transition between the TPH construct and native anatomy at the supra-adjacent level. Facet capsule compromise led to a 49.9% increase in UIV+1 motion, underscoring the importance of preserving the posterior ligamentous complex. Clinical studies that account for fusion rates are warranted to determine if constructs with a “soft transition” result in less proximal junctional kyphosis in vivo.
Thoracolumbar Sagittal Shape Varies with Pelvic Morphology and Aging
Authors: Prost Solène , Charles Yann-Philippe , Ilharreborde Brice , Riouallon Guillaume , Pesenti Sébastien , Blondel Benjamin ,   On behalf of the French Spine Surgery Society (SFCR)
Published: February 2023

Study Design.

Retrospective study of a multicenter prospective database.

Objective.

To determine the organization and correlations between different spinal segments according to pelvic incidence and age.

Summary of Background Data.

When planning surgery for correction of adult spinal deformities, considering lumbar lordosis (LL) as a uniform segment is an approximation that can lead to planning errors.

Methods.

Radiographs of 1540 subjects were analyzed and divided into 3 pelvic incidence (PI) groups: low <45 , intermediate 45-60, high > 60 and stratified by age (<45 y, 45-70, and >70). The different segments of L1-L4 proximal lumbar lordosis (PLL), L4-S1 distal lumbar lordosis (DLL), and T10-L1 thoracolumbar junction (TLJ) were analyzed.

Results.

The mean age was 53.5 years (SD=17, min=20, max=93). There was a significant correlation between thoracic kyphosis T5-T12 and TLJ segment T10-L1 (R =0.581, P<0.001). Only the L1-L4 PLL segment correlated with PI (R =0.47, P<0.001).The T10-L1 TLJ segment was constant regardless of age or PI groups considered (mean =−8, SD=9). PLL did not vary with aging but differed according to PI. The DLL showed significant differences between age and PI groups but without significant correlation between PI and DLL.

Conclusion.

Pelvic morphology is known to determine the curvatures of the spine, however, the distribution of lumbar lordosis is not homogeneous. Our study provided a normative value reference and showed that T10-L1 is constant regardless of the age or the pelvic incidence.

Level of Evidence.

3
The effects of leadership for self-worth, inclusion, trust, and psychological safety on medical error reporting
Authors: Brimhall Kim C. , Tsai Chou-Yu , Eckardt Rory , Dionne Shelley , Yang Biying , Sharp Adam
Published: February 2023

Background

Although trust and psychological safety (PS) are critical for improving patient safety and medical error reporting, little is known about how they work together and how health care systems promote PS.

Purpose

This study examined how leadership for self-worth, inclusion, and trust may work together to foster PS and how this influences medical error reporting.

Approach

Data were collected in 2019 from 373 employees (24% response rate) in 85 hospital departments (54% response rate) in a nonprofit health care system in the eastern United States. Constructs were operationalized at the department level.

Results

Negative binomial path model results found several direct effects. Leadership for self-worth was positively associated with inclusion, inclusion was positively associated with trust and PS, trust was positively associated with reported medical errors, and PS was negatively associated with reported medical errors. Indirect effects uncovered leadership for self-worth was positively associated with PS by enhancing inclusion. In addition, leadership for self-worth increased inclusion, which increased trust and ultimately encouraged PS. Leadership for self-worth was associated with fewer reported medical errors through increasing inclusion, trust, and PS.

Practical Implications

Trust encourages the formal reporting of medical errors whereas PS encourages learning from mistakes and improving care to reduce future errors (and consequently the number of reported errors). Leaders who understand employees’ unique needs, express confidence in employees’ abilities, and encourage employees to share their ideas, create inclusive and trusting work environments that encourage PS and ultimately help reduce reported medical errors.
Managing safety in perioperative settings
Authors: Brooks Joanna Veazey , Nelson-Brantley Heather
Published: February 2023

Background

Perioperative nursing units are described as one of the most challenging practice environments, characterized by a distinct hierarchal culture and rapid pace. These dynamics create challenges for creating a culture of safety, where meso-level nurse leaders (MLNLs) must operate in the space between the micro level of direct patient care and the macro-level administrative priorities.

Purpose

Guided by complexity leadership theory, we sought to understand the strategies MLNLs used to facilitate a culture of safety in perioperative settings.

Methodology

A qualitative descriptive study with semistructured interviews was conducted. Inductive thematic analysis was used to analyze content from the interviews, and several techniques (audit trail, reflexivity, peer debriefing) were used to ensure rigor.

Results

Seventeen MLNLs completed an interview, and analysis identified four strategies that MLNLs reported to foster safety as meso-leaders in perioperative environments: (a) recognizing the unique perioperative management environment, (b) learning not to take interactions personally, (c) developing “super meso-level nurse leader” skills, and (d) appealing to policies and patient safety.

Conclusion

Perioperative environments require MLNLs to use multifaceted strategies to keep the peace among many stakeholders and foster patient safety.

Practice Implications

Our study shows how clear organizational policies and procedures can serve as a vital tool—moving attention away from a feeling of individual “policing” and toward joint discussion about shared patient safety goals—and ultimately support MLNLs in challenging perioperative work environments. Perioperative environments create unique challenges, and organizations should consider perioperative-specific leadership training to prepare MLNLs for these roles.
Descemet Membrane Endothelial Patching: Selective Endothelial Replacement in Eyes With Localized Endothelial Dysfunction
Authors: García-Onrubia Luis , Stanojcic Nick , Bhogal Maninder
Published: February 2023

Descemet membrane (DM) endothelial keratoplasty is considered the gold standard for treating corneal endothelial decompensation and is a true like-for-like replacement. Not all causes of endothelial dysfunction are global, with conditions such as viral endotheliitis affecting discrete populations of endothelial cells. In this study, endothelial grafts matching the area of dysfunction were produced to preserve healthy host cells and limit the immunological burden of new grafts. We have termed this modified DM endothelial keratoplasty procedure DM endothelial patching.
Rotational stability of a new toric intraocular lens with an advanced optical profile
Authors: Zeilinger Johannes , Hienert Julius , Ruiss Manuel , Pilwachs Caroline , Findl Oliver
Published: February 2023

Purpose:

To examine the rotational stability of a new toric intraocular lens (IOL), the TECNIS Eyhance Toric II, over a course of 3 months.

Setting:

Vienna Institute for Research in Ocular Surgery, Hanusch Hospital, Vienna, Austria.

Design:

Prospective unmasked single-center study.

Methods:

50 eyes of 50 patients with cataract and regular corneal astigmatism ≥0.75 diopters (D) were included. The TECNIS Eyhance Toric II IOL was implanted in 1 eye of each study patient. Images of the alignment axis of the IOL were taken intraoperatively, as well as at 1 hour, 1 week, and 3 months postoperatively. For the measurement of toric IOL rotation, images were superimposed on the basis of ocular landmarks. Uncorrected and corrected distance (4 m) and intermediate (66 cm) visual acuities were assessed at the 3-month visit.

Results:

There was no significant difference in the rotational position between the intraoperative and 3 month timepoints, with a mean rotation of 1.34 ± 1.46 degrees, in 27 examined eyes. (P = 0.313). No patients had to undergo repositioning of the toric IOL. A significant reduction of refractive cylinder occurred from preoperatively 1.8 ± 1.1 to 0.40 ± 0.42 D at the 3-month visit (P = .001; n = 43). The corrected distance visual acuity improved significantly from 0.28 ± 0.16 logMAR preoperatively to −0.01 ± 0.13 logMAR at 3 months postoperatively (P = .001; n = 43).

Conclusions:

The TECNIS Eyhance Toric II showed a good visual performance with no significant rotation over a course of 3 months and, therefore, an excellent rotational stability. The intraocular lens showed a good safety profile with no adverse events.
The safety and cost-analysis of simultaneous versus staged bilateral total knee arthroplasty in a Taiwan population
Authors: Chou Te-Feng Arthur , Ma Hsuan-Hsiao , Tsai Chi-Wu , Tsai Shang-Wen , Chen Cheng-Fong , Chiu Fang-Yao , Wu Po-Kuei , Chen Wei-Ming
Published: February 2023

Background:

In patients with advanced osteoarthritis (OA) of the bilateral knees, uncertainty remains as to whether simultaneous bilateral total knee arthroplasty (SiTKA) or staged TKA (StTKA) is the treatment of choice. The purpose of this study was to investigate the safety and relative cost of SiTKA vs StTKA in Taiwan patients.

Methods:

Using the Big Data Center of Taipei Veterans General Hospital, we retrospectively reviewed all patients who underwent SiTKA or StTKA due to OA or spontaneous osteonecrosis of the knee from January 2011 to December 2016. We assessed length of stay, transfusion rate, early postoperative complications, 30- and 90-day readmission rate, 1-year reoperation rate, and the indication for reoperation. Furthermore, we analyzed the total cost of the two groups, including reimbursement from the national health insurance (NHI), cost of the procedures, and net income from each case.

Results:

A total of 2016 patients (1565 SiTKA and 451 StTKA) were included in this study. The two groups had no significant differences in rates of complications, 30- and 90-day readmission, or 1-year reoperation. The length of stay was on average 5.0 days longer for StTKA (p < 0.01). In terms of cost, all categories of medical costs were significantly lower for SiTKA, while the net hospital income was significantly higher for StTKA.

Conclusion:

SiTKA is a safe and cost-effective surgery. Both SiTKA and StTKA have similar rates of postoperative complications, readmission and reoperation, but SiTKA significantly reduces medical expenses for both the patient and the NHI.
Effects of Meditation Intervention on Self-management in Adult Patients With Type 2 Diabetes
Authors: Heo Seongkum , Kang JungHee , Umeakunne Erica , Lee Sohye , Bertulfo Tara F. , Barbé Tammy , Kim JinShil , Black Vicki , An Minjeong , Randolph Justus
Published: February 2023

Background

Diabetes complications are prevalent and cause adverse effects on the physical, psychological, and economic status of adult patients with type 2 diabetes. Meditation may positively affect self-management and, in turn, reduce diabetes complications. However, the systematic examination of the effects of meditation without additional components on self-management in this population have been rarely examined.

Purpose

The aim of this study was to examine the effects of meditation interventions on self-management (ie, control of glucose, blood pressure, cholesterol, and obesity and self-management) among adult patients with type 2 diabetes in randomized controlled trials.

Methods

In this systematic review and meta-analysis, 6 electronic databases were searched using major keywords of meditation, diabetes, and self-management during March 2022.

Results

Eight studies (9 articles) using mindfulness-based meditation were included. The meta-analysis showed that meditation improved hemoglobin A1c (effect size = −0.75; 95% confidence interval, −1.30 to −0.21; P = .007) but not fasting blood glucose. Only a few studies examined meditation effects on other types of self-management (eg, blood pressure, body mass index, cholesterol, diet, exercise, foot care, and monitoring of blood glucose), and the effects were inconsistent. In 1 study, meditation improved diabetes self-management.

Conclusions

Mindfulness-based meditation reduced hemoglobin A1c levels in adult patients with type 2 diabetes but did not consistently improve other types of self-management in a few studies examined. This may imply the need for additional intervention components to improve different types of self-management. Further studies are needed to examine the effects of different types of meditations with additional components on different types of self-management.
Dyadic Associations Between Burden and Depressive Symptoms Among Patients With Heart Failure and Their Caregivers
Authors: Dong Xiaoyu , He Dengxin , Zhang Yilin , Zhao Qiuge , Zhang Xiuting , Fan Xiuzhen
Published: February 2023

Background

Depressive symptoms are prevalent in patients with heart failure and their family caregivers. Given the interpersonal interactions between dyadic individuals with intimate relationship, it is essential to consider the dyads as a unit when exploring the factors associated with depressive symptoms in heart failure patient–caregiver dyads.

Objective

The aims of this study were to explore the dyadic effects of burden on depressive symptoms in heart failure patient–caregiver dyads and investigate whether perceived stress acts as a mediator in these relationships.

Methods

In this cross-sectional study, 237 heart failure patient–caregiver dyads were recruited from 3 hospitals in China between November 2018 and June 2019. Symptom burden, caregiving burden, perceived stress, and depressive symptoms were assessed using self-report questionnaires. The actor-partner interdependence model and actor-partner interdependence mediation model were used to analyze the data.

Results

Patients' symptom burden had an actor effect on their own depressive symptoms and a partner effect on their caregivers' depressive symptoms. Similarly, caregivers' caregiving burden had an actor effect on their own depressive symptoms and a partner effect on patients' depressive symptoms. The actor effects between burden and depressive symptoms were partially mediated by their own perceived stress in heart failure patient–caregiver dyads. Furthermore, the partner effect between caregivers' caregiving burden and patients' depressive symptoms was completely mediated by patients' perceived stress.

Conclusions

Patients' symptom burden and caregivers' caregiving burden aggravated their depressive symptoms by increasing their own perceived stress. Moreover, patients' symptom burden led to caregivers' depressive symptoms, and caregivers' caregiving burden contributed to patients' depressive symptoms through patients' perceived stress. These interdependent relationships suggest that dyadic interventions focused on reducing burden and perceived stress may be beneficial for relieving depressive symptoms in heart failure patient–caregiver dyads.
Combined heart-liver transplantation practices survey in North America: Evaluation and organ listing practices
Authors: Shingina Alexandra , Chadha Ryan , Lim Nicholas , Pillai Anjana , Vodkin Irene , Montenovo Martin , Heller Theo , Yardeni David , Ganger Daniel
Published: February 2023

We conducted a web-based survey to characterize liver transplant (LT) evaluation and listing practices for patients being evaluated for combined heart-liver transplantation (CHLT), with a specific emphasis on patients with congenital heart disease (CHD), around transplant centers in North America. Very few protocols for liver evaluation and listing in patients undergoing combined heart-liver transplantation are published, and no guidelines currently exist on this topic. A subject of intense debate in the transplant community is the decision of which patients with CHD and liver disease benefit from CHLT compared with heart transplantation. A focus group from the American Society of Transplantation Liver-Intestine Community of Practice Education Subcommittee developed a web-based survey that included questions (1) respondee demographic information; (2) LT evaluation practices in CHLT; (3) liver organ listing practices in CHLT, and (4) 4 clinical vignettes with case-based scenarios in CHLT liver listings among CHD patients who underwent Fontan palliation. The survey was distributed to medical and surgical LT program directors of 47 centers that had completed at least 1 CHLT up to July 2021 in the US and the University of Toronto, Canada. The survey had an excellent 83% response rate (87% for centers that completed at least 1 CHLT in the past 5 y). Total 66.7% used transjugular liver biopsy with HVPG measurements, 30% used percutaneous liver biopsy with no consensus on the use of a fibrosis staging system, 95% mandated contrasted cross-sectional imaging, and 65% upper endoscopy. The following isolated findings evaluation mandated CHLT listing: isolated elevated HVPG (61.5%); the presence of portosystemic collaterals on imaging (67.5%); the endoscopic presence of esophageal or gastric varices (75%), and the presence of HCC (80%), whereas the majority of centers did not feel that the presence of isolated splenomegaly (100%), thrombocytopenia (81.6%), endoscopic findings of portal hypertensive gastropathy (66.7%), or highly sensitized patients (84.6%) justified CHLT. In our survey of North American centers that had performed at least 1 CHLT in the past 5 years, we observed heterogeneity in practices for both evaluation and listing protocols in these patients.
Effects of 20% albumin infusion therapy during liver transplantation on plasma neutrophil gelatinase-associated lipocalin level: A randomized controlled trial
Authors: Kim Doyeon , Kim Jeayoun , Han Sangbin , Jung Hyunjoo , Park Hyung-Doo , Ko Justin S. , Gwak Mi Sook , Kim Gaab Soo
Published: February 2023

The risk of acute kidney injury (AKI) after liver transplantation was lower in patients with serum albumin levels ≥3.0 mg/dL during surgery. We tested whether intraoperative infusion of 20% albumin affects neutrophil gelatinase-associated lipocalin (NGAL) level, a reliable indicator of AKI. We randomly assigned 134 patients undergoing liver transplantation into albumin group (n=70, 20% albumin 200 mL) and the control group (n=66, crystalloid solution 200 mL). The 2 study fluids were infused at 100 mL/h from the start of the anhepatic phase. The primary outcome was plasma NGAL level at 1 hour after graft reperfusion. Albumin level at the start of graft reperfusion was significantly greater in albumin group than in the control group [2.9 (2.4–3.3) g/dL vs. 2.3 (2.0–2.7) g/dL, p<0.001]. The NGAL level at 1 hour after graft reperfusion was not significantly different between the 2 groups [100.2 (66.7–138.8) ng/mL vs. 92.9 (70.8–120.6) ng/mL, p=0.46], and the AKI risk was not either (63.9% vs. 67.8%, adjusted p=0.73). There were no significant differences between the 2 groups regarding hospital readmission within 30 days/90 days after transplantation (32.6% vs. 41.5%, adjusted p=0.19 and 55.0% vs. 55.7%, adjusted p=0.87). Graft survival probability at 30 days/90 days/1 year after transplantation was 90.0%/84.3%/78.6% in albumin group and 97.0%/90.9%/89.4% in the control group [HR=1.6 (0.6–4.0), adjusted p=0.31]. In conclusion, intraoperative infusion of 20% albumin 200 mL increased the albumin level but failed to maintain serum albumin ≥3.0 mg/dL during surgery. The hypertonic albumin therapy did not significantly affect plasma NGAL level and clinical outcomes including AKI.
Sudden Death by AL Amyloidosis
Authors: Perez Christian , Waite Kristy
Published: February 2023

We report the case of a young female that died due to systemic amyloidosis.
Surgical Precision Analysis of Orthognathic Surgery Combined With Invisible Orthodontic
Authors: Yi Jing-rui , Yeweng San-jie , Wu Zhong-xing
Published: February 2023

Background:

This study aimed to explore the changes in hard tissue after applying invisible orthodontic-orthognathic treatment and the digital design, and to explore the accuracy of the treatment effect of maxillofacial tissue after invisible orthodontic treatment and orthognathic treatment.

Methods:

From September 2020 to January 2022, 25 patients with class III skeletal malocclusion and 7 patients with class II skeletal malocclusion, were treated with invisible orthodontic treatment and orthognathic combined treatment. Orthodontic treatment with preoperative invisible orthodontic treatment followed by orthodontic surgery. All patients had cephalometric lateral films after surgery to analyze orthognathic surgery's goals and surgical effects of orthognathic surgery and the digital design. Measure the angle of the sella-nasion-A point angle, angle of sella-nasion-B point, ANB angle, maxillary convex angle, mandibular plane (MP) angle, 1-SN angle, 1-MP angle, etc, and compare surgery outcome with digital design.

Result:

All patients were satisfied with the effect and no complications occurred. Angle of sella-nasion-A point, angle of sella-nasion-B point, ANB angle, maxillary convex angle, MP angle, 1-SN angle, and 1-MP angle had no significant difference between the postoperative effect and the purpose of digital design (P>0.05), there was no apparent deviation between the upper and lower jaw and the chin (P>0.05).

Conclusion:

The combined invisible orthodontic treatment and orthognathic treatment are accurate and effective, and are worthy of promotion. It supplements traditional orthognathic therapy and is suitable for corresponding patients.
Human FAM111A inhibits vaccinia virus replication by degrading viral DNA-binding protein I3 and is antagonized by poxvirus host range factor SPI-1
Authors: Zhu Junda , Gao Xintao , Zhang Zihui , Deng Yining , Xie Shijie , Ren Shuning , Li Yarui , Li Hua , Niu Kang , Fu Shufang , Li Yinü , Moss Bernard , Wu Wenxue , Peng Chen
Published: February 2023

Poxviruses are large double-stranded DNA viruses that infect a wide range of animals including humans. Since the eradication of smallpox, other members of the poxvirus family, such as monkeypox virus (MPXV) are still posing a great threat to public health. Vaccinia virus (VACV) is a prototypic poxvirus used as the vaccine strain for smallpox eradication. VACV encodes a serine protease inhibitor 1 (SPI-1) conserved in all orthopoxviruses, which has been recognized as a host range factor for modified vaccinia virus Ankara (MVA), an approved smallpox vaccine and a promising vaccine vector. FAM111A, a nuclear protein that regulates host DNA replication, was shown to restrict the replication of VACV-ΔSPI-1 in human cells. Nevertheless, the detailed antiviral mechanisms of FAM111A were unresolved. Here, we show that FAM111A is a potent restriction factor for VACV-ΔSPI-1 and MVA. Deletion of FAM111A rescued the replication of MVA and VACV-ΔSPI-1 and overexpression of FAM111A significantly reduced viral DNA replication and virus titers but did not affect viral early gene expression. The antiviral effect of FAM111A necessitated its trypsin-like protease domain and DNA binding domain but not the PCNA-interacting motif. We further discovered that FAM111A translocated into the cytoplasm upon VACV infection and this process was mediated by the cGAS-STING signaling pathway. Infection-triggered FAM111A degraded the nuclear pore complex via its protease activity, translocated to the cytoplasm, and interacted with and promoted the degradation of virus DNA binding protein I3 in a DNA-dependent manner. Interestingly, the protease activity of FAM111A was only needed for nuclear export but not I3 degradation as further analysis showed I3 was degraded through autophagy. Moreover, VACV SPI-1 was found primarily in the nucleus of infected cells and antagonized FAM111A by prohibiting its nuclear export. MPXV and lumpy skin disease virus SPI-1s also inhibited human FAM111A. Our findings reveal the detailed mechanism by which FAM111A functions to restrict a cytoplasmic DNA virus and provide explanations for the immune evasive function of VACV SPI-1.