bluuebunny/crossref_metadata_2025 huggingface dataset:
Sepsis-induced endothelial dysfunction drives acute-on-chronic liver failure through Angiopoietin-2-HGF-C/EBPβ pathway
Authors: Elias Grant , Schonfeld Michael , Saleh Sara , Parrish Mark , Barmanova Marina , Weinman Steven A. , Tikhanovich Irina
Published: March 2023

Background and Aims:

Acute-on-chronic liver failure (ACLF) is an acute liver and multisystem failure in patients with previously stable cirrhosis. A common cause of ACLF is sepsis secondary to bacterial infection. Sepsis-associated ACLF involves a loss of differentiated liver function in the absence of direct liver injury, and its mechanism is unknown. We aimed to study the mechanism of sepsis-associated ACLF using a novel mouse model.

Approach and Results:

Sepsis-associated ACLF was induced by cecal ligation and puncture procedure (CLP) in mice treated with thioacetamide (TAA). The combination of TAA and CLP resulted in a significant decrease in liver synthetic function and high mortality. These changes were associated with reduced metabolic gene expression and increased CCAAT enhancer binding protein beta (C/EBPβ) transcriptional activity. We found that C/EBPβ binding to its target gene promoters was increased. In humans, C/EBPβ chromatin binding was similarly increased in the ACLF group compared with control cirrhosis. Hepatocyte-specific Cebpb knockout mice had reduced mortality and increased gene expression of hepatocyte differentiation markers in TAA/CLP mice, suggesting that C/EBPβ promotes liver failure in these mice. C/EBPβ activation was associated with endothelial dysfunction, characterized by reduced Angiopoietin-1/Angiopoietin-2 ratio and increased endothelial production of HGF. Angiopoietin-1 supplementation or Hgf knockdown reduced hepatocyte C/EBPβ accumulation, restored liver function, and reduced mortality, suggesting that endothelial dysfunction induced by sepsis drives ACLF through HGF-C/EBPβ pathway.

Conclusions:

The transcription factor C/EBPβ is activated in both mouse and human ACLF and is a potential therapeutic target to prevent liver failure in patients with sepsis and cirrhosis.
Sutureless Amniotic Membrane Transplantation Using Pediatric Nasogastric Tube for Patients With Acute Stevens–Johnson Syndrome/Toxic Epidermal Necrolysis
Authors: Ceylan Ali , Mergen Burak , Aydin Fahri Onur , Avci Emre , Yildirim Yusuf
Published: March 2023

Purpose:

Evaluation of the results of sutureless amniotic membrane transplantation (AMT) using a pediatric nasogastric tube (NGT) for patients with acute Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) was aimed.

Methods:

Twenty-six eyes of 13 patients with SJS/TEN with ocular involvement at a single tertiary care hospital between May 2020 and January 2022 were included in the study. An amniotic membrane was implanted to the ocular surface and conjunctival fornix using a modified symblepharon ring (MR) created by inserting NGT end-to-end. Patients were followed for at least 6 months. The mean duration of the surgery was recorded. The presence of corneal epithelial defect and vascularization, meibomian gland dysfunction (MGD) grade, conjunctival scarring, eyelid margin keratinization, symblepharon, and trichiasis were recorded.

Results:

The mean age of the patients was 38.4±17.6 years. Amniotic membrane transplantation was performed only once for eight patients and twice for five patients. The mean duration of the surgery was 3.2±0.4 min. The modified symblepharon ring was removed 28 days after its application. At the first examination, 20 eyes (76.9%) had a corneal epithelial defect and 6 (23.1%) had early symblepharon. At the postoperative 6 months, although seven eyes (26.9%) had conjunctival scarring and 5 (19.2%) had eyelid margin keratinization, all patients were without any corneal defect, corneal vascularization, or symblepharon. Only 11 eyes (42.3%) showed MGD, and 1 eye (3.8%) showed trichiasis.

Conclusions:

This study showed that sutureless AMT using pediatric NGT could be a potentially fast and inexpensive treatment option for the treatment of SJS/TEN with ocular involvement at the bedside without the need for general anesthesia.
Pain and insomnia as risk factors for first lifetime onsets of anxiety, depression, and suicidality in adolescence
Authors: Soltani Sabine , Noel Melanie , Bernier Emily , Kopala-Sibley Daniel C.
Published: March 2023

Chronic pain and mental health problems have both been identified as public health emergencies and co-occur at high rates. This prospective, longitudinal investigation examined whether chronic pain status, pain-related symptoms (intensity, interference), pain catastrophizing, and insomnia severity predicted first lifetime onset of depressive and/or anxiety disorders as well as suicidality in a cohort of youth with a parental history of mood and/or anxiety disorders. Participants included 145 youth (M
age = 13.74 years; 64% female) who completed structured diagnostic interviews at baseline and at 9- and 18-month follow-up to assess depressive and anxiety disorders as well as suicidality. Participants completed baseline questionnaires assessing depressive and anxiety symptoms, pain symptoms and characteristics, pain interference, pain catastrophizing, and insomnia severity. Approximately 25% of youth reported having chronic pain at baseline. Nearly half (47.3%) developed a depressive disorder (21.3%), anxiety disorder (15.7%), or both (10.3%), and 34% endorsed experiencing suicidality at follow-up. Increased pain interference, intensity, catastrophizing, and insomnia severity predicted increased likelihood of first lifetime onset of a depressive disorder at follow-up, over and above sex and baseline symptoms. Chronic pain at baseline was associated with the increased likelihood of onset of suicidality at follow-up. Increased pain intensity and interference at baseline predicted increased severity of suicidality at follow-up. Insomnia severity predicted increased likelihood of anxiety disorder onset. The presence of chronic pain and elevated pain-related symptoms and insomnia are premorbid risk factors for the development of significant mental health disorders and issues in youth.
Effect modifiers of virtual reality in pain management: a systematic review and meta-regression analysis
Authors: Lier Elisabeth J. , de Vries Marjan , Steggink Eline M. , ten Broek Richard P.G. , van Goor Harry
Published: March 2023

There is a rapidly growing body of evidence for the application of virtual reality (VR) in pain management, however, with varying effectiveness. Little is known about patient-related and VR-related factors affecting efficacy of VR. A systematic review and meta-analysis was performed including 122 randomised controlled trials (9138 patients), reporting on subjectively reported pain scores comparing an immersive VR intervention to a non-VR control group. Virtual reality significantly reduced pain in the pooled analysis (standardized mean difference = −0.65, 95% CI −0.76 to −0.54, P < 0.001). Subgroup analyses showed no significant differences between type of pain, ie, VR effects were similar in acute, chronic, and procedural pain conditions. Univariate and multivariate meta-regression analyses were performed to investigate the effect of intervention, patient, and pain characteristics on VR. Virtual reality effectively reduced pain, especially in patients reporting moderate to severe pain and in younger subjects. Studies comparing VR with a control group receiving no distraction methods were associated with higher effect sizes. The effect of VR was not related to a specific frequency or duration of use. Type of software and interaction level were related to VR effects in the univariable, but not in the multivariable, meta-regression analysis. Heterogeneity was considerable for all meta-analyses, and risk of bias was moderate to high in most included studies. Studies on mechanisms behind VR analgesia in younger patients and patients reporting moderate to severe pain are recommended to confirm our hypotheses while taking into account risk of bias and the comparator. Optimal application of VR using treatment modules for long-term pain conditions are an important issue for future research.
Feasibility of an Animal Model for Cavopulmonary Support With a Double-Outflow Pump
Authors: Granegger Marcus , Escher Andreas , Karner Barbara , Kainz Matthias , Schlöglhofer Thomas , Schwingenschlögl Harald , Roehrich Michael , Karl Podesser Bruno , Kramer Anne-Margarethe , Kertzscher Ulrich , Laufer Günther , Hübler Michael , Zimpfer Daniel
Published: March 2023

Both single- and double-outflow cavopulmonary assist devices (CPADs) were recently proposed for the Fontan population, whereas single-outflow configurations were evaluated in large animal trials and double-outflow concepts are lacking an equivalent in vivo assessment. The aim of this study was to test the hemodynamic properties of a double-outflow CPAD device in an acute sheep model. The two inflow cannulae of a CPAD were anastomosed to the caval veins. Outflow graft connection was performed via end-to-side anastomosis to the right (RPA) and main pulmonary artery (MPA). Speed ramp protocols were conducted, and hemodynamic effects were monitored in terms of caval flows, cardiac output (CO), central venous pressure (CVP), pulmonary artery pressure (PAP), and left atrial pressure (LAP). Six experiments were conducted (53.35 ± 5.1 kg). In three experiments, the animal model was established, the CPAD was examined, and restoration of biventricular equivalency in terms of venous return was achieved. Venous pressures (CVP) declined linearly with increasing pump speed (r > 0.879), whereas caval flow (r > 0.973), CO (r > 0.993), PAP (r > 0.973), and LAP (r > 0.408) increased. Despite the considerable complexity of the sheep model caused by the sheep pulmonary arterial anatomy that requires substantial graft bending, the CPAD was evaluated in three acute experiments and showed the potential to completely substitute a subpulmonary ventricle.
Dietary approaches for normalizing dysbiosis induced by high-fat, obesogenic diets
Authors: Djuric Zora
Published: March 2023

Purpose of review

Given the world-wide problem of obesity, this review considers what types of dietary changes can be utilized to minimize the adverse effects of an obesogenic diet on the intestinal microbiota.

Recent findings

In rodents fed high-fat diets containing lard or Western blend fats to induce obesity, switching to high-fat diets formulated to contain higher amounts of fiber or fiber-containing foods, plant extracts, omega-3 fatty acids or whole grains has beneficial effects on body weight, metabolic alterations, and the intestinal microbiota. Several studies show that the intestinal microbiota has a role in mediating the beneficial health effects of these dietary factors. Many aspects of the microbiota observed in animals when healthful dietary components were added to the feed have also been observed in humans who follow healthful dietary patterns.

The data shows that specific foods and macronutrients can normalize the obesity-associated microbiota and improve metabolic health. These findings support the design of dietary interventions that would allow individuals to focus on diet quality independently of weight loss to mitigate the adverse sequelae of obesity.
Considerations when administering medications enterally in the critically ill
Authors: MacLaren Robert
Published: March 2023

Purpose of review

Enteral administration of medications to critically ill patients may be advantageous to other routes of administration. This review summarizes key considerations for the bedside clinician when medications are administered through enteral access devices (EADs).

Recent findings

Critical illness is associated with gastrointestinal dysfunction that inconsistently affects drug dispersion and absorption and may enhance or reduce bioavailability. Other factors such as the first-pass metabolism, microbiome alterations and the concomitant use of other medications (vasopressors, acid suppressants) may influence drug absorption. Concurrent administration of medications with enteral nutrition is fraught with potential errors. Drug-nutrient and drug-drug interactions may lead to tube occlusion. Although liquid formulations of medications are preferred over solid dosage forms for EAD administration, they may be hyperosmotic or contain sorbitol to cause gastrointestinal disturbances. The size and placement of the EAD tube may influence drug dispersion and absorption to affect the pharmacokinetic profile and efficacy of a particular drug.

The therapeutic effect may be diminished, or toxicity enhanced when medications are administered through EADs in the critically ill. The bedside clinician must be aware of factors impacting the bioavailability of enterally administered medications and be cognizant that the effect will differ by medication.
Brain FDG PET for visualizing the relation between impaired lung function and cognitive decline in lung cancer: a preliminary study
Authors: Son Seung Hyun , Ahn June Hong , Shin Kyeong Cheol , Kim Hae Won , Kong Eunjung
Published: March 2023

Objective

Impaired lung function is associated with an increased risk for cognitive decline. F-18 fluorodeoxyglucose (FDG) PET is a well-known neurodegenerative biomarker for dementia. We investigated the association between lung and brain function using FDG PET in patients with lung cancer.

Methods

A random sub-sample of 102 patients with lung cancer and without a self-reported history of neuropsychiatric disorders were recruited and underwent both lung function tests and FDG PET scans before treatment. Lung function was analyzed as the percentage predicted value (% pred) of forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1). FDG uptake was measured as standardized uptake values (SUVs) in the frontal, parietal, temporal, and occipital cortices and cognition-related regions. Regional SUV ratios (SUVRs) were calculated by dividing the SUV in each region by the whole-brain SUV and were then evaluated against lung function indices and clinical variables.

Results

After excluding five patients with brain metastases, 97 patients were included in the final analysis (mean age, 67.7 ± 10.3 years). Mean FVC and mean FEV1 were 80.0% ± 15.4% and 77.6% ± 17.8%, respectively. Both FVC and FEV1 were positively correlated with SUVRs in all brain regions after adjusting the data for clinical variables. The degree of decrease in SUVRs related to lung function was not significantly different between cognition-related regions and other regions.

Conclusion

Impaired lung function was associated with decreased glucose metabolism in all regions of the brain, indicating that cognitive decline related to decreased glucose metabolism may be due to reduced perfusion.
Essential equipment and services for otolaryngology care: a proposal by the Global Otolaryngology-Head and Neck Surgery Initiative
Authors: Srinivasan Tarika , Cherches Alexander , Seguya Amina , Salano Valerie , Patterson Rolvix H. , Xu Mary Jue , Alkire Blake C. , Okerosi Samuel N. , Tamir Sharon Ovnat
Published: March 2023

Purpose of review

To highlight the need for comprehensive resource lists to provide baseline care of otolaryngologic conditions; to present a proposed list of essential equipment and services that may be applied toward surgical systems research, policymaking, and charitable efforts in global otolaryngology-head and neck surgery.

Recent findings

To provide effective and high-quality surgical care across care settings, there must be a global standard for equipment and ancillary services necessary to provide baseline care. Though there have been efforts to devise resource standards via equipment lists and appraisal tools, these have been limited in scope to general surgery, emergency care, and a few other subspecialty surgical contexts. Recent efforts have brought attention to the significant burden imposed by otolaryngologic conditions such as hearing loss, otitis media, head and neck cancer, head and neck trauma, and upper airway foreign bodies. Yet, there has not been a comprehensive list of resources necessary to provide baseline care for common otolaryngologic conditions.

Through an internal survey of its members, the Global Otolaryngology-Head and Neck Surgery Initiative has compiled a list of essential equipment and services to provide baseline care of otolaryngologic conditions. Our efforts aimed to address common otolaryngologic conditions that have been previously identified as high-priority with respect to prevalence and burden of disease. This expert-driven list of essential resources functions as an initial framework to be adapted for internal quality assessment, implementation research, health policy development, and economic priority-setting.
Climate and Environmental Change
Authors: Chalupka Stephanie M. , Latter Angela , Trombley Janna
Published: March 2023

Climate and environmental changes have been described as the biggest global health threat of the 21st century, with the potential to cause immediate harm in early life with important lifelong effects, and important consequences for future generations. Pregnant women and children are increasingly being recognized as vulnerable populations in the context of climate change. The effects can be direct or indirect through heat stress, extreme weather events, and air pollution, potentially affecting both the immediate and long-term health of pregnant women and newborns through a broad range of mechanisms. Climate and environmental changes have wide-ranging effects on a woman's reproductive life including sexual maturation and fertility, pregnancy outcomes, lactation, breastfeeding, and menopause. A comprehensive overview of these impacts is presented as well as opportunities for interventions for nurses practicing in perinatal, neonatal, midwifery, and pediatric specialties.
Use of a Recovery Messaging Application in Outpatient Total Joint Replacement
Authors: Melvin Heather W.
Published: March 2023

Total joint replacement (TJR) is performed in an outpatient setting for cost containment and reimbursement changes. However, outpatient readmission to the hospital within 30–90 days postoperatively can be costly. Increases in readmission to the hospital less than 30 days postoperatively increase healthcare expenditure and can leave surgical centers without reimbursement. The purpose of the integrative review was to examine 30-day readmission rates for adults post–outpatient TJR within a 12- to 14-week time frame using the recovery messaging application following discharge. A literature search was conducted, and articles were included if they were peer-reviewed academic journals written in English between 2017 and 2022. Fifteen articles were included and evaluated using the John Hopkins evidence summary table to assess the evidence level. The literature analysis identified three themes after using the smartphone application: (a) reducing hospital 30- day readmissions, (b) increasing patient engagement and early mobility, and (c) improving patient outcomes and satisfaction. The findings of this integrative review indicate that using an evidence-based intervention, such as the smartphone application for recovery messaging, can reduce less than 30-day hospital readmissions after outpatient TJR, thus reducing healthcare costs. Future studies should evaluate specific smartphone applications after other general surgical procedures.
The Effect of Guided Imagery on Postoperative Pain Management in Patients Undergoing Lower Extremity Surgical Operations
Authors: Zengin Aydın Leyla , Doğan Aysel
Published: March 2023

Guided imagery distracts patients from disturbing feelings and thoughts, positively affects emotional well-being, and reduces pain by producing pleasing mental images. This study aimed to determine the effects of guided imagery on postoperative pain management in patients undergoing lower extremity surgery. This randomized controlled study was conducted between April 2018 and May 2019. This study included 60 patients who underwent lower extremity surgery. After using guided imagery, the posttest mean Visual Analog Scale score of patients in the intervention group was found to be 2.56 (1.00 ± 6.00), whereas the posttest mean score of patients in the control group was 4.10 (3.00 ± 6.00), and the difference between the groups was statistically significant (p <.001). Guided imagery reduces short-term postoperative pain after lower extremity surgery.
A Suggested Mechanism for Green Discoloration of the Postmortem Brain
Authors: Shinkawa Norihiro , Takahashi Nobuyasu , Yano Kiyoko , Sawaguchi Akira , Sonoda Ai , Kakizaki Eiji , Yukawa Nobuhiro
Published: March 2023

In the putrefied brain, the cortex and basal ganglia show dark-grayish to green discoloration due to sulfhemoglobin formed from hydrogen sulfide (H2S) produced by endogenous bacteria and hemoglobin. In this study, we propose and demonstrate another mechanism of green discoloration in the brain. The formalin-fixed brain of a cadaver donated for medical education with no putrefaction was used. Half of the brain was immersed in sodium hydrosulfide solution, to imitate the H2S produced by bacteria. This half showed greenish discoloration, mainly in the basal ganglia and cortex. The other half showed positive Perls' Prussian blue staining, mainly in the basal ganglia and cortex. The area of greenish discoloration due to H2S and the region positive for Perls' Prussian blue staining coincided. Tissue treatment with strong oxidizing agents is required to liberate heme iron. The positive Perls' Prussian blue staining in this study thus does not reflect heme iron. In conclusion, we considered that non–heme iron compounds physiologically present in the brain and H2S represent sources of putrefactive greenish discoloration in the brain.
The Role of Whole-Body Magnetic Resonance Imaging in Assessing Extrapulmonary Metastases in Osteosarcoma Staging and Restaging: A Pilot Study
Authors: Karaarslan Ercan , Alis Deniz , Basar Yeliz , Kumbasar Basak , Kalayci Cem Burak , Alpan Bugra , Ozger Harzem
Published: March 2023

Objective

The aim of the study is to investigate the role of whole-body magnetic resonance imaging (MRI) in assessing extrapulmonary metastases in primary osteosarcoma staging.

Methods

We retrospectively reviewed medical data to identify primary osteosarcoma patients with available preoperative whole-body MRI obtained in the staging or restaging. Histopathology was the reference test for assessing the diagnostic performance, if available. Otherwise, oncology board decisions were used as the reference. In addition, the benefits of whole-body MRI to F-fluorodeoxyglucose positron emission tomography–computed tomography (18F-FDG PET-CT) and bone scintigraphy were investigated.

Results

In all, 36 patients with osteosarcoma (24 staging, 12 restaging) with a mean age of 16.36 ± 5.63 years (range, 9–29 years) were included in the study. The median follow-up duration was 26.61 months (interquartile range, 33.3 months). Of 36 patients, 8 had skeletal, 1 had a lymph node, and 1 had a subcutaneous metastasis. Whole-body MRI correctly identified all patients with metastatic disease but incorrectly classified a bone infarct in one patient as a skeletal metastasis, equating a scan-level sensitivity, specificity, accuracy, negative predictive value, and positive predictive value of 100%, 96.3%, 97.3%, 100%, and 90.91%. Whole-body MRI contributed to bone scintigraphy by identifying a skeletal metastasis in one patient and positron emission tomography–computed tomography by ruling out a skeletal metastasis in another.

Conclusions

Whole-body MRI could accurately identify extrapulmonary metastases in primary osteosarcoma patients for staging or restaging. In addition, it might contribute to the standard whole-body imaging methods.
Can Supine Breast Magnetic Resonance Imaging After a Dynamic Contrast-Enhanced Breast Magnetic Resonance Imaging Provide Information for Supine Procedures?
Authors: Kuş Ceyda Civan , Güldoğan Nilgün , Yılmaz Ebru , Soyder Aykut , Arslan Aydan , Arıbal M. Erkin
Published: March 2023

Purpose

The aim of the study is to compare prone with supine breast magnetic resonance imaging (MRI) in terms of breast tumor location, size, shape, and tumor-to-tumor distances in multifocal lesions to improve image-based guidance for surgical planning.

Methods

A retrospective analysis was conducted on 75 lesions in 50 patients with pathologically proven breast cancer who underwent MRI in prone and supine positions between December 2019 and December 2020. The transverse, anteroposterior, and craniocaudal dimensions (in millimeters) of the tumor in the x-, y-, and z-axes were measured. Distances from the center of the tumor to the chest wall and the adjacent skin were measured on transverse and reformatted sagittal images. In cases where multifocal lesions were present, the transverse, anteroposterior, and craniocaudal distances between the tumor centers in the x-, y-, and z-axes were measured. Differences between measurements in supine and prone MRI were evaluated with the Mann-Whitney U and the Wilcoxon tests. P values of less than 0.05 were considered to indicate a statistically significant difference.

Results

The analysis revealed 31 MRIs with 1 and 20 with multifocal lesions. The x-axis dimension of the lesions in prone and supine positions did not significantly differ (P = 0.198) between the 2 positions. A significant difference in the y- and z-axes dimensions was observed between the prone and supine position (P = 0.00 for both). The distance from the tumor to the chest wall and the adjacent skin showed significant difference (P = 0.00 for both). For multifocal lesions, the distance between the lesions showed a significant difference on the y-axis (P = 0.00).

Conclusions

This study showed a significant difference in the tumor size, location, and tumor-to-tumor distances due to change of patient position, from the standard prone MRI to the supine position in the operating room, resulting in distortion, spatial repositioning, and convergence of the lesions. Supine MRI may be considered in providing a less extensive surgery.
Contrast Agent Selection to Prevent Recurrent Severe Hypersensitivity Reaction to Iodinated Contrast Media Based on Nationwide Database
Authors: Ahn Jhii-Hyun , Hong Seung-Phil , Go Tae-Hwa , Kim Hyunjung
Published: March 2023

Objective

To investigate the incidence of severe iodinated contrast media (ICM)–related hypersensitivity reaction (HSR) and to find the optimal alternative ICM to reduce the risk of severe HSR recurrence.

Methods

We retrospectively reviewed 23,383,183 cases of ICM administration between January 2015 and December 2019 from the nationwide health insurance database. We classified ICMs based on generic profiles and the presence of N-(2,3-dihydroxypropyl) carbamoyl side chains. The incidence of severe and recurrent severe HSRs was calculated, and χ
2 tests were performed to compare the prevalence of severe HSR according to ICM groups. In addition, logistic regression analyses were used to assess differences between ICM groups.

Results

The incidence of severe HSRs was 1.92% (450,067 of 23,282,183). Among 1,875,245 individuals who received ICM twice on different days, severe HSR occurred in 40,850 individuals, and severe HSR recurred in 3319 individuals (8.12%). The risk of recurrence significantly decreased when the ICM changed (9.24% vs 7.08%, P < 0.001), especially when the ICM changed to one with a different side chain (6.74%, P < 0.001). In addition, compared with the reuse of the culprit agent, using combinations of iobitridol/iohexol (odds ratio [OR], 0.696; P = 0.04), iohexol/iopamidol (OR, 0.757; P = 0.007), iopamidol/iohexol (OR, 0.447; P < 0.001), and ioversol/iohexol (OR, 0.683; P = 0.04) reduced the risk of recurrence of severe HSR.

Conclusions

Changing the culprit ICM to that with a different side chain can reduce severe HSR recurrence. The optimal choice of an alternative ICM depends on the causative agent.
Effects of the Interruption Management Strategy “Stay S.A.F.E.” During Medication Administration
Authors: Vital Cidalia J. , Nathanson Brian H.
Published: March 2023

Purpose

This study measured the impact of the Stay S.A.F.E. intervention on nursing students’ management of and response to interruptions during medication administration. Time to return to the primary task, performance (procedural failures and error rate), and perceived task load were evaluated.

Design

This experimental study used a randomized prospective trial.

Methods

Nursing students were randomized into two groups. Group 1 (the experimental group) received two educational PowerPoints: the Stay S.A.F.E. strategy and medication safety practices. Group 2 (the control group) received educational PowerPoint on medication safety practices. Nursing students participated in three simulations where they were interrupted during a simulated medication administration. Eye tracking of students’ eye movements determined focus, time to return to the primary task, performance including procedural failures and errors, and fixation time on the interrupter. The perceived task load was measured using the NASA Task Load Index.

Results

The intervention group, which was the Stay S.A.F.E. group, demonstrated a significant reduction in time away from task. There was a significant difference in perceived task load across the three simulations, including decreased frustration scores for this group as well. The control group members reported a higher mental demand, increased effort, and frustration.

Clinical Relevance

Rehabilitation units often hire new nursing graduates or individuals with little experience. For new graduates they have typically practiced their skills without interruptions. However, interruptions in performing care, particularly in medication management, occur frequently in real-world situations. Improving the education of nursing students related to interruption management has the potential to improve their transition to practice and patient care.

Conclusion

Students who received the Stay S.A.F.E. training, a strategy to manage interruptions in care, had decreasing frustration over time and spent more time on the task of medication administration.
Transillumination of an Anterior Fontanelle Dermoid Cyst
Authors: Shastri Darshan , Fisher Wilson A.M. , Wood Jeyhan , Quinsey Carolyn
Published: March 2023

Dermoid cysts are slowly growing benign lesions of ectodermal tissue that often occur in the anterior fontanelle. Clinicians often rely on a negative transillumination test to begin the process of correctly diagnosing a dermoid cyst. However, here the authors present a case of a 7-month-old girl who presents with a transilluminating dermoid cyst.
Bilateral Transient Dilated and Fixed Pupils After Microvascular Decompression: Rare Clinical Experience
Authors: Wang Linkai , Fan Haonan , Xu Xiaohui , Su Sheng , Feng Weijian , Wu Chunlai , Chen Yili
Published: March 2023

Microvascular decompression (MVD) has a satisfactory safety, and it is the only surgical treatment for neurovascular compression diseases, such as hemifacial spasm, trigeminal neuralgia, and glossopharyngeal neuralgia, from the perspective of etiology. Bilateral dilated and fixed pupils have long been regarded as a sign of life threatening, which is common in patients with cerebral herniation due to cranial hypertension. However, transient dilated pupils after MVD have not been previously reported. Here, we presented 2 patients with bilateral transient dilated and fixed pupils after MVD and discussed the possible etiologies through the literature review. Physical examination of both patients showed bilateral pupils were normal and without a medical history of pupil dilation. They underwent MVD under general anesthesia and used propofol and sevoflurane. In both cases, the vertebral artery was displaced, and Teflon pads were inserted between the vertebral artery and the brain stem. Postoperation, we found transient bilateral mydriasis without light reflection in both patients. The emergency head computed tomography revealed no obvious signs of hemorrhage and cerebral herniation. About 1 hour later, this phenomenon disappeared. Therefore, the authors think if MVD is successfully carried out, bilateral transient mydriasis may not necessarily indicate brain stem hemorrhage, cerebral herniation, and other emergency conditions, which can be recovered within a short time. The causes could be related to stimulation of the sympathetic pathway in the brain stem during MVD and side effects of anesthetics.
Differences in the Osseous Ultrastructure in 2 Differing Etiologies of Eagle Syndrome. A Micro-CT Study
Authors: Heim Nils , Warwas Felix B. , Singer Lamia , Kramer Franz-Josef , Bourauel Christoph , Götz Werner
Published: March 2023

Objectives:

Eagle syndrome is a rare disease caused by an elongated styloid process (type I) or ossified stylohyoid ligament (type II) and causes a heterogeneous symptom complex, ranging from pain in the throat and neck to neurological symptoms and neurovascular entrapment. The 2 different types present differing shapes and ultrastructures and cause different symptoms. This study aimed to distinguish the 2 types by investigating the structures by micro–computed tomography.

Methods:

Micro–computed tomography was performed and evaluated in n=10 resected styloid processes from patients diagnosed with Eagle syndrome. The tissues were measured for their shape, ratio of soft tissue and bone amounts, bone volume, and ultrastructure, and compared within the groups.

Results:

The shapes of the different types were different and the ultrastructure differed between the 2 groups, with an absence of trabecular architecture in type II. The area of bone to nonbone tissues in type I samples was significantly higher compared with type II (P=0.007). Alike these results, the bone volume and bone-to-soft tissue ratio were significantly higher in type I compared with type II (P=0.009).

Conclusions:

The findings suggest that both the popular theories (hyperplasia and metaplasia) may be probable but each solely valid for 1 type of Eagle. Type I may derive from bone hyperplasia with cancellous bone formation and rather high bone density in the elongated styloid process. Type II most likely originates from ligament metaplasia into bone without a compact structure.
Advances in trauma care to save lives from traumatic injury: A narrative review
Authors: Schmitt Johan , Gurney Jennifer , Aries Philippe , Danguy Des Deserts Marc
Published: March 2023

Recent advances on trauma management from the prehospital setting to in hospital care led to a better surviving severe trauma rate. Mortality from exsanguination remains the first preventable mortality. Damage-control resuscitation and surgery are evolving and thus some promising concepts are developing. Transfusion toolkit is brought on the prehospital scene while temporary bridge to hemostasis may be helpful. Panel transfusion products allow an individualized ratio assumed by fresh frozen or lyophilized plasma, fresh or cold-stored whole blood, fibrinogen, four-factor prothrombin complex concentrates. Growing interest is raising in whole blood transfusion, resuscitative endovascular balloon occlusion of the aorta use, hybrid emergency room, viscoelastic hemostatic assays to improve patient outcomes. Microcirculation, traumatic endotheliopathy, organ failures and secondary immunosuppression are point out since late deaths are increasing and may deserve specific treatment.

As each trauma patient follows his own course over the following days after trauma, trauma management may be seen through successive, temporal, and individualized aims.
Evidence for some antimicrobial properties of English churchyard lichens.
Authors: Taylor J A , Fourie Toscane , Powell Mark , Chianella Iva
Published: March 2023

The emergence of multidrug resistant bacteria has driven the need for novel antibiotics. Our investigations have focussed on lichens as they naturally produce a wide range of unique and very effective defence chemicals. The aim of this study was to evaluate some of the antimicrobial properties of ten common British churchyard lichens. The lichen material was sampled from 10 species, namely Caloplaca flavescens, Diploicia canescens, Cladonia fimbriata, Psilolechia lucida, Lecanora campestris subsp. Campestris, Lecanora sulphurea, Pertusaria amara f.amara, Lepraria incana, Porpidia tuberculosa  and
 Xanthoria calcicola. Crude acetone extracts of these lichens were tested against 6 bacteria (Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Salmonela typhimurium, Listeria monocytogenes and Lactobacillus acidophilus) and two fungi (Trichophyton interdigitale and Aspergillus flavus) by the disc diffusion susceptibility test method. Extracts of Diploicia canescens, Psilolechia lucida, Lecanora sulphurea,Pertusaria amara and Lepraria incana showed clear inhibition of the Gram- positive bacteria tested (S. aureus, L. monocytogenes, L. Plantarum). Diploicia canescens, Pertusaria  amara and Lepraria incana extracts also inhibited  the dermatophyte fungi tested.  The Lepraria incana sample tested here was the only extract that showed activity against any of the Gram-negative bacteria tested; it showed inhibition of Pseudomnas aeruginosa. Overall, our results showed that crude extracts of Diploicia canescens and Pertusaria amara had the most potent antimicrobial activity of all the extracts tested. Our results are in general agreement with published findings elsewhere. The activity of the Porpidia tuberculosa margin sample being different from that of the main colony material was an interesting and new finding reported here for the first time.
Citrobacter meridianamericanus sp. nov., isolated from a soil sample
Authors: Furlan João Pedro Rueda , Ribeiro Teresa Gonçalves , Novais Ângela , Cabral Hamilton , Peixe Luísa , Stehling Eliana Guedes
Published: March 2023

A Gram-stain-negative strain, designated BR102T, isolated from a soil sample in Brazil was characterized by a polyphasic approach. Comparative 16S rRNA gene sequences indicated that strain BR102T belonged to the genus

Citrobacter

. The recN- and whole-genome-based phylogeny, and multilocus sequence analysis based on concatenated partial fusA, leuS, pyrG and rpoB sequences strongly supported a clade encompassing strain BR102T and a strain from public database that was distinct from currently recognized species of the genus

Citrobacter

. Average nucleotide identity and digital DNA–DNA hybridization values between strain BR102T and the closest relative

Citrobacter freundii

ATCC 8090T were 91.8 and 48.8 %, respectively. The ability to metabolize different compounds further discriminated strain BR102T from other closely related species of the genus

Citrobacter

. The novel variants bla
CMY-179 and qnrB97, which encoded a CMY-2-like β-lactamase and a QnrB-type protein, respectively, were identified in strain BR102T. BR102T was resistant to ampicillin, amoxicillin/clavulanate and cefoxitin. The DNA G+C content of strain BR102T is 51.3 mol%. Based on these results, strain BR102T represents a novel species of the genus

Citrobacter

, for which the name Citrobacter meridianamericanus sp. nov. is proposed. The type strain is BR102T (=MUM 22.55T=IMI 507229T).
Mental simulations and action language are impaired in individuals with aphantasia
Authors: Dupont W. , Papaxanthis C. , Lebon F. , Madden-Lombardi C.
Published: March 2023

Action reading is thought to engage motor simulations, yielding modulations in activity of motor-related cortical regions, and contributing to action language comprehension. To test these ideas, we measured 1) corticospinal excitability during action reading, and 2) reading comprehension ability, in individuals with normal and impaired imagery (i.e., phantasia and aphantasia, respectively). Thirty-four participants (17 phantasic and 17 aphantasic) were asked to read manual action sentences. By means of transcranial magnetic stimulation, we triggered motor-evoked potentials (MEP) in the target right index finger. MEP amplitude, a marker of corticospinal excitability, increased during action reading relative to rest for phantasic individuals, but not for aphantasic individuals. This result provides neurophysiological evidence that individuals living with aphantasia present a real neurophysiological deficit in motor system engagement during action reading. Furthermore, deep-level reading comprehension ability was impaired in individuals with aphantasia, who had difficulty selecting words that best fit the context of sentences. Altogether, these findings support the idea that motor simulations, along with the activation within the motor system, contribute to action language comprehension.
Connectome dysfunction in patients at clinical high risk for psychosis and modulation by oxytocin
Authors: Davies Cathy , Martins Daniel , Dipasquale Ottavia , McCutcheon Robert A. , De Micheli Andrea , Ramella-Cravaro Valentina , Provenzani Umberto , Rutigliano Grazia , Cappucciati Marco , Oliver Dominic , Williams Steve , Zelaya Fernando , Allen Paul , Murguia Silvia , Taylor David , Shergill Sukhi , Morrison Paul , McGuire Philip , Paloyelis Yannis , Fusar-Poli Paolo
Published: March 2023

Abnormalities in functional brain networks (functional connectome) are increasingly implicated in people at Clinical High Risk for Psychosis (CHR-P). Intranasal oxytocin, a potential novel treatment for the CHR-P state, modulates network topology in healthy individuals. However, its connectomic effects in people at CHR-P remain unknown. Forty-seven men (30 CHR-P and 17 healthy controls) received acute challenges of both intranasal oxytocin 40 IU and placebo in two parallel randomised, double-blind, placebo-controlled cross-over studies. Multi-echo resting-state fMRI data was acquired at approximately 1h post-dosing. Using a graph theoretical approach, the effects of group (CHR-P vs healthy control), treatment (oxytocin vs placebo) and respective interactions were tested on graph metrics describing the topology of the functional connectome. Group effects were observed in 12 regions (all pFDR<.05) most localised to the frontoparietal network. Treatment effects were found in 7 regions (all pFDR<.05) predominantly within the ventral attention network. Our major finding was that many effects of oxytocin on network topology differ across CHR-P and healthy individuals, with significant interaction effects observed in numerous subcortical regions strongly implicated in psychosis onset, such as the thalamus, pallidum and nucleus accumbens, and cortical regions which localised primarily to the default mode network (12 regions, all pFDR<.05). Our findings provide new insights on aberrant functional brain network organisation associated with psychosis risk and demonstrate, for the first time, that oxytocin modulates network topology in brain regions implicated in the pathophysiology of psychosis in a clinical status (CHR-P vs healthy control) specific manner. Further profiling of the connectomic, clinical and cognitive effects of oxytocin in this population is warranted.
Long-read proteogenomics to connect disease-associated sQTLs to the protein isoform effectors of disease
Authors: Abood Abdullah , Mesner Larry D. , Jeffery Erin D. , Murali Mayank , Lehe Micah , Saquing Jamie , Farber Charles R. , Sheynkman Gloria M.
Published: March 2023

A major fraction of loci identified by genome-wide association studies (GWASs) lead to alterations in alternative splicing, but interpretation of how such alterations impact proteins is hindered by the technical limitations of short-read RNA-seq, which cannot directly link splicing events to full-length transcript or protein isoforms. Long-read RNA-seq represents a powerful tool to define and quantify transcript isoforms, and recently, infer protein isoform existence. Here we present a novel approach that integrates information from GWAS, splicing QTL (sQTL), and PacBio long-read RNA-seq in a disease-relevant model to infer the effects of sQTLs on the ultimate protein isoform products they encode. We demonstrate the utility of our approach using bone mineral density (BMD) GWAS data. We identified 1,863 sQTLs from the Genotype-Tissue Expression (GTEx) project in 732 protein-coding genes which colocalized with BMD associations (H4PP ≥ 0.75). We generated deep coverage PacBio long-read RNA-seq data (N=∼22 million full-length reads) on human osteoblasts, identifying 68,326 protein-coding isoforms, of which 17,375 (25%) were novel. By casting the colocalized sQTLs directly onto protein isoforms, we connected 809 sQTLs to 2,029 protein isoforms from 441 genes expressed in osteoblasts. Using these data, we created one of the first proteome-scale resources defining full-length isoforms impacted by colocalized sQTLs. Overall, we found that 74 sQTLs influenced isoforms likely impacted by nonsense mediated decay (NMD) and 190 that potentially resulted in the expression of new protein isoforms. Finally, we identified colocalizing sQTLs inTPM2for splice junctions between two mutually exclusive exons, and two different transcript termination sites, making it impossible to interpret without long-read RNA-seq data. siRNA mediated knockdown in osteoblasts showed twoTPM2isoforms with opposing effects on mineralization. We expect our approach to be widely generalizable across diverse clinical traits and accelerate system-scale analyses of protein isoform activities modulated by GWAS loci.
Forest structural diversity determines tree growth synchrony in response to climate change
Authors: Astigarraga J. , Calatayud J. , Ruiz-Benito P. , Madrigal-González J. , Tijerín-Triviño J. , Zavala M. A. , Andivia E. , Herrero A.
Published: March 2023

After centuries of deforestation, many industrialised countries are experiencing an increase in forest area and biomass due to changes in land- and forest-use since the mid-20thcentury. At the same time, the impacts of climate change on forests are aggravating, but the interplay between past land- and forest-use (i.e. land- and forest-use legacies) and climate change in forest functioning remains elusive. Here using network theory and linear mixed models, we quantified how land- and forest-use legacies modulate tree growth synchrony in response to climate change. We analysed tree growth data from European beech (Fagus sylvaticaL.) stands with different histories of forest management at the species’ rear edge. We found that tree growth synchrony increased following heatwaves, late spring frosts, and reduced precipitation. Interestingly, the greatest tree growth synchrony occurred in recently-established forests, while stands containing large trees and heterogeneous tree sizes showed much lower growth synchrony. Our results highlight the importance of maintaining large trees and structurally heterogeneous forests to mitigate the negative effects of climate change on forest productivity, and thereby, increase forest resilience to future forest climate risks.
PhyloSophos: a high-throughput scientific name mapping algorithm augmented with explicit consideration of taxonomic science
Authors: Cho Min Hyung , Cho Kwang-Hwi , No Kyoung Tai
Published: March 2023

The nature of taxonomic science and the scientific nomenclature system makes it difficult to use scientific names as identifiers without running into complications. To facilitate high-throughput analysis of biological data involving scientific names, we designed PhyloSophos, a Python package that takes into account the properties of scientific names and taxonomic systems to map name inputs to the entries within the reference database of choice. We would like to present three case-studies which demonstrates how our implementations, including rule-based pre-processing and recursive mapping could improve mapping performance and information availability. We expect PhyloSophos to help with the systematic processing of poorly digitized and curated biological data, such as biodiversity information and ethnopharmacological resources, thus enabling full-scale bioinformatics analysis using these data.

Availability and implementation

PhyloSophos is available at GitHubhttps://github.com/mhcho4096/phylosophos.

Supplementary information

Supplementary data are available at Bioinformatics online.