bluuebunny/crossref_metadata_2025 huggingface dataset:
Victimization at Home
Authors: Srabstein Jorge C.
Published: June 2024

This chapter examines what is known about all forms of maltreatment that can afflict any member of a household. The discussion goes beyond focusing on the notion and significance of child abuse (the most studied aspect of victimization at home for more than five decades). The chapter examines the nature, prevalence, and correlates of mistreatment between siblings or parents, while emphasizing the limited knowledge available about the subject of maltreatment of parents by their children or custodial grandparents by their grandchildren. It expands the scope of domestic victimization by regarding domestic employees as potential victims, and it widens the range of child maltreatment by underscoring the topic of violent discipline, including corporal punishment. It recommends that future research ascertain the frequency of co-occurrence of the diverse types of domestic maltreatment and their cumulative effect, as well as their association with different forms of victimization in other social settings, such as in school and the workplace.
Victimization in Adolescent Dating Relationships
Authors: Srabstein Jorge C.
Published: June 2024

This chapter examines the nature, prevalence, and health effects of the different forms of victimization that can affect adolescents involved in a dating relationship, as well as its association with maltreatment in other social milieus. The chapter reviews the concept and prevalence of teen dating relationships as well as the different forms of victimization that may affect adolescents involved in dating interactions. Furthermore, the chapter looks at available published research that explored the association of adolescent dating victimization with a variety of correlates, including family context; mental health risks, injuries; suicide, homicide, and other forms of victimization. It also provides a summary of a comprehensive published quantitative review which was aimed at finding relevant randomized controlled trials evaluating effectiveness of adolescent dating violence prevention programs in reducing the prevalence of Adolescent Dating Violence perpetration and/or victimization. Future steps are recommended to develop national prevalence studies about adolescent dating victimization and the risks associated with it, as well as prevention, detection, and intervention strategies.
Bullying and Other Forms of Maltreatment in Prisons
Authors: Srabstein Jorge C.
Published: June 2024

This chapter examines the nature, prevalence, and risks associated with bullying and other forms of maltreatment occurring in the prison environment and affecting both inmates and staff. It reviews what is known about bullying among inmates and between prison officers, sexual abuse and physical violence in prisons, inmate-on-staff assaults, polyvictimization in prisons, predictors of prison victimization, fear of victimization in prisons, and maltreatment of inmates by the penal system by either abuse or neglect. It advances the notion of the penal system milieu as a workplace, where inmates and staff can be affected by workplace bullying and other forms of victimization. Future research should ascertain the prevalence of all forms of maltreatment affecting people living and working in the penal system. Also, there is a need to determine the health risks linked to exposure to victimization in prisons, as well as to advance strategies for its prevention and detection.
Collapsing molecular clouds with tracer particles – II. Collapse histories
Authors: Collins David C , Le Dan K , Jimenez Vela Luz L
Published: June 2024

In order to develop a complete theory of star formation, one essentially needs to know two things: what collapses and how long it takes. This is the second paper in a series, where we query how long a parcel of gas takes to collapse and the process it undergoes. We embed pseudo-Lagrangian tracer particles in simulations of collapsing molecular clouds, identify the particles that end in dense knots, and then examine the collapse history of the gas. We find a nearly universal behaviour of cruise-then-collapse, wherein a core stays at intermediate densities for a significant fraction of its life before finally collapsing. We identify time immediately before each core collapses, $t_{\rm {sing}}$, and examine how it transitions to high density. We find that the time to collapse is uniformly distributed between $0.25 t_{\rm {ff}}$ and the end of the simulation at $\sim\!\! 1 t_{\rm {ff}}$, and that the duration of collapse is universally short, $\Delta t \sim 0.1 t_{\rm {ff}}$, where $t_{\rm {ff}}$ is the free-fall time at the mean density. We describe the collapse in three stages: collection, hardening, and singularity. Collection sweeps low-density gas into moderate density. Hardening brings kinetic and gravitational energies into quasi-equipartition. Singularity is the free-fall collapse, forming an envelope in rough energy balance and central overdensity in $\sim\!\! 0.1 t_{\rm {ff}}$.
Realistic models of general-relativistic differentially rotating stars
Authors: Cassing Marie , Rezzolla Luciano
Published: June 2024

General-relativistic equilibria of differentially rotating stars are expected in a number of astrophysical scenarios, from core-collapse supernovae to the remnant of binary neutron-star mergers. The latter, in particular, have been the subject of extensive studies where they were modelled with a variety of laws of differential rotation with varying degree of realism. Starting from accurate and fully general-relativistic simulations of binary neutron-star mergers with various equations of state and mass ratios, we establish the time when the merger remnant has reached a quasi-stationary equilibrium and extract in this way realistic profiles of differential rotation. This allows us to explore how well traditional laws reproduce such differential-rotation properties and to derive new laws of differential rotation that better match the numerical data in the low-density Keplerian regions of the remnant. In this way, we have obtained a novel and somewhat surprising result: the dynamical stability line to quasi-radial oscillations computed from the turning-point criterion can have a slope that is not necessarily negative with respect to the central rest-mass density, as previously found with traditional differential-rotation laws. Indeed, for stellar models reproducing well the properties of the merger remnants, the slope is actually positive, thus reflecting remnants with angular momentum at large distances from the rotation axis, and hence with cores having higher central rest-mass densities and slower rotation rates.
The VISCACHA survey – X. A fast method to build completeness maps for Magellanic Clouds star clusters
Authors: Gardin João F , Santos João F C , Maia Francisco F S , Dias Bruno , Ferreira Bernardo P L , Bica Eduardo , Santrich Orlando J Katime , Souza Stefano O , Parisi Maria C , Rocha João P
Published: June 2024

Photometric completeness affects the photometry of stars in crowded regions such as the cores of star clusters. Some analysis such as deriving the structural parameters of star clusters using radial density profile is heavily affected by photometric completeness and the classical techniques to map this completeness in a given field are very expensive computationally. In most surveys, for example, the large quantity of data makes it impracticable to estimate the completeness using the traditional method for the whole sample due to time and computational requirements. In this work, we present a new method that is significantly faster and results in similar completeness curves and maps as the traditional approach, providing a great first-step completeness estimator for a large sample of data. Using the completeness corrected data for each cluster we built radial density profiles improving significantly the inner portion of the profile; we also fitted the King model to them, determining the clusters’ structural parameters based on a more realistic cluster profile. In this preliminary analysis, we derived structural parameters for nine selected clusters covering a range of core radii (5–40 arcesc) and tidal radii (40–180 arcesc) and discuss how the photometric completeness affects the determination of these parameters when we count stars to trace the radial profile of a star cluster.
Modelling predicts a molecule-rich disc around the AGB star L2 Puppis
Authors: Van de Sande M , Walsh C , Danilovich T , De Ceuster F , Ceulemans T
Published: June 2024

The nearby oxygen-rich AGB star L$_2$  Pup hosts a well-studied nearly edge-on disc. To date, discs around AGB stars have not been chemically studied in detail. By combining a parametrization commonly used for protoplanetary discs and archival ALMA observations, we retrieved an updated density and temperature structure of this disc. This physical model was then used as input to the first chemical model of an AGB disc. The model shows that the physical structure of the disc has a large impact on its chemistry, with certain species showing large changes in column density relative to a radial outflow, indicating that chemistry could be used as a tracer of discs that cannot be directly imaged. Despite its oxygen-rich nature, the daughter species formed within the disc are surprisingly carbon-rich. Two chemical regimes can be distinguished: cosmic-ray induced chemistry in the midplane and photochemistry induced by the interstellar radiation field in the outer regions. Certain complex organic molecules are formed in the midplane. This occurs via gas-phase chemistry only, as the disc is too warm for dust-gas chemistry. The photochemistry in the outer regions leads to the efficient formation of (long) carbon-chains. The predictions of the model allow us to tentatively put the disc’s age $\lesssim 10^5$ yr. Additional observations are necessary to better constrain the physical structure of L$_2$ Pup’s disc and are essential to test the predictions made by the chemical model. Our exploratory work paves the way for a more general study of the chemistry of AGB discs.
The optical spectropolarimetric behaviour of a selection of high-energy blazars
Authors: Barnard Joleen , van Soelen B , Acharya S , Böttcher M , Britto R J , Cooper J , Buckley D A H , Martin-Carrillo A , Vaidya B , van der Westhuizen I P , Zacharias M
Published: June 2024

At optical/ultraviolet energies, blazars display an underlying thermal (unpolarized) contribution from the accretion disc, torus, and line-emitting regions, diluting the polarized emission from the jet-component. Optical polarimetry can be used to disentangle the thermal and non-thermal components, and place constraints on the particle populations and acceleration mechanisms responsible for the non-thermal emission. We present the results of a linear optical spectropolarimetric observing campaign of 18 blazars (six BL Lac-type objects and 12 flat-spectrum radio quasars) undertaken with the Southern African Large Telescope between 2016 and 2022. This was done to observe these systems during flaring states, as well as long-term monitoring of PKS1510-089, AP Lib, and PKS 1034-293. The observations traced the frequency dependence of the degree and angle of polarization, as well as changes in the spectral line strengths. We investigated possible correlations between the polarization and other observed characteristics for the sources. While an indication of correlation was found between the frequency dependence and the average level of polarization for some sources, a correlation was not found for the population as a whole. These results highlight that continuous observations and in-depth modelling of polarization and its frequency dependence is required to obtain a more holistic view of TeV blazars.
Phase-separated ParB enforces diverse DNA compaction modes and stabilizes the parS-centered partition complex
Authors: Zhao Yilin , Guo Lijuan , Hu Jiaojiao , Ren Zhiyun , Li Yanan , Hu Meng , Zhang Xia , Bi Lulu , Li Dan , Ma Hanhui , Liu Cong , Sun Bo
Published: June 2024

The tripartite ParABS system mediates chromosome segregation in the majority of bacterial species. Typically, DNA-bound ParB proteins around the parS sites condense the chromosomal DNA into a higher-order multimeric nucleoprotein complex for the ParA-driven partition. Despite extensive studies, the molecular mechanism underlying the dynamic assembly of the partition complex remains unclear. Herein, we demonstrate that Bacillus subtilis ParB (Spo0J), through the multimerization of its N-terminal domain, forms phase-separated condensates along a single DNA molecule, leading to the concurrent organization of DNA into a compact structure. Specifically, in addition to the co-condensation of ParB dimers with DNA, the engagement of well-established ParB condensates with DNA allows for the compression of adjacent DNA and the looping of distant DNA. Notably, the presence of CTP promotes the formation of condensates by a low amount of ParB at parS sites, triggering two-step DNA condensation. Remarkably, parS-centered ParB-DNA co-condensate constitutes a robust nucleoprotein architecture capable of withstanding disruptive forces of tens of piconewton. Overall, our findings unveil diverse modes of DNA compaction enabled by phase-separated ParB and offer new insights into the dynamic assembly and maintenance of the bacterial partition complex.
Reactions to a Nicotine Reduction Policy Among Adolescents Who Smoke: A Qualitative Study
Authors: Reed Grace L , Colby Suzanne M , DiLorenzo Jasminette , Totten Julia , Tidey Jennifer W , Cassidy Rachel N
Published: June 2024

Introduction

The Biden administration is pursuing a nicotine reduction policy in the United States to render cigarettes less addictive. In this study, we qualitatively investigated adolescents’ subjective responses to very low nicotine content (VLNC) cigarettes, reasons for incomplete adherence to using them, and their expected responses to a nicotine reduction policy.

Aims and Methods

Adolescents who smoke cigarettes daily (ages 15–19; N = 60) were enrolled in a 3-week double-blind randomized clinical trial and assigned to smoke either normal nicotine content or VLNC research cigarettes. Following the trial, 52 participants completed qualitative interviews about their reactions to the cigarettes and to the idea of a nicotine reduction policy. We utilized a template-style approach to thematic analysis involving immersion in the data, codebook development with both inductive and deductive codes, and iterative refinement of themes.

Results

Reasons for incomplete adherence to smoking only research cigarettes focused on dislike for cigarette taste and lower satisfaction compared to usual brand cigarettes. Negative evaluations of research cigarettes were common across both groups. Many participants in both groups reported that they would decrease their smoking or quit entirely if the research cigarettes were the only ones legally available for purchase in the United States.

Conclusions

Adolescents may respond to a cigarette nicotine reduction policy by decreasing their cigarette smoking and eventually quitting. These findings suggest a need for public health strategies to reduce smoking initiation and progression in young people and to encourage cessation in the context of a nicotine reduction policy.

Implications

Participants’ negative subjective responses and challenges with research on cigarette adherence offer insight into factors that might influence young people’s reactions to a real-world nicotine reduction policy. Adolescents who smoke may increase their use of alternative tobacco products, especially e-cigarettes, if this policy were implemented. Specifically, themes identified across participant responses highlight important considerations for how such a policy might be implemented with specific attention to the unique smoking behaviors and needs of this vulnerable population.
A Comprehensive Study of Light Quality Acclimation in Synechocystis Sp. PCC 6803
Authors: Zavřel Tomáš , Segečová Anna , Kovács László , Lukeš Martin , Novák Zoltán , Pohland Anne-Christin , Szabó Milán , Somogyi Boglárka , Prášil Ondřej , Červený Jan , Bernát Gábor
Published: June 2024

Cyanobacteria play a key role in primary production in both oceans and fresh waters and hold great potential for sustainable production of a large number of commodities. During their life, cyanobacteria cells need to acclimate to a multitude of challenges, including shifts in intensity and quality of incident light. Despite our increasing understanding of metabolic regulation under various light regimes, detailed insight into fitness advantages and limitations under shifting light quality remains underexplored. Here, we study photo-physiological acclimation in the cyanobacterium Synechocystis sp. PCC 6803 throughout the photosynthetically active radiation (PAR) range. Using light emitting diodes (LEDs) with qualitatively different narrow spectra, we describe wavelength dependence of light capture, electron transport and energy transduction to main cellular pools. In addition, we describe processes that fine-tune light capture, such as state transitions, or the efficiency of energy transfer from phycobilisomes to photosystems (PS). We show that growth was the most limited under blue light due to inefficient light harvesting, and that many cellular processes are tightly linked to the redox state of the plastoquinone (PQ) pool, which was the most reduced under red light. The PSI-to-PSII ratio was low under blue photons, however, it was not the main growth-limiting factor, since it was even more reduced under violet and near far-red lights, where Synechocystis grew faster compared to blue light. Our results provide insight into the spectral dependence of phototrophic growth and can provide the foundation for future studies of molecular mechanisms underlying light acclimation in cyanobacteria, leading to light optimization in controlled cultivations.
The SMXL8-AGL9 module mediates crosstalk between strigolactone and gibberellin to regulate strigolactone-induced anthocyanin biosynthesis in apple
Authors: An Jian-Ping , Zhao Lei , Cao Yun-Peng , Ai Di , Li Miao-Yi , You Chun-Xiang , Han Yuepeng
Published: June 2024

Although the strigolactone (SL) signaling pathway and SL-mediated anthocyanin biosynthesis have been reported, the molecular association between SL signaling and anthocyanin biosynthesis remains unclear. In this study, we identified the SL signal transduction pathway associated with anthocyanin biosynthesis and the crosstalk between gibberellin (GA) and SL signaling in apple (Malus × domestica). ELONGATED HYPOCOTYL5 (HY5) acts as a key node integrating SL signaling and anthocyanin biosynthesis, and the SL-response factor AGAMOUS-LIKE MADS-BOX9 (AGL9) promotes anthocyanin biosynthesis by activating HY5 transcription. The SL signaling repressor SUPPRESSOR OF MAX2 1-LIKE8 (SMXL8) interacts with AGL9 to form a complex that inhibits anthocyanin biosynthesis by downregulating HY5 expression. Moreover, the E3 ubiquitin ligase PROTEOLYSIS1 (PRT1) mediates the ubiquitination-mediated degradation of SMXL8, which is a key part of the SL signal transduction pathway associated with anthocyanin biosynthesis. In addition, the GA signaling repressor REPRESSOR-of-ga1-3-LIKE2a (RGL2a) mediates the crosstalk between GA and SL by disrupting the SMXL8-AGL9 interaction that represses HY5 transcription. Taken together, our study reveals the regulatory mechanism of SL-mediated anthocyanin biosynthesis and uncovers the role of SL-GA crosstalk in regulating anthocyanin biosynthesis in apple.
“You Will:” A Macroeconomic Analysis of Digital Advertising
Authors: Greenwood Jeremy , Ma Yueyuan , Yorukoglu Mehmet
Published: June 2024

An information-based model is developed where traditional and digital advertising finance the provision of free media goods and affect price competition. Digital advertising is directed toward specific consumers while traditional advertising is undirected. The equilibrium is suboptimal. Media goods, if valued by the consumer, are under provided with both types of advertising. Additionally, traditional advertising is excessive because it is undirected. The tax-cum-subsidy policy that overcomes these inefficiencies is characterized. The model is calibrated to the U.S. economy. Through the lens of the calibrated model, digital advertising increases welfare significantly. The welfare gain from the optimal policy is much smaller than the gain from digital advertising.
Different ectomycorrhizal fungal species impact poplar growth but not phosphorus utilization under low P supply
Authors: Shi Huili , Lipka Ulrike , Polle Andrea
Published: June 2024

Tree growth is often limited by phosphorus (P) availability. The trade-off between P homeostasis and growth is unknown. Ectomycorrhizal fungi (EMF) facilitate P availability but this trait varies among different fungal species and isolates. Here, we tested the hypotheses that (i) colonization with EMF boosts plant growth under P-limited conditions and that (ii) the poplars show P homeostasis because increased P uptake is used for growth and not for P accumulation in the tissues. We used two P treatments (high phosphate [HP]: 64 μM Pi, low phosphate [LP]: 0.64 μM Pi in the nutrient solution) and four fungal treatments (Paxillus involutus MAJ, Paxillus involutus NAU, Laccaria bicolor dikaryon LBD, Laccaria bicolor monokaryon LBM) in addition to non-inoculated poplar plants (NI) to measure growth, biomass, gas exchange and P contents. High phosphate (HP) stimulated growth compared with LP conditions. Poplars colonized with MAJ, NAU and NI showed higher growth and biomass production than those with LBD or LBM. Photosynthesis rates of poplars with lower biomass production were similar to or higher than those of plants with higher growth rates. The tissue concentrations of P were higher under HP than LP conditions and rarely affected by ectomycorrhizal colonization. Under LP, the plants produced 44% greater biomass per unit of P than under HP. At a given P supply, the tissue concentration was stable irrespective of the growth rate indicating P homeostasis. Laccaria bicolor caused growth inhibition, irrespective of P availability. These results suggest that in young poplars distinct species-specific ectomycorrhizal traits overshadowed potential growth benefits.
Bone marrow mesenchymal stem cell–derived exosomes effectively ameliorate the outcomes of rats with acute graft‐versus‐host disease
Authors: Wang Zhihong , Wei Hong , Li Yunfei , Chen Weimin , Lin Zhifeng , Lai Yiting , Ding Lingling , Zhang Leisheng , Zeng Huake
Published: June 2024

Mesenchymal stem cells (MSCs) reveal multifaceted immunoregulatory properties, which can be applied for diverse refractory and recurrent disease treatment including acute graft‐versus‐host disease (aGVHD). Distinguishing from MSCs with considerable challenges before clinical application, MSCs‐derived exosomes (MSC‐Exos) are cell‐free microvesicles with therapeutic ingredients and serve as advantageous alternatives for ameliorating the outcomes of aGVHD. MSC‐Exos were enriched and identified by western blotting analysis, NanoSight, and transmission electron microscopy (TEM). Bone marrow–derived MSCs (denoted as MSCs) and exosomes (denoted as MSC‐Exos) were infused into the aGVHD SD‐Wister rat model via tail vein, and variations in general growth and survival of rats were observed. The level of inflammatory factors in serum was quantized by enzyme‐linked immunosorbent assay (ELISA). The pathological conditions of the liver and intestine of rats were observed by frozen sectioning. The ratios of CD4+/CD8+ and Treg cell proportions in peripheral blood, together with the autophagy in the spleen and thymus, were analyzed by flow cytometry. After treatment with MSC‐Exos, the survival time of aGVHD rats was prolonged, the clinical manifestations of aGVHD in rats were improved, whereas the pathological damage of aGVHD in the liver and intestine was reduced. According to ELISA, we found that MSC‐Exos revealed ameliorative effect upon aGVHD inflammation (e.g., TNF‐α, IL‐2, INF‐γ, IL‐4, and TGF‐β) compared to the MSC group. After MSC‐Exo treatment, the ratio of Treg cells in peripheral blood was increased, whereas the ratio of CD4+/CD8+ in peripheral blood and the autophagy in the spleen and thymus was decreased. MSC‐Exos effectively suppressed the activation of immune cells and the manifestation of the inflammatory response in the aGVHD rat model. Our data would supply new references for MSC‐Exo‐based “cell‐free” biotherapy for aGVHD in future.
Single‐cell RNA sequencing reveals that NRF2 regulates vascular smooth muscle cell phenotypic switching in abdominal aortic aneurysm
Authors: Xiao Xiaoyong , Li Chenglin , Huang Xiaojia , Chen Guona , Huang Xiaoran , Song Feier , Zhou Yu , Liu Xincheng , Zhou Xueke , Meng Jinxiu , Bellou Abdelouahab , Zhong Lintao , Li Xin
Published: June 2024

Abdominal aortic aneurysm (AAA) is a life‐threatening disease characterized by extensive membrane destruction in the vascular wall that is closely associated with vascular smooth muscle cell (VSMC) phenotypic switching. A thorough understanding of the changes in regulatory factors during VSMC phenotypic switching is essential for managing AAA therapy. In this study, we revealed the impact of NRF2 on the modulation of VSMC phenotype and the development of AAA based on single‐cell RNA sequencing analysis. By utilizing a murine model of VSMC‐specific knockout of nuclear factor E2‐related factor 2 (NRF2), we observed that the absence of NRF2 in VSMCs exacerbated AAA formation in an angiotensin II‐induced AAA model. The downregulation of NRF2 promoted VSMC phenotypic switching, leading to an enhanced inflammatory response. Through genome‐wide transcriptome analysis and loss‐ or gain‐of‐function experiments, we discovered that NRF2 upregulated the expression of VSMC contractile phenotype‐specific genes by facilitating microRNA‐145 (miR‐145) expression. Our data identified NRF2 as a novel regulator involved in maintaining the VSMC contractile phenotype while also influencing AAA formation through an miR‐145‐dependent regulatory mechanism.
Clinical officers in Uganda
Authors: Schaefle Kenneth J. , Habimana Aloyse , Mhoza Gideon , Musominali Sam
Published: June 2024

The clinical role of a clinical officer in Uganda is very similar to that of a physician associate/assistant in the United States. This article describes the qualifications and workforce role of clinical officers in Uganda, as well as their use in two primary care programs that provide effective, low-cost medical care to a growing population with an increasing burden of chronic disease.
Pharmacologic interventions for primary glenohumeral osteoarthritis
Authors: Garcia Ausberto Velasquez , Martini Liborio Ingala , Abache Andres Franco
Published: June 2024

Primary glenohumeral osteoarthritis is a multifactorial condition with a complex cause that affects patients across different age groups, impairing physiologic and psychologic well-being, and substantially reducing patient quality of life and overall productivity. To effectively manage this condition, healthcare providers need to be well informed about treatment guidelines, as well as the available therapeutic options and the evidence supporting their use. Nonsurgical interventions should be regarded as the primary treatment option, particularly for patients in the initial phases of this condition. No conclusive guidelines exist for treating young and active patients, and the literature lacks high-quality data to evaluate the efficacy, safety, and long-term consequences of several interventions, regardless of patient characteristics and expectations.
Travel medicine updates for the NP
Authors: Turner Leah , Hamilton Emily
Published: June 2024

This article provides an overview of the approach to preparing patients for travel, including travel counseling and risk mitigation through vaccination and chemoprophylaxis. Although some patients require referral for consultation with a travel medicine specialist, others can be managed by their primary care provider. In this article, traveler's diarrhea, updated travel-related immunizations, and malaria prophylaxis are discussed.
International Consensus Statements on Intraoperative Testing for Cochlear Implantation Surgery
Authors: Alzhrani Farid , Aljazeeri Isra , Abdelsamad Yassin , Alsanosi Abdulrahman , Kim Ana H. , Ramos-Macias Angel , Ramos-de-Miguel Angel , Kurz Anja , Lorens Artur , Gantz Bruce , Buchman Craig A. , Távora-Vieira Dayse , Sprinzl Georg , Mertens Griet , Saunders James E. , Kosaner Julie , Telmesani Laila M. , Lassaletta Luis , Bance Manohar , Yousef Medhat , Holcomb Meredith A. , Adunka Oliver , Thomasen Per Cayé- , Skarzynski Piotr H. , Rajeswaran Ranjith , Briggs Robert J. , Oh Seung-Ha , Plontke Stefan , O’Leary Stephen J. , Agrawal Sumit , Yamasoba Tatsuya , Lenarz Thomas , Wesarg Thomas , Kutz Walter , Connolly Patrick , Anderson Ilona , Hagr Abdulrahman
Published: June 2024

Objectives:

A wide variety of intraoperative tests are available in cochlear implantation. However, no consensus exists on which tests constitute the minimum necessary battery. We assembled an international panel of clinical experts to develop, refine, and vote upon a set of core consensus statements.

Design:

A literature review was used to identify intraoperative tests currently used in the field and draft a set of provisional statements. For statement evaluation and refinement, we used a modified Delphi consensus panel structure. Multiple interactive rounds of voting, evaluation, and feedback were conducted to achieve convergence.

Results:

Twenty-nine provisional statements were included in the original draft. In the first voting round, consensus was reached on 15 statements. Of the 14 statements that did not reach consensus, 12 were revised based on feedback provided by the expert practitioners, and 2 were eliminated. In the second voting round, 10 of the 12 revised statements reached a consensus. The two statements which did not achieve consensus were further revised and subjected to a third voting round. However, both statements failed to achieve consensus in the third round. In addition, during the final revision, one more statement was decided to be deleted due to overlap with another modified statement.

Conclusions:

A final core set of 24 consensus statements was generated, covering wide areas of intraoperative testing during CI surgery. These statements may provide utility as evidence-based guidelines to improve quality and achieve uniformity of surgical practice.
Motor Examination of the Brachial Plexus
Authors: Pulos Nicholas , Bishop Allen T. , Spinner Robert J. , Shin Alexander Y.
Published: June 2024

Serial physical examination is often required in the evaluation of brachial plexus injuries. (Noland, 2019) A comprehensive evaluation that includes a thorough history, electrodiagnostic evaluation, and imaging studies, in addition to physical examination, can provide valuable information about the location of the lesion, prognosis for recovery, and whether surgical intervention is necessary. After brachial plexus reconstruction, physical examinations are also performed to document clinical improvement and identify any residual issues. The videos included in this clinical examination techniques section demonstrate the muscle strength examination testing for the brachial plexus and offer best practices for documentation.
De Quervain’s Tenosynovitis Release With Excision of the First Dorsal Compartment: Novel Surgical Technique and a Case Series
Authors: Margalit Adam , Bookman Jared , Aversano Michael , Guss Michael , Ayalon Omri , Paksima Nader
Published: June 2024

Incision of the dorsal side of the tendon sheath in release of De Quervain’s tenosynovitis has traditionally been advocated to prevent the risk of volar tendon subluxation. We describe a novel technique of complete excision, rather than simple incision, of the first dorsal compartment tendon sheath. Over a 10-year period, 147 patients (154 wrists) underwent first dorsal compartment release using this technique of complete excision of the sheath. No postoperative immobilization is used. Patients were followed for a mean of 7.0 months. Records were assessed for any complications including reoperation, tendon subluxation, recurrence, wound complications, scar tenderness, and superficial radial sensory nerve paresthesias. There were no cases of recurrence, reoperation, or tendon subluxation after release with this technique. Postoperatively, 7 (4.5%) patients had scar tenderness and 5 (3.2%) of these patients also had superficial radial sensory nerve parasthesias, which all resolved at the time of final follow-up. Mean range of motion was 73±11 degrees of flexion and 69±10 degrees of extension. In contrast to simple incision, we propose that this technique provides a more complete release of the compartment without risk of symptomatic subluxation or bowstringing and provides a complete release of a separate extensor pollicis brevis subsheath or any concomitant retinacular cysts associated with the tendonitis. There is an immediate removal of the symptomatic swelling and visible, painful bump associated with the thickened retinaculum with this technique. Furthermore, no immobilization is required after surgery.
Ligament Suspensionplasty With Suture Tape Augmentation​ for Basal Thumb Arthritis
Authors: Shen Victor , Kuruvilla Davis , Ladehoff Lauren , Talsania Alec , Talsania Jay
Published: June 2024

Thumb carpometacarpal arthritis is common with aging, more common in women than men, and usually occurs after age 40. If a patient fails conservative treatments such as splinting, medications, and corticosteroid injections, then surgical intervention may be appropriate. Currently, there is no consensus on the best surgical treatment. By limiting metacarpal subsidence, ligament suspensionplasty with suture tape augmentation offers great pain relief, excellent functional outcomes, and limited postoperative immobilization. With this technique, trapeziectomy is first performed. A portion of the abductor pollicis longus tendon is resected and loaded onto the SwiveLock anchor using 4-0 FiberLoop, in addition to suture tape. The prepared graft and tape construct is anchored into the lateral first metacarpal (MC) base and index metacarpal base. After surgery, patients are put in a short arm thumb spica splint, interphalangeal (IP) joints free. Active motion is initiated at the first postoperative visit, usually within 1 week. All patients who had thumb arthritis treated with carpometacarpal suspensionplasty and suture tape augmentation between 2015 and 2022 by a single hand surgeon at our institution were queried. A total of 110 patients were invited to take part in this study, and 61 patients consented and were included in this study. Mean last in-office follow up was at 7.5±4.0 months, which showed significant improvements in pinch strength (P=0.011). A survey taken at a mean 2.8±1.3 years (range: 0.5 to 5.2 y) after surgery reports a postoperative DASH score of 7.3±7.7 (range: 0 to 23.3), and VAS pain score of 0.7±1.1 (range: 0 to 5).
“We Wanna Be Nurses Because We Want the Human Connection”
Authors: Coats Heather , Shive Nadia , Adrian Bonnie , Doorenbos Ardith Z. , Schmiege Sarah J.
Published: June 2024

The use of narrative interventions in health care is an effective way to communicate connection between patients and clinicians. The electronic health record (EHR) is a primary mode of communicating patient information across clinical teams. Thus, incorporating a person-centered cocreated narrative with patients into the EHR is an opportunity to share a person's cultural values, beliefs, and preferences; provide connection; and foster positive patient-clinician interactions. This study of a person-centered narrative intervention was a randomized controlled trial to test intervention effects on the person's (patient) perceptions of the quality of communication with their nurses and their psychosocial and existential well-being. This article describes the clinical team's experiences and reach of the cocreated person-centered narrative integration into the patient's EHR. The data collected included (1) exit interviews (n = 14), (2) a usability survey (n = 8), and (3) data collected from the EHR for clinicians (n = 600) who accessed the uploaded narratives. Overall, the System Usability Scale and nurse participant's experiences provided confirmation that the person-centered narrative intervention was usable. There were also interprofessional groups of clinicians in the health care system who accessed the narratives. Future research should continue to identify core components and implementation strategies of EHR-integrated person-centered narratives in complex health care settings.
Comparison of Weighting Methods to Understand Improved Outcomes Attributable to Public Health Nursing Interventions
Authors: Huling Jared D. , Austin Robin R. , Lu Sheng-Chieh , Mathiason Michelle A. , Pirsch Anna M. , Monsen Karen A.
Published: June 2024

Background

The complex work of public health nurses (PHNs) specifically related to mental health assessment, intervention, and outcomes makes it difficult to quantify and evaluate the improvement in client outcomes attributable to their interventions.

Objectives

We examined heterogeneity across parents of infants served by PHNs receiving different interventions, compared the ability of traditional propensity scoring methods versus energy-balancing weight (EBW) techniques to adjust for the complex and stark differences in baseline characteristics among those receiving different interventions, and evaluated the causal effects of the quantity and variety of PHN interventions on client health and social outcomes.

Methods

This retrospective study of 4,109 clients used existing Omaha System data generated during the routine documentation of PHN home visit data. We estimated the effects of intervention by computing and comparing weighted averages of the outcomes within the different treatment groups using two weighting methods: (a) inverse probability of treatment (propensity score) weighting and (b) EBWs.

Results

Clients served by PHNs differed in baseline characteristics with clients with more signs/symptoms. Both weighting methods reduced heterogeneity in the sample. EBWs were more effective than inverse probability of treatment weighting in adjusting for multifaceted confounding and resulted in close balance of 105 baseline characteristics. Weighting the sample changed outcome patterns, especially when using EBWs. Clients who received more PHN interventions and a wider variety of them had improved knowledge, behavior, and status outcomes with no plateau over time, whereas the unweighted sample showed plateaus in outcomes over the course of home-visiting services.

Discussion

Causal analysis of PHN-generated data demonstrated PHN intervention effectiveness for clients with mental health signs/symptoms. EBWs are a promising tool for evaluating the true causal effect of PHN home-visiting interventions.
Physical Heart Failure Symptom Clusters Predictive of Delay in Seeking Treatment
Authors: Sethares Kristen A. , Jurgens Corrine Y. , Vieira Mary-Beth
Published: June 2024

Background

Recent research has focused on the relationship between heart failure (HF) symptom clusters and outcomes, including mortality, hospitalization, functional status, and quality of life. No known studies to date have explored the role of physical HF symptom clusters and delays in seeking treatment.

Objectives

Describe physical symptom clusters in a population of HF patients and determine if a specific cluster is predictive of delay in seeking treatment for HF symptoms.

Method

We analyzed combined data from two studies (n = 406) collected during acute HF hospitalization. The Heart Failure Somatic Awareness Scale quantified physical HF symptoms. Delay, measured in days, was collected from the medical record and confirmed by interview. Hierarchical agglomerative clustering techniques determined physical HF symptom clusters. Hierarchical multiple regression analysis was computed to explore predictors of delay.

Results

Participants were primarily White, male sex older adults. Three physical HF symptom clusters were identified: discordant, edema-related, and dyspnea-related symptoms. Hierarchical multiple regression analysis revealed in Step 1 that age was a significant predictor of delay.

Discussion

Our findings provide valuable insight into the role of physical symptom clusters on delay in persons with HF. Through agglomerative hierarchical clustering techniques, we found three physical HF symptom clusters that were then used to determine differences in cluster membership by demographic and clinical variables. Significant age differences were noted by cluster membership with youngest older adults in a discordant symptom cluster.
Risk Controls Identified in Action Plans Following Serious Incident Investigations in Secondary Care: A Qualitative Study
Authors: Peerally Mohammad Farhad , Carr Susan , Waring Justin , Martin Graham , Dixon-Woods Mary
Published: June 2024

Objectives

The impact of incident investigations in improving patient safety may be linked to the quality of risk controls recommended in investigation reports. We aimed to identify the range and apparent strength of risk controls generated from investigations into serious incidents, map them against contributory factors identified in investigation reports, and characterize the nature of the risk controls proposed.

Methods

We undertook a content analysis of 126 action plans of serious incident investigation reports from a multisite and multispeciality UK hospital over a 3-year period to identify the risk controls proposed. We coded each risk control against the contributory factor it aimed to address. Using a hierarchy of risk controls model, we assessed the strength of proposed risk controls. We used thematic analysis to characterize the nature of proposed risk controls.

Results

A substantial proportion (15%) of factors identified in investigation reports as contributing to serious incidents were not addressed by identifiable risk controls. Of the 822 proposed risk controls in action plans, most (74%) were assessed as weak, typically focusing on individualized interventions—even when the problems were organizational or systemic in character. The following 6 broad approaches to risk controls could be identified: improving individual or team performance; defining, standardizing, or reinforcing expected practice; improving the working environment; improving communication; process improvements; and disciplinary actions.

Conclusions

The identified shortfalls in the quality of risk controls following serious incident investigations—including a 15% mismatch between contributory factors and aligned risk controls and 74% of proposed risk controls centering on weaker interventions—represent significant gaps in translating incident investigations into meaningful systemic improvements. Advancing the quality of risk controls after serious incident investigations will require involvement of human factors specialists in their design, a theory-of-change approach, evaluation, and curation and sharing of learning, all supported by a common framework.
Design of PEG-based hydrogels as soft ionic conductors
Authors: Rodriguez-Rivera Gabriel J. , Xu Fei , Laude Madeline , Shah Vani , Nkansah Abbey , Bashe Derek , Lan Ziyang , Chwatko Malgorzata , Cosgriff-Hernandez Elizabeth
Published: June 2024

Conductive hydrogels have gained interest in biomedical applications and soft electronics. To tackle the challenge of ionic hydrogels falling short of desired mechanical properties in previous studies, our investigation aimed to understand the pivotal structural factors that impact the conductivity and mechanical behavior of polyethylene glycol (PEG)-based hydrogels with ionic conductivity. Polyether urethane diacrylamide (PEUDAm), a functionalized long-chain macromer based on PEG, was used to synthesize hydrogels with ionic conductivity conferred by incorporating ions into the liquid phase of hydrogel. The impact of salt concentration, water content, temperature, and gel formation on both mechanical properties and conductivity was characterized to establish parameters for tuning hydrogel properties. To further expand the range of conductivity available in these ionic hydrogels, 2-acrylamido-2-methyl-1-propanesulfonic acid (AMPS) was incorporated as a single copolymer network or double network configuration. As expected, conductivity in these ionic gels was primarily driven by ion diffusivity and charge density, which was dependent on hydrogel network formation and swelling. Copolymer network structure had minimal effect on the conductivity which was primarily driven by counter-ion equilibrium; however, the mechanical properties and equilibrium swelling was strongly dependent on network structure. The structure-property relationships elucidated here enables the rationale design of this new double network hydrogel to achieve target properties for a broad range of applications.
Bidirectional modulation of negative emotional states by parallel genetically-distinct basolateral amygdala pathways to ventral striatum subregions
Authors: Sniffen Sarah E. , Ryu Sang Eun , Kokoska Milayna M. , Bhattarai Janardhan , Wang Yingqi , Thomas Ellyse R. , Skates Graylin M. , Johnson Natalie L. , Chavez Andy A. , Iaconis Sophia R. , Janke Emma , Ma Minghong , Wesson Daniel W.
Published: June 2024

Distinct basolateral amygdala (BLA) cell populations influence emotional responses in manners thought important for anxiety and anxiety disorders. The BLA contains numerous cell types which can broadcast information into structures that may elicit changes in emotional states and behaviors. BLA excitatory neurons can be divided into two main classes, one of which expressesPpp1r1b(encoding protein phosphatase 1 regulatory inhibitor subunit 1B) which is downstream of the genes encoding the D1 and D2 dopamine receptors (drd1anddrd2respectively). The role ofdrd1+ordrd2+BLA neurons in learned and unlearned emotional responses is unknown. Here, we identified that thedrd1+ anddrd2+ BLA neuron populations form two parallel pathways for communication with the ventral striatum. These neurons arise from the basal nucleus of the BLA, innervate the entire space of the ventral striatum, and are capable of exciting ventral striatum neurons. Further, through three separate behavioral assays, we found that thedrd1+ anddrd2+ parallel pathways bidirectionally influence both learned and unlearned emotional states when they are activated or suppressed, and do so depending upon where they synapse in the ventral striatum – with unique contributions ofdrd1+ anddrd2+ circuitry on negative emotional states. Overall, these results contribute to a model whereby parallel, genetically-distinct BLA to ventral striatum circuits inform emotional states in a projection-specific manner.