bluuebunny/crossref_metadata_2025 huggingface dataset:
Managing Esca in Susceptible ‘Sauvignon Blanc’ Wine Grapes Through Trunk Renewal
Authors: Baumgartner Kendra , Luna Israel , Rumbaugh Arran
Published: May 2024

Trunk renewal was evaluated as a treatment for highly susceptible ‘Sauvignon blanc’ wine grapes with moderate leaf and wood symptoms of the trunk disease Esca in a 17-year-old vineyard 7 years after symptoms first appeared. The trunk was cut above the graft union, removing all woody parts of the vine above it, including infected wood. A new trunk was retrained from a shoot off presumably healthy wood at the base of the trunk. Prior to trunk renewal, we detected Esca pathogens from 26% of 97 symptomatic vines. Five years after trunk renewal, 72 retrained vines were still asymptomatic, 24 were replanted (i.e., did not produce a shoot after trunk renewal), and one had leaf and fruit symptoms. Chemical composition of asymptomatic fruit from asymptomatic-retrained vines (RV-AF) was compared to that of vines that were not retrained, the latter of which included asymptomatic fruit from asymptomatic vines (AV-AF) and both asymptomatic fruit (SV-AF) and symptomatic fruit (SV-SF) from the same symptomatic vines. Given the high proportion of asymptomatic retrained vines after five growing seasons, trunk renewal was an effective cultural practice. Although there were no differences in chemistry parameters used to make harvest decisions (total soluble solids, pH, and titratable acidity), SV-SF was unique in having the highest concentrations of the flavonoids catechin and epicatechin and the lowest concentrations of the volatile-aroma compounds hexanal and 2-hexanal. These findings in all three blocks among fruit with visible spots may reflect a host-defense response and/or the effect of Esca on fruit ripening.
Retained Tampon Fragment as an Unusual Cause of Vesicovaginal Fistula
Authors: Seitz Vienne , Davidson Emily R. W.
Published: May 2024

BACKGROUND:

Vesicovaginal fistula (VVF) is an uncommon cause of urinary incontinence (UI). Iatrogenic etiologies, especially abdominal hysterectomy, are most common; however, a minority of VVFs are caused by retained foreign bodies. Objects associated with VVF include intrauterine devices, gauze, pessaries, bottle caps, and sexual aids, but retained tampons or other menstrual products have not been commonly reported.

CASE:

We present the case of a 53-year-old woman, gravida 0, with no prior pelvic surgery, with 2 months of intermittent UI and hematuria. Although initial diagnostic test results were negative, cystoscopy and vaginoscopy eventually confirmed the diagnosis of VVF associated with a retained foreign body. In the operating room, all debris was removed using vaginoscopy, and the VVF was repaired using a modified Latzko technique. At the patient’s 9-week follow-up appointment, she was found to have complete healing of the VVF and resolution of associated symptoms.

CONCLUSION:

This is a case of VVF secondary to a retained tampon fragment. In addition to this uncommon etiology, our patient's presenting symptoms were atypical, leading to a delay in diagnosis and treatment for which vaginoscopy was critical.
How Much Improvement in Oswestry Disability Index is Necessary to Make Your Patient Satisfied After Lumbar Surgery?
Authors: Hambrecht Jan , Köhli Paul , Chiapparelli Erika , Amoroso Krizia , Zhu Jiaqi , Lan Ranqing , Guven Ali E. , Evangelisti Gisberto , Burkhard Marco D. , Tsuchiya Koki , Duculan Roland , Shue Jennifer , Sama Andrew A. , Cammisa Frank P. , Girardi Federico P. , Mancuso Carol A. , Hughes Alexander P.
Published: May 2024

Study Design.

Retrospective review of cohort studies.

Objective.

To clarify the necessary Oswestry Disability Index (ODI) improvement for patient satisfaction 2 years after lumbar surgery.

Background.

Evaluating elective lumbar surgery care often involves patient-reported outcomes. While postoperative functional improvement measured by ODI is theoretically linked to satisfaction, conflicting evidence exists regarding this association.

Material and Methods.

Baseline ODI and 2-year postoperative ODI were assessed. Patient satisfaction, measured on a scale from 1 to 5, with scores ≥4 considered satisfactory, was evaluated. Patients with incomplete follow-up were excluded. Statistical analyses included Mann-Whitney U and multivariable logistic regression adjusted for age, sex, and body mass index. Receiver operating characteristic analysis determined threshold values for ODI improvement and postoperative target ODI indicative of patient satisfaction.

Results.

A total of 383 patients were included (mean age: 65 ± 10 y, 57% females). ODI improvement was observed in 91% of patients, with 77% reporting satisfaction scores ≥4. Baseline ODI (median: 62, interquartile range: 46–74) improved to a median of 10 (interquartile range: 1–10) 2 years postoperatively. Baseline [odds ratio (OR): 0.98, P = 0.015] and postoperative ODI scores (OR: 0.93, P < 0.001), as well as the difference between them (OR: 1.04, P < 0.001), were significantly associated with patient satisfaction. Improvement of ≥38 ODI points or a relative change of ≥66% was indicative of patient satisfaction, with higher sensitivity (80%) and specificity (82%) for the relative change versus the absolute change (69%, 68%). With a sensitivity of 85% and a specificity of 77%, a postoperative target ODI of ≤24 indicated patient satisfaction.

Conclusion.

Lower baseline ODI and greater improvements in postoperative ODI are associated with an increased likelihood of patient satisfaction. A relative improvement of ≥66% or achieving a postoperative ODI score of ≤24 were the most indicative thresholds for predicting patient satisfaction, proving more sensitivity and specificity than an absolute change of ≥38 points.
Establishing a Benchmark for Iatrogenic Hemodilution and Blood Transfusion in Long-Segment Spine Fusion Surgery
Authors: Twitchell Spencer , Findlay Matthew C. , Nelson Jayson , Sherrod Brandon A. , Menacho Sarah T. , Dorsey David , Dailey Andrew T. , Mazur Marcus D.
Published: May 2024

Study Design.

Single-center retrospective cohort study.

Objective.

To identify risk factors for transfusion during long-segment thoracolumbar fusion surgery and benchmark cutoffs that could be used by the operative team to guide the use of transfusion.

Summary of Background Data.

Perioperative transfusion for patients undergoing long-segment thoracolumbar fusion surgery is common. To date, no standardized intraoperative and perioperative management of transfusion administration has been defined.

Methods.

Patients who underwent thoracolumbar fusion surgeries of 8 or more levels between 2015 and 2020 were identified. Patient demographics, surgical details, anesthesia and critical care records, and laboratory data were compared between patients who received intraoperative and postoperative blood transfusions and those who did not. Univariate and multivariate propensity-matched analyses were performed to identify independent predictors for blood transfusion, and ordinal analysis was performed to identify possible benchmark cutoffs.

Results.

Among 233 patients identified who underwent long-segment fusions, 133 (57.1%) received a blood transfusion. Multivariate propensity-matched logistic regression showed that intravenous (IV) fluid volume was an independent predictor for transfusion (transfusion group 8051 mL vs. non-transfusion group 5070 mL, P<0.01). Patients who received ≥4 L total IV fluids were more likely to undergo transfusion than those who received <4 L (93.2% vs. 50.7%, P<0.01). Those receiving total IV fluids at a rate ≥60 mL/kg (OR 10.45; 95% CI, 2.62–41.72; P<0.01) or intraoperative IV fluids at a rate ≥9 mL/kg/hr (OR 4.46; 95% CI, 1.39–14.32; P<0.01) were more likely to require transfusions.

Conclusions.

IV fluid administration is an independent predictor for blood transfusion after long-segment fusion surgery. Limiting IV fluid administration may prevent iatrogenic hemodilution and decrease transfusion rates. These data can be used to create perioperative protocols with the goal of decreasing transfusion rates when not indicated and allowing earlier administration when indicated.
A Study on the Epidemiology of COVID-19–Related Guillain–Barré Syndrome in the United States
Authors: Sharma Aditya , Sharma Aditi , Soubani Ayman O.
Published: May 2024

Introduction:

Several neurological complications have been reported with COVID-19, including Guillain–Barré syndrome (GBS). We looked at incidence, baseline characteristics, and in-hospital outcomes of COVID-19–associated GBS in the United States.

Study design and methods:

We conducted a retrospective analysis using the US National Inpatient Sample database to identify hospitalizations for COVID-19 and GBS, using International Classification of Disease, 10th Revision, codes G610 and G650 for GBS and U071 for COVID-19. The codes used in this study are listed in Supplemental Digital Content 1 (see e Appendix, http://links.lww.com/JCND/A69).

Results:

In total, 13,705 GBS admissions were recorded nationwide in 2020; of these, 1155 (8.43%) were associated with COVID-19. The frequency of GBS in COVID-19 admissions was 0.07%, compared with 0.08% in non–COVID-19 admissions (P = 0.8166). COVID-19 cohort with GBS had higher utilization of invasive mechanical ventilation (20.8% vs. 11.8%, P < 0.001) in comparison with COVID-19 cohort without GBS. GBS admissions with COVID-19 exhibited significantly higher inpatient mortality (12.2% vs. 3%, P < 0.001) compared with GBS admissions without COVID-19.

Interpretation:

Our findings underscore GBS as a rare yet severe complication of COVID-19, highlighting a significant difference in mortality when compared with GBS not associated with COVID-19.
Representativeness of Participants in the ACCORD Trial Compared to Middle-aged and Older Adults Living with Diabetes in the United States
Authors: Ikesu Ryo , Wu Yingyan , Zimmerman Scott C. , Inoue Kosuke , Buto Peter , Power Melinda C. , Schaefer Catherine A. , Glymour M. Maria , Mayeda Elizabeth Rose
Published: May 2024

Background:

We evaluated whether participants in the landmark Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial represent US adults aged ≥40 with diabetes.

Methods:

Using the nationally representative 2017–2020 prepandemic National Health and Nutrition Examination Survey data, we made operational definitions of ACCORD eligibility criteria. We calculated the percentage of individuals aged ≥40 with diabetes and HbA1c ≥ 6.0% or ≥ 7.5% who met operational ACCORD eligibility criteria.

Results:

Applying survey sampling weights to 715 National Health and Nutrition Examination Survey participants aged ≥40 with diabetes and HbA1c ≥ 6.0% (representing 29,717,406 individuals), 12% (95% confidence interval [CI] = 8%, 18%) met the operational ACCORD eligibility criteria. Restricting to HbA1c ≥ 7.5%, 39% (95% CI = 28%, 51%) of respondents met the operational ACCORD eligibility criteria.

Conclusions:

ACCORD represented a minority of US middle-aged and older adults with diabetes. Given the differential risk profile between ACCORD participants and the general population with diabetes, extrapolating the trial findings may not be appropriate.
Prognosis and assessment of the predictive value of severity scores in paediatric abdominal trauma
Authors: Hanna Sidonie , Montmayeur Juliette , Vergnaud Estelle , Orliaguet Gilles
Published: May 2024

BACKGROUND

Paediatric closed abdominal trauma is common, however, its severity and influence on survival are difficult to determine. No prognostic score integrating abdominal involvement exists to date in paediatrics.

OBJECTIVES

To evaluate the severity and short-term and medium-term prognosis of closed abdominal trauma in children, and the performance of severity scores in predicting mortality.

DESIGN

Retrospective, cohort, observational study.

SETTING AND PARTICIPANTS

Patients aged 0 to 18 years presenting at the trauma room of a French paediatric Level I Trauma Centre over the period 2015 to 2019 with an isolated closed abdominal trauma or as part of a polytrauma.

MAIN OUTCOMES

Primary outcome was the six months mortality. Secondary outcomes were related complications and therapeutic interventions, and performance for predicting mortality of the scores listed. Paediatric Trauma Score (PTS), Revised Trauma Score (RTS), Shock Index Paediatric Age-adjusted (SIPA) score, Reverse shock index multiplied by Glasgow Coma Scale score (rSIG), Base Deficit, International Normalised Ratio, and Glasgow Coma Scale (BIG), Injury Severity Score (ISS) and Trauma Score and the Injury Severity (TRISS) score.

DATA COLLECTION

Data collected include clinical, biological and CT scan data at admission, first 24 h management and prognosis. The PTS, RTS, SIPA, rSIG, BIG and ISS scores were calculated and mortality was predicted according to BIG score and TRISS methodology.

RESULTS

Of 1145 patients, 149 met the inclusion criteria and 12 (8.1%) died. Of the 12 deceased patients, 11 (91.7%) presented with severe head injury, 11 (91.7%) had blood products transfusion and 7 received tranexamic acid. ROC curves analysis concluded that PTS, RTS, rSIG and BIG scores accurately predict mortality in paediatric closed abdominal trauma with AUCs at least 0.92. The BIG score offered the best predictive performance for predicting mortality at a threshold of 24.8 [sensitivity 90%, specificity 92%, negative-predictive value (NPV) 99%, area under the curve (AUC) 0.93].

CONCLUSION

PEVALPED is the first French study to evaluate the prognosis of paediatric closed abdominal trauma. The use of PTS, rSIG and BIG scores are relevant from the acute phase and the pathophysiological interest and accuracy of the BIG score make it a powerful tool for predicting mortality of closed abdominal trauma in children.
Peripapillary Retinoschisis in Glaucoma: A Systematic Review
Authors: Almeida Maria Carolina , Ribeiro Margarida , Barbosa-Breda João
Published: May 2024

Précis:

Peripapillary retinoschisis (PPRS) may bias optical coherence tomography’s (OCT) monitoring of glaucoma progression. Its impact on glaucoma still remains uncertain. Only 2 out of the 10 included studies illustrated a correlation between PPRS and glaucoma progression.

Objectives:

The frequent use of OCT increased the detection of PPRS, which poses challenges in the follow-up of patients with glaucoma. This systematic review aims to summarize the literature regarding PPRS in glaucoma, exploring its prevalence, impact on disease, and clinical management implications.

Methods:

We searched PubMed, Embase, Web of Science, and Scopus with tailored search queries for each platform. All studies had to report PPRS in patients with glaucoma. Exclusion criteria included studies with <10 eyes, studies focusing on schisis outside the disc area, with concomitant retinal or optic nerve lesions, with animals, reviews, studies written in non-English language, and congress abstracts.

Results:

Ten studies were included, of which 7 were case-control, one was a cohort study, and 2 were case series.

Six studies showed that PPRS often overlapped preexisting retinal nerve fiber layer defects. One study reported that the de novo development of PPRS was more frequent in eyes with glaucoma progression than in eyes without progression.

Visual field findings were inconsistent, with just one study (out of 6) showing that patients with glaucoma with PPRS experienced faster visual field deterioration than those without it. Overall, solely 2 studies (out of 7) associated PPRS with faster glaucoma progression.

Conclusions:

PPRS biases OCT analysis in glaucoma. Caution is needed against overestimation of retinal nerve fiber layer thickness when PPRS develops and misinterpretation of its resolution as rapid progression. PPRS’ exact impact on glaucoma progression remains unclear.
An Unusual Case of an Intradiploic Arachnoid Cyst of the Orbit
Authors: Ortiz-Perez Santiago , Zamorano-Martín Francisco , Maciag Ewa , Enseñat Joaquim
Published: May 2024

This study reported a case of an arachnoid cyst of the sphenoid bone causing orbital signs and symptoms in a 58-year-old man with progressive proptosis and nonspecific discomfort in the OS. Orbital MRI showed a 3-cm homogeneous cyst within the left greater wing of the sphenoid bone. To the best of our knowledge, this is the first report of an intradiploic arachnoid cyst in the sphenoid bone with atypical radiological features, causing clinical symptoms, and managed through an eyelid approach, achieving a complete resolution with no complications.
Microbiome of the External Auditory Canal: Changes After Long-Term Hearing Aid Use
Authors: Sjövall Atte , Mustanoja Ella , Lyyski Annina , Auvinen Petri , Silvola Juha , Aarnisalo Antti , Pätäri-Sampo Anu , Laulajainen-Hongisto Anu
Published: May 2024

Objective

To investigate the microbial changes of long-term hearing aid use culture independently.

Study design

Cross-sectional study.

Patients

Fifty long-term hearing aid users and 80 volunteer controls with asymptomatic ears.

Intervention

External auditory canal (EAC) sampling with DNA-free swabs.

Main Outcome Measures

Microbial communities in the samples were investigated with amplicon sequencing of the 16S rRNA gene.

Results

The final analysis contained 48 hearing aid users, 59 controls. Twenty-four samples were excluded because of low sequence count, recent use of antimicrobials and/or corticosteroids, recent cold, or missing health status. The groups showed significant differences in bacterial diversity (beta div., p = 0.011), and hearing aid users showed lower species richness than the control group (alpha div., p < 0.01). The most frequent findings in both groups were Staphylococcus auricularis, Alloiococcus otitis, Cutibacterium acnes, Corynebacterium otitidis, and Staphylococcus unclassified sp. Hearing aid users' samples presented more Corynebacterium tuberculostearicum than the control samples. Common EAC pathogens, such as Staphylococcus aureus or Pseudomonas aeruginosa were rare.

Conclusion

Long-term hearing aid use lowers bacterial diversity and modulates the EAC microbiome. The changes mostly affect commensals. Lowered diversity may predispose individuals to EAC conditions and needs more research.
Does enteral nutrition require continuity of management: a randomized controlled study
Authors: Du Jinlei , Wu Xiaoling , Liu Yan , Lei Ling , Zhao Hongxiang , Chen Yao , Nie Chencong
Published: May 2024

Objective:

To explore a set of enteral nutrition therapy continuity management programs for intensive care unit patients based on the theoretical study of circadian rhythm mechanism.

Methods:

The control group followed routine nursing management. Patients in the experimental group were implemented with an enteral nutrition continuity management program, and their eating behavior was adjusted 3 days before the end of tube feeding. Food intake was intermittent at 2, 3, and 4 h on the first day, the second day, and the third day of intervention, respectively, and all patients stopped eating at night. Abdominal distension assessment, appetite assessment, application of gastric motility drugs, and patient satisfaction were compared between the two groups after tube feeding.

Results:

Three days after the end of tube feeding, abdominal distention assessment, bowel sound auscultation, and appetite assessment were statistically different (P<0.05) between the two groups. There were differences in the first day (15 vs. 6, P<0.05), the second day (9 vs. 3, P<0.05), and the cumulative number (17 vs. 7, P<0.05) of gastrointestinal drugs, but no differences in the third day (2 vs. 1, P>0.05). There was a statistical difference in nursing intervention (6.0 vs. 7.0, P<0.05) and psychological nursing (6.0 vs. 7.0, P<0.05), but no statistical difference in health education, medical environment, and nursing attitude (P>0.05).

Conclusion:

Enteral nutrition continuity management program has a good preventive effect on the gastrointestinal symptoms of intensive care unit patients after the end of tube feeding.
Safety and efficacy of resmetirom in the treatment of patients with non-alcoholic steatohepatitis and liver fibrosis: a systematic review and meta-analysis
Authors: Raja Adarsh , Subhash Sagar Raja , Saeed Sadia , Zia ul haq Amna , Khan Owais , Dileep Bhimani Parshant , Raja Sandesh , Deepak Fnu , Ahmed Muhammad , Ashir Shafique Muhammad , Saqlain Mustafa Muhammad , Sohaib Asghar Muhammad , Sharma Varsha
Published: May 2024

Introduction:

Non-alcoholic fatty liver disease (NAFLD), spanning from non-alcoholic steatohepatitis (NASH) to liver fibrosis, poses a global health challenge amid rising obesity and metabolic syndrome rates. Effective pharmacological treatments for NASH and liver fibrosis are limited.

Objective:

This study systematically reviews and meta-analyzes the safety and efficacy of resmetirom, a selective thyroid hormone receptor-β agonist, in NASH and liver fibrosis treatment. By analyzing data from clinical trials, we aim to offer evidence-based recommendations for resmetirom’s use in managing these conditions and identify avenues for future research.

Methods:

Electronic databases (PubMed, Scopus, Science Direct, Google Scholar, ClinicalTrials.gov, and Cochrane CENTRAL) were systematically searched, supplemented by manual screening of relevant sources. Only English-language randomized controlled trials were included. Data extraction, risk of bias assessment, pooled analyses, and meta-regression were performed.

Results:

Three randomized controlled trials involving 2231 participants were analyzed. Resmetirom demonstrated significant reductions in hepatic fat fraction [standardized mean difference (SMD) −4.61, 95% CI −6.77 to −2.44, P < 0.0001], NASH resolution without worsening fibrosis [risk ratio (RR) 2.51, 95% CI 1.74–3.64, P = 0.00001), and liver fibrosis improvement (RR 2.31, 95% CI 1.20–4.44, P = 0.01). Secondary outcomes showed significant improvements in lipid profiles, liver enzymes, and NASH biomarkers with resmetirom treatment. Meta-regression revealed associations between covariates and primary outcomes.

Conclusion:

Resmetirom exhibits promising efficacy in reducing hepatic fat, improving NASH resolution, and ameliorating liver fibrosis with a favorable safety profile. Further research is warranted to validate findings and optimize therapeutic strategies for NASH and liver fibrosis management.
Detection of Adverse Events With the Austrian Inpatient Quality Indicators
Authors: Schmied Marten , Buchberger Wolfgang , Perkhofer Dieter , Kvitsaridze Irma , Brunner Wolfgang , Kapferer Oliver , Siebert Uwe
Published: May 2024

Objectives

Indicators based on routine data are considered a readily available and cost-effective method for assessing health care quality and safety. The Austrian Inpatient Quality Indicators (A-IQI) have been introduced in all Austrian public hospitals as a mandatory quality measurement. The purpose of this study was to assess the value of conspicuous A-IQI in predicting the presence of adverse events (AEs).

Methods

We conducted an exploratory study comparing all indicator-positive patient cases contributing to 18 conspicuous A-IQI indicators to randomly selected indicator-negative control cases regarding the prevalence and severity of AEs. Structured medical record review using the Institute for Healthcare Improvement Global Trigger Tool was used as the gold standard.

Results

In 421 chart reviews, we identified 158 AEs. 70.9% (n = 112) of the AEs were found in cases with a positive indicator. The relative risk of an AE occurring was 3.47 (95% confidence interval: 2.30, 5.24) in indicator-positive cases compared to indicator-negatives. The proportion of severe events (National Coordination Council for Medication Error Reporting and Prevention Index categories H and I) was 54.5% (n = 61) in indicator-positive cases and only 15.3% (n = 7) in indicator-negative cases. Overall sensitivity of the A-IQI was 68.2%, specificity 69.4%, positive predictive value 36.0%, and negative predictive value 89.6%.

Conclusions

Our study shows that significantly more AEs and more severe AEs were found in cases with positive A-IQI than in indicator-negative control cases. However, studies with larger numbers of cases and with larger numbers of conspicuous indicators are needed for the validation of the entire A-IQI indicator set.
Identification of excessive contact pressures under hand orthosis based on finite element analysis
Authors: Tan Xinyang , Ahmed-Kristensen Saeema , Zhu Qian , Han Ting , Zhu Lei , Chen Wei , Cao Jiangang , Nanayakkara Thrishantha
Published: May 2024

Background:

Implicit magnitudes and distribution of excessive contact pressures under hand orthoses hinder clinicians from precisely adjusting them to relieve the pressures. To address this, contact pressure under a hand orthosis were analysed using finite element method.

Methods:

This paper proposed a method to numerically predict the relatively high magnitudes and critical distribution of contact pressures under hand orthosis through finite element analysis, to identify excessive contact pressure locations. The finite element model was established consisting of the hand, orthosis and bones. The hand and bones were assumed to be homogeneous and elastic bodies, and the orthosis was considered as an isotropic and elastic shell. Two predictions were conducted by assigning either low (fat) or high (skin) material stiffness to the hand model to attain the range of pressure magnitudes. An experiment was conducted to measure contact pressures at the predicted pressure locations.

Results:

Identical pressure distributions were obtained from both predictions with relatively high pressure values disseminated at 12 anatomical locations. The highest magnitude was found at the thumb metacarpophalangeal joint with the maximum pressure range from 13 to 78 KPa. The measured values were within the predicted range of pressure magnitudes. Moreover, 6 excessive contact pressure locations were identified.

Conclusions:

The proposed method was verified by the measurement results. It renders understanding of interface conditions underneath the orthosis to inform clinicians regarding orthosis design and adjustment. It could also guide the development of 3D printed or sensorised orthosis by indicating optimal locations for perforations or pressure sensors.
Rehabilitative outcomes with preparatory suction prostheses following traumatic Gritti-Stokes amputation: A case series
Authors: Stauffer Samantha Jeanne , Horne John Robert , Sions Jaclyn Megan
Published: May 2024

Gritti-Stokes amputation (GSA) is a knee disarticulation variant, where the femur is transected at the level of the epicondyle and the patella is fixated to the distal end. GSA results in a long residual limb with little postoperative swelling and less potential for muscular atrophy, so stable limb volume may allow the use of seal-in suction for suspension for preparatory prostheses. The purpose of this case series was to report on the efficacy of seal-in suction preparatory prostheses for 2 adults with traumatic GSA. Between October and December of 2021, 2 participants with unilateral traumatic Gritti-Stokes amputation, who had received seal-in suction suspension for their preparatory prostheses, were recruited. Information was extracted from medical charts regarding prosthetic care and mobility at preparatory and definitive prosthesis evaluation, and participants underwent standardized measurement of their residual limb and prosthesis. Duration of preparatory prosthesis use was >6 months; neither participant reported loss of suspension nor significant complications with socket fit. Participant 1 required socket replacement because of residual limb pain secondary to osteophyte formation, and Participant 2 required component replacement because of weight gain. At definitive prosthesis evaluations, both participants were unlimited community ambulators; both successfully returned to work before provision of their definitive prostheses. Results indicate that seal-in suction suspension may be viable for preparatory prostheses among adults with traumatic GSA, but knee center height discrepancies persist. GSA may yield highly functional outcomes for adults with traumatic amputation. Further research is required to substantiate these findings.
A scoping review of postoperative early rehabilitation programs after dysvascular-related amputations
Authors: Wong Christopher K , Rosati Jennifer , Forbes Kaitlynne , Feng Shanshan , Donohue Aine , Beckley Akinpelumi
Published: May 2024

Background:

After amputation, people face challenges including wound healing and decreased functional mobility. Early mobilization in acute hospital care has proved safe, improved function, and sped discharge. Still, loss of a leg complicates standing and early mobilization after amputation. Approaches to early mobilization and rehabilitation after amputation surgery have not been widely studied.

Objectives:

To map the evidence regarding early postoperative mobilization after dysvascular amputation. Specific aims included identifying research designs and populations, describing rehabilitation approaches, and identifying gaps within the literature.

Study design:

Scoping review following PRISMA-Sc guidelines.

Methods:

The a priori scoping review methodology conducted in June 2022 with English language and 20-year limits used the OVID Medline, OVID Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane databases, and Journal of Prosthetics and Orthotics archive. Reviewer pairs used Covidence software to screen for inclusion (subjects with major lower limb dysvascular amputations, seen immediately postoperatively for hospital-based rehabilitation) with decisions by concurrence. Data for best practice scoping reviews were synthesized for analysis.

Results:

Two hundred ninety-six citations were screened, 13 full texts reviewed, and 8 articles included: 2 cohort studies, 3 case-control studies, 2 single-group interventional studies, and 1 case study. There were no randomized control trials or prospective comparison group trials.

Conclusions:

Few studies were identified regarding acute rehabilitation after major lower extremity amputation. The limited evidence in this review suggested that early mobilization in the days after amputation was safe with or without use of temporary prostheses, although further research is certainly warranted.
Myelodysplastic Syndrome Related to Successful Treatment With177Lu-PSMA for Metastatic Castration–Refractory Prostate Cancer
Authors: Vija Racaru Lavinia , Krim Mehdi , Rivet Valérian , Mourey Loic , Courbon Pr Frederic
Published: May 2024

177Lu-vipivotide tetraxetan (177Lu-PSMA-617/LuPSMA) received recent EMA approval for metastatic castration–resistant prostate cancer, with promising data for earlier stages. Secondary myeloid neoplasm following exposure to DNA-damaging therapy (therapy-related myelodysplastic syndrome [MDS]) is a rare severe complication of 177Lu-oxodotreotide. We present a 77-year-old man, with synchronous liver, bone, and lymph node metastatic prostate cancer, having developed a low-risk MDS with SF3B1 mutation, 1 month after the sixth administration of LuPSMA. Although on partial metabolic and biological response with PSA nadir at 7 months after therapy, life quality was significantly altered by MDS.
Evaluating the Impact of a Global Cleft Speech Mentorship Program on Expanding Practitioner Competency in Low- and Middle-Income Countries
Authors: Horne Sara A. , Sommer Chelsea L. , Crowley Catherine J.
Published: May 2024

A primary challenge in global cleft care lies in the limited opportunities for cleft-specific training and mentorship available to speech practitioners worldwide, particularly in low-income and middle-income countries (LMICs). In addition, the limited number of speech therapists with cleft experience in LMICs creates a significant barrier to access to care for individuals with cleft lip and palate globally. The inaccessibility of cleft-specific clinical instruction and cleft-trained speech therapists impacts the effectiveness of intervention and, subsequently, the speech-language development of cleft-affected individuals worldwide. A structured virtual clinical mentorship program targeting speech practitioners of all skill levels in LMICs was established to address this gap in comprehensive cleft care provision. This article will examine the effectiveness of a structured cleft speech mentorship program in expanding practitioner competency in LMIC communities and, as a result, building capacity for cleft speech care globally. The authors will outline various aspects of the development and implementation of this cleft speech mentorship program, including rationale, participant recruitment, program requirements, and impact assessment tools utilized. An analysis of pre-program and post-program data will be conducted to evaluate the degree to which clinical skills were improved, identify persistent areas of weakness, and examine the effectiveness of the program in expanding speech practitioner competency.
Unplanned Surgery in Dually Eligible Beneficiaries for Conditions that Should Be Treated Electively
Authors: Dualeh Shukri H.A. , Bonner Sidra N. , Kunnath Nicholas J. , Ibrahim Andrew M.
Published: May 2024

Objective:

To evaluate the rate of unplanned surgery among dually eligible beneficiaries for surgical conditions that should be treated electively.

Summary Background Data:

Access-sensitive surgical conditions (e.g. abdominal aortic aneurysm repair, colectomy for colon cancer, ventral hernia repair) are ideally treated with elective surgery, but when left untreated have a natural history leading to unplanned surgery. Dually eligible beneficiaries may face systematic barriers to access surgical care.

Methods:

Cross-sectional retrospective study of all beneficiaries who were eligible for both Medicare and Medicaid, and underwent surgery for an access-sensitive surgical condition between 2016-2020. We compared the rate of unplanned surgery as well as 30-day mortality, complications and readmissions for dually eligible versus non-dually eligible beneficiaries. Sex, age, race/ethnicity, comorbidities, teaching status, nursing ratio, hospital region and bed size and surgery year were included in the risk-adjustment model.

Results:

Out of 853,500 beneficiaries, 118,812 were dually eligible with an average age (SD) of 75.2(7.7) years. Compared to non-dually eligible beneficiaries, dually eligible beneficiaries had a higher rates of unplanned surgery for access-sensitive surgical conditions (45.1% vs. 31.8%, P<0.001), 30-day mortality (2.9% vs. 2.6%, aOR=1.10 (1.07-1.14), P<0.001), complications (23.6% vs. 20.1%, aOR=1.23 (1.20-1.25), P<0.001), and 30-day readmissions (15.5% vs. 12.9%, aOR=1.24 (1.22-1.27), P<0.001). These differences narrowed significantly when evaluating elective procedures only.

Conclusions:

Dually eligible beneficiaries were more likely to undergo unplanned surgery for access-sensitive surgical conditions, leading to worse rates of mortality, complications and readmissions. Our findings suggest that improving rates of elective surgery for these conditions represents an actionable target to narrow the difference in post-operative outcomes between dually eligible and non-dually eligible beneficiaries.
Screening Oropharyngeal Dysphagia in Older Adults
Authors: Şentürk Durmuş Nurdan , Can Büşra , Alkaç Çiğdem , İlhan Birkan , Tufan Aslı
Published: May 2024

This study investigated the use of the Eating Assessment Tool 10 (EAT-10) in predicting clinical outcomes in older adults hospitalized with COVID-19 infections between February and June 2021. The EAT-10 was performed for all patients. Thirty one percent and 23% of the 153 patients had oropharyngeal dysphagia risk and in-hospital mortality, respectively. Older age (hazard ratio: 1.08; 95% confidence interval, 1.03-1.13; P = .003) and higher EAT-10 score (hazard ratio: 1.02; 95% confidence interval, 1.01-1.04; P = .043) were associated with in-hospital mortality. Older age and having increased risk of oropharyngeal dysphagia were independently associated with a higher risk of in-hospital mortality in older patients with COVID-19.
Use of Federal Reimbursement for Living Donor Costs by Racial and Ethnic Minorities: Implications for Disparities in Access to Living Donor Transplantation
Authors: Mathur Amit K. , Goodrich Nathan , Hong Barry , Smith Abigail R. , Mandell Rebecca J. , Warren Patricia H. , Gifford Kimberly A. , Ojo Akinlolu O. , Merion Robert M.
Published: May 2024

Background.

Minority race, ethnicity, and financial barriers are associated with lower rates of living donor (LD) kidney transplantation (LDKT). Financial reimbursement for LD costs may impact social determinants of health and, therefore, impact disparities in access to LDKT.

Methods.

Among US LDKTs, we studied associations between racial and ethnic minority status and utilization of the National Living Donor Assistance Center (NLDAC), a means-tested reimbursement program for nonmedical LD costs. We analyzed demographic, clinical, income, and survey data from NLDAC and the Scientific Registry of Transplant Recipients (January 1, 2011, to December 31, 2022) to identify predictors of NLDAC utilization.

Results.

Among 70 069 US LDKTs, 6093 NLDAC applicants were identified (9% of US LDKTs). Racial and ethnic minorities were over-represented in NLDAC-supported LDKTs compared with non-NLDAC US LDKTs (Black donors 12% versus 9%; Black recipients 15% versus 12%; Hispanic donors 21% versus 14%; Hispanic recipients 23% versus 15%; all P < 0.001). Among preemptive transplants, use of NLDAC by donors to Hispanic recipients (11%) was nearly twice as high as that of non-Hispanic recipients (6%) (P < 0.001). At time of NLDAC application, 72% stated NLDAC “will make it possible” to donate; higher proportions of minority applicants agreed (Black 80%, White 70%, P < 0.001; Hispanic 79%, non-Hispanic 70%, P < 0.001). Racial and ethnic minority-concordant transplants were significantly more likely to use NLDAC (donor/recipient: Black/Black risk-adjusted odds ratio [OR], 1.85, other/other OR 2.59, Hispanic/Hispanic OR 1.53; all P < 0.05).

Conclusions.

Reduction of LD financial barriers may increase access to LDKT, particularly in racial and ethnic minority communities.
Targeted Restoration of GPX3 Attenuates Renal Ischemia/Reperfusion Injury by Balancing Selenoprotein Expression and Inhibiting ROS-mediated Mitochondrial Apoptosis
Authors: Wu Yikun , Shi Hua , Xu Yuangao , Shu Guofeng , Xiao Yu , Hong Guangyi , Xu Shuxiong
Published: May 2024

Background.

Renal ischemia/reperfusion (IR) injury is the leading cause of acute kidney injury in both autologous and transplanted kidneys. Low-level glutathione peroxidase 3 (GPX3) is associated with renal IR injury. The exact mechanism of targeted GPX3 restoration in renal IR injury has yet to be determined.

Methods.

The distribution of GPX3 in different tissues and organs of the body was investigated. The level of GPX3 in renal IR injury was assessed. To confirm the action of GPX3 and its mechanisms, IR models were used to introduce adeno-associated virus 9 containing GPX3, as well as hypoxia/reoxygenation-exposed normal rat kidney cells that consistently overexpressed GPX3. Reverse molecular docking was used to confirm whether GPX3 was a target of ebselen.

Results.

GPX3 is abundant in the kidneys and decreases in expression during renal IR injury. GPX3 overexpression reduced renal IR injury and protected tubular epithelial cells from apoptosis. Proteomics analysis revealed a strong link between GPX3 and mitochondrial signaling, cellular redox state, and different expression patterns of selenoproteins. GPX3 inhibited reactive oxygen species-induced mitochondrial apoptosis and balanced the disordered expression of selenoproteins. GPX3 was identified as a stable selenoprotein that interacts with ebselen. Ebselen enhanced the level of GPX3 and reduced IR-induced mitochondrial damage and renal dysfunction.

Conclusions.

Targeted restoration of GPX3 attenuates renal IR injury by balancing selenoprotein expression and inhibiting reactive oxygen species-mediated mitochondrial apoptosis, indicating that GPX3 could be a potential therapeutic target for renal IR injury.
Age Is Just a Number for Older Kidney Transplant Patients
Authors: Quint Evelien E. , Pol Robert A. , Segev Dorry L. , McAdams-DeMarco Mara A.
Published: May 2024

The rise in the mean age of the global population has led to an increase in older kidney transplant (KT) patients. This demographic shift, coupled with the ongoing organ shortage, requires a nuanced understanding of which older adults are most suitable for KT. Recognizing the increased heterogeneity among older adults and the limitations of solely relying on chronological age, there is a need to explore alternative aging metrics beyond chronological age. In this review, we discuss the impact of older age on access to KT and postoperative outcomes. Emphasizing the need for a comprehensive evaluation that extends beyond chronological age, we explore alternative aging metrics such as frailty, sarcopenia, and cognitive function, underscoring their potential role in enhancing the KT evaluation process. Most importantly, we aim to contribute to the ongoing discourse, fostering an optimized approach to KT for the rapidly growing population of older adults.
Closing the loop between environment, brain and mental health: how far we might go in real-life assessments?
Authors: Lehmler Stephan , Siehl Sebastian , Kjelkenes Rikka , Heukamp Jannik , Westlye Lars Tjelta , Holz Nathalie , Nees Frauke
Published: May 2024

Purpose of review

Environmental factors such as climate, urbanicity, and exposure to nature are becoming increasingly important influencers of mental health. Incorporating data gathered from real-life contexts holds promise to substantially enhance laboratory experiments by providing a more comprehensive understanding of everyday behaviors in natural environments. We provide an up-to-date review of current technological and methodological developments in mental health assessments, neuroimaging and environmental sensing.

Recent findings

Mental health research progressed in recent years towards integrating tools, such as smartphone based mental health assessments or mobile neuroimaging, allowing just-in-time daily assessments. Moreover, they are increasingly enriched by dynamic measurements of the environment, which are already being integrated with mental health assessments. To ensure ecological validity and accuracy it is crucial to capture environmental data with a high spatio-temporal granularity. Simultaneously, as a supplement to experimentally controlled conditions, there is a need for a better understanding of cognition in daily life, particularly regarding our brain's responses in natural settings.

The presented overview on the developments and feasibility of “real-life” approaches for mental health and brain research and their potential to identify relationships along the mental health-environment-brain axis informs strategies for real-life individual and dynamic assessments.
What Is Brain Damage and Does Electroconvulsive Therapy Cause It?
Authors: Swartz Conrad M.
Published: May 2024

Surveys show public misperceptions and confusion about brain damage and electroconvulsive therapy (ECT). Fictional movies have misrepresented ECT to suggest brain damage and to ridicule mental illness and psychiatric patients. “Brain damage” has become a colloquial expression without consistent meaning. In contrast, brain injury is the medical term for destruction of brain cells, such as from kinetic impact (concussion), hypoxia, or infection. Studies of both high-resolution magnetic resonance imaging (MRI) and enzyme assays find that causes of brain injury are accompanied by observable structural changes on MRI and elevated blood and cerebrospinal fluid levels of brain enzymes that leak from injured brain cells. Concussion is also followed by intracerebral bleeding, progressive brain atrophy, diffuse axonal injury, cranial nerve injury, and 2–4 fold increased risk for dementia. In contrast, there is no evidence that ECT produces any of these. Studies of ECT patients find no brain edema, structural change persisting 6 months, or elevated levels of leaked brain enzymes. Statistical comparisons between brain injury and ECT effects indicate no similarity (P < 0.00000001). Moreover, the kinetic, thermal, and electrical effects of ECT are far below levels that could possibly cause harm. This robust evidence shows that there is no basis to claim that ECT causes brain injury.
Improved cohesin HiChIP protocol and bioinformatic analysis for robust detection of chromatin loops and stripes
Authors: Jodkowska Karolina , Parteka-Tojek Zofia , Agarwal Abhishek , Denkiewicz Michał , Korsak Sevastianos , Chiliński Mateusz , Banecki Krzysztof , Plewczynski Dariusz
Published: May 2024

Chromosome Conformation Capture (3C) methods, including Hi-C (a high-throughput variation of 3C), detect pairwise interactions between DNA regions, enabling the reconstruction of chromatin architecture in the nucleus. HiChIP is a modification of the Hi-C experiment, which includes a chromatin immunoprecipitation step (ChIP), allowing genome-wide identification of chromatin contacts mediated by a protein of interest. In mammalian cells, cohesin protein complex is one of the major players in the establishment of chromatin loops. We present an improved cohesin HiChIP experimental protocol. Using comprehensive bioinformatic analysis, we show that performing cohesin HiChIP with two cross-linking agents (formaldehyde [FA] and EGS) instead of the typically used FA alone, results in a substantially better signal-to-noise ratio, higher ChIP efficiency and improved detection of chromatin loops and architectural stripes. Additionally, we propose an automated pipeline called nf-HiChIP (https://github.com/SFGLab/hichip-nf-pipeline) for processing HiChIP samples starting from raw sequencing reads data and ending with a set of significant chromatin interactions (loops), which allows efficient and timely analysis of multiple samples in parallel, without the need of additional ChIP-seq experiments. Finally, using novel approaches for biophysical modelling and stripe calling we generate accurate loop extrusion polymer models for a region of interest and a detailed picture of architectural stripes, respectively.
Characterization of bacterial intrinsic transcription terminators identified with TERMITe – a novel method for comprehensive analysis of Term-seq data
Authors: Kosiński Jan Grzegorz , Ranaweera Sandeepani , Chełkowska-Pauszek Agnieszka , Kashlev Mikhail , Babitzke Paul , Żywicki Marek
Published: May 2024

In recent years, Term-seq became a standard experimental approach for high-throughput identification of 3’ ends of bacterial transcripts. It was widely adopted to study transcription termination events and 3’ maturation of bacterial RNAs. Despite widespread utilization, a universal bioinformatics toolkit for comprehensive analysis of Term-seq sequencing data is still lacking. Here, we describeTERMITe, a novel method for the identification of stable 3’ RNA ends based on bacterial Term-seq data.TERMITeworks with data obtained from both currently available Term-seq protocols and provides robust identification of the 3’ RNA termini. Unique features ofTERMITeinclude the calculation of the transcription termination efficiency using matched RNA-seq data and the comprehensive annotation of the identified 3’ RNA ends, allowing functional analysis of the results. We have appliedTERMITeto the comparative analysis of experimentally validated intrinsic terminators spanning different species across the bacterial domain of life, revealing substantial differences in their sequence and secondary structure. We also provide a complete atlas of experimentally validated intrinsic transcription termination sites for 13 bacterial species, includingEscherichia coli, Bacillus subtilis, Listeria monocytogenes, Enterococcus faecalis, Synechocystis sp.,Streptomyces clavuligerus, Streptomyces griseus, Streptomyces coelicolor, Streptomyces avermitilis, Streptomyces lividans, Streptomyces tsukubaensis, Streptomyces venezuelae, andZymomonas mobilis.