bluuebunny/crossref_metadata_2025 huggingface dataset:
Preventing medication history errors in high-risk patients: Impact of California Senate Bill 1254
Authors: Tu Thanh , Stephens Sarah , Bajorek Sarah , Leang Donna , Nguyen Daniel , Shane Rita
Published: February 2023

Purpose

California Senate Bill (SB) 1254 (effective January 1, 2019) requires pharmacy staff at acute hospitals with more than 100 beds to obtain a medication profile for high-risk patients upon hospital admission. This multicenter study sought to evaluate the statewide impact of California SB 1254 by capturing the errors intercepted and harm prevented as a result of the passage of the bill.

Methods

This was a multicenter, prospective, observational study conducted at 11 hospitals in California for 6 consecutive weeks between January 2020 and March 2020. Participating sites captured medication history errors identified among high-risk patients using organization-specific criteria. Errors were categorized by type and ranked for severity of potential or actual harm based on the modified National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) categories.

Results

Study sites had an average daily census of 180 to 800 patients. Approximately 94% (n = 2,554) of medication histories conducted disclosed at least 1 error. Approximately 54% (n = 1,474) of histories disclosed at least 1 serious or potentially life-threatening error. Approximately 6 errors were identified and prevented per patient (95% CI, 5.62-6.01 errors per patient), and 1 in 4 errors (25%) was categorized as potentially serious or life-threatening.

Conclusion

Among high-risk patients, pharmacy-led medication histories significantly reduced medication errors. If not intercepted, these errors would have likely resulted in substantial morbidity and mortality. Future research should evaluate opportunities to standardize high-risk criteria to support patient prioritization and allocation of resources.
Circ_0115118 regulates endometrial functions through the miR-138-1-3p/WDFY2 axis in patients with PCOS
Authors: Yang Zi , Liu Fenting , Bai Jiali , Ye Zhenhong , Yin Jingwen , Peng Tianliu , Shan Hongying , Yu Yang , Zhou Ping , Li Rong
Published: February 2023

To investigate the expression profiles of circular RNAs (circRNAs) in the endometria of women with polycystic ovary syndrome (PCOS) and to explore the role of aberrant circ_0115118 expression in endometrial dysfunction in patients with PCOS. CircRNA microarray hybridization and bioinformatic analyses were performed to determine the expression patterns of circRNAs in the endometria of patients with or without PCOS, the expression of target circRNA was evaluated by real-time polymerase chain reaction (PCR). Cell counting kit-8 and Transwell assays were used to detect cellular proliferative, invasive, and migratory capacities. The influence of the circRNA on decidualization was explored by real-time PCR. Animal models were established to investigate the regulatory effect of the circRNA on embryo implantation. Downstream microRNAs and genes were predicted using bioinformatic websites and verified by dual-luciferase reporter assays, real-time PCR, and western blotting. In the endometria of patients with PCOS, there were 113 differentially expressed circRNAs in the secretory phase and 1119 differentially expressed circRNAs in the proliferative phase. The expression of circ_0115118 was significantly higher in endometrial stromal cells during the proliferative phase in patients with PCOS, leading to inhibition of cellular mobilization and embryo implantation. In addition, circ_0115118 exerted effects by sponging miR-138-1-3p, subsequently increasing the expression of WD repeat and FYVE domain-containing protein 2 (WDFY2). Circ_0115118 expression is dysregulated in the endometria of patients with PCOS and adversely affects endometrial function. Our findings reveal that circ_0115118 may be a potential therapeutic target to improve pregnancy outcomes in women with PCOS.
AngioVac debulking of a tricuspid valve mass following complex lead extraction in a rare case of Austrian syndrome: a case report
Authors: Middleton Megan , McDaniel Graham , Attanasio Steve
Published: February 2023

Background

The European Society of Cardiology recommends surgical valvular intervention in right-sided infective endocarditis for persistent vegetations >20 mm after recurrent pulmonary emboli, infection with a difficult-to-eradicate organism with >7 days of persistent bacteraemia, or tricuspid regurgitation causing right-sided heart failure. In this case report, we discuss the role of percutaneous aspiration thrombectomy for a large tricuspid valve (TV) mass as an alternative to surgery due to poor surgical candidacy in a patient with Austrian syndrome, following a complex implantable cardioverter defibrillator (ICD) device extraction.

Case summary

A 70-year-old female presented to the emergency department after being found acutely delirious at home by family. Infectious workup was notable for growth of Streptococcus pneumoniae in the blood, cerebrospinal, and pleural fluid. Transoesophageal echocardiogram was pursued in the setting of bacteraemia and revealed a mobile mass on the TV consistent with endocarditis. Given the size and embolic potential of the mass and eventual need for ICD replacement, the decision was made to pursue extraction of the valvular mass. The patient was a poor candidate for invasive surgery, so we opted to perform percutaneous aspiration thrombectomy. After the ICD device was extracted, the TV mass was successfully debulked using the AngioVac system without complication.

Discussion

Percutaneous aspiration thrombectomy of right-sided valvular lesions has been introduced as a minimally invasive approach to avoid or delay valvular surgery. When intervention is indicated for TV endocarditis, AngioVac percutaneous thrombectomy may be a reasonable operative approach, particularly in patients who are at high risk for invasive surgery. We report a case of successful AngioVac debulking of a TV thrombus in a patient with Austrian syndrome.
Unexpected paradoxical embolization following catheter-directed thrombectomy with the FlowTriever™ system in a patient with pulmonary embolism: a case report
Authors: Uecker Nicola Anne , Rosenkranz Stephan , Bunck Alexander , Tichelbäcker Tobias
Published: February 2023

Background

The optimal therapy for patients suffering from acute pulmonary embolism (PE) classified as intermediate-high risk still needs to be identified. Catheter-directed thrombectomy (CDTE) is a safe procedure to reduce thrombus burden immediately. The lack of randomized trials is one reason: catheter-directed thrombolysis (CDT) has not yet received a clear recommendation in our guidelines. Herein, we report an unexpected event in the course of a patient with PE treated with CDTE using the FlowTriever™ system, the only FDA-approved catheter system for percutaneous mechanical thrombectomy regarding this indication.

Case Summary

A 57-year-old male presented with dyspnoea at the emergency department of our university hospital. The computed tomography (CT) scan showed bilateral PE, and ultrasound of the left lower limb revealed deep venous thrombosis. According to the current ESC guidelines, he was classified intermediate-high risk. We performed bilateral CDTE. On the first and third day post-intervention, our patient presented neurological deficits. Whereas the first CT scan of the cerebrum remained normal, the CT scan at Day 3 showed demarcated embolic stroke. Further imaging diagnostic gave evidence to an ischemic lesion in the left kidney. Transesophageal echocardiography revealed a patent foramen ovale (PFO) as the origin of paradoxical embolism and thus mechanism of both ischemic lesions. Compliant to the current recommendations, percutaneous PFO closure was performed. Our patient recovered properly without any sequelae.

Discussion

Whether the deep venous thrombosis is the source of embolization or the catheter-directed retrieval of clots may have transported clot material to the right atrium which further on embolized systemically will remain unclear. Yet, we have to consider it as a potential complication in catheter-directed treatment of PE in patients with a PFO.
Rapid evolution of sex role specialization in a hermaphrodite under sex-limited selection
Authors: Nordén Anna K , Ramm Steven A , Abbott Jessica K
Published: February 2023

The evolution of separate sexes from hermaphroditism is thought to have occurred independently many times, and may be linked to the evolution of sex chromosomes. Even though we have a good understanding of the theoretical steps in the evolution of sex chromosomes from a hermaphrodite ancestor, the initial stages are still hard to study in animals because many well-studied animal sex chromosome systems are old. We addressed this problem by experimentally selecting a hermaphrodite via sex-limited experimental evolution for several generations, simulating the early stages in the evolution of a sex chromosome. After 14 generations, a fitness assay revealed evidence of incipient sex role specialization in the female-selected lines, presumably reflecting the release from constraints usually imposed by selection on the other sex role. Importantly, however, this was not simply explained by morphology because testis and ovary sizes did not diverge among treatments. There was no evidence of a change in the male-selected lines. Our study shows that sex role specialization can occur rapidly as a result of sex-limited selection, which is consistent with genetic constraints between sex roles, and in line with the first predicted steps toward the evolution of a new sex chromosome system.
Distributions of Resonances of Supercritical Quasi-Periodic Operators
Authors: Liu Wencai
Published: February 2023

We discover that the distribution of (frequency and phase) resonances plays a role in determining the spectral type of supercritical quasi-periodic Schrödinger operators. In particular, we disprove the 2nd spectral transition line conjecture of Jitomirskaya in the early 1990s.
The Impact of Severe Acute Respiratory Syndrome Coronavirus 2 Vaccination and Infection on Neutralizing Antibodies: A Nation-wide Cross-sectional Analysis
Authors: Althaus Thomas , Landier Jordi , Zhu Feng , Raps Hervé , Dejoux Olivier , Costantini Alizée , Lavagna Christian , Rampal Patrick , Mattiuzzo Giada , Xu Shuting , Wang Lin-Fa , Voiglio Eric J
Published: February 2023

Background

Neutralising antibodies (nAbs) play a critical role in the protection against severe COVID-19. In the era of vaccine boosters and repeated SARS-CoV-2 outbreaks, identifying individuals at risk represents a public health priority.

Methods

Relying on the Monaco COVID Public Health Programme, we evaluated nAbs from July 2021-June 2022 in 8,080 SARS-CoV-2 vaccinated and/or infected children and adults, at their inclusion visit. We stratified by infection status and investigated variables associated with nAbs using a generalised additive model.

Results

Infected and vaccinated participants had high and consistent nAbs (>800 IU/mL), which remained stable over time since injection, regardless of the number of vaccine doses, body mass index, sex, or age. By contrast, uninfected participants showed larger variability (two doses [V2] median 157.6; interquartile range [IQR] 43.3-439.1 IU/mL) versus three doses [V3] median 882.5; [829.5-914.8] IU/mL). NAbs decreased by 20% per month after V2 (adjusted ratio 0.80; 95%CI [0.79-0.82]), but remained stable after V3 (adjusted ratio 0.98; 95%CI [0.92-1.05]).

Conclusions

Hybrid immunity provided stable, high and consistent nAbs over time. The benefit of boosters was marked to restore decaying nAbs in uninfected participants. NAbs could identify individuals at risk of severe COVID-19 and provide more targeted vaccine boosters’ campaigns.
In vivoefficacy & resistance prevention of cefiderocol in combination with ceftazidime/avibactam, ampicillin/sulbactam or meropenem using human-simulated regimens versusAcinetobacter baumannii
Authors: Gill Christian M , Santini Debora , Takemura Miki , Longshaw Christopher , Yamano Yoshinori , Echols Roger , Nicolau David P
Published: February 2023

Objective

Evaluate the in vivo efficacy and resistance prevention of cefiderocol in combination with ceftazidime/avibactam, ampicillin/sulbactam and meropenem using human-simulated regimens (HSR) in the murine infection model.

Methods

In total, 15 clinical A. baumannii were assessed: cefiderocol MICs, 2 mg/L (previously developed resistance on therapy), n = 3; 8 mg/L, n = 2; ≥32 mg/L, n = 10 (including VEB and PER-harbouring isolates). Mice received inactive control, cefiderocol, cefiderocol + ceftazidime/avibactam (C-CZA), cefiderocol + ampicillin/sulbactam (C-SAM) or cefiderocol + meropenem (C-MEM) HSRs. The mean change in log10 cfu/thigh compared with starting inoculum was assessed. Resistance development on treatment was a >4-fold increase in MIC relative control animals. In vitro activities of combinations were assessed by disc stacking.

Results

Against cefiderocol-non-susceptible isolates, combinations produced significant kill with C-CZA −3.75 ± 0.37 reduction in log10 cfu/thigh, C-SAM produced −3.55 ± 0.50 and C-MEM produced −2.18 ± 1.75 relative to baseline. Elevated MICs in cefiderocol treated animals occurred in three out of three isolates with MICs of 2 mg/L. Of these isolates, one developed elevated MICs with C-MEM compared with none treated with C-CZA or C-SAM. Disc stacking with C-CZA or C-SAM returned all isolates to at least the CLSI intermediate breakpoint, which may correlate with in vivo efficacy.

Conclusions

Against cefiderocol-non-susceptible isolates, cefiderocol + ceftazidime/avibactam or ampicillin/sulbactam HSR produced in vivo kill against all 12 cefiderocol-non-susceptible isolates. Cefiderocol with ceftazidime/avibactam or ampicillin/sulbactam prevented the development of resistance during treatment against cefiderocol-high-end-susceptible isolates with a propensity for resistance on therapy. These data support the clinical evaluation of cefiderocol with ceftazidime/avibactam or ampicillin/sulbactam against A. baumannii, including multi-drug-resistant isolates.
Improving Statistical Matching when Auxiliary Information is Available
Authors: Moretti Angelo , Shlomo Natalie
Published: February 2023

There is growing interest within National Statistical Institutes in combining available datasets containing information on a large variety of social domains. Statistical matching approaches can be used to integrate data sources through a common set of variables where each dataset contains different units that belong to the same target population. However, a common problem is related to the assumption of conditional independence among variables observed in different data sources. In this context, an auxiliary dataset containing all the variables jointly can be used to improve the statistical matching by providing information on the correlation structure of variables observed across different datasets. We propose modifying the prediction models from the auxiliary dataset through a calibration step and show that we can improve the outcome of statistical matching in a variety of settings. We evaluate the proposed approach via simulation and an application based on the European Union Statistics for Income and Living Conditions and Living Costs and Food Survey for the United Kingdom.
Evaluation of Antinuclear Antibody and Subserology Reflex Testing for the Diagnosis of Systemic Autoimmune Rheumatic Disorders in an Academic Teaching Hospital
Authors: Duff Delicia , Vyas Niti , Enderle Janet , Rajendran Rajkumar
Published: February 2023

Objective

The aim of this study was to examine appropriate utilization of antinuclear antibody (ANA) screening tests with follow-up subserology tests (reflex testing) for diagnosing systemic autoimmune rheumatic disorder (SARD).

Methods

We conducted a retrospective chart review of 3003 SARD-test orders at an academic teaching hospital from January to December 2019. Testing patterns were categorized as American College of Rheumatology (ACR)-recommended reflex testing, panel testing, or single subserology testing. We described testing patterns, assessed their diagnostic accuracy, and explored factors associated with reflex testing.

Results

Reflex testing accounted for 79.7% of SARD test-ordering, whereas improper testing (panel or single subserology) accounted for the other 20.3%. Reflex testing was associated with significantly more SARD diagnoses than improper testing (P = .004). Testing patterns were significantly associated with race/ethnicity (P = .008), with reflex testing being less frequent than improper testing in Hispanics and Whites.

Conclusion

In summary, one-fifth (20.3%) of testing patterns for suspected SARD did not follow the ACR-recommended guidelines for using reflex testing. Use of reflex testing was associated with an increased frequency of SARD diagnosis.
Lemongrass Essential Oil Attenuates Perfluorooctane Sulfonate-Induced Jejunal Mucosal Injury in Rat: A Histological, Immunohistochemical, and Biochemical Study
Authors: Shalaby Amany Mohamed , Albakkosh Abdulfatah Mohammed , Shalaby Rania H , Alabiad Mohamed Ali , Elshamy Amira Mostafa , Alorini Mohammed , Jaber Fatima A , Tawfeek Shereen Elsayed
Published: February 2023

Perfluorooctane sulfonate (PFOS) has harmful impacts on various organs, including the intestine. Lemongrass essential oil (LGEO) has anti-inflammatory, anti-oxidant, antibacterial, and immunomodulatory effects. This study investigated the impact of PFOS on the mucosa of the jejunum of rats and evaluated LGEO’s protective impact. Four groups of rats were created: control, LGEO (100 mg/kg/day), PFOS (5 mg/kg/day), and LGEO-PFOS group. The agents were given orally for 28 days. Oxidative stress parameters, pro-inflammatory cytokines, and caspase-3 were measured in jejunal homogenates. Rat jejunal sections were evaluated histologically (light and electron microscopic examination) and immunohistochemically [for tumor necrosis factor-α (TNF-α), Proliferating cell nuclear antigen (PCNA), cyclooxygenase-2 (COX2), and Bcl2]. PFOS significantly elevated oxidative stress, pro-inflammatory cytokines, caspase-3, and gene expression of nuclear factor kappa B (NF-kB) and inducible nitric oxide synthetase (iNOS). The disturbed architecture of jejunal villi and crypts was demonstrated. Immunohistochemically, a significant rise in TNF-α, PCNA, and COX2 and a significant decrease in Bcl2 expression were revealed compared to control group. Further ultrastructural alterations included dilated RER, mitochondria with destroyed cristae, vacuolated cytoplasm, and shrunken condensed nuclei of enterocytes. LGEO treatment significantly reduced these harmful effects. LGEO protected against PFOS–induced jejunal damage by reducing the oxidative, inflammatory, and apoptotic impacts.
Further evidence that galaxy age drives observed Type Ia supernova luminosity differences
Authors: Wiseman P , Sullivan M , Smith M , Popovic B
Published: February 2023

Type Ia supernovae (SNe Ia) are explosions of white dwarf stars that facilitate exquisite measurements of cosmological expansion history, but improvements in accuracy and precision are hindered by observational biases. Of particular concern is the apparent difference in the corrected brightnesses of SNe Ia in different host galaxy environments. SNe Ia in more massive, passive, older environments appear brighter after having been standardized by their light-curve properties. The luminosity difference commonly takes the form of a step function. Recent works imply that environmental characteristics that trace the age of the stellar population in the vicinity of SNe show the largest steps. Here, we use simulations of SN Ia populations to test the impact of using different tracers and investigate promising new models of the step. We test models with a total-to-selective dust extinction ratio RV that changes between young and old SN Ia host galaxies, as well as an intrinsic luminosity difference between SNe from young and old progenitors. The data are well replicated by a model driven by a galaxy-age varying RV and no intrinsic SN luminosity difference, and we find that specific star formation rate measured locally to the SN is a relatively pure tracer of this galaxy-age difference. We cannot rule out an intrinsic difference causing part of the observed step and show that if luminosity differences are caused by multiple drivers then no single environmental measurement is able to accurately trace them. We encourage the use of multiple tracers in luminosity corrections to negate this issue.
A case of systemic lupus erythematosus having concurrent Evans syndrome and acquired thrombotic thrombocytopenic purpura
Authors: Motoyama Ryo , Higuchi Tomoaki , Hirahara Shinya , Konda Naoko , Yamada Risa , Watanabe Kotaro , Fujisaki Mayuko , Yamaguchi Rei , Katsumata Yasuhiro , Kawaguchi Yasushi , Harigai Masayoshi
Published: February 2023

An 18-year-old Japanese woman with systemic lupus erythematosus experienced dyspnoea, headache, tinnitus, and purpura for 2 weeks and was admitted to our hospital. The patient had been diagnosed with systemic lupus erythematosus and secondary immune thrombocytopenia 8 years before and treated with high-dose prednisolone and mycophenolate mofetil. Since the blood test on admission showed haemolytic anaemia with a positive direct Coombs test and anti-glycoprotein IIb/IIIa antibodies, the patient was initially diagnosed with Evans syndrome (ES). The patient was treated with pulse intravenous methylprednisolone followed by 45 mg/day prednisolone; however, the patient’s platelet count did not normalise. Based on a low level of a disintegrin-like and metalloproteinase with thrombospondin type 1 motif 13 (ADAMTS-13) activity and a high level of ADAMTS-13 inhibitors, a diagnosis of acquired thrombotic thrombocytopenic purpura (TTP) was confirmed. After undergoing therapeutic plasma exchange for 6 consecutive days, the patient’s platelet count recovered rapidly. Although concurrent acquired TTP and ES have not been reported previously, the findings from this case highlight the importance of measuring ADAMTS-13 activity and inhibitors to rule out acquired TTP, especially when ES is refractory to glucocorticoids.
Negatively charged, intrinsically disordered regions can accelerate target search by DNA-binding proteins
Authors: Wang Xi , Bigman Lavi S , Greenblatt Harry M , Yu Binhan , Levy Yaakov , Iwahara Junji
Published: February 2023

In eukaryotes, many DNA/RNA-binding proteins possess intrinsically disordered regions (IDRs) with large negative charge, some of which involve a consecutive sequence of aspartate (D) or glutamate (E) residues. We refer to them as D/E repeats. The functional role of D/E repeats is not well understood, though some of them are known to cause autoinhibition through intramolecular electrostatic interaction with functional domains. In this work, we investigated the impacts of D/E repeats on the target DNA search kinetics for the high-mobility group box 1 (HMGB1) protein and the artificial protein constructs of the Antp homeodomain fused with D/E repeats of varied lengths. Our experimental data showed that D/E repeats of particular lengths can accelerate the target association in the overwhelming presence of non-functional high-affinity ligands (‘decoys’). Our coarse-grained molecular dynamics (CGMD) simulations showed that the autoinhibited proteins can bind to DNA and transition into the uninhibited complex with DNA through an electrostatically driven induced-fit process. In conjunction with the CGMD simulations, our kinetic model can explain how D/E repeats can accelerate the target association process in the presence of decoys. This study illuminates an unprecedented role of the negatively charged IDRs in the target search process.
BRAF V600EandRNF43Co-mutations Predict Patient Outcomes with Targeted Therapies in Real-World Cases of Colorectal Cancer
Authors: Quintanilha Julia C F , Graf Ryon P , Oxnard Geoffrey R
Published: February 2023

Anti-BRAF/EGFR therapy is approved for metastatic colorectal cancer (mCRC) with BRAFV600E mutations, although not all patients respond. Novel recent findings indicate the potential of RNF43 mutations to predict outcomes in patients with BRAF-mutated microsatellite stable (MSS) mCRC treated with anti-BRAF/EGFR therapy. This study aimed to independently and rapidly validate BRAFV600E/RNF43 co-mutations as predictive biomarkers of benefit to anti-EGFR/BRAF therapy. Clinical data were derived from electronic health record data from ~280 US cancer clinics between January 2011 and March 2022 from the Flatiron Health-Foundation Medicine real-world clinico-genomic mCRC database. Real-world cases of BRAFV600E-mutated mCRC, with patients receiving anti-BRAF/EGFR therapy (n = 49), were included. Patients who were MSS, with RNF43 mutations, had favorable progression-free survival (hazard ratio [HR] 0.29; 95% CI [CI], 0.13-0.65) and overall survival (HR 0.32, 95% CI, 0.12-0.84) compared with wild type. No difference in outcomes was observed between patient groups with RNF43-mutant versus wild-type receiving standard-of-care chemotherapy. BRAFV600E/RNF43 co-mutations predict mCRC anti-BRAF/EGFR outcomes in diverse clinical settings.
Pain Medicine Milestones 2.0: a step into the future
Authors: Aggarwal Anuj , Barad Meredith , Braza Diane W , McKenzie-Brown Anne Marie , Lee Debbie , Mayer Robert Samuel , Przkora Rene , Kohan Lynn , Koka Anjali , Szabova Alexandra
Published: February 2023

Objective

To describe the process of revising the Pain Medicine Milestones 1.0 and implementing changes into the Pain Medicine Milestones 2.0 along with implications for pain medicine trainees.

Background

Competency-based medical education has been implemented in graduate medical education, including pain medicine. Milestones 1.0, introduced by the Accreditation Council for Graduate Medical Education (ACGME), has been used to assess learners in six competencies and respective sub-competencies. Recognizing areas for improvement in Milestones 1.0, the ACGME initiated the process of Milestones 2.0 and a working group was created to execute this task for pain medicine. The working group discussed revisions; consensus was sought when changes were introduced. Final milestones were agreed upon and made available for public comment prior to publication.

Results

Redundant sub-competencies were either merged or eliminated, reducing the number of sub-competencies. A maximum of three rows representing skill, knowledge, behavior and attitude were included for each sub-competency. Harmonized Milestones, aligning with other specialties in a predetermined ACGME framework, were adopted and modified to meet the needs of pain medicine. A supplemental guide was developed to assist educators in implementation of Milestones 2.0 and assessment of trainees.

Conclusions

The intent of the Milestones 2.0 was to create an improved tool that is comprehensive, easier to utilize, and of increased value for pain medicine training programs. It is expected that implementation of Milestones 2.0 will streamline pain medicine trainee assessments by educators and prepare trainees for the future practice of pain medicine while serving to be the foundation of an iterative process to match the evolution of the specialty.
Taxonomic practice, creativity and fashion: what’s in a spider name?
Authors: Mammola Stefano , Viel Nathan , Amiar Dylan , Mani Atishya , Hervé Christophe , Heard Stephen B , Fontaneto Diego , Pétillon Julien
Published: February 2023

There is a secret pleasure in naming new species. Besides traditional etymologies recalling the sampling locality, habitat or morphology of the species, names may be tributes to some meaningful person, pop culture references and even exercises of enigmatography. Using a dataset of 48 464 spider etymologies, we tested the hypothesis that species names given by taxonomists are deeply influenced by their cultural background. Specifically, we asked whether naming practices change through space or have changed through time. In absolute terms, etymologies referring to morphology were the most frequently used. In relative terms, references to morphology peaked in 1850–1900 and then began to decline, with a parallel increase in etymologies dedicated to people and geography. We also observed a dramatic increase in etymologies referring to pop culture and other cultural aspects in 2000–2020, especially in Europe and the Americas. While such fashionable names often carry no biological information regarding the species itself, they help give visibility to taxonomy, a discipline currently facing a profound crisis in academia. Taxonomy is among the most unchanged disciplines across the last centuries in terms of tools, rules and writing style. Yet, our analysis suggests that taxonomists remain deeply influenced by their living time and space.
Improving Evidence-Based Methods of Characterizing Shoulder-Related Quality of Life for Survivors of Breast Cancer
Authors: Maciukiewicz Jacquelyn M. , Dickerson Clark R.
Published: February 2023

Background:

Breast cancer is prevalent among Canadian women, but treatments may cause functional impairments among survivors. Despite a substantial number of survivors joining the population yearly, minimal research has approached the challenges faced by this population after primary treatment. The purpose of this study was to classify the different function of survivors of breast cancer and determine factors that differed across groups of survivors.

Methods:

Thirty-five survivors of breast cancer within 2 years since the conclusion of their treatment participated in this cross-sectional study. Participants completed quality-of-life questionnaires, followed by a full-body dual-energy x-ray absorptiometry scanning. The collection concluded with maximal force exertions at the shoulder and maximum shoulder range of motion.

Results:

This study determined, through feature reduction, that internal rotation force production, active extension range of motion, and 3 shoulder-related quality-of-life variables (energy/fatigue, social functioning, and pain) separated survivors within 2 years of treatment into 2 clusters (low- and high-score clusters [LSC/HSC], respectively). The LSC participants had higher self-reported disability, lower shoulder-related quality of life, force production, and flexion range of motion.

Conclusion:

Clustering survivors of breast cancer allows for a better understanding of deficits experienced by some individuals, as well as brings awareness to factors to monitor, and address in rehabilitation efforts.
Universal Brief Mental Health Screenings for First-Year Medical Students: A 6-Year Retrospective of the Keck Checks Program
Authors: Young Chantal , Juliani Maria
Published: February 2023

Medical students are at elevated risk for mental health difficulties and may struggle to ask for help. Innovative outreach programs are warranted to reduce barriers and ensure that students receive the professional care they need and deserve. This article provides a 6-year retrospective of the Keck Checks program, a well-established initiative that offered universal 15-minute mental health screenings to every first-year medical student at the Keck School of Medicine of the University of Southern California from fall 2016 to fall 2022. This early detection program was designed to combat barriers to seeking mental health care by normalizing the concept of all students meeting with a psychologist early in their academic careers. The Keck Checks program showed promising feasibility, with a single full-time clinician successfully hosting appointments for entire classes of first-year medical students (mean of 189 students per class) during approximately 4 months, in addition to other work duties. Participation rates were high, with 715 eligible students (76.3%) choosing to attend their Keck Check. Students were frequently referred to follow-up services during the Keck Check, including mental health care (n = 360 [50.4%] referred), occupational therapy (n = 72 [10.1%] referred), and academic support services (n = 60 [8.4%] referred). Next steps include possible expansion of similar programs to medical students in years 2 to 4, residents, and physicians, as well as understanding the effect of brief mental health screenings on long-term help-seeking, adherence to mental health treatment plans, and general educational or professional success. Brief, universal mental health screenings are a relatively low-cost, high-impact approach for medical schools to consider in supporting the mental health of their student body.
Participation in breast cancer screening and its influence on other cancer screening invitations: study in women aged 56 years old in four French departments
Authors: Poiseuil Marie , Moutel Grégoire , Cosson Mathilde , Quertier Marie-Christine , Duchange Nathalie , Darquy Sylviane
Published: February 2023

Background

Today, women 50 years of age are offered three types of cancer screening in France. However, participation is not optimal. The aim was to describe (1) participation in organised breast cancer screening (OS) of women aged 56 years old, and the influence of this participation on colorectal and cervical cancer screening, (2) the reasons for non-participation in breast cancer OS, and (3) the reasons for screening before age 50.

Methods

A questionnaire was sent to 56-year-old women in four French departments to identify their participation behaviour in three breast cancer OS invitations and their reasons for non-participation. Three groups were determined according to the number of participations in breast cancer OS (3, 1–2 and 0). We described the quantitative responses and grouped the qualitative responses thematically.

Results

A total of 4634 women responded to the questionnaire. Seventy-six percent had undergone all three breast cancer OS, 16% irregular and 7% non-participant. Among women who irregularly perform breast cancer OS, 50.5% also irregularly perform colorectal cancer OS. Women who participated in all three invitations for the breast cancer OS performed more smear tests than women in the other groups. Many of the irregular participants or non-participants underwent opportunistic screening, often initiated before the age of 50. The reasons for non-participation in breast cancer OS were mainly medical or participation in opportunistic screening.

Conclusion

There is no fundamental opposition to participation in breast cancer screening. However, it remains of the utmost importance that women should be better informed about OS and its benefits.
Subclinical Celiac Disease Unmasked by Immune Checkpoint Inhibitor Therapy
Authors: Braun David S. , Patel Shruti , Schwartz Armond
Published: February 2023

Immune checkpoint inhibitors (ICI) are antibodies that block immune checkpoint proteins from binding with their partner proteins on cancer cells, subsequently allowing cytotoxic T-cell-associated enhancement of antitumor responses. Although ICIs have become the standard of care for various malignancies, their use is often limited by unique immune-related adverse events, including dermatologic, endocrine, inflammatory, hepatic, and gastrointestinal events. Diarrhea and colitis are common lower gastrointestinal tract immune-related adverse events, however, only a few cases have reported the association between celiac disease (CD) and ICIs. We report here a case of a 75-year-old man with new onset CD after exposure to the cytotoxic T-lymphocyte-associated antigen-4 ICI, ipilimumab. Although ICI-induced CD is relatively rare, it is essential to consider it in a genetically susceptible patient undergoing treatment with ICI. Patients with known high susceptibility to CD, such as a family history of CD, or with the ancestry of high celiac penetrance (eg, Northern Europe, North Africa, etc), dermatitis herpetiformis, or chronic bowel symptoms, we feel should have celiac panel testing before initiating ICI therapy.
Experimental Design of Vertical Distraction Osteogenesis Using Simple 3 Screws
Authors: Li Zeyu , Jiang Dongbo , Yao Yusheng
Published: February 2023

Distraction osteogenesis devices are complicated. To simplify these devices, we used 3 simple screws and 1 rubber band to realize the idea and analyzed histologic changes induced by mechanical forces. Ten female New Zealand white rabbits were studied. A left or right side of the mandible was randomly selected as the experimental side (ES). The unilateral mandible was distracted, and 2 fixation screws and 1 traction screw were implanted. When the traction screw was rotated downward, the opposite force made the osteotomy block move in opposite directions to increase the bone height. The control side (CS) was not processed. The results were assessed after 20 days of traction. Bone height in the ES increased by 5 mm. Toluidine blue staining showed that the number of osteoblasts per unit area on the ES was higher than that of the CS (P<0.01). PerkinElmer showed that the expressions of proliferating cell nuclear antigen (P=0.016) and collagen-I (P=0.000) on the ES were higher than those on the CS. Transmission electron microscopy showed that the number of mitochondria, endoplasmic reticulum, and Golgi apparatus on the ES was significantly greater than the CS. The results confirmed that the 3 screws vertically increase the bone height. Mechanical force signals stimulate tissue activity and lead to significant cell proliferation and differentiation in the traction zone. Collagen-I may induce osteogenesis in the early stage of traction.
Conflict resolution in a pediatric inpatient unit: a best practice implementation project
Authors: Sinclair Jessica , Palokas Michelle
Published: February 2023

Objectives:

The aim of this project was to promote evidence-based practices regarding conflict resolution in the hospital setting on a pediatric inpatient unit.

Introduction:

Conflict is an inevitable reality in healthcare organizations. Evidence suggests that to facilitate constructive conflict resolution among staff, organizational-level education, as well as formal policies and procedures are both necessary.

Methods:

A baseline audit on conflict resolution utilizing the JBI Practical Application of Clinical Evidence System program was undertaken and involved 34 nurses and two nursing assistants. The implementation project used a three-phase approach, with audits and feedback for the evaluation of compliance with best practices. Following baseline audits, an intervention, including conflict resolution education, was implemented, and recommendations to update the current policy and procedure were communicated to unit leadership. Then a postimplementation audit was undertaken.

Results:

Postimplementation audits revealed improvements in compliance across all seven audit criteria. The greatest improvement was for audit criterion 4, having a structured formal process for remediation if conflict occurs, and criterion 7, having a follow-up of agreed solutions occur, which garnered 75 and 83% improvements, respectively.

Conclusion:

For all seven audit criteria, compliance improved from 24% at baseline to 71% after the implementation of an educational module regarding conflict resolution strategies, tools, and best practices and a recommendation to update the existing policy to include the use of a conflict resolution documentation tool. Recommendations for the next steps include making educational materials and visual reminders about conflict resolution strategies readily available and easily accessible to staff.
Experimentally probing the stability of thin-shell structures under pure bending
Authors: Royer Fabien , Pellegrino Sergio
Published: February 2023

This paper studies the stability of space structures consisting of longitudinal, open-section thin-shells transversely connected by thin rods subjected to a pure bending moment. Localization of deformation, which plays a paramount role in the nonlinear post-buckling regime of these structures and is extremely sensitive to imperfections, is investigated through probing experiments. As the structures are bent, a probe locally displaces the edge of the thin shells, creating local dimple imperfections. The range of moments for which the early buckling of the structures can be triggered by this perturbation is determined, as well as the energy barrier separating the pre-buckling and post-buckling states. The stability of the local buckling mode is then illustrated by a stability landscape, and probing is extended to the entire structure to reveal alternate buckling modes disconnected from the structure’s fundamental path. These results can be used to formulate efficient buckling criteria and pave the way to operating these structures close to their buckling limits, and even in their post-buckling regime, therefore significantly reducing their mass.

This article is part of the theme issue ‘Probing and dynamics of shock sensitive shells’.
Probing the stability landscape of cylindrical shells for buckling knockdown factors
Authors: Groh R. M. J. , Pirrera A.
Published: February 2023

The buckling response of axially compressed cylindrical shells is well known for its imperfection sensitivity. Mapping out a stability landscape by localized probing has recently been proposed as a rational means for establishing shell buckling knockdown factors. Probing using a point force directed radially inwards and perpendicular to the cylinder wall is based on the insight that a localized single dimple exists as an edge state in the basin boundary of the stable prebuckling equilibrium. Here, we extend the idea of probing to bi-directional inwards and outwards forces to trigger both single-dimple and double-dimple edge states. We identify key features of the ensuing probing stability landscape and generalize these to derive three design curves of varying conservatism that are a function of the non-dimensional Batdorf parameter only. Interestingly, the most conservative of the three knockdown curves bounds a large dataset of experimental buckling results from below, despite being derived from probing features of geometrically perfect cylinders. Overall, the three design curves permit a more nuanced design approach than legacy knockdown factors, as different levels of conservatism can be chosen based on expected manufacturing quality. For instance, the most and least conservative of the three design guidelines differ by a factor of 3 for the most slender cylinder geometries, and the associated reduction in safety factor has profound implications for efficient structural design.

This article is part of the theme issue ‘Probing and dynamics of shock sensitive shells’.
Nonspecific Membrane-Matrix Interactions Influence Diffusivity of Lipid Vesicles in Hydrogels
Authors: Tam Nicky W. , Schullian Otto , Cipitria Amaia , Dimova Rumiana
Published: February 2023

The diffusion of extracellular vesicles and liposomesin vivois affected by different tissue environmental conditions and is of great interest in the development of liposome-based therapeutics and drug-delivery systems. Here, we use a bottom-up biomi-metic approach to better isolate and study steric and electrostatic interactions and their influence on the diffusivity of synthetic large unilamellar vesicles in hydrogel environments. Single-particle tracking of these extracellular vesicle-like particles in agarose hydrogels as an extracellular matrix model shows that membrane deformability and surface charge affect the hydrogel pore spaces that vesicles have access to, which determines overall diffusivity. Moreover, we show that passivation of vesicles with PEGylated lipids, as often used in drug delivery systems enhances diffusivity, but that this effect cannot be fully explained with electrostatic interactions alone. Finally, we compare our experimental findings with existing computational and theoretical work in the field to help explain the non-specific interactions between diffusing particles and gel matrix environments.

Statement of Significance

The diffusion of nanoparticles in human tissues is dependent on interactions with the surrounding environment. This has wide implications for the development of nanoparticle-based therapeutics and drug delivery systems. Studying these interactions in human tissues and even in model hydrogels composed of reconstituted tissue components can be hampered by the many different complex interactions that can occur. By using a bio-inert hydrogel material like agarose, we remove the influence of specific biochemical interactions, allowing the study of how particle diffusion can be tuned with simple material properties like charge and rigidity. Taking advantage of these non-specific interactions, nanoparticles could one day be engineered to target specific organs by optimizing diffusion in certain tissue environments or retention and immobilization in others.
Trends in mechanical circulatory support use and outcomes of patients with cardiogenic shock in Japan, 2010-2020: a nationwide inpatient database study
Authors: Nishimoto Yuji , Ohbe Hiroyuki , Matsui Hiroki , Nakata Jun , Takiguchi Toru , Nakajima Mikio , Sasabuchi Yusuke , Sato Yukihito , Watanabe Tetsuya , Yamada Takahisa , Fukunami Masatake , Yasunaga Hideo
Published: February 2023

Background

Little is known about the impact of the downgrade of guideline recommendations for intra-aortic balloon pump (IABP) use and the approval of the Impella in Japan, where IABPs have been enthusiastically used. This study aimed to describe the annual trends in the mechanical circulatory support (MCS) use and outcomes in patients with cardiogenic shock (CS) requiring MCS.

Methods

Using the Japanese Diagnosis Procedure Combination database from July 2010 to March 2021, we identified inpatients with CS requiring MCS. The patients were stratified into three groups: (i) IABP alone, (ii) Impella alone, and (iii) extracorporeal membrane oxygenation (ECMO) regardless of IABP or Impella use. The patient characteristics and outcomes were reported by the fiscal year.

Results

Of the 160,559 eligible patients, 117,599 (73.2%) used IABP alone, 1,465 (0.9%) Impella alone, and 41,495 (25.8%) ECMO. The prevalence of an IABP alone significantly decreased from 80.5% in 2010 to 65.3% in 2020 (P for trend <0.001), whereas the prevalence of an Impella alone significantly increased from 0.0% to 5.0% as well as ECMO from 19.5% to 29.6% (P for trend <0.001 for both). In-hospital mortality significantly increased from 29.3% in 2010 to 32.6% in 2020 in the overall patients with CS requiring MCS, but significantly decreased in those requiring ECMO from 73.7% to 64.1% (P for trend <0.001 for both).

Conclusions

There were significant annual changes in the patterns of MCS use and clinical outcomes in patients with CS requiring MCS.
Cell Population Growth Kinetics in the Presence of Stochastic Heterogeneity of Cell Phenotype
Authors: Wang Yue , Zhou Joseph X. , Pedrini Edoardo , Rubin Irit , Khalil May , Qian Hong , Huang Sui
Published: February 2023

Recent studies at individual cell resolution have revealed phenotypic heterogeneity in nominally clonal tumor cell populations. The heterogeneity affects cell growth behaviors, which can result in departure from the idealized exponential growth. Here we measured the stochastic time courses of growth of an ensemble of populations of HL60 leukemia cells in cultures, starting with distinct initial cell numbers to capture the departure from the exponential growth model in the initial growth phase. Despite being derived from the same cell clone, we observed significant variations in the early growth patterns of individual cultures with statistically significant differences in growth kinetics and the presence of subpopulations with different growth rates that endured for many generations. Based on the hypothesis of existence of multiple inter-converting subpopulations, we developed a branching process model that captures the experimental observations.