bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical characteristics of seizure recurrence and epilepsy development in patients with alcohol‐related seizures
Authors: Chun Min Young , An Hyungmi , Lee Hye Ah , Hwang Sungeun , Chung Seungwon , Kim Na‐Young , Lee Hyang Woon
Published: September 2024

Background

Alcohol withdrawal is widely recognized as a trigger for acute symptomatic seizures among individuals with chronic alcohol consumption. While most alcohol withdrawal seizures occur shortly after cessation, chronic alcohol consumption can be associated with the development of epilepsy, necessitating anti‐epileptic drug (AED) therapy. This study aimed to investigate the clinical characteristics, seizure recurrence, and epilepsy development in patients with alcohol‐related seizures and to identify prognostic factors for epilepsy.

Methods

In a retrospective analysis at Ewha Womans University Mokdong Hospital, 206 patients with alcohol‐related seizures were examined and 15 were excluded due to preexisting epilepsy. Demographic and clinical data, including alcohol withdrawal duration, seizure recurrence, types, and comorbidities, were investigated. Logistic regression models were used to analyze the risk factors for seizure recurrence and epilepsy development. The performance of the final models was evaluated based on the area under the receiver operating characteristic curve (AUC) and validated using calibration plots and leave‐one‐out cross‐validation.

Results

Of the 191 patients (146 males; mean age 48.3 ± 12.1 years) with alcohol‐related seizures, 99 patients (51.8%) experienced seizure recurrence and 79 patients (41.4%) developed epilepsy. Factors associated with seizure recurrence included alcohol consumption levels, occurrence of focal impaired awareness seizure, anxiety, and headache. The number of recurrent seizures, semiology, status epilepticus, electroencephalogram findings, and brain imaging findings was associated with epilepsy development. The predictive models showed strong diagnostic performance, with AUCs of 0.833 for seizure recurrence and 0.939 for epilepsy development.

Conclusion

High alcohol consumption and specific clinical and diagnostic features are significant predictors of seizure recurrence and the development of epilepsy among patients with alcohol‐related seizures. These findings underscore the importance of early identification and intervention to prevent seizure recurrence and the onset of epilepsy, emphasizing the importance of AED treatment in managing these conditions.
Exploring the intersection of polygenic risk scores and prenatal alcohol exposure: Unraveling the mental health equation
Authors: Gerlikhman Lazer , Sarkar Dipak K.
Published: September 2024

Background

Prenatal alcohol exposure poses significant risks to offspring mental health. However, the interplay between genetic predispositions to mental health disorders and prenatal alcohol exposure remains incompletely understood, limiting our ability to develop effective interventions for these conditions.

Methods

Data from the Adolescent Brain and Cognitive Development (ABCD) Study were analyzed to explore associations between polygenic risk scores (PRS) for mental disorders and maternal alcohol consumption during pregnancy. Logistic regression and structural equation modeling were utilized to assess these relationships.

Results

Maternal alcohol consumption after pregnancy awareness was significantly associated with an increased genetic risk for specific mental health disorders, particularly bipolar disorder in offspring. The relationship between maternal alcohol consumption and mental health outcomes was influenced by polygenic risk scores, with both externalizing and internalizing problems being affected.

Conclusions

Our findings highlight the specific interaction between increased genetic risk for bipolar disorder and prenatal alcohol exposure in shaping offspring mental health outcomes. The significant associations we observed underscore the importance of considering both polygenic risk scores and prenatal alcohol exposure when assessing mental health risks in children. These insights emphasize the need for targeted interventions that address both genetic predispositions and environmental exposures to better understand and mitigate the impact on offspring mental health.
Winter mortality of the bark beetle Ips typographus in standing trees and in the ground
Authors: Schroeder Martin , Kärvemo Simon , Cocos Dragos , Öhrn Petter , Weslien Jan
Published: September 2024

Ips typographus is the most important tree‐killing bark beetle in Europe. In the north, it overwinters either in the bark of its host tree or in the ground, while in central Europe, overwintering in trees is most common. Few studies have estimated winter mortality of I. typographus in northern Europe.

Mortality of I. typographus adults overwintering in killed trees was estimated by comparing densities per m2 bark of live (one winter) and dead adults (five winters), and proportion of dead adults (one winter), in bark samples collected before and after winter in Sweden. Densities of live and dead larvae of predatory Medetera spp. (Dolichopodidae) were recorded in the bark samples (one winter), as was the amount of bark removed by woodpeckers from I. typographus‐killed trees during winter foraging (five winters). Mortality of I. typographus adults overwintering in the ground was estimated by spring sampling of soil (three winters).

The density of I. typographus live adults in trees was 3% lower after winter, while densities of dead adults was 6% higher and 5% lower respectively during two different outbreaks (differences after vs. before winters were non‐significant). The proportion of dead adults was 4% higher after winter (significant). Winter mortality of adults overwintering in the ground was on average 58%.

The density of Medetera was 6% and 8% lower after winter for live and dead larvae, respectively (non‐significant).

The amount of remaining bark on standing killed trees was on average 8% lower after than before winter (significant).
Mechanical circulatory support for cardiogenic shock during the peripartum period
Authors: Elad Boaz , Karas Maria , Lee Changhee , Oren Daniel , Fried Justin , Raikhelkar Jayant , Clerkin Kevin , Sayer Gabriel , Uriel Nir , Haythe Jennifer
Published: September 2024

Background

Cardiomyopathies account for more than half of the cardiovascular disease during the peripartum period. In the extreme, patients may present with cardiogenic shock (CS) requiring mechanical circulatory support (MCS). The aim of this study was to report our experience with CS requiring MCS in the peripartum period.

Methods

We present a single‐center retrospective analysis of all CS cases involving MCS during the peripartum period that occurred between 2012 and 2023.

Results

Eleven cases were included. Median age was 33, median BMI was 30.4, and 73% underwent a caesarian‐section for delivery. CS presentation occurred in 36.4% during pregnancy and in 63.6% after delivery. Most patients were in Society for Cardiovascular Angiography & Interventions (SCAI) Stage C shock and in 37% the suspected etiology was peripartum cardiomyopathy. MCS usage included intra‐aortic balloon pump (4), Impella microaxial blood pump (2), veno‐arterial extracorporeal membrane oxygenation (6), and temporary right ventricle assist devices (2), with some patients having multiple MCS devices. The rate of major complications was 36.4%. During a median follow‐up of 4.5 years, 7 patients had sustained cardiac recovery (63.6%), 1 patient (9.1%) underwent cardiac transplantation, 2 patients (18.2%) received a durable LVAD, and 2 (18.2%) have died.

Conclusion

MCS in severe CS cases during the peripartum period is rare and associated with favorable outcomes. High recovery rates suggest favoring first MCS/LVAD over transplant.
Global certification of visual impairment registries: A scoping review
Authors: Cushley Laura N. , Leonard‐Hawkhead Benedict , Jackson Andrew Jonathan , Peto Tunde
Published: September 2024

Background

Visual impairment is a global problem which is predicted to rise in the coming years. Some of the biggest causes of visual impairment globally include uncorrected refractive error, cataract and age‐related macular degeneration. People with a visual impairment often require support and so many countries hold registers of visual impairment. These registers can sit at a national, regional or local level. This scoping review aims to identify which countries hold visual impairment registries and have published data from them.

Methods

Medline All, Embase and EBSCOHost were searched using several search terms after consulting an information specialist. All papers after the year 2000 were included in the scoping review. All results are shown using a PRISMA diagram and presented narratively.

Results

The total number of articles and papers identified was 1266; after screening and review, 57 articles were included in the review from 2000 to 2024. These articles came from 19 different countries and encompassed national, regional and local visual impairment databases. Many countries cited age‐related macular degeneration as the major cause of blindness with diabetic retinopathy and glaucoma following. In less economically developed countries, refractive error was the main cause of sight loss. There were papers which focused on specific eye conditions such as glaucoma and diabetic retinopathy or on specific cohorts including working‐age population and children. The leading causes of blindness in children appeared to be inherited retinal diseases, albinism and cerebral visual impairment.

Conclusion

Certification of visual impairment is held differently across the world. There is commonality among different countries regarding the major causes of visual impairment in both adults and children. The importance of holding visual impairment registers to support people with a visual impairment and to plan services is essential.
Facial basis of stereotypes: Judgements of warmth and competence based on cross‐group typicality/distinctiveness of faces
Authors: Saribay S. Adil , Pokorný Šimon , Tureček Petr , Kleisner Karel
Published: September 2024

Human migration is an increasingly common phenomenon and migrants are at risk of disadvantageous treatment. We reasoned that migrants may receive differential treatment by locals based on the closeness of their facial features to the host average. Residents of Türkiye, the country with the largest number of refugees currently, served as participants. Because many of these refugees are of Arabic origin, we created target facial stimuli varying along the axis connecting Turkish and Arabic morphological prototypes (excluding skin colour) computed using geometric morphometrics and available databases. Participants made judgements of two universal dimensions of social perception–warmth and competence–on these faces. We predicted that participants judging faces manipulated towards the Turkish average would provide higher warmth and competence ratings compared to judging the same faces manipulated towards the Arabic average. Bayesian statistical tools were employed to estimate parameter values in multilevel models with intercorrelated varying effects. The findings did not support the prediction and revealed raters (as well as target faces) to be an important source of variation in social judgements. In the absence of simple cues (e.g. skin colour, group labels), the effect of facial morphology on social judgements may be much more complex than previously assumed.
Whole Exome Sequencing Identifies Epithelial and Immune Dysfunction‐Related Biomarkers in Food Protein‐Induced Enterocolitis Syndrome
Authors: Camino‐Mera Alba , Pardo‐Seco Jacobo , Bello Xabier , Argiz Laura , Boyle Robert J. , Custovic Adnan , Herberg Jethro , Kaforou Myrsini , Arasi Stefania , Fiocchi Alessandro , Pecora Valentina , Barni Simona , Mori Francesca , Bracamonte Teresa , Echeverria Luis , O'Valle‐Aísa Virginia , Hernández‐Martínez Noelia Lara , Carballeira Iria , García Emilio , Garcia‐Magan Carlos , Moure‐González José Domingo , Gonzalez‐Delgado Purificación , Garriga‐Baraut Teresa , Infante Sonsoles , Zambrano‐Ibarra Gabriela , Tomás‐Pérez Margarita , Machinena Adrianna , Pascal Mariona , Prieto Ana , Vázquez‐Cortes Sonia , Fernández‐Rivas Montserrat , Vila Leticia , Alsina Laia , Torres María José , Mangone Giusi , Quirce Santiago , Martinón‐Torres Federico , Vázquez‐Ortiz Marta , Gómez‐Carballa Alberto , Salas Antonio
Published: September 2024

Background

Food protein‐induced enterocolitis syndrome (FPIES) is a food allergy primarily affecting infants, often leading to vomiting and shock. Due to its poorly understood pathophysiology and lack of specific biomarkers, diagnosis is frequently delayed. Understanding FPIES genetics can shed light on disease susceptibility and pathophysiology—key to developing diagnostic, prognostic, preventive and therapeutic strategies. Using a well‐characterised cohort of patients we explored the potential genome‐wide susceptibility factors underlying FPIES.

Methods

Blood samples from 41 patients with oral food challenge‐proven FPIES were collected for a comprehensive whole exome sequencing association study.

Results

Notable genetic variants, including rs872786 (RBM8A), rs2241880 (ATG16L1) and rs2289477 (ATG16L1), were identified as significant findings in FPIES. A weighted SKAT model identified six other associated genes including DGKZ and SIRPA. DGKZ induces TGF‐β signalling, crucial for epithelial barrier integrity and IgA production; RBM8A is associated with thrombocytopenia absent radius syndrome, frequently associated with cow's milk allergy; SIRPA is associated with increased neutrophils/monocytes in inflamed tissues as often observed in FPIES; ATG16L1 is associated with inflammatory bowel disease. Coexpression correlation analysis revealed a functional correlation between RBM8A and filaggrin gene (FLG) in stomach and intestine tissue, with filaggrin being a known key pathogenic and risk factor for IgE‐mediated food allergy. A transcriptome‐wide association study suggested genetic variability in patients impacted gene expression of RBM8A (stomach and pancreas) and ATG16L1 (transverse colon).

Conclusions

This study represents the first case–control exome association study of FPIES patients and marks a crucial step towards unravelling genetic susceptibility factors underpinning the syndrome. Our findings highlight potential factors and pathways contributing to FPIES, including epithelial barrier dysfunction and immune dysregulation. While these results are novel, they are preliminary and need further validation in a second cohort of patients.
Association between aortic calcification and cytokine levels in patients with peripheral artery disease
Authors: Rantasalo Ville , Laukka Dan , Nikulainen Veikko , Jalkanen Juho , Gunn Jarmo , Kiviniemi Tuomas , Hakovirta Harri
Published: September 2024

Aortic calcification—a marker of advanced atherosclerosis in large arteries—associates with cardiovascular mortality and morbidity. Little is known about the soluble inflamJarmatory profiles involved in large artery atherosclerosis. We investigated the correlation between aortic calcification in the abdominal aorta and cytokine levels in a cohort of peripheral artery disease patients. Aortic calcification index was measured from computed tomography exams and circulating cytokine levels were analyzed from blood serum samples of 156 consecutive patients prior to invasive treatment of peripheral artery disease. The study included 156 patients (mean age 70.7 years, 64 (41.0%) women). The mean ankle‐brachial index (ABI) was 0.64 and the mean aortic calcification index (ACI) was 52.3. ACI was associated with cytokines cutaneous T‐cell‐attracting chemokine CTACK (β 23.08, SE 5.22, p < 0.001) and monokine induced by gamma‐interferon MIG (β 9.40, SE 2.82, p 0.001) in univariate linear regression. After adjustment with cardiovascular risk factors, CTACK and MIG were independently associated with ACI, β 17.9 (SE 5.22, p < 0.001) for CTACK and β 6.80 (SE 3.33, p 0.043) for MIG. CTACK was significantly higher in the patients representing the highest ACI tertile (highest vs. middle, 7.53 vs. 7.34 Tukeys HSD p‐value 0.023 and highest vs. lowest tertile 7.53 vs. 7.29, Tukeys HSD p‐value 0.002). MIG was significantly higher in the highest tertile versus lowest (7.65 vs. 7.30, Tukeys HSD p‐value 0.027). Cytokines CTACK and MIG are associated with higher ACI, suggesting that CTACK and MIG reflect atherosclerotic disease burden of the aorta. This might further suggest the possible association with other cardiovascular morbidities.
Optimized fosfomycin regimens for treating carbapenem‐resistant Acinetobacter baumannii in critically ill patients with varying degrees of renal function
Authors: Tidwong Nattapong , Chanruang Anan , Chupradit Suthanya , Parker Suzanne L. , Leelawattanachai Pannee , Winichakoon Poramed , Punyawudho Baralee
Published: September 2024

Fosfomycin has been used to treat carbapenem‐resistant Acinetobacter baumannii (CRAB) infections. However, there is insufficient information on dosage adjustment among critically ill patients with renal impairment. This study aims to evaluate the attainment of PK/PD targets for different dosage regimens of CRAB treatment in critically ill patients based on their renal function. Monte Carlo simulations were conducted to assess the probability of achieving time above the minimum inhibitory concentration (T > MIC) of 80% and 100% and to determine the cumulative fraction response (CFR) against institutional MICs. Our results demonstrated that administering fosfomycin 20–24 g/day to individuals with normal renal function (CrCl ≥60 mL/min) achieved the target at a MIC of ≤64 and ≤32 μg/mL during the first 24 h of treatment and at steady state, respectively. Notably, those with renal impairment achieved higher MIC values at a steady state despite dosage reduction. None of the regimens reached the target CFR. Our study suggested that administering fosfomycin at least 20 g/day to those with normal renal function provides sufficient exposure throughout the treatment course when the MIC value is ≤32 μg/mL. Less aggressive dosing regimens are advisable for patients with renal impairment. Additional clinical studies are necessary to verify our suggestions.
Metastatic Medullary Thyroid Carcinoma Presenting as an Incidental Posterior Mediastinal Mass
Authors: Goldberg Chaya , Diaz DeAnna , Brandler Tamar
Published: September 2024

Medullary thyroid carcinoma (MTC) is an uncommon neuroendocrine tumour that is usually asymptomatic at its onset and therefore may not present clinically until the patient has developed advanced or metastatic disease. Common metastatic sites include cervical lymph nodes, liver, bone and lung. This is the case of a patient who presented with an incidental posterior mediastinal mass. Because the posterior mediastinum is an unusual location for MTC, MTC was not a consideration and preliminary histopathological testing did not include calcitonin, which would have been diagnostic. This case highlights the importance of testing for calcitonin more regularly when encountering a mass of unknown origin with neuroendocrine morphology, which may lead to earlier detection of MTC and thus improved prognosis.
The impact of expiratory muscle strength training on voluntary cough effectiveness in Huntington's disease
Authors: Konvalinkova Romana , Srp Martin , Doleckova Kristyna , Capek Vaclav , Gal Ota , Hoskovcova Martina , Kliment Radim , Muzik Jan , Ruzicka Evzen , Klempir Jiri
Published: September 2024

Background and purpose

Dysfunction of the airway defence system in Huntington's disease (HD) is a significant but often overlooked problem. Although expiratory muscle strength training (EMST) is frequently utilized in cough effectiveness treatment, its specific impact in HD patients has not yet been explored. This study investigated the effects of EMST on voluntary peak cough flow (vPCF) in HD patients and evaluated the retention of potential gains post‐intervention.

Methods

In this prospective case‐controlled trial, 29 HD patients completed an 8‐week wait‐to‐start period, which served to identify the natural development of expiratory muscle strength and vPCF. This was followed by 8 weeks of EMST training and an additional 8 weeks of follow‐up. The study's outcome parameters, vPCF and maximum expiratory pressure (MEP), were measured against those of age‐ and sex‐matched healthy controls.

Results

Huntington's disease patients had significantly lower MEP (p < 0.001) and vPCF (p = 0.012) compared to healthy controls at baseline. Following the EMST, significant improvements in MEP (d = 1.39, p < 0.001) and vPCF (d = 0.77, p = 0.001) were observed, with HD patients reaching the cough performance levels of healthy subjects. However, these gains diminished during the follow‐up, with a significant decline in vPCF (d = −0.451, p = 0.03) and in MEP (d = −0.71; p = 0.002).

Conclusions

Expiratory muscle strength training improves expiratory muscle strength and voluntary cough effectiveness in HD patients, but an ongoing maintenance programme is necessary to sustain the improvements.
Disclosure dilemma: Revealing biological paternity to family and others after unexpected direct‐to‐consumer genetic results
Authors: Grethel Michele , Ross Lily , Obadia Julienne , Freeman Robin
Published: September 2024

Objective

This study explores the experiences of direct‐to‐consumer (DTC) genetic test results of recipients who learn of unexpected biological paternity, not parent expected (NPE). We characterize the process of disclosing NPE discoveries, as well as the benefits and the repercussions of such disclosures on individuals, families, and others.

Background

The popularity of DTC genetic testing is increasing. Consequently, many discover unexpected information about their ancestry, heritage, and paternity.

Methods

This qualitative study used an inductive thematic analysis of in‐depth interviews with adults (n = 27; aged 40–70) who received DTC genetic test results revealing unexpected biological paternity.

Results

The NPE disclosure dilemma encompasses uncertainty about narrating their discovery; gauging the dispositions of others; wondering what repercussions may arise; and managing feelings about stigma, betrayal, and anger. Culture, history, and family dynamics are vital in navigating disclosures. A desire to understand their origins, connect with new genetic families, and validate their sense of self is essential. Biological connections of kinship remain important arbiters of relatedness for many individuals.

Conclusion

Disclosure of NPE discoveries differs from other stigmatized identities because the secret belongs to someone else; thus, self‐disclosure affects the entire family system.

Implications

Drawing on family systems theory and disclosure processes model, our findings provide insights into the intricate dynamics inherent in NPE disclosure.
Recommendations from the ABA Commission on Youth at Risk Convening – “Renewal and Revolution: Recommitting the Legal Profession to Serve Children and Youth, their Families, and Communities”
Authors: Smith Charisa
Published: September 2024

Youth and families impacted by legal systems now resoundingly attest to the systems' lasting harm, echoed by interdisciplinary research. Lawyering thus requires a vastly renewed outlook, boldness, and honest inquiry about the limits of what the law and public systems can (and should) attempt as purported problem‐solving amidst broader socioeconomic forces and injustice. This report synthesizes recommendations from a groundswell of diverse, dedicated voices following an October 2023 convening hosted by the American Bar Association Commission on Youth at Risk, the ABA Center on Children and the Law, and Hofstra University's Maurice A. Deane School of Law. Entitled “Renewal and Revolution: Recommitting the Legal Profession to Serving Children and Youth, Their Families, and Communities,” the convening engaged various professionals—many with firsthand experience in foster and justice systems— and other advocates. Since the 2006 ABA Youth At Risk Initiative Planning Conference, the ABA Commission on Youth At Risk has elevated the representation and voice of youth through ethical practice standards, expanded access, and national initiatives. This report recounts findings of the 2023 convening's four working groups which met for two‐days of (often tense) discussions to chart a path for the legal profession, law, and policy for the next decade and beyond. Priorities include: transcending conceptions of youth “at risk” towards recognition of harms done, a strengths‐based lens, and lived experience leadership and expertise; cultivating next generation attorneys; prioritizing early family defense and diversion; divesting from systems and re‐investing directly with youth and families; and further eliminating racial disparities.
Juvenile coho salmon growth differences track biennial pink salmon spawning patterns
Authors: Fitzgerald Kevin A. , Bellmore J. Ryan , Fellman Jason B. , Cheng Matthew L. H. , Boyles‐Muehleck Naomi , Delbecq Claire E. , Falke Jeffrey A.
Published: September 2024

Spawning Pacific salmon (Oncorhynchus spp.) provide marine‐derived resources (MDR) to freshwater food webs in the form of eggs, flesh and maggots that consume salmon carcasses, all of which positively impact stream‐dwelling fish growth. Pink salmon (O. gorbuscha) are widely distributed throughout coastal catchments along the North Pacific Ocean and display increased spawning abundances in odd years, owing to a fixed 2‐year life history. While many studies have found that foraging and growth of stream‐dwelling salmonids are improved by increased adult salmon spawning abundance, few studies have investigated the importance of alternating pink salmon spawning abundance between years.

Here, we examined how patterns of pink salmon spawning abundance impact the foraging and growth of juvenile coho salmon (O. kisutch). First, we used bioenergetic simulations to generate a hypothesis that coho salmon growth would increase during odd relative to even years. We then collected empirical juvenile coho salmon diet and growth data from a Southeast Alaska catchment in 2021 (pink salmon spawning) and 2022 (no pink salmon spawning). Field data were compared against simulation predictions to understand impacts of biennial pink salmon spawning patterns on juvenile coho salmon growth.

Empirical growth data revealed similar patterns to bioenergetic simulations. Age‐1 coho salmon grew 16.6 mm longer and 5.5 g heavier on average in 2021 compared to 2022. Age‐0 coho salmon displayed minor growth differences between years.

These results support bioenergetic model predictions and suggest that patterns of pink salmon spawning abundance can impart interannual growth disparities to juvenile coho salmon. Moreover, we show that distinct spawning characteristics of Pacific salmon species are important when understanding patterns of MDR transfer and growth responses in stream fishes.
Mical1 deletion in tyrosinase expressing cells affects mouse running gaits
Authors: Micovic Katarina , Canuel Alicia , Remtulla Aasiya , Chuyen Alexandre , Byrsan Margarita , McGarry David J. , Olson Michael F.
Published: September 2024

Neuronal development is a highly regulated process that is dependent on the correct coordination of cellular responses to extracellular cues. In response to semaphorin axon guidance proteins, the MICAL1 protein is stimulated to produce reactive oxygen species that oxidize actin on specific methionine residues, leading to filamentous actin depolymerization and consequent changes in neuronal growth cone dynamics. Crossing genetically modified mice homozygous for floxed Mical1 (Mical1fl/fl) alleles with transgenic mice expressing Cre recombinase under the control of a tyrosinase gene enhancer/promoter (Tyr::Cre) enabled conditional Mical1 deletion. Immunohistochemical analysis showed Mical1 expression in the cerebellum, which plays a prominent role in the coordination of motor movements, with reduced Mical1 expression in Mical1fl/fl mice co‐expressing Tyr::Cre. Analysis of the gaits of mice running on a treadmill showed that both male and female Mical1fl/fl, Tyr::Cre mutant mice had significant alterations to their striding patterns relative to wild‐type mice, although the specific aspects of their altered gaits differed between the sexes. Additional motor tests that involved movement on a rotating rod, descending a vertical pole, or crossing a balance beam did not show significant differences between the genotypes, suggesting that the effect of the Mical1fl/fl, Tyr::Cre genetic modifications was only manifested during specific highly coordinated movements that contribute to running. These findings indicate that there is a behavioral consequence in Mical1fl/fl, Tyr::Cre mutant mice that affects motor control as manifested by alterations in their gait.
Microstructure and electrical properties of aluminum oxide‐reinforced 3 mol% yttria‐stabilized tetragonal zirconia polycrystals/TiSi2 composites by vacuum sintering
Authors: Liu Weikang , Chen Yucong , Wu Cong , Tang Liangying , Yao Zhenhua
Published: September 2024

3 mol% yttria‐stabilized tetragonal zirconia polycrystals (3Y‐TZP)/TiSi2 composites reinforced with aluminum oxide (Al2O3) were synthesized by vacuum sintering. This case investigated the effects of Al2O3 content ranging from 0 to 10 wt.% on the microstructure, mechanical, and electrical properties of 3Y‐TP/TiSi2 composites. According to the results, the addition of Al2O3 hindered the densification of the material, resulting in a deterioration in the relative density of composites. On the contrary, the hardness, flexural strength, and average grain size of the conductive phase increased. The maximum value of hardness and flexural strength was 88.70 HRA with 7.5 wt.% Al2O3 and 635.45 MPa with 10 wt.% Al2O3, respectively. In addition, the addition of Al2O3 increases the ratio of grain size between the conductive and insulating phases in composites, leading to a decrease in the percolation threshold and a reduction in resistivity from 4.00 to 1.60 × 10−3 Ω·cm with increasing Al2O3 content. In conclusion, Al2O3 reinforced the comprehensive mechanical properties and optimized the electrical properties of composites by changing the microstructure of the material.
The impact of the nursing work environment on compassion fatigue: The mediating role of general self‐efficacy
Authors: Chen Xian , Li Jie , Arber Anne , Qiao Chengping , Wu Jinfeng , Sun Cuihua , Han Xue , Wang Dan , Zhu Zhu , Zhou Hui
Published: September 2024

Aim

To explore the interplay between the perceived nursing work environment, general self‐efficacy, and compassion fatigue among registered nurses in Chinese hospitals.

Background

Compassion fatigue emerges as a significant occupational stress response globally, with the nursing work environment being a pivotal influencer. There is a knowledge gap in understanding how the nursing work environment and general self‐efficacy interrelate to affect compassion fatigue, particularly among Chinese nurses.

Methods

Employing a cross‐sectional, descriptive design, this study utilized validated questionnaires to gather data from 7085 nurses across public and private hospitals in China. The analysis focused on assessing the interrelations among the perceived nursing work environment, general self‐efficacy, and different dimensions of compassion fatigue.

Finding

More than half (65.67%) of the participants experienced moderate or high burnout levels, with 76.43% experiencing secondary traumatic stress. The lowest rating in the nursing work environment was for nurse/physician collaboration (10 ± 2.07), while general self‐efficacy scored higher (27.54 ± 6.26). A positive relationship existed between the work environment and both general self‐efficacy and compassion satisfaction, with a negative correlation to burnout and traumatic stress. General self‐efficacy was a partial mediator in the link between work environment and compassion fatigue, suggesting that improving the work environment can decrease compassion fatigue by boosting nurses' self‐efficacy.

Conclusion

This study underscores the profound impact of the nursing work environment on compassion fatigue, mediated by general self‐efficacy. It highlights the necessity of fostering a supportive work environment to enhance nurses' self‐efficacy and overall well‐being.

Implications for nursing and health policy

Healthcare managers and institutions must create supportive work environments to reduce compassion fatigue among nurses. This includes professional development programs to enhance self‐efficacy and job satisfaction. Policies should address high workloads and inadequate support. Nurse leaders should foster environments that promote psychological well‐being, improving outcomes for both nurses and patients. Regular assessments and adjustments of work conditions are essential to maintain a healthy work environment.
BNT162b2 Versus mRNA‐1273 Vaccines: Comparative Analysis of Long‐Term Protection Against SARS‐CoV‐2 Infection and Severe COVID‐19 in Qatar
Authors: Chemaitelly Hiam , Ayoub Houssein H. , Coyle Peter , Tang Patrick , Hasan Mohammad R. , Yassine Hadi M. , Al Thani Asmaa A. , Al‐Kanaani Zaina , Al‐Kuwari Einas , Jeremijenko Andrew , Kaleeckal Anvar Hassan , Latif Ali Nizar , Shaik Riyazuddin Mohammad , Abdul‐Rahim Hanan F. , Nasrallah Gheyath K. , Al‐Kuwari Mohamed Ghaith , Butt Adeel A. , Al‐Romaihi Hamad Eid , Al‐Thani Mohamed H. , Al‐Khal Abdullatif , Bertollini Roberto , Abu‐Raddad Laith J.
Published: September 2024

Background

This study provides a head‐to‐head comparison of the protection provided by the BNT162b2 and mRNA‐1273 vaccines against SARS‐CoV‐2 infection and against severe COVID‐19, covering primary series and third dose/booster vaccinations over up to 3 years of follow‐up, both before and after the emergence of the omicron variant.

Methods

Two national, matched, retrospective cohort studies were conducted on Qatar's vaccinated population from December 16, 2020, to February 18, 2024. Subgroup analyses by pre‐vaccination SARS‐CoV‐2 infection history, as well as sensitivity analyses, were also conducted.

Results

The adjusted hazard ratio (AHR) comparing infection incidence in those vaccinated with BNT162b2 versus mRNA‐1273 was 1.03 (95% CI: 1.02–1.05) after the primary series and 1.11 (95% CI: 1.09–1.13) after the third (booster) dose. The corresponding AHRs for any severe, critical, or fatal COVID‐19 were 1.31 (95% CI: 0.81–2.11) and 1.00 (95% CI: 0.20–4.94), respectively. Subgroup analyses by prior infection status hinted at a dose‐dependent immune imprinting effect, where a combination of two types of immunity, pre‐omicron and omicron, offered greater protection against infection than one type alone, with this effect being amplified by the higher antigen dose of mRNA‐1273 compared to BNT162b2. Sensitivity analyses confirmed the study findings.

Conclusions

BNT162b2 provided slightly less protection against infection than mRNA‐1273 following both primary series and booster vaccinations while offering comparable protection against severe COVID‐19 outcomes. The findings suggested that the vaccine antigen dose in interaction with infection history may determine the extent of immune protection against infection.
Rejection in liver allograft recipients: Clinical characterization and management
Authors: Emond Jean C. , Thistlethwaite J. Richard , Baker Alfred L. , Whitington Peter F. , Ferrari Mauro , Carmellini Mario , Stuart Frank P. , Broelsch Christoph E.
Published: September 2024

A retrospective study of 34 liver transplants in 31 recipients receiving cyclosporine was conducted to assess the clinical features of rejection and the response to therapy. Thirty‐eight rejection episodes were identified and treated in the 34 transplants and form the material of this study. Graft dysfunction was detected by biochemical testing in most cases; clinical assessment, liver biopsy, and radiographic studies were used to establish a specific diagnosis. Rejection therapy was required in 24 of 34 transplants (71 %), occurring between 6 and 400 d after transplantation. Three days of high‐dose steroid therapy successfully reversed 19/24 (79%) first rejection episodes and and 5/14 (36%) recurrent rejections (p<0.1). Salvage therapy using anti‐lymphocyte antibody preparations reversed 4/5 first rejections and 5/8 recurrent rejections. Graft loss due to rejection occurred in 5/34 transplants (15%). Infections occurred in 68% of recipients overall and were no more frequent in patients receiving rejection therapy. Due to the high initial response rate, therapy with steroids is appropriate for first rejection episodes. Salvage therapy is often effective in reversing steroid resistant rejections and should be used early in patients with resistant or recurrent rejection. Graft loss to rejection continues to occur in a significant percentage of cases and retransplantation should be considered early if the response to salvage therapy is poor.
Renal transplantation in sickle cell anemia and sickle disease
Authors: Barber W. Henry , Deierhol Mark H. , Julian Bruce A. , Curtis John J. , Luke Robert G. , Alexander Ronald W. , Dlethelm Arnold G.
Published: September 2024

Sickle cell anemia and sickle cell disease produce a variety of functional renal abnormalities which uncommonly cause end stage renal failure. Although the number of patients is small, transplantation has been described as a suitable alternative to dialysis for renal replacement therapy with outcomes comparable to non‐sickle recipients. We report the results of cadaveric renal transplantation in 8 patients with sickle cell disorders (6 with sickle cell anemia, 1 with HbS‐HbC disease, and 1 with Hbs‐bcta thalassemia disease) at one transplant center between January 1968 and October 1986. Four allografts were lost to sickling; 2 of the recipients died from severe sickle cell crises. A 5th kidney was lost when the recipient died abruptly from a febrile illness of unknown cause. Two allografts were removed for irreversible acute rejection. Only 1 kidney functioned 18 months posttransplantation. We conclude that transplantation at this time may not offer better renal replacement therapy than dialysis for adults with sickle cell anemia, and perhaps other sickle cell disorders experiencing few complications on dialysis.
Late results of living related donor renal transplantation – Effect of HLA, MLR and ABO antigen matching
Authors: Abouna George M. , White Arthur G. , Al‐Abdulla Ismael H. , Kumar M. S. Anil , Panjuwani Dilip , Phillips E. M.
Published: September 2024

The late results of patient and graft survival in 218 consecutive recipients of primary living related donor renal allografts, aged 4 to 65 years, transplanted in a single center were analyzed with respect to HLA, MLR and ABO antigens. All patients received pretransplant blood transfusions and conventional immunosuppression. Acute rejections were treated with 3 pulses of steroids and with ATG if steroid‐resistant. With the exception of MLR, none of the other histocompatibility antigens had any significant effect on the final outcome. Acturial graft survival at 2, 5 and 8 yr was 92%, 90% and 90%; 88%, 85% and 83%; 88%, 88% and 86% for 2 haplotype (N = 50), 1 haplotype (N = 139) and 0 haplotype match (N = 29), respectively (p = NS). Graft survival in MLR‐negative and MLR‐positive recipients at the same intervals was 100%, 100%, 100% and 92%, 86%, 84%, respectively (p = 0.05). Recipients of matched grafts had lower rejection frequency than recipients of mismatched grafts (0.78 vs 1.3/patient) and they required less ATG for rejection therapy (1.66 g vs 2.32 g/patient). All donors are alive and well without serious morbidity. These results indicate that transplantation from mismatched living related donors can be highly successful and it is concluded that the use of mismatched living related donors remains justified as an important and successful source for renal transplantation.
Pancreatic juice cytology in the diagnosis of pancreatic graft rejection
Authors: Reinholt Finn P. , Tydén Gunnar , Bohman Sven‐Olof , Brattström Christina , Groth Carl Gustav
Published: September 2024

The present paper describes the application of cytological analysis of the pancreatic juice as a diagnostic tool in pancreatic transplantation and presents the results in the first 20 patients thus monitored. Cytocentrifuge samples of the pancreatic juice were prepared daily and examined with respect to total number of cells, relative abundance of different types of inflammatory cells and content of parenchymal cells. The first 3–5 d after transplantation, a granulocytic exudation was usually seen in the juice. In uncomplicated cases, the cellularity of the specimens then decreased. In 8 patients who had undergone pancreatic transplantation only, 8 graft rejection episodes were diagnosed by loss of amylase activity in the pancreatic juice. In 7 of these cases cytology showed signs of immunoactivation in the form of increased cellularity with a relative increase in the number of mononuclear cells and the occurrence of lympho‐ and/or monoblasts. This regularly preceded all other signs of rejection, including decreased amylase activity, by 1–2 d. Among 12 patients subjected to combined renal and pancreatic transplantation, there were 13 renal graft rejection episodes and, in 3 of these, pancreatic juice cytology was suggestive of pancreatic graft involvement as well. These results indicate that the presented cytological method is a valuable tool for early diagnosis of pancreatic graft rejection.
Murine monoclonal CD‐3 antibody in cardiac transplantation: Antirejection treatment and preliminary results in a prospectively randomized trial for prophylaxis
Authors: Bristow Michael R. , Renlund Dale G. , Gilbert Edward M. , Lee Howard R. , Gay William A. , O'Connell John B.
Published: September 2024

The murine monoclonal CD‐3 antibody (OKT*3) is a useful new addition to the pharmacologic immunosuppressive armamentarium available to the cardiac transplant clinician. Its advantages include its powerful effect, potency and ease of administration, rapid onset of action, narrow immunosuppressive spectrum and, because of its biologic source, a guaranteed supply. Disadvantages include potentially serious reactions related to mediator release and relatively rapid onset of sensitization, compromising repeat use of the agent. The details of how to best use OKT*3 still remain to be elucidated, particularly for use in heart‐lung and lung transplantation.
OKT 3 for rejection reversal in pediatric renal transplantation
Authors: Ettenger Robert B. , Marik Jennifer , Rosenthal J. Thomas , Malekzadeh Mohammed , Salusky Isidro B. , Kamil Elaine , Fine Richard
Published: September 2024

Fourteen pediatric renal allograft recipients were treated for acute rejection with OKT 3 monoclonal antibody; in 13 it was used for rejection resistant to either high‐dose corticosteroids or anti‐thymocyte globulin, while in 1 it was used as primary therapy. Rejection reversal was observed in 13 patients (93%). OKT 3 was unsuccessful in reversing rejection in 1 patient who had acute humoral vascular rejection on histopathologic examination. The mean serum creatinine level prior to OKT 3 therapy was 3.2 ± 1.6 mg/dl in the 13 patients who responded. One month after the OKT 3 treatment, the serum creatinine level was 1.6 ± 1.0 mg/dl. Following OKT 3 treatment, cyclosporine doses were augmented by a mean of 1 mg/kg/d. No rebound rejection within 1 month of OKT 3 administration was observed, and only 1 patient had a subsequent rejection episode, coincident with medical non‐compliance. OKT 3 was successful in reversing rejection episodes in 4 of 5 poorly HLA‐DR‐matched cadaveric grafts. No pulmonary edema or hypotension was observed, but fever, gastrointestinal disturbances and headache were frequent. Three patients (21%) developed significant viral infections following treatment, and 1 patient experienced a seizure with the first OKT 3 dose. Twenty‐seven percent of children developed low‐titer anti‐OKT 3 antibody. OKT 3 is a potent but effective agent for rejection reversal in pediatric renal allograft recipients.
In response to ‘The role of HLA matching in renal transplant patients with sequential immunosuppression‘
Authors: Opelz Gerhard ,   Collaborative Transplant Study
Published: September 2024

The effect of HLA matching was analyzed in a series of 1259 recipients of first cadaver kidney transplants treated with “sequential immunosuppression”. At 3 years posttransplant, the survival rate of 70 grafts with 0 HLA‐B,‐DR mismatches was 19% higher (85%) than that of 178 grafts with 4 mismatches (66%) (p = 0.02, log rank). The overall success rate of transplants in patients with “sequential immunosuppression” was 5% higher at 1 yr and 4% higher at 3 yr than that in a reference group of 8654 patients who received cyclosporine from the 1st day and who were not treated with ATG or ALG (p = 0.0001, log rank). The HLA matching effect was similar in both patient series. Our results contradict those of Ferguson who reported that “sequential immunosuppression' eliminated the need for HLA matching.
Evidence for hyperacute rejection of human liver grafts: The case of the canary kidneys
Authors: Starzl Thomas E. , Demotris Anthony J. , Todo Satoru , Kang Yoogoo , Tzakis Andreas , Duquesnoy Rene , Makowka Leonard , Banner Barbara , Concepcion Waldo , Porter Kendrick A.
Published: September 2024

Sequential liver and kidney transplantation from the same donor was performed in 2 patients. The kidney in Patient 1, which was transplanted after the liver, was hyperacutely rejected and removed 6 hours later. The first liver as well as another liver transplanted 3 days later developed widespread hemorrhagic necrosis. Although the cytotoxic crossmatch of preoperative recipient serum with both donors was negative, patchy widespread IgM and C1qdeposits were found in all 3 organs. In Patient 2, who had a strongly positive cytotoxic crossmatch with his donor, the liver suffered a massive but reversible injury, while the kidney never functioned. Both patients developed a coagulopathy a few minutes after liver revascularization. The kidneys in these cases had served like the canaries which miners once used to detect a hostile environment and their presence made more understandable how an indolent version of hyperacute rejection of the liver can take place.
Quality of life of diabetic patients after combined pancreatic‐renal transplantation
Authors: Voruganti L. N. P. , Sells R. A.
Published: September 2024

This study examined the relative efficacy of pancreatic‐renal transplantation in the treatment of insulin‐dependent diabetes mellitus (IDDM) with end‐stage renal disease (ESRD). Ten diabetics successfully treated with pancreatic‐renal transplantation to achieve insulin independence were included in the study and 6 diabetics transplanted with kidneys alone comprised the control group. Psychosocial adjustment, various aspects of self image and overall life satisfaction in both the groups were measured using standardized instruments. Recipients of pancreas showed significantly better adjustment, especially in the domestic, vocational and sexual spheres of life. They also had improved self image, with significant increase in the identity stability and control over destiny. Subjective measures of life satisfaction failed to show significant differences between the groups. Young age, short duration of diabetes and non‐use of steroids predicted a better outcome.