bluuebunny/crossref_metadata_2025 huggingface dataset:
Advancing Robotic Supermicrosurgery Training: Evaluating Epigastric Vessel Utility in an Animal Model
Authors: Pires Louçã Laura C , Abellán Rubio E , Vela González F J , Campos Sánchez J L , Sánchez Margallo J A , Sánchez Margallo F M
Published: January 2025

Introduction

Robotic supermicrosurgery has the potential to improve complex procedures, but requires advanced training in surgical techniques and in the use of robots. This study aims to establish a suitable animal model for such training.

Methods

Two microsurgeons with 2 hours of experience on a robotic microsurgery simulator performed 24 anastomoses in superficial caudal epigastric vessels in a rat model. 12 anastomoses were performed with robotic assistance and 12 by conventional techniques. Vessel size, ischemia time and patency were evaluated immediately after anastomosis (T0) and 30 minutes later (T30).

Results

The study compared arterial and venous anastomoses in rats using robotic and conventional techniques. The average diameter of the arteries was ± 0.4 mm, and veins were ± 0.6 mm. Ischemia time was longer for robotic anastomoses (97.6 minutes for arteries and 118.5 minutes for veins) compared to conventional anastomoses (90.3 and 83.3 minutes). Robotic anastomoses showed better patency, with 6 of 6 arteries and 5 of 6 veins achieving patency at T0, and 5 of 6 arteries and 6 of 6 veins at T30. Conventional anastomoses showed lower patency rates.

Conclusion

This model is technically feasible and reliable for training in robotic supermicrosurgery. It provides the necessary skills acquisition and familiarization with the technology, improving the safety and efficacy of these specialized procedures.
Effect of early initiation of empagliflozin with or without sacubitril/valsartan in a swine model of myocardial infarction
Authors: Martínez-Falguera D , Aranyo J , Teis A , Ferrer-Curriu G , Rodriguez-Leor O , Amigó N , Bisbal F , Gálvez-Montón C
Published: January 2025

Introduction

Empagliflozin and sacubitril/valsartan reduce cardiovascular mortality and heart failure hospitalization rates, but the effect of early initiation of these drugs following myocardial infarction (MI) remains unknown.

Methods

Twenty-four pigs with MI were randomized to receive treatment with beta blockers (BB) (Control, n=8), empagliflozin + BB (Empa, n=8), or empagliflozin + sacubitril/valsartan + BB (Empa + Sac/Val, n=8). Cardiac function was assessed via MRI, systemic immune response via flow cytometry, and metabolic profile via nuclear magnetic resonance spectroscopy over time. At follow-up, arrhythmogenic properties, myocardial fibrosis, and vascularization were evaluated.

Results

Empagliflozin treatment reduced acute systemic inflammation, decreasing the number of circulating leukocytes 2 days post-MI (P=0.010) and CCR2+ monocytes 15 days post-MI (P=0.049), increased hepatic lipid content with a cardioprotective profile, and raised type III collagen content in the myocardial scar (P=0.023), however did not modify the arrhythmogenic properties and cardiac function parameters. Empa + Sac/Val treatment increased the number of circulating monocytes at 30 days (P=0.003), predominantly CCR2-, boosted triglyceride metabolism, lowered collagen I content in the scar (P=0.082), decreased ventricular tachycardia inducibility (P=0.025), and improved cardiac function (iLVEDV P=0.029; LVSV P=0.044).

Conclusion

Empagliflozin modulates systemic inflammation, myocardial scar collagen composition, and increases cardioprotective lipid content in the liver. The combination treatment of empagliflozin and sacubitril/valsartan modulates triglyceride metabolism, reduces collagen I in the myocardial scar, decreases arrhythmias, and improves cardiac function.
Validation of a new vascular graft: vascular permeability and endothelialization
Authors: Durán-Rey D , Sánchez-Rumbo C , Brito-Pereira R , Crisóstomo V , Lanceros-Méndez S , Sánchez-Margallo F M
Published: January 2025

Introduction

Cardiovascular diseases are the leading cause of death globally. Tissue-engineered vascular grafts (TEVGs) are a promising therapeutic option because they can replace or repair the biological functions of blood vessels. Poly(vinylidene fluoride) (PVDF) is a synthetic material with favorable physical and biological properties that make it suitable for developing TEVGs.

Methods

A total of 12 sheep were divided into two groups: the test group, which received PVDF electrospun TEVGs (n=6), and the control group, which received commercial expanded polytetrafluoroethylene (ePTFE) grafts (n=6). Both grafts were implanted into the right common carotid artery. After 4 weeks of follow-up, vascular permeability and endothelialization were assessed through histological analysis.

Results

Although no statistically significant differences were observed, histological analysis showed that PVDF TEVGs exhibited greater vascular permeability and higher endothelialization compared to ePTFE grafts.

Conclusion

Histological results suggest that the piezoelectric properties of PVDF foster endothelial cell growth, reduce thrombus formation, and enhance vascular permeability. Although PVDF TEVGs demonstrate potential as medical devices, further preclinical studies are necessary to evaluate their suitability for treating cardiovascular diseases.
Predictive algorithm for total small intestine length for application in bariatric surgery: data recording protocol
Authors: Fernando Trebolle J , Solano Murillo J , Lobo Poyo J , Pellicer Lostao C , Valero Sabater M , Pérez Zapata A I , Tirado Anglés G , Blas Laína J L
Published: January 2025

Introduction

The development of a predictive algorithm for determining total small intestine length using artificial intelligence represents a significant advancement in tailoring bariatric surgical techniques. A robust data registry is fundamental to validate the algorithm and ensure its effective application. This study aims to present a protocol (document, management, and centralization) for training the predictive algorithm.

Methods

Algorithm Development: The dataset (n=1090) was recorded in an Excel database using Filemaker for initial registration. Statistical analysis was conducted in Python (Google Colaboratory Notebook format). The methodology involved data transformation and scaling (using MinMaxScaler), clustering (unsupervised machine learning), data interpolation (machine learning with SMOTE oversampling), and algorithm modeling (XGBoost model via PyCaret).

Data Recording Protocol

An anonymous electronic document was created to centralize data collection. This document includes sociodemographic data, medical history, type of bariatric surgery, and measurements of intestinal loop lengths. New data and variables are progressively added to the database for validation and testing using the K-means clustering model.

Results

The registration document will present sociodemographic data, medical history, type of bariatric surgery, and the length of intestinal loops.

Conclusion

The development of a predictive algorithm for determining total small intestine length through machine learning requires a robust and comprehensive data collection process. A structured and simplified protocol ensures the efficient collection of multicentric data, supporting model training and validation. This framework facilitates the implementation of AI-driven individualization in bariatric surgery.
Validation of a new vascular graft: inflammation and hyperplasia
Authors: Durán-Rey D , Sánchez-Rumbo C , Brito-Pereira R , Crisóstomo V , Lanceros-Méndez S , Sánchez-Margallo F M
Published: January 2025

Introduction

Narrowing or stenosis of blood vessels induces reduced blood flow and tissue damage due to insufficient nutrient supply. Currently, tissue-engineered vascular grafts (TEVGs) are capable of replacing or repairing the biological functions of blood vessels. Considering that the electroactive effect has shown great promise for the development of grafts with biomedical applicability, poly(vinylidene fluoride) (PVDF) is a synthetic and biocompatible material that induces a specific cellular response capable of favouring tissue regeneration, thanks to its piezoelectric properties.

Methods

PVDF electrospun TEVGs were designed and implanted into the right common carotid artery (RCCA) of 6 sheep (test group). As a control group, commercial expanded polytetrafluoroethylene (ePTFE) grafts were implanted into the RCCA of 6 sheep. After 4 weeks of follow-up, a histological study was performed to analyse the inflammation and hyperplasia of the vascular grafts.

Results

Statistically significant differences were observed in inflammation, which was higher in PVDF TEVGs than in ePTFE grafts. Although no statistically significant differences were observed in hyperplasia, histology showed that PVDF TEVGs exhibited less smooth muscle cell proliferation than ePTFE grafts.

Conclusion

Inflammation is a necessary process for tissue regeneration and was more pronounced in PVDF TEVGs. In contrast, hyperplasia causes a mismatch in elasticity, influencing the lack of vascular permeability. This issue was observed more severely in commercial ePTFE grafts. Thanks to the piezoelectric properties of PVDF, this material is able to mimic the dynamic electroactive microenvironment of cells and tissues, inducing specific cellular responses. However, further preclinical studies are required to understand the specific behaviour and interaction between the piezoelectricity of PVDF and cells.
Effect of surgical activation on ovarian functionality and follicular reactivation in ovine animal model. pilot study
Authors: Sánchez-Mateos S , Fabregues F , Párraga-Ros E , Herranz-DIez C , Otero J , Alvarez I S , Domínguez J A , Sánchez Margallo F M
Published: January 2025

Introduction

Poor ovarian reserve (POI) is one of the main factors that affect women with fertility problems. In this study, we tested whether making small incisions in the ovarian cortex leads to changes in the biomechanics of the ovary that could result in reactivation of ovarian functionality and folliculogenesis.

Methods

Given its similarity to the female reproductive system, both anatomically and physiologically, we used 5-year-old sheep (n=3) as an animal model. Incisions were made in one of the ovaries (OD) by laparoscopy, with the other ovary left as the control (OC). To study the effect in the short, medium, and long term, oophorectomy of both ovaries was performed at 2, 4, and 6 months, respectively, with one sheep per group. Half of each ovary was fixed in 4% paraformaldehyde for histological study, a small fragment was fixed in OCT for the biomechanics study, and the remainder was used to measure the expression of the HIPO pathway genes involved in follicular reactivation.

Results

The data from the histological analysis show that the number of growing follicles was greater at 2 months, with a higher proportion of growing follicles in the operated ovary than in the control ovary (58.9% vs. 29.7%, respectively). The biomechanical study of the cortex using AFM showed a similar trend, with greater stiffness at 2 months. Gene expression is currently under analysis.

Conclusion

Surgical manipulation of the ovary resulted in short-term reactivation of folliculogenesis.
Cannabidiol as prophylactic treatment for intestinal ischaemia reperfusion injury in elderly rats
Authors: Marea-Peñalver S , Rancan L , Linillos-Pradillo B , Ortiz M , Iñigo L , Paredes S D , García-Alonso I , Herrero de la Parte B
Published: January 2025

Introduction

The deprivation of blood supply to an intestinal segment, followed by its subsequent restoration, triggers the condition known as intestinal ischaemia-reperfusion syndrome (i-IRI). Throughout this process, proinflammatory and oxidative mediators are produced, released, and distributed via the bloodstream, ultimately causing damage both locally and systemically. Cannabidiol (CBD) is a molecule with antioxidant and anti-inflammatory properties that regulate oxidative stress and inflammatory states. The aim of this study is to evaluate the therapeutic potential of CBD in a model of i-IRI in aged rats.

Methods

Thirty-six 12-month-old male WAG/RijHsd rats were used, divided into three groups: healthy control group (control), untreated i-IRI group (i-IRI), and CBD-treated i-IRI group (CBD). CBD (10 mg/kg) was administered via the femoral route 30 minutes before reperfusion. Blood samples and intestinal biopsies were taken from six animals in each group, while the other six animals underwent the D-xylose absorption test to evaluate intestinal absorptive function.

Results

Treatment with CBD significantly reduced the degree of histological injury (DHI) compared to the untreated group (1.78 ± 1.23 vs. 4.5 ± 0.56; p<0.001). It also improved intestinal absorptive function (control group: 2.08 ± 0.16; untreated: 0.96 ± 0.06; CBD: 1.74 ± 0.06 µg/mL; p<0.001).

Conclusion

The administration of CBD prior to the restoration of the ischaemic insult was effective in reducing damage to the intestinal mucosa and improving absorptive capacity.
Prediction by bioinformatics analysis of the ability of micrornas in the secretome of menstrual blood-derived stem cells (menscs) as a treatment for ENDOMETRiosis
Authors: Suárez Carrasco I , De Pedro Muñoz M Á , Pulido Fresneda M , Álvarez Pérez V , Marchena López A M , Sánchez Margallo F M , López Nieto E
Published: January 2025

Introduction

Hormonal therapies and laparoscopic surgery are currently the gold standard treatments for endometriosis. However, their effectiveness is limited, with high recurrence rates observed in treated patients. This underscores the need for novel therapeutic approaches. This study aims to evaluate, in silico, the potential therapeutic effects of microRNAs present in the secretome released by menstrual blood-derived stem cells (S-MenSCs) in databases of patients with endometriosis.

Methods

MenSCs (n=3) were cultured in DMEM supplemented with 1% ITS for 96 hours. The conditioned medium was ultrafiltered (3 kDa) to isolate the secretome, and the expression of microRNAs was analysed by next-generation sequencing (NGS). Bioinformatics analysis was performed using the MalaCards database to identify differentially expressed genes (DEGs) in endometriotic tissues. The DIANA tools programme was used to assess the interaction capacity of the most abundant microRNAs with these DEGs. Cytoscape 3.8.1 was used to generate the interaction network.

Results

The analysis revealed an interaction network between 26 microRNAs identified in S-MenSCs and 24 DEGs identified in endometriosis. Each DEG interacted with at least three or more microRNAs, creating a network of numerous interactions. This suggests that the secretome may have the potential to modulate gene expression associated with endometriosis pathology.

Conclusion

MicroRNAs present in S-MenSCs may offer the potential to modulate the altered gene response in endometriosis. However, further studies are required to validate these findings and explore their clinical applications.
Tuberculosis screening in hidradenitis suppurativa patients on tumor necrosis factor inhibitors: a retrospective chart review
Authors: Byrnes Katherine G , Flowers Richard H
Published: January 2025

Hidradenitis suppurativa (HS) patients treated with tumor necrosis factor (TNF) inhibitors are at an increased risk for tuberculosis (TB) reactivation, necessitating baseline latent TB infection (LTBI) screening. However, evidence regarding the value of periodic LTBI screening in this population is limited. In this single-center retrospective chart review, we investigated the LTBI rate in HS patients treated with adalimumab or infliximab. The cohort included 92 patients with an average treatment duration of 37.4 months and a median Interferon-Gamma Release Assay (IGRA) number of 3. The cumulative observation time was 286 person-years. Our investigation found no positive LTBI results in HS patients on TNF inhibitors, challenging clinicians to reconsider the utility of serial screening for such patients who are otherwise at low risk for TB. Further research is essential for the development of evidence-based guidelines to optimize patient care and healthcare resource allocation.
Responsible governance of generative AI: conceptualizing GenAI as complex adaptive systems
Authors: Janssen Marijn
Published: January 2025

Organizations increasingly use Generative Artificial Intelligence (AI) to create strategic documents, legislation, and recommendations to support decision-making. Many current AI initiatives are technology-deterministic, whereas technology co-evolves with the social environment, resulting in new applications and situations. This paper presents a novel view of AI governance by organizations from the perspective of complex adaptive systems (CASs). AI is conceptualized as a socio-technological and adaptive system in which people, policies, systems, data, AI, processes, and other elements co-evolve. The CAS lens draws attention to focusing AI governance on the entire organization, taking an outward perspective and considering public values and societal concerns. Although there is no shortage of AI governance instruments, they differ in their effectiveness, and combinations of appropriate mechanisms should be selected to deal with AI’s evolving nature and complexity. A major challenge is that no responsibility, and therefore accountability, is taken due to the lack of understanding of the full socio-technological CAS. As such, joint accountability is needed in which involved parties work together.
Account-Holding Intensity: Six Reasons Why We Need to Look at Both Frequency and Diligence
Authors: Leidorf-Tidå Benjamin , Brandsma Gijs Jan
Published: January 2025

Measurements of accountability tend to gauge account-holding powers or frequencies while neglecting the quality of the account-holding process. In this article we address this with a conceptual innovation, defining account-holding intensity as a combination of both the frequency and the diligence of account holding. We propose this as a framework that is sensitive to both the quantity and the quality of account holding. Subsequently, we provide six reasons why both frequency and diligence matter and should be analyzed and measured in tandem. We illustrate the usefulness of our framework with an example study where we apply it, both in a survey and in interviews, in the context of multiple European Union (EU) account holders overseeing the activities of EU agencies. This analysis showcases all of the six reasons outlined for using this framework.
Creating codes of ethics for public health professionals and institutions
Authors: Thomas James C , Schröder-Bäck Peter , Czabanowska Katarzyna , Athanasopoulos Paul , Mfutso-Bengo Joseph , Baldwin-SoRelle Carrie , Strohmeier Lena , Tahzib Farhang
Published: January 2025

Background

The World Health Organization and the Association of Schools of Public Health in the European Region called for the professionalization of the public health workforce, including the creation of codes of ethics. In this article, the Public Health Ethics and Law Network provides guidance on creating such codes, based on values and principles commonly identified for public health.

Methods

Our interest was in codes addressing public health broadly rather than disciplines within public health. Public Health codes of ethics are typically published on agency and organization websites rather than peer-reviewed literature. We searched several online databases, such as PubMed; United States government websites; Spanish language websites; and English language websites for public health organizations.

Results

We synthesized the principles found into 10 adjectives—such as caring, responsive, and trustworthy—with short elaborations. These terms are practical, for non-philosophers, and provide flexibility for adaptation to country contexts.

Conclusions

The creation of a code of ethics should be followed by the identification and building of ethical competencies and capacity for public health professionals and institutions. There are plans to collaborate with pilot sites in the use and generation of further learning, and additional assistance for competencies and other resources to support a code of ethics and competencies.
Amniocentesis in Pregnancies at or Beyond 24 Weeks: An International Multicenter Study
Authors: Zemet Roni , Maktabi Mohamad Ali , Tinfow Alexandra , Giordano Jessica L. , Heisler Thomas M. , Yan Qi , Plaschkes Roni , Stokes Jenny , Walsh Jennifer M. , Corcoran Siobhán , Schindewolf Erica , Miller Kendra , Talati Asha N. , Miller Kristen A. , Blakemore Karin , Swanson Kate , Ramm Jana , Bedei Ivonne , Sparks Teresa N. , Jelin Angie C. , Vora Neeta L. , Gebb Juliana S. , Crosby David A. , Berkenstadt Michal , Weisz Boaz , Wapner Ronald J. , Van Den Veyver Ignatia B.
Published: January 2025

(Abstracted from Am J Obstet Gynecol 2024:S0002-9378(24)00693-8)

Amniocentesis, a standard method for obtaining fetal samples for genetic testing since the 1970s, is typically performed between 15 and 22 weeks of gestation. While useful for detecting chromosomal or single-gene fetal disorders, it carries low-incidence risks such as pregnancy loss, preterm prelabor rupture of membranes, chorioamnionitis, and fetal needle injury.
Incorporation of Vasa Previa Screening Into a Routine Anomaly Scan: A Single Center Cohort Study
Authors: Nwandison Millicent , Daly-Jones Elizabeth , Drought Alexandra , Story Lisa , De-Rosnay Philippe , Sebire Neil , Nyberg David , Oyelese Yinka
Published: January 2025

(Abstracted from Acta Obstet Gynecol Scand 2024;103:1466–1473)

Vasa previa (VP) is a serious obstetrical complication in which fetal vessels lie unprotected near the cervical opening, posing a high risk of vessel rupture and fetal exsanguination if undiagnosed before delivery. However, antenatal detection and planned cesarean delivery can result in excellent outcomes.
Epidemiology and Management of Gestational Diabetes
Authors: Sweeting Arianne , Hannah Wesley , Backman Helena , Catalano Patrick , Feghali Maisa , Herman Willliam H. , Hivert Marie-France , Immanuel Jincy , Meek Claire , Oppermann Maria Lucia , Nolan Christopher J. , Ram Uma , Schmidt Maria Inês , Simmons David , Chivese Tawanda , Benhalima Katrien
Published: January 2025

(Abstracted from Lancet 2024;404:175–192)

The International Association of Diabetes and Pregnancy Study Groups (IADPSG) estimates the prevalence of gestational diabetes mellitus (GDM) to be 14% worldwide. Of those with GDM, 30% to 70% have early GDM, which is diagnosed before 20 weeks of gestation.
When Is it Necessary to Perform Biopsy in Asymptomatic Postmenopausal Women With Incidental Finding of Thickened Endometrium?
Authors: Wang Jing , Peng Xuebing , Xia Enlan , Xiao Yu , Liu Yuhuan , Su Dan , Xu Jianfeng , Li Tin-Chiu , Huang Xiaowu
Published: January 2025

(Abstracted from Eur J Obstet Gynecol Reprod Biol 2024:302:104–110

Endometrial thickening without vaginal bleeding is frequently considered an indication for referral for pathological evaluation, though gynecologists debate whether this is necessary in women who are asymptomatic and postmenopausal. Current guidelines suggest biopsy when endometrial thickness reaches more than 4–5 mm and individuals experience postmenopausal bleeding, even though up to 15% of endometrial cancer cases occur in individuals without postmenopausal bleeding.
Effectiveness of Workplace Cancer Screening Interventions: A Systematic Review
Authors: Mon Hsu Myat , Robb Kathryn A. , Demou Evangelia
Published: January 2025

(Abstracted from BMC Cancer 2024;24:999

Cancer screenings have been shown to improve outcomes through early detection but can also result in negative side effects. Current recommendations revolve around using screenings that are the least invasive, with lowest harm and highest benefit depending on the type of cancer and age group of individuals.
A comprehensive review of conservative therapies for female stress urinary incontinence: Advancements, efficacy, and future directions
Authors: Luo Can , Niu Xiaoyu
Published: January 2025

Pelvic floor dysfunction poses a significant challenge to women worldwide. Female urinary incontinence is one of the most prevalent types of pelvic floor dysfunctions, affecting at least 50% of females, particularly those who are pregnant or menopausal. Among the various urinary incontinence subtypes, stress urinary incontinence takes the lead, characterized by involuntary urine leakage during activities that increase intra-abdominal pressure, such as sneezing, coughing, laughing, or exercising. This comprehensive review explores the latest advancements and critical insights into conservative treatments for stress urinary incontinence. Stress urinary incontinence symptoms result in profound physical and psychological consequences for individuals and impose a substantial medical and economic burden on society; however, only 5%–10% seek professional help. This narrative review meticulously examines a spectrum of interventions, ranging from lifestyle modifications to emerging modalities, such as laser treatment and electroacupuncture.
Department of Defense Military Treatment Facility and Community Care Costs After Traumatic Brain Injury in Service Members and Veterans Treated in Veterans Affairs Polytrauma Rehabilitation Centers: A VA TBI Model Systems Study
Authors: Dismuke-Greer Clara E. , Almeida Emily , Ryan Jessica L. , Nakase-Richardson Risa
Published: January 2025

Objective: To estimate cost models of military traumatic brain injury (TBI) that can provide evidence for future cost-effectiveness analyses highlighted as a gap in the recent National Academies of Sciences, Engineering, and Medicine (NASEM) report on accelerating progress in TBI. Setting: Military Treatment Facilities (MTFs) and community care facilities within the Military Health System (MHS). Participants: 1,101 service members/veterans (SMV) diagnosed with a TBI and treated at a Veterans Administration (VA) Polytrauma Rehabilitation Center (PRC). Design: This retrospective study analyzed healthcare costs in MTFs and community care facilities among SMVs diagnosed with TBI and treated at 1 of 5 VA PRCs. MTF and community care records were assessed. Main Measures: Annual MTF and community care inpatient and outpatient costs. TBI disability was measured by the Disability Rating Scale (DRS). Results: Mean age was 31, with 9.8 years of service, and time in MHS post-TBI was 7.18 years. The mean annual inpatient cost was $22,126 in MTFs and $112,218 in community. The mean annual outpatient cost was $17,983 in MTFs and $9,141 in community. Each year of age was associated with $8,276 (95% CI 4,068–12,483), each day of acute care length of stay (LOS) before rehabilitation with $1,024 (95% CI 8–2039), and each additional point on the DRS with $10,858 (95% CI 4,273–17,442) higher costs. Conclusion: Findings describe MHS annualized costs across acute and chronic stages in MTFs and the community and their association with SMVs’ TBI disability measured by the DRS. These foundational cost data are critical for informing future hybrid design trials in TBI that examine the economic impact of TBI interventions being studied in future research.
Frontline Clinic Administrator Perspectives on Extreme Weather Events, Clinic Operations, and Climate Resilience
Authors: Wiskel Tess , Matthews-Trigg Nathaniel , Stevens Kristin , Miles Thomas T. , Dresser Caleb , Bernstein Aaron
Published: January 2025

Climate-sensitive extreme weather events are increasingly impacting frontline clinic operations. We conducted a national, cross-sectional survey of 284 self-identified administrators and other staff at frontline clinics determining their attitudes toward climate change and the impacts, resilience, and preparedness of clinics for extreme weather events. Most respondents (80.2%) reported that humans are causing climate change, and nearly half (45.9%) reported concerns about extreme weather impacting their job, with barriers to preparedness including financing and knowledge and resources. Over a third (41.8%) of respondents reported taking steps to protect their clinic infrastructure from extreme weather, including by addressing power and improving ventilation.
Does Concomitant Use of Antidepressants and Direct Oral Anticoagulants Increase the Risk of Bleeding?
Authors: Weng Jinyan , Lan Ruying
Published: January 2025

Purpose

To evaluate the risk of bleeding associated with the simultaneous administration of antidepressants (ADs) and direct oral anticoagulants (DOACs).

Methods

PubMed, Embase, and Scopus databases were searched for papers that focused on the concomitant administration of ADs and DOACs and presented data on the bleeding outcomes. The comparator group of interest was subjects who received only DOACs. Besides the overall pooled analysis, irrespective of the primary disease condition, we were also interested in studies involving patients with atrial fibrillation (AF). We therefore included studies with relevant comparisons (AD with DOACs, compared to DOACs alone), regardless of the reported underlying condition. Thereafter, we conducted a sensitivity analysis to refine estimates specific to AF. Clinical trials and observational studies were eligible. Pooled effect sizes were reported as relative risk (RR) for studies with cohort design and as odds ratio (OR) for case-control studies.

Results

Ten studies were included. Overall pooled analysis showed that treatment with both DOAC and selective serotonin reuptake inhibitor and serotonin and norepinephrine reuptake inhibitor (SSRI/SNRI) was associated with significantly higher risk of major bleeding (cohort: RR 1.25, 95% CI: 1.07–1.47; case-control: OR 1.40, 95% CI: 1.15–1.69). The risk of intracranial bleeding was found to be increased when cohort studies were pooled (RR 1.44, 95% CI: 1.24–1.66), but not with pooling of case-control studies (OR 1.58, 95% CI: 0.43–5.75). The risk of gastrointestinal bleeding and transient ischemic attack (TIA)/ischemic stroke was comparable between the 2 groups (DOAC + SSRI/SNRI vs DOAC only group).

Conclusions

Our results indicate that combined SSRIs/SNRIs and DOAC treatment may be associated with increased incidence of major and intracranial bleeding, further emphasizing the importance of caution when considering their concomitant use.
Results of a 14-Day Challenge to Improve Dispositional Gratitude in an Academic Nursing Setting
Authors: Phillips Amelia , Pryor Stacy , Carden Abigail , Torr Gillian , Menon Usha
Published: January 2025

Background:

The benefits of engaging in regular, intentional gratitude practice have been well studied. Interventions incorporating simple gratitude practices, such as the 3 Good Things exercise, may be ideal for increasing dispositional gratitude levels within an academic setting.

Purpose:

To assess the impact of a 14-day gratitude-focused wellness intervention on increasing gratitude levels among nursing students, faculty, and staff.

Methods:

Students, faculty, and staff from one College of Nursing were invited to participate in a 14-day gratitude challenge. The Gratitude Resentment and Appreciation Scale – Short Form assessed gratitude levels pre- and post-challenge.

Results:

Dispositional gratitude scores increased significantly among participants overall (P = .006). Furthermore, dispositional gratitude levels increased significantly regardless of whether participants were already using a tool to practice gratitude at the start of the challenge.

Conclusions:

Results demonstrate that a 14-day gratitude-focused intervention can improve dispositional gratitude levels among members of the academic nursing community.
Obstetric Characteristics and Outcomes of Gestational Carrier Pregnancies: A Systematic Review and Meta-analysis
Authors: Matsuzaki Shinya , Masjedi Aaron D. , Matsuzaki Satoko , Anderson Zachary S. , Erickson Katherine V. , Mandelbaum Rachel S. , Ouzounian Joseph G. , Paulson Richard J. , Matsuo Koji
Published: January 2025

(Abstracted from JAMA Network Open 2024;7:e2422634)

Gestational carriers (GCs) are surrogates who carry a pregnancy without a genetic link to the fetus, using embryos created from the gametes of donors or intended parents. This approach offers a valuable option for individuals facing biological, ethical, medical, or psychosocial challenges to carrying a pregnancy themselves.
Uterine Contractile Activity and Neonatal Outcome—A Blind Analysis of a Randomized Controlled Trial Cohort
Authors: Juhantalo Milla , Hautakangas Tuija , Palomäki Outi , Uotila Jukka
Published: January 2025

(Abstracted from Acta Obstet Gynecol Scand 2024;103:1396–1407)

For a successful delivery, sufficient contractions are needed. However, when the uterine contractile activity is too powerful, contractions are too long, or relaxation time is insufficient, and oxygenated blood flow can be temporarily restricted to the fetus.
A Mixed Method Evaluation of Practitioners’ Perspectives on Implementation Strategies for Healthy Eating and Active Living Policy, Systems, and Environmental Changes
Authors: Houghtaling Bailey , Pradhananga Nila , Holston Denise , Cater Melissa , Balis Laura
Published: January 2025

Context:

The National Cooperative Extension System is a leader in delivering healthy eating and active living (HEAL) policy, systems, and environmental (PSE) changes; however, these interventions are challenging, and technical assistance efforts often misalign with implementation science concepts.

Objective:

The study objective was to understand the importance of implementation strategies and tailoring needs to support Louisiana Nutrition and Community Health (NCH) practitioners’ delivery of rural HEAL PSE changes.

Design:

An explanatory sequential mixed method study design was used, including a survey to rank the importance of implementation strategies for HEAL PSE changes and a follow-up interview. A review of available implementation strategies (practice activities/resources) for Louisiana HEAL PSE changes was also conducted.

Setting:

This study occurred within Louisiana and focused on NCH practitioners’ ongoing HEAL PSE change efforts throughout the state, with emphasis on rural community settings.

Participants:

All NCH practitioners were eligible to participate. “Practitioners” included Extension NCH administrators and agents/educators directly delivering HEAL PSE changes.

Main Outcomes:

The main quantitative outcome was the ranked importance of implementation strategies to support NCH practitioners’ delivery of HEAL PSE changes. For explanatory interviews, perceptions of higher and lower ranked implementation strategies and tailoring opportunities were of interest. The alignment of available activities/resources with possible implementation strategies was also assessed.

Results:

Highly ranked implementation strategies focused on engaging dedicated community partners and community members and starting small to ensure success, generate buy-in, and demonstrate feasibility. Opportunities for capacity building in these areas were identified. A lower ranked implementation strategy, changing organizational structures, was considered less likely to occur but possibly necessary to improve job satisfaction, retention, and return on investment. Available activities/resources overlapped with a few available implementation strategies.

Conclusions:

This study identified opportunities to use implementation science concepts to improve program support for NCH practitioners delivering complex HEAL PSE changes.
Associations Between Sugar-Sweetened Beverage Taxes and Weight Outcomes Among US Adolescents
Authors: Cui Dinghe , Baum Christopher F. , Hawkins Summer Sherburne
Published: January 2025

Given the recent implementation and preemption of sugar-sweetened beverage taxes across the United States, we aimed to evaluate the associations between sugar-sweetened beverage (SSB) taxes and adolescent weight-related outcomes using data on 364,540 adolescents drawn from 1999 to 2021 district Youth Risk Behavior Surveys. We used difference-in-differences models to assess the associations and the potential mediating roles of SSBs, milk, and 100% fruit juice consumption. We found that a one cent per ounce increase in SSB taxes was associated with a 0.26 lower body mass index (P < .01), and a 2.19 (P < .01) and 1.68 (P < .01) percentage point decrease in the probability of being affected by overweight and obesity, respectively. SSB consumption had a mediating role, as tax increases were associated with a 2.45 (P < .01) percentage point decrease in adolescents’ probability of drinking any SSB. Milk and 100% fruit juices likely also played a role, as we found changes in their consumption in response to tax increases.
Increased circulatory Krebs cycle metabolites in sepsis is associated with increased interleukin-6 release and worse survival
Authors: Chung Kuei-Pin , Chen Yi-Hsuan , Chen Yi-Jung , Chien Jung-Yien , Kuo Han-Chun , Huang Yen-Tsung , Ruan Sheng-Yuan , Lin Yu-Li , Chen Yen-Fu , Keng Li-Ta , Kuo Lu-Cheng , Ku Shih-Chi , Kuo Ching-Hua , Yu Chong-Jen ,   TAiwan CollaboraTive Intensive Care Study group(TACTICS)
Published: January 2025

Objective

Recent studies have proposed that Krebs cycle metabolites may serve as potential biomarkers for prognosis in sepsis. However, whether these metabolites are associated with disease severity and can be applied to improve the effectiveness of current prognosis assessment in sepsis remains unclear and is explored in this study.

Methods

This prospective multicenter cohort study was conducted in medical intensive care units (ICUs). From December 2019 to September 2022, consecutive patients admitted to medical ICUs for sepsis were screened and recruited. Plasma samples were obtained for measurements of cytokines and Krebs cycle metabolites, including citrate/isocitrate, cis-aconitate, alpha-ketoglutarate, succinate, fumarate and malate.

Results

In total, 97 patients admitted for sepsis were enrolled in the study. The 28-day mortality rate was 17.5%, and non-survivors exhibited significantly increased plasma lactate levels and Sequential Organ Failure Assessment (SOFA) scores. Plasma levels of Krebs cycle metabolites were significantly correlated with both plasma lactate and interleukin-6 levels. Except for citrate/isocitrate, all Krebs cycle metabolites were significantly elevated in patients with acute kidney injury. Multivariate Cox proportional hazard models, adjusted for plasma lactate levels and SOFA scores, revealed that plasma levels of alpha-ketoglutarate (adjusted hazard ratio [HR]: 2.404, P = 0.002), fumarate (adjusted HR: 1.904, P = 0.001) and malate (adjusted HR: 1.327, P = 0.019) were associated with increased risk of 28-day mortality.

Conclusions

Study findings indicate that Krebs cycle metabolites, particularly alpha-ketoglutarate, fumarate, and malate, when applied with SOFA score, might enhance prognostic assessment in patients with sepsis.
Cold waves in the Amazon rainforest and their ecological impact
Authors: Holzmann Kim L. , Alonso-Alonso Pedro , Correa-Carmona Yenny , Pinos Andrea , Yon Felipe , Brehm Gunnar , Keller Alexander , Steffan-Dewenter Ingolf , Peters Marcell K.
Published: January 2025

Cold waves crossing the Amazon rainforest are an extraordinary phenomenon likely to be affected by climate change. We here describe an extensive cold wave that occurred in June 2023 in Amazonian–Andean forests and compare environmental temperatures to experimentally measured thermal tolerances and their impact on lowland animal communities (insects and wild mammals). While we found strong reductions in activity abundance of all animal groups under the cold wave, tropical lowland animals showed thermal tolerance limits below the lowest environmental temperatures measured during the cold wave. While mammal activity and the biomass of most insects recovered over the next season, dung beetle biomass remained low. A quarter of all insects showed very small thermal safety margins (0.62 °C) with respect to the recorded minimum temperature of 10.5 °C, suggesting that an increased intensity of cold waves in the future could imperil cold-sensitive taxa of Amazonian animal communities.
Immune response accelerated telomere shortening during early life stage of a passerine bird, the blue tit (
Cyanistes caeruleus
)
Authors: Schiavinato Matteo , Ronanki Shivani , Estruch Ignacio Miro , van den Brink Nico
Published: January 2025

Dealing with infections is a daily challenge for wild animals. Empirical data show an increase in reactive oxygen species (ROS) production during immune response. This could have consequences on telomere length, the end parts of linear chromosomes, commonly used as proxy for good health and ageing. Telomere length dynamics may reflect the costs associated with physiological responses. In this study, immune system of blue tit (
Cyanistes caeruleus
) nestlings was experimentally challenged through a polyinosinic:polycytidylic acid (poly I:C) injection, a synthetic double-stranded RNA that mimics a virus, activating the pathway of immune response triggered via the toll-like receptors 3. This path is known to form ROS downstream. Immune response was quantified by white cell counts in blood, while brain lipoperoxidation has been evaluated as an indicator of oxidative damage. Finally, individuals’ telomere length shortening between days 8 and 15 after hatching was measured in erythrocytes. Challenged nestlings showed increased leukocyte number when compared with control (treated with a saline solution), lower brain lipid peroxidation (likely as a result of a compensatory mechanism after oxidative stress burst) and accelerated telomere shortening. These findings support the ‘ageing cost of infections pathway’ hypothesis, which supposes a role for infections in quick biological ageing.
Autonomous learning of generative models with chemical reaction network ensembles
Authors: Poole William , Ouldridge Thomas E. , Gopalkrishnan Manoj
Published: January 2025

Can a micron-sized sack of interacting molecules autonomously learn an internal model of a complex and fluctuating environment? We draw insights from control theory, machine learning theory, chemical reaction network theory and statistical physics to develop a general architecture whereby a broad class of chemical systems can autonomously learn complex distributions. Our construction takes the form of a chemical implementation of machine learning’s optimization workhorse: gradient descent on the relative entropy cost function, which we demonstrate can be viewed as a form of integral feedback control. We show how this method can be applied to optimize any detailed balanced chemical reaction network and that the construction is capable of using hidden units to learn complex distributions.
I2Bot: an open-source tool for multi-modal and embodied simulation of insect navigation
Authors: Sun Xuelong , Mangan Michael , Peng Jigen , Yue Shigang
Published: January 2025

Achieving a comprehensive understanding of animal intelligence demands an integrative approach that acknowledges the interplay between an organism’s brain, body and environment. Insects, despite their limited computational resources, demonstrate remarkable abilities in navigation. Existing computational models often fall short in faithfully replicating the morphology of real insects and their interactions with the environment, hindering validation and practical application in robotics. To address these gaps, we present I2Bot, a novel simulation tool based on the morphological characteristics of real insects. This tool empowers robotic models with dynamic sensory capabilities, realistic modelling of insect morphology, physical dynamics and sensory capacity. By integrating gait controllers and computational models into I2Bot, we have implemented classical embodied navigation behaviours and revealed some fundamental navigation principles. By open-sourcing I2Bot, we aim to accelerate the understanding of insect intelligence and foster advances in the development of autonomous robotic systems.
Improving propulsive efficiency using bio-inspired intermittent locomotion
Authors: Aurégan Tristan , Lemoine Mathilde , Thiria Benjamin , Courrech du Pont Sylvain
Published: January 2025

Many swimmers, especially small- to medium-sized animals, use intermittent locomotion that differs from continuous swimming of large species. This type of locomotion, called burst and coast, is often associated with an energetic advantage. In this work, we investigate the intermittent locomotion inspired by fish locomotion but applied to a propeller. The energy consumption of burst-and-coast cycles is measured and compared to the continuous rotation regime. We show that a substantial drag ratio between the active and passive phases of the motion, as observed in fish, is critical for energy savings. Such a contrast can be obtained using a folding propeller that passively opens and closes as the propeller starts and stops rotating. For this reconfigurable propeller, intermittent propulsion is found to be energetically advantageous, saving up to 24% of the energy required to cruise at a given speed. Using an analytical model, we show that intermittent motion is more efficient than continuous motion when the drag reduction in the coast phase exceeds 65%. For fish-like locomotion, this threshold seems to be closer to 30%. A formal analogy allows us to explain the difference between propeller propulsion and fish locomotion.
Tissue stresses caused by invasive tumour: a biomechanical model
Authors: Xue Shi-Lei
Published: January 2025

Malignant tumorigenesis is a complex process involving growth, invasion and mechanical deformation of a cancerous tissue. In this paper, a biomechanical model is proposed to couple the mechanical and biological mechanisms governing invasive tumour development. As an example, this model is applied to investigate the spatio-temporal evolution of tissue stresses in an invasive tumour spheroid and its host tissue. I show that cancer invasiveness lowers the compressive tissue stresses and blurs the stress distribution across the cancerous–normal tissue boundary, both consistent with experimental observations. Importantly, with the steady propagation of the cancerous region driven by persistent cancer invasion, tumour stresses are predicted to saturate rather than keep increasing as in benign tumour growth. The model is further used to analyse the deformation and stress state of a cancerous tissue being cut into two pieces, and reproduces the bulge of the cut surface observed in experiments. I hope this study can pave the way for the quantitative evaluation of mechanical states in cancer.