bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Significance of Leukoreduktion of Blood Components
Authors: Brand A. , van de Watering L.M.G. , Claas F.H.J.
Published: September 2024

The clinical significance of leukocyte reduction of all blood components must be deducted from patients transfused in the surgical setting. Under these circumstances many factors contribute to morbidity and mortality, while such factors can be candidates for confounders. Moreover, to investigate effects on infrequent events such as post‐operative mortality and multiple organ dysfunction syndrome, large patient cohorts must be studied. Our studies suggest that leukocytes or leukocyte aggregates in red cell transfusions indeed may be harmful if larger dosages are administered under certain. clinical circumstances. A critical leukocyte load seems to start with approximately 2.5 × 109. Reducing the leukocyte contamination of red cell components, not necessarily by filtration, may benefit patients who require multiple transfusions within a short time interval.
Prions and Transfusion Medicine
Authors: Budka Herbert
Published: September 2024

Background and Objectives:

There is growing concern at national and international levels that blood supplies might be contaminated with Creutzfeldt‐Jakob disease (CJD) agents (prions).

Materials and Methods:

This review on CJD and blood focuses on experimental and epidemiological data, available tests, factors contributed by donors and recipients, and production processes. All of this has been recently detailed in excellent reports and opinions which are summarised here.

Results:

Solid evidence from experimentally infected. animals, and fragmentary evidence from naturally infected humans, indicates that blood may contain low levels of the infectious agent, yet blood products have never been identi‐fied as a cause of CJD in humans.

Conclusion:

The evalua‐tion of all relevant data leads to the opinion that transmission of CJD by blood and blood products either does not occur or does not contribute to the CJD epidemiology. Although a hazard cannot be excluded, a real risk is not recognisable. As the experience with variant CJD (vCJD) is limited, the same statement cannot be made for vCJD [1]. In consequence, it is mainly the risk of vCJD that might have relevance for transfusion medicine; this has already resulted in some precautionary donor exclusion regulations.
Hepatitis C Lookback in Canada
Authors: Goldman Mindy , Long Anne
Published: September 2024

Background and Objectives:

Since March 1990, all blood donations in Canada are screened by enzyme‐linked immunosorbent assay (EIA) for antibodies to HCV, with confirmatory testing done using a recombinant immunoblot assay (RIBA). Because HCV may cause chronic asymptomatic hepatitis, in 1995, the Canadian Red Cross began targeted HCV lookback studies on all confirmed positive donations. These have been continued by the two new operators of the blood system in Canada, Héma‐Québec and the Canadian Blood Services. Subsequent to recommendations made in the public inquiry into the Canadian blood system, led by judge Krever, general lookback through letter notification of all patients transfused in the years prior to the introduction of anti‐HCV testing was initiated in several pediatric hospitals, and later in several Canadian provinces.

Materials and Methods:

Targeted HCV lookback was done for all donors confirmed positive by RIBA testing from the start of HCV testing in 1990. In 1999, stored RIBA 2 indeterminate samples were re‐tested by RIBA 3, and lookback performed on confirmed positive donations. In the province of Quebec, hospitals were surveyed to determine methods and resources involved in lookback. Provinces performing general letter notification entered hospital transfusion records into a central transfusion data bank, and performed linkage with other provincial data banks to remove deceased patients and obtain current addresses.

Results:

As of January 2000, targeted lookback had been completed on 4,859 components of 1,628 anti‐HCV positive repeat donors. 2,991 recipients were deceased, and 451 were not found or tested. Of the 1,422 recipients tested, 954 (67%) were anti‐HCV positive. Approximately half were already aware of their HCV status. Lookback efforts in hospitals were hampered by lack of resources and manual records. General letter notification in British Columbia (BC) and Prince Edward Island (PEI) led to the testing of 38,960 and 1,953 recipients respectively, with 5.0 and 2.2% of tested recipients found to be anti‐HCV positive.

Conclusion:

In completed targeted lookback investigations, 19% of components are eventually linked to an anti‐HCV positive recipient. These results are very similar to those obtained in other countries, such as Denmark and the UK. In general letter notification lookbacks, the frequency of anti‐HCV in the tested recipients is approximately twice the frequency of the general population.
NAT and Viral Safety In Blood Transfusion
Authors: Roth W. Kurt , Buhr Sylvia , Drosten Christian , Seifried Erhard
Published: September 2024

Background and Objectives:

Nucleic acid testing was introduced at our blood transfusion service in order to reduce the diagnostic preseroconversion window for transfusion relevant viruses.

Materials and methods:

Up to 96 donor samples were pooled overnight by two Tecan Genesis RSP 150 pipettors. Pools were centrifuged at 48.000g for one hour to enrich viruses. Viral nucleic acids were extracted from centrifugation pellets using modified Qiagen viral RNA kit. HIV and HBV sequences were amplified by in house TaqMan PCR's with patented primers and probes for HBV. HCV PCR was performed by Roche Amplicor V2.0. “Nadis” software was developed for pooling, resolving positive pools and data communication with main frame computer.

Results:

PCR testing was introduced in January 1997 for HCV HBV and HIV‐1 for all plasma products and for labile components at the 21“ of April 1997. Throughput increased from 2000 to 4000 samples per day. PCR testing is done in parallel to serological testing and products are released eight hours after pooling is completed. Until January 2000, 1.078.940 donations have been tested in 13.274 pools. A total of seven PCR only positives were identified (3 HCV, 3 HBV, 1 HIV).

Conclusion: The

yield of PCR testing for transfusion relevant viruses confirms theoretical estimates on the residual risk of antibody screening.
Molecular Genetics of HLA
Authors: Fischer Gottfried F.
Published: September 2024

A review of the molecular genetics of the HLA gene complex from a tissue typer's point of view.
MHC: Function and Implication on Vaccine Development
Authors: Eckels David D.
Published: September 2024

The purpose of this State of the Art review is to present an overview of structural and functional aspects of human MHC molecules and how polymorphisms in HLA molecules determine the nature of the antigenic peptides bound and how such may impact upon rational vaccine development. The following areas will be discussed: elements of immune recognition, class I and class II structure and function, the class I antigen processing pathway, class II antigen processing and presentation, functional divergence among T‐ cells recognizing class I or class II MHC molecules, and rational vaccine development. While the first section will review our current understanding of MHC structure and function, the latter part will draw on my own work with Hepatitis C Virus (HCV) antigens.
Immunomodulation by Blood Transfusions
Authors: Roelen Dave L. , van Rood Jon J. , Brand Anneke , Claas Frans H.J.
Published: September 2024

Blood transfusions can affect the immune response in two opposite ways. They may either lead to immunization or to tolerance induction. Immunization is reflected by the induction of HLA alloantibodies and T cell activation while the induction of tolerance is suggested by the enhanced graft survival in transfused versus non‐transfused recipients. The immunological mechanism leading to downregulation of the alloimmune response is not clear. One possible explanation is the induction of a Th2 response by non‐professional antigen presentation by the transfused blood cells. On the other hand, evidence is accumulating that the degree of HLA compatibility between transfusion donor and patient is a determining factor. Transfusions sharing at least one HLA‐DR antigen with the recipient induce tolerance while fully HLA‐DR mismatched transfusions lead to immunization. The importance of the degree of HLA‐DR sharing suggests a central role for CD4+ regulatory T cells. We hypothesize that indirect recognition of an allopeptide in the context of self‐HLA‐DR on the transfusion donor by CD4+ T cells of the recipient might be the clue to tolerance induction. Preliminary data show indeed that CD4+ T cells specific for an allopeptide in the context of self HLA‐DR are able to downregulate the alloimmune response of autologous T cells. Further analysis of transplanted patients, who have received an HLA‐DR shared transfusion, should reveal whether such CD4+ regulatory T cells are indeed responsible for the beneficial effect of pretransplant blood transfusions.
Treatment of Post Transfusion Graft‐Versus‐Host Disease
Authors: Juji Takeo , Nishimura Motoko , Tadokoro Kenji
Published: September 2024

Background and Objectives:

In Japan, so many cases of post‐transfusion graft‐versus‐host disease (PT‐GVHD) have been reported, and no effective treatment has been reported.

Materials and Methods: Results:

Totally 61 cases of PT‐GVHD have been collected, and their background were analyzed. A serine protease inhibitor, nafamostat mesilate(N.M.) was examined as a drug for treatment of PT‐GVHD using 4 patients.

Results:

N.M. was confirmed to inhibit cytotoxic activities of established cytotoxic T cell (CTL) clones in vitro. Simultaneously it was confirmed that fever and skin rash disappeared and liver function tests were normalized soon after the administration of N.M. in all four cases. Leukopenia and thrombocytopenia simultaneously improved.

Conclusion:

The effects of N.M. seem to be limited to inhibit cytotoxic activity of CTL. In addition to this drug, how to remove the CTL from the patients will be the essentially important theme for the future.
Total Quality Management in Blood Transfusion
Authors: Smit‐Sibinga Cees Th.
Published: September 2024

Quality management is an ongoing development resulting in consistency products and services and ever increasing customer satisfaction. The ultimum is Total Quality Management. Quality systems and quality management in transfusion medicine have gained considerable attention since the outbreak of the AIDS epidemic. Where product orientation has long been applied through quality control, Good Manufacturing Practice (GMP) principles were introduced, shifting the developments in the direction of process orientation. Globally, and particularly in the more industrialised world people and system orientation has come along with the introduction of the ISO9001 concept. Harmonisation and a degree of uniformity are needed to implement a universally applicable Quality System and related Quality Management. Where the American Association of Blood Banks (AABB) is the professional organisation with the most extensive experience in quality systems in blood transfusion, the European Union and the Council of Europe now are in the process to design a quality system and management applicable to a larger variety of countries, based on a hybrid of current GMP and ISO9001 principles. The International Federation of Red Cross and Red Crescent Societies has developed a more universally to implement Quality Manual, with a pilot project in Honduras. It is recommendable to harmonise the various designs and bring the approaches under one common denominator.
Haemovigilance and Transfusion Safety in France
Authors: Rouger Ph. , Noizat‐Pirenne F. , Le Pennec P‐Y.
Published: September 2024

The risks associated to red cell and platelet transfusions are essentially bound to the polymorphism of blood group antigens and to transfusion transmitted agents including virus, bacterias… In France, the haemovigilance system and several investigations allowed to measure these different kinds of risks. We also developped analysis of failures in order to prevent errors and accidents to increase blood safety.
Getting People to Give Blood
Authors: Sandborg Eila
Published: September 2024

A well functioning blood service is dependent on people who are willing to come forward and give blood as a gift to those in need. This prerequisite brings a deeply human aspect to the blood service but also leaves it vulnerable to the fluctuations of people's donation behaviour, large or small as it may be, no matter is it lain in a developed metropolis or a remote African town. Blood services share a common concern: are they approaching a rising shortage of blood supply? Why does it take more effort than ever to get people to become blood donors? This lecture discusses donor recruitment as systematic work towards a blood supply, which is safe, adequate and reliable. Special attention is paid to the community, an individual's move from awareness to loyalty and demands on blood service personnel. The discussion is based on reports by those who have donor recruitment as full time profession and by those in other professions who have gained wide expertise in this field.

It is human nature to feel needed, important and appreciated. Blood donation has all the possibilities to give these feelings to people. Any search for something new and exciting to motivate people to give blood must stem from a sound understanding of people in the community, an experience gained through years and a systematic working method.
The Masters Degree in Marriage and Family Therapy
Authors: Everett Craig A.
Published: September 2024

This paper reviews the development of the profession, and identifies important issues in the process and structure of graduate clinical education. These factors are related to an analysis of the graduate curricula, the clinical practicum, and the selection and evaluation of students for masters programs in marriage and family therapy.
An Integrative Training Model for Family Therapists: The Hahnemann Master of Family Therapy Program*
Authors: Garfield Robert
Published: September 2024

This paper describes the two year Master of Family Therapy Program at the Hahnemann Medical College in Philadelphia. The program entered its third year in 1979. It is based on a relational, or contextual, model of family therapy, influenced primarily by the ideas and theoretical constructs of Ivan Boszormenyi‐Nagy.
Doctoral Programs in Marital and Family Therapy
Authors: Nichols William C.
Published: September 2024

Although doctoral programs have not developed as extensively as expected, there is a considerable amount of choice available to potential students. Some programs and trends in their development are considered in this paper.
Training in Marital and Family Therapy at Free‐Standing Institutes
Authors: Berman Ellen , Dixon‐Murphy Thelma F.
Published: September 2024

Some of the characteristics of free‐standing post‐degree training programs in marital and family therapy are described in this paper which focuses on two of the oldest, the Marriage Council of Philadelphia and the Blanton Peale Graduate Institute. Such one to three year programs are seen as having continuing possibilities for flexibility and innovation in the training field.
Training of Psychiatric Residents in Marital Therapy*
Authors: Martin Peter A.
Published: September 2024

This paper attempts to present a picture of the current situation in the United States in regard to training psychiatric residents in marital therapy. It updates a 1970 survey of training in marital and family therapy at university training centers, focuses on the developments and research in this area at one university training center, and predicts a marked increase in time for residents training in this area if the delayed White House Conference on Families takes place and if it is followed by federal funding for improving the mental health care of the family in America.
Family Therapy Training at the Ackerman Institute: Thoughts of Form and Substance
Authors: La Perriere Kitty
Published: September 2024

This paper presents the history, philosophy, and form of training at the Ackerman Institute for Family Therapy, the first organization of its kind. The paper attempts to capture the spirit and atmosphere of the program rather then enumerate its details. The basic training at Ackerman consists of generalist family therapy.
“Structured Spontaneity”: The Thoughtful Art of Integrative Family Therapy at BFI
Authors: Duhl Frederick J. , Duhl Bunny S.
Published: September 2024

A description of the “structured spontaneity” approach to family therapy training at the Boston Family Institute as it exists after 10 years, this paper involves a consideration of the context of training as well as imparting the flavor of the program.
Accreditation in Marital and Family Therapy*
Authors: Smith Veon G. , Nichols William C.
Published: September 2024

Accreditation is a major way of encouraging the development and maintenance of quality education and training programs. This paper reviews the role of the Committee on Accreditation of the American Association for Marital and Family Therapy, noting that the development of standards is a function with a long history and a continuing role to play in the field.
Advancement in Raman spectroscopy (RS) for characterizing cementitious materials
Authors: Zhang Zuhua , Huang Ziye , Shi Cheng , Wu Zhu , Zhang Wenjing , Duan Ping , Jiang Zhengwu
Published: September 2024

Raman spectroscopy (RS) has attracted significant attention for the analysis of cementitious materials owing to its remarkable spatial and spectral resolution, which enable the precise investigation of chemical bonds, mineral phases, and microstructures. This review focuses on applications of RS for characterizing cement clinker compositions, monitoring hydration processes, and detecting durability issues, with a particular focus on advancements in quantitative analysis and imaging techniques in recent years. The featured Raman vibration bands are summarized, which are useful for the identification of calcium silicate‐related substances. The current technical limitations of RS for investigating cementitious materials are discussed, and potential approaches to overcome these limitations are proposed. The technological innovations in RS will further enhance its efficacy and applicability for investigations of cementitious materials, thus facilitating a comprehensive understanding of the life cycle of cement across various scales of interest.
Transcriptomics of Diphyllatea (CRuMs) from South Pacific crater lakes confirm new cryptic clades
Authors: Galindo Luis Javier , Mathur Varsha , Frost Hadleigh , Torruella Guifré , Richards Thomas A. , Irwin Nicholas A. T.
Published: September 2024

The Diphyllatea (CRuMs) are heterotrophic protists currently divided into three distinct clades (Diphy I–III). Diphy I are biflagellates in the genus Diphylleia, whereas Diphy II and III represent cryptic clades comprising Collodictyon‐type quadriflagellates that were recently distinguished based on rRNA gene phylogenies. Here, we isolated Diphyllatea from freshwater crater lakes on two South Pacific islands and generated high‐quality transcriptomes from species representing each clade, including the first transcriptomic data from Diphy III. Phylogenomic analyses support the separation of Diphy II and III, while transcriptome completeness highlights the utility of these data for future studies. Lastly, we discuss the biogeography and ecology of Diphyllatea on these remote islands.
The Transition of Care Between Emergency Department and Primary Care: An Integrative Systematic Review
Authors: Hain Kathleen , Scarvell Jennie M. , Paterson Catherine
Published: September 2024

Aims

To identify the barriers and enablers of effective transitions of care between the emergency department and primary care providers.

Background

Successful patient care transitions from the emergency department to primary care providers are important because this process has implications for the quality, patient safety, and cost of patient care. Failure in follow‐up consultations with primary care can result in representations to the emergency department, which can impact negative emergency department operational issues throughout the entire hospital.

Design and Methods

An integrative systematic review was reported according to PRISMA guidelines. The reviewers followed a systematic review protocol registered with PROSPERO (CRD42022316165). A search strategy was applied to extract articles from included databases: CINAHL, MEDLINE, PsycINFO, Scopus, ProQuest Nursing and Allied Health databases. Articles were assessed using a predetermined eligibility criterion. Quality assessment and a narrative synthesis were conducted.

Results

Of the 1200 articles screened, 25 studies were included. Four additional articles were identified from reference lists. The range of study designs included: four qualitative, three mixed methods and 22 quantitative studies. A total of 291,012 patients were represented. Successful care transition was enhanced by access to insurance, ease of payment methods, effective communication, prior booked primary care provider appointments and access to transportation. Many patients experienced financial toxicity, and the shortfall between fees charged and rebates provided was found to influence primary care provider follow‐up compliance.

Conclusion

Future recommendations to provide safe and effective transitions of care would be to optimise supported self‐management for patients and deliver timely and clear communication with standardised discharge documentation to be shared between the emergency department and primary care providers.

Relevance for Clinical Practice

There is no one‐size‐fits‐all approach to delivering safe care transitions between emergency department and primary care providers, and future research should target high‐risk groups.

Trial Registration

Prospero: CRD42022316165
The Relationship Between Individual Social Responsibility and the Public's Intention to Act Violently Toward Nurses—A Cross‐Sectional Study
Authors: David Efrat , Lifshitz Mor , Kraitenbrg Kim , Warshawski Sigalit
Published: September 2024

Aims

To explore (a) the associations between individual social responsibility and the public intention to use violence against nurses; and (b) the relationship between individual social responsibility, personal variables and the public's intention to employ violence against nurses.

Background

Workplace violence against nurses is a significant widespread occupational health issue. To date, no reference has been found to the association between personality traits such as individual social responsibility and the public's intention to use violence against nurses.

Design and Methods

A cross‐sectional survey design with a convenience sample of 667 Israeli participants from among the public. A structured self‐report questionnaire was distributed, including socioeconomic variables, individual social responsibility and responses to four vignettes describing incidents of violence directed at nurses. Multiple linear regressions were calculated for intention to employ violence, with demographic variables and individual social responsibility as independent variables. The STROBE checklist for cross‐sectional studies was used for reporting.

Results

Negative correlations were found between individual social responsibility and the intention to employ violence against nurses. Gender, having witnessed physical violence and individual social responsibility explained 19% of the variance in the intention to employ violence against nurses. Demographic variables and having witnessed verbal or physical violence were found to moderate the association between individual social responsibility and the intention to employ violence against nurses.

Conclusions

Witnessing a violent incident in a healthcare setting is a risk factor for the intention to employ violence against nurses. Our findings point to the role of individual social responsibility as one of the strategies to help reduce violent events.

Implications for the Profession and/or Patient Care

Educating and promoting values of social responsibility among the public can reduce incidents of violence in healthcare settings, thus contributing to the safety and quality of care provided.

Patient or Public Contribution

The public contributed via study participation.
Estrogen‐dependent oxytocin expression in the hypothalamus and estrogen‐dependent vasopressin in the median eminence
Authors: Nishimura Kazuaki , Ueta Yoichi , Yoshino Kiyoshi
Published: September 2024

The posterior pituitary (PP) hormones oxytocin (OXT) and arginine vasopressin (AVP) are synthesized within the hypothalamic nucleus and released from the PP into systemic circulation. Hypothalamic AVP projects its axons into the external layer of median eminence (eME) and regulates anterior pituitary hormone secretion during stress responses. Although similar as PP hormones, we demonstrate distinct regulatory roles of estrogen in hypothalamic OXT and AVP dynamics. OXT dynamics in the hypothalamus exhibit sex‐dependent variations and that estrogen may influence dynamic OXT level changes, as observed in OXT‐mRFP1 transgenic rats. Estrogen was also observed to modulate dynamic changes in AVP levels in the axon terminals of eME in female AVP‐eGFP transgenic rats. Although OXT and AVP are produced within the similar hypothalamic region, both exhibit distinct dynamics within the hypothalamus. Estrogen acts on the hypothalamus, and further effects of estrogen replacement therapy can be expected.
Correlation Between Temporomandibular Joint Disc Perforation and Degenerative Joint Changes: A CBCT and Clinical Analysis
Authors: Yang Rong , Lee Lee Mui , Zhu YaoMin , Jia Wen Yuan , Yao Wei , Yu Yue , Wu Shu Jun
Published: September 2024

Objectives

To analyse the correlation between temporomandibular joint (TMJ) disc perforation and degenerative joint changes (DJC) on cone‐beam computed tomography (CBCT) and related factors.

Study Design

A total of 238 female patients with anterior disc displacement without reduction (ADDwoR), accounting for 348 affected joints, requiring TMJ disc open anchorage surgery were included in the study conducted from June 2021 to August 2022. Following TMJ disc open anchorage surgery, patients were divided into two groups: disc perforation (DP) and disc non‐perforation (DNP). CBCT was utilised to assess different grades of condyle and articular eminence degenerative changes, and comparisons were made between the two groups regarding DJC and clinically relevant factors.

Results

In comparison with the DNP group, the DP group exhibited statistically significant differences in mid‐ and late‐stage condyle bone degenerative changes and bone alterations of the articular eminence (odds ratio [OR] = 7.822; 95% CI [4.438–13.785]; p < 0.001 and OR = 5.575; 95% CI [3.128–9.936]; p < 0.001). Additionally, persistent joint sounds (OR = 1.932; 95% CI [1.011–3.691]; p = 0.046) and longer disease duration (OR = 4.901; 95% CI [2.395–10.028]; p < 0.001) demonstrated statistically significant differences. However, no significant differences were observed between the two groups in terms of age, joint pain and limited mouth opening.

Conclusions

Bone degeneration changes in TMJ CBCT images are a high possible risk factor for DP. With an escalation in the degree of condyle degeneration, the risk of DP may increased correspondingly. Persistent joint sounds and extended duration of the disease were also confirmed to be noteworthy clinical risks of DP.
Identification of Pathogenic Fungi Causing Postharvest Disease of Banana Fruit (Musa acuminata Cavendish Subgroup) in Ho Chi Minh City, Vietnam
Authors: Nguyen Quoc‐Duy , Dang Duy Hung , Nguyen Ngoc Thanh Tuyen , Pham Quoc Dang , Nguyen Vinh Lam , Do Anh Duy
Published: September 2024

Banana (Musa acuminata Cavendish Subgroup) cultivation plays a pivotal role in Vietnam's economy. However, the presence of postharvest diseases poses significant challenges as they adversely affect the quality and market value of the crop. The objective of this study was to identify the microbial strains responsible for these diseases through phylogenetic analysis and morphological characterisation. Four fungal isolates including Colletotrichum musae, C. gloeosporioides, Fusarium musae and Lasiodiplodia theobromae were identified as the primary causal agents of fruit rot in postharvest bananas. Re‐infection tests, which were conducted following Koch's postulates on banana samples, confirmed the isolates' significant pathogenicity, leading to weight loss, colour alteration, firmness reduction and acidity changes in the fungal‐infected bananas. These findings hold profound implications for enhancing our understanding of banana diseases in the postharvest stage, which can contribute to the development of effective control measures and mitigation strategies in the future.
Can computerized intraosseous anaesthesia replaces the inferior alveolar nerve block in children? A randomized controlled clinical trial
Authors: Alkhouli Muaaz , Al‐Nerabieah Zuhair , Dashash Mayssoon
Published: September 2024

Objectives

This study aimed to compare the efficacy of computerized intraosseous anaesthesia (CIOA) administered through the QuickSleeper 5™ system with conventional inferior alveolar nerve block (IANB) in paediatric dental patients. The primary objective was to assess pain perception, efficacy, anaesthesia onset time and duration of anaesthesia between the two techniques.

Materials and Methods

A total of 52 paediatric participants were enrolled in this study. Using a split‐mouth design, each child received CIOA on one side and IANB on the other to perform pulpotomy for lower primary second molars. Pain perception was measured by the Face, Legs, Activity, Cry, and Consolability (FLACC) scale. Efficacy of anaesthesia was measured by FLACC scale during the pulpotomy procedure. Onset time and duration of anaesthesia for anaesthesia was recorded in minutes for both techniques.

Results

CIOA demonstrated significantly lower pain scores compared to IANB (mean pain score = 3.5, 5.75, respectively). IANB showed a success rate of 77%, whereas CIOA showed a success rate of 92%. Moreover, CIOA exhibited a faster onset of anaesthesia (the mean onset time of IANB and CIOA was 3.4 min ±1.1 and 0.2 min ±0.5, respectively). There was no significant difference regarding the duration of anaesthesia between the two techniques (p‐value >0.05).

Conclusion

It was concluded that CIOA causes less pain than IANB. The success rates of both CIOA and IANB were 92% and 77%, respectively. The onset time of anaesthesia was faster in CIOA compared to IANB. However, there was no difference between the two studied techniques regarding the duration of anaesthesia.
Sub‐Acromioclavicular Decompression Increases the Risk of Postoperative Shoulder Stiffness after Arthroscopic Rotator Cuff Repair
Authors: Li Cheng , Wang Zhiling , Ali Maslah Idiris , Long Yi , Alike Ymuhanmode , Zhou Min , Cui Dedong , Zheng Zhenze , Meng Ke , Hou Jingyi , Yang Rui
Published: September 2024

Objective

The sub‐acromioclavicular (SAC) decompression is often performed during arthroscopic rotator cuff repair. However, the impact of SAC decompression on patients with postoperative shoulder stiffness (POSS) are controversial and unclear. This study is aim to evaluate the impact of additional sub‐acromioclavicular (SAC) decompression during arthroscopic rotator cuff repair on the postoperative shoulder stiffness (POSS) in patients.

Methods

This retrospective study examined digital data from patients with full‐thickness rotator cuff tears who underwent arthroscopic rotator cuff repair at a local institution. Patient‐reported outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) Score, the University of California–Los Angeles (UCLA) score, and visual analog scale (VAS) scores. Restricted shoulder mobility occurring within 6 months postoperatively, lasting more than 12 weeks, characterized by a passive forward flexion angle of <120° or an external rotation angle of <30°, with or without associated shoulder pain was identified as POSS. Factors affecting POSS were analyzed by binary logistic regression analysis. The patient‐reported outcomes scores were analyzed by generalized estimating equations to examine the impact of SAC decompression.

Results

A total of 155 patients met the set criteria and were included in the study. The analysis of binary logistic regression showed that diabetes (p = 0.001) and SAC decompression (p = 0.003) were independent factors for POSS. In the analysis of each follow‐up point, only at the 3‐month follow‐up, the ASES scores (p = 0.003), UCLA scores (p = 0.045), and VAS scores (p = 0.005) showed significant differences between the SAC decompression group and the non‐decompression group. For the intergroup comparison, the results showed a significant difference in the ASES scores (β = −4.971, p = 0.008), UCLA scores (β = −1.524, p = 0.019), and VAS scores (β = 0.654, p = 0.010) throughout the study duration between the SAC decompression group and the non‐decompression group.

Conclusion

The findings of this study suggested that SAC decompression during arthroscopic rotator cuff repair increase the risk of POSS compared with those without the decompression, which indicate surgeons do not perform SAC decompression unless necessary.
Artificial Intelligence‐Guided Assessment of Femoral Neck Fractures in Radiographs: A Systematic Review and Multilevel Meta‐Analysis
Authors: Ramadanov Nikolai , Lettner Jonathan , Hable Robert , Hakam Hassan Tarek , Prill Robert , Dimitrov Dobromir , Becker Roland , Schreyer Andreas G. , Salzmann Mikhail
Published: September 2024

Artificial Intelligence (AI) is a dynamic area of computer science that is constantly expanding its practical benefits in various fields. The aim of this study was to analyze AI‐guided radiological assessment of femoral neck fractures by performing a systematic review and multilevel meta‐analysis of primary studies. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) on May 21, 2024 [CRD42024541055]. The updated Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines were strictly followed. A systematic literature search of PubMed, Web of Science, Ovid (Med), and Epistemonikos databases was conducted until May 31, 2024. Critical appraisal using the Quality Assessment of Diagnostic Accuracy Studies‐2 (QUADAS‐2) tool showed that the overall quality of the included studies was moderate. In addition, publication bias was presented in funnel plots. A frequentist multilevel meta‐analysis was performed using a random effects model with inverse variance and restricted maximum likelihood heterogeneity estimator with Hartung‐Knapp adjustment. The accuracy between AI‐based and human assessment of femoral neck fractures, sensitivity and specificity with 95% confidence intervals (CIs) were calculated. Study heterogeneity was assessed using the Higgins test I2 (low heterogeneity <25%, moderate heterogeneity: 25%–75%, and high heterogeneity >75%). Finally, 11 studies with a total of 21,163 radiographs were included for meta‐analysis. The results of the study quality assessment using the QUADAS‐2 tool are presented in Table 2. The funnel plots indicated a moderate publication bias. The AI showed excellent accuracy in assessment of femoral neck fractures (Accuracy = 0.91, 95% CI 0.83 to 0.96; I2 = 99%; p < 0.01). The AI showed good sensitivity in assessment of femoral neck fractures (Sensitivity = 0.87, 95% CI 0.77 to 0.93; I2 = 98%; p < 0.01). The AI showed excellent specificity in assessment of femoral neck fractures (Specificity = 0.91, 95% CI 0.77 to 0.97; I2 = 97%; p < 0.01). AI‐guided radiological assessment of femoral neck fractures showed excellent accuracy and specificity as well as good sensitivity. The use of AI as a faster and more reliable assessment tool and as an aid in radiological routine seems justified.
When and how do people share? Attachment anxiety predicts support‐seeking strategies
Authors: Snyder Matthew D. , Sun Elina R. , Nie Jiaxuan , Jakubiak Brett K.
Published: September 2024

Attachment anxiety is expected to motivate people to seek excessive attention, reassurance, and help from their attachment figures. However, prior studies assessing links between attachment anxiety and this hyperactivating support‐seeking strategy have yielded inconsistent results. To advance this literature, the current research focused on the disclosure of negative personal experiences (i.e., disclosure decisions and disclosure strategies), an overlooked step in the support‐seeking process where hyperactivation may occur. Participants (N = 444) reported whether and how they shared up to four recent negative events with up to three attachment figures, and they reported their relationship‐specific attachment toward each figure (to improve measurement precision). Participants were more likely to report sharing negative events with attachment figures to whom they reported greater attachment anxiety, especially when they also perceived low responsiveness in that relationship. Additionally, participants reported that they displayed greater distress, downplayed their personal responsibility more, and emphasized a need for help more when disclosing negative events in relationships with greater attachment anxiety (behaviors that facilitate support receipt and decrease the risk of rejection). This study helps to clarify links between attachment anxiety and support seeking and provides one of the first empirical demonstrations of strategic support seeking in anxiously attached relationships.
Tetraspanin32 (TSPAN32) is downregulated in rheumatoid arthritis: Evidence from animal models and patients
Authors: Mangano Katia , Munoz‐Valle Jose’ Francisco , Palafox‐Sánchez Claudia Azucena , Petralia Maria Cristina , Leone Gian Marco , Fagone Paolo , Nicoletti Ferdinando
Published: September 2024

This study aimed to investigate the role of TSPAN32, a member of the tetraspanin family, in rheumatoid arthritis (RA). The objective was to assess the expression levels of TSPAN32 in experimental RA models and in RA patient immune cells, exploring its potential as a regulatory factor in RA pathogenesis. The study employed adjuvant‐induced arthritis in rats and collagen‐induced arthritis (CIA) in mice as experimental models. Ex vivo analyses included evaluating TSPAN32 expression in immune cells at different stages of the disease. In silico data analysis involved examining transcriptomic datasets from drug‐naïve and treated RA patients to correlate TSPAN32 expression with clinical parameters. TSPAN32 overexpression experiments in splenocytes from CIA mice aimed to demonstrate its functional impact on antigen‐specific immune responses. The animal models revealed a significant downregulation of TSPAN32, particularly in synovial‐infiltrating T cells. Also, TSPAN32 overexpression inhibited pro‐inflammatory cytokine production in splenocytes. In RA patients, TSPAN32 was consistently downregulated in circulating and synovial‐infiltrating T cells, as well as in CD8+ T cells, B cells and NK cells. Drug treatment did not significantly alter TSPAN32 levels. Negative correlations were observed between TSPAN32 expression and inflammatory markers (CRP, ESR) and clinical scores (SDAI) in RA patients. This study suggests that reduced TSPAN32 expression characterizes pathogenic T‐cell populations in RA, highlighting its potential as biomarker for inflammation and disease activity. TSPAN32 may play a crucial role in shaping adaptive immune responses in RA, opening avenues for novel therapeutic strategies targeting this tetraspanin family member.
Which allogeneic hematopoietic cell transplant recipients have an increased risk for delayed‐onset clinically significant cytomegalovirus infection after letermovir prophylaxis?
Authors: Mendoza Maria Alejandra , Bhaimia Eric , Alkhateeb Hassan B. , Razonable Raymund R. , Thoendel Matthew
Published: September 2024

Introduction

Cytomegalovirus (CMV) reactivation is one of the most common complications after allogeneic hematopoietic stem cell transplantation (HSCT). Letermovir is approved for CMV prophylaxis among high‐risk recipients. However, delayed‐onset post‐prophylaxis clinically significant CMV infection (csCMVi) has been observed, suggesting the potential for extending letermovir prophylaxis beyond the first one hundred days post‐HSCT.

Methods

Retrospective multicenter cohort study of allogeneic HSCT patients from August 2018 to March 2023. The primary aim of this study was to identify the risk factors at day 100 associated with delayed onset csCMVi, in patients who received letermovir prophylaxis up to day 100. Competing risk analysis was used to evaluate incidence with specific risk factors, using Gray's Test comparing groups for each event.

Results

Among 166 eligible allogeneic HSCT recipients, the most common primary hematological diagnosis was acute myelogenous leukemia (AML) (42.2%). Twenty‐six (15.7%) developed a breakthrough csCMVi. Delayed‐onset csCMVi occurred in 23.5%, at a median time of 133 days after SCT. On multivariate analysis, having a matched unrelated donor (odds ratio [OR] 2.46) and a CMV donor negative/recipient positive status (OR 3.47) were associated with delayed onset csCMVi. In contrast, AML had a lower odd of having delayed‐onset csCMVi (OR 0.23).

Conclusions

Having a matched unrelated donor, a CMV donor negative/recipient positive status, and a non‐AML underlying disease were associated with delayed onset csCMVi. Prospective studies are needed to evaluate whether extended letermovir prophylaxis is beneficial for these patients.

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Efficacy and safety of a preventive strategy against tuberculosis in liver transplantation recipients including the treatment of latent infection with moxifloxacin
Authors: Fayos Marina , Silva Jose Tiago , Fernández‐Ruiz Mario , Ruiz‐Merlo Tamara , Visentin Alessandro , Loinaz Carmelo , Manrique‐Municio Alejandro , Caso José María , González‐Olmedo Jesús , Rodríguez‐Góncer Isabel , López‐Medrano Francisco , Lumbreras Carlos , Aguado José María , San‐Juan Rafael
Published: September 2024

Background

Preventive management of tuberculosis in liver transplantation (LT) is challenging due to difficulties in detecting and treating latent tuberculosis infection (LTBI). The aim of this study was to analyze the safety and efficacy of a screening strategy for LTBI with the inclusion of moxifloxacin as treatment.

Methods

We performed a retrospective single‐center study of all LTs performed between 2016 and 2019 with a minimum 4‐year follow‐up and a standardized protocol for the evaluation of LTBI.

Results

Pretransplant LTBI screening was performed in 191/218 (87.6%) patients, and LTBI was diagnosed in 27.2% of them. Treatment for LTBI was administered to 71.2% of the patients and included moxifloxacin in 75.6% of the cases. After a median follow‐up of 1628 days, no cases of active tuberculosis occurred among moxifloxacin‐treated patients. The incidence of Clostridioides difficile (0.46 vs. 0.38 episodes/1000 transplant‐days; p =  .8) and multidrug‐resistant gram‐negative bacilli infection (0 vs. 0.7 episodes per 1000 transplant‐days; p =  .08) were not significantly higher in comparison to patients who did not receive moxifloxacin.

Conclusion

A preventive strategy based on systematic LTBI screening and moxifloxacin treatment before LT in positive cases appears safe and effective in preventing the development of tuberculosis in LT recipients. However, our findings are limited by a small sample size; thus, larger studies are required to validate our observations.

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Blood transfusion in injured older adults: A retrospective cohort study
Authors: Liu Zhinan , Kmail Zaher , Higgins Mairead , Stansbury Lynn G. , Kunapaisal Thitikan , O'Connell Kathleen M. , Bentov Itay , Vavilala Monica S. , Hess John R.
Published: September 2024

Objectives

We asked how increasing age interacts with transfusion and mortality among older injured adults at our large regional trauma center.

Background

Older adults are increasing proportions of acute trauma care and transfusion, but the specific interactions of increasing age with blood product use are unclear.

Methods/Materials

Trauma data (age, injury severity, mechanism, etc.) were linked with transfusion service data (type, timing and numbers of units) for all acute trauma patients treated at our center 2011–2022. Subsets of patients aged ≥55 years were identified by age decade and trends assessed statistically, p < 0.01.

Results

Of 73 645 patients, 25 409 (34.5%) were aged ≥55. Within increasing 10‐year age cohorts, these older patients were increasingly female (32.2%–67.2%), transferred from outside facilities (55.2%–65.9%) and injured in falls (44.4%–90.3%). Overall, patients ≥55, despite roughly equivalent injury severity, were twice as likely to be transfused (24% vs. 12.8%) as younger patients and to die during hospitalisation (7.5% vs. 2.9%). Cohort survival at all ages and levels of transfusion intensity in the first 4 h of care were more than 50%. Through age 94, numbers of red cell and whole blood units given in the first 4 h of care were a function of injury severity, not age cohort.

Conclusions

In our trauma resuscitation practice, patients aged ≥55 years are more likely to receive blood products than younger patients, but numbers of units given in the first 4 h appear based on injury severity. Age equity in acute resuscitation is demonstrated.
A Wearable Multichannel Electrical Stimulator for Tremor Suppression
Authors: Zhang Tongpo , Ying Huiqian
Published: September 2024

Pathological wrist and finger tremors can be mitigated by out-of-phase stimulation of the sensory nerves in the flexor and extensor muscles. This study endeavors to develop a portable, multichannel electrical stimulator designed to deliver high-frequency, low-intensity, biphasic charge-balanced current pulses within a practical load range to effectively suppress wrist and finger tremors. The circuit architecture integrates an Arduino Nanomicrocontroller, a four-channel digital potentiometer, and four Howland current pumps. The Howland current pump, employing an operational amplifier, generates bipolar currents by accepting bipolar voltages, whereas the digital potentiometer offers programmable bipolar voltages via its wiper terminals. Experimental results indicate that the pulse frequency can be adjusted between 50 Hz and 200 Hz, and the current level can be modulated within a range of −10 mA to +10 mA, with load resistance spanning 100 Ω to 1.3 kΩ. This portable and multichannel device is effective in delivering high-frequency, low-intensity sensory nerve stimulation through programmable biphasic charge-balanced current pulses. The proposed stimulator has the potential to enable adaptive muscle activation, thereby initiating, promoting, and generating movements, and facilitating interactive in-home neurorehabilitation for disabled patients. The portability and programmability of this device make it a promising tool for personalized tremor management and rehabilitation, enhancing the quality of life for individuals with motor impairments.