bluuebunny/crossref_metadata_2025_split huggingface dataset:
The expression of intestinal Cyp2c55 is regulated by the microbiota and inflammation
Authors: Hilman Adrian , Sato Tetsu , Wijatniko Bambang Dwi , Fujimura So , Nakamura Katsushi , Miura Hiroto , Iwatsuki Ken , Inoue Ryo , Suzuki Takuya 
Published: October 2024

AbstractAlthough the mutualistic relationship between the intestinal microbiota and the human host is crucial for maintaining health, the underlying mechanisms of this relationship remain unclear. In the present study, aiming to elucidate the regulatory mechanisms governing the Cyp2c55 expression, which is predominantly observed in colonic tissues, germ‐free, antibiotic‐administered and colitic mice, as well as mouse colonoids, were used as experimental models. RNA sequencing showed comparable decreases in the colonic Cyp2c55 expression in germ‐free and antibiotic‐administered mice, when compared with that in specific pathogen‐free mice. Furthermore, administration of dextran sulfate sodium decreased the Cyp2c55 expression in colitic mice. For these mice, a Pearson correlation analysis also showed a positive correlation between the Cyp2c55 expression and unconjugated bile acids (BAs), including chenodeoxycholic, muricholic, deoxycholic, lithocholic, and ursodeoxycholic acids, as well as taurine (T)‐conjugated secondary BAs, including deoxycholic acid. Moreover, bacterial genera, such as Muribaculaceae and unclassified Lachnospiraceae, also exhibited a positive correlation with these BAs. While administration of an agonist of the pregnane X receptor (PXR) increased the Cyp2c55 expression in mouse colonoids, inflammatory cytokines decreased it. In conclusion, Cyp2c55 was highly expressed in the colonic epithelial cells of mice in a microbiota‐dependent manner. The underlying mechanism seemed to involve a BA‐mediated PXR activation. In addition, the colonic expression of Cyp2c55 was regulated by the inflammatory response. Although the physiological function of Cyp2c55 remains largely unidentified, our findings suggested that Cyp2c55 may play a role in the mutualistic interaction between the intestinal microbiota and the intestinal homeostasis.
Pelvic Binder Radiography Is Safe and Feasible for Quantifying Fracture Instability in LC1 Pelvis Fractures: A Clinical Trial
Authors: Patterson Joseph T. , Duong Andrew M. , Flynn Camille , Kim Annabel , Inaba Kenji , Reddy Sravanthi , Blumenthal Sarah R. , Gary Joshua L. 
Published: October 2024

OBJECTIVES:
To demonstrate fracture displacement, patient tolerance, and in-hospital safety quantifying lateral compression type 1 (LC1) pelvis fracture stability with awake stress radiography using a pelvic binder (PBR).

METHODS:

Design:
Prospective clinical trial of PBR diagnostic intervention.

Setting:
Two centers, Level I trauma center and academic hospital.

Patient Selection Criteria:
Alert adults with LC1 (OTA/AO B1.1/2.1) pelvic fractures from blunt mechanism presenting within 3 weeks of injury between February and December 2023 without hypotension or injury precluding pelvic binder application.

Outcome Measures and Comparisons:
The primary outcome was fracture displacement on PBR. Secondary outcomes included feasibility (≥85% patient tolerance) and safety (no major adverse events). Exploratory outcomes included pain during examination, opioid medication consumption within 96 hours, length of hospital stay, discharge destination, and correlation between fracture displacement on PBR and examination under anesthetic.

RESULTS:
One hundred sixty-nine patients with pelvis fractures were screened, 58 were eligible, and 31 were enrolled. The mean age of enrolled patients was 58.7 ± 23 years, 54.8% were female, 22.6% were White, and 67.7% Hispanic. Fracture displacement was 4.3 ± 4.7 mm on PBR at 5 kg and 8.4 ± 9.0 mm at 10 kg. All patients tolerated PBR. Sixteen patients (52%) reported pain during PBR but completed the test. No patient experienced an adverse event. Patients received 40.4 ± 56.4 mg oral morphine equivalents within 96 hours of PBR. Ten patients (32.2%) received internal fixation. The median hospital stay was 6 days (interquartile range 5.5 days) with no inpatient mortality. Fourteen patients (45.2%) discharged home.

CONCLUSIONS:
PBR is feasible and safe as a point-of-care test for LC1 pelvis fracture instability.

LEVEL OF EVIDENCE:
Level II Diagnostic.
Effects of Tranexamic Acid on Human Osteoblasts as Proxy for Fracture Healing
Authors: Abraham Alexander , Meyers D. Nicole , Rieger William D. , Anthony Ryan , Aparicio Humberto , Park Adam Y. , Kellam James F. , Ambrose Catherine G. 
Published: October 2024

OBJECTIVES:
To investigate the effect of tranexamic acid (TXA) through in vitro culture of primary human osteoblasts (HOB) and in vivo using an operative rat femur fracture model. It was hypothesized that there would not be any effect on fracture healing in both studies.

METHODS:
Primary HOBs were exposed to varying concentrations of TXA over different time periods. Cells were assessed for viability, metabolism, and mineralization. For the in vivo model, fractures were created in the femora of adult rats, exposed to either TXA or saline, and then assessed for healing at different time points. A modified radiographic union score for tibia was used to evaluate radiographs, callus mineralization was assessed with microcomputed tomography, and biomechanical tests were performed.

RESULTS:
Overall, HOB viability and metabolism decreased as TXA concentration and exposure time increased. However, at concentrations below 56.44 mg/mL, HOB viability was not affected. Similarly, mineralization also decreased as TXA concentration and exposure time increased. In both groups, in vivo results demonstrated increasing radiographic healing, callus mineralization, and biomechanical strength as a function of time. There was a trend for increased healing in the TXA group at 6 weeks after fracture; however, the difference compared with untreated animals was not statistically significant.

CONCLUSIONS:
Although a degradation of HOB viability and metabolism occurred with increased TXA concentrations and exposure times, clinically relevant concentrations do not adversely affect HOB viability, metabolism, or mineralization. In addition, there were no noticeable adverse effects of TXA administration in the in vivo model.
Diabetes Mellitus Is Not a Risk Factor for Difficult Intubation Among Critically Ill Adults: A Secondary Analysis of Multicenter Trials
Authors: Long Micah T. , Krause Bryan M. , de Jong Audrey , Dollerschell John T. , Brewer J. Michael , Casey Jonathan D. , Gaillard John P. , Gandotra Sheetal , Ghamande Shekhar A. , Gibbs Kevin W. , Ginde Adit A. , Hughes Christopher G. , Janz David R. , Khan Akram , Latimer Andrew , Mitchell Steven , Page David B. , Russell Derek W. , Self Wesley H. , Semler Matthew W. , Stempek Susan , Trent Stacy , Vonderhaar Derek J. , West Jason R. , Halliday Stephen J. ,   for the Pragmatic Critical Care Research Group (PCCRG)
Published: October 2024

OBJECTIVES:
Diabetes mellitus has been associated with greater difficulty of tracheal intubation in the operating room. This relationship has not been examined for tracheal intubation of critically ill adults. We examined whether diabetes mellitus was independently associated with the time from induction of anesthesia to intubation of the trachea among critically ill adults.

DESIGN:
A secondary analysis of data from five randomized trials completed by the Pragmatic Critical Care Research Group (PCCRG).

SETTING:
Emergency departments (EDs) or ICUs at 11 centers across the United States that enrolled in randomized trials of a pre-intubation checklist, fluid bolus administration, bag-mask ventilation between induction and laryngoscopy, and intubation using a bougie vs. stylet.

PATIENTS:
Critically ill adults undergoing tracheal intubation with a laryngoscope in an ED or an ICU.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
A total of 2654 patients were included in this analysis, of whom 638 (24.0%) had diabetes mellitus. The mean time from induction of anesthesia to intubation of the trachea was 169 seconds (sd, 137s). Complications occurred during intubation in 1007 patients (37.9%). Diabetes mellitus was not associated with the time from induction of anesthesia to intubation of the trachea (–4.4 s compared with nondiabetes; 95% CI, –17.2 to 8.3 s; p = 0.50). Use of a video vs. direct laryngoscope did not modify the association between diabetes mellitus and the time from induction to intubation (p for interaction = 0.064). Diabetes mellitus was not associated with the probability of successful intubation on the first attempt (85.6% vs. 84.3%; p = 0.46) or complications during intubation (39.8% vs. 37.4%; p = 0.52).

CONCLUSIONS:
Among 2654 critically ill patients undergoing tracheal intubation in an ED or an ICU, diabetes mellitus was not independently associated with the time from induction to intubation, the probability of successful intubation on the first attempt, or the rate of complications during intubation.
Incidence and influential factors of postoperative pruritus in morphine-based intravenous patient-controlled analgesia
Authors: Liao Chung-Yi , Wu Hsiang-Ling , Wu Yu-Ming , Cata Juan P. , Chen Jui-Tai , Wang Chien-Wun , Cherng Yih-Giun , Tai Ying-Hsuan 
Published: October 2024

Background:
Pruritus is a distressing symptom of systemic opioid analgesia that responds poorly to conventional anti-pruritus treatments. This study aimed to determine the incidence and risk factors for postoperative pruritus using intravenous patient-controlled analgesia (IV-PCA).

Methods:
Opioid-naïve patients who underwent morphine-based IV-PCA for postoperative pain at a tertiary center between January 1, 2020 and June 30, 2023, were included retrospectively. The primary outcome was pruritus within 72 hours after surgery. Cumulative morphine consumption and pain numerical rating scores were measured to evaluate the potential impact of pruritus on postoperative pain control.

Results:
A total of 1696 patients were enrolled, of whom 119 (7.0%) developed pruritus during the study period. Five independent factors for pruritus were identified, including intraoperative uses of hydroxyethyl starch solutions (adjusted odds ratio [aOR]: 0.13, 95% CI, 0.04-0.43), lockout interval of IV-PCA (aOR: 0.50, 95% CI, 0.27-0.94, on base-2 logarithmic scale), droperidol addition to morphine solutions (aOR: 0.53, 95% CI, 0.35-0.81), cumulative morphine dose (aOR: 1.76, 95% CI, 1.47-2.12, on base-2 logarithmic scale), and postoperative uses of antihistamines (aOR: 2.90, 95% CI, 1.83-4.60) (c-statistic = 0.745). Patients with pruritus had higher postoperative morphine consumption (median: 67.5 mg, interquartile range: 38.3-94.0 vs 38.0 mg, 21.0-65.4, p < 0.001) but similar pain intensity compared to those without pruritus.

Conclusion:
Increasing the lockout interval and the droperidol regimen may protect patients from morphine-induced pruritus after IV-PCA. Further studies are warranted to clarify the mechanisms underlying the anti-pruritus effects of hydroxyethyl starch.
Effectiveness of Educational Interventions to Develop Patient Safety Competencies in Undergraduate Nursing Students
Authors: De Rezende Helena , Morais Alexandre Souza , Vitorio Aline Mirema Ferreira , Quadrado Ellen Regina Sevilla , Garzin Ana Claudia Alcântara , Martins Maristela Santini , Lourenção Daniela Campos de Andrade , Modesto Roberto Chrispim , Nicole Andressa Garcia 
Published: October 2024

Background:
Nursing professionals are key to providing safe care that improves patient outcomes. Hence, it is essential to focus on developing nurses’ patient safety competencies and principles.

Purpose:
This review examined the effectiveness of educational interventions in developing patient safety knowledge, skills, behaviors, and attitudes in undergraduate nursing students.

Methods:
The search strategy aimed to identify published and unpublished studies in databases and grey literature. Studies were assessed using the Joanna Briggs Institute critical appraisal tools.

Results:
A total of 36 studies met the inclusion criteria. The teaching methods employed single or combined interventions and the educational interventions suggested either improvements in outcomes or no impact.

Conclusion:
The effectiveness of educational interventions to develop patient safety competencies in undergraduate nursing students, either as a single or combined strategy, was mixed. Further research is needed to provide more robust evidence on which teaching method for patient safety is most effective.
Description of a Nurse Practitioner-Led Orthogeriatric Model of Care
Authors: Vaillancourt Emma , Backman Chantal , Chabot Chantal , Joanisse John 
Published: October 2024

Older adults often present with multiple comorbidities and face significant postoperative complications. This study aimed to describe the role of Nurse Practitioner (NP)-led orthogeriatric services in managing hip fracture patients. We conducted a review of health records of older adults with hip and proximal femoral fractures between July 2017 and June 2018, presenting descriptive statistics on patient characteristics, surgical outcomes, and the involvement of orthogeriatric services. A total of 197 participants were included, with a majority being female (n = 132; 67.0%). Most patients (53.8%; n = 106) had between five and nine pre-existing conditions. Among the 192 patients who underwent surgery, 69.8% (n = 134) experienced up to four surgical complications. The Nurse Practitioner provided care to 89.1% (n = 163) of the patients within the orthogeriatric service, with half of the patients (n = 82) requiring at least five NP interventions to manage complex pre- and postoperative needs. Refining the NP-led model could potentially help reduce the burden on physicians and surgeons in treating complex medical conditions, especially in settings where geriatricians may not be readily available.
Application of the IMB Model in the Vision of Zero Harm Caused by Magnetic Resonance Ferromagnetic Projection Accidents
Authors: Gong Meng , Qin Lei , Cai Longbiao 
Published: October 2024

Objective:
The aim of the study is to explore the application of safety education based on the IMB model to prevent harm caused by magnetic resonance ferromagnetic projection accidents.

Methods:
One hundred ninety-six patients undergoing magnetic resonance imaging were divided into a control group of 90 cases and an observation group of 106 cases. The control group received routine safety education, while the observation group received safety education based on the IMB model in addition to routine education. The knowledge, attitudes, and behaviors related to the prevention of ferromagnetic projection accidents, as well as fear scores, were compared before and after the intervention.

Results:
A total of 90 cases in the control group and 106 cases in the observation group completed the study. There were statistically significant differences in the scores of knowledges, attitudes, and behaviors related to the prevention of ferromagnetic projection accidents, as well as fear scores between the 2 groups after the intervention (all P < 0.01).

Conclusions:
Safety education based on the IMB model can improve the knowledge, attitudes, and behaviors of magnetic resonance imaging patients and reduce the risk of ferromagnetic projection accidents.
Epidemiology and Outcomes Associated with New Persistent Opioid Use after Transabdominal Surgery
Authors: Ingason Arnar B , Galenkamp Amanda L , Jonsdottir Freyja , An Gary , Sigurdsson Martin I 
Published: October 2024

BACKGROUND:
Overall, 3% to 12% of opioid-naive patients develop persistent opioid use after surgery. It is still unclear whether persistent opioid use after transabdominal surgery is associated with adverse surgical outcomes. We aimed to assess if new persistent opioid use after transabdominal surgery is associated with increased long-term mortality and readmission rates.

STUDY DESIGN:
Opioid-naive patients older than 18 years undergoing transabdominal surgery at Landspitali University Hospital, the only tertiary hospital in Iceland, from 2006 to 2018 were included. Persistent opioid use was defined as opioid use more than 3 months postoperatively. Inverse probability weighting was used to yield balanced study groups accounting for baseline characteristics. Long-term mortality (during median follow-up of 5.2 years) was compared using propensity-weighted Cox regression and readmission within 3 to 6 months using propensity-weighted logistic regression.

RESULTS:
Overall, 3,923 patients were included (laparoscopy 2,680 and laparotomy 1,243). Rates of new persistent opioid use were 13%. Rates were higher after laparotomy than laparoscopy in the crude analysis but not in the propensity-weighted analysis. New persistent opioid use was associated with higher long-term mortality (hazard ratio 1.84, 95% CI 1.41 to 2.40) and readmission rates (odds ratio 3.24, 95% CI 2.25 to 4.76). This was consistent for both patients undergoing laparoscopy and laparotomy. There were signs of a dose–response relationship, with patients in higher quartiles of postoperative opioid consumption having higher mortality and readmission rates.

CONCLUSIONS:
New persistent opioid use after transabdominal surgery was associated with higher rates of mortality and readmission rates. This calls for increased postoperative support for at-risk patients and increased support during transitions of care for these patients.
Comparative Analysis of Autologous Skin Cell Suspension Technology and Split-Thickness Skin Grafting for Subacute Wounds in Medically Complex Patients: Propensity-Matched Cohort Study
Authors: Gould Lisa J , Acampora Cheryl , Borrelli Mimi 
Published: October 2024

BACKGROUND:
Nonhealing wounds are particularly prevalent in older adults and in patients with multiple comorbidities, and they represent a significant medicoeconomic burden. Autologous split-thickness skin grafts (STSGs) are considered the gold standard for wound closure but suffer from high failure rates and complications. Autologous skin cell suspension (ASCS) technology is an autografting technique able to significantly minimize donor site morbidity. This retrospective, propensity-matched cohort study compared outcomes of wounds treated with ASCS vs STSG.

STUDY DESIGN:
Seven patients treated with ASCS were propensity-matched to 7 control patients who received STSG according to age and sex. The ASCS was prepared using the RECELL System and applied either alone as spray only (“ASCS alone,” off-label) or combined with a widely meshed STSG (“ASCS + STSG,” 3:1). The primary outcome was time to complete wound healing. Secondary outcomes included donor site healing, pain, and total number of visits. Statistical analyses included descriptive statistics, univariate analyses, and mixed-effect regression modeling to assess the impact of treatment on wound healing.

RESULTS:
A total of 14 patients and 17 wounds (10 treatment vs 7 control) were included. Demographics were well-matched between cohorts. The overall mean wound healing time was 85.6 ± 11.2 days. Wounds treated with ASCS (both ASCS groups) healed faster than STSG (75.9 ± 4.5 vs 99.4 ± 26.7 days). Wounds treated with ASCS alone healed in 80.8 ± 5.1 days, whereas those treated with ASCS and STSG healed in 68.5 ± 7.6 days.

CONCLUSIONS:
This study suggests that ASCS may offer clinically significant improvements in wound and donor site healing, with significantly less donor skin requirements, and comparable pain levels, compared with traditional STSG. Further research with a prospective study and larger sample size is needed to validate these findings.
Neurofeedback: new territories and neurocognitive mechanisms of endogenous neuromodulation
Authors: Sulzer James , Papageorgiou T. Dorina , Goebel Rainer , Hendler Talma 
Published: October 2024

Neurofeedback (NF) is endogenous neuromodulation of circumscribed brain circuitry. While its use of real-time brain activity in a closed-loop system is similar to brain–computer interfaces, instead of controlling an external device like the latter, the goal of NF is to change a targeted brain function. In this special issue on NF, we present current and future methods for extracting and manipulating neural function, how these methods may reveal new insights about brain function, applications, and rarely discussed ethical considerations of guiding and interpreting the brain activity of others. Together, the articles in this issue outline the possibilities of NF use and impact in the real world, poising to influence the development of more effective and personalized NF protocols, improving the understanding of underlying psychological and neurological mechanisms and enhancing treatment precision for various neurological and psychiatric conditions.
This article is part of the theme issue ‘Neurofeedback: new territories and neurocognitive mechanisms of endogenous neuromodulation’.
Semantic fMRI neurofeedback of emotions: from basic principles to clinical applications
Authors: Goebel Rainer , Lührs Michael , Ciarlo Assunta , Esposito Fabrizio , Linden David E. 
Published: October 2024

During fMRI neurofeedback participants learn to self-regulate activity in relevant brain areas and networks based on ongoing feedback extracted from measured responses in those regions. This closed-loop approach has been successfully applied to reduce symptoms in mood disorders such as depression by showing participants a thermometer-like display indicating the strength of activity in emotion-related brain areas. The hitherto employed conventional neurofeedback is, however, ‘blind’ with respect to emotional content, i.e. patients instructed to engage in a specific positive emotion could drive the neurofeedback signal by engaging in a different (positive or negative) emotion. In this future perspective, we present a new form of neurofeedback that displays semantic information of emotions to the participant. Semantic information is extracted online using real-time representational similarity analysis of emotion-specific activity patterns. The extracted semantic information can be provided to participants in a two-dimensional semantic map depicting the current mental state as a point reflecting its distance to pre-measured emotional mental states (e.g. ‘happy’, ‘content’, ‘sad’, ‘angry’). This new approach provides transparent feedback during self-regulation training, and it has the potential to enable more specific training effects for future therapeutic applications such as clinical interventions in mood disorders.
This article is part of the theme issue ‘Neurofeedback: new territories and neurocognitive mechanisms of endogenous neuromodulation’.