bluuebunny/crossref_metadata_2025_split huggingface dataset:
ANTIMICROBIAL WOUND DRESSINGS FOR FULL-THICKNESS INFECTED BURN WOUNDS
Authors: Dhyani Abhishek , Repetto Taylor , VanAken Shannon , Nemzek Jean , VanEpps J. Scott , Mehta Geeta , Tuteja Anish 
Published: August 2024

ABSTRACT
Infection of wounds delays healing, increases treatment costs, and leads to major complications. Current methods to manage such infections include antibiotic ointments and antimicrobial wound dressings, both of which have significant drawbacks, including frequent reapplication and contribution to antimicrobial resistance. In this work, we developed wound dressings fabricated with a medical-grade polyurethane coating composed of natural plant secondary metabolites, cinnamaldehyde, and alpha-terpineol. Our wound dressings are easy to change and do not adhere to the wound bed. They kill gram-positive and -negative microbes in infected wounds due to the Food and Drug Administration–approved for human consumption components. The wound dressings were fabricated by dip coating. Antimicrobial efficacy was determined by quantifying the bacteria colonies after a 24 h of immersion. Wound healing and bacterial reduction were assessed in an in vivo full-thickness porcine burn model. Our antimicrobial wound dressings showed a > 5-log reduction (99.999%) of different gram-positive and gram-negative bacteria, while maintaining absorbency. In the in vivo porcine burn model, our wound dressings were superior to bacitracin in decreasing bacterial burden during daily changes, without interfering with wound healing. Additionally, the dressings had a significantly lower adhesion to the wound bed. Our antimicrobial wound dressings reduced the burden of clinically relevant bacteria more than commercial antimicrobial wound dressings. In an in vivo infected burn wound model, our coatings performed as well or better than bacitracin. We anticipate that our wound dressings would be useful for the treatment of various types of acute and chronic wounds.
COMPARISON OF OXIRIS AND CONVENTIONAL CONTINUOUS RENAL REPLACEMENT THERAPY IN MANAGING SEVERE ABDOMINAL INFECTIONS: IMPACT ON SEPTIC SHOCK MORTALITY
Authors: Liao Xiu-Yu , Chen Yu-Ting , Liu Ming-Jun , Liao Qiu-Xia , Lin Jian-Dong , Lin Hai-Rong , Huang Ying-Hong , Zhou Ye 
Published: August 2024

ABSTRACT

Objective: The objective of this study is to assess and compare the efficacy of oXiris with conventional continuous renal replacement therapy (CRRT) in managing severe abdominal infections. Methods: A retrospective analysis encompassing cases from 2017 to 2023 was conducted at the Department of Critical Care Medicine within the First Affiliated Hospital of Fujian Medical University. Parameters including heart rate (HR), mean arterial pressure (MAP), oxygenation index, lactate (Lac), platelet count, neutrophil ratio, procalcitonin, C-reactive protein (CRP), interleukin 6 (IL-6), norepinephrine dosage, Acute Physiology and Chronic Health Evaluation II (APACHE II), and Sequential Organ Failure Assessment (SOFA) were recorded prior to treatment initiation, at 24 h, and 72 h after treatment for both the oXiris and conventional CRRT groups. In addition, the duration of respiratory support, CRRT treatment, length of stay in the intensive care unit (ICU), total hospitalization period, and mortality rates at 14 and 28 days for both groups were recorded. Results: 1) Within the conventional CRRT group, notable enhancement was observed solely in Lac levels at 24 h after treatment compared with pretreatment levels. In addition, at 72 h after treatment, improvements were evident in HR, Lac, CRP, and IL-6 levels. 2) Conversely, the oXiris group exhibited improvements in HR, MAP, Lac, oxygenation index, neutrophil ratio, and IL-6 at 24 h after treatment when compared with baseline values. In addition, reductions were observed in APACHE II and SOFA scores. At 72 h after treatment, all parameters demonstrated enhancement except for platelet count. 3) Analysis of the changes in the indexes (Δ) between the two groups at 24 h after treatment revealed variances in HR, MAP, Lac, norepinephrine dosage, CRP levels, IL-6 levels, APACHE II scores, and SOFA scores. 4) The Δ indexes at 72 h after treatment indicated more significant improvements following oXiris treatment for both groups, except for procalcitonin. 5) The 14-day mortality rate (24.4%) exhibited a significant reduction in the oXiris group when compared with the conventional group (43.6%). However, no significant difference was observed in the 28-day mortality rate between the two groups. 6) Subsequent to multifactorial logistic regression analysis, the results indicated that oXiris treatment correlated with a noteworthy decrease in the 14-day and 28-day mortality rates associated with severe abdominal infections, by 71.3% and 67.6%, respectively. Conclusion: oXiris demonstrates clear advantages over conventional CRRT in the management of severe abdominal infections. Notably, it reduces the fatality rates, thereby establishing itself as a promising and potent therapeutic option.
MYELOID-DERIVED TLR4-TRIF SIGNALING PATHWAY MEDIATES OXIDATIVE STRESS IN LPS/D-GALN-INDUCED ACUTE LIVER FAILURE
Authors: Li Jing , Jiang Li , Zhao Kai , Tang Yiting , Yuan Xiangning , Xu Yunfei 
Published: August 2024

ABSTRACT

Background: Acute liver failure (ALF) is a severe clinical syndrome characterized by massive hepatocyte death in a short time due to viruses, drugs, alcohol, or other factors. Oxidative stress is an important pathogenic mechanism of ALF. LPS-induced internalization of toll-like receptor 4 (TLR4) and the subsequent activation of the toll/IL-1R domain-containing adaptor-inducing IFN-beta (TRIF) signaling pathway widely mediate inflammatory responses in a series of diseases. However, whether the TLR4-TRIF signaling pathway contributes to ALF by mediating oxidative stress processes remains unclear. Methods: An ALF mouse model was induced by lipopolysaccharide (LPS)/D-galactosamine (D-GalN). TLR4-TRIF systemic knockout mice and TLR4 conditional knockout mice were used to determine the role of the TLR4-TRIF signaling pathway in ALF. The effects of TLR4 or TRIF deficiency on oxidative stress were investigated. In addition, we examined the protective role of the clodronate liposomes (macrophage scavengers) and the antioxidant N-acetylcysteine (NAC) in ALF. Results: TLR4 or TRIF deficiency significantly alleviated LPS/D-GalN-induced lethality, hepatic dysfunction, and hepatic pathologic injury, which was dependent on myeloid-derived TLR4. Hence, macrophage clearance exhibits a similar protective effect. Mechanically, TLR4 or TRIF deficiency was observed to inhibit oxidative stress by increasing glutathione, while decreasing malondialdehyde, 8-hydroxy-2-deoxyguanosine, and γ-H2AX. Therefore, the pharmacologic antioxidant NAC exhibited significant hepato-protective effects. Conclusions: Targeting myeloid-derived TLR4-TRIF signaling pathway or antioxidant therapy may be a potential therapeutic direction to treat ALF.
EFFECT OF ARTESUNATE TREATMENT ON INTESTINAL INJURY AFTER CARDIOPULMONARY RESUSCITATION IN SWINE
Authors: Wang Qianqian , Shen Peng , Zhu Jiangang , Zhu Weidong , Xu Jiefeng 
Published: August 2024

ABSTRACT

Introduction
Intestinal injury is often caused by systemic ischemia-reperfusion injury early after cardiac arrest (CA) and resuscitation. Artesunate (Art) has been confirmed to protect vital organs against diverse of regional I/R injury. This study aimed to investigate the effect of Art on intestinal injury after CA and cardiopulmonary resuscitation (CPR) in swine.

Methods
Twenty-two swine were randomly divided into three groups: sham (n = 6), CA/CPR (n = 8), and CA/CPR + Art (n = 8). The CA/CPR swine model was established by inducing 9 minutes of untreated ventricular fibrillation (VF) followed by 6 minutes of CPR. Five minutes after resuscitation, 4.8 mg/kg of Art was intravenously administered for 2 hours in the CA/CPR + Art group. Intestinal fatty acid-binding protein (iFABP) and diamine oxidase (DAO) concentrations were compared among the three groups before CA and at 1, 2, 4, and 24 hours after resuscitation. At 24 hours post-resuscitation, intestinal zonula occluden-1(ZO-1), occludin, apoptosis, caspase-3/gasdermin E (GSDME)-mediated pyroptosis proteins concentrations, and proinflammatory cytokine concentrations were examined to evaluate intestinal injury.

Results
During CPR, spontaneous circulation was achieved in 7 and 6 swine in the CA/CPR and CA/CPR + Art groups, respectively. Serum iFABP and DAO concentrations were significantly higher and intestinal tissue ZO-1 and occludin concentrations were significantly lower in the CA/CPR and CA/CPR + Art groups than in the sham group. However, Art treatment resulted in markedly improved levels of intestinal injury biomarkers compared with those in the CA/CPR group. Additionally, intestinal apoptosis and concentrations of caspase-3/GSDME-mediated pyroptosis proteins and proinflammatory cytokines were significantly higher in the CA/CPR and CA/CPR + Art groups than in the sham group. However, these variables were significantly lower in the CA/CPR + Art group than in the CA/CPR group.

Conclusions
Art treatment effectively alleviates post-resuscitation intestinal injury, possibly by inhibiting the caspase-3/GSDME-mediated pyroptosis pathway in a swine CA and CPR model.
Five-day Wearable Respiratory Support With a Novel Ambulatory Pulmonary Assist System in an Awake Ovine Model
Authors: Hong Yeahwa , Shin Suji , Nasim Umar , Scala Helen M. , Roberts Kalliope G. , Potchernikov Alexander S. , Woolley Brian E. , Skoog David J. , Bacchetta Matthew , Cook Keith E. 
Published: August 2024

Background.
The pulmonary assist system (PAS) is a wearable respiratory support system that is currently under development for patients with chronic lung disease as a bridge to lung transplantation or as destination therapy. This study evaluates the long-term performance and biocompatibility of the PAS in a 5-d awake, ovine model.

Methods.
The PAS was attached to normal sheep in venovenous configuration. Components of the PAS included a 0.9 m2 surface area oxygenator and a lightweight, battery-powered axial flow pump. The system was also tested using the Abbott PediMag as the control pump. Each sheep was supported on the PAS for 5 d with 2 L/min blood flow and 4 L/min sweep gas. Activated clotting times of 200–240 s were maintained using intravenous heparin. Pump performance, oxygen transfer, oxygenator resistance, and hematologic parameters were measured throughout the support.

Results.
The PAS, either using the axial flow pump or PediMag (n = 4 each), was well tolerated by the sheep without signs of device-related organ damage or hemolysis. All the studies achieved the full, 5-d study duration. The oxygenator resistance remained consistent without significant clot formation in all experiments with an average resistance of 2.55 ± 0.10 mm Hg/(L/min). The system achieved an average oxygen transfer rate of 116.4 ± 5.5 mL/min, with an average Hb concentration of 9.2 ± 0.6 g/dL. White blood cell, platelet, and hematocrit levels also remained stable and within normal limits throughout the study period.

Conclusions.
The PAS provided 5 d of uncomplicated ambulatory respiratory support with minimal clot formation, stable gas exchange, blood flow resistance, and hematologic parameters.
Total body weight estimation by 3D camera systems: potential high-tech solutions for emergency medicine applications? A scoping review
Authors: Wells Mike , Goldstein Lara Nicole , Wells Terran , Ghazi Niloufar , Pandya Abhijit , Furht Borifoje , Engstrom Gabriella , Jan Muhammad Tanveer , Shih Richard 
Published: August 2024

ABSTRACTBackgroundWeight estimation is required in adult patients when weight-based medication must be administered during emergency care, as measuring weight is often not possible. Inaccurate estimations may lead to inaccurate drug dosing, which may cause patient harm. High-tech 3D camera systems driven by artificial intelligence might be the solution to this problem. The aim of this review was to describe and evaluate the published literature on 3D camera weight estimation methods.MethodsA systematic literature search was performed for articles that studied the use of 3D camera systems for weight estimation in adults. Data on the study characteristics, the quality of the studies, the 3D camera methods evaluated, and the accuracy of the systems were extracted and evaluated.ResultsA total of 14 studies were included, published from 2012 to 2024. Most studies used Microsoft Kinect cameras, with various analytical approaches to weight estimation. The 3D camera systems often achieved a P10 of 90% (90% of estimates within 10% of actual weight), with all systems exceeding a P10 of 78%. The studies highlighted a significant potential for 3D camera systems to be suitable for use in emergency care.ConclusionThe 3D camera systems offer a promising method for weight estimation in emergency settings, potentially improving drug dosing accuracy and patient safety. Weight estimates were extremely accurate. Importantly, 3D camera systems possess characteristics that could make them very appropriate for use during emergency care. Future research should focus on developing and validating this methodology in larger studies with true external and clinical validation.
What is next for costing WASH in healthcare facilities? Applying evidence for policy and practice
Authors: Tantum Lucy K. , Cronk Ryan , Asingwire Narathius , Bohara Prakash , Chettry Laxman Kharal , Hirai Mitsuaki , Kpodzro Sena , Mavi Tariro , Miller Joshua D. , Ripkey Carrie , Sharma Sarbesh , Trinies Victoria , Anderson Darcy 
Published: August 2024

AbstractEfforts to improve and sustain water, sanitation, hygiene (WASH), waste management, and cleaning services in healthcare facilities in low- and middle-income countries are constrained by limited funding. Assessments of the costs of delivering WASH services are critical for guiding financial planning and investment, but many countries lack costed plans for WASH in healthcare facilities. A 2023 UNC Water and Health Conference workshop explored how policymakers and practitioners collect and use cost data and identify strategies for overcoming cost barriers. Presenters shared case studies that showcased the utility of cost data for creating national costed roadmaps, identifying and addressing budgetary shortfalls, and planning WASH improvements in Nepal, Uganda, and Zimbabwe. In discussions, workshop participants described leveraging collaborations with multiple government entities and non-governmental organizations (NGOs) to collect cost data. Participants also reported using cost data to plan programs and advocate for additional WASH funding. Strategies to coordinate costing approaches across stakeholder groups and standardize data collection tools will enhance the efficiency and effectiveness of planning and budgeting for WASH in healthcare facilities.HighlightsLocal and national governments and NGOs routinely collect and use cost data to inform decisions about WASH services in healthcare facilitiesWASH responsibilities are divided across multiple institutions, necessitating coordination for cost data collectionGovernments have used costing data to create national costed roadmaps and budgetsCosting data support program planning, monitoring, and advocacy
National consensus statement on opioid agonist treatment in custodial settings
Authors: Chan Jocelyn , Cook Jon , Curtis Michael , Dunlop Adrian , Morrison Ele , Nielsen Suzanne , Winter Rebecca , Naren Thileepan 
Published: August 2024

AbstractIntroductionOpioid use and dependence are prevalent among incarcerated people, contributing to elevated rates of overdose and other harms in this population. Opioid agonist treatment (OAT) has been demonstrated as an effective intervention to mitigate these risks. However, challenges to health care implementation in the custodial sector result in suboptimal and variable access to OAT in prisons nationally.Main recommendationsAmong a national multi-disciplinary expert panel, we conducted a modified Delphi study which yielded 19 recommendations to government, relevant health authorities and custodial health services. These recommendations cover five core domains: induction or continuation of OAT, OAT options and administration, transition of care to the community, special populations, organisational support. Key recommendations include prompt recognition and treatment of opioid withdrawal, active linkage to community-based OAT providers upon release, and ensuring appropriate organisational support through local protocols, adequate funding, and monitoring of key program indicators.Changes in management as a result of this statementThis consensus statement addresses a significant gap in national policy on OAT in Australian prisons. The recommendations set forth best practice standards grounded in evidence and expert consensus. We expect that implementing these recommendations will enhance the quality, consistency, and continuity of OAT both within prison and upon release. Optimizing OAT provision is crucial for improving health outcomes and addressing overdose, which is the leading cause of death among people released from prison.
Generative artificial intelligence models in clinical infectious disease consultations: a cross-sectional analysis among specialists and resident trainees
Authors: Chiu Edwin Kwan-Yeung , Sridhar Siddharth , Wong Samson Sai-Yin , Tam Anthony Raymond , Choi Ming-Hong , Lau Alicia Wing-Tung , Wong Wai-Ching , Chiu Kelvin Hei-Yeung , Ng Yuey-Zhun , Yuen Kwok-Yung , Chung Tom Wai-Hin 
Published: August 2024

ABSTRACTBackgroundThe potential of generative artificial intelligence (GenAI) to augment clinical consultation services in clinical microbiology and infectious diseases (ID) is being evaluated.MethodsThis cross-sectional study evaluated the performance of four GenAI chatbots (GPT-4.0, a Custom Chatbot based on GPT-4.0, Gemini Pro, and Claude 2) by analysing 40 unique clinical scenarios synthesised from real-life clinical notes. Six specialists and resident trainees from clinical microbiology or ID units conducted randomised, blinded evaluations across four key domains: factual consistency, comprehensiveness, coherence, and medical harmfulness.ResultsAnalysis of 960 human evaluation entries by six clinicians, covering 160 AI-generated responses, showed that GPT-4.0 produced longer responses than Gemini Pro (p<0·001) and Claude 2 (p<0·001), averaging 577 ± 81·19 words. GPT-4.0 achieved significantly higher mean composite scores compared to Gemini Pro [mean difference (MD)=0·2313, p=0·001] and Claude 2 (MD=0·2021, p=0·006). Specifically, GPT-4.0 outperformed Gemini Pro and Claude 2 in factual consistency (Gemini Pro, p=0·02 Claude 2, p=0·02), comprehensiveness (Gemini Pro, p=0·04; Claude 2, p=0·03), and the absence of medical harm (Gemini Pro, p=0·02; Claude 2, p=0·04). Within-group comparisons showed that specialists consistently awarded higher ratings than resident trainees across all assessed domains (p<0·001) and overall composite scores (p<0·001). Specialists were 9 times more likely to recognise responses with "Fully verified facts" and 5 times more likely to consider responses as "Harmless". However, post-hoc analysis revealed that specialists may inadvertently disregard conflicting or inaccurate information in their assessments, thereby erroneously assigning higher scores.InterpretationClinical experience and domain expertise of individual clinicians significantly shaped the interpretation of AI-generated responses. In our analysis, we have demonstrated disconcerting human vulnerabilities in safeguarding against potentially harmful outputs. This fallibility seemed to be most apparent among experienced specialists and domain experts, revealing an unsettling paradox in the human evaluation and oversight of advanced AI systems. Stakeholders and developers must strive to control and mitigate user-specific and cognitive biases, thereby maximising the clinical impact and utility of AI technologies in healthcare delivery.
The turbulent soundscape of intertidal oyster reefs
Authors: Volaric Martin P. , Stine Eli M. , Burtner Matthew , Andrews Steven S. , Berg Peter , Reidenbach Matthew A. 
Published: August 2024

AbstractTurbulence and sound are important cues for oyster reef larval recruitment. Numerous studies have found a relationship between turbulence intensity and swimming behaviors of marine larvae, while others have documented the importance of sounds in enhancing larval recruitment to oyster reefs. However, the relationship between turbulence and the reef soundscape is not well understood. In this study we made side-by-side acoustic Doppler velocimeter turbulence measurements and hydrophone soundscape recordings over 2 intertidal oyster reefs (1 natural and 1 restored) and 1 adjacent bare mudflat as a reference. Sound pressure levels (SPL) were similar across all three sites, although SPL > 2000 Hz was highest at the restored reef, likely due to its larger area that contained a greater number of sound-producing organisms. Flow noise (FN), defined as the mean of pressure fluctuations recorded by the hydrophone atf< 100 Hz, was significantly related to mean flow speed, turbulent kinetic energy, and turbulence dissipation rate (ε), agreeing with theoretical calculations for turbulence. Our results also show a similar relationship between ε andFNto what has been previously reported for ε vs. downward larval swimming velocity (wb), with bothFNandwbdemonstrating rapid growth at ε > 0.1 cm2s-3. These results suggest that reef turbulence and sounds may attract oyster larvae in complementary and synergistic ways.
Restraint of melanoma progression by cells in the local skin environment
Authors: Ma Yilun , Tagore Mohita , Hunter Miranda V. , Huang Ting-Hsiang , Montal Emily , Weiss Joshua M. , White Richard M. 
Published: August 2024

AbstractKeratinocytes, the dominant cell type in the melanoma microenvironment during tumor initiation, exhibit diverse effects on melanoma progression. Using a zebrafish model of melanoma and human cell co-cultures, we observed that keratinocytes undergo an Epithelial–Mesenchymal Transition (EMT)-like transformation in the presence of melanoma, reminiscent of their behavior during wound healing. Surprisingly, overexpression of the EMT transcription factor Twist in keratinocytes led to improved overall survival in zebrafish melanoma models, despite no change in tumor initiation rates. This survival benefit was attributed to reduced melanoma invasion, as confirmed by human cell co-culture assays. Single-cell RNA-sequencing revealed a unique melanoma cell cluster in the Twist-overexpressing condition, exhibiting a more differentiated, less invasive phenotype. Further analysis nominated homotypic jam3b-jam3b and pgrn-sort1a interactions between Twist-overexpressing keratinocytes and melanoma cells as potential mediators of the invasive restraint. Our findings suggest that EMT in the tumor microenvironment (TME) may limit melanoma invasion through altered cell-cell interactions.