bluuebunny/crossref_metadata_2025_split huggingface dataset:
Best Practices for Storage of Reusable Medical Devices in the Military Health System
Authors: Blake Matthew G , Gracia Marissa , Uregen James , Brown Elena , Romito Kenneth , Stucky Christopher , Mitchell Christy , Atwood Bethany 
Published: January 2025

ABSTRACT

Introduction
The storage of reusable medical devices (RMDs) is the final reprocessing phase and the step that directly precedes point-of-care delivery. Reusable medical devices, including surgical tools necessitating sterilization and semicritical devices such as endoscopes, undergo high-level disinfection. The rigorous reprocessing protocols and subsequent storage of RMDs are crucial in preserving their sterility and asepsis. This ensures they are available, clean, and safe for patient use, thereby significantly reducing the risk of surgical site infection. The stringent requirements for RMD storage are a testament to the critical role it plays in patient safety, making it a demanding task for health care organizations (HCOs) to comply with. These challenges are further amplified in austere environments. This integrative review aims to identify optimal storage practices, emphasize the critical importance of RMD storage in the Military Health System, and derive implications for policies and future considerations.

Materials and methods
The authors performed an integrative review and comprehensive literature search in PubMed/MEDLINE, CINAHL, and Embase using the keywords “instrument storage,” “surgical instruments,” “sterile storage,” “sterile wrap,” and “flexible endoscope storage.” Articles were limited to English from 1980 to 2024. Additionally, the authors reviewed international guidelines to support RMD storage.

Results
The integrative review of 42 articles and 14 guidelines and articles identified 6 central themes supporting RMD storage, which include facility design, environmental considerations, sterile storage packaging systems, considerations for event-related sterile storage, point-of-care delivery, and endoscope storage best practices. The abundance of evidence-based recommendations and guidelines complicates adherence to optimal practices in HCOs, presenting significant challenges in austere environments. Integrating RMD storage considerations into training, exercises, and operations help promote a culture of RMD stewardship to ensure safe surgical and procedural care within the Military Health System.

Conclusion
Although surgical teams’ capabilities are crucial in delivering effective care in a dynamic environment, the management and storage of RMDs are equally essential. Numerous organizations have outlined rigorous guidelines for HCOs to comply with, which can be intensified in austere conditions. Ultimately, a commitment to integrating the literature and developing the groundwork for clinical practice guidelines can improve the safe storage of RMDs in both standard and austere environments.
Considerations for Perioperative Management Guidance Regarding GLP-1 Receptor Agonists: Evaluation of Current Practices and Future Directions
Authors: Knuf Kayla M , Highland Krista B , Houhoulis Kathryn C , McElrath Angela D 
Published: January 2025

ABSTRACT

Introduction
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have become increasingly prevalent and have the potential to delay gastric emptying. The American Society of Anesthesiologists (ASA) released guidance regarding the perioperative management of patients receiving GLP-1 RAs, but it is unclear the extent to which hospitals in the U.S. Military Health System have implemented policies consistent with this guidance.

Methods
A questionnaire was sent to active duty anesthesiologists and Certified Registered Nurse Anesthetists (CRNAs) working in the U.S. Military Health System. The questions assessed the presence of institutional GLP-1 RA perioperative policies, adherence to the policy (if applicable), the basis and components of current and recommended future institutional policies, institutional tracking of policy implementation and outcomes, and knowledge, skills, barriers, and continuing medical education goals related to the perioperative management of patients receiving GLP-1 RAs.

Results
The response rate was 32% (N = 265); a little over half of the respondents were anesthesiologists (53%); and respondents’ primary practices included over 50 institutions. More than half (54%) indicated that their primary practice location had a GLP-1 RA perioperative policy; 65% of whom indicated that they always followed the policy. In review of practice locations with &gt;1 respondents, there was a lack of perfect agreement across most locations. The most commonly reported basis for the policy was ASA guidance (87%), followed by department leadership (37%). Barriers to any system-wide GLP-1 perioperative management policy included a lack of gastric ultrasound practice and comfort, as well as reported skills and knowledge, pressure not to cancel cases, scheduling problems, and productivity requirements.

Conclusions
Formal policies were reported by most respondents, but inconsistencies within practice locations suggest that local policy implementation could be improved. Commonly reported barriers to future system-wide policy implementation provide data-driven information for system-wide efforts to improve policy success.
The GALAH Survey: Stellar parameters and abundances for 800,000 Gaia RVS spectra using GALAH DR4 and The Cannon
Authors: Das Pradosh Barun , Zucker Daniel B , De Silva Gayandhi M , Borsato Nicholas W , Mura-Guzmán Aldo , Buder Sven , Ness Melissa , Nordlander Thomas , Casey Andrew R , Martell Sarah L , Bland-Hawthorn Joss , de Grijs Richard , Freeman Ken C , Kos Janez , Stello Dennis , Lewis Geraint F , Hayden Michael R , Sharma Sanjib 
Published: January 2025

Abstract
Analysing stellar parameters and abundances from nearly one million Gaia DR3 Radial Velocity Spectrometer (RVS) spectra poses challenges due to the limited spectral coverage (restricted to the infrared Ca ii triplet) and variable signal-to-noise ratios of the data. To address this, we use The Cannon, a data-driven method, to transfer stellar parameters and abundances from the GALAH Data Release 4 (DR4; R ∼ 28 000) catalogue to the lower resolution Gaia DR3 RVS spectra (R ∼ 11,500). Our model, trained on 14,484 common targets, predicts parameters such as Teff, log g, and [Fe/H], along with several other elements across approximately 800 000 Gaia RVS spectra. We utilise stars from open and globular clusters present in the Gaia RVS catalogue to validate our predicted mean [Fe/H] with high precision (∼0.02 −0.10 dex). Additionally, we recover the bimodal distribution of [Ti/Fe] versus [Fe/H], reflecting the high and low α-components of Milky Way disk stars, demonstrating The Cannon’s capability for accurate stellar abundance determination from medium-resolution Gaia RVS spectra. The methodologies and resultant catalogue presented in this work highlight the remarkable potential of the RVS dataset, which by the end of the Gaia mission will comprise spectra of over 200 million stars.
Elevated reactive oxygen species can drive the alternative lengthening of telomeres pathway in ATRX-null cancers
Authors: Goncalves Tomas , Cunniffe Siobhan , Ma Tiffany S , Mattis Natalie , Rose Andrew W , Kent Thomas , Mole David R , Geiller Helene E B , van Bijsterveldt Linda , Humphrey Timothy C , Hammond Ester M , Gibbons Richard J , Clynes David , Rose Anna M 
Published: January 2025

Abstract
The alternative lengthening of telomeres (ALT) pathway is a telomerase-independent mechanism for immortalization in cancer cells and is commonly activated in low-grade and high-grade glioma, as well as osteosarcoma. The ALT pathway can be activated under various conditions and has often been shown to include mutational loss of ATRX. However, this is insufficient in isolation and so other cellular event must also be implicated. It has been shown that excessive accumulation of DNA:RNA hybrid structures (R-loops) and/or formation of DNA–protein crosslinks (DPCs) can be other important driving factors. The underlying cellular events leading to R-loop and DPC formation in ALT cancer cells to date remain unclear. Here, we demonstrate that excessive cellular reactive oxygen species (ROS) is an important causative factor in the evolution of ALT-telomere maintenance in ATRX-deficient glioma. We identified three sources of elevated ROS in ALT-positive gliomas: co-mutation of SETD2, downregulation of DRG2, and hypoxic tumour microenvironment. We demonstrate that elevated ROS leads to accumulation of R-loops and, crucially, resolution of R-loops by the enzyme RNase H1 prevents ALT pathway activity in cells exposed to elevated ROS. Further, we found a possible causal link between the formation of R-loops and the accumulation of DPCs, in particular, formation of TOP1 complexes covalently linked to DNA (Top1cc). We also demonstrate that elevation of ROS can trigger over-activity of the ALT pathway in osteosarcoma and glioma cell lines, resulting in excessive DNA damage and cell death. This work presents important mechanistic insights into the endogenous origin of excessive R-loops and DPCs in ALT-positive cancers, as well as highlighting potential novel therapeutic approaches in these difficult-to-treat cancer types.
Childhood adversity and adolescent epigenetic age acceleration: the role of adolescent sleep health
Authors: DiMarzio Karissa , Rojo-Wissar Darlynn M , Hernandez Valencia Evelyn , Ver Pault Mikayla , Denherder Shane , Lopez Adamari , Lerch Jena , Metrailer Georgette , Merrill Sarah , Highlander April , Parent Justin 
Published: January 2025

Abstract

Study Objectives
We investigated how a dimension of early life adversity (ELA), capturing threat in the home, relates to later epigenetic age acceleration in adolescence through sleep (duration, efficiency, and timing) to empirically test theoretical models suggesting the importance of sleep as a key mechanism linking ELA with poor health outcomes and to expand the limited literature on sleep and epigenetic aging among youth.

Methods
We utilized data from 861 participants in the Future of Families and Child Wellbeing Study who participated in the actigraphy substudy at age 15. Sleep variables used were average total sleep time (TST), sleep efficiency (SE), and sleep onset timing. Home threat was determined at ages 3, 5, and 9 from parent reports on the Child Conflict Tactics Scale, and epigenetic aging was measured through DNA methylation analyses of saliva samples collected at age 15.

Results
Higher levels of childhood home threat exposure were associated with less adolescent TST, lower SE, and later sleep onset timing. Adolescent SE and timing were associated with a faster pace of aging and epigenetic age acceleration. SE and timing mediated the link between childhood home threat exposure and adolescent epigenetic aging.

Conclusions
Epigenetic embedding of childhood threat exposure in the home may occur through adversity-related sleep disturbances in adolescence. Findings warrant greater attention to pediatric sleep health in theoretical models of biological embedding of adversity and point to sleep health improvement as a potential way to prevent adversity-related epigenetic age acceleration. This paper is part of the Genetic and other Molecular Underpinnings of Sleep, Sleep Disorders, and Circadian Rhythms Including Translational Approaches collection.
“He’s a Full-Blown Narcissist:” Tracing an Emerging Cultural Narrative in Action
Authors: Sweet Paige L , Cooper Chiara E 
Published: January 2025

Abstract
The terms “narcissism” and “narcissistic personality disorder” have skyrocketed in popularity over the past several years. What does narcissism discourse accomplish for people who use it? In this paper, we trace the rise of “narcissism” through interviews with victim/survivors of psychological abuse. We find that using the language of narcissism allows people to: 1) reclaim their rationality, or make the case that they are not “the crazy one”; 2) cast the person who harmed them as ontologically “bad”; and 3) justify their decision to leave the relationship. Narcissism discourse therefore helps people organize action. We argue that even as “narcissism” promotes essentializing explanations about abusers and shifts responsibility for intimate abuse onto the victim – who must research narcissism and learn how to avoid narcissists – it also offers a way to make meaning about interpersonal imbalances of power, giving people resources to analyze the politics of intimacy in their lives.
Challenges in managing hump-nosed pit viper envenomation in southern India: a case study
Authors: Philip Anil M , John Jim O , George Lina J , Rajan Sethu 
Published: January 2025

Abstract
Snakebites are a significant health risk in India, with the ‘Big Four’ venomous species often overshadowing other deadly snakes like the hump-nosed pit viper (Hypnale hypnale). Despite its increasing recognition for causing severe envenomation, this species remains under-reported and inadequately addressed in treatment protocols. A woman aged in her sixties was bitten by a suspected hump-nosed pit viper while working in the fields. Despite receiving 26 vials of polyvalent antisnake venom, she developed persistent coagulopathy and anaphylaxis, requiring fresh frozen plasma and antibiotics. Coagulopathy and bleeding were controlled by day 5.This case highlights the need for species-specific antivenoms and improved management protocols for envenomation by Hypnale hypnale.
Redox Status-Selective Imaging of Iron in Vegetative and Pathogenic Fungal Cells Using Fluorescent Dyes Synthesized Via Simple Chemical Reactions
Authors: Aliyeva-Schnorr Lala , Heise Niels V. , Csuk René , Deising Holger B. 
Published: January 2025

Iron plays a prominent role in various biological processes and is an essential element in almost all organisms, including plant-pathogenic fungi. As a transition element, iron occurs in two redox states, Fe2+ and Fe3+, the transition between which generates distinct reactive oxygen species (ROS) such as H2O2, OH− anions, and toxic OH· radicals. Thus, the redox status of Fe determines ROS formation in pathogen attack and plant defense and governs the outcome of pathogenic interactions. Therefore, spatially resolved visualization of Fe2+ and Fe3+ are essential to understand microbial pathogenesis. Here, we report a simple method for synthesis of the redox-state-selective dyes pyrene-tetramethyl piperidinyl oxyl (p-TEMPO) and 4-(4-methylpiperazine-1)-7-nitrobenz-2-oxa-1,3-diazole (MPNBD) for fluorescence microscopy-based imaging of Fe2+ and Fe3+ ions. Using these dyes, the occurrence and spatial distribution of Fe2+ and Fe3+ ions in vegetative and pathogenic hyphae of the hemibiotrophic maize anthracnose fungus Colletotrichum graminicola are shown. [Formula: see text] Copyright © 2025 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Risk Prediction Model of Peristomal Skin Complications Among Patients with Colorectal Cancer and an Ostomy: A Cross-sectional Study in Shanghai, China
Authors: Ma Li-li , Zhang Ya-juan , Zhuang Hui-ren , Jiang Hui 
Published: January 2025

ABSTRACT

OBJECTIVE
To analyze the risk factors for peristomal skin complications (PSCs) in patients with colorectal cancer and an ostomy, construct a prediction model, and verify its effectiveness.

METHODS
In this cross-sectional study, researchers recruited 265 patients with an ostomy at the stoma clinic of a tertiary hospital, from May 2022 to August 2023. Patients were divided into two groups: complications group (n = 81) and no complications group (n = 184). Researchers constructed a logistic regression prediction model using univariate and multivariate analyses. From May 2023 to August 2023, a validation group of 135 patients with an ostomy was selected for external validation of the model.

RESULTS
The incidence of PSCs was 30.57% in the modeling group and 30.37% in the validation group. The predictor variables were preoperative and postoperative health education, tumor therapy within 3 months, preoperative stoma positioning, stoma height, stoma type, and excrement state. The Hosmer-Lemeshow test yielded a P value of .513, the area under the ROC curve was 0.872, the Youden index was 0.561, and the sensitivity and specificity were 0.827 and 0.734. For external validation, the Hosmer-Lemeshow test yielded a P value of .835, the area under the ROC curve was 0.887, and the sensitivity and specificity were 0.905 and 0.720, respectively.

CONCLUSIONS
The prediction model demonstrates good predictive efficacy and can serve as a reference for clinical caregivers in identifying patients at high risk of PSCs.
Evaluation of Oncology/Hematology Nurses’ Proficiency in Assessing Lower-Extremity Skin and Edema in Patients with Cancer: An Observational Study
Authors: Genç Zeliha , Kebapci Ayda , Yildirim Dilek , Can Gulbeyaz , Zeytun Orhan , Kök Elif 
Published: January 2025

ABSTRACT

OBJECTIVE
To assess the competency of oncology/hematology nurses in evaluating the lower extremities of patients with cancer for skin conditions and edema.

METHODS
This prospective and descriptive observational study was conducted with patients in a university hospital’s 48-bed oncology/hematology service. Patients with cancer admitted to the oncology/hematology service were examined independently by three evaluators (two nurse researchers and the patient’s primary nurse) daily. Interrater reliability for assessing patients’ right and left legs was determined using Fleiss κ statistics for categorical variables.

RESULTS
The study revealed a high degree of agreement among the three evaluators in the assessment of skin surface, skin color, and presence of petechiae and rashes on the right and left leg, as well as itching on the left leg. However, only moderate agreement was found for temperature assessment, ecchymoses edema on the left and right leg, and itching on the right leg. The reliability of the two researcher nurses’ assessment of edema on the right and left legs was excellent.

CONCLUSIONS
Although the agreement between the two researcher nurses was near excellent, only moderate agreement was observed among all evaluators in the edema assessment. The result underscores the importance of healthcare providers’ knowledge and enhancing clinical skills through innovative training strategies.
Markers for Pressure Injury Risk in Individuals with Chronic Spinal Cord Injury: A Pilot Study
Authors: Tzen Yi-Ting , Champagne Patricia T. , Wang Jijia , Klakeel Merrine , Tan Wei-Han , Bogie Kath M. , Koh Timothy J. 
Published: January 2025

ABSTRACT

OBJECTIVE
To identify markers associated with pressure injury (PrI) history in individuals with spinal cord injury (SCI) using two approaches: skin blood flow (SBF) response toward localized heating, and serum marker for insulin resistance.

METHODS
For this cross-sectional, observational study of adults with chronic traumatic SCI at T12 and above, researchers recruited two groups of participants: with history of PrI (group 1), and without history of PrI (group 2). The study protocol included obtaining fasting blood samples and measurement of SBF at bilateral heels with localized heating of 42 °C for 30 minutes from all participants. Primary SBF outcomes were initial peak and plateau SBF normalized to baseline SBF. The primary outcome for insulin resistance was Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), calculated from fasting plasma glucose and insulin. Secondary outcomes included demographic and SCI information. Researchers used the Fisher exact test and Wilcoxon-Mann-Whitney test to compare the intergroup difference of categorical and continuous variables, respectively.

RESULTS
Sixteen adults completed this study (group 1, n = 7; group 2, n = 9). In comparison with group 2, group 1 had significantly higher HOMA-IR (3.90 ± 0.71 vs 1.45 ± 0.71), suggesting higher insulin resistance, and longer duration of injury (22.54 ± 7.24 vs 7.98 ± 6.58 years). There were no between-group differences in SBF or other secondary outcomes.

CONCLUSIONS
HOMA-IR is a novel serum index associated with PrI history in persons with chronic SCI. Future longitudinal study is warranted to examine the role of insulin resistance in increasing PrI risk for the SCI population.
Beyond the Case Study: Laboratory Activities to Complement Integumentary Education
Authors: Wendland Deborah M. , Panasci Kathryn , Martinez Hope A. , Mantanona John S. , Powers Melinda G. , Sausman Rachael L. , Gibbs Karen A. 
Published: January 2025

ABSTRACT

OBJECTIVE
To present a full scope of detailed and engaging laboratory activities recommended by physical therapist clinicians and educators from across the US to assist health professions faculty to develop new or improve current integumentary/wound management (IWM) instruction.

METHODS
A three-round Delphi survey was conducted to update IWM curriculum recommendations for entry-level doctor of physical therapy education. First-round participants provided ideas for laboratory activities. Activity responses were discussed, edited for redundancy, and clarified. Missing information (eg, estimated cost and time required) was added to increase usability.

RESULTS
A total of 139 laboratory activities were recommended by survey participants. Many of the suggestions included inexpensive and readily available, do-it-yourself wound models requiring food or other moulage techniques. These simulations are elucidated to facilitate translation of ideas into classroom and community laboratory activities to promote student learning.

CONCLUSIONS
The literature supports that most entry-level healthcare profession programs report limited IWM education, emphasizing the need for effective and efficient use of IWM contact hours. Developing engaging and meaningful hands-on laboratory activities is vital to increasing student knowledge and skill in this area of clinical practice.
Long-term immune related adverse events
Authors: Plaçais Leo , Lambotte Olivier 
Published: January 2025

Purpose of review
Long-term immune related adverse events (irAEs) are an increasing reality in cancer patients treated with immune checkpoint inhibitors (ICIs) but remain under-reported. With the number of ICI treated patients increasing, we here aimed to expose the current evidence on their clinical presentations and diagnosis criteria.

Recent findings
First described in ICI validation trials, long term irAEs were further characterized through retrospective studies, providing clues on their frequency, clinical spectrum, risk factors and impact on patient's quality of life. Recent recommendations proposed consensual definitions to delineate their different subtypes, from delayed/late-onset irAE to chronic active and inactive irAE, paving the way to future prospective studies.

Summary
Knowledge of the different long-term irAE subtypes risk and clinical presentation is required to increase their detection and diagnosis, to better weight therapeutic decisions and to improve cancer patient's care.