bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variation of hair cortisol in two herds of migratory caribou (Rangifer tarandus): implications for health monitoring
Authors: Rakic F , Fernandez-Aguilar X , Pruvot M , Whiteside D P , Mastromonaco G F , Leclerc L M , Jutha N , Kutz S J 
Published: May 2023

Abstract
Migratory caribou (Rangifer tarandus sspp.) is an ecotype of conservation concern that is experiencing increased cumulative stressors associated with rapid climate change and development in Arctic Canada. Increasingly, hair cortisol concentrations (HCCs) are being used to monitor seasonal hypothalamic–pituitary–adrenal axis activity of ungulate populations; yet, the effect of key covariates for caribou (sex, season, sampling source, body location) are largely unknown. The objectives of this research were 4-fold: first, we assessed the impact of body location (neck, rump) sampling sites on HCC; second, we assessed key covariates (sex, sampling method, season) impacting HCCs of caribou; third, we investigated inter-population (Dolphin and Union (DU), Bluenose-East (BNE)) and inter-annual differences in HCC and fourth, we examined the association between HCCs and indices of biting insect activity on the summer range (oestrid index, mosquito index). We examined hair from 407 DU and BNE caribou sampled by harvesters or during capture-collaring operations from 2012 to 2020. Linear mixed-effect models were used to assess the effect of body location on HCC and generalized least squares regression (GLS) models were used to examine the impacts of key covariates, year and herd and indices of biting insect harassment. HCC varied significantly by body location, year, herd and source of samples (harvester vs capture). HCC was higher in samples taken from the neck and in the DU herd compared with the BNE, decreased linearly over time and was higher in captured versus hunted animals (P &lt; 0.05). There was no difference in HCC between sexes, and indices of biting insect harassment in the previous year were not significantly associated with HCC. This study identifies essential covariates impacting the HCC of caribou that must be accounted for in sampling, monitoring and data interpretation.
Sex-based differences in risk factors for incident myocardial infarction and stroke in the UK Biobank
Authors: Remfry Elizabeth , Ardissino Maddalena , McCracken Celeste , Szabo Liliana , Neubauer Stefan , Harvey Nicholas C , Mamas Mamas A , Robson John , Petersen Steffen E , Raisi-Estabragh Zahra 
Published: May 2023

Abstract

Aim
This study examined sex-based differences in associations of vascular risk factors with incident cardiovascular events in the UK Biobank.

Methods
Baseline participant demographic, clinical, laboratory, anthropometric, and imaging characteristics were collected. Multivariable Cox regression was used to estimate independent associations of vascular risk factors with incident myocardial infarction (MI) and ischaemic stroke for men and women. Women-to-men ratios of hazard ratios (RHRs), and related 95% confidence intervals, represent the relative effect-size magnitude by sex.

Results
Among the 363 313 participants (53.5% women), 8470 experienced MI (29.9% women) and 7705 experienced stroke (40.1% women) over 12.66 [11.93, 13.38] years of prospective follow-up. Men had greater risk factor burden and higher arterial stiffness index at baseline. Women had greater age-related decline in aortic distensibility. Older age [RHR: 1.02 (1.01–1.03)], greater deprivation [RHR: 1.02 (1.00–1.03)], hypertension [RHR: 1.14 (1.02–1.27)], and current smoking [RHR: 1.45 (1.27–1.66)] were associated with a greater excess risk of MI in women than men. Low-density lipoprotein cholesterol was associated with excess MI risk in men [RHR: 0.90 (0.84–0.95)] and apolipoprotein A (ApoA) was less protective for MI in women [RHR: 1.65 (1.01–2.71)]. Older age was associated with excess risk of stroke [RHR: 1.01 (1.00–1.02)] and ApoA was less protective for stroke in women [RHR: 2.55 (1.58–4.14)].

Conclusion
Older age, hypertension, and smoking appeared stronger drivers of cardiovascular disease in women, whereas lipid metrics appeared stronger risk determinants for men. These findings highlight the importance of sex-specific preventive strategies and suggest priority targets for intervention in men and women.
Plant-oriented microbiome inoculum modulates age-related maturation of gut-mucosal expression of innate immune and barrier function genes in suckling and weaned piglets
Authors: Vötterl Julia C , Lerch Frederike , Schwartz-Zimmermann Heidi E , Sassu Elena L , Schwarz Lukas , Renzhammer Rene , Bünger Moritz , Koger Simone , Sharma Suchitra , Sener-Aydemir Arife , Quijada Narciso M , Selberherr Evelyne , Berthiller Franz , Metzler-Zebeli Barbara U 
Published: May 2023

Abstract
In the immediate time after weaning, piglets often show symptoms of gut inflammation. The change to a plant-based diet, lack of sow milk, and the resulting novel gut microbiome and metabolite profile in digesta may be causative factors for the observed inflammation. We used the intestinal loop perfusion assay (ILPA) to investigate jejunal and colonic expression of genes for antimicrobial secretion, oxidative stress, barrier function, and inflammatory signaling in suckling and weaned piglets when exposed to “plant-oriented” microbiome (POM) representing postweaning digesta with gut-site specific microbial and metabolite composition. Two serial ILPA were performed in two replicate batches, with 16 piglets preweaning (days 24 to 27) and 16 piglets postweaning (days 38 to 41). Two jejunal and colonic loops were perfused with Krebs–Henseleit buffer (control) or with the respective POM for 2 h. Afterward, RNA was isolated from the loop tissue to determine the relative gene expression. Age-related effects in jejunum included higher expression of genes for antimicrobial secretions and barrier function as well as reduced expression of pattern-recognition receptors post- compared to preweaning (P &lt; 0.05). Age-related effects in the colon comprised downregulation of the expression of pattern-recognition receptors post- compared to preweaning (P &lt; 0.05). Likewise, age reduced the colonic expression of genes encoding for cytokines, antimicrobial secretions, antioxidant enzymes, and tight-junction proteins post- compared to preweaning. Effect of POM in the jejunum comprised an increased the expression of toll-like receptors compared to the control (P &lt; 0.05), demonstrating a specific response to microbial antigens. Similarly, POM administration upregulated the jejunal expression of antioxidant enzymes (P &lt; 0.05). The POM perfusion strongly upregulated the colonic expression of cytokines and altered the expression of barrier function genes, fatty acid receptors and transporters, and antimicrobial secretions (P &lt; 0.05). In conclusion, results indicated that POM signaled via altering the expression of pattern-recognition receptors in the jejunum, which in turn activated the secretory defense and decreased mucosal permeability. In the colon, POM may have acted pro-inflammatory via upregulated cytokine expression. Results are valuable for the formulation of transition feeds for the immediate time after weaning to maintain mucosal immune tolerance towards the novel digesta composition.
Henslow’s Sparrow shows positive response to prescribed fire rotation
Authors: Keating Meghan P , Williams Perry J , Robb Joseph R , Buderman Frances E , Lewis Jason P , Vanosdol Teresa , Harer Ryan 
Published: May 2023

Abstract
We examined Henslow’s Sparrow (Centronyx henslowii) response to prescribed fire at 32 grasslands at Big Oaks National Wildlife Refuge in southeastern Indiana from 1999 to 2009. We burned grasslands in the spring between 1999 and 2007 and monitored Henslow’s Sparrows for up to 4 yr after treatment. We used linear mixed models to analyze our data. Henslow’s Sparrow counts were correlated with time since prescribed fire and grassland size. The estimated changes in mean Henslow’s Sparrow density relative to pre-burn densities were −0.19, 1.15, 0.74, and −0.68 birds ha−1 for 1–4 breeding seasons after a spring burn, respectively. We found that Henslow’s Sparrows preferred larger grasslands both during the first breeding season after prescribed fire, when vegetation was presumed to possess less litter and structural density, and during the fourth breeding season after fire, when vegetation was presumed to be a more ideal composition, but preferred smaller grasslands in the interim. Thus, grassland size shapes the magnitude of Henslow’s Sparrow population response to fire, with populations in smaller grasslands experiencing greater amplitude changes. Larger grasslands might provide more habitat diversity following prescribed fire, attenuating population change. On average, Henslow’s Sparrows responded positively to prescribed fire in a network of grasslands and cumulative net change in densities were highest three breeding seasons after a burn suggesting that maintaining this burn frequency would be beneficial to Henslow’s Sparrow abundance.
Long-term efficacy of penile rehabilitation with low-intensity extracorporeal shock wave therapy for sexual and erectile function recovery following robotic-assisted radical prostatectomy: a single-cohort pilot study
Authors: Kohada Yuki , Babasaki Takashi , Goto Keisuke , Inoue Shogo , Kurimura Yoshimasa , Tasaka Ryo , Takemoto Kenshiro , Miyamoto Shunsuke , Kobatake Kohei , Kitano Hiroyuki , Ikeda Kenichiro , Hieda Keisuke , Hayashi Tetsutaro , Hinata Nobuyuki 
Published: May 2023

Abstract

Background
The long-term efficacy of low-intensity extracorporeal shock wave therapy (LIESWT) for penile rehabilitation after robot-assisted radical prostatectomy (RARP) has not yet been reported.

Aim
To assess the long-term efficacy of LIESWT for penile rehabilitation after RARP by evaluating the postoperative recovery of sexual and erectile functions following RARP.

Methods
Patients who underwent RARP at our institution were categorized into 2 groups: those who received LIESWT and those who underwent penile rehabilitation with a phosphodiesterase type 5 inhibitor (PDE5i). The control group included patients who did not undergo penile rehabilitation. Potency and scores on the Expanded Prostate Cancer Index Composite for sexual function and 5-item International Index of Erectile Function (IIEF-5) were evaluated preoperatively and over 60 months after RARP.

Outcomes
The LIESWT group had significantly higher postoperative sexual function and total IIEF-5 scores and potency than the control group over the long term, and its results were not inferior to those of the PDE5i group.

Results
The LIESWT, PDE5i, and control groups comprised 16, 13, and 139 patients, respectively. As compared with the control group, the LIESWT group had significantly higher sexual function scores at 6, 12, and 60 months after surgery (P &lt; .05) and total IIEF-5 scores at 24 and 60 months (P &lt; .05). The LIESWT group also had a significantly higher potency rate than the control group at 60 months (P &lt; .05). For all time points after surgery, there were no significant differences between the LIESWT and PDE5i groups in terms of sexual function and total IIEF-5 scores and potency.

Clinical Implications
LIESWT may be a new option for penile rehabilitation in patients with erectile dysfunction after RARP.

Strengths and Limitations
This pilot study was performed at a single center and involved relatively few patients, which may have led to selection bias. Furthermore, the selection of this study for penile rehabilitation was not made randomly but by the patient’s choice. Despite these limitations, our results provide evidence in support of LIESWT for penile rehabilitation after RARP because this is the first study to assess the long-term efficacy of LIESWT.

Conclusion
LIESWT can improve sexual and erectile functions in patients with erectile dysfunction after RARP, and its efficacy can be maintained over a long period after surgery.
Phase separation is required for PML nuclear body biogenesis and function
Authors: Wu Wenyu , Tan Yangxia , Yin Hongxin , Jiang Minghao , Jiang Yanling , Ma Xiaodan , Yin Tong , Li Yuwen , Zhang Hao , Cai Xun , Meng Guoyu 
Published: May 2023

AbstractPML nuclear body (NB) malfunction often leads to acute leukemia outbreaks and other severe diseases. PML NB rescue is the molecular basis of arsenic success in acute promyelocytic leukemia (APL) treatment. However, it is unclear how PML NBs are assembled. Here, we observed the presence of liquid–liquid phase separation (LLPS) in NB formation by fluorescence recovery after photobleaching (FRAP) experiment. Compared with the wild‐type (WT) NBs, PML A216V derived from arsenic‐resistant leukemia patients markedly crippled LLPS, but not altered the overall structure and PML RBCC oligomerization. In parallel, we also reported several Leu to Pro mutations that were critical to PML coiled‐coil domain. FRAP characterization and comparison between L268P and A216V revealed markedly different LLPS activities in these mutant NBs. Transmission electron microscopy (TEM) inspections of LLPS‐crippled and uncrippled NBs showed aggregation‐ and ring‐like PML packing in A216V and WT/L268P NBs, respectively. More importantly, the correct LLPS‐driven NB formation was the prerequisite for partner recruitment, post‐translational modifications (PTMs), and PML‐driven cellular regulations, such as ROS stress control, mitochondria production, and PML‐p53‐mediated senescence and apoptosis. Altogether, our results helped to define a critical LLPS step in PML NB biogenesis.
What Are the Barriers and Facilitators for Critical Care Nurse Participation in a Patient Blood Management Program?
Authors: Wabeke Danita , Tolich Deborah 
Published: May 2023

BACKGROUND
Patient blood management (PBM) programs strive to implement best practices, mitigating blood loss through procedures to decrease anemia and the need for transfusion. Critical care nurses may have the greatest impact on blood preservation and anemia prevention for the most critically ill patients. Nurse perceptions of barriers and facilitators in PBM are not fully understood.

OBJECTIVES
The primary aim was to determine critical care nurses' perceptions of barriers and facilitators to participation in PBM. The secondary aim was to understand ways in which they believe the barriers can be addressed.

METHODS
A qualitative descriptive method was used following Colaizzi's process. Critical care nurses (n = 110) were recruited from 10 critical care units in 1 quaternary care hospital to participate in focus groups. Data were analyzed using qualitative methodology and NVivo software. Communication interactions were categorized into codes and themes.

RESULTS
Study findings were gathered under 5 categories: assessing need for blood transfusions, laboratory challenges, availability and appropriateness of supplies, minimizing need for laboratory draws, and communication. Three prominent themes indicated that (a) critical care nurses have a limited awareness of PBM, (b) critical nurses must be empowered to engage in interprofessional collaboration, and (c) addressing barriers is not complex.

CONCLUSION
The data provide insight into the challenges of critical care nurse participation in PBM, driving next step efforts in building on the institution's strengths and improving engagement. It is imperative that the recommendations derived from critical care nurses' experiences be further developed.
Calibration of the PREdiction of DELIRium in ICu Patients (PRE-DELIRIC) Score in a Cohort of Critically Ill Patients
Authors: Gravante Francesco , Giannarelli Diana , Pucci Antonello , Pisani Luigi , Latina Roberto 
Published: May 2023

Background
To predict delirium in intensive care unit (ICU) patients, the Prediction of Delirium in ICU Patients (PRE-DELIRIC) score may be used. This model may help nurses to predict delirium in high-risk ICU patients.

Objectives
The aims of this study were to externally validate the PRE-DELIRIC model and to identify predictive factors and outcomes for ICU delirium.

Method
All patients underwent delirium risk assessment by the PRE-DELIRIC model at admission. We used the Intensive Care Delirium Screening Check List to identify patients with delirium. The receiver operating characteristic curve measured discrimination capacity among patients with or without ICU delirium. Calibration ability was determined by slope and intercept.

Results
The prevalence of ICU delirium was 55.8%. Discrimination capacity (Intensive Care Delirium Screening Check List score ≥4) expressed by the area under the receiver operating characteristic curve was 0.81 (95% confidence interval, 0.75-0.88), whereas sensitivity was 91.3% and specificity was 64.4%. The best cut-off was 27%, obtained by the max Youden index. Calibration of the model was adequate, with a slope of 1.03 and intercept of 8.14. The onset of ICU delirium was associated with an increase in ICU length of stay (P < .0001), higher ICU mortality (P = .008), increased duration of mechanical ventilation (P < .0001), and more prolonged respiratory weaning (P < .0001) compared with patients without delirium.

Discussion
The PRE-DELIRIC score is a sensitive measure that may be useful in early detection of patients at high risk for developing delirium. The baseline PRE-DELIRIC score could be useful to trigger use of standardized protocols, including nonpharmacologic interventions.
Longitudinal Assessment of Mobility and Self-care Among Critically Ill Older Adults. An Age-Friendly Health Systems Initiative Quality Improvement Study.
Authors: Rittel Carleigh M. , Borg Bryan A. , Hanessian Anelis V. , Kuhar Angela , Fain Mindy J. , Bime Christian 
Published: May 2023

Background
Early mobility in the intensive care unit (ICU) is vital to maintaining an older adult patient's performance of activities of daily living, functional mobility, and overall quality of life. Prior studies have shown reduced length of inpatient stay and onset of delirium in patients with early mobilization. Despite these benefits, many ICU patients are often labeled as too sick to participate in therapy and frequently do not receive physical (PT) or occupational therapy (OT) consults until they are considered floor status. This delay in therapy can negatively affect a patient's capacity to participate in his/her self-care, add to the burden on caregivers, and limit disposition options.

Objectives
Our goals were to perform a longitudinal assessment of mobility and self-care among older patients through their medical ICU (MICU) stays and to quantify visits by therapy services to identify areas for improvement in achieving early intervention in this at-risk population.

Method
This was a retrospective quality improvement analysis of a cohort of admissions to the MICU at a large tertiary academic medical center between November 2018 and May 2019. Admission information, PT and OT consult information, Perme Intensive Care Unit Mobility Score, and Modified Barthel Index scores were entered into a quality improvement registry. Inclusion criteria consisted of age older than 65 years and at least 2 distinct visits by PT and/or OT for evaluation. Patients without consults and patients with weekend-only MICU stays were not assessed.

Results
There were 302 MICU patients 65 years or older admitted during the study period. Forty-four percent (132) of these patients received PT/OT consults, and among these, 32% (42) had at least 2 visits to allow comparison of objective scores. Seventy-five percent of patients had improved Perme scores (median, 9.4%; interquartile range, 2.3%-15.6%), and 58% of patients had improved Modified Barthel Index scores (median, 3%; interquartile range, −2% to 13.5%). However, 17% of potential therapy days were missed because of inadequate staffing/time, and 14% were missed because of being sedated or unable to participate.

Conclusions
In our cohort of patients older than 65 years, receipt of therapy in the MICU led to modest improvements in score-assessed mobility and self-care before transfer to floor. Staffing, time constraints, and patient sedation or encephalopathy appeared to interfere most with further potential benefits. In the next phase, we plan to implement strategies to increase PT/OT availability in the MICU and implement a protocol to increase identification and referral of candidates for whom early therapy can prevent loss of mobility and ability to perform self-care.
Multidisciplinary teams, efficient communication, procedure services, and telehealth improve cirrhosis care: A qualitative study
Authors: Serper Marina , Agha Aneeza , Garren Patrik A. , Taddei Tamar H. , Kaplan David E. , Groeneveld Peter W. , Werner Rachel M. , Shea Judy A. 
Published: May 2023

Background:
Cirrhosis care and outcomes are improved with access to subspecialty gastroenterology and hepatology care. In qualitative interviews, we investigated clinicians’ perceptions of factors that optimize or impede cirrhosis care.

Methods:
We conducted 24 telephone interviews with subspecialty clinicians at 7 Veterans Affairs medical centers with high- and low-complexity services. Purposive sampling stratified Veterans Affairs medical centers on timely post-hospitalization follow-up, a quality measure. We asked open-ended questions about facilitators and barriers of care coordination, access to appointments, procedures, transplantation, management of complications, keeping up to date with medical knowledge, and telehealth use.

Results:
Key themes that facilitated care were structural: multidisciplinary teams, clinical dashboards, mechanisms for appointment tracking and reminders, and local or virtual access to transplant and liver cancer specialists through the “specialty care access network extension for community health care outcomes” program. Coordination and efficient communication between transplant and non-transplant specialists and between transplant and primary care facilitated timely care. Same-day access to laboratory, procedural, and clinical services is an indicator of high-quality care. Barriers included lack of on-site procedural services, clinician turnover, patient social needs related to transportation, costs, and patient forgetfulness due to HE. Telehealth enabled lower complexity sites to obtain recommendations for complex patient cases. Barriers to telehealth included lack of credit (eg, VA billing equivalent), inadequate staff, lack of audiovisual technology support, and patient and staff discomfort with technology. Telehealth was optimal for return visits, cases where physical examination was nonessential, and where distance and transportation precluded in-person care. Rapid telehealth uptake during the COVID-19 pandemic was a positive disruptor and facilitated use.

Conclusions:
We identify multi-level factors related to structure, staffing, technology, and care organization to optimize cirrhosis care delivery.