Discharging patients home from the intensive care unit:A new trend

Discharging patients directly to home from the intensive care unit(ICU)is becoming a new trend.This review examines the feasibility,benefits,challenges,and considerations of directly discharging ICU patients.By analyzing available evidence and healthcare professionals'experiences,the review explores the potential impacts on patient outcomes and healthcare systems.The practice of direct discharge from the ICU presents both opportunities and complexities.While it can potentially reduce costs,enhance patient comfort,and mitigate complications linked to extended hospitalization,it necessitates meticulous patient selection and robust post-discharge support mechanisms.Implementing this strategy successfully mandates the availability of home-based care services and a careful assessment of the patient's readiness for the transition.Through critical evaluation of existing literature,this review underscores the significance of tailored patient selection criteria and comprehensive post-discharge support systems to ensure patient safety and optimal recovery.The insights provided contribute evidence-based recommendations for refining the direct discharge approach,fostering improved patient outcomes,heightened satisfaction,and streamlined healthcare processes.Ultimately,the review seeks to balance patientcentered care and effective resource utilization within ICU discharge strategies.

In vitro microglia models:the era of engineered cell microenvironments

Background:The most widely employed approach by cell biologists to performing in vitro cell culture assays is the one using 2D plastic culture ware systems,which allows reproducibility and ease of use.Moreover,this method is cost-effective.However,in most cases,these flat surfaces lead to the formation of unrealistic 2D cell monolayers,which do not reproduce the complex configuration characteristics of native tissues in terms of dimensionality,rigidity,and topography.For this reason,a new generation of interdisciplinary scientists,working across microengineering and cell biology has started to develop engineered cell microenvironments(Huang et al.,2017)by employing advanced materials and fabrication approaches(Fan et al.,2019)over the last two decades.Depending on the level of resolution of the adopted manufacturing technique,the geometrical features of these structures can reach micrometric or even sub-micrometric dimensions comparable to the ones of cellular somas or cellular filopodia,therefore fostering cell-biomaterial interactions.The developed structures are pivotal for a better investigation of fundamental mechanobiology(Lemma et al.,2019),the optimization of in vitro disease modeling,drug/treatment screening(Gao et al.,2021),and tissue engineering(Mani et al.,2022).

The WNT1^(G177C) mutation specifically affects skeletal integrity in a mouse model of osteogenesis imperfecta type XV

The recent identification of homozygous WNT1 mutations in individuals with osteogenesis imperfecta type XV(OI-XV)has suggested that WNT1 is a key ligand promoting the differentiation and function of bone-forming osteoblasts.Although such aninfluence was supported by subsequent studies,a mouse model of OI-XV remained to be established.Therefore,we introduced a previously identified disease-causing mutation(G177C)into the murine Wnt1 gene.Homozygous Wnt1^(G177C/G177C)mice were viable and did not display defects in brain development,but the majority of 24-week-old Wnt1^(G177C/G177C)mice had skeletal fractures.This increased bone fragility was not fully explained by reduced bone mass but also by impaired bone matrix quality.Importantly,the homozygous presence of the G177C mutation did not interfere with the osteoanabolic influence of either parathyroid hormone injection or activating mutation of LRP5,the latter mimicking the effect of sclerostin neutralization.Finally,transcriptomic analyses revealed that short-term administration of WNT1 to osteogenic cells induced not only the expression of canonical WNT signaling targets but also the expression of genes encoding extracellular matrix modifiers.Taken together,our data demonstrate that regulating bone matrix quality is a primary function of WNT1.They further suggest that individuals with WNT1 mutations should profit from existing osteoanabolic therapies.