Miracle-dz/UniFAR-FTUs huggingface dataset:
Redox Potential Correlates with Changes in Metabolite Concentrations Attributable to Pathways Active in Oxidative Stress Response in Swine Traumatic Shock

ABSTRACT Introduction: Oxidation-reduction (redox) reactions, and the redox potential (RP) that must be maintained for proper cell function, lie at the heart of physiologic processes in critical illness. Imbalance in RP reflects systemic oxidative stress, and whole blood RP measures have been shown to correlate with oxygen debt level over time in swine traumatic shock. We hypothesize that RP measures reflect changing concentrations of metabolites involved in oxidative stress. To test this hypothesis, we compared blood and urine RP with concentrations of multiple metabolites in a swine traumatic shock model to identify meaningful RP-metabolite relationships. Methods: Seven swine were subjected to traumatic shock. Mixed venous (MV) RP, urine RP, and concurrent MV and urine metabolite concentrations were assessed at baseline, max O2 Debt (80 mL/kg), end resuscitation, and 2 h post-resuscitation. RP was measured at collection via open circuit potential using nanoporous gold electrodes with Ag/AgCl reference and a ParstatMC potentiostat. Metabolite concentrations were measured by quantitative 1H-NMR spectroscopy. MV and urine RP were compared with time-matched metabolites across all swine. LASSO regression with leave-one-out cross validation was used to determine meaningful RP/metabolite relationships. Metabolites had to maintain magnitude and direction of coefficients across 6 or more swine to be considered as having a meaningful relationship. KEGG IDs of these metabolites were uploaded into Metscape for pathway identification and evaluation for physiologic function. Results: Meaningful metabolite relationships (and mean coefficients across cross-validation folds) with MV RP included: choline (−6.27), ATP (−4.39), glycine (5.93), ADP (1.84), glucose (15.96), formate (−13.09), pyruvate (6.18), and taurine (−7.18). Relationships with urine RP were: betaine (4.81), urea (4.14), glycine (−2.97), taurine (10.32), 3-hydroxyisobutyrate (−7.67), N-phenylacetylglycine, PAG (−14.52), hippurate (12.89), and formate (−5.89). These meaningful metabolites were found to scavenge extracellular peroxide (pyruvate), inhibit ROS and activate cellular antioxidant defense (taurine), act as indicators of antioxidant mobilization against oxidative stress (glycine + PAG), and reflect renal hydroxyl radical trapping (hippurate), among other activities. Conclusions: Real-time RP measures demonstrate significant relationships with metabolites attributable to metabolic pathways involved in systemic responses to oxidative stress, as well as those involved in these processes. These data support RP measures as a feasible, biologically relevant marker of oxidative stress. As a direct measure of redox state, RP may be a useful biomarker and clinical tool in guiding diagnosis and therapy in states of increased oxidative stress and may offer value as a marker for organ injury in these states as well.
Ageing impairs protective immunity and promotes susceptibility to murine visceral leishmaniasis

Abstract Abstract It is well accepted that the impact of diseases is generally more detrimental in elderly individuals than in younger ones. Changes in the immune system due to ageing can directly affect the ability to respond effectively to infections and may contribute to the higher morbidities and mortalities in the elderly population. Leishmaniasis is a complex of clinically unique diseases caused by obligate intracellular protozoa belonging to genus Leishmania, wherein visceral leishmaniasis (VL) is the most severe form and is fatal if left untreated. In this study, aged mice (72 weeks old) presented increased susceptibility to L. infantum infection compared to younger mice (4–6-week-old), with notable parasitism in both the spleen and liver, as well as exhibiting hepatosplenomegaly. A pronounced inflammatory profile was observed in the aged-infected mice, with excessive production of TNF-α and nitrite, along with diminished IFN-γ production and reduced proliferative capacity of T cells (assessed by expression of the Ki67 marker). Additionally, both CD4+ and CD8+ T cells from the aged-infected mice presented increased expression of the inhibitory receptors PD-1 and KLRG1 that strongly correlated with the parasitism found in the liver and spleen of this group. Overall, the data reported in this study suggests for the first time that ageing may negatively impact the VL outcome and provides a perspective for new therapeutic strategies involving manipulation of immunosenescence features against Leishmania infection.
A morte e o morrer segundo representações de estudantes de enfermagem

Trata-se de um estudo qualitativo, cujo objetivo foi conhecer as representacoes das estudantes do curso de graduacao em Enfermagem da Universidade Federal de Sao Paulo, sobre as questoes que envolvem a morte e o morrer. Os sujeitos foram 40 estudantes do sexo masculino e feminino que frequentavam a 2.a, 3.a e 4.a series do curso de graduacao em Enfermagem. Como metodologia, foram utilizadas as premissas das Representacoes Sociais, usando a tecnica de entrevista com duas questoes norteadoras nao estruturadas. Os resultados deste estudo foram organizados e dispostos em uma arvore maxima, tendo como nucleo central da representacao o evento morte e como representacoes perifericas mais importantes: conceitos, medo da morte e relacionamento aluno-paciente.
The Systemic Immune-Inflammation Index Predicts Impaired Myocardial Perfusion and Short-Term Mortality in ST-Segment Elevation Myocardial Infarction Patients

In this study, we aimed to evaluate the utility of the immune-inflammation index (SII) in estimating the no-reflow phenomenon and short-term cardiovascular prognosis in patients with ST-segment elevation myocardial infarction (STEMI). 723 consecutive patients with STEMI who underwent primary percutaneous coronary intervention (PCI) were enrolled in our study. The receiver-operating characteristics (ROC) curve was used to determine the cut-off value of SII to predict the no-reflow. The multivariate regression analysis analyzed the correlation between no-reflow and SII. The median value of SII was significantly higher in patients with no-reflow in comparison with normal reperfusion [1466 (939–2409) vs 905 (566–1379), p < . 001]. The optimal threshold for SII in predicting the no-reflow phenomenon was 1036, with sensitivity and specificity of 70% and 59%, respectively. The area under the ROC curve (AUC) was 0.71 (95% CI, 0.66–0.75, p < .001). In multivariate analysis, SII ≥ 1036 value showed an independent predictive value for the no-reflow (OR = 0.51, 95% CI: 0.29–0.92, p = .02) and the 30-day cardiovascular mortality (OR = 2.37, 95% CI: 1.34–4.19, p = .003). Our results suggest that higher SII levels are independently associated with the no-reflow phenomenon and 30-day mortality in STEMI patients undergoing primary PCI.
Histopathological Study of Mucormycosis in Post COVID-19 Patients and Factors Affecting it in a Tertiary Care Hospital

Introduction. COVID-19 is an infection caused by severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) which may be associated with a wide range of bacterial and fungal co-infections. Mucormycosis is an opportunistic fungal infection occurring in post COVID-19 patients. Objectives. To study the role of histopathology in mucormycosis and the predisposing factors associated in development of mucormycosis in post COVID-19 patients. Materials and methods. A prospective observational study was conducted in our hospital in the pathology department over a period of 3 months on 200 patients with mucormycosis who were infected with SARS-CoV-2 virus. Results. Out of the 200 patients with mucormycosis studied in post COVID-19 patients, age ranged from 21–80 years, of which 132 were men and 68 were women. Sites involved by mucormycosis were sinuses, orbit, cranium, and cutaneous. Ethmoid sinus was most involved, followed by maxillary sinus. Diabetes was present in 162 patients and hypertension in 92 patients. On histopathological examination, fungal load was severe in 49 patients, angioinvasion was present in 48 patients, perineural invasion was present in 32 patients, and necrosis was present in 121 patients. The number of patients discharged after surgery was 169, whereas 31 died. Conclusion. Histopathological features of mucormycosis like angioinvasion, perineural invasion, severe fungal load, and large areas of necrosis were directly proportional to the mortality rate. Thus, histopathologists can help in assessing prognosis at the time of tissue diagnosis, so that clinicians can optimize treatment accordingly. Diabetes and history of corticosteroid intake for treatment of COVID-19 were the two commonest predisposing factors for development of mucormycosis.
Is Performance-Based Financing A Pathway to Strategic Purchasing in Sub-Saharan Africa? A Synthesis of the Evidence

ABSTRACT Many countries in sub-Saharan Africa have implemented performance-based financing (PBF) to improve health system performance. Much of the debate and analysis relating to PBF has focused on whether PBF “works”—that is, whether it leads to improvements in indicators tied to incentive-based payments. Because PBF schemes embody key elements of strategic health purchasing, this study examines the question of whether and how PBF programs in sub-Saharan Africa influence strategic purchasing more broadly within country health financing arrangements. We searched PubMed, Scopus, EconLit, Cochrane Database of Systematic Reviews, Google Scholar, Google, and the World Health Organization and World Bank’s repositories for studies that focused on the implementation experience or effects of PBF in sub-Saharan African and published in English from 2000 to 2020. We identified 44 papers and used framework analysis to analyze the data and generate key findings. The evidence we reviewed shows that PBF has the potential to raise awareness about strategic purchasing, improve governance and institutional arrangements, and strengthen strategic purchasing functions. However, these effects are minimal in practice because PBF has been introduced as narrow, often pilot, projects that run parallel to and have little integration with the mainstream health financing system. We concluded that PBF has not systematically transformed health purchasing in countries in sub-Saharan Africa but that the experience with PBF can provide valuable lessons for how system-wide strategic purchasing can be implemented most effectively in that region—either in countries that currently have PBF schemes and aim to integrate them into broader purchasing systems, or in countries that are not currently implementing PBF. We also concluded that for countries to pursue more holistic approaches to strategic health purchasing and achieve better health outcomes, they need to implement health financing reforms within or aligned with existing financing systems. Video Abstract Read the transcript Lire la transcription Watch the video on Vimeo © 2022 The Author(s). Published with license by Taylor&Francis Group, LLC
Spatially heterogeneous associations between the built environment and objective health outcomes in Japanese cities

ABSTRACT The built environment is a structural determinant of health. Here we reveal spatially heterogeneous associations of built environment indicators with objective health outcomes (morbidity) by combining a random forest (RF) approach and a multiscale geographically weighted (MGWR) regression method. Using data from six Japanese cities, we found that the ratio of morbidity has obvious spatial agglomerations. The mixed land-use diversity with 1000 m buffer, distance to hospital, proportion of park area with 300 m buffer, and house price with 2000 m buffer, negatively affect health outcomes at all locations. For most locations, high PM2.5 or high floor area ratio with 2000 m buffer are linked to a high ratio of morbidity. Our findings support the use of such data for long-term urban and health planning. We expect our study to be a starting point for further research on spatially heterogeneous associations of the built environment with comprehensive health outcomes.
Perception and intention to use reproductive life plan among female final year undergraduates of the University of Ibadan, Nigeria

Abstract A descriptive cross-sectional study was conducted to assess perception (of) and intention to use reproductive life plan among 500 female final year undergraduates of the University of Ibadan, Nigeria. Only 22% of the respondents were aware of RLP and 63% had good perception of RLP. Most (85.1%) had the intention to plan their pregnancy and 64.5% intended to use RLP as a tool for planning pregnancy. More respondents (85.8%) who were aware of family planning methods had intention to plan their pregnancy compared to those that were not (61.5%; p = .015). Similarly, 65.8% of respondents who were aware of family planning methods had intention to use RLP compared to 23.1% of those who were not (p = .002). Respondents’ awareness of the concept of RLP was poor and majority agreed to use RLP as a tool for planning pregnancy. Awareness of family planning methods was associated with intention to use RLP. Impact Statement What is already known on this subject? Reproductive life plan (RLP) is a tool for setting goals in terms of childbearing. It outlines personal goals about pregnancy which includes having the desired number of children, avoiding unintended pregnancies and avoiding ill health that may threaten reproduction. RLP is a useful tool in preconception and the tool can adequately prepare young unmarried girls for motherhood, thus reducing the high rate of unintended pregnancy which remains a public health and social challenge especially in low income settings including Nigeria. What do the results of this study add? This study has been able to bridge an existing gap in knowledge because no study has been conducted to assess the perception of RLP and intention to use it as a preconception tool in Nigeria. The results provided new information on the perception and intention to use reproductive life plan among female final year undergraduate students of University of Ibadan, Nigeria. What are the implications of these findings for clinical practice and/or further research? The use of RLP serves as health promotion strategy to improve the health of each woman prior to conception by planning their pregnancies, identifying risk factors, providing education and stabilising medical conditions so as to optimise maternal and foetal outcomes.
Care dependency of children in Egypt.

AIMS This study aimed to modify the Care Dependency Scale so that it could be used for children, to apply its Arabic version to Egyptian children to test the reliability and validity of the modified scale and to compare the care dependency of disabled and non-disabled Egyptian children. BACKGROUND A higher dependence of children in their daily tasks undoubtedly places a greater burden on their caregivers. To estimate the extent of the problem of care dependency, data from different countries and proper standard instruments are required. METHOD The Care Dependency Scale was modified for children by Delphi technique. This study assessed the care dependency of non-disabled children compared with children with physical and mental disabilities using the modified version of the Care Dependency Scale for paediatrics. The total sample included 260 Egyptian school-age children (50.8% of whom were disabled and 49.2% were non-disabled). RESULTS Reliability was examined in terms of internal consistency using Cronbach's alpha (0.91). Inter-rater reliability revealed moderate to very good Kappa statistics between 0.57-0.89. Content validity and criterion validity were evaluated. Differences regarding care dependency were found between disabled and non-disabled children. CONCLUSION The psychometric properties of the Care Dependency Scale for paediatrics support its usefulness in measuring the care dependency of children in Egypt. This study provides an Arabic version of the Care Dependency Scale for paediatrics that is easy to administer and may be useful to measure the care dependency in various Arabic countries. RELEVANCE TO CLINICAL PRACTICE The findings raise concerns regarding the extent to which disabled and also non-disabled school-age children are care dependent leading to an increased burden of care on nurses or on caregivers in general. The Care Dependency Scale for Paediatrics can help nurses conduct an appropriate assessment of children's care dependency so that any nursing care can be planned according to the children's needs.
Prevalence of palmar crease patterns and associated factors among students at University of Gondar, Northwest Ethiopia

Palmar creases are unique, permanent, and genetically controlled morphological variables. Recognizing palmar crease types are important for personal identification, criminal investigations, and diagnosis of congenital diseases. This study aimed to reveal the anthropological characteristics as well as contribute to the diagnosing of congenital disease of Ethiopian people. In this study, a cross-sectional study design with a multistage sampling technique were used. Chi-square test, bivariable, and multivariable multinomial logistic regression models were employed. At bivariable analysis variables with a P-value of ≤0.2 were selected for multivariable analysis and at multivariable analysis variables with a P-value of ≤0.05 were considered as statistically significant factors. Most of study participants had normal palmar crease patterns (90.8%), followed by simian crease patterns (5.0%), whereas sydney crease patterns was the least (1.92%). Being male was more likely to have simian crease and sydney crease than normal crease. Right-handed subjects were less likely to have simian crease and suwon crease than normal crease. The simian crease was more common among students whose fathers were from Gurage ethnicity than normal creases. Students who have one point of origin of the primary palmar creases were more likely to have simian crease, sydney crease, and suwon crease than normal crease. In this study, the normal type of palmar crease patterns was the most prevalent. Whereas the simian crease pattern was the commonest type among the variant palmar creases. Palmar crease patterns are affected by sex, ethnicity, handedness, and points of origin of the primary palmar crease.
Experiences of personal protective equipment by Australian healthcare workers during the COVID-19 pandemic, 2020: A cross-sectional study

The aim of this study was to capture Australian frontline healthcare workers’ (HCWs) experiences with personal protective equipment (PPE) during the COVID-19 pandemic in 2020. This was a cross-sectional study using an online survey consisting of five domains: demographics; self-assessment of COVID risk; PPE access; PPE training and confidence; and anxiety. Participants were recruited from community and hospital healthcare settings in Australia, including doctors, nurses, allied health professionals, paramedics, and aged care and support staff. Data analysis was descriptive with free-text responses analysed using qualitative content analysis and multivariable analysis performed for predictors of confidence, bullying, staff furlough and anxiety. The 2258 respondents, comprised 80% women, 49% doctors and 40% nurses, based in hospital (39%) or community (57%) settings. Key findings indicated a lack of PPE training (20%), calls for fit testing, insufficient PPE (25%), reuse or extended use of PPE (47%); confusion about changing guidelines (48%) and workplace bullying over PPE (77%). An absence of in-person workplace PPE training was associated with lower confidence in using PPE (OR 0.21, 95%CI 0.12, 0.37) and a higher likelihood of workplace bullying (OR 1.43; 95% CI 1.00, 2.03) perhaps reflecting deficiencies in workplace culture. Deficiencies in PPE availability, access and training linking to workplace bullying, can have negative physical and psychological impacts on a female dominant workforce critical to business as usual operations and pandemic response.
A mouse infection model and long-term lymphatic endothelium co-culture system to evaluate drugs against adult Brugia malayi

The development of new drugs targeting adult-stage lymphatic filarial nematodes is hindered by the lack of a robust long-term in vitro culture model. Testing potential direct-acting and anti-Wolbachia therapeutic candidates against adult lymphatic filariae in vitro requires their propagation via chronic infection of gerbils. We evaluated Brugia malayi parasite burden data from male Mongolian gerbils compared with two immune-deficient mouse strains highly susceptible to B. malayi: CB.17 Severe-Combined Immmuno-Deficient (SCID) and interleukin-4 receptor alpha, interleukin-5 double knockout (IL-4Rα-/-IL-5-/-) mice. Adult worms generated in IL-4Rα-/-IL-5-/- mice were tested with different feeder cells (human embryonic kidney cells, human adult dermal lymphatic endothelial cells and human THP-1 monocyte differentiated macrophages) and comparative cell-free conditions to optimise and validate a long-term in vitro culture system. Cultured parasites were compared against those isolated from mice using motility scoring, metabolic viability assay (MTT), ex vivo microfilariae release assay and Wolbachia content by qPCR. A selected culture system was validated as a drug screen using reference anti-Wolbachia (doxycycline, ABBV-4083 / flubentylosin) or direct-acting compounds (flubendazole, suramin). BALB/c IL-4Rα-/-IL-5-/- or CB.17 SCID mice were superior to Mongolian gerbils in generating adult worms and supporting in vivo persistence for periods of up to 52 weeks. Adult females retrieved from BALB/c IL-4Rα-/-IL-5-/- mice could be cultured for up to 21 days in the presence of a lymphatic endothelial cell co-culture system with comparable motility, metabolic activity and Wolbachia titres to those maintained in vivo. Drug studies confirmed significant Wolbachia depletions or direct macrofilaricidal activities could be discerned when female B. malayi were cultured for 14 days. We therefore demonstrate a novel methodology to generate adult B. malayi in vivo and accurately evaluate drug efficacy ex vivo which may be adopted for drug screening with the dual benefit of reducing overall animal use and improving anti-filarial drug development.
Do racial and ethnic disparities lead to the undertreatment of pain? Are there solutions?

Purpose of review The current review aims to empower anesthesiologists, specifically pain medicine specialists, to become leaders in ensuring equitable care. Recent findings Disparities in both acute and chronic pain medicine lead to increased morbidity for patients of color. Gaps in care include misdiagnosis or under diagnosis of chronic pain disease states, undertreatment of sickle cell disease and other conditions that are common in minorities, under prescription of opioids, and lack of access to novel opioid sparing treatments. While the causes of these disparities are multifactorial, care team implicit bias and lack of representation are two of the major factors. Solutions are challenging, but the authors suggest an inside out solution. We believe that this practice will have far-reaching downstream effects, including improving diversity in our field and quality of care for our patients. Summary The current article reviews disparities in both acute and chronic pain treatment for underrepresented racial and ethnic minorities in the United States. The authors examine whether implicit bias and lack of representation are a contributing factor for these disparities. Lastly, we will discuss potential solutions.