bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing residents’ neonatal resuscitation competency through team-based simulation training: an intervention educational study
Authors: Farhadi Roya , Azandehi Bita Khalili , Amuei Fattane , Ahmadi Mozhgan , Zazoly Atefeh Zabihi , Ghorbani Ali Asghar
Published: October 2023

Background

Neonatal resuscitation training in a simulated delivery room environment is a new paradigm in pediatric medical education. The purpose of this research is to highlight team-based simulation as an effective method of teaching neonatal resuscitation to senior pediatric residents.

Methods

In an intervention educational study, we evaluated the impact of team-based simulation training in the development of neonatal resuscitation. A team consisting of a three-person group of senior pediatric residents performed neonatal resuscitation on a low-fidelity newborn simulator based on the stated scenario. Video-based structured debriefing was performed and followed by the second cycle of scenario and debriefing to evaluate the feasibility of conducting team-based simulation training in a lesser-resourced environment. Evaluation criteria included megacode scores which is a simulation performance checklist, pre-and post-test scores to evaluate residents’ knowledge and confidence, the survey checklist as a previously developed questionnaire assessing residents’ satisfaction, and debriefing from live and videotaped performances. Four months after the end of the training course, we measured the behavioral changes of the residents by conducting an OSCE test to evaluate post-training knowledge retention. Mean ± SD was calculated for megacode, satisfaction (survey checklist), and OSCE scores. Pre- and post-program gains were statistically compared. The first three levels of Kirkpatrick’s training effectiveness model were used to evaluate the progress of the program.

Results

Twenty-one senior residents participated in the team-based simulation. The mean ± SD of the megacode score was 35.6 ± 2.2. The mean ± SD of the overall satisfaction score for the evaluation of the first level of the Kirkpatrick model was 96.3 ± 3.7. For the evaluation of the second level of the Kirkpatrick model, the pre-posttest gain in overall confidence score had a statistically significant difference (P = 0.001). All residents obtained a passing grade in OSCE as an evaluation of the third level.

Conclusions

Team-based simulation training in neonatal resuscitation improves the knowledge, skills, and performance of pediatric residents and has a positive effect on their self-confidence and leadership skills. There is still a need to investigate the transfer of learning and abilities to real-life practice, and further research on cost-effectiveness and impact on patient outcomes is warranted.
Exploring defensive medicine: examples, underlying and contextual factors, and potential strategies - a qualitative study
Authors: Eftekhari Mohammad Hossein , Parsapoor Alireza , Ahmadi Ayat , Yavari Neda , Larijani Bagher , Gooshki Ehsan Shamsi
Published: October 2023

Background

Medical errors, unsatisfactory outcomes, or treatment complications often prompt patient complaints about healthcare providers. In response, physicians may adopt defensive practices to mitigate objections, avoid complaints, and navigate lengthy trial processes or other potential threats. However, such defensive medicine (DM) practices can carry risks, including potential harm to patients and the imposition of unnecessary costs on both patients and the healthcare system. Moreover, these practices may run counter to accepted ethical standards in medicine.

Methods

This qualitative study involved conducting semi-structured interviews with 43 physicians, among whom 38 were faculty members at medical universities, 42 had administrative experience at various levels of the health system, and 23 had previously served as health system policymakers. On average, the participants had approximately 23.5 years of clinical experience. The selection of participants was based on purposive sampling. Data collection through interviews continued until data saturation was achieved.

Results

Based on the findings, DM manifests in both positive and negative forms, illustrated by instances like ordering unnecessary lab tests, imaging, or consultations, reluctance to admit high-risk patients, and avoiding high-risk procedures. The study participants identified a range of underlying and contextual factors contributing to DM, encompassing organizational-managerial, social, personal, and factors inherent to the nature of defensive medical practices. The results also highlight proposed strategies to address and prevent DM, which can be grouped into organizational-managerial, social, and those focused on modifying the medical complaints management system.

Conclusion

DM is a multifaceted and significant phenomenon that necessitates a comprehensive understanding of its various aspects, including interconnected and complex structures and underlying and contextual factors. While the results of this study offer a solid foundation for informing policy decisions within the healthcare system and include some explanatory policy suggestions, we encourage policymakers to complement the findings of this study with other available evidence to address any potential limitations and to gain a more comprehensive understanding of the policymaking process related to DM.
Improved production of β-carotene in light-powered Escherichia coli by co-expression of Gloeobacter rhodopsin expression
Authors: Lee Chao-Yu , Chen Kai-Wen , Chiang Chih-Lu , Kao Hsuan-Yu , Yu Hao-Cheng , Lee Hsiao-Ching , Chen Wen-Liang
Published: October 2023

Background

Providing sufficient and usable energy for the cell factory has long been a heated issue in biosynthesis as solar energy has never been rooted out from the strategy for improvement, and turning Escherichia coli (E. coli) into a phototrophic host has multiple captivating qualities for biosynthesis. In this study, β-carotene was a stable compound for production in E. coli with the expression of four enzymes (CrtE, CrtB, CrtI, CrtY) for production due to its light-harvesting feature as an antenna pigment and as an antioxidant and important precursor for human health. The expression of Gloeobacter rhodopsin (GR) in microbial organisms was proved to have potential for application.

Results

The expression of fusion protein, GR-GFP, in E. coli showed visible GFP signal under fluorescent microscopy, and its in vivo proton pumping activity signal can be detected in induced photocurrent by electrodes on the chip under intervals of illumination. To assess the phototrophic synthesis ability of the host strain compared to wild-type and vector control strain in chemostat batch with illumination, the expression of red fluorescent protein (RFP) as a target protein showed its yield improvement in protein assay and also reflected its early dominance in RFP fluorescence signal during the incubation, whereas the synthesis of β-carotene also showed yield increase by 1.36-fold and 2.32-fold compared with its wildtype and vector control strain. To investigate the effect of GR-GFP on E. coli, the growth of the host showed early rise into the exponential phase compared to the vector control strain and glucose turnover rate was elevated in increased glucose intake rate and upregulation of ATP-related genes in glycolysis (PtsG, Pgk, Pyk).

Conclusion

We reported the first-time potential application of GR in the form of fusion protein GR-GFP. Expression of GR-GFP in E. coli improved the production of β-carotene and RFP. Our work provides a strain of E. coli harboring phototrophic metabolism, thus paving path to a more sustainable and scalable production of biosynthesis.
The perception and interpretation of malaria among Chinese construction workers in sub-Saharan Africa: a qualitative study
Authors: Zou Li , Ma Haohao , Sharifi Mohammad Shahir , Deng Wenyu , Kan Xiaoyu , Luo Junfei , Bai Yin , Ouyang Yunling , Zhou Wenjuan
Published: October 2023

Background

Cooperation between China and Africa is deepening, and business, trade, and people-to-people exchanges are growing closer together, especially in the infrastructure construction field. At the same time, malaria has become a serious health concern for Chinese construction workers in Africa, who are at increased risk of infection and complications due to lack of immunity and exposure to high-transmission environments. One of the biggest challenges in fighting malaria is their lack of knowledge and misinterpretations about the disease, which can impact their need for interventions, adherence to treatments, and health services. This study aims to determine the perception and interpretation of malaria among Chinese construction workers in sub-Saharan Africa.

Methods

Semi-structured interviews were conducted with 20 Chinese construction workers in sub-Saharan Africa. Some early respondents initially made contact through two Chinese construction companies in Africa, while the rest of the participants were engaged via a snowball method by the early participants. NVivo10, a qualitative research data management software and a thematic approach, was used to analyze the data and create themes. In order to achieve the general study goals, an inductive content analysis was applied.

Results

The study classified participants' perceptions and interpretations of malaria into four categories: flu-like malaria, the rumors of malaria, the hard-to-explain confusion about malaria, and the special interpretation of malaria.

Conclusion

Malaria poses major health issues to Chinese construction workers in sub-Saharan Africa who lack immunity and live in an environment of high transmission. Their dearth of awareness and misunderstanding of malaria impacts their prevention and treatment behaviors and health outcomes. This study adopts qualitative methods to examine their perceptions and interpretations of malaria, which can serve as a source for future health management strategies.
Abnormal adipogenic signaling in the bone marrow mesenchymal stem cells contributes to supportive microenvironment for leukemia development
Authors: Sabbah Rawan , Saadi Sahar , Shahar-Gabay Tal , Gerassy Shiran , Yehudai-Resheff Shlomit , Zuckerman Tsila
Published: October 2023

Background

Acute myeloid leukemia (AML) is an aggressive hematological malignancy, associated with unfavorable patient outcome, primarily due to disease relapse. Mesenchymal stem cells (MSCs) residing in the bone marrow (BM) niche are the source of mesenchyma-derived subpopulations, including adipocytes, and osteocytes, that are critical for normal hematopoiesis. This study aimed to characterize BM-derived adipocyte/osteocyte fractions and their crosstalk with AML cells as a potential mechanism underlying leukemogenesis.

Methods

BM cell subpopulations derived from primary AML patients were evaluated using humanized ex-vivo and in-vivo models, established for this study. The models comprised AML blasts, normal hematopoietic stem and progenitor cells and mesenchymal stromal subpopulations. ELISA, FACS analysis, colony forming unit assay, whole exome sequencing and real-time qPCR were employed to assess the differentiation capacity, genetic status, gene expression and function of these cell fractions. To explore communication pathways between AML cells and BM subpopulations, levels of signaling mediators, including cytokines and chemokines, were measured using the ProcartaPlex multiplex immunoassay.

Results

The study revealed deficiencies in adipogenic/osteogenic differentiation of BM-MSCs derived from AML patients, with adipocytes directly promoting survival and clonogenicity of AML cells in-vitro. In whole exome sequencing of BM-MSC/stromal cells, the AHNAK2 gene, associated with the stimulation of adipocyte differentiation, was found to be mutated and significantly under-expressed, implying its abnormal function in AML. The evaluation of communication pathways between AML cells and BM subpopulations demonstrated pronounced alterations in the crosstalk between these cell fractions. This was reflected by significantly elevated levels of signaling mediators cytokines/chemokines, in AML-induced adipocytes/osteocytes compared to non-induced MSCs, indicating abnormal hematopoiesis. Furthermore, in-vivo experiments using a fully humanized 3D scaffold model, showed that AML-induced adipocytes were the dominant component of the tumor microenvironment, providing preferential support to leukemia cell survival and proliferation.

Conclusions

This study has disclosed direct contribution of impaired functional, genetic and molecular properties of AML patient-derived adipocytes to effective protection of AML blasts from apoptosis and to stimulation of their growth in vitro and in vivo, which overall leads to disease propagation and relapse. The detected AHNAK2 gene mutations in AML-MSCs point to their involvement in the mechanism underlying abnormal adipogenesis.
Beyond the G protein α subunit: investigating the functional impact of other components of the Gαi3 heterotrimers
Authors: Rysiewicz Beata , Błasiak Ewa , Mystek Paweł , Dziedzicka-Wasylewska Marta , Polit Agnieszka
Published: October 2023

Background

Specific interactions between G protein-coupled receptors (GPCRs) and G proteins play a key role in mediating signaling events. While there is little doubt regarding receptor preference for Gα subunits, the preferences for specific Gβ and Gγ subunits and the effects of different Gβγ dimer compositions on GPCR signaling are poorly understood. In this study, we aimed to investigate the subcellular localization and functional response of Gαi3-based heterotrimers with different combinations of Gβ and Gγ subunits.

Methods

Live-cell imaging microscopy and colocalization analysis were used to investigate the subcellular localization of Gαi3 in combination with Gβ1 or Gβ2 heterotrimers, along with representative Gγ subunits. Furthermore, fluorescence lifetime imaging microscopy (FLIM-FRET) was used to investigate the nanoscale distribution of Gαi3-based heterotrimers in the plasma membrane, specifically with the dopamine D2 receptor (D2R). In addition, the functional response of the system was assessed by monitoring intracellular cAMP levels and conducting bioinformatics analysis to further characterize the heterotrimer complexes.

Results

Our results show that Gαi3 heterotrimers mainly localize to the plasma membrane, although the degree of colocalization is influenced by the accompanying Gβ and Gγ subunits. Heterotrimers containing Gβ2 showed slightly lower membrane localization compared to those containing Gβ1, but certain combinations, such as Gαi3β2γ8 and Gαi3β2γ10, deviated from this trend. Examination of the spatial arrangement of Gαi3 in relation to D2R and of changes in intracellular cAMP level showed that the strongest functional response is observed for those trimers for which the distance between the receptor and the Gα subunit is smallest, i.e. complexes containing Gβ1 and Gγ8 or Gγ10 subunit. Deprivation of Gαi3 lipid modifications resulted in a significant decrease in the amount of protein present in the cell membrane, but did not always affect intracellular cAMP levels.

Conclusion

Our studies show that the composition of G protein heterotrimers has a significant impact on the strength and specificity of GPCR-mediated signaling. Different heterotrimers may exhibit different conformations, which further affects the interactions of heterotrimers and GPCRs, as well as their interactions with membrane lipids. This study contributes to the understanding of the complex signaling mechanisms underlying GPCR-G-protein interactions and highlights the importance of the diversity of Gβ and Gγ subunits in G-protein signaling pathways.
CD13 facilitates immune cell migration and aggravates acute injury but promotes chronic post-stroke recovery
Authors: Nguyen Justin N. , Mohan Eric C. , Pandya Gargee , Ali Uzma , Tan Chunfeng , Kofler Julia K. , Shapiro Linda , Marrelli Sean P. , Chauhan Anjali
Published: October 2023

Introduction

Acute stroke leads to the activation of myeloid cells. These cells express adhesion molecules and transmigrate to the brain, thereby aggravating injury. Chronically after stroke, repair processes, including angiogenesis, are activated and enhance post-stroke recovery. Activated myeloid cells express CD13, which facilitates their migration into the site of injury. However, angiogenic blood vessels which play a role in recovery also express CD13. Overall, the specific contribution of CD13 to acute and chronic stroke outcomes is unknown.

Methods

CD13 expression was estimated in both mice and humans after the ischemic stroke. Young (8–12 weeks) male wild-type and global CD13 knockout (KO) mice were used for this study. Mice underwent 60 min of middle cerebral artery occlusion (MCAO) followed by reperfusion. For acute studies, the mice were euthanized at either 24- or 72 h post-stroke. For chronic studies, the Y-maze, Barnes maze, and the open field were performed on day 7 and day 28 post-stroke. Mice were euthanized at day 30 post-stroke and the brains were collected for assessment of inflammation, white matter injury, tissue loss, and angiogenesis. Flow cytometry was performed on days 3 and 7 post-stroke to quantify infiltrated monocytes and neutrophils and CXCL12/CXCR4 signaling.

Results

Brain CD13 expression and infiltrated CD13+ monocytes and neutrophils increased acutely after the stroke. The brain CD13+lectin+ blood vessels increased on day 15 after the stroke. Similarly, an increase in the percentage area CD13 was observed in human stroke patients at the subacute time after stroke. Deletion of CD13 resulted in reduced infarct volume and improved neurological recovery after acute stroke. However, CD13KO mice had significantly worse memory deficits, amplified gliosis, and white matter damage compared to wild-type animals at chronic time points. CD13-deficient mice had an increased percentage of CXCL12+cells but a reduced percentage of CXCR4+cells and decreased angiogenesis at day 30 post-stroke.

Conclusions

CD13 is involved in the trans-migration of monocytes and neutrophils after stroke, and acutely, led to decreased infarct size and improved behavioral outcomes. However, loss of CD13 led to reductions in post-stroke angiogenesis by reducing CXCL12/CXCR4 signaling.
First detection of porcine circovirus 4 (PCV-4) in Europe
Authors: Holgado-Martín Rocío , Arnal José Luís , Sibila Marina , Franzo Giovanni , Martín-Jurado Desireé , Risco David , Segalés Joaquim , Gómez Luís
Published: October 2023

Porcine circovirus 4 (PCV-4) is a novel virus recently discovered (2019) in domestic pigs from China, although several studies have proven its circulation since 2008. Later, PCV-4 was also detected in wild boar populations from China and domestic pigs from South Korea and Thailand. Currently, Asia is so far the only continent where this novel virus has been reported; few studies carried out in South America and Europe failed in the attempt to detect it. The objective of this Comment is to communicate the first detection of PCV-4 in Europe, specifically in wild boar and domestic pigs from Mid-South-Western Spain. A retrospective study was carried out on wild boar and domestic pigs, both extensively (Iberian breed) and intensively raised, from Spain and Italy, sampled between 1998 and 2022. PCV-4 genome detection was attempted using different conventional or quantitative real time PCR (qPCR) protocols and some positive results were confirmed through Sanger sequencing. A total of 57 out of 166 (34.3%) Spanish wild boar and 9 out of 223 (4%) Iberian pigs (both geographically located in the Mid-South-Western Spain) were qPCR positive, while the rest of tested animals from North-Eastern Spain and Italy were negative. Partial sequences of Rep or Cap genes of selected samples confirmed the presence of PCV-4. The relatively high prevalence in wild boar and the low one in Iberian pigs from the same areas suggests intra- and interspecific transmission, being the wild boar a potential viral reservoir. The epidemiological and clinical importance of these findings are currently unknown, but guarantees further research on this novel virus.
Dynamics of depressive states among university students in Japan during the COVID-19 pandemic: an interrupted time series analysis
Authors: Shiraishi N. , Sakata M. , Toyomoto R. , Yoshida K. , Luo Y. , Nakagami Y. , Tajika A. , Watanabe T. , Sahker E. , Uwatoko T. , Shimamoto T. , Iwami T. , Furukawa T. A.
Published: October 2023

Background

The coronavirus disease 2019 (COVID-19) pandemic was reported to have increased depression among university students which was associated with impairments in their campus lives. This study examined changes in depressive states among Japanese university students during the COVID-19 pandemic.

Methods

A secondary data analysis from a factorial randomized controlled trial involving smartphone-based cognitive-behavioral therapy was performed. Six cohorts (N = 1626) underwent an 8-week intervention during the spring or autumn of 2019–2021, with a 9-month follow-up. We evaluated participants’ depressive states weekly using the Patient Health Questionnaire-9 (PHQ-9) during the intervention, with monthly evaluations thereafter. The follow-up periods included Japan’s four states of emergency (SOEs) to control COVID-19. Hypothesizing that SOEs caused a sudden worsening of depressive states, Study 1 compared the cohorts’ PHQ-9 scores, and Study 2 employed time series analysis with a mixed-effects model to estimate identified changes in PHQ-9 scores.

Results

Although no changes in depressive states were observed in relation to the SOEs, Study 1 identified sudden increases in PHQ-9 scores at the 28-week evaluation point, which corresponded to the beginning of the new academic year for the three autumn cohorts. In contrast, the three spring cohorts did not exhibit similar changes. Study 2 showed that, for all three autumn cohorts (n = 522), the 0.60-point change was significant (95% CI 0.42–0.78; p < .001) at 28 weeks; that is, when their timeline was interrupted.

Conclusions

While the results do not indicate any notable impact of the SOEs, they highlight the influence of the new academic year on university students’ mental health during COVID-19.

Trial registration UMIN, CTR-000031307. Registered on February 14, 2018.
A framework of NGO inside and outside strategies in the commercial determinants of health: findings from a narrative review
Authors: Townsend Belinda , Johnson Timothy D. , Ralston Rob , Cullerton Katherine , Martin Jane , Collin Jeff , Baum Fran , Arnanz Liz , Holmes Rodney , Friel Sharon
Published: October 2023

Background

Public health scholarship has uncovered a wide range of strategies used by industry actors to promote their products and influence government regulation. Less is known about the strategies used by non-government organisations to attempt to influence commercial practices. This narrative review applies a political science typology to identify a suite of ‘inside’ and ‘outside’ strategies used by NGOs to attempt to influence the commercial determinants of health.

Methods

We conducted a systematic search in Web of Science, ProQuest and Scopus. Articles were eligible for inclusion if they comprised an empirical study, explicitly sought to examine ‘NGOs’, were in English, and identified at least one NGO strategy aimed at commercial and/or government policy and practice.

Results

One hundred forty-four studies met the inclusion criteria. Eight industry sectors were identified: extractive, tobacco, food, alcohol, pharmaceuticals, weapons, textiles and asbestos, and a small number of general studies. We identified 18 types of NGO strategies, categorised according to the target (i.e. commercial actor or government actor) and type of interaction with the target (i.e. inside or outside). Of these, five NGO ‘inside’ strategies targeted commercial actors directly: 1) participation in partnerships and multistakeholder initiatives; 2) private meetings and roundtables; 3) engaging with company AGMs and shareholders; 4) collaborations other than partnerships; and 5) litigation. ‘Outside’ strategies targeting commercial actors through the mobilisation of public opinion included 1) monitoring and reporting; 2) protests at industry sites; 3) boycotts; 4) directly engaging the public; and 5) creative use of alternative spaces. Four NGO ‘inside’ strategies directly targeting government actors included: 1) lobbying; 2) drafting legislation, policies and standards; 3) providing technical support and training; and 4) litigation. NGO ‘outside’ strategies targeting government included 1) protests and public campaigns; 2) monitoring and reporting; 3) forum shifting; and 4) proposing and initiating alternative solutions. We identified three types of NGO impact: substantive, procedural, and normative.

Conclusion

The analysis presents a matrix of NGO strategies used to target commercial and government actors across a range of industry sectors. This framework can be used to guide examination of which NGO strategies are effective and appropriate, and which conditions enable NGO influence.
Surgical management of ostomy complications: a MISSTO–WSES mapping review
Authors: Parini Dario , Bondurri Andrea , Ferrara Francesco , Rizzo Gianluca , Pata Francesco , Veltri Marco , Forni Cristiana , Coccolini Federico , Biffl Walt L. , Sartelli Massimo , Kluger Yoram , Ansaloni Luca , Moore Ernest , Catena Fausto , Danelli Piergiorgio ,   Multidisciplinary Italian Study group for STOmas (MISSTO)
Published: October 2023

Background

The creation of an ileostomy or colostomy is a common surgical event, both in elective and in emergency context. The main aim of stoma creation is to prevent postoperative complications, such as the anastomotic leak. However, stoma-related complications can also occur and their morbidity is not negligible, with a rate from 20 to 70%. Most stomal complications are managed conservatively, but, when this approach is not resolutive, surgical treatment becomes necessary. The aim of this mapping review is to get a comprehensive overview on the incidence, the risk factors, and the management of the main early and late ostomy complications: stoma necrosis, mucocutaneous separation, stoma retraction, stoma prolapse, parastomal hernia, stoma stenosis, and stoma bleeding.

Material and methods

A complete literature research in principal databases (PUBMED, EMBASE, SCOPUS and COCHRANE) was performed by Multidisciplinary Italian Study group for STOmas (MISSTO) for each topic, with no language restriction and limited to the years 2011–2021. An international expert panel, from MISSTO and World Society of Emergency Surgery (WSES), subsequently reviewed the different issues, endorsed the project, and approved the final manuscript.

Conclusion

Stoma-related complications are common and require a step-up management, from conservative stoma care to surgical stoma revision. A study of literature evidence in clinical practice for stoma creation and an improved management of stoma-related complications could significantly increase the quality of life of patients with ostomy. Solid evidence from the literature about the correct management is lacking, and an international consensus is needed to draw up new guidelines on this subject.
N1 lymph node detection in lymph node harvesting in non-small cell lung cancer: Formaldehyde exposure is a drawback?
Authors: Citak Sevinc , Dogruyol Talha , Bayram Serkan , Vayvada Mustafa , Metin Serda Kanbur , Baysungur Volkan
Published: October 2023

Objective

This study aimed to evaluate the effect of lymph node dissection method on staging results, diagnosis of tumor metastasis in single or multiple N1 lymph nodes and survival rates in patients with non-small cell lung cancer (NSCLC).

Methods

Patients with NSCLC who underwent anatomic resection between September 2014 and October 2019 were examined prospectively. All patients with similar clinico-demographic characteristics were randomly assigned to either the surgical group (n = 83) or the pathology group (n = 87). Lymph node dissection was performed by the surgeon in the surgical group and by the pathologists after formaldehyde exposure in the pathology group. Data were analyzed according to formaldehyde exposure, N1 positivity, and number of N1 positive lymph nodes.

Results

There were no significant differences in N1 lymph node positivity between the two groups (p = 0.482). On average 9.08 lymph node sampling was performed in the surgical group and 2.39 in the pathology group (p = 0.0001). Multiple lymph node involvement was significantly higher in the surgical group (P = 0.0001) than in the pathology group.

Conclusion

It is easier to detect lymph node involvement without introducing formaldehyde into the sample. We recommend that N1 lymph node dissection be performed on fresh specimens to detect more lymph node involvement.
Anesthetic management of thoracotomy for massive intrathoracic solitary fibrous tumor of the pleura: a case report
Authors: Shen Wang , Li Yan , Liu Feng , Liu Ning , Wang Xiangrui , Ji Zhonghua
Published: October 2023

Backgrounds

Solitary fibrous tumor of the pleura (SFTP) is a rare thoracic tumor and usually asymptomatic. Massive SFTP may affect adjacent organs and tissues including pulmonary vasculature, bronchus and heart. A thoracotomy for massive SFTP is necessary in severe case. Therefore, it is important for anesthesiologists to understand the condition of patients with massive SFTP and develop an appropriate anesthetic management strategy.

Case summary

A 76-year-old woman with massive SFTP presented to our clinical center and was evaluated as requiring thoracotomy. She received multidisciplinary cooperation treatment from the radiology, cardiac, thoracic surgery and anesthetic teams. The perioperative management of anesthesiologists played a crucial role in the great prognosis of this woman.

Conclusions

This case report demonstrates the importance of comprehensive and meticulous perioperative management and provides guidance to the multidisciplinary team on the potential risk and the rational treatment strategy of patients with massive SFTP during the perioperative period.
Knockout tales: the versatile roles of histone H3.3 in development and disease
Authors: Klein Rachel H. , Knoepfler Paul S.
Published: October 2023

Histone variant H3.3 plays novel roles in development as compared to canonical H3 proteins and is the most commonly mutated histone protein of any kind in human disease. Here we discuss how gene targeting studies of the two H3.3-coding genes H3f3a and H3f3b have provided important insights into H3.3 functions including in gametes as well as brain and lung development. Knockouts have also provided insights into the important roles of H3.3 in maintaining genomic stability and chromatin organization, processes that are also affected when H3.3 is mutated in human diseases such as pediatric tumors and neurodevelopmental syndromes. Overall, H3.3 is a unique histone linking development and disease via epigenomic machinery.
A causal relationship between antioxidants, minerals and vitamins and metabolic syndrome traits: a Mendelian randomization study
Authors: Li Junxian , Song Fengju
Published: October 2023

Background

The available evidence regarding the association of antioxidants, minerals, and vitamins with the risk of metabolic syndrome (MetS) traits is currently limited and inconsistent. Therefore, the purpose of this Mendelian randomization (MR) study was to investigate the potential causal relationship between genetically predicted antioxidants, minerals, and vitamins, and MetS.

Methods

In this study, we utilized genetic variation as instrumental variable (IV) to capture exposure data related to commonly consumed dietary nutrients, including antioxidants (β-carotene, lycopene, and uric acid), minerals (copper, calcium, iron, magnesium, phosphorus, zinc, and selenium), and vitamins (folate, vitamin A, B6, B12, C, D, E, and K1). The outcomes of interest, namely MetS (n = 291,107), waist circumference (n = 462,166), hypertension (n = 463,010), fasting blood glucose (FBG) (n = 281,416), triglycerides (n = 441,016), and high-density lipoprotein cholesterol (HDL-C) (n = 403,943), were assessed using pooled data obtained from the most comprehensive genome-wide association study (GWAS) available. Finally, we applied the inverse variance weighting method as the result and conducted a sensitivity analysis for further validation.

Results

Genetically predicted higher iron (OR = 1.070, 95% CI 1.037–1.105, P = 2.91E−05) and magnesium levels (OR = 1.130, 95% CI 1.058–1.208, P = 2.80E−04) were positively associated with increased risk of MetS. For each component of MetS, higher level of genetically predicted selenium (OR = 0.971, 95% CI 0.957–0.986, P = 1.09E−04) was negatively correlated with HDL-C levels, while vitamin K1 (OR = 1.023, 95% CI 1.012–1.033, P = 2.90E−05) was positively correlated with HDL-C levels. Moreover, genetically predicted vitamin D (OR = 0.985, 95% CI 0.978–0.992, P = 5.51E−5) had a protective effect on FBG levels. Genetically predicted iron level (OR = 1.043, 95% CI 1.022–1.064, P = 4.33E−05) had a risk effect on TG level.

Conclusions

Our study provides evidence that genetically predicted some specific, but not all, antioxidants, minerals, and vitamins may be causally related to the development of MetS traits.
Endothelin mediates sex-differences in acclimation to high salt diet in rats
Authors: Nasci Victoria L. , Almutlaq Rawan N. , Pollock David M. , Gohar Eman Y.
Published: October 2023

Introduction

Current understanding of sodium (Na+) handling is based on studies done primarily in males. Contrary to the gradual increase in high salt (HS) induced natriuresis over 3–5 days in males, female Sprague Dawley (SD) rats have a robust natriuresis after 1 day of HS. Renal endothelin-1 (ET-1) signaling, through ET receptor A and B, is an important natriuretic pathway and was implicated in our previous dietary salt acclimation studies, however, the contribution of ET receptors to sex-differences in acclimation to dietary Na+ challenges has yet to be clarified. We hypothesized that ET receptors mediate the augmented natriuretic capacity of female rats in response to a HS diet.

Methods

To test our hypothesis, male and female SD rats were implanted with telemeters and randomly assigned to treatment with A-182086, a dual ETA and ETB receptor antagonist, or control. 24-h urine samples were collected and assessed for electrolytes and ET-1. Studies were performed on a normal salt (NS, 0.3% NaCl) diet and after challenging rats with HS (4% NaCl) diet for 1 day.

Results

We found that A-182086 increased blood pressure in male and female SD rats fed either diet. Importantly, A-182086 eliminated sex-differences in natriuresis on NS and HS. In particular, A-182086 promotes HS-induced natriuresis in male rats rather than attenuating the natriuretic capacity of females. Further, the sex-difference in urinary ET-1 excretion in NS-fed rats was eliminated by A-182086.

Conclusion

In conclusion, ET receptors are crucial for mediating sex-difference in the natriuretic capacity primarily through their actions in male rats.
RIS-enabled smart wireless environments: deployment scenarios, network architecture, bandwidth and area of influence
Authors: Alexandropoulos George C. , Phan-Huy Dinh-Thuy , Katsanos Konstantinos D. , Crozzoli Maurizio , Wymeersch Henk , Popovski Petar , Ratajczak Philippe , Bénédic Yohann , Hamon Marie-Helene , Gonzalez Sebastien Herraiz , Mursia Placido , Rossanese Marco , Sciancalepore Vincenzo , Gros Jean-Baptiste , Terranova Sergio , Gradoni Gabriele , Di Lorenzo Paolo , Rahal Moustafa , Denis Benoit , D’Errico Raffaele , Clemente Antonio , Strinati Emilio Calvanese
Published: October 2023

Reconfigurable intelligent surfaces (RISs) constitute the key enabler for programmable electromagnetic propagation environments and are lately being considered as a candidate physical-layer technology for the demanding connectivity, reliability, localisation, and sustainability requirements of next-generation wireless networks. In this paper, we first present the deployment scenarios for RIS-enabled smart wireless environments that have been recently designed within the ongoing European Union Horizon 2020 RISE-6G project, as well as a network architecture integrating RISs with existing standardised interfaces. We identify various RIS deployment strategies and sketch the core architectural requirements in terms of RIS control and signalling, depending on the RIS hardware architectures and respective capabilities. Furthermore, we introduce and discuss, with the aid of simulations and reflect array measurements, two novel metrics that emerge in the context of RIS-empowered wireless systems: the RIS bandwidth of influence and the RIS area of influence. Their extensive investigation corroborates the need for careful deployment and planning of the RIS technology in future wireless networks.
Resource allocation strategy for blockchain-enabled NOMA-based MEC networks
Authors: Ding Jianjie , Han Lina , Li Jie , Zhang Dajun
Published: October 2023

Blockchain technology is getting more and more attention due to its decentralization, independence and security features. However, in wireless networks it faces a computational challenge: the proof-of-work problem. Mobile edge computing (MEC) leads to a vaild scheme by providing cloud computing capabilities to mobile devices. Non-orthogonal multiple access (NOMA) exploits the diversity properties in the power domain to further increase system throughput and spectral efficiency. In this paper, we suggest a new NOMA-based MEC wireless blockchain network to minimize system energy consumption through task offloading decision optimization, user clustering, computing resource and transmit power allocation. In order to effectively figure out this non-convex problem, we first propose a offloading decision and user clustering algorithm, and then propose a computing resource allocation algorithm based on user Quality of Service (QoS) requirements. Finally, the transmission power can be easily determined. The numerical simulation results verify that the proposed joint optimization algorithm can effectively decrease the system energy consumption.
Antibiotic use at a tertiary hospital in Tanzania: findings from a point prevalence survey
Authors: Katyali Denis , Kawau Godfrey , Blomberg Bjørn , Manyahi Joel
Published: October 2023

Background

In Tanzania, data on antibiotic use at the patient level is scarce, and intervention measures to optimize antibiotic use and reduce antimicrobial resistance are rarely performed.

Objectives

To describe antibiotic use at Muhimbili National Hospital.

Methods

This was a point prevalence survey on antibiotic use conducted at Muhimbili National Hospital in August-September 2022. The World Health Organization point prevalence survey data collection tool was used to collect patients’ information from the files. All patients admitted to the wards on the day of the survey were included.

Results

Overall, 47% (185/397) of admitted patients were on at least one antibiotic during the survey. All antibiotics prescribed were for empirical treatment and guideline compliance was low, at 45%. Of 185 patients who received antibiotics, the most common indication was community acquired infection (55%) and 36% had no documentation of the reasons for prescribing antibiotics. Almost 75% of the antibiotics were administered parenterally, with only 2% switching to oral route. Microbiological tests were performed in only 9 (5%) patients out of 185 and results were available for only one patient. Of all participants, 52% received two or more antibiotic in combination, with the combination ceftriaxone-metronidazole being most frequently prescribed, followed by the combination of ampicillin, cloxacillin, and gentamicin. For individual antibiotics, ceftriaxone was the most frequently prescribed antibiotic accounting for 28% (79/283), followed by metronidazole (24%) and amoxicillin-clavulanic acid (11%).

Conclusion

The findings of a high prevalence of antibiotic use, inadequate use of bacterial culture, and frequent empiric antibiotic treatment suggests the need for strengthening diagnostic and antimicrobial stewardship programs. Furthermore, this study has identified areas for quality improvement, including education programs focusing on prescription practice.
ECMO in adult patients with severe trauma: a systematic review and meta-analysis
Authors: Zhang Yangchun , Zhang Li , Huang Xihua , Ma Na , Wang Pengcheng , Li Lin , Chen Xufeng , Ji Xueli
Published: October 2023

Background

Severe trauma can result in cardiorespiratory failure, and when conventional treatment is ineffective, extracorporeal membrane oxygenation (ECMO) can serve as an adjunctive therapy. However, the indications for ECMO in trauma cases are uncertain and clinical outcomes are variable. This study sought to describe the prognosis of adult trauma patients requiring ECMO, aiming to inform clinical decision-making and future research.

Methods

A comprehensive search was conducted on Pubmed, Embase, Cochrane, and Scopus databases until March 13, 2023, encompassing relevant studies involving over 5 trauma patients (aged ≥ 16 years) requiring ECMO support. The primary outcome measure was survival until discharge, with secondary measures including length of stay in the ICU and hospital, ECMO duration, and complications during ECMO. Random-effects meta-analyses were conducted to analyze these outcomes. The study quality was assessed using the Joanna Briggs Institute checklist, while the certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.

Results

The meta-analysis comprised 36 observational studies encompassing 1822 patients. The pooled survival rate was 65.9% (95% CI 61.3–70.5%). Specifically, studies focusing on traumatic brain injury (TBI) (16 studies, 383 patients) reported a survival rate of 66.1% (95% CI 55.4–76.2%), while studies non-TBI (15 studies, 262 patients) reported a survival rate of 68.1% (95% CI 56.9–78.5%). No significant difference was observed between these two survival comparisons (p = 0.623). Notably, studies utilizing venoarterial extracorporeal membrane oxygenation (VA ECMO) (15 studies, 39.0%, 95% CI 23.3–55.6%) demonstrated significantly lower survival rates than those using venovenous extracorporeal membrane oxygenation (VV ECMO) (23 studies, 72.3%, 95% CI 63.2–80.7%, p < 0.001). The graded assessment of evidence provided a high degree of certainty regarding the pooled survival.

Conclusions

ECMO is now considered beneficial for severely traumatized patients, improving prognosis and serving as a valuable tool in managing trauma-related severe cardiorespiratory failure, haemorrhagic shock, and cardiac arrest.
Psychometric properties of persian version of escapism scale among Iranian adolescents
Authors: Nooripour Roghieh , Ghanbari Nikzad , Hosseinian Simin , Lavie Carl J. , Mozaffari Nazir , Sikström Sverker , Hosseini Seyed Ruhollah
Published: October 2023

The aim of this study was to assess the psychometric properties of the Persian version of the Escapism Scale among Iranian adolescents aged 14–18. Between January 2021 and August 2021, cross-sectional study was conducted using a convenience sampling method to select 566 participants (340 girls and 226 boys) to investigate the relationship between physical activity and mental health in adolescents. The participants completed several questionnaires, including the Escapism Scale, Erikson Psychosocial Stage Inventory (EPSI), Satisfaction with Life Scale (SWLS), Hope Scale (AHS), Smartphone Addiction Scale-Short Version (SAS-SV), and General Self-efficacy (GSE). Construct validity, reliability using Cronbach’s alpha, and concurrent validity were used to evaluate the Escapism Scale’s validity and reliability. Results of the Confirmatory Factor Analysis (CFA) indicated that a two-factor model provided a good fit for the data: sbX2 = 179.99 (p < 0.01); SRMR = 0.07; RMR = 0.56, CFI = 0.91; NFI = 0.89; IFI = 0.91; NFI = 0.89; GFI = 0.93; AGFI = 0.90, RMSEA = 0.076). The Cronbach’s alpha coefficient for escapism was 0.73. The study found a significant positive relationship between escapism and smartphone addiction (r = 0.19). Additionally, a significant negative relationship was observed between escapism and hope (r=-0.31), satisfaction with life (r=-0.34), and general self-efficacy (r=-0.33). Furthermore, a significant relationship was found between escapism and gender. Lastly, the study found a significant relationship between escapism and identity confusion (r = 0.164, P < 0.01) and identity coherence (P < 0.01, r = 29). In conclusion, the Escapism Scale is a valid and reliable tool for assessing escapism and psychological evaluations in Iranian adolescents. These results may inform future research and suggest re-testing in clinical populations.
Simultaneous observations of equatorial plasma bubbles with an all-sky airglow imager and a HF Doppler sounding system in Taiwan
Authors: Sejima Hiromi , Hosokawa Keisuke , Nakata Hiroyuki , Chum Jaroslav , Lin Chien-Hung , Lin Jia-Ting
Published: October 2023

High-Frequency Doppler (HFD) sounders at low-latitudes often detect characteristic oblique spreading Doppler traces in the spectrogram, known as Oblique Spread Structure (OSS). OSS has been expected to be generated by the dispersion of radio wave reflection due to equatorial plasma bubbles (EPBs). However, it has not yet been confirmed whether OSS is surely a manifestation of EPB by conducting simultaneous observations of EPB and OSS with different observational techniques. Additionally, it remains unclear what kinds of properties of EPB are reflected in the fine structure of OSS. In this study, we investigated three cases of OSSs and EPBs simultaneously observed by a HFD sounding system and an all-sky airglow imager in Taiwan. For the three cases presented here, the timing of OSS occurrence in the HFD data well coincided with that of the EPB appearance in the airglow data. The frequency shift of OSS is quantitatively explained assuming a radio wave reflection at 250–300 km altitudes. These results strongly indicate that OSS is formed by electron density variations at F-region altitudes accompanying EPB; thus, OSS is a manifestation of EPB in the HFD observations. Furthermore, it was suggested that the fine structure of OSS reflected the branching structure of EPB when the multiple branches of EPB reached the intermediate reflection point of the HFD observation. The detection of EPB occurrence and its fine structure using HFD observation enables monitoring of EPB regardless of weather conditions, which will contribute to monitoring the space weather impact of EPBs, for example, on GNSS navigation, in a wide area.

Graphical Abstract