bluuebunny/crossref_metadata_2025 huggingface dataset:
Family physicians and menstrual care: An analysis of CERA 2023
Authors: Casola Allison R , Rea Olivia , Ho Tiffany
Published: April 2024

Background:

Menstrual health is an important indicator of overall health and has large impacts on quality of life. Despite number and impact, discussion of menstruation remains largely taboo within health care. Patients and physicians are not engaging in regular, meaningful discussions on menstruation. Family physicians, as primary care providers, can facilitate these important conversations.

Objectives:

We sought to understand the profile of menstrual care providing family physicians and assessed physician comfort, knowledge, training, and perceived importance regarding menstrual care.

Design/Methods:

This is a cross-sectional analysis of the 2022 Council of Academic Family Medicine Educational Research Alliance survey. The survey included actively practicing US physicians who are members of the Council of Academic Family Medicine organizations. Descriptive demographic statistics were calculated; chi-square tests were generated for menstrual care-specific items; logistic regression models were fit to determine the association between receiving formal menstrual care training, importance of physician training in menstrual care, and demographic factors.

Results:

Eighty-five percent of respondents report frequently providing menstrual care. Participants of younger age, or who had earned their degree more recently, were significantly more likely to provide frequent menstrual care. Respondents who earned their medical degree at an earlier year were significantly more likely to believe that physician training in menstrual care was of limited importance (OR = 1.02, 95% CI = 1.00, 1.03).

Conclusions:

Our findings show that family physicians are providing menstrual care, despite non-uniform training, and recognize its importance to patients. By understanding physician profile and the care they provide, we can work toward comprehensive physician education in menstrual care and providing appropriate menstrual care to patients.
Glucagon-like peptide-1 receptor agonists and stroke: A systematic review and meta-analysis of cardiovascular outcome trials
Authors: Adamou Anastasia , Barkas Fotios , Milionis Haralampos , Ntaios George
Published: April 2024

Background:

In patients surviving stroke, approximately 15% and 60% exhibit concurrent diabetes mellitus and overweight/obesity, respectively, necessitating heightened secondary prevention efforts. Despite glucagon-like peptide-1 receptor agonists (GLP-1 RAs) demonstrating improved outcomes for those with diabetes mellitus or obesity, their underutilization persists among eligible individuals. This systematic review and meta-analysis investigated the impact of GLP-1 RAs on stroke risk. The findings aim to optimize the implementation of this therapeutic strategy in patients surviving stroke with diabetes mellitus or obesity.

Methods:

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we systematically reviewed MEDLINE and Scopus until 15 November 2023. Eligible studies included randomized cardiovascular outcome trials (CVOTs) with individuals, with or without type 2 diabetes, randomized to either GLP-1 RA or placebo. The outcomes were total strokes, non-fatal strokes, and fatal strokes. Analyses were conducted using RevMan 5.4.1.

Results:

Among 1369 screened studies, 11 were eligible, encompassing 82,140 participants (34.6% women) with a cumulative follow-up of 247,596 person-years. In the GLP-1 RAs group, the stroke rate was significantly lower compared to placebo (RR: 0.85, 95% CI: 0.77–0.93; NNT: 200), showing no heterogeneity or interaction with administration frequency (daily vs weekly). In addition, the GLP-1 RAs group exhibited a significantly lower rate of non-fatal strokes compared to placebo (RR: 0.87, 95% CI: 0.79–0.95; NNT: 250), with no heterogeneity or interaction based on administration frequency, route (oral vs subcutaneous), or diabetes presence.

Conclusion:

In this meta-analysis of 11 CVOTs with 82,140 participants, GLP-1 RAs demonstrated a 16% relative reduction in stroke risk compared to placebo. This finding may increase implementation of GLP-1 RAs by stroke specialists in individuals with stroke and comorbid diabetes mellitus or obesity.

Data access statement:

The data that support the findings of this study are available from the corresponding author upon reasonable request.
Threats, victims, or heroes? Media frames about migration in the United Kingdom and Brazil
Authors: Gonçalves Isabella , David Yossi
Published: April 2024

Conservative media often frames migrants negatively, echoing discourses of othering driven by populist leaders. Previous studies have examined the intersections between media framing, migration, and populism, but comparative studies on migration framing including Brazil remain scarce. This study uses quantitative content analysis to explore media frames of news items published in the United Kingdom and Brazil. It aims to contribute new insights regarding migration media framing by comparing conservative news coverage of two countries that experienced a rise in populism wave in the last years. We found that new items in both countries tended to frame migration in similar ways, suggesting a pattern in two different contexts. Findings show the prevalence of negative framing over positive framing, with significant differences for victim frames, and non-significant differences for hero and threat frames. This study contributes by providing new insights into the intersections between media framing, migration, and populism.
How do members of a perpetrator group negotiate multiple past ingroup transgressions? A German case study
Authors: Lienen Carmen S , Eckerle Frank , Cohrs J Christopher
Published: April 2024

How members of perpetrator groups engage with their ingroup’s negative history has received increasing attention over the past years. Yet, little research has addressed how people psychologically negotiate multiple past ingroup transgressions. Across two studies ( n = 362), we exposed German participants to information about two ingroup transgressions, the Holocaust and the colonial genocide in former South West Africa, to test ideas of a multidirectional memory (= one memory productively informs another) versus a competitive memory (= memories stand in competition) effect. Along six indicators of memory (negativity and significance, acknowledging responsibility, collective guilt and shame, willingness to make reparations), we find that people build small memory hierarchies when given the opportunity. Overall, however, it seems that most people show similar levels of history engagement for different transgressions. We discuss how our findings relate to the public discourse on multiple memories.
Measuring the aesthetic and functional outcome of pollicization
Authors: Torabi Faramarz , Laurell Tobias
Published: April 2024

We retrospectively investigated the importance of aesthetics after pollicization in 12 pollicized thumbs in nine patients with current objective and subjective measurements. Subjective improvements in appearance and function correlated even though improvement of function was of greater importance.
Essential Oils for the Treatment and Management of Nonalcoholic Fatty Liver Disease (NAFLD)
Authors: Kim Taehwa , Mijan Mohammad Al , Lee Jeonga , Yun Jungmi , Chung Jae Heun , Son Soo Min , Kwon Ryuk Jun
Published: April 2024

Nonalcoholic fatty liver disease (NAFLD), characterized by excessive liver fat accumulation, is a common liver disease linked to obesity, insulin resistance, and metabolic dysfunction. The lack of effective treatments against NAFLD has led to an increasing focus on alternative and natural remedies. Essential oils, extracted from a variety of plants, have drawn interest due to their high content of active compounds and potential functions to support liver health. Ginger essential oil, known for its anti-inflammatory, antioxidant, and cholesterol-lowering properties, promotes antioxidant enzymes and ameliorates liver fat accumulation in mice model of NAFLD. Nigella sativa oil with its diverse array of bioactive components, mitigates fatty liver by lowering tumor necrosis factor-alpha, malonaldehyde (MDA), and plasma lipids in vivo and in human trials that could contribute to NAFLD management. Garlic oil, rich in organosulfur compounds, has shown potential benefits in modulating oxidative stress and inflammation associated with NAFLD. Similarly, essential oils from turmeric, pepper, patchouli, and basil reduced lipid accumulation and inflammation and enhanced lipid metabolism in animal models of NAFLD. These findings underscore the use of essential oils as complementary medicines for NAFLD, opening avenues for further research and clinical applications.
The origins of public relations in Greece: Tracing the missing link and excavating landmark cases
Authors: Yannas Prodromos , Triantafillidou Amalia
Published: April 2024

The purpose of this paper is to provide an historical narrative tracing precedents of Greek Public Relations (PR) practice as far back as the organizing of mega events in mid-nineteenth century culminating in the first modern Olympic Games in Athens in 1896. The analysis documents that PR activities are interwoven with Greek governments’ initiatives aimed at tourism promotion. The paper is based on archival material and secondary sources. Access was granted to the special collections of the National Library of Greece and the Hellenic Literary and Historical Archive of the National Bank of Greece Cultural Foundation. Moreover, the study interrogates the three landmark events that ushered in the emergence of professional public relations in Greece in the early postwar period and supplements with important information the conventional accounts. The analysis established a PR-Tourism and National image promotion nexus that runs continuously throughout the period under examination, from the emergence of PR activities in mid-nineteenth century up until the early 1950s. The findings are based on the available written records. This historical review does not purport to be exhaustive and comprehensive. Future research could identify more PR-like activities worthy of mention. The study provides a springboard for investigating the precedents of PR practice in the pre-professionalization era. This investigation calls for an interdisciplinary perspective. This paper is the first one to trace precedents of professional PR practice to the second half the nineteenth century and the interwar period in Greece. It shows the interconnection of PR-like activities with tourism and underscores the prominent position of state agencies in those activities.
Comparison of Right Ventricular Outflow Tract Reconstruction Techniques on Mid-Term Pulmonic Valve Fate
Authors: Taksaudom Noppon , Thuropathum Pradchaya , Tepsuwan Thitipong , Tantraworasin Apichat , Sittiwangkul Rekwan , Phothikun Amarit , Woragidpoonpol Surin
Published: April 2024

Introduction: The pulmonic valve-sparing technique (PVS) is an emerging approach of right ventricular outflow tract reconstruction in tetralogy of Fallot (TOF) correction aimed at reducing the incidence of pulmonic regurgitation (PR) and the need for subsequent reintervention. This study aims to compare the long-term occurrence of moderate to severe PR/stenosis (PR/PS) between three different approaches. Patients and Methods: We conducted a retrospective cohort study involving 173 patients who underwent TOF correction at Chiang Mai University hospital between January 2006 and December 2016. The patients were divided into three groups: transannular patch (TAP; n = 88, 50.9%), monocusp insertion (MCI; n = 40, 23.1%), and PVS (n = 45, 26%). The study assessed freedom from moderate to severe PR/PS. Results: The median overall follow-up time was 79.8 months (interquartile range: 50.7-115.5 months. The PVS exhibited larger PV Z-score (−2.6 ± 2.3 mm, P < .001), with predominantly tricuspid morphology (64.4%). The PVS had significantly shorter median ventilator time, intensive care unit stay, hospital stay, and longer median follow-up time. Postoperative moderate-severe PR was lower in the PVS group ( P < .001), with no significant difference in PS ( P = .356) and complications among the groups. Freedom from moderate-severe PR/PS was longer in the MCI group (2.8, 0.2-42.3 months vs 30.9, 0.2-50.9 months, respectively). Multivariable analysis showed TAP and MCI had a higher risk of developing moderate-severe PR (hazard ratio [HR] 2.51; 95% confidence interval [CI] 1.23-5.13 vs HR 1.41; 95%CI 0.59-3.38) but lower risk of moderate-severe PS (HR 0.14; 95%CI 0.02-0.9 vs HR 0.39; 95%CI 0.05-3.19). Conclusion: Pulmonic valve-sparing reconstruction showed promise in preventing late moderate-severe PR in patients with favorable PV anatomy. However, it should be noted that this technique is associated with a higher incidence of PS.
The Moderating Effect of Ski Influencer on Ski Tourism Intention
Authors: Zhao Chen , Shen Huawen
Published: April 2024

The 2022 Beijing Winter Olympic Games has made more people focus on skiing. How to promote the development of ski tourism is the focus of this study. This study explores the relationship between skiers’ motivation and tourism intention. Based on social learning theory, the moderating effect of attractive influencers on satisfaction and travel intentions was explored. The results show that perceived ski motivation and affective engagement positively impact perceived value. The perceived value affects tourism intention through satisfaction, and perceived value directly impacts satisfaction and tourism intention. The willingness of skiers to travel will change with the attraction of ski influencers. Furthermore, the study results provide recommendations for enhancing ski destinations and offer suggestions for improving marketing strategies.
On the Feasibility of Using Behavioral Listening Effort Test Methods to Evaluate Auditory Performance in Cochlear Implant Users
Authors: Hendrikse Maartje M. E. , Dingemanse Gertjan , Goedegebure André
Published: April 2024

Realistic outcome measures that reflect everyday hearing challenges are needed to assess hearing aid and cochlear implant (CI) fitting. Literature suggests that listening effort measures may be more sensitive to differences between hearing-device settings than established speech intelligibility measures when speech intelligibility is near maximum. Which method provides the most effective measurement of listening effort for this purpose is currently unclear. This study aimed to investigate the feasibility of two tests for measuring changes in listening effort in CI users due to signal-to-noise ratio (SNR) differences, as would arise from different hearing-device settings. By comparing the effect size of SNR differences on listening effort measures with test–retest differences, the study evaluated the suitability of these tests for clinical use. Nineteen CI users underwent two listening effort tests at two SNRs (+4 and +8 dB relative to individuals’ 50% speech perception threshold). We employed dual-task paradigms—a sentence-final word identification and recall test (SWIRT) and a sentence verification test (SVT)—to assess listening effort at these two SNRs. Our results show a significant difference in listening effort between the SNRs for both test methods, although the effect size was comparable to the test–retest difference, and the sensitivity was not superior to speech intelligibility measures. Thus, the implementations of SVT and SWIRT used in this study are not suitable for clinical use to measure listening effort differences of this magnitude in individual CI users. However, they can be used in research involving CI users to analyze group data.
From Deficit to Difference: Understanding the Relationship Between K–12 Teacher Training and Disability Discussion
Authors: Bialka Christa S. , Hansen Nicole , Kan Irene P. , Mackintosh Danielle , Jacobson Rebecca
Published: April 2024

One major responsibility of K–12 teachers in United States public schools is to meet the needs of disabled students. While many preservice and in-service teacher training programs present educators with information related to service delivery as outlined in a student’s Individualized Education Program or 504 plan, they rarely address how to talk about disability with all students. This qualitative study examines 50 in-service teachers’ experiences related to disability training and explores the implications of this training on teachers’ disability discussion practices. Findings reveal that teacher training is primarily focused on compliance and “fixing” disability; training and prior experiences affect how teachers define disability; and training affects the framework that teachers use when discussing disability with their students. Based on the findings of this study, we offer recommendations to help programs reimagine training and view disability as a minoritized identity. Results of this study address a significant gap in preparing teachers for disability discussion.
Knowledge of Non-Invasive Biomarkers of Breast Cancer, Risk Factors, and BSE Practices Among Nursing Undergraduates in Farasan Island, KSA
Authors: Sayed Shabihul Fatma , Dailah Hamad G. , Nagarajan Sumathi , Abdelwahab Siddig Ibrahim , Abadi Shaived S. Hasan , Akhtar Nida , Khuwaja Gulrana , Malham Wadeah Ali DA
Published: April 2024

Background of the Study

Mammograms are sometimes met with issues of overdiagnosis and underdiagnosis; therefore, they are less reliable in identifying cancer in women with dense breasts. As a result, it is critical to be aware of other sensitive screening techniques for the early diagnosis of breast cancer.

Aim

The ultimate objective of this study was to assess the knowledge of nursing undergraduates regarding non-invasive biomarkers, such as volatile organic compounds in breath, nipple aspirate fluid, sweat, urine, and tears, for the early detection of breast cancer to help improve patient care, determine the risk factors, and encourage practice of breast self-examination.

Methods

Cross-sectional research was done in the Department of Nursing at Farasan campus using a self-structured questionnaire as the study tool. A total of 260 students willingly participated. The study tool had evaluation questions focused on the non-invasive biomarkers of breast cancer, risk factors, and breast self-examination practices to collect data. The data were subjected to descriptive and inferential statistics. The statistical significance was calculated at P < .05. Data analyses were done using Microsoft Excel (2013).

Results

A significant knowledge gap existed among the study participants about the non-invasive biomarkers of breast cancer. A lesser percentage of students (25%) stated that they do breast self-examination on a monthly basis. The most common reasons for not doing the breast self-examination were “not knowing how to do the breast self-examination” (77.3%), fear of a positive diagnosis (53.9%), thinking that they are not at risk as all were in their teens and hence not required (44.7%), and lack of time (48.7%). Age and frequency of breast self-examination were significantly associated ( P < .05) as those few students (22.7%) who were doing breast self-examination practices every 2–4 months belonged to a higher study year. Furthermore, knowledge regarding incidence rates and health care expenditure by the government on breast cancer was also significantly low ( P < .05).

Conclusions

Outcomes would help prioritize actions to help future nurses better understand breast cancer, allowing them to extend patient care in the best way possible.
Challenges of Clinical Education: From the Perspective of Clinical Instructors and Clinical Staffs at Dire Dawa University, Dire Dawa, Ethiopia, Qualitative Study
Authors: Tadesse Daniel , Solomon Yonatan , Hailu Mickiale , Tigistu Feven
Published: April 2024

OBJECTIVE

To explore the challenges of clinical education from the perspective of clinical instructors and clinical staff at Dire Dawa University College of Health Science.

METHODS

An institutional-based phenomenological qualitative study was conducted. Clinical instructors and staff provided data through in-depth interviews and key informant discussions, which were facilitated by a semistructured tool and a voice recorder. A total of 17 participants, including 11 in-depth interviews (IDIs) with clinical instructors (including two key informants) and six IDIs with clinical staff were included in this study. A purposive sampling method was used to select study participants, and the data were analyzed thematically using the computer-assisted qualitative data analysis software Atlas.ti7. The thematic analysis with an inductive approach involves six steps: familiarization, coding, generating themes, reviewing themes, defining and naming themes, and writing.

RESULTS

Clinical instructors and clinical staff noted a number of challenges in clinical education, including insufficient medical equipment, low incentives, clinical site repetition, unfavorable clinical practice sites, lack of communication from instructors, skill attrition, lack of orientation for instructors and students, client/patient unwelcomingness, uncooperative healthcare workers, and poor university cooperation.

CONCLUSION

The aforementioned issues contributed to the quality of clinical education and its desired impact, as outlined in this research. A multidisciplinary and collaborative effort is needed to address these challenges.
Association of 5-HTTLPR With Post-Traumatic Stress Disorder in US Service Members
Authors: Hu Xian-Zhang , Ursano Robert J. , Benedek David , Li Xiaoxia ,   Biomarker Study Group, Zhang Lei
Published: April 2024

Objective

Post-traumatic stress disorder (PTSD) is a mental disorder that manifests after exposure to a stressful traumatic event, such as combat experience. Accumulated evidence indicates an important genetic influence in the development of PTSD. The serotonin transporter (5-HTT) gene has been identified as a candidate for PTSD and a polymorphism of the serotonin transporter-linked promoter region (5-HTTLPR) is associated with the disorder in the general population. However, whether it is associated with PTSD in active military service members has not been investigated. This study aimed to investigate the relationship between 5-HTTLPR and PTSD in service members.

Methods

Leucocyte genomic DNA was extracted from service members, including those with PTSD (n = 134) or without PTSD (n = 639). The 5-HTTLPR polymorphism was detected by means of 2 stages of TaqMan fluorescent PCR assay. PTSD symptoms and symptom severity were assessed using the PTSD Checklist (PCL), a 17-item, DSM-based, self-report questionnaire with well-established validity and reliability. PTSD was determined based on endorsement of DSM-IV criteria and a PCL total score ≥ 44.

Results

Significant differences in biallele distribution were observed between PTSD and controls (χ2 = 7.497, P = .024). The frequency of SS, SL, and LL genotypes in the PTSD group was 0.17, 0.56, and 0.27 respectively, compared to the frequencies of 0.27, 0.43, and 0.29 in non-PTSD controls. Carriers of the L allele had higher scores for reexperiencing and arousal symptoms on the PCL, compared to SS homozygote carriers ( P < .05). The triallele genotypes showed no significant differences in distribution between the PTSD and control groups ( P > .05) and no relationship with PTSD symptom severity. The interaction of triallelic genotypes of 5-HTTLPR and traumatic life events was associated with re-experiencing, avoidance, and arousal ( P < .05 for all). Multiple regression analysis revealed significant correlations between both biallelic and triallelic genotypes of 5-HTTLPR, the interaction of the number of stressful lifetime events, and 5-HTTLPR genotypes with PCL total score ( P < .001).

Conclusion

Our findings suggested that 5-HTT might play a minor role in PTSD, and the interaction between 5-HTTLPR and the environment had effects on PCL score, complementing and emphasizing 5-HTT for PTSD, especially in the military population.
How to Give Supported Decision-Making “Teeth”: Recommendations From Two Self-Advocates and a Supporter
Authors: Finn Chester A. , Fracht Anne , Smith Matthew S.
Published: April 2024

Supported decision-making (SDM) has the potential to upend age-old legal regimes and belief systems throughout the world to ensure that people with disabilities both can easily access their preferred forms of assistance to make decisions and also get respect for their decisions from other people, even when they make decisions with support. This simple but powerful idea, which has already prompted many countries around the world to rethink their laws, policies, and programs, emerged in response to demands by self-advocates to make their voices heard, have greater say in their own lives, and do away with laws that get in the way. While SDM has inspired provocative thinking and meaningful changes to the benefit of people with intellectual and developmental disabilities (IDD), self-advocates expect that new laws, policies, and programs aim to give this idea “teeth.” At a time when organizations are seizing more opportunities to advance SDM, this article’s co-authors, two self-advocates and an attorney supporter, present recommendations based on their experiences with two SDM advocacy initiatives in New York and Massachusetts. Specifically, we recommend that SDM advocates focus on (a) passing laws that require other people to recognize the supported decisions of people with IDD who have SDM agreements, (b) developing SDM agreements that are easy for people with IDD to understand, (c) encouraging judges to apply SDM in guardianship proceedings, and (d) providing individualized assistance to people with IDD interested in making SDM agreements.
Compassion Fatigue, Resilience, and Endurance of Special Educators in Rural P–12 and Higher Education
Authors: Floyd Kim K. , Horn Annemarie , Sherfinski Melissa
Published: April 2024

The effects of mental health challenges in the United States are growing and affect both Grades P–12 special education teachers and faculty at institutions of higher education (IHE). Educators struggle with compassion fatigue and associated burnout. With educators leaving the field for a plethora of reasons, it is vital to examine factors that support those who remain in education. Thus, we analyzed factors that support the retention of educators at both levels of instruction. In a qualitative analysis of data from survey respondents ( N = 200), we examined the resiliency and endurance of practicing rural P–12 special educators and faculty at IHEs. Results from inductive content analysis indicate that factors leading to persistence in education begin with educators finding meaning in their teaching. Educators who demonstrate career endurance have a strong sense of self-efficacy in their teaching abilities, receive emotional benefits from their students, and have quality opportunities to mentor and collaborate with others. By contrast, some educators indicate burnout is a key factor for leaving the field, and reported reasons include low pay, paperwork, poor work/life balance, lack of respect, and the mental health of themselves and their students. Based on these findings, we offer recommendations for research and practice.
Mitochondrial (mt)DNA–cyclic GMP–AMP synthase (cGAS)–stimulator of interferon genes (STING) signaling promotes pyroptosis of macrophages via interferon regulatory factor (IRF)7/IRF3 activation to aggravate lung injury during severe acute pancreatitis
Authors: Peng Yiqiu , Yang Yuxi , Li Yingying , Shi Tingjuan , Xu Ning , Liu Ruixia , Luan Yingyi , Yao Yongming , Yin Chenghong
Published: April 2024

Background

Macrophage proinflammatory activation contributes to the pathology of severe acute pancreatitis (SAP) and, simultaneously, macrophage functional changes, and increased pyroptosis/necrosis can further exacerbate the cellular immune suppression during the process of SAP, where cyclic GMP–AMP synthase (cGAS)–stimulator of interferon genes (STING) plays an important role. However, the function and mechanism of cGAS–STING in SAP-induced lung injury (LI) remains unknown.

Methods

Lipopolysaccharide (LPS) was combined with caerulein-induced SAP in wild type, cGAS −/− and sting −/− mice. Primary macrophages were extracted via bronchoalveolar lavage and peritoneal lavage. Ana-1 cells were pretreated with LPS and stimulated with nigericin sodium salt to induce pyroptosis in vitro.

Results

SAP triggered NOD-, LRR-, and pyrin domain-containing protein 3 (NLRP3) inflammasome activation-mediated pyroptosis of alveolar and peritoneal macrophages in mouse model. Knockout of cGAS/STING could ameliorate NLRP3 activation and macrophage pyroptosis. In addition, mitochondrial (mt)DNA released from damaged mitochondria further induced macrophage STING activation in a cGAS- and dose-dependent manner. Upregulated STING signal can promote NLRP3 inflammasome-mediated macrophage pyroptosis and increase serum interleukin (IL)-6, IL-1β, and tumor necrosis factor (TNF)-α levels and, thus, exacerbate SAP-associated LI (SAP-ALI). Downstream molecules of STING, IRF7, and IRF3 connect the mtDNA–cGAS–STING axis and the NLRP3–pyroptosis axis.

Conclusions

Negative regulation of any molecule in the mtDNA–cGAS–STING–IRF7/IRF3 pathway can affect the activation of NLRP3 inflammasomes, thereby reducing macrophage pyroptosis and improving SAP-ALI in mouse model.
Supplementation of Jasmonic acid Mitigates the Damaging Effects of Arsenic Stress on Growth, Photosynthesis and Nitrogen Metabolism in Rice
Authors: Attia Houneida , Alamer Khalid H.
Published: April 2024

Experiments were conducted to evaluate the role of exogenously applied jasmonic acid (JA; 0.1 and 0.5 µM) in alleviating the toxic effects of arsenic (As; 5 and 10 µM) stress in rice. Plants treated with As showed considerable decline in growth attributes like height, fresh and dry weight of plant. Arsenic stress reduced the content of δ-amino livulenic acid (δ-ALA), glutamate 1-semialdehyde (GSA), total chlorophylls and carotenoids, with more reduction evident at higher (10 µM) As concentrations, however exogenously supplied JA alleviated the decline to considerable extent. Arsenic stress mediated decline in photosynthetic gas exchange parameters, Fv/Fm (PSII activity) and Rubisco activity was alleviated by the exogenous treatment of JA. Arsenic stress caused oxidative damage which was evident as increased lipid peroxidation, lipoxygenase activity and hydrogen peroxide concentrations however, JA treatment declined these parameters. Treatment of JA improved the activity of nitrate reductase and glutamate synthase under unstressed conditions and also alleviated the decline triggered by As stress. Activity of antioxidant enzymes assayed increased due to As stress, and the supplementation of JA caused further increase in their activities. Moreover, the content of proline, free amino acids and total phenols increased significantly due to JA application under stressed and unstressed conditions. Treatment of JA increased the content of nitrogen and potassium while as reduced As accumulation significantly.
Update on prostate cancer epidemiology in Morocco
Authors: Samtal Chaimae , Bouguenouch Laila , Ismaili Nabil , El Baldi Marwa , El Makhzen Badreddine , El Rhazi Karima , Mzyiene Mohammed , Farih Moulay Hassan , Ouldim Karim , Ghazal Hassan , Bekkari Hicham
Published: April 2024

Background

Prostate cancer stands as the most frequently diagnosed cancer among men globally, with over 600,000 new cases annually. In-depth epidemiological studies play a pivotal role in delineating the unique characteristics of specific populations. This study endeavors to comprehensively document the histopathological pattern of Moroccan prostate cancer patients while assessing the extent of underdiagnosis risk within the Moroccan population.

Methods

A retrospective cross-sectional study, encompassing 141 cases of prostate cancer, was conducted. Prostate cancer-confirming biopsies were executed at both the University Hospital Hassan II in Fez and the University Hospital Mohammed VI in Oujda between 2015 and 2021. Statistical analysis employed SPSS version 21 software.

Results

The mean age at presentation was 72 years. Prostatic adenocarcinoma emerged as the only histopathological type observed in our patients. Clinically staged diseases (T2, T3, and T4) were manifested in 71.1% of patients. Poorly differentiated tumors (Gleason grades 8, 9, and 10) were identified in 29.2% of cases. The majority of enrolled patients exhibited an intermediate to high-risk disease state.

Conclusions

Our findings underscore the significance of prostate cancer as a substantial public health burden, given the severity of this pathology and the limited accessibility to diagnosis within the population. These results substantiate the necessity for further research into the epidemiology of prostate cancer in Morocco.
Intergenerational transmission of unemployment after apprenticeship graduation: does parental socioeconomic background still matter?
Authors: Dummert Sandra
Published: April 2024

A smooth transition from apprenticeship to standard employment is a key step in the professional biographies of apprenticeship graduates. In this study, the transition of apprenticeship graduates from households that receive unemployment benefits are considered. These graduates are thought to be disadvantaged because their parents’ socioeconomic background is assumed to influence their employment outcomes through processes of intergenerational transmission and cumulative disadvantage. Based on administrative data from the Sample of Integrated Welfare Benefit Biographies (SIG) provided by the Institute for Employment Research (IAB), this analysis offers deeper insights into parental socioeconomic background and the individual factors that affect the risk of unemployment following the completion of an apprenticeship. In the case of an unsuccessful direct transition to standard employment, the factors influencing the duration of the first unemployment are also assessed. The results show that, as with individual characteristics, parents’ education level has a significant effect on the graduates’ risk of unemployment. The duration of the household’s benefit receipt, on the other hand, significantly influences the duration of the first unemployment in the case of an unsuccessful transition following an apprenticeship.
Advancing social care integration in health systems with community health workers: an implementation evaluation based in Bronx, New York
Authors: Fiori Kevin P. , Levano Samantha , Haughton Jessica , Whiskey-LaLanne Renee , Telzak Andrew , Muleta Hemen , Vani Kavita , Chambers Earle C. , Racine Andrew
Published: April 2024

Background

In recent years, health systems have expanded the focus on health equity to include health-related social needs (HRSNs) screening. Community health workers (CHWs) are positioned to address HRSNs by serving as linkages between health systems, social services, and the community. This study describes a health system’s 12-month experience integrating CHWs to navigate HRSNs among primary care patients in Bronx County, NY.

Methods

We organized process and outcome measures using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) implementation framework domains to evaluate a CHW intervention of the Community Health Worker Institute (CHWI). We used descriptive and inferential statistics to assess RE-AIM outcomes and socio-demographic characteristics of patients who self-reported at least 1 HRSN and were referred to and contacted by CHWs between October 2022 and September 2023.

Results

There were 4,420 patients who self-reported HRSNs in the standardized screening tool between October 2022 and September 2023. Of these patients, 1,245 were referred to a CHW who completed the first outreach attempt during the study period. An additional 1,559 patients self-reported HRSNs directly to a clinician or CHW without being screened and were referred to and contacted by a CHW. Of the 2,804 total patients referred, 1,939 (69.2%) were successfully contacted and consented to work with a CHW for HRSN navigation. Overall, 78.1% (n = 1,515) of patients reported receiving social services. Adoption of the CHW clinician champion varied by clinical team (median 22.2%; IQR 13.3–39.0%); however, there was no difference in referral rates between those with and without a clinician champion (p = 0.50). Implementation of CHW referrals via an electronic referral order appeared successful (73.2%) and timely (median 11 days; IQR 2–26 days) compared to standard CHWI practices. Median annual cost per household per CHW for the intervention was determined to be $184.02 (IQR $134.72 – $202.12).

Conclusions

We observed a significant proportion of patients reporting successful receipt of social services following engagement with an integrated CHW model. There are additional implementation factors that require further inquiry and research to understand barriers and enabling factors to integrate CHWs within clinical teams.
Association between TB delay and TB treatment outcomes in HIV-TB co-infected patients: a study based on the multilevel propensity score method
Authors: Liao Rujun , Hu Lin , Yu Jie , Chen Ying , Chen Miaoshuang , Yan Jingmin , Li Xin , Han Xinyue , Jike Chunnong , Yu Gang , Wang Ju , Liao Qiang , Xia Lan , Bai Xuefei , Shi Jinhong , Jiang Tian , Du Liang , Zhang Tao
Published: April 2024

Background

HIV-tuberculosis (HIV-TB) co-infection is a significant public health concern worldwide. TB delay, consisting of patient delay, diagnostic delay, treatment delay, increases the risk of adverse anti-TB treatment (ATT) outcomes. Except for individual level variables, differences in regional levels have been shown to impact the ATT outcomes. However, few studies appropriately considered possible individual and regional level confounding variables. In this study, we aimed to assess the association of TB delay on treatment outcomes in HIV-TB co-infected patients in Liangshan Yi Autonomous Prefecture (Liangshan Prefecture) of China, using a causal inference framework while taking into account individual and regional level factors.

Methods

We conducted a study to analyze data from 2068 patients with HIV-TB co-infection in Liangshan Prefecture from 2019 to 2022. To address potential confounding bias, we used a causal directed acyclic graph (DAG) to select appropriate confounding variables. Further, we controlled for these confounders through multilevel propensity score and inverse probability weighting (IPW).

Results

The successful rate of ATT for patients with HIV-TB co-infection in Liangshan Prefecture was 91.2%. Total delay (OR = 1.411, 95% CI: 1.015, 1.962), diagnostic delay (OR = 1.778, 95% CI: 1.261, 2.508), treatment delay (OR = 1.749, 95% CI: 1.146, 2.668) and health system delay (OR = 1.480 95% CI: (1.035, 2.118) were identified as risk factors for successful ATT outcome. Sensitivity analysis demonstrated the robustness of these findings.

Conclusions

HIV-TB co-infection prevention and control policy in Liangshan Prefecture should prioritize early treatment for diagnosed HIV-TB co-infected patients. It is urgent to improve the health system in Liangshan Prefecture to reduce delays in diagnosis and treatment.
A case of NMDAR Encephalitis with muscular pain as the main presentation
Authors: Li Baizhu , Shang Xiuli
Published: April 2024

Background

Persistent somatoform pain disorder (PSPD) is often the initial diagnosis in patients seeking treatment in psychiatric departments, making it challenging to consider organic nervous system diseases. However, autoimmune encephalitis can present with atypical initial symptoms, leading to misdiagnosis or missed diagnosis. Lumbar puncture, with antibody support, plays a crucial role in diagnosing autoimmune encephalitis.

Case presentation

This report describes a 40-year-old male adult patient who was initially diagnosed with persistent somatoform pain disorder in 2022. The patient reported a reduction in pain while resting on his back. There were no fever or relevant medical history. Despite 8 months of symptomatic treatment, the symptoms did not improve. Moreover, the patient developed confusion, gibberish speech, non-cooperation during questioning, and increased frequency and amplitude of upper limb convulsions. Lumbar puncture revealed elevated protein levels and protein-cell dissociation. The autoimmune encephalitis antibody NMDAR (+) was detected, leading to a diagnosis of autoimmune encephalitis (NMDAR).

Conclusion

Autoimmune encephalitis (NMDAR), starting with persistent somatoform pain (PSPD), often presents with atypical symptoms and can be easily misdiagnosed. Therefore, it is important to consider the possibility of organic nervous system disease in time, and to test serum or cerebrospinal fluid antibodies to rule out organic nervous system disease after symptomatic treatment of mental disorders is ineffective. This approach facilitates the early diagnosis of autoimmune encephalitis and other underlying organic neurological disorders.
Effective coverage of antenatal care services in Ethiopia: a population-based cross-sectional study
Authors: Abdissa Zewditu , Alemu Kassahun , Lemma Seblewengel , Berhanu Della , Defar Atkure , Getachew Theodros , Schellenberg Joanna , Marchant Tanya , Shiferaw Solomon , Tariku Amare , Guadu Tadesse , Taye Girum , Zelalem Meseret , Persson Lars Ake
Published: April 2024

Background

Antenatal care (ANC) is a principal component of safe motherhood and reproductive health strategies across the continuum of care. Although the coverage of antenatal care visits has increased in Ethiopia, there needs to be more evidence of effective coverage of antenatal care. The 'effective coverage' concept can pinpoint where action is required to improve high-quality coverage in Ethiopia. Effective coverage indicates a health system's performance by incorporating need, utilization, and quality into a single measurement. The concept includes the number of contacts, facility readiness, interventions received, and components of services received. This study aimed to measure effective antenatal care coverage in Ethiopia.

Methods

A two-stage cluster sampling method was used and included 2714 women aged 15–49 years and 462 health facilities from six Ethiopian regions from October 2019 to January 2020. The effective coverage cascade was analyzed among the targeted women by computing the proportion who received four or more antenatal care visits where the necessary inputs were available, received iron-folate supplementation and two doses of tetanus vaccination according to process quality components of antenatal care services.

Results

Of all women, 40% (95%CI; 38, 43) had four or more visits, ranging from 3% in Afar to 74% in Addis Ababa. The overall mean health facility readiness score of the facilities serving these women was 70%, the vaccination and iron-folate supplementation coverage was 26%, and the ANC process quality was 64%. As reported by women, the least score was given to the quality component of discussing birth preparedness and complication readiness with providers. In the effective coverage cascade, the input-adjusted, intervention-adjusted, and quality-adjusted antenatal coverage estimates were 28%, 18%, and 12%, respectively.

Conclusion

The overall effective ANC coverage was low, primarily due to a considerable drop in the proportion of women who completed four or more ANC visits. Improving quality of services is crucial to increase ANC up take and completion of the recommended visits along with interventions increasing women’s awareness.
Immunophenotype of lymphocytes and real-world outcome of COVID-19 infection in children with hematology and oncology
Authors: Zhang Na , Wang Zhen , Li Hong , Chen Kai , Wang Hong-sheng , Shao Jing-bo , Jiang Sha-yi , Zhai Xiao-wen , Jiang Hui
Published: April 2024

Background

Patients with immunocompromise were suspected to encounter a high risk for severe coronavirus disease 2019 (COVID-19) infection on early period; however, data is lacking nowadays and immune response remain unclear.

Methods

In this retrospective study, internet questionnaire survey and medical records were acquired in pediatric hematology oncology patients. Clinical severity, immunological characteristics, and outcomes were analyzed from December 1, 2022 to January 31, 2023 at the 3rd year of pandemic in China.

Results

A total of 306 patients were included, with 21 patients (6.9%) asymptomatic, 262 (85.6%) mild severity, 17 (5.6%) moderate severity, 5 (1.6%) severe severity, and 1 (0.3%) critical severity. Seventy-eight (25.5%) patients were on intensive chemotherapy, and 32.0% children were on maintenance chemotherapy. Delays in cancer therapy occurred in 86.7% patients. Univariable analysis revealed active chemotherapy (P < 0.0001), long duration of symptom (P < 0.0001), low lymphocytes count (P = 0.095), low CD3 + and CD8 + T cell count (P = 0.013, P = 0.022), high percentage of CD4 + TCM (P = 0.016), and low percentage of transitional B cells (P = 0.045) were high risk factors for severe COVID-19 infection. Cox regression model showed that the absolute lymphocytes count (P = 0.027) and long duration of symptom (P = 0.002) were the independent factors for severity. Patients with CD8 + dominant and B cell depletion subtype wasn’t related with severity, but had higher percentage of CD8 + effector memory T cells (TEM) and terminally differentiated effector memory T cells (TEMRA) (P < 0.001, P < 0.001), and a longer COVID-19 duration (P = 0.045).

Conclusion

The severity was relatively mild in children with immunodeficiencies in the third year of COVID-19 pandemic. Low lymphocyte count and long duration of symptom were the independent risk factors with COVID-19 severity. Delays in cancer care remain a major concern and the long outcome is pending.
Plummer–Vinson syndrome: a rare occurrence in paediatrics
Authors: Vohra Wasif Ilyas , Sadiq Kamran , Iqbal Mubashir , Rehman Ayaz-ur-
Published: April 2024

Background

Plummer–Vinson syndrome (PVS) is characterized by a triad of symptoms consisting of microcytic hypochromic anaemia, oesophageal webs, and dysphagia. PVS is commonly found in women in the fourth and fifth decades of life and is rarely reported in the paediatric population.

Case presentation

We report the case of a 1-year-old male South Asian child who presented with dysphagia and anaemia for 4 months and frequent episodes of vomiting after ingesting semisolid and solid food. A complete blood analysis revealed microcytic hypochromic anaemia. An oesophagogram revealed circumferential narrowing of the upper thoracic oesophagus. Based on these findings, our suspicion was that the patient had an oesophageal web and vascular ring. Oesophageal dilation was performed with a Savary-Gilliard dilator; initially, 5 mm and 7 mm probes were used, and final dilation with a 9 mm probe was performed.

Conclusion

Although rare in paediatric patients, a high suspicion of this syndrome is necessary in these patients to provide relief to the patient for better growth and development. Iron supplements increase the haemoglobin level but do not subside dysphagia, and oesophageal dilation is needed to open the blocked enteral pathway.