bluuebunny/crossref_metadata_2025 huggingface dataset:
A systematic scoping review on patients’ perceptions of dignity
Authors: Chua Keith Zi Yuan , Quah Elaine Li Ying , Lim Yun Xue , Goh Chloe Keyi , Lim Jieyu , Wan Darius Wei Jun , Ong Simone Meiqi , Chong Chi Sum , Yeo Kennan Zhi Guang , Goh Laura Shih Hui , See Ray Meng , Lee Alexia Sze Inn , Ong Yun Ting , Chiam Min , Ong Eng Koon , Zhou Jamie Xuelian , Lim Crystal , Ong Simon Yew Kuang , Krishna Lalit
Published: July 2022

Background

A socioculturally appropriate appreciation of dignity is pivotal to the effective provision of care for dying patients. Yet concepts of dignity remain poorly defined. To address this gap in understanding and enhance dignity conserving end-of-life care, a review of current concepts of dignity is proposed.

Methods

To address its primary research question “How do patients conceive the concept of dignity at the end of life?”, this review appraises regnant concepts and influences of dignity, and evaluates current dignity conserving practices. To enhance accountability, transparency and reproducibility, this review employs the Ring Theory of Personhood (RToP) as its theoretical lens to guide a Systematic Evidence Based Approach guided Systematic Scoping Review (SSR in SEBA) of patient perspectives of dignity. Three independent teams of reviewers independently analysed included articles from a structured search of PubMed, Embase, PsycINFO, Scopus, CINAHL and Cochrane Databases using thematic and content analyses. The themes and categories identified were compared and combined using the Funnelling Process to create domains that guide the discussion that follows.

Results

Seventy-eight thousand five hundred seventy-five abstracts were identified, 645 articles were reviewed, and 127 articles were included. The three domains identified were definitions of dignity, influences upon perceptions of dignity, and dignity conserving care.

Conclusions

This SSR in SEBA affirms the notion that dignity is intimately entwined with self-concepts of personhood and that effective dignity conserving measures at the end of life must be guided by the patient’s concept of dignity. This SSR in SEBA posits that such personalised culturally sensitive, and timely support of patients, their family and loved ones may be possible through the early and longitudinal application of a RToP based tool.
Earning pocket money and girls’ menstrual hygiene management in Ethiopia: a systematic review and meta-analysis
Authors: Sahiledengle Biniyam , Atlaw Daniel , Kumie Abera , Beressa Girma , Tekalegn Yohannes , Zenbaba Demisu , Woldeyohannes Demelash , Desta Fikreab , Assefa Tesfaye , Bogale Daniel , Nugusu Fikadu , Agho Kingsley Emwinyore
Published: July 2022

Background

Many adolescent girls in Ethiopia and elsewhere missed school during their monthly cycles due to a lack of affordable menstrual absorbent materials or money to buy sanitary pads. So far, few studies have looked into the relationship between earning pocket money and maintaining good menstrual hygiene. Hence, this systematic review and meta-analysis aimed to synthesize the best available evidence regarding the association between earning pocket money and menstrual hygiene management among adolescents in Ethiopia.

Methods

We systematically searched PubMed, Hinari, Science Direct, Cochrane Library, ProQuest, POPLINE, African Journal Online, Direct of Open Access Journals, and Google Scholar for studies examining the association between earning pocket money and menstrual hygiene management among adolescent girls in Ethiopia, without restriction in a publication year. The Joanna Briggs Institute quality assessment tool for the cross-sectional studies was used to assess the quality of included studies. A prefabricated checklist, including variables: first author, publication year, sample size, type of questionnaire, and the region was used to extract data from the selected articles. A random-effect meta-analysis model was used to estimate the pooled odds ratio (OR) of the association between earning pocket money and menstrual hygiene management. The heterogeneity and publication bias was assessed by using I2 test statistics and Egger’s test, respectively.

Results

Data from nine studies involving 4783 adolescent girls were extracted. The meta-analysis revealed that adolescent girls who earned pocket money from their parents or relative had 1.64 times higher odds of having good menstrual hygiene management than their counterparts [pooled OR = 1.64, 95% CI: 1.16–2.34, I2:66.7%, n = 7 (number of studies)]. Similarly, the likelihood of having good menstrual hygiene management was lower by 49% among adolescent girls who did not receive any pocket money from their parents compared to their counterparts (pooled OR = 0.51, 95% CI: 0.35–0.74, I2:48.4%, n = 2).

Conclusions

The findings revealed that adolescent girls who earned pocket money were more likely to practice good menstrual hygiene management. Progress toward better menstrual hygiene will necessitate consideration of this factor.
Classification of multi-differentiated liver cancer pathological images based on deep learning attention mechanism
Authors: Chen Chen , Chen Cheng , Ma Mingrui , Ma Xiaojian , Lv Xiaoyi , Dong Xiaogang , Yan Ziwei , Zhu Min , Chen Jiajia
Published: July 2022

Purpose

Liver cancer is one of the most common malignant tumors in the world, ranking fifth in malignant tumors. The degree of differentiation can reflect the degree of malignancy. The degree of malignancy of liver cancer can be divided into three types: poorly differentiated, moderately differentiated, and well differentiated. Diagnosis and treatment of different levels of differentiation are crucial to the survival rate and survival time of patients. As the gold standard for liver cancer diagnosis, histopathological images can accurately distinguish liver cancers of different levels of differentiation. Therefore, the study of intelligent classification of histopathological images is of great significance to patients with liver cancer. At present, the classification of histopathological images of liver cancer with different degrees of differentiation has disadvantages such as time-consuming, labor-intensive, and large manual investment. In this context, the importance of intelligent classification of histopathological images is obvious.

Methods

Based on the development of a complete data acquisition scheme, this paper applies the SENet deep learning model to the intelligent classification of all types of differentiated liver cancer histopathological images for the first time, and compares it with the four deep learning models of VGG16, ResNet50, ResNet_CBAM, and SKNet. The evaluation indexes adopted in this paper include confusion matrix, Precision, recall, F1 Score, etc. These evaluation indexes can be used to evaluate the model in a very comprehensive and accurate way.

Results

Five different deep learning classification models are applied to collect the data set and evaluate model. The experimental results show that the SENet model has achieved the best classification effect with an accuracy of 95.27%. The model also has good reliability and generalization ability. The experiment proves that the SENet deep learning model has a good application prospect in the intelligent classification of histopathological images.

Conclusions

This study also proves that deep learning has great application value in solving the time-consuming and laborious problems existing in traditional manual film reading, and it has certain practical significance for the intelligent classification research of other cancer histopathological images.
Correlates of turnover intention among nursing staff in the COVID-19 pandemic: a systematic review
Authors: Tolksdorf Katharina Herta , Tischler Ulla , Heinrichs Katherina
Published: July 2022

Background

During the COVID-19 pandemic, shortage of nursing staff became even more evident. Nurses experienced great strain, putting them at risk to leave their jobs. Individual and organizational factors were known to be associated with nurses’ turnover intention before the pandemic. The knowledge of factors associated with turnover intention during the pandemic could help to foster nurses’ retention. Therefore, this review aims to identify factors associated with nurses’ turnover intention during the COVID-19 pandemic.

Methods

After a systematic search of six databases, the resulting records were screened in a two-step process based on pre-defined inclusion and exclusion criteria. The included quantitative studies were synthesized qualitatively due to their methodological heterogeneity.

Results

A total of 19 articles were included in the analysis. Individual factors such as health factors or psychological symptoms and demographic characteristics were associated with nurses’ turnover intention. Organizational factors associated with turnover intention were e.g., caring for COVID-19 patients, low job control or high job demands, and moral distress. Resilience and supporting leadership could mitigate adverse associations with turnover intention.

Conclusions

The results help to identify high-risk groups according to individual factors and to develop possible interventions, such as trainings for nurses and their superiors, addressing individual and organizational factors. Future research should focus on longitudinal designs applying carefully defined concepts of turnover intention.
Recruiting males to the nursing profession: acceptability testing of the ‘Make a Difference with Nursing’ intervention for post-primary school students
Authors: Linden Mark A. , Mitchell Gary , Carlisle Susan , Rainey Debbie , Mulvenna Caroline , Monaghan Catherine
Published: July 2022

Background

The nursing profession is facing a worldwide recruitment shortage which could be partially addressed by recruiting more males. However, in many developed countries numbers of male nurses have traditionally been low. To address this issue we developed and tested a post-primary school-based intervention to recruit more males into the nursing profession.

Methods

Participants included thirty-four  female students drawn from an all-girls post-primary school, fifty-one males from an all-boys post-primary school and seven males and fifteen females drawn from a mixed gender post-primary school, all located in Northern Ireland. Participants were all sixteen years of age and were in receipt of careers education. The intervention titled ‘Make a Difference with Nursing’ was co-designed with careers teachers, nurses and post-primary school students. This video based intervention was created to fit within existing career lessons and featured nursing staff and students describing their experiences of the profession. Participants completed the six domains of Nursing as a Career Choice Questionnaire prior to viewing the intervention and again after viewing.

Results

Positive and statistically significant increases in perceptions of the nursing profession were found between pre and post test scores across all six domains. No statistically significant differences in perceptions were found between males and females after watching the intervention. Comparison by school type showed statistically significant differences on the domains of prior healthcare exposure (p = 0.046; 95% CI -0.19 to 3.79) and job prospects (p = 0.005; 95% CI 1.04 to 7.01). Students from the all-girls school rated these more positively than those from the all-boys and mixed-gender schools.

Conclusions

A short video presentation to post-primary school students is capable of changing how they perceive the nursing profession. Students expressed surprise over the variety of professional nursing roles suggesting that many were not well informed about the realities of nursing. Providing tailored resources for use in careers lessons can better educate students and teachers about nursing and provide positive portrayals of male role models in the profession.
Towards the achievement of universal health coverage in the Democratic Republic of Congo: does the Country walk its talk?
Authors: Nyamugira Alexis Biringanine , Richter Adrian , Furaha Germaine , Flessa Steffen
Published: July 2022

In 2009, the Democratic Republic of Congo (DRC) started its journey towards achieving Universal Health Coverage (UHC). This study examines the evolution of financial risk protection and health outcomes indicators in the context of the commitment of DRC to UHC. To measure the effects of such a commitment on financial risk protection and health outcomes indicators, we analyse whether changes have occurred over the last two decades and, if applicable, when these changes happened. Using five variables as indicators for the measurement of the financial risk protection component, there as well retained three indicators to measure health outcomes. To identify time-related effects, we applied the parametric approach of breakpoint regression to detect whether the UHC journey has brought change and when exactly the change has occurred.

Although there is a slight improvement in the financial risk protection indicators, we found that the adopted strategies have fostered access to healthcare for the wealthiest quantile of the population while neglecting the majority of the poorest. The government did not thrive persistently over the past decade to meet its commitment to allocate adequate funds to health expenditures. In addition, the support from donors appears to be unstable, unpredictable and unsustainable. We found a slight improvement in health outcomes attributable to direct investment in building health centres by the private sector and international organizations. Overall, our findings reveal that the prevention of catastrophic health expenditure is still not sufficiently prioritized by the country, and mostly for the majority of the poorest. Therefore, our work suggests that DRC’s UHC journey has slightly contributed to improve the financial risk protection and health outcomes indicators but much effort should be undertaken.
Predictors of mHealth use in promoting adherence to pre-exposure prophylaxis among female sex workers: an evaluation of the Jichunge intervention in Dar es Salaam, Tanzania
Authors: Mbotwa Christopher , Kazaura Method , Moen Kåre , Leshabari Melkizedeck , Metta Emmy , Leyna Germana , Mmbaga Elia J.
Published: July 2022

Background

There is evidence that pre-exposure prophylaxis (PrEP) is effective in preventing HIV transmission, and PrEP is recommended by the World Health organization (WHO) for use by individuals at high risk of HIV infection. However, low adherence has been reported to hamper its effectiveness. Some evidence indicates that mHealth interventions may be a promising way of promoting PrEP adherence. Nevertheless, evaluations of mHealth interventions in Africa, the region most affected by HIV, are scarce. This study aimed at identifying the extent of and predictors for use of a smartphone based mHealth application among female sex workers in Dar es Salaam, Tanzania.

Methods

As part of a quasi-experimental study in Tanzania, 470 female sex workers who were eligible for PrEP and who owned a smartphone were recruited using respondent driven sampling. All participants were provided with an mHealth application called Jichunge, a smartphone-based app designed to promote adherence to PrEP by offering users information, advise and support during start-up and use of PrEP. We collected data through structured interviews at baseline and extracted user data from the app for a period of 30 days. Modified Poisson regression model with robust standard errors was used to identify predictors for the optimal use of the Jichunge app.

Results

Overall, the optimal use of the Jichunge app was 46.4%. Optimal use was significantly higher among women who were older (aPR = 1.3, 95% CI: 1.10-1.65, p = 0.004 for age 25-34 years, and aPR = 1.6, 95% CI: 1.19-2.07, p = 0.001 for age at least 35 years), who had secondary education or higher (aPR = 1.8, 95% CI: 1.08-2.94, p = 0.023), who had suboptimal social support (aPR = 1.2, 95% CI: 1.02-1.48, p = 0.030), who had high awareness of PrEP (aPR = 1.3, 95% CI: 1.08-1.55, p = 0.005), and who had experience using common mainstream social media applications (aPR = 1.4, 95% CI: 1.08-1.71, p = 0.009).

Conclusion

Optimal use of the Jichunge app was substantially higher among women with higher age, higher education, higher PrEP awareness, less social support, and experience using common social media applications. Individual and interpersonal factors should be considered in planning mHealth interventions. Further studies to determine predictors of longer-term mHealth engagement are needed.

Trial registration

International Clinical Trials Registry Platform PACTR202003823226570; 04.03.2020.
Engineering heterologous enzyme secretion in Yarrowia lipolytica
Authors: Wang Weigao , Blenner Mark A.
Published: July 2022

Background

Eukaryotic cells are often preferred for the production of complex enzymes and biopharmaceuticals due to their ability to form post-translational modifications and inherent quality control system within the endoplasmic reticulum (ER). A non-conventional yeast species, Yarrowia lipolytica, has attracted attention due to its high protein secretion capacity and advanced secretory pathway. Common means of improving protein secretion in Y. lipolytica include codon optimization, increased gene copy number, inducible expression, and secretory tag engineering. In this study, we develop effective strategies to enhance protein secretion using the model heterologous enzyme T4 lysozyme.

Results

By engineering the commonly used native lip2prepro secretion signal, we have successfully improved secreted T4 lysozyme titer by 17-fold. Similar improvements were measured for other heterologous proteins, including hrGFP and $$\alpha$$
α
-amylase. In addition to secretion tag engineering, we engineered the secretory pathway by expanding the ER and co-expressing heterologous enzymes in the secretion tag processing pathway, resulting in combined 50-fold improvement in T4 lysozyme secretion.

Conclusions

Overall, our combined strategies not only proved effective in improving the protein production in Yarrowia lipolytica, but also hint the possible existence of a different mechanism of secretion regulation in ER and Golgi body in this non-conventional yeast.
Efficacy and safety of intravenous daratumumab-based treatments for AL amyloidosis: a systematic review and meta-analysis
Authors: Sun Chunyan , Wang Xiaohong , Zhang Renyi , Xu Lingjie , Wang Bin , Li Jian
Published: July 2022

Background

Intravenous daratumumab (DARA IV) has been increasingly used in the treatment of amyloid light-chain (AL) amyloidosis. However, the outcomes for patients administered with DARA IV have not been aggregated. The objective of this systematic review and meta-analysis was to investigate the efficacy and safety of DARA IV for AL amyloidosis.

Methods

We searched Medline, EMBASE, Cochrane Library and Web of Science up to 17 June 2021. Response rates and survival rates, and the corresponding 95% confidence intervals (CIs) were pooled and calculated using a fixed-effects model.

Results

Thirty studies (5 cohort studies and 25 single-arm studies) with 997 patients were included. In patients receiving DARA IV-based treatments, very good partial response or better response rate, complete response rate, very good partial response rate, partial response rate and overall response rate were 66% (95% CI, 62–69%), 30% (95% CI, 23–36%), 40% (95% CI, 33–46%), 17% (95% CI, 14–21%), and 77% (95% CI, 73–80%), respectively. Cardiac and renal responses were 41% (95% CI, 34–49%) and 43% (95% CI, 32–54%), respectively. 58% (95% CI, 49–66%) of patients achieved PFS one year or longer. 2.5% (range, 1–10.0%) of patients experienced grade 3 or 4 adverse events, of which the most common adverse event was lymphocytopenia (range, 13.6–25.0%).

Conclusion

This study supports the efficacy and safety of DARA IV for the treatment of patients with AL amyloidosis.
Salidroside attenuates neuronal ferroptosis by activating the Nrf2/HO1 signaling pathway in Aβ1-42-induced Alzheimer’s disease mice and glutamate-injured HT22 cells
Authors: Yang Sixia , xie Zeping , Pei Tingting , zeng Yi , Xiong Qiaowu , Wei Hui , Wang Yong , Cheng Weidong
Published: July 2022

Background

Alzheimer’s disease (AD) is a neurodegenerative disease. Ferroptosis plays a critical role in neurodegenerative diseases. Nuclear factor E2-related factor 2 (Nrf2) is considered an important factor in ferroptosis. Studies have demonstrated that salidroside has a potential therapeutic effect on AD. The intrinsic effect of salidroside on ferroptosis is unclear. The purpose of this study was to investigate the protective effects and pharmacological mechanisms of salidroside on alleviating neuronal ferroptosis in Aβ1−42-induced AD mice and glutamate-injured HT22 cells.

Methods

HT22 cells were injured by glutamate (Glu), HT22 cells transfected with siRNA Nrf2, and Aβ1−42-induced WT and Nrf2−/−AD mice were treated with salidroside. The mitochondria ultrastructure, intracellular Fe2+, reactive oxygen species, mitochondrial membrane potential, and lipid peroxidation of HT22 cells were detected. Malondialdehyde, reduced glutathione, oxidized glutathione disulfide, and superoxide dismutase were measured. The novel object recognition test, Y-maze, and open field test were used to investigate the protective effects of salidroside on Aβ1−42-induced WT and Nrf2−/−AD mice. The protein expressions of PTGS2, GPX4, Nrf2, and HO1 in the hippocampus were investigated by Western blot.

Results

Salidroside increased the cell viability and the level of MMP of Glu-injured HT22 cells, reduced the level of lipid peroxidation and ROS, and increased GPX4 and SLC7A11 protein expressions. These changes were not observed in siRNA Nrf2 transfected HT22 cells. Salidroside improved the ultrastructural changes in mitochondria of HT22 cells and Aβ1−42-induced AD mice, but not in Aβ1−42-induced Nrf2−/−AD mice. Salidroside increased protein expression levels of GPX4, HO1, and NQO1 and decreased protein expression of PTGS2 in Aβ1−42-induced AD mice but not in Aβ1−42-induced Nrf2−/−AD mice.

Conclusions

Salidroside plays a neuroprotective role by inhibiting neuronal ferroptosis in Aβ1−42-induced AD mice and Glu-injured HT22 cells, and its mechanism is related to activation of the Nrf2/HO1 signaling pathway.

Graphical Abstract
Fluid accumulation and major adverse kidney events in sepsis: a multicenter observational study
Authors: Mele Alessandro , Cerminara Emanuele , Häbel Henrike , Rodriguez-Galvez Borja , Oldner Anders , Nelson David , Gårdh Johannes , Thobaben Ragnar , Jonmarker Sandra , Cronhjort Maria , Hollenberg Jacob , Mårtensson Johan
Published: July 2022

Background

Whether early fluid accumulation is a risk factor for adverse renal outcomes in septic intensive care unit (ICU) patients remains uncertain. We assessed the association between cumulative fluid balance and major adverse kidney events within 30 days (MAKE30), a composite of death, dialysis, or sustained renal dysfunction, in such patients.

Methods

We performed a multicenter, retrospective observational study in 1834 septic patients admitted to five ICUs in three hospitals in Stockholm, Sweden. We used logistic regression analysis to assess the association between cumulative fluid balance during the first two days in ICU and subsequent risk of MAKE30, adjusted for demographic factors, comorbidities, baseline creatinine, illness severity variables, haemodynamic characteristics, chloride exposure and nephrotoxic drug exposure. We assessed the strength of significant exposure variables using a relative importance analysis.

Results

Overall, 519 (28.3%) patients developed MAKE30. Median (IQR) cumulative fluid balance was 5.3 (2.8–8.1) l in the MAKE30 group and 4.1 (1.9–6.8) l in the no MAKE30 group, with non-resuscitation fluids contributing to approximately half of total fluid input in each group. The adjusted odds ratio for MAKE30 was 1.05 (95% CI 1.02–1.09) per litre cumulative fluid balance. On relative importance analysis, the strongest factors regarding MAKE30 were, in decreasing order, baseline creatinine, cumulative fluid balance, and age. In the secondary outcome analysis, the adjusted odds ratio for dialysis or sustained renal dysfunction was 1.06 (95% CI 1.01–1.11) per litre cumulative fluid balance. On separate sensitivity analyses, lower urine output and early acute kidney injury, respectively, were independently associated with MAKE30, whereas higher fluid input was not.

Conclusions

In ICU patients with sepsis, a higher cumulative fluid balance after 2 days in ICU was associated with subsequent development of major adverse kidney events within 30 days, including death, renal replacement requirement, or persistent renal dysfunction.
Anti-social behaviour in the coronavirus pandemic
Authors: Halford Eric , Dixon Anthony , Farrell Graham
Published: July 2022

Anti-social behaviour recorded by police more than doubled early in the coronavirus pandemic in England and Wales. This was a stark contrast to the steep falls in most types of recorded crime. Why was ASB so different? Was it changes in ‘traditional’ ASB such as noisy neighbours, or was it ASB records of breaches of COVID-19 regulations? Further, why did police-recorded ASB find much larger early-pandemic increases than the Telephone Crime Survey for England and Wales? This study uses two approaches to address the issues. The first is a survey of police forces, via Freedom of Information requests, to determine whether COVID-regulation breaches were recorded as ASB. The second is natural language processing (NLP) used to interrogate the text details of police ASB records. We find police recording practice varied greatly between areas. We conclude that the early-pandemic increases in recorded ASB were primarily due to breaches of COVID regulations but around half of these also involved traditional forms of ASB. We also suggest that the study offers proof of concept that NLP may have significant general potential to exploit untapped police text records in ways that inform policing and crime policy.
PCycDB: a comprehensive and accurate database for fast analysis of phosphorus cycling genes
Authors: Zeng Jiaxiong , Tu Qichao , Yu Xiaoli , Qian Lu , Wang Cheng , Shu Longfei , Liu Fei , Liu Shengwei , Huang Zhijian , He Jianguo , Yan Qingyun , He Zhili
Published: July 2022

Background

Phosphorus (P) is one of the most essential macronutrients on the planet, and microorganisms (including bacteria and archaea) play a key role in P cycling in all living things and ecosystems. However, our comprehensive understanding of key P cycling genes (PCGs) and microorganisms (PCMs) as well as their ecological functions remains elusive even with the rapid advancement of metagenome sequencing technologies. One of major challenges is a lack of a comprehensive and accurately annotated P cycling functional gene database.

Results

In this study, we constructed a well-curated P cycling database (PCycDB) covering 139 gene families and 10 P metabolic processes, including several previously ignored PCGs such as pafA encoding phosphate-insensitive phosphatase, ptxABCD (phosphite-related genes), and novel aepXVWPS genes for 2-aminoethylphosphonate transporters. We achieved an annotation accuracy, positive predictive value (PPV), sensitivity, specificity, and negative predictive value (NPV) of 99.8%, 96.1%, 99.9%, 99.8%, and 99.9%, respectively, for simulated gene datasets. Compared to other orthology databases, PCycDB is more accurate, more comprehensive, and faster to profile the PCGs. We used PCycDB to analyze P cycling microbial communities from representative natural and engineered environments and showed that PCycDB could apply to different environments.

Conclusions

We demonstrate that PCycDB is a powerful tool for advancing our understanding of microbially driven P cycling in the environment with high coverage, high accuracy, and rapid analysis of metagenome sequencing data. The PCycDB is available at https://github.com/ZengJiaxiong/Phosphorus-cycling-database.
Diminazene aceturate mitigates cardiomyopathy by interfering with renin-angiotensin system in a septic rat model
Authors: Lu Zhaoqing , Wu Di , Wang Zheng , Zhang Hanyu , Du Yufan , Wang Guoxing
Published: July 2022

Background

There were limited studies investigating treatments of septic cardiomyopathy (SCM), which is a common complication during sepsis. A septic rat model created by cecal ligation and puncture (CLP) was used to investigate the effects of diminazene aceturate (DIZE) in SCM.

Methods

A total of 151 Wistar rats were randomly assigned into the sham, CLP, or CLP + DIZE group. Data evaluated postoperatively at 6, 12, 24, and 48 hours included: cardiac function; plasma concentrations of tumor necrosis factor-alpha (TNF-α), interleukin-6, angiotensin-(1–7) [Ang-(1–7)], angiotensin II (AngII), troponin I, and brain natriuretic peptide; expression levels of myocardial Ang-(1–7), angiotensin-converting enzyme (ACE), ACE2, and angiotensin type 1 and Mas receptors; and histological changes.

Results

We found that the CLP + DIZE group had a lower mortality compared to the CLP group (38.5% versus 61.5%) within 48 h postoperatively, although without statistical significance. In contrast to the sham group, the CLP group had decreased cardiac functions, increased myocardial injuries, and higher TNF-α levels, which were ameliorated in the CLP + DIZE group. Furthermore, administration of DIZE could reverse the decreases of myocardial Ang-(1–7) and ACE2 expressions in the CLP group, which finally minimized the myocardial microstructure disruptions.

Conclusions

It was concluded that DIZE could mitigate the development of SCM and preserve cardiac function during sepsis possibly by interfering with the renin-angiotensin system through promoting myocardial ACE2 expression and restoring local Ang-(1–7) levels.
Fresh produce as a potential vehicle for transmission of Acinetobacter baumannii
Authors: Ababneh Qutaiba , Al-Rousan Ekhlas , Jaradat Ziad
Published: July 2022

Acinetobacter baumannii is a Gram-negative bacterium that has gained a stronghold inside healthcare settings. Due to the ability of A. baumannii to acquire antibiotic resistance easily, its presence in food products could pose a major threat to the public health. The aim of this study therefore, was to investigate the prevalence of A. baumannii in fresh produce and study their genetic diversity. A total of 234 samples of vegetables and fruits were collected. A. baumannii isolates were identified using CHROMagar and two different PCR assays. Also, the isolates were tested for their ability to resist antibiotics and form biofilms. The genetic diversity of the isolates was determined using multi-locus sequence typing (MLST). Of the 234 samples collected, 10 (6.5%) and 7 (8.75%) A. baumannii isolates were recovered from vegetables and fruits, respectively. Antibiotic susceptibility testing revealed that 4 of these isolates were extensively drug-resistant (XDR). All isolates were able to form biofilms and MLST analysis revealed 6 novel strains. This study demonstrated that fresh produce constitutes a reservoir for A. baumannii, including strong biofilm formers and XDR strains. This represents a significant concern to public health because vegetables and fruits may serve as a vehicle for the spread of A. baumannii and antibiotic resistance into the community and healthcare settings.
Blood and faecal biomarkers to assess dietary energy, protein and amino acid efficiency of utilization by growing and finishing pigs
Authors: Camp Montoro Jordi , Solà-Oriol David , Muns Ramon , Gasa Josep , Llanes Núria , Manzanilla Edgar Garcia
Published: July 2022

Background

Diet evaluation and optimization is a slow and expensive process and it is not possible to do it at a farm level. This study aimed to use the blood serum metabolite (BSM) and faecal volatile fatty acid (VFA) profiles as potential biomarkers to identify changes in protein, amino acid and energy dietary content in growing and finishing pig diets at farm level.

Results

Two studies were conducted. The first study (S1) included 20 pens of 11 pigs (87.0 ± 4.10 kg; 18 weeks old) assigned to 5 diets: control (C1), high or low crude protein (HP1 and LP1, respectively), and high or low net energy (HE1 and LE1, respectively). The second study (S2) included 28 pens of 11 pigs (41.3 ± 2.60 kg; 12 weeks old) assigned to 7 diets: control (C2), high or low crude protein (HP2 and LP2, respectively), high or low amino acid (HA2 and LA2, respectively), and high or low net energy (HE2 and LE2, respectively). Pigs were followed for 10 (S1) and 20 (S2) days, and blood and faecal samples were collected at 20 (S1) and 14 (S2) weeks of age. Data were analysed using general linear models and receiver operating characteristic curve analysis. Urea nitrogen showed the best results as a biomarker. Urea nitrogen was higher in pigs fed high protein diets, HP1 (13.6 ± 0.95 mg/dL) and HP2 (11.6 ± 0.61), compared to those fed low protein diets, LP1 (6.0 ± 0.95) and LP2 (5.2 ± 0.61; P < 0.001), showing good discrimination ability (Area under the curve (AUC) = 98.4 and 100%, respectively). These differences were not observed between diets LA2 (6.5 ± 0.61) and HA2 (8.7 ± 0.61; P > 0.05; AUC = 71.9%), which were formulated based on the ideal protein profile but with no excess of protein. Creatinine, triglycerides, branched-chain fatty acids, albumin, propionic acid, and cholesterol showed differences between at least 2 diets but only in one of the studies.

Conclusions

Urea nitrogen showed high accuracy to detect excess of crude protein in growing and finishing pig diets. Other biomarkers like BCFA showed promising results and need to be further studied.
The Your Rheum story: involvement of young people in rheumatology research
Authors: Esen Ecem , Gnanenthiran Suruthi , Lunt Laura , McDonagh Janet E. ,   Your Rheum, Esen Ecem , Gnanenthiran Suruthi
Published: July 2022

Until recently, young people too often fell into the gaps between services due to restrictive age criteria. Furthermore, their voice was too infrequently heard or was represented by proxies in the form of their caregivers or by adults recalling their youth. The lack of young person involvement in adolescent health research including the arena of paediatric and adolescent chronic disease has been highlighted in current literature. However, the involvement of young people at all stages of health research, from priority setting through to dissemination, is widely advocated. Furthermore, such involvement is considered to be important ethically and, most important of all, has been called for by young people themselves. Young people have clear views about research and these views potentially enhance our understanding of how young people form opinions about research. These opinions in turn informs researchers how to best engage young people (including recruitment and retention) in research. Such involvement of young people ensures that research questions, project methodologies and/or interventions are truly resonant with their lives. This paper describes the development of a national youth advisory group in UK rheumatology, an important addition to the evolving evidence base to support the involvement of young people in rheumatology research. The paper is written with two young people who are members of this group, providing them with an opportunity to learn more about a key component of research—writing papers for publication.
Characteristics of the Washington cannabis market from 2014 to 2016
Authors: Kerr William C. , Ye Yu
Published: July 2022

Background

The state of Washington legalized cannabis for adult use in 2012 and retail stores began to open in 2014. While details of the legal market have been tracked by the state, the total market for cannabis and characteristics of purchasers can only be identified through surveys.

Methods

Six cross-sectional samples of the Privatization of Spirits in Washington (PSW) surveys were collected between January 2014 and October 2016 with two in each year. Random digit dial procedures were used to recruit a sample aged 18 and older, with 40% of cases from mobile phones. A total of 5492 respondents participated. Analyses of the population-weighted sample utilized purchasing amounts and frequencies, use frequency and related measures to estimate total and mean amounts and expenditures. Sensitivity analyses were conducted for key assumptions.

Results

The market for cannabis flower is estimated to have increased from 158 metric tons and $1.23 billion in 2014 to 222 metric tons and $1.7 billion in 2016, with little change from 2014 to 2015. Purchases from legal sources, retail and dispensaries, were estimated at 69% of the total market. Daily or near daily (DND) users accounted for about 83% of sales in 2014, rising to 91% in 2016. The prevalence of past year use rose substantially from 25% in 2014 to 32% in 2016, with DND use rising from 10.2 to 11.3%. Average purchase amounts for DND users rose from 291 g in 2014 to 374 g in 2016, while mean amounts among non-DND users declined from 78 to 28.6 g.

Conclusions

The expansion of retail cannabis stores in Washington appears to have led to increased market size in 2016 with all of the increase attributed to DND users. Frequent users may be important to consider in legalization evaluations.
GnRH agonist as a luteal support in IVF cycle: mini-review—is there a role?
Authors: Maghraby Hasan , Abdelbadie Amr S. , Aboali Ashraf , Elnashar Aboubakr
Published: July 2022

Background

It has been established that assisted reproductive technology (ART) cycles are usually accompanied by a defective luteal phase, and that luteal phase support (LPS) is mandatory to improve reproductive outcomes. This review aims to summarize the hypothesis, safety and current evidence about GnRH agonist as a luteal phase support in ART.

Main body

There are many regimens of luteal phase support to improve ART outcomes in women undergoing fresh and thawed cycles. Luteal phase support drugs include progesterone, human chorionic gonadotropin, gonadotropin-releasing hormone agonist, estradiol, and recombinant luteinizing hormone. There is some debate about optimal drugs and timing for start of LPS in ART cycles.

Conclusion

Although most centers support luteal phase by vaginal progesterone, GnRH agonist is a debatable drug for luteal support cycles.
Single port laparoscopic-assisted ovarian cystectomy using optical forceps in neonates: a brief technical report
Authors: Said Hanan , Shafik Yasmine , Faiz Mohammed , Bawazir Osama , Alhallaq Obada , Abdulmoez Asmaa , Al Dahshan Yasser
Published: July 2022

Background

The management of neonatal ovarian cysts is often demanding. However, offering surgery as a definitive treatment for patients who lack easy access to healthcare for follow-up is reasonable. Minimally invasive, ovary-sparing surgery provides benefits, including shorter operative times, hospital stay, and superior cosmesis. The novel modification described here renders added value because it utilizes readily available and reusable instruments, averts the need for multiple ports and large incisions, and is essentially time-saving.

So, the aim of the study is to evaluate the safety and feasibility and describe the use of optical forceps during single-port laparoscopic-assisted (SPLA) ovarian cystectomy in a specific cohort of neonates with simple/complicated ovarian cysts.

Results

Neonates who required ovarian cystectomy/salpingo-oophorectomy, admitted from January 2015 to December 2019 and fulfilled the inclusion criteria, were treated with optical forceps during SPLA. After the surgery, we put in place a follow-up protocol to monitor complications and recurrences.

Twenty-one neonates were included. The average gestational age was 37.2 ± 1.6 weeks, operative time was 43.2 ± 2.4 min, and length of hospital stay was 2.4 ± 0.5 days. In our experiment, there was no encounter with complications, recurrences, or ones that required conversion to laparotomy, nor did we require the use of extra ports.

Conclusion

SPLA procedures using optical forceps for managing neonatal cysts requiring surgery appear to be a safe and achievable option by allowing complete visualization of the cyst/lesion. It also has an excellent cosmetic result with a near-normal umbilicus scar. Further research is required to compare this method to open and laparoscopic standards.
Looking forward to a decade of the biopsychosocial model
Authors: Bolton Derek
Published: July 2022

The topic of this article is the biopsychosocial model. My main contention is that – notwithstanding doubts as to what exactly it is, or indeed whether it is anything – there is a coherent account of it, in terms of both applications to particular health conditions and mechanisms with wide application. There is accumulating evidence from recent decades that psychosocial as well as biological factors are implicated in the aetiology and treatment of a large range of physical as well as mental health conditions. The original proposer of the biopsychosocial model, George Engel, back in 1977, was substantially correct about what he saw was on its way.
Six nations: a clinical scenario comparison of systems for prisoners with psychosis in Australia, Bolivia and four European nations
Authors: Aboaja Anne , Pandurangi Prashant , Almeida Susana , Castelletti Luca , Rivera-Arroyo Guillermo , Opitz-Welke Annette , Welke Justus , Barlow Stephen
Published: July 2022

This paper compares across six nations the mental health systems available to prisoners with the highest acuity of psychosis and risk combined with the lowest level of insight into the need for treatment. Variations were observed within and between nations. Findings highlight the likely impact of factors such as mental health legislation and the prison mental health workforce on a nation's ability to deliver timely and effective treatment close to home for prisoners who lack capacity to consent to treatment for their severe mental illness. The potential benefits of addressing the resulting inequalities are noted.
A Prospective Study on Continuous Glucose Monitoring in Glycogen Storage Disease Type Ia: Toward Glycemic Targets
Authors: Rossi Alessandro , Venema Annieke , Haarsma Petra , Feldbrugge Lude , Burghard Rob , Rodriguez-Buritica David , Parenti Giancarlo , Oosterveer Maaike H , Derks Terry G J
Published: July 2022

Context

Although previous research has shown the benefit of continuous glucose monitoring (CGM) for hepatic glycogen storage diseases (GSDs), current lack of prospectively collected CGM metrics and glycemic targets for CGM-derived outcomes in the hepatic GSD population limits its use.

Objective

To assess CGM metrics for glycemic variation and glycemic control in adult patients with GSDIa as compared to matched healthy volunteers.

Design

Prospective CGM data were collected during the ENGLUPRO GSDIa trial (NCT04311307) in which a Dexcom G6 device was used. Ten adult patients with GSDIa and 10 age-, sex- and body mass index–matched healthy volunteers were enrolled. Capillary blood glucose was concurrently measured during 2 standardized 2-hour time intervals. Descriptive [eg, glycemic variability (GV), time below range, time in range (TIR), time above range (TAR)] and advanced (ie, first- and second-order derivatives, Fourier analysis) CGM outcomes were calculated. For each descriptive CGM outcome measure, 95% CIs were computed in patients with GSDIa and healthy volunteers, respectively.

Results

CGM overestimation was higher under preprandial and level 1 hypoglycemia (ie, capillary glucose values ≥ 3.0 mmol/L and < 3.9 mmol/L) conditions. GV and TAR were higher while TIR was lower in patients with GSDIa compared to healthy volunteers (P < 0.05). Three patients with GSDIa showed descriptive CGM outcomes outside the calculated 95% CI in GSDIa patients. Advanced CGM analysis revealed a distinct pattern (ie, first- and second-order derivatives and glucose curve amplitude) in each of these 3 patients within the patients group.

Conclusions

This is the first study to prospectively compare CGM outcomes between adult patients with GSDIa and matched healthy volunteers. The generation of a set of CGM metrics will provide guidance in using and interpreting CGM data in GSDIa and will be useful for the definition of glycemic targets for CGM in patients with GSDIa. Future studies should investigate the prognostic value of CGM outcomes and their major determinants in patients with GSDIa.
TWIST1 interacts with β/δ-catenins during neural tube development and regulates fate transition in cranial neural crest cells
Authors: Bertol Jessica W. , Johnston Shelby , Ahmed Rabia , Xie Victoria K. , Hubka Kelsea M. , Cruz Lissette , Nitschke Larissa , Stetsiv Marta , Goering Jeremy P. , Nistor Paul , Lowell Sally , Hoskens Hanne , Claes Peter , Weinberg Seth M. , Saadi Irfan , Farach-Carson Mary C. , Fakhouri Walid D.
Published: July 2022

Cell fate determination is a necessary and tightly regulated process for producing different cell types and structures during development. Cranial neural crest cells (CNCCs) are unique to vertebrate embryos and emerge from the neural plate borders into multiple cell lineages that differentiate into bone, cartilage, neurons and glial cells. We have previously reported that Irf6 genetically interacts with Twist1 during CNCC-derived tissue formation. Here, we have investigated the mechanistic role of Twist1 and Irf6 at early stages of craniofacial development. Our data indicate that TWIST1 is expressed in endocytic vesicles at the apical surface and interacts with β/δ-catenins during neural tube closure, and Irf6 is involved in defining neural fold borders by restricting AP2α expression. Twist1 suppresses Irf6 and other epithelial genes in CNCCs during the epithelial-to-mesenchymal transition (EMT) process and cell migration. Conversely, a loss of Twist1 leads to a sustained expression of epithelial and cell adhesion markers in migratory CNCCs. Disruption of TWIST1 phosphorylation in vivo leads to epidermal blebbing, edema, neural tube defects and CNCC-derived structural abnormalities. Altogether, this study describes a previously uncharacterized function of mammalian Twist1 and Irf6 in the neural tube and CNCCs, and provides new target genes for Twist1 that are involved in cytoskeletal remodeling.
A transcriptionally repressed quiescence program is associated with paused RNA polymerase II and is poised for cell cycle re-entry
Authors: Gala Hardik P. , Saha Debarya , Venugopal Nisha , Aloysius Ajoy , Purohit Gunjan , Dhawan Jyotsna
Published: July 2022

Adult stem cells persist in mammalian tissues by entering a state of reversible quiescence, referred to as G0, which is associated with low levels of transcription. Using cultured myoblasts and muscle stem cells, we report that in G0, global RNA content and synthesis are substantially repressed, correlating with decreased RNA polymerase II (RNAPII) expression and activation. Integrating RNAPII occupancy and transcriptome profiling, we identify repressed networks and a role for promoter-proximal RNAPII pausing in G0. Strikingly, RNAPII shows enhanced pausing in G0 on repressed genes encoding regulators of RNA biogenesis (such as Ncl, Rps24, Ctdp1), and release of pausing is associated with increased expression of these genes in G1. Knockdown of these transcripts in proliferating cells leads to induction of G0 markers, confirming the importance of their repression in establishment of G0. A targeted screen of RNAPII regulators revealed that knockdown of Aff4 (a positive regulator of elongation) unexpectedly enhances expression of G0-stalled genes and hastens S phase; however, the negative elongation factor (NELF) complex, a regulator of pausing, appears to be dispensable. We propose that RNAPII pausing contributes to transcriptional control of a subset of G0-repressed genes to maintain quiescence and impacts the timing of the G0-G1 transition.

This article has an associated First Person interview with the first authors of the paper.