bluuebunny/crossref_metadata_2025 huggingface dataset:
Inter-professional collaboration and associated factors among nurses and physicians in specialized public hospitals, the northwest, Ethiopia: mixed method multi-centered cross-sectional study
Authors: Degu Tadele , Amsalu Eden , Kebede Awoke , Adal Ousman
Published: April 2023

Objective

The study aimed to investigate inter-professional collaboration and associated factors among nurses and physicians working in referral and teaching hospitals in the Northwest and Ethiopia in 2022.

Method

This study used a concurrent (quantitative cross-sectional and phenomenological qualitative) design from September to October 2022. A structured, self-administered nurse-physician collaborative scale questionnaire was used to collect quantitative data from 279 nurses and 87 physicians. A simple random sampling technique was used to select participants. The magnitude of the association was measured using the odds ratio at a 95% confidence interval and was statistically significant at a p-value less than 0.05 using binary logistic regression analysis. Qualitative data were collected from nine key informants via focused interviews or semi-structured in-depth interviews and analyzed using ATLAS.ti version 7.0.7 software via narratives using the thematic analysis method.

Result

According to the study’s findings, a greater number (43.4%) of the respondents had ineffective collaboration during their professional activities. In the final model of multivariable analysis, unsatisfactory organizational support, poor professional support, and poor interpersonal support were all independently associated with ineffective collaboration. The qualitative findings identified poor communication, a lack of professionalism, and failure to adhere to professional duties as barriers to nurse-physician collaboration.

Conclusion

In this study, nurse-physician collaboration was less than expected; thus, the large number of participants had ineffective collaborations. Potential predictors of decreased effective nurse-physician collaboration included dissatisfaction with organizational support, poor professional support, and poor interpersonal support. This outcome emphasizes the importance of improving nurse-physician collaboration by enhancing organizational, professional, and interpersonal factors to form effective collaborative practice. The qualitative finding supports the quantitative study, which showed ineffective collaboration. The authors recommended that there is a need to empower interprofessional collaboration among nurses and physicians through the creation of a conducive and safe working environment.
Disabled people’s experiences accessing healthcare services during the COVID-19 pandemic: a scoping review
Authors: McBride-Henry Karen , Nazari Orakani Solmaz , Good Gretchen , Roguski Michael , Officer Tara N.
Published: April 2023

Background

Disruptions to healthcare services during the COVID-19 pandemic are well-recognised problems. However, a dearth of research exists on disabled people’s experiences with accessing these services. A scoping review was undertaken to identify and explore research on the experience of disabled people in accessing healthcare services between 2020 and 6 February 2023.

Methods

PubMed, Web of Science, CINAHL, and OVID were employed to search for research that included the voice of disabled people, or their parents or caregivers. Over two distinct phases, a total of 2,201 articles were reviewed according to article titles, keywords, and abstracts. Eighty-one studies were identified that met the inclusion criteria; these were reviewed in full.

Results

Eighteen studies specifically described the experiences of accessing healthcare or disability services, and sixty-three raised healthcare challenges as a secondary consideration. Many disabled people struggled to access healthcare services and felt they were invisible; as a result, individuals’ mental health was negatively affected. Disabled people with compounding vulnerabilities were at the most risk of experiencing a lack of healthcare access.

Conclusions

There is an urgent need for research and policy that is responsive to disabled people’s access to healthcare during the pandemic; currently many health policies are ‘disability-blind’ and exclude these members of the global community. Furthermore, to assist in creating disability-responsive research, funding needs to prioritise researchers within the disabled community.
Genetic liability to age at first sex and birth in relation to cardiovascular diseases: a Mendelian randomization study
Authors: Chen Miao , Wang Zhen , Xu Hongfei , Chen Xiaofang , Teng Peng , Ma Liang
Published: April 2023

Background

Growing evidence suggests that various reproductive factors, including early menarche, early menopause, and age at first birth, may increase the risk of developing cardiovascular disease (CVD) later in life. However, the associations between reproductive factors and CVDs are inconsistent and controversial. Therefore, we conducted a two-sample Mendelian randomization (MR) analysis to explore the potential links between age at first sex (AFS) and age at first birth (AFB) and several CVDs.

Methods

We obtained summary statistics for exposure from the largest genome-wide association studies of AFS and AFB. To serve as instrumental variables, we selected 259 SNPs associated with AFS and 81 SNPs associated with AFB at the genome-wide significance level. We employed a random-effects inverse-variance weighted method to pool estimates, and conducted multivariable MR analysis to determine the direct association between AFS and AFB with CVDs, while accounting for the effects of confounders.

Results

The genetic liability to later AFS was associated with decreased risks of heart failure (odd ratio [OR] 0.700; 95% confidence interval [CI] 0.639–0.767; p = 2.23 × 10−14), coronary artery disease (OR 0.728; 95% CI 0.657–0.808; p = 1.82 × 10−9), myocardial infarction (OR 0.731; 95% CI 0.657–0.813; p = 8.33 × 10−9), stroke (OR 0.747; 95% CI 0.684–0.816; p = 6.89 × 10−11), and atrial fibrillation (OR 0.871; 95% CI 0.806–0.941; p = 4.48 × 10−4). The genetic liability to later AFB was also associated with decreased risks of CVDs, including myocardial infarction (OR 0.895; 95% CI 0.852–0.940; p = 8.66 × 10−6), coronary heart disease (OR 0.901; 95% CI 0.860–0.943; p = 9.02 × 10−6), heart failure (OR 0.925; 95% CI 0.891–0.961; p = 5.32 × 10−5), and atrial fibrillation (OR 0.944; 95% CI 0.911–0.978; p = 0.001). However, no association was found between AFB and stroke. The associations remained independent from the effects of AFS and AFB on potential confounders, including smoking, alcohol intake, body mass index, and depression. Mediation analysis suggested that education attainment partly mediates the link from AFS and AFB to CVD outcomes.

Conclusion

Our results observed a causal relationship between later AFS, AFB and lower CVDs risk; it emphasizes the importance of providing sex education since early sex and birth may have undesirable effects. Cardiovascular risk stratification that considers reproductive factors may help address CVD risk.
Effectiveness and economic impact of Dupilumab in asthma: a population-based cohort study
Authors: Faverio Paola , Ronco Raffaella , Monzio Compagnoni Matteo , Franchi Matteo , Franco Giovanni , Bonaiti Giulia , Bonifazi Martina , Mei Federico , Luppi Fabrizio , Pesci Alberto , Corrao Giovanni
Published: April 2023

Rationale

Severe asthma is burdened by relevant socio-economic and clinical impact. Randomized controlled trials on Dupilumab showed efficacy and a good safety profile, but post-market studies are needed.

Objectives

To evaluate the impact of Dupilumab on (i) the use of anti-asthmatic drugs, including oral corticosteroids (OCS), (ii) the rates of asthma exacerbation-related hospital admissions, and (iii) the healthcare costs in patients with asthma.

Methods

Data were retrieved from Healthcare Utilization database of Lombardy region (Italy). We compared healthcare resources use between the 6 months after Dupilumab initiation (“post-intervention period”) and (i) the 6 months before Dupilumab initiation (“wash-out period”) and (ii) the corresponding 6 months of the prior year (“pre-intervention period”).

Main results

In a cohort of 176 patients, Dupilumab significantly reduced anti-asthmatic drugs use (including OCS and short-acting β2-agonists, inhaled corticosteroids (ICS)/long-acting β2-agonists and ICS alone) when comparing the “pre-intervention” to the “post-intervention” period. When considering hospital admissions, we observed a not statistically or marginally significant reduction between both periods before Dupilumab and the post-intervention period. Six-months discontinuation rate was 8%. Overall healthcare costs had a tenfold increase between the “pre-intervention” and “post-intervention” period, which was mainly led by the biologic drug cost. Conversely, expenditures connected to hospital admissions did not change.

Conclusions

Our real-world investigation suggests that Dupilumab reduced anti-asthmatic drugs use, including OCS, in comparison to a corresponding period in the prior year. However, long-term healthcare sustainability remains an open issue.
FUT2 inhibits the EMT and metastasis of colorectal cancer by increasing LRP1 fucosylation
Authors: He Lingnan , Guo Zijun , Wang Weijun , Tian Shuxin , Lin Rong
Published: April 2023

Background

Fucosyltransferase 2(FUT2) and its induced α-1,2 fucosylation is associated with cancer metastasis. However, the role of FUT2 in colorectal cancer (CRC) metastasis remains unclear.

Methods

The expression levels and clinical analyses of FUT2 were assessed in CRC samples. Migration and invasion assays, EMT detection, nude mice peritoneal dissemination models and intestinal specific FUT2 knockout mice (FUT2△IEC mice) were used to investigate the effect of FUT2 on metastasis in colorectal cancer. Quantitative proteomics study of glycosylated protein, UEA enrichment, Co-immunoprecipitation identified the mediator of the invasive-inhibiting effects of FUT2.

Results

FUT2 is downregulated in CRC tissues and is positively correlated with the survival of CRC patients. FUT2 is an inhibitor of colorectal cancer metastasis which, when overexpressed, suppresses invasion and tumor dissemination in vitro and in vivo. FUT2 knock-out mice (FUT2△IEC mice) develop AMO and DSS-induced tumors and promote EMT in colorectal cancers. FUT2-induced α-1,2 fucosylation impacts the ability of low-density lipoprotein receptor-related protein 1(LRP1) to suppress colorectal cancer invasion.

Conclusions

Our study demonstrated that FUT2 induces α-1,2 fucosylation and inhibits EMT and metastasis of colorectal cancer through LRP1 fucosylation, suggesting that FUT2 may serve as a therapeutic target for colorectal cancer.
miRNA-seq identification and clinical validation of CD138+ and circulating miR-25 in treatment response of multiple myeloma
Authors: Papadimitriou Maria-Alexandra , Soureas Konstantinos , Papanota Aristea-Maria , Tsiakanikas Panagiotis , Adamopoulos Panagiotis G. , Ntanasis-Stathopoulos Ioannis , Malandrakis Panagiotis , Gavriatopoulou Maria , Sideris Diamantis C. , Kastritis Efstathios , Avgeris Margaritis , Dimopoulos Meletios-Athanasios , Terpos Evangelos , Scorilas Andreas
Published: April 2023

Background

Despite significant advancements in multiple myeloma (MM) therapy, the highly heterogenous treatment response hinders reliable prognosis and tailored therapeutics. Herein, we have studied the clinical utility of miRNAs in ameliorating patients’ management.

Methods

miRNA-seq was performed in bone marrow CD138+ plasma cells (PCs) of 24 MM and smoldering MM (sMM) patients to analyze miRNAs profile. CD138+ and circulating miR-25 levels were quantified usingin houseRT-qPCR assays in our screening MM/sMM cohort (CD138+ plasma cells n = 167; subcohort of MM peripheral plasma samples n = 69). Two external datasets (Kryukov et al.cohort n = 149; MMRF CoMMpass study n = 760) served as institutional-independent validation cohorts. Patients’ mortality and disease progression were assessed as clinical endpoints. Internal validation was performed by bootstrap analysis. Clinical benefit was estimated by decision curve analysis.

Results

miRNA-seq highlighted miR-25 of CD138+ plasma cells to be upregulated in MMvs.sMM, R-ISS II/IIIvs.R-ISS I, and in progressed compared to progression-free patients. The analysis of our screening cohort highlighted that CD138+ miR-25 levels were correlated with short-term progression (HR = 2.729; p = 0.009) and poor survival (HR = 4.581; p = 0.004) of the patients; which was confirmed by Kryukov et al.cohort (HR = 1.878; p = 0.005) and MMRF CoMMpass study (HR = 1.414; p = 0.039) validation cohorts. Moreover, multivariate miR-25-fitted models contributed to superior risk-stratification and clinical benefit in MM prognostication. Finally, elevated miR-25 circulating levels were correlated with poor survival of MM patients (HR = 5.435; p = 0.021), serving as a potent non-invasive molecular prognostic tool.

Conclusions

Our study identified miR-25 overexpression as a powerful independent predictor of poor treatment outcome and post-treatment progression, aiding towards modern non-invasive disease prognosis and personalized treatment decisions.
Emotional and informational social support from health visitors and breastfeeding outcomes in the UK
Authors: Chambers A , Emmott EH , Myers S , Page AE
Published: April 2023

Background

Shorter breastfeeding duration is associated with detrimental consequences for infant health/development and maternal health. Previous studies suggest social support is essential in maintaining breast/chest-feeding and helping to improve general infant feeding experiences. Public health bodies therefore work to support breastfeeding in the UK, yet UK breastfeeding rates continue to be one of the lowest globally. With this, a better understanding of the effectiveness and quality of infant feeding support is required. In the UK, health visitors (community public health nurses specialising in working with families with a child aged 0–5 years) have been positioned as one of the key providers of breast/chest-feeding support. Research evidence suggests that both inadequate informational support and poor/negative emotional support can lead to poor breastfeeding experiences and early breastfeeding cessation. Thus, this study tests the hypothesis that emotional support from health visitors moderates the relationship between informational support and breastfeeding duration/infant feeding experience among UK mothers.

Methods

We ran cox and binary logistic regression models on data from 565 UK mothers, collected as part of a 2017–2018 retrospective online survey on social support and infant feeding.

Results

Informational support, compared to emotional support, was a less important predictor of both breastfeeding duration and experience. Supportive emotional support with unhelpful or absent informational support was associated with the lowest hazard of breastfeeding cessation before 3 months. Results for breastfeeding experience followed similar trends, where positive experience was associated with supportive emotional and unhelpful informational support. Negative experiences were less consistent; however, a higher probability of negative experience was found when both types of support were reported as unsupportive.

Conclusions

Our findings point to the importance of health visitors providing emotional support to bolster the continuation of breastfeeding and encourage a positive subjective experience of infant feeding. The emphasis of emotional support in our results encourages increased allocation of resources and training opportunities to ensure health visitors are able to provide enhanced emotional support. Lowering health visitors caseloads to allow for personalised care is just one actionable example that may improve breastfeeding outcomes in the UK.
Developing a typology of network alteration strategies for implementation: a scoping review and iterative synthesis
Authors: Bunger Alicia C. , Yousefi-Nooraie Reza , Warren Keith , Cao Qiuchang , Dadgostar Porooshat , Bustos Tatiana E.
Published: April 2023

Background

Social networks transmit knowledge, influence, and resources. These relationships among patients, professionals, and organizations can shape how innovations are disseminated, adopted, implemented, and sustained. Network alteration interventions—interventions that change or rewire social networks—have the potential to be used as implementation strategies. Yet, the types, mechanisms, and effectiveness of these interventions for implementation are unclear. This scoping review and iterative synthesis identified and described network alteration strategies that could be tested for implementation.

Methods

We used forward and backward citation tracking of influential articles on network interventions, bibliometric searches, and hand searches of peer-reviewed social network journals. At least two team members screened article titles/abstracts to identify studies that met inclusion criteria: empirical studies of an intervention, the intervention was designed to alter some element of a social network, and changes in social network metrics were measured at two or more time points. During full-text reviews, information about the network interventions, actors, ties, and main findings was extracted. Reporting was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). To develop our typology, we synthesized these results using an iterative team-based and consensus-building process.

Results

Fifty-three articles met the inclusion criteria. The interventions described were conducted in healthcare systems or behavioral health systems (34%), communities (26.4%), and schools (22.6%). The majority included records describing interventions designed to alter social support, information-sharing, or friendship networks (65%) among individual actors (84.9%), or to increase ties. Eight strategies emerged. Three strategies targeted the general context: (1) change the environment, (2) create groups, and (3) change the composition. Four strategies targeted individual actors: change (4) motivations, (5) skills for networking, (6) knowledge of one’s social network, and (7) prominence/roles. One strategy (8) targeted specific ties within the network (targeting a particular pair-wise relationship or changing the nature of an existing tie).

Conclusion

The network alteration strategies in this typology provide further operational specificity for how implementation strategies target relationships. Advancing these strategies will require greater theoretical specification, the development of strategies that target professionals and organizations, and studies that examine the impact on implementation outcomes.
Managing postoperative atrial fibrillation after open-heart surgery using transdermal β1 blockers
Authors: Yamamoto Kenji , Miwa Senri , Yamada Tomoyuki , Setozaki Shuji , Hamuro Mamoru , Kurokawa Shunji , Enomoto Sakae
Published: April 2023

Background

Postoperative atrial fibrillation (POAF) after open-heart surgery is a non-negligible complication. We aimed to describe the efficacy of a transdermal patch of bisoprolol for managing POAF and flutter in thoracic surgical procedures.

Methods

We analyzed the data of 384 patients who underwent open-heart surgery at our hospital and received oral bisoprolol to prevent POAF. Among them, 65 patients (16.9%) also received a 4-mg transdermal patch of bisoprolol to control the heart rate due to POAF. We applied the bisoprolol transdermal patch when the heart rate was > 80 bpm and removed it at ≤ 60 bpm; an additional patch was applied when the heart rate was > 140 bpm. Heparin calcium injections were administered twice daily for anticoagulation between 2 and 6 days postoperatively.

Results

The average number of prescriptions for transdermal patches of bisoprolol during hospitalization was 1.8 ± 1.1 (1–5). The median first prescription date was on postoperative day 2 (range: days 0–37). Sinus rhythm recovered within 24 h in 18 patients (27.7%). Eight patients (12.3%) were switched to continuous landiolol infusion because of persistent tachycardia. In three patients, the transdermal patch was removed owing to severe bradycardia. Fifteen patients experienced persistent atrial fibrillation and were treated with electrical cardioversion during hospitalization. We did not observe any serious complications that could be directly attributed to bisoprolol transdermal patch use.

Conclusions

Single-use bisoprolol transdermal patch may help control the heart rate during the initial treatment of POAF after open-heart surgery.
How I prescribe prolonged intermittent renal replacement therapy
Authors: Clark Edward G. , Vijayan Anitha
Published: April 2023

Prolonged Intermittent Renal Replacement Therapy (PIRRT) is the term used to define ‘hybrid’ forms of renal replacement therapy. PIRRT can be provided using an intermittent hemodialysis machine or a continuous renal replacement therapy (CRRT) machine. Treatments are provided for a longer duration than typical intermittent hemodialysis treatments (6–12 h vs. 3–4 h, respectively) but not 24 h per day as is done for continuous renal replacement therapy (CRRT). Usually, PIRRT treatments are provided 4 to 7 times per week. PIRRT is a cost-effective and flexible modality with which to safely provide RRT for critically ill patients. We present a brief review on the use of PIRRT in the ICU with a focus on how we prescribe it in that setting.
Endocervical adenocarcinoma implantation in episiotomy scar: a case report and review of the literature
Authors: Yarandi Fariba , Aghili Mahdi , Ramhormozian Sara , Shirali Elham
Published: April 2023

Background

Cervical cancer is a rare malignancy in the 1st months of pregnancy. Implantation of this cancer in an episiotomy scar is a condition that is rarely reported.

Case presentation

We reviewed the literature on this condition and reported a 38 year-old Persian patient who had been diagnosed with cervical cancer, clinically stage IB1, 5 months after a term vaginal delivery. She underwent transabdominal radical hysterectomy with ovarian preservation. Two months later she presented with a mass-like lesion in the episiotomy scar which was proved to be of cervical adenocarcinoma origin after biopsy. The patient was scheduled for chemotherapy with interstitial brachytherapy, an alternative to wide local resection, with successful long-term disease-free survival.

Conclusion

Implantation of adenocarcinoma in an episiotomy scar is a rare occurrence in patients with a history of cervical cancer and previous vaginal delivery near the time of diagnosis which requires extensive local excision as a primary treatment when feasible. The proximity of the lesion to the anus can lead to major complications of extensive surgery. Alternative chemoradiation combined with interstitial brachytherapy can be successful in eliminating cancer recurrence without compromising the functional outcome.
Pediatric lymphatic leishmaniasis: a case report
Authors: Kindie Endeshaw Asaye , Yefter Ermias Teklehaimanot , Alemu Bewketu Abebe , Gurji Tiruzer Bekele , Tadesse Amanuel Kassa
Published: April 2023

Background

There are three main forms of leishmaniases: visceral (the most serious form because it is almost always fatal without treatment), cutaneous (the most common, usually causing skin ulcers), and mucocutaneous (affecting mouth, nose, and throat). Leishmaniasis is caused by protozoan parasites, which are transmitted by the bite of infected female phlebotomine sandflies. The disease affects some of the world’s poorest people and is associated with malnutrition, population displacement, poor housing, a weak immune system, and lack of financial resources. An estimated 700,000 to 1 million new cases occur annually. Only a small fraction of those infected by parasites causing leishmaniasis will eventually develop the disease. We report a case of exclusive lymph node involvement in leishmaniasis, presenting as localized lymphadenopathies. The diagnosis of lymphatic leishmaniasis was confirmed by the presence of Leishmania donovani bodies in fine needle aspiration cytology, and positive anti-rK39 antibodies. The bone marrow aspiration was negative for Leishmania donovani bodies. Abdominal ultrasound was done and there was no organomegaly. Furthermore, localized lymphadenopathies may provide a diagnostic challenge by clinically mimicking a lymphoma or other causes of lymphadenopathy. Due to its rarity and its tendency to pose a clinical diagnostic challenge, we decided to report a case of lymphatic leishmaniasis.

Case presentation

A 12-year-old Amara male patient presented to the University of Gondar comprehensive specialized hospital, Northwestern Ethiopia, with six discrete right lateral cervical lymphadenopathies, the largest measuring 3 × 2 cm2, with no cutaneous lesion. Fine needle aspiration cytology confirmed the diagnosis of leishmaniasis in lymph node, and he was put on sodium stibogluconate (20 mg/kg body weight/day) and paromomycin (15 mg/kg body weight/day) injections, which are given intramuscularly for 17 days. Having completed his medication at the University of Gondar comprehensive specialized hospital, he had a smooth course and was discharged with appointment scheduled for follow-up after 3 months.

Conclusion

In the clinical evaluation of a patient with isolated lymphadenopathies, leishmaniasis must be considered as a differential diagnosis in immunocompetent subjects in endemic areas for early diagnostic workup and management.
Association between interleukin-10 gene polymorphisms (rs1800871, rs1800872, and rs1800896) and severity of infection in different SARS-CoV-2 variants
Authors: Abbood Sattar Jabbar Abbood , Anvari Enayat , Fateh Abolfazl
Published: April 2023

Background

Polymorphisms in the interleukin-10 (IL10) gene have been linked to the severity of the patients infected with the viral infections. This study aimed to assess if the IL10 gene polymorphisms rs1800871, rs1800872, and rs1800896 were linked to coronavirus disease 19 (COVID-19) mortality in different severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants in the Iranian population.

Methods

For genotyping IL10 rs1800871, rs1800872, and rs1800896, this study used the polymerase chain reaction-restriction fragment length polymorphism method in 1,734 recovered and 1,450 deceased patients.

Results

The obtained finding indicated IL10 rs1800871 CC genotype in the Alpha variant and CT genotype in the Delta variant had a relationship with COVID-19 mortality; however, there was no association between rs1800871 polymorphism and the Omicron BA.5 variant. The COVID-19 mortality rate was associated with IL10 rs1800872 TT genotype in the Alpha and Omicron BA.5 variants and GT in the Alpha and Delta variants. The COVID-19 mortality rate was associated with IL10 rs1800896 GG and AG genotypes in the Delta and Omicron BA.5; nevertheless, there was no association between rs1800896 polymorphism with the Alpha variant. According to the obtained data, the GTA haplotype was the most common of haplotype in different SARS-CoV-2 variants. The TCG haplotype was related to COVID-19 mortality in the Alpha, Delta and Omicron BA.5 variants.

Conclusion

The IL10 polymorphisms had an impact on COVID-19 infection, and these polymorphisms had different effects in various SARS-CoV-2 variants. To verify the obtained results, further studies should be conducted on various ethnic groups.
Temporal tracking of microglial and monocyte single-cell transcriptomics in lethal flavivirus infection
Authors: Spiteri Alanna G. , Wishart Claire L. , Ni Duan , Viengkhou Barney , Macia Laurence , Hofer Markus J. , King Nicholas J. C.
Published: April 2023

As the resident parenchymal myeloid population in the central nervous system (CNS), microglia are strategically positioned to respond to neurotropic virus invasion and have been implicated in promoting both disease resolution and progression in the acute and post-infectious phase of virus encephalitis. In a mouse model of West Nile virus encephalitis (WNE), infection of the CNS results in recruitment of large numbers of peripheral immune cells into the brain, the majority being nitric oxide (NO)-producing Ly6Chi inflammatory monocyte-derived cells (MCs). In this model, these cells enhance immunopathology and mortality. However, the contribution of microglia to this response is currently undefined. Here we used a combination of experimental tools, including single-cell RNA sequencing (scRNA-seq), microglia and MC depletion reagents, high-dimensional spectral cytometry and computational algorithms to dissect the differential contribution of microglia and MCs to the anti-viral immune response in severe neuroinflammation seen in WNE. Intriguingly, analysis of scRNA-seq data revealed 6 unique microglia and 3 unique MC clusters that were predominantly timepoint-specific, demonstrating substantial transcriptional adaptation with disease progression over the course of WNE. While microglia and MC adopted unique gene expression profiles, gene ontology enrichment analysis, coupled with microglia and MC depletion studies, demonstrated a role for both of these cells in the trafficking of peripheral immune cells into the CNS, T cell responses and viral clearance. Over the course of infection, microglia transitioned from a homeostatic to an anti-viral and then into an immune cell-recruiting phenotype. Conversely, MC adopted antigen-presenting, immune cell-recruiting and NO-producing phenotypes, which all had anti-viral function. Overall, this study defines for the first time the single-cell transcriptomic responses of microglia and MCs over the course of WNE, demonstrating both protective and pathological roles of these cells that could potentially be targeted for differential therapeutic intervention to dampen immune-mediated pathology, while maintaining viral clearance functions.
Mechanical power and 30-day mortality in mechanically ventilated, critically ill patients with and without Coronavirus Disease-2019: a hospital registry study
Authors: Azizi Basit A. , Munoz-Acuna Ricardo , Suleiman Aiman , Ahrens Elena , Redaelli Simone , Tartler Tim M. , Chen Guanqing , Jung Boris , Talmor Daniel , Baedorf-Kassis Elias N. , Schaefer Maximilian S.
Published: April 2023

Background

Previous studies linked a high intensity of ventilation, measured as mechanical power, to mortality in patients suffering from “classic” ARDS. By contrast, mechanically ventilated patients with a diagnosis of COVID-19 may present with intact pulmonary mechanics while undergoing mechanical ventilation for longer periods of time. We investigated whether an association between higher mechanical power and mortality is modified by a diagnosis of COVID-19.

Methods

This retrospective study included critically ill, adult patients who were mechanically ventilated for at least 24 h between March 2020 and December 2021 at a tertiary healthcare facility in Boston, Massachusetts. The primary exposure was median mechanical power during the first 24 h of mechanical ventilation, calculated using a previously validated formula. The primary outcome was 30-day mortality. As co-primary analysis, we investigated whether a diagnosis of COVID-19 modified the primary association. We further investigated the association between mechanical power and days being alive and ventilator free and effect modification of this by a diagnosis of COVID-19. Multivariable logistic regression, effect modification and negative binomial regression analyses adjusted for baseline patient characteristics, severity of disease and in-hospital factors, were applied.

Results

1,737 mechanically ventilated patients were included, 411 (23.7%) suffered from COVID-19. 509 (29.3%) died within 30 days. The median mechanical power during the first 24 h of ventilation was 19.3 [14.6–24.0] J/min in patients with and 13.2 [10.2–18.0] J/min in patients without COVID-19. A higher mechanical power was associated with 30-day mortality (ORadj 1.26 per 1-SD, 7.1J/min increase; 95% CI 1.09–1.46; p = 0.002). Effect modification and interaction analysis did not support that this association was modified by a diagnosis of COVID-19 (95% CI, 0.81–1.38; p-for-interaction = 0.68). A higher mechanical power was associated with a lower number of days alive and ventilator free until day 28 (IRRadj 0.83 per 7.1 J/min increase; 95% CI 0.75–0.91; p < 0.001, adjusted risk difference − 2.7 days per 7.1J/min increase; 95% CI − 4.1 to − 1.3).

Conclusion

A higher mechanical power is associated with elevated 30-day mortality. While patients with COVID-19 received mechanical ventilation with higher mechanical power, this association was independent of a concomitant diagnosis of COVID-19.
Shell folded footings using different angles and EPS cavity filling: experimental study
Authors: Gomaa Ahmed E. , Hasan Ahmed M. M. , Mater Yasser M. , AbdelSalam Sherif S.
Published: April 2023

Shell folded footings have drawn the interest of researchers for decades as an alternative to typical flat isolated footings because folded footings can reduce the needed amount of reinforced concrete in addition to enhancing the overall geotechnical performance of the supporting soil medium. The main setback of utilizing such folded footings is the relatively complex geometry of the bottom cavity, which requires proper compaction of the soil used to fill that cavity. Current geosynthetic materials such as geofoam or expanded polystyrene (EPS) proved efficiency in many geotechnical applications, where EPS was adopted herein as a cavity-filling material for folded footings. EPS and footing concrete properties were determined using the ultrasonic test device, such as modulus of elasticity and damping coefficient. The main aim of this study was to experimentally assess the behavior of folded footings with and without EPS filling using seven fully instrumented footing models with folding angles ranging from 0° to 45°. Reinforcement was placed in the footing models and limited along the perimeter to act as a hidden ring beam. The models were load tested inside a sandbox to measure internal stresses induced in the soil and the overall settlement. Results showed a significant enhancement in the soil behavior after using EPS. Modification factors were developed for the standard bearing capacity and settlement equations to account for the folding angle and EPS filling effects.
Virtual pterygoid implant planning in maxillary atrophic patients: prosthetic-driven planning and evaluation
Authors: Sun Yuanyuan , Xu Chunfeng , Wang Ningtao , Wu Yiqun , Liu Yuelian , Fan Shengchi , Wang Feng
Published: April 2023

Purpose

The study aims to use cone beam computed tomography (CBCT) to (1) define the virtual valid length of pterygoid implants in maxillary atrophic patients from the prosthetic prioritized driven position and (2) measure the implant length engaged in the pterygoid process according to the HU difference of the pterygoid maxillary junction.

Materials and methods

Virtual pterygoid implants were planned with CBCT of maxillary atrophic patients in the software. The entry and angulation of the implant were planned according to the prosthetic prioritized driven position in the 3D reconstruction image. The planned implant length and the valid length defined as the implant between the pterygoid maxillary junction and pterygoid fossa were recorded. The relationship between the implant and sinus cavity was also evaluated.

Results

A total of 120 CBCT samples were enrolled and virtually planned. The mean age of the patients was 56.2 ± 13.2 years. One hundred and sixteen samples could successfully place virtual implants according to the criterion. The mean implant length and mean implant length beyond the pterygoid maxillary junction were 16.3 ± 4.2 mm (range, 11.5–18 mm) and 7.1 ± 3.3 mm (range, 1.5–11.4 mm), respectively. Ninety percent of virtually planned implants had a close relationship with the sinus cavity, and implants exhibited longer lengths when they had no relation with the sinus.

Conclusion

From a prosthetic prioritized driven position with fixed entry and angulation, pterygoid implants achieve adequate bone anchorage length beyond the pterygoid maxillary junction. Due to the individual anatomy and the volume of the maxillary sinus, the implants presented a different positional relationship with the maxillary sinus.

Graphical Abstract
Who do you think I am? Immigrant’s first name and their perceived identity
Authors: Amit Karin , Dolberg Pnina
Published: April 2023

The current study focuses on immigrants’ perceived identity—that is, the way immigrants think the locals perceive them—and examines the link between the first name (ethnic or local) they use in everyday social encounters and their local identity and belonging perceptions. The study model was tested on data obtained from an online survey filled out by 837 immigrants who arrived in Israel from the Former Soviet Union (FSU) or Ethiopia as children or adolescents (1.5 generation). The main findings indicate that immigrants expressing a higher sense of belonging to the host society and using a local first name report higher levels of perceived local identity. FSU immigrants reported higher levels of perceived local identity compared to Ethiopian immigrants. However, contrary to our expectations, the first name played a more significant role among Ethiopian immigrants. Possible explanations for our findings lie in the different naming practices related to the two immigrant groups and in the different social and economic position they hold in the host society. Implications of the first name immigrants use in social encounters are discussed.
Detection of right ventricular dysfunction by three – dimensional echocardiography and two - dimensional speckle tracking in breast cancer patients receiving anthracycline- based chemotherapy
Authors: El-Sherbeny Wafaa S. , Sabry Nesreen M. , El-Saied Shaimaa B. , Elnagar Basma
Published: April 2023

Background

Despite the cardiotoxic effect of anthracycline on the left ventricle (LV) was totally identified. The assessment of the anthracycline effect on the right ventricle(RV) by conventional echocardiography was a challenge due to its complex geometry. We aimed to evaluate the impact of anthracycline on the RV volume and function using 3 dimensional –echocardiography (3DE) and 2 dimensional -speckle tracking echocardiography (2D-STE) in patients with breast cancer.

Methods

This prospective study was conducted on 66 female patients with breast cancer receiving anthracycline chemotherapy, in addition to full echocardiography, 2D-STE and 3DE evaluation of RV function and volume were done at baseline, after 4th cycle of chemotherapy, six and nine months after the end of chemotherapy.

Results

Cardiotoxicity from anthracycline occurred in 18 patients whose LV ejection fraction became significantly reduced after 9 months of therapy according to that, the patients were divided into the non-cardiotoxic group (n:48) and the cardiotoxic group (n:18). At cardiotoxic group, 3D RV end-systolic volume, and 3D RV end-diastolic volume increased significantly at 6 months and continued till 9 months after the therapy end compared to baseline values (42.50 ± 5.98 vs. 50.44 ± 7.01, p = 0.005) and (86.78 ± 9.16 vs. 95.78 ± 9.23, p = 0.021).LV global longitudinal strain (GLS) showed a significant reduction early after 6 months of therapy, 2D GLS and free wall longitudinal strain (FWLS) of RV were significantly decreased at 6 months and continued till 9 months after therapy (-22.54 ± 0.79 vs. -19.53 ± 1.32, p = 0.001) and (-24.67 ± 1.27vs. -22.22 ± 1.41, p = 0.001) respectively. The variation of RV FWLS was a predictor of cardiotoxicity, the relative drop of RV FWLS > 19.3% had 83% sensitivity and 71% specificity, (AUC = 0.82) to identify patients who developed cardiotoxicity.

Conclusion

3DE is a promising modality in recognizing the early changes in RV volumes and minute alteration in RV function and 2D-STE is a reliable predictor of RV systolic dysfunction which identify the subclinical affliction.
Delayed-onset contact dermatitis caused by olanexidine gluconate antiseptic solution: effect of wiping off the remaining drug solution in two cases
Authors: Yamamoto Kasumi Boki , Fujii Keisuke , Mizumoto Kazuhiro , Tanioku Tadashi , Kawamata Tomoyuki
Published: April 2023

Background

Olanexidine glucuronide (Olanedine®), an antiseptic solution may cause skin dermatitis around one week after disinfection. Although removal after the procedure is recommended to avoid skin dermatitis, whether it is effective for preventing skin dermatitis has not been documented in detail in the literature.

Case presentation

We encountered two cases of delayed-onset contact dermatitis by Olanedine®. In both cases, the patient’s back was disinfected with Olanedine® and was covered with a surgical drape for epidural catheterization. After catheterization and removal of the surgical drape, the insertion site of the catheter was covered with a film dressing, then the epidural catheter was taped to the back. On the third postoperative day, the epidural catheter was removed. On the seventh postoperative day, the patients reported pruritus on the back, where an erythematous papule rash was observed. However, it was not observed at the site covered by the tape to secure the epidural catheter or by the tape of the surgical drape. Symptoms were relieved with oral or topical steroids by the time of discharge.

Conclusion

Wiping off the remaining Olanedine® even a few days after disinfection may be helpful not only for reducing symptoms but also for preventing the development of contact dermatitis.
Successful treatment with spinal cord stimulation for pain due to eosinophilic granulomatosis with polyangiitis: a case report
Authors: Tanabe Kumiko , Sugiyama Yoko , Yoshimura Noritaka , Yamaguchi Shinobu
Published: April 2023

Background

Although most patients of eosinophilic granulomatosis with polyangiitis (EGPA) experience a reduction in pain within several weeks to months of the initiation of immunotherapies, some suffer from residual neuropathic symptoms for a long time.

Case presentation

A 28-year-old woman diagnosed with EGPA visited. She had been treated with steroid pulse therapy, intravenous immunoglobulin, and mepolizumab (antiinterleukin-5 agent). Her symptoms other than peripheral neuropathy improved, but posterior lower thigh pain and weakness of the lower legs worsened. At the initial visit, she used crutches and complained of numb pain in both posterior lower thighs, especially the left one. She also presented with left foot drop and reported a decreased tactile sensation on the lateral sides of both lower thighs. We performed spinal cord stimulation (SCS) at the L1 level on both sides. Her pain remarkably decreased, her tactile sensation improved, her muscle strength increased, and she was able to walk without crutches.

Conclusions

We herein report the first case of lower extremity pain being successfully treated with SCS in an EGPA patient who did not respond well to drug therapy. Because the cause of pain in EGPA is neuropathy induced by vasculitis, there is ample ability for SCS to improve this pain. When pain is neuropathic, whatever the cause, SCS may be worth trying, even for pain from disorders other than EGPA.
Trends in global health research among universities in China: a bibliometric analysis
Authors: Wu Chenkai , Yan Lijing L. , Long Qian , Liu Yunguo , Tan Jie , Lou Zhexun , Tang Shenglan
Published: April 2023

Background

There has been considerable progress in developing global health education and research in China. Nevertheless, evidence of the progress of Chinese universities’ contributions to global health research is limited. More efforts are needed to depict the progress Chinese universities have collectively made in advancing the field of global health. This study aimed to examine Chinese universities’ collective contributions to global health research by describing the longitudinal trends in global health research publications, uncovering research themes in global health, and exploring collaboration patterns.

Methods

A comprehensive bibliometric analysis was conducted for original research studies of the ten founding members of the China Consortium of Universities for Global Health, one of the largest networks of global health research and education in China.

Results

We found that (1) the number of research publications in the field of global health has steadily increased from 2014 to 2020, (2) non-communicable disease was the most popular research topic, accounting for over one-third of total publications, followed by maternal and child health and neurological and mental disorders and diseases, (3) less than one-fifth of papers involved primary data collection, with the majority of the study populations from low-income and lower-middle-income countries in Asia and Africa, and (4) a sizable collaboration network has been established with co-authors from over 200 oversea universities or organizations, with about one third from the US.

Conclusions

Despite a variety of challenges and barriers, Chinese universities have been playing an increasingly important role in global health research as assessed by peer-reviewed publications over the last decade. More concerted efforts by multiple stakeholders, including government, private sectors, funding agencies, academic institutions, and researchers, are needed to advance the development of global health research in China.
Key considerations in the analysis of the development of social anthropology in Spain
Authors: Fernández-Álvarez Óscar , González-González Miguel , Ouali-Fernández Sara
Published: April 2023

The objective of this article is to present a brief overview of the long history of anthropology in Spain. Of primary importance is positioning this history both within Spain’s wider social and political contexts, and also against the development of scientific research throughout the country. Methodologically, this study is based on extensive existing literature concerning the history of the discipline, from the start of the twentieth century to contemporary times, which informed the decision to structure this writing in four sections, segmenting the period of history covered. The first section considers the primary or formative development of a regionalist Spanish ethnography at the beginning of the twentieth century. Following this, in the second section, we explore the Francoist era when the twentieth century was well underway; this was a period marked by the strong influence of foreign research on the establishment of teaching methods and practical approaches to anthropology. In the third section, we observe how, as Spain transitioned from a dictatorship to a strong democratic state formed of autonomous regions, a uniquely Spanish anthropology emerged and, as we discuss in the fourth section, the country entered a time of consolidation and institutionalisation throughout the wider field of Spanish scientific endeavour. In this way, we examine Spanish anthropology from the context of intellectual development not dissimilar to that taking place on a global scale. The article concludes with an exploration of the current challenges facing Spanish anthropology.