bluuebunny/crossref_metadata_2025 huggingface dataset:
Bilateral central serous retinal detachment in a patient with nephrotic syndrome: a case report
Authors: Sadeghi Reza , Pashapouryeganeh Amirreza , Karimi Morteza , Khalili Pour Elias , Mirghorbani Masoud , Riazi-Esfahani Hamid
Published: November 2023

Background

The aim of this report is to highlight the importance of considering nephrotic syndrome as a potential underlying cause of bilateral central serous retinal detachment in a patient with systemic lupus erythematosus and to underscore the significance of a comprehensive systemic workup in these patients.

Case presentation

A 19-year-old Iranian female patient with history of systemic lupus erythematosus presented with progressive vision loss and bilateral macular elevation. Ophthalmic examination revealed periorbital edema, chemosis, and subretinal fluid at the macula of both eyes. Optical coherence tomography confirmed the existence of subretinal fluid and serous detachment located at the macula of both eyes. On fluorescein angiography, there were no signs of subretinal leakage such as smoke stack sign or expansile dot in late phases. Laboratory tests detected hypoalbuminemia and significant proteinuria, leading to the diagnosis of nephrotic syndrome. Treatment with prednisolone and albumin infusion resulted in improved visual acuity and resolution of subretinal fluid.

Conclusion

Nephrotic syndrome can be a rare underlying cause of bilateral central serous retinal detachment, and its association with systemic lupus erythematosus should be considered. Hypoalbuminemia in nephrotic syndrome alters fluid dynamics in the retina, contributing to bilateral central serous retinal detachment. Early recognition and management of nephrotic syndrome are essential for vision recovery and preventing long-term complications.
Early acute kidney injury and transition to renal replacement therapy in critically ill patients with SARS-CoV-2 requiring veno-venous extracorporeal membrane oxygenation
Authors: Roedl Kevin , De Rosa Silvia , Fischer Marlene , Braunsteiner Josephine , Schmidt-Lauber Christian , Jarczak Dominik , Huber Tobias B. , Kluge Stefan , Wichmann Dominic
Published: November 2023

Background

Critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) requiring veno-venous extracorporeal membrane oxygenation (vv-ECMO) are at risk for acute kidney injury (AKI). Currently, the incidence of AKI and progression to kidney replacement therapy (RRT) in critically ill patients with vv-ECMO for severe COVID-19 and implications on outcome are still unclear.

Methods

Retrospective analysis at the University Medical Center Hamburg-Eppendorf (Germany) between March 1st, 2020 and July 31st, 2021. Demographics, clinical parameters, AKI, type of organ support, length of ICU stay, mortality and severity scores were assessed.

Results

Ninety-one critically ill patients with SARS-CoV-2 requiring ECMO were included. The median age of the study population was 57 (IQR 49–64) years and 67% (n = 61) were male. The median SAPS II and SOFA Score on admission were 40 (34–46) and 12 (10–14) points, respectively. We observed that 45% (n = 41) developed early-AKI, 38% (n = 35) late-AKI and 16% (n = 15) no AKI during the ICU stay. Overall, 70% (n = 64) of patients required RRT during the ICU stay, 93% with early-AKI and 74% with late-AKI. Risk factors for early-AKI were younger age (OR 0.94, 95% CI 0.90–0.99, p = 0.02) and SAPS II (OR 1.12, 95% CI 1.06–1.19, p < 0.001). Patients with and without RRT were comparable regarding baseline characteristics. SAPS II (41 vs. 37 points, p < 0.05) and SOFA score (13 vs. 12 points, p < 0.05) on admission were significantly higher in patients receiving RRT. The median duration of ICU (36 vs. 28 days, p = 0.27) stay was longer in patients with RRT. An ICU mortality rate in patients with RRT in 69% (n = 44) and in patients without RRT of 56% (n = 27) was observed (p = 0.23).

Conclusion

Critically ill patients with severe SARS-CoV-2 related ARDS requiring vv-ECMO are at high risk of early acute kidney injury. Early-AKI is associated with age and severity of illness, and presents with high need for RRT. Mortality in patients with RRT was comparable to patients without RRT.
Nanotechnology development in surgical applications: recent trends and developments
Authors: Abaszadeh Farzad , Ashoub Muhammad Hossein , Khajouie Ghazal , Amiri Mahnaz
Published: November 2023

This paper gives a detailed analysis of nanotechnology's rising involvement in numerous surgical fields. We investigate the use of nanotechnology in orthopedic surgery, neurosurgery, plastic surgery, surgical oncology, heart surgery, vascular surgery, ophthalmic surgery, thoracic surgery, and minimally invasive surgery. The paper details how nanotechnology helps with arthroplasty, chondrogenesis, tissue regeneration, wound healing, and more. It also discusses the employment of nanomaterials in implant surfaces, bone grafting, and breast implants, among other things. The article also explores various nanotechnology uses, including stem cell-incorporated nano scaffolds, nano-surgery, hemostasis, nerve healing, nanorobots, and diagnostic applications. The ethical and safety implications of using nanotechnology in surgery are also addressed. The future possibilities of nanotechnology are investigated, pointing to a possible route for improved patient outcomes. The essay finishes with a comment on nanotechnology's transformational influence in surgical applications and its promise for future breakthroughs.

Graphical Abstract
Gut microbiota in parasite-transmitting gastropods
Authors: Li Peipei , Hong Jinni , Yuan Zhanhong , Huang Yun , Wu Mingrou , Ding Tao , Wu Zhongdao , Sun Xi , Lin Datao
Published: November 2023

Background

Gastropoda, the largest class within the phylum Mollusca, houses diverse gut microbiota, and some gastropods serve as intermediate hosts for parasites. Studies have revealed that gut bacteria in gastropods are associated with various biological aspects, such as growth, immunity and host–parasite interactions. Here, we summarize our current knowledge of gastropod gut microbiomes and highlight future research priorities and perspectives.

Methods

A literature search was undertaken using PubMed, Web of Science and CNKI for the articles on the gut microbiota of gastropods until December 31, 2022. We retrieved a total of 166 articles and identified 73 eligible articles for inclusion in this review based on the inclusion and exclusion criteria.

Results

Our analysis encompassed freshwater, seawater and land snails, with a specific focus on parasite-transmitting gastropods. We found that most studies on gastropod gut microbiota have primarily utilized 16S rRNA gene sequencing to analyze microbial composition, rather than employing metagenomic, metatranscriptomic, or metabolomic approaches. This comprehensive review provided an overview of the parasites carried by snail species in the context of gut microbiota studies. We presented the gut microbial trends, a comprehensive summary of the diversity and composition, influencing factors, and potential functions of gastropod gut microbiota. Additionally, we discussed the potential applications, research gaps and future perspectives of gut microbiomes in parasite-transmitting gastropods. Furthermore, several strategies for enhancing our comprehension of gut microbiomes in snails were also discussed.

Conclusions

This review comprehensively summarizes the current knowledge on the composition, potential function, influencing factors, potential applications, limitations, and challenges of gut microbiomes in gastropods, with a specific emphasis on parasite-transmitting gastropods. These findings provide important insights for future studies aiming to understand the potential role of gastropod gut microbiota in controlling snail populations and snail-borne diseases.

Graphical abstract
Polytraumatization, defense mechanisms, PTSD and complex PTSD in Indian adolescents: a mediation model
Authors: Ferrajão Paulo , Batista Carolina Isabel , Elklit Ask
Published: November 2023

Background

Adolescence is recognized as a particularly susceptible developmental period for experiencing multiple types of Adverse Childhood Experiences (ACE), increasing the vulnerability to higher levels of Post-Traumatic Stress Disorder (PTSD) and Complex PTSD symptoms. Some studies found that defense mechanisms play an important role on the association between ACE and psychological symptoms.

Methods

We analyzed the associations between direct and indirect exposure to ACE and PTSD and Complex PTSD (affective dysregulation, negative self-concept and disturbances in relationships) through the mediation role of mature defense mechanisms: mature, neurotic, and immature defense mechanisms in Indian adolescents. A sample of 411 Indian adolescents (M = 14.2 years old; S.D. = 0.5) completed validated self-report questionnaires. Serial multiple mediation models were tested by conducting a structural equation modelling employing Preacher and Hayes’ procedures (2008).

Results

Immature and neurotic defense mechanisms mediated the association between direct exposure to ACE with PTSD symptoms. Immature defense mechanisms were mediators of the relationship between direct exposure to ACE and Complex PTSD symptoms clusters.

Conclusions

Maladaptive defense mechanisms can disturb the process of self-regulation and emotion regulation capabilities in coping with traumatic experiences, leading to higher PTSD and Complex PTSD symptoms severity.
Introducing the enterprise data marketplace: a platform for democratizing company data
Authors: Eichler Rebecca , Gröger Christoph , Hoos Eva , Stach Christoph , Schwarz Holger , Mitschang Bernhard
Published: November 2023

In this big data era, multitudes of data are generated and collected which contain the potential to gain new insights, e.g., for enhancing business models. To leverage this potential through, e.g., data science and analytics projects, the data must be made available. In this context, data marketplaces are used as platforms to facilitate the exchange and thus, the provisioning of data and data-related services. Data marketplaces are mainly studied for the exchange of data between organizations, i.e., as external data marketplaces. Yet, the data collected within a company also has the potential to provide valuable insights for this same company, for instance to optimize business processes. Studies indicate, however, that a significant amount of data within companies remains unused. In this sense, it is proposed to employ an Enterprise Data Marketplace, a platform to democratize data within a company among its employees. Specifics of the Enterprise Data Marketplace, how it can be implemented or how it makes data available throughout a variety of systems like data lakes has not been investigated in literature so far. Therefore, we present the characteristics and requirements of this kind of marketplace. We also distinguish it from other tools like data catalogs, provide a platform architecture and highlight how it integrates with the company’s system landscape. The presented concepts are demonstrated through an Enterprise Data Marketplace prototype and an experiment reveals that this marketplace significantly improves the data consumer workflows in terms of efficiency and complexity. This paper is based on several interdisciplinary works combining comprehensive research with practical experience from an industrial perspective. We therefore present the Enterprise Data Marketplace as a distinct marketplace type and provide the basis for establishing it within a company.
First report of geo- and thermochronological results from the Cordillera Central, Luzon, Philippines
Authors: Nakajima Toru , Sueoka Shigeru , Nagata Mitsuhiro , Kohn Barry P. , Ramos Noelynna T. , Tsutsumi Hiroyuki , Tagami Takahiro
Published: November 2023

Geo- and thermochronological methods were applied to diorites from the Cordillera Central, Luzon, Philippines to understand their emplacement and exhumation history in the island arc mountains. Five zircon U–Pb ages range from 32.54 ± 0.70 to 6.11 ± 0.15 (2SE) Ma, indicating that dioritic magmas intruded the upper crust intermittently during Cenozoic magmatism. Five zircon fission-track (ZFT) pooled ages range from 35.63 ± 2.17 to 6.91 ± 0.36 (2SE) Ma and are generally comparable with the U–Pb ages at each locality. These results suggest that the diorites cooled rapidly below ~ 250–350 °C (i.e., through the partial annealing zone of the ZFT system), following their intrusion. On the other hand, two zircon and five apatite U-Th(-Sm)/He (ZHe and AHe) weighted mean ages, ranging from 11.71 ± 0.36 to 8.82 ± 0.26 and 9.21 ± 0.52 to 0.98 ± 0.09 (2SE) Ma, respectively, indicate a decrease in cooling rates at a lower temperature range, especially through the partial retention zone of the AHe system. This observation suggests that the ZFT ages reflect initial cooling of the dioritic magma, whereas the AHe ages reflect the cooling history associated with regional exhumation following the initial cooling phase. The spatial distribution of the AHe ages suggests that rapid exhumation of the Cordillera Central during the Quaternary resulted from the block-like uplift of the entire mountain range.

Graphical abstract
Feasibility of recruiting adolescents into a prospective cohort study of the effects of social isolation during COVID-19
Authors: Kim Kain , Jergel Andrew , Bai Shasha , Bradley Kolbi , Karim Brianna , Shah Amit , Suglia Shakira , Ugboh Ngozi , Gooding Holly C.
Published: November 2023

Background

Social connection and loneliness in adolescence are increasingly understood as critical influences on adult mental and physical health. The unique impact of the social isolation imposed by the COVID-19 lockdown on emerging adults is therefore expected to be especially profound. We sought to investigate the feasibility of using ecological momentary assessment (EMA) and wearable accelerometers to characterize the effects of social isolation and/or loneliness experienced by adolescents during the COVID-19 pandemic.

Methods

We recruited 19 participants aged 13–18 from an Adolescent Medicine practice in Atlanta, GA. Participants completed surveys at baseline and throughout a 2-week study period using EMA regarding their degree of social isolation, loneliness, family functioning, school climate, social media use, and COVID-19 experiences surrounding their physical, mental, and social domains. Six participants agreed to wear an activity tracker and heart rate measurement device for 14 days to monitor their emotional state and physical health. Participant feedback was collected via open-ended exit interviews. Feasibility of recruitment/retention, adherence, and outcome measures were investigated. Implementation was also assessed by evaluating the barriers and facilitators to study delivery. Associations between the social isolation and loneliness variables and all other variables were performed with univariate linear regression analysis with significance set at p < 0.05. The progression criteria were a recruitment rate of > 30% and a retention rate of > 80%.

Results

Progression criteria were met for recruitment (76%) of participants, but not retention (38%). Adherence to EMA survey completion was highly variable with only 54% completing ≥ 1 survey a day, and accelerometry use was not feasible. Social isolation was significantly correlated with lower school climate, higher COVID-19 experiences, higher depression scores, and lower sleep quality. Loneliness also showed a significant correlation with all these factors except COVID-19 experiences.

Conclusions

EMA and wearable accelerometer use was not feasible in this longitudinal study of adolescents during the COVID-19 pandemic. Future research should further investigate barriers to conducting long-term research with adolescents and the potential effects of the pandemic on subject recruitment and retention.
Association between interleg systolic blood pressure difference and apparent peripheral neuropathy in US adults with diabetes: a cross-sectional study
Authors: Lin Xipeng , Liu Zhihao , Weng Haoyu , Liu Xu , Liu Shengcong , Li Jianping
Published: November 2023

Background

Interleg systolic blood pressure difference (ILSBPD) is associated with peripheral artery disease, but the relationship between ILSBPD and apparent peripheral neuropathy in diabetic patients remains unclear. We explored the relationship between ILSBPD and apparent peripheral neuropathy and examined the possible effect modifiers in US adults with diabetes.

Methods

One thousand and fifty-one diabetic participants were included in the study with complete data on systolic blood pressure of the lower extremities and Semmes–Weinstein 10-g monofilament testing from the 1999–2004 National Health and Nutritional Examination Surveys. Systolic blood pressure in the lower extremities was measured using an oscillometric blood pressure device with the patient in the supine position. Apparent peripheral neuropathy was defined as the presence of monofilament insensitivity.

Results

Every 5-mmHg increment in ILSBPD is associated with an about 14% increased risk of apparent peripheral neuropathy in crude model, but after adjustment for covariates, the correlation became nonsignificant (P = 0.160). When participants were divided into groups based on ILSBPD cutoffs of 5, 10 and 15 mmHg in different analyses, there was a significantly increased risk of apparent peripheral neuropathy in the ILSBPD ≥ 15 mmHg group (OR 1.79, 95% CI 1.11–2.91, P = 0.018), even after adjusting for confounders. In subgroup analysis, no interaction effect was found (all P for interaction > 0.05).

Conclusions

In US adults with diabetes, an increase in the ILSBPD (≥ 15 mmHg) was associated with a higher risk of apparent peripheral neuropathy.
Hypoglycemia rates and glycemic hormonal response after laparoscopic Roux-en-Y gastric bypass versus sleeve gastrectomy: a meta-analysis of comparative studies
Authors: Artsitas Sotirios , Artsitas Dimitrios , Smparounis Spyridon , Theodorou Dimitrios , Zografos George C.
Published: November 2023

Background

This study aims to quantify the difference between Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) concerning the incidence of post-bariatric surgery hypoglycemia (PBSH) and variations in glycemic homeostasis.

Main body of the abstract

A literature search was conducted between July and August 2023. Inclusion criteria involved studies exclusively in the English language that comparatively investigated the occurrence of postoperative hypoglycemia in patients undergoing the above two bariatric approaches. A total of 16 studies, comprising data from 1806 patients, were identified and classified based on 39 primary and secondary outcomes pertaining to the period following the first postoperative semester. Our findings reveal that patients undergoing gastric bypass have a 50% higher risk of developing postoperative hypoglycemia compared to those undergoing sleeve gastrectomy. Moreover, this risk doubles when questionnaire data are taken into account. Lower glucose levels (MD = − 10.54 mg/dl, CI95% = [− 16.63; − 4.45]) were observed in the RYGB group at 2 h after an oral glucose tolerance test (OGTT), which is considered a precursor to the development of PBSH. Higher zenith (MD = 49.11 mg/dl, CI95% = [16.12; 82.10]) and lower nadir plasma glucose levels (MD = − 5.70 mg/dl, CI95% = [− 10.03; − 1.37]) were also noted in the same group, with a wider glucose range (MD = 52.22 mg/dl, CI95% = [18.25; 86.19]). Lastly, no differences were observed in insulin and C-peptide levels, glycosylated hemoglobin (HbA1c), as well as insulin sensitivity score (HOMA-IR).

Short conclusion

Patients in the RYGB group are at least 50% more likely to develop postoperative hypoglycemia compared to those in the LSG group. Our analysis suggests a more unstable glycemic homeostasis mechanism, with a strong contribution from late dumping syndrome.
Lymphatic malformations: a 9-year experience at the vascular anomaly clinic
Authors: AbouZeid Amr Abdelhamid , Mohammad Shaimaa Abdelsattar , Aly Nihal Hussein , Ghanem Wael Ahmed , Seada Mohammad , Ragab Iman A. , El-Naggar Osama , AbdelBaky Mohamed Aly
Published: November 2023

Purpose

To share our experience in the management of a specific type of vascular malformations (lymphatic) at a specialized multidisciplinary clinic for vascular anomalies.

Methods

Data of patients attending the vascular anomaly clinic during the period 2015 through 2023 were retrospectively analyzed. The study included cases diagnosed primarily as lymphatic malformations (LMs). We excluded cases associated with complex/syndromic vascular malformations. Available data included regional distribution of the LMs, age at presentation, sex, imaging studies, and different modes of treatment.

Results

The study included 131 cases of LMs whose data were available for retrospective analysis. Generally, LMs had a benign course with good prognosis apart from two recorded mortalities (1.5%) during the 9-year period of the study. In this series, 93 cases were managed by injection sclerotherapy (Bleomycin). About 57 cases showed satisfactory response to injection sclerotherapy alone without the need to add other treatment modalities. Forty cases underwent surgical excision/debulking. Postoperative wound complications were recorded in 5 cases (12.5%). Sirolimus was offered for patients with LMs after the failure of conventional treatment (injection/surgery) to control associated significant complications.

Conclusion

Lymphatic malformations represent a common presentation at the vascular anomaly clinic, which usually have a benign course. Complications are mainly cosmetic especially when involving the face, and sometimes superadded infections may occur. Airway compromise is a potential serious complication with submandibular lymphatic malformations in the neck.
X-chromosome inactivation: a historic topic that's still hot
Authors: Rodriguez Yolanda Moyano , Borensztein Maud
Published: November 2023

The last edition of the X-chromosome inactivation (XCI) meeting was held as an EMBO workshop in Berlin on 19-22 June 2023. The conference took place at the Harnack-haus in the Dahlem district, birthplace of the first modern research campus, where notable scientists such as Lise Meitner, Hans Krebs and, briefly, Albert Einstein conducted their research. This special edition, also accessible online, was organized by Rafael Galupa (Centre for Integrative Biology of Toulouse, France), Joost Gribnau (Erasmus MC Rotterdam, The Netherlands), Claire Rougeulle (Université Paris Cité/CNRS, Epigenetics and Cell Fate Center, Paris, France), Edda Schulz (Max Planck Institute for Molecular Genetics, Berlin, Germany) and James Turner (The Francis Crick Institute, London, UK). Originally scheduled for 2021, to commemorate the 60th anniversary of Mary Lyon's hypothesis on X-chromosome inactivation in mammals and the 30th anniversary of XIST/Xist discovery, the meeting had to be postponed because of the COVID-19 pandemic. Seven years after the latest XCI meeting in London, the enthusiasm and expectations of the community were at their highest, bringing together over 160 scientists from around the world to share and discuss their research. Eighty posters and more than 40 talks were presented at this event, in a collegial and collaborative atmosphere. A historical session and several breakout discussions were also organized, as well as the now traditional boat trip, all thanks to great organization. Here, we debrief readers on this fantastic conference.
Wybrane czynniki kształtujące natężenie dojazdów do różnych typów szkół ponadpodstawowych w Poznaniu
Authors: Bajerski Artur , Kisiała Wojciech
Published: November 2023

The aim of the research presented in this article is to examine the impact of selected socio-economic and spatial factors on the intensity of commuting to different types of secondary schools in Poznań (i.e. general secondary schools, technical secondary schools and first cycle vocational schools). Three econometric models were created on the basis of detailed data on the journey to school, in which the explained variable was the proportion of students from a given municipality who attended a selected type of school in Poznań (depending on the model: a vocational school, a technical secondary school or a general secondary school). The set of explanatory variables was common to all models and consisted of: 1) the proportion of people with higher education in the municipality, 2) the distance between the municipality and Poznań, and 3) the indicator of the availability of local education in the municipality (an indicator created for the purposes of this article). The models explained between 64% and 81% of the variation in the intensity of commuting to schools from different municipalities to Poznań (least in the case of commuting to vocational schools, most in the case of commuting to general secondary schools). The study showed a varied impact of the variables used on the intensity of commuting to Poznań for different types of schools. The level of education in the student’s municipality played the most important role in explaining commuting to general secondary schools (compared to other types of schools), while the distance to Poznań and the availability of local educational opportunities had the greatest impact on commuting to vocational schools.
Η συγκρότηση της κοινωνικής ορθολογικότητας στο έργο του Adam Smith
Authors: Μπανασάκης Γεώργιος
Published: November 2023

Η διδακτορική διατριβή έχει ως στόχο της να παρουσιάσει τη συγκρότηση της «κοινωνικής ορθολογικότητας» στο έργο του Άνταμ Σμιθ. Για το σκοπό αυτό η εργασία εστιάζει σε ζητήματα που αφορούν το πρόβλημα της ορθολογικότητας των νεωτερικών κοινωνιών υποστηρίζοντας, κατ’ αρχάς, ότι αυτά μπορούν να θεωρηθούν από δύο σκοπιές: αφ’ ενός ως ζητήματα που αφορούν την υποκειμενική ορθολογικότητα του ατομικού πράττειν και, αφ’ ετέρου, ως ζητήματα που αφορούν τις αντικειμενικές (κοινωνικές) μορφές ορθολογικότητας. Αυτή η διάκριση μεταξύ υποκειμενικής ορθολογικότητας και αντικειμενικής ορθολογικότητας αντιστοιχεί, εν πολλοίς, στα δύο μείζονα σμιθιανά έργα, τη Θεωρία των Ηθικών Συναισθημάτων και την Έρευνα για τη φύση και τα αίτια του Πλούτου των Εθνών. Αντιστοίχως, το πρώτο κεφάλαιο αυτής της εργασίας προσπαθεί να ανασυγκροτήσει τη σμιθιανή ηθικο-κοινωνική θεωρία υιοθετώντας, κατά βάση, την πρώτη σκοπιά, ενώ το δεύτερο και το τρίτο κεφάλαιο της εργασίας επιχειρούν να ανασυγκροτήσουν τη σμιθιανή πολιτική οικονομία υιοθετώντας τη δεύτερη σκοπιά. Αυτή η γενική διάταξη της εργασίας αποτελεί έκφραση ενός ερμηνευτικού σχήματος που υποστηρίζει ότι στο σύνολο της κοινωνικής θεωρίας του Σμιθ διερευνώνται τόσο η σχέση μεταξύ των δύο μορφών ορθολογικότητας όσο και η εσωτερική σύσταση καθεμίας εξ αυτών.
Effects of evidence-based clinical practice guidelines for COVID-19 in health care quality improvements. A third systematic review.
Authors: Ramírez-Morera Anggie , Salazar-Vargas Jordan , Rivera-Chavarría Ana Leonor , Urrútia Gerard
Published: November 2023

Background Historically, Evidence-Based Clinical Practice Guidelines were thought to primarily enhance healthcare consistency and quality. However, this claim requires conclusive confirmation. We employed the Donabedian model encompassing three dimensions, patient outcomes, process, and structure, to evaluate the use of EB-CPGs and their potential healthcare improvements. This represents our third systematic review within a series exploring significant pathologies. The overarching goal is to assess the effectiveness of EB-CPGs to enhance care quality. Methods Following the methodology of the Manual of Cochrane, a descriptive analysis was performed due to considerable heterogeneity in the included studies. Searches were carried out from 2019 to May 2023 across databases including EMBASE, PubMed, OVID, Cochrane Central RCT, and grey literature. No limitations were imposed on language. We selected only randomised controlled trials (RCTs). Results Across the fifteen evaluated RCTs, 220 interventions were examined. Of these, 6 (3%) were associated with structure, while 136 (62%) focused on the healthcare delivery process, and 78 (35%) targeted patient health outcomes. No significant differences were identified between the compared groups in 155 interventions (71%) regarding the implementation of EB-CPGs. In 27 interventions (12%), the outcome benefited the control group, while the intervention group demonstrated favourable outcomes in 38 (17%). Conclusions Our research revealed slight quality improvement in healthcare through EB-CPGs in patient outcomes and healthcare processes. Neutral results suggest no clear advantage among groups. In future studies, it would be necessary to enhance both the design and methodological rigour of RCTs and to consider in their analysis the strength of the recommendations included in the EB-CPGs along with their respective levels of evidence certainty. This would enable more precise hypotheses to be established regarding the reasons behind these findings. PROSPERO registration CRD42022354708.
Taxonomic additions of the Brazilian fauna of Prosierola (Hymenoptera, Bethylidae)
Authors: Pereira Leonardo Rezeda , Brito Chirlei Dias de , Azevedo Celso Oliveira
Published: November 2023

Prosierola is characterized by having a pair of conspicuous anteromedial metapostnotal foveae on the metapectal-propodeal disc. Little is known about this genus because it is rarely sampled in collections. Therefore, the main goal of this contribution is to expand the knowledge of intraspecific morphological variations and geographical distribution of its species that occur in Brazil. We sorted material from the main collections and obtained 69 specimens of Prosierola nasalis (Westwood) recorded for the first time from Maranhão, Minas Gerais, Pará, Rio Grande do Norte and Rio Grande do Sul; one of Prosierola obliqua Evans recorded for the first time from Distrito Federal; five of Prosierola rotunda Schiffler & Azevedo recorded for the first time from Pará; and 13 of Prosierola rufescens Evans recorded for the first time from Brazil (Amazonas, Bahia, Espírito Santo, Minas Gerais). The mesoscuto-scutellar foveae placed on the dorsal surface of the mesoscutellum shown to be highly variable in size, distance, and shape at both the intra- and interspecific levels.
Estratégias das mulheres dos movimentos de moradia frente à Covid-19 no Brasil e na Argentina.
Authors: Lazarini Kaya
Published: November 2023

As estratégias das mulheres dos movimentos sociais que lutam por moradia na América Latina diante da pandemia da Covid-19 serão investigadas através de entrevistas semiestruturadas com participantes do Movimento Sem Terra Leste 1 (MST-Leste1), em São Paulo, Brasil, e do Movimiento de Ocupantes e Inquilinos (MOI), em Buenos Aires, Argentina. O trabalho reprodutivo e de cuidado, e seu viés de gênero, classe e raça, foram temas de debate durante a pandemia, e a incapacidade do Estado em resolver as demandas e a crescente situação de vulnerabilidade social levaram ao surgimento de numerosas formas de ajuda mútua em territórios populares. Nos conjuntos habitacionais produzidos pela população organizada com base na autogestão, as redes de solidariedade estruturadas por mulheres, que também foram protagonistas na concepção e produção destes espaços, funcionaram de forma sistemática. As entrevistas demonstram o protagonismo das mulheres diante das demandas reprodutivas, destacando que a dimensão política do cuidado coletivizado, a práxis organizativa com base na autogestão dos movimentos populares e a disponibilidade de espaços comuns foram essenciais para enfrentar a pandemia
Neoimperializm rosyjski – geneza i współczesne implikacje
Authors: Kiwior-Filo Małgorzata , Kwiatkowska Monika
Published: November 2023

The problem of “empire” and “imperialism” remains a topical subject of research and theoretical considerations, and “re-imperialization” as an effect of Vladimir Putin’s political strategy opens up a new era in international relations. Russian neo-imperialism, which in the 21st century took a criminal form leading to the outbreak of armed conflict, causing destabilization of Ukraine, stirring up a worldwide crisis and shaking global security, uses the tradition of the Russian Empire, first Tsarist and then Soviet, to implement Putin’s concept of a “Russian world.”
Rozwój współpracy bilateralnej Olkusza i Niżyna w początkowym okresie wojny w Ukrainie (luty-wrzesień 2022 roku)
Authors: Kamionka Mateusz
Published: November 2023

City twinning is a practice that creates formal and informal political, economic,social and cultural relationships between cities around the world.Most often, it is initiated by a partnership between city authorities, officialsor social organizations operating in the administrative area of localgovernment units. However, the events that took place between Februaryand September 2022 meant that the cooperation was also forged asa consequence of the war and humanitarian crisis. Thanks to the cooperationof the informal group “Olkusz Helps Ukraine” and the City andMunicipality of Olkusz that established a humanitarian aid base for theUkrainian city of Nizhyn, bilateral cooperation between these two citieswas initiated. The article will present the history of establishing relationsand the humanitarian aid that was sent from Olkusz to Nizhyn.
Other Kinds of Mind There
Authors: Reddell Trace
Published: November 2023

Cognition in extended brain-body music systems becomes especially agile during psychedelic experience, necessitating a sonic rhetoric emphasizing transformative agency. Rooted in the recursive listening spaces of dub, three forms of psychedelic electronica—ambient house, trip-hop and glitch—foster an echological sensibility unique to records made largely from the bits and pieces of other recordings. In this article, longform albums representing each of these genres are offered as sonic pharmakomedia, pharmacologically activated non-human agencies that sustain psychedelic mind-machine systems. Managing the psychedelic experience by mediating set and setting through music selection is adopted in psychedelic research, therapy sessions and personal practices alike. I consider set and setting in terms of their contributions to a liminal sonic substance that facilitates encounters with non-human agencies. Putting indigenous shamanic practices in conversation with contemporary neuropsychopharmacology, sound studies and psychedelic music production, this article offers a diagnostic inventory of the effects of the sonic substance.
place-based philosophical education: reconstructing ‘place’, reconstructing ethics
Authors: Thornton Simone , Graham Mary , Burgh Gilbert
Published: November 2023

Education as identity formation in Western-style liberal-democracies relies, in part, on neutrality as a justification for the reproduction of collective individual identity, including societal, cultural, institutional and political identities, many aspects of which are problematic in terms of the reproduction of environmentally harmful attitudes, beliefs and actions. Taking a position on an issue necessitates letting go of certain forms of neutrality, as does effectively teaching environmental education. We contend that to claim a stance of neutrality is to claim a position beyond criticism. In the classroom this can also be an epistemically damaging position to hold. To further explore the problem of neutrality in the classroom, and to offer a potential solution, we will look to the philosophical community of inquiry pedagogy, and advocate for the addition of place-based education; a form of experiential education that promotes learning in local communities in which the school is situated, each with its own history, culture, economy and environment. However, how we understand ‘place’ is fundamental to understanding the potential of place-based education in giving students a ‘sense of place’—how they perceive a place, which includes place attachment and place meaning. To this end, we look to Indigenous understandings of Place and social reconstruction learning to inform place-based pedagogies. Doing so, we hold, opens a pathway to ethical education.
reinventando a prática alfabetizadora de paulo freire. uma experiência de alfabetização filosófica em Pau dos Ferros, RN
Authors: Kohan Walter Omar , Salas Ana corina , Monte coelho frota Ana maria , Almeida Carlineide , Santiago jr. José ricardo , Dias coutinho Karyne , Nicodemos Marcio , Dantas cirino Maria reilta , Dos santos araújo barbosa Meirilene , Pulido cortés óscar , Liz belmont Priscila , Roberto martins lins Robson
Published: November 2023

O presente texto narra uma experiência de formação de alfabetizadores de jovens e adultos: uma alfabetização filosófica de 40 horas com 300 alfabetizadores em julho de 2022, como primeira etapa do Programa “Supera RN” em Pau dos Ferros, dentro da Política de Superação do Analfabetismo do Estado do Rio Grande do Norte (RN). O texto tematiza em que sentido a experiência de Alfabetização filosófica se inspira e ao mesmo tempo se diferencia do curso de Alfabetização oferecido por Paulo Freire em Angicos em 1963. Inspirado na curiosidade e no compromisso de Paulo Freire com os esfarrapados do mundo, o conceito “alfabetização filosófica” propõe uma formação experiencial sustentada nas seguintes disposições: escutar atentamente o mundo humano e não humano que nos rodeia; pensar juntos com cuidado e calma; relacionarmo-nos cooperativa e não competitivamente com as ideias das outras pessoas; perguntarmo-nos, colocando em questão, nossa vida e a maneira como nos relacionamos com ela, num tempo especial, singular, suspendido; conversar como iguais na busca de enfrentar as exigências de nossa comunidade; inventar novas formas de estar com outras e outros. O texto apresenta como essas disposições foram pensadas e praticadas durante a alfabetização filosófica em Pau dos Ferros, RN, através de cinco princípios (perguntar; escutar; tempo de infância; igualdade; pensar juntos) e lança algumas perguntas sobre possíveis desdobramentos da alfabetização filosófica no campo de formação de professores.
The self-aware manager: mindfulness
Authors: Ellis Peter , Abbott Jane
Published: November 2023

Peter Ellis and Jane Abbott discuss the importance of mindfulness and how kidney care managers can learn to become more mindful
Kidneys from dying neonates might solve the kidney shortage
Authors: Ellis Peter
Published: November 2023

This article outlines the potential of kidney donation from neonates and the associated challenges
A security analysis of SOHO embedded systems
Authors: Wodo Wojciech , Gancarczyk Michal , Czyszczonik Jakub
Published: November 2023

Due to many unusual constraints imposed on their design, embedded systems carry a large set of challenges related to feature implementation and security. Many systems extant today prove the extreme difficulty of designing a secure software architecture. Nevertheless, IoT systems are crucial in many environments ranging from large-scale, tightly secured commercial deployments to relatively unprotected home networks.
INCIDENCE OF RIFAMPICIN-RESISTANCE IN STAPHYLOCOCAL PERIPROSTHETIC JOINT INFECTION: A SINGLE-CENTRE COHORT STUDY OF 238 PATIENTS
Authors: Lazarinis Stergios , Järhult Josef , Hailer Nils , Brüggemann Anders
Published: November 2023

Aim

Rifampicin as a biofilm-active antibiotic drug has a significant role in the treatment of periprosthetic joint infection (PJI). However, rifampicin resistance is an increasing threat to PJI treatment. This study aimed to evaluate the prevalence of rifampicin resistant staphylococci over time and its association with infection-free survival after PJI in a single centre in Sweden.

Methods

We included 238 PJIs in 238 patients who had undergone PJI revision surgery from 2001 to 2020 on whom the causative bacteria were staphylococci, and the agent was tested for rifampicin resistance. Data regarding agents, rifampicin resistance, treatment and outcome was obtained. Kaplan-Meier survival analysis and a Cox regression model with adjustment for age, sex, localisation (hip or knee) and type of prosthesis (primary or revision) were used to calculate infection-free survival rates and adjusted risk ratios (HRs) of the risk of treatment failure. Treatment failure was defined as any reoperation or suppression treatment with antibiotics due to prolonged infection.

Results

Among the included 238 PJIs, 40 rifampicin-resistant staphylococci [93% Coagulase Negative Staphylococci (CoNS)] and 29 treatment failures were identified. The proportion of rifampicin resistant agents decreased from 25% in 2010–2015 to 12% in 2016–2020. The 2-year infection-free survival rates were 79.0% (95% CI 0.66–0.92) for the rifampicin resistant and 90% (95% CI 0.86–0.94) for the rifampicin sensitive group. Patients with PJI caused by rifampicin resistant bacteria had a significantly higher risk of treatment failure than those caused by sensitive bacteria (HR 2.5; 95% CI 1.0–6.2).

Conclusions

The incidence of PJI caused by rifampicin resistant staphylococci decreased in Uppsala, Sweden over the past 20 years. PJI caused by rifampicin-resistant staphylococci has a two-fold risk for treatment failure compared to PJI caused by rifampicin-sensitive staphylococci, which stresses the importance of retaining rifampicin resistance low. Additionally, the increased risk of treatment failure when PJI is caused by a rifampicin-resistant bacteria warrants consideration of a more conservative treatment strategy.
MICROBIOLOGIC EPIDEMIOLOGY OF HIP PROSTHETIC JOINT INFECTIONS IN ELDERLY PATIENTS CAUSED BY MULTIDRUG-RESISTANT GRAM-NEGATIVE BACTERIA: A RETROSPECTIVE COHORT
Authors: Soares Fernanda , Santos Ingrid Nayara Marcelino , Seriacopi Lais Sales , Durigon Thomas Stravinkas , Cunha Carolina Coelho , Dell Aquila Adriana Macedo , Salles Mauro
Published: November 2023

Aim

Currently, gram-negative bacteria (GNB), including multidrug-resistant (MDR-GNB) pathogens, are gaining importance in the aetiology of prosthetic joint infection (PJI). To characterize the antimicrobial resistance patterns of Gram-negative bacteria (GNB) causing hip prosthetic joint infections in elderly patients treated at a Brazilian tertiary academic hospital.

Method

This is a retrospective, cross-sectional study of patients over 60 years of age undergoing hip arthroplasty from 2018 to 2023 at a tertiary academic trauma, which were diagnosed with hip prosthetic joint infection. PJI diagnosed was based on EBJIS criteria, in which intraoperative tissue cultures identified the pathogens. Demographics, reason for arthroplasty, type of implant and susceptibility patterns using disk diffusion method were analysed.

Results

Overall, among 17 elderly patients diagnosed with hip infected arthroplasty, 45 bacterial isolated were identified. Debridement, irrigation, antibiotic and implant retention (DAIR) procedures due to uncontrolled infection occurred in 47.0% (n=8/17), and five patients underwent more than two DAIR surgeries. Tissue cultures yielded eleven different bacterial species, with GNB accounted for 64.4% (n=29/45) of pathogens. Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, and Pseudomonas aeruginosa were identified in 34.5% (n=10/29), 17.25% (n=5/29), 13.8% (n=4/29), and 13.8% (n=4/29), respectively. In the resistance profile analysis, E. coli was most sensitive to antibiotics, whereas K. pneumoniae showed resistance rates higher than 70% for cephalosporins, carbapenems, and quinolones. All A. baumannii isolates were resistant to meropenem, and 80% of these isolates were resistant to amikacin.

Conclusions

This study emphasizes the role of GNB in the microbiological profile of PJI among elderly patients at a tertiary hospital in a Brazilian centre. The present study portrays a worryingly higher rates of MDR-GNB, mainly to quinolones and cephalosporins resistance which have been the cornerstone of PJI antibiotic treatment. In addition, higher rates carbapenems and aminoglycosides resistance shows a threat to antibiotic treatment of PJI. More global studies need to be carried out to show a likely change in the microbial epidemiology of PJI.
THE CLINICAL RELEVANCE OF LOW-GRADE INFECTION IN THE DEVELOPMENT AND MANAGEMENT OF FRACTURE-RELATED NONUNION
Authors: Trenkwalder Katharina , Erichsen Sandra , Weisemann Ferdinand , Augat Peter , Militz Matthias , Hackl Simon
Published: November 2023

Aim

Treatment algorithms for fracture-related nonunion depend on the presence or absence of bacterial infection. However, the manifestation of septic nonunion varies. Low-grade infections, unlike manifest infections, lack clinical signs of infection and present similarly to aseptic nonunion. The clinical importance of low-grade infection in nonunion is not entirely clear. Therefore, the aim of this study was to evaluate the clinical relevance of low-grade infection in the development and management of femoral or tibial nonunion.

Method

A prospective, multicenter clinical study enrolled patients with nonunion and regular healed fractures. Preoperatively, complete blood count without differential, C-reactive protein (CRP), and procalcitonin were obtained, clinical signs of infection were recorded, and a suspected septic or aseptic diagnosis was made based on history and clinical examination. During surgical nonunion revision or routine implant removal, tissue samples were collected for microbiology and histopathology, and osteosynthesis material for sonication. Nonunion patients were followed for 12 months. Definitive diagnosis of “septic” or “aseptic” nonunion was made according to diagnostic criteria for fracture-related infection, considering the results of any further revision surgery during follow-up.

Results

34 patients with regular healed fractures were included. 62 nonunion patients were diagnosed as aseptic, 22 with manifest, and 23 with low-grade infection. The positive predictive value was 88% and the negative predictive value 72% for the suspected diagnosis. The nonunion groups had significantly higher CRP levels than the regular healer group. Differentiation between septic and aseptic nonunion based on blood values was not possible. Low-grade infection demonstrated less frequently histopathologic signs of infection than manifest infection (22% vs. 50%, p=0.048), with 15% of regular healers having histopathologic signs of infection. Cutibacterium acnes was less present in manifest compared to low-grade infection (p=0.042). Healing rates for septic nonunion involving C. acnes were significantly lower for manifest infection (20%) than for low-grade infection (100%, p=0.002). Patients with low-grade infection were treated with systemic antibiotics less frequently than patients with manifest infection (p=0.026), with no significant difference in healing rate (83% vs. 64%), which was slightly lower for low-grade infection than for aseptic nonunion (90%).

Conclusions

Low-grade infections play a significant role in nonunion development and are difficult to diagnose preoperatively due to the lack of clinical signs of infection and unremarkable blood counts. However, our results imply that for low-grade infections, antibiotic therapy may not always be mandatory to heal the nonunion. This study was supported by the German Social Accident Insurance (FF-FR0276).