bluuebunny/crossref_metadata_2025 huggingface dataset:
Designing Risk Communication Strategy on Social Media for Disaster Risk Reduction in Community Based Tourism
Authors: Tamitiadini Dian
Published: December 2023

This chapter delves into risk communication within the tourism sector. Indonesia boasts many tourist attractions known for their natural beauty, historical significance, and rich culture. Promoting community engagement in tourism planning is advocated as a means of fostering sustainable tourism. However, besides its diverse tourism potential, Indonesia is prone to various types of disasters in different regions. Climate change, floods, droughts, landslides, volcanic eruptions, tsunamis, and earthquakes are recurring disasters frequently associated with tourist attractions and areas. This chapter underscores the role of communication science in addressing disaster management issues in East Java, Indonesia. Situated in a high-risk disaster area, Indonesia places a strong emphasis on disaster risk reduction management. Disaster management programs have become a top priority in the National Medium-Term Development Plan (RPJMN) for 2010-2014. While the Indonesian government has made efforts to establish effective communication methods with local communities in disaster-prone areas, public participation and awareness of disaster risk still fall short of expectations. Furthermore, most basic information does not adequately prepare local communities for disaster risks. Social media is considered an alternative tool to enhance risk communication. With the proliferation of social media platforms such as blogs, Facebook, Twitter, Instagram, and YouTube, users remain continually connected and engaged with each other. They share ideas, files, and risk-related messages in real time, allowing them to bypass institutional control of information. Based on the experts, social media as "a group of Internet-based applications" characterized by two key features: first, they build upon "the ideological and technological foundations of Web 2.0," permitting ongoing content modification and collaborative contributions from all users. Second, social media platforms "facilitate the creation and exchange of user-generated content," resulting in increased interactivity and the democratization of information.
Entre Fotografia e Arte Têxtil: outras epistemologias na arte contemporânea latino-americana
Authors: Carvalho Victa de
Published: December 2023

Com o intuito de refletir sobre algumas estratégias estético-políticas utilizadas na produção artística contemporânea latino-americana, propomos observar a série “Detrás del têxtil” (2018-2019), da artista peruana Ana Teresa Barboza. Nesta série, Ana Teresa Barboza aproxima a imagem fotográfica e a arte têxtil, para criar foto-esculturas de mapas geológicos híbridos de regiões específicas relacionadas às distintas práticas tradicionais de tecelagem em seu país de origem. Ao produzir misturas improváveis entre meios que se utilizam de matérias plásticas e visuais tão distintas, a obra de Ana Teresa dá a ver outras epistemologias capazes de descentrar as matrizes eurocêntricas humanistas dominantes que determinam ainda hoje as bases do atual projeto de mundo. Para além de uma visada salvacionista que promete dar conta de resolver os problemas de nosso tempo, tanto quanto para além de uma perspectiva calcada no esgotamento e no fim, interessa questionar, de que forma essas imagens incitam, de modo propositivo, a invenção de mundos possíveis. Sob a perspectiva de uma fotografia expandida, este trabalho almeja perceber como os atravessamentos da fotografia com outras formas de arte, nesse caso a arte têxtil, comumente voltada para o universo do trabalho das mulheres, podem atuar como estratégias potentes de produção de outros modos de ser e de estar em comum.
A paisagem urbana de Tiradentes (mg): o olhar do observador a partir dos pressupostos de Gordon Cullen
Authors: Paula Karine de Almeida , Miguel Eleusy Natalia
Published: December 2023

Cada paisagem urbana traz consigo atributos, uma identidade iminente à sua formação, comunicando algo ao observador e despertando sensações e sentimentos singulares e únicos frente a um determinado fragmento. Este artigo tem como objetivo analisar a paisagem urbana do centro histórico de Tiradentes (MG) a partir de distintos pontos de observação, com o intuito de identificar diferenças, similaridades e pontos marcantes na paisagem. Foi adotada para as análises a metodologia da visão serial proposta por Gordon Cullen, aplicando-a a um trajeto previamente selecionado. De forma complementar, aplicam-se também os pressupostos de Kevin Lynch às análises. Neste percurso foram observados e registrados, por meio de croquis à mão livre, nove visadas distintas. O artigo se justifica pela importância em se explorarem os mais diversos ângulos visuais na busca pela compreensão da paisagem urbana em sua totalidade.
Paisagem social: reflexões sobre a importância do espaço livre para políticas de habitação de interesse social
Authors: Donoso Veronica Garcia , Queiroga Eugenio Fernandes
Published: December 2023

Este artigo apresenta reflexões sobre as práticas sociais nos espaços livres de conjuntos de habitação de interesse social no contexto latino-americano, resultantes de pesquisa doutoral sobre as realidades chilena e brasileira. A complexidade das práticas sociais em habitação de interesse social é fruto do ambiente urbano criado, derivado da desigualdade social e de cenários de inclusão periférica, assim como da administração e manutenção dessa desigualdade. O artigo demonstra que o modus operandi de construção de conjuntos habitacionais, sem atenção às práticas sociais e sem estimular os grupos sociais a serem atores em seus próprios contextos, é uma prática que precisa ser superada. Há a necessidade de se considerar a relação social criada e possibilitada pelos espaços livres, que precisam ser pensados para a prática social, e de se evitarem limitações das práticas sociais, que levam à (des)prática, conceito apresentado neste artigo. Busca-se demonstrar a importância de se considerarem as práticas sociais e o projeto dos espaços livres em políticas de habitação de interesse social. Reconhece-se que, embora estes não sejam suficientes para resolver as diversas questões surgidas em contextos de vulnerabilidade urbana e social, eles são chave para possibilitar maiores mudanças.
A leitura da paisagem em cidades médias brasileiras: configuração e conformação dos espaços livres na forma urbana
Authors: Cocozza Glauco , Guerra Maria Eliza Alves
Published: December 2023

Este trabalho apresenta os resultados da análise dos espaços livres através do processo de leitura, intepretação e caracterização da sua paisagem urbana. O principal objetivo do artigo é apresentar como se configuram e se caracterizam os espaços livres em cidades médias brasileiras: Uberlândia, Uberaba, Araguari, Ituiutaba, Araxá e Patos de Minas (MG), e como esses conformam suas distintas paisagens urbanas. Foi utilizado, como procedimento metodológico, a identificação das unidades de paisagem, através da caracterização dos elementos morfológicos que compõe os espaços intraurbanos, elencadas por um conjunto de categorias de acordo com sua predominância espacial. Como resultado, percebeu-se as similaridades e as diferenças na estruturação dos espaços livres urbanos, assim como a gênese de configuração das distintas unidades de paisagens.
A duna e a floresta: o projeto paisagístico contemporâneo diante da visão ecológica de Mcharg
Authors: Olivo Carla , Meneguetti Karin
Published: December 2023

Complexidade e simplificação, diversidade e uniformidade, instabilidade e estabilidade são dualidades empregadas por Ian McHarg em Design with Nature para apresentar sua visão naturalista: adaptativa e criativa. Esses termos certamente ressoam na redação da teoria da arquitetura da paisagem em tempos de Antropoceno, notando-se que as questões ambientais não são novas, mas cada vez mais urgentes. Assim, considerando-se o paradigma ampliado da ecologia da paisagem, o presente artigo visa discutir de modo teórico-conceitual o projeto como ferramenta, refletindo sobre implicações da inclusão do adjetivo ambiental. Para tanto, revisa autores importantes sob uma perspectiva global, avaliando compreensões revisadas e ideias transdisciplinares, sobretudo de bases ecológica e cultural. Propõe-se o desenho de um esquema conceitual para compreender o projeto ambiental, organizado em conceitos de projeto, que é aplicado de modo exploratório.
Um viajante raro: apropriações e desvios para escrever uma cidade em Viagem a Buenos Aires, de João do Rio
Authors: González Lucía
Published: December 2023

En la columna Viagem a Buenos Aires publicada en 1915, João do Rio se autofigura como un “viajante raro” y en la utilización de esta categoría, en el Buenos Aires de 1915, resuena claramente Rubén Darío, quien acuñó dicho vocablo en Los raros, y que sirvió para designar, en América Latina, una comunidad de escritores. El presente artículo tiene como objetivo analizar la elección por lo raro que realiza Joao do Rio que, en detrimento de otros tipos de viajeros, le permitirá ingresar a la capital porteña y escribir sobre ella. Para ello, se indagará en los modos en lo que João do Rio reorganiza su trayectoria literaria para conformar parte de aquel grupo de escritores.
O caso Gisberta no romance Pão de Açúcar, de Afonso Reis Cabral: representações em torno de uma mulher trans
Authors: Teotônio Rafaella Cristina  Alves , Almeida João Pedro da Cunha de
Published: December 2023

O artigo oferece uma perspectiva sobre as representações de gênero ligadas à masculinidade, poder e marginalidade dentro do romance Pão de Açúcar, que trata da ficcionalização de um crime de ódio ocorrido em Portugal em 2006. Naquele ano, Gisberta Salce Júnior, mulher trans brasileira, foi assassinada por um grupo de adolescentes infratores nas ruínas de uma grande rede de supermercados. Objetiva-se compreender as representações dos sujeitos ex-cêntricos presentes na obra, principalmente o olhar do narrador acerca da personagem trans Gisberta, através do arcabouço teórico de Stuart Hall (2016), Pierre Bourdieu (2002), Michel Foucault (2013) e Berenice Bento (2015), dentre outros.
Amores sáficos em revista: Safo e a Ilha de Lesbos na Shimmy (RJ, 1925-1933)
Authors: Leite Letticia Batista Rodrigues
Published: December 2023

O objetivo deste artigo é apresentar e analisar brevemente as menções à poeta Safo e/ou à sua ilha de origem, Lesbos, presentes na Shimmy – A revista da vida moderna, publicada no Rio de Janeiro, entre 1925 e 1933. Tendo em vista que, no âmbito da referida revista, essas menções aparecem invariavelmente associadas à temática do lesboerotismo, o objetivo é compreender a funcionalidade dessa associação, no anseio de contribuir para uma historicização desse vínculo entre a poeta e/ou de sua ilha e a temática do lesboerotismo, no Brasil. Vinculação ainda hoje recorrente, não apenas no Brasil, mas cujas manifestações mais sistemáticas em âmbito nacional parecem remontar ao início do século XX.
O manifesto dele a toda a gente
Authors: Cascais António Fernando
Published: December 2023

Não sem uma certa razão, O meu manifesto a toda a gente, de António Botto, sempre foi tido na conta de peça menor na polémica da “literatura de Sodoma”. No entanto, podem nele detetar-se, de forma sintética, todos os elementos de um meta-discurso sobre a sua própria obra, que ele utilizou em vez de assumir qualquer postura ético-política de auto-defesa contra a homofobia omnipresente de que era objeto. A agência que foi Botto a devolver a si próprio contra a extorsão vital de que foi objeto, é em O meu manifesto a toda a gente que se anuncia e será no corpus poético que é posta em ação.
Eunotia pottieziana, a new diatom (Eunotiaceae, Bacillariophyta) species found in a tropical aquarium
Authors: VIJVER BART VAN DE
Published: December 2023

N/A
Spatial richness analysis and an evaluation of extinction risk for the genus Pachyphytum (Crassulaceae), with the description of a new species from Sierra Madre Occidental, Mexico
Authors: CASTRO-CASTRO ARTURO , ORTIZ-BRUNEL JUAN PABLO , ÁVILA-GONZÁLEZ HERIBERTO , LICHTER-MARCK ISAAC H. , CARRILLO-REYES PABLO , LÓPEZ-ENRÍQUEZ IRMA LORENA , BARVOSA-JIMÉNEZ MARCO ANTONIO
Published: December 2023

Pachyphytum is a genus of rupicolous succulents endemic to central Mexico. Here, we present a comprehensive list of currently recognized taxa in Pachyphytum with a review of biogeographical distribution data, a spatial richness analysis, and conservation assessments based on herbarium records and field work. Pachyphytum has been documented in 11 Mexican states, with the highest concentration of species (14) occurring in xerophilous scrubland, Chihuahuan Desert, and the Sierra Madre Oriental. All species of Pachyphytum are narrow endemics and were therefore categorized as at-risk of extinction according to IUCN criteria. Currently, taxa in Pachyphytum do not have formal protected status due to lack of inclusion on Mexico’s list of endangered species. During fieldwork in preparation for this research, an undescribed Pachyphytum was encountered in Durango state, which we here describe as a new species based on a detailed morphological comparative study.
Valeriana dacica, a distinctive tetraploid in the Eastern Carpathians
Authors: KRAHULEC FRANTIŠEK , KIRSCHNER JAN , KRAHULCOVÁ ANNA
Published: December 2023

Floras and taxonomic papers covering the region of the Eastern Carpathians frequently include a taxon of the Valeriana tripteris and V. montana affinity, under various names, most frequently as Valeriana transsilvanica or V. tripteris subsp. heterophylla. After having collected and cultivated a new material from Slovakia and Poland, we discovered that the taxon in question is a separate species, a tetraploid (2n=32) occupying a special habitat and a wide geographical range in Poland, Slovakia, Ukraine and Romania, distinct from both V. tripteris and V. montana. An analysis of relevant (seventeen) names and their original material, where applicable, found the name Valeriana dacica Porcius as the correct specific name for this taxon. Diagnostic characters, habitat requirements and an outline of its geographic distribution are provided. Notes on all relevant names, including the misapplied ones or invalid names surviving in important databases are given. Five names are newly typified.
Droplet Growth or Evaporation Does Not Buffer the Variability in Supersaturation in Clean Clouds
Authors: Anderson Jesse C. , Helman Ian , Shaw Raymond A. , Cantrell Will
Published: December 2023

Water vapor supersaturation in clouds is a random variable that drives activation and growth of cloud droplets. The Pi Convection–Cloud Chamber generates a turbulent cloud with a microphysical steady state that can be varied from clean to polluted by adjusting the aerosol injection rate. The supersaturation distribution and its moments, e.g., mean and variance, are investigated for varying cloud microphysical conditions. High-speed and collocated Eulerian measurements of temperature and water vapor concentration are combined to obtain the temporally resolved supersaturation distribution. This allows quantification of the contributions of variances and covariances between water vapor and temperature. Results are consistent with expectations for a convection chamber, with strong correlation between water vapor and temperature; departures from ideal behavior can be explained as resulting from dry regions on the warm boundary, analogous to entrainment. The saturation ratio distribution is measured under conditions that show monotonic increase of liquid water content and decrease of mean droplet diameter with increasing aerosol injection rate. The change in liquid water content is proportional to the change in water vapor concentration between no-cloud and cloudy conditions. Variability in the supersaturation remains even after cloud droplets are formed, and no significant buffering is observed. Results are interpreted in terms of a cloud microphysical Damköhler number (Da), under conditions corresponding to , i.e., the slow-microphysics regime. This implies that clouds with very clean regions, such that is satisfied, will experience supersaturation fluctuations without them being buffered by cloud droplet growth.

Significance Statement

The saturation ratio (humidity) in clouds controls the growth rate and formation of cloud droplets. When air in a turbulent cloud mixes, the humidity varies in space and time throughout the cloud. This is important because it means cloud droplets experience different growth histories, thereby resulting in broader size distributions. It is often assumed that growth and evaporation of cloud droplets buffers out some of the humidity variations. Measuring these variations has been difficult, especially in the field. The purpose of this study is to measure the saturation ratio distribution in clouds with a range of conditions. We measure the in-cloud saturation ratio using a convection cloud chamber with clean to polluted cloud properties. We found in clouds with low concentrations of droplets that the variations in the saturation ratio are not suppressed.
Structural differences and exploration potential of basins in the eastern and western branches of the East African Rift System
Authors: Ji Tianyu , Wen Zhixin , Wang Zhaoming , Song Chengpeng , He Zhengjun , Chen Xi , Li Hengxuan , Shen Yiping
Published: December 2023

The East African Rift System (EARS) is the youngest rift with the eastern and western branches, consisting of multiple secondary rifts. It is generally characterized by low extent of exploration and great exploration potential. Identifying the differences in hydrocarbon accumulation conditions in various rifts is very important in providing guidance for hydrocarbon exploration and selecting favorable exploration targets in this area. Based on the interpretation of first-hand seismic-geological data, and combining other materials such as commercial databases and open access literature, the structural characteristics of the main rifts in the eastern and western branches of the EARS are comparatively analyzed; based on the anatomy of the discovered hydrocarbon reservoirs, the rifts of the EARS are classified into four types depending on their structural styles, including double-fault type, simple single-fault type, single-fault transfer type, and single-fault terrace type, and the control of structural style over hydrocarbon accumulation in the EARS is discussed. In the Western Branch of the EARS, large rifts such as the Albertine Rift and the Tanganyika Rift are mainly of double-fault type and single-fault transfer type, and only some small rifts are of the simple single-fault type. The rifts in the Eastern Branch of the EARS are generally small; the rifts in the northern section of the Western Branch are mainly of the simple single-fault type, and those in the southern section are mainly of the single-fault terrace type. The hydrocarbon potential of double-fault rifts is the greatest, followed by that of simple single-fault rifts and single-fault transfer rifts, and the hydrocarbon potential of single-fault terrace rifts is relatively limited. The results obtained from a comparative analysis of the structures, sediment fills, and reservoir elements of various rifts show that the west side of the Albertine Rift, the southeast of the Tanganyika Rift, the Kerio Rift, and the land in the northwest of the Turkana Rift have great exploration potential.
Predictive value of CCL2 in the prognosis and immunotherapy response of glioblastoma multiforme
Authors: Deng Longfei , Ren Jie , Li Benqin , Wang Yinggang , Jiang Nianfen , Wang Yi , Cui Hongjuan
Published: December 2023

Background

Glioblastoma multiforme (GBM) is the most common and lethal primary brain tumor with a poor prognosis. The C-C motif chemokine ligand 2 (CCL2) has shown abnormal expression associated with progression of multiple malignancies, however, its role in predicting the prognosis and immunotherapy response of GBM remains poorly understood.

Results

CCL2 was highly expressed in GBM as analyzed by integrating CGGA, GEPIA and UALCAN online platforms, and further verified by histologic examinations, qRT-PCR analysis, and independent GEO datasets. CCL2 could serve as an independent prognostic factor for both the poor overall survival and progression-free survival of GBM patients based on TCGA data, univariate and multivariate cox analyses. Functional enrichment analysis revealed that CCL2 mainly participated in the regulation of chemokine signaling pathway and inflammatory response. Further, CCL2 expression was positively correlated with CD4 T cells, macrophages, neutrophils and myeloid dendritic cells infiltrating GBM as calculated by the TIMER2.0 algorithm. Importantly, the tumor immune dysfunction and exclusion (TIDE) algorithm showed that in CCL2-high GBM group, the expression of CD274, CTLA4, HAVCR2 and other immune checkpoints were significantly increased, and the immune checkpoint blockade (ICB) therapy was accordingly more responsive.

Conclusions

CCL2 can be used as a predictor of prognosis as well as immunotherapy response in GBM, offering potential clinical implications.
Integrative analysis of TBI data reveals Lgmn as a key player in immune cell-mediated ferroptosis
Authors: Yan Liyan , Han Xiaonan , Zhang Mingkang , Fu Yikun , Yang Fei , Li Qian , Cheng Tian
Published: December 2023

Background

Traumatic brain injury (TBI) is a central nervous system disease caused by external trauma, which has complex pathological and physiological mechanisms. The aim of this study was to explore the correlation between immune cell infiltration and ferroptosis post-TBI.

Methods

This study utilized the GEO database to download TBI data and performed differentially expressed genes (DEGs) and ferroptosis-related differentially expressed genes (FRDEGs) analysis. DEGs were further analyzed for enrichment using the DAVID 6.8. Immunoinfiltration cell analysis was performed using the ssGSEA package and the Timer2.0 tool. The WGCNA analysis was then used to explore the gene modules in the data set associated with differential expression of immune cell infiltration and to identify the hub genes. The tidyverse package and corrplot package were used to calculate the correlations between hub genes and immune cell infiltration and ferroptosis-marker genes. The miRDB and TargetScan databases were used to predict complementary miRNAs for the Hub genes selected from the WGCNA analysis, and the DIANA-LncBasev3 tool was used to identify target lncRNAs for the miRNAs, constructing an mRNA-miRNA-lncRNA regulatory network.

Results

A total of 320 DEGs and 21 FRDEGs were identified in GSE128543. GO and KEGG analyses showed that the DEGs after TBI were primarily associated with inflammation and immune response. Xcell and ssGSEA immune infiltration cell analysis showed significant infiltration of T cell CD4+ central memory, T cell CD4+ Th2, B cell memory, B cell naive, monocyte, macrophage, and myeloid dendritic cell activated. The WGCNA analysis identified two modules associated with differentially expressed immune cells and identified Lgmn as a hub gene associated with immune infiltrating cells. Lgmn showed significant correlation with immune cells and ferroptosis-marker genes, including Gpx4, Hspb1, Nfe2l2, Ptgs2, Fth1, and Tfrc. Finally, an mRNA-miRNA-lncRNA regulatory network was constructed using Lgmn.

Conclusion

Our results indicate that there is a certain correlation between ferroptosis and immune infiltrating cells in brain tissue after TBI, and that Lgmn plays an important role in this process.
Screening of four lysosome-related genes in sepsis based on RNA sequencing technology
Authors: Chen Guihong , Zhang Wen , Wang Chenglin , Chen Muhu , Hu Yingchun , Wang Zheng
Published: December 2023

Purpose

Screening of lysosome-related genes in sepsis patients to provide direction for lysosome-targeted therapy.

Methods

Peripheral blood samples were obtained from 22 patients diagnosed with sepsis and 10 normal controls for the purpose of RNA sequencing and subsequent analysis of differential gene expression. Concurrently, lysosome-related genes were acquired from the Gene Ontology database. The intersecting genes between the differential genes and lysosome-related genes were then subjected to PPI, GO and KEGG analyses. Core genes were identified through survival analysis, and their expression trends in different groups were determined using meta-analysis. Single-cell RNA sequencing was used to clarify the cellular localization of core genes.

Results

The intersection of 1328 sepsis-differential genes with 878 lysosome-related genes yielded 76 genes. PPI analysis showed that intersecting genes were mainly involved in Cellular process, Response to stimulus, Immune system process, Signal transduction, Lysosome. GO and KEGG analysis showed that intersecting genes were mainly involved in leukocyte mediated immunity, cell activation involved in immune response, lytic vacuole, lysosome. Survival analysis screened four genes positively correlated with sepsis prognosis, namely GNLY, GZMB, PRF1 and RASGRP1. The meta-analysis revealed that the expression levels of these four genes were significantly higher in the normal control group compared to the sepsis group, which aligns with the findings from RNA sequencing data. Furthermore, single-cell RNA sequencing demonstrated that T cells and NK cells exhibited high expression levels of GNLY, GZMB, PRF1, and RASGRP1.

Conclusion

GNLY, GZMB, PRF1, and RASGRP1, which are lysosome-related genes, are closely linked to the prognosis of sepsis and could potentially serve as novel research targets for sepsis, offering valuable insights for the development of lysosome-targeted therapy. The clinical trial registration number is ChiCTR1900021261, and the registration date is February 4, 2019.
Helicobacter pylori infection and small intestinal bacterial overgrowth: a systematic review and meta-analysis
Authors: Liao Liang , Su Bin-Bin , Xu Shi-Ping
Published: December 2023

Background

There is a link between Helicobacter pylori (HP) infection and small intestinal bacterial overgrowth (SIBO) with nonspecific digestive symptoms. Nonetheless, whether HP infection is associated with SIBO in adults remains unclear. Based on a meta-analysis, we evaluated this relationship.

Results

Observational studies relevant to our research were identified by searching PubMed, Embase, the Cochrane Library, and the Web of Science. We evaluated between-study heterogeneity using the Cochrane Q test and estimated the I2 statistic. Random-effects models were used when significant heterogeneity was observed; otherwise, fixed-effects models were used. Ten datasets from eight studies, including 874 patients, were involved in the meta-analysis. It was shown that HP infection was related to a higher odds of SIBO (odds ratio [OR]: 1.82, 95% confidence interval: 1.29 to 2.58, p < 0.001) with mild heterogeneity (p for Cochrane Q test = 0.11, I2 = 7%). Subgroup analyses showed that HP infection was related to SIBO in young patients (mean age < 48 years, OR: 2.68, 95% CI: 1.67 to 4.28, p < 0.001; I2 = 15%) but not in older patients (mean age ≥ 48 years, OR: 1.15, 95% CI: 0.69 to 1.92, p < 0.60; I2 = 1%; p for subgroup difference = 0.02). Subgroup analyses further indicated that the association was not significantly affected by the country of study, comorbidities, exposure to proton pump inhibitors, or methods of evaluating HP infection and SIBO.

Conclusions

HP infection may be related to SIBO in adults, which supports the detection of SIBO in patients with digestive symptoms and HP infection.
Epidural nalbuphine versus dexmedetomidine as adjuvants to bupivacaine in lower limb orthopedic surgeries for postoperative analgesia: a randomized controlled trial
Authors: Farmawy Manal S. E. , Mowafy Sherif M. S. , Wahdan Rehab A.
Published: December 2023

Background

Administration of adjuvant drugs epidurally in combination with local anesthetics offers new dimensions in the management of postoperative pain. This study aimed to compare the addition of either nalbuphine or dexmedetomidine to epidural bupivacaine for postoperative analgesia in lower limb orthopedic surgeries under combined spinal-epidural anesthesia.

Methods

This prospective randomized double-blind study included 69 patients scheduled for lower limb orthopedic surgeries. Anesthesia was started with 15 mg hyperbaric bupivacaine 0.5% intrathecally, and then an epidural bolus dose of 12 ml (10 ml 0.25% bupivacaine with 2 ml normal saline in group C, 2 ml (10 mg) nalbuphine in group N or dexmedetomidine 2 ml (100 µg) in group D was administered when sensory regression to T10. Postoperatively, when visual analogue scale (VAS) was ≥ 3, an epidural top-up dose of 8 ml (6 ml 0.25% bupivacaine plus 2 ml normal saline in group C, 2 ml (2 mg) nalbuphine in group N or 20 µg dexmedetomidine (2 ml) in group D was given. The primary outcome was to evaluate the duration of postoperative analgesia and secondary outcomes were any side effects and patient satisfaction.

Results

The onset of epidural analgesia was 17.83 ± 2.53 versus 13.39 ± 1.27 versus 12.17 ± 1.27 min in groups C, N and D, respectively (p value < 0.001). The mean duration of analgesia was 241.3 ± 14.24 versus 318.38 ± 22.54 versus 365.87 ± 18.01 min in groups C, N and D, respectively (p value < 0.001). The mean sedation score was less in group C than group N and D (P < 0.001). The patient satisfaction score showed the lowest degree of satisfaction in group C (p value < 0.001). Top-up doses consumed and total analgesic requirements were lower in groups N and D than in group C. There was a statistically significant difference between the studied groups regarding VAS over time (p value < 0.001), intraoperative bradycardia (p value 0.029), and shivering (p value 0.029).

Conclusion

The addition of either nalbuphine or dexmedetomidine to epidural bupivacaine was effective for postoperative analgesia in terms of onset, duration, and patient satisfaction with the superiority of dexmedetomidine over nalbuphine.

Trial registration

Approval from the research ethics committee of the Faculty of Medicine, Zagazig University was obtained with the reference number (ZU-IRB#:7045-15-8-2021) and it was registered under clinicaltrials.gov (NCT05041270) on registration date 13/09/2021.
Effects of intravenous glucocorticoids on postoperative delirium in adult patients undergoing major surgery: a systematic review and meta-analysis with trial sequential analysis
Authors: Li Chengwei , Zhang Zheng , Xu Lin , Lin Xiaojie , Sun Xinyi , Li Jianjun , Wei Penghui
Published: December 2023

Background

The effects of intravenous glucocorticoids on postoperative delirium (POD) in adult patients undergoing major surgery remain controversial. Therefore, we conducted this meta-analysis to assess whether intravenous glucocorticoids can decrease POD incidence in the entire adult population undergoing major surgery and its association with patients age, type of surgery, and type of glucocorticoid.

Methods

We searched the relevant literature published before November 3, 2023, through Cochrane Library, PubMed, Embase, and Web of Science. The primary outcome was POD incidence. The risk ratio for the primary outcome was calculated using the Mantel–Haenszel method. The secondary outcomes included 30-day mortality, length of hospital stay, ICU duration, mechanical ventilation duration, and occurrence of glucocorticoid-related adverse effects (e.g., infection and hyperglycemia). This meta-analysis was registered in PROSPERO: CRD42022345997.

Results

We included eight randomized controlled studies involving 8972 patients. For the entire adult population undergoing major surgery, intravenous glucocorticoids reduced the POD incidence (risk ratio = 0.704, 95% confidence interval, 0.519–0.955; P = 0.024). However, subgroups defined by type of surgery showed differential effects of glucocorticoids on POD. Intravenous glucocorticoids can not reduce POD incidence in adult patients undergoing cardiac surgery (risk ratio = 0.961, 95% confidence interval, 0.769–1.202; P = 0.728), with firm evidence from trial sequential analysis. However, in major non-cardiac surgery, perioperative intravenous glucocorticoid reduced the incidence of POD (risk ratio = 0.491, 95% confidence interval, 0.338–0.714; P < 0.001), which warrants further studies due to inconclusive evidence by trial sequence analysis. In addition, the use of glucocorticoids may reduce the mechanical ventilation time (weighted mean difference, -1.350; 95% confidence interval, -1.846 to -0.854; P < 0.001) and ICU duration (weighted mean difference = -7.866; 95% confidence interval, -15.620 to -0.112; P = 0.047).

Conclusions

For the entire adult population undergoing major surgery, glucocorticoids reduced the POD incidence. However, the effects of glucocorticoids on POD appear to vary according to the type of surgery. In patients receiving major non-cardiac surgery, glucocorticoid may be an attractive drug in the prevention of POD, and further studies are needed to draw a definitive conclusion. In cardiac surgery, intravenous glucocorticoids have no such effect.
The experience and reflections of GC labs as an independent clinical laboratory to the COVID-19 pandemic in South Korea
Authors: La Jeon You , Lee Sang Gon , Lee Eun Hee , Song Sungwook , Lee O-Jin , Go Un Yeong , Chun Ga-Young , Choi Hyun Mi , Choi Jin Young
Published: December 2023

Background

Amid the COVID-19 pandemic, extensive testing was undertaken by independent clinical laboratories (ICLs), yet limited research exists on this matter. Drawing from Green Cross Laboratories (GC Labs)' pandemic response experience, this study seeks to offer insights for preparation for the next pandemic.

Methods

This retrospective study analyzed the outcomes of SARS-CoV-2 real-time reverse transcription polymerase chain reaction (SARS-CoV-2 rRT PCR) tests administered by GC Labs for COVID-19 diagnosis, upon request by different organizations, between February 2020 and April 2022. The distribution of institutions that requested the tests, the type of tests, and the positive rate were analyzed. We investigated resource allocation details.

Results

ICLs were responsible for conducting 85.6% of all tests carried out under South Korea’s COVID-19 testing policy during the pandemic. The availability of free testing regardless of symptoms led to a significant increase in the use of pooled tests, which accounted for more than 80% of all tests conducted after August 2021. The gender and age distribution of COVID-19 cases nationwide and GC Labs’ positive cases were similar. When we analyzed the positive rate by requesting organizations during the COVID-19 pandemic, despite an overall nationwide positivity rate of 35%, high-risk facilities exhibited a positivity rate of less than 5% by maintaining preemptive testing. The most notable increase in resources during the pandemic was seen in human resource input.

Conclusions

South Korea's ICLs were able to conduct large volumes of testing during the COVID-19 pandemic because of their logistics and computer systems, scalable testing space, and trained testing personnel. They also had the flexibility to bring in additional resources to expand testing capacity because they are specialized testing organizations. Hence, ICLs could execute the pooled test that the government had introduced for extensive general population screening. The preemptive periodic testing of high-risk populations kept the positive rate much lower than in the general population. This study's findings will aid in refining mass testing-based policies for the next pandemic.
Nutritional needs, resources, and barriers among unhoused adults cared for by a street medicine organization in Chicago, Illinois: a cross-sectional study
Authors: Adams Elizabeth J. , Lu Michelle , Duan Richard , Chao Alyssa K. , Kessler Helen C. , Miller Charles D. , Richter Adam G. , Latyshev Daniel G. , Dastoor Jehannaz D. , Eckburg Adam J. , Kadambi Namrata S. , Suresh Nila R. , Bales Cayla E. , Green Hannah M. , Camp Daniel M. , Jara Rolando , Flaherty John P.
Published: December 2023

Background

Those experiencing houselessness rely on obtaining food from community organizers and donations. Simultaneously, the houseless face disproportionally high rates of medical conditions that may be affected by diet including diabetes, hypertension, and hyperlipidemia. There is limited literature on the resources and barriers of the houseless community regarding optimal nutrition from an actionable perspective. Further, less data is available on how street medicine organizations may best impact the nutrition of the unhoused they serve. Elucidating this information will inform how organizational efforts may best support the nutrition of the houseless community.

Methods

In partnership with the medical student-run organization, Chicago Street Medicine, at Northwestern University Feinberg School of Medicine, twenty adults experiencing houselessness in Chicago, Illinois participated in the cross-sectional study. A 10-item survey was verbally administered to characterize the participants’ daily food intake, food sources, barriers, resources, and nutritional preferences and needs. All data was directly transcribed into REDCap. Descriptive statistics were generated.

Results

Individuals consumed a median of 2 snacks and meals per day (IQR: 1–3). No participant consumed adequate servings of every food group, with only one participant meeting the dietary intake requirements for one food group. Participants most often received their food from donations (n = 15), purchasing themselves (n = 11), food pantries (n = 4), and shelters (n = 3). Eleven of nineteen participants endorsed dental concerns as a major barrier to consuming certain foods. Twelve participants had access to a can opener and twelve could heat their meals on a stove or microwave. Seven had access to kitchen facilities where they may prepare a meal. Approximately half of participants had been counseled by a physician to maintain a particular diet, with most related to reducing sugar intake.

Conclusion

Most houseless participants were unable to acquire a balanced diet and often relied on organizational efforts to eat. Organizations should consider the chronic health conditions, dentition needs, and physical resources and barriers to optimal nutrition when obtaining food to distribute to the unhoused.
Prevalence of fibromyalgia among university students and its impact on their health-related quality of life: a survey-based study from Egypt
Authors: Tharwat Samar , Mosad Nourhan Ramadan , Abdelmessih Kerolos Ebrahim , Moatamed Eman , Rihan Mohamed , Osama Nouran , Sallam Norhan , Elsayed Yara
Published: December 2023

Background

University students are more likely to experience stress, anxiety, and depression. All these factors are regarded as psychological contributors to fibromyalgia syndrome (FMS).

Aim

To investigate the prevalence and determinants of FMS among university students and its impact on their health-related quality of life (HRQoL).

Methods

This online survey-based study involved 2146 university students who were recruited from various faculties at several Egyptian universities. The participants’ demographics, medical history, academic pursuits, and sleep data were collected. To identify the existence of FMS, the 2016 updates to the 2010/2011 FMS diagnostic criteria were used. Additionally, the participants completed the Short-Form Health Survey-36 (SF-36).

Results

The mean age was 21.26 ± 2.015 years and 76% were females. Of 2146 students, 266 (12.4%) fulfilled the criteria of FMS. FMS group had a significantly lower age (p < 0.001) with predominant female gender (89.5% vs. 74.1%, p < 0.001), positive family history of FMS (8.6% vs. 3.7%, p < 0.001), previous history of traffic accident (10.2% vs. 6.8%, p = 0.045), lower level of physical activity (p = 0.002),higher time spent in study per week (p = 0.002), lower sleep time (p = 0.002), with frequent walk up (p < 0.001) and snoring (p < 0.001) during sleep. Regarding HRQoL, students with FMS had significantly lower scores than students without in all domains.

Conclusion

FMS is prevalent among Egyptian university students and is linked to female gender, positive family history, lower levels of physical activity, and more time spent studying each week. FMS has a negative impact on HRQoL. Therefore, early detection and treatment are recommended.
Association between periodontitis treatment and dementia in Taiwanese adults
Authors: Chen Hui-Ling , Wu Dai-Rong , Chen Jhih-Jhen , Lin Wei-Szu , Chen I-Chieh , Liu Jeng-Fen , Lien Shine , Lin Ching-Heng
Published: December 2023

Background

The chronic systemic inflammatory response in periodontitis may be a potential risk factor for dementia, especially in adults. This study determined the association between periodontal treatment and dementia in adults and evaluated the effect of regular scaling treatment on the risk of dementia in this population.

Methods

This case–control study identified 18,930 patients with a dementia-related diagnosis from the Taiwan National Health Insurance Research Database. Scaling and periodontal emergency treatments were evaluated after 1 year and 3 years. Using multivariable logistic regression analysis to evaluate the association between periodontal emergency treatment and dementia risk.

Results

The results showed that scaling treatment rates were lower in the dementia cohort than the non-dementia cohort after 1 and 3 years. Patients who received periodontal emergency treatment within 3 years had a significantly increased risk of dementia. Furthermore, patients with periodontitis who did not receive scaling treatment within 3 years had a higher risk of dementia than patients without periodontitis (OR, 1.22; 95% CI, 1.10–1.35).

Conclusion

This study demonstrated that periodontitis and dementia are associated, and that periodontitis is a risk factor for dementia in adults. The risk of dementia was dependent on the periodontal health status of adults, and our findings suggest that regular scaling can reduce the incidence of dementia in adults. Therefore, regular and routine scaling treatment is suggested for adults.
Noise exposure among staff in intensive care units and the effects of unit-based noise management: a monocentric prospective longitudinal study
Authors: Armbruster Christoph , Walzer Stefan , Witek Sandra , Ziegler Sven , Farin-Glattacker Erik
Published: December 2023

Background

Intensive care units (ICUs) are often too noisy, exceeding 70–80 dBA, which can have negative effects on staff. The corresponding recommendation of the World Health Organization (average sound pressure level below 35 dBA) is often not achieved. To date there is a lack of intervention studies examining the extent to which unit-based noise management in ICUs contributes to a reduction in noise exposure for the staff. The study therefore aims to provide answers to 1) how unit-based noise management sustainably reduces the subjective noise exposure among staff, and 2) how this intervention affects other noise-related topics.

Methods

We performed a monocentric prospective longitudinal study with three measurement points in a German university hospital in three ICUs. We collected data from different healthcare professionals and other professional groups between October 2021 and August 2022 using an online questionnaire. Data were analyzed using descriptive and inference statistics.

Results

A total of n = 179 participants took part in the surveys. The majority of participants were nurses or pediatric nurses. Most participants worked more than 75% full-time equivalent. Staff on the three ICUs reported high levels of noise exposure. No significant changes in noise exposure over time were observed. Participants were already aware of the topic and believed that a behavior change could positively influence the noise environment.

Conclusions

This study provides an initial insight into how a unit-based noise management could contribute to a reduction in the subjective noise exposure among staff in ICUs. The results of this study highlight the importance of this topic. Future studies should aim to research aspects of adherence and their facilitators or barriers, which promote the sustained implementation of noise-reducing measures by staff.

Trial registration

German Clinical Trials Register (DRKS): DRKS00025835; Date of registration: 12.08.2021.
Association of the availability of pharmaceutical facilities provided in secondary and tertiary hospitals with clinical pharmacists’ work performance
Authors: Cai Rong , Xi Xiaoyu , Huang Yuankai
Published: December 2023

Background

Clinical pharmacists always work as the pivotal role in the process of facilitating the proper use of drug. Based on the person-environment fit theory, the availability of facilities required in pharmaceutical service may influence pharmacists’ performance, but which of them may have positive or negative impact remains unclear.

Objectives

This study aims to analysed the quantitative association of the availability of pharmaceutical facilities provided in Chinese hospitals and clinical pharmacists’ work performance to assist hospitals formulating plans of the improving pharmaceutical working conditions to enhance clinical pharmacists’ performance.

Method

Demonstrated by the panel of expert and literature review, the questionnaire for administrators and clinical pharmacists of secondary and tertiary hospitals in China was formed. Then a mixed sampling was adopted to gather data on information of the participants, as well as evaluation indexes of the availability of facilities and clinical pharmacists’ work performance.

Results

Overall, 625 questionnaires distributed to administrators of hospitals and 1219 ones distributed to clinical pharmacists were retrieved. As for the Pharmaceutical facilities, while the increased availability of Traditional Chinese medicine pharmacy (p = 0.02) has a significantly positive impact on clinical pharmacists’ performance, the great availability of the preparation room (p = 0.07) negatively influences their work performance.

Conclusion

Improving the availability of facilities that significantly influence clinical pharmacists’ work performance possibly reduce their workload, enhance their efficiency and further promote progress in pharmaceutical service.