bluuebunny/crossref_metadata_2025 huggingface dataset:
Multimodal prevention of emergence cough following nasal endoscopic surgery under general anesthesia: a double-blind randomized trial
Authors: Xu Jing , Sun Pei , Ma Jia-Hui , Wang Dong-Xin
Published: January 2024

Purpose

Cough during emergence from anesthesia is a common problem and may cause adverse events. Monotherapy faces uncertainty in preventing emergence cough due to individual differences. We aimed to evaluate the efficacy and safety of multimodal intervention for preventing emergence cough in patients following nasal endoscopic surgery.

Methods

In this double-blind randomized trial, 150 adult patients undergoing nasal endoscopic surgery were randomly allocated into three groups. For the control group (n = 50), anesthesia was performed according to clinical routine, no intervention was provided. For the double intervention group (n = 50), normal saline 3 mL was sprayed endotracheally before intubation, 0.4 μg/kg dexmedetomidine was infused over 10 min after intubation, and target-controlled remifentanil infusion was maintained at an effect-site concentration of 1.5 ng/mL before extubation after surgery. For the multimodal intervention group (n = 50), 0.5% ropivacaine 3 mL was sprayed endotracheally before intubation, dexmedetomidine and remifentanil were administered as those in the double intervention group. The primary endpoint was the incidence of emergence cough, defined as single cough or more from end of surgery to 5 min after extubation.

Results

The incidences of emergence cough were 98% (49/50) in the control group, 90% (45/50) in the double group, and 70% (35/50) in the multimodal group, respectively. The incidence was significantly lower in the multimodal group than those in the control (relative risk 0.71; 95% CI 0.59 to 0.86; p < 0.001) and double (relative risk 0.78; 95% CI 0.63 to 0.95; p = 0.012) groups; the difference between the double and control groups was not statistically significant (relative risk 0.92; 95% CI 0.83 to 1.02; p = 0.20). The severity of sore throat was significantly lower in the multimodal group than that in the control group (median difference-1; 95% CI −2 to 0; p = 0.016). Adverse events did not differ among the three groups.

Conclusion

For adult patients undergoing endonasal surgery, multimodal intervention including ropivacaine topical anesthesia before intubation, dexmedetomidine administration after intubation, and remifentanil infusion before extubation after surgery significantly reduced emergence cough and was safe.
Exploring the complexity of commonly held attitudes and beliefs of low back pain—a network analysis
Authors: Liew Bernard X. W. , Darlow Ben
Published: January 2024

Objectives

The current study used a network analysis approach to explore the complexity of attitudes and beliefs held in people with and without low back pain (LBP). The study aimed to (1) quantify the adjusted associations between individual items of the Back Pain Attitudes Questionnaire (Back-PAQ), and (2) identify the items with the strongest connectivity within the network.

Methods

This is a secondary data analysis of a previously published survey using the Back-PAQ (n = 602). A nonparametric Spearman’s rank correlation matrix was used as input to the network analysis. We estimated an unregularised graphical Gaussian model (GGM). Edges were added or removed in a stepwise manner until the extended Bayesian information criterion (EBIC) did not improve. We assessed three measures of centrality measures of betweenness, closeness, and strength.

Results

The two pairwise associations with the greatest magnitude of correlation were between Q30–Q31 [0.54 (95% CI 0.44 to 0.60)] and Q15–Q16 [0.52 (95% CI 0.43 to 0.61)]. These two relationships related to the association between items exploring the influence of attentional focus and expectations (Q30–Q31), and feelings and stress (Q15–Q16). The three items with the greatest average centrality values, were Q22, Q25, and Q10. These items reflect beliefs about damaging the back, exercise, and activity avoidance, respectively.

Conclusion

Beliefs about back damage, exercise, and activity avoidance are factors most connected to all other beliefs within the network. These three factors may represent candidate targets that clinicians can focus their counseling efforts on to manage unhelpful attitudes and beliefs in people experiencing LBP.
Regulation of virulence in Chromobacterium violaceum and strategies to combat it
Authors: Venkatramanan Mahendrarajan , Nalini Easwaran
Published: January 2024

Chromobacterium is a rod-shaped, Gram-negative, facultatively anaerobic bacteria with a cosmopolitan distribution. Just about 160 Chromobacterium violaceum incidents have been reported globally, but then once infected, it has the ability to cause deadly septicemia, and infections in the lungs, liver, brain, spleen, and lymphatic systems that might lead to death. C. violaceum produces and utilizes violacein to kill bacteria that compete with it in an ecological niche. Violacein is a hydrophobic bisindole that is delivered through an efficient transport route termed outer membrane vesicles (OMVs) through the aqueous environment. OMVs are small, spherical segments detached from the outer membrane of Gram-negative bacteria. C. violaceum OMV secretions are controlled by a mechanism called the quorum sensing system CviI/CviR, which enables cell-to-cell communication between them and regulation of various virulence factors such as biofilm formation, and violacein biosynthesis. Another virulence factor bacterial type 3 secretion system (T3SS) is divided into two types: Cpi-1 and Cpi-2. Cpi-1’s needle and rod effector proteins are perhaps recognized by NAIP receptors in humans and mice, activating the NLRC4 inflammasome cascade, effectively clearing spleen infections via pyroptosis, and cytotoxicity mediated by IL-18-driven Natural killer (NK) cells in the liver. In this paper, we attempt to interrelate quorum-controlled biofilm formation, violacein production, violacein delivery by OMVs and T3SS effector protein production and host mediated immunological effects against the Cpi1 of T3SS. We suggest a research path with natural bioactive molecule like palmitic acid that can act as an anti-quorum agent by reducing the expression of virulence factors as well as an immunomodulatory agent that can augment innate immune defense by hyperactivation of NLRC4 inflammasome hence dramatically purge C. violaceum infections.
Effect of 15 days −6° head-down bed rest on microbial communities of supragingival plaque in young men
Authors: Zhu Di , Qiao Pengyan , Zhou Qian , Sun Hui , Xin Bingmu , Wu Bin , Tang Chuhua
Published: January 2024

Introduction

The microgravity environment astronauts experience during spaceflight can lead to an increased risk of oral diseases and possible changes in oral microecology. In this study, we aimed to assess changes in the microbial community of supragingival plaques to explore the effects of spaceflight microgravity environment on oral microecology.

Methods

Sixteen healthy male volunteers were recruited, and supragingival plaque samples were collected under −6° head-down bed rest (HDBR) at five-time points: day 1 before HDBR; days 5, 10, and 15 of HDBR; and day 6 of recovery. Bacterial genomic DNA was sequenced using gene sequencing technology with 16S ribosomal ribonucleic acid V3–V4 hypervariable region amplification and the obtained data were analyzed bioinformatically.

Results

Alpha diversity analysis showed a significant increase in species richness in supragingival plaque samples on day 15 of HDBR compared with that at pre-HDBR. Beta diversity analysis revealed that the community composition differed among the groups. Species distribution showed that, compared with those at pre-HDBR, the relative abundances of Corynebacterium and Aggregatibacter increased significantly during HDBR, while those of Veillonella, Streptococcus, and Lautropia decreased significantly. Moreover, compared with those at pre-HDBR, the relative abundance of Leptotrichia increased significantly on day 6 of recovery, whereas the relative abundances of Porphyromonas and Streptococcus decreased significantly. Network analysis showed that the interaction relationship between the dominant genera became simpler during HDBR, and the positive and negative correlations between them showed dynamic changes. Phylogenetic investigation of communities by reconstruction of unobserved states analysis showed that the amino acid metabolism function of plaque microorganisms was more enriched during HDBR.

Discussion

In summary, in a 15-day simulated microgravity environment, the diversity, species distribution, interaction relationship, and metabolic function of the supragingival plaque microbial community changed, which suggests that microgravity may affect the oral microecosystem by changing the balance of supragingival plaque microbial communities and further leading to the occurrence and development of oral diseases.
Efficacy of transcranial direct current stimulation for improving postoperative quality of recovery in elderly patients undergoing lower limb major arthroplasty: a randomized controlled substudy
Authors: Tao Mingshu , Yang Jie , Liu Rongguang , Zhang Song , Han Yuan , Li Chunyan , Wei Qi , Chen Dexian , Fang Jiaxing , Zhang Hongxing , Wang Yuwei , Liu He , Cao Jun-Li
Published: January 2024

Background

Previous studies have demonstrated improvements in motor, behavioral, and emotional areas following transcranial direct current stimulation (tDCS), but no published studies have reported the efficacy of tDCS on postoperative recovery quality in patients undergoing lower limb major arthroplasty. We hypothesized that tDCS might improve postoperative recovery quality in elderly patients undergoing lower limb major arthroplasty.

Methods

Ninety-six patients (≥65 years) undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) were randomized to receive 2 mA tDCS for 20 min active-tDCS or sham-tDCS. The primary outcome was the 15-item quality of recovery (QoR-15) score on postoperative day one (Т2). Secondary outcomes included the QoR-15 scores at the 2nd hour (T1), the 1st month (Т3), and the 3rd month (Т4) postoperatively, numeric rating scale scores, and fatigue severity scale scores.

Results

Ninety-six elderly patients (mean age, 71 years; 68.7% woman) were analyzed. Higher QoR-15 scores were found in the active-tDCS group at T2 (123.0 [114.3, 127.0] vs. 109.0 [99.3, 115.3]; median difference, 13.0; 95% CI, 8.0 to 17.0; p < 0.001). QoR-15 scores in the active-tDCS group were higher at T1 (p < 0.001), T3 (p = 0.001), and T4 (p = 0.001). The pain scores in the active-tDCS group were lower (p < 0.001 at motion; p < 0.001 at rest). The fatigue degree scores were lower in the active-tDCS group at T1 and T2 (p < 0.001 for each).

Conclusion

tDCS may help improve the quality of early recovery in elderly patients undergoing lower limb major arthroplasty.

Clinical trial registration

The trial was registered at the China Clinical Trial Center (ChiCTR2200057777, https://www.chictr.org.cn/showproj.html?proj=162744).
Levetiracetam modulates brain metabolic networks and transcriptomic signatures in the 5XFAD mouse model of Alzheimer’s disease
Authors: Burton Charles P. , Chumin Evgeny J. , Collins Alyssa Y. , Persohn Scott A. , Onos Kristen D. , Pandey Ravi S. , Quinney Sara K. , Territo Paul R.
Published: January 2024

Introduction

Subcritical epileptiform activity is associated with impaired cognitive function and is commonly seen in patients with Alzheimer’s disease (AD). The anti-convulsant, levetiracetam (LEV), is currently being evaluated in clinical trials for its ability to reduce epileptiform activity and improve cognitive function in AD. The purpose of the current study was to apply pharmacokinetics (PK), network analysis of medical imaging, gene transcriptomics, and PK/PD modeling to a cohort of amyloidogenic mice to establish how LEV restores or drives alterations in the brain networks of mice in a dose-dependent basis using the rigorous preclinical pipeline of the MODEL-AD Preclinical Testing Core.

Methods

Chronic LEV was administered to 5XFAD mice of both sexes for 3 months based on allometrically scaled clinical dose levels from PK models. Data collection and analysis consisted of a multi-modal approach utilizing 18F-FDG PET/MRI imaging and analysis, transcriptomic analyses, and PK/PD modeling.

Results

Pharmacokinetics of LEV showed a sex and dose dependence in Cmax, CL/F, and AUC0-∞, with simulations used to estimate dose regimens. Chronic dosing at 10, 30, and 56 mg/kg, showed 18F-FDG specific regional differences in brain uptake, and in whole brain covariance measures such as clustering coefficient, degree, network density, and connection strength (i.e., positive and negative). In addition, transcriptomic analysis via nanoString showed dose-dependent changes in gene expression in pathways consistent 18F-FDG uptake and network changes, and PK/PD modeling showed a concentration dependence for key genes, but not for network covariance modeling.

Discussion

This study represents the first report detailing the relationships of metabolic covariance and transcriptomic network changes resulting from LEV administration in 5XFAD mice. Overall, our results highlight non-linear kinetics based on dose and sex, where gene expression analysis demonstrated LEV dose- and concentration-dependent changes, along with cerebral metabolism, and/or cerebral homeostatic mechanisms relevant to human AD, which aligned closely with network covariance analysis of 18F-FDG images. Collectively, this study show cases the value of a multimodal connectomic, transcriptomic, and pharmacokinetic approach to further investigate dose dependent relationships in preclinical studies, with translational value toward informing clinical study design.
Fusing hyperspectral imaging and electronic nose data to predict moisture content in Penaeus vannamei during solar drying
Authors: Wang Jiarong , Wang Wenxiu , Xu Wenya , An Huanjiong , Ma Qianyun , Sun Jianfeng , Wang Jie
Published: January 2024

The control of moisture content (MC) is essential in the drying of shrimp, directly impacting its quality and shelf life. This study aimed to develop an accurate method for determining shrimp MC by integrating hyperspectral imaging (HSI) with electronic nose (E-nose) technology. We employed three different data fusion approaches: pixel-, feature-, and decision-fusion, to combine HSI and E nose data for the prediction of shrimp MC. We developed partial least squares regression (PLSR) models for each method and compared their performance in terms of prediction accuracy. The decision fusion approach outperformed the other methods, producing the highest determination coefficients for both calibration (0.9595) and validation sets (0.9448). Corresponding root-mean square errors were the lowest for the calibration set (0.0370) and validation set (0.0443), indicating high prediction precision. Additionally, this approach achieved a relative percent deviation of 3.94, the highest among the methods tested. The findings suggest that the decision fusion of HSI and E nose data through a PLSR model is an effective, accurate, and efficient method for evaluating shrimp MC. The demonstrated capability of this approach makes it a valuable tool for quality control and market monitoring of dried shrimp products.
Exploring the clinical efficacy and mechanism of high-position colon dialysis combined with Traditional Chinese Medicine retention enema in real-world patients with stage 3–5 chronic kidney disease (non-dialysis) based on the theory of the Gut–Kidney axis
Authors: Deng Yanli , Zhang Leixiao , Chen Si , Xu Dongxian , Wu Wei , Shen Tao , Liu Zhen , Yang Lin , Wen Aiwei , Hou Yuhao , Shao Fanyun
Published: January 2024

Background: With societal and economic development, the annual incidence of chronic kidney disease (CKD) is increasing. Current treatments for CKD are limited, and once patients progress to the uraemic stage, it places a significant economic burden on families and society. Based on the “gut–kidney axis” theory and real-world research, this study aims to evaluate the clinical efficacy, safety, and potential mechanism of high-position colon dialysis combined with traditional Chinese medicine (TCM) retention enema in treating stage 3–5 chronic kidney disease (non-dialysis). Additionally, it seeks to identify new therapeutic targets and approaches for CKD treatment.

Methods: The TCM decoction was analyzed using Ultra-Performance Liquid Chromatography-Quadrupole-Orbitrap-High Resolution Mass Spectrometry (UPLC-Q-Orbitrap-HRMS). Participants meeting the inclusion criteria were divided into a control group (n = 153) and a treatment group (n = 159) based on their preferences and physicians’ recommendations. Both groups adhered to a high-quality low-protein, low-salt, low-phosphorus, and low-fat diet supplemented with essential amino acids, and were monitored for blood pressure, blood glucose, and blood lipids. The treatment group received high-position colon dialysis combined with TCM retention enemas (administered at least 12 times every other day).

Results: Thirteen compounds were identified from the herbs by UPLC-Q-Orbitrap-HRMS. The CKD3–5 treatment group exhibited improvements in blood biochemistry and other laboratory indices, with significant enhancements in renal function-related indices for CKD4 and CKD5 stages (p < 0.05). Following treatment, indoxyl sulfate (IS), endotoxin, and D-lactic acid levels decreased to a certain extent in both groups, with a statistically significant difference observed within the treatment group (p < 0.05). The treatment group displayed a significant reduction in aerobic bacterial colonies, an increase in anaerobic bacterial colonies, a decrease in Escherichia coli colonies, and an increase in Bifidobacterium and Lactobacillus colonies (p < 0.05). No significant changes in colony numbers were observed in the control group.

Conclusion: High-position colon dialysis combined with TCM retention enema may serve as an adjuvant treatment for CKD4-5 (non-dialysis), and its mechanism may be related to the reduction of uraemic toxins, improvement of intestinal mucosal barrier function, and regulation of intestinal microecology.

Clinical Trial Registration:https://www.chictr.org.cn/, identifier ChiCTR2200062852.
Effects of yeast extract supplemented in diet on growth performance, digestibility, intestinal histology, and the antioxidant capacity of the juvenile turbot (Scophthalmus maximus)
Authors: Sun Jingwu , Li Yahui , Ren Tiancong , Gao Qian , Yin Lingqi , Liang Yunzhi , Liu Haiyan
Published: January 2024

An 8-week feeding experiment was conducted on the juvenile turbot (Scophthalmus maximus) to evaluate the influence of yeast extract (YE) supplementation in the diet on growth performance, feed utilization, body composition, nutrient digestibility, intestinal histology, and antioxidant capacity. Four experimental diets were formulated with graded levels of yeast extract 0 (YE0), 1% (YE1), 3% (YE3), and 5% (YE5) and fed to turbots (initial body weight: 4.2 ± 0.1 g) with three replicates per diet and 200 fish in each replicate, respectively. The results showed that turbots fed with diets YE1 and YE3 displayed a significantly higher specific growth rate and protein efficiency rate than those fed with diets YE0 and YE5, while the feed conversion ratios in YE1 and YE3 groups were lower than those in YE0 and YE5. Fish fed with diets YE3 and YE5 showed higher body crude protein contents than those in groups YE0 and YE1. The highest apparent digestibility coefficients for dry matter and crude protein, digestive enzyme activities (trypsin, lipase, and amylase), and the height of the intestinal fold were observed in the YE3 group. YE3 treatment displayed a significantly higher superoxide dismutase (SOD) activity than the YE0 group, while the malondialdehyde (MDA) content in YE1 was significantly lower than those in YE0 and YE5. No significant difference was observed in serum physiological and biochemical parameters among all treatments. Overall, appropriate dietary supplementation of the yeast extract could improve the growth performance, digestibility, and antioxidant capacity of the juvenile turbot, and the recommended yeast extract level in the feed is 2.47%.
An insight into the different responses to salt stress in growth characteristics of two legume species during seedling growth
Authors: Mi Jia , Ren Xinyue , Shi Jing , Wang Fei , Wang Qianju , Pang Haiyan , Kang Lifang , Wang Changhui
Published: January 2024

Legumes play a crucial role in the restoration and utilization of salinized grassland. To explore the physiological response mechanism of Astragalus membranaceus and Medicago sativa seedlings to salt stress, salt stress culture experiments with five NaCl concentration treatments (0 mmol/L, 50 mmol/L, 100 mmol/L, 200 mmol/L, and 300 mmol/L) were conducted on these two legume seedlings. Morphological characteristics, physiological features, biomass, and the protective enzyme system were measured for both seedlings. Correlation analysis, principal component analysis (PCA), and membership function analysis (MFA) were conducted for each index. Structural equation modeling (SEM) was employed to analyze the salt stress pathways of plants. The results indicated that number of primary branches (PBN), ascorbate peroxidase (APX) activity in stems and leaves, catalase (CAT) activity in roots, etc. were identified as the primary indicators for evaluating the salt tolerance of A. membranaceus during its seedling growth period. And CAT and peroxidase (POD) activity in roots, POD and superoxide dismutase (SOD) activity in stems and leaves, etc. were identified as the primary indicators for evaluating the salt tolerance of M. sativa during its growth period. Plant morphological characteristics, physiological indexes, and underground biomass (UGB) were directly affected by salinity, while physiological indexes indirectly affected the degree of leaf succulence (LSD). Regarding the response of the protective enzyme system to salt stress, the activity of POD and APX increased in A. membranaceus, while the activity of CAT increased in M. sativa. Our findings suggest that salt stress directly affects the growth strategies of legumes. Furthermore, the response of the protective enzyme system and potential cell membrane damage to salinity were very different in the two legumes.
Current psychopathology models emphasize very early intersubjectivity-based interventions in children to prevent later mental disorders
Authors: Ouss Lisa
Published: January 2024

Current psychopathology models have evolved toward dimensional models, in which symptoms and diseases are at the extremes of dimensions. Despite these new dimensional proposals, classifications and third-person approach have shown limitations. Their extraordinary evolution nevertheless underlines the contributions of developmental and psychodynamic frameworks. Developmental contributions have made it possible to evolve from disorders centered on a first-person perspective. Complementarily to the first-person/third-person perspectives, we advocate a second-person perspective, based on intersubjectivity. This perspective reverses the intuitive trend to focus our interventions on the most specific symptoms and syndromes, and advocates instead interventions on a “p” general factor that are both generalized and highly targeted. The implications are (1) to intervene as early as possible, (2) to base the definition of our therapeutic targets on an intersubjective perspective, (3) to identify and enhance children’s and parents’ strengths. These empirically informed directions are not in the current mainstream of psychopathology frameworks, and need to be developed.
Writing direction and language activation affect how Arabic-English bilingual speakers map time onto space
Authors: Park Juana , Gagné Christina L. , Spalding Thomas L.
Published: January 2024

We investigated whether writing direction and language activation influence how bilingual speakers map time onto space. More specifically, we investigated how Arabic-English bilingual speakers conceived where (e.g., on the left or on the right) different time periods (e.g., past, present, future) were located, depending on whether they were tested in Arabic (a language that is written from right to left) or in English (a language that is written from left to right). To analyze this, participants were given a task that involved arranging cards depicting different scenes of a story in chronological order. Results show that, when tested in Arabic, participants were significantly more likely to use right-to-left arrangements (following the Arabic writing direction), compared to when tested in English.
Burnout in residents during the first wave of the COVID-19 pandemic: a systematic review and meta-analysis
Authors: Navinés Ricard , Olive Victoria , Hidalgo-Mazzei Diego , Langohr Klaus , Vieta Eduard , Martin-Santos Rocio
Published: January 2024

Introduction

The high prevalence of burnout in resident physicians is expected to have increased as a result of the expansion of the pandemic. We conducted a systematic review with a meta-analysis of studies conducted during the first wave of the COVID-19 pandemic on burnout in residents and potential associated risk factors.

Methods

The search was done in the Web of Science, MEDLINE, Scopus, and Lillac databases (April 2020–October 2021) using a priori protocol based on the PRISMA guidelines. The Newcastle Ottawa Scale was used to assess the risk of bias in the included studies. We estimated the pooled prevalence (95% CI) of burnout and the prevalence ratio (95% CI) of each risk factor associated.

Results

We included 23 studies from 451 potential initial articles and those written in the English language; all of the collected studies were cross-sectional with anonymous online surveys, involving 4,998 responders (34%), of which 53.2% were female responders, 51% were R1-2, and 71% were in direct contact with COVID-19 patients. Eighty-seven percent presented a low-to-moderate risk of bias. Publication bias was not shown. The estimated pooled prevalence of burnout was 40% (95% CI = 0.26 – 0.57). Burnout was associated with psychiatry history (PR = 4.60, 95% CI = 1.06 – 20.06). There were no differences by gender, civil status, children in-charge, year of residency, or time exposure to COVID-19.

Discussion

The overall prevalence of burnout in residents during the first wave of the pandemic was in line with the results described in this collective before the pandemic. The presence of a psychiatry history was a potential burnout risk factor, suggesting a high vulnerability during the peak of the stress period and the need to implement mental health surveillance for this subgroup.
The association between neuroendocrine/glucose metabolism and clinical outcomes and disease course in different clinical states of bipolar disorders
Authors: Zhang Xu , Zhou Yaling , Chen Yuexin , Zhao Shengnan , Zhou Bo , Sun Xueli
Published: January 2024

Objective

The treatment of bipolar disorder (BD) remains challenging. The study evaluated the impact of the hypothalamic–pituitary–adrenal (HPA) axis/hypothalamic–pituitary-thyroid (HPT) axis and glucose metabolism on the clinical outcomes in patients with bipolar depression (BD-D) and manic bipolar (BD-M) disorders.

Methods

The research design involved a longitudinal prospective study. A total of 500 BD patients aged between 18 and 65 years treated in 15 hospitals located in Western China were enrolled in the study. The Young Mania Rating Scale (YMRS) and Montgomery and Asberg Depression Rating Scale (MADRS) were used to assess the BD symptoms. An effective treatment response was defined as a reduction in the symptom score of more than 25% after 12 weeks of treatment. The score of symptoms was correlated with the homeostatic model assessment of insulin resistance (HOMA-IR) index, the HPA axis hormone levels (adrenocorticotropic hormone (ACTH) and cortisol), and the HPT axis hormone levels (thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free triiodothyronine (fT3), and free thyroxine (fT4)).

Results

In the BD-M group, the YMRS was positively correlated with baseline T4 (r = 0.349, p = 0.010) and fT4 (r = 0.335, p = 0.013) and negatively correlated with fasting insulin (r = −0.289, p = 0.013). The pre-treatment HOMA-IR was significantly correlated with adverse course (p = 0.045, OR = 0.728). In the BD-D group, the baseline MADRS was significantly positively correlated with baseline fT3 (r = 0.223, p = 0.032) and fT4 (r = 0.315, p = 0.002), while baseline T3 (p = 0.032, OR = 5.071) was significantly positively related to treatment response.

Conclusion

The HPT axis and glucose metabolism were closely associated with clinical outcomes at 12 weeks in both BD-D and BD-M groups. If confirmed in further longitudinal studies, monitoring T3 in BD-D patients and HOMA-IR for BD-M could be used as potential treatment response biomarkers.
Prevalence, antimicrobial susceptibility profile, and associated risk factors of uropathogenic Escherichia coli among pregnant women attending Dr. Sumait Hospital Mogadishu, Somalia
Authors: Mohamed Fartun Yasin , Dahie Hassan Abdullahi , Mohamoud Jamal Hassan , Adam Mohamed Hussein , Dirie Hassan Mohamud
Published: January 2024

Background

Uropathogenic Escherichia coli (UPEC) is a strain of E. coli commonly associated with urinary tract infections. In addition, antibiotic resistance in UPEC is one of the most significant health problems. This study was conducted to determine the prevalence, antimicrobial resistance, and factors linked to uropathogenic Escherichia coli (UPEC) in pregnant women.

Methods

This cross-sectional study was conducted within a hospital setting between August 2022 and December 2022. Using consecutive convenient sampling, the research enrolled 220 pregnant women. The urine samples obtained from these women were cultured on MacConkey and blood agar and incubated at 37°C overnight, followed by sub-culturing on Mueller Hinton media. Bacterial identification involved Gram staining and biochemical characterization (TSI, indole, citrate, methyl red, urea agar, and motility tests). Conversely, susceptibility tests were performed using the Kirby–Bauer disk diffusion method. A binary logistic regression model and analysis of odds ratios (ORs) were employed to evaluate the risk factors associated with E. coli infection, and statistical significance was attributed to p-values of ≤0.05.

Results

Out of the 220 urine samples examined, 42 (19%) exhibited a positive culture, indicating an E. coli infection in pregnant women. Our analysis revealed that income, gestational age, and history of UTIs were identified as risk factors associated with E. coli infection. Most E. coli isolates demonstrated sensitivity to amikacin (100%), nitrofurantoin (85.7%), amoxicillin/clavulanic acid, and meropenem (83.3%).

Conclusion

The prevalence of E. coli was remarkable. It could be recommended that pregnant women in antenatal care have routine culture and antimicrobial susceptibility tests to prevent transmission of resistant pathogens and complications in both pregnant mothers and the unborn baby.
Do VIP medical services damage efficiency? New evidence of medical institutions’ total factor productivity using Chinese panel data
Authors: Yang Yan , Cheng Mingwang , Chen Ning , Yuan Ling , Wang Zhaoxin
Published: January 2024

This study examines the causal impact of very important person (VIP) medical services on hospital total factor productivity in Deyang, a prefectural-level city in western China, spanning the years 2015–2020. This aims to offer empirical evidence and policy recommendations for the implementation of VIP practices in the medical field. A secondary unbalanced panel dataset of 416 observations was collected from the annual reports of the Health Commission and 92 eligible medical institutions were included. This study utilized a two-stage strategy. First, the Global Malmquist index was used to calculate the total factor productivity and its decomposition terms for hospitals from 2015 to 2020. In the second stage, two-way fixed effects models and Tobit models were used to identify the relationship between VIP medical services and hospital efficiency; instrumental variables were used to solve potential endogeneity problems in the model. The results showed that VIP medical services had a significantly negative impact on medical institutions’ efficiency. The technological advances and pure technical efficiency related to VIP medical care may help explain these negative impacts, which were heterogeneous across groups divided by the nature of the hospital and the outside environment. It is imperative to prioritize the standardized provision of VIP medical services for medical institutions, optimize management and service process, enhance the training of clinical and scientific research capabilities of medical personnel, and scientifically allocate resources for both VIP and general medical services. This will help mitigate health inequality while improving the overall quality of medical services.
Creating musical life reviews with older people: a community case study
Authors: Gilboa Avi , Levy Nomi
Published: January 2024

Older people living in their homes might experience growing loneliness, detachment from their social environment, and decreased functional ability. In this community case study, we report on a project we initiated to enhance the functional ability of older people by creating musical life reviews (MLR) with them. We connected seven of our music therapy graduates (MT) to older people living in the neighborhood across the street from campus. MTs were first trained to work by a protocol for creating MLRs with older people, developed by the authors of this article. They then worked with older people from the neighborhood for 10 one-on-one sessions, on personally tailored MLRs. MTs kept on meeting in weekly group supervision sessions, thus learning from each other- and forming a community of their own. Participants expressed their high satisfaction with the process and reported that their MLRs became increasingly important to them. Most of them were interested in taking their MLR one step ahead, and playing it to family and/or friends, and, as part of the process, planned a personal event to do this. Further, two big community events were initiated by participants and MTs. To conclude, we show how the community project enhanced the functional ability of those participating in it. We also point at possible challenges and recommendations for further implementation of the project.
Prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa: a systematic review and meta-analysis
Authors: Traoré Fatoumata Bintou , Sidibé Cheick Sidya , Diallo El Hadj Marouf , Camara Bienvenu Salim , Sidibé Sidikiba , Diallo Alhassane , Diarra Nielé Hawa , Ly Birama Apho , Ag Ahmed Mohamed Ali , Kayentao Kassoum , Touré Abdoulaye , Camara Alioune , Delamou Alexandre , Sangho Hamadoun , Terera Ibrahim
Published: January 2024

Objectives

This study aimed to determine the prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa.

Methods

This systematic review and meta-analysis used the PRISMA guideline on sepsis data in sub-Saharan Africa. The bibliographic search was carried out on the following databases: Medline/PubMed, Cochrane Library, African Index Medicus, and Google Scholar. Additionally, the reference lists of the included studies were screened for potentially relevant studies. The last search was conducted on 15 October 2022. The Joanna Briggs Institute quality assessment checklist was applied for critical appraisal. Estimates of the prevalence of maternal and neonatal sepsis were pooled using a random-effects meta-analysis model. Heterogeneity between studies was estimated using the Q statistic and the I2 statistic. The funnel plot and Egger’s regression test were used to assess the publication bias.

Results

A total of 39 studies were included in our review: 32 studies on neonatal sepsis and 7 studies on maternal sepsis. The overall pooled prevalence of maternal and neonatal sepsis in Sub-Saharan Africa was 19.21% (95% CI, 11.46–26.97) and 36.02% (CI: 26.68–45.36), respectively. The meta-analyses revealed that Apgar score < 7 (OR: 2.4, 95% CI: 1.6–3.5), meconium in the amniotic fluid (OR: 2.9, 95% CI: 1.8–4.5), prolonged rupture of membranes >12 h (OR: 2.8, 95% CI: 1.9–4.1), male sex (OR: 1.2, 95% CI: 1.1–1.4), intrapartum fever (OR: 2.4, 95% CI: 1.5–3.7), and history of urinary tract infection in the mother (OR: 2.7, 95% CI: 1.4–5.2) are factors associated with neonatal sepsis. Rural residence (OR: 2.3, 95% CI: 1.01–10.9), parity (OR: 0.5, 95% CI: 0.3–0.7), prolonged labor (OR: 3.4, 95% CI: 1.6–6.9), and multiple digital vaginal examinations (OR: 4.4, 95% CI: 1.3–14.3) were significantly associated with maternal sepsis.

Conclusion

The prevalence of maternal and neonatal sepsis was high in sub-Saharan Africa. Multiple factors associated with neonatal and maternal sepsis were identified. These factors could help in the prevention and development of strategies to combat maternal and neonatal sepsis. Given the high risk of bias and high heterogeneity, further high-quality research is needed in the sub-Saharan African context, including a meta-analysis of individual data.

Systematic review registration: PROSPERO (ID: CRD42022382050).
Using participatory videos in understanding farmers experiences with climate smart agricultural practices: reflections from Ghana
Authors: Kwapong Nana Afranaa , Whitfield Stephen , Ambuko Jane , Ankrah Daniel Adu , Swanepoel Frans
Published: January 2024

Climate-smart agriculture (CSA) has gained traction as one of the effective strategies in tackling the climate crisis. Many CSA practices have been promoted by development agencies to smallholder farmers based on the assumption that farmers would adopt these innovations for their potential benefits. However, the adoption of CSA practices in Ghana and much of Africa remains low and decision making and on-farm innovation processes are poorly understood. This study seeks to provide empirical and participatory insight into how smallholder farmers innovate. Based on a novel application of a participatory video methodology, in farming communities in the Upper West Region of Ghana, that have been exposed to multiple CSA intervention programmes, the paper analyses farmers’ own self-curated accounts of experiences with CSA innovation. The findings show that farmer’s motivation to adopt CSA innovations is driven by their concerns for food security, economic gains, and the environmental impact of climate change on their farming activities and livelihood. The study reveals a mismatch between the CSA technologies and practices advanced by the development agencies and what farmers perceive as relevant and important in addressing their farming challenges. In particular, the findings show that in a pool of more than 12 CSA technologies and practices that had been promoted through three donor-driven intervention programmes in the communities, farmers selected less labour intensive, less costly, and CSA technologies and practices that fitted to their current farming practices and the local context. Agricultural extension agents served as an important information source on the CSA innovation and their practical implementation and farmers’ social groups played a crucial role in facilitating learning about the CSA technologies and practices. There is the need to integrate farmers voices using innovative methodologies such as participatory videos to better understand farmers’ experiences in the innovation process which will help inform the design of effective interventions and promote adoption of innovations aimed at enhancing the productivity of smallholder farmers and reducing environmental impacts in African food systems. By focusing on the innovations that farmers perceive as beneficial and adaptable to their local contexts, development organizations can use their resources more efficiently and promote adoption of contextually appropriate CSA innovations.
Avulsion fracture of the anterior superior iliac crest following autograft for anterior lumbar fusion: case report and literature review
Authors: Ge Chao-Yuan , Dong Liang , Xu Zheng-Wei , Yang Wen-Long , Qian Li-Xiong , Yang Xiao-Wei , Hao Ding-Jun
Published: January 2024

Avulsion fracture of the anterior superior iliac crest (ASIC) following autogenous bone grafting for anterior lumbar fusion (ALF) is an extremely rare complication. We describe a very rare case of avulsion fracture of the ASIC following autograft for ALF in a revision surgery for treating lumbar tuberculosis. A 68-year-old woman with lumbar tuberculosis underwent posterior debridement and posterior iliac crest bone graft fusion; however, her lumbar tuberculosis recurred 9 months after surgery. She then underwent a lumbar revision surgery, including removal of the posterior instrumentation and debridement, followed by anterior L2 corpectomy, debridement, anterior left iliac crest bone graft fusion, and internal fixation. When walking for the first time on postoperative day 3, she experienced a sharp, sudden-onset pain in the anterior iliac crest harvest area. X-ray revealed an avulsion fracture of the ASIC. Considering her failure to respond to conservative treatment for one week and large displacement of the fracture ends, an open reduction and internal fixation surgery was scheduled. Her pain symptoms were significantly relieved after the operation. Although rare, fracture of the ASIC following autograft for ALF should not be ignored. Fracture of the ASIC is usually treated conservatively. Additional surgical treatment is required only when intractable pain fails to respond to conservative treatment or when there is a large displacement of fracture ends that are not expected to heal spontaneously.
Comprehensiveness of online sources for patient education on otosclerosis
Authors: Cırık Ahmet Adnan , Yiğit Yeşim Esen , Tekin Ahmet Mahmut , Duymaz Yaşar Kemal , Şahin Şamil , Erkmen Burak , Topsakal Vedat
Published: January 2024

Purpose

This study aimed to assess the readability indices of websites including educational materials on otosclerosis.

Methods

We performed a Google search on 19 April 2023 using the term “otosclerosis.” The first 50 hits were collected and analyzed. The websites were categorized into two groups: websites for health professionals and general websites for patients. Readability indices were calculated using the website https://www.webfx.com/tools/read-able/.

Results

A total of 33 websites were eligible and analyzed (20 health professional-oriented and 13 patient-oriented websites). When patient-oriented websites and health professional-oriented websites were individually analyzed, mean Flesch Reading Ease scores were found to be 52.16 ± 14.34 and 46.62 ± 10.07, respectively. There was no significant difference between the two groups upon statistical analysis.

Conclusion

Current patient educational material available online related to otosclerosis is written beyond the recommended sixth-grade reading level. The quality of good websites is worthless to the patients if they cannot comprehend the text.
Dry Direct-Seeded Rice Yield and Water Use Efficiency as Affected by Biodegradable Film Mulching in the Northeastern Region of China
Authors: Zhao Zijun , He Wenqing , Chen Guangfeng , Yan Changrong , Gao Haihe , Liu Qin
Published: January 2024

In the realm of agriculture, biodegradable films are emerging as a promising substitute for traditional polyethylene (PE) films. Despite their potential, there has been a notable lack of extensive research on their effectiveness in the context of dry direct-seeded rice cultivation. Addressing this gap, a comprehensive biennial study was conducted in the northeastern regions of China, focusing on the ‘Baonong 5’ rice variety. This study meticulously compared three distinct cultivation methods: (1) employing biodegradable film mulching, (2) using conventional plastic film mulching, and (3) cultivating without any mulch. The findings revealed that biodegradable film mulching significantly enhanced soil moisture control, increased leaf area, and improved rice yield and water utilization efficiency (p < 0.05) compared to the plots without mulch. Notably, there was no marked difference in outcomes between the plastic film mulching and the unmulched plots. This research underscores the profound benefits of biodegradable film in rice cultivation, particularly from an environmental sustainability perspective. This innovative method not only boosts agricultural productivity but also addresses critical environmental challenges like climate change and water conservation. The application of biodegradable mulch has proven to be remarkably effective in improving irrigation efficiency and crop water conservation, leading to enhanced rice development and higher yields. The study recorded a substantial increase in water productivity—30% in 2021 and between 52.85% and 60% in 2022—compared to traditional cultivation practices. Furthermore, the use of biodegradable mulch resulted in significantly higher rice yields than the non-mulched plots, thus contributing to increased profitability. Such methods not only yield higher crop outputs but also mitigate environmental issues like water pollution and help alleviate prevalent water shortages in rice farming.
Distribution Characteristics of Carbon Density in Plant–Soil System of Temperate Steppe and Temperate Desert in the Longzhong Loess Plateau
Authors: Li Yali , He Guoxing , Liu Xiaoni , Xu Heguang , Ji Tong , Lin Dong , Jiang Jiachang
Published: January 2024

Grassland, as a key component of the carbon cycle in terrestrial ecosystems, is vital in confronting global climate change. Characterising the carbon density of grassland ecosystems in the Longzhong Loess Plateau is important for accurately assessing the contribution of grasslands to global climate change and achieving the goal of “peak carbon” and “carbon neutral”. In this study, the Longzhong Loess Plateau was used as the research object to explore changes in the plant–soil system carbon density in two grassland types by analysing the aboveground vegetation biomass carbon density, belowground vegetation biomass carbon density, 0–100 cm soil carbon density, and ecosystem carbon density of temperate steppe and temperate desert. The results showed that the vegetation biomass (standing and living, litter, and belowground biomass), soil, and ecosystem carbon densities of the temperate steppe were significantly higher than those of the temperate desert (p < 0.05). Their carbon densities were 700.51, 7612.95, and 8313.45 g·m−2, respectively. The vertical distribution of belowground biomass and soil carbon density in the temperate steppe was significantly higher than that in the temperate desert. The overall trend of belowground biomass carbon density in the temperate steppe and temperate desert showed a gradual decrease, whereas soil carbon density showed a steady increase. More than 91% and 96% of the carbon was stored in soil in the temperate steppe and temperate desert, respectively, and the belowground biomass carbon stock accounted for more than 84% of the total biomass carbon pools in both temperate steppe and temperate desert. Temperate steppe has a significant effect in improving the carbon stock of grassland ecosystems, so ecological protection and restoration of grassland should be strengthened in the future to enhance the capacity of grassland to sequester carbon and increase sinks.