bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of a soluble library of thePseudomonas aeruginosaPAO1 membrane proteome with emphasis on c-di-GMP turnover enzymes
Authors: Scherhag Anna , Räschle Markus , Unbehend Niklas , Venn Benedikt , Glueck David , Mühlhaus Timo , Keller Sandro , Pérez Patallo Eugenio , Zehner Susanne , Frankenberg-Dinkel Nicole
Published: June 2023

Studies of protein–protein interactions in membranes are very important to fully understand the biological function of a cell. The extraction of proteins from the native membrane environment is a critical step in the preparation of membrane proteins that might affect the stability of protein complexes. In this work, we used the amphiphilic diisobutylene/maleic acid copolymer to extract the membrane proteome of the opportunistic pathogen Pseudomonas aeruginosa, thereby creating a soluble membrane-protein library within a native-like lipid-bilayer environment. Size fractionation of nanodisc-embedded proteins and subsequent mass spectrometry enabled the identification of 3358 proteins. The native membrane-protein library showed a very good overall coverage compared to previous proteome data. The pattern of size fractionation indicated that protein complexes were preserved in the library. More than 20 previously described complexes, e.g. the SecYEG and Pili complexes, were identified and analyzed for coelution. Although the mass-spectrometric dataset alone did not reveal new protein complexes, combining pulldown assays with mass spectrometry was successful in identifying new protein interactions in the native membrane-protein library. Thus, we identified several candidate proteins for interactions with the membrane phosphodiesterase NbdA, a member of the c-di-GMP network. We confirmed the candidate proteins CzcR, PA4200, SadC, and PilB as novel interaction partners of NbdA using the bacterial adenylate cyclase two-hybrid assay. Taken together, this work demonstrates the usefulness of the native membrane-protein library of P. aeruginosa for the investigation of protein interactions and membrane-protein complexes. Data are available via ProteomeXchange with identifiers PXD039702 and PXD039700.
The Indivisibility of Human Rights: An Empirical Analysis
Authors: Essink Jan , Quintavalla Alberto , Temperman Jeroen
Published: June 2023

This article aims to test whether human rights have an indivisible nature. To do that, we perform correlation analysis and Granger causality tests to test 1) the relationship within socio-economic rights and 2) between socio-economic rights and civil-political rights. The results show that certain socio-economic rights have mutual reinforcing relationships, lending support to the existence of widespread indivisibility. This finding yields relevant policy implications. Given their financial constraints, states could make use of the existence of widespread indivisibility, in combination with the progressive implementation clause, to foster the efficient allocation of resources for human rights implementation. Furthermore, this article shows that the intensity of indivisibility varies depending on the income category of states: the indivisible nature of socio-economic rights is more intense in low-income countries while seems to achieve a saturation point at the highest levels of human rights compliance. We, thus, propose to define this phenomenon as ‘indivisibility saturation’. Lastly, our findings detect a more complex picture for the indivisibility principle between the two classes of human rights. While widespread indivisibility does not follow from the tests, important unidirectional relationships between different human rights exist and are equally important for human rights policy-making purposes.
A Positivity Criterion for the Wave Equation and Global Existence of Large Solutions
Authors: Beceanu Marius , Soffer Avy
Published: June 2023

In dimensions one to three, the fundamental solution to the free wave equation is positive. Therefore, there exists a simple positivity criterion for solutions. We use this to obtain large global solutions to two well-studied energy-supercritical semilinear wave equations, as well as some new results in the subcritical and critical cases.
Implications of resampling data to address the class imbalance problem (IRCIP): an evaluation of impact on performance between classification algorithms in medical data
Authors: Welvaars Koen , Oosterhoff Jacobien H F , van den Bekerom Michel P J , Doornberg Job N , van Haarst Ernst P ,   OLVG Urology Consortium, and the Machine Learning Consortium, van der Zee J A , van Andel G A , Lagerveld B W , Hovius M C , Kauer P C , Boevé L M S , van der Kuit A , Mallee W , Poolman R
Published: June 2023

Objective

When correcting for the “class imbalance” problem in medical data, the effects of resampling applied on classifier algorithms remain unclear. We examined the effect on performance over several combinations of classifiers and resampling ratios.

Materials and Methods

Multiple classification algorithms were trained on 7 resampled datasets: no correction, random undersampling, 4 ratios of Synthetic Minority Oversampling Technique (SMOTE), and random oversampling with the Adaptive Synthetic algorithm (ADASYN). Performance was evaluated in Area Under the Curve (AUC), precision, recall, Brier score, and calibration metrics. A case study on prediction modeling for 30-day unplanned readmissions in previously admitted Urology patients was presented.

Results

For most algorithms, using resampled data showed a significant increase in AUC and precision, ranging from 0.74 (CI: 0.69–0.79) to 0.93 (CI: 0.92–0.94), and 0.35 (CI: 0.12–0.58) to 0.86 (CI: 0.81–0.92) respectively. All classification algorithms showed significant increases in recall, and significant decreases in Brier score with distorted calibration overestimating positives.

Discussion

Imbalance correction resulted in an overall improved performance, yet poorly calibrated models. There can still be clinical utility due to a strong discriminating performance, specifically when predicting only low and high risk cases is clinically more relevant.

Conclusion

Resampling data resulted in increased performances in classification algorithms, yet produced an overestimation of positive predictions. Based on the findings from our case study, a thoughtful predefinition of the clinical prediction task may guide the use of resampling techniques in future studies aiming to improve clinical decision support tools.
The 2023 Impact of Inflammatory Bowel Disease in Canada: Executive Summary
Authors: Windsor Joseph W , Kuenzig M Ellen , Murthy Sanjay K , Bitton Alain , Bernstein Charles N , Jones Jennifer L , Lee Kate , Targownik Laura E , Peña-Sánchez Juan-Nicolás , Rohatinsky Noelle , Ghandeharian Sara , Im James H B , Davis Tal , Weinstein Jake , Goddard Quinn , Gorospe Julia , Benchimol Eric I , Kaplan Gilaad G
Published: June 2023

The burden of inflammatory bowel disease (IBD) (i.e., associated direct and indirect costs, prevalence of disease, personal impact to the individual and to caregivers) continues to increase in Canada. The prevalence of IBD has increased since Crohn’s and Colitis Canada’s 2018 Impact of IBD report from an estimated 270,000 Canadians living with IBD in 2018 to an estimated 322,600 Canadians living with IBD today in 2023. Consequently, associated costs of IBD have also dramatically increased from an estimated $2.57 billion in 2018 to an estimated $5.38 billion in 2023; this increase is due to multiple factors including increased prevalence of disease, inflation, and additional identified factors (e.g., presenteeism, costs of childcare). Beyond the economic impact of IBD, these diseases have a significant impact on people living with the disease and their caregivers, including different presentations of disease, different commonly associated extra-intestinal manifestations or comorbid conditions, and different barriers to accessing care. In this supplementary issue, we review: Evolving trends in the epidemiology of IBD; updated estimates of indirect and direct costs (including out-of-pocket costs) associated with IBD; information specific to IBD in children, adolescents, and seniors; issues related to IBD pertaining to sex and gender; information specific to risks associated with COVID-19 and cancer related to IBD; an overview of current treatments for IBD; and evolving care models, including access to care.
Prolonging genetic circuit stability through adaptive evolution of overlapping genes
Authors: Chlebek Jennifer L , Leonard Sean P , Kang-Yun Christina , Yung Mimi C , Ricci Dante P , Jiao Yongqin , Park Dan M
Published: June 2023

The development of synthetic biological circuits that maintain functionality over application-relevant time scales remains a significant challenge. Here, we employed synthetic overlapping sequences in which one gene is encoded or ‘entangled’ entirely within an alternative reading frame of another gene. In this design, the toxin-encoding relE was entangled within ilvA, which encodes threonine deaminase, an enzyme essential for isoleucine biosynthesis. A functional entanglement construct was obtained upon modification of the ribosome-binding site of the internal relE gene. Using this optimized design, we found that the selection pressure to maintain functional IlvA stabilized the production of burdensome RelE for >130 generations, which compares favorably with the most stable kill-switch circuits developed to date. This stabilizing effect was achieved through a complete alteration of the allowable landscape of mutations such that mutations inactivating the entangled genes were disfavored. Instead, the majority of lineages accumulated mutations within the regulatory region of ilvA. By reducing baseline relE expression, these more ‘benign’ mutations lowered circuit burden, which suppressed the accumulation of relE-inactivating mutations, thereby prolonging kill-switch function. Overall, this work demonstrates the utility of sequence entanglement paired with an adaptive laboratory evolution campaign to increase the evolutionary stability of burdensome synthetic circuits.
Thumb-domain dynamics modulate the functional repertoire of DNA-Polymerase IV (DinB)
Authors: Okeke Damasus C , Lidman Jens , Matečko-Burmann Irena , Burmann Björn M
Published: June 2023

In order to cope with the risk of stress-induced mutagenesis, cells in all kingdoms of life employ Y-family DNA polymerases to resolve resulting DNA lesions and thus maintaining the integrity of the genome. In Escherichia coli, the DNA polymerase IV, or DinB, plays this crucial role in coping with these type of mutations via the so-called translesion DNA synthesis. Despite the availability of several high-resolution crystal structures, important aspects of the functional repertoire of DinB remain elusive. In this study, we use advanced solution NMR spectroscopy methods in combination with biophysical characterization to elucidate the crucial role of the Thumb domain within DinB’s functional cycle. We find that the inherent dynamics of this domain guide the recognition of double-stranded (ds) DNA buried within the interior of the DinB domain arrangement and trigger allosteric signals through the DinB protein. Subsequently, we characterized the RNA polymerase interaction with DinB, revealing an extended outside surface of DinB and thus not mutually excluding the DNA interaction. Altogether the obtained results lead to a refined model of the functional repertoire of DinB within the translesion DNA synthesis pathway.
You are fired! Exclusion words induce corticospinal modulations associated with vicarious pain
Authors: Vitale Francesca , Urrutia Mabel , Avenanti Alessio , de Vega Manuel
Published: June 2023

Self- and vicarious experience of physical pain induces inhibition of the motor cortex (M1). Experience of social rejections recruits the same neural network as physical pain; however, whether social pain modulates M1 corticospinal excitability remains unclear. This study examines for the first time whether social exclusion words, rather than simulated social exclusion tasks, modulate embodied sensorimotor networks during the vicarious experience of others’ pain. Participants observed visual sequences of painful and functional events ending with a superimposed word with social exclusion, social inclusion or non-social meaning. Motor-evoked potentials (MEPs) to single-pulse transcranial magnetic stimulation of the left M1 were recorded at 400 or 550 ms from word onset. MEPs tended to inhibit during the observation of pain, relative to functional events. Moreover, MEPs recorded at 400 ms from word onset, during pain movies, decreased following the presentation of exclusion, relative to inclusion/neutral words. The magnitude of these two modulations marginally correlated with participants’ interindividual differences in personal distress and self-esteem. These findings provide evidence of vicarious responses to others’ pain in the M1 corticospinal system and enhancement of such vicarious response in the earlier phases of semantic processing of exclusion words—supporting activation of social pain–embodied representations.
The Sights and Sounds of State Violence: Encounters with the Archive of David Oluwale
Authors: Perry Kennetta Hammond
Published: June 2023

This article dwells in the archive documenting the existence of David Oluwale, a Nigerian-born British citizen whose life is captured historically by way of his encounters with the state. Working within and against the dynamics of violation, racialization, and dispossession structuring his archival presence, this article looks to the visual and sonic registers of an archive of Black dispossession to excavate histories of anti-Black state violence in Britain during the second half of the twentieth century. Likewise, it considers the extent to which an archive steeped in Black dispossession might offer possibilities for imagining Black emotive lives and constructing histories of Black sentience and affect even as they are produced in the context of racialized violence and duress.
Optimization and Validation of Singleplex and Multiplex RT-qPCR for Detection of Citrus bark cracking viroid (CBCVd), Hop latent viroid (HLVd), and Hop stunt viroid (HSVd) in Hops (Humulus lupulus)
Authors: Guček Tanja , Jakše Jernej , Radišek Sebastjan
Published: June 2023

Direct crop losses due to plant diseases and the measures used to control them have significant agricultural and economic impacts. The shift from diverse small-scale to large-scale genetically uniform monoculture production, along with agricultural intensification and climate change, has led to several known epidemics in man-made agroecosystems that have been rendered more vulnerable to pathogens. One such example is hop growing, which is threatened by highly aggressive hop viroids. Since 2007, almost one-third (about 500 ha) of Slovenian hop gardens have been affected by severe hop stunt disease caused by Citrus bark cracking viroid (CBCVd), which continues to spread despite strict prevention measures. We have developed and validated a multiplex RT-qPCR (mRT-qPCR) for the sensitive detection of CBCVd, Hop latent viroid (HLVd), and Hop stunt viroid (HSVd). Singleplex RT-qPCR assays were designed individually and subsequently combined in a one-step mRT-qPCR assay. Hop-specific mRNA170 and mRNA1192 internal controls were also developed to detect possible PCR inhibition. Analytical specificity was tested on 35 samples from different hosts, geographic regions, and combinations of viroids. Method validation showed that mRT-qPCR had lower sensitivity than singleplex RT-qPCR, while specificity, selectivity, repeatability, and reproducibility remained unchanged. The newly developed assays were found to be robust, reliable, and suitable for large-scale screening of hop viroids.
Temporal Analysis of Malaria Cases in the Brazilian Yanomami Pediatric Population: A Retrospective Ecologic Study From 2003 to 2022
Authors: Martins-Filho Paulo Ricardo , Lima Shirley Verônica Melo Almeida , Damascena Nicole Prata , Araujo Analany Pereira Dias , Silva Melina Calmon , Santiago Bianca Marques , Santos Francisco Helmer Almeida , Machado Carlos Eduardo Palhares
Published: June 2023

This retrospective ecological study investigated malaria incidence among Brazilian Yanomami children and adolescents from 2003 to 2022. Of the 145,573 recorded cases, 75.9% occurred in the Yanomami pediatric population. Moreover, an increase in the proportion of cases among the 10–19 age group has been observed, potentially associated with the recruitment of Indigenous adolescents to mining areas in recent years.
Clinical utility of inflammatory and genetic biomarkers for cardiovascular disease prevention, categorization, and treatment
Authors: Mewborn Emily K. , Wright David B. , Wicks Mona N.
Published: June 2023

The complex interplay of increased atherogenic lipoproteins, inflammation, and immune activation hallmarks the pathogenesis of atherosclerotic cardiovascular disease (ASCVD). Atherosclerotic cardiovascular disease remains a leading cause of death, yet risk estimator tools lack comprehensiveness for genetic/inflammatory biomarkers associated with ASCVD. Unexplained ASCVD risk necessitates a better understanding of primary, secondary, and tertiary prevention variables. This article discusses the clinical utility of genetic and inflammatory biomarkers for ASCVD risk prediction, management, treatment, and recategorization into primary, secondary, and tertiary prevention. Furthermore, nurse practitioners (NPs) should use a ternary prevention classification system instead of the current binary system to mitigate risk in the large group of patients with subclinical ASCVD. High-sensitivity C-reactive protein (hs-CRP)—linearly associated with ASCVD—and lipoprotein-associated phospholipase-A2 (Lp-PLA2) and myeloperoxidase (MPO), both associated with plaque vulnerability/rupture, are inflammatory biomarkers. Elevated hs-CRP, MPO, and Lp-PLA2 treatment requires addressing root causes of elevation (e.g., obesity, insulin resistance, tobacco use, gingival disease, and chronic autoimmune/infectious conditions). In addition, haptoglobin (Hp) phenotype determines the antioxidant potential of Hp. Haptoglobin phenotype, a root cause of ASCVD, is a one-time test. Individuals with Hp 2-2 should adopt a gluten-free diet to reduce endothelial and intestinal inflammation. Nurse practitioners should use stricter glycemic goals (hemoglobin A1c ≤6.5%) and add daily vitamin E if this group has type 2 diabetes. Genetic/inflammatory biomarkers should be used to better predict ASCVD risk and tailor primary, secondary, and tertiary prevention treatment. Clinical use of these biomarkers reaches beyond the standard of care to reduce residual ASCVD risk.
Red Blood Cell Transfusion Prior to Lung Transplantation: Impact on Patient Outcomes
Authors: Muir Kelsey , Firoz Ahad , Kashem Mohammed A. , Shigemura Norihisa , Toyoda Yoshiya
Published: June 2023

There is an established association between red blood cell (RBC) transfusion and increased mortality and morbidity in cardiac surgery; however, there is little data demonstrating the influence of blood transfusion while awaiting lung transplantation. Therefore, our study compared the impact of pretransplant RBC transfusion on patient survival and post-transplantation adverse events. Adult lung transplant patient data were extracted retrospectively using the United Network for Organ Sharing thoracic database. Patients were stratified into two groups based on pretransplant transfusion status. In total, 28,217 patients were analyzed in our study (transfused: n = 1,415 and not transfused: n = 26,802). There was an increasing trend in pretransplant transfusion rates from 2006 to 2020. Transfused patients had a higher incidence of adverse events post-transplantation, including dialysis, stroke, and acute organ rejection before discharge. Multivariable survival analysis found an increased mortality risk in patients who required pretransplant transfusion(s) compared to those who did not have a transfusion (hazard ratio [HR]: 1.27; 95% confidence interval [CI]: 1.17–1.41; p < 0.001). There was no significant difference in bronchiolitis obliterans syndrome development between groups (HR: 0.92; 95% CI: 0.82–1.04; p = 0.185). To conclude, our study provides data to suggest that RBC transfusion(s) before lung transplantation are associated with increased patient morbidity and mortality, but have no association with chronic graft rejection development.
Assessment the knowledge, care, and experiences of neonatal nurses about enteral nutrition
Authors: Gunes N. Ecem Oksal , Cetinkaya Senay
Published: June 2023

Enteral-feeding refers to any nutritional method throughout the gastrointestinal tract, including oral feeding. This qualitative study examined the information, experiences, and records of neonatal nurses of enterally fed patients. The study was conducted between 05.04.2018 and 05.05.2018 with 22 nurses (73.3%) working in the neonatal intensive care clinic of Çukurova University Balcali Hospital, Adana, Turkey. The data were collected by “Observation and Interview Form” developed based on the literature. Nurses were observed, and interviews were conducted depending on their appointments. Data were collected by observing each nurse on 2 different days. In all observations; it was determined that the nurses changed the feeding set daily, regularly checked the location of the feeding tube and amount of residue, and administered medication through the feeding tube. In 22.7% of the observations, nurses did not securely fix the feeding tube, 27.2% did not write a daily date on the injector with the residual volume measured, and 31.8% did not wash the injector. All the nurses recorded the amount of feed, residual amounts, and content. At the end of the interviews, 9% of the nurses stated that they had experienced aspiration among the complications encountered during enteral feeding. During the interview, they stated that all nurses were educated about enteral nutrition, had control of whether the probe was in place before feeding, performed residual control, washed their hands before the procedure, fixed the food injector to 1 place, and allowed the food injector to flow spontaneously with negative pressure. According to the results of the interviews and observations, nurses could not reflect on their nursing practices correctly. Nurses working in neonatal intensive care units should be regularly trained to share the results of evidence-based studies on enteral nutrition.
A case of endocervical adenocarcinoma of the gastric type that was repeatedly misdiagnosed: A case report and literature review
Authors: Zhang Shurong , Jin Guoyu , Ding Feier , Zhang Junlei , Li Qiuju , Wang Guoyun , Li Changzhong , Yang Chunrun
Published: June 2023

Rationale:

Gastric-type endocervical adenocarcinoma (GAS) is non-human papillomavirus-associated cervical cancer and the location of the lesions is in the cervical canal mostly.

Patient concerns:

Vaginal discharge is mistakenly thought to be caused by uterine fibroids. Misdiagnosis leads to disease progression.

Diagnoses:

Magnetic resonance imaging is an auxiliary tool and pathology is the gold standard for the diagnosis.

Interventions:

Surgery and supplementary radiotherapy and chemotherapy ± targeted therapy are the main treatment methods.

Outcomes:

GAS with high malignant degree poor prognosis and insidious development, tends to develop toward the cervical canal and is lack of specific tumor markers, so it is easy to misdiagnosis and missed diagnosis.

Lessons:

This case highlights the importance of improving the understanding of GAS. And when patients perform vaginal discharge, cervical canal hypertrophy, and cervical cancer screening negative, clinicians ought to be highly alert to GAS.
The impact of standardized perioperative care management on improving outcomes in patients with peptic ulcer disease
Authors: Ding Wei , Jian Man , Xu Rui-jie
Published: June 2023

The present study investigated the impact of standardized perioperative nursing management on improving outcomes in patients with peptic ulcer disease. A total of 90 patients with peptic ulcers were admitted to the Wuhan Wuchang Hospital between July 2020 to July 2022. These patients were included in the present study. They were divided into 2 groups based on the nursing management that they received, with 45 patients classified into each group. The control group received routine nursing care, while the observation group received standardized perioperative nursing management. The improvement in clinical symptoms, recurrence rate, negative emotions and disease management capacity were compared between the 2 groups. The results demonstrated that the improvement rate of clinical symptom in the observation group was significantly higher as compared with the control group (P < .05). The recurrence rate in the observation group was significantly lower than in the control group (P = .026). Patients in the observation group had better psychological status, and better disease management capacity as compared with those in the control group (P < .05). The application of standardized perioperative nursing management for patients with peptic ulcer can help improve the patients’ clinical symptoms, enhance their disease management capacity, reduce anxiety, and ensure the quality of nursing care.
Analysis of pelvic floor electromyography in women screened 42 days postpartum: A cross-sectional study
Authors: Zhang Hong , Gou Yu , Zhang Jing , Liang Kairu , Li Haiyan , Fang Yuan
Published: June 2023

To investigate the characteristics of pelvic floor surface electromyography parameters on the basis of Glazer assessment in women 42 days postpartum, and to analyze the predictive value of surface electromyography (sEMG) in postpartum stress urinary incontinence. This is a retrospective study. Three thousand twenty-nine females in total who were screened 42 days postpartum in Jinniu District Maternal and Children’s Health Hospital of Chengdu from January 2019 to December 2020 were selected, and were randomly allocated into stress urinary incontinence (SUI) (n = 509) and the non-SUI group (n = 2520). Pelvic floor surface electromyography was performed by the same physiotherapists. The evaluation parameters included the average EMG value in the pre-resting baseline, the maximum sEMG value, the rising time, the descent time in the fast-twitch phase, and the average sEMG value in the slow-twitch phase. Mean value and modifiability of EMG value in post-resting stage. The disparities of the mentioned parameters hereinabove in the SUI and non-SUI groups were made comparison, and the relationship between stress urinary incontinence and sEMG parameters was analyzed by multiple logistic regression analysis. The prevalence of SUI was 16.8% in women 42 days after delivery. Body mass index and vaginal delivery were risk factors for SUI. Among the sEMG parameters of the SUI group and the non-SUI group, the maximum EMG values in the fast-twitch phase (28.81 ± 14.41 vs 30.41 ± 15.15), the rising time in the fast-twitch phase (0.55 ± 0.36 vs 0.51 ± 0.30), and the Phase descent time (0.76 ± 0.76 vs 0.68 ± 0.65), mean slow-twitch phase EMG (17.82 ± 10.10 vs 19.69 ± 15.62), slow-twitch phase variability (0.28 ± 0.12 vs 0.26 ± 0.10), are statistically different (P < .05). In the SUI group, body mass index (estimated parameter = 0.029, P = .023), mean EMG during slow-twitch phase (estimated parameter = -0.013, P = .004) were relevant to stress urinary incontinence after delivery. The sEMG based on Glazer protocol indicates the activity of slow-twitch muscle fibers in SUI patients are decreased, and there is a correlation with the occurrence of stress urinary incontinence. sEMG can be applied as a quantitative evaluation tool of the pelvic floor analysis in postpartum SUI.
A case of collagenous gastritis and literature review: A case report
Authors: Wu Channi , Wang Lin , Zhang Lan , Ni Yangdan , Wang Zhiyong , Qu Yichen
Published: June 2023

Rational:

Collagenous gastritis (CG) is rarely encountered in clinical practice. Here, we reported a case of CG with iron-deficiency anemia as the main symptom.

Patient concerns:

The patient was a 26-year-old woman who sought medical advice with a chief complaint of recurrent upper abdominal distention and anemia since the last 3 years.

Diagnoses:

Gastroscopy at admission showed diffuse nodular mucosa. The pathology showed the formation of a belt hyperplasia of collagen in the superficial mucosa along with the infiltration of inflammatory cells. The subepithelial collagen band was 17.68 to 35.73-μm thick and tested positive for Masson staining, thereby confirming the diagnosis of CG.

Interventions:

A polysaccharide iron complex capsule was given in a dosage of 0.3 t.i.d., p.o. in combination with an omeprazole capsule (20 mg q.d. p.o).

Outcomes:

The symptoms (upper abdominal distention and anemia) were ameliorated after 8-week treatment. Blood routine showed that the hemoglobin level rose to 91 g/L.

Lessons:

It is difficult to diagnose CG. Hence, a comprehensive examination based on clinical manifestations, endoscopic findings, and pathological features is required.
The impact of the COVID-19 pandemic on adverse fetal outcomes: A cross-sectional study
Authors: Dagelić Andrea , Mulic Emma , Kuzmic Prusac Ivana , Zekic Tomas Sandra
Published: June 2023

The coronavirus disease 2019 (COVID-19) pandemic has been one of the most damaging pandemics in all of human history. Some of the most vulnerable groups within society such as pregnant women and children have also been affected. This observational research, cross-sectional study was conducted to investigate if there was any difference in the incidence of unfavorable outcomes in pregnancy such as miscarriage, intrauterine fetal demise, and early neonatal death during the year prior to the pandemic and the year of the COVID-19 pandemic. This retrospective study was conducted at the University Hospital of Split at the Department of Pathology, Forensic and Cytology and Department of Obstetrics and Gynecology of the same hospital. All data was collected in the time period from March 1st, 2019, to March 1st, 2021. The study included all pregnant women who had an unfavorable pregnancy outcome such as miscarriage and intrauterine fetal demise, as well as early neonatal death at the University Hospital of Split within the time frame mentioned previously. There was no statistically significant difference in the incidence of adverse pregnancy outcomes in the year prior to the pandemic and during the year of the COVID-19 pandemic. Our study showed that the pandemic did not have a negative effect on pregnant women and their fetuses; there was no increase in miscarriage, intrauterine fetal demise, or perinatal death during the year of the pandemic.
Impact of the COVID-19 pandemic on the trajectory of the number of bronchoscopies performed in a tertiary hospital in Kyoto city
Authors: Fujita Kohei , Kanai Osamu , Ito Takanori , Saito Zentaro , Imakita Takuma , Oi Issei , Yamamoto Yuki , Hashimoto Masayuki , Sawai Satoru , Hata Hiroaki , Odagaki Takao , Mio Tadashi
Published: June 2023

The coronavirus disease 2019 (COVID-19) pandemic has restricted many medical practices. We aimed to investigate the impact of the COVID-19 pandemic on the number of bronchoscopies, outpatients, and hospital admissions. We retrospectively analyzed the number of outpatients, admissions, and bronchoscopies performed between March 2020 and May 2022. We defined “Peak month of the pandemic,” “Wave of the pandemic,” “Month in the wave,” and “Period of a state of emergency” for each analysis. In the first year of the COVID-19 pandemic, analysis of variance (ANOVA) in linear mixed models indicated significant effects of “month in each wave” on the number of bronchoscopies (P = .003), outpatients (P = .041), and admissions (P = .017). The number of outpatients, admissions, and bronchoscopies was significantly influenced by the first wave of the COVID-19 pandemic. In contrast, in the second year of the COVID-19 pandemic, a mixed-ANOVA indicated significant effects of “month in each wave” only on the number of outpatients (P = .020) but no significant effects on the number of bronchoscopies (P = .407) and admissions (P = .219). During the second year of the pandemic, the number of bronchoscopies and admissions was not significantly affected by the waves of the pandemic. There were no significant differences in the number of admissions and bronchoscopies between the fourth and sixth waves. Although the number of bronchoscopies was found to be significantly affected in the early stages of the COVID-19 pandemic, the impact of the pandemic was much more limited thereafter.
Reimagining the Preceptor Role
Authors: McDermott Carrie
Published: June 2023

Preceptors are responsible for departmental specific orientation and shaping the development of the new graduate in the early weeks and months of their nursing career. Turnover of direct care nurses has increased at an alarming rate since the start of the pandemic and new graduate nurses continue to be in high demand, but the diminishing number of qualified preceptors presents a challenge. Innovative approaches are needed to make way for increasing the pace of hiring and onboarding new graduates. A group orientation approach was identified as an opportunity to redesign orientation for newly licensed registered nurses in an employer-based transition to practice nurse residency programs. Findings from the first cohort suggest that leaders, preceptors, direct care nurses, and new graduate orientees were satisfied with a group orientation model. Preparing novice nurses to enter practice requires organizational commitment and resources. Group orientation may be a useful approach to foster new graduate nurses' transition to practice and advance the preceptor role.
Plateau Pressure and Driving Pressure in Volume- and Pressure-Controlled Ventilation: Comparison of Frictional and Viscoelastic Resistive Components in Pediatric Acute Respiratory Distress Syndrome
Authors: Cruces Pablo , Moreno Diego , Reveco Sonia , Ramirez Yenny , Díaz Franco
Published: June 2023

OBJECTIVES:

To examine frictional, viscoelastic, and elastic resistive components, as well threshold pressures, during volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) in pediatric patients with acute respiratory distress syndrome (ARDS).

DESIGN:

Prospective cohort study.

SETTING:

Seven-bed PICU, Hospital El Carmen de Maipú, Chile.

PATIENTS:

Eighteen mechanically ventilated patients less than or equal to 15 years old undergoing neuromuscular blockade as part of management for ARDS.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

All patients were in VCV mode during measurement of pulmonary mechanics, including: the first pressure drop (P1) upon reaching zero flow during the inspiratory hold, peak inspiratory pressure (PIP), plateau pressure (PPLAT), and total positive end-expiratory pressure (tPEEP). We calculated the components of the working pressure, as defined by the following: frictional resistive = PIP–P1; viscoelastic resistive = P1–PPLAT; purely elastic = driving pressure (ΔP) = PPLAT–tPEEP; and threshold = intrinsic PEEP. The procedures and calculations were repeated on PCV, keeping the same tidal volume and inspiratory time. Measurements in VCV were considered the gold standard. We performed Spearman correlation and Bland-Altman analysis. The median (interquartile range [IQR]) for patient age was 5 months (2–17 mo). Tidal volume was 5.7 mL/kg (5.3–6.1 mL/kg), PIP cm H2O 26 (23–27 cm H2O), P1 23 cm H2O (21–26 cm H2O), PPLAT19 cm H2O (17–22 cm H2O), tPEEP 9 cm H2O (8–9 cm H2O), and ΔP 11 cm H2O (9–13 cm H2O) in VCV mode at baseline. There was a robust correlation (rho > 0.8) and agreement between frictional resistive, elastic, and threshold components of working pressure in both modes but not for the viscoelastic resistive component. The purely frictional resistive component was negligible. Median peak inspiratory flow with decelerating-flow was 21 (IQR, 15–26) and squared-shaped flow was 7 L/min (IQR, 6–10 L/min) (p< 0.001).

CONCLUSIONS:

PPLAT, ΔP, and tPEEP can guide clinical decisions independent of the ventilatory mode. The modest purely frictional resistive component emphasizes the relevance of maintaining the same safety limits, regardless of the selected ventilatory mode. Therefore, peak inspiratory flow should be studied as a mechanism of ventilator-induced lung injury in pediatric ARDS.
A Lens on Caregiver Stress in Cancer: Longitudinal Investigation of Cancer-Related Stress and Telomere Length Among Family Caregivers of Adult Patients With Cancer
Authors: Kim Youngmee , Lin Jue , Epel Elissa S. , Carver Charles S.
Published: June 2023

Objective

Family members are typically the primary caregivers of patients with chronic illnesses. Family caregivers of adult relatives with cancer are a fast-growing population, yet the physical consequences of their stress due to the cancer in the family have been poorly understood. This study examined the bidirectional relations of the perceived stress of family caregivers of individuals recently diagnosed with cancer and leukocyte cellular aging indexed by telomere length for 2 years.

Methods

Family caregivers (N = 168; mean age = 51 years, 70% female, 46% Hispanic, 36% spouse to the patient) of patients with colorectal cancer provided psychological data and peripheral blood samples approximately 4 (T1), 12 (T2), and 21 months (T3) after diagnosis. Time-lagged cross-panel modeling was used to test the associations of perceived cancer-related stress and telomere length, controlling for age, sex, and body mass index.

Results

Cancer-related stress was highest at T1 and decreased by 1 year. Greater cancer-related stress predicted longer telomere length at subsequent assessments for 2 years (β ≥ 0.911, p ≤ .019). However, telomere length did not change significantly for 2 years overall and did not prospectively predict cancer-related stress over this period.

Conclusions

Findings suggest the need to better understand how the perceived stress of colorectal cancer caregivers, which tends to be intense for a relatively short period compared with dementia caregiving, may impact immune cell distributions and telomere length. These findings emphasize the need for further knowledge about psychobiological mechanisms of how cancer caregiving may impact cellular aging.
Diversity in the Plastic Surgery Match: The Effect of Program Chair, Program Director, and Faculties’ Race and Sex on Matched Applicants
Authors: Steiner Quinn , Edalatpour Armin , Seitz Allison J. , Bentz Michael L. , Afifi Ahmed M.
Published: June 2023

Introduction:

Prior studies have identified the lack of diversity within the field of plastic surgery (PS) and associated residency matches. In this study, the authors aimed to examine the effect of PS program chairs (PCs), program directors (PD), and faculty members’ race and sex on PS applicants and matriculants within the same program.

Methods:

Deidentified applicant data from 2017 to 2021 submitted to the University of Wisconsin-Madison’s integrated PS program were analyzed. Applicants’ self-reported sex and race were collected. Integrated PS program websites were assessed to determine whether applicants matched the program. Race and sex of PCs, PDs, and faculty members were collected from each program’s website.

Results:

Overall, 79 integrated PS programs’ websites and 1470 applicants were reviewed. The majority of PCs, PDs, and faculty members were male (87.3%, 81.0%, and 69.6%, respectively) and white (74.7%, 70.9%, and 68.8%, respectively). Most applicants were male (54.0%) and white (60.8%). For a given program, white PCs and PDs have 5 and 6 times the odds of matching an applicant of the same race (P<0.001 for both). Having male PCs and PDs did not significantly increase the odds of matching an applicant of the same sex (P=0.198 and 0.905, respectively).

Conclusion:

Although the field of PS has made great strides to close the sex gap within the residency match process, this study highlights ongoing racial disparities among nonwhite applicants.
A fatal case of necrotizing fasciitis by Aeromonas jandaei
Authors: Anil Anjali , Kumar Mani Bhushan , Chauhan Sachin , Ray Pallab , Dahiya Divya , Angrup Archana
Published: June 2023

Introduction : Necrotizing soft tissue infections are associated with an extremely fulminating course, owing to its rapid destruction of tissue planes underlying the skin. Albeit uncommon in incidence, urgent medical and surgical intervention is required once diagnosis is reached. Aeromonas associated monomicrobial NSTIs are usually associated with exposure to fresh water, via trauma, trivial abrasions or even reptile bites, particularly among agricultural workers and fish handlers. Delay in appropriate antimicrobial and surgical management can even lead to fatality.
Case report : A 40-year-old male patient, known case of alcoholic liver disease, presented to the emergency department with pain and diffuse swelling of bilateral lower limbs, which quickly progressed to form blackish discolouration and blebs. Blood for preliminary haematological and biochemical investigations, as well as fluid draining from blebs was sent for microbiological investigation. The gram stain revealed occasional pus cells and gram-negative bacilli, pure growth in aerobic culture was identified as Aeromonasjandaei by MALDI-TOF MS. Patient was started on empirical antimicrobials, though lesions continued to progress and he ultimately succumbed within 24 hours of his hospital stay.
Conclusion : As appropriate antimicrobial therapy and early surgical intervention are required for management of the same, occupational exposure and the fulminant course should raise suspicion of likelihood of Aeromonas associated infections.
ECHOCARDIOGRAPHIC MANIFESTATIONS OF COVID 19 ILLNESS AND DEVELOPMENT OF PERSISTENT RV DYSFUNCTION AND PULMANARY HYPERTENSION AS A LONG TERM SEQUELAE OF COVID 19 ILLNESS: A STUDY AMONG PATIENTS OF SOUTH EAST ASIAN REGION
Authors: Kumar Lalit , Mahla Himanshu , Chaturvedi Neeraj , Sidhu Navdeep Singh , Keshav Manisha , Sharma Shashi Mohan , Bagarhatta Rajeev , Agrawal V.V. , Pathak Vijay , Meena Chandrabhan , Maheshwari Deepak , Meena Pradeep , Pachar Balbir Singh , Sharma Sohan Kumar , Gautam Dinesh , Chaudhary Sarita , Shekhawat Dhananjay
Published: June 2023

Objectives

To study the Echocardiographic manifestations of covid 19 illness among patients admitted in our facility, Correlate MAPSE, TAPSE, PASP, CRP levels and CTSI among covid 19 patients with their 28 day outcome as survivors and non survivors and to look for evidence of residual RV dysfunction and Pulmonary hypertension using TTE after 1 year of follow-up.

Study design

Prospective observational study at various medical wards and ICUs in SMS medical college and associated hospitals.

Methods

258 patients with a Covid-19 RT-PCR positive report from a throat or a nasal swab within 72 hours of admission were included in the study. Each patient underwent a complete clinical assessment and routine blood investigations including CRP levels were done. A complete transthoracic echocardiogram was done within 48 hours of admission. Patients also underwent a HRCT chest and CTSI scores were estimated. All patients were followed for a period of 28 days. The MAPSE, TAPSE, PASP, CTSI and CRP levels were then correlated with the outcome of the patient. The survivors again underwent a TTE at 1 year after their recovery from covid-19 illness to look for residual RV dysfunction by TAPSE and the development of pulmonary hypertension as measured by PASP using Bernoulli’s equation.

Results

Amongst patient of covid 19 illness the MAPSE, TAPSE, PASP, CTSI and CRP levels all correlated well with outcome of patients. While most covid-19 survivors recovered from their illness yet some patients showed evidence of persistent RV dysfunction and pulmonary hypertension even after 1 year of follow up.
Occupational lead exposure in gasoline station forecourt attendants and other occupations in relation to ALS (amyotrophic lateral sclerosis) risk
Authors: Koski Lassi , Tshoni Unathi A. , Olowoyo Joshua O. , Kobyana Aprilia S. , Lion Ntebo G. , Mugivhisa Liziwe L. , Wärmländer Sebastian K.T.S. , Roos Per M.
Published: June 2023

Amyotrophic lateral sclerosis (ALS) is an always fatal neurodegenerative disease characterised by a gradual death of motor neurons in the spinal cord and brain. The cause of ALS is unknown. There appears to be both a genetic and an environmental aspect of ALS disease causation. Multiple occupations are associated with an elevated ALS risk. Interestingly, many of these occupations involve exposure to lead, indicating a possible connection between ALS and lead exposure. Examples include mechanical workers, military service occupations, leather workers and tanners. Gasoline station forecourt attendants, also known as petrol station assistants, show a severely increased ALS risk, and our measurements on forecourt attendants in South Africa show that they display significantly elevated blood lead concentrations. Thus, forecourt attendants can be added to the list of occupations with overlapping risks for lead exposure and ALS incidence. These occupational risks for forecourt attendants are expected to decrease in the future, as leaded gasoline is being phased out worldwide. Nonetheless, the overlapping risks for ALS incidence and lead exposure among forecourt attendants and several other occupations strengthen the hypothesis that lead exposure contributes to ALS.
Hypoxic-Ischemic Encephalopathy Based on clinical biomarkers and associated risk factors in Neonates from Southern Ethiopian Public Hospitals: A Case Control Study
Authors: Ayele Getnet Melaku , Mergia Getachew , Getahun Senait Belay , Kebede Selamawit Semagn , Ferede Zemedu Awoke , Kabthymer Robel Hussien , Abebe Mesfin
Published: June 2023

Hypoxic ischemic encephalopathy (HIE) is a serious condition that results from reduced oxygen supply and blood flow to the brain, leading to brain injury and potential long-term neurodevelopmental impairments. This study aimed to identify the maternal and neonatal factors that are associated with HIE among newborns in Ethiopia. An unmatched-control study was conducted in fifteen public hospitals in Southern Nation Nationalities and the Peoples Regional State of Ethiopia. Data were collected from 515 newborns with their index mothers (175 cases and 340 controls) using a structured questionnaire and clinical records which were created and managed by Kobo software for mobile-assisted data collection. Clinical biomarkers were used to diagnose Hypoxic ischemic encephalopathy. Logistic regression analysis was performed to identify the factors associated with Hypoxic ischemic encephalopathy. Maternal education, ultrasound checkup status, gestational age at delivery, mode of delivery, and labor duration were significantly associated with Hypoxic ischemic encephalopathy. Newborns born to illiterate mothers (AOR= 1.913, 95%CI: 1.177, 3.109), those whose mothers did not have an ultrasound checkup during pregnancy (AOR= 1.859, 95%CI: 1.073, 3.221), those who were born preterm (AOR= 4.467, 95%CI: 1.993, 10.012) or post-term (AOR= 2.903, 95%CI: 1.325, 2.903), those who were delivered by cesarean section (AOR= 7.569, 95%CI: 4.169, 13.741), and those who were delivered after prolonged labor (AOR= 3.591, 95%CI: 2.067, 6.238) had higher odds of developing Hypoxic ischemic encephalopathy than their counterparts. This study provides valuable insights into the risk factors for Hypoxic ischemic encephalopathy among newborns in Southern Ethiopia. Improving maternal education and health care services during pregnancy and delivery may help reduce the incidence and severity of Hypoxic ischemic encephalopathy. Future research should use laboratory or imaging investigations, including private health institutions, and explore the mechanisms and outcomes of Hypoxic ischemic encephalopathy.