bluuebunny/crossref_metadata_2025 huggingface dataset:
Is cardiopulmonary bypass standby still required for laser lead extractions?
Authors: Volk Lindsay , Verghis Nina , Ikegami Hirohisa , Takebe Manabu , Russo Mark J. , Lee Leonard Y. , Lemaire Anthony
Published: September 2022

Objective

Over the last two decades there has been an increase in the number of cardiac implantable electronic devices and consequently, there has also been an increased need for lead extractions. Fibrotic attachments develop between the lead and the venous and cardiac structures that may require the use of a laser to mobilize the lead. Cardiothoracic surgeons (CTS) have traditionally provided backup for surgical emergencies for these extractions. This study evaluates the surgical outcomes of patients undergoing transvenous laser lead extractions (TLE) and determines if CTS are still needed for backup.

Methods

A retrospective review of consecutive patients undergoing laser lead extractions at a single academic center. Lead extractions using only laser sheaths were analyzed. The clinical characteristics, complications, and mortality of the patients were evaluated.

Results

One hundred and twenty-one patients underwent TLEs from January 1st, 2014 to December 31st, 2018. The majority were male (N = 80, 66.1%), and the average age was 66.48 ± 14 years. The indication for removal was either laser lead malfunction or infection. A total of 30 patients (24.8%) had complications postoperatively including wound hematomas, superficial infections, and arrhythmias. The average length of stay was 9 ± 12 for all the patients in the study. 2 patients (1.6%) had injuries that required emergency surgical repair with injuries to the posterior superior vena cava and right ventricle. Both patients survived the initial injury with one patient was discharged home on day 4 and the other succumbing to his injuries on postoperative day 20.

Conclusion

Although the incidence of surgical emergencies is rare the morbidity and mortality for TLE require that surgical backup be available.
Mutation identification and prediction for severe cardiomyopathy in Alström syndrome, and review of the literature for cardiomyopathy
Authors: Dedeoglu Savas , Dede Elif , Oztunc Funda , Gedikbasi Asuman , Yesil Gozde , Dedeoglu Reyhan
Published: September 2022

Objective

Alström syndrome (ALMS) is a rare autosomal recessive genetic disorder that is caused by homozygous or compound heterozygous mutation in the ALMS1 gene. Dilated cardiomyopathy (DCM) is one of the well-recognized features of the syndrome ranging from sudden-onset infantile DCM to adult-onset cardiomyopathy, sometimes of the restrictive hypertrophic form with a poor prognosis. We aimed to evaluate severe cardiomyopathy in Alström syndrome in infancy and display susceptible specific mutations of the disease, which may be linked to severe DCM. Secondarily we reviewed published mutations in ALMS1 with cardiomyopathies in the literature.

Method

We represent new mutagenic alleles related to severe cardiomyopathy and cardiac outcome in this patient cohort. We evaluated echocardiographic studies of nine Turkish patients diagnosed with Alström syndrome (between 2014 and 2020, at age two weeks to twenty years). Thus, we examined the cardiac manifestations of a single-centre prospective series of nine children with specific ALMS mutations and multisystem involvement. All patients underwent genetic and biochemical testing, electrocardiograms, and echocardiographic imaging to evaluate systolic strain with speckle tracking.

Results

Four of the patients died from cardiomyopathy. Three patients (including three of the four fatalities) with the same mutation (c.7911dupC [p.Asn2638Glnfs*24]) had cardiomyopathy with intra-familial variability in the severity of cardiomyopathy. Global longitudinal strain, a measure of systolic contractile function, was abnormal in all patients that can be measured.

Conclusion

Cardiac function in ALMS patients with infantile cardiomyopathy appears to have different clinical spectrums depending on the mutagenic allele. The c.7911dupC (p. Asn2638Glnfs*24) mutation can be related to severe cardiomyopathy. Parents can be informed and consulted about the progression of severe cardiomyopathy in a child carrying this mutagenic allele.
Improving HIV medication adherence among forced migrants living with HIV: a qualitative study of refugees and asylum seekers in Malaysia
Authors: Reddy Dasha , Berry Nicole S.
Published: September 2022

Introduction

Adherence to medication regimens is essential to decrease morbidity/mortality and increase life expectancy among HIV positive persons on Highly Active Anti-retroviral Therapy (HAART). This study was born in response to the absence of information regarding access and adherence to HAART among refugee and asylum seekers in urban, irregular, transit country settings.

Objectives

The purpose was to understand the barriers and facilitators to HIV medication adherence among refugees and asylum seekers living with HIV and to generate novel recommendations to facilitate adherence.

Methods

Individual in-depth interviews were conducted with 34 refugees and asylum seeks to explore their lived experiences. Interviews were structured around the social ecological model to capture influences of multiple levels. Thematic analysis was conducted on transcripts.

Results

Stigma, lack of knowledge and language barriers were among the main barriers noted by refugees and asylum-seekers in relation to HIV medication adherence, whereas interpersonal relationships, improved health, and strong patient-physician relationships were seen as facilitators. Participants noted their desire for community-support groups, education, and increased use of interpreters in order to combat some of the social barriers preventing full HIV medication adherence.

Conclusion

A regular status shapes participants’ adherence to HIV medications. Group-based interventions to support refugees are needed.
Genetic regulation of RNA splicing in human pancreatic islets
Authors: Atla Goutham , Bonàs-Guarch Silvia , Cuenca-Ardura Mirabai , Beucher Anthony , Crouch Daniel J. M. , Garcia-Hurtado Javier , Moran Ignasi ,   the T2DSystems Consortium, Cnop Miriam , Eliasson Lena , Esguerra Jonathan Lou S. , Eizirik Décio L. , Groop Leif , Jensen Thomas S. , Hansen Torben , Marchetti Piero , Mercader Josep M. , Mulder Hindrik , Stabile-Barnett Chris R. , Thirion Christian , Torrents David , Irimia Manuel , Prasad Rashmi B. , Gloyn Anna L. , Marselli Lorella , Suleiman Mara , Berney Thierry , de Koning Eelco J. P. , Kerr-Conte Julie , Pattou Francois , Todd John A. , Piemonti Lorenzo , Ferrer Jorge
Published: September 2022

Background

Non-coding genetic variants that influence gene transcription in pancreatic islets play a major role in the susceptibility to type 2 diabetes (T2D), and likely also contribute to type 1 diabetes (T1D) risk. For many loci, however, the mechanisms through which non-coding variants influence diabetes susceptibility are unknown.

Results

We examine splicing QTLs (sQTLs) in pancreatic islets from 399 human donors and observe that common genetic variation has a widespread influence on the splicing of genes with established roles in islet biology and diabetes. In parallel, we profile expression QTLs (eQTLs) and use transcriptome-wide association as well as genetic co-localization studies to assign islet sQTLs or eQTLs to T2D and T1D susceptibility signals, many of which lack candidate effector genes. This analysis reveals biologically plausible mechanisms, including the association of T2D with an sQTL that creates a nonsense isoform inERO1B, a regulator of ER-stress and proinsulin biosynthesis. The expanded list of T2D risk effector genes reveals overrepresented pathways, including regulators of G-protein-mediated cAMP production. The analysis of sQTLs also reveals candidate effector genes for T1D susceptibility such asDCLRE1B, a senescence regulator, and lncRNAMEG3.

Conclusions

These data expose widespread effects of common genetic variants on RNA splicing in pancreatic islets. The results support a role for splicing variation in diabetes susceptibility, and offer a new set of genetic targets with potential therapeutic benefit.
The maternal reduced uteroplacental perfusion model of preeclampsia induces sexually dimorphic metabolic responses in rat offspring
Authors: Hassanzadeh-Taheri Mohammadmehdi , Mohammadifard Mahtab , Erfanian Zahra , Hosseini Mehran
Published: September 2022

Background

Offspring born to preeclamptic mothers are prone to obesity, diabetes and hypertension in later life, but still, studies investigating the underlying mechanism are limited. Here, we aimed to investigate the impact of the reduced uteroplacental perfusion (RUPP) rat preeclampsia model on offspring metabolic outcomes.

Methods

Timed pregnant Wistar rats underwent RUPP or sham surgeries on day 14 of gestation. Glucometabolic parameters were evaluated on postnatal days (PND), 14 (childhood), and 60 (young adult). In addition, intraperitoneal glucose tolerance test (IPGTT), homeostatic model assessment of insulin resistance (HOMA-IR), immunohistochemical staining for insulin in pancreatic islets, arterial blood pressure and 24-h urine protein (24hUP) excretion were performed at PND60.

Results

Male, but not female, young adult rats (PND60) of RUPP dams exhibited an impaired IPGTT, decreased circulatory insulin and weakened pancreatic insulin immunoreactivity. Compared to the male offspring of the sham group, the body mass of male RUPP offspring significantly caught up after PND42, but it was not sex-specific. RUPP pups also exhibited upregulations in glucagon (only males) and ghrelin (both sexes with a more significant increase in males) during PND14–PND60. However, in sham offspring (both sexes), glucagon levels were downregulated and ghrelin levels unchanged during PND14–PND60. The blood pressure, HOMA-IR and 24hUP values did not alter in RUPP pups.

Conclusions

The overall results suggest that maternal RUPP has negative and sex-specific impacts on insulin, glucagon and ghrelin regulations in offspring and that, as young adults, male RUPP rats may be more prone to develop obesity and diabetes.
The glutamate metabotropic receptor 5 (GRM5) gene is associated with beef cattle home range and movement tortuosity
Authors: Moreno García Cristian A. , Zhou Huitong , Altimira David , Dynes Robyn , Gregorini Pablo , Jayathunga Sadeepa , Maxwell Thomas M. R. , Hickford Jonathan
Published: September 2022

Background

The grazing behaviour of herbivores and their grazing personalities might in part be determined genetically, but there are few studies in beef cattle illustrating this. In this study, we investigated for first time the genetic variation within a candidate ‘grazing gene’, the glutamate metabotropic receptor 5 gene (GRM5), and tested associations between variation in that gene and variation in grazing personality behaviours (GP-behaviours) displayed by free-ranging cows during winter grazing in the steep and rugged rangelands of New Zealand. Mature beef cows (n = 303, from 3 to 10 years of age) were tracked with global positioning system (GPS) and, with 5-minutes (min) relocation frequency, various GP-behaviours were calculated. These included horizontal and vertical distances travelled, mean elevation, elevation range, elevation gain, slope, home range and movement tortuosity, variously calculated using daily relocation trajectories with repeated measurements (i.e., 7 to 24 days (d)) and satellite-derived digital elevation models (DEM). The different GP-behaviours were fitted into mixed models to ascertain their associations with variant sequences and genotypes ofGRM5.

Results

We discovered threeGRM5variants (A, BandC)and identified the six possible genotypes in the cattle studied. The mixed models revealed thatAwas significantly associated with elevation range, home range and movement tortuosity. Similarly,GRM5genotypes were associated (P < 0.05) to home range and movement tortuosity, while trends suggesting association (P <  0.1) were also revealed for elevation range and horizontal distance travelled. Most GP-behaviour models were improved by correcting for cow age-class as a fixed factor. The analysis of GP-behaviours averaged per cow age-class suggests that grazing personality is fully established as beef cows reached 4 years of age. Home range and movement tortuosity were not only associated withGRM5variation, but also negatively correlated with each other (r = − 0.27,P < 0.001).

Conclusions

There seems to be a genetically determined trade-off between home range and movement tortuosity that may be useful in beef cattle breeding programmes aiming to improve the grazing distribution and utilisation of steep and rugged rangelands.
Global Englishes and translanguaging in textbook design and curriculum development for universities in the Greater Bay Area of China
Authors: Fang Fan , Yuan Limin , Xu Hongchen , Wang Xueyi
Published: September 2022

The development of English as a global language has urged the field of Teaching English to Speakers of Other Languages (TESOL) to implement some reforms in relation to textbook design and curriculum development as well as the approaches to and goals of English language teaching (ELT). From the multilingual perspective, Global Englishes (GE) and translanguaging have both challenged the traditional native-oriented goal of ELT. Based on the level of language policy planning in the multilingual Greater Bay Area of China, this paper addresses the need to incorporate GE and translanguaging into textbook design and curriculum development. Referring to Byram’s framework of cultural content in textbooks, and to the GE proposal of exposure of multilingualism/multiculturalism and respect of diverse culture and identity in ELT, the paper further reports a case study to analyse the cultural content of the textbook,Speaking Critically: Intercultural Conversation. The paper also explores university students’ attitudes towards the integration of Chinese local culture into textbooks. The paper ends by addressing some challenges associated with translating GE and translanguaging into textbook design and curriculum development, and it provides further implications of such a proposal.
Genomic Classification of HER2-Positive Patients With 80-Gene and 70-Gene Signatures Identifies Diversity in Clinical Outcomes With HER2-Targeted Neoadjuvant Therapy
Authors: Whitworth Pat W. , Beitsch Peter D. , Murray Mary K. , Richards Paul D. , Mislowsky Angela , Dul Carrie L. , Pellicane James V. , Baron Paul L. , Rahman Rakhshanda Layeequr , Lee Laura A. , Dupree Beth B. , Kelemen Pond R. , Ashikari Andrew Y. , Budway Raye J. , Lopez-Penalver Cristina , Dooley William , Wang Shiyu , Dauer Patricia , Menicucci Andrea R. , Yoder Erin B. , Finn Christine , Blumencranz Lisa E. , Audeh William
Published: September 2022

PURPOSE

The prospective Neoadjuvant Breast Registry Symphony Trial compared the 80-gene molecular subtyping signature with clinical assessment by immunohistochemistry and/or fluorescence in situ hybridization in predicting pathologic complete response (pCR) and 5-year outcomes in patients with early-stage breast cancer.

METHODS

Standard-of-care neoadjuvant chemotherapy combined with trastuzumab or trastuzumab plus pertuzumab was given to patients with human epidermal growth factor receptor 2 (HER2)–positive tumors (n = 295). pCR was the primary end point, with secondary end points of distant metastasis-free survival and overall survival at 5 years.

RESULTS

Among clinically defined HER2-positive (cHER2) tumors, the 80-gene assay identified 29.5% (87 of 295) as Luminal-Type (cHER2/gLuminal), 14.9% (44 of 295) as Basal-Type (cHER2/gBasal), and 55.6% (164 of 295) as HER2-Type (cHER2/genomically classified as HER2 [gHER2]). Patients with cHER2/gHER2 tumors had a higher pCR rate (61.6%) compared with non-gHER2 tumors (26.7%; P < .001). Dual targeting for cHER2/gHER2 tumors yielded a higher pCR rate (75%) compared with those treated with single HER2-targeted therapy (54%; P = .006). For cHER2/gBasal tumors, the 42.9% pCR rate observed with dual targeting was not different from that with trastuzumab alone (46.4%; P = .830). Among those with cHER2/gBasal tumors, 5-year distant metastasis-free survival (68.6%; 95% CI, 49.1 to 81.9) was significantly worse than in patients with cHER2/gLuminal tumors (88.9%; 95% CI, 78.0 to 94.6) and cHER2/gHER2 tumors (87.4%; 95% CI, 80.2 to 92.2; P = .010), with similar corresponding overall survival differences.

CONCLUSION

The 80-gene assay identified meaningful genomic diversity in patients with cHER2 disease. Patients with cHER2/gHER2 tumors, who benefitted most from dual HER2-targeted therapy, accounted for approximately half of the cHER2 cohort. Genomically Luminal tumors had low pCR rates but good 5-year outcomes. cHER2/gBasal tumors derived no benefit from dual therapy and had significantly worse 5-year prognosis; these patients merit special consideration in future trials.
New Horizons: Emerging Antidiabetic Medications
Authors: Mingrone Geltrude , Castagneto-Gissey Lidia , Bornstein Stefan R
Published: September 2022

Over the past century, since the discovery of insulin, the therapeutic offer for diabetes has grown exponentially, in particular for type 2 diabetes (T2D). However, the drugs in the diabetes pipeline are even more promising because of their impressive antihyperglycemic effects coupled with remarkable weight loss.

An ideal medication for T2D should target not only hyperglycemia but also insulin resistance and obesity. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and the new class of GLP1 and gastric inhibitory polypeptide dual RAs counteract 2 of these metabolic defects of T2D, hyperglycemia and obesity, with stunning results that are similar to the effects of metabolic surgery.

An important role of antidiabetic medications is to reduce the risk and improve the outcome of cardiovascular diseases, including coronary artery disease and heart failure with reduced or preserved ejection fraction, as well as diabetic nephropathy, as shown by SGLT2 inhibitors.

This review summarizes the main drugs currently under development for the treatment of type 1 diabetes and T2D, highlighting their strengths and side effects.
Approach to the Patient With Congenital Hypothyroidism
Authors: Stoupa Athanasia , Kariyawasam Dulanjalee , Nguyen Quoc Adrien , Polak Michel , Carré Aurore
Published: September 2022

Congenital hypothyroidism (CH) is the most frequent neonatal endocrine disorder and the most common preventable cause of development delay and growth failure if diagnosed and treated early. The thyroid is the first endocrine gland to develop during embryonic life and to be recognizable in humans. Thyroid development and maturation can be divided into 2 phases: a first phase of embryogenesis and a second phase of folliculogenesis and differentiation with thyroid hormone production at the final steps. Regulation of the thyroid function requires normal development of the hypothalamic–pituitary–thyroid axis, which occurs during the embryonic and neonatal period. Defects in any of steps of thyroid development, differentiation, and regulation lead to permanent CH. Newborn screening programs, established in only one-third of countries worldwide, detect CH and are cost-effective and highly sensitive and specific. During the last decade, epidemiology of CH has changed with increased frequency of thyroid in situ in primary CH. Advances in molecular testing have expanded knowledge and understanding of thyroid development and function. However, a molecular cause is identified in only 5% of CH due to thyroid dysgenesis. The purpose of this article is to describe the clinical approach to the child with CH, focusing on diagnostic work-up and future challenges on optimizing thyroid replacement therapy and regenerative medicine. The review is written from the perspective of the case of 2 girls referred for CH after newborn screening and diagnosed with thyroid ectopy. The genetic work-up revealed novel mutations in TUBB1 gene, associated with large platelets and abnormal platelet physiology.
Acute Hiccups Detected by Electromyographic Recordings During Resection of a Vestibular Schwannoma
Authors: Niedermeyer Sebastian , Greve Tobias , Lamm Ludwig-Maximilian , Thorsteinsdottir Jun , Schichor Christian , Tonn Joerg-Christian , Szelényi Andrea
Published: September 2022

BACKGROUND AND IMPORTANCE:

Intraoperative neuromonitoring (IONM) is routinely used to monitor cranial nerve function during resection of vestibular schwannomas. Sudden movements in the surgical field can be a disturbing factor for the surgeon. IONM can help determine the cause of unexpected patient movements.

CLINICAL PRESENTATION:

We report the case of a 54-year-old patient who underwent retromastoid craniotomy and resection of a vestibular schwannoma. Toward the end of dissection of the tumor from the lower cranial nerves and brainstem, the patient showed repetitive shoulder elevation. Electroencephalography showed burst suppression, confirming deep sedation and excluding voluntary movements. Free-running electromyography recorded spontaneous, simultaneous, bilateral vocal cord activity that was synchronous with upper body movement. There was simultaneous but smaller activity in the right genioglossus muscle and levator veli palatini, indicative for far-field activity. These IONM findings allowed us to classify the clinical observations as intraoperative hiccups.

CONCLUSION:

Hiccups during general anesthesia are rare but should be considered as a differential diagnosis of sudden upper body movement. To the best of our knowledge, this is the first reported case of acute hiccups during resection of a vestibular schwannoma. IONM reliably distinguished it from an increase in intraoperative consciousness or accessory nerve activation resulting in shoulder movements.
Comparison between Eccentric-Only and Coupled Concentric–Eccentric Contractions for Neuromuscular Fatigue and Muscle Damage
Authors: RUAS CASSIO V. , LATELLA CHRISTOPHER , TAYLOR JANET L. , HAFF G. GREGORY , NOSAKA KAZUNORI
Published: September 2022

Purpose

Eccentric contractions induce muscle damage, but less is known about the effects of preceding concentric contractions to eccentric contractions on muscle damage. We compared eccentric-only (ECC) and coupled concentric and eccentric contractions (CON–ECC) of the knee extensors for parameters of neuromuscular fatigue and muscle damage.

Methods

Twenty participants (age, 19–36 yr) were randomly placed into an ECC or a CON–ECC group (n = 10 per group), without significant (P > 0.06) differences in baseline neuromuscular variables between groups. The ECC group performed six sets of eight ECC at 80% of ECC one-repetition maximum (1-RMecc), whereas the CON–ECC group performed six sets of eight alternating concentric (CON) and ECC (16 contractions per set) at 80% of CON 1-RM and 1-RMecc, respectively. Maximal voluntary isometric contraction force, rate of force development, resting twitch force, maximal M-wave (MMAX), voluntary activation, motor evoked potentials, corticospinal silent period, short interval intracortical inhibition, and muscle soreness were measured before, immediately after, and 1–3 d after exercise.

Results

No significant (P ≥ 0.09) differences between ECC and CON–ECC were observed for changes in any variables after exercise. However, maximal voluntary isometric contraction force decreased immediately after exercise (ECC: −20.7% ± 12.8%, CON–ECC: −23.6% ± 23.3%) and was still reduced 3 d after exercise (ECC: −13.6% ± 13.4%, CON–ECC: −3.3% ± 21.2%). Rate of force development at 0–30 ms reduced immediately after exercise (ECC: −38.3% ± 33.9%, CON–ECC: −30.7% ± 38.3%). Voluntary activation, resting twitch force, and motor evoked potential/MMAX decreased and corticospinal silent period increased after exercise (all P ≤ 0.03), but short interval intracortical inhibition and MMAX did not change. Muscle soreness developed (P < 0.001) similarly for both groups (peak, 38.5 ± 29.5 mm).

Conclusions

CON–ECC did not exacerbate neuromuscular fatigue and muscle damage when compared with ECC, despite twice as many contractions performed. Thus, eccentric contractions (n = 48 in both groups) seemed to mainly mediate the neuromuscular responses observed.
Construction and validation of a scale of sexual self-concept for the elderly Chilean population
Authors: Ramirez-Perez Mauricio , Ferrer-Urbina Rodrigo , Flores Angela , Garcia Valerie , Llancabure Michelle
Published: September 2022

Background: Sexual self-concept has a central role in the life of the elderly population. Indeed, their sexual self-concept has significant and positive relationships with their satisfaction with life, pleasure, and willingness to interact with others. However, social-cultural prejudice means that the elderly are considered asexual individuals, harming their sexual self-concept. This prejudice is prominent in Chile, where the elderly do not have access to clear information about their sexuality. However, research on the Chilean elderly population is still in its infancy and requires more attention. Hence, this research aims to construct and validate a scale of sexual self-concept for the elderly Chilean population to cover this identified gap in the literature. Methods: Sixty items were integrated into the first version of the scale. Ten external judges were asked to assess the content validity. Twenty-eight items were maintained. Subsequently, an instrumental and cross-sectional design was implemented with a non-probabilistic sampling (N = 188). Items were refined with corrected homogeneity indices and conditional estimates of Cronbach's alpha and Omega coefficient. Results: A final scale of nine items equally distributed in three dimensions was obtained: Sexual self-efficacy (ω = 0.867), Sexual assertiveness (ω = 0.764), and Sexual self-esteem (ω = 0.803). The confirmatory factor analysis reflects that the theoretical model has an adequate fit (CFI = .989; TLI = .984; RMSEA = .086). Conclusions: The data analyses confirmed that the scale has adequate psychometric properties. This scale can be used for multidimensional measurements of sexual self-concept in the elderly in Chile. Further research can confirm its psychometric properties in different settings within the Spanish language population.
Analysts’ Connections and M&A Outcomes
Authors: Cortes Felipe , Marcet Francisco
Published: September 2022

This paper studies the role of shared analysts, who cover the target and the acquirer, in mergers and acquisitions outcomes. We find that deals where both firms are connected through shared analysts are less likely to be completed than deals without shared analysts. If completed, however, deals with shared analysts exhibit higher expected synergy gains, acquirer announcement returns, and acquirer post-completion performance. Shared analysts are also more likely to issue estimates about the acquirer in the proximity of the impending deal and their estimates are associated with a decrease in the uncertainty about acquirer’s cash flows. Our results highlight how the position of analysts in a deal results in an informational edge that enhances the screening of deals and mitigation of the acquirer’s informational disadvantage. Shared analysts who enhance the acquirer’s ability to screen out deals also exhibit superior career outcomes post-completion. We find similar results in the pre- and post-Regulation Fair Disclosure period, using brokerage house closures as a quasi-natural experiment and after controlling for analysts’ affiliations.

This paper was accepted by Tomasz Piskorski, finance.

Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2022.4468 .
Staff perspectives of a near-real time feedback intervention to improve patient experiences
Authors: Chessell Sarah , Courtiour Sandra , Colman Amanda , Porter Sam , Heaslip Vanessa
Published: September 2022

Background/Aims

Following several major reports of poor quality care in the NHS, including the Francis report, a multi-centre study was undertaken by to improve patient-centred care by implementing near-real time patient feedback. This article follows on from this and explores the experiences of staff from one hospital involved in the multi-centre study, including the learning from the intervention and how it affected their practice.

Methods

Semi-structured interviews were conducted with eight individuals who were involved in the original study, including five clinical staff members and three volunteers. Responses were transcribed and analysed thematically.

Results

The interviews highlighted four inter-related themes: the importance of communication; normalising feedback; confidence to talk to patients; and seeing from the patient perspective. Participants described how near real-time feedback enhanced communication, giving them confidence to interact with patients. Staff responded to negative patient feedback by making improvements to patient experiences. However, the initiative was not sustained following the conclusion of the study.

Conclusions

Near-real time patient feedback can be effective in improving staff–patient communication and creating a more positive experience for both patients and staff. However, this study highlights the need to examine the sustainability of improvement initiatives, as well as their initial effectiveness.
Ants (Hymenoptera, Formicidae) of APA Pandeiros: A Perspective from a Decade of Research in an Environmental Protection Area in the Cerrado-Caatinga Transition
Authors: Queiroz Antonio Cesar Medeiros de , Prado Livia Pires do , Cesarino Rafael Almeida , Santiago Graziele S. , Oliveira Cynthia Valéria , Rabelo Mariana A. , Ribas Carla R.
Published: September 2022

Habitat transformation and species loss bring enormous environmental damage, whereas establishing protected areas promotes more sustainable use of environmental resources through biodiversity conservation. In this study, we aimed to point out gaps in ant knowledge and provide a species checklist that contributes to biodiversity conservation in the transition areas between Cerrado and Caatinga biomes, constantly threatened by land use changes. This checklist integrates data from previous studies developed at “Área de Proteção Ambiental do Rio Pandeiros” (APA Pandeiros), Minas Gerais, Brazil, involving ant diversity and their contribution to ecological processes accessed and described in the studies. We showed and discussed how authors managed and provided information regarding methodologies and habitats sampled. We listed 143 ant species formally named. Pheidole, Camponotus and Cephalotes were the most speciose genera, with more than ten species each. Among ants involved in ecological processes, 40 are linked to diaspore removal (part of seed dispersal) and 30 to carcass interaction (part of the decomposition process). Unbaited pitfall traps, epigeic stratum and Cerrado sensu stricto, were the top sampling method, stratum, and habitats among ant studies. We presented proposals for the best management and integration of data from surveys in APA Pandeiros (e.g., sharing the results of the studies with the APA managers, creating a database, and the local community). These surveys are fundamental for understanding biodiversity and ecological processes and provide valuable information to conservation biology. Therefore, neglecting the importance of the Cerrado-Caatinga transition can lead to irreparable setbacks for scientific knowledge and biodiversity.
Nascent RHOH acts as a molecular brake on actomyosin-mediated effector functions of inflammatory neutrophils
Authors: Peng Shuang , Stojkov Darko , Gao Jian , Oberson Kevin , Latzin Philipp , Casaulta Carmen , Yousefi Shida , Simon Hans-Uwe
Published: September 2022

In contrast to molecular changes associated with increased inflammatory responses, little is known about intracellular counter-regulatory mechanisms that control signaling cascades associated with functional responses of neutrophils. Active RHO GTPases are typically considered as effector proteins that elicit cellular responses. Strikingly, we show here that RHOH, although being constitutively GTP-bound, limits neutrophil degranulation and the formation of neutrophil extracellular traps (NETs). Mechanistically, RHOH is induced under inflammatory conditions and binds to non-muscle myosin heavy chain IIA (NMHC IIA) in activated neutrophils in order to inhibit the transport of mitochondria and granules along actin filaments, which is partially reverted upon disruption of the interaction with NMHC IIA by introducing a mutation in RhoH at lysine 34 (RhoHK34A). In parallel, RHOH inhibits actin polymerization presumably by modulating RAC1 activity. In vivo studies using Rhoh-/- mice, demonstrate an increased antibacterial defense capability against Escherichia coli (E. coli). Collectively, our data reveal a previously undefined role of RHOH as a molecular brake for actomyosin-mediated neutrophil effector functions, which represents an intracellular regulatory axis involved in controlling the strength of an antibacterial inflammatory response.
Radical triads, not pairs, may explain effects of hypomagnetic fields on neurogenesis
Authors: Ramsay Jess , Kattnig Daniel R.
Published: September 2022

Adult hippocampal neurogenesis and hippocampus-dependent cognition in mice have been found to be adversely affected by hypomagnetic field exposure. The effect concurred with a reduction of reactive oxygen species in the absence of the geomagnetic field. A recent theoretical study suggests a mechanistic interpretation of this phenomenon in the framework of the Radical Pair Mechanism. According to this model, a flavin-superoxide radical pair, born in the singlet spin configuration, undergoes magnetic field-dependent spin dynamics such that the pair’s recombination is enhanced as the applied magnetic field is reduced. This model has two ostensible weaknesses: a) the assumption of a singlet initial state is irreconcilable with known reaction pathways generating such radical pairs, and b) the model neglects the swift spin relaxation of free superoxide, which abolishes any magnetic sensitivity in geomagnetic/hypomagnetic fields. We here suggest that a model based on a radical triad and the assumption of a secondary radical scavenging reaction can, in principle, explain the phenomenon without unnatural assumptions, thus providing a coherent explanation of hypomagnetic field effects in biology.
Recovery from spindle checkpoint-mediated arrest requires a novel Dnt1-dependent APC/C activation mechanism
Authors: Bai Shuang , Sun Li , Wang Xi , Wang Shuang-min , Luo Zhou-qing , Wang Yamei , Jin Quan-wen
Published: September 2022

The activated spindle assembly checkpoint (SAC) potently inhibits the anaphase-promoting complex/cyclosome (APC/C) to ensure accurate chromosome segregation at anaphase. Early studies have recognized that the SAC should be silenced within minutes to enable rapid APC/C activation and synchronous segregation of chromosomes once all kinetochores are properly attached, but the underlying silencers are still being elucidated. Here, we report that the timely silencing of SAC in fission yeast requiresdnt1+, which causes severe thiabendazole (TBZ) sensitivity and increased rate of lagging chromosomes when deleted. The absence of Dnt1 results in prolonged inhibitory binding of mitotic checkpoint complex (MCC) to APC/C and attenuated protein levels of Slp1Cdc20, consequently slows the degradation of cyclin B and securin, and eventually delays anaphase entry in cells released from SAC activation. Interestingly, Dnt1 physically associates with APC/C upon SAC activation. We propose that this association may fend off excessive and prolonged MCC binding to APC/C and help to maintain Slp1Cdc20stability. This may allow a subset of APC/C to retain activity, which ensures rapid anaphase onset and mitotic exit once SAC is inactivated. Therefore, our study uncovered a new player in dictating the timing and efficacy of APC/C activation, which is actively required for maintaining cell viability upon recovery from the inhibition of APC/C by spindle checkpoint.
Evaluating the impact of COVID-19 pandemic on complicated malaria admissions and outcomes in the paediatric Ho Teaching Hospital of the Volta Region of Ghana
Authors: Orish Verner N. , Akake Kennedy , Lokpo Sylvester Y. , Kwadzokpui Precious K. , Amegan-Aho Kokou Hefoume , Mac-Ankrah Lennox , Boakye-Yiadom Emily , Ibrahim Jamfaru , Kwofie Theophilus B.
Published: September 2022

Since Ghana recorded its first cases of COVID-19 in early March 2020, healthcare delivery in the country has been hugely affected by the pandemic. Malaria continues to be an important public health problem in terms of morbidity and mortality among children, and it is responsible for significant hospital visits and admission. It is likely that, as with other illnesses, the COVID-19 pandemic may have impacted health seeking behaviour, hospital visits, and admissions of malaria among the paediatric population in Ghana. The aim of this study was to evaluate the impact of COVID-19 pandemic on the admissions and outcome of complicated malaria in the Ho Teaching Hospital of the Volta Region of Ghana. The medical records of children admitted for complicated malaria (cerebral and severe malaria) from 2016 to 2020, were obtained from the admission records of the children. Both demographics and clinical details were collected, and data was analysed using SPSS version 25 statistical software. The yearly differences in the trend and proportions of complicated malaria admissions were performed using rate comparison analysis and Pearson chi-square was used to assess the association between the various demographic factors and yearly admission rates. Clopper-Pearson test statistic was employed to determine the 95% confidence intervals of outcome variables of interest. The year 2020 had the lowest admission for complicated malaria (149, 11.5%; 95% CI: 9.7–13.5) but proportionally had, more cases of cerebral malaria (25, 16.8%; 95% CI: 10.9–24.8), and more deaths (6, 4.0%; 95% CI: 1.5–8.8), compared to the years under review. Children admitted in 2020 had the shortest mean stay on admission (4.34 ±2.48, p<0.001). More studies are needed to further elucidate the impact of the COVID-19 pandemic on the health of children in malaria endemic areas.
Community-level prevalence of epilepsy and of neurocysticercosis among people with epilepsy in the Balaka district of Malawi: A cross-sectional study
Authors: Keller Luise , Stelzle Dominik , Schmidt Veronika , Carabin Hélène , Reinhold Ann-Kristin , Keller Claudius , Welte Tamara M. , Richter Vivien , Amos Action , Boeckman Lindsay , Harrison Wendy , Winkler Andrea S.
Published: September 2022

Background

Epilepsy and neurocysticercosis (NCC) prevalence estimates in sub-Saharan Africa are still scarce but show important variation due to the population studied and different screening and diagnosis strategies used. The aims of this study were to estimate the prevalence of epileptic seizures and epilepsy in the sampled population, and the proportion of NCC among people with epilepsy (PWE) in a large cross-sectional study in a rural district of southern Malawi.

Methods

We conducted a community-based door-to-door screening study for epileptic seizures in Balaka, Malawi between October and December 2012. Past epileptic seizures were reported through a 15-item questionnaire answered by at least one person per household generating five major criteria. People who screened positive were further examined by a neurologist to establish diagnosis. Patients diagnosed with epilepsy were examined and offered Taenia solium cyst antigen and antibody serological tests, and a CT scan for the diagnosis of NCC.

Results

In total, screening information on 69,595 individuals was obtained for lifetime occurrence of epileptic seizures. 3,100 (4.5%) participants screened positive, of whom 1,913 (62%) could be followed-up and underwent further assessment. Lifetime prevalence was 3.0% (95% Bayesian credible interval [CI] 2.8 to 3.1%) and 1.2% (95%BCI 0.9 to 1.6%) for epileptic seizures and epilepsy, respectively. NCC prevalence among PWE was estimated to be 4.4% (95%BCI 0.8 to 8.5%). A diagnosis of epilepsy was ultimately reached for 455 participants.

Conclusion

The results of this large community-based study contribute to the evaluation and understanding of the burden of epilepsy in the population and of NCC among PWE in sub-Saharan Africa.
Individual and community level predictors of utilization of deworming medications among pregnant women in Ethiopia: A multilevel analysis
Authors: Aragaw Fantu Mamo , Belay Daniel Gashaneh , Endalew Mastewal , Asratie Melaku Hunie , Gashaw Moges , Tsega Nuhamin Tesfa
Published: September 2022

Background

Deworming is one strategy for reducing the burden of anaemia in pregnant women caused by intestinal parasites and it is one of the components of prenatal treatment offered to pregnant women in Ethiopia during antenatal care visits. However, there is limited evidence on the levels of deworming utilization and its determinants in Ethiopia. Hence, this study was aimed to assess the levels of deworming utilization and its individual and community level determinants among pregnant women in Ethiopia.

Method

This study used a total weighted sample of 7590 reproductive-aged women who gave birth in the five years preceding the survey from the 2016 EDHS data. The data were cleaned and weighted using STATA version 16. Results were presented with tables and texts. Individual and community level determinants for deworming use among Ethiopian pregnant women were identified using a multilevel binary logistic regression model. In the multivariable multilevel analysis, those variables with p-value < 0.05 were considered to be significantly associated with utilization of deworming medication and reported with adjusted odd ratio with 95% confidence level.

Results

The overall utilization of deworming among pregnant women was 5.69% (95% CI: 5.24%, 6.33) in Ethiopia. Having occupation [AOR = 1.59; 95% CI; 1.27, 1.99], wanted pregnancy [AOR = 1.51; 95% CI; [1.16, 1.95], having ANC visit [AOR = 2.72; 95% CI; 2.03,3.64], media exposure [AOR = 1.67; 95%CI; 1.30,2.15], and high community level poverty [AOR = 0.59; 95% CI; 0.40,0.87] were significantly associated with utilization of deworming among pregnant women’s.

Conclusion

According to the findings of this study, out of twenty pregnant women, only one pregnant woman utilizes deworming medication in Ethiopia. Pregnant woman having an occupation, being exposed for media, having wanted pregnancy, having ANC visits and live with low level community poverty were more likely to use deworming medication. Therefore, intervention efforts to enhance utilization of deworming in Ethiopia requires working on enabling factors like media exposure, ANC visit and pregnancy desirability. In addition, Furthermore, increasing the community’s economic capacity could support in increasing deworming medication uptake.
Occurrence of yellow fever outbreaks in a partially vaccinated population: An analysis of the effective reproduction number
Authors: Ferreira Fernanda Cristina da Silva Lopes , Bastos Camacho Luiz Antônio , Villela Daniel Antunes Maciel
Published: September 2022

Background

Yellow fever is endemic in Africa and the Americas, occurring in urban or sylvatic environments. The infection presents varying symptoms, with high case-fatality among severe cases. In 2016, Brazil had sylvatic yellow fever outbreaks with more than 11 thousand cases, predominantly affecting the country’s Southeast region. The state of Minas Gerais accounted for 30% of cases, even after the vaccine had been included in the immunization calendar for at least 30 years.

Methodology and principal findings

We applied parameters described in the literature from yellow fever disease into a compartmental model of vector-borne diseases, using namely generation time intervals, vital host and vector parameters, and force of infection, using macroregions as the spatial unit and epidemiological weeks as the time interval. The model permits obtaining the reproduction number, which we analyzed from reported cases of yellow fever from 2016 to 2018 in residents of the state of Minas Gerais, Brazil. Minas Gerais recorded two outbreak periods, starting in EW 51/2016 and EW 51/2017. Of all the reported cases (3,304), 57% were men 30 to 59 years of age. Approximately 27% of cases (905) were confirmed, and 22% (202) of these individuals died. The estimated effective reproduction number varied from 2.7 (95% CI: 2.0–3.6) to 7.2 (95% CI: 4.4–10.9], found in the Oeste and Nordeste regions, respectively. Vaccination coverage in children under one year of age showed heterogeneity among the municipalities comprising the macroregions.

Conclusion

The outbreaks in multiple parts of the state and the estimated Re values raise concern since the state population was partially vaccinated. Heterogeneity in vaccination coverage may have been associated with the occurrence of outbreaks in the first period, while the subsequent intense vaccination campaign may have determined lower Re values in the second period.
Pathology and epidemiology of fatal toxoplasmosis in free-ranging marmosets (Callithrix spp.) from the Brazilian atlantic forest
Authors: Rodrigues Oliveira Ayisa , Ritter Jana M. , Oliveira dos Santos Daniel , Pizzolato de Lucena Fabiana , Aquino de Mattos Sara , Parente de Carvalho Thaynara , Bullock Hannah , Giannini Alves Moreira Larissa , Magalhães Arthuso Vasconcelos Izabela , Barroso Costa Fabíola , Alves da Paixão Tatiane , Santos Renato Lima
Published: September 2022

Toxoplasmosis is an important zoonotic disease that affects a wide range of warm-blooded host species. Neotropical primates (New World Primates; NWP) are highly susceptible, developing a lethal acute systemic disease. Toxoplasmosis in free-ranging NWP is poorly described, with only a few studies based on serosurveys. Herein we performed a retrospective study focusing on the epidemiology and pathology of toxoplasmosis among 1,001 free-ranging marmoset (Callithrix spp.) deaths from the Brazilian Atlantic Forest. This study included marmosets necropsied at the Instituto Municipal de Medicina Veterinária Jorge Vaitsman (IJV) from January 2017 to July 2019, which were found dead from all regions in the State of Rio de Janeiro. Histopathology, immunohistochemistry, and transmission electron microscopy were performed to better characterize toxoplasmosis in this free-ranging population. All samples were also tested for Yellow Fever Virus (YFV) RT-qPCR by the official diagnostic service. A total of 1,001 free-ranging marmosets were included in this study, with 16 (1.6%) cases of lethal Toxoplasma gondii infections identified both as individual cases and in outbreaks. Presence of infection was not associated with sex, age, geographical distribution, or year of death, and no co-infection with YFV was observed. The main pathological feature in these cases was random necrotizing hepatitis with detection of intralesional T. gondii zoites in all infected cases. Interstitial pneumonia rich in alveolar foamy macrophages and fibrin deposition, necrotizing myocarditis and necrotizing splenitis were also pathological features in affected marmosets. Therefore, toxoplasmosis was considered the cause of death in 1.6% of free-ranging marmosets in this retrospective series, including some cases associated with outbreaks. Necrotizing random hepatitis was a consistent pathological finding in affected cases and sampling of liver should be ensured from Callitrichid post mortem cases.