bluuebunny/crossref_metadata_2025 huggingface dataset:
Compassionate use of a novel β-lactam enhancer-based investigational antibiotic cefepime/zidebactam (WCK 5222) for the treatment of extensively-drug-resistant NDM-expressing Pseudomonas aeruginosa infection in an intra-abdominal infection-induced sepsis patient: a case report
Authors: Dubey Dilip , Roy Manish , Shah Tajamul H. , Bano Noor , Kulshrestha Vidushi , Mitra Sandeep , Sangwan Pushpender , Dubey Madhulika , Imran Ali , Jain Bhawna , Velmurugan Aravind , Bakthavatchalam Yamuna Devi , Veeraraghavan Balaji
Published: July 2023

Infections in critically-ill patients caused by extensively-drug-resistant (XDR)-Pseudomonas aeruginosa are challenging to manage due to paucity of effective treatment options. Cefepime/zidebactam, which is currently in global Phase 3 clinical development (Clinical Trials Identifier: NCT04979806, registered on July 28, 2021) is a novel mechanism of action based β-lactam/ β-lactam-enhancer combination with a promising activity against a broad-range of Gram-negative pathogens including XDR P. aeruginosa. We present a case report of an intra-abdominal infection-induced sepsis patient infected with XDR P. aeruginosa and successfully treated with cefepime/zidebactam under compassionate use. The 50 year old female patient with past-history of bariatric surgery and recent elective abdominoplasty and liposuction developed secondary pneumonia and failed a prolonged course of polymyxins. The organism repeatedly isolated from the patient was a New-Delhi metallo β-lactamase-producing XDR P. aeruginosa resistant to ceftazidime/avibactam, imipenem/relebactam and ceftolozane/tazobactam, susceptible only to cefepime/zidebactam. As polymyxins failed to rescue the patient, cefepime/zidebactam was administered under compassionate grounds leading to discharge of patient in stable condition. The present case highlights the prevailing precarious scenario of antimicrobial resistance and the need for novel antibiotics to tackle infections caused by XDR phenotype pathogens.
When it comes to assessing the impact of e-cigarettes, estimates of device prevalence matter: the BIDI Stick disposable device
Authors: McKeganey Neil , Patton Andrea , Marza Venus , Barnard Gabriel
Published: July 2023

Background

While e-cigarettes have been identified as an effective means of tobacco harm reduction, the degree to which these devices will realise their harm reduction potential will be determined in large part by how available these products are to adults who smoke. One of the key factors determining that availability is the regulatory regime around these products. Within the US e-cigarettes have become the most commonly used tobacco product by middle and high school students, with disposable e-cigarettes now the most popular type of device used by youth. In this paper, we report data on the prevalence with which one of the most popular disposable e-cigarettes within the US is being used by youth (aged 13–17) and underage young adults (aged 18–20).

Methods

A cross-sectional online survey of a probability-based sample of 1215 youth (13–17 years) recruited via Ipsos’ KnowledgePanel and 3370 young adults aged 18–24, among whom 1125 were aged 18–20, recruited via Ipsos’ KnowledgePanel and online consumer research panels.

Results

Among youth, 3.50% (95% CI: 2.46–4.83) reported smoking combustible cigarettes in the past 30 days, and 6.73% (95% CI: 5.26–8.48) reported using an e-cigarette in the past 30 days. Among underage young adults, 7.22% (95% CI: 5.24–9.67) reported smoking combustible cigarettes every day or some days, and 15.90% (95% CI: 12.96–19.21) reported using e-cigarettes every day or some days. Despite the scale of e-cigarette use in general among the US youth, only 0.04% (95% CI: 0.00–0.38) of 13–17 years old reported using the BIDI® Stick disposable e-cigarette in the past 30 days.

Conclusions

While disposable e-cigarettes have become the most popular type of e-cigarette used by the US youth, it is likely that the prevalence of use of individual devices varies significantly. There is a need to regularly monitor the use of e-cigarettes by type of device and brand, in order to determine which products have the greatest potential to reduce smoking-related harm among adults who smoke and which products are being used by youth and underage young adults.
Stakeholders’ perspectives on the acceptability and feasibility of maternity waiting homes: a qualitative synthesis
Authors: van Braam Eva Julia , McRae Daphne N. , Portela Anayda G. , Stekelenburg Jelle , Penn-Kekana Loveday
Published: July 2023

Background

Maternity waiting homes (MHWs) are recommended to help bridge the geographical gap to accessing maternity services. This study aimed to provide an analysis of stakeholders’ perspectives (women, families, communities and health workers) on the acceptability and feasibility of MWHs.

Methods

A qualitative evidence synthesis was conducted. Studies that were published between January 1990 and July 2020, containing qualitative data on the perspectives of the stakeholder groups were included. A combination of inductive and deductive coding and thematic synthesis was used to capture the main perspectives in a thematic framework.

Results

Out of 4,532 papers that were found in the initial search, a total of 38 studies were included for the thematic analysis. Six themes emerged: (1) individual factors, such as perceived benefits, awareness and knowledge of the MWH; (2) interpersonal factors and domestic responsibilities, such as household and childcare responsibilities, decision-making processes and social support; (3) MWH characteristics, such as basic services and food provision, state of MWH infrastructure; (4) financial and geographical accessibility, such as transport availability, costs for MWH attendance and loss of income opportunity; (5) perceived quality of care in the MWH and the adjacent health facility, including regular check-ups by health workers and respectful care; and (6) Organization and advocacy, for example funding, community engagement, governmental involvement. The decision-making process of women and their families for using an MWH involves balancing out the gains and losses, associated with all six themes.

Conclusion

This systematic synthesis of qualitative literature provides in-depth insights of interrelating factors that influence acceptability and feasibility of MWHs according to different stakeholders. The findings highlight the potential of MWHs as important links in the maternal and neonatal health (MNH) care delivery system. The complexity and scope of these determinants of utilization underlines the need for MWH implementation strategy to be guided by context. Better documentation of MWH implementation, is needed to understand which type of MWH is most effective in which setting, and to ensure that those who most need the MWH will use it and receive quality services. These results can be of interest for stakeholders, implementers of health interventions, and governmental parties that are responsible for MNH policy development to implement acceptable and feasible MWHs that provide the greatest benefits for its users.

Trial registration Systematic review registration number: PROSPERO 2020, CRD42020192219.
Narcotics Anonymous attendees’ perceptions and experiences of substitute behaviors in the Western Cape, South Africa
Authors: Sinclair Deborah Louise , Sussman Steve , Savahl Shazly , Florence Maria , Vanderplasschen Wouter
Published: July 2023

Background

Much remains unknown about the dynamics of substitute behaviors during addiction recovery among persons attending recovery support groups. Insight into the nature, motives for, and course of substitute behaviors could help to shape recovery support and harm reduction services.

Methods

Twenty-three semi-structured in-depth interviews (n = 14 males and n = 9 females) were conducted with a convenience sample of Narcotics Anonymous attendees from a number of groups in the Western Cape, South Africa. Participants ranged in age from 22—55 years (M = 39.3, SD = 9.35).

Results

Thematic analysis yielded four themes: (i) substance-to-substance substitution; (ii) substance-to-behavior substitution; (iii) substitute behaviors and harm (reduction) and (iv) support needs to manage and resolve substitute behaviors. According to the study, participants’ substitute behaviors developed across recovery stages; were temporary or long-term replacements for substance use disorders and were engaged for distraction, isolation from others, calming, assuaging boredom, keeping occupied, filling a perceived experiential void, modifying mood and to self-medicate. While substitutes were utilized for harm reduction or relapse prevention, the potential for ostensibly healthy behaviors to threaten recovery and lead to relapse was also recognized.

Conclusions

Self-monitoring, ongoing vigilance, and awareness of when substitutes become genuine addictions are critical for timely, suitable interventions.
Siblings with Gorlin–Goltz syndrome associated with cardiac tumors: a case report and review of literature
Authors: Wilke Paula I. , Biermann Daniel , Grafmann Maria , Kozlik-Feldmann Rainer , Papingi Dzhoy , Sachweh Jörg S. , Stute Fridrike , Olfe Jakob
Published: July 2023

Primary cardiac tumors in children are very rare and may be associated with severe arrhythmias and sudden infant death syndrome. These cardiac arrhythmias vary depending on the location and size of the tumor. Sixty-four percent of children with cardiac fibroma, the second most common benign cardiac tumor in children, have ventricular arrhythmias, affecting therapeutic management and risk profile of these children. We report on two siblings with cardiac fibromas whose clinical presentations differed depending on their locations and size of the tumors. The first child, a three-year-old girl, was diagnosed with a cardiac fibroma in the left ventricle at the age of 8 months after surviving resuscitation due to ventricular fibrillation. Secondary prophylactic implantation of an ICD was performed. On propranolol, no further malignant arrhythmias have occurred to date. The seven-month-old brother was diagnosed postnatally with a cardiac tumor adjacent to the right ventricle. A few weeks after birth, the boy had refractory supraventricular tachycardia and ventricular arrhythmia that only resolved with amiodarone. In genetic testing, Gorlin–Goltz syndrome was diagnosed in both children. Conservative pharmacological therapy is a therapeutic strategy for asymptomatic patients with cardiac fibromas. The anti-arrhythmic medication depends on the location of the tumor. Implantation of an ICD should be performed in cases of malignant arrhythmias. In rare cases, there is an association between cardiac tumors and genetic syndromes, such as Gorlin–Goltz syndrome. These should always be considered when such a tumor is diagnosed.
The effects of functional foods mixture on inflammatory cytokines and biochemical findings in hospitalized patients with COVID-19: a randomized double-blind controlled trial
Authors: Gouvarchinghaleh Hadi Esmaeili , Kiany Fateme , Parastouei Karim , Alishiri Gholamhosein , Jafari Nematollah Jonaidi , Fooladi Abbas Ali Imani , Pargar Afsaneh , Ghazvini Ali , Mirnejad Reza , Raei Mehdi , Olounabadi Ahmadreza Sharifi , Babaei Mansour , Heydari Soleyman , Rostami Hosein , Shahriary Alireza , Farnoosh Gholamreza , Sobhani Vahid , Mazhari Mohammad Mahdi , NajjarAsiabani Farshad
Published: July 2023

Background

The coronavirus disease 2019 (COVID-19) pandemic has been shown to affect nutritional recommendations. Some functional foods have been demonstrated to be useful in the treatment of people with COVID-19. However, little is known about the impact of combining functional foods on disease control. This study aimed to investigate the effects of functional foods mixture on serum levels of inflammatory cytokines and biochemical findings in patients with COVID-19.

Methods

A randomized double-blind controlled trial was conducted in Baqiyatallah Al-Azam hospital in Tehran, Iran. Sixty patients were randomly assigned to receive either a soup containing functional foods (n = 30) or a usual soup (control group) (n = 30). Participants’ sociodemographic information was gathered using a general questionnaire. Blood levels of inflammatory markers and biochemical findings were assessed using standard protocols.

Results

The results showed that soup containing functional foods was more effective in controlling serum levels of D-dimer, blood urea nitrogen, and creatinine than the control group (P < 0.05). Also, more significant improvement was found in the intervention group vs control group in terms of interleukin (IL)-1β, IL-6, IL-17, IL-10, and tumor necrose factor-α (P < 0.05). In contrast, the control intervention more efficiently controlled potassium levels and reduced quantitative C-reactive protein than the intervention group (P < 0.05).

Conclusions

This study indicates a soup containing functional foods could alleviate biomarkers of inflammation in patients with COVID-19. However, its effectiveness on biochemical findings remained inconclusive which warranted further research.

Trial registration

IRCT, IRCT20180201038585N11. Registered 23 August 2021, https://www.irct.ir/trial/57338
Learning curves for point-of-care ultrasound image acquisition for novice learners in a longitudinal curriculum
Authors: Breunig Mike , Hanson Andrew , Huckabee Michael
Published: July 2023

Background

A learning curve is graphical representation of the relationship between effort, such as repetitive practice or time spent, and the resultant learning based on specific outcomes. Group learning curves provide information for designing educational interventions or assessments. Little is known regarding the learning curves for Point-of-Care Ultrasound (POCUS) psychomotor skill acquisition of novice learners. As POCUS inclusion in education increases, a more thorough understanding of this topic is needed to allow educators to make informed decisions regarding curriculum design. The purpose of this research study is to: (A) define the psychomotor skill acquisition learning curves of novice Physician Assistant students, and (B) analyze the learning curves for the individual image quality components of depth, gain and tomographic axis.

Results

A total of 2695 examinations were completed and reviewed. On group-level learning curves, plateau points were noted to be similar for abdominal, lung, and renal systems around 17 examinations. Bladder scores were consistently good across all exam components from the start of the curriculum. For cardiac exams, students improved even after 25 exams. Learning curves for tomographic axis (angle of intersection of the ultrasound with the structure of interest) were longer than those for depth and gain. Learning curves for axis were longer than those for depth and gain.

Conclusion

Bladder POCUS skills can be rapidly acquired and have the shortest learning curve. Abdominal aorta, kidney, and lung POCUS have similar learning curves, while cardiac POCUS has the longest learning curve. Analysis of learning curves for depth, axis, and gain demonstrates that axis has the longest learner curve of the three components of image quality. This finding has previously not been reported and provides a more nuanced understanding of psychomotor skill learning for novices. Learners might benefit from educators paying particular attention to optimizing the unique tomographic axis for each organ system.
Prurigo Nodularis onset during secukinumab treatment of psoriasis: a case report
Authors: Yang Qingqing , Lyu Jiajie , Gui Yu , Yu Shuling , Chen Jiajie , Zhang Haoxue , Liu Shengxiu
Published: July 2023

Background

Secukinumab has been approved by the U.S. FDA and the European Medicines Agency for the treatment of moderate-to-severe plaque psoriasis and psoriatic arthritis with the documented adverse effects. Here we reported in one case that a new symptom, Prurigo Nodularis (PN), developed during the programmed dosing of secukinumab.

Case introduction

A 22-years-old male with a 6-month history of severe plaque psoriasis vulgaris was presented to the dermatology clinic two weeks after the fifth serial weekly doses of secukinumab, for the reason of the outbreaks of multiple erythematous papules and pruritus nodules on the trunk and extremities. Physical examination showed that psoriatic rash were under effective control with the previous targeted therapy of secukinumab for plaque psoriasis vulgaris, but new dermatologic condition was spotted with multiple edematous red firm papules on the trunk and extremities, in the form of soy or hemispherical nodules, red in color, firm to touch, with some ulcerated crusts visible at tops, but negative Auspitz sign. Pathological examination confirmed these papules as PN.

Conclusion

This case report is shared to inform clinicians about an unannounced adverse effect of the secukinumab in the treatment of psoriasis, and it is recommended that patients be carefully informed of the possible risk of PN before starting treatment.
Chyluria: non-enhanced MR lymphography
Authors: Sabbah Alexandre , Koumako Cedi , El Mouhadi Sanaâ , Ali Amal , Minssen Lise , Vanderbecq Quentin , Arrivé Lionel
Published: July 2023

Chyluria is an uncommon medical condition resulting from an abnormal communication between the abdominal lymphatic system and the urinary tract, which results in the presence of chyle in the urine, making it appear milky white. Proper diagnosis is demonstrated by the concentration of urinary lipids. Worldwide, chyluria is most commonly associated with the parasite Wuchereria bancrofti. However, in Europe and North America, where the condition is rare, non-parasitic etiologies predominate. Identifying the cause and location of the uro-lymphatic communication is essential in guiding therapeutic management, but imaging the lymphatic channels remains a challenge. Magnetic resonance (MR) lymphography, a non-invasive free-breathing 3D high-resolution fast-recovery fast spin-echo sequence similar to that used for 3D MR cholangiopancreatography, may demonstrate the cause and location of an abnormal communication between the lymphatic system and urinary tract. In parasitic causes of chyluria, dilated lymphatics vessels communicating with the lymphatic system are demonstrated. In non-parasitic causes of chyluria channel type lymphatic malformations are the most common. Markedly dilated and dysplastic lymphatic vessels communicating with the urinary tract are demonstrated. In addition, other cystic or channel type lymphatic malformations such as thoracic, soft tissue or bone abnormalities may be observed. This review describes the abdominal lymphatic diseases leading to chyluria and presents the technique and images obtained with non-enhanced MR lymphography to enable radiologists in identifying and classifying uro-lymphatic fistulae.

Critical relevance statement: Non-enhanced MR lymphography enables the identification and categorization of uro-lymphatic fistulae.

Graphical abstract
Acute post sleeve surgery bleeding as rare cause of acute renal failure: a case report
Authors: Mirhashemi Seyed Hadi , Omidvari Samareh , Hakakzadeh Azadeh , Jaberi Najmeh , Samadi Yaser
Published: July 2023

Background

Bariatric surgeries have been considered as one of the most important treatment procedures in recent years. Being aware of the side effects of this surgery will lead to better results after the surgery.

Case presentation

A 37-year-old Iranian male patient presented one day after sleeve surgery with symptoms of weakness, lethargy, and shortness of breath, which hospitalization and workup to were done to rule out pulmonary embolism. Because of the high creatinine and anuria, we couldn’t perform computed tomography angiography. A bedside ultrasound was done for the patient and showed a mild to moderate amount of fluid around the spleen and some blood clots. Due to the progressive clinical findings and suspected internal bleeding, the patient was a candidate for laparoscopic revision procedure. Gradually, after performing the surgery, removing the blood clot and reducing the compressive effect of that on the inferior verna cava which was the main reason of renal failure, the patient was able to urinate afterwards and was discharged in good general condition.

Conclusion

Surgeons should be aware of the management of rare surgical complications after bariatric surgeries. To be best of our knowledge, this was the first case report of a patient with acute renal failure after bariatric surgery and the rare cause of clot compression on inferior vena cava and raised abdominal compartment pressure.
Adult Hirschsprung’s disease presenting as chronic constipation: a case report
Authors: Rahardjo Theresia Monica , Nurzaman Yeppy Arief , Natalia Janice , Hapdijaya Indra , Devina Livia , Andrianto Hendrik , Mahardhika Jeffrey Christian
Published: July 2023

Background

Hirschsprung’s disease is a congenital disorder identified by the absence of ganglion cells at the Meissner’s plexus of the submucosa and Auerbach’s plexus of the muscularis. This disease can be found in approximately 1 in 5000 live births. It is a congenital disorder that is rarely diagnosed in adults, where 95% of cases are diagnosed in infants aged under 1 year old. Here we present a rare case of adult Hirschsprung’s disease to enrich the body of knowledge  in diagnosing adult patients with chronic refractory constipation symptoms.

Case report

An 18-year-old Indonesian woman came to the general surgery department of Unggul Karsa Medika Teaching Hospital with a defecating problem (constipation) since childhood. There was no history of her passage of meconium. A contrast enema study showed that the sigmoid colon was dilated and the rectum was narrowed, with rectosigmoid index < 1. With these findings, it was suspected that the patient may have ultra-short segment Hirschsprung’s disease. The patient was then referred to the digestive surgery department of referral hospital for surgical treatment.

Conclusion

In adult patients presenting with history of constipation since childhood, it is necessary to consider the possibility of Hirschsprung’s disease that was not diagnosed in early childhood. Hirschsprung’s disease in adults is usually a short or ultra-short aganglionic segment because it shows relatively mild symptoms. Surgical removal of the aganglionic segment of the gut is the definitive treatment for Hirschsprung’s disease.
The activation of dormant ependymal cells following spinal cord injury
Authors: Rodriguez-Jimenez Francisco Javier , Jendelova Pavla , Erceg Slaven
Published: July 2023

Ependymal cells, a dormant population of ciliated progenitors found within the central canal of the spinal cord, undergo significant alterations after spinal cord injury (SCI). Understanding the molecular events that induce ependymal cell activation after SCI represents the first step toward controlling the response of the endogenous regenerative machinery in damaged tissues. This response involves the activation of specific signaling pathways in the spinal cord that promotes self-renewal, proliferation, and differentiation. We review our current understanding of the signaling pathways and molecular events that mediate the SCI-induced activation of ependymal cells by focusing on the roles of some cell adhesion molecules, cellular membrane receptors, ion channels (and their crosstalk), and transcription factors. An orchestrated response regulating the expression of receptors and ion channels fine-tunes and coordinates the activation of ependymal cells after SCI or cell transplantation. Understanding the major players in the activation of ependymal cells may help us to understand whether these cells represent a critical source of cells contributing to cellular replacement and tissue regeneration after SCI. A more complete understanding of the role and function of individual signaling pathways in endogenous spinal cord progenitors may foster the development of novel targeted therapies to induce the regeneration of the injured spinal cord.
Vitamin C as a treatment for organ failure in sepsis
Authors: Wang Zitong , Liu Liang , Liu Lixia
Published: July 2023

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, with a high morbidity and mortality rate. Exogenous vitamin C supplementation is a potential therapeutic option for the treatment of multi-organ dysfunction in sepsis due to the significantly lower levels of vitamin C in the circulating blood of sepsis patients compared to healthy subjects and the importance of vitamin C in many of the physiological processes of sepsis. Vitamin C may influence the function of numerous organs and systems, including the heart, lungs, kidneys, brain, and immune defences, by reducing oxidative stress, inhibiting inflammatory factor surges, regulating the synthesis of various mediators and hormones, and enhancing immune cell function. With the development of multiple clinical randomized controlled trials, the outcomes of vitamin C treatment for critically ill patients have been discussed anew. This review's objectives are to provide an overview of how vitamin C affects various organ functions in sepsis and to illustrate how it affects each organ. Understanding the pharmacological mechanism of vitamin C and the organ damage caused by sepsis may help to clarify the conditions and clinical applications of vitamin C.
Transcriptome-wide mapping of milk somatic cells upon subclinical mastitis infection in dairy cattle
Authors: Bisutti Vittoria , Mach Núria , Giannuzzi Diana , Vanzin Alice , Capra Emanuele , Negrini Riccardo , Gelain Maria Elena , Cecchinato Alessio , Ajmone-Marsan Paolo , Pegolo Sara
Published: July 2023

Background

Subclinical intramammary infection (IMI) represents a significant problem in maintaining dairy cows’ health. Disease severity and extent depend on the interaction between the causative agent, environment, and host. To investigate the molecular mechanisms behind the host immune response, we used RNA-Seq for the milk somatic cells (SC) transcriptome profiling in healthy cows (n = 9), and cows naturally affected by subclinical IMI from Prototheca spp. (n = 11) and Streptococcus agalactiae (S. agalactiae; n = 11). Data Integration Analysis for Biomarker discovery using Latent Components (DIABLO) was used to integrate transcriptomic data and host phenotypic traits related to milk composition, SC composition, and udder health to identify hub variables for subclinical IMI detection.

Results

A total of 1,682 and 2,427 differentially expressed genes (DEGs) were identified when comparing Prototheca spp. and S. agalactiae to healthy animals, respectively. Pathogen-specific pathway analyses evidenced that Prototheca’s infection upregulated antigen processing and lymphocyte proliferation pathways while S. agalactiae induced a reduction of energy-related pathways like the tricarboxylic acid cycle, and carbohydrate and lipid metabolism. The integrative analysis of commonly shared DEGs between the two pathogens (n = 681) referred to the core-mastitis response genes, and phenotypic data evidenced a strong covariation between those genes and the flow cytometry immune cells (r2 = 0.72), followed by the udder health (r2 = 0.64) and milk quality parameters (r2 = 0.64). Variables with r ≥ 0.90 were used to build a network in which the top 20 hub variables were identified with the Cytoscape cytohubba plug-in. The genes in common between DIABLO and cytohubba (n = 10) were submitted to a ROC analysis which showed they had excellent predictive performances in terms of discriminating healthy and mastitis-affected animals (sensitivity > 0.89, specificity > 0.81, accuracy > 0.87, and precision > 0.69). Among these genes, CIITA could play a key role in regulating the animals’ response to subclinical IMI.

Conclusions

Despite some differences in the enriched pathways, the two mastitis-causing pathogens seemed to induce a shared host immune-transcriptomic response. The hub variables identified with the integrative approach might be included in screening and diagnostic tools for subclinical IMI detection.
Seasonal malaria chemoprevention in Africa and China’s upgraded role as a contributor: a scoping review
Authors: Xu Ming , Hu Yun-Xuan , Lu Shen-Ning , Idris Muhammad Abdullahi , Zhou Shu-Duo , Yang Jian , Feng Xiang-Ning , Huang Yang-Mu , Xu Xian , Chen Ying , Wang Duo-Quan
Published: July 2023

Background

Children under five are the vulnerable population most at risk of being infected with Plasmodium parasites, especially in the Sahel region. Seasonal malaria chemoprevention (SMC) recommended by World Health Organization (WHO), has proven to be a highly effective intervention to prevent malaria. Given more deaths reported during the COVID-19 pandemic than in previous years due to the disruptions to essential medical services, it is, therefore, necessary to seek a more coordinated and integrated approach to increasing the pace, coverage and resilience of SMC. Towards this end, fully leverage the resources of major players in the global fight against malaria, such as China could accelerate the SMC process in Africa.

Methods

We searched PubMed, MEDLINE, Web of Science, and Embase for research articles and the Institutional Repository for Information Sharing of WHO for reports on SMC. We used gap analysis to investigate the challenges and gaps of SMC since COVID-19. Through the above methods to explore China’s prospective contribution to SMC.

Results

A total of 68 research articles and reports were found. Through gap analysis, we found that despite the delays in the SMC campaign, 11.8 million children received SMC in 2020. However, there remained some challenges: (1) a shortage of fully covered monthly courses; (2) lack of adherence to the second and third doses of amodiaquine; (3) four courses of SMC are not sufficient to cover the entire malaria transmission season in areas where the peak transmission lasts longer; (4) additional interventions are needed to consolidate SMC efforts. China was certified malaria-free by WHO in 2021, and its experience and expertise in malaria elimination can be shared with high-burden countries. With the potential to join the multilateral cooperation in SMC, including the supply of quality-assured health commodities, know-how transfer and experience sharing, China is expected to contribute to the ongoing scale-up of SMC.

Conclusions

A combination of necessary preventive and curative activities may prove beneficial both for targeted populations and for health system strengthening in the long run. More actions are entailed to promote the partnership and China can be one of the main contributors with various roles.
Conceptualizations and implementation of creativity in higher vocational teacher education – a qualitative study of lecturers
Authors: Fischer Silke , Barabasch Antje
Published: July 2023

Creativity is one of the most important skills in the 21st century student’s toolkit and important to vocational education and training (VET). In the context of vocational teacher education, creativity has not yet played a significant role at universities. This is due in part to the fact that it is unclear what creativity means and how it is fostered in the context of higher education. This interview study explores how creativity is conceptualized by lecturers in vocational teacher education and what creativity-promoting measures or teaching/learning scenarios are applied by them in their courses. Generally, the lecturers interviewed associated creativity in their jobs as lecturers with creating something new. From the lecturer’s perspective, student creativity is categorized into a 5-category model in which lecturers ‘see’ student creativity represented by (1) student self-reflection, (2) independent decision-making, (3) curiosity and motivation, (4) producing something and (5) developing original new ideas. Categories identified by the lecturers that promote creativity in courses are openness, individualization, interaction, student activity and generating solutions. In practice, creativity-promoting measures or teaching/learning scenarios are implemented very differently. The type of implementation determines the implementation depth of the individual category. The findings provide an understanding of creativity from the perspective of university lecturers’, which could be valuable for designing university courses in the future.
Mechanisms of metabolic stress induced cell death of human oligodendrocytes: relevance for progressive multiple sclerosis
Authors: Fernandes Milton Guilherme Forestieri , Mohammadnia Abdulshakour , Pernin Florian , Schmitz-Gielsdorf Laura Eleonora , Hodgins Caroline , Cui Qiao-Ling , Yaqubi Moein , Blain Manon , Hall Jeffery , Dudley Roy , Srour Myriam , Zandee Stephanie E. J. , Klement Wendy , Prat Alexandre , Stratton Jo Anne , Rodriguez Moses , Kuhlmann Tanja , Moore Wayne , Kennedy Timothy E. , Antel Jack P.
Published: July 2023

Oligodendrocyte (OL) injury and loss are central features of evolving lesions in multiple sclerosis. Potential causative mechanisms of OL loss include metabolic stress within the lesion microenvironment. Here we use the injury response of primary human OLs (hOLs) to metabolic stress (reduced glucose/nutrients) in vitro to help define the basis for the in situ features of OLs in cases of MS. Under metabolic stress in vitro, we detected reduction in ATP levels per cell that precede changes in survival. Autophagy was initially activated, although ATP levels were not altered by inhibitors (chloroquine) or activators (Torin-1). Prolonged stress resulted in autophagy failure, documented by non-fusion of autophagosomes and lysosomes. Consistent with our in vitro results, we detected higher expression of LC3, a marker of autophagosomes in OLs, in MS lesions compared to controls. Both in vitro and in situ, we observe a reduction in nuclear size of remaining OLs. Prolonged stress resulted in increased ROS and cleavage of spectrin, a target of Ca2+-dependent proteases. Cell death was however not prevented by inhibitors of ferroptosis or MPT-driven necrosis, the regulated cell death (RCD) pathways most likely to be activated by metabolic stress. hOLs have decreased expression of VDAC1, VDAC2, and of genes regulating iron accumulation and cyclophilin. RNA sequencing analyses did not identify activation of these RCD pathways in vitro or in MS cases. We conclude that this distinct response of hOLs, including resistance to RCD, reflects the combined impact of autophagy failure, increased ROS, and calcium influx, resulting in metabolic collapse and degeneration of cellular structural integrity. Defining the basis of OL injury and death provides guidance for development of neuro-protective strategies.
Different definitions of feeding intolerance and their associations with outcomes of critically ill adults receiving enteral nutrition: a systematic review and meta-analysis
Authors: Li Jianbo , Wang Lijie , Zhang Huan , Zou Tongjuan , Kang Yan , He Wei , Xu Yuan , Yin Wanhong
Published: July 2023

Background

A unified clinical definition of feeding intolerance (FI) is urged for better management of enteral nutrition (EN) in critically ill patients. We aimed to identify optimum clinical FI definitions based on reported evidence.

Methods

We searched clinical studies comparing FI with non-FI with a clear definition, summarized the evidence by random-effect meta-analyses, and rated the certainty of evidence by the Grading of Recommendations Assessment, Development and Evaluation frameworks.

Results

Five thousand five hundred twenty-five records were identified, of which 26 eligible studies enrolled 25,189 adult patients. Most patient-centered outcomes were associated with FI overall. Low to very low certainty evidence established FI defined as large gastric residual volume (GRV) ≥ 250 ± 50 mL combined with any other gastrointestinal symptoms (GIS) had a significant association with high mortalities in particular all-cause hospital mortality (odds ratio [OR] 1.90, 95% confidence interval [CI] 1.40–2.57), the incidence of pneumonia (OR 1.54, 95% CI 1.13–2.09) and prolonged length of hospital stay (mean difference 4.20, 95% CI 2.08–6.32), with a moderate hospital prevalence (41.49%, 95% CI 31.61–51.38%). 3-day enteral feeding (EF) delivered percentage < 80% had a moderate hospital prevalence (38.23%, 95% CI 24.88–51.58) but a marginally significant association with all-cause hospital mortality (OR 1.90, 95% CI 1.03–3.50).

Conclusions

In critically ill adult patients receiving EN, the large-GRV-centered GIS to define FI seemed to be superior to 3-day EF-insufficiency in terms of both close associations with all-cause hospital mortality and acceptable hospital prevalence (Registered PROSPERO: CRD42022326273).

Trial registration: The protocol for this review and meta-analysis was registered with PROSPERO: CRD42022326273. Registered 10 May 2022.
Alteration of circulating redox balance in coronavirus disease-19-induced acute respiratory distress syndrome
Authors: Bellanti Francesco , Kasperczyk Sławomir , Kasperczyk Aleksandra , Dobrakowski Michał , Pacilli Gabriella , Vurchio Giuseppina , Maddalena Alessandro , Quiete Stefano , Lo Buglio Aurelio , Capurso Cristiano , Serviddio Gaetano , Vendemiale Gianluigi
Published: July 2023

Background

Mechanisms underpinning ARDS induced by COVID-19 are mostly immune-mediated, but need to be completely clarified. This study aimed to investigate redox balance in COVID-19 patients with ARDS, trying to recognize possible differences from typical ARDS related to the pathophysiology of severe disease.

Methods

Patients affected by ARDS and positive for the SARS-CoV-2 virus (N = 40, COVID-19) were compared to ARDS patients negative to the molecular test (N = 42, No COVID-19). Circulating markers of redox balance were measured in serum and erythrocytes, and related to markers of inflammation and coagulability.

Results

No differences in serum markers of oxidative damage were found between both groups, but a reduction in total antioxidant status and serum ceruloplasmin level was observed in COVID-19 rather than No COVID-19 patients. Redox balance alterations were described in erythrocytes from COVID-19 with respect to No COVID-19 group, characterized by increased lipofuscin and malondialdehyde concentration, and reduced glutathione S-transferase and glutathione reductase activity. These markers were associated with circulating indexes of respiratory disease severity (Horowitz index and alveolar-to-arterial oxygen gradient), inflammation (interleukin-6 and interleukin-10), and hypercoagulability (D-dimer) in COVID-19 patients with ARDS.

Conclusions

ARDS caused by COVID-19 is sustained by impairment of redox balance, particularly in erythrocytes. This alteration is associated with the pro-inflammatory and pro-coagulant status which characterizes severe COVID-19.
How does dental implant macrogeometry affect primary implant stability? A narrative review
Authors: Heimes Diana , Becker Philipp , Pabst Andreas , Smeets Ralf , Kraus Annika , Hartmann Amely , Sagheb Keyvan , Kämmerer Peer W.
Published: July 2023

Purpose

The macrogeometry of a dental implant plays a decisive role in its primary stability. A larger diameter, a conical shape, and a roughened surface increase the contact area of the implant with the surrounding bone and thus improve primary stability. This is considered the basis for successful implant osseointegration that different factors, such as implant design, can influence. This narrative review aims to critically review macro-geometric features affecting the primary stability of dental implants.

Methods

For this review, a comprehensive literature search and review of relevant studies was conducted based on formulating a research question, searching the literature using keywords and electronic databases such as PubMed, Embase, and Cochrane Library to search for relevant studies. These studies were screened and selected, the study quality was assessed, data were extracted, the results were summarized, and conclusions were drawn.

Results

The macrogeometry of a dental implant includes its surface characteristics, size, and shape, all of which play a critical role in its primary stability. At the time of placement, the initial stability of an implant is determined by its contact area with the surrounding bone. Larger diameter and a conical shape of an implant result in a larger contact area and better primary stability. But the linear relationship between implant length and primary stability ends at 12 mm.

Conclusions

Several factors must be considered when choosing the ideal implant geometry, including local factors such as the condition of the bone and soft tissues at the implant site and systemic and patient-specific factors such as osteoporosis, diabetes, or autoimmune diseases. These factors can affect the success of the implant procedure and the long-term stability of an implant. By considering these factors, the surgeon can ensure the greatest possible therapeutic success and minimize the risk of implant failure.

Graphical Abstract
Impacts of cigarette smoking on blood circulation: do we need a new approach to blood donor selection?
Authors: Wang Jie , Wang Yuhan , Zhou Weixin , Huang Yuanshuai , Yang Jianbo
Published: July 2023

Smoking is a major public health problem and is considered the leading cause of preventable death worldwide. Gas-phase smoke carries bioactive substances and toxic compounds, affecting human health and reducing life spans. The negative effects of smoking on red blood cell (RBC) quality include destroying RBCs and increasing carboxy hemoglobin (COHb). Smoking increases the concentrations of heavy metals such as cadmium (Cd) and lead (Pb) in the blood. Moreover, tobacco smoking has been found to be associated with heightened platelet (PLT)-dependent thrombin level which will induce a prothrombotic state. Smoking may affect the blood circulation of donors, and subsequently the blood components, and ultimately the recipients of transfusion. Nevertheless, there are no restrictions on smoking for volunteer blood donor screenings currently. We reviewed the articles about the influence of smoking on smokers' blood circulation as well as the impact of donated blood products on transfusion when these smokers act as blood donors. We aim to attract blood collection centers’ attention to strengthen the management of blood donors who smoke, avoiding their use in massive transfusion protocol and susceptible recipients, especially pediatric ones.
Experiences of being at high-risk during the COVID-19 pandemic and its impact on emotional well-being and daily life in people with chronic conditions: a qualitative study
Authors: Mejdahl Caroline Trillingsgaard , Nielsen Pernille Bjørnholt , Nielsen Lise Arnth , Christensen Astrid Fyrstenborg , Nielsen Berit Kjærside
Published: July 2023

Background

With its health risks and extensive disruption to everyday life, the SARS-CoV-2 (COVID-19) pandemic has affected the lives of billions of people. People with chronic conditions are particularly susceptible to severe illness if infected by COVID-19, and they have repeatedly been urged to take stringent steps to ‘shield’ themselves from the virus. It is argued that the negative impact of isolation and other lockdown-related restrictions on emotional well-being and daily life may be most prominent among people at increased risk for severe illness from COVID-19. This qualitative thematic analysis aimed to explore how individuals with chronic conditions perceived the risk posed by COVID-19 and to understand how being at high risk affected their emotional well-being and everyday life.

Methods

The study is a thematic analysis of qualitative data consisting of semi-structured interviews with adults affected by at least one chronic condition supplemented with free text comments from a PRO-based survey.

Results

Based on 17 semi-structured interviews and 144 free text comments from a PRO-based survey three thematic patterns representing diverse COVID-19-related risk experiences were extracted: (1) Feeling vulnerable and at risk, (2) Uncertainty about being at risk, and (3) Distancing from the high-risk label.

Conclusions

The risk of COVID-19 impacted the participants’ everyday lives and emotional well-being in various ways. Some participants felt vulnerable and at risk causing them and their families to take on far-reaching precautions with significant consequences for their everyday life and emotional well-being. Some participants expressed uncertainty associated with whether they were at increased risk. Such uncertainty gave rise to dilemmas about how to navigate their everyday life. Other participants did not identify themselves as at higher risk and took no special precautions. Such a lack of perceived risk may undermine their motivation for taking preventive measures, which calls for public attention regarding current or future pandemics.
Tanta stroke chain performance during era of COVID-19 pandemic: how to minimize the real/expectation gap
Authors: Kasem Nada Talaat , Abdel-khalek Hazem Mohamed , Bahnasy Wafik Said , El-Seidy Ehab Ahmed Shawky
Published: July 2023

Background

During the coronavirus disease of 2019 (COVID-19) pandemic, it would be so difficult to keep the balance between time-saving best stroke care and medical staff safety which obliges healthcare decision-makers to think extraordinarily. The objectives of this study were to evaluate the performance of the Tanta stroke chain (TSC) during the period of the study as well as to identify areas of strength and disparities of the system while dealing with the COVID-19 pandemic measures. The study was conducted on 492 acute ischemic stroke (AIS) patients who were divided into COVID-19 suspected (115 patients) and COVID-19 non-suspected (377 patients). The former group was further COVID-19 confirmed and COVID-19 negative patients. The latter group was subdivided according to the timing of the patient’s arrival at the hospital in the morning, evening, and night shifts group while the fourth group constitute those reached during shifting hours. Patients received early stroke management regarding the 2018 AHA/ASA guideline and its 2019 update.

Results

Suspected COVID-19 patients represented 23.37% of studied patients. Onset to needle time was significantly prolonged in suspected COVID-19 patients with little chance of utilizing IV thrombolysis (IVT) and consecutive higher morbidity and mortality rates. For COVID-19 non-suspected patients group, a higher rate of IVT utilization was noticed in those reached during the morning shift with a lower chance of utilization in those reached during the shifting hours.

Conclusion

COVID-19 measures had an inverse effect on TSC logistics which needed upgrading of the service to better cope with the pandemic and to improve AIS patients’ functional outcomes.