bluuebunny/crossref_metadata_2025 huggingface dataset:
Do surgimento ao ocaso da anuência prévia da Anvisa: uma análise crítica do patenteamento farmacêutico no Brasil
Authors: Barbosa Allan Fuezi , Velloso Fabiana Pereira , Bastos João Pedro Valentim
Published: June 2024

The article aims to develop a critical and historical analysis of the prior consent of patents for pharmaceutical products and processes by the Brazilian Health Regulatory Agency (Anvisa) from its creation until its extinction. Firstly, (i) we examine the emergence of the institute; and (ii) we analyze the history of institutional divergence between the Brazilian National Institute of Industrial Property (INPI) and Anvisa concerning the subject. Subsequently, we analyze recent events concerning the extinction of prior consent: (i) the main aspects of Recurso Especial n. 1.543.826, judged in 2021, in which the Superior Tribunal of Justice in Brazil brought a paradigmatic decision on the subject; and (ii) the revocation process of article 229-C of the Brazilian Intellectual Property Law and its repercussions. We defend the convenience of conducting further studies on the subject and conclude, preliminarily, by the importance of redesigning a new, more stable, and effective Anvisa's prior consent mechanism.
First nesting record of Black-necked Stork Ephippiorhynchus asiaticus (Aves: Ciconiiformes) in Kumana National Park, Sri Lanka
Authors: W.D.C.N. Gunathilaka  , B.K.P.D. Rodrigo  , D.M.A. Kumara  , E.G.D.P. Jayasekara  , W.A.D. Mahaulpatha
Published: June 2024

Black-necked Stork is a tall, long-necked wading bird of the stork family (Ciconiidae). It is a rare breeding resident and fewer than 50 birds inhabit the island of Sri Lanka. This study was conducted in Kumana National Park from August 2022 to August 2023 to observe nesting characteristics of Black-necked Storks. Nesting locations were searched during three predefined periods each day. During the study, the first recorded Black-necked Stork nest in Sri Lanka was observed, with both male and female birds engaging in nesting behavior. The findings provide important insights for conserving this nationally critically endangered bird species.
Occurrence of Early Cretaceous Shimakuroxylon wood in southeastern China, and its palaeobiogeographic significance
Authors: CHEN MENG-YU , XIE AO-WEI , XU MIN , WU HAO , TIAN NING
Published: June 2024

The Mesozoic gymnosperm genus Shimakuroxylon Philippe, Boura, Oh et Pons is a peculiar petrified wood taxon which was exclusively recorded from the Jurassic–Early Cretaceous interval in eastern Asia. To date, ten occurrences of this genus were documented in Japan, Indochina and Tibet (southwestern China). However, little is known about the record of Shimakuroxylon in eastern China. Here, we describe a new fossil wood specimen from the Lower Cretaceous Laocun Formation in Longyou County of Quzhou City, Zhejiang Province, southeastern China. This fossil specimen exhibits typical Shimakuroxylon anatomy with japonicum-type (shimakurean) radial tracheid pitting and araucarioid cross-field pitting, representing a new record of Shimakuroxylon in eastern Asia. This new finding contributes to our understanding of the fossil wood diversity of the Early Cretaceous xyloflora in southern China, and provides additional data that furthers our knowledge of the palaeobiogeographical distribution of Shimakuroxylon. Shimakuroxylon is commonly suggested as an indicator of warm and wet climates based on its palaeobiogeographical distribution pattern. However, evidence from plant megafossils and sporopollen suggests the local climate of the study area was warm and arid to semiarid during the Early Cretaceous. It is tentatively suggested that the wood plant might have lived in a warm and humid basin margin with relatively sufficient water supply, though the general environmental background might have been arid to semiarid.
Newly identified late Early Cretaceous volcanic rocks in the Beixiangshan area, Lower Yangtze River Belt, South China and its implications
Authors: GAO HAI-LONG , ZHANG YONG , SU YI-TONG , SHEN LIN-WEI , LIAO HUAN-YU , NIE XIAO-MEI , HUANG DI-YING
Published: June 2024

The magmatic events in the Lower Yangtze River Belt could be divided into four stages: 148–133 Ma, 131–127 Ma, 127–121 Ma, and 109–100 Ma. The final episode is represented by the intrusions in the Ningzhen area, however no contemporaneous volcanic rocks have been reported. In this study, we present an integrated analysis of petrology, zircon U-Pb ages, and whole rock major-trace elements for newly identified volcanic rocks in the Beixiangshan area. Zircon U-Pb dating yields an eruption age of 106.3 ± 0.4 Ma, indicating that these rocks likely belong to the lower part of the Pukou Formation. The volcanic rocks exhibit arc-like geochemical features, distinct from those of the intrusions in the Ningzhen area. The volcanic rocks may be formed during a tectonic transition phase from compression to extension, due to the direction changes of plate convergence. The widespread angular unconformity around the volcanic rocks may represent episode C of the Yanshanian tectonic event, based on the dating work on volcanic rocks, its minimum age should be ca. 106 Ma.
An electrocardiogram-based AI algorithm for early detection of pulmonary hypertension
Authors: DuBrock Hilary M. , Wagner Tyler E. , Carlson Katherine , Carpenter Corinne L. , Awasthi Samir , Attia Zachi I. , Frantz Robert P. , Friedman Paul A. , Kapa Suraj , Annis Jeffrey , Brittain Evan L. , Hemnes Anna R. , Asirvatham Samuel J. , Babu Melwin , Prasad Ashim , Yoo Unice , Barve Rakesh , Selej Mona , Agron Peter , Kogan Emily , Quinn Deborah , Dunnmon Preston , Khan Najat , Soundararajan Venky
Published: June 2024

Background

Early diagnosis of pulmonary hypertension (PH) is critical for effective treatment and management. We aimed to develop and externally validate an artificial intelligence algorithm that could serve as a PH screening tool, based on analysis of a standard 12-lead ECG.

Methods

The PH Early Detection Algorithm (PH-EDA) is a convolutional neural network developed using retrospective ECG voltage–time data, with patients classified as “PH-likely” or “PH-unlikely” (controls) based on right heart catheterisation or echocardiography. In total, 39 823 PH-likely patients and 219 404 control patients from Mayo Clinic were randomly split into training (48%), validation (12%) and test (40%) sets. ECGs taken within 1 month of PH diagnosis (diagnostic dataset) were used to train the PH-EDA at Mayo Clinic. Performance was tested on diagnostic ECGs within the test sets from Mayo Clinic (n=16 175/87 998 PH-likely/controls) and Vanderbilt University Medical Center (VUMC; n=6045/24 256 PH-likely/controls). In addition, performance was tested on ECGs taken 6–18 months (pre-emptive dataset), and up to 5 years prior to a PH diagnosis at both sites.

Results

Performance testing yielded an area under the receiver operating characteristic curve (AUC) of 0.92 and 0.88 in the diagnostic test sets at Mayo Clinic and VUMC, respectively, and 0.86 and 0.81, respectively, in the pre-emptive test sets. The AUC remained a minimum of 0.79 at Mayo Clinic and 0.73 at VUMC up to 5 years before diagnosis.

Conclusion

The PH-EDA can detect PH at diagnosis and 6–18 months prior, demonstrating the potential to accelerate diagnosis and management of this debilitating disease.
Low smoking exposure and development and prognosis of COPD over four decades: a population-based cohort study
Authors: Çolak Yunus , Løkke Anders , Marott Jacob L. , Lange Peter , Vestbo Jørgen , Nordestgaard Børge G. , Afzal Shoaib
Published: June 2024

Background

A diagnosis of COPD is mainly considered in individuals with >10 pack-years of smoking. We tested the hypothesis that low smoking exposure, below the critical threshold of 10 pack-years, increases risk of COPD and leads to poor prognosis.

Methods

We followed non-obstructed adult smokers from the Copenhagen City Heart Study for COPD, defined as a forced expiratory volume in 1 s (FEV1)/forced vital capacity <0.70 and FEV1<80% predicted, and for related clinical outcomes. First, we followed individuals for 5 years according to baseline smoking for risk of developing COPD, and thereafter for up to four decades for severe exacerbations and death.

Results

In 6098 non-obstructed smokers, 1781 (29%) developed COPD after 5 years of follow-up: 23% of individuals with <10 pack-years of smoking at baseline, 26% of those with 10–19.9 pack-years, 30% of those with 20–39.9 pack-years and 39% of those with ≥40 pack-years. During four decades of follow-up, we recorded 620 exacerbations and 5573 deaths. Compared to individuals without COPD with <10 pack‑years of smoking, multivariable adjusted hazard ratios (HRs) for exacerbations were 1.94 (95% CI 1.36–2.76) in those without COPD and ≥10 pack-years, 2.83 (95% CI 1.72–4.66) in those with COPD and <10 pack-years, 4.34 (95% CI 2.93–6.43) in those with COPD and 10–19.9 pack-years, 4.39 (95% CI 2.98–6.46) in those with COPD and 20–39.9 pack-years and 4.98 (95% CI 3.11–7.97) in those with COPD and ≥40 pack-years. Corresponding HRs for all-cause mortality were 1.20 (95% CI 1.10–1.32), 1.31 (95% CI 1.13–1.53), 1.59 (95% CI 1.40–1.79), 1.81 (95% CI 1.62–2.03) and 1.81 (95% CI 1.55–2.10).

Conclusion

Low smoking exposure below the critical threshold of 10 pack-years increases risk of COPD in middle-aged adults within 5 years, and these individuals have increased risk of severe exacerbation and early death over four decades.
Development and validation of a machine learning-based model for post-sepsis frailty
Authors: Yeo Hye Ju , Noh Dasom , Kim Tae Hwa , Jang Jin Ho , Lee Young Seok , Park Sunghoon , Moon Jae Young , Jeon Kyeongman , Oh Dong Kyu , Lee Su Yeon , Park Mi Hyeon , Lim Chae-Man , Cho Woo Hyun , Kwon Sunyoung ,   on behalf of the Korean Sepsis Alliance investigators
Published: June 2024

Background

The development of post-sepsis frailty is a common and significant problem, but it is a challenge to predict.

Methods

Data for deep learning were extracted from a national multicentre prospective observational cohort of patients with sepsis in Korea between September 2019 and December 2021. The primary outcome was frailty at survival discharge, defined as a clinical frailty score on the Clinical Frailty Scale ≥5. We developed a deep learning model for predicting frailty after sepsis by 10 variables routinely collected at the recognition of sepsis. With cross-validation, we trained and tuned six machine learning models, including four conventional and two neural network models. Moreover, we computed the importance of each predictor variable in the model. We measured the performance of these models using a temporal validation data set.

Results

A total of 8518 patients were included in the analysis; 5463 (64.1%) were frail, and 3055 (35.9%) were non-frail at discharge. The Extreme Gradient Boosting (XGB) achieved the highest area under the receiver operating characteristic curve (AUC) (0.8175) and accuracy (0.7414). To confirm the generalisation performance of artificial intelligence in predicting frailty at discharge, we conducted external validation with the COVID-19 data set. The XGB still showed a good performance with an AUC of 0.7668. The machine learning model could predict frailty despite the disparity in data distribution.

Conclusion

The machine learning-based model developed for predicting frailty after sepsis achieved high performance with limited baseline clinical parameters.
Bilateral corpus cavernosum abscess: a case report and a review of the literature
Authors: Steven  , Rasyid Nur , Birowo Ponco , Seno Doddy Widyawan Hami , Aulia Indri , Atmoko Widi
Published: June 2024

Background

Corpus cavernosum abscess is an uncommonly described urological condition. We report a case of bilateral corpus cavernosum abscess in a 49-year-old man with a history of the left scrotal abscess.

Case presentation

A 49-year-old man was present with 10 days history of painful and swollen penis. He had a history of an abscess in the left scrotum. The examination revealed non-erythematous palpable edema and tenderness on the shaft of the penis. Laboratory results showed leukocytosis. He was diagnosed with bilateral corpus cavernosum abscess and right testicular hypotrophy after an MRI examination. He underwent a bilateral corporotomy, debridement with Mulcahy salvage solution, and placement of a Penrose drain.

Discussion

A penile abscess can be caused by a variety of factors. Treatment includes intravenous antibiotics, radiologically guided needle aspiration, or open surgical drainage.

Conclusion

In addition to antibiotic treatment, surgical debridement is required for the majority of penile abscess cases.
Livestock predation, crop raiding, and community attitudes towards sustainable wildlife conservation in and around Mankira Forest, Southwest Ethiopia
Authors: Asaye Birhanu , Tekalign Wondimagegnehu , Dobamo Taye
Published: June 2024

Crop raiding and livestock predation negatively impact the views of the local community towards wildlife conservation. Farmers across the African continent, especially those in rural regions, incur financial losses as a result of crop raiding and livestock depredation. The sustainability of the forest relies heavily on comprehending the essential connection between a harmonious park-people relationship and the coexistence of humans and wildlife. The primary aim of this study is to evaluate the predation of livestock, the raiding of crops, and the attitudes of the community towards wildlife in the Mankira Forest located in southwest Ethiopia. This particular area has been lacking in scientific research, making it crucial to conduct this assessment. The data were collected between November 2021 and September 2022 via a structured questionnaire. This study used a sample of 241 randomly selected respondents from the four villages, and responses were compared using chi-square tests. Pearson correlation was also used to test the relationship between the distance of farmland and the extent of crop raiding. The majority of the respondents (95%) reported the presence of crop raiding and livestock predation in the area. These losses were caused by the Papio anubis (39%), the Chlorocebus aethiops (24.1%), the Hystrix cristata (15.3%), the Canis aures (58.3%), and the Crocutacrocuta (29.5%). Maize stood out as the crop type most susceptible to crop raiders. Most of the respondents (56.7%) had a negative attitude towards wildlife conservation. There was a significant difference among age groups of respondents related to their attitude towards wildlife conservation (p < 0.05). The study highlights the need to address several gaps in understanding and managing human-wildlife conflict through research on predation, raiding, and community attitudes. Therefore, to fulfill the dual goals of community support and conservation of wildlife, rigorous management and planning are needed.
Inhibitory activity of bacterial lipopeptides against Fusarium oxysporum f.sp. Strigae
Authors: Assena Mekuria Wolde , Pfannstiel Jens , Rasche Frank
Published: June 2024

This study investigated the influence of bacterial cyclic lipopeptides (LP; surfactins, iturins, fengycins) on microbial interactions. The objective was to investigate whether the presence of bacteria inhibits fungal growth and whether this inhibition is due to the release of bacterial metabolites, particularly LP. Selected endophytic bacterial strains with known plant-growth promoting potential were cultured in the presence of Fusarium oxysporum f.sp. strigae (Fos), which was applied as model fungal organism. The extracellular metabolome of tested bacteria, with a focus on LP, was characterized, and the inhibitory effect of bacterial LP on fungal growth was investigated. The results showed that Bacillus velezensis GB03 and FZB42, as well as B. subtilis BSn5 exhibited the strongest antagonism against Fos. Paraburkholderia phytofirmans PsJN, on the other hand, tended to have a slight, though non-significant growth promotion effect. Crude LP from strains GB03 and FZB42 had the strongest inhibitory effect on Fos, with a significant inhibition of spore germination and damage of the hyphal structure. Liquid chromatography tandem mass spectrometry revealed the production of several variants of iturin, fengycin, and surfactin LP families from strains GB03, FZB42, and BSn5, with varying intensity. Using plate cultures, bacillomycin D fractions were detected in higher abundance in strains GB03, FZB42, and BSn5 in the presence of Fos. Additionally, the presence of Fos in dual plate culture triggered an increase in bacillomycin D production from the Bacillus strains. The study demonstrated the potent antagonistic effect of certain Bacillus strains (i.e., GB03, FZB42, BSn5) on Fos development. Our findings emphasize the crucial role of microbial interactions in shaping the co-existence of microbial assemblages.
Flower color modification in Torenia fournieri by genetic engineering of betacyanin pigments
Authors: Nishihara Masahiro , Hirabuchi Akiko , Teshima Takuya , Uesugi Shota , Takahashi Hideyuki
Published: June 2024

Background

Betalains are reddish and yellow pigments that accumulate in a few plant species of the order Caryophyllales. These pigments have antioxidant and medicinal properties and can be used as functional foods. They also enhance resistance to stress or disease in crops. Several plant species belonging to other orders have been genetically engineered to express betalain pigments. Betalains can also be used for flower color modification in ornamental plants, as they confer vivid colors, like red and yellow. To date, betalain engineering to modify the color of Torenia fournieri—or wishbone flower—a popular ornamental plant, has not been attempted.

Results

We report the production of purple-reddish-flowered torenia plants from the purple torenia cultivar “Crown Violet.”  Three betalain-biosynthetic genes encoding CYP76AD1, dihydroxyphenylalanine (DOPA) 4,5-dioxygenase (DOD), and cyclo-DOPA 5-O-glucosyltransferase (5GT) were constitutively ectopically expressed under the cauliflower mosaic virus (CaMV) 35S promoter, and their expression was confirmed by quantitative real-time PCR (qRT-PCR) analysis. The color traits, measured by spectrophotometric colorimeter and spectral absorbance of fresh petal extracts, revealed a successful flower color modification from purple to reddish. Red pigmentation was also observed in whole plants. LC-DAD-MS and HPLC analyses confirmed that the additional accumulated pigments were betacyanins—mainly betanin (betanidin 5-O-glucoside) and, to a lesser extent, isobetanin (isobetanidin 5-O-glucoside). The five endogenous anthocyanins in torenia flower petals were also detected.

Conclusions

This study demonstrates the possibility of foreign betacyanin accumulation in addition to native pigments in torenia, a popular garden bedding plant. To our knowledge, this is the first report presenting engineered expression of betalain pigments in the family Linderniaceae. Genetic engineering of betalains would be valuable in increasing the flower color variation in future breeding programs for torenia.
Hypertension and cardiac damage in pheochromocytoma and paraganglioma patients: a large-scale single-center cohort study
Authors: Yu Yang , Chen Chuyun , Meng Lei , Han Wencong , Zhang Yan , Zhang Zheng , Yang Ying
Published: June 2024

Background

Hypertension (HT) is one of the most common manifestations in patients with catecholamine-secreting neuroendocrine tumors. Although the cardiovascular manifestations of these tumors have been described, there have been no large-scale investigations of the profile of HT and changes in cardiac structure and function that occur in patients with pheochromocytomas and paragangliomas (PPGL).

Materials and methods

In this study, we investigated the prevalence of HT and left ventricular remodeling (LVR) in a cohort of 598 patients who underwent surgery for PPGL at our center between January 2001 and April 2022. Information on demographics, reason for hospitalization, medical history, biochemical parameters, findings on echocardiography, and tumor characteristics were recorded. The LVR index was compared according to whether or not there was a history of HT.

Results

The average age was 47.07 ± 15.07 years, and 277 (46.32%) of the patients were male. A history of HT was found in 423 (70.74%) of the 598 patients. Paraganglioma was significantly more common in the group with HT (26.00% vs. 17.71%, P = 0.030) and significantly less likely to be found incidentally during a health check-up in this group (22.93% vs. 59.43%, P < 0.001). Among 365 patients with complete echocardiography data, left ventricular mass index (86.58 ± 26.70 vs. 75.80 ± 17.26, P < 0.001) and relative wall thickness (0.43 ± 0. 08 vs. 0.41 ± 0.06, P = 0.012) were significantly higher in patients with PPGL and a history of HT. The proportions with left ventricular hypertrophy (LVH) (19.40% vs. 8.25%, P = 0.011) and LVR (53.73% vs. 39.18%, P = 0.014) were also higher when there was a history of HT. After adjusting for age, gender, body mass index, alcohol consumption, smoking status, diabetes, stroke, creatinine level, tumor location, and tumor size, a history of HT was significantly correlated with LVH (odds ratio 2.71, 95% confidence interval 1.18–6.19; P = 0.018) and LVR (odds ratio 1.83, 95% confidence interval 1.11–3.03; P = 0.018).

Conclusion

HT is common in patients with PPGL (70.74% in this cohort). PPGL without a history of HT is more likely to be found incidentally (59.43% in our cohort). HT is associated with LVR in PPGL patients with complete echocardiography data. These patients should be observed carefully for cardiac damage, especially those with a history of HT.
Recruitment, data collection, participation rate, and representativeness of the international cross-sectional PRICOV-19 study across 38 countries
Authors: Tatsioni Athina , Groenewegen Peter , Van Poel Esther , Vafeidou Kyriaki , Assenova Radost , Hoffmann Kathryn , Schaubroeck Emmily , Stark Stefanie , Tkachenko Victoria , Willems Sara
Published: June 2024

Background

Recruitment for surveys has been a great challenge, especially in general practice.

Methods

Here, we reported recruitment strategies, data collection, participation rates (PR) and representativeness of the PRICOV-19 study, an international comparative, cross-sectional, online survey among general practices (GP practices) in 37 European countries and Israel.

Results

Nine (24%) countries reported a published invitation; 19 (50%) had direct contact with all GPs/GP practices; 19 (50%) contacted a sample of GPs /GP practices; and 7 (18%) used another invitation strategy. The median participation rate was 22% (IQR = 10%, 28%). Multiple invitation strategies (P-value 0.93) and multiple strategies to increase PR (P-value 0.64) were not correlated with the PR. GP practices in (semi-) rural areas, GP practices serving more than 10,000 patients, and group practices were over-represented (P-value < 0.001). There was no significant correlation between the PR and strength of the primary care (PC) system [Spearman’s r 0.13, 95% CI (-0.24, 0.46);P-value 0.49]; the COVID-19 morbidity [Spearman’s r 0.19, 95% CI (-0.14, 0.49);P-value 0.24], or COVID-19 mortality [Spearman’s r 0.19, 95% CI (-0.02, 0.58);P-value 0.06] during the three months before country-specific study commencement.

Conclusion

Our main contribution here was to describe the survey recruitment and representativeness of PRICOV-19, an important and novel study.
Tailoring communication practices to support effective delivery of telehealth in general practice
Authors: White Sarah J. , Nguyen Amy D. , Roger Peter , Tse Tim , Cartmill John A. , Hatem Sarah , Willcock Simon M.
Published: June 2024

Background

The unprecedented increase in telehealth use due to COVID-19 has changed general practitioners’ (GP) and patients’ engagement in healthcare. There is limited specific advice for effective communication when using telehealth. Examining telehealth use in practice in conjunction with perspectives on telehealth as they relate to communication allows opportunities to produce evidence-based guidance for optimal use of telehealth, while also offering practitioners the opportunity to reflect on elements of their communicative practice common to both styles of consultation. The objective of this research was to develop evidence-based resources to support effective, person-centred communication when GPs and patients use telehealth. This included examination of interactional practices of recorded telehealth consultations, exploration of GP and patient perspectives relating to telehealth, and identifying priorities for guidance informed by these analyses as well as participant co-design.

Methods

This study involved recording telehealth consultations (n = 42), conducting patient surveys (n = 153), and interviewing patients (n = 9) and GPs (n = 15). These were examined using interaction analytic methods, quantitative analysis, and thematic analyses, to create a robust, integrated picture of telehealth practice and perspectives. The process of research translation involved a co-design approach, engaging with providers, patients, and policy makers to facilitate development of evidence-based principles that focus on supporting effective communication when using telehealth.

Results

Three key themes relating to communication in telehealth were identified across the different analyses. These were relationship building, conversational flow, and safety netting. The draft best practice principles drawn from these themes were modified based on co-design feedback into five Best Practice Principles for Communication between GPs and Patients using Telehealth.

Conclusions

Effective communication is supported through relationship building and attention to conversational flow in telehealth consultations, which in turn allows for safety netting to occur. In telehealth, GPs and patients recognise that not being co-present changes the consultation and use both intuitive and strategic interactional adjustments to support their exchange. The mixed-method examination of experiences through both a detailed analysis of telehealth consultations in practice and comparative exploration of GP and patient perspectives enabled the identification of principles that can support effective communication when using telehealth. Co-design helped ensure these principles are ready for implementation into practice.
Hypertension knowledge, attitudes and perceptions among adults in the Navrongo Health and Demographic Surveillance Site: a mixed methods analysis
Authors: Singh Ahaana , Agongo Godfred , Chatio Samuel T. , Logonia Bernard , Debpuur Cornelius Y. , Ansah Patrick O. , Oduro Abraham R. , Klipstein-Grobusch Kerstin , Nonterah Engelbert A.
Published: June 2024

Background

This study assessed knowledge, behaviors, and perceptions towards hypertension following community dissemination on cardiovascular disease (CVD) risk within the Navrongo Health and Demographic Surveillance Site in Northern Ghana.

Methods

A cross-sectional mixed methods study was conducted among middle aged men and women following education on CVD and their risk factors. Knowledge and attitudes of participants regarding hypertension were measured in 310 participants using a survey tool and the resultant data was analyzed with descriptive statistics. Focus group discussions (FDG) were used to assess perceptions of 40 study participants on their lived experiences with hypertension. Recorded interviews were transcribed verbatim and coded into themes using Nvivo 12 software before thematic analysis.

Results

Of the 310 surveyed participants, 54% were women and the mean age was 50 ± 6 years. The results showed that 84% of participants had heard about hypertension, 70% knew it was an increase in blood pressure and could be caused by excess salt intake, poor diet and physical inactivity. About 22.3% of participants were aware of the had hypertension. In terms of management, majority of the participants were aware that hypertension could be treated with antihypertensive medication and that untreated or uncontrolled hypertension could result in adverse health consequences. Few participants had ever had their blood pressure measured and did not access screening or healthcare care services and rather perceived the health system as inadequate to screen, and manage hypertension.

Conclusion

Though, knowledge on hypertension was high, awareness of hypertension status and access to screening and healthcare services was low. Community beliefs and perceptions strongly influence treatment, and control of hypertension. Effective sustained community dissemination efforts addressing misperceptions could improve hypertension treatment and control.
Real-world evidence of a novel tetravalent immunoglobulin Y effectiveness and safety in patients with the refractory Helicobacter pylori infection
Authors: Hao Nan , Liu Bo , Zhao Meng , Lu Mingming , Chen Feiyi , Kang Jialu , Tang Xiaojun , Zhang Yong , Dang Chengxue
Published: June 2024

Background

Refractory Helicobacter pylori (H. pylori) infection inevitably increase the difficulty of drug selection. Here, we described our experience with the use of a novel tetravalent IgY against H. pylori for the treatment of patients with refractory H. pylori infection.

Methods

Patients were randomly assigned to receive the standard quadruple therapy (amoxicillin, clarithromycin, omeprazole and bismuth potassium citrate ) for 2 weeks or 250 mg of avian polyclonal IgY orally twice a day for 4 weeks. The binding efficacy of IgY to H. pylori antigens was detected by western blotting13. C-urea breath test was performed to evaluate the eradication therap’s efficacy. The side effects of IgY were evaluated via various routine tests. The questionnaire was used to gather clinical symptoms and adverse reactions.

Results

Western blot analysis showed that tetravalent IgY simultaneously bind to VacA, HpaA, CagA and UreB of H. pylori. Tetravalent IgY had an eradication rate of 50.74% in patients with refractory H. pylori and an inhibition rate of 50.04% against DOB (delta over baseline) of 13C-urea. The symptom relief rate was 61.76% in thirty-four patients with clinical symptoms, and no adverse reactions were observed during tetravalent IgY treatment period.

Conclusions

Polyclonal avian tetravalent IgY reduced H. pylori infection, and showed good efficacy and safety in the treatment of refractory H. pylori infection patients, which represented an effective therapeutic option of choice for patients with refractory H. pylori infection.
Fatal co-infection by multiple pathogens in an indigenous woman with autoimmune hemolytic anemia and tuberculosis: a case report
Authors: Tabares Bryan , Sarmiento-Suárez Alisson Dayana , Gil Óscar , Hernández-Pabón Juan Camilo , Firacative Carolina
Published: June 2024

Background

Tuberculosis (TB), one of the leading causes of death worldwide, has a higher incidence among indigenous people. Albeit uncommon, autoimmune hemolytic anemia (AIHA) has been deemed a risk condition to develop mycobacterial infection, as a result of the immunosuppressive treatments. TB, in turn, can be a predisposing factor for secondary infections.

Case presentation

Here we present a case of a 28-year-old indigenous woman from Colombia, previously diagnosed with AIHA and pulmonary TB. Despite various treatments, therapies and medical interventions, the patient died after severe medullary aplasia of multiple causes, including secondary myelotoxicity by immunosuppressive therapy and secondary disseminated infections, underlining infection by Staphylococcus aureus, Klebsiella pneumoniae and Candida glabrata, which were identified as drug-resistant microorganisms. Together, this led to significant clinical complications. Invasive aspergillosis was diagnosed at autopsy.

Conclusions

This report presents a rarely finding of AIHA followed by TB, and highlights the great challenges of dealing with co-infections, particularly by drug resistant pathogens. It also aims to spur governments and public health authorities to focus attention in the prevention, screening and management of TB, especially among vulnerable communities, such as indigenous people.
Incidence of Parkinson’s disease in Germany based on prevalence data from 70 million patients of the statutory health insurance
Authors: Wattenbach Claudius , Ellrichmann Gisa , Feinkohl Insa , Voß Sabrina , Brinks Ralph
Published: June 2024

Background

Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by motor and nonmotor system manifestations and psychiatric symptoms. The aim of this study was to estimate the age- and sex-specific incidence of PD in Germany using an illness-death model and a corresponding partial differential equation (PDE) based on prevalence and mortality data.

Methods

Based on a PDE that describes the dynamics in an illness-death model, the age- and sex-specific incidence of PD in Germany was estimated using published prevalence and mortality rates. Prevalence rates were provided by the Central Institute for Statutory Health Insurance (Zi) for the period from 2010 to 2019. Parkinson’s related mortality was estimated based on comparable population data from Norway. Bootstrapping was used for incidence estimation (median of 5000 samples) and to obtain 95% confidence intervals to interpret the accuracy of the incidence estimation.

Results

Men had higher incidences of PD than women at all ages. The highest incidences (median of 5000 bootstrap samples) for both groups were estimated for the age of 85 years with an incidence of 538.49 per 100,000 person-years (py) in men and 284.09 per 100,000 py in women, with an increasing width of bootstrapping 95% CIs showing greater uncertainty in the estimation at older ages.

Conclusion

The illness-death model and the corresponding PDE, which describes changes in prevalence as a function of mortality and incidence, can be used to estimate the incidence of PD as a chronic disease. As overestimation of incidence is less likely with this method, we found incidence rates of Parkinson’s disease that are suitable for further analyses with a lower risk of bias.
A qualitative meta-synthesis of service users’ and carers’ experiences of assessment and involuntary hospital admissions under mental health legislations: a five-year update
Authors: Bartl Gergely , Stuart Ruth , Ahmed Nafiso , Saunders Katherine , Loizou Sofia , Brady Grainne , Gray Hannah , Grundy Andrew , Jeynes Tamar , Nyikavaranda Patrick , Persaud Karen , Raad Ari , Foye Una , Simpson Alan , Johnson Sonia , Lloyd-Evans Brynmor
Published: June 2024

Background

Compulsory admissions occur in psychiatric hospitals around the world. They result in coercive and sometimes traumatic experiences for service users and carers. Legal and service reforms in various countries are intended to reduce rates of detention and improve service user experience. We aimed to inform policy and service delivery by providing an up-to-date synthesis of qualitative evidence on service users’ and carers’ experiences of assessment and detention under mental health legislation, updating previous reviews in which we searched for literature published up to 2018.

Methods

We searched five bibliographic databases for studies published between January 2018 and March 2023. We identified 24 additional studies reporting qualitative investigations of service users’ or carers’ experiences of assessment or detention under mental health legislation. A team including researchers with relevant personal experience analysed and synthesised data using a thematic synthesis approach.

Results

Findings suggest that views on compulsory admissions and assessment varied: many reports highlighted its often negative, traumatic impacts on emotional well-being and self-worth, with fewer accounts of it as an opportunity to access help and support, accompanied by feelings of relief. Experiences of racial discrimination, inequality of access, and dissatisfaction with support before and after hospital stay were more prominent than in our previous reviews.

Conclusions

Increasing service user and carer involvement in treatment decisions, provision of timely information at key stages of the admission process, training of key personnel, addressing the issue of discrimination, and investing in community alternatives of inpatient care may contribute to and lead to better overall treatment experiences.

Protocol registration

The study protocol has been registered in the PROSPERO database on 30th May 2023 (CRD42023423439).
Psychological interventions to pregnancy-related complications in patients with post-traumatic stress disorder: a scoping review
Authors: Peng Zhuo , Liu Jin , Liu Bangshan , Zhou Jiansong , Zhang Li , Zhang Yan
Published: June 2024

Objective

This scoping review sought to investigate the association between pregnancy-related complications and post-traumatic stress disorder (PTSD) among postpartum women, then summarize effective psychological interventions for pregnancy-related PTSD or sub-PTSD.

Method

Publications in English and Chinese were searched in PubMed, Embase, Cochrane, ISI Web of Science, China National Knowledge Infrastructure (CNKI), and WanFang databases using the subject headings of “Stress Disorders, Post-Traumatic”, “Pregnant Women”, and “psychotherapy”. To ensure that as many relevant studies are incorporated as possible, free terms such as prenatal, postnatal, perinatal and gestation were also used. Intervention studies and related cases published by July 1st, 2023, were also searched.

Results

Twenty-one articles (including 3,901 mothers) were included in this review. Evidence showed that typical psychological interventions exhibited great effect, and family support programs, peer support, online yoga, and music therapy were also effective in reducing risk and improving the psychological well-being of the studied population.

Conclusion

Fetal abnormalities, miscarriage, premature birth, infants with low birth weights, hypertension, pre-eclampsia, HELLP syndrome, and hyperemesis gravidarum are associated with an increased risk of PTSD. Moreover, high-risk pregnant women may benefit from psychological interventions such as cognitive behavioral therapy (CBT). It may also be feasible and well-accepted for music therapy and exposure therapy to lessen the intensity of PTSD in mothers.
Housing conditions and risk of incident COPD: a Danish cohort study, 2000–2018
Authors: Kloster Stine , Kirkegaard Anne Marie , Davidsen Michael , Christensen Anne Illemann , Nielsen Niss Skov , Gunnarsen Lars , Vestbo Jørgen , Ersbøll Annette Kjær
Published: June 2024

Background

More knowledge is needed on the risk of developing chronic obstructive pulmonary disease (COPD) associated with housing conditions and indoor environment based on cohort studies with a long follow-up time.

Objective

To examine the association between housing conditions and indoor environment and the risk of developing COPD.

Methods

In this cohort study, we followed 11,590 individuals aged ≥ 30 years free of COPD at baseline. Information on incident COPD and housing conditions and indoor environment was obtained from the Danish national registers and the Danish Health and Morbidity Survey year 2000. Poisson regression of incidence rates (IRs) were used to estimate incidence rate ratios (IRRs) of COPD.

Results

The overall IR of COPD was 8.6 per 1,000 person-years. Individuals living outside the biggest cities vs. living in the biggest cities (≥ 50,000) had a lower risk of COPD (200-4,999; IRR 0.77 (95% CI 0.65-0.90). Individuals living in semi-detached houses had a higher risk compared to individuals living in detached houses (IRR 1.29 (95% CI 1.07-1.55)). Likewise, individuals living in rented homes had a higher risk (IRR 1.47 (95% CI 1.27-1.70)) compared to individuals living in owned homes. The IR of COPD was 17% higher among individuals living in dwellings build > 1982 compared with individuals living in older dwellings (< 1962), not statistically significant though (IRR 0.83 (95% CI 0.68-1.03)). Likewise, the IR of COPD was 15% higher among individuals living in the densest households compared with individuals living in the least dense households, not statistically significant though (IRR 1.15 (95% CI 0.92-1.45)). This was primary seen among smokers. There was no difference in risk among individuals with different perceived indoor environments. Overall, similar patterns were seen when stratified by smoking status with exception of perceived indoor environment, where opposite patterns were seen for smokers and never smokers.

Conclusion

Individuals living in semi-detached houses or rented homes had a higher risk of developing COPD compared to individuals living in detached or owned homes. Individuals living in cities with < 50.000 residents had a lower risk of COPD compared to individuals living in cities with ≥ 50.000 residents.
Facility characteristics preferred by older men seeking medical male circumcision services in Kenya: qualitative findings from the ‘Tasco’ study (May 2014-June 2016)
Authors: Omondi Aduda Dickens S. , Agot Kawango , Ohaga Spala , Aoko Appolonia , Onyango Jacob , Toroitich-Ruto Cathy , Kambona Caroline , Odoyo-June Elijah
Published: June 2024

Primary healthcare facilities are central to the implementation of voluntary medical male circumcision (VMMC) as points of access to integrated health services in line with the Kenya AIDS Strategic Framework II (2020/21-2024/25). Knowledge of factors that explain men’s uptake of VMMC and sexual health services at these facilities and preferences of where to get the services remain poorly understood. Using qualitative methodologies, we examined factors that determined facility choice for VMMC services and reasons for preferring the facility among men aged 25–39 years who previously underwent VMMC. The current study draws from focus group discussion interviews with circumcised men and their partners conducted as part of a randomized controlled trial to assess impact of two demand creation interventions in western Kenya. This involved 12 focus group discussions (FGD) with 6–10 participants each. Six FGDs were conducted with circumcised men, and 6 with their sex partners. Thematic issues relevant to a predetermined framework were identified. The themes were organized as follows: service availability, accessibility, affordability, appropriateness and, acceptability. Facility location, physical layout, organization of patient flow, infrastructure, and service provider skills were the outstanding factors affecting the choice of VMMC service outlets by men aged 25–39 years. Additionally, preferences were influenced by individual’s disposition, attitudes, knowledge of VMMC services and tacit balance between their own recognized health needs versus desire to conform to social-cultural norms. Facility choice and individual preference are intricate issues, simultaneously involving multiple but largely intra-personal and facility-level factors. The intrapersonal dimensions elicited may also reflect differential responses to strategic communications and demand creation messages with promotion and prevention frames.
Strategies for knowledge mobilization by advanced practice nurses in three hospitals in Spain: a qualitative study
Authors: Zaforteza-Lallemand Concha , Blanco-Mavillard Ian , Pol-Castañeda Sandra , Villafáfila-Gomila Carlos Javier , Ferrer-Cruz Francisco , Rodríguez-Calero Miguel Ángel
Published: June 2024

Background

Evidence-based practice, in conjunction with optimum care quality, improves patients’ clinical outcomes. However, its implementation in daily clinical practice continues to present difficulties. The aim of this study was to identify the strategies applied by Advanced Practice Nurses (APNs) to foster adherence to clinical practice guideline recommendations.

Methods

An exploratory qualitative study was conducted with six focus groups at three public hospitals belonging to the Balearic Islands Health Care Service (Spain). The study participants were 32 ward nurses and 5 advanced practice nurses working routinely with inpatients at these hospitals. The study was conducted from November 2020 to January 2021, using thematic analysis, based on the COREQ checklist.

Results

Four major themes related to the facilitation process were identified either by RNs and APNs: the context of the project, APN contribution to nursing team management, healthcare provision on the ward, and the acquisition and application of knowledge.

Conclusions

The APNs adapted their actions to the characteristics and needs of the local context, employing strategies aimed at improving teamwork, healthcare, and knowledge management. Each of these contributions enhanced the sustainability of the changes made.
Deletion of VPS50 protein in mouse brain impairs synaptic function and behavior
Authors: Ahumada-Marchant Constanza , Ancatén-Gonzalez Carlos , Haensgen Henny , Brauer Bastian , Merino-Veliz Nicolas , Droste Rita , Arancibia Felipe , Horvitz H. Robert , Constantine-Paton Martha , Arriagada Gloria , Chávez Andrés E. , Bustos Fernando J.
Published: June 2024

Background

The VPS50 protein functions in synaptic and dense core vesicle acidification, and perturbations of VPS50 function produce behavioral changes in Caenorhabditis elegans. Patients with mutations in VPS50 show severe developmental delay and intellectual disability, characteristics that have been associated with autism spectrum disorders (ASDs). The mechanisms that link VPS50 mutations to ASD are unknown.

Results

To examine the role of VPS50 in mammalian brain function and behavior, we used the CRISPR/Cas9 system to generate knockouts of VPS50 in both cultured murine cortical neurons and living mice. In cultured neurons, KO of VPS50 did not affect the number of synaptic vesicles but did cause mislocalization of the V-ATPase V1 domain pump and impaired synaptic activity, likely as a consequence of defects in vesicle acidification and vesicle content. In mice, mosaic KO of VPS50 in the hippocampus altered synaptic transmission and plasticity and generated robust cognitive impairments.

Conclusions

We propose that VPS50 functions as an accessory protein to aid the recruitment of the V-ATPase V1 domain to synaptic vesicles and in that way plays a crucial role in controlling synaptic vesicle acidification. Understanding the mechanisms controlling behaviors and synaptic function in ASD-associated mutations is pivotal for the development of targeted interventions, which may open new avenues for therapeutic strategies aimed at ASD and related conditions.