bluuebunny/crossref_metadata_2025 huggingface dataset:
PS-C30-10: EFFECT OF OBESITY ON SERUM PROFILES OF THE RENIN ANGIOTENSIN ALDOSTERONE SYSTEM (RAAS) IN PREGNANCY
Authors: Davis Dolph L , Poglitsch Marko , Vignes Katherine , Huang Hong , Bauer John A , OBrien John , Shoemaker Robin
Published: January 2023

Objective:

Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal and infant morbidities and mortalities. Activity of the renin angiotensin aldosterone system (RAAS) is critical for the physiology of pregnancy, and suppressed RAAS during pregnancy is associated with adverse outcomes, such as preeclampsia. Obesity is a major contributor to adverse outcomes of pregnancy, and obesity modulates the RAAS in non-pregnant conditions. It is not known how the RAAS is regulated with obesity during pregnancy. We quantified serum biomarkers of the classical and alternative arms of the RAAS in a cohort of pregnant women to determine associations between obesity and activity of the RAAS during pregnancy.

Design and Methods:

We recruited a prospective cohort of n = 36 pregnant women in the first trimester with no clinical risk factors. Patients were separated into two groups, greater (n = 23) or less than (n = 13) body mass index (BMI) of 30 kg/m2 at enrollment. We quantified 6 angiotensin peptides, aldosterone, and enzyme activities of ACE2 and NEP in serum using LC-MS/MS in the first and third trimester. PRA, S was calculated as: Ang I + Ang II (pmol/L). Data are median [IQR].

Results:

PRA, S and aldosterone increased with pregnancy in both groups, but the change from first to third trimester was reduced in the BMI > 30 group compared to those with BMI < 30 (PRA-S: 24.1 [-45.4 to 194.7] versus 70.9 [9.2 to 113.1]) pmol/L, respectively; Aldo: 234.3 [45.5 to 532.7] versus 648.2 [182.1 to 1207.3] pmol/L, respectively; P < 0.05). ACE2 activity was increased during pregnancy, with no differences between groups, however, NEP activity was elevated in the BMI > 30 group at both time points during pregnancy compared to the BMI < 30 group (1st trim: 13.4 [8.1 to 20.38] versus 8.4 [3.7 to 12.03]; 3rd trim: 21.3 [11.7 to 26.5] versus 13.47 [10.5 to 22.8] ng/mL; P < 0.01). In the BMI < 30 group, n = 2 developed gestational hypertension and n = 1 developed postpartum preeclampsia. In contrast, in the BMI > 30 group, n = 7 developed gestational hypertension, n = 2 developed preeclampsia/postpartum preeclampsia.

Conclusion:

Activity of the classical RAAS is reduced in women with 1st trimester BMI > 30 compared to those with BMI < 30. In contrast, the alternative RAS is not suppressed by obesity during pregnancy. Further, elevated 1st trimester BMI was associated with more adverse outcomes. Reduced activity of the classical RAAS with obesity may contribute to adverse outcomes in pregnancy.
PS-C31-4: METABOLIC RISK FACTORS DIFFER IN OBESE CHILDREN AND ADOLESCENTS FROM RURAL VERSUS NON-RURAL REGIONS
Authors: Valdez Lucrecia K , Huang Hong , AlSiraj Yasir , Murphy Margaret , Oberle |Micaila R , III Dolph L Davis , Bauer John A , Radulescu Aurelia , Shoemaker Robin
Published: January 2023

Objective:

The obesity rate in children is rising in the United States, and this is particularly true in children located in rural regions. Rural communities are at greater risk for health disparities, such as metabolic disease, due to socioeconomic factors and access to food and healthcare. Previous studies in rural youth have focused on lifestyle intervention and behavior modification to improve obesity rates. However, there are limited studies comparing clinical parameters of metabolic disease in rural versus non-rural regions in youth. The objective of this study was to examine blood markers of glucose and lipid status among rural vs non-rural adolescents to identify risk factors for metabolic disease.

Design and method:

This is a single timepoint pilot study of n = 82 children and adolescents ages 6–17 recruited from a Pediatric High BMI Clinic. Subjects were grouped according to region: rural (n = 12), micropolitan (n = 20), and metropolitan (n = 50). Weight, adiposity, clinical data, and blood samples were collected at the time of initial clinic visit. Data were analyzed via one-way ANOVA.

Results:

BMI and waist circumference (WC) was highest in rural subjects (BMI - rural: 38.5 ± 5.4 versus micropolitan: 37.7 ± 9.1 versus metropolitan: 33.5 ± 5.5 kg/m2; P < 0.05. WC - rural: 116 ± 12.5 versus micropolitan: 115.1 ± 19.8 versus metropolitan: 105.2 ± 15.6 cm; P < 0.05). In contrast, there was no difference in markers of glucose homeostasis or lipids between regions. Serum concentrations of 25(OH)D3 were different among groups, with the lowest in subjects from the metropolitan area, and highest in the rural area (rural: 34.9 ± 9.6; micropolitan: 30.2 ± 9.7; metropolitan: 23.0 ± 9.3 ng/mL; P < 0.001).

Conclusions:

In agreement with literature, adiposity was greatest in subjects living in non-metropolitan areas. However, this was not associated with elevated markers of metabolic risk, and rural subjects had the greatest serum vitamin D3 concentrations. Further understanding of differences in lifestyle in rural versus non-rural areas may improve opportunities for targeted health interventions.
PS-C31-9: A RANDOMISED TRIAL OF THE TRADITIONAL CHINESE MEDICINE (TCM) CONSTITUTION-BASED DIETARY REGIME IN GRADE 1 HYPERTENSIVE PATIENTS: RATIONALE AND DESIGN
Authors: Wang Harry HX , Wu Xiao Ya , Li Yu Ting , Wang Yi , Fu Yu , Wang Jia Ji , Wong Martin CS , Fan Yu Ling
Published: January 2023

Background and Objective:

Cardiovascular disease (CVD) represents enormous challenges to population health. Body constitution, from the perspective of traditional Chinese medicine (TCM), differentiates how individuals feel and behave, and ultimately affects how different bodies respond to dietary intake. We hypothesise that the TCM constitution-based dietary intervention would be an effective approach to achieving favourable clinical and TCM-related outcomes when compared to usual care alone among the Chinese grade 1 hypertensive patients.

Design and method:

This is a parallel-group, randomised trial (registered as ChiCTR2000034749; http://www.chictr.org.cn). Participants consist of 274 primary care adults, aged 35 years or older, with uncomplicated grade 1 hypertension and at low risk of cardiovascular and renal events. Participants will be randomly assigned to either control or intervention group with a 1:1 allocation as per computer-generated random numbers. Permuted blocks of random sizes will be used. Subjects in the invention group will receive an on-site constitution assessment based on physical signs, personality, body symptoms, and the susceptibility to environmental changes. This will be conducted by the attending TCM practitioners trained in a prior session to improve the inter-rater reliability. A colour-printed constitution-specific brochure will be provided onsite. Health education materials will be made available to patients by courier service thereafter. All participants receive routine care provided by the ‘family doctor team’ in the context of the national basic public health service delivery. Measurements will be undertaken at three time-points, i.e., at baseline, at 6- and 12-month follow-ups. At each follow-up interview, subjects in the intervention group will be questioned about the constitution types of their own, and a full awareness of the constitution profile will be seen as an adherence to the protocol.

Results and outcome evaluation:

The primary outcome of the study is the difference between the two arms in the proportion of participants who had optimal control of blood pressure at 12 months. A point estimate of 25% inferiority in effectiveness would be acceptable assuming a gain that is considered to be clinically relevant. The secondary outcome measures include differences in the profile of clinical parameters and TCM symptoms between the two arms.

Conclusions:

We believe that this study offers new insights for cardiovascular health management through TCM constitution-based strategies in primary care settings to target those who need continuous attention in dietary modifications. The findings may advance our knowledge of the practical contribution of complementary and alternative medicine in the prevention and control of CVD.
PS-C33-2: HYPERTENSION, OBSTRUCTIVE SLEEP APNEA AND HYPERALDOSTERONISM: A BIDIRECTIONAL MENDELIAN RANDOMIZATION STUDY
Authors: Sun Yancui , Song Wei , Jiang Yinong
Published: January 2023

Aim:

The aim of this study was to investigate the causal effects between hypertension, obstructive sleep apnea and hyperaldosteronism.

Methods and Results:

We performed a bidirectional Mendelian randomization (MR) analysis implementing the results from a large-scale genome-wide association study for hypertension by the UK Biobank (N = 462933), obstructive sleep apnea (N = 217955) and hyperaldosteronism and (N = 211463) by the FinnGen to identify genetic instruments. The inverse variance weighted method was the main MR method used. A genetic predisposition to hypertension was significantly increased risk of OSA (OR and 95%CI, 1.49(1.159–1.939) and hyperaldosteronism (OR and 95%CI, 123.863(25.598–599.338). The significance remained consistent in MR sensitivity analyses. Genetically OSA did not show a significant association with the risk of hypertension and hyperaldosteronism, and hyperaldosteronism did not associate with hypertension and OSA.

Conclusions:

Our study supports that hypertension is a causal risk factor for OSA and hyperaldosteronism. However, the effect of OSA on hypertension and hyperaldosteronism, hyperaldosteronism on hypertension and OSA were not identified in this study.
PS-C34-8: INFLUENCE OF RISK FACTORS IN THE DEVELOPMENT OF ARTERIAL STIFFNESS IN PATIENTS WITH UNCONTROLLED ARTERIAL HYPERTENSION
Authors: Yusupova Dilafruz , Sadulloeva Mokhinur , Abdussatarovna Gulnoza , Yuldasheva Aziza , Masharipov Shukhrat
Published: January 2023

Introduction:

Arterial stiffness is an unfavorable prognostic marker in patients with arterial hypertension (AH). Early diagnosis of the development of arterial stiffness contributes to the selection of pathogenetic therapy aimed at vascular protection. As noted in the recommendations for hypertension, markers of vascular damage in hypertension are pulse pressure (PP) and pulse wave velocity (PWV) > 10 m/s. However, in the conditions of practical medicine in our republic, there is no possibility of applanation tonometry to assess PWV.

Aim:

to search for risk factors associated with the early development of arterial stiffness in patients with uncontrolled hypertension.

Material and Methods:

133 patients with an average age of 59.13 ± 8.18 years with uncontrolled hypertension, 22.5% of who were smokers. All patients underwent office blood pressure measurements, ECG, duplex scanning of the carotid arteries, applanation tonometry to determine PWV (Sphygmocor, Atcor, Australia) on the segment of the carotid-femoral artery, lipid spectrum, creatinine, and blood serum glucose.

Results:

Office systolic, diastolic and pulse BP (SBP, DBP and PP) were 164.92 ± 19.0 mm Hg, 99.2 ± 9.08 mm Hg, 65.73 ± 13.67 mm Hg, which corresponded to 2 degrees of arterial hypertension. Central SBP, DBP and PP: 166.96 ± 29.75 mm Hg, 84.8 ± 14.59 mm Hg, PD 81.96 mm Hg. respectively. An increase in PP characterized the development of vascular stiffness in patients with uncontrolled hypertension. At the same time, PWV was 10.8 ± 2.03 m/s; in 60% of patients, PWV exceeded the standard values (> 10 m/s). There was a thickening of the thickness of the intima-media complex (IMC) of the common carotid artery up to 1.11 ± 0.18 mm. The correlation analysis performed showed a direct correlation between PWV and the age of patients (r = 0.383, p = 0.0001), tobacco smoking (r = 0.2, p = 0.004), SBP (r = 0.15, p = 0.046), blood glucose level (r = 0.2, p = 0.008), CMM thickness (r = 0.3, p = 0.0001).

Conclusion:

The results showed an association of age, SBP, smoking, fasting glucose levels, IMT thickness with the development of arterial stiffness in patients with uncontrolled hypertension. These markers can be determined at the primary health care level and included in the stratification of the risk of vascular damage in patients with uncontrolled hypertension.
PS-P13-11: ASSOCIATION BETWEEN SPOT URINE SODIUM-TO-POTASSIUM RATIO AND BLOOD PRESSURE IN HEALTHY ADOLESCENTS: THE WAKAYAMA STUDY
Authors: Zhang Yan , Miyai Nobuyuki , Sougawa Yukiko , Hayakawa Hiroko , Tsuji Kumiko , Arima Miho , Utsumi Miyoko , Miyashita Kazuhisa , Arita Mikio
Published: January 2023

Objective:

Spot urine sodium to potassium ratio (Na/K) is a simple measure of sodium loading and has been shown to be associated with blood pressure (BP) levels. This study aimed to evaluate the association between spot urine Na/K and BP in a cross sectional sample of healthy adolescent population.

Design and method:

The study participants consisted of 457 healthy adolescents (217 males and 240 females) aged 12 to 15 years (mean age: 13.9 years). Brachial arterial BP was measured in the supine position using digital BP monitor with an appropriate cuff size. Urinary Na, K, and creatinine levels were measured using spot urine specimens collected in the early morning of the sampling day.

Results:

The spot urine Na/K levels of participants was 4.99 ± 2.76 (Na, 148.1 ± 58.4 mEq/L; K, 36.1 ± 18.7 mEq/L), and there was no significant difference between males and females. When the participants were stratified based on the quartiles of urinary Na/K distribution (< 2.95, 2.95 to 4.54, 4.55 to 6.59, > = 6.6), systolic and diastolic BP gradually increased with an increase in Na/K levels (systolic BP, 106.1, 106.9, 108.2, and 111.5 mmHg, P for trend < 0.001; diastolic BP, 62.0, 62.4, 63.1, 64.3 mmHg, P for trend = 0.022). The Na/K was more closely associated with BP than urinary Na and K levels, as well as daily salt intake estimated from urinary Na. In multiple regression analysis, Na/K was significantly associated with systolic BP (β; = 0.144, P < 0.001) and diastolic BP (β; = 0.114, P = 0.015), independent of potential confounding factors. The BP of the subgroup with high Na/K (> = 6.6) and high salt intake (> = 8.5 g/day) was significantly higher than that of those with only high salt intake (systolic BP, 115.0 mmHg vs. 109.1 mmHg, P < 0.001; diastolic BP, 66.0 mmHg vs. 62.5 mmHg, P = 0.017).

Conclusions:

High Na/K levels is associated with elevated BP in healthy adolescents, and Na/K may be useful in assessing the effect of salt loading on BP than Na excretion alone.
PS-P14-2: ARTERIAL HYPERTENSION AND SALT CONSUMPTION IN LITHUANIA
Authors: Zakauskiene Urte , Sukackiene Diana , Macioniene Ernesta , Bratcikoviene Nomeda , Banys Valdas , Zabuliene Lina , Miglinas Marius
Published: January 2023

Objective:

Though it is an easily modifiable factor, high salt consumption remains the major contributor of the development of arterial hypertension and cardiovascular mortality. The World Health Organization recommends to consume less than 5 g salt per day. We aimed to evaluate the associations of 24-hour urinary sodium excretion and arterial blood pressure in Lithuanian adult population.

Design and method:

1082 randomly selected individuals (18–69 years) were invited to participate in the study. We obtained 1035 samples of 24-hour urine collections, but 147 participants were excluded due to incomplete or inaccurate urine collection and/or 24 h urinary creatinine excretion outside 2 standard deviations of the sex-specific distribution. Three blood pressure (BP) readings were measured, separated by at least 1 min. Arterial hypertension was defined as systolic or diastolic BP > 140/90 mmHg and/or antihypertensive treatment and/or previously diagnosed hypertension. 9 individuals were excluded due to missing blood pressure measurements.

Results:

In a final analysis 879 individuals were enrolled, 52.67% was female. Mean age of all participants was 47.49 (±12.05) years old. Mean 24-hour urinary sodium excretion was 162.5mmol/24 hours and calculated mean salt consumption was 9.97 g (±5.29). Males had higher mean salt consumption than females (11.76 ± 5.8 g vs. 8.36 ± 4.2, p < 0.001). 35.7% of participants were identified to have arterial hypertension, a quarter were treated with antihypertensive medication. Hypertensive individuals had significantly higher salt consumption than normotensive participants of this study (11.1 ± 6.3 g vs. 9.35 ± 4.5 g, p < 0.01). Correlation coefficient between arterial hypertension and salt consumption was 0.25 (p < 0.001).

Conclusions:

Mean salt consumption in Lithuania twofold exceeds recommended amount. Male individuals use more salt than female. Hypertensive individuals have higher salt consumption.
PS-P16-6: FEASIBILITY AND MEASUREMENT STABILITY OF SMARTWATCH-BASED CUFFLESS BLOOD PRESSURE MONITORING
Authors: Lee Hae-Young
Published: January 2023

Aim:

To evaluate the feasibility and stability of smartwatch-based blood pressure (BP) monitoring.

Methods and Results:

Using real-world data from a campaign entitled Daily BP measurement with your Galaxy Watch, we collected 35,646 BP readings from 760 participants (mean age 43.7 ± 11.9, 80.3% men). Each participant measured BP 1.5 ± 1.3 times a day, and 19.7% of the participants had measurements every day. BP showed large variability, mainly depending on measurement time (hours) and days. The average pre-post calibration error for systolic BP (SBP), defined as the difference of SBP before and after calibration, was 6.8 ± 5.6 mmHg, which increased with higher SBP before calibration. SBP measurements showed good stability and reproducibility until the 15th day after calibration and showed increments afterward by 0.02 mmHg per day.

Conclusion:

Smartwatch is a feasible monitoring tool for out-of-office monitoring in the real-world setting. However, a substantial extent of pre-post calibration error was observed, warranting the sophisticated assistance by medical personnel in the calibration process.
PS-R06-8: AMLODIPINE WELL RESPONDED TO HYPERTENSION ALONG WITH HEADACHE IN PATIENT UNDERGOING WHOLE BRAIN RADIATION THERAPY (CASE REPORT)
Authors: Ozeki Rie , Sai Hyonmi , Iijima Kotaro , Watanabe Junichiro , Saito Mitsue
Published: January 2023

Objective:

According to the current treatment guideline for breast cancer issued by Japanese Breast Cancer Society, surgery or stereotactic radiotherapy is recommended for patients with solitary brain metastasis (BM), while whole brain radiotherapy (WBRT) is recommended for patients with multiple BMs. Common treatment-related toxicities during radiotherapy include fatigue, drowsiness, alopecia, headache, nausea, or vomiting, however, elevation of blood pressure has not been reported. We report a case of headache due to high blood pressure during WBRT.

Case:

A 5X-year female was diagnosed as HER2-positive operable left breast cancer underwent radical mastectomy followed by adjuvant chemotherapy including one-year trastuzumab. Three years after surgery she was diagnosed as having cancerous pleurisy, cancerous pericarditis, and multiple bone metastases. The patient received 6 cycles of trastuzumab, pertuzumab and docetaxel and 5 cycles of trastuzumab and pertuzumab. She noticed chronic headache and magnetic resonance imaging of the brain showed metastases to the right frontal lobe and left cerebellum. She was hospitalized and underwent WBRT. She received corticosteroid and glycerin-fructose injection to reduce the intracranial pressure (ICP) along with WBRT. On the 10th day of hospitalization, she complained severe headache with numerical rating scale (NRS) of 6. While an analgesic was not effective, elevated blood pressure (160/80 mmHg) since admission was suspected as a cause of headache. High-dose amlodipine at the dose of 10 mg was prescribed and the patient well responded to amlodipine as blood pressure of 130/70 mmHg and headache was relieved.

Discussion:

In patients with BMs, headache is common symptom due to elevate ICP or leptomeningeal dissemination. However, analgesic and ICP relief therapy did not work in this case. Guidelines for the management of hypertension 2019 (JSH 2019) define hypertension as 140/90 mmHg or higher, and in low-risk cases without underlying disease, non-pharmacologic therapy is recommended. Ultimately, the use of a calcium channel blockers resulted in a decrease in blood pressure and improvement in headache. It is possible that the headache was caused by increased sympathetic nerve activity via ischemia in the brainstem due to increased ICP, such as in brain tumors, which can lead to hypertension. Amlodipine is recommended for patients with chronic cerebrovascular disease because of its long acting and slow onset of effect, as well as its ability to protect organ blood flow.

Conclusion:

This case revealed hypertension may be the cause of headaches during WBRT, in which case amlodipine was effective.
Application of a Thoracic CT Decision Rule in the Evaluation of Injured Children: A Quality Improvement Initiative
Authors: Downie Katie , McIntire Alicia , Tobias Joseph , Krishnaswami Sanjay , Jafri Mubeen
Published: January 2023

Background:

Differences in injury patterns in children suggest that life-threatening chest injuries are rare. Radiation exposure from computed tomography increases cancer risk in children. Two large retrospective pediatric studies have demonstrated that thoracic computed tomography can be reserved for patients based on mechanism of injury and abnormal findings on chest radiography.

Objective:

Implement a decision rule to guide utilization of thoracic computed tomography in the evaluation of pediatric blunt trauma, limiting risk of unnecessary radiation exposure and clinically significant missed injuries.

Methods:

A protocol for thoracic computed tomography utilization in pediatric blunt trauma was implemented using a Plan-Do-Study-Act cycle at our Level I pediatric trauma center, reserving thoracic computed tomography for patients with (1) mediastinal widening on chest radiography or (2) vehicle-related mechanism and abnormal chest radiography. We modified our resuscitation order set to limit default imaging bundles. The medical record and trauma registry data were reviewed for all pediatric blunt trauma patients (younger than 18 years) over a 30-month study period before and after protocol implementation (May 2017 to July 2018 and February 2019 to April 2020), allowing for a 6-month implementation period (August 2018 to January 2019).

Results:

During the study period, 1,056 blunt trauma patients were evaluated with a median (range) Injury Severity Score of 5 (0–58). There were no significant demographic differences between patients before and after protocol implementation. Thoracic computed tomography utilization significantly decreased after implementation of the protocol (26.4% [129/488] to 12.7% [72/568; p < .05]), with no increase in clinically significant missed injuries. Protocol compliance was 88%.

Conclusions:

Application of decision rules can safely limit ionizing radiation in injured children. Further limitations to thoracic computed tomography utilization may be safe and warrant continued study due to the rarity of significant injuries.
Impact of COVID-19 on U.S. Hospital-Based Injury Prevention Professionals: A National Survey
Authors: Edwards Courtney , Arabian Sandra Strack , Colburn-Hargis Paige , Duchossois Gina , Adams Christy
Published: January 2023

Background:

COVID-19 challenged U.S. trauma centers to grapple with demands for expanded services with finite resources while also experiencing a concurrent increase in violent injuries.

Objective:

The purpose of this study was to describe the impact of COVID-19 on the roles and duties of U.S. hospital-based injury prevention professionals.

Methods:

This descriptive cross-sectional survey study of hospital-based injury prevention professionals was conducted between June 2021 and August 2021. Participants were recruited from six organizational members of the national Trauma Prevention Coalition, including the American Trauma Society, Emergency Nurses Association, Injury Free Coalition for Kids, Safe States Alliance, Society for Trauma Nurses, and Trauma Center Association of America. Results were analyzed using descriptive and inferential statistics.

Results:

A total of 216 participants affiliated with 227 trauma centers responded. The following changes were reported during 2020: change in injury prevention position (range = 31%–88%); change in duties (range = 92%–100%); and change to hospital-based injury prevention programs (range = 75%–100%). Sixty-one (43%) single-center participants with a registered nurse license were reassigned to clinical duties compared with six (10%) nonlicensed participants (OR = 5.6; 95% CI [1.96, 13.57]; p < .001). Injury prevention programs at adult-only and combined adult and pediatric trauma centers had higher odds of suspension than pediatric-only trauma centers (OR = 3.6; 95% CI [1.26, 10.65]; p < .017).

Conclusion:

The COVID-19 response exposed the persistent inequity and limited prioritization of injury prevention programming as a key deliverable for trauma centers.
Practice and experience in the teaching system of clinical pharmacy laboratory in the post-epidemic era: A review
Authors: Huang Qi , Su Hong , Zhang Yingfan , Liu Shao , Liu Qiong , Jiang Yueping
Published: January 2023

Out of the global outbreak of COVID-19, clinical pharmaceutical therapeutic analytical-teaching laboratories underwent an increasing number of digitally-led teaching research. A teaching system working online and offline to monitor medicinal drugs was explored and established using a clinical pharmaceutical therapy through a drug concentration monitoring laboratory within a comprehensive tertiary hospital. Meanwhile, laboratory access training and standards of laboratory biosafety management system were also strictly implemented, improving the technical operation and daily management. Moreover, a new, significant, and efficient teaching mode was set up based on vocational training needs for efficient and professional learning. The learning results are enforced to have dynamic checks accomplished using stage-oriented assessment. Moreover, the questionnaire survey results, especially during independent learning ability and laboratory skills training, reveal that teachers and students have commented positively on the new teaching mode. Hereon, a clinical pharmaceutical teaching system during the Post-Epidemic Era was elaborated to provide a unique teaching mode and experience dedicated to teaching and scientific research in clinical therapeutic drug monitoring laboratory.
Therapeutic efficacy of Chinese patent medicine containing pyrite for fractures: A protocol for systematic review and meta-analysis
Authors: Choi Su Hyeon , Nam Eun-Young , Hwang Ji Hye
Published: January 2023

Background:

Fractures are a condition in which bone continuity is lost or linear deformity occurs. They are a worldwide public health problem and a significant economic burden. The purpose of this study is to analyze the efficacy of Chinese patent medicine containing pyrite (CPMP) through systematic review and meta-analysis of fracture clinical data.

Methods:

A literature search will be carried out from the inception of CPMP studies to September 2022 using EMBASE, PubMed, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Korean Studies Information Service System, National Digital Science Library, and Oriental Medicine Advanced Searching Integrated System. Randomized controlled trials which include CPMP will be considered as eligible regardless of the type of fracture. After screening the literature, extracting the data, and assessing the risk of bias from the included studies, a meta-analysis will be performed using Review Manager version 5.4.

Results:

This study is expected to provide evidence for the efficacy and safety of CPMP for fractures.

Conclusion:

Our findings will provide evidence to determine whether CPMP can be an effective intervention for patients with fractures, which would expand the possible treatment options.
A Novel Way to Objectively Review Emerging Rehabilitation Technologies
Authors: Cook Hayley , McLaughlin Kevin H. , Johnson Ken , Raghavan Preeti
Published: January 2023

Technology-enhanced rehabilitation can improve access to training activities in multiple care delivery settings and may improve patient outcomes. However, the rate at which rehabilitation technology is being developed makes it difficult for healthcare systems to keep pace with the volume of products emerging in this space. Formal processes are needed to help healthcare systems review products as they emerge and to determine whether they should be incorporated into clinical practice. Here, we describe an approach to reviewing emerging rehabilitation technologies as performed by the Center for Emerging Rehabilitation Technology at our institution. Developed using an iterative approach, the rehabilitation technology review process used by the Center for Emerging Rehabilitation Technology team classifies technologies into the following three categories: (1) for clinical deployment, (2) for innovation in product development/product-market fit testing, and (3) for research, for example, a sponsored clinical trial. We describe the processes used to evaluate, categorize, investigate, and integrate rehabilitation technology, share our experience with the review process, and make recommendations for other institutions who may wish to implement rehabilitation technology into clinical practice.
Comments on Case Report: A fatal case of Aspergillus felis infection in an immunocompetent host.
Authors: Barrs Vanessa R.
Published: January 2023

Not applicable
Clostridium caldaquaticum sp. nov., a thermophilic bacterium isolated from a hot spring sediment
Authors: Lv Ai-Ping , Ming Yu-Zhen , Liu Ze-Tao , Ouyang Yu-Ting , Li Meng-Meng , Lian Zheng-Han , Jiao Jian-Yu , She Ting-Ting , Liu Lan , Li Wen-Jun
Published: January 2023

A novel anaerobic bacterium, designated SYSU GA19001T, was isolated from a hot spring sediment sample. Phylogenetic analysis indicated that the isolate belongs to the genus

Clostridium

, and showed the highest sequence similarity to

Clostridium swellfunianum

CICC 10730T (96.63 %) and

Clostridium prolinivorans

PYR-10T (96.11 %). Cells of strain SYSU GA19001T were Gram-stain-positive, spore-forming, rod-shaped (0.6–0.8×2.6–4.0 µm) and motile. Growth was observed at pH 5.0–9.0 (optimum, pH 7.0), 37–55 °C (optimum, 45 °C) and in NaCl concentrations of 0–2.0 % (optimum, 0 %). The genomic DNA G+C content was 31.62 %. The major cellular fatty acids of strain SYSU GA19001T were C14 : 0, iso-C15 : 0, C16 : 0 and summed feature 8. The prominent polar lipids were diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylglycerol. Meso-diaminopimelic acid was the diamino acid in peptidoglycan. Based on the results of phylogenetic, chemotaxonomic and phenotypic analyses, strain SYSU GA19001T represents a novel species of the genus

Clostridium

, for which the name Clostridium caldaquaticum sp. nov. is proposed. The type strain of the proposed novel species is SYSU GA19001T (=NBRC 115040T= CGMCC 1.17864T).
Quantitative Assessment of Injectable Medication Delivery Practices
Authors: Aggerwal Salena , Minerbi Amir , Beliveau Lt(N) Peter , Meredith LCol Sean , Lalonde MCpl Sasha , Laurin Erica , Gupta Gaurav
Published: January 2023

Background

While medical advances for in-hospital care rapidly evolve, a mainstay of effective pre-hospital care remains the ability to treat medical emergencies such as anaphylaxis, overdosing, and/or uncontrolled bleeding through rapid administration of appropriate medication. Therefore, investigators looked at various injection methods and their possible utility in medical emergencies.

Method

30 participants were asked to inject ‘medication’ that mimicked three different methods of injection: 1) autoinjectors, 2) prefilled syringes, and 3) traditional standard syringes using clinical scenarios. Three variables that were measured in the study were: the time required to complete the injection, the perceived difficulties, and the participant’s performance errors.

Results

The perceived difficulty and injection time for the autoinjector device were statistically significantly lower compared to prefilled syringes and standard syringes. No significant difference in errors were seen between platforms.

Discussion

To our knowledge, this is the first study to quantify the gain of efficiency when comparing autoinjectors to other methods of medication administration, like prefilled syringes or drawing medication from vials for administration. The clinical implications of the noted differences are not clear at this time. Many potential limitations exist, including the size of the study, the use of non-clinical participants, the immediate use of platforms after training, and the lack of applied stress in the environment.

Conclusion

This study compares autoinjectors to other methods of medication administration; prefilled syringes and standard syringes. Further study in larger datasets with clinicians and/or military personnel is required to compare these platforms in various environments. The outcome of this project provides insights into the relative efficiencies of treating medical emergencies such as anaphylaxis, overdosing, and/or uncontrolled bleeding.
Virtual fun in a virtual workplace: employee socialization for “work from home”
Authors: Ghosh Koustab , Sinha Sweta , Sharma Dheeraj
Published: January 2023

Purpose

This paper introduces “virtual fun at the virtual workplace” and conceptualizes its impact on virtual socialization and the formation of virtual professional ties. The conceptual model also recognizes the moderation of a few variables: “awareness of being observed,” “diversity in the virtual workplace” and “virtual impression management.”

Design/methodology/approach

The paper takes a theoretical approach to develop a conceptual framework of virtual fun in the virtual workplace, drawing on social exchange theory (SET) and social network theory (SNT).

Findings

The study extends the tenets of the SET and extends the applicability of SNT to a virtual workplace. The study suggests that managers should introduce semi-organized virtual fun during scheduled breaks within work hours to aid in virtual socialization, which further aids in the formation and strengthening of “professional ties” in the virtual workplace.

Originality/value

This study is the first of its kind to conceptualize a model for virtual fun in the virtual workplace.
Do changes in distributors' incentive structure drive mutual fund flows?
Authors: Sandhu Harsimran , Guha Deb Soumya
Published: January 2023

Purpose

This study estimates the impact of changes in the mutual fund distributor incentive structure on distributor-advised mutual fund flows. The authors employ two recent major policy interventions by the Indian self-regulatory authority and the financial market regulator – one partial ban and another complete ban on upfront commissions – paid to mutual fund distributors on distributor-advised mutual fund flows.

Design/methodology/approach

The authors use novel distributor-level data across the 198 largest distributors in India between 2013 and 2020 and a series of pooled panel random-effect generalized least squares models with robust standard errors to explore the effect of changes of distributor commissions on distributor assets-under-management (AUM), gross sales, commissions and changes (%) in the number of investors in alternate investment avenues like portfolio management services (PMS).

Findings

Changes in the incentive structure have a significant negative effect on mutual fund flows at an aggregate level and within MF distributor categories. A significant diversion of investor funds toward PMS is noted, which paid higher upfront commissions to distributors during the same period.

Practical implications

The authors posit that these two developments are not mutually independent and that both fall out of the aforementioned policy changes by Securities and Exchange Board of India and Association of Mutual Funds in India. The study findings have implications for all stakeholders in the Indian mutual fund industry and, by extension, for Indian and global alternative investment avenues.

Originality/value

This study is the first to explore the effects of these two major policy interventions by regulators on mutual fund flows in India.
Collaborative research services: a peer-led cohort approach
Authors: Johnson Matthew Weirick , Bowline Estéfani , King Diana Leigh , Osuna-Garcia Antonia , Page Sylvia , Tadesse Alohie , Tarmey Maggie , Vest Matthew
Published: January 2023

Purpose

Prior to 2020, University of California, Los Angeles (UCLA) Library's research services spanned multiple service points. Multiple locations were staffed by Library Student Research Assistants (LSRAs) and each location was supervised independently. While efforts to increase collaboration had been underway, much of the work and services remained siloed and often duplicated training and service hours.

Design/methodology/approach

With the onset of coronavirus disease 2019 (COVID-19), UCLA Library rapidly transitioned from entirely in-person to entirely online services. With multiple service points pivoting, UCLA was redundant to have multiple online desks providing Zoom appointments and that quickly became apparent. Moreover, transitioning in-person student work to remote work was paramount to providing both normal services to users and allowing LSRAs to keep jobs during a time of uncertainty and insecurity.

Findings

While the authors' original consolidation of services and implementation of shared supervision was a result of the pandemic and primarily involved online services, the authors have maintained this shared approach and collaborative vision in returning to in-person services. For the past year, the authors have offered shared in-person (at two library locations) and online services. As subject-specific library locations begin to reopen their desks, the authors continue to identify ways to leverage shared supervision and a robust referral model for those on-site services while negotiating student staffing and the need for both general and subject-specific services.

Originality/value

The authors present a novel approach to peer-to-peer teaching and learning and research services and shared student worker supervision with services coordinated across multiple locations and disciplines within a large academic library serving a large student population.
Predicting primate–parasite associations using exponential random graph models
Authors: Herrera James P. , Moody James , Nunn Charles L.
Published: January 2023

Ecological associations between hosts and parasites are influenced by host exposure and susceptibility to parasites, and by parasite traits, such as transmission mode. Advances in network analysis allow us to answer questions about the causes and consequences of traits in ecological networks in ways that could not be addressed in the past.

We used a network‐based framework (exponential random graph models or ERGMs) to investigate the biogeographic, phylogenetic and ecological characteristics of hosts and parasites that affect the probability of interactions among nonhuman primates and their parasites. Parasites included arthropods, bacteria, fungi, protozoa, viruses and helminths.

We investigated existing hypotheses, along with new predictors and an expanded host–parasite database that included 213 primate nodes, 763 parasite nodes and 2319 edges among them. Analyses also investigated phylogenetic relatedness, sampling effort and spatial overlap among hosts.

In addition to supporting some previous findings, our ERGM approach demonstrated that more threatened hosts had fewer parasites, and notably, that this effect was independent of hosts also having a smaller geographic range. Despite having fewer parasites, threatened host species shared more parasites with other hosts, consistent with loss of specialist parasites and threat arising from generalist parasites that can be maintained in other, non‐threatened hosts. Viruses, protozoa and helminths had broader host ranges than bacteria, or fungi, and parasites that infect non‐primates had a higher probability of infecting more primate species.

The value of the ERGM approach for investigating the processes structing host–parasite networks provided a more complete view on the biogeographic, phylogenetic and ecological traits that influence parasite species richness and parasite sharing among hosts. The results supported some previous analyses and revealed new associations that warrant future research, thus revealing how hosts and parasites interact to form ecological networks.
Effect of sodium trimetaphosphate on the physicochemical properties of modified soy protein isolates and its lutein‐loaded emulsion
Authors: Lu Xingxing , Yin Qi , Zheng Zhi , Mu Dongdong , Zhong Xiyang , Luo Shuizhong , Zhao Yanyan
Published: January 2023

Due to people's pursuit of healthy and green life, soy protein isolate (SPI) is occupying a larger and larger market share. However, the low solubility of SPI affects its development in the field of food and medicine. This paper aimed to investigate the effects of sodium trimetaphosphate (STMP) on the functional properties and structures of phosphorylated SPI and its lutein‐loaded emulsion. After modification by STMP, the phosphorus content of phosphorylated SPI reached 1.2–3.61 mg/g. Infrared spectrum and X‐ray photoelectron spectrum analysis confirmed that PO43− had phosphorylation with –OH in serine of SPI molecule. X‐ray diffraction analysis showed that phosphorylation destroyed the crystal structure of protein molecules. Zeta potential value of phosphorylated SPI decreased significantly. When STMP addition was 100 g/kg, particle size of protein solution decreased to 203 nm, and solubility increased to 73.5%. Furthermore, emulsifying activity and emulsifying stability increased by 0.51 times and 8 times, respectively. At the same protein concentration (1%–3% [w/w]), lutein‐loaded emulsion prepared by phosphorylated SPI had higher absolute potential and smaller particle size. The phosphorylated protein emulsion at 2% concentration had the best emulsion stability after storage for 17 days.

Practical Application

Phosphorylation significantly improved the emulsifying properties and solubility of SPI. Phosphorylated SPI significantly improved the stability of lutein‐loaded emulsion. It provides theoretical basis for the application of phosphorylated SPI as emulsifier in delivery system and broadens the development of lutein in food and medicine field.
Adjuvant chemotherapy in node‐positive patients after esophagectomy for esophageal squamous cell carcinoma
Authors: Jeon Yeong Jeong , Cho Jong Ho , Choi Yong Soo , Shim Young Mog , Sun Jong‐Mu , Kim Hong Kwan
Published: January 2023

Background

The role of adjuvant chemotherapy in esophageal squamous cell carcinoma (ESCC) remains controversial. This study aimed to evaluate the impact of adjuvant chemotherapy on survival in patients with positive nodes after surgery for ESCC.

Methods

We retrospectively reviewed the survival outcomes of node‐positive patients with ESCC who underwent curative resection with or without adjuvant chemotherapy between January 1994 and December 2015.

Results

We analyzed 460 patients (333 adjuvant chemotherapy, 127 surgery alone). The surgery‐alone group was older (64 vs. 60 years, p < 0.001) and had more comorbidities (p = 0.004) than the adjuvant chemotherapy group. After propensity score matching, overall survival (OS) and recurrence‐free survival (RFS) of the adjuvant chemotherapy group were better than those of the surgery‐alone group: 5‐year OS rate 62.7% (95% confidence interval [CI] 54.4–72.3%) vs. 46.8% (95% CI 38.5–57%, p = 0.001) and 5‐year RFS rate 53.9% (95% CI 45.4–63.9%) vs. 36.2% (95% CI 28.3–46.3%, p < 0.001). Notably, in patients with pT3–4 stage, the adjuvant chemotherapy group had significantly better 5‐year OS rate (41.3% [95% CI 29.3–58.3%] vs. 18% [95% CI 10–32.5%], p = 0.01) and 5‐year RFS rate (37% [95% CI 25.3–53.9%] vs. 12% [95% CI 5.7–25.4%], p < 0.001) than in the surgery‐alone group. In multivariable analysis, adjuvant chemotherapy had a favorable effect on both OS (hazard ratio [HR] 0.562, 95% CI 0.426–0.741, p < 0.001) and RFS (HR 0.702, 95% CI 0.514–0.959; p = 0.026).

Conclusion

Adjuvant chemotherapy may improve survival in node‐positive patients with ESCC, especially in those with pT3–4 stage.
Prospective comparison of three methods for detecting peri‐operative neurocognitive disorders in older adults undergoing cardiac and non‐cardiac surgery
Authors: van Zuylen M. L. , Kampman J. M. , Turgman O. , Gribnau A. , ten Hoope W. , Preckel B. , Willems H. C. , Geurtsen G. J. , Hermanides J.
Published: January 2023

Postoperative neurocognitive disorders occur frequently in older adult patients. Neuropsychological assessment is the gold standard for diagnosis, but the resources required for routine use are significant. Instead, it is common for simplified and unvalidated tests to be used for trials and in clinical practice. We undertook a single‐centre prospective observational study in elective surgical patients aged ≥ 65 years recruited between September 2019 and January 2021. Patients underwent neuropsychological assessment, the Modified Telephone Interview for Cognitive Status and Montreal Cognitive Assessment before surgery. Tests were repeated at approximately four to eight postoperative weeks. We included 105 patients and 28 (27%) were lost to follow‐up. Pre‐operative Modified Telephone Interview for Cognitive Status and cognitive domain scores were very weakly to moderately correlated (r = 0.09–0.41). Pre‐operative Montreal Cognitive Assessment and cognitive domain scores were very weakly to weakly correlated (r = 0.17–0.37) Postoperative Modified Telephone Interview for Cognitive Status and cognitive domain scores were very weakly to weakly correlated (r = 0.09–0.36). Postoperative Montreal Cognitive Assessment score and cognitive domain scores were very weakly to weakly correlated (r = 0.07–0.36). Overall, there was limited agreement between tests. We conclude that the Modified Telephone Interview for Cognitive Status and Montreal Cognitive Assessment should not be used in isolation to diagnose postoperative neurocognitive disorders. There seems to be little to no pre‐operative, postoperative or pre‐ to postoperative correlation between these tests and the neuropsychological assessment in older adults without pre‐operative cognitive impairment.
Islands, the Anthropocene, and Decolonisation
Authors: Stratford Elaine , Farbotko Carol , Watson Phillipa , Kitara Taukiei , Berthelsen Juno , Hnaraki Maria Chnaraki aka Maria , Ginoza Ayano , Cozier Christopher , Hardenberg Julie Edel
Published: January 2023

The Anthropocene is deployed as incontrovertible fact, yet its foundations merit strong critique to challenge how particular voices and locations are absented, silenced, or enrolled in the fallacies that attend this epochal framework. Other placed, grounded, and scale‐sensitive explanations exist for present and future state scenarios, including on islands—often the focus of apocalyptic thinking. Dealing with historical and contemporary struggles to decolonise is more powerful than engaging with a reified framework that is part of ongoing colonial‐imperial excesses, uneven development, and racial capitalism. This work considers how four of us, as instigating authors, worked with five others, as collaborating authors, to understand academic works, activism, and artistic expressions of island life and concerns. Our aim was to learn about how and why their efforts to prioritise decolonisation is at the heart of what is needed to shore up island peoples’ futures.