bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of 3D technology in the practical education of congenital coarctation and its treatment—a feasibility pilot study
Authors: Barabas Imre J. , Vegh Daniel , Bottlik Olivia , Kreuter Patrik , Hartyanszky Istvan , Merkely Bela , Palkovics Daniel
Published: March 2024

Background

Coarctation of the aorta (CoA) is a congenital disease with an incidence of 4 out of 10,000 live births, therefore proper education of its treatment is essential. Understanding the disease and the wide array of treatment options is often difficult. Additive manufacturing technology can be used to produce 3D printed hands-on surgical training tools (HOSTT), which can be used for the education and practical training of CoA. This study aimed to investigate the effectiveness of a 3D printable HOSTT for the simulation of coarctation surgery, and it’ possible role in practical education.

Methods

Participants were medical students of Semmelweis University between the second and sixth academic year. A virtual 3D model of an aorta with CoA was generated from a computed tomography angiography scan. Each participant received a 3D-printed aorta phantom and performed either one of four surgical treatment modalities. The simulated surgeries included end-to-end anastomosis, end-to-side anastomosis, prosthetic patch, and subclavian flap aortoplasty. Participants provided feedback, evaluating their understanding of the disease and its treatment by the four surgical reconstruction modalities on a seven-point Likert scale before and after the sessions.

Results

21 medical students participated in this study. Participants’ average rating of their understanding of CoA disease and it treatment options before practical training was 4.62 ± 1.07. After training, their average rating increased to 6.19 ± 1.08, showing statistically significant difference.

Conclusions

Within this study’s limitations, the applied HOSTT, manufactured using 3D printing, was effective for the practical training of CoA’s surgical treatment methods for medical students.
Status and content of outpatient preoperative education for rectal cancer patients undergoing stoma surgery provided by Japanese wound, ostomy, and continence nurses: a cross-sectional study
Authors: Matsubara Yasumi , Hirohata Azusa
Published: March 2024

Background

Preoperative education can improve postoperative quality of life in patients undergoing stoma surgery. However, the prevalence and when, where, and how preoperative education is implemented are unclear. Therefore, this study aimed to assess the current status of outpatient preoperative education for patients undergoing stoma surgery for rectal cancer as perceived by nurses. Additionally, it sought to identify the information provided by Japanese healthcare providers as a part of preoperative education.

Methods

This cross-sectional study included 1,716 wound, ostomy, and continence nurses (WOCNs) in charge of stoma clinics at Japanese hospitals. Unsigned self-administered survey forms were mailed to the participants, and paper- or web-based responses were obtained. The main questions included: overview of the participants and their facilities, provision of outpatient preoperative education, status of implementation, and preoperative education components. To examine the factors associated with preoperative education, the independent variable was the presence or absence of preoperative education in the clinic, and the explanatory variables were the years of experience as a nurse, years of experience as a WOCN, type of hospital, number of beds, and number of intestinal stoma surgeries per year. Regression analysis was performed.

Results

We received 773 valid responses (valid response rate: 45%). Duration of experience as a nurse and as a WOCN were 24.6 and 10.9 years, respectively. Outpatient preoperative education was provided by 24% of the participants. Most preoperative education sessions were conducted for patients or caregivers. Preoperative education took 31–60 min per patient, and one to five patients received preoperative education each month. Booklets, ostomy appliances, and stoma models/dolls were used as supplementary materials for preoperative education. The most frequently mentioned components of preoperative education were stoma care, daily life, social security, stoma clinic, traveling and going out, quality of life after stoma surgery, and precautions for medical treatment. In addition, education on the use of restrooms on the go, disaster preparedness, defecation disorders after restorative proctectomy, and complications after stoma closure were considered necessary.

Conclusions

The implementation rate of outpatient preoperative education was low (24%). Future challenges include the development of specific educational content and procedures suitable for the Japanese medical environment and the establishment of preoperative medical care teams for stoma surgery to promote the provision of outpatient preoperative education.
How does strength use relate to burnout among Chinese healthcare professionals? Exploring the mediating roles of beliefs about stress and basic psychological needs satisfaction
Authors: Bai Chengzhi , Ma Jie , Bai Baoyu
Published: April 2024

Background

The prevalence of burnout among healthcare workers remains chronically high. Former studies have indicated that strength use is a promising approach to reduce burnout. However, relatively little is known about the psychological mechanisms underlying the ability of strength use to reduce burnout, especially among healthcare workers.

Aim

This study sought to examine the link between strength use and burnout in Chinese healthcare workers, and to explore the mediating roles of beliefs about stress and basic psychological needs satisfaction in that relationship.

Methods

This study was conducted in two time periods, from September to October 2020 and from February to September 2022. A total of 812 healthcare workers completed a multi-section questionnaire.

Results

Strength use was negatively associated with burnout and negative stress beliefs, and positively associated with positive stress beliefs, control beliefs, and basic psychological needs satisfaction. Moreover, negative stress beliefs, control beliefs, and basic psychological needs satisfaction fully mediated the relationship between strength use and burnout. Furthermore, effect contrasts revealed that the mediating effect of basic psychological needs satisfaction was stronger than that of negative stress beliefs and control beliefs.

Conclusion

Our findings revealed that negative stress beliefs, control beliefs, and basic psychological needs satisfaction act as mediators in the association of strength use with burnout. Furthermore, basic psychological needs satisfaction plays a more important mediating role than negative stress beliefs and control beliefs in the strength use–burnout relationship.
Cognitive flexibility's role in shaping self-perception of aging, body appreciation, and self-efficacy among community-dwelling older women
Authors: El-Sayed Mona Metwally , Hawash Manal Mohammed , Khedr Mahmoud Abdelwahab , Hafez Sarah Ali , Salem El-Saied Abd El-Hamid , Essa Samir Abdelnaby , Sayyd Sameer Mohammed , El-Ashry Ayman Mohamed
Published: April 2024

Background

Cognitive flexibility, the capacity to adjust to new information, affects how aging is perceived. In Egyptian culture, older women’s views on aging are shaped by societal gender roles and expectations. These views influence their body image and belief in their abilities, all melded by cultural standards and values.

Aim

Investigate the mediating role of cognitive flexibility in the relationship between self-aging perception, body appreciation, and self-efficacy among community-dwelling older women.

Methods

A correlational analytical design was used on 200 women aged 60 years or older using the Cognitive Flexibility Inventory, Self-Perceptions of Aging, General Self-Efficacy Scale, and Body Appreciation Scales. Structural equation modeling was used in the analysis.

Results

The study found that cognitive flexibility is positively related to self-perception of aging and body appreciation and is also significantly related to general self-efficacy. However, no significant relationship was found between body appreciation and general self-efficacy. Additionally, the study found that cognitive flexibility partially mediates the relationship between self-perception of aging and body appreciation and fully mediates the relationship between body appreciation and self-efficacy.

Conclusion

Cognitive flexibility is vital in the relationships between self-perceptions of aging, body appreciation, and self-efficacy among older women. Therefore, nursing interventions targeting cognitive flexibility are recommended to promote positive self-aging perceptions, body appreciation, and self-efficacy in this population.
“These are just finishing our medicines”: older persons’ perceptions and experiences of access to healthcare in public and private health facilities in Uganda
Authors: Wandera Stephen Ojiambo , Golaz Valerie , Kwagala Betty , Ntozi James P. M. , Ayuku David Otundo
Published: March 2024

Background

There is limited research on the experiences of access to medicines for non-communicable diseases (NCDs) in health facilities among older persons in Uganda. This paper explores the perspectives of older persons and healthcare providers concerning older persons’ access to essential medicines in Uganda.

Methods

It is based on qualitative data from three districts of Hoima, Kiboga, and Busia in Uganda. Data collection methods included seven (07) focus group discussions (FGDs) and eighteen (18) in-depth interviews with older persons. Nine (9) key informant interviews with healthcare providers were conducted. Deductive and inductive thematic analysis (using Health Access Livelihood Framework) was used to analyze the barriers and facilitators of access to healthcare using QSR International NVivo software.

Results

The key facilitators and barriers to access to healthcare included both health system and individual-level factors. The facilitators of access to essential medicines included family or social support, earning some income or Social Assistance Grants for Empowerment (SAGE) money, and knowing a healthcare provider at a health facility. The health system barriers included the unavailability of specialized personnel, equipment, and essential medicines for non-communicable diseases, frequent stock-outs, financial challenges, long waiting times, high costs for medicines for NCDs, and long distances to health facilities.

Conclusion

Access to essential medicines for NCDs is a critical challenge for older persons in Uganda. The Ministry of Health should make essential drugs for NCDS to be readily available and train geriatricians to provide specialized healthcare for older persons to reduce health inequities in old age. Social support systems need to be strengthened to enable older persons to access healthcare.
“They seemed to be like cogs working in different directions”: a longitudinal qualitative study on Long COVID healthcare services in the United Kingdom from a person-centred lens
Authors: Fang Chao , Baz Sarah Akhtar , Sheard Laura , Carpentieri J. D.
Published: April 2024

Background

The COVID-19 pandemic has presented significant challenges to the already over-stretched healthcare system in the United Kingdom (UK). These challenges are particularly pronounced for people living with the novel condition of Long COVID (LC) as they often face persistent and fluctuating symptoms, encountering prolonged uncertainty when seeking medical support. Despite a growing understanding of the healthcare challenges associated with LC, existing qualitative studies have predominantly focused on individual experiences rather than examining the structural aspects of healthcare.

Methods

A longitudinal qualitative study with 80 participants and 12 healthcare practitioners was conducted in the UK to explore the healthcare experiences of those with LC. In total, 178 interviews (with attrition) were collected across two rounds, from November 2021 to March 2022, and from June to October 2022.

Results

Embracing a person-centred framework that recognises and nurtures interconnected individual, relational, and existential needs, we investigated healthcare experiences related to LC across primary, secondary, and specialist integrated care. Using this perspective, we identified three overarching themes. Theme 1 addresses the persistent hurdle of accessing primary care as the initial point of contact for LC healthcare; Theme 2 underscores the complexity of navigating secondary care; and Theme 3 encapsulates the distinctive challenges of developing LC integrated care. These themes are interlinked, as people with LC often had to navigate or struggle between the various systems, with practitioners seeking to collaborate across the breadth of their professional responsibilities.

Conclusion

From a person-centred approach, we were able to identify the needs of those affected by lasting LC symptoms and comprehend how health services intricately influence these needs. The focus on healthcare systems also captures the nuanced impact that continuing healthcare struggles can have on people’s identity. As such, our findings provide evidence to inform a more effective and sustainable delivery of person-centred care for people with LC across various healthcare settings and over time.
In vivo assessment of the antiparasitic effects of Allium sativum L. and Artemisia absinthium L. against gastrointestinal parasites in swine from low-input farms
Authors: Băieş Mihai-Horia , Cotuţiu Vlad-Dan , Spînu Marina , Mathe Attila , Cozma-Petruț Anamaria , Bolboacǎ Sorana D. , Engberg Ricarda Margaret , Collin Anne , Cozma Vasile
Published: April 2024

Background

Ethno-veterinary practices could be used as a sustainable developmental tool by integrating traditional phytotherapy and husbandry. Phytotherapeutics are available and used worldwide. However, evidence of their antiparasitic efficacy is currently very limited. Parasitic diseases have a considerable effect on pig production, causing economic losses due to high morbidity and mortality. In this respect, especially smallholders and organic producers face severe challenges. Parasites, as disease causing agents, often outcompete other pathogens in such extensive production systems. A total of 720 faecal samples were collected in two farms from three age categories, i.e. weaners, fatteners, and sows. Flotation (Willis and McMaster method), modified Ziehl–Neelsen stained faecal smear, centrifugal sedimentation, modified Blagg technique, and faecal cultures were used to identify parasites and quantify the parasitic load.

Results

The examination confirmed the presence of infections with Eimeria spp., Cryptosporidium spp., Balantioides coli (syn. Balantidium coli), Ascaris suum, Oesophagostomum spp., Strongyloides ransomi, and Trichuris suis, distributed based on age category. A dose of 180 mg/kg bw/day of Allium sativum L. and 90 mg/kg bw/day of Artemisia absinthium L. powders, administered for 10 consecutive days, revealed a strong, taxonomy-based antiprotozoal and anthelmintic activity.

Conclusions

The results highlighted the therapeutic potential of both A. sativum and A. absinthium against gastrointestinal parasites in pigs. Their therapeutic effectiveness may be attributed to the content in polyphenols, tocopherols, flavonoids, sterols, sesquiterpene lactones, and sulfoxide. Further research is required to establish the minimal effective dose of both plants against digestive parasites in pigs.
Coronary inflammation based on pericoronary adipose tissue attenuation in type 2 diabetic mellitus: effect of diabetes management
Authors: Liu Yuankang , Dai Lisong , Dong Yue , Ma Cong , Cheng Panpan , Jiang Cuiping , Liao Hongli , Li Ying , Wang Xiang , Xu Xiangyang
Published: March 2024

Background

Coronary inflammation plays crucial role in type 2 diabetes mellitus (T2DM) induced cardiovascular complications. Both glucose-lowering drug interventions (GLDIS) and glycemic control (GC) status potentially correlate coronary inflammation, as indicated by changes in pericoronary adipose tissue (PCAT) attenuation, and thus influence cardiovascular risk. This study evaluated the impact of GLDIS and GC status on PCAT attenuation in T2DM patients.

Methods

This retrospective study collected clinical data and coronary computed tomography angiography (CCTA) images of 1,342 patients, including 547 T2DM patients and 795 non-T2DM patients in two tertiary hospitals. T2DM patients were subgroup based on two criteria: (1) GC status: well: HbA1c < 7%, moderate: 7 ≤ HbA1c ≤ 9%, and poor: HbA1c > 9%; (2) GLDIS and non-GLDIS. PCAT attenuations of the left anterior descending artery (LAD-PCAT), left circumflex artery (LCX-PCAT), and right coronary artery (RCA-PCAT) were measured. Propensity matching (PSM) was used to cross compare PCAT attenuation of non-T2DM and all subgroups of T2DM patients. Linear regressions were conducted to evaluate the impact of GC status and GLDIS on PCAT attenuation in T2DM patients.

Results

Significant differences were observed in RCA-PCAT and LCX-PCAT between poor GC-T2DM and non-T2DM patients (LCX: − 68.75 ± 7.59 HU vs. – 71.93 ± 7.25 HU, p = 0.008; RCA: − 74.37 ± 8.44 HU vs. − 77.2 ± 7.42 HU, p = 0.026). Higher PCAT attenuation was observed in LAD-PCAT, LCX-PCAT, and RCA-PCAT in non-GLDIS T2DM patients compared with GLDIS T2DM patients (LAD: − 78.11 ± 8.01 HU vs. − 75.04 ± 8.26 HU, p = 0.022; LCX: − 71.10 ± 8.13 HU vs. − 68.31 ± 7.90 HU, p = 0.037; RCA: − 78.17 ± 8.64 HU vs. − 73.35 ± 9.32 HU, p = 0.001). In the linear regression, other than sex and duration of diabetes, both metformin and acarbose were found to be significantly associated with lower LAD-PCAT (metformin: β coefficient = − 2.476, p=0.021; acarbose: β coefficient = − 1.841, p = 0.031).

Conclusion

Inadequate diabetes management, including poor GC and lack of GLDIS, may be associated with increased coronary artery inflammation in T2DM patients, as indicated by PCAT attenuation on CCTA, leading to increased cardiovascular risk. This finding could help healthcare providers identify T2DM patients with increased cardiovascular risk, develop improved cardiovascular management programs, and reduce subsequent cardiovascular related mortality.
Lipidome characterisation and sex-specific differences in type 1 and type 2 diabetes mellitus
Authors: Barranco-Altirriba Maria , Alonso Núria , Weber Ralf J. M. , Lloyd Gavin R. , Hernandez Marta , Yanes Oscar , Capellades Jordi , Jankevics Andris , Winder Catherine , Falguera Mireia , Franch-Nadal Josep , Dunn Warwick B , Perera-Lluna Alexandre , Castelblanco Esmeralda , Mauricio Didac
Published: March 2024

Background

In this study, we evaluated the lipidome alterations caused by type 1 diabetes (T1D) and type 2 diabetes (T2D), by determining lipids significantly associated with diabetes overall and in both sexes, and lipids associated with the glycaemic state.

Methods

An untargeted lipidomic analysis was performed to measure the lipid profiles of 360 subjects (91 T1D, 91 T2D, 74 with prediabetes and 104 controls (CT)) without cardiovascular and/or chronic kidney disease. Ultra-high performance liquid chromatography-electrospray ionization mass spectrometry (UHPLC-ESI-MS) was conducted in two ion modes (positive and negative). We used multiple linear regression models to (1) assess the association between each lipid feature and each condition, (2) determine sex-specific differences related to diabetes, and (3) identify lipids associated with the glycaemic state by considering the prediabetes stage. The models were adjusted by sex, age, hypertension, dyslipidaemia, body mass index, glucose, smoking, systolic blood pressure, triglycerides, HDL cholesterol, LDL cholesterol, alternate Mediterranean diet score (aMED) and estimated glomerular filtration rate (eGFR); diabetes duration and glycated haemoglobin (HbA1c) were also included in the comparison between T1D and T2D.

Results

A total of 54 unique lipid subspecies from 15 unique lipid classes were annotated. Lysophosphatidylcholines (LPC) and ceramides (Cer) showed opposite effects in subjects with T1D and subjects with T2D, LPCs being mainly up-regulated in T1D and down-regulated in T2D, and Cer being up-regulated in T2D and down-regulated in T1D. Also, Phosphatidylcholines were clearly down-regulated in subjects with T1D. Regarding sex-specific differences, ceramides and phosphatidylcholines exhibited important diabetes-associated differences due to sex. Concerning the glycaemic state, we found a gradual increase of a panel of 1-deoxyceramides from normoglycemia to prediabetes to T2D.

Conclusions

Our findings revealed an extensive disruption of lipid metabolism in both T1D and T2D. Additionally, we found sex-specific lipidome changes associated with diabetes, and lipids associated with the glycaemic state that can be linked to previously described molecular mechanisms in diabetes.
Human resources for health and maternal mortality in Latin America and the Caribbean over the last three decades: a systemic-perspective reflections
Authors: Nigenda Gustavo , Serván-Mori Edson
Published: April 2024

Background

The role of human resources for health in the operation of health systems is crucial. However, training and incorporating them into institutions is a complex process due to the continuous misalignment between the supply and demand of health personnel. Taking the case of the Latin American and Caribbean region countries, this comment discusses the relationship between the availability of human resources for health and the maternal mortality ratio for the period 1990–2021. It proposes the need to resume planning exercises from a systemic perspective that involves all areas of government and the private sector linked to the training and employment of health workers.

Main text

We used secondary data from a global source to show patterns in the relationship between these two aspects and identify gaps in the Latin American and Caribbean regions. The results show enormous heterogeneity in the response of regional health systems to the challenge of maternal mortality in the region. Although most countries articulated specific programs to achieve the reduction committed by all countries through the Millennium Development Goals, not all had the same capacity to reduce it, and practically none met the target. In addition, in the English Caribbean countries, we found significant increases in the number of health personnel that do not explain the increases in the maternal mortality rate during the period.

Conclusions

The great lesson from the data shown is that some countries could articulate responses to the problem using available resources through effective strategies, considering the specific needs of their populations. Although variations in maternal mortality rate cannot be explained solely through the provision of health personnel, it is important to consider that it is critical to find new modalities on how human resources for health could integrate and create synergies with other resources to increase systems capacity to deliver care according to conditions in each country.
Collision of herbal medicine and nanotechnology: a bibliometric analysis of herbal nanoparticles from 2004 to 2023
Authors: Ai Sinan , Li Yake , Zheng Huijuan , Zhang Meiling , Tao Jiayin , Liu Weijing , Peng Liang , Wang Zhen , Wang Yaoxian
Published: April 2024

Background

Herbal nanoparticles are made from natural herbs/medicinal plants, their extracts, or a combination with other nanoparticle carriers. Compared to traditional herbs, herbal nanoparticles lead to improved bioavailability, enhanced stability, and reduced toxicity. Previous research indicates that herbal medicine nanomaterials are rapidly advancing and making significant progress; however, bibliometric analysis and knowledge mapping for herbal nanoparticles are currently lacking. We performed a bibliometric analysis by retrieving publications related to herbal nanoparticles from the Web of Science Core Collection (WoSCC) database spanning from 2004 to 2023. Data processing was performed using the R package Bibliometrix, VOSviewers, and CiteSpace.

Results

In total, 1876 articles related to herbal nanoparticles were identified, originating from various countries, with China being the primary contributing country. The number of publications in this field increases annually. Beijing University of Chinese Medicine, Shanghai University of Traditional Chinese Medicine, and Saveetha University in India are prominent research institutions in this domain. The Journal “International Journal of Nanomedicine” has the highest number of publications. The number of authors of these publications reached 8234, with Yan Zhao, Yue Zhang, and Huihua Qu being the most prolific authors and Yan Zhao being the most frequently cited author. “Traditional Chinese medicine,” “drug delivery,” and “green synthesis” are the main research focal points. Themes such as “green synthesis,” “curcumin,” “wound healing,” “drug delivery,” and “carbon dots” may represent emerging research areas.

Conclusions

Our study findings assist in identifying the latest research frontiers and hot topics, providing valuable references for scholars investigating the role of nanotechnology in herbal medicine.

Graphical Abstract
Biomechanical response of decompression alone in lower grade lumbar degenerative spondylolisthesis--A finite element analysis
Authors: Liu Renfeng , He Tao , Wu Xin , Tan Wei , Yan Zuyun , Deng Youwen
Published: April 2024

Background

Previous studies have demonstrated the clinical efficacy of decompression alone in lower-grade spondylolisthesis. A higher rate of surgical revision and a lower rate of back pain relief was also observed. However, there is a lack of relevant biomechanical evidence after decompression alone for lower-grade spondylolisthesis.

Purpose

Evaluating the biomechanical characteristics of total laminectomy, hemilaminectomy, and facetectomy for lower-grade spondylolisthesis by analyzing the range of motion (ROM), intradiscal pressure (IDP), annulus fibrosus stress (AFS), facet joints contact force (FJCF), and isthmus stress (IS).

Methods

Firstly, we utilized finite element tools to develop a normal lumbar model and subsequently constructed a spondylolisthesis model based on the normal model. We then performed total laminectomy, hemilaminectomy, and one-third facetectomy in the normal model and spondylolisthesis model, respectively. Finally, we analyzed parameters, such as ROM, IDP, AFS, FJCF, and IS, for all the models under the same concentrate force and moment.

Results

The intact spondylolisthesis model showed a significant increase in the relative parameters, including ROM, AFS, FJCF, and IS, compared to the intact normal lumbar model. Hemilaminectomy and one-third facetectomy in both spondylolisthesis and normal lumbar models did not result in an obvious change in ROM, IDP, AFS, FJCF, and IS compared to the pre-operative state. Moreover, there was no significant difference in the degree of parameter changes between the spondylolisthesis and normal lumbar models after undergoing the same surgical procedures. However, total laminectomy significantly increased ROM, AFS, and IS and decreased the FJCF in both normal lumbar models and spondylolisthesis models.

Conclusion

Hemilaminectomy and one-third facetectomy did not have a significant impact on the segment stability of lower-grade spondylolisthesis; however, patients with LDS undergoing hemilaminectomy and one-third facetectomy may experience higher isthmus stress on the surgical side during rotation. In addition, total laminectomy changes the biomechanics in both normal lumbar models and spondylolisthesis models.
Multiple thrombi mimicking metastases in the right atrium of patients with non-Hodgkin’s lymphoma diagnosed by multimodal cardiac imaging: one case report
Authors: Hu Zhiqiang , Yuan Shuai , Mou Yun
Published: April 2024

Background

Right-side heart mass can be found incidentally on routine transthoracic echocardiography (TTE). Accurate diagnosis of cardiac mass often requires more than one imaging method. We present a mid-age woman with non-Hodgkin lymphoma who was found to have multiple right atrial masses mimicking metastases on routine TTE, which were finally diagnosed as thrombi by multimodal cardiac imaging.

Case presentation

A 52-year-old woman was diagnosed with primary mediastinal diffuse large B cell lymphoma (DLBCL) almost six months prior. The TTE revealed multiple masses in the right atrium with normal cardiac function when she was being evaluated for the next chemotherapy. On arrival, she was hemodynamically stable and asymptomatic. Physical examination was no remarkable. Laboratory findings showed leukocytosis of 17,900 cells/mm3, hemoglobin of 7.5 mg/dL, and a normal D-dimer level. The suspicious diagnosis of right atrial metastasis was made by TEE. However, the diagnosis of right atrial thrombi was made by contrast CMR. Finally, the 18 F-FDG PET-CT demonstrated no metabolic activity in the right atrium, which further supported the diagnosis of thrombi. Eventually, the masses were removed by cardiopulmonary bypass thoracotomy because of a high risk of pulmonary embolism. Histopathology confirmed the diagnosis of thrombi.

Conclusions

This case highlights the importance of multimodality cardiac imaging in the appropriate diagnosis of a RA masses in patient of lymphoma. Diagnosis of RA masses can be made using multimodal cardiac imaging like TTE, TEE and CMR, even PET. Echocardiography is the most commonly used on multimodal imaging in cardiac thrombus. CMR has high specificity in differentiating a tumor from thrombus, while 18 F-FDG PET has good sensitivity to determine the nature of the masses.
Management of incessant ventricular arrhythmias in a patient with left ventricular assist device: a case report
Authors: Chen Chen , Du Juan , Wang Xianqiang , Zou Liang
Published: April 2024

Background

The implantation of left ventricular assist devices (LVADs) as a bridge to transplantation or as destination therapy in end-stage heart failure patients is frequently complicated by the emergence of ventricular arrhythmias (VAs). These arrhythmias have been implicated in precipitating deleterious clinical outcomes, increased mortality rates and augmented healthcare expenditures.

Case Presentation

We present a challenging case of a 49-year-old male with a history of dilated cardiomyopathy who received an LVAD. Post-implantation, the patient suffered from intractable VAs, leading to multiple rehospitalizations and hemodynamic deterioration. Despite exhaustive medical management and electrical cardioversion attempts, the patient’s VAs persisted, ultimately necessitating prioritization for cardiac transplantation.

Discussion

This case highlights the challenges in managing VAs in LVAD patients and the importance of multidisciplinary collaboration. While pharmacological intervention is the initial strategy, catheter ablation may be considered in selected cases when medication is insufficient. In instances of intractable VAs, expeditious listing for heart transplantation as a high-priority candidate is advisable when feasible.
The N-terminal dimerization domains of human and Drosophila CTCF have similar functionality
Authors: Kamalyan Sofia , Kyrchanova Olga , Klimenko Natalia , Babosha Valentin , Vasileva Yulia , Belova Elena , Fursenko Dariya , Maksimenko Oksana , Georgiev Pavel
Published: April 2024

Background

CTCF is highly likely to be the ancestor of proteins that contain large clusters of C2H2 zinc finger domains, and its conservation is observed across most bilaterian organisms. In mammals, CTCF is the primary architectural protein involved in organizing chromosome topology and mediating enhancer–promoter interactions over long distances. In Drosophila, CTCF (dCTCF) cooperates with other architectural proteins to establish long-range interactions and chromatin boundaries. CTCFs of various organisms contain an unstructured N-terminal dimerization domain (DD) and clusters comprising eleven zinc-finger domains of the C2H2 type. The Drosophila (dCTCF) and human (hCTCF) CTCFs share sequence homology in only five C2H2 domains that specifically bind to a conserved 15 bp motif.

Results

Previously, we demonstrated that CTCFs from different organisms carry unstructured N-terminal dimerization domains (DDs) that lack sequence homology. Here we used the CTCFattP(mCh) platform to introduce desired changes in the Drosophila CTCF gene and generated a series of transgenic lines expressing dCTCF with different variants of the N-terminal domain. Our findings revealed that the functionality of dCTCF is significantly affected by the deletion of the N-terminal DD. Additionally, we observed a strong impact on the binding of the dCTCF mutant to chromatin upon deletion of the DD. However, chromatin binding was restored in transgenic flies expressing a chimeric CTCF protein with the DD of hCTCF. Although the chimeric protein exhibited lower expression levels than those of the dCTCF variants, it efficiently bound to chromatin similarly to the wild type (wt) protein.

Conclusions

Our findings suggest that one of the evolutionarily conserved functions of the unstructured N-terminal dimerization domain is to recruit dCTCF to its genomic sites in vivo.
Resilience and mindfulness among radiological personnel in Norway, their relationship and their impact on quality and safety– a questionnaire study
Authors: Gransjøen Ann Mari
Published: April 2024

Background

Stress and burnout are widespread problems among radiological personnel Individual and organizational resilience and mindfulness offer protection against burnout.

Aim

To investigate the level of resilience and mindfulness among radiological personnel, the associations between organizational resilience, individual resilience, and mindfulness, and how these factors impact the quality of care provided in radiological departments.

Methods

An online questionnaire consisting of the Connor-Davidson Resilience Scale, the Mindful Attention Awareness Scale, the Benchmark Resilience Tool, and questions regarding burnout, and quality and safety was used. Data analysis consisted of descriptive statistics, bivariate correlation and standard multiple regression.

Results and Conclusion

Few participants considered burnout a significant challenge. Individual and organizational resilience were low (30.40 ± 4.92 and 63.21 ± 13.63 respectively), and mindfulness was high (4.29 ± 0.88). There was a significant correlation between individual and organizational resilience (p = 0.004), between individual resilience and mindfulness (p = 0.03), and between organizational resilience and mindfulness (p = 0.02). Individual and organizational resilience affect each other. However; neither significantly affect quality and safety, nor mindfulness
Expression profiling of stemness markers in testicular germline stem cells from neonatal and adult Swiss albino mice during their transdifferentiation in vitro
Authors: Indu Sivankutty , Devi Anandavally N. , Sahadevan Mahitha , Sengottaiyan Jeeva , Basu Asmita , K Shabith Raj , Kumar Pradeep G.
Published: April 2024

Background

Spermatogonial stem cells (SSCs) were considered to be stem cells with limited potencies due to their existence in adult organisms. However, the production of spermatogonial stem cell colonies with broader differentiation capabilities in primary germ cell cultures from mice of select genetic backgrounds (C57BL6/Tg14, ddY, FVB and 129/Ola) indicated that SSCs from these strains were pluripotent.

Methods

We established primary cultures of SSCs from neonatal and adult Swiss 3T3 Albino mice. Stemness of SSC colonies were evaluated by performing real-time PCR and immunofluorescence analysis for a panel of chosen stemness markers. Differentiation potentials of SSCs were examined by attempting the generation of embryoid bodies and evaluating the expression of ectodermal, mesodermal and endodermal markers using immunofluorescence and real-time PCR analysis.

Results

Spermatogonial stem cells from neonatal and mature mice testes colonised in vitro and formed compact spermatogonial stem cell colonies in culture. The presence of stem cell markers ALPL, ITGA6 and CD9 indicated stemness in these colonies. The differentiation potential of these SSC colonies was demonstrated by their transformation into embryoid bodies upon withdrawal of growth factors from the culture medium. SSC colonies and embryoid bodies formed were evaluated using immunofluorescence and real-time PCR analysis. Embryoid body like structures derived from both neonatal and adult mouse testis were quite similar in terms of the expression of germ layer markers.

Conclusion

These results strongly suggest that SSC-derived EB-like structures could be used for further differentiation into cells of interest in cell-based therapeutics.
Sexual differences in neuronal and synaptic properties across subregions of the mouse insular cortex
Authors: Iezzi Daniela , Cáceres-Rodríguez Alba , Strauss Benjamin , Chavis Pascale , Manzoni Olivier J.
Published: April 2024

Background

The insular cortex (IC) plays a pivotal role in processing interoceptive and emotional information, offering insights into sex differences in behavior and cognition. The IC comprises two distinct subregions: the anterior insular cortex (aIC), that processes emotional and social signals, and the posterior insular cortex (pIC), specialized in interoception and perception of pain. Pyramidal projection neurons within the IC integrate multimodal sensory inputs, influencing behavior and cognition. Despite previous research focusing on neuronal connectivity and transcriptomics, there has been a gap in understanding pyramidal neurons characteristics across subregions and between sexes.

Methods

Adult male and female C57Bl/6J mice were sacrificed and tissue containing the IC was collected for ex vivo slice electrophysiology recordings that examined baseline sex differences in synaptic plasticity and transmission within aIC and pIC subregions.

Results

Clear differences emerged between aIC and pIC neurons in both males and females: aIC neurons exhibited distinctive features such as larger size, increased hyperpolarization, and a higher rheobase compared to their pIC counterparts. Furthermore, we observed variations in neuronal excitability linked to sex, with male pIC neurons displaying a greater level of excitability than their female counterparts. We also identified region-specific differences in excitatory and inhibitory synaptic activity and the balance between excitation and inhibition in both male and female mice. Adult females demonstrated greater synaptic strength and maximum response in the aIC compared to the pIC. Lastly, synaptic long-term potentiation occurred in both subregions in males but was specific to the aIC in females.

Conclusions

We conclude that there are sex differences in synaptic plasticity and excitatory transmission in IC subregions, and that distinct properties of IC pyramidal neurons between sexes could contribute to differences in behavior and cognition between males and females.
Automated extraction of the arterial input function from brain images for parametric PET studies
Authors: Moradi Hamed , Vashistha Rajat , Ghosh Soumen , O’Brien Kieran , Hammond Amanda , Rominger Axel , Sari Hasan , Shi Kuangyu , Vegh Viktor , Reutens David
Published: April 2024

Background

Accurate measurement of the arterial input function (AIF) is crucial for parametric PET studies, but the AIF is commonly derived from invasive arterial blood sampling. It is possible to use an image-derived input function (IDIF) obtained by imaging a large blood pool, but IDIF measurement in PET brain studies performed on standard field of view scanners is challenging due to lack of a large blood pool in the field-of-view. Here we describe a novel automated approach to estimate the AIF from brain images.

Results

Total body 18F-FDG PET data from 12 subjects were split into a model adjustment group (n = 6) and a validation group (n = 6). We developed an AIF estimation framework using wavelet-based methods and unsupervised machine learning to distinguish arterial and venous activity curves, compared to the IDIF from the descending aorta. All of the automatically extracted AIFs in the validation group had similar shape to the IDIF derived from the descending aorta IDIF. The average area under the curve error and normalised root mean square error across validation data were − 1.59 ± 2.93% and 0.17 ± 0.07.

Conclusions

Our automated AIF framework accurately estimates the AIF from brain images. It reduces operator-dependence, and could facilitate the clinical adoption of parametric PET.
UHC in Morocco: a bottom-up estimation of public hospitals' financing size based on a costing database
Authors: Akhnif El Houcine , Belmadani Abdelouahab , Mataria Awad , Bigdeli Maryam
Published: April 2024

Background

Morocco is engaged in a health system reform aimed at generalizing health insurance across the whole population by 2025. This study aims to build a national database of costs at all levels of public hospitals in Morocco and craft this database as a resource for further use in a strategic purchasing system. It also aims at estimating the funding gap and the budget that should be secured for public hospitals in Morocco to fully play their roles in the current ambitious reform.

Method

A costing study was implemented in 39 hospitals in 12 regions of Morocco (10 provincial hospitals, 11 regional hospitals, and 18 teaching hospitals). Using the hospital costing approach, we adapted and validated nationally our methodology to generate a database of unit costs based on data from 2019. All perspectives on cost were considered. Data collection was performed by cadres from MoH and facilitated by the WHO country office in Morocco. The production of the cost database allowed the development of a bottom-up estimation of the financing size for public health hospitals.

Results

The study showed the feasibility of large-scale costing in the context of Morocco. The ownership of MoH and adherence to the process ensured the high quality of the collected data. There are many differences in unit costs for the same services moving from one hospital to another, which indicates existing inefficiencies. The database will contribute to shaping the strategic purchasing mechanism within the generalized health insurance schemes. The studied hospitals could be used as references to systematically update the billing system for health insurance.
Effects of chronic physical exercise on executive functions and episodic memory in clinical and healthy older adult populations: a systematic review and meta-analysis protocol
Authors: Ballesteros Soledad , Audifren Michel , Badache Andreea , Belkin Vera , Giannaki Christoforos D. , Kaltsatou Antonia , Marusic Uros , Ziaaldini Mohammad Mosaferi , Peskar Manca , Reales José M. , Rieker Jennifer A. , Stavrinou Pinelopi S. , Tortosa-Martinez Juan , Voelcker-Rehage Claudia , Netz Yael
Published: April 2024

Background

Executive functions (EFs) and episodic memory are fundamental components of cognition that deteriorate with age and are crucial for independent living. While numerous reviews have explored the effect of exercise on these components in old age, these reviews screened and analyzed selected older adult populations, or specific exercise modes, thus providing only limited answers to the fundamental question on the effect of exercise on cognition in old age. This article describes the protocol for a systematic review and multilevel meta-analytic study aiming at evaluating the effectiveness of different types of chronic exercise in improving and/or maintaining EFs and long-term episodic memory in older adults.

Methods and analysis

The study protocol was written in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Several databases will be searched. Randomized controlled trials (RCTs) conducted in older adults aged ≥ 60 years providing any kind of planned, structured, and repetitive exercise interventions, and EFs and/or episodic memory measures as outcomes, published in English in peer-reviewed journals and doctoral dissertations will be included. Two independent reviewers will screen the selected articles, while a third reviewer will resolve possible conflicts. The Cochrane risk-of-bias tool will be used to assess the quality of the studies. Finally, data will be extracted from the selected articles, and the formal method of combining individual data from the selected studies will be applied using a random effect multilevel meta-analysis. The data analysis will be conducted with the metafor package in R.

Discussion and conclusion

This review will synthesize the existing evidence and pinpoint gaps existing in the literature on the effects of exercise on EFs and episodic memory in healthy and unhealthy older adults. Findings from this meta-analysis will help to design effective exercise interventions for older adults to improve and/or maintain EFs and episodic memory. Its results will be useful for many researchers and professionals working with older adults and their families.

Systematic review registration

PROSPERO CRD42022367111.
Long-term monitoring reveals the effect of precipitation and silviculture on Nothofagus regeneration in Northern Patagonia mixed forests
Authors: Sola Georgina , Mateo Camila , Dezzotti Alejandro , Marchelli Paula , Attis Beltrán Hernán , Sbrancia Renato , Chauchard Luis , González Peñalba Marcelo , Lara Martín , El Mujtar Verónica
Published: April 2024

Background

Tree regeneration is a key component of resilience because it promotes post-disturbance recovery of forests. Northwestern Patagonia from Argentina is occupied by Nothofagus alpina (Na), N. obliqua (No), and N. dombeyi (Nd) forests that grow along an intense precipitation gradient, managed throughout shelterwood silvicultural system by technicians of the Lanin Natural Reserve. The objective of this study was to evaluate the influence of seeding cuttings over the dynamics of Nothofagus mixed forests across landscape (precipitation gradient) based mainly on the composition and abundance of tree regeneration, permanent sampling plots and generalized linear mixed models. In particular, we analysed: (i) the structure of sexual and asexual regeneration during < 10, 10–20 and > 20 years after harvest (the dynamics of managed forests), and (ii) the structure of sexual regeneration in primary and managed forests after > 20 years of harvest (the effect of silviculture).

Results

Nd was the most abundant species in the regeneration of managed forests during all periods in both sites despite its lower contribution to the adult cohort. During the 10–20 years period after harvest, the humid site exhibited higher regeneration density than the mesic site (120,000 and 6000 ind ha−1, respectively), and it decreased afterwards. The number of established regeneration (> 2 m height) was lower for Na in the mesic site and for No in the humid site (0 and 57 ind ha−1, respectively). However, in comparison to No, Na showed a higher number of sprouted stumps and sprouts per stump, and a higher sprout height in the mesic site. No exhibited higher sprout mortality in the humid site. Finally, the regeneration of primary forests showed lower density and height, and a more balanced composition than that of managed forests.

Conclusions

The silvicultural effects on the mixed forest regeneration dynamics was strongly influenced by the condition of sites. Therefore, management prescriptions should be adjusted in order to consider the environmental variation occurring through the entire landscape. An adaptive management that considers the pattern and process of sexual and asexual regeneration and disturbance will contribute to promote a greater resilience of mixed forest ecosystems.