bluuebunny/crossref_metadata_2025 huggingface dataset:
Unexpected Clinical Outcome for Myxoinflammatory Fibroblastic Sarcoma, When Should They Be Considered High Grade?
Authors: Sparkman Brian K. , Nguyen Tuong Vi V. , Smith Steven Christopher , Bear Harry D.
Published: October 2023

Myxoinflammatory fibroblastic sarcoma (MIFS) is a rare tumor of soft tissue. It typically presents as a low-grade sarcoma with myxoid stroma, has a predilection for distal extremities, and displays a high propensity for local recurrence, but low metastatic potential. The risk factors associated with high-risk lesions metastasizing are poorly defined. In cases where the tumor metastasizes, therapeutic options are few, and death is rare. Our case discusses an aggressive MIFS that progressed from a painless lesion on a patient’s calf, to her death from a malignant pleural effusion within 21 months. The 58-year-old woman presented with a mass on her left calf. It was excised and was originally thought to be a benign process. It re-grew quickly after the initial resection, and she underwent re-excision of the mass. The pathologic examination was consistent with an MIFS. Despite negative margins on her second resection and an attempt at local control with radiotherapy, it metastasized to her lungs within less than 2 years. This resulted in a malignant pleural effusion that caused her death. An MIFS is typically benign but can metastasize in atypical cases. Even if the disease is metastatic, it is unlikely to be the cause of death. Treatment of metastatic MIFS is poorly defined, but there are suggested therapies beyond surgical resection and radiotherapy. Successful treatment of an MIFS should include a high index of suspicion in extremity lesions, screening for metastasis, and possible targeted therapies based on tumor genomics.
Euglycemic Diabetic Keto Acidosis in a Type 1 Diabetic Patient After Glucose Like Peptide-1 Administration: A Case Presentation
Authors: Widhalm Cameron , Pulido Victor
Published: October 2023

Type 1 diabetes mellitus (DM) occurs when insulin-producing beta cells are destroyed. Destruction of these cells and subsequent loss of insulin signaling can cause diabetic keto acidosis (DKA). This case describes a type 1 DM patient who presented to the emergency department (ED) with nausea and vomiting after glucose like peptide-1 (GLP-1) agonist administration. The patient was noted to have elevated anion gap and elevated beta-hydroxybutyrate with euglycemic blood glucose levels. The patient was confirmed to have a functioning insulin pump and then was sent home with nausea control. The patient was not able to consume food without vomiting and therefore did not administer any postprandial insulin. These symptoms were attributed to the GLP-1 agonist. It contributed to suppression of the patient’s appetite while also inhibiting gluconeogenesis, and glycogenolysis resulting in small amounts of blood glucose entering the blood stream, negating the need for a bolus of insulin. The patient was admitted and given dextrose with an insulin drip until the anion gap was returned to normal. As GLP-1 agonists become more popular, this presentation may become more common. If not easily recognized this can lead to patient endangerment and unnecessary medical costs.
Successful Mechanical Thrombectomy of Bilateral Middle Cerebral Artery Occlusions Following Apixaban Discontinuation
Authors: Srichawla Bahadar S. , Fang Ton , Bose Abigail , Kipkorir Vincent , Ferris Annie
Published: October 2023

Optimal anticoagulation management in patients with atrial fibrillation (AF) during acute ischemic stroke is complex and often poses a significant clinical challenge. An 82-year-old man with AF presented with left-sided hemiparesis and hypoesthesia due to occlusion of the right middle cerebral artery (MCA) after discontinuing apixaban for 5 days. Successful mechanical thrombectomy (MT) achieved thrombolysis in cerebral infarction (TICI) score of 2C. Anticoagulation was postponed due to a small risk of hemorrhagic conversion. However, the patient developed a rare bilateral M1 segment MCA occlusions on the fifth day with a National Institute of Health Stroke Scale (NIHSS) score of 23, leading to an emergent thrombectomy, resulting in TICI 3 and TICI 2C recanalization in left and right MCAs, respectively. The patient required admission to the intensive care unit and was eventually discharged to an inpatient rehabilitation facility with only residual left hemiparesis and moderate dysarthria. This case underscores the delicate balance between the risk of recurrent ischemic stroke and the potential for hemorrhagic conversion when treating anticoagulation in the acute setting. Close monitoring and an individualized approach are necessary for the treatment of patients with AF who have suffered an acute stroke, especially when anticoagulation must be stopped. We encourage future guidelines to incorporate both imaging and clinical data when determining the continuation of anticoagulation in patients with a recent ischemic stroke. This case also depicts the effectiveness of neuroendovascular interventions such as MT to effectively manage rare simultaneous large multi-vessel occlusions with good outcomes.
Acute Fulminant Hepatic Failure in 23-Year-Old Female Taking Homeopathic Remedy
Authors: Goldhaber Nicole Hamilton , Barnard Giustini Abbey , Parekh Justin , Mekeel Kristin L. , Ajmera Veeral
Published: October 2023

Homeopathic remedies made primarily from eggshells, and therefore calcium, can be marketed for treatment of back pain and vaginal discharge. We present a case of a 23-year-old otherwise healthy woman who presented with acute liver failure (ALF) ultimately requiring liver transplantation as a result of taking increased doses of a homeopathic product with the primary ingredient of eggshells. Although relatively uncommon compared with medications such as acetaminophen, herbal supplements have been reported to cause drug-induced liver injury (DILI), thought to be primarily due to contaminants. This is the first known report of DILI resulting from a homeopathic product with the primary ingredient of eggshells, and it demonstrates the importance of early ALF recognition and treatment, as well as the importance of practicing caution when using homeopathic supplements.
Risk Factors for Glenoid Bone Loss in the Setting of Posterior Glenohumeral Instability
Authors: Green Clare K. , Scanaliato John P. , Sandler Alexis B. , Wynkoop Emily I. , Goldman Adam , Turner Robert C. , Czajkowski Hunter , Rolf Robert H. , Parnes Nata
Published: October 2023

Background:

Posterior instability has been reported to account for up to 24% of cases of shoulder instability in certain active populations. However, there is a paucity of data available regarding the risk factors associated with posterior glenoid bone loss.

Purpose:

To characterize the epidemiology of, and risk factors associated with, glenoid bone loss within a cohort of patients who underwent primary arthroscopic shoulder stabilization for isolated posterior-type glenohumeral instability.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

This was a retrospective analysis of patients who underwent primary arthroscopic shoulder stabilization for posterior-type instability between January 2011 and December 2019. Preoperative magnetic resonance arthrograms were used to calculate posterior glenoid bone loss using a perfect circle technique. Patient characteristics and revision rates were obtained. Bone loss (both in millimeters and as a percentage) was compared between patients based on sex, age, arm dominance, sports participation, time to surgery, glenoid version, history of trauma, and number of anchors used for labral repair.

Results:

Included were 112 patients with a mean age of 28.66 ± 10.07 years; 91 patients (81.25%) were found to have measurable bone loss. The mean bone loss was 2.46 ± 1.68 mm (8.98% ± 6.12%). Significantly greater bone loss was found in athletes versus nonathletes (10.09% ± 6.86 vs 7.44% ± 4.56; P = .0232), female versus male patients (11.17% ± 6.53 vs 8.17% ± 5.80; P = .0212), and patients dominant arm involvement versus nondominant arm involvement (10.26% ± 5.63 vs 7.07% ± 6.38; P = .0064). Multivariate regression analysis identified dominant arm involvement as an independent risk factor for bone loss ( P = .0033), and dominant arm involvement ( P = .0024) and athlete status ( P = .0133) as risk factors for bone loss >13.5%. At the conclusion of the study period, 7 patients had experienced recurrent instability (6.25%).

Conclusion:

The findings of this study are in alignment with existing data suggesting that posterior glenoid bone loss is highly prevalent in patients undergoing primary arthroscopic stabilization for posterior-type shoulder instability. Our results suggest that patients with dominant arm involvement are at risk for greater posterior glenoid bone loss. Athlete status and dominant arm involvement were identified as independent risk factors for bone loss >13.5%.
An Analysis of Trends in the US Undocumented Population Since 2011 and Estimates of the Undocumented Population for 2021
Authors: Warren Robert
Published: October 2023

Executive Summary

In 2021, the undocumented population residing in the United States (US) increased slightly to 10.3 million, compared to 10.2 million the previous year. The gradual decline or near-zero growth of this population has continued for more than a decade. However, the large increases in apprehensions at the southern border in recent years, along with continued legislative gridlock in Congress, could portend a new era of growth of this population. Unfortunately, the data needed to determine whether the population will enter a period of growth after 2021 — or whether the era of near-zero growth will continue — will not be available for at least a year or two. The most accurate demographic estimates of the undocumented population are derived from data collected in the US Census Bureau’s American Community Survey. Estimates of the size of the undocumented population in 2022 will not be available until early 2024.

This report focuses on the most significant trend in the undocumented population in the past decade — the remarkable decline of 1.9 million in the undocumented population from Mexico from 2011 to 2021. The decline for Mexico in this period was 600,000 more than the total population increase from the seven countries (in order) with the fastest growing US undocumented populations: Guatemala, Honduras, India, Venezuela, El Salvador, Brazil, and China. This paper finds that: The long-term decline, or near-zero growth, of the total undocumented population that began in 2008 continued in 2021. The percent of undocumented residents in the total US population declined from 3.8 percent in 2011 to 3.1 percent in 2021. The undocumented population from Mexico declined from 6.4 million in 2011 to 4.4 million in 2021, a drop of 1.9 million in 10 years. A total of 2.9 million, or 47 percent, of the US undocumented population from Mexico in 2011 had left the undocumented population by 2021. The drop in the undocumented population from Mexico from 2011 to 2021 occurred nationwide, and the decline affected the undocumented population in nearly every state. The fastest growing undocumented populations by country in the last 10 years were from Guatemala, Honduras, India, El Salvador, Venezuela, and Brazil. The combined undocumented populations from these six countries grew by 1.2 million. Countries that had declining populations after 2011 included Poland, Peru, Ecuador, Korea, and Philippines, in addition to the large drop for Mexico. California had the largest decline in undocumented residents — 665,000 from 2011 to 2021. The undocumented population from Mexico living in California during this period declined by 720,000. The combined undocumented population in California, New York, and Illinois fell by more than one million from 2021 to 2011.
A Comparative Cross-sectional Study on Prevalence of Low Birth Weight and its Anticipated Risk Factors
Authors: Alsamae Assmaa A. , Elzilal Hala A. , Alzahrani Eman , Abo-Dief Hala M. , Sultan Mujeeb A.
Published: October 2023

Objective. This study aims to highlight the low birth weight (LBW) in Taiz City (Yemen), as LBW is one of the public health challenges experiencing a profound effect on newborns. Methods. This was a cross-sectional study since the interview and medical records were the sources of data to be analyzed by SPSS. Results. The findings of this study include; a high prevalence of LBW (39.11%), the maternal age was not associated with LBW ( P = .68), and education level, economic status, residence place, and health status were not associated with LBW ( P < .05). Although the pre-pregnancy BMI, during-pregnancy BMI, MUAC, and gestational age were significantly associated with LBW ( P < .05), the only risk factor was gestational age (OR = 9.606, CI = 3.988-23.135, P = .00). Conclusion. LBW is highly prevalent in Taiz (Yemen), so providing good healthcare services is essential to manage LBW incidence.
Symptom Experience and Perceived Health Status of People With Long COVID in Thailand
Authors: Pumipak Bangern , Jittimanee Sirinapha , Thananun Sirima , Mathong Kaewjai , Poungdok Jomtien , Sinsap Manthana , Sueathong Thatsanee , Kongruang Oranong , Faungprachakorn Sujitraporn , Thunyaphun Thunyarut , Insook Poramate , Soontornmon Kaewalee
Published: October 2023

Introduction

Despite the World Health Organization declaring COVID-19 no longer a public health emergency, reports of long COVID persist globally, raising concerns about its impact on individuals.

Objective

This retrospective study aimed to explore the symptom experiences of individuals with long COVID-19 and examine the relationship between those experiences and perceived negative health status in Thailand.

Methods

The study focused on individuals with moderate to severe COVID-19 infections. Between July 3, 2022 and December 1, 2022, we conducted telephone interviews with 86 individuals who tested positive for SARS-CoV-2 and received outpatient care in Bangkok. The COVID-19 Yorkshire Rehabilitation Screening was utilized to measure symptom occurrence, duration, severity, and health status on an 11-point numerical rating scale from 0 (none or excellent) to 10 (the worst). A Spearman rank correlation was used to analyze the relationships between long COVID symptoms and negative perception of health status.

Results

Among the participants, 75.6% had long COVID, with a median of three symptoms lasting for a median duration of 5.6 months. Difficulties in performing daily activities were most common, reported by 50.8% of participants. The majority (80.0%) experienced itching, headache, cognition, muscle pain, continence, and sleeping problem for 6 months. Loss of taste was the most severe symptom, with a mean severity rating of 8.8. There were significant positive relations between a negative perception of health status and multiple symptoms, symptom severity, functional disability, and additional symptoms.

Conclusion

Individuals with moderate to severe COVID-19 infection who experienced long COVID had poorer perceived health status. To effectively manage and improve the health status of individuals with long COVID, nurses should provide follow-up care, assess not only the occurrence of symptoms but also their duration and severity, and evaluate performance outcomes.
Sources of Stress and Coping Behaviors among Nursing Students Throughout Their First Clinical Training
Authors: Toqan Dalia , Ayed Ahmad , Malak Malakeh Z. , Hammad Bahaaeddin M. , ALBashtawy Mohammed , Hayek Mohammed , Thultheen Imad
Published: October 2023

Introduction

Clinical training allows nursing students to acquire and strengthen their psychomotor abilities, which is an important component of nursing education. The clinical components of nursing training programs were much more demanding than the academic ones.

Purposes

The purpose of this study was to examine sources of stress-related and coping behaviors during first clinical training among nursing students in the Arab American University.

Methods

The study was cross-sectional and conducted with a convenience sample of 266 participants of nursing students. Data collection was performed by “Perceived Stress Scale and the Coping Behavior Inventory.” The data were analyzed by using the descriptive, that is, frequency and percentage, mean, and standard deviation.

Results

The results revealed that the perceived stress mean was 41.2 ( SD = 19.5). The main stressors were taking care of the patients ( M = 11.4 ± 0.85) and teachers and nursing staff ( M = 8.32 ± 5.3). Coping behaviors mean was ( M = 29.0 ± 15.2). The main coping behavior was problem-solving ( M = 9.5 ± 5.6).

Conclusion

The study confirmed that students perceived moderate levels of stress in their first clinical training, and the most common sources of stress were taking care of the patients and teachers and nursing staff. However, the main coping behavior was problem-solving.
Effect of Prefilled vs Vial-Drawn Syringes on Sustained Increases in Intraocular Pressure in Patients Treated With Aflibercept
Authors: Russell Matthew W. , Chalasani Meghana , Rana Neil , Muste Justin C. , Rachitskaya Aleksandra V. , Talcott Katherine E. , Singh Rishi P. , Sharma Sumit
Published: October 2023

Purpose: To evaluate the effect of syringe type on developing sustained intraocular pressure (IOP) increases. Methods: This retrospective cohort study included patients in a single academic center receiving antivascular endothelial growth factor (anti-VEGF) injections from 2012 to 2022 for various indications. Patients were grouped by anti-VEGF treatment of either vial-drawn or prefilled syringe delivery. Trends in IOP were recorded for 1 year after treatment began. Development of sustained IOP increase, ocular hypertension, and glaucoma was recorded. Sustained IOP increase was defined as ≥5 mm Hg above baseline for at least 4 weeks. Results: Of 257 total patients, 6 (2.3%) developed sustained IOP increases throughout the study’s duration. No significant differences were noted with respect to prefilled versus vial-drawn syringe status on the development of sustained IOP increases or incident glaucoma (IOP: 1.8% vs 2.7%, respectively, P = .65; glaucoma: 0.0% vs 2.0%, respectively, P = .14). Patients treated with prefilled syringes were significantly less likely to develop ocular hypertension (2.8% vs 8.8%, P < .05). Conclusions: This study found that aflibercept intravitreal injection with prefilled syringes was not associated with a significant increase in IOP-related adverse effects when compared with those treated with vial-drawn syringes.
A Cross-Sectional Analysis of Community Perceptions of Flu and COVID-19 Vaccines at Turtle Creek Primary Care Center
Authors: Murali Anjana , Sojati Jorna , Levochkina Marina , Pressimone Catherine , Griffith Kobi , Fan Erica , Dakroub Allie
Published: October 2023

Background

Influenza (flu) and COVID-19 vaccination rates are subpar across the US, especially in racial and/or socioeconomic minority groups who are understudied in public health literature.

Objective

The objective of this mixed-methods study was to elucidate attitudes of patients at the Turtle Creek Primary Care Center, a clinic that cares for ∼70% non-white patients, towards flu and COVID-19 vaccines, with the goal of establishing vaccine education gaps and increasing vaccine uptake in minority communities.

Design/Patients

This study was conducted as a cross-sectional analysis. Authors completed 123 patient phone surveys of patients cared for at the Turtle Creek clinic inquiring about flu and COVID-19 infection status and vaccination uptake (August 26–October 10, 2021).

Approach/Key Results

We found that rates of vaccination were subpar in the Turtle Creek community, with only 54% having received the COVID-19 vaccine and only 44% receiving the flu vaccine regularly. There was a strong association between COVID-19 and flu vaccine acceptance and a notable correlation between vaccine acceptance and age. When assessing how vaccine acceptance was influenced by trusted sources of information, those who cited trusting “medical professionals” and “word of mouth” had higher odds of COVID-19 vaccine acceptance but those who cited trusting “social media” had decreased odds of acceptance. Finally, we uncovered 14 common factors for either vaccine acceptance or refusal that clustered into four overarching themes of trust, need, safety, and availability.

Conclusion

These data highlight the necessity of improved vaccine education and reveal targetable populations and approaches for disseminating vaccine information.
The oxidation state and distribution of Fe in pumpellyite from the Northern Chichibu Belt in the Hijikawa district, western Shikoku, Japan
Authors: Akasaka Masahide , Goishi (Imaizumi) Yumi , Sakakibara Masayuki , Nakamuta Yoshihiro
Published: October 2023

Intracrystalline distribution of ferrous and ferric iron within pumpellyites (VIIW8VIX4VIY8IVZ12O56–n(OH)n, Z = 1) from low-grade metamorphic green rocks of the Kanogawa unit in the Northern Chichibu Belt, Hijikawa district, western Shikoku, Japan, was investigated using electron microprobe analysis, X-ray Rietveld refinement, and 57Fe Mössbauer spectroscopic analysis to verify the regularity of the distribution of Fe within the octahedral X and Y sites in pumpellyite and its effect on the pumpellyite structure. Two Fe-rich pumpellyite samples, labelled CLW and CHG, with average total Fe2O3 of 10.01±1.69 and 16.07±1.08 wt.%, respectively, were separated from the rock samples. The site occupancies at the X and Y sites in the CLW and CHG pumpellyites, refined using powder X-ray diffraction data, are X[Mg0.298Fe0.298(5)Al0.405]Y[Fe0.191Al0.809] and X[Mg0.244Fe0.42(1)Al0.34]Y[Fe0.32Al0.68], respectively. The Fe2+:Fe3+ ratio of the CLW pumpellyite, determined using Mössbauer spectroscopy, is 12(1):88(3). By combining the average chemical composition data, the site occupancies at the X and Y sites, and the Fe2+:Fe3+ ratio of the CLW pumpellyite, the chemical formulae of CLW and CHG pumpellyites are constructed as (Ca7.96K0.02Na0.01)Σ7.99(Mg1.19Mn2+0.09Fe2+0.39Fe3+0.71Al1.62)Σ4.00(Al6.47Fe3+1.50V0.02Ti0.01)Σ8.00Si12.26O43.33(OH)12.67 and (Ca8.01K0.01)Σ8.02(Mg0.97Mn2+0.02Fe2+0.63Fe3+1.03Al1.19)Σ4.01(Al5.44Fe3+2.55V0.01)Σ8.00Si12.02O42.69OH)13.31, respectively, implying that the proper name of both pumpellyites is pumpellyite-(Al). The intracrystalline distribution coefficients of Fe3+ versus Al between the X and Y sites, KD = (Fe3+/Al)X/(Fe3+/Al)Y, are 1.62 and 1.90 for the CLW and CHG pumpellyites, respectively, implying stronger X-site preference of Fe3+ than Al3+. In the CHG pumpellyite, where the Fe contents at the X and Y sites are higher than in the CLW pumpellyite, the mean  and  distances are 2.06 and 1.98 Å, respectively, which are larger than  = 2.040 and  = 1.944 Å in the CLW pumpellyite. The unit-cell parameters of the CHG pumpellyite are a = 8.8672(3), b = 5.9562(2), c = 19.1899(6) Å, β = 97.473(2)° with V = 1004.9(2) Å3 and are larger than those of the CLW pumpellyite, a = 8.8456(4), b = 5.9393(2), c = 19.1613(8) Å, β = 97.461(3)° with V = 998.14(7) Å3.
Pre-compensation of Friction for CNC Machine Tools through Constructing a Nonlinear Model Predictive Scheme
Authors: Xiao Qunbao , Wan Min , Qin Xuebin
Published: October 2023

Nonlinear friction is a dominant factor affecting the control accuracy of CNC machine tools. This paper proposes a friction pre-compensation method for CNC machine tools through constructing a nonlinear model predictive scheme. The nonlinear friction-induced tracking error is firstly modeled and then utilized to establish the nonlinear model predictive scheme, which is subsequently used to optimize the compensation signal by treating the friction-induced tracking error as the optimization objective. During the optimization procedure, the derivative of compensation signal is constrained to avoid vibration of machine tools. In contrast to other existing approaches, the proposed method only needs the parameters of Stribeck friction model and an additional tuning parameter, while finely identifying the parameters related to the pre-sliding phenomenon is not required. As a result, it greatly facilitates the practical applicability. Both air cutting and real cutting experiments conducted on an in-house developed open-architecture CNC machine tool prove that the proposed method can reduce the tracking errors by more than 56%, and reduce the contour errors by more than 50%.
Carrier lifetime modulation on current capability of SiC PiN diodes in a pulsed system
Authors: Xu Xingliang , Zhang Lin , Li lianghui , Li Zhiqiang , Li Juntao , Zhang Jian , Dong Peng
Published: October 2023

Silicon carbide (SiC) PiN diode has shown substantial promise as the freewheel diode for switch protection in a pulsed system. In this paper, we investigate the carrier lifetime (τ) modulation on pulsed current capability of SiC PiN diodes. The carrier lifetime in 4H–SiC is modulated by the generation of the Z1/2 center through neutron irradiation. Surprisingly, we found that the pulsed current of SiC PiN diodes shows a limited improvement when the carrier lifetime (τ) increases from 0.22 to 1.3 μs, while is significantly promoted as the carrier lifetime increases from 0.03 to 0.22 μs. This changing trend is obviously different from the on-state resistance, which decreases with the increased carrier lifetime. The simulation result indicates that the heat generation (i.e., maximum temperature rise) inside the PiN diodes, especially in the drift layer, is remarkably aggravated in the pulse tests for τ < 0.1 μs, but which is significantly suppressed as carrier lifetime rises to 0.2 μs and above. Therefore, the dependence of pulsed current on carrier lifetime is ascribed to the heat generation resulting from the carrier lifetime controlled conductivity modulation effect, which hence affects the temperature rise and brings about the failure of SiC PiN diodes under high pulsed current.
Metabolomics in severe traumatic brain injury: a scoping review
Authors: Fedoruk Riley Page , Lee Chel Hee , Banoei Mohammad Mehdi , Winston Brent W.
Published: October 2023

Background

Diagnosis and prognostication of severe traumatic brain injury (sTBI) continue to be problematic despite years of research efforts. There are currently no clinically reliable biomarkers, though advances in protein biomarkers are being made. Utilizing Omics technology, particularly metabolomics, may provide new diagnostic biomarkers for sTBI. Several published studies have attempted to determine the specific metabolites and metabolic pathways involved; these studies will be reviewed.

Aims

This scoping review aims to summarize the current literature concerning metabolomics in sTBI, review the comprehensive data, and identify commonalities, if any, to define metabolites with potential clinical use. In addition, we will examine related metabolic pathways through pathway analysis.

Methods

Scoping review methodology was used to examine the current literature published in Embase, Scopus, PubMed, and Medline. An initial 1090 publications were identified and vetted with specific inclusion criteria. Of these, 20 publications were selected for further examination and summary. Metabolic data was classified using the Human Metabolome Database (HMDB) and arranged to determine the ‘recurrent’ metabolites and classes found in sTBI. To help understand potential mechanisms of injury, pathway analysis was performed using these metabolites and the Kyoto Encyclopedia of Genes and Genomes (KEGG) Pathway Database.

Results

Several metabolites related to sTBI and their effects on biological pathways were identified in this review. Across the literature, proline, citrulline, lactate, alanine, valine, leucine, and serine all decreased in adults post sTBI, whereas both octanoic and decanoic acid increased. Hydroxy acids and organooxygen compounds generally increased following sTBI, while most carboxylic acids decreased. Pathway analysis showed significantly affected glycine and serine metabolism, glycolysis, branched-chain amino acid (BCAA) metabolism, and other amino acid metabolisms. Interestingly, no tricarboxylic acid cycle metabolites were affected.

Conclusion

Aside from a select few metabolites, classification of a metabolic profile proved difficult due to significant ambiguity between study design, sample size, type of sample, metabolomic detection techniques, and other confounding variables found in sTBI literature. Given the trends found in some studies, further metabolomics investigation of sTBI may be useful to identify clinically relevant metabolites.
Prevalence of pediatric sepsis in hospitalized children of Maiwand Teaching Hospital, Kabul, Afghanistan
Authors: Sediqi Mohammad Sharif , Wali Abdulwali , Ibrahimi Mohammad Akbar
Published: October 2023

Background

Sepsis is a clinical syndrome associated with a systemic reaction to infection that is seen as a bacteremia with systemic symptoms. Sepsis is one of the most important problems in children and is associated with many deaths, so recognizing this disease and it’s causing factors and identifying the predisposing factors for it is of great importance. Globally, the prevalence and occurrences of sepsis and septic shock are increasing, while the incidence of deaths from them has decreased with the improvement of diagnostic and treatment facilities. According to a 2015 World Health Organization report, approximately 5.9 million children under 5 years old have lost their lives due to sepsis worldwide, the majority of which have occurred in developing countries.

Methods

This study was conducted in the pediatric department of Maiwand Teaching Hospital (MTH) in 2020 as a descriptive cross-sectional study. All children who were admitted to the pediatric department of Maiwand Teaching Hospital during 2020 were included in the research. Among them, the prevalence of sepsis in children with respect to age and sex was studied. The study included children over the age of 28 days who were admitted to the Maiwand Teaching Hospital pediatrics department in 2020. However, in this study, patients have been categorized into five categories according to age: less than two months, two months to one year, one to three years, three to five years old, and older than five years old.

Results

This study was conducted in the pediatric department of Maiwand Teaching Hospital in 2020 as a descriptive cross-sectional study, and it was found that the prevalence of sepsis in children who were admitted to the pediatric department at this year was 50.5%, including the highest prevalence in males (65.75%) and at the age of two months to one year (37.9%). In this study, it was found that the prevalence of sepsis was higher (88.46%) among urban children than children who were living in villages (11.53%). In this study, the mortality rate was 2.44% for patients admitted to Maiwand Teaching Hospital.

Conclusions

In this study, it was found that the prevalence of sepsis was 50.5% in children admitted to the pediatrics department of Maiwand Teaching Hospital, of whom 67.75% were boys, 37.94% were aged two months to three years old, and it was more prevalent (88.46%) among children living in cities. The mortality rate was 2.44%.
Determination and prioritization of factors affecting the occurrence of needle stick injuries among healthcare workers using techniques of Delphi and fuzzy analytical hierarchy process (FAHP)
Authors: Mousavi Seyed Mahdi , Yazdanirad Saeid , Althubiti Sara , Majdabadi Masoud Askari , Najarian Faranak , Sepehr Parvin
Published: October 2023

Introduction

Needlestick injuries (NSIs) are a major hazard in the workplace for healthcare workers. To prevent these injuries, it is essential to determine the important factors affecting the occurrence of them. This study aimed to identify, classify and prioritize these factors using techniques of Delphi and fuzzy analytical hierarchy process (FAHP).

Methods

This descriptive-analytical study was conducted in 2022. Firstly, the factors affecting the occurrence of needlestick injuries were identified by the literature review. Moreover, the Delphi technique was used to identify the factors. 20 experts (physicians, nurses, and occupational health experts) participated in the steps of the Delphi method. Then, these factors were grouped into six groups. In the next step, the fuzzy analytical hierarchy process (FAHP) was applied to prioritize the factors. For this purpose, the pairwise comparison questionnaire was designed and filled out by 20 experts. Finally, data were analyzed using MATLAB software (version 2018a).

Results

42 factors (31 factors extracted from the literature review and 11 factors obtained from the Delphi technique) were identified in this study. These factors were categorized into six groups. Based on the results, the relative weight of non-demographic personal factors, tool and technology factors, job factors, organizational factors, demographic personal factors, and environmental factors were computed by 0.200, 0.185, 0.184, 0.157, 0.142, and 0.133, respectively.

Conclusion

These results determined the importance of the factors affecting the occurrence of needlestick injuries. These findings can be useful for planning preventive measures.
Establishment of prognostic model of bladder cancer based on apoptosis-related genes, in which P4HB promotes BLCA progression
Authors: Zou Zhenhai , Li Zhong , Sun Wei , Gao Wuyue , Liu Beibei , Liu Jianmin , Guo Yuanyuan
Published: October 2023

Background

A variety of apoptosis genes have been confirmed to be related to the occurrence and development of bladder cancer patients, but few studies have paid attention to their significance in the prognosis of bladder cancer. Therefore, this study explored the value of apoptosis-related genes in the prognosis of BLCA by using the data in TCGA database.

Methods

We downloaded the mRNA expression profiles and corresponding clinical data of bladder cancer patients from TCGA database, and obtained 2411 apoptosis-related genes from Deathbase database. Screening out differentially expressed apoptosis-related genes. Cox regression was used to determine the prognostic value of apoptosis-related genes, and then a prognostic risk model was developed. A nomogram based on risk model was constructed to predict the prognosis of bladder cancer patients. At the same time, immune infiltration correlation analysis of genes in the prognosis model.

Results

A prognostic model composed of 12 apoptosis-related genes was constructed. According to the risk score calculated by the model, patients were divided into high-risk group and low-risk group. There are significant differences in the expression of immune cells, immune function and immune checkpoint molecules between high-risk group and low-risk group. P4HB may promote bladder cancer progression.

Conclusion

Based on the differential expression of apoptosis-related genes, we established a risk model to predict the prognosis of bladder cancer patients, in which P4HB promotes BLCA progression.
Experience of verbal violence among Chinese nursing students in clinical practice: a qualitative study
Authors: Qian Meiyan , Zhu Pingting , Wu Qiwei , Wang Wen , Shi Guanghui , Ding Yinwen , Zhang Hui , Gu Xinyue , Xu Ting , Zhang QianQian
Published: October 2023

Background

Workplace violence is prevalent in the nursing profession, and as a relatively junior link of the professional hierarchy, nursing students are not immune to it. Among these, verbal violence may have more serious consequences for the victims than physical violence, but the literature on verbal violence among nursing students in Chinese clinical settings is limited.

Aims

To explore the verbal violence experience among Chinese nursing students in clinical practice, and the strategies used by nursing students to cope with violence.

Design

A descriptive qualitative study.

Methods

From January 2022 to June 2022, semi-structured interviews were conducted with 21 nursing students in clinical practice by purposive snowball sampling. Nvivo12 software and inductive content analysis were used for data analysis. This paper followed the COREQ (Consolidated criteria for Reporting Qualitative Research) guidance.

Results

Through data analysis, three themes were defined:(1) Multiform verbal violence; (2) Hurting and impacting and (3) Struggling or Coping. The findings indicated that nursing students were subjected to multiple forms of verbal violence in clinical practice, not only from patients and caregivers, but also from peers such as clinical tutors and doctors, which not only harmed students’ personal health and well-being, but may also contribute to the nursing industry’s future loss of human resources. Seeking emotional support from others and forcing themselves to grow up were the most commonly used coping strategies.

Conclusion

Nursing educators and nursing managers need to pay attention to verbal violence in the clinical environment, and actively develop the ability of nursing students to deal with uncivilized behavior. Establishing relevant courses and training such as communication, resilience, and violence prevention, establishing a stricter clinical mentor appointment system, and teaching assessment system may be strategies to help nursing students better perform clinical practice.
Assessing user preferences for design characteristics of oral dissolvable strips for pediatric HIV medication: a qualitative study
Authors: Wexler Catherine , Maloba May , Sliefert Michala , Babu Shadrack , Maosa Nicodemus , Maliski Edward , Nicolay Zachary , Were Frederick , Mbithi Yvonne , Mugendi George , Thomas Gregory , Acharya Harshdeep , Finocchario-Kessler Sarah
Published: October 2023

Background

Current infant antiretroviral therapy formulations pose barriers to daily adherence due to complex weight-based dosing, conspicuous preparation, and poor palatability. These adherence barriers jeopardize adherence, making patients vulnerable to virologic failure, development of drug resistance, and preventable mortality. Our team has previously established proof-of-principle for multi-drug oral dissolvable strips as alternative pediatric antiretroviral formulations with the potential to overcome these challenges and improve pediatric ART adherence and outcomes. The objective of this study was to assess caregiver and provider preferences for oral dissolvable strips and its packaging to inform its development.

Methods

Guided by concepts of user-centered design, we conducted key informant interviews with 30 HIV care providers and focus group discussions targeting caregivers of children < 10 years of age living with HIV at 3 Kenyan hospitals. Key informant interviews and focus group discussions were audio recorded, translated/transcribed verbatim, and hand coded for a-priori and emergent themes.

Results

A total of 30 providers and 72 caregivers (caring for 83 children, aged 5 months to 18 years) participated in the study. Caregivers and providers expressed a strong desire for an easier way to administer medication, especially among children too young to swallow tablets whole, and expressed enthusiasm around the idea of oral dissolvable strips. Key preferences included a pleasant taste; one strip per dose; small size with rapid dissolution; clear markings and instructions; and no special storage requirements. For packaging, stakeholders preferred individually wrapped strips within a dispenser. The individual packaging should be durable, waterproof, and easy to dispose of in communal spaces. They should also be easy to open, with clear indications where to open. The packaging holding the strips should be durable, re-usable, accommodating of various refill frequencies, and easy to use for children as young as 6.

Discussion

The concept of oral dissolvable strips was highly acceptable to caregivers of children living with HIV and HIV care providers. By engaging stakeholders in an iterative design process starting from the early phases of design and development, we will maximize the likelihood of developing a product that is acceptable to the caregiver and infant, therefore leading to sustainable adherence.
What is the impact of one’s chronic illness on his or her spouse’s future chronic illness: a community-based prospective cohort study
Authors: An Hoyoung , Yang Hee Won , Oh Dae Jong , Lim Eunji , Shin Jin , Moon Dong Gyu , Suh Seung Wan , Byun Seonjeong , Kim Tae Hui , Kwak Kyung Phil , Kim Bong Jo , Kim Shin Gyeom , Kim Jeong Lan , Moon Seok Woo , Park Joon Hyuk , Ryu Seung-Ho , Lee Dong Woo , Lee Seok Bum , Lee Jung Jae , Jhoo Jin Hyeong , Bae Jong Bin , Han Ji Won , Kim Ki Woong
Published: October 2023

Background

Integrating a joint approach to chronic disease management within the context of a couple has immense potential as a valuable strategy for both prevention and treatment. Although spousal concordance has been reported in specific chronic illnesses, the impact they cumulatively exert on a spouse in a longitudinal setting has not been investigated. We aimed to determine whether one’s cumulative illness burden has a longitudinal impact on that of their spouse.

Methods

Data was acquired from a community-based prospective cohort that included Koreans aged 60 years and over, randomly sampled from 13 districts nationwide. Data from the baseline assessment (conducted from November 2010 to October 2012) up to the 8-year follow-up assessment was analyzed from October 2021 to November 2022. At the last assessment, partners of the index participants were invited, and we included 814 couples in the analysis after excluding 51 with incomplete variables. Chronic illness burden of the participants was measured by the Cumulative Illness Rating Scale (CIRS). Multivariable linear regression and causal mediation analysis were used to examine the longitudinal effects of index chronic illness burden at baseline and its change during follow-up on future index and spouse CIRS scores.

Results

Index participants were divided based on baseline CIRS scores (CIRS < 6 points, n = 555, mean [SD] age 66.3 [4.79] years, 43% women; CIRS ≥ 6 points, n = 259, mean [SD] age 67.7 [4.76] years, 36% women). The baseline index CIRS scores and change in index CIRS scores during follow-up were associated with the spouse CIRS scores (β = 0.154 [SE: 0.039], p < 0.001 for baseline index CIRS; β = 0.126 [SE: 0.041], p = 0.002 for change in index CIRS) at the 8-year follow-up assessment. Subgroup analysis found similar results only in the high CIRS group. The baseline index CIRS scores and change in index CIRS scores during follow-up had both direct and indirect effects on the spouse CIRS scores at the 8-year follow-up assessment.

Conclusions

The severity and course of one’s chronic illnesses had a significant effect on their spouse’s future chronic illness particularly when it was severe. Management strategies for chronic diseases that are centered on couples may be more effective.
Microbial signatures in amniotic fluid at preterm birth and association with bronchopulmonary dysplasia
Authors: Staude Birte , Gschwendtner Silvia , Frodermann Tina , Oehmke Frank , Kohl Thomas , Kublik Susanne , Schloter Michael , Ehrhardt Harald
Published: October 2023

Background

Microbiome dysbiosis can have long-lasting effects on our health and induce the development of various diseases. Bronchopulmonary dysplasia (BPD) is a multifactorial disease with pre- and postnatal origins including intra-amniotic infection as main risk factor. Recently, postnatal pathologic lung microbiota colonization was associated with BPD. The objectives of this prospective observational cohort study were to describe differences in bacterial signatures in the amniotic fluid (AF) of intact pregnancies without clinical signs or risk of preterm delivery and AF samples obtained during preterm deliveries and their variations between different BPD disease severity stages.

Methods

AF samples were collected under sterile conditions during fetal intervention from intact pregnancies (n = 17) or immediately before preterm delivery < 32 weeks (n = 126). Metabarcoding based approaches were used for the molecular assessment of bacterial 16S rRNA genes to describe bacterial community structure.

Results

The absolute amount of 16S rRNA genes was significantly increased in AF of preterm deliveries and detailed profiling revealed a reduced alpha diversity and a significant change in beta diversity with a reduced relative abundance of 16S rRNA genes indicative for Lactobacillus and Acetobacter while Fusobacterium, Pseudomonas, Ureaplasma and Staphylococcus 16S rRNA gene prevailed. Although classification of BPD by disease severity revealed equivalent absolute 16S rRNA gene abundance and alpha and beta diversity in no, mild and moderate/severe BPD groups, for some 16S rRNA genes differences were observed in AF samples. Bacterial signatures of infants with moderate/severe BPD showed predominance of 16S rRNA genes belonging to the Escherichia-Shigella cluster while Ureaplasma and Enterococcus species were enriched in AF samples of infants with mild BPD.

Conclusions

Our study identified distinct and diverse intrauterine 16S rRNA gene patterns in preterm infants immediately before birth, differing from the 16S rRNA gene signature of intact pregnancies. The distinct 16S rRNA gene signatures at birth derive from bacteria with varying pathogenicity to the immature lung and are suited to identify preterm infants at risk. Our results emphasize the prenatal impact to the origins of BPD.
Mass distribution campaign of long-lasting insecticidal nets (LLINs) during the COVID-19 pandemic in Uganda: lessons learned
Authors: Aguma Herbert Bush , Rukaari Medard , Nakamatte Rukia , Achii Pamela , Miti Joel Tutu , Muhumuza Solomon , Nabukenya Mariam , Opigo Jimmy , Lukwago Martin
Published: October 2023

Background

Uganda implemented its third mass campaign to distribute long-lasting insecticidal nets (LLINs) in 2020 during the COVID-19 pandemic. This context necessitated modification of implementation guidelines. The mass campaign's objective was to ensure that at least 85% of the targeted population had access to LLINs.

Methods

Revised implementation guidelines were followed while conducting the LLIN distribution campaign. Lessons learned were captured from documented activities and reports.

Results

A total of 27,789,044 mosquito nets were distributed in 11,287,392 households, with an average of 5.1 persons per household. Household coverage of the LLIN distribution was 94.1%. The 2020/2021 campaign design was modified to follow COVID-19 Standard Operating Procedures (SOPs). These included using Personal Protective Equipment (PPE), e-platforms for training and briefing meetings, electronic data management systems and door-to-door household registration and distribution of LLINs.

Conclusions

Campaign modifications due to the COVID-19 pandemic were effective in implementing mass distribution of LLINs despite the disruptions and restrictions. The campaign’s net coverage far exceeded its objective. Electronic data management was critical in monitoring and reporting distribution activities.