bluuebunny/crossref_metadata_2025 huggingface dataset:
European survey showed wide variations in diagnostic procedures and management strategies for metabolic bone disease of prematurity in 22 countries
Authors: Brado Luise , Matheisl Daniel , Mildenberger Eva , Fuchs Hans , Klotz Daniel , Kidszun André
Published: May 2024

Aim

The aim of this study was to evaluate the clinical relevance, diagnostic procedures and treatment strategies for metabolic bone disease in preterm infants across Europe.

Methods

An e‐survey was distributed by email to 545 neonatal units in 38 European countries between July and October 2021. The protocol was based on the Checklist for Reporting Results of Internet E‐Surveys.

Results

In total, 76 neonatal units (14%) from 22 European countries (58%) completed the e‐survey. In the 12 months prior to the survey, 29% of 76 units reported at least one symptomatic case of fracture associated with metabolic bone disease of prematurity, and 18% of 76 units reported at least one case of craniofacial deformity. Most centres followed local guidelines for diagnosis (77% of 73 units) and treatment (63% of 72 units). Alkaline phosphatase was the blood marker most used for treatment indication (81% of 72 units), and phosphate supplementation was the treatment most used (82% of 71 units).

Conclusion

Metabolic bone disease of prematurity remains clinically relevant. Wide variations in diagnostic procedures and management strategies were observed in European neonatal units. Evidence‐based consensus guidelines appear urgently needed to reduce the number of symptomatic cases.
Early impact assessment of the paninvasive polyphagous shot hole borer beetle on commercial pear production
Authors: Neethling Emma C. , Engelbrecht Karyn , Roets Francois , Crous Casparus J.
Published: May 2024

The polyphagous shot hole borer (PSHB) beetle, Euwallacea fornicatus (Eichhoff) (Coleoptera: Curculionidae, Scolytinae), and its phytopathogenic fungal symbiont (Fusarium euwallaceae Freeman et al.) threaten commercial and urban tree species worldwide. This pest–fungus complex has been newly discovered in the commercial deciduous fruit industry (Western Cape, South Africa), where its effect is still unknown. This study explored the impact of PSHB infestation on fruit quality and plant water‐use efficiency (WUE) – as indicated by carbon and nitrogen stable isotope ratios – of commercially cultivated Packham's Triumph pear trees within the first year of invasion, as well as changes in phenotypic plasticity (trait expression range). The impact of PSHB infestation is currently most evident in fruit quality traits, with a clear distinction between the control and most densely attacked tree categories. Fruit and leaf traits showed high variation and a significant change in phenotypic plasticity. Increased PSHB attack density was associated with smaller, duller‐toned, sweeter fruit at the time of harvest and data tended towards reduced plant WUE. Producers can expect significant variation in fruit quality and plant WUE even in hosts without branch dieback, visible plant stress or extensive beetle breeding, especially in orchards where infestations persist beyond the first year. These findings necessitate additional research to describe the long‐term impact, examine the threat to other deciduous fruit crops and cultivars and assess the need for adapted management or harvesting methods.
Trends in preterm birth in women living with HIV in Switzerland over the last three decades: A multicentric, prospective, cohort study
Authors: Lumbreras Areta Marina , Migliorelli Falcone Federico E. , Rudin Christoph , Kahlert Christian R. , Paioni Paolo , Baumann Marc U. , Darling Katharine , Polli Christian , Martinez de Tejada Begoña
Published: May 2024

Background

HIV infection and its management during pregnancy to reduce perinatal transmission has been associated with preterm birth (PTB). This management has drastically changed. We aimed to evaluate changes in rates of PTB over 34 years in women living with HIV (WLWH) in Switzerland, and to identify factors and interventions associated with these changes.

Methods

We analysed data from 1238 singleton pregnancies, prospectively collected by the Swiss Mother and Child HIV Cohort Study (MoCHiV) and the Swiss HIV Cohort Study (SHCS) between 1986 and 2020. Rates of PTB in this cohort were compared with that of the general Swiss population for three time periods according to changing treatment strategies recommended at the time. We evaluated the association of PTB with sociodemographic, HIV infection and obstetric variables in uni‐ and multivariate logistic regression.

Results

Rate of PTB in WLWH was highest prior to 2010 (mean 20.4%), and progressively decreased since then (mean 11.3%), but always remained higher than in the general population (5%). Older maternal age, lower CD4 count and detectable viraemia at third trimester (T3), drug consumption and mode of delivery were all significantly associated with both PTB and period of study in univariate analysis. There was no association between PTB and type of antiretroviral regimen. No difference was found in the rate of spontaneous labor between PTB and term delivery groups. Only higher CD4 count at T3 and vaginal delivery were significantly associated with a decrease in PTB over time in multivariate analysis.

Conclusions

Preterm birth in WLWH in Switzerland has drastically decreased over the last three decades, but remains twice the rate of that in the general population. Improved viral control and changes in mode of delivery (vaginal birth recommended if viral loads are low near birth) have led to this progress.
Program logic of a service collaboration to support parents with intellectual disability
Authors: Doery Elizabeth Jane , Varcoe Jay , Benstead Michelle , Ghayour‐Minaie Matin , Sheils Rebecca , Kavanagh Siobhan , Little Keriann , Pert Allie , Toumbourou John W.
Published: May 2024

Background

This article describes the Steps to Confident Parenting (SCP) program, developed by an Australian family service consortium. The SCP integrates home‐based and case‐management services to enhance the skills of parents with a diagnosed or suspected intellectual disability/cognitive impairment and to prevent child protection interventions.

Method

‘Program explication’ methodology documented the components/activities, and underpinning evidence for this practitioner designed service through interviews with nine agency staff. A literature review evaluated evidence for the implicit program benefit theory.

Results and Conclusion

The SCP comprised five logically consistent components—Targeted Referral, Assessments, Initial Consultation, Program Delivery, Closure and Follow‐up. Components generally had ‘some’ supportive evidence, however there was a ‘lack of’ evidence for Closure and Follow‐up. In the context of a partnership seeking to build the evidence for the SCP, it was recommended that a protocol for a randomised trial evaluation with longer term follow‐up be drafted by the consortia.
Promoting solidarity based collective action through increasing hope using nonviolent communication intervention
Authors: Avichail Tamar , Ruhrman Anat , Eick Noa Cohen , Estlein Roi , Halperin Eran
Published: May 2024

The present study explores the impact of nonviolent communication (NVC) intervention on advantaged group members’ actual participation in collective action on behalf of disadvantaged outgroups, also known as solidarity‐based collective action (SBCA). It also examines the mediating role of hope and empathy in this process. Using an experimental longitudinal field study in the context of the Israeli–Palestinian conflict, Jewish Israelis (N = 220) were randomly assigned either to an NVC or to a control condition. Results indicated that, relative to the control, participants in the NVC condition showed an increased tendency to engage in activities that are considered part of SBCA 6 weeks after the intervention. Furthermore, the NVC intervention affected both hope and empathy by maintaining higher levels of hope 6 weeks after intervention and by increasing empathy immediately after intervention. Yet hope, but not empathy, mediated the effect of the NVC intervention on participation in SBCA. Theoretical and applicable implications are discussed.
Best anticoagulation strategy with and without appendage occlusion for stroke‐prophylaxis in postablation atrial fibrillation patients with cardiac amyloidosis
Authors: Mohanty Sanghamitra , Torlapati Prem Geeta , La Fazia Vincenzo Mirco , Kurt Merve , Gianni Carola , MacDonald Bryan , Mayedo Angel , Allison John , Bassiouny Mohamed , Gallinghouse G. Joseph , Burkhardt John D. , Horton Rodney , Di Biase Luigi , Al‐Ahmad Amin , Natale Andrea
Published: May 2024

Introduction

Both atrial fibrillation (AF) and amyloidosis increase stroke risk. We evaluated the best anticoagulation strategy in AF patients with coexistent amyloidosis.

Methods

Consecutive AF patients with concomitant amyloidosis were divided into two groups based on the postablation stroke‐prophylaxis approach; group 1: left atrial appendage occlusion (LAAO) in eligible patients and group 2: oral anticoagulation (OAC). Group 1 patients were further divided into Gr. 1A: LAAO + half‐does NOAC (HD‐NOAC) for 6 months followed by aspirin 81 mg/day and Gr. 1B: LAAO + HD‐NOAC. In group 1 patients, with complete occlusion at the 45‐day transesophageal echocardiogram, patients were switched to aspirin, 81 mg/day at 6 months. In case of leak, or dense “smoke” in the left atrium (LA) or enlarged LA, they were placed on long‐term half‐dose (HD) NOAC. Group 2 patients remained on full‐dose NOAC during the whole study period.

Results

A total of 92 patients were included in the analysis; group 1: 56 and group 2: 36. After the 45‐day TEE, 31 patients from group 1 remained on baby‐aspirin and 25 on HD NOAC. At 1‐year follow‐up, four stroke, one TIA and six device‐thrombus were reported in group 1A, compared to none in patients in group 1B (5/31 vs. 0/25, p = .03). No bleeding events were reported in group 1, whereas group 2 had five bleeding events (one subdural hematoma, one retinal hemorrhage, and four GI bleedings). Additionally, one stroke was reported in group 2 that happened during brief discontinuation of OAC.

Conclusion

In patients with coexistent AF and amyloidosis, half‐dose NOAC following LAAO was observed to be the safest stroke‐prophylaxis strategy.
Norm Contestation in EU Foreign Policy: The Case of Sexual and Reproductive Health and Rights
Authors: Badell Diego
Published: May 2024

The EU considers gender equality fundamental to its identity, with Sexual and Reproductive Health and Rights (SRHR) playing a crucial role. This article delves into the contested aspects of EU foreign policy concerning SRHR from 1997 to 2021. Through document analysis and 18 semi‐structured interviews, it discerns three phases of contestation. Between 1997 and 2017, contestation was institutionalised within the EU, and the norm was reinforced. However, from 2017 to 2020, validity contestation arose as Hungary, Poland and the United States formed an alliance opposing SRHR, resulting in their symbolic exclusion from the EU's normative community. In 2021, within a less polarised international context (with the United States returning to consensus on SRHR), Hungary and Poland reaffirmed their commitment to the EU's SRHR consensus, highlighting the resilience of the norm.
Sporophytic control of tapetal development and pollen fertility by a mitogen‐activated protein kinase cascade in rice
Authors: Zeng Jianguo , Duan Manman , Wang Yiqing , Li Guangtao , You Yujing , Shi Jie , Liu Changhao , Zhang Jinyang , Xu Juan , Zhang Shuqun , Zhao Jing
Published: May 2024

Tapetum, the innermost layer of the anther wall, provides essential nutrients and materials for pollen development. Timely degradation of anther tapetal cells is a prerequisite for normal pollen development in flowering plants. Tapetal cells facilitate male gametogenesis by providing cellular contents after highly coordinated programmed cell death (PCD). Tapetal development is regulated by a transcriptional network. However, the signaling pathway(s) involved in this process are poorly understood. In this study, we report that a mitogen‐activated protein kinase (MAPK) cascade composed of OsYDA1/OsYDA2‐OsMKK4‐OsMPK6 plays an important role in tapetal development and male gametophyte fertility. Loss of function of this MAPK cascade leads to anther indehiscence, enlarged tapetum, and aborted pollen grains. Tapetal cells in osmkk4 and osmpk6 mutants exhibit an increased presence of lipid body‐like structures within the cytoplasm, which is accompanied by a delayed occurrence of PCD. Expression of a constitutively active version of OsMPK6 (CA‐OsMPK6) can rescue the pollen defects in osmkk4 mutants, confirming that OsMPK6 functions downstream of OsMKK4 in this pathway. Genetic crosses also demonstrated that the MAPK cascade sporophyticly regulates pollen development. Our study reveals a novel function of rice MAPK cascade in plant male reproductive biology.
The Incidence of Intrahepatic Cholestasis of Pregnancy and its Maternal, Fetal, and Neonatal Adverse Outcomes: A Systematic Review and Meta‐Analysis
Authors: Odabaş Resmiye Kaya , Sökmen Yasemin , Dünder Emre , Taşpınar Ayten
Published: May 2024

Introduction

Intrahepatic cholestasis of pregnancy (ICP) is a problem with an increasing incidence and negative maternal, fetal, and neonatal consequences. This problem is becoming increasingly important. This systematic review and meta‐analysis aimed to determine the incidence of ICP and its adverse maternal, fetal, and neonatal adverse outcomes based on primary research studies.

Methods

This systematic review and meta‐analysis used Preferred Reporting Items for Systematic Reviews and Meta‐Analyses reporting guidelines and was conducted between June and September 2023 using the following keywords: obstetric cholestasis OR intrahepatic cholestasis AND pregnancy OR pregnant OR prenatal OR antenatal OR perinatal OR maternal OR fetal OR neonatal. Quality assessment of the studies was performed using the Critical Appraisal Checklists developed by the JBI Institute. Data were synthesized using meta‐analysis methods.

Results

The analysis included 10 studies published between 2013 and 2023. The meta‐analysis showed that the incidence of ICP was 1.7% (odds ratio [OR], 0.021; 95% CI, 0.012‐0.027), whereas maternal, fetal, and neonatal adverse outcomes included cesarean birth (OR, 2.938; 95% CI, 1.467‐5.881), preterm birth or preterm prelabor rupture of membranes (OR, 4.241; 95% CI, 1.996‐9.009), hypertensive disorders of pregnancy (OR, 3.715; 95% CI, 1.545‐8.929), maternal infection (OR, 3.301; 95% CI, 2.917‐3.737), neonatal intensive care unit admission (OR, 2.715; 95% CI, 1.458‐5.056), birth weight less than or equal to 2500 g (OR, 2.518; 95% CI, 1.296‐4.892), and small for gestational age (OR, 1.915; 95% CI, 1.424‐2.573).

Discussion

This systematic review and meta‐analysis revealed that ICP has a high incidence and several maternal, fetal, and neonatal adverse outcomes. Therefore, midwives and other health professionals must be aware of these outcomes and provide appropriate care to pregnant individuals with ICP.
The advantages of being disadvantaged
Authors: Bohas Alexandre , Grolleau Gilles , Mzoughi Naoufel
Published: May 2024

Although many contributions examine how individuals and various entities (e.g., organizations and countries) manage to obtain a (competitive) advantage, there is a knowledge gap on how to make the best of disadvantages. Using notably the theories of self‐enhancement and psychological reactance, the existing literature has explained the mechanisms that can motivate and support an entity to get out from a disadvantageous position. We go further by addressing the “how” issues. We conceptualize disadvantages and adopt a provocative stance by showing how they can be transformed into valuable opportunities. Specifically, we document how being disadvantaged may be a driver of compensatory behaviors, effectual thinking, and innovation and serves as an emotional bond and in‐group marker. We also draw managerial and policy implications that offer a refreshing view on how to take advantage of disadvantages, such as changing the non‐market context and promoting the disadvantage as a market differentiation factor. As a caveat, adopting this stance should not be interpreted as a catch‐all solution that exonerates stakeholders from doing their part in providing support to disadvantaged entities.
Living with semantic indeterminacy: The teleosemanticist's guide
Authors: Bergman Karl Gustav
Published: May 2024

Teleosemantics has an indeterminacy problem. In an earlier publication, I argued that teleosemanticists may afford to be realists about indeterminacy, pointing to the phenomenon of vagueness as a case of really‐existing semantic indeterminacy. Here, I continue that project by proposing two criteria of adequacy that a semantically indeterminate theory should meet: a criterion of theoretical adequacy and a criterion of extensional adequacy. I present reasons to think that indeterminate versions of teleosemantics can meet these criteria. I end by discussing vagueness, concluding that it most likely is not the same kind of phenomenon as the semantic indeterminacy afflicting teleosemantics.
The role of pre‐supplementary motor cortex in action control with emotional stimuli: A repetitive transcranial magnetic stimulation study
Authors: Battaglia Simone , Nazzi Claudio , Di Fazio Chiara , Borgomaneri Sara
Published: May 2024

Swiftly halting ongoing motor actions is essential to react to unforeseen and potentially perilous circumstances. However, the neural bases subtending the complex interplay between emotions and motor control have been scarcely investigated. Here, we used an emotional stop signal task (SST) to investigate whether specific neural circuits engaged by action suppression are differently modulated by emotional signals with respect to neutral ones. Participants performed an SST before and after the administration of one session of repetitive transcranial magnetic stimulation (rTMS) over the pre‐supplementary motor cortex (pre‐SMA), the right inferior frontal gyrus (rIFG), and the left primary motor cortex (lM1). Results show that rTMS over the pre‐SMA improved the ability to inhibit prepotent action (i.e., better action control) when emotional stimuli were presented. In contrast, action control in a neutral context was fostered by rTMS over the rIFG. No changes were observed after lM1 stimulation. Intriguingly, individuals with higher impulsivity traits exhibited enhanced motor control when facing neutral stimuli following rIFG stimulation. These results further our understanding of the interplay between emotions and motor functions, shedding light on the selective modulation of neural pathways underpinning these processes.
Immunohistochemical and transcriptomic characterization of T and myeloid cell infiltrates in canine malignant melanoma
Authors: Cronise Kathryn E. , Coy Jonathan , Dow Steven , Hauck Marlene L. , Regan Daniel P.
Published: May 2024

Immune checkpoint inhibitor therapy can provide significant clinical benefit in patients with certain cancer types including melanoma; however, objective responses are only observed for a subset of patients. Mucosal melanoma is a rare melanoma subtype associated with a poor prognosis and, compared with cutaneous melanoma, is significantly less responsive to immune checkpoint inhibitors. Spontaneous canine tumours have emerged as valuable models to inform human cancer studies. In contrast to human melanoma, most canine melanomas are mucosal—an incidence that may be leveraged to better understand the subtype in humans. However, a more comprehensive understanding of the immune landscape of the canine disease is required. Here, we quantify tumour infiltrative T and myeloid cells in canine mucosal (n = 13) and cutaneous (n = 5) melanomas using immunohistochemical analysis of CD3 and MAC387 expression, respectively. Gene expression analysis using the Canine IO NanoString panel was also performed to identify genes and pathways associated with immune cell infiltration. T and myeloid cell densities were variable with geometric means of 158.7 cells/mm2 and 166.7 cells/mm2, respectively. Elevated T cell infiltration was associated with increased expression of cytolytic genes as well as genes encoding the coinhibitory checkpoint molecules PD‐1, CTLA‐4, TIM‐3 and TIGIT; whereas increased myeloid cell infiltration was associated with elevated expression of protumourigenic cytokines. These data provide a basic characterization of the tumour microenvironment of canine malignant melanoma and suggest that, like human melanoma, inherent variability in anti‐tumour T cell responses exists and that a subset of canine melanomas may respond better to immunomodulation.
Particle verbs versus simplex verbs in Maldivian English
Authors: Bernaisch Tobias , Suad Aishath , Saeed Aminath
Published: May 2024

Notwithstanding current indications that English might soon become the country's dominant L1, the structures of English in the Maldives have—despite laudable exceptions—not yet received sufficient academic attention. The present paper studies the contrast between simplex verbs (e.g. COMPRISE) and their innovative particle–verb alternatives (e.g. COMPRISE of) (a) in a short‐term diachronic database of Maldivian newspaper texts and (b) with the help of acceptability ratings of the forms concerned collected through an online survey. The research questions address the relative frequencies of use of innovative particle verbs as opposed to corresponding simplex verbs, the diachronic variability of these relative frequencies and the degree to which the local speech community accepts innovative verb–particle combinations. While the well‐established simplex verbs constitute the overall dominant structural choices, each of the innovative particle verbs has become more frequent in the course of the 14‐year time period observed. These corpus‐based insights align with the generally high acceptability ratings for the innovative particle–verb constructions evident from the survey data, where young women display the largest degree of acceptance towards the innovative particle verbs.
La dimensión vertical de la metrópolis : surgimiento y evolución de los edificios altos en Bogotá, 1920-2017
Authors: Montenegro Miranda Germán
Published: May 2024

Este libro responde a la necesidad de entender el crecimiento vertical de la ciudad a partir del surgimiento de torres y rascacielos, cuya altura determina exigencias económicas, tecnológicas y funcionales, con grandes efectos tanto en la armadura general, en la que sobresalen grandes brotes de densificación constructiva, como en la pregnancia y significación social de este gigantismo en el paisaje. En concreto, La dimensión vertical de la metrópolis pone el foco en la masa edificada de Bogotá para explicar su crecimiento hacia arriba, desde el siglo pasado hasta el presente (1920- 2017). Para esto, se describen tres ciclos de transformación de la silueta urbana que hablan de un ensamblaje entre la materialidad, los hechos históricos, el conocimiento, las acciones y los actores. Se explora desde la verticalización incipiente que ocultó las cúpulas de iglesias con la erección del primer centro del capitalismo moderno; hasta el auge y declive de las torres y bloques de la modernidad en un paisaje alterado por altibajos, entrantes y salientes que rompieron la rígida morfología colonial del centro; y, finalmente, la proliferación de múltiples alturas de rascacielos y bloques de vivienda que continuaron la redensificación del centro e invadieron la periferia tanto formal como informal. El libro aporta recursos para teorizar la altura edilicia, desde una visión que muestra la materia edificada enredada con las estructuras sociales que la piensan, producen, habitan y demuelen.
Contar: visualizaciones con datos
Authors: Martínez Eraso Camilo Ernesto
Published: May 2024

En un mundo saturado de datos, su visualización se convierte en una herramienta clave para comprender lo que realmente nos están diciendo. Sin embargo, surge una pregunta fundamental: ¿cuántas de las visualizaciones que encontramos diariamente son realmente efectivas? Este libro aborda el desafío de representar la realidad a través de los datos. Se centra en cómo construir un mensaje enriquecedor, diseñar su presentación y narrar la historia detrás de los datos. A lo largo del libro, se proporcionan ejemplos y visualizaciones relevantes para aclarar algunos conceptos y retar al lector a pensar críticamente cómo hacer una visualización con impacto. Más que un manual técnico, este libro es una invitación a explorar y narrar las historias ocultas en los datos, transformando cifras y estadísticas en relatos convincentes y reveladores.
Vuelo sostenido
Authors: Angueyra Estefanía
Published: May 2024

Hay palabras livianas con el peso de un yunque. Los poemas de Estefanía Angueyra son la violencia que esconde la quebrada calma que en invierno baja con la fuerza de un río. Este libro es un vuelo sostenido en el tono, a la vez sobrio y sensual, de la poeta, pero es también una montaña rusa que te levanta, hunde y sosiega: en él caben la muerte, la guerra por la tierra, las heridas patrias, y así mismo caben la vida, las plantas, la infancia, los horrores, los gozos, la burla, el misterio de Dios.
Combined Gas Tungsten Arc Welding and Shielded Metal Arc Welding Processes for Joining Tube to Tubesheet in Shell and Tube Heat Exchangers
Authors: Saffiudeen Mohamed Fayas , Thekkuden Dinu Thomas , Mourad Abdel-Hamid Ismail , Mohammed Fasil T. , Syed Abdullah , Abdulrahman Al-Sayed Khalid , Alamri Yassir A. , Al Qahtani Mohammad N.
Published: May 2024

Flawless tube and tubesheet joints are necessary for shell and tube heat exchanger with high leakproof ability and durability. The consequence of mixing of transfer fluids due to the defective welded or expanded tube-to-tubesheet joint results in complete malfunctioning of the heat exchange process. In this case, there is a high demand for quality assessment of the fabricated tube-to-tubesheet joints (TTS) based on the international standards. Additionally, the literature on assessing the mechanical and metallurgical characteristics of tube-to-tubesheet joints using any one welding technique is available; however, articles dealing with the use of multiple welding techniques are scanty. In the current work, the quality assessment of strength welded and light expanded (3%) tube-to-tubesheet joints followed by light expansion was performed whereas for welding, combined gas tungsten arc welding (GTAW) and shielded metal arc welding (SMAW) as root pass and cap pass were adopted in the fabrication stage. Quality and sound tube-to-tubesheet joints were produced using welding and tube expansion process. Linear and circular indications representing the cracks were absent on the developer in the liquid penetration test. The minimum leak path (MLP) was greater than the two-third of tube wall thickness. The results strongly qualify the use of combined gas tungsten inert gas and shielded metal arc welding process for manufacturing of tube-to-tubesheet joints. The methodology and results in the current article are beneficial for researchers and industrialists working close to shell and tube heat exchangers and boilers.
Tool use promotes dental health
Authors: Klump Barbara C.
Published: May 2024

Using tools increases foraging success in sea otters and protects their teeth from damage
In Other Journals
Authors: Walia Ankit , McCartney Melissa , Lopez Bianca , Jiang Di , Suleymanov Yury , Szuromi Phil , Simonti Corinne N.
Published: May 2024

Editors’ selections from the current scientific literature
Why are elite athletes prone to heart arrhythmias?
Authors: Couzin-Frankel Jennifer
Published: May 2024

Studying cardiac effects of extreme exercise could yield clues to atrial fibrillation
Adaptive attenuation of virulence in hypervirulent carbapenem-resistant
Klebsiella pneumoniae
Authors: Teng Gaoqin , Zhang Meng , Fu YingYing , Yang Xiaoqiang , Kang Yanhua , Qin Qiuying , Jin Ye , Huang Man , Xu Yongchang
Published: May 2024

The emergence of nosocomial infections caused by hypervirulent and carbapenem-resistant
K. pneumoniae
(hv-CRKP) has become a significant public health challenge. The genetic traits of virulence and resistance plasmids in hv-CRKP have been extensively studied; however, research on the adaptive evolution strategies of clinical strains inside the host was scarce. This study aimed to understand the effects of antibiotic treatment on the phenotype and genotype characteristics of hv-CRKP. We investigated the evolution of hv-CRKP strains isolated from the same patient to elucidate the transition between hospital invasion and colonization. A comparative genomics analysis was performed to identify single nucleotide polymorphisms in the
rmpA
promoter. Subsequent validation through RNA-seq and gene deletion confirmed that distinct
rmpA
promoter sequences exert control over the mucoid phenotype. Additionally, biofilm experiments, cell adhesion assays, and animal infection models were conducted to illuminate the influence of
rmpA
promoter diversity on virulence changes. We demonstrated that the P12T and P11T promoters of
rmpA
possess strong activity, which leads to the evolution of CRKP into infectious and virulent strains. Meanwhile, the specific sequence of polyT motifs in the
rmpA
promoter led to a decrease in the lethality of hv-CRKP and enhanced cell adhesion and colonization. To summarize, the
rmpA
promoter of hv-CRKP is utilized to control capsule production, thereby modifying pathogenicity to better suit the host’s ecological environment.

IMPORTANCE

The prevalence of hospital-acquired illness caused by hypervirulent carbapenem-resistant
Klebsiella pneumoniae
(hv-CRKP) is significant, leading to prolonged antibiotic treatment. However, there are few reports on the phenotypic changes of hv-CRKP in patients undergoing antibiotic treatment. We performed a comprehensive examination of the genetic evolutionary traits of hv-CRKP obtained from the same patient and observed variations in the promoter sequences of the virulence factor
rmpA
. The strong activity of the promoter sequences P11T and P12T enhances the consistent production of capsule polysaccharides, resulting in an invasive strain. Conversely, weak promoter activity of P9T and P10T is advantageous for exposing pili, hence improving bacterial cell attachment ability and facilitating bacterial colonization. This finding also explains the confusion of some clinical strains carrying wild-type
rmpA
but exhibiting a low mucoid phenotype. This adaptive alteration facilitates the dissemination of
K. pneumoniae
within the hospital setting.
The shifts in intergenerational relations in Cameroon and their potential impact on the health of older adults
Authors: Gouttefarde Pauline , Gay Elsa , Guyot Jessica , Kamdem Odette , Socpa Antoine , Tchundem Guylène , Dupré Caroline , Nkenfou Céline , Bongue Bienvenu , Barth Nathalie , Adam Stéphane
Published: May 2024

Introduction

Africa is experiencing a gradual demographic shift due to rising life expectancy and increasing urbanisation. In sub-Saharan Africa, elderly individuals typically reside with their children. The rise in life expectancy by almost a decade and the prevalence of precarious living conditions raise concerns about the sustainability of the healthcare system, which has traditionally relied on intergenerational solidarity.

Methods

The research aims to analyse the evolving role of older adults in Cameroonian society and to examine the potential impact of this change on intergenerational relationships and the health of older adults. A qualitative methodology was employed, using intergenerational focus groups in Cameroon.

Results

Traditionally, older adults held a central role in knowledge transmission through discourse. However, the modernisation of society is challenging this position.

The emergence of new technologies, particularly communication tools, is leading to a questioning of older adults’ experiential knowledge. Societal changes are contributing to a decline in respect for older adults in discourse. Older adults deplore these societal changes and fear for their place in society while young people are questioning the central role of older people in society.

Discussion

These changes could reduce the sense of usefulness of older people, with negative consequences for their health. Several studies have highlighted the impacts of ageism on the health of older adults in industrialised countries. However, there are little data on the impact of the marginalisation of older adults on their health in industrialising societies. Further research is needed to study the impact on the health of older adults.
Recreational nitrous oxide and thrombotic events: a case series
Authors: Patyjewicz Marta , Mair Devan , Zaloum Safiya A , Onen Barbara , Walton Joseph , Dobson Ruth , Joerres Christine , Shah Apeksha Madhusudan , MacCallum Peter , Massey Thomas H , Bariana Tadbir , White Veronica , De Freitas Sarah A , Noyce Alastair
Published: May 2024

Background

The study aimed to elucidate the prevalence of nitrous oxide (N2O) usage in patients with unexplained venous thromboembolism (VTE), highlighting the potential association with hyperhomocysteinaemia (HHcy).

Methods

We conducted a retrospective study at the Royal London Hospital, examining cases of N2O-related VTE from March to August 2023. Among 50 patients identified, four (8%) had recent unprovoked VTE. Patient data were collected based on N2O ambulatory emergency care pathway admissions.

Results

Among the 50 patients identified, four (8%) had recent or concurrent VTE. Three were male (75%), with an ethnic distribution of 50% Asian or Asian British and 50% Black or Black British. Patients were distributed across quintiles of the index of multiple deprivation. All had actual or functional vitamin B12 deficiency.

Discussion

The association between N2O use and VTE requires further investigation, though a plausible mechanism involving HHcy has been proposed. Clinicians should be vigilant for VTE in N2O users, especially those presenting with unexplained symptoms. VTE prophylaxis may be worth considering, particularly if continued exposure to nitrous oxide is anticipated.

Conclusion

N2O misuse may increase the risk of VTE, warranting attention from healthcare providers. Further research is needed to elucidate this association and inform preventive strategies. Public awareness about the risks of N2O remains essential.
Oral Chinese herbal medicine for psoriasis vulgaris: protocol for a randomised, double-blind, double-dummy, multicentre clinical trial
Authors: Deng Jingwen , Yao Danni , Lu Chuanjian , Wen Zehuai , Yan Yuhong , He Ziyang , Wu Huimei , Deng Hao
Published: May 2024

Introduction

Psoriasis vulgaris is a common skin disease that is characterised by persistent localised erythematous scaly plaques. Yinxieling is a Chinese herbal formula for psoriasis that has been used for more than 20 years in China. To facilitate application, PSORI-CM01 was developed based on the optimisation and simplification of Yinxieling tablets performed in a previous study and in clinical practice. However, the scientific evidence regarding whether PSORI-CM01 is more effective for psoriasis than the original Yinxieling remains insufficient. Therefore, we designed a randomised clinical trial to investigate the effect, safety and cost-effectiveness of PSORI-CM01 granules compared with those of Yinxieling tablets for the treatment of patients with psoriasis.

Methods and analysis

This ongoing study is a two-arm parallel, randomised, double-blind, double-dummy clinical trial. Five hundred and fifty-six participants with psoriasis will be recruited and then randomly allocated into two groups in a 1:1 ratio. Participants in PSORI-CM01 group will receive a 5.5 g granule of PSORI-CM01 two times daily and five placebo tablets three times daily for 12 weeks. The participants in the Yinxieling group will receive five Yinxieling tablets three times daily and a placebo granule two times daily for 12 weeks. The primary outcome is the reduction of the Psoriasis Area and Severity Index. The secondary outcomes include relapse rate, Visual Analogue Scale scores, body surface area and the Dermatology Life Quality Index. Cost-effectiveness analysis will be performed from a health and community care provider perspective.

Ethics and dissemination

This research protocol had been reviewed and approved by the institutional review boards of three trial centres (Guangdong Provincial Hospital of Chinese Medicine (B2014-026-01), Affiliated Hospital of Tianjin Chinese Medicine Academy (2014-KY-001) and Third Hospital of Hangzhou (B2014-026-01)). The findings will be disseminated to the public through conference presentations and open-access journals.

Trial registration number

Chinese Clinical Trial Registry (ChiCTR-TRC-14005185); Pre-results.
100: PROFESSIONAL VALUES OF THE NURSING STUDENTS' PERSPECTIVE: DO NURSING EDUCATION PREPARE STUDENTS FOR APPLYING OF PROFESSIONAL VALUES IN CLINICAL PRACTICE?
Authors: Poorchangizi Batool , Farokhzadian Jamileh , Borhani Fariba , Abbaszadeh Abbas , Mirzaee Moghaddameh
Published: May 2024

Background and aims:

Professional values of undergraduate nursing students are considerably to changes made by educational programs. Therefore, this is important to integrate professional values in nursing curricula and study about professional values of nursing students in applying them in their professional future. The aim of this study was to examine the professional values from perspective undergraduate nursing students.

Methods:

This study was a descriptive-analytical research. A total of 100 undergraduate nursing students by stratified random sampling participated from a university in Kerman, Iran in 2016. Data were collected by Persian version of the Nurses Professional Values Scale-Revised (NPVS-R) Weis and Schank. Data analyzed by SPSS version 19.

Results:

The findings showed that student's mean score of professional values were high (101.79±12.42). The four most important professional values identified by students were maintaining confidentiality of patients, safeguarding patients' right to privacy, assuming responsibility for meeting health needs of the culturally diverse population, maintain competency in area of practice and accepting responsibility and accountability for own practice. The four least important values include participating in public policy decisions affecting distribution of resources, participating in peer review, recognizing role of professional nursing associations in shaping healthcare policy and participating in nursing research and/or implement research findings appropriate to practice. Score of values had statistically significant relationship with classroom grade average and economic status of family of students (P<0.05).

Conclusion:

The high total score students' professional values could indicate impact of education and role of educators in formation and instillation of professional values in classrooms and clinical settings. Regarding low importance of some values for undergraduate nursing students, this is necessary to institutionalize comprehensive of professional values in nursing students as future nurses.
103: PSYCHOMETRIC PROPERTIES OF THE PERSIAN VERSION OF THE PATIENT SATISFACTION QUESTIONNAIRE
Authors: Nouri Mahdi , Ghaffarifar Saeideh , Bazargani Homayoun Sadeghi , Ghaffari Reza
Published: May 2024

Background and aims:

to explore the psychometric properties of the Persian version of the Patient Satisfaction Questionnaire (PSQ).

Methods:

In this cross-sectional study in 2015, the psychometric properties of the Persian version of the PSQ were determined by participation of 10 patients, 14 experts and 488 residents. Impact score, content validity index, content validity ratio of the items were calculated. Construct validity and reliability of the scale were examined conducting exploratory factor analysis and Cronbach's Alpha and Inter class correlation coefficient (ICC), respectively, using STATA, version 13. This research project was approved by the Ethics Committee of Tabriz University of Medical Sciences.

Results:

Based on the findings, questionnaire had: CVI=0.94, CVR=0.84, Impact Score=4.61, Cronbach's Alpha=0.93 and ICC=0.513 (Sig.0.00). A single factor was identified according to the eigenvalue distribution of PSQ. That factor could predict about 93% of the variance.

Conclusion:

Persian version of PSQ had satisfactory reliability and validity, as well as adequate feasibility based on the field results. Medical teachers and managers at every Persian-speaking country can reliably evaluate residents' communication skills, applying the Persian version of PSQ.
117: THE ASSESSMENT OF PERFORMANCE AND EFFICIENCY OF TEHRAN PUBLIC AND PRIVATE HOSPITALS IN 2015
Authors: Forootan Sara , Forootan Mohammad Reza , Mousazadeh Yalda
Published: May 2024

Background and aims:

The presence or absence of efficient performance assessment system is directly related to the organizations life or death. Because of Hospitals importance role in community health the need to assess the performance and efficiency improvement feels more than others and to assess health care units quantitative indicators were used. The proper techniques for comparing hospitals performance based on three indicators of bed occupancy rate, average length of stay, bed occupancy turnover, is “PABON LASSO” graphical models. The aim of this study was The Assessment of Performance and Efficiency of Tehran Public and Private Hospitals by Pabon Lasso Model in 2015.

Methods:

This cross-sectional descriptive study was carried out in 16 public and private hospitals in Tehran in 2015.Pabon Lasso model was used and to analysis of data spss 18.0 was applied.

Results:

The average of bed occupancy rate, length of stay and bed turnover rate in hospitals were respectively 58.46%, 3.84 days and 64.51 per year. In this study, three hospitals in the first region, five hospitals in the second region, two hospitals in third region and six hospitals were located in the fourth region. Just two hospitals were efficient.

Conclusion:

Results of this study indicated that only two hospitals (12.5% from a total of 16 hospitals) had the desired performance. In conjunction with hospitals that are located in the first region, manager's serious act to analyzing the root causes of poor performance and corrective actions to optimize the use of limited resources is necessary.
123: THE EFFECT OF 12 WEEKS AEROBIC TRAINING WITH MODERATE TO SEVERE INTENSITY ON SERUM TNF-α AND INSULIN RESISTANCE IN MALES WITH TYPE II DIABETES
Authors: Eizadi Mojtaba
Published: May 2024

Background and aims:

Clinical studies support the role of inflammatory mediators in the relationship between obesity with insulin resistance and type2 diabetes. This study aimed to determine the effect of long term aerobic training program on serum levels of Tumor necrosis factor-alpha (TNF-α) and insulin resistance in males with type II diabetic.

Methods:

For this purpose, thirty inactive adult obese men with type II diabetes were participated in study by accessible samples and divided into experimental (n=15) and control (n=15) groups by randomly. Then experimental subjects were participated in three months aerobic training program (3 times weekly) at 60–75 (%) of maximal heart rate and subjects in control group continued inactive lifestyle. To determine the effect of training program on serum TNF-α, fasting glucose and insulin resistance, fasting blood samples were collected before and 48 hours after lased exercise session. Independent T test used to compare variables between two groups at baseline paired T test to determine the effect of training program on independent variables.

Results:

serum TNF-α did not significant change by three months aerobic training (p=0.83). Fasting glucose and insulin resistance decreased significantly after exercise program when compared with baseline (p<0.05).

Conclusion:

despite improved glucose and insulin resistance, three months aerobic training does not affect serum TNF-α in type II diabetes patients. Therefore, improved insulin resistance and glucose can be attributing to the change in other hormonal or inflammatory mediators in response to exercise program.
138: THE EVALUATION OF CONCENTRATION OF CALPROTECTIN, IN PLEURAL FLUID WITH CAUSES OF EXUDATIVE PLEURAL EFFUSION IN THE PATIENTS REFERRED TO SHAHID SAYYAD SHIRAZI HOSPITAL OF GORGAN IN 2014
Authors: Asgharzade Ali Zhiani , Mostafavi S , Zare M , Abbasi F , Karimi M , Kiani M , Mehrjerdian M
Published: May 2024

Background and aims:

Nowadays, routine invasive techniques to diagnose the causes of exudative pleural effusion are going to be replaced by new noninvasive methods such as biomarkers which with the same diagnostic accuracy can confirm malignant situations at least in a group of cases who do not need more invasive means.

Methods:

In this descriptive-analytical and case-control study, the calprotectin concentrations in pleural fluid was evaluated in 90 patients with exudative pleural effusion, and compared among two groups Including 34 patients with malignant pleural effusion (MPE) and 56 patients with benign pleural effusion (BPE). All patients underwent examination and the necessary laboratory tests were done and Closed pleural biopsy was performed if necessary. Collected Data were analyzed by SPSS-21statistical software and chi-square, t-test, ANOVA and logistic regression analysis.

Results:

Calprotectin concentration was (107.72±10.59) in patients with malignant causes and (114.42±23.95) in others. Calprotectin concentration was (122.34±27.03) in patient with TB. The results showed that this difference was statistically significant (p=0.05) and calprotectin rate, is lower in the malignant pleural effusion. Especially, when the results were compared with patients with TB, this difference was more prominent (p=0.01).

Conclusion:

According to higher levels of calprotectin in tuberculous pleural effusions, maybe we can achieve important results in differentiating between malignant and non-malignant pleural exudate, without the need for invasive procedures, by putting together the clinical symptoms, the calprotectin concentration in pleural fluid and pleural fluid cytology results.