bluuebunny/crossref_metadata_2025 huggingface dataset:
Aproximação teórica do conceito de Cuidado Centrado na Pessoa: Uma revisão integrativa da literatura
Authors: Ribeiro Rodrigo Verzeletti , Signor Eduarda , Forgiarini Giorgio
Published: October 2023

Estudo de revisão integrativa da literatura que relaciona ao conceito do Cuidado Centrado na Pessoa. Objetivou-se identificar a produção de artigos científicos do tema reconhecendo elementos centrais do conceito, características dos usuários e serviços de saúde que desenvolvem esse tipo de cuidado. Realizou-se no período de janeiro de 2014 a dezembro 2019, nas bases de dados LILACS, PubMed e Scielo. A amostra foi constituída por 12 artigos. O Cuidado Centrado na Pessoa possui conceito multidimensional, ainda não bem definido na literatura científica. Identificou-se como elementos centrais do conceito: cuidado que respeite as preferências das pessoas; que inclui as pessoas nas decisões clínicas e que exige a empatia profissional, para melhorar a comunicação entre usuário-profissional e aumentar o vínculo para a adesão à terapêutica. Identificaram-se nos artigos que os locais de estudo foram unidades de atenção básica, serviços de referência e hospitais que atendiam idosos, gestantes e pacientes com condições crônicas.
Avaliação do efeito de acabamento na rugosidade superficial da madeira de Paricá (Schizolobium amazonicum Huber ex Ducke)
Authors: Santos Jorge Artur , Reis Keliane de Jesus , Santos Lara Soares Ribeiro dos , Vieira Isadora Luz Silva Moreira , Lima Márcio Ricardo Nascimento , Silva Mariane , Andrade Anna Carolina de Almeida
Published: October 2023

A crescente demanda da sociedade por produtos madeireiros torna a busca pelo conhecimento acerca das espécies plantadas cada vez mais indispensável, uma vez que estas diminuem a pressão exercida sob as florestas nativas. Desta forma, o presente trabalho pretendeu investigar características da rugosidade da madeira de Paricá (Schizolobium amazonicum), através dos parâmetros Ra e Rz, após as peças serem submetidas ao processo de lixamento com lixas de distintas granulometrias, variando entre 80 e 600 grãos, para assim destiná-las ao seu melhor uso. Para tal, foi utilizado o aparelho rugosímetro de arraste, modelo SURFTEST SJ-210. Os resultados obtidos foram analisados pelo programa estatístico SISVAR, onde foi realizada a análise de variância (ANOVA) e o teste de Scott & Knott, ambos à 5% de significância. Desta forma, foi observado a melhor relação rugosidade e acabamento após a sequência de lixas de 80 –120 – 220 – 400 grãos. Nesse caso, obteve valores médios de 0,9222 μm e 4,6766 μm, para os parâmetros Ra e Rz, respectivamente. Assim, é concluído que a madeira de Paricá, quando devidamente tratada, torna-se fonte praticável para a geração de painéis laminados devido aos baixos valores de rugosidade obtidos, fato que possibilita maior contato entre as lâminas de madeira, aumentando ainda a aderência de colas e evitando assim maiores desperdícios.
Uso de células-tronco em cirurgia plástica: Uma revisão integrativa de literatura
Authors: Carvalho Bruna Damas de , Saad Jhamile , Branco Taynna Feitosa Araújo , Castanheiro Henrique de Santana , Cruz Marina Vieira , Mustafá Yasmin Rodrigues , Entler Talita , Santos Julia Duran Andre dos , Silva Amanda Colares Soares , Leite Gabriela do Nascimento
Published: October 2023

O presente artigo propõe uma discussão acerca das perspectivas do uso de células-tronco em cirurgia plástica, por meio de uma revisão bibliográfica bastante detalhada. As células-tronco (SC) são caracterizadas por serem indiferenciadas ou não especializadas, possuírem a capacidade de se autorrenovar e se diferenciar em vários tipos celulares (multilinhagem), do mesmo tecido e de tecidos diferentes com funções distintas. Diante dos estudos analisados entendemos que as células-tronco derivadas do tecido adiposo são um avanço na cirurgia plástica, já que, elas são capazes de se diferenciarem em vários outros tecidos, sendo muito eficiente em cirurgias estéticas e reparadoras. Foi encontrado que quando enxertadas, também favorecem na angiogênese, acelerando o processo de cicatrização e aumentando a taxa de sucesso do procedimento. Ademais, por ser transplante autólogo apresenta baixo risco de rejeição e transmissão de doenças em comparação a possíveis fontes de células-tronco exógenas. Porém, foi discutido por diversos profissionais da área sobre a importância da utilização dessa técnica por profissionais capacitados, demonstrando a necessidade do estudo e conhecimento da técnica por parte dos cirurgiões plásticos, para que assim sejam estabelecidos confiança e sucesso no procedimento.
Assistência de enfermagem á gestantes de alto risco
Authors: Santos Celiane Veras dos , Araújo Danielle Soares de , Pachêco Laylla Mayara Portela , Soares Maria Helena Lopes , Gomes Maria Ivanilde de Sousa , Araújo Raquel Vilanova
Published: October 2023

Objetivo: O presente estudo tem o objetivo de descrever a assistência do enfermeiro sobre as principais formas de prevenção, diagnóstico e tratamento da gestação de alto risco. Metodologia: A pesquisa trata-se de uma revisão integrativa da literatura, que consiste na construção de uma análise abrangente de dados provenientes da literatura, sendo utilizados como auxílio para discussões sobre métodos e resultados de pesquisas, além de conter inúmeras definições de conceitos, revisão de teorias e evidências e análise de problemas metodológicos, ocasionando uma reflexão sobre a realização de estudos futuros. Resultados: A amostra final resultou em 11 artigos. Discussão: Portanto, foi observado como é importante envolver a conduta de assistência ao pré-natal, em prol da detecção de patologia por meio dos exames específicos e como o processo de cuidado da enfermagem, pode auxiliar de forma positiva na assistência qualificada e integral às gestantes. Conclusão: Os enfermeiros atuam de forma sistematizada, com o objetivo de desenvolver uma boa comunicação, ofertando as informações necessárias de maneira clara e compreensível. No qual, o cuidado é imprescindível para que haja uma mudança comportamental efetiva. Neste contexto, conclui-se a importância da aplicação no processo de enfermagem baseado na teoria do autocuidado, facilitando o empoderamento da gestante no seu cuidado, no enfrentamento da ansiedade e na diminuição da insegurança. A pesquisa, contribuirá no desenvolvimento de novos estudos, com o objetivo de promover uma assistência de qualidade a gestante e o nascimento do seu filho.
Projeto Educação e Prevenção em Saúde Bucal: um relato de experiência em uma escola na Ilha de Cotijuba-PA, Brasil
Authors: Leite Lilia Nazaré de Oliveira , Silva Jorge Ederson Araújo da , Cunha Yolanda Maria Alencar Lima
Published: October 2023

A saúde bucal é fundamental para atividades básicas como falar, comer, sorrir, demonstrar emoções, entre outras. Afetando-se essas capacidades básicas, interfere-se diretamente na autoestima, bem-estar e a saúde em geral, o que pode implicar em baixo desempenho e frequência escolar. A partir do olhar dos autores, percebeu-se uma necessidade de ações relacionadas à saúde bucal, bem como tema de discussão e contextualização no espaço escolar. Aqui relatamos a vivência da prática educativa realizada no projeto ‘Educação e Prevenção em Saúde Bucal’, cujo objetivo foi promover a saúde bucal em uma escola na ilha de Cotijuba, PA. O método utilizado neste trabalho foi o Relato de Experiência. Foram desenvolvidas práticas pedagógicas nas quais os alunos puderam fortalecer a cultura do cuidado com a saúde bucal, dentre elas: contação de histórias, rodas de conversa, dinâmicas envolvendo hábitos e cuidados de saúde bucal, e culminância do projeto foi a escovação supervisionada dos dentes. Os temas relacionados à Educação em Saúde Bucal foram discutidos em sala de aula proporcionando aos alunos ampliação de conhecimentos sobre a saúde bucal. As ações desenvolvidas são fundamentais para educação em hábitos benéficos à saúde bucal coletiva, contribuindo para o diálogo sobre os cuidados básicos com a saúde para prevenção de doenças.
Satanic Rituals in Spanish Horror Films and the Franco Dictatorship
Authors: Tiburcio Erika
Published: October 2023

Spanish horror films set in the late Franco period are a highly successful genre. However, academics have criticised its study, arguing that such films are of low quality. Nevertheless, the genre is a fundamental cultural source for understanding how fiction interacts with a society’s fears as it undergoes a profound transformation. This article aims to analyse the ways rituals were represented as allegorical figures of the anxieties and conflicts in the final years of Francisco Franco’s dictatorship (1968–1975). On the one hand, we will examine the three main discourses that were instrumental to the founding of monstrous cults based on gender, class and nationalism. On the other hand, we will analyse the intermingling of political violence and modernisation through the performance of rituals. Satanic rituals served as visual metaphors for a reality constructed from the Manichaean vision of Catholicism and the exclusionary nationalism of Francoism imposed through political violence.
Clinical significance of anemia in chronic heart failure in patients infected with human immunodeficiency virus
Authors: Goryacheva O. G.
Published: October 2023

Anemia, as the most common hematological complication of HIV infection, is one of the key indicators of its severity and a predictor of death from its complications. Within 3 years, 240 patients with HIV infection were examined in a multidisciplinary hospital. In the examined group, 160 (66.60 %) people had clinical, instrumental and laboratory signs of CHF. Among them, 94 patients (58.75 %) had anemia of varying severity. The presence of CHF 2.75 times increases the chances of developing anemia in HIV-infected people. The development of anemia is associated with the development of CKD stage 3A and above, an increase in the volume of the left atrium, the development of diastolic dysfunction of the left ventricle and severe CHF with a concentration of NT-proBNP ≥ 1500 pg/ml in blood plasma. In patients with CHF and HIV infection, determining the concentration of NT-proBNP ≥ 170 pg/ml is associated with the development of anemia, which gives this test additional clinical significance. Reduced transferrin less than 200 mg/dl 10.99 times increases the chances of developing severe CHF with NT-proBNP ≥ 1500 pg/ml, which makes it recommended to determine the level of serum transferrin in all patients with HIV infection and CHF in order to predict the development of severe CHF with NT-proBNP ≥ 1500 pg/ml.
PENGUKURAN KUALITAS PELAYANAN PROGRAM PENGUNGKAPAN SUKARELA (PPS) DENGAN METODE SERQUAL-HOQ
Authors: Kusuma Yudha Adi
Published: October 2023

Pelayan publik memberikan kontribusi dalam hal pelayanan masyarakat. Salah satu bentuk program pelayanan publik yaitu Program Pengungkapan Sukarela (PPS). Kegiatan PPS juga dilakukan pada KP2KP. Pelaksanaan PPS dilakukan antara 1 januari 2022 sampai 30 juni 2022. Selama pelaksanaan PPS jumlah masyarakat yang terlibat jauh dari jumlah yang diinginkan. Pada penelitian ini dilakukan pengukuran terhadap kulaitas pelayanan pada kegiatan PPS di KP2KP XYZ. Jumlah responden yang menjadi objek observasi berjumlah 150 yang mana itu semua total peserta PPS. Peran responden untuk mengisi 2 kuisioner yaitu kuesioner pendahuluan dan kuesioner inti. Hasil kuesioner kemudian diolah dengan metode SERQUAL-HOQ. Hasil pengujian terkait persepsi dan harapan menunjukkan hasil valid (r hitung > r tabel) dan reliabel (cronbach α > 0,6). Hasil gap tertinggi antara persepsi dan harapan adalah akurasi waktu dalam pelayanan dengan nilai mencapai 0,3. Hasil analisis HoQ terbentuk 18 atribut dari VoC. Pengembangan atribut VoC terbentuk 5 kriteria dari technical response. Nilai absolute importance tertinggi dari technical response berada pada ketepatan waktu pelayanan dengan nilai 135,43.
Numerical study of critical straight, frown, and chevron incisions in small incision cataract surgery
Authors: Han Yang , Qi Nan
Published: October 2023

Introduction: When an intraocular lens (IOL) injector is inserted through a pre-cut corneal incision (e.g., an empirical size of 2.2 mm) during small incision cataract surgery, uncontrollable tearing to the corneal tissue may occur, which is highly associated with the incision shape, size, and location. The goal of this numerical study was to investigate the optimal incision scheme amongst three typical shapes, i.e., straight, frown, and chevron incisions using mechanical modeling and finite element analysis.

Methods: Assuming that the damage is caused by the tissue fracture at the incision tips and is governed by the classical energy release rate (ERR) theory which compares the current ERR value subject to IOL injection and the material’s intrinsic parameter, critical ERR Gc.

Results: It was found that for chevron incisions, the incision shape with an angle of 170° was superior which induced minimal ERR value, while for frown incisions, the shape with a central angle of 6° was optimal. Both chevron and frown incisions could allow a larger size of injector to inject through than a straight pre-cut. In particular, the frown incision performed the best due to its lowest corresponding ERR and easy operation.

Discussion: It was also observed that regions where the embedded fibrils are more dispersed and exhibit high isotropy were more favorable. If necessary, the chevron incision was recommended to be more aligned with the direction exhibiting a larger modulus, for example, along the circumferential direction near the limbus. This study provides useful knowledge in operation design and a deep insight into mechanical damage to corneal wounds in small incision cataract surgery.
External magnetic field-induced circularly polarized luminescence and electroluminescence from optically inactive thermally activated delayed fluorescence material 4CzIPN
Authors: Kuroda Takumi , Kitahara Maho , Yagi Shigeyuki , Imai Yoshitane
Published: October 2023

An achiral optically inactive organic luminophore, 4CzIPN, exhibits circularly polarized thermally activated delayed fluorescence when photoexcited under an external magnetic field. By embedding this luminophore in an active emission layer, an external-magnetic-field-induced circularly polarized electroluminescent device is developed in this study. The Faraday geometry of the applied magnetic field completely controls the direction of rotation of 4CzIPN-derived circularly polarized luminescence and electroluminescence.
Case report of snaring-assisted TAVR under cerebral embolic protection: the “Chaperone” with “Top Hat” technique
Authors: Medda Massimo , Casilli Francesco , Bande Marta , Tespili Maurizio , Donatelli Francesco
Published: October 2023

Symptomatic severe aortic stenosis (AS) in patients with intermediate-to-high surgical risk is currently being treated with transcatheter aortic valve replacement (TAVR). We present a case of a TAVR in a severe calcific AS with porcelain aorta and ‘gothic’ aortic arch. Pre-operative thoraco-abdominal computed tomography angiography showed also severe calcification at the sinotubular junction with protruding huge calcified nodules extending in ascending aorta and multiple calcific stenosis of both iliac-femoral vessels, severely tortuous. The choice of the interventional access was not easy and the high risk of an acute intra-procedural brain event guided the procedural planning. To our knowledge, this is the first case of TAVR with complete cerebral protection with Triguard system device and ‘snaring-assisted’ valve advancement.
Case Report: Optical coherence tomography to guide PCI of iatrogenic injury of the circumflex artery after minimally invasive mitral valve repair
Authors: Borzanovic Dusan , Ilic Ivan , Nikolic Dusan , Stojanovic Ivan
Published: October 2023

We present a case of a 42-year-old man who suffered an iatrogenic injury to his left circumflex (Cx) coronary artery after mitral valve (MV) repair surgery. After the patient suffered from myocardial infarction without ST-segment elevation following minimally invasive MV surgery, we performed repeated coronary angiography and optical coherence tomography (OCT), which revealed severe coronary stenosis of the dominant Cx caused by intramural hematoma. In addition, we proceeded with percutaneous coronary intervention and stent implantation.
Induction immunosuppression and post-transplant diabetes mellitus: a propensity-matched cohort study
Authors: Gupta Suruchi K. , Mostofsky Elizabeth , Motiwala Shweta R. , Hage Ali , Mittleman Murray A.
Published: October 2023

Introduction

Post-transplant diabetes mellitus (PTDM) is a common complication among cardiac transplant recipients, causing diabetes-related complications and death. While certain maintenance immunosuppressive drugs increase PTDM risk, it is unclear whether induction immunosuppression can do the same. Therefore, we evaluated whether induction immunosuppression with IL-2 receptor antagonists, polyclonal anti-lymphocyte antibodies, or Alemtuzumab given in the peri-transplant period is associated with PTDM.

Methods

We used the Scientific Registry of Transplant Recipients database to conduct a cohort study of US adults who received cardiac transplants between January 2008-December 2018. We excluded patients with prior or multiple organ transplants and those with a history of diabetes, resulting in 17,142 recipients. We created propensity-matched cohorts (n=7,412) using predictors of induction immunosuppression and examined the association between post-transplant diabetes and induction immunosuppression by estimating hazard ratios using Cox proportional-hazards models.

Results

In the propensity-matched cohort, the average age was 52.5 (SD=13.2) years, 28.7% were female and 3,706 received induction immunosuppression. There were 867 incident cases of PTDM during 26,710 person-years of follow-up (32.5 cases/1,000 person-years). There was no association between induction immunosuppression and post-transplant diabetes (Hazard Ratio= 1.04, 95% confidence interval 0.91 – 1.19). Similarly, no associations were observed for each class of induction immunosuppression agents and post-transplant diabetes.

Conclusion

The use of contemporary induction immunosuppression in cardiac transplant patients was not associated with post-transplant diabetes.
Association of cholecystectomy with osteoporosis risk: a prospective study using data from the UK Biobank
Authors: Yang Qin , Wang Ming , Zhang Tongtong , Wen Jun , Long Lu , Xia Congying
Published: October 2023

Objective

To investigate whether prior cholecystectomy is associated with incident osteoporosis.

Background

Cholecystectomy may have consequences involving abnormal metabolism. Studies investigating the association between prior cholecystectomy and osteoporosis have yielded inconsistent results.

Methods

In total, 17,603 UK Biobank participants underwent cholecystectomy, and 35,206 matched controls were included in this study. They were followed up for incident osteoporosis, which was determined using ICD-10 codes (M80–82). The association between cholecystectomy and osteoporosis was assessed using Cox proportional regression modeling. The association between osteoporosis risk and cholecystectomy was further analyzed across age, sex, serum vitamin D level, and body mass index (BMI) categories.

Results

Within a median follow-up period of 13.56 years, 3,217 participants were diagnosed with osteoporosis. After adjustment for relevant confounders, prior cholecystectomy was associated with a 1.21 times higher risk of osteoporosis in women (hazard ratio (HR): 1.21 [95% CI, 1.12–1.31], p < 0.001) and a 1.45 times higher risk in men (HR: 1.45 [95% CI, 1.10–1.90], p = 0.007). In women, the association was stronger for patients who were aged 40–55 years, with BMI < 18.5 kg/m2, and vitamin D between 30 and 50 nmol/ml. No significant interactions between cholecystectomy and income level, education level, presence of hypertension, or diabetes were identified in either sex.

Conclusions

Our findings indicated that people who underwent cholecystectomy had a higher risk of developing osteoporosis after adjustment for potential confounders. Our findings suggest that awareness of the risk of osteoporosis in patients with a history of cholecystectomy is merited.
A resilience-oriented multi-stage operation strategy for distribution networks considering multi-type resources
Authors: Yao Fuxing , Miao Shihong , Wang Tingtao , Chen Chiyao , Wang Jiaxu , Wei Wenrong
Published: October 2023

With the increasing severity of global warming and the rapid evolution of cyber-attack techniques, the enhancement of distribution network (DN) resilience that can effectively cope with natural disasters and man-made attacks has received extensive attention. Hence, in the context of a high impact low probability (HILP) event where attackers launch malicious attacks after a natural disaster occurs, a multi-stage DN operation strategy for resilience enhancement is proposed considering multi-type resources, such as gas turbines, stationary energy storage systems, mobile energy storage systems (MESSs), repair crews (RCs) and network reconfiguration. Firstly, the operation process of DN is divided into five stages based on the time lag between the natural disaster and the man-made attacks: the normal operation stage, the disaster disruption stage, the post-disaster degradation stage, the man-made attack stage and the defense and recovery stage. Secondly, under the background of a coupled power-transportation system, the optimal scheduling model for each stage of DN is established considering the effects of dynamic changes in traffic flow on the movement process of MESSs and RCs. Finally, the model is converted into a 5-layer mixed integer linear programming (MILP) problem that can be solved by sophisticated optimization software according to the time series relationship, and a case study is carried out with a modified IEEE 33-node system and the corresponding transportation network. The results demonstrate that under extreme scenarios, the proposed model can guarantee the load-side power supply as much as possible through flexible cooperation between multi-type resources, effectively enhancing the resilience of the DN.
Effect of natural enemies on the invasion of the exotic plant buffalobur (Solanum rostratum Dunal.) in the arid oasis of Urumqi
Authors: Jian-Xiao He , Yimingniyazi Amanula
Published: October 2023

Studying the interspecific relationships of exotic species can provide an important theoretical basis for revealing the invasion processes of exotic species, predicting the scope and harm of proliferation, and, subsequently, suggesting reasonable prevention and control measures. Buffalobur (Solanum rostratum Dunal.) is a typical alien invasive plant that causes significant harm in the oasis of the arid region of Xinjiang, being primarily distributed on both sides of the Toutun River and irrigated farmland. Parasitic dodders (Cuscuta australis R. Br.), in addition to phytophagous insects, such as potato beetles (Leptinotarsa decemlineata (Say)), and cotton bollworms (Helicoverpa armigera (Hubner)), that fed on the buffalobur plant were observed to be distributed in the field. In order to explore the impact of dodder parasitism and insect feeding on buffalobur invasion, buffalobur was selected as the main research material in this study. The effects of different degrees of parasitism (non-parasitism, mild parasitism, and severe parasitism), different stages of parasitism (non-parasitism, seedling parasitism, flowering parasitism, and fruit parasitism), and different levels of simulated insect feeding (non-parasitism, mild feeding, moderate feeding, and severe feeding) on the growth, development, and competitiveness of buffalobur were studied. The results showed that parasitism from dodders and feeding by phytophagous insects significantly reduced the biomass of buffalobur (p < 0.05), thus inhibiting its growth and development. In addition, the root–shoot ratio of the buffalobur was increased, which influenced its growth–defense strategy. At different degrees of parasitism from dodders and different degrees of feeding by phytophagous insects, the biomass of the buffalobur was decreased. However, parasitism from dodders at different stages reduced the biomass and competitive ability of buffalobur (p < 0.05). Considering that the dodders and phytophagous insects could parasitize and feed not only on buffalobur but also on other crops, they cannot be used for the control of buffalobur.
The missing link: how the holobiont concept provides a genetic framework for rapid evolution and the inheritance of acquired characteristics
Authors: Huitzil Saúl , Huepe Cristián , Aldana Maximino , Frank Alejandro
Published: October 2023

The microbiome, encompassing the genetic material of all the microorganisms associated with a host organism, has an evolutionary potential that has been overlooked in the prevailing paradigm of the Modern Synthesis. Recognizing this untapped potential could shed light on various unresolved evolutionary phenomena that have remained elusive through the lens of genetic variants alone. Such phenomena include rapid evolution, inheritance of acquired characteristics, and the missing heritability problem. In this review, we explore the microbiome’s potential role in these processes, considering the holistic holobiont perspective as a possible guiding framework for new insights. Drawing inspiration from the foundational contributions of Rosenberg, Zilber-Rosenberg, and their contemporaries, we emphasize the significance of the microbiome in driving evolutionary innovation. Building on our previous research, coupled with emerging studies highlighting the microbiome’s relevance in addressing missing heritability, we advocate for its recognition as a wellspring of evolutionary innovation. Throughout, we collate and analyze recent evidence to bolster our position and delve into the broader implications of these findings.
Height reverse perspective transformation for crowd counting
Authors: Zhao Xiaomei , Li Honggang , Zhao Zhan , Li Shuo
Published: October 2023

Introduction

Crowd counting plays a critical role in the intelligent video surveillance of public areas. A significant challenge to this task is the perspective effect on human heads, which causes serious scale variations. Height reverse perspective transformation (HRPT) alleviates this problem by narrowing the height gap among human heads.

Methods

It employs depth maps to calculate the rescaling factors of image rows, and then it performs image transformation accordingly. HRPT enlarges small human heads in far areas to make them more noticeable and shrinks large human heads in closer areas to reduce redundant information. Then, convolutional neural networks can be used for crowd counting. Previous crowd-counting methods mainly solve the scale variation problem by designing specific networks, such as multi-scale or perspective-aware networks. These networks cannot be conveniently employed by other methods. In contrast, HRPT solves the scale variation problem through image transformation. It can be used as a preprocessing step and easily employed by other crowd-counting methods without changing their original structures.

Results and discussion

Experimental results show that HRPT successfully narrows the height gap among human heads and achieves state-of-the-art performance on a large crowd-counting RGB-D dataset.
Immune-mediated cholangiopathies in children: the need to better understand the pathophysiology for finding the future possible treatment targets
Authors: Grama Alina , Mititelu Alexandra , Sîrbe Claudia , Benţa Gabriel , Pop Tudor Lucian
Published: October 2023

Cholangiopathies are defined as focal or extensive damage of the bile ducts. According to the pathogenetic mechanism, it may be immune-mediated or due to genetic, infectious, toxic, vascular, and obstructive causes. Their chronic evolution is characterized by inflammation, obstruction of bile flow, cholangiocyte proliferation, and progression toward fibrosis and cirrhosis. Immune-mediated cholangiopathies comprise primary sclerosing cholangitis (PSC), autoimmune cholangitis and IgG4-associated cholangitis in adults and biliary atresia (BA), neonatal sclerosing cholangitis (NSC) in children. The main purpose of this narrative review was to highlight the similarities and differences among immune-mediated cholangiopathies, especially those frequent in children in which cholangiocyte senescence plays a key role (BA, NSC, and PSC). These three entities have many similarities in terms of clinical and histopathological manifestations, and the distinction between them can be hard to achieve. In BA, bile duct destruction occurs due to aggression of the biliary cells due to viral infections or toxins during the intrauterine period or immediately after birth. The consequence is the activation of the immune system leading to severe inflammation and fibrosis of the extrahepatic biliary tract, lumen stenosis, and impairment of the biliary flow. PSC is characterized by inflammation and fibrosis of intra- and extrahepatic bile ducts, leading to secondary biliary cirrhosis. It is a multifactorial disease that occurs because of genetic predisposition [human leukocyte antigen (HLA) and non-HLA haplotypes], autoimmunity (cellular immune response, autoantibodies, association with inflammatory bowel disease), environmental factors (infections or toxic bile), and host factors (intestinal microbiota). NSC seems to be a distinct subgroup of childhood PSC that appears due to the interaction between genetic predisposition (HLA B8 and DR3) and the disruption of the immune system, validated by elevated IgG levels or specific antibodies [antinuclear antibody (ANA), anti-smooth muscle antibody (ASMA)]. Currently, the exact mechanism of immune cholangiopathy is not fully understood, and further data are required to identify individuals at high risk of developing these conditions. A better understanding of the immune mechanisms and pathophysiology of BA, NSC, and PSC will open new perspectives for future treatments and better methods of preventing severe evolution.
Porto-spleno-mesenteric venous thrombosis after elective splenectomy: a retrospective cohort study
Authors: Baldari Ludovica , Boni Luigi , Giuliani Beatrice , Cassinotti Elisa
Published: October 2023

Background

Elective splenectomy is the main treatment for a wide range of haematological diseases. Porto-spleno-mesenteric venous thrombosis represents one of the most severe complications of this procedure. The aim of this study was to evaluate risk factors associated with development of porto-spleno-mesenteric venous thrombosis after elective splenectomy.

Methods

All cases of elective splenectomy carried out from April 1st 2017 to January 31st 2023 were included in this single centre retrospective cohort study. Patients’ demographics and perioperative data were analysed and correlated with the incidence of postoperative thrombosis. All patients underwent postoperative doppler ultrasound screening for thrombosis. Analysis was performed using SPSS 28, with p-value < 0.05 considered significant.

Results

Twenty-two patients (10 women, 12 men) underwent splenectomy during the study period. Indications were: immune thrombocytopenia (n: 6), myeloproliferative disorder (n: 6), hereditary spherocytosis (n: 4), thalassemia (n: 1), lymphoma (n: 1), leukaemia (n: 1), other malignancies (n: 3). Six patients developed porto-spleno-mesenteric venous thrombosis and only 2 of them were symptomatic. Patients were treated with anticoagulation therapy with complete resolution. Analysis identified three main factors associated with thrombosis: spleen diameter (p = 0.03), myeloproliferative disorder (p = 0.02), intraoperative platelet transfusion (p = 0.002) and intraoperative red blood cells transfusion (p = 0.009).

Conclusion

Standardized postoperative screening allows prompt diagnosis and treatment of porto-spleno-mesenteric venous thrombosis even in asymptomatic cases. Patient with splenomegaly and affected by myeloproliferative disorder have a greater risk to develop this complication.
Case report: Acute kidney injury as the initial manifestation of chronic lymphocytic leukemia/small lymphocytic lymphoma
Authors: Bender Sascha T. , Zeremski Vanja , Wiech Thorsten , Mertens Peter R. , Gross Christian
Published: October 2023

Chronic lymphocytic leukemia (CLL) is a lymphoproliferative disorder often diagnosed after incidental finding of leukocytosis. Renal involvement is usually clinically silent. Symptomatic renal impairment due to CLL/small lymphocytic lymphoma (SLL) cell infiltration in the kidney tissue is uncommon, and acute kidney injury (AKI) as a presenting feature is rare. In this case report, we describe the case of a patient with AKI caused by CLL/SLL infiltration as a presenting feature. Our report highlights the possibility of kidney injury as the first evident symptom of CLL/SLL. Kidney biopsy is the mainstay in these cases in order to establish a diagnosis. Treatment with zanubrutinib resulted in improved kidney function.
Prehospital tranexamic acid in trauma patients: a systematic review and meta-analysis of randomized controlled trials
Authors: Acharya Pawan , Amin Aamir , Nallamotu Sandhya , Riaz Chaudhry Zaid , Kuruba Venkataramana , Senthilkumar Virushnee , Kune Harika , Bhatti Sandeep Singh , Sarlat Iván Moguel , Krishna Chekuri Vamsi , Asif Kainat , Nashwan Abdulqadir J. , Cheema Huzaifa Ahmad
Published: October 2023

Background

Prehospital tranexamic acid (TXA) may hold substantial benefits for trauma patients; however, the data underlying its efficacy and safety is scarce.

Methods

We searched PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov from inception to July 2023 for all randomized controlled trials (RCTs) investigating prehospital TXA in trauma patients as compared to placebo or standard care without TXA. Data were pooled under a random-effects model using RevMan 5.4 with risk ratio (RR) and mean difference (MD) as the effect measures.

Results

A total of three RCTs were included in this review. Regarding the primary outcomes, prehospital TXA reduced the risk of 1-month mortality (RR 0.82, 95% CI 0.69–0.97) but did not increase survival with a favorable functional outcome at 6 months (RR 1.00, 95% CI 0.93–1.09). Prehospital TXA also reduced the risk of 24-h mortality but did not affect the risk of mortality due to bleeding and traumatic brain injury. There was no significant difference between the TXA and control groups in the incidence of RBC transfusion, and the number of ventilator- and ICU-free days. Prehospital TXA did not increase the risk of adverse events except for a small increase in the incidence of infections.

Conclusion

Prehospital TXA is useful in reducing mortality in trauma patients without a notable increase in the risk of adverse events. However, there was no effect on the 6-month favorable functional status. Further large-scale trials are required to validate the aforementioned findings.

Systematic review registration

PROSPERO (CRD42023451759).
Degenerative Cervical Myelopathy induces sex-specific dysbiosis in mice
Authors: Farkas Carlos , Retamal-Fredes Eduardo , Ávila Ariel , Fehlings Michael G. , Vidal Pia M.
Published: October 2023

Degenerative Cervical Myelopathy (DCM) is the most common cause of spinal cord impairment in elderly populations. It describes a spectrum of disorders that cause progressive spinal cord compression, neurological impairment, loss of bladder and bowel functions, and gastrointestinal dysfunction. The gut microbiota has been recognized as an environmental factor that can modulate both the function of the central nervous system and the immune response through the microbiota-gut-brain axis. Changes in gut microbiota composition or microbiota-producing factors have been linked to the progression and development of several pathologies. However, little is known about the potential role of the gut microbiota in the pathobiology of DCM. Here, DCM was induced in C57BL/6 mice by implanting an aromatic polyether material underneath the C5-6 laminae. The extent of DCM-induced changes in microbiota composition was assessed by 16S rRNA sequencing of the fecal samples. The immune cell composition was assessed using flow cytometry. To date, several bacterial members have been identified using BLAST against the largest collection of metagenome-derived genomes from the mouse gut. In both, female and males DCM caused gut dysbiosis compared to the sham group. However, dysbiosis was more pronounced in males than in females, and several bacterial members of the families Lachnospiraceae and Muribaculaceae were significantly altered in the DCM group. These changes were also associated with altered microbe-derived metabolic changes in propionate-, butyrate-, and lactate-producing bacterial members. Our results demonstrate that DCM causes dynamic changes over time in the gut microbiota, reducing the abundance of butyrate-producing bacteria, and lactate-producing bacteria to a lesser extent. Genome-scale metabolic modeling using gapseq successfully identified pyruvate-to-butanoate and pyruvate-to-propionate reactions involving genes such as Buk and ACH1, respectively. These results provide a better understanding of the sex-specific molecular effects of changes in the gut microbiota on DCM pathobiology.
The impact of main Areca Catechu root exudates on soil microbial community structure and function in coffee plantation soils
Authors: Zhao Shaoguan , Zhang Ang , Zhao Qingyun , Dong Yunping , Su Lanxi , Sun Yan , Zhu Feifei , Hua Dangling , Xiong Wu
Published: October 2023

Coffee is an important cash crop worldwide, but it has been plagued by serious continuous planting obstacles. Intercropping with Areca catechu could alleviate the continuous planting obstacle of coffee due to the diverse root secretions of Areca catechu. However, the mechanism of Areca catechu root secretion in alleviating coffee continuous planting obstacle is still unclear. The changes of coffee rhizosphere soil microbial compositions and functions were explored by adding simulated root secretions of Areca catechu, the primary intercropping plant species (i.e., amino acids, plant hormone, organic acids, phenolic acids, flavonoids and sugars) in current study. The results showed that the addition of coffee root exudates altered soil physicochemical properties, with significantly increasing the availability of potassium and organic matter contents as well as promoting soil enzyme activity. However, the addition of plant hormone, organic acids, or phenolic acids led to a decrease in the Shannon index of bacterial communities in continuously planted coffee rhizosphere soil (RS-CP). The inclusion of phenolic acids specifically caused the decrease of fungal Shannon index. Plant hormone, flavonoids, phenolic acids, and sugars increased the relative abundance of beneficial bacteria with reduced bacterial pathogens. Flavonoids and organic acids increased the relative abundance of potential fungal pathogen Fusarium. The polyphenol oxidase, dehydrogenase, urease, catalase, and pH were highly linked with bacterial community structure. Moreover, catalase, pH, and soil-available potassium were the main determinants of fungal communities. In conclusion, this study highlight that the addition of plant hormone, phenolic acids, and sugars could enhance enzyme activity, and promote synergistic interactions among microorganisms by enhancing the physicochemical properties of RS-CP, maintaining the soil functions in coffee continuous planting soil, which contribute to alleviate the obstacles associated with continuous coffee cultivation.
Transcriptional and metabolomic responses of Methylococcus capsulatus Bath to nitrogen source and temperature downshift
Authors: Bedekar Ashwini Ashok , Deewan Anshu , Jagtap Sujit S. , Parker David A. , Liu Ping , Mackie Roderick I. , Rao Christopher V.
Published: October 2023

Methanotrophs play a significant role in methane oxidation, because they are the only biological methane sink present in nature. The methane monooxygenase enzyme oxidizes methane or ammonia into methanol or hydroxylamine, respectively. While much is known about central carbon metabolism in methanotrophs, far less is known about nitrogen metabolism. In this study, we investigated how Methylococcus capsulatus Bath, a methane-oxidizing bacterium, responds to nitrogen source and temperature. Batch culture experiments were conducted using nitrate or ammonium as nitrogen sources at both 37°C and 42°C. While growth rates with nitrate and ammonium were comparable at 42°C, a significant growth advantage was observed with ammonium at 37°C. Utilization of nitrate was higher at 42°C than at 37°C, especially in the first 24 h. Use of ammonium remained constant between 42°C and 37°C; however, nitrite buildup and conversion to ammonia were found to be temperature-dependent processes. We performed RNA-seq to understand the underlying molecular mechanisms, and the results revealed complex transcriptional changes in response to varying conditions. Different gene expression patterns connected to respiration, nitrate and ammonia metabolism, methane oxidation, and amino acid biosynthesis were identified using gene ontology analysis. Notably, key pathways with variable expression profiles included oxidative phosphorylation and methane and methanol oxidation. Additionally, there were transcription levels that varied for genes related to nitrogen metabolism, particularly for ammonia oxidation, nitrate reduction, and transporters. Quantitative PCR was used to validate these transcriptional changes. Analyses of intracellular metabolites revealed changes in fatty acids, amino acids, central carbon intermediates, and nitrogen bases in response to various nitrogen sources and temperatures. Overall, our results offer improved understanding of the intricate interactions between nitrogen availability, temperature, and gene expression in M. capsulatus Bath. This study enhances our understanding of microbial adaptation strategies, offering potential applications in biotechnological and environmental contexts.
Bacillus velezensis BVE7 as a promising agent for biocontrol of soybean root rot caused by Fusarium oxysporum
Authors: Sun Lei , Wang Wei , Zhang Xue , Gao Zhongchao , Cai Shanshan , Wang Shuang , Li Yonggang
Published: October 2023

Introduction

Soybean root rot (SRR), caused byFusarium oxysporum, is a severe soil-borne disease in soybean production worldwide, which adversely impacts the yield and quality of soybean. The most effective method for managing crop soil-borne diseases and decreasing reliance on chemical fungicides, such asBacillusspp., is via microbial biocontrol agents.

Methods and Results

In this study, a soil-isolated strain BVE7 was identified asB. velezensis, exhibiting broad-spectrum activity against various pathogens causing soybean root rot. BVE7 sterile filtrate, at a concentration of 10%, demonstrated significant antifungal activity by inhibiting the conidial germination, production, and mycelial growth ofF. oxysporumby 61.11%, 73.44%, and 85.42%, respectively, causing hyphal malformations. The antifungal compound produced by BVE7 demonstrated adaptability to a standard environment. The pot experiment showed that BVE7 suspension could effectively control soybean root rot, with the highest control efficiency of 75.13%. Furthermore, it considerably enhanced the activity of catalase, phenylalanine ammonia lyase, superoxide dismutase, and peroxidase in soybean roots, while also preventing an increase in malondialdehyde activity. By improving the host resistance towards pathogens, the damage caused by fungi and the severity of soybean root rot have been reduced.

Discussion

This study presents the innovative utilization ofB. velezensis, isolated from soybean roots in cold conditions, for effectively controlling soybean root rot caused byF. oxysporum. The findings highlight the remarkable regional and adaptive characteristics of this strain, making it an excellent candidate for combating soybean root rot in diverse environments. In conclusion,B. velezensisBVE7 demonstrated potential in effectively reducing SRR incidence and can be considered as a viable option for SRR management.
Magnetic resonance-guided laser interstitial thermal therapy vs. stereoelectroencephalography-guided radiofrequency thermocoagulation in epilepsy patients with focal cortical dysplasia: a systematic review and meta-analysis
Authors: Li Yiming , Gao Jiayi , Ye Zi , Mu Jie
Published: October 2023

Background

Magnetic resonance-guided laser interstitial thermal therapy (MRgLiTT) and stereoelectroencephalography-guided radiofrequency thermocoagulation (SEEG-RFTC) are two effective, minimally invasive treatments for epilepsy with focal cortical dysplasia (FCD). The purpose of this study is to conduct a meta-analysis to evaluate and compare the efficacy and safety of these two therapies in epilepsy patients with FCD.

Methods

We searched PubMed, Embase, Cochrane, and other databases for articles published before March 2023. The primary objective was to compare the effectiveness and complications of MRgLiTT and SEEG-RFTC in epilepsy patients with FCD. The second objective was to determine which method provides a better prognosis for specific subgroup patients.

Results

According to the inclusion and exclusion criteria, 18 studies were included, comprising 270 FCD patients including 37 patients from 6 MRgLiTT studies and 233 from 12 SEEG-RFTC studies. There were no significant differences between MRgLiTT and SEEG-RFTC groups in the seizure-freedom rate (59%, 95% CI 44–74%; 52%, 95% CI 47–57%, P = 0.86) and the rate of ≥50% seizure-reduction of FCD (90%, 95% CI 80–100%; 90%, 95% CI 86–94%, P = 0.42). Both methods had low complication rates (17.1%, 28/159) and long-term complication (2.5%, 4/159) rate, with no significant difference between them (P = 0.17).

Conclusion

Both MRgLiTT and SEEG-RFTC are safe and minimally invasive treatments for patients with FCD. They have comparable performance in terms of postoperative seizure-freedom rates in patients with FCD, and both can be used as treatment options for patients with FCD. Our study found that SEEG-RFTC had a better therapeutic effect in the FCD2b subgroup.
Occurrence and treatment of peripheral nerve injuries after cosmetic surgeries
Authors: Chen Qiang , Li Pengfei , Zhao QingFang , Tu Tian , Lu Hui , Zhang Wei
Published: October 2023

Although non-invasive and minimally invasive aesthetic procedures increasingly dominate the cosmetic market, traditional plastic surgery remains the most effective improvement method. One of the most common complications in plastic surgery, peripheral nerve injuries, though has a low incidence but intrigued plastic surgeons globally. In this article, a narrative review was conducted using several databases (PubMed, EMBASE, Scopus, and Web of Science) to identify peripheral nerve injuries following cosmetic surgeries such as blepharoplasty, rhinoplasty, rhytidectomy, breast surgeries, and abdominoplasty. Surgery-related nerve injuries were discussed, respectively. Despite the low incidence, cosmetic plastic surgeries can cause iatrogenic peripheral nerve injuries that require special attention. The postoperative algorithm approaches can be effective, but the waiting and treatment processes can be long and painful. Preventive measures are undoubtedly more effective than postoperative remedies. The best means of preventing disease is having a good understanding of anatomy and conducting a careful dissection.