bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of Bacterial Populations and Functional Mechanisms Potentially Involved in Biochar-Facilitated Antagonism of the Soilborne PathogenFusarium oxysporum
Authors: Dror Barak , Amutuhaire Hildah , Frenkel Omer , Jurkevitch Edouard , Cytryn Eddie
Published: February 2022

Biochar soil amendment alleviates plant disease through microbial-mediated processes but drivers facilitating this “biochar effect” are not fully understood. In this study, cucumber plants were inoculated with and without the fungus Fusarium oxysporum f. sp. radicis-cucumerinum in either biochar-amended or nonamended soils, and disease severity was assessed. Amplicon sequencing and shotgun metagenomics were then applied to identify bacteria and associated mechanisms potentially involved in pathogen inhibition, and candidate bacteria were tested for in vitro F. oxysporum f. sp. radicis-cucumerinum-antagonizing capacity. Biochar-amended plants showed lower F. oxysporum f. sp. radicis-cucumerinum-associated growth stagnation compared with nonamended plants, supporting the biochar effect. Their rhizosphere had a more diverse microbiome with higher levels of secondary metabolite-encoding biosynthetic gene clusters (BGCs). Families Pseudonocardiaceae (Lentzea spp.) and Myxococcaceae were significantly more abundant in biochar-amended rhizospheres of F. oxysporum f. sp. radicis-cucumerinum-inoculated plants, and metagenomically assembled genomes (MAGs) from these taxa contained genes encoding enzymes involved in binding and degradation of chitin, and novel BGCs encoding secondary metabolites. Lentzea spp. isolates related to the above MAGs showed in vitro antagonistic activity against F. oxysporum f. sp. radicis-cucumerinum. Collectively, we postulate that biochar amendment generates a “buffering effect” that reduces F. oxysporum f. sp. radicis-cucumerinum-facilitated destabilization of the root-associated microbiome, maintaining beneficial taxa that produce antagonizing enzymes and secondary metabolites that sustain plant health.
Faba Bean Gall Pathogen Physoderma viciae: New Primers Reveal Its Puzzling Association with the Field Pea Ascochyta Complex
Authors: You Ming Pei , Eshete Beyene Bitew , Kemal Seid Ahmed , Barbetti Martin J.
Published: February 2022

Recent morphological and molecular studies confirmed Physoderma viciae, and not Olpidium viciae, to be the causative agent of the devastating Faba Bean Gall (FBG) disease on faba bean (Vicia faba) in Ethiopia and also highlighted its ability to cross-infect with other host genera such as Pisum and Trifolium. In this study, the first pair of specific primer ‘Physo 1’ and primer pair ‘Physo D’ are reported from molecular sequences of this pathogen from the conserved LSU (S28) gene. Whereas ‘Physo 1’ readily detects P. viciae, ‘Physo D’, clearly separates its identity from the common and confounding presence of Didymella/Phoma spp. The study also reports the presence of the Ascochyta blight pathogen complex, symptomless but almost universal on field pea (Pisum sativum), within faba bean infested by P. viciae. We emphasize historical evidence confirming such unique association in other legumes, such as the subterranean clover (Trifolium subterraneum). This new finding has significant implications for rotations involving different legume crop and/or forage legume genera and possibly provides the first explanation for the widespread occurrence of the field pea Ascochyta blight pathogen complex even in the absence of field pea cropping for many years.
Evaluation of Usability and Learning Motivation of e-Learning Courses for People With Chronic Kidney Disease
Authors: Takahashi Satsuki , Oka Michiyo , Hiromura Keiju , Ikeuchi Hidekazu , Shimizu Miwako , Joboshi Hiroko
Published: February 2022

Nurses need to increase patient education opportunities so that more people with chronic kidney disease can understand the disease accurately from its early stages. We developed an e-learning course based on the Dick and Carey system approach model and the attention, relevance, confidence, satisfaction model for people with chronic kidney disease. People with chronic kidney disease, on average, are aged around 50 to 60 years, and this population tends to lack perceived susceptibility toward and concern for the disease owing to the asymptomatic nature of early chronic kidney disease. Therefore, e-learning should be easy to use and motivate learning. This study aimed to evaluate the usability and learning motivation of this course. The participants included 10 outpatients (mean age, 51.2 years) with chronic kidney disease whose mastery percentage of learning objectives was compared by the knowledge tests immediately before and after the course. We also observed the participants' operation status and measured their motivation for using instructional materials with a questionnaire. The results demonstrated that this course facilitates independent operation, improves postcourse performance, and motivates participants in all areas of learning motivation. Thus, this e-learning course can be recommended as easy to use and motivating for people with chronic kidney disease.
Nurses' Experience and Perception of Technology Use in Practice
Authors: Gaughan Mary Rose , Kwon Misol , Park Eunhee , Jungquist Carla
Published: February 2022

The purposes of this study are to provide insight into the factors identified as benefits and drawbacks of technology use by nurses and obtain suggestions on improving technology, based on challenges identified to improve patient outcomes. Holden's extended technology acceptance model was used to describe nurses' perception of technology use in practice. A descriptive design and thematic analysis were used to evaluate participants' logged reflections of their experiences and suggestions for improvements of health information technology. Findings indicate that nurses' experiences and perceptions regarding the use of various types of technology (electronic health records, large databases, crowdsourcing, bio-surveillance) were positive. New subdomains emerged for job performance and efficiency, usefulness for public health, contribution to nursing science, and better communication. Identified challenges were insufficient training and support, lack of interoperability, risk of low-quality care from reliance on technology, increased cost, glitches, and alarm fatigue. Understanding nurses' perceptions of technology is anticipated to enhance care quality and possibly lead to improved outcomes. Nurses' perceptions of the use and acceptance of technology are important as their view is associated with performance and may directly influence clinical outcomes and patient satisfaction. Thematic findings include recommendations from participants to improve patient outcomes and patient care.
Applying the Technology Acceptance Model to Explore Nursing Students' Behavioral Intention to Use Nursing Information Smartphones in a Clinical Setting
Authors: Lai Ching-Yi , Lee Tzu-Ying , Lin Shu-Chuan , Lin I-Hsiang
Published: February 2022

The integration of mobile devices and nursing information systems has become a trend in modern clinical practice with various information and communication technologies available. Smartphones are gradually replacing notebooks in clinical practice as a medium for nursing information systems. Clinical nursing practicums are a necessary means for nursing students to foster their professional competence. In addition to professional skills, nursing students must also learn to apply information technologies in clinical settings. This study aimed to understand nursing students' behavioral intention toward nursing information smartphones and to further identify the factors influencing nursing students' behavioral intentions based on the technology acceptance model. A cross-sectional research design was used in this study. Eighty nursing students were recruited from a regional teaching hospital in Central Taiwan. The findings demonstrated that subjects' perceived ease of use and perceived usefulness of nursing information smartphones, as well as their attitude toward using and behavioral intention to use the smartphones, were positive, and they provided constructive feedback and suggestions to improve nursing information systems in hospitals. The findings can serve as a reference for hospitals and clinical training institutions seeking to integrate nursing information systems in clinical nursing education.
The Efficacy of CT-Based Conformal Electron Beam Radiation Therapy After Keloid Excision
Authors: Hwang Na-Hyun , Lee Nam Kwon , Chae Jung Hyun , Park Seung-Ha , Yoon Eul-Sik
Published: February 2022

BACKGROUND

Adjuvant computed tomography–based conformal electron beam radiation therapy (RT) for patients with keloids enables radiation oncologists to customize the target volume with precision and deliver the maximal prescription dose while sparing normal surrounding tissues.

OBJECTIVE

To report treatment and cosmetic outcomes by the patient's self-assessment survey.

METHODS

Medical records of patients with keloids, who were treated with postoperative electron beam RT between January 2015 and December 2020, were reviewed. A total of 85 consecutive patients with 136 keloids were included in this study. Subjective cosmetic outcomes were scored by each patient using a 5-point Likert scale survey.

RESULTS

The median follow-up time was 29.0 months (range, 12.1–77.9 months), and local recurrence was observed in 10 lesions (7.4%). The recurrence rate of keloids occurring in the ear was 5.4%, whereas the recurrence rate of keloids occurring at other body sites was 11.4%. Among the patients who responded to the questionnaire about the cosmetic outcome, 70.2% of patients declared being either very satisfied (44.7%) or satisfied (25.5%).

CONCLUSION

Surgical excision, followed by CT-based conformal electron beam RT, for patients with keloids ensures a high degree of local control resulting in good cosmetic outcomes.
Homocysteine Suppresses Autophagy Through AMPK-mTOR-TFEB Signaling in Human THP-1 Macrophages
Authors: Yang Yu-ping , Ren Yong-gang , Cai Bi-qing , Huang Dan-dan
Published: February 2022

Hyperhomocysteinemia is an independent risk factor for atherosclerosis. It is known that macrophage autophagy plays a protective role in atherosclerosis and that hyperhomocysteinemia is strongly linked to autophagy. Therefore, it is of great significance to study the molecular mechanisms underlying the effect of homocysteine (Hcy) on macrophage autophagy. This study aimed to investigate the effects of Hcy on autophagy in a human acute monocytic leukemia cell line (THP-1). The Hcy-treated THP-1 cells exhibited increased levels of the autophagy substrate SQSTM1 (p62) and decreased levels of the autophagy markers LC3 II/I and Beclin-1, indicating a decrease in autophagy in vitro. Furthermore, Western blotting showed that Hcy significantly increased the levels of p-mTOR and nuclear TFEB and decreased the levels of p-AMPK and cytoplasmic TFEB. These data suggest that Hcy inhibits autophagosome formation in human THP-1 macrophages through the AMPK-mTOR-TFEB signaling pathway. Our findings provide new insights into the mechanisms of atherosclerotic diseases caused by Hcy.
Association Between Self-Reported Disability and Lifetime History of Traumatic Brain Injury With Loss of Consciousness Among Veterans and Nonveterans in North Carolina
Authors: Sarmiento Kelly , Waltzman Dana , Daugherty Jill , Okoro Catherine A. , Proescholdbell Scott
Published: February 2022

Background:

Compared with civilians, service members and veterans who have a history of traumatic brain injury (TBI) are more likely to experience poorer physical and mental health. To investigate this further, this article examines the association between self-reported history of TBI with loss of consciousness and living with 1 or more current disabilities (ie, serious difficulty with hearing, vision, cognition, or mobility; any difficulty with self-care or independent living) for both veterans and nonveterans.

Methods:

A cross-sectional study using data from the North Carolina Behavioral Risk Factor Surveillance System for 4733 veterans and nonveterans aged 18 years and older.

Results:

Approximately 34.7% of veterans residing in North Carolina reported having a lifetime history of TBI compared with 23.6% of nonveterans. Veterans reporting a lifetime history of TBI had a 1.4 times greater risk of also reporting living with a current disability (adjusted prevalence ratio = 1.4; 95% confidence interval, 1.2-1.8) compared with nonveterans. The most common types of disabilities reported were mobility, cognitive, and hearing.

Conclusions:

Compared with nonveterans, veterans who reported a lifetime history of TBI had an increased risk of reporting a current disability. Future studies, such as longitudinal studies, may further explore this to inform the development of interventions.
Concussion Evaluation Patterns Among US Adults
Authors: Womack Lindsay S. , Breiding Matthew J. , Daugherty Jill
Published: February 2022

Objective:

The objective of this study was to compare individuals who were not evaluated by a doctor or nurse for a self-reported concussion versus individuals who were evaluated for a concussion by demographic variables, concussion history, and concussion circumstances.

Settings and Participants:

Data were collected from 2018 SpringStyles, a web-based panel survey of US adults 18 years or older (n = 6427), fielded in March-April.

Design:

Cross-sectional.

Main Measures:

Respondents were asked whether they believed they had sustained a concussion in their lifetime and details about their most recent concussion, including whether they were evaluated by a doctor or nurse.

Results:

Twenty-seven percent of adults in the survey reported a lifetime concussion (n = 1835). Among those individuals, 50.4% were not evaluated by a healthcare provider for their most recent concussion. Not being evaluated was higher among individuals whose concussion was caused by a slip, trip, or fall (adjusted prevalence ratio [APR] = 2.22; 95% CI, 1.65-2.99), riding a bicycle (APR = 2.28; 95% CI, 1.58-3.27), being struck by or against something by accident (APR = 2.50; 95% CI, 1.88-3.34), or being struck by or against something during a fight or argument (APR = 2.89; 95% CI, 2.11-3.97), compared with individuals whose concussion was caused by a motor vehicle crash. No evaluation was also higher among individuals whose concussion occurred while engaging in a sports or recreational activity (APR = 1.39; 95% CI, 1.07-1.82) or engaging in regular activities around the house (APR = 1.65; 95% CI, 1.27-2.14), compared with individuals whose concussion occurred while working for pay.

Conclusion:

More than a quarter of adults reported a lifetime concussion; however, half of them were not evaluated for their last concussion by a healthcare provider. Examination by a healthcare professional for a suspected concussion may prevent or mitigate potential long-term sequelae. Furthermore, current US surveillance methods may underestimate the burden of TBI because many individuals do not seek evaluation.
Reactive Balance Responses After Mild Traumatic Brain Injury: A Scoping Review
Authors: Morris Amanda , Casucci Tallie , McFarland Mary M. , Cassidy Benjamin , Pelo Ryan , Kreter Nicholas , Dibble Leland E. , Fino Peter C.
Published: February 2022

Objective:

Balance testing after concussion or mild traumatic brain injury (mTBI) can be useful in determining acute and chronic neuromuscular deficits that are unapparent from symptom scores or cognitive testing alone. Current assessments of balance do not comprehensively evaluate all 3 classes of balance: maintaining a posture; voluntary movement; and reactive postural response. Despite the utility of reactive postural responses in predicting fall risk in other balance-impaired populations, the effect of mTBI on reactive postural responses remains unclear. This review sought to (1) examine the extent and range of available research on reactive postural responses in people post-mTBI and (2) determine whether reactive postural responses (balance recovery) are affected by mTBI.

Design:

Scoping review.

Methods:

Studies were identified using MEDLINE, EMBASE, CINAHL, Cochrane Library, Dissertations and Theses Global, PsycINFO, SportDiscus, and Web of Science. Inclusion criteria were injury classified as mTBI with no confounding central or peripheral nervous system dysfunction beyond those stemming from the mTBI, quantitative measure of reactive postural response, and a discrete, externally driven perturbation was used to test reactive postural response.

Results:

A total of 4747 publications were identified, and a total of 3 studies (5 publications) were included in the review.

Conclusion:

The limited number of studies available on this topic highlights the lack of investigation on reactive postural responses after mTBI. This review provides a new direction for balance assessments after mTBI and recommends incorporating all 3 classes of postural control in future research.
Parent Interventions Improve Behavior After Pediatric Traumatic Brain Injury: A Systematic Review and Meta-analysis
Authors: Cermak Carly A. , McCabe Sarah A. , Kuchurean Brianna , Schaefer Julia , Tendera Anna , Beal Deryk S.
Published: February 2022

Objective:

To examine child behavior change scores from randomized controlled trials (RCTs) of parent interventions for pediatric traumatic brain injury (TBI).

Methods:

MEDLINE, EMBASE, PsycINFO, and CINAHL were searched to identify studies that examined parent interventions for pediatric TBI. Inclusion criteria included (i) a parent intervention for children with TBI; (ii) an RCT study design; (iii) statistical data for child behavior outcome(s); and (iv) studies that were published in English.

Results:

Seven studies met inclusion criteria. All interventions reported improved child behavior after pediatric TBI; however, child and parent factors contributed to behavior change scores in some interventions. Factors found to contribute to the level of benefit included age of child, baseline behavior levels, sociodemographics (eg, parent income, parent education), and parent mental health.

Conclusion:

Improved child behavior outcomes resulting from parent interventions for pediatric TBI are well supported by the evidence in the peer-reviewed literature. Clinicians are encouraged to consider child and parent factors as they relate to child behavior outcomes.
VISUAL AND ANATOMICAL CHANGES AFTER DRUG CESSATION IN PENTOSAN POLYSULFATE SODIUM–ASSOCIATED MACULOPATHY
Authors: Gupta Priya R. , Grewal Dilraj S.
Published: February 2022

Purpose:

The purpose of this study was to describe a case of development of pentosan polysulfate sodium (PPS)–related maculopathy that exhibited potential improvement in imaging findings after drug cessation.

Methods:

This study is a case report.

Results:

A 66-year-old woman presented with progressive pigmentary maculopathy associated with long-term PPS usage, including development of a choroidal neovascular membrane in her right eye. After discontinuation of PPS, her clinical course was notable for partial subjective and objective improvement in visual acuity, as well as partial improvement in outer retinal architecture on ocular coherence tomography, but persistence of retinal pigment epithelium atrophy and autofluorescence changes.

Conclusion:

The course of retinopathy after discontinuation of PPS has yet to be fully determined and has so far been suggested to be progressive. Anatomical improvements seen in our case suggest that further investigations are warranted to determine whether there is potential for partial reversal of some changes in PPS maculopathy.
Intraocular lens power calculation with ray tracing based on AS-OCT and adjusted axial length after myopic excimer laser surgery
Authors: Savini Giacomo , Hoffer Kenneth J. , Ribeiro Filomena J. , Dias Joao Mendanha , Coutinho Catarina P. , Barboni Piero , Schiano-Lomoriello Domenico
Published: February 2022

Purpose:

To report the results of intraocular lens (IOL) power calculation by ray tracing in eyes with previous myopic excimer laser surgery.

Setting:

G.B. Bietti Foundation I.R.C.C.S., Rome, Italy.

Design:

Retrospective interventional case series.

Methods:

A series of consecutive patients undergoing phacoemulsification and IOL implantation after myopic excimer laser was investigated. IOL power was calculated using ray-tracing software available on the anterior segment optical coherence tomographer MS-39. Axial length (AL) was measured by optical biometry, and 4 values were investigated: (1) that from the printout, (2) the modified Wang/Koch formula, and (3) the polynomial equation for the Holladay 1 and (4) for the Holladay 2 formulas. The mean prediction error (PE), median absolute error (MedAE), and percentage of eyes with a PE within ±0.50 diopters (D) were reported.

Results:

The study enrolled 39 eyes. Entering the original AL into ray tracing led to a mean hyperopic PE (+0.56 ±0.54 D), whereas with the Wang/Koch formula, a mean myopic PE (−0.41 ±0.53 D) was obtained. The Holladay 1 and 2 polynomial equations lead to the lowest PEs (−0.10 ±0.49 D and +0.08 ±0.49 D, respectively), lowest MedAE (0.37 D and 0.25 D), and highest percentages of eyes with a PE within ±0.50 D (71.79% and 76.92%). Calculations based on the Holladay 2 polynomial equation showed a statistically significant difference compared with other methods used (including Barrett-True K formula), with the only exception of the Holladay 1 polynomial equation.

Conclusions:

IOL power was accurately calculated by ray tracing with adjusted AL according to the Holladay 2 polynomial equation.
Characterisation of the pathophysiology of neuropathy and sensory dysfunction in a mouse model of recessive dystrophic epidermolysis bullosa
Authors: Schmidt Daniela , Díaz Paula , Muñoz Daniela , Espinoza Fernanda , Nystrom Alexander , Fuentes Ignacia , Ezquer Marcelo , Bennett David L. , Calvo Margarita
Published: February 2022

Recessive dystrophic epidermolysis bullosa (RDEB) is a rare genetic condition in which mutations in the type VII collagen gene (COL7A1) lead to decreased expression of this anchoring protein of the skin, causing the loss of stability at the dermo-epidermal junction. Most patients with RDEB experience neuropathic pain and itch due to the development of a small fibre neuropathy, characterised by decreased intraepidermal innervation and thermal hypoaesthesia. To understand the physiopathology of this neuropathy, we used a mouse model of RDEB (Col7a1flNeo/flNeo) and performed a detailed characterisation of the somatosensory system. Col7a1flNeo/flNeo mice showed a decrease in heat sensitivity, an increase in spontaneous scratching, and a significant decrease in intraepidermal nerve fibre density in the hindpaw; these changes were distal because there was no significant loss of unmyelinated or myelinated fibres in the nerve trunk. Of interest, we observed a decrease in axon diameter in both myelinated and unmyelinated fibres. This axonal damage was not associated with inflammation of the dorsal root ganglion or central projection targets at the time of assessment. These results suggest that in RDEB, there is a distal degeneration of axons produced by exclusive damage of small fibres in the epidermis, and in contrast with traumatic and acute neuropathies, it does not induce sustained neuroinflammation. Thus, this animal model emphasizes the importance of a healthy cutaneous environment for maintenance of epidermal innervation and faithfully replicates the pathology in humans, offering the opportunity to use this model in the development of treatments for pain for patients with RDEB.
Estrogen modulation of the pronociceptive effects of serotonin on female rat trigeminal sensory neurons is timing dependent and dosage dependent and requires estrogen receptor alpha
Authors: Kaur Sukhbir , Hickman Taylor M. , Lopez-Ramirez Angela , McDonald Hanna , Lockhart Lauren M. , Darwish Omar , Averitt Dayna Loyd
Published: February 2022

The role of the major estrogen estradiol (E2) on orofacial pain conditions remains controversial with studies reporting both a pronociceptive and antinociceptive role of E2. E2 modulation of peripheral serotonergic activity may be one mechanism underlying the female prevalence of orofacial pain disorders. We recently reported that female rats in proestrus and estrus exhibit greater serotonin (5HT)-evoked orofacial nocifensive behaviors compared with diestrus and male rats. Further coexpression of 5HT2A receptor mRNA in nociceptive trigeminal sensory neurons that express transient receptor potential vanilloid 1 ion channels contributes to pain sensitization. E2 may exacerbate orofacial pain through 5HT-sensitive trigeminal nociceptors, but whether low or high E2 contributes to orofacial pain and by what mechanism remains unclear. We hypothesized that steady-state exposure to a proestrus level of E2 exacerbates 5HT-evoked orofacial nocifensive behaviors in female rats, explored the transcriptome of E2-treated female rats, and determined which E2 receptor contributes to sensitization of female trigeminal sensory neurons. We report that a diestrus level of E2 is protective against 5HT-evoked orofacial pain behaviors, which increase with increasing E2 concentrations, and that E2 differentially alters several pain genes in the trigeminal ganglia. Furthermore, E2 receptors coexpressed with 5HT2A and transient receptor potential vanilloid 1 and enhanced capsaicin-evoked signaling in the trigeminal ganglia through estrogen receptor α. Overall, our data indicate that low, but not high, physiological levels of E2 protect against orofacial pain, and we provide evidence that estrogen receptor α receptor activation, but not others, contributes to sensitization of nociceptive signaling in trigeminal sensory neurons.
Causative organisms and antimicrobial susceptibility in jaundiced infants with significant bacteriuria
Authors: Chen Lih-Ju , Chen Ping-Ju , Yang Shun-Fa , Chen Jia-Yuh
Published: February 2022

Background:

Jaundice may be one of the first signs of urinary tract infection (UTI) in infants. The most common pathogen is Escherichia coli. Currently recommended antibiotic treatment for neonatal UTI is ampicillin and an aminoglycoside. Recently, increasing ampicillin and gentamicin resistance in strains of E. coli has been isolated. The aim of this study was to determine causative organisms and antimicrobial susceptibility in jaundiced infants with significant bacteriuria (SB).

Methods:

We evaluated admitted afebrile, asymptomatic infants younger than 1-month old with hyperbilirubinemia (total bilirubin >15 mg/dl) requiring phototherapy between January 2011 and December 2015. A total of 615 asymptomatic jaundiced infants were enrolled. Urinalysis and urine cultures were performed on all jaundiced infants. A urine culture was defined as SB if a single pathogen with more than 105-colony forming units per milliliter (CFU/ml) by sterile urinary collection bag or 104 CFU/ml by catheterization was isolated.

Results:

A total of 88 (14.3%) of 615 asymptomatic jaundiced infants had positive urinary culture. E coli was the most common cultured bacteria (40 cases, [45.5%]). Enterococcus faecalis was the second most common bacteria (17 cases, [19.3%]). Seven cases (8.0%) of Streptococcus agalactiae and six cases (6.8%) of Klebsiella pneumoniae were also identified. Ampicillin sensitivity was found in 22.5% of E. coli infections, gentamicin sensitivity was found in 84.2%, and extended-spectrum β-lactamases were found in 7.5%.

Conclusion:

E. coli was the most common causative organism for infants with SB. We suggest modifying current empiric antibiotics by changing gentamicin to amikacin for neonatal Gram-negative bacterial infections.
Lycopene treatment improves intrahepatic fibrosis and attenuates pathological angiogenesis in biliary cirrhotic rats
Authors: Huang Hui-Chun , Hsu Shao-Jung , Chang Ching-Chih , Kao Yun-Chieh , Chuang Chiao-Lin , Hou Ming-Chih , Lee Fa-Yauh
Published: February 2022

Background:

Liver cirrhosis is characterized by liver fibrosis and pathological angiogenesis, which results in hyperdynamic circulation, portal-systemic collateral vascular formation, and abnormal angiogenesis. Lycopene is a nutrient mostly found in tomatoes. The beneficial effects of lycopene include anti-inflammation, anti-oxidation, anti-fibrosis, and anti-angiogenesis; however, the association between liver cirrhosis and pathological angiogenesis has yet to be studied. This study aimed to investigate the effects of lycopene on biliary cirrhotic rats.

Methods:

The efficacy of lycopene treatment in common bile duct ligation (BDL)-induced biliary cirrhotic rats was evaluated. Sham-operated rats served as surgical controls. Lycopene (20 mg/kg/day, oral gavage) or vehicle was administered to BDL or sham-operated rats for 4 weeks, after which the hemodynamics, liver biochemistry, portal-systemic shunting, liver and mesenteric angiogenesis, and hepatic angiogenesis-related protein expressions were examined.

Results:

Lycopene alleviated hyperdynamic circulation as evidenced by decreased cardiac index and increased peripheral vascular resistance (p < 0.05), but it did not affect portal pressure or liver biochemistry in the BDL rats (p > 0.05). Lycopene significantly diminished the shunting degree of portal-systemic collaterals (p = 0.04) and mesenteric vascular density (p = 0.01), and also ameliorated intrahepatic angiogenesis and liver fibrosis. In addition, lycopene upregulated endothelial nitric oxide synthase, protein kinase B (Akt) and phosphatidylinositol 3-kinases (PI3K), and downregulated vascular endothelial growth factor receptor 2 (VEGFR-2) protein expressions (p < 0.05) in the livers of the BDL rats.

Conclusion:

Lycopene ameliorated liver fibrosis, hyperdynamic circulation, and pathological angiogenesis in biliary cirrhotic rats, possibly through the modulation of intrahepatic Akt/PI3K/eNOS and VEGFR-2 pathways.
A Reduced Deck of Conversation Cards of Wishes and Priorities of Patients in Palliative Care
Authors: Olsson Möller Ulrika , Beck Ingela , Fürst Carl Johan , H. Rasmussen Birgit
Published: February 2022

The individual wishes and priorities of patients with advanced disease are too often neglected, making a deck of cards with statements reflecting potential wishes and priorities a useful conversation tool. However, in the most ill patients, the card selection and sorting process may be too strenuous. The aims of this study were to explore the wishes and priorities of patients receiving palliative care and to reduce a deck of statement cards to be clinically useable even for the most ill patients. In interviews, participants selected their top 10 from a deck of 46 statement cards. Descriptive and analytical statistics were used. Thirty-nine patients from 5 specialized palliative care units in Sweden participated. Six participants died within 1 month of the interviews. “To be free from pain” was ranked as the highest priority by the majority, and “To have staff I feel comfortable with” was ranked highest by the 6 most ill participants. A deck of cards with the 20 statements most chosen by patients receiving palliative care was created. The cards cover physical, psychological, social, existential, and practical aspects and are helpful for formulating goals of care for patients and informing the development of a core outcome set for palliative care.
Not All that Strictures Is IBD: Gastric Heterotopia Leading to Perforation and Small Bowel Obstruction Mimicking IBD
Authors: Ralbovsky Amariel , Reyna Troy , Kabeer Mustafa , Nael Ali , Yang Christine
Published: February 2022

A 14-year-old male presented with worsening chronic intermittent abdominal pain, mild anemia, positive fecal occult blood test, and elevated calprotectin. Computerized tomography and magnetic resonance imaging showed ileal dilation with mucosal enhancement and inflammatory changes suspicious for inflammatory bowel disease (IBD). Prominent mucosal folds were suggestive of gastric heterotopia, but Meckel’s scan was negative. Upper endoscopy, colonoscopy, and double balloon enteroscopy were grossly and microscopically normal. Laparotomy revealed 17 cm of a dense, inflamed, stenotic segment of ileum. The strictured ileum had perforated and had been concealed by an adjacent loop of small bowel, ultimately producing an obstructive IBD-like picture, but was found to be histologically consistent with gastric oxyntic mucosa. This case illustrates the challenges of diagnosing and treating heterotopic gastric mucosa, and the importance of considering diagnoses other than IBD when evaluating stricturing disease of the small bowel.
A Mixed-Methods Examination of the Impact of the Partnerships to Improve Community Health Produce Prescription Initiative in Northeastern North Carolina
Authors: Lyonnais Mary Jane , Kaur Archana P. , Rafferty Ann P. , Johnson Nevin S. , Jilcott Pitts Stephanie
Published: February 2022

Objective:

To conduct a mixed-methods examination of the impact of the Partnerships to Improve Community Health produce prescription initiative in northeastern North Carolina.

Design:

Quantitative surveys were conducted among participants before and after the distribution of produce prescription vouchers. Univariate statistics were used to describe the participant population, and paired t tests were used to examine change in fruit and vegetable intake. Qualitative, in-depth telephone interviews were conducted among participants, health educators, and food retailers and coded for themes.

Setting:

Eight health promotion programs, 2 food pantries, and 11 food retailers.

Participants:

In each health promotion program or food pantry, between 6 and 97 participants were enrolled.

Intervention:

Produce prescription vouchers were distributed to participants and redeemed at local food retailers.

Main Outcome Measure (s):

An increase in local fruit and vegetable purchasing and consumption.

Results:

Of the produce prescription participants who completed the baseline survey (n = 93), 86% were female, 64% were African American, and 68% were food insecure. The voucher redemption rate was 18%. The majority of participants indicated that they visit farmers' markets more now than before the produce prescription initiative, that shopping at the farmers' market made it easy to include more fresh produce in their family's diet, and that they tried a new farmers' market because of the produce prescription initiative. All health educators and food retailers who participated felt that the initiative benefited their program or operation and were willing to partner with the program again.

Conclusions:

While redemption rates were lower than anticipated, the produce prescription initiative had positive impacts on participants' local fruit and vegetable purchasing and consumption. Because of COVID-19, the initiative was not implemented until late in the North Carolina produce season. Moving forward, the program will start earlier and work with local food retailers to connect with their communities to increase redemption rates.
Operationalizing Community Assessment Results to Enhance Preparedness for a Radiological Emergency
Authors: Ferguson Rennie W. , Barnett Daniel J. , Kennedy Ryan David , Sell Tara Kirk , Wieder Jessica S. , Spannhake Ernst W.
Published: February 2022

Objective:

A radiological emergency such as the detonation of a radiological dispersal device would have catastrophic health, environmental, and economic consequences. Community assessments can provide useful information about radiological and other emergency preparedness at the household level. Tools such as logic models can be applied to link data collected in a community assessment to planned activities and targeted outcomes. This study sought to answer how public health departments can use the results of a community assessment to improve preparedness for radiological and other types of emergencies and to present a sample logic model demonstrating how questions asked in a community assessment can be used to drive intended outcomes.

Design:

Surveys were fielded in 2019 to professionals with experience in radiological emergency preparedness, state and local health and emergency management, and journalism. Questions included the role of health departments in radiological emergency preparedness, the operationalization of results from a community assessment for preparedness, and information sharing in a radiological emergency. Descriptive statistics and a modified framework approach were used for open-ended questions.

Results:

Nearly three-fourths of state/local officials reported that it would be at least somewhat difficult (73%; 11 of 15 state/local officials) for a local health department to operationalize the results of a community health assessment for radiological emergency preparedness. Potential barriers included competing priorities, lack of funds, and limited staff. Resources such as pretested communication materials, tailored messaging, and technical tools and training can assist health departments and emergency management agencies in using the information collected from a community assessment.

Conclusions:

To address implementation challenges in operationalizing the results of a community assessment, officials can use tools such as logic models to illustrate how the information gathered from a community health assessment will create an intended preparedness outcome and to advocate for funds for this type of assessment.
Lack of Consistent Investment in Federal Insurance Navigator Program Undermines Navigators' Equity Work in Vulnerable Communities
Authors: van Eijk Marieke S. , Kett Paula M. , Prueher Lillian , Frogner Bianca K. , Guenther Grace A.
Published: February 2022

Context:

Navigators in the federal Insurance Navigator Program (“Navigator Program”), who are employed by organizations in states with Federally Facilitated Marketplaces, provide enrollment assistance, outreach, and education to individuals who are eligible for health insurance coverage. Such work is central to public health efforts to address inequities but continues to be poorly understood and undervalued. More information is needed to understand the components of navigators' equity work and how decreases in program funding have affected their service provision.

Objective:

To examine navigators' labor at a granular level to better understand and highlight the equity work they do, the training and skills required for this work, and the Navigator Program–based challenges they face.

Design:

This was a descriptive qualitative study using data collected from interviews conducted in February-May 2021. We used a thematic analysis approach to develop major themes and subthemes.

Setting:

This was a national study.

Participants:

We conducted 18 semistructured interviews with 24 directors, navigators, and other professionals at organizations funded as federally certified Navigator Programs.

Main Outcome Measures:

Components of navigators' work; required training and skills; and challenges faced in accomplishing the work.

Results:

We identified 3 major themes: (1) navigators' health equity work goes beyond required responsibilities; (2) equity skills are built on the job; and (3) financial instabilities challenge navigators' health equity work.

Conclusion:

Navigators bring specialized and essential skills and services to underserved communities. They are trusted sources of information, advocates, resource connectors, and, most significantly, health equity workers. However, the Navigator Program fails to support navigators' work and the communities they serve in the long term. To facilitate organizations' capacities to train, keep, and support navigators in this health equity work and to guarantee long-term enrollment assistance for underserved communities, efforts to stabilize funding are needed.
Communication During Interhospital Transfers of Emergency General Surgery Patients: A Qualitative Study of Challenges and Opportunities
Authors: Alagoz Esra , Saucke Megan , Arroyo Natalia , Fernandez Taylor Sara , Ingraham Angela
Published: February 2022

Objectives

Transferred emergency general surgery (EGS) patients experience worse outcomes than directly admitted patients. Improving communication during transfers may improve patient care. We sought to understand the nature of and challenges to communication between referring (RP) and accepting (AP) providers transferring EGS patients from the transfer center nurse’s (TCN) perspective.

Methods

Guided by the Relational Coordination Framework, we interviewed 17 TCNs at an academic medical center regarding (in)efficient and (in)effective communication between RPs and APs. In-person interviews were recorded, transcribed, and managed in NVivo. Four researchers developed a codebook, cocoded transcripts, and met regularly to build consensus and discuss emergent themes. We used data matrices to perform constant comparisons and arrive at higher-level concepts.

Results

Challenges to ideal communication centered on the appropriateness and completeness of information, efficiency of the conversation, and degree of consensus. Transfer center nurses described that RPs provided incomplete information because of a lack of necessary infrastructure, personnel, or technical knowledge; competing clinical demands; or a fear of the transfer request being rejected. Inefficient communication resulted from RPs being unfamiliar with the information APs expected and the lack of a structured process to share information. Communication also failed when providers disagreed about the necessity of the transfer. Accepting providers diffused tension and facilitated communication by embracing the role of a “coach,” negotiating “wait-and-see” agreements, and providing explanations of why transfers were unnecessary.

Conclusions

Transfer center nurses described numerous challenges to provider communication. Opportunities for improvement include sharing appropriate and complete information, ensuring efficient communication, and reaching consensus about the course of action.
Recent Trends in Adult and Pediatric Antiretroviral Therapy Monitoring and Failure
Authors: Boettiger David C. , An Vu Thien , Kumarasamy Nagalingeswaran , Azwa Iskandar , Sudjaritruk Tavitiya , Truong Khanh Huu , Avihingsanon Anchalee , Ross Jeremy , Kariminia Azar ,   for the International Epidemiology Databases to Evaluate AIDS—Asia-Pacific
Published: February 2022

Objective:

To assess recent trends in the monitoring of antiretroviral therapy (ART) and detection of ART failure in adult and pediatric HIV clinics.

Methods:

We used data collected from 21 adult and 17 pediatric sites (across 13 and 6 countries/territories, respectively) in the International Epidemiology Databases to Evaluate AIDS - Asia-Pacific cohort. ART failure was defined as viral, immune, or clinical consistent with WHO guidelines.

Results:

A total of 8567 adults and 6149 children contributed data. Frequency of CD4 count monitoring declined between 2010 and 2019 among adult sites (from 1.93 to 1.06 tests/person per year, a 45.1% decline) and pediatric sites (from 2.16 to 0.86 testsperson per year, a 60.2% decline), whereas rates of viral load monitoring remained relatively stable. The proportion of adult and pediatric treatment failure detected as immune failure declined (from 73.4% to 50.0% and from 45.8% to 23.1%, respectively), whereas the proportion of failure detected as viral failure increased (from 7.8% to 25.0% and from 45.8% to 76.9%, respectively). The proportion of ART failure detected as clinical failure remained stable among adult and pediatric sites. The largest shifts in ART monitoring and failure type occurred in lower middle-income countries.

Conclusions:

Although viral failure in our Asian cohort now comprises a larger portion of ART failure than in prior years, the diagnostic characteristics of immune and clinical failure, and recommendations on their management, remain important inclusions for regional ART guidelines.
Oxcarbazepine versus sodium valproate in treatment of acute mania: a double-blind randomized clinical trial
Authors: Talaei Ali , Dastgheib Masumeh Sadat , Soltanifar Atefeh , Mokhber Naghmeh , Akhondzadeh Shahin , Afzaljavan Fahimeh
Published: February 2022

Oxcarbazepine as an anticonvulsant has been suggested as an effective drug in affective disorders. The present study was designed to compare the efficacy of oxcarbazepine and sodium valproate in the treatment of acute mania in the Iranian population. In a double-blind, randomized clinical trial, hospitalized bipolar patients in the acute manic phase who were admitted to Ibn-e-Sina psychiatric hospital in Mashhad city (north-eastern part of Iran) were enrolled. The diagnosis was confirmed using Structured Clinical Interview for DSM-IV-TR. Patients were then randomly allocated into two groups taking oxcarbazepine (900–2400 mg/day) and sodium valproate (about 20 mg/kg/day) for 6 weeks. Young Mania Rating Scale (YMRS), Clinical Global Impression Scale (CGI-S), and adverse effects of drugs were assessed at baseline and after 3 and 6 weeks. Mania symptoms based on mean scores of YMRS and CGI-S significantly decreased from baseline to endpoint in both treatments (P < 0.01). However, there was no significant difference between the two groups in terms of reduction of symptoms during times (P = 0.715 and P = 0.446, respectively) and adverse events (P > 0.05). This study confirmed the previous findings that indicate the efficacy of oxcarbazepine as same as sodium valproate. Moreover, its adverse effects resemble sodium valproate in the treatment of acutely manic patients.
Untying relaxed circular DNA of hepatitis B virus by polymerase reaction provides a new option for accurate quantification and visualization of covalently closed circular DNA
Authors: Kamiya Naohiro , Sugimoto Takahiko , Abe-Chayama Hiromi , Akiyama Rie , Tsuboi Yasunori , Mogami Akira , Imamura Michio , Hayes C. Nelson , Chayama Kazuaki
Published: February 2022

Hepatitis B virus (HBV) is a small hepatotropic DNA virus that replicates via an RNA intermediate. After entry, the virus capsid carries relaxed circular DNA (rcDNA) into the nucleus where the viral genome is converted into covalently closed circular DNA (cccDNA), which serves as the template for all viral transcripts. To monitor cccDNA levels, preprocessing methods to eliminate rcDNA have emerged for quantitative PCR, although Southern blotting is still the only method to discriminate cccDNA from other DNA intermediates. In this study, we have established a robust method for untying mature rcDNA into double stranded linear DNA using specific polymerases. Untying rcDNA provides not only an alternative method for cccDNA quantification but also a sensitive method for visualizing cccDNA. We combined this method with plasmid-safe DNase and T5 exonuclease preprocessing and revealed that accurate quantification requires cccDNA digestion by a restriction enzyme because heat stability of cccDNA increases after T5 exonuclease treatment. In digital PCR using duplex TaqMan probes, fewer than 1000 copies of cccDNA were successfully visualized as double positive spots that were distinct from single positives derived from untied rcDNA. This method was further applied to the infection model of primary hepatocytes treated with nucleoside analogues and a core protein allosteric modulator to monitor cccDNA levels. Relative quantification of cccDNA by human genome copy demonstrated the possibility of precise evaluation of cccDNA level per nucleus. These results clearly indicate that the sequential reaction from untying rcDNA is useful to investigate cccDNA fates in a small fraction of nuclei.