bluuebunny/crossref_metadata_2025 huggingface dataset:
Together but still alone - A qualitative study exploring how family members of persons with incurable oesophageal or gastric cancer manage everyday life
Authors: Kårmark Sofia , Malmström Marlene , Kristensson Jimmie
Published: October 2024

Background

Cancer affects not only the person with the disease but those around them. Being a family member is described as strenuous and, often, associated with stress, anxiety and feelings of loneliness. There is a heightened risk of distress for family of those with fast-progressing, severe oesophageal or gastric cancer. Early palliative care involving family is vital yet often overlooked. In order to include family members in early palliative care their management in everyday life needs to be explored.

Method

Qualitative inductive interview study using content analysis guided by Graneheim and Lundman.

Result

The analysis resulted in the overarching theme “Managing the disease together but still alone”. Three categories were identified: Adapting to the disease, Taking control of the situation, Processing emotions. Each category described family members management in various aspects of everyday life together with the ill person and alone.

Conclusion

The results may contribute to an awareness of family members’ management of large parts of everyday life and, further, their feelings of loneliness, and indicates that family members should be included early in oesophageal or gastric cancer palliative care. Further studies are needed to develop the content of such family-inclusive early palliative care.
Guideline concordant opioid therapy in Veterans receiving VA and community care
Authors: Ma Phillip , Cheng Yan , Goulet Joseph L. , Sandbrink Friedhelm , Brandt Cynthia , Spevak Chris , Kean Jacob T. , Becker William , Libin Alexander , Shara Nawar , Sheriff Helen M , Houston James S. , Butler Jorie , Workman Elizabeth T. , Agrawal Rajeev M , Kupersmith Joel , Zeng-Treitler Qing
Published: October 2024

Guideline concordant opioid therapy is a key part of the concerted effort to address the opioid crisis in the United States. The study aimed to compare the rates of guideline concordant care between veterans who solely used VA services (mono users) and veterans who used both VA services and community care (dual-system users). We used electronic health record data from the Washington DC and Baltimore VA Medical Centers from 2015 to 2019. We provided descriptive statistics as well as generalized estimating equations models to find associations between mono vs. dual-system users and each guideline outcome, controlling for demographic factors and comorbid conditions. The study found that overall rates of guideline concordant care were high in both mono and dual-system users with over 90% adherence rates for the majority of recommendations. However, there were variations in adherence to specific guidelines, with urine drug screening at initiation being the least commonly followed recommendation (8.9% of mono-user opioid initiators and 11.2% of dual-user initiators). This study also found that there was no consistent pattern of higher guideline adherence in mono vs. dual-system users but did show that through the course of this study (2015–2019) overall rates of guideline concordance increased. Future research will explore additional guideline recommendations and potential coordination issues among dual-system users.
Proteomic analysis of extracellular vesicles derived from canine mammary tumour cell lines identifies protein signatures specific for disease state
Authors: Gutierrez-Riquelme Tania , Karkossa Isabel , Schubert Kristin , Liebscher Gudrun , Packeiser Eva-Maria , Nolte Ingo , von Bergen Martin , Murua Escobar Hugo , Aguilera-Rojas Matias , Einspanier Ralf , Stein Torsten
Published: October 2024

Background

Canine mammary tumours (CMT) are among the most common types of tumours in female dogs. Diagnosis currently requires invasive tissue biopsies and histological analysis. Tumour cells shed extracellular vesicles (EVs) containing RNAs and proteins with potential for liquid biopsy diagnostics. We aimed to identify CMT subtype-specific proteome profiles by comparing the proteomes of EVs isolated from epithelial cell lines derived from morphologically normal canine mammary tissue, adenomas, and carcinomas.

Methods

Whole-cell protein lysates (WCLs) and EV-lysates were obtained from five canine mammary cell lines: MTH53A (non-neoplastic); ZMTH3 (adenoma); MTH52C (simple carcinoma); 1305, DT1406TB (complex carcinoma); and their proteins identified by LC-MS/MS analyses. Gene Ontology analysis was performed on differentially abundant proteins from each group to identify up- and down-regulated biological processes. To establish CMT subtype-specific proteomic profiles, weighted gene correlation network analysis (WGCNA) was carried out.

Results

WCL and EVs displayed distinct protein abundance signatures while still showing the same increase in adhesion, migration, and motility-related proteins in carcinoma-derived cell lines, and of RNA processing and RNA splicing factors in the adenoma cell line. WGCNA identified CMT stage-specific co-abundant EV proteins, allowing the identification of adenoma and carcinoma EV signatures not seen in WCLs.

Conclusions

EVs from CMT cell lines exhibit distinct protein profiles reflecting malignancy state, allowing us to identify potential biomarkers for canine mammary carcinomas, such as biglycan. Our dataset could therefore potentially serve as a basis for the development of a less invasive clinical diagnostic tool for the characterisation of CMT.
Comparison of DNA extraction procedures for detection of Mycoplasma bovis directly from extended bovine semen straw samples using a commercial M. bovis PCR
Authors: Taylor Emma , Deeney Alannah , Birch Colin , Mayne Georgia , Ridley Anne
Published: October 2024

Background

Mycoplasma bovis is a global pathogen of cattle but was detected for the first time in New Zealand in 2017, triggering a response under their Biosecurity Act as an “unwanted organism”. Following a lengthy eradication campaign, the Ministry of Primary Industries (MPI) now requires all bovine semen destined for export to New Zealand to be screened with an M. bovis-specific real-time PCR (rtPCR) compliant with amended import health standard (IHS) test requirements aimed at preventing the accidental importation of M. bovis. The standard stipulates that semen samples cannot be centrifuged prior to DNA extraction. To comply with these strict requirements, one of the listed tests was validated together with different DNA preparation steps and compared with existing in-house procedures. DNA was extracted from semen straws using the current in-house semi-automated platform procedures for processing culture, tissue and body fluid sample submissions and was compared with the stipulated test requirements. DNA from centrifuged and unspun semen samples spiked with M. bovis was also compared.

Results

The rtPCR had a sensitivity and specificity of 100% (95% confidence interval = 79–100% and 74–100%, respectively) when testing DNA from other Mycoplasma species or bovine semen spiked with the latter, with a high level of repeatability for within- and between- run replicates. The consistent limit of detection was 0.001 pg/µl M. bovis DNA and between 5.3 × 102 and 7.5 × 102 CFU/ml M. bovis when artificially spiked in semen. DNA extracted using the KingFisher Flex was detected with lower Cq values than the Maxwell 16, but the comparable improvements in sensitivity were mainly associated with non-centrifuged samples (p < 0.001). None of the procedures tested impeded the detection sensitivity of M. bovis in the presence of competitor organisms Acholeplasma laidlawii, Mycoplasma bovigenitalium and Ureaplasma diversum, confirming M. bovis specificity of the polC target.

Conclusions

Under the experimental conditions applied, this rtPCR test efficiently detected M. bovis in extended bovine semen straw samples from DNA extracted using both semi-automated extraction platforms, irrespective of prior centrifugation of extended semen.
Endothelial KLF11 is a novel protector against diabetic atherosclerosis
Authors: Zhao Guizhen , Zhao Yang , Liang Wenying , Lu Haocheng , Liu Hongyu , Deng Yongjie , Zhu Tianqing , Guo Yanhong , Chang Lin , Garcia-Barrio Minerva T. , Chen Y. Eugene , Zhang Jifeng
Published: October 2024

Background

Atherosclerotic cardiovascular diseases remain the leading cause of mortality in diabetic patients, with endothelial cell (EC) dysfunction serving as the initiating step of atherosclerosis, which is exacerbated in diabetes. Krüppel-like factor 11 (KLF11), known for its missense mutations leading to the development of diabetes in humans, has also been identified as a novel protector of vascular homeostasis. However, its role in diabetic atherosclerosis remains unexplored.

Methods

Diabetic atherosclerosis was induced in both EC-specific KLF11 transgenic and knockout mice in the Ldlr−/− background by feeding a diabetogenic diet with cholesterol (DDC). Single-cell RNA sequencing (scRNA-seq) was utilized to profile EC dysfunction in diabetic atherosclerosis. Additionally, gain- and loss-of-function experiments were conducted to investigate the role of KLF11 in hyperglycemia-induced endothelial cell dysfunction.

Results

We found that endothelial KLF11 deficiency significantly accelerates atherogenesis under diabetic conditions, whereas KLF11 overexpression remarkably inhibits it. scRNA-seq profiling demonstrates that loss of KLF11 increases endothelial-to-mesenchymal transition (EndMT) during atherogenesis under diabetic conditions. Utilizing gain- and loss-of-function approaches, our in vitro study reveals that KLF11 significantly inhibits EC inflammatory activation and TXNIP-induced EC oxidative stress, as well as Notch1/Snail-mediated EndMT under high glucose exposure.

Conclusion

Our study demonstrates that endothelial KLF11 is an endogenous protective factor against diabetic atherosclerosis. These findings indicate that manipulating KLF11 could be a promising approach for developing novel therapies for diabetes-related cardiovascular complications.
The probability density function of the surface electromyogram and its dependence on contraction force in the vastus lateralis
Authors: Rodriguez-Falces Javier , Malanda Armando , Mariscal Cristina , Recalde Silvia , Navallas Javier
Published: October 2024

Introduction

The probability density function (PDF) of the surface electromyogram (sEMG) depends on contraction force. This dependence, however, has so far been investigated by having the subject generate force at a few fixed percentages of MVC. Here, we examined how the shape of the sEMG PDF changes with contraction force when this force was gradually increased from zero.

Methods

Voluntary surface EMG signals were recorded from the vastus lateralis of healthy subjects as force was increased in a continuous manner vs. in a step-wise fashion. The sEMG filling process was examined by measuring the EMG filling factor, computed from the non-central moments of the rectified sEMG signal.

Results

(1) In 84% of the subjects, as contraction force increased from 0 to 10% MVC, the sEMG PDF shape oscillated back and forth between the semi-degenerate and the Gaussian distribution.

(2) The PDF–force relation varied greatly among subjects for forces between 0 and ~ 10% MVC, but this variability was largely reduced for forces above 10% MVC.

(3) The pooled analysis showed that, as contraction force gradually increased, the sEMG PDF evolved rapidly from the semi-degenerate towards the Laplacian distribution from 0 to 5% MVC, and then more slowly from the Laplacian towards the Gaussian distribution for higher forces.

Conclusions

The study demonstrated that the dependence of the sEMG PDF shape on contraction force can only be reliably assessed by gradually increasing force from zero, and not by performing a few constant-force contractions. The study also showed that the PDF–force relation differed greatly among individuals for contraction forces below 10% MVC, but this variability was largely reduced when force increased above 10% MVC.
Plasma lipids and glycaemic indices in Australians following plant-based diets versus a meat-eating diet
Authors: Austin Grace , Ferguson Jessica J. A. , Eslick Shaun , Oldmeadow Christopher , Wood Lisa G. , Garg Manohar L.
Published: October 2024

Background

Vegan and vegetarian dietary patterns are known to beneficially modulate risk factors for cardiovascular disease; however, the current literature does not differentiate between various plant-based diets. This study aimed to examine the association between various plant-based diets and plasma lipids and glycaemic indices compared to a regular meat-eating diet.

Methods

A cross-sectional study of Australian adults (n = 230) aged 30-75yrs habitually consuming the following were recruited: vegan, lacto-vegetarian, pesco-vegetarian, semi-vegetarian, or regular meat-eater. Multivariable regression analysis was used to adjust for covariates.

Results

Compared to regular meat-eaters, vegans had significantly lower total cholesterol (-0.77mmol/L,95% CI -1.15, -0.39, P < 0.001), low-density lipoprotein cholesterol (LDL-C, -0.71mmol/L, 95% CI -1.05, -0.38, P < 0.001), non-high-density lipoprotein cholesterol (non-HDL-C, -0.75mmol/L, 95% CI -1.11, -0.39, P < 0.001), total cholesterol/HDL-C-ratio (-0.49mmol/L, 95% CI -0.87, -0.11, P = 0.012), fasting blood glucose (FBG, -0.29mmol/L, 95% CI -0.53, -0.06, P = 0.014), haemoglobin A1C (-1.85mmol/mol, 95% CI -3.00, -0.71, P = 0.002) and insulin (-1.76mU/L, 95% CI -3.26, -0.26, P = 0.021) concentrations. Semi-vegetarians had significantly lower LDL-C (-0.41mmol/L, 95% CI -0.74, -0.08, P = 0.041) and non-HDL-C (-0.40mmol/L, 95% CI -0.76, -0.05, P = 0.026) and lacto-ovo vegetarians had significantly lower FBG (-0.34mmol/L, 95% CI -0.56, -0.11, P = 0.003) compared to regular meat-eaters. There were no differences in HDL-C and triglycerides between plant-based and regular-meat diets.

Conclusions

Plasma lipaemic and glycaemic measures as a collective were more favourable among vegans, whereas among lacto-ovo vegetarians and semi-vegetarians, only some measures were favourable.

Trial registration

ACTRN12621000743864. Date 6/11/2021.
Self-confidence as a mediator in the relationship between executive functioning and depression among ICU survivors: a latent variable analysis
Authors: Johannesson Elias , Malmgren Johan
Published: October 2024

Background

Executive dysfunction and depression are common among ICU survivors, yet the mechanisms linking these two factors remain poorly understood. Self-confidence has been implicated as a key mediator in the relationship between cognitive impairments and mental health outcomes. This study aimed to explore the mediating role of self-confidence in the association between executive functioning and depression in ICU survivors.

Method

A provisional questionnaire was used in a cross-sectional study to assess quality of life in 395 adult ICU survivors, each with a minimum 72-h stay at one of three ICUs at a Swedish university hospital, six months to three years post-discharge. Responses to questions on executive function, self-confidence, and depression were analysed. Structural equation modelling and confirmatory factor analysis were employed to examine the mediating effect of self-confidence on the relationship between executive function and depression. Model fit was evaluated using established indicators. Reliability of the measures was assessed using McDonald’s Omega and Cronbach’s Alpha.

Results

A significant positive correlation was found between depressive symptoms and both diminished self-confidence (r = 0.80, p < 0.001) and poorer executive function (r = 0.55, p < 0.001). Additionally, a correlation was observed between reduced self-confidence and compromised executive function (r = 0.62, p < 0.001). Age was negatively associated with depression, self-confidence, and executive function, while male gender was positively correlated with higher self-confidence.

Mediation analysis revealed that the effect of impaired executive function on depressive symptoms was fully mediated by diminished self-confidence (B = 0.45; 95% CI 0.34–0.59). The direct effect of executive function on depression became non-significant when self-confidence was included in the model (B = 0.07, p = 0.18), suggesting complete mediation. The overall model fit was satisfactory (CFI = 0.962; RMSEA = 0.075), highlighting the robustness of the mediation pathway.

Conclusions

Self-confidence mediates the relationship between executive function and depression among ICU survivors. Interventions aimed at enhancing self-confidence could mitigate depressive symptoms in the ICU survivor population. Longitudinal studies are needed to confirm these findings and further explore the causal pathways involved.

Trial registration ClinicalTrials.gov Ref# NCT02767180; Registered 28 April 2016.
A single treatment with a fluralaner injectable suspension (Bravecto® injectable) provides 1-year efficacy against Rhipicephalus sanguineus sensu lato and Ctenocephalides felis in dogs
Authors: Raulf Marie-Kristin , Raue Katharina , Schwarz Anna , Petersen Ivo , Zschiesche Eva , Heinau Lea , Strube Christina
Published: October 2024

Background

Rhipicephalus sanguineus sensu lato (s.l.) and Ctenocephalides felis are among the most important year-round ectoparasites of dogs. The persistent efficacy of one treatment with fluralaner injectable suspension (Bravecto® 150 mg/ml powder and solvent for suspension for dogs, referred to as Bravecto® injectable) was investigated in a negative-controlled, randomised, partially blinded 12-month laboratory study.

Methods

A total of 20 dogs were randomly allocated to two equal groups (treatment and control). Treatment-group dogs were injected subcutaneously on study day 0 with the investigational veterinary product at the recommended dose of 15 mg fluralaner/kg body weight (0.1 mL/kg), whereas the control group dogs received saline solution (0.1 mL/kg). Each dog was infested with 50 (25 female, 25 male) adult R. sanguineus s.l. and 100 adult C. felis 2 days before treatment, 5 and 28 days after treatment, and then once monthly for a 12-month period. Live tick and flea counts were performed 48 h after treatment or subsequent infestation, respectively. Efficacy was determined by comparing arithmetic means of the treatment group tick and flea counts with those of the control group. Infestation was considered adequate if at least 25.0% of ticks and 40.0% of fleas were recovered from at least six dogs in the control group at the respective assessment times.

Results

Adequate R. sanguineus s.l. and C. felis infestations of control group dogs were observed at each time point. Arithmetic mean treatment group values were significantly lower than those of the control group at all time points. The immediate efficacy when treating existing infestations of R. sanguineus s.l. and C. felis (infestation 2 days before treatment), was 49.7% and 89.7%, respectively. The persistent efficacy against post-treatment re-infestations was 94.4–100% against R. sanguineus s.l. and 92.2–100% against C. felis. Seven dogs in the control group developed flea allergy dermatitis due to the repeated re-infestations over the study period, whereas no dogs in the treatment group were affected. No clinically relevant side effects were observed over the entire study period.

Conclusions

The fluralaner injectable suspension (Bravecto® injectable) provides 1 year of efficacy against R. sanguineus s.l. and C. felis infestations in dogs following a single treatment, allowing once-yearly treatment, which can significantly improve owner compliance with year-round protection of dogs.

Graphical Abstract
N-glycosylation of the envelope glycoprotein I is essential for the proliferation and virulence of the duck plague virus
Authors: Ning Yaru , Wang Mingshu , Cheng Anchun , Yang Qiao , Tian Bin , Ou Xumin , Sun Di , He Yu , Wu Zhen , Zhao Xinxin , Zhang Shaqiu , Wu Ying , Huang Juan , Yu Yanling , Zhang Ling , Jia Renyong , Liu Mafeng , Zhu Dekang , Chen Shun
Published: October 2024

Duck plague virus (DPV) causes the highly pathogenic duck plague, and the envelope glycoprotein I (gI), as one of the key virulence genes, has not yet had its critical virulence sites identified through screening. This study used reverse genetics technology to target the gI, specifically within the DPV genome. Four DPV mutants with gI N-glycosylation site mutations were designed and constructed, and these mutant strains were successfully rescued. Our results confirmed that three asparagine residues of gI (N69, N78, and N265) are N-glycosylation sites, and western blot analysis substantiated that glycosylation at each predicted N-glycosylation site was compromised. The deglycosylation of gI leads to the protein misfolding and subsequent retention in the endoplasmic reticulum (ER). The subsequent deglycosylated gI is carried into the Golgi apparatus (GM130) in the interaction of gE. Compared to the parental virus, the mutated virus shows a 66.3% reduction in intercellular transmission capability. In ducks, the deglycosylation of gI significantly reduces DPV replication in vivo, thereby weakening the virulence of DPV. This study represents the first successful creation of a weak DPV virus strain by specific mutation at the N-glycosylation site. The findings provide a foundational understanding of DPV pathogenesis and form the basis for developing live attenuated vaccines against the disease.
Early sedation using ciprofol for intensive care unit patients requiring mechanical ventilation: a pooled post-hoc analysis of data from phase 2 and phase 3 trials
Authors: Liu Yongjun , Zuo Lingyun , Li Xiaoyun , Nie Yao , Chen Chuanxi , Liu Ning , Chen Minying , Wu Jianfeng , Guan Xiangdong
Published: October 2024

Background

Ciprofol was approved for use in intensive care unit (ICU) patients requiring sedation during mechanical ventilation in July 2022. A pooled post-hoc analysis of phase 2 and phase 3 trials was conducted primarily to explore hypotension-free outcome in ICU patients who required mechanical ventilation and achieved the target light sedation goal at an early stage after being sedated with ciprofol or propofol.

Methods

All eligible ICU patients who were expected to require sedation for 6–24 h were randomly assigned in a 2:1 ratio to either a ciprofol or propofol group. Ciprofol or propofol was initially infused at loading doses of 0.5 or 1.0 mg/kg followed by maintenance doses of 0.3 or 1.5 mg/kg/h. Ciprofol or propofol dosages were adjusted up or down at rates of 0.05–0.10 mg/kg/h or 0.25–0.50 mg/kg/h, respectively, to achieve the target light sedation (a Richmond Agitation-Sedation Scale of -2 to + 1). The primary post-hoc outcome was the hypotension-free rate in patients who had achieved the target sedation goal after 30-min administration of ciprofol or propofol.

Results

In total, 174 patients were enrolled for pooled post-hoc analysis, of whom 116 and 58 were assigned to the ciprofol and propofol groups, respectively. The hypotension-free rate was significantly higher in patients who achieved the target sedation goal after 30-min administration of ciprofol (93.0% vs. 81.0%, P = 0.018), and especially in the subgroups of males and patients aged < 65 years. Multivariable analysis revealed that ciprofol treatment, a younger age and lower baseline body mass index were independent favorable predictors for a higher hypotension-free rate in patients who achieved the target sedation goal after 30-min of drug administration. Moreover, hypotension-free patients who reached the target sedation level after 30 min had a more favorable short-term prognosis including a lower incidence of drug-related treatment-emergent adverse events, shorter time to extubation and fewer dose adjustments of ciprofol or propofol (all P < 0.05).

Conclusion

ICU patients undergoing mechanical ventilation and sedated with ciprofol had significantly lower rate of hypotension during the early phase of achieving light sedation during a 6–24 h period, leading to a more favorable short-term prognosis (within 24 h).

Trial registration

Phase 2 trial (clinicaltrials.gov, NCT04147416. Registered November 1, 2019, https://classic.clinicaltrials.gov/ct2/show/NCT04147416) and phase 3 trial (clinicaltrials.gov, NCT04620031. Registered November 6, 2020, https://classic.clinicaltrials.gov/ct2/show/NCT04620031).
Successful management of anaphylactic shock prior to elective cesarean delivery: a case report
Authors: Watanabe Kaede , Najid Nazuha Mohd , Mazda Yusuke
Published: October 2024

Background

Anaphylactic cardiovascular collapse is complicated by aortocaval compression during pregnancy, exacerbated by neuraxial anesthesia. Despite recommendations to administer perioperative antibiotics before anesthesia, common practice in Japan involves administering them after anesthesia induction. We report a case of possible antibiotics-induced anaphylaxis just before anesthesia for cesarean delivery.

Case presentation

A 24-year-old woman at 37 weeks of gestation presented for a scheduled repeat cesarean under spinal anesthesia. After starting administration of cefazolin prior to anesthesia, she developed anaphylactic symptoms. Hypotension refractory to adrenaline necessitated conversion to an emergency cesarean section under general anesthesia. A neonate was delivered with favorable Apgar scores. Post-delivery, the mother’s hemodynamics stabilized significantly. Elevated plasma tryptase confirmed anaphylaxis. Both mother and infant were discharged without further complications.

Conclusions

This case emphasizes the importance of administering prophylactic antibiotic before anesthesia in mitigating severity of shock induced by anaphylaxis and the crucial role of prompt emergency cesarean in achieving successful outcomes.
Tratamento cirúrgico de displasia fibrosa em mandíbula
Authors: Silva Muniz Ravanna , Vitória Gomes Viana Mariana , De Oliveira Brandão Tagna , Passos da silva Natália , Elze Falcão Lins Kusterer Liliane
Published: October 2024

Objetivo: descrever um caso de displasia fibrosa em mandíbula tratada com osteoplastia funcional. Relato de caso: paciente de 40 anos, compareceu ao ambulatório de bucomaxilofacial queixando-se de alteração no posicionamento da língua devido à crescimento ósseo em mandíbula. Ao exame físico notou-se aumento de volume de consistência firme em região mandibular a esquerda e que radiograficamente evidenciava alteração em forma de vidro fosco compatível com displasia fibrosa. Como tratamento, optou-se pela osteoplastia funcional seguida de proservação. Considerações finais: a abordagem é norteada pela gravidade da doença e no seu potencial deformador e recidivante, sendo a osteoplastia escolhida para evitar mutilações e prejuízos funcionais.
Isolated fungal sphenoid sinusitis with unilateral lateral rectus palsy six years post lung transplant
Authors: Jenkins Mallory , Jang Wooyoung , Tello Nadia , Idicula Winslo
Published: October 2024

Rhino-orbital-cerebral mucormycosis (ROCM) infections are rare and usually occur in patients with diabetes, malignancy, or organ transplantation. The most common presenting symptoms include facial pain and swelling, fever, and rhinorrhea. Mortality rates reach nearly 50%. Those with previous organ transplants typically present with sinus symptoms a few weeks to months after transplantation. A 75-year-old man presented with headache. His history was significant for bilateral lung transplantation in 2017. On his fourth presentation, he was admitted to the hospital for work up. Imaging showed small fluid levels within the right maxillary and sphenoid sinuses. Infectious work-up revealed no meningitis. On day three, the patient complained of diplopia on the right. His examination was significant for right lateral rectus palsy. Repeat imaging was performed and showed increasing fluid levels of the right maxillary and sphenoid sinuses, and the otolaryngology consultation service was consulted. Nasal endoscopy was significant for pink, vascularised mucosa with no obvious regions of pallor or necrosis. Endoscopic sinus surgery was performed. There were no findings suggestive of fungus but purulence of the right sphenoid grew Rhizopus. The patient’s nerve palsy did not resolve and progressed to the contralateral orbit. Repeat nasal endoscopy continued to show healthy mucosa while MRI showed enhancement worrisome for meningitis. To our knowledge, this is the only reported case of fungal sphenoid sinusitis resulting in meningitis and death six years after transplant. Current literature documents fungal infection in post-transplant patients up to four years after surgery, with most occurring within the first year. Suspicion for fungal infection should remain high in this patient population.
Keywords: mucormycosis, lung transplant, sinusitis, lateral rectus palsy
The impact of intravenous metoprolol tartrate on mortality rates in patients with septic shock due to ventilator-associated pneumonia: A randomized clinical trial
Authors: Fayed Akram , Meligy Haytham , Hamad Sherouk
Published: October 2024

Background: Septic shock, particularly due to ventilator-associated pneumonia (VAP), is a significant cause of mortality in critically ill patients. Traditional treatments include antimicrobial therapy, fluid resuscitation, and vasopressors. However, recent interest has emerged in using β-blockers to modulate the hyperadrenergic state seen in sepsis. β-blockers, like metoprolol, may improve cardiac efficiency, reduce myocardial oxygen demand, and ultimately enhance patient outcomes.
Objective: This study aimed to assess the impact of administering intravenous metoprolol tartrate on the mortality rates of patients with septic shock due to VAP.
Methods: This study employed a randomized clinical trial design within the Intensive Care Units of Alexandria Main University Hospital. A cohort of 100 patients diagnosed with septic shock due to ventilator-associated pneumonia (VAP) participated in the trial. Upon achieving hemodynamic stabilization, participants were randomly assigned to either receive standard care alone or standard care supplemented with intravenous metoprolol. Variables of interest included assessing 28-day mortality rates, duration of ICU stay and mechanical ventilation, reliance on intravenous fluids and vasopressors, acid-base balance, lactate levels, inflammatory markers, and mean arterial pressure (MAP). This comprehensive approach aimed to evaluate the impact of metoprolol on critical outcomes in this patient population.
Results: The administration of intravenous metoprolol tartrate resulted in significant clinical benefits, including lower 28-day mortality rates (P = 0.013), shortened durations of ICU stay (P < 0.001), and reduced mechanical ventilation periods (P < 0.001). These outcomes were explained by the observed decreased reliance on intravenous fluids and vasopressors (P < 0.001), improved acid-base balance and lactate levels. The rapid reduction of inflammatory markers (P < 0.001) and the sustained improvement of MAP in the metoprolol group compared to the control group further contributed to the explication of these findings.
Conclusion: Intravenous metoprolol tartrate effectively controlled inflammation, optimized hemodynamics, and improved patient outcomes compared to standard care, suggesting it as a beneficial adjunct in the management of septic shock.
Trial registration: PACTR202404531355476.
Keywords: Metoprolol; septic shock; ventilator-associated pneumonia; beta-blockers; mortality.
Percutaneous transcatheter closure of a large saphenous vein graft aneurysm with Amplatzer vascular plug
Authors: Nagasawa Takuya , Nagasawa Tomokazu , Elliott John , Cevik Cihan
Published: October 2024

A saphenous vein graft (SVG) aneurysm is a rare complication seen in coronary artery bypass grafts (CABG). While the sternotomy for surgical correction is used in most of these patients, depending on the patient’s condition, an alternative method may be required. This case is a 64-year-old man who developed SVG aneurysm more than 10 years after CABG and underwent a successful percutaneous transcatheter exclusion of SVG aneurysm using 10 mm Amplatzer Vascular Plug 2, resulting in prevention of blood flow into the aneurysm and future rupturing. This case illustrates the potential of noninvasive treatment with flexible procedures based on the patient’s anatomy and risk for complicated surgery.
Keywords: Amplatzer vascular plug, saphenous vein graft, saphenous vein graft aneurysm, coronary artery bypass graft
African dust: Occurrence, health consequences, and impacts on Texas
Authors: Gill Thomas E , Mims Forrest M. , Chellam Shankararaman
Published: October 2024

The drylands of North Africa (Sahara and Sahel) are the world’s largest sources of airborne dust. Clouds of African dust aerosols have been long known to be blown westwards across the Atlantic, and by the 1990s were recognized to be transported across and over Texas. African dust incursions in Texas typically happen several times per year in late spring and summer, manifesting as hazy skies overhead and increased ground-level concentrations of PM2.5 (particulate matter fine enough to be inhaled into the human lower respiratory tract). African dust exposure has many reported human health effects in Europe and the Caribbean, including increased all-cause mortality and increased respiratory and cardiovascular disease morbidity and mortality. In Texas, African dust’s greatest impacts occur in the Houston metropolitan area where it has been quantitatively shown to increase ambient aerosol concentrations. The potential of African dust increasing concentrations of inhalable particulate matter beyond regulatory limits is of concern. A sequence of investigations filtering particles from the air, measuring their concentrations, and subjecting them to elemental analysis documented far-transported African dust’s role in air quality in Houston and Galveston. African dust’s contributions to air pollution have been separated from those of local soils and industrial emissions, and Saharan-Sahelian dust has been indicated to sometimes constitute the majority of PM2.5 mass in Houston. While studies show the presence of inhalable metals and microorganisms including opportunistic pathogens during Saharan air incursions in Houston, the human health effects of African dust in Texas remain yet unspecified and merit further investigation.
Keywords: aerosols; Africa, Northern; air pollution; dust; particulate matter; public health; Texas
Lock, stock, and Leuconostoc: an unusual presentation of a rare pathogen
Authors: Gordon Douglas , Peterson Christopher , Vattikonda Kirit , Wang Yunan
Published: October 2024

Leuconostoc mesenteroides is a Gram-positive bacterium in the Lactobacillaceae family. This species is rarely encountered clinically and in the past was regarded as a contaminant when cultured. Recently it is being recognized as a pathogen responsible for opportunistic infections in immunocompromised patients. Compared to other Gram-positive cocci, Leuconostoc spp. carry intrinsic resistance to vancomycin. It is not common for clinical microbiology laboratories to isolate this organism and instead incorrectly report enterococcus and streptococcus organisms. Here, we present a case of bacteremia resulting in febrile illness and pneumonia in an 81-year-old woman with a history of rheumatoid arthritis and a notable lapse between immunomodulator therapy exposure. She was successfully treated when this organism was identified, and her antibiotic therapy was switched from vancomycin to ampicillin-sulbactam. This case highlights the importance of considering L. mesenteroides as a source of infection in patients predisposed to an immunocompromised state despite this organism’s being a rare pathogen.
Keywords: Leuconostoc mesenteroides, rheumatoid arthritis, immunomodulators; vancomycin resistance
Pulmonary arterial hypertension in human immunodeficiency virus infections
Authors: Singh Tushi , Motes Arunee , Vinan-Vega Myrian , Nugent Kenneth
Published: October 2024

Pulmonary arterial hypertension (PAH) is an important health issue in the twenty-first century. The introduction of highly active retroviral therapy has prolonged survival in patients infected with the human immunodeficiency virus (HIV), and this has led to the emergence of new health issues, including PAH, in those patients. This review considers the advances in understanding the pathophysiology of PAH in HIV infections and the approaches to the treatment of these patients.
Keywords: Pulmonary arterial hypertension, HIV, pathophysiology, treatment
Discussion of the Most Effective Scar Treatment Methods
Authors: Nojek Paweł , Pawlik Wiktoria , Zimonczyk Mariusz , Zawół Monika , Błaszczyński Gustaw , Nowotarska Agnieszka
Published: October 2024

Scars are a natural consequence of the wound healing process, but excessive scarring can lead to aesthetic and functional concerns. This paper aims to review current scar treatment methods, including modern techniques such as laser therapies, microneedling, corticosteroid injections, and silicone dressings. Special attention is given to the treatment of hypertrophic scars and keloids, which present significant challenges in contemporary medicine. An analysis of recent studies highlights the effectiveness of these methods in improving scar appearance and reducing discomfort associated with scars. Additionally, emerging experimental therapies, such as the use of stem cells and monoclonal antibody treatments, are discussed. The findings suggest that early intervention and individualized treatment approaches are crucial for achieving optimal aesthetic and functional outcomes.
Lebenslanges Lernen verstehen
Authors: Erol Şerife
Published: October 2024

Wie beeinflussen Arbeitsorientierungen das Weiterbildungsverhalten von Beschäftigten? Şerife Erol zeigt, dass neben objektiven Faktoren wie soziodemografischen, arbeitsbezogenen und betriebsbezogenen Merkmalen auch subjektive Reaktionen eine signifikante Rolle spielen. Besonders hervorzuheben ist, dass eine starke organisations- oder berufsbezogene Arbeitsorientierung die Wahrscheinlichkeit erhöht, an Weiterbildungen teilzunehmen. Im Gegensatz dazu kann eine ausgeprägte marktbezogene Arbeitsorientierung diese Wahrscheinlichkeit verringern. Die Ergebnisse der Untersuchung verdeutlichen, wie Arbeitsbedingungen gestaltet sein sollten, um Mitarbeitende zur Weiterbildung zu motivieren. https://creativecommons.org/licenses/by-nc/4.0
Bildungsklagen in Kolumbien
Authors: Ciesielski Markus
Published: October 2024

Mithilfe der Soziologie von Pierre Bourdieu untersucht dieses Buch die Wechselwirkungen zwischen rechtlichen Transformationen und gesellschaftlichem Wandel im Bildungssektor Kolumbiens, eines Landes, das von sozialer Ungleichheit und Gewalt geprägt ist. Die Studie greift dafür auf die Erfahrungen von Schüler:innen, Studierenden und Eltern zurück, die ihre Rechte vor Gericht mit Berufung auf die bekannte kolumbianische Grundrechtsbeschwerde, die »Acción de Tutela« eingefordert haben. Der Vergleich ihres Denkens, Handelns und Wahrnehmens zeigt, dass klagebedingte Veränderungen stark von ihrer jeweiligen sozialen Lage abhängen. Markus Ciesielski greift neben den qualitativen Interviews mit den Kläger:innen auf Justiz- und Bildungsstatistiken zurück. Seine Studie lässt die Rolle des Rechts in der sozialen Ungleichheitsforschung besser verstehen und liefert wertvolle Impulse für zukünftige Forschung an der Schnittstelle von Recht und Gesellschaft. https://creativecommons.org/licenses/by-nc-sa/4.0/legalcode
Wa(h)re Mutterschaft
Authors: Schmidt Petra
Published: October 2024

Die ethnografische Studie untersucht die kreativen Arbeitspraktiken von Müttern aus urbanen Milieus, die während ihrer Elternzeit und im Familienalltag begonnen haben, ihre Erfahrungen und Erlebnisse ästhetisch auf Internetblogs zu verarbeiten und zu vermarkten. Diese sogenannten »Mombloggerinnen« wollen authentische Einblicke in den Lebensstil urbaner Mütter vermitteln: von Erziehungsfragen und Modevorlieben über Vorstellungen von Nachhaltigkeit, Gesundheit und Ernährung bis hin zu ihren Lieblingscafés und anderen Orten. Dabei machen sie auch Werbung für Unternehmen. Mutterschaft wird auf diese Weise für diese kreative Klasse, gemäß postfordistischen Erwerbslogiken, zum Ausgangspunkt ihrer beruflichen Tätigkeit. In ihrer Forschung bietet Petra Schmidt Einblicke in die ästhetischen Arbeitspraktiken von Mombloggerinnen und beleuchtet die Gestaltungsprozesse, die ökonomischen Mechanismen, das Können und Wissen sowie die Ambivalenzen, die mit der Verwischung der Grenzen zwischen Mutterschaft und Arbeit durch das Momblogging einhergehen und zeigt die ökonomische Relevanz und Normalisierung ästhetischer Praktiken im Arbeits- und Alltagsleben von Müttern und darüber hinaus auf.
Reconsidering Fromm and feminisms, part II: a case for psychosocial compatibilities
Authors: Chancer Lynn S.
Published: October 2024

This article continues an earlier one about how the work of Erich Fromm and feminist theories are compatible despite the connection usually remaining overlooked. Drawing on Fromm’s critique of Freud’s analysis of Dora, but also going further, I argue that associating Fromm and contemporary feminist thought is particularly important in the context of growing authoritarianism on the right and sometimes as reflected also on the left. The article elaborates upon five points of ‘psychosocial compatibility’ between Fromm’s humanistic vision and the ideas of several well-known feminist theorists including Simone de Beauvoir, Nancy Chodorow, Jessica Benjamin and others. The five points of psychosocial compatibility addressed between From and contemporary feminisms as addressed here are: connecting the personal and the political while stressing the prefigurative; kindred issues concerning objectification and self-love; emphases on relatedness and the pre-oedipal stage of human development; concerns about multi-dimensionality and intersectionality; and shared political beliefs aimed at overcoming gender and other oppressive inequalities
Rethinking replacement, rebound and environmental impact in reuse practice
Authors: Isenhour Cindy , Berry Brieanne , Scruton Emily
Published: October 2024

Despite the current emphasis on reuse as a primary strategy for realising more circular economic systems, researchers have questioned the assumed environmental benefits of the practice – arguing that reuse can result in unintended rebound effects that diminish or outweigh environmental gains. This article reviews studies focused on potential rebound effects in reuse practices – not as a means to re-adjudicate the environmental virtues of reuse – but rather to critically examine common assumptions about the people and practices that animate reuse markets. The article thus responds to calls for additional research on the behavioural dimensions of reuse in more circular economic systems – and the associated implications for modelling environmental impact. We draw on an in-depth study of 30 active participants in direct product reuse markets to theorise everyday circularity from a critical social science perspective. We argue, based on our observations, that environmental impact models of reuse should not assume that: (1) all forms of product reuse are the same; (2) buyers and sellers are driven primarily by price logics; and (3) new goods are the default preference. We find reuse markets to be much more fluid than imagined by environmental impact models and argue that these insights are particularly important to consider as we approach the end of cheap nature and the costs of overconsumption are increasingly clear.
Exploratory study of groundwater infiltration in lough arrow using thermal imagery and geochemical tracers
Authors: Garland Darren , Wilson Raymond , McElarney Yvonne , Touzet Nicolas , Lucy Frances , Arnscheidt Joerg
Published: October 2024

abstract: Groundwater dynamics were investigated in Lough Arrow in the north-west of Ireland. The lake is designated under the EU Habitats Directive (92/43/EEC) for its representative Annex I habitat from which charophytes are the main feature of interest. Groundwater interactions are considered a significant component of the lough's hydrology with its Annex I archetype deemed vulnerable to the pressures of nutrient pollution. This study utilised thermal imagery and geochemical tracers to detect and quantify groundwater inputs. Landsat 7 Thermal Infrared Imagery from two dates in both summer and winter was processed to investigate the potential occurrence of localised seepage points of groundwater captured as anomalous spatial plumes. In situ surveys of radon were undertaken in summer to confirm the presence of groundwater in the lake. Results were subsequently modelled to estimate the total groundwater discharge into the lake during the survey period. Additionally, a conceptual site model was created to characterise potential pressures to the lake from groundwater interactions within the catchment. Thermal imaging failed to conclusively identify thermal plumes consistent with localised groundwater inputs in Lough Arrow. However, the radon inventory applied to the mass balance estimated the lake was subject to 6,722m3 of groundwater influx per day at the time of the survey. The conceptual site model determined the lake was subject to potential pollution pressures from groundwater due to the catchment's physical attributes and land use activities. This is primarily due to the presence of a karst aquifer in the majority of the catchment coupled with significant agricultural and forestry practices. The vulnerability of the aquifer and the influx of groundwater to the lake highlights the potential threat groundwater contamination may pose to the favourable conservation condition of Lough Arrow's Annex I habitat.
Incarnation and Manifestation: A Franciscan-Augustinian Approach to Mahāyāna Theology
Authors: Pomplun Trent
Published: October 2024

abstract: This article aims to supplement the work of previous scholars on Mahāyāna Theology by expanding the sources we use to compare Buddhist and Christian notions of embodiment. It advances three arguments: (i) Early Christian doctrines of the Holy Trinity and the Incarnation, especially so-called angelomorphic conceptions of the Son and the Spirit, are closer to classic notions of the Buddha's three bodies than many Christian theologians have realized; (ii) these similarities compel the Christian theologian to recognize the significance of conciliar definitions after Nicaea and Chalcedon for comparisons of Buddhist and Christian notions of embodiment; and (iii) the Franciscan-Augustinian tradition of Robert Grosseteste (1175–1253), St. Bonaventure of Bagnoregio (1221–1274), and Bl. John Duns Scotus (ca. 1266–1308) allows one to unite the pre-Nicaean and post-Nicaean traditions with a Christology sufficiently maximalist to interpret many Buddhist notions of embodiment favorably without losing sight of the identity of nature between the Trinitarian persons mandated by the logic of Nicaea and the difference in divine and human natures mandated by Chalcedon.
There Is Nothing to Acquire: Comparing the Unborn Mind and the Silent Land
Authors: Thralls Chad
Published: October 2024

abstract: This paper uncovers similarities and differences between Zen Buddhist and Christian understandings of contemplative practice through a comparison of the writings of the Japanese Zen master Bankei Yotaku and the contemporary Christian contemplative writer Martin Laird. Though both claim that human beings are fundamentally connected to their spiritual goal, Zen emerges from the comparison with a more radical version of nonduality. The paper concludes by asking whether Christians can adopt such a radical nonduality within their own religious framework.