bluuebunny/crossref_metadata_2025 huggingface dataset:
Leitura e argumentação: cronotopos de um manual escolar para o Novo Ensino Médio
Authors: Campos Maria Inês Batista , Mitsunari Nathalia Akemi Sato
Published: January 2024

No Novo Ensino Médio, os volumes únicos de Língua Portuguesa devem promover o protagonismo juvenil, a partir do ensino da argumentação e de gêneros digitais, tendo em vista seu potencial participativo e colaborativo. Essa proposta didática busca ampliar a participação do aluno nos campos da atividade humana, diante de diferentes tensões discursivas em torno de seu alcance ético. Neste artigo, o objetivo é discutir o alcance ético da proposta de Ser protagonista: a voz das juventudes (Moreno et al., 2020) na seção de leitura da unidade “As culturas juvenis e o consumo” com foco no gênero unboxing. Dentre os sete livros aprovados no Programa Nacional do Livro e do Material Didático de Língua Portuguesa de 2021, este foi o único manual que incluiu esse gênero. A análise, ancorada nos conceitos de arquitetônica (Bakhtin, 2011, 2017b, 2018) e de cronotopo (Bakhtin, 2018), investiga possíveis sentidos construídos nas relações interativas entre os textos apresentados, os boxes e as atividades. Como resultado, foram identificados três tipos de espaço-tempo na seção de leitura, que trabalham universalidade e singularidade e promovem distintas formas de participação do estudante nas atividades didáticas: passiva; ativa, com exigências de conhecimentos prévios; ativa, independente do diálogo com a leitura realizada.
Desenvolvendo habilidades de argumentação por meio do ensino do plano de texto argumentativo
Authors: Faria Vanessa Fabíola Silva de , Macedo Ana Maria , Campanha Paula de Col
Published: January 2024

Este artigo investiga o impacto do ensino do plano de texto argumentativo no desenvolvimento das habilidades de argumentação dos alunos por meio de um estudo de abordagem qualitativa, de natureza bibliográfica e documental, com o aporte teórico da Análise Textual dos Discursos, que envolveu uma amostra de produções de textos dissertativo-argumentativos de participantes do projeto de extensão “Juntos Somos Mais Fortes”, ofertado pela Universidade do Estado de Mato Grosso (UNEMAT) em parceria com a Universidade Federal de Mato Grosso (UFMT) no campus de Sinop. Observou-se que, mesmo entre os relutantes, a adoção do procedimento de planejamento textual promoveu melhora do desempenho na elaboração dos planos de texto, contribuindo para o desenvolvimento da argumentação da produção textual. Os resultados obtidos demonstraram que o ensino do plano de texto pode ser uma ferramenta eficaz para melhorar a habilidade dos alunos na produção de textos-dissertativos argumentativos, contanto que sejam abordadas também as questões gramaticais e de coesão.
Propriedades discursivas como estratégia argumentativa em redações do Enem
Authors: Sá Kleiane Bezerra de
Published: January 2024

Neste artigo, temos como objetivo mais amplo propor uma reflexão sobre as relações entre o tópico discursivo e a argumentação de candidatos em redações do Exame Nacional do Ensino Médio (ENEM). Partimos da redefinição dos traços caracterizadores das propriedades tópicas, centração e organicidade, para explorar a construção argumentativa tendo em vista a definição de subtópicos mais concernentes à defesa do ponto de vista. Deste modo, demonstramos, com base nas conclusões de nossa tese de doutorado, como se dá a hierarquização de informações com base no alargamento e no aprofundamento de subtópicos em uma redação nota mil da edição do Enem 2022, tendo em vista a construção de um quadro tópico. Acreditamos que as reflexões engendradas podem subsidiar o trabalho docente, na medida em que o exercício de análise da organização tópica beneficia os candidatos do Enem com o desenvolvimento da habilidade de organização de ideias.
Impactos do componente curricular ‘Argumentação na Educação’ na competência argumentativa e no manejo de metodologias potencialmente argumentativas por futuros professores
Authors: Lima Raquel Cordeiro Nogueira , Leitão Selma , De Chiaro Sylvia
Published: January 2024

O presente trabalho investigou os impactos da participação de estudantes de Pedagogia no componente curricular eletivo ‘Argumentação na Educação’, que propõe desenvolver nos estudantes competências necessárias para argumentar, bem como para construir e mediar estratégias didáticas argumentativas em ambientes educacionais. Observando os estudantes durante um semestre letivo, nossos objetivos envolveram investigar os impactos na competência argumentativa, bem como na apropriação de conhecimentos de conteúdo pedagógico, relacionados ao manejo da argumentação. As análises apontaram melhorias na qualidade da argumentação construída, além de refinamento do pensamento reflexivo. Houve também ganhos nas habilidades de planejamento e de desenho de atividades potencialmente argumentativas, no emprego de diversas ações discursivas durante a mediação da atividade prática docente, bem como um grau de apropriação dos princípios do Ensino Dialógico. Tais resultados indicam que a combinação dos elementos presentes na disciplina (currículo, metodologias, cultura, postura do professor) foi essencial para o desenvolvimento observado.
Argumentação em perspectiva discursiva: implicações para o ensino
Authors: Rodrigues Eduardo Alves , Agustini Carmen Lucia Hernandes
Published: January 2024

Neste artigo, objetivamos, a partir do quadro teórico-metodológico da Análise de Discurso de filiação pecheutiana, realizar uma experimentação teórico-analítica sobre a concepção de argumentação e, assim procedendo, apresentar consequências para o trabalho com texto(s) no processo de ensino da argumentação. Para tanto, de início, trabalhamos um modo de inscrição da concepção de argumentação na Análise de Discurso e, na sequência, analisamos uma seleção de textos, a fim de expor um modo discursivo de ensinar argumentação no trabalho com texto(s). Com base nesse trabalho e nas análises, compreendemos que o ensino de argumentação, na perspectiva discursiva, requer tanto do professor quanto do aluno a exposição a um tipo de trabalho com o texto no qual possam experimentar, se colocar corpo a corpo com a linguagem, de tal modo a deslocarem-se da função comunicativa do texto para o seu funcionamento estruturado pelo trabalho simbólico da ideologia.
Categorias de argumentação no ensino de matemática: atividades para estudantes com deficiência visual
Authors: Attie João Paulo , Costa Thais Santos
Published: January 2024

A utilização de atividades de ensino inclusivas tem sido apontada como de grande relevância na área da Educação Matemática. Este artigo traz os resultados de uma pesquisa que teve como objetivo identificar as categorias argumentativas que foram utilizadas nas atividades de ensino de matemática para estudantes com deficiência visual apresentadas em um dos maiores eventos da área, o Encontro Nacional de Educação Matemática (ENEM), nas duas últimas décadas. Utilizamos como base teórica as categorias de argumentação explicativa e justificativa, já descritas na literatura. A pesquisa teve natureza qualitativa e aspectos bibliográficos, documental, exploratório e descritivo. Foram investigadas as atividades dos oito últimos eventos, que acontecem a cada três anos. O trabalho foi desenvolvido a partir de pesquisa no sítio da Sociedade Brasileira de Educação Matemática (SBEM) e, como resultados, podemos indicar que há poucos trabalhos envolvendo argumentação, e, nos casos positivos, há a utilização de argumentação explicativa.
Resenha: Introdução à análise da argumentação
Authors: Rasquel Sandra Gomes
Published: January 2024

A obra em apreço é fruto de um curso de extensão organizado pela Profa. Dra. Isabel Cristina Michelan de Azevedo e pelo Prof. Dr. Rubens Damasceno-Morais, promovido pela Universidade Federal de Sergipe (Brasil) e pela Universidade Federal de Goiás (Brasil), no ano de 2020. Trata-se de livro relevante e plural, na medida em que cada capítulo, construído de forma cuidadosa e bastante didática, abarca distintas perspectivas para o estudo da argumentação, dando ao leitor uma visão abrangente de possíveis referenciais teóricos e recursos metodológicos para se empreender a análise de textos (escritos e orais) argumentativos.
Resenha: Introdução às teorias da argumentação
Authors: Isola-Lanzoni Gabriel
Published: January 2024

A obra Introdução às Teorias da Argumentação, organizada pelo Prof. Dr. Eduardo Lopes Piris e pelo Prof. Dr. Rui Alexandre Grácio, marca um momento oportuno para os estudos de argumentação no Brasil, uma vez que busca, nas palavras dos organizadores, tornar-se “uma obra de referência sobre as principais teorias contemporâneas da argumentação” (p. 8). O livro reúne um conjunto de pesquisadores/as vinculados/as a instituições brasileiras e estrangeiras interessados/as nas distintas propriedades da argumentação, que são focalizadas em maior ou menor grau pelas diversas perspectivas teóricas contemporâneas. As doze perspectivas discutidas são representativas de um panorama dos estudos argumentativos tanto no âmbito mundial quanto no contexto brasileiro, haja vista a apropriação desses arcabouços por parte de pesquisadores/as brasileiros/as para reflexões e para proposições acerca da argumentação a partir de seus interesses, em especial, no tocante aos estudos da linguagem.
A argumentação como instrumento para pensar a desencapsulação do ensino-aprendizagem de língua inglesa
Authors: Carmona Milena Maria Nunes de Matos , Liberali Fernanda Coelho
Published: January 2024

O presente artigo propõe uma análise da linguagem argumentativa de uma proposta de formação que ocorreu entre onze professores de inglês e uma coordenadora, em uma escola da rede privada, na cidade de São Paulo, em 2022. Para tanto, inicialmente, discute o papel da argumentação no processo de desencapsulação do ensino-aprendizagem de inglês. Em seguida, faz uma breve descrição das ações que organizaram a proposta em um contexto de argumentação colaborativa. Na sequência, analisa as características enunciativas, discursivas e linguísticas entrelaçadas pela multimodalidade de um relato reflexivo que foi produzido por um dos participantes acerca do desenvolvimento de agência. Por fim, apresenta um relato que foi escrito colaborativamente entre todos os participantes para refletir sobre a importância da argumentação na produção compartilhada de significados.
A argumentação como ferramenta de análise de práticas dialógicas e monológicas materializadas no discurso de professores de Língua Inglesa
Authors: Hartemink Patricia Streppel , Ticks Luciane Kirchhof
Published: January 2024

Este artigo tem por objetivo analisar de que modo e em que medida a argumentação pode contribuir para a construção do conhecimento durante os processos de ensino e de aprendizagem no âmbito da disciplina de língua inglesa da Educação de Jovens e Adultos (EJA). Para tanto, utilizamos como recursos analíticos as categorias discursivo-argumentativas de caráter epistêmico (Compiani, 1996; Brum, 2015; Halliday; Matthiessen, 2014), no plano linguístico, bem como as categorias dialógicas e monológicas (Mateus, 2016; De Chiaro; Leitão, 2005) no plano discursivo. Como resultados, concluímos que o processo argumentativo instaurado entre professores e alunos apresenta um caráter argumentativo mais dialógico do que monológico.
Pharmacological Inhibition of Epidermal Growth Factor Receptor Prevents Intracranial Aneurysm Rupture by Reducing Endoplasmic Reticulum Stress
Authors: Ishiguro Taichi , Furukawa Hajime , Polen Kyle , Take Yushiro , Sato Hiroki , Kudo Daisuke , Morgan Jordan , Uchikawa Hiroki , Maeda Takuma , Cisneros Oscar , Rahmani Redi , Ai Jinglu , Eguchi Satoru , Lawton Michael T. , Hashimoto Tomoki
Published: January 2024

BACKGROUND:

Multiple pathways and factors are involved in the rupture of intracranial aneurysms. The EGFR (epidermal growth factor receptor) has been shown to mediate inflammatory vascular diseases, including atherosclerosis and aortic aneurysm. However, the role of EGFR in mediating intracranial aneurysm rupture and its underlying mechanisms have yet to be determined. Emerging evidence indicates that endoplasmic reticulum (ER) stress might be the link between EGFR activation and the resultant inflammation. ER stress is strongly implicated in inflammation and apoptosis of vascular smooth muscle cells, both of which are key components of the pathophysiology of aneurysm rupture. Therefore, we hypothesized that EGFR activation promotes aneurysmal rupture by inducing ER stress.

METHODS:

Using a preclinical mouse model of intracranial aneurysm, we examined the potential roles of EGFR and ER stress in developing aneurysmal rupture.

RESULTS:

Pharmacological inhibition of EGFR markedly decreased the rupture rate of intracranial aneurysms without altering the formation rate. EGFR inhibition also significantly reduced the mRNA (messenger RNA) expression levels of ER-stress markers and inflammatory cytokines in cerebral arteries. Similarly, ER-stress inhibition also significantly decreased the rupture rate. In contrast, ER-stress induction nullified the protective effect of EGFR inhibition on aneurysm rupture.

CONCLUSIONS:

Our data suggest that EGFR activation is an upstream event that contributes to aneurysm rupture via the induction of ER stress. Pharmacological inhibition of EGFR or downstream ER stress may be a promising therapeutic strategy for preventing aneurysm rupture and subarachnoid hemorrhage.
Technological impact of funded research: A case study of nonpatent references
Authors: Quemener Justin , Miotti Luis , Maddi Abdelghani
Published: January 2024

Research funding is essential to expand knowledge, foster innovation, and address the complex challenges that shape our future. The scientific literature has extensively addressed the relationship between research funding and academic impact. More recently, several studies have analyzed the technological impact of funded research as measured through citations in patents, known as nonpatent references (NPRs). But there remains much to know about NPRs and the multiplication of case studies is necessary to characterize them. Here we analyze a sample of 7,065 publications funded by the French Foundation for Medical Research (FRM) and the citations of these publications in patents. This study shows the high scientific and technological impacts of FRM funding. Indeed, the publications funded by FRM that are cited in patents are 3.5 times more frequently cited by other publications than the global average (for funded publications in the entire database, this ratio is 2.6). Furthermore, our results also indicate that USPTO patents citing these publications exhibit high-quality indicators. Moreover, five of these patents have led to approved drug products by the United States Food and Drug Administration (FDA). This study provides further evidence of the positive influence that research funding can have on both scientific and technological advancements.
Quantifying Americanization: Coverage of American Topics in Different Wikipedias
Authors: Konieczny Piotr , Lewoniewski Włodzimierz
Published: January 2024

As one of the most popular sources of information in the world, Wikipedia is edited by a large, global community of contributors. User-generated nature of this online encyclopedia ensures that the information reflects a wide range of topics. Hovewer, Wikipedia articles are created and edited independently in each language version. Therefore, some topics may be presented with varying degrees of completeness depending on their importance in a particular language community. In this paper, we quantified the concept of Americanization on a global scale through comparative analysis of the coverage of American topics in different language versions of Wikipedia. For this purpose, we analyzed over 90 million Wikidata items and 40 million Wikipedia articles in 58 languages. We discussed whether Americanization is more or less dominant in different languages, regions, and cultures. We showed that the interest in American topics is not universal. Western, developed countries are more Americanized (more interested in topics related to America) than the rest of the world. This is the first global, quantitative confirmation of issues often hypothesized, or assumed, in the literature on Americanization and related phenomena. This study shows that Wikipedia and Wikidata can allow quantification of social science concepts that previously were considered not realistically measurable. Finally, the presented research is also relevant to the discourses on the biases of Wikipedia.
Endovascular Management of Aortic Stump Blowout by Parallel Grafting and Coil Embolization of Visceral Aorta
Authors: Shafique Hana , Quaye Kofi , Cox Mitchell W. , Long Chandler A. , Williams Zachary F.
Published: January 2024

Aortic graft and endograft infections remain a significant source of morbidity and mortality after abdominal aortic aneurysm repair. With graft excision and extra-anatomic bypass, an infrarenal aortic stump remains which can have suture line dehiscence and catastrophic stump blowout. Treatment of this is extremely challenging, especially for severely co-morbid patients who cannot undergo major surgery, or in patients with a hostile abdomen. We present a case study of a 74-year-old male found to have an aortoenteric fistula (AEF). This case broadens operative options for this type of patient population by demonstrating an endovascular technique for addressing aortic stump blowout by parallel grafting and coil embolization of the visceral aorta.
Studies on Healthcare and Hygiene Textile Materials Treated With Natural Antimicrobial Bioactive Agents Derived From Plant Extracts
Authors: Alemu Reta Beletech , Babu K. Murugesh , Tesfaye Tamrat
Published: January 2024

Antimicrobial textiles with improved functionality have a wide range of applications, including health and hygiene products, particularly garments worn next to the skin, and a number of medical applications, including infection control and barrier materials. Furthermore, these textiles are used in household materials, air filters, food packaging, athletic wear, storage, ventilation, and water purification systems. Cotton-based materials are hygienic and are commonly used in non-implantable hygiene medical textile products such as lint, gauze, bandages, wound dressing, and sanitary napkins. In terms of absorbency, comfort, and durability, non-implantable cotton fabric materials outperform standard clothing materials. Several studies show that depending on the type of components present in the plant extract, several plant extracts can be effective against both Gram-positive and Gram-negative bacteria. As a result, research into eco-friendly antimicrobial agents and their application on various textile products is gaining worldwide attention. Plants such as neem, eucalyptus, aloe vera, and clove contain natural antimicrobial compounds. Extracts of neem, eucalyptus, aloe vera, and clove are used in textile finishing. These bioactive substances could be used to impart antimicrobial properties to textiles for the development of health care and hygiene products. This review focuses on research into various natural antimicrobial agents derived from plant extracts and their applications as textile finishing agents for healthcare and hygiene applications.
Genome-wide identification, characterization, and expression analysis of m6A readers-YTH domain-containing genes in alfalfa
Authors: Fan Shugao , Xu Xiao , Chen Jianmin , Yin Yanling , Zhao Ying
Published: January 2024

Eukaryotic messenger RNAs (mRNAs) are often modified with methyl groups at the N6 position of adenosine (m6A), and these changes are interpreted by YTH domain-containing proteins to regulate the metabolism of m6A-modified mRNAs. Although alfalfa (Medicago sativa) is an established model organism for forage development, the understanding of YTH proteins in alfalfa is still limited. In the present investigation, 53 putative YTH genes, each encoding a YT521 domain-containing protein, were identified within the alfalfa genome. These genes were categorized into two subfamilies: YTHDF (49 members) and YTHDC (four members). Each subfamily demonstrates analogous motif distributions and domain architectures. Specifically, proteins encoded by MsYTHDF genes incorporate a single domain structure, while those corresponding to MsYTH5, 8, 12, 16 who are identified as members of the MsYTHDC subfamily, exhibit CCCH-type zinc finger repeats at their N-termini. It is also observed that the predicted aromatic cage pocket that binds the m6A residue of MsYTHDC consists of a sequence of two tryptophan residues and one tyrosine residue (WWY). Conversely, in MsYTHDF, the binding pocket comprises two highly conserved tryptophan residues and either one tryptophan residue (WWW) or tyrosine residue (WWY) in MsYTHDF.

Through comparative analysis of qRT-PCR data, we observed distinct expression patterns in specific genes under abiotic stress, indicating their potential regulatory roles. Notably, five genes (MsYTH2, 14, 26, 27, 48) consistently exhibit upregulation, and two genes (MsYTH33, 35) are downregulated in response to both cold and salt stress. This suggests a common mechanism among these YTH proteins in response to various abiotic stressors in alfalfa. Further, integrating qRT-PCR with RNA-seq data revealed that MsYTH2, MsYTH14, and MsYTH16 are highly expressed in leaves at various development stages, underscoring their potential roles in regulating the growth of these plant parts. The obtained findings shed further light on the biological functions of MsYTH genes and may aid in the selection of suitable candidate genes for future genetic enhancement endeavors aimed at improving salt and cold tolerance in alfalfa.
Coloration differences in three Camellia reticulata Lindl. cultivars: ‘Tongzimian’, ‘Shizitou’ and ‘Damanao’
Authors: Qu Yan , Ou Zhi , Yong Qing Qing , Yao Xiang , Luo Jun
Published: January 2024

Camellia reticulata Lindl., also known as Yunnan Camellia, is an important ornamental plant in China, especially for its large and stunning flowers. A comprehensive understanding of their coloration mechanisms can aid breeders in developing new cultivars and improving their ornamental value; however, it is still unclear in Yunnan Camellia, especially in mixed-color flowers. In this study, we conducted metabolic and transcriptomic comparison analyses to investigate the coloration differences in three Yunnan Camellia cultivars: C. reticulata ‘Shizitou’ (SZT), C. reticulata ‘Damanao’ (MN), and C. reticulata ‘Tongzimian’ (TZM). Our results revealed that the initial flowering stage may play a critical role in the color change of MN. Metabolome analysis demonstrated that cyanidin was the primary anthocyanin in SZT and MN’s red region, while its content was low in TZM and MN’s white region. According to the transcriptome analysis, the anthocyanins biosynthesis pathway was reconstructed in Yunnan Camellia, and the low expression of CHS was detected in TZM and MN’s white region, while ANR maintained a high expression level, which may lead to the low content of cyanidin in them. Transcription factors MYBs, bHLH, and bZIP may play a key role in regulating anthocyanin-structural genes. The co-expression analysis showed that the meristem tissue may play a crucial role in the formation of the mixed white-red color in MN. Our study enriched the genetic basis of flower coloration differences in Yunnan Camellia which will be a valuable genomic resource to understanding the biology of coloration formation and for breeding the Camellia cultivars.
Major pneumothorax during pediatric cardiac MRI procedure under general anesthesia: step-by-step analysis and importance of a well-known environment and material
Authors: Delhez Quentin , Bairy Laurent , Mitchell John , Maseri Adrien
Published: January 2024

Background

To perform step-by-step analysis of the different factors (material, anesthesia technique, human, and location) that led to major pneumothorax during an infrequent pediatric cardiac MRI and to prevent its occurrence in the future. Anesthesia equipment used in a remote location is often different than those in operating rooms. For magnetic resonance imaging (MRI), ventilation devices and monitors must be compatible with the magnetic fields. During cardiac MRI numerous apneas are required and, visual contact with the patient is limited for clinical evaluation. Anesthesia-related barotrauma and pneumothorax are rare in children and the first symptoms can be masked.

Case Presentation

A 3-year-old boy with atrial septal defect (ASD) and suspicious partial anomalous pulmonary venous return was anesthetized and intubated to perform a follow up with MRI. Sevoflurane maintenance and ventilation were performed using a circular CO2 absorber device, co-axial circuit, and 500 mL pediatric silicone balloon. Apneas were facilitated by Alfentanyl boluses and hyperventilation. A few moderated desaturations occurred during the imaging sequences without hemodynamic changes. At the end of the MRI, facial subcutaneous emphysema was observed by swollen eyelids and crackling snow neck palpation. A complete left pneumothorax was diagnosed by auscultation, sonography examination, and chest radiograph. Pneumo-mediastinum, -pericardium and -peritoneum were present. A chest drain was placed, and the child was extubated and transferred to the pediatric intensive care unit (PICU). Despite the anesthesiologist’s belief that PEEP was minimal, critical analysis revealed that PEEP was maintained at a high level throughout anesthesia. After the initial barotrauma, repeated exposure to high pressure led to the diffusion of air from the pleura to subcutaneous tissues and mediastinal and peritoneal cavities. Equipment check revealed a functional circular circuit; however, the plastic adjustable pressure-limiting valve (APL) closed within the last 30° rotation. The balloon was found to be more rigid and demonstrated significantly reduced compliance.

Conclusions

Anesthetists require proficiency is using equipment in non-OR locations and this equipment must be properly maintained and checked for malfunctions. Controlling the human factor risks by implementing checklists, formations, and alarms allows us to reduce errors. The number of pediatric anesthesia performed routinely appeared to be essential for limiting risks and reporting our mistakes will be a benefit for all who care about patients.
An ambulatory dental treatment of a child with Rett syndrome and limited mouth opening under muscle relaxant-free general anesthesia: a case report
Authors: Tan Xiao , Zhu Bo , Li Yanchen , Huang Yuguang
Published: January 2024

Background

Rett Syndrome (RTT) is a rare, severe, and progressive developmental disorder with intellectual disability. Anesthesia in RTT patients presents a range of challenges. We report a child with RTT who received dental treatment under muscle relaxant-free general anesthesia in our ambulatory center.

Case presentation

A 15-year-old girl with RTT was admitted to our dental clinic with multiple dental caries and residual roots. Dental treatment was scheduled under ambulatory general anesthesia. After anesthesia induction, a nasal tube was initiated under the guidance of a fiberoptic bronchoscope. Multimodal analgesia, body temperature monitoring, and postoperative nausea and vomiting prevention were applied. No muscle relaxants were used throughout the process. The endotracheal tube was successfully removed after the operation and the patient was discharged home the same day.

Conclusion

An individualized anesthesia strategy enabled a quick and safe recovery for this RTT patient after dental treatment under muscle relaxant-free general anesthesia.
Blood pressure measurements for diagnosing hypertension in primary care: room for improvement
Authors: Voorbrood Vincent M.I. , de Schepper Evelien I.T. , Bohnen Arthur M. , Ruiterkamp Marit F.E. , Rijnbeek Peter R. , Bindels Patrick J.E.
Published: January 2024

Background

In the adult population, about 50% have hypertension, a risk factor for cardiovascular disease and subsequent premature death. Little is known about the quality of the methods used to diagnose hypertension in primary care.

Objectives

The objective was to assess the frequency of use of recognized methods to establish a diagnosis of hypertension, and specifically for OBPM, whether three distinct measurements were taken, and how correctly the blood pressure levels were interpreted.

Methods

A retrospective population-based cohort study using electronic medical records of patients aged between 40 and 70 years, who visited their general practitioner (GP) with a new-onset of hypertension in the years 2012, 2016, 2019, and 2020. A visual chart review of the electronic medical records was used to assess the methods employed to diagnose hypertension in a random sample of 500 patients. The blood pressure measurement method was considered complete if three or more valid office blood pressure measurements (OBPM) were performed, or home-based blood pressure measurements (HBPM), the office- based 30-minute method (OBP30), or 24-hour ambulatory blood pressure measurements (24 H-ABPM) were used.

Results

In all study years, OBPM was the most frequently used method to diagnose new-onset hypertension in patients. The OBP-30 method was used in 0.4% (2012), 4.2% (2016), 10.6% (2019), and 9.8% (2020) of patients respectively, 24 H-ABPM in 16.0%, 22.2%, 17.2%, and 19.0% of patients and HBPM measurements in 5.4%, 8.4%, 7.6%, and 7.8% of patients, respectively. A diagnosis of hypertension based on only one or two office measurements occurred in 85.2% (2012), 87.9% (2016), 94.4% (2019), and 96.8% (2020) of all patients with OBPM. In cases of incomplete measurement and incorrect interpretation, medication was still started in 64% of cases in 2012, 56% (2016), 60% (2019), and 73% (2020).

Conclusion

OBPM is still the most often used method to diagnose hypertension in primary care. The diagnosis was often incomplete or misinterpreted using incorrect cut-off levels. A small improvement occurred between 2012 and 2016 but no further progress was seen in 2019 or 2020. If hypertension is inappropriately diagnosed, it may result in under treatment or in prolonged, unnecessary treatment of patients. There is room for improvement in the general practice setting.
Comparative profiles of lubiprostone, linaclotide, and elobixibat for chronic constipation: a systematic literature review with meta-analysis and number needed to treat/harm
Authors: Rao Satish S. , Manabe Noriaki , Karasawa Yusuke , Hasebe Yuko , Nozawa Kazutaka , Nakajima Atsushi , Fukudo Shin
Published: January 2024

Objective

To comprehensively evaluate the efficacy, safety, patient symptoms, and quality-of-life (QoL) of lubiprostone, linaclotide, and elobixibat as treatment for chronic constipation (CC).

Design

Systematic literature review (SLR) and meta-analysis (MA). Literature searches were conducted on PubMed and Embase using the Ovid platform.

Methods

SLR including randomized controlled trials (RCTs) and observational studies was conducted to identify the overall efficacy and safety of lubiprostone, linaclotide, and elobixibat. Thereafter, MA was performed using only RCTs. The number needed to treat (NNT) and number needed to harm (NNH) analyses were additionally conducted.

Primary and secondary outcome measures

The primary outcome was efficacy regarding change in spontaneous bowel movements. Secondary outcomes included safety, constipation-related symptoms, and QoL.

Results

Twenty-four studies met the inclusion criteria for the SLR: 17 RCTs, 4 observational studies, and 3 single-arm trials. Feasibility assessment for the MA resulted in 14 studies available for safety data analysis, and 8 available for efficacy analysis, respectively. Three drugs showed similar efficacy in the MA and NNT analysis. However, the NNH analysis revealed distinct safety profiles: lubiprostone, linaclotide, and elobixibat were linked to the highest risk of nausea, diarrhea, and abdominal pain, respectively.

Conclusion

The current study provides an updated overview of the efficacy, safety, patient symptoms, and QoL of the three drugs with different mechanisms of action for CC treatment.The findings could help physicians adopt an individualized approach for treating patients with CC in clinical practice.
Incidence of urinary incontinence after hip fracture surgery and associated risk factors: a prospective study
Authors: Arroyo-Huidobro Marta , de la Fuente Josefa López , Pagespetit Mar Riera , Perez Oscar Macho , Morera Jaume Roig , López Anna Maria Abelleira , Casanova David Aivar , Garcia-Lerma Esther , Pérez-López Carlos , Rodríguez-Molinero Alejandro
Published: January 2024

Background

The contribution of the postoperative process to developing or worsening urinary incontinence (UI) after hip fracture surgery (HFS) remains unclear. We aimed to evaluate UI incidence and worsening among older patients undergoing HFS, and explore associated risk factors.

Methods

This prospective cohort study included patients ≥ 75 years admitted between October 2019 and October 2021 to the Traumatology Service of three hospitals in the Consorci Sanitari de Alt-Penedès i Garraf (Barcelona, Spain) with hip fracture requiring surgical treatment. UI was assessed using the first two questions of the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) at baseline and at days 30 (± 3 days) and 90 (± 3 days) after HFS. Surgery-related data and post-surgical complications were recorded.

Results

A total of 248 patients with a mean (SD) age of 85.8 (6.78) years were included; 77.8% were female and 154 (62.1%) had UI at baseline. After HFS, 3.24% experienced urinary tract infections (UTIs), 3.64%, acute urinary retention (AUR), 8.57%, constipation, and 53.9%, prolonged catheterization (> 24 h). Fifty-eight patients without baseline UI developed UI at 30 days, resulting in a UI incidence of 61.7% (95% CI 51.1–71.54) between days 0 and 30. Of the 248 patients, 146 (59.1%) experienced worsening of UI. AUR and UTIs were identified as risk factors for UI development and worsening after HFS, respectively.

Conclusion

The incidence of UI in older patients after HFS is significant. Patient management protocols should consider AUR and UTIs to reduce or eliminate the incidence of UI in older patients undergoing HFS.
Hepatitis E virus and Klebsiella pneumoniae co-infection detected by metagenomics next-generation sequencing in a patient with central nervous system and bloodstream Infection: a case report
Authors: Cui Manman , Sun Wei , Xue Yuan , Yang Jiangnan , Xu Tianmin
Published: January 2024

Background

Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis worldwide with major prevalence in the developing countries and can cause extrahepatic disease including the nervous system. Central nervous system infections caused by HEV are rare and caused by HEV together with other bacteria are even rarer.

Case presentation

A 68-year-old man was admitted to the hospital due to a headache lasting for 6 days and a fever for 3 days. Lab tests showed significantly raised indicators of inflammation, cloudy cerebrospinal fluid, and liver dysfunction. Hepatitis E virus and Klebsiella pneumoniae were identified in the blood and cerebrospinal fluid using metagenomic next-generation sequencing. The patient received meropenem injection to treat K. pneumoniae infection, isoglycoside magnesium oxalate injection and polyene phosphatidylcholine injection for liver protection. After ten days of treatment, the patient improved and was discharged from the hospital.

Conclusion

Metagenomic next-generation sequencing, which can detect various types of microorganisms, is powerful for identifying complicated infections.
Dyslipidemia among HIV-infected patients in Ethiopia: a systematic review and meta-analysis
Authors: Mohammed Ousman , Alemayehu Ermiyas , Debash Habtu , Belete Melaku Ashagrie , Gedefie Alemu , Tilahun Mihret , Ebrahim Hussen , Gebretsadik Weldehanna Daniel
Published: January 2024

Background

Dyslipidemia is responsible for more than half of the global ischemic heart disease (IHD) and more than 4 million deaths annually. Assessing the prevalence of dyslipidemia can be crucial in predicting the future disease development and possible intervention strategies. Therefore, this systematic review and meta-analysis was aimed at assessing the pooled prevalence of dyslipidemia in HIV-infected patients.

Methods

Electronic databases such as EMBASE, Google Scholar, PubMed, Web of Science, ResearchGate, Cochrane Library, and Science Direct were searched for articles and grey literature. All relevant studies found until our search period of May 24, 2023 were included. The Newcastle–Ottawa Quality Assessment Scale was used to assess the quality of the included studies. The data were extracted in Microsoft Excel. The STATA version 14 software was used to conduct the meta-analysis. I2 and Cochran’s Q test were employed to assess the presence of heterogeneity between studies. Due to the presence of heterogeneity, a random effect model was used. The publication bias was assessed using the symmetry of the funnel plot and Egger's test statistics. Moreover, subgroup analysis, and sensitivity analysis were also done.

Results

A total of nine studies that reported the prevalence of dyslipidemia were included. The overall pooled prevalence of dyslipidemia among HIV-infected patients in Ethiopia was 67.32% (95% CI = 61.68%–72.96%). Furthermore, the overall pooled estimates of dyslipidemia among ART-taking and treatment-naïve HIV-infected patients were 69.74% (95% CI: 63.68–75.8, I2 = 87.2) and 61.46% (95% CI: 45.40–77.52, I2 = 90.3), respectively. Based on lipid profile fractionations, the pooled estimates for high total cholesterol (TC) were 39.08% (95% CI: 31.16–46.99), high triglycerides were 38.73% (95% CI: 28.58–48.88), high low density lipoprotein (LDL-c) was 28.40% (95% CI: 17.24–39.56), and low high density lipoprotein (HDL-c) was 39.42% (95% CI: 30.47–48.38).

Conclusion

More than two-thirds of HIV-infected patients experienced dyslipidemia. Therefore, it's critical to regularly evaluate lipid alterations in HIV-infected patients in order to prevent the onset of atherosclerosis and other cardiovascular problems.
Central intra-lesional iron deposits as a possible novel imaging marker at 7 Tesla MRI in Susac Syndrome - an exploratory study
Authors: Strunk Daniel , Sinnecker Tim , Kleffner Ilka , Doerr Jan , Ringelstein Marius , Gross Catharina C. , Deuschl Cornelius , Maderwald Stefan , Quick Harald H. , Yamac Elif , Wrede Karsten H. , Kraemer Markus
Published: January 2024

Background

Susac syndrome (SuS) is a rare autoimmune disease that leads to hearing impairment, visual field deficits, and encephalopathy due to an occlusion of precapillary arterioles in the brain, retina, and inner ear. Given the potentially disastrous outcome and difficulties in distinguishing SuS from its differential diagnoses, such as multiple sclerosis (MS), our exploratory study aimed at identifying potential new SuS-specific neuroimaging markers.

Methods

Seven patients with a definite diagnosis of SuS underwent magnetic resonance imaging (MRI) at 7 Tesla (7T), including T2* weighted and quantitative susceptibility mapping (QSM) sequences. T2 weighted hyperintense lesions were analyzed with regard to number, volume, localization, central vein sign, T1 hypointensity, and focal iron deposits in the center of SuS lesions (“iron dots”). Seven T MRI datasets from the same institute, comprising 75 patients with, among others, MS, served as controls.

Results

The “iron dot” sign was present in 71.4% (5/7) of the SuS patients, compared to 0% in our control cohort. Thus, sensitivity was 71.4% and specificity 100%. A central vein sign was only incidentally detected.

Conclusion

We are the first to demonstrate this type of “iron dot” lesions on highly resolving 7T T2*w and QSM images in vivo as a promising neuroimaging marker of SuS, corroborating previous histopathological ex vivo findings.
Association between stress hyperglycemia ratio and prognosis in acute ischemic stroke: a systematic review and meta-analysis
Authors: Jiang Zhuoya , Wang Kunyu , Duan Hanying , Du Heqian , Gao Su , Chen Jing , Fang Shaokuan
Published: January 2024

Background

Stress hyperglycemia is a relatively transient increase in blood glucose in response to inflammation of the body and neurohormonal disorders. It is still debated whether stress hyperglycemia ratio (SHR) in the acute phase, a new indicator of stress hyperglycemia, is related to poor prognosis in acute ischemic stroke (AIS) patients. This meta-analysis provides insight into the connection between SHR and prognosis in AIS patients.

Methods

We screened all potentially relevant studies using a comprehensive database search. The standardized mean difference (SMD) and 95% confidence interval (CI) were utilized to investigate the relationship between SHR in the acute phase and the prognosis of AIS.

Results

The pooled results revealed that AIS patients with poor prognoses had significantly higher SHR values than those with good prognoses (SMD = 0.56, 95%CI: 0.37–0.75, p<0.001). Subgroup analysis indicated that study design and differences in post-stroke treatment might be the sources of heterogeneity in this meta-analysis.

Conclusions

High SHR in the acute period is related to poor prognosis after AIS. SHR may be a new predictor of poor outcomes in AIS patients.
Barriers in utilization and provisioning of obstetric care services (OCS) in India: a mixed-methods systematic review
Authors: Singh Sushmita , Rajak Rahul
Published: January 2024

Background

Despite the reduction in the maternal mortality ratio, barriers in obstetric care services (OCS) remain a significant risk factor for adverse maternal and perinatal outcomes in India. This review covers the ‘continuum of care’ (ANC, child delivery, and PNC services) and identifies multiple barriers in provisioning as well as utilization of OCS in India. We conducted a systematic review to understand the barriers using a mixed-methods approach.

Methods

PubMed, Scopus, Web of Science, Google Scholar, and Science Direct databases were searched from 1 January 2000 to 30 June 2022. The methodological quality of the included studies was assessed using appropriate tools. After a full-text review of 164 studies, total of 56 studies (33 quantitative, 18 qualitative, and 5 mixed-methods studies) were finally included in the review. All the barriers were classified into five major themes: (i) individual and interpersonal barriers, (ii) social and cultural barriers, (iii) structural barriers, (iv) logistical barriers, and (v) organizational barriers. A thematic synthesis approach was used to present the findings of the included studies.

Results

Lack of knowledge and awareness and less family support in availing the required OCS were key individual and interpersonal barriers. Negative social and cultural practices, such as belief in traditional herbs/healers, dietary restrictions, and discarding colostrum were frequently reported barriers, especially in rural settings. Poor economic status and high health service costs were the most often cited barriers to low institutional delivery and delayed ANC services. Long distances to health facilities and poor road conditions were the most frequently reported logistical barriers. On the provisioning side, poor quality of treatment, shortage of drugs and equipment, and non-cooperative attitude of health professionals were the most significant barriers.

Conclusion

This review identified several important barriers ranging from individual and cultural to structural, logistical, and organizational, which are prevalent in India. To mitigate the barriers, the governments need to develop strategies at the individual and organizational levels. Innovative interventions and program implementation at the community and village levels could also be contributory steps towards improving OCS utilization in India.
Analysis of correlative risk factors for radiation-induced hypothyroidism in head and neck tumors
Authors: Wang Chan , Hou Yanjie , Wang Lili , Yang Ye , Li Xianfeng
Published: January 2024

Objective

The aim of the study is to identify clinical and dosimetric factors that could predict the risk of radiation-induced hypothyroidism(RIHT) in head and neck cancer(HNC) patients following intensity-modulated radiotherapy(IMRT).

Methods

A total of 103 HNC patients were included in our study. General clinical characteristic and dosimetric data of all recruited patients were analyzed, respectively. The univariate and multivariate logistic regression anlalysis were successively conducted to identify optimal predictors, which aim to construct the nomogram. And the joint prediction was performed.

Results

The incidence of patients with HNC was 36.9% (38/103). Among the clinical factors, gender, N stage, chemotherapy, frequency of chemotherapy and surgery involving the thyroid were related to RIHT. Logistic regression analysis showed that thyroid volume, Dmean, VS45, VS50, VS60and V30,60were independent predictors of RIHT, which were also incorporated in the nomogram. An AUC of 0.937 (95%CI, 0.888–0.958) also was showed outstanding resolving ability of the nomogram. When the volume of the thyroid was greater than 10.6 cm3, the incidence of RIHT was 14.8%, and when the volume of the thyroid was equal to or smaller than 10.6 cm3, the incidence was 72.5%. The incidence rates of RIHT in the group with VS60≦8.4cm3and VS60 > 8.4cm3were 61.4% and 19.3%, respectively.

Conclusions

Thyroid volume and thyroid VS60are independent predictors of RIHT in patients with HNC. Moreover, more attention should be paid to patients with thyroid volume ≤ 10.6cm3. Thyroid VS60 > 8.4cm3may be a useful threshold for predicting the development of RIHT. The nomogram conducted by the research may become a potential and valuable tool that could individually predict the risk of RIHT for HNC patients.