bluuebunny/crossref_metadata_2025 huggingface dataset:
Network Pharmacology-Based Prediction and Verification of the Potential Mechanisms of He’s Yangchao Formula against Diminished Ovarian Reserve
Authors: Yang Liuqing , Zhao Ying , Xu Hongbin , Ma Yang , Wang Lin , Ma Jing , Zhang Qin
Published: June 2022

Background. He’s Yangchao formula (HSYC) has been clinically proven to be effective in treating diminished ovarian reserve (DOR). However, the underlying molecular mechanisms of HSYC in DOR are unclear. Objective. This study aims to predict the underlying mechanisms of He’s Yangchao formula (HSYC) against DOR through network pharmacology strategies and verify in vivo. Methods. Systematic network pharmacology was used to speculate the bioactive components, potential targets, and the underlying mechanism of HSYC in the treatment of DOR. Then, the CTX-induced DOR mouse model was established to verify the effect of HSYC against DOR and the possible molecular mechanisms as predicted in the network pharmacology approach. Results. A total of 44 active components and 423 potential targets were obtained in HSYC. In addition, 91 targets of DOR were also screened. The identified hub genes were AKT1, ESR1, IL6, and P53. Further molecular docking showed that the four hub targets were well-bound with their corresponding compounds. In vivo experiments showed that HSYC could promote the recovery of the estrous cycle and increase the number of primordial, growing follicles and corpora lutea. Besides, The results of qRT-PCR showed HSYC could regulate the expression of AKT1, ESR1, P53, and IL6 in DOR mice. Conclusion. It was demonstrated that HSYC could increase ovarian reserves, and AKT1, ESR1, IL6, and P53 may play an essential role in this effect, which provided a new reference for the current lack of active interventions of DOR.
The “Inside” Story on Tumor-Expressed PD-L1
Authors: Hanks Brent A.
Published: June 2022

While the extracellular domain of PD-L1 is well-recognized for playing a critical role in immune evasion by suppressing CD8+ T-cell activity through direct PD-1 interactions, a series of studies has evolved highlighting important functional roles for the PD-L1 cytoplasmic domain in supporting various aspects of tumorigenesis. Kornepati and colleagues contribute to our overall understanding of PD-L1 in tumor biology by describing a link between tumor PD-L1 expression and DNA repair. These studies demonstrate that PD-L1 promotes breast cancer type 1 (BRCA1)–mediated homologous recombination while inhibiting cytosolic DNA sensing, thus suppressing tumor immunogenicity. Notably, these effects could not be reversed with anti-PD-L1 antibodies utilized in the clinic, suggesting that pharmacologic agents promoting PD-L1 degradation may be a more effective treatment strategy for select tumors. Studies that are improving our understanding of the pathways driven by PD-L1 cytoplasmic signaling are providing increased insight into the design of next generation combinatorial immunotherapy strategies.

See related article by Kornepati et al., p. 2156
Escrita e oralidade no Parque Indígena do Xingu: inserção na vida social e a percepção dos índios
Authors: Ferreira Mariana Leal
Published: June 2022

O ensaio tem como objetivo "mostrar que a percepção e a inserção na vida social de povos 'agrafos' da escrita letrada, alfabética, vão depender da natureza de cada sociedade e da constituição do campo social em que está inserida". Em pesquisa desenvolvida com os povos do Parque Indígena do Xingu (período de 1980-1990), a autora verifica que a incorporação da escrita depende do tipo de contato que a sociedade indígena tem com a sociedade nacional. Diferentes posições de diversos autores (Jack Goody e Joanne Rappaport, entre outros) sobre as implicações da aquisição da escrita são discutidas, em uma avaliação crítica da literatura sobre o tema.
Um Natal de negros: esboço etnográfico sobre um ritual religioso num quilombo amazônico
Authors: Figueiredo Aldrin Moura de
Published: June 2022

This article intends to approximate the Anthropology and the History through the description of a religious ritual lived by descendents of ancient fugitive slaves of Curuá river, dístrict of Alenquer, Médio-Amazonas paraense, who had lived in that region since middle-eighteen century . Therefore, we try to penetrate into the meanders of one of the most important feasts of Christisnity - Christmas - and in its reorganization in the daily life of an amazon quilombo, arranging several temporalities, recreating biblical passages in the light of black human experience in the community of fugitive slaves
Antropólogos nativos em la Argentina. Análisis Reflexivo de un incidente de Campo
Authors: Guber Rosana
Published: June 2022

El análisis de un incidente de mi trabajo de campo con veteranos argentinos que participaron en el conflicto del Atlántico Sur entre Argentina y Gran Bretaña (1982) , permite profundizar mi objeto de investigación, las memorias sobre Malvinas, y sobre el debate antropológico tradicional referido a los "antropólogos nativos " . Me propongo mostrar que el trabajo de campo es un proceso de conocimiento de la realidad social: que para la antropología, parte importante de ese proceso de conocimiento se produce en el encuentro entre investigador y sujetos de estudio en el campo, cuando se analiza como reflexiva a la realidad social, cuando se hace extensiva la reflexividad a las situaciones de campo, y cuando el investigador se convierte en su propio informante
Uma categoria do pensamento antropológico: a noção de pessoa
Authors: Goldman Marcio
Published: June 2022

The "notion de personne" is certainly one of the most recurring categorics in the conceptual fraime of social and cultural anthropology, but we use to forget the greal number of problems underlying this notion, as well as that its specific sense seems to change from author to author. Beginning wilh Mauss's classic paper about the issue, this article intends to map some of these problems and ambiguitics. To do that it sketches the historical hackground of the question and tries to present some ways to recover the creative potential of a concept that has always pennitted the elaboration of alternalive points or view about social and cultural diversity.
Reciprocidade e Hierarquia
Authors: Lanna Marcos
Published: June 2022

This paper suggests a re-evaluation of several analysis of exchange relations. It places special emphasis on M. Sahlins interpretation of gift exchange in Stone Age Economics, focusing on the complex of exchanges around "primitive" chiefs. It aims to set the grounds for a demonstration of the possibility of a concept which would synthesize Dumont's "hierarchy" with Levi Strauss's "reciprocity". Is is implied that this "redistributive" or "hierarchical reciprocity" would be differently institutionalized in specific situations. Only historical or ethnographic descriptions which consider the political aspects of exchange relations could allow us in the future to re-think the concept of reciprocity as implying a hierarchical dimension.
Fronteiras Religiosas em movimento no Cone-Sul
Authors: Oro Ari Pedro
Published: June 2022

A characteristic of modernity is the transnationalization of goods and of culture, including religion. This text shows how this occurs in the Cone-Sul involving Afro-Brazilian  Religions and Brazilian Neo-Pentecostal churches which spread out from Rio Grande do Sul accross national borders to neighboring countries in the La Plata region. After a consideration of the empirical data available about the expansion of these two religious groups to Argentina and Uruguay, we will review explanations furnished by researchers on this theme.
As hipótese sobre o centro de origem e rotas de expansão dos Tupi
Authors: Noelli Francisco Silva
Published: June 2022

The origins and expansion of the Tupian has been fancied and investigated since 1838. Only in the last 40 ye ars the problem has been tackled with help from Historical, Linguistic asd Archaeological data. Yet those new information has not been incorporated, and hypotesis and conclusions proposed more than a century ago are still extand
Early skeletal remains and the peopling of the Americas
Authors: Neves Walter Alves , Meyer Diogo , Pucciarelli Héctor Maria
Published: June 2022

Nós investigamos as afinidades morfológicas das populações esqueletais mais antigas da Arnérica do Norte e do Sul, com base na variabilidade craniana mundial, através de uma Análise de Componentes Principais. Duas análises foram efetuadas, uma usando-se tamanho e forma e outra usando somente informação quanto a forma. Os resultados obtidos para as mulheres, em ambas as análises, não permitiram qualquer interpretação factível sobre as afinidades extra-continentais dos primeiros americanos. Quanto aos homens, a análise baseada em tamanho e forma mostrou que as séries arqueológicas americanas ocupam uma posição intermediária entre os grupos do Pacífico Sul e do Sul da Ásia/Europa. Quando a informação quanto a tamanho foi retirada da análise, as quatro séries esqueletais exibiram uma associação mais pronunciada com o Pacífico Sul. Esses resultados sugerem que tanto a América do Norte, quanto a do Sul foram, ambas, ocupadas por populações pré-mongoloides similares, cuja morfologia demonstra uma semelhança acentuada com aquela das populações do Pacífico Sul
Missões católicas e políticas tribais na frente de expansão: os Bororo entre o século XIX e o século XX
Authors: Vangelista Chiara
Published: June 2022

This article deals with the ethnic and interethnic dimension of the frontier in Mato Grosso from the second half of the XIX century till the beginning of the XX century. The analysis focus on the territory of the Bororo Indians, trying to understand how the tribal strategies relate to a national project of territorial and cultural frontier wherc the Salesian missionaries are one of their main agents
「東京都・首都圏方言の実態」―移りゆく日本語の話しことばー
Authors: Kuno Mariko
Published: June 2022

Population of Tokyo has been increasing as well as the transportation system, and residents are overflowing to the Grand Tokyo metropolitan area. Language is also changing from Tokyo dialect to the Grand Tokyo metropolitan dialect. The New Linguistic Atlas of Tokyo has been edited mainly by Mariko Kuno and her students, and, so far, Phonology edition, Accent edition, and Grammar edition are completed and published. The discussion will be main features of phonology, accent, and grammar of Tokyo dialect, comparing older generation and younger generation, based on these Atlases. The older generation maintain the traditional stratum but the younger generation lost large part of the old stratum. The old generation of Tokyo keeps some grammatical phenomenon unique to Kanto dialect and younger generation keeps a part of it.
CircPrimer 2.0: a software for annotating circRNAs and predicting translation potential of circRNAs
Authors: Zhong Shanliang , Feng Jifeng
Published: June 2022

Background

Some circular RNAs (circRNAs) can be translated into functional peptides by small open reading frames (ORFs) in a cap-independent manner. Internal ribosomal entry site (IRES) and N6-methyladenosine (m6A) were reported to drive translation of circRNAs. Experimental methods confirming the presence of IRES and m6A site are time consuming and labor intensive. Lacking computational tools to predict ORFs, IRESs and m6A sites for circRNAs makes it harder.

Results

In this report, we present circPrimer 2.0, a Java based software for annotating circRNAs and predicting ORFs, IRESs, and m6A sites of circRNAs. circPrimer 2.0 has a graphical and a command-line interface that enables the tool to be embed into an analysis pipeline.

Conclusions

circprimer 2.0 is an easy-to-use software for annotating circRNAs and predicting translation potential of circRNAs, and freely available at www.bio-inf.cn.
phyloMDA: an R package for phylogeny-aware microbiome data analysis
Authors: Liu Tiantian , Zhou Chao , Wang Huimin , Zhao Hongyu , Wang Tao
Published: June 2022

Background

Modern sequencing technologies have generated low-cost microbiome survey datasets, across sample sites, conditions, and treatments, on an unprecedented scale and throughput. These datasets often come with a phylogenetic tree that provides a unique opportunity to examine how shared evolutionary history affects the different patterns in host-associated microbial communities.

Results

In this paper, we describe an R package, phyloMDA, for phylogeny-aware microbiome data analysis. It includes the Dirichlet-tree multinomial model for multivariate abundance data, tree-guided empirical Bayes estimation of microbial compositions, and tree-based multiscale regression methods with relative abundances as predictors.

Conclusion

phyloMDA is a versatile and user-friendly tool to analyze microbiome data while incorporating the phylogenetic information and addressing some of the challenges posed by the data.
Whole-genome-sequence-based characterization of an NDM-5-producing uropathogenic Escherichia coli EC1390
Authors: Thuy Tran Thi Dieu , Lu Hsu-Feng , Kuo Pei-Yun , Lin Wei-Hung , Lin Tzu-Ping , Lee Yi-Tzu , Duong Tran Thi Thuy , Wang Ming-Cheng , Lee Yi-Hong , Wen Li-Li , Chen Yu-Chen , Kao Cheng-Yen
Published: June 2022

Background

Urinary tract infection (UTI) is one of the most common outpatient bacterial infections. In this study, we isolated and characterized an extensively-drug resistant (XDR) NDM-5-producing Escherichia coli EC1390 from a UTI patient by using whole-genome sequencing (WGS) in combination with phenotypic assays.

Methods

Antimicrobial susceptibility to 23 drugs was determined by disk diffusion method. The genome sequence of EC1390 was determined by Nanopore MinION MK1C platform. Conjugation assays were performed to test the transferability of EC1390 plasmids to E. coli recipient C600. Phenotypic assays, including growth curve, biofilm formation, iron acquisition ability, and cell adhesion, were performed to characterize the function of EC1390 plasmids.

Results

Our results showed that EC1390 was only susceptible to tigecycline and colistin, and thus was classified as XDR E. coli. A de novo genome assembly was generated using Nanopore 73,050 reads with an N50 value of 20,936 bp and an N90 value of 7,624 bp. WGS analysis showed that EC1390 belonged to the O101-H10 serotype and phylogenetic group A E. coli. Moreover, EC1390 contained 2 conjugative plasmids with a replicon IncFIA (pEC1390-1 with 156,286 bp) and IncFII (pEC1390-2 with 71,840 bp), respectively. No significant difference was observed in the bacterial growth rate in LB broth and iron acquisition ability between C600, C600 containing pEC1390-1, C600 containing pEC1390-2, and C600 containing pEC1390-1 and pEC1390-2. However, the bacterial growth rate in nutrition-limited M9 broth was increased in C600 containing pEC1390-2, and the cell adhesion ability was increased in C600 containing both pEC1390-1 and pEC1390-2. Moreover, these plasmids modulated the biofilm formation under different conditions.

Conclusions

In summary, we characterized the genome of XDR-E. coli EC1390 and identified two plasmids contributing to the antimicrobial resistance, growth of bacteria in a nutrition-limited medium, biofilm formation, and cell adhesion.
Plant organ- and growth stage-diversity of endophytic bacteria with potential as biofertilisers isolated from wheat (Triticum aestivum L.)
Authors: Pang Fahu , Tao Aili , Ayra-Pardo Camilo , Wang Tan , Yu Ziwei , Huang Siliang
Published: June 2022

Background

Chemical fertilisers are extensively used for crop production, which may cause soil deterioration and water pollution. Endophytic bacteria with plant-growth-promoting (PGP) activities may provide a solution to sustainably improve crop yields, including in-demand staples such as wheat. However, the diversity of the PGP endophytic bacteria in wheat across plant organs and growth stages has not been thoroughly characterised.

Results

Here, we report the isolation of endophytic bacteria from root, stem, leaf and seed of three winter wheat varieties at tillering, jointing, heading and seed-filling growth stages that were identified via 16S rRNA gene sequence analysis. Strains were screened for indole-3-acetic acid (IAA) production, potassium and phosphate solubilisation and the ability to grow on a nitrogen-free medium. Strain's capacity to stimulate various plant growth parameters, such as dry root weight, dry above-ground parts weight and plant height, was evaluated in pot trials. A total of 127 strains were randomly selected from 610 isolated endophytic bacterial cultures, representing ten genera and 22 taxa. Some taxa were organ-specific; others were growth-stage-specific. Bacillus aryabhattai, B. stratosphericus, Leclercia adecarboxylata and Pseudomonas oryzihabitans were detected as wheat endophytes for the first time. The IAA production, inorganic phosphorous solubilisation, organic phosphorus solubilisation, potassium solubilisation and growth on N-free medium were detected in 45%, 29%, 37%, 2.4% and 37.8% of the 127 strains, respectively. In pot trials, each strain showed variable effects on inoculated wheat plants regarding the evaluated growth parameters.

Conclusions

Wheat endophytic bacteria showed organ- and growth-stage diversity, which may reflect their adaptations to different plant tissues and seasonal variations, and differed in their PGP abilities. Bacillus was the most predominant bacterial taxa isolated from winter wheat plants. Our study confirmed wheat root as the best reservoir for screening endophytic bacteria with potential as biofertilisers.
Transcriptome analysis of the winter wheat Dn1 in response to cold stress
Authors: Tian Yu , Peng Kankan , Lou Guicheng , Ren Zhipeng , Sun Xianze , Wang Zhengwei , Xing Jinpu , Song Chunhua , Cang Jing
Published: June 2022

Background

Heilongjiang Province has a long and cold winter season (the minimum temperature can reach -30 ℃), and few winter wheat varieties can safely overwinter. Dongnongdongmai1 (Dn1) is the first winter wheat variety that can safely overwinter in Heilongjiang Province. This variety fills the gap for winter wheat cultivation in the frigid region of China and greatly increases the land utilization rate. To understand the molecular mechanism of the cold response, we conducted RNA-sequencing analysis of Dn1 under cold stress.

Results

Approximately 120,000 genes were detected in Dn1 under cold stress. The numbers of differentially expressed genes (DEGs) in the six comparison groups (0 ℃ vs. 5 ℃, -5 ℃ vs. 5 ℃, -10 ℃ vs. 5 ℃, -15 ℃ vs. 5 ℃, -20 ℃ vs. 5 ℃ and -25 ℃ vs. 5 ℃) were 11,313, 8313, 15,636, 13,671, 14,294 and 13,979, respectively. Gene Ontology functional annotation suggested that the DEGs under cold stress mainly had “binding”, “protein kinase” and “catalytic” activities and were involved in “oxidation–reduction”, “protein phosphorylation” and “carbohydrate metabolic” processes. Kyoto Encyclopedia of Genes and Genomes enrichment analysis indicated that the DEGs performed important functions in cold signal transduction and carbohydrate metabolism. In addition, major transcription factors (AP2/ERF, bZIP, NAC, WRKY, bHLH and MYB) participating in the Dn1 cold stress response were activated by low temperature.

Conclusion

This is the first study to explore the Dn1 transcriptome under cold stress. Our study comprehensively analysed the key genes involved in cold signal transduction and carbohydrate metabolism in Dn1 under cold stress. The results obtained by transcriptome analysis could help to further explore the cold resistance mechanism of Dn1 and provide basis for breeding of cold-resistant crops.
The effect of continuous adductor canal block combined with distal interspace between the popliteal artery and capsule of the posterior knee block for total knee arthroplasty: a randomized, double-blind, controlled trial
Authors: Wang Chun-Guang , Ma Wen-hai , Liu Rui , Yang Ming-Yu , Yang Yang , Ding Yan-Ling
Published: June 2022

Background

The optimal analgesia for total knee arthroplasty (TKA) requires excellent analgesia while preserving muscle strength. This study aimed to determine the hypothesis that continuous adductor canal block (CACB) combined with the distal interspace between the popliteal artery and the posterior capsule of the knee (IPACK) block could effectively alleviate the pain of the posterior knee, decrease opioids consumption, and promote early recovery and discharge.

Methods

Patients undergoing unilateral, primary TKA were allocated into group CACB+SHAM (receiving CACB plus sham block) or group CACB+IPACK (receiving CACB plus IPACK block). The primary outcome was cumulative opioid consumption. Secondary outcomes included the incidence of postoperative pain originated from the posterior knee, visual analogue scale (VAS) score, range of motion, ambulation distance, and satisfaction for pain management.

Results

The incidence of moderate-severe pain of the posterior knee was lower in group CACB+IPACK than that of the group CACB+SHAM at 4 hours (17.1% vs. 42.8%; p = 0.019), 8 hours (11.4% vs. 45.7%; p = 0.001), and 24 hours (11.4% vs. 34.3%; p = 0.046) after TKA. The VAS scores of the posterior knee were lower in group CACB+IPACK than that of the group CACB+SHAM at 4 hours [2 (2) vs. 3 (2–4); p = 0.000], 8 hours [1 (1, 2) vs. 3 (2–4); p = 0.001], and 24 hours [1(0–2) vs. 2 (1–4); p = 0.002] after TKA. The overall VAS scores were lower in group CACB+IPACK than that of the group CACB+SHAM at 4 hours [3 (2, 3) vs. 3 (3, 4); p = 0.013] and 8 hours [2 (2, 3) vs. 3 (2–4); p = 0.032] at rest and 4 hours [3 (3, 4) vs. 4 (4, 5); p = 0.001], 8 hours [3 (2–4) vs. 4 (3–5); p = 0.000], 24 hours [2 (2, 3) vs. 3 (2–4); p = 0.001] during active flexion after TKA. The range of motion (59.11 ± 3.90 vs. 53.83 ± 5.86; p = 0.000) and ambulation distance (44.60 ± 4.87 vs. 40.83 ± 6.65; p = 0.009) were superior in group CACB+IPACK than that of the group CACB+SHAM in postoperative day 1. The satisfaction for pain management was higher in group CACB+IPACK than that of the group CACB+SHAM [9 (8, 9) vs. 8 (7–9); p = 0.024]. There was no difference in term of cumulative opioids consumption between group CACB+IPACK and group CACB+SHAM [120(84–135) vs. 120(75–135); p = 0.835].

Conclusion

The combination of CACB and distal IPACK block could decrease the incidences of moderate-severe posterior knee pain, improve the postoperative pain over the first 24 hours after TKA, as well as promoting recovery of motor function. However, the opioids consumption was not decreased by adding distal IPACK to CACB.

Trial registration

This study was registered at Chinese Clinical Trial Registry (ChiCTR2200059139; registration date: 26/04/2022; enrollment date: 16/11/2020; http://www.chictr.org.cn).
Diagnosis of fast-growing thoracic aneurysm with microscopic evidence of dissection over 6 months follow-up in an asymptomatic middle aged gentleman: a case report
Authors: Sharifkazemi Mohammadbagher , Nemati Mohammadhassan , Owji Seyed Mohammad , Ahmadi Leila
Published: June 2022

Background

Thoracic aortic aneurysm (TAA), is a pathological dilatation of the aortic segment with the tendency to expand, dissect or rupture, and risk of mortality. The progression rate is mainly slow. As the risk of rupture increases with the size of the aortic diameter, it is important to diagnose TAA appropriately to prevent mortality.

Case presentation

Here, we present a case with a fast-growing TAA, complicated by subclinical dissection in a middle-aged gentleman, associated with non-compaction left ventricle, diagnosed 6 months after the first diagnosis of this co-occurrence, successfully managed by an uneventful surgical procedure. The pathological examination was the key to the diagnosis of this concealed phenomenon, i.e. a fast-growing aortic aneurysm complicated by subclinical dissection.

Conclusion

This case report emphasizes the importance of close follow-up of patients with fast-growing TAA for considering remote possibility of this silent life-threatening disease; subclinical dissecting aneurysm, especially in patients with other cardiac comorbidities. Although imaging modalities can help accurate diagnosis, in cases with fast-growing TAA, we should not wait for imaging signs of dissection and/or rupture.
Enhancing and assessing fidelity in the TANDEM (Tailored intervention for ANxiety and DEpression Management in COPD) trial: development of methods and recommendations for research design
Authors: L. Steed , V. Wileman , R. Sohanpal , MJ. Kelly , H. Pinnock , SJC Taylor
Published: June 2022

Background

Development of complex interventions for management of chronic conditions has become increasingly common, with guidance now provided. Fidelity (whether the intervention is designed, delivered and received as intended) is critical to understanding if, and how an intervention works (or not). However, methods for achieving this are still evolving. This study describes the methods used in the TANDEM trial – a large multicentre study evaluating the impact of a cognitive behavioural intervention preceding routine pulmonary rehabilitation for people with chronic obstructive pulmonary disease and anxiety and or depression. Results for enhancement and training aspects of fidelity, are presented.

Methods

Using the National Institute for Health Behaviour Change Consortium (NIH BCC) framework of fidelity, a set of enhancement strategies and a fidelity measurement strategy were developed with input from a multidisciplinary team. The Cognitive First Aid Rating Scale (CFARS) was used to assess Facilitator (the respiratory professional delivering TANDEM) therapeutic competence at the end of the initial training and throughout treatment delivery (on a randomly selected set of cases). A TANDEM specific treatment adherence measure was developed following previously recommended procedures. Together these (the CFARS and adherence measure) comprised the TANDEM treatment delivery fidelity tool.

Results

Hiring of respiratory professionals to the initial training programme was successful, with 44% of those expressing initial interest in being a Facilitator successfully completing the process. Video recordings of potential Facilitators conducting standardized patient role plays at the end of the initial training demonstrated fidelity of training.

Conclusions

Addressing fidelity in complex intervention trials is a time and resource intensive process but has significant potential to increase understanding of results and strengthen the evidence base for effective interventions. By defining a full fidelity assessment method prior to analysis we aimed to minimise bias when interpreting results.

Trial registration

ISRCTN59537391. Registered on 20 March 2017. Trial protocol version 6.0, 22 April 2018. Process evaluation protocol version 4.0, 1 November 2020.
Survival probability and factors associated with time to loss to follow-up and mortality among patients on antiretroviral treatment in central Kenya
Authors: Wekesa P. , McLigeyo A. , Owuor K. , Mwangi J. , Ngugi E.
Published: June 2022

Background

Retention of patients who are receiving antiretroviral therapy (ART) remains a challenge especially in the setting of rapid expansion of HIV services. Retention in care remains vital to the HIV care continuum, and has been associated with viral suppression and improved survival. This study aimed to ascertain survival rates, time to loss to follow-up (LTFU) or mortality events and factors associated with time to LTFU or mortality among patients enrolled on antiretroviral therapy at health facilities in central Kenya.

Methods

This was a retrospective cohort study among patients initiated on ART between 2004 and 2012 in central Kenya. Demographic characteristics, clinical characteristics and outcomes data were analyzed using Stata version 15.1. Competing risks regression analysis and cummulative incidence functions were used to estimate survival.

Results

A total of 31,346 patients were included, of whom 65.6% were female, 76.0% were aged between 20 and 50 years old, and 38.9% were diagnosed at WHO stage III. At 36 months, overall retention was 68.8%, LTFU was 27.1%, and mortality was 4.1%. The total person-years of follow up was 74,986. The incidence rate of LTFU was 9.99 per 100 person years for a total of 9383.25 person-years of follow up. The mortality rate was 1.25 per 100 person years for a total of 875.5 person-years among those who died. The median time to LTFU was 11 months (IQR 3–22) while median time to death was 3 months (IQR 0–13). Men, unmarried patients, patients presenting with advanced HIV, not on TB treatment, and enrolled into the HIV program in later cohorts, had a shorter time to mortality and LTFU.

Conclusion

Our study demonstrated evidence of scale-up of HIV treatment programs in central Kenya. While most patients were enrolled at an advanced WHO clinical stage, overall 36-month mortality remained low, but occurred earlier during follow-up. Cohort LTFU at 36-months reduced in later years with the losses occurring within the 1st year of follow-up. Predictors of early mortality and LTFU included being male, single, separated or divorced, advanced WHO clinical stage, and among patients not on TB treatment.
Burnout, stress and intentions to leave work in New Zealand psychiatrists; a mixed methods cross sectional study
Authors: Chambers Charlotte N. L. , Frampton Christopher M. A.
Published: June 2022

Background

Demand for mental health services in New Zealand and internationally is growing. Little is known about how psychiatrists are faring in this environment. This study aimed to investigate wellbeing of psychiatrists working in the public health system in New Zealand, identify the main risk factors for work-related stress, gauge perceptions of how workload has changed over time, assess job satisfaction and whether individuals intend or desire to leave their work.

Methods

Psychiatrists working in New Zealand who were also members of the Association of Salaried Medical Specialists were invited to participate in an online survey. Main outcome measures were degree of burnout and stress experienced at work. Supplementary measures included perceived workplace demands and levels of support. Predictor variables included perceptions of changes to workloads over time, degree of job satisfaction and intentions to leave work. Logistic regression assessed characteristics associated with burnout and job satisfaction as well as intentions to leave work. Free text comments were analysed thematically alongside quantitative trends.

Results

368/526 responded (70% response rate). 34.6% met the criteria for burnout and 35.3% scored with high work stress. There were no significant patterns of association with demographic variables but significant correlation with all but one predictor variable; having experienced a change to the demands of the on-call workload. 45% agreed they would leave their current job if able and 87% disagreed that they are working in a well-resourced mental health service. Respondents emphasised the impact of growing workloads and expressed concerns about their ability to provide optimal care in these circumstances.

Conclusions

High burnout appears to affect one in three psychiatrists in New Zealand. Many attribute their feelings of burnout to demand for their services. These findings may assist with better workforce planning for psychiatry and emphasises potential consequences of demand for and poor resourcing of mental health services for the retention and wellbeing of doctors in psychiatry worldwide.
Socioeconomic, intrapersonal and food environmental correlates of unhealthy snack consumption in school-going adolescents in Mumbai
Authors: Moitra Panchali , Madan Jagmeet
Published: June 2022

Background

Unhealthy snacking habits in adolescents are typically triggered by obesogenic food environments and possibly perpetuated through interactions between socio-environmental factors and personal perceptions, attitudes, and motivations to change eating behaviors. This study attempted to address the knowledge gap regarding the association of intrapersonal, socioeconomic, and food environmental characteristics with unhealthy snack consumption in Indian adolescents, presenting several targets for effective interventions.

Methods

A representative sample of 10–12 years old adolescents (n 712) completed a cross-sectional survey including eating habits, characteristics of school and home food environments, and perceptions related to affordability, convenience, and barriers within the food environments. The frequency of unhealthy snack consumption was assessed using a validated qualitative food frequency questionnaire. Multivariate regression analyses determined the associated factors of unhealthy snack consumption in adolescents attending private and public schools.

Results

The mean age of adolescents was 10.9 (1.1) years, 48.2% were girls and 53.9% attended private schools. The most frequently consumed unhealthy snacks were biscuits/ cookies (5.2d/wk) followed by wafers (3.4d/wk) and Indian fried snacks- samosa/ vada pav (2.8 d/wk). Among the public-school adolescents, the odds of unhealthy snack consumption were 0.89 times lower when meals were had frequently at the dinner table and 4.97 times higher when the perceived barriers related to the affordability of healthy snacks were greater. Maternal education (OR 0.78, 95% CI 0.66–0.82, p < 0.001), family income (OR 2.15, 95% CI 1.98–2.32, p < 0.001), availability of unhealthy snacks (OR 2.98, 95% CI 1.36–3.46, p < 0.001) and fruits (OR 0.57, 95% CI 0.49–0.69, p < 0.001) at home, having evening meals together (OR 0.71, 95% CI 0.63–0.81, p 0.031), and perceived parental control during mealtimes (OR 0.67, 95% CI 0.62–0.72, p < 0.001) were associated with unhealthy snack consumption in adolescents attending private schools.

Conclusions

The results highlighted a pervasiveness of unhealthy snacks in adolescents’ food environments. Improving provisions and affordability of fruits and healthy snacks at schools, encouraging family mealtimes, and limiting the availability of unhealthy snacks at home whilst addressing the perceived barriers within food environments, and inculcating self-efficacy skills can improve snacking habits in Indian adolescents, irrespective of socioeconomic backgrounds.
Kawasaki disease shock syndrome with acute respiratory distress syndrome in a child: a case report and literature review
Authors: Liu Jingwei , Yang Chunfeng , Zhang Zhen , Li Yumei
Published: June 2022

Background

Kawasaki disease (KD) is an acute systemic vasculitis that may involve multiple organs. KD shock syndrome (KDSS) is a rare complication of KD. Pulmonary involvement is rare in KD; reports of patients with KD who develop KDSS and acute respiratory distress syndrome (ARDS) are extremely rare.

Case presentation

A 2-year-old girl was brought to the emergency department with fever, cough and tachypnea. The patient was diagnosed with KDSS and ARDS. Extracorporeal membrane oxygenation (ECMO) and continuous blood purification were performed because of her critical condition. The patient eventually recovered completely. One year after discharge, there has been no coronary artery dilatation or pulmonary fibrosis.

Conclusion

KDSS patients may develop ARDS due to fluid resuscitation and the release of inflammatory mediators. Early aggressive management and comprehensive treatment may improve prognosis.
Treatment of symptomatic hip dysplasia by posterolateral small incision assisted Bernese periacetabular osteotomy
Authors: Li Chuan , Zhang Xianghong , Meng Xuhan , Pu Luqiao , Chen Hongxuan , Su Yongyue , Bu Pengfei , Xu Yongqing , Liu Tang
Published: June 2022

Background

For periacetabular osteotomy, traditional approaches usually have a long learning curve. We aimed to evaluate the postoperative results and complications of periacetabular osteotomy under a new double-incision approach.

Methods

The records of 58 consecutive patients (65 hips) who underwent periacetabular osteotomy using the new approach were retrospectively reviewed and evaluated. There were 52 women and 6 men with a mean age of 28.1 years at the time of surgery.

Results

The average follow-up period was 35.2 months, during which no patients were converted to total hip arthroplasty. Complications included 6 hips (9.2%) with nerve dysesthesias and 1 hip (1.5%) with delayed wound healing. The mean operative time and intraoperative blood loss were 88.6 min and 402.8 ml, respectively. The mean modified Harris hip score had improved from 72.2 points preoperatively to 91.3 points at the last follow-up. Fifty-five patients (62 hips, 95.4%) were satisfied to their outcomes, and good preoperative functional score was associated with a satisfactory outcome. Furthermore, the average lateral center–edge angle, anterior center–edge angle and acetabular index angle were corrected well after surgery.

Conclusion

Periacetabular osteotomy using modified Smith-Petersen or Bikini approach with posterolateral assisted small incision can be performed safely and with satisfactory results. In addition, this technique shortens the learning curve, and reduces the operating complexity, especially for beginner.
A warning system for urolithiasis via retrograde intrarenal surgery using machine learning: an experimental study
Authors: Jeong Jinho , Chang Kidon , Lee Jisuk , Choi Jongeun
Published: June 2022

Background

To develop a warning system that can prevent or minimize laser exposure resulting in kidney and ureter damage during retrograde intrarenal surgery (RIRS) for urolithiasis. Our study builds on the hypothesis that shock waves of different degrees are delivered to the hand of the surgeon depending on whether the laser hits the stone or tissue.

Methods

A surgical environment was simulated for RIRS by filling the body of a raw whole chicken with water and stones from the human body. We developed an acceleration measurement system that recorded the power signal data for a number of hours, yielding distinguishable characteristics among three different states (idle state, stones, and tissue–laser interface) by conducting fast Fourier transform (FFT) analysis. A discrete wavelet transform (DWT) was used for feature extraction, and a random forest classification algorithm was applied to classify the current state of the laser-tissue interface.

Results

The result of the FFT showed that the magnitude spectrum is different within the frequency range of < 2500 Hz, indicating that the different states are distinguishable. Each recorded signal was cut in only 0.5-s increments and transformed using the DWT. The transformed data were entered into a random forest classifier to train the model. The test result was only measured with the dataset that was isolated from the training dataset. The maximum average test accuracy was > 95%. The procedure was repeated with random signal dummy data, resulting in an average accuracy of 33.33% and proving that the proposed method caused no bias.

Conclusions

Our monitoring system receives the shockwave signals generated from the RIRS urolithiasis treatment procedure and generates the laser irradiance status by rapidly recognizing (in 0.5 s) the current laser exposure state with high accuracy (95%). We postulate that this can significantly minimize surgeon error during RIRS.
Chronic hepatitis B virus infection increases the risk of upper urinary calculi
Authors: Hou Bingbing , Lin Changming , Hao Zongyao
Published: June 2022

Background

Although hepatitis B virus (HBV) is a recognized risk factor for renal diseases, little is known about HBV infection in individuals with upper urinary calculi (UUC). We investigated the relationship between chronic HBV infection and UUC.

Methods

We retrospectively analysed data from 1399 patients who were discharged from the Department of Urology (2017–2018). The diagnosis of UUC was determined using urinary tract ultrasonography or computed tomography, and HBV infection was evaluated by a positive hepatitis B surface antigen (HBsAg) test. Data on patients with and without UUC and HBsAg-positive and HBsAg-negative patients were compared by univariate and multivariate analyses.

Results

Data on chronic HBV infection and UUC were available for 1062 patients, including 514 who presented with UUC and 548 who did not. Overall, 5.8% of total patients, 8.0% of UUC patients and 3.8% of non-UUC patients had chronic HBV infection. UUC patients (41/514) had a significantly higher prevalence of HBsAg positivity (OR 2.175; 95% CI 1.267–3.734;P = 0.004) than non-UUC patients (21/548). After stratifying by sex, the relative odds of HBsAg positivity were statistically significant in men (OR 2.156; 95% CI 1.162–4.003;P = 0.015) but not in women (OR 2.947; 95% CI 0.816–10.643;P = 0.099). The incidence of urinary pH > 6 and staghorn stones was significantly higher in HBsAg-positive UUC patients than in HBsAg-negative UUC patients.

Conclusion

This is the first study to demonstrate that chronic HBV infection is strongly associated with UUC, at least in men. The urinary pH > 6 and staghorn stones were more common in UUC patients with chronic HBV infection.
Development of the opioid self-management scale for advanced Cancer patients with pain and examination of its validity and reliability
Authors: Yoshida Shiori , Sato Fumiko , Tagami Keita , Sasaki Rie , Takahashi Chikako , Sasaki Konosuke , Takahashi Shin
Published: June 2022

Background

Approximately 60% of outpatients with advanced cancer experience pain; therefore, self-management of opioid use is important for appropriate pain relief. To date, no studies have clearly described the concept of opioid self-management or assessed the factors involved, including the improvement of self-management abilities. This study developed, and evaluated the validity and reliability of an opioid self-management scale for advanced cancer patients with pain (OSSA). Opioid self-management in advanced cancer patients with pain was defined as the management of opioid medication performed by patients with advanced cancer to relieve cancer pain on their own.

Methods

Three phases were required for validation and reliability of the OSSA: 1) testing content validity, 2) testing face validity, and 3) testing construct validity, concurrent validity and reliability.

Results

After a three-phase process, the OSSA consisted of 33 items on six subscales. The structural equation modeling was such that the χ2 value was 709.8 (p < 0.001, df = 467), goodness-of-fit index was 0.78, adjusted goodness-of-fit index was 0.73, root mean squares of approximation was 0.063, and comparative fit index was 0.92. The Pearson correlation coefficients between the total OSSA score and the 24-hour average pain or pain relief over 24 hours were − 0.21 (p < 0.05) and 0.26 (p < 0.01), respectively. Cronbach’s α was 0.93. The intraclass correlation coefficient range was 0.59–0.90.

Conclusion

The findings of this study show that the OSSA has acceptable validity and reliability, and that better self-management leads to greater pain relief. The OSSA can be considered effective for use in research, but shortened version should be prepared for realistic and practical clinical use.
Impacts of early clinical exposure on undergraduate student professionalism—a qualitative study
Authors: Liu Chun-i , Tang Kung-pei , Wang Yun-chu , Chiu Chiung-hsuan
Published: June 2022

Introduction

Early clinical exposure (ECE), or authentic human contact in a social or clinical context during preclinical training, has been adopted by many medical schools. This study aims to investigate how medical students’ sense of professionalism changed after ECE intervention, with the aim of informing curriculum design to enhance student awareness of the importance of medical professionalism.

Method

Focus groups of ECE students were held to collect data for the study. All participants read interview guidelines before starting. During the focus groups, the students discussed their medical obligations as perceived throughout the course, which offered a choice between four different ECE tracks. They were then asked to report their understanding of the situations they encountered during the course and reflect on their implications.

Results

Six focus groups of 22 students in total from a medical school in northern Taiwan were held shortly after the students completed an ECE course in September 2019. From their responses, 10 categories relating to medical professionalism were deduced categorized under 5 major dimensions. An additional 8 sub-dimensions on attitudes and 2 sub-dimensions on personal well-being were also identified as new categories separate from but related to medical professionalism. After the ECE intervention, about 59% of participants redefined their understanding of medical professionalism.

Conclusion

ECE and intensive interaction with key stakeholders, including patients and their families, help students in the early stages of medical education form and cultivate a sense of medical professionalism. However, the relationship between participants’ personalities, motivations, and clinical activities requires further investigation.
Attitudes of home-visiting nurses toward risk management of patient safety incidents in Japan
Authors: Yoshimatsu Keiko , Nakatani Hisae
Published: June 2022

Background

In situations of home care, patients and their family members must address problems and emergencies themselves. For this reason, home-visiting nurses (HVNs) must practice risk management to ensure that patients can continue receiving care in the comfort of their homes. The purpose of this study was to examine HVNs’ attitudes toward risk management.

Methods

This study adopted a qualitative description approach. Semi-structured interviews were conducted to collect information on HVNs’ risk management behavior and their attitudes toward it. Participants comprised 11 HVNs working at home-visiting nursing agencies in a prefecture of Japan. Transcribed interviews were analyzed using content analysis.

Results

Nurses’ attitudes toward risk management comprised the following themes: (i) predicting and avoiding risks, (ii) ensuring medical safety in home settings, (iii) coping with incidents, and (iv) playing the role of administrators in medical safety, which was answered only by administrators.

Conclusions

When practicing risk management, home-visiting nurses should first assess the level of understanding of the patient and family, followed by developing safety measures tailored to their everyday needs. These results further suggest that administrators should take actions to foster a working environment conducive to risk management. These actions include coordinating duties to mitigate risk and improve the process of reporting risks. This study provides a baseline for future researchers to assist patients and families requiring medical care services of this nature.