bluuebunny/crossref_metadata_2025 huggingface dataset:
Pericardial effusion secondary to epicardial undifferentiated pleomorphic sarcoma in a young cat
Authors: Stone Marisa D , Davies Rebecca K , Kridel Heather A
Published: May 2023

Case summary

A 6.4 kg 3-year-old male neutered indoor–outdoor domestic shorthair cat was referred for further evaluation of non-resolving lethargy and hyporexia of 4 days’ duration. Physical examination identified tachypnea with mild respiratory effort and muffled lung sounds bilaterally. Point-of-care ultrasound revealed a large volume of pleural and pericardial effusion (PCE), which was confirmed by thoracic radiography. Echocardiogram indicated normal cardiac function but revealed a mass-like structure along the left epicardium within the pericardial space. After 72 hours in hospital, re-evaluation via echocardiogram showed the epicardial mass lesion to have doubled in size and with apparent extension to involve the pericardium. The patient was hospitalized for 72 h of supportive care and intervention, including therapeutic pericardiocentesis, bilateral thoracocentesis, thoracic and cardiac imaging and infectious disease testing. On the third day of hospitalization, the patient developed cardiac tamponade. Further workup was discussed, including CT and subtotal pericardiectomy with biopsy, but the cat was euthanized due to clinical decline and rapid re-accumulation of effusion. Post-mortem histopathologic evaluation diagnosed an epicardial pleomorphic sarcoma, exclusive of mesothelioma or histiocytic sarcoma on immunohistochemistry (IHC).

Relevance and novel information

This report describes a case of epicardial undifferentiated pleomorphic sarcoma (UPS) in a young cat presenting with pleural and PCE. Pleomorphic sarcoma is a rarely reported mesenchymal neoplasia in the feline patient and has thus far primarily been identified in peripheral soft tissue structures. IHC is key to the correct histopathologic diagnosis. To our knowledge, epicardial UPS has not been previously reported in a cat.
Potential assistive technology preferences of informal caregivers of people with disability
Authors: Atoyebi Oladele , Beaudoin Maude , Routhier François , Auger Claudine , Demers Louise , Wister Andrew , Plante Michelle , Mortenson W Ben
Published: May 2023

Background

Preferences of informal caregivers of people with neurocognitive disorders for technological solutions are important in user- centered design approaches. It is crucial to take into consideration the needs and preferences of users when developing new technology to facilitate their uptake.

Objectives

The objective of this study was to determine caregiver preferences for potential technological solutions to help address their needs and compare technology preferences of caregivers who provide care to those with and without neurocognitive disorders (NCD).

Methods

This was a quantitative descriptive study. We surveyed informal caregivers of older adults with disability in Canada. Participants were asked to answer questions about their preferences for 10 potential technological solutions that could be developed to make caregiving easier.

Results

Data from 125 respondents (72 caregivers of people with NCD and 53 caregivers of people with non-NCD-related disabilities) were analyzed. Generally, caregivers preferred web-based solutions as these were among the first five choices for both groups combined. However, there were some differences in the order of preference of potential solutions in both groups.

Conclusion

Informal caregivers of people with NCD preferred web-based solutions to help address their needs.
Pediatric Brucellosis: A Challenging Diagnosis—Case Report
Authors: Shaikh Areeba , Sarfaraz Munira , Ehsan Shaista
Published: May 2023

Background:

Brucellosis is the second most widely spread zoonotic disease. There is less literature on this disease in Pakistan, leading to delayed diagnosis, or the patient remains undiagnosed. This study aims to contribute to Pediatric brucellosis literature, epidemiological, clinical features, laboratory findings, and treatment.

Case Presentation:

We present an 11-year-old child who was admitted to the hospital due to abdominal pain for one month and a fever for 15 days. On abdominal ultrasound, she had hepato-splenomegaly with minimal pleural effusion. A comprehensive diagnostic workup for infectious and immunologic disorders confirmed brucellosis with the antibody tests report. She received doxycycline, rifampin, and trimethoprim-sulfamethoxazole for three months. The treatment was continued with Syrup Doxycycline (50 mg/5 ml), and Syrup Rifampicin (2 g/100 ml) was prescribed for five weeks. Her symptoms were improved by the end of the treatment.

Conclusion:

Brucella is an intracellular pathogen affecting multi-systems of the human body; thus, the treatment is started with antimicrobials that have penetrative effects on a cell. The treatment can be adjusted based on the age group and the complication of the symptoms.
Examining the Implementation of Health-Related Social Need (HRSN) Screenings at a Pediatric Community Health Center
Authors: Gray Thomas W. , Podewils Laura J. , Rasulo Rasulo M. , Weiss Randie P. , Tomcho Margaret M.
Published: May 2023

Introduction:

Social determinants of health (SDoH) influence health outcomes and screening for health-related social needs (HRSN) is a recommended pediatric practice. In 2018, Denver Health and Hospitals (DH) implemented the Accountable Health Communities (AHC) model under the Centers for Medicare and Medicaid Services (CMS) and began using the AHC HRSN screening tool during selected well child visits (WCVs) at a DH Federally Qualified Health Center (FQHC). The current evaluation aimed to examine the program implementation and identify key lessons learned to inform the expansion of HRSN screening and referral to other populations and health systems.

Methods:

Patients who completed a WCV between June 1, 2020 and December 31, 2021 (N = 13 750) were evaluated. Frequencies and proportions were used to describe patient characteristics of those that had a WCV, were screened, and received resource information. Multivariable logistic regression models with odds ratios (OR) and 95% confidence intervals (CI) were used to determine the association between patient characteristics and completing HRSN screening and provision of resource information.

Results:

The screening tool was completed by 80% (n = 11 004) of caregivers bringing children to a WCV at the DH Westside Clinic, with over one-third (34.8%; n = 3830) reporting >1 social need. Food insecurity was the most common concern (22.3%; n = 2458). Non-English, non-Spanish (NENS) speakers were less likely to be screened (OR 0.43, 95% CI 0.33, 0.57) and less likely to report a social need (OR 0.59, 95% CI 0.42, 0.82) than speakers of English, after adjusting for age, race/ethnicity, and health insurance.

Conclusions:

A high rate of screening indicates feasibility of administering HRSN screenings for pediatric patients in a busy FQHC. More than a third of patients reported one or more social needs, underscoring the importance to identity these needs and the opportunity to offer personalized resources. Comparatively lower rates of screening and potential underreporting among NENS may be indicative of the availability and acceptability of current translation procedures as well as how the tool translates linguistically and culturally. Our experience highlights the need to partner with community organizations and involve patients and families to ensure SDoH screening and care navigation is part of culturally-appropriate patient-centered care.
Using the Theory of Planned Behaviour to Explore Predictors of Financial Behaviour Among Working Adults in Malaysia
Authors: She Long , Rasiah Ratneswary , Weissmann Marc Arul , Kaur Harpaljit
Published: May 2023

The current study sought to explore the predictors of financial behaviour among working adults based on the theory of planned behaviour. This study employed the correlational cross-sectional questionnaire-based research design. In total, 558 samples were obtained through a purposive sampling technique. The measurement model and proposed research model were evaluated using partial least squares structure equation modelling. The findings revealed that financial knowledge is positively associated with the attitudes towards retirement, perceived behavioural control, subjective norms, and financial behaviour of working adults. In addition, the findings demonstrated that retirement attitude, perceived behavioural control, and subjective norms each had a positive relationship with behavioural intention towards planning for retirement. Furthermore, the results showed that behavioural intention and perceived behavioural control are positively associated with the financial behaviour of working adults. The findings could aid financial educators and advisors in delivering the correct blend of financial knowledge to assist working adults in making better financial decisions and practising proper financial behaviour.
Sexual Harassment of Women in Higher Academia: A Study with Special Reference to Teacher–Student Relation
Authors: Mishra Praveen , Bhutia Sonam Yangchen
Published: May 2023

Sexual harassment is one of the major challenges in academia in India and abroad. It has been manifested in various forms such as physical, verbal and non-verbal harassment. At times the issue of sexual harassment goes unreported and where it is reported, to what extent it is addressed and how effectively it is handled by the authorities responsible to prevent the same is an issue of concern. The paper explores through case studies, the nature and magnitude of sexual harassment in institutions imparting higher education. It attempts to understand the nature of sexual harassment of women in such institutions and to find the legal and procedural mechanism to prevent and control sexual harassment of students and employees in academia. The paper argues that the law on prevention of sexual harassment of women in the workplace has various gaps which need to be addressed for doing justice to the complainant and accused of sexual harassment. The paper attempts to provide suggestions for dealing with the deficiencies of the Act of 2013 and the rules made under it. The research methodology applied in this research is primarily doctrinal and is based on secondary sources such as research papers, case studies, case comments, reports, commentaries, media reporting, books, human rights instruments and judicial decisions. The researchers have made a case study of 30 cases, and 15 representative cases have been incorporated into the present study.
Kaposiform Lymphangiomatosis in a Male Adolescent: A Clinical Challenge and the Role of Genetics
Authors: Pereira-Nunes Joana , Madureira Miguel , Dinis Alexandra , Barroca Helena , Lima Jorge , do Bom-Sucesso Maria
Published: May 2023

Kaposiform lymphangiomatosis (KLA) is a rare and aggressive generalized lymphatic anomaly (GLA), with distinctive clinical, radiology, morphologic, and genetic features. It does not have a current standard treatment and presents poor overall prognosis. Somatic mutations in the RAS pathway were reported as the likely driver for the majority of patients. We report a case of a 17-year-old male adolescent who was referred to the emergency department due to a severe anemia. Laboratory workup confirmed the anemia and revealed coagulation factor consumption and fibrinolysis. Chest-abdomen-pelvis computed tomography revealed an extensive cervical, mediastinal, abdominal and retroperitoneal “hematoma.” During admission, progressive pancytopenia, and disseminated intravascular coagulation were observed, and the hypothesis of a tumor/neoplastic etiology was considered. A thoracoscopy revealed a moderate hemorrhagic pleural effusion and a mediastinal mass resembling a “hemolymphangiomatosis” malformation, which was biopsied. Histology displayed a lymphatic-venous malformation. The patient was presented at the multidisciplinary Vascular Anomalies Center and, due to the complex vascular anomaly diagnosis, oral sirolimus monotherapy was initiated. Four years later, the patient remains clinically stable, with stability of the lesion’s dimensions and characteristics. A p.Q61R variant in the NRAS gene [NM_002524.4: c.182A>G, p.(Gln61Arg)], with 5% allelic fraction and 1993x coverage was detected. In conjunction with clinical and pathological findings, it allowed KLA final diagnosis. This case reinforces the importance of a high index of clinical suspicion and highlights the need of referring these cases to referral to Vascular Anomalies Centers.
Collective Responsibility in the Workplace and its Effects on COVID-19 Vaccine Acceptance Among Employees: The Role of Strategic Internal Communication
Authors: Li Jo-Yun , Tao Weiting , Lee Yeunjae
Published: May 2023

Businesses, as one of the largest units in society, are expected to be socially responsible and become vaccine advocate to help with recovery from the COVID-19 pandemic. Building upon this expectation, this study takes an internal communication perspective to explore the role of organizations in motivating employees to stand in solidarity and adopt prosocial behavior (i.e., vaccination against COVID-19 in this study) in the fight against the pandemic. Specifically, we propose a psychological model that pictures how organizational informing and listening can facilitate employee attitude toward vaccination by realizing their collective responsibility to protect others at work via communal relationships with the organizations. The findings of this study contribute to ethical practices of organizational communication by revealing the under-explored role of organizations in addressing vaccine hesitance and resistance during the current pandemic.
Medical Assistance in Dying: A Review of Canadian Health Authority Policy Documents
Authors: Thomas Robyn , Pesut Barbara , Puurveen Gloria , Thorne Sally , Tishelman Carol , Leimbigler Betsy
Published: May 2023

The purpose of this study was to describe policies developed by English-speaking Canadian health authorities to guide multi-disciplinary healthcare practice in the context of MAID. Seventeen policies from 9 provinces and 3 territories were identified and analyzed thematically. Themes developed from these documents related to ensuring a team approach to care, supporting informed patient choice, creating region-specific guidance on eligibility criteria and safeguards, accommodating conscientious objection, and making explicit organizational responsibilities. Ethical language concerned vulnerability, non-judgmental care, dignity, non-abandonment, confidentiality, moral conscience, and diverse cultural values. Overall, these policies addressed important risk mitigation strategies, acknowledged important social contracts, and supported ethical practice. Collectively, these policies outline important considerations in the evolving Canadian context for other jurisdictions seeking to create policy around assisted death.
“I Needed for You to See What I’m Talking About”: Experiences With Telehealth Among Homeless-Experienced Older Adults
Authors: Zahir Ali , Yip Deborah , Garcia Cheyenne , Smith Ashley Nicole , Dhatt Zena , Duke Michael , Kushel Margot
Published: May 2023

Little is known about how older adults with a current or recent experience of homelessness navigated the switch to telehealth during the COVID-19 pandemic. We examined the perceptions and use of telehealth in a purposive sample of 37 homeless-experienced older adults in mid-late 2020 through semi-structured qualitative interviews. We purposively recruited participants from a larger longitudinal study on homeless-experienced older adults in Oakland, CA. We subjected the data to content analysis. We found that most participants who used telehealth used audio-only phone calls for care. We found that (1) participants experienced challenges accessing the necessary technologies for telehealth, (2) perceptions of telehealth for physical health differed based on the modality (video vs. audio-only), and (3) participants had generally positive perceptions of telehealth for mental healthcare. Our findings suggest that clinicians interacting with homeless-experienced older adults should address the potential skepticism of audio-only telehealth patients, and assess their access to, and knowledge of, video conferencing technology.
Politicizing the “unknown”: Territorial narratives, shared spatial imaginaries, and Bermuda’s oceans
Authors: Acton Leslie
Published: May 2023

Marine conservation advocates have promoted the designation of large-scale marine protected areas (LSMPAs) in the EEZs of small island states and territories. These offshore spaces, early proponents argued, are too remote for people to use and are thus “politically less risky” than nearshore areas to promote conservation. This paper counters this assertion through an empirical examination of how the mistaken assumption that offshore spaces are unpeopled contributed to a failed LSMPA designation attempt in Bermuda. Drawing on policy documents, speech transcripts, media, and 104 semi-structured interviews, it presents an analysis of the territorial narratives used to discursively (re)produce Bermuda’s EEZ during LSMPA negotiations. Three major findings emerge. First, rather than a blank slate on which conservation values could be easily inscribed, these narratives showed Bermuda’s EEZ to be a space entangled with diverse values, identities, and goals. Second, the narratives that actors used revealed broadly overlapping values related to Bermuda’s EEZ, even among people promoting opposing governance outcomes, demonstrating that opportunities for broad agreement on the EEZ’s purpose and governance did, and may still, exist. Third, by using an imaginary of Bermuda’s EEZ as “unknown” to legitimize its decision to delay negotiations, the Bermuda government effectively reinstated the “blank slate,” aligning itself with popular values while avoiding a definitive stance on the contentious national debate. This decision and the broader negotiations demonstrate how the use of territorial narratives and spatial imaginaries can alter offshore spaces, even when no regulatory changes occur, with implications for future ocean governance options.
Possibilities in postnormal times
Authors: Montuori Alfonso
Published: May 2023

In a time of global unrest and “polycrises,” the study and utilization of possibilities is a matter of urgency. In this article I briefly review some of the current studies that point to a view of human beings as having greater capacities, potentials, and possibilities, from the cognitive to the relational and spiritual. I celebrate the birth of this journal in the hope that a greater awareness of human possibilities will lead to more attention and research and an awareness that current assumptions about human possibilities are too limited.
Easing the sublime: Flow, daoism, and being-nature
Authors: Brillenburg Wurth Kiene
Published: May 2023

Comparative Literature brings to Possibility Studies the toolbox to closely read the generative materiality of things, and the resonances between them, from a plurality of cultural, temporal, affective, and critical perspectives. What is the agency of things in making people think and feel “otherwise”? In this article, I try to answer this question with a view to the idea of the sublime. I revise this idea within a Daoist theoretical perspective of wuwei (doing not-doing)—carefully differentiating it from Czíkszentmihályi’s idea of flow— and self/no-self: of entanglement. I call this re-vision easing the sublime, and I argue that such easing is crucial to the continued relevance of this esthetic category in Possibility Studies. As I conclude, easing the sublime ultimately boils down to an attitude of a being-at-ease with (without being indifferent to) the eternal transformation of things ( wu hua).
An improved algorithm for inferring mutational parameters from bar-seq evolution experiments
Authors: Li Fangfei , Mahadevan Aditya , Sherlock Gavin
Published: May 2023

Background

Genetic barcoding provides a high-throughput way to simultaneously track the frequencies of large numbers of competing and evolving microbial lineages. However making inferences about the nature of the evolution that is taking place remains a difficult task.

Results

Here we describe an algorithm for the inference of fitness effects and establishment times of beneficial mutations from barcode sequencing data, which builds upon a Bayesian inference method by enforcing self-consistency between the population mean fitness and the individual effects of mutations within lineages. By testing our inference method on a simulation of 40,000 barcoded lineages evolving in serial batch culture, we find that this new method outperforms its predecessor, identifying more adaptive mutations and more accurately inferring their mutational parameters.

Conclusion

Our new algorithm is particularly suited to inference of mutational parameters when read depth is low. We have made Python code for our serial dilution evolution simulations, as well as both the old and new inference methods, available on GitHub (https://github.com/FangfeiLi05/FitMut2), in the hope that it can find broader use by the microbial evolution community.
The clinical manifestation and outcome of COVID-19 in patients with a history of ischemic heart disease; a retrospective case-control study
Authors: Tajmirriahi Marzieh , Sami Ramin , Mansourian Marjan , Khademi Niloufar , Hosseini Nastaran-sadat , Dehghan Mehrneagar , Soltaninejad Forogh
Published: May 2023

Introduction

Coronary artery disease (CAD) is considered an independent risk factor for COVID-19. However, no study has specifically examined the clinical manifestations and outcomes of COVID-19 in patients with ischemic heart disease (IHD).

Methods

In a retrospective case-control study between 20 March 2020 to 20 May 2020, the medical record of 1611 patients with laboratory-confirmed SARS-CoV-2 infection was reviewed. IHD was defined as a history of an abnormal coronary angiography, coronary angioplasty, coronary artery bypass graft (CABG), or chronic stable angina. Demographic data, past medical history, drug history, symptoms, vital signs, laboratory findings, outcome, and death were investigated from medical records.

Results

1518 Patients (882 men (58.1%)) with a mean age of 59.3 ± 15.5 years were included in the study. Patients with IHD (n = 300) were significantly less likely to have fever (OR: 0.170, 95% CI: 0.34–0.81, P < 0.001), and chills (OR: 0.74, 95% CI: 0.45–0.91, P < 0.001). Patients with IHD were 1.57 times more likely to have hypoxia (83.3% vs. 76%, OR: 1.57, 95% CI: 1.13–2.19, P = 0.007). There was no significant difference in terms of WBC, platelets, lymphocytes, LDH, AST, ALT, and CRP between the two groups (P > 0.05). After adjusting for demographic characteristics, comorbidities and vital signs, the risk factors for mortality of these patients were older age (OR: 1.04 and 1.07) and cancer (OR: 1.03, and 1.11) in both groups. In addition, in the patients without IHD, diabetes mellitus (OR: 1.50), CKD (OR: 1.21) and chronic respiratory diseases (OR: 1.48) have increased the odds of mortality. In addition, the use of anticoagulants (OR: 2.77) and calcium channel blockers (OR: 2.00) has increased the odds of mortality in two groups.

Conclusion

In comparison with non-IHD, the symptoms of SARS-CoV-2 infection such as fever, chills and diarrhea were less common among patients with a history of IHD. Also, older age, and comorbidities (including cancer, diabetes mellitus, CKD and chronic obstructive respiratory diseases) have been associated with a higher risk of mortality in patients with IHD. In addition, the use of anticoagulants and calcium channel blockers has increased the chance of death in two groups without and with IHD.
Association between serum 25(OH)D and risk of all-cause mortality in adults with prior cardiovascular disease: a cohort study from NHANES 2007–2018
Authors: Hu Ben , Chen Jian , Shi Yihang , Hou Linlin
Published: May 2023

Background

Serum vitamin D deficiency is common in the patients with cardiovascular disease (CVD), but the association between serum vitamin D levels and risk of all-cause mortality in patients with CVD is controversial.

Objective

This study aimed to understand better the association between serum 25(OH)D status and risk of all-cause mortality in patients with prior CVD.

Method

We conducted a cohort study using data from the National Health and Nutrition Examination Survey from 2007 to 2018 to investigate the association between serum 25(OH)D and the risk of all-cause mortality using multivariate Cox regression models, with further subgroup analyses and interactions smooth curve fitting to address possible nonlinearities.

Result

A total of 3220 participants with prior CVD were included in this study, with a total of 930 deaths over a median follow-up of 5.52 years, with multivariable-adjusted serum vitamin D levels after natural log transformation (4.31–4.5 ) as a reference in COX regression, and corrected HRs and 95% CIs of 1.81 (1.31, 2.50), 1.34 (1.07, 1.66), 1.28 (1.05, 1.56),1.00 (reference), 1.10 (0.89, 1.37) for all-cause mortality, respectively. Results remained robust in the stratified analysis of interactions, but a L-shaped relationship was detected. We identified an inflection point of 4.5 after multivariate adjustment through a two-stage linear regression model and recursive algorithm.

Conclusion

Our findings demonstrate that increasing serum 25(OH)D levels may have a L-shaped relationship with risk of all-cause mortality and that increases in serum 25(OH)D levels do not continue to reduce the risk of all-cause mortality.
Factors associated with bleeding events from enoxaparin used for patients with acute coronary syndrome
Authors: Weerasaksanti Adisak , Siwamogsatham Sarawut , Kunlamas Yotsaya , Bunditanukul Krittin
Published: May 2023

Background

Low molecular weight heparins (LMWHs) are the mainstay of treatment for acute coronary syndrome (ACS). However, bleeding, the main side effect, is associated with prolonged hospitalization and mortality. Therefore, assessment of the incidence of bleeding and associated risk factors is crucial in developing an appropriate treatment plan to prevent bleeding.

Methods

A retrospective cohort study was conducted in patients with ACS admitted to a university hospital in Bangkok, Thailand between 2011 and 2015 and received enoxaparin. To estimate the incidence of bleeding events, patients were followed up for 30 days from the first enoxaparin dose. Multiple logistic regression was used to determine factors associated with bleeding events.

Results

From a total of 602 patients, the incidence of bleeding was 15.8%, of which 5.7% involved major bleeding. The risk factors for any form of bleeding were aged at least 65 years (odds ratio [OR], 1.99; 95% confidence interval [CI], 1.18 to 3.36), history of bleeding (OR, 3.79; 95% CI, 1.24 to 11.55), and history of oral anticoagulant exposure (OR, 4.73; 95% CI, 1.74 to 12.86).

Conclusion

ACS patients treated with enoxaparin had an increased risk of bleeding if they were aged 65 years or older, had a history of bleeding events, and had a history of taking oral anticoagulants.
Dementia-related disability in the population aged 90 years and over: differences over time and the role of comorbidity in the vitality 90 + study
Authors: Vargese Saritha Susan , Jylhä Marja , Raitanen Jani , Enroth Linda , Halonen Pauliina , Aaltonen Mari
Published: May 2023

Background

The burden of dementia, multimorbidity, and disability is high in the oldest old. However, the contribution of dementia and comorbidities to functional ability in this age group remains unclear. We examined the combined effects of dementia and comorbidities on ADL and mobility disability and differences between dementia-related disability between 2001, 2010, and 2018.

Methods

Our data came from three repeated cross-sectional surveys in the population aged 90 + in the Finnish Vitality 90 + Study. The associations of dementia with disability and the combined effects of dementia and comorbidity on disability adjusted for age, gender, occupational class, number of chronic conditions, and study year were determined by generalized estimating equations. An interaction term was calculated to assess differences in the effects of dementia on disability over time.

Results

In people with dementia, the odds of ADL disability were almost five-fold compared to people with three other diseases but no dementia. Among those with dementia, comorbidities did not increase ADL disability but did increase mobility disability. Differences in disability between people with and without dementia were greater in 2010 and 2018 than in 2001.

Conclusion

We found a widening gap in disability between people with and without dementia over time as functional ability improved mainly in people without dementia. Dementia was the main driver of disability and among those with dementia, comorbidities were associated with mobility disability but not with ADL disability. These results imply the need for strategies to maintain functioning and for clinical updates, rehabilitative services, care planning, and capacity building among care providers.
Bilateral anterior thalamic symmetrical infarction: a case study
Authors: Wu Tong , Li He , Zhang Qian , Tang Wei , Jia Gehui , Li Lei , Zhang Yong , Wang Jiawei
Published: May 2023

Background

Bilateral anterior thalamic symmetrical infarction is very rarely observed in clinical practice and has rarely been reported in the literature. In this paper we introduce a patient with bilateral anterior thalamic symmetrical infarction and discuss his symptoms, treatment process, and follow-up visit results, as well as the potential pathological mechanisms of the disease.

Case presentation

: A 71-year-old male had a sudden cognitive decline four days prior to medical consultation. The patient’s brain MRI showed symmetrical high signals in the anterior part of both sides of the thalamus. The patient’s head MRV and immunological tests were normal, and we considered that this patient had a rare case of bilateral anterior thalamic infarction. After 10 days of anti-platelet aggregation that lowered blood lipids and improved circulation, the patient’s symptoms significantly abated. Two years later, we found through telephone follow-up that the patient’s symptoms had not relapsed substantially and that he was able to perform self-care, having only continued to suffer a slight decline in short-term memory.

Conclusion

For patients with bilateral prethalamic lesions who have only acute cognitive impairment, if the lesions conform to the blood supply area of both thalamic nodular arteries and DWI shows a high signal, the diagnosis of acute cerebral infarction should be considered, and the standard treatment plan for cerebral infarction should be given as soon as possible.
DKK3 expression is associated with immunosuppression and poor prognosis in glioblastoma, in contrast to lower-grade gliomas
Authors: Han Myung-Hoon , Baek Jeong Min , Min Kyueng-Whan , Cheong Jin Hwan , Ryu Je Il , Won Yu Deok , Kwon Mi Jung , Koh Seong-Ho
Published: May 2023

Purpose

We previously reported that expression of dickkopf-3 (DKK3), which is involved in the Wnt/β-catenin pathway, is significantly associated with prognosis in patients with glioblastoma multiforme (GBM). The aim of this study was to compare the association of DKK3 with other Wnt/β-catenin pathway-related genes and immune responses between lower grade glioma (LGG) and GBM.

Methods

We obtained the clinicopathological data of 515 patients with LGG (World Health Organization [WHO] grade II and III glioma) and 525 patients with GBM from the Cancer Genome Atlas (TCGA) database. We performed Pearson’s correlation analysis to investigate the relationships between Wnt/β-catenin-related gene expression in LGG and GBM. Linear regression analysis was performed to identify the association between DKK3 expression and immune cell fractions in all grade II to IV gliomas.

Results

A total of 1,040 patients with WHO grade II to IV gliomas were included in the study. As the grade of glioma increased, DKK3 showed a tendency to be more strongly positively correlated with the expression of other Wnt/β-catenin pathway-related genes. DKK3 was not associated with immunosuppression in LGG but was associated with downregulation of immune responses in GBM. We hypothesized that the role of DKK3 in the Wnt/β-catenin pathway might be different between LGG and GBM.

Conclusion

According to our findings, DKK3 expression had a weak effect on LGG but a significant effect on immunosuppression and poor prognosis in GBM. Therefore, DKK3 expression seems to play different roles, through the Wnt/β-catenin pathway, between LGG and GBM.
Differential immunophenotype of circulating monocytes from pregnant women in response to viral ligands
Authors: Farias-Jofre Marcelo , Romero Roberto , Xu Yi , Levenson Dustyn , Tao Li , Kanninen Tomi , Galaz Jose , Arenas-Hernandez Marcia , Liu Zhenjie , Miller Derek , Bhatti Gaurav , Seyerle Megan , Tarca Adi L. , Gomez-Lopez Nardhy
Published: May 2023

Background

Viral infections during pregnancy can have deleterious effects on mothers and their offspring. Monocytes participate in the maternal host defense against invading viruses; however, whether pregnancy alters monocyte responses is still under investigation. Herein, we undertook a comprehensive in vitro study of peripheral monocytes to characterize the differences in phenotype and interferon release driven by viral ligands between pregnant and non-pregnant women.

Methods

Peripheral blood was collected from third-trimester pregnant (n = 20) or non-pregnant (n = 20, controls) women. Peripheral blood mononuclear cells were isolated and exposed to R848 (TLR7/TLR8 agonist), Gardiquimod (TLR7 agonist), Poly(I:C) (HMW) VacciGrade™ (TLR3 agonist), Poly(I:C) (HMW) LyoVec™ (RIG-I/MDA-5 agonist), or ODN2216 (TLR9 agonist) for 24 h. Cells and supernatants were collected for monocyte phenotyping and immunoassays to detect specific interferons, respectively.

Results

The proportions of classical (CD14hiCD16−), intermediate (CD14hiCD16+), non-classical (CD14loCD16+), and CD14loCD16− monocytes were differentially affected between pregnant and non-pregnant women in response to TLR3 stimulation. The proportions of pregnancy-derived monocytes expressing adhesion molecules (Basigin and PSGL-1) or the chemokine receptors CCR5 and CCR2 were diminished in response to TLR7/TLR8 stimulation, while the proportions of CCR5− monocytes were increased. Such differences were found to be primarily driven by TLR8 signaling, rather than TLR7. Moreover, the proportions of monocytes expressing the chemokine receptor CXCR1 were increased during pregnancy in response to poly(I:C) stimulation through TLR3, but not RIG-I/MDA-5. By contrast, pregnancy-specific changes in the monocyte response to TLR9 stimulation were not observed. Notably, the soluble interferon response to viral stimulation by mononuclear cells was not diminished in pregnancy.

Conclusions

Our data provide insight into the differential responsiveness of pregnancy-derived monocytes to ssRNA and dsRNA, mainly driven by TLR8 and membrane-bound TLR3, which may help to explain the increased susceptibility of pregnant women to adverse outcomes resulting from viral infection as observed during recent and historic pandemics.
Determinants of male involvement in antenatal care at Palabek Refugee Settlement, Lamwo district, Northern Uganda
Authors: Auma Irene , Nabaweesi Dinah , Orech Sam , Alege John Bosco , Komakech Allan
Published: May 2023

Background

In 2014, Uganda launched the National Male Involvement Strategy in Maternal and Child Health. In 2020, the District Health Management Information System report for Lamwo district, where Palabek Refugee Settlement is located, indicated a 10% male involvement in antenatal care (ANC) at the settlement. We investigated determinants of male involvement in ANC in Palabek Refugee Settlement to inform programs on improvement of male involvement in ANC in a refugee setting.

Methodology

We conducted a community-based cross-sectional analytical study among a proportionate sample of mothers in Palabek Refugee Settlement from October-December 2021. Using a standardized questionnaire, we collected information on demographics and the constructs of the socio-ecological model where consent was given. We summarized data in tables and figures. We used Pearson chi-square test to determine significance of independent variables at bivariate level. A multivariable logistic regression model was run for all variables found significant at bivariate analysis to determine association between the different independent variables and male involvement in ANC.

Results

We interviewed 423 mothers. The mean age of their male partners was 31 years, SD 7. 81% (343/423) of male partners had formal education, with 13% (55/423) having a source of income and 61% (257/423) having access to ANC information during their pregnancy. The level of male involvement in ANC in Palabek Refugee Settlement was 39% (164/423). Male involvement in ANC was positively associated with access to information on ANC (AOR 3.0; 95%Cl: 1.7–5.4) and frequent couple discussion on ANC (AOR 10.1; 95%Cl: 5.6–18.0). However, it was negatively associated with distance ≥ 3 km to the health facility (AOR 0.6 ;95%Cl: 0.4-1.0).

Conclusions

Approximately one in three male partners in Palabek Refugee Settlement were involved in ANC. Male partners who had access to information during ANC and those who had frequent discussions were more likely to get involved in ANC. Men who lived ≥ 3 km from the health facility were less likely to be involved in ANC. We recommend intensified awareness creation on importance of male involvement in ANC and implementation of integrated community outreaches to reduce distance to the health facility.
Model-based assessment of combination therapies – ranking of radiosensitizing agents in oncology
Authors: Baaz Marcus , Cardilin Tim , Lignet Floriane , Zimmermann Astrid , El Bawab Samer , Gabrielsson Johan , Jirstrand Mats
Published: May 2023

Background

To increase the chances of finding efficacious anticancer drugs, improve development times and reduce costs, it is of interest to rank test compounds based on their potential for human use as early as possible in the drug development process. In this paper, we present a method for ranking radiosensitizers using preclinical data.

Methods

We used data from three xenograft mice studies to calibrate a model that accounts for radiation treatment combined with radiosensitizers. A nonlinear mixed effects approach was utilized where between-subject variability and inter-study variability were considered. Using the calibrated model, we ranked three different Ataxia telangiectasia-mutated inhibitors in terms of anticancer activity. The ranking was based on the Tumor Static Exposure (TSE) concept and primarily illustrated through TSE-curves.

Results

The model described data well and the predicted number of eradicated tumors was in good agreement with experimental data. The efficacy of the radiosensitizers was evaluated for the median individual and the 95% population percentile. Simulations predicted that a total dose of 220 Gy (5 radiation sessions a week for 6 weeks) was required for 95% of tumors to be eradicated when radiation was given alone. When radiation was combined with doses that achieved at least 8 $$\mu \mathrm{g}/\mathrm{mL}$$

μ
g
/
mL

of each radiosensitizer in mouse blood, it was predicted that the radiation dose could be decreased to 50, 65, and 100 Gy, respectively, while maintaining 95% eradication.

Conclusions

A simulation-based method for calculating TSE-curves was developed, which provides more accurate predictions of tumor eradication than earlier, analytically derived, TSE-curves. The tool we present can potentially be used for radiosensitizer selection before proceeding to subsequent phases of the drug discovery and development process.
Effects of interdisciplinary pain rehabilitation programs on neuropathic and non-neuropathic chronic pain conditions – a registry-based cohort study from Swedish Quality Registry for Pain Rehabilitation (SQRP)
Authors: Ghafouri Nazdar , Bäckryd Emmanuel , Dragioti Elena , Rivano Fischer Marcelo , Ringqvist Åsa , Gerdle Björn
Published: May 2023

Background and aim

Neuropathic pain arises as a direct consequence of a lesion or disease affecting the somatosensory system. Pharmacological treatments for neuropathic pain often fail despite following guidelines. Interdisciplinary Pain Rehabilitation Programs (IPRP) are an effective intervention for chronic pain conditions. Little research has investigated whether IPRP can benefit patients with chronic neuropathic pain compared to other chronic pain conditions.

This study assesses the real-world effects of IPRP on patients with chronic neuropathic pain compared to non-neuropathic patients using Patient-Reported Outcome Measures (PROMs) available in the Swedish Quality Registry for Pain Rehabilitation (SQRP).

Methods

A neuropathic group of patients (n = 1,654) were identified in two steps. This group was compared to a non-neuropathic group (n = 14,355) composed of common diagnoses (low back pain, fibromyalgia, whiplash associated disorders, and Ehlers-Danlos Syndrome) in relation to background variables, three overall outcome variables, and mandatory outcome variables (pain intensity, psychological distress symptoms, activity/participation aspects and health-related quality of life variables). Of these patients 43–44% participated in IPRP.

Results

At assessment, the neuropathic group reported significantly (with small effect sizes (ES)) more physician visits the previous year, older age, shorter pain durations, and less spatial extent of the pain (moderate ES). Moreover, for the 22 mandatory outcome variables, we found only clinically insignificant differences according to ESs between the groups. For patients participating in IPRP, the neuropathic group displayed equal or in some cases slightly superior results compared to the non-neuropathic group.

Discussion and conclusion

After assessing the real-world effects of IPRP, this large study found that neuropathic pain patients can benefit from the IPRP intervention. Both registry studies and RCTs are needed to better understand which patients with neuropathic pain are most suitable for IPRP and to what extent special considerations need to be made for these patients within the framework of IPRP.
The differences between normal and obese patient handling: re- structural analysis of two questionnaires
Authors: Heidarimoghadam Rashid , Mosaferchi Saeedeh , Ray Pradip Kumar , Saednia Hamid , Najafi Ghobadi Khadijeh , Mortezapour Alireza
Published: May 2023

Background

Precise causes of musculoskeletal complaints among nurses are not known well, but many studies have pointed to manual patient handling tasks. Subjective judgment and decision-making process for patient lifting is crucial for gathering data regards patient handling. The aim of this study was to consider reliability and validity and re-structure of two special tools for patient handling’s tasks.

Methods

In this cross- sectional study 249 nurses were fully participated. As recommended by literature for cultural adaptation of instruments, forward/backward translation method was applied. Reliability of the translated version was assessed by Cronbach’s alpha coefficient. Validity testing for the two scales was based on content validity index/ratio analysis and also Exploratory Factor Analysis was run to extract latent factors.

Results

Reliability estimated by internal consistency reached a Cronbach’s Alpha of above 0.7 for all subscales of two questionnaires. After testing the validity, the final version of questionnaires was remained by 14 and 15 questions respectively.

Conclusions

These instruments evaluated for manual handling of normal and obese patients had acceptable validity and reliability in Iranian Nursing context. So, these tools can be used in further studies with the same cultures.
Diabetes mellitus-related hospital admissions and prescriptions of antidiabetic agents in England and Wales: an ecological study
Authors: AbuHammad Gayda Abdel Rahman , Naser Abdallah Y. , Hassouneh Loay Khaled Mohammad
Published: May 2023

Background

Around 6.5% of the population in the United Kingdom has been diagnosed with diabetes. It is associated with several long-term consequences and higher hospitalization rates.

Aim

To examine the profile of hospital admissions related to diabetes mellitus and the prescription rates of antidiabetic medications in England and Wales.

Method

This is an ecological study that was conducted for the period between April 1999 and April 2020 using publicly available hospitalisation data in England and Wales. Hospital admission data for patients of all ages was extracted from Hospital Episode Statistics in England and the Patient Episode Database for Wales. The difference between admission rates in 1999 and 2020, as well as the difference between diabetes mellitus medication prescription rates in 2004 and 2020, were assessed using the Pearson Chi-squared test. A Poisson regression model with robust variance estimation was used to examine the trend in hospital admissions.

Results

A total of 1,757,892 diabetes mellitus hospital admissions were recorded in England and Wales during the duration of the study. The hospital admission rate for diabetes mellitus increased by 15.2%. This increase was concomitant with an increase in the antidiabetic medication prescribing rate of 105.9% between 2004 and 2020. Males and those in the age group of 15–59 years had a higher rate of hospital admission. The most common causes of admissions were type 1 diabetes mellitus related complications, which accounted for 47.1% of all admissions.

Conclusion

This research gives an in-depth overview of the hospitalization profile in England and Wales during the previous two decades. In England and Wales, people with all types of diabetes and related problems have been hospitalized at a high rate over the past 20 years. Male gender and middle age were significant determinants in influencing admission rates. Diabetes mellitus type 1 complications were the leading cause of hospitalizations. We advocate establishing preventative and educational campaigns to promote the best standards of care for individuals with diabetes in order to lower the risk of diabetes-related complications.
Relationship between mental health and climacteric adjustment in middle aged women: a confirmatory analysis
Authors: Khakkar Maedeh , Kazemi Ashraf
Published: May 2023

Background

Climacteric changes in women are associated with an increased probability of psychological symptoms. Identifying the relationship between adjustment to this period and mental health helps to plan for middle-aged women’s health improvement. Therefore, the present study aimed to investigate the relationship between climacteric adjustment (CA) and mental health in middle aged women.

Method

This cross-sectional study was conducted on 190 women aged 40 to 53 years. Mental health symptoms (including hypochondriasis, anxiety, depression, and social impairment) and CA were assessed using 28-item general health questionnaire and the CA questionnaire, respectively, as a self-report. Data were analyzed using linear and stepwise regression methods, and the fitting of the resulting conceptual model was assessed using AMOS software.

Results

The results showed that hypochondriasis score and social impairment, anxiety level and CA in the perfection dimension, and social impairment score and CA in perfection, decline in beauty, and sexual silence dimensions had an inverse relationship. Moreover, the relationship between anxiety score and CA in the reaction to end of menstruation and the relationship between social impairment and decline of femininity were positive and significant. Factor analysis of the conceptual model obtained from the study results demonstrated a good model fit (CMIN /DF = 0.807, P = .671).

Conclusion

The results showed a relationship between CA and psychological symptoms in middle-aged women. In other words, the level of hypochondriasis, anxiety, and social impairment symptoms decreased with increasing CA in sexual silence, perfection, and decline in beauty.