bluuebunny/crossref_metadata_2025 huggingface dataset:
Probiotic bacteria alleviate chlorpyrifos‐induced rat testicular and renal toxicity: A possible mechanism based on antioxidant and anti‐inflammatory activity
Authors: Nejati Roghayeh , Nematollahi Amene , Doraghi Hashmieh Kabi , Sayadi Mehran , Alipanah Hiva
Published: September 2023

Chlorpyrifos (CPF) has caused many potential toxicities in nontarget organisms. Fewer studies have been conducted on the effects of lactic acid bacteria (LAB) in mitigating tissue damage induced by CPF in vivo. Therefore, we investigated CPF renal and testicular toxicity and the alleviating effect of probiotic lactobacilli, based on antioxidant and anti‐inflammatory activity, on induced toxicity in an animal model. Biochemical assays showed that CPF induced oxidative stress along with a change in superoxide dismutase (SOD) and catalase (CAT) activity in a tissue‐dependent manner. After treatment with CPF, testicular and renal levels of TNF‐α were significantly reduced and enhanced, respectively, compared to the control group. The probiotic treatment restored renal and testicular TNF‐α levels and modulated and blocked the increasing effect of CPF on renal IL‐1β levels. Testicular IL‐1β levels in the probiotic‐treated and CPF groups demonstrated similar values. Exposure to CPF significantly induced renal histopathological damage that, of course, was completely inhibited by treatment withLactobacillus caseiand the LAB mixture. In summary, CPF showed significant toxicological effects on oxidative stress and the inflammation rate in CPF‐exposed rats. Therefore, supplementation with probiotic bacteria may alleviate CPF renal toxicity and mitigate its oxidative stress and inflammation effects.
Cerebral microbleeds in the poisoned patient: An observational magnetic resonance imaging study
Authors: Naïm Giulia , Malissin Isabelle , Mégarbane Bruno
Published: September 2023

Critical illness‐associated cerebral microbleeds of poorly understood pathophysiology have been observed on magnetic resonance imaging (MRI) in severely hypoxaemic patients similarly to high‐altitude cerebral oedema patients. The prevalence and circumstances of occurrence of such cerebral microbleeds in the severely poisoned patients are unknown. We retrospectively reviewed all cerebral MRIs performed in the poisoned patients with atypical neurological presentation or outcome admitted to our intensive care unit in 2014–2021. Three out of 64 patients (4.7%) investigated with cerebral MRI among the 2986 severely poisoned patients presented cerebral microbleeds. Microbleeds were localized in the white cerebral matter mainly in the corpus callosum. Ingested toxicants included dichlorvos, methadone and tramadol. Patients were found comatose with possibly prolonged severe hypoxaemia requiring prompt tracheal intubation and mechanical ventilation. They presented delayed arousal and dysexecutive syndrome leading to sequelae. Microbleeds on MRI can occur in the critically ill poisoned patients and seems to be a multifactorial phenomenon. A direct relationship with the toxicant seems improbable. Physicians should be aware of such a non‐specific complication accounting for sequelae.
Invasive fungal infection following venetoclax and posaconazole co‐administration
Authors: Reynolds Gemma , Urbancic Karen F. , Fong Chun Y. , Trubiano Jason A.
Published: September 2023

The co‐administration of venetoclax, a BCL‐2 inhibitor, with a mould‐active azole, such a posaconazole, has potential to both prevent invasive fungal infection (IFI) and reduce the required treatment dose, and cost, of venetoclax. Posaconazole drug‐level monitoring is critical to ensuring adequate mould prophylaxis. A retrospective audit of 99 patients at a tertiary cancer centre, with myeloid malignancies co‐prescribed venetoclax and posaconazole between January 2018 and April 2022, was undertaken to evaluate the adequacy of posaconazole prescribing and the rate of breakthrough IFI. Seventy‐six patients (77%) had at least one posaconazole level measured in the study period, with 37% requiring a dose adjustment based on steady‐state trough levels. Breakthrough IFI occurred in 4% of patients, typically within 1 month of commencing anti‐mould prophylaxis. Close monitoring of posaconazole levels in venetoclax‐treated patients, particularly in the early, outpatient setting, is critical.
The transformational potential of the traumatic experience of parents of children with cerebral palsy
Authors: Vasyutin Ruslan
Published: September 2023

This commentary is on the original article by Smyth et al. on pages 258–266 of this issue.
Changing queenships in tenth‐century England: rhetoric and (self‐)representation in the case of Eadgifu of Kent at Cooling
Authors: Tickle Jonathan
Published: September 2023

The charter now known as Sawyer 1211 contains a detailed account of an intergenerational property dispute between Queen Eadgifu and her rival Goda, concerning the possession of two Kentish estates. Typically, the charter has either been understood as evidence of dispute settlement or to establish facts about Eadgifu that are otherwise unattested. This article argues that Sawyer 1211 has further value when approached as a narrative which drew upon Eadgifu’s memories and oral testimony. Read in this way, it reveals a (self‐)representation of her legal agency that has important implications for the understanding of early English queenship.
Classification, selfhood, and culture in the Diagnostic and Statistical Manual of Mental Disorders and the Psychodynamic Diagnostic Manual
Authors: Aggarwal Neil Krishan
Published: September 2023

For decades, social scientists have critiqued the construction of knowledge in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM). However, they have not conducted research with an alternate classification from psychoanalytic and psychodynamic practitioners known as the Psychodynamic Diagnostic Manual (PDM), which is beginning to disseminate globally. This article analyzes cultural assumptions underpinning the classification rationale, concept of the self, and relationship between culture and mental disorders through close readings of DSM‐5‐TR (2022) and PDM‐2 (2017). It shows that DSM‐5‐TR's notion of scientific evidence is informed by an emphasis on biological research in psychiatry, which PDM‐2 views as mostly irrelevant to clinical work. Instead, PDM‐2 claims to speak authoritatively for the inner experiences of patients and clinicians in the therapeutic relationship. Both classifications share a concept of an ideal self that is individualistic, consistent across time, able to narrate rather than just feel emotions, and in control of cognition, emotion, and relationships. Whereas DSM‐5‐TR views the culture concept as a lens to interpret the patient–clinician encounter, PDM‐2 uses the culture concept inconsistently. I situate these findings within extant anthropological research and propose new directions to examine how both classifications are used in local contexts.
Himalayan birds that show the greatest elevational shifts remain within the narrowest thermal regimes
Authors: Menon Tarun , Ramesh Vijay , Barve Sahas
Published: September 2023

Aim

Elevational migration is a globally ubiquitous animal behaviour. Understanding the mechanisms that drive variation in elevational movement can help explain the evolution of this widespread animal behaviour and its role in shaping montane life history. We examine the role of thermal regime (the intra‐annual variation in temperature experienced by a species), dispersal ability and diet in explaining the extent of elevational movements.

Location

Eastern and Western Himalayas.

Time Period

2011–2022.

Major Taxa Studied

Birds.

Methods

We used community science data from eBird to acquire checklist‐based observations of birds and used comprehensive data cleaning procedures and randomization tests to produce estimates of seasonal elevational shifts for 302 species of Himalayan birds. Using these data, we ran phylogenetic least squares regressions (PGLS) to test if the extent of elevational shift is driven by thermal regime, dispersal ability and diet.

Results

Most Himalayan birds (up to 65%) showed downslope shifts in the winter, although some (5%‐10%) low elevation species shifted upslope. Elevational shift was negatively associated with a species' thermal regime. Species that showed the greatest elevational shifts in both eastern and western Himalayas moved within the narrowest intra‐annual temperature regimes, but did not match their breeding range temperatures as closely as possible. Diet influenced elevational shift in both eastern and western Himalayas, while dispersal ability did not drive elevational shifts.

Main Conclusions

Species that show the biggest elevational shifts track thermal regimes most closely. However, in addition to tracking thermal regimes, diet and potentially habitat availability/preferences may drive seasonal elevational shifts. Our results show convergent evolution of elevational shifts across clades. Low elevation habitats are important not only for conserving low elevation birds but also for conserving wintering sites of most high elevation breeders.
SARS‐CoV‐2 vaccine immunogenicity for people living with HIV: A systematic review and meta‐analysis
Authors: Søndergaard Mads Herluf , Thavarajah Jannifer Jasmin , Churchill Henson Henry , Wejse Christian Morberg
Published: September 2023

Background

Previous publications on the immunogenicity of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccines in people living with HIV (PLWH) have reported inconsistent results. Additionally, a meta‐analysis investigating the immunogenicity in PLWH after the third SARS‐CoV‐2 vaccine dose is lacking. In this article we aim to provide a systematic review and a meta‐analysis studying the immunogenicity of SARS‐CoV‐2 vaccines in PLWH and to identify potential drivers for antibody response in PLWH.

Methods

We used three databases (PubMed, Embase and Web of Science) to conduct our review. Studies with information on numbers of PLWH producing immunoglobulin G (IgG) antibodies or neutralizing antibodies were included.

Results

The meta‐analysis included 59 studies and illustrated a pooled serological response of 87.09% in the 10 343 PLWH after they received a SARS‐CoV‐2 vaccine. High CD4 T‐cell counts and low viral load indicated that the study populations had HIV that was well treated, despite varying in location. The pooled effect increased to 91.62% for 8053 PLWH when excluding studies that used inactivated vaccines (BBIBP‐CorV and CoronaVac). For the third vaccine dose, the pooled effect was 92.35% for 1974 PLWH. Additionally, weighted linear regression models demonstrated weak relationships between CD4 T‐cell count, percentages of people with undetectable HIV load, and age compared with the percentages of PLWH producing a serological response. However, more research is needed to determine the effect of those factors on SARS‐CoV‐2 vaccine immunogenicity in PLWH.

Conclusion

SARS‐CoV‐2 vaccines show a favourable effect on immunogenicity in PLWH. However, the results are not ideal. This meta‐analysis suggests that a third SARS‐CoV‐2 vaccine dose and good HIV treatment procedures are vital to induce a good immunogenicity in PLWH.
Trajectory of suicide as a transformation in obscurity—As told by the deceased's next of kin
Authors: Ovox Säidi Margot , Wärdig Rikard , Hultsjö Sally , Rytterström Patrik
Published: September 2023

There is a collective call from the field of suicide research for studies on the individual dynamics of suicidality in order to understand the deadliness of the suicidal process. This study examines the deceased next of kin's (‘survivor's) experience of the suicidal process in order to gain perspectives that can be used in the preventive care of suicidal patients. The aim of this study was to explore the suicide process through the suicide survivor's experience. The study is designed and conducted through a phenomenological, reflective lifeworld approach. Twelve in‐depth interviews concerning lived experiences of a suicide were conducted. The suicide process is described as the emerging of an obscured transformation of self, and an aligning to this changing understanding of self that forms a unique suicidal death course. This death course contains the co‐occurrence of life and death orientations. Survivors' collected knowledge of a suicidal trajectory helps us understand the life conditions of a suicidal person that has ended their life. Life orientation and experiences of self‐governance are critical parts of a suicidal trajectory and can have great preventive potential for care and assessments during suicidality. The Consolidated Criteria for Reporting Qualitative Research (COREQ) were used for the reporting structure of this article.
Adolescents' satisfaction with abortion services received and factors associated with satisfaction at reproductive health centres
Authors: Amoah Elizah , Enos Juliana Yartey , Ganle John , Maya Ernest Tei
Published: September 2023

Aim

This study assessed adolescents' satisfaction with services received during their most recent abortion and the factors associated with satisfaction at reproductive health centres in the Greater Accra region of Ghana.

Design

A facility‐based cross‐sectional survey was used for this study.

Methods

Overall, 254 adolescent girls aged between 15 and 19 years, who had an abortion within 1 week of the study period were recruited for the study. All the 254 respondents were recruited consecutively as they visited health facilities for abortion services from March 2019 to February 2020. Written informed consent was signed by respondents, and data were collected using the Patient Satisfaction with Nursing Care Quality Questionnaire, and the data were analysed using Stata version 15.0. Univariate, bivariate and multivariate logistic regression analyses were conducted.

Results

A majority of adolescents reported being satisfied with the abortion services they received. Ample waiting space and the system of ‘first‐come‐first‐served’ were the highest rated elements of service satisfaction. Adolescents were least satisfied with the inadequacy of instructions and lack of information on medications received and their therapeutic or side effects. Ethnicity, having a stable intimate partner and perceived adequacy of staff were the factors associated with satisfaction with abortion services.

Conclusion

Adolescents are unique group of people with peculiar health needs. If they are treated with respect and dignity, they are likely to be satisfied with services received from the reproductive health centres offering comprehensive abortion care.

Impact

The study addresses adolescent satisfaction with abortion care received; if health providers treat adolescent seeking abortion care with respect, friendly and non‐judgemental attitude, it will enable adolescents to seek abortion care from qualified professionals instead of unskilled service providers to reduce maternal mortality.

Patient's contribution

Patients from 11 reproductive centres responded to the questionnaire used for the data collection.
Hyperbaric oxygen therapy suppresses hypoxia and reoxygenation injury to retinal pigment epithelial cells through activating peroxisome proliferator activator receptor‐alpha signalling
Authors: Sun Tzong‐Bor , Huang Kuo‐Feng , Niu Ko‐Chi , Lin Cheng‐Hsien , Liu Wen‐Pin , Yeh Chao‐Hung , Kuo Shu‐Chun , Chang Ching‐Ping
Published: September 2023

Retinal ischemia followed by reperfusion (IR) is a common cause of many ocular disorders, such as age‐related macular degeneration (AMD), which leads to blindness in the elderly population, and proper therapies remain unavailable. Retinal pigment epithelial (RPE) cell death is a hallmark of AMD. Hyperbaric oxygen (HBO) therapy can improve IR tissue survival by inducing ischemic preconditioning responses. We conducted an in vitro study to examine the effects of HBO preconditioning on oxygen–glucose deprivation (OGD)‐induced IR‐injured RPE cells. RPE cells were treated with HBO (100% O2 at 3 atmospheres absolute for 90 min) once a day for three consecutive days before retinal IR onset. Compared with normal cells, the IR‐injured RPE cells had lower cell viability, lower peroxisome proliferator activator receptor‐alpha (PPAR‐α) expression, more severe oxidation status, higher blood‐retinal barrier disruption and more elevated apoptosis and autophagy rates. HBO preconditioning increased PPAR‐α expression, improved cell viability, decreased oxidative stress, blood‐retinal barrier disruption and cellular apoptosis and autophagy. A specific PPAR‐α antagonist, GW6471, antagonized all the protective effects of HBO preconditioning in IR‐injured RPE cells. Combining these observations, HBO therapy can reverse OGD‐induced RPE cell injury by activating PPAR‐α signalling.
Effect of exercise after a deep venous thrombosis: A systematic review
Authors: Rook B. , van Rijn M. J. E. , Jansma E. P. , van Montfrans C.
Published: September 2023

Post‐thrombotic syndrome (PTS) is a common complication after deep vein thrombosis (DVT) and has a major impact on physical symptoms, quality of life (QoL) and economic costs. Relatively simple lifestyle interventions as physical exercise might reduce PTS severity and increase QoL. To evaluate the direct and long‐term effects of physical activity in patients with an acute or previous DVT. We conducted a systematic review through an additional search from 2007 up to March 2022, to complement the comprehensive systematic review of Kahn et al. Articles evaluating the effect of exercise after a DVT including symptoms, QoL and the incidence and severity of PTS, were included. Quality of the studies was assessed using a GRADE‐like checklist and results were reported according to the PRISMA Statement. Ten studies were included, seven randomized controlled trials and three cohort studies. We identified three types of physical activity based on timing and duration; (1) early mobilisation in the acute phase of the DVT; (2) short duration exercise 1 year after DVT and (3) prolonged exercise during follow‐up after a previous DVT. Early mobilisation showed improvement in QoL and pain reduction and after 2 years it resulted in a significant reduction of PTS severity. Prolonged supervised exercise resulted in improvement of QoL. In addition, positive effects on symptoms of venous insufficiency and muscle functions were observed. None of the included studies reported an increased risk of PTS or worsening of symptoms due to physical activity. Physical exercise after a DVT is safe, improves QoL, reduces pain and decreases PTS severity. Lifestyle intervention such as guided individualized training programs can be a useful supplementary therapy for patients after a DVT or for PTS patients. Optimal training programs may be identified by further studies that improve patient‐oriented outcomes for both adults and children after a DVT.
Comparison of specificity and sensitivity of diagnostic methods for Enteromyxum leei and Enteromyxum fugu detected from cultured tiger puffer, Takifugu rubripes in Korea
Authors: Lee Young Juhn , Jun Lyu Jin , Kim Ye Ji , Han Ji Eun , Ko Ye Jin , Oh Yeong Eun , Lee Eung Joon , Lee Jehee , Jeong Joon Bum
Published: September 2023

Enteromyxum leei and Enteromyxum fugu, which are myxosporean parasites, were first found in cultured tiger puffer Takifugu rubripes in Korea. We collected four tiger puffers that showed severe emaciation signs for our experiments. DNA sequencing was confirmed that the tiger puffers were coinfected with E. leei and E. fugu. Furthermore, similar amounts of E. leei and E. fugu were confirmed using real‐time PCR in the intestine. To the best of our knowledge, there have been no reports of E. fugu infection in the olive flounder Paralichthys olivaceus. However, the diagnosis of inflowing water, discharged water and olive flounder samples using highly sensitive diagnostic methods confirmed the presence of E. fugu in water and fish samples from olive flounder farms near the tiger puffer farm. Therefore, the present study aimed to develop highly sensitive diagnostic methods such as real‐time and two‐step PCR for early diagnosis and follow‐up of the emaciation disease and multiplex PCR for rapid diagnosis. The multiplex PCR method exhibited the same sensitivity as the one‐step PCR method developed in this study, demonstrating its efficacy for rapid diagnosis. Therefore, the suggested methods can be utilized for the early diagnosis and rapid diagnosis of emaciation diseases and reduction of economic losses through rapid disease control.
The interplay of metabolic dysfunction‐associated fatty liver disease and viral hepatitis on liver disease severity: A large community‐based study in a viral endemic area
Authors: Huang Chung‐Feng , Liang Po‐Cheng , Tsai Pei‐Chien , Wei Yu‐Ju , Huang Ching‐I , Wang Chih‐Wen , Jang Tyng‐Yuan , Yeh Ming‐Lun , Hsu Po‐Yao , Hsieh Ming‐Yen , Lin Yi‐Hung , Dai Chia‐Yen , Chuang Wan‐Long , Huang Jee‐Fu , Yu Ming‐Lung
Published: September 2023

Background and Aim

The prevalence of metabolic dysfunction‐associated fatty liver disease (MAFLD) and its interplay with hepatitis B virus (HBV) and hepatitis C virus (HCV) in terms of liver disease severity is elusive.

Methods

A mass surveillance program was conducted in a viral hepatitis endemic area. The objective was to identify MAFLD/non‐MAFLD subjects with advanced liver disease.

Results

Two thousand two hundred and forty‐two (41.7%) of the 5378 subjects were identified as having MAFLD, and 375 (7.0%) had advanced liver disease. The proportions of anti‐HCV and HBsAg seropositivity were 19.3% and 9.7%, respectively. The proportions of advanced fibrosis in subjects with non‐viral hepatitis (NBNC), HBV and HCV infection were 2.8%, 5.7% and 23.4%, respectively. Subjects with MAFLD had a significantly higher proportion of advanced fibrosis (8.7% vs 5.7%, P < 0.001). Factors associated with advanced fibrosis included age (odds ratio [OR]/95% confidence interval [CI]: 4.8/3.7–6.0, P < 0.001), male sex (OR/CI: 1.3/1.0–1.7, P = 0.019), anti‐HCV seropositivity (OR/CI: 5.9/4.6–7.5, P = 0.019), MAFLD‐lean metabolic dysregulation (MS) (OR/CI: 2.6/1.3–5.2, P = 0.005; compared with the non‐MAFLD group) and MAFLD‐diabetes (OR/CI: 1.5/1.1–2.1, P = 0.008; compared with the non‐MAFLD group). MAFLD did not aggravate liver disease severity in patients with viral hepatitis. However, among NBNC subjects, factors associated with advanced liver disease included MAFLD‐lean MS group (OR/CI: 9.1/2.4–34.6, P = 0.001; compared with non‐MAFLD group) and MAFLD‐DM group (OR/CI: 2.0/1.2–3.2, P = 0.004; compared with non‐MAFLD group).

Conclusions

MAFLD patients with diabetes and metabolic dysregulation had a higher risk of advanced liver disease. The effect was more significant in non‐viral hepatitis subjects in a community level.
Career development in pragmatic clinical trials to improve care for people living with dementia
Authors: Gabbard Jennifer , Sadarangani Tina R. , Datta Rupak , Fabius Chanee D. , Gettel Cameron J. , Douglas Natalie F. , Juckett Lisa A. , Kiselica Andrew M. , Murali Komal Patel , McCarthy Ellen P. , Torke Alexia M. , Callahan Christopher M.
Published: September 2023

The growing number of people living with dementia (PLWD) requires a coordinated clinical response to deliver pragmatic, evidence‐based interventions in frontline care settings. However, infrastructure to support such a response is lacking. Moreover, there are too few researchers conducting rigorous embedded pragmatic clinical trials (ePCTs) to make the vision of high quality, widely accessible dementia care a reality. National Institute on Aging (NIA) Imbedded Pragmatic Alzheimer's disease and Related Dementias Clinical Trials (IMPACT) Collaboratory seeks to improve the pipeline of early career researchers qualified to lead ePCTs by funding career development awards. Even with support from the Collaboratory, awardees face practical and methodological challenges to success, recently exacerbated by the COVID‐19 pandemic. We first describe the training opportunities and support network for the IMPACT CDA recipients. This report then describes the unique career development challenges faced by early‐career researchers involved in ePCTs for dementia care. Topics addressed include challenges in establishing a laboratory, academic promotion, mentoring and professional development, and work‐life balance. Concrete suggestions to address these challenges are offered for early‐career investigators, their mentors, and their supporting institutions. While some of these challenges are faced by researchers in other fields, this report seeks to provide a roadmap for expanding the work of the IMPACT Collaboratory and initiating future efforts to recruit, train, and retain talented early‐career researchers involved in ePCTs for dementia care.
Effectiveness of the Kaufman Brief Intelligence Test in people with Prader–Willi syndrome
Authors: Jaime M. P. , Gerk A. , Stegmann J.
Published: September 2023

Background

Evaluating intelligence using conventional tools is very complex in patients with Prader–Willi Syndrome (PWS), as it is time consuming and requires levels of care that are difficult to sustain for this population. Therefore, we explore the ability of a brief test to assess intelligence in these patients.

Methods

This study included individuals with a genetically confirmed diagnosis of PWS, with regular attendance at transdisciplinary treatment in an institution dedicated to the care of rare diseases in Argentina. The Wechsler Intelligence Scale for Children (WISC‐IV), the Wechsler Adult Intelligence Scale (WAIS‐III) and the Kaufman Brief Intelligence Test (K‐BIT) were used.

Results

Correlation was obtained between the scales in paediatric and adult populations. Within the paediatric population, no significant differences were identified between the WISC‐IV scale (Wechsler for paediatrics) and the K‐BIT (56.4 ± 8.6, vs. 53.4 ± 10.1, P = 0.28), with a good agreement between the methods {intraclass correlation 0.79 [95% confidence interval (CI) 0.15–0.95]}. Regarding the adult population, the discrimination of the WAIS‐III scale (Wechsler for adults) and the K‐BIT of adults (16 years and over) presented an acceptable concordance [0.77 (95% CI −0.09; 0.93)], although also underestimating the results (58.3 ± 7.2 vs. 51.1 ± 11.2, P < 0.0001).

Conclusions

We observed the feasibility and potential usefulness of a brief intelligence test (K‐BIT) in patients with PWS with an acceptable agreement with conventional tools.
Investigation of cardiopulmonary parameters, motor development and muscle strength in children with Down syndrome with and without congenital heart disease
Authors: Siyah T. , Saglam M. , Yagli N. V. , Ertugrul I. , Aykan H. H. , Karagoz T.
Published: September 2023

Background

Children with Down syndrome (DS) frequently have concomitant clinical problems. There are no studies in the literature evaluating gross motor development and handgrip strength in the presence of congenital heart disease (CHD), which is one of the most common comorbidities in population with DS. The aim of this study was to compare cardiopulmonary parameters, gross motor development and handgrip strength in children with DS with and without CHD.

Methods

A total of 28 children with DS (14 with CHD and 14 without CHD) were evaluated. Demographic data and cardiopulmonary parameters were recorded. Gross motor development and handgrip strength were assessed.

Results

Children with DS and CHD had lower GMFM‐88 scores and right handgrip strength and higher Wang respiratory score than children with DS and no CHD (P < 0.05). GMFM‐88 scores were moderately correlated with resting oxygen saturation (r = 0.46, P = 0.01) and right handgrip strength (r = 0.67, P < 0.001).

Conclusions

Peripheral muscle strength and oxygen saturation may be factors affecting gross motor development in children with DS. From this point of view, evaluating cardiopulmonary parameters, motor development and handgrip strength in children with DS and CHD is important to identify risks, provide early intervention and support development.
The influence of dietary diversity on anthropometric status among young children ages 12 and 24 months in Wuhan, China
Authors: Xu Qianqian , Zhong Chunrong , Tan Tianqi , Lin Lixia , Yang Hongying , Xu Zhiyong , Yang Nianhong
Published: September 2023

The relative research on investigating the association between dietary diversity scores and anthropometric status among young children is few and inconsistent. Since understanding this association is quite essential to give more detailed advice about diet to ensure young children's healthy growth, we sought to determine the association between dietary diversity levels and anthropometric status among young children under 24 months. The study included 1408 mother−child pairs from the Tongji Maternal and Child Health Cohort, whose children range in age from 12 to 24 months. Multivariable logistic regressions were used to examine the effect of dietary diversity on children's anthropometric failure and obesity. All obese children aged 12 and 24 months had low‐medium diverse diets in their first year of life. Risks of anthropometric failure for 12‐month young children consumed low‐medium diverse diets in their first year and 24‐month young children consumed low‐medium diverse diets in their second year are, respectively, 1.27 (odds ratio [OR], 95% confidence interval [CI] = [1.06−1.53]) and 1.19 (OR, 95% CI = [1.02−1.40]) times of those who consumed high diverse diets in corresponding year. The risk of anthropometric failure for 24‐month‐old children who consumed low‐medium diverse diets during their first year of life is 4.70 (OR, 95% CI = [1.62−19.91]) times that of young children who consumed highly diverse diets during their first year of life. Introducing more diverse diets to young children under 24 months of age may be an effective strategy to prevent anthropometric failure and obesity in young children in later life.
Evidence on the prevalence of emerging and re‐emerging tick‐ and flea‐borne rickettsial agents in acute encephalitis syndrome endemic areas of northeast Uttar Pradesh, India
Authors: Candasamy Sadanandane , Ayyanar Elango , Devaraju Panneer , Kumar Ashwani , Zaman Kamran , Bhaskar Mishra Bhuwan , Srinivasan Lakshmy , Purushothaman Jambulingam
Published: September 2023

Outbreaks of acute encephalitis syndrome (AES) with unknown aetiology are reported every year in Gorakhpur district, Uttar Pradesh, India, and Orientia tsutsugamushi, the rickettsial pathogen, responsible for scrub typhus has been attributed as the primary cause of AES problem. However, information on the prevalence of other rickettsial infections is lacking. Hence, this study was carried out to assess any occurrence of tick‐ and flea‐borne rickettsial agents in villages reporting AES cases in this district. In total, 825 peridomestic small mammals were trapped, by setting 9254 Sherman traps in four villages with a trap success rate of 8.9%. The Asian house shrew, Suncus murinus, constituted the predominant animal species (56.2%) and contributed to the maximum number (87.37%) of ectoparasites. In total, 1552 ectoparasites comprising two species of ticks and one species each of flea and louse were retrieved from the trapped rodents/shrews. Rhipicephalus sanguineus, the brown dog tick, was the predominant species retrieved from the trapped rodents/shrews, and the overall infestation rate was 1.75 per animal. In total, 4428 ectoparasites comprising five tick species, three louse species and one flea species were collected from 1798 domestic animals screened. Rhipicephalus microplus was the predominant tick species collected from the domestic animals. The cat flea, Ctenocephalides felis, constituted 1.5% of the total ectoparasites. Of all the ectoparasite samples (5980) from domestic animals and rodents, tested as 1211 pools through real‐time PCR assays, 64 pools were positive for 23S rRNA gene of rickettsial agents. The PCR‐positive samples were subjected to multi‐locus sequence typing (MLST). In BLAST and phylogenetic analysis, the ectoparasites were found to harbour Rickettsia asembonensis (n = 9), Rickettsia conorii (n = 3), Rickettsia massiliae (n = 29) and Candidatus Rickettsia senegalensis (n = 1). A total of 22 pools were detected to have multiple rickettsial agents. The prevalence of fleas and high abundance of tick vectors with natural infections of rickettsial agents indicates the risk of transmission of tick‐ and flea‐borne rickettsial diseases in rural villages of Gorakhpur. Further epidemiological studies are required to confirm the transmission of these agents to humans.
Myelin oligodendrocyte glycoprotein antibody‐associated disease presenting with dystonia
Authors: Zveik Omri , Benoliel Berman Tal , Keadan Tarek , Barhum Khalil , Rechtman Ariel , Vaknin‐Dembinsky Adi
Published: September 2023

Myelin oligodendrocyte glycoprotein antibody‐associated disease (MOGAD) commonly presents as optic neuritis or transverse myelitis. We report an atypical clinical presentation for MOGAD in a 28‐year‐old female experiencing right‐arm dystonic episodes. MRI scans demonstrated multifocal periventricular and subcortical lesions, including in the left centrum semiovale and corona radiata. Despite the atypical presentation, her clinical, serological, and radiographic features favor a MOGAD diagnosis. This report emphasizes the heterogeneity of MOGAD phenotypes and the need to consider MOGAD, even in a non‐typical presentation.
Thromboembolic complications after COVID‐19 in kidney transplant recipients
Authors: Artan Ayse Serra , Dirim Ahmet Burak , Yavuzkilic Halil , Demir Erol , Oto Ozgur Akin , Guller Nurana , Safak Seda , Yazici Halil , Turkmen Aydin
Published: September 2023

Aim

Increased venous thrombosis and arterial embolism rates are observed in the general population during or after COVID‐19. Data regarding the kidney transplant population are scarce. In this study, we aim to investigate the thrombotic complications and risk factors associated with thrombotic complications in kidney transplant patients.

Methods

This retrospective observational study included adult kidney transplant recipients diagnosed with COVID‐19 between March 2020 and June 2022. The endpoint was the occurrence of thromboembolic events.

Results

Four hundred and sixty‐nine patients were followed for a median of 10.8 months after COVID‐19. Forty patients (8.5%) died. Thromboembolic complications developed in 51 (11.9%) of the surviving patients. Twenty‐four patients with thromboembolic events were receiving prophylactic anticoagulation before the event. The patients with mild, moderate, and severe COVID‐19 were 292, 129, and 48, respectively. Patients with moderate COVID‐19 had a significantly higher percentage of thromboembolic complications than patients with mild COVID‐19. Older age, prior heart disease, and moderate COVID‐19 were significantly associated with thromboembolic events. The incidence of thromboembolic events after COVID‐19 is 10.9 per 100 patient‐year.

Conclusion

Thromboembolic complications were observed at increased rates in kidney transplant recipients after COVID‐19. Therefore, prospective and cohort studies for post‐COVID‐19 complications regarding the treatment modalities are urgently needed.

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Improved diagnosis of reflux hypersensitivity
Authors: Voulgaris Theodoros , Hoshino Shintaro , Sifrim Daniel , Yazaki Etsuro
Published: September 2023

Background

Reflux hypersensitivity (RH) is characterized by normal esophageal exposure to acid and positive correlation of symptoms to reflux episodes. Positivity of Symptomatic Index (SI) and/or Symptom Association Probability (SAP) is used diagnostically, though experts support that concordance of both is needed. We evaluated differences among patients with RH and concordance of SI/SAP or not.

Methods

Patients with typical reflux symptoms without previous GERD diagnosis, submitted simultaneously to Ph‐Impedance off PPI and high resolution manometry were included. Self‐response to PPI was evaluated. Patients showing SI and/or SAP positivity were considered having RH and further classified to definite RH if both SI/SAP were positive or indefinite if only one positive.

Key Results

Totally 2659 patients (M/F: 35.6%/64.7%, mean age: 45 ± 14) were included. Final diagnosis was; FH: 21.8%, RH: 29.3% (definite: 14.3%/indefinite: 15%), GERD: 36% and inconclusive GERD: 12.9%. Patients with definite RH showed increased total reflux time, total number of reflux episodes and length of hiatus hernia, and also numerically but not statistically significant increased rates of PPI responsiveness versus indefinite RH and decreased mean nocturnal baseline impedance. Moreover, they showed significantly increased rate of PPI response versus patients with functional heartburn (FH).

Conclusion & Inferences

Some PPI responsiveness is frequent among patients with RH as also with FH, and cannot discriminate those entities clinically when diagnosing RH using SI and/or SAP positive criterion. Patients with RH and SI/SAP concordance differ from patients without. Implementation of a strict RH definition (both SI and SAP positive) can better distinguish RH from FH and should be used in the future.
Is it true that all human beings have dignity?
Authors: Ferdynus Marcin Paweł
Published: September 2023

The discussion around dignity in nursing philosophy has been underway for many years. The literature still lacks philosophical arguments that would justify the thesis that all people have dignity. Scholars who defend dignity as an intrinsic value most often refer to Kant. However, Kant does not seem to be the most suitable candidate to defend the thesis that all human beings possess dignity. In this paper, I attempt to show that Aristotle's and Aquinas's views can help justify this thesis. To this end, I distinguish between actual dignity, potential dignity, and existential dignity. I state that all human beings have existential dignity or potential dignity.
Randomised controlled trial of Jiandu granule in preventing chemoradiotherapy‐induced oral mucositis
Authors: Li Huakang , Ke Jianlong , Wang Xiaoyan , Xu Bo , Li Qiang , Wu Ziliang , Wang Yue , Lin Bing
Published: September 2023

Objective

This clinical trial aimed to evaluate the efficacy and safety of Jiandu granule, a Chinese herbal medicine formula, for preventing oral mucositis in patients with nasopharyngeal carcinoma undergoing concurrent chemoradiotherapy.

Materials and Methods

A single‐centre, open‐label, randomised controlled trial was conducted, enrolling 138 patients with locally advanced nasopharyngeal carcinoma. Patients were randomly allocated to either the experimental group (n = 69) or the control group (n = 69). Both groups received concurrent chemoradiotherapy and standard care for oral mucositis, with the experimental group additionally receiving Jiandu granule intervention. The primary outcome was the incidence of severe oral mucositis (grade III to IV).

Results

In the full‐analysis set, severe oral mucositis occurred in 14 of 69 (20.3%) patients in the experimental group and 31 of 69 (44.9%) patients in the control group (absolute risk reduction: 24.6%; relative risk reduction: 54.8%; p = 0.002; number needed to treat: 4). Jiandu granule was associated with mild/moderate gastrointestinal reactions, with an overall incidence of 5.9%.

Conclusion

Jiandu granule reduced the incidence of severe oral mucositis in nasopharyngeal carcinoma patients during concurrent chemoradiotherapy and had an acceptable safety profile.
Continued challenges in pediatric anesthesia during COVID‐19 in 2022: An international survey from the pediatric anesthesia COVID‐19 collaborative
Authors: Zhong John , Bradford Victoria , Fernandez Allison M. , Infosino Andrew , Soneru Codruta N. , Staffa Steven J. , Raman Vidya T. , Cravero Joseph , Zurakowski David , Meier Petra M. ,   The Pediatric Anesthesia COVID‐19 Collaborative
Published: September 2023

Introduction

This international survey explored the ongoing impact of COVID‐19 on pediatric anesthesiology. It assessed COVID‐19's impact on the practice of pediatric anesthesiology, staffing, job satisfaction, and retention at the beginning of 2022 and addressed what should be done to ameliorate COVID‐19's impact and what initiatives hospitals had implemented.

Methods

This survey focused on five major domains: equipment/medication, vaccination/testing, staffing, burnout, and economic repercussions. Pilot testing for questionnaire clarity was conducted by members of the Pediatric Anesthesia COVID‐19 Collaborative. The survey was administered by e‐mail to a representative of the 72 collaborative centers. Respondents were instructed to answer based on their institution's practice from February through April of 2022. Descriptive statistics with 95% confidence intervals are reported.

Results

Seventy of seventy‐two institutions participated in this survey (97% response rate). Fifty‐nine (84%) were from the United States, and 11 (16%) included other countries. The majority experienced equipment (68%) and medication (60%) shortages. Many institutions reported staffing shortages in nursing (37%), perioperative staff (27%), and attending anesthesiologists (11%). Sixty‐two institutions (89%) indicated burnout was a frequent topic of conversation among pediatric anesthesiologists. Forty‐three institutions (61%) reported anesthesiologists leaving current practice and 37 (53%) early retirement. Twenty‐eight institutions (40%) canceled elective cases. The major suggestions for improving job retention included improving financial compensation (76%), decreasing clinical time (67%), and increasing flexibility in scheduled clinical time (66%). Only a minority of institutions had implemented the following initiatives: improving financial compensation (19%), increased access to mental health/counseling services (30%), and assistance with child or elder care (7%). At the time of the survey, 34% of institutions had not made any changes.

Conclusion

Our study found that COVID‐19 has continued to impact pediatric anesthesiology. There are major discrepancies between what anesthesiologists believe are important for job satisfaction and faculty retention compared to implemented initiatives. Data from this survey provide insight for institutions and departments for addressing these challenges.
Alleviation of ultraviolet‐B radiation‐induced photoaging using Saussurea medusa Maxim polysaccharide
Authors: Guo Yan , Kong Yue , Sun Juan , Jiao Yang , Hong Yan , Wang Yan
Published: September 2023

Saussurea medusa polysaccharide, the polysaccharide extract of Saussurea medusa Maxim, a traditional Chinese herbal medicine, is used to combat intense ultraviolet radiation, cold, and hypoxia in patients, as well as during drought. This polysaccharide has rich medicinal and ecological values. We aimed to determine whether saussurea medusa polysaccharides can reduce ultraviolet B (UVB)‐induced skin photoaging. Seventy‐five male Kunming mice were divided into five groups: control, UVB‐only, UVB plus vitamin E (VE group), UVB plus saussurea medusa (2 g/kg), and UVB plus saussurea medusa (6 g/kg). The control group was irradiated with normal light, while the other four groups were subcutaneously administered 10 mL/kg/day D‐galactose and irradiated with narrow‐spectrum UVB for 40 min daily. From day 11, the VE group was administered 0.25 g/kg/day vitamin E, while the saussurea medusa intervention groups were administered 2 and 6 g/kg/day saussurea medusa polysaccharide. After 30 days of continuous administration, treatment with saussurea medusa polysaccharides was found to reduce UVB‐induced skin photoaging in mice by elevating the levels of superoxide dismutase, glutathione peroxidase, and hydroxyproline (HYP), while reducing the level of MDA, and inhibiting the EGFR/MEK/ERK/c‐Fos pathway. Overall, our findings suggest that treatment with saussurea medusa polysaccharides positively influences skin photoaging.
Restricted O2 consumption in pea roots induced by hexanoic acid is linked to depletion of Krebs cycle substrates
Authors: Casolo Valentino , Zancani Marco , Pellegrini Elisa , Filippi Antonio , Gargiulo Sara , Konnerup Dennis , Morandini Piero , Pedersen Ole
Published: September 2023

Plant roots are exposed to hypoxia in waterlogged soils, and they are further challenged by specific phytotoxins produced by microorganisms in such conditions. One such toxin is hexanoic acid (HxA), which, at toxic levels, causes a strong decline in root O2 consumption. However, the mechanism underlying this process is still unknown. We treated pea (Pisum sativum L.) roots with 20 mM HxA at pH 5.0 and 6.0 for a short time (1 h) and measured leakage of key electrolytes such as metal cations, malate, citrate and nonstructural carbohydrates (NSC). After treatment, mitochondria were isolated to assess their functionality evaluated as electrical potential and O2 consumption rate. HxA treatment resulted in root tissue extrusion of K+, malate, citrate and NSC, but only the leakage of the organic acids and NSC increased at pH 5.0, concomitantly with the inhibition of O2 consumption. The activity of mitochondria isolated from treated roots was almost unaffected, showing just a slight decrease in oxygen consumption after treatment at pH 5.0. Similar results were obtained by treating the pea roots with another organic acid with a short carbon chain, that is, butyric acid. Based on these results, we propose a model in which HxA, in its undissociated form prevalent at acidic pH, stimulates the efflux of citrate, malate and NSC, which would, in turn, cause starvation of mitochondrial respiratory substrates of the Krebs cycle and a consequent decline in O2 consumption. Cation extrusion would be a compensatory mechanism in order to restore plasma membrane potential.
Continuous positive airway pressure or high‐flow nasal cannula oxygen therapy for acute hypoxemic respiratory failure unrelated to COVID‐19: Another brick in the wall?
Authors: Coudroy Rémi
Published: September 2023

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Oscillations in three‐reaction quadratic mass‐action systems
Authors: Banaji Murad , Boros Balázs , Hofbauer Josef
Published: September 2023

It is known that rank‐two bimolecular mass‐action systems do not admit limit cycles. With a view to understanding which small mass‐action systems admit oscillation, in this paper we study rank‐two networks with bimolecular source complexes but allow target complexes with higher molecularities. As our goal is to find oscillatory networks of minimal size, we focus on networks with three reactions, the minimum number that is required for oscillation. However, some of our intermediate results are valid in greater generality.

One key finding is that an isolated periodic orbit cannot occur in a three‐reaction, trimolecular, mass‐action system with bimolecular sources. In fact, we characterize all networks in this class that admit a periodic orbit; in every case, all nearby orbits are periodic too. Apart from the well‐known Lotka and Ivanova reactions, we identify another network in this class that admits a center. This new network exhibits a vertical Andronov–Hopf bifurcation.

Furthermore, we characterize all two‐species, three‐reaction, bimolecular‐sourced networks that admit an Andronov–Hopf bifurcation with mass‐action kinetics. These include two families of networks that admit a supercritical Andronov–Hopf bifurcation and hence a stable limit cycle. These networks necessarily have a target complex with a molecularity of at least four, and it turns out that there are exactly four such networks that are tetramolecular.