bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the efficacy of catha edulis extract-loaded nanofibrous scaffolds seeded with bone marrow-derived stem cells for diabetic wound healing: A preclinical investigation
Authors: Song Yinsen , Zhang Sisen , Fan Tianli , Yang Zhenzhen , Li Peiliang , Zhang Lu , Gao Na , Mei Wei
Published: April 2024

Objectives:

The aim of this study was to investigate the potential of incorporating catha edulis extract into polycaprolacton/gelatin scaffolds using electrospinning technique for the treatment of diabetic wounds in a rat model.

Methods:

The in vitro characterization of the scaffolds was performed using various assays, including anti-inflammatory assay, microstructure study, DPPH radical scavenging assay, cell viability assay, hemocompatibility assay, and bacterial penetration assays. The scaffolds were then seeded with bone marrow-derived stem cells and cultured before implantation into the rat model.

Results:

The results of the in vitro study showed that the produced scaffolds were nanofibrous, antioxidative, and non-toxic to skin cells. In vivo study demonstrated that the stem cell and catha edulis extract-loaded scaffolds had the highest rate of wound closure and histomorphometric parameters compared to other groups. Moreover, gene expression studies showed that the developed wound dressings increased the expression of VEGF gene and reduced the expression of glutathione peroxidase gene.

Conclusion:

These findings suggest that the catha edulis extract-loaded polycaprolacton/gelatin scaffolds could be a promising therapeutic option for diabetic wounds.
Substance Use and Mental Health as Mediators of the Association Between Intimate Partner Violence Victimization and Condomless Sex with Serodiscordant Partners Among Black Sexual Minority Men Living with HIV
Authors: Gizaw Mahlet , Bogart Laura M. , Mutchler Matthew G. , Lawrence Sean J. , Klein David J. , Goggin Kathy , Storholm Erik D. , Wagner Glenn J.
Published: April 2024

Black sexual minority men (SMM) are disproportionately impacted by HIV in the United States. Intimate partner violence (IPV), substance use, and depression are associated with HIV risk behavior such as condomless sex. In this study, we assessed cross-sectional associations between multiple types of IPV victimization and condomless sex with serodiscordant partners. We then evaluated the mediating roles of mental health and substance use, in a sample of 213 Black SMM living with HIV. We used validated scales to assess IPV victimization, depression, post-traumatic stress symptoms, general mental health, and substance use. All independent variables (IPV type) that had at least a marginal ( p < .10) association with the dependent variable (condomless sex with a serodiscordant partner) and any potential mediator were included in mediation models. Mediator role was determined based on a statistically significant outcome ( p < .05) in the mediation model. Physical assault, injury-inducing IPV, and sexual coercion were each positively correlated with condomless sex. Depression, overall mental health, and substance use were associated with physical assault and injury-inducing IPV, and depression was associated with sexual coercion IPV. Both physical assault and injury-inducing IPV were associated with overall mental health, but none of the mental health and substance use measures mediated the associations between IPV and condomless sex. Findings suggest that HIV prevention efforts for Black SMM may need to incorporate IPV screening and prevention services. Further research is needed to understand the psychosocial pathways by which physical forms of IPV relate to condom use.
Addition of constitutional symptoms to the SLEDAI-2K improves overall disease activity assessment: A pilot study
Authors: Anderson Erik W , Sansone Marissa , Shah Bhakti , Kline Myriam , Franchin Giovanni , Aranow Cynthia , Mackay Meggan
Published: April 2024

Objective

Constitutional symptoms (fatigue, lymphadenopathy, and weight loss) are not included in the SLE disease activity index-2000 (SLEDAI-2K). In this pilot study, we assessed the concurrent and construct validity of a revised SLEDAI-2K (SLED-R) that included these symptoms with the original SLEDAI-2K (SLED-O), using the physician global assessment of disease activity (PGA) as the reference.

Methods

Our revised SLED-R substituted the SLED-O’s fever descriptor with a constitutional descriptor that included fever, fatigue, lymphadenopathy, and/or weight loss. SLED-O, SLED-R, PGA and patient global assessment (PtGA) scores were collected prospectively. Bland-Altman correlations for repeated measures were calculated and Meng’s z-test was used to compare correlations between dependent and overlapping correlation coefficients. Associations between constitutional symptoms and disease activity measures were analyzed using Mann-Whitney U, Kruskal-Wallis, Chi-square tests and repeated measures correlations.

Results

1123 SLED-O, SLED-R, PGA, and 1066 PtGA were collected in 239 subjects. The new descriptor was scored in 45 subjects (18.8%) and 92 instances (8.1%), while the original descriptor, fever, was scored in only 4 subjects (1.7%) and 5 instances (0.4%). Mean SLED-O, PGA and PtGA scores were higher when the constitutional descriptor was scored versus not ( p < .001). The correlation between SLED-R and PGA was marginally higher than between SLED-O and PGA ( p < .001). Fatigue contributed most to this increase ( p = .001) and associated with both higher PGA and PtGA scores ( p < .001). Mean SLED-O and PGA scores were higher when ≥1 constitutional symptom(s) were scored versus not ( p < .002). Correlations between PGA and PtGA when the new descriptor was scored versus not were similar ( p = .860). The frequency of concordance between PGA and PtGA was lower when the new descriptor was scored (55%) versus not (72.5%), with PGA > PtGA when the new descriptor was scored ( p < .001).

Conclusion

The addition of constitutional symptoms to SLEDAI-2K, particularly fatigue, resulted in a marginal increase in its correlation with PGA, and new constitutional symptoms associated with higher SLED-O and PGA scores. As fatigue is subjective and difficult to attribute to SLE, its validity and inter-rater reliability in scoring remains uncertain. The clinical utility of SLED-R remains unclear, and further studies of its validity and reliability are needed.
Factors associated with healthcare transition readiness for adolescents with chronic conditions: A cross-sectional study
Authors: Hong Hye Seung , Im YeoJin
Published: April 2024

Healthcare transition readiness (HCTR) plays a vital role by fostering autonomy, self-management skills, and active involvement in healthcare, leading to positive health outcomes. This study aimed to examine the factors associated with HCTR in adolescents with chronic conditions (ACCs) including adolescents’ autonomy, parental overprotection, and autonomy support from healthcare providers (HCPs). This descriptive study included 107 adolescents aged 14–19 years (median age: 17 years, IQR = 1), recruited from online communities and support groups in South Korea. Data were analyzed using hierarchical linear regression. Our research has shown that HCTR is linked to a lower level of parental overprotection (β = −0.46, 95% CI [−0.59, −0.33]) and higher levels of autonomy support from HCPs (β = 0.46, 95% CI [0.36, 0.56]). Among general characteristics, we also found that having a transfer plan to adult care (β = 0.24, 95% CI [0.04, 0.44]) is significantly associated with HCTR. This study contributes to a broader understanding of HCTR by examining its associated factors in ACC. The results emphasize the pivotal roles of parental involvement, healthcare provider support, and structured transition to adult care in enhancing HCTR. These findings underscore the need for comprehensive assistance to ensure successful healthcare transitions.
The shared decision-making tool for caregivers of children with prenatal opioid exposure: A pilot and acceptability study
Authors: Arter Sara , Bush Elsie , Clark Katie , Weber Stephanie
Published: April 2024

This pilot and acceptability study sought to report provider acceptability and developmental concerns expressed by caregivers of children with prenatal opioid exposure using the Shared Decision-Making Tool (SDMT), an instrument created by study authors. Data were collected from five health care and early intervention providers and 83 caregivers from a medical clinic and early intervention service center. Descriptive statistics were used to identify frequency, mean level, and prioritization of developmental concerns using the SDMT, and to summarize provider acceptability about integrating the SDMT into their workflow. Communication was the most frequently cited concern in four consecutive age categories, followed by Inattention/impulsivity and Problem behavior. All providers “strongly agreed” or “agreed” with all statements on the provider feedback survey, except two instances. Results of this study support the SDMT as a potential tool to help engage caregivers and providers of children with prenatal opioid exposure in the shared decision-making process by standardizing communication related to areas of developmental concern and caregivers’ priority needs. Findings from this pilot study will inform modifications to the SDMT and administration instructions before our next study, which will examine psychometric properties and caregiver acceptability of the scale.
Associations between food intake and psychosomatic symptoms in 16-year-old adolescents
Authors: Tell Maria Norburg , Hedin Katarina , Nilsson Mats , Golsäter Marie , Lingfors Hans
Published: April 2024

Aims:

An increase in psychosomatic symptoms among adolescents has recently been reported. Few studies have examined the relation between food intake and psychosomatic symptoms. The aim was to study the association between food intake and overall psychosomatic burden and separate psychosomatic symptoms.

Methods:

In this cross-sectional study, we used data from 6248 girls and 7153 boys in south-east Sweden who turned 16 years of age during the academic years 2009/2010 to 2015/2016 and responded to a health questionnaire at the school health services. The association between overall healthy food intake and a low psychosomatic burden was calculated as odds ratios (95% confidence interval) and stratified for other lifestyle habits and gender.

Results:

Sixty-nine per cent of the boys and 35% of the girls had a low psychosomatic burden. There was a positive association between an overall healthy food intake and a low psychosomatic burden ( P<0.0001), regardless of other lifestyle habits and gender. An overall healthy food intake was also positively associated with a lower frequency of the separate psychosomatic symptoms of concentration difficulties, sleep difficulties, a poor appetite or dizziness ( P<0.0001).

Conclusions:

A healthy food intake seems to be associated with a low psychosomatic burden among adolescents. Further knowledge is needed to explore whether an improved food intake can reduce psychosomatic symptoms and enhance mental health.
Using Empirical Information to Prioritize Early Literacy Assessment and Instruction in Preschool and Kindergarten
Authors: Wackerle-Hollman Alisha , Hojnoski Robin , Missall Kristen , Abuela Mohammed A. A. , Running Kristin
Published: April 2024

Early literacy skill development predicts later reading success, and development of skills in specific domains during the preschool years has been established as both a prerequisite and precursory for reading. Early literacy assessments typically include measures of separate skills across domains, and results can assist with determining where instructions may be most needed. When multiple areas of need are identified, understanding which skills to prioritize can be a challenge. Therefore, empirically identifying the relative contribution of each skill measured in preschool to subsequent reading success can promote more efficient systems of assessment. This study, conducted in the United States, examined the predictive validity of early literacy skills measured in preschool compared to skills measured in kindergarten, with a specific practical focus on identifying the most efficient predictive model for understanding reading readiness. Participants were 119 preschoolers (mean age = 66 months) who mostly spoke English as their primary language (79%). Results indicated early literacy and language skills in preschool are highly predictive of early reading in kindergarten, accounting for 59% of the variance in a reading composite score. The most parsimonious model indicated that first sounds, letter sounds, early comprehension, and expressive vocabulary measures adequately explained 52% of the variance in children’s kindergarten reading performance.
A 63-year-old Chinese female with mixed connective tissue disease who suffered from renal crisis
Authors: Shao Jiasheng , Liu Jiayan , Guo Qiang , Cao Liou
Published: April 2024

Mixed connective tissue disease (MCTD) is a rare autoimmune disorder. We present a case of a Chinese female who has been admitted to our hospital on eight separate occasions. Her initial symptoms involved internal organs including the lung and heart. Due to the presence of anti-U1RNP antibodies and other clinical features, a diagnosis of MCTD was considered. Throughout her first to seventh admissions, her serum creatinine levels remained normal. During her eighth hospitalization, her renal function deteriorated rapidly, culminating in renal crisis. Chest computed tomography (CT) confirmed pulmonary edema, necessitating hemodialysis. Her interleukin (IL)-6 level increased significantly during throughout hospitalizations. The patient responded well to treatment with an IL-6 receptor antagonist (IL-6RA). This case raises the question of whether IL-6 could serve as a potential biomarker for predicting renal crisis incidence in MCTD patients, a topic warranting further investigation in the future.
Understanding Mass Panic
Authors: Fletcher Henry W. , Aunger Robert
Published: April 2024

Mass panics can arise in response to a variety of situations, such as the spread of pathogens, bank failures, or insecurities about economic supplies. Such panics can produce contagious behaviors such as fleeing social contacts, bank withdrawals, and panic buying. In such situations, the processing of external stimuli, mediated by the perceptions and biases of the individual, can reach a threshold point at which panic behaviors are triggered. Due to the human propensity to imitate the behavior of others in uncertain crisis situations, one individual’s panic behavior can spread contagiously. This paper looks at the similarities among case studies of mass panic around the world and from these cases synthesizes a conceptual model to aid our understanding. Decision-makers can use this model to strengthen national resilience against panic-generated behaviors and ensure an orderly and successful public response to future biological, financial, or economic crises.
When the Future Dies: The Here(After)
Authors: Rush Juli
Published: April 2024

Our futures are always dying and there are futures always being born. There is a liminal space in which we stand and experience both those deaths and births which send ripples through our multiplex systems. Drawing upon fields and tools such as thanatology, neuroscience, and trauma-informed care may allow us frameworks with which to manage not just how we think about the future but also how we feel about the future. There is a hallowed ground where the births and deaths of our futures exist and it takes both courage and creativity to stand there. As futurists, our job is often to sit bedside with others as they nurse and hospice their futures - both imagined and unimagined. Recognizing the skill needed to serve as container for individuals, systems, and the world requires something new from the field of Foresight and its practitioners. With the shocking, global loss from the Covid-19 pandemic, related individual micro-loss, the continuing climate decline partnered with increasing disruption, the world stands on the precipice of new understanding around grief and hope. Thoughtful consideration here allows us to better anticipate futures death and the transitional grief that often accompanies change.
Listening to children and young people in Sweden: Practices, possibilities, and tensions
Authors: Baldini Myung Hwa , Tiefenbacher Rebecka , Terzoglou Effrosyni , Strand Joacim , Hällqvist Veronica , Holmbom Strid Emilia , Anatoli Olga , Sparrman Anna , Tesar Marek
Published: April 2024

This piece is a collective exploration by seven doctoral researchers in Child Studies, who discuss notions of listening to children and young people in a Swedish context. We approach different aspects of listening in research and in practices such as education, psychiatry, and social work. The discussions in this collective writing are an invitation for continuous reflections about the contexts where listening to children is done, its challenges and possibilities.
Selections From the ABC 2023 Annual Conference, Denver, Colorado, USA: A Rocky Mountain of Business Communication Teaching Innovations
Authors: Whalen D. Joel , Drehmer Charles , Cavanaugh Andrew
Published: April 2024

Innovative classroom-tested approaches to cross-cultural communication—diversity, equity, and inclusion—and personal and professional development are featured. Readers can explore 10 teaching creations debuted at the 2023 My Favorite Assignment sessions at the Association for Business Communication Annual International Conference held in Denver, Colorado, USA.
Emotional experiences in palliative care and professional quality of life: a qualitative approach
Authors: Cañas-Lerma Ana Josefa , Hidalgo-Andrade Paula , Araujo-Lugo Viviana , Moya Gabriela , Verger Sebastià
Published: April 2024

Objective:

To explore the experiences that significantly impact the professional quality of life of people providing palliative care (PC) in Ecuador.

Design:

Observational cross-sectional qualitative research.

Methods:

In September 2022, 10 focus groups were carried out in four cities in Ecuador; each group lasted from 1 to 2 h, was audio recorded, and transcribed verbatim. Recruitment was conducted through convenience sampling, and a total of 71 individuals (15 students, 50 professionals, and 6 volunteers) linked to PC participated. Content analysis with a phenomenological and inductive approach was used to analyze the data.

Results:

People recognized their experiences in PC as having positive and negative impacts on their professional quality of life. Experiences were mapped as affecting them at individual, relational, and contextual levels. These experiences included personal growth, opportunity to provide care, teamwork, death-related issues, inability to deal with work-related stress, social acceptance of PC, and dealing with inefficient health systems, among others.

Conclusion:

Despite the positive emotions that arise with caring for others, individuals working and volunteering in PC experience situations that influence their professional quality of life. Addressing these factors to increase satisfaction and ease the burden of PC work is essential. Undergraduate education, continuous professional training, and PC teams should incorporate actions to address these factors at all levels, such as teaching coping skills, fostering social support, and increasing awareness of PC.
Venous thromboembolism characteristics and outcomes among RIETE patients tested and untested for inherited thrombophilia
Authors: Cohen Omri , Waldman Radinsky Liat , Kenet Gili , Mahé Isabelle , Barillari Giovanni , Soler Silvia , Sigüenza Patricia , Del Valle Morales María , Villares Paula , Monreal Manuel
Published: April 2024

Inherited thrombophilia (IT) workup is commonly pursued in patients with venous thromboembolism (VTE). Recent American Society of Hematology guidelines recommend a selective approach to IT testing, nevertheless, evidence on whether thrombophilia testing can actually improve patient-important outcomes through tailored management is limited. Data from the large, prospective Registro Informatizado de Enfermedad TromboEmbólica (RIETE) registry were analyzed to compare VTE risk factors, management, and outcomes between patients who were tested for IT and untested patients, during anticoagulant treatment and after its discontinuation. Among 103 818 patients enrolled in RIETE, 21 089 (20.3%) were tested for IT, 8422 (8.1%) tested positive, and 82 729 (79.7%) were not tested. IT testing was more frequent in patients with VTE provoked by minor risk factors and less common in those with major risk factors such as surgery or active cancer. Choices of anticoagulant treatment did not differ based on IT testing results. Untested patients exhibited inferior outcomes across all VTE categories, with higher rates of VTE recurrence, major bleeding, mortality, and notably, cancer-related mortality. After treatment discontinuation, IT-negative patients with surgically provoked VTE showed lower recurrence rates. For immobilization-related VTE as well as in estrogen-related VTE, no significant differences in recurrence rates were observed between IT-negative and IT-positive patients. However, IT-negative patients with pregnancy or postpartum-related VTE had significantly lower recurrence rates. Patients with unprovoked VTE, particularly those testing positive for IT, had high recurrence rates after treatment. These findings underscore the complex role of IT testing in managing VTE, supporting personalized treatment strategies that consider VTE risk factors and comorbidities. The trial was registered at www.clinicaltrials.gov as #NCT02832245.
DISPLACE study shows poor quality of transcranial doppler ultrasound for stroke risk screening in sickle cell anemia
Authors: Davidow Kimberly A. , Miller Robin E. , Phillips Shannon M. , Schlenz Alyssa M. , Mueller Martina , Hulbert Monica L. , Hsu Lewis L. , Bhasin Neha , Adams Robert J. , Kanter Julie
Published: April 2024

Children with sickle cell anemia (SCA) are at increased risk of stroke when compared with their age-based counterparts. The Stroke Prevention Trial in Sickle Cell Anemia (STOP) previously demonstrated that with the use of transcranial Doppler ultrasound (TCD; Sickle Stroke Screen) and chronic red cell transfusion, the risk of stroke is reduced by over 90%. The STOP criteria detailed the type and method of measurement required; the time–averaged mean maximum velocity (TAMMV). Unfortunately, it has been difficult to adhere to the appropriate TAMMV measurements. The objectives of this study were to assess the quality of TCD and transcranial Doppler imaging (TCDi) reports to determine the report quality and accuracy. This is a subanalysis of the DISPLACE (Dissemination and Implementation of Stroke Prevention Looking at the Care Environment) study. Over 12 000 TCD/TCDi reports were collected during this study from 28 institutions; 391 TCDs were reviewed for this subanalysis. There were significant variations in the vessels being assessed, the velocities used to define abnormal results, and who was interpreting the scans. In 52% of reports, it was impossible to identify whether the TAMMV was what was measured. Similarly, it was only clear in 42% of reports that the TAMMV was used to interpret the examination as normal/abnormal. Given this inconsistency, we strongly recommend standardization of TCD/TCDi reporting, specialized training for those performing and interpreting the scans in the use of TCD/TCDi in patients with SCA, internal quality assurance, and institutional quality improvement work to ensure appropriate use of this potentially lifesaving technology.
Defining primary refractory large B-cell lymphoma
Authors: Bock Allison M. , Mwangi Raphael , Wang Yucai , Khurana Arushi , Maurer Matthew J. , Ayers Amy , Kahl Brad S. , Martin Peter , Cohen Jonathon B. , Casulo Carla , Lossos Izidore S. , Farooq Umar , Ayyappan Sabarish , Reicks Tanner , Habermann Thomas M. , Witzig Thomas E. , Flowers Christopher R. , Cerhan James R. , Nastoupil Loretta J. , Nowakowski Grzegorz S.
Published: April 2024

Patients with large B-cell lymphoma (LBCL) that fail to achieve a complete response (CR) or who relapse early after anthracycline-containing immunochemotherapy (IC) have a poor prognosis and are commonly considered to have “primary refractory disease.” However, different definitions of primary refractory disease are used in the literature and clinical practice. In this study, we examined variation in the time to relapse used to define refractory status and association with survival outcomes in patients with primary refractory LBCL in a single-center prospective cohort with validation in an independent multicenter cohort. Patients with newly diagnosed LBCL were enrolled in the Molecular Epidemiological Resource cohort (MER; N = 949) or the Lymphoma Epidemiology of Outcomes cohort (LEO; N = 2755) from September 2002 to May 2021. Primary refractory LBCL was defined as no response (stable disease [SD]) or progressive disease (PD) during, or by the end of, frontline (1L) IC (primary PD; PPD); partial response at end of treatment (EOT PR); or relapse within 3 to 12 months after achieving CR at EOT to 1L IC (early relapse). In the MER cohort, patients with PPD had inferior overall survival (OS; 2-year OS rate: 15% MER, 31% LEO) when compared with other subgroups considered in defining primary refractory disease, EOT PR (2-year OS rate: 38% MER, 50% LEO) and early relapse (2-year OS rate: 44% MER, 58% LEO). Among patients receiving 1L IC with curative intent, we identified that patients with PPD are the key subgroup with poor outcomes. We propose a definition of primary refractory LBCL as SD or PD during, or by the end of, 1L treatment.
Deciphering the impact of circRNA-mediated autophagy on tumor therapeutic resistance: a novel perspective
Authors: Wang Ting , He Mengjie , Zhang Xudong , Guo Zhixun , Wang Pinghan , Long Fangyi
Published: April 2024

Cancer therapeutic resistance remains a significant challenge in the pursuit of effective treatment strategies. Circular RNAs (circRNAs), a class of non-coding RNAs, have recently emerged as key regulators of various biological processes, including cancer progression and drug resistance. This review highlights the emerging role of circRNAs-mediated autophagy in cancer therapeutic resistance, a cellular process that plays a dual role in cancer by promoting both cell survival and death. Increasing evidence suggests that circRNAs can modulate autophagy pathways, thereby influencing the response of cancer cells to therapeutic agents. In this context, the intricate interplay between circRNAs, autophagy, and therapeutic resistance is explored. Various mechanisms are discussed through which circRNAs can impact autophagy, including direct interactions with autophagy-related genes, modulation of signaling pathways, and cross-talk with other non-coding RNAs. Furthermore, the review delves into specific examples of how circRNA-mediated autophagy regulation can contribute to resistance against chemotherapy and radiotherapy. Understanding these intricate molecular interactions provides valuable insights into potential strategies for overcoming therapeutic resistance in cancer. Exploiting circRNAs as therapeutic targets or utilizing them as diagnostic and predictive biomarkers opens new avenues for developing personalized treatment approaches. In summary, this review underscores the importance of circRNA-mediated autophagy in cancer therapeutic resistance and proposes future directions for research in this exciting and rapidly evolving field.
4D label-free proteomics analysis of oxygen-induced retinopathy with or without anti-VEGF treatment
Authors: Xu Zhaokai , Wu Yubo , Mao Jianbo , Chen Yiqi , Chen Huan , Zhang Shian , Yu Jiafeng , Deng Xinyi , Shen Lijun
Published: April 2024

Oxygen-induced retinopathy (OIR) animal model is widely used for retinopathy of prematurity (ROP) researches. The purpose of this study was to identify proteins and related pathways of OIR with or without anti-vascular endothelial growth factor (VEGF) treatment, for use as biomarkers in diagnosing and treating ROP. Nine samples were subjected to proteomic analysis. Retina specimens were collected from 3 OIR mice, 3 OIR mice with anti-VEGF treatment and 3 normal mice (control group). Liquid chromatography-tandem mass spectrometry analysis was performed using the 4D label-free technique. Statistically significant differentially expressed proteins, gene ontology (GO) terms, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway representations, InterPro (IPR) and protein interactions were analyzed. In total, 4585 unique proteins were identified as differentially expressed proteins (DEPs). Enrichment analysis of the GO and KEGG indicated functional clusters related to peptide biosynthetic and metabolic process, cellular macromolecule biosynthetic process and nucleic acid binding in OIR group. For anti-VEGF treatment group, DEPs were clustered in DNA replication, PI3K/Akt signaling pathway and Jak/STAT signaling pathway. Proteomic profiling is useful for the exploration of molecular mechanisms of OIR and mechanisms of anti-VEGF treatment. These findings may be useful for identification of novel biomarkers for ROP pathogenesis and treatment.
Tailored videoconferencing counselling program to support family carers of people living with dementia during the transition to permanent residential care: a pilot and feasibility randomised trial
Authors: Brooks Deborah , Wyles Katy , Pachana Nancy A. , Beattie Elizabeth , Gaugler Joseph E.
Published: April 2024

Background

Decisions surrounding the permanent residential care placement of people living with dementia can be stressful and distressing; however, providing access to targeted information and support prior to placement may help carers better cope. This mixed methods study aimed to test the feasibility, acceptability, and potential benefits of providing a tailored, individual counselling program (the Residential Care Transition Module), delivered via videoconferencing, to Australian family carers of a relative with dementia during the transition to permanent residential care.

Methods

A total of 18 family carers were randomly allocated to receive either the counselling intervention (six sessions delivered over 12 weeks) or a check-in call, delivered by a trained Transition Counsellor. Both groups received help-sheets about residential care, coping with placement, and managing feelings. Carers completed online surveys about stress, guilt, anxiety, depression, grief, and support for caring at baseline and four months post-baseline. Carers were also invited to participate in semi-structured exit interviews, conducted after follow-up surveys were completed. Process data relating to recruitment, retention, intervention dose and delivery were collected via logs. Quantitative data were analysed using descriptive statistics and repeated measures ANOVA. Qualitative data, relating to feasibility, acceptability, and perceived benefits of the program, were analysed using the ‘framework’ approach developed by the Medical Research Council to inform the process evaluation of complex interventions.

Results

Qualitative findings indicated that delivery of the counselling program during the transition period was deemed by participants to be feasible and acceptable. Delivery via videoconferencing was deemed convenient and acceptable, with few technical issues. The skills and knowledge of the Transition Counsellor were perceived to be important mechanisms of impact. Though not statistically significant, promising quantitative findings were identified in terms of reduced carer stress and guilt and improved support for caring.

Conclusions

Delivery of a tailored counselling program via videoconferencing to family carers of people living with dementia during the transition to residential care was feasible and acceptable. The program has the potential to improve transitional support to family carers.

Trial registration

This study was registered in the Australian New Zealand Clinical Trials Registry: ACTRN12621001462875.
Nomogram predictive model for in-hospital mortality risk in elderly ICU patients with urosepsis
Authors: Wei Jian , Liang Ruiyuan , Liu Siying , Dong Wanguo , Gao Jian , Hua Tianfeng , Xiao Wenyan , Li Hui , Zhu Huaqing , Hu Juanjuan , Cao Shuang , Liu Yu , Lyu Jun , Yang Min
Published: April 2024

Background

Urinary tract infection (UTI) is a common cause of sepsis. Elderly patients with urosepsis in intensive care unit (ICU) have more severe conditions and higher mortality rates owing to factors such as advanced age, immunosenescence, and persistent host inflammatory responses. However, comprehensive studies on nomograms to predict the in-hospital mortality risk in elderly patients with urosepsis are lacking. This study aimed to construct a nomogram predictive model to accurately assess the prognosis of elderly patients with urosepsis and provide therapeutic recommendations.

Methods

Data of elderly patients with urosepsis were extracted from the Medical Information Mart for Intensive Care (MIMIC) IV 2.2 database. Patients were randomly divided into training and validation cohorts. A predictive nomogram model was constructed from the training set using logistic regression analysis, followed by internal validation and sensitivity analysis.

Results

This study included 1,251 patients. LASSO regression analysis revealed that the Glasgow Coma Scale (GCS) score, red cell distribution width (RDW), white blood count (WBC), and invasive ventilation were independent risk factors identified from a total of 43 variables studied. We then created and verified a nomogram. The area under the receiver operating characteristic curve (AUC), net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA) of the nomogram were superior to those of the traditional SAPS-II, APACHE-II, and SOFA scoring systems. The Hosmer-Lemeshow test results and calibration curves suggested good nomogram calibration. The IDI and NRI values showed that our nomogram scoring tool performed better than the other scoring systems. The DCA curves showed good clinical applicability of the nomogram.

Conclusions

The nomogram constructed in this study is a convenient tool for accurately predicting in-hospital mortality in elderly patients with urosepsis in ICU. Improving the treatment strategies for factors related to the model could improve the in-hospital survival rates of these patients.
Antibiotic use and resistance patterns at Rumphi District Hospital in Malawi: a cross-sectional study
Authors: Mithi Brany , Luhanga Mosen , Kaminyoghe Felix , Chiumia Francis , Banda Daniel L. , Nyama Lottie
Published: April 2024

Background

Overuse of antibiotics is a key driver of antimicrobial resistance (AMR) world-wide. Malawi continues to report rising cases of AMR among both in-patients and out-patients. We investigated antibiotic use and resistance patterns among patients with suspected first line antibiotic treatment failure at Rumphi District Hospital, Malawi.

Methods

We used a cross-sectional study design in which records of patients data on culture and antimicrobial sensitivity tests were extracted, alongside treatment history from 2019 to March, 2023, retrospectively. We also included findings for point prevalence survey (PPS) conducted within four hospital wards in June, 2022 by a well-trained multi-disciplinary team from within the hospital. The data was analyzed for antibiotic use, characterization of pathogens and their susceptibility patterns using Microsoft excel and STATA-14 software.

Results

A total of 85 patients’ data records were reviewed on antibiotics resistance pattern in which 54 (63.5%) were females. Patient antibiotic history captured indicated Metronidazole (23%), Gentamycin (20%) and Doxycycline (23%) as the most frequently used antibiotics among clients referred for microbiological investigations. Among locally available antibiotics with over 50% sensitivity were Chloramphenicol (61%), ciprofloxacin (55%), and ceftriaxone (54%). Penicillins were among antibiotics with highest resistance: ampicillin (100%), amoxyclav (90%), Piperacilin-tazobactam (63%). The majority of patients came from STI clinic and presented with genital discharges 44% (n = 39). Over 80% of the isolated N. gonorrhoeae exhibited a reduced susceptibility to gentamycin. Prevalence of Methicillin resistant staphylococcus Aureus (MRSA) was 46% and were mostly isolated from wound pus. Among 80 data records of the patients reviewed during PPS, Ceftriaxone (54.3%) and Metronidazole (23.3%) emerged as the most frequently used antibiotics in the wards which were prescribed empirically without a microbiological indication.

Conclusion

In this study setting, we observed high use of watch antibiotics along with problem of multi-drug resistant infections in patients experiencing clinical failure in a variety of clinical syndromes. The findings underline the need to revamp diagnostic microbiology to increase the uptake of antimicrobial susceptibility testing to guide specific prescriptions of broad-spectrum antibiotics in the watch list.
Risk factors for bacteremic pneumonia and mortality (28-day mortality) in patients with Acinetobacter baumannii bacteremia
Authors: Lan Meng , Dongmei Kang , Guodong Shen , Haifeng Yao , Guofeng Cui , Mengting Chen , Xiaoyun Fan
Published: April 2024

Background

Patients infected with Acinetobacter baumannii (AB) bacteremia in hospital have high morbidity and mortality. We analyzed the clinical characteristics of pneumonia and nonpneumonia-related AB bloodstream infections (AB BSIs) and explored the possible independent risk factors for the incidence and prognosis of pneumonia-related AB BSIs.

Methods

A retrospective monocentric observational study was performed. All 117 episodes of hospital-acquired AB bacteremia sorted into groups of pneumonia-related AB BSIs (n = 45) and nonpneumonia-related AB BSIs (n = 72) were eligible. Univariate/multivariate logistic regression analysis was used to explore the independent risk factors. The primary outcome was the antibiotic susceptibility in vitro of pneumonia-related AB BSIs group. The secondary outcome was the independent risk factor for the pneumonia-related AB BSIs group.

Results

Among 117 patients with AB BSIs, the pneumonia-related group had a greater risk of multidrug resistant A. baumannii (MDRAB) infection (84.44%) and carbapenem-resistant A. baumannii (CRAB) infection (80%). Polymyxin, minocycline and amikacin had relatively high susceptibility rates (> 80%) in the nonpneumonia-related group. However, in the pneumonia-related group, only polymyxin had a drug susceptibility rate of over 80%. Univariate analysis showed that survival time (day), CRAB, MDRAB, length of hospital stay prior to culture, length of ICU stay prior to culture, immunocompromised status, antibiotics used prior to culture (n > = 3 types), endotracheal tube, fiberoptic bronchoscopy, PITT, SOFA and invasive interventions (n > = 3 types) were associated with pneumonia-related AB bacteremia. The multivariate logistic regression analysis revealed that recent surgery (within 1 mo) [P = 0.043; 0.306 (0.098–0.962)] and invasive interventions (n > = 3 types) [P = 0.021; 0.072 (0.008–0.671)] were independent risk factors related to pneumonia-related AB bacteremia. Multivariate logistic regression analysis revealed that length of ICU stay prior to culture [P = 0.009; 0.959 (0.930–0.990)] and recent surgery (within 1 mo) [P = 0.004; 0.260 (0.105–0.646)] were independent risk factors for mortality in patients with pneumonia-related AB bacteremia. The Kaplan‒Meier curve and the timing test showed that patients with pneumonia-related AB bacteremia had shorter survival time compared to those with nonpneumonia-related AB bacteremia.

Conclusions

Our study found that A. baumannii had a high rate of antibiotic resistance in vitro in the pneumonia-related bacteremia group, and was only sensitive to polymyxin. Recent surgery was a significantly independent predictor in patients with pneumonia-related AB bacteremia.
Health education to promote knowledge about sickle cell disease and newborn screening in pregnant women: a community-based pilot study using the healthy beginning initiative
Authors: Ezenwosu Osita U. , Olawepo John O. , Lacroix-Willliamson Lorraine J. , Itanyi Ijeoma U. , Ogidi Amaka , Onyeka Tonia C. , Gully Madeline , Gregory Maisha , Breeze Janis L. , Ibemere Stephanie , Idemili-Aronu Ngozi , Molnar Beth E. , Ezeanolue Echezona E.
Published: April 2024

Background

Pregnancy presents a critical period for any maternal and child health intervention that may impact the health of the newborn. With low antenatal care attendance by pregnant women in health facilities in Nigeria, community-based programs could enable increased reach for health education about sickle cell disease (SCD) and newborn screening (NBS) among pregnant women. This pilot study aimed to assess the effect of education on the knowledge about SCD and NBS among pregnant women using the Healthy Beginning Initiative, a community-based framework.

Methods

A pre-post study design was used to evaluate knowledge of SCD and NBS in a convenience sample of 89 consenting pregnant women from three communities. Participants were given surveys prior to and following completion of a health education session. McNemar’s test was used to compare the proportion of participants with correct responses. The level of significance was taken as p < 0.05.

Results

Compared to pre-test values, post-test values showed that participants understood that SCD is hereditary (93.3% vs. 69.7%), both parents must have at least one gene for someone to have SCD (98.9% vs. 77.5) and blood test is the right way to know if one has SCD (98.8% vs. 78.7%). Also, a large proportion of participants (post-test ~ 89.9%; compared to pre-test ~ 23.6%) understood that the chance of conceiving a child with SCD was 25% for a couple with the sickle cell trait (SCT). Knowledge of the possibility of diagnosing SCD shortly after birth was highly increased in the post test phase of the study when compared to the pre-test phase (93.3% vs. 43.9%, respectively). Concerning the overall knowledge scores, those with high level of knowledge significantly increase from 12.6% pretest to 87.4% posttest (p = 0.015).

Conclusion

The health education intervention was associated with significant improvement on almost all measures of SCD knowledge. Focused health education for pregnant women using community structures can improve knowledge of SCD and NBS.
Emergency cervical cerclage in delayed-interval delivery of twin pregnancies: a scoping review
Authors: Cui Hong , Li Huan , Yin Zhihua
Published: April 2024

Background

The protocol for delayed-interval delivery of the second twin in twin pregnancies has not been standardized. Cervical cerclage is often performed, but its use is debated. To conduct a scoping review on cervical cerclage for prolonging the intertwin delivery interval and improving second twin survival and maternal outcomes after preterm delivery or spontaneous abortion of the first twin in twin pregnancies.

Methods

Seven Chinese and English language databases were searched from inception to March 1, 2023, including PubMed, The Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP Chinese Science Journal Database, and Sinomed. Relevant observational studies that assessed the effectiveness of the use of cervical cerclage in delayed-interval delivery of twins were screened and selected, and raw data were extracted, and descriptive statistics and chi-square analysis were performed.

Results

A total of 102 articles were retrieved. After screening and exclusion of duplicate and irrelevant articles, 22 articles meeting the inclusion criteria were obtained. Studies in which cerclage was performed reported longer intertwin delivery intervals than those that did not perform cerclage, and the difference was statistically significant. The cerclage group also tended to have lower rates of chorioamnionitis and maternal complications, but the difference between the two groups was not statistically significant.

Conclusion

After excluding patients with contraindications, emergency cervical cerclage can be considered in cases of spontaneous abortion of the first twin in twin pregnancies to prolong the gestation and improve the prognosis of the remaining fetus until it becomes viable and increases its birth weight.
Hematological, clinical, cytogenetic and molecular profiles of confirmed chronic myeloid leukemia patients at presentation at a tertiary care teaching hospital in Addis Ababa, Ethiopia: a cross-sectional study
Authors: Urgessa Fekadu , Lengiso Boki , Tsegaye Aster , Gebremedhin Amha , Abdella Fozia , Tadesse Fisihatsion , Radich Jerald , Nigussie Helen , Kuru Gerbaba Teklu
Published: April 2024

Background

In low-income countries there is insufficient evidence on hematological, clinical, cytogenetic and molecular profiles among new CML patients. Therefore, we performed this study among newly confirmed CML patients at Tikur Anbesa Specialized Hospital (TASH), Ethiopia.

Objective

To determine the hematological, clinical, cytogenetic and molecular profiles of confirmed CML patients at tertiary care teaching hospital in Addis Ababa, Ethiopia.

Methods

A facility-based cross-sectional study was conducted to evaluate hematological, clinical, cytogenetic and molecular profiles of confirmed CML patients at TASH from August 2021 to December 2022. A structured questionnaire was used to collect the patients’ sociodemographic information, medical history and physical examination, and blood samples were also collected for hematological, cytogenetic and molecular tests. Descriptive statistics were used to analyze the sociodemographic, hematological, clinical, cytogenetic and molecular profiles of the study participants.

Results

A total of 251 confirmed new CML patients were recruited for the study. The majority of patients were male (151 [60.2%]; chronic (CP) CML, 213 [84.7%]; and had a median age of 36 years. The median (IQR) WBC, RBC, HGB and PLT counts were 217.7 (155.62–307.4) x103/µL, 3.2 (2.72–3.6) x106/µL, 9.3 (8.2–11) g/dl and 324 (211–499) x 103/µL, respectively. All patients had leukocytosis, and 92.8%, 95.6% and 99.2% of the patients developed anemia, hyperleukocytosis and neutrophilia, respectively. Fatigue, abdominal pain, splenomegaly and weight loss were the common signs and symptoms observed among CML patients. Approximately 86.1% of the study participants were Philadelphia chromosome positive (Ph+) according to fluorescence in situ hybridization (FISH). P210, the major breakpoint protein, transcript was detected by both qualitative polymerase chain reaction (PCR) and quantitative real time polymerase chain reaction (PCR).

Conclusion

During presentation, most CML patients presented with hyperleukocytosis, neutrophilia and anemia at TASH, Addis Ababa. Fatigue, abdominal pain, splenomegaly and weight loss were the most common signs and symptoms observed in the CML patients. Most CML patients were diagnosed by FISH, and p120 was detected in all CML patients diagnosed by PCR. The majority of CML patients arrive at referral center with advanced signs and symptoms, so better to decentralize the service to peripheral health facilities.