bluuebunny/crossref_metadata_2025 huggingface dataset:
FIGURE 4 from Metastatic Competency and Tumor Spheroid Formation Are Independent Cell States Governed by RB in Lung Adenocarcinoma
Authors: Freeburg Nelson F. , Peterson Nia , Ruiz Dain A. , Gladstein Amy C. , Feldser David M.
Published: October 2023

Spheroid formation represents a distinct cell state from metastatic competency. A, Principal component analysis plot for eight KP;RbTR/TR tumor spheroid lines, colored by metastatic competency group membership. Red dots are members of Group 1, and blue dots are members of Group 2. Percentage values represent the percent of variation among samples represented by a given axis. B, Volcano plot of gene expression differences between metastatic competency groups. Each dot represents a gene, and colored dots are members of gene expression signatures representing each group. Red dots are members of the Group 1 gene expression signature, and blue dots are members of the Group 2 gene expression signature. C, Expression of key metastatic competency-related genes in each group. Gene expression is measured as TMM-normalized CPM. D, Contingency analysis of the number of mice injected with tumor spheroid single-cell suspensions which developed tumors after 6 weeks. Statistical significance was assessed by χ2 test. For both groups, n = 8 mice. E, Representative images and lung sections stained with hematoxylin and eosin from D. Lung section images were taken with a Leica DMI6000 using a 5X objective. White asterisks mark surface tumors.
Immune-related Adverse Events after Immune Checkpoint Blockade–based Therapy Are Associated with Improved Survival in Advanced Sarcomas
Authors: Rosenbaum Evan , Seier Kenneth , Bradic Martina , Kelly Ciara , Movva Sujana , Nacev Benjamin A. , Gounder Mrinal M. , Keohan Mary L. , Avutu Viswatej , Chi Ping , Thornton Katherine A. , Chan Jason E. , Dickson Mark A. , Donoghue Mark T.A. , Tap William D. , Qin Li-Xuan , D'Angelo Sandra P.
Published: October 2023

The association between immune-related AEs (irAE) and outcome in patients with sarcoma is not known. We retrospectively reviewed a cohort of patients with advanced sarcoma treated with immune checkpoint blockade (ICB)-based therapy. Association of irAEs with survival was assessed using a Cox regression model that incorporated irAE occurrence as a time-dependent covariate. Tumor samples with available RNA sequencing data were stratified by presence of an irAE to identify patterns of differential gene expression. A total of 131 patients were included. Forty-two (32%) had at least one irAE of any grade and 16 (12%) had at least one grade ≥ 3 irAE. The most common irAEs were hypothyroidism (8.3%), arthralgias (5.3%), pneumonitis (4.6%), allergic reaction (3.8%), and elevated transaminases (3.8%). Median progression-free survival (PFS) and overall survival (OS) from the time of study entry were 11.4 [95% confidence interval (CI), 10.7–15.0) and 74.6 weeks (CI, 44.9–89.7), respectively. On Cox analysis adjusting for clinical covariates that were significant in the univariate setting, the HR for an irAE (HR, 0.662; CI, 0.421–1.041) approached, but did not reach statistical significance for PFS (P = 0.074). Patients had a significantly lower HR for OS (HR, 0.443; CI, 0.246–0.798; P = 0.007) compared with those without or before an irAE. Gene expression profiling on baseline tumor samples found that patients who had an irAE had higher numbers of tumor-infiltrating dendritic cells, CD8+ T cells, and regulatory T cells as well as upregulation of immune and inflammatory pathways.

Significance:

irAE after ICB therapy was associated with an improved OS; it also approached statistical significance for improved PFS. Patients who had an irAE were more likely to have an inflamed tumor microenvironment at baseline.
Delegation of Legislative Power between Levels of Government in Nigeria and Kenya
Authors: Adigun Muyiwa
Published: October 2023

The concept of delegated legislation has always been examined between three arms of government. However, the concept has not been seriously addressed between levels of government. This study therefore seeks to examine the concept of delegated legislation between levels of government in Nigeria and Kenya. The study finds that in both Nigeria and Kenya, the concept of delegated legislation within levels of government has not been seriously explored and that in both countries, there is ethnic tension and the need for devolution of power. The study therefore argues that delegated legislation between levels of government if carefully managed may be used to achieve devolution of power and douse ethnic tension in Nigeria and Kenya. The study concludes that Nigeria and Kenya should explore the concept of delegated legislation at levels of government.
A review and analysis of the use of epithets in infrageneric, species, and infraspecific names in Kalanchoe (Crassulaceae subfam. Kalanchooideae): trends in the plant naming game
Authors: SMITH GIDEON F. , FIGUEIREDO ESTRELA
Published: October 2023

Given recent wide-ranging international debates in the scientific press and on social media platforms on, especially, aspects of the ethics of historically published and currently used biological nomenclature, an analysis is presented of trends in the use of epithets in the scientific names of Kalanchoe taxa (Crassulaceae subfam. Kalanchooideae). Kalanchoe, in which about 200 taxa are recognised at various taxonomic ranks, has a wide natural geographical distribution range in Madagascar and on some Indian Ocean Islands, in southern, eastern, and northern Africa, and in the Near, Middle, and Far East. A comprehensive database of epithets published at infrageneric, species, and infraspecific ranks in Kalanchoe over a period of 270 years—1753 to the present—was compiled and analysed to establish tendencies in the selection of epithets. The 370 epithets published to date were classified under: (1) plant characteristics; (2) the celebration of people (eponyms); (3) place names (toponyms); and (4) ‘other’ (habitat features, an ethnic group, etc.). Names derived from plant characteristics are the most commonly used in the naming of kalanchoes. However, since the early 1900s and continuing to the present, naming taxa after people is the preferred option. Lists of gender-based eponymic, toponymic, and ‘other’ epithets, with their derivations, used in the validly published names of kalanchoes are provided. We point out that one epithet used in the genus is contentious. We briefly reflect on the derivation of the genus name Kalanchoe.
Taxonomic notes on some species of Campanula, sect. Oreocodon
Authors: ZERAATKAR AMIN , NASAB FARZANEH KHAJOEI
Published: October 2023

Based on detailed studies of the protologues, types, herbarium specimens, and comparison with living specimens, Campanula hystricula and C. escalerae are reduced under Asyneuma persicum and Campanula perpusilla, respectively. In this publication, we have provided sufficient morphological evidence for the separation of C. persepolitana and C. perpusilla species. In addition, the morphological descriptions are improved by us. The first photographic documentary on living plants and information about habitat, ecology, phenology, and notes on morphological affinities of C. persepolitana and C. perpusilla, are provided to help them better understand. Distribution maps of the species mentioned are also provided.
Pseudocyclosorus pubescens, the correct name for Pseudocyclosorus canus (Thelypteridaceae)
Authors: KOVALCHUK ANDRIY
Published: October 2023

N/A
A taxonomic study on the genus Stichillus (Diptera: Phoridae) from South Korea, with a key to species from East Asia
Authors: LEE JUN-HO , KIM SAM-KYU
Published: October 2023

The South Korean species of the genus Stichillus Enderlein are reviewed and four species are newly recognized. One of them, S. koreanus sp. nov., is described as new to science and the other three species, viz. S. cylindratus Nakayama & Shima, S. japonicus (Matsumura) and S. spinosus Liu & Chou are new to South Korea. Detailed descriptions with photographs of four Korean Stichillus species, and a revised key to males of ten species from East Asia except Mongolia and North Korea are provided.
A new species of Entomobrya Rondani, 1861 (Collembola, Entomobryidae, Entomobryinae) from Croatia with the redescription of Entomobrya margaretae Gruia, 1967
Authors: WINKLER DANIEL , GRUJIĆ NIKOLA Z. , FIERA CRISTINA
Published: October 2023

In the present paper, a new species of the genus Entomobrya is described from Croatia. E. silvicola sp. nov. has a unique colour pattern that distinguishes it from other Entomobrya species in Europe and worldwide. Besides the different colour pattern, there are notable differences in the dorsal macrochaetotaxy and other characters that distinguish the new species from the other Entomobrya sharing the same dorsal macrochaetotaxy formula of Abd II–III. Herein, we also provide the redescription of E. margaretae Gruia, 1967, based on topotypic specimens, of which a neotype was designated.
Institutionalization of public interest in planning: Evolving mechanisms of public representation in China’s urban regeneration policymaking
Authors: Zhao Nannan , Wang June , Liu Yuting
Published: October 2023

How to capture, represent, and materialize public interest in urban planning has gone through multiple rounds of experimentation, crystallizing a number of regulatory regimes of planning in different historical and political-economic contexts. However, how to define the “public” and capture the public interest in urban planning remains problematic in both planning practices and democratic theory. Therefore, drawing upon Dewey and Habermas’s view of the public sphere, this paper introduces a scale perspective to examine the subjects in planning and the power framing process in defining the public in urban regeneration policymaking. First, this paper revisits the current debates on the concept of public interest and identifies three interpretations of public interest materialization: utilitarian, unitary, and communicative. Second, this paper illustrates the institutionalization process of public interest in China’s urban planning system. We critically examine the evolving mechanisms of public representation in China’s urban regeneration policymaking since 1949. The institutionalization of public interest in China shows distinguished trajectories from the Western countries. These differences are caused by different values that define the scale of “public” in different socio-political contexts. Given the emerging communicative turn in China, we found a hybrid norm of public interest as reflected in the recent “co-production” model of urban regeneration. The contribution of this paper is threefold: 1) highlights the validity of the public interest concept by introducing a scale sensitivity to analyze the subjects in planning; 2) complements public interest typology by identifying a hybrid norm in China that weaves between unitary and communicative interpretations; 3) revisits Dewey’s democratization theory by conceptualizing the institutionalization of public interest in semi-authoritarian China that is determined across the scales of subjects in planning, the ever-changing political-economic contexts, and the planning application in established rules.
Therapeutic strategies to improve liver regeneration after hepatectomy
Authors: Jeong Hayeong , Lee Chanbin , Lee Min Jae , Jung Youngmi
Published: October 2023

Chronic liver disease is one of the most common diseases worldwide, and its prevalence is particularly high among adults aged 40–60 years; it takes a toll on productivity and causes significant economic burden. However, there are still no effective treatments that can fundamentally treat chronic liver disease. Although liver transplantation is considered the only effective treatment for chronic liver disease, it has limitations in that the pool of available donors is vastly insufficient for the number of potential recipients. Even if a patient undergoes liver transplantation, side effects such as immune rejection or bile duct complications could occur. In addition, impaired liver regeneration due to various causes, such as aging and metabolic disorders, may cause liver failure after liver resection, even leading to death. Therefore, further research on the liver regeneration process and therapeutic strategies to improve liver regeneration are needed. In this review, we describe the process of liver regeneration after hepatectomy, focusing on various cytokines and signaling pathways. In addition, we review treatment strategies that have been studied to date to improve liver regeneration, such as promotion of hepatocyte proliferation and metabolism and transplantation of mesenchymal stem cells. This review helps to understand the physiological processes involved in liver regeneration and provides basic knowledge for developing treatments for successful liver regeneration.
Participation of ASK-1 in the cardiomyocyte-protective role of mechanical ventilation in a rat model of myocardial infarction
Authors: Lai Jiying , Li Ailin , Yue Linlin , Zhong Huifeng , Xu Shuo , Liu Xin
Published: October 2023

Non-invasive positive-pressure ventilation (NIPPV) has been demonstrated to exhibit a cardioprotective function in a rat model of myocardial infarction (MI). However, the mechanism underlying NIPPV-mediated MI progression requires further investigation. We aimed to investigate the effectiveness and corresponding mechanism of NIPPV in an acute MI-induced heart failure (HF) rat model. Thirty each of healthy wild type (WT) and apoptosis signal-regulating kinase 1 (ASK-1)-deficient rats were enrolled in this study. MI models were established via anterior descending branch ligation of the left coronary artery. The corresponding data indicated that NIPPV treatment reduced the heart infarct area, myocardial fibrosis degree, and cardiac function loss in MI rats, and ameliorated apoptosis and reactive oxygen species (ROS) levels in the heart tissue. Furthermore, the expression level of ASK-1 level, a key modulator of the ROS-induced extrinsic apoptosis pathway, was upregulated in the heart tissues of MI rats, but decreased after NIPPV treatment. Meanwhile, the downstream cleavage of caspase-3, caspase-9, and PARP, alongside p38 phosphorylation and FasL expression, exhibited a similar trend to that of ASK-1 expression. The involvement of ASK-1 in NIPPV-treated MI in ASK-1-deficient rats was examined. Although MI modeling indicated that cardiac function loss was alleviated in ASK-1-deficient rats, NIPPV treatment did not confer any clear efficiency in cardiac improvement in ASK-1-knockdown rats with MI modeling. Nonetheless, NIPPV inhibited ROS-induced extrinsic apoptosis in the heart tissues of rats with MI by regulating ASK-1 expression, and subsequently ameliorated cardiac function loss and MI-dependent pathogenic changes in the heart tissue.
Plasmodium vivax transcriptomics: What is new?
Authors: Ferraboli Julia Weber , Soares da Veiga Gisele Tatiane , Albrecht Letusa
Published: October 2023

Malaria is the leading human parasitosis and is transmitted through the bite of anopheline mosquitoes infected with parasites of the genus Plasmodium spp. Among the seven species that cause malaria in humans, Plasmodium vivax is the most prevalent species in Latin America. In recent years, there have been an increasing number of reports of clinical complications caused by P. vivax infections, which were previously neglected and underestimated. P. vivax biology remains with large gaps. The emergence of next-generation sequencing technology has ensured a breakthrough in species knowledge. Coupled with this, the deposition of the P. vivax Sal-1 reference genome allowed an increase in transcriptomics projects by accessing messenger RNA. Thus, the regulation of differential gene expression according to the parasite life stage was verified, and several expressed genes were linked to different biological functions. Today, with the progress associated with RNA sequencing technologies, it is possible to detect nuances and obtain robust results. Discoveries provided by transcriptomic studies allow us to understand topics such as RNA expression and regulation and proteins and metabolic pathways involved during different stages of the parasite life cycle. The information obtained enables a better comprehension of immune system evasion mechanisms; invasion and adhesion strategies used by the parasite; as well as new vaccine targets, potential molecular markers, and others therapeutic targets. In this review, we provide new insights into P. vivax biology by summarizing recent findings in transcriptomic studies.
Circulating H-FABP as a biomarker of frailty in patients with chronic heart failure
Authors: Ahmad Firdos , Karim Asima , Khan Javaidullah , Qaisar Rizwan
Published: October 2023

Increased vulnerability to physiologic stressors, termed frailty, is a common occurrence in patients with chronic heart failure (CHF). However, the definite biomarkers to assess frailty in CHF patients are not known. Here, we assessed the frailty phenotype and its potential association with heart failure (HF) markers in CHF patients. We categorized controls ( n = 59) and CHF patients ( n = 80), the participants, into robust, pre-frail, and frail based on the cardiovascular health study (CHS) frailty index. The plasma levels of HF markers, including tumorigenicity 2 (s-ST2), galectin-3, and heart-type fatty acid binding protein (H-FABP), were measured and correlated with frailty phenotype and cardiac function. The levels of plasma s-ST2, galectin-3, and H-FABP were profoundly elevated in CHF patients. Conversely, the frailty index scores were significantly lower in ischemic and non-ischemic CHF patients versus controls. Of the assessed HF markers, only H-FABP was positively correlated ( r2 = 0.07, P = 0.02) with the frailty score in CHF patients. Collectively, these observations suggest that circulating H-FABP may serve as a biomarker of frailty in CHF patients.
Interpreting single-step genomic evaluation as a neural network of three layers: pedigree, genotypes, and phenotypes
Authors: Zhao Tianjing , Cheng Hao
Published: October 2023

The single-step approach has become the most widely-used methodology for genomic evaluations when only a subset of phenotyped individuals in the pedigree are genotyped, where the genotypes for non-genotyped individuals are imputed based on gene contents (i.e., genotypes) of genotyped individuals through their pedigree relationships. We proposed a new method named single-step neural network with mixed models (NNMM) to represent single-step genomic evaluations as a neural network of three sequential layers: pedigree, genotypes, and phenotypes. These three sequential layers of information create a unified network instead of two separate steps, allowing the unobserved gene contents of non-genotyped individuals to be sampled based on pedigree, observed genotypes of genotyped individuals, and phenotypes. In addition to imputation of genotypes using all three sources of information, including phenotypes, genotypes, and pedigree, single-step NNMM provides a more flexible framework to allow nonlinear relationships between genotypes and phenotypes, and for individuals to be genotyped with different single-nucleotide polymorphism (SNP) panels. The single-step NNMM has been implemented in the software package “JWAS’.
Genome-wide identification, comparative analysis and functional roles in flavonoid biosynthesis of cytochrome P450 superfamily in pear (Pyrus spp.)
Authors: Zhang Wei , Li Hongxiang , Li Qionghou , Wang Zewen , Zeng Weiwei , Yin Hao , Qi Kaijie , Zou Ying , Hu Jian , Huang Baisha , Gu Peng , Qiao Xin , Zhang Shaoling
Published: October 2023

Background

The cytochrome P450 (CYP) superfamily is the largest enzyme metabolism family in plants identified to date, and it is involved in many biological processes, including secondary metabolite biosynthesis, hormone metabolism and stress resistance. However, the P450 gene superfamily has not been well studied in pear (Pyrus spp.).

Results

Here, the comprehensive identification and a comparative analysis of P450 superfamily members were conducted in cultivated and wild pear genomes. In total, 338, 299 and 419 P450 genes were identified in Chinese white pear, European pear and the wild pear, respectively. Based on the phylogenetic analyses, pear P450 genes were divided into ten clans, comprising 48 families. The motif and gene structure analyses further supported this classification. The expansion of the pear P450 gene family was attributed to whole-genome and single-gene duplication events. Several P450 gene clusters were detected, which have resulted from tandem and proximal duplications. Purifying selection was the major force imposed on the long-term evolution of P450 genes. Gene dosage balance, subfunctionalization and neofunctionalization jointly drove the retention and functional diversification of P450 gene pairs. Based on the association analysis between transcriptome expression profiles and flavonoid content during fruit development, three candidate genes were identified as being closely associated with the flavonoid biosynthesis, and the expression of one gene was further verified using qRT-PCR and its function was validated through transient transformation in pear fruit.

Conclusions

The study results provide insights into the evolution and biological functions of P450 genes in pear.
The role of apheresis and insulin therapy in hypertriglyceridemic acute pancreatitis—a concise review
Authors: Gubensek Jakob
Published: October 2023

Severe hypertriglyceridemia (HTG) is the third most common cause of acute pancreatitis (AP) and is involved in its pathogenesis. Chylomicrons increase blood viscosity and induce ischemia, while free fatty acids induce inflammation and distant organ damage. Conservative treatment options include fasting and insulin; limited evidence shows their comparable efficacy. Plasma exchange might provide more rapid lowering of triglycerides and amelioration of systemic effects of severe AP. Available data from controlled studies show only moderately faster lowering of triglycerides with apheresis (about 70% vs. 50% with conservative treatment within 24 h) and limited data from non-randomized studies show no improvement in clinical outcomes. New evidence is expected soon from ongoing large randomized trials. Until then, insulin may be used in mild HTG-AP and plasma exchange should be considered only in severe HTG-AP, especially if the decline of triglycerides with conservative treatment is slow, and in HTG-AP during pregnancy.
Risk assessment of rectal anastomotic leakage (RAREAL) after DIXON in non-emergency patients with rectal cancer
Authors: Zheng Xue-Cong , Su Jin-Bo , Zheng Jin-Jie
Published: October 2023

Background

The routine establishment of a diverting stoma (DS) remains controversial in every patient undergoing Dixon operation. We aimed to establish a model for the risk assessment of rectal anastomotic leak (RAREAL) after Dixon in non-emergency patients with rectal cancer, using routinely available variables, by which surgeons could individualize their approach to DS.

Methods

323 patients who underwent Dixon operation for rectal cancer from January 2015 to December 2018 were taken as the model group for retrospective study. Univariable and multivariable logistic regression analysis was used to determine the independent risk factors associated with anastomotic leakage. We constructed the RAREAL model. 150 patients who underwent Dixon operation due to rectal cancer from January 2019 to December 2020 were collected according to the uniform criteria as a validation group to validate the RAREAL model.

Results

In the model group, multivariable analysis identified the following variables as independent risk factors for AL: HbA1c (odds ratio (OR) = 4.107; P = 0.044), Left colic artery (LCA) non preservation (OR = 4.360; P = 0.026), Tumor distance from the anal margin (TD) (OR = 6.373; P = 0.002). In the model group, the area under the curve (AUC) of the receiver operating characteristic (ROC) for evaluating AL with RAREAL was 0.733, and when RAREAL score = 2.5, its sensitivity, specificity and Youden index were 0.385, 0.973, 0.358, respectively. The AUC was 0.722 in the validation group and its sensitivity and specificity were 0.333 and 0.985, respectively, when RAREAL score = 2.5.

Conclusion

The RAREAL score can be used to assess the risk of AL after Dixon operation for rectal cancer, and prophylactic DS should be proactively done when the score is greater than 2.5.
Leptospirosis in humans and selected animals in Sub-Saharan Africa, 2014–2022: a systematic review and meta-analysis
Authors: Gizamba Jacob Mugoya , Mugisha Lawrence
Published: October 2023

Background

Leptospirosis is an emerging neglected tropical zoonotic disease of public health importance causing substantial morbidities and mortalities among humans. The infection is maintained within the population through interactions between humans, animals, and the environment. Understanding the burden of disease in both humans and animals is necessary for effective prevention and control in Sub-Saharan Africa (SSA). Therefore, we aimed to determine the seroprevalence of leptospirosis in humans, selected domestic animals, and rodents in SSA.

Methods

A comprehensive search was done in six databases: Scopus, PubMed, Google Scholar, CINAHL, Web of Science, and African Journals Online databases for articles published between 01 January 2014 and 30 August 2022. Thirty-seven articles distributed across 14 out of 46 countries in SSA were included. The random effects meta-analysis model was used to pool the extracted seroprevalence data.

Results

The overall pooled seroprevalence of leptospirosis among humans was 12.7% (95% CI: 7.5,20.8), 15.1% (95% CI: 9.4,23.5), and 4.5% (95% CI: 0.4, 35.6) based on results obtained using ELISA, MAT, and PCR diagnostic methods respectively. The pooled seroprevalence estimates among cattle were 29.2%, 30.1%, and 9.7% based on ELISA, MAT, and PCR respectively. Further, the pooled seroprevalence in goats was 30.0% for studies that used MAT, and among rodents, the pooled seroprevalence estimates were 21.0% for MAT and 9.6% for PCR diagnostic criteria. The seroprevalence of leptospirosis varied extensively between studies, across SSA regions and study setting (rural or urban).

Conclusion

Leptospirosis is widespread in SSA in both humans and animals based on the current results of the pooled seroprevalence in the limited studies available. The burden is high in animals and humans and underestimated due to limited studies and challenges with limited diagnostic capacity in most healthcare settings in SSA. Hence, we recommend that leptospirosis should be listed as a disease of concern and be included on the list of routine diagnostics among patients presenting with febrile illness in healthcare settings. Further, we recommend the enhancement of surveillance of leptospirosis in all countries in SSA and the development of strategies with a One Health perspective to effectively prevent and control leptospirosis.
Community-associated methicillin-resistant Staphylococcus aureus infection of diabetic foot ulcers in an eastern diabetic foot center in a tertiary hospital in China: a retrospective study
Authors: Chen Yixin , Yang Jie , Wang Ying , You Jiaxing , Zhu Weifen , Liu Chao , Luan Yi , Li Lin , Li Hong
Published: October 2023

Background

Diabetic foot concerns are a major public health problem. Methicillin-resistant Staphylococcus aureus (MRSA) plays a significant role in diabetic foot ulcers. Community-associated MRSA has become notorious for skin and skin soft tissue infections over the last two decades. This study investigated MRSA infection in diabetic foot patients at a tertiary hospital, focusing on the epidemiology and characteristics of community-associated MRSA.

Methods

A total of 149 patients with diabetic foot infection whose culture results indicated Staphylococcus aureus as the source were selected. Epidemiological investigations, clinical characteristics, laboratory index records, antibiotic susceptibility analysis, and clinical outcome tracking were performed in all cases. Based on oxacillin resistance using the Vitek Compact 2 system, cases were divided into methicillin-sensitive Staphylococcus aureus and MRSA groups. Subgroup analysis of the MRSA group was performed in accordance with the Centers for Disease Control definition: community-associated MRSA and hospital-associated MRSA.

Results

The MRSA group (n = 41, 27.5%) had a longer duration of ulcers and hospital stay and higher hospitalization costs than the methicillin-sensitive Staphylococcus aureus group (n = 108, 72.5%). According to the classification criteria of Infectious Diseases Society of America, the severity of infection in the community-associated MRSA group was higher than that in the hospital-associated MRSA group. The analysis of antimicrobial susceptibility of 41 MRSA isolates showed that the resistance rates to erythromycin, clindamycin, quinolone, gentamicin, tetracycline, and rifampicin were 78.0%, 68.3%, 31.7%, 17.1%, 9.8%, and 2.4%, respectively. All the MRSA strains were sensitive to linezolid, tigecycline, and vancomycin. The resistance rates to quinolones and gentamycin in the community-associated MRSA group (both 0%) were lower than those in the hospital-associated MRSA group.

Conclusion

Emergence of MRSA in diabetic foot ulcer was associated with a prolonged wound duration and increased consumption of medical resources. Community-associated MRSA strains predominated among MRSA isolates from diabetic foot wounds and caused more severe infections.
A case report of reversible cerebral vasoconstriction syndrome with thunderclap headache significantly exacerbated in the supine position and alleviated in the standing position
Authors: Toyama Genri , Tsuboguchi Shintaro , Igarashi Kazuya , Saji Etsuji , Konno Takuya , Onodera Osamu
Published: October 2023

Background

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by sudden onset thunderclap headache and multiple segmental reversible cerebral vasoconstrictions that improve within 3 months. The postpartum period is a well-known precipitating factor for the onset of RCVS. Cerebral venous thrombosis (CVT) causes thunderclap headaches in the postpartum period. While headache in CVT is sometimes exacerbated in the supine position, the severity of the headache in RCVS is usually independent of body position. In this study, we report a case of RCVS with thunderclap headache exacerbated in the supine position, and headache attacks that resolved quickly in the standing position during the postpartum period.

Case presentation

A 33-year-old woman presented with a sudden increase in blood pressure and thunderclap headache on the fifth postpartum day (day 1: the first sick day). The headache was severe and pulsatile, with onset in the supine position in bed, and peaked at approximately 10 s. It was accompanied by nausea and chills but there were no scintillating scotomas or ophthalmic symptoms. The headache resolved in the standing or sitting position but was exacerbated and became unbearable within a few seconds when the patient was in the supine position. Therefore, she was unable to lie supine at night. Computed tomography angiography (CTA) of the head on day 2 and magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) on day 3 showed no abnormalities. However, considering the possibility of RCVS, verapamil was initiated on day 3. The headache resolved the following day. MRA of the head on day 10 revealed diffuse and segmental stenoses in the bilateral middle and posterior cerebral arteries and basilar artery. Therefore, the patient was diagnosed with RCVS. The headache gradually resolved and disappeared completely on day 42. Cerebral vasoconstriction was also improved on MRA on day 43.

Conclusions

This postpartum RCVS case was notable for the exacerbation of headaches in the supine position. For the diagnosis of thunderclap headache in the postpartum period, RCVS should be considered in addition to CVT when the patient presents with a headache that is exacerbated in the supine position.
The existential dimension of the experience of seclusion: a qualitative study among former psychiatric inpatients
Authors: Trapman Eva S. , Braam Arjan W.
Published: October 2023

Background

Seclusion is a coercive measure - temporary confinement in an almost empty, non-stimulating room in a closed psychiatric admission ward to prevent (further) urgent danger due to a mental disorder. Although there is observational research about patients’ behaviors during separation (e.g. hitting walls or doors, sleeping, or praying), research into the subjective and existential dimension of the experience of seclusion in psychiatry is rare.

Aim

Aim of the current study is to describe and analyze - using the theoretical lenses of Yalom (1980) and Jaspers (1919) - how clients experience their involuntary stay in a seclusion room in a closed psychiatric clinic in existential terms.

Methods

A qualitative study was carried out among former clients (N = 10) who were asked, in retrospect, about their existential concerns in the seclusion room. In the thematic analysis, the main, deductive codes were theory based (Yalom, Jaspers), composed of subcodes that were inductively derived from the interviews.

Results

The respondents affirmed the ultimate existential concerns about death (e.g. sensing to be dead already), lack of freedom (e.g. loss of agency), isolation (e.g. interpersonal, not able to speak, feeling an object) and meaninglessness. With respect to the latter, the respondents reported a rich variety of spiritual experiences (both negative, such as knowing to be in hell, as positive, hearing/imagining a comforting voice or noticing/imagining a scenery of nature in the room).

Discussion

Although some experiences and behaviors may conflate with symptoms of psychosis, the participants generally expressed a relief about the ability to talk about their experiences. Sharing and discussing the existential experiences fits into the paradigm of psychiatric recovery and personalized care. Their intensity was obvious and might have warranted additional support by a chaplain or spiritual counselor in mental health care settings.
Analyzing mechanisms of interdisciplinary cooperation in promoting students’ health at university
Authors: Bachert Philip , Wolbring Laura , Hildebrand Claudia , Woll Alexander , Wäsche Hagen
Published: October 2023

Background

Interdisciplinary cooperation among university actors and resulting intersectoral synergies are considered cornerstones in the process of incorporating health promotion practices in everyday university life in order to break down barriers and provide better access to health promotion services. To date, no network of a health-promoting university has been examined regarding the processes underlying tie formation, network emergence, and maintenance.

Objectives and methods

The goals of this study are to obtain insight into the mechanisms of cooperation between university actors in a health-promoting network and to identify the structural and attributive factors associated with establishing cooperation between actors in the observed network in order to better understand how to build and develop successful networks in the future. For this purpose, a social network analysis was carried out and exponential random graph models were estimated to test corresponding hypotheses.

Results

The network at hand consists of 33 actors (e.g. University Sports Center, General Student Committee) and shows a flat, non-hierarchical structure. Data reveal that attributed competence predicts cooperation (0.32; p < 0.05). Significant homophily effects among student actors (1.31; p < 0.05) and among university actors (0.59; p < 0.05) were found. All structural predictors examined were significant (0.22–5.40; p < 0.05) and are therefore essential in determining the likelihood of cooperation between actors involved in the network.

Conclusion

The results of this study provide for a better understanding of the mechanisms of cooperation and can be used to further develop the network at hand (e.g. selection of key actors for information dissemination or integration of peripheral actors). In addition, the findings offer starting points for sustained network development at other universities (e.g. significance of network governance form or goal consensus). Knowing the factors that influence the network structure, here the conditions of cooperation, results in opportunities to encourage empowerment among actors. However, the analysis of the network undertaken does not directly bear on the success of the network.
Stricter correction of leg length discrepancy is required during total hip arthroplasty in patients with ankylosing spondylitis
Authors: Im Chae-Jin , Lee Chan Young , Beom Jae Young , Kim Min-Gwang , Yoon Taek-Rim , Park Kyung-Soon
Published: October 2023

Background

Patients with ankylosing spondylitis often have fusions in the spine and sacroiliac joints, such that it is difficult to compensate for leg length discrepancy (LLD).

Methods

We retrospectively measured the LLD after total hip arthroplasty (THA) in 89 patients with ankylosing spondylitis from June 2004 to February 2021 at our institute. Patients were divided into two groups based on an LLD of 5 mm. Clinical outcomes were investigated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Harris Hip Score (HHS). In addition, these points are investigated: patient satisfaction with the operation; whether there was a current difference in leg length; and whether there was a limping gait.

Results

The group with an LLD of 5–10 mm rather than < 5 mm had significantly worse WOMAC pain and stiffness. The survey revealed statistically significant differences in patient satisfaction with the operation, limping gait, and whether back pain had improved.

Conclusion

For patients with ankylosing spondylitis, reducing the LLD to < 5 mm, which is more accurate than the current standard of < 10 mm, may produce greater improvement in clinical outcomes after hip arthroplasty.
Topical betamethasone and systemic colchicine for treatment of recurrent aphthous stomatitis: a randomised clinical trial
Authors: Alsahaf Surab , Alkurdi Khlood A. , Challacombe Stephen J. , Tappuni Anwar R.
Published: October 2023

Background

Recurrent Aphthous Stomatitis (RAS) is painful oral ulceration frequently treated with topical steroids. There is limited published evidence for the efficacy of any treatment for RAS and there remains a need for longitudinal randomised clinical trials to evaluate and compare the effectiveness of different therapies in the management of RAS. The aim of the current project was to assess the efficacy of betamethasone mouthwash and colchicine tablets, individually and combined, for the treatment of RAS, and to establish the optimum treatment period necessary for a significant reduction in the disease severity.

Methodology

A randomised, prospective, parallel-group clinical trial was conducted over one year, to compare the efficacy of three therapies in RAS. One hundred and six patients were randomized into three groups; 35 received betamethasone mouthwash, 35 had colchicine tablets and 36 received both therapies. The response was evaluated quantitatively every 3 months for 1 year, using the Ulcer Severity Score (USS).

Results

For all three treatment regimes, the mean USS decreased by about 30% in the first 3 months (p < 0.001). Further improvement was noted for up to 9 months. At the end of the study, the mean USS had improved by 50% from 34.9 ± 7.2 before treatment to 17.5 ± 8.9 after treatment (p < 0.001). Of included participants, 86% showed significant clinical improvement by the end of the study. There were no significant differences in outcomes between the three regimes (p < 0.05).

Conclusions

This clinical trial has provided evidence for the efficacy of betamethasone mouthwash and for colchicine tablets in the treatment of RAS and has shown that at least six months of treatment may be required for optimum effect.

Clinical trial registration number:

ISRCTN3267716. Date of clinical trial registration: 15/04/2018
Progress in transforming a health sciences postgraduate cohort in a south african research-intensive institution, 2008–2017
Authors: Meela Moraba , Kramer Beverley , Libhaber Elena
Published: October 2023

Background

Equity redress in the higher education and health sectors is a global discourse that seeks to address the inequalities caused by past discrimination practices. The apartheid regime in South Africa fragmented both the higher education and the health sectors, creating White and male dominated systems. Consequently, Black Africans and females were under-represented in these sectors. Furthermore, the provision of higher education including medical training was unequal between the different populations. As democracy was established in South Africa in 1994, it is necessary to assess whether transformation in population affinity and sex of postgraduate students in the higher education and health sector has occurred, as these individuals are crucial for providing the future academic workforce and also healthcare to the public.

Methods

The demographic profile of postgraduate students graduating in a health sciences facility in South Africa over the period 2008–2017 was retrospectively assessed. Survival analysis models were used to investigate the time taken to graduate. Log-rank tests were used to compare the completion rates.

Results

More females (53.3%) than males (41.9%) completed their postgraduate degree over the period 2008–2017 (p˂0.0001). In relation to population affinity, more White students (56.4%) than Black African students (40.8%) completed their degrees overall (p˂0.0001).

Conclusion

While transformation occurred in the sex of graduating students over the ten year period, the same change has not occurred with regards to population affinity. The under-representation of Black African graduates is a major setback for efforts to diversify the South African higher education and health sectors. Transformation of the demographic profile of postgraduate students at South African institutions is vital for developing individuals who will contribute to equitable redress of academic staff in the higher education sector and also of the healthcare workforce. Diversified health personnel including highly skilled clinician scientists will aid in improving the provision of health care to communities particularly the underpriviledged rural areas, and also assist in training the next generation of healthcare staff. The challenges identified in this study may assist other countries where adequate transformation of the education and health sectors has not occurred.
Assessment of nurse’s perceived just culture: a cross-sectional study
Authors: Logroño Kenneth Jun , Al-Lenjawi Badriya Abdulla , Singh Kalpana , Alomari Albara
Published: October 2023

Background

The non-punitive approach to error investigation in most safety culture surveys have been relatively low. Most of the current patient safety culture measurement tools also lack the ability to directly gauge concepts important to a just culture (i.e. perceptions of fairness and trust). The purpose of this study is to assess nurses’ perceptions of the six just culture dimensions using the validated Just Culture Assessment Tool (JCAT).

Methods

This descriptive, cross-sectional study was conducted between November and December 2020. Data from 212 staff nurses in a large referral hospital in Qatar were collected. A validated, self-reported survey called the JCAT was used to assess the perception of the just culture dimensions including feedback and communication, openness of communication, balance, quality of event reporting process, continuous improvement, and trust.

Results

The study revealed that the overall positive perception score of just culture was (75.44%). The strength areas of the just culture were “continuous improvement” dimension (88.44%), “quality of events reporting process” (86.04%), followed by “feedback and communication” (80.19%), and “openness of communication” (77.55%) The dimensions such as “trust” (68.30%) and “balance” (52.55%) had a lower positive perception rates.

Conclusion

A strong and effective just culture is a cornerstone of any organization, particularly when it comes to ensuring safety. It places paramount importance on encouraging voluntary error reporting and establishing a robust feedback system to address safety-related events promptly. It also recognizes that errors present valuable opportunities for continuous improvement. Just culture is more than just a no-blame practice. By prioritizing accountability and responsibility among front-line workers, a just culture fosters a sense of ownership and a commitment to improve safety, rather than assigning blame.
The role of bidirectional associations between depression, anxiety, and emotional exhaustion on turnover intention among nurses: a multicenter cross-sectional study in China
Authors: Qin Ning , Yao Ziqiang , Guo Meiying
Published: October 2023

Background

A high turnover rate in nursing has become a global concern. Mental health issues may increase the turnover intention of nurses and lead to turnover behaviors. However, very little is known about the role of bidirectional associations between emotional exhaustion and depression/anxiety on turnover intention. This study aimed to examine the associations among depression, anxiety, emotional exhaustion and turnover intention, and to test the role of bidirectional associations between depression, anxiety, and emotional exhaustion on turnover intention among nurses.

Methods

An online multicenter cross-sectional study was conducted in Hunan Province, China, from December 2021 to February 2022. The questionnaire collected data from the Turnover Intention Scale, the Emotional Exhaustion Scale, the Patient Health Questionnaire-2, and the Generalized Anxiety Disorder Scale-2, as well as sociodemographic information. Data analysis was performed by univariate analysis, Pearson correlation analysis, multiple linear regression analysis, and structural equation modeling.

Results

The average turnover intention score among Chinese nurses was 14.34 ± 3.75. The prevalence of depression and anxiety was 25.9% and 22.3%, respectively. Depression (r = 0.378, P < 0.001), anxiety (r = 0.391, P < 0.001), and emotional exhaustion (r = 0.532, P < 0.001) were positively associated with turnover intention. Emotional exhaustion partially mediated the associations between depression/anxiety and turnover intention, with both mediating effects accounting for 60.7%. The mediating ratios of depression/anxiety on the associations between emotional exhaustion and turnover intentions were 17.6% and 16.5%, respectively.

Conclusions

Depression, anxiety, and emotional exhaustion showed significant positive effects on turnover intention among nurses. Emotional exhaustion played a partial mediation role between depression/anxiety and turnover intention, while depression/anxiety played no significant mediation role between emotional exhaustion and turnover intention.