bluuebunny/crossref_metadata_2025 huggingface dataset:
Displaced AICD Lead Presenting as Hiccups: A Rare Complication
Authors: Sandhu Michael , Abuzuaiter Basel , Dhand Rajat , Rao Suman , Chaudhuri Debanik
Published: June 2022

Ventricular fibrillation can lead to sudden cardiac death. Automatic implantable cardioverter defibrillator (AICD) devices have shown to be highly successful in the termination of these arrhythmias and are a first-line modality of treatment for the prevention of sudden cardiac death. We present the case of a 69-year-old female with a history of paroxysmal atrial fibrillation on anticoagulation with apixaban and rate controlled with metoprolol who presented from home with a chief complaint of hiccups. She had a prior admission to the hospital after she was found to have monomorphic ventricular tachycardia during a nuclear stress test. A cardiac work-up including cardiac catheterization and cardiac magnetic resonance imaging did not show any evidence of significant coronary artery disease or reversible cardiomyopathy. The patient underwent successful placement of a single chamber ICD and was discharged home. Twelve weeks after placement of the AICD, the patient was lifting furniture and experienced sudden onset of hiccups. A chest X-ray showed displacement of the AICD lead from the right ventricular apex to the superior vena cava. The patient underwent lead repositioning with complete resolution of her hiccups. The etiology hiccups was suspected to be secondary to irritation of the right phrenic nerve which travels along the anterolateral border of the superior vena cava. We present the case of hiccups following ICD lead displacement. This serves to highlight a rare complication of ICD displacement that healthcare providers should consider when patients with recently placed ICD devices complain of hiccups.
The Pain of Staying Alert: A Case Report and Literature Review on Energy Drink–Induced Acute Pancreatitis
Authors: Randhawa Navkiran , Shah Misha , Spyratos Tilemahos
Published: June 2022

Energy drink consumption has increased over the past decade. It is associated with several common side effects including diarrhea, heartburn, and dyspepsia. Energy drinks have been proposed as a rare but potential cause of acute pancreatitis. This paper investigates a unique case of energy drink–induced pancreatitis and further explores current literature on this topic. This study stresses the importance of asking all patients presenting with acute pancreatitis about their daily energy drink consumption, especially if the cause is unknown.
Measuring urban nighttime vitality and its relationship with urban spatial structure: A data-driven approach
Authors: Wu Chao , Zhao Minwei , Ye Yu
Published: June 2022

Nighttime vitality has garnered attention in recent years as an important indicator reflecting urban economy and quality of life. However, it is difficult to characterize this intangible issue. As a response, this study employed a data-driven approach to measure nighttime vitality and explored its relationships with urban spatial structure. Specifically, the data from Meituan.com—the largest Chinese shopping platform for local consumer products and retail services—were used to measure nighttime vitality based on a hierarchical weighting method. Multidimensional characteristics of the urban spatial structure were evaluated. Spatial regression models were conducted on the effect analysis of urban spatial structure on nighttime vitality. Relationship estimations were statistically significant with indicators, such as block functions, building density, interaction density, enclosure of locals, and the age structure of the main population. Our findings provide a more complete understanding of nighttime vitality, which is often overlooked in urban vitality studies. Insights derived from this study could help formulate spatial strategies to enhance nighttime vitality and quality of life.
Book review: Rup Kumar Barman, Paribarta Anusandhan: Rashtra, Nagarikatta, Bastuchyuti O Itihascharcha
Authors: Mukherjee Partha
Published: June 2022

Rup Kumar Barman, Paribarta Anusandhan: Rashtra, Nagarikatta, Bastuchyuti O Itihascharcha. Gangchil, 2022, 170 pp. ₹450 (Hardback), ISBN: 978-93-93569-38-7.
Optimal Device and Regimen of Nasal Saline Treatment for Sinonasal Diseases: Systematic Review
Authors: Chitsuthipakorn Wirach , Kanjanawasee Dichapong , Hoang Minh P. , Seresirikachorn Kachorn , Snidvongs Kornkiat
Published: June 2022

Objective

This review aimed to systematically determine the optimal nasal saline regimen for different types of sinonasal diseases.

Data Sources

PubMed, Embase, SCOPUS, Cochrane Library, Web of Science, ClinicalTrials.gov. The last search was on December 6, 2021.

Review Methods

Study selection was done by 2 independent authors. Randomized controlled trials and meta‐analyses were included. The effects of nasal saline treatment through various devices, saline tonicities, and buffer statuses were evaluated in patients with allergic and nonallergic rhinitis, acute and chronic rhinosinusitis (CRS), CRS with cystic fibrosis, and postoperative care, including septoplasty/turbinoplasty and endoscopic sinus surgery.

Results

Sixty‐nine studies were included: 10 meta‐analyses and 59 randomized controlled trials. For allergic rhinitis, large‐volume devices (≥60 mL) were effective for treating adults, while low‐volume devices (5‐59 mL) were effective for children. Isotonic saline was preferred over hypertonic saline due to fewer adverse events. For acute rhinosinusitis, saline irrigation was beneficial in children, but it was an option for adults. Large‐volume devices were more effective, especially in the common cold subgroup. For CRS, large‐volume devices were effective for adults, but saline drop was the only regimen that had available data in children. Buffered isotonic saline was more tolerable than nonbuffered or hypertonic saline. The data for CRS with cystic fibrosis and nonallergic rhinitis were limited. For postoperative care, buffered isotonic saline delivered by large‐volume devices was effective.

Conclusion

Nasal saline treatment is recommended for treating most sinonasal diseases. Optimal delivery methods for each condition should be considered to achieve therapeutic effects of saline treatment.
The scene and the unseen: Neglect and death in immigration detention and aged care
Authors: Loughnan Claire
Published: June 2022

Institutional confinement is paradoxically characterised by intense surveillance, while those confined are often rendered invisible as persons of value and agency. Our capacity to ‘see’ violence in such sites can also be harder to discern when it is the manifestation of neglect: not so much as mistreatment but untreatment, the failure to act. Drawing on Mbembe’s concept of necropolitics and Agamben's conceptualisation of the exception and abandonment, I propose that the deaths resulting from the untreated skin wounds of Annunziata Nancy Santoro, in aged care, and those of Hamid Khazaei, in immigration detention, are the effect of their location in what I call ‘zones of neglect’. Whether in places of care or punishment, neglect functions here as a form of power, in which responsibility for suffering paradoxically recedes from view. This analysis contributes to a growing body of research on quasi-carceral sites that sit uneasily along a continuum of care and control.
Post-COVID-19 related osteonecrosis of the jaw (PC-RONJ): an alarming morbidity in COVID-19 surviving patients
Authors: Al-Mahalawy Haytham , El-Mahallawy Yehia , Dessoky Noha Y. , Ibrahim Sally , Amer Hatem , Ayad Haytham Mohamed , El Sherif Hagar Mahmoud , Shabaan Alshaimaa Ahmed
Published: June 2022

Purpose

The recent coronavirus disease (COVID-19) pandemic mainly affects the respiratory system; however, several oral and maxillofacial post-COVID-19 complications have also been observed. This series reports the growing number of osteonecrosis cases associated with post-COVID-19 patients.

Materials and methods

This is a retrospective, multi-center case series that reports cases with maxillary osteonecrosis after various periods of SARS-CoV-2 infection in the period between January and August 2021 based on the PROCESS guidelines.

Results

Twelve cases were reported with post-COVID-19 manifestation of spontaneous osteonecrosis of the maxillary jaw. Five patients were hospitalized during COVID-19 management and all of the twelve cases had at least one systematic Co-morbidity, and undertake corticosteroids prescription based on the COVID-19 disease treatment protocol. The mean onset of osteonecrosis symptoms appearance was 5.5 ± 2.43 weeks calculated from the day of the negative PCR test. The management was successfully done through surgical debridement and pre and post-operative antibiotics. No anti-fungal medications were prescribed as the fungal culture and the histopathological report were negative.

Conclusion

Post-COVID-related osteonecrosis of the jaw (PC-RONJ) could be now considered as one of the potential post-COVID-19 oral and maxillofacial complications that occurs unprovokedly and mainly in the maxilla.
Prognostic factors and clinical efficacy of second-line treatments of Pneumocystis jirovecii pneumonia for non-HIV patients after first-line treatment failure
Authors: Liu Anlei , Sun Ruixue , Cao Guanghui , Liu Xiaohang , Zhu Huadong , Yang Jing
Published: June 2022

Background

Pneumocystis jirovecii pneumonia (PCP) is a life-threatening opportunistic infection. In non-HIV immunocompromised patients with PCP, a standard second-line treatment has not been established up to now.

Methods

Non-HIV immunocompromised patients with confirmed PCP between April 2013 and December 2020 were included. Their PCP treatment history was tracked. Factors related to first-line trimethoprim/sulfamethoxazole (TMP/SMX) and second-line treatment failure were identified. Different second-line treatment strategies were compared.

Results

Among the 220 patients, 127 (57.73%) did not respond to first-line TMP/SMX treatment. Risk factors related to treatment failure included symptom triad with breathlessness at rest, persistent fever and cough (85% in the treatment failure group versus 74% in the treatment success group, P = 0.034), treatment with invasive mechanical ventilation (67 vs. 19%, P < 0.001), coinfection with CMV (69 vs. 47%, P = 0.035), and bacteremia (59 vs. 10%, P < 0.001). A total of 49 patients received second-line treatment on the basis of TMP/SMX, and 28 (57.1%) of them responded to the treatment. No clinical parameter, including selection of different therapies, was found to be significantly associated with second-line treatment failure. Further, the prognosis of different second-line therapies showed no drug or drug combination strategy superior to others. The primaquine group had lower 90-day mortality rate (45.9%) but showed no statistically significant difference compared with the non-primaquine group (64.6%). The patients in the clindamycin plus primaquine group had the lowest in-hospital mortality rate (22.2%, P = 0.042) among different second-line therapies, although the in-hospital mortality of the primaquine group was not significantly different from that of the non-primaquine group. The differences in 28 day mortality and overall mortality rates were not statistically significant, too.

Conclusion

CMV infection and bacteremia were risk factors significantly associated with treatment failure of TMP/SMX. The response and survival rates of second-line treatment, including clindamycin, primaquine, and caspofungin, were poor, maybe clindamycin plus primaquine as second line treatment was better than other treatment strategies. These results suggest that clinicians should carefully evaluate whether the treatment of TMP/SMX has failed due to a coinfection rather than hastily changing to a second-line drug when the patient worsens.
Visual health and prevalence of dry eye syndrome among university students in Iraq and Jordan
Authors: Abdulmannan Dina M. , Naser Abdallah Y. , Ibrahim Omar khaleel , Mahmood Abdullah Shakir , Alyoussef Alkrad Jamal , Sweiss Kanar , Alrawashdeh Hamzeh Mohammad , Kautsar Angga Prawira
Published: June 2022

Dry eye syndrome (DES), is a multifactorial disease that affects the ocular surface and contributes to the ocular symptoms. The COVID-19 pandemic influenced the general population and university students' health in different ways. The pandemic forced many people including university students around the world to use virtual platforms on their digital devices, such as computers and smartphones, to work from a distance. This study aimed to explore the visual health and prevalence of dry eye syndrome among university students in Iraq and Jordan. This was a cross-sectional study that was conducted in Iraq and Jordan using online questionnaire tool for the duration between November 2021 and January 2022. University students in Jordan and Iraq were invited to participate in this study and formed the study population. No restrictions on study level or field of study were applied. A previously developed and validated questionnaire tools were used in this study (National Eye Institute Visual Functioning Questionnaire – 25 (VFQ-25) and the Women’s Health Study Questionnaire (WHS), which was developed by Schaumberg et al.). A total of 1,431 university students were involved in this study (1,018 students from Iraq, 71.1%). Around one third the study participants (29.0%) reported that have been diagnosed by a clinician as having dry eye syndrome. Around15.3% of the total study participants reported that they feel their eyes are dry (not wet enough) and 17.3% reported that they feel their eyes are irritated. Based on Women’s Health Study Questionnaire (WHS) criteria, a total of 479 participants (33.4%) are symptomatically diagnosed with DES. Students aged 27–29 years, those at their fifth year of study, and those who wear contact lenses are at higher risk of developing DYS compared to others. Dry eye syndrome is common health problem among university students. Further studies are required to identify other risk factors associated with DES. Future research should focus on identifying strategies that could help reduce the risk of developing DES as a result of the inevitability of long-term use of digital devices among many categories of society, including university students.
The use of digital stories as a health promotion intervention: a scoping review
Authors: Lohr Abby M. , Raygoza Tapia Jhenitza P. , Valdez Elizabeth Salerno , Hassett Leslie C. , Gubrium Aline C. , Fiddian-Green Alice , Larkey Linda , Sia Irene G. , Wieland Mark L.
Published: June 2022

Background

It is challenging to develop health promotion interventions created in collaboration with communities affected by inequities that focus beyond individual behavior change. One potential solution is interventions that use digital stories (DS).

Digital storytelling (DST) is an opportunity for reflection, connection with others, and the elevation of voices often absent from daily discourse. Consequently, public health researchers and practitioners frequently employ the DST workshop process to develop messaging that promotes health and highlights concerns in partnership with historically marginalized communities. With participants’ permission, DS can reach beyond the storytellers through behavior or attitude change interventions for health promotion among communities who share the targeted health concern. Our goal was to synthesize the literature describing interventions that use DS for health promotion to identify gaps.

Methods

We conducted a scoping review. Our inclusion criteria were articles that: 1) described empirical research; 2) used DS that were developed using the StoryCenter DST method; 3) assessed an intervention that used DS to address the health promotion of viewers (individuals, families, community, and/or society) impacted by the targeted health issue 4) were written in English or Spanish.

To synthesize the results of the included studies, we mapped them to the health determinants in the National Institute of Minority Health and Health Disparities (NIMHD) research framework. We assessed the number of occurrences of each determinant described in the results of each article.

Results

Ten articles met the eligibility criteria. All the included articles highlighted health equity issues. Our mapping of the articles with definitive results to the NIMHD research framework indicates that interventions that use DS addressed 17 out of 20 health determinants. All mapped interventions influenced intentions to change health behaviors (NIMHD level/domain: Individual/Behavioral), increased health literacy (Individual/Health Care System), and/or stimulated conversations that addressed community norms (Community/Sociocultural Environment).

Conclusions

Interventions that use DS appear to positively affect the health promotion of participants across a range of health issues and determinants. Future research is needed in the Interpersonal, Community, and Societal levels and within the Biological, Physical/Built Environment, and Sociocultural Environment domains.
The posterior/medial dry needling approach of the tibialis posterior muscle is an accurate and safe procedure: a cadaveric study
Authors: Pérez-Bellmunt Albert , López-de-Celis Carlos , Rodríguez-Sanz Jacobo , Koppenhaver Shane L. , Zegarra-Chávez Daniel , Ortiz-Miguel Sara , Fernández-de-las-Peñas César
Published: June 2022

Background

Evidence suggests that tibialis posterior muscle plays an important role in equinovarus foot deformity in patients who had suffered a stroke and it is one of the most frequently injected lower-extremity muscles for the management of spasticity. Our aim was to assess if a needle accurately and safely penetrates the tibialis posterior muscle during the application of dry needling. 

Methods 

We conducted a cadaveric descriptive study. Needling insertion of the tibialis posterior was conducted in 11 cryopreserved cadavers with a 70 mm needle. The needle was inserted using two common approaches, at midpoint (posterior/medial approach) and at upper third (anterior approach) of the leg towards the tibialis posterior. The needle was advanced into the tibialis posterior based upon clinician judgement. Cross-sectional anatomical dissections were photographed and analyzed by photometry. Safety was assessed by calculating the distances from the tip and the path of the needle to proximate neurovascular structures.

Results

Accurate needle penetration of the tibialis posterior muscle was observed in all cadavers with both approaches. In general, distances from the needle to the neurovascular bundles were larger with the posterior/medial approach than with the anterior approach, reaching statistically significance for needle tip to nerve (mean difference: 0.6 cm, 95%CI 0.35 to 0.85 cm) and vascular bundle (mean difference: 0.55 cm, 95%CI 0.3 to 0.8 cm) distances (P < 0.001) and needle path to vascular bundle distance (difference: 0.25 cm, 95%CI 0.1 to 0.4 cm, P = 0.045). Age and gender did not influence the main results.

Conclusions

This cadaveric study suggests that needling of the tibialis posterior muscle can be accurately and safely conducted. Safety seems to be larger with the posterior/medial approach when compared with the anterior approach.
Safety and efficacy of Ninjin’yoeito along with iron supplementation therapy for preoperative anemia, fatigue, and anxiety in patients with gynecological disease: an open-label, single-center, randomized phase-II trial
Authors: Yagi Taro , Sawada Kenjiro , Miyamoto Mayuko , Kinose Yasuto , Nakagawa Satoshi , Takiuchi Tsuyoshi , Kodama Michiko , Kobayashi Eiji , Hashimoto Kae , Mabuchi Seiji , Tomimatsu Takuji , Yoshino Kiyoshi , Kimura Tadashi
Published: June 2022

Background

Preoperative anemia affects perioperative outcomes and often causes fatigue and psychological disorders. Therefore, anemia should be treated before a patient undergoes surgery. Ninjin’yoeito (NYT), a Japanese Kampo medicine composed of ginseng and Japanese angelica root with the other 10 herbs, is administered for anemia, fatigue and anxiety; however, there are a few reports that have prospectively examined the effects of NYT before surgery for gynecological diseases. Hence, we tended to investigate its efficacy and safety.

Methods

In this open-label randomized trial, women with gynecological diseases accompanied by preoperative anemia (defined as < 11.0 g/dL Hemoglobin [Hb]) were randomly assigned (1:1) into the iron supplementation and NYT groups. Patients of the iron supplementation group and the NYT group received 100 mg/day iron supplementation with and without NYT (7.5 g/day) for at least 10 days before surgery. The primary endpoint was improvement in Hb levels before and after treatment, and Cancer Fatigue Scale (CFS) and Visual Analogue Scale for Anxiety (VAS-A) scores between groups. Statistical analyses were performed with Wilcoxon signed rank test, Wilcoxon rank sum test, and Fisher’s exact test as appropriate.

Results

Forty patients were enrolled of whom 30 patients were finally analyzed after allocating 15 to each group. There was no difference in the characteristics between both groups. Hb significantly increased in both groups (iron supplementation group, 9.9 ± 0.8 g/dL vs. 11.9 ± 1.6 g/dL; NYT group, 9.8 ± 1.0 g/dL vs. 12.0 ± 1.0 g/dL); the difference in the elevations in Hb between both groups was statistically insignificant (P = 0.72). Contrarily, CFS (17.9 ± 10.2 vs. 8.1 ± 5.2) and VAS-A (56 mm (50–70) vs. 23 mm (6–48)) scores were significantly decreased only in the NYT group and these changes were greater in the NYT group (∆CFS, P = 0.015; ∆VAS-A, P = 0.014). Liver dysfunction occurred in one patient of the NYT group.

Conclusions

For treating preoperative anemia in women with gynecological conditions, NYT administration along with iron supplementation safely and efficiently improved the preoperative fatigue and anxiety in addition to the recovery from anemia.

Trial registration: jRCT1051190012 (28/April/2019, retrospectively registered).
Antibiotic prescription errors: the relationship with clinical competence in junior medical residents
Authors: Martínez-Domínguez Joshua , Sierra-Martínez Octavio , Galindo-Fraga Arturo , Trejo-Mejía Juan Andrés , Sánchez-Mendiola Melchor , Ochoa-Hein Eric , Vázquez-Rivera Mirella , Gutiérrez-Cirlos Carlos , Naveja Jesús , Martínez-González Adrián
Published: June 2022

Background

A large portion of prescribing errors can be attributed to deficiencies in medication knowledge. These errors are preventable and most often occur at the time of prescription. Antimicrobials are the drug class most common incorrectly prescribed.

Objective

To characterize the relationship between clinical competence and antibiotic prescription errors. We also investigated the frequency and severity of antibiotic prescription errors to identify items and attributes of clinical competence which are correlated with the antibiotic prescription error ratio.

Method

A cross-sectional study was applied to assess clinical competence of junior medical residents in two reference academic hospitals and a regional hospital in Mexico City. It was conducted during February 2019. We used an infectious disease Objective Structured Clinical Examination (OSCE) to assess clinical competence and a measure of frequency, and severity of antibiotic prescription errors.

Results

The number of eligible participants was ~ 255 (hospital meeting attendance), and the number of residents in this study were 51 (~ 20%), 31 were female (60.8%). The mean OSCE score was 0.692 ± 0.073. The inter-item (Cronbach’s alpha = 0.927) and inter-station internal consistency was adequate (Cronbach’s alpha = 0.774). The G coefficient in generalizability theory analysis was 0.84. The antibiotic prescription error ratio was 45.1% ± 7%. The most frequent category of severity of antibiotic prescription errors was category E (errors that may contribute to or result in temporary harm to the patient and require intervention), 235 (65.2%). We observed a negative and significant correlation between clinical competence and antibiotic prescription errors (r = -0.33,p < 0.05, CI95% -0.57 to -0.07), which remained significant after controlling for the effect of gender and time since graduation from medical school (r = -0.39,p < 0.01, CI95% -0.625 to -0.118). Using exploratory factor analysis we identified two factors, which explained 69% of the variance in clinical competence, factor 1 evaluated socio-clinical skills and factor 2 evaluated diagnostic-therapeutic skills. Factor 2 was correlated with antibiotic prescription error ratio (r = -0.536,p < 0.001).

Conclusions

We observed a negative correlation between clinical competence and antibiotic prescription error ratio in graduated physicians who have been accepted in a medical specialty. The therapeutic plan, which is a component of the clinical competence score, and the prescription skills had a negative correlation with antibiotic prescription errors. The most frequent errors in antibiotic prescriptions would require a second intervention.
Comparison of self versus expert-assisted feedback for cricothyroidotomy training: a randomized trial
Authors: Aldinc Hasan , Gun Cem , Yaylaci Serpil , Senuren Cigdem Ozkaya , Guven Feray , Sahiner Melike , Kayayurt Kamil , Turkmen Suha
Published: June 2022

Background

The self-video feedback method may have the potential to provide a low-cost alternative to physician-driven simulation-based training. This study aimed to assess the utility of two video feedback methods by comparing the improvement in performing cricothyroidotomy procedure following self video feedback (trainees review their performance by themselves) and expert-assisted video feedback (trainees review their performance while an emergency physician provides additional feedback).

Methods

This study was pretest-posttest and two-group designed research performed at a university simulation center with 89 final-year medical students and used a cricothyroidotomy simulation model. After seeing an educational presentation and a best practice video, trainees were randomized into two groups; self video feedback group (SVFG) and expert-assisted video feedback group (EVFG). They performed the cricothyroidotomy before and after the feedback. The procedures were also recorded and scored by two emergency physicians.

Results

There was a statistically significant improvement between pre-feedback and post-feedback assessments in terms of scores received and time needed for the procedures in both SVFG and EVFG groups (p < 0.05). Additionally, the post-feedback assessment scores were higher and time needed for the procedure was lower in the EVFG when compared with SVFG (p < 0.05 for both).

Conclusions

Results demonstrated significant improvement in cricothyroidotomy performance with both types of video feedback method. Even though the improvement was better in the EVFG compared to the SVFG, the self video feedback may have value especially in situations where expert-assisted feedback is not possible.
Providers’ perspectives on implementing resilience coaching for healthcare workers during the COVID-19 pandemic
Authors: Rosen Benjamin , Preisman Mary , Read Heather , Chaukos Deanna , Greenberg Rebecca A. , Jeffs Lianne , Maunder Robert , Wiesenfeld Lesley
Published: June 2022

Background

The COVID-19 pandemic severely exacerbated workplace stress for healthcare workers (HCWs) worldwide. The pandemic also magnified the need for mechanisms to support the psychological wellbeing of HCWs. This study is a qualitative inquiry into the implementation of a HCW support program called Resilience Coaching at a general hospital. Resilience Coaching was delivered by an interdisciplinary team, including: psychiatrists, mental health nurses allied health and a senior bioethicist. The study focuses specifically on the experiences of those who provided the intervention.

Methods

Resilience Coaching was implemented at, an academic hospital in Toronto, Canada in April 2020 and is ongoing. As part of a larger qualitative evaluation, 13 Resilience Coaches were interviewed about their experiences providing psychosocial support to colleagues. Interviews were recorded, transcribed, and analyzed for themes by the research team. Interviews were conducted between February and June 2021.

Results

Coaches were motivated by opportunities to support colleagues and contribute to the overall health system response to COVID-19. Challenges included finding time within busy work schedules, balancing role tensions and working while experiencing burnout.

Conclusions

Hospital-based mental health professionals are well-positioned to support colleagues’ wellness during acute crises and can find this work meaningful, but note important challenges to the role. Paired-coaches and peer support among the coaching group may mitigate some of these challenges. Perspectives from those providing support to HCWs are an important consideration in developing support programs that leverage internal teams.
Success rate of artificial insemination, reproductive performance and economic impact of failure of first service insemination: a retrospective study
Authors: Tadesse Belege , Reda Abadi Amare , Kassaw Nuredin Teshale , Tadeg Wedajo
Published: June 2022

Background

A retrospective cohort study using a 10 year artificial insemination (AI) and cow reproductive performance data was conducted to study the success rate of AI; associations between effectiveness of AI and breed, AI season and, number of service per conception, and economic impact of failure of FSC in Dessie town, Dessie zuria and Kutaber districts. A total of 3480 dairy cows’ AI and reproductive performance records which were performed between 2003 and 2013 in the three selected districts of South Wollo were used. The economic losses and costs for cows that failed to conceive at their first AI associated with the larger number of days open were estimated.

Result

The prevalence of conception has a statistically significant difference between breeds of cows (P = 0.019). The non-return rate for first service was 58.54%. The median days to first service (DFS), inter-service interval (ISI) and gestation length (GL) were 126, 30 and 278 days respectively. Whereas, the mean + SD days open, calving interval (CI), number of inseminations (NOI) and number of services per conception (NSPC) were 147.2 ± 60.26, 424.5 ± 60.55, 1.14 ± 0.38 and 1.15 ± 0.39 respectively. Based on AI season there was a significant difference in conception between winter and spring (P = 0.021). There is a 45.04 days extension in the mean calving to conception interval in cows that did not conceive at their first AI but conceived by 2nd and 3rd AI than in cows that did conceive at their first AI. A total of 21,665.3 ETB extra costs was spent on reproductive treatment and other management for cows that failed to conceive at their first AI but conceived by second and third service. In cows that did not conceive totally the owner losses on average 473.7 ETB per cow per day extra costs until the cows will be culled.

Conclusion

Therefore to increase the conception rate and decrease the economic loss the owners of the dairy cows should supervise the cows regularly and should be trained on how to identify cows on estrous, the AI technicians should be trained to conduct the AI service accurately.
Recent advances in porous nanomaterials-based drug delivery systems for cancer immunotherapy
Authors: Li Su-Ran , Huo Fang-Yi , Wang Han-Qi , Wang Jing , Xu Chun , Liu Bing , Bu Lin-Lin
Published: June 2022

Cancer immunotherapy is a novel therapeutic regimen because of the specificity and durability of immune modulations to treat cancers. Current cancer immunotherapy is limited by some barriers such as poor response rate, low tumor specificity and systemic toxicities. Porous nanomaterials (PNMs) possess high loading capacity and tunable porosity, receiving intense attention in cancer immunotherapy. Recently, novel PNMs based drug delivery systems have been employed in antitumor immunotherapy to enhance tissue or organ targeting and reduce immune-related adverse events. Herein, we summarize the recent progress of PNMs including inorganic, organic, and organic–inorganic hybrid ones for cancer immunotherapy. The design of PNMs and their performance in cancer immunotherapy are discussed in detail, with a focus on how those designs can address the challenges in current conventional immunotherapy. Lastly, we present future directions of PNMs for cancer immunotherapy including the challenges and research gaps, providing new insights about the design of PNMs for efficient cancer immunotherapy with better performance as powerful weapons against tumors. Finally, we discussed the relevant challenges that urgently need to be addressed in clinical practice, coupled with corresponding solutions to these problems.
High androgen concentrations in follicular fluid of polycystic ovary syndrome women
Authors: Bongrani Alice , Plotton Ingrid , Mellouk Namya , Ramé Christelle , Guerif Fabrice , Froment Pascal , Dupont Joëlle
Published: June 2022

Background

According to current definitions of Polycystic Ovary Syndrome (PCOS), hyperandrogenism is considered as a key element in the pathogenesis of this common endocrinopathy. However, until now, studies about ovarian androgen profile in women are very rare. Our aim was then to characterise the expression profile of the androgens in follicular fluid of 30 PCOS patients, and compare it to those of 47 Control women and 29 women with only polycystic ovary morphology on ultrasounds (ECHO group).

Methods

A retrospective, single-centre cohort study was performed. The intrafollicular concentrations of the key androgens were assessed and correlated with the intrafollicular levels of some adipokines of interest. Androgens were quantified by mass spectrophotometry combined with ultra-high-performance liquid chromatography, while adipokine concentrations were measured by ELISA assays.

Results

In PCOS patients, the intrafollicular concentrations of the androgens synthesised by ovarian theca cells, i.e., 17OH-pregnenolone, dehydroepiandrosterone, Δ4-androstenedione and testosterone, were significantly higher than those of the androgens of adrenal origin, and positively correlated with the main PCOS clinical and biological features, as well as with the adipokines mostly expressed in the follicular fluid of PCOS patients, i.e. resistin, omentin, chemerin and apelin. Conversely, Control women showed the highest levels of 17OH-progesterone, deoxycorticosterone and 11-deoxycortisol. Confirming these results, apelin levels were negatively associated with pregnenolone and deoxycorticosterone concentrations, while visfatin levels, which were higher in the Control group, negatively correlated with the Δ4-androstenedione and testosterone ones.

Conclusions

PCOS is characterised by a selective increase in the intrafollicular levels of the androgens synthesised by theca cells, strengthening the hypothesis that ovarian hyperandrogenism plays a central role in its pathogenesis. Further, the significant correlation between the intrafollicular concentrations of the androgens and most of the adipokines of interest, including apelin, chemerin, resistin and omentin, confirms the existence of a close relationship between these two hormonal systems, which appear deeply involved in ovarian physiology and PCOS physiopathology.
Potential risk factors for the presence of anti-Toxoplasma gondii antibodies in finishing pigs on conventional farms in the Netherlands
Authors: Eppink Dorien M. , Bouwknegt Martijn , van der Giessen Joke W. B. , Swanenburg Manon , Oorburg Derk , Urlings Bert A. P. , van Wagenberg Coen P. A. , van Asseldonk Marcel A. P. M. , Wisselink Henk J.
Published: June 2022

Background

The parasiteToxoplasma gondii (T. gondii)causes a substantial human disease burden worldwide. Ingesting improperly cooked pork containingT. gondiiis considered one of the major sources of human infection in Europe and North America. Consequently, control ofT. gondiiinfections in pigs is warranted. The European Food Safety Authority advised to perform serological monitoring of pigs and to conduct farm audits for the presence of risk factors. Serological monitoring was implemented in several Dutch slaughterhouses, one to six blood samples (a total of 5134 samples) were taken from each delivery of finishing pigs and samples were tested for the presence of anti-T. gondiiantibodies. Using these test results, a cross-sectional study was initiated to assess the association between the within-herdT. gondiiseroprevalence and the presence of risk factors forT. gondiiinfections at 69 conventional finishing pig farms in the Netherlands.

Results

A multivariable model showed significant (P ≤ 0.05) association with twelve potential risk factors: type of farm, presence of dogs, presence of ruminants, use of boots, use of shower and farm clothing, mode of rodent control, bedding accessibility for rodents, presence of cats, type of drinking water, heating of the feed, use of goat whey and shielding of birds.

Conclusions

Serological monitoring of finishing pigs forT. gondiiin slaughterhouses can be used to identify the presence ofT. gondiirisk factors on Dutch conventional finishing pig farms and seems a valuable tool to guide and monitor the control ofT. gondiiin pork production.
Heterotaxy polysplenia syndrome presenting with bleeding from the greater curvature of stomach: a case report
Authors: Ali Mahrukh , Khan Noman , Shahid Jehanzeb , Shah Samana Zainab , Raees Aimun
Published: June 2022

Background

The “heterotaxy syndrome” also called “situs ambiguus” is a rare condition in which the internal organs of the chest and abdomen are abnormally arranged. This syndrome is usually associated with a spectrum of health-related conditions involving birth defects in organs like the heart, spleen, liver, lungs and others.

Case presentation

We present a case of a 29-year-old male who came with an episode of massive upper gastrointestinal bleeding. On arrival he was vitally unstable and after resuscitation underwent a contrast-enhanced CT scan examination. The CT scan identified the features of heterotaxy syndrome with left isomerism and an abnormal blush from the branch of splenic artery supplying the greater curvature of the stomach. Embolization of the splenic artery branches was performed with the help of gel foam. No abnormal blush was identified post-embolization. Later on, in his hospital stay the patient went into pulse less electrical activity and died.

Conclusion

Upper gastrointestinal bleed in the patients with heterotaxy syndrome is a rare presentation of a rare condition. Our case highlights the importance of diagnostic and interventional radiology in diagnosing such patients and identifying the site of bleed especially where endoscopic visualization is not possible and managing the bleeding efficiently.
Waldenstrom Macroglobulinemia: Tailoring Therapy for the Individual
Authors: Gertz Morie A.
Published: June 2022

With the introduction of multiple new effective therapeutic options for the treatment of macroglobulinemia, a structured approach to management of this rare lymphoma is currently needed. A review of phase II and III treatment trials over the past 20 years was performed, and high-quality trials are summarized in this manuscript. Because of the lack of large prospective trials comparing different classes of therapy, a uniform recommendation applicable to all patients cannot be made, and the approach must be individualized incorporating patient preferences, comorbidities, and the range of therapeutic toxicities. Therapeutic options for patients with newly diagnosed and previously treated macroglobulinemia are presented on the basis of the best available evidence in the literature.
Versatile Conversions of Substituents in Guaiazulene: Synthesis of Carboxylic Acid Derivatives with Controlled Regiospecific Reactivities
Authors: Maruoka Kiyotaka , Kamishima Takaaki , Koseki Yoshitaka , Suzuki Ryuju , Dao Anh Thi Ngoc , Murafuji Toshihiro , Kasai Hitoshi
Published: June 2022

Azulene derivatives such as guaiazulene have unique properties and thus play important roles in electronic materials. However, the application of these materials is limited by the lack of functionalization approaches for guaiazulene extracted from natural products. Herein, we report a method for the synthesis of three guaiazulene carboxylic acid derivatives in four to five steps by controlling the reactivity of guaiazulene. 7-Isopropyl-4-methylazulene-1-carboxylic acid was prepared by protecting the C-3 position of guaiazulene with an ester group to inhibit unexpected reactions. We also introduced a carboxyl group at the inactive C-2 position of guaiazulene using a boryl group as a key intermediate. The C4-methyl group of guaiazulene was converted to a formyl group utilizing the acidity of the protons on the C4-methyl group. By protecting the C-3 position of guaiazulene with a tosyl group, 7-isopropyl-1-methylazulene-4-carboxylic acid was synthesized via Kraus-Pinnick oxidation. Ultraviolet/visible spectra of the synthesized guaiazulene carboxylic acids indicate that the longest wavelength at maximum absorption varied depending on the substitution position of the carboxyl group in guaiazulene. Guaiazulene carboxylic derivatives will serve as building blocks for the development of guaiazulene-based materials because the carboxyl group can be converted to various functional groups.
A systematic review protocol of quantitative instruments of income inequality in studies of children and adolescents
Authors: O Driscoll David , Kiely Elizabeth , O Keeffe Linda , Khashan Ali
Published: June 2022

Background: Income inequality is an important indicator of socioeconomic position which is a determinant of social, psychological, and physical health outcomes from childhood to adulthood. Different income inequality instruments (metrics) are used to investigate associations between income inequality and health outcomes (e.g. Gini coefficient). Income inequality instruments provide unique information on the construct of socioeconomic inequality. Albeit there is variation in studies as to the type and rationale for using a particular quantitative instrument of income inequality. The aim of this systematic review will be to investigate and identify the most used quantitative income inequality instrument in studies of children and adolescents up to 18 years of age.  

Methods: The PRISMA-P framework will be applied to identify high quality articles (PROSPERO: CRD42021259114). A search will be conducted in PubMed, Embase, and PsycINFO. The search will include studies concerned with income inequality and/or socioeconomic inequality in children and adolescents. All articles will be independently reviewed, data extracted, and quality appraised by two

reviewers and a third to arbitrate disputes. Articles will be reviewed by title and abstract using inclusion criteria. A data extraction form will be used. Three questions will assess the quality of the rationale for using a particular income inequality instrument and the Newcastle-Ottawa Scale will be used to assess bias

and quality. The primary outcome of interest is the type and frequency of quantitative income inequality instruments used and the study outcome associated with that income inequality instrument. 

Conclusions: This systematic review will aim to provide a summary of the different types of quantitative income inequality instruments used in studies of child and adolescent populations. This will help to guide researchers and policy makers on the use of income inequality metrics in future studies aimed at understanding associations with health and social outcomes in children and adolescents.
Long-term trends in total cloud cover in the Arctic based on surface observations in 1985–2020
Authors: Sviashchennikov Pavel , Drugorub Aleksandr
Published: June 2022

This paper provides an assessment of long-term trends in total cloud cover in the Arctic for the period 1985–2020 based on surface observations. Analysis shows that total cloud cover exhibits a substantial variation both between seasons and from year to year. Two areas of positive trends were found in the total cloud cover from October to April over the Arctic: one in the North Atlantic from 20° W up to 90° E and another from 150° E up to 150° W, which may be a result of atmospheric heat and moisture transport through the Atlantic and Pacific gates. Throughout the year, positive trends dominate over the Arctic Ocean and its seas (except for the Laptev Sea). Negative trends prevail over the continental parts of the Arctic
Serum Renalase Levels in Children with Essential Hypertension
Authors: YAKUT Halil İbrahim , ÇERKEZOĞLU Ali Ata , BAYRAKÇI Umut Selda , ÇETİN İbrahim İlker
Published: June 2022

Objective: Left ventricular hypertrophy is the most commonly studied index for hypertension related target organ damage due to the wide usage of echocardiography. Renalase is a monoamine oxidase, mainly produced by the kidneys, regulating blood pressure by reducing catecholamines and acting on cardiovascular functions. In this study, the relationship between serum renalase level and hypertensive cardiac changes in children with essential hypertension was compared with the healthy control group.
Materials and Methods: A total of 60 hypertensive children (female/male 20/40) aged between 4-18 years (mean 15.1 ± 1.9 years) were included in the study. Twenty healthy children with normal body mass index (4-18, mean14.2 ± 1.3 years) and similar gender (female/male 10/10) formed the control group. In 30 of hypertensive children (female/male: 9/21), echocardiography showed left ventricular hypertrophy. Echocardiographic findings of 30 remaining hypertensive patients (female/male: 11/19) were normal. A venous blood sample was collected from the hypertensive groups for biochemical examinations and renalase level. Urine samples and 24-hour urine samples were collected. 24-hour ambulatory blood pressure monitoring (ABPM) was used to measure blood pressure of hypertensive groups. The cardiac evaluation of hypertensive groups was performed using M-mode echocardiography.

Results: The body mass index was significantly higher in hypertensive groups than the group with normal blood pressure (p <0.05). In comparison of hypertensive groups, no significant difference was found in terms of body mass index. All day systolic, diastolic; night systolic, diastolic, and daytime systolic blood pressure loads were significantly higher in hypertensive left-ventricular hypertrophic group than hypertensive non-hypertrophic group (p <0.05). Left ventricular mass index in M-mode echocardiography, revealed 39.7 g/m2 in the left ventricular hypertrophic group and 27.9 g/m2 in the hypertensive non-hypertrophic group (p <0.05). When the relationship between blood pressure loads and left ventricular mass index was compared between the groups, a significant correlation was found between daytime systolic blood pressure load and increased left ventricular mass index (p <0.05). Renalase level was significantly lower in hypertensive groups compared to normotensive group (p <0.05). There is a relationship between renalase deficiency and increased left ventricular mass index.
Conclusion: There is a correlation between renalase deficiency and increased left ventricular mass index. We believe that utilization of low renalase levels as an early marker may be a useful and valuable parameter for determining the patients at risk for left ventricular hypertrophy and long-term complications of hypertension
Evolving with new threats
Authors: Scheer Kate
Published: June 2022

Kate Scheer discusses how infectious dieseases influence infection control in dentistry.
Growing your role within practice
Authors: Jackson Josie
Published: June 2022

Josie Jackson speaks to Natalie Totton about her experience working as a dental nurse, referral coordinator and reputation manager.
Occlusal considerations for single tooth implant crowns
Authors: Charadva Hemal
Published: June 2022

With the rise in popularity of dental implants to replace missing teeth, there are also increasing concerns surrounding complications. Within the plethora of complications and associated aetiologies, occlusion is possibly the least understood. The biomechanical principles shown in this article can provide some suggestions on occlusal schemes for single implants.

CPD/Clinical Relevance: By understanding occlusal considerations for single implant crowns, the risk of complications can be minimized.