bluuebunny/crossref_metadata_2025 huggingface dataset:
The Contrast Principle, Typicality, and Cultural Longevity in 19th-Century Symphony Slow Movements: A Corpus Analysis
Authors: McDonald Geoffrey , Wöllner Clemens
Published: July 2023

The notion of contrast is integral to both aesthetic and psychological accounts of attention and interest. It therefore represents a useful heuristic for understanding contrasting slow movements in Western art music. Based on the observation from music theory that within-movement tonal contrast (mode and key) increased during the 19th century, we assumed that a corpus of symphonic slow movements ( n = 246) composed between 1800 and 1913 would exhibit increasing between-movement tonal contrast when compared to a sample of symphonies composed between 1757 and 1795 ( n = 141). Synchronic analysis confirmed that slow movements contrast with their key-defining first movements. Diachronic analysis confirmed that within-symphony tonal contrast increases after 1800. Each of five style parameters observed for era comparison (changes in use of mode, key, meter, form, and structure) conformed to musicologically distinct yet plausible historical boundaries. Cluster analysis of the post-1800 corpus generated three clusters, with mode (non-)match between slow movement and symphony, printed tempo marking, and key relationship (measured by tonal distance) as the three strongest predictors. Since discussions of style naturally raise questions of influence, we also examined the relationship between prototypicality and composer prominence. To that end, analysis of clusters suggests the possibility of multiple, distinct “Beethovenian prototypes.” Finally, we found that, with the exceptions of Beethoven and Brahms, the most statistically typical pieces lack enduring impact, from today's perspective. Conformity to general stylistic norms thus seems to predict against the cultural longevity of a 19th-century symphony.
Unmet Needs and Coping Strategies of Older Underserved Veterans During the COVID-19 Pandemic
Authors: Haltom Trenton M. , Tiong Joyce , Evans Tracy L. , Kamdar Nipa , True Gala , Kunik Mark E.
Published: July 2023

Introduction:

The COVID-19 pandemic has had profound impacts on people with diabetes, a group with high morbidity and mortality. Factors like race, age, income, Veteran-status, and limited or interrupted resources early in the COVID-19 pandemic compounded risks for negative health outcomes. Our objective was to characterize the experiences and needs of under-resourced Veterans with type 2 diabetes during the COVID-19 pandemic.

Methods:

We conducted semi-structured qualitative interviews (March through September 2021) with U.S. military Veterans with diabetes. Transcripts were analyzed using a team-based, iterative process of summarizing and coding to identify key themes. Participants included Veterans (n = 25) who were mostly men (84%), Black or African American (76%), older (mean age = 62.6), and low-income (<$20 000/year; 56%). Most participants self-reported moderate (36%) or severe (56%) diabetes-related distress.

Results:

Shutdowns and social distancing negatively impacted Veterans’ social, mental, and physical health. Veterans reported feeling increased isolation, depression, stress, and unmet mental health needs. Their physical health was also negatively affected. Despite pandemic-related challenges, Veterans adapted with new technological skills, appreciating their families, staying active, and relying on their religious faith.

Conclusions:

Veterans’ experiences during the pandemic revealed the importance of social support and access to technology. For those without social support, peer support could protect against negative health outcomes. Emergency-preparedness efforts for vulnerable patients with type 2 diabetes should include raising awareness about and increasing access to technological resources (eg, Zoom or telehealth platforms). Findings from this study will help tailor support programs for specific populations’ needs in future health crises.
Communion Among Community-Recruited Emerging Adults: Testing Descriptive and Inferential Questions
Authors: Montgomery Amanda M. , Graci Matthew E. , Booker Jordan A.
Published: July 2023

Communion reflects motivations for social connectivity and intimacy in life stories. We tested the ways communion may differ among emerging adults and may inform psychosocial adjustment. We rated 300 US adults’ ( M age = 24.3 years; 60% women) high point and low point narratives for communion, testing a) differences in communion by demographics (i.e., gender, ethnicity), b) direct associations between communion with psychosocial adjustment (i.e., life satisfaction, stress), and c) moderation of communion’s ties with adjustment by demographic factors. Women expressed more high point communion. European Americans expressed more communion across narratives. Low point communion had direct ties with psychosocial adjustment. The effects of communion on adjustment differed by ethnicity and event valence: African Americans showed larger benefits with high point communion; and Asian Americans showed larger benefits with low point communion. Findings reinforce the importance of communal values and emphasize research needs in accounting for cultural upbringing.
A Nurses’ Guide for Egyptian Women Regarding Female Sexual Function During COVID-19 Pandemic: A Quasi-Experimental Study
Authors: Abd El-Kader Azza Ibrahim
Published: July 2023

Introduction

The pandemic of coronavirus disease 2019 (COVID-19) is still affecting individuals all over the world. Restrictions resulting from lifestyle changes have been demonstrated to cause mental and sexual health issues.

Objectives

This research was performed to assess the effect of the COVID-19 pandemic on female sexual function in Egypt and also to assess the knowledge and information for those with sexual dysfunction before and after the administration of nursing guidelines.

Methods

A quasi-experimental research design was carried out for women diagnosed with positive COVID-19 at Isolation Hospital in Heart and Chest Hospital-Zagazig University. The study comprised a purposive sample of 496 women who were active COVID-19 patients. A structured interviewing form and a female sexual function index would be utilized to collect data. The nursing guidelines were designed by the researcher and given to women with positive COVID-19 after assessment of their knowledge and information concerning sexual health during this pandemic.

Results

According to the findings of this study, the incidence of normal sexual function and sexual dysfunction was 62.7% and 37.3%, respectively. Nearly half of the participating women (46.7%) were 25–34 years of age. 63.7% of them were residing in rural areas. Before guidelines administration: poor knowledge (23.5%), fair knowledge (68.4%), and good knowledge (8.1%); and after intervention: poor knowledge (0.0%), fair knowledge (29.4%), and good knowledge (70.6%) were recorded.

Conclusion

Women with sexual dysfunction had statistically higher accurate information following the administration of nursing guidelines regarding sexual function.
Gender Heterogeneity and Inter-generational Transmission of Learning Ability in India
Authors: Tiwari Sandeep Kumar , Paltasingh Kirtti Ranjan , Jena Pabitra Kumar , Rao K. Ramachandra
Published: July 2023

This article examines the role of gender heterogeneity in inter-generational transmission of learning efficiency, a proxy for scholastic ability. We use primary survey data of 1000 elementary students collected from 125 public schools in Uttar Pradesh in 2019. Efficiency scores calculated from data envelopment analysis by considering students’ academic test scores in various courses are used as a proxy for learning ability. First, we find strong evidence of inter-generational transmission of schooling of father, mother, and average parents to their children. Second, the study finds that a mother’s educational attainment in children’s learning efficiency is relatively more significant than that of the father. In addition, we observe the gender heterogeneous effect of parents’ education on children’s learning efficiency, where transmission effects in the case of girls show improvement if parents’ level of education increases. As a policy implication, the study highlights the importance of girls’ education, which not only narrows the gender gap in education but also facilitates the inter-generational transmission of learning, benefitting the family and society.
Aluminotaipingite-(CeCa), (Ce6Ca3)Al(SiO4)3[SiO3(OH)]4F3, a new member of the cerite-supergroup minerals
Authors: Campostrini Italo , Demartin Francesco , Finello Giuseppe , Vignola Pietro
Published: July 2023

Aluminotaipingite-(CeCa), (Ce6Ca3)Al(SiO4)3[SiO3(OH)]4F3, is a new member of the cerite-supergroup minerals, whose general chemical formula is A9XM[TO3Ø]7Z3, (A = REE, Ca, Sr, Na and □; X = □, Ca, Na and Fe2+; M = Mg, Fe2+, Fe3+, Al and Mn; T = Si and P; Ø = O and OH; Z = □, OH and F). It was found in cavities of a leucogranitic orthogneiss at the Casette quarry, Montoso, Bagnolo Piemonte, Cuneo Province, Piedmont, Italy. Crystals of aluminotaipingite-(CeCa) are light pink to pink, transparent or semi-transparent, with a vitreous lustre. It forms pyramidal crystals up to 0.07 mm in size and observed forms are {0 0 1}, {1 0 $\bar{2}$}. The tenacity is brittle, no distinct cleavage is observed and the fracture is uneven. The mineral does not fluoresce in long- or short-wave ultraviolet light. The streak is white. Hardness (Mohs) = 5. The calculated density is 4.476 g cm–3.

The mineral is trigonal, space group R3c, with a = 10.658(3), c = 37.865(9) Å, V = 3725(2) Å3 and Z = 6. The eight strongest powder X-ray diffraction lines are [dobs, Å (I, %) (h k l)]: 8.38(29)(0 1 2), 4.499(28)(2 0 2), 3.282(41)(2 1 4), 2.936(100)(0 2 10), 2.816(51)(1 2 8), 2.669(37)(2 2 0), 2.207 (29)(3 0 12) and 1.935(35)(2 3 8). The structure was refined to R =0.0306 for 2297 reflections with I >2σ(I). The crystal structure of aluminotaipingite-(CeCa) contains two nine-fold coordinated sites (A1 and A2), which are occupied mainly by lanthanides, and a third nine-fold coordinated A3 site containing almost equal amounts of lanthanides and Ca. The X site is vacant and at the octahedral M site aluminium prevails over Fe3+. Among the three independent T sites, T2 belongs to a (SiO4)4– anion, whereas T1 and T3 belong to (SiO3OH)3– anions. Fluorine is involved in coordination with the A1 and A3 sites.
A phase 2 trial of defibrotide for the prevention of chimeric antigen receptor T-cell–associated neurotoxicity syndrome
Authors: Jacobson Caron A. , Rosenthal Allison C. , Arnason Jon , Agarwal Shirali , Zhang Peixin , Wu Wendy , Amber Vian , Yared Jean A.
Published: July 2023

Chimeric antigen receptor T-cell (CAR-T) therapy represents a major advance in cancer immunotherapy; however, it can be associated with life-threatening neurotoxicity linked to blood-brain barrier disruption and endothelial activation. Defibrotide was shown to reduce endothelial cell activation in vitro and is approved in the United States for treatment of veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) in patients with renal or pulmonary dysfunction after hematopoietic cell transplantation (HCT), and in the European Union for severe VOD/SOS after HCT in patients aged >1 month. Defibrotide may stabilize the endothelium during CAR-T therapy and reduce the rate of CAR-T–associated neurotoxicity. This phase 2 study evaluated the safety and efficacy of defibrotide for prevention of CAR-T–associated neurotoxicity in patients with relapsed/refractory large B-cell lymphoma receiving axicabtagene ciloleucel. Part 1 established the recommended phase 2 dose (RP2D; 6.25 mg/kg); 20 patients (from parts 1 and 2) receiving the RP2D were evaluable for efficacy. Rate of CAR-T–associated neurotoxicity by day 30 (primary end point) was ∼50%, lower than reported in the ZUMA-1 trial (64%). Median event duration of grade ≥3 neurotoxicity was 7 days. No unexpected defibrotide-related safety findings and defibrotide-related treatment-emergent adverse events or deaths were reported. Results showed modest reduction in rate of CAR-T–associated neurotoxicity and high-grade neurotoxicity event duration relative to historical data; however, reduction was unlikely to meet the primary end point, so the study was terminated early. Nevertheless, results contribute valuable data for potential therapeutic insight on the management of CAR-T–associated neurotoxicity. This trial was registered at www.clinicaltrials.gov as #NCT03954106.
Epigenetic regulatory mechanism of ADAMTS12 expression in osteoarthritis
Authors: Yang Shu , Zhou Xuanping , Jia Zhen , Zhang Mali , Yuan Minghao , Zhou Yizhao , Wang Jing , Xia Duo
Published: July 2023

Background

Osteoarthritis (OA) is a degenerative joint disease with lacking effective prevention targets. A disintegrin and metalloproteinase with thrombospondin motifs 12 (ADAMTS12) is a member of the ADAMTS family and is upregulated in OA pathologic tissues with no fully understood molecular mechanisms.

Methods

The anterior cruciate ligament transection (ACL-T) method was used to establish rat OA models, and interleukin-1 beta (IL-1β) was administered to induce rat chondrocyte inflammation. Cartilage damage was analyzed via hematoxylin-eosin, Periodic Acid-Schiff, safranin O-fast green, Osteoarthritis Research Society International score, and micro-computed tomography assays. Chondrocyte apoptosis was detected by flow cytometry and TdT dUTP nick-end labeling. Signal transducer and activator of transcription 1 (STAT1), ADAMTS12, and methyltransferase-like 3 (METTL3) levels were detected by immunohistochemistry, quantitative polymerase chain reaction (qPCR), western blot, or immunofluorescence assay. The binding ability was confirmed by chromatin immunoprecipitation-qPCR, electromobility shift assay, dual-luciferase reporter, or RNA immunoprecipitation (RIP) assay. The methylation level of STAT1 was analyzed by MeRIP-qPCR assay. STAT1 stability was investigated by actinomycin D assay.

Results

The STAT1 and ADAMTS12 expressions were significantly increased in the human and rat samples of cartilage injury, as well as in IL-1β-treated rat chondrocytes. STAT1 is bound to the promoter region of ADAMTS12 to activate its transcription. METTL3/ Insulin-like growth factor 2 mRNA-binding protein 2 (IGF2BP2) mediated N6-methyladenosine modification of STAT1 promoted STAT1 mRNA stability, resulting in increased expression. ADAMTS12 expression was reduced and the IL-1β-induced inflammatory chondrocyte injury was attenuated by silencing METTL3. Additionally, knocking down METTL3 in ACL-T-produced OA rats reduced ADAMTS12 expression in their cartilage tissues, thereby alleviating cartilage damage.

Conclusion

METTL3/IGF2BP2 axis increases STAT1 stability and expression to promote OA progression by up-regulating ADAMTS12 expression.
Associations of circulating proteins with lipoprotein profiles: proteomic analyses from the OmniHeart randomized trial and the Atherosclerosis Risk in Communities (ARIC) Study
Authors: Kim Hyunju , Lichtenstein Alice H. , Ganz Peter , Miller Edgar R. , Coresh Josef , Appel Lawrence J. , Rebholz Casey M.
Published: July 2023

Background

Within healthy dietary patterns, manipulation of the proportion of macronutrient can reduce CVD risk. However, the biological pathways underlying healthy diet-disease associations are poorly understood. Using an untargeted, large-scale proteomic profiling, we aimed to (1) identify proteins mediating the association between healthy dietary patterns varying in the proportion of macronutrient and lipoproteins, and (2) validate the associations between diet-related proteins and lipoproteins in the Atherosclerosis Risk in Communities (ARIC) Study.

Methods

In 140 adults from the OmniHeart trial, a randomized, cross-over, controlled feeding study with 3 intervention periods (carbohydrate-rich; protein-rich; unsaturated fat-rich dietary patterns), 4,958 proteins were quantified at the end of each diet intervention period using an aptamer assay (SomaLogic). We assessed differences in log2-transformed proteins in 3 between-diet comparisons using paired t-tests, examined the associations between diet-related proteins and lipoproteins using linear regression, and identified proteins mediating these associations using a causal mediation analysis. Levels of diet-related proteins and lipoprotein associations were validated in the ARIC study (n = 11,201) using multivariable linear regression models, adjusting for important confounders.

Results

Three between-diet comparisons identified 497 significantly different proteins (protein-rich vs. carbohydrate-rich = 18; unsaturated fat-rich vs. carbohydrate-rich = 335; protein-rich vs. unsaturated fat-rich dietary patterns = 398). Of these, 9 proteins [apolipoprotein M, afamin, collagen alpha-3(VI) chain, chitinase-3-like protein 1, inhibin beta A chain, palmitoleoyl-protein carboxylesterase NOTUM, cathelicidin antimicrobial peptide, guanylate-binding protein 2, COP9 signalosome complex subunit 7b] were positively associated with lipoproteins [high-density lipoprotein (HDL)-cholesterol (C) = 2; triglyceride = 5; non-HDL-C = 3; total cholesterol to HDL-C ratio = 1]. Another protein, sodium-coupled monocarboxylate transporter 1, was inversely associated with HDL-C and positively associated with total cholesterol to HDL-C ratio. The proportion of the association between diet and lipoproteins mediated by these 10 proteins ranged from 21 to 98%. All of the associations between diet-related proteins and lipoproteins were significant in the ARIC study, except for afamin.

Conclusions

We identified proteins that mediate the association between healthy dietary patterns varying in macronutrients and lipoproteins in a randomized feeding study and an observational study.

Trial registration

NCT00051350 at clinicaltrials.gov.
Rare presentation of BRASH syndrome with hypoglycemia and altered mental status
Authors: Sedlák Marián , Brúsiková Kamila , Sobolová Vladimíra , Králik Michal
Published: July 2023

Background

BRASH syndrome (bradycardia, renal failure, atrioventricular nodal blockade, shock, and hyperkalemia) is a rare clinical condition with potentially severe outcomes. Patients with BRASH syndrome can present with diverse signs and symptoms and are usually in critical condition, but if recognized early, the syndrome is treatable and may have a favorable prognosis.

Case presentation

This case study presents a 74-year-old patient with a history of multiple chronic conditions who was brought to the emergency department with a suspected cerebrovascular accident, altered mental status, and bradycardia. A head computed tomography scan was unremarkable but laboratory results showed hyperkalemia, acidosis, and renal failure with concomitant progressive hypoglycemia. The patient was diagnosed with a BRASH syndrome characterized by a vicious cycle of atrioventricular nodal blockade induced by the potentiated effect of beta-blockers or calcium channel blockers, in combination with progressive hypoglycemia due to the suspected accumulation of anti-diabetic medications, which influenced the presentation and initial triage in the emergency department. She was admitted to the intensive care unit for further management, where she continued to improve and was ultimately discharged in a relatively stable condition.

Conclusion

This case study highlights the importance of considering rare and atypical presentations of medical conditions, particularly in elderly patients who may have multiple comorbidities. Early recognition and prompt management of such cases are crucial for improving patient outcomes.
Effectiveness of Saccharomyces Boulardii CNCM I-745 probiotic in acute inflammatory viral diarrhoea in adults: results from a single-centre randomized trial
Authors: Salazar-Parra Marcela AG , Cruz-Neri Roberto U , Trujillo-Trujillo Xóchitl AR , Dominguez-Mora Juan J , Cruz-Neri Héctor I , Guzmán-Díaz Jazmín M , Guzmán-Ruvalcaba Mario J , Vega-Gastelum Jesús O , Ascencio-Díaz Kriscia V , Zarate-Casas Maria F , González-Ponce Fanny Y , Barbosa-Camacho Francisco J , Fuentes-Orozco Clotilde , Cervantes-Guevara Gabino , Cervantes-Pérez Enrique , Cervantes-Cardona Guillermo Alonso , Cortés-Flores Ana Olivia , González-Ojeda Alejandro
Published: July 2023

Background

Probiotics are effective for treating acute infectious diarrhoea caused by bacteria, but there are inconsistent results for the effectiveness of probiotics for diarrhoea caused by viruses. In this article we want to determine whether Sb supplementation has an effect on acute inflammatory viral diarrhoea diagnosed with the multiplex panel PCR test. The aim of this study was to evaluate the efficacy of Saccharomyces boulardii (Sb) as a treatment in patients diagnosed with viral acute diarrhoea.

Methods

From February 2021 to December 2021, 46 patients with a confirmed diagnosis of viral acute diarrhoea diagnosed with the polymerase chain reaction multiplex assay were enrolled in a double-blind, randomized placebo-controlled trial. Patients received paracetamol 500 mg as a standard analgesic and 200 mg of Trimebutine as an antispasmodic treatment plus 600 mg of Sb (n = 23, 1 × 109/100 mL Colony forming unit) or a placebo (n = 23) orally once daily for eight days. The improvement in and severity of symptoms were measured using a symptom diary, the Patient Global Impression and the Patient Global Impression of Change scales (days 4 and 8), both answered and recorded by the patient.

Results

Of the 46 patients who completed treatment, 24 (52%) were men and 22 (48%) were women. The average age was 35.6 ± 12.28 years (range 18 to 61 years). The average duration of the evolution of illness at the time of diagnosis was 0.85 ± 0.73 days (maximum 2 days). On day 4 after the diagnosis, 20% reported pain and 2% reported fever, but on day 8, no patient reported pain or fever. On day 4, 70% of patients in the Sb group and 26% in the placebo group reported improvement (P = 0.03), based on the Patients’ Global Impression of Change scale, which assesses patient’s rating of overall improvement. These findings suggest that 3 to 4 days of treatment with Sb helped to improve symptoms of diarrhoea caused by a virus.

Conclusion

Treatment with Sb on acute inflammatory diarrhoea of viral aetiology shows no changes regarding the severity of the symptoms; nevertheless, it seems to impact improvement positively.

Trial registration

22CEI00320171130 dated on 16/12/2020, NCT05226052 dated on 07/02/2022.
Hemophagocytic lymphohistiocytosis secondary to virus infection and followed by lupus nephritis recurrence in a renal transplantation pediatric recipient: a case report
Authors: Li Jiyuan , Gao Chen , Zhu Xuejing , Yang Danyi , Mao Wendan , Yao Hengchang , Deng Mingyang , Tan Liang , Dai Helong , Xie Xubiao , Peng Longkai , Peng Fenghua
Published: July 2023

Background

Hemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening disorder characterized by systemic inflammation and organ failure as a result of dysregulated immune cell activation. HLH can be induced by a variety of factors including infection, tumours and autoimmune disease and can also occur in patients following solid organ transplantation. Occurrence of HLH and lupus nephritis (LN) successively within a short period of time after renal transplantation is uncommon.

Case presentation

We described an 11-year-old female post-transplant patient who presented with hemocytopenia, fever, elevated serum ferritin, splenomegaly, hyperlipidemia, and hypofibrinemia, and was clinically diagnosed with HLH. After comprehensive treatment with corticosteroids, intravenous immunoglobulin (IVIG), and reducing immunosuppressants, her condition improved, but then hematuria ensued. The transplant kidney biopsy showed LN. She was treated with hydroxychloroquine and methylprednisolone while intensive immunosuppressive agents were given. She has remained in remission for two years until now.

Conclusions

The main inducing factors of HLH should be identified as early as possible, and accurate treatment plans should be taken. The long-course IVIG regimen may be one of the effective treatments for virus-induced HLH. After remission of HLH, we need to be alert to the recurrence of autoimmune diseases in patients with underlying diseases, and timely increase immunosuppressants.
Does residential exposure to air pollutants influence mortality and cardiovascular morbidity of older people from primary care?
Authors: D’Acquisto Maurizio Pietro , Krause Dietmar , Klaassen-Mielke Renate , Trampisch Matthias , Trampisch Hans Joachim , Trampisch Ulrike , Rudolf Henrik
Published: July 2023

Background

Diseases affecting the cardiovascular system are the most common cause of death worldwide. In addition to classical risk factors of atherosclerosis, long-term exposure to particulate matter with particles of size up to 10 µm (PM10) in the atmosphere has become an increasing focus of scientific attention in recent decades. This study analyses the associations of residential-associated air pollutants exposure with all-cause mortality and cardiovascular morbidity of older patients in a primary care setting.

Methods

The “German Epidemiological Trial on Ankle Brachial Index” (getABI) is a prospective cohort study that started in 2001 and included 6,880 primary care patients with a follow-up of 7 years. The PM10 and nitrogen dioxide (NO2) concentrations in the atmosphere are interpolated values from the study "Mapping of background air pollution at a fine spatial scale across the European Union". The primary outcome in this analysis is death of any cause, a secondary outcome is onset of PAD. Cox proportional hazards regression was used in a two-step modelling, the first step with basic adjustment only for age, sex, and one or more air pollutants, the second with additional risk factors.

Results

A total of 6,819 getABI patients were included in this analysis. 1,243 of them died during the study period. The hazard ratio (HR) (1.218, 95%-confidence-interval (CI) 0.949–1.562) for the risk of death from any cause was elevated by 22% per 10 µg/m3 increase of PM10 in the fully adjusted model, although not statistically significant. Increased PM10 exposure in combination with the presence of PAD had a significantly increased risk (HR = 1.560, 95%-CI: 1.059-2.298) for this endpoint in the basic adjustment, but not in the fully adjusted model. 736 patients developed peripheral artery disease (PAD) during the course of the study. There was no association of air pollutants and the onset of PAD.

Conclusions

Our analysis renders some hints for the impact of air pollutants (PM10, NO2, and proximity to major road) on mortality. Interaction of PAD with PM10 was found. There was no association of air pollutants and the onset of PAD.

Trial registration

German Clinical Trials Register: DRKS00029733 (19/09/2022).
Awareness of reporting practices and barriers to incident reporting among nurses
Authors: Oweidat Islam , Al-Mugheed Khalid , Alsenany Samira Ahmed , Abdelaliem Sally Mohammed Farghaly , Alzoubi Majdi M.
Published: July 2023

Background

Adequate incident reporting practices for clinical incident among nurses and even all healthcare providers in clinical practice settings is crucial to enhance patient safety and improve the quality of care delivery. This study aimed to investigate the level of awareness of incident reporting practices and identify the barriers that impact incident reporting among Jordanian nurses.

Methods

A descriptive design using a cross-sectional survey was employed among 308 nurses in 15 different hospitals in Jordan. Data collection was conducted between November 2019 and July 2020 using an Incident Reporting Scale.

Results

The participants showed a high level of awareness of the incident reporting with a mean score of 7.3 (SD = 2.5), representing 94.8% of the highest score. Nurses perceived their reporting practices at the medium level, with a mean score of 2.23 out of 4. The main reporting barriers included worrying about disciplinary actions, fearing being blamed, and forgetting to make a report. In regard to awareness of incident reporting, there were statistically significant differences in the mean for total awareness of the incident reporting system scores according to the type of hospital (p < .005*). In regard to self-perceived reporting practices, nurses working in accredited hospitals demonstrated statistically significant differences in self-perceived reporting practices (t = 0.62, p < .005).

Conclusions

The current results provide empirical results about perceived incident reporting practices and perceived barriers to reporting frequently. Recommendations are made to urge nursing policymakers and legislators to provide solutions for those barriers, such as managing staffing issues, nursing shortage, nurses’ empowerment, and fear of disciplinary actions by front-line nurse managers.
The usage of data in NHS primary care commissioning: a realist review
Authors: Jager Alexandra , Wong Geoff , Papoutsi Chrysanthi , Roberts Nia
Published: July 2023

Background

Primary care has been described as the ‘bedrock’ of the National Health Service (NHS) accounting for approximately 90% of patient contacts but is facing significant challenges. Against a backdrop of a rapidly ageing population with increasingly complex health challenges, policy-makers have encouraged primary care commissioners to increase the usage of data when making commissioning decisions. Purported benefits include cost savings and improved population health. However, research on evidence-based commissioning has concluded that commissioners work in complex environments and that closer attention should be paid to the interplay of contextual factors and evidence use. The aim of this review was to understand how and why primary care commissioners use data to inform their decision making, what outcomes this leads to, and understand what factors or contexts promote and inhibit their usage of data.

Methods

We developed initial programme theory by identifying barriers and facilitators to using data to inform primary care commissioning based on the findings of an exploratory literature search and discussions with programme implementers. We then located a range of diverse studies by searching seven databases as well as grey literature. Using a realist approach, which has an explanatory rather than a judgemental focus, we identified recurrent patterns of outcomes and their associated contexts and mechanisms related to data usage in primary care commissioning to form context-mechanism-outcome (CMO) configurations. We then developed a revised and refined programme theory.

Results

Ninety-two studies met the inclusion criteria, informing the development of 30 CMOs. Primary care commissioners work in complex and demanding environments, and the usage of data are promoted and inhibited by a wide range of contexts including specific commissioning activities, commissioners’ perceptions and skillsets, their relationships with external providers of data (analysis), and the characteristics of data themselves. Data are used by commissioners not only as a source of evidence but also as a tool for stimulating commissioning improvements and as a warrant for convincing others about decisions commissioners wish to make. Despite being well-intentioned users of data, commissioners face considerable challenges when trying to use them, and have developed a range of strategies to deal with ‘imperfect’ data.

Conclusions

There are still considerable barriers to using data in certain contexts. Understanding and addressing these will be key in light of the government’s ongoing commitments to using data to inform policy-making, as well as increasing integrated commissioning.
Evaluation of community-based vector surveillance system for routine entomological monitoring under low malaria vector densities and high bed net coverage in western Kenya
Authors: Abong’o Bernard , Stanton Michelle C. , Donnelly Martin J. , Ochomo Eric , ter Kuile Feiko O. , Samuels Aaron M. , Kariuki Simon , Musula George , Oxborough Richard , Munga Stephen , Torr Steve J. , Gimnig John E.
Published: July 2023

Background

Entomological surveillance is traditionally conducted by supervised teams of trained technicians. However, it is expensive and limiting in the number of sites visited. Surveillance through community-based collectors (CBC) may be more cost-effective and sustainable for longitudinal entomological monitoring. This study evaluated the efficiency of CBCs in monitoring mosquito densities compared to quality-assured sampling conducted by experienced entomology technicians.

Methods

Entomological surveillance employing CBCs was conducted in eighteen clusters of villages in western Kenya using indoor and outdoor CDC light traps and indoor Prokopack aspiration. Sixty houses in each cluster were enrolled and sampled once every month. Collected mosquitoes were initially identified to the genus level by CBCs, preserved in 70% ethanol and transferred to the laboratory every 2 weeks. Parallel, collections by experienced entomology field technicians were conducted monthly by indoor and outdoor CDC light traps and indoor Prokopack aspiration and served as a quality assurance of the CBCs.

Results

Per collection, the CBCs collected 80% fewer Anopheles gambiae sensu lato (s.l.) [RR = 0.2; (95% CI 0.14–0.27)] and Anopheles coustani [RR = 0.2; (95% CI 0.06–0.53)] and 90% fewer Anopheles funestus [RR = 0.1; (95% CI 0.08–0.19)] by CDC light traps compared to the quality assured (QA) entomology teams. Significant positive correlations were however observed between the monthly collections by CBCs and QA teams for both An. gambiae and An. funestus. In paired identifications of pooled mosquitoes, the CBCs identified 4.3 times more Anopheles compared to experienced technicians. The cost per person-night was lower in the community-based sampling at $9.1 compared to $89.3 by QA per collection effort.

Conclusion

Unsupervised community-based mosquito surveillance collected substantially fewer mosquitoes per trap-night compared to quality-assured collection by experienced field teams, while consistently overestimating the number of Anopheles mosquitoes during identification. However, the numbers collected were significantly correlated between the CBCs and the QA teams suggesting that trends observed by CBCs and QA teams were similar. Further studies are needed to evaluate whether adopting low-cost, devolved supervision with spot checks, coupled with remedial training of the CBCs, can improve community-based collections to be considered a cost-effective alternative to surveillance conducted by experienced entomological technicians.
Impact of genetic variations in the WNT family members and RUNX2 on dental and skeletal maturation: a cross-sectional study
Authors: Bitencourt Reis Caio Luiz , Nakane Matsumoto Mirian Aiko , Baratto-Filho Flares , Scariot Rafaela , Sasso Stuani Maria Bernadete , Lourenço Romano Fábio , Della Coletta Ricardo , Silva Barroso de Oliveira Daniela , Proff Peter , Kirschneck Christian , Calvano Küchler Erika
Published: July 2023

Background

This study evaluated if genetic variations in the WNT family members and RUNX2 are associated with craniofacial maturation, investigating dental and skeletal maturity in children and teenagers.

Methods

Radiographs from pre-orthodontic treatment of Brazilian patients (7 to 17 years-old) were used to assess dental (panoramic radiographs) and skeletal maturity (cephalometric radiographs). The chronological age (CA) was calculated based on the date of birth and the time the radiographs were performed. For the dental maturity analysis, the Demirjian (1973) method was used and a delta [dental age - chronological age (DA-CA)] was calculated. For the skeletal maturity analysis, the Baccetti et al. (2005) method was used and the patients were classified as “delayed skeletal maturation”, “advanced skeletal maturation” or “normal skeletal maturation”. DNA isolated from buccal cells was used for genotyping of two genetic variations in WNT family genes: rs708111 (G > A) in WNT3A and rs1533767 (G > A) in WNT11; and two genetic variations in RUNX2: rs1200425 (G > A) and rs59983488 (G > T). A statistical analysis was performed and values of p < 0.05 indicated a significant difference.

Results

There were no associations between dental maturity and genotypes (p > 0.05). In the skeletal maturity analysis, the allele A in the rs708111 (WNT3A) was statistically more frequent in patients with delayed skeletal maturation (Prevalence Ratio = 1.6; 95% Confidence Interval = 1.00 to 2.54; p-value = 0.042).

Conclusions

The rs708111 in the WNT3A gene impacts on skeletal maturation.
Comparison of outcomes between tubular microdiscectomy and conventional microdiscectomy for lumbar disc herniation: a systematic review and meta-analysis of randomized controlled trials
Authors: Zhang Tingxin , Guo Nana , Wang Kaifeng , Gao Gang , Li Yanhong , Gao Feng , Yang Wupeng , Wang Yonghua , Wang Yongjiang
Published: July 2023

Purpose

The clinical outcomes of using a tubular microdiscectomy for lumbar disc herniation were evaluated by comparison with conventional microdiscectomy.

Methods

All of the comparative studies published in the PubMed, Cochrane Library, Medline, Web of Science, and EMBASE databases as of 1 May 2023 were included. All outcomes were analysed using Review Manager 5.4.

Results

This meta-analysis included four randomized controlled studies with a total of 523 patients. The results showed that using tubular microdiscectomy for lumbar disc herniation was more effective than conventional microdiscectomy in improving the Oswestry Disability Index (P < 0.05). However, there were no significant differences in operating time, intraoperative blood loss, hospital stay, Visual Analogue Scale, reoperation rate, postoperative recurrence rate, dural tear incidence, and complications rate (all P > 0.05) between the tubular microdiscectomy and conventional microdiscectomy groups.

Conclusions

Based on our meta-analysis, it was found that the tubular microdiscectomy group had better outcomes than the conventional microdiscectomy group in terms of Oswestry Disability Index. However, there were no significant differences between the two groups in terms of operating time, intraoperative blood loss, hospital stay, Visual Analogue Scale, reoperation rate, postoperative recurrence rate, dural tear incidence, and complications rate. Current research suggests that tubular microdiscectomy can achieve clinical results similar to those of conventional microdiscectomy.

PROSPERO registration number is: CRD42023407995.
Outcomes of valve-sparing aortic root replacement in patients with bicuspid aortic valve and tricuspid aortic valve: a systematic review and meta-analysis
Authors: Zuo Yiding , Tan Ruixi , Qin Chaoyi
Published: July 2023

Background

Valve-sparing aortic root replacement (VSARR) is a safe and effective surgical procedure to treat aortic root aneurysm. This meta-analysis aimed to investigate how this procedure might differ in patients with bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV).

Design

Meta-analysis with meta-regression and systematic review.

Setting

Systematic search in the following databases: PubMed, Cochrane Central Register of Controlled Trials, and Embase.

Interventions

All observational studies of VSARR in patients with BAV or TAV were included in our study. Studies were included without any restrictions on language or publication date. A trial sequential analysis and a post-hoc meta-regression was performed on the main outcomes.

Result

Eleven articles met the inclusion criteria. A total of 1138 patients in BAV group, and 2125 patients in TAV group. No significant differences in gender and age were observed between BAV and TAV patients. BAV and TAV patients showed no differences in in-hospital mortality rate [0.00% vs. 1.93%; RR (95% CI) 0.33 (0.09, 1.26), I2 = 0%, P = 0.11] and the rate of in-hospital reoperation [5.64% vs. 5.99%; RR (95% CI) 1.01(0.59, 1.73), I2 = 33%, P = 0.98]. The overall long-term mortality rate of BAV patients was better than that of TAV patients [1.63% vs. 8.15%; RR (95% CI) 0.34 (0.13, 0.86), I2 = 0%, P = 0.02]. During the follow-up observation period, patients in TAV group showed small but no statistic advantage in 3-year, 5-year, and over 10-year incidences of reintervention. Regarding the secondary endpoints, the two groups showed similar aortic cross-clamping time and total cardiopulmonary bypass time.

Conclusion

The VSARR techniques yielded similar clinical outcomes in both BAV and TAV patients. Although patients with BAV might have a higher incidence of reinterventions after initial VSARR, it is still a safe and effective approach to treat aortic root dilation with or without aortic valve insufficiency. TAV patients showed small but no statistic advantage in long-term (over 10 years) reintervention rate, which means, patients with BAV may face a higher risk of reintervention in the clinic.
Executive functions in preschool children with moderate hyperphenylalaninemia and phenylketonuria: a prospective study
Authors: Paermentier Laetitia , Cano Aline , Chabrol Brigitte , Roy Arnaud
Published: July 2023

Background

The risk of neuropsychological disorders appears to be high in hyperphenylalaninemia (HPA). The hypothesis of executive function impairment is prominent in accounting for the neuropsychological phenotype in phenylketonuria (PKU) and is suspected in moderate hyperphenylalaninemia (MHP). However, the issue of early onset of executive disorders remains. The aim of this study was to explore the hypothesis of early executive dysfunction in HPA patients and the possible links with certain metabolic variables according to the new international classifications for patients with PKU and MHP. A group of 23 HPA children (12 PKU, 11 MHP) aged 3 to 5 years was included and compared to 50 control children. The two groups were comparable in terms of socio-demographics (age, sex, parental education level). Executive functions were assessed using performance-based tests and daily life questionnaires (parents and teachers).

Results

Preschool HPA patients have comparable executive scores to control subjects. In contrast, PKU patients score significantly worse than MHP patients on 3 executive tests (verbal working memory, visual working memory and cognitive inhibition. There is no executive complaints in daily life (parents and teachers) for the 2 groups of patients. In addition, 3 correlations were identified between executive scores and Phe levels at inclusion, mean Phe level and variability of Phe levels throughout life.

Conclusions

Thus, there appears to be evidence of early executive dysfunction in PKU preschool-children, but not in MHP children. Occasionally, certain metabolic indicators can predict executive difficulties in young children with PKU.
Single-cell sequencing analysis of peripheral blood in patients with moyamoya disease
Authors: Tang Qikai , Li Wenjun , Huang Jie , Wu Yuting , Ma Chenfeng , Tu Yiming , Zhu Qianmiao , Lu Jiacheng , Xie Jiaheng , Liu Yu , Mao Xiaoman , Wu Wei
Published: July 2023

Background

At present, the etiology of moyamoya disease is not clear, and it is necessary to explore the mechanism of its occurrence and development. Although some bulk sequencing data have previously revealed transcriptomic changes in Moyamoya disease, single-cell sequencing data has been lacking.

Methods

Two DSA(Digital Subtraction Angiography)-diagnosed patients with moyamoya disease were recruited between January 2021 and December 2021. Their peripheral blood samples were single-cell sequenced. CellRanger(10 x Genomics, version 3.0.1) was used to process the raw data, demultiplex cellular barcodes, map reads to the transcriptome, and dowm-sample reads(as required to generate normalized aggregate data across samples). There were 4 normal control samples, including two normal samples GSM5160432 and GSM5160434 of GSE168732, and two normal samples of GSE155698, namely GSM4710726 and GSM4710727. Weighted co-expression network analysis was used to explore the gene sets associated with moyamoya disease. GO analysis and KEGG analysis were used to explore gene enrichment pathways. Pseudo-time series analysis and cell interaction analysis were used to explore cell differentiation and cell interaction.

Results

For the first time, we present a peripheral blood single cell sequencing landscape of Moyamoya disease, revealing cellular heterogeneity and gene expression heterogeneity. In addition, by combining with WGCNA analysis in public database and taking intersection, the key genes in moyamoya disease were obtained. namely PTP4A1, SPINT2, CSTB, PLA2G16, GPX1, HN1, LGALS3BP, IFI6, NDRG1, GOLGA2, LGALS3. Moreover, pseudo-time series analysis and cell interaction analysis revealed the differentiation of immune cells and the relationship between immune cells in Moyamoya disease.

Conclusions

Our study can provide information for the diagnosis and treatment of moyamoya disease.
Advanced practice nurse intervention versus usual care for hypertension control: study protocol for an open-label randomized controlled trial
Authors: Vay-Demouy Juliette , Cinaud Alexandre , Malka Nathan , Mion Baptiste , Kretz Sandrine , Lelong Hélène , Blacher Jacques
Published: July 2023

Background

Hypertension is the most frequent chronic pathology in France and in the world. It is one of the main modifiable cardiovascular risk factors. In France, 50% of treated hypertensives are uncontrolled and only 30% of treated patients are fully adherent to their antihypertensive treatment. Poor adherence to drug treatments is considered as one of the main causes of non-control of hypertension. Since 2018, a new profession has entered the French healthcare system: advanced practice nurses (APN). They have many broad-based skills, at the interface of nursing and medical exercises. The purpose of this study is to assess the impact of an APN intervention versus usual care on hypertension control.

Methods

The study will take place at the Hôtel-Dieu University Hospital, Paris, France, as prospective, open-label, controlled, randomized 1-to-1, monocentric, and superiority trial. The participants will be recruited during day hospitalization for cardiovascular assessment in the context of their hypertension management. Patients will be divided into two groups: a “usual care” group which will continue traditional follow-up (day hospitalization followed by consultation with a medical doctor (MD) within approximately 2–12 months) and an “intervention” group which will meet an APN between the day hospitalization and the MD consultation. Participants will be monitored until 12 months after the day hospitalization, depending on their last follow-up study appointment (MD consultation). The primary outcome is the rate of controlled BP (BP < 140/90 mmHg in office BP measurement) in each group. The hypothesis formulated is that an individual APN intervention, included in usual hypertension management, improves hypertension control.

Discussion

This innovative study will be the first in France where APNs are beginning to be established in the healthcare system. It will provide an objective look at this new profession and the impact it can have in the framework of global management of hypertension.

Trial registration

ClinicalTrials.gov NCT0448249. Registered on June 24, 2020.