bluuebunny/crossref_metadata_2025 huggingface dataset:
Studi Korelasional Self Efficacy dan Burnout Syndrome Perawat Ruang Kritis pada Masa Pandemi Covid-19
Authors: Rudiyanto Rudiyanto , Purnamasari Andita , Barata Brian Putra
Published: February 2023

Abstrak
Peningkatan jumlah pasien terjadi selama masa pandemi Covid-19 menyebabkan peningkatan beban pekerjaan terhadap perawat yang bekerja di ruang kritis yang berisiko menyebabkan burnout, sehingga dibutuhkan self efficacy untuk mencegah terjadinya burnout. Tujuan dari penelitian ini untuk mengetahui hubungan self efficacy dan burnout syndrome pada perawat ruang kritis di masa pandemi Covid-19. Pada penelitian ini jenis penelitian yang digunakan adalah study correlation dengan metode penelitian cross sectional. Sampel yang didapatkan sebanyak 55 responden dengan menggunakan total sampling. Analisis data pada penelitian ini menggunakan Chi-square dengan uji Fisher’s Exact Test. Pengumpulan data menggunakan kuesioner self efficacy dan MBI-HSS (Maslach Burnout Inventory Human Service Survey). Hasil penelitian menunjukkan hampir seluruh perawat memiliki self efficacy yang tinggi (78,2%) dan sebagian besar perawat tidak mengalami burnout syndrome (60,0%). Diperoleh nilai sig. (2-sided) 0,006 (p<0,05) maka ada hubungan yang signifikan antara self efficacy dan burnout syndrome pada perawat ruang kritis di masa pandemi Covid-19. Upaya peningkatan self efficacy pada diri perawat dengan berbagai upaya pengalaman dan belajar akan mampu meminimalisir kejadian burnout meskipun dengan beban kerja yang tinggi.
Kata kunci: self efficacy, burnout, perawat kritis
 
Abstract
The increased number of patients during the Covid-19 pandemic increased the workload of nurses working in a critical room, putting them at risk of burnout. Thus, self-efficacy is required to prevent burnout. The goal of this study was to see if there was a link between self-efficacy and burnout syndrome in the nurses' critical care unit during the Covid-19 pandemic. This study was a correlation study using a cross-sectional research method. The total sampling technique was used to obtain 55 respondents for the sample. The data in this study was analyzed using Chi-square and Fisher's Exact Test. The data were gathered using self-efficacy questionnaires and the MBI-HSS (Maslach Burnout Inventory Human Service Survey). The results showed that almost all nurses had high self-efficacy (78.2%) and most nurses did not experience burnout syndrome (60.0%). From the data analysis, it was obtained sig. (2-sided) value of 0.006 (p <0.05). During the Covid-19 pandemic, there was a significant correlation between self efficacy and burnout syndrome in the nurses' critical care unit. Attempts to improve self efficacy through experience and learning will help minimize burnout even with a high workload.
Keywords: Self efficacy, burnout, critical nurse
Faktor Pengetahuan dan Perilaku dalam Mematuhi Protokol Kesehatan pada Keluarga Pasien di Era Pandemi Covid-19
Authors: Muliawati Dian Ika , Yulitasari Brune Indah , Putri Tengku Isni Yuli Lestari
Published: February 2023

Abstrak
Pengetahuan, perilaku dan kepatuhan keluarga dalam melakukan protokol kesehatan mempunyai peranan besar untuk memutus mata rantai Covid-19. Tujuan penelitian untuk mengetahui hubungan pengetahuan dan perilaku dengan kepatuhan keluarga pasien terhadap protokol kesehatan sebagai upaya pencegahan dan penyebaran penyakit Covid-19 di ruang tunggu Instalasi Layanan Jantung Pembuluh Darah Terpadu RSUP Dr Sardjito Yogyakarta di Era Pandemi Covid-19. Penelitian ini merupakan penelitian kuantitatif dengan desain penelitian analitik korelasi. Rancangan penelitian adalah cross sectional study. Sampel penelitian sebesar 63 responden dengan menggunakan consecutive sampling. Instrumen penelitian ini menggunakan kuesioner pengetahuan dan perilaku yang telah digunakan dalam penelitian oleh Yanti NPD dkk serta pedoman observasi. Analisis data kuantitatif menggunakan uji analisis Chi-Square. Hasil Uji analisis Chi-Square antara pengetahuan dengan kepatuhan memiliki nilai p=0,000, dan perilaku dengan kepatuhan memiliki nilai p= 0,000. Ada hubungan antara pengetahuan dan perilaku dengan kepatuhan protokol kesehatan pada keluarga pasien di ruang tunggu Instalasi Layanan Jantung Pembuluh Darah Terpadu RSUP Dr Sardjito Yogyakarta di Era Pandemi Covid-19. Hasil penelitian menunjukkan bahwa pengetahuan dan perilaku yang baik dapat mempengaruhi kepatuhan seseorang dalam mematuhi protokol kesehatan di Era Pandemic Covid-19.
Kata kunci: pengetahuan, perilaku, kepatuhan, protokol kesehatan, Covid-19
 
Abstract
Knowledge, behavior, and family obedience in following health protocols all play a significant role in breaking the Covid-19 chain. The study sought to ascertain the relationship between knowledge and behavior with patient family compliance with health protocols in an effort to prevent and spread Covid-19 disease in the waiting room of the Integrated Cardiovascular Service Installation of Dr Sardjito General Hospital, Yogyakarta, during the Covid-19 Pandemic. This is a quantitative study using a correlation analytic research design. A cross-sectional study was used for the research. Using consecutive sampling, 63 people were chosen for the study. The research instrument included knowledge and behavior questionnaires developed by Yanti NPD et al, as well as observation guidelines. Chi-Square analysis test for quantitative data analysis. The Chi-Square analysis test results between knowledge and compliance have p = 0.000, and behavior with compliance has p = 0.000. In the era of the Covid-19 pandemic, there is a link between knowledge and behavior and adherence to health protocols in patient families in the waiting room of the Integrated Cardiovascular Service Installation of Dr Sardjito General Hospital Yogyakarta. The study's findings indicate that good knowledge and behavior can influence a person's compliance to health protocols in the Covid-19 Pandemic Era.
Keywords: knowledge, behavior, compliance, health protocols, Covid-19
Sialendoscopy as a Useful Diagnostic and Interventional Tool for the Various Salivary Gland Disease: Our Experiences
Authors: Park Soomin , Kim Seunghwa , Kim Subin , Kim Ji-Sun , Kim Byung Guk , Chang Ki-Hong , Lee Dong-Hyun , Park Jun-Ook
Published: February 2023

Background and Objectives Sialendoscopy is useful for the diagnosis and treatment of obstructive salivary gland diseases, but not yet universally employed because it requires dedicate, expensive, and fragile endoscopic equipment; moreover, the surgical technique is also delicate. Here, we describe our initial experience of sialendoscopy, as well as the learning curve, precautions, and drawbacks that beginners must overcome in employing sialendoscopy.Subjects and Method The medical records of 98 patients who underwent sialendoscopic procedures at Eunpyeong St. Mary’s Hospital from May 2019 to March 2022 were retrospectively reviewed. The type of procedure, success rate, operation time, and complications were analyzed.Results We have performed a total of 85 sialendoscopic procedures, including 79 to treat submandibular sialolithiasis, two to treat submandibular ductal stenosis, two to treat parotid sialolithiasis, and two to treat parotid ductal stenosis. Of the total of 81 patients with sialolithiasis, 82.4% were treated by sialendoscopy only, 15.3% by hybrid procedure, and 2.3% opted to preserve the salivary gland and convert to external submandibular gland excision. Four patients with ductal stenosis were treated via endoscopic bougination; stents were placed for 4 weeks without any restenosis. The operation time was significantly shorter for the second half than for the first half of the patients (58.6 min vs. 39.8 min). Longer operation time was associated with the parotid gland diseases, larger stones (>5 mm in diameter), more proximal stones (from the salivary gland), and multiple stones. We encountered no major surgical complications.Conclusion Sialendoscopy is useful and safe; even beginners can evaluate and manage obstructive salivary gland diseases.
Protective Effect of Locally Injected Polydeoxyribonucleotide in Ischemic Murine Random Skin Flaps
Authors: Kim Jiye , Yang Jaemoon , Ku Minhee , Im Jinhyuck , Lee Ji Yong , Koh Yoon Woo , Choi Eun Chang , Sim Nam Suk , Kim Ji-Hoon
Published: February 2023

Background and Objectives This study aimed to investigate the protective effect of polydeoxyribonucleotide (PDRN) against skin flap necrosis in a murine skin flap model.Materials and Method Twenty mice with rectangular skin flaps on the dorsum were randomly divided into the PDRN (n=10) and pentobarbital sodium (PBS) (n=10) injection groups. PDRN (8 mg/kg) was subdermally injected at 12 different points immediately after the operation. After 7 days, the flap perfusions were evaluated using a laser speckle contrast imaging (LSCI) system, and specimens were collected for immunohistochemistry analysis.Results The percentage of survival area relative to the total flap area was significantly higher in the PDRN group (60.87%±7.63%) than in the PBS group (45.23%±10.72%) (p<0.05). The mean LSCI perfusion signal of the distal part of the skin flap in the PBS group was 0.57±0.12, and that in the PDRN group was 0.74±0.13 (p<0.05). The PDRN group had a significantly lower interleukin 1 beta expression than the PBS group and higher vascular endothelial growth factor α expression than the PBS group (p<0.05).Conclusion These findings suggest that subdermally injected PDRN is more effective in enhancing flap survival during necrosis.
Lessons From a Case of Failed Attempt to Remove Pleomorphic Adenoma of the Accessory Parotid Gland via Transoral Approach
Authors: Park Sang Hoo , Heo Jae Won , Lee Dong Kun
Published: February 2023

An accessory parotid gland is salivary gland tissue that exists separately anterior to the parotid gland. Since malignant tumors can be found in about 50% of accessory parotid tumors, the standard treatment is radical resection via externa l approach. However, with the development of endoscopic surgery in the head and neck field, the transoral approach using an endoscope is also being tried. Although this technique could remove benign tumors without skin incision, there may be cases where removal via transoral approach may prove difficult. The authors experienced a case of failed attempt to remove pleomorphic adenoma in the accessory parotid gland via transoral approach in a 24-year-old male patient. We analyzed the causes of surgical failure in this case from various perspectives. We believe that our lessons from this failed case could help determine the appropriate surgical indications of transoral approach in the accessory parotid gland tumor.
Merocel® in a Glove Finger Packing After Endoscopic Endonasal Reduction of Medial Blowout Fractures
Authors: Jung Il Gu , Kim Dong Guk , Shim Woo Sub , Jung Hahn Jin
Published: February 2023

Orbital blowout fracture (BOF) is quite common in maxillofacial trauma. In recent years, with the development of endoscopic technique, endoscopic endonasal reduction (EER) has been widely performed for medial BOFs by otolaryngologists. After EER for medial BOF, nasal packing may be necessary for sustaining the reduced orbital contents. When we applied the packing method using Merocel® (Medtronic) in a glove finger, we found that it could reduce the operation time as well as difficulty. In addition, pain and bleeding during packing removal was minimized. In this article, we share our experience by introducing this novel packing method using a glove with Merocel®.
Changes and correlations of T-cell coinhibitory molecule programmed death-1 and interferon-γ in pediatric immune thrombocytopenia
Authors: El-Gendy Fady Mohamed , Shehata Amira M.F. , El-Kawy Esam Awad Abd , El-Hawy Mahmoud Ahmed
Published: February 2023

Background: Immune thrombocytopenia (ITP) is an acquired autoimmune disease characterized by abnormalities of T cells subsets. Programmed death-1 (PD-1) is a co-signaling inhibitory molecule in T cells that is involved in many autoimmune diseases.Purpose: Here we aimed to measure changes in PD-1 expression and serum interferon-γ (IFN-γ) levels before and 1 month after treatment in pediatric patients with newly diagnosed ITP.Methods: We measured PD-1+ CD4+ T cells percentages using flow cytometry and the serum IFN-γ levels by enzyme-linked immunosorbent assay in 40 pediatric patients with ITP and 20 healthy controls.Results: Compared with healthy controls, the PD-1+ CD4+ T cells percentages and serum IFN-γ levels were significantly higher in ITP patients before and 1 month after therapy. A correlation study revealed that PD-1+ CD4+ T cells percentage was negatively associated with platelet count and positively associated with IFN-γ level in patients with ITP. Furthermore, serum IFN-γ levels were significantly decreased in patients after treatment, but no significant change was detected in the percentage of PD-1+ CD4+ T cells before or 1 month after therapy.Conclusion: PD-1+ CD4+ T cells expression and IFN-γ levels were increased in patients with ITP. These preliminary data suggest a potential role of PD-1+ CD4+ T cells as mediators of ITP. We also found a correlation between PD-1+ CD4+ T cells and both platelet counts and IFN-γ levels. These findings suggest a potential role of PD-1+ CD4+ T cells and IFN-γ in the pathogenesis of ITP. Further studies investigating PD-1 expression in different T-cell subsets, serum IFN-γ concentrations, and antiplatelet antibodies levels over a longer duration after therapy initiation could delineate the precise role of PD-1 in ITP pathogenesis. Consequently, novel nontraditional therapeutic strategies for ITP patients may become available.
Stomach content and stable isotopes illustrate large spatial similarity in the Wadden Sea fish food-web structure
Authors: Poiesz SSH , Witte JIJ , van der Meer MTJ , Jager Z , Soetaert KER , van der Heide T , van der Veer HW
Published: February 2023

Spatial variability in the Wadden Sea fish food-web structure was studied by comparing stomach content and bulk stable isotopes of fish species caught simultaneously in the Ems and Marsdiep basins during 2012-2014. Almost all 31 fish species caught were generalist feeders. In both basins, similar predator-prey relationships were found in which a few key prey species fuelled the fish food web. Copepods and brown shrimp were the most important prey species in both basins, mysid shrimp were more important as prey in the Ems basin, while shore crab and herring were more important prey species in the Marsdiep basin. The observed spatial variability in prey preferences was most likely the result of local differences in predator and prey abundances. Published absolute trophic positions based on compound-specific stable isotopes were available for some fish species and indicated low variability between the basins. Estimated absolute trophic positions based on stomach content and on bulk stable isotopes could not be used for the analysis of spatial variability due to sensitivity to sampling procedure (stomach content) and sampling size and baseline (bulk stable isotopes). Although estimates based on bulk stable isotopes underestimated absolute trophic levels in both basins, they can be used for the analysis of relative trophic positions of fish species. Relative trophic positions showed a significant correlation for most fish between the Ems and Marsdiep basins, also indicating a large spatial similarity in trophic structure.
Assessing sea floor functional biodiversity and vulnerability
Authors: Beauchard O , Thompson MSA , Ellingsen KE , Piet G , Laffargue P , Soetaert K
Published: February 2023

The marine benthos has been largely studied through the use of response traits that characterise species vulnerability to disturbance. More limited has been the specific use of effect traits that represent other species descriptors and that express ecosystem functions. On the sea floor, the benthos is a key ecosystem-engineering component for which functions can be relevantly derived from effect traits. This study provides a typology of sea floor functions based on an extensive data compilation of effect traits. We classified 812 benthic invertebrate species from the northeast Atlantic by 15 effect traits expressing substratum alteration and habitat creation. Cluster analysis identified 15 species groups that represented various epi- or endobenthic functions. Beyond function-habitat specificity, we show that soft sediment species exhibited broader functional niches in the trait space that increase multi-functionality, and were endowed with rare combinations of traits that expanded the functional extent of the species assemblage. As a consequence, soft sediments can host a higher functional diversity than hard substrata because a wider range of above- and below-substratum activities are possible in soft bottoms. Based on response traits documented for the same species and used to express vulnerability to natural or human-induced disturbance, we then show that vulnerability within sea floor functions can be considerably variable. This can be a consequence of the independence between the evolutionary nature of response traits and the contingent engineering abilities of benthic species through effect traits. The paper provides theoretical and utilitarian clarifications on this trait dichotomy.
Цифровая система управления жизненным циклом объектов капитального строительства
Authors: ЧЕЛЫШКОВ Павел Дмитриевич , ВОЛКОВ Андрей Анатольевич , ДАВЫДОВ Алексей Евгеньевич
Published: February 2023

Рассмотрены современные теоретические и практические аспекты формирования цифровой системы управления жизненным циклом объектов капитального строительства, включая вопросы формализации структуры системы, анализ взаимосвязей ее элементов и мероприятия по их разработке. Система управления способствует повышению качества строительства за счет обеспечения достоверности информации, автоматизации процессов принятия решений и прозрачности контроля исполнения. Реализация механизмов системы управления на практике формирует возможность построения информационных систем градостроительного планирования, а на более высоком уровне - территориального развития. Таким образом, предполагается полноценное включение строительного комплекса в экосистему цифровой экономики, сокращение сроков обоснования инвестиций, инженерных изысканий, проектирования и строительства в интересах конечного потребителя. Масштаб задачи создания системы управления предполагает ее декомпозицию на отдельные проекты по созданию элементов и подсистем различных уровней. Подобные проекты имеют, как правило, свои целевые показатели и график выполнения. В статье в первом приближении предпринята попытка систематизации рассматриваемой предметной области и анализа задач по построению системы управления. Рассмотрены вопросы построения и применения государственной информационной системы обеспечения градостроительной деятельности, применения классификатора строительной информации, обмена данными с использованием XML-схем, построения цифровой системы требований. Создавая цифровую экосистему отрасли в целом, на всех уровнях управления необходимо осознанно следовать принципу приоритета и первоосновы стратегического планирования в отношении тактического и тактического в отношении оперативного, включая четкую иерархию, прозрачность и преемственность ответственности; профессионализм и объективность лиц, принимающих решения; независимость экспертизы.
Перераспределение изгибающих моментов в перекрытиях с внешним армированием
Authors: СИМАКОВ Олег Александрович
Published: February 2023

Приводится анализ численного решения задачи перераспределения изгибающих моментов в монолитном безбалочном беcкапительном перекрытии при локальном усилении внешним армированием, вызванном увеличением полезной нагрузки. Задача повышения несущей способности имеющихся несущих конструкций перекрытия актуальная. Как правило, это необходимо при изменении функционального назначения помещений или размещении специального тяжелого оборудования большой массы. Характерное решение усиления монолитных перекрытий с применением внешнего армирования - локальное усиление опорных и пролетных зон. Алгоритмы расчета усиления конструкций, приведенные в нормативно-технической литературе, ограничены общими правилами определения несущей способности усиленных сечений без рассмотрения вопросов перераспределения усилий. В этой связи рассмотрены различные алгоритмы расчета усиления конструкций, применяемые в настоящее время. На основе этих алгоритмов выработаны общие рекомендации по снижению общей ошибки подбора усиления, что позволит выполнить усиление железобетонных конструкций внешним армированием с достаточным уровнем как надежности, так и запаса несущей способности.
Poly (trimethylene carbonate)/doxycycline hydrochloride films in the treatment of Achilles tendon defect in rats
Authors: Zhang Jinchi , Zhang Xiaowei , Li Wei , Guo Jing , Yang Liqun , Yan Guangqi
Published: February 2023

Introduction: In this study, Poly (trimethylene carbonate)/Doxycycline hydrochloride (PTMC/DH) films were introduced to repair the Achilles tendon defects for the first time.

Methods: (PTMC/DH) films with different DH content of 10, 20, and 30% (w/w) were prepared by solvent casting. The in vitro and in vivo drug release of the prepared PTMC/DH films was investigated.

Results: The results of drug release experiments showed that the PTMC/DH films released effective concentrations of doxycycline for more than 7 and 28 days in vitro and in vivo, respectively. The results of antibacterial activity experiments showed diameters of 25.00 ± 1.00 mm, 29.33 ± 1.15 mm, and 34.67 ± 1.53 mm, respectively, for the inhibition zones produced by the release solutions of PTMC/DH films with 10, 20 and 30% (w/w) DH at 2 h, indicating that the drug-loaded films could inhibit Staphylococcus aureus well. After treatment, the Achilles tendon defects have recovered well, as indicated by the more robust biomechanical properties and the lower fibroblast density of the repaired Achilles tendons. Pathology revealed that the pro-inflammatory cytokine, IL-1β, and the anti-inflammatory factor, TGF-β1, peaked in the first three days and gradually decreased as the drug was released more slowly.

Discussion: These results demonstrated that the PTMC/DH films have great potential for regenerating Achilles tendon defects.
Improvement of magnetite adsorption performance for Pb (II) by introducing defects
Authors: Li Yuxin , Lv Guocheng , Liu Hao , Liu Xin , Liao Libing
Published: February 2023

Surface defect engineering is an efficient strategy to enhance the adsorption properties of materials. After calcination in argon, the adsorption capacity of natural magnetite to Pb (II) is significantly improved. The Rietveld refinement, Mössbauer spectrum, and XPS were used to prove the existence of oxygen and cation vacancies in the crystal structure of magnetite after calcination, and it is found that the vacancy content is linearly related to the adsorption amount of Pb (II). This indicates that the increase in the adsorption performance of magnetite after calcination is determined by the vacancy. The adsorption capacity increases from 8 to 26 mg/g when the calcination temperature reaches 700°C. The equilibrium adsorption process of Pb (II) on magnetite can be well fitted to the Langmuir model, and the kinetic adsorption followed a pseudo-second-order mechanism. The improvement of the adsorption performance of magnetite is mainly due to the change in its structure, which depends on the oxidation degree and surface effect of magnetite in the calcination process. This work also provides a theoretical basis for the broad application of magnetite as environmental material.
Epidemiological characteristics, virulence potential, antimicrobial resistance profiles, and phylogenetic analysis of Aeromonas caviae isolated from extra-intestinal infections
Authors: Song Yang , Wang Li-feng , Zhou Kuai , Liu Shuang , Guo Ling , Ye Li-yan , Gu Jiang , Cheng Yan , Shen Ding-xia
Published: February 2023

Objective

Aeromonas caviae (A. caviae) is one of the major etiological agents in human intestinal infections reported to be associated with a broad spectrum of extra-intestinal infections with increasing incidence over recent years. Although previous studies have established its significance as a causative agent of both bloodstream and gastrointestinal infections, the characteristics of A. caviae that cause extra-intestinal infections remain unilluminated.In this single-center retrospective study, we investigated epidemiological characteristics, antimicrobial resistance genes and phenotypes, virulence genes, and phyloevolution of 47 clinical A. caviae isolated from patients with extra-intestinal infections from 2017 to 2020.

Methods

A. caviae strains were identified by biochemical tests and matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF/MS), ultimately confirmed to species level by whole-genome sequencing (WGS). Antimicrobial resistance and virulence genes were identified using the Comprehensive Antibiotic Resistance Database (CARD) and the virulence factor database (VFDB), respectively. Phylogenetic analysis of 47 clinical strains was performed by combining with 521 A. caviae strains from NCBI database.

Results

A. caviae was an opportunistic pathogen in immunocompromised patients, especially those with underlying hepatobiliary diseases and malignancies. 19 out of 47 isolates were identified as multidrug resistance (MDR) strains. Piperacillin-tazobactam, levofloxacin, gentamicin, amikacin with a resistance rate of less than 10% remained as options to treat extra-intestinal infections. 24 out of 47 isolates exhibited non-susceptibility to cephalosporins and cephamycins, all of which carried β-lactamase gene, including blaMOX, blaPER-3, blaOXA, blaNDM, and blaCphA. Most stains (98%, 46/47) carried at least one of the virulence genes, but extra-intestinal infections had a low mortality rate. Phylogenetic analysis indicated the risk of nosocomial transmission but revealed no outbreak. However, the emergence of MDR and β-lactamase resistance genes in extra-intestinal isolates of A. caviae is becoming an increasing risk to public health and requires attention.

Conclusions

This study strengthen our understanding of A.caviae isolated from extra-intestinal infections. It may contribute to the management of extra-intestinal infections as well as the prevention and control of drug resistance.
A systematic review and meta-analysis of thoracic endovascular aortic repair with the proximal landing zone 0
Authors: Zhu Longtu , Li Xiaoye , Lu Qingsheng
Published: February 2023

Background

Thoracic endovascular aortic repair, initially intended for thoracic aortic disease treatment, has extended its application to the proximal zone of the aorta. However, the safety and surgical outcomes of extending the proximal landing zone into the ascending aorta (zone 0) in selected cases remain unknown. Thus, we performed a systematic review and meta-analysis of zone 0 thoracic endovascular aortic repair (TEVAR) to obtain a deeper understanding of its safety, outcomes, and trends over time.

Methods

A literature search was performed using PubMed, EMBASE, and Web of Science databases in accordance with the preferred reporting items for systematic reviews and meta-analyses guidelines, from January, 1997 to January, 2022. Only studies involving zone 0 TEVAR were included. The retrieved data from the eligible studies included basic study characteristics, 30-day/in-hospital mortality rate, indications, comorbidities, stent grafts, techniques, and complications. Summary effect measures of the primary outcomes were obtained by logarithmically pooling the data with an inverse variance-weighted fixed-effects model.

Results

Fifty-three studies with 1,013 patients were eligible for analysis. The pooled 30-day/in-hospital mortality rate of zone 0 TEVAR was 7.49%. The rates of post-operative stroke, type Ia endoleak, retrograde type A aortic dissection, and spinal cord ischemia were 8.95, 9.01, 5.72, and 4.12%, respectively.

Conclusions

Although many novel stent grafts and techniques targeting zone 0 TEVAR are being investigated, a consensus on technique and device selection in zone 0 TEVAR is yet to be established in current practice. Furthermore, the post-operative stroke rate is relatively high, while other complication rates and perioperative death rate are comparable to those of TEVAR for other aortic zones.
Constipation and cardiovascular disease: A two-sample Mendelian randomization analysis
Authors: Dong Qichao , Chen Delong , Zhang Yuxuan , Xu Yi , Yan Longhui , Jiang Jun
Published: February 2023

Background

Although several observational studies have suggested positive associations between constipation and cardiovascular disease (CVD), a solid causal association has not been demonstrated. Therefore, a two-sample Mendelian randomization (MR) study was performed to investigate the causal associations between constipation and CVD.

Methods

Independent genetic variants strongly associated with constipation were obtained from the FinnGen consortium. Summary-level data for CVD, including coronary artery disease (CAD), myocardial infarction (MI), heart failure (HF), atrial fibrillation (AF), stroke, and its subtypes, were collected from a few extensive genome-wide association studies (GWASs). The inverse-variance weighted methods, weighted median, and MR-Egger were used for the MR estimates. The Cochran’s Q test, MR-Egger intercept tests, MR-PRESSO, MR Steiger test, leave-one-out analyses, and funnel plot were used in the sensitivity analysis.

Results

Genetically determined constipation was suggestively associated with AF risk (odds ratio (OR), 1.07; 95% confidence interval (CI), 1.01, 1.14; p = 0.016). Constipation and other CVD do not appear to be causally related. It was demonstrated that the results were robust through sensitivity analyses.

Conclusion

This MR study demonstrated suggestive causal associations of constipation on AF, despite no associations achieving a significance value after multiple testing corrections. There was no evidence of an association between constipation and the risk of CAD, MI, HF, stroke, or stroke subtypes.
Gastrointestinal functional disorders can benefit from the use of medical devices made of substances
Authors: Savarino Vincenzo , Marabotto Elisa , Zentilin Patrizia , Furnari Manuele , Bodini Giorgia , Giovanni Giannini Edoardo , Vincenzo Savarino Edoardo
Published: February 2023

Medical devices made of substances (MDMS) have recently gained great popularity in several specialties of internal medicine, including gastroenterology. In the last decades this discipline has known relevant advances in the cure of severe diseases, such as peptic ulcer, gastroesophageal reflux disease and chronic hepatitis C, thanks to the revolutionary development of new drugs able to act on single receptors changing a particular cell function or blocking microbial and viral replication. However, there are many gastroenterological illnesses that are difficult to treat with traditional medicinal products because of their complex and poorly known pathophysiology, which comprises altered motility, visceral hypersensitivity, gut dysbiosis, intestinal mild inflammation with impaired immune function, increased mucosal permeability and abnormal brain-gut interaction. They are mainly represented by esophageal functional disorders (reflux hypersensitivity, functional heartburn), functional dyspepsia, irritable bowel syndrome, functional constipation and functional diarrhea. Traditional drugs do not provide a definitive resolution of these disorders with a multifactorial pathogenesis and they can benefit from the use of MDMS, which seem to have the ability to act on different factors thanks to the synergistic action of their various components. International medical literature already reports many clinical trials performed with the well-known standards for evaluating their efficacy and safety in a great part of the above-mentioned conditions.
P-wave velocity structure and implications for magmatism and metallogenesis in the southern Altaids: Constraint from wide-angle seismic data along the Altai-Eastern Tianshan traverse
Authors: Bai Zhiming , Zhao Liang , Xiao Wenjiao , Xu Tao , Badal José
Published: February 2023

Altaids in the Central Asian Orogenic Belt (CAOB) is one of the world’s largest orogenic belts containing mineral deposits. Together with the Junggar terrain they open an important window to study the Paleozoic tectonic evolution of the CAOB. In this paper, we analyze a 637-km-long wide-angle refraction/reflection seismic profile across the Altai-Eastern Tianshan orogenic belt in the southern Altaids, conducted in September 2018 using 10 large explosive charges fired in drilled holes. We use a traveltime inversion method to reconstruct the lithospheric P-wave velocity structure along the profile. The lithosphere is composed of a 43-55-km-thick crust, a ∼10-km-thick crust-mantle transition layer beneath the Altai Mountain, and a ∼25-km-thick layer of lithospheric mantle. The results clearly reveal: a prominent Moho uplift beneath the Yemaquan Island Arc, two major crustal-scale low-velocity anomalies (LVAs) beneath the Yemaquan Arc and Bogda Mountain, and three high-velocity anomalies (HVAs) near the surface around the Kalatongke, Yemaquan and Kalatage mining areas. We hypothesize that the subduction of the Paleo-Asian Ocean occurred with strong mantle upwelling. We suggest that continued compression of the Paleo-Asian Ocean causes the delamination of lithosphere, as well as asthenospheric material upwelling and magma underplating into the crust. Consistently, Paleozoic mafic-ultramafic rocks and mantle-derived minerals related to gold, copper and nickel deposits, are widely extended in the area. Our results show that the P-wave velocity-depth curves for deeper depths (>30 km) in the southern Altai and Junggar Basin are close to those of the continental arcs and global continent average. Despite powerful Paleozoic subduction activity, orogeny and volcanism strongly modified the lower crust in the region, part of ancient continental crust was still preserved below the southern Altai and Junggar Basin. In addition, the upper part (depth 5–30 km) of the velocity-depth curve for the Junggar Basin is close to that of the Costa Rica volcanic front and the British Columbia accreted terrain, suggesting that Paleozoic orogenic activity has intensively reconstructed the upper-middle crust beneath the Junggar Basin.
Examining culturally diverse learners’ motivation and engagement processes as situated in the context of a complex task
Authors: Anyichie Aloysius C. , Butler Deborah L.
Published: February 2023

Student learning processes, including motivation and engagement, have been identified as malleable and situated in context. We have limited understanding about how to enhance motivation and engagement processes for culturally diverse learners in today’s multicultural classrooms. To support thinking about that challenge, this work built on research on both culturally responsive teaching (CRT) and self-regulated learning (SRL), each of which identifies pedagogical practices that enhance student engagement and motivation. This study examined how students at a culturally diverse independent elementary school in the West Coast of Canada participated in classroom context that integrated CRT and SRL-promoting practices. Specifically, this study examined culturally diverse learners’ engagement and motivation during a complex learning task. Data collected included classroom observations, practice records and documents, students’ work samples, and student interviews and student surveys. The results demonstrated: (1) above medium levels of engagement and motivation, among participants, that varied across specific contexts; and (2) associations between culturally diverse learners’ engagement and motivation; and complex learning context such as CRT and SRL-promoting practices. Implications for future research on culturally diverse students’ engagement as well as designing a complex task that integrated a culturally responsive teaching and self-regulated learning pedagogical practices to support engagement and motivation are discussed.
Social emotional learning matters: Interpreting educators’ perspectives at a high-needs rural elementary school
Authors: Dyson Ben , Shen Yanhua , Howley Donal , Baek Seunghyun
Published: February 2023

Introduction

School educators’ have a great influence on the adoption, sustainability, and development of school-based Social and Emotional Learning (SEL) programs. The purpose of this school-based research was to investigate educators’ experiences and perspectives on implementing SEL in a high-needs rural elementary school setting.

Methods

Fifteen school educators (n= 15), including ten K-5 classroom teachers, one special education teacher, one social worker, and three school leaders, participated in this study. In addition, lessons were observed, and 17 sets of field notes were taken during 17 different days of visit (60–90 min) over the two semesters. A case study design drawing on qualitative research methods was utilized.

Results

The inductive analysis and constant comparison of the collected data generated six themes:prerequisite for academic success, essential skills for everyday life, lack of time, lack of preparation and development, home-school disconnection, andpushback from students.

Discussion

The study provided qualitative evidence to support the need for quality SEL implementation and revealed nested levels of constraints for school educators’ implementing SEL from the “voices” of school educators. The study also calls for collaborative efforts and shared strategies to facilitate “legitimate” long-term partnerships between universities and schools, families, and communities, particularly in rural areas, in promoting a more holistic vision of the social and emotional development of our children.
Aspartate aminotransferase/alanine aminotransferase ratio was associated with type 2 diabetic peripheral neuropathy in a Chinese population: A cross-sectional study
Authors: Yan Pijun , Wu Yuru , Dan Xiaofang , Wu Xian , Tang Qian , Chen Xiping , Xu Yong , Zhu Jianhua , Miao Ying , Wan Qin
Published: February 2023

Objective

Despite previous research that focused on aspartate aminotransferase/alanine aminotransferase ratio (AAR) as predictors of type 2 diabetes mellitus (T2DM) and cardiovascular disease, there has been limited research evaluating the association between AAR and diabetic microvascular complications. This study aimed to investigate the association of AAR with diabetic peripheral neuropathy (DPN).

Methods

A total of 1562 hospitalized patients with T2DM were divided into four groups according to AAR quartiles. The relationship between AAR and DPN and related parameters was explored by the Spearman correlation coefficients, multivariable logistic regression analysis, and receiver operating characteristic (ROC) curves.

Results

Patients with higher AAR quartiles had higher levels of vibration perception threshold (VPT) and presence of DPN, and AAR was positively associated with VPT and presence of DPN independent of sex, age, body mass index, and diabetic duration (P<0.01 or P<0.05). Moreover, AAR remained significantly associated with a higher odds ratio (OR) of DPN (OR 2.413, 95% confidence interval [CI] 1.081-5.386, P<0.05) after multivariate adjustment. Additionally, the risk of presence of DPN increased progressively as AAR quartiles increased (all P for trend <0.01) in both male and female subjects, and the highest quartile of AAR of male and female subjects was respectively associated with 107.3% (95% CI: 1.386-3.101; P<0.01) and 136.8% (95% CI: 1.550-3.618; P<0.01) increased odds of DPN compared with the lower quartiles. Last, the analysis of receiver operating characteristic curves revealed that the best cutoff values for AAR to predict the presence of DPN were 0.906 (sensitivity: 70.3%; specificity: 49.2%; and area under the curve [AUC]: 0.618) and 1.402 (sensitivity: 38%; specificity: 81.9%; and AUC: 0.600) in male and female subjects, respectively.

Conclusions

These findings suggest that the high AAR may be associated with the presence of DPN in Chinese patients with T2DM, and may be used as an additional indicator of risk of DPN.
Butyrate and obesity: Current research status and future prospect
Authors: Peng Ke , Dong Wenjie , Luo Taimin , Tang Hui , Zhu Wanlong , Huang Yilan , Yang Xuping
Published: February 2023

Over the past few decades, increasing prevalence of obesity caused an enormous medical, social, and economic burden. As the sixth most important risk factor contributing to the overall burden of disease worldwide, obesity not only directly harms the human body, but also leads to many chronic diseases such as diabetes, cardiovascular diseases (CVD), nonalcoholic fatty liver disease (NAFLD), and mental illness. Weight loss is still one of the most effective strategies against obesity and related disorders. Recently, the link between intestinal microflora and metabolic health has been constantly established. Butyrate, a four-carbon short-chain fatty acid, is a major metabolite of the gut microbiota that has many beneficial effects on metabolic health. The anti-obesity activity of butyrate has been demonstrated, but its mechanisms of action have not been fully described. This review summarizes current knowledge of butyrate, including its production, absorption, distribution, metabolism, and the effect and mechanisms involved in weight loss and obesity-related diseases. The aim was to contribute to and advance our understanding of butyrate and its role in obesity. Further exploration of butyrate and its pathway may help to identify new anti-obesity.
High glucose induced HIF-1α/TREK1 expression and myometrium relaxation during pregnancy
Authors: Li Tengteng , Fei Jiajia , Yu Huihui , Wang Xingxing , Bai Jingjing , Chen Fucai , Li Dan , Yin Zongzhi
Published: February 2023

Background

The incidence of gestational diabetes mellitus (GDM) is increasing worldwide. GDM patients have a significantly higher rate of cesarean section and postpartum hemorrhage, suggesting changes in uterine contractility. TWIK-1-related potassium channel (TREK1) expressed in the pregnant uterus and its role in uterine contraction. In this study, we examined the expression of HIF-1α and TREK1 proteins in GDM uterine and investigated whether high glucose levels are involved in the regulation of human uterine smooth muscle cells (HUSMCs) contraction through TREK1, and verified the role of HIF-1α in this process.

Methods

Compared the uterine contractility between GDM and normal patients undergoing elective lower segment cesarean section. The HUSMCs were divided into normal glucose group, high glucose group, normal glucose with CoCl2 group, CoCl2 with echinomycin/L-Methionine group, and high glucose with echinomycin/L-Methionine group; Compare the cell contractility of each group. Compared the expression of hypoxia-inducible factor-1α (HIF-1α) and TREK1 protein in each group.

Results

The contractility of human uterine strips induced by both KCl and oxytocin was significantly lower in patients with GDM compared with that in normal individuals, with increased TREK1 and HIF-1α protein expression. The contractility of cultured HUSMCs was significantly decreased under high glucose levels, which was consistent with increased expression of HIF-1α and TREK1 proteins. The contractility of HUSMCs was decreased when hypoxia was induced by CoCl2 and increased when hypoxia was inhibited by echinomycin. The TREK1 inhibitor L-methionine also recovered the decreased contractility of HUSMCs under high glucose levels or hypoxia.

Discussion

The high glucose levels decreased the contractility of the myometrium, and increased expression of HIF-1a and TREK1 proteins play a role in changes in uterus contractility.
Obesity and myeloma: Clinical and mechanistic contributions to disease progression
Authors: Marques-Mourlet Constance , Di Iorio Reagan , Fairfield Heather , Reagan Michaela R.
Published: February 2023

Obesity and obesogenic behaviors are positively associated with both monoclonal gammopathy of unknown significance (MGUS) and multiple myeloma (MM). As the only known modifiable risk factor, this association has emerged as a new potential target for MM prevention, but little is known about the mechanistic relationship of body weight with MM progression. Here we summarize epidemiological correlations between weight, body composition, and the various stages of myeloma disease progression and treatments, as well as the current understanding of the molecular contributions of obesity-induced changes in myeloma cell phenotype and signaling. Finally, we outline groundwork for the future characterization of the relationship between body weight patterns, the bone marrow microenvironment, and MM pathogenesis in animal models, which have the potential to impact our understanding of disease pathogenesis and inform MM prevention messages.
The effects of prebiotics on gastrointestinal side effects of metformin in youth: A pilot randomized control trial in youth-onset type 2 diabetes
Authors: Dixon Sydney A. , Mishra Sidharth , Dietsche Katrina B. , Jain Shalini , Mabundo Lilian , Stagliano Michael , Krenek Andrea , Courville Amber , Yang Shanna , Turner Sara A. , Meyers Abby G. , Estrada Doris E. , Yadav Hariom , Chung Stephanie T.
Published: February 2023

Disclosure summary

Dr. Yadav is Chief Scientific Officer and Co-Founder of Postbiotics Inc and has no conflict of interest with this work. All other authors have no conflicts of interest to disclose.

Background

Metformin is the only approved first-line oral glucose lowering agent for youth with type 2 diabetes mellitus (Y-T2DM) but often causes gastrointestinal (GI) side effects, which may contribute to reduced treatment adherence and efficacy. Prebiotic intake may reduce metformin’s side effects by shifting microbiota composition and activity.

Objective

The aims of this study were to determine the feasibility and tolerability of a prebiotic supplement to improve metformin-induced GI symptoms and explore the changes in glycemia and shifts in the microbiota diversity.

Methods

In a two-phase pilot clinical trial, we compared, stool frequency and stool form every 1-2 days, and composite lower GI symptoms (weekly) at initiation of daily metformin combined with either a daily prebiotic or a placebo shake in a 1-week randomized double-blind crossover design (Phase 1), followed by a 1-month open-labeled extension (Phase 2). Plasma glycemic markers and stool samples were collected before and after each phase.

Results

Six Y-T2DM (17.2 ± 1.7y (mean ± SD), 67% male, BMI (42 ± 9 kg/m2), HbA1c (6.4 ± 0.6%)) completed the intervention. Stool frequency, stool composition, and GI symptom scores did not differ by group or study phase. There were no serious or severe adverse events reported, and no differences in metabolic or glycemic markers. After one week Phase 1metformin/placebo Proteobacteria, Enterobacteriaceae, and Enterobacteriales were identified as candidate biomarkers of metformin effects. Principle coordinate analyses of beta diversity suggested that the metformin/prebiotic intervention was associated with distinct shifts in the microbiome signatures at one week and one month.

Conclusion

Administration of a prebiotic fiber supplement during short-term metformin therapy was well tolerated in Y-T2DM and associated with modest shifts in microbial composition. This study provides a proof-of-concept for feasibility exploring prebiotic-metformin-microbiome interactions as a basis for adjunctive metformin therapy.

Clinical trial registration

https://clinicaltrials.gov/, identifier NCT04209075.