bluuebunny/crossref_metadata_2025 huggingface dataset:
Kimura's disease successively affecting multiple body parts: a case-based literature review
Authors: Yang Baodi , Liao Hailan , Wang Minghua , Long Qiaoyan , Zhong Huanhuan , Luo Lin , Liu Zhongmin , Cheng Xiaohui
Published: April 2022

Background

Kimura’s disease is a rare, benign, chronic inflammatory disease that presents as painless, solid masses mainly affecting the deep subcutaneous areas of the head and neck, especially the salivary glands, parotid glands and nearby lymph nodes. It is characterized by elevated peripheral blood eosinophil and Immunoglobulin E (IgE) levels.

Case presentation

A 31-year-old Asian male presented with an orbital space-occupying lesion lasting for 1.5 years. Ten years prior, surgical excision of bilateral fossa cubitalis and groin masses was performed, and the pathological examination showed "lymphoproliferative disease". One year later, masses reappeared near the surgical sites; they grew slowly and shrank after glucocorticoid treatment. At this point, admission examinations showed in the peripheral blood an eosinophil proportion of 13.4%, a total IgE level of 26,900.00 IU/mL, prurigo present on the whole body, and multiple palpable masses near the bilateral fossa cubitalis and groin. The left eyeball was exophthalmic. The left elbow mass was excised, and the pathological examination confirmed Kimura’s disease. Oral glucocorticoid therapy is taken and tapering regularly. The eosinophil count returned to normal, the IgE level gradually decreased, the orbital space-occupying lesion and elbow and groin masses shrank significantly, and the whole-body skin prurigo disappeared. Currently, the patient has been in a stable condition for eighteen months.

Conclusion

Our case provides a novel insight that Kimura’s disease should be involved in the differential diagnosis of inflammatory lesion mass of orbit and also supports systemic regular glucocorticoid as a valuable therapy of such condition, but close follow-up and long-term observation are crucial.
Development of necrotizing enterocolitis in full-term infants with duct dependent congenital heart disease
Authors: Choi Gwang-Jun , Song Jinyoung , Kim Hanna , Huh June , Kang I-Seok , Chang Yun Sil , Sung Se In , Hyun Myung Chul
Published: April 2022

Background

Although many studies have described an increased risk of necrotizing enterocolitis in duct dependent congenital heart diseases, very few have investigated its occurrence in full-term infants with duct dependent congenital heart diseases.

Methods

To evaluate the characteristics and risk factors of necrotizing enterocolitis, we performed a retrospective review of 355 full-term infants with duct dependent congenital heart diseases who received prostaglandin E1 therapy from April 2000 to May 2020.

Results

Necrotizing enterocolitis was observed in 10 patients (3.0%). Their average gestational age and birth weight were 38.2 weeks and 2783.5 g, respectively. The median age at diagnosis was 8.0 days (2–70 days). One patient was diagnosed with necrotizing enterocolitis stage IIA, five with stage IIB, two with stage IIIA, and two with stage IIIB; two (20%) received surgical treatment. The duct dependent pulmonary circulation group had higher frequencies of necrotizing enterocolitis (4.4%) than the duct dependent systemic circulation (2.0%) and parallel circulation (1.3%) groups. The necrotizing enterocolitis and the other groups had significantly different birth weight (2783.5 g vs 3170.9 g, respectively) and gestational age (38.2 weeks vs 39.1 weeks, respectively). Gestational age under 38 weeks (OR 8.87, p = 0.002), birth weight of < 2500 g (OR 5.1, p = 0.042), need for mechanical ventilation (OR 4.6, p = 0.021), parenteral nutrition (OR 107.7, p < 0.001), and functional single ventricle (OR 5.8, p = 0.009) were significant risk factors. The case-fatality rate was higher in the necrotizing enterocolitis (40.0%) than in the other group (8.3%, p = 0.009).

Conclusions

Three percent of full-term infants with duct dependent congenital heart diseases developed necrotizing enterocolitis. Neonates with low birth weight, gestational age less than 38 weeks, functional single ventricle, or receiving assisted mechanical ventilation or parenteral nutrition are at increased risk.
Characterizing the social support and functioning of a low-threshold medication for opioid use disorder treatment cohort at intake
Authors: Oles William , Alexander Marcus , Kumar Navin , Howell Benjamin , O’Connor Patrick G. , Madden Lynn M. , Barry Declan T.
Published: April 2022

Background

Despite the growing morbidity and mortality rates associated with opioid use disorder, a large gap still exists between treatment need and capacity. Low-threshold clinics utilizing medication for opioid use disorder (MOUD) treatment can increase treatment access but are understudied, and little is known about how patient demographic characteristics are associated with their social support and functioning in these settings.

Methods

We used multivariate regression to estimate associations between demographic characteristics and self-reported social support or functioning indicators among patients receiving MOUD in a low-threshold clinic using several validated instruments administered at intake: Behavior and Symptom Identification Scale, Brief Pain Inventory, and Life Events Checklist for DSM-5. Patients initiating MOUD treatment between April 1 and December 31, 2017, with complete surveys were included (N=582).

Results

Patients were primarily male (62%), aged 34 or older (53%), non-Hispanic White (79%), separated or not married (86%), and unemployed (64%). Over 20% did not live in a house or apartment in the past month. Women were more likely to “get along” with people outside their family or in social situations and to identify their partner as their source of support. Women, non-White, and older patients were at higher risk of social functioning-disrupting events (physical/sexual assaults or experiencing chronic pain), while employment and housing were protective against exposure to these trauma-related events. However, employment and housing also decreased the odds of talking with others about substance use. The aforementioned results were obtained from multivariate logistic regression models and were significant to p<0.05.

Conclusions

Variation in support and functioning by demographic characteristics suggests that treatment facilities may benefit from adopting strategies that take baseline disparities in support and functioning into account.
Drivers, facilitators, and sources of stigma among Akha and Lahu hill tribe people who used methamphetamine in Thailand: a qualitative approach
Authors: Udplong Anusorn , Apidechkul Tawatchai , Srichan Peeradone , Mulikaburt Thanatchaporn , Wongnuch Pilasinee , Kitchanapaibul Siwarak , Upala Panupong , Chomchoei Chalitar , Yeemard Fartima , Tamornpark Ratipark , Singkhorn Onnalin
Published: April 2022

Background

The stigma related to drug use has several impacts, including effects on users’ physical and mental health. Methamphetamine is a major drug that is used among hill tribes living in the border areas of Thailand and Myanmar. This study aimed to understand the drivers, facilitators, sources and outcomes of the stigma surrounding drug use, including the expectations among Akha and Lau hill tribe people who use methamphetamine in Thailand.

Methods

Qualitative data were used to elicit information from key informants and members of the hill tribes who used methamphetamine. The questionnaire was developed from a literature review and tested for validity before use. In-depth interviews were used to confidentially gather information from the participants in private rooms in villages. Each interview lasted 45 min, and a thematic analysis was conducted to examine the findings.

Results

A total of 46 participants were recruited to provide information; 95.7% were male, and 50.0% were aged 15–34 years. The majority were married (47.8%), 76.1% were Christian, and 45.7% graduated high school. Six drivers of stigma were detected: being poor, illiterate, unemployed, working aged, female, and married. Culture and tribe acted as facilitators of the stigma attached to methamphetamine use. Four sources of stigma were found: self, family members, peers, and community members. Three outcomes of stigma were determined: poor physical health, mental health, and relationships with others. There were four levels of expectations: no expectations, expectations for themselves, expectations for their family members, and expectations for their community members.

Conclusions

Many personal traits, people living nearby, and socioeconomic factors, including culture and tribes, act as drivers, facilitators, and sources of stigma among hill tribe people who use methamphetamine. A program to reduce methamphetamine use among hill tribes should be implemented, which could eventually minimize stigma.
Study protocol to assess de-implementation of the initial provider encounter for diagnosis and treatment of obstructive sleep apnea: the DREAM (Direct Referral for Apnea Monitoring) Project
Authors: Folmer Robert L. , Boudreau Eilis A. , Atwood Charles W. , Smith Connor J. , Totten Annette M. , Tock Jamie L. , Chilakamarri Priyanka , Sarmiento Kathleen F.
Published: April 2022

Background

Obstructive sleep apnea (OSA) is a very common and serious health condition which is highly prevalent among U.S. military Veterans. Because the demand for sleep medicine services often overwhelms the availability of such services, it is necessary to streamline diagnosis and treatment protocols. The goals of this study are to, (1) assess the efficacy of de-implementing the initial provider encounter for diagnosis and treatment of OSA; (2) determine the negative predictive value (NPV) of home sleep apnea testing (HSAT); (3) develop HSAT usage recommendations for various at-risk patient populations.

Methods

This is a large, pragmatic study that will take place in 3 VA sleep medicine programs: San Francisco, CA; Portland, OR; and Pittsburgh, PA. All Veterans referred for new sleep apnea evaluations at these sites will be included in this four-year study. Outcomes will include time from referral for OSA to sleep testing and treatment; positive airway pressure (PAP) treatment adherence measures; patient-reported clinical outcomes and measures of satisfaction; determination of the NPV of HSAT; HSAT usage recommendations for at-risk patient populations.

Discussion

The DREAM (Direct Referral for Apnea Monitoring) Project will inform sleep medicine providers and clinical organizations regarding strategies to streamline diagnosis and treatment protocols for OSA. Results of this study should have significant impact on clinical practices and professional guidelines.

Trial registration The majority of this project is an observational study of clinical procedures. Therefore, clinical trial registration is not required.
Reliability of different smartphones measuring the hallux valgus parameters in a new rapid method: a follow-up study
Authors: Wang Lin , Zhang Chao , Liang Hao , Zhang Jun , Zhong Weiyang , Zhao Zenghui , Huang Tianji , Luo Xiaoji
Published: April 2022

Objective

This study aimed to further compare the abilities to measure hallux valgus parameters in different smartphones using the intrinsic photograph-editing function.

Methods

We retrospectively reviewed 61 patients (100 feet) of hallux valgus without medical or surgical interventions at our department. The radiographic parameters were assessed and measured via the Picture archiving and communication systems (PACS), iPhone, and Android. The accuracy, reliability, and the time-taken were compared and analyzed between each two methods.

Results

The mean value of measured hallux valgus parameters were as follow: hallux valgus angle (HVA): 33.71 ± 7.25°; the first and second intermetatarsal angle (IMA): 12.84 ± 3.62° in PACS; HVA: 33.59 ± 7.18° and IMA: 12.80 ± 3.65° in Android; HVA: 33.63 ± 7.23° and IMA: 12.87 ± 3.60° in iPhone. No significant difference was found among the average results measured by PACS, Android and iPhone (F = 0.008, P = 0.992 in HVA; F = 0.009, P = 0.991 in IMA). For measurements by PACS, Android smartphone, and iPhone, the variability of HVA (F = 0.061, P = 1.000) and IMA (F = 0.133, P = 1.000) was similar. The intraclass correlation coefficients (ICCs) of the mean results of four times measurements of HVA and IMA as follows: PACS vs Android: 0.995 (0.993–0.997) and 0.982 (0.973–0.988); PACS vs iPhone:0.997 (0.995–0.998) and 0.974 (0.962–0.982); Android vs iPhone:0.997 (0.995–0.998) and 0.981 (0.971–0.987). The interobserver and intraobserver reliability was very good for Android smartphones and iPhone in measuring hallux valgus parameters. The mean time of measurement by PACS, Android smartphone, and iPhone were 25.34 ± 1.18 s, 20.10 ± 0.92 s, and 19.92 ± 0.99 s respectively. The measurement time of smartphones is significantly faster than that of PACS by about 5 seconds (P = 0.000). The measurement time of iPhone was slightly faster than that of Android smartphone, while no significant difference was found (P = 0.24).

Conclusion

It is more convenient and faster to use smartphones when compared with PACS, at the same level of accuracy. Furthermore, the abilities of different smartphone platforms are proven to be of no significant difference.
Acceptability of, and preferences for, remote consulting during COVID-19 among older patients with two common long-term musculoskeletal conditions: findings from three qualitative studies and recommendations for practice
Authors: Paskins Zoe , Bullock Laurna , Manning Fay , Bishop Simon , Campbell Paul , Cottrell Elizabeth , Partner G. P. , Jinks Clare , Narayanasamy Melanie , Scott Ian C. , Sahota Opinder , Ryan Sarah
Published: April 2022

Background

Guidance for choosing face-to-face vs remote consultations (RCs) encourages clinicians to consider patient preferences, however, little is known about acceptability of, and preferences for RCs, particularly amongst patients with musculoskeletal conditions. This study aimed to explore the acceptability of, and preferences for, RC among patients with osteoporosis and rheumatoid arthritis.

Methods

Three UK qualitative studies, exploring patient experiences of accessing and receiving healthcare, undertaken during the pandemic, with people with osteoporosis and rheumatoid arthritis. Study team members agreed a consistent approach to conduct rapid deductive analysis using the Theoretical Framework of Acceptability (TFA) on transcripts from each data set relating to RC, facilitated by group meetings to discuss interpretations. Findings from the three studies were pooled.

Results

Findings from 1 focus group and 64 interviews with 35 people were included in the analysis. Participants’ attitudes to RC, views on fairness (ethicality) and sense-making (intervention coherence) varied according to their needs within the consultation and views of the pandemic. Some participants valued the reduced burden associated with RC, while others highly valued non-verbal communication and physical examination associated with face-to-face consults (opportunity costs). Some participants described low confidence (self-efficacy) in being able to communicate in RCs and others perceived RCs as ineffective, in part due to suboptimal communication.

Conclusions

Acceptability of, and preferences for RC appear to be influenced by societal, healthcare provider and personal factors and in this study, were not condition-dependant. Remote care by default has the potential to exacerbate health inequalities and needs nuanced implementation.
Selection of 1-mm venting or 2.5-mm screw access holes on implant crowns based on cement extrusion and retention capacity
Authors: Zhou Huangjun , Ye Sixian , Liu Min , Feng Hao , Wen Cai
Published: April 2022

Background

This in vitro study aimed to provide evidence regarding the selection of hole diameters of implant crowns to reduce excess cement extrusion at the abutment margin, and to examine the maintenance of their retention capacity in anterior and posterior cement-retained implant crowns.

Methods

Six groups of implant crowns were prepared according to the position of the teeth and the size of their holes as follows: anterior crown without hole (ANH), anterior crown with 1-mm mini venting hole (AMH), anterior crown with 2.5-mm regular screw access hole (ARH), posterior crown without hole (PNH), posterior crown with 1-mm mini venting hole (PMH), and posterior crown with 2.5-mm regular screw access hole (PRH). Temporary cement was used to bond the crowns to the abutments. The mean amount of excess cement extrusion among the different groups at the abutment margin was calculated. Retentive strength under different hole designs was measured as the dislocation force of the crown using a universal testing machine. One-way ANOVA and Welch’s t-test were used to analyze the results.

Results

The average amounts of extruded excess cement were 18.96 ± 0.64, 1.78 ± 0.41, and 1.30 ± 0.41 mg in the ANH, AMH, and ARH groups, respectively, and 14.87 ± 0.36, 1.51 ± 0.40, and 0.82 ± 0.22 mg in the PNH, PMH, and PRH groups, respectively. The hole opening in the crowns could significantly reduce residual cement regardless of its size (p < 0.001). The mean retentive strengths were 54.16 ± 6.00, 47.63 ± 13.54, and 31.99 ± 7.75 N in the ANH, AMH, and ARH groups, respectively, and 57.84 ± 10.19, 53.22 ± 6.98, and 39.48 ± 5.12 N in the PNH, PMH, and PRH groups, respectively. The retention capacity of the implant crown deteriorated rapidly as the holes on the crown surface enlarged.

Conclusions

The presence of a hole on the implant crown reduced the amount of excess cement. The retention ability of the implant crowns deteriorated as the size of the hole increased. Considering the esthetic effect of the crown and the possible influence on crown retention, an implant crown with a 1-mm mini venting hole is a better clinical choice than the one with a 2.5-mm regular screw access hole.
The effect of fluoride iontophoresis on seal ability of self-etch adhesive in human dentin in vitro
Authors: Kijsamanmith Kanittha , Wallanon Parintorn , Pitchayasatit Chanya , Kittiratanaviwat Poonnapha
Published: April 2022

Background

Fluoride iontophoresis (FI) is a non-invasive method for the transfer of fluoride ions under electrical pressure into dental hard tissue. This study aimed to determine the effect of FI on the seal ability of self-etch adhesive in human dentin using dentin permeability test and scanning electron microscopy (SEM).

Methods

The experiments were divided into 2 series: series 1 was performed on 28 extracted intact third molars and series 2 was performed on 28 extracted carious third molars (ICDAS 4 and 5). In each series, 20 teeth were used for dentin permeability test and 8 teeth were used for SEM study. For dentin permeability test, the specimens were divided into dentin without FI (control) and dentin with FI (experimental) subgroups. Hydraulic conductance (HD) of dentin was measured before and after adhesive treatment, and calculated for the percentage decrease of HD in each subgroup. Two-way ANOVA and Tukey test were used for statistical analysis. SEM study was used to assess the seal ability of self-etch adhesive and penetration of fluoride ions into dentinal tubules.

Results

HD after self-etch adhesive treatment reduced by 57.75 ± 17.99% in intact dentin with FI, 46.60 ± 17.03% in intact dentin without FI, 45.00 ± 15.30% in caries affected dentin without FI, and 37.28 ± 14.72% in caries affected dentin with FI. There was no significant difference in percentage decrease of HD between dentin without FI and dentin with FI (P = 0.742); meanwhile, intact dentin with FI had significant greater percentage decrease than caries affected dentin with FI (P < 0.05). SEM findings showed FI produced more particle formation and deeper precipitation in intact dentin than those in caries affected dentin.

Conclusions

FI did not affect the seal ability of self-etch adhesive in human dentin when compared to without FI. However, FI could augment the seal ability of the self-etch adhesive in intact dentin better than that in caries affected dentin.
Hesperidin identified from Citrus extracts potently inhibits HCV genotype 3a NS3 protease
Authors: Khan Mahim , Rauf Waqar , Habib Fazal-e- , Rahman Moazur , Iqbal Shoaib , Shehzad Aamir , Iqbal Mazhar
Published: April 2022

Background

Hepatitis C virus infection is the main cause of liver ailments across the globe. Several HCV genotypes have been identified in different parts of the world. Effective drugs for combating HCV infections are available but not affordable, particularly to infected individuals from resource-limited countries. Hence, cost-effective drugs need to be developed against important HCV drug targets. As Citrus fruits naturally contain bioactive compounds with antiviral activities, the current study was designed to identify antiviral inhibitors from Citrus fruit extracts against an important drug target, NS3 protease, of HCV genotype 3a which is found predominantly in South Asian countries.

Methods

The full-length NS3 protease alone and the NS3 protease domain in fusion with the cognate NS4A cofactor were expressed in Escherichia coli, and purified by chromatographic techniques. Using the purified protein as a drug target, Citrus extracts were evaluated in a FRET assay, and active ingredients, identified using ESI–MS/MS, were docked to observe the interaction with active site residues of NS3. The best interacting compound was further confirmed through the FRET assay as the inhibitor of NS3 protease.

Results

Fusion of the NS3 protease domain to the NS4A cofactor significantly improved the purification yield, and NS3-NS4A was functionally more active than the full-length NS3 alone. The purified protein (NS3-NS4A) was successfully employed in a validated FRET assay to evaluate 14 Citrus fruit extracts, revealing that the mesocarp extract of Citrus paradisi, and whole fruit extracts of C. sinesis, C. aurantinum, and C. reticulata significantly inhibited the protease activity of HCV NS3 protease (IC50 values of 5.79 ± 1.44 µg/mL, 37.19 ± 5.92 µg/mL, 42.62 ± 6.89 µg/mL, and 57.65 ± 3.81 µg/mL, respectively). Subsequent ESI-MSn analysis identified a flavonoid, hesperidin, abundantly present in all the afore-mentioned Citrus extracts. Importantly, docking studies suggested that hesperidin interacts with active site residues, and acts as a potent inhibitor of NS3 protease, exhibiting an IC50 value of 11.34 ± 3.83 µg/mL.

Conclusions

A FRET assay was developed using NS3-NS4A protease, which was successfully utilized for the evaluation of Citrus fruit extracts. Hesperidin, a compound present in the Citrus extracts, was identified as the main flavonoid, which can serve as a cost-effective potent inhibitor of NS3 protease, and could be developed as a drug for antiviral therapy against HCV genotype 3a.
Factors influencing measurement for improvement skills in healthcare staff: trainee, and trainer perspectives
Authors: Khurshid Zuneera , De Brún Aoife , McAuliffe Eilish
Published: April 2022

Background

Measurement for improvement is an integral component of quality improvement (QI) trainings and demonstrates whether a change resulted in an improvement. Despite its critical role, the development of measurement for improvement skills for QI is relatively under-explored.

Purpose

To explore the training, curricular and contextual factors that influence the development of measurement for improvement skills in healthcare professionals.

Methods

This is a retrospective, qualitative, multiple case study design, based on two QI collaboratives. Trainees and trainers from these programmes participated in semi-structured interviews. A framework drawing on the Kirkpatrick’s evaluation model and the Model for Understanding Success in Quality (MUSIQ) model was developed. The interviews were analysed based on a three-step qualitative thematic analysis method.

Results

A total of 21 participants were interviewed (15 trainees and 6 trainers). Six themes emerged in the analysis of trainee interviewees: impact of differences in job role and hierarchical levels, narrow conception of QI, knowledge disparity between trained and untrained staff, balancing the benefits and burdens of measurement, early adopters of QI driving change and supportive and engaged leadership. Themes in trainer perspectives were knowledge and understanding of measurement, application of PDSA approach to programme design, balancing consistency with adaptation to context, and attributes of sites receptive to change as predictors of development of measurement for improvement skills in staff.

Conclusion

Training alone does not determine the development, sustainability and spread of measurement and QI skills. Instead, it is influenced by a combination of curricular, training, and contextual support structures. Training programmes should be aware of the impact of job role and hierarchy, increased knowledge disparity between trained and untrained staff and trainees equating QI to bundle implementation while designing programmes. Similarly, organisational support through leaders, encouraging staff who have an interest in measurement and a culture receptive to QI also supports development of measurement skills. The study highlights the need for trainees, trainers, and organisations to work together in balancing the benefits and burdens of measurement, leading to sustainable skill development in line with international best practices.
Mobile device: a useful tool to teach inhaler devices to healthcare professionals
Authors: Puah Ser Hon , Goh Chee Yen , Chan Chung Leung , Teoh Amy Kui Jie , Zhang Hao , Shen Zhiqi , Neo Lay Ping
Published: April 2022

Background

Proper inhaler device usage is paramount for control of underlying obstructive airway disease. Hence, education to healthcare professionals who will eventually educate patients need to be done effectively. We developed an application for mobile devices for education on six medical inhaler devices, the metered-dose inhaler (MDI), Turbuhaler, Accuhaler, Breezhaler, Ellipta and Respimat, and studied if there were any difference between the application and the manufacturer’s instructions on inhaler technique. The aim of this study is to see if inhaler education via a mobile phone app is comparable to manual instruction for health care professions.

Methods

Participants, who were nursing students, were randomized to learn the inhaler devices via the manufacturer’s instruction guide or a mobile device app designed specifically for education on inhaler devices.

Results

There were 45 participants in each group. 78% of them were females with a median age of 21 (IQR 3). 67% used an Apple mobile device and the remainder used an Android device. The mobile device showed better total improvement points for the Turbuhaler device (262 vs 287 points; P = 0.02). Participants learning from the manufacturer’s guide had a significantly higher total improvement points in the Breezhaler (370 vs 327 points; P < 0.01) and Ellipta (214 vs 174 points; P < 0.01) device. Both interventions showed improvement in total scores for demonstrating the correct usage of all inhaler devices. MDI has the least number of correct steps for both interventions. The participants’ reported their mean (SD) self-rated knowledge was significantly higher for those using the app for all devices as compared to those that did not (4.33 (0.68) vs 4.73 (0.42); P = < 0.01). Self-reported confidence level was found to be higher in the mobile app group, but this was not statistically significant. The app was well received and scored of 4.42 of 5 with regards to its quality.

Conclusion

Using a mobile inhaler app is just as effective to teach inhaler device techniques to healthcare professionals and is likely a more convenient, versatile and important adjunct to learning.

Trial registration

National Healthcare Group Ethics Board (2018/00960).
Translation and cultural adaptation of the Integrated Palliative care Outcome Scale for Dementia (IPOS-Dem) to Swedish
Authors: Martinsson Lisa , Sahlén Klas-Göran
Published: April 2022

Introduction

Systematic assessment tools are helpful for improving and maintaining quality of care. The Integrated Palliative care Outcome Scale (IPOS) was developed for systematic assessment of persons receiving palliative care in a patient-centred way. A version of this tool, the Integrated Palliative care Outcome Scale for Dementia (IPOS-Dem), has been developed for patients with dementia.

The aim of this study was to develop a version of the IPOS-Dem translated into Swedish and culturally adapted to a Swedish care setting.

Methods

Forward and backward translations from English into Swedish were performed to develop a first Swedish version. This version was modified for clarity and cultural adaptation based on 13 interviews with nurses and assistant nurses working in geriatrics and dementia care homes.

Results

The interview process revealed several issues with the first version that emerged from the translation process. This was changed and further tested to work well, resulting in the final version of the Swedish IPOS-Dem. The tool was perceived as clinically useful but somewhat overlapping with already implemented tools for assessing behavioural and psychological symptoms in dementia.

Conclusion

The Swedish version of the IPOS-Dem can now be used as a tool for assessing palliative care related problems and concerns for persons with advanced dementia. Future studies can focus on implementation as well as examining validity and reliability of this tool in a Swedish context.
The associations between intestinal bacteria of Eospalax cansus and soil bacteria of its habitat
Authors: Zou Yao , Han Chongxuan , Zhang Xuxin , Nan Xiaoning
Published: April 2022

Background

Intestinal bacteria of mammal can be influenced by many factors, environmental bacteria is an important factor. However, there are few studies on the interactions between environmental bacteria and intestinal bacteria in wild mammals. To explore the associations between the intestinal bacteriome and the related environmental bacteriome, the intestinal bacterial communities of Eospalax cansus at three different sites and the bacterial communities of the surrounding soil (outside and inside the cave) at each site were investigated by 16S rRNA sequencing.

Results

The composition and structure between zokor intestinal bacteria and related soil bacteria were distinct, and the soil of zokor habitat harbored significantly higher diversity than that of zokor intestinal bacteria. We have found that host factors may be more important than environmental factors in shaping intestinal bacteriome. In addition, it was found that the relative abundances of shared OTUs between zokors and related soil were significantly negatively related. These shared OTUs were present in the soil at relatively low abundance. However, these shared OTUs between zokors and soil were affiliated with diverse bacterial taxa, and they were related to the degradation of complex carbohydrates.

Conclusions

These results suggested that the zokor gut may mainly select for low-abundance but diverse soil bacteria, which may be a host- specific choice for zokor to meet the needs of its phytophagous dietary.
NADH oxidase of Mycoplasma hyopneumoniae functions as a potential mediator of virulence
Authors: Hao Fei , Xie Xing , Feng Zhixin , Chen Rong , Wei Yanna , Liu Jin , Xiong Qiyan , Shao Guoqing , Lin Johnson
Published: April 2022

Background

Mycoplasma hyopneumoniae (M. hyopneumoniae) is the etiological agent of enzootic pneumonia, a highly infectious swine respiratory disease that distributed worldwide. The pathogenesis and virulence factors of M. hyopneumoniae are not fully clarified. As an important virulence factor of bacteria, nicotinamide adenine dinucleotide (NADH) oxidase (NOX) participates in host-pathogen interaction, however, the function of NOX involved in the pathogenesis of M. hyopneumoniae is not clear.

Results

In this study, significant differences in NOX transcription expression levels among different strains of M. hyopneumoniae differed in virulence were identified, suggesting that NOX may be correlated with M. hyopneumoniae virulence. The nox gene of M. hyopneumoniae was cloned and expressed in Escherichia coli, and polyclonal antibodies against recombinant NOX (rNOX) were prepared. We confirmed the enzymatic activity of rNOX based on its capacity to oxidize NADH to NAD+. Flow cytometry analysis demonstrated the surface localization of NOX, and subcellular localization analysis further demonstrated that NOX exists in both the cytoplasm and cell membrane. rNOX was depicted to mediate adhesion to immortalized porcine bronchial epithelial cells (hTERT-PBECs). Pre-neutralizing M. hyopneumoniae with anti-rNOX antibody resulted in a more than 55% reduction in the adhesion rate of high- and low-virulence M. hyopneumoniae strains to hTERT-PBECs. Moreover, a significant difference appeared in the decline in CCU50 titer between virulent (168) and virulence-attenuated (168L) strains. NOX not only recognized and interacted with host fibronectin but also induced cellular oxidative stress and apoptosis in hTERT-PBECs. The release of lactate dehydrogenase by NOX in hTERT-PBECs was positively correlated with the virulence of M. hyopneumoniae strains.

Conclusions

NOX is considered to be a potential virulence factor of M. hyopneumoniae and may play a significant role in mediating its pathogenesis.
Does zinc oxide nanoparticles potentiate the regenerative effect of platelet-rich fibrin in healing of critical bone defect in rabbits?
Authors: Zalama Esraa , Karrouf Gamal , Rizk Awad , Salama Basma , Samy Alaa
Published: April 2022

Background

Many encouraging studies confirmed the ability of Zinc Oxide Nanoparticles (ZnONPs) in accelerating bone growth and mineralization. The use of Platelet Rich-Fibrin (PRF) as a sole filling material for large segmental bone defects remains questionable. The objectives are to investigate the regenerative efficacy of autologous Platelet Rich-Fibrin (PRF) and Zinc Oxide Nanoparticles (ZnONPs) in repairing large segmental bone ulnar defects in a randomized controlled study in rabbits using computed tomographic interpretations. A 12 mm critical size defect was surgically induced in the ulna of 30 rabbits (n = 10/ group). In the control group, the defect was left empty. In the PRF group, the defect is filled with PRF. In the PRF/ZnONPs group, the defect is filled with PRF that was inoculated with 0.1 ml of 0.2% ZnONPs. Radiologic healing capacity was evaluated at the first, second, and third postoperative months.

Results

Statistical analysis showed significant differences in the radiologic healing scores between the groups (P = 0.000–0.0001) at all-time points (P = 0.000–0.047) during the study.

Conclusion

Rabbits in the PRF/ZnONPs group showed the highest appreciable bone quality and quantity followed by the PRF group with high quantity but low bone quality meanwhile, rabbits in the control group showed minimal quantity but medium bone quality. Interestingly, the addition of ZnONPs to PRF can accelerate the healing of ulnar critical-size defects in rabbits.
bZIP transcription factors PcYap1 and PcRsmA link oxidative stress response to secondary metabolism and development in Penicillium chrysogenum
Authors: Pérez-Pérez W. D. , Carrasco-Navarro U. , García‑Estrada C. , Kosalková K. , Gutiérrez-Ruíz M. C. , Barrios-González J. , Fierro F.
Published: April 2022

Background

Reactive oxygen species (ROS) trigger different morphogenic processes in filamentous fungi and have been shown to play a role in the regulation of the biosynthesis of some secondary metabolites. Some bZIP transcription factors, such as Yap1, AtfA and AtfB, mediate resistance to oxidative stress and have a role in secondary metabolism regulation. In this work we aimed to get insight into the molecular basis of this regulation in the industrially important fungus Penicillium chrysogenum through the characterization of the role played by two effectors that mediate the oxidative stress response in development and secondary metabolism.

Results

In P. chrysogenum, penicillin biosynthesis and conidiation are stimulated by the addition of H2O2 to the culture medium, and this effect is mediated by the bZIP transcription factors PcYap1 and PcRsmA. Silencing of expression of both proteins by RNAi resulted in similar phenotypes, characterized by increased levels of ROS in the cell, reduced conidiation, higher sensitivity of conidia to H2O2 and a decrease in penicillin production. Both PcYap1 and PcRsmA are able to sense H2O2-generated ROS in vitro and change its conformation in response to this stimulus. PcYap1 and PcRsmA positively regulate the expression of brlA, the first gene of the conidiation central regulatory pathway. PcYap1 binds in vitro to a previously identified regulatory sequence in the promoter of the penicillin gene pcbAB: TTAGTAA, and to a TTACTAA sequence in the promoter of the brlA gene, whereas PcRsmA binds to the sequences TGAGACA and TTACGTAA (CRE motif) in the promoters of the pcbAB and penDE genes, respectively.

Conclusions

bZIP transcription factors PcYap1 and PcRsmA respond to the presence of H2O2-generated ROS and regulate oxidative stress response in the cell. Both proteins mediate ROS regulation of penicillin biosynthesis and conidiation by binding to specific regulatory elements in the promoters of key genes. PcYap1 is identified as the previously proposed transcription factor PTA1 (Penicillin Transcriptional Activator 1), which binds to the regulatory sequence TTAGTAA in the pcbAB gene promoter. This is the first report of a Yap1 protein directly regulating transcription of a secondary metabolism gene. A model describing the regulatory network mediated by PcYap1 and PcRsmA is proposed.
A synthesized olean-28,13β-lactam targets YTHDF1-GLS1 axis to induce ROS-dependent metabolic crisis and cell death in pancreatic adenocarcinoma
Authors: Wu Shijia , Ai Yong , Huang Huimin , Wu Guangyu , Zhou Shipeng , Hong Weilong , Akuetteh Percy David Papa , Jin Guihua , Zhao Xingling , Zhang Yihua , Zhang Xiaolong , Lan Linhua
Published: April 2022

Background

Pancreatic adenocarcinoma (PAAD) is a severe malignant with a 5-year survival rate of approximately 9%. Oleanolic acid is a well-known natural triterpenoid which exhibits pharmacological activities. We previously synthesized a series of oleanolic acid derivatives and evaluated the tumor-suppressive activity of olean-28,13β-lactam (B28) in prostate cancer. However, the detailed mechanism remains to be understood.

Methods

The anti-tumor activity of B28 in PAAD was confirmed by RTCA, colony formation assay and flow cytometry. GO and KEGG enrichment analyses were performed to analyze the differentially expressed genes (DEGs) obtained by RNA sequencing. The effects of B28 on cell bioenergetics were evaluated by seahorse analyzer. Lenti-virus packaged plasmids were performed to knockdown or overexpress target genes. Alteration of mitochondrial membrane potential, ROS and GSH/GSSG were measured by corresponding detection kits according to the manufacturer's protocol.

Results

We evaluated and confirmed the promising anti-tumor activity of B28 in vitro. RNA-seq profile indicated that multiple metabolic pathways were interrupted in B28 treated PAAD cells. Next, we demonstrated that B28 induces cellular bioenergetics crisis to inhibit PAAD cells growth and induce cell death. We further validated that cell cycle arrest, inhibition of cell growth, cell apoptosis and cell bioenergetics disruption were functionally rescued by ROS scavenger NAC. Mechanistically, we found glutamine metabolism was inhibited due to B28 administration. Moreover, we validated that down-regulation of GLS1 contributes to ROS generation and bioenergetics interruption induced by B28. Furthermore, we elucidated that YTHDF1-GLS1 axis is the potential downstream target of B28 to induce PAAD cell metabolic crisis and cell death. Finally, we also confirmed the anti-tumor activity of B28 in vivo.

Conclusions

Current study demonstrates B28 disrupts YTDFH1-GLS1 axis to induce ROS-dependent cell bioenergetics crisis and cell death which finally suppress PAAD cell growth, indicating that this synthesized olean-28,13β-lactam maybe a potent agent for PAAD intervention.
A review of progress and an advanced method for shock advice algorithms in automated external defibrillators
Authors: Nguyen Minh Tuan , Nguyen Thu-Hang T. , Le Hai-Chau
Published: April 2022

Shock advice algorithm plays a vital role in the detection of sudden cardiac arrests on electrocardiogram signals and hence, brings about survival improvement by delivering prompt defibrillation. The last decade has witnessed a surge of research efforts in racing for efficient shock advice algorithms, in this context. On one hand, it has been reported that the classification performance of traditional threshold-based methods has not complied with the American Heart Association recommendations. On the other hand, the rise of machine learning and deep learning-based counterparts is paving the new ways for the development of intelligent shock advice algorithms. In this paper, we firstly provide a comprehensive survey on the development of shock advice algorithms for rhythm analysis in automated external defibrillators. Shock advice algorithms are categorized into three groups based on the classification methods in which the detection performance is significantly improved by the use of machine learning and/or deep learning techniques instead of threshold-based approaches. Indeed, in threshold-based shock advice algorithms, a parameter is calculated as a threshold to distinguish shockable rhythms from non-shockable ones. In contrast, machine learning-based methods combine multiple parameters of conventional threshold-based approaches as a set of features to recognize sudden cardiac arrest. Noticeably, those features are possibly extracted from stand-alone ECGs, alternative signals using various decomposition techniques, or fully augmented ECG segments. Moreover, these signals can be also used directly as the input channels of deep learning-based shock advice algorithm designs. Then, we propose an advanced shock advice algorithm using a support vector machine classifier and a feature set extracted from a fully augmented ECG segment with its shockable and non-shockable signals. The relatively high detection performance of the proposed shock advice algorithm implies a potential application for the automated external defibrillator in the practical clinic environment. Finally, we outline several interesting yet challenging research problems for further investigation.
Effect of COVID-19 on patient access to health services for noncommunicable diseases in Latin America: a perspective from patient advocacy organizations
Authors: Kruse Meredith H. , Durstine Alessandra , Evans Dabney P.
Published: April 2022

Background

The COVID-19 pandemic has been felt acutely in Latin America with several countries having among the highest numbers of SARS-CoV-2 cases and related deaths. Individuals living with underlying health conditions have an increased risk of severe disease or death from COVID-19. Patient advocacy organizations often provide supportive services to these individuals and can offer a unique perspective of the patient experience. The objective of this study was to assess the effects of COVID-19 on access to health services in Latin America, as reported by patient advocacy organizations representing individuals living with autoimmune, chronic, and noncommunicable diseases.

Methods

A cross-sectional study was conducted in August 2020 with patient advocacy organizations in Latin America to measure perceived effects from COVID-19 and reported access to health services among individuals living with autoimmune, chronic, and noncommunicable diseases. An original, online survey was developed and deployed in Spanish and Portuguese. Univariate and bivariate analysis was conducted across two main subject areas: perceived patient effects from COVID-19 and patient access to health services. The main outcomes of analysis considered patient access to care during COVID-19 based on type of chronic illness and geographical region in Latin America.

Results

A total of 81 survey responses were analyzed. A majority (83%) of patient advocacy organizations reported their patients experienced delays receiving their treatment and care services; 52% experienced delays of 30 days or more. Telemedicine was considered available, but not accessible to patients (37%) and a majority (76%) of patients faced challenges with electronic prescriptions. Patients were not likely to receive a multi-month prescription from their doctor (38%) or successfully fill it at the pharmacy (26%).

Conclusions

According to responses from patient advocacy organizations, individuals living with noncommunicable diseases in Latin America have faced unique challenges during the COVID-19 pandemic. As countries re-evaluate their health systems, it is critical that chronic diseases are considered so that all can fully realize the right to health.
Symptoms and functional limitations related to respiratory health and carbon monoxide poisoning in Tanzania: a cross sectional study
Authors: Zoller Thomas , Mfinanga Elirehema H. , Zumba Tresphory B. , Asilia Peter J. , Mutabazi Edwin M. , Wimmersberger David , Mhimbira Francis , Haraka Frederick , Reither Klaus
Published: April 2022

Background

The burden of chronic respiratory symptoms and respiratory functional limitations is underestimated in Africa. Few data are available on carbon monoxide (CO) poisoning in sub-Saharan Africa and existing data is derived from CO in ambient air, but not from biomarkers in the blood.

Methods

Data from the Tanzanian Lung Health study, a cross-sectional study on lung health among outpatients and visitors to an urban as well as a rural hospital in Tanzania, was analyzed to describe respiratory symptoms and functional limitations. Saturation of peripheral blood with carbon monoxide (SpCO) was measured transcutaneously and non-invasively in participants using a modified pulse oxymeter indicative of CO poisoning. Univariate and multivariate analysis was performed.

Results

Nine hundred and ninety-seven participants were included in the analysis, the median age of participants was 46 years (49% male). 38% of participants reported some degree of chronic shortness of breath and 26% felt limited in their daily activities or at work by this symptom. The median SpCO was 7% (IQR 4–13, range 2–31%) among all participants without active smoking status (N = 808). Participants cooking with gas or electricity had the lowest SpCO (median 5%), followed by participants cooking with charcoal (median 7%). Cooking with wood, particularly using a stove, resulted in highest SpCO (median 11.5%). Participants from households where cooking takes place in a separate room had the lowest SpCO as compared to cooking outside or cooking in a shared room inside (6% vs. 9% vs.10.5%, p < 0.01). Sex or the activity of cooking itself was not associated with a difference in SpCO. Multivariate analysis confirmed cooking in a separate room (as compared to cooking outside) and living in a rural vs. urban setting as protective factors against high SpCO.

Conclusion

The findings demonstrate a high burden of chronic respiratory symptoms which also cause socioeconomic impact. High levels of SpCO indicate a relevant burden of carbon monoxide poisoning in the local population. The level of CO in the blood is more dependent on shared exposure to sources of CO with the type of housing and type of cooking fuel as most relevant factors, and less on person-individual risk factors or activities.