bluuebunny/crossref_metadata_2025 huggingface dataset:
Medical waste generation rate and management practices among government hospitals in Eastern Ethiopia. A descriptive survey
Authors: Tolera Sina Temesgen , Kebede Kuma , Muzeyin Mohammed , Aschalew Alemayehu
Published: June 2024

Introduction:

Healthcare facilities generate medical waste, also known as healthcare waste or health facility waste, during the healthcare delivery process, which is improperly managed as a result of underfunded healthcare systems, poor training, and lack of awareness of policies and legislation on handling medical waste as well as do not have national guidelines in place to adhere to the correct disposal of such wastage in developing countries like Ethiopia.

Objectives:

To estimate the healthcare waste generation rate among selected public hospitals in eastern Ethiopia.

Methods:

A cross-sectional study design was conducted in eight public in eastern Ethiopia from 1st June 2023 to 30th July 2023. The “Bed-Patient-healthcare wastes” model was used to estimate the healthcare waste generation rate based on WHO and empirical evidence. HCW generation rate = No of (Inpatients (Inpts) + Outpatients (Outpts))/day*0.53 kg/day. Meanwhile, general (GW), infectious (IW), pharmaceutical (PW), sharps (SW), and pathological (PtW) are computed as follows: GW = No. of (Inpt + Oupt)/day*0.53 kg/day and IW, PW, SW, and PtW = No. of Inpts/day*0.53 kg/day. In contrast, for hazardous and non-hazardous healthcare wastes, No of HCWs/day*0.8 and no. of HCWs/day*0.2 were utilized, and Key informant interviews and field observational were also applied. Descriptive analysis such as percentage, mean, and standard deviation were presented.

Result:

According to the current assessment, 105.1-142.8 kg/day healthcare waste was generated from outpatient and 167.3-244.2 kg/day from inpatients of public hospitals. From these, the Mean ± SD of daily healthcare waste generation rate estimated by non-hazardous and hazardous waste were 164.6 ± 80.9 kg/patients/day and 41.2 ± 20.2 kg/patients/day, respectively. In daily generation, the mean and standard deviations (Mean ± SD) of general wastes, infections waste, pharmaceutical wastes, sharp wastes, and pathological waste/patient were 62% (521.9), 23% (194.8), 4% (35.4), 2% (17.7), and 9% (70.9), respectively.

Conclusion:

The current assessment concluded that a large volume of healthcare waste is generated from selected public hospitals, which were not effectively segregated, separated at the source, and haven’t conventional or standard treatment. As a result, the study advised that regional and global collaboration in hospital waste and wastewater management be encouraged.
Burden of irregular menstrual cycle and its predictors among reproductive-age women in Ethiopia: Systematic review and meta-analysis
Authors: Mussa Ibsa , Jibro Usmael , Sertu Addisu , Deressa Alemayehu , Mohammed Fethia , Regassa Lemma Demissie , Cheru Abera , Mohammed Eptisam , Abdurahman Dureti , Balis Bikila
Published: June 2024

Introduction:

Irregular menstrual cycle has negative health and psychosocial repercussions for women of reproductive age worldwide. However, there is no national data for policymakers and health planners in Ethiopia. Therefore, this review aimed to determine the overall burden of irregular menstrual cycle and predictors among reproductive-age women in Ethiopia.

Methods:

International databases (SCOPUS, CINAHL, CAB Abstract, EMBASE, PubMed, Web of Science, Google, and Google Scholar) and lists of references were employed to search literature in Ethiopia. The random-effects model was used to calculate the odds ratios of the outcome variable using STATA version 18. The heterogeneity of the studies was measured by computing I2 and p-values. In addition, sensitivity analysis and funnel plots were performed to test the stability of pooled data in the presence of outliers and publication bias.

Results:

The review includes 21 studies and 9109 populations. The overall burden of irregular menstrual cycles among reproductive-age women was 35% (95% CI: 30–41) with I2 = 96.96%. Sleeping for <5 h a day (AOR: 2.49; 95% CI: 1.49–3.49) and a stressful life (AOR: 3.15; 95% CI: 1.44–4.85) were predictors of irregular menstrual cycles.

Conclusion:

More than one in every three reproductive-age women in Ethiopia experience irregular menstrual cycles. Sleeping for <5 h a day and stress increase the likelihood of an irregular menstrual cycle, which can be modified by improving sleeping hours and decreasing stress stimulators through psychotherapy.
Breaking Barriers With Memes: How Memes Bridge Political Cynicism to Online Political Participation
Authors: Ahmed Saifuddin , Masood Muhammad
Published: June 2024

While numerous studies have explored the participatory benefits of social media use for political participation, the empirical literature on the mobilizing role of political memes is nearly absent. In addition, most of the attention has been on Western democratic contexts. By employing survey data from an Asian context—Singapore—this study scrutinizes the impact of exposure to political memes in the interplay between political use of social media and online political participation. In addition, it investigates the contingent role of political cynicism. First, the results show that political social media use is associated with online political participation and that association is mediated by exposure to political memes. Further, moderation analyses indicate that social media use provides participatory gains only for individuals exhibiting low political cynicism. However, when such social media use facilitates exposure to political memes, it primarily mobilizes those with high political cynicism into active online political participation. The results suggest that memes can mobilize disengaged groups into active participation.
Exploring the Mindsets of Thai Undergraduate Students: A Comprehensive Study of General and Language-Related Beliefs
Authors: Wilang Jeffrey Dawala
Published: June 2024

This paper presents the findings of a large-scale quantitative study, which involved surveying 1,184 undergraduates from a Thai science and technology university to assess both their general and language mindsets. The study’s primary aims were to identify the prevalence of growth or fixed among these students, explore potential statistical variations in mindsets based on gender, year level, and perceived language proficiencies, and ascertain the relationships between mindsets, gender, year level, and perceived proficiency. Additionally, the research delved into the structural dimensions of their general and language mindsets. Descriptive, inferential and factor analyses were employed for data analysis. Descriptive analysis revealed that Thai undergraduate students predominantly embrace growth mindsets in both their general and language-related beliefs. Notably, t-test showed no significant disparities were detected among the variables examined, indicating a consistent mindset across various demographic groups. Moreover, correlational analysis identified relationships between general mindset, language mindset and perceived general language proficiency. Furthermore, language mindset showed significant associations with year level and perceived general language proficiency. In terms of the factorial structure, factor analysis yielded three distinct factors of general mindset, while the language mindset exhibited a unidimensional structure. Discussions included theoretical and pedagogical implications, as well as directions for future research in language mindset.
The use of topical tranexamic acid in geriatric fractured hip
Authors: Zheng Alvin Chen , Chun Ting Lam , Chi Kit Chiu
Published: June 2024

Background: Topical tranexamic acid (TXA) is used preoperatively to reduce blood loss. This study evaluated the effect of topical TXA on post-operative transfusion rate and haemoglobin level in geriatric patients with hip fractures. Methods: This retrospective cohort study included 135 patients over 65 years old with hip fractures from June 2020 to June 2023. Their total haemoglobin mass loss, transfusion rate and thromboembolic events were compared based on the fracture type and intervention (10–15 mg/kg of topical TXA). Results: No significant differences were found in total haemoglobin mass, transfusion rate or thromboembolic events. There was no evidence of an association between the use of TXA and post-operative blood transfusion (OR = 0.82, 95% CI: 0.27–2.52, p = 0.734) or thromboembolic events (OR = 0.81, 95% CI: 0.07–9.49, p = 0.866). Conclusion: A 10–15 mg/kg topical TXA did not reduce total haemoglobin mass loss, influence transfusion needs or increase thromboembolic events or 30-day mortality.
Changes Over Time in the Proportion of Advanced HIV Disease in Two High HIV Prevalence Settings in Ndhiwa (Kenya) and Eshowe (South Africa)
Authors: Chihana Menard , Conan Nolwenn , Ohler Liesbet , Huerga Helena , Wanjala Stephen , Masiku Charles , Szumilin Elisabeth , Ellman Tom , Etard Jean-Francois , Maman David , Davies Mary-Ann
Published: June 2024

Background

The burden of advanced HIV disease remains a significant concern in sub-Saharan Africa. In 2015, the World Health Organization released recommendations to treat all people living with HIV (PLHIV) regardless of CD4 (“treat all”) and in 2017 guidelines for managing advanced HIV disease. We assessed changes over time in the proportion of PLHIV with advanced HIV and their care cascade in two community settings in sub-Saharan Africa.

Methods

Cross-sectional population-based surveys were conducted in Ndhiwa (Kenya) in 2012 and 2018 and in Eshowe (South Africa) in 2013 and 2018. We recruited individuals aged 15-59 years. Consenting participants were interviewed and tested for HIV at home. All participants with HIV had CD4 count measured. Advanced HIV was defined as CD4 < 200 cells/µL.

Results

Overall, 6076 and 6001 individuals were included in 2012 and 2018 (Ndhiwa) and 5646 and 3270 individuals in 2013 and 2018 (Eshowe), respectively. In Ndhiwa, the proportion of PLHIV with advanced HIV decreased from 2012 (159/1376 (11.8%; 95% CI: 9.8-14.2)) to 2018 (53/1000 (5.0%; 3.8-6.6)). The proportion of individuals with advanced HIV on antiretroviral therapy (ART) was 9.1% (6.9-11.8) in 2012 and 4.2% (3.0-5.8) in 2018. In Eshowe, the proportion with advanced HIV was 130/1400 (9.8%; 8.0-11.9) in 2013 and 38/834 (4.5%; 3.3-6.1) in 2018. The proportion with advanced HIV among those on ART was 6.9% (5.5-8.8) in 2013 and 2.8% (1.8-4.3) in 2018. There was a significant increase in coverage for all steps of the care cascade among people with advanced HIV between the two Ndhiwa surveys, with all the changes occurring among men and not women. No significant changes were observed in Eshowe between the surveys overall and by sex.

Conclusion

The proportion with advanced HIV disease decreased between the first and second surveys where all guidelines have been implemented between the two HIV surveys.
“Every Day We Wake Up with Something to Prove”: Black Misandry and Black Men’s Experiences in Navigating the College Environment
Authors: Brooms Derrick R.
Published: June 2024

This research analyzes how Black men understand and make sense of their college experiences through their racialized and gendered identities and the campus climate. In-depth interviews with 105 Black men attending 5 different institutions, including three historically White institutions (HWIs) and two Hispanic-serving institutions (HSIs), reveal how they are accosted by Black misandry on a continual and routine basis during their college years. Based on students’ narratives, I find that Black misandry renders Black men as undeserving and unworthy, which is predicated on their seeming nothingness and nonbeing. Students cite being unseen and misperceived, acknowledge various ways that they are subjected to hyper-surveillance on campus, and discuss differential treatment. Given the ways that they are troubled and challenged on campus, the students describe what can be considered as daily battles of Black misandry—a specific form of gendered racism that creates seemingly daily phenomena that require them to prove their worth and being. Such efforts, including the emotional and psychological labor that they must enact, inform how they make sense of and navigate the campus ethos at HWIs and HSIs alike. Findings are presented across two main themes: (1) always already facing deficits and (2) dispositions and responses to anti-Blackness and Black misandry. These themes reveal a near consistency of Black misandry across both institutional types and inform the coping strategies that Black men employ in order to pursue their educational goals and keep their humanity intact.
Long-Acting Contraceptive Switching and Its Associated Factors among Married Women in Southwest Ethiopia
Authors: Destaw Alemnew , Tesfaye Melkamsew , Shifera Nigusie , Yosef Tewodros
Published: June 2024

Introduction

Contraceptive switching from a more effective to a less effective method is a concern, especially in developing countries with high unmet needs for family planning. Indeed, the lack of understanding regarding the reasons behind contraceptive switching behavior in the study area poses a significant challenge in effectively addressing this issue.

Objective

This study aimed to assess the magnitude and factors associated with long-acting contraceptive switching in Mizan-Aman town, southwest Ethiopia.

Methods

A community-based cross-sectional study was conducted, involving 345 women randomly selected from the population of married women in their reproductive age group. Data collection was conducted through interviewer-administered questionnaires. Bivariate and multivariable logistic regression analyses were employed to ascertain factors linked with contraceptive method switching status. Statistical significance was determined at a P-value of less than .05.

Results

Out of the 345 participants interviewed, the prevalence of switching from long-acting to short-acting contraceptives was 28.4%, 95% CI (13.6%, 33.2%). Upon adjusting for confounding variables, factors significantly associated with contraceptive switching included women aged 31–35 [adjusted odds ratio (AOR) = 0.58; 95% CI (0.36, 0.74)] and aged 41–49 [AOR = 0.54; 95% CI (0.48, 0.82)], those with formal education [AOR = 0.79; 95% CI (0.52, 0.87)], those desiring future pregnancy [AOR = 2.12; 95% CI (1.98, 3.38)], experiencing complications from previous method use [AOR = 3.67; 95% CI (2.57, 7.40)], and encountering stockouts of their preferred contraceptive choice [AOR = 2.01; 95% CI (1.39, 3.24)].

Conclusion and recommendation

The study area exhibited a notable prevalence of switching from long-acting contraceptives. Complications arising from prior method use and the unavailability of preferred contraceptive options emerged as significant factors influencing this switching behavior. Thus, it underscores the importance of providing counseling and ongoing support to women, ensuring access to safer and more effective modern contraceptive methods.
Deep learning survival model predicts outcome after intracerebral hemorrhage from initial CT scan
Authors: Chen Yutong , Rivier Cyprien A , Mora Samantha A , Torres Lopez Victor , Payabvash Sam , Sheth Kevin N , Harloff Andreas , Falcone Guido J , Rosand Jonathan , Mayerhofer Ernst , Anderson Christopher D
Published: June 2024

Background:

Predicting functional impairment after intracerebral hemorrhage (ICH) provides valuable information for planning of patient care and rehabilitation strategies. Current prognostic tools are limited in making long term predictions and require multiple expert-defined inputs and interpretation that make their clinical implementation challenging. This study aimed to predict long term functional impairment of ICH patients from admission non-contrast CT scans, leveraging deep learning models in a survival analysis framework.

Methods:

We used the admission non-contrast CT scans from 882 patients from the Massachusetts General Hospital ICH Study for training, hyperparameter optimization, and model selection, and 146 patients from the Yale New Haven ICH Study for external validation of a deep learning model predicting functional outcome. Disability (modified Rankin scale [mRS] > 2), severe disability (mRS > 4), and dependent living status were assessed via telephone interviews after 6, 12, and 24 months. The prediction methods were evaluated by the c-index and compared with ICH score and FUNC score.

Results:

Using non-contrast CT, our deep learning model achieved higher prediction accuracy of post-ICH dependent living, disability, and severe disability by 6, 12, and 24 months (c-index 0.742 [95% CI –0.700 to 0.778], 0.712 [95% CI –0.674 to 0.752], 0.779 [95% CI –0.733 to 0.832] respectively) compared with the ICH score (c-index 0.673 [95% CI –0.662 to 0.688], 0.647 [95% CI –0.637 to 0.661] and 0.697 [95% CI –0.675 to 0.717]) and FUNC score (c-index 0.701 [95% CI– 0.698 to 0.723], 0.668 [95% CI –0.657 to 0.680] and 0.727 [95% CI –0.708 to 0.753]). In the external independent Yale-ICH cohort, similar performance metrics were obtained for disability and severe disability (c-index 0.725 [95% CI –0.673 to 0.781] and 0.747 [95% CI –0.676 to 0.807], respectively). Similar AUC of predicting each outcome at 6 months, 1 and 2 years after ICH was achieved compared with ICH score and FUNC score.

Conclusion:

We developed a generalizable deep learning model to predict onset of dependent living and disability after ICH, which could help to guide treatment decisions, advise relatives in the acute setting, optimize rehabilitation strategies, and anticipate long-term care needs.
Multimodal Imaging of Unilateral Benign Yellow Dot Maculopathy
Authors: Balas Michael , Wong Jovi , Arjmand Parnian
Published: June 2024

Purpose: To describe the multimodal imaging findings associated with benign yellow dot maculopathy. Methods: A case report was analyzed. Results: A healthy 42-year-old White man was evaluated after several weeks of photopsias and an inferior retinal tear in the right eye. The tear was treated with laser retinopexy. A fundus examination showed numerous small, yellow, subretinal lesions in and around the macula of the right eye only. The patient had no known systemic conditions and an unremarkable family and ocular history, with 20/20 visual acuity in both eyes. Multimodal imaging findings were consistent with the newly described phenotype of benign yellow dot maculopathy. Conclusions: This is the second known case of unilateral benign yellow dot maculopathy. Distinct multimodal imaging findings between unilateral cases and bilateral cases may suggest differences in their etiology and manifestation.
Studies of radioactive minerals and geochemistry of uranium at the granitic rocks of Wadi Um Shillman Area, South Eastern Desert, Egypt
Authors: El Shaib Gehan B.
Published: June 2024

The northwestern part of Gabal Um Ara granitic pluton is represents a good example for uranium occurrence in the southeastern desert of Egypt. Among the different lithologies in the study area, the granitic rocks attract attention for more detailed geological, geochemical and radiometrical studies. Um Ara granitic masses cover an oval outline area of about 300 km2, which is characterised by moderate topography. The granitic rocks are classified as monzogranite and alkali feldspar granite. Both of them belong to the post-orogenic younger granite magmatic activity that intruded the Egyptian shield between 620 and 530 Ma. The intrusion of Um Ara monzogranite and alkali feldspar granite appears to have been controlled by deep-seated tectonic zones and block faulting. The studied area lies at southeast of Aswan City between 22ͦ 38′ 12˝–22ͦ 38′ 34˝ N and 33ͦ 47′ 27˝–33ͦ 48′ 14˝ E. Geochemically, the average concentration of the elements in North Um Ara granite shows that the relative abundance decreases gradually with decreasing incompatibility from Rb to Y. The common features are enrichment in more mobile elements Rb, Th and U. The monzogranite shows the lowest U and Th content, whereas the alkali-feldspar shows an enhanced contents of both elements, with average Th/U ratio = 3.0. the alkali-feldspar exhibits an expanded enrichment of Th relative to U. The U of the alkali-feldspar may be included within the structure of the refractory accessory minerals. The northern part of the Um Ara granitoids has subjected to different types of alterations. The radiometric survey of the northwestern part of Gabal Um area granitic pluton revealed the presence of several radioactive anomalies near the contact with the Dokhan volcanic and metavolcanic rocks in the north. Some visible uranium mineralisation of uranium minerals occur mainly along the NW, NE, E-W and N-S joints, of a highly sheared alkali feldspar-granite. Uranophane is visible secondary uranium mineral, characterised by bright yellow lemon colours and occurs mainly as filling fractures and joints associated with violet fluorite, iron and manganese oxides. The radioactive and accessory minerals studying and X-ray diffraction analysis that of the mineralised alkali feldspar-granite granite in the northwestern part of Gabal Um Ara granitic pluton revealed include the presence of fluorite, zircon, columbite, spessartine garnet whereas, the secondary uranium minerals are represented by uranophane, β-uranophane and kasolite. The hydrothermal origin was proposed as two possible alternatives for this uranium mineralisation.
Study on fatigue damage and frequency attenuation characteristics of carbon fiber composite
Authors: Yang Zhiqiang , Yang Yu , Zheng Zijun , Shao Jiaru
Published: June 2024

Fatigue analysis and life prediction are the key and challenging issues in the mechanics research of composite material. In this paper, based on the progressive damage analysis method and fatigue cumulative damage theory, a three-dimensional fatigue cumulative damage numerical model is constructed by introducing the orthotropic constitutive equation, 3D-Hashin fatigue criterion, and material performance degradation scheme. Two loading conditions of tension–tension fatigue and compression–compression fatigue of Carbon Fiber composite laminates were investigated. In the tension–tension fatigue experiments, when the cycle is [Formula: see text] times, the experiment and the numerical simulation all not completely destroyed. However, progressive degradation of stiffness and strength was observed in certain elements, accompanied by some internal damage. On the other hand, the experimental and predicted values for compression–compression fatigue were within a triple error band. Then the cumulative damage evolution law of each laminate under fatigue load was analyzed. Compression–compression fatigue damage initiated from the center of the hole and expanded to both sides of the composite laminate, and its fatigue life increased with the increase of the compression–compression fatigue load. Considering the degradation of stiffness in composite materials under fatigue loading, which leads to frequency attenuation in the structure, this paper established a connection between the fatigue state and frequency to obtain the frequency attenuation curve under fatigue loading. The relationship between frequency and fatigue life was revealed, allowing for the prediction of remaining fatigue life in practical engineering based on the rate of inherent frequency reduction.
Evaluation of solar powered irrigation systems in Palestine: Feasibility and social and environmental impact
Authors: Khatib Tamer
Published: June 2024

This paper evaluates solar powered irrigation systems in Palestine. This practice is mainly to promote the use of these systems as currently there are only three such system in Palestine. The evaluation is done based on technical, financial, social and environmental aspects. The technical evaluation is done based on actual system's performance. Meanwhile, social impact study is conducted based on focus group discussion and questionnaire. Results show that a 1 kWp of photovoltaic panels can pump up to 1.5 m3 of water per hour at a cost of USD 0.025 per m3. This pumping rate is subject to a surface distance pumping up to 1500 meters with a collecting pond depth of up to 8 meters, and system's life time of 20 years. Meanwhile, the capital cost of such a system is found to be USD 1754 per kWp. On the other hand, the conducted social impact study shows that 70% of farmers believed that the government did not encourage investment in this area. Meanwhile, 50% of farmers believed that using solar powered irrigation systems had increased their income by 10% to 30%, while 56% of farmers were able to hire new workers after using the system. Finally it is concluded that solar powered irrigation systems have low impact on environment subject to not using fertile land for installation.
Mindfulness-Based Group Medical Visits: Strategies to Improve Equitable Access and Inclusion for Diverse Patients in Cancer Treatment
Authors: Mishra Kavita K. , Leung Ivan C. , Chao Maria T. , Thompson-Lastad Ariana , Pollak Christine , Dhruva Anand , Hartogensis Wendy , Lister Michael , Cheng Stephanie W. , Atreya Chloe E.
Published: June 2024

Background

Mindfulness-based interventions (MBIs) are supported by clinical practice guidelines as effective non-pharmacologic interventions for common symptoms experienced by cancer patients, including anxiety, depression, and fatigue. However, the evidence predominately derives from White breast cancer survivors. Racial and ethnic minority patients have less access to integrative oncology care and worse cancer outcomes. To address these gaps, we designed and piloted a series of mindfulness-based group medical visits (MB-GMVs), embedded into comprehensive cancer care, for racially and ethnically diverse patients in cancer treatment.

Methods

As a quality improvement project, we launched a telehealth MB-GMV series for patients undergoing cancer treatment, delivered as four weekly 2-hour visits billable to insurance. Content was concordant with evidence-based guidelines and established MBIs and adapted to improve cultural relevance and fit (eg, access-centered, trauma-informed, with inclusive communication practices). Program structure was adapted to address barriers to participation, with ≥50% slots per series reserved for racial and ethnic minority patients. Intake surveys incorporated a demographic questionnaire and symptom assessments. Evaluations were sent following the visits.

Results

In our first ten cohorts (n = 78), 80% of referred patients enrolled. Participants were: 22% Asian, 14% Black, 17% Latino, 45% non-Latino White; 65% female; with a median age of 54 years (range 27-79); and 80% had metastatic cancer. Common baseline symptoms included lack of energy, difficulty sleeping, and worrying. Most patients (90%) attended ≥3 visits. On final evaluations, 87% patients rated the series as “excellent”; 81% “strongly agreed” that they liked the GMV format; and 92% would “definitely” recommend the series to others. Qualitative themes included empowerment and connectedness.

Conclusion

Telehealth GMVs are a feasible, acceptable, and financially sustainable model for increasing access to MBIs. Diverse patients in active cancer treatment were able to participate and reported high levels of satisfaction with this series that was tailored to center health equity and inclusion.
Whither the post-industrial city?
Authors: Glass Michael R.
Published: June 2024

This commentary provides a sympathetic critique to Luger and Schwartz's contention that the concept of ‘post-industrial’ lacks continued utility in a world of urban (and regional) change. Drawing on the authors’ use of stigma and narrative, I argue the post-industrial concept remains relevant, though scholars must attend to who is mobilizing the concept, and to what ends.
The evolution of Commonwealth, postcolonial, and decolonial scholarship: Tracing the impact of field transformation on the Journal of Commonwealth Literature and vice versa
Authors: Chambers Claire , Gilmour Rachael
Published: June 2024

This article explores the title change from the Journal of Commonwealth Literature ( JCL) to Literature, Critique, and Empire Today using a tripartite structure. We are the journal’s most recent ex-editors, and so the article is the culmination of about 15 years of thinking on these and related matters. In the essay’s first part, we interrogate the limitations of the term “Commonwealth” across the axes of global geopolitics as well as literature, in order to draw out some common threads within and beyond postcolonial studies. The second section thinks through the journal’s role in shaping postcolonial studies over time. Changes have been wrought in response to literary-critical and political concerns, as well as amid the self-transformation the journal has undergone over the past decade so as to open itself up to more diverse perspectives. Finally, we analyse the likely impact of the journal’s altered title for both registering and challenging understandings in its field. We hope that the article constitutes a thought-provoking exploration of the journal’s present and future avenues, and the knock-on effects this will have for postcolonial, world, and decolonial literary studies more broadly.
Iron deficiency affects oxygen transport and activates HIF1 signaling pathway to regulate phenotypic transformation of VSMC in aortic dissection
Authors: Chen Yuanyang , Li Xu , Wang Zhiwei , Yuan Shun , Shen Xiaoyan , Xie Xiaoping , Xing Kai , Zhu Qingyi
Published: June 2024

Background

Aortic dissection (AD) is a macrovascular disease which is pathologically characterized by aortic media degeneration.This experiment aims to explore how iron deficiency (ID) affects the function of vascular smooth muscle cell (VSMC) and participates in the occurrence and development of AD by regulating gene expression.

Methods

The relationship between iron and AD was proved by Western-blot (WB) and immunostaining experiments in human and animals. Transcriptomic sequencing explored the transcription factors that were altered downstream. WB, flow cytometry and immunofluorescence were used to demonstrate whether ID affected HIF1 expression through oxygen transport. HIF1 signaling pathway and phenotypic transformation indexes were detected in cell experiments. The use of the specific HIF1 inhibitor PX478 further demonstrated that ID worked by regulating HIF1.

Results

The survival period of ID mice was significantly shortened and the pathological staining results were the worst. Transcriptomic sequencing indicated that HIF1 was closely related to ID and the experimental results indicated that ID might regulate HIF1 expression by affecting oxygen balance. HIF1 activation regulates the phenotypic transformation of VSMC and participates in the occurrence and development of AD in vivo and in vitro.PX478, the inhibition of HIF1, can improve ID-induced AD exacerbation.
Characterization and the first complete genome sequence of a novel strain of Bergeyella porcorum isolated from pigs in China
Authors: Liu Gang , Chen Chao , Jiang Zhikang , Liu Yu , Wang Xianwen , Qiao Lei , Liu Kang , Han Xianjie
Published: June 2024

Background

Bergeyella porcorum is a newly identified bacterium that has an ambiguous relationship with pneumonia in pigs. However, few studies have adequately characterized this species.

Results

In this study, we analyzed the morphological, physiological, and genomic characteristics of the newly identified B. porcorum sp. nov. strain QD2021 isolated from pigs. The complete genome sequence of the B. porcorum QD2021 strain consists of a single circular chromosome (2,271,736 bp, 38.51% G + C content), which encodes 2,578 genes. One plasmid with a size of 70,040 bp was detected. A total of 121 scattered repeat sequences, 319 tandem repeat sequences, 4 genomic islands, 5 prophages, 3 CRISPR sequences, and 51 ncRNAs were predicted. The coding genes of the B. porcorum genome were successfully annotated across eight databases (NR, GO, KEGG, COG, TCDB, Pfam, Swiss-Prot and CAZy) and four pathogenicity-related databases (PHI, CARD, VFDB and ARDB). In addition, a comparative genome analysis was performed to explore the evolutionary relationships of B. porcorum QD2021.

Conclusions

To our knowledge, this is the first study to provide fundamental phenotypic and whole-genome sequences for B. porcorum. Our results extensively expand the current knowledge and could serve as a valuable genomic resource for future research on B. porcorum.
The relationship between atmospheric particulate matter, leaf surface microstructure, and the phyllosphere microbial diversity of Ulmus L.
Authors: Xu Liren , Liu Yichao , Feng Shuxiang , Liu Chong , Zhong Xinyu , Ren Yachao , Liu Yujun , Huang Yinran , Yang Minsheng
Published: June 2024

Background

Plants can retain atmospheric particulate matter (PM) through their unique foliar microstructures, which has a profound impact on the phyllosphere microbial communities. Yet, the underlying mechanisms linking atmospheric particulate matter (PM) retention by foliar microstructures to variations in the phyllosphere microbial communities remain a mystery. In this study, we conducted a field experiment with ten Ulmus lines. A series of analytical techniques, including scanning electron microscopy, atomic force microscopy, and high-throughput amplicon sequencing, were applied to examine the relationship between foliar surface microstructures, PM retention, and phyllosphere microbial diversity of Ulmus L.

Results

We characterized the leaf microstructures across the ten Ulmus lines. Chun exhibited a highly undulated abaxial surface and dense stomatal distribution. Langya and Xingshan possessed dense abaxial trichomes, while Lieye, Zuiweng, and Daguo had sparsely distributed, short abaxial trichomes. Duomai, Qingyun, and Lang were characterized by sparse stomata and flat abaxial surfaces, whereas Jinye had sparsely distributed but extensive stomata. The mean leaf retention values for total suspended particulate (TSP), PM2.5, PM2.5-10, PM10-100, and PM> 100 were 135.76, 6.60, 20.10, 90.98, and 13.08 µg·cm− 2, respectively. Trichomes substantially contributed to PM2.5 retention, while larger undulations enhanced PM2.5-10 retention, as evidenced by positive correlations between PM2.5 and abaxial trichome density and between PM2.5-10 and the adaxial raw microroughness values. Phyllosphere microbial diversity patterns varied among lines, with bacteria dominated by Sediminibacterium and fungi by Mycosphaerella, Alternaria, and Cladosporium. Redundancy analysis confirmed that dense leaf trichomes facilitated the capture of PM2.5-associated fungi, while bacteria were less impacted by PM and struggled to adhere to leaf microstructures. Long and dense trichomes provided ideal microhabitats for retaining PM-borne microbes, as evidenced by positive feedback loops between PM2.5, trichome characteristics, and the relative abundances of microorganisms like Trichoderma and Aspergillus.

Conclusions

Based on our findings, a three-factor network profile was constructed, which provides a foundation for further exploration into how different plants retain PM through foliar microstructures, thereby impacting phyllosphere microbial communities.
Diagnosis and cardiac transplantation of a Carney syndrome-induced cardiac myxoma combined with dilated cardiomyopathy: a case report
Authors: Cheng Cheng , Song Yang , Yan Haidong , Bao Daojun , Zhang Xiaodi , Zhao Yi , Liu Daxing , Zhang Dengshen
Published: June 2024

Background

Carney syndrome is an uncommon autosomal disorder closely linked to mutations in the PRKAR1A gene. Skin lesions are the most pronounced feature of Carney syndrome, affecting over 80% of individuals with this condition. This syndrome is characterized by a triad of myxomas, skin pigmentation, and endocrine hyperfunction, featuring multiple endocrine neoplasms with skin and cardiac involvement.

Dilated cardiomyopathy, a primary cardiomyopathy, is defined as the dilation and impaired systolic function of the left or both ventricles. Its clinical presentation varies from being asymptomatic to heart failure or sudden cardiac death, making it a leading global cause of heart failure. Currently, Dilated cardiomyopathy has an estimated prevalence of 1/2500–1/250 individuals, predominantly affecting those aged 30–40 years, with a male-to-female ratio of 3:1. This case report describes a heart failure patient with cardiac myxoma caused by Carney syndrome combined with dilated cardiomyopathy. The patient was successfully treated for heart failure by heart transplantation.

Case presentation

Herein, we report a case of heart failure due to Carney syndrome that resulted in cardiac myxoma combined with dilated cardiomyopathy. A 35-year-old male was admitted to the hospital three years ago because of sudden chest tightness and shortness of breath. Echocardiography indicated myxoma, and a combination of genetic screening and physical examination confirmed Carney syndrome with cardiac myxoma. Following symptomatic management, he was discharged. Surgical interventions were not considered at the time. However, the patient’s chest tightness and shortness of breath symptoms worsened, and he returned to the hospital. A New York Heart Association grade IV heart function was confirmed, and echocardiography indicated the presence of dilated cardiomyopathy accompanied by cardiac myxoma. Ultimately, the patient’s heart failure was successfully treated with heart transplantation.

Conclusions

Cardiac myxoma caused by Carney syndrome combined with heart failure caused by dilated cardiomyopathy can be resolved by heart transplantation.
Combined effect of inflammation and malnutrition for long-term prognosis in patients with acute coronary syndrome undergoing percutaneous coronary intervention: a cohort study
Authors: Yuxiu Yang , Ma Xiaoteng , Gao Fei , Liu Tao , Deng Jianping , Wang Zhijian
Published: June 2024

Background

Inflammation is a key driver of atherosclerotic diseases and is often accompanied by disease-related malnutrition. However, the long-term burden of dysregulated inflammation with superimposed undernutrition in patients with acute coronary syndrome (ACS) remains unclear. This study sought to investigate the double burden and interplay of inflammation and malnutrition in patients with ACS undergoing percutaneous Coronary Intervention (PCI).

Methods

We retrospectively included 1,743 ACS patients undergoing PCI from June 2016 through November 2017 and grouped them according to their baseline nutritional and inflammatory status. Malnutrition was determined using the nutritional risk index (NRI) with a score lower than 100 and a high-inflamed condition defined as hs-CRP over 2 mg/L. The primary outcome was major adverse cardiovascular events (MACEs), compositing of cardiac mortality, non-fatal myocardial infarction, non-fatal stroke, and unplanned revascularization. Long-term outcomes were examined using the Kaplan-Meier method and compared with the log-rank test. Multivariable Cox proportional hazards regression analysis was applied to adjust for confounding. The reclassification index (NRI)/integrated discrimination index (IDI) statistics estimated the incremental prognostic impact of NRI and hs-CRP in addition to the Global Registry of Acute Coronary Events (GRACE) risk score.

Results

During a median follow-up of 30 months (ranges 30–36 months), 351 (20.1%) MACEs occurred. Compared with the nourished and uninflamed group, the malnourished and high-inflamed group displayed a significantly increased risk of MACEs with an adjusted hazard ratio of 2.446 (95% CI: 1.464–4.089; P < 0.001). The prognostic implications of NRI were influenced by patients’ baseline inflammatory status, as it was only associated with MACEs among those high-inflamed (P for interaction = 0.005). Incorporating NRI and hs-CRP into the GRACE risk score significantly improved its predictive ability for MACEs (NRI: 0.210, P < 0.001; integrated discrimination index; IDI: 0.010, P < 0.001) and cardiac death (NRI: 0.666, P < 0.001; IDI: 0.023, P = 0.002).

Conclusions

Among patients with ACS undergoing PCI, the double burden of inflammation and malnutrition signifies poorer outcomes. Their prognostic implications may be amplified by each other and jointly improve the GRACE risk score’s risk prediction performance.
IRIS U kit usefulness in transanal total mesorectal excision for lower rectal cancer to avoid urethral injury
Authors: Ishii Masatsugu , Nitta Toshikatsu , Kataoka Jun , Ueda Yasuhiko , Matsutani Ayumi , Taki Masataka , Kubo Ryutaro , Ota Masato , Ishibashi Takashi
Published: June 2024

Transanal total mesorectal excision (taTME) has improved the laparoscopic dissection for rectal cancer in the narrow pelvis. Although taTME has more clinical benefits than laparoscopic surgery, such as a better view of the distal rectum and direct determination of distal resection margin, an intraoperative urethral injury could occur in excision ta-TME. This study aimed to determine the feasibility and efficacy of the ta-TME with IRIS U kit surgery. This retrospective study enrolled 10 rectal cancer patients who underwent a taTME with an IRIS U kit. The study endpoints were the safety of access (intra- or postoperative morbidity). The detectability of the IRIS U kit catheter was investigated by using a laparoscope-ICG fluorescence camera system. Their mean age was 71.4±6.4 (58–78) years; 80 were men, and 2 were women. The mean operative time was 534.6 ± 94.5 min. The coloanal anastomosis was performed in 80%, and 20% underwent abdominal peritoneal resection. Two patients encountered postoperative complications graded as Clavien–Dindo grade 2. The transanal approach with IRIS U kit assistance is feasible, safe for patients with lower rectal cancer, and may prevent intraoperative urethral injury.
Cognition of diet quality and dietary management in elderly patients with coronary and other atherosclerotic vascular disease in western China, a qualitative research study
Authors: Chen Jiamengying , Li Xiaojie , Wang Yun , Zhang Chunling , Yang Li , Zhao Lvheng , Zhu Qingqing , Wang Li , Zhou Yixia
Published: June 2024

Background

Healthy eating is one of the most important nonpharmacologic treatments for patients with atherosclerosis(AS). However, it is unclear how elderly AS patients in western China perceive their dietary status and which type of nutritional assistance they would be willing to receive. Therefore, the primary purpose of this study was to understand the level of knowledge about current dietary habits and healthy eating habits among elderly AS patients in western China, and the secondary purpose was to identify acceptable nutritional assistance measures or pathways for those patients to help them manage disease progression.

Methods

An implementation study approach was used to recruit elderly patients with AS-related diseases in western China for semistructured interviews.

Results

14 participants were included in the study, and the following three themes were identified from the interviews:(1) the diet with regional characteristics; (2) low nutrition-related health literacy; (3) complex attitudes towards nutritional assistance. Most participants had misconceptions about healthy eating, and the sources of their knowledge might not be trustworthy. Participants expressed a preference for personalized nutritional assistance, especially that provided by medical-nursing combined institutions.

Conclusion

Patients in western China need nutritional assistance for their regional dietary habits; therefore, healthy dietary patterns consistent with the regional culture are proposed to improve the prevailing lack of knowledge about healthy diets, improve the dietary structure of patients, and control the development of the disease.
Remotely monitored physical activity from older people with cardiac devices associates with physical functioning
Authors: Taylor J.K. , Peek N. , Greenstein A.S. , Sammut-Powell C. , Martin G.P. , Ahmed F.Z.
Published: June 2024

Introduction

Accelerometer-derived physical activity (PA) from cardiac devices are available via remote monitoring platforms yet rarely reviewed in clinical practice. We aimed to investigate the association between PA and clinical measures of frailty and physical functioning.

Methods

The PATTErn study (A study of Physical Activity paTTerns and major health Events in older people with implantable cardiac devices) enrolled participants aged 60 + undergoing remote cardiac monitoring. Frailty was measured using the Fried criteria and gait speed (m/s), and physical functioning by NYHA class and SF-36 physical functioning score. Activity was reported as mean time active/day across 30-days prior to enrolment (30-day PA). Multivariable regression methods were utilised to estimate associations between PA and frailty/functioning (OR = odds ratio, β = beta coefficient, CI = confidence intervals).

Results

Data were available for 140 participants (median age 73, 70.7% male). Median 30-day PA across the analysis cohort was 134.9 min/day (IQR 60.8–195.9). PA was not significantly associated with Fried frailty status on multivariate analysis, however was associated with gait speed (β = 0.04, 95% CI 0.01–0.07, p = 0.01) and measures of physical functioning (NYHA class: OR 0.73, 95% CI 0.57–0.92, p = 0.01, SF-36 physical functioning: β = 4.60, 95% CI 1.38–7.83, p = 0.005).

Conclusions

PA from cardiac devices was associated with physical functioning and gait speed. This highlights the importance of reviewing remote monitoring PA data to identify patients who could benefit from existing interventions. Further research should investigate how to embed this into clinical pathways.
Management of serum phosphorus over a 1-year follow-up in patients on peritoneal dialysis prescribed sucroferric oxyhydroxide as part of routine care: a retrospective analysis
Authors: Kalantar-Zadeh Kamyar , Ficociello Linda H. , Zhou Meijiao , Anger Michael S.
Published: June 2024

Background

Hyperphosphatemia is associated with increased morbidity and mortality in patients with end-stage kidney disease (ESKD). Whereas clinical and observational studies have demonstrated the effectiveness of sucroferric oxyhydroxide (SO) in controlling serum phosphorus (sP) in ESKD, data on the real-world impact of switching to SO in patients on peritoneal dialysis (PD) are limited. In this retrospective database analysis, we examine the impact of SO on sP management over a 1-year period among PD patients prescribed SO as part of routine clinical care.

Methods

We analyzed de-identified data from adults on PD in Fresenius Kidney Care clinics who were prescribed SO monotherapy between May 2018 and December 2019 as part of routine clinical management. Changes from baseline in sP levels, phosphate binder (PB) pill burden, and laboratory parameters were evaluated during the four consecutive 91-day intervals of SO treatment.

Results

The mean age of the 402 patients who completed 1 year of SO was 55.2 years at baseline, and they had been on PD for an average of 19.9 months. SO was initiated with no baseline PB recorded in 36.1% of patients, whereas the remaining 257 patients were switched to SO from sevelamer (39.7%), calcium acetate (30.4%), lanthanum (1.2%), ferric citrate (14.0%), or more than one PB (14.8%). Mean sP at baseline was 6.26 mg/dL. After being prescribed SO, the percentage of patients achieving sP ≤ 5.5 mg/dL increased from 32.1% (baseline) to 46.5–54.0% during the 1-year follow-up, whereas the mean number of PB pills taken per day decreased from 7.7 at baseline (among patients on a baseline PB) to 4.6 to 5.4. Serum phosphorus and PB pill burden decreased regardless of changes in residual kidney function over the 12-month period. Similar results were observed for the full cohort (976 patients who either completed or discontinued SO during the 1-year follow-up).

Conclusions

Patients on PD who were prescribed SO as part of routine care for phosphorus management experienced significant reductions in SP and PB pills per day and improvements in sP target achievement, suggesting the effectiveness of SO on SP management with a concurrent reduction in pill burden.