bluuebunny/crossref_metadata_2025 huggingface dataset:
Variations in healthcare utilization for mental health problems prior to suicide by socioeconomic status: a Norwegian register-based population study
Authors: Øien-Ødegaard Carine , Christiansen Solveig Tobie Glestad , Hauge Lars Johan , Stene-Larsen Kim , Bélanger Sissel Marguerite , Bjertness Espen , Reneflot Anne
Published: May 2024

Background

Suicide poses a major public health challenge, claiming around 650 lives annually in Norway. There is limited understanding of mental healthcare utilization patterns preceding suicide, particularly relating to socioeconomic status (SES). This study analyzes mental health service use among Norwegian citizens aged 20–64 from 2009 to 2021, emphasizing disparities related to SES.

Methods

This is a population-wide registry-based study. We include mental health consultations with both primary and specialist healthcare services, and investigate patterns of service use regarding educational attainment, employment status and income and compare this to the population in general. All suicides in the period (N = 4731) are included in the study. The aim is to investigate potential discrepancies in service use the year and month preceding suicide, seeking to enhance targeted preventive interventions.

Results

Our results show significant variations in healthcare use for mental health problems the last year preceding suicide, according to the components of SES, for both men and women. Those with higher education utilize the mental healthcare services prior to suicide to a higher degree than men and women with high school education or less, whereas employed men and men with high income level have significantly lower mental healthcare usage prior to suicide both the last year and month compared to the non-employed men and men with low-income level. Employed women also had a lower mental healthcare usage, whereas the results regarding income are not significant for women.

Conclusion

Mental healthcare use prior to suicide varies across the SES components. Notably, the SES groups exhibit heterogeneity, with gendered patterns. Targeted interventions for low consultation rates among employed men, and men with high income and lower education are needed, while women, and men in at-risk groups, such as the non-employed and those with low income, demonstrate higher mental healthcare utilization, warranting comprehensive suicide prevention measures.
Juvenile dermatomyositis with Anti-SAE antibodies in a Moroccan child associated with pseudo-angioedema: a case report
Authors: Nainia Khalila , Aouzal Mohamed Amine , Ouafik Imane , Charhbili Mariyam , Bouchhab Amal , Daoudi Abdellatif , Tizki Samira , Chakiri Radia
Published: May 2024

Background

Juvenile Dermatomyositis (JDM) is the leading cause of non-infectious inflammatory myopathy in children. It is a heterogeneous group of autoimmune diseases characterized by a variable combination of muscular, dermatological, and visceral involvement. Myositis-specific autoantibodies help define homogeneous subgroups with common clinical characteristics and prognoses. Anti-SAE (small ubiquitin-like modifier 1 (SUMO-1) activating enzyme) antibodies are among the most recently discovered specific autoantibodies. The presence of these antibodies is very rare, making it challenging to define clinical features and prognosis in the juvenile form. We report the first case of an African patient with juvenile dermatomyositis and positive anti-SAE antibodies.

Case Report

A 5-year-3-month-old Moroccan boy presented to the pediatric emergency department with dysphagia that had been evolving for two days, preceded two months earlier by facial erythema associated with fatigue, lower limb pain, difficulty walking, and progressive inflammatory polyarthralgia. On admission, the child had a heliotrope rash with predominant pseudo-angioedema on the lips, periungual telangiectasia, and Gottron’s papules over the bilateral interphalangeal and metatarsophalangeal joints. The patient had a more pronounced proximal muscle weakness in the lower limbs. He had no urticaria, fever, arthritis, calcinosis, cutaneous ulcers, or lipodystrophy. The Joint examination was normal, as was the pleuropulmonary examination. The electroneuromyography showed myogenic changes in all four limbs. Laboratory findings showed elevated levels of creatine phosphokinase and lactate dehydrogenase and a mild inflammatory syndrome. The electrocardiogram was normal. The anti-SAE antibodies were positive. The boy was diagnosed with juvenile dermatomyositis. He received methylprednisolone bolus therapy followed by oral prednisone. The latter was gradually tapered in combination with weekly intramuscular methotrexate. As a result, dysphagia disappeared within 48 h. After two weeks, there was an improvement in the muscular score and a significant regression of facial pseudo-angioedema.

Conclusion

We report the first African patient with anti-SAE autoantibody-positive JDM. He had a typical dermatological manifestation of JDM associated with pseudo-angioedema predominant on the lips; a rarely reported sign in DM and JDM patients. The patient responded well to corticosteroid therapy and methotrexate.
Intracranial pressure following surgery of an unruptured intracranial aneurysm—a model for normal intracranial pressure in humans
Authors: Norager Nicolas Hernandez , Lilja-Cyron Alexander , Riedel Casper Schwartz , Holst Anders Vedel , Pedersen Sarah Hornshoej , Juhler Marianne
Published: May 2024

Objective

Optimizing the treatment of several neurosurgical and neurological disorders relies on knowledge of the intracranial pressure (ICP). However, exploration of normal ICP and intracranial pressure pulse wave amplitude (PWA) values in healthy individuals poses ethical challenges, and thus the current documentation remains scarce. This study explores ICP and PWA values for healthy adults without intracranial pathology expected to influence ICP.

Methods

Adult patients (age > 18 years) undergoing surgery for an unruptured intracranial aneurysm without any other neurological co-morbidities were included. Patients had a telemetric ICP sensor inserted, and ICP was measured in four different positions: supine, lateral recumbent, standing upright, and 45-degree sitting, at day 1, 14, 30, and 90 following the surgery.

Results

ICP in each position did not change with time after surgery. Median ICP was 6.7 mmHg and median PWA 2.1 mmHg in the supine position, while in the upright standing position median ICP was − 3.4 mmHg and median PWA was 1.9 mmHg. After standardization of the measurements from the transducer site to the external acoustic meatus, the median ICPmidbrain was 8.3 mmHg in the supine position and 1.2 mmHg in the upright standing position.

Conclusion

Our study provides insights into normal ICP dynamics in healthy adults following a uncomplicated surgery for an unruptured aneurysm. These results suggest a slightly wider normal reference range for invasive intracranial pressure than previously suggested, and present the first normal values for PWA in different positions. Further studies are, however, essential to enhance our understanding of normal ICP.

Trial registration The study was preregistered at www.clinicaltrials.gov (NCT03594136) (11 July 2018)
Effect of adjuvant radiotherapy on overall survival and breast cancer-specific survival of patients with malignant phyllodes tumor of the breast in different age groups: a retrospective observational study based on SEER
Authors: Yang Ping , Zhang Gongyin , Zhang Yu , Zhao Wanying , Tang Jinhai , Zeng Siyuan , Lv Xiupeng , Lv Li
Published: May 2024

Purpose

Malignant phyllodes tumor of the breast (MPTB) is a rare type of breast cancer, with an incidence of less than 1%. The value of adjuvant radiotherapy (RT) for MPTB has been controversial. The aim of the study was to explore the effect of radiotherapy on the long-term survival of female patients with MPTB at different ages.

Methods

Female MPTB patients were selected from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2020. A Kaplan–Meier survival analysis was conducted to investigate the value of RT for the long-term survival of MPTB patients in different age groups. Additionally, univariate and multivariate Cox regression analyses were performed for overall survival (OS) and breast cancer-specific survival (BCSS) of MPTB patients. Furthermore, propensity score matching (PSM) was also performed to balance the differences in baseline characteristics.

Results

2261 MPTB patients were included in this study, including 455 patients (20.12%) with RT and 1806 patients (79.88%) without RT. These patients were divided into four cohorts based on their ages: 18–45, 46–55, 56–65, and 65–80. Before adjustment, there was a statistically significant difference in long-term survival between RT-treated and non-RT-treated patients in the younger age groups (age group of 18–45 years: OS P = 0.019, BCSS P = 0.016; age group of 46–55 years: OS P < 0.001, BCSS P < 0.001). After PSM, no difference was found in long-term survival of patients in both younger and older groups regardless of whether they received RT (age group of 18–45 years: OS P = 0.473, BCSS P = 0.750; age group of 46–55 years: OS P = 0.380, BCSS P = 0.816, age group of 56–65 years: OS P = 0.484, BCSS P = 0.290; age group of 66–80 years: OS P = 0.997, BCSS P = 0.763). In multivariate COX regression analysis, RT did not affect long-term survival in patients with MPTB.

Conclusion

There is no evidence that long-term survival of MPTB patients in specific age groups can benefit from RT.
Bone marrow lesion and 5-year incident joint surgery in patients with knee osteoarthritis: a retrospective cohort study
Authors: Lin Liang , Zhang Jinshan , Zhu Hongyi , Wang Zefeng , Liu Xiaofeng , Xu Yongquan , Fang Yangzhen , Lin Zhenyu , Zheng Yongqiang
Published: May 2024

Background

It is beneficial for society to discover the risk factors associated with surgery and to carry out some early interventions for patients with these risk factors. Few studies specifically explored the relationship between bone marrow lesions (BMLs) and long-term incident joint surgery.

Objective

To investigate the association between BML severity observed in knee osteoarthritis (OA) patients’ first MRI examination and incident knee surgery within 5 years. Additionally, to assess the predictive value of BMLs for the incident knee surgery.

Design

Retrospective cohort study.

Methods

We identified patients diagnosed with knee OA and treated at our institution between January 2015 and January 2018, and retrieved their baseline clinical data and first MRI examination films from the information system. Next, we proceeded to determine the Max BML grades, BML burden grades and Presence BML grades for the medial, lateral, patellofemoral, and total compartments, respectively. Multi-variable logistic regression models examined the association of the BML grades with 5-year incident knee surgery. Positive and negative predictive values (PPVs and NPVs) were determined for BML grades referring to 5-year incident knee surgery.

Results

Totally, 1011 participants (knees) were found eligible to form the study population. Within the 5 years, surgery was performed on 74 knees. Max BML grade 2 and grade 3 of medial, patellofemoral and total compartments were strongly and significantly associated with incident surgery. None of the BML grades from lateral compartment was associated with incident surgery. The PPV was low and NPV was high for BMLs.

Conclusions

BMLs found in the first MRI examination were associated with 5-year incident joint surgery, except for those allocated in lateral compartments. The high NPVs imply that patients without BMLs have a low risk of requiring surgery within 5 years.
The accuracy of prehospital triage decisions in English trauma networks – a case-cohort study
Authors: Fuller G. , Baird J. , Keating S. , Miller J. , Pilbery R. , Kean N. , McKnee K. , Turner J. , Lecky F. , Edwards A. , Rosser A. , Fothergill R. , Black S. , Bell F. , Smyth M. , Smith JE. , Perkins GD. , Herbert E. , Walters S. , Cooper C. ,   the MATTS research group, Maconochie Ian , Ward Mathew , Millins Mark , Turton Emily , Waterhouse Simon , Stevenson Matt , Pollard Daniel , Pandor Abdullah , Robinson Maria , Reid Stuart , Charles Di
Published: May 2024

Background

Care for injured patients in England is provided by inclusive regional trauma networks. Ambulance services use triage tools to identify patients with major trauma who would benefit from expedited Major Trauma Centre (MTC) care. However, there has been no investigation of triage performance, despite its role in ensuring effective and efficient MTC care. This study aimed to investigate the accuracy of prehospital major trauma triage in representative English trauma networks.

Methods

A diagnostic case-cohort study was performed between November 2019 and February 2020 in 4 English regional trauma networks as part of the Major Trauma Triage Study (MATTS). Consecutive patients with acute injury presenting to participating ambulance services were included, together with all reference standard positive cases, and matched to data from the English national major trauma database. The index test was prehospital provider triage decision making, with a positive result defined as patient transport with a pre-alert call to the MTC. The primary reference standard was a consensus definition of serious injury that would benefit from expedited major trauma centre care. Secondary analyses explored different reference standards and compared theoretical triage tool accuracy to real-life triage decisions.

Results

The complete-case case-cohort sample consisted of 2,757 patients, including 959 primary reference standard positive patients. The prevalence of major trauma meeting the primary reference standard definition was 3.1% (n=54/1,722, 95% CI 2.3 – 4.0). Observed prehospital provider triage decisions demonstrated overall sensitivity of 46.7% (n=446/959, 95% CI 43.5-49.9) and specificity of 94.5% (n=1,703/1,798, 95% CI 93.4-95.6) for the primary reference standard. There was a clear trend of decreasing sensitivity and increasing specificity from younger to older age groups. Prehospital provider triage decisions commonly differed from the theoretical triage tool result, with ambulance service clinician judgement resulting in higher specificity.

Conclusions

Prehospital decision making for injured patients in English trauma networks demonstrated high specificity and low sensitivity, consistent with the targets for cost-effective triage defined in previous economic evaluations. Actual triage decisions differed from theoretical triage tool results, with a decreasing sensitivity and increasing specificity from younger to older ages.
Chromatin profiling and state predictions reveal insights into epigenetic regulation during early porcine development
Authors: Innis Sarah M. , Cabot Ryan A.
Published: May 2024

Background

Given their physiological similarities to humans, pigs are increasingly used as model organisms in human-oriented biomedical studies. Additionally, their value to animal agriculture across the globe has led to the development of numerous studies to investigate how to improve livestock welfare and production efficiency. As such, pigs are uniquely poised as compelling models that can yield findings with potential implications in both human and animal contexts. Despite this, many gaps remain in our knowledge about the foundational mechanisms that govern gene expression in swine across different developmental stages, particularly in early development. To address some of these gaps, we profiled the histone marks H3K4me3, H3K27ac, and H3K27me3 and the SWI/SNF central ATPase BRG1 in two porcine cell lines representing discrete early developmental time points and used the resulting information to construct predicted chromatin state maps for these cells. We combined this approach with analysis of publicly available RNA-seq data to examine the relationship between epigenetic status and gene expression in these cell types.

Results

In porcine fetal fibroblast (PFF) and trophectoderm cells (PTr2), we saw expected patterns of enrichment for each of the profiled epigenetic features relative to specific genomic regions. H3K4me3 was primarily enriched at and around global gene promoters, H3K27ac was enriched in promoter and intergenic regions, H3K27me3 had broad stretches of enrichment across the genome and narrower enrichment patterns in and around the promoter regions of some genes, and BRG1 primarily had detectable enrichment at and around promoter regions and in intergenic stretches, with many instances of H3K27ac co-enrichment. We used this information to perform genome-wide chromatin state predictions for 10 different states using ChromHMM. Using the predicted chromatin state maps, we identified a subset of genomic regions marked by broad H3K4me3 enrichment, and annotation of these regions revealed that they were highly associated with essential developmental processes and consisted largely of expressed genes. We then compared the identities of the genes marked by these regions to genes identified as cell-type-specific using transcriptome data and saw that a subset of broad H3K4me3-marked genes was also specifically expressed in either PFF or PTr2 cells.

Conclusions

These findings enhance our understanding of the epigenetic landscape present in early swine development and provide insight into how variabilities in chromatin state are linked to cell identity. Furthermore, this data captures foundational epigenetic details in two valuable porcine cell lines and contributes to the growing body of knowledge surrounding the epigenetic landscape in this species.
Taekwondo win-loss determining factors using data mining-based decision tree analysis: focusing on game analysis for evidence-based coaching
Authors: Jeon Minsoo , Lim Hyosung
Published: May 2024

Background

Purpose In this study, the purpose of this study is to identify the determinants of winning and losing in taekwondo by applying decision tree analysis, one of the data mining techniques, based on the 2022 World taekwondo championships women’s competition.

Methods

272 women’s games in the taekwondo championships in Guadalajara held by the WT in 2022 were used. For data processing, an independent sample t-test was performed for differences in game content variables according to the win/lose group, and a decision tree analysis was performed to confirm game content variables affecting the win/lose group. To check the predictive power of the model, classification accuracy, standard error, and misclassification estimates were calculated. All statistical significance levels were set at 0.05.

Results

First, it was found that there was no statistically significant difference only in body attack (attempt) and number of kicking variables according to the winning and losing groups(p > .05), and there were differences in all other game content variables(p < .05). Second, as a result of conducting a decision tree analysis to confirm the determinants of winning and losing in taekwondo sparring, winning situation, tie situation, and number of kicks were identified as important variables.

Conclusion

The World taekwondo championships are analyzed in the currently changed taekwondo competition rules to identify important factors, and at the same time, based on this, data-based coaching is expected to improve performance.
Managers’ attitudes to depression and the association with their rating of how work capacity is affected in employees with common mental disorders
Authors: Hultqvist Jenny , Hensing Gunnel , Björk Lisa , Bertilsson Monica
Published: May 2024

Objective

This explorative, cross-sectional study assessed the association between managers’ attitudes to employee depression and their rating of how common mental disorders (CMDs) affect employee work capacity.

Results

A principal component analysis was performed for the nine variables concerning managers’ rating of how CMDs can affect work capacity among employees. The analysis resulted in two factors: task-oriented- and relational work capacity. The result of the multivariate analysis of covariance showed a p value of 0.014 (Pillai’s trace) indicating a statistically significant association between managers’ attitudes towards employee depression and managers’ rating of how CMDs affect work capacity. The association was significant for both factors as indicated by the p value of 0.024 for task-oriented work capacity and the p value of 0.007 for relational work capacity. The R2 value was 0.022 for task-oriented work capacity and 0.017 for relational work capacity. We assumed that negative attitudes towards employee depression would be associated with a perception of decreased work capacity among employees with CMDs. The results showed a significant association; however, the effect (~ 2%) was small. Further studies of manager’s attitudes and other possible determinants of managers’ rating of CMD-related work capacity are needed to better understand these factors.
Experimental colitis in young Tg2576 mice accelerates the onset of an Alzheimer’s-like clinical phenotype
Authors: Lorenzini Luca , Zanella Lorenzo , Sannia Michele , Baldassarro Vito Antonio , Moretti Marzia , Cescatti Maura , Quadalti Corinne , Baldi Simone , Bartolucci Gianluca , Di Gloria Leandro , Ramazzotti Matteo , Clavenzani Paolo , Costanzini Anna , De Giorgio Roberto , Amedei Amedeo , Calzà Laura , Giardino Luciana
Published: May 2024

Systemic inflammation and neuroinflammation affect the natural course of the sporadic form of Alzheimer’s disease (AD), as supported by epidemiological and preclinical data, and several epidemiological studies indicate a higher prevalence of AD in patients with inflammatory bowel disease. In this study, we explored whether colitis induced by dextran sulfate sodium (DSS) in young, presymptomatic/preplaque mice worsens and/or anticipates age-dependent cognitive impairment in Tg2576, a widely used mouse model of AD. We demonstrated that DSS colitis induced in young Tg2576 mice anticipates the onset age of learning and memory deficit in the Morris water maze test. To explore potential mechanisms behind the acceleration of cognitive decline in Tg2576 mice by DSS colitis, we focused on gut microbiota, systemic inflammation and neuroinflammation markers. We observed a Firmicutes/Bacteroidetes ratio change in Tg2576 DSS animals comparable to that of elderly Tg2576 mice, suggesting accelerated microbiota aging in Tg2576 DSS mice, a change not observed in C57BL6 DSS mice. We also observed substantial differences between Tg2576 and WT mice in several inflammation and neuroinflammation-related parameters as early as 3 months of age, well before plaque deposition, a picture which evolved rapidly (between 3 and 5.5 months of age) in contrast to Tg2576 and WT littermates not treated with DSS. In detail, following induction of DSS colitis, WT and Tg2576 mice exhibited contrasting features in the expression level of inflammation-evoked astrocyte-associated genes in the hippocampus. No changes in microglial features occurred in the hippocampus between the experimental groups, whereas a reduced glial fibrillary acidic protein immunoreactivity was observed in Tg2576 vs. WT mice. This finding may reflect an atrophic, “loss-of-function” profile, further exacerbated by DSS where a decreased of GFAP mRNA expression level was detected. In conclusion, we suggest that as-yet unidentified peripheral mediators evoked by DSS colitis and involving the gut-brain axis emphasize an astrocyte “loss-of-function” profile present in young Tg2576 mice, leading to impaired synaptic morphological and functional integrity as a very early sign of AD.
Human Muse cells isolated from preterm- and term-umbilical cord delivered therapeutic effects in rat bleomycin-induced lung injury model without immunosuppressant
Authors: Win Kaung Htet Nay , Kushida Yoshihiro , Yamana Keiji , Iwatani Sota , Yoshida Makiko , Nino Nanako , Mon Cho Yee , Ohsaki Hiroyuki , Kamoshida Shingo , Fujioka Kazumichi , Dezawa Mari , Nishimura Noriyuki
Published: May 2024

Background

Bleomycin (BLM)-induced lung injury is characterized by mixed histopathologic changes with inflammation and fibrosis, such as observed in human patients with bronchopulmonary dysplasia, idiopathic pulmonary fibrosis, and chronic obstructive pulmonary disease. Although no curative therapies for these lung diseases exist, stem cell therapy has emerged as a potential therapeutic option. Multilineage-differentiating stress-enduring (Muse) cells are endogenous pluripotent- and macrophage-like stem cells distributed in various adult and fetal tissues as stage-specific embryonic antigen-3-positive cells. They selectively home to damaged tissue by sensing sphingosine-1-phosphate and replace the damaged/apoptotic cells by in vivo differentiation. Clinical trials for some human diseases suggest the safety and therapeutic efficacy of intravenously injected human leukocyte antigen-mismatched allogenic Muse cells from adult bone marrow (BM) without immunosuppressant. Here, we evaluated the therapeutic effects of human Muse cells from preterm and term umbilical cord (UC), and adult BM in a rat BLM-induced lung injury model.

Methods

Rats were endotracheally administered BLM to induce lung injury on day 0. On day 3, human preterm UC-Muse, term UC-Muse, or adult BM-Muse cells were administered intravenously without immunosuppressants, and rats were subjected to histopathologic analysis on day 21. Body weight, serum surfactant protein D (SP-D) levels, and oxygen saturation (SpO2) were monitored. Histopathologic lung injury scoring by the Ashcroft and modified American Thoracic Society document scales, quantitative characterization of engrafted Muse cells, RNA sequencing analysis, and in vitro migration assay of infused Muse cells were performed.

Results

Rats administered preterm- and term-UC-Muse cells exhibited a significantly better recovery based on weight loss, serum SP-D levels, SpO2, and histopathologic lung injury scores, and a significantly higher rate of both Muse cell homing to the lung and alveolar marker expression (podoplanin and prosurfactant protein-C) than rats administered BM-Muse cells. Rats receiving preterm-UC-Muse cells showed statistically superior results to those receiving term-UC-Muse cells in many of the measures. These findings are thought to be due to higher expression of genes related to cell migration, lung differentiation, and cell adhesion.

Conclusion

Preterm UC-Muse cells deliver more efficient therapeutic effects than term UC- and BM-Muse cells for treating BLM-induced lung injury in a rat model.
A microcosting approach for planning and implementing community-based mental health prevention programs: what does it cost?
Authors: Roy Sharmily , Brown Henry Shelton , Blinn Lisa Sanger , Narendorf Sarah Carter , Hamilton Jane E.
Published: May 2024

Background

Estimating program costs when planning community-based mental health programs can be burdensome. Our aim was to retrospectively document the cost for the first year of planning and implementing Healthy Minds Healthy Communities (HMHC), a mental health promotion and prevention multi-level intervention initiative. This Program is among the first to use the Community Initiated Care (CIC) model in the US and is aimed at building community resilience and the capacity for communities to provide mental health support, particularly among those disproportionately impacted by COVID-19. Our objective is to share our methods for costing a program targeting 10 zip codes that are ethnically and linguistically diverse and provide an example for estimating the cost of a mental health prevention and promotion programs consisting of multiple evidence-based interventions.

Methods

We used a semi-structured interview process to collect cost data through the first year of program planning, start-up and initial implementation from key staff. We calculated costs for each activity, grouped them by major project categories, and identified the cost drivers of each category. We further validated cost estimates through extensive literature review. The cost analysis was done from the provider’s perspective, which included the implementing agency and its community partners. We delineated costs that were in-kind contributions to the program by other agency, and community partners. Sensitivity analyses were conducted to estimate uncertainty around parameters.

Results

For the first year of the development and implementation of the program, (funded through program and in-kind) is estimated at $1,382,669 (2022 US$). The costs for the three main activity domains for this project are: project management $135,822, community engagement $364,216 and design and execution $756,934. Overall, the cost drivers for the first year of this intervention were: hiring and onboarding staff, in-person community building/learning sessions, communications and marketing, and intervention delivery.

Conclusion

Implementation of community-based mental health promotion and prevention programs, when utilizing a participatory approach, requires a significant amount of upfront investment in program planning and development. A large proportion of this investment tends to be human capital input. Developing partnerships is a successful strategy for defraying costs.
Family centeredness of care: a cross-sectional study in intensive care units part of the European society of intensive care medicine
Authors: Azoulay Élie , Kentish-Barnes Nancy , Boulanger Carole , Mistraletti Giovanni , van Mol Margo , Heras-La Calle Gabriel , Estenssoro Elisa , van Heerden Peter Vernon , Delgado Maria-Cruz Martin , Perner Anders , Arabi Yaseen M , Myatra Sheila Nainan , Laake Jon Henrik , De Waele Jan J. , Darmon Michael , Cecconi Maurizio
Published: May 2024

Purpose

To identify key components and variations in family-centered care practices.

Methods

A cross-sectional study, conducted across ESICM members. Participating ICUs completed a questionnaire covering general ICU characteristics, visitation policies, team-family interactions, and end-of-life decision-making. The primary outcome, self-rated family-centeredness, was assessed using a visual analog scale. Additionally, respondents completed the Maslach Burnout Inventory and the Ethical Decision Making Climate Questionnaire to capture burnout dimensions and assess the ethical decision-making climate.

Results

The response rate was 53% (respondents from 359/683 invited ICUs who actually open the email); participating healthcare professionals (HCPs) were from Europe (62%), Asia (9%), South America (6%), North America (5%), Middle East (4%), and Australia/New Zealand (4%). The importance of family-centeredness was ranked high, median 7 (IQR 6–8) of 10 on VAS. Significant differences were observed across quartiles of family centeredness, including in visitation policies availability of a waiting rooms, family rooms, family information leaflet, visiting hours, night visits, sleep in the ICU, and in team-family interactions, including daily information, routine day-3 conference, and willingness to empower nurses and relatives. Higher family centeredness correlated with family involvement in rounds, participation in patient care and end-of-life practices. Burnout symptoms (41% of respondents) were negatively associated with family-centeredness. Ethical climate and willingness to empower nurses were independent predictors of family centeredness.

Conclusions

This study emphasizes the need to prioritize healthcare providers’ mental health for enhanced family-centered care. Further research is warranted to assess the impact of improving the ethical climate on family-centeredness.
A network meta-analysis on responses of forest soil carbon concentration to interventions
Authors: Shen Kaihui , Li Lin , Wei Shiguang , Liu Jiarun , Zhao Yi
Published: May 2024

Background

Forests play a crucial role in absorbing CO2 from the atmosphere. 55% of the carbon in terrestrial ecosystems is stored in forests, with the majority of forest carbon stored in soil. To better understand soil organic carbon (SOC) of forests and to access interventions that affect their SOC concentration, we conducted a comparative analysis between natural and planted forests. Forest interventions refer to the actions taken by humans to manage, protect, or transform forests, and can be divided into two main categories: environmental intervention and anthropogenic intervention. This study focused on the effects of different interventions on SOC in natural and planted forests by reviewing a total of 75 randomized controlled trials in the global literature and extracting a total of 15 different interventions.

Results

Through network meta-analysis, we found that natural forests have 22.3% higher SOC than planted forests, indicating their stronger carbon storage function. In natural forests, environmental interventions have a stronger impact. SOC is significantly influenced by forest age, fertilization, and elevation. In planted forests, however, anthropogenic interventions have a stronger impact. Pruning branches and fertilization are effective interventions for planted forests. Furthermore, forest degradation has a significantly negative impact on SOC in planted forests.

Conclusion

Overall, interventions to enhance soil carbon storage function differ between natural and planted forests. To address global climate change, protect biodiversity, and achieve sustainable development, it is imperative to globally protect forests and employ scientifically sound forest management practices. Regarding natural forests, the emphasis should be on comprehending the effects of environmental interventions on SOC. Conversely, concerning planted forests, the emphasis should be on comprehending the effects of anthropogenic interventions.
An updated analysis of safety climate and downstream outcomes in two convenience samples of U.S. fire departments (FOCUS 1.0 and 2.0 survey waves)
Authors: Geczik Ashley M. , Lee Jin , Allen Joseph A. , Raposa Madison E. , Robinson Lucy F. , Quistberg D. Alex , Davis Andrea L. , Taylor Jennifer A.
Published: May 2024

Background

The Fire service Organizational Culture of Safety (FOCUS) survey is an assessment tool comprised of psychometrically validated metrics of safety climate, safety behavior, and downstream outcomes (organizational and injury) that are specific to the U.S. fire and rescue service.

Methods

This analysis consists of a descriptive summary of two independent survey waves (FOCUS 1.0 and 2.0). The fire departments included in these survey waves were from convenience sampling (n1.0 = 275; n2.0 = 170). In addition to department level characteristics, we examined individual level characteristics for firefighters and EMS providers in participating departments (n1.0 = 22,719; n2.0 = 16,882). We conducted regression analyses to examine the associations between safety climate and safety behaviors, organizational outcomes, and safety outcomes. All analyses were stratified by organization type (career, volunteer).

Results

Our analysis indicated that a majority of respondents were males (90.7%FOCUS 1.0; 90.4%FOCUS 2.0), non-officers (68.4%FOCUS 1.0; 66.4%FOCUS 2.0), and non-Hispanic Whites (70.8%FOCUS 1.0; 69.5%FOCUS 2.0). For both samples there was a higher prevalence of injuries among individuals in career departments (nFOCUS 1.0 = 3778 [17.5%]; nFOCUS 2.0 = 3072 [18.7%]) than volunteer departments (nFOCUS 1.0 = 103 [8.8%]; nFOCUS 2.0 = 34 [7.4%]). We observed an approximate 10-point difference between the mean scores of Management Commitment to Safety for career and volunteer departments in both samples. We observed associations for two organizational outcomes, Safety Behavior and Job Satisfaction, with Management Commitment to Safety and Supervisor Support for Safety overall and when stratified by organization type. We observed a decrease in the odds of injuries associated with a one-unit increase in Management Commitment to Safety (OR1.0 overall: 0.98, 95% CI 0.97–0.99; OR2.0 volunteer: 0.90, 95% CI 0.85–0.95) and Supervisor Support for Safety (OR1.0 overall: 0.95, 95% CI 0.93–0.97; OR1.0 career: 0.95, 95% CI 0.92–0.98).

Conclusions

From our current study, and a prior analysis of a geographically stratified random sample of U.S. fire departments, we identified that from all the organizational outcomes, job satisfaction was most consistently associated with FOCUS safety climate. Further, firefighters in our samples consistently rated Supervisor Support for Safety higher than Management Commitment to Safety. Future interventions should support fire departments in improving their departmental Management Commitment to Safety and maintaining their Supervisor for Safety.
Ways of integrating eating into everyday lives – a qualitative study in Germany
Authors: Lampmann Lyn , Emberger-Klein Agnes , Brückner Katrin , Menrad Klaus
Published: May 2024

Background

Food-related behaviour is a very complex topic. A common way to reduce complex issues to their essential content is to create a typology. In Germany, with regard to food-related behaviour, the creation of a typology has often been carried out by commercial research institutes, but also by (international) scientific institutes. The former have mostly used quantitative methods, the latter usually have a specific content focus. Within this study, we want to investigate how people integrate eating into their everyday lives while engaging with themselves and the environment, thereby living out personality development and related socialisation.

Methods

37 qualitative interviews were conducted and evaluated by means of content-structuring qualitative analysis and type-forming qualitative content analysis. Interviewees were recruited via recruitment calls using different channels, such as newspapers or university e-mail lists. Participants over the age of seventeen were eligible to take part in the study. Both the individual action processes and the interpretation processes regarding food-related behaviour were taken into account. The final sample consisted of 20 male and 18 female participants with an age range from 18 to 83.

Results

The result were seven eating action types, namely: Eating as a way of life, The Relaxed, Eating as self-determination, Eating as a necessary Evil, The Adaptive, The Overstrained and The Controlled.

Conclusions

We contribute to the study of food-related behaviour with the chosen qualitative method of type-building and by looking at how people integrate eating into their everyday lives. This contributes to a broader understanding of this phenomenon and complements the findings of existing commercial and academic food-related typing-building activities. Specifically, through identifying “The Overstrained” as a novel eating action type, this study adds to the literature in the field and may be a useful baseline for future research.
We should concern about Nipah virus epidemic in Bangladesh
Authors: Roney Miah
Published: May 2024

The zoonotic Nipah virus (NiV) is very lethal and may spread from animals to people. There is yet no known cure or therapy for NiV. The outbreaks are seasonal in Bangladesh, occurring between December and April, with cases reported almost annually. Since the virus was discovered in Bangladesh in 2001, 341 individuals had been affected, and as of February 2024, 242 fatalities have been documented. The case fatality rate (CFR) for NiV has been estimated to range from 40 to 75% in Bangladesh according to the World Health Organisation (WHO). As a result of the high CFR, difficulties in diagnosing the virus, and lack of specific treatments or vaccines for NiV infection, the WHO rates the overall risk at the national level as moderate. The virus has the potential to become a global public health concern due to its ability to spread from individual to person and beyond the region.
Strategic fire zones are essential to wildfire risk reduction in the Western United States
Authors: North Malcolm P. , Bisbing Sarah M. , Hankins Don L. , Hessburg Paul F. , Hurteau Matthew D. , Kobziar Leda N. , Meyer Marc D. , Rhea Allison E. , Stephens Scott L. , Stevens-Rumann Camille S.
Published: May 2024

Background

Over the last four decades, wildfires in forests of the continental western United States have significantly increased in both size and severity after more than a century of fire suppression and exclusion. Many of these forests historically experienced frequent fire and were fuel limited. To date, fuel reduction treatments have been small and too widely dispersed to have impacted this trend. Currently new land management plans are being developed on most of the 154 National Forests that will guide and support on the ground management practices for the next 15–20 years.

Results

During plan development, we recommend that Strategic Fire Zones (SFZs) be identified in large blocks (≥ 2,000 ha) of Federal forest lands, buffered (≥ 1–2.4 km) from the wildland-urban interface for the reintroduction of beneficial fire. In SFZs, lightning ignitions, as well as prescribed and cultural burns, would be used to reduce fuels and restore ecosystem services. Although such Zones have been successfully established in a limited number of western National Parks and Wilderness Areas, we identify extensive remote areas in the western US (8.3–12.7 million ha), most outside of wilderness (85–88%), where they could be established. Potential wildland fire Operational Delineations or PODs would be used to identify SFZ boundaries. We outline steps to identify, implement, monitor, and communicate the use and benefits of SFZs.

Conclusions

Enhancing collaboration and knowledge-sharing with Indigenous communities can play a vital role in gaining agency and public support for SFZs, and in building a narrative for how to rebuild climate-adapted fire regimes and live within them. Meaningful increases in wildland fire use could multiply the amount of beneficial fire on the landscape while reducing the risk of large wildfires and their impacts on structures and ecosystem services.
Neutrophil lymphocyte ratio and heart type fatty acid binding protein as a prognostic marker in Myocardial infarction within 48 h of admission
Authors: Nikhil K. G. , Jayakumar K. T. , Shiny P. J. , Ramya N. K. , Kumar J. S.
Published: May 2024

Background

The neutrophil to lymphocyte ratio (NLR) is a measure of systemic inflammation, whereas Heart type fatty acid protein (HFABP) is a cytosolic protein released early after acute coronary syndrome (ACS). The aim of this research study is to determine whether NLR and H-FAB are useful in predicting the prognosis in patients with ST segment elevation myocardial infarction (STEMI) 48 h after admission. This is a prospective observational study conducted on 97 patients who had been admitted to emergency room with ST-elevation myocardial infarction in their ECG in a tertiary care centre of south India. The neutrophil–lymphocyte ratio was measured at the time of admission, 24th hour and 48th hour, and then compared with the outcome. To determine their significance in the MI episode, troponin-I and H-FABP were also measured.

Results

A significant correlation was found in the final outcomes of patients and the NLR at the time of admission and at 48 h (p = 0.01). Additionally, a substantial correlation between NLR and various degrees of LV dysfunction was also observed (p = 0.01). H-FABP was found to be positive in all 97 of the patients examined, whereas Troponin-I was only found to be positive in 56.7%.

Conclusion

The study's findings, indicated strong correlations between NLR and LVEF, indicated that NLR might serve as an early predictor of cardiac events which could be either poor prognosis or higher mortality. This research found that H-FABP may serve as an early MI diagnostic marker.
First record of an alien species of Amerianna Strand, 1928 (Gatropoda: Hygrophila: Planorbidae) in the Kimpese region, Democratic Republic of Congo
Authors: Kieng Katsang Germain Kapour , Wambui Cecilia Wangari , Schols Ruben , Ntwan Joule Madinga , Mulopo Patrick Mitashi , Huyse Tine
Published: May 2024

This study provides the first case report of Amerianna species in the Democratic Republic of Congo (DRC), first confirmed presence in Central Africa and the first molecular data from the African continent. The Amerianna species was found during a snail survey focused on schistosomiasis intermediate hosts. After sequence analysis of the partial cytochrome c oxidase I (COI) marker, three of these specimens were found to belong to the genus Amerianna. Combining morphological and molecular data, we tentatively identify the three specimens as Amerianna cf. carinata. This species is originally found in Australian freshwater bodies and was first detected in 1983 in several Nigerian man-made waterbodies. Therefore, special care should be taken when mapping Bulinus truncatus, the intermediate host for Schistosoma haematobium, as to not confuse both species as this might misguide snail control.
Extensively drug-resistant Salmonella typhi Infection in Adults; Experience from A Tertiary Care Hospital
Authors: Mahmood Afsheen , Rahim Fawad , Amin Said , Noor Mohammad
Published: May 2024

Objectives: This study aimed to determine the epidemiology, clinical features, and complications of extensively drug-resistant Salmonella typhi (XDR S. typhi) infection in adults.
Method: This cross-sectional study enrolled adults with culture-proven XDR S. typhi admitted to Hayatabad Medical Complex, Peshawar from 1st March to 10th September 2022. Their demographic characteristics, clinical features, treatment, and complications were recorded.
Results: Out of 84 patients, 68 (80.9%) were male. The mean age of enrolled patients was 25.2 ± 11.3 years. The mean duration of fever at the time of admission was 13.6 ± 8.2 days, respectively. The most common symptom was loose stools (n=25, 29.8%). Most of the patients (n=69, 82.1%) had received empirical treatment before hospitalization. The majority of the patients (n=42, 50%) received meropenem and a combination of meropenem and azithromycin (n=35, 41.7%) during the study. The time to defervescence for both regimens was similar. Five patients (6%) developed complications of enteric fever. There was no mortality among the participants.
Conclusions: Diarrhea was the most common associated clinical feature in XDR typhoid fever. Most of the patients received meropenem alone or in combination with azithromycin with a comparable time to defervescence. The majority of the patients recovered uneventfully and there was no mortality among the study participants.
doi: https://doi.org/10.12669/pjms.40.6.8384
How to cite this: Mahmood A, Rahim F, Amin S, Noor M. Extensively drug-resistant Salmonella typhi Infection in Adults; Experience from A Tertiary Care Hospital. Pak J Med Sci. 2024;40(6):1219-1224. doi: https://doi.org/10.12669/pjms.40.6.8384
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Τα κοινά της Θεσσαλίας
Authors: Ζαχαράκης Τριαντάφυλλος
Published: May 2024

Η παρούσα διδακτορική διατριβή μελετά τα ομοσπονδιακά κράτη (Κοινά) που άκμασαν στην περιοχή της Θεσσαλίας κατά την Ύστερη Ελληνιστική εποχή και τους Αυτοκρατορικούς χρόνους (2ος αι. π.Χ.-3ος αι. μ.Χ.) και συγκεκριμένα τα Κοινά των Θεσσαλών, των Μαγνήτων, των Περραιβών, των Αινιάνων και των Οιταίων. Με βάση ένα σώμα 300 περίπου επιγραφών, η παρούσα έρευνα παρέχει μια αφήγηση της ιστορίας και της οργάνωσης των ομοσπονδιακών κρατών της Θεσσαλίας προσπαθώντας να καλύψει όσο το δυνατόν περισσότερες πτυχές τους, όπως η ιστορία και τα όριά τους, οι θεσμοί τους, οι σχέσεις μεταξύ των πόλεων κάθε Κοινού, η δικαιοσύνη, τα πολιτικά δικαιώματα, οι διεθνείς σχέσεις, η άμυνα, η οικονομία και η λατρεία σε κάθε Κοινό. Επιπλέον, συγκρίνει τα Κοινά της Θεσσαλίας με άλλα Κοινά της ίδιας περιόδου, προκειμένου να διερευνήσει τις ιδιαίτερες πτυχές του ομοσπονδιακού φαινομένου στη Θεσσαλία κατά την Ύστερη Ελληνιστική εποχή και τους Αυτοκρατορικούς χρόνους. Συνολικά, η παρούσα έρευνα αποτελεί συμβολή στη μελέτη του ομοσπονδιακού φαινομένου στην Αρχαιότητα και ταυτόχρονα στη μελέτη της θεσσαλικής ιστορίας.