bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of serum uric acid with anemia in U.S. adults: a cross-sectional study using secondary data
Authors: Wang Yingying , Ming Jingjing , Guo Zongyun , Zhang Wei , Li Xiang , Zhou Shengguo , Li Xia , Ma Huijuan
Published: June 2023

Background

High serum uric acid (SUA) is a risk factor of cardiovascular disease (CVD). Abnormal SUA have been correlated with a significant increase in mortality. Anemia is an independent predictor of mortality and CVD. To date, no study has investigated the relationship between SUA and anemia. Here, we explored the correlation between SUA and anemia in the American population.

Methods

The cross-sectional study involved 9205 US adults from NHANES (2011–2014). The relationship between SUA and anemia was explored using multivariate linear regression models. Two-piecewise linear regression model, generalized additive models (GAM) and smooth curve fitting were performed to explore the non-linear relationships between SUA and anemia.

Results

We found a U-shaped non-linear relationship between SUA and anemia. The inflection point of the SUA concentration curve was 6.2 mg/dL. The ORs (95% CIs) for anemia on the left and right of the inflection point were 0.86 (0.78–0.95) and 1.33 (1.16–1.52), respectively. The 95% CI of inflection point was 5.9-6.5 mg/dL. The findings showed that both genders presented a U-shaped correlation. Safe ranges of SUA in men and women were 6-6.5 and 4.3–4.6 mg/dL, respectively.

Conclusions

Both high and low SUA levels were correlated with increased risk of anemia, and a U-shaped relationship was observed between SUA and anemia.
Clinical and economic hospital burden of acute respiratory infection (BARI) due to respiratory syncytial virus in Spanish children, 2015–2018
Authors: Martinón-Torres F. , Carmo M. , Platero L. , Drago G. , López-Belmonte JL. , Bangert M. , Díez-Domingo J.
Published: June 2023

Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory infection (ALRI) in children, causing frequent outpatient visits and hospitalizations. Our study aimed to describe the clinical and direct economic burden of ALRI hospitalizations related to RSV in children in Spain and the characteristics of patients and their episodes. In this retrospective study, ALRI hospitalizations in children aged < 5 years for 2015–2018 were reviewed using anonymized administrative public hospital discharge data from Spain. Three case definitions were considered: (a) RSV-specific; (b) RSV-specific and unspecified acute bronchiolitis (RSV-specific and bronchiolitis); and (c) RSV-specific and unspecified ALRI (RSV-specific and ALRI). The study reported a mean of 36,743 yearly admissions potentially due to RSV, resulting in a mean annual cost of €87.1 million. RSV-specific codes accounted for 39.2% of cases, unspecified acute bronchiolitis for 20.1%, and other unspecified ALRI codes for the remaining 40.6%. The mean hospitalization rate per 1,000 children was 55.5 in the first year of life, 16.0 in the second, and 5.4 between 24 and 59 months. A considerable proportion of cases occurred in children under two years old (> 80.4%) and even during the first year of life (> 61.7%). Otherwise healthy children accounted for 92.9% of hospitalizations and 83.3% of costs during the period. Children born preterm accounted for 1.3% of hospitalizations and 5.7% of costs. The findings revealed that RSV still contributes to a high burden on the Spanish health care system. Children under one year of age and otherwise healthy term infants accounted for most of the substantial clinical and economic burden of RSV. Current evidence potentially underestimates the true epidemiology and burden of severe RSV infection; thus, further studies focusing on the outpatient setting are needed.
Prediction model for day 3 embryo implantation potential based on metabolites in spent embryo culture medium
Authors: Liang Rong , Duan Sheng Nan , Fu Min , Chen Yu Nan , Wang Ping , Fan Yuan , Meng Shihui , Chen Xi , Shi Cheng
Published: June 2023

Background

Metabolites in spent embryo culture medium correlate with the embryo’s viability. However, there is no widely accepted method using metabolite dada to predict successful implantation. We sought to combine metabolomic profiling of spent embryo culture medium and clinical variables to create an implantation prediction model as an adjunct to morphological screening of day 3 embryos.

Methods

This investigation was a prospective, nested case-control study. Forty-two day 3 embryos from 34 patients were transferred, and the spent embryo culture medium was collected. Twenty-two embryos implanted successfully, and the others failed. Metabolites in the medium relevant to implantation were detected and measured by Liquid Chromatography-Mass Spectrometry. Clinical signatures relevant to embryo implantation were subjected to univariate analysis to select candidates for a prediction model. Multivariate logistical regression of the clinical and metabolomic candidates was used to construct a prediction model for embryo implantation potential.

Results

The levels of 13 metabolites were significantly different between the successful and failed groups, among which five were most relevant and interpretable selected by Least Absolute Shrinkage and Selection Operator regression analysis. None of the clinical variables significantly affected day 3 embryo implantation. The most relevant and interpretable set of metabolites was used to construct a prediction model for day 3 embryo implantation potential with an accuracy of 0.88.

Conclusions

Day 3 embryos’implantation potential could be noninvasively predicted by the spent embryo culture medium’s metabolites measured by LC-MS. This approach may become a useful adjunct to morphological evaluation of day 3 embryos.
Lifestyle causal beliefs are associated with higher personal and perceived stigma regarding depressive disorders: results from a representative population survey
Authors: Scholze Katharina , Reich Hanna , Passow Phyllis , Sander Christian , Czaplicki Andreas , Hegerl Ulrich
Published: June 2023

Background

Depression is a prevalent and severe disorder associated with considerable stigma. This stigma contributes to the suffering and impedes help seeking behaviour of those affected. Stigma can be influenced by causal beliefs about depression and personal contact with people suffering from depression. The aim of this study was to investigate (1) the associations between beliefs about the aetiology of depression and personal / perceived stigma, as well as (2) a possible moderating effect of personal contact with people with depression on these associations.

Methods

Stigma, causal beliefs, and contact with depression were assessed in a representative online survey among German adults (N = 5,000). Multiple regression analyses were performed with contact levels (unaffected vs. personally affected (diagnosed) vs. personally affected (undiagnosed) vs. affected by relatives with depression vs. persons who treat depression) and causal beliefs (biogenetic vs. psychosocial vs. lifestyle) as predictor variables for personal and perceived stigma as dependent variables.

Results

Higher personal stigma was associated with lifestyle causal beliefs (p < .001, f² = 0.07), lower personal stigma with biogenetic (p = .006, f² = 0.01) and psychosocial (p < .001, f² = 0.02) causal beliefs. A positive interaction between psychosocial beliefs and the contact group “relatives” (p = .039) further suggests that this contact group does not benefit so strongly from psychosocial causal beliefs regarding personal stigma. Higher perceived stigma was associated with psychosocial (p < .001, f² = 0.01) and lifestyle (p < .011, f² = 0.01) causal beliefs. Regarding contact levels, the “unaffected” had significantly higher personal stigma scores than each of the other contact groups (p < .001). The contact group “affected (diagnosed)” had significantly higher perceived stigma scores than “unaffected”.

Conclusions

The available data show that anti-stigma campaigns should clearly communicate, that depression is not caused by an unfavorable lifestyle. In general, psychosocial or biological explanatory models should be explained. Especially for the target group “relatives of depressive patients”, who can be an important support for patients, education about biogenetic explanatory models should be provided. However, it is important to note that causal beliefs are only one of many factors that impact on stigma.
Incidence and risk factors of pneumococcal pneumonia in adults: a population-based study
Authors: Ochoa-Gondar Olga , Torras-Vives Verónica , de Diego-Cabanes Cinta , Satué-Gracia Eva M. , Vila-Rovira Angel , Forcadell-Perisa María J. , Ribas-Seguí Domingo , Rodríguez-Casado Clara , Vila-Córcoles Angel
Published: June 2023

Background

Infection caused by Streptococcus pneumoniae, mainly invasive pneumococcal disease (IPD) and pneumococcal pneumonia (PP), are a major public health problem worldwide. This study investigated population-based incidence and risk of PP among Catalonian persons ≥ 50 years-old with and without specific underlying conditions/comorbidities, examining the influence of single and multi-comorbidities in the risk of suffering PP.

Methods

Population-based cohort study involving 2,059,645 persons ≥ 50 years-old in Catalonia, Spain, who were retrospectively followed between 01/01/2017-31/12/2018. The Catalonian information system for development of research in primary care (SIDIAP) was used to establish baseline characteristics of the cohort (comorbidities/underlying conditions), and PP cases were collected from discharge codes (ICD-10: J13) of the 68 referral Catalonian hospitals.

Results

Global incidence rate (IR) was 90.7 PP cases per 100,000 person-years, with a 7.6% (272/3592) case-fatality rate (CFR). Maximum IRs emerged among persons with history of previous IPD or all-cause pneumonia, followed by haematological neoplasia (475.0), HIV-infection (423.7), renal disease (384.9), chronic respiratory disease (314.7), liver disease (232.5), heart disease (221.4), alcoholism (204.8), solid cancer (186.2) and diabetes (159.6). IRs were 42.1, 89.9, 201.1, 350.9, 594.3 and 761.2 in persons with 0, 1, 2, 3, 4 and ≥ 5 comorbidities, respectively. In multivariable analyses, HIV-infection (hazard ratio [HR]: 5.16; 95% CI: 3.57–7.46), prior all-cause pneumonia (HR: 3.96; 95% CI: 3.45–4.55), haematological neoplasia (HR: 2.71; 95% CI: 2.06–3.57), chronic respiratory disease (HR: 2.66; 95% CI: 2.47–2.86) and prior IPD (HR: 2.56; 95% CI: 2.03–3.24) were major predictors for PP.

Conclusion

Apart of increasing age and immunocompromising conditions (classically recognised as high-risk conditions), history of prior IPD/pneumonia, presence of chronic pulmonary/respiratory disease and/or co-existing multi-comorbidity (i.e., two or more underlying conditions) are major risk factors for PP in adults, with an excess risk near to immunocompromised subjects. Redefining risk categories for PP, including all the above-mentioned conditions into the high-risk category, could be necessary to improve prevention strategies in middle-aged and older adults.
Pregnant women’s perception of midwifery-led continuity care model in Ethiopia: a qualitative study
Authors: Mose Ayenew , Fikadu Yohannes , Zewdie Amare , Haile Kassahun , Shitu Solomon , Wasie Kasahun Abebaw , Nuriye Keyredin
Published: June 2023

Background

A Midwifery-led continuity care (MLCC) model is the provision of care by a known midwife (caseload model) or a team of midwives (team midwifery model) for women throughout the antenatal, intrapartum, and postnatal period. Evidence shows that a MLCC model becomes the first choice for women and improves maternal and neonatal health outcomes. Despite this, little is known about pregnant women’s perception of the MLCC model in Ethiopia. Therefore, this study aimed to explore pregnant women’s perception and experience of a MLCC model in Ethiopia.

Methods

A qualitative study was conducted in Gurage zone public hospital, Southwest Ethiopia, from May 1st to 15th, 2022. Three focused group discussions and eight in-depth interviews were conducted among pregnant women who were selected using a purposive sampling method. Data were first transcribed and then translated from Amharic (local language) to English. Finally, the thematic analysis technique using open code software was used for analysis.

Results

Thematic analysis revealed that women want a continuity of care model. Four themes emerged. Three were specific to women’s improved care. That is, (1) improved continuum of care, (2) improved woman-centred care, and (3) improved satisfaction of care. Theme four (4), barrier to implementation, was concerned with possible barriers to implementation of the model.

Conclusion

The finding of this study shows that pregnant women had positive experiences and showed a willingness to receive midwifery-led continuity care. Woman-centred care, improved satisfaction of care, and continuum of care were identified as the main themes. Therefore, it is reasonable to adopt and implement midwifery-led continuity care for low-risk pregnant women in Ethiopia.
Emotional intelligence weakly predicts academic success in medical programs: a multilevel meta-analysis and systematic review
Authors: Alabbasi Ahmed M. Abdulla , Alabbasi Fatema A. , AlSaleh Aseel , Alansari Ahmed M. , Sequeira Reginald P.
Published: June 2023

Background

Emotional intelligence (EI) is a predictive factor of academic success in undergraduate Doctor of Medicine (MD) programs. Although some research suggests a positive association between EI and academic success in MD programs, other research reports neither an association nor a negative correlation between the two variables. The current study aimed to resolve these contradictory findings by conducting a systematic review and a meta-analysis using research from 2005 to 2022.

Methods

Data were analyzed using a multilevel modeling approach to (a) estimate the overall relationship between EI and academic success in MD programs and (b) determine whether the mean effect size varies according to country (United States vs. non-United States countries), age, EI test, EI task nature (ability-based vs. trait-based), EI subscales, and academic performance criteria (grade point average vs. examinations).

Results

Findings from 20 studies (m = 105;N = 4,227) indicated a positive correlation between EI and academic success (r = .13, 95% CI [.08, – .27],p < .01). Moderator analyses indicated that the mean effect size significantly varied according to EI tests and EI subscales. Moreover, three-level multiple regression analyses showed that between-study variance explained 29.5% of the variability in the mean effect size, whereas within-study variance explained 33.5% of the variability in the mean effect.

Conclusions

Overall, the current findings show that EI is significantly, albeit weakly, related to academic success in MD programs. Medical researchers and practitioners can therefore focus on integrating EI-related skills into the MD curriculum or target them through professional development training and programs.
The effect of work setting and demographic factors on caring behaviour among nurses in the public hospitals and public health services, Sabah, Malaysia
Authors: Arsat Norkiah , Lah Nik Amin Sahid Nik , Thomas Deena Clare , Soong Sui Fun , Chong Li Tsu , Sawatan Waidah , Dasan Norsimah , Wider Walton
Published: June 2023

Background

The nursing profession's uniqueness contributes to the development of knowledge, experience, age, education, economy, and position, as well as a unique gender role. Thus, the development and advancement of demographic characteristics of nurses while in this profession influences their caring behavior.

Objective

The purpose of this study was to determine the effect of work setting and demographic factors on nurses' caring behaviour, as well as the differences in nurses' caring behaviour based on demographic factors between nurses in public hospitals and nurses in public health services in Sabah, Malaysia.

Methods

This research is a cross-sectional study using the survey method. Data were collected from 3,532 nurses (88.3% response rate) in public hospitals and public health services within Sabah, Malaysia. Data were analysed using two-way ANOVA.

Results

The two-way ANOVA test revealed no significant impact of the work setting on CB, nor was there a notable interaction between the work setting and demographic factors influencing nurses’ CB. However, demographic factors such as gender, age, education, economic status, position, and experience had a significant effect on CB.

Conclusion

The present research has provided convergent evidence on the effect of demographic factors on nurses caring behavior and the differences in caring behavior based on demographic factors among nurses in public hospitals and public health services in Sabah, Malaysia.
Exploring the psychological impact of contact tracing work on staff during the COVID-19 pandemic
Authors: Fulham-McQuillan Hugh , O’Donovan Róisín , Buckley Claire M. , Crowley Philip , Gilmore Brynne , Martin Jennifer , McAuliffe Eilish , Martin Gregory , Moore Gemma , Morrissey Mary , Nicholson Emma , Shé Éidín Ní , O’Hara Mary Clare , Segurado Ricardo , Sweeney Mary Rose , Wall Patrick , De Brún Aoife
Published: June 2023

Background

Contact tracing is a key control measure in the response to the COVID-19 pandemic. While quantitative research has been conducted on the psychological impact of the pandemic on other frontline healthcare workers, none has explored the impact on contact tracing staff.

Methods

A longitudinal study was conducted using two repeated measures with contact tracing staff employed in Ireland during the COVID-19 pandemic using two-tailed independent samplesttests and exploratory linear mixed models.

Results

The study sample included 137 contact tracers in March 2021 (T1) and 218 in September 2021 (T3). There was an increase from T1 to T3 in burnout related exhaustion (p < 0·001), post-traumatic stress disorder (PTSD) symptom scores (p < 0·001), mental distress (p < 0·01), perceived stress (p < 0·001) and tension and pressure (p < 0·001). In those aged 18–30, there was an increase in exhaustion related burnout (p < 0·01), PTSD symptoms (p < 0·05), and tension and pressure scores (p < 0·05). Additionally, participants with a background in healthcare showed an increase in PTSD symptom scores by T3 (p < 0·001), reaching mean scores equivalent to those of participants who did not have a background in healthcare.

Conclusions

Contact tracing staff working during the COVID-19 pandemic experienced an increase in adverse psychological outcomes. These findings highlight a need for further research on psychological supports required by contact tracing staff with differing demographic profiles.
Evaluation of accessibility and equity to hospitals by public transport: evidence from six largest cities of Ohio
Authors: Alam M. S. , Tabassum N. J. , Tokey A. I.
Published: June 2023

Introduction

In the United States, health care has long been viewed as a ‘right,’ and residents of the state of Ohio are no exception. The Ohio Department of Health ensures that this right exists for all residents of Ohio. Socio-spatial characteristics, however, can have an impact on access to health care, particularly among vulnerable groups. This article seeks to measure the spatial accessibility to healthcare services by public transport in the six largest cities of Ohio based on population and to compare the accessibility of healthcare to vulnerable demographic groups. To the authors’ knowledge, this is the first study to analyze the accessibility and equity of hospitals by public transit across different cities in Ohio, allowing the identification of common patterns, difficulties, and knowledge gaps.

Methodology

Using a two-step floating catchment area technique, the spatial accessibility to general medical and surgical hospitals through public transportation was estimated, considering both service-to-population ratios and travel time to these health services. The average accessibility of all census tracts and the average accessibility of the 20% of most susceptible census tracts were determined for each city. Using Spearman’s rank correlation coefficient between accessibility and vulnerability, an indicator was then devised to evaluate vertical equity.

Findings

Within cities (except Cleveland), people of vulnerable census tracts have less access to hospitals via public transportation. These cities (Columbus, Cincinnati, Toledo, Akron, and Dayton) fail in terms of vertical equity and average accessibility. According to this, vulnerable census tracts in these cities have the lowest accessibility levels.

Conclusion

This study emphasizes the issues connected with the suburbanization of poverty in Ohio’s large cities and the need to provide adequate public transportation to reach hospitals on the periphery. In addition, this study shed light on the need for additional empirical research to inform the implementation of guidelines for healthcare accessibility in Ohio. Researchers, planners, and policymakers who want to make healthcare more accessible for everyone should take note of the findings in this study.
Developing quality indicators for cross-sectoral psycho-oncology in Germany: combining the RAND/UCLA appropriateness method with a Delphi technique
Authors: Derendorf Lisa , Stock Stephanie , Simic Dusan , Lemmen Clarissa
Published: June 2023

Background

Internationally, the need for appropriately structured, high-quality care in psycho-oncology is more and more recognized and quality-oriented care is to be established. Quality indicators are becoming increasingly important for a systematic development and improvement of the quality of care. The aim of this study was to develop a set of quality indicators for a new form of care, a cross-sectoral psycho-oncological care program in the German health care system.

Methods

The widely established RAND/UCLA Appropriateness Method was combined with a modified Delphi technique. A systematic literature review was conducted to identify existing indicators. All identified indicators were evaluated and rated in a two-round Delphi process. Expert panels embedded in the Delphi process assessed the indicators in terms of relevance, data availability and feasibility. An indicator was accepted by consensus if at least 75% of the ratings corresponded to category 4 or 5 on a five-point Likert scale.

Results

Of the 88 potential indicators derived from a systematic literature review and other sources, 29 were deemed relevant in the first Delphi round. After the first expert panel, 28 of the dissented indicators were re-rated and added. Of these 57 indicators, 45 were found to be feasible in terms of data availability by the second round of expert panel. In total, 22 indicators were transferred into a quality report, implemented and tested within the care networks for participatory quality improvement. In the second Delphi round, the embedded indicators were tested for their practicability. The final set includes 16 indicators that were operationalized in care practice and rated by the expert panel as relevant, comprehensible, and suitable for care practice.

Conclusion

The developed set of quality indicators has proven in practical testing to be a valid quality assurance tool for internal and external quality management. The study findings could contribute to traceable high quality in cross-sectoral psycho-oncology by providing a valid and comprehensive set of quality indicators.

Trial registration

“Entwicklung eines Qualitätsmanagementsystems in der integrierten, sektorenübergreifenden Psychoonkologie—AP “Qualitätsmanagement und Versorgungsmanagement” zur Studie "integrierte, sektorenübergreifende Psychoonkologie (isPO)" a sub-project of the “integrierte, sektorenübergreifende Psychoonkologie (isPO)”, was registered in the German Clinical Trials Register (DRKS) (DRKS-ID: DRKS00021515) on 3rd September 2020. The main project was registered on 30th October 2018 (DRKS-ID: DRKS00015326).
Pseudomonas aeruginosa’s greenish-blue pigment pyocyanin: its production and biological activities
Authors: Abdelaziz Ahmed A. , Kamer Amal M. Abo , Al-Monofy Khaled B. , Al-Madboly Lamiaa A.
Published: June 2023

A subject of great interest is the bioprospecting of microorganisms and their bioactive byproducts, such as pigments. Microbial pigments have various benefits, including being safe to use due to their natural makeup, having therapeutic effects, and being produced all year round, regardless of the weather or location.Pseudomonas aeruginosaproduces phenazine pigments that are crucial for interactions betweenPseudomonasspecies and other living things. Pyocyanin pigment, which is synthesized by 90–95% ofP. aeruginosa, has potent antibacterial, antioxidant, and anticancer properties. Herein, we will concentrate on the production and extraction of pyocyanin pigment and its biological use in different areas of biotechnology, engineering, and biology.
Effects of spicy food consumption on overweight/obesity, hypertension and blood lipids in China: a meta‐analysis of cross-sectional studies
Authors: Wang Mei , Huang Wei , Xu Yong
Published: June 2023

Background and objectives

Effect of spicy food consumption on health has attracted widespread attention in recent years. However, the relationships between spicy food intake and overweight/obesity, hypertension and blood lipid levels remain unclear. A meta-analysis of available observational studies was conducted in order to explore the associations.

Methods

PubMed, Embase, Cochrane Library and Web of science databases were searched for studies published up to 10 August 2021 without language limitation. The fixed and random effects models were selected to aggregate the effect sizes and 95% confidence intervals (CIs) in this study.

Results

A total of nine observational studies involving 189,817 participants were included. Results from this meta-analysis showed that the highest category of spicy food intake significantly increased the risk of overweight/obesity (pooled Odds Ratio (OR): 1.17; 95% CI: 1.07, 1.28; P < 0.001), compared with the lowest category of spicy food intake. Conversely, a remarkable negative association was observed between the highest category of spicy food intake and hypertension (pooled OR: 0.87; 95% CI: 0.81, 0.93; P = 0.307). In addition, the highest category of spicy food intake increased the level of low density lipoprotein cholesterol (LDL-C) (weighted mean difference (WMD): 0.21; 95% CI: 0.02, 0.39; P = 0.040), and reduced high density lipoprotein cholesterol level (HDL-C) (WMD: -0.06; 95% CI: -0.10, -0.02; P = 0.268) concentrations, but it was not related to total cholesterol (TC) (WMD: 0.09; 95% CI: -0.08, 0.26; P = 0.071) and triglyceride (TG) (WMD: -0.08; 95% CI: -0.19, 0.02; P = 0.333)] levels.

Conclusion

Spicy food intake may have a beneficial effect on hypertension, but adversely affect overweight/obesity, as well as blood lipid levels. However, the results should be interpreted cautiously because the present analyses were based on only observational studies and not intervention studies. More large and high-quality studies in different populations will be needed to verify these associations in the future.
Use of sentinel lymph node biopsy in elderly patients with breast cancer – 10-year experience from a Swiss university hospital
Authors: Heidinger Martin , Maggi Nadia , Dutilh Gilles , Mueller Madleina , Eller Ruth S. , Loesch Julie M. , Schwab Fabienne D. , Kurzeder Christian , Weber Walter P.
Published: June 2023

Background

The Choosing Wisely initiative recommended the omission of routine sentinel lymph node biopsy (SLNB) in patients ≥ 70 years of age, with clinically node-negative, early stage, hormone receptor (HR) positive and human epidermal growth factor receptor 2 (Her2) negative breast cancer in August 2016. Here, we assess the adherence to this recommendation in a Swiss university hospital.

Methods

We conducted a retrospective single center cohort study from a prospectively maintained database. Patients ≥ 18 years of age with node-negative breast cancer were treated between 05/2011 and 03/2022. The primary outcome was the percentage of patients in the Choosing Wisely target group who underwent SLNB before and after the initiative went live. Statistical significance was tested using chi-squared test for categorical and Wilcoxon rank-sum tests for continuous variables.

Results

In total, 586 patients met the inclusion criteria with a median follow-up of 2.7 years. Of these, 163 were ≥ 70 years of age and 79 were eligible for treatment according to the Choosing Wisely recommendations. There was a trend toward a higher rate of SLNB (92.7% vs. 75.0%, p = 0.07) after the Choosing Wisely recommendations were published. In patients ≥ 70 years with invasive disease, fewer received adjuvant radiotherapy after omission of SLNB (6.2% vs. 64.0%, p < 0.001), without differences concerning adjuvant systemic therapy. Both short-term and long-term complication rates after SLNB were low, without differences between elderly patients and those < 70 years.

Conclusions

Choosing Wisely recommendations did not result in a decreased use of SLNB in the elderly at a Swiss university hospital.
Paediatric Cogan´s syndrome - review of literature, case report and practical approach to diagnosis and management
Authors: Rücklová Kristina , von Kalle Thekla , Koitschev Assen , Gekeler Katrin , Scheltdorf Miriam , Heinkele Anita , Blankenburg Friederike , Kötter Ina , Hospach Anton
Published: June 2023

Background

Cogan´s syndrome is a rare, presumed autoimmune vasculitis of various vessels characterized by interstitial keratitis and vestibular impairment accompanied by sensorineural hearing loss. Due to the rarity of Cogan´s syndrome in children, therapeutic decision making may be challenging. Therefore, a literature search was performed to collect all published paediatric Cogan´s syndrome cases with their clinical characteristics, disease course, treatment modalities used and their outcome. The cohort was supplemented with our own patient.

Main text

Altogether, 55 paediatric Cogan´s syndrome patients aged median 12 years have been reported so far. These were identified in PubMed with the keywords “Cogan´s syndrome” and “children” or “childhood”. All patients suffered from inflammatory ocular and vestibulo-auditory symptoms. In addition, 32/55 (58%) manifested systemic symptoms with musculoskeletal involvement being the most common with a prevalence of 45%, followed by neurological and skin manifestations. Aortitis was detected in 9/55 (16%). Regarding prognosis, remission in ocular symptoms was attained in 69%, whereas only 32% achieved a significant improvement in auditory function. Mortality was 2/55. Our patient was an 8 year old girl who presented with bilateral uveitis and a history of long standing hearing deficit. She also complained of intermittent vertigo, subfebrile temperatures, abdominal pain with diarrhoea, fatigue and recurrent epistaxis. The diagnosis was supported by bilateral labyrinthitis seen on contrast-enhanced magnetic resonance imaging. Treatment with topical and systemic steroids was started immediately. As the effect on auditory function was only transient, infliximab was added early in the disease course. This led to a remission of ocular and systemic symptoms and a normalization of hearing in the right ear. Her left ear remained deaf and the girl is currently evaluated for a unilateral cochlear implantation.

Conclusions

This study presents an analysis of the largest cohort of paediatric Cogan´s syndrome patients. Based on the collected data, the first practical guide to a diagnostic work-up and treatment in children with Cogan´s syndrome is provided.
Trajectories of children and adolescents attending a psychiatric emergency unit during the COVID-19 confinements: 2020–2022 longitudinal study
Authors: Adrados-Pérez Marina , Llorca-Bofí Vicent , Laín María Mur , Porcar Carla Albert , Nicolau-Subires Eugènia , Ibarra-Pertusa Lucía , Jiménez-Mayoral Andrea , Buil-Reiné Esther , Budny Filip , Resa-Pérez Belén , Velásquez-Acebey Vanessa Gladys , Arenas-Pijoan Laura , Irigoyen-Otiñano María , López-Castroman Jorge
Published: June 2023

Introduction

The prevalence of psychiatric disorders has not shifted widely through the COVID pandemic, except for some specific groups such as young people or women. Our objective is to examine prospectively the evolution of children and adolescents who consulted in a psychiatric emergency service during the COVID-19 confinements.

Method

We collected prospective clinical information about 296 young people under 18 who visited a tertiary hospital for psychiatric reasons during the confinement periods in Spain. Clinical diagnoses, suicide attempts, hospital admissions, and pharmacological prescriptions were extracted from electronic health records through 2020, 2021, and 2022. Features of those who maintained psychiatric care and those who did not were compared.

Results

Three out of four children and adolescents who visited the psychiatric emergency department during the confinements continued psychiatric care at the end of 2022. Those who did not showed better premorbid adjustment at baseline. During follow-up, diagnoses of neurodevelopmental disorders and eating disorders, as well as the dosage of psychotropic drug prescriptions, increased. The diagnoses of major depressive disorder and eating disorder at baseline were associated with attempting suicide during follow-up. Patients with internalizing symptoms were admitted earlier than those with externalizing symptoms but no differences were found in terms of suicide attempts.

Conclusions

The continuity of psychiatric care after an initial emergency visit during the confinements implied greater clinical severity, as reflected by changes in clinical diagnoses and pharmacological regimens. Emergent symptoms of depression or eating disorders after social distancing or isolation could predict subsequent suicidal behavior in young populations.
Advances in the application of Mxene nanoparticles in wound healing
Authors: Liang Chengzhi , He Jing , Cao Yuan , Liu Guoming , Zhang Chengdong , Qi Zhiping , Fu Chuan , Hu Yanling
Published: June 2023

Skin is the largest organ of the human body. It plays a vital role as the body’s first barrier: stopping chemical, radiological damage and microbial invasion. The importance of skin to the human body can never be overstated. Delayed wound healing after a skin injury has become a huge challenge in healthcare. In some situations, this can have very serious and even life-threatening effects on people’s health. Various wound dressings have been developed to promote quicker wound healing, including hydrogels, gelatin sponges, films, and bandages, all work to prevent the invasion of microbial pathogens. Some of them are also packed with bioactive agents, such as antibiotics, nanoparticles, and growth factors, that help to improve the performance of the dressing it is added to. Recently, bioactive nanoparticles as the bioactive agent have become widely used in wound dressings. Among these, functional inorganic nanoparticles are favored due to their ability to effectively improve the tissue-repairing properties of biomaterials. MXene nanoparticles have attracted the interest of scholars due to their unique properties of electrical conductivity, hydrophilicity, antibacterial properties, and biocompatibility. The potential for its application is very promising as an effective functional component of wound dressings. In this paper, we will review MXene nanoparticles in skin injury repair, particularly its synthesis method, functional properties, biocompatibility, and application.
Financial outcomes after pediatric critical illness among commercially insured families
Authors: Carlton Erin F. , Moniz Michelle H. , Scott John W. , Prescott Hallie C. , Becker Nora V.
Published: June 2023

Critical illness results in subjective financial distress for families, but little is known about objective caregiver finances after a child’s pediatric intensive care unit (PICU) hospitalization. Using statewide commercial insurance claims linked to cross-sectional commercial credit data, we identified caregivers of children with PICU hospitalizations in January–June 2020 and January–June 2021. Credit data included delinquent debt, debt in collections (medical and non-medical), low credit score (< 660), and a composite of any debt or poor credit and were measured in January 2021 for all caregivers. For the 2020 cohort (“post-PICU”), credit outcomes in January 2021 were measured at least 6 months following PICU hospitalization and reflect financial status after the hospitalization. For the 2021 cohort (comparison), financial outcomes were measured prior to their child’s PICU hospitalization and therefore reflect pre-hospitalization financial status. We identified 2032 caregivers, 1017 post-PICU caregivers and 1015 comparison cohort caregivers, of which 1016 and 1014 were matched to credit data, respectively. Post-PICU caregivers had higher adjusted odds of having any delinquent debt [aOR 1.25; 95%CI 1.02–1.53; p = 0.03] and having a low credit score [aOR 1.29; 95%CI 1.06–1.58; p = 0.01]. However, there was no difference in the amount of delinquent debt or debt in collections among those with nonzero debt. Overall, 39.5% and 36.5% of post-PICU and comparator caregivers, respectively, had delinquent debt, debt in collections or poor credit. Many caregivers of critically ill children have financial debt or poor credit during hospitalization and post-discharge. However, caregivers may be at higher risk for poor financial status following their child’s critical illness.
Prevalence of systemic venous congestion assessed by Venous Excess Ultrasound Grading System (VExUS) and association with acute kidney injury in a general ICU cohort: a prospective multicentric study
Authors: Andrei Stefan , Bahr Pierre-Alain , Nguyen Maxime , Bouhemad Belaid , Guinot Pierre-Grégoire
Published: June 2023

Background

The importance of assessing venous congestion in ICU patients is widely acknowledged, but its study is hampered by the lack of a practical evaluation tool. The Venous Excess Ultrasound Grading System (VExUS), based on a semi-quantitative combined ultrasound assessment, has been associated with acute kidney injury (AKI) in cardiac ICU patients. The objectives of this study were to assess the prevalence of congestion using VExUS in general ICU patients, and to evaluate the association between VExUS, AKI and death.

Methods

This prospective, observational study included adult patients within 24 h of ICU admission. VExUS and hemodynamic parameters were measured four times during the ICU stay: within 24 h of ICU admission, after day 1 (between 24 and 48 h), after day 2 (between 48 and 72 h), and last day of ICU stay. The prevalence of AKI during the first week in ICU and 28-day mortality were assessed.

Results

Among the 145 patients included, the percentage of patients with a VExUS score of 2 (moderate congestion) and 3 (severe congestion) was 16% and 6%, respectively. The prevalence did not change over the study period. There was no significant association between admission VExUS scores and AKI (p = 0.136) or 28-day mortality (p = 0.594). Admission VExUS ≥ 2 was not associated with AKI (OR 0.499, CI95% 0.21–1.17, p = 0.109) nor 28-day mortality (OR 0.75, CI95% 0.2–2.8, p = 0.669). The results were similar for VExUS scores measured at day 1 and day 2.

Conclusions

In general ICU cohort the prevalence of moderate to severe venous congestion was low. Early assessment of systemic venous congestion using VExUS scores was not associated with the development of AKI or with 28-day mortality.
Evaluation of renal values during treatment for heartworm disease in 27 client-owned dogs
Authors: Vetter C. Autumn M. , Meindl Alison G. , Lourenço Bianca N. , Coyne Michael , Drake Corie , Murphy Rachel , Roth Ira G. , Moorhead Andrew R.
Published: June 2023

Background

Canine heartworm disease (CHD) caused by Dirofilaria immitis remains a common preventable disease with increasing incidence in some parts of the USA. The treatment guidelines of the American Heartworm Society (AHS) currently recommend monthly macrocyclic lactone administration, 28 days of doxycycline given orally every 12 h and three injections of melarsomine dihydrochloride (1 injection on day 2 of treatment followed 30 days later by 2 injections 24 h apart). Minocycline has also been utilized when doxycycline is unavailable. The systemic effects of CHD, which particularly impact cardiac and renal function, have been described, with infected dogs often experiencing renal damage characterized by an increase in serum concentrations of renal biomarkers. Although the AHS treatment protocol for CHD has been shown to be safe and effective in most cases, the potential for complications remains. No study as of yet has evaluated changes in symmetric dimethylarginine (SDMA), a sensitive marker of renal function, during treatment for CHD. The purpose of the present study was to evaluate renal function in dogs by measuring serum creatinine and SDMA concentrations during the adulticide treatment period.

Methods

Serum creatinine and SDMA concentrations were measured in 27 client-owned dogs affected by CHD at the following time points: prior to starting doxycycline or minocycline therapy (baseline), during doxycycline or minocycline therapy (interim), at the time of the first dose of melarsomine (first dose), at the time of the second dose of melarsomine (second dose) and at the dog’s follow-up visit after treatment, occurring between 1 and 6 months after completion of therapy (post-treatment). Concentrations of creatinine and SDMA were compared between time points using a mixed effects linear model.

Results

Mean SDMA concentrations following the second dose of melarsomine were significantly lower (−1.80 ug/dL, t-test, df = 99.067, t = −2.694, P-Value = 0.00829) than baseline concentrations. There were no other statistically significant differences in the concentration of either biomarker between the baseline and the other time points in CHD dogs undergoing treatment.

Conclusions

The results suggest that the current AHS protocol may not have a substantial impact on renal function.

Graphical Abstract
Sex differences in the influence of type 2 diabetes (T2D)-related genes, parental history of T2D, and obesity on T2D development: a case–control study
Authors: Berumen Jaime , Orozco Lorena , Gallardo-Rincón Héctor , Rivas Fernando , Barrera Elizabeth , Benuto Rosa E. , García-Ortiz Humberto , Marin-Medina Melissa , Juárez-Torres Eligia , Alvarado-Silva Anabel , Ramos-Martinez Espiridión , MartÍnez-Juárez Luis Alberto , Lomelín-Gascón Julieta , Montoya Alejandra , Ortega-Montiel Janinne , Alvarez-Hernández Diego-Abelardo , Larriva-Shad Jorge , Tapia-Conyer Roberto
Published: June 2023

Background

This study investigated the effect of sex and age at type 2 diabetes (T2D) diagnosis on the influence of T2D-related genes, parental history of T2D, and obesity on T2D development.

Methods

In this case–control study, 1012 T2D cases and 1008 healthy subjects were selected from the Diabetes in Mexico Study database. Participants were stratified by sex and age at T2D diagnosis (early, ≤ 45 years; late, ≥ 46 years). Sixty-nine T2D-associated single nucleotide polymorphisms were explored and the percentage contribution (R2) of T2D-related genes, parental history of T2D, and obesity (body mass index [BMI] and waist–hip ratio [WHR]) on T2D development was calculated using univariate and multivariate logistic regression models.

Results

T2D-related genes influenced T2D development most in males who were diagnosed early (R2 = 23.5%; females,R2 = 13.5%; males and females diagnosed late,R2 = 11.9% andR2 = 7.3%, respectively). With an early diagnosis, insulin production-related genes were more influential in males (76.0% ofR2) while peripheral insulin resistance-associated genes were more influential in females (52.3% ofR2). With a late diagnosis, insulin production-related genes from chromosome region 11p15.5 notably influenced males while peripheral insulin resistance and genes associated with inflammation and other processes notably influenced females. Influence of parental history was higher among those diagnosed early (males, 19.9%; females, 17.5%) versus late (males, 6.4%; females, 5,3%). Unilateral maternal T2D history was more influential than paternal T2D history. BMI influenced T2D development for all, while WHR exclusively influenced males.

Conclusions

The influence of T2D-related genes, maternal T2D history, and fat distribution on T2D development was greater in males than females.
A relict Triassic brittle star (Echinodermata, Ophiuroidea) in Lower Jurassic strata of Asturias, north-west Spain
Authors: Thuy Ben , Piñuela Laura , García-Ramos José Carlos
Published: June 2023

Ophiuroids, also known as brittle stars, are an important component of modern marine benthos, yet their fossil record is still poorly understood. Here, we describe new finds of ophiuroids from the upper Sinemurian (Lower Jurassic) of Asturias, north-west Spain. The material consists of several articulated specimens that show all relevant anatomical details to allow for an exhaustive description of a new species, Arenorbis santameraensis sp. nov., which adds a Jurassic member to the genus Arenorbis previously known exclusively from the Middle Triassic of central Europe. We demonstrate that Arenorbis has characters that are typically found in the suborder Ophiodermatina. The new Jurassic record of Arenorbis shows remarkable parallels with its Middle Triassic equivalents in terms of sedimentological and taphonomic context, suggesting niche conservatism in this genus. In contrast to its wide geographical distribution during the Middle Triassic, the new species is currently only known from a restricted area, which suggests that it represents a Jurassic relict of a formerly widespread Triassic lineage.

ZooBank LSID: urn:lsid:zoobank.org:pub:D253BD9D-53C3-44BA-884B-15BA1F7876D3
Characterization of phytochemical profile of rhizome of artificial cultured Polygonatum sibiricum with multiple rhizome buds
Authors: Cheng Weiqing , Pan Zhibin , Zheng Hanjing , Luo Gelian , Liu Zhibin , Xu Suli , Lin Junhan
Published: June 2023

Rhizome of Polygonatum sibiricum is both a renowned traditional Chinese remedy and a commonly consumed delicacy. Due to the escalating demand and excessive overexploitation, there has been a growing interest in the artificial cultivation of this plant in recent years. To assess the therapeutic benefits of artificially cultivated P. sibiricum, it is crucial to identify and classify its phytochemical components, which are the primary bioactive compounds found in its rhizome. In this study, the phytochemical profile of an artificially cultivated P. sibiricum rhizomes with multiple rhizome buds (ACM) was characterized by using untargeted UHPLC-Q-Orbitrap-MS based approach. In addition, two-wild-types P. sibiricum rhizomes, namely the wild-type with multiple rhizome buds (WTM) and the wild-type with single rhizome bud (WTS), were used for comparison. A total of 183 phytochemicals, including 20 alkaloids, 48 flavonoids, 33 phenolic acids, and 82 terpenoids, were tentatively identified. Generally, the phytochemical profile of ACM was comparable to that of WTM and WTS. In specific, most of the identified alkaloids and phenolic acids, and approximately half of the identified terpenoids, were not significantly different. Notably, several phytochemicals with potent therapeutic properties, such as epiberberine, laetanine, sinapic acid, curcumenol, were present in ACM. Additionally, artificial cultivation increased the abundance of geniposide and naringenin, which have been linked to cardioprotective effects. These findings provide valuable insights for the future utilization of artificially cultivated P. sibiricum.