bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Method to Sanitize Breast Pump Equipment in the Neonatal Intensive Care Unit
Authors: Marron Susan , Stracuzzi Lauren , Rahman Tariq
Published: July 2024

Background:

Enhancing the current breast pump sanitization method may improve maternal satisfaction and increase a mother’s likelihood of providing human milk for their hospitalized infants in the Neonatal Intensive Care Unit (NICU). Other than Centers for Disease Control (CDC) data, there is lack of studies on sanitization practices. Currently, the only option in the hospital setting for breast pump equipment cleaning is a steam sanitization plastic bag.

Purpose:

Using the Q. Basin will increase participant satisfaction compared to the steam sanitization bag.

Methods:

A multi-phased pilot study was conducted in our quaternary care NICU to test the Q. Basin, a novel design developed to wash, dry, and safely steam sanitize breast pump equipment compared to the standard steam bag. A bacterial study was conducted on breast pump equipment from 10 mothers by swabbing the equipment immediately at hour zero and 24 hours. Twenty NICU mothers concurrently evaluated their satisfaction via a 3-question survey comparing the Q. Basin and the steam sanitization plastic bag method.

Results:

The results showed a 20% increase in satisfaction with Q. Basin compared to the steam bag method.

Implications for Practice and Research:

Data analysis from the satisfaction survey concludes that mothers pumping preferred the Q. Basin as a quicker, faster, and more environmentally friendly method for breast pump part sanitization. Additional safety and materials studies are required before using the Q. Basin in the clinical environment.
Super-Mentors to Train Multiple Neonatal Advanced Practice Providers
Authors: Morris April L. , Bosque Elena M.
Published: July 2024

Background:

Despite available training programs for neonatal advanced practice providers (Neo APP), including neonatal nurse practitioners and physician assistants, it is difficult to meet the demand for these providers. There are no publications regarding training models with greater than 1 Neo APP learner per mentor.

Purpose:

To create and measure outcomes of a 12-month program to educate Neo APP “Super-Mentors” able to train 2 Neo APP learners simultaneously.

Methods:

Super-Mentors were selected and attended monthly classes to learn mentorship concepts and receive support. Learners received didactic content and support through a Fellowship program. Quantitative data regarding recruitment and retention, as well as Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS) results were compared pre- and postprogram. Qualitative satisfaction measures via survey from 21 stakeholders were analyzed through a phenomenological approach.

Results:

Six Super-Mentors trained 14 Neo APPs, as compared to 7 in the previous year. One Neo APP left after training. Summative preprogram MNPJSS scores were better (5.1 ± 0.37) than postprogram (4.7 ± 0.47) (P < .001). The most important preprogram subscale item was “vacation” versus “quality of assistive personnel” postprogram. Both pre- and postprogram scores reflected positive job satisfaction so differences may not be clinically significant. Qualitative program benefits included faster and increased onboarding, stronger relationships, and dedicated time. Challenges included role clarity among other stakeholders, learning culture, and spacial/technological logistics.

Implications for Practice:

Super-Mentors can train twice the number of Neo APP learners, with optimal preparation and support of all stakeholders, adequate space, and appropriate technology.
A Nurse-Driven Protocol for Neonatal Enteral Access Device Placement Confirmation
Authors: Cooley Kim V. , Denning Patricia W.
Published: July 2024

Background:

Preterm infants require the use of nasogastric and orogastric enteral access devices (EADs) to provide nutrition and medications. Confirmation of the location of the tip of the EAD is essential to minimize complications. At the study site, EAD location was limited to verifying the centimeter marking at the lip/nares and nonevidence-based methods of visual observation of aspirate and auscultation.

Purpose:

Implement an evidenced-based EAD placement confirmation protocol, and by 90 days post-education and implementation, achieve adherence of 90%.

Methods:

This quality improvement project implemented a nurse-driven evidence-based protocol for EAD verification. The intervention was based on the New Opportunities for Verification of Enteral Tube Location best practice recommendations. Prior to implementation, education sessions focused on insertion measurement technique and gastric pH measurement. Radiographs, insertion measurement technique, centimeter marking, and gastric pH measurement were used for EAD location confirmation. To determine compliance with the protocol, audits were conducted and questionnaires assessing current practice regarding EAD confirmation were administered pre- and postimplementation.

Results:

The protocol increased nursing knowledge regarding evidence-based EAD insertion and verification procedures, incorporated pH measurement into practice, and reduced use of auscultation for confirmation. Nursing adherence to the protocol was 92%.

Implications for Practice and Research:

This provides a model for how to successfully implement and achieve adherence to an evidence-based EAD placement confirmation nurse-driven protocol. Further research is needed to verify the effectiveness of the protocol and establish consensus on approaches specifically for the neonatal population.
Analysis of the orthopaedic trauma literature utilizing machine learning and latent dirichlet allocation
Authors: Rowley M. Andrew , Barfield William R. , Rivas Gabriella A. , Reid Kristoff , Hartsock Langdon A.
Published: July 2024

Objectives:

To demonstrate a new method to review literature utilizing machine learning and latent Dirichlet allocation and summarize the past 20 years of orthopaedic trauma research.

Methods:

All original research articles published in the Journal of Bone and Joint Surgery American volume, Journal of Orthopaedic Trauma, Journal of Bone and Joint Surgery British volume, Trauma, Injury, Clinical Orthopaedics and Related Research, and the Journal of the American Academy of Orthopaedic Surgeons from 2000-2020 were analyzed using latent Dirichlet allocation (LDA), which is a form of machine learning. 100 topics were created by the algorithm and only topics that were relevant to trauma were included, leaving 30 topics ranked by popularity and associated with a best-fitting article and trend over the past 20 years.

Results:

Research article abstracts totaling 21,968 from 2000-2020 in the orthopaedic trauma literature were analyzed to create 30 topics. The topics were ranked by popularity, trended over the specified time period, and associated with a best fitting article. The 3 “hottest” and “coldest” topics were visualized in graphical form.

Conclusions:

This is the first study of its kind to utilize machine learning as a method of reviewing the orthopaedic trauma literature. Machine learning possesses the ability to rapidly synthesize a large body of literature to assess the current state of research and trends of research topics. Machine learning can aid clinicians and researchers in time-intensive tasks to quickly provide clues that will promote avenues further research.
Health outcomes of electronic cigarettes
Authors: Li Xinmeng , Yuan Lingzhi , Wang Fen
Published: July 2024

The usage of electronic cigarettes (e-cigarettes) sparked an outbreak of unidentified vaping-related lung disease in the US during late 2019. With e-cigarettes becoming more and more popular, smokers have more options other than conventional cigarettes. Under these circumstances, a comprehensive evaluation of the general safety of new tobacco and tobacco-related products, represented by e-cigarettes, to human health is necessary. In this review, we summarize the current research on potential negative impacts of e-cigarette exposure on human health. In particular, studies detailing the relationship between e-cigarettes and the digestive system are summarized, with mechanisms mainly including hepatic metabolic dysfunction, impaired gut barrier, and worsened outcomes of inflammatory bowel disease (IBD). Although believed to be safer than traditional cigarettes, e-cigarettes exert adverse effects on systemic health and induce the development of multiple diseases including asthma, cardiovascular disease, and IBD. Moreover, nicotine-containing e-cigarettes have a negative impact on the childhood development and increase the risk of arterial stiffness compared to the non-nicotine e-cigarettes. However, non-nicotine e-cigarette components have detrimental effects including promoting liver damage and metabolic disorders.
Association of copy number variation in X chromosome-linked PNPLA4 with heterotaxy and congenital heart disease
Authors: Gao Han , Huang Xianghui , Chen Weicheng , Feng Zhiyu , Zhao Zhengshan , Li Ping , Tan Chaozhong , Wang Jinxin , Zhuang Quannan , Gao Yuan , Min Shaojie , Yao Qinyu , Qian Maoxiang , Ma Xiaojing , Wu Feizhen , Yan Weili , Sheng Wei , Huang Guoying
Published: July 2024

Background:

Heterotaxy (HTX) is a thoracoabdominal organ anomaly syndrome and commonly accompanied by congenital heart disease (CHD). The aim of this study was to analyze rare copy number variations (CNVs) in a HTX/CHD cohort and to examine the potential mechanisms contributing to HTX/CHD.

Methods:

Chromosome microarray analysis was used to identify rare CNVs in a cohort of 120 unrelated HTX/CHD patients, and available samples from parents were used to confirm the inheritance pattern. Potential candidate genes in CNVs region were prioritized via the DECIPHER database, and PNPLA4 was identified as the leading candidate gene. To validate, we generated PNPLA4-overexpressing human induced pluripotent stem cell lines as well as pnpla4-overexpressing zebrafish model, followed by a series of transcriptomic, biochemical and cellular analyses.

Results:

Seventeen rare CNVs were identified in 15 of the 120 HTX/CHD patients (12.5%). Xp22.31 duplication was one of the inherited CNVs identified in this HTX/CHD cohort, and PNPLA4 in the Xp22.31 was a candidate gene associated with HTX/CHD. PNPLA4 is expressed in the lateral plate mesoderm, which is known to be critical for left/right embryonic patterning as well as cardiomyocyte differentiation, and in the neural crest cell lineage. Through a series of in vivo and in vitro analyses at the molecular and cellular levels, we revealed that the biological function of PNPLA4 is importantly involved in the primary cilia formation and function via its regulation of energy metabolism and mitochondria-mediated ATP production.

Conclusions:

Our findings demonstrated a significant association between CNVs and HTX/CHD. Our data strongly suggested that an increased genetic dose of PNPLA4 due to Xp22.31 duplication is a disease-causing risk factor for HTX/CHD.
Comparison of Glaucoma Diagnosis by Telemedicine, In-Person Ophthalmologist, and Optometrist
Authors: Balakrishnan Poojitha , Swain Thomas A. , McGwin Gerald , Owsley Cynthia , Girkin Christopher A. , Rhodes Lindsay A.
Published: July 2024

Précis:

Diagnosis of glaucoma through telemedicine demonstrates moderate agreement with in-person ophthalmologist (MD) and in-person optometrist (OD) diagnosis, providing evidence that telemedicine is a timely, accurate screening method in settings where an in-person visit may not be feasible.

Objective:

To compare diagnostic agreement of glaucoma between in-person MD, in-person OD, and a simulated telemedicine program.

Patients and Methods:

A cross-sectional study of patients with normal optic nerve structural and functional imaging and new patients referred for glaucoma evaluation examined in-person by an MD for glaucoma with a dilated examination and structural and functional optic nerve testing (optical coherence tomography, photos, and visual field); examined in person by an OD with a dilated examination and optic nerve testing; and structural and functional optic nerve testing reviewed separately by 2 ophthalmologists [telemedicine ophthalmologist reviewer 1 (TMD1), telemedicine ophthalmologist reviewer 2 (TMD2)] with masking of prior MD and OD diagnoses. Interrater agreement between each diagnostic method (MD, OD, TMD1, and TMD2) of normal versus disease (open angle glaucoma, normal tension glaucoma, other types of glaucoma, other optic nerve disorders, ocular hypertension, and glaucoma suspect) for each eye was calculated (Cohen unweighted kappa).

Results:

A total of 100 patients with a median age of 66 years (interquartile range: 59–72), male (40%) and white (62%) were analyzed. There was moderate agreement between MD and telemedicine [TMD1 kappa 0.49 (95% CI: 0.37–0.61), TMD2 kappa 0.44 (95% CI: 0.32–0.56)] and between MD and OD diagnosis [0.41 (95% CI: 0.28–0.54)] and fair-moderate agreement between OD and telemedicine [TMD1: 0.46 (95% CI: 0.34–0.58), TMD2: 0.61 (95% CI: 0.50–0.72)].

Conclusions:

The simulated telemedicine approach had comparable levels of agreement in glaucoma diagnosis with in-person fellowship-trained ophthalmologists, presenting a crucial complementary role in screening and increasing access to care, particularly in rural or underserved settings.
Diagnosis and Treatment of Membranous Nephropathy in Integrative Medicine
Authors: Bi Jingru , Guo Wenkai , Ji Pengcheng , Wang Xinhui , Xie Yuansheng
Published: July 2024

Membranous nephropathy (MN) is a common glomerular disease. The related pathological changes are primarily characterized by the deposition of immune complexes beneath the epithelial cells of the glomerular basement membrane, accompanied by diffuse thickening of the basement membrane. Its etiology and pathogenesis are not fully understood yet; however, they are associated with genetics, infections, tumors, drugs, heavy metals poisoning, environmental pollution, and the loss of immune tolerance. Over 10 target antigens, including the phospholipase A2 receptor (PLA2R) and thrombospondin type 1 domain containing 7A (THSD7A), associated with MN have been identified, each having different clinical implications. Clinical manifestations of MN patients mainly include proteinuria and nephrotic syndrome, with a propensity to form thrombi. Its diagnostic accuracy can be enhanced by combining clinical manifestations, serum antibody testing, and renal biopsy. Proteinuria, estimated glomerular filtration rate (eGFR), and PLA2R antibody levels are vital for the prognostic risk stratification of MN. Low-risk patients primarily undergo non-immunosuppressive treatment (angiotensin-converting enzyme inhibitor [ACEI]/angiotensin II receptor blocker [ARB], sodium-glucose cotransporter 2 inhibitor [SGLT2i], anticoagulants, and traditional Chinese medicine [TCM] treatments), while high-risk patients need to consider using steroids and immunosuppressants, such as cyclophosphamide (CTX), calcineurin inhibitors (CNIs), and anti-cluster of differentiation 20 (anti-CD20) monoclonal antibodies. TCM holds that MN is the imbalance of Fei (lung), Pi (spleen), and Shen (kidney) function, leading to the generation of Neixie such as Shi, Re, Du, and Yu. This disease is difficult to heal because of Shire and Yu. The treatment is based on the use of Jianpi Bushen, simultaneously emphasizing the use of drugs for Qingre Qushi Huoxue. Dialectical use of TCM can obviously improve the clinical response rate and alleviate symptoms such as edema and fatigue by increasing the serum albumin level more rapidly while introducing fewer adverse reactions. Combined with Western medicine, TCM can also reduce toxicity and increase efficiency. This article systematically reviews the etiology, podocyte antigens, clinical manifestations, diagnostic approaches, risk assessment, and integrative medicine therapeutic strategies for MN, aiming to deepen the understanding of MN and guide clinical practice.
Integrating Social Drivers of Health into Hospital Ratings with Application to the 100 Top Hospitals Study
Authors: Korvink Michael , Choi Hyeong , Biondolillo Madeleine , Zrull Louise , Trail Jessica , Martin John , Ballard Amy , Bain Tara , DeBehnke Daniel
Published: July 2024

The objective was to investigate the relationship between social drivers of health (SDOH) and hospital performance within the 100 Top Hospitals study, exploring methods to recognize hospitals serving marginalized communities. Publicly available data sourced from the Centers for Medicare and Medicaid Services and the 2023 100 Top Hospitals study was used. The study employed multivariable hierarchical generalized linear regression models to assess the association between an SDOH composite variable derived using principal component analysis and overall hospital performance measures within the 100 Top Hospitals study. The analysis revealed a statistically significant association between SDOH factors and study ranking results. The SDOH composite variable is a significant predictor of performance within the 100 Top Hospitals study. Accounting for SDOH is essential to recognize high-performing hospitals serving marginalized communities. The findings suggest a need for broader considerations of SDOH in hospital ranking methodologies across various industry programs.
Perception of Ridesharing Among Veterans With Cardiovascular Diseases in the Era of the MISSION Act
Authors: Shah Pal , Mishra Atreya , Larkin Claire , Soltes Tiago , Vidovich Mladen I.
Published: July 2024

The Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018 expanded veteran’s access to community care leading to increased utilization of non-Veterans Affairs (VA) care and prompting concerns about the sustainability and cost-effectiveness of this care model for the VA. This study seeks to explore veterans’ attitudes toward ridesharing services as a means of accessing VA-based cardiovascular care. This cross-sectional, quality improvement study utilized a 7-question survey administered to patients in an urban VA Heart Center to assess transportation preferences and opinions on ridesharing. Participants were more likely to support ridesharing if they held a positive opinion of rideshare (P = 0.024), felt safe utilizing rideshare (P = 0.025), or were undergoing invasive procedures (P = 0.007). Distance traveled did not influence support of ridesharing (P = 0.617). In conclusion, investing in ridesharing for veterans may provide a cost-effective means to improve VA access and continuity of care regardless of distance.
Psychometric Properties of the Chinese Version of the Gratitude at Work Scale in Employed Nurses: A Cross-Sectional Study
Authors: YANG Chiu-Yueh , YOUNG Mu-Hsi , BECKSTEAD Jason
Published: July 2024

Background

The Gratitude at Work Scale, originally developed by American scholars, has been widely administered to mental health professionals and human service workers to explore gratitude in the workplace. No Chinese-language instrument is currently available for assessing workplace gratitude.

Purposes

The aims of this study were to (a) translate the original English version of the Gratitude at Work Scale into a traditional Chinese version (TC-GAWS), confirm its factor structure, and analyze its psychometric properties among newly employed nurses and (b) develop and evaluate the psychometric properties of the TC-GAWS short form.

Methods

A psychometric study using a cross-sectional web-based design was conducted in Taiwan. Three hundred twenty-two employed nurses completed a battery of self-administered online questionnaires that included a demographic datasheet, the Gratitude Questionnaire–Six-Item Form, the Connor–Davidson Resilience Scale-10, and the Thoughts of Quitting Scale. IBM SPSS 24.0 and AMOS 28.0 were used for data analysis, and Cronbach's alpha and Pearson's correlation were used to assess reliability and concurrent validity. Exploratory factor analysis and confirmatory factor analysis (CFA) were conducted.

Results

The internal consistency and stability of the TC-GAWS total scale were .88 and .91, respectively. The exploratory factor analysis showed a satisfactory Kaiser–Meyer–Olkin value of .88 and a Bartlett's test value of 654.01 (p < .001), suggesting that 64.55% of the total variance was explained by the two-factor TC-GAWS. After item reduction, the CFA of the six remaining items of the TC-GAWS short form revealed adequate fit statistics for a two-factor structure and a second-order factor. Strong correlations were found between the 10-item and six-item TC-GAWS (r > .94) in the two samples, suggesting good concurrent validity. The overall scores for the 10-item and six-item TC-GAWS had similar convergent validity, with moderate-to-strong correlations for the Gratitude Questionnaire–Six-Item Form (r = .45 and .540), Connor–Davidson Resilience Scale-10 (r = .49 and .51), and Thoughts of Quitting Scale (r = −.57 and −.53). The CFA yielded a two-factor, six-item model that exhibited good fit with the latent constructs of χ2/df = 11.06/8 = 1.38, p = .198, comparative fit index = .996, goodness-of-fit index = .979, root mean square error of approximation = .045, root mean square residual = .030, and standardized root mean squared residual = .023.

Conclusions/Implications for Practice

Both the 10- and six-item TC-GAWS instruments demonstrated good reliability and validity in nurse participants. The TC-GAWS may be used to measure gratitude in nurses in the workplace. This instrument has the potential to facilitate a better understanding of gratitude in nurses, which may be applied to the improvement of nursing management, research, and education.
The Effect of Nursing Counseling on Treatment Compliance: Acute Coronary Syndrome and Diabetes Mellitus
Authors: CELIK Selda , TASKIN YILMAZ Feride , GUNDOGDU Seval , TURKOGLU Meryem
Published: July 2024

Background

The comorbidity of acute coronary syndrome and diabetes affects patient prognoses. Therefore, it is important to manage these diseases simultaneously.

Purpose

In this study, the effect of nursing counseling on treatment compliance was investigated in patients who had received surgical treatment for acute coronary syndrome and had been recently diagnosed with diabetes.

Methods

A quasi-experimental design with pretest–posttest control group was used. The study sample consisted of 60 patients (intervention group = 30, control group = 30). The data were collected using a patient information form, the Patient Learning Needs Scale, and the Scale for Patient Compliance with Type 2 Diabetes Mellitus Treatment. This study was conducted in compliance with the Transparent Reporting of Evaluations with Nonrandomized Designs checklist.

Results

The intervention group earned significantly higher posttest scores on the Patient Learning Needs total scale and subscales than the control group. Moreover, intervention group compliance with treatment was higher than that of the control group. Furthermore, although significant improvements were found in the average posttest body mass index, fasting blood glucose, HbA1c, total cholesterol, triglyceride, and low-density lipoprotein cholesterol values of the control group, the between-group differences in these values were not significant.

Conclusions/Implications for Practice

It is important for nurses to provide counseling services that align with the learning needs of their patients. Also, nursing counseling units should be created and staffed by both specialist nurses and nurse trainers working in healthcare institutions.
The Relationship between Socket Comfort, Pain, and Mobility Over Treatment Milestones for Individuals with Lower-Limb Loss
Authors: Pousett Brittany Mae , Harasym Charlene C. , Rapaport Malena Sofia , Moe David W. , Miller William C.
Published: July 2024

Introduction

This study investigates the relationships among mobility, pain, and socket comfort for people with lower-limb amputations who use prostheses over specific treatment milestones.

Methods

This is a retrospective chart analysis from January 1, 2015, to July 15, 2021. Outcome measures included are the Socket Comfort Score, Pain Scale, 2-Minute Walk Test, and PLUS-M (Prosthetic Limb Users Survey of Mobility). Data were collected at 4 milestones: Baseline and Discharge from Rehabilitation for those receiving their first prosthesis in rehabilitation and Initial Evaluation and Definitive Fitting for experienced prosthesis users receiving a replacement socket. Demographic data were analyzed using descriptive statistics, and the strength of the correlations was determined using Pearson’s correlations.

Results

Measures were included from 59 individuals in rehabilitation and 165 individuals receiving a replacement socket. The sample was in general older males with transtibial amputations due to a variety of etiologies. The Pain Scale was negatively correlated with the Socket Comfort Score (−0.49 < r < −0.60), and the PLUS-M was correlated with the 2-minute walk test (0.41 < r < 0.61) at all milestones. Additionally, there were positive correlations between the PLUS-M and Socket Comfort Score (0.30 < r < 0.32), and negative correlations between the PLUS-M and Pain Scale (−0.46 < r < −0.32) for those receiving a replacement socket.

Conclusions

The relationship among comfort, pain, and mobility changes over the treatment timeline. There is evidence that, by addressing comfort and pain for those with experience using a prosthesis, clinicians can support the goal of increasing self-reported functional mobility.

Clinical Relevance

This study provides novel information about the relationships among pain, comfort, and mobility and the importance of considering the impact of treatment milestones when taking outcome measures and providing interpretative values as scores and relationships differ over the course of treatment.
Beyond diagnosis: exploring coeliac disease incidence alongside clinical and laboratory characteristics of newly diagnosed children in Slovenia
Authors: Rižnik Petra , Kamhi Trop Tina , Klemenak Martina , Krenčnik Tomaž , Milanič-Koron Tanja , Mojškerc Eva Miler , Pavlin Tatjana , Požek Šavs Tina , Zupančič Janez , Dolinšek Jernej
Published: July 2024

Objective

Coeliac disease is characterized by a wide array of clinical presentations. The focus of our study was to comprehensively assess the clinical manifestations of coeliac disease in newly diagnosed children in Slovenia. Our objectives include estimating the incidence of the disease in children in 2022.

Methods

In this prospective study, Slovenian paediatric gastroenterologists were invited to provide patient data using medical records of children under 19 diagnosed with coeliac disease from March 2021 to October 2023. Patient data were collected through a dedicated web-based form adapted from the CD SKILLS project, including data on clinical manifestations and laboratory results. Furthermore, the study included an estimation of the incidence of coeliac disease in children and adolescents in Slovenia in 2022.

Results

Analysis involved data from 160 children and adolescents (median age: 8 years; 61.9% female). Overall, 16.9% were asymptomatic at diagnosis and 29.4% belonged to a high-risk group for coeliac disease. Among symptomatic cases (N = 133), abdominal pain was the leading symptom (44.4%), followed by anaemia (12.0%) and diarrhoea (10.5%). Malabsorption symptoms were more prevalent in very young children. Anaemia was found in 22.8 and 10.7% had abnormal alanine aminotransferase levels. The estimated incidence of coeliac disease in Slovene children in 2022 was 17.5/100 000.

Conclusion

Abdominal pain emerged as the primary symptom of coeliac disease in children and adolescents, except in very young children where malabsorption symptoms were predominant. Our observation of a lower prevalence of abnormal liver function tests suggests subclinical coeliac disease may be less common in children. Moreover, the calculated coeliac disease incidence in Slovenia aligns with existing data.
African Immigrant Women's Experiences of Maternity Care in the United States
Authors: Appiah-Kubi Ruth , Kim Yeong-Hyun , Attanasio Laura B.
Published: July 2024

Objective:

The purpose of this study was to explore maternity care experiences of African immigrant women during the perinatal period including factors affecting access to and use of care.

Methods:

We used Sandelowski's (2010) qualitative descriptive approach to examine how African immigrant women from various countries of origin and with diverse ethnic backgrounds experienced and navigated the maternity care system in the United States during pregnancy and childbirth. We conducted semi-structured interviews with 15 African immigrant women living in the Columbus, Ohio area. Participants were recruited using purposive and snowball sampling between February 2021 and May 2021. Interviews were recorded, transcribed, and analyzed using a reflexive thematic analysis approach.

Findings:

Four major themes defined the experiences of our study participants: access to information, patient–clinician relationships, experiences of discrimination, and costs of maternity care.

Clinical Implications:

Findings highlight key barriers to providing quality and acceptable maternity care to African immigrant women at multiple levels. This group's unique barriers underlie the importance of incorporating their diverse experiences into maternity care models and clinical practice. Further research is needed to evaluate and improve maternity care for African immigrant women.
Survey of the Barriers, Enablers, and Preferences to Swimming for People With Chronic Low Back Pain
Authors: Oakes Helen , De Vivo Marlize , Stephensen David , Mills Hayley
Published: July 2024

Background and Purpose:

It is common practice for health professionals to recommend swimming to people with chronic low back pain (CLBP) for rehabilitation and pain management and to improve levels of physical activity. Uptake and engagement in swimming involve a change in behavior, influenced by various factors including barriers, enablers, and preferences. The aim of this study was to identify the most common barriers, enablers, and preferences to swimming for people with CLBP and map them onto the Capability Opportunity Motivation-Behavior (COM-B) model.

Methods:

People with CLBP were invited to complete a survey collecting data regarding the barriers, enablers, and preferences in relation to swimming. The questions were scored on a 5-point Likert scale and mapped onto the COM-B model.

Results:

Eighty-two people completed the survey. More than 50% of participants agreed with the following barriers: I am not sure which swimming stroke is best for my back pain and I lack motivation to go swimming. These barriers mapped to the psychological capability and reflective motivation dimensions on the COM-B model. At least 50% of participants agreed with the following enablers: I would like to use swimming to improve my strength, flexibility, weight, fitness, health, mood, and well-being; setting goals and making an action plan could help me swim regularly, I am more likely to go swimming if a health professional advised me and I believe that swimming is good for my back. These enablers were also mapped to the reflective motivation and physical and social opportunity dimensions on the COM-B model.

Discussion and Conclusions:

The findings from this survey suggest that when recommending swimming, health professionals should discuss the wider health benefits of swimming, discuss specific swimming strokes and why swimming could be beneficial for back pain, and consider using motivational tools to encourage reflective motivation such as goal setting and action planning.
Rolipram promotes hippocampal regeneration in mice after trimethyltin-induced neurodegeneration
Authors: Sakurai Masashi , Imaizumi Miko , Sakai Yusuke , Morimoto Masahiro
Published: July 2024

This study aimed to investigate the effects of rolipram, a phosphodiesterase inhibitor, on brain tissue regeneration. Trimethyltin-injected mice, an animal model of hippocampal tissue regeneration, was created by a single injection of trimethyltin chloride (2.2 mg/kg, intraperitoneally). Daily rolipram administration (10 mg/kg, intraperitoneally) was performed from the day after trimethyltin injection until the day before sampling. In Experiment 1, brain samples were collected on day 7 postinjection of trimethyltin following the forced swim test. In Experiment 2, bromodeoxyuridine (150 mg/kg, intraperitoneally/day) was administered on days 3–5 and sampling was on day 21 postinjection of trimethyltin. Samples were routinely embedded in paraffin and sections were obtained for histopathological investigation. In Experiment 1, rolipram-treated mice showed shortened immobility times in the forced swim test. Histopathology revealed that rolipram treatment had improved the replenishment of neuronal nuclei-positive neurons in the dentate gyrus, which was accompanied by an increase in the percentage of phosphorylated cyclic AMP response element-binding protein–positive cells. In addition, rolipram had decreased the percentage of ionized calcium-binding adapter protein 1–positive microglia with activated morphology and the number of tumor necrosis factor-alpha–expressing cells. In Experiment 2, double immunofluorescence for bromodeoxyuridine/neuronal nuclei revealed an increase of double-positive cells in rolipram-treated mice. These results demonstrate that rolipram effectively promotes brain tissue regeneration by enhancing the survival of newborn neurons and inhibiting neuroinflammation.
Invasive Streptococcus pyogenes infection: a case report
Authors: Bazhar Samia , ElBenaissi Yassine , Benaissa Elmostafa , Ben Lahlou Yassine , Chadli Mariama
Published: July 2024

The Group A Streptococcus (GAS), also known as Streptococcus pyogenes (S. pyogenes), is a human pathogen causing various infections, ranging from mild, such as tonsillitis and impetigo, to severe and invasive conditions like septicemia and necrotizing fasciitis. Despite a decline in incidence and severity during the twentieth century due to antibiotics, there has been a reported increase in severe cases since the 1980s in industrialized countries. S. pyogenes is a human pathogen with a natural reservoir in the pharynx and skin, exhibits asymptomatic carriage in various body sites. It is responsible for a spectrum of clinical manifestations, from asymptomatic carriage to severe invasive infections. Transmission occurs through respiratory droplets or direct contact with skin lesions. Bacteriologically, S. pyogenes is a Gram-positive β-hemolytic streptococcus. This summary highlights a case of invasive Group A Streptococcus infection in a 28-year-old diagnosed at the microbiology laboratory of the Mohammed V Military Training Hospital in Rabat, Morocco. A 28-year-old patient, without any specific medical history, presented with acute febrile oligoarthritis. Following a recent flu-like syndrome and febrile tonsillitis, the patient experienced asymmetric inflammatory oligoarthralgia affecting the left knee, left ankle, and right shoulder, accompanied by functional impairment of the left lower limb. Upon admission, clinical examination revealed swelling, positive patellar tap, and sternal involvement. Laboratory and imaging findings indicated an abscessed collection in the left knee and anterior mediastinitis. Emergency aspirations revealed Group A Streptococcus, specifically Streptococcus pyogenes, leading to a diagnosis of septic arthritis. Dual antibiotic therapy and knee joint drainage resulted in symptom resolution after 45 days. The rise in severe Group A Streptococcus infection underscores the need for early detection and treatment. Widely sharing the French High Council for Public Health’s antibiotic prophylaxis recommendations is crucial for awareness. Collaborating between clinicians and microbiologists is essential for effective management.
Red knots in Europe: a dead end host species or a new niche for highly pathogenic avian influenza?
Authors: King Jacqueline , Pohlmann Anne , Bange Andreas , Horn Elisabeth , Hälterlein Bernd , Breithaupt Angele , Globig Anja , Günther Anne , Kelm Angie , Wiedemann Christian , Grund Christian , Haecker Karena , Garthe Stefan , Harder Timm , Beer Martin , Schwemmer Philipp
Published: July 2024

The 2020/2021 epidemic in Europe of highly pathogenic avian influenza virus (HPAIV) of subtype H5 surpassed all previously recorded European outbreaks in size, genotype constellations and reassortment frequency and continued into 2022 and 2023. The causative 2.3.4.4b viral lineage proved to be highly proficient with respect to reassortment with cocirculating low pathogenic avian influenza viruses and seems to establish an endemic status in northern Europe. A specific HPAIV reassortant of the subtype H5N3 was detected almost exclusively in red knots (Calidris canutus islandica) in December 2020. It caused systemic and rapidly fatal disease leading to a singular and self-limiting mass mortality affecting about 3500 birds in the German Wadden Sea, roughly 1 % of the entire flyway population of islandica red knots. Phylogenetic analyses revealed that the H5N3 reassortant very likely had formed in red knots and remained confined to this species. While mechanisms of virus circulation in potential reservoir species, dynamics of spill-over and reassortment events and the roles of environmental virus sources remain to be identified, the year-round infection pressure poses severe threats to endangered avian species and prompts adaptation of habitat and species conservation practices.
Basophils drive the resolution and promote wound healing in adult and aged mice
Authors: Bex Julie , Peter Victoria , Saji Chaimae , Chapart Léa , Jin Suoqin , Gautier Gregory , Thibaudeau Olivier , Thaminy Morgane K. , Tchen John , Simon Quentin , Dai Xing , Miyake Kensuke , Karasuyama Hajime , Jiang Jean X. , Naidoo Karmella , Benhamou Marc , Blank Ulrich , Monteiro Renato , Gros Graham Le , Charles Nicolas , Pellefigues Christophe
Published: July 2024

An active resolution is critical to control the duration of inflammation and limit its pathological consequences. Defects in resolution during wound healing allow the emergence of chronic wounds, a common complication in the elderly. Here, we show that basophils infiltrate the periphery of mouse skin wounds for at least three weeks, during both the inflammation and resolution phases of wound healing. Depletion of basophils induces an increased secretion of inflammatory molecules, accumulation and activation of pro-inflammatory leukocytes, and delays the wound healing response. Basophils particularly promote epidermal differentiation towards homeostasis in the wounds. Basophil-derived IL-4 and M-CSF drive partly their immunoregulatory and healing properties. Unexpectedly, aged mice basophils infiltrate more potently the wounds to promote inflammation resolution, showing a transcriptomic signature biased towards tissue remodeling. Thus, basophils are not pro-inflammatory but pro-resolution cells during an essential biological process such as skin wound healing. Unraveling basophil pro-resolution properties may reveal new strategies to fight chronic wounds in the elderly.

The resolution of inflammation is essential for homeostasis and becomes defective with age. Here we show basophil immunoregulatory properties promote resolution during skin wound healing, in both adult and aged mice.
Large language models management of complex medication regimens: a case-based evaluation
Authors: Xu Steven , Most Amoreena , Chase Aaron , Hedrick Tanner , Murray Brian , Keats Kelli , Smith Susan , Barreto Erin , Liu Tianming , Sikora Andrea
Published: July 2024

Background

Large language models (LLMs) have shown capability in diagnosing complex medical cases and passing medical licensing exams, but to date, only limited evaluations have studied how LLMs interpret, analyze, and optimize complex medication regimens. The purpose of this evaluation was to test four LLMs ability to identify medication errors and appropriate medication interventions on complex patient cases from the intensive care unit (ICU).

Methods

A series of eight patient cases were developed by critical care pharmacists including history of present illness, laboratory values, vital signs, and medication regimens. Then, four LLMs (ChatGPT (GPT-3.5), ChatGPT (GPT-4), Claude2, and Llama2-7b) were prompted to develop a medication regimen for the patient. LLM generated medication regimens were then reviewed by a panel of seven critical care pharmacists to assess for presence of medication errors and clinical relevance. For each medication regimen recommended by the LLM, clinicians were asked to assess for if they would continue a medication, identify perceived medication errors in the medications recommended, identify the presence of life-threatening medication choices, and rank overall agreement on a 5-point Likert scale.

Results

The clinician panel rated to continue therapies recommended by the LLMs between 55.8-67.9% of the time. Clinicians perceived between 1.57-4.29 medication errors per recommended regimen, and life-threatening recommendations were present between 15.0-55.3% of the time. Level agreement was between 1.85-2.67 for the four LLMs.

Conclusions

LLMs demonstrated potential to serve as clinical decision support for the management of complex medication regimens with further domain specific training; however, caution should be used when employing LLMs for medication management given the present capabilities.
Calcium-triggered (de)ubiquitination events in synapses
Authors: Ainatzi Sofia , Kaufmann Svenja V. , Silbern Ivan , Georgiev Svilen V. , Lorenz Sonja , Rizzoli Silvio O. , Urlaub Henning
Published: July 2024

Neuronal communication relies on neurotransmitter release from synaptic vesicles (SVs), whose dynamics are controlled by calcium-dependent pathways, as many thoroughly studied phosphorylation cascades. However, little is known about other post-translational modifications, as ubiquitination. To address this, we analysed resting and stimulated synaptosomes (isolated synapses) by quantitative mass spectrometry. We identified more than 5,000 ubiquitination sites on ∼2,000 proteins, the majority of which participate in SV recycling processes. Several proteins showed significant changes in ubiquitination in response to calcium influx, with the most pronounced changes in CaMKIIα and the clathrin adaptor protein AP180. To validate this finding, we generated a CaMKIIα mutant lacking the ubiquitination target site (K291) and analysed it both in neurons and non-neuronal cells. K291 ubiquitination influences CaMKIIα activity and synaptic function by modulating its autophosphorylation at a functionally important site (T286). We suggest that ubiquitination in response to synaptic activity is an important regulator of synaptic function.
Transcriptional landscapes underlying Notch-induced lineage conversion and plasticity of mammary basal cells
Authors: Merle Candice , Rodrigues Calvin , Langeroudi Atefeh Pourkhalili , Journot Robin , Rost Fabian , Dang Yiteng , Rulands Steffen , Fre Silvia
Published: July 2024

The mammary epithelium derives from multipotent mammary stem cells (MaSCs) that progressively restrict their potency and engage into lineage commitment during embryonic development. Although postnatal mammary progenitors are lineage-restricted and unipotent, several lines of evidence have documented their extensive plasticity and ability to reactivate multipotency in several non-physiological contexts. We have previously shown that ectopic Notch1 activation in committed mammary basal cells, which never experience Notch activity in homeostatic conditions, triggers a progressive cell fate switch from basal to luminal cell identity in both the pubertal and adult mouse mammary gland. Here, we tested the conservation of this mechanism in other glandular epithelia and found that constitutive Notch1 signaling also induces a basal-to-luminal cell fate switch in adult cells of the lacrimal gland, the salivary gland, and the prostate. Since cells do not undergo lineage transition synchronously and this switch is progressive in time, we performed single cell transcriptomic analysis by SMART-Seq on index-sorted mutant mammary cells at different stages of lineage conversion, to reveal the molecular pathways underlying the fate transition. Combining single cell transcriptomics analyses with assays in organoid cultures, we demonstrate that proliferation of basal mutant cells is indispensable to convert them into luminal progenitors. We thus reveal the molecular mechanisms and individual transcriptional landscapes controlling lineage conversion and cellular plasticity of unipotent committed mammary cellsin vivowith spatial and temporal resolution. Given the strong implications of Notch signaling in cancer, these results also provide important insights into the mechanisms that drive cellular transformation.
Modelling the spatiotemporal dynamics of senescent cells in wound healing, chronic wounds, and fibrosis
Authors: Chandrasegaran Sharmilla , Sluka James P. , Shanley Daryl
Published: July 2024

Cellular senescence is known to drive age-related pathology through the senescence-associated secretory phenotype (SASP). However, it also plays important physiological roles such as cancer suppression, embryogenesis and wound healing. Wound healing is a tightly regulated process which when disrupted results in conditions such as fibrosis and chronic wounds. Senescent cells appear during the proliferation phase of the healing process where the SASP is involved in maintaining tissue homeostasis after damage. Interestingly, SASP composition and functionality was recently found to be temporally regulated, with distinct SASP profiles involved: a fibrogenic, followed by a fibrolytic SASP, which could have important implications for the role of senescent cells in wound healing. Given the number of factors at play a full understanding requires addressing the multiple levels of complexity, pertaining to the various cell behaviours, individually followed by investigating the interactions and influence each of these elements have on each other and the system as a whole. Here, a systems biology approach was adopted whereby a multi-scale model of wound healing that includes the dynamics of senescent cell behaviour and corresponding SASP composition within the wound microenvironment was developed. The model was built using the software CompuCell3D, which is based on a Cellular Potts modelling framework. We used an existing body of data on healthy wound healing to calibrate the model and validation was done on known disease conditions. The model provides understanding of the spatiotemporal dynamics of different senescent cell phenotypes and the roles they play within the wound healing process. The model also shows how an overall disruption of tissue-level coordination due to age-related changes results in different disease states including fibrosis and chronic wounds. Further specific data to increase model confidence could be used to explore senolytic treatments in wound disorders.