bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient Perspective on Adherence to Reflux Lifestyle Modifications: A Qualitative Study
Authors: Chouhdry Hira , Villwock Jennifer
Published: October 2023

Objective:

Acid reflux disease is a common condition with recurrent symptoms affecting the quality of life of many Americans. Lifestyle/dietary modification is critical for management of acid reflux disease. Adherence to these recommendations is variable. The purpose of this study was to better understand the experience of patients with reflux disease (GERD/LPR) and explore factors that impact the integration of lifestyle modifications into their daily lives.

Methods:

Patient with diagnoses of GERD and/or LPR were recruited from an outpatient laryngology clinic and completed the Reflux Symptom Index (RSI) and a semi-structured interview. Interviews were transcribed and underwent thematic analysis.

Results:

Twenty-three patients—mean age and RSI of 61 and 16.1 respectively—were recruited. Four main themes emerged: (1) Care team interaction—focus and quality of physician counseling, useful educational handouts, dietician/nutritionist counseling; (2) Motivation to change—impact on symptom severity, avoiding undesired interventions, and poor health outcomes; (3) Implementing lifestyle changes; and (4) Impact of disease on patient. No patient had seen a dietician. Patients who experienced dietary counseling for other conditions felt reflux-specific counseling with a dietician would be beneficial. While patients found educational material on diet to be helpful, lists of foods to avoid were discouraging; providing a positive list of preferred foods may be more helpful.

Conclusion:

Lifestyle modification counseling should incorporate multiple aspects of the patient experience. Patients desire information regarding medication side effects. Educational handouts should include prioritized list of recommended dietary restrictions and acceptable/alternative food options. Referral for dedicated dietician counseling can also be considered to increase understanding of the importance of, and adherence to, lifestyle modification.
Iatrogenic Anomalous Origin of the Right Pulmonary Artery From the Aorta: A Rare Complication of Ligation of Aortopulmonary Window
Authors: Prabhu Sudesh , Ramachandra Prakash , Maiya Shreesha , Shanmugasundaram Balasubramanian , Karl Tom R.
Published: October 2023

An aortopulmonary window (APW) is a communication between the main pulmonary artery (MPA) and the ascending aorta in the presence of two separate semilunar valves. Surgical strategies described for the management of APW include ligation, division and suturing, patch closure of APW (transaortic or transpulmonary or transwindow), and device closure. Ligation of a type-2 APW can result in stenosis or complete closure of the right pulmonary artery (RPA) off the MPA, while leaving the aorta still opening into the RPA. We describe a delayed presentation of iatrogenic anomalous origin of the RPA from the aorta, post APW ligation, and its management.
The Impact of Social Isolation and Environmental Deprivation on Blood Pressure and Depression-Like Behavior in Young Male and Female Mice
Authors: Challa Siva Reddy , Fornal Casimir A. , Wang Billy C. , Boyineni Jerusha , DeVera Roberto E. , Unnam Pavani , Song Yajing , Soares Marcelo Bento , Malchenko Sergey , Gyarmati Peter , Veeravalli Krishna Kumar
Published: October 2023

Background: Social isolation (SI) and loneliness are major adult and adolescent health concerns, particularly in the coronavirus disease 2019 (COVID-19) era. Recent prospective cohort studies indicate that older women who experienced both SI and loneliness had a significantly higher risk of cardiovascular disease (CVD). Hypertension, a well-established risk factor for CVD, is more prevalent in elderly women than men. Furthermore, a lack of social relationships is strongly associated with an increased risk of hypertension in middle-aged and elderly women compared to men. Although this has not been extensively studied, adolescents and young adults who experience loneliness or SI may also be at risk for CVD and depression. The purpose of this study was to examine the effect of SI on blood pressure and depression-like behavior in young male and female mice. Methods: Weaned C57BL/6 mice were randomly assigned ( n  =  6/group/sex) to either group housing (GH) or SI. Animals in the SI group were housed in individual cages for 8 weeks with no view of other animals. The cages were kept in ventilated racks to prevent pheromone exposure and socially isolated animals had no cage enrichment. Results: SI increased systolic, diastolic, and mean arterial blood pressure in females and elevated heart rate in both sexes. Body weight gain was dramatically increased in socially isolated females but tended to decrease in socially isolated males. In the forced swim test, which detects depression-like behavior, there was no difference between groups in total immobility time. The latency to immobility, however, was significantly decreased in socially isolated females. Serum concentrations of corticosterone and metanephrine did not differ between socially isolated and group-housed females, but corticosterone levels were significantly reduced in socially isolated males. Conclusions: Our results indicate that 8 weeks of SI leads to significant changes in blood pressure and heart rate and mild changes in depression-like behavior in young mice, with females affected more than males.
Everyday youth climate politics and performances of climate citizenship in Aotearoa New Zealand
Authors: Parsons Meg , Bhor Gautami , Crease Roa Petra
Published: October 2023

Young people around the world are creating their own spaces, strategies, and politics for climate action. In this article we explore the everyday informal politics of climate activism by youth from Aotearoa New Zealand's largest city (Auckland). We examine how young people, frustrated by the lack of global and domestic political inertia, are operationalizing their concerns about climate change into actions in their daily lives directed at mitigating their greenhouse gas emissions. Through a relational qualitative approach, we document the contradictory standing of youth, specifically as agentic actors and environmental citizens, who are aware of and seeking climate action through multiple modes of action including protesting, eco-consuming, influencing others, and eco-caring work. Our youth participants reported how their participation in various forms of climate activism helped to reduce their eco-anxiety and made them more hopeful about their collective abilities to address climate change. Our participants highlighted a hopeful view that their small-scale individual actions will collectively add up to large-scale changes at a systemic level. However, they were highly aware of and critical of state and corporate actors attempts to shift responsibility for taking actions to mitigate climate change onto individuals. Rather than situating themselves solely as eco-consumers engaging in eco-friendly purchasing practices, our youth participants narrated their sometimes contradictory climate actions (protesting, buy-cotting or boycotting, changing how they used goods, and services) as acts of resistance against the socio-economic status quo (high-carbon, neoliberal, and capitalist) that could act as trigger points for wider change. In this article we identify the various methods by which young people are participating in daily climate politics and demonstrating their agency, which are evident in their diverse pro-environmental-oriented and climate mitigation actions; all of which is evidence of how youth are seeking to be good climate citizens.
Dynamic relationship among immediate release fentanyl use and cancer incidence: A multivariate time-series analysis using vector autoregressive models
Authors: González-Bermejo Diana , Castillo-Cano Belén , Rodríguez-Pascual Alfonso , Rayón-Iglesias Pilar , Montero-Corominas Dolores , Huerta-Álvarez Consuelo
Published: October 2023

Background

A substantial increase in the incidence of immediate release fentanyl (IRF) use was reported in Spain from 2012 to 2017.

Purpose

This study aimed to investigate the relationship dynamically with cancer incidence in order to provide empirical evidence of inappropriate use of IRF with respect to the pathology.

Research design

A vector autoregresive (VAR) model was constructed using data from a nationwide electronic healthcare record database in primary care in Spain (BIFAP) according to the following step procedure: (1) split data into training data for modelling and test for validation (2) assessing for time series stationarity; (3) selecting lag-length; (4) building the VAR model; (5) assessing residual autocorrelation; (6) checking stability of the VAR system; (7) evaluating Granger causality; (8) impulse response analysis and forecast error variance decomposition (9) prediction performance with validation data.

Results

The analysis showed a strong and linear correlation between IRF and cancer (Pearson correlation coefficient: 0.594 (95% CI: 0.420–0.726). Two VAR models, VAR (2) and VAR (11) were selected and compared. All tests performed for both models satisfied assumptions for stability, predictability and accuracy. Granger causality revealed cancer incidence is a good predictor for IRF use. VAR (2) seemed to be slightly more accurate, according to the RMSE of the test data.

Conclusions

This study demonstrates that using a robust and structured VAR modelling approach, is able to estimate dynamics associations, involving IRF use and cancer incidence.
Asymmetric response of gross primary productivity to precipitation changes over China’s karst areas
Authors: Dong Guanyu , Fang Hongqian , Yu Ling , Xiao Yao , Zhong Shiyu
Published: October 2023

China’s karst areas play an important role in regulating the global carbon dynamic and mitigating atmospheric CO2 concentration. Yet, extreme drought events have occurred frequently in recent years over China’s karst areas, which have a negative effect on the gross primary productivity (GPP) in the region. It is unclear whether gross primary productivity gains in the wet years can compensate for its losses in the dry years over the karst areas. In this study, we selected the asymmetry indices to assess the potential asymmetric response of gross primary productivity to the change in precipitation over China’s karst areas during the 2003 to 2018 period, using the gross primary productivity and precipitation dataset. Our results show that the gross primary productivity exhibits a positive asymmetry in response to precipitation changes, namely, the gains caused by increased precipitation in the wet years overcompensate the losses caused by decreased precipitation in the dry years. In addition, the gross primary productivity asymmetry shows an increasing trend over the study period despite extreme drought events occurring frequently, which is due to the response of gross primary productivity to drought has significantly decreased over the study period. For each biome, grasslands show the highest positive gross primary productivity asymmetry, indicating that the grassland biomes have a stronger capacity to utilize the increased precipitation during the wet years to increase gross primary productivity compared to other biomes. Furthermore, the gross primary productivity asymmetry over China’s karst areas can be effected by the precipitation asymmetry as well as mean annual precipitation. Our results will contribute to our knowledge of the response of gross primary productivity to precipitation changes in the karst areas of China.
How inhaled corticosteroids target inflammation in COPD
Authors: Lea Simon , Higham Andrew , Beech Augusta , Singh Dave
Published: October 2023

Inhaled corticosteroids (ICS) are the most commonly used anti-inflammatory drugs for the treatment of COPD. COPD has been previously described as a “corticosteroid-resistant” condition, but current clinical trial evidence shows that selected COPD patients, namely those with increased exacerbation risk plus higher blood eosinophil count (BEC), can benefit from ICS treatment. This review describes the components of inflammation modulated by ICS in COPD and the reasons for the variation in response to ICS between individuals. There are corticosteroid-insensitive inflammatory pathways in COPD, such as bacteria-induced macrophage interleukin-8 production and resultant neutrophil recruitment, but also corticosteroid-sensitive pathways including the reduction of type 2 markers and mast cell numbers. The review also describes the mechanisms whereby ICS can skew the lung microbiome, with reduced diversity and increased relative abundance, towards an excess of proteobacteria. BEC is a biomarker used to enable the selective use of ICS in COPD, but the clinical outcome in an individual is decided by a complex interacting network involving the microbiome and airway inflammation.
Evaluation of human monkeypox knowledge and beliefs regarding emerging viral infections among healthcare workers
Authors: Alkalash Safa H. , Marzouk Marzouk M. , Farag Nagwa A. , Elesrigy Fatma A. , Barakat Ayah M. , Ahmed Faransa A. , Mohamed Rasha A. , Almowafy Abeer A.
Published: October 2023

Objectives

The purpose of this study was to evaluate possible factors that might be accompanied by high level of human monkey pox (HMPX) knowledge and to explain the relationship between HMPX knowledge and Beliefs regarding emerging viral infections.

Study design

A descriptive cross-sectional study was conducted for the implementation of this study.

Methods

Study was conducted at two general hospitals in Mansoura City (Old General Hospital and International Hospital) El Dakahlia Governorate among 620 healthcare workers (HCWs) using a self-managed questionnaire for 1 week (1 to 7 January 2023). The questionnaire has items adapted from the previously published literature to assess HMPX knowledge and Beliefs regarding emerging viral infections.

Results

The mean age of the study sample was 27.97 years and most of them were female (86.1%). Physicians and other HCWs (nurses, laboratory technicians, radiographer technicians, and pharmacists) had significantly different levels of knowledge of monkeypox for the majority of the questions. A higher belief was found among two items: viruses are biological weapons manufactured by the superpowers to take global control and the government is misleading the public about the cause of the virus.

Conclusion

This study discovered lower levels of knowledge of HMPX among HCWs in Egypt. Beliefs about emerging viral infections were widespread, and future research should look into their potential negative impact on health behavior.
Mindfulness interventions for craving reduction in substance use disorders and behavioral addictions: systematic review and meta-analysis of randomized controlled trials
Authors: Demina Anastasia , Petit Benjamin , Meille Vincent , Trojak Benoit
Published: October 2023

Background

High-quality evidence is still required to affirm the efficacy of mindfulness-based interventions (MBIs) in craving reduction. MBIs may be particularly appropriate for this purpose given the neurobiological mechanisms of addiction with automatic behavior in response to the negative affect. In this systematic review and meta-analysis, we aimed to study the efficacy of MBIs in craving reduction and to synthetize the newly published data.

Methods

We searched four databases and three clinical trial registries for randomized controlled trials (RCTs) up to August 2023, including studies with MBIs in all types of substance use disorders or behavioral addictions. We chose as our outcome of interest the change from the baseline of craving measures at posttreatment. Standardized mean difference was used as an effect size estimator.

Results

We included 17 RCTs with 1228 participants. The overall effect size was estimated at -0.70 (95% CI -1.15, -0.26) in favor of MBIs.

Conclusion

Due to the high inconsistency (I2 = 92%), we were unable to conclude that there is a medium to large effect size. Overall risk of bias was high for most studies, and the GRADE approach detected a low quality of evidence. Previous clinical and fundamental research suggest that MBIs have a promising potential in addiction medicine. However, further investigation of whether MBIs effectively reduce craving is needed, and innovative solutions for resolving methodological limitations in MBI research are warranted.

Trial registration

PROSPERO registration ID CRD42020221141.
Rural health dialogue for the sustainability of help-seeking behaviors among older patients: grounded theory approach
Authors: Ohta Ryuichi , Sano Chiaki
Published: October 2023

Background

Help-seeking behaviors (HSBs) are essential for disease prevention and health promotion. Dialogues with peers and medical professionals can improve HSBs, both qualitatively and quantitatively. Rural communities lacking healthcare resources require effective HSBs for healthcare sustainability. The current study aimed to investigate the effect of health dialogues between medical professionals and rural citizens on their HSBs.

Methods

All procedures complied with the Declaration of Helsinki and its subsequent amendments. The Unnan City Hospital Clinical Ethics Committee approved the study protocol (No. 20,220,002). A grounded theory approach was employed for the health dialogue participants in rural communities. Health dialogues with family physicians were conducted once a month at rural community centers. The dialogues and focus group interviews were recorded and coded to investigate changes in participants’ perceptions and behaviors regarding HSBs.

Results

Twenty-one dialogues were conducted in two rural community centers, with a total of 112 participants. The average age of the participants was 70.2 years (standard deviation = 5.4), with 24% being males. Analysis of the grounded theory approach revealed four themes, namely joy-driven dialogue driving the realization of HSBs, reflection on personal HSBs through learning from others, revising HSBs based on rural social resources, and familiarity with physicians, hence motivating safe and secure HSBs.

Conclusions

Mitigation of barriers between citizens and medical professionals and improvement of psychological safety in communities can drive effective HSBs in rural communities.
Clinical characteristics of tuberculous meningitis in older patients compared with younger and middle-aged patients: a retrospective analysis
Authors: Zhu Xiaolin , He Na , Tong Le , Gu Zhi Han , Li Hong
Published: October 2023

Background

Few studies have analyzed the clinical characteristics and adverse factors affecting prognosis in older patients with tuberculous meningitis (TBM). This study aimed to compare the clinical characteristics of TBM in older patients with those in younger and middle-aged patients.

Methods

This single-center retrospective study extracted data on the clinical features, cerebrospinal fluid changes, laboratory results, imaging features, and outcomes of patients with TBM from patient medical records and compared the findings in older patients (aged 60 years and older) with those of younger and middle-aged patients (aged 18–59 years).

Results

The study included 197 patients with TBM, comprising 21 older patients aged 60–76 years at onset, and 176 younger and middle-aged patients aged 18–59 years at onset. Fever was common in both older (81%) and younger and middle-aged patients (79%). Compared with younger and middle-aged patients, older patients were more likely to have changes in awareness levels (67% vs. 40%), peripheral nerve dysfunction (57% vs. 29%), changes in cognitive function (48% vs. 20%), and focal seizures (33% vs. 6%), and less likely to have headache (71% vs. 93%), neck stiffness on meningeal stimulation (38% vs. 62%), and vomiting (47% vs. 68%). The Medical Research Council staging on admission of older patients was stage II (52%) and stage III (38%), whereas most younger and middle-aged patients had stage I (33%) and stage II (55%) disease. Neurological function evaluated on the 28th day of hospitalization was more likely to show poor prognosis in older patients than in younger and middle-aged patients (76% vs. 25%). Older patients had significantly higher red blood cell counts and blood glucose levels, and significantly lower serum albumin and sodium levels than those in younger and middle-aged patients. The cerebrospinal fluid protein levels, nucleated cell counts, glucose levels, and chloride levels did not differ significantly by age.

Conclusion

In patients with TBM, older patients have more severe clinical manifestations, a higher incidence of hydrocephalus and cerebral infarction, and longer hospital stays than younger and middle-aged patients. Older patients thus require special clinical attention.
Directional versus ring-mode deep brain stimulation for Parkinson’s disease: protocol of a multi-centre double-blind randomised crossover trial
Authors: Brinke Timo R. ten , Jergas Hannah , Sisodia Vibuthi , Barbe Michael T. , Odekerken Vincent J. J. , Verbaan Dagmar , Dijk Joke M. , Bot Maarten , Beudel Martijn , van den Munckhof Pepijn , Schuurman P. Rick , de Bie Rob M. A.
Published: October 2023

Background

The effectiveness of Deep Brain Stimulation (DBS) therapy for Parkinson’s disease can be limited by side-effects caused by electrical current spillover into structures adjacent to the target area. The objective of the STEEred versus RING-mode DBS for Parkinson’s disease (STEERING) study is to investigate if directional DBS for Parkinson’s disease results in a better clinical outcome when compared to ring-mode DBS.

Methods

The STEERING study is a prospective multi-centre double-blind randomised crossover trial. Inclusion criteria are Parkinson’s disease, subthalamic nucleus DBS in a ‘classic’ ring-mode setting for a minimum of six months, and optimal ring-mode settings have been established. Participants are categorised into one of two subgroups according to their clinical response to the ring-mode settings as ‘responders’ (i.e., patient with a satisfactory effect of ring-mode DBS) or ‘non-responder’ (i.e., patient with a non-satisfactory effect of ring-mode DBS). A total of 64 responders and 38 non-responders will be included (total 102 patients). After an optimisation period in which an optimal directional setting is found, participants are randomised to first receive ring-mode DBS for 56 days (range 28–66) followed by directional DBS for 56 days (28–66) or vice-versa. The primary outcome is the difference between ring-mode DBS and directional DBS settings on the Movement Disorders Society Unified Parkinson’s Disease Rating Scale – Motor Evaluation (MDS-UPDRS-ME) in the off-medication state. Secondary outcome measures consist of MDS-UPDRS-ME in the on-medication state, MDS-UPDRS Activities of Daily Living, MDS-UPDRS Motor Complications–Dyskinesia, disease related quality of life measured with the Parkinson’s Disease Questionnaire 39, stimulation-induced side-effects, antiparkinsonian medication use, and DBS-parameters. Participants’ therapy preference is measured at the end of the study. Outcomes will be analysed for both responder and non-responder groups, as well as for both groups pooled together.

Discussion

The STEERING trial will provide insights into whether or not directional DBS should be standardly used in all Parkinson’s disease DBS patients or if directional DBS should only be used in a case-based approach.

Trial registration

This trial was registered on the Netherlands Trial Register, as trial NL6508 (NTR6696) on June 23, 2017.
An evaluation of cervical maturity for Chinese women with labor induction by machine learning and ultrasound images
Authors: Liu Yan-Song , Lu Shan , Wang Hong-Bo , Hou Zheng , Zhang Chun-Yu , Chong Yi-Wen , Wang Shuai , Tang Wen-Zhong , Qu Xiao-Lei , Zhang Yan
Published: October 2023

Background

To evaluate the improvement of evaluation accuracy of cervical maturity for Chinese women with labor induction by adding objective ultrasound data and machine learning models to the existing traditional Bishop method.

Methods

The machine learning model was trained and tested using 101 sets of data from pregnant women who were examined and had their delivery in Peking University Third Hospital in between December 2019 and January 2021. The inputs of the model included cervical length, Bishop score, angle, age, induced labor time, measurement time (MT), measurement time to induced labor time (MTILT), method of induced labor, and primiparity/multiparity. The output of the model is the predicted time from induced labor to labor. Our experiments analyzed the effectiveness of three machine learning models: XGBoost, CatBoost and RF(Random forest). we consider the root-mean-squared error (RMSE) and the mean absolute error (MAE) as the criterion to evaluate the accuracy of the model. Difference was compared using t-test on RMSE between the machine learning model and the traditional Bishop score.

Results

The mean absolute error of the prediction result of Bishop scoring method was 19.45 h, and the RMSE was 24.56 h. The prediction error of machine learning model was lower than the Bishop score method. Among the three machine learning models, the MAE of the model with the best prediction effect was 13.49 h and the RMSE was 16.98 h. After selection of feature the prediction accuracy of the XGBoost and RF was slightly improved. After feature selection and artificially removing the Bishop score, the prediction accuracy of the three models decreased slightly. The best model was XGBoost (p = 0.0017). The p-value of the other two models was < 0.01.

Conclusion

In the evaluation of cervical maturity, the results of machine learning method are more objective and significantly accurate compared with the traditional Bishop scoring method. The machine learning method is a better predictor of cervical maturity than the traditional Bishop method.
Patients’ experiences with coercive mental health treatment in Flexible Assertive Community Treatment: a qualitative study
Authors: Brekke Eva , Clausen Hanne , Brodahl Morten , Landheim Anne S.
Published: October 2023

Background

Flexible Assertive Community Treatment (FACT) teams have been implemented in Norwegian health and social services over the last years, partly aiming to reduce coercive mental health treatment. We need knowledge about how service users experience coercion within the FACT context. The aim of this paper is to explore service user experiences of coercive mental health treatment in the context of FACT and other treatment contexts they have experienced. Are experiences of coercion different in FACT than in other treatment contexts? If this is the case, which elements of FACT lead to a different experience?

Method

Within a participatory approach, 24 qualitative interviews with service users in five different FACT teams were analyzed with thematic analysis.

Results

Participants described negative experiences with formal and informal coercion. Three patterns of experiences with coercion in FACT were identified: FACT as clearly a change for the better, making the best of FACT, and finding that coercion is just as bad in FACT as it was before. Safety, improved quality of treatment, and increased participation were described as mechanisms that can prevent coercion.

Conclusion

Results from this study support the argument that coercion is at odds with human rights and therefore should be avoided as far as possible. Results suggest that elements of the FACT model may prevent the use of coercion by promoting safety, improved quality of treatment and increased participation.
Tobacco retailer density and smoking behaviour: how are exposure and outcome measures classified? A systematic review
Authors: Baker John , Lenz Katrin , Masood Mohd , Rahman Muhammad Aziz , Begg Stephen
Published: October 2023

Introduction

To date only a limited number of reviews have focused on how exposure and outcome measures are defined in the existing literature on associations between tobacco retailer density (‘density’) and smoking behaviour (‘smoking’). Therefore this systematic review classified and summarised how both density and smoking variables are operationalised in the existing literature, and provides several methodological recommendations for future density and smoking research.

Methods

Two literature searches between March and April 2018 and April 2022 were conducted across 10 databases. Inclusion and exclusion criteria were developed and keyword database searches were undertaken. Studies were imported into Covidence. Cross-sectional studies that met the inclusion criteria were extracted and a quality assessment was undertaken. Studies were categorised according to the density measure used, and smoking was re-categorised using a modified classification tool.

Results

Large heterogeneity was found in the operationalisation of both measures in the 47 studies included for analysis. Density was most commonly measured directly from geocoded locations using circular buffers at various distances (n = 14). After smoking was reclassified using a smoking classification tool, past-month smoking was the most common smoking type reported (n = 26).

Conclusions

It is recommended that density is measured through length-distance and travel time using the street network and weighted (e.g. by the size of an area), or by using Kernel Density Estimates as these methods provide a more accurate measure of geographical to tobacco and e-cigarette retailer density. The consistent application of a smoking measures classification tool, such as the one developed for this systematic review, would enable better comparisons between studies. Future research should measure exposure and outcome measures in a way that makes them comparable with other studies.

Implications

This systematic review provides a strong case for improving data collection and analysis methodologies in studies assessing tobacco retailer density and smoking behaviour to ensure that both exposure and outcome measures are clearly defined and captured. As large heterogeneity was found in the operationalisation of both density and smoking behaviour measures in the studies included for analysis, there is a need for future studies to capture, measure and classify exposure measures accurately, and to define outcome measures in a manner that makes them comparable with other studies.
Can 3D imaging modeling recognize functional tissue and predict liver failure? A retrospective study based on 3D modelling of the major hepatectomies after hepatic modulation
Authors: Vicente Emilio , Quijano Yolanda , Duran Hipolito , Diaz Eduardo , Fabra Isabel , Malave Luis , Ruiz Pablo , Pizzuti Giada , Naldini Chiara , De Nobili Giovanni , Caruso Riccardo , Ferri Valentina
Published: October 2023

Background

Thanks to the introduction of radiomics, 3d reconstruction can be able to analyse tissues and recognise true hypertrophy from non-functioning tissue in patients treated with major hepatectomies with hepatic modulation.The aim of this study is to evaluate the performance of 3D Imaging Modelling in predict liver failure.

Methods

Patients submitted to major hepatectomies after hepatic modulation at Sanchinarro University Hospital from May 2015 to October 2019 were analysed.

Three-dimensional reconstruction was realised before and after surgical treatment. The volumetry of Future Liver Remnant was calculated, distinguishing in Functional Future Liver Remnant (FRFx) i.e. true hypertrophy tissue and Anatomic Future Liver Remnant (FRL) i.e. hypertrophy plus no functional tissue (oedema/congestion) These volumes were analysed in patients with and without post hepatic liver failure.

Results

Twenty-four procedures were realised (11 ALPPS and 13 PVE followed by major hepatectomy). Post hepatic liver failure grade B and C occurred in 6 patients. The ROC curve showed a better AUC for FRFxV (74%) with respect to FRLV (54%) in prediction PHLF > B. The increase of anatomical FRL (iFRL) was superior in the ALPPS group (120%) with respect to the PVE group (73%) (p = 0,041), while the increase of functional FRFX (iFRFx) was 35% in the ALLPS group and 46% in the PVE group (p > 0,05), showing no difference in the two groups.

Conclusion

The 3D reconstruction model can allow optimal surgical planning, and through the use of specific algorithms, can contribute to differential functioning liver parenchyma of the FLR.
Nurses and doctors ‘s awareness and knowledge towards treatment and care of cervical cancer patients: a cross-sectional study
Authors: Li Zhen , Chen Sinuo , Mahjabeen Ishrat , Shafique Rabia
Published: October 2023

Aim

The present study aimed to investigate healthcare professionals’ perceptions and experiences in caring for cervical cancer patients. The present study was also designed to assess the healthcare professionals’ attitudes toward cervical cancer screening and its prevention.

Methods

A cross-sectional quantitative descriptive study was conducted, and 540 participants (240 nurses and 300 doctors), from different hospitals of Pakistan have been selected and interviewed.

Results

Data was collected using structured questionnaires and SPSS was used to statistically analyze the data. Participants in the present study are questioned with respect to age, gender, and work experience. The mean age of the participants is 35 years. Among them, 41% of participants are < 35 years of age and 59% are > 35 years of age. In the case of gender, 22% of participants are males and 78% are females. 47% of the participants have work experience < 20 years and 53% have work experience > 20 years. Data from the present study showed that most of the nurses are less educated (basic education of middle and matric degree) with a simple diploma in nursing and midwifery. Nurses and doctors do not have any knowledge/experience of the patient’s psychological counselling. Participants are also questioned with respect to HPV vaccination, 39% of nurses and 62% of doctors are vaccinated. The difference in vaccination frequency of participants was observed as statistically significant (p < 0.0001). In the case of treatment modalities, doctors have statistically more knowledge about the pap smear (p < 0.0001), cervical biopsy (p < 0.0001), colposcopy (p < 0.0001), and visual application after acetic acid application (p < 0.0001) compared to nurses. Data analysis showed that Pap smear was performed significantly higher in married females compared to unmarried (p < 0.0001).

Conclusion

our study provides a comprehensive and in-depth perspective of the nurses and doctors for cervical cancer patients. Cervical cancer prevalence is increasing due to inadequate knowledge and awareness among healthcare professionals. Improvement can be brought about by the regular use of treatment modalities in unmarried females also.
Job stressors and burnout among clinical nurses: a moderated mediation model of need for recovery and career calling
Authors: Jin Tingting , Zhou Yaoying , Zhang Leigang
Published: October 2023

Background

Burnout is a major concern in healthcare professions. Although theory and empirical evidence support the relationship between job stressors and burnout, the question remains how and when the job stressors are related to burnout. Based on conservation of resources theory and effort recovery model, the current study aimed to provide a deeper understanding of the effect of job stressors on burnout by investigating the mediating role of need for recovery and the moderating role of career calling.

Methods

A cross-sectional online survey was conducted among 709 nurses enrolled from eight public hospitals in China. The Work Stressors Scale, Psychological Detachment Scale, Brief Calling Scale, and Maslach Burnout Inventory were used to collect data. Hierarchical regression analysis with bootstrapping procedure was performed to test the proposed model.

Results

The results showed that need for recovery mediated the job stressors-burnout relationship, and that high career calling buffered against the relationships between job stressors and need for recovery and burnout. Furthermore, the result revealed a moderated mediation model that career calling buffered the indirect effect of job stressors on burnout through need for recovery.

Conclusions

Our findings suggest that environmental demands and personal resource are important antecedents of nurses’ burnout. Career calling as personal resources can serve as a protective factor that guards against burnout. Thus, nursing managers can reduce nurse burnout by focusing on effective strategies related to recovery experiences, as well as investing in training career calling.
Intra-aortic band impairs transapical device implantation in a pig: a case report
Authors: Meissner Florian , Costa Galbas Michelle , Dinkelaker Johannes , Schmitz Heidi Cristina , Straky Hendrik , Reuter Johanna , Czerny Martin , Bothe Wolfgang
Published: October 2023

Background

Anatomic anomalies in the ascending aorta may impair the implantation and testing of cardiovascular devices in humans and animal models.

Case presentation

We present the rare case of an intra-aortic band in a German Landrace pig. During terminal animal testing, the band hindered the implantation of a left ventricular assist device (LVAD) with transventricular outflow graft across the aortic valve. After lower partial sternotomy, epicardial echocardiography displayed an intraluminal echogenic structure at the sinotubular junction causing unspecific flow turbulences. Under cardiopulmonary bypass, coring of the left ventricular apex was performed. Due to strong resistance in the proximal aorta, accurate positioning of the transventricular LVAD outflow graft was impossible. After euthanasia, necropsy revealed a fibrous band located at the sinotubular junction, dividing the lumen of the ascending aorta.

Conclusions

The occurrence of an intra-aortic band represents an extremely rare case of a most likely congenital anomaly. Awareness of such anomalies is important for planning and performing animal testing. Perioperative echocardiography may help to either remove such anomalies or allow discontinuing the procedure prior to device implantation.
Exploring the global immune landscape of peripheral blood mononuclear cells in H5N6-infected patient with single-cell transcriptomics
Authors: Gao Jiamin , Wei Jing , Qin Simei , Liu Sheng , Mo Shuangyan , Long Qian , Tan Shiji , Lu Ning , Xie Zhouhua , Lin Jianyan
Published: October 2023

Background

Avian influenza viruses (AIV), particularly H5N6, have risen in infection frequency, prompting major concerns. Single-cell RNA sequencing (scRNA-seq) can illustrate the immune cell landscape present in the peripheral circulation of influenza H5N6-infected individuals at the single-cell level. This study attempted to employ scRNA-seq technology to map the potentially hidden single cell landscape of influenza H5N6.

Methods

High-quality transcriptomes were generated from scRNA-seq data of peripheral blood mononuclear cells (PBMCs), which were taken from a critically-ill child diagnosed with H5N6 avian influenza infection and one healthy control donor. Cluster analysis was then performed on the scRNA-seq data to identify the different cell types. The pathways, pseudotime developmental trajectories and gene regulatory networks involved in different cell subpopulations were also explored.

Results

In total, 3,248 single cell transcriptomes were captured by scRNA-seq from PBMC of the child infected with H5N6 avian influenza and the healthy control donor and further identified seven immune microenvironment cell types. In addition, a subsequent subpopulation analysis of innate lymphoid cells (ILC) and CD4+ T cells revealed that subpopulations of ILC and CD4+ T cells were involved in cytokine and inflammation-related pathways and had significant involvement in the biological processes of oxidative stress and cell death.

Conclusion

In conclusion, characterizing the overall immune cell composition of H5N6-infected individuals by assessing the immune cell landscape in the peripheral circulation of H5N6 avian influenza-infected and healthy control donors at single-cell resolution provides key information for understanding H5N6 pathogenesis.
Critical roles of airway smooth muscle in mediating deep-inspiration-induced bronchodilation: a big stretch?
Authors: Yasuda Yuto , Wang Lu , Chitano Pasquale , Seow Chun Y.
Published: October 2023

Background

Deep inspiration (DI) has been shown to induce bronchodilation and bronchoprotection in bronchochallenged healthy subjects, but not in asthmatics. Strain-induced relaxation of airway smooth muscle (ASM) is considered one of the factors responsible for these effects. Other factors include the release or redistribution of pulmonary surfactant, alteration in mucus plugs, and changes in airway heterogeneity.

Main body

The present review is focused on the DI effect on ASM function, based on recent findings from ex vivo sheep lung experiments showing a large change in airway diameter during a DI. The amount of stretch on the airways, when applied to isolated airway rings in vitro, caused a substantial decrease in ASM contractility that takes many minutes to recover. When challenged with a bronchoconstrictor, the increase in pulmonary resistance in the ex vivo ovine lungs is mostly due to the increase in airway resistance.

Conclusions

Although non-ASM related factors cannot be excluded, the large strain on the airways associated with a DI substantially reduces ASM contractility and thus can account for most of the bronchodilatory and bronchoprotective effects of DI.
Transgenerational inheritance of adrenal steroidogenesis inhibition induced by prenatal dexamethasone exposure and its intrauterine mechanism
Authors: He Zheng , Zhang Jinzhi , Chen Yawen , Ai Can , Gong Xiaohan , Xu Dan , Wang Hui
Published: October 2023

Background

Adrenal gland is the synthesis and secretion organ of glucocorticoid, which is crucial to fetal development and postnatal fate. Recently, we found that prenatal dexamethasone exposure (PDE) could cause adrenal dysfunction in offspring rats, but its multigenerational genetic effects and related mechanisms have not been reported.

Methods

The PDE rat model was established, and female filial generation 1 (F1) rats mate with wild males to produce the F2, the same way for the F3. Three generation rats were sacrificed for the related detection. SW-13 cells were used to clarify the epigenetic molecular mechanism.

Results

This study confirmed that PDE could activate fetal adrenal glucocorticoid receptor (GR). The activated GR, on the one hand, up-regulated Let-7b (in human cells) to inhibit steroidogenic acute regulatory protein (StAR) expression directly; on the other hand, down-regulated CCCTC binding factor (CTCF) and up-regulated DNA methyltransferase 3a/3b (Dnmt3a/3b), resulting in H19 hypermethylation and low expression. The decreased interaction of H19 and let-7 can further inhibit adrenal steroidogenesis. Additionally, oocytes transmitted the expression change of H19/let-7c axis to the next generation rats. Due to its genetic stability, F2 generation oocytes indirectly exposed to dexamethasone also inhibited H19 expression, which could be inherited to the F3 generation.

Conclusions

This cascade effect of CTCF/H19/Let-7c ultimately resulted in the transgenerational inheritance of adrenal steroidogenesis inhibition of PDE offspring. This study deepens the understanding of the intrauterine origin of adrenal developmental toxicity, and it will provide evidence for the systematic analysis of the transgenerational inheritance effect of acquired traits induced by PDE.
Macrophages release IL11-containing filopodial tip vesicles and contribute to renal interstitial inflammation
Authors: Zhu Xiaodong , Zhao Yu , Liu Yuqiu , Shi Wen , Yang Junlan , Liu Zhihong , Zhang Xiaoliang
Published: October 2023

Macrophage filopodia, which are dynamic nanotube-like protrusions, have mainly been studied in the context of pathogen clearance. The mechanisms by which they facilitate intercellular communication and mediate tissue inflammation remain poorly understood. Here, we show that macrophage filopodia produce a unique membrane structure called “filopodial tip vesicle” (FTV) that originate from the tip of macrophages filopodia. Filopodia tip-derived particles contain numerous internal-vesicles and function as cargo storage depots via nanotubular transport. Functional studies indicate that the shedding of FTV from filopodia tip allows the delivery of many molecular signalling molecules to fibroblasts. We observed that FTV derived from M1 macrophages and high glucose (HG)-stimulated macrophages (HG/M1-ftv) exhibit an enrichment of the chemokine IL11, which is critical for fibroblast transdifferentiation. HG/M1-ftv induce renal interstitial fibrosis in diabetic mice, while FTV inhibition or targeting FTV IL11- alleviates renal interstitial fibrosis, suggesting that the HG/M1-ftvIL11 pathway may be a novel mechanism underlying renal fibrosis in diabetic nephropathy. Collectively, FTV release could represent a novel function by which filopodia contribute to cell biological processes, and FTV is potentially associated with macrophage filopodia-related fibrotic diseases.
Circular RNA-FK501 binding protein 51 boosts bone marrow mesenchymal stem cell proliferation and osteogenic differentiation via modulating microRNA-205-5p/Runt-associated transcription factor 2 axis
Authors: Shen Yingchao , Jiang Bo , Luo Bin , Jiang Xiaowei , Zhang Yang , Wang Qiang
Published: October 2023

Objective

Osteogenesis is the key process of bone homeostasis differentiation. Numerous studies have manifested that circular RNA (circRNA) is a critical regulator of osteogenesis. The research was to explore circRNA-mediated mechanisms in osteogenesis.

Methods

Bone marrow mesenchymal stem cells (BMSCs) were cultured and induced to osteogenic differentiation (OD). Then, oe-circ-FKBP5, oe-NC, si-circ-FKBP5, si-NC, miR-205-5p mimic, mimic NC, miR-205-5p inhibitor, inhibitor NC, sh-RUNX2, or sh-NC were transfected into BMSCs. Alkaline phosphatase (ALP) activity was detected by ALP staining, cell mineralization was detected by alizarin red staining, cell proliferation was detected by CCK-8, and cell apoptosis was detected by flow cytometry. Then, the expression of circ-FKBP5, miR-205-5p, RUNX2 and osteogenic marker genes was detected by RT-qPCR, and the expression of RUNX2 protein was detected by Western blot. Finally, the targeting relationship between miR-205-5p and circ-FKBP5 or RUNX2 was verified by bioinformation website analysis and dual luciferase reporter gene detection.

Results

Circ-FK501 binding protein 51 (FKBP5) was distinctly elevated during OD of BMSCs. Elevated circ-FKBP5 boosted the proliferation and OD, as well as expression of osteogenic marker genes while reduced apoptosis of BMSCs. Down-regulation of circ-FKBP5 inhibited BMSCs proliferation, OD and osteogenic marker gene expression, and promoted apoptosis of BMSCs. Subsequently, circ-FKBP5 combined with miR-205-5p and constrained miR-205-5p expression. Silenced miR-205-5p boosted proliferation, OD, and expression of osteogenic marker genes and suppressed apoptosis of BMSCs. However, up-regulation of miR-205-5p inhibited BMSC proliferation, OD and osteogenic marker gene expression, and promoted apoptosis. Additionally, miR-205-5p targeted Runt-associated transcription factor 2 (RUNX2). Repression of RUNX2 turned around the effect of circ-FKBP5 overexpression on BMSCs.

Conclusion

In brief, circ-FKBP5 boosted BMSC proliferation and OD by mediating the miR-205-5p/RUNX2 axis.