bluuebunny/crossref_metadata_2025 huggingface dataset:
Life-Threatening Severe Thrombocytopenia and Mild Autoimmune Hemolytic Anemia Associated with Brucellosis
Authors: Ahmed Waleed Amsaib M. , Ahmed Khalil Khalid , Azwari Asma , Ebid Gamal T. A. , Nazir Imran , Aly Mohamed Hassan
Published: January 2023

Methods. We report the case of a 73-year-old Saudi female who presented with severe thrombocytopenia and mild autoimmune hemolytic anemia associated with brucellosis. The coexistence of published cases of two hematological disorders with brucellosis is rare. Results. Despite the initial treatment with eltrombopag and intravenous immunoglobulin (IVIG), our patient’s platelets count remained low and significantly improved after initiation of brucellosis treatment in the form of rifampicin and doxycycline. Discussion. We conclude by reviewing the case that in many parts of Saudi Arabia, brucellosis remains a prevalent infection. Hence, it should be considered as a possible diagnosis in febrile individuals with no localizing indications and the presence of severe thrombocytopenia in acute febrile illness. Although it is a rare association, it could be related to brucellosis. Conclusion. This is our region’s first published case of severe thrombocytopenia and mild autoimmune hemolytic anemia associated with brucellosis. It contributes to the literature on the successful use of rifampicin and doxycycline to treat hematological disorders associated with brucellosis.
Fisetin Ameliorates Diabetic Nephropathy‐Induced Podocyte Injury by Modulating Nrf2/HO‐1/GPX4 Signaling Pathway
Authors: Qian Xiaojing , Lin Shan , Li Ji , Jia ChengLin , Luo Yun , Fan Rui , Hu Cheng , Chen Ying
Published: January 2023

Diabetic nephropathy (DN) is one of the most severe microvascular complications of diabetes and has become the leading cause of end‐stage renal disease formation. The pathogenesis of diabetic nephropathy is very complex and is still not fully understood. Fisetin is a flavonoid polyphenolic compound that is widely found in different fruits, vegetables, and medicinal plants. Many studies have indicated that it has a variety of pharmacological activities. In this study, we investigated the mechanism of action of fisetin in the protection of DN‐induced podocyte injury both in vivo and in vitro. Results showed that fisetin could reduce high glucose (HG)‐induced podocyte injury and streptozotocin (STZ)‐induced diabetic nephropathy in mice. According to the histopathological staining results, fisetin ameliorated DN‐induced glomerular injury in a dose‐dependent manner. Western blot and immunofluorescence results showed that fisetin effectively promoted the expression of podocyte functional integrity marker proteins and inhibited the expression of podocyte injury marker proteins. In addition, according to the Western blot and RT‐qPCR results, fisetin activates the nuclear translocation of Nrf2 to exert antioxidative stress ability and affects the expression of downstream antioxidant enzymes HO‐1, GPX4, and other ferroptosis‐related markers, thereby protecting against HG‐induced podocyte ferroptosis and oxidative stress injury in DN mice. In summary, this study demonstrated that fisetin could enhance the antioxidative stress capacity of DN mice by promoting the activation of the Nrf2/HO‐1/GPX4 signaling pathway in renal tissues, and attenuated HG‐induced podocytes injury and STZ‐induced DN in mice.
Antihelminthic Activity of Lophira Lanceolata on Heligmosomoides polygyrus Using an Automated High-Throughput Method
Authors: Cédric Yamssi , Christelle Nadia Noumedem Anangmo , Sylvain Raoul Simeni Njonnou , Berinyuy Samuel , Azizi Mounvera Abdel , Jemimah Sandra Tientcheu Noutong , Aboubakar Sidiki Ngouyamsa Nsapkain , Payne Vincent Khan
Published: January 2023

Background. There are about 13 parasitic infections that are responsible for significant morbidity and mortality but have not received the attention they deserve; thus, they are now known as “neglected tropical diseases” (NTDs). This study was aimed at evaluating the antihelminthic activities of Lophira lanceolata using an automated high-throughput method. Methods. The antihelminthic activity effect of the extracts against H. polygyrus was determined using an automated high-throughput method. For the egg-hatching test, 100 μL of embryonated egg suspension (60 eggs) was added to 100 μL of various concentrations of extracts, levamisole, and 1.5% DMSO in a 96-well round-bottom microtitre plate. After mixing, the 96-well microplate was placed in WMicroTracker and incubated for 24 h at 25°C; the movements were recorded every 30 minutes. The same procedure was used for the larval motility assays, where 100 μL of L1 or L2 larvae (50 larvae) were put in contact with 100 μL of various concentrations of extracts. Results. The ovicidal activity (hatching) had an IC50 of 1.4 mg/mL for the ethanol extract. The aqueous and ethanol extracts of L. lanceolata showed larvicidal activity on the L1 larvae with IC50 of 1.85 mg/mL and 2.4 mg/mL, respectively, as well as on the L2 larvae with IC50 values of 1.08 mg/mL and 1.02 mg/mL for the aqueous and ethanol extracts, respectively. These results showed that the aqueous extract exhibited a stronger inhibitory power on the hatching rate of parasites than ethanol extracts, while the contrary effect was observed for the larval motility assays. Conclusion. This study provides scientific data on the use of L. lanceolata by the local population for the treatment of helminthiases. However, in vivo and toxicity tests are necessary to assess its activity and safety.
SWI/SNF Blockade Disrupts PU.1-Directed Enhancer Programs in Normal Hematopoietic Cells and Acute Myeloid Leukemia
Authors: Chambers Courtney , Cermakova Katerina , Chan Yuen San , Kurtz Kristen , Wohlan Katharina , Lewis Andrew Henry , Wang Christiana , Pham Anh , Dejmek Milan , Sala Michal , Loeza Cabrera Mario , Aguilar Rogelio , Nencka Radim , Lacorazza H. Daniel , Rau Rachel E. , Hodges H. Courtney
Published: January 2023

In acute myeloid leukemia (AML), SWI/SNF chromatin remodeling complexes sustain leukemic identity by driving high levels of MYC. Previous studies have implicated the hematopoietic transcription factor PU.1 (SPI1) as an important target of SWI/SNF inhibition, but PU.1 is widely regarded to have pioneer-like activity. As a result, many questions have remained regarding the interplay between PU.1 and SWI/SNF in AML as well as normal hematopoiesis. Here we found that PU.1 binds to most of its targets in a SWI/SNF-independent manner and recruits SWI/SNF to promote accessibility for other AML core regulatory factors, including RUNX1, LMO2, and MEIS1. SWI/SNF inhibition in AML cells reduced DNA accessibility and binding of these factors at PU.1 sites and redistributed PU.1 to promoters. Analysis of nontumor hematopoietic cells revealed that similar effects also impair PU.1-dependent B-cell and monocyte populations. Nevertheless, SWI/SNF inhibition induced profound therapeutic response in an immunocompetent AML mouse model as well as in primary human AML samples. In vivo, SWI/SNF inhibition promoted leukemic differentiation and reduced the leukemic stem cell burden in bone marrow but also induced leukopenia. These results reveal a variable therapeutic window for SWI/SNF blockade in AML and highlight important off-tumor effects of such therapies in immunocompetent settings.

Significance:

Disruption of PU.1-directed enhancer programs upon SWI/SNF inhibition causes differentiation of AML cells and induces leukopenia of PU.1-dependent B cells and monocytes, revealing the on- and off-tumor effects of SWI/SNF blockade.
COVID-19 and Lifestyle Changes: A Cross-Sectional Study at Primary Care Settings in Dubai
Authors: Al Sakkal Alia M.H.D. Waleed , AlFalasi Alia Juma , AlMehairi Mouza Khalifa Mohd Saeed , Mohamed Heba Ahmed Reda Hassan , Khan Jawad Ahmad , Dabbous Imad Saaid
Published: January 2023

Introduction: The first report on COVID-19 was in Wuhan, Hubei Province, China on December 31, 2019. COVID-19 was declared a pandemic by the World Health Organization on March 11, 2020. As a result of the COVID-19 pandemic, the world had to adopt certain modifications to hinder the transmission of the disease. These changes have affected patients’ sleeping, dietary, and lifestyle habits. Little research is conducted on these changes among patients presenting at primary healthcare settings following the pandemic. Therefore, we conducted this study to determine the self-reported changes in these habits in patients attending primary health care centers of Dubai both before and during the pandemic. Material and Methods: A cross-sectional study was conducted among patients attending primary health care centers in Dubai from November 2020 to August 2021. Patients filled out an online questionnaire that included items for sociodemographic characteristics and study outcomes. The outcomes included changes in sleeping, smoking, dietary, and sporting habits both before and during the pandemic. Data were further stratified by gender. Results: A total number of 385 patients participated in this study. Significant changes in sleeping habits both before and during the pandemic were observed among included patients (p = 0.004) which were consistent in female patients only (p = 0.025). Most patients were not smokers both before and during the pandemic (92.98% vs. 92.46%); however, no significant change was noted across male (p = 0.503) and female patients (p = 0.391). There was a positive change in sporting habits across both male (p = 0.005) and female patients (p = 0.001). The majority of patients reported no change in the number of daily meals eaten (50.13%) following the pandemic. Conclusion: Our study highlighted that sleeping habits among primary care patients were negatively affected during the pandemic as compared to before. However, there was a positive change in their sporting habits with no change in smoking. Additionally, no substantial change in dietary habits was noted. However, further research is needed to confirm our findings.
Effectiveness on the Use of Blended Learning Approach (BLA): Its Implications on the Students’ Performance
Authors: Vilo Anna Marie Ewican , Taha Hapifa Sakilan
Published: January 2023

The study was conducted to assess the effectiveness of Blended Learning Approach (BLA) and its implication on the students’ performance. The study utilized the descriptive-evaluative research design and it was conducted at Sultan Kudarat State University-Kalamansig Campus. Further, this study utilized simple random sampling to select the number of respondents. Twenty-three (23) teachers and twenty-nine (29) students during the 2nd semester, A.Y 2020-2021 were used as the respondents of the study. A researchers-made questionnaire was utilized to collect the data. The data were analysed using Statistical Package for the Social Sciences (SPSS) Software V21 x64. Statistical tools used were the frequency and percentages counts, mean, and grand mean. The Pearson-Product moment correlation coefficient was also utilized.

The level of effectiveness of blended learning approach was fairly effective as assessed by both teachers and students. The students’ performance was described as above average. Further, the effectiveness on the use of blended learning approach has a significant relationship with the students’ performance.

It is recommended that that the teachers’ expertise in using the said approach is indispensable. Thus, the SKSU-Kalamansig campus must maintain if not improve their performance in using the blended learning approach in various field of disciplines. Further, the institution must design a monitoring strategy relative on the use of blended learning approach for the sustainability of its effectiveness in developing students’ performance.
A Physical Explanation for Ocean Air–Water Warming Differences under CO2-Forced Warming
Authors: Richardson Mark T.
Published: January 2023

Modeled global warming is often quantified using global near-surface air temperature (Tas). Meanwhile, long-term temperature datasets combine observations of Tas over land with sea surface temperature (SST) over ocean. Modeled ocean Tas warms more than SST, which can bias model–observation comparisons. Skin temperature (Ts), which is typically warmer than Tas, follows SST changes so the ocean surface temperature discontinuity δTs = Ts − Tas decreases with warming. Here I show that under CO2 forcing, decreased δTs is consistently simulated for nonpolar ocean within ±60°S/N, but not for other regions. I investigate the causes of oceanic δTs decrease using a LongRunMIP climate simulation, radiative kernels, and standard methods for diagnosing forcing and feedbacks from the CMIP5 ensemble. CO2 forcing establishes longwave heating of the lower atmosphere and subsequent adjustments that result in a small Tas increase, and therefore a δTs decrease. During the subsequent warming in response to CO2 forcing, the model-mean surface evaporation feedback is 3.6 W m−2 °C−1 over oceans, which reduces Ts warming relative to Tas and further shrinks δTs. Present-day forcing and feedback contributions are of similar magnitude, and both contribute to small differences in model–observation comparisons of global warming rates when these differences are not accounted for.

Significance Statement

Earth’s surface skin temperature is generally warmer than that of the air just above, and this discontinuity drives upward turbulent heat fluxes. Under global warming, climate models consistently show that over oceans, the air above warms more than the water below. This causes issues when comparing model output and observational temperature records, since observational records blend land air and ocean water temperature. It also affects understanding of how surface energy and moisture fluxes will change with warming. Observational data are currently too uncertain to confidently support or refute this model behavior, and the IPCC recently noted that “there is no simple explanation based on physical grounds alone for how this difference responds to climate change.” This study provides such an explanation for changes over ocean, and shows that this result applies only to nonpolar oceans.
Loneliness and Death Anxiety: Differences Between Active and Bedridden Older Men
Authors: Khodabakhshi-Koolaee Anahita , Frouzan Fazel
Published: January 2023

Physical activity might be impact on death anxiety and loneliness in adult people. Accordingly, the present study examined loneliness and death anxiety in two groups of active and bedridden older men living in nursing homes in Yazd. This descriptive-analytical and cross-sectional study was conducted on older men living in nursing homes in Yazd, Iran. The participants were 148 older men who were randomly selected. The instruments used to collect the data were the Social and Emotional Loneliness Scale for Adults (SELSA-S) and the Death Anxiety Scale One-way ANOVA was also used. The findings indicated the active older men scored lower in loneliness and death compared to the bedridden older men. Loneliness and death anxiety are important psychological components that are more common in inactive older than their active counterparts. Therefore, physical activity in old age can improve older adults’ quality of life.
Role of achievement value, teachers’ autonomy support, and teachers’ academic pressure in promoting academic engagement among high school seniors
Authors: Lee Taerim , Hong So E. , Kang Jieun , Lee Sang M.
Published: January 2023

This study investigated the effects of individual and contextual factors (students and classrooms) on academic engagement by adopting an analytical approach based on hierarchical linear modeling. The participants in this study included 906 high school students (42.7% male) from 42 classrooms in South Korea. We established that achievement value and teachers’ autonomy support had a statistically significant positive impact on academic engagement at both the student and classroom levels. However, teachers’ academic pressure had a positive impact on academic engagement only at the classroom level. Cross-level interaction effects between the student and classroom levels, achievement value (LV 1) and autonomy support (LV 2), teachers’ academic pressure (LV1) and achievement value (LV 2), and those on teachers’ academic pressure at both levels were also identified.
Class, union membership, and organizational commitment: A multilevel analysis of 28 countries
Authors: Pérez Ahumada Pablo
Published: January 2023

This article studies how organizational commitment is shaped by individual and macro-level factors. Drawing upon data from the 2015 International Social Survey Program (ISSP) and using multilevel modeling, the article shows that workers have less organizational commitment than employers. The article also presents evidence indicating that strong trade unions are positively correlated with organizational commitment. Finally, contrary to the hypothesis derived from previous studies, cross-level interactions suggest that in countries with strong corporatist industrial relations (IR) institutions, union members have lower levels of organizational commitment than non-union members. The article discusses how the findings contribute to the literature on class, neo-corporatism, and power resources. In addition, it reflects on how the findings contribute to the recent debate on the ‘neoliberal convergence’ of IR systems.
Texting or face-to-face for support-seeking in romantic relationships: The role of affordances and attachment
Authors: Chen Y. Anthony , Lu Runzhi Mary
Published: January 2023

Support-seeking, a critical and strategic function of close relationships, is increasingly practiced via texting. Guided by attachment theory and an affordance-centric approach, this study investigated to what extent individuals in a romantic relationship would use texting and face-to-face for support-seeking, and what stimulates their interest in mediated support-seeking. A survey of college students in exclusive romantic relationships ( N = 211) found that several affordances (i.e., accessibility, the availability of social cues, and conversation control) were associated with varying levels of interest in texting or face-to-face for support-seeking. Both accessibility and the availability of social cues were perceived as less important by avoidant individuals, which was related to a lack of interest in texting and face-to-face interactions for support-seeking. Anxious individuals valued the availability of social cues more, which led to a greater interest in face-to-face interactions when seeking assistance. These findings contribute to a better understanding of support-seeking behavior in today’s mediated world.
Assessing Capture Risks in the Regulatory Mechanism: Insights from Kenya’s Regulation of Professionals in the Construction Labour Market
Authors: K’Akumu O. A.
Published: January 2023

The article draws academic attention to capture risks in the regulatory statutes that may lead to capture by regulators. It takes a practical outlook of Kenya for empirical demonstration of the statute-based capture risks. The article uses the Regulatory Impact Assessment (RIA) framework to identify the risk factors in the regulatory environment for professions involved in real estate development, that is, architects, engineers and quantity surveyors. The OECD Reference Checklist for Regulatory Decision-making is used as a reference point in identifying risk analysis as a candidate of inclusion in the checklist for purposes of improvement in regulatory outcomes. Document analysis is used to make observations on the statutes and generate data for qualitative analysis and interpretation. Capture risks are identified in terms of composition of regulatory boards that include powerful public servants. Exclusion of relevant stakeholders in the regulation of professions, inclusion of extraprofessional regulations and uncontrolled legislative powers are other sources of risk of regulatory capture. The article gives central focus to the capture by regulators. Existing regulatory capture literature predominantly consider regulatory capture by private or special interest groups.
Words that hurt: Why mental health stigma is often vilification, and requires legal protection
Authors: Katterl Simon
Published: January 2023

Despite a series of education programs and initiatives, mental health stigma persists across the community. This is due, in part, to the law’s silence on whether mental health stigma should be considered vilification. This article analyses current Australian anti-discrimination and anti-vilification protections, finding that the latter needs enhancing to include protections against mental health vilification.
Long Hallucal Tendon Force Vectors and First Metatarsophalangeal Deformity After Hallux Valgus Surgery
Authors: Kim Minsoo , Lee Ho Seong , Choi Young Rak , Kim Jeongho , Chee Choong Guen , Hong Sang Hyup
Published: January 2023

Background:

Recurrence is one of the most common complications following hallux valgus surgery. Moreover, hallux varus occurs in cases of overcorrection. We aimed to quantitatively measure, using radiographic examination, the dynamics of the soft tissues that act on deformities (recurrence of valgus and occurrence of varus) after the surgery.

Methods:

This retrospective single-institution study included 60 patients (98 feet) who underwent hallux valgus surgery between 2009 and 2018. According to radiographic findings of the foot under weightbearing conditions at postoperative month 1, we examined the tendons’ pathway and calculated the forces on the first metatarsophalangeal joint, which we termed the deformity force angle (DFA). We compared whether there was a significant difference in DFAs between the groups in which deformities occurred and those in which deformities did not occur after correction. In addition, the DFA was compared to known radiographic measurements of hallux valgus recurrence (hallux valgus angle, distal metatarsal articular angle, intermetatarsal angle, and sesamoid position) to assess association with recurrence.

Results:

We observed a significant difference in the DFA between patients with and without hallux valgus recurrence ( P < .001) and between those with and without hallux varus ( P < .001) based on standing radiographs taken at a minimum of 6 months postoperation. For predicting the deformities, the areas under the curve were 0.863 (hallux valgus recurrence) and 0.831 (hallux varus occurrence), respectively, which was greater than other factors evaluated. The DFA values greater than 9.5 degrees and less than 5.5 degrees were associated with the recurrence of valgus and occurrence of varus, respectively.

Conclusion:

In our study, DFA was associated with hallux valgus recurrence when it exceeded 9.5 degrees and hallux varus when it was less than 5.5 degrees. Moreover, in the hallux valgus surgery we performed, a DFA from 5.5 to 9.5 degrees appeared to be a “safe zone” for preventing early deformity after surgery.

Level of Evidence:

Level III, prognostic.
Reshaping the Battlefield: The International Committee of the Red Cross, Video Games, and Public Relations
Authors: Fisher Jolene
Published: January 2023

Although the use of video games to achieve public relations (PR) goals is not new, there is limited extant research that analyzes such projects using PR theory or that takes into account organizations’ roles in their development. This study addresses this gap through an examination of the International Committee of the Red Cross's (ICRC) development of a creative mode called LifeRun within the global gaming phenomenon Fortnite. I argue that LifeRun must be analyzed as a strategic communication game and draw on critical PR theory to examine its use to reshape narratives of war in gaming. Using in-depth interviews, organizational documents, and media interviews, I analyze the organization's motivations and goals for developing LifeRun, the ways in which PR considerations shaped the project, and its implications for practical and scholarly work in this area.
Leflunomide-Induced Immune-Mediated Necrotizing Myopathy in a Patient With Rheumatoid Arthritis: A Case Report
Authors: Salazar Dylan Matthew , Damani Devanshi Narendra , Kositangool Piya , Ortiz Melina Jo , Lavezo Jonathan , Dihowm Fatma
Published: January 2023

Immune-mediated necrotizing myopathy (IMNM) is a subtype of inflammatory myopathy that is characterized by proximal muscle weakness, markedly elevated serum creatine kinase, myopathic electromyographic findings, and muscle biopsies revealing necrosis or regeneration with sparse inflammatory infiltrate. IMNM tends to be idiopathic but has been associated with certain medications. This supports the possibility for other pharmacotherapies to induce IMNM—particularly leflunomide. Leflunomide is used in the treatment for rheumatoid arthritis and has been shown to induce autoimmune diseases—including autoimmune hepatitis and polymyositis. After an extensive review of history and workup of muscle weakness, we conclude that leflunomide induced an IMNM in our patient. As this is the first case of leflunomide-induced IMNM, it is important for clinicians to suspect an inflammatory myopathy in the setting of myositis while on leflunomide.
Comparing the diagnostic performance of QuantiFERON-TB Gold Plus with QFT-GIT, T-SPOT.TB and TST: a systematic review and meta-analysis
Authors: Zhang Yu , Zhou Guozhong , Shi Wei , Shi Weili , Hu Meijun , Kong Defu , Long Rong , He Jian , Chen Nan
Published: January 2023

Background

QuantiFERON-TB Gold Plus (QFT-Plus) is an important test that has emerged in recent years for detecting TB infection. We conducted a review to compare the sensitivity, specificity and positive rate of QFT-Plus with that of QuantiFERON-TB Gold In-Tube (QFT-GIT), T-cell spot of tuberculosis assay (T-SPOT.TB) and Tuberculin test (TST).

Methods

PubMed and Embase were searched, without language restrictions, from 1 January 2015 to 31 March 2022 using “Mycobacterium tuberculosisInfections” and “QuantiFERON-TB-Plus” as search phrases. We estimated the sensitivity from studies of patients with active tuberculosis, specificity from studies of populations with very low risk of TB exposure, and positive rate from studies of high-risk populations. The methodological quality of the eligible studies was assessed, and a random-effects model meta-analysis was used to determine the risk difference (RD). We assessed the pooled rate by using a random-effects model. This study was registered in PROSPERO (CRD 42021267432).

Results

Of 3996 studies, 83 were eligible for full-text screening and 41 were included in the meta-analysis. In patients with active TB, the sensitivity of QFT-Plus was compared to that of QFT-GIT and T-SPOT.TB, respectively, and no statistically differences were found. In populations with a very low risk of TB exposure, the specificity of QFT-Plus was compared with that of QFT-GTI and T-SPOT.TB, respectively, and no statistically differences were found. Two studies were eligible to compare the specificity of the QFT-Plus test with that of the TST test, and the pooled RD was 0.12 (95% CI 0.02 to 0.22). In high-risk populations, 18 studies were eligible to compare the positive rate of the QFT-Plus test with that of the QFT-GIT test, and the pooled RD was 0.02 (95% CI 0.01 to 0.03). The positive rate of QFT-Plus was compared with that of T-SPOT.TB and TST groups, and no statistically differences were found.

Conclusions

The diagnostic performance of QFT-Plus was similar to that of QFT-GIT and T-SPOT.TB, but was slightly more specific than TST.
Experiences of family members when a parent is hospitalized for their mental illness: a qualitative systematic review
Authors: Reupert Andrea , Tchernegovski Phillip , Chen Lingling , Huddle Maddison
Published: January 2023

Background

A considerable proportion of people attending mental health services are parents with dependent children. Parental mental illness can be challenging for all family members including the parent’s children and partner. The hospitalization of the parent and subsequent separation from dependent children may be a particularly challenging time for all family members. The aim of this paper was to review qualitative studies of family members’ experiences when parents, who have dependent children, were hospitalized for their mental illness. The experiences of parents themselves, their children aged 0–18 (including retrospective accounts of adults describing their childhoods), and other family members are included.

Methods

This systematic review followed Cochrane Collaboration and PRISMA guidelines. A search was performed with keywords relating to parents, mental illness, psychiatric treatment, inpatient units, family members and experiences. Databases included CINAHL Plus, PsycINFO, ProQuest, MEDLINE, PubMed and Scopus. Quality assessment was undertaken using an expanded version of the Critical Appraisal Skills Programme. Thematic synthesis was conducted on the included papers.

Results

Eight papers were identified. The quality assessment was rated as high in some papers, in terms of the clarity of research aims, justification of the methodology employed, recruitment strategy and consideration of ethics. In others, the study design, inclusion criteria and reporting of participant demographics were unclear. Family experiences of pressure and additional responsibilities associated with the parent receiving inpatient treatment were identified along with the family’s need for psychoeducational information, and guidance when visiting the parent in hospital. Children expressed various emotions and the need to connect with others. The final theme related to adverse impacts on the parent–child bond when the parent was hospitalized.

Conclusion

The limited research in this area indicates that the needs of families are not being met when a parent is hospitalized for their mental illness. There is a considerable need for adequate models of care, family-focused training for staff, and psychoeducational resources for families. Additional research in this area is essential to understand the experiences of different family members during this vulnerable time.
A qualitative exploration of the experiences of peer leaders in an intervention to improve diabetes medication adherence in African Americans
Authors: Tarfa Adati , Nordin Jenna , Mott Mattigan , Maurer Martha , Shiyanbola Olayinka
Published: January 2023

Background

African Americans chronically managing their diabetes benefit from receiving support from peers with shared experiences. Peer support is known to improve the well-being of individuals receiving support, however, there is limited literature on the experiences of those providing the support. The Peers Supporting Health Literacy, Self-efficacy, Self-Advocacy, and Adherence (Peers LEAD) program pairs Peer Ambassadors who are adherent to their diabetes medication, with Peer Buddies who need support with their medication adherence. Peer Ambassadors engage with Peer Buddies as they receive diabetes information, develop the skills and motivation to address identified psychosocial/sociocultural issues to enhance their diabetes medication adherence. This study qualitatively explores the experiences of African Americans who provided peer support in the Peers LEAD medication adherence intervention.

Methods

Two focus groups were conducted with twelve Peer Ambassadors to explore their experiences of providing peer support in the Peers LEAD medication adherence intervention. Qualitative content analysis was conducted using an inductive open coding approach.

Results

Emergent themes provided insight into Peer Ambassador’ rationale for providing peer support and the benefits and challenges they experienced in their roles. Themes regarding their rationale included: their desire to receive support for their diabetes self-management as well as to contribute to their communities in reducing the stigma associated with diabetes. The perceived benefits they gained centered on creating interpersonal connections, experiencing personal growth as they adapted to their roles, and experiencing opportunities to contribute to an intervention regardless of professional training. Peer Ambassadors reflected on the challenges which included difficulties on coming to terms with their role as Peer Ambassadors, seeing African Americans experience complications associated with diabetes, and navigating supporting Peer Buddies who are also burdened with the challenges their family members are experiencing with managing their diabetes.

Conclusions

This study provides unique insight to what motivates individuals to provide peer support and what they gain from these experiences despite the challenges. Understanding the experiences of peers participating in such interventions may help inform the structure and content of programs that use peer support to focus on the benefits of and the motivation for participating in the program.
Human papilloma virus infection and its associated risk for cervical lesions: a cross-sectional study in Putuo area of Shanghai, China
Authors: Luan Haiping
Published: January 2023

Objective

To investigate the human papilloma virus (HPV) infection status, main subtypes and age distribution characteristics of women in the Putuo area of Shanghai.

Methods

A total of 13,936 subjects were enrolled in this study. These subjects were 15–89 years old, with a mean age of 41.68. Real-time fluorescence quantitative polymerase chain reaction technology was used to detect 21 types of HPV.

Results

A total of 2,500 subjects with HPV infections were detected in 13,936 cervical exfoliated cell specimens (total infection rate 17.9%). There were 15 people aged below 20,486 people aged 21-30,876 people aged 31-40,484 people aged 41–50, 338 people aged 51–60, and 301 people aged > 60. In total, 1,893 (75.7%) subjects had a single type of HPV infection, 424 (16.9%) had a double infection, and 183 had triple or more infections (7.4%). The top 6 subtypes of HPV infection in the Shanghai Putuo District were HPV 52 (3.81%), HPV 58 (2.46%), HPV 16 (2.43%), HPV 53 (2.30%), HPV 81 (1.74%) and HPV 39 (1.5%). The number of high-risk HPV infections was 1,978, and the total infection rate was 14.19%. The number of intermediate-risk HPV infections was 578, and the total infection rate was 4.15%. The number of low-risk HPV infections was 338, and the total infection rate was 2.43%.

Conclusion

The top 3 populations with HPV infection rates in the Putuo District, Shanghai, were ≤ 20 years old, older than 60, and 21–30 years old. The infection rate of HPV in cervical outpatient clinics was significantly higher than that of other departments. The 9-valent vaccine is recommended for HPV vaccination in this area.
Automatic medical specialty classification based on patients’ description of their symptoms
Authors: Mao Chao , Zhu Quanjing , Chen Rong , Su Weifeng
Published: January 2023

In China, patients usually determine their medical specialty before they register the corresponding specialists in the hospitals. This process usually requires a lot of medical knowledge for the patients. As a result, many patients do not register the correct specialty for the first time if they do not receive help from the hospitals. In this study, we try to automatically direct the patients to the appropriate specialty based on the symptoms they described. As far as we know, this is the first study to solve the problem. We propose a neural network-based model based on a hybrid model integrated with an attention mechanism. To prove the actual effect of this hybrid model, we utilized a data set of more than 40,000 items, including eight departments, such as Otorhinolaryngology, Pediatrics, and other common departments. The experiment results show that the hybrid model achieves more than 93.5% accuracy and has a high generalization capacity, which is superior to traditional classification models.
Feasibility and acceptability of integrating hepatitis B care into routine HIV services: a qualitative study among health care providers and patients in West Nile region, Uganda
Authors: Mutyoba Joan Nankya , Wandera Claude , Ejalu David , Seremba Emmanuel , Beyagira Rachel , Amandua Jacinto , Mugagga Kaggwa , Kambugu Andrew , Muganzi Alex , Easterbrook Philippa , Ocama Ponsiano
Published: January 2023

Background

Despite facing a dual burden of HBV and HIV, Africa lacks experience in offering integrated care for HIV and HBV. To contextualize individual and group-level feasibility and acceptability of an integrated HIV/HBV care model, we explored perspectives of health care providers and care recipients on feasibility and acceptability of integration.

Methods

In two regional hospitals of West Nile region, we performed a demonstration project to assess feasibility and acceptability of merging the care of HBV-monoinfected patients with existing HIV care system. Using interviews with health care providers as key informants, and 6 focus groups discussions with 3 groups of patients, we explored feasibility [(i)whether integration is perceived to fit within the existing healthcare infrastructure, (ii) perceived ease of implementation of HIV/HBV integrated care, and (iii) perceived sustainability of integration] and acceptability [whether the HIV/HBV care model is perceived as (i) suitable, (ii) satisfying and attractive (iii) there is perceived demand, need and intention to recommend its use]. We audio-recorded the interviews and data was analysed using framework analysis.

Results

The following themes emerged from the data (i) integrating HBV into HIV care is perceived to be feasible, fit and beneficial, after making requisite adjustments (ii) integration is acceptable due to the need for both free treatment and anticipated collaboration between HIV and HBV clients in terms of peer-support (iii) there are concerns about the likely rise in stigma and the lack of community awareness about integrated care.

Conclusion

The integrated HIV/HBV care model is feasible and acceptable among both providers and recipients. Necessary adjustments to the existing care system, including training, for community sensitization on the reasons and significance of integration are required.
Invert emulsions alleviate biotic interactions in bacterial mixed culture
Authors: Dijamentiuk Alexis , Mangavel Cécile , Elfassy Annelore , Michaux Florentin , Burgain Jennifer , Rondags Emmanuel , Delaunay Stéphane , Ferrigno Sandie , Revol-Junelles Anne-Marie , Borges Frédéric
Published: January 2023

The large application potential of microbiomes has led to a great need for mixed culture methods. However, microbial interactions can compromise the maintenance of biodiversity during cultivation in a reactor. In particular, competition among species can lead to a strong disequilibrium in favor of the fittest microorganism. In this study, an invert emulsion system was designed by dispersing culture medium in a mixture of sunflower oil and the surfactant PGPR. Confocal laser scanning microscopy revealed that this system allowed to segregate microorganisms in independent droplets. Granulomorphometric analysis showed that the invert emulsion remains stable during at least 24 h, and that the introduction of bacteria did not have a significant impact on the structure of the invert emulsion. A two-strain antagonistic model demonstrated that this invert emulsion system allows the propagation of two strains without the exclusion of the less-fit bacterium. The monitoring of single-strain cultures of bacteria representative of a cheese microbiota revealed that all but Brevibacterium linens were able to grow. A consortium consisting of Lactococcus lactis subsp. lactis biovar diacetylactis, Streptococcus thermophilus, Leuconostoc mesenteroides, Staphylococcus xylosus, Lactiplantibacillus plantarum and Carnobacterium maltaromaticum was successfully cultivated without detectable biotic interactions. Metabarcoding analysis revealed that the system allowed a better maintenance of alpha diversity and produced a propagated bacterial consortium characterized by a structure closer to the initial state compared to non-emulsified medium. This culture system could be an important tool in the field of microbial community engineering.
Biomechanical effects of hybrid constructions in the treatment of noncontinuous cervical spondylopathy: a finite element analysis
Authors: Sun Xiangyao , Zhang Qingming , Cao Li , Wang Juyong , Huang Jiang , Liu Yuqi , Zhang Yang , Song Zelong , Tang Wei , Chen Yunqiang , Sun Siyuan , Lu Shibao
Published: January 2023

Background

Hybrid construction (HC) may be an ideal surgical strategy than noncontinuous total disc replacement (TDR) and noncontinuous anterior cervical discectomy and fusion (ACDF) in the treatment of noncontinuous cervical spondylopathy. However, there is still no consensus on the segmental selection for ACDF or TDR in HC. The study aims to analyse the effects of different segment selection of TDR and ACDF on cervical biomechanical characteristics after HC surgery.

Methods

Twelve FEMs of C2–C7 were constructed based on CT images of 12 mild cervical spondylopathy volunteers. Two kinds of HC were introduced in our study: Fusion-arthroplasty group (Group 1), upper-level (C3/4) ACDF, and lower-level TDR (C5/6); Arthroplasty-fusion group (Group 2), upper-level (C3/4) TDR and lower-level ACDF (C5/6). The follow-load technique was simulated by applying an axial initial load of 73.6 N through the motion centre of FEM. A bending moment of 1.0 Nm was applied to the centre of C2 in all FEMs. Statistical analysis was carried out by SPSS 26.0. The significance threshold was 5% (P < 0.05).

Results

In the comparison of ROMs between Group 1 and Group 2, the ROM in extension (P = 0.016), and lateral bending (P = 0.038) of C4/5 were significantly higher in Group 1 group. The average intervertebral disc pressures at C2/3 in all directions were significantly higher in Group 1 than those in Group 2 (P < 0.005). The average contact forces in facet joints of C2/3 (P = 0.007) were significantly more than that in Group 2; however, the average contact forces in facet joints of C6/7 (P < 0.001) in Group 1 group were significantly less than that in Group 2.

Conclusions

Arthroplasty-fusion is preferred for intervertebral disc degeneration in adjacent upper segments. Fusion-arthroplasty is preferred for patients with lower intervertebral disc degeneration or lower posterior column degeneration.

Trial registration: This research was registered in Chinese Clinical Trial Registry (ChiCTR1900020513).
Impact of smoking on the outcomes of minimally invasive direct coronary artery bypass
Authors: Shahin Youssef , Gofus Ján , Harrer Jan , Šorm Zdeněk , Voborník Martin , Čermáková Eva , Smolák Petr , Vojáček Jan
Published: January 2023

Background

Tobacco smoking has been associated with an increased risk of complications after conventional coronary surgery. However, the impact of smoking on the risk of postoperative complications in minimally invasive coronary surgery is yet to be studied. We aimed to analyze the impact of the preoperative smoking status on the short- and long-term outcomes of minimally invasive direct coronary artery bypass grafting (MIDCAB) in the context of isolated surgical revascularization or in association with percutaneous coronary intervention.

Methods

This was a retrospective observational study of all patients undergoing MIDCAB at our institution between 2006 and 2020. Patients were divided into three groups: active smokers, ex-smokers who have quit smoking for at least 1 month before surgery, and non-smokers. The groups were compared using conventional statistical methods. Multivariate analysis was then performed where significant differences were found to eliminate bias.

Results

Throughout the study period, 541 patients underwent MIDCAB, of which 135 (25%) were active smokers, 183 (34%) were ex-smokers, and 223 (41%) were non-smokers. Smokers presented for surgery at a younger age (p < 0.0001), more frequently with a history of myocardial infarction (p < 0.001), peripheral artery disease (p < 0.001) and chronic obstructive pulmonary disease (p < 0.0001). Using multivariate analysis, active smoking was determined to be a significant risk factor for the need of urgent revascularization (odds ratio 2.36 [1.00–5.56], p = 0.049) and the composite of pulmonary complications (including pneumothorax, respiratory infection, respiratory dysfunction, subcutaneous emphysema and exacerbation of chronic obstructive pulmonary disease; odds ratio 2.84 [1.64–4.94], p < 0.001). Preoperative smoking status did not influence the long-term survival (p = 0.83).

Conclusions

In our study, active smokers presented for MIDCAB at a younger age and more often with signs of atherosclerotic disease (history of myocardial infarction and peripheral artery disease). Active smoking was found to be the most significant risk factor for postoperative pulmonary complications, and is also associated with a more frequent need for urgent surgery at diagnosis. Long-term postoperative survival is not affected by the preoperative smoking status.
Global critical care: a call to action
Authors: Crawford Ana Maria , Shiferaw Ananya Abate , Ntambwe Papytcho , Milan Alexei Ortiz , Khalid Karima , Rubio Rodrigo , Nizeyimana Francoise , Ariza Fredy , Mohammed Alhassan Datti , Baker Tim , Banguti Paulin Ruhato , Madzimbamuto Farai
Published: January 2023

Critical care is underprioritized. A global call to action is needed to increase equitable access to care and the quality of care provided to critically ill patients. Current challenges to effective critical care in resource-constrained settings are many. Estimates of the burden of critical illness are extrapolated from common etiologies, but the true burden remains ill-defined. Measuring the burden of critical illness is epidemiologically challenging but is thought to be increasing. Resources, infrastructure, and training are inadequate. Millions die unnecessarily due to critical illness. Solutions start with the implementation of first-step, patient care fundamentals known as Essential Emergency and Critical Care. Such essential care stands to decrease critical-illness mortality, augment pandemic preparedness, decrease postoperative mortality, and decrease the need for advanced level care. The entire healthcare workforce must be trained in these fundamentals. Additionally, physician and nurse specialists trained in critical care are needed and must be retained as leaders of critical care initiatives, researchers, and teachers. Context-specific research is mandatory to ensure care is appropriate for the patient populations served, not just duplicated from high-resourced settings. Governments must increase healthcare spending and invest in capacity to treat critically ill patients. Advocacy at all levels is needed to achieve universal health coverage for critically ill patients.