bluuebunny/crossref_metadata_2025 huggingface dataset:
An Immunologic Storm: A Case of Encephalitis and Thrombotic Thrombocytopenic Purpura With Underlying Likely Sjogren’s Syndrome Induced by a COVID-19 Immune Response
Authors: Kasturiarachi Brittany M. , Alsbrook Diana L. , Crook Jennifer , Shah Namrata
Published: March 2022

Introduction

There are rare cases of Sjogren’s syndrome presenting with manifestations of encephalitis. There are also rare patients with Sjogren’s presenting with acute thrombotic thrombocytopenic purpura (TTP). There are no cases of both occurring together as the only symptoms of the syndrome. During the COVID-19 pandemic, more cases of autoimmunity are being described given its robust immune response. It is important to keep a wide differential about these varying clinical presentations.

Case Presentation

Our patient is a 19-year-old female with a history of menorrhagia, recent COVID-19 infection, and remote suicidal ideation. She presented with headaches, vomiting, and psychosis. Her labs found platelets of 12,000 and she was soon discovered to have TTP. She was found to have contrast enhancing lesions scattered in her left hemisphere on magnetic resonance imaging as well as seizures. Her workup was negative for infection, but labs revealed a positive antinuclear antibody, elevated anti-Ro antibody (anti-SSA) and anti-La antibody (anti-SSB), and elevated COVID-19 antibodies. She was treated with antiepileptics, pulse dose steroids for 5 days, plasmapheresis, and weekly rituximab for 4 weeks. She had significant clinical improvement.

Conclusion

Sjogren’s syndrome can have varying presentations including TTP with or without encephalitis as a presenting feature. Autoimmunity can also be triggered from COVID-19 infection.
Effectiveness of using calligraphic activity to treat people with schizophrenia: a randomized controlled trial in Southern Taiwan
Authors: Huang Wen-Yi , Tsang Hector W.H. , Wang Shu-Mei , Huang Yu-Chen , Chen Yi-Chun , Cheng Chih-Heng , Chen Chih-Yin , Chen Jung-Sheng , Chang Yen-Ling , Huang Ru-Yi , Lin Chung-Ying , Potenza Marc N. , Pakpour Amir H.
Published: March 2022

Background:

Prior research has shown preliminary evidence that calligraphy activity improves various body functions and decreases severity of psychotic symptoms in individuals with schizophrenia. However, major limitations of earlier studies include small and heterogeneous samples. The current large-scale randomized controlled trial examined effects of calligraphy activity on cognition (including attention), emotions, psychotic symptoms, quality of life, and mood in people with schizophrenia.

Methods:

One-hundred-and-fifty patients with schizophrenia were randomly allocated to the treatment group (receiving calligraphy activity) or the control group (receiving general activity), both of which lasted for 24 weeks (70 minutes per session; one session per week). Assessments were conducted at pretest, posttest, and three-month follow-up. The Montreal Cognitive Assessment, Chu’s Attention Test, Depression, Anxiety, and Stress Scale, Positive and Negative Syndrome Scale, World Health Questionnaire on the Quality of Life-Brief Form, and Visual Analogue Scale were used.

Results:

Improved cognition and attention were found in both groups, although no group effects were shown. The treatment group appeared to show lower severity of positive symptoms at follow-up than posttest, whereas the control group appeared to show the opposite pattern. Improved mood was found in the treatment group.

Conclusion:

This study provides evidence regarding effects of calligraphy activity on increasing cognition and potentially decreasing severity of positive symptoms in patients with schizophrenia. Calligraphy activity can be incorporated in clinical occupational therapy and may be provided to supplement medication treatment.

Trial Registration:

ClinicalTrials.gov NCT03882619; https://clinicaltrials.gov/ct2/show/NCT03882619
Life-Threatening Bronchospasm
Authors: La-Crette Jonathan , Abdelhamid Ahmed , Chadwick Andrew , Chakraborty Arup
Published: March 2022

Summary

While Eosinophilic Asthma is frequently underdiagnosed, COPD is often misdiagnosed. This case focusses on a COPD misdiagnosis that had life-threatening consequences. The patient was a 59-year-old, male smoker, who presented to the Emergency Department with a week's history of increasing shortness of breath. On presentation, severe respiratory acidosis persisted acidotic despite Nebulisers, Oxygen, Steroids, and Magnesium. He was intubated for two weeks and had severe bronchospasm associated with type 2 respiratory failure. Eosinophils on admission were markedly elevated and remained so despite a week of intravenous steroids. As he missed the window for ECMO, we were advised to look at his diagnostic spirometry. Surprisingly, the spirometry done by his general practitioner, two years prior, showed Asthma not COPD. His blood eosinophils were elevated then, too. A revised diagnosis of Eosinophilic Asthma was given. Intravenous steroids were increased, and nebulised steroids were started. Soon thereafter, his condition improved, and he was stepped down from Intensive care. Hopefully, this case report increases physician knowledge of the different Asthma phenotypes and reduces incidences where correct treatment is only started during an avoidable life-threatening exacerbation.
Science Factionalism: How Group Identity Language Affects Public Engagement With Misinformation and Debunking Narratives on a Popular Q&A Platform in China
Authors: Chen Kaiping , Jin Yepeng , Shao Anqi
Published: March 2022

Misinformation and intergroup bias are two pathologies challenging informed citizenship. This article examines how identity language is used in misinformation and debunking messages about controversial science on the Chinese digital public spheres and their impact on how the public engage with science. We collected an 8-year time series dataset of public discussion ( N = 6,039) on one of the most controversial science issues in China (GMO) from a popular Q&A platform, Zhihu. We found that both misinformation and debunking messages use a substantial amount of group identity languages when discussing the controversial science issue, which we define as science factionalism—discussion about science is divided by factions that are formed upon science attitudes. We found that posts that use science factionalism receive more digital votes and comments, even among the science-savvy community in China. Science factionalism also increases the use of negativity in public discourse. We discussed the implications of how science factionalism interacts with the digital attention economy to affect public engagement with science misinformation.
Antiracism Starts With Us: School Counselor Critical Reflection Within an Multitiered Systems of Support Framework
Authors: Betters-Bubon Jennifer , Pianta Rebecca , Sweeney Damien , Goodman-Scott Emily
Published: March 2022

Due to ongoing inequities, discrimination, and injustice, the antiracist movement has gained momentum in all parts of society, including education and school counseling. A foundational aspect of antiracism is self-reflection to increase awareness, identify biases, and build cultural proficiency. Multitiered systems of support (MTSS) is an evidence-based framework widely used throughout K–12 education in the United States to assist with every student’s school-related success. In this article, we propose an antiracist approach to the MTSS framework, in which reflection serves as the foundation. We provide practical activities and reflections to facilitate growth and promote antiracism within MTSS.
Exploring the Career Decision-Making Process During the COVID-19 Pandemic: Opportunities and Challenges for Young People
Authors: Jemini-Gashi Liridona , Kadriu Erëblir
Published: March 2022

The COVID-19 pandemic, along with the measures taken against its spread, including quarantine, school closures, and online teaching, have affected young people’s career planning and decision-making process. This study explores their career decision-making process during the pandemic by analysing the following categories: effects the pandemic might have had on emotional, social, and professional aspects; support provided by family, school, and peers; challenges and difficulties experienced during the career planning process; and the need and opportunities for career guidance. Thirty high school students in the 12th grade were individually interviewed using Google Meet. The findings of thematic analysis revealed that the participants struggled with the career decision-making process during the pandemic. Concerns related to abrupt changes in daily routines and restrictive measures affected their emotional and social states. Participants reported feeling sufficiently supported by their families, but not their schools or peers. They indicated that career orientation information provided by their schools or other institutions would be beneficial. Our findings highlight the need for a structured, well planned, official career orientation program for schools.
Africological Historiography: Primary Considerations
Authors: Adé Taharka
Published: March 2022

Africological Historiography is scholarship dedicated to the preservation of African cosmology in the telling of African history. Such an historiography also serves as a means to tease out the agency of African people in any circumstance of marginality, misinterpretation, suppression, and omission of said historical agency. For the purposes of developing Africological Historiography, Africologists may take on various interests in other fields in order to garner the data necessary for their inquiries. However, it is important to make sure that the data garnered from other disciplines are approached using Afrocentric methodology or they will be no good for Africological research. In this article, I explore the benefits and dangers of other fields of interests, the dangers of Eurocentric theoretical models, afrophobic historiographies, and the inherent praxis of the discipline in its use for producing Africological Historiography. These are primary considerations for Africologists in the presentation of African history.
Structural Model for the Antecedents and Consequences of Internal Crisis Communication (ICC) in Malaysia Oil and Gas High Risk Industry
Authors: Mohamad Bahtiar , Abbas Adamu Adamu , Akanmu Muslim Diekola
Published: March 2022

A considerable amount of literature has concluded that employee relations has always been overlooked in the area of crisis communication. Therefore, the aim of this study is to investigate the antecedents of internal crisis communication (ICC) that include safety culture, supportive environment, social media usage, management commitment and the consequences on the other hand comprising affective commitment, perceived organizational support, and employee crisis perception in the context of high risk industry in Malaysia. Past literature are used to develop a self-administered questionnaire and in-depth interview, was conducted for 277 employees of oil and gas industry while structural equation model (SEM) was employed as the tool of the analysis technique. The results show that safety culture, supportive environment, and management commitment have positive effects on internal crisis communication but with no effect on social media usage. Also, ICC is reported to correlate positively with affective commitment, perceived organizational support, and employee crisis perception. The model is developed on the basis of Situational Crisis Communication Theory and Sense-making Theory as the underpinning theories.
A Framework for Investigating Green Purchase Behavior with a Focus on Individually Perceived and Contextual Factors
Authors: Asl Roghayeh Teimourfamian , Khoddami Soheila
Published: March 2022

The role of individually perceived and contextual factors on green purchase behavior (GPB) with a focus on the dimensions of consumer perceived value has been evaluated in this research. The basis of the model is a stimuli–organism–response (SOR) 1 framework, and the theory of planned behavior and the theory of consumption values have been combined. The research has been conducted on Iranian green consumers with green purchase experiences. It is an empirical study using the questionnaire survey method. Structural equation modelling (SEM) is utilized to measure the research framework. It has been revealed that individually perceived factors have more impact on GPB than contextual factors in this research. On the other hand, contextual factors do not affect the GPB of Iranian consumers. In addition, perceived social value had less effect on GPB than perceived emotional value. Therefore, the present study was likely proposed to fill the gap of previous studies, deprived of categorized factors affecting GPB focusing on internal and external approaches.
COVID-19 and Unemployment: Showcasing Sub-Saharan African Experience
Authors: Fagbemi Fisayo , Osinubi Tolulope T. , Olatunde Olufemi S.
Published: March 2022

In the face of unusual global health crisis, governments would strive to foster right conditions through maintenance of broad-based macro-economic management for businesses to thrive. However, the COVID-19 pandemic response measures have put a disproportionate burden on most economies, especially in the region with high economic vulnerabilities. Between 2020 and 2021, the outbreak of COVID-19 has not only upended normal economic and social pattern but also distorted the development trajectory in Sub-Saharan Africa (SSA). Hence, this study reveals how lack of economic resilience weakened policymakers’ capacity to maintain an inclusive and sustainable policy approach across African countries, which has accentuated underdevelopment and unemployment crisis. Through the conceptual coverage of the economic impact of COVID-19 policy measures in the SSA region, the adverse effect of the pandemic on employment is further confirmed. The effect of the COVID-19 outbreak on unemployment seems to have outweighed the resulting morbidity and fatality. Furthermore, the impact of COVID-19 policy responses on unemployment was found to be pervasive in key SSA economies like Nigeria and South Africa. This has led to entrenched social crisis and pandemic-induced economic challenges in the region. It is therefore suggested that maintaining appropriate policy measures is critical to offsetting the structural characteristics that have given rise to unemployment crisis in the region. In addition, with the support of international organizations, the use of COVID-19 vaccines with effective treatments should be encouraged across African countries.
Type 2 Myocardial Infarction Related to Very Low Carbohydrate Ketogenic Diet
Authors: Taha Ahmed , Ahmed Selma , Ahmed, MBBS Roaa , Mohammed, MD Ahmed
Published: March 2022

A 38-year-old male with no history of cardiac disease presented with chest pain typical of acute coronary syndrome. He assumed very-low-carbohydrate ketogenic diet (VLC-KD) 4 weeks prior to admission but no other lifestyle change. Workup showed dynamic ST-T changes on electrocardiogram, significantly elevated troponins, ketonuria, and mild rhabdomyolysis. Transthoracic echocardiogram revealed mild inferior wall hypokinesia and cardiac catheterization showed normal coronaries; hence, the diagnosis of type II myocardial infarction (MI) was established. Although the pathogenesis remains unclear, this temporal association between VLC-KD and type 2 MI raised some concerns about VLC-KD’s cardiovascular safety profile.
Outcomes of Combined Lateral Meniscus Posterior Root Repair and Anterior Cruciate Ligament Reconstruction
Authors: Shekhar Anshu , Tapasvi Sachin , Williams Andy
Published: March 2022

Background:

Lateral meniscus posterior root tears (LMPRTs) almost always occur in association with anterior cruciate ligament (ACL) tears. Their repair is advocated to restore the stabilizing and load-sharing functions of the meniscus.

Purpose:

To study the functional outcomes of combined arthroscopic repair of LMPRTs and ACL reconstruction (ACLR).

Study Design:

Case series; Level of evidence, 4.

Methods:

The authors evaluated patients who underwent simultaneous arthroscopic ACLR and LMPRT repair. All patients had chronic injuries, with a mean time since ACL rupture of 7.9 months. Patient characteristics, Lachman and pivot-shift test results, type of LMPRT, associated injuries, and surgery details were documented. Pre- and postoperative functional status was assessed using the International Knee Documentation Committee (IKDC) score, Knee injury and Osteoarthritis Outcome Score (KOOS), and Lysholm score. An independent single-tunnel transtibial repair using 2 SutureTapes was performed for Forkel type 1 and 3 tear root avulsions, while side-to-side suture repair was performed for type 2 radial/oblique tears. The Wilcoxon signed rank test and minimal clinically important difference (MCID) of the IKDC score were used for statistical analysis.

Results:

Included were 25 patients with a mean age of 29.6 ± 6.5 years. Of these, 22 patients (88%; 95% CI, 73.1%-100%) had a high-grade (grade 2 or 3) preoperative pivot shift. Diagnosis of the LMPRT on magnetic resonance imaging (MRI) scans was possible only in 5 patients (20%). At final evaluation, performed at 37.4 ± 7.1 months postoperatively, all functional scores had improved significantly from preoperatively: IKDC score, from 47.6 ± 9.5 to 81.8 ± 11.5; KOOS, from 45.5 ± 10.9 to 86.5 ± 10.3, and Lysholm score, from 49.0 ± 11.5 to 88.8 ± 7.6 ( P < .001 for all). Twenty-four patients (96%) achieved the MCID for the IKDC score. All knees had a negative pivot shift at final analysis, and no patient underwent revision ACLR or LMPRT repair.

Conclusion:

LMPRT repair combined with ACLR led to good short-term clinical outcomes in this study. An LMPRT may frequently go undetected on preoperative MRI scans, but a high-grade pivot shift is present in a large majority of these patients.
Iran–USA Relations: From Exceptionalism to Containment Policy
Authors: Siraj Uzma , Bakare Najimdeen
Published: March 2022

Since making it out as the most powerful nation following the Second World War, Washington has demonstrated and employed two independent yet interlocking policies of Exceptionalism and Containment in its foreign policy. American exceptionalism is ingrained in its pride as the most powerful military and economic power, and a champion of democracy. While Washington sees itself as exceptional, it also believes that the fruition of its national interest and strategic objectives depends on bestowing friendly states with exceptional code. To place the discussion in perspective, we take Iran as a case study and explore the transition of Iran from being a recipient of American exceptional code, a strategic tool of American containment policy, to becoming an object of containment itself. The article applies George Kennan’s exceptionalism and containment strategy on USA–Iran relations in both Shah’s rule and post-revolution era. We conclude that decades of US exceptionalism in the region have multiplied into regional challenges for the USA itself and raised the importance of Iran and increased its security threats.
Analysis of shape grammars: Continuity of rules
Authors: Haridis Alexandros , Stiny George
Published: March 2022

The rules in a shape grammar apply in terms of embedding to take advantage of the parts that emerge visually in the appearance of shapes. While the shapes are kept unanalyzed as a computation moves forward, part-structures for shapes can be defined retrospectively by analyzing how the rules were applied. An important outcome of this is that rule continuity is not built-in but it is “fabricated” retrospectively to analyze the computation as a continuous process. An aspect of continuity analysis that has not been addressed in the literature is how to decide which mapping forms to use to study the continuity of rule applications. This is addressed in this paper using recent results on shape topology and continuous mappings. A characterization is provided that distinguishes the suitable mapping forms from those that are inherently discontinuous or practically inconsequential for continuity analysis. It is also shown that certain intrinsic properties of shape topologies and continuous mappings provide an effective method of computing topologies algorithmically.
Neurocognition in the reading of Chinese characters
Authors: Wu Junru
Published: March 2022

Chinese characters, which form an ideographic writing system, have shown distinctive features in the neurocognition of their reading. This paper gives a comprehensive review of five main issues of Chinese reading, which are (1) the relationship across written forms, sounds, and meanings during the neurocognitive processing of Chinese reading, (2) the involvement of structural and linguistic units, such as strokes (笔画), radicles (部件), components (偏旁), whole characters (整字), and words (词), in character reading, (3) the influence of attentional conditions on character reading, (4) the activation of Chinese characters from non-character input, and (5) the influences of readers’ linguistic experiences on character reading. We summarize that the reading of Chinese characters involves dynamic integration of multi-channel information and multiple levels of processing units, which, as compared with alphabetic writing systems, rely more on form-to-meaning semantic processing, while its form-to-phonology non-semantic processing is greatly influenced by para-linguistic context.
Combining nilotinib and PD-L1 blockade reverses CD4+ T-cell dysfunction and prevents relapse in acute B-cell leukemia
Authors: Tracy Sean I , Venkatesh Hrishi , Hekim Can , Heltemes Harris Lynn M , Knutson Todd Philip , Bachanova Veronika , Farrar Michael A
Published: March 2022

Patients with acute lymphoblastic leukemia have experienced significantly improved outcomes due to the advent of chimeric antigen receptor T-cells and bispecific T-cell engagers, although a proportion of patients still relapse despite these advances. T-cell exhaustion has been recently suggested to be an important driver of relapse in these patients. Indeed, phenotypic exhaustion of CD4+ T-cells is predictive of relapse and poor overall survival in B-ALL. Thus, therapies that counter T-cell exhaustion, such as immune checkpoint blockade, may improve leukemia immunosurveillance and prevent relapse. Here, we used a murine model of Ph+ B-ALL as well as human bone marrow biopsy samples to assess the fundamental nature of CD4+ T-cell exhaustion and the preclinical therapeutic potential for combining anti-PD-L1 based checkpoint blockade with tyrosine kinase inhibitors targeting the BCR-ABL oncoprotein. scRNA-seq analysis revealed that B-ALL induces a unique subset of CD4+ T-cells with both cytotoxic and helper functions. Combination treatment with the tyrosine kinase inhibitor nilotinib and anti-PD-L1 dramatically improves long-term survival of leukemic mice. Depletion of CD4+ T-cells prior to therapy completely abrogates the survival benefit, implicating CD4+ T-cells as key drivers of the protective anti-leukemia immune response. Indeed, treatment with anti-PD-L1 leads to clonal expansion of leukemia-specific CD4+ T-cells with the afore-mentioned helper/cytotoxic phenotype, as well as reduced expression of exhaustion markers. These findings support efforts to utilize PD1/PD-L1 checkpoint blockade in clinical trials and highlight the importance of CD4+ T-cell dysfunction in limiting the endogenous anti-leukemia response.
Barriers and facilitators to infection prevention and control in Dutch psychiatric institutions: a theory-informed qualitative study
Authors: Houben Famke , van Hensbergen Mitch , den Heijer Casper D. J. , Dukers-Muijrers Nicole H. T. M. , Hoebe Christian J. P. A.
Published: March 2022

Background

The unique characteristics of psychiatric institutions contribute to the onset and spread of infectious agents. Infection prevention and control (IPC) is essential to minimise transmission and manage outbreaks effectively. Despite abundant studies regarding IPC conducted in hospitals, to date only a few studies focused on mental health care settings. However, the general low compliance to IPC in psychiatric institutions is recognised as a serious concern. Therefore, this study aimed to assess perceived barriers and facilitators to IPC among professionals working at psychiatric institutions, and to identify recommendations reported by professionals to improve IPC.

Methods

A descriptive, qualitative study involving 16 semi-structured interviews was conducted (before COVID-19) among professionals from five Dutch psychiatric institutions. The interview guide and data analysis were informed by implementation science theories, and explored guideline, individual, interpersonal, organisational, and broader environment barriers and facilitators to IPC. Data was subjected to thematic analysis, using inductive and deductive approaches. This study followed the Consolidated criteria for Reporting Qualitative research (COREQ) guidelines.

Results

Our findings generated six main themes: (1) patients’ non-compliance (strongly related to mental illness); (2) professionals’ negative cognitions and attitude towards IPC and IPC knowledge deficits; (3) monitoring of IPC performance and mutual professional feedback; (4) social support from professional to patient; (5) organisational support and priority; and (6) financial and material resource limitations (related to financial arrangements regarding mental health services). The main recommendations reported by professionals included: (1) to increase awareness towards IPC among all staff members, by education and training, and the communication of formal agreements as institutional IPC protocols; (2) to make room for and facilitate IPC at the organisational level, by providing adequate IPC equipment and appointing a professional responsible for IPC.

Conclusions

IPC implementation in psychiatric institutions is strongly influenced by factors on the patient, professional and organisational level. Professional interaction and professional-patient interaction appeared to be additional important aspects. Therefore, a multidimensional approach should be adopted to improve IPC. To coordinate this approach, psychiatric institutions should appoint a professional responsible for IPC. Moreover, a balance between mental health care and IPC needs is required to sustain IPC.
Multistakeholder perspectives on the mistreatment of indigenous women during childbirth in Colombia: drivers and points for intervention
Authors: Gleason Emily Gaffney , López Ríos Jennifer Marcela , Molina Berrío Diana Patricia , Mejía Merino Cristina
Published: March 2022

Background

Abusive and disrespectful treatment of women during childbirth is a critical global issue that threatens women’s sexual rights and reproductive rights and access to quality maternal care. This phenomenon has been documented in Colombia. However, little emphasis has been placed on identifying the drivers of and potential interventions against disrespect and abuse against particularly vulnerable populations in the country, including internally displaced indigenous women.

Methods

This report is a sub-analysis of a larger project. Semi-structured interviews were conducted with indigenous (Embera) women with childbirth experience (n = 10), maternal healthcare workers (n = 6), and community stakeholders (n = 5) in Medellín, Colombia. Qualitative analysis techniques, consisting of inductive and deductive approaches, were used to identify and characterize the drivers of disrespect and abuse against indigenous women during childbirth and points for intervention. Existing frameworks were adapted to thematically organize drivers and potential solutions into four interrelated subsystems: individual and community factors, clinician factors, facility factors, and national health system factors.

Results

Participants highlighted disrespect and abuse as stemming from (within the individual and community level) its normalization, lack of autonomy and empowerment among indigenous women, lacking antenatal care, (within the clinician level) prejudice, linguistic or cultural barriers to communication, lack of understanding of indigenous culture, medical culture and training, burnout and demoralization, (within the facility level) inadequate infrastructure, space, and human resources, and (within the national systems level) lack of clear policies and the devaluing of respectful maternity care. They called for interventions specific to these drivers, grounded in dignity and respect for indigenous culture.

Conclusion

This paper expands upon the growing literature on global mistreatment during childbirth by highlighting drivers of mistreatment and identifying points for intervention in a previously unstudied population. Our data show that indigenous women are especially vulnerable to mistreatment due to cultural and linguistic barriers and prejudice. Broad and meaningful action is urgently needed to realize these women’s rights to respectful maternity care. Interventions must be multifaceted and locally specific, taking into account the needs and wants of the women they serve.
Effects of early essential newborn care versus routine birth care on physiological variables and sleep state among newborn infants: a quasi-experimental design
Authors: Huang Chuanya , Hu Lei , He Jingjing , Luo Biru
Published: March 2022

Background

Early essential newborn care (EENC) was introduced to medical practice in China in 2016, but the number of medical institutions that have put EENC into practice remains low due to insufficient clinical evidence and the absence of awareness among health professionals. This study aimed to explore the effect of EENC on physiological variables and sleep state among newborn infants and to provide evidence to support the implementation of EENC.

Methods

A quasi-experimental design was conducted among 182 newborn infants in a tertiary maternity hospital in China from May 2020 to January 2021. A total of 91 newborn infants were included in the intervention group, and 91 were included in the control group to receive EENC or routine birth care, respectively.

Results

The newborn infants in the intervention group had a lower incidence of hypothermia than those in the control group at 75 min, 90 min, 105 min, and 120 min after birth (p < 0.05). The time of first breathing after birth in the intervention group was earlier than that in the control group (5 s vs. 7 s, p < 0.05), and the infants had a better sleep state at 30 min, 60 min, 90 min, and 120 min after birth (p < 0.05).

Conclusions

EENC can decrease the incidence of hypothermia, promote the initiation of breathing, and improve the sleep state among newborn infants compared to routine birth care in China. More coaching should be provided to health professionals to promote the implementation of EENC in China.

Trial registration

Chinese Clinical Trial Registry, Retrospective Registration (27/7/2021), registration number: ChiCTR2100049231.
Autism spectrum disorder in a boy with congenital insensitivity to pain with anhidrosis: a case report
Authors: Zhang Mi , Cao Xueqin , Li Ningbo , Duan Guangyou , Zhang Xianwei
Published: March 2022

Background

In this case report, we described the past history, clinical manifestations, genetic characteristics and cognitive evaluation of a boy with congenital insensitivity to pain with anhidrosis (CIPA) who developed autism spectrum disorder (ASD).

Case presentation

The boy had an early onset of CIPA at the age of 48 months, and was later diagnosed with ASD at 5 years old. Developmental delays in communication, social skills and the presence of maladaptive behaviors were observed in the patient. Professional treatments significantly improved the developmental delays.

Conclusions

This case demonstrated that ASD may develop in children with CIPA, and pediatricians should be aware that if they suspect or identify a child with CIPA that they should also be screened for ASD using similar examination and diagnostic tools as shown in the present report. Moreover, therapeutic interventions for ASD was helpful for the remission of both diseases.
Dexmedetomidine combined with ropivacaine for erector spinae plane block after posterior lumbar spine surgery: a randomized controlled trial
Authors: Yi-han Wang , Rong Tang , Jun Li , Min Wang , Yan Zhang , Yi Li , Jie-ting Liu , Sheng-hui Huang
Published: March 2022

Purpose

Due to lumbar spinal surgery is frequently accompanied with moderate-to-severe postoperative pain, it is necessary to find an effective postoperative analgesia for patients with this surgery. This study aimed to observe the analgesic effect of dexmedetomidine combined with ropivacaine erector spinae plane block (ESPB) used in posterior lumbar spine surgery.

Methods

In this clinical trial, patients undergoing posterior lumbar spine surgery were recruited and randomly divided into two groups: intervention and control. The intervention group (Group E) received 0.375% ropivacaine with 1 µg/kg dexmedetomidine in a total of 20 ml for ESPB; the control group (Group C) received 20 ml ropivacaine 0.375% for ESPB. US-guided ESPB was performed preoperatively in all patients. Demographics, anesthesia time, surgery time, and ASA grade from the participants were recorded at baseline. The primary clinical outcome measures were 2-, 4-, 8-, 12-, 24-and 48-h visual analog scale (VAS) pain scores after surgery at rest and movement state. Other end points included opioid consumption, number of PCIA presses, flurbiprofen-axetil consumption, quality of recovery and pain management after surgery.

Results

One hundred twenty patients were enrolled in the study (mean [SD] ages: Group E, 54.77 [8.61] years old; Group C,56.40 [7.87] years old; P = 0.280). The mean anesthesia time was 152.55 (15.37) min in Group E and 152.60 (16.47) min in Group C (P = 0.986). Additionally, the surgery time was 141.70 (15.71) min in Group E compared to 141.48 (17.13) min in Group C (P = 0.943). In addition, we found that the VAS pain scores in the resting state during the postoperative period at 8–48 h were lower in Group E than in Group C. However, the VAS pain scores in the active state were lower in Group E at 12–48 h (P < 0.05). More importantly, the consumption of opioids and flurbiprofen-axetil after surgery was also lower in Group E (P < 0.05). Subsequently, we administered questionnaires on the quality of recovery and pain management after surgery that were positively correlated with the postoperative analgesic effect. It was worth affirming that the QoR-15 scores and APS-POQ-R questionnaire results were different between the two groups, further confirming that the combination of drugs not only could obtain an ideal analgesic effect but also had no obvious adverse reactions (P < 0.05).

Conclusions

All the findings suggested that dexmedetomidine could significantly relieve postoperative pain and reduce the consumption of opioids in patients undergoing posterior lumbar spine surgery without obvious adverse reactions as a local anesthetic adjuvant. Further studies with larger sample sizes and different drug dosages may be useful in understanding the potential clinical benefits of dexmedetomidine.
IgG4-related prostatitis manifesting as urinary obstruction in a 28-year-old male
Authors: Jazdarehee Aria , Ahrari Azin , Bowie Drew , Chang Silvia D. , Tran Henry , Jamal Shahin , Chen Luke Y. C. , Tran Karen C.
Published: March 2022

Background

Immunoglobulin G4-related disease (IgG4-RD) is a systemic lymphoproliferative disorder characterized by elevated serum IgG4 levels and tumefactive lesions that can involve nearly every organ system. Involvement of the prostate is rare but has been reported in limited cases.

Case presentation

A 28-year-old man of Asian descent with a history of sinusitis and priapism presented to hospital with rigors and voiding symptoms. He was diagnosed with IgG4-RD one month prior to presentation, following pathological analysis of a submandibular mass that demonstrated chronic sclerosing sialadenitis. On presentation, white blood cell count, C-reactive protein, and prostate serum antigen levels were all within normal limits. Examination was notable for a large, firm prostate, and a foley catheter was inserted. Contrast CT of the abdomen was unremarkable. Further workup revealed elevated serum IgG4 levels (9.22 g/L) and he was subsequently started on prednisone 35 mg daily. Imaging to screen for systemic IgG4-RD involvement demonstrated paravertebral soft tissue involvement and he was given rituximab 1000 mg IV × 2 doses. MRI revealed diffuse prostatitis. Five days after starting prednisone and one day after his first dose of rituximab, he successfully passed trial of void and was discharged home.

Conclusions

IgG4-related prostatitis is a rare and underrecognized manifestation of IgG4-RD. Our case highlights the need to consider IgG4-related prostatitis as an etiology of urinary obstruction in young individuals. Resolution of symptoms following treatment with steroids may be diagnostic of IgG4-related prostatitis, and may potentially avoid the need for invasive diagnostic procedures such as prostate biopsy.
The relationship between moral sensitivity and caring behavior among nurses in iran during COVID-19 pandemic
Authors: Hajibabaee Fatemeh , Salisu Waliu Jawula , Akhlaghi Elham , Farahani Mansoureh Ashghali , Dehi Maryam Mohamadzadeh Nojeh , Haghani Shima
Published: March 2022

Background

Caring for patients during a pandemic can be difficult for healthcare workers, the patients themselves, and healthcare systems. Nurses are expected to recognize ethical dilemmas and make sound judgments when confronted with them. Sensitizing nurses to ethical issues strengthen their ability to identify ethical dilemmas and make ethical choices. As a result, this study aimed to determine a relationship between moral sensitivity and caring behavior among nurses during the coronavirus (COVID-19) pandemic.

Method

The current study is a cross-sectional study of 406 nurses who worked in a single hospital during the COVID-19 epidemic. We used a demographic questionnaire and the caring behavior inventory (CBI) tool to collect data online. The data were analyzed using descriptive and correlational statistics.

Findings

Eighty-three point seven percent of participants in this study were female, and 71.9% were married. 47.5% reported caring for a COVID-19 patient for longer than a month; their average work experience was 13.1 years. Additionally, Moral Sensitivity correlated positively with caring behavior and its dimensions (r = 0.164, P = 0.001). However, a significant and inverse link existed between the dimension "following the rules" and the nurse's caring conduct (r = -0.117, P = 0.019).

Conclusion

During the pandemic, nurses' moral sensitivity was moderate and significantly connected with their caring behavior. Because nurses encounter numerous obstacles while caring for patients in critical conditions, they require ethical empowerment to perform correctly, as caring behavior improves with increased moral sensitivity.
Parvovirus enteritis and other risk factors associated with persistent gastrointestinal signs in dogs later in life: a retrospective cohort study
Authors: Sato-Takada Kanae , Flemming Anne M. , Voordouw Maarten J. , Carr Anthony P.
Published: March 2022

Background

Parvoviral enteritis (PE) is a viral gastrointestinal (GI) infection of dogs. Recovery from PE has been associated with persistent GI signs later in life. The objectives of this study were: (i) To determine whether dogs that have recovered from PE (post-parvo dogs) had an increased risk of persistent GI signs compared to uninfected control dogs. (ii) To investigate the lifestyle and clinicopathologic factors that are associated with persistent GI signs in post-parvo dogs.

Methods

A total of 86 post-parvo dogs and 52 age-matched control dogs were enrolled in this retrospective cohort study. Many years after hospitalization for PE, the owners were interviewed about the health and habits of their dogs using a questionnaire. We used generalized linear mixed effects models to test whether parvovirus enteritis and other risk factors are associated with owner-recognized general health problems in all dogs and with owner-recognized persistent GI signs in post-parvo dogs.

Results

The prevalence of persistent GI signs was significantly higher in post-parvo dogs compared to control dogs (57% vs 25%, P < 0.001). Markers of disease severity at the time of hospital admission such as neutropenia, low body temperature (BT), and treatment with an antiemetic medication (metoclopramide) were significant risk factors for persistent GI signs in post-parvo dogs. For example, PE-affected dogs that were hypothermic at hospital admission (BT of 37.2 °C) were 16.6 × more likely to have GI signs later in life compared to hyperthermic dogs (BT of 40.4 °C). The presence of persistent GI signs in post-parvo dogs was a risk factor for health problems in other organ systems.

Conclusions

Parvovirus enteritis is a significant risk factor for persistent GI signs in dogs highlighting the importance of prevention. The risk factors identified in the present study may guide future investigations on the mechanisms that link parvovirus enteritis to chronic health problems in dogs.
Additive effect of aortic regurgitation degree on left ventricular strain in patients with type 2 diabetes mellitus evaluated via cardiac magnetic resonance tissue tracking
Authors: Shen Li-Ting , Jiang Li , Zhu Ya-Wen , Shen Meng-Ting , Huang Shan , Shi Rui , Li Yuan , Yang Zhi-Gang
Published: March 2022

Background

Type 2 diabetes mellitus causes left ventricular (LV) remodeling and increases the risk of aortic regurgitation (AR), which causes further heart damage. This study aimed to investigate whether AR aggravates LV deformation dysfunction and to identify independent factors affecting the global peak strain (PS) of LV remodeling in patients with type 2 diabetes mellitus (T2DM) who presented with AR and those without T2DM.

Methods

In total, 215 patients with T2DM and 83 age- and sex-matched healthy controls who underwent cardiac magnetic resonance examination were included. Based on the echocardiogram findings, T2DM patients with AR were divided into three groups (mild AR [n = 28], moderate AR [n = 21], and severe AR [n = 17]). LV function and global strain parameters were compared, and multivariate analysis was performed to identify the independent indicators of LV PS.

Results

The T2DM patients with AR had a lower LV global PS, peak systolic strain rate (PSSR), and peak diastolic strain rate (PDSR) in three directions than those without AR and non-T2DM controls. Patients without AR had a lower PS (radial and longitudinal) and PDSR in three directions and higher PSSR (radial and longitudinal) than healthy controls. Further, regurgitation degree was an independent factor of LV global radial, circumferential, and longitudinal PS.

Conclusion

AR may aggravate LV stiffness in patients with T2DM, resulting in lower LV strain and function. Regurgitation degree and sex were independently correlated with LV global PS in patients with T2DM and AR.
Chromatin accessibility and transcriptome integrative analysis revealed AP-1-mediated genes potentially modulate histopathology features in psoriasis
Authors: Xu Xiaoqing , Tang Xianfa , Zhang Yuxi , Pan Zhaobing , Wang Qingping , Tang Lili , Zhu Caihong , Cheng Hui , Zhou Fusheng
Published: March 2022

Background

Psoriasis is a chronic and hyperproliferative skin disease featured by hyperkeratosis with parakeratosis, Munro micro-abscess, elongation of rete pegs, granulosa thinning, and lymphocyte infiltration. We previously profiled gene expression and chromatin accessibility of psoriatic skins by transcriptome sequencing and ATAC-seq. However, integrating both of these datasets to unravel gene expression regulation is lacking. Here, we integrated transcriptome and ATAC-seq of the same psoriatic and normal skin tissues, trying to leverage the potential role of chromatin accessibility and their function in histopathology features.

Results

By inducing binding and expression target analysis (BETA) algorithms, we explored the target prediction of transcription factors binding in 15 psoriatic and 19 control skins. BETA identified 408 upregulated genes (rank product < 0.01) and 133 downregulated genes linked with chromatin accessibility. We noticed that cumulative fraction of genes in upregulation group was statistically higher than background, while that of genes in downregulation group was not significant. KEGG pathway analysis showed that the upregulated 408 genes were enriched in TNF, NOD, and IL-17 signaling pathways. In addition, the motif module in BETA suggested the 57 upregulated genes are targeted by transcription factor AP-1, indicating that increased chromatin accessibility facilitated the binding of AP-1 to the target regions and further induced expression of relevant genes. Among these genes, SQLE, STRN, EIF4, and MYO1B expression was increased in patients with hyperkeratosis, parakeratosis, and acanthosis thickening.

Conclusions

In summary, with the advantage of BETA, we identified a series of genes that contribute to the disease pathogenesis, especially in modulating histopathology features, providing us with new clues in treating psoriasis.
The microbiota restrains neurodegenerative microglia in a model of amyotrophic lateral sclerosis
Authors: Cox Laura M. , Calcagno Narghes , Gauthier Christian , Madore Charlotte , Butovsky Oleg , Weiner Howard L.
Published: March 2022

Background

The gut microbiota can affect neurologic disease by shaping microglia, the primary immune cell in the central nervous system (CNS). While antibiotics improve models of Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, and the C9orf72 model of amyotrophic lateral sclerosis (ALS), antibiotics worsen disease progression the in SOD1G93A model of ALS. In ALS, microglia transition from a homeostatic to a neurodegenerative (MGnD) phenotype and contribute to disease pathogenesis, but whether this switch can be affected by the microbiota has not been investigated.

Results

In this short report, we found that a low-dose antibiotic treatment worsened motor function and decreased survival in the SOD1 mice, which is consistent with studies using high-dose antibiotics. We also found that co-housing SOD1 mice with wildtype mice had no effect on disease progression. We investigated changes in the microbiome and found that antibiotics reduced Akkermansia and butyrate-producing bacteria, which may be beneficial in ALS, and cohousing had little effect on the microbiome. To investigate changes in CNS resident immune cells, we sorted spinal cord microglia and found that antibiotics downregulated homeostatic genes and increased neurodegenerative disease genes in SOD1 mice. Furthermore, antibiotic-induced changes in microglia preceded changes in motor function, suggesting that this may be contributing to disease progression.

Conclusions

Our findings suggest that the microbiota play a protective role in the SOD1 model of ALS by restraining MGnD microglia, which is opposite to other neurologic disease models, and sheds new light on the importance of disease-specific interactions between microbiota and microglia.