bluuebunny/crossref_metadata_2025 huggingface dataset:
Precision medicine is coming to town: personalising home ventilatory equipment in COPD patients with chronic hypercapnic respiratory failure
Authors: Gonzalez-Bermejo Jesus , Nava Stefano , Rabec Claudio , Vega Maria Laura
Published: October 2024

Discharging a chronic critically ill patient is a risky procedure if the clinician does not have full control of his prescription. This is even more important when applying a machine to replace a failing organ, as is the case for home ventilation. Even if modern home ventilators fulfil quality and safety criteria and, ‘on paper’, ventilators and masks look very similar, performance and scenarios of applicability are not always equivalent. In the case of ventilators, the type of circuit, accessories provided and available modes vary between devices. Bench studies comparing ventilators have shown large differences in triggering, rise time, pressurisation capacities, maximal flow provided, cycling and level of authorised expiratory positive airway pressure. Automated algorithms to deal with leaks also vary and have not been sufficiently evaluated. In the case of interfaces, the choice of mask requires careful evaluation of the underlying disease and of the type of ventilator and circuit, which could have a potentially major impact on patient compliance and clinical effectiveness. This could explain different results in the same clinical situation.

The choice of ventilator and type of mask represents a medical prescription and should be respected by the provider and not subject to financial constraints.
Sphingolipids in COPD
Authors: Chakinala Raja Chandra , Khatri Akshay , Gupta Kriti , Koike Kengo , Epelbaum Oleg
Published: October 2024

Sphingolipids are a distinct class of lipid molecules widely found in nature, principally as cell membrane constituents. After initial uncertainty about their function, sphingolipids have been increasingly recognised to be metabolically active entities involved in many biological processes, including the control of inflammation. Their role as mediators of inflammation may have significant implications for a range of lung diseases in which inflammation is a central element of pathogenesis. Chronic obstructive pulmonary disease (COPD), a highly prevalent and morbid condition predominantly affecting cigarette smokers, is a prime example of a respiratory illness with an inflammatory component. Understandably, sphingolipids have received growing attention for their increasingly demonstrated role in the pathophysiology of COPD. The present review aims to be among the first to focus exclusively on the connection between sphingolipids and lung inflammation in COPD, providing the reader with a clinically oriented synopsis of this intriguing association.
Referral pathway and competency profiles of primary care physiotherapists and kinesiologists for physical activity interventions for diabetes: a modified Delphi study
Authors: Proctor Carly , Brown Cara L.
Published: October 2024

Background

High quality diabetes care is an essential service in primary care settings since the prevalence and associated complications of diabetes is increasing. Physical activity is effective for the prevention and management of diabetes yet is underutilized in diabetes care. Exercise professionals have specialized skills to deliver physical activity interventions, but effective interprofessional collaboration for diabetes care requires role clarity. This study established the competencies of entry-level physiotherapists and kinesiologists for physical activity interventions for diabetes care in primary care settings and used these competencies to develop clinical tools to promote role clarity in interprofessional care teams.

Methods

We used a modified Delphi process. Eleven physiotherapy and three kinesiology subject matter experts participated in two rounds of Delphi surveys to develop discipline and context specific competencies. These competencies were used to draft competency profiles and a referral pathway tool. Eleven of the participants then participated in a focus group for member-checking of the tools. Descriptive statistics and content analysis were used to analyze quantitative and qualitative data respectively.

Results

The modified Delphi process resulted in 38 physiotherapy and 27 kinesiology competencies that identify the distinct roles of physiotherapists and kinesiologists in delivering physical activity interventions for diabetes care. The physiotherapy competencies describes their unique role in supporting people with all types of diabetes to engage in physical activity despite complex medical or physical barriers. The kinesiology competencies indicate where these professionals may require additional training, especially when working with people living with type 1 diabetes or who are pregnant. All developed tools had good face validity and were seen to be potentially useful tools by the subject matter experts.

Conclusions

The findings highlight that both physiotherapists and kinesiologists have fundamental skills and abilities to deliver physical activity interventions to people living with diabetes, but that different exercise professionals may be needed depending on the complexity of the clinical profile. The developed clinical tools support improved interprofessional collaboration by clarifying physiotherapy and kinesiology roles in delivering physical activity interventions for diabetes care and highlighting how the two distinct professions can contribute to addressing the growing diabetes epidemic in primary care.
Allopregnanolone and progesterone in relation to a single electroconvulsive therapy seizure and subsequent clinical outcome: an observational cohort study
Authors: Thörnblom Elin , Cunningham Janet L. , Gingnell Malin , Landén Mikael , Bergquist Jonas , Bodén Robert
Published: October 2024

Background

Electroconvulsive therapy (ECT) is an important treatment for several severe psychiatric conditions, yet its precise mechanism of action remains unknown. Increased inhibition in the brain after ECT seizures, mediated by γ-aminobutyric acid (GABA), has been linked to clinical effectiveness. Case series on epileptic patients report a postictal serum concentration increase of the GABAA receptor agonist allopregnanolone. Serum allopregnanolone remains unchanged after a full ECT series, but possible transient effects directly after a single ECT seizure remain unexplored. The primary aim was to measure serum concentrations of allopregnanolone and its substrate progesterone after one ECT seizure. Secondary aims were to examine whether concentrations at baseline, or postictal changes, either correlate with seizure generalization or predict clinical outcome ratings after ECT.

Methods

A total of 130 participants (18–85 years) were included. Generalization parameters comprised peak ictal heart rate, electroencephalographic (EEG) seizure duration, and prolactin increase. Outcome measures were ratings of clinical global improvement, perceived health status and subjective memory impairment. Non-parametric tests were used for group comparisons and correlations. The prediction analyses were conducted with binary logistic and simple linear regression analyses.

Results

Allopregnanolone and progesterone remained unchanged and correlated neither with seizure generalization nor with clinical outcome. In men (n = 50), progesterone increased and allopregnanolone change correlated negatively with EEG seizure duration. In a subgroup analysis (n = 62), higher baseline allopregnanolone and progesterone correlated with postictal EEG suppression.

Conclusions

ECT seizures have different physiologic effects than generalized seizures in epilepsy. Progesterone might have implications for psychiatric illness in men.
Women’s health and psychological well-being in the return-to-work process after long-term sick leave for common mental disorders: women’s and first-line managers’ perspectives
Authors: Hedlund Åsa , Kristofferzon Marja-Leena , Boman Eva , Nieuwenhuijsen Karen , Nilsson Annika
Published: October 2024

Background and aim

Common mental disorders are common reasons for long-term sick leave, especially among women. Return to work is often complex and unsuccessful, why more knowledge is needed regarding women’s health and psychological well-being in the return-to-work process. Therefore, the aim was to describe women’s health and psychological well-being in the return-to-work process, from women’s and first-line managers’ perspectives.

Methods

Individual interviews were conducted with 17 women and 16 first-line managers. Qualitative content analysis was performed based on the content areas “Women’s health (i.e. overall well-being, both physical and psychological) throughout the whole RTW process” and “Women’s psychological well-being (happiness, meaning and a sense of being significant) at work after work resumption” Themes and categories were created.

Results

Women and managers had similar descriptions, i.e. that women’s health and psychological well-being depend on the individual characteristics of women themselves, their private life, work and other stakeholders. However, women described relational work tasks (e.g. meeting patients) as beneficial for health, and highlighted small stressors in the work environment, which the managers did not. Having work that was compatible with private life, being in good health, having stimulating work tasks and strengthening relationships at work were important for the women’s psychological well-being.

Conclusions

Based on women’s and first-line managers experiences, promotion of women’s health and psychological well-being during the return-to-work process requires individually adapted assessments and actions involving women’s entire life situation. First-line managers should know that relational work tasks (e.g., meeting patients) can be beneficial for women’s health as well as that minor stressor in the work environment can put their health at risk.
Modeling CSF circulation and the glymphatic system during infusion using subject specific intracranial pressures and brain geometries
Authors: Dreyer Lars Willas , Eklund Anders , Rognes Marie E. , Malm Jan , Qvarlander Sara , Støverud Karen-Helene , Mardal Kent-Andre , Vinje Vegard
Published: October 2024

Background

Infusion testing is an established method for assessing CSF resistance in patients with idiopathic normal pressure hydrocephalus (iNPH). To what extent the increased resistance is related to the glymphatic system is an open question. Here we introduce a computational model that includes the glymphatic system and enables us to determine the importance of (1) brain geometry, (2) intracranial pressure, and (3) physiological parameters on the outcome of and response to an infusion test.

Methods

We implemented a seven-compartment multiple network porous medium model with subject specific geometries from MR images using the finite element library FEniCS. The model consists of the arterial, capillary and venous blood vessels, their corresponding perivascular spaces, and the extracellular space (ECS). Both subject specific brain geometries and subject specific infusion tests were used in the modeling of both healthy adults and iNPH patients. Furthermore, we performed a systematic study of the effect of variations in model parameters.

Results

Both the iNPH group and the control group reached a similar steady state solution when subject specific geometries under identical boundary conditions was used in simulation. The difference in terms of average fluid pressure and velocity between the iNPH and control groups, was found to be less than 6% during all stages of infusion in all compartments. With subject specific boundary conditions, the largest computed difference was a 75% greater fluid speed in the arterial perivascular space (PVS) in the iNPH group compared to the control group. Changes to material parameters changed fluid speeds by several orders of magnitude in some scenarios. A considerable amount of the CSF pass through the glymphatic pathway in our models during infusion, i.e., 28% and 38% in the healthy and iNPH patients, respectively.

Conclusions

Using computational models, we have found the relative importance of subject specific geometries to be less important than individual differences in resistance as measured with infusion tests and model parameters such as permeability, in determining the computed pressure and flow during infusion. Model parameters are uncertain, but certain variations have large impact on the simulation results. The computations resulted in a considerable amount of the infused volume passing through the brain either through the perivascular spaces or the extracellular space.
Identification of circRNA CDR1as/miR-214-3p regulatory axis in Legg-Calvé-Perthes disease
Authors: Lan Xia , Yu Ronghui , Xu Jianyun
Published: October 2024

Background

Legg-Calvé-Perthes disease (LCPD) commonly occurs among adolescents, threatening their health. However, the potential mechanism underlying LCPD remains unclear. miR-214-3p is shown as a critical role in LCPD development with unspecified upstream regulators.

Methods

Levels of miR-214-3p and circCDR1as in healthy controls and LCPD patients were determined by qRT-PCR. The role of circCDR1as/miR-214-3p axis in LCPD was determined by testing the cell viability and apoptosis in TC28 cells and primary chondrocytes. Regulation between circCDR1as and miR-214-3p was examined by RIP and ChIP assays. The inflammatory response and angiogenesis were evaluated by M2 macrophage polarization and HUVECs tumor formation.

Results

circCDR1as was overexpressed in LCPD patients with a negative correlation with miR-214-3p. Inhibition of circCDR1as alleviated the cell viability and apoptosis of DEX-treated chondrocytes, stimulated M2 macrophage polarization and angiogenesis. miR-214-3p was proved as a downstream effector to participate in circCDR1as mediated actions. circCDR1as recruited PRC2 complex to epigenetically suppress miR-214-3p.

Conclusion

Our study illustrated the role and mechanism of circCDR1as in LCPD development by targeting miR-214-3p, highlighting its potential in the therapy for LCPD.
Oral functions in adult persons with spinal muscular atrophy compared to a healthy control group: a prospective cross-sectional study with a multimodal approach
Authors: Kruse Teresa , Leflerovà Diana , Cap Annette , Portegys Sara , Wirth Brunhilde , Heller Raoul , Brakemeier Svenja , Hagenacker Tim , Braumann Bert , Wunderlich Gilbert
Published: October 2024

Background

Oral function tests have been shown to reliably detect impaired bulbar function in adults with spinal muscular atrophy (SMA). Although not routinely recorded, it is known that persons with SMA are affected to varying degrees. Detecting differences in bite and tongue force, endurance, and maximum mouth opening has become particularly promising since the introduction of causal therapy for SMA. This study aimed to compare oral function among adult persons with SMA with different SMA types, walking abilities, and treatment status to a healthy control group.

Methods

Data from oral function tests conducted on 58 persons with SMA and 45 healthy individuals were analyzed. Differences in oral function between SMA subgroups were pairwise tested and compared to the healthy control group using Wilcoxon rank sum tests.

Results

In an overall comparison, three out of five oral function tests revealed lower values for the SMA group compared to the control group. Subgroup analyses indicated lower scores for most oral function tests in non-ambulatory, untreated patients with SMA type 2 compared to controls. Ambulatory, treated patients with SMA type 3 achieved strength and endurance values comparable to those of healthy individuals.

Conclusions

The impairment of oral function varies across persons with SMA. Routine measurement of oral function is warranted to determine individual bulbar involvement stages. Further evaluation should be scheduled if indicators such as restricted maximum mouth opening arise.

Trial registration DRKS, DRKS00015842. Registered 30 July 2019, https://drks.de/register/de/trial/DRKS00015842/preview.
Delayed diagnosis and treatment of achalasia: a case report
Authors: Ginsburg Sabrina , Caplan Chelsea , Agarwal Gauri
Published: October 2024

Background

Achalasia is characterized as an esophageal motility disorder with incomplete relaxation of the lower esophageal sphincter. Achalasia can be associated with abnormal peristalsis and symptoms of dysphagia, acid reflux, and chest pain. The exact pathophysiology of achalasia remains unclear, but it is hypothesized to be due to degeneration of the myenteric plexus.

Case presentation

In this case, a 46-year-old Hispanic man presented to the emergency room with a 12-year history of progressive discomfort with swallowing solids and liquids. Due to many years of incomplete follow-up care and lack of understanding of the course of his disease, this patient’s symptoms escalated to complete intolerance of oral intake and significant weight loss. He was diagnosed with achalasia during his hospital stay and treated successfully with laparoscopic Heller myotomy.

Conclusions

This case discussion illustrates the importance of follow-up care and patient education so that diagnosis and treatment of achalasia are not delayed.
Isolated during adolescence: long-term impact on social behavior, pain sensitivity, and the oxytocin system in male and female rats
Authors: P. Graf Akseli , Hansson Anita C. , Spanagel Rainer
Published: October 2024

Background

Adolescent social isolation (ASI) has profound long-term effects on behavioral and neural development. Despite this, the specific long-term impact of ASI during different adolescent stages and across sexes remain underexplored.

Methods

Our study addresses this gap by examining the effects of early- and late- adolescent social isolation on both male and female rats. Rats were either isolated (or group-housed) starting from PD 21 (early) or PD 42 (late) for three weeks and then rehoused into groups. In adulthood (PD 90), rats underwent a battery of tests: elevated plus-maze, open field, novel object recognition, social interaction and social recognition memory and hotplate tests. Finally, we analyzed oxytocin receptor binding in several regions in the brains of a second cohort of rats.

Results

Both, male and female rats from the late adolescent social isolation (LASI) groups spent significantly less time interacting in the social interaction test. Additionally, we observed a general decrease in social recognition memory regardless of sex. Both male ASI groups demonstrated heightened thermal pain sensitivity, while the opposite was observed in early adolescent social isolation (EASI) female rats. In the brain, we observed changes in oxytocin receptor (OTR) binding in the paraventricular nucleus of the hypothalamus (PVN) and paraventricular nucleus of the thalamus (PVT) and central amygdala (CeA) with the largest changes in EASI and LASI female rats.

Conclusion

Our model demonstrates long-lasting alterations on behavior and oxytocin receptor binding levels following ASI providing insights into the long-term effects of ASI in a time- and sex-specific manner.
Investigating the effects of mobile bottom fishing on benthic carbon processing and storage: a systematic review protocol
Authors: Felgate Stacey L. , Aldridge John , Bolam Stefan G. , Breimann Sarah , de Borger Emil , Claes Jolien , Depestele Jochen , Epstein Graham , Garcia Clement , Hicks Natalie , Kaiser Michel , Laverick Jack H. , Lessin Gennadi , O’Neill Finbarr G. , Paradis Sarah , Parker Ruth , Pereira Ryan , Poulton Alex J. , Powell Claire , Smeaton Craig , Snelgrove Paul , Tiano Justin , van der Molen Johan , van de Velde Sebastiaan , Sciberras Marija
Published: October 2024

Background

Marine sediments represent one of the planet’s largest carbon stores. Bottom trawl fisheries constitute the most widespread physical disturbance to seabed habitats, which exert a large influence over the oceanic carbon dioxide (CO2) sink. Recent research has sparked concern that seabed disturbance from trawling can therefore turn marine sediments into a large source of CO2, but the calculations involved carry a high degree of uncertainty. This is primarily due to a lack of quantitative understanding of how trawling mixes and resuspends sediments, how it alters bioturbation, bioirrigation, and oxygenation rates, and how these processes translate into carbon fluxes into or out of sediments.

Methods

The primary question addressed by this review protocol is: how does mobile bottom fishing affect benthic carbon processing and storage? This question will be split into the following secondary questions: what is the effect of mobile bottom fishing on: (i) the amount and type of carbon found in benthic sediments; (ii) the magnitude and direction of benthic-pelagic carbon fluxes; (iii) the biogeochemical, biological, and physical parameters that control the fate of benthic carbon; and (iv) the biogeochemical, biological, and physical parameters that control the fate of resuspended carbon. Literature searches will be conducted in Web of Science, SCOPUS, PROQUEST, and a range of grey and specialist sources. An initial scoping search in Web of Science informed the final search string, which has been formulated according to Population Intervention Comparator Outcome (PICO) principles. Eligible studies must contain data concerning a change in a population of interest caused by mobile bottom fishing. Eligible study designs are Before and After, Control and Impact, and Gradient studies. Studies included at full-text screening will be critically appraised, and study findings will be extracted.Extracted data will be stored in an Excel spreadsheet. Results will be reported in narrative and quantitative syntheses using a variety of visual tools including forest plots. Meta-analysis will be conducted where sufficient data exists.
What does e-invoice data bring to SNA and real-time economy?
Authors: Akagi Kaya
Published: October 2024

This paper explores the potential of electronic invoice data to enhance the System of National Accounts (SNA) and facilitate a Real-Time Economy (RTE). The rise of data science and advancements in information and communication technologies have increased the use of big data in economic statistics. E-invoice data is being digitized in Europe to detect VAT fraud, but it also contains a vast amount of information on economic entities that make up the SNA. This study focuses on integrating electronic accounting information to improve the coverage, granularity, and update speed of SNA. The paper examines the concept of RTE, which emphasizes real-time data processing and automation, particularly in Estonia and Finland. It also highlights the benefits and challenges of using invoice data for economic statistics, including issues related to data storage formats, legislative systems, and the coordination of data linkages. The research demonstrates invoice data’s theoretical and practical applications for constructing Input–Output Tables (IOTs) and monitoring financial situations. Despite the technical and institutional hurdles, the study suggests integrating invoice data can significantly transform economic statistics.
Emerging and ecofriendly biological methods for agricultural wastewater treatment
Authors: Abonyi Matthew Ndubuisi , Obi Christopher Chiedozie , Nwabanne Joseph Tagbo , Aniagor Chukwunonso Onyeka
Published: October 2024

The quest for sustainable agricultural practices has led to a surge in research focused on innovative wastewater treatment methods. This review explores the emerging biological treatment approaches designed to address the challenges of eco-friendly agricultural wastewater treatment and subsequent reuse. The investigation centers around three novel techniques: constructed wetlands, algae-based systems, and microbial fuel cells. Constructed wetlands (CWs) mimic natural processes to treat agricultural wastewater, providing habitat for various plant species that collaboratively remove contaminants. Algae-based systems(ABs) harness the photosynthetic prowess of algae to absorb nutrients and pollutants, producing biomass that can be repurposed. Meanwhile, microbial fuel cells (MFCs) employ microorganisms to break down organic matter in wastewater while generating electricity as a valuable byproduct. This review aims to provide insights into the potential of these biological treatment methods to revolutionize wastewater management in agriculture. By mitigating environmental impact, conserving water resources, and yielding reusable outputs, these techniques will offer a sustainable pathway towards addressing the pressing challenges of agricultural wastewater treatment and enhancing the overall ecological balance.
BRD4 inhibitor reduces exhaustion and blocks terminal differentiation in CAR-T cells by modulating BATF and EGR1
Authors: Sui Songnan , Zhong Mengjun , Zhong Shuxin , Peng Xueting , Mao Lipeng , Chen Cunte , Zeng Chengwu , Luo Oscar Junhong , Li Yangqiu
Published: October 2024

Background

Exhaustion is a key factor that influences the efficacy of chimeric antigen receptor T (CAR-T) cells. Our previous study demonstrated that a bromodomain protein 4 (BRD4) inhibitor can revise the phenotype and function of exhausted T cells from leukemia patients. This study aims to elucidate the mechanism by which a BRD4 inhibitor reduces CAR-T cell exhaustion using single-cell RNA sequencing (scRNA-Seq).

Methods

Exhausted CD123-specific CAR-T cells were prepared by co-culture with CD123 antigen-positive MV411 cells. After elimination of MV411 cells and upregulation of inhibitory receptors on the surface, exhausted CAR-T cells were treated with a BRD4 inhibitor (JQ1) for 72 h. The CAR-T cells were subsequently isolated, and scRNA-Seq was conducted to characterize phenotypic and functional changes in JQ1-treated cells.

Results

Both the proportion of exhausted CD8+ CAR-T cells and the exhausted score of CAR-T cells decreased in JQ1-treated compared with control-treated cells. Moreover, JQ1 treatment led to a higher proportion of naïve, memory, and progenitor exhausted CD8+ CAR-T cells as opposed to terminal exhausted CD8+ CAR-T cells accompanied by enhanced proliferation, differentiation, and activation capacities. Additionally, with JQ1 treatment, BATF activity and expression in naïve, memory, and progenitor exhausted CD8+ CAR-T cells decreased, whereas EGR1 activity and expression increased. Interestingly, AML patients with higher EGR1 and EGR1 target gene ssGSEA scores, coupled with lower BATF and BATF target gene ssGSEA scores, had the best prognosis.

Conclusions

Our study reveals that a BRD4 inhibitor can reduce CAR-T cell exhaustion and block exhausted T cell terminal differentiation by downregulating BATF activity and expression together with upregulating EGR1 activity and expression, presenting an approach for improving the effectiveness of CAR-T cell therapy.
Evaluation of size-dependent uptake, transport and cytotoxicity of polystyrene microplastic in a blood-brain barrier (BBB) model
Authors: Cho Yeongseon , Seo Eun U , Hwang Kyeong Seob , Kim Hyelim , Choi Jonghoon , Kim Hong Nam
Published: October 2024

Microplastics, particularly those in the micrometer scale, have been shown to enter the human body through ingestion, inhalation, and dermal contact. Recent research indicates that microplastics can potentially impact the central nervous system (CNS) by crossing the blood-brain barrier (BBB). However, the exact mechanisms of their transport, uptake, and subsequent toxicity at BBB remain unclear. In this study, we evaluated the size-dependent uptake and cytotoxicity of polystyrene microparticles using an engineered BBB model. Our findings demonstrate that 0.2 μm polystyrene microparticles exhibit significantly higher uptake and transendothelial transport compared to 1.0 μm polystyrene microparticles, leading to increased permeability and cellular damage. After 24 h of exposure, permeability increased by 15.6-fold for the 0.2 μm particles and 2-fold for the 1.0 μm particles compared to the control. After 72 h of exposure, permeability further increased by 27.3-fold for the 0.2 μm particles and a 4.5-fold for the 1.0 μm particles compared to the control. Notably, microplastics administration following TNF-α treatment resulted in enhanced absorption and greater BBB damage compared to non-stimulated conditions. Additionally, the size-dependent toxicity observed differently between 2D cultured cells and 3D BBB models, highlighting the importance of testing models in evaluating environmental toxicity.

Graphical Abstract
Individual and community-level factors associated with adequate antenatal care service utilization in sub-Saharan Africa
Authors: Fenta Setegn Muche , Fenta Haile Mekonnen , Yilema Seyifemickael Amare , Chen Ding-Geng , Mekonnin Amsalu Worku
Published: October 2024

Background

Sub-Saharan Africa (sSA) continues to rank among the regions in the world with the highest rates of maternal mortality and the lowest rates of utilization of maternal health care. The risk of death for women in sSA is 268 times higher than that of women in high-income nations. Adequate antenatal care (ANC) services utilization is essential to the mother's and the baby's survival and well-being. This study aimed to identify both individual and community-level factors associated with adequate antenatal care services utilization in sSA.

Method

We used data from the most recent Health and Demographic Surveys (DHS), which were carried out between 2012 and 2022 in 33 sSA countries. A total of 240,792 women were included in this study. The two-level mixed-effects logistic regression model was used to identify the individual and community-level factors associated with the use of adequate ANC service.

Results

The pooled prevalence of adequate ANC service utilization in sSA was 55.48% (95% CI: 55.28–55.68). The study showed that secondary and above-educated women (AOR = 2.13, 95% CI 2.07–2.19, secondary and above-educated husbands (AOR = 1.55, 95% CI 1.51–1.60), rich women AOR = 1.26, 95% CI 1.24–1.29), women 35–49 years of age (AOR = 1.36, 95% CI 1.32–1.41) and distance to a health facility is not a big problem (AOR = 1.13; 95% CI 1.11–1.16) was significantly and positively correlated with the use of adequate ANC services. However, rural women (AOR = 0.80; 95% CI 0.78–0.82), not having mass media access (AOR = 0.74, 95% CI 0.72–0.75), 5 and above birth order (AOR = 0.73, 95% CI 0.68–0.78) were significantly and negatively correlated with the use of adequate ANC services. Additionally, the random effects model showed that variables at the community and individual levels were responsible for approximately 62.60% of the variation in the use of adequate ANC services.

Conclusion

The sSA countries had a low prevalence of adequate utilization of ANC with a significant variation among countries. Moreover, public health initiatives should focus on rural women, poor women, and uneducated women to enhance maternal health services utilization. Furthermore, policies and programs that address cluster variations in the utilization of adequate ANC services must be developed, and their implementation must be vigorously pursued.
The role of electronic health records in improving pediatric nursing care: a systematic review
Authors: Al-Shammari Moustafa A. , Jaafar Jaafar Sadiq , Elfeshawy Reda
Published: October 2024

Background

The adoption of electronic health records (EHRs) has revolutionized healthcare delivery, offering potential benefits for enhancing the quality and safety of pediatric nursing care. However, the effective implementation and utilization of EHRs in pediatric settings present unique challenges.

Objectives

This systematic review aims to critically analyze the available literature on the role of EHRs in improving various aspects of pediatric nursing care, including clinical documentation, medication management, care coordination, and patient engagement.

Methods

A comprehensive search of multiple electronic databases (PubMed, CINAHL, Embase, and Cochrane Library) was conducted to identify relevant studies published between January 2000 and March 2023. Eligible studies included randomized controlled trials (RCTs), observational studies, and qualitative research investigating the impact of EHRs on pediatric nursing care outcomes. Study selection, data extraction, and quality assessment were performed by two independent reviewers.

Results

Out of 1,257 records, 28 studies (12 RCTs, 10 observational, 6 qualitative) were included, involving 3,642 pediatric patients and 1,278 healthcare professionals. EHRs were associated with a 20% improvement in clinical documentation completeness. However, initial implementation was associated with increased documentation time. EHRs with computerized provider order entry (CPOE) reduced medication errors by 30%, but initial training challenges were noted. Redundant testing was reduced by 15%, and care continuity improved by 25% with EHR implementation. Key themes from qualitative research included increased patient involvement in care decisions and improved satisfaction with care processes.

Conclusion

EHRs have the potential to enhance various aspects of pediatric nursing care, including improved documentation, medication management, care coordination, and patient engagement. Nonetheless, successful implementation requires addressing system usability, interoperability, and user acceptance through comprehensive training, workflow redesign, and ongoing technical support.

Systematic review registration 

This review was registered with PROSPERO (CRD42024563092).
Predictors of breast cancer HER2-receptor positivity by MRI intuitive imaging features
Authors: Bayoumi Dalia , ELagamy Ahmed Alaa EL-Din , Salem Hesham Sabry Mohamed , Elboghdady Aya
Published: October 2024

Background

Today, breast cancer is the most diagnosed cancer worldwide. There are many different clinical presentations, radiological characteristics, and histological types of breast cancer. HER2 is overexpressed in a significant number of breast cancer cases reaching 20% of all breast cancers, and its overexpression is seen directly proportionate with a poor outcome and prognosis.

Methods

We started this cross-sectional research from January 2022–December 2023 on 202 breast cancer patients who had 220 lesions. The molecular subtypes of the different lesions were determined in all the included cases. Magnetic resonance imaging (MRI) studies were conducted in all included cases. The MRI parameters included conventional MRI, diffusion-weighted analysis, and dynamic post-contrast T1-weighted imaging.

Results

The prevalence of irregular margins (P < 0.001), linear and segmental distribution (P = 0.044), heterogeneous pattern (P < 0.001), and type 2 curve was statistically significantly higher in the HER2-positive lesions. Nipple infiltration incidence showed statistically significant elevation in the HER2-positive lesions (P = 0.017). The lesions’ ADC and perilesional ADC in the HER2-positive lesions were also statistically significantly elevated. The best cutoff point of ADC to detect lesions with positive HER2 expression was > 0.885 × 10–3 mm2/s, with 65.7% sensitivity and 60% specificity, with a statistically significant value (p = 0.005).

Conclusions

Magnetic resonance imaging of breast imaging is a promising noninvasive method for identifying breast tumors with the HER2 molecular subtype. Combining various radiological features by MRI may provide a conclusion for recognizing positive HER2 lesions.
Necessity for a global patient co-owned cloud (GPOC)
Authors: Lidströmer Niklas , Davids Joe , ElSharkawy Mohamed , Ashrafian Hutan , Herlenius Eric
Published: October 2024

Background

The use of Cloud-based storage of personal health records has increased globally. The GPOC Series introduces the concept of a Global Patient co-Owned Cloud (GPOC) of personal health records. Here, we present the GPOC Series’ international survey on the necessity of a GPOC.

Methods

Online global survey with invitations sent to health ministries and major organisations. It received answers from health ministries and affiliated advisors of all 193 United Nations (UN) member states, 2 UN observer states (Holy See & Palestine) and 1 de facto UN non-member state (Taiwan) and from 18 major international organisations. The survey examined a dozen aspects encompassing demographics, privacy, sharing, movability, co-ownership, research, company usage, regulation and the necessity of a GPOC.

Results

The GPOC Survey elicited responses from 267 individuals from 214 entities, including all UN member states, and major international organisations. Twelve domains were identified, covering demographics, correctness, privacy, commercial use, medical and non-medical research, co-ownership, data sharing, record movement, ownership centralisation, patient rights, environmental concerns, and foundation creation. Results show high agreement on most issues, including support for co-ownership (89%) and movement of personal health records (84%). Disagreement was prominent regarding centralised ownership by the state (64%) and data sharing without consent (85%). Additionally, respondents expressed interest in a neutral, decentralised foundation for regulation (73%) and the environmental sustainability of electronic health records (84%).

Conclusions

A Global Patient co-Owned Cloud (GPOC) of personal health records could significantly enhance patient independence and involvement in health management, supported by the near consensus agreement across various domains identified in our survey. This consensus underscores the potential of GPOC to democratise healthcare and align with UN Sustainable Development Goals (SDGs). The survey results demonstrate strong support for GPOC’s role in promoting evidence-based patient management, reducing information silos, and fostering ethical data sharing. Moreover, the overwhelming agreement on key principles of co-ownership, data sharing, and environmental sustainability highlights the global inclination for a decentralised, patient-controlled PHR platform. This platform stands to empower patients worldwide, advance precision medicine, and contribute to the global development and dissemination of artificial intelligence in healthcare.
CIGVis: An open-source Python tool for the real-time interactive visualization of multidimensional geophysical data
Authors: Li Jintao , Shi Yunzhi , Wu Xinming
Published: October 2024

As Python’s role in processing and interpreting geophysical data expands, the need for a Python-based tool tailored for visualizing geophysical data has become increasingly critical. In response, the Computational Interpretation Group Visualization tool (CIGVis) — a fully open-source Python tool optimized for researchers and licensed under the Massachusetts Institute of Technology License — has been developed. It specializes in the real-time interactive visualization of multi-dimensional geophysical data, including volumetric data of geophysical properties, meshes of geologic objects (e.g., faults, horizons, and geobodies), points and tubes of well-log data. CIGVis enables users to interact with the data through operations such as rotation, panning, magnifying, and dragging slices. It also supports a multicanvas functionality, allowing a simultaneous visualization across multiple subcanvases with a unified camera perspective. Its ease of use allows for effective visualization with just a few lines of code across all major operating systems and extends to desktop and Jupyter environments, facilitating code execution in various settings. The core functionalities of CIGVis are exemplified using standard geophysical data sets, such as the F3 data set.
HIV-1 assembly – when virology meets biophysics
Authors: Lacouture Claire , Carrio Baptiste , Favard Cyril , Muriaux Delphine
Published: October 2024

Cells naturally produce vesicles that bud from different lipid membranes using dedicated molecular machineries. Enveloped RNA viruses, including human immunodeficiency virus type 1 (HIV-1), also generate particles that bud from host cell membranes by hijacking cellular factors and signaling pathways similar to those involved in the budding of extracellular vesicles. HIV-1 buds from the host cell plasma membrane mainly via the self-assembly of Gag, a structural protein. Gag is a polyprotein that forms assembly complexes containing viral genomic RNA (gRNA), host cell lipids and proteins. HIV-1 Gag binds and segregates host cell plasma membrane lipids while self-assembling simultaneously on the gRNA and the plasma membrane. This self-assembly causes membrane bending and formation of a new viral particle with the help of host cell proteins, likely including cortical actin-associated factors. However, it is unclear whether the energy of Gag self-assembly is sufficient to generate new HIV-1 particles. In this Review, we discuss these processes in the light of the past and recent virology literature, incorporating lessons from studies on the quantitative biophysics of viral self-assembly, and explore how Gag might reorganize the plasma membrane and divert host cell membrane curving proteins and cortical actin-related factors to achieve particle assembly and budding.
Εκχρηματισμός της οικονομίας, θρησκεία, κοινωνικοί ανταγωνισμοί
Authors: Μπουγιούκα Αθανασία
Published: October 2024

Το 1524-25 εξαπλώθηκε στις νότιες και κεντρικές περιοχές της γερμανόφωνης Ευρώπης μια μεγάλη εξέγερση αγροτικών κυρίως πληθυσμών, ο ονομαζόμενος «Πόλεμος των Χωρικών». Το κίνημα στράφηκε κατά των αρχόντων, της επίσημης εκκλησίας και γενικότερα των αρχών της εποχής. Στη διάρκεια της εξέγερσης στην περιοχή του Μιλχάουζεν της Θουριγγίας, οι εξεγερμένοι υπό την ηγεσία του Τόμας Μίντσερ, εγκαθίδρυσαν για δύο μήνες, από τις 17 Μαρτίου έως τις 25 Μαΐου 1525, ένα ιδιαίτερο καθεστώς, το οποίο για πρώτη φορά στη χριστιανική Ευρώπη στηριζόταν στην άρνηση κάθε ιδιοκτησίας, ένα καθεστώς κοινοκτημοσύνης και αυτοδιοίκησης με βάση το σύνθημα «όλα είναι κοινά». Λίγα χρόνια μετά, τον Φεβρουάριο 1534, οι Αναβαπτιστές, που η συγκρότησή τους συμπίπτει χρονικά με τον «Πόλεμο των Χωρικών», εγκαθίδρυσαν στην πόλη του Μύνστερ ένα καθεστώς ανάλογο με αυτό του Μιλχάουζεν. Στις αρχές του 16ου αι. οι χρηματικές οικονομικές σχέσεις είναι κυρίαρχες στις βασικές ευρωπαϊκές χώρες, συμπεριλαμβανομένης και της Αγίας Ρωμαϊκής Αυτοκρατορίας: οι καπιταλιστικές σχέσεις παραγωγής έχουν ήδη εδραιωθεί, ενώ παράλληλα αυξάνονταν η παραγωγή, ο εξορυκτικός πλούτος και η εμπορική δραστηριότητα, καθώς οι εμπορικοί δρόμοι περνούσαν από τα γερμανόφωνα εδάφη. Είχαν ιδρυθεί σημαντικές τράπεζες (π.χ. Βέλζερ και Φούγκερ στο Άουγκσμπουργκ) και μετοχικές εταιρίες, ενώ οι συναλλαγματικές ήταν μια παγιωμένη οικονομική πρακτική. Οι φεουδαρχικές ιδιοκτησίες σε πολλές περιοχές μετατρέπονται σε «επιχειρήσεις» για την παραγωγή χρηματικού πλεονάσματος, το κράτος οργανώνει τα συμφέροντα των κατόχων χρήματος, ενώ και οι οικοτέχνες αλλά και μια μερίδα αγροτών μετασχηματίζονται σε «μισθωτούς με το κομμάτι» με τη βοήθεια του «προαγοραστή». Παρατηρείται λοιπόν η ύπαρξη ενός οικονομικού συστήματος που προκύπτει από τον εκχρηματισμό της φεουδαρχίας σε μια κοινωνία όπου έχει ήδη εδραιωθεί ο καπιταλιστικός τρόπος παραγωγής. Ο εργαζόμενος παραμένει δέσμιος σχέσεων δουλοπαροικίας και ο γαιοκτήμονας γίνεται «επιχειρηματίας», δηλ. χρησιμοποιεί επιχειρηματικά την εργασία των δουλοπάροικων για τη μεγιστοποίηση του κέρδους.Θα πρέπει να αντιληφθούμε τον Πόλεμο των Χωρικών ως απότοκο των κοινωνικών μετασχηματισμών που λάμβαναν χώρα σε συνάρτηση με τον εκχρηματισμό της κοινωνίας, που εκτόπιζε τον κλασικό φεουδαρχικό τρόπο παραγωγής και τον μετέτρεπαν σε «επιχειρηματική φεουδαρχία». Η εργασία ενταντικοποιήθηκε λόγω της υπαγωγής της παραγωγής στη λογική της ανταλλακτικής αξίας, ενώ παράλληλα οι άρχοντες μετέτρεπαν την κοινοτική ιδιοκτησία των χωριών σε ατομική ιδιοκτησία τους, συνολικά επιβαρύνοντας τους όρους ζωής των λαϊκών τάξεων. Το εκρηκτικό αυτό μείγμα, οδήγησε αφενός στην εξέγερση και αφετέρου στην αναζήτηση εκ μέρους μιας μερίδας εξεγερμένων μιας κοινωνικής τάξης που αρνιόταν το χρήμα και κάθε μορφή εξουσίας και εκμετάλλευσης, μιας κομμουνιστικής προοπτικής.
GIS integration for spatial analysis of urban expansion in Tisaleo canton (Ecuador).
Authors: Chiriboga Zamora Patricia Alexandra , Tapia Hermida Ligia Ximena , Romero Flores Martha Lucia , Espín Real Danny Francisco , Carretero Poblete Pedro A.
Published: October 2024

Political or economic interests have led to an empirical zonal delimitation, and the deficient use of Geographic Information Systems does not allow the specific characterisation of the territories. This article aims to determine the spatial analysis of the urban expansion areas of the canton of Tisaleo by integrating Geographic Information Systems, using a quantitative research method. The main components analysed are: the situational diagnosis of the canton through the characterisation of its biophysical component, its human settlements and the public system of facilities and social services that support it. Based on this information, an interrelation of the data collected is carried out to complement a spatial analysis with GIS software (ArcGis/QGis, ESRI, 2018). The results show that in the canton of Tisaleo there are areas suitable for urban growth, but their limits are overdimensioned, i.e. they include areas that do not have the aptitude to be urbanised, as well as rural areas that have the characteristics to be considered urban.
Case Report: Case report: Aslanger’s sign in electrocardiogram.
Authors: Bradai Haifa , Laajimi Sondes , Mbarek Rabeb , Chebbi Nabil , Loghmari Dorra , Naija Mounir , Chebili Naoufel
Published: October 2024

Electrocardiograms (ECGs) can be affected by various factors and technical problems. It is rare for an artefact to be the cause of ST-segment elevation, especially in asymptomatic patients. An important distinction between true ST segment elevation caused by myocardial infarction and an artefact is that the baseline elevation in an artefact may begin before or after the appearance of the QRS complex. When confronted with an abnormal ECG with suspicious waveform contours and possibly only one completely normal limb lead, the diagnosis of arterial pulse artefact should be considered. It is important to exclude subjective assessments unless they are clearly labelled as such. When encountering an abnormal ECG with suspicious waveform contours and possibly only one completely normal limb lead, the diagnosis of arterial pulse artefact should be considered.
Case Report: Invasive candidiasis of the head and neck in a five-month-old infant: A case study
Authors: Mezri Sameh , Laabidi Eya , Zitouni Chaima , Thabet Wadii
Published: October 2024

Invasive sino-orbital fungal infection is an uncommon, yet severe condition that predominantly affects individuals with compromised immune systems. In this study, we report the case of a 5-month-old immunocompetent infant who exhibited persistent dacryocystitis despite receiving broad-spectrum antibiotics. Subsequently, the patient developed ethmoiditis, orbital subperiosteal abscess, and ulceration of the hard palate. Mycological and histological samples were indicative of Candida infections. The patient underwent sinus surgery and surgical debridement, along with antifungal therapy. The treatment was successful, and the follow-up was uneventful for up to 6 months. To our knowledge, this is the first reported case of invasive sino-orbital candidiasis in an immunocompetent infant with dacryocystitis as the entry point. This study explores the clinical features, management approaches, and outcomes of this potentially fatal disease.