bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhanced production of ‘spilanthol’ through elicitation of cell suspension cultures in Acmella ciliata (Kunth) Cass. and spilanthol characterization by HPLC-HRMS analysis
Authors: NeethuMohan S , Hemanthakumar AS , Preetha TS 
Published: April 2024

Abstract

The study presented here has established a cell suspension culture system for the in vitro production of the high value bioactive alkamide ‘spilanthol’ in Acmella ciliata. White, purple, friable callus procured from leaf explants in MS medium containing 0.5 mgl-1 BA and 1.0 mgl-1 NAA have succeeded in fourfold increase in cell mass after 25 days of culture upon 120 rpm agitation in a gyratory shaker and the presence of ‘spilanthol’ in the harvested cells was detected using HPLC coupled with HRMS. Here, high spilanthol content (239.512 µgg-1) was noticed in embryogenic callus cultures established in NAA-BA combination followed by in vitro plant (193.935 µgg-1) as well as cells harvested from suspension culture (173.702 µgg-1). In A. ciliata flower heads 102.730 µgg-1 spilanthol content was recorded, while the leaves and stem contained 96.69 and 61.146 µgg-1 spilanthol respectively. The least quantity of spilanthol was noticed in the in vivo plant (92.198 µgg-1) that was the absolute control. Thus quantification of spilanthol in the in vitro system revealed more amount of the same in it especially in embryogenic callus than in vivo plant (control). Elicitation was attempted using both biotic and abiotic elicitors to scale up the production of spilanthol in cell suspension culture system. Elicitation using biotic elicitors showed maximum 34.61-fold increase with Yeast extract (YE) in 24 hrs exposure; while the abiotic elicitor MeJA (Methyl jasmonate) treatment evoked the production of spilanthol to 41.02 fold in 72 hrs treatment. Comparatively more time of exposure was required in abiotic elicitation than with biotic elicitors. By considering the merit of perceiving maximum yield in short duration, treatment with YE for 24 hrs period can be suggested as the choice of elicitation for improved production of the alkamides particularly spilanthol in cell suspension cultures of A. ciliata. The established system can be extended for the bioproduction of the bioactive alkamide ‘spilanthol’ using bioreactor technology with suitable refinement thus benefiting the phyto-pharma needs.
6-months mortality predictors easily recognizable upon inpatient geriatric rehabilitation admission
Authors: Sawicki Amitai Avnon , Feldman Itamar , Justo Dan 
Published: April 2024

Abstract

Purpose
To study 6-months mortality predictors upon inpatient geriatric rehabilitation admission.
Methods
A single-center retrospective study of all patients admitted for inpatient geriatric rehabilitation during 2018–2020. Logistic regression analysis and Chi-squared automatic interaction detection (CHAID) decision tree were used to study which variables were independently associated with 6-months mortality upon rehabilitation admission including: age, gender, chronic co-morbidities, prior functional status, and rehabilitation indication.
Results
The final cohort included 993 patients: 588 (59.2%) females, median age 82.0 years (IQR 75.0–87.0 years). Overall, 101 (10.2%) patients died within six months of rehabilitation admission. Logistic regression analysis showed that mortality was independently associated with male gender (OR 1.9, 95%CI 1.2–3.1), symptomatic severe aortic stenosis (OR 3.6, 95%CI 1.4–9.6), chronic kidney disease (OR 2.0, 95%CI 1.3–3.3), active cancer (OR 3.3, 95%CI 1.8–6.1), prior mild dependency (OR 5.3, 95%CI 2.3–12.4), prior severe dependency (OR 5.8, 95%CI 2.4–14.0), and deconditioning indicating rehabilitation (OR 2.2, 95%CI 1.2–3.9). CHAID decision tree showed that chronic kidney disease was the first splitting variable (p < 0.001) followed by male gender (p < 0.001) and age > 81 years (p = 0.027).
Conclusion
Symptomatic severe aortic stenosis and chronic kidney disease are presented herein, for the first time, as 6-months mortality predictors upon geriatric rehabilitation admission.
Perspectives of Pharmacy Students on Ethical Issues Related to Artificial Intelligence: A Comprehensive Survey Study
Authors: Hasan Hisham E. , Jaber Deema , Khabour Omar F. , Alzoubi Karem H. 
Published: April 2024

Abstract

Background
The integration of artificial intelligence (AI) into pharmacy education and practice holds the potential to advance learning experiences and prepare future pharmacists for evolving healthcare practice. However, it also raises ethical considerations that need to be addressed carefully. This study aimed to explore pharmacy students’ attitudes regarding AI integration into pharmacy education and practice.
Methods
A cross-sectional design was employed, utilizing a validated online questionnaire administered to 702 pharmacy students from diverse demographic backgrounds. The questionnaire gathered data on participants’ attitudes and concerns regarding AI integration, as well as demographic information and factors influencing their attitudes.
Results
Most participants were female students (72.8%), from public universities (55.6%) and not working (64.2%). Participants expressed a generally negative attitude toward AI integration, citing concerns and barriers such as patient data privacy (62.0%), susceptibility to hacking (56.2%), potential job displacement (69.3%), cost limitations (66.8%), access (69.1%) and the absence of regulations (48.1% agree), training (70.4%), physicians’ reluctance (65.1%) and patient apprehension (70.8%). Factors including country of residence, academic year, cumulative GPA, work status, technology literacy, and AI understanding significantly influenced participants' attitudes (p < 0.05).
Conclusion
The study highlights the need for comprehensive AI education in pharmacy curricula including related ethical concerns. Addressing students' concerns is crucial to ensuring ethical, equitable, and beneficial AI integration in pharmacy education and practice.
Long-term Survival Comparison of Patients Admitted to Icu Following in-hospital Cardiac Arrest in Perioperative and Ward Settings: a Multicentre Retrospective Cohort Study
Authors: Ueno Ryo , Chan Rachel , Reddy Mallikarjuna Ponnapa , Jones Daryl , Pilcher David , Subramaniam Ashwin 
Published: April 2024

Abstract

Purpose: Perioperative in-hospital cardiac arrests (Perioperative IHCAs) may have better outcomes than IHCAs in the ward (ward IHCAs), due to enhanced monitoring and faster response. However, quantitative comparisons of their long-term outcomes are lacking, posing challenges for prognostication.
Methods: This retrospective multicentre study included adult ICU admissions from theatre/recovery or wards with a diagnosis of cardiac arrest between January 2018 and March 2022. We used data from 175 ICUs in the ANZICS Adult Patient Database. The primary outcome was a survival time of up to four years. We used the Cox-proportional hazards model adjusted for SOFA score, age, sex, comorbidities, hospital type, and ICU treatments. Subgroup analyses examined age (≥65 years), intubation within the first 24 hours, elective vs emergency admission, and survival on discharge.
Results: Of 702,675 ICU admissions, 5,659 IHCAs were included (Perioperative IHCA 38.0%; ward IHCA 62.0%). Perioperative IHCA group were younger, less frail, and less comorbid. Perioperative IHCA were most frequent in patients admitted to ICU after cardiovascular, gastrointestinal, or trauma surgeries. Perioperative IHCA group had longer four-year survival (59.9% vs. 33.0%, p<0.001) than the ward IHCA group, even after adjustments (adjusted HR: 0.63, 95%-CI: 0.57-0.69). This was concordant across all subgroups. Of note, older patients with Perioperative IHCA survived longer than both younger and older patients with ward IHCA.
Conclusions: Patients admitted to the ICU following Perioperative IHCA had longer survival than ward IHCA. Future studies on IHCA should distinguish these patients.
Staffing level in the discharge planning department and average length of stay in acute care wards: A cross-sectional study using a nationwide hospital- and ward-level data in Japan
Authors: Machida Ako , Morioka Noriko , Kashiwagi Masayo 
Published: April 2024

Abstract

Background The transition from hospital to the next care setting is when care fragmentations are likely to occur, making discharge planning essential; however, the relationship between discharge planning and length of stay is unclear. This study aimed to investigate the association between staffing levels, particularly the number of nurses and medical social workers in the discharge planning department, and the average length of stay at the ward level in acute care hospitals in Japan.Methods Applying a cross-sectional approach, we used nationwide administrative hospital- and ward-level data from the fiscal year 2021. A total of 5,580 acute care wards in 1,101 hospitals across 206 secondary medical areas were included. A two-level multilevel regression analysis with random intercept stratified by three types of acute care ward functions was performed by adjusting ward, hospital, and regional characteristics.Results A total of 1,017 wards in 70 designated special function hospitals, 3,828 general acute care wards with a 7:1 patient-to-nurse ratio in 596 hospitals, and 735 general acute care wards with a 10:1 patient-to-nurse ratio in 435 hospitals were included in the final analysis. The average length of stay was 12.5 days, 11.5 days, and 18.0 days, respectively. There was a significant association between the total number of nurses and medical social workers per 100 hospital beds in acute care wards with a 7:1 patient-to-nurse ratio, but not in special function wards or in acute care wards with a 10:1 patient-to-nurse ratio. Sensitivity analysis that separately analysed the number of nurses and medical social workers showed that the number of nurses per 100 hospital beds was associated with the average length of stay in acute care wards with a 7:1 patient-to-nurse ratio. Medical social workers per 100 hospital beds showed no association in any ward model.Conclusions A greater number of nurses and medical social workers per 100 hospital beds in the discharge planning department, especially greater nurse staffing, was associated with short lengths of stay in acute care wards with a 7:1 patient-to-nurse ratio.
Proteus faecis: a putative pathogen of the freshwater Yangtze finless porpoise
Authors: McLaughlin Richard William , Wang YaLu , Zhang ShuYa , Xie HaiXia , Wan XiaoLing , Liu Hui , Hao YuJiang , Wang ChaoQun , Zheng JinSong 
Published: April 2024

Abstract

Proteus faecis is a Gram-negative facultative anaerobic rod-shaped bacterium capable of swarming motility. It has been isolated from numerous sources such as humans, animals, and refuse and is considered a putative human pathogen. In this study, bacteria were isolated from the blowhole of a Yangtze finless porpoise (Neophocaena asiaeorientalis asiaeorientalis; YFP) living in captivity in China. One bacterium, P. faecis porpoise, was isolated and whole genome sequencing done. Biofilm formation, motility and antimicrobial resistance were also investigated. To find putative virulence factors, the genome of P. faecis strain porpoise was compared to the genomic sequences of eight other P. faecis isolates using the Bacterial and Viral Bioinformatics Resource Center (BV-BRC) (https://www.bv-brc.org/). The goal of this study was to initially characterize the pathogenicity of this bacterium isolated from a cetacean species using both pathogenomics and conventional approaches.
Pressure versus volume assist-control ventilation in Acute Respiratory Distress Syndrome: a randomised clinical trial.
Authors: Richard Jean Christophe Marie , Beloncle Francois , Beduneau Gaetan , Mortaza Satar , Ehrmann Stephan , Diehl Jean-Luc , Prat Gwenael , Jaber Samir , Rahmani Hassene , Reigner Jean , Boulain Thierry , Yonis Hodane , Richecoeur Jack , Thille Arnaud W , Declercq Pierre-Louis , Antok Emmanuel , Carteaux Guillaume , Vielle Bruno , Brochard Laurent , Mercat Alain 
Published: April 2024

Abstract

Background: To compare the effect of a pressure-controlled strategy allowing non-synchronized unassisted spontaneous ventilation (PC-SV) to a conventional volume assist-control strategy (ACV) on the outcome of patients with Acute Respiratory Distress Syndrome (ARDS).
Methods: Open-label randomized clinical trial in 22 ICUs in France. Seven hundred adults with moderate or severe ARDS (PaO2/FiO2 < 200 mmHg) were enrolled from February 2013 to October 2018. Patients were randomly assigned to PC-SV (n=348) or ACV (n=352) with similar objectives of tidal volume (6 mL/kg predicted body weight) and positive end-expiratory pressure (PEEP). Paralysis was stopped after 24h and sedation adapted to favour patients’ spontaneous ventilation. The primary endpoint was in-hospital death from any cause at day 60.
Findings: Hospital mortality (34.6% vs 33.5%, p=.77, RR=1.03 (95% CI, 0.84-1.27)), 28-day mortality, as well as the number of ventilator-free days and organ failure-free days at day 28 did not differ between PC-SV and ACV groups. Patients in the PC-SV group received significantly less sedation and neuro-muscular blocking agents than in the ACV group. A lower proportion of patients required adjunctive therapy of hypoxemia (including prone positioning) in the PC-SV group than in the ACV group (33.1% vs 41.3%, p=.03, RR=0.80 (95% CI, 0.66-0.98)). The incidences of pneumothorax and refractory hypoxemia did not differ between the groups.
Interpretation: A strategy based on a pressure-controlled mode that favours spontaneous ventilation did not significantly reduce mortality compared to ACV with similar tidal volume and PEEP levels but reduced the need for sedation and adjunctive therapies of hypoxemia.
Funding: French Ministry of Health (PHRC 49RC-09-04-01)
Trial registration: ClinicalTrials.gov Identifier: NCT01862016
Ethnozoological scatology: A situational report on the utilization of animal excrement in traditional medicine in Ghana
Authors: Ameade Evans Paul  Kwame , Gmawurim Stephen , Adom Emmanuel 
Published: April 2024

Abstract

Animal excrement although may be considered as a waste product, has since ancient days found use in the management of several physical disorders and sometimes for spiritual or mystical purposes. This study assessed the extent of use and the attitude towards the use of animal excrement in traditional medicine among the Ghanaian public. Data was collected from 399 persons in the Tamale metropolis of the Northern Region of Ghana using a semi-structured questionnaire. Data analysis involved the use of the Statistical Package for the Social Sciences, Version 26 and the results presented in the form of tables and charts. The multivariate logistic regression model was used to assess predictors. Using a confidence interval of 95%, an association between variables was assumed to be significant when p ≤ 0.05. Whereas 44 (11.6%) indicated a personal use of animal excrement for traditional medicine, up to 234 (58.6%) knew some other person who had ever used animal excrement as medicine. For users of animal excrements, the majority, 42 (97.7%) used them for therapeutic reasons with only 1 (2.3%) claiming to use them for spiritual or mystical purposes. The top two most cited excrements were from the Dromedary camel (Camelus dromedarius) and the cow (Bos taurus). Statistically significant associations were found between the use of animal excrement for traditional medicine and respondents’ ages (p-value < 0.001), religious affiliation (p-value < 0.001), employment status (p-value = 0.018), highest educational attainment (p-value = 0.003) and knowing someone who used animal excrement (p-value < 0.001). The predictors of the use of animal excrement for traditional medicine were age, religious affiliation and knowing a user. The attitude towards the use of animal excrement for traditional medicine is barely average (51.8%) with the worst attitude towards the therapeutic use of human excreta. This attitude towards animal excrement in traditional medicine was significantly associated with the age of respondents, their religious affiliation, their educational attainment, ever used animal excrement or knowing a user.
Sevoflurane exposure triggers ferroptosis of neuronal cells initiated by the activation of ATM/p53 in the neonatal brain via JNK/p38 MAPK-mediated oxidative DNA damage
Authors: Gu Wanping , Pan Tingting , Wang Xuedong , Kang Liheng , Liu Nan , Piao Meihua , Feng Chunsheng 
Published: April 2024

Abstract

The safety of volatile anesthetic exposure in an early life has attracted widespread concern on its potential developmental neurotoxicity. Neuronal death has been regarded as the pivotal pathological factor related to neurotoxic effect caused by volatile anesthetic sevoflurane in the neonatal brain, but the detailed mechanism remains controversial. Ferroptosis is a novel type of regulated cell death driven by excess lipid peroxidation secondary to intracellular iron overload, and implicated in the pathogenesis progression of various neurological disorders. Acting as a death messenger, p53 is mainly activated by ATM during DNA damage, and functions to mediate diverse types of cell death including apoptosis, autophagy and ferroptosis. JNK/p38 MAPK have been proposed important stress-responsive pathways to exacerbate intracellular ROS production, linking DNA damage to many pathological conditions such as neurodegeneration and ischemic injury. Here, we focused on the role of activated ATM/p53-mediated ferroptosis in neuronal death caused by sevoflurane in neonatal brain and elucidated its underlying mechanisms. Our present study demonstrated that sevoflurane exposure-triggered neuronal death was correlated with intracellular iron overload and lipid peroxidation in vitro and in vivo, which was in accordance with the typical features of ferroptosis. Furthermore, we found that neuronal death caused by sevoflurane was associated with ATM/p53 activation in response to DNA damage. Suppressing ATM/p53 pathway counteracted iron-dependent lipid peroxidation, which inhibited neonatal neuronal ferroptosis triggered by sevoflurane. Additionally, sevoflurane exposure resulted in JNK/p38 MAPK activation, followed by intracellular ROS accumulation, leading to DNA damage. Mechanistically, ATM/p53 contributed to neonatal neuronal ferroptosis caused by sevoflurane via two pathways, one is to increase intracellular ferrous iron through upregulating TFR and downregulating FPN, the other is to promote lipid peroxidation via activating NOX4, ALOX12 and ALOX15 and suppressing SLC7A11. Collectively, these findings demonstrated that sevoflurane exposure induced ferroptosis of neuronal cells in the neonatal brain, which was triggered by the ATM/p53 activation via JNK/p38 MAPK-mediated ROS accumulation and resultant DNA damage.
Successful Management of DVT and PE in IVC-Agenesis and FVL Mutation with Direct Oral Anticoagulation (Factor Xa inhibitor): A Case Report
Authors: Siddiqui Abid , Waris Waris , Hatfield Tara , Nguyen Quynh 
Published: April 2024

Abstract

Background:Inferior vena cava (IVC) agenesis is a rare congenital condition identified as a primary cause of unprovoked deep vein thrombosis (DVT) in up to 5% of young men under 30. This case report is significant due to the rare co-occurrence of IVC agenesis and a heterozygous Factor V Leiden (FVL) mutation, contributing to extensive venous thromboembolisms (VTE). The literature has not previously documented cases with this specific combination treated with direct Factor Xa oral anticoagulation, adding to its novelty and clinical importance.
Case Presentation: A 28-year-old obese Caucasian male presented with significant pain and swelling in his right lower extremity. Initial diagnostics included a venous Doppler ultrasound which revealed extensive right lower extremity DVT. Further CT scans of his chest and abdomen confirmed IVC agenesis and detected pulmonary emboli in his left central pulmonary arteries. Laboratory tests showed a positive result for heterozygous Factor V Leiden mutation. Treatment involved an intravenous heparin drip followed by a transition to direct Factor Xa oral anticoagulation.
Conclusions: This case highlights the clinical complexity of treating patients with multiple risk factors for VTE and illustrates the potential for direct Factor Xa inhibitors as a successful long-term management strategy. It opens a discussion on the continuous use of direct Factor Xa oral anticoagulation in managing similar cases, which could influence future treatment protocols and provide a foundation for further research in this area.
Co-Designing Planning Interventions to Facilitate Participation in Mail-Out Bowel Cancer Screening
Authors: Anderson Laura E , Myers Larry , Collins Katelyn , Vicario Jazmin , Viljoen Bianca , Ireland Michael J , Goodwin Belinda C 
Published: April 2024

Abstract

Background
Population mail-out bowel cancer screening programs save lives through prevention and early detection; however, their effectiveness is constrained by low participation rates. Most non-screeners intend to screen but fail to do so, often procrastinating and forgetting to complete the screening kit. This study aimed to co-design interventions to increase screening participation in the Australian National Bowel Cancer Screening Program with kit recipients.
Methods
Studies were informed by the Health Action Process Approach to behaviour change, and included three semi-structured interviews, and one online cross-sectional survey, all conducted between August 2021 and December 2022. Logistic regression of survey data was used to analyse strategies used to participate in bowel cancer screening. All three semi-structured interviews were analysed using the framework approach of codebook thematic analysis to describe consumers’ preferences on strategies and to develop interventions to improve bowel screening participation.
Results
Interview participants who returned their kit shared their effective planning strategies—such as putting the kit in a visible place or by the toilet, planning a time at home to complete the kit, and using reminders. Survey participants who reported using such strategies were more likely to have completed their screening kit when compared to those who did not report using planning strategies. Finally, interview participants who intended to use their kits—but did not—worked with researchers to adapt these strategies into interventions to facilitate screening participation. Interventions included providing a prompt to place the kit—or a sticker—near the toilet as a reminder, a deadline for kit return, the option to sign up for reminders, a bag to store the sample in the fridge, and gloves for sample collection.
Conclusions
These novel, consumer-centred interventions that are built upon the needs and experience of screening invitees provide promising solutions for improving participation in population bowel cancer screening.