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JMIR Public Health and Surveillance May 2024Food-induced anaphylaxis (FIA) is a major public health problem resulting in serious clinical complications, emergency department visits, hospitalization, and death.
BACKGROUND
Food-induced anaphylaxis (FIA) is a major public health problem resulting in serious clinical complications, emergency department visits, hospitalization, and death.
OBJECTIVE
The objectives of this investigation were to assess the epidemiology and the trends in hospitalizations because of FIA in Spain between 2016 and 2021.
METHODS
An observational descriptive study was conducted using data from the Spanish National hospital discharge database. Information is coded based on the International Classification of Diseases, Tenth Revision. The study population was analyzed by sex and age group and according to food triggers, clinical characteristics, admission to the intensive care unit (ICU), severity, and in-hospital mortality (IHM). The annual incidence of hospitalizations because of FIA per 100,000 person-years was estimated and analyzed using Poisson regression models. Multivariable logistic regression models were constructed to identify which variables were associated with severe FIA.
RESULTS
A total of 2161 hospital admissions for FIA in were recorded in Spain from 2016 to 2021. The overall incidence rate was 0.77 cases per 100,000 person-years. The highest incidence was found in the <15-year age group (3.68), with lower figures among those aged 15-59 years (0.25) and ≥60 years (0.29). Poisson regression showed a significant increase in incidence from 2016 to 2021 only among children (3.78 per 100,000 vs. 5.02 per 100,000 person-years; p=.047). The most frequent food triggers were ""Milk and dairy products" (419/2161, 19.4% of cases) and "Peanuts and tree nuts and seeds" (409/2161, 18.9%). Overall, 256 of 2161 (11.9%) patients hospitalized because of FIA required admission to the ICU, and 11 patients (0.5%) died in hospital. Among children, the most severe cases of FIA appeared in patients aged 0 to 4 years (40/99, 40.4%). Among adults, 69.4% (111/160) of cases occurred in those aged 15 to 59 years. Multivariable logistic regression showed the variables associated with severe FIA to be age 15-59 years (OR, 5.1; 95% CI, 3.11-8.36), age ≥60 years (OR, 3.87; 95% CI, 1.99-7.53), and asthma.
CONCLUSIONS
In Spain, the incidence of hospitalization because of FIA increased slightly, although the only significant increase was among children. Even if IHM remains low and stable, the proportion of severe cases is high and has not improved from 2016 to 2021, with older age and asthma being risk factors for severity. Surveillance must be improved, and preventive strategies implemented to reduce the burden of FIA.
PubMed: 38940759
DOI: 10.2196/57340 -
JMIR Medical Education Jun 2024Over the last decade, there has been growing interest in inverted classroom teaching (ICT) and its various forms within the education sector. Physiology is a core course...
BACKGROUND
Over the last decade, there has been growing interest in inverted classroom teaching (ICT) and its various forms within the education sector. Physiology is a core course that bridges basic and clinical medicine, and ICT in physiology has been sporadically practiced to different extents globally. However, students' and teachers' responses and feedback to ICT in physiology are diverse, and the effectiveness of a modified ICT model integrated into regular teaching practice in physiology courses is difficult to assess objectively and quantitatively.
OBJECTIVE
This study aimed to explore the current status and development direction of ICT in physiology in basic medical education using bibliometric visual analysis of the related literature.
METHODS
A bibliometric analysis of the ICT-related literature in physiology published between 2000 and 2023 was performed using CiteSpace, a bibliometric visualization tool, based on the Web of Science database. Moreover, an in-depth review was performed to summarize the application of ICT in physiology courses worldwide, along with identification of research hot spots and development trends.
RESULTS
A total of 42 studies were included for this bibliometric analysis, with the year 2013 marking the commencement of the field. University staff and doctors working at affiliated hospitals represent the core authors of this field, with several research teams forming cooperative relationships and developing research networks. The development of ICT in physiology could be divided into several stages: the introduction stage (2013-2014), extensive practice stage (2015-2019), and modification and growth stage (2020-2023). Gopalan C is the author with the highest citation count of 5 cited publications and has published 14 relevant papers since 2016, with a significant surge from 2019 to 2022. Author collaboration is generally limited in this field, and most academic work has been conducted in independent teams, with minimal cross-team communication. Authors from the United States published the highest number of papers related to ICT in physiology (18 in total, accounting for over 43% of the total papers), and their intermediary centrality was 0.24, indicating strong connections both within the country and internationally. Chinese authors ranked second, publishing 8 papers in the field, although their intermediary centrality was only 0.02, suggesting limited international influence and lower overall research quality. The topics of ICT in physiology research have been multifaceted, covering active learning, autonomous learning, student performance, teaching effect, blended teaching, and others.
CONCLUSIONS
This bibliometric analysis and literature review provides a comprehensive overview of the history, development process, and future direction of the field of ICT in physiology. These findings can help to strengthen academic exchange and cooperation internationally, while promoting the diversification and effectiveness of ICT in physiology through building academic communities to jointly train emerging medical talents.
Topics: Bibliometrics; Humans; Physiology; Education, Medical; Teaching; Curriculum
PubMed: 38940629
DOI: 10.2196/52224 -
MBio Jun 2024The purine nucleotides ATP and GTP are made from the common precursor inosine monophosphate (IMP). Maintaining the correct balance of these nucleotides for optimal cell...
UNLABELLED
The purine nucleotides ATP and GTP are made from the common precursor inosine monophosphate (IMP). Maintaining the correct balance of these nucleotides for optimal cell growth is controlled in part by the enzyme IMP dehydrogenase (IMPDH), which catalyzes the first dedicated step of GTP biosynthesis. The regulation of IMPDH mRNA and protein levels in the yeast grown in liquid culture has been studied in some detail, but regulation of IMPDH protein under conditions of cellular crowding on a solid substrate has not been examined. Here, we report real-time, live-cell analysis of the accumulation of the Imd2 isoform of IMPDH in yeast cells forming a monolayer colony in a microfluidic device over a 50-hour time course. We observe two distinct phases of increased Imd2 accumulation: a guanine-insensitive phase early in outgrowth and a guanine-sensitive phase later, when cells become crowded. We show that the IMPDH inhibitor mycophenolic acid enhances both phases of increase. Deletion of a transcription attenuator upstream of the mRNA start site that decreases Imd2 mRNA synthesis in the presence of high GTP increases the baseline level of Imd2 protein 10-fold and abolishes guanine-sensitive but not guanine-insensitive induction. Our results suggest that at least two mechanisms of yeast Imd2 regulation exist, the known GTP-dependent attenuation of RNA polymerase II elongation and a GTP concentration-independent pathway that may be controlled by cell growth state. Live-cell analysis of IMPDH protein levels in a growing yeast colony confirms a known mechanism of regulation and provides evidence for an additional mode of regulation.
IMPORTANCE
This study used live-cell microscopy to track changes in the level of a key enzyme in GTP nucleotide biosynthesis, inosine monophosphate dehydrogenase (IMPDH), during growth of a brewers yeast colony over 2 days in a microfluidic device. The results show that feedback regulation via transcription attenuation allows cells to adapt to nutrient limitation in the crowded environs of a yeast colony. They also identify a novel mode of regulation of IMPDH level that is not driven by guanine nucleotide availability.
PubMed: 38940616
DOI: 10.1128/mbio.01021-24 -
MSystems Jun 2024Over almost three decades, average nucleotide identity (ANI) analysis has been instrumental in operationally defining species in bacteria. However, barely any attention...
Over almost three decades, average nucleotide identity (ANI) analysis has been instrumental in operationally defining species in bacteria. However, barely any attention has been paid to soundly defining intra-species units employing ANI analyses until recently. Notably, some very recent publications are good steps forward in that direction. The level of granularity provided by these intra-species units will be relevant to understanding the eco-evolutionary dynamics and transmission of bacterial lineages and mobile genetic elements, antibiotic resistance, and virulence genes. These intra-species units will undoubtedly advance the genomic epidemiology of many bacterial pathogens. In the coming years, we anticipate that many studies will implement ANI-based definitions of different intra-species units, such as strains or sequence types, for many different bacterial species.
PubMed: 38940600
DOI: 10.1128/msystems.00584-24 -
Nursing Open Jul 2024To examine changes in advanced nurse practitioner (ANP) well-being, satisfaction and motivation over a four-year period. (Review)
Review
AIMS
To examine changes in advanced nurse practitioner (ANP) well-being, satisfaction and motivation over a four-year period.
DESIGN
Longitudinal Cohort study.
METHODS
Surveys were carried out each year from 2019 to 2022 with the same cohort of ANPs in the United Kingdom (UK). The survey consisted of demographics, questions on contemporary issues in advanced practice, National Health Service (NHS) staff survey questions and validated questionnaires. A core set of questions were asked every year with some changes in response to the COVID-19 pandemic.
RESULTS
Response rate ranged from 40% to 59% and appeared to be affected by COVID-19. Staff satisfaction with pay and the well-being score were stable throughout. Other questions on well-being, job satisfaction and motivation saw statistically significant reductions after 4 years. Open-ended questions about ongoing well-being concerns show participants are concerned about exhaustion levels caused by workload, staffing issues, abuse from patients and colleagues' mental health.
CONCLUSION
The findings highlight a decline in ANP well-being, job satisfaction and motivation post-COVID-19. Reasons for this, explored in the qualitative data, show that ANPs have faced extremely difficult working conditions. Urgent action is required to prevent a workforce retention crisis as many nursing staff are close to retirement and may not be motivated to remain in post.
IMPACT
This study has followed ANPs through the most challenging years the NHS has ever seen. Job satisfaction, motivation and enjoyment of the job all significantly reduced over time. In many areas, the ANP role has been used to fill medical workforce gaps, and this will become harder to do if ANPs are dissatisfied, disaffected and struggling with stress and burnout. Addressing these issues should be a priority for policymakers and managers.
PATIENT OR PUBLIC CONTRIBUTION
None as this study focussed on staff. Staff stakeholders involved in the design and conduct of the study.
Topics: Humans; Job Satisfaction; COVID-19; United Kingdom; Nurse Practitioners; Female; Male; Longitudinal Studies; Surveys and Questionnaires; Adult; Middle Aged; SARS-CoV-2; Motivation; Cohort Studies; State Medicine; Pandemics; Workload; Burnout, Professional
PubMed: 38940475
DOI: 10.1002/nop2.2218 -
Cancer Medicine Jul 2024The Cancer Health Awareness through screeNinG and Education (CHANGE) initiative delivers cancer awareness education with an emphasis on modifiable risk factors and...
BACKGROUND
The Cancer Health Awareness through screeNinG and Education (CHANGE) initiative delivers cancer awareness education with an emphasis on modifiable risk factors and navigation to screening for prostate, breast, and colorectal cancers to residents of public housing communities who experience significant negative social determinants of health.
METHODS
Residents of five communities participated. Community advisory board members were recruited and provided feedback to local environmental change projects, recruitment, and community engagement at each site. At each site, four education sessions were provided by trained facilitators on cancer risk factors and etiology, racial disparities, eligibility for cancer screening, and participation in clinical trials. Attendance, knowledge, attitudes and beliefs about cancer, and height, weight, and waist circumference were measured at baseline and 1-week post-CHANGE sessions.
RESULTS
90 residents (60% 65 and older years old, 33% male, 60% High School education, 93% AA) participated in the program. 95% completed post-intervention evaluation. Participants were eligible for breast (n = 12), prostate (n = 15), and colorectal screening (n = 25) based on American Cancer Society guidelines, and 22 for tobacco cessation; 21 participants accepted navigation assistance for these services. At post-test, participants significantly increased in knowledge and behaviors around obesity/overweight risk for cancer, nutrition, and physical activity. Colorectal, prostate, and breast cancer knowledge scores also increased, but were not significant.
CONCLUSIONS
CHANGE participants demonstrated improved health knowledge and intentions to improve their modifiable health behaviors. Participants reported being motivated and confident in seeking preventive care and satisfaction with community engagement efforts. Replication of this project in similar communities may improve knowledge and health equity among underserved populations.
Topics: Humans; Male; Female; Early Detection of Cancer; Aged; Health Knowledge, Attitudes, Practice; Middle Aged; Health Equity; Prostatic Neoplasms; Health Education; Neoplasms; Breast Neoplasms; Colorectal Neoplasms; Adult; Risk Factors
PubMed: 38940418
DOI: 10.1002/cam4.7357 -
Global Public Health Jan 2024Urban inequalities are exacerbated due to rapid urbanisation. This is also evident within slums in low- and middle-income countries, where high levels of heterogeneity... (Review)
Review
Urban inequalities are exacerbated due to rapid urbanisation. This is also evident within slums in low- and middle-income countries, where high levels of heterogeneity amongst the slum population lead to differential experiences in Water, Sanitation, and Hygiene (WASH) and housing access. This scoping review provides evidence of the interconnection of WASH and housing and presents barriers to access and the consequences thereof for slum dwellers. It does so while considering the social stratification amongst urban slum dwellers and their lived experiences. A systematic search of journal articles was conducted in November 2022 in PubMed, Scopus, and Web of Science. A total of 33 papers were identified which were full text reviewed and data extracted. Infrastructure, social and cultural, socio-economic, governance and policy and environmental barriers emerged as general themes. Barriers to WASH and housing were more frequently described concerning women and girls due to gender norms within WASH and the home. Barriers to WASH lead to compromised health, socio-economic burdens, and adverse social impacts, thus causing residents of slums to navigate their WASH mobility spatially and over time. Insights from this review underscore the need for an intersectional approach to understanding access inequalities to WASH and housing.
Topics: Humans; Poverty Areas; Housing; Sanitation; Developing Countries; Hygiene; Socioeconomic Factors
PubMed: 38940272
DOI: 10.1080/17441692.2024.2369099 -
Polish Archives of Internal Medicine Jun 2024This narrative review summarizes the current body of literature regarding the periprocedural management of direct anticoagulants (DOACs) for patients undergoing...
This narrative review summarizes the current body of literature regarding the periprocedural management of direct anticoagulants (DOACs) for patients undergoing digestive endoscopy since the publication of the 2022 American College of Gastroenterology - Canadian Association of Gastroenterology guidelines. We provide a detailed analysis of TE risk, endoscopic procedure-specific bleeding risks, contemporary intra-procedural techniques to reduce bleeding risk, and a summary of major gastrointestinal societies' periprocedural DOAC guidelines, including procedure risk stratification. While there exists heterogeneity in the data, the overall trend of the current literature supports the contemporary practice of a minimal DOAC interruption without the need for heparin bridging.
PubMed: 38940268
DOI: 10.20452/pamw.16781 -
Cardiology Journal 2024
Topics: Humans; Artificial Intelligence; Writing; Periodicals as Topic; Cardiology; Biomedical Research
PubMed: 38940258
DOI: 10.5603/cj.94335 -
Annals of Agricultural and... Jun 2024. Pets infected with zoonotic pathogens might become a source of infections for their owners, especially those who are immuno-compromised. The aim of this report is to...
. Pets infected with zoonotic pathogens might become a source of infections for their owners, especially those who are immuno-compromised. The aim of this report is to describe a case of chronic, untreatable pneumonia in a domestic ferret. The subject was a 5-year-old female ferret suffering from recurrent pneumonia. Ante-mortally, swabs from the nasal cavity, alveolus and throat were collected from the animal. Post-mortally, lesioned organ fragments were collected. Standard microbiological testing was performed. Additionally, mycobacterial diagnosis including culture and molecular tests was performed. . The co-infection of Mycobacterium avium and Klebsiella pneumoniae was microbiologically confirmed. This case demonstrates the need to pay attention to the possibility of zoonotic pathogens in ferrets. Veterinarians diagnosing ferrets are potentially exposed to Mycobacteria spp. infections and other pathogens.
Topics: Animals; Ferrets; Female; Klebsiella pneumoniae; Coinfection; Klebsiella Infections; Mycobacterium avium; Tuberculosis; Fatal Outcome
PubMed: 38940116
DOI: 10.26444/aaem/174216