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Frontiers in Medicine 2024Chronic kidney disease (CKD) is a growing global public health challenge worldwide. In Mexico, CKD prevalence is alarmingly high and remains a leading cause of morbidity... (Review)
Review
Chronic kidney disease (CKD) is a growing global public health challenge worldwide. In Mexico, CKD prevalence is alarmingly high and remains a leading cause of morbidity and mortality. Diabetic kidney disease (DKD), a severe complication of diabetes, is a leading determinant of CKD. The escalating diabetes prevalence and the complex regional landscape in Mexico underscore the pressing need for tailored strategies to reduce the burden of CKD. This narrative review, endorsed by the Mexican College of Nephrologists, aims to provide a brief overview and specific strategies for healthcare providers regarding preventing, screening, and treating CKD in patients living with diabetes in all care settings. The key topics covered in this review include the main cardiometabolic contributors of DKD (overweight/obesity, hyperglycemia, arterial hypertension, and dyslipidemia), the identification of kidney-related damage markers, and the benefit of novel pharmacological approaches based on Sodium-Glucose Co-Transporter-2 Inhibitors (SGLT2i) and Glucagon-Like Peptide-1 Receptor Agonists (GLP-1 RA). We also address the potential use of novel therapies based on Mineralocorticoid Receptor Antagonists (MRAs) and their future implications. Emphasizing the importance of multidisciplinary treatment, this narrative review aims to promote strategies that may be useful to alleviate the burden of DKD and its associated complications. It underscores the critical role of healthcare providers and advocates for collaborative efforts to enhance the quality of life for millions of patients affected by DKD.
PubMed: 38962740
DOI: 10.3389/fmed.2024.1376115 -
Frontiers in Medicine 2024A considerable percentage of daily emergency calls are for nursing home residents. With the ageing of the overall European population, an increase in emergency calls and...
INTRODUCTION
A considerable percentage of daily emergency calls are for nursing home residents. With the ageing of the overall European population, an increase in emergency calls and interventions in nursing homes (NH) is to be expected. A proportion of these interventions and hospital transfers may be preventable and could be considered as inappropriate by prehospital emergency medical personnel. The study aimed to understand Belgian emergency physicians' and emergency nurses' perspectives on emergency calls and interventions in NHs and investigate factors contributing to their perception of inappropriateness.
METHODS
An exploratory non-interventional prospective study was conducted in Belgium among emergency physicians and emergency nurses, currently working in prehospital emergency medicine. Electronic questionnaires were sent out in September, October and November 2023. Descriptive statistics were used to analyze the overall results, as well as to compare the answers between emergency physicians and emergency nurses about certain topics.
RESULTS
A total of 114 emergency physicians and 78 nurses responded to the survey. The mean age was 38 years with a mean working experience of 10 years in prehospital healthcare. Nursing home staff were perceived as understaffed and lacking in competence, with an impact on patient care especially during nights and weekends. General practitioners were perceived as insufficiently involved in the patient's care, as well as often unavailable in times of need, leading to activation of Emergency Medical Services (EMS) and transfers of nursing home residents to the Emergency Department (ED). Advance directives were almost never available at EMS interventions and transfers were often not in accordance with the patient's wishes. Palliative care and pain treatment were perceived as insufficient. Emergency physicians and nurses felt mostly disappointed and frustrated. Additionally, differences in perception were noted between emergency physicians and nurses regarding certain topics. Emergency nurses were more convinced that the nursing home physician should be available 24/7 and that transfers could be avoided if nursing home staff had more authority regarding medical interventions. Emergency nurses were also more under the impression that pain management was inadequate, and emergency physicians were more afraid of the medical implications of doing too little during interventions than emergency nurses. Suggestions to reduce the number of EMS interventions were more general practitioner involvement (82%), better nursing home staff education/competences (77%), more nursing home staff (67%), mobile palliative care support teams (65%) and mobile geriatric nursing intervention teams (52%).
DISCUSSION AND CONCLUSION
EMS interventions in nursing homes were almost never seen as necessary or indicated by emergency physicians and nurses, with the appropriate EMS level almost never being activated. The following key issues were found: shortages in numbers and competence of nursing home staff, insufficient primary care due to the unavailability of the general practitioner as well as a lack of involvement in patient care, and an absence of readily available advance directives. General practitioners should be more involved in the decision to call the Emergency Medical Services (EMS) and to transfer nursing home residents to the Emergency Department. Healthcare workers should strive for vigilance regarding the patients' wishes. The emotional burden of deciding on an avoidable hospital admission of nursing home residents, perhaps out of fear for medico-legal consequences if doing too little, leaves the emergency physicians and nurses frustrated and disappointed. Improvements in nursing home staffing, more acute and chronic general practitioner consultations, and mobile geriatric and palliative care support teams are potential solutions. Further research should focus on the structural improvement of the above-mentioned shortcomings.
PubMed: 38962739
DOI: 10.3389/fmed.2024.1396858 -
Frontiers in Medicine 2024Genetics plays a crucial role in the field of medicine, offering numerous applications. However, health professionals often have insufficient knowledge in this area....
BACKGROUND
Genetics plays a crucial role in the field of medicine, offering numerous applications. However, health professionals often have insufficient knowledge in this area. Therefore, it is essential to provide appropriate genetics education during university studies.
AIM
This study aimed to assess the knowledge and attitudes towards genetic testing among final-year medical students at a public university in Ecuador.
METHODS
A cross-sectional study was conducted involving final-year medical students from a public university in Ecuador. The third version of the Genetic Literacy and Attitudes Survey was administered between April and May 2022. The study examined sociodemographic characteristics, genetic knowledge, and attitudes towards genetic testing.
RESULTS
The study included 153 medical students, of which 58.2% identified as female. Most participants fell within the age range of 22 to 25 years old (85.0%). Regarding genetic knowledge, three-quarters of the participants (75.2%) demonstrated intermediate proficiency, while only 9.80% possessed a high level of knowledge. Attitudes towards the clinical and therapeutic applications of genetics, scientific advancements, access to conventional medicine, and other related topics were found to be appropriate.
CONCLUSION
The findings suggest that most final-year medical students at a public university in Ecuador have intermediate genetic knowledge and hold appropriate attitudes towards genetic testing. However, higher education institutions should conduct a comprehensive analysis and restructure their curricula to better prepare students for the medical and technological challenges of the 21st century.
PubMed: 38962733
DOI: 10.3389/fmed.2024.1363552 -
Frontiers in Rehabilitation Sciences 2024Although mechanical properties of running specific prostheses (RSPs) can affect running performance, manufacturers do not consistently report them. This study aimed to... (Review)
Review
BACKGROUND
Although mechanical properties of running specific prostheses (RSPs) can affect running performance, manufacturers do not consistently report them. This study aimed to review existing literature on RSP mechanical and structural properties and their relationship with running performance.
METHODS
A comprehensive search was conducted using keywords related to mechanical properties of RSPs and running performance. Search terms included stiffness and hysteresis, as well as performance outcomes including metabolic cost and running speed. Non-peer-reviewed and non-English publications were excluded.
RESULTS
Twenty articles were included in the review. Sixteen studies used a material testing machine to measure RSP material properties, and four articles used other techniques including 2D/3D video capture and force platforms. Both measurement techniques and reporting of outcomes were inconsistent, which limits the ability to draw broad conclusions. Additionally, several studies did not report the numerical data for material properties despite measuring them. Relatively few articles measured both material properties and running performance and assessed correlations.
CONCLUSION
Several articles connected prosthesis properties to running performance. However, inconsistent measurement and reporting of mechanical properties, along with the multifactorial nature of the athlete-prosthesis system, limit the ability to draw broad conclusions regarding the relationship between material and structural properties and athlete performance. Current evidence may be useful for clinicians seeking ways to optimize RSP stiffness in a case-by-case basis; however, clinicians would benefit from more consistent and systematic comparisons of the attributes of different RSPs and their role in performance.
PubMed: 38962729
DOI: 10.3389/fresc.2024.1402114 -
International Journal of Dentistry 2024Several endodontic difficulty assessment forms are available to help dental students and general dentists estimate the difficulty of the case before initiating the...
BACKGROUND
Several endodontic difficulty assessment forms are available to help dental students and general dentists estimate the difficulty of the case before initiating the endodontic treatment.
OBJECTIVES
This study aimed to assess if the American Association of Endodontics (AAE) case difficulty assessment form affects the dental student's perception of the difficulty encountered while performing root canal treatment (RCT).
MATERIALS AND METHODS
This was a cross-sectional online survey. After obtaining IRB approval, an electronic questionnaire was sent to dental students enrolled in the 4th and 5th years at King Saud University (KSU) and King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia. The questionnaire was divided into informed consent, demographic data, the use of the AAE case assessment form, RCT steps, diagnosis, local anesthesia administration, tooth isolation, and endodontic procedure.
RESULTS
A total of 195 dental students participated in the study. There were 101 (52%) females, and 139 (71%) were from KSAU-HS. A positive association was found between students who used the AAE assessment form and who did not with their ability to reach the correct diagnosis (=0.005), tooth isolation (=0.03), and endodontic procedure difficulty score (=0.018).
CONCLUSION
The use of the AAE form by dental students enabled them to differentiate between complicated and uncomplicated cases, thus lowering the difficulty encountered during RCT.
PubMed: 38962725
DOI: 10.1155/2024/1217448 -
Frontiers in Veterinary Science 2024()-infected livestock and wildlife have been epidemiologically linked to human Q fever outbreaks. Despite this growing zoonotic threat, knowledge of coxiellosis in wild...
INTRODUCTION
()-infected livestock and wildlife have been epidemiologically linked to human Q fever outbreaks. Despite this growing zoonotic threat, knowledge of coxiellosis in wild animals remains limited, and studies to understand their epidemiologic role are needed. In -endemic areas, ticks have been reported to harbor and spread and may serve as indicators of risk of infection in wild animal habitats. Therefore, the aim of this study was to compare molecular techniques for detecting DNA in ticks.
METHODS
In total, 169 ticks from wild animals and cattle in wildlife conservancies in northern Kenya were screened for DNA using a conventional PCR (cPCR) and two field-friendly techniques: Biomeme's qPCR Go-strips (Biomeme) and a new PCR high-resolution melt (PCR-HRM) analysis assay. Results were evaluated, in the absence of a gold standard test, using Bayesian latent class analysis (BLCA) to characterize the proportion of positive ticks and estimate sensitivity (Se) and specificity (Sp) of the three tests.
RESULTS
The final BLCA model included main effects and estimated that PCR-HRM had the highest Se (86%; 95% credible interval: 56-99%), followed by the Biomeme (Se = 57%; 95% credible interval: 34-90%), with the estimated Se of the cPCR being the lowest (24%, 95% credible interval: 10-47%). Specificity estimates for all three assays ranged from 94 to 98%. Based on the model, an estimated 16% of ticks had DNA present.
DISCUSSION
These results reflect the endemicity of in northern Kenya and show the promise of the PCR-HRM assay for surveillance in ticks. Further studies using ticks and wild animal samples will enhance understanding of the epidemiological role of ticks in Q fever.
PubMed: 38962707
DOI: 10.3389/fvets.2024.1396714 -
Neurobiology of Stress Jul 2024Stressors can initiate a cascade of central and peripheral changes that modulate mesocorticolimbic dopaminergic circuits and, ultimately, behavioral response to rewards.... (Review)
Review
Stressors can initiate a cascade of central and peripheral changes that modulate mesocorticolimbic dopaminergic circuits and, ultimately, behavioral response to rewards. Driven by the absence of conclusive evidence on this topic and the Research Domain Criteria framework, random-effects meta-analyses were adopted to quantify the effects of acute stressors on reward responsiveness, valuation, and learning in rodent and human subjects. In rodents, acute stress reduced reward responsiveness ( = -1.43) and valuation ( = -0.32), while amplifying reward learning ( = 1.17). In humans, acute stress had marginal effects on valuation ( = 0.25), without affecting responsiveness and learning. Moderation analyses suggest that acute stress neither has unitary effects on reward processing in rodents nor in humans and that the duration of the stressor and specificity of reward experience (i.e., food vs drugs) may produce qualitatively and quantitatively different behavioral endpoints. Subgroup analyses failed to reduce heterogeneity, which, together with the presence of publication bias, pose caution on the conclusions that can be drawn and point to the need of guidelines for the conduction of future studies in the field.
PubMed: 38962695
DOI: 10.1016/j.ynstr.2024.100647 -
Frontiers in Epidemiology 2024Emerging risk factors for atrial fibrillation (AF) incidence and episodes (exacerbation), the most common and clinically significant cardiac arrhythmia, include air and...
Oil and gas development exposure and atrial fibrillation exacerbation: a retrospective study of atrial fibrillation exacerbation using Colorado's all payer claims dataset.
INTRODUCTION
Emerging risk factors for atrial fibrillation (AF) incidence and episodes (exacerbation), the most common and clinically significant cardiac arrhythmia, include air and noise pollution, both of which are emitted during oil and natural gas (O&G) well site development.
METHODS
We evaluated AF exacerbation risk and proximity to O&G well site development by employing a novel data source and interrupted time-series design. We retrospectively followed 1,197 AF patients living within 1-mile of an O&G well site (at-risk of exposure) and 9,764 patients living >2 miles from any O&G well site (unexposed) for AF claims in Colorado's All Payer Claims Dataset before, during, and after O&G well site development. We calculated AF exacerbation risk with multi-failure survival analysis.
RESULTS
The analysis of the total study population does not provide strong evidence of an association between AF exacerbation and proximity to O&G wells sites during (HR = 1.07, 95% CI: 0.94, 1.22) or after (HR = 1.01, 95% CI: 0.88, 1.16) development. However, AF exacerbation risk differed by patient age and sex. In patients >80 years living within 0.39 miles (2,059 feet) of O&G well site development, AF exacerbation risk increased by 83% (HR = 1.83, 95% CI: 1.25, 2.66) and emergency room visits for an AF event doubled (HR = 2.55, 95% CI: 1.50, 4.36) during development, with risk increasing with proximity. In female patients living within 0.39 miles of O&G well site development, AF exacerbation risk increased by 56% percent (95% CI: 1.13, 2.15) during development. AF exacerbation risk did not persist past the well development period. We did not observe increased AF exacerbation risk in younger or male patients.
DISCUSSION
The prospect that proximity to O&G well site development, a significant noise and air pollution source, may increase AF exacerbation risk in older and female AF patients requires attention. These findings support appropriate patient education to help mitigate risk and development of mitigation strategies and regulations to protect the health of populations in O&G development regions.
PubMed: 38962693
DOI: 10.3389/fepid.2024.1379271 -
F1000Research 2024The exponential increase in the number of submissions, further accelerated by generative AI, and the decline in the availability of experts are burdening the peer review...
The exponential increase in the number of submissions, further accelerated by generative AI, and the decline in the availability of experts are burdening the peer review process. This has led to high unethical desk rejection rates, a growing appeal for the publication of unreviewed preprints, and a worrying proliferation of predatory journals. The idea of monetarily compensating peer reviewers has been around for many years; maybe, it is time to take it seriously as one way to save the peer review process. Here, I argue that paying reviewers, when done in a fair and transparent way, is a viable solution. Like the case of professional language editors, part-time or full-time professional reviewers, managed by universities or for-profit companies, can be an integral part of modern peer review. Being a professional reviewer could be financially attractive to retired senior researchers and to researchers who enjoy evaluating papers but are not motivated to do so for free. Moreover, not all produced research needs to go through peer review, and thus persuading researchers to limit submissions to their most novel and useful research could also help bring submission volumes to manageable levels. Overall, this paper reckons that the problem is not the peer review process per se but rather its function within an academic ecosystem dominated by an unhealthy culture of 'publish or perish'. Instead of reforming the peer review process, academia has to look for better science dissemination schemes that promote collaboration over competition, engagement over judgement, and research quality and sustainability over quantity.
Topics: Peer Review, Research; Humans; Publishing; Periodicals as Topic; Peer Review
PubMed: 38962691
DOI: 10.12688/f1000research.148985.1 -
Frontiers in Aging Neuroscience 2024Ferroptosis, a newly proposed concept of programmed cell death, has garnered significant attention in research across different diseases in the last decade. Despite... (Review)
Review
BACKGROUND
Ferroptosis, a newly proposed concept of programmed cell death, has garnered significant attention in research across different diseases in the last decade. Despite thorough citation analyses in neuroscience, there is a scarcity of information on ferroptosis research specifically related to neurodegenerative diseases.
METHOD
The Web of Science Core Collection database retrieved relevant articles and reviews. Data on publications, countries, institutions, authors, journals, citations, and keywords in the included studies were systematically analyzed using Microsoft Excel 2019 and CiteSpace 6.2.R7 software.
RESULT
A comprehensive analysis and visualization of 563 research papers on ferroptosis in neurodegenerative diseases from 2014 to 2023 revealed emerging research hotspots and trends. The number of annual publications in this field of study has displayed a pattern of stabilization in the early years of the decade, followed by a notable increase in the later years and peaking in 2023 with 196 publications. Regarding publication volume and total citations, notable research contributions were observed from countries, institutions, and authors in North America, Western Europe, and China. Current research endeavors primarily focus on understanding the intervention mechanisms of neurodegenerative diseases through the ferroptosis pathway and exploring and identifying potential therapeutic targets.
CONCLUSION
The study highlights key areas of interest and emerging trends in ferroptosis research on neurodegenerative diseases, offering valuable insights for further exploration and potential directions for diagnosing and treating such conditions.
PubMed: 38962561
DOI: 10.3389/fnagi.2024.1417989