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<i>Spilanthes filicaulis</i> (Schumach. & Thonn.) C.D. Adams leaves protects against streptozotocin-induced diabetic nephropathy

by Oluwafemi Adeleke Ojo, Akingbolabo Daniel Ogunlakin, Christopher Oloruntoba Akintayo, Olaoluwa Sesan Olukiran, Juliana Bunmi Adetunji, Omolola Adenike Ajayi-Odoko, Theophilus Oghenenyoreme Ogwa, Olorunfemi Raphael Molehin, Omolara Olajumoke Ojo, Ramzi A. Mothana, Abdullah R. Alanzi

Background and objective

Diabetic neuropathy (DN) is a complex type of diabetes. The underlying cause of diabetic nephropathy remains unclear and may be due to a variety of pathological conditions resulting in kidney failure. This study examines the protective effect of the methanolic extract of Spilanthes filicaulis leaves (MESFL) in fructose-fed streptozotocin (STZ)-induced diabetic nephropathy and the associated pathway.

Methods

Twenty-five rats were equally divided randomly into five categories: Control (C), diabetic control, diabetic + metformin (100 mg/kg), diabetic + MESFL 150 mg/kg bw, and diabetic + MESFL 300 mg/kg bw. After 15 days, the rats were evaluated for fasting blood glucose (FBG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), urea, uric acid, serum creatinine, reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), and lipid peroxidation (MDA). Gene expression levels of cyclic adenosine monophosphate (cAMP), protein kinase A (PKA), cAMP response element-binding (CREB), cFOS and the antiapoptotic protein Bcl-2 were examined.

Results

We observed that MESFL at 150 and 300 mg/kg bw significantly downregulated the protein expression of cAMP, PKA, CREB, and cFOS and upregulated the Bcl-2 gene, suggesting that the nephroprotective action of MESFL is due to the suppression of the cAMP/PKA/CREB/cFOS signaling pathway. In addition, MESFL increases SOD and CAT activities and GSH levels, reduces MDA levels, and reduces renal functional indices (ALP, urea, uric acid, and creatinine).

Conclusion

Therefore, our results indicate that MESFL alleviates the development of diabetic nephropathy via suppression of the cAMP/PKA/CREB/cFOS pathways.

Characterization and comparison of human and mouse milk cells

by Rose Doerfler, Saigopalakrishna Yerneni, Alexandra Newby, Namit Chaudhary, Ashley Shu, Katherine Fein, Juliana Hofstatter Azambuja, Kathryn A. Whitehead

Recent data has characterized human milk cells with unprecedented detail and provided insight into cell populations. While such analysis of freshly expressed human milk has been possible, studies of cell functionality within the infant have been limited to animal models. One commonly used animal model for milk research is the mouse; however, limited data are available describing the composition of mouse milk. In particular, the maternal cells of mouse milk have not been previously characterized in detail, in part due to the difficulty in collecting sufficient volumes of mouse milk. In this study, we have established a method to collect high volumes of mouse milk, isolate cells, and compare the cell counts and types to human milk. Surprisingly, we found that mouse milk cell density is three orders of magnitude higher than human milk. The cell types present in the milk of mice and humans are similar, broadly consisting of mammary epithelial cells and immune cells. These results provide a basis of comparison for mouse and human milk cells and will inform the most appropriate uses of mouse models for the study of human phenomena.

Platelet versus fresh frozen plasma transfusion for coagulopathy in cardiac surgery patients

by Jake V. Hinton, Calvin M. Fletcher, Luke A. Perry, Noah Greifer, Jessica N. Hinton, Jenni Williams-Spence, Reny Segal, Julian A. Smith, Christopher M. Reid, Laurence Weinberg, Rinaldo Bellomo

Background

Platelets (PLTS) and fresh frozen plasma (FFP) are often transfused in cardiac surgery patients for perioperative bleeding. Their relative effectiveness is unknown.

Methods

We conducted an entropy-weighted retrospective cohort study using the Australian and New Zealand Society of Cardiac and Thoracic Surgeons National Cardiac Surgery Database. All adults undergoing cardiac surgery between 2005–2021 across 58 sites were included. The primary outcome was operative mortality.

Results

Of 174,796 eligible patients, 15,360 (8.79%) received PLTS in the absence of FFP and 6,189 (3.54%) patients received FFP in the absence of PLTS. The median cumulative dose was 1 unit of pooled platelets (IQR 1 to 3) and 2 units of FFP (IQR 0 to 4) respectively. After entropy weighting to achieve balanced cohorts, FFP was associated with increased perioperative (Risk Ratio [RR], 1.63; 95% Confidence Interval [CI], 1.40 to 1.91; P Conclusion

In perioperative bleeding in cardiac surgery patient, platelets are associated with a relative mortality benefit over FFP. This information can be used by clinicians in their choice of procoagulant therapy in this setting.

Sex differences in growth and mortality in pregnancy-associated hypertension

by Jess C. Hercus, Katherine X. Metcalfe, Julian K. Christians

Background

It is hypothesized that male fetuses prioritize growth, resulting in increased mortality, whereas females reduce growth in the presence of adversity. Preeclampsia reflects a chronic condition, in which fetuses have the opportunity to adjust growth. If females reduce their growth in response to preeclampsia, but males attempt to maintain growth at the cost of survival, we predict that differences in birthweight between preeclamptic and non-preeclamptic pregnancies will be greater among females, whereas differences in mortality will be greater among males.

Methods

We analysed data from the Centers for Disease Control and Prevention. We compared pregnancies with pregnancy-associated hypertension (PAH) and controls.

Results

The difference in birthweight between pregnancies affected by PAH and controls varied by fetal sex and gestational age. Among pregnancies of White individuals, at 34–35 weeks, the difference between PAH and controls was higher among females, as predicted. However, this pattern was reversed earlier in pregnancy and around term. Such variation was not significant in Black pregnancies. In both Black and White pregnancies, early in gestation, males had lower odds of death in PAH pregnancies, but higher odds of death in control pregnancies, counter to our prediction. Later, males had higher odds of death in PAH and controls, although the increased odds of death in males was not higher in PAH pregnancies than in controls. Overall, the difference in birthweight between surviving and non-surviving infants was greater in males than in females, opposite to our prediction.

Conclusions

The impact of PAH on birthweight and survival varies widely throughout gestation. Differences in birthweight and survival between male and female PAH and controls are generally not consistent with the hypothesis that males prioritize fetal growth more than females, and that this is a cause of increased mortality in males.

Correlational study of ergonomic knowledge and level of MSK discomfort during online classes of 1st-4th year UST-CRS physical therapy students: a cross-sectional study

Por: Siy · W. · Sicat · Z. M. · Bautista · T. M. · Formalejo · A. · Gatdula · M. E. · Ico · A. A. · Julian · C. J. · Pabion · M. C. · Reyes · J. L. · Santander · N. M.
Introduction

The abrupt transition of the mode of learning due to the COVID-19 pandemic resulted in an increase in complaints of musculoskeletal (MSK) discomfort among students in Higher Education Institutions (HEI). Inadequate physical space and equipment are one major cause of these complaints. Among HEIs, physical therapy (PT) students have sufficient background in managing MSK discomforts. However, this does not prevent them from experiencing pain and discomfort during online classes. This analytical cross-sectional study aims to determine the correlation between ergonomic knowledge and MSK discomfort among first-year to fourth-year PT students.

Methods and analysis

The study will use two questionnaires, the Ergonomic Knowledge Questionnaire, and the Cornell Musculoskeletal Discomfort Questionnaire, that determine the level of ergonomic knowledge and MSK discomfort, respectively. This will be disseminated to 144 students through google forms. Results will then be analysed using Pearson Correlation Test. The study anticipates a correlation between the level of ergonomic knowledge and MSK discomfort among the participants.

Ethics and dissemination

The study has been approved by the University of Santo Tomas-College of Rehabilitation Sciences Ethics Review Committee. The participants will receive the results prior to publication in a peer-reviewed scientific journal.

Trial registration number

Philippine Health Research Registry with registry ID PHRR230216-005443.

Lambs supplemented with Amazonian oilseed co-products: Meat quality and fatty acid profile

by Vinícius Costa Gomes de Castro, Juliana Cristina de Castro Budel, Thomaz Cyro Guimarães de Carvalho Rodrigues, Bruna Almeida Silva, Waléria Cristina Lopes Joset, Alyne Cristina Sodré de Lima, Shirley Motta Souza, Rui José Branquinho Bessa, Suzana Paula Almeida Alves, Jamile Andrea Rodrigues da Silva, Maria Regina Sarkis Peixoto Joele, André Guimarães Maciel e Silva, José de Brito Lourenço-Júnior

The Amazon has a wide variety of oilseeds that generate a huge amount of co-products with potential for use in animal nutrition. The objective was to use alternative resources (oilseed cakes) in the feeding of lambs to assign a sustainable destination to this biomass, and evaluate its influence on the quality and fatty acid (FA) profile of the meat. Twenty-four lambs, male, castrated, crossbred Dorper × Santa Inês, weighing 30 ± 1.3 kg of initial body weight, were distributed in a completely randomized design in 4 treatments (diets) with six replications (animals). The control diet (Control) contained corn and soybean meal as main ingredients, which were partially replaced in the other diets by cupuassu cake diet (Cup), palm kernel cake diet (Palm) and tucuma cake diet (Tuc). The inclusion of Amazon cakes influences the lipid (P = 0.02) and protein (P longissimus lumborum); reduces cooking losses (P 0.05). The inclusion of oilseed cakes influences the chemical composition, physical parameters, composition and fatty acid profile of the meat, but does not influence the indicators of atherogenicity, thrombogenicity and cholesterolemia.

Associations Between Psychosocial Needs, Carbohydrate-Counting Behavior, and App Satisfaction: A Randomized Crossover App Trial on 92 Adults With Diabetes

imageTo examine whether psychosocial needs in diabetes care are associated with carbohydrate counting and if carbohydrate counting is associated with satisfaction with diabetes applications' usability, a randomized crossover trial of 92 adults with type 1 or 2 diabetes requiring insulin therapy tested two top-rated diabetes applications, mySugr and OnTrack Diabetes. Survey responses on demographics, psychosocial needs (perceived competence, autonomy, and connectivity), carbohydrate-counting frequency, and application satisfaction were modeled using mixed-effect linear regressions to test associations. Participants ranged between 19 and 74 years old (mean, 54 years) and predominantly had type 2 diabetes (70%). Among the three tested domains of psychosocial needs, only competence—not autonomy or connectivity—was found to be associated with carbohydrate-counting frequency. No association between carbohydrate-counting behavior and application satisfaction was found. In conclusion, perceived competence in diabetes care is an important factor in carbohydrate counting; clinicians may improve adherence to carbohydrate counting with strategies designed to improve perceived competence. Carbohydrate-counting behavior is complex; its impact on patient satisfaction of diabetes application usability is multifactorial and warrants consideration of patient demographics such as sex as well as application features for automated carbohydrate counting.

Ethnic inequalities during clinical placement: A qualitative study of student nurses' experiences within the London National Health Service

Abstract

Aim

To understand how student nurse experiences on clinical placement, within National Health Service (NHS) hospitals, differ for ethnic minority and White British groups.

Design

A qualitative thematic analysis with an inductive approach.

Methods

Data from semi-structured interviews with 21 London (United Kingdom) hospital-based student nurses were examined using thematic analysis. Participants were interviewed as part of the Tackling Inequalities and Discrimination Experiences in Health Services (TIDES) study and asked about their experiences during clinical placement.

Results

Five main themes were identified: (1) Role of mentors, (2) Discrimination and unfair treatment, (3) Speaking up/out, (4) Career progression, and (5) Consequences of adverse experiences. All themes were linked, with the social dynamics and workplace environment (referred to as “ward culture”) providing a context that normalizes mistreatment experienced by nursing students. Students from ethnic minority backgrounds reported racism as well as cultural and/or religious microaggressions. While being valued for their race and ethnicity, White British students also experienced discrimination and inequity due to their age, sex, gender, and sexual orientation. Students from both White British and ethnic minority groups acknowledged that being treated badly was a barrier to career progression. Ethnic minority students also noted the lack of diverse representation within senior nursing positions discouraged career progression within the UK NHS.

Conclusion

These initial experiences of inequality and discrimination are liable to shape a student's perspective of their profession and ability to progress within nursing. The NHS is responsible for ensuring that student nurses' developmental opportunities are equal, irrespective of ethnicity.

Impact

Ward culture is perpetuated by others who normalize mistreatment and concurrently disadvantage ethnic minority students, making them feel unvalued. This in turn impacts both staff retention and career progression within the NHS. Training assessors should be aware of the existing culture of discrimination within clinical placements and work to eradicate it.

Repercusiones de la pandemia por el nuevo coronavirus para la salud de los profesionales de enfermería

Objetivo: Analizar las repercusiones de la pandemia por el nuevo coronavirus en la salud de los profesionales de enfermería. Método: Investigación cuantitativa, descriptiva, realizada en un hospital universitario de Salvador, Bahía, Brasil, entre septiembre y octubre de 2020. La recolección de datos se realizó a través de un cuestionario electrónico estructurado, que fue respondido por 209 profesionales de enfermería de la institución. El proyecto fue aprobado por un Comité de Ética en Investigación (nº CAAE 36841720.0.0000.0049). Resultados: La mayoría de los profesionales relató insomnio o dormir menos de lo necesario (62,67%); mostró aumento del deseo de comer (46,89%) o pérdida del apetito (16,75%); tuvo pérdidas en actividades de ocio (97,6%); relataron una disminución en la práctica de actividad física (91,87%); mostró alteraciones en el estado de ánimo (83,75%); reportó algún grado de ansiedad (89,95%); y tenía diagnóstico de covid-19 (28,23%). Conclusión: Los resultados indican las repercusiones que trajo la pandemia para la salud física y mental de los profesionales de enfermería.

Experiencia en la atención al paciente con Covid-19: de las reacciones a lo nuevo a la atención sensible

Objetivo principal: Aprehender las experiencias de los profesionales de enfermería en el cuidado de pacientes con covid-19. Metodología: Investigación cualitativa realizada con 17 profesionales de enfermería en un hospital universitario de Salvador, Bahía, Brasil. La información fue recolectada a través de entrevistas semiestructuradas y analizada con el apoyo del software IRAMUTEQ. Resultados principales: La experiencia de las prácticas fue descrita como difícil, aterradora, complicada, causando miedo, aprensión y estrés. Surgió el énfasis en las medidas de autoprotección y como medio para superar el aislamiento, los profesionales utilizaron estrategias para favorecer la aproximación y la comunicación entre los pacientes y el equipo, evidenciando así un cuidado sensible a las necesidades del otro. Conclusión principal: Las reacciones indican que los profesionales desarrollaron estados emocionales negativos; adaptaron el servicio; y el fortalecimiento del autocuidado mediante la exposición al riesgo de contaminación y utilizaron estrategias de atención permeadas por la sensibilidad.

Calidad de vida de madres cuidadoras de niños con necesidades especiales de salud

Objetivo: evaluar la calidad de vida de los cuidadores de niños con necesidades especiales de salud. Método: estudio cuantitativo, en una Unidad de Pediatría, con 16 madres de niños con necesidades especiales de salud. La recolección de datos se produjo mediante la aplicación del instrumento WHOQOL-bref. Para el análisis de los datos se utilizó la estadística descriptiva e inferencial. Resultados: la calidad de vida de los familiares cuidadores es influenciada por los aspectos físicos; psicológica; del medio ambiente y de las relaciones sociales. Conclusiones: la percepción general de la calidad de vida de estos cuidadores no puede considerarse satisfactoria, ya que los valores asociados a todos los ámbitos son relativamente bajos.

Análisis de los componentes de la Red de Atención Psicosocial en el cuidado al adolescente usuario de crack

Objetivo: analizar los componentes de la Red de Atención Psicosocial (RAPS) orientadas a la atención de adolescentes usuarios de crack. Método: estudio exploratorio y descriptivo con enfoque cualitativo de los datos, desarrollado en el Centro de Atención Psicosocial Alcohol y Drogas (CAPSad) y en el Centro de Atención Psicosocial Infanto-juvenil (CAPSi). Participaron 20 profesionales del CAPSad y 10 del CAPSi. Los datos se recopilaron mediante entrevistas semiestructuradas y se analizaron conforme al Análisis Temático. Resultados: se identificaron como componentes de la RAPS orientadas a la atención de los adolescentes usuarios de crack: Atención Psicosocial Especializada; Atención Residencial de Carácter Transitorio; Atención Hospitalaria – Hospital Psiquiátrico y Atención Primaria – Unidad de Atención Primaria. Conclusión: el desempeño del CAPSad se subrayó en la atención de los adolescentes usuarios de crack, con acciones dirigidas a rescatar los lazos escolares y en entornos más saludables, así como la atención a la familia de estos jóvenes.

Evaluación y cuidado de la piel al final de la vida

Este artículo contempla una actualización con base a los diez puntos establecidos por el consenso Skin Changes at the Life's End [Cambios en la Piel en el Final de la Vida] (Scale, por su sigla en inglés) y tiene por objetivo discutir la evaluación de las condiciones y el cuidado de la piel en el final de la vida. Acerca de los pacientes y familiares, se propone la construcción de un plan de cuidados basándose en sus deseos que deben ser debidamente registrados. Para los profesionales de salud, las recomendaciones buscan la educación para la evaluación de los signos clínicos de falla e insuficiencia de la piel. Así pues, la prioridad es la comodidad del paciente. Se concluye que la utilización del consenso Scale va al encuentro de la filosofía de los cuidados paliativos y puede así mejorar los aspectos multidimensionales involucrados en la calidad del proceso de morir.

WITHDRAWN: Post-traumatic stress disorder-related perinatal factors after the first postpartum year

This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause.
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