Exploring perinatal asphyxia by metabolomics

Brain damage related to perinatal asphyxia is the second cause of neuro-disability worldwide. Its incidence was estimated in 2010 as 8.5 cases per 1000 live births worldwide, with no further recent improvement even in more industrialized countries. If so, hypoxic-ischemic encephalopathy is still an issue of global health concern. It is thought that a consistent number of cases may be avoided, and its sequelae may be preventable by a prompt and efficient physical and therapeutic treatment. The lack of early, reliable, and specific biomarkers has up to now hampered a more effective use of hypothermia, which represents the only validated therapy for this condition. The urge to unravel the biological modifications underlying perinatal asphyxia and hypoxic-ischemic encephalopathy needs new diagnostic and therapeutic tools. Metabolomics for its own features is a powerful approach that may help for the identification of specific metabolic profiles related to the pathological mechanism and foreseeable outcome. The metabolomic profiles of animal and human infants exposed to perinatal asphyxia or developing hypoxic-ischemic encephalopathy have so far been investigated by means of 1H nuclear magnetic resonance spectroscopy and mass spectrometry coupled with gas or liquid chromatography, leading to the identification of promising metabolomic signatures. In this work, an extensive review of the relevant literature was performed

Ultrafine particle distribution and chemical composition assessment during military operative trainings

The assessment of airborne particulate matter (PM) and ultrafine particles (UFPs) in battlefield scenarios is a topic of particular concern; (2) Methods: Size distribution, concentration, and chemical composition of UFPs during operative military training activities (target drone launches, ammunition blasting, and inert bomb impact) were investigated using an electric low-pressure impactor (ELPI+) and a scanning electron microscope (SEM), equipped with energy-dispersive spectroscopy (EDS); (3) Results: The median of UFPs, measured for all sampling periods and at variable distance from sources, was between 1.02 × 103 and 3.75 × 103 particles/cm3 for drone launches, between 3.32 × 103 and 15.4 × 103 particles/cm3 for the ammunition blasting and from 7.9 × 103 to 1.3 × 104 particles/cm3 for inert launches. Maximum peak concentrations, during emitting sources starting, were 75.5 × 106 and 17.9 × 106 particles/cm3, respectively. Particles from the drone launches were predominantly composed of silicon (Si), iron (Fe) and calcium (Ca), and those from the blasting campaigns by magnesium (Mg), sulphur (S), aluminum (Al), iron (Fe), barium (Ba) and silicon (Si); (4) Conclusions: The investigated sources produced UFPs with median values lower than other anthropogenic sources, and with a similar chemical compositio

Patient verbal abuse, emotional exhaustion, and affective commitment among healthcare workers: A moderated mediation model of peer support

In the last decade, patient violence against hospital workers has been recognized as an emerging occupational hazard with negative effects at both individual and organizational levels. The aims of the current study were to examine the mediating role of emotional exhaustion on the relationship between patient verbal abuse (PVA) and unit affective commitment in a sample of healthcare workers (HCWs). In addition, we analyzed whether peer support was a moderator on the mediating effect. Using survey data from 870 HCWs, the results indicated that there was no significant direct effect of PVA on unit affective commitment after controlling for emotional exhaustion. The conditional indirect effect test showed that emotional exhaustion mediated the relationship between PVA and unit affective commitment at both low and high levels of peer support. Particularly, our results showed that the more peer support the stronger the relationship between PVA and emotional exhaustion. Finally, the moderation tests also showed that the less peer support the stronger the negative effect of emotional exhaustion on unit affective commitment. Several implications for future research and policy are discussed.Au cours de la dernière décennie, la violence des patients contre les travailleurs hospitaliers a été reconnue comme un risque professionnel émergent avec des effets négatifs tant au niveau individuel qu’organisationnel. Les objectifs de la présente étude étaient d’examiner le rôle médiateur de l’épuisement émotionnel sur la relation entre la violence verbale du patient et l’attachement affectif de l’unité chez un échantillon de travailleurs de la santé. En outre, il a été examiné si le soutien par les pairs était un modérateur sur l’effet de médiation. À l’aide des données d’enquête de 870 travailleurs de la santé, les résultats ont indiqué qu’il n’y avait pas d’effet direct significatif de la violence des patients sur l’attachement affectif de l’unité après le contrôle de l’épuisement émotionnel. Le test de l’effet indirect conditionnel a montré que l’épuisement émotionnel influait sur la relation entre la violence des patients et l’attachement affectif de l’unité à la fois au niveau élevé et faible du soutien par les pairs. En particulier, les résultats ont montré que plus le soutien par les pairs est fort, plus la relation entre la violence des patients et l’épuisement émotionnel est forte. Enfin, les tests de modération ont également montré que moins les pairs font preuve de soutiens, plus fort sera l’effet négatif de l’épuisement émotionnel sur l’attachement affectif à l’unité. Plusieurs implications pour la recherche et la politique sont discutées à partir des résultats

The use of bone block allografts in sinus augmentation, followed by delayed implant placement: A case series

PURPOSE: This article reports the clinical outcomes observed in a large number of patients receiving block bone allograft used for sinus augmentation and delayed implant placement. PATIENTS AND METHODS: In total, 28 patients (13 males) with a mean age of 49.8 ± 10.1 years (range: 33-67 years) were included in this case series. All selected patients suffered from severe alveolar ridge atrophy in the posterior maxilla and required bone augmentation procedures, followed by implant placement after 6 months. All patients were followed for 18 months after the grafting, with scheduled monthly visits and/or more frequent visits if required. The survival rates for both the bone blocks and placed implants were then evaluated. RESULTS: A total of 42 blocks and 90 implants were placed. Only one bone graft and 5 implants failed; the survival rate was 97.2% and 95.5% for the bone grafts and implants, respectively. The graft failed due to the onset of post-surgical infectious sinusitis, while in some patients' implants showed absence of osteointegration at the end of the healing phase. Of note, all failed implants were observed in heavy smokers; in all other patients, blocks and implants were successful. CONCLUSIONS: This preliminary case series suggests that the grafting of bone allograft followed by delayed implant placement may be a promising strategy for sinus augmentation. More extended and larger follow-up studies are needed to confirm this preliminary data

Patient Involvement in Shared Decision-Making: Do Patients Rate Physicians and Nurses Differently?

Background. Shared decision-making implies that patients and healthcare professionals make decisions together about clinical exams, available treatments, choice of options, and the benefit or downside of every choice. Patients involved in the shared decision-making process are more compliant with treatments and have a reduced risk of complications related to the pathology. In Italy, patient involvement in caring processes is still barely investigated. Aim. To investigate patients’ perceptions about shared decision-making with physicians and nurses, respectively, and to examine the relationship between shared decision-making and patient satisfaction and perceived quality of care/treatment. Methods. The study was performed between March and June 2019 in two wards of one Italian hospital. A questionnaire was administered to inpatients at the time of admission and again at discharge, including demographic information and measurement scales regarding patient involvement in shared decision-making, patient satisfaction, and perceived quality of treatment/care. Results. A total of 151 out of 301 patients completed questionnaires at both admission and discharge. Patients’ scores for shared decision-making (information, patient needs, treatment planning) were significantly different for physicians and nurses. At both admission and discharge, patients rated shared decision-making significantly higher for physicians compared to nurses, while there were no differences in their satisfaction ratings. Patient ratings of physicians did not change from admission (information: mean (M) = 3.50, standard deviation (SD) = 0.81; patient need: M = 3.05, SD = 1.05; treatment planning: M = 2.75, SD = 1.23) to discharge (information: M = 3.50, SD = 0.79; patient need: M = 3.17, SD = 1.02; treatment planning: M = 2.66, SD = 1.23) (p = 0.924, p = 0.098, p = 0.293, respectively), but patients’ ratings of nurses’ behavior increased significantly from admission (information: M = 2.44, SD = 1.23; patient need: M = 2.27, SD = 1.17; treatment planning: M = 2.12, SD = 1.19) to discharge (information: M = 2.62, SD = 1.22; patient need: M = 2.53, SD = 1.24; treatment planning: M = 2.35, SD = 1.21) (p = 0.019, p = 0.001, p = 0.003, respectively). Attention to patients’ needs was the key determinant of both satisfaction with nurses (OR = 3.65, 95% CI = 1.31–10.14, p = 0.013) and perceived quality of care (OR = 3.97, 95% CI = 1.49–10.55, p = 0.006). Providing appropriate information about disease progress and treatments was a key determinant of both satisfaction with physicians (OR = 19.75, 95% CI = 7.29–53.55, p < 0.001) and perceived quality of treatment (OR = 8.03, 95% CI = 3.25–19.81, p < 0.001). Discussion. Nurses should be sensitized to involving patients in the decision-making process, especially upon hospital admission. Specific training about effective communication techniques can be implemented to manage relationships with patients in different caring situations. Practical implications and future directions are discussed

The elderly and the city: Lack of knowledge on violence perception and consequences on daily life

Introduction: Two main demographic phenomena have substantially changed the condition of elderly: the growth of the urban population and the increase in longevity. Objective: The aim of the present review is to investigate how the elderly living in the cities perceive the sense of insecurity compared to those who reside in rural areas, and their Quality of Life (QoL). Method: Studies published from January 2011 to August 2017 were identified on Google and PubMed combining the following terms: "elderly urban/rural QoL" or "old age urban/rural QoL". Results: We found 18 different papers published. However, there was only one study on how the elderly perceive the violence in the city. Studies on quality of life were not univocal. Studies on depressive disorders in old age were most homogeneous showing a condition worsening in the cities. A study on the perception of violence in US showed in residents of cities and neighborhoods with the entertainment arena and casinos an increase of criminality perception. In contrast, the crime decreased in both above-mentioned neighborhoods. Conclusion: The condition of elderly in the cities is changed considerably in the recent years. It is estimated that this trend will increase in the coming years. We do not know how older people are experiencing these changes and how they perceive the persistence of violence in the cities. Future researches must satisfy this need by addressing the issue with appropriate methodological tools. This is a public health priority

Job demand–control–support latent profiles and their relationships with interpersonal stressors, job burnout, and intrinsic work motivation

In the Job Demand–Control–Support (JDCS) model, the combination of job demands, job control, and social support was hypothesized to lead to eight different constellations of job types. According to the model, these constellations are linked to wellbeing/health and learning outcomes. In the last three decades, these constellations of job types have been investigated by adopting a variable-centered perspective. However, latent profile analyses (LPA) enable a person-centered approach and empirically capture constellations of job types. In the present study, we used LPA to empirically identify distinct profiles of JDCS among Italian healthcare workers. Furthermore, we investigated the role of social stressors (workplace relationships and coworkers’ incivility) as antecedents of these profiles and the association of these profiles with job burnout and work motivation. Results from LPA (n = 1671) revealed four profiles: Isolated Prisoner, Participatory Leader, Moderate Strain, and Low Strain. Negative relationships at work and coworkers’ incivility increased the chances of being included in both Isolated prisoner and Participatory Leader profiles. Finally, the Isolated Prisoner and Moderate Strain profiles showed the highest levels of emotional exhaustion and cynicism and the lower levels of intrinsic work motivation. This study extends previous JDCS research, highlighting that researchers should consider empirically identified profiles rather than theoretically defined subgroups. Implications for stress theory, future research, and practice are discussed

Blood Biomarkers and Metabolomic Profiling for the Early Diagnosis of Vancomycin-Associated Acute Kidney Injury: A Systematic Review and Meta-Analysis of Experimental Studies

Background: several blood-based biomarkers have been proposed for predicting vancomycin-associated kidney injury (VIKI). However, no systematic analysis has compared their prognostic value. Objective: this systematic review and meta-analysis was designed to investigate the role of blood biomarkers and metabolomic profiling as diagnostic and prognostic predictors in pre-clinical studies of VIKI. Methods: a systematic search of PubMed was conducted for relevant articles from January 2000 to May 2022. Animal studies that administered vancomycin and studied VIKI were eligible for inclusion. Clinical studies, reviews, and non-English literature were excluded. The primary outcome was to investigate the relationship between the extent of VIKI as measured by blood biomarkers and metabolomic profiling. Risk of bias was assessed with the CAMARADES checklist the SYRCLE’s risk of bias tool. Standard meta-analysis methods (random-effects models) were used. Results: there were four studies for the same species, dosage, duration of vancomycin administration and measurement only for serum creatine and blood urea nitrogen in rats. A statistically significant increase was observed between serum creatinine in the vancomycin group compared to controls (pooled p = 0.037; Standardized Mean Difference: 2.93; 95% CI: 0.17 to 5.69; I2 = 92.11%). Serum BUN levels were not significantly different between control and vancomycin groups (pooled p = 0.11; SMD: 3.05; 95% CI: 0.69 to 6.8; I2 = 94.84%). We did not identify experimental studies using metabolomic analyses in animals with VIKI. Conclusions: a total of four studies in rodents only described outcomes of kidney injury as defined by blood biomarkers. Blood biomarkers represented included serum creatinine and BUN. Novel blood biomarkers have not been explored. © 2022 by the authors