α-ketoglutarate preconditioning extends the survival of engrafted adipose-derived mesenchymal stem cells to accelerate healing of burn wounds.

The application of adipose-derived stem cells (ADSCs) in treating hard-to-heal wounds has been widely accepted, while the short-term survival rate remains an obstacle in stem cell therapy. The aim of this study is to investigate the effect of preconditioning ADSCs with α-ketoglutarate (α-KG) on the healing of acid burn wounds and cell survival within wounds. Preconditioning of ADSCs was performed by treating cells at passage 3 with 3.5 mM DM-αKG for 24 h. Proliferation and migration of ADSCs was examined. An acid burn wound was created on the dorsal skin of mice. Cell suspension of ADSCs (2 × 106 cells/ml), either pre-treated with α-KG or not, was injected subcutaneously around the margin of wound. At 1,4,7,10,14 days after injection, the percentage of wound closure was evaluated. Expression of pro-angiogenic factors, matrix molecules and HIF1-α in pretreated ADSCs or in wounds was evaluated by qRT-PCR and immunohistochemistry staining, respectively. The survival rate of DiO-labelled ADSCs was determined with the in vivo bioluminescent imaging system. Treating with α-KG induced an enhancement in migration of ADSCs, while their proliferation was not affected. Expression of Vegf and Fgf-2 was significantly increased. With injection of pretreated ADSCs, healing of wounds was remarkably accelerated, along with increased ECM deposition and microvessel density. Moreover, pretreatment with α-KG resulted a prolonged survival of engrafted ADSCs was observed. Expression of HIF-1α was significantly increased in ADSCs treated with α-KG and in wounds injected with preconditioned ADSCs. Our results revealed that healing of acid burn wound was accelerated with administration of ADSCs pretreated with α-KG, which induced elevated expression of HIF-1α and prolonged survival of engrafted stem cells.

An evaluation of survive and thrive: a 10-week group psychoeducational course for adult interpersonal trauma survivors in Scotland.

Emerging evidence supports a phased approach to trauma treatment, including manualised group-based interventions, to facilitate symptom reduction resulting from complex trauma sequelae. This study investigates the efficacy of Survive and Thrive, a 10-week group psychoeducational course for adult survivors of interpersonal trauma. Between August 2019 and February 2022, participants were enrolled on the course. The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) and Difficulties in Emotion Regulation Scale-Short Form (DERS-SF) were administered pre-intervention and immediately post-intervention. In addition, thematic analysis was applied to qualitative feedback. Results revealed significant reductions in CORE-OM and DERS-SF scores post-intervention, with minimal variability in scores attributed to group delivery (either face-to-face or online). The thematic analysis demonstrated that normalising trauma symptoms and providing coping skills positively impacted participants' experiences. At the same time, the breadth and nature of the content were observed to be an occasional barrier to engagement. In summary, this study proposes that group-based psychoeducational interventions are generally effective for those with mild-to-moderate symptoms of complex trauma. However, further evidence is needed to offer more nuanced recommendations for identifying individuals who may benefit the most from these interventions.

Clinical characteristics of survivors versus non-survivors after acute diquat poisoning: a comparative study.

The aim of this study was to compare the clinical characteristics between survivors and non-survivors after acute diquat (DQ) poisoning. Patients treated in the Emergency Department of Fu Yang People's Hospital for DQ poisoning between January 2018 and February 2022 were enrolled in this retrospective comparative study. A total of 65 patients were collected, including 36 males (55.4%) and 29 females (44.6%). There were 34 survivors (52.3%), and 31 non-survivors (47.7%). Patients in the non-survivor group were significantly older (P = 0.003), received a higher dose of DQ before admission (P < 0.001), had more severe organ damage (P < 0.001), lower respiration rate (P < 0.001) and enema (P = 0.009), lower GCS score (P = 0.038), and higher SIRS score (P = 0.018) and APACHE-II score (P < 0.001) than patients in the survivor group. Additionally, biochemical indicators after admission between survivors and non-survivors were significantly different (all P < 0.05). Multivariate logistic regression analysis showed that respiratory failure (P = 0.021), the dose of DQ (P = 0.022), respiratory rate (P = 0.007), and highest alanine transaminase (ALT) level after admission (P = 0.030) were independent risk factors for acute DQ-induced death. These data suggest that non-survivors with acute DQ poisoning are more likely to suffer from respiratory failure, have higher respiratory rate and ALT after admission, and are exposed higher doses of DQ before admission than survivors.

Joint Modeling of Social Determinants and Clinical Factors to Define Subphenotypes in Out-of-Hospital Cardiac Arrest Survival: Cluster Analysis.

Background: Machine learning clustering offers an unbiased approach to better understand the interactions of complex social and clinical variables via integrative subphenotypes, an approach not studied in out-of-hospital cardiac arrest (OHCA). Objective: We conducted a cluster analysis for a cohort of OHCA survivors to examine the association of clinical and social factors for mortality at 1 year. Methods: We used a retrospective observational OHCA cohort identified from Medicare claims data, including area-level social determinants of health (SDOH) features and hospital-level data sets. We applied k-means clustering algorithms to identify subphenotypes of beneficiaries who had survived an OHCA and examined associations of outcomes by subphenotype. Results: We identified 27,028 unique beneficiaries who survived to discharge after OHCA. We derived 4 distinct subphenotypes. Subphenotype 1 included a distribution of more urban, female, and Black beneficiaries with the least robust area-level SDOH measures and the highest 1-year mortality (2375/4417, 53.8%). Subphenotype 2 was characterized by a greater distribution of male, White beneficiaries and had the strongest zip code-level SDOH measures, with 1-year mortality at 49.9% (4577/9165). Subphenotype 3 had the highest rates of cardiac catheterization at 34.7% (1342/3866) and the greatest distribution with a driving distance to the index OHCA hospital from their primary residence >16.1 km at 85.4% (8179/9580); more were also discharged to a skilled nursing facility after index hospitalization. Subphenotype 4 had moderate median household income at US $51,659.50 (IQR US $41,295 to $67,081) and moderate to high median unemployment at 5.5% (IQR 4.2%-7.1%), with the lowest 1-year mortality (1207/3866, 31.2%). Joint modeling of these features demonstrated an increased hazard of death for subphenotypes 1 to 3 but not for subphenotype 4 when compared to reference. Conclusions: We identified 4 distinct subphenotypes with differences in outcomes by clinical and area-level SDOH features for OHCA. Further work is needed to determine if individual or other SDOH domains are specifically tied to long-term survival after OHCA.

Lymphocyte immunophenotyping and concentration of MMP-9 in transudates and exudates in horses.

This study is the first to provide information on the lymphocyte subpopulations in peritoneal effusions in horses. Peritoneal transudates (n = 12), peritoneal exudates (n = 6) and a pleural exudate (n = 1) were analyzed. The total nucleated cell count (TNCC), total protein (TP) and matrix metalloproteinase-9 (MMP-9) concentration determined by ELISA were measured and routine cytological evaluation was performed. CD3, CD4, CD8 and CD21 positive cells were detected by flow cytometry. A higher percentage of neutrophils (P < 0.05) and higher MMP-9 (P < 0.01) levels were found in exudates. A higher percentage of macrophages (P < 0.05) and lymphocytes (P < 0.01) were found in transudates. CD4 + lymphocytes were the most common lymphocyte subpopulation in all samples. CD21 + lymphocytes were the least common in all samples. A large variability in the percentage of CD21 + lymphocytes was found in exudates. The percentage of CD21 + lymphocytes positively correlated with the level of total protein (r = 0.5704, P < 0.05). The correlation was even stronger in the group of exudates. The percentages of lymphocyte subpopulations did not correlate with the level of MMP-9 or with cytological findings. The level of MMP-9 positively correlated with the percentage of neutrophils (r = 0.4980, P < 0.05), the level of TP (r = 0.7855, P < 0.01) and TNCC (r = 0.6129, P < 0.01). A significantly higher level of MMP-9 was detected in euthanized horses than in horses that survived (P < 0.05). However, it was shown that the level of MMP-9 in the peritoneal fluid can change significantly in a short time. More studies on repeated abdominocentesis could contribute to elucidating the role of MMP-9 as a prognostic indicator.

Turning the Gaze from Survive to Thrive for Children in India: Learnings from Two Case Studies.

Despite significant efforts and progress made in newborn care programs in India, implementation gaps persist across the continuum of care. The present case studies of two districts in Himachal Pradesh revealed that pathways of care were often fragmented with inconsistent linkages between facility and community due to poor documentation, lack of tiered referral, health system weaknesses, low utilization of primary level institutions, and inadequate post-natal home visits by Accredited Social Health Activists (ASHAs). Involvement of healthcare providers (HCPs) and frontline health workers (FHWs) was low and uneven in generating awareness across the districts with limited participation in supporting care in the community. Ensuring functionality of health centers and first-level care facilities; strengthening referral systems; adequate/trained human resources; strengthening routine health management systems, discharge processes and community-based care with adequate integration with facilities are necessary in closing access gaps.

"Safer Births Bundle of Care" Implementation and Perinatal Impact at 30 Hospitals in Tanzania-Halfway Evaluation.

Safer Births Bundle of Care (SBBC) consists of innovative clinical and training tools for improved labour care and newborn resuscitation, integrated with new strategies for continuous quality improvement. After implementation, we hypothesised a reduction in 24-h newborn deaths, fresh stillbirths, and maternal deaths by 50%, 20%, and 10%, respectively. This is a 3-year stepped-wedged cluster randomised implementation study, including 30 facilities within five regions in Tanzania. Data collectors at each facility enter labour and newborn care indicators, patient characteristics and outcomes. This halfway evaluation reports data from March 2021 through July 2022. In total, 138,357 deliveries were recorded; 67,690 pre- and 70,667 post-implementations of SBBC. There were steady trends of increased 24-h newborn and maternal survival in four regions after SBBC initiation. In the first region, with 13 months of implementation (n = 15,658 deliveries), an estimated additional 100 newborns and 20 women were saved. Reported fresh stillbirths seemed to fluctuate across time, and increased in three regions after the start of SBBC. Uptake of the bundle varied between regions. This SBBC halfway evaluation indicates steady reductions in 24-h newborn and maternal mortality, in line with our hypotheses, in four of five regions. Enhanced focus on uptake of the bundle and the quality improvement component is necessary to fully reach the SBBC impact potential as we move forward.

Are the main effects of the will to exist, live, survive and fight on optimizing executive function due to its optimizing self-motivation? A longitudinal study.

The study aims to identify the mechanisms underlying the findings that will to exist, live, survive and fight (WTELS-F) optimizes executive functions. Defining executive functions (EF) as having cold (working memory, inhibition, and cognitive flexibility) and hot (e.g., motivation) components, we hypothesized that WTELS-F affects executive functions positively via two pathways. The first pathway is through the hot executive function (motivation), and the second is via survival or existential processing. In a longitudinal study of 228 adult participants two times with ten weeks in between, we used measures for WTELS-F, working memory, inhibition, shift/cognitive flexibility, and self-motivation. We tested the structural validity of the four factors' executive function by exploratory factor analysis in time 1 data and confirmatory factor analysis in time 2 data. We conducted structural equation modeling WTELS-F change as a latent variable predicted by the change in its three components between times 1 and 2., affecting changes in self-motivation (the hot EF), and changes in the latent variable of cold EF as predicted by changes in working memory, inhibition, and shift. Results indicated that the model of EF fit the data well without modification. WTELS-F significantly affected self-motivation (the hot EF) and the cold EF longitudinally. It had further mediated effects on cold EF via its impact on self-motivation. The results provided evidence for the two pathways hypothesis of the effects of WTELS-F on EF. The conceptual and clinical implications of these findings were discussed.

The association of WTELS as a master motivator with higher executive functioning and better mental health.

The goal is to test the validity of the "Will to exist-live and survive (WTELS) as a master motivator that activates executive functions. A sample of 262 adults administered different measures that included WTELS and executive functions. We conducted hierarchical regressions with working memory deficits (WMD) and inhibition deficits (ID) as dependent variables. We entered in the last steps resilience and WTELS as independent variables. We conducted path analysis with WTELS as independent variables and WMD and ID as outcome variables and resilience and social support as mediating variables. WTELS accounted for the high effect size for lower working memory deficits and medium effect size for lower inhibition deficits. In path analysis, the effects of WTELS on decreased WMD were direct, while its effects on the ID were indirect. PROCESS analysis indicated that WTELS was directly associated with lower depression, anxiety, PTSD, and COVID-19 traumatic stress, and its indirect effects were mediated by lower executive function deficits (Kira et al., Psych 12:992-1024 2021c, Kira et al., in press). The path model discussed was generally superior to the alternative models and was strictly invariant across genders (male/ female). Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-021-02078-8.

Short-term and long-term outcomes of uniportal versus three portal thoracoscopic radical resection of non-small cell lung cancer: A retrospective cohort study / 中国胸心血管外科临床杂志

@#Objective     To compare the short-term efficacy and long-term survival of patients with non-small cell lung cancer (NSCLC) treated by uniportal or three portal thoracoscopic radical resection. Methods     A total of 388 patients who underwent uniportal or three portal thoracoscopic radical resection of lung cancer in the Department of Thoracic Surgery of Anhui Chest Hospital from 2015 to 2016 were analyzed retrospectively. The patients were divided into two groups including an uniportal group and a three portal group according to the procedure. The clinicopathological features, perioperative data and long-term survival of the two groups were compared. Results     Finally, we included 205 patients with 105 males and 100 females at an average age of 58.73±10.93 years. There were 102 patients in the uniportal group and 103 patients in the three portal group. There was no statistical difference in clinicopathological features between the two groups (P>0.05). But compared with the three portal group, the uniportal group had less postoperative drainage, shorter postoperative catheterization time and postoperative hospital stay (P<0.05). There was no statistical difference in the number of lymph node dissection stations between the two groups (P=0.058). The pain score at 24 hours after operation in the uniportal group was significantly lower than that in the three portal group (P<0.001). There was no  statistical difference in the total incidence of complications and the incidence of pulmonary complications between the two groups (P=0.161 and P=0.275). The median survival period and the 1st, 3rd, and 5th year survival rate in the uniportal group was 63.0 months and 95.0%, 75.2%, 51.5%, respectively. The median survival period and the 1st, 3rd, and 5th year survival rate in the three portal group was 61.0 months and 89.3%, 70.9%, 50.5%, respectively. There was no satistical difference in the survival results between the two groups (P=0.440). Conclusion     Uniportal thoracoscopic radical resection of lung cancer is more minimally invasive and safe and effective in the treatment of NSCLC. It can make patients recover faster after operation.

Health workers' experiences of implementation of Helping Mothers Survive Bleeding after Birth training in Tanzania: a process evaluation using the i-PARIHS framework.

BACKGROUND: In-service training, including the competency-based Helping Mothers Survive Bleeding After Birth (HMS BAB) is widely implemented to improve the quality of maternal health services. To better understand how this specific training responds to the needs of providers and fits into the existing health systems, we explored health workers' experiences of the HMS BAB training. METHODS: Our qualitative process evaluation was done as part of an effectiveness trial and included eight focus group discussions with 51 healthcare workers in the four districts which were part of the HMS BAB trial. We employed deductive content analysis informed by the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) construct of context, recipients, innovation and facilitation. RESULTS: Overall, health workers reported positive experiences with the training content and how it was delivered. They are perceived to have improved competencies leading to improved health outcomes. Interviews proposed that peer practice coordinators require more support to sustain the weekly practices. Competing tasks within the facility in the context of limited time and human resources hindered the sustainability of weekly practices. Most health facilities had outlined the procedure for routine learning environments; however, these were not well operational. CONCLUSION: The HMS BAB training has great potential to improve health workers' competencies around the time of childbirth and maternal outcomes. Challenges to successful implementation include balancing the intervention within the routine facility setting, staff motivation and workplace cultures.

Using Mobile Virtual Reality Simulation to Prepare for In-Person Helping Babies Breathe Training: Secondary Analysis of a Randomized Controlled Trial (the eHBB/mHBS Trial).

BACKGROUND: Neonatal mortality accounts for approximately 46% of global under-5 child mortality. The widespread access to mobile devices in low- and middle-income countries has enabled innovations, such as mobile virtual reality (VR), to be leveraged in simulation education for health care workers. OBJECTIVE: This study explores the feasibility and educational efficacy of using mobile VR for the precourse preparation of health care professionals in neonatal resuscitation training. METHODS: Health care professionals in obstetrics and newborn care units at 20 secondary and tertiary health care facilities in Lagos, Nigeria, and Busia, Western Kenya, who had not received training in Helping Babies Breathe (HBB) within the past 1 year were randomized to access the electronic HBB VR simulation and digitized HBB Provider's Guide (VR group) or the digitized HBB Provider's Guide only (control group). A sample size of 91 participants per group was calculated based on the main study protocol that was previously published. Participants were directed to use the electronic HBB VR simulation and digitized HBB Provider's Guide or the digitized HBB Provider's Guide alone for a minimum of 20 minutes. HBB knowledge and skills assessments were then conducted, which were immediately followed by a standard, in-person HBB training course that was led by study staff and used standard HBB evaluation tools and the Neonatalie Live manikin (Laerdal Medical). RESULTS: A total of 179 nurses and midwives participated (VR group: n=91; control group: n=88). The overall performance scores on the knowledge check (P=.29), bag and mask ventilation skills check (P=.34), and Objective Structured Clinical Examination A checklist (P=.43) were similar between groups, with low overall pass rates (6/178, 3.4% of participants). During the Objective Structured Clinical Examination A test, participants in the VR group performed better on the critical step of positioning the head and clearing the airway (VR group: 77/90, 86%; control group: 57/88, 65%; P=.002). The median percentage of ventilations that were performed via head tilt, as recorded by the Neonatalie Live manikin, was also numerically higher in the VR group (75%, IQR 9%-98%) than in the control group (62%, IQR 13%-97%), though not statistically significantly different (P=.35). Participants in the control group performed better on the identifying a helper and reviewing the emergency plan step (VR group: 7/90, 8%; control group: 16/88, 18%; P=.045) and the washing hands step (VR group: 20/90, 22%; control group: 32/88, 36%; P=.048). CONCLUSIONS: The use of digital interventions, such as mobile VR simulations, may be a viable approach to precourse preparation in neonatal resuscitation training for health care professionals in low- and middle-income countries.

Burkholderia pseudomallei biofilm phenotypes confined but surviving in neutrophil extracellular traps of varying appearance.

Melioidosis is a fatal infectious disease caused by Burkholderia pseudomallei. Complications following treatment are usually due to antibiotic resistance and relapse is mainly caused by B. pseudomallei biofilm. Although the release of neutrophil extracellular traps (NETs) is crucial to capture and eliminate bacterial pathogens, to date response of NETs to B. pseudomallei biofilm is poorly understood. Here we compare the NETs produced by neutrophils in response to B. pseudomallei H777 (a biofilm-producing strain containing the bpsl0618 gene), a biofilm-defect strain lacking this gene (B. pseudomallei M10) and a bpsl0618 biofilm-complemented strain, B. pseudomallei C17, in which function of bpsl0618 was restored. Co-cultivation of these strains with healthy human neutrophils at MOI 10 with or without cytochalasin D demonstrated that H777 significantly resisted neutrophil-mediated killing and non-phagocytotic mechanisms compared to M10 (p < 0.0001). Three distinct morphotypes of NETs were seen: "aggregated", "spiky" and "cloudy". These were induced in different proportions by the different bacterial strains. All types of NETs were shown to confine all B. pseudomallei strains. Strains H777 and C17 could stimulate production of twice as much extracellular DNA (234.62 ng/mL and 205.43 ng/mL, respectively) as did M10 (111.87 ng/mL). Cells of H777 and C17 were better able to survive in the presence of neutrophil killing mechanisms relative to M10 (p < 0.0001) and NET formation (p < 0.0001 and 0.05). These findings suggest that NET stimulation was insufficient to eradicate B. pseudomallei H777 and C17 despite their possession of bpsl0618, a sugar-transferase gene associated with biofilm formation ability. Our findings demonstrate that B. pseudomallei biofilm phenotype may be a key factor in assisting pathogens to escape killing by neutrophils. This work provides a better understanding of how B. pseudomallei biofilm-associated infections induce and survive NET formation, resulting in bacterial persistence and increased severity of disease.

Perforated duodenal ulcer in the third trimester of pregnancy, with survival of both the mother and neonate, in Ethiopia: a case report.

BACKGROUND: Perforated peptic ulcer disease is a serious complication of peptic ulcer disease (PUD) that presents as acute abdomen. It is very uncommon during pregnancy, but its diagnosis in pregnancy is very challenging in general, and more so in the third trimester. Timely diagnosis and prompt surgical intervention can prevent maternal and fetal mortality, but delayed diagnosis is linked with poor maternal and fetal outcomes. The aim of this case report is to emphasize the need for healthcare professionals to consider the differential diagnosis of perforated PUD when presented with cases of acute abdomen in pregnancy and to involve a multidisciplinary team in management for better feto-maternal outcome. CASE PRESENTATION: A 35-year-old pregnant Ethiopian woman, Gravida 7 and Para 6, presented with a sudden onset of right upper quadrant pain, nausea, and vomiting of 7 hours duration at 36 weeks of gestation. She also had contractions and leakage of liquor of two hours duration. Her abdomen was grossly distended, rigid, and diffusely tender, and showed limited movement with respiration. An upright abdominal X-ray demonstrated air under the diaphragm. She was diagnosed with perforated peptic ulcer disease. Labor was augmented, and a 2.9-kg live male neonate was delivered vaginally. Two hours after delivery, laparoscopic omental patch repair was performed. The patient was discharged 7 days after the omental patch repair surgery in stable condition. CONCLUSIONS: Perforated PUD in pregnancy is a rare occurrence, which may account for the delay in diagnosis and management. Obstetricians should keep a high index of suspicion when a pregnant woman presents with acute abdomen. Care provided by obstetricians should be coupled with care provided by other disciplinary teams, in order to reduce maternal and fetal morbidity and mortality.

Various detailed characteristics of a new enhanced neurotrophic factor secreting rat derived bone marrow mesenchymal stem cells and its preliminary application in rat models of ischemic stroke.

Because MSC-NTF has a higher ability to secrete neurotrophic factors, it may have a greater potential than ordinary MSC in clinical applications. At present, research on MSC-NTF mainly focuses on clinical aspects, but its basic research is relatively few. In particular, the research on the comprehensive and detailed characteristics of MSC-NTF is missing. And its in vivo research in animals is also rare. Since the transplantation of human-derived MSC-NTF into rats is cross-species, its survival in the rat and the therapeutic effect may be seriously affected due to severe immune rejection. This will inevitably affect the research on the basic characteristics and the therapeutic mechanisms of MSC-NTF in vivo. Therefore, we chose the rat-derived MSCs to be induced as the MSC-NTF which had a stronger neurotrophic factor secretion function. This will also be helpful to perform the research of the basic therapeutic mechanisms of MSC-NTF in vivo. In addition, we have established some important characteristics that can be used to distinguish between MSC-NTF and MSCs: different multi-factor secretion ability and secretion characteristics, immunogenicity, three-line differentiation ability, stemness, etc. In addition to paying attention to their safety differences, this study also explored the differences in their in vivo survivability. Finally, we applied this newly induced rat-derived MSC-NTF in a rat model of ischemic stroke, and obtained beneficial therapeutic effects.

Role of the hydrogen sulfide-releasing donor ADT-OH in the regulation of mammal neural precursor cells.

Neural precursor cells (NPCs) generate new neurons to supplement neuronal loss as well as to repair damaged neural circuits. Therefore, NPCs have potential applications in a variety of neurological diseases, such as spinal cord injury, traumatic brain injury, and glaucoma. Specifically, improving NPCs proliferation and manipulating their differentiated cell types can be a beneficial therapy for a variety of these diseases. ADT-OH is a slow-releasing organic H2 S donor that produces a slow and continuous release of H2 S to maintain normal brain functions. In this study, we aimed to explore the effect of ADT-OH on NPCs. Our results demonstrated that ADT-OH promotes self-renewal and antiapoptosis ability of cultured NPCs. Additionally, it facilitates more NPCs to differentiate into neurons and oligodendrocytes, while inhibiting their differentiation into astrocytes. Furthermore, it enhances axonal growth. Moreover, we discovered that the mRNA and protein expression of ß-catenin, TCF7L2, c-Myc, Ngn1, and Ngn2, which are key genes that regulate NPCs self-renewal and differentiation, were increased in the presence of ADT-OH. Altogether, these results indicate that ADT-OH may be a promising drug to regulate the neurogenesis of NPCs, and needs to be studied in the future for clinical application potential.

Women's experiences of surviving severe obstetric complications: a qualitative inquiry in southern Ghana.

Women who survive severe obstetric complications (SOC) have health and well-being issues even up to 1 year postpartum and have challenges in their quality-of-life (QoL). However, little is known about their predicaments. This study aimed to describe the impact of severe obstetric complications on women's QoL and well-being after surviving severe obstetric complications. Using the WHO standards for near-miss, twelve (12) women who survived severe obstetric complications were recruited between January and March 2019. The study adopted a qualitative approach with an exploratory descriptive design to explore the experiences of women who survived SOC in Southern Ghana. The participants were purposively sampled and were interviewed face to face in their homes and healthcare facility after discharge from the Hospital. Recorded interviews were transcribed and analyzed. Two (2) major themes and nine (9) sub-themes emerged. The findings revealed that women who suffered SOC are unable to perform functional activities, have financial constraints, residual hypertension, signs and symptoms of anaemia, pain, and mostly have difficulty in sleeping due to fear of death when they fall asleep. Anxiety, sadness, and emotional trauma was a common phenomenon. The study findings offer insights and directions on measures to improve the care and QoL of women who have survived severe obstetric complications in Ghana.

Coping with COVID-19 Prolonged and Cumulative Stressors: the Case Example of Egypt.

The current study aimed to explore how COVID-19-traumatized populations cope using a coping model based on wills to exist, live, and survive (WTELS) that leads to positive coping and posttraumatic growth (PTG). We used data from 11 Arab countries (N = 2732), including Egypt (N = 831), and included measures for COVID-19 stressors (COVID-fear, economic, lockdown, and grief stressors), WTELS, resilience, religiosity, spirituality, social support, and PTG. We conducted ANOVA on the main sample to explore the differences between Arab countries, hierarchical regressions, and path analysis on the Egyptian subsample to test a model of the effects on WTELS. In the path model, WTELS was the independent variable. Other coping strategies were mediating variables, and COVID-19 stressor types were outcome variables. ANOVA on the main sample indicated that Egypt was the highest on COVID-19 stressors (infection fears, economic, lockdown, and grief stressors), actual infection, and WTELS. Hierarchical regression indicated that social support, resilience, and WTELS were positive predictors of PTG, with WTELS had the highest effect size (ß = .41) and WTELS being a negative predictor of COVID-19 stressors, while resilience and social support were not. Path analysis indicated that WTELS predicted higher religiosity, spirituality, social support, resilience, and lower COVID-19 stressors. Religiosity predicted higher spirituality, social support, and resilience and lower COVID-19 stressors. Interfaith spirituality predicted higher resilience and lower COVID-19 grief stressors. The results validated the central role of WTELS. Results helped to identify potentially effective interventions with COVID-19 victims that focus on WTELS, spirituality, and religiosity. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11469-021-00712-x.

Analysis on disease burden of occupational coal workers′ pneumoconiosis in Anhui Province / 中国职业医学

@# Objective To analyze the disease burden caused by occupational coal workers' pneumoconiosis (CWP) in Anhui Methods Province. A total of 1 649 patients with occupational CWP diagnosed in Anhui Province from 1950 to 2019 were selected as the study subjects using a retrospective study method. Age, gender, survival time, location, working age of disease onset, age of death, stage and date of diagnosis of CWP, comorbidities at the time of investigation, hospitalization and outpatient expenses in the past year, cost of absence from work, cost of absence from work of caregivers, and cost of nutrition and transportation were investigated. The years of life lost, years lived with disability (YLDs), disability adjusted life years (DALYs) Results and economic losses were calculated. Among these patients, 1 405 cases survived and 244 cases died. In the age range - - - of 20.0 70.0 years, the YLDs of surviving patients were 2.12 22.20 (8.19±3.59) person years. The YLDs of patients with disease vs - P complications was higher than that of patients without complications [(8.55±3.95) (7.87±3.21) person years, <0.01]. The total - - DALYs of the patients was 14 031.59 person years, and the average per capita DALYs was 8.51 person years. Its YLDs accounted for 82.0 % of the total DALYs. The total economic loss caused by CWP in the 1 405 surviving patients was 354.903 0 Conclusion million yuan, and the average per capita economic loss was 252 600 yuan. The disease burden caused by CWP is relatively high in Anhui Province. In addition to early detection, diagnosis and treatment, it is necessary to focus on prevention and treatment of CWP complications to reduce the disease burden.

Evaluating the implementation of helping babies survive program to improve newborn care conditiona.

BACKGROUND: The main reason of newborn mortalities in low- and middle-income countries is due to the lack of skilled caregivers in providing essential care for babies. The aim of the present study was to evaluate the implementation of helping babies survive (HBS) program to improve newborn care condition in Isfahan, Iran. MATERIALS AND METHODS: This quasi-experimental study was conducted in the labor and midwifery wards of Shahid Beheshti Hospital in Isfahan. Convenience sampling method was used for all healthy newborns who weighed >1500 g. First, the samples were selected for the control group. Then, the Helping Babies Breathe and Essential Care for Every Baby training courses were held over for ward nurses and midwives. Then, the samples of the intervention group were selected. The research tools consisted of demographic characteristic questionnaire, caregiver performance evaluation checklist, and breastfeeding registration checklist. SPSS software version 16 was used for data analysis. RESULTS: A total of 130 newborns were divided into control (n = 65) and intervention groups (n = 65). The average time of umbilical cord clamping increased from 13.85 to 61.48 s, and the average duration of skin-to-skin contact between mother and baby increased from 11.75 to 60.47 min. The mean of early initiation of breastfeeding improved during the 1st h and the 1st day of the birth. The rate of neonatal hypothermia in the intervention group decreased sharply. CONCLUSION: The implementation of the HBS program can positively impact newborn care condition.