Miracle-dz/UniFAR-FTUs huggingface dataset:
Ototoxicity After Cisplatin-Based Chemotherapy: Factors Associated With Discrepancies Between Patient-Reported Outcomes and Audiometric Assessments

Objectives: To provide new information on factors associated with discrepancies between patient-reported and audiometrically defined hearing loss (HL) in adult-onset cancer survivors after cisplatin-based chemotherapy (CBCT) and to comprehensively investigate risk factors associated with audiometrically defined HL. Design: A total of 1410 testicular cancer survivors (TCS) ≥6 months post-CBCT underwent comprehensive audiometric assessments (0.25 to 12 kHz) and completed questionnaires. HL severity was defined using American Speech-Language-Hearing Association criteria. Multivariable multinomial regression identified factors associated with discrepancies between patient-reported and audiometrically defined HL and multivariable ordinal regression evaluated factors associated with the latter. Results: Overall, 34.8% of TCS self-reported HL. Among TCS without tinnitus, those with audiometrically defined HL at only extended high frequencies (EHFs) (10 to 12 kHz) (17.8%) or at both EHFs and standard frequencies (0.25 to 8 kHz) (23.4%) were significantly more likely to self-report HL than those with no audiometrically defined HL (8.1%) [odds ratio (OR) = 2.48; 95% confidence interval (CI), 1.31 to 4.68; and OR = 3.49; 95% CI, 1.89 to 6.44, respectively]. Older age (OR = 1.09; 95% CI, 1.07 to 1.11, p < 0.0001), absence of prior noise exposure (OR = 1.40; 95% CI, 1.06 to 1.84, p = 0.02), mixed/conductive HL (OR = 2.01; 95% CI, 1.34 to 3.02, p = 0.0007), no hearing aid use (OR = 5.64; 95% CI, 1.84 to 17.32, p = 0.003), and lower education (OR = 2.12; 95% CI, 1.23 to 3.67, p = 0.007 for high school or less education versus postgraduate education) were associated with greater underestimation of audiometrically defined HL severity, while tinnitus was associated with greater overestimation (OR = 4.65; 95% CI, 2.64 to 8.20 for a little tinnitus, OR = 5.87; 95% CI, 2.65 to 13.04 for quite a bit tinnitus, and OR = 10.57; 95% CI, 4.91 to 22.79 for very much tinnitus p < 0.0001). Older age (OR = 1.13; 95% CI, 1.12 to 1.15, p < 0.0001), cumulative cisplatin dose (>300 mg/m2, OR = 1.47; 95% CI, 1.21 to 1.80, p = 0.0001), and hypertension (OR = 1.80; 95% CI, 1.28 to 2.52, p = 0.0007) were associated with greater American Speech-Language-Hearing Association-defined HL severity, whereas postgraduate education (OR = 0.58; 95% CI, 0.40 to 0.85, p = 0.005) was associated with less severe HL. Conclusions: Discrepancies between patient-reported and audiometrically defined HL after CBCT are due to several factors. For survivors who self-report HL but have normal audiometric findings at standard frequencies, referral to an audiologist for additional testing and inclusion of EHFs in audiometric assessments should be considered.
Are physiotherapy student-led services a suitable model of clinical education? – perceptions & experiences of physiotherapists, students & patients, a qualitative meta-synthesis

ABSTRACT Introduction Physiotherapy student-led services (SLS) are becoming increasingly prevalent in clinical education (CE) practice within physiotherapy curricula. This innovative model differs from traditional styles adopted by many, as its primary focus is on increased student responsibility and replicating the reality of practice. However, limited literature is currently available on its suitability as a CE model and on the perceptions of such a model. Purpose This qualitative study aims to evaluate the suitability of physiotherapy SLS as a model of CE, as perceived by all involved stakeholders. Methods A qualitative meta-synthesis of literature sourced from popular healthcare databases was conducted. Studies incorporating any stakeholder perspectives on physiotherapy SLS, or that focused on it as a method of CE were included. Quality appraisal and thematic analysis were conducted on nine included studies. Results All included studies were deemed to be of high-quality following appraisal. Five key themes were developed, showcasing the added benefits and challenges of SLS. These included: 1) Development of Desirable Professional Skills and Attributes; 2) Need for Optimal Supervision; 3) Peer Learning Experience; 4) High-Quality Care; and 5) Student Autonomy. Conclusion Physiotherapy SLS offers attractive opportunities for students conducting CE. Involved stakeholders believe that this model does not negatively impact the quality of care and safety provided to patients who attend.
Prevalence and determinants of medication administration errors in clinical wards: A two‐centre prospective observational study

Abstract Aims and objectives To identify the prevalence and determinants of medication administration errors (MAEs). Background Insight into determinants of MAEs is necessary to identify interventions to prevent MAEs. Design A prospective observational study in two Dutch hospitals, a university and teaching hospital. Methods Data were collected by observation. The primary outcome was the proportion of administrations with one or more MAEs. Secondary outcomes were the type, severity and determinants of MAEs. Multivariable mixed‐effects logistic regression analyses were used for determinant analysis. Reporting adheres to the STROBE guideline. Results MAEs occurred in 352 of 2576 medication administrations (13.7%). Of all MAEs (n = 380), the most prevalent types were omission (n = 87) and wrong medication handling (n = 75). Forty‐five MAEs (11.8%) were potentially harmful. The pharmaceutical forms oral liquid (odds ratio [OR] 3.22, 95% confidence interval [CI] 1.43–7.25), infusion (OR 1.73, CI 1.02–2.94), injection (OR 3.52, CI 2.00–6.21), ointment (OR 10.78, CI 2.10–55.26), suppository/enema (OR 6.39, CI 1.13–36.03) and miscellaneous (OR 6.17, CI 1.90–20.04) were more prone to MAEs compared to oral solid. MAEs were more likely to occur when medication was administered between 10 a.m.–2 p.m. (OR 1.91, CI 1.06–3.46) and 6 p.m. –7 a.m. (OR 1.88, CI 1.00–3.52) compared to 7 a.m.–10 a.m. and when administered by staff with higher professional education compared to staff with secondary vocational education (OR 1.68, CI 1.03–2.74). MAEs were less likely to occur in the teaching hospital (OR 0.17, CI 0.08–0.33). Day of the week, patient‐to‐nurse ratio, interruptions and other nurse characteristics (degree, experience, employment type) were not associated with MAEs. Conclusions This study identified a high MAE prevalence. Identified determinants suggest that focusing interventions on complex pharmaceutical forms and error‐prone administration times may contribute to MAE reduction. Relevance to clinical practice The findings of this study can be used to develop targeted interventions to improve patient safety.
Session-to-session effects of therapist adherence and facilitative conditions on symptom change in CBT and IPT for depression

ABSTRACT Objective The objective of this study was to analyze the effect of adherence to both specific technique factors and facilitative condition variables (e.g., therapists’ involvement, understanding and support) in Cognitive Behavior Therapy (CBT) and Interpersonal Psychotherapy (IPT). In addition, we were interested in whether the effect of therapist adherence would depend on the level of the working alliance. Method Three sessions each from 74 patients diagnosed with Major Depressive Disorder who were randomized to 14 sessions of IPT or CBT were rated for adherence using a modified version of The Collaborative Study Psychotherapy Rating Scale—6 (CSPRS-6). Data was analyzed using Multilevel Modeling. Results No effects of adherence to specific factors on outcome were found in neither CBT nor IPT. Facilitative conditions were associated with better outcome in CBT but not in IPT, even after adjustment for the quality of the working alliance. No interaction effects were found. Conclusions Our findings highlight the importance of relational factors in CBT, but do not support the need for specific adherence to any of the two treatments. Possible explanations of the findings and directions for future research are discussed. Trial registration: ClinicalTrials.gov identifier: NCT01851915.
The effect of tranexamic acid dosing regimen on trauma/hemorrhagic shock-related glycocalyx degradation and endothelial barrier permeability: An in vitro model

Early tranexamic acid administration protects against trauma hemorrhagic shock. There was a concentration and temporal effect of TXA administration on endothelial glycocalyx degradation. TXA if administered in patients with trauma hemorrhagic shock should be administered “early. ” BACKGROUND Improved outcomes with early tranexamic acid (TXA) following trauma hemorrhagic shock (T/HS) may be related to its antifibrinolytic, as well as anti-inflammatory properties. Previous in vitro studies have shown that early TXA administration protects against T/HS endothelial barrier dysfunction and associated glycocalyx degradation. An intact endothelial glycocalyx may protect against subsequent neutrophil mediated tissue injury. We postulated that early TXA administration would mitigate against glycocalyx damage and resultant neutrophil adherence and transmigration through the endothelial barrier. This was studied in vitro using a microfluidic flow platform. METHODS Human umbilical vein endothelial cell monolayers were subjected to control or shock conditions (hypoxia + epinephrine) followed by administration of TXA 90 minutes or 180 minutes later. RESULTS “Early” TXA administration protected against glycocalyx degradation, biomarkers of increased permeability and the development of a fibrinolytic phenotype. This was associated with decreased neutrophil endothelial adherence and transmigration. There were no differences in low versus high TXA concentrations. The protective effects were only significant with “early” TXA administration. CONCLUSION There was a concentration and temporal effect of TXA administration on endothelial glycocalyx degradation. This was associated with “vascular leakiness” as indexed by the relative ratio of Ang-2/1 and polymorphonuclear neutrophil transmigration. Tranexamic acid if administered in patients with T/HS should be administered “early”; this includes in the prehospital setting.
The Effect of Krocina™ on Decreasing Substance User Withdrawal Syndrome, Craving, Depression and Stress: A Double-Blind Randomized Parallel Clinical Trial

Abstract Introduction Due to the association between substance use abstinence with some psychological syndromes, the use of herbal medicines such as Crocus sativus L. have been considered as a proper approach to controlling withdrawal syndrome. The present study aimed to identify the effect of Krocina™ in reducing withdrawal symptoms, craving, depression, stress, anxiety and durability of treatment in the detoxification period and abstinence phase. Methods In a double-blind randomized parallel clinical trial, 72 opioid users passing the detoxification period who were referred to the Soroush Center during 2020, randomly categorized into the two groups. Motivational interviewing sessions and 15 mg of Krocina™ twice a day were provided for six weeks for the cases. The placebo group received pills with the same coating and motivational interviewing. Withdrawal symptoms, craving, depression, stress and anxiety were assessed at the start of the study and then weekly using the Clinical Opiate Withdrawal Scale, Obsessive-Compulsive Drug Use Scale, and the Depression Anxiety Stress Scales-21, respectively. SPSS-v16 was used for statistical analyses. Results Drug withdrawal symptoms and craving did not indicate a significant difference by Krocina™ intervention during the time (p > 0.05). Furthermore, depression, stress and anxiety were statistically similar between Krocina™ and placebo groups (p > 0.05). Moreover, we found similar findings between the two groups when analyzing only patients with negative urinary test (F = 0.03;p = 0.86). Conclusion Our finding rejected the effectiveness of 30 mg/day of Krocina™ for six weeks as an effective substance for decreasing withdrawal symptoms, craving, depression, anxiety and stress at the detoxification period and abstinence phase.
Rotavirus Infection in Children <5 Years of Age in Suzhou, China, 2013–2019

Background: This study aimed to determine the disease burden and strain distribution of rotavirus in children with diarrhea <5 years old in Suzhou, China. Methods: The study was conducted among children with diarrhea <5 years old at Suzhou University Affiliated Children’s Hospital from 2013 to 2019. Rotavirus antigen was detected in clinical laboratory and then sent to Suzhou Centers for Disease Control and Prevention for further molecular analysis. Group A rotavirus (RVA) was detected through enzyme-linked immunosorbent assays, and G-genotype and P-genotype of RVA were tested using reverse transcription-polymerase chain reaction. Results: Of a total of 198,130 children with diarrhea, 70,813 (35.7%) were positive for RVA; RVA-related diarrhea was detected in 7798 (20.7%, n = 7798/37,710) inpatients and 63,015 (39.3%, n = 63,015/160,420) outpatients. Most children (92.0%, n = 65,171/70,813) positive for RVA were found as children <3 years old. Children 12-35 months old were reported as the highest prevalence among all age groups. The seasonal peak of RVA was in the autumn and winter. Among all 673 RVA strains genotyped, the G9P[8] strain was reported to be persistently predominant in the pediatric population from 2013 to 2019. Conclusions: The burden of diarrhea disease due to rotavirus infection remains high in Suzhou.
Sustainable Development Strategies: A Resource Book

About the Resource Book * Sustainable Development and the Need for Strategic Responses * The Nature of Sustainable Development Strategies and Current Practice * Key Steps in Starting or Improving Strategies for Sustainable Development * Analysis * Participation in Strategies for Sustainable Development * Communications * Strategy Decision-making * The Financial Basis for Strategies * Monitoring and Evaluation Systems * Appendices * References * Index
Disparate Mechanisms of Fatigability in Response to Prolonged Running versus Cycling of Matched Intensity and Duration

Supplemental digital content is available in the text. ABSTRACT Introduction Running and cycling represent two of the most common forms of endurance exercise. However, a direct comparison of the neuromuscular consequences of these two modalities after prolonged exercise has never been made. The aim of this study was to compare the alterations in neuromuscular function induced by matched-intensity and duration cycling and running exercise. Methods During separate visits, 17 endurance-trained male participants performed 3 h of cycling and running at 105% of the gas exchange threshold. Neuromuscular assessments were taken are preexercise, midexercise, and postexercise, including knee extensor maximal voluntary contractions (MVC), voluntary activation (VA), high- and low-frequency doublets (Db100 and Db10, respectively), potentiated twitches (Qtw,pot), motor evoked potentials (MEP), and thoracic motor evoked potentials (TMEP). Results After exercise, MVC was similarly reduced by ~25% after both running and cycling. However, reductions in VA were greater after running (−16% ± 10%) than cycling (−10% ± 5%; P < 0.05). Similarly, reductions in TMEP were greater after running (−78% ± 24%) than cycling (−15% ± 60%; P = 0.01). In contrast, reductions in Db100 (running vs cycling, −6% ± 21% vs −13% ± 6%) and Db10:100 (running vs cycling, −6% ± 16% vs −19% ± 13%) were greater for cycling than running (P ≤ 0.04). Conclusions Despite similar decrements in the knee extensor MVC after running and cycling, the mechanisms responsible for force loss differed. Running-based endurance exercise is associated with greater impairments in nervous system function, particularly at the spinal level, whereas cycling-based exercise elicits greater impairments in contractile function. Differences in the mechanical and metabolic demands imposed on the quadriceps could explain the disparate mechanisms of neuromuscular impairment after these two exercise modalities.
The Beneficial Effect of the First COVID-19 Lockdown on Undergraduate Students of Education: Prospective Cohort Study

Background The COVID-19 pandemic has been spreading consistently since the beginning of 2020. On February 27, 2020, the first patient with coronavirus was diagnosed in Israel. On March 14, 2020, the Israeli government declared a general lockdown that lasted about a month, which altered the lives of the entire population. Objective The objective of this paper is to evaluate the change in the well-being, physical activity, and sleep quality of undergraduate students of education at 2 time points: before (November 2019) and during (April 2020) the first COVID-19 lockdown. Methods In total, 533 undergraduate students of education submitted an online questionnaire before the lockdown and at its end. The questionnaire comprised 4 parts: a (1) sociodemographic and (2) weekly exercise questionnaire taken from the International Physical Activity Questionnaire–Short Form; (3) sleep quality, rated using the Mini Sleep Questionnaire; and (4) well-being, rated using the short version of the Mental Health Inventory. This was a pre-post prospective cohort questionnaire study. Results It was predicted that there would be a decrease in the aforementioned parameters. Contrary to all expectations, an increase was observed in all 3. Results showed that during the lockdown, there was an increase in the level of exercise students engaged in. Overall, 102 (61.4%) of 166 students engaged in a greater amount of physical activity during the COVID-19 lockdown compared to 150 (40.9%) of 367 students who engaged in a greater amount of physical activity before COVID-19. Levels of sleep quality (mean 5.34 [SD 0.92] vs mean 5.12 [SD 0.46], P=.02) and well-being (mean 3.79 [SD 0.62] vs mean 3.67 [SD 0.59], P=.02) were also higher during the COVID-19 lockdown. Conclusions These findings indicate that undergraduate students seem to have taken advantage of the change in lifestyle due to the lockdown, directing the free time toward improving health by engaging in more physical activity, thus improving sleep quality and well-being.
Synthesized nano particles of glimepiride via spray freezing into cryogenic liquid: characterization, antidiabetic activity, and bioavailability

Abstract The aim of this work was to formulate glimepiride (class II drug) which is characterized by low solubility and high permeability as nanostructured particles using a cryogenic technique with an aid of water-soluble polymer to improve its aqueous solubility and hence its bioavailability. 27 formula of glimepiride nano size particles were prepared by a spray freezing into cryogenic liquid (SCFL) using poly vinyl pyrrolidone K-30 (PVP K-30); that three drug polymer ratio (1:1, 1:2, and 1:3), with three different volumes of feeding solution (50, 100, 150 mL), at three flow rates (10, 20, and 30 mL/min). The prepared formulations were evaluated for production yield, particle size, zeta potential, drug content, release rate, in vivo hypoglycemic activity, and bioavailability. All prepared formulations showed high production yield and drug content ranged between 91.1 ± 3.4% and 94.3 ± 1.8% and 95.1 ± 2.8% and 97.1 ± 2.5%, respectively. The mean particles size was ranged between 280 ± 62 nm and 520 ± 30 nm. The results of in vitro release study revealed significant enhancement in the solubility of prepared formulations compared with the pure drug. It was found that optimal formula showed a significant reduction in blood glucose levels in diabetic rats, and 1.79-fold enhancements in oral bioavailability compared with market tablets. Nanoparticle prepared by SCFL method is an encouraging formula for improving the solubility and the bioavailability of glimepiride.
Adaptation of the standardized plant analysis–risk human reliability analysis technique for the surgical setting: expert judgment approach

Objectives. Application of human reliability analysis (HRA) techniques originally developed for industrial settings to the healthcare sector may be controversial in terms of reliability and methodological level. The aim of the present study was to adapt a standardized plant analysis risk–human reliability analysis (SPAR-H) technique for application in surgical settings through suggesting more context-specific definitions for performance shaping factors (PSFs), designing precise levels and elicitation of multipliers through a domain expert judgment approach. Methods. A ratio magnitude estimation approach was used for carrying out domain expert judgment for multiplier elicitation. Experts from four teaching hospitals participated in the present study. Intra-class correlation was used in order to examine the inter-rater reliability of the estimated multipliers for each level of diagnosis and action task type. Results. Available time, threat stress, task complexity, experience/training, procedures, working conditions, human–machine interface, fatigue and teamwork were the nine suggested PSFs for the adapted SPAR-H technique. Conclusion. Context-specific definitions of the PSFs can enhance the reliability of human error probability assessments. Eventually, it could be concluded that multiplier elicitation through domain expert judgment is an efficient approach for adaptation of the HRA techniques for application in specific contexts.
Preliminary Study in Relationship Between Cleft Lip and Palatal Bony Defect in Submucous Cleft Palate

Submucous cleft palate, presenting as varying degrees of palatal bony defect, can be difficult to detect in its early stage. The connection between submucous cleft palate and cleft lip has been noticed by clinicians but are rarely reported in literature. Aims: To investigate the correlation between the degree of deformity of palatal bony defect and that of cleft lip. Patients and Methods: Thirty-four patients with unilateral (n = 23) or bilateral (n = 11) cleft lip presenting with submucous cleft palate were included. Patients were divided into 3 groups according to the degree of malformation of cleft lip (microform, incomplete, and complete). The length and width of palatal bony defect was then measured from the palatal computer tomography. Results: In patients with unilateral cleft lip, the proportions of microform cleft lip, incomplete cleft lip, and complete cleft lip were 17.4%, 60.9%, and 21.7%, respectively. In patients with bilateral cleft lip, there were 3 cases with microform and 1 case with incomplete cleft lip on both sides. No correlation was found between the length or relative width of palatal bony defect with the side (P length = 1.000; P relative width = 0.262) or the severity (P length = 0.605; P relative width = 0.254) of cleft lip. Conclusions: The form of cleft lip presenting with submucous cleft palate varies, and there was no correlation with the length or relative width of palatal bony defect. Advanced imaging techniques for children with cleft lip may assist the early diagnosis of submucous cleft palate.