bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcomes of Patellar Stabilization Utilizing a Combined Arthroscopic and Open Technique: A Retrospective Review With 5-Year Follow-up
Authors: Zhou MAJ Liang , Cruz CPT Christian A. , Johnson MAJ Zackary A. , Bottoni Craig R.
Published: February 2022

Background:

Few studies have reported the long-term outcomes of patellar stabilization surgery in an active duty military cohort.

Purpose:

To evaluate the long-term results of a combined open and arthroscopic patellar stabilization technique for the treatment of recurrent lateral patellar instability in members of a military population.

Study Design:

Case series; Level of evidence, 4.

Methods:

We performed a retrospective review of a consecutive series of 63 patients who underwent operative management for patellar instability at a tertiary military medical center between 2003 and 2017. All cases were performed by a single sports medicine fellowship–trained orthopaedic surgeon. Patients with recurrent lateral patellar instability whose nonoperative management failed were included. All patients underwent arthroscopic imbrication of the medial patellar retinaculum, an open lateral retinacular release, and an Elmslie-Trillat tibial tubercle osteotomy. Outcome measures at final follow-up included recurrent instability, need for surgical revision, subjective assessments, and military-specific metrics. We also analyzed anatomic risk factors for failure: patella alta, coronal plane alignment, trochlear dysplasia, and tibial tubercle–trochlear groove distance.

Results:

A total of 51 patients were included (34 men, 17 women; mean ± SD age at surgery, 27.2 ± 5.8 years; mean follow-up, 5.3 years). The mean postoperative SANE score (Single Assessment Numeric Evaluation) was 75.0 ± 17.7, and the mean visual analog scale pain score was 2.5 ± 2.1. Four patients (7.8%) reported redislocation events, and 4 underwent revision surgery. Twenty-five patients (49.0%) reported a decrease in activity level as compared with preinjury, while 10 (19.6%) cited restrictions in activities of daily living. Of the 21 patients remaining on active duty, 6 (28.6%) required an activity-limiting medical profile. Of the 48 active duty patients, 12 (25.0%) underwent evaluation by a medical board for separation from the military. Differences in the Caton-Deschamps Index and tibial tubercle–trochlear groove distance between surgical success and failure were not statistically significant.

Conclusion:

Surgical management of patellar instability utilizing a multifaceted technique resulted in low recurrence rates and may be independent of predisposing anatomic risk factors for instability. At 5-year follow-up, most patients retained their active duty status, although nearly half experienced a decrease in activity level.
Cancer Care in Pakistan: A Descriptive Case Study
Authors: Rattani Salma A , Dahlke Sherry , Cameron Brenda
Published: February 2022

In this descriptive case study, we aimed to understand the experiences of cancer diagnosis, treatment, and palliative care in Pakistan. The case was limited to a hospital for cancer and hospice care in Karachi, Pakistan. Data collection included interviews with patients who had a cancer diagnosis, family members, healthcare providers, and unstructured observations. Two themes of suffering and late diagnosis were developed to describe the experiences of people with cancer. Suffering occurred as a result of poverty, social ideas about cancer, and physical suffering. Late diagnosis happened because of cultural ideas about health, low health literacy, and healthcare challenges, although both themes are interconnected. The findings illuminate three key pathways that will improve cancer diagnosis and palliative care in Pakistan: specifically, the need to (a) educate healthcare providers about cancer and palliative care, (b) eradicate corruption in healthcare, and (c) develop policies for universal access to health.
Factors in the neurodevelopment of negative urgency: Findings from a community-dwelling sample
Authors: Evans Casey L. , Sawyer Kayle S. , Levy Sarah A. , Conklin Jessica P. , McDonough EmilyKate , Gansler David A.
Published: February 2022

This study investigated neuroanatomic, genetic, cognitive, sociodemographic and emotional underpinnings of the Negative Urgency subscale of the Urgency, Premeditation, Perseverance, Sensation-Seeking and Positive Urgency Impulsive Behavior Scale in a healthy developmental sample. The goal of the investigation is to contribute to the harmonisation of behavioural, brain and neurogenetic aspects of behavioural self-control. Three domains – (1) Demographic, developmental, psychiatric and cognitive ability; (2) Regional brain volumes (neurobiological); and (3) Genetic variability (single nucleotide polymorphisms) – were examined, and models with relevant predictor variables were selected. Least absolute shrinkage and selection operator and best subset regressions were used to identify sparse models predicting negative urgency scores, which revealed that variables related to emotional regulation and right cingulate volume, as well as single nucleotide polymorphisms in CADM2 and SLC6A4, were associated with negative urgency. Our results contribute to the construct and criterion validity of negative urgency and support the hypothesis that negative urgency is a result of a complex array of influences across domains whose integration furthers developmental psychopathology research.
Bicarbonate transport of airway surface epithelia in luminally perfused mice bronchioles
Authors: Liu Libin , Yamamoto Akiko , Yamaguchi Makoto , Taniguchi Itsuka , Nomura Nao , Nakakuki Miyuki , Kozawa Yuka , Fukuyasu Tomoya , Higuchi Mayuko , Niwa Erina , Tamada Tsutomu , Ishiguro Hiroshi
Published: February 2022

HCO3−secretion in distal airways is critical for airway mucosal defense. HCO3−/H+transport across the apical membrane of airway surface epithelial cells was studied by measuring intracellular pH in luminally microperfused freshly dissected mice bronchioles. Functional studies demonstrated that CFTR, ENaC, Cl−–HCO3−exchange, Na+-H+exchange, and Na+–HCO3−cotransport are involved in apical HCO3−/H+transport. RT-PCR of isolated bronchioles detected fragments from Cftr, α, β, γ subunits of ENaC, Ae2, Ae3, NBCe1, NBCe2, NBCn1, NDCBE, NBCn2, Nhe1, Nhe2, Nhe4, Nhe5, Slc26a4, Slc26a6, and Slc26a9. We assume that continuous decline of intracellular pH following alkaline load demonstrates time course of HCO3−secretion into the lumen which is perfused with a HCO3−-free solution. Forskolin-stimulated HCO3−secretion was substantially inhibited by luminal application of CFTRinh-172 (5 μM), H2DIDS (200 μM), and amiloride (1 μM). In bronchioles from a cystic fibrosis mouse model, basal and acetylcholine-stimulated HCO3−secretion was substantially impaired, but forskolin transiently accelerated HCO3−secretion of which the magnitude was comparable to wild-type bronchioles. In conclusion, we have characterized apical HCO3−/H+transport in native bronchioles. We have demonstrated that cAMP-mediated and Ca2+-mediated pathways are involved in HCO3−secretion and that apical HCO3−secretion is largely mediated by CFTR and H2DIDS-sensitive Cl−–HCO3−exchanger, most likely Slc26a9. The impairment of HCO3−secretion in bronchioles from a cystic fibrosis mouse model may be related to the pathogenesis of early lung disease in cystic fibrosis.
Dysbiosis of skin microbiome and gut microbiome in melanoma progression
Authors: Mekadim Chahrazed , Skalnikova Helena Kupcova , Cizkova Jana , Cizkova Veronika , Palanova Anna , Horak Vratislav , Mrazek Jakub
Published: February 2022

Background

The microbiome alterations are associated with cancer growth and may influence the immune system and response to therapy. Particularly, the gut microbiome has been recently shown to modulate response to melanoma immunotherapy. However, the role of the skin microbiome has not been well explored in the skin tumour microenvironment and the link between the gut microbiome and skin microbiome has not been investigated in melanoma progression. Therefore, the aim of the present study was to examine associations between dysbiosis in the skin and gut microbiome and the melanoma growth using MeLiM porcine model of melanoma progression and spontaneous regression.

Results

Parallel analysis of cutaneous microbiota and faecal microbiota of the same individuals was performed in 8 to 12 weeks old MeLiM piglets. The bacterial composition of samples was analysed by high throughput sequencing of the V4-V5 region of the 16S rRNA gene. A significant difference in microbiome diversity and richness between melanoma tissue and healthy skin and between the faecal microbiome of MeLiM piglets and control piglets were observed. Both Principal Coordinate Analysis and Non-metric multidimensional scaling revealed dissimilarities between different bacterial communities. Linear discriminant analysis effect size at the genus level determined different potential biomarkers in multiple bacterial communities.Lactobacillus, Clostridiumsensu stricto 1 andCorynebacterium1 were the most discriminately higher genera in the healthy skin microbiome, whileFusobacterium, Trueperella, Staphylococcus, StreptococcusandBacteroideswere discriminately abundant in melanoma tissue microbiome.Bacteroides, FusobacteriumandEscherichia-Shigellawere associated with the faecal microbiota of MeLiM piglets. Potential functional pathways analysis based on the KEGG database indicated significant differences in the predicted profile metabolisms between the healthy skin microbiome and melanoma tissue microbiome. The faecal microbiome of MeLiM piglets was enriched by genes related to membrane transports pathways allowing for the increase of intestinal permeability and alteration of the intestinal mucosal barrier.

Conclusion

The associations between melanoma progression and dysbiosis in the skin microbiome as well as dysbiosis in the gut microbiome were identified. Results provide promising information for further studies on the local skin and gut microbiome involvement in melanoma progression and may support the development of new therapeutic approaches.
Transcriptome analysis revealed growth phase-associated changes of a centenarian-originated probiotic Bifidobacterium animalis subsp. lactis A6
Authors: Wang Hui , An Jieran , Fan Chengfei , Zhai Zhengyuan , Zhang Hongxing , Hao Yanling
Published: February 2022

Background

The physiology and application characteristics of probiotics are closely associated with the growth phase. Bifidobacterium animalis subsp. lactis A6 is a promising probiotic strain isolated from the feces of a healthy centenarian in China. In this study, RNA-seq was carried out to investigate the metabolic mechanism between the exponential and the stationary phase in B. lactis A6.

Results

Differential expression analysis showed that a total of 815 genes were significantly changed in the stationary phase compared to the exponential phase, which consisted of 399 up-regulated and 416 down-regulated genes. The results showed that the transport and metabolism of cellobiose, xylooligosaccharides and raffinose were enhanced at the stationary phase, which expanded carbon source utilizing profile to confront with glucose consumption. Meanwhile, genes involved in cysteine-cystathionine-cycle (CCC) pathway, glutamate dehydrogenase, branched-chain amino acids (BCAAs) biosynthesis, and Clp protease were all up-regulated in the stationary phase, which may enhance the acid tolerance of B. lactis A6 during stationary phase. Acid tolerance assay indicated that the survival rate of stationary phase cells was 51.07% after treatment by pH 3.0 for 2h, which was 730-fold higher than that of 0.07% with log phase cells. In addition, peptidoglycan biosynthesis was significantly repressed, which is comparable with the decreased growth rate during the stationary phase. Remarkably, a putative gene cluster encoding Tad pili was up-regulated by 6.5 to 12.1-fold, which is consistent with the significantly increased adhesion rate to mucin from 2.38% to 4.90% during the transition from the exponential phase to the stationary phase.

Conclusions

This study reported growth phase-associated changes of B. lactis A6 during fermentation, including expanded carbon source utilizing profile, enhanced acid tolerance, and up-regulated Tad pili gene cluster responsible for bacterial adhesion in the stationary phase. These findings provide a novel insight into the growth phase associated characteristics in B. lactis A6 and provide valuable information for further application in the food industry.
What matters most in acute care: an interview study with older people living with frailty
Authors: van Oppen James David , Coats Timothy John , Conroy Simon Paul , Lalseta Jagruti , Phelps Kay , Regen Emma , Riley Peter , Valderas Jose Maria , Mackintosh Nicola
Published: February 2022

Background

Healthcare outcome goals are central to person-centred acute care, however evidence among older people is scarce. Older people who are living with frailty have distinct requirements for healthcare delivery and have distinct risk for adverse outcomes from healthcare. There is insufficient evidence for whether those living with frailty also have distinct healthcare outcome goals. This study explored the nature of acute care outcome goals in people living with frailty.

Methods

Healthcare outcome goals were explored using semi-structured patient interviews. Participants aged over 65 with Clinical Frailty Score 5-8 (mild to very severe frailty) were recruited during their first 72 hours in a UK hospital. Purposive, maximum variation sampling was guided by lay partners from a Patient and Public Involvement Forum specialising in ageing-related research. Qualitative analysis used a blended approach based on framework and constant comparative methodologies for the identification of themes. Findings were validated through triangulation with participant, lay partner, and technical expert review.

Results

The 22 participants were aged 71 to 98 and had mild to very severe frailty. One quarter were living with dementia. Most participants had reflected on their situation and considered their outcome goals. Theme categories (and corresponding sub-categories) were ‘Autonomy’ (information, control, and security) and ‘Functioning’ (physical, psychosocial, and relief). A novel ‘security’ theme was identified, whereby participants sought to feel safe in their usual living place and with their health problems. Those living with milder frailty were concerned to maintain ability to support loved ones, while those living with most severe frailty were concerned about burdening others.

Conclusions

Outcome goals for acute care among older participants living with frailty were influenced by the insecurity of their situation and fear of deterioration. Patients may be supported to feel safe and in control through appropriate information provision and functional support.
Initiation of lactation and the provision of human milk to preterm infants in German neonatal intensive care units from the mothers’ perspective
Authors: Scholten N. , Mause L. , Horenkamp-Sonntag D. , Klein M. , Dresbach T.
Published: February 2022

Background

If infants with a very low birth weight (VLBW) are to be fed exclusively with human milk, it is essential to focus on lactation initiation. The aim of the study is to learn more about the current state of lactation initiation and human milk provision in neonatal intensive care units in Germany from the mothers' perspective.

Methods

Written surveys were conducted with mothers of VLBW infants to learn more about the timing of initiation of lactation, pumping frequency during the first three days postpartum and feeding of the preterm infant during hospitalisation.

Results

The data of 437 mothers (response rate: 44.7%) were included in the analyses. Of these, only 7.8% stated that they had initiated lactation immediately after delivery and 38.2% within 6 h. In terms of pumping frequency, 50.1% pumped 7–9 times a day within the first 3 days postpartum; 60.9% reported that their infant received formula feedings during the hospital stay.

Conclusion

Overall, deficits were still evident with regard to the initiation of lactation in mothers of VLBW infants in Germany, resulting in a large proportion of VLBW infants receiving formula in the hospital.

Trial registration

German Clinical Trial Register: DRKS00017755.
Impact on routine psychiatric diagnostic practice from implementing the DSM-5 cultural formulation interview: a pragmatic RCT in Sweden
Authors: Wallin Malin Idar , Galanti Maria Rosaria , Nevonen Lauri , Lewis-Fernández Roberto , Bäärnhielm Sofie
Published: February 2022

Background

Culture and social context affect the expression and interpretation of symptoms of distress, raising challenges for transcultural psychiatric diagnostics. This increases the risk that mental disorders among migrants and ethnic minorities are undetected, diagnosed late or misdiagnosed. We investigated whether adding a culturally sensitive tool, the DSM-5 core Cultural Formulation Interview (CFI), to routine diagnostic procedures impacts the psychiatric diagnostic process.

Method

We compared the outcome of a diagnostic procedure that included the CFI with routine diagnostic procedures used at Swedish psychiatric clinics. New patients (n = 256) admitted to a psychiatric outpatient clinic were randomized to a control (n = 122) or CFI-enhanced diagnostic procedure (n = 134) group. An intention-to-treat analysis was conducted and the prevalence ratio and corresponding 95% confidence intervals (CI) were calculated across arms for depressive and anxiety disorder diagnoses, multiple diagnoses, and delayed diagnosis.

Results

The prevalence ratio (PR) of a depressive disorder diagnosis across arms was 1.21 (95% CI = 0.83-1.75), 33.6% of intervention-arm participants vs. 27.9% of controls. The prevalence ratio was higher among patients whose native language was not Swedish (PR =1.61, 95% CI = 0.91-2.86). The prevalence ratio of receiving multiple diagnoses was higher for the CFI group among non-native speaking patients, and lower to a statistically significant degree among native Swedish speakers (PR = .39, 95% CI = 0.18-0.82).

Conclusions

The results suggest that the implementation of the DSM-5 CFI in routine psychiatric diagnostic practice may facilitate identification of symptoms of certain psychiatric disorders, like depression, among non-native speaking patients in a migration context. The CFI did not result in a reduction of patients with a non-definite diagnosis.

Trial registration

ISRCTN51527289, 30/07/2019. The trial was retrospectively registered.
Correlation between functional disability and quality of life among rural elderly in Anhui province, China: a cross-sectional study
Authors: Zhang Min , Zhu Weizheng , He Xinran , Liu Yuyang , Sun Qian , Ding Hong
Published: February 2022

Objective

We aimed to explore the correlation between functional disability and quality of life (QoL). And exploring the interaction of functional disability, basic demographic characteristics and health-related information on QoL among the rural elderly in Anhui Province.

Methods

This study used multi-stage stratified cluster sampling in rural Anhui Province from January to July 2018 to conduct a cross-sectional survey of older adults who met the inclusion criteria. The Five-Dimensional European Quality Of Health Scale (EQ-5D) and the WHO Disability Assessment Schedule (WHODAS2.0) scale were used to evaluate the QoL and functional disability, and the basic demographic characteristics of the survey subjects were also collected. Using binary logistic and Classification and regression tree model (CART) models to analyze the data, explore the relationship between functional disability and QoL in the elderly.

Results

A total of 3491 older adults were included in the survey, and 3336 completed the entire survey, with an effective response rate of 95.56%. After adjusting for covariables, those who had limited in dimension of mobility (AOR=2.243, 95%CI: 1.743-2.885), getting along (AOR=1.615, 95%CI: 1.173-2.226), life activities (AOR=2.494, 95%CI:1.928-3.226), and social participation (AOR=2.218, 95%CI: 1.656-2.971) had a lower QoL. However, the dimension of cognition (AOR=0.477, 95%CI: 0.372-0.613) is a protective factor for QoL. Additionally, we also observe that 96.3% of those who were unemployed and limited in both mobility and life activities dimensions had a lower QoL, but among those who were robust in both mobility and social participation dimensions and not suffer from chronic diseases, 56.3% had a higher QoL.

Conclusions

Our findings indicate that special attention should be paid to the elderly who are unemployed, have limited in cognition, getting along, social participation, mobility, life activities and cognition robust to improve their QoL. This research is of great significance for formulating targeted strategies and measures to improve the QoL for rural elderly.
Impact of COVID-19 on Malaysian dental students’ physical, mental, financial and academic concerns
Authors: Lestari Widya , Yazid Nur Hazirah , Azhar Zawin Najah , Ismail Azlini , Sukotjo Cortino
Published: February 2022

Background

The coronavirus disease 2019 (COVID-19) caused by a novel coronavirus (SARS-CoV-2) has gained worldwide attention and proved to hold an impact to humankind in all aspects of life. Dental students’ performances may indirectly be affected following the preventive measures in containing the disease. This study aims to evaluate the impact of COVID-19 pandemic on physical, mental, financial health and academic concern among dental students in Malaysia.

Methods

The current research implemented a cross sectional study among dental students in Malaysia. Assessment of the impact of COVID-19 on dental education was done by the distribution of a set of online survey consisting of 28 questions to dental students (n = 353) from public and private universities in Malaysia. The questionnaires include sociodemographic backgrounds and assessment on the mental health, financial health, physical health and academic concern. Kruskal Wallis test and Mann–Whitney U test were used to analyse the impact of COVID-19 to these 4 domains according to sociodemographic background.

Results

A total number of 353 respondents was recorded and 76.2% comprised of female. 59.7% were clinical students and 40.3% were preclinical students. Most of students were concerned about their own emotional health, financial concern, physical wellbeing, in which Year 3 students were found to be more concerned about their mental and financial health concern.

Conclusions

COVID-19 pandemic had indeed significantly affected Malaysian dental students mainly due to fear of the quality of online learning and the amount of clinical skills acquired. Therefore, it is important to identify dental stressors and lessen the impact of COVID-19 to dental students.
Cytotoxicity and anti-HIV activities of extracts of the twigs of Croton dichogamus Pax
Authors: Terefe Ermias Mergia , Okalebo Faith Apolot , Derese Solomon , Batiha Gaber El-Saber , Youssef Amal , Alorabi Mohammed , Muriuki Joseph
Published: February 2022

Background

Acquired immunodeficiency syndrome (AIDS) is a clinical syndrome resulting from infection with human immunodeficiency virus (HIV), which causes profound immunosuppression. Anti-HIV drugs that are currently available are chemically synthesized and are frequently limited by side effects, the emergence of drug resistance, affordability, and availability, with over 5 million people in the world lacking access to treatment. As a result, to discover new anti-HIV agents, we investigated the effects of Kenyan C. dichogamus extracts on the laboratory-adapted strain HIV-1IIIB in human T-lymphocytic MT-4 cells.

Methods

Four soluble fractions of 1:1 v/v CH2Cl2:MeOH extract of the twigs of C. dichogamus Pax were tested for their replication inhibition activity against the laboratory-adapted strain HIV-1IIIB in the human T-lymphocytic MT-4 cell line. The plant extracts were further evaluated for their cytotoxicity in MT-4 cells using the MTT assay.

Results

The cytotoxicity CC50 values of the methanol and methylene chloride soluble fractions of C. dichogamus were found to be between 19.58 ± 0.79 and 167 ± 0.8 µg/ml, respectively. The hexane, methylene chloride, and methanol soluble fractions of the 1:1 v/v CH2Cl2:MeOH extract of the twigs of C. dichogamus showed inhibition of the HIV-1IIIB laboratory-adapted strain in a virus-infected cell culture antiviral assay. The methanol soluble fraction of the 1:1 v/v CH2Cl2:MeOH extract of the twigs of C. dichogamus showed significant anti-HIV activity by inhibiting more than 90% of viral-induced cytopathic effects with an IC50 value of 0.06 ± 0.01 µg/ml, giving an SI of 318.5.

Conclusion

Based on our findings, the methanol soluble fraction of the 1:1 v/v CH2Cl2:MeOH extract of the twigs of C. dichogamus has shown potential efficacy in inhibiting viral replication and could be considered a promising candidate for further studies.
The use of emotional intelligence skills in combating burnout among residency and fellowship program directors
Authors: Khesroh Eiman , Butt Melissa , Kalantari Annahieta , Leslie Douglas L. , Bronson Sarah , Rigby Andrea , Aumiller Betsy
Published: February 2022

Background

Current rates of burnout among physicians are alarming when compared to nonphysician U.S. workers, and numerous interventions have been introduced to mitigate the issue. However, no interventions have specifically targeted the 30% burnout rate among physician program directors. The complex and demanding role of program directors necessitates building relationships, solving crises, securing jobs for residents and maintaining well-being of trainees. The aim of this study is to investigate the impact of emotional intelligence (EQ) on burnout levels among program directors.

Methods

A cross-sectional survey was administered from May 17 to June 30, 2021 to program directors and assistant/ associate program directors at an academic medical center in south-central Pennsylvania. A self-report questionnaire was used to collect data. The survey included an open-ended question along with the Trait Emotional Intelligence Questionnaire- Short Form (TEIQue-SF), Copenhagen Burnout Inventory (CBI), and demographic questions. All data were analyzed using SAS Version 9.4.

Results

Of the 109 program directors and assistant/associate program directors invited in the survey, 34 (31.20%) responded. The findings indicate that there is a moderate inverse association between EQ and burnout, suggesting EQ as a protective factor against burnout. We also found that program directors who were considering leaving their position demonstrated higher levels of burnout compared to those who did not. Results from the open-ended question suggest that perceived lack of support, micromanagement, criticism, and extra duties with less payment were among the reasons program directors and associates were considering steeping down from their position. The results showed no association between EQ skills and years of practicing.

Conclusions

Burnout among program directors and assistant/associate program directors is not as alarming as rates of burnout among physicians-in-training. However, despite high level of EQ skills and low burnout level, nearly 43% of program directors were considering leaving their position. Nurturing EQ skills may be useful in improving retention and reducing turnover among medical leaders.
Implementing a standardised perioperative nutrition care pathway in upper gastrointestinal cancer surgery: a mixed-methods analysis of implementation using the Consolidated Framework for Implementation Research
Authors: Deftereos Irene , Hitch Danielle , Butzkueven Sally , Carter Vanessa , Fetterplace Kate , Fox Kate , Ottaway Aurora , Pierce Kathryn , Steer Belinda , Varghese Jessie , Kiss Nicole , Yeung Justin M
Published: February 2022

Background

Implementation studies of complex interventions such as nutrition care pathways are important to health services research, as they support translation of research into practice. There is limited research regarding implementation of a nutrition care pathway in an upper gastrointestinal (UGI) cancer population. The aim of this study was to comprehensively evaluate the implementation process of a perioperative nutrition care pathway in UGI cancer surgery using The Consolidated Framework for Implementation Research (CFIR).

Methods

This was a mixed methods implementation study conducted during a pilot study of a standardised nutrition care pathway across four major hospitals between September 2018 to August 2019. Outcome measures included five focus groups among study dietitians (n = 4–8 per group), and quantitative satisfaction surveys from multi-disciplinary team (MDT) members (n = 14) and patients (n = 18). Focus group responses were analysed thematically using the CFIR constructs, which were used as a priori codes. Survey responses were summarised using means and standard deviations. A convergent parallel mixed methods approach according to CFIR domains and constructs was used to integrate qualitative and quantitative data.

Results

Qualitative data demonstrated that dietitian perceptions primarily aligned with five CFIR constructs (networks and communications, structural characteristics, adaptability, compatibility and patient needs/resources), indicating a complex clinical and implementation environment. Challenges to implementation mostly related to adapting the pathway, and the compatibility of nutrition coordination to existing aspects of care within each setting. Identified benefits from dietitian qualitative data and MDT survey responses included increased engagement between the dietitian and MDT, and a more proactive approach to nutrition care. Patients were highly satisfied with the service, with the majority of survey items being rated highly (≥4 of a possible 5 points).

Conclusions

The nutrition care pathway was perceived to be beneficial by key stakeholders. Based on the findings, sustainability and compliance to this model of care may be achieved with improved systems level coordination and communication.
Social prescribing during the COVID-19 pandemic: a qualitative study of service providers’ and clients’ experiences
Authors: Morris Stephanie L. , Gibson Kate , Wildman Josephine M. , Griffith Bethan , Moffatt Suzanne , Pollard Tessa M.
Published: February 2022

Background

COVID-19 public health restrictions, such as social distancing and self-isolation, have been particularly challenging for vulnerable people with health conditions and/or complex social needs. Link worker social prescribing is widespread in the UK and elsewhere and is regarded as having the potential to provide support to vulnerable people during the pandemic. This qualitative study explores accounts of how an existing social prescribing service adapted to meet clients’ needs in the first wave of the pandemic, and of how clients experienced these changes.

Methods

Data were collected in a deprived urban area of North East England via remote interviews with clients (n = 44), link workers (n = 5) and service provider managerial staff (n = 8) from May–September 2020. Thematic data analysis was conducted.

Results

The research found that service providers quickly adapted to remote intervention delivery aiming to serve existing clients and other vulnerable groups. Service providers experienced improved access to some existing clients via telephone in the first months of remote delivery and in some cases were able to engage clients who had previously not attended appointments at GP surgeries. However, link workers also experienced challenges in building rapport with clients, engaging clients with the aims of the intervention and providing a service to digitally excluded people. Limited link worker capacity meant clients experienced variable contact with link workers with only some experiencing consistent support that was highly valued for helping to manage their conditions and mental wellbeing. Limited access to linked services also adversely affected clients. Clients living in less affluent circumstances and/or with worse health were more likely to experience negative impacts on their long-term condition. Some found their health and progress with social prescribing was ‘on hold’ or ‘going backwards’, which sometimes negatively affected their health.

Conclusions

Social prescribing offered valued support to some during the pandemic, but remote support sometimes had limited impact for clients and findings highlight the vulnerability of social prescribing’s success when linked services are disrupted. Findings also show the need for more to be done in the upscaling of social prescribing to provide support to digitally excluded populations.
Comparison of left atrial deformation parameters between renal transplant and hemodialysis patients
Authors: Yildirim Ufuk , Akcay Murat , Coksevim Metin , Turkmen Ercan , Gulel Okan
Published: February 2022

Background

Renal transplantation (RT) has been demonstrated to improve left ventricular systolic function. However, only few studies have attempted to reveal the effects of transplantation on left atrial (LA) function. In our study, we aimed to compare LA function between RT and hemodialysis patients.

Methods

This cross-sectional study included 75 consecutive patients with RT, and 75 age- and gender-matched patients on maintenance hemodialysis. LA strain and strain rate (SR) analyzed by two-dimensional (2D) speckle tracking echocardiography (STE) were compared between the groups in addition to standard echocardiographic parameters.

Results

LA strain during reservoir phase (29.88 ± 5.76% vs 26.11 ± 5.74%, P < .001), LA strain during conduit phase (− 15.28 ± 5.00% vs − 12.92 ± 4.38%, P = .003), and LA strain during contraction phase (− 14.60 ± 3.32% vs − 13.19 ± 3.95%, P = .020) were higher in the transplantation group. Similarly, LA peak SR during reservoir phase (1.54 ± 0.33 s− 1 vs 1.32 ± 0.33 s− 1, P < .001), LA peak SR during conduit phase (− 1.47 ± 0.49 s− 1 vs − 1.12 ± 0.42 s− 1, P < .001), and LA peak SR during contraction phase (− 2.13 ± 0.46 s− 1 vs − 1.83 ± 0.58 s− 1, P = .001) were higher in the transplantation group as well.

Conclusions

LA function assessed by 2D STE was better in RT patients than hemodialysis patients. This may suggest favorable effects of RT on LA function.
Gambling treatment service providers’ views about contingency management: a thematic analysis
Authors: Dorey Lucy , Christensen Darren R. , May Richard , Hoon Alice E. , Dymond Simon
Published: February 2022

Background

There is a need to improve retention and outcomes for treatment of problem gambling and gambling disorder. Contingency management (CM) is a behavioural intervention involving identification of target behaviours (such as attendance, abstinence, or steps towards recovery) and the provision of incentives (such as vouchers or credits towards the purchase of preferred items) contingent on objective evidence of these behaviours. Contingency management for abstinence and attendance in substance misuse treatment has a substantial evidence base but has not been widely adopted or extended to other addictive behaviours such as gambling. Potential barriers to the widespread adoption of CM may relate to practitioners’ perceptions about this form of incentive-based treatment. The present study sought to explore United Kingdom (UK) gambling treatment providers’ views of CM for treatment of problem gambling and gambling disorder.

Methods

We conducted semi-structured interviews with 30 treatment providers from across the UK working with people with gambling problems. Participants were provided with an explanation of CM, several hypothetical scenarios, and a structured questionnaire to facilitate discussion. Thematic analysis was used to interpret findings.

Results

Participants felt there could be a conflict between CM and their treatment philosophies, that CM was similar in some ways to gambling, and that the CM approach could be manipulated and reduce trust between client and therapist. Some participants were more supportive of implementing CM for specific treatment goals than others, such as for incentivising attendance over abstinence due to perceived difficulties in objectively verifying abstinence. Participants favoured providing credits accruing to services relevant to personal recovery rather than voucher-based incentives.

Conclusions

UK gambling treatment providers are somewhat receptive to CM approaches for treatment of problem gambling and gambling disorder. Potential barriers and obstacles are readily addressable, and more research is needed on the efficacy and effectiveness of CM for gambling.
Long-term survival outcomes of esophageal cancer after minimally invasive Ivor Lewis esophagectomy
Authors: Pather Keouna , Mobley Erin M. , Guerrier Christina , Esma Rhemar , Kendall Heather , Awad Ziad T.
Published: February 2022

Objectives

The aim of this study was to determine the long-term overall and disease-free survival and factors associated with overall survival in patients with esophageal cancer undergoing a totally minimally invasive Ivor Lewis esophagectomy (MILE) at a safety-net hospital.

Methods

This was a single-center retrospective review of consecutive patients who underwent MILE from September 2013 to November 2017. Overall and disease-free survival were analyzed by Kaplan-Meier estimates, and hazard ratios (HR) were derived from multivariable Cox regression models.

Results

Ninety-six patients underwent MILE during the study period. Overall survival at 1, 3, and 5 years was 83.2%, 61.9%, and 55.9%, respectively. Disease-free survival at 1, 3, and 5 years was 83.2%, 60.6%, and 47.5%, respectively. Overall survival (p < 0.001) and disease-free survival (p < 0.001) differed across pathological stages. By multivariable analysis, increasing age (HR, 1.06; p = 0.02), decreasing Karnofsky performance status score (HR, 0.94; p = 0.002), presence of stage IV disease (HR, 5.62; p = 0.002), locoregional recurrence (HR, 2.94; p = 0.03), and distant recurrence (HR, 4.78; p < 0.001) were negatively associated with overall survival. Overall survival significantly declined within 2 years and was independently associated with stage IV disease (HR, 3.29; p = 0.04) and distant recurrence (HR, 5.78; p < 0.001).

Conclusion

MILE offers favorable long-term overall and disease-free survival outcomes. Age, Karnofsky performance status score, stage IV, and disease recurrence are shown to be prognostic factors of overall survival. Prospective studies comparing long-term outcomes after different MIE approaches are warranted to validate survival outcomes after MILE.
Advantages of McKeown minimally invasive oesophagectomy for the treatment of oesophageal cancer: propensity score matching analysis of 169 cases
Authors: Xie Jun , Zhang Lei , Liu Zhen , Lu Chun-lei , Xu Guang-hui , Guo Man , Lian Xiao , Liu Jin-Qiang , Zhang Hong-Wei , Zheng Shi-ying
Published: February 2022

Background

Oesophagectomy, the gold standard for oesophageal cancer treatment, causes significantly high morbidity and mortality. McKeown minimally invasive oesophagectomy (MIE) is preferred for treating oesophageal malignancies; however, limited studies with large sample sizes focusing on the surgical and oncological outcomes of this procedure have been reported. We aimed to compare the clinical safety and efficacy of McKeown MIE with those of open oesophagectomy (OE).

Patients and methods

Overall, 338 oesophageal cancer patients matched by gender, age, location, size, and T and N stages (McKeown MIE: 169 vs OE: 169) were analysed. The clinicopathologic features, operational factors, postoperative complications, and prognoses were compared between the groups.

Results

McKeown MIE resulted in less bleeding (200 mL vs 300 mL, p<0.01), longer operation time (335.0 h vs 240.0 h, p<0.01), and higher number of harvested lymph nodes (22 vs 9, p<0.01) than OE did. Although the rate of recurrent laryngeal nerve injury in the two groups was not significantly different, incidence of anastomotic leakage (8 vs 24, p=0.003) was significantly lower in the McKeown MIE group. In addition, patients who underwent McKeown MIE had higher 5-year overall survival than those who underwent OE (69.9% vs 40.4%, p<0.001).

Conclusion

McKeown MIE is proved to be feasible and safe to achieve better surgical and oncological outcomes for oesophageal cancer compared with OE.
Mediterranean natural extracts improved cognitive behavior in zebrafish and healthy rats and ameliorated lps-induced cognitive impairment in a sex dependent manner
Authors: Pusceddu Matteo M. , Hernandez-Baixauli Julia , Puiggrós Francesc , Arola Lluis , Caimari Antoni , Del Bas Josep M. , Baselga Laura
Published: February 2022

Background

Several findings suggest neuroinflammation as a contributing factor for the onset of psychiatric disorders such as Alzheimer’s disease, depression, and anxiety. There is increasing evidence pointing out that the Mediterranean diet influences brain and behavior. Mediterranean herbs and spices have been shown to be within those components of the Mediterranean diet involved in cognitive enhancement. Thus, we investigated the influence of Mediterranean natural extracts (MNE), Rosemary extract (RE) and Glycyrrhiza glabra root extract (GGRE), on cognitive behavior.

Results

Adult zebrafish were exposed to RE or GGRE (100 and 250 mg/L) treatments. Both MNE improved memory retention during the T-maze test, although no improvements were observed during the novel object preference. Similarly, chronic administration of RE (150 mg/Kg) and GGRE (150 mg/Kg) improved, respectively, spatial and retention memory, as assessed by the Morris Water Maze (MWM), and the Elevated Plus Maze (EPM) in healthy male rats. However, no improvements were observed during the novel object recognition. Finally, male, and female rats were chronically treated with lipopolysaccharide [(LPS) 300 ug/kg] and orally administered with RE. Interestingly, RE reversed LPS-induced cognitive deficit during the MWM and EPM in female rats.

Conclusions

We found that MNE improved cognition in both zebrafish and rats. Moreover, MNE rescued LPS-induced cognitive impairment in a gender-specific manner. Therefore, our study supports the view that zebrafish represent a valuable preclinical model for drug discovery in neuroscience. These findings contribute to an exciting and growing body of research suggesting that MNE may play an important role in the prevention of cognitive impairment.
Analytical validity of DecisionDx-SCC, a gene expression profile test to identify risk of metastasis in cutaneous squamous cell carcinoma (SCC) patients
Authors: Borman Sherri , Wilkinson Jeff , Meldi-Sholl Lauren , Johnson Clare , Carter Kelsey , Covington Kyle R. , Fitzgerald Alison L. , Kurley Sarah J. , Farberg Aaron S. , Goldberg Matthew S. , Monzon Federico A. , Oelschlager Kristen , Cook Robert W.
Published: February 2022

Background

To improve identification of patients with cutaneous squamous cell carcinoma (SCC) at high risk for metastatic disease, the DecisionDx-SCC assay, a prognostic 40-gene expression profile (40-GEP) test, was developed and validated. The 40-GEP assay utilizes RT-PCR gene expression analysis on primary tumor biopsy tissue to evaluate the expression of 34 signature gene targets and 6 normalization genes. The test provides classifications of low risk (Class 1), moderate risk (Class 2A), and high risk (Class 2B) of metastasis within 3 years of diagnosis. The primary objective of this study was to validate the analytical performance of the 40-gene expression signature.

Methods

The repeatability and reproducibility of the 40-GEP test was evaluated by performance of inter-assay, intra-assay, and inter-operator precision experiments along with monitoring the reliability of sample and reagent stability for class call concordance. The technical performance of clinical orders from September 2020 through July 2021 for the 40-GEP test was assessed.

Results

Patient hematoxylin and eosin (H&E) stained slides were reviewed by a board-certified pathologist to assess minimum acceptable tumor content. Class specific controls (Class 1 and Class 2B) were evaluated with Levey-Jennings analysis and demonstrated consistent and reproducible results. Inter-assay, inter-operator and intra-assay concordance were all ≥90%, with short-term and long-term RNA stability also meeting minimum concordance requirements. Of the 2586 orders received, 93.5% remained eligible for testing, with 97.1% of all tested samples demonstrating actionable class call results.

Conclusion

DecisionDx-SCC demonstrates a high degree of analytical precision, yielding high concordance rates across multiple performance experiments, along with exhibiting robust technical reliability on clinical samples.
Relationship between sleep quality, mood state, and performance of elite air-rifle shooters
Authors: Lu Jiaojiao , An Yan , Qiu Jun
Published: February 2022

Background

To evaluate the impact of pre-competition sleep quality on the mood and performance of elite air-rifle shooters.

Methods

Elite shooters who participated in an air-rifle shooting-competition from April 2019 to October 2019 were evaluated using actigraphy, including Total Sleep Time (TST), Sleep Efficiency (SE), Sleep Latency (SL), Wake-time after Sleep Onset (WASO). Sleep quality was assessed by Pittsburgh sleep quality index (PSQI) and Profile of Mood State (POMS). Mood state was assessed by Competitive State Anxiety Inventory-2.

Results

Study included 23 shooters, of them 13 male and 10 female with the mean age 23.11 ± 4.82 years. The average time to fall asleep was 20.6 ± 14.9 min, TST was 7.0 ± 0.8 h and SE was 85.9 ± 5.3%. Average sleep quality was 5.2 ± 2.2 and tended to decrease as the competition progressed. Pre-competition sleep time in female athletes was significantly higher compared to the competition day (P = 0.05). Pre-competition SL was significantly longer in women than in men (P = 0.021). During training and pre-competition, the tension, fatigue, depression, and emotional disturbance were significantly lower in athletes with good sleep quality. Athletes with good sleep quality had significantly more energy. The PSQI total score positively correlated with cognitive anxiety (r = 0.471, P < 0.01), and somatic anxiety (r = 0.585, P < 0.01), and negatively correlated with energy (− 0.504, P < 0.01) and self-confidence scores (r = − 0.523, P < 0.01).

Conclusion

Poor sleep quality negatively impacted the mood of athletes; however, sleep indices and competition performance of athletes during competitions were not significantly correlated.