bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing Cognitive Functions in Patients with Schizophrenia and Methamphetamine-Induced Psychosis with Healthy Controls
Authors: Eslami Shahrbabaki Mahin , Barfehie Delaram , Mazhari Shahrzad , Ahmadi Atefeh , Shafiee Shahideh
Published: February 2023

Background: There are similar findings about the similarities and differences of cognitive dysfunctions in patients with schizophrenia and methamphetamine-induced psychosis (MIP). This study aimed to compare cognitive functioning in schizophrenia and MIP patients, using a performance-based cognitive assessment battery and an interview-based assessment of cognition. Methods: Three groups participated in this study including, (a) 30 patients with MIP, (b) 30 patients with schizophrenia, and (c) 30 healthy individuals. All participants received the Brief Assessment of Cognition in Schizophrenia (BACS), a standardized performance-based cognitive battery, the Schizophrenia Cognition Rating Scale (SCoRS), and the interview-based assessment of cognition. Findings: Both groups of patients with schizophrenia and MIP performed poorly on all the BACS cognitive domains compared with the healthy controls. The two patient groups were significantly different on the three BACS subscales including verbal fluency, verbal memory, and speed of information processing. Schizophrenia patients performed worse than the MIP group concerning these three subscales. However, the two patient groups were similar in executive function, working memory, and motor speed. Moreover, the SCoRS-informant, SCoRS-global, and PANSS-negative significantly differed between schizophrenia and MIP patients. Conclusion: Although cognitive dysfunctions are mostly similar in patients with MIP and schizophrenia, there are some differences especially in the functions related to prefrontal and temporal lobes.
Neurocognitive Functions Related to Parietal Lobe in Patients with Schizophrenia and Methamphetamine Induced Psychotic Disorder and Healthy Individuals: A Comparative Study
Authors: Khalili Navid , Mazhari Shahrzad , Mortazavi Nahid
Published: February 2023

Background: There are some inconsistent findings about neurocognitive functions in schizophrenia and methamphetamine induced psychosis (MIP). This study aimed to compare these two disorders in terms of neurocognitive functions related to parietal lobe. Methods: This was a cross-sectional study in which 30 patients with schizophrenia, 30 patients with MIP, and 32 healthy individuals were compared. The two groups of patients were selected through convenience sampling from among patients hospitalized in Shahid Beheshti hospital in Kerman, Iran and healthy individuals were selected via convenience sampling from among the employees of Kerman University of Medical Sciences. The three groups were administered clock-drawing test (CDT), Rey-Osterrieth complex figure (ROCF) copying test, and interlocking finger test (IFT) and their demographic and clinical data were collected. The one-way analysis of variance (ANOVA) was used to investigate the differences between the groups. Multivariate analysis of covariance was also used to examine the effects of confounding factors. Besides, follow-up pairwise comparisons were performed after adjustment for multiple testing. Findings: The group with schizophrenia had significantly more impairment than the group with MIP with reference to the results of IFT and the ROCF test. However, the scores of patients with MIP on these two tests were not different from those of the normal controls. With regard to the CDT, the only significant difference was observed between the group with schizophrenia and controls. Conclusion: On the condition that the results are replicated in other studies, some parietal lobe neurocognitive tests might be used when it is difficult to differentially diagnose schizophrenia and MIP.
Frequency and Predictors of Opioid Use in Rheumatoid Arthritis and Seronegative Spondyloarthropathy Patients
Authors: Sahebari Maryam , Ahmadi Kourosh , Mehrad-Majd Hassan , Karimani Asieh , Salari Masoumeh
Published: February 2023

Background: Pain is one of the most challenging symptoms in patients with rheumatoid arthritis (RA) and spondyloarthropathies (SpAs), and pain relief is one of the top priorities for improving health-related quality of life. When medication therapy does not significantly reduce pain, chronic opioid consumption becomes more prominent in such patients. This study aimed to evaluate the state of opioid use in RA and SpA patients. Methods: This cross-sectional study was performed on 316 patients with RA and spondyloarthropathies (SpAs) from January to March 2014. The convenience sampling method was used to select the participants, and by obtaining verbal consent, everyone was given 15 minutes to complete a checklist independently. Demographic and opioid use data were evaluated in terms of opioid use and its predictors. In this regard, univariate and multivariate logistic regressions were used to evaluate the predictors of opioid consumption in patients. All analyses were conducted using SPSS 21 and the significance level was set at P<0.05. Findings: About 9.5% of all participants, including 8.8% of RA and 22.6% of SpA cases, were opioid abusers. In the first step of the analysis, it was observed that opioid abuse was significantly higher in men, married participants, urban residents, patients with no biological therapy, and patients with a negative family history of addiction. The most prevalent ways of drug abuse were smoking and ingestion. The results of univariate logistic regression analysis revealed SpA and other factors significantly increase the chance of opioid abuse. Furthermore, multivariate logistic regression analysis showed male gender (OR=10.4) and negative family history of addiction (OR=3.19) significantly affected addiction in RA and SpA patients with a 95% confidence interval. Conclusion: Lack of suitable responsiveness to medication therapy to relieve pain, inconsistent pain evaluation, and shame of asking direct questions about addiction in RA and SpA patients may lead to opioid consumption in some cases. Seronegative SpA may make patients more prone to addiction. However, in this study, male gender and no family history of addiction were related to opioid abuse.
Comparing the Effectiveness of Cognitive-Behavioral Therapy and Brief Intervention on Relapse Prevention among Drug Users
Authors: Davasaz Irani Reza , Ahmadi Reza , Norouzi Shahin , Ghazanfari Ahmad
Published: February 2023

Background: This study aimed to compare the effectiveness and stability of group cognitive-behavioral therapy (CBT) and brief intervention (BI) for relapse prevention (RP) among drug users of drop-in-centers (DICs) in Ahvaz, Iran. Methods: The present study was a quasi-experimental one with a pretest-posttest design, a follow-up phase, and a control group. The statistical population included all drug users of drop- in-centers of Ahvaz in 2021. The sample of the study included 78 drug users selected randomly and assigned to two experimental groups and one control group (each 26 members). A morphine test (special kits) that detects the presence of morphine in urine was used to check the relapse. Data were analyzed using repeated measures ANOVA with SPSS (version 24). Findings: The results showed BI and CBT had a significant effect on reducing RP in drug users (P<0.001). The BI was more effective than CBT for RP. Conclusion: It can be concluded that both BI and CBT can be effective in reducing the likelihood of relapse among drug users but BI is more effective than CBT for RP.
A Review of the Prevention of Drug Addiction: Specific Interventions, Effectiveness, and Important Topics
Authors: Flora Katerina
Published: February 2023

Background: This study was a narrative review on prevention of addictive behaviors with an effort to clarify the major concepts of prevention and its dimensions. Methods: The PsycInfo and MedInfo databases were used to identify prevention. Α total of 65 articles were found 46 of which were included in the review. Τhe data were analyzed using content analysis. Findings: For a better understanding of the results, it was deemed advisable to categorize them into: (a) the types of major interventions and the theoretical approaches on which they were based, (b) the results of the review articles according to (1) variables and factors concerning the prevention proved important through the review and (2) a number of more general important topics which arose in the prevention of addictive behaviors. Conclusion: The results highlighted the greater effectiveness of community-based programs, applied primarily in broader contexts but also secondarily in high-risk groups. Τhe results were discussed based on the combination of the emerged factors with each other and prevention experience.
"Waterpipe Is Like a Wife": Qualitative Assessment of Perspectives on Waterpipe Smoking Dependence
Authors: Kedia Satish , Ahuja Nikhil , Hammal Fadi , Asfar Taghrid , Eissenberg Thomas , Maziak Wasim , Ward Kenneth D.
Published: February 2023

Background: Waterpipe (WP) smoking has become a global public health problem in recent decades and growing evidence indicates that it can cause nicotine dependence. Most evidence on WP dependence to date has been derived from survey- or laboratory-based studies. This study employed qualitative methods to explore WP users’ perceptions of dependence in Aleppo, Syria. Methods: A total of 15 focus groups were conducted with 64 adult WP smokers (51 males and 13 females) using a semi-structured interview. All focus group discussions were audiotaped, transcribed, and coded using directed content analysis. Findings: Several WP dependence features were consistent with those commonly reported by cigarette smokers. These included positively reinforced features, such as smoking’s association with social gatherings and cultural connectedness, and negatively reinforced features including relief of withdrawal symptoms, stress, and boredom. Although interest in quitting was low, many users perceived quitting WP to be difficult and an indicator of loss of control over smoking, a common marker of dependence. Several observed dependence features were specific to WP, including transitioning from social smoking to smoking alone, and adapting one’s behavior to the considerable effort normally required to engage in WP smoking despite inconvenience or cost, and often at the expense of other reinforcers such as social interaction. Conclusion: The general and specific features of WP dependence need to be considered in developing instruments to measure WP dependence, in clinical assessment of WP dependence, and in developing cessation programs.
An Evaluation of the Factors Related to Internet Gaming Disorder in Young Adults
Authors: Ünal Egemen , Gökler Mehmet Enes , Turan Şenol
Published: February 2023

Background: Game addiction is a growing problem all over the world. The present study aimed to evaluate the prevalence and psychological, social, and behavioral effects of internet gaming disorder (IGD) on young adults. Methods: A preliminary study was conducted and the game types most commonly played on the internet were determined. Then, approximately 60 gaming site managers were contacted. After obtaining consent, the questionnaires were sent to gaming site members and they were asked to complete the questionnaires. Data were collected through a sociodemographic form, Internet Gaming Disorder Scale–Short Form (IGDS9-SF), Strengths and Difficulties Questionnaire (SDQ), and State-Trait Anxiety Inventory (STAI). Findings: The study was conducted with 613 participants. The age of the participants ranged from 15 to 30 years, with a mean age of 20.80±4.63 years. The prevalence of IGD was 10% (n=67). Those with low-income families and low academic performance were identified as more likely to develop IGD. Moreover, IGD was revealed to be more likely in individuals with fewer close friends, playing games from an early age, and those with a habit of devoting extensive time to watching online game videos on Twitch or YouTube. In addition, the risk of gaming disorder was approximately two times higher in individuals who preferred First Person Shooter (FPS) games and Massively Multiplayer Online Role-Playing Games (MMORPG). Conclusion: The results of this study could be useful for estimating the level of IGD and carrying out more comprehensive studies to possibly be able to control IGD.
Evaluation of Testosterone, Blood Antioxidants, and Histopathological Changes Following Chemical Castration With Calcium Chloride in Rats
Authors: Hami Mehdi , Veshkini Abbas , Jahandideh Alireza , Mashhadi Rafiee Siamak , Mortazavi Pejman
Published: February 2023

Objectives: Castration is one of the most common methods of contraception in animals. This method can prevent animals from contracting various diseases, such as testicular tumors, and prevent the overgrowth of animal populations. Materials and Methods: In this experiment, 10 adult and clinically healthy male Wistar rats weighing approximately 250-200 g were divided into two equal groups of control and treatment (n=5 in each). In the control group, normal saline and in the treatment group, 20% calcium chloride was injected into the testicular tissue. Blood samples were taken at the beginning and end of the experiment (day 21) and the superoxide dismutase (SOD), glutathione peroxidase (GPx), and testosterone levels were measured. Then, the tissue samples of testis were evaluated on days 7, 14, and 21. Results: On day 21, SOD and GPx enzymes significantly increased in the treatment group compared to day zero (P=0.01). However, calcium chloride injection reduced the mean testosterone levels on day 21 compared to day zero (P=0.06). Meanwhile, the mean number of sperms in the right testis of treated mice significantly decreased (P=0.03). Seminiferous tubule necrosis significantly increased on day 7, neutrophil infiltration significantly increased on days 7 and 14, and calcification significantly increased on days 7 and 21 (P<0.01). Conclusions: Although chemical sterilization using 20% calcium chloride can lead to testicular degeneration, it is not a recommended method because it does not reduce testosterone and activates oxidative stress biomarkers. However, the negative effects might be eliminated in future studies using some substances such as tannic acid.
Association Between Nutritional Status and Quality of Life in Patients With Allergic Rhinitis
Authors: Bagherinia Elham , Bagherinia Marzieh , Khamoushi Firoozeh , Davoodi Akram , Mortazavi Seyed Hamidreza
Published: February 2023

Objectives: Allergic rhinitis (AR) is a heterogeneous disorder with immune pathophysiology affecting quality of life (QOL) and productivity at work or education. This study aimed to evaluate the association between macro- and micro-nutrient intakes with QOL in AR patients. Materials and Methods: Using convenience sampling method, this cross-sectional study included 60 AR patients in the age range of 15-60 years referred to the Allergy Clinic of Mohammad Kermanshashi hospital, Kermanshash, Iran from March to December 2018. Data including body composition, QOL, and nutritional status were collected. Independent t test, chi-square, and Pearson correlation were used for data analysis. Results: According to the results of Spearman test, while cholesterol intake level was directly associated with low QOL (P = 0.049, r=0.283), dietary zinc intake had a negative correlation with low QOL (P = 0.045, r=-0.262). However, there were no significant associations between other macro- and micro-nutrient intakes and QOL in patients. Conclusions: In this study, higher intake of cholesterol, unlike zinc, had a negative effect on QOL in AR patients.
Effective Characteristics of Iranian Oncology Nurses in Their Therapeutic Communication With Cancer Patients
Authors: Bafandeh Zendeh Mostafa , Hemmati Maslakpak Masumeh , Jasemi Madineh
Published: February 2023

Objectives: Therapeutic communication is a central element of the nurse-patient interaction in providing quality care to cancer patients. The present study aimed to evaluate effective characteristics of Iranian oncology nurses in their therapeutic communication that might determine the nature of nurses’ communication patients with cancer. Materials and Methods: This was a qualitative study performed with a conventional content analysis method in 2020. The participants included 18 nurses working in oncology wards of educational and medical centers in northwestern Iran, selected by purposive sampling. In addition, data were collected using semi-structured interviews. Results: The qualitative data analysis led to the extraction effective characteristics of oncology nurses encompassed related of inner views and beliefs, family upbringing regarding therapeutic communication and personality characteristics. This is based on caringparticipatory attitude, empathy, trust, mutual respect. Inner satisfaction (Nurse’s and patient satisfaction), improved positive mutual approach (patient comfort and satisfaction with patient’s good feeling) positive outcomes of therapeutic communication nurses with cancer patients were. Conclusions: The establishment of effective therapeutic communication with cancer patients requires a change in the philosophy and attitude of nurses toward the potential skills of this area. In addition, nurses must have self-awareness of the importance of therapeutic communication in the improvement of patient quality care and consequences. Moreover, they should receive proper education in this area to meet their needs and encourage holistic and patient-centered approaches in these individuals.
A Case Report of Treating Femur Head Necrosis Applying Persian-Medicine
Authors: Navabzadeh Maryam , Abdi Mojtaba , Hadinia Javad , Ghods Roshanak
Published: February 2023

The avascular necrosis (AVN) of the femur head due to the death of the osteocytes of the bone marrow occurs because the organ is not supplied with sufficient blood. The prevalence of the problem is 10%-50% in adults. The etiology of the disease includes various factors such as trauma, cigarette smoking, drinking spirits, taking corticosteroids, genetics, metabolic disorders, human immunodeficiency virus, pregnancy, and the like. The treatment of necrosis can be conducted regarding the degree of the problem. In the present paper, a case was reported whose femur head necrosis was treated by applying Iranian Medicine without using common drugs in modem Medicine. The patient was a 46-year-old man who had felt severe pain in his left hip since a month before referring. The pain had gradually increased and the AVN of the femur head was diagnosed after magnetic resonance imaging. Finally, the surgery and arthroplasty of the femur head were recommended in this regard. In general, surgery and arthroplasty were recommended regarding the hard medicinal and complicated treatment of the AVN of the femur head. However, it is noteworthy that applying Iranian medicine capacities is possible for curing the disease.
Do Educated Women Have More Sexual Satisfaction? A Systematic Review Study
Authors: Bayat Fatemeh , Ozgoli Giti , Mahmoodi Zohreh , Nasiri Malihe
Published: February 2023

Objectives: Educational status affects all aspects of life, including sex life. Regarding the relationship between women’s sexual satisfaction and their education level, contradictory results have been obtained so far. This systematic review aimed to summarize the existing knowledge in this area. Methods: In this study, three electronic databases, including PubMed, Scopus, and Web of Science were searched for all the related articles published from 1 January, 2000 to 28 June, 2022. The MeSH keywords including "educational status", "education", and "sexual satisfaction" were combined with Boolean operators of AND and OR. There were no geographical constraints in this study. Inclusion criteria were all observational articles evaluating the relationship between the educational status of heterosexual, nonpregnant, and non-sick women with sexual satisfaction. The quality of articles was assessed by the Newcastle-Ottawa scale (NOS) and the data were analyzed qualitatively. Result: Out of a total of 4984 retrieved articles, nine studies with a sample size of 10488 women were included in this systematic review (2003-2021). In subjects with sexual dysfunction and mental health problems, as well as those affected by economic pressure, sexual satisfaction was predicted by the mentioned factors and not by the education level. Generally, in the studies where it was possible to compare the participants with all levels of education (illiterate to academic) and there was no sexual dysfunction, mental health problems, and economic pressure, women’s level of education was the predictor of their sexual satisfaction. Conclusions: According to our results, education was the most effective predictor of women’s sexual satisfaction in stable conditions without sexual dysfunction. Education can improve women’s educability, knowledge, and attitudes towards sexual issues, thereby increasing their sexual satisfaction. However, for a more definite conclusion, high-quality and larger studies are needed to measure the relationship between sexual satisfaction and women’s education.
Explanation of the Concept of Wet Liver Dystemperament (sue-mizaj) in Iranian Traditional Medicine (Persian medicine): A Hybrid Concept Analysis
Authors: Hakimi Fatemeh , Yaghmaei Farideh , Alipour Abbas , Asghari Majid , Namdar Hasan , Jafari Parisa , Movahhed Mina
Published: February 2023

Objectives: The semiology of liver dystemperament can help in predicting susceptibility to some diseases and improving the treatment process of the liver or general disease such as non-alcoholic fatty liver disease (NAFLD). Therefore, the aim of this study was to explain the wet liver dystemperament concept in Iranian traditional medicine (ITM) based on a hybrid concept analysis. Materials and Methods: The literature review of this qualitative study focused on evaluating 11 major academic textbooks from the 3rd to 19th century and some databases. In-depth, semi-structured, and face-to-face interviews were conducted with 16 ITM experts with a minimum of five years of clinical experience and maximum variations in terms of gender, age, and clinical experiences for empirical data gathering. Data were analyzed with MAXQAD10 and conventional content analysis. Results: In this study, wet liver dystemperament was classified into three main themes of systemic, local, and Para-clinical symptoms and 10 categories. Conclusions: This manuscript explains wet liver dystemperament as a disorder in general temperament and determines more important diagnostic criteria.
Development and Validation of an Electronic Scale for Sexual Violence Experiences in Iranian Women
Authors: Sanjari Shahrzad , Mohammidi Soleimani Mohammad Reza , Keramat Afsaneh
Published: February 2023

Objectives: According to the evidence, 35% of women have experienced sexual violence worldwide. This study aimed to develop and validate an electronic scale for sexual violence experiences (SVE) in Iranian women. Materials and Methods: In this mixed-method study, we conducted an item pool by reviewing the existing sexual violence scales in the literature and sent the items to the expert team for initial consensus. Then, we measured the validity and reliability of the developed scale. The samples included 808 women (age range: 15-45 years) in Kerman province from October to December 2020. Results: The final scale consisted of 43 items. Face validity was achieved by applying the views of the target community. The content validity results were acceptable. The correlation coefficient between the Sexual Experience Questionnaire (SEQ) and the Domestic Violence Questionnaire (DVQ) with the SVE was 0.68 and 0.51, respectively. Exploratory factor analysis (EFA) (χ2 =27973.72, df=903, and P=0.001) identified eight factors. The results also showed good reliability (Cronbach’s alpha=0.9, Pearson’s correlation r=0.9, P=0.001). Conclusions: Since the SVE had good validity and reliability, the scale can be regarded as a suitable tool for measuring sexual violence among Iranian women.
Effect of Muscle Fatigue on the Upper Trapezius Muscle With and Without Myofascial Trigger Points in Students With Neck Pain: A Randomized Controlled Clinical Trial
Authors: Mehdikhani Roya , Olyaei Gholam Reza , Hadian Mohammad Reza , Talebian Moghadam Saeed , Azadeh Shadmehr
Published: February 2023

Objectives: The purpose of this work was to explore cervical position sense and electromyographic (EMG) responses of cervical muscles during head repositioning movements in students with and without upper trapezius muscle trigger points. Materials and Methods: Forty-six right-handed men and women subjects without upper extremity disorders participated in this study. The maximal voluntary contraction (MVC) was measured three time before the fatigue test. A force gauge was used to measure force while recording with a monitor. Measurement was initiated with a MVC force before and after fatigue pain and head positioning were measured. When the protocol was accomplished, the subjects showed signs of exhaustion; however, they were not subjectively evaluated for fatigue. As the protocol aimed at assessing muscle fatigue, a force level of 80% MVC was induced. Results: These findings support the argument that the precision of the neck position sense can be reduced by the fatigue of the neck muscle. Fatigue impaired balance in the trapezius muscles. After removing vision this resulted in an increased center of pressure excursions on a force platform. Motor control did not change significantly in this study. Conclusions: Fatigue had a more significant effect on cervical kinematics in the healthy subjects, probably due to the fact that altered neck motor control in volunteers implied that these individuals were not completely able to make up for fatigue of the neck muscle. Significant pain and head positioning changes were identified following fatigue applied to the pre-determined myofascial trigger points, but the changes were insignificant in the sham control group.
Protective Effect of Hydroalcoholic Extracts of Galega officinalis and Cornus mas on Spermatogenesis and Oxidative Stress Associated With Diabetes in the Testes of Adult Rats: An Experimental Study
Authors: Sanati Ehsan , Posti Iraj , Gilanpour Hassan , Hesaraki Saeed
Published: February 2023

Objectives: In this research, we evaluated the protective effect of hydroalcoholic extracts of Galega officinalis and Cornus mas on spermatogenesis and oxidative stress associated with diabetes in the testes of adult rats. Materials and Methods: In this experimental study, a total of 64 adult male Wistar rats were divided into eight equal groups (n=8 in each) as follows: (1) control group, (2) diabetic control group, (3) diabetic group receiving Galega extract daily at a dose of 50 mg/kg, (4) healthy group receiving Galega extract daily at a dose of 50 mg/kg for 14 days, (5) diabetic group receiving Cornus mas extract daily at a dose of 100 mg/kg, (6) healthy group receiving Cornus mas extract daily, (7) diabetic group receiving Cornus mas and Galega daily, and (8) healthy group receiving Galega and Cornus mas extract daily. Diabetes was induced by single intraperitoneal injection of streptozotocin (50 mg/kg). At the end of treatment period, all animals were anesthetized and blood samples were taken to measure the serum levels of insulin, glucose, and oxidative stress markers. Finally, the testicles and epididymis were removed and sperm parameters were assessed. Results: Galega and Cornus mas extract significantly reduced the oxidative stress, sperm parameters, glucose, and insulin plasma levels (P=0.001). Furthermore, the malondialdehyde (MDA) level was increased in diabetic rats. The activity of superoxide dismutase (SOD) and catalase (CAT) enzymes decreased in testicular tissue (P=0.001). Administering Galega and Cornus mas extract significantly improved these parameters (P<0.05). Conclusions: Our results confirmed the antioxidant effect of administering Galega extract and Cornus mas extract on improving the sperm parameters and testicular oxidative damage caused by diabetes.
Ultrasonographic and Radiographic Evaluation of Zeolite/Collagen Nanocomposite Scaffolds Compared With Nanohydroxyapatite on Experimental Bone Defect Healing in Rabbit Femur
Authors: Javadian Negar , Veshkini Abbas , Jahandideh Alireza , Akbarzadeh Abolfazl , Asghari Ahmad
Published: February 2023

Objectives: The use of a biomaterial scaffold can improve the healing process of bone defects. Using radiologic and ultrasonographic methods, this study aimed to evaluate the effects of zeolite/collagen nanocomposite and nanohydroxyapatite (nHA) bone scaffolds on the healing process of bone defect in rabbit femur. Materials and Methods: Twenty-eight mature male New Zealand white rabbits were classified into four equal groups (n=7 in each). In the first group, the defect was made, and the wound was closed with no treatment; in the second group, the nHA was implanted into the defect; in the third group, the nanocomposite of zeolite/collagen was implanted; and in the fourth group, the defect was filled using autograft. Radiologic (Sedecal Veterinary X-Ray System, Model No. A6544-2) and ultrasonographic (Mindray Z5 Veterinary Ultrasound Scanner) examinations were done on days 0, 15, 30, 45, and 60 postoperatively. Results: There were no healing effects on days 0 and 7 in any of the studied groups in the radiologic examination. The highest and lowest healing effects were related to treatment with zeolite/collagen nanocomposite and control group on day 60 after operation, respectively. There was no angiogenesis on day 0 in any group in the ultrasonographic examination. The highest and lowest levels of angiogenesis were related to rabbits treated with zeolite/collagen nanocomposite and the control group on day 30 after operation, respectively. Also, bone filling and angiogenesis in rabbits treated with zeolite/collagen nanocomposite were higher than other groups. Conclusions: Zeolite/collagen nanocomposite scaffolds bear a crucial capability in the reconstruction of bone defects and can be used in bone fractures.
Cervical Nerve Root Cavernoma – Case Report and Literature Review
Authors: Moolchandani Sandeep , Tyagi Gaurav , Yagnick Nishant S , Sinha Sumit , Mehta Veer Singh
Published: February 2023

Spinal cavernous angiomas are uncommon vascular malformations in the spine accounting for 5%-12% of all spinal vascular lesions. When present in an intradural extra-medullary location, these usually present with radicular pain and neurological deficits due to mass effect (myelopathy). Herein, we present an atypical presentation of cavernous angioma in a 54-year-old man with tinnitus, headache and sensorineural hearing loss. We have also reviewed 51 cases of intradural extramedullary cavernous angiomas including our case with respect to demographic and clinical profile. A 54-year-old man presented with tinnitus in the left ear and occipital headache with neck pain and slight weakness of left-hand grip along with atrophy of thenar muscles. His pure tone audiometry (PTA) test reveled mild left sensorineural hearing loss. Magnetic resonance imaging (MRI) of cervical spine showed T2WI heterogeneously hyperintense left intradural extramedullary lesion at C7 vertebral body level. It was avidly enhancing with contrast. The patient underwent C7 laminectomy with a midline durotomy and complete excision of the lesion under neuromonitoring with sacrifice of the C8 sensory root. His symptoms improved following the surgery. The diagnosis of a cavernoma in an unusual location in the presence of cranial nerve dysfunction needs a high degree of diagnostic suspicion. Most of these cavernomas have a nerve root origin or attachment. The optimal treatment is microsurgical en bloc resection which leads to an effective resolution of both the symptoms.
Evaluation of Karnofsky Performance Scale as a Postsurgical Prognosis Criteria in Chronic Subdural Hematoma Cases: Discordance Between Clinical and Radiological Outcomes
Authors: Asan Ziya , Eroglu Sercan , Koysuren Aydan , Durmaz Sezai
Published: February 2023

Background: Chronic subdural hematoma (CSDH) may cause neurological deficits as well as adverse effects on the patient’s general health status. Although CSDH cases are diagnosed in the advanced age group with a very high rate, clinical findings may not be related only to CSDH. The aim should be related to clinical recovery rather than radiological recovery for these cases. We aimed to evaluate Karnofsky’s score as a measurement criterion of postoperative clinical outcomes in patients with CSDH. Methods: Cases operated for the diagnosis of CSDH were defined retrospectively. The cases that had been operated with this diagnosis were identified by examining the institution database records. Karnofsky scores equivalent to clinical status were performed by examining patient files. Karnofsky scoring before the symptomatic period was determined and compared with the Karnofsky score belonging to the late postoperative period. The clinical and radiological findings of the preoperative and postoperative periods were compared. Independent samples t test was used to reveal the difference between the two groups. Results: Data of 184 cases were evaluated. Seventy-three cases were operated on the left, 51 cases on the right, and 60 cases bilaterally with the diagnosis of CSDH. Burrhole exploration was performed in 119 cases, and a craniotomy was performed in 65 cases. Although a significant decrease in hematoma thickness was detected radiologically in cases operated with the craniotomy method, a more significant improvement was observed in Karnofsky’s score in cases operated with the burrhole method. In younger patients, improvement in Karnofsky’s score was significantly higher. Conclusion: The main aim should be to improve clinical status rather than radiological improvement in the treatment of CSDH cases. In the surgical treatment of these cases, it is possible to encounter a high rate of complications depending on age. It is possible to evaluate the postoperative status rationally with Karnofsky scoring. According to the preoperative Karnofsky scoring, deciding on the surgical technique may help reduce complications.
What Makes People With Chronic Illnesses Discontinue Treatment? A Practice Theory Informed Analysis of Adherence to Treatment among Patients With Drug-Resistant Tuberculosis in Pakistan
Authors: Abbas Shazra , Kermode Michelle , Khan Mohammad Dost , Denholm Justin , Adetunji Hamed , Kane Sumit
Published: February 2023

Background: Non-adherence to treatment is a frequently observed phenomenon amongst those on long-term treatment for chronic illnesses. This qualitative study draws upon the tenets of ‘practice theory’ to reveal what shapes patients’ ability to adhere to the demanding treatment for drug-resistant tuberculosis (DR-TB) at three treatment sites in Khyber-Pakhtunkhwa (KP) province of Pakistan. Methods: This qualitative study involved observation of service provision over a period of nine months of stay at, and embedment within the three treatment sites and in-depth interviews with 13 service providers and 22 patients who became non-adherent to their treatment. Results: Consistent with the extensive research based on the barriers and facilitator approach, both patients, and providers in our study also talked of patients’ doubts about diagnosis and treatment efficacy, side-effects of drugs, economic constraints, unreliable disbursements of monetary incentive, attitude of providers and co-morbidities as reasons for non-adherence to treatment. Applying a practice theory perspective yielded more contextualised insights; inadequate help with patients’ physical complaints, unempathetic responses to their queries, and failure to provide essential information, created conditions which hindered the establishment and maintenance of the ‘practice’ of adhering to treatment. These supply-side gaps created confusion, bred resentment, and exacerbated pre-existing distrust of public health services among patients, and ultimately drove them to disengage with the TB services and stop their treatment. Conclusion: We argue that the lack of supply-side ‘responsiveness’ to patient needs beyond the provision of a few material inputs is what is lacking in the existing DR-TB program in Pakistan. We conclude that unless Pakistan’s TB program explicitly engages with these supply side, system level gaps, patients will continue to struggle to adhere to their treatments and the TB program will continue to lose patients. Conceptually, we make a case for reimagining the act of adherence (or not) to long-term treatment as a ‘Practice.’
Alignment in the Hospital-Physician Relationship: A Qualitative Multiple Case Study of Medical Specialist Enterprises in the Netherlands
Authors: Ubels Sander , van Raaij Erik M.
Published: February 2023

Background: Policy-makers and hospital boards throughout the world have implemented different measures to create and sustain effective hospital-physician relationships. The ‘integrated funding’ policy reform in the Netherlands was aimed at increasing hospital-physician alignment and led to the unforeseen formation of medical specialist enterprises (MSEs): a fiscal entity representing all self-employed physicians in a hospital. It is unknown how hospitals and MSEs perceive their alignment and how they govern the relationship. This study explores the hospital-MSE relationship, and how governance styles influence perceived alignment in this relationship. Methods: A multiple case study of five non-academic hospitals in the Netherlands was performed. Data was derived from two sources: (1) analysis of hospital-MSE contracts and (2) semi-structured interviews with hospital and MSE board members. Contracts were analysed using a predefined contract analysis template. Interview recordings were transcribed and subsequently coded using the sensitizing concepts approach. Results: Contracts, relational characteristics, governance styles and perceived alignment differed substantially between cases. Two out of five contracts were prevention contracts, one was a mixed type, and two were promotion contracts. However, in all cases the contract played no role in the relationship. The use of incentives varied widely between the hospitals; most incentives were financial penalties. The governance style varied between contractual for two hospitals, mixed for one hospital and predominantly relational for two hospitals. Development of a shared business strategy was identified as an important driver of relational governance, which was perceived to boost alignment. Conclusion: Large variation was observed regarding relational characteristics, governance and perceived alignment. MSE formation was perceived to have contributed to hospital-physician alignment by uniting physicians, boosting physicians’ managerial responsibilities, increasing financial alignment and developing shared business strategies. Relational governance was found to promote intensive collaboration between hospital and MSE, and thus may improve alignment in the hospital-physician relationship.
Retrospective Impact Evaluation Continuing to Prove Challenging Irrespective of Setting: A Study of Research Impact Enablers and Challenges Cloaked as an Impact Evaluation? Comment on "‘We’re Not Providing the Best Care If We Are Not on the Cutting Edge of Research’: A Research Impact Evaluation at a Regional Australian Hospital and Health Service"
Authors: Ramanathan Shanthi
Published: February 2023

The original article provides a detailed and insightful presentation of enablers and detractors for research participation, translation, and impact, at a regional Australian hospital and health service. This information builds on existing knowledge, from the perspective of a non-metropolitan healthcare organisation. It stands to inform all healthcare organisations keen to embed research into their institutions. However, what the article fails to do is present the results of the research impact evaluation in a systematic and useful way for the reader to assess the benefits of research investment by a healthcare organisation including delivery of better quality care and improved patient outcomes. This commentary suggests why such information is critical to justify continued research investment by healthcare organisations and to showcase the potential benefits of the embedded research model. It also discusses the limitations of undertaking impact evaluation retrospectively and suggests that a prospective approach coupled with proper data collection systems and processes upfront could help future reporting of organisational research impact.
Things That Become Visible, for a While, Can Leave a Residue Comment on "Ensuring Global Health Equity in a Post-pandemic Economy"
Authors: Jensen Nele
Published: February 2023

Professor Labonté’s editorial is an important intervention that reiterates the stark socio-economic and health inequities that were exposed and perpetuated during the coronavirus disease 2019 (COVID-19) pandemic to call on the public health community to hold politicians to account for their promises of ‘building back better.’ The editorial makes present how quickly pandemic promises seem to have become dislodged by an ostensibly endless cycle of political and economic crises. But it also expresses a hope that lessons from the pandemic will eventually serve to challenge prevailing (economic) policy orthodoxy and feed a collective demand for more progressive social, economic and environmental justice-oriented politics.
What, Where, and How to Collect Real-World Data and Generate Real-World Evidence to Support Drug Reimbursement Decision-Making in Asia: A reflection into the Past and A Way Forward
Authors: Kc Sarin , Lin Lydia Wenxin , Bayani Diana Beatriz Samson , Zemlyanska Yaroslava , Adler Amanda , Ahn Jeonghoon , Chan Kelvin , Choiphel Dechen , Genuino-Marfori Anne Julienne , Kearney Brendon , Liu Yuehua , Nakamura Ryota , Pearce Fiona , Prinja Shankar , Pwu Raoh-Fang , Akmal Shafie Arsul , Sui Binyan , Suwantika Auliya , Tunis Sean , Wu Hui-Min , Zalcberg John , Zhao Kun , Isaranuwatchai Wanrudee , Teerawattananon Yot , Wee Hwee-Lin
Published: February 2023

Background: Globally, there is increasing interest in the use of real-world data (RWD) and real-world evidence (RWE) to inform health technology assessment (HTA) and reimbursement decision-making. Using current practices and case studies shared by eleven health systems in Asia, a non-binding guidance that seeks to align practices for generating and using RWD/RWE for decision-making in Asia was developed by the REAL World Evidence In ASia for HEalth Technology Assessment in Reimbursement (REALISE) Working Group, addressing a current gap and needs among HTA users and generators. Methods: The guidance document was developed over two face-to-face workshops, in addition to an online survey, a face-to-face interview and pragmatic search of literature. The specific focus was on what, where and how to collect RWD/ RWE. Results: All 11 REALISE member jurisdictions participated in the online survey and the first in-person workshop, 10 participated in the second in-person workshop, and 8 participated in the in-depth face-to-face interviews. The guidance document was iteratively reviewed by all working group members and the International Advisory Panel. There was substantial variation in: (a) sources and types of RWD being used in HTA; and (b) the relative importance and prioritization of RWE being used for policymaking. A list of national-level databases and other sources of RWD available in each country was compiled. A list of useful guidance on data collection, quality assurance and study design were also compiled. Conclusion: The REALISE guidance document serves to align the collection of better quality RWD and generation of reliable RWE to ultimately inform HTA in Asia.
National Public Health Surveillance of Corporations in Key Unhealthy Commodity Industries – A Scoping Review and Framework Synthesis
Authors: Bennett Elizabeth , Topp Stephanie M. , Moodie Alan Rob
Published: February 2023

Background: Corporations in unhealthy commodity industries (UCIs) have growing influence on the health of national populations through practices that lead to increased consumption of unhealthy products. The use of government-led public health surveillance is best practice to better understand any emerging public health threat. However, there is minimal systematic evidence, generated and monitored by national governments, regarding the scope of UCI corporate practices and their impacts. This study aims to synthesise current frameworks that exist to identify and monitor UCI influence on health to highlight the range of practices deployed by corporations and inform future surveillance efforts in key UCIs. Methods: Seven biomedical, business and scientific databases were searched to identify literature focused on corporate practices that impact human health and frameworks for monitoring or assessment of the way UCIs impact health. Content analysis occurred in three phases, involving (1) the identification of framework documents in the literature and extraction of all corporate practices from the frameworks; (2) initial inductive grouping and synthesis followed by deductive synthesis using Lima and Galea’s ‘vehicles of power’ as a heuristic; and (3) scoping for potential indicators linked to each corporate practice and development of an integrated framework. Results: Fourteen frameworks were identified with 37 individual corporate practices which were coded into five different themes according the Lima and Galea ‘Corporate Practices and Health’ framework. We proposed a summary framework to inform the public health surveillance of UCIs which outlines key actors, corporate practices and outcomes that should be considered. The proposed framework draws from the health policy triangle framework and synthesises key features of existing frameworks. Conclusion: Systematic monitoring of the practices of UCIs is likely to enable governments to mitigate the negative health impacts of corporate practices. The proposed synthesised framework highlights the range of practices deployed by corporations for public health surveillance at a national government level. We argue there is significant precedent and great need for monitoring of these practices and the operationalisation of a UCI monitoring system should be the object of future research.