bluuebunny/crossref_metadata_2025 huggingface dataset:
A randomized controlled trial comparing carbazochrome sodium sulfonate and tranexamic acid in reducing blood loss and inflammatory response after simultaneous bilateral total hip arthroplasty
Authors: Han Guangtao , Cai Lijun , Wang Qin , Li Qianhao , Kang Pengde
Published: November 2024

Purpose

A drug known as carbazochrome sodium sulfonate (CSS) can reduce blood loss. But, it is not known how it can prevent the development of hemostatic and inflammatory conditions in patients who undergo bilateral simultaneous total hip arthroplasty (SBTHA). This study will analyze the safety and effectiveness of combining this drug with SBTHA.

Methods

The study was conducted on 100 patients who underwent SBTHA with simultaneous total hip replacement. They were split into two groups: group B received TXA with CSS, group A received TXA with no CSS. The main observation of the study was the total blood loss, which is the most common indication of blood loss. Other secondary indicators of the study included hidden blood loss, postoperative blood transfusion rate, level of inflammatory reactants, hip function, pain score, venous thromboembolism (VTE) and the incidence of adverse events.

Results

Group B had significantly lower TBL and HBL compared to Group A. Group B showed significant improvement in inflammatory biomarker levels, blood transfusion rate when compared to Group A ( p < .05). No thromboembolic complications occurred in either group. There were no significant differences between the two groups in terms of postoperative swelling rate, intraoperative blood loss, visual analog scale pain score, platelet count, discharge motion and average length of stay.

Conclusions

As a hemostatic agent, CSS combined with TXA can reduce postoperative blood loss in patients undergoing SBTHA, and is more effective than TXA alone in terms of blood loss and inflammation, and does not increase the incidence of thromboembolic complications.
Weathering the pandemic storm: Inter-organizational imitation and hotel survival
Authors: Yang Yang , Wen Zhihong
Published: November 2024

No previous studies have provided insights into inter-organizational spillover in hotel market exit behaviors amidst great uncertainty. This study investigates the impact of local pandemic severity on hotel survival rates and identifies inter-organizational imitation moderating this effect. We conduct survival analysis on a sample of 3841 hotel properties in the U.S. state of Texas. Results confirm the detrimental roles of pandemic severity on hotel survival rates. We observe a negative spillover stemming from inter-organizational imitation based on the market exits of same-class hotel peers. Results further unveil that hotels operated by third-party management companies and high-end hotels are less likely to exhibit inter-organizational imitation in their closure responses to the pandemic.
Scenario-based capability assessment in professional learning contexts
Authors: Holdsworth Sarah , Sandri Orana , Hayes Jan , Maslen Sarah
Published: November 2024

Assessing the learning outcomes from professional learning is crucial for understanding its impact, especially for training focusing on capability development. This paper explores the benefits of using scenario-based assessments to assess the immediate capability learning outcomes in professional learning settings. Existing research underscores the complexities of assessing capability in tertiary education environments. Unlike knowledge and skills, capabilities are demonstrated in context, and their application varies with each situation which poses a challenge in their assessment. Additional challenges are imposed on the assessment of capability in professional learning contexts where professionals take time outside of their work practice to develop additional knowledge and skills. As such, they are time-constrained, and therefore in depth assessment activities suitable for university environments are not practical in professional learning contexts. This paper explores the benefits of a pre- and post-learning scenario-based assessment in professional learning contexts. It demonstrates that these assessments offer a dual advantage of formative and summative learning assessment, while also contextualising the learning assessment within professional practice, aligning with the principles of effective professional learning.
Paradigm Shifts in Education: An Ecological Analysis
Authors: Zhao (赵勇) Yong , Zhong (仲若君) Ruojun
Published: November 2024

Purpose

The purpose of this article is to analyze educational changes, in particular transformational changes, and suggest a new approach to shift the paradigm in education using an ecological conceptual framework.

Design/Approach/Methods

An ecological analysis of two key factors in education: prescribed curriculum and student autonomy.

Findings

Paradigm shift can happen in schools, but it cannot be imposed by systems, and systems typically are unable to propose transformational changes. Such changes should happen within schools, but not affecting the entire school. Thus a “school within a school” approach is proposed with some examples. The small change could affect entire systems from the perspective of panachy theory.

Originality/Value

This article brings a fresh perspective on making the much needed transformational changes possible in schools. AI partnership, personalized learning, student autonomy and self-determination, self-directed learning are all fascinating and hopeful ideas that could bring the best education possible for all students. But implementing these would demand a paradigm shift in schools. Schools are the most resilient social entities, but they are also the easiest to change organizations. For over 200 years, the essence of schooling has not changed, but there have been significant changes in curriculum, textbooks, testing, and pedagogy. Today, we need schools to operate with a different education paradigm to enable students to have more autonomy and control of their learning in order to survive and thrive in the uncertain age of Artificial Intelligence. It seems apparent that the school system has successfully resisted paradigm shifts or transformational changes.
Ibrutinib plus rituximab and mini-CHOP in older patients with newly diagnosed DLBCL: a phase 2 ALLG study
Authors: Verner Emma , Johnston Amanda , Pati Nalini , Hawkes Eliza A. , Lee Hui-Peng , Cochrane Tara , Cheah Chan Yoon , Filshie Robin , Purtill Duncan , Sia Hanlon , Enjeti Anoop K. , Brown Christina , Murphy Nicholas , Curnow Jennifer , Lee Kenneth , Gandhi Maher K. , Walia Mannu , Butcher Belinda E. , Trotman Judith
Published: November 2024

The multicenter, prospective phase 2 Australasian Leukaemia & Lymphoma Group NHL29 trial was conducted to assess the addition of ibrutinib to R-mini-CHOP (dose attenuated R-CHOP; rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) in patients aged ≥75 years with newly diagnosed diffuse large B-cell lymphoma (DLBCL). Treatment consisted of six 21-day cycles of ibrutinib–R-mini-CHOP followed by two 21-day cycles of R-ibrutinib. Coprimary end points were deliverability and 2-year overall survival (OS). The median average relative total dose and average relative dose intensity for the entire regimen were both 97% (interquartile range, 82-100 and 88-100, respectively). With a median follow-up of 35.5 months, the 2-year OS was 68% (95% confidence interval [CI], 55.6-77.4) with a 2-year progression-free survival (PFS) of 60.0% (95% CI, 47.7-70.3). Median OS and PFS were 72 months (95% CI, 35 to not reached) and 40 months (95% CI, 20.4 to not reached), respectively. The overall response rate was 76% (61/79) of patients, with a complete response rate of 71% (56/79). Deaths occurred in 34 of 79 patients (43%), including 17 from progressive disease and 5 treatment related. Overall, 67% patients experienced at least 1 serious adverse event. Most common adverse events were infections and diarrhea (the majority grade 1-2). In both health-related quality of life measures, there was an improvement in functional and symptom scales, median health state classification score, and median visual analogue scale in responders over time. In conclusion, this study showed that the addition of ibrutinib to R-mini-CHOP was both deliverable and efficacious in elderly DLBCL patients.
Bibliometric analysis of the usage of tenecteplase for stroke
Authors: Bhasin Garv , Ganti Latha
Published: November 2024

Introduction

In recent years, tenecteplase has been competing with alteplase as a treatment for acute ischemic stroke given its ease of administration, lower dosage, cost-effectiveness, and better safety data. This paper seeks to analyze academic literature regarding the burgeoning usage of tenecteplase as a treatment for acute ischemic stroke across the world.

Method

The Web of Science database was used to collect the data from articles containing the keywords “Tenecteplase” and “Stroke” published from 1999 to 2023. The search resulted in 576 journal articles. This study analyzed metadata related to the country, institution, keywords, and date published for each article in the database pertaining to tenecteplase use for stroke.

Results

The United States led in publications (260, 39.93%), followed by Australia (101, 15.51%), and a tie for third place between Canada and China (77, 11.83% each). The three most prevalent keywords were tenecteplase (N = 324), alteplase (N = 284), and thrombolysis (N = 244). The University of Melbourne and the University of Calgary were the leading institutions publishing on the use of tenecteplase as a treatment for stroke. In 2023, the number of publications on the usage of tenecteplase for stroke was the greatest, making up 24.3% of all papers on the topic.

Conclusion

The surge in academic papers regarding tenecteplase in stroke in 2023 could be a good indicator of the drug’s increasing prevalence as a treatment for stroke. Despite this finding, tenecteplase is currently not an FDA-approved therapy in the US as Genentech, the drug’s manufacturer, has yet to file for federal approval for acute ischemic stroke treatment.
Does the effect of employment protection depend on the composition of unemployment?
Authors: Bastgen Andreas
Published: November 2024

I develop an equilibrium-matching model with job rationing and endogenous layoffs in order to investigate whether the composition of unemployment (rationing versus frictional) influences the way firing costs affect employment. The model suggests that firing costs lead to a strong adverse employment effect if unemployment is mainly caused by job rationing, whereas in labor markets driven by search frictions firing costs have only a negligible impact on employment. The paper tests this hypothesis using data on the adoption of wrongful-dismissal laws adopted by U.S. state courts during the 1970s and 1980s. Results indicate that for two of the three wrongful-dismissal laws investigated, unemployment composition is crucial for the induced employment effects.
Genetic diversities and drug resistance in Mycobacterium bovis isolates from zoonotic tuberculosis using whole genome sequencing
Authors: Soliman Noha Salah , Soliman May Sherif , Khairat Sahar Mohammed , Gad Maha Ali , Shawky Sherine , Elkholy Amani Ali
Published: November 2024

Background

Zoonotic human tuberculosis (TB) caused by Mycobacterium bovis (M. bovis) is as vital as Mycobacterium tuberculosis, however with scarce available information. We aimed to use whole-genome sequencing (WGS) technology to take a deep insight into the circulating genotypes of human M. bovis and the genomic characteristics underlying virulence and drug resistance.

Methods

The study included smear positive Ziehl-Neelsen samples from patients with suspected tuberculosis. Samples were cultured on Lowenstein-Jensen media and suspected colonies of M. bovis were selected to undergo DNA extraction and WGS. Data was analysed using the Bacterial and Viral Bioinformatics Resource Center (BV-BRC), and online bioinformatics tools. A phylogenetic tree was constructed for our sequenced strains, in addition to a set of 59 previously sequenced M. bovis genomes from different hosts and countries.

Results

Out of total 112 mycobacterial positive cultures, five M. bovis were isolated and underwent WGS. All sequenced strains belonged to Mycobacterium tuberculosis var bovis, spoligotype BOV_1; BOV_11. Resistance gene mutations were determined in 100% of strains to pyrazinamide (pncA and rpsA), isoniazid (KatG and ahpC), ethambutol (embB, embC, embR and ubiA), streptomycin (rpsl) and fluoroquinolones (gyrA and gyrB). Rifampin (rpoB and rpoC) and delamanid (fbiC) resistance genes were found in 80% of strains. The major represented virulence classes were the secretion system, cell surface components and regulation system. The phylogenetic analysis revealed close genetic relatedness of three sequenced M. bovis strains to previous reported cow strains from Egypt and human strains from France, as well as relatedness of one M. bovis strain to four human Algerian strains. One sequenced strain was related to one cow strain from Egypt and a human strain from South Africa.

Conclusions

All sequenced M. bovis isolates showed the same spoligotype, but diverse phylogeny. Resistance gene mutations were detected for anti-TB drugs including pyrazinamide, isoniazid, streptomycin, ethambutol, fluoroquinolones, cycloserine, rifampin and delamanid. The virulence profile comprised genes assigned mainly to secretion system, cell surface components and regulation system. Phylogenetic analysis revealed genetic relatedness between our isolates and previously sequenced bovine strains from Egypt as well as human strains from other nearby countries in the region.
Barriers and facilitators of collaboration during the implementation of vocational rehabilitation interventions: a systematic review
Authors: Noteboom Yvonne , Montanus Alexandra W. A. , van Nassau Femke , Burchell George , Anema Johannes R. , Huysmans Maaike A.
Published: November 2024

Background

Stakeholders from the mental health care sector and the social security sector are often involved in the implementation of vocational rehabilitation (VR) interventions, so-called coordinated or integrated program, as clients need support from both fields. Collaboration of the involved stakeholders from both sectors is therefore important. In this study, a review was performed to provide an overview of the barriers and facilitators for collaboration during the implementation of coordinated or integrated vocational rehabilitation interventions.

Methods

A systematic review (PROSPERO ID CRD42023404823) was performed in the databases of Medline PubMed (n = 11.511), Web of Science (n = 4821), and PSYCINFO (n = 368). We used the AI-driven tool ASReview to support the screening process, conducted by two researchers independently. A thematic content analysis was performed to analyse the reported barriers and facilitators. Appraisal of the quality of included studies was conducted using Critical Appraisal Skills Programme (CASP).

Results

We included 105 of the 11,873 identified articles for full text screening, of which 26 were included for final analysis. Six themes of barriers and facilitators were found: attitude and beliefs, engagement and trust, governance and structure, practical issues, professionals involved, and client-centeredness. We found a reporting quality between 8 and 20, based on CASP.

Conclusion

We found that a positive attitude towards and belief of those involved in collaboration during coordinated of integrated VR interventions can enhance collaboration. Moreover, a negative attitude or lack of trust, most often found among mental health professionals, hindered collaboration. Collaboration between stakeholders from different sectors could be increased by improving positive attitudes and mutual trust and increasing knowledge about each other’s expertise. Also sharing success stories, co-location of professionals, and having a clear governance were found to be a factor in collaborations’ success.
Robotic surgery of the urothelial carcinoma of the upper urinary tract single surgeon initial experience, 66 consecutive cases
Authors: Farzat Mahmoud , Leyh-Bannurah Sami-Ramzi , Wagenlehner Florian M.
Published: November 2024

Purpose

Robotic surgery is increasingly utilized in the treatment of urothelial carcinoma of the upper urinary tract (UTUC). This study investigates the advantages and burden of robot-assisted surgical treatment of the urothelial carcinoma of the upper urinary tract in a referral urological department, along with their functional and oncological results.

Methods

The study included 66 prospectively enrolled patients who were surgically treated by a single, robotically specialized surgeon between July 2019 and December 2023. Patients were divided into three groups. Group 1: 50 patients underwent robot-assisted radical Nephroureterectomy (RANU) with bladder cuff excision, Group 2: 11 patients underwent RANU simultaneously with robot-assisted radical cystectomy (RARC), and Group 3: 5 patients underwent robot-assisted segmental ureterectomy (RASU). Clinical and oncological parameters were compared. Perioperative morbidity according to Clavien-Dindo was the primary endpoint of our study. The secondary endpoint was oncologic outcomes.

Results

37.8% of patients had locally advanced carcinomas. The average console time of RANU with bladder cuff excision was 69 min. The rate of positive surgical margins was n = 1/66 (2%). Lymphadenectomy (LAD) was performed on 30% of patients, with a mean of 13.7 lymph nodes removed. Of those who received LAD, 33% had lymph node metastasis. n = 6/66 (9%) patients received blood transfusion. The overall complication rate was 24%. The readmission rate was 7.5%. With a median follow-up of 26 months, the 2-year recurrence-free survival rate was 84.4%, and the 2-year overall survival rate was 94%.

Conclusion

Robotic surgery is a feasible option for treating UTUC that can be adapted to meet the surgical needs of each patient. Prospective studies are warranted to confirm its benefits.
Thermomechanical aging effects on vertical marginal gap and fracture resistance: a comparative study of Bioflx and traditional pediatric crowns
Authors: Abo-Elsoud Asmaa Ali Emam , Mohamady Eman Mohamed , Fathi Abdou Noha El-Sayed
Published: November 2024

Background

Various types of crowns are used for full-coverage restoration of primary teeth affected by caries, developmental defects, or after pulp therapy. Prefabricated Stainless Steel and Zirconia crowns are commonly utilized. Bioflx crowns, which blend the properties of Stainless Steel and Zirconia, provide a flexible and aesthetically pleasing alternative.

Aim

This study aimed to evaluate the vertical marginal gap and fracture resistance of Bioflx pediatric crowns compared to Zirconia and Stainless Steel crowns following thermomechanical aging.

Methods

This in-vitro study was conducted using mandibular second primary crowns of three different materials (n = 30). Crowns were divided into three groups; Zirconia crowns group (n = 10, Nu Smile, USA), Bioflx crowns group (n = 10, Nu Smile, USA) and Stainless Steel crowns group (n = 10, Nu Smile, USA). The crowns were cemented onto standardized acrylic resin dies and subjected to thermomechanical aging. Vertical marginal gap measurements were obtained using a USB digital microscope with an integrated camera, while fracture resistance was assessed with a universal testing machine. Data were analyzed for outliers and tested for normality using the Shapiro-Wilk or Kolmogorov-Smirnov tests, with statistical significance set at 0.05.

Results

Significant differences were observed in the vertical marginal gaps among the groups after cementation and thermomechanical aging (P = 0.013 and P = 0.001, respectively). Zirconia crowns exhibited the largest average marginal gap, followed by Bioflx and Stainless Steel crowns. Stainless steel crowns demonstrated the highest fracture resistance, followed by Bioflx crowns, while Zirconia crowns showed the lowest.

Conclusions

Bioflx crowns exhibit the largest vertical marginal gap but show greater fracture resistance compared to Zirconia crowns, although they are still less resistant than Stainless Steel crowns after undergoing thermomechanical aging.
Unscheduled home consultations by registered nurses may reduce acute clinic visits
Authors: Bergman Karin , Hedén Lena , Sundler Annelie J , Östman Malin , Hallgren Jenny
Published: November 2024

Background

To effectively utilize available healthcare resources, integrated care models are recommended. According to such model’s, registered nurses have the potential to increase patient access to health care services and alleviate organizational workload. Studies on acute home consultation assessments by registered nurses are sparse. The aim was to describe the reasons and actions for unscheduled same-day face-to-face registered nurse consultation at home offered to patients calling the national telephone helpline for healthcare in Sweden (SHD 1177), according to the integrated Collaborative Health Care model.

Methods

A descriptive cross-sectional study was designed. Data from registered nurses (n = 259) working within the Collaborative Health Care model, who performed unscheduled consultations at home (n = 615) using a data collection tool from 2017 to 2018 were collected.

Results

Among the 615 unscheduled home consultations performed by registered nurses, > 50% of the patients were managed at home as their health problems were not deemed as requiring a same-day referral to a clinic when assessed by the registered nurses. The most frequent health problems and reasons for contact were urinary tract problems, followed by medical and surgical conditions. Social factors, including living alone, impacted referral. Those living with a partner received care at home to a greater extent than those who lived alone.

Conclusion

An integrated model for healthcare involving registered nurses direct assessment, action and accountability seems to be an efficient option for providing integrated care at home and reducing acute clinic visits.
Economic impact case study of a wearable medical device for the diagnosis of obstructive sleep apnoea
Authors: Setters Jo , Paynter Jonathan , Hanlon Jo
Published: November 2024

Background

AcuPebble SA100 (‘AcuPebble’) is a novel wearable medical device to diagnose obstructive sleep apnoea (OSA). This paper investigates the potential economic impact of the technology in the UK through cost savings analysis, and the redirection of savings into further diagnoses.

Methods

A cost comparison study was conducted, comparing AcuPebble to the standard diagnostic approach of home respiratory polygraphy (HRP) and in-clinic polysomnography (PSG), estimating the net benefit value (NBV) and return on investment (ROI). Cohort size was varied to model the effects of volume discounted pricing and staff training costs. To demonstrate the potential for cost savings, data on the healthcare costs of undiagnosed OSA patients were used to quantify the benefit of increased OSA diagnosis rates, as facilitated by AcuPebble.

Results

For 500 uses of AcuPebble, the NBV in the diagnostic pathway over one year would be in excess of £101,169, increasing to £341,665 for 1,500 uses, £1,263,993 for 5,000 uses, and to £2,628,198 for 10,000 uses, with ROIs of 2.02, 3.03, 5.05, and 6.56, respectively. Given an initial cohort of 1,500 patients, 4,555 extra AcuPebble studies could be completed by redirecting resources from HRP/PSG. Direct cost savings to the NHS from resultant lower undiagnosed rates could be between £24,147 and £4,707,810, based on the cost per use and the percentage of tests that result in a positive diagnosis (varied from 25 to 75% positives).

Conclusions

AcuPebble presents an opportunity for substantial healthcare savings, enabling an increase in the number of people tested, diagnosed and treated for OSA.
Assessing suicidality in adult ADHD patients: prevalence and related factors
Authors: Di Salvo Gabriele , Perotti Camilla , Filippo Lorenzo , Garrone Camilla , Rosso Gianluca , Maina Giuseppe
Published: November 2024

Background

The association between Attention-deficit hyperactivity disorder (ADHD) and suicidality has been subject of growing interest for research in the latest years. Suicidality was generally assessed categorically and without the use of validated instruments, leading to heterogeneous or even conflicting evidence. The prevalence of both suicidal ideation and attempts varies considerably, and the associated risk factors remain unclear. Our study investigated suicidality in ADHD using a dimensional approach and a validated and internationally recognized instrument. Our primary aim was to evaluate the prevalence of suicidal ideation (SI), severe suicidal ideation (SSI), suicidal behavior (SB) and non suicidal self-injury behavior (NSSIB) in a sample of adult patients with ADHD. The second objective was to identify sociodemographic and clinical features associated with increased risk of suicidality in these patients.

Methods

The sample included 74 adult patients with clinical diagnosis of ADHD. Suicidality was assessed by administering the Columbia-Suicide Severity Rating Scale. Logistic regressions were used to examine predictors of SI, SSI, SB and NSSIB.

Results

The lifetime prevalence of SI and SSI were 59.5% and 16.2%, respectively. The 9.5% of patients showed lifetime SB, while NSSIB was found in 10.8% of the subjects. Lifetime SI was associated with severity of inattentive symptoms during adulthood, low self-esteem and impairment in social functioning. Lifetime SSI appeared related to severity of inattentive symptoms during childhood, attentional impulsiveness and number of hospitalizations, while physical activity appeared to be protective. The prevalence of lifetime SB and NSSIB did not appear significantly related to any socio-demographic or clinical feature.

Conclusions

Adults with ADHD should be considered at risk of suicide and it is important to determine which patients are at higher risk, in order to guide preventive interventions. The association between ADHD and suicidal ideation did not appear to be influenced by psychiatric comorbidities, but rather by inattention itself, which represents the core symptom of ADHD.
Long-term course and factors influencing work ability and return to work in post-COVID patients 12 months after inpatient rehabilitation
Authors: Müller Katrin , Poppele Iris , Ottiger Marcel , Wastlhuber Alois , Weber Rainer-Christian , Stegbauer Michael , Schlesinger Torsten
Published: November 2024

Background

Rehabilitation plays a crucial role in restoring work ability and facilitating the reintegration of post-COVID patients into the workforce. The impact of rehabilitation on work ability and return to work (RTW) of post-COVID patients remains poorly understood. This study was conducted to assess the work ability and RTW of post-COVID patients before rehabilitation and 12 months after rehabilitation and to identify physical and neuropsychological health factors influencing RTW 12 months after rehabilitation.

Methods

This longitudinal observational study included 114 post-COVID patients with work-related SARS-CoV-2 infection who underwent inpatient post-COVID rehabilitation with indicative focus on pulmonology and/or psychotraumatology (interval between date of SARS-CoV-2 infection and start of rehabilitation: M = 412.90 days). Employment status, work ability, and the subjective prognosis of employment (SPE) scale were assessed before rehabilitation (T1) and 12 months after rehabilitation (T4). The predictors analysed at T4 were functional exercise capacity, physical activity, subjective physical and mental health status, fatigue, depression, and cognitive function. Longitudinal analyses were performed via the Wilcoxon signed-rank test. Logistic and linear regression analyses identified predictors of work ability and return to work (RTW), whereas mediation analyses examined the relationships between these predictors and work ability.

Results

At T4, the median of WAI total score indicated poor work ability, which significantly worsened over time (p < 0.001; r = 0.484). The SPE scale significantly increased from T1 to T4 (p = 0.022, r = -0.216). A total of 48.6% of patients had returned to work 12 months after rehabilitation. Fatigue was identified as the main predictor of reduced work ability and RTW, with each unit increase in fatigue severity decreasing the odds of RTW by 3.1%. In addition, physical capacity and subjective health status were significant predictors of perceived work ability.

Conclusions

The findings highlight the significant challenges that post-COVID patients face in regaining work ability and achieving successful RTW 12 months after rehabilitation. Fatigue appears to be an important predictor of work ability and RTW. To optimize recovery and enhance both biopsychosocial health and work ability, it is crucial to develop and implement personalised interventions that address fatigue, improve physical capacity, and support mental health.

Trial registration

This study is registered in the German Clinical Trials Register under DRKS00022928.
Effectiveness of a psychoeducational intervention on myositis patients’ quality of life and well-being: a randomized controlled trial
Authors: Armadans-Tremolosa Imma , Palacin-Lois Maria , Castrechini-Trotta Angela , Sanduvete-Chaves Susana , Chacón-Moscoso Salvador , Selva-O’Callaghan Albert
Published: November 2024

Background

Myositis is a rare disease associated with impaired health-related quality of life. A study evaluating the effectiveness of an intervention to improve the quality of life and well-being of myositis patients is presented.

Methods

All myositis patients in a health district were contacted. Thirty-four eligible patients were randomly assigned to the experimental (n = 17) or control (n = 17) group. A psychoeducational intervention of 5 100-min sessions focusing on the disease as related to daily life was conducted only in experimental patients. Several reliable tools to measure quality of life and well-being were administered twice, before and after the intervention, to both groups.

Results

In the experimental group, post-test scores were higher than pre-test in quality of life, well-being, and self-efficacy to manage the disease. Improvements were more evident in the experimental group than controls in 70% of the variables studied. Specifically, sedentariness decreased and satisfaction with social relationships increased in the post-test evaluation to a greater degree in the experimental group than in controls.

Conclusions

This randomized controlled trial on a representative sample of myositis patients in an extensive population provides evidence indicating the effectiveness of a psychoeducational intervention for improving HRQoL, well-being, and self-efficacy to manage the disease.

Trial registration: NCT06300983.
Changes in portal pulsatility index induced by a fluid challenge in patients with haemodynamic instability and systemic venous congestion: a prospective cohort study
Authors: Ruste Martin , Reskot Rehane , Schweizer Rémi , Mayet Valentin , Fellahi Jean-Luc , Jacquet-Lagrèze Matthias
Published: November 2024

Background

It is uncertain whether fluid administration can improve patients with systemic venous congestion and haemodynamic instability. This study aimed to describe the changes in systemic venous congestion and peripheral perfusion parameters induced by a fluid challenge in these patients, and to analyse the influence of the fluid responsiveness status on these changes.

Methods

The study is a single-centre prospective cohort study of 36 critically ill ICU patients with haemodynamic instability and a maximum vena cava diameter ≥ 20 mm. Changes in cardiac index during a fluid challenge (4 mL/kg of lactated Ringer’s solution during 5 min) assessed by pulse contour analysis, central venous pressure, ultrasound systemic congestion parameters (portal venous flow pulsatility index, supra hepatic and intrarenal venous Doppler), and peripheral perfusion parameters (capillary refill time and peripheral perfusion index) were assessed in the overall population. All these data were compared between patients presenting a cardiac index increase > 10% during the fluid challenge (fluid responders) and the others (fluid non-responders).

Results

Twenty-eight (78%) patients were admitted for postoperative care following cardiac surgery; their mean ± SD left ventricular ejection fraction was 42 ± 9% and right ventricular dysfunction was found in at least 61% of the patients. The mean ± SD SOFA score was 9 ± 3. Thirteen (36%) patients were fluid responders. The fluid challenge administration induced a significant increase in portal pulsatility index, VExUS score, and central venous pressure without significant difference of these changes between fluid responders and non-responders. No significant change in perfusion parameters was observed.

Conclusion

Fluid administration in patients with haemodynamic instability and systemic venous congestion worsens venous congestion regardless of the fluid responsiveness status, without improving perfusion parameters.
Current status of bacteriophage therapy for severe bacterial infections
Authors: Sawa Teiji , Moriyama Kiyoshi , Kinoshita Mao
Published: November 2024

The increase in the incidence of antibiotic-resistant bacteria poses a global public health threat. According to a 2019 WHO report, approximately 1.27 million deaths were attributed to antibiotic-resistant bacteria, with many cases linked to specific bacterial species, such as drug-resistant Pseudomonas aeruginosa and Staphylococcus aureus. By 2050, the number of deaths caused by these bacteria is predicted to surpass that caused by cancer. In response to this serious situation, phage therapy, an alternative to antibiotic treatment, has gained attention. Phage therapy involves the use of viruses that target specific bacteria to treat infections. This method has proven effective in multiple clinical cases, particularly for patients with severe infections caused by multidrug-resistant bacteria. For example, there are reports of patients with systemic infections caused by multidrug-resistant Acinetobacter who recovered following phage administration and patients infected with panresistant Pseudomonas aeruginosa who were cured by phage therapy. A key feature of phage therapy is its high specificity. Phages infect only specific bacteria and eliminate them. However, this specificity can also be a disadvantage, as careful selection of the appropriate phage for the target bacteria is needed. Additionally, bacteria can develop resistance to phages, potentially reducing treatment effectiveness over time. Efforts are underway to select, combine, and improve phages to address these challenges. In Belgium, a national phage bank has been established, and in the United States, the University of California, San Diego, has founded Innovative Phage Applications and Therapeutics (IPATH), marking significant progress toward the clinical application of phage therapy in the country. As a result, phage therapy is emerging as a component of personalized medicine, offering a new treatment option against antibiotic-resistant bacteria. The clinical application of phage therapy is particularly important in life-saving treatments for patients with severe bacterial infections, and its use in conjunction with antibiotics could enhance therapeutic outcomes. Continued research and development of this therapy could provide hope for many more patients in the future.
Comparison of bilateral implantation of monofocal intraocular lenses with enhanced intermediate function targeting with − 2.00 D and emmetropia in moderate to high myopic Asian patients
Authors: Jeon Yoo Young , Lee Hayoung , Eah Kyu Sang , Park Nahyun , Chung Ho Seok , Kim Jae Yong , Tchah Hungwon , Lee Hun
Published: November 2024

Background

To investigate the outcomes of bilateral implantation of enhanced monofocal intraocular lenses (IOLs, ICB00) with a − 2.00 diopter (D) target in patients with moderate to high myopia and to compare the clinical outcomes of a − 2.00 D binocular target with an emmetropia target in patients who underwent cataract surgery.

Methods

In this retrospective study, we reviewed the medical records of patients who underwent uncomplicated phacoemulsification with ICB00 IOL implantation. Emmetropia (Group 1) and − 2.00 D (Group 2) were targeted in 60 and 20 eyes of 30 and 10 patients, respectively. Three months after surgery, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), and uncorrected near visual acuity (UNVA) were measured. Defocus curves were measured under the photopic condition by intervals of 0.50 D from + 0.50 D to − 4.00 D.

Results

The postoperative binocular logMAR UDVA, UIVA, and UNVA were 0.01 ± 0.03, 0.08 ± 0.11, and 0.33 ± 0.15 in Group 1 and 0.31 ± 0.13, 0.04 ± 0.05, and 0.11 ± 0.07 in Group 2, respectively. Group 2 showed a significantly superior postoperative binocular UNVA (P = 0.027) and inferior binocular UDVA (P = 0.003) than Group 1. Binocular UIVA and CDVA did not significantly differ between the groups although UIVA was better in Group 2 than in Group 1. Near glasses were needed by 66% of Group 1 and 0% of Group 2.

Conclusions

Bilateral implantation of ICB00 IOL with − 2.00 D of residual myopia is suitable for patients with moderate to high myopia to improve UDVA, UIVA, and UNVA.
The role of antibody-dependent enhancement in dengue vaccination
Authors: Aynekulu Mersha D. G. , van der Sterren I. , van Leeuwen L. P.M. , Langerak T. , Hakim M. S. , Martina B. , van Lelyveld S. F.L. , van Gorp E. C.M
Published: November 2024

Dengue is the most rapidly spreading vector-borne disease worldwide, with over half the global population at risk for an infection. Antibody-dependent enhancement (ADE) is associated with increased disease severity and may also be attributable to the deterioration of disease in vaccinated people. Two dengue vaccines are approved momentarily, with more in development. The increasing use of vaccines against dengue, combined with the development of more, makes a thorough understanding of the processes behind ADE more important than ever. Above that, due to the lack of treatment options, this method of prevention is of great importance. This review aims to explore the impact of ADE in dengue vaccinations, with the goal of enhancing potential vaccination strategies in the fight against dengue.
Association of aerobic and muscle-strengthening physical activity with chronic kidney disease in participants with hypertension
Authors: Han Yunmin , Choi Younghwan , Kim Yeon Soo
Published: November 2024

Background

In Korea, chronic kidney disease (CKD) is increasingly prevalent among adults with hypertension, of which approximately 30% of the population is affected. Despite the recognized benefits of adherence to physical activity (PA) recommendations, including aerobic and muscle-strengthening activities (MSA), the impact of such adherence on the prevalence of CKD in individuals with hypertension has not been extensively studied. This study aimed to investigate the association between aerobic PA and MSA levels, and the prevalence of CKD in individuals with hypertension.

Methods

This study included 5,078 individuals with hypertension using data from the Korean National Health and Nutrition Examination Survey (2019–2021). PA levels were measured as min/week of moderate-to-vigorous PA (MVPA) based on self-reports, and MSA was quantified as the number of days per week. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m². Logistic regression analysis evaluated the association between meeting PA guidelines and CKD after adjusting for potential confounders. Additionally, a joint analysis was conducted to assess the combined effects of MVPA and MSA on CKD.

Results

After adjusting for all covariates, higher MVPA was associated with a lower prevalence of CKD. Compared to the group with inactive, the group with MVPA 1–149 min/week had an odds ratio (OR) of 0.80 (95% confidence interval [CI], 0.61–1.05), the group that met the MVPA 150–299 min/week criteria had an OR of 0.85 (95% CI, 0.62–1.17), and the group that met the MVPA ≥ 300 min/week criteria had an OR of 0.53 (95% CI, 0.37–0.76). MSA alone did not show a significant association with CKD. In the joint analysis, the group that met the MVPA and MSA guidelines had the lowest OR of 0.54 (95% CI, 0.34–0.86), compared to the group that did not meet either.

Conclusions

MVPA was associated with the prevalence of CKD in participants with hypertension but not in those with MSA alone. However, compared with the group that did not meet both guidelines, the group that met both guidelines showed the lowest prevalence of CKD.
The p.D417N variant of TUBB4A as a possible cause of hereditary spastic paraplegia: a case report
Authors: Matteoni Enrico , Canosa Antonio , Tessa Alessandra , Natale Gemma , Gallone Salvatore
Published: November 2024

Background

Tubulins are dimeric proteins expressed in all eukaryotic cells, serving as the fundamental building blocks of microtubule filaments. The TUBB4A gene encodes the protein β-tubulin. Mutations of TUBB4A have been associated with two neurodegenerative diseases with very different clinical characteristics: dystonia type 4 (DYT4) and Hypomyelination with Atrophy of the Basal Ganglia and Cerebellum (H-ABC). Several cases of patients with H-ABC or unclassified leukoencephalopathy show spastic ataxia with or without leukodystrophy in association with mutations in exon 5 of TUBB4A gene.

Case presentation

We report the case of a 65-year-old woman who has been complaining of progressive difficulty in walking since childhood. The neurological examination revealed, among all, a spastic gait, difficulties in standing on the toes and heels, brisk deep tendon reflexes at upper limbs, clonic patellar reflexes, brisk ankle reflexes, as well as bilateral Babinski and Hoffmann sign, brisk jaw jerk and severe lower limb spasticity. NGS studies for inherited cases of spastic paraplegia revealed a novel variant of unknown significance (VUS) (c.1249A > G, p.D417N), in TUBB4A. To the best of our knowledge, this variant has not been reported in the literature or any databases in association with these diseases.

Conclusion

We report the case of a patient carrying a variant of uncertain significance (VUS) of the TUBB4A gene, showing a progressive, spastic paraparesis, supporting the extension of the phenotypic spectrum up to include spastic paraplegia.
Riverbank plastic distributions and how to sample them
Authors: Tasseron Paolo F. , van Emmerik Tim H. M. , de Winter Winnie , Vriend Paul , van der Ploeg Martine
Published: November 2024

As plastic pollution exists in aquatic ecosystems globally, monitoring its abundance and distribution has become crucial for understanding transport pathways, sources, sinks, and impacts. Riverbanks are accumulation zones for plastic, but the selection of monitoring methods is constrained by research goals, available resources, and site-specific conditions. This diversity in approaches has led to disparate datasets, highlighting the need for standardized monitoring protocols. Here, we study the spatial distribution of plastic at the riverbank scale, quantify the uncertainty of existing riverbank methods, and provide recommendations for improved monitoring based on the balance between uncertainty loss and increase in effort. We measured riverbank plastic abundance at eight Dutch riverbanks, categorizing the items using 108 item categories (River-OSPAR). For every riverbank, an area of 100 by 25 meters was subdivided into five-by-five-meter squares, resulting in 100 individual monitored sub-areas. We found riverbank plastic exhibited high spatial variability, with deposition patterns ranging from parallel to the waterline to clustered, random, or uniform (Moran’s I between -0.050 and 0.301). Individual measurements from diverse sampling protocols are 5-49 times less accurate than estimates derived from extensive sampling, highlighting the diminishing impact of specific methods with increased data collection. Lastly, our findings suggest that increasing the sampling area quickly reaches diminishing returns in terms of accuracy. Reducing the sampled area by 80% only increases the uncertainty in estimating the true plastic density by 20%. While standardized protocols are essential for data comparability, a rigid, uniform sampling approach may be less efficient and resource-intensive than a flexible (step-wise) strategy that adapts to local conditions. By demonstrating that extensive sampling can mitigate the differences between unique sampling protocols, this study promotes a shift towards flexible and efficient riverbank plastic monitoring, ultimately accelerating global efforts to combat plastic pollution.
Maximize the value of DAS VSP using full wavefields
Authors: Gao Fuchun , Liu Faqi , Zhan Ge , Malik Raheel , Calderón-Macías Carlos , Kiyashchenko Denis , Wall Jonathan
Published: November 2024

The acquisition of vertical seismic profiles (VSPs) using distributed acoustic sensing (DAS) has made VSP acquisition a robust technique and a cost-effective tool for reservoir imaging and monitoring. However, VSP acquisition also brings intrinsic challenges due to its limited spatial coverage. DAS recording typically produces data of suboptimal quality with directional sensitivity. Conventional reverse time migration imaging of primaries in DAS VSP data typically results in limited spatial coverage, particularly because events above the shallowest channel cannot be imaged at all. While it has been demonstrated that surface multiples can be complementary in imaging conventional streamer or ocean-bottom-node data, this paper shows that incorporating surface multiples as input for dynamic matching full-waveform inversion (FWI) can have a more significant impact in overcoming the intrinsic limitation and maximizing the value of DAS VSP surveys. Furthermore, the resulting FWI image from inversion has better amplitude fidelity.
The Unforgetting of Claribel Alegría
Authors: Escobar Guadalupe
Published: November 2024

This essay examines women’s perspectives on Salvadoran memory struggles that reckon with enmeshed military repression and US colonial capitalism. The two texts by Central American writer Claribel Alegría investigated here, the novel Ashes of Izalco (1966; trans. 1989) and the testimonio They Won’t Take Me Alive (1983; trans. 1987), expose the entanglements of state terror and foreign interests, providing an opportunity to critique the coffee regimes in the 1930s and the intimate apparel industry in the 1960s and 1970s, respectively. The author claims that both of Alegría’s texts can be understood as narrative acts of “unforgetting” that not only recuperate neglected labor histories often overshadowed by militarized spectacles but also break seeming silences. Consolidating critical interventions in memory studies and Marxist feminisms, the author argues that Alegría’s narratives invite an undoing of the memory paradigm premised on transnational oblivion.