bluuebunny/crossref_metadata_2025 huggingface dataset:
The contribution of adult experiences, multimorbidity and positive psychological well-being to social inequalities in health
Authors: Fancourt Daisy , Steptoe Andrew
Published: July 2024

We focus on three aspects of health inequalities. The first is the role of adult adversities such as chronic work stress, breakdown of intimate relationships, social isolation and discrimination, all of which contribute to increased morbidity and to premature mortality. These experiences are more common among less advantaged groups, so promote health inequalities. Second, we emphasize the impact of multimorbidity, the presence of two or more long-term physical and mental health conditions, on health inequalities. Inequalities in mental ill-health early in life are directly linked to later physical health inequalities, highlighting the critical importance of managing multiple conditions effectively. Third, we discuss socio-economic inequalities in protective psychological characteristics, such as purpose in life, optimism and positive well-being. These experiences are graded by education, income and occupational prestige. They are not only health protective but also malleable. Enhancing these factors through psychological and social interventions may contribute to reductions in health inequalities.
Intergenerational mobility in the UK
Authors: van der Erve Laura , Krutikova Sonya , Macmillan Lindsey , Sturrock David
Published: July 2024

Intergenerational mobility is a subject of a large literature in social science. In this commentary, we review existing evidence for the UK and present some new estimates for England using novel administrative and survey data spotlighting some of recent directions in intergenerational mobility research within economics driven by changes in several key trends in the recent decades, as well as growing availability of administrative data.
Inequality, firms, ownership and governance
Authors: Mayer Colin
Published: July 2024

Levels of productivity have been low in the UK since the financial crisis of 2008 for two reasons. First, the UK has a highly centralized banking sector that provides predominantly short-term working capital. As a result, small- and medium-sized enterprises are dependent on equity sources to fund their creation and expansion that are not readily available outside of London. Second, ownership of listed companies in the UK is exceptionally dispersed amongst global short-term asset management firms. This has had adverse consequences for productivity and inequality within as well as between firms and regions.
Early childhood inequalities
Authors: Cattan Sarah , Fitzsimons Emla , Goodman Alissa , Phimister Angus , Ploubidis George B , Wertz Jasmin
Published: July 2024

While there is widespread agreement in societies like the UK that every child has the right to a secure childhood and the opportunity to develop to their full potential, this does not match with reality for many of the 4 million children under the age of 5 years currently living in the UK. This article draws on existing evidence and presents new UK-focused analysis on the nature, magnitude, evolution and long-term implications of early childhood inequalities. Reflecting on this evidence, the article provides a critical appraisal of how policy aimed at supporting very young children and their families has fared in terms of reducing inequality. Reflecting on this evidence, the article provides a critical appraisal of how policy aimed at supporting very young children and their families has fared in terms of reducing inequality. The evidence presented in the article gives a motivating call to policy to support the complex needs of parents of infants and young children, alongside addressing the structural inequalities that can have devastating long-term consequences for children.
The inclusive entrepreneurial state: collective wealth creation and distribution
Authors: Mazzucato Mariana
Published: July 2024

This commentary explores how a new theory of value creation has implications for the distribution of that value. It argues that different theories of value creation lead to different resource allocations and different justifications for them. Thus, to achieve a more equitable distribution of value, a new theory of how that value is created in the first place is needed. This new theory should recognize that value is created collectively, not only by business but also by government and civil society. The state, while predominantly portrayed in traditional economics as a market fixer, has instead often been responsible for actively shaping and creating markets, not just fixing them. Indeed, the most successful capitalist economies have had proactive states that made risky investments, many of which led to technological revolutions. A better understanding of the state's role as a lead risk-taker and innovator (the ‘entrepreneurial state’) can thus also enable a more socially equitable distribution of value.
Living at the sharp end of socio-economic inequality: everyday experiences of poverty and social security receipt
Authors: Patrick Ruth
Published: July 2024

This commentary explores lived experiences of social security and poverty, drawing on qualitative data generated over 11 years, and across four research studies. The research shows clearly the relational harms caused by poverty, inequality and social security delivery which is highly conditional and too often fails to treat individuals with dignity and respect. The commentary details the misrecognition and disrespect that routinely feature in claimants encounters with social security, and sets out the importance of policy change that encompasses both redistribution and recognition of the very real contributions made by people experiencing poverty. It is also vital to centre reforms that focus on the relational dimension of social security receipt, and improvements herein.
CANTATAdb 3.0: An Updated Repository of Plant Long Non-Coding RNAs
Authors: Szcześniak Michał Wojciech , Wanowska Elżbieta
Published: July 2024

CANTATAdb 3.0 is an updated database of plant long non-coding RNAs (lncRNAs), containing 571,688 lncRNAs identified across 108 species, including 100 Magnoliopsida (flowering plants), a significant expansion from the previous version. A notable feature is the inclusion of 112,980 lncRNAs that are expressed specifically in certain plant organs or embryos, indicating their potential role in development and organ-specific processes. In addition, CANTATAdb 3.0 includes 74,886 pairs of evolutionarily conserved lncRNAs found across 47 species and inferred from genome–genome alignments as well as conserved lncRNAs obtained using a similarity search approach in 5,479 species pairs, which would further aid in the selection of lncRNAs for functional studies. Interestingly, we find that conserved lncRNAs with tissue-specific expression patterns tend to occupy the same plant organ across different species, pointing toward conserved biological roles. The database now offers extended search capabilities and downloadable data in popular formats, further facilitating research on plant lncRNAs.
Buprenorphine for acute pain in older adults: a systematic review with meta-analysis
Authors: Selman Katherine , Perelman Sarah , Blatcher Caroline , Fett David , Adams Amanda , Roberts Brian
Published: July 2024

Background

Buprenorphine, a partial opioid agonist, has emerging evidence as an alternative to full agonist opioids for treatment of acute pain. This systematic review aimed to evaluate the safety and efficacy of buprenorphine for acute pain in older adults.

Methods

PubMed Medline, Embase, Cochrane Central Register of Controlled Trials, CINHAL, Web of Science database, and Google Scholar were searched. We included articles that reported buprenorphine as an intervention to treat acute pain among patients 60 years or older. Primary outcome was difference in pain scores for patients treated with buprenorphine compared to other analgesia. Secondary outcomes included adverse events, opioid consumption, and patient satisfaction. Meta-analysis was conducted on difference in pain scores and differences in nausea and vomiting.

Results

Twenty-two studies were included (n = 2610). Buprenorphine was administered as nerve blocks in 6 studies, transdermal in eight, intravenous or intramuscular in 5, sublingual in 2 studies, and both intravenous and sublingual in one study. 10 out of 20 (50%) studies found improved pain control in buprenorphine groups. Meta-analysis found no significant difference in pain scores between buprenorphine and control analgesia at 24 hours [Cohen’s d = −0.29 (95% confidence interval (CI) −0.85 to 0.27)] and 7 days [Cohen’s d = −0.89 (95% CI −2.66 to 0.88)]. Six studies (54.5%) found reduced opioid consumption in patients receiving buprenorphine. There was no difference in adverse effects in most studies.

Conclusions

This review did not find buprenorphine to be superior to alternative analgesia; however, the mixed results provide scientific rationale for future studies testing buprenorphine in older populations.
A Culture Shift for Excellence in Physical Therapy: Promoting Equity Through the Structural Determinants of Health
Authors: Bell Karla A , Adams Tiffany
Published: July 2024

The purpose of this perspective is to discuss the imperative for curricular change that focuses on the utilization of structural competency to promote excellence in physical therapist professional education, transform society, and achieve health equity. Pedagogy centered around biomedical and social determinants of health (SDOH) models are limited in that they lack self-reflexivity, encode social identities like race and gender as risk factors for poor health, fail to examine structural causes of health inequity, conflate SDOH and the structural forces that shape their unequal distribution, and overlook instances of injustice. Promoting health equity will require structural competency, an approach that considers drivers of health beyond the individual and their conditions of daily living (ie, SDOH). Utilizing this approach in physical therapist professional education will help learners understand the evolving needs of society in a deeper, more holistic way: one that considers structural determinants of health as the primary drivers of health equity and inequity.

Impact

This paper provides a perspective on how physical therapist professional education can promote health equity for all by embracing an equity-focused, structurally competent pedagogy/approach.
Technologies for retrospective radiation dosimetry
Authors: Narayan Pradeep
Published: July 2024

Radiation dosimetry is an important task for assessing the biological damages created in human being due to ionising radiation exposure. Ionising radiation being invisible and beyond the perception of human natural sensors, the dosimetry equipments/systems are the utmost requirement for its measurement. Retrospective measurement of radiation doses is a challenging task as conventional radiation dosemeters are not available at the exposure site. The material/s in close proximity of exposed individual or individuals’ biological samples may be used as retrospective radiation sensor for dosimetry purpose. Environment materials such as sand, bricks, ceramics, sand stones, quartz, feldspar, glasses and electronic chips have been utilised using TL (Thermoluminescence) techniques for retrospective gamma dose (min 10 cGy) measurement. Electron Spin Resonance techniques have been employed to human biological samples such as tooth enamel, bones, nails, hair, etc. and reported for dosimetry for ~20 cGy min dose measurement. Some commercial glasses have been found sensitive enough to measure the minimum gamma doses of the order of 100 cGy using TL techniques. For internal retrospective dosimetry, the radioactivity contamination assessment in food items, water, other edible product and ambient air are the prerequisites. The radioactivity concentration vis-à-vis their consumption rate may help in controlling the internal contamination and estimation of dose absorption in human body. Defence Laboratory, Jodhpur has been working extensively on the dosimetry techniques for external dose measurement using environmental material and developed portable contamination monitoring systems for food and water radioactivity measurement in the range of 50 Bq kg−1 to 1000 kBq kg−1 in 60 s measurement time. The recent research and development in the methodologies, equipments and systems undertaken towards capacity building and self-reliance in retrospective radiation dosimetry is reported in this paper.
A study of 222Rn/220Rn exhalation rate and indoor 222Rn/220Rn levels in higher Himalayan terrain
Authors: Sajwan Rohit Singh , Joshi Veena , Kumar Naresh , Ahamad Taufiq , Dutt Sanjay , Lavanya Bevinathalapura Shankarappa Kempalingappa
Published: July 2024

The noble radioactive gas radon and its isotope thoron dominate terrestrial radiation in the indoor environment. These gases eventually disintegrate generating radioactive ions that readily adhere to aerosol particles. This study was conducted in a tectonically active location with significant radon concentrations. The obtained average values of radon mass exhalation and thoron surface exhalation rate from this study are higher than the global average values of 56 mBq kg−1 h−1 and 1000 mBq m−2 s−1, respectively. As the exhalation rates are higher, naturally the average radon and thoron concentrations are also greater than the worldwide average values of 40 and 10 Bq m−3, respectively. No significant correlation was observed between 222Rn and 220Rn exhalation rate and indoor 222Rn/220Rn concentration. The exposure dose due to 222Rn, 220Rn and their progenies shows no significant health risk.
Study on seasonal variation of radon, thoron, and their progeny levels in indoor environments and their radiological effects on human health
Authors: Srinivasa Erathimmaiah , Suresh Shesha , Rangegowda Rangaswamy Devagondanahalli , Sannappa Jadiyappa
Published: July 2024

Indoor radon (222Rn), thoron (220Rn) and their progeny concentrations have been measured in different types of buildings at different locations in different dwellings in different seasons in Hassan city, Karnataka, using time-integrated passive radon dosemeters containing LR-115 Type II solid-state nuclear track detectors. The annual effective dose due to radon and thoron has been estimated. The activity concentrations were observed to be highest in winter and lowest in summer, and the data also shows that bathrooms and kitchens have significantly higher radon-thoron concentrations and annual effective doses.
Analysis of 115In(n,γ)116mIn reaction cross-section and covariance for 13.52 MeV and 14.54 MeV neutron induced energies
Authors: Aladahalli Madegowda Sunitha , Basavanna Rudraswamy , Nagaraja Kamsali
Published: July 2024

Neutron induced reactions play a vital role in the field of nuclear and particle physics. An effort was made to study the neutron-induced reaction cross-section of 115In(n,γ)116mIn with 197Au(n,γ)198Au as monitor reaction and carried out the reaction for the neutron energies of 13.520 ± 0.005 and 14.54 ± 0.24 MeV. The neutrons obtained from the D-T fusion reaction of Purnima neutron generator were used for the activation of the given reaction and the monitor. The covariance analysis and the partial uncertainties due to various attributes were utilised for estimating the uncertainty propagation and hence obtained the correlation for measured reaction cross-sections. The measured reaction cross-sections have been validated with earlier reported data from EXFOR, ENDF data of various libraries, and also theoretically calculated the values of the TALYS-1.9 code.
Incongruence in Perceptions of Pain: Associations with Mental Health in Couples Living with Fibromyalgia
Authors: Grafft Natalie , Lyons Karen S
Published: July 2024

Guided by the theory of dyadic illness management, this study examined the association between the within-couple incongruence regarding perceptions of pain experienced by adults with fibromyalgia (AwFM) and symptoms of depression and anxiety in AwFM and their partners. Participants included 204 couples. Three second-order dyadic variables were created from the couples’ perceptions of pain interference experienced by AwFM: (1) absolute magnitude of incongruence in perception of pain, (2) average perception of pain, and (3) direction of incongruence (i.e., who perceives pain to be higher). Structural equational modeling was used to examine the association between the three dyadic variables and AwFM and partner symptoms of depression and anxiety, adjusting for covariates. These steps were repeated for pain severity. Higher average perception of pain interference within the couple was associated with greater symptoms of depression and anxiety in AwFM and partners. AwFM exhibited greater symptoms of depression when their perception of their pain interference was higher than their partner’s. Incongruence variables were not significantly associated with AwFM or partners’ anxiety symptoms. Near identical results were found for pain severity. A dyadic approach to mental health treatment, which includes enhanced communication skills, should be adopted to optimize the mental health of couples living with fibromyalgia.
Postbiotic lactobacilli induce cutaneous antimicrobial response and restore the barrier to inhibit the intracellular invasion of Staphylococcus aureus in vitro and ex vivo
Authors: Dinić Miroslav , Burgess Jamie L. , Lukić Jovanka , Catanuto Paola , Radojević Dušan , Marjanović Jelena , Verpile Rebecca , Thaller Seth R. , Gonzalez Tammy , Golić Nataša , Strahinić Ivana , Tomic‐Canic Marjana , Pastar Irena
Published: July 2024

Intracellular pathogens including Staphylococcus aureus contribute to the non‐healing phenotype of chronic wounds. Lactobacilli, well known as beneficial bacteria, are also reported to modulate the immune system, yet their role in cutaneous immunity remains largely unknown. We explored the therapeutic potential of bacteria‐free postbiotics, bioactive lysates of lactobacilli, to reduce intracellular S. aureus colonization and promote healing. Fourteen postbiotics derived from various lactobacilli species were screened, and Latilactobacillus curvatus BGMK2‐41 was selected for further analysis based on the most efficient ability to reduce intracellular infection by S. aureus diabetic foot ulcer clinical isolate and S. aureus USA300. Treatment of both infected keratinocytes in vitro and infected human skin ex vivo with BGMK2‐41 postbiotic cleared S. aureus. Keratinocytes treated in vitro with BGMK2‐41 upregulated expression of antimicrobial response genes, of which DEFB4, ANG, and RNASE7 were also found upregulated in treated ex vivo human skin together with CAMP exclusively upregulated ex vivo. Furthermore, BGMK2‐41 postbiotic treatment has a multifaceted impact on the wound healing process. Treatment of keratinocytes stimulated cell migration and the expression of tight junction proteins, while in ex vivo human skin BGMK2‐41 increased expression of anti‐inflammatory cytokine IL‐10, promoted re‐epithelialization, and restored the epidermal barrier via upregulation of tight junction proteins. Together, this provides a potential therapeutic approach for persistent intracellular S. aureus infections.
G protein‐coupled receptor‐mediated signaling of immunomodulation in tumor progression
Authors: Qiu Guang‐Hong , Yu Bin , Ma Mei
Published: July 2024

G protein‐coupled receptors (GPCRs) are essential contributors to tumor growth and metastasis due to their roles in immune cell regulation. Therefore, GPCRs are potential targets for cancer immunotherapy. Here, we discuss the current understanding of the roles of GPCRs and their signaling pathways in tumor progression from an immunocellular perspective. Additionally, we focus on the roles of GPCRs in regulating immune checkpoint proteins involved in immune evasion. Finally, we review the progress of clinical trials of GPCR‐targeted drugs for cancer treatment, which may be combined with immunotherapy to improve treatment efficacy. This expanded understanding of the role of GPCRs may shed light on the mechanisms underlying tumor progression and provide a novel perspective on cancer immunotherapy.
Psychiatric-Mental Health Nurse Educators’ Perceptions of Teaching Dissociative Disorders: A Reflexive Thematic Analysis
Authors: Snyder Briana L. , Curran Mary Sharon , Cooney Caroline
Published: July 2024

BACKGROUND AND PURPOSE

Although the prevalence of dissociative disorders (DDs) is up to 10 percent of the general population, psychiatric-mental health (PMH) registered nurses lack education on how to care for individuals diagnosed with these disorders.

METHOD

Sixty-two PMH nurse educators completed an anonymous online survey about their perceptions of teaching DDs to nursing students. Braun and Clarke’s six-phase framework was used to conduct an inductive, reflexive thematic analysis of the data.

RESULTS

Three primary themes were identified: lack of resources, differing opinions on the value of teaching DDs, and stigma.

CONCLUSION

Though roughly 75 percent of participants reported that they teach DDs to their nursing students, they endorsed concerning misperceptions about the diagnoses. By failing to properly educate future PMH RNs about DDs, individuals with DDs are at risk of receiving inadequate and inappropriate nursing care and experiencing poor outcomes.
Screw Configuration Does Not Significantly Alter Neck Shortening After Valgus-Impacted Femoral Neck Fracture (OTA Type 31B1.1)
Authors: DeClouette Brittany , Resad Ferati Sehar , Kingery Matthew T. , Egol Kenneth A.
Published: July 2024

OBJECTIVES:

To compare 3 different cancellous screw configurations used for Garden 1 femoral neck fractures (FNFs).

METHODS:

Design:

Retrospective review.

Setting:

A large urban academic medical center.

Patient Selection Criteria:

All patients with Orthopaedic Trauma Association 31B1.1 FNF who underwent in situ fixation with cancellous screws between 2012 and 2021 were included. Patients were divided into 3 groups: 2 screws placed in a parallel fashion, 3 screws placed in an inverted triangle configuration, and 3-screw fixation with placement of 1 “out-of-plane” screw perpendicular to the long axis of the femur.

Outcome Measures and Comparisons:

Postoperative femoral neck shortening (mm) was the primary outcome, which was compared among the 3 groups of different screw configurations.

RESULTS:

Sixty-one patients with a median follow-up of 1 year (interquartile range 0.6–1.8 years) and an average age of 72 years (interquartile range 65.0–83.0 years) were included. All fractures demonstrated bony healing. Overall, 68.9% of the cohort had ≤2 mm of femoral neck shortening. There was no difference between groups in the proportion of patients who experienced greater than 2 mm of shortening (P = 0.839) or in the amount (mm) of femoral neck shortening (Kruskal–Wallis χ2 = 0.517, P = 0.772).

CONCLUSIONS:

Although most patients with valgus-impacted FNF treated with screw fixation do not experience further femoral neck shortening, some patients demonstrated continued radiographic shortening during the healing process. The development of further femoral neck shortening and the amount of shortening that occurs do not differ based on implant configuration. Multiple different screw configurations seem to be acceptable for achieving healing and minimizing further femoral neck impaction.

LEVEL OF EVIDENCE:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Is oral nano-curcumin formulation a safe and effective measure for preventing cisplatin-induced nephrotoxicity in cancer patients?
Authors: Hosseini Sare , Rahsepar Sara , Naghipour Sara , Elyasi Sepideh
Published: July 2024

Nephrotoxicity is one of the most important complications in cancer patients under treatment with cisplatin-containing regimens. Curcumin, as the most important active component of Curcuma longa, is an antioxidant and anti-inflammatory compound. In this clinical trial, we assessed the preventive effect of nano-curcumin oral formulation against cisplatin-induced nephrotoxicity in cancer patients. In this triple-blind clinical trial 30 cancer patients on cisplatin were randomly included in the treatment group, receiving nano-curcumin 40 mg capsules (n = 15) or the placebo group (n = 15) twice a day during four chemotherapy courses. Kidney function was measured at the beginning of the study and then at the end of each course of chemotherapy. There was no significant difference in acute kidney injury occurrence rate and creatinine and blood urine nitrogen serum levels between the treatment and placebo groups at the end of each chemotherapy course (P value >0.05). Just at the end of the first course, the difference was close to significant (P = 0.055). We also found no difference in mortality and recurrence rate in an average 30-month follow-up. Nano-curcumin in the prescribed dose and duration was not effective in preventing cisplatin-induced nephrotoxicity in cancer patients in comparison with the placebo. Further studies with larger sample size using different doses and duration of nano-curcumin are recommended.
Lung Protective Ventilation Adherence and Outcomes for Patients With COVID-19 Acute Respiratory Distress Syndrome Treated in an Intermediate Care Unit Repurposed to ICU Level of Care
Authors: Hochberg Chad H. , Case Aaron S. , Psoter Kevin J. , Brodie Daniel , Dezube Rebecca H. , Sahetya Sarina K. , Outten Carrie , Street Lara , Eakin Michelle N. , Hager David N.
Published: July 2024

OBJECTIVE:

During the COVID-19 pandemic, some centers converted intermediate care units (IMCUs) to COVID-19 ICUs (IMCU/ICUs). In this study, we compared adherence to lung protective ventilation (LPV) and outcomes for patients with COVID-19-related acute respiratory distress syndrome (ARDS) treated in an IMCU/ICU versus preexisting medical ICUs (MICUs).

DESIGN:

Retrospective observational study using electronic medical record data.

SETTING:

Two academic medical centers from March 2020 to September 2020 (period 1) and October 2020 to May 2021 (period 2), which capture the first two COVID-19 surges in this health system.

PATIENTS:

Adults with COVID-19 receiving invasive mechanical ventilation who met ARDS oxygenation criteria (Pao
2/Fio
2 ≤ 300 mm Hg or Spo
2/Fio
2 ≤ 315).

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

We defined LPV adherence as the percent of the first 48 hours of mechanical ventilation that met a restrictive definition of LPV of, tidal volume/predicted body weight (Vt/PBW) less than or equal to 6.5 mL/kg and plateau pressure (Pplat) less than or equal to 30 cm H2
o. In an expanded definition, we added that if Pplat is greater than 30 cm H2
o, Vt/PBW had to be less than 6.0 mL/kg. Using the restricted definition, period 1 adherence was lower among 133 IMCU/ICU versus 199 MICU patients (92% [95% CI, 50–100] vs. 100% [86–100], p = 0.05). Period 2 adherence was similar between groups (100% [75–100] vs. 95% CI [65–100], p = 0.68). A similar pattern was observed using the expanded definition. For the full study period, the adjusted hazard of death at 90 days was lower in IMCU/ICU versus MICU patients (hazard ratio [HR] 0.73 [95% CI, 0.55–0.99]), whereas ventilator liberation by day 28 was similar between groups (adjusted subdistribution HR 1.09 [95% CI, 0.85–1.39]).

CONCLUSIONS:

In patients with COVID-19 ARDS treated in an IMCU/ICU, LPV adherence was similar to, and observed survival better than those treated in preexisting MICUs. With adequate resources, protocols, and staffing, IMCUs provide an effective source of additional ICU capacity for patients with acute respiratory failure.
Temporary Intravascular Shunting Using a Pruitt-F3 Carotid Shunt for Traumatic Popliteal Artery Injury
Authors: Izawa Yuta , Murakami Hiroko , Sato Kazuo , Minegishi Mizuki , Tsuchida Yoshihiko
Published: July 2024

Temporary intravascular shunting (TIVS) is an effective method to shorten the duration of ischemia and contribute to limb salvage in the treatment of popliteal artery injury (PAI). Traditionally used shunt tubes require ligation or clamping to the blood vessel, which has the disadvantage of causing secondary damage to the vessel. We present two cases in which TIVS was performed using the Pruitt-F3 Carotid Shunt (LeMaitre Vascular Inc., Burlington, Mass.) for traumatic PAI and report the effectiveness of the method. Two patients diagnosed with PAI had pallor of the feet and complete motor and sensory paralysis. The patients were immediately transferred to the operating room. PAI was confirmed in one patient by the medial approach and in the other by the posterior approach. In both patients, the vascular injury extended to the vicinity of the bifurcation into the anterior tibial artery. TIVS was performed using a 9Fr Pruitt-F3 Carotid Shunt. In both patients, the color tone of the feet improved. No vascular damage occurred secondary to TIVS. The popliteal artery was reconstructed using a great saphenous vein graft on the contralateral lower extremity, and the limb was salvaged. If the artery is injured near its bifurcation, it may be possible to preserve the branch vessel by using the Pruitt-F3 Carotid Shunt for TIVS.
Expert Consensus Recommendations for the Management of Ocular Surface Inflammation in Patients With Glaucoma
Authors: Messmer Elisabeth M. , Baudouin Christophe , Benitez-Del-Castillo José-Manuel , Iester Michele , Anton Alfonso , Thygesen John , Topouzis Fotis
Published: July 2024

Précis:

We have developed through a consensus process 24 clinical recommendations for the comprehensive management of ocular surface inflammation in glaucoma patients, including diagnostic criteria, prevention measures, and treatment strategies according to ocular surface disease severity.

Purpose:

To obtain expert consensus on the diagnosis, prevention, and management of ocular surface inflammation (OSI) in patients with glaucoma.

Methods:

An international steering committee of glaucoma and/or ocular surface disease (OSD) experts and a wider faculty of members from the Educational Club of Ocular Surface and Glaucoma (ECOS-G) collaborated to develop clinical recommendations on best practice in the management of OSI in glaucoma patients using a nonanonymous interactive quasi-Delphi process. Clinical recommendations were formulated by the steering committee based on an analysis of the recent literature to determine unmet needs, together with a web-based interactive survey of faculty members’ opinion in seven identified areas of OSI management in glaucoma. Topics included (1) diagnosis of OSD, (2) diagnosis of OSI, (3) causes of OSI, (4) impact of OSD/OSI, (5) prevention of OSI, (6) treatment of OSI, and (7) inflammation and the deep structures of the eye. Faculty members were invited to vote on the clinical recommendations, and the steering committee then determined whether consensus had been achieved.

Results:

Consensus was obtained on 24 clinical recommendations by 80%–100% of faculty members. There was consensus that OSI should be investigated in all glaucoma patients. The main prevention measure in glaucoma patients with pre-existing OSD was the elimination/minimisation of preserved medications, especially BAK-preserved eye drops. A subtractive treatment strategy rather than an additive strategy is recommended according to OSI/OSD severity to improve the ocular health and/or before glaucoma surgery.

Conclusion:

These recommendations for the management of OSI in glaucoma should be useful to guide decision-making in clinical practice.
Liver resection had better disease-free survival rates compared with radiofrequency ablation in hepatocellular carcinoma: a meta-analysis based on randomized clinical trials
Authors: Yeo Yee-Hui , Kang Yi-No , Chen Chiehfeng , Lee Teng-Yu , Yeh Chun-Chieh , Huang Tsai-Wei , Wu Chun-Ying
Published: July 2024

Background:

Liver resection (LR) and radiofrequency ablation (RFA) are the most commonly used treatment modalities for early-stage hepatocellular carcinoma (ES-HCC). The comparative efficacy of LR and RFA in ES-HCC remains debated. The authors conducted a meta-analysis based on randomized trials to compare the outcomes of LR and RFA.

Methods:

The authors searched PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov for randomized controlled trials (RCTs) comparing RFA and LR interventions for the treatment of ES-HCC. The primary outcomes were overall survival (OS) and disease-free survival (DFS). The authors used meta-regression to determine the source of heterogeneity and conducted a trial sequential analysis to examine whether the outcome was statistically reliable.

Results:

Our meta-analysis included nine RCTs with a total of 1516 HCC patients. Compared with patients receiving RFA, those receiving LR did not have significantly different 2-year OS (HR=1.28, 95% CI: 0.73–2.23) and 5-year OS (HR=1.49, 95% CI: 0.99–2.24). However, patients receiving LR showed a favorable trend in 2-year DFS (HR=1.40, 95% CI: 1.16–1.69) and 5-year DFS (HR=1.37; 95% CI: 1.05–1.77), although these results are not conclusive due to underpowered significance. The heterogeneity was low, and the outcomes were statistically reliable.

Discussion:

Meta-analysis suggests that while LR shows a favorable trend in DFS compared to RFA for ES-HCC, the present evidence does not thoroughly support recommending LR over RFA. The inconclusive nature of these findings highlights the need for further large-scale RCTs to establish definitive comparative efficacy.
The Impact of Graduate Record Exam Threshold Scores in Disqualifying Underrepresented Ethnic–Racial Minority Applicants for Admission to a Doctor of Physical Therapy Program
Authors: Coleman-Salgado Bryan , Moore Brian
Published: July 2024

Introduction.

A growing number of graduate-level health professions education programs in the United States are discontinuing the use of the Graduate Record Exam (GRE) in their admissions requirements amidst concerns that its use puts Underrepresented Racial Minority (URRM) applicants at a disadvantage. This retrospective cross-sectional study analyzes the association between ethnic–racial selection and the reasons for disqualification among applicants to a public Doctor of Physical Therapy (DPT) program that used a minimum grade point average (GPA), and Analytic Writing and Quantitative Reasoning GRE minimum threshold scores to qualify applicants.

Review of Literature.

There is evidence across the health professions literature that both GRE scores and GPA are associated with success on licensure examinations and academic performance. However, these variables also tend to disadvantage URRM applicants in gaining admissions to postgraduate health care fields, including physical therapy.

Subjects.

All applicants (N = 4,797) to a single DPT program from a 9-year period were included.

Methods.

Racial and ethnic self-selections, GRE scores, and prerequisite GPA were coded for each applicant and classified for meeting qualifying criteria.

Results.

The URRM applicants were disqualified based on GRE scores alone (P < .001) and in combination of GRE and GPA at a statistically significantly (P < .001) higher rate than Overrepresented Racial Group (ORRG) applicants, although the associations were negligible or weak.

Conclusion.

Compared with ORRG applicants, URRM applicants were at a statistically significant disadvantage because of the GRE threshold scores requirement. Furthermore, this study demonstrated that use of GRE minimum threshold scores disproportionately reduced URRM applicants in the qualified applicant pool. This investigation can be used as a model to inform holistic admission decisions regarding the use of academic variables to achieve the diversity and success goals of the program.
Survivorship Experiences of Allogeneic Hematopoietic Stem Cell Transplantation Survivors
Authors: Ruan Jiayin , Cheng Huilin , Liu Qi , Xu Fen , Kwok Wilson Yeung Yuk , Luo Dan , Qian Ying , Cheung Denise Shuk Ting , Li Hangting , Yeung Wing Fai
Published: July 2024

Background

The number of allogeneic hematopoietic stem cell transplantation (allo-HSCT) survivors is increasing globally. Although qualitative studies in this population are reported, clear understanding of how allo-HSCT survivors experience survivorship is lacking.

Objective

This study aimed to identify, appraise, and synthesize evidence from qualitative research on survivorship experience among allo-HSCT survivors.

Methods

A qualitative systematic review was conducted. A literature search of 9 databases and OpenGrey, Google Scholar, and Google was performed from inception to February 2023. Two reviewers independently screened and assessed the eligibility of each study. Descriptive information was extracted from the studies by one reviewer and checked by another. Findings were extracted and analyzed using thematic synthesis.

Results

Seventeen articles were included. Four themes and 12 subthemes regarding allo-HSCT survivors’ experiences emerged: (1) recovery as being a longer process than they thought (influenced by long-term physical symptoms, disturbed by survivorship uncertainty); (2) experiencing a restricted survivorship life (shrunken social world, forced dietary limitations, centered around hospitals); (3) suffering from stigma and discrimination (perceived as a burden, seen differently by others, difficulties establishing and maintaining romantic relationships and marriage, limited opportunities in work); and (4) realizing something positive obtained during survivorship (enriched survivorship self-management skills, enhanced personal growth, developed positive relationships).

Conclusions

The findings reveal the challenges, needs, and growth that allo-HSCT survivors experienced during survivorship. Some understudied areas were identified, which warrant further exploration.

Implications for Practice

Targeted survivor-centered care should be provided to allo-HSCT survivors, and interventions to resolve issues experienced during survivorship should be developed.
Effect of a Web-Based Integrative Support Intervention to Improve Family Caregiver Positive Caregiving Experience and Quality of Life
Authors: Lu Shu-Hua , Yiin Jia-Jean , Lin Yun-Ping , Lee Kwo-Chen
Published: July 2024

Background

Cancer caregivers experience significant stress due to their multifaceted role. Current support methods are limited by unidimensional assessments.

Objective

The aim of this study was to evaluate a Web-based support system aimed at reducing caregiver stress and anxiety, and improving resilience, vigilance, and quality of life, using both subjective and objective measures.

Methods

A randomized controlled trial with a single-center, 2-arm parallel design and longitudinal assessment was conducted in Taiwan. Caregivers of patients recently diagnosed with cancer were randomly allocated to either a standard care group or an intervention group that received enhanced nurse-led support. Metrics including psychological resilience, caregiver burden, anxiety, quality of life, stress levels, and vigilance were systematically evaluated on a monthly basis over a period of 5 months, starting from the initial baseline measurement.

Results

Following the intervention, participants in the intervention group exhibited statistically significant reductions in caregiver burden and anxiety, alongside a notable improvement in resilience. Objective evaluations revealed a significant reduction in stress levels within this group. However, there were no discernible differences in vigilance and quality of life metrics between the intervention and control groups.

Conclusion

The Web-based program effectively reduced caregiver stress and burden, as indicated by multiple metrics.

Implications for Practice

This accessible and efficient Web-based support is beneficial for cancer caregivers facing diverse challenges.
Instruments for Evaluating Student Learning Outcomes in Palliative Care
Authors: Lippe Megan P. , Wingett Gabrielle , Davis Andra , Jizba Theresa , Ehrlich Olga , Cormack Carrie L. , Fasolino Tracy , Glover Toni L. , Meskis Susan , LeBlanc Raeann G. , Weiss Dan , Kirkpatrick Amanda J.
Published: July 2024

Primary palliative care is a core component of nursing practice for which all students must receive formal education. Through competency-based education, nursing students develop the knowledge, attitudes, and skills to deliver quality primary palliative care before they transition to practice. Nurse educators in academic and practice settings should use reliable and valid means to evaluate student learning across cognitive, affective, and psychomotor domains. Expert faculty conducted a literature review to identify published instruments that evaluate primary palliative care student learning outcomes. Selected articles were required to include instrument reliability, validity, or both. The literature search yielded 20 articles that report on the development and testing of 21 instruments. Findings are organized into 3 learning domains that encompass 5 outcomes. Four instruments assess knowledge within the cognitive domain. In the affective domain, 3 instruments assess attitudes about caring for seriously ill or dying patients, 7 assess attitudes about death, and 5 assess self-efficacy. Competence and competency are evaluated in the psychomotor domain with 4 tools. Instrument implementation considerations within each domain are discussed. Faculty are encouraged to use robust evaluation measures such as those identified in the literature review to measure primary palliative care learning outcomes within a competency-based education framework.
Comprehensive Molecular Characterization of a Large Series of Calcified Chondroid Mesenchymal Neoplasms Widening Their Morphologic Spectrum
Authors: Benard Clément , Le Loarer François , Gomez-Mascard Anne , Azmani Rihab , Garcia Jeremy , Perret Raul , de Pinieux Gonzague , Miquelestorena-Standley Elodie , Weingertner Noelle , Karanian Marie , Meurgey Alexandra , Michot Audrey , Tirode Franck , Truffaux Nathalene , Macagno Nicolas , Bouvier Corinne
Published: July 2024

Recently,FN1fusions to receptor tyrosine kinase genes have been identified in soft tissue tumors with calcified chondroid matrix named calcifying chondroid mesenchymal neoplasms (CCMNs). We collected 33 cases of CCMN from the French network for soft tissue and bone tumors. We performed whole-exome RNA sequencing, expression analysis, and genome-wide DNA methylation profiling in 33, 30, and 20 cases of CCMN compared with a control group of tumors, including noncalcified tenosynovial giant cell tumor (TGCT). Among them, 15 cases showed morphologic overlap with soft tissue chondroma, 8 cases with tophaceous pseudogout, and 10 cases with chondroid TGCT. RNA-sequencing revealed a fusion ofFN1in 76% of cases (25/33) with different 5′ partners, including most frequentlyFGFR2(14 cases),TEKorFGFR1. Among CCMN associated withFGFR1fusions, 2 cases had overexpression of FGF23 without tumor-induced osteomalacia. Four CCMN hadPDGFRA::USP8fusions; 3 of which had histologic features of TGCT and were located in the hip, foot, and temporomandibular joint (TMJ). All cases withFN1::TEKfusion were located at TMJ and had histologic features of TGCT with or without chondroid matrix. They formed a distinct cluster on unsupervised clustering analyses based on whole transcriptome and genome-wide methylome data. Our study confirms the high prevalence ofFN1fusions in CCMN. In addition, through transcriptome and methylome analyses, we have identified a novel subgroup of tumors located at the TMJ, exhibiting TGCT-like features andFN1::TEKfusions.
Preterm birth among women with HIV: impact of preconception cART initiation
Authors: Duffy Cassandra R. , Herlihy Julie M. , Zulu Ethan , Mwananyanda Lawrence , Forman Leah , Heeren Tim , Gill Christopher J. , Harper Megan , Chilengi Roma , Chavuma Roy , Payne-Lohman Barbara , Thea Donald M.
Published: July 2024

Objective:

To examine the risk of preterm birth (PTB) and small for gestational age (SGA) among women with HIV compared to women without HIV. Secondary objectives were to explore the role of maternal immune activation (IA) and effect of cART timing on these outcomes.

Design:

Prospective observational cohort.

Setting:

Urban government-run clinic at Chawama Hospital in Lusaka, Zambia.

Participants:

A total of 1481 women with and without HIV with singleton pregnancies enrolled before 26 weeks’ gestation by ultrasound dating.

Methods:

From August 2019 to November 2022, pregnant women were enrolled in a 1 : 1 ratio of HIV infection. Maternal baseline clinical factors were collected, as well as CD4+, viral load and CD8+ T-cell IA in women with HIV. Birth outcomes were also collected. The association of HIV-exposure and cART timing on outcomes was assessed by multivariable logistic regression. The independent role of IA was determined by mediation analysis.

Main outcome measures:

PTB (<37 weeks) and SGA.

Results:

There were 38 fetal deaths and 1230 singleton live births. Maternal HIV infection was associated with PTB [adjusted odds ratio (AOR) 1.60, 95% confidence interval (CI) 1.11–2.32] and to a lesser extent SGA (AOR 1.29, 95% CI 0.98–1.70). Maternal cART timing impacted these associations, with highest risk in women who started cART after conception (PTB AOR 1.77, 95% CI 1.09–2.87, SGA AOR 1.52, 95% CI 1.04–2.22). Maternal IA was not associated with PTB independent of HIV infection.

Conclusions:

HIV is associated with PTB. Risk of PTB and SGA was highest in women with HIV who started cART in pregnancy, a modifiable risk factor.
Treatment Algorithm for Surgical Correction of Lower Eyelid Bags and Tear Trough Deformity Based on Barton Grading System
Authors: Yang Fan , Zang Mengqing , Yang Mingyong , Liu Yuanbo
Published: July 2024

Facial rejuvenation procedures for lower eyelid bags and tear trough deformity have recently gained increasing attention. This study introduced a treatment algorithm tailored to the severity of tear trough deformity, categorized using the Barton grading system, to tackle this concern effectively. One hundred seventy-six patients with combined lower eyelid bags and tear trough deformity underwent lower lid blepharoplasty at our center between 2018 and 2023. Preoperative assessment utilized the Barton grading system to categorize the severity of tear trough deformity, guiding personalized surgical approaches for each patient. Postoperative outcomes, including satisfaction levels, complications, and tear trough deformity improvement, were evaluated. Following surgery, 175 out of 176 patients achieved a reduction to Barton grade level of 0. Postoperative satisfaction scores averaged 4.4, with a satisfaction rate of 96.6%. Complications were minimal, including mild postoperative ectropion in patients and single occurrences of postoperative hematoma, infection, insufficient improvement, and recurrence. Our treatment algorithm offers a straightforward and effective approach for addressing tear trough deformity and lower eyelid bags. Further research is warranted to validate these findings.
Laparoscopic complete mesocolic excision in colon cancer: a prospective cohort study
Authors: Nguyen Minh T. , Dang Thuan C , Nguyen Song T. B. , Pham Cuong N. , Le Duong D. , Pham Duc M. , Nguyen Tri H. , Phan Dung D. T. , Nguyen Phu D. V. , Nguyen Phuc T. , Doan Vung P. , Nguyen Son D. , Pham Vu A.
Published: July 2024

Introduction:

Compared to conventional colon cancer surgery, laparoscopic complete mesocolic excision (CME) increases the likelihood of lymph node dissection. However, this surgery is not yet considered a safe strategy. The authors study this topic to evaluate the safety and feasibility of this surgery.

Methods:

A prospective cohort study was performed on patients undergoing laparoscopic CME surgery at the Hue University of Medicine and Pharmacy Hospital and Hue Central Hospital.

Results:

Demographic data, surgical features, and postoperative complications. Evaluate different clinicopathological factors determining the number and distribution of lymph nodes; and the rate of lymph node metastasis by tumor location and lymph node groups. Three-year overall survival and disease-free survival follow-up after surgery.

Conclusion:

The results of laparoscopic CME colectomy surgery are safe, with a reliable maximum number of harvested nodes.