bluuebunny/crossref_metadata_2025 huggingface dataset:
Postgraduate Programs in Orthopaedic Surgery for Physician Assistants and Nurse Practitioners
Authors: Kidd Vasco Deon , Hooker Roderick S.
Published: July 2021

Postgraduate orthopaedic programs for physician assistants (PAs) and nurse practitioners (NPs) number 14 as of 2020. To better understand the characteristics of these programs a census was undertaken. The result is that most programs are 1 year in duration and in 2019 produced 40 graduates. The role of the orthopaedic PA and NP fellow is to gain an understanding of a wide range of musculoskeletal disorders, develop procedural skills, first assist in the operating room, and facilitate management of patients and discharge throughput. PA and NP fellows work alongside categorical orthopaedic physician residents. The number of graduates from PA orthopaedic training programs is estimated at 200, spanning 20 years. The other 11,145 + PAs (99%) are trained on-the-job. For hospital systems, the employment of orthopaedic postgraduate PA and NP fellows provides value through cost management and billable services.
How Is Jump Performance Affected in Male Athletes when Completed with a Visual Impairment?
Authors: Timmis Matthew A. , Ferrandino Michael , Morrison Andrew , Allen Peter M. , Latham Keziah
Published: July 2021

SIGNIFICANCE

High-, long-, and triple-jump athletic events may need to consider whether it is appropriate to group vision-impaired athletes in the same classification with loss of different visual functions, and a greater emphasis may need to be placed on the visual field (VF) within the current classification system used.

PURPOSE

Athletes with vision impairment are grouped, based on their visual function, into one of three different classes (B1, B2, and B3, with B1 being the most severe). Athletes in class B2 have loss in visual acuity (VA; range, 1.50 to 2.60 logMAR) or VF (constricted to a diameter of <10°). The current study investigated how loss of different visual function (VA or VF) within the same class impacts jumping performance, a fundamental component in long-, triple-, and high-jump athletic events.

METHODS

Ten subelite male athletes (age, 21.6 ± 0.96 years; height, 178.8 ± 2.97 cm; mass, 82.2 ± 10.58 kg) with normal vision who participate in athletics were recruited. Participants completed drop jumps in four vision conditions: habitual vision condition (Full), VA no better than 1.60 logMAR (B2-VA), VF restricted to <10° (B2-VF), and VA no better than 1.30 logMAR (B3-VA).

RESULTS

Meaningful differences were observed between Full and B2-VF conditions. After rebound, vertical velocity at take-off was highest in Full condition (2.84 ± 0.35 m · s−1; 95% confidence interval [CI], 2.68 to 2.99 m · s−1) and was lowest in B2-VF condition (20% reduction; 2.32 ± 0.29 m · s−1; 95% CI, 2.16 to 2.48 m · s−1). Peak vertical jump height was highest in Full (0.42 ± 0.10 m; 95% CI, 0.38 to 0.46 m) and reduced by 40% in B2-VF (0.28 ± 0.07 m; 95% CI, 0.24 to 0.32 m). Minimal differences were found between Full and B2-VA, or B3-VA conditions.

CONCLUSIONS

Jump performance is compromised in athletes with simulated vision impairment. However, decrements in performance seem specific to those with severely constricted VF. Those with reduced VA (in B2-VA and B3-VA classes) seem to produce performance comparable to those with normal vision.
Visual Cognition and Experience Mediate the Relation between Age and Decision Making in Youth Volleyball Players
Authors: De Waelle Silke , Van Bostraeten Sara , Lenoir Matthieu , Deconinck Frederik J. A. , Bennett Simon J.
Published: July 2021

SIGNIFICANCE

Experts in different sports show superior decision-making skills compared with novices, but little is known about its development in youth players. This study shows that the age-related improvements in visual cognition and accumulation of sport-specific experience explain a considerable amount of the development in decision making in volleyball.

PURPOSE

The aim of this study was to investigate the mediating effects of visual cognition and volleyball experience on the relationship between age and decision making in youth volleyball players.

METHODS

A total of 171 female volleyball players aged 6 to 17 years performed a sport-specific, video-based test of decision making, as well as four different visual cognition tests. Using structural equation modeling, we examined if volleyball experience and a latent variable constructed from the four tests of visual cognition act as parallel mediators in the association between age and decision making.

RESULTS

The parallel multiple mediation model for the association between age and decision making was supported in youth volleyball players. Moreover, significant indirect effects and a nonsignificant direct effect indicated that visual cognition and experience fully mediated the relation between age and decision making and together explain 38% of the variance in decision-making performance. The effects of both mediators were not significantly different, and there was no residual correlation between experience and visual cognition, which indicates that these mediators are unrelated to each other.

CONCLUSIONS

Our findings demonstrate that visual cognition and volleyball experience mediate the relation between age and decision making independently, which indicates that they each influence different parts of the decision-making process. These results highlight the importance of the development of perceptual-cognitive skill in young players, and future research should further investigate the development of these skills as well as their underlying factors in different kinds of sports.
Review: Vision and On-field Performance: A Critical Review of Visual Assessment and Training Studies with Athletes
Authors: Laby Daniel M. , Appelbaum Lawrence Gregory
Published: July 2021

SIGNIFICANCE

Sports vision is an emerging field that seeks to establish the relationships between visual function and sports performance. Here we provide the first critical review of empirical studies that attempt to link visual assessments and vision training to competitive game performance.

Vision is essential to producing controlled movement, and therefore, it is intuitive that better visual abilities should relate to better sporting performance. This notion has been central to the field of sports vision, an area of study that seeks to determine the visual skills that underlie optimal sports performance and investigate approaches to train these abilities to improve sports performance. Although this field now contains hundreds of published articles addressing visual assessment and training in athletes, relatively few have attempted to directly link these capabilities to on-field production statistics from competitive matches. The objectives of this article are both to describe the theoretical and experimental framework necessary for such research and to critically review the empirical literature that has attempted to directly link visual assessments and/or training to athletic performance. We begin by describing why such associations are important and then provide an evidence-based framework for evaluating the quality of research in this domain. This is followed by a summary and review of the qualified literature that has addressed either relationships between baseline assessments and game performance or the effects of visual training interventions on game performance. Based on this review, it is concluded that, despite promising evidence supporting the role of vision in sports performance and improvements due to training, the specialty is still in need of methodological improvements. It is recommended that studies aim for larger better-powered studies, consistent and precise outcome measures, and greater scientific rigor such as obtained through randomized placebo-controlled designs with pre-registration of hypotheses.
Impact of Next-generation Sequencing on Interobserver Agreement and Diagnosis of Spitzoid Neoplasms
Authors: Benton Sarah , Zhao Jeffrey , Zhang Bin , Bahrami Armita , Barnhill Raymond L. , Busam Klaus , Cerroni Lorenzo , Cook Martin G. , de la Fouchardière Arnaud , Elder David E. , Johansson Iva , Landman Gilles , Lazar Alexander , LeBoit Philip , Lowe Lori , Massi Daniela , Duncan Lyn M. , Messina Jane , Mihic-Probst Daniela , Mihm Martin C. , Piepkorn Michael W. , Schmidt Birgitta , Scolyer Richard A. , Shea Christopher R. , Tetzlaff Michael T. , Tron Victor A. , Xu Xiaowei , Yeh Iwei , Yun Sook Jung , Zembowicz Artur , Gerami Pedram
Published: July 2021

Atypical Spitzoid melanocytic tumors are diagnostically challenging. Many studies have suggested various genomic markers to improve classification and prognostication. We aimed to assess whether next-generation sequencing studies using the Tempus xO assay assessing mutations in 1711 cancer-related genes and performing whole transcriptome mRNA sequencing for structural alterations could improve diagnostic agreement and accuracy in assessing neoplasms with Spitzoid histologic features. Twenty expert pathologists were asked to review 70 consultation level cases with Spitzoid features, once with limited clinical information and again with additional genomic information. There was an improvement in overall agreement with additional genomic information. Most significantly, there was increase in agreement of the diagnosis of conventional melanoma from moderate (κ=0.470, SE=0.0105) to substantial (κ=0.645, SE=0.0143) as measured by an average Cohen κ. Clinical follow-up was available in all 70 cases which substantiated that the improved agreement was clinically significant. Among 3 patients with distant metastatic disease, there was a highly significant increase in diagnostic recognition of the cases as conventional melanoma with genomics (P<0.005). In one case, none of 20 pathologists recognized a tumor with BRAF and TERT promoter mutations associated with fatal outcome as a conventional melanoma when only limited clinical information was provided, whereas 60% of pathologists correctly diagnosed this case when genomic information was also available. There was also a significant improvement in agreement of which lesions should be classified in the Spitz category/WHO Pathway from an average Cohen κ of 0.360 (SE=0.00921) to 0.607 (SE=0.0232) with genomics.
Interview-Rated Meaning and Survival Over 17 Years in People Living With HIV
Authors: Ironson Gail , Verhagen Rachel , da Rosa Beatriz , Hylton Emily
Published: July 2021

Objective

The primary purpose of this study was to determine whether meaning in life predicts survival in people living with HIV (PLWH) over 17 years. This study also examined whether interviewer- and transcript-rated meanings predict survival equivalently. A third purpose of the study was to investigate whether meaning in life adds to the prediction of survival over positive emotional expression.

Methods

A diverse sample of people with HIV (n = 177) completed an interview on stress and coping at baseline and were followed up for survival up to 17 years. Meaning was measured by interviewer rating of four items (meaningful purpose, unfinished business, finding new meaning, and meaningful activities). Transcript-rated meaning was assessed by two independent raters. Cox proportional hazards regression was used to determine whether meaning predicted survival over 17 years.

Results

Meaning in life predicted significantly greater survival, adjusting for biomedical and sociodemographic variables whether assessed by interviewer or by transcript raters. Hazard ratios suggest that the effect is moderate to large (2.66–3.45 for top versus bottom third; 2.05–2.49 for top versus bottom half). Significance was maintained after adjusting for positive emotion.

Conclusions

Meaning assessed by interview (by both interviewer and transcript ratings) predicted greater survival over 17 years in PLWH and did so above positive emotion. This adds to a literature that is primarily based on self-report questionnaires. Meaning may have beneficial effects for both psychological and physical health in PLWH.
Sleep Disturbances and the Risk of Incident Suicidality: A Systematic Review and Meta-Analysis of Cohort Studies
Authors: Dong Min , Lu Li , Sha Sha , Zhang Ling , Zhang Qinge , Ungvari Gabor S. , Balbuena Lloyd , Xiang Yu-Tao
Published: July 2021

Objective

The association between sleep disturbances and suicidality is not well understood partly because of the variability in research results. This meta-analysis aimed to investigate the predictive value of sleep disturbances for incident suicidality.

Methods

A systematic search was conducted in PubMed, EMBASE, PsycINFO, and Web of Science databases for studies examining sleep disturbances and incident suicidality. Cohort studies were screened following a registered protocol, and the eligible ones were meta-analyzed.

Results

Seven studies comprising 1,570,181 individuals at baseline, with 1407 attempting suicide and 1023 completing suicide during follow-up, were included. Individuals with baseline sleep disturbances had a significantly higher incidence of suicidality than did those without (relative risk = 2.17, 95% confidence interval [CI] = 1.45–3.24, I
2 = 82.50%, p < .001). The risk of an incident suicide attempt was 3.54-fold higher (95% CI = 3.07–4.09, I
2 = 0%, p = .44), whereas the risk of incident completed suicide was 1.80-fold higher (95% CI = 1.32–2.44, I
2 = 59.33%, p = .01) in individuals with baseline sleep disturbances.

Conclusions

Incident suicide attempts and deaths are higher among people with sleep disturbances. Regular screening and preventive measures should be undertaken for people with sleep disturbances to prevent progression into suicide attempts and deaths.

Clinical Trial Registration:
CRD42019136397.
Fecal Short-Chain Fatty Acid Ratios as Related to Gastrointestinal and Depressive Symptoms in Young Adults
Authors: Müller Bettina , Rasmusson Annica J. , Just David , Jayarathna Shishanthi , Moazzami Ali , Novicic Zorana Kurbalija , Cunningham Janet L.
Published: July 2021

Objective

Short-chain fatty acids (SCFAs) are produced by the gut microbiota and may reflect health. Gut symptoms are common in individuals with depressive disorders, and recent data indicate relationships between gut microbiota and psychiatric health. We aimed to investigate potential associations between SCFAs and self-reported depressive and gut symptoms in young adults.

Methods

Fecal samples from 164 individuals (125 were patients with psychiatric disorders: mean [standard deviation] age = 21.9 [2.6] years, 14% men; 39 nonpsychiatric controls: age = 28.5 [9.5] years, 38% men) were analyzed for the SCFA acetate, butyrate, and propionate by nuclear magnetic resonance spectroscopy. We then compared SCFA ratios with dimensional measures of self-reported depressive and gut symptoms.

Results

Depressive symptoms showed a positive association with acetate levels (ρ = 0.235, p = .003) and negative associations with both butyrate (ρ = −0.195, p = .014) and propionate levels (ρ = −0.201, p = .009) in relation to total SCFA levels. Furthermore, symptoms of diarrhea showed positive associations with acetate (ρ = 0.217, p = .010) and negative associations with propionate in relation to total SCFA levels (ρ = 0.229, p = 0–007). Cluster analysis revealed a heterogeneous pattern where shifts in SCFA ratios were observed in individuals with elevated levels of depressive symptoms, elevated levels of gut symptoms, or both.

Conclusions

Shifts in SCFAs are associated with both depressive symptoms and gut symptoms in young adults and may have of relevance for treatment.
What Can We Learn From More Than 140,000 Moments of Ecological Momentary Assessment–Assessed Negative Emotion and Ambulatory Blood Pressure? A Systematic Review and Meta-Analysis
Authors: Joseph Nataria T. , Chow Elvina C. , Peterson Laurel M. , Kamarck Thomas W. , Clinton Morgan , DeBruin Madison
Published: July 2021

Objective

Two decades of research has examined within-person associations between negative emotion states and ambulatory blood pressure (ABP) using ecological momentary assessment (EMA), but no meta-analysis has been conducted. We conducted this systematic review and meta-analysis to quantify the magnitude of this association and identify moderators, review strengths and weaknesses in conceptual and measurement approaches, and provide recommendations.

Methods

We searched databases (PsycINFO, PubMed), identified 15 studies, and obtained data from 13 studies (n = 2511; 142,307 observations).

Results

Random-effects meta-analyses demonstrated small effect r values between momentary negative emotions and systolic ABP (r = 0.06) and diastolic ABP (r = 0.05; p values < .001). Meta-regressions found that effects were larger among studies focused on anxiety, multidimensional negative emotions, predominantly female samples, or less observations of each participant (p values from .003 to .049). A qualitative review found that few studies examined moderators contributing to the substantial interindividual differences in this association.

Conclusions

The small association between momentary negative emotion and ABP extends laboratory findings on the association between the experiential and physiological aspects of emotion to the daily, natural emotional experiences of individuals. This literature could be strengthened by determining interindividual and intraindividual moderators of this association (e.g., trait negative emotion and state positive emotion), examining differential associations of different negative emotions with ABP, and standardizing EMA protocols. Although the effect is small, to the extent that repeated emotion-related cardiovascular reactivity may contribute to cardiovascular disease risk, identifying daily life triggers of emotion is important.
The Relationship Between Pain Severity, Insomnia, and Suicide Attempts Among a National Veteran Sample Initiating Pain Care
Authors: Ashrafioun Lisham , Bishop Todd M. , Pigeon Wilfred R.
Published: July 2021

Objective

We assessed the longitudinal association of suicide attempts by moderate to severe pain and insomnia before and after the initiation of pain services among veterans.

Methods

A cohort of 221,817 veterans initiating pain care was divided into four subgroups: a) no/mild pain + no insomnia (LowPain-NoINS), b) no/mild pain + insomnia (LowPain-INS), c) moderate/severe pain + no insomnia (HighPain-NoINS), and d) moderate/severe pain + insomnia (HighPain-INS). Data on diagnoses, pain severity, demographics, medications, and suicide attempts were extracted from Veterans Health Administration data sets.

Results

Overall, there were 2227 (1.0%) suicide attempts before initiating pain services and 1655 (0.8%) after initiating pain services. Cox proportional hazard models accounting for key covariates revealed that patients in the HighPain-INS group were significantly more likely to attempt suicide in the year after the initiation of pain services relative to all subgroups (versus LowPain-NoINS: hazard ratio [HR] = 1.44, 95% confidence interval [CI] = 1.21–1.72; versus LowPain-INS: HR = 1.71, 95% CI = 1.23–2.38; versus HighPain-NoINS: HR = 1.17, 95% CI = 1.01–1.34) even after accounting for prior attempts. Adjusted logistic regression analyses found that patients with moderate/severe pain and insomnia had higher odds of attempting suicide in the year before initiating pain services compared to all subgroups (versus LowPain-NoINS: HR = 1.75, 95% CI = 1.50–2.05; versus LowPain-INS: HR = 1.41, 95% CI = 1.09–1.82; versus HighPain-NoINS: HR = 1.21, 95% CI = 1.07–1.37).

Conclusions

These results suggest that those with both moderate/severe pain and insomnia are more likely to have a history of suicide attempts and are at greater risk of a suicide attempt relative to those with insomnia with low/mild pain and those with moderate/severe pain with no insomnia. Suicide prevention efforts for chronic pain and insomnia could address pain and insomnia within the same intervention or in parallel.
Artemisinin and multidrug-resistant Plasmodium falciparum – a threat for malaria control and elimination
Authors: Dhorda Mehul , Amaratunga Chanaki , Dondorp Arjen M.
Published: July 2021

Purpose of review

Artemisinin-based combination therapies (ACTs) are globally the first-line treatment for uncomplicated falciparum malaria and new compounds will not be available within the next few years. Artemisinin-resistant Plasmodium falciparum emerged over a decade ago in the Greater Mekong Subregion (GMS) and, compounded by ACT partner drug resistance, has caused significant ACT treatment failure. This review provides an update on the epidemiology, and mechanisms of artemisinin resistance and approaches to counter multidrug-resistant falciparum malaria.

Recent findings

An aggressive malaria elimination programme in the GMS has helped prevent the spread of drug resistance to neighbouring countries. However, parasites carrying artemisinin resistance-associated mutations in the P. falciparum Kelch13 gene (pfk13) have now emerged independently in multiple locations elsewhere in Asia, Africa and South America. Notably, artemisinin-resistant infections with parasites carrying the pfk13 R561H mutation have emerged and spread in Rwanda.

Enhancing the geographic coverage of surveillance for resistance will be key to ensure prompt detection of emerging resistance in order to implement effective countermeasures without delay. Treatment strategies designed to prevent the emergence and spread of multidrug resistance must be considered, including deployment of triple drug combination therapies and multiple first-line therapies.
Where was my patient born? The Intersection of tropical medicine and migrant health
Authors: Berto Cesar G. , Coyle Christina M. , Friedman Lianna , Walker Patricia F.
Published: July 2021

Purpose of review

There is unprecedented movement of people across international borders and parasitic infections, previously restricted to endemic regions, are now encountered in nonendemic areas of the world.

Recent findings

Migrants may import parasitic infections acquired in their countries of origin. Increasingly, clinicians in nonendemic regions are faced with patients with neglected diseases such as Chagas disease, malaria and strongyloidiasis. There are gaps in knowledge among physicians in nonendemic regions, which lead to missed opportunities for preventive strategies and early treatment. Both primary care and infectious disease physicians should have a broad knowledge of common parasitic infections to improve health outcomes and decrease healthcare disparities through early identification and treatment of disease encountered in migrants.

Migrant health is still a young field in medicine; clinicians should be aware of diseases seen in migrants, and access both educational and clinical resources, including experts in tropical medicine, in order to reduce health disparities among migrants. Collaboration between primary care and infectious disease/tropical medicine experts should be strengthened.
Pineal Gland Metastasis From Gastric Carcinoid—A Rare Manifestation
Authors: Fine Gabriel C. , Zhu Grace G. , Morton Kathryn A. , Damme Nikolas , Koppula Bhasker R.
Published: July 2021

Pineal region metastases are very rare, occurring in 0.4% to 3.8% of patients with solid tumors and most frequently arise from a lung cancer primary tumor. We present a case of a 67-year-old man with a gastric well-differentiated neuroendocrine tumor (NET) metastatic to the pineal gland identified on 68Ga-DOTATATE PET/CT imaging followed by MRI confirmation. To our knowledge, this is the third NET case to be reported in the literature with such presentation and first case to be described on 68Ga-DOTATATE PET/CT. A case of metastatic bronchial NET as well as a case of metastatic esophageal NET to the pineal gland were reported previously.
The Use of Live Streaming Technologies in Surgery
Authors: Abu-Rmaileh Muhammad , Osborn Tamara , Gonzalez Santiago R. , Yuen James C.
Published: July 2021

Background

Live streaming surgery is a developing communication platform in medicine. To maximize the technological advances that allow for the live streaming of surgery, it is crucial to have an understanding of the various video-capturing devices that are available and their pros and cons of implementation. Possible barriers to the widespread use of live streaming surgery include cost, concerns about patient safety and privacy, and limited understanding of the current available resources. In this article, we present the results of our literature review of techniques for live streaming of surgery as a means to inform readers and promote their implementation.

Methods

We conducted a literature review of the literature to identify previous articles indexed in PubMed and Ovid. We used the following search terms: [Surgery AND Streaming], which generated 32 articles for initial review. References were reviewed within each document to find similar articles that were not captured by the initial search. The article selection criteria were peer-reviewed publications, case reports, and case series describing the use of live surgical streaming technologies.

Results

Literature review showed enhanced surgeon interaction with viewers and improved anatomy scores with the widespread use of live streaming. Surgeons reported positive feedback and wished to engage in more sessions in the future. The largest barriers to implementation of streaming technology are video quality through the Internet and patient information protection.

Conclusions

Live streaming of surgery for educational purposes has not been widely accepted in surgical training programs to date. Streaming accessibility has advanced over the past 2 decades with the availability of handheld mobile devices. However, little has been done to allow for live streaming of surgery to trainees in a manner compliant with the Health Portability Insurance and Accountability Act.
Breast Implant–associated Anaplastic Large Cell Lymphoma Diagnosis 6 Years After Implant Removal
Authors: Barnea Yoav , Clemens Mark W. , Madah Ehab , Arad Ehud , Ben-Ezra Jonathan , Haran Oriana
Published: July 2021

We present a case report of a 48-year-old woman with a late-onset seroma of her left breast, 6 years after removal of her textured breast implants. At that time, she also had a late-onset seroma of her left breast, and capsulectomy was performed along with removal of the implants. The current late seroma presentation, which followed 6 years of uneventful healing, was treated with en bloc excision of the encapsulated seroma. Pathology results were concordant with locally invasive anaplastic large cell lymphoma (ALCL). Review of her previous seroma cytology from 6 years ago was performed given the current updated guideline standards on breast implant–associated ALCL (BIA-ALCL). Evidence of BIA-ALCL confirmed the patient had the diagnosis 6 years ago. The disease persisted and remained indolent for 6 years and manifested clinically as a late seroma of the left breast. This case report emphasizes the high degree of suspicion that is required in late seroma cases involving textured breast implants or a history of textured breast implants, along with the need for en bloc capsulectomy as a primary treatment for diagnosed BIA-ALCL to avoid incomplete capsulectomy and recurrence of the disease.
The Impact of Septoplasty on Cardiopulmonary Functions in Patients With Nasal Septal Deviation: A Prospective Comprehensive Analysis of Echocardiographic Outcome and Serum N-Terminal Pro BNP Levels
Authors: Yigit Enes , Manav Ali , Ture Muhammet , Karabag Turgut
Published: July 2021

This study was designed to evaluate the impact of septoplasty on cardiopulmonary functions in patients with nasal septal deviation (NSD). A total of 30 consecutive adult patients (mean [standard deviation] age: 33.7 [10.9] years, 56.7% were males) who underwent septoplasty due NSD were included. Visual analog scale scores, nose obstruction symptom evaluation scale scores, serum N-terminal Pro BNP levels, and cardiologic examination findings on electrocardiogram, transthoracic echocardiography, and exercise treadmill testing were evaluated both 7 days before and 3-months after septoplasty operation. A significant decrease was noted in mean (standard deviation) visual analog scale scores (8.27 [0.83] versus 1.87 [0.73],P < 0.001), and nose obstruction symptom evaluation scores (83.7 [4.9] versus 12.7 [(5.4],P < 0.001) from preoperative to postoperative period, while maximum effort capacity was improved significantly (11.8 [1.9] versus 13.1 [2.1],P = 0.010) after septoplasty. Echocardiography findings at 3rd postoperative month revealed significant decrease in pulmonary artery systolic pressure (22.2 [3.2] versus 19.0 [3.6],P = 0.001), whereas significant increase in trans-mitral early diastolic rapid filling (Ewave, 0.82 [0.14] versus 0.87 [0.13],P = 0.011), peak systolic velocity (S, 0.11 [0.02] versus 0.12 [0.02],P = 0.002), tricuspid annular plane systolic excursion (22.6 [3.2] versus 24.9 [2.9],P = 0.002), and right ventricle stroke volume (0.14 [(0.02] versus 0.15 [0.02],P = 0.013). In conclusion, our findings indicate favorable outcome of septoplasty in NSD patients not only in terms of improved nasal airflow but also cardiopulmonary functions, particularly the exercise capacity, pulmonary artery pressure, and right ventricular systolic functions. In this regard, our findings emphasize the important role of treating NSD patients without delay, given the likelihood of septoplasty to reverse the changes in the pulmonary artery system and to prevent onset of permanent cardiopulmonary dysfunction via amelioration of chronic obstruction of the upper respiratory tract.
The Comparison of Conventional Osteotomes and Magic Saws in Terms of Edema and Ecchymosis After Rhinoplasty
Authors: Yildirim Yavuz Sultan Selim , Seneldir Sureyya , Cetiner Hasan
Published: July 2021

Objective:

The goal of this study was to compare conventional osteotomes and Magic Saws in terms of edema and ecchymosis, in rhinoplasty patients.

Study Design:

A retrospective, case-control study.

Methods:

In this prospective, randomized study, we evaluated the results of 258 rhinoplasty patients who underwent osteotomy by either conventional osteotomes or new designed saws called; “Magic Saws.” On postoperative days 2 and 7, the patients were photographed by the surgeon; photographs were evaluated by another otolaryngologist, blinded from the osteotomy procedure.

Results:

There were no statistically differences between the groups, in terms of age, sex, weight, or average arterial blood pressure (P > 0.05). The postoperative periorbital edema (days 2 and 7) and ecchymosis (day 2) scores were significantly higher in the conventional osteotomy group, as compared to Magic Saw group (P < 0.05). However, on postoperative day 7, the differences in the periorbital ecchymosis scores between the groups, were not statistically significant (P > 0.05).

Conclusions:

As compared to conventional osteotomes, Magic Saws were reported to be associated with minimal soft tissue injury, as well as decreased edema and ecchymosis, in the early postoperative period after rhinoplasty.
Effectiveness of a Telephone-Based Motivational Intervention for Smoking Cessation in Patients With Crohn Disease
Authors: Navarro Correal Ester , Casellas Jorda Francesc , Borruel Sainz Natalia , Robles Alonso Virginia , Herrera de Guise Claudia , Ibarz Casas Arantxa , Sánchez García Josep Maria , Vila Morte Genoveva , Fuentelsaz Gallego Carmen
Published: July 2021

A randomized, open-label, controlled clinical trial was designed to assess the effectiveness of a motivational intervention based on the 5 R's model (relevance, risks, rewards, roadblocks, and repetition) delivered by specialized inflammatory bowel disease nurses every 3 months over a 1-year period as compared with patients who were followed regularly. Patients diagnosed with Crohn disease, aged 18 years or older, who reported being active smokers with Internet access at home and an e-mail address were eligible. A total of 144 patients (72 per group) were included (50% women, median age 40 years). They smoked a median of 10 cigarettes per day (range = 1–40) and had been smoking for a median of 22 years (range = 1–51). Motivation to quit (Richmond test) was low in 73 patients, moderate in 39 patients, and high in 32 patients. Statistically significant differences between the study groups in the predisposition to change, motivation to quit, and tobacco withdrawal were not found. However, 14 patients (20.9%) in the intervention group and 9 patients (13.2%) among controls stopped smoking at the end of the study. These findings support a higher trend toward smoking cessation associated with the motivational intervention 5 R's. This behavioral strategy can aid patients with Crohn disease to quit smoking.
Knowledge Levels and Practices About the Enteral Nutritional Practices of Informal Caregivers Caring for Patients Fed Through a Percutaneous Endoscopic Gastrostomy Tube
Authors: Kahveci Guldan , Akin Semiha
Published: July 2021

This research aimed to evaluate informal caregivers' knowledge of and practices with enteral nutrition in caring for patients fed through a percutaneous endoscopic gastrostomy tube. Knowledge levels of caregivers about nutritional practices and percutaneous endoscopic gastrostomy tube care practices for patients fed enterally are important to prevent possible complications associated with the percutaneous endoscopic gastrostomy tube in the early period. The research sample for this descriptive observational study consisted of 126 individuals caring for patients fed through a gastrostomy tube. Knowledge and practices of caregivers were evaluated using a knowledge survey and a practice survey. The knowledge (18.90 ± 3.13; range = 0–24) and practice scores (13.41 ± 1.45; range = 0–15) of the caregivers about tube feeding were above the mean. Caregiver confusion was noted around practical aspects of care such as tube care verification of tube position, and care of the insertion site. Elderly caregivers and those with a low education level need more support about enteral nutrition when caring for patients fed through a percutaneous endoscopic gastrostomy tube. It is recommended that the nutrition nurse and other health team members provide more regular training to informal caregivers of patients fed with percutaneous endoscopic gastrostomy tubes.
NO, way to go: critical amino acids to replenish nitric oxide production in treating mucositis
Authors: Molendijk Eva Benedicte Dieudonnée , Blijlevens Nicole Marie Anna
Published: July 2021

Purpose of review

There is still an unmet need for preventive and treatment strategies for chemotherapy-induced and radiotherapy-induced mucositis and its associated systemic inflammatory response (SIR) in cancer patients. Because of citrulline depletion due to cytotoxic therapy, nitric oxide (NO) production can be reduced, limiting its effect in many physiological processes. Restoring NO production could relieve mucositis severity by supporting host damage control mechanisms. Amino acids glutamine, arginine and citrulline are involved in NO production. This review including recent literature of preclinical and clinical studies will discuss the potential benefits of glutamine, arginine and citrulline on mucositis development with focus on NO production.

Recent findings

Mucositis severity is more defined by host response to DNA damage than by DMA damage itself. Citrulline depletion because of afunctional enterocytes could be responsible for NO depletion during cytotoxic therapy. Restoring NO production during cytotoxic therapy could have a beneficial effect on mucositis development. Citrulline seems a more promising NO donor than glutamine or arginine during cytotoxic therapy, although clinical studies in mucositis patients are currently lacking.

Glutamine, arginine and citrulline show in-vitro beneficial effects on inflammatory processes involved in mucositis. Translation to the clinic is difficult as demonstrated with use of glutamine and arginine. Citrulline, being the most potent NO donor with excellent oral bio-availability, is very promising as treatment choice for mucositis and its use deserves to be investigated in clinical trials with mucositis patients.
Maintenance Physical Therapy
Authors: Stikeleather Sondra Jill , Simmons Tammy Marie
Published: July 2021

Background:

Medicare recipients historically have been discharged from rehabilitation when progress plateaus. This improvement standard continues to shape episodic practice of physical therapy (PT). The Jimmo v Sebelius decision of 2013 has the potential to open physical therapist practice with the adoption of community-based maintenance PT into everyday practice.

Conclusion:

Prevention and maintenance of function are supported by the American Physical Therapy Association. Evidence suggests that intervention over time combats frailty, reduces fall risk, improves functional outcomes, and prevents movement disability. Community-based maintenance PT as a method of moving from the episodic restorative model to a continuous paradigm of restoration, prevention, and maintenance is proposed.
Community-Based Best Practices for Early Identification and Referrals for Dementia
Authors: Mason Mary Beth , Serianni Robert W. , Julian Abigail
Published: July 2021

Context:

The purpose of this article is to describe the typical aging process and compare this to mild cognitive impairment and early symptoms of dementia, specifically cognitive-communicative and swallowing deficits, to help professionals better identify dementia in the care of community-based adults.

Objective:

To evaluate the role and importance of the speech-language pathologist in early identification and management of dementia. Suggested interprofessional considerations for best practice for early identification, management, and referral are also addressed.

Conclusion:

Speech-language pathologists are critical for assessing and treating those with early stages of dementia and mild cognitive impairment. It is critical for medical professionals to recognize the speech pathologist's role in treating those with cognitive impairments and swallowing disorders.
Depression Screening by the Interprofessional Team for Community-Dwelling Older Adults
Authors: Salmon Christine , Hidalgo Leona , Jenkins Lisa , Vitente Arvie , Garcia Miguel , Dias Dalila
Published: July 2021

Objective:

A miniature semisystematic review to determine health professionals' current practices when screening for depression in older adult community dwellers.

Evidence Review:

A review of research studies published between April 2010 and April 2020 using a university library system and key words specific to factors essential to this review.

Findings:

Health professionals inconsistently perform depression screening to rule out or determine the risk of diagnosis or after a new diagnosis.

Conclusions and Relevance:

Health professionals are not routinely screening for depression despite possible impacts on outcomes. More evidence is needed to promote depression screening in health care for improved patient outcomes.
Fitness in the Park
Authors: Collins Kayla , Layne Kelly , Schooley Megann , Chase Lisa , Faradj-Bakht Sanaz
Published: July 2021

Occupational and physical therapists have an opportunity to partner with community organizations to develop community-based programs to facilitate safe, effective engagement in physical activity and promote health and wellness practices for community-dwelling older adults. An interprofessional team of physical and occupational therapists partnered with a local organization to design, implement, and evaluate the use of a community-based wellness program for older adults called Fitness in the Parks. The investigators identified opportunities and barriers for developing and implementing sustainable, feasible, and effective community-based wellness programming for older adults and made recommendations for future program development.
Anonymous Living Liver Donation: Literature Review and Case Series Report
Authors: Shan Sarah , Vargas Paola , Durden Jakob , Seay Tara , Williams Tessa , Lyster Emily , Sites Anita , Northup Patrick , Pelletier Shawn , Oberholzer Jose , Argo Curtis , Goldaracena Nicolas
Published: July 2021

Background.

Anonymous living liver donations (ALLDs) raise ethical concerns regarding the donors’ motivations. Thus, ALLDs are not as widely accepted as directed donations from friends and family. Literature on ALLDs is limited. Understanding this particular group of individuals is crucial, as they could further help mitigate the shortage of liver grafts worldwide.

Methods.

A literature review was performed to identify current definitions, ethical considerations, different approaches, and barriers to ALLD worldwide. Furthermore, we present our current experience after the establishment of a protocol to enable an ALLD program in our center and surveyed potential donors to better understand their motives throughout the process.

Results.

Literature regarding ALLD is scarce. Canada leads the experience with the majority of case reports published to date. Survey-based evaluation of this unique group of individuals reflects the selflessness nature of anonymous living donors and shows that most of them experience the donation as a positive and life-changing event. In our experience, 41 individuals initiated the process of ALLD during the study period. Most were lost to follow-up or deemed ineligible. Five candidates fully completed the donation process and successfully underwent living liver donation. Given that 2 candidates have a follow-up period <3 mo from donation, we have only included data on the first 3 donors in this analysis. Eight individuals (19.5%) responded to the survey with respondents sharing similar reasons for initiating ALLD but varied and multifactorial reasons for terminating.

Conclusions.

Different institutional protocols can be used to accomplish ALLD, including the one utilized by our institution. Adopting policies to allow for ALLDs and reducing modifiable factors that contribute to ending donation has the potential to increase grafts and decrease wait times.

Supplemental Visual Abstract: http://links.lww.com/TP/C251
Neuromuscular monitoring devices – where to go next?
Authors: Damian Maxwell Simon
Published: July 2021

Purpose of review

This paper reviews the clinical applications, technology, and evidence supporting the use of telemedicine devices and telehealth in neuromuscular disease.

Recent findings

The COVID-19 pandemic interrupted standard multidisciplinary care of patients with neuromuscular disease and created a need to adapt to remote care. Telemedicine applications were rapidly introduced and have rapidly proved an important tool in maintaining specialist care. This review presents the current data being gathered identifying the patients who benefit from telehealth applications, the appropriate type of telemedicine approach to specific conditions, the conditions needed to optimise telehealth approaches, and potential pitfalls and limitations in their use.

Telemedicine is an important tool in providing robust remote care for patients with neuromuscular disorders, but further investigation is needed to optimise applications.
A retrospective naturalistic study on the psychopharmacological treatment of schizoaffective disorder
Authors: Muñoz-Negro José E. , Aguado Bailón Lidia , Calvo Rivera Pilar , Cervilla Jorge A.
Published: July 2021

Evidence on the effectiveness of psychopharmacological treatment of schizoaffective disorder is scarce and mostly comes from indirect, nonspecific sources. We carried out a large retrospective study (n = 770) of every other consecutively numbered clinical record with a recorded ICD-10 diagnosis of schizoaffective disorder in the Andalusian Health Service record system. We gathered sociodemographic, drug treatment and clinical outcomes such as improvement, relapses and change over time on DSM-5 psychotic dimensions. We analyzed data to explore associations between drug use and clinical improvement. Antipsychotics were the most commonly used drugs (77%). 22.4% of patients experienced at least a mild improvement. Clozapine (odds ratio [OR] = 2.4) and aripiprazole (OR = 2.3) for global improvement, and quetiapine (OR = 3.5) for depression were the most effective drugs. Antidepressants, mood stabilizers and benzodiazepines were also associated with a better outcome in some DSM-5 dimensions such as delusions, hallucinations and language, respectively. Antipsychotic monotherapy was not associated with a better outcome. Our findings corroborate the role of antipsychotics as the essential psychopharmacological treatment for different symptoms of schizoaffective disorder. However, the role of mood stabilizers, antidepressants or BZD is controversial and should be individually considered.
Murine Ifit3 restricts the replication of Rabies virus both in vitro and in vivo
Authors: Chai Benjie , Tian Dayong , Zhou Ming , Tian Bin , Yuan Yueming , Sui Baokun , Wang Ke , Pei Jie , Huang Fei , Wu Qiong , Lv Lei , Yang Yaping , Wang Caiqian , Fu Zhenfang , Zhao Ling
Published: July 2021

Rabies virus (RABV) infection can initiate the host immune defence response and induce an antiviral state characterized by the expression of interferon (IFN)-stimulated genes (ISGs), among which the family of genes of IFN-induced protein with tetratricopeptide repeats (Ifits) are prominent representatives. Herein, we demonstrated that the mRNA and protein levels of Ifit1, Ifit2 and Ifit3 were highly increased in cultured cells and mouse brains after RABV infection. Recombinant RABV expressing Ifit3, designated rRABV-Ifit3, displayed a lower pathogenicity than the parent RABV in C57BL/6 mice after intramuscular administration, and Ifit3-deficient mice exhibited higher susceptibility to RABV infection and higher mortality during RABV infection. Moreover, compared with their individual expressions, co-expression of Ifit2 and Ifit3 could more effectively inhibit RABV replication in vitro. These results indicate that murine Ifit3 plays an essential role in restricting the replication and reducing the pathogenicity of RABV. Ifit3 acts synergistically with Ifit2 to inhibit RABV replication, providing further insight into the function and complexity of the Ifit family.